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研究生:張祝芬
研究生(外文):Chu-Fen Chang
論文名稱:足弓墊治療扁平足之生物力學效應評估
論文名稱(外文):Biomechanical Evaluation of The Effect of Arch Supports on Flatfoot
指導教授:鄭誠功鄭誠功引用關係
指導教授(外文):Cheng-Kung Cheng
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:醫學工程研究所
學門:工程學門
學類:生醫工程學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
中文關鍵詞:功能性與結構性扁平足足弓墊足弓指標地面反作用力分析踝關節運動學與運動力學
外文關鍵詞:functional and structural flatfootarch supportsarch indexground reaction force analysiskinematics and kinetics of the ankle joints
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足部是步行過程中地面反作用力首當其衝影響的部位,若足部的排列結構與運動出現變化,勢必會影響到足部正常的生物力學機制。扁平足是常見的足部病變之ㄧ,由於足弓的塌陷會使得足部結構不穩定,臨床上,一般會建議扁平足患者穿著適當的足弓墊以支撐塌陷的足弓,讓足部結構趨向穩定並改善其生物力學機制。因此本研究之目的在於評估足弓墊對於扁平足之生物力學效應。
本研究先採用超高解析立體攝影系統與測力板進行步態實驗,藉以進一步瞭解足弓墊對於結構性扁平足與功能性扁平足在地面反作用力以及踝關節運動學與運動力學之立即(適應15分鐘)與短期(使用兩星期)功能性效應。再利用足弓指標來探討足弓墊對於扁平足患者足弓結構之短期影響。
結果顯示,扁平足比正常足之地面反作用力垂直分量的第二個峰值(V2)低,顯示扁平足於站立終期之推進力確實較正常足差,且結構性扁平足之步行推進力比功能性扁平足來得更差。功能性扁平足使用足弓墊15分鐘後之步態與初始步態並無顯著差異。而使用足弓墊兩週後,功能性扁平足之站立期與擺盪期比值明顯增加,顯示足弓墊對於功能性扁平足步態站立期的延長有一定的成效,但在其他評估參數方面則並未顯示足弓墊能改善功能性扁平足之步態。而結構性扁平足在使用足弓墊前後之V2皆明顯小於正常足,顯示足弓墊沒有改善其步行推進能力。由足弓指標則顯示足弓墊並未顯著改善功能性與結構性扁平足足弓排列結構。
總結以上研究結果,採用步態以及地面反作用力分析的評估方式確實可以有效區分扁平足與正常足之差異;此外,短期使用足弓墊對於改善扁平足患者之足弓結構效果並不顯著,因此有必要進行更進一步的長期追蹤研究以確立足弓墊之生物力學影響。
The foot is the first part to respond to the ground reaction force during walking. Variations in foot alignment and motion will influence the normal biomechanical mechanism of the foot. Flatfoot is one of the common foot deformities. Because of the instability of the foot structure resulted from the collapse of the foot arch, the flatfoot patients are generally recommended to use the proper arch supports to support the flattened arch, improving foot structural stability and therefore biomechanical performance. Therefore, the aim of this study is evaluating the biomechanical effect of arch support on the flatfoot.
This study first carried out gait analyses using ultra-high resolution stereophotogrammetry system and forceplates to understand the immediate (15 minutes) and short-term (2 weeks) functional influence of prefabricated arch supports respectively on the ground reaction force, kinematics and kinetics of the ankle joints of the structural flatfoot and the functional flatfoot subjects, and then used the arch index confered on the short-term effects of the arch supports on the foot structure of the flatfoot subjects.
The results showed that the V2 values of flatfoot subjects were lower than those of normal ones which indicated that the propulsive force of flatfoot subjects during terminal stance phase was worse than normal one. Compared with functional flatfoot subjects, the propulsion of structural flatfoot subjects was poorer. There was no difference between gaits used arch supports for 15 min. and original gait. After using arch supports for 2 weeks, the stance/swing ratio of the functional flatfoot subjects was obviously higher than normal. However, from results of other parameters analysis, there was no modification resulting from arch supports influence in gait of functional flatfoot subjects. The V2 values of structural flatfoot subject were apparently lower than normal, indicating arch supports did not provide the these subjects with the propulsive ability of gait. The short-term results of arch index evidently showed that arch supports did not reform the foot arch alignment of the functional flatfoot and structural the flatfoot subjects.
In conclusion, adopting gait analysis and ground reaction force analysis could distinguish flatfoot from normal foot effectively. Additionally, the short-term effect of arch supports on the modification of foot arch structure of the flatfoot subjects was not significant, so it was necessary to carry out the long-term follow-up for confirmation of the biomechanical influence of the arch supports.
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