不同姿势站立时人体的平衡能力及足型特征
|
摘要
背景:站立时身体重心的改变反映了下肢乃至全身的结构、功能和肌肉等方面的信息。站立姿势控制与足型、平衡能力、肌肉激活程度之间关系的研究不足。目的:探讨自然站立、前倾站立、后倾站立对足弓、身体平衡和肌肉激活程度的影响。方法:选取受试者15名,均无足部病变和影响足部功能相关的疾病。使用三维足型扫描仪对3种站立姿势下的足弓进行测试与分析、使用BTS FREEMG 300无线表面肌电测试仪、平衡测力台对3种站立姿势下肌肉均方根最大值、2个平衡能力指标(包络面积、重心平均速度)进行测试与分析。结果与结论:①足弓高度指数:自然站立与前倾站立对比时差异有显著性意义(P <0.05),自然站立与后倾站立对比时差异有显著性意义(P <0.05),前倾站立与后倾站立对比时差异无显著性意义(P> 0.05);②肌肉激活程度由大到小:自然站立时依次为腓长肌内侧、竖脊肌、腹直肌、臀中肌、股二头肌长头、股外斜肌、胫骨前肌、股直肌、臀大肌;前倾站立时依次为腓长肌内侧、臀中肌、竖脊肌、股二头肌长头、胫骨前肌、腹直肌、臀大肌、股外斜肌、股直肌;后倾站立时依次为股外斜肌、胫骨前肌、股直肌、股二头肌长头、竖脊肌、腹直肌、腓长肌内侧、臀中肌、臀大肌;③平衡:自然站立与前倾站立对比差异无显著性意义(P> 0.05),自然站立与后倾站立对比差异有显著性意义(P <0.05),而前倾站立与后倾站立对比差异无显著性意义(P> 0.05);④结果说明,人体自然站立时可以在低肌肉激活强度下轻松维持身体稳定,身体后倾时,由于不稳定造成肌肉激活强度最高,身体重心向前、后移动时主要激活对侧肌肉;足弓在身体前倾和后倾时较自然站立时升高;站立姿势下重心轻微的前后移动都会导致肌肉激活程度和平衡控制的变化。
BACKGROUND: Changes in the center of body weight during standing reflects the structure, function and muscles of the lower limbs and even the whole body. The relationship between standing posture control and foot type, balance ability, and muscle activation is rarely reported. OBJECTIVE: To investigate the effects of natural, lean forward and lean backward standing on foot arch, body balance and muscle activation. METHODS: Fifteen subjects without foot lesions and diseases related to foot function were selected. Three-dimensional foot scanner was used to test and analyze the foot arch in three standing postures. BTS FREEMG 300 surface electromyography tester and balance tester were used to test and analyze the maximum root mean square of muscle and two balance ability indexes(envelope area and average velocity of center of gravity) in three standing postures. RESULTS AND CONCLUSION:(1) For height index of foot arch: there was significant difference between natural standing and forward standing(P < 0.05). There was significant difference between natural standing and backward standing(P < 0.05), but there was no significant difference between forward standing and backward standing(P > 0.05).(2) The degree of muscle activation was as follows: when standing naturally, the medial peroneal muscles > erector muscles > rectus abdominis > gluteus medius > biceps femoris > external oblique femoris > anterior tibial muscle > rectus femoris muscle > gluteus maximus muscle. During forward standing: the medial of the peroneal muscle > medius gluteus > vertical ridge > long head of biceps femoris > anterior tibial muscle > rectus abdominis muscle > gluteus maximus. During backward standing: the obliquus externus femur > rectus femoris > long head of biceps femoris > erector spinae > musculus rectus abdominis > the medial of the peroneal muscle > gluteus medius > gluteus maximus.(3) Balance: there was no significant difference between natural standing and forward standing(P > 0.05); there was significant difference between natural standing and backward standing(P < 0.05), but there was no significant difference between forward standing and backward standing(P > 0.05).(4) In summary, it is easy to maintain body stability at low muscle activation intensity when the human body is standing naturally. During the body backward standing, the muscle activation intensity is highest due to instability. When the center of gravity moves forward and backward, the contralateral muscle is mainly activated. The arch of the foot rises when it leans forward and backward. The slight anterior and posterior movements of the center of gravity in the standing posture can lead to changes in muscle activation degree and balance control.
BACKGROUND: Changes in the center of body weight during standing reflects the structure, function and muscles of the lower limbs and even the whole body. The relationship between standing posture control and foot type, balance ability, and muscle activation is rarely reported. OBJECTIVE: To investigate the effects of natural, lean forward and lean backward standing on foot arch, body balance and muscle activation. METHODS: Fifteen subjects without foot lesions and diseases related to foot function were selected. Three-dimensional foot scanner was used to test and analyze the foot arch in three standing postures. BTS FREEMG 300 surface electromyography tester and balance tester were used to test and analyze the maximum root mean square of muscle and two balance ability indexes(envelope area and average velocity of center of gravity) in three standing postures. RESULTS AND CONCLUSION:(1) For height index of foot arch: there was significant difference between natural standing and forward standing(P < 0.05). There was significant difference between natural standing and backward standing(P < 0.05), but there was no significant difference between forward standing and backward standing(P > 0.05).(2) The degree of muscle activation was as follows: when standing naturally, the medial peroneal muscles > erector muscles > rectus abdominis > gluteus medius > biceps femoris > external oblique femoris > anterior tibial muscle > rectus femoris muscle > gluteus maximus muscle. During forward standing: the medial of the peroneal muscle > medius gluteus > vertical ridge > long head of biceps femoris > anterior tibial muscle > rectus abdominis muscle > gluteus maximus. During backward standing: the obliquus externus femur > rectus femoris > long head of biceps femoris > erector spinae > musculus rectus abdominis > the medial of the peroneal muscle > gluteus medius > gluteus maximus.(3) Balance: there was no significant difference between natural standing and forward standing(P > 0.05); there was significant difference between natural standing and backward standing(P < 0.05), but there was no significant difference between forward standing and backward standing(P > 0.05).(4) In summary, it is easy to maintain body stability at low muscle activation intensity when the human body is standing naturally. During the body backward standing, the muscle activation intensity is highest due to instability. When the center of gravity moves forward and backward, the contralateral muscle is mainly activated. The arch of the foot rises when it leans forward and backward. The slight anterior and posterior movements of the center of gravity in the standing posture can lead to changes in muscle activation degree and balance control.
引文
[1]Boonstra TA,Schouten AC,van der Kooij H.Identification of the contribution of the ankle and hip joints to multisegmental balance control.J Neuroeng Rehabil.2013;10:23.
[2]Birinci T,Demirbas SB.Relationship between the mobility of medial longitudinal arch and postural control.Acta Orthop Traumatol Turc.2017;51(3):233-237.
[3]袁刚,张木勋,王中琴,等.正常人足底压力分布及其影响因素分析[J].中华物理医学与康复杂志,2004,26(3):30-33.
[4]Page P,Frank CC,Lardner R.Assessment and Treatment of Muscle Imbalance,the JandaApproach.United States:Human Kinetics;2010:6-150.
[5]Fukano M,Fukubayashi T.Motion characteristics of the medial and lateral longitudinal arch during landing.Eur J Appl Physiol.2009;105(3):387-392.
[6]Hughes,Chris.Kinesiology:The Mechanics and Pathomechanics of Human Movement[M]//Kinesiology:the mechanics and pathomechanics of human movement.Lippincott Williams&Wilkins.2009:662-672.
[7]Williams DS 3rd,Tierney RN,Butler RJ.Increased medial longitudinal arch mobility,lower extremity kinematics and ground reaction forces in high-arched runners.J Athl Train.2014;49(3):290-296.
[8]Chang YW,Hung W,Wu HW,at al.Measurements of foot arch in standing,level walking,vertical jump and sprint start.Int J Sport Excerc Sci.2010;2(2):31-38.
[9]Cote KP,Brunet ME,Gansneder BM,et al.Effects of Pronated and Supinated Foot Postures on Static and Dynamic Postural Stability.J Athl Train.2005;40(1):41-46.
[10]Williams DS 3rd,McClay IS,Hamill J.Arch structure and injury patterns in runners.Clin Biomech(Bristol,Avon).2001;16(4):341-347.
[11]朱世杰,王文婷,章露.足部姿态变化对静态姿势稳定控制的即刻作用[J].中国组织工程研究,2012,16(37):6910-6915.
[12]陈平,韩宝,周璐,等.中国居民肛肠疾病患病工作相关因素调查[J].中国公共卫生,2017,33(11):1628-1631.
[13]Han KS,Shin SH,Yu CH,et al.Postural responses during the various frequencies of anteroposterior perturbation.Biomed Mater Eng.2014;24(6):2537-2545.
[14]Hwang S,Tae K,Sohn R,et al.The balance recovery mechanisms against unexpected forward perturbation.Ann Biomed Eng.2009;37(8):1629-1637.
[15]DVM Jurriaan.The effect of perturbation properties on system identification of human balance control during stance.Delft University of Technology.2017.
[16]Cavanagh PR,Rodgers MM.The arch index:a useful measure from footprints.J Biomech.1987;20(5):547-551.
[17]王洪瑞,郑辉,刘琨.站立平衡调节的肌力优化求解与分析[J].生物医学工程学杂志,2015,32(1):59-66.
[18]张阳,张秋霞.功能性踝关节不稳者的静态平衡能力[J].中国组织工程研究,2013,17(35):6287-6292.
[19]Cheung JT,Zhang M,An KN.Effect of Achilles tendon loading on plantar fascia tension in the standing foot.Clin Biomech(Bristol,Avon).2006;21(2):194-203.
[20]张燊,张希妮,崔科东,等.足弓的运动功能进展及其在人体运动中的生物力学贡献[J].体育科学,2018,38(5):73-79.
[21]Jameson BH,Teague DC.Bilateral navicular body fractures.JTrauma.2003;54(6):1231-1234.
[22]温子星,祁奇,危小焰,等.前后方向水平姿势扰动对人体站立平衡响应的影响[J].中国康复,2017,32(5):404-407.
[23]Fujiwara K,Kiyota N,Maekawa M,et al.Postural control during transient floor translation while standing with the leg and trunk fixed.Neuroscience Letters.2015;594:93-98.
[24]温子星,徐欣,潘景文,等.预测性姿势调节对人体站立受扰后姿势响应影响的研究[J].中国康复医学杂志,2016,31(10):1104-1110.
[2]Birinci T,Demirbas SB.Relationship between the mobility of medial longitudinal arch and postural control.Acta Orthop Traumatol Turc.2017;51(3):233-237.
[3]袁刚,张木勋,王中琴,等.正常人足底压力分布及其影响因素分析[J].中华物理医学与康复杂志,2004,26(3):30-33.
[4]Page P,Frank CC,Lardner R.Assessment and Treatment of Muscle Imbalance,the JandaApproach.United States:Human Kinetics;2010:6-150.
[5]Fukano M,Fukubayashi T.Motion characteristics of the medial and lateral longitudinal arch during landing.Eur J Appl Physiol.2009;105(3):387-392.
[6]Hughes,Chris.Kinesiology:The Mechanics and Pathomechanics of Human Movement[M]//Kinesiology:the mechanics and pathomechanics of human movement.Lippincott Williams&Wilkins.2009:662-672.
[7]Williams DS 3rd,Tierney RN,Butler RJ.Increased medial longitudinal arch mobility,lower extremity kinematics and ground reaction forces in high-arched runners.J Athl Train.2014;49(3):290-296.
[8]Chang YW,Hung W,Wu HW,at al.Measurements of foot arch in standing,level walking,vertical jump and sprint start.Int J Sport Excerc Sci.2010;2(2):31-38.
[9]Cote KP,Brunet ME,Gansneder BM,et al.Effects of Pronated and Supinated Foot Postures on Static and Dynamic Postural Stability.J Athl Train.2005;40(1):41-46.
[10]Williams DS 3rd,McClay IS,Hamill J.Arch structure and injury patterns in runners.Clin Biomech(Bristol,Avon).2001;16(4):341-347.
[11]朱世杰,王文婷,章露.足部姿态变化对静态姿势稳定控制的即刻作用[J].中国组织工程研究,2012,16(37):6910-6915.
[12]陈平,韩宝,周璐,等.中国居民肛肠疾病患病工作相关因素调查[J].中国公共卫生,2017,33(11):1628-1631.
[13]Han KS,Shin SH,Yu CH,et al.Postural responses during the various frequencies of anteroposterior perturbation.Biomed Mater Eng.2014;24(6):2537-2545.
[14]Hwang S,Tae K,Sohn R,et al.The balance recovery mechanisms against unexpected forward perturbation.Ann Biomed Eng.2009;37(8):1629-1637.
[15]DVM Jurriaan.The effect of perturbation properties on system identification of human balance control during stance.Delft University of Technology.2017.
[16]Cavanagh PR,Rodgers MM.The arch index:a useful measure from footprints.J Biomech.1987;20(5):547-551.
[17]王洪瑞,郑辉,刘琨.站立平衡调节的肌力优化求解与分析[J].生物医学工程学杂志,2015,32(1):59-66.
[18]张阳,张秋霞.功能性踝关节不稳者的静态平衡能力[J].中国组织工程研究,2013,17(35):6287-6292.
[19]Cheung JT,Zhang M,An KN.Effect of Achilles tendon loading on plantar fascia tension in the standing foot.Clin Biomech(Bristol,Avon).2006;21(2):194-203.
[20]张燊,张希妮,崔科东,等.足弓的运动功能进展及其在人体运动中的生物力学贡献[J].体育科学,2018,38(5):73-79.
[21]Jameson BH,Teague DC.Bilateral navicular body fractures.JTrauma.2003;54(6):1231-1234.
[22]温子星,祁奇,危小焰,等.前后方向水平姿势扰动对人体站立平衡响应的影响[J].中国康复,2017,32(5):404-407.
[23]Fujiwara K,Kiyota N,Maekawa M,et al.Postural control during transient floor translation while standing with the leg and trunk fixed.Neuroscience Letters.2015;594:93-98.
[24]温子星,徐欣,潘景文,等.预测性姿势调节对人体站立受扰后姿势响应影响的研究[J].中国康复医学杂志,2016,31(10):1104-1110.