摘要
目的探究唐氏综合征患儿站立时足部内结构的关节接触力、韧带拉力和力传导模式。方法基于1名唐氏综合征患儿与1名典型健康儿童CT影像学数据,分别建立足部有限元模型,采用静态站立下的足底压力分布实测数据验证模型。模拟站立时足踝受力,以地面反作用力和小腿三头肌肌力作为加载条件,计算分析胫距、距舟和跟骰关节的关节接触压力、弹簧韧带和足底短韧带的拉力,以及跗横关节处的力传导模式。结果足部有限元模型可靠且有效。与健康儿童相比,患儿胫距关节的接触压力更高,距舟关节的接触压力更低;患儿弹簧韧带和足底短韧带的拉力分别是健康儿童的10倍和58倍;患儿跗横关节的关节间力均小于健康儿童。结论唐氏综合征患儿站立时存在异常的胫距关节接触压力、较大的中足韧带拉力及较小的跗横关节传导力。临床康复应充分考虑唐氏综合征患儿足部内结构应力模式的异常变化,为筛选和制定早期康复介入计划和设计个性化矫形鞋垫提供理论支撑。
Objective To explore the joint contact force,ligament tensile force and force transmission mode of foot internal structure in Down’s syndrome child(DSC)during standing.Methods The finite element models of foot were constructed based on CT image data from one DSC and one typically developing child(TDC).The models were validated by plantar pressure measurement during static standing.To simulate foot force during standing,the ground reaction force and the triceps surae force were applied as the loading condition.Contact pressure of the tibiotalar,talonavicular and calcaneocuboid joints,tensile force of the spring and plantar calcaneocuboid ligaments,and force transmission mode in transverse tarsal joints were calculated and analyzed.Results The finite element models of foot were validated to be reliable.Compared with the TDC,the DSC showed higher contact pressure at the tibiotalar joint and lower contact pressure at the talonavicular joint.The tensile force of spring and plantar calcaneocuboid ligaments of DSC was 10 times and 58 times of TDC,respectively.The forces transmitted through both mediate and lateral columns in DSC were lower than those in TDC.Conclusions Abnormal contact pressure of the tibiotalar joint,larger tensile force of midfoot ligaments and smaller force of the transverse tarsal joint were found in DSC during standing.The abnormal alteration of stress patterns in foot internal structure of DSC should be fully considered in clinical rehabilitation,so as to provide theoretical references for screening and making intervention plans for early rehabilitation,as well as designing individualized orthopedic insoles.
作者
李亚琦
黄尚军
张蓓华
黄伟志
王岩
牛文鑫
张明
LI Yaqi;HUANG Shangjun;ZHANG Beihua;HUANG Weizhi;WANG Yan;NIU Wenxin;ZHANG Ming(Laboratory of Rehabilitation Engineering and Biomechanics,Tongji University School of Medicine,Shanghai 200092,China;Yangzhi Rehabilitation Hospital,Tongji University(Shanghai Sunshine Rehabilitation Conter),Shanghai 201619,China;Department of Biomedical Engineering,Faculty of Engineering,the Hong Kong Polytechnic University,Hong Kong 999077,China;Shenzhen Research Institute,the Hong Kong Polytechnic University,Shenzhen 518057,Guangdong,China)
出处
《医用生物力学》
CAS
CSCD
北大核心
2022年第1期59-65,共7页
Journal of Medical Biomechanics
基金
国家自然科学基金项目(11732015,11972315)
上海市残疾人联合会资助项目。
关键词
唐氏综合征
足踝
接触力
韧带拉力
应力传导
Down’s syndrome
foot ankle
contact force
ligament tension
force transmission
作者简介
通信作者:牛文鑫,副教授,E⁃mail:niu@tongji.edu.cn。
