| Background and objective: In recent years,knee Osteoarthritis(KOA)is a serious health problem in middle-aged and elderly people.It usually presents symptoms such as knee joint pain,contracture,and muscle strength decline in clinical practice.Long term dysfunction of the knee joint results in abnormal foot structures such as pronation and arch decline.As the axis of lower limb movement,the ankle joint is closely related to knee joint function in biomechanics.Ankle muscle strength training can improve the stability of the arch and foot,restore the foot to a neutral position,and limit the occurrence of adverse knee joint torsion.Improving knee biomechanics can not only alleviate pain,stiffness and other symptoms,but also improve the foot posture of KOA patients,thus treating and preventing the occurrence and development of knee Articular bone.In the context of integration of sports and medicine,we will explore economic,safe and effective sports rehabilitation measures for KOA patients through sports training,and provide references for KOA patients to improve gait disorders and improve their quality of life.Research methods: A total of 32 patients with knee Osteoarthritis were enrolled in this study,and were randomly divided into an experimental group(ankle training group)and a control group(routine training group)with 16 patients each.Before and after the experiment,KOA patients were tested as follows:(1)Clinical manifestations:WOMAC score,VAS,Berg balance scale,6MWD walking test;(2)Foot posture:Standard navicular height index,FPI foot posture score;(3)Gait characteristics: use the Myo Motion motion analysis system and Foot Scan dynamic plantar pressure test to collect the Kinematics,dynamics and other data of the subjects during walking.The test data was statistically processed using SPSS 24.0 software.Paired sample t-tests were used to analyze intra group differences before and after the experiment,while independent sample t-tests were used to analyze inter group differences before and after the experiment,with a significance level of P<0.05.Research results:Changes in clinical manifestations:Pain and function: Compared with before the experiment,the VAS value and WOMAC score of the two groups of patients were significantly reduced after treatment(P<0.05);Compared with the control group,the experimental group showed significant improvement in pain(2.73 ± 1.17)and knee joint function(23.29 ± 6.22) after treatment compared to the control group(3.07 ± 1.14)and function(30.11 ± 2.37)(P<0.05);Walking and balance abilities: Compared with before the experiment,the Berg score and 6MWD of the two groups of patients were significantly improved(P<0.05)within the group.Compared with the conventional training group(41.86 ± 3.90),the Berg score of the experimental group patients improved significantly after treatment(45.86 ± 4.05)(P<0.05),while there was no significant difference between the6 MWD experimental group(P>0.05).Foot arch and foot posture: Compared with before the experiment,there were significant changes in the standard navicular height index(0.24 ± 0.02)and foot posture score(3.94 ± 1.02)of the experimental group patients after treatment(P<0.05),while there was no significant difference in the control group(P>0.05);Comparison between groups showed significant differences(P<0.05)in the standard navicular height index(0.18 ± 0.03)and foot posture score(7.05 ± 1.69)between the experimental group and the conventional training group after treatment,indicating that the intervention in the experimental group had better therapeutic effects.Gait characteristicsSpatiotemporal parameters: Compared with before the experiment,the routine training group showed a significant increase in stride length(1.22 ± 0.13 m)and stride speed(0.93 ± 0.33 m/s)after treatment(P<0.05);The experimental group showed significant differences in stride length(1.33 ± 0.11 m),stride speed(1.02 ± 0.06 m/s),stride width(16.29 ± 3.23cm),percentage of support period(40.04 ± 2.51),and foot deviation angle(18.21 ± 2.07 °)after treatment(P<0.05);Compared with the control group,the experimental group showed significant differences in gait speed,stride length,and percentage of single foot support period(P<0.05),indicating that the intervention in the experimental group was more effective in improving gait.Support period time: Compared within the group,the routine muscle strength group showed a significant increase in the flat foot period(364.93 ± 21.45ms)after training(P<0.05),while the experimental group showed a significant increase in the heel contact period(47.93 ± 4.58ms).The flat foot period(348.36 ± 31.94ms)and the front foot extension period(232.64 ± 44.13ms)also decreased significantly(P<0.05);Compared with the control group,the inter group comparison showed significant changes in the experimental group during the heel contact and forefoot extension periods(P<0.05).Peak joint angle: Compared within the group,the peak knee joint flexion angle in the conventional muscle strength group after training(45.42 ± 4.84 °)significantly increased compared to before the experiment(38.37 ± 2.53 °)(P<0.05);The experimental group showed significant increases in hip extension(-10.75 ± 2.13 °),hip abduction(7.24 ± 1.75 °),knee flexion(54.64 ± 8.51 °),and ankle dorsiflexion(16.78 ± 3.59 °)angles(P<0.05);Compared with the control group,the experimental group showed significant changes in hip extension,knee flexion,and ankle dorsiflexion(P<0.05),while there was no significant difference in hip abduction and ankle plantar flexion activity.Plantar pressure:Percentage of plantar partition impulse: Compared with before the experiment,the percentage of posterior foot impulse(25.64 ± 3.35)in the experimental group patients significantly increased,while the percentage of anterior foot impulse(70.33 ±3.22)significantly decreased(P<0.05).However,there was no significant difference between before and after the routine group patients;Compared with the conventional group,the experimental group showed a significant decrease in the percentage of posterior foot impulse(18.52 ± 4.42)and anterior foot impulse(77.14 ± 4.72),with a significant difference(P<0.05).Peak plantar pressure: Compared within the group,T1(61.60 ± 7.16),M4(89.16± 11.48),and LH(185.94 ± 12.64)significantly increased in the conventional muscle strength group after training(P<0.05);After training,T1(63.53 ± 6.61),M1(77.95 ± 9.81),and M5(68.94 ± 8.35)in the experimental group significantly increased(P<0.05),while MF(189.11 ± 16.86)and MH(179.16 ± 19.38)significantly decreased(P<0.05);Compared with the conventional group,the experimental group showed significant differences in M1,M5,MH,and MF changes(P<0.05).Peak valley difference of vertical reaction force: Compared within the group,the peak valley difference of vertical reaction force between the two groups of patients after treatment was significantly reduced(P<0.05);Compared with the conventional training group,there was a significant difference(P<0.05)in the peak valley difference of vertical reaction force between the experimental group patients(0.57 ±0.11)after treatment and the conventional training group patients(0.38 ± 0.05),indicating that the intervention in the experimental group had better therapeutic effects.Research conclusion:1.Eight weeks of ankle muscle training can effectively reduce pain,improve knee joint function,and improve clinical performance in KOA patients.2.Eight weeks of ankle muscle training can effectively improve foot posture and arch characteristics,and enhance the ability to maintain arch shape.3.KOA patients with pronation feet exhibit poor cushioning ability due to a lack of good arch support during walkingEight weeks of ankle muscle training can improve the foot buffering ability of KOA patients,increase stability during walking,and improve their abnormal gait,which is different from the gait of the normal foot population. |
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