| Objective: To observe and evaluate the biomechanical characteristics of plantar fasciitis treated by the joint tendon manipulation of Li's School of bone injury in Guanzhong.Methods: 60 patients with plantar fasciitis who met the inclusion criteria were collected as the patient group,and 30 healthy foot subjects were collected as the healthy group.The differences of plantar pressure related indicators between the two groups were measured and analyzed.According to the method of random number table,the patients were divided into two groups,30 cases in each group.The differences between the patients and the healthy group were analyzed by using the biomechanical evaluation indexes of the plantar;the traditional evaluation indexes(VAS score,the longest walking time)and the biomechanical evaluation indexes of the plantar were used to compare the changes of the patients before and after the treatment of plantar fasciitis in the manipulation group and the shockwave group,and the differences of the curative effects of the two treatment methods were compared by combining the two evaluation indexes.Results:(1)There was no significant difference in gender,age,weight and BMI between the patients and the healthy group(P>0.05).The average height of the patients was higher than that of the healthy group(P<0.05).(2)The contact area of the medial side of the posterior foot in the patient group was smaller than that in the healthy group(P<0.05),and the maximum pressure of the lateral side of the posterior foot was smaller than that in the healthy group(P<0.05).(3)Before treatment,there was no difference in age,gender,VAS score and the longest walking time between the two groups(P>0.05).Two groups can be compared.(4)After the first treatment,the VAS score of the two groups was lower than that before treatment(P<0.05)The longest walking time was longer than that before treatment,but there was no significant difference(P>0.05).After the last treatment: the VAS score and the longest walking time of the two groups were statistically different(P<0.05).With the treatment,the VAS score decreased and the longest walking time increased.(5)After the first treatment,the maximum pressure and peak pressure of the middle foot in the manipulation group were lower than those before treatment(P<0.05)The maximum pressure,peak pressure,impulse and average pressure were all decreased(P<0.05)The peak pressure on the lateral side of the hind foot decreased(P<0.05).The maximum pressure,impulse and average pressure of the plantar area in the shockwave group were lower than those before treatment(P<0.05)The maximum pressure impulse and impulse of midfoot were decreased(P<0.05)The maximum pressure,peak pressure,impulse and average pressure were all decreased(P<0.05)The maximum pressure,impulse and average pressure on the outside of the hind foot decreased(P<0.05).After the last treatment: the contact area,maximum pressure and impulse of the toe area in the manipulation group were decreased compared with those in the pre treatment group(P<0.05)The contact area of metatarsal area,medial side of hind foot and lateral side of hind foot increased(P<0.05).There was no difference between the shockwave group and the treatment group(P>0.05).(6)In terms of immediate effect,there was no significant difference in plantar pressure between the manipulation group and the shockwave group(P>0.05)In terms of the overall efficacy,the peak pressure of plantar area was small,and the average pressure of lateral hindfoot was small(P < 0.05).Conclusion:(1)The plantar biomechanical characteristics of plantar fasciitis patients show that the contact area of the medial part of the hind foot is smaller and the plantar pressure is more inclined to the anterior foot.Because of the local pain of the hind foot,the patient is forced to walk on tiptoe with the forefoot,and the main load-bearing of the forefoot,so the foot of patients with plantar fasciitis is characterized by mild plantar flexion.(2)Through this study,the two groups of treatment schemes have clinical effects on plantar fasciitis,can slow down the heel pain symptoms of patients,prolong the walking time,and there are no adverse reactions.This study preliminarily proves that the immediate effect of joint tendon regulating manipulation of Li's school in Guanzhong is the same as that of shockwave therapy recommended in the current guidelines,and the overall effect is better.Combining the advantages and disadvantages of the two methods,the manipulation is more economic and easy to operate,which is worth clinical application.(3)Plantar pressure analysis can well quantify the plantar pressure distribution of patients with plantar fasciitis,reflect the pain state of patients with plantar fasciitis,to some extent,it can be used as a preliminary evaluation method for the efficacy of plantar fasciitis. |
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