| Research Background:Gout is a chronic metabolic inflammatory disease that most often affects the foot and ankle joints,especially the first metatarsophalangeal joint and the Achilles tendon,followed by biomechanics such as spatiotemporal parameters,joint angle parameters,and plantar pressure distribution.Features also have pathological changes,and a full understanding of these abnormal features and the reasons behind them will help develop more targeted interventions to treat gait-related foot injuries and disabilities in gout patients.At present,for gait changes in gout patients,prescription shoes are usually used to correct them abroad.However,only a few studies have shown that prescription shoes can only improve the pain and foot injury and disability of gout patients in the short term,and the long-term application effect is not obvious.For the cause of abnormal gait,reasonable exercise intervention is necessary,but at present,there are studies on the effect of exercise on its metabolic changes in China.Exercise intervention to improve its abnormal gait has not been carried out,so we pay more attention to the lower limbs of patients with gout.Abnormal gait related to functional exercise training to improve gait.Research purposes:1.Analyze the gait characteristics of patients with intermittent gout when walking normally.2.To explore the functional training of lower limbs on gout patients gait and lower limb motor function changes.Research method:This study first of all to patients with gout break(experimental group)and age and sex matched healthy volunteers groups(healthy control group)as the research object,through the gait parameters of time and space(step length,stride length,step velocity,frequency,support time,single support time,double supporting time,the oscillating time),knee,ankle Angle parameters(knee flexion Angle,maximum back stretch and maximum ankle plantar flexion Angle change and flexion and extension)and plantar pressure(instantaneous peak pressure and pressure time integral)of evaluation,analysis of gout in patients with normal walking gait characteristics;And then to the gout patients as the research object,and give the design of lower limb functional exercise guidance training prescription,for 12 weeks,4 times/w,determination in 12 weeks in patients with lower limb function before and after the training,the gait parameters of time and space,knee,ankle,plantar pressure and knee joint Angle parameter isometric muscle strength and flexion and extension ratio,foot pain and disability score changes,on patients with lower limb functional training on gout gait and the influence of the lower limb motor function change,practical for gout patients to improve gait and improve the function of motion solutions,provide experimental basis for the recovery of the walking function in patients with gout.Research result:1.Comparison of foot pain and disability score(MFPDI)between gout patients and healthy control subjects: functional restriction score,self-perception score,pain degree score,work and leisure activity score and total MFPDI score of gout patients were significantly increased,with statistically significant differences(P<0.01).2.Gout patients compared with healthy control subjects gait parameters of time and space: the stride length and stride of gout patients decreased greatly,the pace and pace slowed significantly,the double support time increased significantly,the difference had statistical significance(P<0.05,P<0.01),whereas single support time,support and swing time difference between the two groups had no statistical significance(P>0.05).3.Gout patients compared with healthy control subjects were walking joint Angle parameters: gout patients walking knee flexion Angle,ankle plantar flexion Angle and the largest flexion and amplitude decrease obviously,differences were statistically significant(P<0.05),while the ankle back stretching Angle difference between the two groups has no statistical significance(P>0.05).4.Comparison of foot pressure parameters between gout patients and healthy control subjects during walking: the peak pressure and pressure-time integral in the big toe area were significantly reduced,while the peak pressure in the middle part ofthe foot and pressure-time integral in the first metatarsal area were significantly increased,with statistically significant differences(P<0.05,P<0.01).However,there was no significant difference between the other two groups(P>0.05).5.Gout patients peak pressure in the big toe area and the gait kinematics data correlation analysis: the peak pressure in the big toe area and the step length,stride length,double support time,knee,ankle back stretching Angle all have correlation(P<0.05),and step length,stride length,stride frequency,maximum ankle back Angle were positively correlated,and negatively correlated with the double support time.There was no significant correlation with single support time,support time,swing time,walking speed,knee joint maximum flexion Angle,ankle joint maximum plantar flexion Angle and flexion and extension amplitude(P>0.05).6.Comparison of scores of foot pain and disability before and after exercise intervention: comparison within the group showed that after intervention,self-perception score,pain degree score,work and leisure activity score in the experimental group were significantly lower than before the experiment(P<0.05),while the changes before and after the experiment in the disease control group were not statistically significant(P>0.05).Compared with the control group,the self-perception score of the experimental group was significantly reduced(P<0.05).7.Comparison of spatial and temporal parameters of gait before and after exercise intervention: comparison in the group showed that,after the intervention compared with before the experiment,the step length and stride length of the experimental group increased,the single support time was prolonged,the double support time was shortened,and the step speed and step frequency were accelerated(P<0.05,P<0.01),while the changes before and after the experiment in the control group were not statistically significant(P>0.05).Comparison between groups showed that after intervention,the step size of the experimental group increased,the single support time was prolonged,the double support time was shortened,and the step speed and step frequency were accelerated(P<0.05,P<0.01).8.Comparison of joint Angle parameters before and after exercise intervention:comparison within the group showed that the maximum knee flexion Angle,themaximum plantar flexion Angle of the ankle joint and the range of ankle flexion and extension changes were significantly increased after the intervention compared with those before the experiment in the experimental group(P<0.05,P<0.01),while the changes before and after the experiment in the control group were not statistically significant(P>0.05).Compared with the control group,the maximum plantar flexion Angle of the ankle joint in the experimental group increased after intervention(P<0.05,P<0.01).9.Comparison of foot pressure parameters before and after exercise intervention:comparison in the group showed that the peak pressure and pressure-time integral in the big toe area of the experimental group increased significantly after the intervention compared with that before the experiment(P<0.05),while the changes before and after the experiment in the control group were not statistically significant(P>0.05).Comparison between the two groups showed that the peak pressure and pressure-time integration in the big toe area and the peak pressure in the second metatarsal area of the experimental group increased after intervention compared with the control group(P<0.05).10.Comparison of lower limb muscle strength before and after exercise intervention: comparison in the group showed that after intervention,the maximum knee flexor and extensor muscle strength of the experimental group was significantly increased compared with that before the experiment(P<0.01),while the changes before and after the experiment in the control group were not statistically significant(P>0.05).Comparison between groups showed that after intervention,the maximum knee flexor and extensor muscle strength of the experimental group increased compared with that of the control group(P<0.05,P <0.01).Analysis conclusion:1.Patients with intermittent gout had obvious abnormal gait,which was mainly manifested as decreased step length and stride length,slower step speed and step frequency,and longer double support time.The motion amplitude of knee and ankle joint decreased.During walking,the load of the medial forefoot of the affected side decreased and the load of the middle foot increased.2.Patients with gout break after 12 weeks of lower limb functional training can obviously change the abnormal gait pattern,strengthen muscle,knee flexion and enlarge the knee ankle flexion Angle,extending frequency,stride length,single support time,shorten the double support time,correct the plantar pressure distribution,the patients to reduce the bad feelings,enhance functional walking ability. |
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