| Research purposes:To study the postural stability and gait characteristics of patients with chronic ankle instability.Explore the possible mechanisms leading to the instability of the ankle joint.Research method:36 patients with chronic ankle instability and 32 normal subjects who met the inclusion criteria were divided into a patient group and a normal subject group.The foot and ankle force lines(front line,back line)of the patient group were analyzed,and the Cumberland Ankle Instability Scale score and the AFOAS ankle-hindfoot score were performed.Collect plantar morphology data,plantar dynamic and static posture stability index and gait characteristic data of all subjects.After the patient group was treated with orthopedic insoles for 3 months(one treatment cycle),the scale was scored again,and plantar morphology data,plantar dynamic and static posture stability indicators,and gait characteristic data were collected.Compare the postural stability performance and gait characteristics of patients with chronic ankle instability and normal subjects;compare the changes in postural stability and gait characteristics of patients before and after a treatment cycle.Research results:(1)The postural stability and gait characteristics of patients with chronic ankle instability are different from those of normal people.Patients with chronic ankle instability have varying degrees of ankle instability,sense of loss of control,and abnormal plantar pressure distribution.The arch height of the affected limb in the patient group was significantly higher than that of the normal subjects when standing statically,and the arch index was significantly lower than that of the normal subjects,and the difference was statistically significant(P<0.05).Compared with the normal subjects,the pressure center of the affected plantar in the patient group was significantly shifted to the outside in the X-axis direction,while in the Y-axis direction,the pressure center of the patient group was significantly shifted back compared with the normal subjects,and the difference was statistically significant(P<0.05).The maximum pressure value of the affected foot and hindfoot load in the patient group were significantly higher than those of the normal subjects,and the difference was statistically significant(P<0.05),and the difference in average pressure was not statistically significant.The pace,acceleration,standing time,and swing time of the affected side of the patient group were significantly lower than those of the normal subjects,and the difference was statistically significant(P<0.05).In patients with chronic ankle instability,the load change and the resultant COF of the affected foot were significantly higher than those of normal subjects,and the difference was statistically significant(P<0.05).Compared with normal subjects,the peak ground reaction force during walking in the patient group was significantly reduced in the direction of the loss axis and the coronal axis,and the difference was statistically significant(P<0.05),and the difference in the vertical axis direction was not statistically significant.(2)After 3 months of orthopedic insole treatment(one treatment cycle),the CAIT score and AOFAS score of the affected foot were significantly increased,but the arch height and arch index were not significantly different after treatment compared to before treatment.After treatment,the swing distance of COP in the X-axis direction of patients with chronic ankle instability was significantly reduced,and the swing distance of COP in the Y-axis direction was also significantly reduced from before treatment,the difference was statistically significant(P<0.05).There was no significant difference in the average pressure of the patients’ soles before and after treatment,and the maximum pressure and hindfoot load were significantly lower than before treatment(P<0.05).After treatment,the patient’s average pace and acceleration increased significantly,and the standing time increased significantly compared with the previous period(P<0.05),while the swing time did not change significantly.After 3 months of treatment with orthopedic insoles for CAI patients,the load change and the resultant COF were significantly reduced,and the difference was statistically significant(P<0.05).After 3 months of orthopedic insole treatment in patients with CAI.compared with before treatment,the peak ground reaction force during the patient’s walking process was significantly higher in the direction of the lossy axis and the coronal axis,and the difference was statistically significant(P<0.05).The difference in axial direction was not statistically significant.Analysis conclusion:(1)Chronic ankle instability can lead to abnormal plantar biomechanical distribution and gait characteristics.Patients with chronic ankle instability have obvious ankle instability,sense of loss of control and mild active restriction.When standing statically,the hindfoot load on the affected side was significantly higher than that of normal subjects,and the plantar pressure center shifted to the outside.(2)During natural walking,the pace,acceleration,standing time,and swing time of CAI patients were significantly lower than those of normal subjects.The load change and the combined COF of the foot in CAI patients were significantly higher than those in normal subjects.Compared with normal subjects,the peak ground reaction force of CAI patients is significantly reduced in the direction of the loss axis and the coronal axis,the patient’s stepping efficiency is reduced,and the foot stability is reduced.(3)Ankle function and stability have been restored to a certain extent after wearing orthopedic insoles.The patient’s maximum plantar pressure and hindfoot load were significantly reduced,which reconstructed the ideal plantar pressure distribution to a certain extent;the average pace and acceleration of pedaling were significantly increased,which improved the efficiency of stepping.(4)The intervention of the orthopedic insole increases the load stability of the plantar during the patient’s gait cycle,reduces the swing distance of the pressure center during the travel process,and significantly improves the posture stability of the ankle joint;the peak ground reaction force is at the loss-of-shape axis and the coronal axis The direction was significantly larger than that before treatment,indicating that the ankle joint driving ability and lateral stability were enhanced after orthopedic insole treatment. |
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