A Clinical Research Of Plantar Pressure And Gait Characteristics In Patients With Metatarsalgia

Research purpose:1.To compare plantar pressure distribution and gait characteristics between patients with plantar pain and normal subjects;2.Objective To observe the changes of plantar pressure and gait characteristics of patients with plantar pain before and after wearing custom orthopedic insole,and to explore the clinical effect of custom orthopedic insole on patients with plantar pain.Research method:30 patients with plantar pain were enrolled in the experimental group,and 30 healthy people were selected as the normal subjects.The plantar pressure and gait characteristics of the two groups were collected and compared.The data of pain,foot function score and clinical treatment of plantar pain were collected.The patients were given custom orthopedic insoles,and the pain and foot function scores were collected after one month of treatment.At the end of a treatment cycle(3 months),the pain,function score,clinical treatment observation table of plantar pain,plantar pressure and gait characteristics were collected.The scores of pain and function were compared before treatment,one month and three months after treatment;The changes of plantar pressure and gait characteristics before and after a treatment cycle were compared.Research results:(1)Plantar pressure and gait characteristics of patients with plantar pain are different from those of normal people.In the natural standing state,the affected foot bears more plantar pressure than the healthy person,and there is a phenomenon of excessive single foot load,and the excessive load is more distributed to the front foot.The hind foot load decreased significantly,while the midfoot load increased to a certain extent,but it was not significant.The height of foot arch decreased and the index of foot arch increased in patients with plantar pain.Under the natural walking gait,the forefoot of patients with plantar pain is under greater pressure,and at the same time,they are under greater single foot,forefoot and midfoot load,while the corresponding hindfoot load is significantly reduced.During the gait cycle,the support time increased,the swing time decreased,the acceleration increased,and the step length shortened.The load of hindfoot/forefoot decreases,the load change and resultant force COF increase.(2)After the treatment of orthopedic insole,the pain symptoms,foot function and plantar dynamic and static biomechanical indexes of patients with plantar pain were changed.The main manifestations are as follows:①VAS pain score of patients decreased significantly after treatment(P<0.01).②The activity score of AOFAS toe metatarsophalangeal joint increased significantly after treatment(P<0.01).③The area of corpus callosum decreased after treatment,and the difference was statistically significant(P<0.05).④Foot static indicators:after treatment,the maximum plantar pressure,average pressure,single foot load and forefoot load of the patients were decreased in varying degrees,and the difference was statistically significant(P<0.05);The difference was significant(P<0.01);There was no significant difference in midfoot load(P=0.12).Arch height increased,arch index decreased,the difference was statistically significant(P<0.05).⑤Plantar dynamic indicators:after treatment,the maximum pressure,average pressure,single foot load,forefoot load and midfoot load of the affected foot were significantly reduced(P<0.05),while the changes of hindfoot load and hindfoot/forefoot load were significantly increased(P<0.05).After treatment,the foot support time decreased,the swing time increased,the acceleration decreased,the difference was statistically significant(P<0.05),and the walking speed decreased without significant difference(P=0.15).The decrease of step width was not significant(P>0.05),but the increase of step length was significant(P<0.05).The difference was statistically significant(P<0.05).Research conclusion:(1)Abnormal plantar pressure and gait characteristics of patients with plantar pain can lead to forefoot pain,corpus callosum hyperplasia and other symptoms,which affect the foot function and daily life of patients.(2)Orthopedic insole treatment can effectively improve the pain symptoms and forefoot function of patients,correct the imbalance of foot load distribution and disorder of plantar pressure distribution;Improve the uneven distribution of foot support and swing time during walking;Improve the height of the medial longitudinal arch and enhance the stability of the whole foot.(3)Wearing orthopedic insole for a long time can effectively correct the pain and discomfort symptoms caused by plantar biomechanical disorder,and improve the quality of life of patients.Orthopedic insole is safe and effective in the treatment of plantar pain,which is worthy of further clinical application.