نوع مقاله : مقاله کامل پژوهشی

نویسندگان

1 کارشناسی ارشد، گروه بیومکانیک، دانشکده‌ی مهندسی پزشکی، دانشگاه صنعتی سهند، تبریز، ایران

2 استادیار، گروه بیومکانیک، دانشکده‌ی مهندسی پزشکی، دانشگاه صنعتی سهند، تبریز، ایران

3 استادیار، گروه توان‌بخشی، دانشکده‌ی توان‌بخشی، دانشگاه علوم پزشکی، اصفهان، ایران

10.22041/ijbme.2021.141814.1647

چکیده

افرادی که از اختلاف طول پا ناشی از کوتاهی یک طرف اندام تحتانی رنج می­برند، به دلیل به کار بردن مکانیسم­های جبرانی، الگوی حرکت خود را تغییر می­دهند. برای بازگرداندن الگوی حرکت به حالت نرمال، استفاده از روش­های اصلاحی مانند به کار بردن کفی جبران کننده­ تجویز می­شود. بنابراین آگاهی از تغییرات حرکتی با­ و بدون استفاده از کفی می­تواند در طراحی روش­های درمانی به این افراد کمک کند. هدف از این مطالعه بررسی تغییرات سینماتیک اندام تحتانی، با و بدون استفاده از کفی در افراد دارای کوتاهی پا در بالا رفتن از پله است. در این مطالعه حرکت 20 شرکت کننده در هنگام بالا رفتن از پله در دو گروه افراد سالم و افراد دارای کوتاهی پا توسط سیستم سه‌بعدی آنالیز حرکت ثبت شده است. تغییرات زوایای سه مفصل لگن، زانو و مچ پا با مدل 7 عضوی از روش اویلر محاسبه شده و با استفاده از آزمون آماری t مستقل و زوجی در سطح اطمینان 95% مقایسه شده است. نتایج نشان داده است که بین افراد سالم و کوتاه پای بدون کفی، تفاوت معنی­داری وجود دارد. افراد بیمار دارای باز شدن بیش‌تر زانو، لگن و مچ پا در لحظه‌ی تماس اولیه و لحظه‌ی جدا­­­­­­­­­­ شدن پا از پله در صفحه‌ی ساجیتال، دامنه‌ی حرکتی بیش‌تر و نزدیک شدن کم‌تر پا در تماس اولیه با پله برای زانو و لگن در صفحه‌ی فرونتال و چرخش داخلی و خارجی بیش‌تر لگن و مچ پا به ترتیب در تماس اولیه و لحظه‌ی جدا شدن پا از پله در صفحه‌ی عرضی، نسبت به افراد سالم هستند (05/0p< ). پس از استفاده از کفی، تنها بیشینه‌ی دور شدن و نزدیک شدن لگن و مچ پا، بیشینه‌ی چرخش داخلی و مقدار زاویه در تماس اولیه و جدا شدن زانو و مچ پا بین دو گروه آزمون وکنترل تفاوت معنی­داری نشان نداده است (05/0p> ). بنابراین استفاده از کفی می­تواند بسیاری از تغییرات الگوی حرکت مفاصل تحتانی را به حالت طبیعی برگرداند.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Assessment of Three-Dimensional Changes in Lower Limb Joint Angles in People with Leg Length Discrepancy during Stair Climbing with and without using Insoles

نویسندگان [English]

  • Seyed Mehran Ayati Najafabadi 1
  • Alireza Hashemi Oskooi 2
  • Seyed Masoud Rafiaei 3

1 M.Sc., Department of Biomechanics, Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Iran

2 Assistant Professor, Department of Biomechanics, Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Iran

3 Assistant Professor, Department of Rehabilitation, University of Medical Sciences, Isfahan, Iran

چکیده [English]

People who suffer from leg length discrepancy (LLD) due to the shortening of one side of the lower extremities change their movement pattern because of using compensatory mechanisms. Methods such as manipulating a compensating insole are used to correct the movement pattern to normal. Therefore, the knowledge of movement pattern changes in with and without using of insoles can help to develop rehabilitation methods. The aim of this study was to investigate the kinematics of the lower extremities of people with leg length discrepancy during stair climbing with and without using insoles. Twenty participants including 10 normal and 10 LLD people took part in this study. Their movement on stair was recorded using a 7 camera 3-D motion analysis system. Changes in the angles of the hip, the knee and the ankle joints were calculated by the 7-member Euler model and compared by independent and paired sample t-test at 95% confidence level. The results showed that there was a significant difference between healthy people and people with LLD without using insoles. These people had higher extension of the knee, pelvis and ankle at the initial contact and toe off in sagittal plane and more knee and pelvis range of movement, less adduction of the knee and pelvis at the initial contact in frontal plane, higher internal and external rotation of pelvis at the initial contact and ankle in toe off in horizontal plane (p<0.05). The results also showed that maximum abduction of the pelvis and maximum adduction of the ankle, maximum internal rotation and the value of the angle of the knee and ankle had no significant different between normal and LLD people (p>0.05) when using insoles. Therefore, the use of insoles can correct some parameters of the movement pattern of the lower joints. 

کلیدواژه‌ها [English]

  • Leg Length Discrepancy
  • Compensatory Insoles
  • Kinematics
  • Motion Analysis
  • Stair
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