一种刚度可调的前置式足下垂矫形器研究
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1.复旦大学;2.复旦大学附属华山医院

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Research on an anterior foot drop ankle foot orthosis with adjustable stiffness
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    摘要:

    目的:针对足下垂步态的患者,本研究设计一种刚度可调的前置式踝足矫形器,实现对患者踝关节病态跖屈的最佳限制以恢复踝关节自然步态的目的。方法:通过自制实验装置测得10名18-55岁肌肉无力导致足下垂患者畸形矫正所需的最小矫治力矩,应用于踝足矫形器的材料选择。通过力学拉伸实验,研究了不同填充结构及填充率参数和杨氏模量的关系。选取一名典型性足下垂患者,以其足部几何数据和特定的填充材料和填充结构3D打印快速制作出贴合患者足部形状的前置式矫形器,进行赤足和分别穿戴2种踝足矫形器(前置式刚性和前置式柔性)情况下的运动学和跖屈肌群(比目鱼肌、腓肠肌内侧头和腓肠肌外侧头)的表面肌电测试,验证矫形器对跖屈的最佳限制的有效性和踝关节外翻、跖屈功能保留的程度。结果:足下垂患者所需的最小矫正力矩为2.16N.m,相比前置式刚性踝足矫形器,穿戴前置式柔性踝足矫形器时,踝关节跖屈的活动度增加67.8%;内外翻的活动度增加88.6%;负责跖屈功能的肌群(比目鱼肌、腓肠肌内侧头和腓肠肌外侧头)激活程度也分别减少了38.3%、46.6%和55.8%。 结论:该刚度可调式踝足矫形器可用于足下垂患者的个性化矫形定制,具备更有效、更适合日常长期使用的矫形功能和潜力。

    Abstract:

    Objective For patients with foot drop gait, the research aims to design a kind of anterior ankle foot orthosis with adjustable stiffness. This kind of orthosis can complete the function of limiting unusual plantar flexion under the condition that the abduction and rotation of ankle joint are limited as little as possible. Methods The minimum orthodontic moment of 10 foot drop male patients was measured by self-made experimental equipment, which can be used to select the optimum material modulus of ankle foot orthosis. The relationship between Young"s modulus and different filling structure and filling ratio parameters was studied by tensile test. A typical patient with foot ptosis was selected, and the anterior orthosis fitting the shape of patient"s foot was quickly made by 3D printing with foot geometric data and specific filling material, filling structure and filling rate. The kinematics and surface electromyography of plantar flexors were tested under barefoot and wearing two kinds of AFOs to verify the effect of the orthosis on plantar flexion. The effectiveness of the limitation and the degree of preservation of ankle valgus and plantar flexion were discussed. Results The minimum corrective torque required for patients with foot drop was 2.16 N.m. Compared with the rigid AFO, the range of motion of plantar flexion and valgus increased by 67.8% and 88.6% respectively when with flexible AFO. The activation of the muscles responsible for plantar flexion (soleus, medial head of gastrocnemius and lateral head of gastrocnemius) also decreased by 38.3%、 46.6% and 55.8%, maintaining a certain normal function. Conclusions This AFO can be used for orthosis customization of patients with foot drop, providing more effective and long-term orthosis function.

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  • 收稿日期:2021-02-08
  • 最后修改日期:2021-03-23
  • 录用日期:2021-03-24
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