应用弹性成像技术对比不同足弓形态腓肠肌-跟腱复合体硬度的研究

关键词：腓肠肌  跟腱  足弓  剪切波弹性成像  硬度  关节活动度

Keywords:gastrocnemius  achilles tendon  foot arch  shear wave elastography  stiffness  range of motion

摘要：

      摘要 目的：使用剪切波弹性成像技术（shear wave elastography， SWE）探究健康人群在不同踝关节角度下的腓肠肌-跟腱复合体硬度及其与足弓形态的相关性。 方法：招募40名健康受试者，在负重和非负重条件下进行足弓高度评估。根据负重下的足弓高度将受试者分为正常组、低足弓组和高足弓组，在踝关节自然位和中立位下进行内、外侧腓肠肌和跟腱硬度评估。根据负重和非负重下的足弓高度计算出足弓硬度指数。 结果：与高弓足相比，低足弓组在中立位时的内侧腓肠肌硬度显著增加（P=0.021）。内、外侧腓肠肌硬度与足弓硬度指数的相关系数分别为0.355和0.484，与被动踝关节背屈活动度的相关系数分别为﹣0.331和﹣0.276。踝关节自然位时，内、外侧腓肠肌硬度均不会随着足弓高度而改变（P>0.05）。在任何踝关节角度下，跟腱硬度与足弓高度、硬度指数以及被动踝关节背屈活动度均无显著相关性（P>0.05）。 结论：低足弓人群具有更高的内侧腓肠肌硬度。足弓硬度的增加以及被动踝关节背屈活动度的降低均与其密切相关。

Abstract:

      Abstract Objective： To investigate the stiffness of the gastrocnemius muscle-tendon complex at different ankle joint angles and its correlation with foot arch morphology in healthy subjects using shear wave elastography （SWE）. Method： Forty healthy subjects were recruited and divided into standard， low-arch， and high-arch groups based on arch height index under load （AHIload）. The arch stiffness index was calculated from both loaded and non-loaded arch height. The stiffness of the medial gastrocnemius， lateral gastrocnemius， and achilles tendon were measured by SWE at natural and neutral ankle positions. Result： The stiffness of medial gastrocnemius increased in the low-arch group at the neutral position compared with the high-arch group （P=0.021）. The correlation coefficients between the stiffness of medial and lateral gastrocnemius and the arch stiffness index were 0.355 and 0.484， respectively. The correlation coefficients between passive ankle dorsiflexion range of motion were ﹣0.331 for the medial gastrocnemius and ﹣0.276 for the lateral gastrocnemius. The medial and lateral gastrocnemius stiffness at the natural position did not change with arch height （P>0.05）. The stiffness of the achilles tendon at any ankle position showed no significant correlation with arch height， arch stiffness index， or passive ankle dorsiflexion range of motion （P>0.05）. Conclusion： Individuals with low arches exhibited higher medial gastrocnemius stiffness. Increased arch stiffness and decreased passive ankle dorsiflexion were associated with higher medial gastrocnemius stiffness.