足底筋膜對於足部生物力學行為之影響

The Effects of Plantar Fascia on biomechanical Behavior of Foot

鍾曜丞(Yao-Cheng Chung)

指導教授 ： 陳文斌

中原大學/工學院/醫學工程研究所/碩士(2007年)

https://doi.org/10.6840/CYCU.2007.00668

摘要

足底筋膜為足弓結構中重要之元件，其主要功能為提供足部結構之穩定度，協助人體步行時衝擊能量之吸收。不正常之重複性負載，可能導致筋膜附著端之骨骼及其相連組織產生過度之牽引，提高了筋膜損傷之風險，甚至產生足底筋膜炎之病徵。然而，過去探討足底筋膜在步態週期中對於足部結構穩定性與負載承受能力並無深入之研究。因此本研究將利用動態有限元素分析探討足底筋膜對於足部生物力學行為之影響。
本研究有別於以往相關之研究，利用動態有限元素分析結合步態實驗所獲得之運動學參數作為邊界條件，模擬正常足在完整步態站立期之運動，並利用實驗所獲得之動力學參數進行驗證。研究結果顯示缺乏足底筋膜之足部模型在步行過程，骨骼內部應力與中足結構之變形造成增加。筋膜切除能有效減輕足跟疼痛，隨著筋膜切除程度的增加卻可能造成在步行時中足關節應力過大，增加足部肌肉骨骼系統損害之機率。未來臨床上治療足底筋膜炎時，建議優先考慮穿著治療性鞋內墊等保守性物理治療。分析結果的量化數據可供臨床醫師以及從事生物力學相關人員研究之參考。

關鍵字

步態分析 ； 有限元素法 ； 足底筋膜 ； 動態模擬

並列摘要

The plantar fascia is the major component of foot arch structure, which functions as a stabilizing component of the longitudinal arch of human foot and an energy-absorbing component during ambulation. Excessive and repetitive load may lead to overstretching of calcaneal plantar fascia attachment and surrounding soft tissues, and thus increase the risk of plantar fascia injury and plantar fasciitis. However, there was no literature to investigate the influence of plantar fascia on the stability and load-bearing ability of foot arch complex during gait cycle. Therefore, the purpose of this study was to investigate the effects of plantar aponeurosis on the biomechanical behavior of foot during stance phase by dynamic finite element analysis.
The current study combined gait analysis experiment to simulate the foot motion during stance phase of gait cycle. The boundary condition was obtained from the kinematic data of gait analysis. The validation of the finite element analysis was performed by comparing with the experimental results. The results showed that the finite element model without plantar fascia will increase the internal stress of foot bone and mid-foot cartilage deformation. Though plantar fascia release could decrease the stress at calcaneal plantar fascia attachment, the stress of mid-foot cartilage may rise during ambulation, and thus increase the risk of musculoskeletal system injury.
Therefore, this study suggests that conservative therapy is preferred prior to plantar fasciotomy when clinician treating patients with plantar fasciitis. The quantitative data of current study can provide reference for clinician as well as foot biomechanics researchers.

並列關鍵字

dynamic simulate ； gait analysis ； finite element analysis ； plantar fascia

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