|
|
|
| Biomechanical Study of Heel Pain During Push-off Period Based on Finite Element Method |
| Zhang Haowei1*, Chen Liang1, Yang Junyan1, Liu Ying1, Zheng Yongjun2 |
1(School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China)
2(Department of Pain, East China Hospital, Fudan University, Shanghai 200093, China) |
|
|
|
|
Abstract The pathogenesis and mechanism of rehabilitation of heel pain was studied in this paper. Images from CT scan and MRI of patients with heel pain were collected for three-dimensional reconstruction. Geomagic was used to optimize the surface of the obtained model, and the model was preprocessed with finite element through Hypermesh. The obtained lower limbs finite element model was imported intoAbaqus for analysis and calculation. The validity of the model was verified by comparing with the test results of plantar pressure plate. According to the calculation, the influence of the changes of triceps surae force on the biomechanical behavior characteristics of foot and ankle gait during the push-off was analyzed. The result showed that the muscle strength of the triceps surae increases from 550 N to 1100 N, the peak pressure in the first phalangeal area increased by 32.8%, and the peak pressure in the metatarsal area increased by 14.3%; the stress of the first plantar fascia was up to 4.69 MPa; the stress peaks at the junction of tendon and calcaneal and the calcaneal tuberosity were 7.41 MPa and 6.79 MPa respectively. These indicated that contracture of triceps surae and the windlass effect in the push-off period will lead to excessive stretch of plantar fascia, which would lead to stress level improvement at calcaneal tuberosity and change in the biomechanical environment of the foot, thus inducing plantar fasciitis and heel pain. Relieving the contracture of the triceps surae, reducing the muscle force and avoiding the overstretch of the plantar fascia and reducing the stress level at the attachment point, thus restoring the normal biomechanical environment of the foot are the main rehabilitation mechanisms for the treatment of heel pain.
|
|
Received: 29 April 2019
|
|
|
|
Corresponding Authors:
*E-mail: howiezh@aliyun.com
|
|
|
|
[1] Eftekharsadat B, Babaei-Ghazani A, Zeinolabedinzadeh V. Dry needling in patients with chronic heel pain due to plantar fasciitis: a single-blinded randomized clinical trial [J]. Medical Journal of the Islamic Republic of Iran, 2016, 30(1):1-9.
[2] Ye Le, Mei Qiyong, Li Mingli, et al. A comparative efficacy evaluation of ultrasound-guided pulsed radiofrequency treatment in the gastrocnemius in managing plantar heel pain: a randomized and controlled trial [J]. Pain Medicine, 2015, 16(4):782-790.
[3] Rastegar S, Baradaran Mahdavi S, Hoseinzadeh B, et al. Comparison of dry needling and steroid injection in the treatment of plantar fasciitis: a single-blind randomized clinical trial [J]. International Orthopaedics, 2017, 42(1):109-116.
[4] Cheung TM, An KN, Zhang Ming. Consequences of partial and total plantar fascia release: A finite element study [J]. Foot & Ankle International, 2006, 27(2):125-132.
[5] Chen Wenming, Lee SJ, Lee PVS. Plantar pressure relief under the metatarsal heads-therapeutic insole design using three-dimensional finite element model of the foot[J]. Journal of Biomechanics,2015, 48(4):659-665.
[6] Wong DW, Wang Yan, Leung AK, et al. Finite element simulation on posterior tibial tendinopathy: load transfer alteration and implications to the onset of pes planus [J]. Clinical Biomechanics, 2018, 51:10-16.
[7] Lemmon D, Shiang TY, Hashmi A, et al. The effect of insoles in therapeutic footwear—A finite element approach [J]. Journal of Biomechanics, 1997, 30(6):615-620.
[8] Reeves ND, Maganaris CN, Ferretti G, et al. Influence of 90-day simulated microgravity on human tendon mechanical properties and the effect of resistive countermeasures [J]. Journal of Applied Physiology, 2005, 98(6):2278-2286.
[9] 章浩伟, 孙洋洋, 刘颖, 等. 基于三维膝-踝-足有限元模型的足跟痛足底压力生物力学分析 [J]. 医用生物力学, 2017,32(5):47-52.
[10] Morales-Orcajo E, Bayod J, Casas EB. Computational foot modeling: scope and applications [J]. Archives Comput Methods Eng, 2016, 23(3): 389-416.
[11] 张明, 张德文, 余嘉, 等. 足部三维有限元建模方法及其生物力学应用 [J]. 医用生物力学, 2007, 22(4):339-344.
[12] 励建安, 孟殿怀. 步态分析的临床应用 [J]. 中华物理医学与康复杂志, 2006(7):500-503.
[13] Arnold EM, Ward SR, Lieber RL, et al. A model of the lower limb for analysis of human movement [J]. Annals of Biomedical Engineering, 2010, 38(2):269-279.
[14] Froberg A, Komi P, Ishikawa M, et al. Force in the Achilles tendon during walking with ankle foot orthosis [J]. The American Journal of Sports Medicine, 2009, 37(6):1200-1207.
[15] Gefen A, Megidoravid M, Itzchak Y, et al. Biomechanical analysis of the three-dimensional foot structure during gait: A basic tool for clinical applications [J]. J Biomech Eng, 2000, 122(6):630-639.
[16] Yu Jia, Wong DW, Zhang Hongtao, et al. The influence of high-heeled shoes on strain and tension force of the anterior talofibular ligament and plantar fascia during balanced standing and walking [J]. Med Eng Phys, 2016,38(10):1152-1156.
[17] Chen Yennien, Chang Chihwei, Li Chunting, et al. Finite element analysis of plantar fascia during walking: a quasi-static simulation [J]. Foot & Ankle International, 2015, 36(1):90-97.
[18] Dai Xiaoqun, Li Yi, Zhang Ming, et al. Effect of sock on biomechanical responses of foot during walking [J]. Clinical Biomechanics, 2006, 21(3):314-321.
[19] Hayafune N, Hayafune Y, Jacob HAC. Pressure and force distribution characteristics under the normal foot during the push-off phase in gait [J]. The Foot, 1999, 9(2):88-92.
[20] Nakale NT, Strydom A, Saragas NP, et al. Association between plantar fasciitis and isolated gastrocnemius tightness[J]. Foot & Ankle International, 2017, 33(3):49-52.
[21] Gu Yaodong, Li Zhiyong, Shen WW, et al. Mechanical analysis of foot plantar fascia in normal walking condition [J]. Chinese Journal of Biomedical Engineering, 2016, 25(4):168-171.
[22] 张力文, 马云茹, 朱晓兰, 等. 跑鞋与着地方式对跑步损伤的影响 [J]. 医用生物力学, 2018,33(1):76-81.
[23] Guo Junchao, Wang Lizhen, Mo Zhongjun, et al. Biomechanical analysis of suture locations of the distal plantar fascia in partial foot [J]. Int Orthop, 2015, 39(12): 2373-2380. |
| [1] |
Pei Baoqing, Shi Zhenpeng, Wang Wei, Lu Shibao, Kong Chao. Biomechanical Study of Posterior Fixation for Thoracolumbar Burst Fractures[J]. Chinese Journal of Biomedical Engineering, 2017, 36(6): 718-723. |
| [2] |
Dong Yilong, Huang Xiangxiang, Qian Yuenan, Liu Liangle, Zhang Yuanxun, Zhong Xiqiang, Cai Chunyuan. Biomechanical Consequences of Different Step-Off Displacement of Both-Column Acetabular Fractures[J]. Chinese Journal of Biomedical Engineering, 2017, 36(3): 370-374. |
|
|
|
|
