보행 시 키 높이 인솔이 젊은 남성의 하지관절에 미치는 영향
The Influence of Raised Heel Insoles on Lower Extremity Joint Kinematics of Young Male During Walking
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이 연구에서는 최근 남성들에게 널리 사용되고 있는 세가지 재질의 키 높이 인솔(RHI)이 보행 특성에 미치는 영향을 알아보고자 하였다. 근골격계 이상이 없는 18명(연령∶25.9±2.1yrs, 신장∶175.3±5.0cm, 체중∶77.4±7.5kg)의 젊은 남성을 피험자로 선정하여 키 높이 인솔의 주관적 편안함 평가, 시상면에서의 하지 관절의 변화 그리고 지면반력을 분석하였다. 키 높이 인솔의 주관적 편안함 평가에서 키 높이 인솔 중 에어캡 인솔(AIS)이 다른 인솔을 넣고 보행하였을 때 보다 편하다고 대답하였다(p＜.05). 엉덩 관절에서는 중간 입각기 시점에서 키 높이 인솔 보행 시 굴곡각이 크게 나타났다(p＜.05). 무릎 관절에서는 중간 입각기에는 키 높이 인솔 보행 시 굴곡각이 크게 나타났고, 발가락 들림, 최대굴곡각도에서는 굴곡각도가 작게 나타났다(p＜.05). 발목 관절의 움직임을 살펴본 결과 뒤축 접지, 반대발 발가락 들림, 중간 입각기, 반대발 뒤축 들림, 발가락 들림, 중간 유각기 시점에서 일반 운동화보다 키 높이 인솔 보행 시 더 저측굴곡 되는 것으로 나타났다(p＜.05). 지면반력에서는 좌-우방향(Fz1, Fx2, Fx3), 전-후방향(Fy1, Fy2) 그리고 수직방향(Fz1, Fz2, Fz3)에서 일반 운동화 보다 키 높이 인솔들의 지면반력이 크게 나타났다(p＜.05). 이러한 운동학적 변인의 차이는 키 높이 인솔 보행 시 정상 패턴과 다른 불안정한 보행동작을 유발시키고 이러한 불안정한 동작이 지속적으로 이루어진다면 근골격계에 변화를 유발시켜 부상 유발의 가능성이 있을 것으로 생각된다.
Abstract
The effect of raised heel insoles (RHI) on lower extremity joint kinematics are not clearly understood. The purpose of this study was to investigate the effects of different types of RHI on lower extremity joint angles, ground reaction forces during gait, and comfort as reflected by the subjective comfort rating. Eighteen male college students (age; 25.9±2.10yrs, height; 175.3±5.0cm, weight; 77.4±7.5kg) with no lower limb neuromuscular injury participated in this study. A three-dimensional motion analysis system (VICON MX-F20, Oxford Metrics Ltd, Oxford, UK) and force plates (ORG-6 AMTI, Watertown, MA, USA ) were used to analyze the movements of joints for the lower extremities. The subjective comfort rating was higher for different RHIs than the Air Cap Insole (AIS) (p<.05). Walking with the RHI showed greater plantarflexion angles at heel contact, opposite toe off, mid stance, opposite heel contact, and toe off (p<.05). Walking with the RHI showed larger knee flexion angles at mid stance and smaller knee flexion angles at toe off (p<.05). Walking with the RHI showed larger hip flexion angles at mid stance (p<.05). Significant differences were observed for ground reaction force in the medial-lateral direction for Fx1, Fx2, Fx3, breaking force (Fy1) and the progression force (Fy2) in the anterior-posterior direction. Furthemore, significant differences were observed in the vertical direction for Fz1, Fz2, Fz3 (p<.05). These results showed that wearing shoes with a RHI had significant influence on walking pattern and potential to induce chronic alterations in the musculoskeletal system. Future studies should employ various RHI heights and types of RHI materials to clarify the effects of RHI on gait.
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