| 摘要: | 人體足部的結構對於站立及行走非常重要，不正常的足型會造成下肢容易疲勞甚至發生病變，導致行走時平衡的失調。例如兩種常見的足弓高度異常造成的疾病：扁平足與高弓足。因此評估足弓高度(Arch Height)在足部醫療檢測上是必要的。檢測足弓高度的方法有很多種，例：X 光檢測、足弓測量、足印指標參數與足壓指數(Modified Arch Index; MAI)等。在考慮設備價格與取得難易後，本研究選擇足弓測量、七種足印指標參數(包含：AA、ALI、FI、TFI、SI、CSI與AI)與足壓指數(MAI)，三種檢測方式並配合影像處理與自動化測量系統進行檢測。本研究將對三十三名受試者進行實驗共六十六筆足印樣本(男性二十二人、女性十一人，平均身高169±6.7cm公分、體重64±12.3公斤、年齡23±3歲)做為正常控制組。本實驗先假設具有完整足印且無足部病歷的受試者為正常足，並另外招募十名扁平足(男性八人、女性二人共二十筆足印樣本)與十名高弓足的受試者(男性四人、女性六人，共二十筆足印樣本)作為對照組，分別進行足弓高度、足印指標參數與足壓指數(MAI)檢測實驗，最後將實驗結果與文獻資料進行比較，找出可信度最高的檢測方法。實驗結果顯示，正常足、扁平足與高弓足的平均足弓高度分別為4.03±0.82、2.45±0.14與5.47±0.26 cm。足壓指數(MAI)與足弓高度的相關度最高，其次是Arch Index(AI)足印指標參數; 正常足的足壓指數(MAI)：中足占26%~30%，分佈較均勻；扁平足：中足占33%~37%，主要集中在中足區；高弓足：中足占18%~22%，主要集中在前足與足跟。在七種足印指標參數中足弓高度與Arch Index(AI)相關度最高，而與Arch Length Index(ALI)的相關度最低，而且二維面積比值參數(FI與TFI)的相關度高於一維長度比值參數(SI與CSI)。由於足壓指數(MAI)對於異常的足弓高度具有檢測的功能。因此，我們認為此法是在X光檢測足弓高度前，預測足弓高度的最佳檢測方式。 Human foot's structure is important regarding stands and walks. Abnormal foot state could make the lower limb easily weary and even lead to the pathological changes, resulting in unbalanced when walking. There are two common diseases: the flat foot and the high arch foot caused by abnormal arch height. Therefore, the arch height assessment of foot is essential in foot medical examination. There are many ways to detect arch height, including: x-ray examination, arch height measurement, footprint index parameters and foot pressure index (exp. Modified Arch Index; MAI) etc. In this study, we choose arch measurements, footprint index parameters (including AA, ALI, FI, TFI, SI, CSI and AI) and MAI with image processing and automated measurement system for detection as they are easy to access and the equipments are relatively cheap. 33 participants with a complete footprint and without any foot pathological history were assumed to be normal and recruited in this study to give a total of 66 samples of footprints (22 male, 11 female, average height in 169±6.7cm, weight in 64±12.3 kg, age in 23±3 years). This is the normal control group. In addition, 10 participants with flat foot (8 male, 2 female; a total of 20 samples of footprints) and 10 participants with high arch foot (4 men, 6 women, a total of 20 samples of footprints) were recruited as the contrast group. The arch height, seven footprint index parameters and MAI were measured and compared between groups and with data from literatures for cross validation in order to identify the best detection method. The empirical results of the foot arch height detection experiments show that the average foot arch heights are 4.03±0.82, 2.45±0.14 and 5.47±0.26 cm for normal, flat foot and high arch foot, respectively. The parameters that can best represent the arch height (highest correlation) is MAI. The situation of MAI of normal foot which is 26%~30% on the middle foot, the distribution is uniform. The flat foot which is 33%~37% on the middle foot, the main distribution is on the middle foot. The high arch foot which is 18%~22% on the middle foot, the main distribution is on the front foot and the heel. Among seven footprint index parameters, the Arch Index (AI) is most correlated with arch height and Arch Length Index (ALI) is lowest. Furthermore, the two-dimensional area ratio parameters (FI and TFI) are more related with arch height than one-dimensional length ratio parameters (SI and CSI). In conclusion, we have indentified the best examine method: MAI among methods tested for abnormal arch height detection. As the method is capable of detecting abnormal foot arch and can provide useful and reliable information, we believe that it could predict the arch height before clinical x-ray foot arch examination. |
