Randolph A L, Nelson M, deAraujo M P, Perez-Millan R, Wynn T T
Department of Physical Medicine and Rehabilitation, New York Medical College, Valhalla 10595, USA.
Arch Phys Med Rehabil. 1999 Jul;80(7):801-4. doi: 10.1016/s0003-9993(99)90230-7.
Evaluation of orthosis purported to decrease pressure on the heel while walking.
The Multipodus System is an orthotic device, designed for this purpose, that can be worn with flat or rocker bottom boot. Ten subjects underwent four trials: first, an initial walk wearing their usual shoes, then using the orthosis on the left, with a flat bottom boot, then with a rocker bottom boot, and a final walk. Pressures exerted on the plantar surface of the hindfoot, midfoot, and forefoot were measured electronically and analyzed.
Ten consecutive normal subjects were tested on a conventional tile floor in a gait laboratory.
Peak pressures in the initial walk averaged: heel, 9.6 +/- 2.3psi; midfoot, 2.6 +/- 1.7psi; and forefoot, 10.3 +/- 2.6psi. Pressures on the foot were redistributed significantly when the orthosis was used. Heel pressure was reduced significantly compared to the ordinary shoes using both the flat bottom boot (5.0 +/- 1.2psi, a decrease of 48% [p = .0001]) and the rocker bottom boot (4.5 +/- 1.5psi, a decrease of 53% [p = .0001]). Pressure was increased at the midfoot with both the flat bottom boot (6.6 +/- 3.2psi, an increase of 61% [p = .0001]) and the rocker bottom boot (6.8 +/- 2.9psi, an increase of 62% [p = .0001]). Pressures at the forefoot decreased 19% (8.3psi) with the flat bottom boot and 32% (7.0psi; p = .0003) with the rocker bottom boot.
Redistribution of pressure on the foot with orthosis is characterized by reduction at the hindfoot and forefoot and increase at the midfoot with both the flat and rocker bottom boots, thereby promoting healing of calcaneal and forefoot ulcers. The integrity of the midfoot, however, must not be compromised.
评估一种声称可在行走时减轻足跟压力的矫形器。
Multipodus系统是一种为此目的设计的矫形装置，可与平底或摇椅底靴子搭配使用。10名受试者进行了四项试验：首先，穿着他们平常的鞋子进行初始行走，然后在左侧使用矫形器，搭配平底靴，接着搭配摇椅底靴，最后再次行走。对后足、中足和前足足底表面施加的压力进行电子测量并分析。
10名连续的正常受试者在步态实验室的传统瓷砖地面上进行测试。
初始行走时的峰值压力平均为：足跟9.6±2.3磅力/平方英寸；中足2.6±1.7磅力/平方英寸；前足10.3±2.6磅力/平方英寸。使用矫形器时足部压力明显重新分布。与普通鞋子相比，使用平底靴（5.0±1.2磅力/平方英寸，降低48%[p = 0.0001]）和摇椅底靴（4.5±1.5磅力/平方英寸，降低53%[p = 0.0001]）时足跟压力均显著降低。使用平底靴（6.6±3.2磅力/平方英寸，增加61%[p = 0.0001]）和摇椅底靴（6.8±2.9磅力/平方英寸，增加62%[p = 0.0001]）时中足压力均增加。使用平底靴时前足压力降低19%（8.3磅力/平方英寸），使用摇椅底靴时降低32%（7.0磅力/平方英寸；p = 0.0003）。
使用矫形器时足部压力重新分布的特点是后足和前足压力降低，中足压力增加，平底靴和摇椅底靴均如此，从而促进跟骨和前足溃疡的愈合。然而，中足的完整性不得受到损害。
