Payne C, Chuter V
Department of Podiatry, School of Human Biosciences, La Trobe University, Melbourne, Australia.
Clin Podiatr Med Surg. 2001 Oct;18(4):705-13, vi.
Foot orthoses have been shown to be effective in the management of lower extremity pathologic conditions, but the mechanism by which orthoses achieve this effect is unclear. Kinematic studies that investigate changes in skeletal alignment from the use of foot orthoses have shown mixed results with generally small changes which may not be sufficient to account for the outcomes achieved with foot orthoses. A number of theoretic constructs have not been taken into account in the design and reporting of kinematic studies, and these omissions may account for mixed results. Kinematic studies need to report information about participants, (e.g., the subtalar joint axis position) so readers can judge the appropriateness of the orthoses prescriptions and the kinematic variable measured. The high prevalence of forefoot varus reported in some studies and the variability in orthoses prescriptions and in casting for these devices used in studies also needs to be addressed. In light of some of the theoretic explanations offered here, the recent suggestions that foot orthoses may work by methods other than aligning the skeleton may need to be re-evaluated.
足部矫形器已被证明在下肢病理状况的管理中有效，但矫形器实现这种效果的机制尚不清楚。研究使用足部矫形器后骨骼排列变化的运动学研究结果不一，总体变化较小，可能不足以解释足部矫形器所取得的效果。在运动学研究的设计和报告中，一些理论构想未被考虑在内，这些遗漏可能是结果不一的原因。运动学研究需要报告有关参与者的信息（例如距下关节轴位置），以便读者能够判断矫形器处方的合理性以及所测量的运动学变量。一些研究中报告的前足内翻高患病率以及研究中使用的这些装置在矫形器处方和石膏模型制作方面的变异性也需要得到解决。鉴于此处提供的一些理论解释，最近关于足部矫形器可能通过使骨骼对齐以外的方法起作用的建议可能需要重新评估。
