Holmes Clayton F, Wilcox Donald, Fletcher James P
Department of Physical Therapy, University of Central Arkansas, Conway 72035-0001, USA.
J Orthop Sports Phys Ther. 2002 May;32(5):194-201. doi: 10.2519/jospt.2002.32.5.194.
STUDY DESIGN: Single-group repeated measures design pre- and postintervention. OBJECTIVES: To determine if the modified low-Dye medial longitudinal arch (MLA) taping procedure places the subtalar joint into the neutral position and maintains the subtalar joint neutral (STJN) position following 10 minutes of walking. BACKGROUND: Subtalar malalignment in excessive pronation is commonly accepted as a contributing factor to a variety of musculoskeletal pathologies. The modified low-Dye MLA taping procedure is often used on the plantar surface of the foot as a short-term corrective tool for excessive foot pronation. However, research that evaluates the efficacy of this taping technique during light exercise is lacking. Measurement of navicular height is commonly used as a measure of subtalar position. METHODS AND MEASURES: Prior to the study, one tester-established reliability in the navicular drop technique measurement by initially practicing the measurements on 400 feet, followed by a reliability study performed on 29 subjects. In this study, a screening procedure excluded subjects with ankle or foot pathology, supinated feet, or neutral feet, and included only subjects with pronated feet. The study, which included 40 subjects, involved four steps: (1) measuring navicular height in the relaxed position; (2) measuring navicular height in the STJN position; (3) measuring navicular height after application of the modified low-Dye MLA taping procedure; and (4) measuring navicular height after subjects had walked for 10 minutes with the taping. RESULTS: Results indicated an intrarater intraclass correlation coefficient (ICC) for measuring navicular height of 0.96 for the right foot and 0.94 for the left foot. Repeated measures ANOVA revealed that significant differences existed (P < 0.05) among the 4 measures. A Bonferroni post hoc analysis showed a difference between relaxed stance measurements and all other measurements, and between taped-prewalking measurements and taped-postwalking measurements. In addition, no significant difference was observed between navicular height measured in STJN and the taped-prewalking and taped-postwalking conditions. The average navicular height for the taped-prewalking condition was 1.6 mm higher than that for the STJN position. For the taped-postwalking condition, the average height of the navicular was 1.2 mm lower than that of the STJN position. CONCLUSION: These results demonstrate that the modified low-Dye MLA taping procedure places the subtalar joint near the neutral position. Despite a significant reduction in the height of the navicular after the subjects walked for 10 minutes with the tape on, the height of the navicular was still not significantly different than that of the STJN position.
研究设计:干预前后的单组重复测量设计。 目的:确定改良的低染料内侧纵弓(MLA)贴扎程序是否能使距下关节处于中立位,并在步行10分钟后维持距下关节中立(STJN)位。 背景:过度旋前时的距下关节排列不齐通常被认为是导致多种肌肉骨骼疾病的一个因素。改良的低染料MLA贴扎程序常用于足底,作为足部过度旋前的一种短期矫正工具。然而,缺乏评估这种贴扎技术在轻度运动期间疗效的研究。舟骨高度的测量通常用作距下关节位置的一种测量方法。 方法和测量指标:在研究之前,一名测试者通过最初在400只脚上练习测量,建立了舟骨下降技术测量的可靠性,随后对29名受试者进行了可靠性研究。在本研究中,筛查程序排除了有踝关节或足部病变、旋后足或中立足的受试者,仅纳入旋前足的受试者。该研究包括40名受试者,涉及四个步骤:(1)在放松位测量舟骨高度;(2)在STJN位测量舟骨高度;(3)应用改良的低染料MLA贴扎程序后测量舟骨高度;(4)受试者贴扎步行10分钟后测量舟骨高度。 结果:结果表明,测量右足舟骨高度的组内相关系数(ICC)为0.96,左足为0.94。重复测量方差分析显示这4项测量之间存在显著差异(P<0.05)。Bonferroni事后分析显示,放松站立位测量与所有其他测量之间,以及贴扎前步行测量与贴扎后步行测量之间存在差异。此外,在STJN位测量的舟骨高度与贴扎前步行和贴扎后步行情况之间未观察到显著差异。贴扎前步行情况的舟骨平均高度比STJN位高1.6毫米。对于贴扎后步行情况而言,舟骨的平均高度比STJN位低1.2毫米。 结论:这些结果表明,改良的低染料MLA贴扎程序可使距下关节接近中立位。尽管受试者贴扎步行10分钟后舟骨高度显著降低,但舟骨高度仍与STJN位无显著差异。
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