Nester C J, van der Linden M L, Bowker P
Centre for Rehabilitation and Human Performance Research, Brian Blatchford Building, University of Salford, M6 6PU, Salford, UK.
Gait Posture. 2003 Apr;17(2):180-7. doi: 10.1016/s0966-6362(02)00065-6.
Despite their wide clinical application and success, our understanding of the biomechanical effects of foot orthoses is relatively limited. The aim of this study was to assess the effect of medially wedged and laterally wedged foot orthoses on the kinematics and joint moments of the rearfoot complex, knee, hip and pelvis and the ground reaction forces. The principal effect of the foot orthoses was on the rearfoot complex, where significant changes in joint rotations and moments were observed. Medially wedged orthoses decreased rearfoot pronation and increased the laterally directed ground reaction force during the contact phase, suggesting reduced shock attenuation. The laterally wedged orthoses increased rearfoot pronation and decreased the laterally directed ground reaction force during the contact phase, suggesting increased shock attenuation. The effects of the orthoses on knee, hip and pelvis kinematics were generally minimal. In view of the minimal effect the orthoses had on joints proximal to the foot, it is suggested that the orthoses may have additional effects on the passive and active soft tissues of the lower limb and it is these changes that result in the documented clinical success.
尽管足部矫形器在临床上得到了广泛应用且取得了成功，但我们对其生物力学效应的了解相对有限。本研究的目的是评估内侧楔形和外侧楔形足部矫形器对后足复合体、膝关节、髋关节和骨盆的运动学及关节力矩以及地面反作用力的影响。足部矫形器的主要作用部位是后足复合体，在该部位观察到了关节旋转和力矩的显著变化。内侧楔形矫形器在后足着地阶段减少了后足内旋，并增加了向外侧的地面反作用力，这表明减震效果降低。外侧楔形矫形器在后足着地阶段增加了后足内旋，并降低了向外侧的地面反作用力，这表明减震效果增强。矫形器对膝关节、髋关节和骨盆运动学的影响通常较小。鉴于矫形器对足部近端关节的影响较小，有人提出矫形器可能对下肢的被动和主动软组织有额外影响，正是这些变化导致了已记录的临床成功。
