Spooner Simon K, Smith David K, Kirby Kevin A
Peninsula Podiatry, Plymouth, England.
J Am Podiatr Med Assoc. 2010 Nov-Dec;100(6):518-29. doi: 10.7547/1000518.
Foot orthoses are believed to exert their therapeutic effect on the human locomotor apparatus by altering the location, magnitude, and temporal patterns of ground reaction forces acting on the plantar foot during weightbearing activities. In-shoe pressure-measurement systems are increasingly being used by clinicians and researchers to assess kinetic changes at the foot-orthosis interface to better understand the function of foot orthoses and to derive more efficacious treatments for many painful foot and lower-extremity abnormalities. This article explores how the inherent three-dimensional surface topography and load-deformation characteristics of foot orthoses may challenge the validity, reliability, and clinical usefulness of the data obtained from in-shoe pressure-measurement systems in the context of foot orthotic therapy and research. The inability of in-shoe pressure-measurement systems to measure shearing forces beneath the foot, the required bending of the flat two-dimensional sensor insole to fit the pressure insole to the three-dimensional curves of the orthosis, the subsequent unbending of the sensor insole to display it on a computer monitor, and variations in the load-deformation characteristics of orthoses are all sources of potential error in examination of the kinetic effects of foot orthoses. Consequently, caution is required when interpreting the results of orthotic research that has used in-shoe pressure insole technology. The limitations of the technology should also be given due respect when in-shoe pressure measurement is used to make clinical decisions and prescribe custom foot orthoses for patients.
足部矫形器被认为是通过改变负重活动期间作用于足底的地面反作用力的位置、大小和时间模式，对人体运动器官发挥治疗作用。临床医生和研究人员越来越多地使用鞋内压力测量系统来评估足部矫形器界面处的动力学变化，以便更好地了解足部矫形器的功能，并为许多足部和下肢疼痛异常制定更有效的治疗方法。本文探讨了足部矫形器固有的三维表面形貌和载荷变形特性如何在足部矫形治疗和研究的背景下，对从鞋内压力测量系统获得的数据的有效性、可靠性和临床实用性提出挑战。鞋内压力测量系统无法测量足底下方的剪切力，扁平二维传感器鞋垫需要弯曲以使其与矫形器的三维曲线相适配，随后传感器鞋垫又要伸直以便在计算机显示器上显示，以及矫形器载荷变形特性的变化，这些都是在研究足部矫形器动力学效应时潜在的误差来源。因此，在解释使用鞋内压力鞋垫技术的矫形研究结果时需要谨慎。当使用鞋内压力测量来做出临床决策并为患者定制足部矫形器时，也应充分考虑该技术的局限性。
