Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University Bundoora, Victoria, Australia.
Med Sci Sports Exerc. 2011 Sep;43(9):1603-10. doi: 10.1249/MSS.0b013e318211c45d.
There is emerging evidence that foot orthoses are effective in the management of patellofemoral pain syndrome (PFPS). However, the identification of those most likely to benefit from foot orthoses has not been adequately explored. The aim of this study was to develop a preliminary clinical prediction rule to help identify individuals with PFPS who are most likely to benefit from foot orthoses.
A total of 60 individuals with PFPS were issued with noncustomized prefabricated foot orthoses containing built-in arch supports and 4° rear foot varus wedging. Patient-reported level of improvement was documented at 12 wk. Potential baseline predictor variables of interest included patient demographics, pain characteristics, footwear motion control properties, foot and ankle characteristics, and functional performance measures.
Fourteen (25%) participants reported marked improvement at 12 wk. The number of participants with marked improvement increased to 78% if three of the following four criteria were met: footwear motion control properties score of <5.0 (indicative of less supportive footwear), usual pain <22.0 mm, ankle dorsiflexion range of motion (knee flexed) <41°, and reduced single-leg squat pain when wearing the orthoses.
Individuals with PFPS who wear less supportive footwear, report lower levels of pain, exhibit less ankle dorsiflexion range of motion, and report an immediate reduction in pain with foot orthoses when performing a single-leg squat are more likely to benefit from foot orthoses.
有新的证据表明，足部矫形器在髌股关节疼痛综合征（PFPS）的治疗中是有效的。然而，对于那些最有可能从足部矫形器中受益的患者尚未进行充分的研究。本研究旨在制定一个初步的临床预测规则，以帮助识别最有可能从足部矫形器中受益的 PFPS 患者。
共有 60 名 PFPS 患者使用非定制预制足部矫形器，其中包含内置足弓支撑和 4°后跟外翻楔形垫。在 12 周时记录患者报告的改善程度。潜在的基线预测变量包括患者人口统计学、疼痛特征、鞋类运动控制特性、足部和踝关节特征以及功能表现测量。
14 名（25%）参与者在 12 周时报告明显改善。如果满足以下四个标准中的三个，则有明显改善的参与者比例增加到 78%：鞋类运动控制特性评分<5.0（表示支撑性较差的鞋类）、通常疼痛<22.0mm、踝关节背屈活动范围（膝关节弯曲）<41°，以及在穿矫形器时单腿深蹲疼痛减轻。
PFPS 患者如果穿支撑性较差的鞋类、报告较低的疼痛水平、踝关节背屈活动范围较小，以及在进行单腿深蹲时佩戴矫形器后疼痛立即减轻，那么更有可能从足部矫形器中受益。
