Sadra Saba, Fleischer Adam, Klein Erin, Grewal Gurtej S, Knight Jessica, Weil Lowell Scott, Weil Lowell, Najafi Bijan
Center for Lower Extremity Ambulatory Research, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL.
J Am Podiatr Med Assoc. 2013 Nov-Dec;103(6):489-97. doi: 10.7547/1030489.
Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance.
Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants. Assessments were made in the clinic using body-worn sensors.
Patients in the preoperative group generally demonstrated poorer static balance control compared with the other two groups. Despite similar age and body mass index, postoperative patients exhibited 29% and 63% less center of mass sway than preoperative patients during double-and single-support balance assessments, respectively (analysis of variance P =.17 and P =.14, respectively [both eyes open condition]). Overall, gait performance was similar among the groups, except for speed during gait initiation, where lower speeds were encountered in the postoperative group compared with the preoperative group (Scheffe P = .049).
This study provides supportive evidence regarding the benefits of corrective lower-extremity surgery on certain aspects of balance control. Patients seem to demonstrate early improvements in static balance after corrective HV surgery, whereas gait improvements may require a longer recovery time. Further research using a longitudinal study design and a larger sample size capable of assessing the long-term effects of HV surgical correction on balance and gait is probably warranted.
拇外翻（HV）与步态和平衡任务中的较差表现相关，并且是老年人跌倒的独立危险因素。我们试图评估矫正性HV手术是否能改善步态和平衡。
采用横断面研究设计，从40名成年人中获取步态和静态平衡数据：19名单纯HV患者（术前组）、10名近期成功接受HV手术的患者（术后组）和11名对照参与者。在诊所使用身体佩戴式传感器进行评估。
与其他两组相比，术前组患者总体上表现出较差的静态平衡控制。尽管年龄和体重指数相似，但在双支撑和单支撑平衡评估期间，术后患者的质心摆动分别比术前患者少29%和63%（方差分析，P值分别为0.17和0.14[双眼睁开情况]）。总体而言，除了步态起始时的速度外，各组之间的步态表现相似，术后组的速度低于术前组（谢费检验，P = 0.049）。
本研究为矫正性下肢手术在平衡控制某些方面的益处提供了支持性证据。矫正性HV手术后患者的静态平衡似乎有早期改善，而步态改善可能需要更长的恢复时间。可能有必要使用纵向研究设计和更大样本量进行进一步研究，以评估HV手术矫正对平衡和步态的长期影响。
