Trieb K, Zachhuber D, Hofstätter S
Abteilung für Orthopädie und Orthopädische Chirurgie, Klinikum Wels-Grieskirchen, Österreich.
Z Orthop Unfall. 2014 Jun;152(3):247-51. doi: 10.1055/s-0034-1368530. Epub 2014 Jun 24.
Insoles and foot orthotics change the distribution of the plantar pressure. No information exists concerning the effects of plantar pressure distribution and lateral wedge orthoses. The purpose of this study was to determine the effect of the lateral wedge on the plantar pressure distribution.
The GP Mobil Data system was used to evaluate the data mentioned above, using a 6 mm lateral wedge orthotic worn by 50 healthy volunteers (100 feet). Patient age was 18 to 61 years. The first measurement was performed with, the second without a 6 mm lateral wedge. 50 volunteers walked a standardised distance of 10 m and the results with and without the wedge were compared. For evaluation, the foot was divided in 6 different anatomic regions. Statistical analysis was performed with the t2 test using graph pad prism.
The preliminary results revealed that the maximum peak pressure and intermediate pressure, contact time and force time integral decreased significantly at the medial middle- and forefoot plus the heel and increased significantly at the lateral middle- and forefoot using the lateral wedge. The maximum peak pressure under the great toe decreased by 22 % using a wedge, under the MTP I joint by 19 %, under the MTP II-III joints by 8 % and under the heel by 7 %. By contrast, maximum peak pressure increased under the area of MTP IV-V (+ 11.3 %) and under the lateral metatarsus (+ 15 %) when wearing a wedge.
This study reveals the effects of a lateral wedge orthosis on the plantar pressure distribution of the foot. These relationships and the changing pattern may serve as a useful guide for the clinician. A full medical screen of the foot should be undertaken before laterally wedged foot orthotic devices are prescribed.
鞋垫和足部矫形器会改变足底压力分布。目前尚无关于足底压力分布和外侧楔形矫形器效果的相关信息。本研究的目的是确定外侧楔形物对足底压力分布的影响。
使用GP Mobil Data系统评估上述数据,50名健康志愿者(100只脚)佩戴6毫米外侧楔形矫形器。患者年龄为18至61岁。第一次测量时佩戴6毫米外侧楔形物,第二次测量时不佩戴。50名志愿者行走标准化距离10米,比较佩戴和不佩戴楔形物的结果。为了进行评估,将足部划分为6个不同的解剖区域。使用GraphPad Prism软件通过t2检验进行统计分析。
初步结果显示,使用外侧楔形物时,内侧中足和前足以及足跟处的最大峰值压力、中间压力、接触时间和力时间积分显著降低,而外侧中足和前足处则显著增加。使用楔形物时,拇趾下的最大峰值压力降低了22%,第一跖趾关节下降低了19%,第二至三跖趾关节下降低了8%,足跟下降低了7%。相比之下,佩戴楔形物时,第四至五跖趾关节区域(+11.3%)和外侧跖骨下(+15%)的最大峰值压力增加。
本研究揭示了外侧楔形矫形器对足部足底压力分布的影响。这些关系和变化模式可为临床医生提供有用的指导。在开具外侧楔形足部矫形器之前,应进行全面的足部医学检查。