Kalron Alon, Pasitselsky Diana, Greenberg-Abrahami Michal, Achiron Anat
Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel; and Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Israel(∗).
Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel(†).
PM R. 2015 Jan;7(1):17-25. doi: 10.1016/j.pmrj.2014.08.942. Epub 2014 Aug 19.
Balance and gait deficits are common in people with multiple sclerosis (MS). Physical interventions directed at improving balance and walking abilities have been implemented using various approaches. Nonetheless, no mode of training has been universally agreed upon.
To determine whether textured insoles have immediate effects on postural control and spatiotemporal parameters of gait and plantar sensation in people with people with MS and to explore effects 4 weeks after insole wear as to whether any immediate effects are maintained over time.
Within-subject experimental study with a 4-week intervention phase.
Multiple Sclerosis Center, Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel-Hashomer, Israel.
Twenty-five relapsing-remitting patients diagnosed with MS, 16 women and 9 men, aged 49.6 years (standard deviation = 6.5 years).
Textured insoles customized according to foot size and adapted to the participant's casual shoes.
Spatiotemporal parameters of gait and center of pressure (CoP) excursions during static postural control were studied using the Zebris FDM-T Treadmill. Light-touch and pressure-sensation thresholds were determined using the Semmes-Weinstein monofilaments test.
Textured insoles did not alter static postural control parameters when examined with eyes open. Examination during the eyes-closed task demonstrated an immediate reduction in the CoP path length (298.4 mm, standard error = 49.7 mm, versus 369.9 mm, SE = 56.3 mm; P = .04) and sway rate (12.0 mm/s, standard error = 1.4 mm/s, versus 15.1 mm/s, standard error = 1.6 mm/s; P = .03) after insertion of the textured insoles compared to casual shoes alone. These findings were maintained at termination of the insole 4-week intervention period. In terms of spatiotemporal parameters of gait, differences were not observed between casual shoes and shoes with textured insoles at baseline. Likewise, no differences were observed between initial and concluding gait trials. Significant differences in plantar sensitivity measures were not observed after the insole 4-week intervention phase.
Although there were improvements in some aspects of balance, the efficacy of textured insoles in the MS population remains unclear.
平衡和步态缺陷在多发性硬化症（MS）患者中很常见。针对改善平衡和行走能力的物理干预已采用多种方法实施。然而，尚未就训练模式达成普遍共识。
确定纹理鞋垫对MS患者的姿势控制、步态时空参数和足底感觉是否有即时影响，并探讨鞋垫佩戴4周后的效果，即任何即时影响是否随时间持续存在。
为期4周干预阶段的受试者内实验研究。
以色列特拉哈希默尔市谢巴医疗中心康复先进技术中心多发性硬化症中心。
25名复发缓解型MS患者，16名女性和9名男性，年龄49.6岁（标准差 = 6.5岁）。
根据脚的尺寸定制纹理鞋垫，并适配参与者的便鞋。
使用Zebris FDM-T跑步机研究步态的时空参数和静态姿势控制期间的压力中心（CoP）偏移。使用Semmes-Weinstein单丝试验确定轻触和压力感觉阈值。
睁眼检查时，纹理鞋垫未改变静态姿势控制参数。闭眼任务期间的检查表明，与仅穿便鞋相比，插入纹理鞋垫后CoP路径长度立即缩短（298.4毫米，标准误差 = 49.7毫米，而之前为369.9毫米，标准误差 = 56.3毫米；P = 0.04），摇摆率降低（12.0毫米/秒，标准误差 = 1.4毫米/秒，而之前为15.1毫米/秒，标准误差 = 1.6毫米/秒；P = 0.03）。这些结果在鞋垫4周干预期结束时仍然存在。就步态的时空参数而言，基线时便鞋和带纹理鞋垫的鞋子之间未观察到差异。同样，初始和最终步态试验之间也未观察到差异。鞋垫4周干预阶段后，足底敏感性测量未观察到显著差异。
尽管在平衡的某些方面有所改善，但纹理鞋垫在MS人群中的疗效仍不明确。
