Khodaei Banafsheh, Saeedi Hassan, Jalali Maryam, Farzadi Maede, Norouzi Ehsan
School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran 13487-15459, Iran.
Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran 13487-15459, Iran.
Foot (Edinb). 2017 Dec;33:76-80. doi: 10.1016/j.foot.2017.07.002. Epub 2017 Jul 13.
The effect of foot orthoses on plantar pressure distribution has been proven by researchers but there are some controversies about advantages of custom-made foot orthoses to less expensive prefabricated foot orthoses.
Nineteen flatfeet adults between 18 and 45 participated in this study. CAD-CAM foot orthoses were made for these patients according to their foot scan. Prefabricated foot orthoses were prepared according to their foot size. Plantar pressure, force and contact area were measured using pedar-x in-shoe system wearing shoe alone, wearing CAD-CAM foot orthoses and wearing prefabricated foot orthoses. Repeated measures ANOVA model with post-hoc, Bonferroni comparison were used to test differences.
CAD-CAM and prefabricated foot orthoses both decreased pressure and force under 2nd, 3-5 metatarsal and heel regions comparing to shoe alone condition. CAD-CAM foot orthosis increased pressure under lateral toe region in comparison to shoe alone and prefabricated foot orthosis. Both foot orthoses increased pressure and contact area in medial midfoot region comparing to shoe alone condition. Increased forces were seen at hallux and lateral toes by prefabricated foot orthoses in comparison with CAD-CAM foot orthoses and control condition, respectively.
According to the results, both foot orthoses could decrease the pressure under heel and metatarsal area. It seems that the special design of CAD-CAM foot orthoses could not make great differences in plantar pressure distribution in this sample. Further research is required to determine whether these results are associated with different scan systems or design software.
研究人员已证实足部矫形器对足底压力分布有影响，但关于定制足部矫形器相较于价格较低的预制足部矫形器的优势存在一些争议。
19名年龄在18至45岁之间的扁平足成年人参与了本研究。根据这些患者的足部扫描结果制作了计算机辅助设计与制造（CAD-CAM）足部矫形器。预制足部矫形器则根据他们的脚尺寸准备。使用pedar-x鞋内系统分别在仅穿鞋子、穿戴CAD-CAM足部矫形器和穿戴预制足部矫形器的情况下测量足底压力、力和接触面积。采用重复测量方差分析模型及事后Bonferroni比较来检验差异。
与仅穿鞋子的情况相比，CAD-CAM和预制足部矫形器均降低了第二跖骨、第三至第五跖骨以及足跟区域的压力和力。与仅穿鞋子和预制足部矫形器相比，CAD-CAM足部矫形器增加了外侧脚趾区域的压力。与仅穿鞋子的情况相比，两种足部矫形器均增加了足内侧中足区域的压力和接触面积。与CAD-CAM足部矫形器和对照情况相比，预制足部矫形器分别在拇趾和外侧脚趾处增加了力。
根据结果，两种足部矫形器均可降低足跟和跖骨区域的压力。在本样本中，CAD-CAM足部矫形器的特殊设计似乎在足底压力分布方面没有产生很大差异。需要进一步研究以确定这些结果是否与不同的扫描系统或设计软件有关。
