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制定一项临床预测规则,以识别可能从生物力学抗内翻贴扎中获益的足底足跟痛患者:一项前瞻性队列研究。

Development of a clinical prediction rule to identify patients with plantar heel pain likely to benefit from biomechanical anti-pronation taping: A prospective cohort study.

作者信息

Wu Fu-Lien, Shih Yi-Fen, Lee Si-Huei, Luo Hong-Ji, Wang Wendy Tzyy-Jiuan

机构信息

Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.

Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

Phys Ther Sport. 2018 May;31:58-67. doi: 10.1016/j.ptsp.2018.01.010. Epub 2018 Feb 2.

Abstract

OBJECTIVES

To develop a clinical prediction rule (CPR) to identify patients with plantar heel pain (PHP) likely to benefit from biomechanical anti-pronation taping (BAPT).

DESIGN

A prospective cohort study.

SETTING

An outpatient rehabilitation department in a general hospital.

PARTICIPANTS

Seventy-five patients with PHP.

MAIN OUTCOME MEASURES

After completing a series of physical examinations, all patients received BAPT and were evaluated with a numeric rating scale for pain intensity, the patient-specific functional scale and foot function index (FFI) for function, and the global rating of change for perceived improvement.

RESULTS

Twenty-eight patients achieved a successful outcome. A CPR with 6 significant variables was identified by a multivariate logistic regression: FFI score less than 33.3, hip adduction angle of the most affected side was greater than the contralateral side, ankle plantarflexors and hip abductors on the most affected side were not weaker than those on the contralateral side, ankle invertors on the most affected side were weaker than the contralateral side, and having more than 2 painful sites in the low back and lower extremity regions. If 5 or more of the 6 predictors were presented, the probability of success increased from 37% to 80%.

CONCLUSIONS

A CPR has been developed to identify patients with PHP likely to benefit from BAPT.

摘要

目的

制定一项临床预测规则(CPR),以识别可能从生物力学抗内翻贴扎(BAPT)中获益的足底足跟痛(PHP)患者。

设计

一项前瞻性队列研究。

地点

一家综合医院的门诊康复科。

参与者

75例PHP患者。

主要观察指标

完成一系列体格检查后,所有患者均接受BAPT,并采用数字疼痛评分量表评估疼痛强度,采用患者特异性功能量表和足部功能指数(FFI)评估功能,采用整体改善评级评估感知到的改善情况。

结果

28例患者取得成功结果。通过多因素逻辑回归确定了一个包含6个显著变量的CPR:FFI评分低于33.3、患侧髋关节内收角度大于对侧、患侧踝关节跖屈肌和髋关节外展肌不比对侧弱、患侧踝关节内翻肌比对侧弱、以及腰背部和下肢区域有2个以上疼痛部位。如果6个预测因素中出现5个或更多,则成功概率从37%提高到80%。

结论

已制定一项CPR,以识别可能从BAPT中获益的PHP患者。

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