Department of Sports and Exercise Medicine, Institute of Human Movement Science, University of Hamburg, Germany; Department of Sports and Rehabilitation Medicine, BG Trauma Hospital of Hamburg, Germany.
Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Germany.
Gait Posture. 2019 Jul;72:109-122. doi: 10.1016/j.gaitpost.2019.05.031. Epub 2019 Jun 1.
BACKGROUND: Medial longitudinal arch characteristics are thought to be a contributing factor to lower limb running injuries. Running biomechanics associated with different foot types have been proposed as one of the potential underlying mechanisms. However, no systematic review has investigated this relationship. RESEARCH QUESTION: The aim of this study was to conduct a systematic literature search and synthesize the evidence about the relationship between foot posture and running biomechanics. METHODS: For this systematic review and meta-analysis different electronic databases (Pubmed, Web of Science, Cochrane, SportDiscus) were searched to identify studies investigating the relationship between medial longitudinal arch characteristics and running biomechanics. After identification of relevant articles, two independent researchers determined the risk of bias of included studies. For homogenous outcomes, data pooling and meta-analysis (random effects model) was performed, and levels of evidence determined. RESULTS: Of the 4088 studies initially identified, a total of 25 studies were included in the qualitative review and seven in the quantitative analysis. Most studies had moderate and three studies a low risk of bias. Moderate evidence was found for a relationship between foot posture and subtalar joint kinematics (small pooled effects: -0.59; 95%CI -1.14 to - 0.003) and leg stiffness (small pooled effect: 0.59; 95%CI 0.18 to 0.99). Limited or very limited evidence was found for a relationship with forefoot kinematics, tibial/leg rotation, tibial acceleration/shock, plantar pressure distribution, plantar fascia tension and ankle kinetics as well as an interaction of foot type and footwear regarding tibial rotation. SIGNIFICANCE: While there is evidence for an association between foot posture and subtalar joint kinematics and leg stiffness, no clear relationship was found for other biomechanical outcomes. Since a comprehensive meta-analysis was limited by the heterogeneity of included studies future research would benefit from consensus in foot assessment and more homogenous study designs.
背景：人们认为内侧纵弓特征是下肢跑步损伤的一个促成因素。已经提出了与不同足型相关的跑步生物力学是潜在的潜在机制之一。但是，没有系统的综述研究过这种关系。
研究问题：本研究的目的是进行系统的文献检索，并综合有关足弓结构和跑步生物力学之间关系的证据。
方法：为了进行这项系统的综述和荟萃分析，我们在不同的电子数据库（Pubmed、Web of Science、Cochrane、SportDiscus）中进行了搜索，以确定研究内侧纵弓特征与跑步生物力学之间关系的研究。在确定了相关文章之后，两名独立的研究人员确定了纳入研究的偏倚风险。对于同质的结果，进行了数据汇总和荟萃分析（随机效应模型），并确定了证据水平。
结果：最初确定的 4088 项研究中，共有 25 项研究进行了定性综述，7 项进行了定量分析。大多数研究的偏倚风险为中度，三项研究为低度。有中度证据表明足弓结构与距下关节运动学（小的汇总效应：-0.59；95%CI-1.14 至 0.003）和腿部刚度（小的汇总效应：0.59；95%CI 0.18 至 0.99）之间存在关系。对于前足运动学、胫骨/腿部旋转、胫骨加速度/冲击、足底压力分布、足底筋膜张力和踝关节动力学以及足型和鞋类对胫骨旋转的相互作用，证据有限或非常有限。
意义：虽然有证据表明足弓结构与距下关节运动学和腿部刚度之间存在关联，但对于其他生物力学结果没有发现明确的关系。由于纳入研究的异质性限制了综合荟萃分析，因此未来的研究将受益于足部评估的共识和更同质的研究设计。
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