Güner Senem, Haghari Sema, Alsancak Serap, Uluğ Naime, İnanıcı Fatma
Department of Prosthetics and Orthotics, Vocational School of Health Services, Ankara University, Ankara, Turkey.
Department of Physical Medicine and Rehabilitation, Ethica Hospital, İstanbul,Turkey.
Turk J Phys Med Rehabil. 2018 Feb 25;64(3):261-267. doi: 10.5606/tftrd.2018.2246. eCollection 2018 Sep.
This study aims to determine the effect of insoles with arch support on gait patterns in patients with multiple sclerosis (MS) and somatosensory impairment.
Ten patients (7 females, 3 males; mean age 34.9±6.8 years; range, 48 to 35 years) with clinically definite relapsing remitting MS and age- and sex-matched 10 healthy volunteers (7 females, 3 males; mean age 33.8±3.2; range, 40 to 31 years) were included in the study between January 2011 and January 2012. A medial longitudinal arch and transverse arch supporting polyurethane insole covered with foam shaped using plantar sensory feedback was used. Three-dimensional gait analysis was performed via a Vicon 612 system with six cameras. The participants initially walked barefoot and, then, wore the insoles in their short slipper socks.
All participants were evaluated in terms of kinetics, kinematics, and temporospatial parameters with a gait analysis system. The patients with MS showed improvements in cadence and walking speed when using the insoles. Sagittal plane angles of the hip and knee were increased while using insoles (p<0.05) and ankle plantar flexion was found to be decreased, compared to barefoot walking (p<0.05).
Our study results suggest that insole with arch support affects gait cycle, but does not improve gait impairments in patients with MS. Insoles may ensure plantar sensory feedback in feet during walking, which increases pressure in the mid-forefoot area.
本研究旨在确定带足弓支撑的鞋垫对多发性硬化症（MS）和躯体感觉障碍患者步态模式的影响。
2011年1月至2012年1月期间，本研究纳入了10例临床确诊为复发缓解型MS的患者（7例女性，3例男性；平均年龄34.9±6.8岁；年龄范围35至48岁）以及10名年龄和性别匹配的健康志愿者（7例女性，3例男性；平均年龄33.8±3.2岁；年龄范围31至40岁）。使用了一种内侧纵弓和横弓支撑的聚氨酯鞋垫，其覆盖有根据足底感觉反馈塑形的泡沫。通过配备六个摄像头的Vicon 612系统进行三维步态分析。参与者最初赤脚行走，然后穿着带有鞋垫的短袜拖鞋行走。
使用步态分析系统对所有参与者的动力学、运动学和时空参数进行了评估。MS患者在使用鞋垫时步频和步行速度有所改善。与赤脚行走相比，使用鞋垫时髋部和膝部矢状面角度增加（p<0.05），且发现踝关节跖屈减少（p<0.05）。
我们的研究结果表明，带足弓支撑的鞋垫会影响步态周期，但不能改善MS患者的步态障碍。鞋垫可能会在行走过程中确保足部的足底感觉反馈，从而增加前脚掌中部区域的压力。
