Mouri Hisashi, Kim Wook-Cheol, Arai Yuji, Yoshida Takashi, Oka Yoshinobu, Ikoma Kazuya, Fujiwara Hiroyoshi, Kubo Toshikazu
Hisashi Mouri, Wook-Cheol Kim, Yuji Arai, Takashi Yoshida, Yoshinobu Oka, Kazuya Ikoma, Hiroyoshi Fujiwara, Toshikazu Kubo.
Turk J Phys Med Rehabil. 2019 Feb 14;65(1):9-15. eCollection 2019 Mar.
This study aims to investigate the effectiveness of orthosis therapy using a medial-wedge insole (MWI) with a height of 5 mm and an arch support for children with intoeing gait who are prone to falling.
Between January 1997 and July 2014, a total of 51 children (24 males, 27 females; mean age 5.0 years; range, 3 to 8 years) who were treated for an intoeing gait symptom of easily falling using the MWI (toe-in gait group) were included. The effectiveness of the MWI was evaluated based on the scores reported by children and their parents on a scale. Physical findings of the study group were also compared with a control group consisting of seven healthy children (4 males, 3 females; mean age 5.2 years; range, 3 to 6.2 years). Foot stability with and without MWI were assessed.
The MWI was found to be effective in 80.8% of the toe-in gait group. Bilateral sum of the internal rotation angle of the hip (IRAB) was significantly higher (136±17°) (p=0.007) and bilateral sum of thigh foot angle (TFAB) significantly lower (-27±21°) (p<0.001) before using MWI in the toe-in gait group, compared to the control group. The maximum range of motion of the foot in six children in the toe-in gait group significantly decreased from 14.1±5.0° without MWI to 8.2±3.0° with MWI (p=0.002) in the gait analysis.
These study results suggest that MWI is effective in reducing the risk of falling in children with intoeing gait, mainly due to the internal torsion of the tibia or femur. In addition, it appears to be effective in improving the maximum range of motion of the foot.
本研究旨在调查使用高度为5毫米的内侧楔形鞋垫（MWI）和足弓支撑对易跌倒的内八字步态儿童进行矫形器治疗的有效性。
在1997年1月至2014年7月期间，共纳入51名因内八字步态且易跌倒症状而接受MWI治疗的儿童（24名男性，27名女性；平均年龄5.0岁；范围为3至8岁）。根据儿童及其父母在量表上报告的分数评估MWI的有效性。还将研究组的体格检查结果与由7名健康儿童组成的对照组（4名男性，3名女性；平均年龄5.2岁；范围为3至6.2岁）进行比较。评估了使用MWI和未使用MWI时的足部稳定性。
发现MWI对80.8%的内八字步态组有效。与对照组相比，内八字步态组在使用MWI之前，双侧髋关节内旋角度总和（IRAB）显著更高（136±17°）（p = 0.007），双侧大腿足部角度总和（TFAB）显著更低（-27±21°）（p < 0.001）。在步态分析中，内八字步态组的6名儿童足部的最大活动范围从未使用MWI时的14.1±5.0°显著降至使用MWI时的8.2±3.0°（p = 0.002）。
这些研究结果表明，MWI对于降低因胫骨或股骨内扭转导致内八字步态儿童的跌倒风险有效。此外，它似乎对改善足部的最大活动范围也有效。
