Chen Kun-Chung, Chen Yueh-Chi, Yeh Chih-Jung, Hsieh Ching-Lin, Wang Chun-Hou
Department of Physical Therapy.
Physical Therapy Room, Chung Shan Medical University Hospital.
Medicine (Baltimore). 2019 Sep;98(36):e17074. doi: 10.1097/MD.0000000000017074.
Flatfoot is a common reason for parents to seek help from health care professionals, and limited evidence is available regarding the effects of insoles on preschool-aged children. This study mainly investigated the effect of insoles on symptomatic flatfoot in preschool-aged children and followed up the changes in footprints after 1 year.This study was a prospective, observational cohort study. Children aged 3 to 5 years old who exhibit the signs of flatfoot feet were recruited from the kindergartens in the central Taiwan between March 2010 and December 2013. The Chippaux-Smirak index (CSI) was used to determine whether the footprints of children were associated with flatfoot. The children were divided into an insole group and a no-insole group according to diagnoses by doctors. This study used the modified shoe insole as the intervention, and the CSI measured and followed up the changes in footprints after 1 year.A total of 466 preschool-aged children aged 3 to 5 years old with flatfoot completed the 1-year follow-up study. Of these, 123 children (men 77; women 46) were in the insole group and 343 children (men 187; women 156) were in the no-insole group. After the insoles were worn for 1 year, the CSI values of the children with symptomatic flatfoot decreased by 9.7%, and the 5-year-old children had the biggest change (effect size = 1.25). In the insole group, 34.1% of the footprints were determined as normal at 1-year follow-up, and CSI values decreased by 17.5%. High prevalence of joint laxity was found in both groups (insole group: 34.5%; no-insole group: 35.1%). Of the children in the insole group, the proportion of joint laxity was significantly higher in the flatfoot group (43.1%) than in the normal group (17.7%).This study showed that wearing insoles indeed can reduce the signs of flatfoot in preschool-aged children, and the effect is better in 5-year-old children. It is suggested that insoles can be provided as a conservative treatment for preschool-aged children with symptomatic flatfoot.
扁平足是家长向医疗保健专业人员寻求帮助的常见原因，而关于鞋垫对学龄前儿童的影响，现有证据有限。本研究主要调查了鞋垫对学龄前儿童症状性扁平足的影响，并随访了1年后脚印的变化。本研究是一项前瞻性观察队列研究。2010年3月至2013年12月期间，从台湾中部的幼儿园招募了3至5岁有扁平足迹象的儿童。采用奇波-斯米拉指数（CSI）来确定儿童的脚印是否与扁平足有关。根据医生的诊断，将儿童分为鞋垫组和无鞋垫组。本研究采用改良鞋垫作为干预措施，通过CSI测量并随访1年后脚印的变化。共有466名3至5岁有扁平足症状的学龄前儿童完成了1年的随访研究。其中，123名儿童（男77名；女46名）在鞋垫组，343名儿童（男187名；女156名）在无鞋垫组。佩戴鞋垫1年后，有症状扁平足儿童的CSI值下降了9.7%，5岁儿童的变化最大（效应量=1.25）。在鞋垫组，1年随访时34.
