University of Mohaghegh Ardabili, Faculty of Educational Sciences and Psychology, Department of Physical Education and Sport Sciences, Ardabil, Iran.
University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran.
Hum Mov Sci. 2020 Apr;70:102593. doi: 10.1016/j.humov.2020.102593. Epub 2020 Feb 28.
Flat feet in children negatively affect lower limb alignment and cause adverse health-related problems. The long-term application of foot orthoses (FOs) may have the potential to improve lower limb coordination and its variability.
To evaluate the effects of long-term use of arch support FOs on inter-joint coordination and coordination variability in children with flexible flat feet.
Thirty boys with flexible flat feet were randomly assigned to the experimental (EG) and control groups. The EG used medial arch support FOs during daily activities over a four-month period while the control group received a flat 2-mm-thick insole for the same time period. Lower-limb coordination and variability during the 3 sub-stance phases were quantified using a vector coding technique.
Frontal plane ankle-hip coordination in EG during mid-stance changed to an anti-phase pattern (156.9) in the post-test compared to an in-phase (221.1) in the pre-test of EG and post-test of CG (222.7). Frontal plane knee-hip coordination in EG during loading response (LR) changed to an anti-phase pattern (116) in the post-test compared to an in-phase (35.5) in the pre-test of EG and post-test of CG (35.3). Ankle inversion/eversion-knee internal/external rotation joint coupling angle in EG changed to an in-phase pattern (59) in the post-test compared to a proximal phase (89) in the pre-test. Coupling angle variability increased in the post-test of EG for sagittal plane ankle-hip during push-off, transverse plane ankle-hip during LR and mid-stance, and transverse plane knee-hip during LR and mid-stance compared to pre-test of EG and post-test of CG.
The long-term use of arch support FOs proved to be effective to alter lower limb coordination and coordination variability during walking in children with flexible flat feet. This new insight into coordinative function may be useful for improving corrective exercise strategies planned for children with flat feet.
儿童平足会影响下肢对线，并导致相关健康问题。长期应用足弓支撑矫形鞋垫（foot orthoses，FOs）可能有助于改善下肢协调性及其可变性。
评估长期使用足弓支撑 FO 对柔韧性平足儿童关节间协调性及其可变性的影响。
将 30 名柔韧性平足男孩随机分为实验组（EG）和对照组。EG 在日常活动中使用内侧足弓支撑 FO，为期 4 个月，而对照组在相同时间内使用 2mm 厚的平底鞋垫。使用向量编码技术量化 3 个支撑相下肢协调性及其可变性。
EG 在站立中期的额状面踝关节-髋关节协调从预测试的同相（221.1）变为后测试的反相（156.9），而 CG 在预测试和后测试的同相（222.7）。EG 在负重反应（loading response，LR）期间的额状面膝关节-髋关节协调从预测试的同相（35.5）变为后测试的反相（116），而 CG 在预测试和后测试的同相（35.3）。EG 在踝关节内翻/外翻-膝关节内收/外展关节耦合角在后测试中变为同相（59），而在预测试中为近相（89）。EG 在足离地、LR 和站立中期矢状面踝关节-髋关节，LR 和站立中期横状面踝关节-髋关节，LR 和站立中期横状面膝关节-髋关节的后测试中耦合角的可变性增加，与 EG 的预测试和 CG 的后测试相比。
长期使用足弓支撑 FO 被证明可有效改变柔韧性平足儿童步行时的下肢协调性及其可变性。对协调功能的这种新认识可能有助于改善为平足儿童制定的矫正运动策略。
