Fuchs M C H W, Hermans M M N, Kars H J J, Hendriks J G E, van der Steen M C
Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA Eindhoven, The Netherlands; Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600 PD Eindhoven, The Netherlands.
Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600 PD Eindhoven, The Netherlands.
Foot (Edinb). 2020 Dec;45:101744. doi: 10.1016/j.foot.2020.101744. Epub 2020 Sep 9.
Forefoot offloading shoes are used to reduce pressure on specific regions of the foot. Aim of the pressure reduction is to aid healing of the soft and bony tissues and prevent complications by treating foot disorders. A great variety of forefoot offloading shoes are available. In a first step to investigate the appropriate use of these footwear in orthopedic settings, we studied plantar pressure distribution and wearing characteristics of three forefoot offloading shoes namely the Mailand, OrthoWedge and Podalux in a healthy population. Twenty subjects walked in a randomized order wearing three forefoot offloading shoes and a reference shoe for six minutes. The Pedar system was used to measure the pressure in 7 regions. Peak pressure and pressure time integral were analyzed as measures of pressure distribution. Furthermore, wearing characteristics were addressed using a Numeric Rating Scale. Pressure distribution and wearing characteristics of the forefoot offloading shoes were compared to a reference shoe. The Mailand and OrthoWedge shoes significantly reduced peak pressure with more than 80% under the hallux and more than 45% under MTH1 (p<.001). The Podalux did not show significant peak pressure reduction under the forefoot compared to the reference shoe. Under the lesser toes, the MTH4-5 region and heel region the Podalux shoe showed even a significant increase in peak pressure (p=.001). Looking at wearing characteristics, the Podalux and reference shoe scored significantly better than the other two forefoot offloading shoes (p<.01). In this study the differences between different forefoot offloading shoes was assessed. The Mailand and OrthoWedge shoes gave the best pressure reduction in the forefoot but are less comfortable in use. The Podalux rocker shoe showed opposite results. Next step is a patient study to compare our results in a patient population.
前足减压鞋用于减轻足部特定区域的压力。减压的目的是帮助软组织和骨组织愈合，并通过治疗足部疾病预防并发症。市面上有各种各样的前足减压鞋。为了研究这些鞋类在骨科环境中的合理使用，我们在健康人群中研究了三种前足减压鞋，即米兰鞋、Orthowedge鞋和Podalux鞋的足底压力分布和穿着特性。20名受试者以随机顺序穿着三种前足减压鞋和一双参照鞋行走6分钟。使用Pedar系统测量7个区域的压力。分析峰值压力和压力时间积分作为压力分布的指标。此外，使用数字评分量表评估穿着特性。将前足减压鞋的压力分布和穿着特性与参照鞋进行比较。米兰鞋和Orthowedge鞋显著降低了峰值压力，拇趾下降低超过80%，第一跖趾关节下降低超过45%（p<0.001）。与参照鞋相比，Podalux鞋在前足下方未显示出显著的峰值压力降低。在小脚趾、第四和第五跖趾关节区域以及足跟区域，Podalux鞋的峰值压力甚至显著增加（p = 0.001）。从穿着特性来看，Podalux鞋和参照鞋的评分明显优于其他两种前足减压鞋（p<0.01）。在本研究中评估了不同前足减压鞋之间的差异。米兰鞋和Orthowedge鞋在前足减压方面效果最佳，但使用起来不太舒适。Podalux摇摆鞋则呈现相反的结果。下一步是进行患者研究，以在患者群体中比较我们的结果。
