Kaczmarczyk Katarzyna, Barton Gabor J, Wiszomirska Ida, Wychowanski Michal
Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland.
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK.
J Clin Med. 2021 Feb 5;10(4):608. doi: 10.3390/jcm10040608.
Hallux valgus (HV) is a gait-altering orthopedic deformity, somewhat more prevalent in women, which often affects both limbs. Although surgery is a commonly applied treatment, there is no consensus in the literature on how invasive HV correction affects spatiotemporal gait parameters, or how quickly improvement can be expected. We investigated gait parameters in female HV patients who underwent bilateral surgical correction of hallux valgus, both preoperatively and 18 weeks following surgery (a timeframe relevant from the perspective of physical therapy), and also in relation to a non-HV control group.
A total of 23 women aged 40-70 years, with moderate to severe HV deformity in both feet, were assessed preoperatively and 18 weeks postoperatively, and an age-matched control group of 76 healthy women was also assessed. A total of 22 spatiotemporal parameters were collected during 30 s walks over an electronic walkway (Zebris Medical System).
Of the 22 parameters analyzed, significant differences between the preoperative experimental and control groups were found only in 4 parameters (Velocity, Right step time, Total double support and Stride time), but in 16 parameters between the postoperative experimental and control groups (the greatest impact being found for: Left and Right Step time, Stride time, Cadence, Right Foot rotation, Left Step length (%leg length) and Stride length (%leg length)).
Women after bilateral HV correction did not exhibit improved (i.e., more normal) gait parameters at 18 weeks postoperatively; rather, they showed more gait abnormalities than preoperatively. These findings urge longer-term planning of postoperative rehabilitation, involving continual evaluation of gait improvement.
拇外翻（HV）是一种改变步态的骨科畸形，在女性中更为常见，且常累及双下肢。尽管手术是常用的治疗方法，但关于侵入性拇外翻矫正如何影响时空步态参数，以及预期改善速度有多快，文献中尚无共识。我们对接受双侧拇外翻手术矫正的女性HV患者在术前和术后18周（从物理治疗角度来看这是一个相关的时间框架）的步态参数进行了研究，并与非HV对照组进行了比较。
共有23名年龄在40 - 70岁之间、双足患有中度至重度HV畸形的女性接受了术前和术后18周的评估，同时还评估了一个由76名健康女性组成的年龄匹配对照组。在电子步道（Zebris医疗系统）上进行30秒步行期间，共收集了22个时空参数。
在分析的22个参数中，术前实验组和对照组之间仅在4个参数（速度、右步时间、总双支撑时间和步幅时间）上存在显著差异，但术后实验组和对照组之间在16个参数上存在显著差异（影响最大的参数为：左、右步时间、步幅时间、步频、右脚旋转、左步长（%腿长）和步幅长（%腿长））。
双侧HV矫正术后的女性在术后18周时步态参数并未改善（即更接近正常）；相反，她们表现出比术前更多的步态异常。这些发现促使对术后康复进行更长期的规划，包括持续评估步态改善情况。
