Grin L, van der Steen M C, Wijnands S D N, van Oorschot L, Besselaar A T, Vanwanseele B
KU Leuven, Department of Movement Sciences, Tervuursevest 101, 3001, Heverlee, Belgium; Fontys University of Applied Sciences, Dominee Theodoor Fliednerstraat 2, 5361 BN, Eindhoven, the Netherlands.
Department of Orthopaedic Surgery & Trauma, Máxima Medical Center, Postbus 90052, 5600 PD, Eindhoven, the Netherlands; Department of Orthopaedic Surgery & Trauma, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA, Eindhoven, the Netherlands.
Gait Posture. 2021 Oct;90:415-421. doi: 10.1016/j.gaitpost.2021.09.185. Epub 2021 Sep 20.
Understanding the kinematic characteristics of relapse clubfoot compared to successfully treated clubfoot could aid early identification of a relapse and improve treatment planning. The usage of a multi segment foot model is essential in order to grasp the full complexity of the multi-planar and multi-joint deformity of the clubfoot.
The purpose of this study was to identify differences in foot kinematics, using a multi-segment foot model, during gait between patients with Ponseti treated clubfoot with and without a relapse and age-matched healthy controls.
A cross-sectional study was carried out including 11 patients with relapse clubfoot, 11 patients with clubfoot and 15 controls. Gait analysis was performed using an extended Helen Hayes model combined with the Oxford Foot Model. Statistical analysis included statistical parametric mapping and discrete analysis of kinematic gait parameters of the pelvis, hip, knee, ankle, hindfoot and forefoot in the sagittal, frontal and transversal plane.
The relapse group showed significantly increased forefoot adduction in relation with the hindfoot and the tibia. Furthermore, this group showed increased forefoot supination in relation with the tibia during stance, whereas during swing increased forefoot supination in relation with the hindfoot was found in patients with relapse clubfoot compared with non-relapse clubfoot.
Forefoot adduction and forefoot supination could be kinematic indicators of relapse clubfoot, which might be useful in early identification of a relapse clubfoot. Subsequently, this could aid the optimization of clinical decision making and treatment planning for children with clubfoot.
了解复发性马蹄内翻足与成功治疗的马蹄内翻足相比的运动学特征，有助于早期识别复发情况并改善治疗方案。使用多节段足部模型对于全面掌握马蹄内翻足多平面和多关节畸形的复杂性至关重要。
本研究的目的是使用多节段足部模型，确定接受潘塞缇治疗的马蹄内翻足患者复发组与未复发组以及年龄匹配的健康对照组在步态期间足部运动学的差异。
进行了一项横断面研究，纳入11例复发性马蹄内翻足患者、11例马蹄内翻足患者和15名对照组。使用扩展的海伦·海斯模型结合牛津足部模型进行步态分析。统计分析包括对骨盆、髋、膝、踝、后足和前足在矢状面、额状面和横断面的运动步态参数进行统计参数映射和离散分析。
复发组与后足和胫骨相关的前足内收明显增加。此外，该组在站立期与胫骨相关的前足旋后增加，而在摆动期，与未复发的马蹄内翻足患者相比，复发性马蹄内翻足患者与后足相关的前足旋后增加。
前足内收和前足旋后可能是复发性马蹄内翻足的运动学指标，这可能有助于早期识别复发性马蹄内翻足。随后，这可以帮助优化马蹄内翻足儿童的临床决策和治疗方案。
