Shi Yuanyuan, Pang Haotian, Xu Hang, Li Xiaotong, Cao Yuqing, Merryweather Andrew, Zheng Pengfei, Xiang Jie
The Second Clinical Medicine College, Xuzhou Medical University, Xuzhou, China.
Department of Orthopaedic surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
Gait Posture. 2022 Mar;93:191-197. doi: 10.1016/j.gaitpost.2022.02.003. Epub 2022 Feb 9.
Leg length discrepancy (LLD) is commonly associated with compensatory gait strategies leading to musculoskeletal disorders of the lower extremity and lumbar spine. Orthotic insole (OI) is considered as a conservative treatment for patients with mild LLD, especially for children. However, the restoration of normal gait when wearing OI with foot lift are still poorly understood.
What are the immediate effects of OI on the gait patterns in children with mild LLD?
Gait data and plantar pressure data were collected for 12 children with mild anatomical LLD in barefoot and OI conditions. Paired t-test was performed to determine the changes in gait between these two conditions, and also the symmetry between limbs in the same condition for spatiotemporal, kinematic, and kinetic variables.
Children with mild LLD showed an immediate gait improvement confirmed by increased step length and velocity, decreased peak plantar pressure in both limbs with OI. Additionally, the significant between-limb differences disappeared for peak ankle dorsiflexion, hip adduction, pelvis upward obliquity and also second peak plantar pressure with OI, which improved gait symmetry.
This study provides a better understanding of the immediate effect of OI with foot lift on biomechanical changes in gait, which identify that OI with foot lift could be a potential therapeutic option for children with mild structural LLD to improve gait metrics.
腿长差异（LLD）通常与代偿性步态策略相关，会导致下肢和腰椎的肌肉骨骼疾病。矫形鞋垫（OI）被认为是轻度LLD患者，尤其是儿童的一种保守治疗方法。然而，对于穿着带足垫的OI时正常步态的恢复情况仍知之甚少。
OI对轻度LLD儿童的步态模式有哪些即时影响？
收集了12名轻度解剖学LLD儿童在赤脚和OI条件下的步态数据和足底压力数据。进行配对t检验以确定这两种条件下步态的变化，以及相同条件下双下肢在时空、运动学和动力学变量方面的对称性。
轻度LLD儿童在穿着OI时步长和速度增加，双下肢峰值足底压力降低，证实步态立即得到改善。此外，穿着OI时，踝关节背屈峰值、髋关节内收、骨盆向上倾斜以及第二个足底压力峰值的显著双侧差异消失，改善了步态对称性。
本研究更好地理解了带足垫的OI对步态生物力学变化的即时影响，确定带足垫的OI可能是改善轻度结构性LLD儿童步态指标的一种潜在治疗选择。
