Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada 3351 Boul des Forges, Trois-Rivières, PQ G9A 5H7, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Trois-Rivières, PQ, Canada.
Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Canada 75 University Ave., West Waterloo, ON N2L 3C5, Canada.
Clin Biomech (Bristol). 2022 May;95:105641. doi: 10.1016/j.clinbiomech.2022.105641. Epub 2022 Apr 9.
Foot orthoses are among the most commonly used external supports to treat musculoskeletal disorders. It remains unclear how they change the biomechanics of the lower extremities during functional tasks. This systematic review aimed to determine the effects of foot orthoses on primary outcomes (i.e., kinematics, kinetics and electromyography of the lower extremities) in adults with and without musculoskeletal disorders during functional tasks.
A literature search was conducted for articles published from inception to June 2021 in Medline, CINAHL, SPORTDiscus, Cochrane libraries and PEDro electronic databases. Two investigators independently assessed the titles and abstracts of retrieved articles based on the inclusion criteria. Of the 5578 citations, 24 studies were included in the qualitative synthesis as they reported the effects of foot orthoses on the primary outcomes. Risk of bias of included studies was determined using the modified Downs and Black Quality Index.
During low impact tasks, foot orthoses decrease ankle inversion and increase midfoot plantar forces and pressure. During higher impact tasks, foot orthoses had little effects on electromyography and kinematics of the lower extremities but decreased ankle inversion moments.
Even though the effects of foot orthoses on the biomechanics of the lower extremities seem task-dependent, foot orthoses mainly affected the biomechanics of the distal segments during most tasks. However, few studies determined their effects on the biomechanics of the foot. It remains unclear to what extent foot orthoses features induce different biomechanical effects and if foot orthoses effects change for different populations.
足矫形器是治疗肌肉骨骼疾病最常用的外部支撑之一。目前尚不清楚它们在功能任务中如何改变下肢的生物力学。本系统评价旨在确定足矫形器对有和没有肌肉骨骼疾病的成年人在功能任务中对主要结局（即下肢的运动学、动力学和肌电图）的影响。
从 Medline、CINAHL、SPORTDiscus、Cochrane 图书馆和 PEDro 电子数据库中检索从成立到 2021 年 6 月发表的文章，进行文献搜索。两名调查员根据纳入标准独立评估检索文章的标题和摘要。在 5578 条引文中有 24 项研究被纳入定性综合分析，因为它们报告了足矫形器对主要结局的影响。使用改良的 Downs 和 Black 质量指数确定纳入研究的偏倚风险。
在低冲击任务中，足矫形器可减少踝关节内翻并增加中足跖骨力和压力。在高冲击任务中，足矫形器对下肢的肌电图和运动学几乎没有影响，但可减少踝关节内翻力矩。
尽管足矫形器对下肢生物力学的影响似乎取决于任务，但在大多数任务中，足矫形器主要影响远端节段的生物力学。然而，很少有研究确定它们对足部生物力学的影响。目前尚不清楚足矫形器的特征在多大程度上引起不同的生物力学效应，以及足矫形器的效应是否会因不同人群而改变。
