Department of Physical Therapy, Creighton University, Omaha, NE.
Department of Health and Human Performance, Texas State University, San Marcos.
J Athl Train. 2023 Nov 1;58(11-12):941-951. doi: 10.4085/1062-6050-0162.22.
To critically assess the literature focused on strength training of the intrinsic foot muscles (IFMs) and resulting improvements in foot function.
A search of electronic databases (PubMed, CINAHL, Scopus, and SPORTDiscus) was completed between January 2000 and March 2022.
Randomized control trials with an outcome of interest and at least 2 weeks of IFM exercise intervention were included. Outcomes of interest were broadly divided into 5 categories of foot posture (navicular drop and Foot Posture Index), namely: balance, strength, patient-reported outcomes, sensory function, and motor performance. The PEDro scale was used to assess the methodologic quality of the included studies with 2 independent reviewers rating each study. Studies with a PEDro score greater than 4/10 were included.
Data extracted by 2 independent reviewers were design, participant characteristics, inclusion and exclusion criteria, type of intervention, outcomes, and primary results. We performed a random-effects meta-analysis to analyze the difference between intervention and control groups for each outcome when at least 2 studies were available. Standardized mean differences (SMDs) describe effect sizes with 95% CIs (SMD ranges). When the CI crossed zero, the effect was not significant.
Thirteen studies were included, and IFM exercise interventions were associated with decreasing navicular drop (SMD range = 0.37, 1.83) and Foot Posture Index (SMD range = 1.03, 1.69) and improving balance (SMD range = 0.18, 1.86), strength (SMD range = 0.06, 1.52), and patient-reported outcomes for disability (SMD range = 0.12, 1.00), with pooled effect sizes favoring the IFM intervention over the control. The IFM exercises were not superior (SMD range = -0.15, 0.66) for reducing pain. We could not perform a meta-analysis for sensory function and motor performance, as only 1 study was available for each outcome; however, these results supported the use of IFM strength training.
Strength training of the IFMs was helpful for patients in improving foot and ankle outcomes.
批判性评估专注于内在足部肌肉（IFM）力量训练的文献以及由此带来的足部功能改善。
2000 年 1 月至 2022 年 3 月期间，对电子数据库（PubMed、CINAHL、Scopus 和 SPORTDiscus）进行了检索。
纳入了具有感兴趣结局且 IFM 运动干预至少 2 周的随机对照试验。感兴趣的结局广泛分为 5 类足弓（舟骨下降和足弓指数），即：平衡、力量、患者报告的结局、感觉功能和运动表现。使用 PEDro 量表对纳入研究的方法学质量进行评估，由 2 位独立的审稿人对每项研究进行评分。PEDro 评分大于 4/10 的研究被纳入。
由 2 位独立的审稿人提取的资料包括设计、参与者特征、纳入和排除标准、干预类型、结局和主要结果。当至少有 2 项研究可用时，我们进行了随机效应荟萃分析，以分析干预组与对照组之间每个结局的差异。标准化均数差（SMD）描述了具有 95%置信区间（SMD 范围）的效应大小。当 CI 跨越零界点时，效应不显著。
纳入了 13 项研究，IFM 运动干预与降低舟骨下降（SMD 范围=0.37，1.83）和足弓指数（SMD 范围=1.03，1.69）以及改善平衡（SMD 范围=0.18，1.86）、力量（SMD 范围=0.06，1.52）和患者报告的残疾结局（SMD 范围=0.12，1.00）相关，汇总效应大小表明 IFM 干预优于对照组。IFM 运动对减轻疼痛没有优势（SMD 范围=-0.15，0.66）。由于每个结局只有 1 项研究可用，因此我们无法进行感觉功能和运动表现的荟萃分析；然而，这些结果支持使用 IFM 力量训练。
IFM 的力量训练有助于改善患者的足部和踝关节结局。
