Vimal Amit Kumar, Sharma Shivani, Gahlawat Bindu, Pandian G, Sural Sumit
Department of Orthotics and Prosthetics, Pt. Deendayal Upadhyaya National Institute for Persons With Physical Disabilities (Divyangjan), 4-Vishnu Digambar Marg, New Delhi, 110002 India.
Student at Department of Orthotics and Prosthetics, Pt. Deendayal Upadhyaya National Institute for Persons With Physical Disabilities (Divyangjan), New Delhi, 110002, India.
Indian J Orthop. 2022 Jul 20;56(11):1897-1905. doi: 10.1007/s43465-022-00699-0. eCollection 2022 Nov.
Flexible flat foot or pes planovalgus is a common foot deformity, and silicone and customized insole are commonly used as a non-operative treatment modality of flexible planovalgus. However, there are inadequate data and limited evidence available regarding the immediate effects of their use in midfoot and hindfoot of adults. The aim of this study is to quantify and compare the radiological parameters immediately on weightbearing with silicon and customized insoles and without them to assess the effect on midfoot and hindfoot of the flexible planovalgus in adults.
A total number of 11 (8 females and 3 males) subjects with flexible pes planovalgus deformity without any other foot deformity were included in the study. Each patient was assessed three times in a random sequence without and with use of either silicon insoles or customized insole. The radiographic parameters without insole, with silicon insole, and with customized insole conditions were calculated using online available computer software Kinovea.
One-way ANOVA analysis was performed between groups (without insole, with silicone insole and with customized insole). The hindfoot parameters depicted that calcaneal inclination angle (CIA) was significant increased ( = 0.000) and talar declination angle (TDA) was significantly decreased ( = 0.003) only with the use of customized insole compared to without insole. The midfoot parameters depicted that the first metatarsal angle (FMA) and talonavicular coverage angle (TCA) were significantly lower with customized insole ( = 0.00) as compared to other two groups and significantly lower with silicone insole ( = 0.00) as compared to without insole group.
The results imply that the compressibility of the insole material affects the forefoot and hindfoot biomechanics differently. This study concludes that silicone insole affects only the midfoot which bears 45% of bodyweight and customized insole affects both midfoot and more importantly the hindfoot which bears 55% of bodyweight.
柔韧性扁平足或平足外翻是一种常见的足部畸形，硅胶鞋垫和定制鞋垫通常用作柔韧性扁平足的非手术治疗方式。然而，关于它们在成人中足和后足使用的即时效果的数据不足且证据有限。本研究的目的是量化并比较在负重时使用硅胶鞋垫和定制鞋垫与不使用时的放射学参数，以评估对成人柔韧性扁平足中足和后足的影响。
本研究纳入了11名（8名女性和3名男性）患有柔韧性平足外翻畸形且无任何其他足部畸形的受试者。每位患者按照随机顺序在不使用鞋垫、使用硅胶鞋垫或定制鞋垫的情况下接受三次评估。使用在线可用的计算机软件Kinovea计算无鞋垫、有硅胶鞋垫和有定制鞋垫情况下的放射学参数。
在各组（无鞋垫、有硅胶鞋垫和有定制鞋垫）之间进行单因素方差分析。后足参数显示，与不使用鞋垫相比，仅使用定制鞋垫时跟骨倾斜角（CIA）显著增加（P = 0.000），距骨倾斜角（TDA）显著减小（P = 0.003）。中足参数显示，与其他两组相比，定制鞋垫组的第一跖骨角（FMA）和距舟覆盖角（TCA）显著更低（P = 0.00），与无鞋垫组相比，硅胶鞋垫组的这两个角度也显著更低（P = 0.00）。
结果表明鞋垫材料的可压缩性对前足和后足生物力学的影响不同。本研究得出结论，硅胶鞋垫仅影响承担45%体重的中足，而定制鞋垫影响中足，更重要的是影响承担55%体重的后足。
