Brasiliano Paolo, Alvini Martina, Di Stanislao Eugenio, Vannozzi Giuseppe, Di Rosa Giuseppe, Camomilla Valentina
Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome "Foro Italico", Rome, Italy.
Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy.
Heliyon. 2022 Oct 12;8(10):e11021. doi: 10.1016/j.heliyon.2022.e11021. eCollection 2022 Oct.
Idiopathic toe walking (ITW) is a gait deviation characterized by forefoot contact with the ground, possibly enhancing the risk of falling and causing Achilles' tendon shortening and psychological discomfort. Between possible treatments, foot orthosis may limit ITW when worn. With these premises, the effects of a novel foot orthosis (A.Dyn.O.®) on ankle function were analyzed in children with ITW during gait.
Twenty-one children were recruited in the study after ITW diagnosis. At follow-up assessment after a habituation period of at least two weeks, participants walked in barefoot condition and while wearing A.Dyn.O.®. Kinetics and kinematics were derived from a multi-segment foot model using an optoelectronic system. Gait spatiotemporal parameters, ankle kinetic and kinematic and rockers timing were analyzed. Lastly, ITW severity was classified according to Alvarez classification. Differences between conditions were verified with paired t-test. Statistical parametric mapping was used to evaluate differences in the entire kinematic and kinetic waveforms.
Wearing A.Dyn.O.®, step cadence was reduced, step length, stance phase and stride duration increased; physiological heel rocker was present, thus postponing the timing of ankle and forefoot rockers; ankle dorsiflexion angular excursion, range of motion, maximal dorsiflexor and plantarflexor moments together with maximal power absorption and production were all amplified.
While wearing it, A.Dyn.O.® limited gait deviations typical of ITW and improved ITW severity classification for most of the participants. These findings suggest that the use of A.Dyn.O.® may assist ITW treatment, preventing children from toe walking and thus limiting its side effects.
特发性足尖行走（ITW）是一种步态异常，其特征为前足着地，这可能会增加跌倒风险，并导致跟腱缩短和心理不适。在可能的治疗方法中，足部矫形器在佩戴时可能会限制足尖行走。基于这些前提，本研究分析了一种新型足部矫形器（A.Dyn.O.®）在ITW儿童步态期间对踝关节功能的影响。
21名儿童在被诊断为ITW后被纳入本研究。在至少两周的适应期后的随访评估中，参与者分别在赤足状态和佩戴A.Dyn.O.®的情况下行走。使用光电系统从多节段足部模型中获取动力学和运动学数据。分析了步态时空参数、踝关节动力学和运动学以及摇摆时间。最后，根据阿尔瓦雷斯分类法对ITW严重程度进行分类。使用配对t检验验证不同条件之间的差异。采用统计参数映射来评估整个运动学和动力学波形的差异。
佩戴A.Dyn.O.®时，步频降低，步长、支撑相和步幅持续时间增加；出现了生理性足跟摇摆，从而推迟了踝关节和前足摇摆的时间；踝关节背屈角偏移、运动范围、最大背屈肌和跖屈肌力矩以及最大能量吸收和产生均增大。
佩戴A.Dyn.O.®时，它限制了ITW典型的步态偏差，并改善了大多数参与者的ITW严重程度分类。这些发现表明，使用A.Dyn.O.®可能有助于ITW的治疗，防止儿童足尖行走，从而限制其副作用。
