Kayll Samual A, Hinman Rana S, Bryant Adam L, Bennell Kim L, Rowe Patrick L, Paterson Kade L
Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
Br J Sports Med. 2023 Jul;57(13):872-881. doi: 10.1136/bjsports-2022-106542. Epub 2023 Mar 10.
To evaluate the effects of biomechanical foot-based interventions (eg, footwear, insoles, taping and bracing on the foot) on patellofemoral loads during walking, running or walking and running combined in adults with and without patellofemoral pain or osteoarthritis.
Systematic review with meta-analysis.
MEDLINE, CINAHL, SPORTdiscus, Embase and CENTRAL.
English-language studies that assessed effects of biomechanical foot-based interventions on peak patellofemoral joint loads, quantified by patellofemoral joint pressure, reaction force or knee flexion moment during gait, in people with or without patellofemoral pain or osteoarthritis.
We identified 22 footwear and 11 insole studies (participant n=578). Pooled analyses indicated low-certainty evidence that minimalist footwear leads to a small reduction in peak patellofemoral joint loads compared with conventional footwear during running only (standardised mean difference (SMD) (95% CI) = -0.40 (-0.68 to -0.11)). Low-certainty evidence indicated that medial support insoles do not alter patellofemoral joint loads during walking (SMD (95% CI) = -0.08 (-0.42 to 0.27)) or running (SMD (95% CI) = 0.11 (-0.17 to 0.39)). Very low-certainty evidence indicated rocker-soled shoes have no effect on patellofemoral joint loads during walking and running combined (SMD (95% CI) = 0.37) (-0.06 to 0.79)).
Minimalist footwear may reduce peak patellofemoral joint loads slightly compared with conventional footwear during running only. Medial support insoles may not alter patellofemoral joint loads during walking or running and the evidence is very uncertain about the effect of rocker-soled shoes during walking and running combined. Clinicians aiming to reduce patellofemoral joint loads during running in people with patellofemoral pain or osteoarthritis may consider minimalist footwear.
评估基于足部生物力学的干预措施（如鞋类、鞋垫、贴扎和足部支具）对患有或未患有髌股疼痛或骨关节炎的成年人在行走、跑步或行走与跑步相结合过程中髌股关节负荷的影响。
系统评价与荟萃分析。
MEDLINE、CINAHL、SPORTdiscus、Embase和CENTRAL。
评估基于足部生物力学的干预措施对髌股关节峰值负荷影响的英文研究，通过髌股关节压力、反作用力或步态期间的膝关节屈曲力矩进行量化，研究对象为患有或未患有髌股疼痛或骨关节炎的人群。
我们确定了22项关于鞋类的研究和11项关于鞋垫的研究（参与者n = 578）。汇总分析表明，证据确定性较低，即与传统鞋类相比，极简主义鞋类仅在跑步时会使髌股关节峰值负荷略有降低（标准化均值差（SMD）（95%置信区间）= -0.40（-0.68至-0.11））。证据确定性较低表明，内侧支撑鞋垫在行走（SMD（95%置信区间）= -0.08（-0.42至0.27））或跑步（SMD（95%置信区间）= 0.11（-0.17至0.39））时不会改变髌股关节负荷。证据确定性非常低表明，摇椅底鞋在行走和跑步相结合时对髌股关节负荷没有影响（SMD（95%置信区间）= 0.37（-0.06至: 0.79））。
与传统鞋类相比，极简主义鞋类可能仅在跑步时略微降低髌股关节峰值负荷。内侧支撑鞋垫在行走或跑步时可能不会改变髌股关节负荷，并且关于摇椅底鞋在行走和跑步相结合时的效果证据非常不确定。旨在减轻患有髌股疼痛或骨关节炎的人群跑步时髌股关节负荷的临床医生可能会考虑使用极简主义鞋类。
