Suh Jee Hyun, Yoon Seo Yeon
Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea.
Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, South Korea.
Prosthet Orthot Int. 2023 Dec 1;47(6):614-620. doi: 10.1097/PXR.0000000000000238. Epub 2023 Apr 4.
Pediatric flexible flat foot (PFFF) is often associated with pain along the medial longitudinal arch and potential disability. There are several conservative treatment options for PFFF, ranging from intrinsic muscle exercises to orthosis, including University of California Biomechanics Laboratory (UCBL) and custom-made semi-rigid insoles.
To investigate and compare the effect of UCBL and custom-made semi-rigid insoles on pedobarographic and radiologic parameters in PFFF.
This study prepared a retrospective chart review of 143 children diagnosed with PFFF between the age of 4 and 12 years.
Data of twenty-seven children with PFFF who were prescribed foot orthoses between the age of 4 and 12 years were retrospectively reviewed. Medical charts were retrospectively reviewed, and pedobarographic and radiological parameters assessed before and 1 year after application of orthoses were reviewed.
The difference in the calcaneal pitch angle and the center of pressure excursion index (CPEI) were significantly improved in the custom-made semi-rigid insole group compared to that in the UCBL group. The contact area ratio of the midfoot and toe and CPEI at 1 year after wearing the insole was significantly improved in the custom-made semi-rigid insole group compared to that in the UCBL group. Moreover, the calcaneal pitch angle and CPEI were significantly improved 1 year after application of the insole in the custom-made semi-rigid insole group.
This result showed that the custom-made semi-rigid insole is more effective in improving the deviation of the center pressure curve and calcaneal pitch angle than the UCBL. The custom-made semi-rigid insole may help relieve foot instability during gait and improve the medial longitudinal arch in children with PFFF.
小儿柔性扁平足(PFFF)常伴有内侧纵弓疼痛及潜在功能障碍。PFFF有多种保守治疗方法,从内在肌肉锻炼到矫形器,包括加利福尼亚大学生物力学实验室(UCBL)矫形器和定制半刚性鞋垫。
研究并比较UCBL矫形器和定制半刚性鞋垫对PFFF患儿足底压力和放射学参数的影响。
本研究对143例4至12岁被诊断为PFFF的儿童进行回顾性病历分析。
回顾性分析27例4至12岁佩戴足部矫形器的PFFF患儿的数据。对病历进行回顾性分析,并评估矫形器应用前及应用1年后的足底压力和放射学参数。
与UCBL组相比,定制半刚性鞋垫组的跟骨倾斜角和压力中心偏移指数(CPEI)差异有显著改善。与UCBL组相比,定制半刚性鞋垫组在佩戴鞋垫1年后中足和脚趾的接触面积比及CPEI有显著改善。此外,定制半刚性鞋垫组在应用鞋垫1年后跟骨倾斜角和CPEI有显著改善。
该结果表明,定制半刚性鞋垫在改善压力中心曲线偏差和跟骨倾斜角方面比UCBL矫形器更有效。定制半刚性鞋垫可能有助于缓解PFFF患儿步态期间的足部不稳,并改善内侧纵弓。