Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.
Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.
Gait Posture. 2023 Sep;105:163-170. doi: 10.1016/j.gaitpost.2023.08.003. Epub 2023 Aug 10.
Customized foot orthoses (CFOs) are often recommended for the management of plantar heel pain. However, there is a lack of information regarding lower limb and multi-segment foot motion during gait.
This study aimed to determine the effects of heat moulded CFOs on foot and lower limb kinematics when compared with prefabricated foot orthoses (PFOs) and wearing no orthoses (shod condition), and to determine the short-term effects of CFOs on pain intensity and foot function.
The immediate effects of CFOs on the lower limb and multi-segment foot motion were assessed. Participants were then asked to use the CFOs for one month and foot pain, function, and temporal-spatial parameters were assessed at baseline and at one month follow up.
Thirty-five participants (22 females), aged 40.1 (10.5) years, with a mean duration of symptoms of 12.59 months were recruited. The symptomatic limbs showed a higher forefoot varus angle and greater rearfoot and forefoot corrections were required compared to the non-symptomatic limbs. When compared with PFOs and shod conditions, CFOs provided the least forefoot and knee motion in the transverse plane during contact phase (P < 0.05, d=0.844-1.720), least rearfoot motion in the coronal plane during midstance (P < 0.05, d=0.652), and least forefoot motion in the frontal plane, knee motion in the transverse plane, and hallux motion during the propulsive phase (P < 0.05, d=0.921-1.513). Significant improvements were seen for foot pain and function (P < 0.05, d=1.390-2.231) with significant increases in cadence and walking velocity after one month of CFO use (P < 0.05, d=0.315-0.353), and those most likely to respond had greater pain and less ankle eversion (P < 0.05, d=0.855-1.115).
CFOs appear to improve pathological biomechanics associated with plantar heel pain. After one month follow up, the CFOs decreased pain intensity and increased foot function, and showed significant improvements in temporal and spatial parameters of gait.
定制足矫形器（CFO）常用于治疗足底跟痛。然而，关于步态时下肢和多节段足运动的信息较少。
本研究旨在比较热成型 CFO 与预制足矫形器（PFO）和不穿鞋（穿鞋状态）对足部和下肢运动学的影响，并确定 CFO 对疼痛强度和足部功能的短期影响。
立即评估 CFO 对下肢和多节段足运动的影响。然后，要求参与者使用 CFO 一个月，并在基线和一个月随访时评估足部疼痛、功能和时空参数。
共招募了 35 名（22 名女性）年龄 40.1（10.5）岁，症状平均持续 12.59 个月的参与者。症状侧的前足内翻角较高，需要更大的后足和前足矫正。与 PFO 和穿鞋状态相比，CFO 在接触阶段（P<0.05，d=0.844-1.720）提供的前足和膝关节在横平面的运动最小，中足时后足在冠状面的运动最小（P<0.05，d=0.652），前足在额状面、膝关节在横平面和大脚趾在推进阶段的运动最小（P<0.05，d=0.921-1.513）。使用 CFO 一个月后，足部疼痛和功能显著改善（P<0.05，d=1.390-2.231），步频和步行速度显著增加（P<0.05，d=0.315-0.353），最有可能产生反应的患者疼痛更严重，踝关节外翻程度更小（P<0.05，d=0.855-1.115）。
CFO 似乎可以改善与足底跟痛相关的病理性生物力学。随访一个月后，CFO 降低了疼痛强度，增加了足部功能，并显著改善了步态的时空参数。
