School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China.
Sci Rep. 2024 Sep 11;14(1):21186. doi: 10.1038/s41598-024-72149-w.
The aim of this study is to compare the efficacy of different exercise interventions for adult flexible flatfoot. Nine databases (PubMed, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), SCOPUS, PRDro, Google Scholar, China National Knowledge Infrastructure(CNKI) and Wanfang data) were systematically searched from their inception until February 2024. The search resulted in 2112 records, with 11 studies included. All networks revealed low heterogeneity and non-significant inconsistency (I ≤ 25.0%). Three network plots were formed for navicular drop. Firstly, compared with the control group, strengthening the posterior tibial muscle + stretching the iliopsoas muscle + TCE (MD: 3.32, 95% CI: 1.78, 4.89), PNF (MD: 1.81, 95%CI: -0.05, 3.70), SFE (MD: 1.23, 95%CI: 1.02, 1.44) all showed better effects. And strengthening the posterior tibial muscle + stretching the iliopsoas muscle + TCE exercise is considered to be the most effective intervention, with SUCRA of 0.97. Secondly, compared with the control group, hip-focused neuromuscular exercise (MD: 6.22, 95% CI: -1.69, 14.12), SFE with EMG biofeedback (MD: -0.81, 95%CI: -1.59, 3.21) all showed better effects. And hip-focused neuromuscular exercise is considered to be the most effective intervention, with SUCRA of 0.92. Thirdly, the internal foot muscle training combined with gluteus muscle strengthening is significantly better than the other two groups, with SUCRA of 0.99. For the foot posture index, comprehensive reinforcement (MD: 1.95, 95% CI - 0.19, 4.03) showed better effects compared with the control group. In the probability ranking table, comprehensive reinforcement is significantly better than the other two groups, with SUCRA of 0.98. For the foot function index, orthoses wear + stretching + eccentric progressive resistive exercise of tibialis posterior is significantly better than the other two groups, with SUCRA of 0.92. In conclusion, various exercise therapies improve the arch shape and function of patients with flexible flatfoot, particularly hip muscle and lower limb overall muscle training.
本研究旨在比较不同运动干预措施对成人柔性平足的疗效。系统检索了 9 个数据库（PubMed、EMBASE、Web of Science、Cochrane 中央对照试验注册库（CENTRAL）、SCOPUS、PRDro、Google Scholar、中国知网（CNKI）和万方数据），检索时间从建库至 2024 年 2 月。检索结果得到 2112 条记录，其中纳入 11 项研究。所有网络均显示低异质性和非显著不一致（I≤25.0%）。为了研究距骨下降，形成了 3 个网络图。首先，与对照组相比，强化胫骨后肌+拉伸髂腰肌+TCE（MD：3.32，95%CI：1.78，4.89）、PNF（MD：1.81，95%CI：-0.05，3.70）、SFE（MD：1.23，95%CI：1.02，1.44）均显示出更好的效果。强化胫骨后肌+拉伸髂腰肌+TCE 运动被认为是最有效的干预措施，SUCRA 为 0.97。其次，与对照组相比，髋关节为焦点的神经肌肉运动（MD：6.22，95%CI：-1.69，14.12）、SFE 结合肌电图生物反馈（MD：-0.81，95%CI：-1.59，3.21）均显示出更好的效果。髋关节为焦点的神经肌肉运动被认为是最有效的干预措施，SUCRA 为 0.92。第三，内部足肌训练结合臀肌强化明显优于其他两组，SUCRA 为 0.99。对于足弓指数，综合强化（MD：1.95，95%CI-0.19，4.03）与对照组相比效果更好。在概率排序表中，综合强化明显优于其他两组，SUCRA 为 0.98。对于足功能指数，矫形器佩戴+拉伸+胫骨后肌离心渐进性抗阻运动明显优于其他两组，SUCRA 为 0.92。总之，各种运动疗法可改善柔性平足患者的足弓形态和功能，尤其是髋关节肌肉和下肢整体肌肉训练。
