Kyung Min Gyu, Seo Hyun Seok, Yoon Young Sik, Kim Dae-Yoo, Lee Seung Min, Lee Dong Yeon
Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Clin Orthop Surg. 2024 Dec;16(6):987-993. doi: 10.4055/cios24106. Epub 2024 Jun 27.
The choice of an appropriate type of orthosis depends on the patient's specific condition and needs. Different types of orthoses can affect plantar pressure distribution during certain gait patterns. Toe and heel gaits are common patterns of gait assigned for optimal recovery in patients with foot or ankle injuries. This study aimed to evaluate differences in plantar pressure between postoperative shoes and walker boots during toe and heel gaits in healthy individuals.
A total of 30 healthy individuals with a mean age of 21.7 ± 1.2 years were included in this study. Two types of gaits, toe and heel, were performed while wearing each orthosis on the right side of the foot. A standardized running shoe was worn on the left side of the foot. Plantar pressure variables including contact area, peak pressure, and maximum force were collected using the Pedar-X in-shoe pressure measuring system.
During toe gait, while both orthoses demonstrated similar offloading in the hindfoot areas, walker boots were superior in reducing the peak pressure (first toe, = 0.003; second to fifth toes, < 0.001) and contact area (first toe, = 0.003; second to fifth toes, = 0.003) in the forefoot areas. During heel gait, both orthoses demonstrated similar offloading in the toe areas; however, the walker boots were superior in reducing the peak pressure in the lateral hindfoot ( < 0.001).
The results of our study can serve as a guideline for orthopedic physicians in prescribing an appropriate type of orthosis during specific types of gait for patients following foot and ankle injury and postoperative recovery.
选择合适类型的矫形器取决于患者的具体病情和需求。不同类型的矫形器会在特定步态模式下影响足底压力分布。趾行和跟行步态是为足部或踝部损伤患者的最佳恢复而指定的常见步态模式。本研究旨在评估健康个体在趾行和跟行步态中术后鞋与助行靴之间的足底压力差异。
本研究共纳入30名平均年龄为21.7±1.2岁的健康个体。在右脚穿戴每种矫形器的同时进行两种步态，即趾行和跟行。左脚穿着标准化跑鞋。使用Pedar-X鞋内压力测量系统收集包括接触面积、峰值压力和最大力在内的足底压力变量。
在趾行步态中，虽然两种矫形器在后足区域均表现出相似的减负效果，但助行靴在前足区域降低峰值压力（第一趾，=0.003；第二至第五趾，<0.001）和接触面积（第一趾，=0.003；第二至第五趾，=0.003）方面更具优势。在跟行步态中，两种矫形器在趾部区域均表现出相似的减负效果；然而，助行靴在降低后足外侧的峰值压力方面更具优势（<0.001）。
我们的研究结果可为骨科医生在为足部和踝部损伤及术后恢复患者的特定步态类型开具合适类型的矫形器时提供指导。
