Bollepalli Harshavardhan, White Carter J K, Kodra Jacob Dane, Liu Xue-Cheng
Department of Orthopedic Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Greenfield, WI 53227, USA.
Healthcare (Basel). 2025 Feb 28;13(5):531. doi: 10.3390/healthcare13050531.
: In-toeing and out-toeing gait are rotational deformities commonly observed in children with neuromuscular conditions. These gait abnormalities often result from internal tibial torsion, increased femoral anteversion, and metatarsus adductus. This study was conducted to create a comprehensive evaluation of the effectiveness of lower extremity orthotics as a non-operative treatment option, given their regular use in clinical settings. The aim of this literature review was to understand the efficacy of various orthotic devices in correcting rotational deformities in the transverse plane, thereby improving ambulation stability and 3D joint motion. : Literature published after 1 January 1990 was reviewed, utilizing databases such as CENTRAL (Wiley), CINAHL (EBSCO), Medline (OVID), Scopus (Elsevier), and Web of Science (Clarivate). In totality, 13 studies were included, evaluating 365 participants with neuromuscular conditions using various orthotic devices. : Among these studies, two were randomized control trials (Level 1), nine were quasi-experimental studies (Level 2), and two were case studies (Level 4). Quality assessment determined that 69% of the included studies had a low risk of bias, while 31% demonstrated a moderate risk. Compression garments and rotational systems showcased the greatest change in proximal lower extremity rotation at 19.73° ± 1.57 and 24.13° ± 8.49, respectively. The most significant difference in foot progression angle is through the use of rotational systems, 19° ± 26.87. : In a short-term treatment, children with neuromuscular disorders exhibiting in-toeing or out-toeing gait may benefit from different types of orthoses. Compression garments may aid joint alignment and enhance proprioception, rotational systems correct alignment with precise adjustability, AFOs that achieve effective stabilization can deliver benefits in the transverse plane, and foot orthotics may be appropriate for mild gait abnormality management.
内八字和外八字步态是神经肌肉疾病患儿中常见的旋转畸形。这些步态异常通常由胫骨内旋、股骨前倾增加和内收足引起。鉴于下肢矫形器在临床环境中的常规使用,本研究旨在全面评估其作为非手术治疗选择的有效性。这篇文献综述的目的是了解各种矫形器在纠正横平面旋转畸形方面的疗效,从而改善步行稳定性和三维关节运动。
回顾了1990年1月1日之后发表的文献,使用了CENTRAL(Wiley)、CINAHL(EBSCO)、Medline(OVID)、Scopus(Elsevier)和Web of Science(Clarivate)等数据库。总共纳入了13项研究,评估了365名使用各种矫形器的神经肌肉疾病患者。
在这些研究中,两项为随机对照试验(1级),九项为准实验研究(2级),两项为病例研究(4级)。质量评估确定,69%的纳入研究存在低偏倚风险,而31%显示出中度风险。压缩衣和旋转系统在近端下肢旋转方面的变化最大,分别为19.73°±1.57和24.13°±8.49。足前进角的最大显著差异是通过使用旋转系统,为19°±26.87。
在短期治疗中,表现出内八字或外八字步态的神经肌肉疾病患儿可能会从不同类型的矫形器中受益。压缩衣可能有助于关节对线并增强本体感觉,旋转系统可通过精确的可调节性纠正对线,实现有效稳定的踝足矫形器可在横平面带来益处,而足部矫形器可能适用于轻度步态异常的管理。