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足内翻或足外翻步态的矫形器评估

An Evaluation of Orthotics on In-Toeing or Out-Toeing Gait.

作者信息

Bollepalli Harshavardhan, White Carter J K, Kodra Jacob Dane, Liu Xue-Cheng

机构信息

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.

出版信息

Healthcare (Basel). 2025 Feb 28;13(5):531. doi: 10.3390/healthcare13050531.

DOI:10.3390/healthcare13050531
PMID:40077093
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11898468/
Abstract

: 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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e26/11898468/8fd121b043d1/healthcare-13-00531-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e26/11898468/8fd121b043d1/healthcare-13-00531-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e26/11898468/8fd121b043d1/healthcare-13-00531-g001.jpg

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本文引用的文献

1
Quality of Life and Functional Independence of TheraTogs in Children with Spastic Diplegic Cerebral Palsy: A Randomized Controlled Clinical Trial.TheraTogs对痉挛型双侧瘫脑瘫儿童生活质量和功能独立性的影响:一项随机对照临床试验
J Multidiscip Healthc. 2024 Oct 7;17:4645-4652. doi: 10.2147/JMDH.S485973. eCollection 2024.
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Effects of a range of 6 prefabricated orthotic insole designs on plantar pressure in a healthy population: A randomized, open-label crossover investigation.6 种预制矫形鞋垫设计对健康人群足底压力的影响:一项随机、开放标签交叉研究。
Prosthet Orthot Int. 2024 Aug 1;48(4):474-480. doi: 10.1097/PXR.0000000000000292. Epub 2023 Sep 14.
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Approach to gait disorders and orthotic management in adult onset neuromuscular diseases.
成人起病的神经肌肉疾病的步态障碍及矫形器治疗方法
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Walking and Running of Children with Decreased Femoral Torsion.股骨扭转减小的儿童的行走与跑步
Children (Basel). 2024 May 22;11(6):617. doi: 10.3390/children11060617.
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The efficacy of shoes modification and orthotics in hallux valgus deformity: a comprehensive review of literature.鞋子改良和矫形在拇趾外翻畸形中的疗效:文献综合评价。
Musculoskelet Surg. 2024 Dec;108(4):395-402. doi: 10.1007/s12306-024-00839-9. Epub 2024 Jun 26.
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Accuracy, Validity, and Reliability of Markerless Camera-Based 3D Motion Capture Systems versus Marker-Based 3D Motion Capture Systems in Gait Analysis: A Systematic Review and Meta-Analysis.基于无标记相机的 3D 运动捕捉系统与基于标记的 3D 运动捕捉系统在步态分析中的准确性、有效性和可靠性:系统评价和荟萃分析。
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Tibial derotational osteotomy for idiopathic tibial torsion: A systematic review of surgical indications based on clinical presentation and measurement technique.胫骨扭转截骨术治疗特发性胫骨扭转:基于临床表现和测量技术的手术适应证的系统评价。
Knee Surg Sports Traumatol Arthrosc. 2024 Jul;32(7):1798-1809. doi: 10.1002/ksa.12231. Epub 2024 May 7.
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