澳大利亚足病医生对中足骨关节炎的评估与管理:当前实践的横断面调查
Assessment and management of midfoot osteoarthritis by podiatrists in Australia: a cross-sectional survey of current practice.
作者信息
Lim Polly Q X, Menz Hylton B, Landorf Karl B, Kaminski Michelle R, Paterson Kade L, Munteanu Shannon E
机构信息
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia.
Department of Podiatry, Monash Health, Melbourne, VIC, 3168, Australia.
出版信息
Rheumatol Int. 2025 May 12;45(6):141. doi: 10.1007/s00296-025-05881-9.
Midfoot osteoarthritis (OA) is a common and disabling condition, yet lacks clinical guidelines for its assessment and management. This study aimed to investigate strategies used by Australian podiatrists to assess and manage midfoot OA. An exploratory cross-sectional survey of podiatrists working in Australia was conducted. Respondents were invited through professional organisations to complete an online questionnaire on their usual assessment and management practices for midfoot OA, based on a vignette. Between November 2022 and July 2023, 103 participants (52% women, mean age 40 years) with an average of 15 years of clinical experience responded. Physical assessments (including history taking and musculoskeletal assessments) (96%) and medical imaging (90%) were commonly used diagnostic methods, with palpation (96%), passive movement testing (95%) and x-ray imaging (62%) frequently reported. Associated impairments were assessed with range of motion testing of the midfoot (96%), gait analysis (95%), functional tests (83%), muscle strength (72%), and observation of static alignment (71%), including foot posture (69%). Most participants assessed comorbidities (93%), body composition (66%) and cognitive/psychosocial impairments (62%). Treatment approaches included footwear advice (97%), orthotic therapy (85%), strapping/taping (81%), education (79%), and exercise therapy (75%). One-third (34%) expected a 'satisfactory' treatment response within two months, and 36% would refer to another healthcare practitioner for co-management between two and three months if treatment was ineffective. A wide range of approaches are used to assess and manage midfoot OA. These findings have potential to inform the design of future studies in developing valid assessment approaches and effective interventions for this condition.
中足骨关节炎(OA)是一种常见的致残性疾病,但缺乏关于其评估和管理的临床指南。本研究旨在调查澳大利亚足病医生评估和管理中足OA所采用的策略。对在澳大利亚工作的足病医生进行了一项探索性横断面调查。通过专业组织邀请受访者根据一个病例 vignette 完成一份关于他们对中足OA的常规评估和管理实践的在线问卷。在2022年11月至2023年7月期间,103名参与者(52%为女性,平均年龄40岁)做出了回应,他们平均拥有15年的临床经验。体格检查(包括病史采集和肌肉骨骼评估)(96%)和医学影像检查(90%)是常用的诊断方法,其中触诊(96%)、被动运动测试(95%)和X线成像(62%)被频繁提及。通过中足活动范围测试(96%)、步态分析(95%)、功能测试(83%)、肌肉力量(72%)以及静态对线观察(71%)(包括足部姿势观察(69%))来评估相关功能障碍。大多数参与者评估了合并症(93%)、身体成分(66%)和认知/心理社会功能障碍(62%)。治疗方法包括鞋类建议(97%)、矫形器治疗(85%)、绑扎/贴扎(81%)、教育(79%)和运动疗法(75%)。三分之一(34%)的人期望在两个月内获得“满意”的治疗反应,36%的人表示如果治疗无效,会在两到三个月内转诊给其他医疗从业者进行联合管理。评估和管理中足OA使用了广泛的方法。这些发现有可能为未来研究设计提供参考,以开发针对这种疾病的有效评估方法和干预措施。