Jor Abu, Lau Noelle W K, He Yufan, Daryabor Aliyeh, Lam Wing-Kai, Hobara Hiroaki, Gao Fan, Kobayashi Toshiki
Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong; Department of Leather Engineering, Faculty of Mechanical Engineering, Khulna University of Engineering & Technology, Khulna, Bangladesh.
Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong.
Gait Posture. 2025 Sep;121:281-294. doi: 10.1016/j.gaitpost.2025.06.003. Epub 2025 Jun 6.
Foot orthoses (FO) are commonly prescribed by clinicians to manage foot and ankle conditions and improve biomechanical function.
Are there any potential kinematic and kinetic effects of FO on individuals with asymptomatic flatfeet during running?
The database search from inception to September 2024, including PubMed, Scopus, Web of Science, Embase, ProQuest, Cochrane, and CINAHL, identified 12 studies including 18 different orthotic interventions. These included FO with either arch-support-only or arch-support with medial-side posts. The methodological quality and risk of bias were assessed using ROBINS-I index. Primary outcome measures were joint angles and moments of midfoot/arch, ankle, and knee.
Our meta-analysis revealed non-significant changes with the arch-support-only FO. However, random effects analysis indicated that arch-support FO with rearfoot and forefoot medial posts significantly decreased standardized mean difference (SMD) in peak ankle eversion angles (SMD=-0.41, 95 %CI[-0.78 to -0.04]), peak ankle invertor moments (SMD=-0.51, 95 %CI[-0.97 to -0.05]), and Achilles tendon loading rates (SMD=-0.94, 95 %CI[-1.78 to -0.09]) during running.
The findings of this meta-analysis suggest that arch-support FO with strategically placed medial posts may enhance stability and alleviate internal loading on the foot-ankle complex during running in individuals with asymptomatic flatfeet. Specifically, FO with medial posts at both the rearfoot and forefoot reduced peak ankle eversion angle, although this is based on only six studies. FO with such features may also decrease loading on the invertor muscles and Achilles tendon during running in individuals with asymptomatic flatfeet. Further research is needed to confirm these findings in larger populations.
临床医生通常会开具足部矫形器（FO）来治疗足踝疾病并改善生物力学功能。
在跑步过程中，FO对无症状扁平足个体是否存在潜在的运动学和动力学影响？
从数据库建立至2024年9月进行检索，包括PubMed、Scopus、科学网、Embase、ProQuest、Cochrane和CINAHL，共识别出12项研究，包含18种不同的矫形干预措施。这些措施包括仅带有足弓支撑的FO或带有内侧支柱的足弓支撑FO。使用ROBINS-I指数评估方法学质量和偏倚风险。主要结局指标为中足/足弓、踝关节和膝关节的关节角度和力矩。
我们的荟萃分析显示，仅带有足弓支撑的FO无显著变化。然而，随机效应分析表明，带有后足和前足内侧支柱的足弓支撑FO在跑步过程中显著降低了踝关节峰值外翻角度的标准化均值差（SMD=-0.41，95%CI[-0.78至-0.04]）、踝关节峰值内翻力矩（SMD=-0.51，95%CI[-0.97至-0.05]）以及跟腱负荷率（SMD=-0.94，95%CI[-1.78至-0.09]）。
这项荟萃分析的结果表明，在无症状扁平足个体跑步过程中，带有策略性放置内侧支柱的足弓支撑FO可能会增强稳定性并减轻足踝复合体的内部负荷。具体而言，后足和前足均带有内侧支柱的FO降低了踝关节峰值外翻角度，尽管这仅基于六项研究。具有此类特征的FO在无症状扁平足个体跑步过程中也可能会减少内翻肌和跟腱的负荷。需要进一步研究以在更大规模人群中证实这些发现。
