Eng J J, Pierrynowski M R
Department of Community Health, Faculty of Medicine, University of Toronto, Ontario, Canada.
Phys Ther. 1994 Sep;74(9):836-44. doi: 10.1093/ptj/74.9.836.
Although foot orthotics are often prescribed to alter the lower-extremity mechanics during the stance period of gait, there is little documentation of the actual effect of foot orthotics on the movement of the lower-extremity joints during walking and running. This study examined the effect of foot orthotics on the range of motion of the talocrural/subtalar joint and the knee joint in three dimensions during walking and running.
Ten female adolescent subjects, aged 13 to 17 years (X = 14.4, SD = 1.1) who were diagnosed with patellofemoral pain syndrome and exhibited forefoot varus greater than 6 degrees and/or calcaneal valgus greater than 6 degrees participated in the study.
Thirty strides of walking and running on a treadmill were recorded for each of the orthotic and nonorthotic conditions for each subject using an optoelectronic recording technique. Analyses of variance for repeated measures were performed on the range of motion of the talocrural/subtalar joint and knee joint for each plane of motion (ie, six separate analyses). The main factors of each analysis were the effect of the orthotic (orthotic condition versus nonorthotic condition), mode of ambulation (walking and running), and phase of the stance period (contact, mid-stance, and propulsion).
No differences were found in sagittal-plane movements. Reductions of 1 to 3 degrees occurred with orthotic use for the talocrural/subtalar joint during walking and running in the frontal and transverse planes. The orthotics reduced knee motion in the frontal plane during the contact and mid-stance phases of walking, but increased the motion during the contact and mid-stance phases of running.
This study shows that corrections to the static position of forefoot varus and calcaneal valgus can result in changes in transverse- and frontal-plane motion of the foot and knee during walking and running.
尽管足部矫形器常用于改变步态站立期的下肢力学，但关于足部矫形器对行走和跑步时下肢关节运动实际效果的文献记载较少。本研究探讨了足部矫形器对行走和跑步过程中距下关节/距跟关节及膝关节三维活动范围的影响。
10名年龄在13至17岁（平均年龄X = 14.4，标准差SD = 1.1）的女性青少年受试者，她们被诊断为髌股疼痛综合征，且前足内翻大于6度和/或跟骨外翻大于6度，参与了本研究。
使用光电记录技术，为每位受试者在使用矫形器和不使用矫形器的情况下，各记录30步的行走和跑步过程。对距下关节/距跟关节及膝关节在每个运动平面（即六个单独分析）的活动范围进行重复测量方差分析。每个分析的主要因素包括矫形器的影响（矫形器条件与非矫形器条件）、行走方式（行走和跑步）以及站立期阶段（着地、站立中期和推进期）。
矢状面运动未发现差异。在行走和跑步时，使用矫形器可使距下关节/距跟关节在额状面和横断面上的活动范围减少1至3度。矫形器在行走着地和站立中期阶段减少了膝关节在额状面的活动，但在跑步着地和站立中期阶段增加了膝关节的活动。
本研究表明，矫正前足内翻和跟骨外翻的静态位置可导致行走和跑步时足部和膝关节在横断面和额状面运动的变化。
