Beliefs About and Use of Forefoot Lateral Wedging in Podiatric Medical Practice: A Survey of Podiatric Physicians in New Zealand.

IF 0.5 4区医学 Q4 ORTHOPEDICS

Journal of the American Podiatric Medical Association Pub Date : 2025-01-01 DOI:10.7547/22-022

Aaron Jackson, Kelly Sheerin, Duncan Reid, Matthew R Carroll

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引用次数: 0

Abstract

Background: Evidence is limited exploring the beliefs and application of forefoot lateral wedges (FLWs) in clinical practice by podiatric physicians. We aimed to understand rationale and beliefs that guide the use of FLWs among podiatrists.

Methods: A cross-sectional study of New Zealand (NZ) podiatrists was conducted between May 31 and July 26, 2021. Data were collected anonymously using a Web-based survey platform. The 30-item survey included questions to elicit participant characteristics, why and when podiatrists used orthosis modifications, what biomechanical assumptions influenced clinical decision-making, and how podiatrists fabricated and placed FLWs.

Results: Of 65 survey completers, most were trained in NZ (90.8%), had more than 10 years' experience (70.8%), and worked with a mixed case load (60.0%); 77.3% prescribed zero to ten foot orthoses per week, with FLWs used in 44% of prescriptions. Peroneal tendon injuries and chronic ankle instability were most likely to be treated with FLWs. The most common belief was that FLWs increase first metatarsophalangeal joint range of motion (86.2%). The FLWs were regularly manufactured from 3-mm (73.8%), medium-density ethyl vinyl acetate (92.9%) and positioned from the calcaneocuboid joint (54.8%) to the sulcus (78.6%).

Conclusions: Podiatrists in NZ frequently use FLWs. These were generally manufactured from 3-mm, medium-density ethyl vinyl acetate and positioned from the calcaneocuboid joint to the sulcus. The most common rationales for use were to increase first metatarsophalangeal joint range of motion, shift the center of pressure medially, and balance the foot. A discordance was found between the theories of foot function on which clinicians placed the greatest importance and the biomechanical outcomes they thought were being achieved. Survey data also highlighted inconsistency in the nomenclature used to describe FLW thickness and inclination.

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对新西兰足科医生前脚侧楔的信念和使用的调查

背景：足科医生在临床实践中对前脚外侧楔（flw）的信念和应用的研究证据有限。我们的目的是了解指导足科医生使用flw的基本原理和信念。方法：在2021年5月31日至7月26日期间对新西兰（NZ）足病医生进行横断面研究。数据是通过基于网络的调查平台匿名收集的。30个项目的调查包括引出参与者特征的问题，足病医生为什么和何时使用矫形器修改，什么生物力学假设影响临床决策，以及足病医生如何制造和放置flw。结果：在65名调查完成者中，大多数在新西兰接受过培训（90.8%），有10年以上的经验（70.8%），并处理过混合病例负荷（60.0%）；77.3%的人每周处方0到10英尺的矫形器，44%的处方使用flw。腓骨肌腱损伤和慢性踝关节不稳定最有可能用flw治疗。最常见的观点是flw增加了第一跖指关节的活动范围（86.2%）。定期制作3-mm(73.8%)，中密度乙酸乙酯（92.9%），定位于跟骨八方关节（54.8%）至沟（78.6%）。结论：新西兰足科医生经常使用flw。这些通常由3毫米，中等密度的乙基醋酸乙烯制成，从跟骰关节到沟放置。最常见的使用理由是增加第一跖指关节的活动范围，将压力中心向内侧移动，并平衡足部。临床医生认为最重要的足部功能理论与他们认为正在实现的生物力学结果之间存在不一致。调查数据还强调了用于描述FLW厚度和倾斜度的术语的不一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Podiatric Medical Association 医学-整形外科

CiteScore

1.10

自引率

0.00%

发文量

128

审稿时长

6-12 weeks

期刊介绍： The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.