不同定制足部矫形器对结构性拇趾受限患者足关节刚度的影响：一项准实验研究。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2024.106423

Magdalena Martinez-Rico , Gabriel Gijon-Nogueron , Ana Belen Ortega-Avila , Luis Enrique Roche-Seruendo , Ana Climent-Pedrosa , Kevin Deschamps , Enrique Sanchis-Sales

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引用次数: 0

摘要

背景：动态活动时第一跖趾关节的正常背屈对于有效推进至关重要。治疗性足部矫形可以解决这一人群所面临的病理机械负荷和关节运动学问题。本研究旨在评估两种不同类型的定制足部矫形器对结构性拇趾限制症患者步行时后脚、中足和第一跖趾关节刚度的影响。方法：本准实验研究采用单队列重复测量设计。选取了24例结构性拇局限性患者。使用极简SAGURO氯丁橡胶鞋，在三种条件下比较两种定制足矫形器-切割式和前足稳定元件：鞋，鞋与切割式定制足矫形器，鞋与前足稳定元件足矫形器。使用改进的Bruening模型捕获运动数据。我们检查了可变刚度（以Nm/Kg/rad量化）。结果：仅前足稳定器定制足矫形器与患者在第一跖趾关节推进阶段的动态刚度存在显著差异（R2 = 0.07 p = 0.027），差异为0.86 Nm/kg/rad。在所有条件下，动态刚度在站立周期的任何其他阶段都没有显著差异。解释：与步行鞋相比，前足稳定元件，特别是前足稳定元件，显著增加了第一跖趾关节的刚度。

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Effect of different custom-made foot orthotics on foot joint stiffness in individuals with structural hallux limitus: A quasi-experimental study

Background

Normal dorsiflexion of the first metatarsophalangeal joint during dynamic activities is critical for effective propulsion. Therapeutic foot orthotics may address the pathomechanical loading and joint kinematics issues faced by this population. This study aims to evaluate the effect of two different types of Custom-made foot orthosis compared to shod condition on the stiffness of the rearfoot, midfoot, and 1st metatarsophalangeal joint during walking in patients with Structural Hallux Limitus.

Methods

This quasi-experimental study used a repeated-measures design with a single cohort. 24 participants with structural hallux limitus were sampled. Two custom-made Foot Orthotics – a cut-out and an anterior forefoot stabiliser element – were compared under three conditions using minimalist SAGURO neoprene shoes: shod, shod with cut-out custom-made foot orthosis, and shod with anterior forefoot stabiliser element foot orthosis. Kinematic data were captured using a modified Bruening model. We examined the variable stiffness (quantified in Nm/Kg/rad).

Findings

Significant differences were found in dynamic stiffness only between Anterior forefoot stabiliser element custom-made foot orthosis, and the patient shod during the propulsion phase at the 1st Metatarsophalangeal joint (R² = 0,07 p = 0.027) and a difference of 0,86 Nm/kg/rad. No significant differences were observed for dynamic stiffness in any other phase of the stance period across all conditions.

Interpretation

The Anterior forefoot stabiliser element, in particular, significantly increases the stiffness of the 1st Metatarsophalangeal joint compared to walking shod.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.