矫形鞋垫干预柔韧性扁平足儿童青少年下肢功能的Scoping综述

doi:10.3969/j.issn.1006-9771.2024.11.012

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (11): 1343-1350.doi: 10.3969/j.issn.1006-9771.2024.11.012

矫形鞋垫干预柔韧性扁平足儿童青少年下肢功能的Scoping综述

黄兆欣¹, 唐乐天², 肖晓飞²(), 娄彦涛³()

1.山东中医药高等专科学校，山东烟台市 264199
2.滨州医学院特殊教育与康复学院，山东烟台市 264003
3.沈阳体育学院运动健康学院，辽宁沈阳市 110102

收稿日期:2024-11-08 出版日期:2024-11-25 发布日期:2024-12-05
通讯作者: 肖晓飞(1980-)，男，汉族，山东荣成市人，博士，副教授，主要研究方向：康复科学。E-mail： xxf1013@126.com；娄彦涛(1979-)，男，汉族，河南开封市人，博士，教授，主要研究方向：运动生物力学理论与实践。E-mail： louyantao2008@163.com
作者简介:黄兆欣(1997-)，女，汉族，山东菏泽市人，硕士研究生，主要研究方向：肌肉骨骼康复。
基金资助:
国家体育总局科技创新项目(22KJCX008);辽宁省教育厅科研平台建设项目(LJ232410176004)

Effect of orthopedic insoles on lower extremities function in children and adolescents with flexible flatfoot: a scoping review

HUANG Zhaoxin¹, TANG Letian², XIAO Xiaofei²(), LOU Yantao³()

1. Shandong College of Traditional Chinese Medicine, Yantai, Shandong 264199, China
2. School of Special Education and Rehabilitation, Binzhou Medical University, Yantai, Shandong 264003, China
3. College of Exercise and Health, Shenyang Sport University, Shenyang, Liaoning 110102, China

Received:2024-11-08 Published:2024-11-25 Online:2024-12-05
Contact: XIAO Xiaofei, E-mail: xxf1013@126.com;LOU Yantao, E-mail: louyantao2008@163.com
Supported by:
General Administration of Sport of China Science and Technology Innovation Project(22KJCX008);Department of Education of Liaoning Province Research Platform Construction Project(LJ232410176004)

摘要/Abstract

摘要：

目的对穿戴矫形鞋垫干预柔韧性扁平足儿童青少年足弓形态、疼痛和下肢运动功能进行Scoping综述。

方法检索自建库至2024年10月PubMed、Web of Science、Embase、中国知网、万方数据库、中国生物医学文献数据库、维普数据库中相关文献，提取相关数据进行Scoping综述。

结果最终纳入10篇文献，包括7篇队列研究，3篇随机对照试验，来自中国、韩国、伊朗、罗马尼亚，涉及520例柔韧性扁平足儿童和青少年。矫形鞋垫能增加跟骨倾斜角，降低距骨第一跖骨角和足弓指数；改善足部和下肢运动功能，提高前后、内侧和整体稳定性，调整步行运动学和地面反作用力；缓解疼痛并降低疼痛发生率。

结论穿戴矫形鞋垫能改善柔韧性扁平足儿童青少年的足弓形态，提高动态平衡，改善步行，并缓解疼痛。

关键词: 柔韧性扁平足, 矫形鞋垫, 儿童, 青少年, Scoping综述

Abstract:

Objective To review the effect of orthopedic insoles on arch morphology, pain and lower limb motor function in children and adolescents with flexible flatfoot.

Methods Relevant literature was retrieved from PubMed, Web of Science, Embase, CNKI, CBM, Wanfang data and VIP databases, from inception to October, 2024, and a scoping review was conducted.

Results Ten researches were included, comprising seven cohort studies and three randomized controlled trials, originating from China, Korea, Iran and Romania, involving 520 children and adolescents with flexible flatfoot. Orthopedic insoles could increase the calcaneal pitch angle, reduce the Meary's angle and arch index; improve motor function of feet and lower limbs, stability of anterior and posterior, medial, and overall, adjust the kinematics and ground reaction force in walking; relieve pain and reduce incidence of pain.

Conclusion Wearing orthopedic insoles could improve the arch morphology, dynamic balance and gait function, and relieve pain in children and adolescents with flexible flatfeet.

Key words: flexible flatfoot, orthopedic insoles, children, adolescents, scoping review

中图分类号:

R682.1

黄兆欣, 唐乐天, 肖晓飞, 娄彦涛. 矫形鞋垫干预柔韧性扁平足儿童青少年下肢功能的Scoping综述[J]. 《中国康复理论与实践》, 2024, 30(11): 1343-1350.

HUANG Zhaoxin, TANG Letian, XIAO Xiaofei, LOU Yantao. Effect of orthopedic insoles on lower extremities function in children and adolescents with flexible flatfoot: a scoping review[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(11): 1343-1350.

图/表 4

表1

图1

表2

表3

纳入文献基本特征"

纳入文献	国家	样本特征		研究类型	干预措施(T)	干预方案	比较	指标	结局
纳入文献	国家	T	C	研究类型	干预措施(T)	干预方案	比较	指标	结局
Kim等^[15] (2023)	韩国	n = 200 (6.49±2.96)岁	无	队列研究	定制矫形鞋垫	门诊治疗1~6年	与干预前比较	结构跟骨倾斜角、距骨第一跖骨角	跟骨倾斜角增加，距骨第一跖骨角降低
Rusu等^[16] (2022)	罗马尼亚	n = 15 (9.37±1.42)岁	n = 15 (9.37±1.42)岁	队列研究	运动疗法+矫形鞋垫(热塑性、半刚性)	每次30 min，每周3次，共12周	与对照组比较	结构距下关节柔韧性、AI	距下关节柔韧性、AI改善
Lee等^[17] (2017)	韩国	n = 66 (5.0±2.7)岁	无	队列研究	定制刚性矫形鞋垫	每天≥ 8 h，共2年	与干预前比较	结构静息跟骨站立位置角、跟骨倾斜角、距骨第一跖骨角	静息跟骨站立位置角降低，且与距骨第一跖骨角相关
Cho等^[18] (2021)	韩国	n = 24 (12.06±1.24)岁	无	队列研究	刚性矫形鞋垫	每天≥ 6 h，共1年	与干预前比较	结构静息跟骨站立位置角、跟骨倾斜角、距骨第一跖骨角、距跟角、踝内翻肌和外翻肌横截面积比率功能足功能指数(疼痛、残疾和活动受限)	静息跟骨站立位置角降低，跟骨倾斜角增加，踝内翻肌和外翻肌横截面积比率增加；疼痛和残疾评分降低
Yalfani等^[19] (2023)	伊朗	n = 15 (13.40±2.38)岁	n = 15 (13.66±1.98)岁	RCT	硅胶矫形鞋垫(内侧纵弓支撑)	跆拳道训练和日常活动中连续使用，共12周	与对照组比较	功能压力中心轨迹	压力中心轨迹减小
Jafarnezhadgero等^[20] (2018)	伊朗	n = 15 (10.5±1.4)岁	n = 15 (10.4±1.5)岁	RCT	定制内侧纵弓支撑鞋垫	第1天< 1 h，每隔1天增加1 h，直到全天穿戴，共16周	与对照组比较	功能步态(运动学和地面反作用力)	最大踝内旋角，最大膝关节内、外旋角减小，最大前后和垂直地面反作用力降低
Hsieh等^[21] (2018)	中国	n = 26 (6.9±0.6)岁	n = 26 (6.2±0.4)岁	RCT	定制内侧纵弓支撑的热塑性鞋垫	每天≥ 5 h，共12周	与对照组比较	功能和疼痛 PODCI	疼痛/舒适度、身体健康、楼梯上升时间、上肢和身体功能、转移和基本活动能力改善
Lee等^[22] (2020)	韩国	n = 16 (9.16±3.53)岁	n = 13 (7.73±2.37)岁	队列研究	3D打印定制矫形鞋垫	门诊治疗共16个月	与对照组比较	结构跟骨倾斜角、距骨第一跖骨角、距跟角功能和疼痛 PODCI、VAS	外侧距跟角、PODCI改善
Shu等^[23] (2024)	中国	n = 27 (8.0±0.9)岁	无	队列研究	3D打印定制矫形鞋垫	每天站立或行走≥ 8 h，共4年	与干预前比较	结构 AI 疼痛疼痛频率、VAS	AI、疼痛频率、VAS评分降低
Li等^[24] (2022)	中国	n = 32 7~12岁	无	队列研究	定制矫形鞋垫	每天≥ 8 h，共2年	与干预前比较	结构 AI 疼痛疼痛频率、VAS	AI、疼痛频率和VAS评分改善

表3

参考文献 19

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纳入文献	1	2	3	4	5	6	7	8	总分
Kim等^[15] (2023)	√	√	√	√			√	√	6
Rusu等^[16] (2022)	√	√	√	√	√	√	√	√	8
Lee等^[17] (2017)	√	√	√	√			√	√	6
Cho等^[18] (2021)	√	√	√	√			√	√	6
Yalfani等^[19] (2023)	√	√	√	√	√	√	√	√	8
Jafarnezhadgero等^[20] (2018)	√	√	√	√	√	√	√	√	8
Hsieh等^[21] (2018)	√	√	√	√	√	√	√	√	8
Lee等^[22] (2020)	√	√	√	√	√	√	√	√	8
Shu等^[23] (2024)	√	√	√	√			√	√	6
Li等^[24] (2022)	√	√	√	√			√	√	6

矫形鞋垫干预柔韧性扁平足儿童青少年下肢功能的Scoping综述

Effect of orthopedic insoles on lower extremities function in children and adolescents with flexible flatfoot: a scoping review

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