背景:对于成骨不全症(OI)的儿童,一种罕见的遗传性骨病,由于骨骼脆弱和畸形的结合,行走可能很难进行,肌肉无力,关节过度活动,和痛苦。双膦酸盐治疗促进了更多的儿童能够走路,但对很多人来说,足踝活动过度是一个限制因素。目前关于OI儿童足部矫形器的证据很少。这项研究旨在评估OI赤脚行走的儿童与使用脚矫形器行走相比的步态特征。
方法:本横断面研究包括23名OI和过度活动的儿童(平均年龄8.3±3.0岁)。儿童赤脚进行三维步态分析,以及足部矫形器和适当的足部磨损(稳定但重量轻),分别。步行速度,步长,收集下肢运动学和动力学。使用配对样本t检验评估测试条件之间的步态特征的差异。
结果:用脚矫形器走路时,外部足部发展角度减小,峰值踝关节背屈角度增加,与赤脚相比,足底弯曲力矩峰值增加。试验条件之间的步行速度没有差异,然而,与赤脚相比,患有OI的孩子用脚部矫形器走路的步子更长。
结论:观察到的步态改变表明足部矫形器,旨在支撑脚和踝关节,导致通过外部足部进展测量的整体足部旋转减少,增加的峰屈矩,增加了步长。从更广泛的角度来看,走路的能力提供了身体活动的机会,从而增加骨骼负荷并防止骨折,因此,足部矫形器可能是OI患儿需要考虑的重要治疗选择.
方法:III.
BACKGROUND: For children with Osteogenesis Imperfecta (OI), a rare genetic bone disease, walking can be difficult to carry out due to a combination of bone fragility and deformity, muscle weakness, joint hypermobility, and pain. Bisphosphonate treatment has facilitated more children being able to walk, but for many, foot and ankle hypermobility is a limiting factor. Current evidence on foot orthoses in children with OI is sparse. This
study aimed to evaluate gait characteristics in children with OI walking
barefoot as compared to walking with foot orthoses.
METHODS: Twenty-three children with OI and hypermobility (mean age 8.3 ± 3.0 years) were included in this cross-sectional
study. Children conducted three-dimensional gait analysis
barefoot, and with foot orthoses and appropriate foot wear (stable yet light-weight), respectively. Walking speed, step length, lower limb kinematics and kinetics were collected. Differences in gait characteristics between test conditions were evaluated using paired sample t-tests.
RESULTS: When walking with foot orthoses, the external foot progression angle was reduced, peak ankle dorsiflexion angle increased, and peak plantarflexion moment increased as compared to
barefoot. No difference was found in walking speed between test conditions, however, children with OI walked with longer steps with foot orthoses as compared to
barefoot.
CONCLUSIONS: The observed gait alterations suggest that foot orthoses, aiming to support the foot and ankle joint, contributed to reduced overall foot rotation as measured by external foot progression, increased peak plantarflexion moment, and increased step length. In a wider perspective, the ability to walk provides the opportunity to be physically active, and thereby increase skeletal loading and prevent fractures, thus, foot orthoses may be an important treatment option to consider in children with OI.
METHODS: III.