Article

OBJECTIVE: To assess the effect of a 4-week intervention with a full-length
carbon graphite (FL) orthosis on pain and function in patients with midfoot
arthritis, and to identify alterations in in vivo foot kinematics accompanying FL
use in patients with midfoot arthritis. These results have immediate application
for enhancing patient care through effective orthotic recommendations. DESIGN:
Experimental laboratory study supplemented by a case series. SETTING: University
based clinical research laboratory. PARTICIPANTS: Patients (n=30) with midfoot
arthritis and age-, sex-, and body mass index-matched control subjects (n=20).
INTERVENTION: Four-week intervention with FL orthoses. MAIN OUTCOME MEASURES:
Pain and function were assessed using the Foot Function Index-Revised (FFI-R). In
vivo foot kinematics were quantified as peak and total range of calcaneal
eversion, forefoot abduction, first metatarsal plantarflexion, and first
metatarsophalangeal joint dorsiflexion during walking in 2 conditions: with FL
orthoses and with shoes only. A paired t test and repeated-measures analysis of
variance were used to assess statistical significance (alpha=.05) of change in
FFI-R score and in vivo foot kinematics, respectively. RESULTS: Significant
improvements in pain and function, discerned as lower FFI-R scores (P<.001), were
noted after the 4-week intervention with FL orthoses. During walking, FL orthosis
use resulted in decreased first metatarsophalangeal joint dorsiflexion (P=.024)
and first metatarsal plantarflexion range of motion (P=.038), compared with the
shoe-only condition. CONCLUSIONS: Orthotic intervention emphasizing a
"stiffening" strategy of the first metatarsal and first metatarsophalangeal joint
may be valuable in patients with midfoot arthritis and early degenerative
changes.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS