鞋墊介入足底筋膜炎之效果：系統性回顧與統合分析

Effect of Foot Orthotic Intervention for Plantar Fasciitis: Systemic Review and Meta Analysis

羅國峰(Guo-Fong Luo) ； 鄭又寧(Yu-Ning Cheng) ； 張莞芳(Wan-Fang Chang) ； 李雪禎(Hsuei-Chen Lee) ； 王子娟(Wendy T. J. Wang) ； 施怡芬(Yi-Fen Shih)

《物理治療》 42卷1期 (2017/03) Pp. 42-54

https://doi.org/10.6215/FJPT.PTS1472533711

摘要

背景與目的：足底筋膜炎為一種慢性傷害，常造成足跟或內側足弓疼痛。足底筋膜炎之保守治療方式種類繁多，包括鞋墊介入。然而，目前僅有一篇系統性回顧與統合性分析之文獻探討鞋墊對於足底筋膜炎的療效；且在不同類型鞋墊之介入效果方面尚未有統合分析或是系統性回顧的文章。因此本篇研究的目的為，以系統性回顧與統合分析的方式，探討鞋墊介入對於足底筋膜炎症候群病患之疼痛與足部功能的治療效果、比較客製型與預製型(prefabricated) 鞋墊之治療效果、及加上夜間副木之治療效果。研究方法：以電腦資料庫及交叉比對方式進行文獻蒐集。收集的研究須符合下列條件：(1) 各篇文獻的受試者須限制為診斷為足底筋膜炎者，並排除患有他種骨科或醫療情況、先前已接受過其他鞋墊介入、類固醇注射與手術治療，或是曾經有外傷或骨折；(2) 介入方式需為鞋墊介入，介入的種類可包含客製型鞋墊或預製型鞋墊；(3) 療效評估項目需包含疼痛或功能量表；(4) 文章語言為英文。我們排除實驗設計為單組實驗、實驗控制組並非使用偽鞋墊或包含其他治療、無法取得完整實驗結果數據之研究。結果：本研究共收錄7 篇相關文獻。統合分析結果顯示鞋墊對於減輕疼痛有短期療效(p = 0.007)；鞋墊介入不論短期或長期均能夠顯著增加患者功能表現(p ＜ 0.001)。預製型鞋墊及客製型鞋墊對於疼痛與功能改善的效果類似(p ＞ 0.05)。鞋墊介入合併夜間副木對於疼痛減輕(p = 0.022) 與功能改善(p = 0.015)均有統計上顯著優於單獨使用鞋墊的療效。結論與臨床意義：使用鞋墊介入能有效降低足底筋膜炎患者的疼痛以及改善功能，合併夜間副木使用能更有效地改善足底筋膜患者的疼痛以及功能。

關鍵字

足底筋膜炎 ； 鞋墊介入 ； 系統性回顧 ； 統合分析

並列摘要

Background purpose: Plantar fasciitis is a chronic condition which often results in heel or medial arch pain. A variety of conservative intervention options is available for plantar fasciitis, including foot orthotic intervention. However, there is only one systemic review and meta-analysis study describing the treatment effect of foot orthoses; and no study comparing treatment effect between customized and prefabricated orthoses. Therefore, the purpose of this study was to systemically review and meta-analyze the effects of foot orthoses on pain and function in patients with plantar fasciitis, including the effect of customized and prefabricated orthoses, and additional effect of using night splint. Methods: Studies were identified by a systematic computer database and cross-reference search. Original research studies which met these criteria were included: (1) subjects with plantar fasciitis, and with no other musculoskeletal and/or systematic problems and previous uses of foot orthoses, injection, or surgery; (2) using foot orthoses as the intervention, either customized or prefabricated; (3) outcome measure containing the efficacy of foot orthoses with self-reported pain and/or function, and giving pre-and-post data with means, standard deviations, and sample size of each group; (4) written in English. We excluded studies which used single group or used other treatment rather than sham orthoses in the control group, or studies with no original data available. Results: Seven studies were included. The results of meta-analysis showed that orthoses were significantly better than sham orthoses on short-term pain control (p = 0.007) and both short-term and long-term functional improvement (p ＜ 0.001). Customized orthoses and prefabricated orthoses had similar effect on pain and functional improvement (p ＞ 0.05). Orthoses combined with night splint resulted in better pain control (p = 0.022) and functional improvement (p = 0.015) as compared to the orthoses alone. Conclusion and clinical relevance: Orthoses could effectively decrease pain intensity and improve function in patients with plantar fasciitis. The combination of night splint and orthoses was better than orthoses only in pain control and functional improvement.

並列關鍵字

Plantar fasciitis ； Orthotic intervention ； Systematic review ； Meta-analysis