- 期刊
功能性足部輔具於足底筋膜炎之應用治療－病例報告
Clinical Application of Functional Foot Orthoses to Plantar Fasciitis-A Case Report
摘要
足底筋膜炎(plantar fasciitis)為一重覆性過度使用的傷害，發生於足底筋膜附著於跟骨粗隆內側處，尤其常發生於跑者。造成足底筋膜炎除了使用過度為其主要發生的原因之外，訓練方式、訓練場地的不當，骨骼肌肉系統（肌力和伸展度）於生物力學上的不平衡，不當鞋具以及生長發育的影響皆可能是形成的原因。其中足部結構於生物力學上不當的代償如旋前足(pronated foot)、空凹足(cavus foot)為常見之原因。前者造成跟骨不正常外翻(everston)形成足底筋膜承受過度張力，而後者則無法適度分散足底負載之壓力。目前保守療法包括休息、冰敷、物理治療如超音波等、藥物的使用、減少載重的負荷如減輕體重、足弓貼紮、足部輔具的使用等。本篇報告即利用功能性足部輔具調整足部之生物力學的不平衡，以改善足底筋膜炎的症狀，以求達到治療的目的。且本研究主要以足底壓力分析系統(EMED)評估病人治療前後足底壓力分佈以研究功能性足部輔具的使用效果，即以客觀、數據化的評估方法輔助。結果發現經向功能性足部輔具的使用，從實驗上得到足底壓力的重新平均分佈以及降低單位面積所永受之最大壓力的證明，使病人的疼痛確實得到改善。進而驗證功能性足部輔具的使用改善生物力學上的缺陷並達治療上相輔相成之成效。
並列摘要
Plantar fasciitis results from repetitive microtrauma over the insertion of the plantar fascia at the medial tubercle of the calcaneus. Incorrective training program, poor running surface, insufficient flexibility and strength of leg muscles, abnormal biomechanical features of foot, inadequate footwear and the stage of foot development have all been cited as possible causes of plantar fasciitis. Pronated feet and cavus feet are the major biomechanical abnormalities. Pronated foot will stretch the plantar fascia. Conversely, a cavus foot causes the plantar fascia unable to dissipate the weightbearing force adequately. Conservative treatments for plantar fasciitis usually include rest, icing, ultrasound, anti-inflammatory agents, and reduced bearing weight over painful area, by taping or foot orthoses. There is a successful case report, a plantar fasciitis receiving foot orthoses gets much improvement in both pain and walking scale, and obvious changes in peak foot pressure and foot pressure distribution shown by EMED system. On the other hands, functional foot orthoses maybe play a role in the treatment of plan-tar fasciitis.