客製足部矯具對一般足部疼痛之療效及療效預測因子之探討

Therapeutic Effect and Predictors of the Effectiveness of Custom-made Foot Orthoses for Common Foot Pain

林彥任(Yan-Ren Lin) ； 洪辰宇(Chen-Yu Hung) ； 李俊傑(Chun-Chieh Lee) ； 謝有丁(Yu-Ting Hsieh) ； 王亭貴(Tyng-Guey Wang)

《台灣復健醫學雜誌》 42卷3期 (2014/09) Pp. 137-145

https://doi.org/10.6315/2014.42(3)01

摘要

客製足部矯具為醫療上針對足部疼痛常使用之治療方式。足部矯具可以重新分佈足底壓力，使疼痛部位的尖峰壓力降低，因此可以改善足部疼痛。然而不同病患對於治療的效果反應不一，且對於具何種足部特徵之足部疼痛病患能藉由客製足部矯具得到較佳的治療效果，目前仍不清楚。本研究之對象為一般足部疼痛且經轉介接受客製足部矯具治療之病患。收集其基本資料、足部特徵及活動程度後，以李克特五分量表（5-point Likert scale）、台灣中文版足部功能問卷及台灣簡短36健康量表（Short Form 36，SF-36），評估其接受足部矯具治療後一個月及四個月時之療效，並分析可能之療效預測因子。本研究共納入26位受測者，治療前足部功能問卷內之足部疼痛指數為30.9±16.1（0-90分），治療後一個月及四個月分別進步為22.8±13.2（p＜0.05）以及19.8±11.3（p＜0.05）；治療前足部功能問卷內因疼痛造成的日常生活困難程度為26.5±22.0（0-90分），治療後一個月及四個月分別進步為8.8±8.9（p＜0.05）以及6.8±10.8（p＜0.05）。治療後四個月，足部功能問卷內因足部疼痛造成的日常生活延宕時間也有顯著改善。代表健康相關生活品質之台灣簡短36量表中的身體生理功能及身體疼痛兩項分數，則在穿戴一個月開始有持續性之顯著改善。雖然台灣簡短36量表中其他面向的分數亦有進步趨勢，但無統計上的顯著差異。此外，本研究透過「李克特五分量表」將受測者分為穿戴矯具有效組及無效組，再比較兩組間基本資料及足部特徵是否有差異，分析可能之療效預測因子。結果發現兩組間的基本資料及足部特徵並無統計上之顯著差異。本研究結果支持客製足部矯具可能對一般足部疼痛具有療效，但在預測因子探查方面，無法藉由病人基本資料或足部特徵預測可能較有療效之病患族群。

關鍵字

足部矯具 ； 鞋墊 ； 足部疼痛

並列摘要

Purpose: Custom-made foot orthoses are commonly used to treat foot pain by modifying the distribution of foot pressure. The therapeutic effect of custom-made foot orthoses on specific foot pain such as pes cavus, rheumatoid arthritis, and plantar fasciitis has been established. However, the therapeutic effect of custom-made foot orthoses on common foot pain remains unclear, and the foot characteristics with which patients are most likely to benefit from this intervention have not been adequately explored. The purposes of this study were to investigate the therapeutic effect of custom-made foot orthoses on common foot pain and to determine potential predictors of effectiveness. Method: Twenty-six patients with common foot pain were recruited. After baseline data on demographic characteristics, foot characteristics, and activity levels were collected, the patients were prescribed custom-made foot orthoses. The Foot Function Index, Short Form 36, and a 5-point Likert scale were administered at the baseline and after 1 and 4 months of treatment as outcome measures. Patients who reported marked improvement in the 5-point Likert scale were assigned to an effective group and patients who did not were assigned to a noneffective group. Predictors of effectiveness were analyzed by comparing the variables (demographic data, foot characteristics, activity level, and baseline Foot Function Index and Short Form 36 scores) between groups. Results: The score on the pain subscale of the Foot Function Index was 30.9±16.1 at the baseline and improved to 22.8±13.2 (p＜.05) and 19.8±11.3 (p＜.05) after 1 and 4 months of treatment, respectively. The score on the disability subscale of the Foot Function Index was 26.5±22.0 at the baseline and improved to 8.8±9.8 (p＜.05) and 6.8±10.8 (p＜.05) after 1 and 4 months of treatment, respectively. In addition, the score on the activity restriction subscale of the Foot Function Index improved significantly after 4 months of treatment. The physical functioning and pain variables of the Short Form 36 improved significantly after 1 and 4 months of treatment. No significant predictor of effectiveness was identified in this study. Conclusion: Custom-made foot orthoses may be effective in treating common foot pain. However, no predictor of effectiveness was identified in this study.

並列關鍵字

foot orthoses ； insole ； foot pain