短足训练对扁平足患者足踝功能影响的Meta分析与系统评价

Effect of short-foot training on foot and ankle function in patients with flat feet:Meta-analysis and systematic review

目的:运用Meta分析方法综合定量评价短足训练对扁平足患者足踝功能的影响,为扁平足患者更有效地进行训练提供理论依据。方法:检索Web of Science、The Cochrane Library、PubMed、Embase、CNKI数据库、维普数据库、中国生物医学文献数据库等中外文献数据库。检索文献时限为各数据库建库至2022-01-31。中文数据库检索词与检索式:(扁平足OR外翻足OR硬足)AND(短足训练OR物理治疗);英文数据库检索词与检索式(flat foot OR talipes valgus OR talipes calcaneovalgus)AND(short foot exercises OR physical therapy OR neurophysiotherapy)。选用Cochrane偏倚风险评估工具对纳入文献进行质量评价,运用Revman 5.4和Stata 12.0软件对所有纳入文献的足舟下降高度、足姿指数进行分析。结果:共纳入12篇文献,443名受试者。5篇为中度偏倚风险文献、7篇为低度偏倚风险文献。短足训练具有降低足舟下降高度的效果(SMD=-0.59,P<0.05)。受试者年龄(回归系数:-1.5639,P=0.004)、体质量指数(回归系数:-1.5639,P=0.023)和干预时间(回归系数:-1.4456,P=0.042)影响了纳入文献的整体效应。从效应量上来看,短足训练对足姿指数的干预有效果,但差异无显著性意义(SMD=-0.26,P>0.05)。结论:短足训练可以有效降低扁平足患者的足舟下降高度,对足姿指数的影响尚不明确。年龄、体质量指数和干预时间是影响短足训练干预效果的因素,是展开相关研究和组织扁平足患者康复训练需要考虑的因素。推荐扁平足患者选择短足训练作为训练手段。

OBJECTIVE:To perform a Meta-analysis to comprehensively and quantitatively evaluate the effects of short foot training on foot and ankle function in patients with flat feet,and to provide a theoretical basis for more effective training in patients with flat feet.METHODS:Chinese and foreign literature databases such as Web of Science,The Cochrane Library,PubMed,Embase,CNKI database,VIP database,and China Biomedical Literature Database were searched.The search time was from database inception to January 31,2022.Chinese database search terms and search formula:(flatfoot OR valgus foot OR stiff foot)AND(short foot training OR physical therapy).English database search terms and search formula:(flatfoot OR talipes valgus OR talipes calcaneovalgus)AND(short foot exercises OR physical therapy OR neurophysiotherapy).The Cochrane risk of bias assessment tool was selected to evaluate the quality of the included literature,and all included articles were analyzed for outcome indicators(navicular drop and foot posture index)using Revman 5.4 and Stata 12.0 software.RESULTS:A total of 12 papers with 443 subjects were included.Five were moderate risk of bias and seven were low risk of bias literature.Short-foot training could reduce navicular drop[standardized mean difference(SMD)=-0.59,P<0.05).Subject age(regression coefficient:-1.5639,P=0.004),body mass index(regression coefficient:-1.5639,P=0.023)and intervention duration(regression coefficient:-1.4456,P=0.042)influenced the overall effect of the included literature.Short foot training showed insignificant effects on foot posture index(SMD=-0.26,P>0.05).CONCLUSION:Short-foot training can effectively reduce navicular drop in patients with flat foot but has no clear effects on foot posture index.Age,body mass index,and intervention time are the factors that influence the effectiveness of short-foot training interventions and are the factors that need to be considered when conducting relevant studies and organizing rehabilitation training for patients with flat feet.Short-foot training is recommended as a training tool for patients with flat feet.