Učinki različnih terapevtskih pristopov pri proniranem stopalu : pregled literature

Košir, Tina (author), Vauhnik, Renata (mentor)

Uvod: Pronacija stopala je kombiniran gib v več sklepih stopala, ki je biomehansko zelo pomemben za absorpcijo sil ob dostopu na podlago in prenos sil po stopalu ter na proksimalne sklepne in mehkotkivne strukture spodnjega uda med gibanjem. Povečana pronacija stopala je dejavnik tveganja za pojav bolečine pri teku, ki lahko vodi tudi do preobremenitvenih poškodb spodnjega uda. Namen: Pregledati učinkovitost različnih terapevtskih pristopov pri proniranem stopalu. Metode dela: Članke smo iskali v podatkovni bazi PubMed in na podlagi vključitvenih in izključitvenih kriterijev v pregled vključili 7 raziskav. Rezultati: V vključenih raziskavah so preučevali vpliv in učinkovitost ortoz za stopalo, vaj za intrinzične stopalne mišice, uporabe elastičnih lepilnih trakov in različnih tipov prilagojene tekaške obutve. Preučevali so vpliv na položaj stopala, pojav in jakost bolečine ter tveganje za poškodbe pri tekačih. Vzorce so v večini sestavljali mladi in zdravi posamezniki brez simptomov ali že prisotnih preobremenitvenih poškodb spodnjega uda. Razprava: Pregled je pokazal, da ortoze po meri kratkoročno zmanjšajo jakost in zakasnijo pojav bolečine ter da imajo boljši učinek, kadar so kombinirane z vajami za intrinzične stopalne mišice. Elastični lepilni trakovi imajo kratkoročni učinek na pronacijo stopala po teku. Ugotovitve raziskav kažejo, da so pasivni terapevtski pristopi (ortoze za stopalo ali uporaba elastičnih lepilnih trakov) učinkovitejši, kadar so kombinirani z mišično aktivnostjo. O učinkovitosti različnih tipov prilagojene tekaške obutve so si rezultati nasprotujoči in zgolj oblika stopala ni dovolj za predpis določenega tipa tekaške obutve. Zaključek: Zaradi majhnih vzorcev in neklinične populacije v večini vključenih raziskav so rezultati težko posplošljivi na širšo populacijo. Ugotovitve pregleda imajo zato predvsem preventivni pomen pri fizioterapetski obravnavi oseb s proniranim stopalom, kjer preobremenitvene poškodbe (še) niso prisotne. Potrebne so dodatne raziskave, ki bi preučevale kombinacijo pasivnega in aktivnega pristopa. Prav tako so potrebne raziskave, ki bi se osredotočile na mehkotkivne vzroke za pronacijo stopala.

• Language: Slovenian
• Keywords: pronacija stopala, ortoze za stopalo, elastični lepilni trakovi, prilagojena tekaška obutev, vaje za intrinzične stopalne mišice
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-102349
• COBISS.SI-ID: 5469291
• Publication date in RUL: 22.08.2018

Secondary language

• Language: English
• Title: The effects of different therapeutic approaches to foot pronation : literature review

Abstract

Introduction: Pronation of the foot is a combined movement in many joints of the foot and plays an important role in the biomechanics of the foot during locomotion – especially in shock - absorption and force - transmission along the foot and to proximal joints and soft tissues of lower limb. Excessive pronation is a risk factor for pain during running and can lead to lower limb overuse injuries. Purpose: To overview and compare the effectiveness of different therapeutic approaches to foot pronation. Methods: Search for studies was performed in the PubMed database and the review includes 7 studies which met the inclusion and exclusion criteria. Results: Included studies investigated the effectiveness of customized foot orthoses, intrinsic-foot-muscles training, kinesiotaping and different types of running footwear. They investigated the effects on foot posture, incidence and intensity of pain and injury risk in runners. Participants were mostly young and healthy individuals without symptoms or present overuse injuries of the lower limb. Discussion Customized foot orthosis proved to have positive short-term effects on pain onset and intensity, however they were more effective in combination with intrinsic foot muscles training. Kinesiotaping was effective for correcting foot posture after running. The review showed that passive approaches (foot orthoses and kinesiotaping) were more effective when combined with muscle activity. Different types of running footwear showed contrasting results, and foot posture alone is not enough for running footwear prescription. Conclusion: The results cannot be generalized for entire population due to small sample sizes, and lack of clinical relevance in most of the included studies. However the findings of the review can be interpreted in terms of prevention and useful for physiotherapists when working with people with excessive foot pronation yet without present overuse injuries. More research is needed to investigate the combination of passive and active approaches. Future research should also focus on soft tissue causes for foot pronation.

• Keywords: foot pronation, foot orthoses, kinesiotaping, running footwear, intrinsic-foot-muscles training