The Effects Of Customized Orthopaedic Insoles On Foot Pressure And Gait Of Patients With Hallux Valgus

Hallux valgus is a kind of foot distortion symptom with high morbidity in life and clinic.The main manifestations of hallux valgus are that the toes of the foot deviate from the normal sagittal plane,great toe produces great toe sac with pain sensation,and the first metatarsal bone is close to the median sagittal plane.The long course of the disease and the complexity of surgical methods have always been a difficult problem for patients and doctors.From the initial surgical treatment to the emerging orthopaedic devices,reliable approaches have been sought for the treatment of hallux valgus deformity or to delay the progression of hallux valgus.Although there are more than 200 surgical methods,with the deepening of clinical and research,only some of them have become the mainstream surgical methods for treating hallux valgus.With the gradual development of modern emerging gait and foot pressure analysis,the use of various great hallux eversion orthotics has also made some progress in conservative treatment.Objective:to compare the physiological differences between hallux valgus patients and normal people through the gait analyzer,and to customize the orthopedic insole based on the gait data of hallux valgus patients,and to evaluate its effect on the gait of hallux valgus patients after 6 months of treatment.Methods:from August 2018 to September 2019,25 great hallux valgus patients in the reversible stage and contracture stage who were treated for foot pain in changzhou hospital of traditional Chinese medicine were selected,including 19 males and 31 females.The research object is single bipedal,a total of 100 feet.At the same time,20 healthy people who underwent physical examination in our hospital were selected to form the control group.After data collection,the differences in arch height,arch index,VAS score and AOFAS score between the two groups were evaluated.At the same time,VAS score,AOFAS score and gait data of patients in the two stages of the experimental group were compared and analyzed after six months of intervention according to the standard experimental procedure to observe the efficacy of customized orthopedic insoles on hallux valgus foot.Results:VAS score,AOFAS score and arch height of the reversible stage group and the contracture stage group were abnormal compared with the control group.In the experimental group,the pain symptoms and functional activities of patients in the two groups were improved after wearing the customized orthotic insoles.In the experimental group,after wearing the customized orthotic insole,the maximum static and dynamic plantar pressure and the load on the front foot all decreased,while the average plantar pressure did not change significantly.In the experimental group,after wearing the customized orthopaedic insole,the step width of the two groups changed significantly,but the step length did not change significantly.In terms of dynamic transient value,the walking speed and acceleration of the patients after treatment were significantly changed compared with those before,while the standing time and rocking time were not significantly changed.The two groups of patients in the experimental group showed significant improvement in the data of the foot axis Angle after wearing the customized orthotic insoles,but no significant change in the longitudinal metatarsal Angle and the transverse metatarsal Angle.The two groups of patients in the experimental group showed significant improvement in the load variation and resultant force(COF)data after wearing the customized orthotic insoles.Conclusion:patients with hallux valgus have different symptoms and signs in different stages of the course of disease,which are significantly different from those of normal subjects,and have a tendency of progressive aggravation.After wearing the customized orthotic insoles for 6 months,the symptoms,signs and gait of the patients in the reversible stage and the contracture stage were significantly improved.The purpose of customized orthotic insoles is to redistribute plantar stress,reduce pain and delay disease progression by remodeling arch shape,stabilizing diseased facet joints,correcting lower limb lines,and improving foot axis Angle.Although the abnormal foot structure of patients with early hallux valgus could not be significantly changed or reversed after wearing the orthotic insoles,the feasibility of the orthotic insoles in the intervention of patients with early hallux valgus was demonstrated through the analysis of its biomechanics and other improvement indicators.