目的:评价牵伸训练联合双氯芬酸二乙胺超声透入以及牵伸训练联合脉冲超声波对跖筋膜炎的治疗效果,并比较其疗效。方法:自2009年6月至2012年3月治疗跖筋膜炎30例,分为3组:超声透入加牵伸组,脉冲超声波加牵伸组,单纯牵伸组,各10例。牵伸组...目的:评价牵伸训练联合双氯芬酸二乙胺超声透入以及牵伸训练联合脉冲超声波对跖筋膜炎的治疗效果,并比较其疗效。方法:自2009年6月至2012年3月治疗跖筋膜炎30例,分为3组:超声透入加牵伸组,脉冲超声波加牵伸组,单纯牵伸组,各10例。牵伸组男2例,女8例,平均年龄(46.7±6.5)岁,体质指数(26.7±2.8)kg/m2;脉冲超声波加牵伸组男4例,女6例,平均年龄(45.8±6.1)岁,体质指数(26.4±3.4)kg/m2;超声透入加牵伸组男3例,女7例,平均年龄(48.4±8.0)岁,体质指数(25.4±3.0)kg/m2。超声透入加牵伸和脉冲超声波加牵伸组的超声治疗每日10min,每周治疗5次,共4周,其中超声透入加牵伸组耦合剂使用双氯芬酸二乙胺(扶他林)。另外,所有患者进行小腿后群肌、跟腱及跖筋膜的牵伸训练。在治疗前、治疗后即刻及治疗3个月后,以视觉类比标度(visual analog scale,VAS)评价晨起足跟痛,并抽取足部功能指数量表(foot function index,FFI)中的行动障碍子量表评价患足功能状态。结果:治疗前3组患者资料和足跟痛起始状态组间无明显差异。晨痛及行动障碍的改善:治疗1个月时超声透入加牵伸组改善较单纯牵伸组明显(P<0.05),3个月时3组差异无统计学意义(P>0.05)。而组内比较显示3组晨痛及行动障碍在治疗前后的3个时间点均得到有效改善(P<0.05)。结论:单纯牵伸训练以及联合超声透入或脉冲超声波对治疗跖筋膜炎的晨痛和功能障碍均有效,而联合超声透入治疗效果最佳。展开更多
Background A causal link between the metatarsus adductus and hallux valgus is not clear.The aim of this study was to investigate the configurations of the metatarsus adductus deformity by radiological measurements and...Background A causal link between the metatarsus adductus and hallux valgus is not clear.The aim of this study was to investigate the configurations of the metatarsus adductus deformity by radiological measurements and reappraise the relationship between hallux valgus and metatarsus adductus.Methods The first step was evaluation of the relationship between metatarsus adductus and hallux valgus on 143 dorsoplantar weight-bearing radiographs diagnosed as hallux valgus which was also known as bunions.Measurements including the hallux valgus angle （HVA）,the intermetatarsal angle （IMA）,the Kilmartin angle （KA）,the tibial sesamoid position （TSP）,and metatarsus adductus angle were taken.The metatarsus adductus angle is defined by Sgarlato＇s angle （SMA） and Engel＇s angle （EMA） respectively.Results The metatarsus adductus angle positively correlates with the HVA （r=0.590,P=0.000） and KA （r=0.601,P=0.000）,yet negatively correlates with the grade of TSP,（r=-0.348,P=0.000）.Contradiction of diagnosis existed in 22 （22/100） subjects diagnosed as metatarsus adductus by SMA yet normal by EMA.In this group,the correlation between HVA and metatarsus adductus angle was negative （r=-0.472,P=0.027）.Conclusions EMA and SMA defined metatarsus adductus by different deformity apexes.Metatarsus adductus configurations in that the apex of the deformity lay in either the base of metatarsals or tarsus.They respectively correlate positively or negatively to the HVA.展开更多
文摘目的:评价牵伸训练联合双氯芬酸二乙胺超声透入以及牵伸训练联合脉冲超声波对跖筋膜炎的治疗效果,并比较其疗效。方法:自2009年6月至2012年3月治疗跖筋膜炎30例,分为3组:超声透入加牵伸组,脉冲超声波加牵伸组,单纯牵伸组,各10例。牵伸组男2例,女8例,平均年龄(46.7±6.5)岁,体质指数(26.7±2.8)kg/m2;脉冲超声波加牵伸组男4例,女6例,平均年龄(45.8±6.1)岁,体质指数(26.4±3.4)kg/m2;超声透入加牵伸组男3例,女7例,平均年龄(48.4±8.0)岁,体质指数(25.4±3.0)kg/m2。超声透入加牵伸和脉冲超声波加牵伸组的超声治疗每日10min,每周治疗5次,共4周,其中超声透入加牵伸组耦合剂使用双氯芬酸二乙胺(扶他林)。另外,所有患者进行小腿后群肌、跟腱及跖筋膜的牵伸训练。在治疗前、治疗后即刻及治疗3个月后,以视觉类比标度(visual analog scale,VAS)评价晨起足跟痛,并抽取足部功能指数量表(foot function index,FFI)中的行动障碍子量表评价患足功能状态。结果:治疗前3组患者资料和足跟痛起始状态组间无明显差异。晨痛及行动障碍的改善:治疗1个月时超声透入加牵伸组改善较单纯牵伸组明显(P<0.05),3个月时3组差异无统计学意义(P>0.05)。而组内比较显示3组晨痛及行动障碍在治疗前后的3个时间点均得到有效改善(P<0.05)。结论:单纯牵伸训练以及联合超声透入或脉冲超声波对治疗跖筋膜炎的晨痛和功能障碍均有效,而联合超声透入治疗效果最佳。
基金This work was supported by a grant from the National Natural Science Foundation of China （No.81171670/H0601）.
文摘Background A causal link between the metatarsus adductus and hallux valgus is not clear.The aim of this study was to investigate the configurations of the metatarsus adductus deformity by radiological measurements and reappraise the relationship between hallux valgus and metatarsus adductus.Methods The first step was evaluation of the relationship between metatarsus adductus and hallux valgus on 143 dorsoplantar weight-bearing radiographs diagnosed as hallux valgus which was also known as bunions.Measurements including the hallux valgus angle （HVA）,the intermetatarsal angle （IMA）,the Kilmartin angle （KA）,the tibial sesamoid position （TSP）,and metatarsus adductus angle were taken.The metatarsus adductus angle is defined by Sgarlato＇s angle （SMA） and Engel＇s angle （EMA） respectively.Results The metatarsus adductus angle positively correlates with the HVA （r=0.590,P=0.000） and KA （r=0.601,P=0.000）,yet negatively correlates with the grade of TSP,（r=-0.348,P=0.000）.Contradiction of diagnosis existed in 22 （22/100） subjects diagnosed as metatarsus adductus by SMA yet normal by EMA.In this group,the correlation between HVA and metatarsus adductus angle was negative （r=-0.472,P=0.027）.Conclusions EMA and SMA defined metatarsus adductus by different deformity apexes.Metatarsus adductus configurations in that the apex of the deformity lay in either the base of metatarsals or tarsus.They respectively correlate positively or negatively to the HVA.
