| Objective:Flexible Flatfoot(FFT)is a common foot deformity,which is mainly manifested as the collapse or disappearance of the arch of the foot when the human body is standing normally,rather than the restoration of normal shape under load.At the same time,the flexible flatfoot lacks the cushioning effect of normal elastic foot arch on the ground reaction force in the weight-bearing exercise,resulting in greater pressure on the sole,and fatigue and pain at the scaphoid nodules of the medial plantar.Athletic Tape(AT)is often used to treat the injury of the arch of the foot due to its ability to provide mechanical support and structural abnormality correction of the middle foot.However,there are few studies on foot arch deformation and plantar pressure before and after exercise in patients with flexible flatfoot.This study aims to explore the effect of exercise white plaster on arch deformation and plantar pressure of flexible flatfoot.Firstly,a systematic review was carried out to explore which athletic tape has better immediate and post-exercise effects on improving the arch morphology of flexible flatfoot.Secondly,on the basis of systematic review,the intervention experiment was carried out to further explore the effect of exercise white bandage on the angle of the coronal plane of the hind foot and the distribution of plantar pressure in the walking of flexible flat feet,which was confirmed in the current research that the effect of foot arch deformation improvement was better so as to provide a theoretical basis for the selection of appropriate AT in the clinical practice of FFT rehabilitation therapy.Study one:Effects of taping techniques on arch morphology in adults with pes planusObjective:To investigate effects of taping techniques on arch deformation in adults with flexible flat foot.Methods:The following databases were searched up to March 2020,including Web of Science,Pub-med,EBSCO,CNKI and Cochrane Library.Heterogeneity and publication bias were assessed by I~2 index and funnel plots,respectively.In addition,Cochrane scale was used to evaluate the quality of research.Results:Navicular height for three anti-pronation taping techniques significantly increased immediately post tape compared with baseline(mean difference=4.86 mm,95%CI=2.86–6.87 mm,Z=4.75,p<0.001).The highest increase was observed in Augmented low-Dye(ALD).Modified low-Dye(MLD)was second only to ALD(p<0.001).Navicular height after walking for 10 min was much higher than baseline(p<0.001),with MLD decreased smaller than ALD.Conclusions:ALD was the most effective taping technique for controlling foot arch collapse immediately post tape compared with baseline,followed by MLD.By contrast,MLD could possibly performed better than ALD in maintaining immediate navicular height after walking for 10 min.Although positive effects of Navicular sling,low-Dye and Double X taping interventions were observed,they could not maintain this immediate navicular height effect after a period of higher intensity weight-bearing exercise.Study two:Effect of athletic taping on arch morphology and plantar pressure in female young students with pes planusMethods:This study recruited 20 female subjects with flexible flatfoot who met the inclusion criteria.Each participant was randomly divided into two groups,namely,ALD and MLD.The arch shape and plantar pressure of the subjects under different intervention methods were collected before,immediately after and 20 min after walking.Navicular drop distance(NDT)and resting calcaneal stance position(RCSP)were used to measure the arch shape of the subjects.Novel pedar measurement was used for plantar test during walking.The outcomes mainly including:plantar peak pressure,peak pressure,pressure time integration,pressure time integration and contact area.In addition,this study also collected the eversion angle of the coronal plane of the foot after the gait support phase.All data were analyzed by SPSS 20.0 statistical software.Repeated variance measurement was used to determine whether there were significant differences between the two athletic tape before,immediately after and 20 minutes after walking.Bonferroni was used for post hoc analysis.Statistical difference was set as p<0.05.Results:1.Foot arch morphology:(1)The descending height of scaphoid bone:There were significant differences in the descending height of scaphoid bone measured at different time points under the intervention of sports white plaster(p=0.019).After the analysis found that the application of ALD and MLD taping techniques immediately compared with the baseline value,the height of the scaphoid decline significantly reduced.Similarly,NDD increased significantly after walking with MLD for 20minutes than immediately after posting,and decreased significantly after walking with ALD(p<0.001).After walking for 20 minutes,there were significant differences in navicular drop distance between the two sports.After walking for 20 minutes with ALD,the NDD value was significantly lower than MLD(p<0.001).There was no significant difference in navicular drop distance between the two methods at the time points before and immediately after the placement.(2)Calcaneal relaxation angle:at different time points,there was no significant difference in the calcaneal relaxation angle measured under the intervention of exercise paste(p=0.339).However,multiple comparisons after the application of ALD exercise showed that the relaxation angle of calcaneus after 20 min walking was significantly higher than baseline(p=0.004).There was no significant difference in the calcaneus relaxation angle between the two kinds of exercise pastes at three time points:baseline,immediately after taping and 20min after walking.2.Plantar pressure:(1)Peak pressure:There is no significant difference in the peak pressure of each plantar area at three time points after walking with athletic tape.However,the post-analysis showed that the peak pressure in the middle of the forefoot was significantly increased after walking for 20 min with ALD(p=0.041).Similarly,the peak medial plantar pressure increased significantly after 20 min walking with MLD(p=0.026).(2)Medium foot pressure time integral,pressure time integral,contact area:Midfoot pressure time integral,pressure time integral,contact area:the results show that the application of athletic tape after walking at a free speed,at each time point,the midfoot pressure time integral,pressure time integral,contact area there is no significant difference.However,after multiple comparisons,it was found that the time integral of medial plantar pressure immediately after MLD exercise was significantly increased than that before MLD exercise(p=0.013),and the contact area of medial plantar immediately after MLD exercise was also significantly increased than that before MLD exercise(p=0.022).However,there was no significant difference in the time integral of medial and lateral pressure between the three time points.There is no significant difference between two tapes of the foot pressure time integral,pressure time integral,contact area in the three time points.3.The calcaneus angle in coronal plane:At three time points,there was no significant difference in the calcaneus angle in coronal plane of middle foot.However,multiple comparisons after the application of ALD exercise showed that the maximum calcaneus eversion immediately after 20 min walking was significantly increased(p=0.02),and the maximum calcaneus eversion immediately after 20 min walking was significantly increased(p=0.003).The maximum calcaneal varus value was significantly increased after 20 min walking with MLD(p=0.001),and the calcaneal coronal angle was significantly increased after 20 min walking(p=0.002).There was no significant difference between the two kinds of athletic tapes in calcaneus coronal angle at three time points before,immediately after and 20 min after walking.Conclusions:Athletic taping can significantly improve the arch deformation of the foot arch immediately after application,changing peak pressure of the 2nd to 5th toe area and medial midfoot,the medial contact area and the pressure time integral.While the control effect on the resting calcaneal stance position and the angle of the coronal plane of the gait support phase during walking is limited.ALD can maintain the arch morphology after 20min walking,while MLD can’t maintain the arch morphology after 20min walking.Therefore,in clinical practice,it is recommended that the ALD taping technique can be used to provide a prescription basis for the treatment of flexible flat feet,so as to improve the arch morphology of patients with flexible flat feet and optimize the pressure distribution of the plantar in a short period of time. |
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