扁平足児における靴と足底装具の効果についての検討

Clinical Efficacy of Shoes and Custom-made Insoles in Treating Children with Flatfoot

要旨　目的：扁平足児における靴及び足底装具の装着効果を検討することである．方法・対象：当センター装具外来を受診した扁平足患者132名（平均年齢4.20±2.53歳，男児66名，女児66名）を対象に，①裸足，②靴（足底装具なし）を装着，③靴（足底装具あり）を装着の3条件で，シート式下肢加重計を用いて歩行分析を行った．結果：裸足と靴（足底装具なし）装着時を比較すると，靴による効果として，歩行速度と左右歩幅，左右つま先角度の増加，左遊脚期，右歩行角度の減少を認め，裸足と靴（足底装具あり）装着時の比較では，これに加えて，右遊脚期と左歩行角度が有意に減少していた（対応のあるt検定；p＜0.002）．考察と結論：裸足との比較で，靴が扁平足児の歩行速度と歩幅を増加させる即時効果があり，また，靴と足底装具を合わせて装着することで，遊脚期と歩行角度が減少し歩行が安定することが明らかとなった．

　Abstract : We performed a prospective study to determine whether the walking pattern of children with flatfoot can be influenced by using shoes and custom-modeled insoles. One hundred and thirty-two children (mean age ; 4.20±2.53) who had been referred by a physiatrist, and who were diagnosed with flatfoot at the brace clinic in our institute, were assigned to three groups : The first group was asked to walk barefoot, the second one to walk with shoes without insoles and the last one to walk with shoes with insoles. We measured walking speed, cadence, step length, step width, the duration of right and left stance phases, both double-limb stance phases, both swing phases, walking angle, and toe angle using a 2.4 m sheet-type Gait Analyzer, the Walk Way MW-1000^TM, at the individual's self-selected speed. Compared with the barefoot group, a significant increase was observed in the group using shoes with custom-modeled insoles in both walking speed and step length on both sides, and there were reductions in swing phase and walking angle on both sides (paired t-test ; p＜0.002).