Self-reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review.
Self-reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review.
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DOI：
10.1186/s13047-018-0292-z
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发表时间：
2018
影响因子：
2.9
通讯作者：
Vicenzino B
中科院分区：
文献类型：
--
作者：
Ross MH;Smith M;Plinsinga ML;Vicenzino B
胫骨后肌腱功能障碍（PTTD）是一种疼痛的进行性肌腱病变，据报道主要发生在中年超重女性中。没有临床医生可以用来指导治疗计划的循证指南，这使得临床医生只能根据临床损伤和自我报告的疼痛和残疾做出决定。本系统评价的目的是量化PTTD患者与对照组相比的临床损伤、疼痛和残疾。检索了5个数据库中截至2018年3月11日（含）的胫骨后肌腱和扁平足相关术语。该系统综述已在PROSPERO注册（CRD：42016046951）。如果研究以英语发表，并且包含诊断为PTTD的参与者与无疼痛个体之间的临床损伤，疼痛或残疾的数据，则研究符合条件。在可能的情况下计算标准化平均差异（SMD），并在结果同质性允许的情况下进行荟萃分析。在荟萃分析中确定并汇总了10项合格研究。足跟抬高耐力差（SMD-1.52，95% CI -2.05至-0.99）、前足内收-内翻强度较低（SMD-1.19，95% CI -1.68至-0.71）和足弓高度较低（SMD-1.76，95% CI -2.29至-1.23）显示出较强的影响。与对照组相比，PTTD患者自我报告的僵硬（SMD 1.45，95% CI 0.91至1.99）、足部问题引起的困难（SMD 1.42，95% CI 0.52至2.33）和社交限制（SMD 1.26，95% CI 0.25至2.27）也更多。有证据表明PTTD患者与对照组相比，胫骨后肌能力受损，足弓高度降低。除了解决局部肌腱功能和足部姿势的预期损伤外，在管理PTTD时还应考虑疼痛、僵硬、功能限制和社会参与限制。本文的在线版本（10.1186/s13047-018-0292-z）包含补充材料，可供授权用户使用。
Posterior tibial tendon dysfunction (PTTD) is a painful, progressive tendinopathy that reportedly predominates in middle-age, overweight women. There is no evidence based guidelines that clinicians can use to guide treatment planning, which leaves clinicians to make decisions on the basis of presenting clinical impairments and self-reported pain and disability. The purpose of this systematic review was to quantify clinical impairments, pain and disability in individuals with PTTD compared with controls. Five databases were searched for terms referring to the posterior tibial tendon and flatfoot up to and including 11 March 2018. The systematic review was registered with PROSPERO (CRD: 42016046951). Studies were eligible if they were published in the English language and contained data on clinical impairments, pain or disability compared between participants diagnosed with PTTD and pain-free individuals. Standardised mean differences (SMDs) were calculated where possible and meta-analysis was performed when homogeneity of outcomes allowed. Ten eligible studies were identified and pooled in the meta-analyses. Strong effects were revealed for poor heel rise endurance (SMD -1.52, 95% CI -2.05 to − 0.99), less forefoot adduction-inversion strength (SMD -1.19, 95% CI -1.68 to − 0.71) and lower arch height (SMD -1.76, 95% CI -2.29 to − 1.23). Compared to controls, individuals with PTTD also had more self-reported stiffness (SMD 1.45, 95% CI 0.91 to 1.99), difficulties caused by foot problems (SMD 1.42, 95% CI 0.52 to 2.33) and social restrictions (SMD1.26, 95% CI 0.25 to 2.27). There is evidence of impaired tibialis posterior capacity and lowered arch height in individuals with PTTD compared to controls. Further to addressing the expected impairments in local tendon function and foot posture, pain, stiffness, functional limitations and social participation restrictions should be considered when managing PTTD. The online version of this article (10.1186/s13047-018-0292-z) contains supplementary material, which is available to authorized users.
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作者：
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DOI：
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