{"title":"为 Charcot-Marie-Tooth 疾病患者定制的 3D 打印踝关节支架：试点研究。","authors":"Adam Philps, Mike Frecklington, Sarah Stewart","doi":"10.1002/jfa2.70013","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Charcot-Marie-Tooth disease (CMT) is a neurodegenerative condition resulting in footdrop, ankle instability and impaired balance and gait. This study aimed to determine (1) whether 3D-printed custom ankle braces improve function and balance in people with CMT and (2) whether this is an acceptable device for use in this population.</p><p><strong>Methods: </strong>A within-subject comparison pragmatic/pilot study was undertaken. Ten people with CMT (mean [SD] age 48 [14] years, 60% male) were fitted with 3D-printed ankle braces. Following a 4-week wear-in period, walking and balance tests and patient-reported outcomes were assessed in two experimental conditions: (i) usual shoes and (ii) usual shoes with 3D-printed custom ankle braces. Differences in outcome measures between experimental conditions were analysed using linear mixed models. Comfort, aesthetics and overall satisfaction of the brace were assessed via 100-mm visual analogue scale (VAS). Adverse events and tripping/falls associated with the brace during the wear-in period were also recorded by participants using daily diaries.</p><p><strong>Results: </strong>A significant improvement was seen during single-leg balance with eyes open (p = 0.026, Cohen's d = 0.55) and a significant reduction in foot pain (p = 0.045, Cohen's d = 0.82), with use of the ankle brace. Mean (SD) 100 mm VAS scores were 62.7 mm (17.9) for overall comfort and 73.9 mm (21.2) for overall satisfaction. Subjective data from the daily dairies showed that one participant found the brace too firm around the ankle due to loss of soft tissue mass and two participants found it challenging to don and doff the brace due to loss of hand dexterity.</p><p><strong>Conclusion: </strong>This pilot study suggests that a 3D-printed custom ankle brace may improve balance and reduce foot pain in people with CMT; however, larger-scale trials are needed to further explore the impact of this brace on function and balance. Further customisation of the brace may also be required to improve acceptability for some people.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489305/pdf/","citationCount":"0","resultStr":"{\"title\":\"3D-printed custom ankle braces for people with Charcot-Marie-Tooth disease: A pilot study.\",\"authors\":\"Adam Philps, Mike Frecklington, Sarah Stewart\",\"doi\":\"10.1002/jfa2.70013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Charcot-Marie-Tooth disease (CMT) is a neurodegenerative condition resulting in footdrop, ankle instability and impaired balance and gait. This study aimed to determine (1) whether 3D-printed custom ankle braces improve function and balance in people with CMT and (2) whether this is an acceptable device for use in this population.</p><p><strong>Methods: </strong>A within-subject comparison pragmatic/pilot study was undertaken. Ten people with CMT (mean [SD] age 48 [14] years, 60% male) were fitted with 3D-printed ankle braces. Following a 4-week wear-in period, walking and balance tests and patient-reported outcomes were assessed in two experimental conditions: (i) usual shoes and (ii) usual shoes with 3D-printed custom ankle braces. Differences in outcome measures between experimental conditions were analysed using linear mixed models. Comfort, aesthetics and overall satisfaction of the brace were assessed via 100-mm visual analogue scale (VAS). Adverse events and tripping/falls associated with the brace during the wear-in period were also recorded by participants using daily diaries.</p><p><strong>Results: </strong>A significant improvement was seen during single-leg balance with eyes open (p = 0.026, Cohen's d = 0.55) and a significant reduction in foot pain (p = 0.045, Cohen's d = 0.82), with use of the ankle brace. Mean (SD) 100 mm VAS scores were 62.7 mm (17.9) for overall comfort and 73.9 mm (21.2) for overall satisfaction. Subjective data from the daily dairies showed that one participant found the brace too firm around the ankle due to loss of soft tissue mass and two participants found it challenging to don and doff the brace due to loss of hand dexterity.</p><p><strong>Conclusion: </strong>This pilot study suggests that a 3D-printed custom ankle brace may improve balance and reduce foot pain in people with CMT; however, larger-scale trials are needed to further explore the impact of this brace on function and balance. 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引用次数: 0
摘要
简介Charcot-Marie-Tooth 病（CMT）是一种神经退行性疾病，会导致足下垂、踝关节不稳定以及平衡和步态受损。本研究旨在确定：（1）3D 打印定制踝关节支架是否能改善 CMT 患者的功能和平衡；（2）该装置是否可用于此类人群：方法：进行了一项受试者内比较实用/试点研究。10 名 CMT 患者（平均 [SD] 年龄为 48 [14] 岁，60% 为男性）安装了 3D 打印踝关节支架。经过 4 周的磨合期后，在两种实验条件下对行走和平衡测试以及患者报告的结果进行了评估：(i) 普通鞋；(ii) 普通鞋与 3D 打印定制踝部支架。采用线性混合模型分析了不同实验条件下结果测量的差异。通过 100 毫米视觉模拟量表（VAS）对护踝的舒适度、美观度和总体满意度进行评估。参与者还通过每日日记记录了穿戴期间与支架相关的不良事件和绊倒/跌倒情况：结果：使用护踝后，睁眼单腿平衡能力明显改善（p = 0.026，Cohen's d = 0.55），足部疼痛明显减轻（p = 0.045，Cohen's d = 0.82）。100毫米VAS评分的平均值（标度）为：总体舒适度62.7毫米（17.9），总体满意度73.9毫米（21.2）。来自日常乳房的主观数据显示，一名参与者因软组织质量下降而认为踝部支架太硬，两名参与者因手部灵活性下降而认为穿脱支架具有挑战性：这项试验性研究表明，3D 打印定制踝关节护具可以改善肌肉萎缩性苔藓症患者的平衡能力并减轻足部疼痛；不过，还需要进行更大规模的试验，以进一步探索该护具对功能和平衡的影响。可能还需要进一步定制该护具，以提高某些人的接受度。
3D-printed custom ankle braces for people with Charcot-Marie-Tooth disease: A pilot study.
Introduction: Charcot-Marie-Tooth disease (CMT) is a neurodegenerative condition resulting in footdrop, ankle instability and impaired balance and gait. This study aimed to determine (1) whether 3D-printed custom ankle braces improve function and balance in people with CMT and (2) whether this is an acceptable device for use in this population.
Methods: A within-subject comparison pragmatic/pilot study was undertaken. Ten people with CMT (mean [SD] age 48 [14] years, 60% male) were fitted with 3D-printed ankle braces. Following a 4-week wear-in period, walking and balance tests and patient-reported outcomes were assessed in two experimental conditions: (i) usual shoes and (ii) usual shoes with 3D-printed custom ankle braces. Differences in outcome measures between experimental conditions were analysed using linear mixed models. Comfort, aesthetics and overall satisfaction of the brace were assessed via 100-mm visual analogue scale (VAS). Adverse events and tripping/falls associated with the brace during the wear-in period were also recorded by participants using daily diaries.
Results: A significant improvement was seen during single-leg balance with eyes open (p = 0.026, Cohen's d = 0.55) and a significant reduction in foot pain (p = 0.045, Cohen's d = 0.82), with use of the ankle brace. Mean (SD) 100 mm VAS scores were 62.7 mm (17.9) for overall comfort and 73.9 mm (21.2) for overall satisfaction. Subjective data from the daily dairies showed that one participant found the brace too firm around the ankle due to loss of soft tissue mass and two participants found it challenging to don and doff the brace due to loss of hand dexterity.
Conclusion: This pilot study suggests that a 3D-printed custom ankle brace may improve balance and reduce foot pain in people with CMT; however, larger-scale trials are needed to further explore the impact of this brace on function and balance. Further customisation of the brace may also be required to improve acceptability for some people.
期刊介绍：
Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders.
Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care.
The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care.
The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.
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