RESUMEN
Objective:To observe the effect of braces combined with insoles on scoliosis and walking performance in patients with adolescent idiopathic scoliosis (AIS). Methods:From September, 2019 to September, 2020, 42 subjects with AIS were selected and randomly divided into brace group (n = 21) and brace combined with insole group (n = 21). Both groups received two-month routine rehabilitation, including braces for 22 to 23 hours a day and gymnastics for 30 minutes a day. The brace combined with insole group additionally wore insoles, at least eight hours a day for two months. Meanwhile, 32 even-aged adolescents were recruited as healthy controls. Firstly, gait and plantar pressure of 42 patients and 32 healthy adolescents were compared to find out abnormal indicators. Secondly, the scoliosis and above abnormal indicators were compared between the brace group and the brace combined with insole group Results:The center of pressure excursion index (CPEI) was higher in AIS group than in the healthy group (F = 3.120, P < 0.05), and there was no significant difference in walking speed, gait cycle and phase between two groups (P>0.05). An obvious imbalanced pressure was observed between the medial and lateral heel of the single foot and the bilateral foot in AIS patients (P < 0.05). After treatment, the Cobb's angle decreased in AIS patients (t > 7.552, P < 0.001), however, no difference was found between the brace group and the brace combined with insole group (t = 0.459, P > 0.05); the CPEI decreased (t = 2.209, P < 0.05), and the pressure in medial and lateral heel as well as the left and right foot tended to be balanced (t > 2.306, P < 0.05) in the brace combined with insole group, and were better than that of the brace group (|t| > 2.319, P < 0.05). Conclusion:Plantar pressure distribution shows obvious local and global asymmetric changes in AIS patients. The efficacy of insoles on the scoliosis is limited, but the insole can effectively improve the abnormal biomechanics and balance the force.
RESUMEN
BACKGROUND: The exact pathogenesis of osteoarthritis is unclear. Studies have shown that macrophages in synovial tissue are involved in sliding-inflammation response and the production of cartilage matrix degradation enzyme. OBJECTIVE: Based on the important role of synovial macrophages in osteoarthritis, to review and summarize the major research achievements and important research methods in this field, laying a foundation for future research on synovial macrophages. METHODS: The first author used computer to search relevant literatures included in PubMed and VIP from 1999 to 2019. The search terms were “osteoarthritis, synovitis, synovial macrophages” in English and Chineserespectively. Manual screening was conducted according to the inclusion criteria, and irrelevant, repetitive and obsolete articles were excluded. Finally, 46 eligible articles were included.RESULTS AND CONCLUSION: There is an inflammatory response in the synovial tissue, and the severity of synovitis is closely related to osteoarthritis symptoms and progression. A large number of macrophages with different activation states are infiltrated in the synovial tissues of osteoarthritis patients at different stages. M1 macrophages are the main subgroup of macrophages involved in the production, cartilage degradation and osteophyte formation of osteoarthritis inflammatory factors, while M2 macrophages have a protective effect on osteoarthritis by secreting anti-inflammatory factors. Inhibiting the differentiation of macrophages into M1 type and promoting their M2 type differentiation can alleviate the pathological changes of osteoarthritis and delay the progression of osteoarthritis. It may be an effective method to treat osteoarthritis by regulating the polarization state of synovial macrophages.