Arch Support Insoles Research Articles

Structural Effect of Long-Term Use of Medial Arch Support Insole on Children with Pediatric Flexible Flatfoot

Category:Midfoot/ForefootIntroduction/Purpose:This prospective study aimed to rule out the effect of the normal physiologic maturation in applying medial arch support insole for patients with pediatric flexible flatfoot (PFFF).Methods:From January 2005 to June 2015, 18 patients (34 feet) in group 1 (insole was continuously applied) and 16 patients (32 feet) in group 2 (untreated group) were enrolled. A medial arch support insole was applied from age 10-11 years until radiographic physeal closure.Results:In group 1, the talonavicular coverage angle, lateral talo-first metatarsal angle, calcaneal pitch angle, and medial cuneiform height were significantly changed at final follow-up, although all values were still within the abnormal range. Moreover, no significant differences were found in any of the increments of the radiographic parameters between groups 1 and 2.Conclusion:Radiographic improvements were found in both medial arch support insole-treated and untreated groups even if all radiographic values were still within the abnormal range. This means that PFFF could be somehow improved with heel stretching exercise until the physes were closed. Further, hindfoot alignment remained unchanged regardless of the medial arch support insole application.

Does the long-term use of medial arch support insole induce the radiographic structural changes for pediatric flexible flat foot? — A prospective comparative study

BackgroundSeveral conservative treatment methods, from intrinsic muscle exercises to orthoses, including insoles or specially designed shoes, have been introduced for pediatric flexible flat foot (PFFF). However, the structural effects of a long-term use of medial arch support insole remain unclear because the normal physiological maturation of the medial longitudinal arch cannot be ruled out. MethodsFrom January 2005 to June 2015, 18 patients (34 feet) in group 1 (continuously insole applied group) and 13 patients (26 feet) in group 2 (untreated group) were enrolled. Medial arch support insole was applied from the age 10–11years to radiographic physeal closure. ResultsIn group 1, talonavicular coverage angle, lateral talo-1st metatarsal angle, calcaneal pitch angle and medial cuneiform height were significantly changed at final follow-up, although all values were still within the abnormal range. Further, no significant differences were found in any of the increments of the radiographic parameters between group 1 and 2. ConclusionsRadiographic improvements were found in both of medial arch support insole treated or untreated group despite all radiographic values were still within the abnormal range. It was meaningful that the PFFF could be improved somewhat until the physes were closed. And the hindfoot alignment remained unchanged regardless of medial arch support insole application.

The effect of medial longitudinal arch height and medial longitudinal arch-support insoles on postural balance in perimenopausal women

Background/aim Changes in balance and postural control have been reported during the perimenopausal period. We investigated the effect of medial longitudinal arch height and medial arch support insoles on postural sway and balance in middle-aged perimenopausal women. Materials and methods 29 women with normal arches and 29 women with low arches were included in the study. The foot arches of the participants were determined using the arch height index. The static balance index (SBI) measured by Kinesthetic Ability Trainer 3000 and functional reach test were used to evaluate postural balance. Measurements were obtained from all participants with and without medial arch support insoles. Results The SBI-total scores without the insoles were found to be significantly higher in the lower arch group than in the normal arch group. SBI-total, SBI-anteroposterior, and SBI-mediolateral scores significantly improved in the low arch group in the presence of insoles, whereas the usage of insoles resulted in no difference in the normal arch group. In the presence of insoles, the reach distances to left and right sides increased in both groups, while the forward functional reach distances decreased. Conclusion Medial longitudinal arch height and medial arch support insoles affect the balance parameters in perimenopausal women.

Short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children: A randomized controlled trial.

Background:Limited evidence is available regarding the effects of insoles on pediatric flexible flatfoot because of the heterogeneity and low methodological quality of previous studies. The purpose of this prospective trial is to examine the short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children by using the International Classification of Functioning, randomized controlled Disability, and Health (ICF) framework.Methods:This study was conducted in a rehabilitation outpatient clinic of a teaching hospital. Fifty-two children with symptomatic flexible flatfoot were included. The children in the treatment group wore customized arch support insoles for 12 weeks, whereas those in the control group did not wear the insoles. Both clinical and radiographic measurements, including the navicular drop, foot posture index, Beighton hypermobility score, talonavicular coverage angle, calcaneal inclination angle, and calcaneal-first metatarsal angle, were used for diagnosing flexible flatfoot. Physical activity (10-m normal and fast walking, stair ascent, stair descent, and chair rising), physical function, and psychometric properties (Pediatric Outcome Data Collection Instrument and Pediatric Quality of Life Inventory) were evaluated at the baseline and 12 weeks after the intervention.Results:Compared with the control group, the treatment group exhibited significant improvement in pain/comfort (P = .048), physical health (P = .035), stair ascent time (P = .015), upper extremity and physical function (P = .016), and transfer and basic mobility (P = .042) during the intervention period.Conclusion:Children with flexible flatfoot who wore customized arch support insoles for 12 weeks exhibited significantly improved pain/comfort, physical health, stair ascent time, upper extremity and physical function, and transfer and basic mobility. These variables belong to the domains of body functions and structures and activity and participation in the ICF framework. However, because the groups were not comparable, additional studies with larger sample sizes should be conducted.

A systematic review and meta-analysis into the effect of lateral wedge arch support insoles for reducing knee joint load in patients with medial knee osteoarthritis.

The aim of this study was to evaluate the immediate effects of lateral wedge arch support insoles (LWAS) on reducing the knee joint load in patients with medial knee osteoarthritis (OA) compared with an appropriate control. Databases including Medline, EMBASE, Web of Science, Wiley Online Library, Cochrane library, and Google Scholar were searched with no limits on study date or language, from the earliest available date to October 31, 2016. The included studies had to have the aim of reducing knee load and have an appropriate control. The main measured values were the first and second peak external knee adduction moments (EKAM) and the knee adduction angular impulse (KAAI). The random-effects model was used for analyzing the eligible studies. Nine studies met the inclusion criteria with a total of 356 participants of whom 337 received LWAS treatment. The risk of methodological bias scores (quality index) ranged from 21 to 27 of 32. Treatment with LWAS resulted in statistically significant reductions in the first peak EKAM (P = .005), the second peak EKAM (P = .01), and the KAAI (P = .03). However, among trials in which the control treatment was control shoes, the LWAS showed no associations on the first peak EKAM (P = .10) or the KAAI (P = .06); among trials in which the control treatment was neutral insoles, the LWAS showed no associations on the second peak EKAM (P = .21) or the KAAI (P = .23). At the same time, the LWAS showed no statistically significant reduction on the first peak EKAM (P = .39) when compared with flat insoles. Although meta-analysis outcomes of all studies indicated statistically significant associations between LWAS and reductions of the first peak EKAM, second peak EKAM and KAAI in people with medial knee OA while walking, different results existed in subgroups using various control conditions for comparison. These findings do not support the use of LWAS insoles for reducing knee load. An optimal LWAS treatment should provide the appropriate height of arch support and amount of lateral wedging. Further research should investigate the best combination of these 2 parameters to achieve efficacy without altered comfort.

The effects of short foot exercises and arch support insoles on improvement in the medial longitudinal arch and dynamic balance of flexible flatfoot patients.

[Purpose] The purpose of the present study is to apply short foot exercises and arch support insoles in order to improve the medial longitudinal arch of flatfoot and compare the results to identify the effects of the foregoing exercises on the dynamic balance of the feet and the lower limbs. [Subjects and Methods] Fourteen university students with flexible flatfoot were selected by conducting navicular drop tests and randomly assigned to a short foot exercise group of seven subjects and an arch support insoles group of seven subjects. The intervention in the experiment was implemented for 30 minutes per time, three times per week for five weeks in total. [Results] In inter-group comparison conducted through navicular drop tests and Y-balance tests, the short foot exercise group showed significant differences. Among intra-group comparisons, in navicular drop tests, the short foot exercise group showed significant decreases. In Y-balance tests, both the short foot exercise group and the arch support insoles group showed significant increases. [Conclusion] In the present study, it could be seen that to improve flatfoot, applying short foot exercises was more effective than applying arch support insoles in terms of medial longitudinal arch improvement and dynamic balance ability.

The Immediate Effects of Arch Support Insole on Ground Reaction Forces during Walking

Introduction: Evaluation of ground reaction forces (GRF) and other kinetic parameters have clinical importance. These parameters may cover all possible interaction between shoe type and insole. This study aimed to investigate the immediate effects of arch support insole on GRF and their peak time, impulse, loading rate, and free moment during stance phase of gait in normal individuals. Materials and Methods: Sixteen healthy male subjects with mean ± SD age; 29.4 ± 4.8 years, mean ± SD mass; 77.9 ± 12.6 kg and mean ±SD height; 176.5 ± 5.8 cm were participated in this study. All parameters were measured using two adjacent Kistler force plates (1000Hz) during stance phase of walking in two different conditions: with and without shoe insole. Maximum GRF and their related peak time, impulse, loading rate, and free moment were recorded. Repeated measure ANOVA was used to analyze the data (α = 0.05). Results: Wearing insole caused reduction the peak vertical GRF (PvGRF) in heel contact phase by 6.9% of body weight (BW) (P = 0.001) and the loading rate (8.4%, P = 0.02). However, it increased the propulsive force (7% N/BW, P = 0.001), anterior-posterior impulse by 1.2% BW (P = 0.003) and normal impulse by 2% of BW (P = 0.032).

Effects of Arch Support Insoles on Gait Patterns of Patients with Knee Osteoarthritis

Although arch support orthotics are prescribed for knee osteoarthritis (OA) patients in clinics, the biomechanical effects of such devices are not fully clear. This study conducts an experimental investigation to evaluate the short-term effects of shoes with arch support insoles on the gait patterns of patients with knee OA during level walking. Twelve adults with knee OA were recruited, and biomechanical data were measured under three test conditions: walking barefoot, walking in shoes, and walking in shoes and insoles. Participants’ gait patterns were recorded and analyzed using a motion analysis system, Kistler force plates, and EVaRT software. Walking in shoes with insoles significantly increased the peak knee flexion angle and the peak dorsiflexion and external rotation angles of the ankle, but reduced the peak ankle internal rotation angle compared to those for walking barefoot. Both walking in shoes with insoles and walking in shoes significantly reduced the toe-out angle compared to that for walking barefoot. However, no significant difference was observed in the peak knee varus moment. The results suggest that the foot insoles and shoes tested in this study might have influenced the ankle joint in OA patients. In view of the significantly decreased toe-out angle of the foot and increasing trend in the knee varus moment, the use of shoes with insoles may be unsuitable for knee OA patients.

The effects of Foot Orthoses on Pain Management of People with Plantar Fasciitis

Introduction: Plantar fasciitis is the most common cause of plantar heel pain, accounting for almost 15% of all foot-related complaints. Arch supports and heel pads are the main foot orthotics to manage the heel pain. Despite the high prevalence of plantar fasciitis, information about the effectiveness of different orthoses is still scarce. This study was aimed to compare the effectiveness of using an arch support and a silicone heel pad in the pain management of people with plantar fasciitis. Methods: Forty subjects (mean ± SD age; 44.46 ± 9.7 years) with unilateral plantar fasciitis were recruited in this randomized clinical trial study. They randomly and equally allocated to the intervention groups (the soft arch support insole and silicone heel pad). The primary outcomes were pain and foot function. Outcomes were measured while participants were administrated prior to receiving the allocated intervention and after 6-week follow up period. In the admission and follow-up sessions, the heel pain was scored via visual analogue scale (VAS) and the foot function were measured by foot and ankle outcome score (FAOS) questionnaire. Data were analysed by Mann-Whitney test. Results: Foot orthoses significantly improved the foot function, reduce the heel pain (p<0.001). There was no significant difference between two orthoses in pain relief (p=0.094). The results indicated that both silicone heel pad and soft insole had successful outcomes in the management of plantar fasciitis over a 6-week period. Conclusion: The silicone heel pad and the soft insole with arch support are effective to reduce heel pain and improve the activity level in people with plantar fasciitis.

Effectiveness of a heel cup with an arch support insole on the standing balance of the elderly

BackgroundThe use of insoles may enhance postural stability and prevent falls. The aim of this study was to design a new insole and to explore the effectiveness of the insole on the standing balance of the healthy elderly.MethodsThe study was conducted at a community hospital. Patients older than 65 years at an outpatient clinic without abnormal gait patterns, lower limb deformities, or foot pain were enrolled. The participants were assigned to good- and poor-stability groups on the basis of the stability index (SI), using the Biodex® Balance System. A heel cup with an arch support insole was provided. Participants wore the insole for 8 weeks for a minimum of 4 hours/day. A static balance test for SI was performed at the initial meeting and 8 weeks after the assigned insoles were worn for each participant.ResultsFive participants (10.0%) of 50 total did not finish the study. There were 25 patients in the good-stability group and 20 in the poor-stability group. The SI, before and after intervention, was significantly different for all 45 participants (3.244±0.688 versus 3.064±0.671; P<0.001). The differences in SI before and after the intervention both in the good-stability group (2.764±0.546 versus 2.592±0.538) and the poor-stability group (3.845±0.188 versus 3.655±0.128) were statistically significant (P<0.001). No statistically significant difference on changes of SI were seen between the two groups.ConclusionThe results suggest a heel cup with arch support insole is effective in enhancing the standing balance of the elderly. This may be of benefit in preventing falls.

Cycling performance enhancement and injury prevention use an arch support insole with forefoot wedge

Bicycle riding is an increasingly popular recreational and competitive activity, however, the more popular the more biking-related injuries. Most of cycling injuries are musculoskeletal related and caused by a combination of inadequate preparation, inappropriate bike fitting, poor technique, and overuse of prolonged uphill biking. However, after well bike fitting, the injury is still existed, the leg alignment and foot types might be an important factor that mainly causes the muscular injury after an appropriate bike fitting. [1-3]The purpose of this study was to investigate the efficacy of an arch support insole with/o forefoot wedge in muscle activities and joint loads in order to mimic the musculoskeletal sport injury in cycling and to enhance the performance. Eleven amateur cyclists were recruited for this study. Vicon motion analysis system, Pedar in-sole foot pressure sensor and Delsys EMG system were used to measure the three-dimensional lower extremity kinematics, kinetics, EMG signal. Each subject was randomly shot four different insoles (Bikepro, off-counter insole with/o arch support and forefoot wedge) with his own bike shoes and bike mounted on a cycle ergometer set to a fixed power of 150W in 75rpm. An One-way ANOVA repeated measurement was used to discriminate the effect of insole material, arch, and forefoot wedge. The results showed that the BikePro significantly increased the ankle varus angle(0.4°, p=0.029), the knee internal rotation (1.4°, p=0.030), and it significantly decreased the ankle abduction angle (1.2°, p=0.047)at the bottom dead center (BDC); reduced the knee sway area by (10.4% , p=0.037). Combined with forefoot wedge, it significantly decreased the ankle varus(0.5°, p=0.005), and increased the ankle abduction angle (1.2°, p=0.005) but without changing the knee trajectory patterns.

운동효과 증진을 위한 Arch Support 효과에 관한 연구

Walking shoes for walking and jogging have been used to enjoy lots of leisure time. Functional shoes such as walking shoes have special functions to improve body motility by changing of shoe shapes. The walking shoes could improve the motility by structural transformation of outsole as increase degrees of heel and toe. The study on insoles has not been conducted enough on the contrary of the study of outsole. The purpose of this study is to perform ergonomics analysis whether the Arch Supported insoles have an improving effect of muscle activities or not. Experiments were performed with 6 subjects who are health and haven't experienced any diseases past. EMG(Electromyography) and Foot Pressures were measured repeatedly for 5 seconds at 0 hour, after 1 hour and after 2 hours of walking. Insoles used for experiment are normal insole, insole inserted Arch Support and pad. The electrodes for EMG measurement were set on waist (erector spinae), and thigh (vastus lateralis), calf (gastrocnemius). Evaluations of EMG were analyzed by shift of MF (Median Frequency) and MPF (Mean Power Frequency). Foot Pressure was analyzed by mean pressure of feet and change of walking time. As results, Arch Support insole had larger frequency shift value than that of normal insole. Frequency shift between Arch Support insoles and normal insole showed significant difference on 95% confidence interval. And insole 1 has the highest value of frequency shift. For results of foot pressure, Arch Support insoles show continuous decreasing tendency when comparing with normal insoles by changing of times. Also, insole 1 has the highest decreasing value of foot pressure. Therefore, this study presented that the Arch Support insole can promote muscle activities and improves comfort for a prolonged walking.

Effect of arch supports on ankle-subtalar complex instability: a biomechanical experimental study.

Subtalar instability, which may cause persistent symptoms after severe inversion ankle sprains, often involves failure of the interosseous talocalcaneal ligament (ITCL). While several clinicians have reported surgical treatment for this pathology, nonsurgical management policy has not been well considered. Previously, it was proposed that ITCL failure possibly causes looseness of the tarsal arch construction resulting in abnormal ankle-subtalar kinematics occurring with axial forces. In the current study the author hypothesized that arch-support insole functions to improve abnormal joint kinematics in ankle-subtalar complex instability. Five fresh-frozen cadaver lower extremities with simulated ankle-subtalar complex instability, which was created by combined sectioning of the anterior talofibular ligament (ATFL) and the ITCL, were subjected to a biomechanical experiment. Cyclic axial loading from 9.8 to 668 N was applied with a material testing machine, while three-dimensional angular displacements in both the ankle and subtalar joints were determined with electric goniometers. The specimens were tested before and after inserting an arch-support insole that supports the medial-longitudinal and transverse arches of the foot. Inserting the insole decreased the maximum ankle internal rotation, from 3.3 degrees +/- 0.9 degrees to 2.3 degrees +/- 0.4 degrees (p = .028), while subtalar rotation was not significantly changed. The medial longitudinal arch-support insole reduced abnormal ankle internal rotation created by combined sectioning of the ATFL and ITCL, likely due to improved arch configuration stability.