Effect Of Foot Orthotics Research Articles

Influence of Foot Orthotics and Intrinsic Factors on Strain Measurements in the Fifth Metatarsal

Category:Midfoot/Forefoot; SportsIntroduction/Purpose:Fractures of the fifth metatarsal occur in young, athletic populations and often result in sub-optimal clinical outcomes, even after surgical fixation. With such a high demand for decreased return to play in athletic populations, the development of intervention strategies which mitigate intrinsic and extrinsic risk factors of initial injury is important. Foot orthotics have been shown to decrease strain in the 2nd metatarsal. However, limited research has investigated the influence of intrinsic risk factors and the use of foot orthotics on fifth metatarsal strain. Therefore, the purpose of our study was to investigate the effect of foot orthotics and intrinsic risk factors on fifth metatarsal strain during cadaveric simulation.Methods:Ten specimens were loaded to simulate the stance phase of normal gait using a validated 6-degree of freedom robot with tendon actuators. Strain gauges were placed at the metaphyseal - diaphyseal junction (Zone II), and the proximal diaphysis (Zone III) to measure principal strain. Specimens were tested in a sneaker-only control condition and ten orthotic conditions, which include combinations of a commercial orthotic insole, three plates, and two foam wedges (Figure 1A). The average peak strain from three simulations were recorded for each orthotic condition. Relevant intrinsic factors were recorded from reconstructions of axially loaded computed tomography scans. A two-way repeated measures ANOVA was conducted to determine the effect of orthotic conditions on fifth metatarsal strains, with significantly correlated intrinsic factors included as covariates. Tukey-Kramer post-hoc analysis with a Bonferroni correction was used to analyze differences between individual orthotic conditions and main effects of components.Results:Metatarsus adductus angle, 4-5 intermetatarsal angle, and Meary’s angle (R2= 0.944; p<0.001) were included as covariates in analysis of Zone III strain. Significant (p<0.05) differences in Zone III strain were found for the both the main effect of a plate and individual orthotic conditions with statistical adjustment for previously stated intrinsic measurements. However, post- hoc testing revealed no significant differences between non-plate conditions and full plate conditions(p=0.23), lateral plate conditions (p=0.025), or lateral cut plate conditions (p=0.026). Additionally, the Full Plate with Lateral Wedge condition reduced strains by 285 µΕ relative to the sneaker condition, no significant differences (p = 0.07) were found in post-hoc analysis. No significant differences were found in Zone II with the models considered.Conclusion:Zone III strains were shown to be significantly correlated with intrinsic factors in the current analysis. Plate conditions demonstrated a trend towards significant reduction of Zone III strain relative to the sneaker condition, despite failing to achieve statistical significance in conservative post-hoc analysis. However, these results may be clinically significant as the reduction of strain in plate conditions exceeded previously reported significant decreases in the 2nd metatarsal. Correlations found between intrinsic risk factors and strain in this study corroborate with previous studies. This indicates that the effectiveness of foot orthotics to reduce strain is strongly influenced by individual foot structure.

Acute effect of foot orthotics on drag area and perceived comfort in cyclists affected by an anatomic asymmetry in time trial position

The aim of this study was to analyse the acute effect of biomechanical foot orthotics on drag area (ACd) and perceived comfort in elite cyclists affected by a lower limb length inequality (LLLI) in TT position. Twenty-nine cyclists performed two discontinuous incremental exercises (before and after orthopaedic correction) using their personal TT bicycle and equipment on a 250-m indoor velodrome. The ACd was unchanged in both the test group (TG) (‑0.5%, p = 0.707) and the control group (CG) (-1.4%, p = 0.276), whereas the perceived comfort was improved in the TG (+6.2%, p = 0.002) and stabilised in the CG (+0.7%, p = 0.546), after the fitting of the foot orthotics. Pelvis movements were decreased (small effect size) in the TG (-6.2%, p = 0.093, ES = 0.251), whereas they were increased (small effect size) in the CG (+5.2%, p= 0.159, ES = 0.215). TT position was slightly improved by compensating for a LLLI, as the ACd was stabilised and the level of comfort was improved. Thus, cyclists affected by a LLLI are recommended to compensate with foot orthotics in order to improve their level of comfort and consequently their performance in TT position.

Effect of custom foot orthotics on three-dimensional kinematics and dynamics during walking

Foot orthotics is regularly used in the correction of various disorders of the musculoskeletal system. Some recent scientific studies showed a limited effect of foot orthotics and that the results ...

Center of pressure trajectory during gait: A comparison of four foot positions

Knowledge of the center of pressure (COP) trajectory during stance can elucidate possible foot pathology, provide comparative effectiveness of foot orthotics, and allow for appropriate calculation of balance control and joint kinetics during gait. Therefore, the goal of this study was to investigate the COP movement when walking at self-selected speeds with plantigrade, equinus, inverted, and everted foot positions. A total of 13 healthy subjects were asked to walk barefoot across an 8-m walkway with embedded force plates. The COP was computed for each stance limb using the ground reaction forces and moments collected from three force plates. Results demonstrated that the COP excursion was 83% of the foot length and 27% of the foot width in the anterior–posterior and medial lateral directions for plantigrade walking, respectively. Regression equations explained 94% and 44% of the anterior–posterior and medial–lateral COP variability during plantigrade walking, respectively. While the range of motion and COP velocity were similar for inverted and everted walking, the COP remained on the lateral and medial aspects of the foot for these two walking conditions, respectively. A reduced anterior–posterior COP range of motion and velocity were demonstrated during equinus walking. Ankle joint motion in the frontal and sagittal planes supported this COP movement, with increased inversion and plantar flexion demonstrated during inverted and equinus conditions, respectively. Results from this study demonstrated the COP kinematics during simulated pathological gait conditions, with the COP trajectory providing an additional tool for the evaluation of patients with pathology.

The Effectiveness of Foot Orthotics in Improving Postural Control in Individuals With Chronic Ankle Instability: A Critically Appraised Topic

Chronic ankle instability (CAI) is a condition commonly experienced by physically active individuals. It has been suggested that foot orthotics may increase a CAI patient's postural control. For patients with CAI, is there evidence to suggest that an orthotic intervention will help improve postural control? The literature was searched for studies of level 2 evidence or higher that investigated the effects of foot orthotics on postural control in patients with CAI. The search of the literature produced 5 possible studies for inclusion; 2 studies met the inclusion criteria and were included. One randomized controlled trial and 1 outcomes study were included. Foot orthotics appear to be effective at improving postural control in patients with CAI. There is moderate evidence to support the use of foot orthotics in the treatment of CAI to help improve postural control. There is grade B evidence that foot orthotics help improve postural control in people with CAI. The Centre of Evidence Based Medicine recommends a grade of B for level 2 evidence with consistent findings.

Effects of foot orthoses on the temporal pattern of muscular activity during walking

BackgroundSeveral studies have described the biomechanical effects of foot orthotics, as well as their effects at the level of muscular recruitment. Although the latter effect is unlikely to be limited to muscular intensity, the temporal pattern of activity of the muscles involved in walking with orthoses is still unclear. MethodsTwelve adults with everted static rearfoot posture higher than 5° of valgus participated in the study. For all participants, the kinematic data and the muscular temporal activity of the tibialis anterior, the soleus, the gastrocnemius medialis, the gastrocnemius lateralis and the peroneus longus were measured under two experimental conditions, walking with and without custom-made orthoses. Data were recorded and analyzed using a motion analysis and a surface EMG system. FindingsThe results showed that, when walking with insoles, the activity of the tibialis anterior, the soleus, the gastrocnemius medialis, the gastrocnemius lateralis and the peroneus longus is shorter than walking without orthoses. Furthermore, when walking with orthoses, the activity of the soleus and the gastrocnemius medialis is delayed. InterpretationOur study corroborates that the realignment of the calcaneus with the talus decreases the range of eversion and inversion of midfoot. Moreover, it reports noticeable modifications on the start time and the duration of the muscular activity of the tibialis anterior, soleus, gastrocnemii and peroneus longus while using foot orthoses.

Changes in Balancing Ability of Athletes With Chronic Ankle Instability After Foot Orthotics Application and Rehabilitation Exercises

ObjectiveTo compare the effect of foot orthotics and rehabilitation exercises by assessing balancing ability and joint proprioception in athletes who have chronic ankle instability.MethodsForty-one athletes who visited hospitals due to chronic ankle instability were randomly assigned to two groups. One group had ankle rehabilitation exercises while the other group had the same rehabilitation exercises as well as foot orthotics. Joint position sense of the ankle joint was examined by using an isokinetic exercise machine. Balancing abilities categorized into static, dynamic and functional balance abilities were evaluated by using computerized posturography. We tested the subjects before and after the four-week rehabilitation program.ResultsAfter the four-week treatment, for joint reposition sense evaluation, external 75% angle evaluation was done, revealing that the group with the application of foot orthotics improved by -1.07±1.64 on average, showing no significant difference between the two groups (p>0.05). Static, dynamic and functional balancing abilities using balance masters were evaluated, revealing that the two groups improved in some items, but showing no significant difference between them (p>0.05).ConclusionThis study found that athletes with chronic ankle instability who had foot orthotics applied for four weeks improved their proprioceptive and balancing abilities, but did not show additional treatment effects compared with rehabilitation exercise treatment.

The Effect of Foot Orthotics on Arch Height: Prediction of Arch Height Correction in Flat-foot Children

Prognosis of the arch height correction could provide valuable information in prescribing appropriate treatment to reduce the consequences of flat-foot. The goal of this study was twofold. First we explored effect of foot orthotics wedging on the gait pattern of flat-footed children population. Then a simple model to predict arch height correction using six variables was proposed. Measured parameters included the arch height, X-ray measurement, and ground reaction force (GRF). The suggested model allows predicting of the arch height correction. The results show that foot orthotics has small, but a positive impact on the arch height correction.

The short-term effect of foot orthotics on dynamic balance and muscle intensity of the lower limb: A pilot study

The short-term effect of foot orthotics on dynamic balance and muscle intensity of the lower limb: A pilot study

Effect of Foot Orthotics on Single- and Double-Limb Dynamic Balance Tasks in Patients With Chronic Ankle Instability

Deficits have been observed in patients with chronic ankle instabil- ity while performing dynamic balance tasks. Foot orthotic intervention has demonstrated improvements in static balance following lateral ankle sprain, but the effect is unknown in patients with chronic ankle instability during dynamic balance tasks. Twenty patients with self-reported unilateral chronic ankle instability volunteered for partic- ipation. They completed a familiariza- tion session and 2 test sessions separated by 4 weeks. The familiarization ses- sion consisted of practice trials of the Star Excursion Balance Test (SEBT) and Limits of Stability (LOS) test, orthotic fitting, and the Cumberland Ankle Instability Tool (CAIT) questionnaire. Patients were instructed to wear the custom-fitted orthotics for at least 4 hours a day to a preferred 8 hours a day for the 4 weeks between sessions. There was an increase in distance reached in the posterolateral direction over the 4-week period in the orthotic condition. There was an increase in distance reached in the medial direction, demonstrat- ing an improvement on the injured side in the orthotic condition after 4 weeks of orthotic intervention. No consistent, meaningful results were observed in the LOS. The involved leg had a signifi- cantly lower CAIT score than the unin- volved leg during both sessions, but the involved leg CAIT scores significantly improved over 4 weeks compared with the baseline measure. Orthotic interven- tion may prove beneficial for improving dynamic balance as measured by the SEBT in individuals with chronic ankle instability and may be a useful adjunct to clinical and sport interventions.

Effect of Foot Orthotics on Single- and Double-Limb Dynamic Balance Tasks in Patients With Chronic Ankle Instability

Deficits have been observed in patients with chronic ankle instability while performing dynamic balance tasks. Foot orthotic intervention has demonstrated improvements in static balance following lateral ankle sprain, but the effect is unknown in patients with chronic ankle instability during dynamic balance tasks. Twenty patients with self-reported unilateral chronic ankle instability volunteered for participation. They completed a familiarization session and 2 test sessions separated by 4 weeks. The familiarization session consisted of practice trials of the Star Excursion Balance Test (SEBT) and Limits of Stability (LOS) test, orthotic fitting, and the Cumberland Ankle Instability Tool (CAIT) questionnaire. Patients were instructed to wear the custom-fitted orthotics for at least 4 hours a day to a preferred 8 hours a day for the 4 weeks between sessions. There was an increase in distance reached in the posterolateral direction over the 4-week period in the orthotic condition. There was an increase in distance reached in the medial direction, demonstrating an improvement on the injured side in the orthotic condition after 4 weeks of orthotic intervention. No consistent, meaningful results were observed in the LOS. The involved leg had a significantly lower CAIT score than the uninvolved leg during both sessions, but the involved leg CAIT scores significantly improved over 4 weeks compared with the baseline measure. Orthotic intervention may prove beneficial for improving dynamic balance as measured by the SEBT in individuals with chronic ankle instability and may be a useful adjunct to clinical and sport interventions.

The Kinematic Comparative Study about Effects of Foot Orthotics

The Kinematic Comparative Study about Effects of Foot Orthotics

달리기 동호인들의 상해예방을 위한 맞춤형 발 보장구의 평가연구

The purpose of this study was to examine the effect of foot orthotics on the overall comfort and muscle activity during running. The subjects were 10 members from the joggers` club which consisted of 2 women and 8 men. These individuals ran on the treadmill by 4.0m/s speed with and without the custom foot orthotics. The data concerning the overall comfort was collected by a questionairre that examined the overall comfort, heel cushioning, forefoot cushioning, medio-lateral control, arch height, heel cup fit, shoe heel width, forefoot width, and shoe length The MegaWin ver. 2.1(Mega Electronics lid, Ma. Finland) was used to gain electromyography signals of the muscle activity; Tibialis anterior, medial gastronemius, lateral gastronemius, vastus lateralis, vastus medialis, biceps femoris, and rectus femoris were measured. The results of the study were as follows. 1. During running the overall comfort was higher for the foot arthotic condition than the nonorthotic condition. Among the inquiries the overall comfort showed the biggest difference comparing the two conditions. and the shoe heel width showed the highest score for contort. 2 The muscle activity of the biceps femoris, and vastus lateralis in the stance period decreased. due to the foot orthotics. The muscle activity of the vastus medialis in the swing period also decreased and the muscle activity tibialis anterior in the stance and swing stance decreased as well During running, orthotics showed positive result in foot comfort. The foot comfort related to decreased stress, muscle activity, and foot arch strain. Overall comfort and the adequate decrease of muscle activity were associated with injury prevention and the best method to prevent injury semms to be the maintenance of foot comfort.

Chiropractic adjustments and orthotics reduced symptoms for standing workers

Objective This controlled study was designed to explore the effectiveness of foot orthotics in solving problems of the feet and other parts of the lower extremities and to reduce low back pain. Methods Thirty-two subjects (24 males) were recruited and randomly assigned into 3 study groups. There were 10 subjects in the chiropractic care plus orthotics group, 14 subjects in the orthotics group, and 8 in the control group. All subjects filled out a patient information sheet and pre-screening foot pain questionnaire. Foot orthotics information was collected and the data was sent to Foot Level-ers, Inc. for orthotic fabrication. Chiropractic treatment was performed using Activator Technique. In-home exercise was prescribed to subjects receiving orthotics and chiropractic care. Results The control group did not experience much change during the testing period. The orthotics group showed improvement in symptoms (P = 0.053), activities of daily living (P = 0.058), sport and recreation (P = 0.186) and quality of life (P = 0.085). While trends were apparent, the improvements did not reach statistically significant levels. In contrast, there was no trend with pain (P = 0.492). The orthotics plus chiropractic group showed improvement in the four conditions over the study period. Greater improvement was seen in quality of life (P < 0.05), symptoms (P < 0.05) and activities of daily living (P < 0.05), which were statistically significant. Improvement was also seen in sports and recreation but it did not reach statistical significant level (P = 0.097). Conclusion This study showed that a combination of chiropractic care and orthotics improved symptoms, activities of daily living, sport and recreation and quality of life in workers whose job requires them to stand at least 6 hours daily.

Poster 202: Evaluating the Effects of Foot Orthotics on Plantar Pressures in the Normal Adult Population: A Pilot Study

Poster 202: Evaluating the Effects of Foot Orthotics on Plantar Pressures in the Normal Adult Population: A Pilot Study

Effect of foot orthotics on rearfoot and tibia joint coupling patterns and variability

The purpose of this study was to compare joint coupling patterns and variability of the rearfoot and tibia during running in subjects who were treated with two types of orthotic devices to that of controls. Eleven subjects with various lower extremity injuries were treated unsuccessfully with a standard orthotic, and then successfully with an inverted orthotic. Three-dimensional kinematic data were collected while subjects ran without orthoses and then in standard and inverted orthoses. Eleven healthy subjects ran without orthoses for comparison. The rearfoot inversion/eversion and tibial internal/external rotation joint coupling pattern and variability relationship was assessed using a vector coding technique. It was hypothesized that when the treated runners ran without orthotic devices, they would exhibit lower joint coupling angles and lower joint coupling variability compared to the controls. In addition, it was hypothesized that there would be no difference in the coupling angle or coupling variability between the standard and no orthotic conditions of the treated runners. Finally, it was hypothesized that coupling angle would decrease and variability would increase in the inverted versus the standard and non-orthotic conditions. No significant differences in joint coupling pattern or variability were observed between the treated and control subjects. In addition, no significant differences were noted between the orthotic conditions in the treated group. These results suggest that foot orthotic devices do not produce significant changes in rearfoot–tibial coupling. Therefore, the relief experienced with the inverted orthotic is likely due to factors other than alterations in this coupling.

Effect of foot orthotics on quadriceps and gluteus medius electromyographic activity during selected exercises

Hertel J, Sloss BR, Earl JE. Effect of foot orthotics on quadriceps and gluteus medius electromyographic activity during selected exercises. Objective To compare electromyographic activity of the vastus medialis, vastus lateralis, and gluteus medius during functional activities in subjects with different foot types while wearing various off-the-shelf foot orthotics. Design Experimental, controlled; 3 foot-type groups (pes planus, pes cavus, pes rectus) each tested in 4 orthotic conditions while performing 3 different exercises. Setting Laboratory. Participants Thirty healthy young adults, 10 with each foot type. Interventions Four conditions: no orthotic, 7° medial rearfoot post, 4° lateral rearfoot post, and neutral rearfoot post. Main outcome measure Surface electromyographic activity for the vastus medialis, vastus lateralis, and gluteus medius during single-leg squatting, lateral stepdown, and maximum vertical jump exercises. Results Greater vastus medialis and gluteus medius activity was found with all 3 orthotic conditions, regardless of subject foot type, during the single-leg squat and lateral stepdown. Less vastus lateralis activity was found with the vertical jump with all orthotic conditions, again regardless of foot type. Conclusions During slow controlled exercises such as the single-leg squat and lateral stepdown, vastus medialis and gluteus medius activity may be enhanced with an off-the-shelf orthotic, regardless of posting or foot type. These same findings do not appear to carry over to a more explosive task such as the maximal vertical jump.

The effect of foot orthotics on myoelectric fatigue in the vastus lateralis during a simulated skier’s squat

Fatigue in the legs is a problem experienced by skiers. It has been suggested that optimal orthotics may reduce muscle fatigue for a given movement task by minimising muscle activity (Med. Sci. Sports Exerc. 31 (1999) S421). The aims were to determine whether EMG would provide an independent method of analysing myoelectric fatigue in the vastus lateralis (VL) during a skier’s squat and whether orthotics could affect this fatigue response. Six skiers performed skier’s squats for as long as possible with no orthotic, low volume orthotics and high volume orthotics in their ski boots. Bipolar, active surface electrodes recorded EMG activity in the VL throughout each squat. Results for the EMG median frequency showed a significant shift in the power density spectrum towards the lower frequencies ( P<0.05) at the end of the contraction, suggesting that myoelectric fatigue was occurring and was measurable using EMG. All conditions displayed a significant decrease in median frequency at the end of the contraction ( P=0.001). The high volume orthotic showed a significant reduction in myoelectric fatigue, however, there was no difference in the duration of squats across the three conditions ( P>0.05). Subjective and objective findings support the use of the high volume foot orthotic for skiers.

Foot orthotics affect lower extremity kinematics and kinetics during running

Objective. To quantify the effects of posting and custom-molding of foot orthotics on lower extremity kinematics and kinetics during running. Design. Repeated measures. Background. Several kinematic and kinetic factors have been suggested to increase a runner’s risk for injuries. It has been speculated that foot orthotics can be used to reduce injury related complaints or even prevent running injuries by affecting these factors. Methods. Twenty one volunteers participated in this study. Kinematic and kinetic variables obtained during overground running for medial posting, custom-molding, and the combination of medial posting and custom-molding of foot orthotics were compared to a control condition. Repeated measures anova and student t-tests were used to detect significant differences ( α=0.05). Results. Posting of foot orthotics reduced maximum foot eversion and ankle inversion moment and increased vertical loading rate and maximum knee external rotation moment ( P<0.05). Molding and posting and molding reduced vertical loading rate and ankle inversion moment and increased maximum foot inversion and maximum knee external rotation moment ( P<0.05). Conclusions. The effects of posting and molding of foot orthotics are extremely different and when combining posting and molding, the effects of molding appear to be dominant. It yet remains to be determined whether posting or molding is more beneficial with respect to overuse running injuries. Relevance The potential of foot orthotics for reducing pain and injuries is convincing. The current study provides valuable information about the role of specific structural components of foot orthotics and contributes to the knowledge about the mechanism underlying the effect of foot orthotics in running.

Effect of foot orthotics on calcaneal eversion during standing and treadmill walking for subjects with abnormal pronation.

Repeated measures analysis of intervention. To determine the effects of foot orthotics and shoewear on calcaneal eversion for standing and treadmill walking. Foot orthotics are commonly used as an intervention for treating lower extremity musculoskeletal pathology. Qualitative research regarding the benefit of foot orthotics tends to be favorable, while the results of quantitative studies often conflict. Eight men (mean age = 35.8 +/- 12.7 years) and 5 women (mean age = 30.4 +/- 10.6 years), who demonstrated abnormal pronation, walked quickly (average velocity = 1.9 m/s) on a treadmill with and without foot orthotics. Subjects were filmed using a 2-dimensional video system and plastic molds designed to indicate calcaneal position inside the shoe during static standing and treadmill walking. Paired t tests indicated that foot orthotics significantly reduced the mean maximum calcaneal eversion angle by 2.2 degrees and the mean calcaneal eversion angle at heel rise by 2.1 degrees during fast walking. Orthotic and nonorthotic conditions did not differ significantly for the remaining kinematic variables. A one-way ANOVA indicated that calcaneal eversion in standing was significantly greater for barefoot standing compared with standing in shoes with or without orthotics. ANOVA also indicated that the plastic molds provided reliable measures of calcaneal position. Foot orthotics have a significant effect on calcaneal eversion and shoes also should be considered in conjunction with foot orthotic prescription.