Immediate Effects Of Foot Orthoses Research Articles

Immediate effects of foot orthoses on gait biomechanics in individuals with persistent patellofemoral pain

BackgroundThe efficacy of foot orthoses in reducing patellofemoral pain (PFP) is well documented; however, the mechanisms by which foot orthoses modulate pain and function are poorly understood. Research questionThis within-subject study investigated the immediate effects of foot orthoses on lower limb kinematics and angular impulses during level walking and stair ambulation in individuals with persistent PFP. MethodsForty-two participants with persistent PFP (≥3 months duration) underwent quantitative gait analysis during level walking, stair ascent and stair descent while using: (i) standard running sandals (control); and (ii) standard running sandals fitted with prefabricated foot orthoses. Hip, knee, and ankle joint kinematics and angular impulses were calculated and statistically analyzed using paired t-tests (p < 0.05). ResultsRelative to the control condition, foot orthoses use was associated with small but significant decreases in maximum ankle inversion angles during walking (mean difference [95% confidence interval]: −1.00° [−1.48 to −0.53]), stair ascent (−1.06° [−1.66 to −0.45]) and stair decent (−0.94° [−1.40 to −0.49]). Foot orthoses were also associated with decreased ankle eversion impulse during walking (−9.8Nms/kg [−12.7 to −6.8]), and decreased ankle dorsiflexion and eversion impulse during stair ascent (−67.6Nms/kg [−100.7 to −34.6] and −17.5Nms/kg [−23.6 to −11.4], respectively) and descent (−50.4Nms/kg [−77.2 to −23.6] and −11.6Nms/kg [−15.6 to −7.5], respectively). Ankle internal rotation impulse decreased when participants ascended stairs with foot orthoses (−3.3Nms/kg [−5.4 to −1.3]). Limited changes were observed at the knee and hip. SignificanceIn individuals with persistent PFP, small immediate changes in kinematics and angular impulses – primarily at the ankle – were observed when foot orthoses were worn during walking or stair ambulation. The clinical implications of these small changes, as well as the longer-term effects of foot orthoses on lower limb biomechanics, are yet to be determined.

Immediate effects of foot orthoses on lower limb biomechanics, pain, and confidence in individuals with patellofemoral osteoarthritis

BackgroundFoot orthoses are a recommended treatment for patellofemoral (PF) pain and a number of lower limb osteoarthritic (OA) conditions. However, their mechanism of effect is poorly understood. Research questionTo compare the immediate effects of foot orthoses and flat inserts on lower limb biomechanics, knee pain and confidence in individuals with PFOA. MethodsTwenty-one participants (14 females; mean ± SD age 58 ± 8 years) with PFOA underwent three-dimensional motion analysis during level-walking, stair ascent, and stair descent under three footwear conditions: (i) their own shoes; (ii) prefabricated foot orthoses; and (iii) flat shoe inserts. Participants reported their average levels of knee pain and confidence after each task. Data were analysed with repeated-measures analysis of variance (ANOVA), effect sizes (partial eta squared), and Bonferroni post-hoc tests. ResultsDuring level-walking, there was a significant main effect of foot orthoses on peak ankle dorsiflexion angle (F2 = 0.773, p < 0.001, ƞ2 = 0.773) and peak ankle external dorsiflexion moment (F2 = 0.356, p = 0.046, ƞ2 = 0.356). Foot orthoses decreased the peak ankle dorsiflexion angle compared to the flat insert and shoe conditions, and decreased the peak ankle external dorsiflexion moment relative to flat inserts. During stair descent, there was a significant main effect of foot orthoses on peak ankle external dorsiflexion moment (F2 = 0.823, p = 0.006, ƞ2 = 0.738), with a trend towards lower peak dorsiflexion moment for foot orthoses compared to the flat insert and shoe conditions. No significant main effects were observed during stair ascent. No other lower limb biomechanical changes were observed across all three conditions. Knee pain and confidence scores were not significantly different across the three conditions. SignificancePrefabricated foot orthoses altered sagittal plane biomechanics of the ankle during level-walking and stair descent in individuals with PFOA. Further research is required to determine whether these changes are clinically beneficial.

Foot orthoses induce immediate changes in intrinsic foot muscle EMG activity during walking

Introduction: Sports medicine practitioners frequently use foot orthoses to manage lower limb pain and injury. Individual variability in biomechanical response to foot orthoses questions the conventional kinematic paradigm, whereby orthoses effects occur via passive control of foot pronation. It is plausible that foot orthoses exert their therapeutic effects by modulating activity of the intrinsic foot muscles, acting as the foot's own internal stabilising mechanism. The aim of this study was to evaluate the immediate effects of foot orthoses on patterns of EMG activity of the intrinsic foot muscles during walking.

Effects of foot orthoses on walking and jump landing biomechanics of individuals with chronic ankle instability

ObjectivesTo evaluate the kinematic, kinetic and electromyographic (EMG) immediate effects of foot orthoses (FOs) during walking, maximal single-leg side jump landing (SIDE) and unilateral drop landing on even (DROP), inclined and unstable (FOAM) surfaces in individuals with chronic ankle instability (CAI). DesignCohort study. SettingBiomechanics laboratory. Participants26 healthy individuals with CAI. Main outcome measuresAnkle and knee angles/moments and lower-limb EMG of the gluteus medius, vastus medialis, vastus lateralis, biceps femoris, gastrocnemis medialis, gastrocnemius lateralis, peroneus longus and tibialis anterior muscles. ResultsThe main results are that with FOs, individuals with CAI exhibited decreased tibialis anterior muscle activity from 19 to 38% and 39–99% of the landing phase during the DROP task. They also exhibited increased biceps femoris muscle activity from 56 to 65% of the preactivation phase during walking. No significant ankle and knee joints angles and moments difference was observed when wearing FOs in any of the experimental tasks. ConclusionsThe results of this study suggest that the biomechanical effects of FOs are task-dependent and only affect EMG activity. They will help clinicians and researchers to better understand FOs’ role in treatment and prevention of CAI.

Immediate effects of foot orthoses on pain during functional tasks in people with patellofemoral osteoarthritis: A cross-over, proof-of-concept study

BackgroundThe purpose of the study was to determine whether prefabricated foot orthoses immediately reduce pain during functional tasks in people with patellofemoral osteoarthritis, compared to flat insoles and shoes alone. MethodsEighteen people with predominant lateral patellofemoral osteoarthritis (nine women; mean [SD] age 59 [10]years; body mass index 27.9 [3.2]kg/m2) performed functional tasks wearing running sandals, and then wearing foot orthoses and flat insoles (random order). Participants rated knee pain during each task (11-point numerical rating scales), ease of performance and knee stability (five-point Likert scales), and comfort (100mm visual analogue scales). ResultsCompared to shoes alone, foot orthoses (p=0.002; median difference 1.5 [IQR 3]) and flat insoles (p<0.001; 2 [3]) significantly reduced pain during step-downs; foot orthoses reduced pain during walking (p=0.008; 1 [1.25]); and flat insoles reduced pain during stair ambulation (p=0.001; 1 [1.75]). No significant differences between foot orthoses and flat insoles were observed for pain severity, ease of performance or knee stability. Foot orthoses were less comfortable than flat insoles and shoes alone (p<0.05). ConclusionsIn people with patellofemoral osteoarthritis, immediate pain-relieving effects of prefabricated, contoured foot orthoses are equivalent to flat insoles. Further studies should investigate whether similar outcomes occur with longer-term wear or different orthosis designs.

Immediate effects of foot orthoses on single leg squat performance in ‘poor’ performers

Immediate effects of foot orthoses on single leg squat performance in ‘poor’ performers

The immediate effects of foot orthoses on lower limb neuromotor control in patellofemoral joint osteoarthritis: A pilot study

The immediate effects of foot orthoses on lower limb neuromotor control in patellofemoral joint osteoarthritis: A pilot study

The immediate effects of foot orthoses on hip and knee kinematics and muscle activity during a functional step-up task in individuals with patellofemoral pain

BackgroundEvidence shows that anti-pronating foot orthoses improve patellofemoral pain, but there is a paucity of evidence concerning mechanisms. We investigated the immediate effects of prefabricated foot orthoses on (i) hip and knee kinematics; (ii) electromyography variables of vastus medialis oblique, vastus lateralis and gluteus medius during a functional step-up task, and (iii) associated clinical measures. MethodsHip muscle activity and kinematics were measured during a step-up task with and without an anti-pronating foot orthoses, in people (n=20, 9 M, 11 F) with patellofemoral pain. Additionally, we measured knee function, foot posture index, isometric hip abductor and knee extensor strength and weight-bearing ankle dorsiflexion. FindingsReduced hip adduction (0.82°, P=0.01), knee internal rotation (0.46°, P=0.03), and decreased gluteus medius peak amplitude (0.9mV, P=0.043) were observed after ground contact in the ‘with orthoses’ condition. With the addition of orthoses, a more pronated foot posture correlated with earlier vastus medialis oblique onset (r=−0.51, P=0.02) whilst higher Kujala scores correlated with earlier gluteus medius onset (r=0.52, P=0.02). InterpretationAlthough small in magnitude, reductions in hip adduction, knee internal rotation and gluteus medius amplitude observed immediately following orthoses application during a task that commonly aggravates symptoms, offer a potential mechanism for their effectiveness in patellofemoral pain management. Given the potential for cumulative effects of weight bearing repetitions completed with a foot orthoses, for example during repeated stair ascent, the differences are likely to be clinically meaningful.

Foot orthoses induce immediate changes in lower limb neuromotor control of gait in people with patellofemoral joint osteoarthritis: a pilot study

Foot orthoses induce immediate changes in lower limb neuromotor control of gait in people with patellofemoral joint osteoarthritis: a pilot study

Neuromotor control of the triceps surae during running in people with and without Achilles tendinopathy and the immediate effect of foot orthoses

Background Achilles tendinopathy (AT) is a common injury among physically active populations. It has been proposed that changes in neuromotor control of the triceps surae may increase differential intratendinous forces and thus be associated with the pain and pathology seen in this condition. However, it is not known if neuromotor differences actually exist between those with and without this condition. Thus the primary purpose of this research was to investigate whether neuromotor control of the triceps surae in distance runners with AT is altered compared to controls (Study 1). The secondary purpose of this research was to investigate the immediate effects of foot orthoses on triceps surae neuromotor control in subjects with AT (Study 2).

The immediate effects of foot orthoses on functional performance in individuals with patellofemoral pain syndrome

ObjectivePatellofemoral pain syndrome (PFPS) often results in reduced functional performance. There is growing evidence for the use of foot orthoses to treat this multifactorial condition. In this study, the immediate...

The Immediate Effects Of Foot Orthoses On Functional Performance In Individuals With Patellofemoral Pain Syndrome

Symptoms due to patellofemoral pain syndrome (PFPS) often result in recurrent or chronic knee pain and significantly affect functional performance. Although there is some evidence supporting the use of foot orthoses to treat this multifactorial condition, the effects of foot orthoses on functional performance is unclear. PURPOSE: Evaluate the immediate effects of foot orthoses on functional performance, and the association of foot posture and footwear with improved function. METHODS: A cohort of 52 individuals with PFPS (18 - 35 years) was recruited. Each participant was prescribed standard prefabricated foot orthoses (Vasyli Pro, Vasyli International) to wear in their own footwear. Four functional outcome measures were evaluated including the change in pain and ease of a single leg squat on a 5-point Likert scale using Wilcoxin sign rank statistics, and change in the number of pain free step down and single leg rises from sitting using independent t-tests. The association of foot posture using the Foot Posture Index, normalised navicular drop, and calcaneal angle relative to subtalar joint neutral, and the footwear motion control properties scale score with improved function was evaluated using Spearman's rho statistics. RESULTS The majority (between 71 and 83%) of participants demonstrated reduced functional performance for each of the tests evaluated. Prefabricated foot orthoses produced significant improvements (p <.05) for all functional outcome measures. A more pronated foot type was found to be associated with reduced pain and improved ease of completing a single leg squat, and improvements in the number of pain free single leg rises from sitting after foot orthoses prescription (p <.05). Additionally, poorer motion control properties of participant's footwear were found to be associated with reduced pain during the single leg squat and improvements in the number of pain free single leg rises from sitting after foot orthoses prescription (p <.05). CONCLUSION: Prefabricated foot orthoses are able provide immediate improvements to functional performance in individuals with PFPS. Improved functional performance with foot orthoses is associated with a more pronated foot type and poorer footwear motion control properties.

Consistent Immediate Effects of Foot Orthoses on Comfort and Lower Extremity Kinematics, Kinetics, and Muscle Activity

In order to accommodate patients to new foot orthoses over time, two steps are required: The first is to obtain a baseline reading of the immediate effects across several weeks to ensure consistency. The second step is to look at changes with progressively longer wear periods similar to what occurs in general practice. This study addressed the first step. The purpose of this study was to determine whether the baseline reading of the immediate effects of foot orthoses on comfort and lower extremity kinematics, kinetics, and muscle activity is consistent between days. Participants were 21 recreational runners who volunteered for the study. Three orthotic conditions (posting, custom-molding, posting and custom-molding) were compared to a control (flat) insert. Lower extremity kinematic, kinetic, and EMG data were collected for 108 trials per participant and condition in 9 sessions for each person for running at 4 m/s. Comfort for all orthotic conditions was assessed in each session using a visual analog scale. Statistically significant session effects were detected using repeated-measures ANOVA (α = .05). Three of the 93 variables had a significant session effect. A significant interaction between orthotic condition and session was observed for 6 of the 93 variables. The results of this study showed that the effects of foot orthoses on comfort, lower extremity kinematics, kinetics, and muscle activity are consistent across a 3-week period when the wear time for each condition is restricted. Thus, foot orthoses lead to immediate changes in comfort, kinematics, kinetics, and muscle activity with limited use. These immediate effects of foot orthoses on comfort, kinematics, kinetics, and muscle activity are consistent between days.