Types Of Foot Orthoses Research Articles

Effect of Foot Orthoses and Footwear in People with Rheumatoid Arthritis: An Updated Systematic Review.

Rheumatoid arthritis is a chronic, systemic, inflammatory disease of an autoimmune nature that causes pain and disability in affected patients. Foot pain has become a challenge due to its negative impact on physical function. The objective of this updated systematic review is to describe the effect of foot orthoses and/or footwear in patients with rheumatoid arthritis and foot problems. Scopus, PubMed, CINALH, WOS, and Dialnet were searched for all articles published from January 2013 to September 2024. Inclusion criteria included randomised clinical trials and crossover trials (level of evidence I), published within the last 10 years, involving adults with a diagnosis of rheumatoid arthritis, with no restrictions on gender, race, or ethnicity. All studies that addressed the use of foot orthoses and/or shoe therapy in any type of comparison between these interventions were considered relevant. Review Manager was used to carry out the bias analysis of the selected studies. The reporting was based on the new PRISMA guidelines. A total of 9 relevant articles were selected from an initial sample of 438. These articles analyse and compare the effectiveness of various types of foot orthoses in reducing pain, functional limitation, and disability, as well as improving balance and kinetic and kinematic parameters affected by rheumatoid arthritis. Foot orthoses reduce pain and disability in rheumatoid arthritis, improving balance and kinematic parameters. However, no significant improvements in the patients' functionality and walking ability have been demonstrated. Customised ones with good arch control, heel reinforcement, and metatarsal pad are more effective. No results on the impact of footwear on patients with rheumatoid arthritis have been found in the last 10 years. This systematic review was registered in PROSPERO (CRD42023405645).

Effects of the Custom Mold With a Raised Ridge Around the Perimeter Foot Orthoses on Dynamic Postural Control in Chronic Ankle Instability

Objectives: Among the foot orthoses prescribed to improve postural control in chronic ankle instability, foot orthoses designed to affect both types of mechanical and functional instability have a limited research background. In the present study, a type of foot orthosis named the custom mold with a raised ridge around the perimeter was designed, and manufactured, and its effect on the dynamic posture control of the subjects was investigated. Methods: This study was a quasi-experimental type in which 30 active young people with chronic ankle instability were selected from sports clubs and divided into two groups. One of these groups used custom mold foot orthoses (CFO) and the other group used custom mold with a raised ridge around the perimeter foot orthoses (CRFO). Dynamic postural control of the participants was evaluated before and after one month with the star excursion balance test (SEBT). A repeated measured statistical test was used to evaluate the obtained data. Results: Both types of foot orthoses increased the reaching distance of the SEBT, but the result of CRFO was significant in this field, so that after one month in medial (P=0.045), posteromedial (P=0.002), and anteromedial (P˂0.001) directions, significant differences were observed between the two groups. Discussion: The CRFO can put the subtalar joint in optimal conditions and change the amount of input resulting from the stimulation of the mechanoreceptors in the plantar area of the foot, thus increasing the improvement of dynamic postural control; however, more studies are needed to prove this claim.

The Effect of Two Types of Foot Orthoses on the Knee Valgus Angle Within Single-Leg Landing: Implications for ACL Damage Hazard Decrease

Background: Non-contact anterior cruciate ligament (ACL) injuries commonly occur when athletes land in high risk positions such as knee valgus. The impact of foot orthoses during exercises that recreate a non-contact ACL harm system (i.e., landing) in any case will be obscured. Objectives: The purpose of the current study research was to evaluate the effect of two foot orthoses (semi-hard foot orthoses and hard foot orthoses) on knee valgus angle during single-leg drop landing. Methods: Twenty male leisure volleyball gamers performed landing in one-leg step from 30 cm height in 3 conditions (without foot orthoses, mid-hard foot orthoses, and hard foot orthoses). A motion capture system was used to measure lower extremity kinematics. Two risk factors of ACL injury, maximum knee valgus angle (KVA), and maximum knee flexion was measured. ANOVA was used for statistical analysis (P < 0.05). Results: With mid-hard foot, orthoses provide the maximum level of knee flexion and the minimum level of knee valgus during single-leg drop landing. Conclusions: It may be concluded showed that foot orthoses affect knee kinematics. More knee flexion and less knee valgus brought about by mid-hard foot orthoses can reduce injuries of the anterior cruciate ligament (ACL).

Efficacy of Different Types of Foot Orthoses on Postural Control in Subjects With Lateral Ankle Sprain: A Systematic Review

Objectives: Lateral ankle sprain is one of the most common injuries to the musculoskeletal system, especially among active people. This injury causes complex complications, such as recurrent sprain because of reduced postural control. Foot orthoses are among the interventions used to improve postural control in this population. This review aims to investigate foot orthoses to improve postural control among patients with an acute or chronic lateral ankle sprain. Methods: Four electronic databases (Scopus, PubMed, Web of Sciences, and Google scholar) were searched for experimental studies. Articles were selected using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method. The articles were reviewed for their quality based on the standards for reporting diagnostic accuracy statements and then entered into this review. Results: The search results in all databases provided a total of 48 articles. After reviewing the documents, we excluded 38 articles that did not pass the inclusion criteria, resulting in 10 remaining articles. Data extraction from population, interventions, and outcome measures was done for these 10 articles. Discussion: Foot orthoses are effective in improving the postural control of individuals with an acute or chronic lateral ankle sprain. Considering the existence of mechanical and functional instability, foot orthosis which is made to affect the proprioception and follow the biomechanics of the body seems to be the most effective in this field; however, more studies are required to confirm this

Analyzing the Effect of Varus Forefoot Wedge in Addition to Arch Support on Self-Reported Pain, Function, and Quality of Life in Patients with Moderate Hallux Valgus: A Pilot Study

ABSTRACT Introduction The hallux valgus, a painful forefoot deformity, is defined as lateral deviation of the hallux, which is highly correlated with forefoot pronation. This study aimed to compare the effect of two types of foot orthoses, one with and one without a varus forefoot wedge, on self-reported outcomes of pain, function, and QOL (by FAOS questionnaire) in patients with moderate hallux valgus. Materials and Methods Sixteen patients with hallux valgus were assigned to two equal groups randomly in a before-after trial. Results The within-group comparison showed significant improvements in all subscales of the FAOS questionnaire for both groups (P < 0.05). The between-group analysis showed no statistically significant difference. Conclusions It seems the addition of varus forefoot wedge to foot orthoses may have no adverse effect on self-reported outcomes. Clinical Relevance It seems in conservative treatment of hallux valgus by medical insoles to correct forefoot pronation may be useful for relieving pain.

Biomechanical effects of three types of foot orthoses in individuals with posterior tibial tendon dysfunction

BackgroundPosterior tibial tendon dysfunction (PTTD) is characterized by degeneration of this tendon leading to a flattening of the medial longitudinal arch of the foot. Foot orthoses (FOs) can be used as a treatment option, but their biomechanical effects on individuals with PTTD are not yet fully understood. Research questionThe aim of this study was to investigate the effects of three types of FOs on gait biomechanics in individuals with PTTD. MethodsFourteen individuals were recruited with painful stage 1 or 2 PTTD based on Johnson and Strom’s classification. Quantitative gait analysis of the affected limb was performed in four conditions: shoes only (Shoe), prefabricated FO (PFO), neutral custom FO (CFO) and custom varus FO (CVFO) with a 5° medial wedge and a 4 mm medial heel skive. A curve analysis, using 1D statistical parametric mapping, was undertaken to assess differences in lower limb joint motion, joint moments and muscle activity over the stance phase of gait across conditions. ResultsDecreased hindfoot eversion angles, decreased ankle inversion moments and increased ankle eversion moments were observed with custom FOs compared to the Shoe and PFO conditions (p < 0.001). CFOs and CVFOs induced an increased knee abduction moment compared to Shoe (p < 0.001). No changes in hip kinematics and kinetics or in EMG activity of tested muscles were observed between conditions. SignificanceCustom orthoses may be more suitable than PFOs to decrease the pathological biomechanical outcomes observed in PTTD. Decreased ankle inversion moments during the stance phase could explain why custom orthoses are effective at reducing pain in PTTD patients. However, clinicians should be careful when prescribing custom orthoses for PTTD since unwanted collateral biomechanical effects can be observed at the knee.

Effect of prefabricated thermoformable foot orthoses on plantar surface temperature after running: A gender comparison.

There is a lack of evidence about the effect of different type of foot orthoses on plantar surface temperature. Moreover, that effect could be different depending on gender due to anatomical and physiological differences between men and women. The aim of the study was to analyze the effect of a prefabricated thermoformable foot orthosis on plantar surface temperature after running and taking gender differences into account. Thirty recreational runners (15 males, mean (standard deviation): 28 (7) years, 69.7 (6.5) kg, 1.74 (0.05) cm and 22.9 (1.7) kg/m2; and 15 females: 35 (7) years, 55.2 (6.9) kg, 1.63 (0.06) cm and 20.6 (1.9) kg/m2) carried out a maximum incremental test as pre-test, and two running tests on a treadmill at the laboratory wearing previously randomized different foot orthoses (thermoformable and prefabricated generic). The plantar surface temperature of the dominant foot sole in ten regions of interest was assessed before and immediately after 30-min running at 75% of VO2max. The use of thermoformable foot orthoses produced lower temperatures only in men after the run in medial heel (P=0.033, ES=0.7), which then disappeared in temperature variation (after - before) (P=0.910). Regarding gender, women showed lower temperatures before the run in both orthosis conditions (P<0.039, ES>0.8), but no differences in temperatures after the run (P=0.910) in comparison with men. Moreover, absolute temperatures after running were always greater than before the run (P<0.001, ES>5.0). In conclusion, the thermoformable foot orthoses do not modify plantar surface temperature after running in healthy runners of either gender, compared to prefabricated generic foot orthoses. Although women present lower baseline plantar temperatures than men, these differences disappear after exercise.

The Effect of Different Types of Foot Orthoses on the Biomechanical Variables, Lower Extremity Muscular Activity and Balance in Elderly: A Systematic Review Study

Older adults demonstrate increased amounts of postural sway, which may ultimately lead to falls. The purpose of this systematic review was to investigate the effect of different foot orthoses on lower limb biomechanical variables, lower limb muscular activity, and balance in elderly people. Examining texts based on the search on the Magiran, Google Schoolar, Pubmed, Scopus, and SIVILICA sites were done by using following keywords: foot orthoses, footwear, aging, aged, elderly, Kinematic, walking, loading rate, Kinetic Walking, in combination in four part from 2005 to 2018. In the initial searches, 72 papers were obtained, eight articles based on the inclusion and exclusion criteria were selected. This systematic review demonstrated that the use of textures and modeling orthoses strengthens sensory receptors and improves postures, as well as improves the biomechanical parameters such as evertor and invertor moments and ground reaction forces in some cases.

The Effect of Different Types of Foot Orthoses on Foot Plantar Pressure in Subjects with Plantar Fasciitis: A Literature Review

The Effect of Different Types of Foot Orthoses on Foot Plantar Pressure in Subjects with Plantar Fasciitis: A Literature Review

Biomechanical effects of three types of foot orthoses on a posterior tibial tendon dysfunction population during a stair climbing task

Posterior tibial tendon dysfunction (PTTD) is characterized by a loss of strength of the tibialis posterior muscle and has a negative impact on health-related quality of life. The pathology is freq...

Foot orthoses for people with rheumatoid arthritis: a survey of prescription habits among podiatrists

BackgroundGuidelines recommend foot orthoses for people with both early (< 2 years) and established rheumatoid arthritis (RA). While prefabricated foot orthoses are cheaper and can exhibit comparable effects to customised devices, the available evidence for their effectiveness is inconsistent. Little is known about what types of foot orthoses clinicians prescribe. This study describes the foot orthoses prescription habits of podiatrists for people with rheumatoid arthritis.MethodsOne hundred and eighty-three podiatrists from the United Kingdom (UK) (n = 88), Australia (n = 68) and New Zealand (n = 27) completed a self-administered, online survey regarding the types of foot orthoses prescribed in clinical practice for people with RA. This study forms part of a wider international survey exploring foot orthosis prescription habits.ResultsUK respondents were more likely to prescribe prefabricated orthoses for early RA (n = 47, 53%) and customised orthoses for established RA (n = 47, 53%). Respondents in Australia were more likely to prescribe customised orthoses for both early (n = 32, 47%) and established (n = 46, 68%) RA, whilst respondents in New Zealand were more likely to prescribe prefabricated orthoses for both early (n = 16, 59%) and established (n = 10, 37%) disease.Irrespective of disease stage, the use of foam impression boxes was more prevalent in the UK and New Zealand when capturing a model of the feet prior to manufacturing customised orthoses. In contrast, electronic scanning and plaster of Paris were more common in Australia. Computer aided manufacture was utilised more frequently among respondents in Australia than in the UK and New Zealand. Respondents in all three countries specified more flexible shell materials for established RA, compared to early disease. Cushioning top covers (e.g. PORON® or polyurethane) were most frequently specified in all countries for both disease stages.ConclusionsConsiderable variation was seen in the self-reported foot orthoses prescription habits of respondents for people with RA. Variation between countries and disease stage was seen in type of orthoses, specific brands, manufacturing methods, and materials prescribed. The results allow podiatrists and broader health service providers to compare their practice against reported national and international patterns.

Muscle activation during fast walking with two types of foot orthoses in participants with cavus feet

The aim of this study was to quantify the effects of foot orthoses (FOs) with and without a lateral bar on muscle activity of participants with cavus feet. Fifteen participants were recruited from the Université du Québec à Trois-Rivières students and podiatry clinic. The muscle activity of the tibialis anterior, fibularis longus, gastrocnemius lateralis and medialis, vastus medialis and lateralis, biceps femoris and gluteus medius were recorded during fast walking under two experimental conditions (FOs with and without a lateral bar) and a control condition (shoes). Experimentations were completed after a one-month adaptation period to each experimental condition. The root mean square of the electromyography (EMG) data was analyzed. To compare the effects between conditions, a curve analysis was performed using one-dimensional statistical parametric mapping. The main result of this study was an increased gastrocnemius lateralis muscle activity (maximum mean difference: +28%) during the propulsion phase of gait (44–46%) when participants wore FOs compared to the control condition. This result will help researchers and clinicians better understand the FOs’ EMG effects of individuals with cavus feet. As FOs are mainly prescribed for symptomatic patients, future studies should assess their effects on individuals suffering of a pathology, such as Achilles tendinopathy.

When, why and how foot orthoses (FOs) should be prescribed for children with flexible pes planus: a Delphi survey of podiatrists

BackgroundFlexible pes planus (flat feet) in children is a common reason parents and caregivers seek health professionals consult and a frequent reason podiatrists prescribe foot orthoses. Yet no universal agreement exists on the diagnosis of this condition, or when and how foot orthoses should be prescribed. The aim of this study was to garner consensus and agreement among podiatrists on the use of FOs for paediatric flexible pes planus.MethodsA three round Delphi consensus survey was undertaken with 15 podiatry experts from Australia, New Zealand and the United Kingdom. Round One gathered consensus on the diagnosis and intervention into paediatric pes planus with specific questions on types of FOs and prescription variables used. Round Two and Three were based on answers from Round One and gathered agreement (rationale for choices) on a five point Likert scale. 70% of respondents had to agree to a statement for it to be accepted as consensus or agreement.ResultsConsensus and agreement was achieved for 83 statements directing the diagnosis of pes planus (using FPI-6 and/or rearfoot measures), common signs and symptoms (e.g., pain, fatigue, abnormal gait and other functional concerns) that direct when to intervene into paediatric flexible pes planus. Prefabricated orthoses were the preferred intervention where adequate control is gained with their use. When customised orthoses are prescribed, a vertical [heel] cast pour (71.4%) and minimal arch fill (76.9%) are the prescription variables of choice, plus or minus additional variables (i.e., medial heel (Kirby) skive, the use of a University of California Biomechanical Laboratory device or a medial flange) dependent on level of disorder and plane of excessive motion.ConclusionsThis study identified consensus and agreement on a series of diagnosis methods and interventions for the paediatric flexible pes planus. A clinical protocol was developed from the resultant consensus statements which provides clinicians with a series of evidenced-informed statements to better guide them on when, how and why FOs are used specific to this population.

The effectiveness of non-surgical intervention (Foot Orthoses) for paediatric flexible pes planus: A systematic review: Update

BackgroundFlexible pes planus (flat feet) in children is a common presenting condition in clinical practice due to concerns amongst parents and caregivers. While Foot Orthoses (FOs) are a popular intervention, their effectiveness remains unclear. Thus, the aim of this systematic review was to update the current evidence base for the effectiveness of FOs for paediatric flexible pes planus.MethodsA systematic search of electronic databases (Cochrane, Medline, AMED, EMBASE, CINHAL, SportDiscus, Scopus and PEDro) was conducted from January 2011 to July 2017. Studies of children (0–18 years) diagnosed with flexible pes planus and intervention to be any type of Foot Orthoses (FOs) were included. This review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. McMaster critical review form for quantitative studies, was used to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis of the included studies was undertaken.ResultsOut of 606 articles identified, 11 studies (three RCTs; two case-controls; five case-series and one single case study) met the inclusion criteria. A diverse range of pre-fabricated and customised FOs were utilised and effectiveness measured through a plethora of outcomes. Summarised findings from the heterogeneous evidence base indicated that FOs may have a positive impact across a range of outcomes including pain, foot posture, gait, function and structural and kinetic measures. Despite these consistent positive outcomes reported in several studies, the current evidence base lacks clarity and uniformity in terms of diagnostic criteria, interventions delivered and outcomes measured for paediatric flexible pes planus.ConclusionThere continues to remain uncertainty on the effectiveness of FOs for paediatric flexible pes planus. Despite a number of methodological limitations, FOs show potential as a treatment method for children with flexible pes planus.PROSPERO registration numberCRD42017057310.

Effectiveness of custom-made foot orthoses for treating forefoot pain: a systematic review

Pain in and around the metatarsal heads, the metatarsal phalangeal joints and the surrounding soft tissues is called metatarsalgia. Non-operative treatment of metatarsalgia includes foot orthoses. Foot orthoses may be classified as standard or custom-made. A systematic review was carried out to determine whether custom-made foot orthoses are effective for treating forefoot pain. The MEDLINE, CINAHL, The Cochrane Library and PEDro databases were searched for relevant articles reporting patients undergoing treatment for forefoot pain by means of custom-made foot orthoses. Two reviewers independently reviewed all titles and abstracts and extracted the available data. The study eligibility criteria were randomised controlled clinical trials that included participants with forefoot pain treated with custom-made foot orthoses and that reported levels of forefoot pain after the use of orthoses. The data consisted of patient demographics, pathologies related to forefoot pain, type of foot orthoses used, follow-up period and clinical outcomes. Nine studies were selected which had a total of 487 participants. The pathologies evaluated were rheumatoid arthritis, hallux abductus valgus and isolated and secondary metatarsalgia. The use of custom-made foot orthoses was the intervention that exerted the most significant reduction of the level of pain in the forefoot in most of the studies. The use of custom-made foot orthoses improved the level of forefoot pain in rheumatoid arthritis, hallux abductus valgus and secondary metatarsalgia as it increases sole pressures.

A survey of foot orthoses prescription habits amongst podiatrists in the UK, Australia and New Zealand

BackgroundFoot orthoses are frequently used but little is known about which types are used in contemporary practice. This study aimed to explore the types of foot orthoses currently used by podiatrists and the prescription variations in a range of conditions.MethodsA web-based, cross-sectional survey was distributed through professional bodies in the United Kingdom (UK), Australia, and New Zealand. Questions focussed on foot orthosis prescription habits in relation to 26 conditions affecting the back and lower limb.ResultsTwo hundred and sixty-four podiatrists practising in 19 different countries completed the survey; the majority practised in the UK (47%, n = 124), Australia (30%, n = 79) and New Zealand (12%, n = 32). Respondents qualified between 1968 and 2016, and 147 (56%) were female. Respondents worked in different healthcare sectors and this varied between countries: 42 (34%) respondents in the UK worked solely in the public sector, compared to 3 (4%) in Australia and 2 (6%) in New Zealand. Forty-four (35%) respondents in the UK worked solely in private practice, compared to 64 (81%) in Australia and 14 (44%) in New Zealand.UK respondents prescribed more prefabricated orthoses per week (mean 5.5 pairs) than simple insole-type devices (±2.7) and customised devices (±2.9). Similarly, respondents in New Zealand prescribed more prefabricated orthoses per week (±7.7) than simple (±1.4) and customised (±2.8) devices. In contrast, those in Australia prescribed more customised orthoses per week (±4.4) than simple (±0.8) and prefabricated (±1.9) orthoses. Differences in the types of orthoses prescribed were observed between country of practice, working sector, and the condition targeted. Generally, prefabricated orthoses were commonly prescribed for the 26 highlighted conditions in the UK and New Zealand. Australian podiatrists prescribed far fewer devices overall, but when they did prescribe, they were more likely to prescribe custom devices. Respondents in all three countries were more likely to prescribe customised orthoses for people with diabetes complicated by peripheral neuropathy than for diabetes without this complication.ConclusionsFoot orthosis prescription habits vary between countries. Prefabricated orthoses were frequently prescribed in the UK and New Zealand, and customised orthoses in Australia. Prescriptions for people with diabetes differed depending on the presence of neuropathy, despite a lack of robust evidence supporting these decisions. This study provides new insight into contemporary practice.

Clinical effectiveness and cost-effectiveness of foot orthoses for people with established rheumatoid arthritis: an exploratory clinical trial

Objectives: Foot orthoses are commonly prescribed as an intervention for people with rheumatoid arthritis (RA). Data relating to the cost-effectiveness of foot orthoses in people with RA are limited. The aim was to evaluate the clinical and cost-effectiveness of two types of foot orthoses in people with established RA.Method: A single-blind randomized controlled trial was undertaken to compare custom-made foot orthoses (CMFOs) and simple insoles (SIs) in 41 people with established RA. The Foot Function Index (FFI) was used to measure foot pain, disability, and functional limitation. Costs were estimated from the perspective of the UK National Health Service (NHS), societal (patient and family) perspective, and secondary care resource use in terms of the intervention and staff time. Effects were assessed in terms of health gain expressed as quality-adjusted life years (QALYs).Results: At baseline, 20 participants received a CMFO and 21 participants received an SI. After 16 weeks foot pain improved in both the CMFOs (p = 0.000) and the SIs (p < 0.01). However, disability scores improved for CMFOs (p < 0.001) but not for SIs (p = 0.40). The cost-effectiveness results demonstrated no difference in cost between the arms (CMFOs: £159.10; SIs: £79.10; p = 0.35), with the CMFOs being less effective in terms of cost per QALY gain (p < 0.001).Conclusions: In people with established RA, semi-rigid customized foot orthoses can improve pain and disability scores in comparison to simple insoles. From a cost-effectiveness perspective, the customized foot orthoses were far more expensive to manufacture, with no significant cost per QALY gain.

Effects of two types of foot orthoses on lower limb muscle activity before and after a one-month period of wear

The purpose of this study was to quantify the effects of two types of foot orthoses (FOs) on muscle activity during walking. Twenty-one healthy participants were recruited to walk on a five-meter walkway with a control condition (no FOs) and two experimental conditions (FOs and FOs with lateral bar). The experimental protocol was performed before and after a one-month period of wear for each experimental condition. Electromyographic signals were recorded for six muscles (gluteus medius, vastus lateralis, medial gastrocnemius, lateral gastrocnemius, peroneus longus and tibialis anterior). Mean muscle activity was analyzed during the contact, the combined midstance/terminal stance and the pre-swing phases of gait. Peak amplitude and time to peak amplitude were quantified during the stance phase. Unacceptable level of variability was observed between the testing sessions. Therefore, no comparisons were performed to compare the effects of the experimental conditions between testing sessions. After a one-month period of wear, FOs with lateral bar decreased peak amplitude and mean activity of the peroneus longus muscle during the combined midstance/terminal stance phase and FOs decreased peak amplitude and mean activity of the tibialis anterior muscle during the contact phase compared to a control condition. In conclusion, repeated-test design should be used with caution when assessing the muscular adaptation to the wear of FOs for a certain period of time. More studies are needed to determine if the decreased activity of the peroneus longus muscle could be of benefit to treat pathologies such as peroneal tendinopathy or lateral ankle instability.

The Influence of Foot Orthoses on Patellofemoral Pain Syndrome: A Systematic Analysis of the Literature

The patellofemoral pain syndrome (PFPS) is one of the most commonly encountered disorders involving the knee. The symptoms often lead to a reduction of physical activities resulting in sport- and job-related disabilities and the potential occurrence of severe disorders. Different theories for the development of the syndrome exist which result in different therapy modalities. A change in foot posture and its effect on lower limb kinematics seem to be one potential risk factor for the development of the syndrome. This leads to the assumption that foot orthoses might be a potential therapy device. The aims of this study were to outline the state of evidence for the treatment of PFPS with foot orthoses and to identify the effect of foot orthoses on PFPS. A systematic review of clinical (CT) and randomized controlled trials (RCT) was undertaken. A systematic search for studies (CT, RCT) was conducted using the databases of Medline (PubMed), Cochrane library, and PEDro. The relevance for further analysis of studies was reviewed on the basis of title and abstract. An additional search was undertaken using the reference lists of the included studies and additional literature as well as the PubMed function "related articles". 11 studies were included in this analysis. The effect of different types of foot orthoses on pain, function and kinematics of the lower limb and muscle activation of selected lower limb muscles was analysed. Significant effects on pain and function were determined. A slight effect on kinematics of the lower limb and muscle activation of selected lower limb muscles was identified. Foot orthoses seem to be an effective treatment device in the therapy for PFPS. An immediate and long-term reduction in pain and an improvement of function occurred following the intervention. There was just a slight change in lower limb kinematics and muscle activation of selected lower limb muscles. The relationship between biomechanical effects of orthoses and pain still seems to be unclear.

Comparison of postural control with different customized foot orthoses on isolated subtalar arthrodesis

Background Studies describe subtalar and ankle arthrodesis as a factor altering the biomechanics of the foot during walking [1-3] whereas postural control appears physiological [3]. Furthermore, foot orthoses (FOs) are also recognized for their actions on dynamics [4] and balance [5] but not for their postural impact on an isolated subtalar arthrodesis (ISA). Previous studies have shown that depending on the type of FOs [6] and along the comfort felt by the subject [7], the variations induced by different FOs were significantly different. The aim of this study was to compare effects of different types of FOs on balance of patients with an ISA. Two subjects with ISA were volunteers for one session of three repeated measures: without FOs (Control), with Classical FOs (FOsC) and with Molded FOs (FOsM). After a clinical examination, these two types of FOs are custom-made including same posting. We compared postural variations through a force platform with shoes. Three modalities have been demanded at each measure: Normal stance, One-leg stance on the ISA (OnISA) and One-leg stance on the control foot (OnControl). Three data’s have been compared: Center of Pressure Area (CoP), CoP Movement (MoV) and Mean Velocity (Vel). The perception of comfort was evaluated by using previously established footwear comfort measures [7]: 100mm visual analog scale (VAS).