Anderson KM, Corlett MA, Magdziarz SM, Anderson DD, Wilken JM. Foot offloading associated with carbon fiber orthosis use: A pilot study.
Gait Posture 2024;
111:191-195. [PMID:
38718525 DOI:
10.1016/j.gaitpost.2024.04.032]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/27/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND
Traumatic lower limb injuries can result in chronic pain. Orthotic interventions are a leading conservative approach to reduce pain, manage loading, and protect the foot. Robust carbon fiber custom dynamic orthoses (CDOs) designed for military service members have been shown to reduce foot loading. However, the effect of carbon fiber orthosis design, including designs widely used in the civilian sector, on foot loading is unknown.
RESEARCH QUESTION
Determine if carbon fiber orthoses alter foot loading during gait.
METHODS
Loadsol insoles were used to measure peak forces and force impulse acting on the forefoot, midfoot, hindfoot, and total foot. Nine healthy, able-bodied individuals participated. Force impulse was quantified as cumulative loading throughout stance phase. Participants walked without an orthosis and with three carbon fiber orthoses of differing designs: a Firm stiffness CDO, a Moderate stiffness CDO, and a medial and lateral strut orthosis (MLSO).
RESULTS
There were significant main effects of orthosis condition on peak forefoot forces as well as forefoot and hindfoot force impulse. Peak forefoot forces were significantly lower in the Moderate and Firm CDOs compared to no orthosis and MLSO. Compared to walking without an orthosis, forefoot force impulse was significantly lower and hindfoot force impulse was significantly greater in all carbon fiber orthoses. Additionally, hindfoot force impulse in the Firm CDO was significantly higher than in the MLSO and Moderate CDO.
SIGNIFICANCE
The three carbon fiber orthosis designs differed regarding foot loading, with more robust orthoses providing greater forefoot offloading. Orthosis-related changes in forefoot loading suggest that carbon fiber orthoses could reduce loading-associated pain during gait. However, increased hindfoot force impulse suggests caution should be used when considering carbon fiber orthoses for individuals at risk of skin breakdown with repetitive loading.
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