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Dami A, Payen E, Farahpour N, Robb K, Isabelle PL, Moisan G. Medially wedged foot orthoses generate greater biomechanical effects than thin-flexible foot orthoses during a unilateral drop jump task on level and inclined surfaces. Clin Biomech (Bristol, Avon) 2024; 112:106193. [PMID: 38330734 DOI: 10.1016/j.clinbiomech.2024.106193] [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: 10/03/2023] [Revised: 12/08/2023] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Foot orthoses are therapeutic insoles designed to induce various effects on lower limb biomechanics. However, conflicting findings in previous research, highlight the need to better understand how foot orthoses with different features affect lower limb biomechanics during challenging tasks, particularly during unilateral drop jump landings. METHODS Seventeen participants with flat feet were recruited to participate in this cross-sectional descriptive study that examined the effects of thin-flexible foot orthoses and medially wedged foot orthoses on lower limb biomechanics during unilateral drop jump landings on level and valgus inclined surfaces. Midfoot, ankle, knee, and hip angles and moments were calculated and compared across conditions with repeated measures ANOVAs, using a statistical parametric mapping approach. FINDINGS Medially wedged and thin-flexible foot orthoses reduced ankle pronation and arch flattening during unilateral drop jump landings on level and valgus inclined surfaces. Medially wedged foot orthoses further decreased midfoot dorsiflexion and ankle eversion angles compared to thin-flexible foot orthoses. Medially wedged foot orthoses also generated greater effects on ankle kinetics and hip kinematics during unilateral drop jump landings. INTERPRETATION Medially wedged foot orthoses are more effective than thin-flexible foot orthoses in optimizing lower limb biomechanics during unilateral drop jump landings. While the biomechanical effects did not increase on inclined surfaces, medially wedged foot orthoses generated greater effects on proximal joints, highlighting their potential to improve hip stability and enhance overall lower limb function. Personalized foot orthoses selection based on specific biomechanical profiles should be further explored to optimize orthotic interventions benefiting individuals with musculoskeletal conditions.
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Affiliation(s)
- Ahmed Dami
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Canada.
| | - Eléna Payen
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Canada
| | - Nader Farahpour
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada; Department of Sport Biomechanics, Faculty of Sport Sciences, Bu Ali Sina University, Hamedan, Iran
| | - Kelly Robb
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Pier-Luc Isabelle
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada
| | - Gabriel Moisan
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Canada
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McNally T, Edwards S, Halaki M, O'Dwyer N, Pizzari T, Blyton S. Quantifying demands on the hamstrings during high-speed running: A systematic review and meta-analysis. Scand J Med Sci Sports 2023; 33:2423-2443. [PMID: 37668346 DOI: 10.1111/sms.14478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/24/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Hamstring strain injury (HSI) remains a performance, economic, and player availability burden in sport. High-speed running (HSR) is cited as a common mechanism for HSI. While evidence exists regarding the high physical demands on the hamstring muscles in HSR, meta-analytical synthesis of related activation and kinetic variables is lacking. METHODS A systematic search of Medline, Embase, Scopus, CINAHL, SportDiscus, and Cochrane library databases was conducted in accordance with the PRISMA 2020 guidelines. Studies reporting hamstring activation (electromyographic [EMG]) or hamstring muscle/related joint kinetics were included where healthy adult participants ran at or beyond 60% of maximum speed (activation studies) or 4 m per second (m/s) (kinetic studies). RESULTS A total of 96 studies met the inclusion criteria. Run intensities were categorized as "slow," "moderate," or "fast" in both activation and kinetic based studies with appropriate relative, and raw measures, respectively. Meta-analysis revealed pooled mean lateral hamstring muscle activation levels of 108.1% (95% CI: 84.4%-131.7%) of maximal voluntary isometric contraction (MVIC) during "fast" running. Meta-analysis found swing phase peak knee flexion internal moment and power at 2.2 Newton meters/kilogram (Nm/kg) (95% CI: 1.9-2.5) and 40.3 Watts/kilogram (W/kg) (95% CI: 31.4-49.2), respectively. Hip extension peak moment and power was estimated as 4.8 Nm/kg (95% CI: 3.9-5.7) and 33.1 W/kg (95% CI: 17.4-48.9), respectively. CONCLUSIONS As run intensity/speed increases, so do the activation and kinetic demands on the hamstrings. The presented data will enable clinicians to incorporate more objective measures into the design of injury prevention and return-to-play decision-making strategies.
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Affiliation(s)
- Timothy McNally
- Faculty of Medicine & Health, Sydney School of Health Sciences, Discipline of Exercise & Sport Science, Sydney, New South Wales, Australia
| | - Suzi Edwards
- Faculty of Medicine & Health, Sydney School of Health Sciences, Discipline of Exercise & Sport Science, Sydney, New South Wales, Australia
| | - Mark Halaki
- Faculty of Medicine & Health, Sydney School of Health Sciences, Discipline of Exercise & Sport Science, Sydney, New South Wales, Australia
| | - Nicholas O'Dwyer
- Faculty of Medicine & Health, Sydney School of Health Sciences, Discipline of Exercise & Sport Science, Sydney, New South Wales, Australia
| | - Tania Pizzari
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah Blyton
- School of Health Sciences (Physiotherapy), University of Newcastle, Newcastle, New South Wales, Australia
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Mai P, Robertz L, Robbin J, Bill K, Weir G, Kurz M, Trudeau MB, Hollander K, Hamill J, Willwacher S. Towards functionally individualised designed footwear recommendation for overuse injury prevention: a scoping review. BMC Sports Sci Med Rehabil 2023; 15:152. [PMID: 37951935 PMCID: PMC10638717 DOI: 10.1186/s13102-023-00760-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/25/2023] [Indexed: 11/14/2023]
Abstract
Injury prevention is essential in running due to the risk of overuse injury development. Tailoring running shoes to individual needs may be a promising strategy to reduce this risk. Novel manufacturing processes allow the production of individualised running shoes that incorporate features that meet individual biomechanical and experiential needs. However, specific ways to individualise footwear to reduce injury risk are poorly understood. Therefore, this scoping review provides an overview of (1) footwear design features that have the potential for individualisation; and (2) the literature on the differential responses to footwear design features between selected groups of individuals. These purposes focus exclusively on reducing the risk of overuse injuries. We included studies in the English language on adults that analysed: (1) potential interaction effects between footwear design features and subgroups of runners or covariates (e.g., age, sex) for running-related biomechanical risk factors or injury incidences; (2) footwear comfort perception for a systematically modified footwear design feature. Most of the included articles (n = 107) analysed male runners. Female runners may be more susceptible to footwear-induced changes and overuse injury development; future research should target more heterogonous sampling. Several footwear design features (e.g., midsole characteristics, upper, outsole profile) show potential for individualisation. However, the literature addressing individualised footwear solutions and the potential to reduce biomechanical risk factors is limited. Future studies should leverage more extensive data collections considering relevant covariates and subgroups while systematically modifying isolated footwear design features to inform footwear individualisation.
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Affiliation(s)
- Patrick Mai
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg, Germany.
- Department of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway.
| | - Leon Robertz
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Johanna Robbin
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg, Germany
| | - Kevin Bill
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Gillian Weir
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
| | - Markus Kurz
- Sports Tech Research Centre, Mid Sweden University, Östersund, Sweden
| | | | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Joseph Hamill
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
| | - Steffen Willwacher
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg, Germany
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Lewin M, Price C, Nester C. Can a shoe-mounted IMU identify the effects of orthotics in ways comparable to gait laboratory measurements? J Foot Ankle Res 2023; 16:54. [PMID: 37670403 PMCID: PMC10478350 DOI: 10.1186/s13047-023-00654-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/16/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Footwear and orthotic research has traditionally been conducted within laboratories. With increasing prevalence of wearable sensors for foot and ankle biomechanics measurement, transitioning experiments into the real-world is realistic. However wearable systems must effectively detect the direction and magnitude of response to interventions to be considered for future usage. METHODS RunScribe IMU was used simultaneously with motion capture, accelerometers, and force plates during straight-line walking. Three orthotics (A, B, C) were used to change lower limb biomechanics from a control (SHOE) including: Ground reaction force (GRF) loading rate (A), pronation excursion (A and B), maximum pronation velocity (A and B), and impact shock (C) to test whether RunScribe detected effects consistent with laboratory measurements. Sensitivity was evaluated by assessing: 1. Significant differences (t-test) and effect sizes (Cohen's d) between measurement systems for the same orthotic, 2. Statistical significance (t-test and ANOVA) and effect size (Cohen's d & f) for orthotic effect across measurement systems 3. Direction of orthotic effect across measurement systems. RESULTS GRF loading rate (SHOE: p = 0.138 d = 0.403, A: p = 0.541 d = 0.165), impact shock (SHOE: p = 0.177 d = 0.405, C: p = 0.668 d = 0.132), pronation excursion (A: p = 0.623 d = 0.10, B: p = 0.986 d = 0.00) did not significantly differ between measurement systems with low effect size. Significant differences and high effect sizes existed between systems in the control condition for pronation excursion (p = 0.005 d = 0.68), and all conditions for pronation velocity (SHOE: p < 0.001 d = 1.24, A: p = 0.001 p = 1.21, B: p = 0.050 d = 0.64). RunScribe (RS) and Laboratory (LM) recorded the same significant effect of orthotic but inconsistent effect sizes for GRF loading rate (LM: p = 0.020 d = 0.54, RS: p = 0.042 d = 0.27), pronation excursion (LM: p < 0.001 f = 0.31, RS: p = 0.042 f = 0.15), and non-significant effect of orthotic for impact shock (LM: p = 0.182 d = 0.08, RS: p = 0.457 d = 0.24). Statistical significance was different between systems for effect of orthotic on pronation velocity (LM: p = 0.010 f = 0.18, RS: p = 0.093 f = 0.25). RunScribe and Laboratory agreed on the direction of change of the biomechanics variables for 69% (GRF loading rate), 40%-70% (pronation excursion), 47%-65% (pronation velocity), and 58% (impact shock) of participants. CONCLUSION The RunScribe shows sensitivity to orthotic effect consistent with the laboratory at the group level for GRF loading rate, pronation excursion, and impact shock during walking. There were however large discrepancies between measurements in individuals. Application of the RunScribe for group analysis may be appropriate, however implementation of RunScribe for individual assessment and those including pronation may lead to erroneous interpretation.
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Affiliation(s)
- Max Lewin
- School of Health and Society, University of Salford, Manchester, UK.
- Scholl's Wellness Company, Hull, UK.
| | - Carina Price
- School of Health and Society, University of Salford, Manchester, UK
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Sakamoto K, Sasaki M, Tsujioka C, Kudo S. An Elastic Foot Orthosis for Limiting the Increase of Shear Modulus of Lower Leg Muscles after a Running Task: A Randomized Crossover Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15212. [PMID: 36429931 PMCID: PMC9690485 DOI: 10.3390/ijerph192215212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Excessive foot pronation may be attributed to an increasing burden on leg muscles during running, which might be a factor in medial tibial stress syndrome. We developed an elastic foot orthosis (EFO) that can decrease foot pronation and aimed to identify whether this orthosis could limit the increase in lower leg muscle hardness after running. METHODS Twenty-one healthy volunteers participated in this randomized crossover trial with an elastic or sham foot orthosis (SFO). All volunteers ran on a treadmill for 60 min while wearing either orthosis. Muscle hardness of the posterior lower leg was assessed using shear wave elastography before and after running. The Wilcoxon signed rank test was used to compare muscle hardness between the two orthotic conditions. RESULTS No significant differences were observed between the two orthotic conditions before running (p > 0.05). After running, the flexor digitorum longus (FDL) hardness in the EFO group was significantly lower than that in the SFO group (p < 0.01). No significant changes were observed in the other muscles. CONCLUSION The results suggest that the EFO can restrict the increase in FDL hardness with running. The EFO may be an effective orthotic treatment for medial tibial stress syndrome.
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Affiliation(s)
- Kodai Sakamoto
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, Osaka 559-8611, Japan
- Mikage Gokigen Clinic, Kobe 658-0048, Japan
| | - Megumi Sasaki
- Yanase Orthopedic Clinic, Utsunomiya-shi 329-1115, Japan
| | | | - Shintarou Kudo
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, Osaka 559-8611, Japan
- Graduate School of Health Science, Morinomiya University of Medical Sciences, Osaka 559-8611, Japan
- AR-Ex Medical Research Center, Tokyo 158-0082, Japan
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An exploration of the effects of prefabricated and customized insoles on lower limb kinetics and kinematics during walking, stepping up and down tasks: A time series analysis. Gait Posture 2022; 98:297-304. [PMID: 36257239 DOI: 10.1016/j.gaitpost.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 07/29/2022] [Accepted: 10/06/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Prefabricated and customized insoles are used in clinical practice to reduce foot pronation. Although data exist on the effects at key points within the stance phase, exploring the impact of different insoles using time series analysis may reveal more detail about their efficacy. RESEARCH QUESTION What are the effects revealed by a time series analysis of arch-supported prefabricated insoles (PREFABRICATED) versus arch-supported prefabricated insoles customized with a 6º medial wedge (CUSTOMIZED) on the lower limb biomechanics during walking, stepping up and down tasks in individuals with pronated feet? METHODS Nineteen individuals with excessive foot pronation performed walking, stepping up and down tasks using three insoles: CONTROL (flat insole), CUSTOMIZED, and PREFABRICATED. Angles and moments of ankle and knee coronal and hip transverse planes were compared between conditions using statistical parametric mapping (SPM). RESULTS For walking, CUSTOMIZED reduced ankle eversion moment compared to CONTROL during midstance and PREFABRICATED during propulsion. CUSTOMIZED decreased KAM during midstance and propulsion compared to PREFABRICATED. Compared to CONTROL, CUSTOMIZED and PREFABRICATED reduced hip internal rotation during propulsion and loading response, respectively. CUSTOMIZED decreased eversion movement during midstance and propulsion for the stepping up task. PREFABRICATED reduced eversion movement during midstance in comparison to CONTROL. For the stepping down task, CUSTOMIZED increased eversion movement during propulsion compared to PREFABRICATED. CUSTOMIZED reduced hip internal rotation angle for stepping up task during propulsion, decreased medial rotation movement during midstance compared to CONTROL, and reduced medial rotation during midstance compared to PREFABRICATED. CUSTOMIZED increased KAM for stepping up and down tasks during propulsion. SIGNIFICANCE These findings suggest that both CUSTOMIZED and PREFABRICATED reduce foot pronation. However, non-local effects, such as changes in KAM and hip internal rotation, were seen only in the CUSTOMIZED. Therefore, CUSTOMIZED may be preferable if the objective is to modify the knee and hip mechanics.
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Lewin M, Price C, Nester C. Validation of the RunScribe inertial measurement unit for walking gait measurement. PLoS One 2022; 17:e0273308. [PMID: 35994458 PMCID: PMC9394823 DOI: 10.1371/journal.pone.0273308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/07/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The use of portable gait measurement systems in research is appealing to collect real-world data at low-cost, low participant burden, and without requirement for dedicated lab space. Most commercially available inertial measurement units (IMU’s) designed for running only capture temporospatial data, the ability to capture biomechanics data such as shock and motion metrics with the RunScribe IMU makes it the closest to a lab alternative. The RunScribe system has been validated in running, however, is yet to be validated for walking. Method Qualisys motion capture, AMTI force plates, and Delsys Trigno accelerometers were used as gold standard lab measures for comparison against the RunScribe IMU. Twenty participants completed 10 footsteps per foot (20 total) measured by both systems simultaneously. Variables for validation included: Vertical Ground reaction force (GRF), instantaneous GRF rate, pronation excursion, pronation velocity, total shock, impact force, braking force. Interclass correlation (ICC) was used to determine agreement between the measurement systems, mean differences were used to evaluate group level accuracy. Results ICC results showed moderate agreement between measurement systems when both limbs were averaged. The greatest agreement was seen for GRF rate, pronation excursion, and pronation velocity (ICC = 0.627, 0.616, 0.539), low agreement was seen for GRF, total shock, impact shock, braking shock (ICC = 0.269, 0.351, 0.244, 0.180). However mean differences show the greatest level of accuracy for GRF, GRF rate, and impact shock. Discussion Results show mixed agreement between the RunScribe and gold standard lab measures, and varied agreement across left and right limbs. Kinematic variables showed the greatest agreement, however GRF had the lowest relative mean difference for group results. The results show acceptable levels of agreement for most variables, however further work must be done to assess the repeatability and sensitivity of the RunScribe to be applied within areas such as footwear testing and gait retraining protocols.
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Affiliation(s)
- Max Lewin
- School of Health and Society, University of Salford, Manchester, United Kingdom
- * E-mail:
| | - Carina Price
- School of Health and Society, University of Salford, Manchester, United Kingdom
| | - Christopher Nester
- School of Health and Society, University of Salford, Manchester, United Kingdom
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Zhang X, Yang F, Zhao K, Vanwanseele B. Symptomatic and asymptomatic pronated feet show differences in the forefoot abduction motion during jogging, but not in the arch deformation. Sports Biomech 2022:1-12. [PMID: 35959794 DOI: 10.1080/14763141.2022.2109506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
Pronated feet have been associated with higher risks of running-related overuse injuries than neutral feet. However, it remains unclear why some pronated feet develop running-related injuries, while others do not. This study aimed to examine the differences in foot kinematics during jogging among individuals with symptomatic pronated feet (SP), asymptomatic pronated feet (AP) and asymptomatic neutral feet (AN). Thirty-nine recreational runners were recruited and classified into the SP, AP and AN groups. Statistical parametric mapping (SPM) and ANOVA were used to identify kinematic differences among three groups. The SPM results showed that the SP had larger forefoot abduction than the AN and AP during jogging, while three groups had similar rearfoot eversion during jogging. Both the AP and SP had larger forefoot sagittal range of motion (ROM) (mean difference = 3.5 and 4.8 deg, respectively) and smaller rearfoot sagittal ROM (mean difference = 5.0 and 3.5 deg, respectively) than the AN. Forefoot abduction during jogging may have the potential to identify pronated feet at greater risk of injury. Pronated feet, symptomatic or not, have comparable large forefoot sagittal ROM, i.e., arch deformation, compared to neutral feet. The findings could have implications for the injury aetiology and intervention strategies for SP.
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Affiliation(s)
- Xianyi Zhang
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Fan Yang
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company Limited, Beijing, China
- Department of Physical Education and Research, China University of Mining and Technology-Beijing, Beijing, China
- School of Sports Science, Lingnan Normal University, Guangdong, China
| | - Kaidi Zhao
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Benedicte Vanwanseele
- Department of Movement Sciences, Human Movement Biomechanics Research Group, KU Leuven, Leuven, Belgium
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Peng Y, Wang Y, Wong DWC, Chen TLW, Chen SF, Zhang G, Tan Q, Zhang M. Different Design Feature Combinations of Flatfoot Orthosis on Plantar Fascia Strain and Plantar Pressure: A Muscle-Driven Finite Element Analysis With Taguchi Method. Front Bioeng Biotechnol 2022; 10:853085. [PMID: 35360398 PMCID: PMC8960448 DOI: 10.3389/fbioe.2022.853085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/18/2022] [Indexed: 11/23/2022] Open
Abstract
Customized foot orthosis is commonly used to modify foot posture and relieve foot pain for adult acquired flexible flatfoot. However, systematic investigation of the influence of foot orthotic design parameter combination on the internal foot mechanics remains scarce. This study aimed to investigate the biomechanical effects of different combinations of foot orthoses design features through a muscle-driven flatfoot finite element model. A flatfoot-orthosis finite element model was constructed by considering the three-dimensional geometry of plantar fascia. The plantar fascia model accounted for the interaction with the bulk soft tissue. The Taguchi approach was adopted to analyze the significance of four design factors combination (arch support height, medial posting inclination, heel cup height, and material stiffness). Predicted plantar pressure and plantar fascia strains in different design combinations at the midstance instant were reported. The results indicated that the foot orthosis with higher arch support (45.7%) and medial inclination angle (25.5%) effectively reduced peak plantar pressure. For the proximal plantar fascia strain, arch support (41.8%) and material stiffness (37%) were strong influencing factors. Specifically, higher arch support and softer material decreased the peak plantar fascia strain. The plantar pressure and plantar fascia loading were sensitive to the arch support feature. The proposed statistics-based finite element flatfoot model could assist the insole optimization and evaluation for individuals with flatfoot.
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Affiliation(s)
- Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Shane Fei Chen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- *Correspondence: Ming Zhang,
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Kudo S, Sakamoto K. Influence of a novel elastic foot orthosis in foot motion during locomotion in adults with mild flatfoot. Gait Posture 2022; 93:59-63. [PMID: 35086050 DOI: 10.1016/j.gaitpost.2022.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/15/2022] [Accepted: 01/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Collapse of the foot arch is a one of the risk factors in medial tibial stress syndrome. Custom-made foot orthoses are used to reduce the collapse of foot arch, but the orthoses are designed for a specific shoe and cannot be used in other shoes. We developed an elastic foot orthosis that is highly fitted on the foot using thin films, is lightweight, and can be used with any shoe or without shoes. The purpose of this study was to investigate foot kinematics with our elastic foot orthosis during walking and running. METHODS We recruited 30 participants with asymptomatic flatfoot for this study. Foot kinematic data were recorded for treadmill walking, treadmill running, and over-ground walking. Foot kinematics were recorded in three conditions, barefoot (BF), with the elastic foot orthosis (EFO), and with sham foot orthosis (SFO), and foot strain was measured using a stretch strain sensor. The difference in foot strain from initial contact to maximum strain during gait was calculated as loading arch strain, which was reflected as forefoot eversion excursion. A one-way analysis of variance with Bonferroni test was performed to compare the loading arch strain among the three conditions. RESULTS In all tasks, loading arch strain with the EFO was significantly less than that in the BF and SFO conditions. Loading arch strain with the SFO was significantly more than that of BF in the treadmill gait condition. CONCLUSION Our results indicate that the EFO decreased foot strain during locomotion compared to without the EFO and is capable of supporting the foot arch during locomotion.
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Affiliation(s)
- Shintarou Kudo
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16 Nankokita Suminoe Ward, Osaka City, Osaka Prefecture 559-8611, Japan; Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, 1-26-16 Nankokita Suminoe Ward, Osaka City, Osaka Prefecture 559-8611, Japan; AR-Ex Medical Research Center, 1109-4 Iwamurata, Saku-shi, Nagano 385-0022, Japan.
| | - Kodai Sakamoto
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, 1-26-16 Nankokita Suminoe Ward, Osaka City, Osaka Prefecture 559-8611, Japan
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The immediate effect of foot orthoses on gluteal and lower limb muscle activity during overground walking in healthy young adults. Gait Posture 2021; 89:102-108. [PMID: 34265525 DOI: 10.1016/j.gaitpost.2021.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 06/21/2021] [Accepted: 07/04/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although foot orthoses are often used in the management of lower limb musculoskeletal conditions, their effects on muscle activation is unclear, especially in more proximal segments of the lower limb. RESEARCH QUESTION Primary aim: Is there an immediate effect of foot orthoses on gluteal muscle activity during overground walking in healthy young adults? Secondary aim: Is there an immediate effect of foot orthoses on the activity of hamstring, quadriceps and calf muscles? METHODS In eighteen healthy young adults, muscle activity was recorded using fine wire electrodes for gluteus minimus (GMin; anterior, posterior) and gluteus medius (GMed; anterior, middle, posterior); and surface electrodes for gluteus maximus (GMax), hamstring, quadriceps and calf muscles. Participants completed six walking trials for two conditions; shoe and shoe with prefabricated foot orthoses. Muscle activity was normalised to the peak activity of the shoe condition and analysed using one-dimensional statistical non-parametric mapping to identify differences across the gait cycle. RESULTS Activity of GMed (anterior, middle, posterior) and GMin (posterior) was reduced in early stance phase when the orthosis was worn in the shoe (p < 0.05). GMin (anterior) activity was significantly reduced during swing (p < 0.05). Muscle activity was also significantly reduced during the orthoses condition for the lateral hamstrings and calf muscles (p < 0.05). SIGNIFICANCE Using foot orthoses may provide a strategy to reduce demand on GMin, GMed, lateral hamstring and calf muscles while walking.
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Peng Y, Wang Y, Wong DWC, Chen TLW, Zhang G, Tan Q, Zhang M. Extrinsic foot muscle forces and joint contact forces in flexible flatfoot adult with foot orthosis: A parametric study of tibialis posterior muscle weakness. Gait Posture 2021; 88:54-59. [PMID: 33991769 DOI: 10.1016/j.gaitpost.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/11/2021] [Accepted: 05/06/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The posterior tibialis tendon dysfunction (PTTD) is typically associated with progressive flatfoot deformity, which could be alleviated with foot orthosis. However, the evaluation of tibialis posterior (TP) weakness on lower limb mechanics of flatfoot adults with foot orthoses is scarce and requires further investigation. RESEARCH QUESTION This study aimed to examine the effects of TP weakness on lower limb mechanics in flatfoot adults with foot orthosis through gait analysis and musculoskeletal modelling. METHODS Fifteen young adults with flatfoot were recruited from University to perform a gait experiment with and without foot orthoses. Data collected from the motion capture system were used to drive the musculoskeletal modelling for the estimation of the joint force and extrinsic muscle forces of the lower limb. A parametric analysis was conducted by adjusting the TP muscle strength from 40 % to 100 %. Two-way repeated measures ANOVA was used to compare the peak extrinsic foot muscle forces and joint forces among different levels of TP weakness and insole conditions. RESULTS TP weakness significantly increased ankle joint force superoinferiorly (F = 125.9, p < 0.001) and decreased anteroposteriorly (F = 125.9, p < 0.001), in addition to a significant increase in the muscle forces of flexor hallucis longus (p < 0.001) and flexor digitorum longus (p < 0.001). Besides, the foot orthosis significantly reduced most peak muscle forces whilst significantly reduced the second peak knee force and peak ankle force compared to the control condition (F = 8.79-30.9, p < 0.05). SIGNIFICANCE The increased extrinsic foot muscle forces (flexor hallucis longus and flexor digitorum longus) and ankle joint forces in the TP weakness condition indicated that TP weakness may induce compensatory muscle activation and attenuated joint load. The abnormal muscle and joint mechanics in flatfoot adults with TP weakness might be restored by the orthosis.
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Affiliation(s)
- Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.
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Immediate Effects of Medially Posted Insoles on Lower Limb Joint Contact Forces in Adult Acquired Flatfoot: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072226. [PMID: 32224985 PMCID: PMC7178021 DOI: 10.3390/ijerph17072226] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/16/2022]
Abstract
Flatfoot is linked to secondary lower limb joint problems, such as patellofemoral pain. This study aimed to investigate the influence of medial posting insoles on the joint mechanics of the lower extremity in adults with flatfoot. Gait analysis was performed on fifteen young adults with flatfoot under two conditions: walking with shoes and foot orthoses (WSFO), and walking with shoes (WS) in random order. The data collected by a vicon system were used to drive the musculoskeletal model to estimate the hip, patellofemoral, ankle, medial and lateral tibiofemoral joint contact forces. The joint contact forces in WSFO and WS conditions were compared. Compared to the WS group, the second peak patellofemoral contact force (p < 0.05) and the peak ankle contact force (p < 0.05) were significantly lower in the WSFO group by 10.2% and 6.8%, respectively. The foot orthosis significantly reduced the peak ankle eversion angle (p < 0.05) and ankle eversion moment (p < 0.05); however, the peak knee adduction moment increased (p < 0.05). The reduction in the patellofemoral joint force and ankle contact force could potentially inhibit flatfoot-induced lower limb joint problems, despite a greater knee adduction moment.
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Braga UM, Mendonça LD, Mascarenhas RO, Alves COA, Filho RGT, Resende RA. Effects of medially wedged insoles on the biomechanics of the lower limbs of runners with excessive foot pronation and foot varus alignment. Gait Posture 2019; 74:242-249. [PMID: 31574408 DOI: 10.1016/j.gaitpost.2019.09.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 09/06/2019] [Accepted: 09/21/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Excessive foot pronation during running in individuals with foot varus alignment may be reduced by medially wedged insoles. RESEARCH QUESTION This study investigated the effects of a medially wedged insole at the forefoot and at the rearfoot on the lower limbs angles and internal moments of runners with excessive foot pronation and foot varus alignment. METHODS Kinematic and kinetic data of 19 runners (11 females and 8 males) were collected while they ran wearing flat (control condition) and medially wedged insoles (insole condition). Both insoles had arch support. We used principal component analysis for data reduction and dependent t-test to compare differences between conditions. RESULTS The insole condition reduced ankle eversion (p = 0.003; effect size = 0.63); reduced knee range of motion in the transverse plane (p = 0.012; effect size = 0.55); increased knee range of motion in the frontal plane in early stance and had earlier knee adduction peak (p = 0.018; effect size = 0.52); reduced hip range of motion in the transverse plane (p = 0.031; effect size = 0.48); reduced hip adduction (p = 0.024; effect size = 0.50); reduced ankle inversion moment (p = 0.012; effect size = 0.55); and increased the difference between the knee internal rotation moment in early stance and midstance (p = 0.012; effect size = 0.55). SIGNIFICANCE Insoles with 7˚ medial wedges at the forefoot and rearfoot are able to modify motion and moments patterns that are related to lower limb injuries in runners with increased foot pronation and foot varus alignment with some non-desired effects on the knee motion in the frontal plane.
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Affiliation(s)
- Uiara M Braga
- Universidade Federal do Vale do Jequitinhonha e Mucuri, Department of Physical Therapy, Rodovia MGT 367 - KM 583/5000, Campus Diamantina, Alto do Jacuba, 39100 000, Diamantina, MG, Brazil.
| | - Luciana D Mendonça
- Universidade Federal do Vale do Jequitinhonha e Mucuri, Department of Physical Therapy, Rodovia MGT 367 - KM 583/5000, Campus Diamantina, Alto do Jacuba, 39100 000, Diamantina, MG, Brazil.
| | - Rodrigo O Mascarenhas
- Universidade Federal do Vale do Jequitinhonha e Mucuri, Department of Physical Therapy, Rodovia MGT 367 - KM 583/5000, Campus Diamantina, Alto do Jacuba, 39100 000, Diamantina, MG, Brazil.
| | - Carolina O A Alves
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Avenida Antônio Carlos 6627, Campus Pampulha, Pampulha, 31270-901, Belo Horizonte, MG, Brazil.
| | - Renato G T Filho
- Universidade Federal do Vale do Jequitinhonha e Mucuri, Department of Physical Therapy, Rodovia MGT 367 - KM 583/5000, Campus Diamantina, Alto do Jacuba, 39100 000, Diamantina, MG, Brazil.
| | - Renan A Resende
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Avenida Antônio Carlos 6627, Campus Pampulha, Pampulha, 31270-901, Belo Horizonte, MG, Brazil.
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Crago D, Bishop C, Arnold JB. The effect of foot orthoses and insoles on running economy and performance in distance runners: A systematic review and meta-analysis. J Sports Sci 2019; 37:2613-2624. [PMID: 31423908 DOI: 10.1080/02640414.2019.1651582] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Foot orthoses and insoles are prescribed to runners, however their impact on running economy and performance is uncertain. The aim of this systematic review and meta-analysis was to determine the effect of foot orthoses and insoles on running economy and performance in distance runners. Seven electronic databases were searched from inception until June 2018. Eligible studies investigated the effect of foot orthoses or insoles on running economy (using indirect calorimetry) or running performance. Standardised mean differences (SMDs) were computed and meta-analyses were conducted using random effects models. Methodological quality was assessed using the Quality Index. Nine studies met the criteria and were included: five studies investigated the effect of foot orthoses on running economy and four investigated insoles. Foot orthoses were associated with small negative effects on running economy compared to no orthoses (SMD 0.42 [95% CI 0.17,0.72] p = 0.007). Shock absorbing insoles were also associated with negative effects on running economy, but an imprecise estimate (SMD 0.26 [95% CI -0.33,0.84] p = 0.83). Quality Index scores ranged from 4 to 15 out of 17. Foot orthoses and shock absorbing insoles may adversely affect running economy in distance runners. Future research should consider their potential effects on running performance.
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Affiliation(s)
- Daniel Crago
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, School of Health Sciences, University of South Australia , Adelaide , Australia
| | - Christopher Bishop
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, School of Health Sciences, University of South Australia , Adelaide , Australia.,The Biomechanics Lab , Adelaide , Australia
| | - John B Arnold
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, School of Health Sciences, University of South Australia , Adelaide , Australia
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Alavi-Mehr SM, Jafarnezhadgero A, Salari-Esker F, Zago M. Acute effect of foot orthoses on frequency domain of ground reaction forces in male children with flexible flatfeet during walking. Foot (Edinb) 2018; 37:77-84. [PMID: 30326416 DOI: 10.1016/j.foot.2018.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/26/2018] [Accepted: 05/20/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Flatfoot is a structural and functional abnormality of the foot that may cause lower limb mechanical damage during walking. The aim of this study was to investigate the acute effect of foot orthoses on the frequency domain of ground reaction forces in children with flatfeet during the stance phase of walking. METHODS Bilateral gait data were collected from fifteen male children suffering from flatfeet syndrome. Two Kistler force platforms were used to record the ground reaction forces of each limb during level walking. Arc support foot orthoses were used as an intervention. RESULTS No significant differences in the frequency content of the dominant limb ground reaction forces were found in the three directions in the two conditions (P>0.05). However, the use of foot orthoses decreased non-dominant limb medio-lateral ground reaction force frequency with a power of 99.5% (P=0.015). Overall, for both limbs, the amplitude of the three-dimensional ground reaction force components during walking with foot orthoses were lower than those obtained without foot orthoses (P<0.05). For both dominant and non-dominant limbs, the essential number of harmonics in three directions during walking with and without foot orthoses were similar (P>0.05). CONCLUSIONS Foot orthoses decreased medio-lateral ground reaction force frequency in the non-dominant limb, but have little effect on other ground reaction frequency components. Decreased frequency phenomena due to foot orthoses in children with flatfeet suggest an attenuation of ground reaction forces during walking. Frequency domain analysis thus offered new insights on the gait improvements associated with using foot orthoses.
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Affiliation(s)
- Seyed Majid Alavi-Mehr
- Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - AmirAli Jafarnezhadgero
- Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Fatemeh Salari-Esker
- Department of Sport Biomechanics, Faculty of Physical Education and Sport Sciences, University of Mazandaran, Babolsar, Iran.
| | - Matteo Zago
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy.
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Jafarnezhadgero A, Madadi-Shad M, Alavi-Mehr SM, Granacher U. The long-term use of foot orthoses affects walking kinematics and kinetics of children with flexible flat feet: A randomized controlled trial. PLoS One 2018; 13:e0205187. [PMID: 30300405 PMCID: PMC6177172 DOI: 10.1371/journal.pone.0205187] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/30/2018] [Indexed: 12/23/2022] Open
Abstract
Background Due to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet. Methods Thirty boys aged 8–12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected. Results Significant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group. Conclusions The long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking.
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Affiliation(s)
- AmirAli Jafarnezhadgero
- Department of Physical Education and Sport Sciences, University of Mohaghegh Ardabili, Ardabil, Iran
| | | | - Seyed Majid Alavi-Mehr
- Department of Physical Education and Sport Sciences, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
- * E-mail:
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Abstract
Arthroscopic subtalar fusion is an excellent approach to subtalar pathologic condition where conservative treatment has failed and a fusion has been indicated. Formal contraindications include excessive malalignment and bone loss. The posterior arthroscopic approach is analyzed in this article, including indications, surgical technique, surgical tips, and complications. Excellent results can be expected, including a shorter time to fusion, and faster rehabilitation, including activities of daily living and sports.
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Affiliation(s)
- Emilio Wagner
- Foot and Ankle Unit, Clinica Alemana, Universidad del Desarrollo, 5951, Vitacura, Vitacura, Santiago 7650568, Chile.
| | - Rodrigo Melo
- Foot and Ankle Unit, Hospital Militar, Universidad de Los Andes, Av. Alcalde Fernando Castillo Velasco 9100, La Reina, Santiago, Chile
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Trudeau MB, Jewell C, Rohr E, Fischer KM, Willwacher S, Brueggemann GP, Hamill J. The calcaneus adducts more than the shoe's heel during running. FOOTWEAR SCIENCE 2017. [DOI: 10.1080/19424280.2017.1334712] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Carl Jewell
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Eric Rohr
- Brooks Running Company, Seattle, WA, USA
| | - Katina Mira Fischer
- Institute of Biomechanics and Orthopaedics, German Sport University, Cologne, Germany
| | - Steffen Willwacher
- Institute of Biomechanics and Orthopaedics, German Sport University, Cologne, Germany
| | | | - Joseph Hamill
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
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