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Menz HB, Lim PQX, Hurn SE, Mickle KJ, Buldt AK, Cotchett MP, Roddy E, Wluka AE, Erbas B, Munteanu SE. Effectiveness of footwear and foot orthoses in reducing medial metatarsophalangeal joint pressure in women with hallux valgus. Gait Posture 2024; 111:156-161. [PMID: 38703444 DOI: 10.1016/j.gaitpost.2024.04.021] [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: 10/08/2023] [Revised: 01/24/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Hallux valgus is a common condition where the subluxation of the first metatarsophalangeal joint and lateral deviation of the hallux at the interphalangeal joint creates difficulty with footwear fit. Footwear and foot orthoses are commonly prescribed nonsurgical treatments for hallux valgus. RESEARCH QUESTION Do extra-width footwear and foot orthoses influence peak pressure at the medial aspect of the metatarsophalangeal and interphalangeal joints in women with hallux valgus? METHODS Community-dwelling women with symptomatic hallux valgus underwent gait testing when wearing their own shoes and when wearing extra-width footwear fitted with three-quarter length, arch-contouring prefabricated foot orthoses. Peak pressure (kPa) on the medial aspect of the metatarsophalangeal and medial interphalangeal joints and on the plantar surface of the foot (hallux, lesser toes, metatarsophalangeal joint 1, metatarsophalangeal joints 2-5, midfoot and heel) were measured using the novel pedar®-X system with the pedar® pad and pedar® insole, respectively (Novel, GmbH, Munich, Germany). Paired samples t-tests were used to calculate the differences between the two conditions, and the magnitude of observed differences was calculated using Cohen's d. RESULTS We tested 28 participants (aged 44-80 years, mean 60.7, standard deviation 10.7). Compared to their own footwear, wearing the intervention footwear and orthoses was associated with a statistically significant decrease in pressure on the medial aspect of the metatarsophalangeal joint (58.3 ± 32.8 versus 42.6 ± 32.8, p=0.026, d=0.49), increased pressure under the midfoot (70.7 ± 25.7 versus 78.7 ± 23.6, p=0.029, d=0.33) and decreased pressure underneath the heel (137.3 ± 39.0 versus 121.3 ± 34.8, p=0.019, d=0.45). SIGNIFICANCE The intervention footwear and orthoses significantly decreased peak pressure on the medial aspect of the first metatarsophalangeal joint but had no significant effect on the interphalangeal joint. Further studies are required to determine whether these changes are associated with improvements in symptoms associated with hallux valgus.
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Affiliation(s)
- Hylton B Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia.
| | - Polly Q X Lim
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Sheree E Hurn
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
| | - Karen J Mickle
- Applied Sport Science and Exercise Testing Laboratory, College of Health, Medicine and Wellbeing, University of Newcastle, Ourimbah, New South Wales 2258, Australia
| | - Andrew K Buldt
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Matthew P Cotchett
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Edward Roddy
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom; Haywood Academic Rheumatology Centre, Midlands Partnership University NHS Foundation Trust, Haywood Hospital, Burslem, Staffordshire ST6 7AG, United Kingdom
| | - Anita E Wluka
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria 3004, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Shannon E Munteanu
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia
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Lavigne A, Chicoine D, Esculier JF, Desmeules F, Frémont P, Dubois B. The Role of Footwear, Foot Orthosis, and Training-Related Strategies in the Prevention of Bone Stress Injuries: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2023; 16:721-743. [PMID: 37649463 PMCID: PMC10464778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Objective To evaluate the effectiveness of footwear, foot orthoses and training-related strategies to prevent lower extremity bone stress injury (BSI). Design Systematic review and meta-analysis. Data sources Four bibliographic databases (from inception until November 2021): Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and CINAHL. Eligibility criteria Randomised controlled trials (RCTs) that assessed the risk of developing a BSI when using particular footwear, foot orthoses or training-related strategies such as muscle strengthening, stretching, and mechanical loading exercises. Results Eleven studies were included in this systematic review. When wearing foot orthoses, the risk ratio of developing a BSI on any lower extremity bone is 0.47 (95% CI 0.26 to 0.87; p = 0.02). When doing pre-exercise dynamic stretching, the risk ratio of suffering a tibial BSI is 1.06 (95% CI 0.67 to 1.68; p = 0.79). No meta-analyses could be performed for footwear or training-related strategies. The quality of evidence for all these results is low considering the high risk of bias in each study, the low number of studies and the low number of cases in each study. Conclusion This systematic review reveals the lack of high-quality studies in BSI prevention. Based on studies at high risk of bias, foot orthoses could potentially help prevent BSIs in the military setting. It is still unknown whether footwear and training-related strategies have any benefits. It is crucial to further investigate potential BSI prevention strategies in women and athletes. Research is also needed to assess the influence of running shoes and loading management on BSI incidence.
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Affiliation(s)
- Alexandre Lavigne
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC, CANADA
| | | | - Jean-François Esculier
- The Running Clinic, Lac Beauport, QC, CANADA
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, QC, CANADA
| | - François Desmeules
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC, CANADA
- Centre de Recherche de l'Hôpital Maisonneuve-Rosemont, Montreal, QC, CANADA
| | - Pierre Frémont
- Département de Réadaptation, Faculté de Médecine, Université Laval, Québec, QC, CANADA
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Channasanon S, Praewpipat B, Duangjinda N, Sornchalerm L, Tesavibul P, Paecharoen S, Tanodekaew S. 3D-printed medial arch supports of varying hardness versus a prefabricated arch support on plantar pressure: A 1-month randomized crossover study in healthy volunteers. Prosthet Orthot Int 2023; 47:210-217. [PMID: 36037286 DOI: 10.1097/pxr.0000000000000178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 06/01/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Foot orthoses are commonly used as a noninvasive treatment to relieve foot pain. The custom full-length insoles with various materials and designs have been studied for their effectiveness in reducing plantar pressure. However, few studies have been conducted with respect to custom medial arch support on the relationships between material hardness and measured plantar pressure and level of comfort. OBJECTIVES To evaluate the effects of the hardness of custom medial arch supports on plantar pressure and comfort perception. STUDY DESIGN Randomized crossover study. METHODS Two custom silicone medial arch supports of varying hardness (A and B) were fabricated using 3D printing technology and tested in 12 healthy volunteers against a commercially prefabricated arch support (C). The volunteers wore three medial arch supports in a random order, one month for each arch support with 3-4 days of washout period before wearing the next one. The plantar pressure was measured and analyzed according to each foot zone: forefoot, midfoot, and hindfoot, comparing before intervention, immediately after intervention, and 1 month after intervention. The comfort perception was assessed by collecting volunteer feedback with a questionnaire after using each medial arch support. RESULTS After 1-month intervention, both 3D-printed and prefabricated medial arch supports demonstrated significantly higher average pressure in the midfoot ( P < 0.001), whereas significantly lower average pressure in the forefoot ( P < 0.001) and hindfoot ( P = 0.014, 0.026, and 0.018 for A, B, and C, respectively), compared with those before intervention. There were no significant differences in plantar pressure distribution between the 3D-printed and prefabricated medial arch supports. However, the 3D-printed medial arch supports resulted in better comfort than the prefabricated arch support. CONCLUSIONS The material hardness had no apparent effect on plantar pressure distribution. The three medial arch supports showed reducing plantar heel pressure. Further research is needed to investigate the potential effect of 3D-printed silicone medial arch supports on reducing foot pain in patients.
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Affiliation(s)
- Somruethai Channasanon
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Bongkoch Praewpipat
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Nitkamon Duangjinda
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Lertchai Sornchalerm
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Passakorn Tesavibul
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Siranya Paecharoen
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Siriporn Tanodekaew
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
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McClelland JA, Allan JJ, Auhl M, Buldt AK, Landorf KB, Cicuttini FM, Roddy E, Menz HB, Munteanu SE. Effects of Shoe-Stiffening Inserts on Lower Extremity Kinematics in Individuals With First Metatarsophalangeal Joint Osteoarthritis. Arthritis Care Res (Hoboken) 2022; 74:1849-1856. [PMID: 34057298 DOI: 10.1002/acr.24647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/12/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To examine the effects of shoe-stiffening inserts on lower extremity kinematics in individuals with first metatarsophalangeal (MTP) joint osteoarthritis (OA). METHODS Forty-eight individuals with radiographically confirmed first MTP joint OA (24 male and 24 female; mean ± SD age 57.8 ± 10.5 years) were randomized to receive either shoe-stiffening inserts or sham inserts and underwent gait analysis during level walking using a 10-camera infrared Vicon motion analysis system. Sagittal plane kinematics of the first MTP, ankle, knee, and hip joints were compared between the shoe only (control) and insert conditions in both groups (within-groups) and between both insert conditions (between-groups). RESULTS Compared to the shoe only condition, the sham insert reduced knee flexion and total excursion, and the shoe-stiffening insert reduced first MTP joint maximum dorsiflexion and ankle joint maximum plantarflexion, and increased maximum knee flexion and total excursion. Between-group comparisons indicated that the shoe-stiffening inserts significantly decreased first MTP joint maximum dorsiflexion, ankle joint maximum plantarflexion, and total excursion and increased knee joint maximum flexion and total excursion compared to the sham inserts. CONCLUSION Carbon fiber shoe-stiffening inserts significantly alter sagittal plane lower extremity joint kinematics during walking, particularly first MTP joint maximum dorsiflexion. These findings provide insights into the mechanisms that may be responsible for their clinical effectiveness in the treatment of first MTP joint OA and potentially explain changes in symptoms in other lower extremity joints.
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Affiliation(s)
| | | | - Maria Auhl
- La Trobe University, Melbourne, Victoria, Australia
| | | | | | | | - Edward Roddy
- Keele University, Keele, UK, and Midlands Partnership NHS Foundation Trust, Haywood Hospital, Burslem, UK
| | - Hylton B Menz
- La Trobe University, Melbourne, Victoria, Australia, and Keele University, Keele, UK
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Custom-made foot orthoses with and without heel plugs and their effect on plantar pressures during treadmill walking. Prosthet Orthot Int 2022; 46:e357-e361. [PMID: 35315833 DOI: 10.1097/pxr.0000000000000101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 01/06/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Foot orthoses have consistently demonstrated an improvement in pain scores for plantar fasciitis. The fabrication of custom-made foot orthoses (CFOs) can vary between clinicians and may include the use of different materials and casting techniques. This cross-sectional study's objective was to quantify plantar pressure for two CFOs, one with a heel plug (HP) and one without. METHODS Fourteen healthy participants (8 men and 6 women; 35.4 ± 7.7 years) were cast by the same practitioner. Both CFOs were made with the same materials and specifications, except for the HP orthosis, which replaced hard material under the heel with a softer blue PORON ® plug for added cushioning. Plantar pressures were recorded during treadmill walking for both devices in a running shoe. Average pressure, peak pressure, and pressure contact area were determined for three regions of the foot: hindfoot, midfoot, and forefoot. A paired samples t -test determined differences in each region ( P < 0.05). RESULTS The HP orthosis reduced the overall means of average pressure, peak pressure, and pressure contact area in the hindfoot while tending to increase these measures in the midfoot and forefoot. The three measures showed statistically significant decreases in the hindfoot, whereas a statistically significant increase was seen in average and peak pressures in the midfoot ( P < 0.05). CONCLUSIONS CFOs with HPs are more effective than regular CFOs in offloading plantar pressures in the hindfoot while increasing pressures in the midfoot. This is an important finding because offloading the hindfoot is critical in pathologies such as plantar fasciitis to decrease pain and increase function.
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Paterson KL, Hinman RS, Metcalf BR, McManus F, Jones SE, Menz HB, Munteanu SE, Bennell KL. Effect of foot orthoses vs sham insoles on first metatarsophalangeal joint osteoarthritis symptoms: a randomized controlled trial. Osteoarthritis Cartilage 2022; 30:956-964. [PMID: 35272050 DOI: 10.1016/j.joca.2022.01.014] [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: 09/28/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To compare contoured foot orthoses to sham flat insoles for first MTP joint OA walking pain. DESIGN This was a participant- and assessor-blinded, sham-controlled, multi-centre randomized clinical trial set in community-based private practices. Eighty-eight adults aged ≥45 years with symptomatic radiographic first MTP joint OA were randomized to receive contoured foot orthoses (n = 47) or sham flat insoles (n = 41), worn at all times when wearing shoes for 12 weeks. Primary outcome was change in first MTP joint walking pain (11-point numerical rating scale (NRS), 0-10) over 12 weeks. Secondary outcomes included additional first MTP joint and foot pain measures, physical function, quality of life and physical activity. Separate linear regression models for primary and secondary outcomes on treatment group were fit, adjusting for the outcome at baseline and podiatrist. Other measures included adverse events. RESULTS 88 participants were randomized and 87 (99%) completed the 12-week primary outcome. There was no evidence foot orthoses were superior to sham insoles for reducing pain (mean difference -0.3 NRS units (95% CI -1.2 to 0.6), p = 0.53). Similarly, foot orthoses were not superior to sham on any secondary outcomes. Sensitivity analyses yielded similar results. Adverse events were generally minor and transient. CONCLUSION Contoured foot orthoses are no more effective than flat sham insoles for the clinical management of first MTP joint OA. Given the dearth of evidence on treatments for first MTP joint OA, further research is needed to identify effective management approaches for this common and debilitating condition.
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Affiliation(s)
- K L Paterson
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia.
| | - R S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - B R Metcalf
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - F McManus
- Biostatistics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - S E Jones
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - H B Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - S E Munteanu
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - K L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
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Morrow EM, Theologis T, Kothari A. Construction and validation of sham insoles used in clinical trials: A systematic review. Prosthet Orthot Int 2022; 46:121-133. [PMID: 35019884 DOI: 10.1097/pxr.0000000000000091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 11/11/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Insoles are commonly prescribed to treat pathologies in a variety of patient groups; however, there is limited evidence to guide clinical decision-making. A well-validated sham insole is critical to conducting a double-blind placebo-controlled trial. OBJECTIVES The aims were to establish: (1) How are sham insoles constructed? (2) What measures are undertaken to ensure adequate blinding? (3) What methods are used to validate the biomechanical effects? STUDY DESIGN A systematic search of the methodology of level I-II therapeutic evidence. METHODS Searches were conducted in MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials. Inclusion criteria were placebo-controlled clinical trials, sham insoles used, treatment insoles alter biomechanics, treatment insoles meet the ISO definition of foot orthotics, sham and treatment insoles tested in normal walking, and article available in English. RESULTS The search generated 270 results. Twenty-four trials were included. 19% of sham insoles were described sufficiently to be replicated. The most common sham construction characteristics were full length, ethylene-vinyl acetate material, and flat insoles. 58% of studies were double-blinded; however, many did not describe any blinding methods. There is evidence that blinding the intervention details and a similar insole appearance is effective to blind participants. 13% of studies included a shoe-only condition to allow assessment of the biomechanical effects of sham insoles. CONCLUSIONS There is inconsistent construction, blinding, and biomechanical validation of sham insoles. This casts a substantial doubt on the quality and reliability of the evidence base to support the prescription of insoles.
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Affiliation(s)
- Eileen Mairi Morrow
- Paediatric Orthopaedics Department, Oxford University Hospitals NHS Foundation Trust, NDORMS, University of Oxford, Oxford, UK
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Mochizuki T, Nasu Y, Yano K, Ikari K, Hiroshima R, Okazaki K. Foot and ankle functions and deformities focus on posterior tibial tendon dysfunction using magnetic resonance imaging in patients with rheumatoid arthritis. Mod Rheumatol 2021; 32:885-890. [PMID: 34918140 DOI: 10.1093/mr/roab084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/09/2021] [Accepted: 09/16/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Posterior tibial tendon dysfunction (PTTD) affects the support of the medial longitudinal arch and stability of the hindfoot. The purpose of this study was to assess the relationships of PTTD with foot and ankle functions and foot deformities in patients with rheumatoid arthritis (RA). METHODS A total of 129 patients (258 feet) who underwent magnetic plain and contrast-enhanced magnetic resonance imaging were enrolled in this study. Positive magnetic resonance imaging findings were defined as tenosynovitis and incomplete and complete rupture of the posterior tibial tendon. Foot and ankle functions were assessed using the Japanese Society for Surgery of the Foot standard rating system for the RA foot and ankle scale (JSSF-RA) and self-administered foot evaluation questionnaire. Plain radiographs were examined for the hallux valgus angle, first metatarsal and second metatarsal angle, lateral talo-first metatarsal angle, and calcaneal pitch angle. RESULTS PTTD was associated with motion in the JSSF-RA (p = .024), activities of daily living in JSSF-RA (p = .017), and pain and pain-related factors in the self-administered foot evaluation questionnaire (p = .001). The calcaneal pitch angle was significantly lower in the feet with PTTD than in those without PTTD (median: 16.2° vs. 18.0°; p = .007). CONCLUSIONS The present study shows that PTTD was associated with foot and ankle functions and flatfoot deformity. Thus, a better understanding of PTTD in patients with RA is important for the management of foot and ankle disorders in clinical practice.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Yuki Nasu
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.,Division of Multidisciplinary Management of Rheumatic Diseases, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryo Hiroshima
- Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
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Comparison of the immediate effects of prefabricated soft medical insoles and custom-molded rigid medical insoles on plantar pressure distribution in athletes with flexible flatfoot: a prospective study. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Reeves J, Jones R, Liu A, Bent L, Martinez-Santos A, Nester C. No change in foot soft tissue morphology and skin sensitivity after three months of using foot orthoses that alter plantar pressure. FOOTWEAR SCIENCE 2021. [DOI: 10.1080/19424280.2021.1961880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Joanna Reeves
- School of Health Sciences, University of Salford, Salford, United Kingdom
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Richard Jones
- School of Health Sciences, University of Salford, Salford, United Kingdom
| | - Anmin Liu
- School of Health Sciences, University of Salford, Salford, United Kingdom
| | - Leah Bent
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | | | - Christopher Nester
- School of Health Sciences, University of Salford, Salford, United Kingdom
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Effectiveness and Reliability of Foot Orthoses on Impact Loading and Lower Limb Kinematics When Running at Preferred and Nonpreferred Speeds. J Appl Biomech 2020; 37:66-73. [PMID: 33232937 DOI: 10.1123/jab.2019-0281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 07/16/2020] [Accepted: 09/08/2020] [Indexed: 11/18/2022]
Abstract
This study examined the effect of foot orthoses used on ground reaction forces, ankle, and knee kinematics when running at preferred and nonpreferred speeds. Sixteen runners ran on instrumented treadmills at various speeds (90%, 100%, and 110% of preferred speed) when wearing arch-support and flat-control orthoses. Two-way repeated analysis of variance (ANOVA) was performed on the mean and coefficient of variation of all variables. Results indicated that arch-support orthoses experienced larger maximum loading rates than flat-control orthoses (P = .017, 95% CI, 2.22 to 19.53). Slower speed was related to smaller loading rates (preferred: P = .002, 95% CI, -17.02 to -4.20; faster: P = .003, 95% CI, -29.78 to -6.17), shorter stride length (preferred: P < .001, 95% CI, -0.204 to -0.090; faster: P < .001, 95% CI, -0.382 to -0.237), and longer contact time (preferred: P < .001, 95% CI, 0.006-0.021; faster: 95% CI, 0.012-0.042). In arch-support condition, preferred speed induced higher stride length coefficient of variation (P = .046, 95% CI, 0.035-1.117) than faster speed, while displaying no differences in flat-control condition. These findings suggest that the use of arch-support orthoses would influence impact loading, but not spatial-temporal and joint kinematics in recreational runners.
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Gómez-Jurado I, Juárez-Jiménez JM, Munuera-Martínez PV. Orthotic treatment for stage I and II posterior tibial tendon dysfunction (flat foot): A systematic review. Clin Rehabil 2020; 35:159-168. [PMID: 33040609 DOI: 10.1177/0269215520960121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate whether orthotic treatment is effective for the treatment of posterior tibial tendon dysfunction stages I and II (flat foot). DATA SOURCES Five databases (PubMed, Scopus, PEDro, SPORTDiscus and The Cochrane Library) were searched for potential RCTs from their inception until August 2020. REVIEW METHODS Only randomised controlled trials (RCT) that included subjects diagnosed with posterior tibial dysfunction in the initial stage and treated with orthotic treatments were selected. The outcomes assessed were whatever symptom related to posterior tibial tendon dysfunction stage I and II. Included RCTs were appraised using the Cochrane collaboration risk of bias tool. RESULTS Four RCT articles and 186 subjects were included. 75% were at high risk of bias for blinding of participants and personnel. Three different types of conservative treatment were used in the studies: foot/ankle-foot orthoses, footwear and stretching /strengthening exercises. Foot orthoses, together with exercise programmes, seemed to improve the effect of orthotic treatment. Foot orthoses with personalised internal longitudinal arch support were more effective than flat insoles or standard treatments in reducing pain. CONCLUSIONS The use of orthotic treatment may be effective in reducing pain in the early stages of posterior tibial tendon dysfunction. Further research is needed into individualised orthotic treatment and high-intensity monitored exercise programmes.
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Affiliation(s)
- Isabel Gómez-Jurado
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
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Menz HB, Cotchett MP, Whittaker GA, Munteanu SE, Landorf KB. Plantar heel pain: should you consult a general practitioner or a podiatrist? Br J Sports Med 2020; 55:245-246. [PMID: 32878871 DOI: 10.1136/bjsports-2020-102957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia .,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Matthew P Cotchett
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Glen A Whittaker
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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14
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Effect of different orthotic materials on plantar pressures: a systematic review. J Foot Ankle Res 2020; 13:35. [PMID: 32527296 PMCID: PMC7291735 DOI: 10.1186/s13047-020-00401-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background The effect of different orthotic materials on plantar pressures has not been systematically investigated. This study aimed to review and summarise the findings from studies that have evaluated the effect of orthotic materials on plantar pressures. Methods We conducted a systematic review of experimental studies that evaluated the effect of foot orthotic materials or shoe insole materials on plantar pressures using in-shoe testing during walking. The following databases were searched: MEDLINE, CINAHL, Embase and SPORTDiscus. Included studies were assessed for methodological quality using a modified Quality Index. Peak pressure, pressure-time integral, maximum force, force-time integral, contact area, and contact time were variables of interest. Data were synthesised descriptively as studies were not sufficiently homogeneous to conduct meta-analysis. Standardised mean differences (Cohen’s d) were calculated to provide the size of the effect between materials found in each study. Results Five studies were identified as meeting the eligibility criteria. All five studies were laboratory-based and used a repeated measures design. The quality of the studies varied with scores ranging between 20 and 23 on the modified Quality Index (maximum index score 28). The included studies investigated the effects of polyurethane (including PORON®), polyethylene (including Plastazote®), ethyl vinyl acetate (EVA) and carbon graphite on plantar pressures. Polyurethane (including PORON®), polyethylene (including Plastazote®) and EVA were all found to reduce peak pressure. Conclusion Based on the limited evidence supplied from the five studies included in this review, some orthotic materials can reduce plantar pressures during walking. Polyurethane (including PORON®), polyethylene (including Plastazote®) and EVA reduce peak pressure beneath varying regions of the foot. Future well-designed studies will strengthen this evidence.
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15
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Lullini G, Giangrande A, Caravaggi P, Leardini A, Berti L. Functional Evaluation of a Shock Absorbing Insole During Military Training in a Group of Soldiers: A Pilot Study. Mil Med 2020; 185:e643-e648. [PMID: 32175582 DOI: 10.1093/milmed/usaa032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/01/2019] [Accepted: 02/07/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Soldiers' lower limbs and feet are frequently affected by overload- and overuse-related injuries. In order to prevent or limit the incidence of these injuries, the use of foot orthoses is often recommended. The aim of this study is to assess the effects of shock-absorbing insoles on in-shoe plantar pressure magnitude and distribution in a group of professional infantry soldiers wearing military boots during standard indoor military training. METHODS Twenty male professional soldiers of the Italian Army (age 35.1 ± 6.1 years; BMI 25.2 ± 2.3 kg/m2) were recruited for this study. Each subject underwent clinical examination to assess possible overuse-related diseases of the lower limb and trunk. Subjects with altered foot morphology according to the Foot Posture Index (FPI) were excluded from this study. Twelve subjects were considered eligible and therefore underwent an indoor training routine comprised of marching, running, jumping inside parallel bars and jumping from different heights. Soldiers repeated the training session twice wearing standard military boots along with two types of insoles: the standard prefabricated insole within the boots (STI), and a special shock-absorbing insole (SAI) featuring an elastic medial arch support. A 99-capacitive sensor insole system was used to record plantar pressure distribution in both feet. Analysis of in-shoe pressure parameters at rearfoot, midfoot and forefoot and in the total foot was performed via a custom-software application developed in MATLAB. Perceived foot comfort (VAS 0-15) was also assessed. RESULTS Pressure parameters recorded during walking and running were considered suitable for statistical analysis. In the whole foot region, pressure parameters were 18-22% lower in military boots fitted with the SAI during walking and 14-18% lower during running. SAI resulted in better comfort (+25%) with respect to the prefabricated boot orthotics (median comfort: SAI = 15/15; STI = 12/15; p = 0.0039) both during walking and running. CONCLUSIONS Shock-absorbing insoles can be an effective solution when fitted inside military boots. The present functional evaluation shows that wearing a prefabricated shock-absorbing insole can provide a significant amelioration of perceived foot comfort and plantar pressure parameters. Further studies are now needed with a larger population and more demanding exercises.
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Affiliation(s)
- Giada Lullini
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy.,DIBIMNEM-University of Bologna, Via Zamboni 33, 40110 Bologna, Italy
| | - Alessia Giangrande
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy
| | - Paolo Caravaggi
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy
| | - Alberto Leardini
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy
| | - Lisa Berti
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy.,DIBIMNEM-University of Bologna, Via Zamboni 33, 40110 Bologna, Italy
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16
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Vermand S, Duc S, Ferrari FJ, Joly P. Immediate, short and medium-term effects of orthopedic insoles with a metatarsal retro-capital bar on biomechanical variables, plantar pressures and muscle activity in running. J Sports Med Phys Fitness 2020; 60:848-854. [PMID: 32487980 DOI: 10.23736/s0022-4707.20.10471-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of 12 weeks of use of orthopedic insoles equipped with a metatarsal retro-capital bar (MRCB) on plantar pressure under the feet and lower limb kinematic variables during running. METHODS Two groups of 10 runners used for 12 weeks while running orthopedic insoles without correction or equipped with a MRCB. All participants performed successively a standing posture (CoP displacement) test and a running test at 11 km.h-1 (lower limb kinematic variables) using with flat insoles and orthopedic neutral or MRCB insoles at the beginning (T0), after 4 (T4) and 12 weeks (T12) of use. RESULTS For the MRCB group, CoP moved backwards while forefoot plantar pressure was decreased during standing position at T4 and T12 compared to T0. During running, the plantar pressure under the 2nd, 3rd and 4th metatarsal heads was reduced with MRCB at T0, T4 and T12. The one under the 1st metatarsal head was decreased at T4 and T12, when MRCB or flat insoles were used. The maximal extension and the total amplitude of ankle were slightly increased at T4 and T12 with or without wearing MRCB insoles. Similar changes in knee joint kinematics were observed but only at T12. Any significant changes were found in runners that used orthopedic insoles without correction. CONCLUSIONS Orthopedic insoles equipped with MRCB involve lower plantar pressure under the metatarsal heads, which may be of interest to treat forefoot injuries in runners.
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Affiliation(s)
- Stéphane Vermand
- Performance, Health, Measurement Society (PSMS), University of Reims Champagne-Ardennes, Reims, France - .,Podiatrist Office and Postural Study, Amiens, France - .,Association of Sport's Podiatrist Podo'kygèm, Tourcoing, France -
| | - Sébastien Duc
- Podiatrist Office and Postural Study, Amiens, France
| | - Frank-Jourdan Ferrari
- Performance, Health, Measurement Society (PSMS), University of Reims Champagne-Ardennes, Reims, France
| | - Philippe Joly
- Performance, Health, Measurement Society (PSMS), University of Reims Champagne-Ardennes, Reims, France
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17
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Influence of Different Hardness Custom Foot Insoles in the Electromyography Activity Patterns of the Thigh and Hip Muscles during Motorcycling Sport: A Crossover Study. SENSORS 2020; 20:s20061551. [PMID: 32168780 PMCID: PMC7146395 DOI: 10.3390/s20061551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/05/2020] [Accepted: 03/10/2020] [Indexed: 11/16/2022]
Abstract
Nowadays, the use of insoles in sport practice have been recognized to decrease the foot and lower limb injury patterns. The aim of this study was to analyse the effect of four types of hardness insoles (HI) in the activity patterns of the hip and thigh muscles (HTM) in motoriders during motorcycling sport. The study was a crossover trial. Subjects were elite motoriders. The mean age was 33 ± 5.14 years. Electromyography (EMG) of hip and thigh muscles (HTM) data was registered via surface while subjects were riding on an elite motorcycle simulator. Subjects had to complete different tests with randomly hardest insoles (HI): 1: only polypropylene (58° D Shore); 2: Polypropylene (58° D Shore) with selective aluminium in hallux and metatarsal heads (60 HB Brinell hardness); 3: Ethylene vinyl acetate (EVA) (52° A Shore); and finally, 4: Ordinary EVA (25° A Shore) as the control. EMG patterns of the HTM, riding on an elite motorcycle simulator, showed the lowest peak amplitude with the insoles with polypropylene and selective aluminium. Using the hardest insoles in our study (selective aluminium) the EMG amplitude peaks decreased in all HTM.
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18
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Immediate effects of foot orthoses on lower limb biomechanics, pain, and confidence in individuals with patellofemoral osteoarthritis. Gait Posture 2020; 76:51-57. [PMID: 31731134 DOI: 10.1016/j.gaitpost.2019.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 10/02/2019] [Accepted: 10/12/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Foot 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 QUESTION To compare the immediate effects of foot orthoses and flat inserts on lower limb biomechanics, knee pain and confidence in individuals with PFOA. METHODS Twenty-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. RESULTS During 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. SIGNIFICANCE Prefabricated 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.
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19
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Reeves J, Jones R, Liu A, Bent L, Plater E, Nester C. A systematic review of the effect of footwear, foot orthoses and taping on lower limb muscle activity during walking and running. Prosthet Orthot Int 2019; 43:576-596. [PMID: 31547793 DOI: 10.1177/0309364619870666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND External devices are used to manage musculoskeletal pathologies by altering loading of the foot, which could result in altered muscle activity that could have therapeutic benefits. OBJECTIVES To establish if evidence exists that footwear, foot orthoses and taping alter lower limb muscle activity during walking and running. STUDY DESIGN Systematic literature review. METHODS CINAHL, MEDLINE, ScienceDirect, SPORTDiscus and Web of Science databases were searched. Quality assessment was performed using guidelines for assessing healthcare interventions and electromyography methodology. RESULTS Thirty-one studies were included: 22 related to footwear, eight foot orthoses and one taping. In walking, (1) rocker footwear apparently decreases tibialis anterior activity and increases triceps surae activity, (2) orthoses could decrease activity of tibialis posterior and increase activity of peroneus longus and (3) other footwear and taping effects are unclear. CONCLUSION Modifications in shoe or orthosis design in the sagittal or frontal plane can alter activation in walking of muscles acting primarily in these planes. Adequately powered research with kinematic and kinetic data is needed to explain the presence/absence of changes in muscle activation with external devices. CLINICAL RELEVANCE This review provides some evidence that foot orthoses can reduce tibialis posterior activity, potentially benefitting specific musculoskeletal pathologies.
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Affiliation(s)
- Joanna Reeves
- School of Health Sciences, University of Salford, Salford, UK.,Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Richard Jones
- School of Health Sciences, University of Salford, Salford, UK
| | - Anmin Liu
- School of Health Sciences, University of Salford, Salford, UK
| | - Leah Bent
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Emma Plater
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
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20
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Hassan NM, Shields N, Landorf KB, Buldt AK, Taylor NF, Evans AM, Williams CM, Menz HB, Munteanu SE. Efficacy of custom-fitted footwear to increase physical activity in children and adolescents with Down syndrome (ShoeFIT): randomised pilot study. Disabil Rehabil 2019; 43:2131-2140. [PMID: 31756300 DOI: 10.1080/09638288.2019.1692380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To determine the feasibility of conducting a definitive randomised trial to evaluate the efficacy of custom-fitted footwear for increasing physical activity in children and adolescents with Down syndrome. METHODS Assessor-blinded, parallel-group randomised pilot study. Thirty-three children and adolescents with Down syndrome were randomly allocated to a custom-fitted footwear group (Clarks® footwear) or a wait-list control group. Six feasibility domains were evaluated at baseline, 6 and 12 weeks; demand (recruitment), implementation (co-interventions and adherence), acceptability, practicality (adverse events), limited efficacy testing (physical activity, disability associated with foot and ankle problems, and gait parameters), and adaptation (shoe-fit). RESULTS Three participants were recruited per month. The use of co-interventions was common with six control group participants purchasing new footwear during the study. Mean adherence was 35 h/week in the custom-fitted footwear group, and there were few minor adverse events. There were trends for differences in physical activity favouring the custom-fitted footwear, but no trends for differences in disability associated with foot and ankle problems or gait parameters. The fit of the custom-fitted footwear was no better than participants' regular footwear. CONCLUSIONS A definitive randomised trial is feasible. However, recruitment, use of co-interventions and footwear fit need further consideration.Implications for rehabilitationConducting a definitive randomised trial to determine the efficacy of custom-fitted footwear in increasing physical activity in children and adolescents with Down syndrome is feasible.Custom-fitted footwear may improve physical activity in children and adolescents with Down syndrome.Commercially available footwear may not be suitable for children and adolescents with Down syndrome due to their unique foot shape.
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Affiliation(s)
- Nirmeen M Hassan
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,Living with Disability Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Nora Shields
- Living with Disability Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Andrew K Buldt
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Nicholas F Taylor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Angela M Evans
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Cylie M Williams
- Physiotherapy Department, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia.,Allied Health, Peninsula Health, Melbourne, Victoria, Australia
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,Living with Disability Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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21
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Van Alsenoy K, Ryu JH, Girard O. The Effect of EVA and TPU Custom Foot Orthoses on Running Economy, Running Mechanics, and Comfort. Front Sports Act Living 2019; 1:34. [PMID: 33344957 PMCID: PMC7739627 DOI: 10.3389/fspor.2019.00034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/09/2019] [Indexed: 11/16/2022] Open
Abstract
Custom made foot orthoses (CFO) with specific material properties have the potential to alter ground reaction forces but their effect on running mechanics and comfort remains to be investigated. We determined if CFO manufactured from ethyl-vinyl acetate (EVA) and expanded thermoplastic polyurethane (TPU) materials, both compared to standardized footwear (CON), improve running economy (RE), running mechanics, and comfort at two running speeds. Eighteen well-trained, male athletes ran on an instrumented treadmill for 6 min at high (HS) and low (LS) speeds corresponding to and 15% lower than their first ventilatory threshold (13.8 ± 1.1 and 11.7 ± 0.9 km.h−1, respectively) in three footwear conditions (CON, EVA, and TPU). RE, running mechanics and comfort were determined. Albeit not reaching statistical significance (P = 0.11, η2 = 0.12), RE on average improved in EVA (+2.1 ± 4.8 and +2.9 ± 4.9%) and TPU (+0.9 ± 5.9 and +0.9 ± 5.3%) compared to CON at LS and HS, respectively. Braking force was decreased by 3.4 ± 9.1% at LS and by 2.7 ± 9.8% at HS for EVA compared to CON (P = 0.03, η2 = 0.20). TPU increased propulsive loading rate by 20.2 ± 24 and 16.4 ± 23.1% for LS and HS, respectively compared to CON (P = 0.01, η2 = 0.25). Both arch height (P = 0.06, η2 = 0.19) and medio-lateral control (P = 0.06, η2 = 0.16) showed a trend toward improved comfort for EVA and TPU vs. CON. Compared to shoes only, mainly EVA tended to improve RE and comfort at submaximal running speeds. Specific CFO-related running mechanical adjustments included a reduced braking impulse occurring in the first 25% of contact time with EVA, whereas wearing TPU increased propulsive loading rate.
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Affiliation(s)
- Ken Van Alsenoy
- Exercise and Sport Science Department, ASPETAR Orthopedic and Sports Medicine Hospital, Doha, Qatar.,Centre for Health, Activity and Rehabilitation Research (CHEAR), Queen Margaret University, Musselburgh, United Kingdom
| | - Joong Hyun Ryu
- Department of Sport Sciences, ASPIRE Academy for Sports Excellence, Doha, Qatar
| | - Olivier Girard
- Murdoch Applied Sports Science (MASS) Laboratory, Murdoch University, Perth, WA, Australia.,Athlete Health and Performance Research Center, ASPETAR Orthopedic and Sports Medicine Hospital, Doha, Qatar
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22
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Tan JM, Menz HB, Crossley KM, Munteanu SE, Hart HF, Middleton KJ, Smith AJ, Collins NJ. The efficacy of foot orthoses in individuals with patellofemoral osteoarthritis: a randomised feasibility trial. Pilot Feasibility Stud 2019; 5:90. [PMID: 31338205 PMCID: PMC6625074 DOI: 10.1186/s40814-019-0469-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 06/21/2019] [Indexed: 11/22/2022] Open
Abstract
Background Foot orthoses have the potential to be an efficacious treatment for patellofemoral osteoarthritis (PFOA) but have not been evaluated in clinical trials in this population. This study aimed to determine the: (i) feasibility of conducting a randomised controlled trial (RCT) investigating the efficacy of foot orthoses in individuals with PFOA; and (ii) effects of foot orthoses versus flat shoe inserts on pain, function, and knee-related quality of life (QOL). Methods This 6-week, single-blinded pilot RCT randomly allocated participants with PFOA to receive foot orthoses or flat inserts. The primary outcome of feasibility was determined via the following parameters: one participant recruited per week, 20% (35 h/week) adherence to the intervention, 50% log book completion rate, and < 20% drop-out, with results reported using descriptive statistics. Secondary outcomes included average and maximum pain severity (100 mm visual analogue scale), Anterior Knee Pain Scale, and Knee injury and Osteoarthritis Outcome Score, analysed using analysis of covariance. Results Twenty-six participants (16 women; mean (SD) age of 60 (8) years) with PFOA were recruited. All feasibility parameters were exceeded, with three participants recruited per week, > 20% (37.2 [9.8] hours/week) adherence to the intervention, 69.2% (18/26) log-book completion, and 3.8% (1/26) drop-outs. The most common adverse events were arch irritation and shoe fit issues, which were more common in the foot orthoses group (67.9% versus 32.1%). There was a trend for the foot orthoses group to report larger improvements in average and maximum pain than the flat insert group, with the mean difference for maximum knee pain severity (21.9 mm, 95% CI − 2.1 to 46.0) exceeding the minimal clinically important difference (15 mm). The estimated sample size for a full-scale RCT is 160 participants. Suggestions to improve study design include a greater number of face-to-face follow-up appointments, a larger variety of foot orthoses to reduce rates of adverse events, and increasing follow-up time to determine long-term efficacy. Conclusion This study supports the feasibility of a full-scale RCT to determine the efficacy of foot orthoses versus flat inserts in individuals with PFOA. Trial registration The trial protocol was retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR number: 12616001287426).
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Affiliation(s)
- Jade M Tan
- 1Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Hylton B Menz
- 1Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Kay M Crossley
- 2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Shannon E Munteanu
- 1Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Harvi F Hart
- 2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,4The Wolf Orthopaedic Biomechanics Laboratory, University of Western Ontario, London, Ontario N6A 3K7 Canada
| | - Kane J Middleton
- 2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,3Discipline of Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia
| | - Anne J Smith
- 5School of Physiotherapy and Exercise Science, Curtin University, Perth, 6102 Australia
| | - Natalie J Collins
- 2La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086 Australia.,6School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072 Australia
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23
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Electromyographic Evaluation of the Impacts of Different Insoles in the Activity Patterns of the Lower Limb Muscles during Sport Motorcycling: A Cross-Over Trial. SENSORS 2019; 19:s19102249. [PMID: 31096654 PMCID: PMC6567345 DOI: 10.3390/s19102249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/23/2019] [Accepted: 05/13/2019] [Indexed: 11/29/2022]
Abstract
Customized foot insoles (CFI) have been recognized to reduce the prevalence of foot disorders in sport. The aim of this study was to evaluate the effect of four types of CFI on the activity patterns of the lower limb muscles (LLM) in healthy people during sport motorcycling. Methods: This was a cross-over trial (NCT03734133. Participants were recruited from an outpatient foot specialist clinic. Their mean age was 33 ± 5.14 years. While participants were sport motorcycling in a simulator, the electromyography (EMG) function was registered for LLM via surface electrodes. Participants completed separate tests while wearing one of four types of CFI: (1) only polypropylene (58° Shore D), (2) selective aluminum (60 HB Brinell hardness) in metatarsal and first hallux areas and polypropylene elsewhere (58° Shore D), (3) ethylene vinyl acetate (EVA) (52° Shore A), and (4) standard EVA (25° Shore A) as the control. Results: The activity patterns of the LLM while sport motorcycling showed significantly lower peak amplitude for the selective aluminum CFI than the other types of CFI. Conclusion: EMG amplitude peaks for several LLM were smaller for the hardest CFI (selective aluminum 60 HB Brinell hardness) than the other CFIs (polypropylene 58° Shore D, EVA 52° Shore A, and standard EVA 25° Shore A), except for the fibularis longus in right curves that is increased when the knee touches the road increasing the stability.
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24
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Xu R, Wang Z, Ren Z, Ma T, Jia Z, Fang S, Jin H. Comparative Study of the Effects of Customized 3D printed insole and Prefabricated Insole on Plantar Pressure and Comfort in Patients with Symptomatic Flatfoot. Med Sci Monit 2019; 25:3510-3519. [PMID: 31079137 PMCID: PMC6528551 DOI: 10.12659/msm.916975] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There are many shortcomings in traditional prefabricated rehabilitation insoles for symptomatic flatfoot patients. This study investigated the effects of customized 3-dimensional (3D) printed insoles on pressure and comfort of the plantar foot in symptomatic flatfoot patients. MATERIAL AND METHODS Eighty patients with bilateral flatfoot participated in this study. At week 0, patients were randomly assigned into 1 of 2 groups. In the control group, the patients wore standardize shoes with prefabricated insoles; and in the experimental group the patients wore standardize shoes and customized insoles. The Footscan® system recorded peak pressure, peak force, and peak contact area in 10 areas of the sole at weeks 0 and at week 8. Patients used visual analogue scale scores at week 0 and at week 8 to assess overall comfort of insoles. RESULTS At week 0, compared with the control group, the peak pressure in the metatarsal was significantly lower in the experimental group (P<0.05) while the peak pressure in the mid-foot was significantly higher than the control group (P<0.05). At week 8, in the experimental group, the peak pressures in the mid-foot were significantly higher than the control group (P<0.05). The comfort scores (measured by pain scale) reported by the experimental group were significantly lower than those reported by the control group (P<0.05). CONCLUSIONS Customized 3D printed insoles reduced the pressure on the metatarsals by distributed it over the mid-foot area, thus reduced the damage from symptomatic flatfoot. Customized 3D printed insoles were more effective than prefabricated insoles and offered better comfort for patients with symptomatic flatfoot.
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Affiliation(s)
- Rui Xu
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital Of Jilin University, Changchun, Jilin, China (mainland)
| | - Zhenxiao Ren
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Tingjian Ma
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Zhe Jia
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Shuyan Fang
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Hui Jin
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
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Xu R, Wang Z, Ma T, Ren Z, Jin H. Effect of 3D Printing Individualized Ankle-Foot Orthosis on Plantar Biomechanics and Pain in Patients with Plantar Fasciitis: A Randomized Controlled Trial. Med Sci Monit 2019; 25:1392-1400. [PMID: 30789873 PMCID: PMC6394143 DOI: 10.12659/msm.915045] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Traditional ankle-foot orthoses (AFOs) are not effective in treating plantar fasciitis, while customized 3-dimensional (3D) printed ankle-foot orthoses are effective in treating many ankle-foot diseases. This study investigated the effects of customized 3D printed AFOs on biomechanics and comfort of the plantar foot in plantar fasciitis. MATERIAL AND METHODS Sixty patients with bilateral plantar fasciitis aged 31-60 years participated in this study. At week 0, patients were randomly assigned into 2 groups: the control group consisting of those wearing separate shoes with prefabricated AFOs; and the experimental group consisting of those wearing a separate shoe and customized 3D-printed AFO. The Footscan® system recorded maximum pressure, maximum strength, and contact area of patients' hallux, toes 2-5, first to fifth metatarsal, midfoot, lateral heel, and midfoot heel at weeks 0 and 8. Patients used visual analogue scale scores at weeks 0 and 8 to assess overall comfort of foot orthosis, to determine the credibility and comfort of both orthopedic insole conditions. RESULTS At week 0, in the experimental group, peak pressure in the hallux and first metatarsal area was significantly higher than the control group (P<0.05), while mid-heel and lateral heel peak pressures were significantly lower than the control group (P<0.05). After 8 weeks, all groups reported more comfort compared with the same group in week 0 (P<0.05). The comfort scores reported by the experimental group were significantly lower than those of the control group (P<0.05). CONCLUSIONS This study supports the efficiency of customized 3D printing AFO for reducing damage associated with plantar lesions and improving comfort in patients with plantar fasciitis compared with prefabricated AFO. Customized AFO is useful in the treatment of plantar fasciitis compared with prefabricated AFOs.
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Affiliation(s)
- Rui Xu
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Tingjian Ma
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Zhenxiao Ren
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Hui Jin
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
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Bonanno DR, Ledchumanasarma K, Landorf KB, Munteanu SE, Murley GS, Menz HB. Effects of a contoured foot orthosis and flat insole on plantar pressure and tibial acceleration while walking in defence boots. Sci Rep 2019; 9:1688. [PMID: 30737450 PMCID: PMC6368555 DOI: 10.1038/s41598-018-35830-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/12/2018] [Indexed: 12/21/2022] Open
Abstract
This study investigated the effects of a contoured, prefabricated foot orthosis and a flat insole on plantar pressure and tibial acceleration while walking in defence boots. Twenty-eight adults walked along an 8-metre walkway in a: (i) defence boot (control condition), (ii) defence boot with a flat insole, and (iii) defence boot with a contoured foot orthosis. Plantar pressure data were collected using the pedar-X in-shoe system and tibial accelerations were measured with an accelerometer. In relation to plantar pressure under the rearfoot, the contoured foot orthosis, compared to the defence boot, decreased peak pressure and maximum force, and increased contact area. Under the medial midfoot, the contoured foot orthosis and flat insole increased peak pressure, maximum force and contact area. Under the medial forefoot, the contoured foot orthosis and flat insole increased maximum force. Under the lateral forefoot, the contoured foot orthosis and flat insole increased contact area, with the flat insole also increasing maximum force. In relation to tibial acceleration, the contoured foot orthosis, compared to the defence boot, decreased tibial peak positive acceleration. These findings provide novel biomechanical evidence for the effects of contoured foot orthoses in defence boots.
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Affiliation(s)
- Daniel R Bonanno
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia. .,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.
| | - Ketharasarma Ledchumanasarma
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - George S Murley
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
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Yurt Y, Şener G, Yakut Y. The effect of different foot orthoses on pain and health related quality of life in painful flexible flat foot: a randomized controlled trial. Eur J Phys Rehabil Med 2019; 55:95-102. [DOI: 10.23736/s1973-9087.18.05108-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hamdan PNF, Hamzaid NA, Usman J, Islam MA, Kean VSP, Wahab AKA, Hasnan N, Davis GM. Variations of ankle-foot orthosis-constrained movements increase ankle range of movement while maintaining power output of recumbent cycling. ACTA ACUST UNITED AC 2018; 63:691-697. [PMID: 28915105 DOI: 10.1515/bmt-2017-0004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 07/24/2017] [Indexed: 11/15/2022]
Abstract
Previous research investigated recumbent cycle power output (PO) from the perspective of knee and hip joint biomechanics. However, ankle-foot biomechanics and, in particular, the effect of ankle-foot orthosis (AFO)-constrained movements on cycle PO has not been widely explored. Therefore, the purpose of this study was to determine whether AFOs of a fixed position (FP) and in dorsi-plantarflexion (DPF)-, dorsiflexion (DF)- and plantarflexion (PF)-constrained movements might influence PO during voluntary recumbent cycling exercises. Twenty-five healthy individuals participated in this study. All underwent 1-min cycling at a fixed cadence for each of the AFOs. The peak and average PO of each condition were analyzed. The peak and average PO were 27.2±12.0 W (range 6-60) and 17.2±9.0 W (range 2-36), respectively, during voluntary cycling. There were no significant differences in the peak PO generated by the AFOs (p=0.083). There were also no significant differences in the average PO generated using different AFOs (p=0.063). There were no significant differences in the changes of the hip and knee joint angles with different AFOs (p=0.974 and p=1.00, respectively). However, there was a significant difference in the changes of the ankle joint angle (p<0.00). The present study observed that AFO-constrained movements did not have an influence in altering PO during voluntary recumbent cycling in healthy individuals. This finding might serve as a reference for future rehabilitative cycling protocols.
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Affiliation(s)
- Puteri N F Hamdan
- Faculty of Engineering, Department of Biomedical Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Nur Azah Hamzaid
- Faculty of Engineering, Department of Biomedical Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia, Phone: +60379674487, Fax: +60379674579
| | - Juliana Usman
- Faculty of Engineering, Department of Biomedical Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Md Anamul Islam
- Faculty of Engineering, Department of Biomedical Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Victor S P Kean
- Faculty of Engineering, Department of Biomedical Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ahmad K Abdul Wahab
- Faculty of Engineering, Department of Biomedical Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Nazirah Hasnan
- Faculty of Medicine, Department of Rehabilitation Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Glen M Davis
- Faculty of Engineering, Department of Biomedical Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.,Faculty of Health Sciences, Clinical Exercise and Rehabilitation Unit, Discipline of Exercise and Sports Science, The University of Sydney, Sydney, NSW 2006, Australia
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Özmanevra R, Angin S, Günal İH, Elvan A. Effect of Different Insole Materials on Kinetic and Kinematic Variables of the Walking Gait in Healthy People. J Am Podiatr Med Assoc 2018; 108:390-396. [PMID: 31136720 DOI: 10.7547/16-175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND There is a lack of data that could address the effects of off-the-shelf insoles on gait variables in healthy people. METHODS Thirty-three healthy volunteers ranging in age from 18 to 35 years were included to this study. Kinematic and kinetic data were obtained in barefoot, shoe-only, steel insole, silicone insole, and polyurethane insole conditions using an optoelectronic three-dimensional motion analysis system. A repeated measures analysis of variance test was used to identify statistically significant differences between insole conditions. The alpha level was set at P < .05. RESULTS Maximum knee flexion was higher in the steel insole condition (P < .0001) compared with the silicone insole (P = .001) and shoe-only conditions (P = .032). Reduced maximum knee flexion was recorded in the polyurethane insole condition compared with the shoe-only condition (P = .031). Maximum knee flexion measured in the steel insole condition was higher compared to the barefoot condition (P = .020). Higher maximum ankle dorsiflexion was observed in the barefoot condition, and there were significant differences between the polyurethane insole (P < .0001), silicone insole (P = .001), steel insole (P = .002), and shoe conditions (P = .004). Least and highest maximum ankle plantarflexion were detected in the steel insole and silicone insole conditions, respectively. Maximum ankle plantarflexion in the barefoot and steel insole conditions (P = .014) and the barefoot and polyurethane insole conditions (P = .035) were significant. There was no significant difference between conditions for ground reaction force or joint moments. CONCLUSIONS Insoles made by different materials affect maximum knee flexion, maximum ankle dorsiflexion, and maximum ankle plantarflexion. This may be helpful during the decision-making process when selecting the insole material for any pathological conditions that require insole prescription.
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Bishop C, Thewlis D, Hillier S. Custom foot orthoses improve first-step pain in individuals with unilateral plantar fasciopathy: a pragmatic randomised controlled trial. BMC Musculoskelet Disord 2018; 19:222. [PMID: 30021556 PMCID: PMC6052580 DOI: 10.1186/s12891-018-2131-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 06/14/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Foot orthoses are routinely used to treat plantar fasciopathy in clinical practice. However, minimal evidence exists as to the effect of both truly custom designed foot orthoses, as well as that of the shoe the foot orthoses are placed into. This study investigated the effect of wearing custom foot orthoses and new athletic footwear on first-step pain, average 24-h pain and plantar fascia thickness in people with unilateral plantar fasciopathy over 12 weeks. METHODS A parallel, three-arm randomised controlled trial with blinding of participants and assessors. 60 participants diagnosed with unilateral plantar fasciopathy were randomised to either custom foot orthoses and new shoes (orthoses group), a sham insole with a new shoes (shoe group) or a sham insole placed in the participant's regular shoes (control group). Primary outcome was first-step pain. Secondary outcomes were average 24-h pain and plantar fascia thickness measured on ultrasound. Outcomes were assessed at baseline, 4 week and 12 week trial time-points. RESULTS At 4 weeks, the orthoses group reported less first-step pain (p = 0.002) compared to the control group. At 12 weeks, the orthoses group reported less first-step pain compared to both the shoe (p = < 0.001) and sham (p = 0.01) groups. Both the orthoses (p = < 0.001) and shoe (p = 0.006) groups reported less average 24-h pain compared to the control group at 4 and 12 weeks. The orthoses group demonstrated reduced plantar fascia thickness on ultrasound compared to both the shoe (p = 0.032) and control groups (p = 0.011). CONCLUSIONS Custom foot orthoses in new shoes improve first-step pain and reduce plantar fascia thickness over a period of 12 weeks compared to new shoes alone or a sham intervention. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ( ACTRN 12613000446763 ). Submitted on the 10th of April 2013 and registered on the 18th of April 2013.
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Affiliation(s)
- Chris Bishop
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, East Campus, North Terrace, SA 5000 Australia
| | - Dominic Thewlis
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, East Campus, North Terrace, SA 5000 Australia
- Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, Australia
| | - Susan Hillier
- Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
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MAHARAJ JAYISHNIN, CRESSWELL ANDREWG, LICHTWARK GLENA. The Immediate Effect of Foot Orthoses on Subtalar Joint Mechanics and Energetics. Med Sci Sports Exerc 2018; 50:1449-1456. [DOI: 10.1249/mss.0000000000001591] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Koo S, Chun S, Lee KM, Cho BC, Koo YJ, Kang DW, Park MS. Sex Differences in Pedobarographic Findings and Relationship between Radiographic and Pedobarographic Measurements in Young Healthy Adults. Clin Orthop Surg 2018; 10:216-224. [PMID: 29854346 PMCID: PMC5964271 DOI: 10.4055/cios.2018.10.2.216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 11/17/2017] [Indexed: 11/25/2022] Open
Abstract
Background Although pedobarographic measurement is increasingly used for clinical and research purposes, relatively few published studies have investigated normative data. This study examined pedobarographic findings in young healthy adults with regard to sex-related differences and correlations among measurement indices. Methods Twenty young healthy adults (mean age, 22.4 years; standard deviation, 1.2 years; and 10 males and 10 females) were included. Weight bearing anteroposterior (AP) and lateral foot radiographs were taken, and dynamic pedobarographic data during treadmill walking and maximum ankle dorsiflexion were obtained. AP talo-first metatarsal angle, naviculocuboid overlap, lateral talo-first metatarsal angle, and plantar soft tissue thickness were measured on foot radiographs. Pedobarographic data including peak pressure and pressure-time integral were measured on five plantar segments: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel. Results Male and female subjects significantly differed in body mass index (BMI, p < 0.001), AP talo-first metatarsal angle (p = 0.018), soft tissue thickness under the metatarsal head (p = 0.040) and calcaneal tuberosity (p < 0.001), maximum dorsiflexion during stance phase (p = 0.041), peak pressure on the MFF (p = 0.005) and LFF (p = 0.004), and pressure-time integral on the MFF (p = 0.018) and heel (p = 0.001). BMI was significantly correlated with soft tissue thickness under the metatarsal head (r = 0.521, p = 0.018) and calcaneal tuberosity (r = 0.585, p = 0.007), peak pressure on the MFF (r = 0.601, p = 0.005) and LFF (r = 0.487, p = 0.029), pressure-time integral on the heel (r = 0.552, p = 0.012), and total pressure-time integral (r = 0.755, p < 0.001). Maximum dorsiflexion demonstrated significant negative correlations with pressure-time integral on the MFF (r = −0.595, p = 0.007) and total pressure-time integral (r = −0.492, p = 0.032). Pressure-time integral varus/valgus index was significantly correlated with pressuretime integral forefoot/heel index (r = 0.472, p = 0.036). Conclusions Sex-related differences in pedobarographic examination were observed, which could provide useful information in setting appropriate treatment goals and obtaining appropriate control data. The effects of subtalar motion in distributing plantar pressure should be investigated in a future study.
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Affiliation(s)
- Seungbum Koo
- Department of Mechanical Engineering, Chung-Ang University, Seoul, Korea
| | - Sangho Chun
- Department of Mechanical Engineering, Chung-Ang University, Seoul, Korea
| | - Kyoung Min Lee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Chae Cho
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Jun Koo
- Department of Mechanical Engineering, Chung-Ang University, Seoul, Korea
| | - Dong-Wan Kang
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Moon Seok Park
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
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Hsieh RL, Peng HL, Lee WC. Short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children: A randomized controlled trial. Medicine (Baltimore) 2018; 97:e10655. [PMID: 29768332 PMCID: PMC5976302 DOI: 10.1097/md.0000000000010655] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Limited evidence is available regarding the effects of insoles on pediatric flexible flatfoot because of the heterogeneity and low methodological quality of previous studies. The purpose of this prospective trial is to examine the short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children by using the International Classification of Functioning, randomized controlled Disability, and Health (ICF) framework. METHODS This study was conducted in a rehabilitation outpatient clinic of a teaching hospital. Fifty-two children with symptomatic flexible flatfoot were included. The children in the treatment group wore customized arch support insoles for 12 weeks, whereas those in the control group did not wear the insoles. Both clinical and radiographic measurements, including the navicular drop, foot posture index, Beighton hypermobility score, talonavicular coverage angle, calcaneal inclination angle, and calcaneal-first metatarsal angle, were used for diagnosing flexible flatfoot. Physical activity (10-m normal and fast walking, stair ascent, stair descent, and chair rising), physical function, and psychometric properties (Pediatric Outcome Data Collection Instrument and Pediatric Quality of Life Inventory) were evaluated at the baseline and 12 weeks after the intervention. RESULTS Compared with the control group, the treatment group exhibited significant improvement in pain/comfort (P = .048), physical health (P = .035), stair ascent time (P = .015), upper extremity and physical function (P = .016), and transfer and basic mobility (P = .042) during the intervention period. CONCLUSION Children with flexible flatfoot who wore customized arch support insoles for 12 weeks exhibited significantly improved pain/comfort, physical health, stair ascent time, upper extremity and physical function, and transfer and basic mobility. These variables belong to the domains of body functions and structures and activity and participation in the ICF framework. However, because the groups were not comparable, additional studies with larger sample sizes should be conducted.
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Affiliation(s)
- Ru-Lan Hsieh
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University
| | - Hui-Ling Peng
- Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital
| | - Wen-Chung Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Comparison of plantar pressure distribution in CAD-CAM and prefabricated foot orthoses in patients with flexible flatfeet. Foot (Edinb) 2017; 33:76-80. [PMID: 29128666 DOI: 10.1016/j.foot.2017.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 06/22/2017] [Accepted: 07/06/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUNDS The effect of foot orthoses on plantar pressure distribution has been proven by researchers but there are some controversies about advantages of custom-made foot orthoses to less expensive prefabricated foot orthoses. METHODS Nineteen flatfeet adults between 18 and 45 participated in this study. CAD-CAM foot orthoses were made for these patients according to their foot scan. Prefabricated foot orthoses were prepared according to their foot size. Plantar pressure, force and contact area were measured using pedar®-x in-shoe system wearing shoe alone, wearing CAD-CAM foot orthoses and wearing prefabricated foot orthoses. Repeated measures ANOVA model with post-hoc, Bonferroni comparison were used to test differences. RESULTS CAD-CAM and prefabricated foot orthoses both decreased pressure and force under 2nd, 3-5 metatarsal and heel regions comparing to shoe alone condition. CAD-CAM foot orthosis increased pressure under lateral toe region in comparison to shoe alone and prefabricated foot orthosis. Both foot orthoses increased pressure and contact area in medial midfoot region comparing to shoe alone condition. Increased forces were seen at hallux and lateral toes by prefabricated foot orthoses in comparison with CAD-CAM foot orthoses and control condition, respectively. CONCLUSION According to the results, both foot orthoses could decrease the pressure under heel and metatarsal area. It seems that the special design of CAD-CAM foot orthoses could not make great differences in plantar pressure distribution in this sample. Further research is required to determine whether these results are associated with different scan systems or design software.
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Telfer S, Woodburn J, Collier A, Cavanagh P. Virtually optimized insoles for offloading the diabetic foot: A randomized crossover study. J Biomech 2017; 60:157-161. [DOI: 10.1016/j.jbiomech.2017.06.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 06/15/2017] [Accepted: 06/16/2017] [Indexed: 11/17/2022]
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Munteanu SE, Landorf KB, McClelland JA, Roddy E, Cicuttini FM, Shiell A, Auhl M, Allan JJ, Buldt AK, Menz HB. Shoe-stiffening inserts for first metatarsophalangeal joint osteoarthritis (the SIMPLE trial): study protocol for a randomised controlled trial. Trials 2017; 18:198. [PMID: 28449699 PMCID: PMC5408786 DOI: 10.1186/s13063-017-1936-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 04/11/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This article describes the design of a parallel-group, participant- and assessor-blinded randomised controlled trial comparing the effectiveness of shoe-stiffening inserts versus sham shoe insert(s) for reducing pain associated with first metatarsophalangeal joint (MTPJ) osteoarthritis (OA). METHODS Ninety participants with first MTPJ OA will be randomised to receive full-length shoe-stiffening insert(s) (Carbon Fibre Spring Plate, Paris Orthotics, Vancouver, BC, Canada) plus rehabilitation therapy or sham shoe insert(s) plus rehabilitation therapy. Outcome measures will be obtained at baseline, 4, 12, 24 and 52 weeks; the primary endpoint for assessing effectiveness being 12 weeks. The primary outcome measure will be the foot pain domain of the Foot Health Status Questionnaire (FHSQ). Secondary outcome measures will include the function domain of the FHSQ, severity of first MTPJ pain (using a 100-mm Visual Analogue Scale), global change in symptoms (using a 15-point Likert scale), health status (using the Short-Form-12® Version 2.0 and EuroQol (EQ-5D-5L™) questionnaires), use of rescue medication and co-interventions, self-reported adverse events and physical activity levels (using the Incidental and Planned Activity Questionnaire). Data will be analysed using the intention-to-treat principle. Economic analysis (cost-effectiveness and cost-utility) will also be performed. In addition, the kinematic effects of the interventions will be examined at 1 week using a three-dimensional motion analysis system and multisegment foot model. DISCUSSION This study will determine whether shoe-stiffening inserts are a cost-effective intervention for relieving pain associated with first MTPJ OA. The biomechanical analysis will provide useful insights into the mechanism of action of the shoe-stiffening inserts. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry, identifier: ACTRN12616000552482 . Registered on 28 April 2016.
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Affiliation(s)
- Shannon E. Munteanu
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
| | - Karl B. Landorf
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
- Allied Health Department, Melbourne Health, 300 Grattan Street, Parkville, VIC 3050 Australia
| | - Jodie A. McClelland
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
| | - Edward Roddy
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, ST5 5BG UK
| | - Flavia M. Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004 Australia
| | - Alan Shiell
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
| | - Maria Auhl
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
| | - Jamie J. Allan
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
| | - Andrew K. Buldt
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
| | - Hylton B. Menz
- Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086 Australia
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Gerrard JM, Bonanno DR. Increasing preferred step rate during running reduces plantar pressures. Scand J Med Sci Sports 2017; 28:144-151. [PMID: 28345173 DOI: 10.1111/sms.12886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 12/01/2022]
Affiliation(s)
- James M. Gerrard
- Discipline of Podiatry; School of Allied Health; La Trobe University; Melbourne Vic. Australia
| | - Daniel R. Bonanno
- Discipline of Podiatry; School of Allied Health; La Trobe University; Melbourne Vic. Australia
- La Trobe Sport and Exercise Medicine Research Centre; School of Allied Health; La Trobe University; Melbourne Vic. Australia
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38
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Collins NJ, Hinman RS, Menz HB, Crossley KM. Immediate effects of foot orthoses on pain during functional tasks in people with patellofemoral osteoarthritis: A cross-over, proof-of-concept study. Knee 2017; 24:76-81. [PMID: 27825592 DOI: 10.1016/j.knee.2016.09.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/13/2016] [Accepted: 09/16/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND The 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. METHODS Eighteen 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). RESULTS Compared 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). CONCLUSIONS In 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.
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Affiliation(s)
- Natalie J Collins
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Department of Mechanical Engineering, Melbourne School of Engineering, The University of Melbourne, Melbourne, Australia.
| | - Rana S Hinman
- Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Hylton B Menz
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Kay M Crossley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
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39
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Bonanno DR, Landorf KB, Munteanu SE, Murley GS, Menz HB. Effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury: a systematic review and meta-analysis. Br J Sports Med 2016; 51:86-96. [PMID: 27919918 DOI: 10.1136/bjsports-2016-096671] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the evidence relating to the effectiveness of foot orthoses and shock-absorbing insoles for the prevention of musculoskeletal injury. DESIGN Systematic review and meta-analysis. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Clinical trials evaluating the effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury. DATA SOURCES Cochrane Library, CINAHL, EMBASE, MEDLINE and SPORTDiscus from their inception up to the first week of June 2016. RESULTS 11 trials that had evaluated foot orthoses and 7 trials that had evaluated shock-absorbing insoles were included. The median Physiotherapy Evidence Database (PEDro) score for trials that had evaluated foot orthoses and shock-absorbing insoles was 5 (range 3-8/10) and 3 (range 1-7/10), respectively. Meta-analysis found that foot orthoses were effective for preventing overall injuries (risk ratio (RR) 0.72, 95% CI 0.55 to 0.94) and stress fractures (RR 0.59, 95% CI 0.45 to 0.76), but not soft-tissue injuries (RR 0.79, 95% CI 0.55 to 1.14). In contrast, shock-absorbing insoles were not effective for preventing overall injuries (RR 0.92, 95% CI 0.73 to 1.16), stress fractures (RR 1.15, 95% CI 0.57 to 2.32) or soft-tissue injuries (RR 0.92, 95% CI 0.74 to 1.15). CONCLUSIONS Foot orthoses were found to be effective for preventing overall injuries and stress fractures but not soft-tissue injuries, while shock-absorbing insoles were not found to be effective for preventing any injury. However, further well-designed trials will assist the accuracy and precision of the estimates of risk reduction as the quality of the included trials varied greatly.
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Affiliation(s)
- Daniel R Bonanno
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,Department of Allied Health, Melbourne Health, Parkville, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - George S Murley
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
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40
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Griffiths IB, Spooner SK. Foot orthoses research: identifying limitations to improve translation to clinical knowledge and practice. Br J Sports Med 2016; 52:350. [PMID: 27789429 DOI: 10.1136/bjsports-2016-096269] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2016] [Indexed: 11/04/2022]
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41
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Chapman GJ, Halstead J, Redmond AC. Comparability of off the shelf foot orthoses in the redistribution of forces in midfoot osteoarthritis patients. Gait Posture 2016; 49:235-240. [PMID: 27459418 PMCID: PMC5038933 DOI: 10.1016/j.gaitpost.2016.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/08/2016] [Accepted: 07/13/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Midfoot osteoarthritis (OA) is more prevalent and strongly associated with pain than previously thought. Excessive mechanical loading of the midfoot structures may contribute to midfoot OA and studies suggest that functional foot orthoses (FFO) may relieve pain through improving function. This exploratory study aimed to evaluate the mechanical effect of two off-the-shelf FFOs, compared to a sham orthosis in people with midfoot OA. METHODS Thirty-three participants with radiographically confirmed symptomatic midfoot OA were randomly assigned to wear either a commercially available FFO or a sham orthosis. After wearing their assigned orthoses for 12 weeks, plantar pressure measurements were obtained under shoe-only and assigned orthoses conditions. Participants assigned to the sham, were additionally tested wearing a second type of FFO at the end of trial. Descriptive mean change (±95% confidence intervals) in plantar pressure for each orthoses condition, versus a shoe only baseline condition are presented. FINDINGS Compared to the shoe only conditions, both FFOs decreased hindfoot and forefoot maximum force and peak pressure, whilst increasing maximum force and contact area under the midfoot. The sham orthosis yielded plantar pressures similar to the shoe-only condition. INTERPRETATION Findings suggest that both types of off-the-shelf FFO may provide mechanical benefit, whilst the sham orthoses produced similar findings to the shoe only condition, indicating appropriate sham properties. This paper provides insight into the mechanisms of action underpinning the use of FFOs and sham orthoses, which can inform future definitive RCTs examining the effect of orthoses on midfoot OA.
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Affiliation(s)
- Graham J. Chapman
- Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, Leeds, UK,NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK,Arthritis Research UK, Experimental Osteoarthritis Treatment Centre, UK,Corresponding author at: Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Road, Leeds, LS7 4SA, UK.
| | - Jill Halstead
- Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, Leeds, UK,Arthritis Research UK, Experimental Osteoarthritis Treatment Centre, UK
| | - Anthony C. Redmond
- Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, Leeds, UK,NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK,Arthritis Research UK, Experimental Osteoarthritis Treatment Centre, UK,Arthritis Research UK, Sports, Exercise and Osteoarthritis Centre, UK
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42
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The Effect of Different Foot Orthosis Inverted Angles on Plantar Pressure in Children with Flexible Flatfeet. PLoS One 2016; 11:e0159831. [PMID: 27458719 PMCID: PMC4961415 DOI: 10.1371/journal.pone.0159831] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 07/08/2016] [Indexed: 11/30/2022] Open
Abstract
Although orthotic modification using the inverted technique is available for the treatment of flatfoot, empirical evidence for the biomechanical effects of inverted-angle foot orthoses (FOs) is lacking. The aim of this study was to evaluate the effects of different FO inversion angles on plantar pressure during gait in children with flatfoot. Twenty-one children with flexible flatfeet (mean age 9.9 years) were enrolled in this study. The plantar pressures were measured for the rearfoot; medial and lateral midfoot; and medial, central, and lateral forefoot as participants walked on a treadmill while wearing shoes only and shoes with the following 3 orthotic conditions: (i) orthosis with no inverted angle, (ii) orthosis with a 15° inverted angle, and (iii) orthosis with a 30° inverted angle. A one-way repeated measures analysis of variance (ANOVA) with the Bonferroni-adjusted post-hoc test was used to compare the mean values of each orthotic condition. Compared with the shoe only condition, the peak pressure decreased significantly under the medial forefoot and rearfoot with all FOs (p <0.05). However, no significant differences in the peak pressure under the medial forefoot and rearfoot were observed between the FOs. The peak pressure under the medial midfoot increased significantly with all FOs, and a maximal increase in the peak pressure was obtained with a 30° inverted angle orthosis. Furthermore, the contact area under the medial midfoot and rearfoot increased significantly with all FOs, compared with the shoe only condition (p <0.05). Again, no significant differences were observed between the FOs. For plantar pressure redistribution, a FO with a low inverted angle could be effective, accommodative, and convenient for children with flatfoot.
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43
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Lewinson RT, Stefanyshyn DJ. Wedged Insoles and Gait in Patients with Knee Osteoarthritis: A Biomechanical Review. Ann Biomed Eng 2016; 44:3173-3185. [PMID: 27436294 DOI: 10.1007/s10439-016-1696-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 07/08/2016] [Indexed: 01/04/2023]
Abstract
The study of gait biomechanics in individuals with knee osteoarthritis has become widespread, especially in regards to the knee adduction moment-a variable commonly believed to be associated with knee osteoarthritis progression. Unfortunately, this variable is often studied clinically without considering how it is derived, or what it means in a mechanical context. The use of footwear for knee osteoarthritis management has received much attention as well. However, in many cases, footwear is studied without regard for the mechanical effects they actually induce on the patient. Therefore, this review aims to summarize the current state of knowledge in regards to knee osteoarthritis gait and footwear biomechanics, by taking a step back to review the foundations of these two research areas. First, an overview of the calculation of the knee adduction moment is provided, along with mechanical considerations. Then, this is used to discuss current evidence for wedged insoles and highlight knowledge gaps. The intent was to place this mechanical information in a clinically-oriented framework for approachability by scientists, engineers and clinicians alike. Based on this discussion, areas for future investigation are proposed.
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Affiliation(s)
- Ryan T Lewinson
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada. .,Schulich School of Engineering, University of Calgary, Calgary, AB, Canada. .,Cumming School of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, AB, T2N 4N1, Canada.
| | - Darren J Stefanyshyn
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
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44
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Lewinson RT, Worobets JT, Stefanyshyn DJ. Control conditions for footwear insole and orthotic research. Gait Posture 2016; 48:99-105. [PMID: 27477717 DOI: 10.1016/j.gaitpost.2016.04.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 04/09/2016] [Accepted: 04/11/2016] [Indexed: 02/02/2023]
Abstract
Footwear insoles/orthotics alter variables associated with musculoskeletal injury; however, their clinical effectiveness is inconclusive. One explanation for this is the possibility that control conditions may actually produce biomechanical changes that induce clinical responses. The purpose of this study was to compare insole/orthotic control conditions to identify if variables at the ground, ankle and knee that are associated with injury are altered relative to what participants would normally experience in their own shoes. Gait analysis was performed on 15 participants during walking and running while wearing (1) their own shoes, (2) #1 with a 3mm flat insole, (3) a standardized shoe, and (4) #3 with a 3mm flat insole, where external knee adduction moments, external knee adduction angular impulses, internal ankle inversion moments, and vertical ground reaction force loading rates were determined. Conditions 2-4 were expressed as percent changes relative to condition 1, and tests of proportions assessed if there were a significant number of individuals experiencing a biomechanically relevant change for each variable. Repeated-measures ANOVAs were used to identify group differences between conditions. The majority of movement-footwear-variable combinations contained a proportion of individuals experiencing biomechanically relevant changes compared to condition 1 that was significantly greater than the expected proportion of 20%. No systematic differences were found between conditions. This suggests that conditions 2-4 may alter biomechanics relative to baseline for many participants, but not in a consistent way across participants. It is recommended that participant's own footwear be used as control conditions in future trials where biomechanics are primary variables of interest.
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Affiliation(s)
- Ryan T Lewinson
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada; Schulich School of Engineering, University of Calgary, Calgary, AB, Canada; Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Jay T Worobets
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada; Nike Sport Research Laboratory, Nike Inc., Beaverton, OR, United States
| | - Darren J Stefanyshyn
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada; Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
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45
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Menz HB, Auhl M, Tan JM, Levinger P, Roddy E, Munteanu SE. Effectiveness of Foot Orthoses Versus Rocker-Sole Footwear for First Metatarsophalangeal Joint Osteoarthritis: Randomized Trial. Arthritis Care Res (Hoboken) 2016; 68:581-9. [PMID: 26638878 PMCID: PMC5074253 DOI: 10.1002/acr.22750] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/17/2015] [Accepted: 09/22/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the effectiveness of prefabricated foot orthoses to rocker-sole footwear in reducing foot pain in people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). METHODS Participants (n = 102) with first MTP joint OA were randomly allocated to receive individualized, prefabricated foot orthoses or rocker-sole footwear. The primary outcome measure was the pain subscale on the Foot Health Status Questionnaire (FHSQ) at 12 weeks. Secondary outcome measures included the function, footwear, and general foot health subscales of the FHSQ; the Foot Function Index; severity of pain and stiffness at the first MTP joint; perception of global improvement; general health status; use of rescue medication and co-interventions to relieve pain; physical activity; and the frequency of self-reported adverse events. RESULTS The FHSQ pain subscale scores improved in both groups, but no statistically significant difference between the groups was observed (adjusted mean difference 2.05 points, 95% confidence interval [95% CI] -3.61, 7.71; P = 0.477). However, the footwear group exhibited lower adherence (mean ± SD total hours worn 287 ± 193 versus 448 ± 234; P < 0.001), were less likely to report global improvement in symptoms (39% versus 62%; relative risk [RR] 0.63, 95% CI 0.41, 0.99; P = 0.043), and were more likely to experience adverse events (39% versus 16%; RR 2.47, 95% CI 1.12, 5.44; P = 0.024) compared to the orthoses group. CONCLUSION Prefabricated foot orthoses and rocker-sole footwear are similarly effective at reducing foot pain in people with first MTP joint OA. However, prefabricated foot orthoses may be the intervention of choice due to greater adherence and fewer associated adverse events.
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Affiliation(s)
| | - Maria Auhl
- La Trobe University, BundooraVictoriaAustralia
| | - Jade M. Tan
- La Trobe University, BundooraVictoriaAustralia
| | - Pazit Levinger
- La Trobe University, Bundoora, Victoria, Australia, and Victoria UniversityMelbourneVictoriaAustralia
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46
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Halstead J, Keenan AM, Chapman GJ, Redmond AC. The feasibility of a modified shoe for multi-segment foot motion analysis: a preliminary study. J Foot Ankle Res 2016; 9:7. [PMID: 26913080 PMCID: PMC4765151 DOI: 10.1186/s13047-016-0138-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/16/2016] [Indexed: 11/12/2022] Open
Abstract
Background The majority of multi-segment kinematic foot studies have been limited to barefoot conditions, because shod conditions have the potential for confounding surface-mounted markers. The aim of this study was to investigate whether a shoe modified with a webbed upper can accommodate multi-segment foot marker sets without compromising kinematic measurements under barefoot and shod conditions. Methods Thirty participants (15 controls and 15 participants with midfoot pain) underwent gait analysis in two conditions; barefoot and wearing a shoe (shod) in a random order. The shod condition employed a modified shoe (rubber plimsoll) with a webbed upper, allowing skin mounted reflective markers to be visualised through slits in the webbed material. Three dimensional foot kinematics were captured using the Oxford multi-segment foot model whilst participants walked at a self-selected speed. Results The foot pain group showed greater hindfoot eversion and less hindfoot dorsiflexion than controls in the barefoot condition and these differences were maintained when measured in the shod condition. Differences between the foot pain and control participants were also observed for walking speed in the barefoot and in the shod conditions. No significant differences between foot pain and control groups were demonstrated at the forefoot in either condition. Conclusions Subtle differences between pain and control groups, which were found during barefoot walking are retained when wearing the modified shoe. The novel properties of the modified shoe offers a potential solution for the use of passive infrared based motion analysis for shod applications, for instance to investigate the kinematic effect of foot orthoses.
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Affiliation(s)
- J Halstead
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA UK
| | - A M Keenan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA UK ; NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK ; Arthritis Research UK Experimental Arthritis Centre, Leeds, UK
| | - G J Chapman
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA UK ; NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK ; Arthritis Research UK Experimental Arthritis Centre, Leeds, UK
| | - A C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA UK ; NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK ; Arthritis Research UK Experimental Arthritis Centre, Leeds, UK ; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham, UK ; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Oxford, UK ; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Loughborough, UK ; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Leeds, UK
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47
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Bonanno DR, Murley GS, Munteanu SE, Landorf KB, Menz HB. Foot orthoses for the prevention of lower limb overuse injuries in naval recruits: study protocol for a randomised controlled trial. J Foot Ankle Res 2015; 8:51. [PMID: 26366203 PMCID: PMC4567833 DOI: 10.1186/s13047-015-0109-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/03/2015] [Indexed: 02/18/2023] Open
Abstract
Background Foot orthoses are frequently used for the prevention of lower limb overuse injuries but evidence for their effectiveness is limited. The primary aim of this study is to determine if prefabricated foot orthoses reduce the incidence of lower limb overuse injuries in naval recruits undertaking 11 weeks of basic training. Methods This study is a participant and assessor blinded, parallel-group, randomised controlled trial. The trial will recruit participants undertaking 11 weeks of basic training at the Royal Australian Navy Recruit School, Cerberus, Victoria, Australia. Participants will be randomised to a control group (flat insole) or an intervention group (prefabricated foot orthosis). Over the 11 weeks of basic training, participants will document the presence and location of pain in weekly self-report diaries. The end-point for each participant will be the completion of 11 weeks of basic training. The primary outcome measure will be the combined incidence of four lower limb injuries (medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy, and plantar fasciitis/plantar heel pain) which are common among defence members. Secondary outcome measures include: (i) overall incidence of lower limb pain, (ii) severity of lower limb pain, (iii) time to injury, (iv) time to drop-out due to injury, (v) adverse events, (vi) number of lost training days, (vii) shoe comfort, and (viii) general health status. Data will be analysed using the intention-to-treat principle. Discussion This randomised controlled trial will evaluate the effectiveness of prefabricated foot orthoses for the prevention of common lower limb overuse injuries in naval recruits. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12615000024549.
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Affiliation(s)
- Daniel R Bonanno
- Discipline of Podiatry, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia ; Lower Extremity and Gait Studies Program, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia
| | - George S Murley
- Discipline of Podiatry, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia ; Lower Extremity and Gait Studies Program, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia ; Lower Extremity and Gait Studies Program, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia
| | - Karl B Landorf
- Discipline of Podiatry, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia ; Lower Extremity and Gait Studies Program, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia
| | - Hylton B Menz
- Discipline of Podiatry, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia ; Lower Extremity and Gait Studies Program, College of Science, Health and Engineering, La Trobe University, Victoria, 3086 Australia
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48
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Chang JS, Lee HY, Kim MK. Effects of the ankle angle of an ankle foot orthosis on foot pressure during the gait in healthy adults. J Phys Ther Sci 2015; 27:1033-5. [PMID: 25995549 PMCID: PMC4433970 DOI: 10.1589/jpts.27.1033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 11/28/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of the ankle angle of
an ankle foot orthosis (AFO) on foot pressure during the gait in healthy adults.
[Subjects] Sixteen healthy males with neither orthopedic nor neurological problems
participated in this study. [Methods] Subjects walked on a walkway at a self-selected pace
with an AFO set at four different ankle angles (−5°, 0°, 5°, and 10°). Foot pressure was
measured randomly according to the ankle angle of the AFO using an F-scan system. Three
trials were measured and averaged for data analysis. [Results] The peak foot pressure of
the hallux, 2nd–5th toes, 2nd and 3rd metatarsal heads, 4th and 5th metatarsal heads, and
the heel showed significant differences among the AFO ankle angles: angles of 0° and −5°
increased the foot pressure of the lateral legions, and the peak foot pressure of the heel
at an AFO ankle angle of 10° was significantly greater than those of the other angles.
[Conclusion] The ankle angle of the AFO affected foot pressure and gait patterns during
gait. The results suggest that the appropriate angle for an AFO is between 5° and 10° when
AFOs are prescribed by clinicians.
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Affiliation(s)
- Jong-Sung Chang
- Department of Physical Therapy, Yeungnam University College, Republic of Korea
| | - Hae-Yong Lee
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Myoung-Kwon Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University: 201 Daegudae-ro, Gyeongsan-si, Gyeongsangbuk-do, Republic of Korea
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49
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Halstead J, Chapman GJ, Gray JC, Grainger AJ, Brown S, Wilkins RA, Roddy E, Helliwell PS, Keenan AM, Redmond AC. Foot orthoses in the treatment of symptomatic midfoot osteoarthritis using clinical and biomechanical outcomes: a randomised feasibility study. Clin Rheumatol 2015; 35:987-96. [PMID: 25917211 PMCID: PMC4819552 DOI: 10.1007/s10067-015-2946-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 04/12/2015] [Accepted: 04/16/2015] [Indexed: 12/31/2022]
Abstract
This randomised feasibility study aimed to examine the clinical and biomechanical effects of functional foot orthoses (FFOs) in the treatment of midfoot osteoarthritis (OA) and the feasibility of conducting a full randomised controlled trial. Participants with painful, radiographically confirmed midfoot OA were recruited and randomised to receive either FFOs or a sham control orthosis. Feasibility measures included recruitment and attrition rates, practicality of blinding and adherence rates. Clinical outcome measures were: change from baseline to 12 weeks for severity of pain (numerical rating scale), foot function (Manchester Foot Pain and Disability Index) and patient global impression of change scale. To investigate the biomechanical effect of foot orthoses, in-shoe foot kinematics and plantar pressures were evaluated at 12 weeks. Of the 119 participants screened, 37 were randomised and 33 completed the study (FFO = 18, sham = 15). Compliance with foot orthoses and blinding of the intervention was achieved in three quarters of the group. Both groups reported improvements in pain, function and global impression of change; the FFO group reporting greater improvements compared to the sham group. The biomechanical outcomes indicated the FFO group inverted the hindfoot and increased midfoot maximum plantar force compared to the sham group. The present findings suggest FFOs worn over 12 weeks may provide detectable clinical and biomechanical benefits compared to sham orthoses. This feasibility study provides useful clinical, biomechanical and statistical information for the design and implementation of a definitive randomised controlled trial to evaluate the effectiveness of FFOs in treating painful midfoot OA.
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Affiliation(s)
- Jill Halstead
- Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA, UK.
| | - Graham J Chapman
- Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA, UK.,Leeds NIHR Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK.,Arthritis Research UK Experimental Arthritis Centre, Leeds, UK
| | - Janine C Gray
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Andrew J Grainger
- Leeds NIHR Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK.,Department of Musculoskeletal Radiology, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Sarah Brown
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Richard A Wilkins
- Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA, UK
| | - Edward Roddy
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Philip S Helliwell
- Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA, UK
| | - Anne-Maree Keenan
- Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA, UK.,Leeds NIHR Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Anthony C Redmond
- Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds, LS7 4SA, UK.,Leeds NIHR Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK.,Arthritis Research UK Experimental Arthritis Centre, Leeds, UK.,Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham, Oxford, Loughborough, Leeds, UK
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50
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Lewinson RT, Stefanyshyn DJ. Losing control over control conditions in knee osteoarthritis orthotic research. Contemp Clin Trials 2015; 42:258-9. [PMID: 25841564 DOI: 10.1016/j.cct.2015.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Ryan T Lewinson
- Biomedical Engineering, Schulich School of Engineering, University of Calgary, Canada.
| | - Darren J Stefanyshyn
- Biomedical Engineering, Schulich School of Engineering, University of Calgary, Canada
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