1
|
Shu W, Jiang G, Yang Z, Rong Z, Li X, Yu B, Tang X. Four-Year Treatment Effect of Custom-Made Foot Orthosis on Pediatric Symptomatic Accessory Navicular Bone Combined with Flexible Flatfoot. Indian J Orthop 2024; 58:1159-1165. [PMID: 39087034 PMCID: PMC11286606 DOI: 10.1007/s43465-024-01210-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 06/18/2024] [Indexed: 08/02/2024]
Abstract
Purpose Congenital accessory navicular bone (ANB) is a common variant in the foot and is prone to cause several clinical symptoms. Wearing custom-made foot orthosis is considered a desirable option; however, there is limited evidence of its effectiveness. This study aims to report the mid-term effect of foot orthosis for symptomatic pediatric ANBs. Methods School-age children with symptomatic ANBs combined with flexible flatfoot in the authors' institute were recruited and got custom-made foot orthosis treatment. They were followed up over 4 years. The general characteristics of these children were collected before treatment, including age, gender, and body mass index (BMI). The indicators of foot symptoms, including frequency and location of pain, visual analogue scale (VAS), arch index (AI), and hind foot valgus angle (HVA), were measured during pretreatment and at the last follow-up. Results Twenty-seven children were recruited for this study. After 4 years of custom-made foot orthosis treatment, significant improvements showed in pain frequency, VAS, AI, and HVA (P < 0.001). Type II ANBs showed a higher pain index pretreatment (P < 0.001) and reduced after treatment (P < 0.001). Conclusion Mid-term effect of custom-made foot orthosis is inspiring in clinical symptoms of pediatric congenital ANBs combined with flexible flatfoot and may be an optional nonoperative treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s43465-024-01210-7.
Collapse
Affiliation(s)
- Wen Shu
- Department of Orthopaedic, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Guoyong Jiang
- Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Zimo Yang
- Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Zhao Rong
- Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Xiangrui Li
- Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Bin Yu
- Department of Orthopaedic, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xin Tang
- Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| |
Collapse
|
2
|
Herchenröder M, Goetz K, Stamer T, Klee M, Steinhäuser J. Physicians' experiences with indications and prescriptions of foot orthoses-A cross-sectional study in northern Germany. Heliyon 2024; 10:e33584. [PMID: 39035521 PMCID: PMC11259866 DOI: 10.1016/j.heliyon.2024.e33584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 06/24/2024] [Accepted: 06/24/2024] [Indexed: 07/23/2024] Open
Abstract
Background Foot orthoses (FOs) are prescribed by general practitioners (GPs) and orthopedic surgeons for various complaints. As there are very limited medical guidelines and checklists, the prescription of FOs is often inconsistent. Therefore, our study to evaluate the general prescription behavior and indication experiences with FOs from the perspective of GPs and orthopedists. Methods A survey was carried out using a questionnaire from October to December 2021. GPs and orthopedic surgeons in northern Germany were included. The focus of the survey was to examine which foot problems would lead GPs and orthopedic surgeons to prescribe FOs and to evaluate what factors these physicians included in their diagnostic analysis. Apart from descriptive analyses, a stepwise linear regression analysis was performed to explore potential associations of the primary outcome variable 'specific effect on the prescription of FOs', which was introduced to shed light upon the estimated added value of the prescription of FOs. Results Out of the 790 questionnaires distributed, 184 questionnaires were returned by GPs (n = 95) and orthopedic surgeons (n = 74) (response rate 23 %). FOs were most frequently prescribed for talipes valgus (96 %) and heel spur (54 %). Diagnostic analysis was mainly carried out clinically. Custom-made FOs (82 %) were prescribed more frequently than prefabricated FOs (6 %). Regular interaction within the prescription process was most commonly with orthopedic technicians (61 %). The estimation of the specific effect on FO prescription was assessed by a mean of 66 % of the participants, 82 % recommended self-exercises as an additional therapy. Conclusions FOs are a specific and well-established aid prescribed by many GPs and orthopedic surgeons for a variety of foot complaints. Despite being one of the most frequently prescribed orthopedic devices, the utilization of FOs is predominantly explorative due to a growing but nevertheless still deficient body of well-researched evidence. There is a clear need for a uniform approach to the indication and prescription of FOs among physicians.
Collapse
Affiliation(s)
| | | | - Tjorven Stamer
- Institute of Family Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Malte Klee
- Institute of Family Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Jost Steinhäuser
- Institute of Family Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| |
Collapse
|
3
|
Xie Y, Zheng X, Li Y, He J, Wang P, Han X. The effect of somatic pain and comorbid mental distress on oral health-related quality of life in orthodontic patients. Clin Oral Investig 2024; 28:296. [PMID: 38700536 DOI: 10.1007/s00784-024-05666-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 04/16/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVES The purpose of the present study was to evaluate the prevalence of somatic pain in orthodontic patients and determine whether somatic pain contributes to worsening oral health-related quality of life (OHRQoL) through the mediating effect of psychological discomfort. MATERIALS AND METHODS Scale measurements and analyses were conducted on a cohort of 769 orthodontic outpatients, encompassing Patient Health Questionnaire-15-pain (PHQ-15-P), Hua-Xi Emotional-Distress Index (HEI), Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and Oral Health Impact Profile-14 (OHIP-14). RESULTS Among the respondents, 56.3% (N = 433) reported somatic pain and 20.0% (N = 154) had mental discomfort based on PHQ-15-P and HEI scores. Patients with somatic pain symptoms had significantly higher scores of HEI and OHIP-14 (P < 0.001), and higher PHQ-15-P and HEI scores emerged as statistically significant predictors of lower OHIP-14 scores (P < 0.001). HEI scores which assessed anxiety and depression partially mediated the correlation between PHQ-15-P and OHIP-14 scores, of which anxiety accounted for 52.9% of the overall mediation effect, dominating the indirect effect. CONCLUSION Orthodontic patients reporting somatic pains were at a significantly higher risk of worsening OHRQoL during treatment, and this adverse effect is partially mediated by anxiety and depression. CLINICAL RELEVANCE Our findings highlight the necessity for the assessment of general health and mental well-being during orthodontic interventions. To prevent delays in treating general disorders and the potential failure of orthodontic treatments, we encourage increased attentiveness towards patients with somatic symptoms and consideration of the adverse effects of comorbid mental distress.
Collapse
Affiliation(s)
- Yaxin Xie
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xinrui Zheng
- Stomatology School of Nanchang University, Nanchang, China
| | - Yuanhong Li
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jiayue He
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Peiqi Wang
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Xianglong Han
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
4
|
Dami A, Payen E, Farahpour N, Robb K, Isabelle PL, Moisan G. Medially wedged foot orthoses generate greater biomechanical effects than thin-flexible foot orthoses during a unilateral drop jump task on level and inclined surfaces. Clin Biomech (Bristol, Avon) 2024; 112:106193. [PMID: 38330734 DOI: 10.1016/j.clinbiomech.2024.106193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/08/2023] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Foot orthoses are therapeutic insoles designed to induce various effects on lower limb biomechanics. However, conflicting findings in previous research, highlight the need to better understand how foot orthoses with different features affect lower limb biomechanics during challenging tasks, particularly during unilateral drop jump landings. METHODS Seventeen participants with flat feet were recruited to participate in this cross-sectional descriptive study that examined the effects of thin-flexible foot orthoses and medially wedged foot orthoses on lower limb biomechanics during unilateral drop jump landings on level and valgus inclined surfaces. Midfoot, ankle, knee, and hip angles and moments were calculated and compared across conditions with repeated measures ANOVAs, using a statistical parametric mapping approach. FINDINGS Medially wedged and thin-flexible foot orthoses reduced ankle pronation and arch flattening during unilateral drop jump landings on level and valgus inclined surfaces. Medially wedged foot orthoses further decreased midfoot dorsiflexion and ankle eversion angles compared to thin-flexible foot orthoses. Medially wedged foot orthoses also generated greater effects on ankle kinetics and hip kinematics during unilateral drop jump landings. INTERPRETATION Medially wedged foot orthoses are more effective than thin-flexible foot orthoses in optimizing lower limb biomechanics during unilateral drop jump landings. While the biomechanical effects did not increase on inclined surfaces, medially wedged foot orthoses generated greater effects on proximal joints, highlighting their potential to improve hip stability and enhance overall lower limb function. Personalized foot orthoses selection based on specific biomechanical profiles should be further explored to optimize orthotic interventions benefiting individuals with musculoskeletal conditions.
Collapse
Affiliation(s)
- Ahmed Dami
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Canada.
| | - Eléna Payen
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Canada
| | - Nader Farahpour
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada; Department of Sport Biomechanics, Faculty of Sport Sciences, Bu Ali Sina University, Hamedan, Iran
| | - Kelly Robb
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Pier-Luc Isabelle
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada
| | - Gabriel Moisan
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Canada
| |
Collapse
|
5
|
Sancho-Bru JL, Sanchis-Sales E, Rodríguez-Cervantes PJ, Vergés-Salas C. Foot Sole Contact Forces vs. Ground Contact Forces to Obtain Foot Joint Moments for In-Shoe Gait-A Preliminary Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:6744. [PMID: 37571530 PMCID: PMC10422389 DOI: 10.3390/s23156744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
In-shoe models are required to extend the clinical application of current multisegment kinetic models of the bare foot to study the effect of foot orthoses. Work to date has only addressed marker placement for reliable kinematic analyses. The purpose of this study is to address the difficulties of recording contact forces with available sensors. Ten participants walked 5 times wearing two different types of footwear by stepping on a pressure platform (ground contact forces) while wearing in-shoe pressure sensors (foot sole contact forces). Pressure data were segmented by considering contact cells' anteroposterior location, and were used to compute 3D moments at foot joints. The mean values and 95% confidence intervals were plotted for each device per shoe condition. The peak values and times of forces and moments were computed per participant and trial under each condition, and were compared using mixed-effect tests. Test-retest reliability was analyzed by means of intraclass correlation coefficients. The curve profiles from both devices were similar, with higher joint moments for the instrumented insoles at the metatarsophalangeal joint (~26%), which were lower at the ankle (~8%) and midtarsal (~15%) joints, although the differences were nonsignificant. Not considering frictional forces resulted in ~20% lower peaks at the ankle moments compared to previous studies, which employed force plates. The device affected both shoe conditions in the same way, which suggests the interchangeability of measuring joint moments with one or the other device. This hypothesis was reinforced by the intraclass correlation coefficients, which were higher for the peak values, although only moderate-to-good. In short, both considered alternatives have drawbacks. Only the instrumented in-soles provided direct information about foot contact forces, but it was incomplete (evidenced by the difference in ankle moments between devices). However, recording ground reaction forces offers the advantage of enabling the consideration of contact friction forces (using force plates in series, or combining a pressure platform and a force plate to estimate friction forces and torque), which are less invasive than instrumented insoles (which may affect subjects' gait).
Collapse
Affiliation(s)
- Joaquín L. Sancho-Bru
- Department of Mechanical Engineering and Construction, Universitat Jaume I, 12071 Castellón de la Plana, Spain;
| | - Enrique Sanchis-Sales
- Departmental Section of Podiatry, Nursing Department, Universitat de València, 46010 Valencia, Spain;
| | | | - Carles Vergés-Salas
- Departmental Section of Podiatry, Department of Clinical Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain;
| |
Collapse
|
6
|
Pelaez AST, Farahpour N, Griffiths IB, Moisan G. Thick shells and medially wedged posts increase foot orthoses medial longitudinal arch stiffness: an experimental study. J Foot Ankle Res 2023; 16:11. [PMID: 36869383 PMCID: PMC9983200 DOI: 10.1186/s13047-023-00609-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Foot orthoses (FOs) are commonly prescribed devices to attenuate biomechanical deficits and improve physical function in patients with musculoskeletal disorders. It is postulated that FOs provide their effects through the production of reaction forces at the foot-FOs interface. An important parameter to provide these reaction forces is their medial arch stiffness. Preliminary results suggest that adding extrinsic additions to FOs (e.g., rearfoot posts) increases their medial arch stiffness. A better understanding of how FOs medial arch stiffness can be modulated by changing structural factors is necessary to better customise FOs for patients. The objectives of this study were to compare FOs stiffness and force required to lower the FOs medial arch in three thicknesses and two models (with and without medially wedged forefoot-rearfoot posts). METHODS Two models of FOs, 3D printed in Polynylon-11, were used: (1) without extrinsic additions (mFO), and (2) with forefoot-rearfoot posts and a 6o medial wedge (FO6MW). For each model, three thicknesses (2.6 mm, 3.0 mm, and 3.4 mm) were manufactured. FOs were fixed to a compression plate and vertically loaded over the medial arch at a rate of 10 mm/minute. Two-way ANOVAs and Tukey post-hoc tests with Bonferroni corrections were used to compare medial arch stiffness and force required to lower the arch across conditions. RESULTS Regardless of the differing shell thicknesses, the overall stiffness was 3.4 times greater for FO6MW compared to mFO (p < 0.001). FOs with 3.4 mm and 3.0 mm thicknesses displayed 1.3- and 1.1- times greater stiffness than FOs with a thickness of 2.6 mm. FOs with a thickness of 3.4 mm also exhibited 1.1 times greater stiffness than FOs with a thickness of 3.0 mm. Overall, the force to lower the medial arch was up to 3.3 times greater for FO6MW than mFO and thicker FOs required greater force (p < 0.001). CONCLUSIONS An increased medial longitudinal arch stiffness is seen in FOs following the addition of 6o medially inclined forefoot-rearfoot posts, and when the shell is thicker. Overall, adding forefoot-rearfoot posts to FOs is significantly more efficient than increasing shell thickness to enhance these variables should that be the therapeutic aim.
Collapse
Affiliation(s)
- Ana Sofia Tavera Pelaez
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Faculty of Engineering, Universidad de Antioquia, Medellín, Colombia
| | - Nader Farahpour
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Department of Sport Biomechanics, Faculty of Sport Sciences, Bu Ali Sina University, Hamedan, Iran
| | - Ian B Griffiths
- Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London, UK.
| | - Gabriel Moisan
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| |
Collapse
|
7
|
Oerlemans LNT, Peeters CMM, Munnik-Hagewoud R, Nijholt IM, Witlox A, Verheyen CCPM. Foot orthoses for flexible flatfeet in children and adults: a systematic review and meta-analysis of patient-reported outcomes. BMC Musculoskelet Disord 2023; 24:16. [PMID: 36611153 PMCID: PMC9825043 DOI: 10.1186/s12891-022-06044-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/30/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis examined the effectiveness of orthoses for flexible flatfeet in terms of patient-reported outcomes in children and adults. METHODS EMBASE, Medline (OvidSP), Web-of-Science, Scopus, CINAHL, Cochrane Central Register of Controlled Clinical Trials, i.e., Cochrane Central and Pubmed were searched to identify relevant studies since their inception up to February 2021. We included randomized controlled trials (RCT) and prospective studies in which patient reported outcomes at baseline and follow-up in an orthoses group were compared with a no orthoses or sham sole group. Methodological quality of the studies was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I). A meta-analysis was performed where there were multiple studies with the same outcome measures, which was the case for the Visual Analogue Scale (VAS) for pain in adults. RESULTS In total nine studies were included: four RCT in children (N = 353) and four RCT and one prospective study in adults (N = 268) were included. There was considerable heterogeneity between studies. A meta-analysis demonstrated that pain reduction between baseline and follow-up was significantly larger in the orthoses (N = 167) than in the control groups in adults (N = 157; - 4.76, 95% CI [- 9.46, - 0.06], p0.05). CONCLUSION Due to heterogeneity in study designs, we cannot conclude that foot orthoses are useful for flexible flatfoot in children and adults. However, based on the meta-analysis orthoses might be useful in decreasing pain in adults. The authors did not receive support from any organization for the submitted work.
Collapse
Affiliation(s)
- Leonoor N. T. Oerlemans
- grid.452600.50000 0001 0547 5927Department of Orthopaedics, Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Charles M. M. Peeters
- grid.452600.50000 0001 0547 5927Department of Orthopaedics, Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands ,grid.4494.d0000 0000 9558 4598Department of Orthopaedics, University Medical Center of Groningen, Groningen, The Netherlands
| | - Roelina Munnik-Hagewoud
- grid.452600.50000 0001 0547 5927Department of Orthopaedics, Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Innovation and Science, Isala Hospital, Zwolle, The Netherlands
| | - Ingrid M. Nijholt
- grid.452600.50000 0001 0547 5927Department of Innovation and Science, Isala Hospital, Zwolle, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Radiology and Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
| | - Adhiambo Witlox
- grid.412966.e0000 0004 0480 1382Department of Orthopaedics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Cees C. P. M. Verheyen
- grid.452600.50000 0001 0547 5927Department of Orthopaedics, Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands ,grid.4494.d0000 0000 9558 4598Department of Orthopaedics, University Medical Center of Groningen, Groningen, The Netherlands
| |
Collapse
|
8
|
Jeong BO, Jeong SJ, Park K, Kim BH, Yim SV, Kim S. Effects of three-dimensional image based insole for healthy volunteers: a pilot clinical trial. Transl Clin Pharmacol 2023; 31:49-58. [PMID: 37034127 PMCID: PMC10079510 DOI: 10.12793/tcp.2023.31.e5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
Insoles are used to treat various foot diseases, including plantar foot, diabetic foot ulcers, and refractory plantar fasciitis. In this study, we investigated the effects of 3-dimensional image-based (3-D) insole in healthy volunteers with no foot diseases. Additionally, the comfort of the 3-D insole was compared with that of a custom-molded insole. A single-center, randomized, open clinical trial was conducted to address the effectiveness of insole use in a healthy population with no foot or knee disease. Two types of arch support insoles were evaluated for their effectiveness: a 3-D insole and a custom-molded insole. Fifty Korean volunteers participated in the study and were randomly allocated into the "3-D insole" (n = 40) or "custom-molding insole" (n = 10) groups. All subjects wore 3-D insoles or custom-molded insoles for 2 weeks. The sense of wearing shoes (Visual Analog Scale [VAS] and score) and fatigue of the foot were used to assess the insole effects at the end of the 2-week study period. The 3-D insole groups showed significantly improved sense of wearing shoes (VAS, p = 0.0001; score, p = 0.0002) and foot fatigue (p = 0.0005) throughout the study period. Although the number of subjects was different, the custom-molding insole group showed no significant changes in the sense of wearing shoes (VAS, 0.1188; score, p = 0.1483). Foot fatigue in the 3-D insole group improved significantly (p = 0.0005), which shows that a 3-D insole might have favorable effects on foot health in a healthy population. Trial Registration Clinical Research Information Service Identifier: KCT0008100.
Collapse
Affiliation(s)
- Bi O Jeong
- Department of Orthopedic Surgery, Kyung Hee University Medical Center, Seoul 02447, Korea
| | - Su Jin Jeong
- Medical Science Research Institute, Kyung Hee University Medical Center, Seoul 02447, Korea
| | | | - Bo-Hyung Kim
- Department of Clinical Pharmacology and Therapeutics, Kyung Hee University Medical Center, Seoul 02447, Korea
- East-West Medical Research Institute, Kyung Hee University, Seoul 02447, Korea
| | - Sung-Vin Yim
- Department of Clinical Pharmacology and Therapeutics, Kyung Hee University Medical Center, Seoul 02447, Korea
| | - Sehyun Kim
- Graduate School of Dankook University, Yongin 16890, Korea
| |
Collapse
|
9
|
Carranza García LE, López-García R, Lagunes-Carrasco JO, Hernández-Cortés PL, Enríquez-Reyna MC, Navarro-Orocio R. Pie plano y tratamientos conservadores en adultos físicamente activos. Una revisión sistemática. REVISTA IBEROAMERICANA DE CIENCIAS DE LA ACTIVIDAD FÍSICA Y EL DEPORTE 2022. [DOI: 10.24310/riccafd.2022.v11i3.15205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
El término pie plano es utilizado para describir cualquier anormalidad que causa el colapso del arco longitudinal medial del pie, cuando es sintomático condiciona el grado, tipo y calidad de actividad física que practique un adulto. Como objetivo nos planteamos revisar los tratamientos conservadores existentes para el pie plano en adultos jóvenes y de mediana edad. Siguiendo las directrices de la declaración PRISMA, se realizó una revisión sistemática de la literatura científica publicada sobre el pie plano y tratamientos conservadores. Los tratamientos conservadores para el pie plano son aplicados de manera aislada o en combinación, estos incluyen ejercicios de fortalecimiento, de estiramientos, uso de ortesis, aplicación de vendaje, modificación del calzado y estimulación eléctrica. Son requeridos estudios de tratamientos conservadores en adultos de mediana edad con pie plano sintomático que evalúen el efecto a corto y largo plazo de los actuales protocolos en poblaciones con diferente nivel de condición física.
Collapse
|
10
|
Schmitt APL, Liebau KH, Hamm A, Hacke C, Mittelmeier W, Schulze C. Comparison of the influence of supportive and sensorimotor insoles in the muscle activity of tibialis anterior and peroneus longus in combat boots. Foot (Edinb) 2022; 52:101910. [PMID: 36049266 DOI: 10.1016/j.foot.2022.101910] [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: 08/26/2020] [Revised: 01/11/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Flatfoot is a very common static deformity. It occurs frequently in soldiers and causes problems in the lower extremities. There is a lack of data regarding therapy with insoles, especially with sensorimotor insoles. The objective of this study was to investigate the influence in muscle activity of supporting/correcting and sensorimotor insoles in combat boots in the muscles of the lower limb and thus to draw conclusions according to the benefits of insole therapy in military footwear. METHODS 73 patients (12 female, 61 males; average age: 30.8 ± 7.9 years) with pes planovalgus deformity were included in this prospective randomized placebo-controlled study. For intervention supporting (N = 23), sensorimotor (N = 28) and placebo insoles (N = 22) were used. During gait analysis muscle activity was measured by means of surface electromyography (EMG) of the tibialis anterior and peroneus longus muscle in combat boots with and without insoles. Statistical evaluation was performed using two-factor ANOVA with repeated measures. RESULTS EMG measures (amplitude, integral, maximum, mean) showed mainly activating effects in the peroneus longus muscle in the case of sensorimotor and activity reductions in supporting insoles. Comparing effects of different kinds of insoles to the peroneus longus muscle, significant differences could be shown. No significant differences in muscular activation were observed for the tibialis anterior muscle. CONCLUSION Even in combat boots effects of sensorimotor insoles on the peroneus longus muscle can be detected. The expected effects, attributed to the different kinds of insole, could be observed, too. While sensorimotor insoles had an activating kind of effect, supportive insoles reduced muscular activity of the peroneus longus. In contrast for the tibialis anterior muscle no clear conclusion could be drawn. Its muscular activity seems not to be influenced by insoles in combat boots. However, it remains unclear whether clinical long term effects, e.g. pain and function, can be improved.
Collapse
Affiliation(s)
- Alexander Pascal-Laurent Schmitt
- Orthopädische Klinik & Poliklinik, Universitätsmedizin Rostock, Doberaner Str. 142, 18057 Rostock, Germany; Bundeswehr Medical Center Hohe Düne, Hohe Düne 30, 18119 Rostock, Germany
| | - Kira-Henriette Liebau
- Orthopädische Klinik & Poliklinik, Universitätsmedizin Rostock, Doberaner Str. 142, 18057 Rostock, Germany
| | - Alexander Hamm
- Bundeswehr Medical Center Hohe Düne, Hohe Düne 30, 18119 Rostock, Germany
| | - Claudia Hacke
- Clinic for Pediatrics and Adolescent Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Wolfram Mittelmeier
- Orthopädische Klinik & Poliklinik, Universitätsmedizin Rostock, Doberaner Str. 142, 18057 Rostock, Germany
| | - Christoph Schulze
- Orthopädische Klinik & Poliklinik, Universitätsmedizin Rostock, Doberaner Str. 142, 18057 Rostock, Germany; Zentrum für Sportmedizin der Bundeswehr, Dr.-Rau-Allee 32, 48231 Warendorf, Germany.
| |
Collapse
|
11
|
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: 2] [Impact Index Per Article: 1.0] [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.
Collapse
Affiliation(s)
- Eileen Mairi Morrow
- Paediatric Orthopaedics Department, Oxford University Hospitals NHS Foundation Trust, NDORMS, University of Oxford, Oxford, UK
| | | | | |
Collapse
|
12
|
Abstract
Background Flatfoot is characterised by the falling of the medial longitudinal arch, eversion of the hindfoot and abduction of the loaded forefoot. Furthermore, flatfoot leads to a variety of musculoskeletal symptoms in the lower extremity, such as knee or hip pain. The standard conservative treatment for flatfoot deformity is exercise therapy or treatment with foot orthoses. Foot orthoses are prescribed for various foot complaints. However, the evidence for the provision of foot orthoses is inconsistent. The aim of this systematic review is to synthesize the evidence of foot orthoses for adults with flatfoot. Methods A computerized search was conducted in August 2021, using the databases PubMed, Scopus, Pedro, Cochrane Library, and the Cochrane Central Register of Controlled Trials. Intervention studies of any design investigating the effects of foot orthoses were included, apart from case studies. Two independent reviewers assessed all search results to identify eligible studies and to assess their methodological quality. Results A total of 110 studies were identified through the database search. 12 studies met the inclusion criteria and were included in the review. These studies investigated prefabricated and custom-made foot orthoses, evaluating stance and plantar pressure during gait. The sample sizes of the identified studies ranged from 8 to 80. In most of the studies, the methodological quality was low and a lack of information was frequently detected. Conclusion There is a lack of evidence on the effect of foot orthoses for flatfoot in adults. This review illustrates the importance of conducting randomized controlled trials and the comprehensive development of guidelines for the prescription of foot orthoses. Given the weak evidence available, the common prescription of foot orthoses is somewhat surprising. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-021-00499-z.
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Demircioğlu A, Özkal Ö, Dağ O. Multiple Factors Affecting Health-Related Quality of Life in Women With Chronic Multisite Musculoskeletal Pain: A Cross-Sectional Study in Ankara, Turkey. Eval Health Prof 2021; 45:115-125. [PMID: 34579589 DOI: 10.1177/01632787211049273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although chronic multi-site musculoskeletal pain is known to cause decreased physical function and impair work and social life, there is insufficient research about its impact on health-related quality of life (HRQoL) in women. The aim of this study was to investigate multiple factors affecting HRQoL in women with chronic multi-site musculoskeletal pain. This study included 227 women with two or more musculoskeletal areas which were painful during the last 3 months. The HRQoL and musculoskeletal system symptoms were evaluated with the Nottingham Health Profile (NHP) and the Nordic Musculoskeletal Questionnaire (NMQ), respectively. Physical activity level, social functionality and depressive symptoms were assessed with the International Physical Activity Questionnaire-Short Form (IPAQ- SF), Social Functioning Scale (SFS) and Beck Depression Inventory (BDI), respectively. Significant predictors for the total score on the NHP were found to be the number of children (p < 0.001), social engagement/withdrawal scale (p:0.094), the number of regions with musculoskeletal pain during the last year (p:0.002) and last 7 days (p:0.036), depressive symptoms (p < 0.001), current employment status (p:0.084), and the presence of chronic disease (p < 0.001). The results of this study demonstrated that both sociodemographic characteristics, and social and psychological factors may affect the HRQoL in women with chronic multi-site musculoskeletal pain.
Collapse
Affiliation(s)
- Arzu Demircioğlu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Özden Özkal
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bursa Uludağ University, Bursa, Turkey
| | - Osman Dağ
- Department of Biostatistics, Hacettepe University, Ankara, Turkey
| |
Collapse
|
15
|
Yildiz K, Medetalibeyoglu F, Kaymaz I, Ulusoy GR. Triad of foot deformities and its conservative treatment: With a 3D customized insole. Proc Inst Mech Eng H 2021; 235:780-791. [PMID: 33845665 DOI: 10.1177/09544119211006528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The coexisting of three deformities as hallux valgus, flatfoot, and the calcaneal spur is an undefined medical condition, and it may be called triad of foot deformities (TFD) as a definition for a new disease entity. A customized 3D insole prototype was created by postprocessing of MRI data, and printed by 3D printer technology for the purpose of providing effective and innovative treatment for TFD. A 42 years-old female was clinically examined for TFD findings. All radiological measurements were made on the weightbearing anteroposterior and lateral X-rays. The patient underwent the pedogram (RSscan International, footscan©). MRI images were taken for the purpose of 3D scanning that was used for producing the 3D splint for TFD. AOFAS (American Orthopedic Foot and Ankle Society scores) and FHSQ (Foot Health Status Questionnaire) were used for clinical follow-up. MRI images of the patient were imported to Mimics software in order to create a 3D model using image processing. Thus, Patient-Specific 3D customized silicone orthotic insole that was based on 3D printing technology was produced. The one-simple test was used to compare the results of AOFAS and FHSQ scores. The measurements of radiological measurements were given. On the clinical follow-up, AOFAS was FHSQ scores were obtained. There was a significant difference in terms of AOFAS and FHSQ scores (p ≤ 0.05). As a result of our study; our 3D customized insole was produced at the price of approximately 1/3 of the total cost of three standard medical products. The coexisting of these three deformities may be called triad of foot deformities (TFD). The 3D printer technology enables us to access a customized, personalized conservative treatment option for TFD. The conservative treatment of TFD is possible by a single orthotic insole.
Collapse
Affiliation(s)
- Kadri Yildiz
- Medical School Orthopaedia and Traumatology Department, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Fatih Medetalibeyoglu
- Mechanical Engineering Department, Engineering Faculty, Kafkas University, Kars, Turkey
| | - Irfan Kaymaz
- Mechanical Engineering Department, Engineering Faculty, Erzurum Technical University, Erzurum, Turkey
| | - Gokhan Ragip Ulusoy
- Medical School Orthopaedia and Traumatology Department, Faculty of Medicine, Kafkas University, Kars, Turkey
| |
Collapse
|
16
|
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.
Collapse
Affiliation(s)
- Isabel Gómez-Jurado
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | | | | |
Collapse
|
17
|
Affiliation(s)
| | - Ka Ho Ng
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong
| | - Joyce Lai
- Department of Family Medicine and Primary Care, Queen Mary Hospital, Hong Kong
| |
Collapse
|