Analyzing the effect of an arch support functional insole on walking and jogging in young, healthy females

Effects of foot orthoses on running kinetics and kinematics: A systematic review and meta-analysis

BACKGROUND

Foot orthoses (FOs) are often prescribed by clinicians to treat foot and ankle conditions, prevent running injuries, and enhance performance. However, the lack of higher-order synthesis of clinical trials makes it challenging for clinicians to adopt an evidence-based approach to FOs' prescriptions.

RESEARCH QUESTION

Do FOs with different modifications alter lower extremity running kinematics and kinetics?

METHODS

A systematic search of seven databases was conducted from inception to February 2023. The analysis was restricted to healthy adults without foot musculoskeletal impairments and studies that compared the FOs effects with the controls. The methodological quality of the 35 studies that met the eligibility criteria was evaluated using the modified Downs and Black checklist. The random effects model estimated the standardized mean difference (SMD) with 95% confidence intervals and effect sizes. Sub-group analyses based on FOs type were performed to assess the potential effects of the intervention.

RESULTS

Our findings indicated that both custom and off-the-shelf arch-support FOs reduced peak plantar pressure at the medial heel (SMD=-0.35, and SMD=-1.03), lateral heel (SMD=-0.50, and SMD=-0.53), and medial forefoot (SMD=-0.20, and SMD=-0.27), but increased plantar pressure at the mid-foot (SMD=0.30, and SMD=0.56). Compared with the controls, significant increases (SMD=0.36) in perceived comfort were found with custom FOs. A reduction (SMD=-0.58) in initial ankle inversion was found when a raised heel cup was integrated with arch-support FOs. A medial post integrated with arch support exhibited a reduced ankle (SMD=-1.66) and tibial (SMD=-0.63) range of motion. Custom FOs, however, unfavorably affected the running economy (SMD=-0.25) and perceived exertion (SMD=0.20).

SIGNIFICANCE

Although FOs have been reported to have some positive biomechanical effects in healthy populations without musculoskeletal impairments or running-related issues, they need to be optimized and generalized to achieve better running performance and prevent injury.

4D-foot analysis on effect of arch support on ankle, subtalar, and talonavicular joint kinematics

BACKGROUND

It has been difficult to study the effects of arch support on multiple joints simultaneously. Herein, we evaluated foot and ankle kinematics using a fully automated analysis system, "4D-Foot," consisting of a biplane X-ray imager and two-dimensional‒three-dimensional registration, with automated image segmentation and landmark detection tools.

METHODS

We evaluated the effect of arch support on ankle, subtalar, and talonavicular joint kinematics in five healthy female volunteers without a clinical history of foot and ankle disorders. Computed tomography images of the foot and ankle and X-ray videos of walking barefoot and with arch support were acquired. A kinematic analysis using the "4D-Foot" system was performed. The ankle, subtalar, and talonavicular joint kinematics were quantified from heel-strike to foot-off, with and without arch support.

RESULTS

For the ankle joint, significant differences were observed in dorsi/plantarflexion, inversion/eversion, and internal/external rotation in the late midstance phase. The dorsi/plantarflexion and inversion/eversion motions were smaller with arch support. For the subtalar joint, a significant difference was observed in all the dynamic motions in the heel-strike and late midstance phases. For the talonavicular joint, significant differences were observed in inversion/eversion and internal/external rotation in heel-strike and the late midstance phases. For the subtalar and talonavicular joints, the motion was larger with arch support. An extremely strong correlation was observed when the motion of the subtalar and talonavicular joints was compared for each condition and motion.

CONCLUSIONS

The results indicated that the arch support decreased the ankle motion and increased the subtalar and talonavicular joint motions. Additionally, our study demonstrated that the in vivo subtalar and talonavicular joints revealed a strong correlation, suggesting that the navicular and calcaneal bones were moving similarly to the talus and that the arch support stabilizes the ankle joint and compensatively increases the subtalar and talonavicular joint motions.

Pilot Study: Effect of Morton's Extension on the Subtalar Joint Forces in Subjects with Excessive Foot Pronation

This study focuses on the assessment of the mechanical effect produced by Morton's extension as an orthopedic intervention in patients with bilateral foot pronation posture, through a variation in hindfoot and forefoot prone-supinator forces during the stance phase of gait. A quasi-experimental and transversal research was designed comparing three conditions: barefoot (A); wearing footwear with a 3 mm EVA flat insole (B); and wearing a 3 mm EVA flat insole with a 3 mm thick Morton's extension (C), with respect to the force or time relational to the maximum time of supination or pronation of the subtalar joint (STJ) using a Bertec force plate. Morton's extension did not show significant differences in the moment during the gait phase in which the maximum pronation force of the STJ is produced, nor in the magnitude of the force, although it decreased. The maximum force of supination increased significantly and was advanced in time. The use of Morton's extension seems to decrease the maximum force of pronation and increase supination of the subtalar joint. As such, it could be used to improve the biomechanical effects of foot orthoses to control excessive pronation.

Effects of three-dimensional image based insole for healthy volunteers: a pilot clinical trial

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.

EFFECTS OF RUNNING ON RECOVERY OF FUNCTION IN ATHLETES WITH KNEE OSTEOARTHRITIS

ABSTRACT Introduction Running can promote health prevent obesity, cardiovascular, and cerebrovascular diseases, among other chronic diseases. Much research reports the benefits of this aerobic resistance exercise, but little is known about the impacts of running on knee osteoarthritis. Objective To observe and study the clinical effect of running on pain and function improvement in patients with knee osteoarthritis. Methods Seventy cases that met the inclusion criteria were selected and randomly divided into control and observation groups. Patients in the observation group received eight weeks of neuromuscular exercise (NEMEX) and eight weeks of quadriceps muscle strength training while the control group was subjected to a running protocol. Patients were assessed using the Western Ontario and McMaster Universities Pain Scale and Osteoarthritis Index (WOMAC) after 1, 2, 4 and 8 weeks of treatment. Results After 1, 2, 4, and 8 weeks of treatment, the WOMAC function scores of the two groups significantly improved compared to that found before treatment (P < 0.05); There was no difference between the two groups before treatment and after 1, 2 weeks of treatment. After 4 and 8 weeks of treatment, the function of the observation group was better than that of the control group; the difference was statistically significant (t= -4.287, -6.355, P<0.05). Conclusions NEMEX training methods and quadriceps muscle strength training can effectively improve patients’ functional level, but NEMEX improves more significantly than quadriceps muscle strength training. Evidence level II; Therapeutic Studies - Investigating the results.

Effects of arch support doses on the center of pressure and pressure distribution of running using statistical parametric mapping

Insoles with an arch support have been used to address biomechanical risk factors of running. However, the relationship between the dose of support and running biomechanics remains unclear. The purpose of this study was to determine the effects of changing arch support doses on the center of pressure (COP) and pressure mapping using statistical parametric mapping (SPM). Nine arch support variations (3 heights * 3 widths) and a flat insole control were tested on fifteen healthy recreational runners using a 1-m Footscan pressure plate. The medial-lateral COP (COPML) coordinates and the total COP velocity (COPVtotal) were calculated throughout the entirety of stance. One-dimensional and two-dimensional SPM were performed to assess differences between the arch support and control conditions for time series of COP variables and pressure mapping at a pixel level, respectively. Two-way ANOVAs were performed to test the main effect of the arch support height and width, and their interaction on the peak values of the COPVtotal. The results showed that the COPVtotal during the forefoot contact and forefoot push off phases was increased by arch supports, while the COP medial-lateral coordinates remained unchanged. There was a dose-response effect of the arch support height on peak values of the COPVtotal, with a higher support increasing the first and third valleys but decreasing the third peak of the COPVtotal. Meanwhile, a higher arch support height shifted the peak pressure from the medial forefoot and rearfoot to the medial arch. It is concluded that changing arch support doses, primarily the height, systematically altered the COP velocities and peak plantar pressure at a pixel level during running. When assessing subtle modifications in the arch support, the COP velocity was a more sensitive variable than COP coordinates. SPM provides a high-resolution view of pressure comparisons, and is recommended for future insole/footwear investigations to better understand the underlying mechanisms and improve insole design.

The effect of arch-support insole on knee kinematics and kinetics during a stop-jump maneuver

BACKGROUND

Anterior cruciate ligament injuries commonly occur during sports that involve sudden stops or direction changes. Although athletes often use arch-support insoles in competition and training, little is known about the effect of foot insoles on knee biomechanics and jump take-off performances.

OBJECTIVE

This study aimed to investigate the effects of arch-support insoles on knee kinematics and kinetics during the stop-braking phase and the subsequent jump take-off performances.

STUDY DESIGN

That is a quasi-experimental study, repeated-measures design.

METHODS

Twenty male healthy recreational university basketball athletes performed stop-jump with maximum effort in both arch-support and flat insole conditions. Paired t -tests were performed on knee kinetics and kinematics and jump performance variables to determine whether there were significant differences between insole conditions.

RESULTS

Wearing arch-support insoles experienced larger ground reaction forces (GRFs), loading rates of peak vertical and posterior GRFs, peak knee adduction and rotation moments, and knee flexion angular velocity than the flat insoles ( P < 0.05).

CONCLUSIONS

The increased GRFs and knee loading in arch-support insoles are indicative of a higher risk of anterior cruciate ligament injuries. The findings could be insightful to the knee mechanics that are related to performance and injury potential during stop-jump maneuvers.

Effect of additional body weight on arch index and dynamic plantar pressure distribution during walking and gait termination

The medial longitudinal arch is considered as an essential feature which distinguishes humans from other primates. The longitudinal arch plays a supporting and buffering role in human daily physical activities. However, bad movement patterns could lead to deformation of arch morphology, resulting in foot injuries. The authors aimed to investigate any alterations in static and dynamic arch index following different weight bearings. A further aim was to analyze any changes in plantar pressure distribution characteristics on gait during walking and stopping, Twelve males were required to complete foot morphology scans and three types of gait tests with 0%, 10%, 20% and 30% of additional body weight. The dynamic gait tests included walking, planned and unplanned gait termination. Foot morphology details and plantar pressure data were collected from subjects using the Easy-Foot-Scan and Footscan pressure platform. No significant differences were observed in static arch index when adding low levels of additional body weight (10%). There were no significant changes observed in dynamic arch index when loads were added in the range of 20% to 30%, except in unplanned gait termination. Significant maximal pressure increases were observed in the rearfoot during walking and in both the forefoot and rearfoot during planned gait termination. In addition, significant maximum pressure increases were shown in the lateral forefoot and midfoot during unplanned gait termination when weight was increased. Findings from the study indicated that excessive weight bearing could lead to a collapse of the arch structure and, therefore, increases in plantar loading. This may result in foot injuries, especially during unplanned gait termination.