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Alshahrani MS, Reddy RS, Alshahrani A, Gautam AP, Alsubaie SF. Exploring the interplay between ankle muscle strength, postural control, and pain intensity in chronic ankle instability: A comprehensive analysis. Heliyon 2024; 10:e27374. [PMID: 38486775 PMCID: PMC10937675 DOI: 10.1016/j.heliyon.2024.e27374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
Background Chronic Ankle Instability (CAI) is a common musculoskeletal condition characterized by recurring ankle sprains and impaired postural control (PC). Understanding the relationship between ankle muscle strength, PC, and the role of pain is essential for effective management. Objectives This prospective cross sectional study aimed to 1. Compare ankle isometric muscle strength (IMS) and PC between CAI and asymptomatic sides. 2. Assess the correlations between ankle IMS and PC and explore the potential mediating effect of pain in individuals with CAI. Methods A total of 44 individuals with CAI, were enrolled in the study. Ankle IMS (dorsiflexors, plantar flexors, invertors, and evertors) was measured using a dynamometer, while PC was evaluated using sway parameters (anterior-posterior and medial-lateral sway, ellipse area). Pain levels were reported using a Visual Analog Scale. Results The CAI ankles exhibited significantly lower ankle IMS in all muscle groups compared to the asymptomatic ankles (p < 0.001). Additionally, the CAI side showed increased postural sway and a larger ellipse area (p < 0.001), indicating reduced PC. Negative correlations were observed between ankle IMS and PC parameters on the CAI side, with dorsiflexor strength showing correlations ranging from -0.423 to -0.387, plantar flexor strength ranging from -0.423 to -0.371, invertor strength ranging from -0.412 to -0.238, and evertor strength ranging from -0.451 to -0.365 (p < 0.001). Mediation analysis revealed that pain played a significant mediating role in connecting ankle IMS and PC parameters among individuals with CAI, with statistical significance (p < 0.05). Conclusions Individuals with CAI exhibit weaker ankle IMS and diminished PC in comparison to their healthy side. Moreover, pain was identified as a mediator in the relationship between ankle IMS and PC in CAI. These findings underscore the importance of addressing both ankle IMS and pain in the rehabilitation and management of CAI.
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Affiliation(s)
- Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Adel Alshahrani
- Department of Medical Rehabilitation Sciences-Physiotherapy Program, College of Applied Medical Sciences, Najran University, Najran, 55461, Saudi Arabia
| | - Ajay Prashad Gautam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Saud F. Alsubaie
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
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Chen H, Hu W, Liu Y, Na J, Li Q, Wan X. The impact of whole-body vibration training and proprioceptive neuromuscular facilitation on biomechanical characteristics of lower extremity during cutting movement in individuals with functional ankle instability: A parallel-group study. Clin Biomech (Bristol, Avon) 2024; 113:106208. [PMID: 38377653 DOI: 10.1016/j.clinbiomech.2024.106208] [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: 11/11/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND We compared the effects of whole-body vibration training and proprioceptive neuromuscular facilitation on the biomechanical characteristics of the lower limbs in functional ankle instability patients during cutting movement to ascertain the superior rehabilitation method. METHODS Twenty-two male College students with unilateral functional ankle instability volunteered for this study and were randomly divided into whole-body vibration training group and proprioceptive neuromuscular facilitation group. Kinematics data and ground reaction forces were collected using infrared motion capture system and 3-D force plates synchronously during cutting. Repeated measures two-way ANOVA was performed to analyze the data. FINDINGS Both training methods reduced the maximum hip abduction angle (p = 0.010, effect size: proprioceptive neuromuscular facilitation = 0.69; whole-body vibration training = 0.20), maximum knee flexion angle (p = 0.008, effect size: proprioceptive neuromuscular facilitation = 0.39, whole-body vibration training = 1.26) and angular velocity (p = 0.014, effect size: proprioceptive neuromuscular facilitation = 0.62, whole-body vibration training = 0.55), maximum ankle inversion angular velocity (p = 0.020, effect size: proprioceptive neuromuscular facilitation = 0.52, whole-body vibration training = 0.81), and knee flexion angle at the time of maximum vertical ground reaction forces (p = 0.018, effect size: proprioceptive neuromuscular facilitation = 0.27, whole-body vibration training = 0.76), and increased the maximum ankle dorsiflexion moment (p = 0.049, effect size: proprioceptive neuromuscular facilitation = -0.52, whole-body vibration training = -0.22). Whole-body vibration training reduced the maximum ground reaction forces value in the mediolateral directions (p = 0.010, effect size = 0.82) during cutting movement. INTERPRETATION These findings suggested that the two types of training might increase neuromuscular conduction function around the ankle. After these two types of training, functional ankle instability patients showed a similar risk of injury to the lateral ankle ligaments during cutting.
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Affiliation(s)
- Huimeng Chen
- Department of Sports Biomechanics, Beijing Sport University, Beijing 100084, China
| | - Wenxia Hu
- Department of Rehabilitation, People's Hospital of Queshan, Zhumadian 463200, China
| | - Yuduo Liu
- Department of Sports Biomechanics, Beijing Sport University, Beijing 100084, China
| | - Jia Na
- Department of Sports Biomechanics, Beijing Sport University, Beijing 100084, China
| | - Qiujie Li
- Department of Sports Biomechanics, Beijing Sport University, Beijing 100084, China
| | - Xianglin Wan
- Department of Sports Biomechanics, Beijing Sport University, Beijing 100084, China.
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Liu X, He M, Hu R, Chen Z. Randomized controlled trial study of intelligent rehabilitation training system for functional ankle instability. Sci Rep 2024; 14:4996. [PMID: 38424225 PMCID: PMC10904850 DOI: 10.1038/s41598-024-55555-y] [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: 12/14/2023] [Accepted: 02/25/2024] [Indexed: 03/02/2024] Open
Abstract
To investigate the intervention effect of an intelligent rehabilitation training system on patients with functional ankle instability (FAI) and to advance the research to optimise the effect of FAI rehabilitation training. Thirty-four FAI patients who participated in this trial in Guilin City from April 2023 to June 2023 were recruited as research subjects, and all subjects were randomly divided into the control group (n = 17) and the observation group (n = 17). Both groups received the conventional rehabilitation training intervention for 6 weeks, and the observation group received the additional training using the intelligent rehabilitation training system training invented by our team. Visual analogue scale (VAS), ankle active mobility, ankle muscle strength and Y-balance test (YBT) were assessed before and after treatment. Two-way repeated measures ANOVA shows that the interaction effect between time and group of VAS scores was significant (F = 35.644, P < 0.05). The interaction effect between time and group of plantar flexion mobility was significant (F = 23.948, P < 0.05), the interaction effect between time and group of dorsiflexion mobility was significant (F = 6.570, P < 0.05), the interaction effect between time and group of inversion mobility was significant (F = 8.360, P < 0.05), the interaction effect between time and group of eversion mobility was significant (F = 10.113, P < 0.05). The interaction effect between time and group of inversion muscle strength was significant (F = 18.107, P < 0.05). The interaction effect between time and group of YBT scores was significant (F = 33.324, P < 0.05). The Intelligent Rehabilitation Training System can effectively reduce pain in FAI patients, improve joint range of motion, increase inversion strength, and improve dynamic balance of the affected limb.
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Affiliation(s)
- Xiaolong Liu
- School of Life and Environmental Science, Guilin University of Electronic Technology, Guilin, 541004, Guangxi, China
- School of Electronic Engineering and Automation, Guilin University of Electronic Technology, Guilin, 541004, Guangxi, China
- Rehabilitation College, Guilin Life and Health Career Technical College, Guilin, 541001, Guangxi, China
| | - Mengxiao He
- School of Physical Education and Health, Guilin University, Guilin, 541006, Guangxi, China
| | - Rongbo Hu
- Credo Robotics GmbH, Bajuwarenstrasse 47, 94315, Straubing, Germany
- Department of System Design Engineering, Keio University, Yokohama, Kanagawa, 223-8522, Japan
| | - Zhencheng Chen
- School of Life and Environmental Science, Guilin University of Electronic Technology, Guilin, 541004, Guangxi, China.
- School of Electronic Engineering and Automation, Guilin University of Electronic Technology, Guilin, 541004, Guangxi, China.
- Guangxi Colleges and Universities Key Laboratory of Biomedical Sensors and Intelligent Instruments, Guilin, 541004, Guangxi, China.
- Guangxi Engineering Technology Research Center of Human Physiological Information Noninvasive Detection, Guilin, 541004, Guangxi, China.
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Tang Y, Li X, Li Y, Liang P, Guo X, Zhang C, Kong PW. Effects of textured insoles and elastic braces on dynamic stability in patients with functional ankle instability. J Foot Ankle Res 2023; 16:59. [PMID: 37705053 PMCID: PMC10498520 DOI: 10.1186/s13047-023-00662-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Functional ankle instability (FAI) is a common condition that affects individuals who have experienced previous ankle sprains. Textured insoles and elastic ankle braces have been previously used as interventions to improve stability in FAI patients. However, the optimal combination of these interventions has not been fully explored. The objective of this study was to investigate the effects of different types of textured insoles and elastic ankle braces on the dynamic stability of individuals diagnosed with FAI. METHODS The study involved 18 FAI patients who performed single-leg landing tasks with and without wearing an eight-band elastic ankle brace while wearing textured insoles with protrusion heights of 0 mm, 1 mm, and 2 mm. The dynamic posture stability index (DPSI) and its components in the anterior-posterior (APSI), mediolateral (MLSI) and vertical (VSI) directions were calculated from the ground reaction force collected from the Kistler force plate during the first three seconds of the landing tasks. RESULTS A significant interaction was found between textured insole type and ankle brace for DPSI (P = 0.026), APSI (P = 0.001), and VSI (P = 0.021). However, no significant interaction was observed for MLSI (P = 0.555). With elastic ankle braces, textured insoles with 1-mm protrusions significantly enhanced anterior-posterior, mediolateral, vertical, and overall stability compared to textured insoles with no and 2 mm protrusions (P < 0.05). Without elastic ankle braces, textured insoles with 1-mm protrusions significantly improved the anterior-posterior (P = 0.012) and overall stability (P = 0.014) of FAI patients compared to smooth insoles. CONCLUSIONS The combination of textured insoles with 1-mm protrusion heights and an elastic ankle brace could enhance the dynamic stability of individuals with FAI, potentially mitigating the risk of ankle sprains.
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Affiliation(s)
- Yunqi Tang
- College of Art and Design, Shaanxi University of Science and Technology, Xi 'an, 710021, China
| | - Xinyue Li
- College of Art and Design, Shaanxi University of Science and Technology, Xi 'an, 710021, China
| | - Yi Li
- Department of Foot and Ankle Surgery, Honghui Hospital Affiliated to Medical College of Xi 'an Jiaotong University, Xi 'an, 710054, China
| | - Peiyao Liang
- College of Art and Design, Shaanxi University of Science and Technology, Xi 'an, 710021, China
| | - Xinyu Guo
- College of Art and Design, Shaanxi University of Science and Technology, Xi 'an, 710021, China
| | - Cui Zhang
- Sport biomechanics lab, Shandong Institute of Sports Science, Jinan, 250014, China
- Graduate School of Shandong Physical Education University, Jinan, 250014, China
| | - Pui Wah Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, 637616, Singapore.
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Tai WH, Zhang R, Zhao L. Cutting-Edge Research in Sports Biomechanics: From Basic Science to Applied Technology. Bioengineering (Basel) 2023; 10:668. [PMID: 37370600 DOI: 10.3390/bioengineering10060668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Sports biomechanics is the study of the mechanical principles of human movement and how they apply to sports performance [...].
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Affiliation(s)
- Wei-Hsun Tai
- Graduate School, Chengdu Sport University, Chengdu 610000, China
- School of Physical Education, Quanzhou Normal University, Quanzhou 362000, China
| | - Rui Zhang
- School of Physical Education, Quanzhou Normal University, Quanzhou 362000, China
- Key Laboratory of Bionic Engineering (Ministry of Education, China), Jilin University, Changchun 130022, China
| | - Liangliang Zhao
- Key Laboratory of Bionic Engineering (Ministry of Education, China), Jilin University, Changchun 130022, China
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Guo J, Yang J, Wang Y, Mo Z, Pu J, Fan Y. Effect of Different Protection on Lateral Ankle during Landing: An Instantaneous Impact Analysis. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 10:bioengineering10010034. [PMID: 36671606 PMCID: PMC9854853 DOI: 10.3390/bioengineering10010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/27/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
Ankle sprain is the most common injury during parachute landing. The biomechanical behavior of the tissues can help us understand the injury mechanism of ankle inversion. To accurately describe the injury mechanism of tissues and assess the effect of ankle protection, a stable time of landing was obtained through the dynamic stability test. It was used for the boundary condition of the foot finite element (FE). The FE model was provided a static load equal to half of the bodyweight applied at the distal tibia and fibula; a foot-boot-brace FE model was established to simulate the landing of subjects on an inversion inclined platform of 0-20°, including non-, external, and elastic ankle braces. Compared with the non-ankle brace, both the external and elastic ankle braces decreased the peak strains of the cal-fibular, anterior Ta-fibular, and posterior Ta-fibular ligaments (15.2-33.0%), and of the peak stress of the fibula (15.2-24.5%). For the strain decrement of the aforementioned ligaments, the elastic brace performed better than the external ankle brace under the inversion of the 10° condition. The peak stress of the fibula (15.6 MPa) decreased up to 24.5% with an elastic brace and 5.6-10.3% with an external brace. The findings suggested that the behaviors of lateral ankle ligaments and fibula were meaningful for the functional ability of the ankle. This provides some suggestions regarding the optimal design of ankle protection.
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Affiliation(s)
- Junchao Guo
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Jiemeng Yang
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Yawei Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Zhongjun Mo
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
| | - Jingyu Pu
- The Second Center Kindergarten of Yinghai Town, Daxing District, Beijing 100176, China
- Correspondence: (J.P.); (Y.F.); Tel.: +86-10-8233-9852 (J.P.); +86-10-8233-9428 (Y.F.)
| | - Yubo Fan
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
- Correspondence: (J.P.); (Y.F.); Tel.: +86-10-8233-9852 (J.P.); +86-10-8233-9428 (Y.F.)
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Kang M, Zhang T, Yu R, Ganderton C, Adams R, Han J. Effect of Different Landing Heights and Loads on Ankle Inversion Proprioception during Landing in Individuals with and without Chronic Ankle Instability. Bioengineering (Basel) 2022; 9:bioengineering9120743. [PMID: 36550949 PMCID: PMC9774139 DOI: 10.3390/bioengineering9120743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
Proprioception is essential for neuromuscular control in relation to sport injury and performance. The effect of landing heights and loads on ankle inversion proprioceptive performance in individuals with or without chronic ankle instability (CAI) may be important but are still unclear. Forty-three participants (21 CAI and 22 non-CAI) volunteered for this study. The Ankle Inversion Discrimination Apparatus for Landing (AIDAL), with one foot landing on a horizontal surface and the test foot landing on an angled surface (10°, 12°, 14°, 16°), was utilized to assess ankle proprioception during landing. All participants performed the task from a landing height of 10 cm and 20 cm with 100% and 110% body weight loading. The four testing conditions were randomized. A repeated measures ANOVA was used for data analysis. The result showed that individuals with CAI performed significantly worse across the four testing conditions (p = 0.018). In addition, an increased landing height (p = 0.010), not loading (p > 0.05), significantly impaired ankle inversion discrimination sensitivity. In conclusion, compared to non-CAI, individuals with CAI showed significantly worse ankle inversion proprioceptive performance during landing. An increased landing height, not loading, resulted in decreased ankle proprioceptive sensitivity. These findings suggest that landing from a higher platform may increase the uncertainty of judging ankle positions in space, which may increase the risk of ankle injury.
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Affiliation(s)
- Ming Kang
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Tongzhou Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Ruoni Yu
- School of Medicine, Jinhua Polytechnic, Jinhua 321000, China
| | - Charlotte Ganderton
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2234, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
- Correspondence:
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Gómez Carrión Á, Atín Arratibe MDLÁ, Morales Lozano MR, Martínez Rincón C, Martínez Sebastián C, Saura Sempere Á, Nuñez-Fernandez A, Sánchez-Gómez R. Changes in the Kinematics of Midfoot and Rearfoot Joints with the Use of Lateral Wedge Insoles. J Clin Med 2022; 11:jcm11154536. [PMID: 35956151 PMCID: PMC9369829 DOI: 10.3390/jcm11154536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/02/2022] [Indexed: 01/27/2023] Open
Abstract
The lateral wedge insole (LWI) is a typical orthopedic treatment for medial knee osteoarthritis pain, chronic ankle instability, and peroneal tendon disorders. It is still unknown what the effects are in the most important joints of the foot when using LWIs as a treatment for knee and ankle pathologies. Objectives: The aim of this study was to determine the influence of LWIs on the position of the midfoot and rearfoot joints by measuring the changes using a tracking device. Methods: The study was carried out with a total of 69 subjects. Movement measurements for the midfoot were made on the navicular bone, and for the rearfoot on the calcaneus bone. The Polhemus system was used, with two motion sensors fixed to each bone. Subjects were compared by having them use LWIs versus being barefoot. Results: There were statistically significant differences in the varus movement when wearing a 4 mm LWI (1.23 ± 2.08°, p < 0.001) versus the barefoot condition (0.35 ± 0.95°), and in the plantarflexion movement when wearing a 4 mm LWI (3.02 ± 4.58°, p < 0.001) versus the barefoot condition (0.68 ± 1.34°), in the midfoot. There were also statistically significant differences in the valgus movement when wearing a 7 mm LWI (1.74 ± 2.61°, p < 0.001) versus the barefoot condition (0.40 ± 0.90°), and in the plantar flexion movement when wearing a 4 mm LWI (2.88 ± 4.31°, p < 0.001) versus the barefoot condition (0.35 ± 0.90°), in the rearfoot. Conclusions: In the navicular bone, a varus, an abduction, and plantar flexion movements were generated. In the calcaneus, a valgus, an adduction, and plantar flexion movements were generated with the use of LWIs.
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