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Do foot orthoses replicate the static longitudinal arch angle during midstance in walking?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Jan 22, 2011.

  1. NewsBot

    NewsBot The Admin that posts the news.


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    Do foot orthoses replicate the static longitudinal arch angle during midstance in walking?
    Burn H, Branthwaite H, Chockalingam N, Chevalier TL, Naemi R.
    Foot (Edinb). 2011 Jan 18. [Epub ahead of print]
  2. davidh

    davidh Podiatry Arena Veteran

    A fairrly sweeping conclusion considering the small size and distribution of the cohort.
  3. I recon there something quite positive in this, we have a static measurement of LLA which is the same in static and dynamic conditions.
  4. davidh

    davidh Podiatry Arena Veteran

    It's irrelevant how positive or negative the findings are.

    The age distribution and small size of the sample makes the conclusion meaningless.
  5. Interesting data.

    So we have 3 conditions. Barefoot, (BF) Shod (S) and Shod with orthoses (SO)

    Beyond that we have 2 states. Static and dynamic. So six conditions total

    Static barefoot (SBF)
    Static Shod (SS)
    Static shod with orthoses (SSO)

    Dynamic Barefoot (DBF)
    Dynamic Shod (DS)
    Dynamic Shod with orthoses (DSO).

    So what they've told us is:

    So SBF = DBF. The LAA is the same static as walking. I believe Mcpoil produced similar data. Fine.

    So SSO = DSO . The LAA standing still on an orthotic is the same as the LAA walking on it.

    Same as the above on both sides. 'K.

    So SS is not the same as DS. In other words the shoe changes the LAA when dynamic but not static (or vice versa?). Makes sort of sense. Interesting data too, as one suspects that the shoe did not have a high arch (or why bother with the insole) so the change in LAA was affected by other elements of the shoe than straight out upward ORF under the arch? And why did this mechanism only act in either static OR dynamic, but not the same in both?

    But this Data holds the answer to much more interesting questions! I want to know:-

    Was SSO different to SS and was DSO different to DS? In other words If the shoe altered the LAA, was there a difference between that and the difference the orthoses made?

    Was SBF or DBF different to SSO or DSO? Did the orthoses make a significant difference to the LAA?

    This is frustrating! the same results would be yeilded if the orthoses was a piece of flat paper.

    Perhaps the answers are in the full text. Anyone have a copy?

  6. Oh and
    Yeah, I noticed that. Since the effect of orthoses on arch height was measured in shoe, unless one has a fibre optic goniometer it would be tricky to make this into a clinical test.

    And of course, since when has the arch height been the measure of "efficacy" of orthoses.
  7. Still some what positive that a static measurement is the "same" in dynamic midstance, if it onlty for 17 people and some of the conclusions maybe a little sweeping it is still a positive measurement LLA at midstance which you may use to help determine arch height of the device.

    Robert I would have thought you would have been getting a little more excited also - Foam box casting, another argument for your side ( not thats it about side but you get the idea)
  8. Not really. They didn't show that the height of the device predicted the arch height of the arch. As I said, if the orthotic was a piece of paper which had precisely zero effect on either the kinetics or the kinematics. One could have acheived the same result, because the paper would have had the same effect (none) in both static and midstance. So it doesn't help us determine the arch height of the device because we still don't fully understand how the orthotic shape / prescription affects the arch height of the foot. All we know from this is that with that device, whatever effect the orthotic had on arch, it had the same effect standing still in the shoe as walking.

    And we can't even use it clinically because A: You can't see arch height in shoes and B: It depends (I suspect) on the orthotic. And the shoe come to that!

    Thats why I want the raw data. For me, they answered the wrong questions! But the data should contain some interestion answers to the right ones!
  9. Griff

    Griff Moderator

    Check your email
  10. Thanks buddy!

    Will get stuck in when I get chance.
  11. I still think it´s positive....

    if we take a patient get then to stand a midstance, we can measure the LAA, this study has shown us that at midstance the LAA is the "same"- now the in-shoe result was not but how different need to read full text.

    So now we have an arch height at midstance add this to our supination resistance test etc etc and it may help us with the construction of the device, ie the arch must be higher than x to push on the arch at midstance (if thats what you want to do).

    So you don´t need to see the foot shod the midstance measurement will the guide you need.

    Now they say the shoes effect the arch height so need to full text to say how much, but the argument that because you can´t see the arch shod is silly- you can´t determine the position of navicular drift or drop shod either.

    Now I agree that I´m stretching the conclusions abit, but if a midstance measurement (ie dynamic) can be determined static it is positive in my book.
  12. Just read the data. There is a tiney tiny flaw in the plan...
  13. Got no love from Ian, but I don´t really want the paper Ian 12 000 PDF´s to read at the moment it seems.

    hit me with info Robert- if it tiney tiny then how big a truck can you drive though the hole ?
  14. The data provided is in the form of mean, and standard deviation

    Barefoot static 140.18
    Barefoot dynamic 139.83

    Shoe only static 156.65
    Shoe only Dynamic 154.27

    Orthotic and shoe static 154.32
    Orthotic and shoe Dynamic 154.12

    Bear in mind that this is LAA (or SNA or Feiss line depending on your terminology) so higher number = higher arch.

    So on this data, putting an orthoses in someones shoe made no difference at all! Oh, apart from in static WB in which it made a statistically significant lowering of the arch.

    No THAT is interesting data!!
  15. I'm thinking optimus prime.
  16. :confused:

    The way I read it, it showec no such thing! It showed supination of the foot (strike that, increase in LAA) when shoes were introduced and a drop in the LAA when orthoses were introduced (Presumably more pronation).

    Hang on, earlier in the study the difference between shoe standing and shoe dynamic, a difference of 2.38 degrees is statistically significant. Now a difference between static shoe and static shoe and insole, 2.33 is described as minimal.

    Whilst I appreciate that the focus of the study is on the static / dynamic repeatability, this seems a bit of an oversight to me!

    And in terms of the conclusion

    Once again, :confused:.

    The study Did show that the static measure of LAA predicted the dynamic measure of LAA with insoles. It also showed that the static measure of LAA Shod was SIGNIFICANTLY DIFFERENT to the Dynamic shod position. So the dynamic position of the foot, shod, midstance, CAN'T be predicted by the static postition of the foot, shod. Which is sort of the opposite of what they said.

    Also. The title of the paper is

    What has that got to do with whether static LAA predicts dynamic LAA?

    Also. The clinical examination in static WB it refers to is carried out barefoot static right? And this data DEFINITLY shows that the static wb LAA bears very little resembelance to the shod LAA. So unless we're looking at barefoot folk its not a screaming endorsement of LAA to predict anything very much!

    Unless I'm being dense here the conclusions don't match the data. Does it make sense to anyone else?
  17. davidh

    davidh Podiatry Arena Veteran

    Quite right - it doesn't match.

    Any of the authors on here?
    Or a supervisor?
  18. Griff

    Griff Moderator

    I still haven't fully read the article - only skimmed it - but have to say that on first glance I am in agreement with David's instinct regarding the over generalisation of the results.

    Even if they did show what they claim, to do so on a cohort of 17 asymptomatic males of mean weight 73kg (+/- 11kgs) seems a far cry from:

    Would have been nice to see subject specific data.
  19. And that is now the key subject specific data, hence the big truck. Pity still would have been nice to see static measurment replicate a dynamic.
  20. I'd say it's a pretty good piece of evidence that barefoot static assessment does not predict shod.

    Also. Notice the gulf between dynamic barefoot and dynamic shod? What does that tell us about barefoot gait analysis?

    But the the jaw dropper for me is that the shoe, a fairly guttless pump, made such a huge difference, where the insoles made no difference, or a difference in the wrong direction!

    It's a very interesting study if you ignore the texty bit and look at the data. I'd say that it gives us some very useful data about what can be acheived with shoes and some alarming data about barefoot assessment.
  21. davidh

    davidh Podiatry Arena Veteran

    Personally I wouldn't like to extrapolate any conclusions from data produced in this study.

    The published conclusions are so far off the mark that there are bound to be other mistakes:wacko:.
  22. Meh. Depends if you trust the raw data. I'm inclined to myself, but that might well be because it fits my prejudice ;)
  23. Oh hell no.

    This is fast becoming my least favourite study of all time!
  24. .....

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