Effect of Foot Orthotics on EMG

NewsBot · Sep 26, 2019

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A systematic review of the effect of footwear, foot orthoses and taping on lower limb muscle activity during walking and running.
Reeves J et al
Prosthet Orthot Int. 2019 Sep 24

BACKGROUND:
External devices are used to manage musculoskeletal pathologies by altering loading of the foot, which could result in altered muscle activity that could have therapeutic benefits.

OBJECTIVES:
To establish if evidence exists that footwear, foot orthoses and taping alter lower limb muscle activity during walking and running.

STUDY DESIGN:
Systematic literature review.

METHODS:
CINAHL, MEDLINE, ScienceDirect, SPORTDiscus and Web of Science databases were searched. Quality assessment was performed using guidelines for assessing healthcare interventions and electromyography methodology.

RESULTS:
Thirty-one studies were included: 22 related to footwear, eight foot orthoses and one taping. In walking, (1) rocker footwear apparently decreases tibialis anterior activity and increases triceps surae activity, (2) orthoses could decrease activity of tibialis posterior and increase activity of peroneus longus and (3) other footwear and taping effects are unclear.

CONCLUSION:
Modifications in shoe or orthosis design in the sagittal or frontal plane can alter activation in walking of muscles acting primarily in these planes. Adequately powered research with kinematic and kinetic data is needed to explain the presence/absence of changes in muscle activation with external devices.

CLINICAL RELEVANCE:
This review provides some evidence that foot orthoses can reduce tibialis posterior activity, potentially benefitting specific musculoskeletal pathologies.
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NewsBot · Jan 21, 2021

Effects of corrective insole on leg muscle activation and lower extremity alignment in rice farmers with pronated foot: a preliminary report
Agung Kristanto et al
Foot (Edinb). 2020 Dec 25

Background: Execution of strenuous activities in conjunction with slippery and viscous muddy working terrain in rice cultivation leads to a high prevalence of farmer musculoskeletal disorders and malalignments. Recommended intervention strategies originally designed for congenitally disabled individuals may also be applicable to farmers, including simple corrective wedges to reduce foot eversion. The objective of the present study was to conduct a preliminary investigation of the effects of corrective wedges on lower extremity muscle activity and alignment when subjects stood on flat rigid ground or muddy terrain, simulating typical work conditions encountered by the unique but populous Thai rice farming workforce.

Methods: Nine healthy farmers with pronated feet were recruited to participate and wedges were custom fabricated for each farmer based on physical therapy assessment and use of rapid prototyping techniques. Participants were asked to stand barefoot or with wedges on the two surface types.

Results: Results revealed foot pronation and knee valgus to improve (ranging, on average between 5.5 and 16.1 degrees) when participants were equipped with corrective wedges. The muscle activity of the peroneus longus and the tibialis anterior increased for muddy terrain, as compared with the rigid surface. In general, the wedges induced less tibialis anterior activity and greater peroneus longus activity, compared to when participants were standing barefoot. An elevation in evertor muscle activity may reflect stretching of the shortened muscle as a result of the reduced degree of foot pronation.

Conclusions: Findings demonstrate potential benefits of corrective insole usage for farmers with pronated feet, including improved lower extremity alignment and invertor muscle activity reduction for both rigid and muddy terrains.
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NewsBot · Oct 24, 2021

Extrinsic foot muscle forces and joint contact forces in flexible flatfoot adult with foot orthosis: A parametric study of tibialis posterior muscle weakness
YinghuPeng et al
Gait & Posture; Volume 88, July 2021, Pages 54-59

Highlights
•Tibialis posterior weakness altered foot muscle recruitment in flatfoot.
•TP weakness mainly affected ankle joint contact forces.
•Flexor digitorum /hallucis longus compensated for the TP weakness.
•Muscle and joint forces were overall lower in foot orthosis condition.
•This study may contribute to foot pain relief using foot orthosis in flatfoot.
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Background
The posterior tibialis tendon dysfunction (PTTD) is typically associated with progressive flatfoot deformity, which could be alleviated with foot orthosis. However, the evaluation of tibialis posterior (TP) weakness on lower limb mechanics of flatfoot adults with foot orthoses is scarce and requires further investigation.

Research question
This study aimed to examine the effects of TP weakness on lower limb mechanics in flatfoot adults with foot orthosis through gait analysis and musculoskeletal modelling.

Methods
Fifteen young adults with flatfoot were recruited from University to perform a gait experiment with and without foot orthoses. Data collected from the motion capture system were used to drive the musculoskeletal modelling for the estimation of the joint force and extrinsic muscle forces of the lower limb. A parametric analysis was conducted by adjusting the TP muscle strength from 40 % to 100 %. Two-way repeated measures ANOVA was used to compare the peak extrinsic foot muscle forces and joint forces among different levels of TP weakness and insole conditions.

Results
TP weakness significantly increased ankle joint force superoinferiorly (F = 125.9, p < 0.001) and decreased anteroposteriorly (F = 125.9, p < 0.001), in addition to a significant increase in the muscle forces of flexor hallucis longus (p < 0.001) and flexor digitorum longus (p < 0.001). Besides, the foot orthosis significantly reduced most peak muscle forces whilst significantly reduced the second peak knee force and peak ankle force compared to the control condition (F = 8.79–30.9, p < 0.05).

Significance
The increased extrinsic foot muscle forces (flexor hallucis longus and flexor digitorum longus) and ankle joint forces in the TP weakness condition indicated that TP weakness may induce compensatory muscle activation and attenuated joint load. The abnormal muscle and joint mechanics in flatfoot adults with TP weakness might be restored by the orthosis.
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NewsBot · Nov 11, 2021

The immediate effects of foot orthosis geometry on lower limb muscle activity and foot biomechanics
JoannaReeves et al
Journal of Biomechanics Volume 128, 9 November 2021, 110716

Foot orthoses (FOs) are used to treat clinical conditions by altering the external forces applied to the foot and thereafter the forces of muscles and tendons. However, whether specific geometric design features of FOs affect muscle activation is unknown. The aim of this study was to investigate if medial heel wedging and increased medial arch height have different effects on the electromyography (EMG) amplitude of tibialis posterior, other muscles of the lower limb and the kinematics and kinetics at the rearfoot and ankle. Healthy participants (n = 19) walked in standardised shoes with i) a flat inlay; ii) a standard shape FOs, iii) standard FOs adjusted to incorporate a 6 mm increase in arch height, iv) and standard FOs adjusted to incorporate an 8° medial heel wedging and v) both the 6 mm increase in arch height and 8° increase in medial wedging. EMG was recorded from medial gastrocnemius, peroneus longus, tibialis anterior and in-dwelling tibialis posterior muscles. Motion and ground reaction force data were collected concurrently. Tibialis posterior EMG amplitude reduced in early stance with all FOs (ηp2 = 0.23–1.16). Tibialis posterior EMG amplitude and external ankle eversion moment significantly reduced with FOs incorporating medial wedging. The concurrent reduction in external eversion moment and peak TP EMG amplitude in early stance with medial heel wedging demonstrates the potential for this specific FOs geometric feature to alter TP activation. Medial wedged FOs could facilitate tendon healing in tibialis posterior tendon dysfunction by reducing force going through the TP muscle tendon unit.
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