Effects of Custom-Made Rigid Foot Orthosis on Pes Planus in Children Over 6 Years Old

NewsBot · Jul 12, 2014

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Effects of Custom-Made Rigid Foot Orthosis on Pes Planus in Children Over 6 Years Old
Soo-Kyung Bok, MD, Bong-Ok Kim, MD, Jun-Ho Lim, MD and So-Young Ahn, MD
Ann Rehabil Med. 2014 Jun;38(3):369-375

Objective
To identify the effects of a custom-made rigid foot orthosis (RFO) in children over six years old with pes planus.
Methods
The medical records of 39 children (mean age, 10.3±4.09 years) diagnosed with pes planus, fitted with RFOs, and had who more than two consecutive radiological studies were reviewed. The resting calcaneal stance position (RCSP), anteroposterior talocalcaneal angle (APTCA), lateral talocalcaneal angle (LTTCA), the lateral talometatarsal angle (LTTMA), and calcaneal pitch (CP) of both feet were measured to evaluate foot alignment. After diagnosis, children were fitted with a pair of RFOs and recommended to walk with heel strike and reciprocal arm swing to normalize the gait pattern. A follow-up clinical evaluation with radiological measurements was performed after 12-18 months and after 24 months of RFO application. Post-hoc analysis was used to test for significant differences between the radiological indicators and RCSP.
Results
With RFOs, all radiological indicators changed in the corrective direction except LTTCA. RCSP and CP in the third measurement showed significant improvement in comparison with the second and baseline measurements. Additionally, APTCA and LTTMA revealed improvements at the third measurement versus the baseline measurements.
Conclusion
This study revealed that radiological indicators improved significantly after 24 months of RFO application. A prospective long-term controlled study with radiographical evaluation is necessary to confirm the therapeutic effects of RFOs and to determine the optimal duration of wear in children with pes planus.
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Admin2 · Jul 12, 2014

Related Threads:
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The Flat-Footed Child—To Treat or Not to Treat; What Is the Clinician to Do?

RobinP · Jul 12, 2014

Given where we are, this seems like a strange study

1. Is pes planus a diagnosis?
2. "All radiographic indicators changed in the corrective direction" - which direction is that?
3. No control - so we are measuring against what?

Admittedely, it does say "A prospective long-term controlled study with radiographical evaluation is necessary to confirm the therapeutic effects of RFOs" BUT is quickly followed by ".....determine the optimal duration of wear in children with pes planus." the assumption being that it has theraputic benefits......for potentially asymptomatic feet

Mental

Orthican · Jul 15, 2014

Mental indeed!

Robin it appears the arch correctors are writing again. LOL

NewsBot · Apr 8, 2017

Effect of foot orthoses on the medial longitudinal arch in children with flexible flatfoot deformity: A three-dimensional moment analysis
Amir Ali Jafarnezhadgero et al
Gait and Posture; Article in Press

Highlights
•Foot orthoses decrease the ankle evertor and knee abductor moments in dominant side.
•Foot orthoses decrease the hip abductor and flexor moments in dominant side.
•Orthoses decrease ankle evertor and internal rotator moments in non-dominant side.
•Foot orthoses increase dorsiflexor moment at the ankle in non-dominant side.
•Dominant and non-dominant lower limbs show different responses to the orthoses.
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Foot orthoses are often used to correct altered gait patterns. The purpose of this study was to investigate how foot orthoses can modify the magnitude of three dimensional moments of ankle, knee, and hip joints during a stride of gait in children with flexible flat feet. Bilateral gait data were collected from fourteen male children (age 10.2 ± 1.4 years) suffering from flat feet syndrome. In order to obtain the kinematics data, a Vicon system with six cameras (100 Hz) was used and two Kistler force plates (1000 Hz) to record the kinetics data under each leg. Arc support foot orthoses were used as an intervention. Paired-sample T-test was used for within-group comparisons (α = 0.05). The results of data analysis showed that foot orthoses can decrease the ankle evertor moment, knee and hip abductor moments and hip flexor moment in dominant lower limb. In non-dominant lower limb, using the orthoses can decrease evertor and internal rotator moments at the ankle, flexor and internal rotator moments at the knee and extensor moment at the hip, while it can increase dorsiflexor moment at the ankle. The findings imply that effects of orthoses on three dimensional moments differ in dominant and non-dominant lower limbs. Furthermore, results demonstrated that dominant and non-dominant lower limbs would also show different responses to the same intervention.
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NewsBot · Apr 20, 2017

The effect of foot orthoses on joint moment asymmetry in male children with flexible flat feet
AmirAli Jafarnezhadgero et al
Journal of Bodywork and Movement Therapies; Article in Press

Introduction
It has been widely postulated that structural and functional misalignments of the foot, such as flat foot, may cause mechanical deviations of the lower limb during walking. The aim of this study was to investigate the effect of foot orthoses on lower extremity joint moment asymmetry during the stance phase of walking in children with asymptomatic flexible flat feet.

Methods
Fourteen volunteer male children, clinically diagnosed with flexible flat feet, participated in this study. Subjects completed 12 walking trials at a self-selected walking speed while 3-dimensional kinematic and kinetic data were collected for two conditions: shod with no orthoses, and shod with orthoses. The gait asymmetry index for each variable for each subject was defined as: (1-(lesser moment/greater moment)) × 100.

Results
Results reveal no significant differences in ankle or knee joint moment asymmetry. However, the use of foot orthoses decreased asymmetry for the hip abduction moment (P = 0.04) compared to walking without orthoses and also resulted in subtle, non-significant increases in frontal plane subtalar and sagittal plane knee and hip joints moment asymmetry.

Conclusion
We conclude that foot orthoses decrease frontal plane hip joint moment asymmetry, but have little effect on ankle and knee joint asymmetry.
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NewsBot · May 9, 2017

Changes in Resting Calcaneal Stance Position Angle Following Insole Fitting in Children With Flexible Flatfoot
Eui Chang Lee, MD, Myeong Ok Kim, MD, PhD, Hyo Sang Kim, MD and Sang Eun Hong, MD
Ann Rehabil Med. 2017 Apr;41(2):257-265

Objective
To clarify the relationship of the initial radiologic and a biomechanical parameter at first clinical visit, and define the effectiveness of modified insole, following insole fitting in children with flexible flatfoot.

Methods
Children aged less than 13 years with flexible flatfoot were enrolled. The total number of subjects was 66 (33 boys, 33 girls). The subjects were divided into 5 subgroups, based on age: 1–2, 3–4, 5–6, 7–9, and 10–12 years. The mean time period between the initial & final examination for their resting calcaneal stance position angle (RCSPA) was 24 months. Radiography quantified the deformity by measuring angles, including the talometatarsal angle, the metatarsal angle, and the calcaneal pitch angle.

Results
From the angles measured on radiographs, only the talometatarsal angle showed a statistically significant correlation to the initial RCSPA (r=-0.578 for right side, r=-0.524 for left side; p<0.01). The mean RCSPA improved in all subgroups of subjects following insole fitting. Moreover, in children younger than 7 years, the improvement in RCSPA from the insole fitting was greater compared to children aged 7 years and older.

Conclusion
The insole has additionally beneficial effects in all populations younger than 13 years. However, there might exist a hidden effect of normal structural pedal alignment during growth accompanied with bony maturation and developmental process. To date, it is controversial whether the treatment of flexible flatfoot is necessary in the vast majority of cases, or simple observation and advice to parents would suffice.
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NewsBot · Mar 24, 2019

Immediate and long-term effects of foot orthoses on asymmetry index of the
ground reaction force frequency spectrum: A clinical trial study
Seyed Majid Alavi Mehr et al
Journal of Gorgan University of Medical Sciences / 22

Background and Objective: The asymmetry index during walking can be used for clinical treatment.
This study was done to determine the immediate and long-term effects of foot orthoses on asymmetry of
ground reaction forces frequency spectrum in male children with flat foot during walking.
Methods: This clinical trial study was done on fifteen children with flat foot. Subjects were randomly
divided into without foot orthoses, immediate and long term usage of foot orthoses groups. The kinematic
and kinetic data during three without foot orthoses, immediate and long term use of foot orthoses
conditions were recorded by the motion analysis and force platform systems, respectively.
Results: Asymmetry index of medio-lateral frequency spectrum component during walking without foot
orthoses, immediate and long term use of orthoses in median frequency and band width were greater than
4 percent. There were not any significant differences in asymmetry index of ground reaction force
frequency spectrum components, asymmetry index of essential harmony numbers, asymmetry index of
essential harmony total powers, and asymmetry index of fundamental harmony number in vertical,
anterior-posterior, and medio-lateral axes between without foot orthoses, immediate and long term use of
foot orthoses conditions. However, asymmetry index of essential harmony total power in medio-lateral
axis during immediate use of foot orthoses tend to be reduced than that walking without foot orthoses.
However, this difference was not significant. Conclusion: Despite the high asymmetry index of the ground reaction force frequency spectrum in the
medio-lateral component during walking without foot orthoses, immediate and long-term effects of foot
orthoses in the median and bandwidth frequency variables, the acute or long term use of foot orthoses did
not show any significant effect on improvement of asymmetry index of ground reaction force frequency
spectrum
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NewsBot · Mar 5, 2020

Quantifying lower limb inter-joint coordination and coordination variability after four-month wearing arch support foot orthoses in children with flexible flat feet
AmirAli et al
Human Movement Science; Volume 70, April 2020, 102593

Highlights
•Four-month wearing FO alters inter-joint coordination in children with FF.
•Four-month wearing FO alters inter-joint coordination variability in children with FF.
•Frontal plane ankle-hip coordination in EG changed to an anti-phase pattern.
•Frontal plane knee-hip coordination in EG changed to an anti-phase pattern.
•Sagittal plane ankle-hip coupling angle variability increased in the post-test of EG.
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Introduction
Flat feet in children negatively affect lower limb alignment and cause adverse health-related problems. The long-term application of foot orthoses (FOs) may have the potential to improve lower limb coordination and its variability.

Aim
To evaluate the effects of long-term use of arch support FOs on inter-joint coordination and coordination variability in children with flexible flat feet.

Methods
Thirty boys with flexible flat feet were randomly assigned to the experimental (EG) and control groups. The EG used medial arch support FOs during daily activities over a four-month period while the control group received a flat 2-mm-thick insole for the same time period. Lower-limb coordination and variability during the 3 sub-stance phases were quantified using a vector coding technique.

Results
Frontal plane ankle-hip coordination in EG during mid-stance changed to an anti-phase pattern (156.9°) in the post-test compared to an in-phase (221.1°) in the pre-test of EG and post-test of CG (222.7). Frontal plane knee-hip coordination in EG during loading response (LR) changed to an anti-phase pattern (116°) in the post-test compared to an in-phase (35.5°) in the pre-test of EG and post-test of CG (35.3). Ankle inversion/eversion-knee internal/external rotation joint coupling angle in EG changed to an in-phase pattern (59°) in the post-test compared to a proximal phase (89°) in the pre-test. Coupling angle variability increased in the post-test of EG for sagittal plane ankle-hip during push-off, transverse plane ankle-hip during LR and mid-stance, and transverse plane knee-hip during LR and mid-stance compared to pre-test of EG and post-test of CG.

Conclusion
The long-term use of arch support FOs proved to be effective to alter lower limb coordination and coordination variability during walking in children with flexible flat feet. This new insight into coordinative function may be useful for improving corrective exercise strategies planned for children with flat feet.
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NewsBot · May 11, 2020

The long-term effect of foot insoles on kinetic gait
parameters in female children with flexible flat foot
Nadia L. Radwan et al
Volume 25, Issue 02, February, 2020

Children flatfoot is a frequent deformity in which there is a reduction in the medial longitudinal
arch. Previous studies afford useful information about the prompt effects of foot insoles (FI). It is not clear if
these effects long-lasting or might change over a longer period. The aim of this study was to investigate if
wearing FI for a long time might change gait variables in children with flexible flat feet (FFF). Thirty Female
children (9-13 years) with asymptomatic bilateral FFF were selected according to their arch index. Vicon 3D
Gait analysis was used to calculate the kinetic variables (ankle, knee, and hip peak moments) during the gait
cycle before and after 6 and 12- months period of wearing the FI. Significant decrease was achieved in terms
of foot eversion and forefoot, knee and hip abduction and hip flexion peak moments after 6-months of
wearing the FI. After 12-months, the previous parameters continued to decrease, in addition to significant
increases were found in ankle dorsiflexion and forefoot adduction peak moments, and significant decreases
were obtained in foot plantar-flexion and inversion, knee flexion, extension, and internal rotation and hip
extension and internal rotation moments. It could be concluded that FI is feasible and effective in improving
the lower limb kinetic parameters by achieving permanent changes in the young females with FFF when
applied for successive 12 months.
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