Effects of different medial arch support heights on rearfoot kinematics

NewsBot · Mar 4, 2017

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Effects of different medial arch support heights on rearfoot kinematics.
Wahmkow G, Cassel M, Mayer F, Baur H
PLoS One. 2017 Mar 3;12(3):e0172334. doi: 10.1371/journal.pone.0172334. eCollection 2017.

BACKGROUND:
Foot orthoses are usually assumed to be effective by optimizing mechanically dynamic rearfoot configuration. However, the effect from a foot orthosis on kinematics that has been demonstrated scientifically has only been marginal. The aim of this study was to examine the effect of different heights in medial arch-supported foot orthoses on rear foot motion during gait.
METHODS:
Nineteen asymptomatic runners (36±11years, 180±5cm, 79±10kg; 41±22km/week) participated in the study. Trials were recorded at 3.1 mph (5 km/h) on a treadmill. Athletes walked barefoot and with 4 different not customized medial arch-supported foot orthoses of various arch heights (N:0 mm, M:30 mm, H:35 mm, E:40mm). Six infrared cameras and the `Oxford Foot Model´ were used to capture motion. The average stride in each condition was calculated from 50 gait cycles per condition. Eversion excursion and internal tibia rotation were analyzed. Descriptive statistics included calculating the mean ± SD and 95% CIs. Group differences by condition were analyzed by one factor (foot orthoses) repeated measures ANOVA (α = 0.05).
RESULTS:
Eversion excursion revealed the lowest values for N and highest for H (B:4.6°±2.2°; 95% CI [3.1;6.2]/N:4.0°±1.7°; [2.9;5.2]/M:5.2°±2.6°; [3.6;6.8]/H:6.2°±3.3°; [4.0;8.5]/E:5.1°±3.5°; [2.8;7.5]) (p>0.05). Range of internal tibia rotation was lowest with orthosis H and highest with E (B:13.3°±3.2°; 95% CI [11.0;15.6]/N:14.5°±7.2°; [9.2;19.6]/M:13.8°±5.0°; [10.8;16.8]/H:12.3°±4.3°; [9.0;15.6]/E:14.9°±5.0°; [11.5;18.3]) (p>0.05). Differences between conditions were small and the intrasubject variation high.
CONCLUSION:
Our results indicate that different arch support heights have no systematic effect on eversion excursion or the range of internal tibia rotation and therefore might not exert a crucial influence on rear foot alignment during gait.
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Craig Payne · Mar 4, 2017

I triple face palmed this study here;
http://www.itsafootcaptain.com/more-non-translatable-orthotic-research/

NewsBot · Aug 29, 2017

Analyzing the effect of Slipper cast and Circumferential wrap molding
in the manufacture of insoles on ankle kinematics in patients with
flexible flat foot
Hamiad Rezapour kordlou et al
Journal of Advanced Sport Technology 1(1):38-43

In this study, the kinematic effect of two molding methods in the manufacture of foot orthoses on ankle joint
was examined. The aim of this study was to determine a more beneficial method about ankle kinematics in the
manufacture of insoles for people with flexible flat foot. Ten males aged 19 to 27 years, with normal BMI and
normal gait pattern participated in this study, all of them had flexible flatfoot. Each person wearing special
shoes on three situations: stepped without the insole, with the Slipper cast insole and Circumferential wrap
method insole and in each situation completed a walk cycle. The kinematic data were collected and measured
for each subject under three assumed positions by VICON motion analysis system. For comparison and analysis
of three assumed situation, repeated measures test (ANOVA) was used. The results of this study show that the
use of two molding method, had no immediate effect on reducing the average maximum eversion angle of the
ankle. Eversion speed limit in the ankle was not affected by insole molding and no significant difference was
observed. Compared to the situation without insoles, insole with the Slipper cast and Circumferential wrap
molding method led to little difference in amplitude eversion. This study evaluated immediate effect of insoles.
Two custom foot orthotics intervention did not lead to significant decreases in maximum eversion angle of
ankle in the frontal plane.
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NewsBot · Dec 9, 2017

Effect of total-contact orthosis on medial longitudinal arch and lower extremities in flexible flatfoot subjects during walking.
Prachgosin T et al
Prosthet Orthot Int. 2017 Dec;41(6):579-586. doi: 10.1177/0309364617691621

BACKGROUND:
Total-contact orthosis (TCO) is one kind of foot orthosis (FO) that is used to adjust biomechanics in flexible flatfoot.
OBJECTIVE:
To determine the effects of a TCO on the MLA moment, MLA deformation angle and lower limb biomechanics.
STUDY DESIGN:
Cross-sectional study.
METHODS:
Seven-flatfoot and thirteen-normal foot subjects were recruited by footprint and radiographs. The biomechanics of subjects with normal foot (NF), flatfoot with shoe only (FWOT) and flatfoot with TCO (FWT) were collected in a 3D motion analysis laboratory and force plates. The MLA and lower limb biomechanics in each condition during specific sub-phases of stance were analyzed.
RESULTS:
The NF had larger MLA eversion moment after shod walking ( p = 0.001). The FWT condition compared with the FWOT condition had a significantly larger peak MLA upward moment ( p = 0.035) during pre-swing, larger peak knee external rotation angle ( p = 0.040) during mid stance, smaller peak knee extension moment during terminal stance ( p = 0.035) and a larger ground reaction force in the anterior-posterior direction during early stance ( p < 0.05).
CONCLUSION:
Our study found positive effects from the customized TCOs which included an increased TCO angle that led to a decreased peak MLA moment in the frontal plane in flexible flatfoot subjects during walking. Clinical relevance Lower limb biomechanics is different from normal in subjects with flexible flatfoot. The design of a TCO affects MLA, ankle and knee biomechanics and may be used to clinically correct biomechanical changes in flexible flatfoot.
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NewsBot · Oct 25, 2020

How Far an Arch Support Foot Orthosis Can Affect Lower Limb
Joint Angular Accelerations during Normal Gait?
Morteza Madadi-Shad et al
Journal of Advanced Sport Technology 4(2):11- 18 Received: June. 4, 2020; Accepted: September. 7, 2020

The purpose of this study was to determine how far an arch support foot orthosis can affect lower limb joint angular
accelerations during normal gait. In this study, sixteen male healthy volunteers were selected as participants. Subjects
performed 12 walking trials at a self-selected walking speed while 3-dimensional kinematic data were collected for two
conditions: shod with no orthoses, and shod with orthoses. Our results showed that the use of foot orthoses decreased
the peak ankle angular acceleration during dorsiflexion (p= 0.034). No significant difference was found in the values
of knee angular accelerations between the two walking conditions (p>0.05). Furthermore, the subjects experienced a
reduction in hip angular acceleration during extension in response to the application of foot orthoses (p=0.027). It seems
that the use of arch support foot orthoses is effective to improve lower limb kinematics during walking and it can
prevent overuse injuries in the lower extremity.
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NewsBot · Oct 25, 2020

The arch support insoles show benefits to people with flatfoot on stance time, cadence, plantar pressure and contact area
Yu-ping Huang , Hsien-Te Peng , Xin Wang, Zong-Rong Chen, Chen-Yi Song
PLOSOne: August 20, 2020

Background
Pes planus (flatfoot) is a common deformity characterized by the midfoot arch collapses during walking. As the midfoot is responsible for shock absorption, persons with flatfoot experience increased risk of injuries such as thumb valgus, tendinitis, plantar fasciitis, metatarsal pain, knee pain, lower-back pain with prolonged uphill, downhill, and level walking, depriving them of the physical and mental health benefits of walking as an exercise.

Methods
Fifteen female college students with flatfoot were recruited. A wireless plantar-pressure system was used to measure the stance time, cadence, plantar pressure, and contact area. Parameters were compared between wearing flat and arch-support insoles using a two-way repeated measures ANOVA with on an incline, decline, and level surface, respectively. The significance level α was set to 0.05. The effect size (ES) was calculated as a measure of the practical relevance of the significance using Cohen’s d.

Results
On the level surface, the stance time in the arch-support insole was significantly shorter than in the flat insole (p<0.05; ES = 0.48). The peak pressure of the big toe in the arch-support insole was significantly greater than in the flat insole on the uphill (p<0.05; ES = 0.53) and level surfaces (p<0.05; ES = 0.71). The peak pressure of the metatarsals 2–4 and the contact area of the midfoot in the arch-support insole were significantly greater than in the flat insole on all surfaces (all p< 0.05).

Conclusions
These results imply that wearing an arch-support insole provides benefits in the shortened stance time and generation of propulsion force to the big toe while walking on uphill and level surfaces and to the metatarsals 2–4 while walking on the level surface. More evenly distributed contact areas across the midfoot may help absorb shock during uphill, downhill and level walking.
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NewsBot · Oct 25, 2020

An individually moulded insole with 5-mm medial arch support reduces peak impact and loading at the heel after a one-hour treadmill run
Daniel T.P.Fong et al
Gait & Posture Volume 82, October 2020, Pages 90-95

Highlights
•Insole with medial arch support reduced heel impact in a one-hour treadmill run.
•However, it does not reduce the impact and load under the metatarsal regions.
•At the end of the run, loading shifted from metatarsal regions to medial mid-foot.
•This is caused by the arch support which spread the load over the plantar surface.
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Background
Foot pain experienced by long-distance runners could be relieved by functional insoles which aim at evenly distributing the plantar pressure.

Research question
We hypothesised that an individually moulded insole with medial arch support would reduce the impact and loading under the heel and metatarsal regions.

Methods
Twelve male recreational runners ran on a treadmill at 10 km/h for 1 hour with flat insoles and medial arch supported insoles. A pressure insole system (Novel Pedar, Germany) was used to obtain the peak pressure, peak force, time normalised pressure-time integrals, and the percentage of the total force-time integrals under 10 regions.

Results
Medial arch supported insoles reduced the peak force under the heel (medial: -15.3%, p = 0.001; lateral: -19.2%, p = 0.037) during the initial run, and reduced peak pressure under the heel (medial: -13.3%, p = 0.005; lateral: -9.9%, p = 0.006), and peak force under the medial heel (-17.8%, p = 0.006) after the run. The percentage of the total force-time integrals under the heel was reduced (medial: -23.8%, p = 0.004; lateral: -13.6%, p = 0.022) after the run. No significant difference was found under the metatarsal regions. There is shift of load from the metatarsal regions to the medial mid-foot as indicated by the change of the percentage of total force-time integrals.

Significance
Medial arch supported insoles were effective in reducing the impact and loading under the heel region in prolonged running on a treadmill.
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NewsBot · Oct 25, 2020

Main types of insoles described in the literature and their applicability for musculoskeletal disorders of the lower limbs: A systematic review of clinical studies
André Augusto Martines Teixeira Mendes et a;
July 10, 2020

The objective of this review was to identify the main types of insoles described in the literature that are used to treat musculoskeletal alterations of lower limbs and to analyze the existence of previous evaluation for the prescription of these insoles. To this end, two researchers, independently and blindly, searched the PubMed, SciELO, Bireme, MEDLINE, Lilacs, PEDro, Cochrane Library and Web of Science databases between June and July of 2018, from the free combination of the following descriptors: insoles, foot orthoses, foot, orthoses, musculoskeletal diseases and clinical trial. We included randomized or non-randomized clinical trials in which at least one intervention group used insoles and individuals with some type of musculoskeletal disorder had been sampled. Of the 227 documents identified in date bases, 20 were included in this review. In general, it is suggested to carry out more studies with more precise methods and that include evaluation before the prescription.
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