Effects of foot orthotics on rearfoot motion

NewsBot · Feb 22, 2008

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Effect of medial arch-heel support in inserts on reducing ankle eversion: a biomechanics study.
Fong DT, Lam MH, Lao ML, Chan CW, Yung PS, Fung KY, Lui PP, Chan KM.
J Orthop Surg. 2008 Feb 20;3(1):7 [Epub ahead of print]

BACKGROUND: Excessive pronation (or eversion) at ankle joint in heel-toe running correlated with lower extremity overuse injuries. Orthotics and inserts are often prescribed to limit the pronation range to tackle the problem. Previous studies revealed that the effect is product-specific. This study investigated the effect of medial arch-heel support in inserts on reducing ankle eversion in standing, walking and running.

METHODS: Thirteen pronators and 13 normal subjects participated in standing, walking and running trials in each of the following conditions: (1) barefoot, and shod condition with insert with (2) no, (3) low, (4) medium, and (5) high medial arch-heel support. Motions were captured and processed by an eight-camera motion capture system. Maximum ankle eversion were calculated by incorporating the raw coordinates of 15 anatomical positions to a self-compiled Matlab program with kinematics equations. Analysis of variance with repeated measures with post-doc Tukey pairwise comparisons was performed on the data among the five walking conditions and the five running conditions separately.

RESULTS: Results showed that the inserts with medial arch-heel support were effective in dynamics trials but not static trials. In walking, they successfully reduced the maximum eversion by 2.1 degrees in normal subjects and by 2.5-3.0 degrees in pronators. In running, the insert with low medial arch support significantly reduced maximum eversion angle by 3.6 and 3.1 degrees in normal subjects and pronators respectively.

CONCLUSIONS: Medial arch-heel support in inserts is effective in reducing ankle eversion in walking and running, but not in standing. In walking, there is a trend to bring the over-pronated feet of the pronators back to the normal eversion range. In running, it shows an effect to restore normal eversion range in 84% of the pronators
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Admin2 · Feb 22, 2008

See:
Foot orthoses outcomes and kinematic changes

Robertisaacs · Feb 24, 2008

Thirteen pronators and 13 normal subjects
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Wow. Where did they find 13 peoples who did NOT pronate for the "normal" group?:confused:

Regards
Robert

NewsBot · Mar 22, 2008

Influence of orthotic devices prescribed using pressure data on lower extremity kinematics and pressures beneath the shoe during running.
Dixon SJ, McNally K.
Clin Biomech (Bristol, Avon). 2008 Mar 18 [Epub ahead of print]

BACKGROUND: Orthotic devices are frequently prescribed as a conservative treatment of lower extremity injury. The purpose of this study was to investigate the influence of orthotic devices prescribed using pressure data on lower extremity movement and loading patterns.

METHODS: Twenty-two subjects ran barefoot over a pressure plate for the prescription of orthotic devices. The influence of the prescribed orthoses on lower extremity kinematics and pressure beneath the shoe was assessed by collection of data for 10 running trials with a neutral shoe and 10 with the addition of the orthotic device. For each running trial, initial and peak angles were determined for rearfoot inversion-eversion, lower leg internal rotation, ankle dorsi-plantar flexion, knee flexion and rearfoot eversion velocity. In addition, the relative pressure on the lateral side to medial side of the shoe (pressure balance) was determined by dividing the foot into areas of medial and lateral heel and five metatarsals. Peak lateral and medial heel and foot balance were determined during early stance to indicate differences in balance during this phase.

FINDINGS: The orthotic devices resulted in a significant reduction in peak eversion and eversion velocity and a significant increase in the initial inversion angle (P<0.05). In addition, the peak ankle dorsi-flexion and initial dorsi-flexion angle were significantly increased (P<0.05). Consistent with the observed increase in initial inversion, the early pressure balance data revealed a significantly more lateral (less medial) concentration of pressure (P<0.05).

INTERPRETATION: It is concluded that the devices used in the present study have resulted in the production of shoe inserts that successfully lower peak eversion and eversion velocity by encouraging the foot to operate in a more inverted orientation throughout the initial stance phase of running. In addition, there is evidence that orthotic effects can be detected through the use of pressure data collected from beneath the shoe.
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