Foot Orthoses for posterior tibial tendon dysfunction

NewsBot · Nov 6, 2020

Members do not see these Ads. Sign Up.
Biomechanical effects of three types of foot orthoses in individuals with posterior tibial tendon dysfunction
DominicChicoine et al
Gait & Posture; 6 November 2020

Highlights
•Custom orthoses decreased foot and hindfoot eversion angle compared to PFO and shoe.
•Custom orthoses decreased ankle inversion moment compared to PFO and shoe.
•Custom orthoses decreased knee abduction moment compared to PFO and shoe.
•CVFO acted for a longer duration of change in the stance phase of gait than CFO.
Click to expand...

Background
Posterior tibial tendon dysfunction (PTTD) is characterized by degeneration of this tendon leading to a flattening of the medial longitudinal arch of the foot. Foot orthoses (FOs) can be used as a treatment option, but their biomechanical effects on individuals with PTTD are not yet fully understood.

Research question
The aim of this study was to investigate the effects of three types of FOs on gait biomechanics in individuals with PTTD.

Methods
Fourteen individuals were recruited with painful stage 1 or 2 PTTD based on Johnson and Strom’s classification. Quantitative gait analysis of the affected limb was performed in four conditions: shoes only (Shoe), prefabricated FO (PFO), neutral custom FO (CFO) and custom varus FO (CVFO) with a 5° medial wedge and a 4 mm medial heel skive. A curve analysis, using 1D statistical parametric mapping, was undertaken to assess differences in lower limb joint motion, joint moments and muscle activity over the stance phase of gait across conditions.

Results
Decreased hindfoot eversion angles, decreased ankle inversion moments and increased ankle eversion moments were observed with custom FOs compared to the Shoe and PFO conditions (p < 0.001). CFOs and CVFOs induced an increased knee adduction moment compared to Shoe (p < 0.001). No changes in hip kinematics and kinetics or in EMG activity of tested muscles were observed between conditions.

Significance
Custom orthoses may be more suitable than PFOs to decrease the pathological biomechanical outcomes observed in PTTD. Decreased ankle inversion moments during the stance phase could explain why custom orthoses are effective at reducing pain in PTTD patients. However, clinicians should be careful when prescribing custom orthoses for PTTD since unwanted collateral biomechanical effects can be observed at the knee.
Click to expand...

NewsBot · Nov 6, 2020

Related Threads:
Other threads on posterior tibial tendon dysfunction

NewsBot · Jun 22, 2021

Comparison of the effects of low level laser and insoles on pain, functioning, and muscle strength in subjects with stage 2 posterior tibial tendon dysfunction: A randomized study
Cansu Koltak, Yasin Yurt
J Back Musculoskelet Rehabil. 2021 Jun 18

Background: Low level laser therapy (LLLT) is known to be effective in tendinopathies. No study yet investigated the effect of LLLT on posterior tibial tendon dysfunction (PTTD) in comparison to orthotic treatment.

Objective: The aim was to compare the effects of LLLT and insole application on pain, function and muscle strength in subjects with stage 2 PTTD.

Methods: Fifty-two subjects with stage 2 PTTD were randomly assigned to the LLLT and insole groups. The foot pain, function and strength of invertor and evertor muscles of the subjects was evaluated before and after treatment, and after 9 months.

Results: Significant improvement was observed in the foot function and pain (p< 0.05) in both groups after treatment, but in the 9-month follow-up, the insole group had better values. The increase in 180∘.sec-1 concentric invertor muscle strength was found significant after the treatment and in month-9 as compared to the initial values (p< 0.05).

Conclusions: Both treatments are effective in reducing treating foot pain, as well as improving the function in subjects with stage 2 PTTD. However, at the end of the 9-month follow-up, it was seen that insoles were more effective. Neither method had a clinically important effect on muscle strength.
Click to expand...

NewsBot · Jan 19, 2022

Evidence for foot orthoses for adults with flatfoot: a systematic review
Minettchen Herchenröder, Denise Wilfling & Jost Steinhäuser
Journal of Foot and Ankle Research volume 14, Article number: 57 (2021)

Background
Flatfoot is characterised by the falling of the medial longitudinal arch, eversion of the hindfoot and abduction of the loaded forefoot. Furthermore, flatfoot leads to a variety of musculoskeletal symptoms in the lower extremity, such as knee or hip pain. The standard conservative treatment for flatfoot deformity is exercise therapy or treatment with foot orthoses. Foot orthoses are prescribed for various foot complaints. However, the evidence for the provision of foot orthoses is inconsistent. The aim of this systematic review is to synthesize the evidence of foot orthoses for adults with flatfoot.

Methods
A computerized search was conducted in August 2021, using the databases PubMed, Scopus, Pedro, Cochrane Library, and the Cochrane Central Register of Controlled Trials. Intervention studies of any design investigating the effects of foot orthoses were included, apart from case studies. Two independent reviewers assessed all search results to identify eligible studies and to assess their methodological quality.

Results
A total of 110 studies were identified through the database search. 12 studies met the inclusion criteria and were included in the review. These studies investigated prefabricated and custom-made foot orthoses, evaluating stance and plantar pressure during gait. The sample sizes of the identified studies ranged from 8 to 80. In most of the studies, the methodological quality was low and a lack of information was frequently detected.

Conclusion
There is a lack of evidence on the effect of foot orthoses for flatfoot in adults. This review illustrates the importance of conducting randomized controlled trials and the comprehensive development of guidelines for the prescription of foot orthoses. Given the weak evidence available, the common prescription of foot orthoses is somewhat surprising.
Click to expand...

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Foot Orthoses and Greater Trochanteric Pain Syndrome

Ankle-foot orthoses

Foot orthoses for first metatarsophalangeal joint osteoarthritis

Deformable Foot Orthoses Redistribute Power from the Ankle to the Distal Foot

The Impact of Foot Orthoses and Exercises on Pain and Navicular Drop for Adult Flatfoot

Effect by custom-made foot orthoses with added support under the first metatarsophalangeal joint

Plantar forefoot pain: ultrasound findings before and after treatment with custom-made foot orthoses

Share This Page