Foot Orthotics for Hallux Valgus

NewsBot · Jun 7, 2015

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Biomechanical Evaluation of Custom Foot Orthoses for Hallux Valgus Deformity
Jesse F. Doty, MD, Richard G. Alvarez, MD, Timothy B. Ervin, MS, Ashley Heard, MSPO, CPO, John Gilbreath, CPO, Nicholas S. Richardson, MD
JFAS; Published Online: June 06, 2015

The purpose of the present study was to compare the hallux valgus deformity pressure parameters seen in standard footwear (no orthosis) versus the pressure observed in the same footwear with the addition of 3 different length orthoses. The forefoot pressure at a hallux valgus deformity was recorded with pressure sensors placed on the plantar, medial, and dorsal surface of the first metatarsal head. The participants performed walking trials without an orthosis and with orthoses of 3 different lengths. The average pressure and maximum pressure of each area was recorded for each orthosis, and comparisons were made across the groups. The plantar pressures were decreased in the full length and 3/4 length orthoses, and the dorsal pressures were increased with the use of the full-length and sulcus-length orthoses. Significant changes in medial pressure were not seen with the addition of any orthosis compared with standard footwear alone. However, a trend toward increased medial pressures was seen with the full- and sulcus-length orthoses, and the 3/4-length orthoses exhibited a trend toward decreased medial pressures. We were unable to demonstrate that the use of a custom foot orthosis significantly decreases the medial pressures on the first metatarsal head in patients with hallux valgus deformity. The 3/4-length orthosis was less likely to negatively affect the dorsal or medial pressures, which were noted to increase with the sulcus- and full-length orthoses. Our data suggest that if a clinician uses this treatment option, a 3/4-length orthosis might be a better choice than a sulcus- or full-length orthosis
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Admin2 · Dec 5, 2018

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Craig Payne · Jun 7, 2015

NewsBot said: ↑

The 3/4-length orthosis was less likely to negatively affect the dorsal or medial pressures, which were noted to increase with the sulcus- and full-length orthoses. Our data suggest that if a clinician uses this treatment option, a 3/4-length orthosis might be a better choice than a sulcus- or full-length orthosis
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Why would you want to do that for? What has those pressures got to do with the pathophysiology of hallux valgus? Why would changing those pressure have any impact on hallux valgus?

NewsBot · Dec 5, 2018

Efficacy of foot orthoses as nonoperative treatment for hallux valgus: A 2-year follow-up study.
Nakagawa R et al
J Orthop Sci. 2018 Nov 30. pii: S0949-2658(18)30326-9. doi: 10.1016/j.jos.2018.11.003

BACKGROUND:
The purpose of this study was to clarify the 2-year clinical and radiological outcomes of nonoperative treatment using foot orthosis for hallux valgus patients.

METHODS:
Patients who underwent nonoperative treatment using foot orthosis were surveyed prospectively. Foot orthoses were made by one certified orthotist using the standardized method. Pain and quality of life were evaluated using subjective and objective assessment measures at 3, 6, 12, 18, and 24 months. Furthermore, radiological outcomes, patient satisfaction, and adherence to treatment were surveyed.

RESULTS:
A total of 53 patients (50 women and 3 men; median age, 63 years) were included for analysis. The pain visual analogue scale score significantly decreased over time, with the lowest score observed at 12 months. The treatment effect was maintained over 24 months (median score, 52, 21, and 27 points at baseline, 12 months, and 24 months, respectively; P < .001). The Japanese Society for Surgery of the Foot hallux scale, American Academy of Orthopaedic Surgeons Foot and Ankle Scale, and 36-Item Short-Form Health Survey bodily pain subscale also improved, although the treatment effects were maximal at 6 months and decreased thereafter. At 24 months, 43 (81%) patients continued to use the orthosis, with the median visual analogue scale score for patient satisfaction of 76 points. The hallux valgus angle and intermetatarsal angle did not change during the 24-month period.

CONCLUSION:
Nonoperative treatment using foot orthoses decreased pain in patients with hallux valgus. The effect of treatment was maintained up to 2 years with a relatively high degree of patient satisfaction. However, treating physicians should inform patients to set realistic expectations and be aware that a limited degree of pain reduction is expected.
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NewsBot · Jun 27, 2022

Effects of Orthotic Correction of Hallux Valgus on Three-Dimensional Moments of Ankle Joint during Gait in Individuals with Hallux Valgus Deformity
Yongwook Kim
J Musculoskelet Sci Technol 2022; 6(1):1-7 Jun 30, 2022

Background
Although many different types of foot-toe orthoses have known to correct hallux valgus deformity, most previous studies focused on the effects of a foot-toe orthosis as a clinical intervention for hallux valgus (HV) on simple gait function or alignment of the foot and ankle joints.

Purpose
To investigate effects of a hard and soft type foot orthoses on three-dimensional (3D) kinetic moments of ankle joints known to contribute to ankle arthrosis in individuals with HV using a force platform system based on motion analysis during gait.

Study design
This was a repeated-measures design.

Methods
Kinetic 3D moment data were obtained from 26 participants with HV. Two force platforms were used to collect kinetic data in three different foot-toe orthosis conditions during free walking. Repeated-measures analysis of variance was used to determine the effect of each foot-toe orthosis condition on ankle moment variables.

Results
There were significant differences in the maximal plantar flexion moment, second peak eversion moment, and maximal external rotation moment occurred at the terminal stance phase of the ankle joints between without foot orthosis and hard foot orthosis conditions (p<0.05). In addition, there were significant differences in maximal plantar flexion moment occurred at the late stance phase during gait between without foot orthosis and soft foot orthosis conditions (p< 0.05).

Conclusions
The results indicated the potential relationship between HV deformity and ankle osteoarthrosis through increasing ankle moments at the terminal stance under the without foot-toe orthosis condition. Particularly, the application of a hard foot-toe orthosis could contribute to treatment and prevention of ankle osteoarthrosis as well as HV correction.
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NewsBot · Jan 16, 2023

Can a Biomechanical Foot Orthosis Affect Gait in Patients With Hallux Valgus? A Pilot Study
Ji Young Lee et al
Ann Rehabil Med. 2022 Dec;46(6):312-319

Objective: To investigate the effects of customized biomechanical foot orthosis (BFO) on kinematic data during gait in patients with hallux valgus (HV) deformities and compare the results with those of a normal control group.

Methods: Ten patients with HV deformities and 10 healthy volunteers were enrolled in this study. HV deformity was diagnosed using biomechanical and radiological assessments by a rehabilitation physician. Patients received the customized BFO manufactured at a commercial orthosis laboratory (Biomechanics, Goyang, South Korea) according to the strictly defined procedure by a single experienced technician. The spatiotemporal and kinematic data acquired by the Vicon 3D motion capture system (Oxford Metrics, Oxford, UK) were compared between the intervention groups (control vs. HV without orthosis) and between the HV groups (with vs. without orthosis).

Results: The temporal-spatial and kinematic parameters of the HV group were significantly different from those of the control group. After applying BFO to the HV group, significantly increased ranges of plantar flexion motion and hindfoot inversion were observed. Furthermore, the HV group with BFO showed improved gait cadence, walking speed, and stride length, although the results were not statistically significant.

Conclusion: Our results suggest that it is imperative to understand the pathophysiology of HV, and the application of customized BFO can be useful for improving kinematics in HV deformities.
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