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Foot orthotics & Parkinson's Disease

Discussion in 'General Issues and Discussion Forum' started by TOC, Jun 4, 2010.

  1. TOC

    TOC Member

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    Hello fellow Pods & Orthotists,

    I have a patient with Parkinson's at the moment with severe pes planovalgus feet and subsequent plantar fascia issues. I have determined that she would be stable should orthoses be made to accommodate her situation, however a colleague of mine has mentioned that foot orthoses are contraindicated for patients suffering from Parkinson's. Any thoughts any of you have on this matter would be greatly appreciated.

  2. Craig Payne

    Craig Payne Moderator

    Re: Orthotics & Parkinson's

    I have never heard of that before and can not think of any reason why they would be contraindicated.
  3. Admin2

    Admin2 Administrator Staff Member

  4. DaVinci

    DaVinci Well-Known Member

    Re: Orthotics & Parkinson's

    News to me as well. I have used them lots of times in people with Parkinsons.

    TOC, can you get your colleague to explain their rantionale and come back and tell us what it is?
  5. TOC

    TOC Member

    Thank you for your replies, I will hopefully get a chance to speak to my colleague again soon. Just your your info, he is a local GP, and I think he may be a little bit from the old school :)

    Although I have successfully treated several patients with PD over the years, his comment threw me a little bit, so I will get back to you all because I too would to know the reasoning behind his comments.

  6. TOC:

    Foot orthoses can be quite helpful for patients with most neurological diseases that affect gait function, including Parkinson's disease. In fact, some of the most profound cases of therapeutic benefit of foot orthoses in my quarter century of clinical practice have come in my treatment of neurologically induced abnormal gait patterns, such as from multiple sclerosis and Parkinson's disease with custom foot orthoses.

    In most neurological gait patterns, the addition of a slight forefoot valgus wedge with only mild support of the medial longitudinal arch can make a huge difference in gait stability for these patients, causing a reduced base of gait, a increased stride length and a perception of increased gait stability. There is a great potential for this type of therapy for podiatrists that is virtually untapped due to a lack of knowledge and teaching of the neurological effects of foot orthoses within our profession. More research validation of the therapeutic benefits of this type of approach is sorely needed within the scientific literature.
  7. CamWhite

    CamWhite Active Member

    I agree. Interestingly enough, Z-CoiL shoes, coupled with the right orthotic support have been very effective for many people with Parkinson's disease in our store. I have actually witnessed tremors reducing as people walked in the shoes.

    I asked a neurologist about this phenomenon, and he remarked that tremor activity is heightened by physical and emotional stress. Since the Z-CoiL shoes reduce GRF forces by 50%*, the physical trauma of walking to the skeletal frame is dramatically reduced. I am not a scientist, but his rationale made sense to me. Our Parkinson's patients (not very many) swear by these shoes.

    *The Z-CoiL shoes reduce GRF forces by 50% according to a studies performed by the US Dept. of Energy, Los Alamamos and Sandia National Laboratories.
  8. Cam:

    I would be interested in what your gait observations of these patients would be with a 1/8" reverse Morton's extension added to the plantar aspect of the Z-coil sockliner. Haven't yet suggested Z-coils for my Parkinson's patients but I would like to see a video of this if you ever get a chance. Very interesting.
  9. CamWhite

    CamWhite Active Member


    I am going back a couple of years, and my memory is dim. We don't routinely see Parkinson's patients in our store. To your point, a 1/8" reverse Morton's extension, Cluffy Wedge or similar modification could be helpful for the individual described in this post.

    What was most striking was watching the customers walking in the Z-CoiL shoes. Their gait was more steady and fluid. But what was more interesting was watching their hand tremors. The tremors diminished dramatically.

    I shared this information with several other Z-CoiL distributors, and they reported similar observations. That prompted my discussion with my neurologist friend.

    I personally believe that impact reduction can make a huge impact on Parkinson's disease. I also believe, based on personal observation, that it can be helpful for MS, Lupus and similar conditions. By no means a cure, but it makes life more bearable.
  10. myfootdr

    myfootdr Welcome New Poster

    TOC, I would be interested in your friend's reasoning as to why orthotics are contraindicated in patients with Parkinson's. i sukspect he is thinking that Parkinson's tremors might cause problems with standing or gait and that orthotics interfere with that somehow. To me, that does not make much sence. In fact, just the opposite seems true. If we balance the gait it should help stabilize people with tremors which might cause balance problems.
    Dave Cornell, Omaha NE
  11. cdm2333

    cdm2333 Welcome New Poster

    Hi guys:)
    Are there any useful articles / evidence regarding the use Of orthotics with patients with Parkinson's? Especially those who are active eg: running :)
    Thank u:)
  12. Craig Payne

    Craig Payne Moderator

    I not aware of any. If there are any, they probably would get added to this thread.
  13. NewsBot

    NewsBot The Admin that posts the news.

    This clinical trial was just registered:

    Orthotics and Parkinson's Disease: The Acute and Long-term Effects of Increased Somatosensory Feedback
  14. NewsBot

    NewsBot The Admin that posts the news.

    Effects of a sensory-motor orthotic on postural instability rehabilitation in Parkinson's disease: a pilot study.
    Volpe D et al
    J Clin Mov Disord. 2017 Jul 6;4:11. doi: 10.1186/s40734-017-0058-y. eCollection 2017.

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