Predictors of the Biomechanical Effects of Customized Foot Orthoses in Adults With Flat-Arched Feet.

NewsBot · Jul 26, 2017

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Predictors of the Biomechanical Effects of Customized Foot Orthoses in Adults With Flat-Arched Feet.
Clin J Sport Med. 2017 Jul 21. doi: 10.1097/JSM.0000000000000461.
Arnold JB, May T, Bishop C.

OBJECTIVE:
To determine the potential presence and characteristics of biomechanical responders to customized foot orthoses during walking in adults with flat-arched feet.
DESIGN:
Experimental, repeated-measures.
SETTING:
University clinic and laboratory.
PARTICIPANTS:
Eighteen symptom-free adults with flat-arched feet.
INTERVENTIONS:
Customized foot orthoses.
MAIN OUTCOME MEASURES:
In-shoe foot biomechanics were measured during walking with and without customized foot orthoses using 3D analysis. Selected kinematic and kinetic variables during baseline walking were compared between subgroups who displayed reductions in calcaneal eversion with foot orthoses to those with no change or increases.
RESULTS:
Biomechanical responders displayed significantly greater peak calcaneal eversion (+2.2 degrees, P = 0.009). Time to peak calcaneal eversion (-11%, P = 0.006), peak dorsiflexion of the hallux (-6 degrees, P = 0.001), and medial-lateral excursion of the center of pressure during loading response were all reduced in the responder subgroup (-2 mm, P ≤ 0.001). Variables significantly different between subgroups were moderately associated with the response to foot orthoses (canonical correlation = 0.687, effect size = 0.47, P = 0.063).
CONCLUSIONS:
Individuals with increased dynamic foot pronation were more likely to show a favorable biomechanical response to customized foot orthoses, providing preliminary evidence to support the stratified use of foot orthoses to optimize their effectiveness.
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William Fowler · Jul 26, 2017

So a worse foot is more likely to respond biomechanically. What about clinically?

STfootcare · Jul 30, 2017

Makes sense - people with flexible flatfeet love support and crave more correction. I don't get the first line of the results though - Biomechanical responders displayed GREATER calcaneal eversion. ?

NewsBot · Jul 16, 2018

Influence and benefits of foot orthoses on kinematics, kinetics and muscle activation during step descent task
Douglas Bonifácio, Jim Richards, James Selfe, Sarah Curran
Gait and Posture; Article in Press

Highlights
•Orthopaedic insoles can change the kinematic, kinetic and EMG during a single step descent task.
•Medial wedged insoles can increase the knee adduction moment.
•Medial wedged insoles can reduce the work done by the abductor hallucis muscle.
•Wedges under rearfoot or rearfoot/forefoot produce similar biomechanical changes.
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Background
Medial wedged foot orthoses are frequently prescribed to reduce retropatellar stress in patients with patellofemoral pain (PFP) by controlling calcaneal eversion and internal rotation of the tibia. During activities of daily living, the highest patella loads occur during stair descent, but the effect of foot orthoses during stair descent remains unclear.

Research Question
The purpose of this study was to compare the kinematics, kinetics and muscle activation during a step descent task in healthy volunteers using three designs of foot orthoses (insoles).

Methods
Sixteen healthy subjects with a mean age of 25.7 years, BMI of 23.3, and +5 Foot Posture Index were recruited. Subjects performed a step down task from 20 cm using a 5o rearfoot medial wedge (R), a 5o rearfoot and forefoot medial wedge (R/F), and a control flat insole (C).

Results
Significant improvements in control were seen in the R and R/F insoles over the C insole in the foot and at the ankle and hip kinematics. The R and R/F insoles increased the knee adduction moments, but reduced knee internal rotation moment compared to the C insole. Adductor hallucis (AH) activity was reduced with both insoles, whereas tibialis anterior (TA) activity was reduced with the R insole only.

Significance
Foot orthoses can change joint mechanics in the foot and lower limbs providing greater stability and less work done by AH and TA muscles. This data supports the use of foot orthoses to provide functional benefits during step descent, which may benefit patients with PFP.
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William Fowler Active Member

STfootcare Member

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