The Effect of an Antipronation Foot Orthosis on Ankle and Subtalar Kinematics
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Liu, Anmin; Nester, Christopher James; Jones, Richard Keith; Lundgren, Paul; Lund-berg, Arne; Arndt, Antony; Wolf, Peter
Medicine & Science in Sports & Exercise 10 September 2012
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Low injury rate strongly correlates with team success in football
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full text anyone?
I've been waiting for this one to come out for some time. I have to say on the basis of the abstract alone, I'm a little disappointed: which paradigm says the effects of foot orthoses occur only at the subtalar joint and are just kinematic in nature? I think it's pretty obvious that the kinetic effects of foot orthoses span multiple joints and that given the tri-planal motion available within the ankle mortice there will be potential for some kinematic effect here. A more interesting question is why some people show greater effect at one of the joints of the ankle complex than another? -
Unfortunately, the foot orthoses used were prefabricated orthoses.:confused:
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Sorry to be difficult - but I am not being so............. Why are you disapointed that the orthoses used were prefabricated? When one of my staff (Karl Llandorf) did a comparative study (admittedly on a narrow range - heel pain), I seem to remember that they were just as effective. The questionis this: is there any hard evidence, from correctly conducted RCT's, that bespoke orthoses are more effective for any particular symptoms than prefabs? I could do with knowing - I am teaching full time next year! Rob
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Here's a study as requested:
http://www.jrheum.org/content/32/5/943.short -
The effect of the foot orthoses was unsystematic- so the same orthosis has a different effect on different subjects. This is useful information. Now... will changing the orthoses have a different effect on the same subject???
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The reason I was somewhat disappointed about the use of prefab orthoses in this otherwise excellent study is that prefab orthoses are generally much more compressible, more deformable and they are all the same morphology when compared to custom foot orthoses made of, for example, polypropylene.
If these relatively deformable identically-shaped orthoses are now applied to three individuals with low arch, medium arch and high arch feet, the low arch foot will have a relatively high magnitude of pressure in the medial longitudinal arch (MLA), the medial arch foot will have a medium magnitude of pressure in the MLA and the high arch foot may have minimal pressure in the MLA. Therefore, since the prefab orthoses do no all exert the same plantar pressures in the MLA of all foot shapes, we would expect non-systematic changes in foot kinetics and kinematics due to the highly variable changes in MLA plantar pressure changes with use of these orthoses.
This is not to say that prefab orthoses are not helpful for many people, since I use them regularly, and find them sometimes very effective for my patients. However, I also routinely modify these prefab orthoses to more closely contour the MLA of my patients' feet since, after a quarter century of doing so, I know that they simply work better for the patient when I do so for them. Therefore, unless researchers account for the variable changes in contact pressures between the prefab orthosis and various regions of the plantar foot that would be expected with the use of such an in-shoe device in a number of subjects with non-identical foot morphology and foot function, they may not be able to adequately explain the results of their experiment.
Hope this helps.:drinks -
In Landorf's study, all of the orthoses used were custom-molded to the foot. If insoles are custom-molded to the foot then, by definition, they are custom foot orthoses, not prefab foot orthoses. -
Rob:
Here is another nicely done study comparing pre-made insoles to custom foot orthoses by a few of your own colleagues from Oz which show the superior therapeutic benefits of custom vs premade insoles.
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I`d like a copy? Feel like I`m missing the party.....
Thanks Kevin ;):drinks -
You may say that at least the orthoses are standardised when we perform a study using prefabricated devices. Be cognisant though that foot orthoses work by altering kinetics at the foot-orthosis interface and that they can only directly do this by: a) altering the surface topography at the foot-orthoses interface b) altering the load/ deformation characteristics at the foot- orthoses interface c) altering the frictional characteristics at the foot-orthosis interface. Together, these three characteristics are the orthoses prescription variables. Thus, if the subjects within a trial use different size versions of the prefabricated device, they may be getting a different prescription in terms of at least some of these variables. -
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least effective at reducing pressure." The study by Landorf et al used the following protocol:
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Place me in your stiff devices and record the kinetics as I walk; now place you in the same devices and record kinetics- different twixt me and thee, right?
Now place me in your compliant devices and record kinetics as I walk; now place you in the same devices and record kinetics- different twixt me and thee, right? Different within me in the two types of device too; different in you in the two types of device too.
But, it doesn't matter whether the devices are complaint or stiff, custom or prefabricated, the kinetic effects will be different in me and you. It's the inter-subject variation in the same devices I was referring to. Now, stop pretending you don't understand and get that meeting organised at the cabin. I could do with some California dreaming (Spooner is across the lake and Reno is just down the road). -
Thanks for better explaining yourself. That is what I wanted since you are ....... da man.:drinks -
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"However, I'm afraid that all of the seminar registrants would rather be hiking, fishing, exploring old gold mines and riding mountain bikes rather than discussing midfoot kinematics."
oooooh, field trips as well!! I can see the paper coming out from this.
"The carrying of 10lbs of gold in the pocket and its impact on the kinetics of foot function over rough terrain in minimalist footwear as opposed to barefoot or military boots whilst avoiding snakes or snake oilsmen" -
<
Low injury rate strongly correlates with team success in football
|
Carbon fibre as a foot orthotic material
>
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