The influence of insoles with a peroneal pressure point on the electromyographic activity of tibiali

NewsBot · Aug 22, 2016

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The influence of insoles with a peroneal pressure point on the electromyographic activity of tibialis anterior and peroneus longus during gait
Oliver LudwigEmail author, Jens Kelm and Michael Fr?hlich
Journal of Foot and Ankle Research20169:33

Background
Peroneus longus acts as a foot evertor and pronator, thus ensuring stability of the talocrural joint by curbing inversion movement of the rearfoot. Increased activation of the peroneus longus muscle in the stance phase could have a stabilising effect on the ankle joint. This study aimed to determine whether the activity of the peroneus longus muscle could be increased by the targeted use of a specially formed lateral pressure element in a customised orthopaedic insole.

Methods
This was a laboratory-based study that utilised a randomised crossover design. Thirty-four healthy participants walked along a walkway in neutral footwear wearing a control insole or a sensorimotor insole with a lateral pressure point adjacent to the tendon of the peroneus longus muscle. The electromyographic muscle activity of the peroneus longus and tibialis anterior muscles was measured using surface electromyography. Contact with the ground was recorded via two pressure sensors under the sole of the shoe. Muscle activity during the stance phase was analysed in the time and amplitude domains and compared statistically with paired t-tests for both insole types.

Results
In 27 out of the 34 participants, an additional activity peak of the peroneus longus muscle was observed in the loading response phase with the sensorimotor insole, which reached its maximum at 29.7 % (?4.5 %) of the stance phase. When averaged over all 34 participants, the integrated electromyographic output for the peroneus longus in the mid-stance phase revealed a significant higher activity (p < 0.001, post hoc power = 0.98, effect size: Cohen?s d = 0.71) with the sensorimotor insole (18.1 ? 11.3 % MVCs) than with the control insole (11.2 ? 7.7 % MVCs). No significant effects were established for the other gait phases or for the tibialis anterior.

Conclusions
An increase of muscle activity of the peroneus longus muscle was observed during the loading response and mid-stance phase, when orthopedic insoles with a lateral pressure point were worn. We conclude that the pressure point changes afferent information and leads to an increased peroneus longus activation in the time interval in which the pressure point exerted pressure on the peroneal tendon.
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NewsBot · Feb 15, 2022

Comparison of the Influence of Supportive and Sensorimotor Insoles in the Muscle Activity of Tibialis anterior and Peroneus longus in Combat Boots
Alexander Pascal-LaurentSchmitt et al
The Foot; Available online 11 February 2022, 101910

Highlights
•Muscular activity of tibialis anterior and peroneus longus is mainly reduced by arch supporting/correcting insoles.
•Sensorimotor insoles have no relevant effect in M. tibialis anterior but a moderate effect in M. peroneus longus during wearing combat boots.
•Shape and material of footwear overweigh the influence of sensorimotor insole on muscular activity in combat boots.
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Introduction
Flatfoot is a very common static deformity. It occurs frequently in soldiers and causes problems in the lower extremities. There is a lack of data regarding therapy with insoles, especially with sensorimotor insoles. The objective of this study was to investigate the influence in muscle activity of supporting/correcting and sensorimotor insoles in combat boots in the muscles of the lower limb and thus to draw conclusions according to the benefits of insole therapy in military footwear.

Methods
73 patients (12 female, 61 males; average age: 30.8 ± 7.9 years) with pes planovalgus deformity were included in this prospective randomized placebo-controlled study. For intervention supporting (N = 23), sensorimotor (N = 28) and placebo insoles (N = 22) were used.

During gait analysis muscle activity was measured by means of surface electromyography (EMG) of the tibialis anterior and peroneus longus muscle in combat boots with and without insoles. Statistical evaluation was performed using two-factor ANOVA with repeated measures.

Results
EMG measures (amplitude, integral, maximum, mean) showed mainly activating effects in the peroneus longus muscle in the case of sensorimotor and activity reductions in supporting insoles. Comparing effects of different kinds of insoles to the peroneus longus muscle, significant differences could be shown. No significant differences in muscular activation were observed for the tibialis anterior muscle.

Conclusion
Even in combat boots effects of sensorimotor insoles on the peroneus longus muscle can be detected. The expected effects, attributed to the different kinds of insole, could be observed, too. While sensorimotor insoles had an activating kind of effect, supportive insoles reduced muscular activity of the peroneus longus. In contrast for the tibialis anterior muscle no clear conclusion could be drawn. Its muscular activity seems not to be influenced by insoles in combat boots. However, it remains unclear whether clinical long term effects, e.g. pain and function, can be improved.
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NewsBot · Jan 17, 2024

Comparison of the Influence of Supportive and Sensorimotor Insoles on Flat Feet in Children - a Double-Blind, Prospective, Randomized, Controlled Trial
Kira-Henriette Liebau et al
Ortop Traumatol Rehabil. 2023 Aug 31;25(4):195-206.

Background: Besides arch-supportive insoles, sensorimotor insoles are used for the treatment of flatfoot in children. The aim of this study was to compare the effect of both types of insoles on the arch-supporting muscles and clinical aspects in children with flexible flatfoot.

Material and methods: 52 children with flexible flatfoot (mean age of 8.22.7 years) were enrolled. Supportive, sensorimotor, and placebo insoles were compared. Muscle activity was detected by surface electromyography during the midstance phase. Valgus index, foot and ankle disability index (FADI) and pain were assessed at enrolment and after 6 and 12 months. Mixed-design ANOVA was used for statistical evaluation.

Results: Supportive and sensorimotor insoles caused significantly lower activity in the tibialis anterior in comparison to placebo insoles regarding the parameter Mean. No significant differences could be detected between both types of therapeutic insoles. Supportive insoles showed a significant decrease regarding the parameter Amplitude of the peroneus longus. Placebo insoles produced an increase in the valgus index, while both therapeutic insoles did not induce any changes. The sensorimotor insoles induced an increase in FADI, while the supportive and placebo insoles had no significant effect on this parameter.

Conclusions: 1. Supportive and sensorimotor insoles potentially influence muscle activity in the lower leg. 2. Both could influence the longitudinal arch in flat feet. 3. While placebo insoles caused a deterioration of the valgus index, both kinds of therapeutic insoles could possibly prevent the progression of the flatfoot. 4. Clinical studies including more clinical aspects and long-term observations are necessary.
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