Journal articles on the topic 'In-shoe orthoses'
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Illgner, Ulrich, Tymo Budny, Marc Hoyer, and Hans Henning Wetz. "Clinical Acceptance, Reasons for Rejection, and Reduction of In-Shoe Peak Pressure with Interdigital Silicone Orthoses." Journal of the American Podiatric Medical Association 104, no. 1 (January 1, 2014): 30–33. http://dx.doi.org/10.7547/0003-0538-104.1.30.
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Background For several years, confectioned or customized interdigital silicone orthoses have been used to treat toe malformations; however, long-term clinical and biomechanical studies are missing. The aim of this study was to evaluate the biomechanical effects of these orthoses and their clinical acceptance. Methods In 2008, 46 patients (30 women and 16 men; average age, 56.8 years) received interdigital silicone orthoses. All of the patients were included in the biomechanical and clinical study. Compliance and acceptance were measured by the Muenster shoe and foot questionnaire, which includes 13 items on pain, activities of daily living, satisfaction, and activity. Mean follow-up was 18 months. Ten feet (eight patients) were chosen by random and underwent pedobarography. One forefoot sensor and two single sensors were attached between the skin and the orthosis. Measurements were performed in-shoe three times with and without the orthosis without removal of the sensors. Results Forty-four of the 46 patients (95.7%) were included. At the 18-month investigation, 19 patients no longer used their orthoses, most commonly because of pain and failure of the material. Twenty-two patients regularly used their orthoses (8 h/d on average). In-shoe peak pressure lowered significantly with orthosis use (P < .04). Patients who used the orthoses were mostly satisfied. Conclusions Interdigital silicone orthoses reduce in-shoe peak pressure. Patient satisfaction was good. The durability of the material has to be optimized, and manufacturing remains difficult. The effect on ulcer reduction must be evaluated in a large prospective study.
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Spooner, Simon K., David K. Smith, and Kevin A. Kirby. "In-Shoe Pressure Measurement and Foot Orthosis Research." Journal of the American Podiatric Medical Association 100, no. 6 (November 1, 2010): 518–29. http://dx.doi.org/10.7547/1000518.
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Foot orthoses are believed to exert their therapeutic effect on the human locomotor apparatus by altering the location, magnitude, and temporal patterns of ground reaction forces acting on the plantar foot during weightbearing activities. In-shoe pressure-measurement systems are increasingly being used by clinicians and researchers to assess kinetic changes at the foot-orthosis interface to better understand the function of foot orthoses and to derive more efficacious treatments for many painful foot and lower-extremity abnormalities. This article explores how the inherent three-dimensional surface topography and load-deformation characteristics of foot orthoses may challenge the validity, reliability, and clinical usefulness of the data obtained from in-shoe pressure-measurement systems in the context of foot orthotic therapy and research. The inability of in-shoe pressure-measurement systems to measure shearing forces beneath the foot, the required bending of the flat two-dimensional sensor insole to fit the pressure insole to the three-dimensional curves of the orthosis, the subsequent unbending of the sensor insole to display it on a computer monitor, and variations in the load-deformation characteristics of orthoses are all sources of potential error in examination of the kinetic effects of foot orthoses. Consequently, caution is required when interpreting the results of orthotic research that has used in-shoe pressure insole technology. The limitations of the technology should also be given due respect when in-shoe pressure measurement is used to make clinical decisions and prescribe custom foot orthoses for patients. (J Am Podiatr Med Assoc 100(6): 518–529, 2010)
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Arvin, Mina, Mojtaba Kamyab, Vahideh Moradi, Behnam Hajiaghaei, and Nader Maroufi. "Influence of modified solid ankle-foot orthosis to be used with and without shoe on dynamic balance and gait characteristic in asymptomatic people." Prosthetics and Orthotics International 37, no. 2 (August 20, 2012): 145–51. http://dx.doi.org/10.1177/0309364612454159.
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Background: Ankle-foot orthoses are usually used in combination with footwear. Shoe design can have a significant effect on kinematics of the lower limb joints and line of action of the ground reaction force during walking. But, ankle-foot orthosis–footwear combination is not appropriate for indoor barefoot walking in some Asian cultures. In this study, we have modified a solid ankle-foot orthosis in order to set it in the same position as a solid ankle-foot orthosis–footwear combination. Objective: To investigate the effect of a modified solid ankle-foot orthosis; a solid ankle-foot orthosis which can be locked in different positions on gait and balance performance in comparison with a conventional solid ankle-foot orthosis, a common solid ankle-foot orthosis–shoe combination in asymptomatic adults. Study Design: Cross sectional. Methods: Two standard solid ankle-foot orthoses were manufactured with the ankle joint in neutral position. Then, one of these solid ankle-foot orthoses was modified in order to allow locking in a different alignment. Walk across, limit of stability, and sit-to-stand tests of the balance master system were performed while participants wore the modified solid ankle-foot orthosis aligned in 5°–7° anterior inclination without a shoe and a conventional solid ankle-foot orthosis–shoe combination. Results: There was no significant change in walking speed, step length, and step width with the conventional and modified solid ankle-foot orthoses. In addition, movement velocity and maximum excursion of the center of gravity during the limit of stability test were not different, although the maximal forward excursion of the center of gravity was longer when wearing the modified solid ankle-foot orthosis compared to the conventional solid ankle-foot orthosis–shoe combination ( P = 0.000). Sway velocity of the center of gravity did not change during the sit-to-stand test. Conclusion: The results demonstrated that the modified solid ankle-foot orthosis had the same effects as the conventional solid ankle-foot orthosis–shoe combination on the gait and balance performance of asymptomatic adults. Clinical relevance The findings of the present study can be used as the basis for further investigations on the efficacy of the modified solid ankle-foot orthoses in different neuromuscular populations in order to help people who do not wear shoes at home, as is the custom in some Asian cultures.
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Condie, David N. "In-shoe orthoses." Current Opinion in Orthopaedics 9, no. 6 (December 1998): 100–104. http://dx.doi.org/10.1097/00001433-199812000-00018.
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Brown, Melanie, Sally Rudicel, and Alberto Esquenazi. "Measurement of Dynamic Pressures at the Shoe-Foot Interface During Normal Walking with Various Foot Orthoses Using the FSCAN System." Foot & Ankle International 17, no. 3 (March 1996): 152–56. http://dx.doi.org/10.1177/107110079601700306.
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Foot orthoses are routinely used in clinical practice to redistribute pressure at the shoe-foot interface, although there is very little scientific evidence to support the efficacy of their use. In this study, the FSCAN sensor (an ultrathin in-shoe transducer) was used to determine the efficacy of pressure redistribution with a Plastizote, Spenco, cork, and a plastic foot orthosis as compared with control (no orthosis). Measurement variations of up to 18% occurred between sensors, and changes in stance time of up to 5% occurred between the orthoses and the control conditions. In spite of these potentially confounding variables, statistically significant differences in peak pressure between the orthotic types and the control condition (range, 9–146%) were noted. We conclude that Plastizote, cork, and plastic foot orthoses can be beneficial in relieving pressure in certain regions of the shoe-foot interface, but that they may do so at the cost of increasing pressure in other areas of the plantar surface.
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Imhauser, Carl W., Nicholas A. Abidi, David Z. Frankel, Kenneth Gavin, and Sorin Siegler. "Biomechanical Evaluation of the Efficacy of External Stabilizers in the Conservative Treatment of Acquired Flatfoot Deformity." Foot & Ankle International 23, no. 8 (August 2002): 727–37. http://dx.doi.org/10.1177/107110070202300809.
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This study quantified and compared the efficacy of in-shoe orthoses and ankle braces in stabilizing the hindfoot and medial longitudinal arch in a cadaveric model of acquired flexible flatfoot deformity. This was addressed by combining measurement of hindfoot and arch kinematics with plantar pressure distribution, produced in response to axial loads simulating quiet standing. Experiments were conducted on six fresh-frozen cadaveric lower limbs. Three conditions were tested: intact-unbraced; flatfoot-unbraced; and flatfoot-braced. Flatfoot deformity was created by sectioning the main support structures of the medial longitudinal arch. Six different braces were tested including two in-shoe orthoses, three ankle braces and one molded ankle-foot orthosis. Our model of flexible flatfoot deformity caused the calcaneus to evert, the talus to plantarflex and the height of the talus and medial cuneiform to decrease. Flexible flatfoot deformity caused a pattern of medial shift in plantar pressure distribution, but minimal change in the location of the center of pressure. Furthermore, in-shoe orthoses stabilized both the hindfoot and the medial longitudinal arch, while ankle braces did not. Semi-rigid foot and ankle orthoses acted to stabilize the medial longitudinal arch. Based on these results, it was concluded that treatment of flatfoot deformity should at least include use of in-shoe orthoses to partially restore the arch and stabilize the hindfoot.
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Payehdar, Somaieh, Hassan Saeedi, Amir Ahmadi, Mohammad Kamali, Maryam Mohammadi, and Vahid Abdollah. "Comparing the immediate effects of UCBL and modified foot orthoses on postural sway in people with flexible flatfoot." Prosthetics and Orthotics International 40, no. 1 (June 18, 2014): 117–22. http://dx.doi.org/10.1177/0309364614538091.
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Background: Different types of foot orthoses have been prescribed for patients with flatfoot. Results of several studies have shown that orthoses were able to change balance parameters in people with flatfoot. However, the possible effect of orthosis flexibility on balance has not yet been investigated. Objectives: The aim of the current study was to investigate the immediate effect of a rigid University of California Berkeley Laboratory (UCBL) foot orthosis, a modified foot orthosis, and a normal shoe on the postural sway of people with flexible flatfoot. Study design: Quasi-experimental. Methods: In all, 20 young adults with flatfoot (aged 23.5 ± 2.8 years) were invited to participate in this study. The Biodex Stability System was employed to perform standing balance tests under three testing conditions, namely, shoe only, UCBL, and modified foot orthosis. Total, medial–lateral, and anterior–posterior sway were evaluated for each condition. Results: The results of this study revealed no statistical difference in the medial–lateral and anterior–posterior stability indices between foot orthoses and shoed conditions. The overall stability index with the UCBL foot orthosis, however, was significantly lower than that with the modified foot orthosis. Conclusion: The UCBL foot orthosis was able to decrease total sway and improve balance in people with flexible flatfoot. Clinical relevance Results of previous studies have indicated that foot orthoses were able to affect the balance of people with flatfeet. However, the possible effects of flexible orthoses on balance have not been examined. The results of this study may provide new insight into material selection for those people with balance disorders.
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Guldemond, Nick A., Pieter Leffers, Antal P. Sanders, Hans Emmen, Nicolaas C. Schaper, and Geert H. I. M. Walenkamp. "Casting Methods and Plantar Pressure." Journal of the American Podiatric Medical Association 96, no. 1 (January 1, 2006): 9–18. http://dx.doi.org/10.7547/0960009.
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Foot orthoses are widely used to treat various foot problems. A literature search revealed no publications on differences in plantar pressure distribution resulting from casting methods for foot orthoses. Four casting methods were used for construction of orthoses. Two foam box techniques were used: accommodative full weightbearing method (A) and functional semiweightbearing method (B). Also, two suspension plaster casting techniques were used: accommodative casting (C) and functional subtalar joint neutral position (Root) method (D). Their effects on contact area, plantar pressure, and walking convenience were evaluated. All orthoses increased the total contact area (mean, 17.4%) compared with shoes without orthoses. Differences in contact areas between orthoses for total plantar surface were statistically significant. Peak pressures for the total plantar surface were lower with orthoses than without orthoses (mean, 22.8%). Among orthoses, only the difference between orthoses A and B was statistically significant. Differences between orthoses for the forefoot were small and not statistically significant. The gait lines of the shoe without an insole and of the accommodative orthoses are more medially located than those of functional orthoses. Walking convenience in the shoe was better rated than that with orthoses. There were no differences in perception of walking convenience between orthoses A, B, and C. Orthosis D had the lowest convenience rating. The four casting methods resulted in differences between orthoses with respect to contact areas and walking convenience but only slight differences in peak pressures. (J Am Podiatr Med Assoc 96(1): 9–18, 2006)
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Aminian, Gholamreza, Zahra Safaeepour, Mahboobeh Farhoodi, Abbas Farjad Pezeshk, Hassan Saeedi, and Basir Majddoleslam. "The effect of prefabricated and proprioceptive foot orthoses on plantar pressure distribution in patients with flexible flatfoot during walking." Prosthetics and Orthotics International 37, no. 3 (October 19, 2012): 227–32. http://dx.doi.org/10.1177/0309364612461167.
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Background:Previous studies have suggested that orthoses with different constructions could alter gait parameters in flexible flatfoot. However, there is less evidence about the effect of insoles with proprioceptive mechanism on plantar pressure distribution in flatfoot.Objectives:To assess the effect of orthoses with different mechanisms on plantar pressure distribution in subjects with flexible flatfoot.Study Design:Quasi-experimental.Methods:In total, 12 flatfoot subjects were recruited for this study. In-shoe plantar pressure in walking was measured by Pedar-X system under three conditions including wearing the shoe only, wearing the shoe with a proprioceptive insole, and wearing the shoe with a prefabricated foot insole.Results:Using the proprioceptive insoles, maximum force was significantly reduced in medial midfoot, and plantar pressure was significantly increased in the second and third rays (0.94 ± 0.77 N/kg, 102.04 ± 28.23 kPa) compared to the shoe only condition (1.12 ± 0.88 N/kg and 109.79 ± 29.75 kPa). For the prefabricated insole, maximum force was significantly higher in midfoot area compared to the other conditions ( p < 0.05).Conclusions:Construction of orthoses could have an effect on plantar pressure distribution in flatfeet. It might be considered that insoles with sensory stimulation alters sensory feedback of plantar surface of foot and may lead to change in plantar pressure in the flexible flatfoot.Clinical relevanceBased on the findings of this study, using orthoses with different mechanisms such as proprioceptive intervention might be a useful method in orthotic treatment. Assessing plantar pressure can also be an efficient quantitative outcome measure for clinicians in evidence-based foot orthosis prescription.
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Palamarchuk, HJ, and J. Fry. "In-shoe casting technique for specialized sports shoes." Journal of the American Podiatric Medical Association 79, no. 9 (September 1, 1989): 462–65. http://dx.doi.org/10.7547/87507315-79-9-462.
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The use of vacuum casting to create better-fitting orthoses for special athletic shoes has been discussed. By vacuum-forming a negative cast within the confines of special athletic shoes, such as bicycling cleats or fencing shoes, a better-fitting orthosis can be fabricated with little or no special adjustments or modifications necessary to create the best fit and function.
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McPoil, TG, and MW Cornwall. "Variability of the center of pressure pattern integral during walking." Journal of the American Podiatric Medical Association 88, no. 6 (June 1, 1998): 259–67. http://dx.doi.org/10.7547/87507315-88-6-259.
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The objective of this study was to measure the between-trial variability of the center of pressure pattern integral (COPPI) at the shoe-floor interface and within the shoe. Ten trials of the COPPI were recorded simultaneously at the shoe-floor interface and within the shoe as ten subjects walked over ground in standardized footwear and with two types of foot orthoses. While the results showed that the within-shoe shoe-only and soft orthoses conditions caused the greatest decrease in the COPPI, it was extremely inconsistent-between trials, whether measured at the shoe-floor interface or within the shoe. This suggests that the COPPI is not an acceptable method of assessing the effectiveness of foot orthoses.
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Farzadi, Maede, Zahra Safaeepour, Mohammad E. Mousavi, and Hassan Saeedi. "Effect of medial arch support foot orthosis on plantar pressure distribution in females with mild-to-moderate hallux valgus after one month of follow-up." Prosthetics and Orthotics International 39, no. 2 (February 10, 2014): 134–39. http://dx.doi.org/10.1177/0309364613518229.
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Background:Higher plantar pressures at the medial forefoot are reported in hallux valgus. Foot orthoses with medial arch support are considered as an intervention in this pathology. However, little is known about the effect of foot orthoses on plantar pressure distribution in hallux valgus.Objectives:To investigate the effect of a foot orthosis with medial arch support on pressure distribution in females with mild-to-moderate hallux valgus.Study design:Quasi-experimental.Methods:Sixteen female volunteers with mild-to-moderate hallux valgus participated in this study and used a medial arch support foot orthosis for 4 weeks. Plantar pressure for each participant was assessed using the Pedar-X®in-shoe system in four conditions including shoe-only and foot orthosis before and after the intervention.Results:The use of the foot orthosis for 1 month led to a decrease in peak pressure and maximum force under the hallux, first metatarsal, and metatarsals 3–5 ( p < 0.05). In the medial midfoot region, peak pressure, maximum force, and contact area were significantly higher with the foot orthosis than shoe-only before and after the intervention ( p = 0.00).Conclusion:A foot orthosis with medial arch support could reduce pressure beneath the hallux and the first metatarsal head by transferring the load to the other regions. It would appear that this type of foot orthosis can be an effective method of intervention in this pathology.Clinical relevanceFindings of this study will improve the clinical knowledge about the effect of the medial arch support foot orthosis used on plantar pressure distribution in hallux valgus pathology.
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Aboutorabi, Atefeh, Hassan Saeedi, Mohammad Kamali, Behshid Farahmand, Arezoo Eshraghi, and Roghaye S. Dolagh. "Immediate effect of orthopedic shoe and functional foot orthosis on center of pressure displacement and gait parameters in juvenile flexible flat foot." Prosthetics and Orthotics International 38, no. 3 (August 28, 2013): 218–23. http://dx.doi.org/10.1177/0309364613496111.
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Background:Flat foot in children is a common deformity in which the medial longitudinal arch is reduced or eliminated.Objectives:The objective of this article was to compare flat foot and healthy children on the displacement of the center of pressure and walking parameters in children with two common orthoses (functional foot orthosis and medical shoe).Study design:Comparative study.Methods:This study included 30 children with flat foot and 20 healthy children as a control group. The step length and width, walking velocity, symmetry, and center of pressure (CoP) displacements were recorded and compared for three conditions: functional foot orthosis and regular shoe, a medical shoe and barefoot.Results:The results from the CoP displacements showed that the regular shoe with functional foot orthosis caused a significant decrease in the level of displacement of the CoP in flat foot children. The findings indicated a significant improvement in symmetry of steps and walking speed with the functional foot orthosis in comparison to the medical shoe in flat foot children.Conclusion:The CoP displacement was decreased and the percentage of gait symmetry and walking speed were increased by the use of regular shoes with a functional foot orthosis in comparison to the medical shoes.Clinical relevanceAn orthopaedic shoe can be expensive, and in particular heavy with most children reluctant to wear it. This study focussed on the CoP displacement and selected gait parameters with an orthopaedic shoe and functional foot orthosis, and showed that a combined prescription of a functional foot orthosis and with regular shoes may be a useful alternative for children with moderate flat foot.
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Kavlak, Yasemin, Fatma Uygur, Cengiz Korkmaz, and Nilgün Bek. "Outcome of Orthoses Intervention in the Rheumatoid Foot." Foot & Ankle International 24, no. 6 (June 2003): 494–99. http://dx.doi.org/10.1177/107110070302400608.
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This study was carried out to determine the effect of foot orthoses on pain, gait, and energy expenditure in patients with rheumatoid arthritis. Eighteen patients were evaluated for these parameters. Each patient was given a foot insert or shoe modification suitable for his or her foot deformity. Following 3 months of orthosis use, a significant difference was found in regards to pain ( p <.05), step length and stride length ( p <.05), and physiological cost index ( p <.05). The results suggest that foot orthoses are an important feature in the rehabilitation of the rheumatoid foot.
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Chao, Wen, Keith L. Wapner, Thomas H. Lee, Jeffrey Adams, and Paul J. Hecht. "Nonoperative Management of Posterior Tibial Tendon Dysfunction." Foot & Ankle International 17, no. 12 (December 1996): 736–41. http://dx.doi.org/10.1177/107110079601701204.
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Forty-nine patients with posterior tibial tendon dysfunction (4 patients had bilateral involvement) were treated with orthoses. Forty feet were treated with molded ankle-foot orthoses, and 13 feet were treated with University of California Biomechanics Laboratory shoe inserts with medial posting. A total of 37 women and 12 men were included in the study. The mean follow-up period was 20.3 months (range, 8–60 months). The average age of the patients was 66 years (range, 42–89 years). Sixty-seven percent of patients had good to excellent results, according to a functional scoring system based on pain, function, use of assistive device, distance of ambulation, and patient satisfaction. The average period of orthosis use was 14.9 months (range, 1.5–29 months), with an average length of daily orthosis wear of 12.3 hours. One patient elected to undergo surgical treatment rather than continuing with long-term orthosis use. Thirty-three percent of patients had discountinued using the orthosis at the time of follow-up evaluation. Three patients were unable to wear the orthosis because of concurrent medical conditions. Nine patients stopped wearing the orthosis after experiencing discomfort and inconvenience. Although these patients continued to exhibit signs and symptoms of posterior tibial tendon dysfunction, they were not disabled enough to consider further treatment. Four patients tolerated orthosis treatment poorly and were treated surgically. Patients with posterior tibial tendon dysfunction can be treated by aggressive nonoperative management using molded ankle-foot orthoses or University of California Biomechanics Laboratory shoe inserts with medial posting. Surgical treatment can be reserved for patients who fail to respond to an adequate trial of brace treatment. Nonoperative management using an orthosis is particularly useful for elderly patients with a sedentary lifestyle or for patients at high risk because of medical problems.
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Ekenman, Ingrid, Charles Milgrom, Aharon Finestone, Michal Begin, Carin Olin, Toni Arndt, and David Burr. "The Role of Biomechanical Shoe Orthoses in Tibial Stress Fracture Prevention." American Journal of Sports Medicine 30, no. 6 (November 2002): 866–70. http://dx.doi.org/10.1177/03635465020300061801.
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Background Biomechanical orthoses have been shown to lower stress fracture incidence in infantry recruits. However, these results may not be applicable to running athletes. Hypothesis Training in either running shoes or military boots with custom biomechanical shoe orthoses lessens tibial bone strains and strain rates during walking and running. Study Design Randomized controlled laboratory study. Methods In vivo strain measurements were made in nine subjects to determine whether the use of biomechanical orthoses lowers tibial strains during both walking and running and whether such lowering depends on the type of shoe worn. Measurements were made during treadmill walking at 5 km/hr and then during serial 2-km treadmill runs at 13 km/hr with running shoes, with and without the orthoses, and during serial 1-km runs with army boots, with and without the orthoses. Results When soft or semirigid biomechanical orthoses were worn with boots, the tibial peak-to-peak strains were significantly lowered. Soft orthoses also significantly lowered the tension and compression strain rates when worn with boots. During running, semirigid orthoses significantly increased the compression and tension strain rates when worn with boots. Conclusions The use of biomechanical orthoses may be warranted for tibial stress fracture prevention during training in which boots are worn and that mostly involves walking, but they are not warranted for activities that primarily involve running or are performed in running shoes.
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Wegener, Caleb, Katrin Wegener, Richard Smith, Karl-Heinz Schott, and Joshua Burns. "Biomechanical effects of sensorimotor orthoses in adults with Charcot–Marie–Tooth disease." Prosthetics and Orthotics International 40, no. 4 (May 2015): 436–46. http://dx.doi.org/10.1177/0309364615579318.
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Background: Charcot–Marie–Tooth disease is an inherited neuropathy causing progressive weakness, foot deformity and difficulty walking. Clinical anecdotes suggest orthoses designed on the ‘sensorimotor’ paradigm are beneficial for improving gait in Charcot–Marie–Tooth disease. Objectives: Investigate the effect of sensorimotor orthoses on in-shoe and lower limb biomechanics in adults with Charcot–Marie–Tooth disease. Study design: Randomised, repeated-measures, exploratory study. Methods: Eight males and two females with Charcot–Marie–Tooth disease aged 31–68 years fitted with pedorthic shoes and custom-made sensorimotor orthoses were randomly tested at baseline and after 4 weeks of adaptation. In-shoe three-dimensional multi-segment foot and lower limb kinematics and kinetics were collected as were plantar pressures, electromyography and self-reported comfort, stability, cushioning and preference. Results: Compared to the shoe only condition, sensorimotor orthoses increased midfoot eversion and plantarflexion, increased ankle eversion and produced small but significant changes at the knee and hip indicating increased internal rotation. The orthoses increased medial ground reaction forces and increased pressure at the heel, midfoot and toes. There were minimal effects on electromyography. The sensorimotor orthoses were rated higher for comfort, cushioning, stability and preference. Conclusion: Sensorimotor orthoses produced changes in kinematic, kinetic and pressure variables in adults with Charcot–Marie–Tooth disease and were regarded as more comfortable, cushioned and stable during walking. Clinical relevance In this study, the walking ability of patients with Charcot–Marie–Tooth disease improved with the use of foot orthoses designed according to the sensorimotor paradigm. However, the mechanism of action appears to be primarily mechanical in origin. Randomised controlled trials are necessary to evaluate the long-term patient-reported outcomes of sensorimotor orthoses.
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McPoil, Thomas G., Bill Vicenzino, and Mark W. Cornwall. "Effect of Foot Orthoses Contour on Pain Perception in Individuals with Patellofemoral Pain." Journal of the American Podiatric Medical Association 101, no. 1 (January 1, 2011): 7–16. http://dx.doi.org/10.7547/1010007.
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Background: Foot orthoses have been described as a possible intervention for individuals with patellofemoral joint pain. No study has attempted to quantify the perceived comfort and support of foot orthoses when used as an intervention for patellofemoral joint pain. Methods: A randomized case-control trial with crossover between contoured and flat orthoses was conducted on ten individuals with patellofemoral pain and ten healthy participants. All of the participants completed a comfort-support assessment and had in-shoe plantar pressure data collected before and after 3 weeks of wear. A 1-week washout period was used to minimize any continued treatment effect between orthotics testing. The patellofemoral pain group also completed a numeric rating scale to assess pain reduction after using each orthosis. Results: All of the participants perceived that greater support was provided by the contoured orthoses in the heel and arch regions. Even with a 30% difference in material hardness between the two orthoses, all of the participants rated cushioning as equivalent. Six individuals in the patellofemoral pain group reported a clinically significant reduction in knee pain as a result of wearing foot orthoses. Conclusions: A key factor in the selection of contoured foot orthoses versus flat inserts is the amount of support that an individual perceives in the arch and heel regions. In addition, clinicians using foot orthoses as an intervention for patellofemoral pain should expect an individualistic, nonsystematic response. (J Am Podiatr Med Assoc 101(1): 7–16, 2011)
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Williams, Bruce E., and James D. Yakel. "Clinical Uses of In-Shoe Pressure Analysis in Podiatric Sports Medicine." Journal of the American Podiatric Medical Association 97, no. 1 (January 1, 2007): 49–58. http://dx.doi.org/10.7547/0970049.
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Athletic injuries of the foot and lower extremity are commonly treated with custom foot orthoses. These devices usually provide immediate relief of the athlete’s pain and dysfunction. Occasionally, however, they do not help, or even increase the patient’s discomfort. We discuss a method of using in-shoe pressure-measurement systems to analyze the athletic patient’s foot and lower-extremity function before and after treatment with custom foot orthoses, with a focus on sagittal plane biomechanics. Case histories are presented of athletes whose gait pathologies were identified and treated successfully using an in-shoe pressure-measurement system. (J Am Podiatr Med Assoc 97(1): 49–58, 2007)
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Kelly, Adam, and Justin Stanek. "The Impact of a Foot-Toe Orthosis on Dynamic Balance: An Exploratory Randomized Control Trial." Journal of Sport Rehabilitation 29, no. 7 (September 1, 2020): 871–78. http://dx.doi.org/10.1123/jsr.2017-0321.
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Context: The influence of custom and over-the-counter foot orthoses on dynamic balance has been investigated in the past. However, there has not been an exploration of the use of a foot-toe orthosis for improving balance. The ability of clinicians to influence balance could have important implications for injury prevention and rehabilitation. Objective: To determine the impact of a foot-toe orthosis on dynamic balance in healthy, young adults. Design: Randomized control trial. Setting: Athletic training laboratory. Participants: In total, 64 healthy, recreationally active participants aged 18–29 years were randomly allocated to one of the following groups: the foot-toe orthosis and laboratory-issued shoe group, the laboratory-issued shoe only (SO) group, or the control group. Interventions: Subjects in the intervention group wore the foot-toe orthosis and laboratory-issued shoe with activities of daily living for 4 weeks. Subjects in the SO intervention group wore the laboratory-issued shoe with activities of daily living for 4 weeks. Participants in the control group did not receive any intervention. Main Outcome Measures: The instrumented version of the Star Excursion Balance Test, known as the Lower Quarter Y-Balance Test, was used to quantify the dynamic balance at baseline and follow-up. Reaches were normalized for leg length. Results: There were statistically significant differences in postintervention scores on the Lower Quarter Y-Balance Test for both the dominant (P = .03, effect size = 0.84; 95% confidence interval, 0.25 to 1.43) and nondominant (P = .002, effect size = 0.74; 95% confidence interval, 0.15 to 1.32) legs when comparing dynamic balance scores of the foot-toe orthosis and laboratory-issued shoe group with the SO and control groups. No significant differences were observed when comparing dynamic balance between the SO and control groups. Conclusions: A 4-week intervention with a foot-toe orthosis and laboratory-issued shoe resulted in improved dynamic balance in a healthy young adult population. These findings suggest a novel intervention for increasing balance.
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Ki, S. W., A. K. L. Leung, and A. N. M. Li. "Comparison of plantar pressure distribution patterns between foot orthoses provided by the CAD-CAM and foam impression methods." Prosthetics and Orthotics International 32, no. 3 (January 2008): 356–62. http://dx.doi.org/10.1080/03093640802016159.
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Foot orthotic treatment is one of the major conservative methods used to handle foot problems. Total plantar contact foot orthoses are used to reduce and redistribute peak pressures. For the fabrication of a total plantar contact foot orthosis, the computer-aided design and computer-aided manufacturing (CAD-CAM) method has been applied. In this study, the plantar foot-orthosis interface pressure data during walking were collected by the Novel Pedar-mobile in-shoe plantar pressure measuring system. The data were collected under three conditions: (i) Flat insole, (ii) foot orthosis provided by the CAD-CAM method, and (iii) foot orthosis provided by the foam impression method. The Swiss Comfort CAD-CAM foot orthotics system was used in this study. For conditions (ii) and (iii), foot shapes were collected in partial weight bearing and subtalar neutral conditions. Thirty normal subjects were recruited for this study. The plantar foot surface was divided into eight plantar foot regions and then was investigated. These regions included the heel, the medial and lateral arches, the medial, mid and lateral forefoot, the hallux, and the lateral toes. The results showed that the orthoses provided by both the CAD-CAM and foam impression methods could decrease the peak pressure and the maximum force in the heel region, and increase the peak pressure and the maximum force in the medial arch region. Both orthoses redistributed the peak pressure and the maximum force from the heel to the medial arch region. The peak pressure in the mid forefoot region was different between the orthoses provided by the CAD-CAM and foam impression methods.
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Kearney, Rebecca S., Sarah E. Lamb, Juul Achten, Nicholas R. Parsons, and Matthew L. Costa. "In-Shoe Plantar Pressures Within Ankle-Foot Orthoses." American Journal of Sports Medicine 39, no. 12 (September 9, 2011): 2679–85. http://dx.doi.org/10.1177/0363546511420809.
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Background: Advances in the management of Achilles tendon rupture have led to the development of immediate weightbearing protocols. These vary regarding which ankle-foot orthoses (AFOs) are used and the number of inserted heel wedges used within them. Purpose: This study was conducted to evaluate plantar pressure measurements and temporal gait parameters within different AFOs, using different numbers of heel wedges. Study Design: Controlled laboratory study. Methods: Fifteen healthy participants were evaluated using 3 different AFOs, with 4 different levels of inserted heel wedges. Therefore, a total of 12 conditions were evaluated, in a sequence that was randomly allocated to each participant. Pressure and temporal gait parameters were measured using an in-shoe F-Scan pressure system, and range of movement was measured using an electrogoniometer. Results: Ankle-foot orthoses that were restrictive in design, combined with a higher number of inserted heel wedges, reduced forefoot pressures, increased heel pressures, and decreased the amount of time spent in the terminal stance and preswing phase of the gait cycle ( P = .029, .002, and .001). Conclusion: The choice of AFO design and the number of inserted heel wedges have a significant effect on plantar pressure measurements and temporal gait parameters. The implications of these changes need to be applied to the clinical management of acute Achilles tendon ruptures. This clinical management requires a balance between protected weightbearing and functional loading, requiring further research within a clinical context. Clinical Relevance: The biomechanical data from this research imply that a carbon-fiber AFO, with 1 heel raise, protects against excessive dorsiflexion while facilitating the restoration of near-normal gait parameters. This could lead to an accelerated return to function, avoiding the effects of disuse atrophy. This is in contrast to the rigid rocker-bottom AFO design with a greater number of heel-wedge inserts. However, research within a clinical context would be required to ascertain if these biomechanical advantages translate into a functional benefit for patients. The results should also be considered in relation to the amount of force a healing Achilles tendon can withstand.
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Ramdharry, G. M., J. F. Marsden, B. L. Day, and A. J. Thompson. "De-stabilizing and training effects of foot orthoses in multiple sclerosis." Multiple Sclerosis Journal 12, no. 2 (April 2006): 219–26. http://dx.doi.org/10.1191/135248506ms1266oa.
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This study evaluates the effects of dynamic foot orthoses (DFO) on walking and balance performance in people with multiple sclerosis (MS). Sixteen ambulant subjects with MS and ten age-matched healthy control subjects were studied on initial receipt of foot orthoses and after four weeks of daily wear. Walking speed, MS Walking Scale-12 (MSWS-12) and standing balance were assessed with and without orthoses at both these times. During standing, stance width and vision were varied, and performance was quantified using the velocity of the centre of pressure (COP), body sway velocity and the mean COP position relative to the shoe. People with MS walked slower (p<0.001) and showed increased sway when standing (p<0.001). At the first assessment, the foot orthoses caused an increase in sway and a medial and posterior shift of the COP position. At repeat measurement, the DFOs continued to increase sway compared to a shoe only condition. However, MS subjects reported an improvement in the MSWS-12 (p<0.05) and, compared to the initial session, showed decreased sway when eyes were closed both with and without DFOs. Dynamic foot orthoses may increase sway and change COP position by altering foot alignment and/or plantar afferent stimulation. Improvement in body sway over time may be an overall training effect of the DFOs, as MS subjects adapt to the initial de-stabilization.
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Reeves, Joanna, Richard Jones, Anmin Liu, Leah Bent, Emma Plater, and Christopher Nester. "A systematic review of the effect of footwear, foot orthoses and taping on lower limb muscle activity during walking and running." Prosthetics and Orthotics International 43, no. 6 (September 24, 2019): 576–96. http://dx.doi.org/10.1177/0309364619870666.
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Background: External devices are used to manage musculoskeletal pathologies by altering loading of the foot, which could result in altered muscle activity that could have therapeutic benefits. Objectives: To establish if evidence exists that footwear, foot orthoses and taping alter lower limb muscle activity during walking and running. Study design: Systematic literature review. Methods: CINAHL, MEDLINE, ScienceDirect, SPORTDiscus and Web of Science databases were searched. Quality assessment was performed using guidelines for assessing healthcare interventions and electromyography methodology. Results: Thirty-one studies were included: 22 related to footwear, eight foot orthoses and one taping. In walking, (1) rocker footwear apparently decreases tibialis anterior activity and increases triceps surae activity, (2) orthoses could decrease activity of tibialis posterior and increase activity of peroneus longus and (3) other footwear and taping effects are unclear. Conclusion: Modifications in shoe or orthosis design in the sagittal or frontal plane can alter activation in walking of muscles acting primarily in these planes. Adequately powered research with kinematic and kinetic data is needed to explain the presence/absence of changes in muscle activation with external devices. Clinical relevance This review provides some evidence that foot orthoses can reduce tibialis posterior activity, potentially benefitting specific musculoskeletal pathologies.
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Kilmartin, Timothy Edward, and W. Angus Wallace. "Effect of Pronation and Supination Orthosis on Morton's Neuroma and Lower Extremity Function." Foot & Ankle International 15, no. 5 (May 1994): 256–62. http://dx.doi.org/10.1177/107110079401500505.
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Twenty-three adult patients with Morton's neuroma of one foot were randomized to receive in-shoe orthoses made from a hard, compressed, felt material that would either pronate or supinate both feet. The response of the neuroma pain was measured using subjective visual analogue scales, an objective examination, and the MACTAR patient-specific measure of maximal function. The development of any other lower limb symptoms was also recorded. The pain associated with Morton's neuroma was not significantly altered by changing the position of the foot with the compressed felt orthosis. Forcibly pronating the foot did not produce a significant incidence of lower limb symptoms in the short term.
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MacLean, Christopher L., Richard van Emmerik, and Joseph Hamill. "Influence of Custom Foot Orthotic Intervention on Lower Extremity Intralimb Coupling during a 30-Minute Run." Journal of Applied Biomechanics 26, no. 4 (November 2010): 390–99. http://dx.doi.org/10.1123/jab.26.4.390.
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The purpose of this study was to analyze the influence of a custom foot orthotic (CFO) intervention on lower extremity intralimb coupling during a 30-min run in a group of injured runners and to compare the results to a control group of healthy runners. Three-dimensional kinematic data were collected during a 30-min run on healthy female runners (Shoe-only) and a group of female runners who had a recent history of overuse injury (Shoe-only and Shoe with custom foot orthoses). Results from the study revealed that the coordination variability and pattern for the some couplings were influenced by history of injury, foot orthotic intervention and the duration of the run. These data suggest that custom foot orthoses worn by injured runners may play a role in the maintenance of coordination variability of the tibia (transverse plane) and calcaneus (frontal plane) coupling during the Early Stance phase. In addition, it appears that the coupling angle between the knee (transverse plane) and rearfoot (frontal plane) joints becomes more symmetrical in the late stance phase as a run progresses.
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Elattar, Osama, Tyler Smith, Adam Ferguson, Daniel Farber, and Keith Wapner. "Uses of Braces and Orthotics for Conservative Management of Foot and Ankle Disorders." Foot & Ankle Orthopaedics 3, no. 3 (July 1, 2018): 247301141878070. http://dx.doi.org/10.1177/2473011418780700.
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Nonsurgical management is almost always considered the first-line treatment for the vast majority of foot and ankle pathologies. Foot orthoses, shoe modifications, and therapeutic footwear are considered essential tools for successful conservative management of different foot and ankle disorders. Orthopedic foot and ankle surgeons should have a meticulous understanding of the lower extremity biomechanics as well as the pathoanatomy and the sequelae of diseases affecting the foot and/or ankle. This is essential to the understanding of the desired effects of the different inserts, orthotics, shoe modifications, or braces that may be prescribed for these conditions. In this article, we will summarize the orthoses used for treatment of the most commonly encountered foot and ankle pathologies, with the exclusion of treatment for the diabetic foot because of the unique requirements of that disease process.
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Reed, Lloyd, and Paul J. Bennett. "Changes in Foot Function with the Use of Root and Blake Orthoses." Journal of the American Podiatric Medical Association 91, no. 4 (April 1, 2001): 184–93. http://dx.doi.org/10.7547/87507315-91-4-184.
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This study examined the effects of two designs of rigid foot orthoses on plantar pressure measurements and identified differences between the devices. While wearing modified Root- and Blake-style orthoses, 27 subjects were examined with the Electrodynogram (EDG) in-shoe pressure measurement system. Reliability testing was performed on the EDG data. Significant changes were observed in the temporal parameters of gait when subjects wore the orthoses. When the devices were used, the duration of some of the components of stance phase was altered, and the initiation of loading beneath the medial forefoot was delayed. A reduction in the total duration of loading at discrete sites beneath the heel and forefoot was also observed. The effects of the two orthoses were similar, with only small differences observed between the devices. (J Am Podiatr Med Assoc 91(4): 184-193, 2001)
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Lin, Kuang-Wei, Chia-Jung Hu, Wen-Wen Yang, Li-Wei Chou, Shun-Hwa Wei, Chen-Sheng Chen, and Pi-Chang Sun. "Biomechanical Evaluation and Strength Test of 3D-Printed Foot Orthoses." Applied Bionics and Biomechanics 2019 (December 7, 2019): 1–8. http://dx.doi.org/10.1155/2019/4989534.
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Foot orthoses (FOs) are commonly used as interventions for individuals with flatfoot. Advances in technologies such as three-dimensional (3D) scanning and 3D printing have facilitated the fabrication of custom FOs. However, few studies have been conducted on the mechanical properties and biomechanical effects of 3D-printed FOs. The purposes of this study were to evaluate the mechanical properties of 3D-printed FOs and determine their biomechanical effects in individuals with flexible flatfoot. During mechanical testing, a total of 18 FO samples with three orientations (0°, 45°, and 90°) were fabricated and tested. The maximum compressive load and stiffness were calculated. During a motion capture experiment, 12 individuals with flatfoot were enrolled, and the 3D-printed FOs were used as interventions. Kinematic and kinetic data were collected during walking by using an optical motion capture system. A one-way analysis of variance was performed to compare the mechanical parameters among the three build orientations. A paired t-test was conducted to compare the biomechanical variables under two conditions: walking in standard shoes (Shoe) and walking in shoes embedded with FOs (Shoe+FO). The results indicated that the 45° build orientation produced the strongest FOs. In addition, the maximum ankle evertor and external rotator moments under the Shoe+FO condition were significantly reduced by 35% and 16%, respectively, but the maximum ankle plantar flexor moments increased by 3%, compared with the Shoe condition. No significant difference in ground reaction force was observed between the two conditions. This study demonstrated that 3D-printed FOs could alter the ankle joint moments during gait.
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Shrader, Joseph A., and Karen Lohmann Siegel. "Nonoperative Management of Functional Hallux Limitus in a Patient With Rheumatoid Arthritis." Physical Therapy 83, no. 9 (September 1, 2003): 831–43. http://dx.doi.org/10.1093/ptj/83.9.831.
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Background and Purpose. Functional hallux limitus (FHL) is a condition that affects motion at the first metatarsophalangeal joint and may lead to abnormal forefoot plantar pressures, pain, and difficulty with ambulation. The purpose of this case report is to describe a patient with rheumatoid arthritis (RA) and FHL who was managed with foot orthoses, footwear, shoe modifications, and patient education. Case Description. The patient was a 55-year-old woman diagnosed with seropositive RA 10 years previously. Her chief complaint was bilateral foot pain, particularly under the left great toe. Her foot pain had been present for several years, but during the past 5 months it had intensified and interfered with her work performance, activities of daily living, and social life. Outcomes. Following 4 sessions of physical therapy over a 6-week time period, the patient reported complete relief of forefoot pain despite no change in medication use or RA disease pathophysiology. She was able to continuously walk for up to 4 hours. Left hallux peak plantar pressures were reduced from 43 N/cm2 to 18 N/cm2 with the foot orthoses. Discussion. Patients with RA who develop FHL may benefit from physical therapist management using semirigid foot orthoses, footwear, shoe modifications, and patient education.
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Burns, Joshua, Lindy Begg, and Mauro Vicaretti. "Comparison of Orthotic Materials on Foot Pain, Comfort, and Plantar Pressure in the Neuroischemic Diabetic Foot." Journal of the American Podiatric Medical Association 98, no. 2 (March 1, 2008): 143–48. http://dx.doi.org/10.7547/0980143.
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Foot pain and lower-limb neuroischemia in diabetes mellitus is common and can be debilitating and difficult to treat. We report a comparison of orthotic materials to manage foot pain in a 59-year-old man with type 1 diabetes mellitus, peripheral neuropathy, peripheral arterial disease, and a history of foot ulceration. We investigated a range of in-shoe foot orthoses for comfort and plantar pressure reduction in a cross-sectional study. The most comfortable and most effective pressure-reducing orthoses were subsequently evaluated for pain relief in a single system alternating-treatment design. After 9 weeks, foot pain was completely resolved with customized multidensity foot orthoses. The outcome of this case study suggests that customized multidensity foot orthoses may be a useful intervention to reduce foot pain and maintain function in the neuroischemic diabetic foot. (J Am Podiatr Med Assoc 98(2): 143–148, 2008)
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Arazpour, Mokhtar, Stephen W. Hutchins, Farhad T. Ghomshe, Fahimeh Shaky, Masome V. Karami, and Andrey Y. Aksenov. "Effects of the heel-to-toe rocker sole on walking in able-bodied persons." Prosthetics and Orthotics International 37, no. 6 (February 11, 2013): 429–35. http://dx.doi.org/10.1177/0309364612474920.
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Background and aim: The most commonly prescribed external shoe modification is the use of rocker soles. The aim of this study was to evaluate the effect of a heel-to-toe rocker sole profile on specific temporal–spatial parameters and the kinematics of walking when added to footwear. Method: Seventeen healthy adult volunteers participated in this study. For each subject, gait analysis was performed under two conditions that were tested in a random order: walking with either a baseline shoe with a flat sole or a modified shoe adapted with a heel-to-toe rocker sole. Results: Significant differences were observed between rocker sole conditions during initial double-limb support and second double-limb support during stance phase. In frontal plane movement, significant differences were observed between the rocker sole conditions but only during second double-limb support phase. Conclusions: This heel-to-toe rocker sole may be useful for patients with conditions such as ankle arthrodesis or for use with ankle–foot orthoses where limited ankle motion is required. Clinical relevance The heel-to-toe rocker sole may be useful for conditions including ankle arthrodesis and for use with solid ankle–foot orthoses but may not be suitable for patients with reduced balance or an unstable posture.
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Mills, K., A. Chapman, R. Blanch, and B. Vicenzino. "Systematic review of physiological adaptations to in-shoe foot orthoses." Journal of Science and Medicine in Sport 12 (January 2009): S43. http://dx.doi.org/10.1016/j.jsams.2008.12.105.
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Scherer, Paul R., Jennifer Sanders, Denten E. Eldredge, Susan J. Duffy, and Ryan Y. Lee. "Effect of Functional Foot Orthoses on First Metatarsophalangeal Joint Dorsiflexion in Stance and Gait." Journal of the American Podiatric Medical Association 96, no. 6 (November 1, 2006): 474–81. http://dx.doi.org/10.7547/0960474.
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Reduction in first metatarsophalangeal joint maximum degree of dorsiflexion with dorsiflexion of the first ray has been proposed to be the predominant cause of hallux abducto valgus and hallux rigidus. We sought to determine whether orthoses made from a cast with the first ray plantarflexed and a 4-mm medial skive could increase the maximum degree of dorsiflexion in patients with functional hallux limitus in stance and gait. Forty-eight feet of 27 subjects were casted for orthoses with the first ray plantarflexed and in the customary neutral rearfoot position with locked midtarsal joint. First metatarsophalangeal joint maximum dorsiflexion was measured with and without orthoses in stance, and subhallux pressure was measured with and without orthoses at heel-off. Changes in mean maximum dorsiflexion in stance and in mean maximum subhallux pressure in gait with orthoses were significant. We investigated the relationship between this increase in dorsiflexion and gender, shoe size, resting calcaneal stance position, and change in resting calcaneal stance position with the use of orthoses. These correlations were not statistically significant. The biomechanical implication of increasing limited first metatarsophalangeal joint dorsiflexion with orthoses is discussed and related to the clinical treatment of deformities, including hallux valgus and hallux rigidus. The use of orthoses to decrease subhallux pressure is also discussed. (J Am Podiatr Med Assoc 96(6): 474–481, 2006)
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MacLean, Christopher L., Irene S. Davis, and Joseph Hamill. "Influence of Running Shoe Midsole Composition and Custom Foot Orthotic Intervention on Lower Extremity Dynamics during Running." Journal of Applied Biomechanics 25, no. 1 (February 2009): 54–63. http://dx.doi.org/10.1123/jab.25.1.54.
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The purpose of this study was to analyze the influence of varying running shoe midsole composition on lower extremity dynamics with and without a custom foot orthotic intervention. Three-dimensional dynamics were collected on 12 female runners who had completed 6 weeks of custom foot orthotic therapy. Participants completed running trials in 3 running shoe midsole conditions—with and without a custom foot orthotic intervention. Results from the current study revealed that only maximum rearfoot eversion velocity was influenced by the midsole durometer of the shoe. Maximum rearfoot eversion velocity was significantly decreased for the hard shoe compared with the soft shoe. However, the orthotic intervention in the footwear led to significant decreases in several dynamic variables. The results suggest that the major component influencing the rearfoot dynamics was the orthotic device and not the shoe composition. In addition, data suggest that the foot orthoses appear to compensate for the lesser shoe stability enabling it to function in a way similar to that of a shoe of greater stability.
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Munuera, Pedro V., Jose M. Castillo, Gabriel Dominguez, and Guillermo Lafuente. "Orthotic Devices with Out-toeing Wedge as Treatment for In-toed Gait in Children." Journal of the American Podiatric Medical Association 100, no. 6 (November 1, 2010): 472–78. http://dx.doi.org/10.7547/1000472.
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Background: Orthotic devices are used to help children progressively acquire a more physiologic walking pattern. Methods: To determine the effect of an orthotic device with an out-toeing wedge along with a physiologic shoe as treatment for in-toed gait, angle of gait was measured in 48 children aged 3 to 14 years with in-toed gait. The following comparisons were made: angle of gait in children unshod versus children shod without treatment, angle of gait in children shod without treatment versus children shod plus orthoses, and angle of gait in children unshod versus children shod plus orthoses. Results: Using a correctly fitting shoe increased the angle of gait in a nonsignificant manner, but a significant increase was revealed in the comparison of the angle of gait in children unshod versus children under treatment. The results showed that the behavior in boys and girls was similar to that in the total sample. Regarding side, the corrective effect of the orthotic device was similar in the two feet. However, the data showed a greater corrective effect of the shoe in the right foot. Conclusions: Orthotic devices with out-toeing wedge combined with correctly fitting shoes, as well as shoes alone, are useful tools in the treatment of in-toed gait in children. (J Am Podiatr Med Assoc 100(6): 472–478, 2010)
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Whitford, Deirdre, and Adrian Esterman. "A Randomized Controlled Trial of Two Types of In-Shoe Orthoses in Children with Flexible Excess Pronation of the Feet." Foot & Ankle International 28, no. 6 (June 2007): 715–23. http://dx.doi.org/10.3113/fai.2007.0715.
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Background: Orthoses for children with flexible excess pronation are estimated to cost Australian parents millions of dollars per year; however, there is no high-level evidence that orthoses improve function or reduce pain. Methods: A randomized parallel, single-blinded, controlled trial of custom-made and ready-made orthoses was conducted in children between the ages of 7 and 11 years with bilateral flexible excess pronation. The diagnosis was based on calcaneal eversion and navicular drop. Outcomes included gross motor proficiency, self-perception, exercise efficiency, and pain. Measurements were taken at baseline, and at 3 and 12 months. Of the 178 children who participated at baseline, 160 continued to the end of the trial. Results: After randomization, baseline characteristics were similar between the three treatment groups (custom-made, ready-made, and control). Statistical modeling demonstrated that although for most outcome measures there were statistically significant trends over time, none of the group comparisons were statistically significant. A sub-group analysis of those presenting with pain found no significant differences at 3 or 12 months. Conclusions: This study found no evidence to justify the use of in-shoe orthoses in the management of flexible excess foot pronation in children.
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Trotter, Leslie C., and Michael Raymond Pierrynowski. "Changes in Gait Economy Between Full-Contact Custom-made Foot Orthoses and Prefabricated Inserts in Patients with Musculoskeletal Pain." Journal of the American Podiatric Medical Association 98, no. 6 (November 1, 2008): 429–35. http://dx.doi.org/10.7547/0980429.
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Background: Specific kinematic and kinetic outcomes have been used to detect biomechanical change while wearing foot orthoses; however, few studies demonstrate consistent effects. We sought to observe changes in walking economy in patients with musculoskeletal pain across 10 weeks while wearing custom-made foot orthoses and prefabricated shoe inserts. Methods: In this crossover randomized controlled trial, 40 participants wore custom-made orthoses and prefabricated inserts for 4 weeks each, consecutively. The path length ratio was used to quantify walking economy by comparing the undulating path of a point in the pelvis with its direct path averaged across multiple strides. Results: For the prefab-custom group (n = 27), significant decreases in path length ratio (improved economy of gait) were noted at the initial introduction of prefabricated inserts (P = .02) and custom orthoses (P = .02) but maintained a trend toward improved economy only while wearing custom orthoses (P = .08). For the custom-prefab group (n = 13), there was worsening of the path length ratio that was significant after removing the custom-made orthoses for 4 weeks (P = .01). Conclusion: For patients with lower-extremity musculoskeletal pain, immediate improvements in economy of gait can be expected with both interventions. It seems, however, that only the custom-made orthoses maintain economy of gait for 4 weeks. Patients who begin wearing custom-made orthoses and then wear prefabricated insoles can expect a decrease in economy of gait. (J Am Podiatr Med Assoc 98(6): 429–435, 2008)
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Lin, Kuang-Wei, Li-Wei Chou, Yi-Tien Su, Shun-Hwa Wei, and Chen-Shen Chen. "Biomechanical Effect of 3D-Printed Foot Orthoses in Patients with Knee Osteoarthritis." Applied Sciences 11, no. 9 (May 5, 2021): 4200. http://dx.doi.org/10.3390/app11094200.
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Lateral wedges are a common conservative treatment for medial knee osteoarthritis (OA). However, use of lateral wedges might increase the ankle eversion moment. To minimize the risk of ankle symptoms, lateral wedges with custom arch support are suggested. However, the manufacturing process of a custom foot orthosis (FO) is complicated, labor-intensive, and time-consuming. The technology of 3D printing is an ideal method for mass customization. Therefore, the purpose of this study was to develop custom FOs using 3D-printing techniques and to evaluate the effects of 3D-printed FOs in patients with knee OA. Fifteen patients with medial knee OA were enrolled into this study. Kinematic and kinetic data were collected during walking by using an optical motion capture system. A paired-sample t-test was conducted to compare biomechanical variables under two conditions: walking in standard shoes (Shoe) and walking in shoes embedded with 3D-printed FOs (Shoe + FO). The results show that the first and second peak knee adduction moments were significantly reduced by 4.08% and 9.09% under the Shoe + FO condition. The FOs alter the biomechanical environment in a way that reduces the variables used to infer abnormal loads at the knee and ankle that could result in painful symptoms.
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Collins, Natalie J., Jade M. Tan, Hylton B. Menz, Trevor G. Russell, Anne J. Smith, Bill Vicenzino, Shannon E. Munteanu, et al. "The FOOTPATH study: protocol for a multicentre, participant- and assessor-blind, parallel group randomised clinical trial of foot orthoses for patellofemoral osteoarthritis." BMJ Open 9, no. 4 (April 2019): e025315. http://dx.doi.org/10.1136/bmjopen-2018-025315.
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IntroductionPatellofemoral (PF) osteoarthritis (OA) is a common and burdensome subgroup of knee OA, with very little evidence for effective treatments. Prefabricated foot orthoses are an affordable and accessible intervention that have been shown to reduce PF pain in younger adults. Similarities between PF pain and PFOA, as well as our pilot work, suggest that foot orthoses may also be an effective intervention for PFOA. The primary objective of this study is to compare the 3 month efficacy of prefabricated foot orthoses and flat shoe inserts in people with PFOA, on knee pain severity.Methods and analysisThe FOOTPATH Study (FOot OrThoses for PAtellofemoral osteoarTHritis) is a multicentre, randomised, participant- and assessor-blinded superiority trial with two parallel groups, a 3 month observation period (pre-randomisation) and 12 month follow-up. 160 participants with a clinical diagnosis of PFOA will be recruited from three sites in Australia, and randomised to one of two groups (prefabricated foot orthoses or flat shoe inserts). The primary outcome is worst knee pain severity during a self-nominated aggravating activity in the previous week (100 mm visual analogue scale) at 3 months, with a secondary endpoint at 12 months. Secondary outcomes include global rating of change, symptoms, function, health-related quality of life, kinesiophobia, self-efficacy and use of co-interventions for knee pain. Blinded, intention-to-treat analyses of primary and secondary patient-reported outcomes will be performed, as well as economic analyses.Ethics and disseminationEthical approval has been granted by La Trobe University’s Human Ethics Committee and The University of Queensland’s Medical Research Ethics Committee. Study outcomes will be disseminated via peer-reviewed journals, conference presentations targeting a range of healthcare disciplines and an open access website with clinician resources.Trial registration numberANZCTRN12617000385347; Pre-results.
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Klyushkin, I. V., and K. A. Koreyba. "Orthoses in diabetic foot treatment and prevention." Kazan medical journal 94, no. 4 (December 15, 2013): 536–41. http://dx.doi.org/10.17816/kmj1966.
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Aim. To define the role of orthoses in the treatment and rehabilitation of patients with diabetic foot syndrome. Methods. The review of the literature addressing the use of special orthopedic shoes in the treatment and rehabilitation of patients with complicated diabetes mellitus was performed. Results. The common requirements for orthopedic shoes for patients with complicated diabetes mellitus are the following: (1) rigid sole with an artificial curvature; (2) boot-tree elevated by 8 mm due to arch supporter, adequate volume, wide sole, removable insole; (3) insole without functional memory; (4) thermally variable elastic material, advisably with silver ions, for the lining; (5) minimal number of sutures at the lining; (6) no elastic material at the front of the shoe and at the lining at the toes; (7) increased volume and enough space for the toes; (8) front slant of 15°; (9) potential ability to adjust the inner volume of the shoe; (10) hard counter - stabilizing hard back with additional softening at the lining side; (11) heel with a front slant or a solid sole without a heel; (12) smooth non-traumatic surface suitable for scrubbing including cleansing with antiseptics. The indications for orthopedic relief in patients with diabetic foot syndrome are explained. Economic superiority of organ-preserving approaches in such patients is shown. There is an opposition for conservative methods of treatment of patients with diabetic foot syndrome, nevertheless, an amputation can not be estimated as a positive treatment outcome in such patients. Almost 70-90% of ulcers in this group of patients are healed without amputation. Limb-saving treatment and the use of specially selected shoes are cheaper and more cost-effective compared to the limb loss. Conclusion. The use of orthopedic shoes in patients with diabetic foot syndrome is used both for treatment and rehabilitation. This technique can reduce the risk of ulceration and prevent organ-sparing surgeries.
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Aboutorabi, Atefeh, Mahmood Bahramizadeh, Mokhtar Arazpour, Reza Fadayevatan, Farzam Farahmand, Sarah Curran, and Stephen W. Hutchins. "A systematic review of the effect of foot orthoses and shoe characteristics on balance in healthy older subjects." Prosthetics and Orthotics International 40, no. 2 (June 25, 2015): 170–81. http://dx.doi.org/10.1177/0309364615588342.
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Background:Foot orthoses are used to optimize lower extremity function and can improve postural stability by enhancing the afferent somatosensory feedback available to the central nervous system.Objective:The aim of this review was to evaluate the effect of foot orthoses on balance control in older subjects.Study design:Systematic review.Methods:The search strategy was based on the Population Intervention Comparison Outcome method. A search was performed in PubMed, Science Direct, Google Scholar, and ISI Web of Knowledge databases by using selected keywords. A total of 22 articles were selected for final evaluation.Results:The results demonstrated that older people should be advised to wear thin, hard-soled footwear with high collars to reduce the risk of falling. The findings for insoles demonstrated an increase in balance control via vibratory or magnetic insoles, but textured insoles do not appear to be beneficial for balance improvement.Conclusion:Foot orthoses improve postural stability via a somatosensory or biomechanical effect. Use of footwear with the proper features can be an appropriate intervention in order to increase the balance in the older population and reduce falls.Clinical relevanceLoss of balance is an important factor in increasing the risk of falling in older subjects. Foot orthoses can improve functional measures of stability in older adults. In this review, results from studies suggest a number of recommendations regarding the optimal footwear for older people to reduce the risk of falling.
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Kruizinga, C. P., A. M. Boonstra, J. W. Groothoff, A. Elzinga, and L. N. H. Göeken. "Health complaints and disabilities in patients supplied with foot orthoses for degenerative foot disorders." Prosthetics and Orthotics International 26, no. 3 (December 2002): 235–42. http://dx.doi.org/10.1080/03093640208726653.
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This exploratory study attempted to estimate the severity of health complaints and disabilities in patients supplied with foot orthoses for degenerative foot disorders in the Netherlands. Information on the severity and the distribution of the complaints in these patients is important to acquire insight in the problems which these patients experience, and moreover is essential for further research, especially for evaluating effects of patients undergoing foot orthosis treatment. Patients with degenerative foot disorders aged 18 years and over were recruited from nine orthopaedic workshops over a period of three months in 2000. One hundred and twenty-two (122) patients were included in the study. Two approaches were used to obtain data. Firstly, shoe technicians and orthotists inspected patients’ feet and legs and interviewed them at their initial visit. Data on gender, age, height, weight, existing and prescribed orthotic devices were recorded on a report form. Secondly, patients were asked to fill in a questionnaire assessing type, location, frequency, intensity and duration of health complaints, and disability. Data indicate that females with degenerative foot disorders and foot orthoses are twice as common as men. Patients supplied with foot orthoses are twice as often overweight compared to subjects in the general population. Besides frequent and protracted pain there are also fatigue complaints, particularly in the feet and lower leg. Duration and frequency of the complaints suggest that these patients suffer from a chronic pain syndrome. In addition, the results indicate that the functional level of these patients is below that of the general population, in particular regarding physical activities.
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King, Matthew G., Joanne L. Kemp, Ryan Hon, Tania Pizzari, Justin Wong, Hylton Menz, Nicholas F. Taylor, Anton Harms, Jodie A. McClelland, and Adam Ivan Semciw. "Prefabricated contoured foot orthoses to reduce pain and increase physical activity in people with hip osteoarthritis: protocol for a randomised feasibility trial." BMJ Open 12, no. 9 (September 2022): e062954. http://dx.doi.org/10.1136/bmjopen-2022-062954.
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IntroductionThe aim of this randomised feasibility trial is to determine the feasibility of conducting an adequately powered randomised controlled trial (RCT) investigating the efficacy of prefabricated contoured foot orthoses in people with hip osteoarthritis (OA). The secondary aims of the trial are to compare the effect of prefabricated contoured foot orthoses to a flat shoe insert comparator on outcomes of hip-related pain, physical activity and quality of life. We hypothesise that the demand, implementation, acceptability and practicality of foot orthoses as a treatment option for people with hip OA will be deemed feasible, informing the development of an adequately powered RCT to evaluate the efficacy and long term outcomes.Methods and analysisWe will recruit 28 people with hip OA who will be randomised to receive either prefabricated contoured foot orthoses or flat shoe inserts to use for a 6-week period. Both groups will receive standardised education on hip OA and physical activity. The study’s primary outcome is the feasibility domains of demand, implementation, acceptability and practicality. The secondary outcomes include the change in Hip Osteoarthritis Outcome Score-12, Patient Health Questionnaire-9, Brief Fear of Movement Scale for OA, Physical activity accelerometry and the Physical Activity Questionnaire-short form. Descriptive statistics will be used to describe feasibility outcomes with limited efficacy analysis used for the secondary outcomes. Linear mixed models will be used to analyse between-group differences at 6 weeks, with baseline values used as covariates, treatment allocation as a fixed factor and participant as a random factor.Ethics and disseminationThis trial has been approved by the La Trobe University Human Research Ethics Committee (HEC20427), St. Vincent’s Hospital Melbourne, Human Research Ethics Committee (HREC 266/20) and Northern Health Research Governance (NH-2021-292862). The results will be disseminated via a peer-reviewed journal and presented at international conferences.Trial registration numberNCT05138380.
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Hayda, R., M. David Tremaine, K. Tremaine, S. Banco, and K. Teed. "Effect of Metatarsal Pads and Their Positioning: A Quantitative Assessment." Foot & Ankle International 15, no. 10 (October 1994): 561–66. http://dx.doi.org/10.1177/107110079401501008.
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Many conditions of the foot have been related to pressure maldistribution. Alteration of plantar pressure through improvements of shoe fit, orthoses, and surgery are presumed to correct pressure maldistribution. We evaluated 10 volunteers with normal, asymptomatic feet. With the use of an ultrathin in-shoe sensor, plantar pressures were measured within the shoe at the shoe/foot interface. Test conditions included three pad types: large foam, large felt, and small felt. They were evaluated in three positions: normal (at the metatarsal head base) and 5 mm proximal and 5 mm distal to the normal position. When compared with the control condition without the pad, each pad type and position caused a variable effect upon plantar pressure. On average, the small felt pad caused the greatest and most consistent decrease in pressure at the metatarsal heads (19.15%). Distal positioning tended to cause the greatest decreases in pressure for all pad types. A pad type and position was found to decrease metatarsal pad pressure in each subject. Metatarsal pads can effectively decrease plantar pressures within the shoe.
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Wrobel, James S., Sarah Edgar, Dana Cozzetto, James Maskill, Paul Peterson, and Bijan Najafi. "A Proof-of-Concept Study for Measuring Gait Speed, Steadiness, and Dynamic Balance Under Various Footwear Conditions Outside of the Gait Laboratory." Journal of the American Podiatric Medical Association 100, no. 4 (July 1, 2010): 242–50. http://dx.doi.org/10.7547/1000242.
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Background: This pilot study examined the effect of custom and prefabricated foot orthoses on self-selected walking speed, walking speed variability, and dynamic balance in the mediolateral direction. Methods: The gait of four healthy participants was analyzed with a body-worn sensor system across a distance of at least 30 m outside of the gait laboratory. Participants walked at their habitual speed in four conditions: barefoot, regular shoes, prefabricated foot orthoses, and custom foot orthoses. Results: In the custom foot orthoses condition, gait speed was improved on average 13.5% over the barefoot condition and 9.8% over the regular shoe condition. The mediolateral range of motion of center of mass was reduced 55% and 56% compared with the shoes alone and prefabricated foot orthoses conditions, respectively. This may suggest better gait efficiency and lower energy cost with custom foot orthoses. This tendency remained after normalizing center of mass by gait speed, suggesting that irrespective of gait speed, custom foot orthoses improve center of mass motion in the mediolateral direction compared with other footwear conditions. Gait intercycle variability, measured by intercycle coefficient of variation of gait speed, was decreased on average by 25% and 19% compared with the barefoot and shoes-alone conditions, respectively. The decrease in gait unsteadiness after wearing custom foot orthoses may suggest improved proprioception from the increased contact area of custom foot orthoses versus the barefoot condition. Conclusions: These findings may open new avenues for objective assessment of the impact of prescribed footwear on dynamic balance and spatiotemporal parameters of gait and assess gait adaptation after use of custom foot orthoses. (J Am Podiatr Med Assoc 100(4): 242–250, 2010)
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Wapner, Keith L., and Peter F. Sharkey. "The Use of Night Splints for Treatment of Recalcitrant Plantar Fasciitis." Foot & Ankle 12, no. 3 (December 1991): 135–37. http://dx.doi.org/10.1177/107110079101200301.
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This study reports the results of the use of molded ankle foot orthosis night splints for the treatment of recalcitrant plantar fasciitis on 14 patients with a total of 18 symptomatic feet. All patients had symptoms for greater than 1 year and had previously undergone treatment with nonsteroidal anti-inflammatory medicines, cortisone injections, shoe modifications, and physical therapy without resolution. All patients were provided with custom-molded polypropylene ankle foot orthoses in 5° of dorsiflexion to be used as a night splint. With continued use of nonsteroidal anti-inflammatory medication, Tuli heel cups, Spenco liners, and general stretching exercises, successful resolution occurred in 11 patients in less than 4 months. There were three failures. It is felt that the use of night splints provides a useful, cost-effective adjunct to current therapeutic regimens of plantar fasciitis.
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Kobayashi, Toshiki, Fan Gao, Nicholas LeCursi, K. Bo Foreman, and Michael S. Orendurff. "Effect of Shoes on Stiffness and Energy Efficiency of Ankle-Foot Orthosis: Bench Testing Analysis." Journal of Applied Biomechanics 33, no. 6 (December 1, 2017): 460–63. http://dx.doi.org/10.1123/jab.2016-0309.
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Understanding the mechanical properties of ankle-foot orthoses (AFOs) is important to maximize their benefit for those with movement disorders during gait. Though mechanical properties such as stiffness and/or energy efficiency of AFOs have been extensively studied, it remains unknown how and to what extent shoes influence their properties. The aim of this study was to investigate the effect of shoes on stiffness and energy efficiency of an AFO using a custom mechanical testing device. Stiffness and energy efficiency of the AFO were measured in the plantar flexion and dorsiflexion range, respectively, under AFO-alone and AFO-Shoe combination conditions. The results of this study demonstrated that the stiffness of the AFO-Shoe combination was significantly decreased compared to the AFO-alone condition, but no significant differences were found in energy efficiency. From the results, we recommend that shoes used with AFOs should be carefully selected not only based on their effect on alignment of the lower limb, but also their effects on overall mechanical properties of the AFO-Shoe combination. Further study is needed to clarify the effects of differences in shoe designs on AFO-Shoe combination mechanical properties.
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Saygi, Baransel, Yakub Yildirim, Evrim K. Saygi, Hasan Kara, and Tanil Esemenli. "Morton Neuroma: Comparative Results of Two Conservative Methods." Foot & Ankle International 26, no. 7 (July 2005): 556–59. http://dx.doi.org/10.1177/107110070502600711.
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Background: The initial treatment of Morton neuromas consists of conservative methods that include shoe modifications and steroid injections. The purpose of this prospective study was to compare the efficacy of these two methods to determine which is more effective as the initial treatment method. Methods: Eighty-two patients with Morton neuromas were randomly assigned to receive either footwear modification with orthoses or steroid injections as initial treatment. Outcomes were evaluated at 1 month, 6 months, and 12 months. Results: Patient satisfaction was significantly better ( p < 0.01) in the group treated with steroid injections than those treated with shoe modifications at all three followup intervals. At 12-month followup, 82% of those treated with steroid injections had complete or partial relief of pain compared to 63% of those treated with footwear modifications alone. Conclusion: Steroid injections as initial treatment and shoe modifications with steroid injections at 6 months appear to give better results in Morton neuromas than shoe modifications alone, but the difference in the two groups were not statistically significant at one year followup.
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Redmond, A., PS Lumb, and K. Landorf. "Effect of cast and noncast foot orthoses on plantar pressure and force during normal gait." Journal of the American Podiatric Medical Association 90, no. 9 (October 1, 2000): 441–49. http://dx.doi.org/10.7547/87507315-90-9-441.
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A variety of plantar pressure and force measures were explored in 22 healthy individuals with excessive pronation. The measures were obtained while the subjects wore a thin-soled athletic shoe alone, a modified Root foot orthosis made from a neutral cast, and a flat noncast insole with a 6 degrees varus rearfoot post. The data obtained from subjects wearing the noncast insole differed only minimally from those obtained while they were wearing the shoe only. In contrast, the modified Root orthosis had a profound effect on foot function. Heel forces and pressures were reduced, and the rearfoot contact area was increased. Measures of force in the midfoot demonstrated substantial increases in load in this region, but the increase in area associated with the contoured device resulted in no increase in midfoot pressure measurements. Forefoot pressures were reduced both medially and laterally with the cast device in place.