An Ankle-Foot Orthosis With a Lateral Extension Reduces Forefoot Abduction in Subjects With Stage II Posterior Tibial Tendon Dysfunction

Neville, Christopher; Bucklin, Mary; Ordway, Nathaniel R.; Lemley, Frederick

doi:10.2519/jospt.2016.5618

Cited by 16 publications

(7 citation statements)

References 33 publications

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“…This is not surprising, as the inclination of a medial/lateral forefoot wedge lies in the frontal plane, which only indirectly can manipulate foot motion in the transverse plane motion. An orthotic component in the transverse plane has been adopted in the ankle-foot orthoses to reduce forefoot abduction ( Neville et al, 2016 ). But such component is difficult to be fitted in conventional footwear, which limits its application to FOs.…”

Section: Discussionmentioning

confidence: 99%

“…Controlling excessive foot pronation involves reducing forefoot abduction, forefoot dorsiflexion and rearfoot eversion ( Neville et al, 2016 ). Currently, most FOs focused on reducing the rearfoot eversion ( Banwell et al, 2014 ; Mo et al, 2019 ), and consequently a majority of FO studies adopt the rearfoot wedge as the main anti-pronator FO component ( Telfer et al, 2013 ; Cherni et al, 2021 ; Desmyttere et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Immediate effects of forefoot wedges on multi-segment foot kinematics during jogging in recreational runners with a symptomatic pronated foot

Zhang

Vanwanseele²

2023

Front. Physiol.

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Background: Foot orthoses (FOs) have been used to alter lower limb kinematics and kinetics in pronated feet. A clear relationship between FOs’ features, e.g., the amount of wedging and support, and the corresponding biomechanical responses is vital for the design and prescription of FOs. In this study, we sought to determine if changing the level of the forefoot wedge would cause a linear response in the multi-segment foot kinematics during jogging, and if this effect would be enhanced by an arch support.Methods: Ten pairs of 3D printed FOs with five levels of forefoot wedges and two levels of arch supports were tested on 12 recreational runners with a symptomatic pronated foot. Multi-segment foot kinematic data during jogging was measured using the Oxford Foot Model. Two-way ANOVAs were performed to examine the main effect of the forefoot wedge and arch support, as well as their interaction on peak joint angles. Statistical parametric mapping and paired-t tests were used to identify differences in the foot kinematic traces and the joint range of motion (ROM) between each FO and the control, respectively.Results: Linear main effects for the forefoot wedge level were found in the forefoot peak dorsiflexion, eversion and rearfoot peak dorsiflexion of jogging. FOs with a medial forefoot wedge caused an average of 2.5° reduction of the forefoot peak abduction during jogging. Furthermore, forefoot wedges showed an opposite effect on the sagittal ROM of the forefoot and rearfoot. Adding an arch support did not improve the kinematic performance of a forefoot wedge during jogging.Conclusion: This study highlights a linear dose-response effect of a forefoot wedge on forefoot kinematics during jogging, and suggests using a medial forefoot wedge as an anti-pronator component for controlling forefoot motion of a pronated foot.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Immediate effects of forefoot wedges on multi-segment foot kinematics during jogging in recreational runners with a symptomatic pronated foot

Zhang

Vanwanseele²

2023

Front. Physiol.

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“…As a widely used rehabilitation treatment for patients, AFO has the effect of improving postural control of the foot and ankle in the swing and loading response phases, which has a significant positive effect on improving gait [ 36 ]. However, the restriction of the foot and ankle caused by the AFO can also obstruct the normal degree of movement of the foot and ankle joints.…”

Section: Discussionmentioning

confidence: 99%

Effect of Different Ankle-Foot Immobility on Lateral Gait Stability in the Stance Phase

Fan

Hatanaka

2022

Applied Bionics and Biomechanics

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Background. This study aimed to investigate the effect of limited foot and ankle mobility on the lateral stability of gait through the observation of the mediolateral margin of stability and related kinematic parameters. Methods. Thirty young, healthy participants walked at a fixed gait velocity on a level surface. Participants achieved different degrees of restricted mobility by wearing soft-soled shoes (S), an ankle-foot orthosis with unrestricted dorsiflexion-plantarflexion activity only (A), and an ankle-foot orthosis with unrestricted dorsiflexion-plantarflexion and adjustable horizontal rotation of the foot (OU/OR). Furthermore, the spatiotemporal parameters, mediolateral margin of stability, center of pressure, angle of the fore and hind foot relative to the tibia, and correlation coefficients of the factors were analyzed. Regression analysis was also performed. Results. At right heel strike, group A had a significantly lower mediolateral margin of stability than group S and group OU. Meanwhile, forefoot adduction (0.2 < | r | <0.4) and plantarflexion (0.2 < | r | <0.4), as well as hindfoot internal rotation (0.2 < | r | <0.6) and inversion (0.2 < | r | <0.4), correlated negatively with lateral stability. Regression analysis revealed forefoot dorsiflexion and supination were the main independent variables for group A. At right heel off, groups OU and OR had a significantly lower mediolateral margin of stability than those in groups A and S. Forefoot adduction (0.2 < | r | <0.4) and dorsiflexion (0.4 < | r | <0.6) were correlated with lateral stability, as were hindfoot dorsiflexion (0.2 < | r | <0.4) and inversion (0.2 < | r | <0.4). Regression analysis revealed forefoot abduction and plantarflexion were the main independent variables for groups OU and OR. Conclusions. The present study verified from gait data that forefoot dorsiflexion and supination at the initial contact of the stance phase were relevant factors for the differences in lateral gait stability, whereas abduction and plantar flexion of the forefoot at the terminal stance phase were the main influencing factors of lateral gait stability.

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“…In addition, both devices had distal trimlines, which were proximal to the metatarsal heads. Recent research supports encompassing the fifth metatarsal head to further increase hindfoot inversion 32 . Modification of the original UCBL trimlines to improve control of forefoot abduction deformity could have a significant impact on FPI, as both calcaneal position and forefoot orientation contribute to FPI.…”

Section: Discussionmentioning

confidence: 99%

Immediate Impacts of Two Foot Orthotic Designs on Foot Posture Index, Gait, and Comfort in Adults With Asymptomatic, Flexible Pes Planus

et al. 2022

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Introduction Flexible flatfeet are commonly treated with functional foot orthoses (FFOs) and University of California Berkeley Laboratory (UCBL) designs. This study sought to evaluate the immediate effects of low-profile FFOs and high-profile UCBL orthoses on Foot Posture Index (FPI), spatiotemportal measures of gait, and perceived comfort and compliance in adults with flexible flatfeet. Materials and Methods Fourteen individuals with self-reported asymptomatic flexible flatfeet participated in this randomized cross-sectional study. Custom FFOs and UCBL orthoses were fabricated for each participant, who then walked at a self-selected speed in each condition on a Zeno Mat. Foot Posture Index, perceived comfort and compliance, and spatiotemporal parameters were collected across conditions. Results There were no significant differences in velocity, cadence, step length, stride width, toe-in/toe-out, or stance center of pressure distance percentage. Stance phase duration significantly increased from baseline to UCBL condition. There was a statistically significant decrease bilaterally in FPI from baseline to FFO and from baseline to UCBL orthosis, but not between FFO and UCBL orthosis. There were no significant differences in comfort and compliance ratings between FFOs and UCBL orthoses. Conclusions With regard to immediate effects, both the UCBL and FFO designs improve foot posture without significant impact on spatiotemporal gait patterns or perceived comfort and compliance. Additional research is needed to determine the longevity of these effects. Clinical Relevance The results of this study support the use of both FFOs and UCBL orthoses when trying to provide foot posture correction for adults with asymptomatic flexible flatfeet.

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An Ankle-Foot Orthosis With a Lateral Extension Reduces Forefoot Abduction in Subjects With Stage II Posterior Tibial Tendon Dysfunction

Cited by 16 publications

References 33 publications

Immediate effects of forefoot wedges on multi-segment foot kinematics during jogging in recreational runners with a symptomatic pronated foot

Immediate effects of forefoot wedges on multi-segment foot kinematics during jogging in recreational runners with a symptomatic pronated foot

Effect of Different Ankle-Foot Immobility on Lateral Gait Stability in the Stance Phase

Immediate Impacts of Two Foot Orthotic Designs on Foot Posture Index, Gait, and Comfort in Adults With Asymptomatic, Flexible Pes Planus

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