Choosing Among 3 Ankle-Foot Orthoses for a Patient With Stage II Posterior Tibial Tendon Dysfunction

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

“…Compared to the standard AFO, the AFO with a lateral extension further improved forefoot plantar flexion by 1.5°; however, this did not exceed the 2-SEM value of 2.4°. Of importance is that the custom AFO improved forefoot plantar flexion, consistent with previous studies, 25,26 and the addition of the lateral extension did not adversely affect this motion. Therefore, the positive effect of lateral extension on controlling forefoot abduction is not offset by a negative or neutral effect on other foot kinematics.…”

“…This was a modification of our original model, in which the flexion/extension angle was calculated from movement of the first metatarsal but forefoot abduction/adduction angle was calculated from the lateral forefoot segment (second, third, and fourth metatarsals). 34 Consistent with a previous study, 25 the lateral forefoot segment could not be observed, owing to the use of the AFO and shoes.…”

“…The standard AFO did not result in a significant increase in forefoot adduction, which is consistent with previous studies. 25,26 The observed change of 1.5° in the standard AFO, however, did not exceed the 2-SEM value of 2.5° (TABLE 2). The standard AFO is designed to increase forefoot adduction through a 3-point pressure system that opposes abnormal forces caused by foot deformity.…”

Adult-Acquired Flatfoot Deformity and Age-Related Differences in Foot and Ankle Kinematics During the Single-Limb Heel-Rise Test

“…Similarly, orthotic strategies typically emphasize rearfoot control as opposed to forefoot control for patients with AAFD. 25 Yet, the findings of the current study, along with the study by Houck et al, 11 indicate that abnormal sagittal plane kinematics of both the forefoot and rearfoot need to be considered.…”

A musculoskeletal foot model for clinical gait analysis

“…Models vary in terms of the number of segments, definitions of segments, coordinate alignments and use of static offsets. These models have been validated and are being used to research pathological conditions and treatment strategies in posterior tibial tendon dysfunction (Neville and Houck, 2009), diabetes (Sawacha et al, 2009), adult flat foot (Arangio et al, 2007) and rheumatoid arthritis (Woodburn et al, 2004) among others. Till date, no multi-segment kinematic foot model has been used as part of a musculoskeletal model.…”