Effect of 7-Degree Rearfoot Varus and Valgus Wedging on Rearfoot Kinematics and Kinetics During the Stance Phase of Walking

Huerta, Javier Pascual; Moreno, Juan Manuel Ropa; Kirby, Kevin A.; Carmona, Francisco javier García; García, Angel Manuel Orejana

doi:10.7547/0990415

Cited by 14 publications

(3 citation statements)

References 41 publications

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“…Furthermore, less internal tibia rotation was described using semi-rigid, custom-moulded orthoses [15] or orthoses supported medial- anteriorly and posteriorly [16]. In contrast, other studies showed no effect on peak eversion, eversion excursion [17,18] or on internal tibia rotation with a 4° medially-wedged orthosis [11] or 7° varus wedge [19]. This controversy is also addressed in a meta-analysis by Mills et al [20], which revealed only marginal effects on kinematics by the use of foot orthoses.…”

Section: Introductionmentioning

confidence: 99%

Effects of different medial arch support heights on rearfoot kinematics

et al. 2017

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BackgroundFoot orthoses are usually assumed to be effective by optimizing mechanically dynamic rearfoot configuration. However, the effect from a foot orthosis on kinematics that has been demonstrated scientifically has only been marginal. The aim of this study was to examine the effect of different heights in medial arch-supported foot orthoses on rear foot motion during gait.MethodsNineteen asymptomatic runners (36±11years, 180±5cm, 79±10kg; 41±22km/week) participated in the study. Trials were recorded at 3.1 mph (5 km/h) on a treadmill. Athletes walked barefoot and with 4 different not customized medial arch-supported foot orthoses of various arch heights (N:0 mm, M:30 mm, H:35 mm, E:40mm). Six infrared cameras and the `Oxford Foot Model´ were used to capture motion. The average stride in each condition was calculated from 50 gait cycles per condition. Eversion excursion and internal tibia rotation were analyzed. Descriptive statistics included calculating the mean ± SD and 95% CIs. Group differences by condition were analyzed by one factor (foot orthoses) repeated measures ANOVA (α = 0.05).ResultsEversion excursion revealed the lowest values for N and highest for H (B:4.6°±2.2°; 95% CI [3.1;6.2]/N:4.0°±1.7°; [2.9;5.2]/M:5.2°±2.6°; [3.6;6.8]/H:6.2°±3.3°; [4.0;8.5]/E:5.1°±3.5°; [2.8;7.5]) (p>0.05). Range of internal tibia rotation was lowest with orthosis H and highest with E (B:13.3°±3.2°; 95% CI [11.0;15.6]/N:14.5°±7.2°; [9.2;19.6]/M:13.8°±5.0°; [10.8;16.8]/H:12.3°±4.3°; [9.0;15.6]/E:14.9°±5.0°; [11.5;18.3]) (p>0.05). Differences between conditions were small and the intrasubject variation high.ConclusionOur results indicate that different arch support heights have no systematic effect on eversion excursion or the range of internal tibia rotation and therefore might not exert a crucial influence on rear foot alignment during gait.

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Section: Introductionmentioning

confidence: 99%

Effects of different medial arch support heights on rearfoot kinematics

et al. 2017

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“…However, the Coleman block test confirms the flexible of the patients with SCF and the potential of foot orthoses to effectively realign the foot nature of the deformity ( Manoli and Graham, 2018 ). Adjusting the foot to a neutral position can improve the biomechanical function of the foot, providing support and stability, and reducing discomfort or pain ( Pascual et al, 2009 ). As a result, podiatrists recommend the use of a forefoot wedge pad and lowering the support under the arch to help correct SCF ( Manoli and Graham, 2018 ; Benjamin et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The effect of personalized orthopedic insoles on plantar pressure during running in subtle cavus foot

Ma,

Song,

Liu

2024

Front. Bioeng. Biotechnol.

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Objective: This study aims to investigate the patterns of plantar pressure distribution during running for patients with subtle cavus foot (SCF) and determine the impact of personalized orthopedic insoles with forefoot wedge on plantar pressure distribution in patients with SCF.Methods: Sixteen undergraduate participants (8 with SCF and 8 with normal arches) were recruited based on arch height index measurements. Two full-length insoles were personalized for each SCF based on plantar pressures during running, an arch support insole (ASI) and an arch support with forefoot wedge insole (AFI). Foot pressure data collected during different insole conditions in running, analyzing ten regions of footprints for peak pressure and pressure-time integral.Results: Higher peak pressures were observed in patients with SCF at the medial forefoot (p = 0.021), medial heel (p = 0.013), and lateral heel (p = 0.025), with a higher pressure-time integral also noted at the medial forefoot (p = 0.025), medial heel (p = 0.015), and lateral heel (p = 0.047) when compared to normal arches. Compared with without-insole, both the AFI and the ASI reduced peak pressure at the medial (AFI p = 0.011; ASI p = 0.024) and lateral heel (AFI p = 0.028; ASI p = 0.032). The AFI reduced peak pressure at the medial heel (p = 0.013) compared with the ASI. Both the AFI and the ASI reduced pressure-time integral at the medial forefoot (AFI p = 0.003; ASI p = 0.026), central forefoot (AFI p = 0.005; ASI p = 0.011), medial heel (AFI p = 0.017; ASI p = 0.005), and lateral heel (AFI p = 0.017; ASI p = 0.019). Additionally, the ASI reduced pressure-time integral at the big toe (p = 0.015) compared with the without-insole.Conclusion: These findings demonstrate that during running in patients with SCF, plantar pressures are concentrated in the forefoot and heel compared to the normal arch. The personalized orthotic insoles can be used to effectively redistribute plantar pressure in patients with SCF running. Incorporating a forefoot wedge to specifically address the biomechanical abnormalities associated with SCF may enhance the effectiveness of orthopedic insoles.

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“… 3 The goal is to stop the total amount of the overpronation moment, to decrease the medial acceleration of the foot during the initial-contact and full-contact phases of gait, 18 or even to correct a valgus heel. 13 However, the lower limbs can be affected by kinetic and kinematic reactions to foot orthoses, for example, by changing the pulling activity of the muscles. 25 The use of traditional foot orthoses could affect the lever arm of the leg muscles and therefore affect ankle balance.…”

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confidence: 99%

Assessment of a New Lateral Cushioned Casting Orthosis: Effects on Peroneus Longus Muscle Electromyographic Activity During Running

Sánchez-Gómez

Romero‐Morales

Gómez-Carrión

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Classical medial wedge (CMW) orthoses have been prescribed to treat overpronation foot pathologies in runners. The effects of a novel supination orthosis (NSO) on the surface electromyography (EMG) activity of the peroneus longus (PL) muscle during a complete cycle of running have yet to be tested. Purpose/Hypothesis: The purpose of this study was to compare the EMG activity of the PL in participants wearing CMW orthoses and NSOs versus neutral running shoes (NRS) during a full cycle of running gait. It was hypothesized that the PL muscle activity would be lower for the NSO compared with CMW or NRS. Study Design: Controlled laboratory study. Methods: Included were 31 healthy recreational runners of both sexes (14 male and 17 female; mean age, 38.58 ± 4.02 years) with a neutral Foot Posture Index and standard rearfoot-strike pattern. Participants ran on a treadmill at 9 km/h while wearing NSO (3-, 6-, and 9-mm thicknesses), CMW (3-, 6-, and 9-mm thicknesses), and NRS, for a total of 7 different conditions randomly selected, while the EMG signal activity of the PL was recorded for 30 seconds. Each trial was recorded 3 times, and the intraclass correlation coefficient (ICC) to test reliability of the measurements was calculated. The Wilcoxon pair to pair nonparametric test with Bonferroni correction was performed to analyze differences among the conditions. Results: The reliability of all assessments was almost perfect (ICC, >0.81). For both the CMW and NSO, regardless of thickness, the PL activity was statistically significantly lower compared with the NRS ( P < .05 for all). For all CMW thicknesses, the PL activity was lower compared with the respective NSO thicknesses, with the 3-mm thickness having the largest difference (CMW3mm, 18.63 ± 4.64 vs NSO3mm, 20.78 ± 4.99 mV; P < .001). Conclusion: Both CMW and NSO produced reduced EMG activity of the PL muscle; therefore, they can be prescribed to treat overpronation pathologies without associated PL strain concerns. In addition, the NSO saved the enhancement material placed on the medial-rear side of CMW, making it easier to wear sports shoes. Clinical Relevance: Knowing the safety of CMW and NSO will aid in understanding treatments for overpronation pathologies.

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Effect of 7-Degree Rearfoot Varus and Valgus Wedging on Rearfoot Kinematics and Kinetics During the Stance Phase of Walking

Abstract: These results support the idea that foot orthoses work by methods other than by changing kinematic parameters. The present study supports the concept that foot orthoses work primarily by altering kinetics, with their effects on kinematics being secondary.

Cited by 14 publications

References 41 publications

Effects of different medial arch support heights on rearfoot kinematics

Effects of different medial arch support heights on rearfoot kinematics

The effect of personalized orthopedic insoles on plantar pressure during running in subtle cavus foot

Assessment of a New Lateral Cushioned Casting Orthosis: Effects on Peroneus Longus Muscle Electromyographic Activity During Running

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