Effects of foot orthoses on the biomechanics of the lower extremities in adults with and without musculoskeletal disorders during functional tasks: A systematic review

Moisan, Gabriel; Robb, Kelly; Mainville, Camille; Blanchette, Virginie

doi:10.1016/j.clinbiomech.2022.105641

Cited by 12 publications

(11 citation statements)

References 52 publications

(157 reference statements)

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“…Fallen foot arches result in increased pronation which may affect loading patterns across the lower limbs. Foot pronation and lateral foot pressure are increased when the talar head is lowered by 1 cm [13] . Internal tibial rotation induces mal-positioning of the patella and anterior pelvic tilt when the foot pronates.…”

Section: Biomechanical Substitution Lower Limbsmentioning

confidence: 99%

"A Review: Biomechanical Substitutions during Pregnancy and Application of Orthoses"

Yar

2022

JUMDC

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Pregnancy-related biomechanical adjustments might result in alterations in gait patterns. These modifications can change spine balance, curvature, and ambulatory patterns during pregnancy by influencing important parts of the body. The musculoskeletal system's responses to structural substitutions during pregnancy are not entirely apprehended. As a result, the primary goal of this review is to gather the important biomechanical replacements that affect gait patterns during pregnancy. Furthermore, these biomechanical alterations are investigated in-depth, and several orthotic interventions are proposed to combat these changes; nevertheless, it has yet to be determined whether or not orthoses are advantageous during pregnancy. In the light of literature, some pieces of evidence are included, but suitable guidelines are lacking to gain a better grasp of pregnancy biomechanical changes and the effect of orthoses.

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Section: Biomechanical Substitution Lower Limbsmentioning

confidence: 99%

"A Review: Biomechanical Substitutions during Pregnancy and Application of Orthoses"

Yar

2022

JUMDC

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“…They were historically prescribed with the belief that they restore normal medial longitudinal arch and skeletal alignment during locomotion and thus provide therapeutic benefits [7] according to Root et al paradigm [8]. Even though FOs do provide therapeutic benefits to patients [5,9,10], recent systematic reviews concluded that FOs do not consistently or predictably realign lower limbs during locomotion as previously suggested [11][12][13]. One systematic review with meta-analysis showed that FOs reduce rearfoot eversion by approximately two degrees during gait [14], which is far from being sufficient to completely realign the rearfoot in relation to the leg.…”

Section: Introductionmentioning

confidence: 99%

“…FOs medial longitudinal arch stiffness is a key parameter as greater stiffness is correlated with greater pronatory control of the foot and ankle during locomotion [16,18,20]. Rearfoot and forefoot extrinsic posts are among the most commonly used extrinsic additions in research and in clinical contexts [11,13,21,22] to increase FOs medial arch stiffness and consequently enhance their ability to change lower limb biomechanics through greater resistance to deformation [17,23]. FOs with posts decrease ankle eversion angles/moments [23][24][25][26] and tibialis posterior muscle activity [26] during locomotion.…”

Section: Introductionmentioning

confidence: 99%

“…FOs modify plantar pressure [16, 17], normalise centre of pressure trajectory [18] as well as modify joint moments [17, 18]. However, most studies that investigated the effects of FOs on lower limb biomechanics have used generic devices with little customisation to individuals' morphological and biomechanical particularities [11, 12]. Such devices may not generate sufficient reaction forces to modify lower limb biomechanics and thus be inadequate for studied populations and generate conflicting results.…”

Section: Introductionmentioning

confidence: 99%

“…Even though there are discrepancies between the conclusions of different studies regarding the biomechanical effects of FOs during locomotion [11][12][13], it has been hypothesised that they could provide their clinical benefits through their kinetic effects, according to the tissue stress model [15]. FOs modify plantar pressure [16,17], normalise centre of pressure trajectory [18] as well as modify joint moments [17,18].…”

Section: Introductionmentioning

confidence: 99%

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Thick shells and medially wedged posts increase foot orthoses medial longitudinal arch stiffness: an experimental study

Pelaez

Farahpour

Griffiths

et al. 2023

Journal of Foot and Ankle Research

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Background Foot orthoses (FOs) are commonly prescribed devices to attenuate biomechanical deficits and improve physical function in patients with musculoskeletal disorders. It is postulated that FOs provide their effects through the production of reaction forces at the foot-FOs interface. An important parameter to provide these reaction forces is their medial arch stiffness. Preliminary results suggest that adding extrinsic additions to FOs (e.g., rearfoot posts) increases their medial arch stiffness. A better understanding of how FOs medial arch stiffness can be modulated by changing structural factors is necessary to better customise FOs for patients. The objectives of this study were to compare FOs stiffness and force required to lower the FOs medial arch in three thicknesses and two models (with and without medially wedged forefoot-rearfoot posts). Methods Two models of FOs, 3D printed in Polynylon-11, were used: (1) without extrinsic additions (mFO), and (2) with forefoot-rearfoot posts and a 6o medial wedge (FO6MW). For each model, three thicknesses (2.6 mm, 3.0 mm, and 3.4 mm) were manufactured. FOs were fixed to a compression plate and vertically loaded over the medial arch at a rate of 10 mm/minute. Two-way ANOVAs and Tukey post-hoc tests with Bonferroni corrections were used to compare medial arch stiffness and force required to lower the arch across conditions. Results Regardless of the differing shell thicknesses, the overall stiffness was 3.4 times greater for FO6MW compared to mFO (p < 0.001). FOs with 3.4 mm and 3.0 mm thicknesses displayed 1.3- and 1.1- times greater stiffness than FOs with a thickness of 2.6 mm. FOs with a thickness of 3.4 mm also exhibited 1.1 times greater stiffness than FOs with a thickness of 3.0 mm. Overall, the force to lower the medial arch was up to 3.3 times greater for FO6MW than mFO and thicker FOs required greater force (p < 0.001). Conclusions An increased medial longitudinal arch stiffness is seen in FOs following the addition of 6o medially inclined forefoot-rearfoot posts, and when the shell is thicker. Overall, adding forefoot-rearfoot posts to FOs is significantly more efficient than increasing shell thickness to enhance these variables should that be the therapeutic aim.

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An expository analysis of biomechanical and subjective impacts induced by shoe inserts in asymptomatic subjects: A systematic review on functionality and mechanisms of action

Ahmad,

Alam

2024

Hum Ftrs & Erg Mfg Svc

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This systematic review explores the biomechanical and subjective effects of shoe inserts, including foot orthotics (FOs) and insoles, in asymptomatic subjects. Aimed at understanding their implications, the review poses two key research questions: (i) the influence of shoe inserts on lower extremity biomechanics and subjective perception and (ii) the effects of different design characteristics on these aspects. Following Preferred Reporting of Systematic Reviews and Meta‐Analysis guidelines, a meticulous search of Scopus and PubMed from August 2022 to March 2023 yielded 34 articles, with 26 focusing on biomechanical effects and eight on comfort effects. The studies, conducted during static and dynamic activities, such as standing, walking, jogging, running, jumping, and cycling, reveal significant reductions in rearfoot eversion, knee joint forces, and lower extremity muscle forces through postings and wedging in FOs. Changes in stiffness impact rearfoot kinematics, plantar pressure distribution, and ankle–foot power distribution. Conversely, surface texture and arch variations demonstrate limited significance. FOs and shoe inserts, characterized by geometric, material, location, size, and fabrication features, effectively regulate forces and moments on the lower extremity. This control promotes uniform plantar pressure distribution and enhances comfort during various activities. These insights benefit manufacturers, clinicians, and stakeholders, providing a deeper understanding of the positive benefits of FOs and shoe inserts. However, further well‐designed studies on clinical populations are necessary to validate these findings and establish their clinical efficacy, as the current focus remains on healthy subjects.

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Effects of foot orthoses on the biomechanics of the lower extremities in adults with and without musculoskeletal disorders during functional tasks: A systematic review

Cited by 12 publications

References 52 publications

"A Review: Biomechanical Substitutions during Pregnancy and Application of Orthoses"

"A Review: Biomechanical Substitutions during Pregnancy and Application of Orthoses"

Thick shells and medially wedged posts increase foot orthoses medial longitudinal arch stiffness: an experimental study

An expository analysis of biomechanical and subjective impacts induced by shoe inserts in asymptomatic subjects: A systematic review on functionality and mechanisms of action

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