The Effect of 5-Degree Valgus and Varus Rearfoot Wedging on Peak Hallux Dorsiflexion During Gait

Smith, C. T.; Spooner, Simon K.; Fletton, John Alan

doi:10.7547/0940558

Cited by 10 publications

(7 citation statements)

References 19 publications

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“…While two studies have reported increases in first MTPJ dorsiflexion with orthoses placed under the foot in static stance [85,86], one study reported no change in first MTPJ dorsiflexion [87]. Gait studies have been similarly inconsistent, with two studies reporting a decrease in first MTPJ dorsiflexion (with medial wedging [88] and orthoses [34]) and one study reporting no change [35]. …”

Section: Discussionmentioning

confidence: 99%

Rocker-sole footwear versus prefabricated foot orthoses for the treatment of pain associated with first metatarsophalangeal joint osteoarthritis: study protocol for a randomised trial

Menz

Levinger

Tan

et al. 2014

BMC Musculoskelet Disord

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BackgroundOsteoarthritis affecting the first metatarsophalangeal joint of the foot is a common condition which results in pain, stiffness and impaired ambulation. Footwear modifications and foot orthoses are widely used in clinical practice to treat this condition, but their effectiveness has not been rigorously evaluated. This article describes the design of a randomised trial comparing the effectiveness of rocker-sole footwear and individualised prefabricated foot orthoses in reducing pain associated with first metatarsophalangeal joint osteoarthritis.MethodsEighty people with first metatarsophalangeal joint osteoarthritis will be randomly allocated to receive either a pair of rocker-sole shoes (MBT® Matwa, Masai Barefoot Technology, Switzerland) or a pair of individualised, prefabricated foot orthoses (Vasyli Customs, Vasyli Medical™, Queensland, Australia). At baseline, the biomechanical effects of the interventions will be examined using a wireless wearable sensor motion analysis system (LEGSys™, BioSensics, Boston, MA, USA) and an in-shoe plantar pressure system (Pedar®, Novel GmbH, Munich, Germany). The primary outcome measure will be the pain subscale of the Foot Health Status Questionnaire (FHSQ), measured at baseline and 4, 8 and 12 weeks. Secondary outcome measures will include the function, footwear and general foot health subscales of the FHSQ, severity of pain and stiffness at the first metatarsophalangeal joint (measured using 100 mm visual analog scales), global change in symptoms (using a 15-point Likert scale), health status (using the Short-Form-12® Version 2.0 questionnaire), use of rescue medication and co-interventions to relieve pain, the frequency and type of self-reported adverse events and physical activity levels (using the Incidental and Planned Activity Questionnaire). Data will be analysed using the intention to treat principle.DiscussionThis study is the first randomised trial to compare the effectiveness of rocker-sole footwear and individualised prefabricated foot orthoses in reducing pain associated with osteoarthritis of the first metatarsophalangeal joint, and only the third randomised trial ever conducted for this condition. The study has been pragmatically designed to ensure that the findings can be implemented into clinical practice if the interventions are found to be effective, and the baseline biomechanical analysis will provide useful insights into their mechanism of action.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12613001245785

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Section: Discussionmentioning

confidence: 99%

Rocker-sole footwear versus prefabricated foot orthoses for the treatment of pain associated with first metatarsophalangeal joint osteoarthritis: study protocol for a randomised trial

Menz

Levinger

Tan

et al. 2014

BMC Musculoskelet Disord

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“…Smith y cols. (9) confi rman, en otro estudio que cuñas de 5º de valgo a nivel del retropié aumentan la fl exión dorsal de la primera articulación metarsofalágica en dinámica, como en el estudio de Munuera y cols. (7) donde utilizan ortesis para disminuir la pronación, demostrando que hay una relación entre el aumento pronación del pie y el hallux limitus.…”

Section: Relación Del Hallux Limitus Con El Aumento De La Pronaciónunclassified

“…Pero en cambio, en estática no hay muchos artículos, de ahí la importancia de estos tipos (9) (*) Articulación metatarsofalángica 6. BIBLIOGRAFIA de estudio, como el estudio de Paton (15) que demuestra que, existe una relación entre la disminución de la fl exión dorsal del hallux en estatica, Hallux Limitus Estructural y la pronación a nivel de la articulación mediotarsiana con la prueba del Navicular Drop en estática.…”

Section: Relación Del Hallux Limitus Con El Aumento De La Pronaciónunclassified

“…El rango de movimiento de la primera articulación metatarsofalángica es de 65º, aunque algunos autores hablan que puede llegar hasta los 90º, de los cuales entre 43º-48º respecto al primer metatarsiano y entre 20º-30º son respecto al suelo en carga, aunque algunos autores hablan entre valores de 50º a 90º de fl exión dorsal (1,4,5,7,8) . La dorsifl exión de la primera articulación metatarsofalángica es necesaria para estabilizar el pie durante la fase propulsiva de la marcha (3,4,9,10,11,12) y activar el Mecanismo de Windlass (13,14,15,16,17,18) por eso de este modo, una disminución de la fl exión dorsal de la primera articulación metatarsofalángica, se cree que es causante de una función anormal del pie y por tanto, de patología como el Hallux Rigidus, como se demuestra en varios artículos y estudios (19,20) . (19,20) :…”

Section: Introducción Y Definiciónunclassified

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Hallux Limitus y su relación con el pie pronado como factor etiológico

Viudas¹

2011

Rev. Int. Cienc. Podol.

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“…Several authors 9,10 have previously shown that a change in the position of the foot using varus or valgus wedges can increase hallux dorsiflexion. One study 11 investigated the effect of modified Root orthoses on maximum hallux dorsiflexion.…”

Section: Review Of the Literaturementioning

confidence: 99%

Effect of Functional Foot Orthoses on First Metatarsophalangeal Joint Dorsiflexion in Stance and Gait

Scherer

Sanders

Eldredge

et al. 2006

JAPMA

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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.

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The Effect of 5-Degree Valgus and Varus Rearfoot Wedging on Peak Hallux Dorsiflexion During Gait

Cited by 10 publications

References 19 publications

Rocker-sole footwear versus prefabricated foot orthoses for the treatment of pain associated with first metatarsophalangeal joint osteoarthritis: study protocol for a randomised trial

Rocker-sole footwear versus prefabricated foot orthoses for the treatment of pain associated with first metatarsophalangeal joint osteoarthritis: study protocol for a randomised trial

Hallux Limitus y su relación con el pie pronado como factor etiológico

Effect of Functional Foot Orthoses on First Metatarsophalangeal Joint Dorsiflexion in Stance and Gait

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