The immediate effects of foot orthosis geometry on lower limb muscle activity and foot biomechanics

Reeves, JoAnna; Jones, Richard; Liu, Anmin; Bent, Leah R.; Nester, Christopher

doi:10.1016/j.jbiomech.2021.110716

Cited by 7 publications

(2 citation statements)

References 37 publications

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“…The varus rearfoot wedge (VRFW) is commonly employed in the management of lower limb pathologies, including patellofemoral pain syndrome [ 20 ], medial tibial stress syndrome [ 21 ], posterior tibial dysfunction [ 22 ] and plantar fasciitis [ 23 ]. It has been proposed as a treatment for the management of foot problems during running [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of varus rearfoot wedges on hallux dorsiflexion resistance

Gómez-Carrión,

Reguera-Medina,

Ayerra-Andueza

et al. 2024

BMC Musculoskelet Disord

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Background The first metatarsophalangeal joint (MTPJ), which includes the first metatarsal and proximal phalanx, plays a crucial role in gait and impacts the windlass mechanism. Disruptions to this mechanism are implicated in various foot pathologies. Jack’s Test serves as a valuable tool for clinicians to assess the functionality of the MTPJ. Varus rearfoot wedges (VRFWs) are a common treatment employed in the management of lower limb pathologies. The impact of VRFWs on the resistance of the first MTPJ during Jack´s Test is currently unknown. This study aimed to measure the influence of VRFWs on the resistance of the first MTPJ during Jack´s Test. The secondary objective was to validate a new measurement method using a digital force gauge. Methods Thirty participants (17 women and 13 men) were enrolled. A digital force gauge measured the weight-bearing force needed for Jack’s Test, thereby evaluating the effects of VRFWs of different angulations. The Kolmogorov–Smirnov test confirmed that the data followed a normal distribution (p > 0.05). The nonparametric Friedman test (p < 0.001) showed that there were significant differences among all VRFWs, while the Wilcoxon test (p < 0.001) showed that there were differences between barefoot conditions and 3°, 5°, and 8° VRFWs. Results: The use of 8° VRFWs yielded a statistically significant reduction in the passive dorsiflexion force of hallux during Jack’s Test (12.51 N ± 4.12, p < 0.001). Conclusions The use of VRFWs has been observed to reduce dorsiflexion resistance in the proximal phalanx of the first MTPJ during Jack’s Test. Additionally, the digital force gauge was proven to be a valid tool for conducting Jack’s Test, thus offering a reliable measurement method.

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Section: Introductionmentioning

confidence: 99%

The effect of varus rearfoot wedges on hallux dorsiflexion resistance

Gómez-Carrión,

Reguera-Medina,

Ayerra-Andueza

et al. 2024

BMC Musculoskelet Disord

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“…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. Preliminary results showed that adding posts to FOs increases the medial longitudinal arch stiffness by up to 35% [27].…”

Section: Introductionmentioning

confidence: 99%

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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The immediate effects of foot orthosis geometry on lower limb muscle activity and foot biomechanics

Cited by 7 publications

References 37 publications

The effect of varus rearfoot wedges on hallux dorsiflexion resistance

The effect of varus rearfoot wedges on hallux dorsiflexion resistance

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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