Hard, soft and off-the-shelf foot orthoses and their effect on the angle of the medial longitudinal arch: A biplane fluoroscopy study

Background: Foot orthoses have proven to be effective for conservative management of various pathologies. Pathologies of the lower limb can be caused by abnormal biomechanics such as abnormal foot structure and alignment, leading to inadequate support. Objectives: To compare biomechanical effects of different foot orthoses on the medial longitudinal arch (MLA) during dynamic gait using skeletal kinematics. Study Design: Prospective, cross-sectional study design. Methods: The MLA angle was measured for 12 participants among three groups: pes planus, pes cavus and normal arch. Five conditions were compared: three orthotic devices (hard custom foot orthosis (CFO), soft CFO, and off-the-shelf Barefoot Science©), barefoot and shod. An innovative method, markerless fluoroscopic radiostereometric analysis (RSA), was used to measure the MLA angle. Results: Mean MLA angles for both CFO conditions were significantly different from the barefoot and shod conditions (p0.05). Additionally, the differences between hard and soft CFOs were not statistically significant. All foot types showed an MLA angle decrease with both the hard and soft CFOs. Conclusions: These results suggest that CFOs can reduce motion of the MLA for a range of foot types during dynamic gait

Effect of custom design insole applications with 3D modelling on baropodometric parameters in individuals with pes planus

It was aimed to investigate the effect of custom made insoles on baropodometric analysis parameters in individuals with pes planus, using objective measurement and production methods. 100 individuals with pes planus, aged between 4-18 years in the study. Individuals who met the inclusion criteria and the medial longitudinal arch index were included in the study. Valgus angles of individuals, plantar measurements of the feet before the use of insoles and after 6 months of the use of insoles were evaluated with the Sensor Medica® device. When the measurement results of the ankle valgus angles of the individuals before and after the insoles were examined, it was observed that there was a statistical decrease in the mean results in both feet (p[removed]

The Effect of Three Foot Orthoses on Plantar Pressure Under the First Metatarsophalangeal Joint of Pes Planus Foot Type During Standing and Slow Running

The purpose of this study was to examine the effect of three different foot orthoses on plantar pressure under the first metatarsophalangeal joint during standing and slow running. Twenty physically active participants, 12 males (19.7±1.3 years, 181.5±6.3cm, 83.6±12.3kg) and 8 females (20.8±1.5 years, 172.7±11.2cm, 69.9±14.2kg) with navicular drop greater than 10mm, no history of surgery to the lower extremity, and no history of pain or injury to the 1st metatarsophalangeal joint in the past six months volunteered for the study. Each subject performed standing and slow running tasks with four different orthosis conditions: no orthosis, metatarsal dome, U-shaped orthosis, and donut-shaped orthosis. The Pedar in-shoe pressure measurement system was used to examine the effects of each orthosis peak and mean pressure under four areas of the foot: rearfoot, lateral forefoot, medial forefoot, and the first metatarsophalangeal joint. Data were collected using Pedar-X Expert software and exported into an Excel spreadsheet for analysis. Separate 2X4X4 repeated measures ANOVAs were used to analyze peak plantar pressure and mean plantar pressure. The metatarsal dome significantly decreased peak running pressure compared to no orthosis and the donut-shaped orthosis, as well as mean standing and running pressure compared to all orthosis conditions. The U-shaped orthosis significantly reduced mean running pressure compared to no orthosis. The donut-shaped orthosis significantly increased peak and mean standing pressure compared to all orthosis conditions; it similarly significantly increased peak and mean running pressure compared to the metatarsal dome and U-shaped orthosis. Findings suggest that the metatarsal dome is most effective in reducing both peak and mean plantar pressure during standing and slow running. Further research is needed to examine the application of these results to other foot types as well as symptomatic individuals

AI-Driven Personalised Offloading Device Prescriptions: A Cutting-Edge Approach to Preventing Diabetes-Related Plantar Forefoot Ulcers and Complications

Diabetes-related foot ulcers and complications are a significant concern for individuals with diabetes, leading to severe health implications such as lower-limb amputation and reduced quality of life. This chapter discusses applying AI-driven personalised offloading device prescriptions as an advanced solution for preventing such conditions. By harnessing the capabilities of artificial intelligence, this cutting-edge approach enables the prescription of offloading devices tailored to each patient's specific requirements. This includes the patient's preferences on offloading devices such as footwear and foot orthotics and their adaptations that suit the patient's intention of use and lifestyle. Through a series of studies, real-world data analysis and machine learning algorithms, high-risk areas can be identified, facilitating the recommendation of precise offloading strategies, including custom orthotic insoles, shoe adaptations, or specialised footwear. By including patient-specific factors to promote adherence, proactively addressing pressure points and promoting optimal foot mechanics, these personalised offloading devices have the potential to minimise the occurrence of foot ulcers and associated complications. This chapter proposes an AI-powered Clinical Decision Support System (CDSS) to recommend personalised prescriptions of offloading devices (footwear and insoles) for patients with diabetes who are at risk of foot complications. This innovative approach signifies a transformative leap in diabetic foot care, offering promising opportunities for preventive healthcare interventions.Comment: 33 pages, 2 figure

Ergonomics, anthropometrics, and kinetic evaluation of gait: A case study

This study aimed to develop appropriate changes in a pair of shoes in order to improve the gait of an individual selected for this case study. This analysis took into account ergonomic aspects, namely those relating to the individual’s anthropometrics. Gait analysis was done with the adapted footwear both before and after intervention.A conventional X-ray was performed, which revealed a 29-mm left lower limb shortening and possible foot adduction. The anthropometric assessment confirmed a 27-mm asymmetry between the left knee and foot.Corrective changes were implemented in the left boot, with a 20-mm increase in the plantar aspect and approximately 30-mm in the calcaneus area.The pressure-mapping system WalkinSense was used for the kinetic gait analysis. Results showed some improvement in plantar pressure distribution after corrective changes in footwear. Peak pressure in the left foot decreased from 2.8kg/cm2 to 1.6kg/cm2. The second peak also showed a marked decrease. The right foot presented with a reduction in peak plantar pressure from 2.7kg/cm2 to 2.3kg/cm2.After identifying asymmetries, the associated pathologies and modifyingthe footwear, a kinetic analysis of gait before and after altering the footwear was undertaken, which showed improvements in the gait. According to the obtained results, it was possible to demonstrate that the initially proposed objectives were achieved, i.e., the changes in footwear resulted in an improvement of the analyzed individual.This work was financed by FEDER funds through the Competitive Factors Operational Program (COMPETE) and by national funds through FCT (Portuguese Foundation for Science and Technology) with the projects BD SFRH/BD/79762/2011, PEst-C/CTM/U10264/2013 and ID/CEC/00319/2013

Republication of Uses of Braces and Orthotics for Conservative Management of Foot and Ankle Disorders .

Nonsurgical management is almost always considered the first-line treatment for the vast majority of foot and ankle pathologies. Foot orthoses, shoe modifications, and therapeutic footwear are considered essential tools for successful conservative management of different foot and ankle disorders. Orthopedic foot and ankle surgeons should have a meticulous understanding of the lower extremity biomechanics as well as the pathoanatomy and the sequelae of diseases affecting the foot and/or ankle. This is essential to the understanding of the desired effects of the different inserts, orthotics, shoe modifications, or braces that may be prescribed for these conditions. In this article, we will summarize the orthoses used for treatment of the most commonly encountered foot and ankle pathologies, with the exclusion of treatment for the diabetic foot because of the unique requirements of that disease process

APPLICATION OF CUSTOM-FIT FOOT ORTHOSES TO ENHANCE ATHLETIC PERFORMANCE –EXAMPLES IN RUNNING AND CYCLING

Running or cycling related soft tissue and joint injuries of the lower extremities are thought mainly due to the malalignment of skeletal structure which causes muscle overuse activity and high joint obstruct loading. In correcting this abnormal foot and lower extremity dysfunction, functional foot orthoses (or orthotic) are often prescribed to control abnormal foot motions and to alter the abnormal joint loadings, particularly for the over- pronated foot. They are many types of orthosis on the market, most of off-shelf products and expensive custom made ones are usually exaggerated, some even provides misleading concepts, which results in over expectation from users. Many recent literatures have challenged the accepted concept that the foot dysfunction is necessary associated with sports injury, and the orthosis is good prescription for sports injury prevention. The disagreement of efficacy of functional orthosis may be caused by the experimental setup of biomechanical researches and underlined abnormality of recruited individuals. This paper presented three separate studies to reveal the efficacy of foot orthosis in sports injury prevention and pitfall of experimental design

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Impact of Self-Selected Customized Orthotics on Lower Limbs Biomechanics

Customized insoles are commonly prescribed to prevent or treat a variety of foot pathologies and to reduce foot and lower limb fatigue. Due to the patient-specific design and production of such orthotics, the concept of self-selected customized orthotics (SSCO) has recently been developed. The goal of this study was to assess the impact of SSCO technology on several physiological and biomechanical variables during uphill power walking. Thirty male participants underwent an uphill power walking intervention at constant speed in two insoles conditions (control and SSCO). The electromyographic (EMG) activity of their right gastrocnemii and vastii muscles was measured. Perceived fatigue was assessed every 5 minutes and the intervention stopped when the targeted fatigue level was reached. Baseline and post-intervention assessments were also performed. Sixty-three percent of the participants experienced an improvement in foot fatigue while wearing the SSCO. The foot arch seemed to collapse less when participants wore the SSCO, but statistical significance was not reached. The changes in mean EMG activity was not consistent between the 50% isometric contraction and the walking trial. In conclusion, while some interesting trends were observed when wearing SSCO, further investigations should be performed to try and reach statistical significance