Effect of foot orthoses on lower extremity kinetics during running: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Throughout the period of one year, approximately 50% of recreational runners will sustain an injury that disrupts their training regimen. Foot orthoses have been shown to be clinically effective in the prevention and treatment of several running-related conditions, yet the physical effect of this intervention during running remains poorly understood. The aim of this literature review was therefore to evaluate the effect of foot orthoses on lower extremity forces and pressure (kinetics) during running.</p> <p>Methods</p> <p>A systematic search of electronic databases including Medline (1966-present), CINAHL, SportDiscus, and The Cochrane Library occurred on 7 May 2008. Eligible articles were selected according to pre-determined criteria. Methodological quality was evaluated by use of the Quality Index as described by Downs & Black, followed by critical analysis according to outcome variables.</p> <p>Results</p> <p>The most widely reported kinetic outcomes were loading rate and impact force, however the effect of foot orthoses on these variables remains unclear. In contrast, current evidence suggests that a reduction in the rearfoot inversion moment is the most consistent kinetic effect of foot orthoses during running.</p> <p>Conclusion</p> <p>The findings of this review demonstrate systematic effects that may inform the direction of future research, as further evidence is required to define the mechanism of action of foot orthoses during running. Continuation of research in this field will enable targeting of design parameters towards biomechanical variables that are supported by evidence, and may lead to advancements in clinical efficacy.</p

A three-experiment examination of iliotibial band strain characteristics during different conditions using musculoskeletal simulation.

PURPOSE: Iliotibial band syndrome (ITBS) is a common chronic pathology mediated via excessive Iliotibial band (ITB) strain. The purpose using a three-experiment approach is to provide insight into the differences in strain between different athletic movements, the incidence of ITBS in females, the efficacy of different prophylactic modalities for ITBS and also the kinematic parameters associated with ITB strain. METHODS: Experiment 1 examined male and female athletes performing run, 45° cut and one-legged hop movements, experiment 2 observed males and females, whilst running in five different orthotic conditions and experiment 3 examined males and females riding a cycle ergometer at 70, 80 and 90RPM whilst in prophylactic knee brace and no-brace conditions. In each experiment, kinematics were obtained using a motion capture system and ITB strain was measured using a musculoskeletal simulation approach. RESULTS: In experiment 1 ITB strain was greater in the run (male=3.87% & female=4.37%; P<0.001) and cut (male=3.12% & female=4.06%; P<0.001) movements compared to hop (male=0.87% & female=1.54%). Experiment 2 showed that females exhibited increased ITB strain (male=6.34% & female=8.91%; P<0.05) and ITB strain velocity (male=57.17%/s & female=77.41%/s; P<0.05) and also in females that ITB strain velocity was greater (P≤0.01) in lateral (80.22%/s) and no-orthotic (83.01%/s) conditions compared to medial (72.58%/s) and off the shelf orthoses (74.52%/s). The regression analyses across movements showed that ITB strain was predicted by sagittal and coronal plane mechanics at the hip (R2=0.15-0.30; P<0.05) and sagittal, coronal and transverse plane kinematics at the knee joint (R2=0.15-0.22; P<0.05). CONCLUSION: Further insight is provided into differences in ITB strain across functional athletic movements, the increased incidence of ITBS in females and the parameters linked most strongly with ITB strain during different movements is provided; whilst also highlighting the prophylactic efficacy of medial and off the shelf orthoses in female runners