Comparative Biomechanical Effectiveness of Over-the-Counter Devices for Individuals With a Flexible Flatfoot Secondary to Forefoot Varus

OBJECTIVES:: Evaluate effects of a new off-the-shelf insert on frontal plane foot biomechanics and compare effectiveness of the new and an existing off-the-shelf insert and a motion-control shoe in neutralizing frontal plane foot biomechanics. Design: Descriptive. Setting: Biomechanics laboratory. Participants: Fifteen uninjured subjects with a flexible flatfoot secondary to forefoot varus. Assessment of risk factors: Three-dimensional kinematic and kinetic data were collected as subjects walked and jogged at their self-selected speed while wearing a motion-control running shoe, the shoe with a new off-the-shelf insert, and the shoe with an existing off-the-shelf insert. Main outcome measures: Frontal plane kinematics and rearfoot kinetics were evaluated during stance. Statistical analysis was performed using a repeated measures analysis of variance and Student-Newman-Keuls post hoc tests (α ≤ 0.05). Results: The new insert and motion-control shoe placed the forefoot in a less-everted position than the existing off-the-shelf insert during walking. There were no differences in forefoot kinematics during jogging, nor were there differences in rearfoot motion during walking or jogging. The rearfoot eversion moment was significantly lower with the new off-the-shelf insert compared with the motion-control shoe and the existing insert during walking and jogging. Conclusions: A new off-the-shelf device is available that promotes more neutral frontal plane biomechanics, thus providing a theoretical rationale for using this device for injury prevention and treatment. The comparative biomechanical effectiveness of a motion-control shoe and the orthotic inserts may assist health care professionals in selecting a device to correct the flatfoot structure

Walking the tight rope: The positionality of the researcher

This paper seeks to examine the position of the researcher within a doctoral study entitled 'The influence of\ud professional cultures on collaborative working in Children's Centres'. It draws upon previous studies by Berger\ud (2105), Walker (2007) and Eide and Kahn (2008). Drawing upon identity theory with reference to Woodward\ud (1997, Hudson (2002) and Weedon (2004) this paper makes reference to reflexivity, ethical dilemmas and\ud insider/outsider tensions. The study, based within the interpretivist paradigm, drawing upon grounded theory,\ud sought to elicit the voices of teachers, early years practitioners, health workers and family support workers.\ud Sixteen semi-structured interviews and a focus group took place within a case study Children's Centre and twelve\ud semi-structured interviews took place with 'others' from Children's Centres outside the case study. Written\ud consent was sought from participants at every stage, and confidentiality and anonymity were ensured by the\ud use of pseudonyms throughout. This paper considers some of the ethical tensions that were encountered in\ud relation to the positionality of the researcher. Ways in which these were addressed through engagement with a\ud learning circle, critical friends and a focus group will be examined. As researchers, we cannot separate ourselves\ud from the research activities in which we are engaged. Our world view is informed by our professional heritage,\ud gender, ethnicity, beliefs, and emotional responses, these all have an impact upon the research process. It is\ud important for researchers to develop strategies to enable reflexivity to be maintained throughout. Peer review\ud opportunities and developing peer support networks could be a way forward