There is an ongoing debate in the literature regarding the relationships between static foot posture, dynamic foot function, and lower limb musculoskeletal disorders. 1,2 One reason for this debate is the common confusion between foot posture, which is static, and foot function, which is dynamic. 3 Foot pronation (FP) designates a movement of the whole foot. 4 It has been defined as "a range of motion within the foot that makes the foot more prone to the support surface that is greater than that required by the individual to adjust to morphology or to adapt to the forces placed in the musculoskeletal system by kinetic and kinematic events within gait or another given action." 3 A few studies have evaluated the effect of different types of foot function on gait kinematics. Foot pronation is commonly associated with the flat foot (FF) static foot posture, 3 and several studies have reported a relationship between FP and FF. 5,6 The static FF posture has

Background: Mild leg length discrepancy (LLD) increases the biomechanical asymmetry during gait, which leads to low back pain (LBP). Orthotic insoles (OI) with a directly integrated heel lift were used to reduce this asymmetry and thus the associated LBP. The aim of this study was to analyze the biomechanical adaptations of the locomotor apparatus during gait and the subjective pain ratings before and after the establishment of OI use. Methods: Eight subjects with mild LLD ({less than or equal to} 2.0 cm) underwent 3-dimensional biomechanical analysis while walking, before and after 3 weeks of OI use. LBP was assessed separately before both measurement sessions using a visual analogue scale. Results: The analysis of the kinematic parameters highlighted individual adaptations. The symmetry index (SI) of Robinson indicated that OI had no significant effect on the kinematic gait parameters and an unpredictable effect across subjects. OI use significantly and systematically (in all subjects) reduced LBP (P < 0.05), which was correlated with changes in ankle kinematics (P = 0.02, r = 0.80). Conclusions: The effects of OI on gait symmetry are unpredictable and specific to each subject's individual manner of biomechanical compensation. The reduction in LBP seems associated with the improved ankle kinematics during gait.

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