For children with CP, use of specific types of AFOs improved gait parameters, including ankle and knee range of motion, walking speed and stride length. AFOs reduced energy expenditure in children with spastic CP. However, further studies with good PEDro scores are required for more conclusive evidence regarding the effectiveness of AFOs in children with CP.
The objective of this study was to compare the effects of wearing an insole with toe separator and night splint on hallux valgus and intermetatarsal angles and also on the intensity of pain in patients suffering from painful hallux valgus deformity. Subjects in this study consisted of 30 female patients aged 19 -45 years (mean 27.83 + 8.91) who were divided into two groups. The first group received the insole and toe separator and the second group received night splint. Hallux valgus angle and intermetatarsal angle were radiographically measured before and after a 3-month study period. Foot pain intensity was assessed by 10 cm Visual Analogue Scale before and after intervention. After statistical analysis the reduction of pain was significant in the first group (p 5 0.05) whereas in the second group no significant difference was obtained. The hallux valgus angle and intermetatarsal angle decreased in both groups; however, the reduction was not significant. According to the results of this study, using night splint seems to have no effect on painful hallux valgus deformity. On the other hand, although the insole with toe separator significantly decreased the pain intensity in these patients and was a good option for pain reduction, it was not effective in improvement of the great toe angles.
Based on the findings of this study, using orthoses with different mechanisms such as proprioceptive intervention might be a useful method in orthotic treatment. Assessing plantar pressure can also be an efficient quantitative outcome measure for clinicians in evidence-based foot orthosis prescription.
Findings of this study will improve the clinical knowledge about the effect of the medial arch support foot orthosis used on plantar pressure distribution in hallux valgus pathology.
An orthopaedic shoe can be expensive, and in particular heavy with most children reluctant to wear it. This study focussed on the CoP displacement and selected gait parameters with an orthopaedic shoe and functional foot orthosis, and showed that a combined prescription of a functional foot orthosis and with regular shoes may be a useful alternative for children with moderate flat foot.
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