Background Flat-footed individuals are believed to have poorer jump performance compared to normal-arched individuals. Foot orthoses are commonly used to support the deformed foot arch, and improve normal foot function. However, it is unclear if foot orthoses use affects jump performance in athletes. Our study aims to investigate if foot type and/or foot orthosis influence countermovement jump (CMJ) and standing broad jump (SBJ) performance and lower limb biomechanics. Methods Twenty-six male basketball players were classified into normal-arched ( n = 15) or flat-footed ( n = 11) groups using the Chippaux-Smirak index, navicular drop test, and the resting calcaneal angle measurement. They performed jumps with and without prefabricated foot orthoses. We measured jump height and distance for CMJ and SBJ, respectively. Hip, knee and ankle joint angles, angular velocities, moments and powers during take-off were also measured. Results For CMJ, the flat-footed group exhibited less ankle plantarflexion ( F 1,24 = 8.407, p = 0.008, η p 2 = 0.259 large effect) and less hip joint power ( F 1,24 = 7.416, p = 0.012, η p 2 = 0.244 large effect) than the normal-arched group. Foot orthoses reduced ankle eversion in both groups ( F 1,24 = 6.702, p = 0.016, η p 2 = 0.218 large effect). For SBJ, the flat-footed group produced lower peak hip angular velocity ( F 1,24 = 7.115, p = 0.013, η p 2 = 0.229 large effect) and generated lower horizontal GRF ( F 1,24 = 5.594, p = 0.026, η p 2 = 0.189 large effect) than the normal-arched group. Wearing foot orthoses reduced ankle eversion ( F 1,24 = 5.453, p = 0.028, η p 2 = 0.185 large effect), peak horizontal GRF ( F 1,24 = 13.672, p = 0.001, η p 2 = 0.363 large effect) and frontal plane ankle moment ( F 1,24 = 4.932, p = 0.036, η p 2 = 0.170 large effect). Conclusion Foot type and the use of foot orthoses influence take-off biomechanics, but no...
Background: Custom-made foot orthoses (FOs) play an integral part in managing foot disorders. Traditional FO fabrication is timeconsuming and labor intensive. Three-dimensional (3D) printed FOs save time and cost compared with the traditional manufacturing process. To date, the differences in dimensions and comfort perception of these orthoses have not been compared in a pathological population.Objective: Compare the dimensions between 3D-printed and traditionally made FOs and comfort perception between 3D-printed, traditionally made, and no FOs in individuals with flatfeet and unilateral heel pain. Study design: Within-subject single-blinded randomized crossover study design. Methods: Thirteen participants had custom-made FOs using 3D-printing and traditional processes. Orthotic lengths, widths, arch heights, and heel cup heights were compared. Participants performed walking trials under three conditions: (1) no orthoses, (2) 3Dprinted orthoses, and (3) traditionally made orthoses. Comfort perception was recorded. Orthotic dimensions were compared using paired t tests, and comfort perception were compared using one-way multiple analysis of variance and Bonferroni post hoc tests. Results: Three-dimensional-printed orthoses were wider, have higher arch heights, and heel cup heights compared with traditionally made FOs (medium to large effect sizes). There was a difference in comfort perception between the three orthotic conditions, F(12,62) 5 1.99, P 5 0.04; Wilk L 5 0.521, h p 2 5 0.279. Post hoc tests show that there is no difference in comfort perception between the 3Dprinted and traditionally made FOs. Both FOs were significantly more comfortable than no orthoses. Conclusions: Three-dimensional printing seems to be a viable alternative orthotic fabrication option. Future studies should compare the biomechanical effects of 3D-printed and traditionally made FOs.
Background Diabetic peripheral neuropathy is a common complication of diabetes mellitus. Neuropathy predisposes patients to diabetic foot ulcers (DFU) due to the loss of protective sensation and associated deformities. Management of foot ulcers are multifactorial, but pressure offloading can be considered as one of the most important aspects of management. According to IWGDF Guidelines, non-removable knee-high offloading devices are recommended as the 1st line of treatment for these ulcers. However, this is a very underutilised treatment modality. This study aimed to evaluate the practitioner preferred offloading modalities and reasons for their preference. Methods This project was approved by the university’s human research ethics committee. An online survey was distributed amongst Australian podiatrist via an industry related social media group. The survey collected simple demographical information, management strategies, preferred offloading modalities for the management of diabetic foot ulcers and reasons for their preferred method. Results Sixty-three podiatrists completed the survey with the majority practicing in private clinics. All practitioners treat diabetic foot ulcers regularly with most participants treating up to ten ulcer cases per week and 14% of participants treating more than 20 ulcers per week. Contrary to the IWGDF guidelines, standard therapeutic footwear was the most preferred method of management for the treatment of diabetic foot ulcers, with ease of use reported as the main reason for practitioners using this modality. Non-compliance to the use of non-removable knee-high offloading devices include perceived patient non-compliance and poor tolerance. Conclusion This study shows that practitioners’ offloading strategies do not adhere to the IWGDF guidelines. The reasons for not adhering to the guidelines seems to be a clinical practicality rather than evidence-based practice. Reasons for choosing a management strategy is multi-factorial (not just reducing plantar pressures). Further studies may be required to evaluate the effectiveness of therapeutic footwear in ulcer healing, taking into consideration other factors such as practitioner and patient preference, clinical practicality, and access to support. Based on the findings, this study provides suggestions on how to overcome the barriers that prevent podiatrist from adhering to the recommendations of the IWGDF when selecting offloading devices in general clinical practice.
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