Customized foot orthosis is commonly used to modify foot posture and relieve foot pain for adult acquired flexible flatfoot. However, systematic investigation of the influence of foot orthotic design parameter combination on the internal foot mechanics remains scarce. This study aimed to investigate the biomechanical effects of different combinations of foot orthoses design features through a muscle-driven flatfoot finite element model. A flatfoot-orthosis finite element model was constructed by considering the three-dimensional geometry of plantar fascia. The plantar fascia model accounted for the interaction with the bulk soft tissue. The Taguchi approach was adopted to analyze the significance of four design factors combination (arch support height, medial posting inclination, heel cup height, and material stiffness). Predicted plantar pressure and plantar fascia strains in different design combinations at the midstance instant were reported. The results indicated that the foot orthosis with higher arch support (45.7%) and medial inclination angle (25.5%) effectively reduced peak plantar pressure. For the proximal plantar fascia strain, arch support (41.8%) and material stiffness (37%) were strong influencing factors. Specifically, higher arch support and softer material decreased the peak plantar fascia strain. The plantar pressure and plantar fascia loading were sensitive to the arch support feature. The proposed statistics-based finite element flatfoot model could assist the insole optimization and evaluation for individuals with flatfoot.
Shoe attrition is inevitable as wearing time increases, which may produce diverse influences on kinematics and kinetics of lower limb joints. Excessive attrition may change support alignment and lead to deleterious impacts on the joints. The study identifies the biomechanical influences of aging shoes on lower limb joints. The shoes in the experiment were manually worn in the lateral heel. Nineteen healthy participants, including thirteen males and six females, were recruited to conduct walking experiments wearing attrition shoes (AS) and new shoes (NS) with a random order. A Vicon motion analysis system was used to collect kinematic data and ground reaction force. Kinematic and kinetic parameters of the hip, knee, and ankle joints were calculated using the Anybody Musculoskeletal Model and compared between the two conditions, AS and NS. The results showed that wearing an attrition shoe decreased the plantarflexion angle and plantarflexion moment of the ankle joint, while significantly increasing the magnitude of the first peak of the knee adduction moment and hip abduction moment and hip internal rotation moment (p < .05). The results of the study implied that wearing attrition shoes is not recommended for those people with knee problems due to increase in medial loading.
Studies have shown that individuals with knee osteoarthritis (KOA) may benefit from cycling exercise. However, the supportive evidence remains unclear. This systematic review aimed to investigate the effects of cycling rehabilitation training (CRT) on the recovery of osteoarthritic knee joints. Five databases were searched with publishing date restrictions from 1 January 2000 to 1 March 2022. We included studies that 1) recruited participants with KOA, 2) used CRT in the intervention, 3) compared measurements before and after the intervention or between a KOA group and a healthy group, and 4) included the measurements of interest. The quality of the studies was assessed using the modified Downs and Black checklist. A random-effects meta-analysis of Western Ontario and McMaster Universities Arthritis index, Lequesne index, and Timed Up and Go test scores was performed. The changes in muscle strength, kinetics, and kinematics as a result of the intervention were summarised. The quality of the 19 included studies was moderate with a median quality score of 19.05. CRT improved muscle strength and physical function (SMD 0.94, 95% CI [0.66, 1.22]), and reduce pain (SMD 0.94, 95% CI [0.66, 1.22]) and joint stiffness (SMD 0.74, 95% CI [0.46, 1.01]) in KOA patients. Compared with healthy subjects, KOA patients showed increased extensor moments and abduction peak adduction angles of their knee joints, and decreased internal rotation moment and peak angles of knee flexion and extension. CRT was effective in relieving knee pain, restoring motor function, and improving lower limb muscle strength. Knee abduction moment may be an indicator of rehabilitation progress.
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