Foot orthotic devices to modify selected aspects of lower extremity mechanics

Bates, Barry T.; Osternig, Louis R.; Mason, Bruce R.; James, L.

doi:10.1177/036354657900700606

Cited by 177 publications

(55 citation statements)

References 2 publications

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“…Additionally, the orthotic may have placed the ligaments at the talocrural joint in a more optimal position to allow joint mechanoreceptors to detect perturbations to postural sway. It is also speculated that the orthotic offers enhanced tactile stimulation to the sur- The effectiveness of orthotic intervention for correcting malalignments of the foot has been well documented in the literature (1,14,21,22,24). Orteza et a1 (15) proposed that orthotics help to control the excessive pronation commonly seen in many athletes and that orthotic intervention prevents undue stress to the injured anterior talofibular ligament.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Orthotics on Postural Sway Following Inversion Ankle Sprain

Guskiewicz

Perrin

1996

J Orthop Sports Phys Ther

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Section: Discussionmentioning

confidence: 99%

“…Several studies have addressed the compensatory foot and ankle mechanics which accompany foot abnormalities (1,11,14,20,22,24,30). Orthotic devices have been shown to successfully modify selected aspects of lower extremity mechanics and enhance foot stability during the s u p port phase of running (l,l4,21,22).…”

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confidence: 99%

Effect of Orthotics on Postural Sway Following Inversion Ankle Sprain

Guskiewicz

Perrin

1996

J Orthop Sports Phys Ther

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“…13,27,46 Relief of pain and the ability to return to previous levels of activity are major outcome measures used to assess the success of orthotic intervention. 2,10,12,19 In addition to the subjective changes reported with their use, foot orthoses have been shown to modify selected aspects of lower extremity kinematic behavior during the stance phase of gait. To date, the majority of investigations have assessed the effectiveness of orthoses on rearfoot motion parameters, 2,5,23,36,48 rearfoot-tibia coupling behavior, 15,34,49 or tibial rotation.…”

mentioning

confidence: 99%

“…2,10,12,19 In addition to the subjective changes reported with their use, foot orthoses have been shown to modify selected aspects of lower extremity kinematic behavior during the stance phase of gait. To date, the majority of investigations have assessed the effectiveness of orthoses on rearfoot motion parameters, 2,5,23,36,48 rearfoot-tibia coupling behavior, 15,34,49 or tibial rotation. 34,49 The findings from these studies have shown varied responses to orthotic intervention, ranging from no significant differences to an assortment of changes that include a reduction in maximum pronation (calcaneal eversion), maximum pronation velocity, time to maximal pronation, total rearfoot motion, alterations in the displacement and velocity coupling between the rearfoot and tibia, and tibial rotation.…”

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confidence: 99%

The Effect of Forefoot and Arch Posting Orthotic Designs on First Metatarsophalangeal Joint Kinematics During Gait

Nawoczenski¹,

Ludewig²

2004

J Orthop Sports Phys Ther

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Study Design: Repeated-measures analysis of variance. Objective: To examine the effect of 2 different orthotic posting designs on first metatarsophalangeal (first MTP) joint kinematics during gait. Background: Common orthotic designs used to control abnormal pronation incorporate the use of a medial post in the forefoot and/or rearfoot locations. Although this design may favorably alter rearfoot and lower-limb kinematics, the incorporation of a forefoot post has been theorized to negatively impact first MTP joint function by limiting hallux dorsiflexion during push off. An alternative design that has been proposed to be more favorable for function of the hallux and first metatarsal is the medial arch support. Methods and Measures: Eighteen subjects with a mean age of 28.2 years (SD, 8.3 years) completed the study. All subjects were judged to have excessive pronation based on a clinical orthopaedic examination. Two different pairs of orthoses were custom molded for each subject. One design incorporated an extrinsic rearfoot and forefoot post and the second design had a high medial longitudinal arch in combination with an extrinsic rearfoot post. The ''Flock of Birds'' electromagnetic tracking device was used to collect 3-dimensional position and orientation data of 3 body segments (hallux, first metatarsal, and calcaneus) during the stance phase of walking for 3 conditions (no orthosis and each of the 2 different orthotic designs). A repeated-measures analysis of variance was used to assess differences in first MTP joint dorsiflexion at midstance and during the push-off period of gait, as well as metatarsal declination angle changes during relaxed stance. An exploratory regression analysis was used to investigate factors that related to the change in peak dorsiflexion for the orthotic conditions. Results: Peak first MTP joint dorsiflexion averaged between 38°and 40°across all conditions. Although slight increases in first MTP joint dorsiflexion values were noted with both types of orthotic designs, these differences were not significant at either phase of the stance cycle (P = .50). The metatarsal declination angle in relaxed stance significantly increased (P = .001) under both orthotic conditions. Considerable individual variability was present. For the rearfoot-forefoot posted orthosis, a change in the declination angle of the first metatarsal during relaxed stance with the orthosis was a significant nonlinear predictor of change in peak dorsiflexion during push off. Deborah A. Nawoczenski, Professor, Ithaca College, University of Rochester Campus, 300 East River Road 1-102, Rochester, NY 14623. E-mail: dnawoczenski@ithaca.edu Conclusions: Foot orthoses that incorporate a medial forefoot post do not have a consistent negative effect of reducing first MTP joint dorsiflexion during walking.

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“…* This premise is further supported by a 2dimensional kinematic study, demonstrating significant reductions in the time period of pronation with orthotic use. 2 Excessive or prolonged pronation of the midtarsal joint in late stance is thought to diminish the ability of the peroneus longus muscle to stabilize the first ray.8.2"..5" The tendon of the peroneus longus crosses beneath the foot and inserts onto the first metatarsal. Electromyographic profiles show a large burst of peroneus longus activity occurs at h e e l -~f f .~~ Contraction of the muscle everts and plantar flexes the first ra~.~"he effectiveness of the peroneus longus in stabilizing the first metatarsal is contingent upon the direction of pull of the tendon insertion.…”

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confidence: 99%

Comparison of First Ray Dorsal Mobility Among Different Forefoot Alignments

Glasoe¹,

Allen

Ludewig

2000

J Orthop Sports Phys Ther

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Study Design: Experimental design using 1-way analysis of variance and regression analysis to test the influence of 3 forefoot alignments on the dorsal mobility of the first ray. Objectives: To determine the effect of forefoot alignment on the magnitude of first ray dorsal mobility to an imposed load and to describe any association between forefoot alignment and age on dorsal mobility of the first ray. Background: Instability of the first ray has been implicated as a primary mechanical etiology of many foot problems. It has been proposed that a relationship exists between forefoot alignment and mobility of the first ray, with a varus aligned forefoot contributing to the development of an unstable first ray. Methods and Measures: Sixty female (n = 34) and male (n = 26) subjects aged 18-77 were assigned into valgus, neutral, and varus foot groups (20 per group) based on a clinical measurement of forefoot alignment. A load cell device measured dorsal mobility of the first ray under a standard load of 55 N. Withinday repeat measures were taken from a subsample of subjects. In addition to reliability analysis, analysis of variance and regression analyses tested the relationship between forefoot alignment, age and sex, and mobility of the first ray. Results: The forefoot valgus group demonstrated significantly less dorsal mobility of the first ray than neutral or varus groups. The varus and neutral groups were not significantly different from one another. Forefoot alignment and sex were significant linear predictors (R = 0.40) of first ray dorsal mobility. Age had no significant association to dorsal mobility of the first ray. Conclusion: Subjects having a valgus aligned forefoot had less dorsal excursion of the first ray than subjects having a neutral aligned forefoot. This investigation provides evidence supporting a relationship between forefoot alignment and mobility of the first ray. / Orthop Sports Phys Ther 2OOO;30:6 12-623.

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Foot orthotic devices to modify selected aspects of lower extremity mechanics

Cited by 177 publications

References 2 publications

Effect of Orthotics on Postural Sway Following Inversion Ankle Sprain

Effect of Orthotics on Postural Sway Following Inversion Ankle Sprain

The Effect of Forefoot and Arch Posting Orthotic Designs on First Metatarsophalangeal Joint Kinematics During Gait

Comparison of First Ray Dorsal Mobility Among Different Forefoot Alignments

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