Immediate Effects of Medially Posted Insoles on Lower Limb Joint Contact Forces in Adult Acquired Flatfoot: A Pilot Study

Peng, Yonghan; Wong, Duo Wai-Chi; Yan, Wang; Chen, Tony Lin-Wei; Tan, Qitao; Chen, Zhenxian; Zhang, Jin; Zhang, Ming

doi:10.3390/ijerph17072226

Cited by 38 publications

(63 citation statements)

References 53 publications

(84 reference statements)

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“…Our study found that the manifestation of the first metatarsal medial deviation induced by deforming load may be hindered by the forefoot abduction or pronation that formed a viscous cycle to provoke more deforming load. Controlling the pronation or eversion by supporting the medial longitudinal arch by orthosis (Glasoe et al, 2010;Nakagawa et al, 2019;Peng et al, 2020) may slow down the deterioration process and supplement surgical outcomes to reduce recurrence.…”

Section: Discussionmentioning

confidence: 99%

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Wong

Yan

Chen

et al. 2020

Front. Bioeng. Biotechnol.

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Hallux valgus is a common foot problem affecting nearly one in every four adults. Generalized ligament laxity was proposed as the intrinsic cause or risk factor toward the development of the deformity which was difficult to be investigated by cohort clinical trials. Herein, we aimed to evaluate the isolated influence of generalized ligament laxity on the deterioration using computer simulation (finite element analysis). We reconstructed a computational foot model from a mild hallux valgus participant and conducted a gait analysis to drive the simulation of walking. Through parametric analysis, the stiffness of the ligaments was impoverished at different degrees to resemble different levels of generalized ligament laxity. Our simulation study reported that generalized ligament laxity deteriorated hallux valgus by impairing the loadbearing capacity of the first metatarsal, inducing higher deforming force, moment and malalignment at the first metatarsophalangeal joint. Besides, the deforming moment formed a deteriorating vicious cycle between hallux valgus and forefoot abduction and may result in secondary foot problems, such as flatfoot. However, the metatarsocuneiform joint did not show a worsening trend possibly due to the overriding forefoot abduction. Controlling the deforming load shall be prioritized over the correction of angles to mitigate deterioration or recurrence after surgery.

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Section: Discussionmentioning

confidence: 99%

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Wong

Yan

Chen

et al. 2020

Front. Bioeng. Biotechnol.

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“…Jiang et al [ 46 ] measured three different conditions: using an orthotic insole, a flat foot insole and 3-D printed insole. Two studies [ 43 , 44 ], used imaging as well as pressure plates. In Murley et al [ 42 ], imaging and electromyogram were conducted at baseline.…”

Section: Resultsmentioning

confidence: 99%

“…In contrast Park et al [ 43 ] investigated the change in pelvic angle using foot orthoses and reported a significant decrease after wearing the orthotic. Peng et al [ 44 ] investigated the patellofemoral joint and the medial and lateral tibiofemoral joint. After wearing the foot orthoses, the second peak patellofemoral contact force and the peak contact force of the ankle were significantly lower.…”

Section: Resultsmentioning

confidence: 99%

Evidence for foot orthoses for adults with flatfoot: a systematic review

Herchenröder

Wilfling

Steinhäuser

2021

Journal of Foot and Ankle Research

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Background Flatfoot is characterised by the falling of the medial longitudinal arch, eversion of the hindfoot and abduction of the loaded forefoot. Furthermore, flatfoot leads to a variety of musculoskeletal symptoms in the lower extremity, such as knee or hip pain. The standard conservative treatment for flatfoot deformity is exercise therapy or treatment with foot orthoses. Foot orthoses are prescribed for various foot complaints. However, the evidence for the provision of foot orthoses is inconsistent. The aim of this systematic review is to synthesize the evidence of foot orthoses for adults with flatfoot. Methods A computerized search was conducted in August 2021, using the databases PubMed, Scopus, Pedro, Cochrane Library, and the Cochrane Central Register of Controlled Trials. Intervention studies of any design investigating the effects of foot orthoses were included, apart from case studies. Two independent reviewers assessed all search results to identify eligible studies and to assess their methodological quality. Results A total of 110 studies were identified through the database search. 12 studies met the inclusion criteria and were included in the review. These studies investigated prefabricated and custom-made foot orthoses, evaluating stance and plantar pressure during gait. The sample sizes of the identified studies ranged from 8 to 80. In most of the studies, the methodological quality was low and a lack of information was frequently detected. Conclusion There is a lack of evidence on the effect of foot orthoses for flatfoot in adults. This review illustrates the importance of conducting randomized controlled trials and the comprehensive development of guidelines for the prescription of foot orthoses. Given the weak evidence available, the common prescription of foot orthoses is somewhat surprising.

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“…Controlling the patients' physical conditions, such as the joint alignment and weight-bearing state during casting, plays a vital role, aside from the geometrical fitness and maintaining the subtalar joint neutral being a rule of thumb [49]. To evaluate whether the orthosis could adjust the muscular action and internal load transfer, some studies measured the surface electromyography [50] while computer simulations were also utilized to predict the muscle force, internal joint loading, and the stress of the plantar fascia and ligaments [51][52][53].…”

Section: Discussionmentioning

confidence: 99%

A Three-Dimensional Printed Foot Orthosis for Flexible Flatfoot: An Exploratory Biomechanical Study on Arch Support Reinforcement and Undercut

et al. 2021

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The advancement of 3D printing and scanning technology enables the digitalization and customization of foot orthosis with better accuracy. However, customized insoles require rectification to direct control and/or correct foot deformity, particularly flatfoot. In this exploratory study, we aimed at two design rectification features (arch stiffness and arch height) using three sets of customized 3D-printed arch support insoles (R+U+, R+U−, and R−U+). The arch support stiffness could be with or without reinforcement (R+/−) and the arch height may or may not have an additional elevation, undercutting (U+/−), which were compared to the control (no insole). Ten collegiate participants (four males and six females) with flexible flatfoot were recruited for gait analysis on foot kinematics, vertical ground reaction force, and plantar pressure parameters. A randomized crossover trial was conducted on the four conditions and analyzed using the Friedman test with pairwise Wilcoxon signed-rank test. Compared to the control, there were significant increases in peak ankle dorsiflexion and peak pressure at the medial midfoot region, accompanied by a significant reduction in peak pressure at the hindfoot region for the insole conditions. In addition, the insoles tended to control hindfoot eversion and forefoot abduction though the effects were not significant. An insole with stronger support features (R+U+) did not necessarily produce more favorable outcomes, probably due to over-cutting or impingement. The outcome of this study provides additional data to assist the design rectification process. Future studies should consider a larger sample size with stratified flatfoot features and covariating ankle flexibility while incorporating more design features, particularly medial insole postings.

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Immediate Effects of Medially Posted Insoles on Lower Limb Joint Contact Forces in Adult Acquired Flatfoot: A Pilot Study

Cited by 38 publications

References 53 publications

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Evidence for foot orthoses for adults with flatfoot: a systematic review

A Three-Dimensional Printed Foot Orthosis for Flexible Flatfoot: An Exploratory Biomechanical Study on Arch Support Reinforcement and Undercut

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