The effectiveness of rearfoot medial wedge intervention on balance for athletes with chronic ankle instability

Chang, H.; Chang, Yun-Chi; Cheng, Shih-Chung; Wang, Chun-Hou

doi:10.1097/md.0000000000016217

Cited by 9 publications

(15 citation statements)

References 27 publications

(36 reference statements)

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“…The relationship between the foot characteristics and the insole type should be examined in future studies. In contrast, several previous studies reported the effectiveness of a medial heel wedge similar in shape to the one we used [10,[42][43][44][45]. We believe that these findings support our study.…”

Section: Discussionsupporting

confidence: 84%

The Effects of a Medial Heel Wedge on the Weight-Bearing Response of Hindfoot Valgus and the Total Weight-Bearing Responses of the Navicular and Talus Bones

et al. 2021

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OBJECTIVES Medial heel wedges are commonly prescribed to manage the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones. Previous studies have reported that a medial heel wedge is effective in the management of musculoskeletal injuries. However, it remains unclear the effect of a medial heel wedge on the weight-bearing responses of footarch bones in vivo. To clarify the effects of a medial heel wedge on the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones is necessary to understand how best to treat musculoskeletal injuries clinically. The purpose of our study was to clarify the effects of a medial heel wedge on the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones.METHODS Twenty-five healthy males were analyzed. We obtained MRI scanning of the right foot under non-loading (NL) and full weight-bearing (FW) conditions. Participants wore two insole types, a flat insole and a medial heel wedge. To evaluate the weight-bearing response in hindfoot valgus, the hindfoot alignment view (HAV) was measured. We also measured navicular and talus bone positions and calculated the total positional changes of the navicular and talus bones (ΔTPCN, ΔTPCT) from the vertical and medial displacements using the Pythagorean theorem.RESULTS Significant interactions were observed with the HAV. Under both NL and FW conditions, the HAV was smaller on the medial heel wedge than on the flat insole. In addition, the ΔTPCN was significantly smaller on the medial heel wedge than on the flat insole. However, no significant differences were observed for ΔTPCT.CONCLUSIONS Our results suggest that use of a medial heel wedge decreases hindfoot valgus values under both NL and FW conditions and stabilizes the total weight-bearing response of the navicular bone.

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Section: Discussionsupporting

confidence: 84%

The Effects of a Medial Heel Wedge on the Weight-Bearing Response of Hindfoot Valgus and the Total Weight-Bearing Responses of the Navicular and Talus Bones

et al. 2021

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“…Some researchers have suggested that increased contact area leads to tactile stimulation and proprioception feedback under the foot and improvement of static balance. [31] We believe that two toe lengths in Egyptian-type toes might induce different strengths of stimulation on plantar receptors and result in greater COP displacement.…”

Section: Discussionmentioning

confidence: 92%

Effect of Toe Type on Static Balance in Ballet Dancers

Kizawa

Yasuda²,

Shima³

et al. 2020

Medical Problems of Performing Artists

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OBJECTIVES: Some forefoot shapes are ideal for pointe work in ballet. Egyptian-type, with the hallux being longest and the remaining toes decreasing in size, and Greek-type, with the second toe longer than the hallux, are considered less optimal for pointe work. Square-type, with the second toe the same length as the hallux, is considered optimal. This study compared postural stability in the bipedal stance, demi pointe, and en pointe between ballet dancers with the two toe types using a stabilometer. METHODS: This study included 25 Japanese ballet academy dancers who had received ballet lessons for at least 6 years. Toes were categorized into Egyptian-type (n=14) and square-type (n=11). Bipedal stance, demi pointe, and en pointe were tested. Center of pressure (COP) parameters were calculated from ground-reaction forces using two force plates: total trajectory length (LNG), velocities of anterior-posterior (VAP) and medial-lateral directions (VML), and maximum range displacement in the anterior-posterior (MAXAP) and medial-lateral directions (MAXML). Mann-Whitney U-tests were used to examine differences in COP parameters. RESULTS: There were no differences in parameters during bipedal stance or demi pointe. However, dancers with Egyptian-type toes had significantly greater LNG (p<0.01), VML (p=0.01), MAXML (p<0.01), and MAXAP (p=0.03) during en pointe. CONCLUSIONS: Ballet dancers with Egyptian-type toes demonstrated greater displacement in the medial-lateral and anterior-posterior directions during en pointe. Ballet dancers should be aware of toe types and sway character to optimize ballet training and balance.

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“…As mentioned, depending on the injury extent and management rendered, nearly 70% of patients will experience a subsequent sprain within 1 year of the inciting injury 7,10,25 , with more than half of those patients presenting with residual pain, weakness, instability, and swelling similar to the symptoms experienced with CAI 8 . According to Delahunt et al, patients have a 2-fold risk increase of subsequent injury within 1 year after an index ankle sprain 11 .…”

Section: Discussionmentioning

confidence: 99%

Section: Biomechanics Of the Ankle And Lower Extremitymentioning

confidence: 99%

“…It is believed that ankle dorsiflexion deficits may result from decreased talocrural joint mobilization 9 , calcaneal valgus, and subtalar joint hypermobility 10,20,21 , which may contribute to a higher propensity for recurrent lateral ankle sprains 8 . These deficits cause changes in normal ankle joint alignment and kinematics, negatively affecting postural stability 9,10 . In addition, in a study conducted by Yoshida and Suzuki, patients with CAI exhibited greater sagittal and vertical sways while performing a 1-legged stand on the affected lower extremity.…”

Section: Biomechanics Of the Ankle And Lower Extremitymentioning

confidence: 99%

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Therapeutic Approach in the Reduction of Chronic Ankle Instability Risk in Adults

Bryson

2022

JBJS Journal of Orthopaedics for Physician Assistants

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Ankle sprains are common injuries in healthy, active adults, especially those engaging in athletics or high-intensity training. Research assessing the effects and sequelae of sustained index ankle sprains demonstrates a high risk of subsequent injuries, leading to chronic ankle instability. Numerous studies have isolated risk factors and mitigation techniques, altering the progression of instability and decreased performance associated with ankle injuries. Enrollment in adequate early rehabilitation programs focused on the restoration of joint biomechanics and sensorineural control is essential in minimizing instability progression. The biomechanics, evaluation, special testing, and progressive spectrum of nonsurgical and surgically invasive treatment options are discussed.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSJOPA/A162).

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The effectiveness of rearfoot medial wedge intervention on balance for athletes with chronic ankle instability

Abstract: Supplemental Digital Content is available in the text

Cited by 9 publications

References 27 publications

The Effects of a Medial Heel Wedge on the Weight-Bearing Response of Hindfoot Valgus and the Total Weight-Bearing Responses of the Navicular and Talus Bones

The Effects of a Medial Heel Wedge on the Weight-Bearing Response of Hindfoot Valgus and the Total Weight-Bearing Responses of the Navicular and Talus Bones

Effect of Toe Type on Static Balance in Ballet Dancers

Therapeutic Approach in the Reduction of Chronic Ankle Instability Risk in Adults

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