Foot orthoses in rehabilitation—what's new

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Evidence and contradictions

Advances in motion analysis technology have improved our understanding of foot orthoses and shoe design effects on foot and lower extremity movement. Comparative studies of orthotic effectiveness are often confusing, however: it appears that for every investigation showing a positive response for some biomechanical parameter, another study may show no change. Discrepancies among the studies may be due to a number of factors, including the anatomical variability in the subjects' foot structures,

Alternative mechanisms of foot orthoses action

To date, the majority of clinical studies have assessed orthotic effectiveness on changing the biomechanical parameters of lower extremity movement patterns. The multifactorial nature of many athletic injuries, and intrinsic biomechanical abnormalities (training techniques, training terrain, equipment, footwear, previous injury history, etc) make it difficult to draw clear conclusions on the specific etiological factors contributing to a particular injury. Orthotic intervention may be

Specific sports-related injuries and orthotic applications

Though not exhaustive, the following section provides examples of common conditions of the forefoot, midfoot, and rearfoot that may benefit from foot orthoses and external shoe modifications [21]. In many cases, premade or generic over-the-counter orthoses are adequate and are significantly less expensive than custom-made designs. The over-the-counter orthoses are available in a variety of materials and, in general, are designed to provide shock absorption, increased support, or both in

Summary

Foot orthoses have been effective in the treatment of a variety of sport-related foot conditions. Although their use is well-established in clinical practice, many of the orthoses have not been evaluated in experimental conditions. Of the clinical studies that have examined the biomechanical changes associated with their use, many do not have predictable results. The failure of some studies to find trends for a particular variable does not preclude this variable being affected by the orthoses

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      2019, Foot and Ankle Clinics
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      However, metatarsal bars show favorable results in pressure reduction compared with pads, especially when placed obliquely on the shoe instead of perpendicular.11 Custom-molded insoles may achieve more significant reductions of pain compared with rockerbars,6 but in general there is no strong evidence of superiority with regard to custom-made insoles in foot complaints.12 Considering shoe wear, highest peak pressures were demonstrated with hard-soled shoes and lowest peak pressures were demonstrated with soft-soled shoes.13

    • 3-D reconstruction of foot plantar surface by using incoherent structured illumination

      2015, Optik
      Citation Excerpt :

      Orthotics is a specially designed shoe insert, which provides support for the foot by distributing pressure or realigning foot joints while standing, walking, or running. Research reports show that orthotics is effective in relieving symptoms of lower extremity problem and facilitating rehabilitation [15–18]. Customized foot orthotics is fabricated by taking a negative cast of the 3-D plantar surface of the foot with a plaster or impression foam.

    • Metatarsal bars more effective than metatarsal pads in reducing impulse on the second metatarsal head

      2011, Foot
      Citation Excerpt :

      On the other hand, metatarsal bars are shoe modifications placed on the outside sole and are therefore more cumbersome and not always well tolerated by patients. Despite the widespread use of orthotics in the treatment of metatarsalgia current literature lacks sufficient evidence regarding the superiority of one over the other [5,7,8]. We compared the efficacy of metatarsal pads to external metatarsal bars in reducing impulse on the second metatarsal head in normal subjects.

    • Custom formed orthoses in cycling

      2011, Journal of Science and Medicine in Sport
      Citation Excerpt :

      Additionally, all subjects reported subjective improvements in cycling technique (“feels smoother”, “better knee tracking”) and/or power development (“less leg fatigue”, “more stable through the down-stroke”) while using their CFOs, in addition to the improvements in various musculoskeletal pains. Similar subjective improvements have been found in previous research.11,15 The third finding of this study is that three distinct patterns of frontal plane knee mechanics during the power phase of the pedal stroke were seen, which were independent of the Null or Ortho conditions.

    • From the CORE to the Floor-Interrelationships

      2007, Sports-Specific Rehabilitation
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