Effect of foot orthoses on the kinematics and kinetics of normal walking gait
Introduction
Evidence relating to the clinical efficacy of foot orthoses in the management of a variety of lower limb disorders is widely available in the literature [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14]. In contrast, descriptions of the biomechanical effects of foot orthoses on the lower limb, that is the mechanisms through which we believe the clinical benefits are derived, are comparatively limited. It has been reported that medially wedged foot orthoses reduce the range of rearfoot pronation during stance [15], [16], [17], the maximum angle of calcaneal eversion, maximum calcaneal eversion moment during stance [18] and the range of internal tibial rotation associated with rearfoot pronation during running [19]. Eng and Pierrynowski [17] reported that medially wedged orthoses resulted in a decrease in the range of frontal and transverse plane motion at the knee during the contact and mid stance phases of gait, although the effects were less than 1 and 2°, respectively for the frontal and transverse planes. Lafortune et al. [20] described effects of a similar magnitude during running with a medially wedged shoe. None of these studies have reported data for the whole lower limb and pelvis, which would provide a more complete understanding of the effect of foot orthoses. Whilst the majority of investigations concentrate on medially wedged foot orthoses, designed to reduce rearfoot pronation, laterally wedged foot orthoses have had favourable reports with respect to the management of medial compartmental osteoarthritis of the knee [2], [21], [22], [23], [24], but our understanding of the biomechanical effects of these orthoses is also limited [25], [26].
The aim of this study was to describe the effects of medially wedged and laterally wedged foot orthoses on the kinematics and joint moments of the rearfoot complex, knee, hip and pelvis using a sample of asymptomatic subjects. The term rearfoot complex is used to describe the combined motions at the ankle, sub talar and mid tarsal joints. Rearfoot complex pronation is synonymous with foot pronation and associated with internal rotation of the leg relative to the foot. Rearfoot complex supination is synonymous with foot supination and external rotation of the leg relative to the foot.
Section snippets
Method
Fifteen subjects (8 male, 7 female) aged between 19 and 41 years and who had no musculoskeletal disorders, were recruited. Each subject performed ten gait cycles in each of three experimental conditions; shod, shod with medially wedged foot orthoses, and shod with laterally wedged foot orthoses. In each experimental condition, subjects walked at a controlled cadence of 108 steps/min and wore their own footwear.
The medially wedged orthoses comprised a 3 mm base material with a 10° wedge
Kinematics
The mean kinematic data for the pelvis, hip, knee and rearfoot complex in each experimental condition are presented in Fig. 1. Table 2 details the mean and standard deviation of the kinematic variables that were statistically significantly different between experimental conditions (P<0.05). The effects of the orthoses were most consistent at the rearfoot complex, with a highly statistically significant effect of both orthoses on the transverse plane kinematics. At the knee there were small
Rearfoot complex
The greatest effect of the orthoses was on the rearfoot complex. The changes in the sagittal plane rearfoot complex kinematics and joint moments were unexpected. The differences in the angular values may be an artefact of the foot being lifted inside the shoe by the depth of the orthoses and altering the sagittal plane angular value of the rearfoot complex. This is suggested because both orthoses had the same effect on the rearfoot complex position during mid stance. However, the effect was
Acknowledgements
This work was funded by the Arthritis Research Campaign (ARC).
References (41)
- et al.
The use of orthotic devices to correct plantar callus in people with diabetes
Diabetes Res. Clin. Pract.
(1995) - et al.
Effects of foot orthoses on skeletal motion during running
Clin. Biomech.
(2000) - et al.
Hip joint center location from palpable bony landmarks–a cadaver study
J. Biomech.
(1995) - et al.
ISB recommendations for standardization in the reporting of kinematic data
J. Biomech.
(1995) Adjustments to Zatsiorsky-Seluyanov's segment inertia parameters
J. Biomech.
(1996)- et al.
Electromyographic effects of foot orthotics on selected lower extremity muscles during running
Arch. Phys. Med. Rehabil.
(1999) - et al.
The effect of changes in foot sensation on plantar pressure and muscle activity
Clin. Biomech.
(2001) - et al.
Repeated measures of adult normal walking using a video tracking system
Gait Posture
(1997) - et al.
Position and orientation in space of bones during movement: experimental artefacts
Clin. Biomech.
(1996) - et al.
Surface movement error in shank kinematics and kinetic during gait
Gait Posture
(1997)
Data management in gait analysis for clinical applications
Clin. Biomech.
The influence of orthotic devices and vastus medialis strength and timing on patellofemoral loads during running
Clin. Biomech.
Functional foot orthoses for athletic injuries. A retrospective study
J. Am. Podiatr. Med. Assoc.
Clinical evaluation of the treatment of osteoarthritic knees using a newly designed wedged insole
Clin. Orthop.
Biomechanical foot orthotics: a retrospective study
J. Orthop. Sports Phys. Ther.
To cast or not to cast? The comparative effectiveness of casted and non casted orthoses
The Chiropodist
Effectiveness of orthotic shoe inserts in the long-distance runner
Am. J. Sports Med.
Orthotic therapy in the management of osteoarthritis
J. Am. Podiatr. Med. Assoc.
TL-61 versus Rohadur orthoses in heel spur syndrome
J. Am. Podiatr. Med. Assoc.
Orthotic survey. Preliminary results
J. Am. Podiatr. Med. Assoc.
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