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Postural stability and foot orthoses

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  #1  
Old 27th April 2007, 01:03 PM
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Default Postural stability and foot orthoses

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Effect of Orthoses on Postural Stability in Asymptomatic Subjects With Rearfoot Malalignment During a 6-Week Acclimation Period
Mattacola CG, Dwyer MK, Miller AK, Uhl TL, McCrory JL, Malone TR.
Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 5, May 2007, Pages 653-660

Quote:
Objective
To determine the effect of custom-fitted orthoses on postural sway over a 6-week acclimation period.

Design
Repeated-measures analysis of variance on postural sway measures with factors being group (control, malaligned), time (initial, 2wk, 4wk, 6wk postintervention), and condition (with orthoses, without orthoses). For single-limb stance, side (right, left) was analyzed to determine bilateral differences.

Setting
Biodynamics laboratory.

Participants
Twenty-one subjects, 11 asymptomatic with rearfoot malalignment and 10 asymptomatic with normal rearfoot alignment.

Interventions
Orthoses were prescribed and worn for 6 weeks. Balance testing was performed on 4 different dates with each subject tested in both orthotic conditions. Postural control was measured with three 10-second eyes-closed trials for single-limb stance, one 20-second eyes-closed bilateral stance with the platform moving, and one 20-second eyes-open bilateral stance with the platform and surroundings moving.

Main Outcome Measures
Sway velocity (in deg/s) for single-limb stance and equilibrium score for bilateral stance.

Results
Postural sway measures were significantly decreased during single-limb testing with orthoses versus without orthoses, regardless of group. The orthotic intervention significantly improved bilateral stance equilibrium score in the malaligned group at weeks 2, 4, and 6 when compared with measures at the initial week. Equilibrium score of the malaligned group with orthoses at initial week was significantly lower (worse) than the control group with orthoses at initial week; however, these results were not repeated during measurements taken at weeks 2, 4, or 6.

Conclusions
The application of orthoses decreased sway velocity for single-limb stance, improving postural stability regardless of group when visual feedback was removed. During bilateral stance, postural stability was initially worse for the malaligned group with and without orthoses when compared with the control group; however, improvements were seen by week 2 and continued throughout the remainder of testing. Clinically, the application of orthoses appears to improve postural control in people with rearfoot malalignment, particularly when vision is removed.
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  #3  
Old 8th August 2008, 11:03 AM
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Default Re: Postural stability and foot orthoses

Arch support use for improving balance and reducing pain in older adults.
Mulford D, Taggart HM, Nivens A, Payrie C.
Appl Nurs Res. 2008 Aug;21(3):153-8
Quote:
PURPOSE: The purpose of this study was to examine the effects of arch supports on balance, functional mobility, and pain in the back and lower extremity joints among older adults.

DESIGN: A single-factor within-subjects design was used. METHOD: A convenience sample of older adults formed a single group for fitting with arch supports. Balance, functional mobility, and self-reported pain in the back and lower extremities were measured without the arch supports, immediately after the insertion of the supports in the subjects' shoes, and after 6 weeks of arch support use.

FINDINGS: Sixty-seven older adults completed the study. The measures used indicated statistically significant improvements in scores for the Berg Balance Scale [Berg, K., Williams-Dauphinee, S., & Williams, J. I., (1995). The Balance Scale: Reliability assessment for elderly residents and patients with an acute stroke. Scandinavian Journal of Rehabilitation Medicine, 27, 27-31] and functional mobility [Timed Up and Go test; Podsiadlo, D., & Richardson, S. (1991). The Timed "Up and Go": A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39, 142-148] as well as reduced back, foot, knee, and hip pain (p < .05). There was no statistically significant change in ankle pain (p > .05).

IMPLICATIONS: Knowledge of interventions that enhance health and well-being is essential for nurses. Arch supports may provide improved balance and functional mobility while reducing back and lower extremity joint pains. Further research is needed to support evidence-based practice.
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  #4  
Old 21st May 2010, 01:51 PM
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Default Re: Postural stability and foot orthoses

Do ankle orthoses improve ankle proprioceptive thresholds or unipedal balance in older persons with peripheral neuropathy?
Son J, Ashton-Miller JA, Richardson JK.
Am J Phys Med Rehabil. 2010 May;89(5):369-75.
Quote:
OBJECTIVE: To determine whether ankle orthoses that provide medial and lateral support, and have been found to decrease gait variability in older persons with peripheral neuropathy, decrease (improve) frontal plane ankle proprioceptive thresholds or increase unipedal stance time in that same population.

DESIGN: Observational study in which unipedal stance time was determined with a stopwatch, and frontal plane ankle (inversion and eversion) proprioceptive thresholds were quantified during bipedal stance using a foot cradle system and a series of 100 rotational stimuli, in 11 older neuropathic subjects (8 men; age 72 +/- 7.1 yr) with and without ankle orthoses.

RESULTS: The subjects demonstrated no change in combined frontal plane (inversion + eversion) proprioceptive thresholds or unipedal stance time with vs. without the orthoses (1.06 +/- 0.56 vs. 1.13 +/- 0.39 degrees, respectively; P = 0.955 and 6.1 +/- 6.5 vs. 6.2 +/- 5.4 secs, respectively; P = 0.922).

CONCLUSION: Ankle orthoses that provide medial-lateral support do not seem to change ankle inversion/eversion proprioceptive thresholds or unipedal stance time in older persons with diabetic peripheral neuropathy. Previously identified improvements in gait variability using orthoses in this population are therefore likely related to an orthotically induced stiffening of the ankle rather than a change in ankle afferent function.
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Old 7th July 2010, 08:40 AM
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Default Postural control deficits: the role of foot orthoses

The mechanism by which foot orthoses improve postural control remains uncertain, but research suggests that it may stem from improvements in sensory feedback or changes in center of pressure that in turn affect joint moments. http://www.lowerextremityreview.com/...-foot-orthoses
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  #6  
Old 28th January 2012, 02:53 PM
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Default Re: Postural stability and foot orthoses

Effects of Foot Orthoses on Balance in Older Adults.
Gross MT, Mercer VS, Lin FC.
J Orthop Sports Phys Ther. 2012 Jan 25
Quote:
STUDY DESIGN:
Controlled laboratory study using a single cohort design.

OBJECTIVES:
To determine if balance in older adults could be significantly improved with foot orthotic intervention.

BACKGROUND:
Poor balance has been associated with risk for falls. Limited evidence exists indicating that foot orthoses influence balance.

METHODS:
Thirteen individuals older than 65 who reported at least 1 unexplained fall during the past year and who demonstrated poor balance participated in the study. Subjects were tested for one-leg stance, tandem stance, tandem gait, and alternating step tests during the first (SCREEN) and second (PRE) sessions prior to foot orthotic intervention. Tests were repeated during the second testing session immediately after custom foot orthotic intervention (POST), and 2 weeks following foot orthotic use (FU). SCREEN and PRE measures were compared for stability using absolute difference computations and Friedman's rank test. PRE, POST, and FU data were analyzed using the Friedman's rank test (alpha = 0.05) with Bonferroni correction for multiple post-hoc comparisons.

RESULTS:
Each balance measure was statistically equivalent between the SCREEN and PRE measurements. One-leg stance times for PRE were significantly less than POST (P = .002) and FU (P = .013) measurements. Tandem stance times for PRE were significantly less than POST (P = .013) and FU (P = .013) measurements. Steps taken for the tandem gait test during the PRE measurements were significantly fewer than steps taken for the FU test (P = .007). Steps taken during the alternating step test for the PRE test were significantly fewer than steps taken during the POST (P = .002) and FU (P =.001) tests. POST and FU measurements were not significantly different for any of the 4 outcome measures.

CONCLUSIONS:
The results provide preliminary evidence that foot orthoses can effect improvement in balance measures for older adults
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Old 21st July 2012, 11:50 AM
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Default Re: Postural stability and foot orthoses

Changes of Postural Steadiness Following Use of Prefabricated Orthotic Insole.
Bateni H.
J Appl Biomech. 2012 Jul 5
Quote:
Orthoses are designed to assist a mal-aligned foot in adapting to the environment and reduce the frequency of injury. Literature is divided on the benefits of orthotics insoles for postural stability. The current study was conducted to determine the effect of prefabricated orthotic arch supports on postural stabilization. Twelve healthy young adults participated in this study and were tested with and without prefabricated orthotics. Different variables were computed from movement of center of pressure (COP) during orthotic use as suggested in the literature. The mean position of COP was significantly shifted forward and toward the dominant side. Neither the COP movement nor the velocity changes following the use of orthotics revealed significant differences. Mediolateral range of COP movement and the 95% confidence circle area of sway was significantly reduced (p=0.022 and 0.048 respectively), but changes in 95% confidence circle and ellipse areas of fractal dimension were not significant (p=.053 and p=.057 respectively). In conclusion, orthotic insoles significantly improved postural sway initially by reducing mediolateral range of postural sway and 95% confidence circle area of sway at the cost of increased fractal dimension area variables and power.
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Old 21st July 2012, 11:51 AM
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Default Re: Postural stability and foot orthoses

Effects of Foot Orthoses on Balance in Older Adults
Michael T. Gross, Vicki S. Mercer, Feng-Chang Lin
J Orthop Sports Phys Ther 2012;42(7):649-657
Quote:
STUDY DESIGN: Controlled laboratory study using a single-cohort design. OBJECTIVES: To determine if balance in older adults could be significantly improved with foot-orthotic intervention.

BACKGROUND: Poor balance has been associated with risk for falls. Limited evidence exists indicating that foot orthoses influence balance.

METHODS: Thirteen individuals older than 65 years, who reported at least 1 unexplained fall during the past year and demonstrated poor balance, participated in the study. Subjects were tested for 1-leg stance, tandem stance, tandem gait, and alternating step tests during the first (SCREEN) and second (PRE) sessions prior to foot-orthotic intervention. Tests were repeated during the second testing session immediately after custom foot-orthotic intervention (POST) and 2 weeks following foot-orthotic use (FU). SCREEN and PRE measures were compared for stability using absolute difference computations and the Friedman rank test. PRE, POST, and FU data were analyzed using the Friedman rank test (α = .05), with Bonferroni correction for multiple post hoc comparisons.

RESULTS: Each balance measure was statistically equivalent between the SCREEN and PRE measurements. One-leg stance times for PRE were significantly less than POST (P = .002) and FU (P = .013) measurements. Tandem stance times for PRE were significantly less than POST (P = .013) and FU (P = .013) measurements. Steps taken for the tandem gait test during the PRE measurements were significantly fewer than steps taken for the FU test (P = .007). Steps taken during the alternating step test for the PRE test were significantly fewer than steps taken during the POST (P = .002) and FU (P =.001) tests. POST and FU measurements were not significantly different for any of the 4 outcome measures.

CONCLUSIONS: The results provide preliminary evidence that foot orthoses can effect improvement in balance measures for older adults.
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  #9  
Old 7th May 2013, 06:11 AM
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Default Re: Postural stability and foot orthoses

Changes of postural steadiness following use of prefabricated orthotic insoles.
Bateni H.
J Appl Biomech. 2013 Apr;29(2):174-9.
Quote:
Orthoses are designed to assist a malaligned foot in adapting to the environment and reduce the frequency of injury. Literature is divided on the benefits of orthotics insoles for postural stability. The current study was conducted to determine the effect of prefabricated orthotic arch supports on postural stabilization. Twelve healthy young adults participated in this study and were tested with and without prefabricated orthotics. Different variables were computed from movement of center of pressure (COP) during orthotic use as suggested in the literature. The mean position of COP was significantly shifted forward and toward the dominant side. Neither the COP movement nor the velocity changes following the use of orthotics revealed significant differences. Mediolateral range of COP movement and the 95% confidence circle area of sway was significantly reduced (P = .022 and 0.048 respectively), but changes in 95% confidence circle and ellipse areas of fractal dimension were not significant (P = .053 and P = .057 respectively). In conclusion, orthotic insoles significantly improved postural sway initially by reducing mediolateral range of postural sway and 95% confidence circle area of sway at the cost of increased fractal dimension area variables and power.
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  #10  
Old 8th May 2013, 04:24 AM
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Default Re: Postural stability and foot orthoses

Postural Distortions leading to chronic musculoskeletal pain is the basic tenant behind proprioceptive therapy. Current studies linking insoles to changes in postural permutations tend to validate (in my opinion) this basic tenant.

The fact that proprioceptive insoles dramatically change postural alignments is evident when one reviews the changes in posture - pre vs post proprioceptive Tx. What is not so apparent to many healthcare providers, are the visceral changes that accompany the postural corrections.

Professor Brian
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Old 8th May 2013, 11:13 PM
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Default Re: Postural stability and foot orthoses

Quote:
Originally Posted by Brian A. Rothbart View Post
Postural Distortions leading to chronic musculoskeletal pain is the basic tenant behind proprioceptive therapy. Current studies linking insoles to changes in postural permutations tend to validate (in my opinion) this basic tenant.

The fact that proprioceptive insoles dramatically change postural alignments is evident when one reviews the changes in posture - pre vs post proprioceptive Tx. What is not so apparent to many healthcare providers, are the visceral changes that accompany the postural corrections.

Professor Brian
This is a strange thread Brian (btw, do you mean tenet rather than tenant?).

From where I'm sitting the explanation is very simple:
The foot is designed to conform and provide a stable platform for ambulation on all kinds of surfaces, but as we age some joints stiffen and others stop working altogether.
This will affect stability in some subjects.

Anything which cradles the plantar foot profile on the upper surface, and provides a flat under-surface to conform to the flat,hard surface which the study was undoubtedly carried out on, is bound to help overall stability in some subjects.
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Old 9th May 2013, 09:28 AM
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Default Re: Postural stability and foot orthoses

Doesn't postural stability begin with spinal/pelvic stabilisation?.
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Old 9th May 2013, 09:01 PM
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Default Re: Postural stability and foot orthoses

Quote:
Originally Posted by davidh View Post
but as we age some joints stiffen and others stop working altogether.
This will affect stability in some subjects.
^ Fix this first.


Quote:
Originally Posted by davidh View Post
Anything which cradles the plantar foot profile on the upper surface, and provides a flat under-surface to conform to the flat,hard surface which the study was undoubtedly carried out on, is bound to help overall stability in some subjects.
But there joints are still stiff & immobile.

Lets not gloss over a serious problem with a pat solution.
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Old 9th May 2013, 10:41 PM
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Default Re: Postural stability and foot orthoses

Quote:
Originally Posted by Sicknote View Post
^ Fix this first.




But there joints are still stiff & immobile.

Lets not gloss over a serious problem with a pat solution.
It was an explanation, not a solution. The solution is orthotics, suitable footwear, and, depending on the level of instability or infirmity, a walker on wheels, or a frame.
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Old 10th May 2013, 01:10 AM
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Default Re: Postural stability and foot orthoses

Quote:
Originally Posted by davidh View Post
The solution is orthotics, suitable footwear, and, depending on the level of instability or infirmity, a walker on wheels, or a frame.
Where referring to poor joint health.

You have totally overlooked the most important factor.

How do your solutions go about getting to the core of the problem when the patient is constantly feeding (degrading/calcifying/inflaming) the joint problems?.
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Old 12th May 2013, 01:23 AM
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Default Re: Postural stability and foot orthoses

If poor foot posture and bad mechanics are causing the postural problem, having a Kinematic effect on foot posture will effect the stability of the body as it will feel more stable.
Neil
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Old 13th May 2013, 10:54 AM
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Default Re: Postural stability and foot orthoses

Quote:
Originally Posted by davidh View Post
Anything which cradles the plantar foot profile on the upper surface, and provides a flat under-surface to conform to the flat,hard surface which the study was undoubtedly carried out on, is bound to help overall stability in some subjects.
Yes!

I rather like Dr. Richie's definition of Postural Control:

Quote:
The term balance describes a person’s ability to remain upright in stance.14 Postural control is the ability to maintain the body’s center of gravity (CoG) within the borders of support.15 Postural control, therefore, is a strategy to maintain balance. Balance occurs during static stance and dynamic gait. Postural control is typically measured during quiet static stance and can be evaluated during either single- or double-limb support.

Quote:
Originally Posted by Sicknote View Post
Doesn't postural stability begin with spinal/pelvic stabilisation?.
No, it can be independent of the hemipelvis. Sicknote you're obviously a chiropractor and I'd bet dollars to donuts you dispense Foot Levelers (you are reciting their mantra are you not)? I feel the hemipelvis is not often the genesis of foot and/or balance problems.

Podiatrists tend to look to the feet first and chiropractors to the spine.

Everything we believe and do is as a result of the lens through which we view the world.

I wish you would just post under your real name so that we could have an adult discussion as colleagues.

Best
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Old 14th May 2013, 01:47 PM
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Default Re: Postural stability and foot orthoses

http://www.podiatry-arena.com/podiat...6&postcount=61

Influence of foot positions on the spine and pelvis.
Betsch M, Schneppendahl J, Dor L, Jungbluth P, Grassmann JP, Windolf J, Thelen S, Hakimi M, Rapp W, Wild M.
Arthritis Care Res (Hoboken). 2011 Dec;63(12):1758-65.

Quote:
OBJECTIVE:
The management of knee osteoarthritis includes the use of wedged shoe insoles to unload the affected knee compartment. Although the biomechanical effects of shoe insoles on the knee joint are known and described, only little is known about their influence on the pelvis and spine. Therefore, the purpose of this study was to evaluate the effects of different foot positions, such as how they could be achieved by shoe insoles, on pelvic position and spinal posture.

METHODS:
A total of 51 test subjects were measured for this study. The different foot positions (inner and outer margin increase, positive and negative heel height) were simulated with a specially designed stand platform. A rasterstereographic device was used to measure the immediate effects of the simulated foot positions on the pelvic position and spinal posture.

RESULTS:
Positive and negative heel heights as well as an increase of the outer margin of the platform led to significant changes of the pelvic tilt. The pelvic torsion also changed significantly during positive heel height changes of 10 and 15 mm and increases of the outer margin of the foot. No significant changes were found between foot position and spinal parameters.

CONCLUSION:
The results of our study support the existence of a kinematic chain, where changes of foot position also led to significant alterations of the pelvic position. Whether these changes could lead to long-term pathologic alterations still needs to be evaluated. However, in our setting, no correlation between foot position and spinal posture changes was found.


I'd like to see evidence to the contrary, takers?
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Old 23rd December 2013, 04:39 PM
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Default Re: Postural stability and foot orthoses

The effect of lateral or medial wedges on control of postural sway in standing
Mohan Ganesan, Yun-Ju Lee, Alexander S. Aruin
Gait & Posture; Article in Press
Quote:
The objective of this study was to evaluate the effects of lateral and medial wedges on postural sway. Twenty healthy volunteers (mean age range of 28.45±3.34) participated in the study. They stood barefoot with eyes open or closed on each of the three surfaces: 10° lateral wedges, 10° medial wedges, and no wedges. Force platform data were collected and the mean and root mean square (RMS) distance, range, and velocity and the mean frequency of the center of pressure (COP) were calculated in the anterior-posterior (AP) and medial-lateral (ML) directions. Standing on both lateral and medial wedges was associated with improved postural stability seen through the decreased mean and RMS distance of COP displacement in ML direction. The results of this study suggest that standing on either lateral or medial wedges might enhance postural control in standing.
Quote:
Highlights
•We studied the role of bilateral wedges on body sway.
•Standing on lateral and medial wedges improved postural stability.
•Standing on wedges might be helpful while performing tasks requiring precision.
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Old 1st March 2014, 01:06 PM
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Default Re: Postural stability and foot orthoses

Effectiveness of a heel cup with an arch support insole on the standing balance of the elderly
Chen TH, Chou LW, Tsai MW, Lo MJ, Kao MJ
Clinical Interventions in Aging; February 2014 Volume 2014:9 Pages 351 - 356
Quote:
Background: The use of insoles may enhance postural stability and prevent falls. The aim of this study was to design a new insole and to explore the effectiveness of the insole on the standing balance of the healthy elderly.
Methods: The study was conducted at a community hospital. Patients older than 65 years at an outpatient clinic without abnormal gait patterns, lower limb deformities, or foot pain were enrolled. The participants were assigned to good- and poor-stability groups on the basis of the stability index (SI), using the Biodex® Balance System. A heel cup with an arch support insole was provided. Participants wore the insole for 8 weeks for a minimum of 4 hours/day. A static balance test for SI was performed at the initial meeting and 8 weeks after the assigned insoles were worn for each participant.
Results: Five participants (10.0%) of 50 total did not finish the study. There were 25 patients in the good-stability group and 20 in the poor-stability group. The SI, before and after intervention, was significantly different for all 45 participants (3.244±0.688 versus 3.064±0.671; P<0.001). The differences in SI before and after the intervention both in the good-stability group (2.764±0.546 versus 2.592±0.538) and the poor-stability group (3.845±0.188 versus 3.655±0.128) were statistically significant (P<0.001). No statistically significant difference on changes of SI were seen between the two groups.
Conclusion: The results suggest a heel cup with arch support insole is effective in enhancing the standing balance of the elderly. This may be of benefit in preventing falls.
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Old 8th April 2014, 07:52 PM
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Default Re: Postural stability and foot orthoses

The effects of pronated foot posture and medial heel and forefoot wedge orthoses on static balance in older people
Fateme Hemmati, Saeed Forghany and Christopher Nester
Journal of Foot and Ankle Research 2014, 7(Suppl 1):A17 doi:10.1186/1757-1146-7-S1-A17
Quote:
Background
Aging has been associated with increasing foot pronation [1] and changes in foot mobility and posture which may influence standing balance [2,3]. Orthotic interventions change foot posture [4] and load distribution under the foot [5] and therefore may have important effects on balance in older people.

Objective
To investigate whether a pronated foot posture is associated with poorer standing balance in older people and whether medial heel and forefoot wedge orthoses affect their standing balance.

Design
Between groups, repeated-measures design.

Methods
Ten healthy older people with a pronated foot posture (age 67.1± 5.5 years) and sixteen healthy elderly with normal foot posture (age 67.1± 5.9 years) were recruited.The Foot Posture Index (FPI) was used to determine pronated and normal foot posture. Static balance in double limb stance was assessed using Kistler force plate measures during four shod conditions: 1) 5° medial heel and forefoot wedge (W5); 2) 8° medial heel and forefoot wedge (W8); 3) Control insole for W5 (flat EVA base with the same thickness as W5 (NW5)); 4) Control insole for W8 (flat EVA base with the same thickness as W8 (NW8)). Each of the four cases was completed with eyes open and eyes closed. The center-of-pressure (COP) total excursion and mean velocity and area of 95% confidence ellipse were derived as measures of standing balance.

Results
Participants with a pronated foot type (Mean FPI: 7.5) demonstrated greater total excursion (298.19±28.59mm versus 262.69±22.92mm) and total mean velocity (11.78±1.41mm.s-1 versus 10.41±1.13mm.s-1), and larger ellipse area (630.81±244.19mm2 versus 298.15±195.79 mm2), compared with participants with normal foot type (Mean FPI: 3.8) during normal standing, but this did not reach statistical significance (p>0.05) (Figure 1). There was a significant main effect for eyes open (p<0.05) with the total excursion (290.0 ± 14.7mm versus 321.9 ± 14.1mm) and mean velocity of COP in ML (8.9 ± 0.5mm.s-1 versus 10.2 ± 0.6mm.s-1) being significantly lower.

There were no statistically significant effects from the four orthoses in the pronated nor the normal foot types (p<0.05). There were no significant differences in interaction of all conditions (foot posture × eye condition × orthoses) (p<0.05).

Conclusion
A trend towards less stable balance was observed in pronated foot type but this was not significant. Use of orthoses had no effect on balance parameters including negating the effects of eyes closed. Orthoses showed no negative effects on standing balance and therefore do not pose a threat to balance (e.g. if they are used for another purpose).
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Old 26th June 2014, 05:02 AM
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Default Re: Postural stability and foot orthoses

Comparing the immediate effects of UCBL and modified foot orthoses on postural sway in people with flexible flatfoot
Somaieh Payehdar et al
Prosthet Orthot Int June 18, 2014

Quote:
Background: Different types of foot orthoses have been prescribed for patients with flatfoot. Results of several studies have shown that orthoses were able to change balance parameters in people with flatfoot. However, the possible effect of orthosis flexibility on balance has not yet been investigated.

Objectives: The aim of the current study was to investigate the immediate effect of a rigid University of California Berkeley Laboratory (UCBL) foot orthosis, a modified foot orthosis, and a normal shoe on the postural sway of people with flexible flatfoot.

Study design: Quasi-experimental.

Methods: In all, 20 young adults with flatfoot (aged 23.5 ± 2.8 years) were invited to participate in this study. The Biodex Stability System was employed to perform standing balance tests under three testing conditions, namely, shoe only, UCBL, and modified foot orthosis. Total, medial–lateral, and anterior–posterior sway were evaluated for each condition.

Results: The results of this study revealed no statistical difference in the medial–lateral and anterior–posterior stability indices between foot orthoses and shoed conditions. The overall stability index with the UCBL foot orthosis, however, was significantly lower than that with the modified foot orthosis.

Conclusion: The UCBL foot orthosis was able to decrease total sway and improve balance in people with flexible flatfoot.

Clinical relevance Results of previous studies have indicated that foot orthoses were able to affect the balance of people with flatfeet.However, the possible effects of flexible orthoses on balance have not been examined. The results of this study may provide new insight into material selection for those people with balance disorders.
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Old 30th September 2014, 02:30 PM
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Default Re: Postural stability and foot orthoses

Effectiveness of a heel cup with an arch support insole on the standing balance of the elderly.
Chen TH, Chou LW, Tsai MW, Lo MJ, Kao MJ.
Clin Interv Aging. 2014 Feb 20;9:351-6.
Quote:
BACKGROUND:
The use of insoles may enhance postural stability and prevent falls. The aim of this study was to design a new insole and to explore the effectiveness of the insole on the standing balance of the healthy elderly.
METHODS:
The study was conducted at a community hospital. Patients older than 65 years at an outpatient clinic without abnormal gait patterns, lower limb deformities, or foot pain were enrolled. The participants were assigned to good- and poor-stability groups on the basis of the stability index (SI), using the Biodex® Balance System. A heel cup with an arch support insole was provided. Participants wore the insole for 8 weeks for a minimum of 4 hours/day. A static balance test for SI was performed at the initial meeting and 8 weeks after the assigned insoles were worn for each participant.
RESULTS:
Five participants (10.0%) of 50 total did not finish the study. There were 25 patients in the good-stability group and 20 in the poor-stability group. The SI, before and after intervention, was significantly different for all 45 participants (3.244±0.688 versus 3.064±0.671; P<0.001). The differences in SI before and after the intervention both in the good-stability group (2.764±0.546 versus 2.592±0.538) and the poor-stability group (3.845±0.188 versus 3.655±0.128) were statistically significant (P<0.001). No statistically significant difference on changes of SI were seen between the two groups.
CONCLUSION:
The results suggest a heel cup with arch support insole is effective in enhancing the standing balance of the elderly. This may be of benefit in preventing falls.
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