Welcome to the Podiatry Arena forums, for communication between foot health professionals about podiatry and related topics.
You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members (PM), upload content, view attachments, receive a weekly email update of new discussions, earn CPD points and access many other special features. Registered users do not get displayed the advertisments in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!
If you have any problems with the registration process or your account login, please contact contact us.
A randomised control trial of short term efficacy of in-shoe foot orthoses compared with a wait and see policy for anterior knee pain and the role of foot mobility.
Mills K, Blanch P, Dev P, Martin M, Vicenzino B. Br J Sports Med. 2012 Mar;46(4):247-52
Quote:
OBJECTIVES:
To investigate the short-term clinical efficacy of in-shoe foot orthoses over a wait-and-see policy in the treatment of anterior knee pain (AKP) and evaluate the ability of foot posture measures to predict outcome.
DESIGN:
Single-blind, randomised control trial.
PARTICIPANTS:
Forty participants (18-40 years) with clinically diagnosed AKP of greater than 6-week duration, who had not been treated with orthoses in the previous 5 years.
INTERVENTION:
Prefabricated orthoses perceived as most comfortable from a selection of 3 different hardness values compared with a wait-and-see control group.
OUTCOME MEASURES:
Participant-perceived global improvement, Kujala Patellofemoral Score, usual and worst pain severity over the previous week and the Patient Specific Functional Scale measures at 6 weeks.
RESULTS:
Foot orthoses produced a significant global improvement compared with the control group (p = 0.008, relative risk reduction = 8.47%, numbers needed to treat = 2). Significant differences also occurred in measures of function (standardised mean difference = 0.71). Within the intervention group, individuals who exhibited a change in midfoot width from weight bearing to non-weight bearing of >11.25 mm were more likely to report a successful outcome (correct classification 77.8%).
CONCLUSION:
This is the first study to show orthoses provide greater improvements in AKP than a wait-and-see approach. Individuals with greater midfoot mobility are more likely to experience success from treatment.
Re: Foot orthoses and patellofemoral pain syndrome
Effects of Medially Wedged Foot Orthoses on Knee and Hip Joint Running Mechanics in Females with and without Patellofemoral Pain Syndrome.
Boldt AR, Willson JD, Barrios JA, Kernozek TW. J Appl Biomech. 2012 Jul 5.
Quote:
We examined the effects of medially wedged foot orthoses on knee and hip joint mechanics during running in females with and without patellofemoral pain (PFPS). We also tested if these effects depend on standing calcaneal eversion angle. Twenty female runners with and without PFPS participated. Knee and hip joint transverse and frontal plane peak angle, excursion, and peak internal knee and hip abduction moment were calculated while running with and without a 6° full-length medially wedged foot orthoses. Separate 3-factor mixed ANOVAs (group (PFPS, control) x condition (medial wedge, no medial wedge) x standing calcaneal angle (everted, neutral, inverted)) were used to test the effect of medially wedged orthoses on each dependent variable. Knee abduction moment increased 3% (P = 0.03) and hip adduction excursion decreased 0.6° (P <0.01) using medially wedged foot orthoses. No significant group x condition or calcaneal angle x condition effects were observed. The addition of medially wedged foot orthoses to standardized running shoes had minimal effect on knee and hip joint mechanics during running thought to be associated with the etiology or exacerbation of PFPS symptoms. These effects did not appear to depend on injury status or standing calcaneal posture.
Re: Foot orthoses and patellofemoral pain syndrome
Medially posted insoles consistently influence foot pronation in runners with and without anterior knee pain
Pedro Rodrigues, Ryan Chang, Trampas TenBroek, Joseph Hamill Gait and Posture (in press)
Quote:
Anterior knee pain (AKP) is a common injury among runners and effectively treated with posted insoles and foot orthotics. While clinically effective, the underlying biomechanical mechanisms that bring about these improvements remain debatable. Several methodological factors contribute to the inconsistent biomechanical findings, including errors associated with removing and reattaching markers, inferring foot motion from markers placed externally on a shoe, and redefining segmental coordinate systems between conditions. Therefore, the purpose of this study was to evaluate the influence of medially posted insoles on lower extremity kinematics in runners with and without AKP while trying to limit the influence of these methodological factors. Kinematics of 16 asymptomatic and 17 runners with AKP were collected while running with and without insoles. Reflective markers were attached to the surface of the calcaneus and kept in place (as opposed to detached) between conditions, eliminating the error associated with reattaching markers and redefining segmental coordinate systems. Using these methods, no significant interactions between insole and injury and the main effect of injury were detected (p>0.05); therefore, means were pooled across injury. Insoles, on average, reduced peak eversion by 3.6° (95% confidence interval −2.9° to −4.3°), peak eversion velocity by 53.2°/s (95% confidence interval −32.9 to −73.4) and eversion range of motion by 1.33 (95% confidence interval −0.8 to −1.9). However, while insoles systematically reduced eversion variables, they had small influences on the transverse plane kinematics of the tibia or knee, indicating that they may bring about their clinical effect by influencing other variables.
Quote:
Highlights
► Studies have not shown motion controlling devices to consistently affect lower extremity biomechanics.
► Several methodological factors may contribute to these inconsistencies.
► These factors include placing markers externally on a shoe and redefining segmental coordinate systems between conditions.
► When limiting the influence of these methodological factors medially posted insoles consistently reduce foot pronation variables.
Re: Foot orthoses and patellofemoral pain syndrome
Effects of medially wedged foot orthoses on knee and hip joint running mechanics in females with and without patellofemoral pain syndrome.
Boldt AR, Willson JD, Barrios JA, Kernozek TW. J Appl Biomech. 2013 Feb;29(1):68-77.
Quote:
We examined the effects of medially wedged foot orthoses on knee and hip joint mechanics during running in females with and without patellofemoral pain syndrome (PFPS). We also tested if these effects depend on standing calcaneal eversion angle. Twenty female runners with and without PFPS participated. Knee and hip joint transverse and frontal plane peak angle, excursion, and peak internal knee and hip abduction moment were calculated while running with and without a 6° full-length medially wedged foot orthoses. Separate 3-factor mixed ANOVAs (group [PFPS, control] x condition [medial wedge, no medial wedge] x standing calcaneal angle [everted, neutral, inverted]) were used to test the effect of medially wedged orthoses on each dependent variable. Knee abduction moment increased 3% (P = .03) and hip adduction excursion decreased 0.6° (P < .01) using medially wedged foot orthoses. No significant group x condition or calcaneal angle x condition effects were observed. The addition of medially wedged foot orthoses to standardized running shoes had minimal effect on knee and hip joint mechanics during running thought to be associated with the etiology or exacerbation of PFPS symptoms. These effects did not appear to depend on injury status or standing calcaneal posture.
Re: Foot orthoses and patellofemoral pain syndrome
Quote:
Originally Posted by NewsBot
with and without a 6° full-length medially wedged foot orthoses
Why that? Why not use "foot orthotics of the type that are commonly used in clinical practice"?
__________________ Craig Payne
__________________________________________________ ___________________________________ Follow me on Twitter | Run Junkie God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
Re: Foot orthoses and patellofemoral pain syndrome
Quote:
Originally Posted by Craig Payne
Why that? Why not use "foot orthotics of the type that are commonly used in clinical practice"?
I in a bad mood today, so this paper gets the dumbass piece of research for the week. I finally got the full paper; the "orthoses" was a full length 6 degree EVA wedge ... who does that clinically? really dumb to use something that is not used clinically. To make it worse, the authors said in the discussion that the 6 degree wedge was to ".....elevate the first metatarsal head ..."! What were they thinking? duh? Have they not heard of the windlass mechanism that this would have inhibited and made the foot pronate even more ... really dumb! That total invalidates the study and makes the results meaningless.
__________________ Craig Payne
__________________________________________________ ___________________________________ Follow me on Twitter | Run Junkie God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
Re: Foot orthoses and patellofemoral pain syndrome
Linear Mode
