Podiatry Arena members do not see these ads

Whilst doing a lit. search for something else I came across this. May be of interest?

From volume 25, Issue 2 of Gait and Posture

A systematic review of the effects of shoes and other ankle or foot appliances on balance in older people and people with peripheral nervous system disorders

Abstract

The objective of this paper is to identify and review all publications on effects ankle and/or foot appliances (AFA) on balance in older people (≥60 years) and patients with peripheral nervous system disorders (PNSD). These two groups account for the majority of the population with deteriorated balance due to peripheral somatosensory feedback problems. To provide a context for understanding and interpreting the studies that have been published to date, we will briefly summarize current theories on the role of somatosensory mechanisms in control of balance and how balance can be affected by AFA. A systematic literature review is presented in which publications were searched in Medline, Embase and Recal.

In total 146 papers were identified and 18 were selected based on title and abstract for qualitative assessment by two independent reviewers. Based on assessment of the total articles, seven of the 18 papers fulfilled predetermined qualitative criteria and were selected for detailed review. No definitive conclusions can be drawn concerning the effects of AFA on balance in older people or in patients with PNSD because of the small number of studies and the weak level of evidence. The available literature seems to indicate that a training program may be helpful in ensuring the effectiveness of an appliance. Insoles with tubing or vibrating elements may improve balance, whereas thick or soft soles may deteriorate balance. The effects of these different types of insoles or soles are consistent with theories about somatosensory mechanisms that play a role in control of balance. More and better quality research is needed to support the prevalent use of appliances in these populations.



Any thoughts anyone?

__________________
Kind regards

Gavin Wylie
Podiatrist (Paediatrics),
Perth Royal Infirmary,
Perth, UK

Tweet

Share

Gavin

I always assumed that thick and/or soft orthoses/footwear would reduce mechanorecpetor feedback. However I read an article that assessed a group of step aerobic-ers(?). They had 3 different densities of EVA mats placed on the ground.
They conclusively showed that the subjective feedback was for the soft materials.
This introduces the additional component of compliance etc when looking at interventions for balance.
What are your experiences with kids re orthos complinace and material choice.

Phil

Phil

Apologies for the late reply.

As far as kids are concerned, I have had very few problems as regards orthoses compliance. Give them a week-2 weeks and most are wearing their devices all day long - no probs. This goes for both rigid shells and softer EVA devices.

On the back of what you were saying about the study which related EVA density to mechanoreceptor feedback: I have been known to attend yoga sessions now and again. One session in particular (group of about 30) we all tried the balance positions first on the mat (about 20mm thick medium density) then on the hard wooden floor; the vast majority got on better with balance on the hard floor, thus agreeing with your initial assumption. Hardly scientific, but worthy of a mention.

Have you the reference for the study?

__________________
Kind regards

Gavin Wylie
Podiatrist (Paediatrics),
Perth Royal Infirmary,
Perth, UK