Foot orthoses for treating paediatric flat feet.
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ABSTRACT:
SUBMITTER: Evans AM
PROVIDER: S-EPMC8759438 | biostudies-literature | 2022 Jan
REPOSITORIES: biostudies-literature
Publications
Foot orthoses for treating paediatric flat feet.
Evans Angela M AM Rome Keith K Carroll Matthew M Hawke Fiona F
The Cochrane database of systematic reviews 20220114
<h4>Background</h4>Paediatric flat feet are a common presentation in primary care; reported prevalence approximates 15%. A minority of flat feet can hurt and limit gait. There is no optimal strategy, nor consensus, for using foot orthoses (FOs) to treat paediatric flat feet.<h4>Objectives</h4>To assess the benefits and harms of foot orthoses for treating paediatric flat feet.<h4>Search methods</h4>We searched CENTRAL, MEDLINE, and Embase to 01 September 2021, and two clinical trials registers on ...[more]
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| S-EPMC8790962 | biostudies-literature
Project description:There is some uncertainty regarding how foot orthoses (FO) affect the biomechanics of the lower extremities during running in non-injured individuals. This study aims to describe the behavior of the angular velocity of the foot in the stride cycle measured with a low-sampling-rate IMU device commonly used by podiatrists. Specific objectives were to determine if there are differences in angular velocity between the right and left foot and to determine the effect of foot orthoses (FO) on the 3D angular velocity of the foot during running. The sample was composed of 40 male adults (age: 43.0 ± 13.8 years, weight: 72.0 ± 5.5 kg, and height: 175.5 ± 7.0 cm), who were healthy and without any locomotor system alterations at the time of the test. All subjects use FO on a regular basis. The results show that there are significant differences in the transverse plane between feet, with greater differences in the right foot. Significant differences between FO and non-FO conditions were observed in the frontal and transverse planes on the left foot and in the sagittal and transverse planes on the right foot. FO decreases the velocity of the foot in dorsi-plantar flexion and abduction and increases the velocity in inversion. The kinematic changes in foot velocity occur between 30% and 60% of the complete cycle, and the FO reduces the velocity in abduction and dorsi-plantar flexion and increases the velocity in inversion-eversion, which facilitates the transition to the oscillating leg and with it the displacement of the center of mass. Quantifying possible asymmetries and assessing the effect of foot orthoses may aid in improving running mechanics and preventing injuries in individuals.
| S-EPMC10650853 | biostudies-literature
Project description:BackgroundDue to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet.MethodsThirty boys aged 8-12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected.ResultsSignificant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group.ConclusionsThe long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking.
| S-EPMC6177172 | biostudies-literature
Project description:ObjectiveThis study aimed to investigate the impact of foot orthoses on foot radiological parameters and pain in children diagnosed with flexible flatfoot.MethodsA comprehensive search was conducted across several databases, including PubMed, Web of Science, EMBASE, Cochrane Library, and EBSCO, covering publications from the inception of each database up to 8 June 2024. The study focused on randomized controlled trials investigating the use of foot orthoses for treating flexible flat feet in children. Four researchers independently reviewed the identified literature, extracted relevant data, assessed the quality of the studies, and performed statistical analyses using RevMan 5.4 software.ResultsSix studies involving 297 participants were included. The methodological quality of the included literature ranged from moderate to high. Radiological parameters of the foot improved significantly in older children with flexible flat feet following foot orthotic intervention compared to controls, particularly in the lateral talar-first metatarsal angle [mean difference (MD) = -2.76, 95% confidence interval (95% CI) -4.30 to -1.21, p = 0.0005], lateral talo-heel angle (MD = -5.14, 95% CI -7.76 to -2.52, p = 0.0001) and calcaneal pitch angle (MD = 1.79, 95% CI 0.88-2.69, p = 0.0001). These differences were statistically significant. Additionally, foot orthoses significantly improved the ankle internal rotation angle and reduced foot pain in children with symptomatic flexible flatfoot (MD = -2.51, 95% CI -4.94 to -0.07, p = 0.04).ConclusionThe use of foot orthoses positively impacts the improvement of radiological parameters of the foot and reduces pain in older children with flexible flat feet. However, in younger children with flexible flat feet, the improvement from foot orthoses was not significant, likely due to challenges in radiological measurements caused by the underdevelopment of the ossification centers in the foot. Further studies are needed. Consequently, the results of this meta-analysis support the implementation of an early intervention strategy using foot orthoses for the management of symptomatic flat feet in older children.Systematic review registrationhttps://www.crd.york.ac.uk/, PROSPERO [CRD42023441229].
| S-EPMC11327157 | biostudies-literature
Project description:BackgroundAll typically developing children are born with flexible flat feet, progressively developing a medial longitudinal arch during the first decade of their lives. Whilst the child's foot is expected to be flat, there is currently no consensus as to how flat this foot should be. Furthermore, whilst feet are observed to decrease in flatness with increasing age, it is not known how flat they should be at each age increment. The objective of this systematic review is to define the postural characteristics of the 'typically' developing paediatric foot.MethodsThe PRISMA protocol was applied to compare all data currently published describing the typical development of the paediatric foot. The Epidemiological Appraisal Instrument (EAI) was used to assess the risk of bias of the included studies.ResultsThirty four epidemiological papers pertaining to the development of the paediatric foot were graphically compared. Sixteen different foot posture assessments were identified of which footprint based measures were the most reported outcome.ConclusionFirstly, the use of the term normal in relation to foot posture is misleading in the categorisation of the paediatric foot, as indeed a flat foot posture is a normal finding at specific ages. Secondly, the foot posture of the developing child is indeed age dependent and has been shown to change over time. Thirdly, no firm conclusion could be reached as to which age the foot posture of children ceases to develop further, as no two foot measures are comparable, therefore future research needs to consider the development of consensus recommendations as to the measurement of the paediatric foot, using valid and reliable assessment tools.
| S-EPMC5558233 | biostudies-literature
Project description:BackgroundFlexible pes planus (flat feet) in children is a common presenting condition in clinical practice due to concerns amongst parents and caregivers. While Foot Orthoses (FOs) are a popular intervention, their effectiveness remains unclear. Thus, the aim of this systematic review was to update the current evidence base for the effectiveness of FOs for paediatric flexible pes planus.MethodsA systematic search of electronic databases (Cochrane, Medline, AMED, EMBASE, CINHAL, SportDiscus, Scopus and PEDro) was conducted from January 2011 to July 2017. Studies of children (0-18 years) diagnosed with flexible pes planus and intervention to be any type of Foot Orthoses (FOs) were included. This review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. McMaster critical review form for quantitative studies, was used to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis of the included studies was undertaken.ResultsOut of 606 articles identified, 11 studies (three RCTs; two case-controls; five case-series and one single case study) met the inclusion criteria. A diverse range of pre-fabricated and customised FOs were utilised and effectiveness measured through a plethora of outcomes. Summarised findings from the heterogeneous evidence base indicated that FOs may have a positive impact across a range of outcomes including pain, foot posture, gait, function and structural and kinetic measures. Despite these consistent positive outcomes reported in several studies, the current evidence base lacks clarity and uniformity in terms of diagnostic criteria, interventions delivered and outcomes measured for paediatric flexible pes planus.ConclusionThere continues to remain uncertainty on the effectiveness of FOs for paediatric flexible pes planus. Despite a number of methodological limitations, FOs show potential as a treatment method for children with flexible pes planus.Prospero registration numberCRD42017057310.
| S-EPMC5815602 | biostudies-literature
Project description:BackgroundFoot orthoses have been demonstrated to be effective in the management of a range of conditions, but there is debate as to the benefits of customised foot orthoses over less expensive, prefabricated devices.MethodsIn a randomised, cross-over trial, 15 flat-footed participants aged between 18 and 45 years were provided with semi-rigid, customised orthoses and semi-rigid, contoured, prefabricated orthoses. Pressures and forces were measured using an in-shoe system with subjects wearing shoes alone, wearing customised orthoses, and again when wearing contoured prefabricated orthoses. Two weeks acclimatisation was included between cross-over of therapy. Repeated measures ANOVA models with post-hoc, pair-wise comparisons were used to test for differences.ResultsWhen compared to wearing shoes alone, wearing either the customised orthoses or the prefabricated orthoses was associated with increases in force and force time integrals in the midfoot region. Peak and maximum mean pressure and pressure-time, and force-time integrals were reduced in both the medial and lateral forefoot. There were, however, no significant differences between the customised orthoses and the prefabricated orthoses at any site.ConclusionThere was a similar change in loading with both the semi-rigid customised and the semi-rigid prefabricated orthoses when compared to the shoe alone condition. However, while customised devices offered minor differences over prefabricated orthoses in some variables, these were not statistically significant. The results suggest that there may be only minor differences in the effects on plantar pressures between the customised and the less expensive prefabricated orthoses tested in this study, however further research is warranted.
| S-EPMC2711934 | biostudies-literature
Project description:The analysis of ground reaction forces and muscle activities during walking or running can help clinicians decide on the usage of foot orthoses, particularly in individuals with pronated feet. Here, we aimed to investigate the effects of double- density foot orthoses on running kinetics and lower limb muscle activities in adults with and without pronated feet. Forty male adults with pronated feet (PF: n = 20, age = 25.4 ± 0.3 years, body-mass-index [BMI] = 23.3 ± 1.2 kg/m2) and without pronated feet (WPF: n = 20, age = 26.4 ± 1.0 years, BMI = 24.0 ± 0.7 kg/m2) volunteered to participate in this study. The study was registered with the Iranian Registry of Clinical Trials (IRCT20220129053865N1). Ground reaction forces (Fx, Fy, Fz) and lower limb muscle activities (e.g., m. gastrocnemius) were recorded using surface electromyography (EMGs) during running at a constant speed of 3.2 m/s over an 18-m walkway with an embedded force plate. EMGs were normalized to maximum voluntary isometric contractions. Test-retest reliability for running speed data was excellent for PF and WPF groups and for the entire study cohort with intraclass correlation coefficients > 0.95. The 2-way ANOVA revealed lower peak Fz (p = 0.011; d = 1.226), lower time-to-peak for Fx (p = 0.023, d = 1.068), Fy (p = 0.025, d = 1.056), and Fz (p = 0.045, d = 0.931) during running with foot orthoses in PF individuals. During the loading phase, PF and WPF exhibited lower gastrocnemius (WPF: p = 0.005, d = 1.608; PF: p = 0.001, d = 2.430 ) and vastus medialis (WPF: p < 0.001, d = 2.532; PF: p < 0.001, d = 2.503) activity when running with foot orthoses. Although double- density foot orthoses resulted in some beneficial biomechanical effects such as lower muscle activation (e.g., m. vastus medialis) in individuals with PF, foot orthoses constructions need further modifications to achieve even better running mechanics to enhance performance and lower limbinjury occurrence. IRCT20220129053865N1 (Registration date 19/08/2024).
| S-EPMC11927312 | biostudies-literature
Project description:Robotic technologies are being employed increasingly in the treatment of lower limb disabilities. Individuals suffering from stroke and other neurological disorders often experience inadequate dorsiflexion during swing phase of the gait cycle due to dorsiflexor muscle weakness. This type of pathological gait, mostly known as drop-foot gait, has two major complications, foot-slap during loading response and toe-drag during swing. Ankle foot orthotic (AFO) devices are mostly prescribed to resolve these complications. Existing AFOs are designed with or without articulated joint with various motion control elements like springs, dampers, four-bar mechanism, series elastic actuator, and so forth. This paper examines various AFO designs for drop-foot, discusses the mechanism, and identifies limitations and remaining design challenges. Along with two commercially available AFOs some designs possess promising prospective to be used as daily-wear device. However, the design and mechanism of AFO must ensure compactness, light weight, low noise, and high efficiency. These entailments present significant engineering challenges to develop a new design with wide consumer adoption.
| S-EPMC4032669 | biostudies-other
Project description:IntroductionFoot pain can be a significant burden for patients. Custom foot orthoses (CFOs) have been a mainstay in podiatry treatment for foot pain management and improving foot function. However, little is known about podiatrists' experience of prescribing CFOs or patient experience of using foot orthoses (FOs), including CFOs, for foot pain.MethodsA focus group (FG) discussion with three FOs users (Female = 2 and Male = 1) was conducted in November 2022 within a private podiatry practice. This group represented non-experts from the general local population of individuals with existing or previous foot pain who have personally experienced using either over-the-counter FOs or CFOs. An online FG discussion with five musculoskeletal (MSK) specialist podiatrists (Female = 2 and Male = 3) was also conducted in December 2022. This group represented podiatrists with specialist knowledge in foot biomechanics and clinical experience in CFO provision. The FG discussions were recorded and lasted 49 and 57 min respectively. Transcribed data was manually coded, and a thematic analysis was undertaken to identify patterns within the collected data.ResultsThe participants in the patient FG detailed mixed experiences of the prescription process and CFOs received, with reports of limited involvement/input in their prescription, the need for frequent adjustments and high costs. The impact on footwear choices, replicability and transferability of CFOs into different types of shoes and technologies to aid design were also highlighted. In the podiatrist FG, lack of confidence in design and manufacture processes, prescription form language, relationship and communication building with manufacturers, variability in the CFOs issued and the need for better student education in CFO provision emerged as key themes.ConclusionPatients and podiatrists shared similar views on CFO provision, namely poor communication with manufacturers leading to dissatisfaction with the CFOs prescribed causing negative impacts on patient experiences. Podiatrists called for greater education at registration level to increase new graduate podiatrist knowledge in CFO design and manufacture and better collaboration with manufacturing companies.
| S-EPMC11339317 | biostudies-literature