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We studied the use of powered ankle-foot orthoses (PAFOs) and walking stability of the wearers, focusing on the ankle joint, which is known to play a critical role in gait stability. Recognizing that the subtalar joint is an important modulator of walking stability, we conducted the walking experiment on a treadmill by applying varying assistance techniques to the 2-degree-of-freedom (DOF) PAFO, which has the subtalar joint as the rotating axis, and the commonly used 1-DOF PAFO. The participants were 8 healthy men (mean±SD: height, 174.8±7.1 cm; weight, 69.8±6.5 kg; and age, 29.1±4.8 years) with no history of gait abnormality. Center of pressure (COP) was measured with an in-shoe pressure sensor, and stability was estimated on the basis of the angular acceleration measured with the inertial measurement unit attached to the trunk. The experimental results of the 2-DOF PAFO, with or without assistance, showed a significantly higher stability than those of the 1-DOF PAFO (up to 23.78%, p<0.0326). With the 1-DOF PAFO, the stability deteriorated with the increase in the degree of assistance provided. With the 2-DOF PAFO, this tendency was not observed. Thus, the importance of the subtalar joint was proven using PAFOs. The mean position analysis of the COP during the stance phase confirmed that the COP highly correlated with stability (Pearson correlation coefficient: -0.6607). Thus, we conclude that only the 2-DOF PAFO can maintain walking stability, regardless of the assistance characteristics, by preserving the COP in the medial position through eversion. Awareness regarding the role of the subtalar joint is necessary during the manufacture or use of PAFOs, as lack of awareness could lead to the degradation of the wearer's gait stability, regardless of effective assistance, and deteriorate the fundamental functionality of PAFO., Competing Interests: The authors have declared that no competing interests exist.

BACKGROUND 3D-printed insoles are widely used. This study was conducted to test a customized three-dimensional (3D)-printed heel support insole based on arch lift and to investigate whether the pressure distribution on the sole was improved while maintaining foot function. MATERIAL AND METHODS The design was based on a 3D plantar contour scanning modeling technique. Thirty healthy male participants walked along a 10-m track under 3 self-controlled interventions. A customized 3D-printed heel support insole based on arch lift was inserted into the socks for the experimental condition A. For condition B, a customized 3D-printed heel-supporting insole was inserted into the socks, and a standardized pre-made heel-supporting insole was inserted into the socks as a control (condition C). We used the Footscan® pressure plate to measure the plantar parameters in the forefoot contact and foot flange phases in each condition. RESULTS Compared with condition B and the control condition, the peak pressure under the heel was significantly lower in condition A (P<0.05), and the peak pressure in the midfoot region was not significantly increased (P>0.05). CONCLUSIONS The biomechanical properties of the customized 3D-printed heel support are better than those of the traditional heel support insole, especially when there is a need for an additional increase in heel height. Patients do not decrease midfoot motion function while using this customized insole.

The aim of this study was to quantify the effects of foot orthoses (FOs) with and without a lateral bar on muscle activity of participants with cavus feet. Fifteen participants were recruited from the Université du Québec à Trois-Rivières students and podiatry clinic. The muscle activity of the tibialis anterior, fibularis longus, gastrocnemius lateralis and medialis, vastus medialis and lateralis, biceps femoris and gluteus medius were recorded during fast walking under two experimental conditions (FOs with and without a lateral bar) and a control condition (shoes). Experimentations were completed after a one-month adaptation period to each experimental condition. The root mean square of the electromyography (EMG) data was analyzed. To compare the effects between conditions, a curve analysis was performed using one-dimensional statistical parametric mapping. The main result of this study was an increased gastrocnemius lateralis muscle activity (maximum mean difference: +28%) during the propulsion phase of gait (44-46%) when participants wore FOs compared to the control condition. This result will help researchers and clinicians better understand the FOs' EMG effects of individuals with cavus feet. As FOs are mainly prescribed for symptomatic patients, future studies should assess their effects on individuals suffering of a pathology, such as Achilles tendinopathy., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Foot orthoses are routinely used to treat plantar fasciopathy in clinical practice. However, minimal evidence exists as to the effect of both truly custom designed foot orthoses, as well as that of the shoe the foot orthoses are placed into. This study investigated the effect of wearing custom foot orthoses and new athletic footwear on first-step pain, average 24-h pain and plantar fascia thickness in people with unilateral plantar fasciopathy over 12 weeks., Methods: A parallel, three-arm randomised controlled trial with blinding of participants and assessors. 60 participants diagnosed with unilateral plantar fasciopathy were randomised to either custom foot orthoses and new shoes (orthoses group), a sham insole with a new shoes (shoe group) or a sham insole placed in the participant's regular shoes (control group). Primary outcome was first-step pain. Secondary outcomes were average 24-h pain and plantar fascia thickness measured on ultrasound. Outcomes were assessed at baseline, 4 week and 12 week trial time-points., Results: At 4 weeks, the orthoses group reported less first-step pain (p = 0.002) compared to the control group. At 12 weeks, the orthoses group reported less first-step pain compared to both the shoe (p = < 0.001) and sham (p = 0.01) groups. Both the orthoses (p = < 0.001) and shoe (p = 0.006) groups reported less average 24-h pain compared to the control group at 4 and 12 weeks. The orthoses group demonstrated reduced plantar fascia thickness on ultrasound compared to both the shoe (p = 0.032) and control groups (p = 0.011)., Conclusions: Custom foot orthoses in new shoes improve first-step pain and reduce plantar fascia thickness over a period of 12 weeks compared to new shoes alone or a sham intervention., Trial Registration: Australian New Zealand Clinical Trials Registry ( ACTRN 12613000446763 ). Submitted on the 10th of April 2013 and registered on the 18th of April 2013.