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Background: Effectiveness of therapeutic footwear in reducing peak pressure in persons with diabetes and loss of protective sensation to prevent diabetic foot ulcers varies due to manual production and possible changing foot structure. A previous two-way approach to address this issue, featuring individualized 3D-printed rocker midsoles and self-adjusting insoles, proved effective in the forefoot but less in the heel. To address this, new insoles incorporating a heel cup are developed., Methods: In-shoe pressure was measured, while persons with diabetes and loss of protective sensation with high peak pressure (≥ 200 kPa) in the heel walked on a treadmill with control and individualized rocker shoe paired with control and new insole., Findings: Generalized estimating equations revealed significant decrease in peak pressure in the proximal heel with the new insole alone and combined with rocker shoe compared to rocker shoe alone. For the distal heel, significant decrease in peak pressure is shown with the combination of new insole and rocker shoe compared to control shoe. For the forefoot and toes (excluding hallux) significant decrease in peak pressure is shown using the rocker shoe alone or combined with the heel cup compared to control shoe., Interpretation: The new insole paired with rocker shoe is effective in reducing peak pressure in the distal heel. To have similar (or more) success in proximal heel, one could replace the rocker midsole with more compliant materials. The rocker shoe used separately or combined with a heel cup effectively reduces the peak pressure in the forefoot and other toes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Footwear, orthoses, and insoles have been shown to influence balance in older adults; however, it remains unclear which features, singular or in combination, are considered optimal. The aim of this scoping review was to identify and synthesise the current evidence regarding how footwear, orthoses, and insoles influence balance in older adults. Four electronic databases (MEDLINE, CINAHL, Embase, and AMED) were searched from inception to October 2023. Key terms such as "shoe*," "orthoses," "postural balance" and "older people" were employed in the search strategy. Studies meeting the following criteria were included: (i) participants had a minimum age ≥60 years, and were free of any neurological, musculoskeletal, and cardiovascular diseases; (ii) an active intervention consisting of footwear, foot orthoses, or insoles was evaluated; and (iii) at least one objective outcome measure of balance was reported., Summary: A total of 56 studies from 17 different countries were included. Three study designs were utilised (cross-sectional study, n = 44; randomised parallel group, n = 6; cohort study n = 6). The duration of studies varied considerably, with 41 studies evaluating immediate effects, 14 evaluating effects from 3 days to 12 weeks, and 1 study having a duration of 6 months. Seventeen different interventions were evaluated, including/consisting of textured insoles (n = 12), heel elevation (n = 8), non-specific standardised footwear and changes in sole thickness or hardness (n = 7 each), sole geometry or rocker soles, contoured or custom insoles and high collar height (n = 6 each), insole thickness or hardness and vibrating insoles (n = 5 each), outsole tread (n = 4), minimalist footwear and slippers (n = 3 each), balance-enhancing shoes, footwear fit, socks, and ankle-foot orthoses (n = 2 each), and eversion insoles, heel cups, and unstable footwear (n = 1 each). Twenty-three different outcomes were assessed, and postural sway was the most common (n = 20), followed by temporo-spatial gait parameters (n = 17). There was uncertainty regarding intervention effectiveness. Overall, features such as secure fixation, a textured insole, a medium-to-hard density midsole and a higher ankle collar, in isolation, were able to positively impact balance. Conversely, footwear with an elevated heel height and the use of socks and slippers impaired balance., Key Messages: There is a substantial body of literature exploring the effects of footwear, orthoses, and insoles on balance in older adults. However, considerable uncertainty exists regarding the efficacy of these interventions due to variability in methodological approaches. Further high-quality research is necessary to determine whether a singular intervention or a combination of interventions is most effective for enhancing balance in older adults., (© 2024 S. Karger AG, Basel.)

It is recognized that gait analysis is a powerful tool used to capture human locomotion and quantify the related parameters. PODOSmart ® insoles have been designed to provide accurate measurements for gait analysis. PODOSmart ® insoles are lightweight, slim and cost-effective. A recent publication presented the characteristics and data concerning the validity of PODOSmart ® insoles in gait analysis. In literature, there is still no evidence about the repeatability of PODOSmart ® gait analysis system. Such evidence is essential in order to use this device in both research and clinical settings. The aim of the present study was to assess the repeatability of PODOSmart ® system. In this context, it was hypothesized that the parameters of gait analysis captured by PODOSmart ® would be repeatable. In a sample consisting of 22 healthy male adults, participants performed two walking trials on a six-meter walkway. The ICC values for 28 gait variables provided by PODOSmart ® indicated good to excellent test-retest reliability, ranging from 0.802 to 0.997. The present findings confirm that PODOSmart ® gait analysis insoles present excellent repeatability in gait analysis parameters. These results offer additional evidence regarding the reliability of this gait analysis tool.

The aim of this review was to examine the effects of shoes and insoles on low back pain (LBP). Seven electronic databases were searched from their inception to May 2020. The methodological quality of the 14 included studies was assessed by PEDro scale. Quality of evidence was assessed using GRADE. Moderate evidence on the disability questionnaire score (SMD, 0.52; 95% CI, 0.28 to 0.77; P < 0.001) and pain score (SMD, 0.61; 95% CI, 0.36 to 0.85; P < 0.001) of the custom-made orthotics for chronic LBP compared with no orthotics/insoles intervention was found. Meta-analysis results also showed moderate evidence on the disability questionnaire score (SMD, 0.44; 95% CI, 0.05 to 0.82; P =0.03) in patients who wore unstable shoes compared with regular shoes. Pain and life quality scores showed low-quality evidence of unstable shoes for chronic LBP. Custom-made orthotics and unstable shoes can be recommended to patients as a management option of chronic LBP.

There is a lack of evidence about the effect of different type of foot orthoses on plantar surface temperature. Moreover, that effect could be different depending on gender due to anatomical and physiological differences between men and women. The aim of the study was to analyze the effect of a prefabricated thermoformable foot orthosis on plantar surface temperature after running and taking gender differences into account. Thirty recreational runners (15 males, mean (standard deviation): 28 (7) years, 69.7 (6.5) kg, 1.74 (0.05) cm and 22.9 (1.7) kg/m 2 ; and 15 females: 35 (7) years, 55.2 (6.9) kg, 1.63 (0.06) cm and 20.6 (1.9) kg/m 2 ) carried out a maximum incremental test as pre-test, and two running tests on a treadmill at the laboratory wearing previously randomized different foot orthoses (thermoformable and prefabricated generic). The plantar surface temperature of the dominant foot sole in ten regions of interest was assessed before and immediately after 30-min running at 75% of VO 2max . The use of thermoformable foot orthoses produced lower temperatures only in men after the run in medial heel (P = 0.033, ES = 0.7), which then disappeared in temperature variation (after - before) (P = 0.910). Regarding gender, women showed lower temperatures before the run in both orthosis conditions (P < 0.039, ES > 0.8), but no differences in temperatures after the run (P = 0.910) in comparison with men. Moreover, absolute temperatures after running were always greater than before the run (P < 0.001, ES > 5.0). In conclusion, the thermoformable foot orthoses do not modify plantar surface temperature after running in healthy runners of either gender, compared to prefabricated generic foot orthoses. Although women present lower baseline plantar temperatures than men, these differences disappear after exercise., Competing Interests: Declaration of competing interest The authors have no financial interest in any of the products used in this study, nor do they have any other conflict of interest to report., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The aim of this systematic review was to identify the best footwear and insole design features for offloading the plantar surface of the foot to prevent foot ulceration in people with diabetic peripheral neuropathy. We searched multiple databases for published and unpublished studies reporting offloading footwear and insoles for people with diabetic neuropathy and nonulcerated feet. Primary outcome was foot ulcer incidence; other outcome measures considered were any standardized kinetic or kinematic measure indicating loading or offloading the plantar foot. Fifty-four studies, including randomized controlled studies, cohort studies, case-series, and a case-controlled and cross-sectional study were included. Three meta-analyses were conducted and random-effects modelling found peak plantar pressure reduction of arch profile (37 kPa (MD, -37.5; 95% CI, -72.29 to -3.61; P  < .03), metatarsal addition (35.96 kPa (MD, -35.96; 95% CI, -57.33 to -14.60; P  < .001) and pressure informed design 75.4 kPa (MD, -75.4 kPa; 95% CI, -127.4 to -23.44 kPa; P  < .004).The remaining data were presented in a narrative form due to heterogeneity. This review highlights the difficulty in differentiating the effect of different insole and footwear features in offloading the neuropathic diabetic foot. However, arch profiles, metatarsal additions and apertures are effective in reducing plantar pressure. The use of pressure analysis to enhance the effectiveness of the design of footwear and insoles, particularly through modification, is recommended., Competing Interests: Richard Collings is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Fellowship for this research project. This publication presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care., (© 2020 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.)

Objective: Explore the effects of a 4-week intervention using semi-custom insoles in recreational runners with patellofemoral pain., Design: Mixed methods., Participants: Seventeen (10 males and 7 females) recreational runners., Setting: Laboratory., Outcome Measurements: Participants were separated into specific subgroups, then provided with a pair of semi-custom insoles, for a period of 4-weeks. Lower extremity kinetics/kinematics during running at 4.0 m/s were obtained. In addition, knee pain was examined using the Knee injury and Osteoarthritis Outcome Score-Patellofemoral scale (KOOS-PF). Data were collected before and after wearing the insoles for 4-weeks., Results: Significant improvements were shown for KOOS-PF in both subgroups (strong: (pre) = 63.84 & (post) = 71.49 and weak and tight: (pre) = 53.03 & (post) = 72.73), although only improvements in the weak and tight group exceeded the minimum clinically important difference (MCID). In addition, significant reductions in peak patellofemoral stress were shown in both subgroups (strong: (pre) = 6.82 & (post) = 6.39KPa/BW and weak and tight: (pre) = 7.66 & (post) = 6.28KPa/BW), although only reductions in the weak and tight group exceeded the MCID., Conclusions: Semi-custom insoles may be a mechanism to reduce patellofemoral pain symptoms in recreational runners from the weak and tight subgroup. It is proposed that this improvement was mediated through reductions in patellofemoral loading in this subgroup., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The aim of this systematic review with meta-analysis was to investigate if using textured or other types of stimulating insoles improve gait characteristics and balance/postural control in patients with multiple sclerosis and Parkinson's disease. Primary outcomes for balance were the center of pressure (CoP) displacement and CoP velocity/sway rate. Primary outcomes for gait were the cadence, velocity, and step length. Standardized mean differences (SMD) were used to verify the efficacy of wearing the insoles on gait and balance outcome measures. Study quality was evaluated using the checklist of the CONSORT- Statement. Six studies were included in the review. Five studies had low methodological quality, scoring <17/37 on the checklist, one study had moderate methodological quality, scoring 27/37 on the checklist. Due to designs of the included studies, only immediate effects could be calculated. Among the primary outcome measures cadence, gait velocity and step length, there was no evidence of an effect of using textured/stimulating insoles compared with the respective control condition (Totals: SMD -0.09, 95% CI -0.35 to 0.16; SMD 0.18, 95% CI -0.17 to 0.53; SMD -0.13, 95% CI -0.31 to 0.05). Furthermore, among the primary outcome measures CoP displacement and CoP velocity, no evidence of an effect was found as well (Subtotals multiple sclerosis: SMD 0.07, 95% CI -0.15 to 0.28; SMD -0.08, 95% CI -0.55 to 0.39). Therefore, using textured or other types of stimulating insoles for the treatment of balance and gait impairments in patients with multiple sclerosis and Parkinson's disease seem to have no effect., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Plantar loading may influence comfort, performance and injury risk in soccer boots. This study investigated the effect of cleat configuration and insole cushioning levels on perception of comfort and in-shoe plantar pressures at the heel and fifth metatarsal head region. Nine soccer academy players (age 15.7 ± 1.6 years; height 1.80 ± 0.40 m; body mass 71.9 ± 6.1 kg) took part in the study. Two boot models (8 and 6 cleats) and two insoles (Poron and Poron/gel) provided four footwear combinations assessed using pressure insoles during running and 180° turning. Mechanical and comfort perception tests differentiated boot and insole conditions. During biomechanical testing, the Poron insole generally provided lower peak pressures than the Poron/gel insole, particularly during the braking step of the turn. The boot model did not independently influence peak pressures at the fifth metatarsal, and had minimal influence on heel loads. Specific boot-insole combinations performed differently (P < 0.05). The 8-cleat boot and the Poron insole performed best biomechanically and perceptually, but the combined condition did not. Inclusion of kinematic data and improved control of the turning technique are recommended to strengthen future research. The mechanical, perception and biomechanical results highlight the need for a multi-faceted approach in the assessment of footwear.

Background: Deformities of the foot due to rheumatic disease, particularly rheumatoid arthritis, occur in 85-95% of patients during the course of their disease., Objective: This study investigates whether treatment with orthopedic shoes still has a place in modern therapies., Results: Foot orthotics and technical orthopedic shoes can play an important role in purely conservative treatment as well as postoperative therapy., Conclusion: Due to a lack of knowledge concerning modern orthopedic shoe techniques, this treatment option has slipped out of focus--in part because of its association with the old-fashioned unshapely black orthopedic shoes. Nevertheless, these shoes can contribute significantly to maintenance of patient mobility; a factor of extreme importance to the individuals who already suffer considerably from the disease per se.

Context: Participants with chronic ankle instability (CAI) use an altered neuromuscular strategy to shift weight from double-legged to single-legged stance. Shoes and foot orthoses may influence these muscle-activation patterns., Objective: To evaluate the influence of shoes and foot orthoses on onset times of lower extremity muscle activity in participants with CAI during the transition from double-legged to single-legged stance., Design: Cross-sectional study., Setting: Musculoskeletal laboratory., Patients or Other Participants: A total of 15 people (9 men, 6 women; age = 21.8 ± 3.0 years, height = 177.7 ± 9.6 cm, mass = 72.0 ± 14.6 kg) who had CAI and wore foot orthoses were recruited., Intervention(s): A transition task from double-legged to single-legged stance was performed with eyes open and with eyes closed. Both limbs were tested in 4 experimental conditions: (1) barefoot (BF), (2) shoes only, (3) shoes with standard foot orthoses, and (4) shoes with custom foot orthoses (SCFO)., Main Outcome Measure(s): The onset of activity of 9 lower extremity muscles was recorded using surface electromyography and a single force plate., Results: Based on a full-factorial (condition, region, limb, vision) linear model for repeated measures, we found a condition effect (F(3,91.8) = 9.39, P < .001). Differences among experimental conditions did not depend on limb or vision condition. Based on a 2-way (condition, muscle) linear model within each region (ankle, knee, hip), earlier muscle-activation onset times were observed in the SCFO than in the BF condition for the peroneus longus (P < .001), tibialis anterior (P = .003), vastus medialis obliquus (P = .04), and vastus lateralis (P = .005). Furthermore, the peroneus longus was activated earlier in the shoes-only (P = .02) and shoes-with-standard-foot-orthoses (P = .03) conditions than in the BF condition. No differences were observed for the hip muscles., Conclusions: Earlier onset of muscle activity was most apparent in the SCFO condition for ankle and knee muscles but not for hip muscles during the transition from double-legged to single-legged stance. These findings might help clinicians understand how shoes and foot orthoses can influence neuromuscular control in participants with CAI.

Study Design: Prospective, randomized, controlled single-blind intervention trial., Objectives: Shock-absorbing insoles (SAIs), compared with usual insoles, were hypothesized to result in larger increases in pressure pain threshold (PPT) after 3 weeks of use., Background: Shock-absorbing insoles can decrease self-reported pain among young soccer players training on artificial turf. However, nothing is known about the underlying changes in pain sensitivity assessed by PPT. Methods Seventy-five players were included from the youth teams of under 15, under 17, and under 19 years of age, playing for the Aalborg Boldspilklub (AaB) professional sports club. After a randomization stratified by team and age, players were divided into 2 groups, one that received SAIs and a control group that used their usual insoles. Assessments were made in both groups after 3 weeks of training on artificial turf (baseline) and 3 weeks later (follow-up). The primary outcome was change in PPTs from baseline to follow-up, with PPTs measured over 13 locations on the plantar surface of the foot, leg, and low back of the nonpreferred kicking leg., Results: A significantly larger increase was found in PPTs from baseline to follow-up for the SAI group compared with the control group (mean difference, 62 kPa; 95% confidence interval [CI]: 40, 85 kPa). The PPTs increased significantly more among the SAI group compared with the control group (P<.05) for the abductor digiti minimi (mean difference, 82 kPa; 95% CI: 6, 157 kPa), tibialis anterior (mean difference, 125 kPa; 95% CI: 20, 230 kPa), medial gastrocnemius (mean difference, 83 kPa; 95% CI: -6, 171 kPa), and erector spinae (mean difference, 86 kPa; 95% CI: -17, 188 kPa)., Conclusion: The use of SAIs resulted in increased PPTs after 3 weeks of training on artificial turf compared with controls, suggesting a protective role of SAIs in pressure sensitivity and pain perception.

Stair gait falls are prevalent in older adults aged 65 years and older. Extrinsic variables such as changes to insole hardness are important factors that can compromise the balance control system and increase the incidence of falls, especially since age-related decline in the cutaneous sensation is common. Balance measurements such as the minimum center of mass/base of support (COM-BOS, termed 'stability margin') and COM-BOS medial/lateral range provide information about stability during stair gait. This study was conducted to investigate stair gait stability of young and older adults, with modifications to insole hardness. Twenty healthy adults (10 young adults, 10 older adults) were recruited (mean age = 23.1, SD 2.1; mean age = 73.2, SD 5.5) and instructed to descend a 4 step staircase, for a total of 40 trials. All participants wore similar canvas shoes of varying sizes, and corresponding insole hardnesses (barefoot, soft, medium, hard). Kinematic equipment utilized 12 infrared markers anteriorly placed on the individual to record COM motion and BOS location. The findings from the study demonstrated that older adults were less stable during stair descent. Consequently, insole conditions revealed that the barefoot condition may increase the likelihood of falls, as opposed to the other insole hardnesses (soft, medium and hard). These results suggest that older adults while barefoot are putting themselves at a great risk of falling during stair descent. Since age-related changes are inevitable and the preferred footwear of choice inside the home is bare feet, this is a crucial issue that should be addressed., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background and Objectives: Plantar fasciitis (PF) is a prevalent musculoskeletal disease, with inflammation at the origin of the plantar fascia, that affects sedentary people, particularly middle-aged women. Foot pain and functional limitations lead patients to seek treatment. Investigate the therapeutic effect of conservative treatment combining a custom insole with minimalist flexible shoes and the shoes alone in a gait-training protocol, in the short and long term, in women with PF. Materials and Methods: Design: A randomized, controlled, and single-blind trial. Setting: Biomechanics laboratory. Participants: 36 women, 26 with acute PF and 10 controls. Intervention: Gait-training protocol wearing the minimalist shoes alone (SG, n = 12, age: 46.4 ± 9.6, height: 1.60 ± 0.2, BMI: 28.8 ± 4.2), with a custom insole in the shoes (CIG, n = 14, age: 48.9 ± 9.8, height: 1.60 ± 0.1, BMI: 26.7 ± 5.6), and control (CG, n = 10, age: 46.1 ± 10.7, height: 1.61 ± 0.2, BMI: 26.4 ± 4.8). Evaluations were performed at baseline (T0) and after three (T3) and six (T6) months. The intervention had a duration of six months (six hours a day, seven days a week). Primary outcomes were rearfoot pain (visual analogue scale), the Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ-Br), and 6 min walk test (6MWT). The secondary outcomes were plantar pressure distribution during gait, measured by the pressure platform, and foot posture. Results: The CIG was effective for reducing pain and improving the FPI after T6 compared to CG. The FPI, FHSQ-Br and 6MWT demonstrated improvements after T6 in both the CIG and SG, compared to the CG. After T6, contact area (rearfoot) and maximum force (forefoot) reduced with CIG. Maximum force (midfoot and rearfoot) reduced with CIG and SG, as did peak pressure (forefoot and midfoot) in relation to CG. Conclusions: A customized insole associated with minimalist flexible shoes during a gait-training protocol can be recommended as a more effective treatment than minimalist flexible shoes alone over the short and long term, for reduction in calcaneus pain, increased function and foot health, and improved walking through reduced plantar load in women with PF. [ABSTRACT FROM AUTHOR]

Abstract Background Appropriate footwear is important for those who stand for prolonged periods of time at work, enabling them to remain comfortable, healthy and safe. Preferences for different footwear cushioning or hardness are often person specific and one shoe or insole will not be the choice for all. The aim of this study was to develop a range of insole options to maintain comfort during long periods of standing at work and test insole material preferences in the workplace. Methods The study consisted of two parts. Part one evaluated 9 insoles of the same geometry that varied in hardness under 2 different plantar regions (n = 34). Insole preference, plantar pressure and selected anthropometric foot measures were taken. Three insole designs based on the most preferred options were identified from this part. In part two, these three insoles were evaluated with 22 workers immediately after trying them on (1 min) and after a working day. Foot anthropometric measures and subjective questions concerning material hardness preferences and self-reported foot characteristics were used to investigate whether either had a relationship with insole preference. Results Part one found insole preference predominantly varied according to material hardness under the medial arch rather than the heel/forefoot. Softer material under the heel and forefoot was associated with a reduction in peak pressures in these regions (p

Background: Appropriate footwear is important for those who stand for prolonged periods of time at work, enabling them to remain comfortable, healthy and safe. Preferences for different footwear cushioning or hardness are often person specific and one shoe or insole will not be the choice for all. The aim of this study was to develop a range of insole options to maintain comfort during long periods of standing at work and test insole material preferences in the workplace. Methods: The study consisted of two parts. Part one evaluated 9 insoles of the same geometry that varied in hardness under 2 different plantar regions (n = 34). Insole preference, plantar pressure and selected anthropometric foot measures were taken. Three insole designs based on the most preferred options were identified from this part. In part two, these three insoles were evaluated with 22 workers immediately after trying them on (1 min) and after a working day. Foot anthropometric measures and subjective questions concerning material hardness preferences and self-reported foot characteristics were used to investigate whether either had a relationship with insole preference. Results: Part one found insole preference predominantly varied according to material hardness under the medial arch rather than the heel/forefoot. Softer material under the heel and forefoot was associated with a reduction in peak pressures in these regions (p < 0.05). The most preferred insole had lower pressures under the hallux and first metatarsal phalangeal joint, and greater pressures and contact area under the medial midfoot (p < 0.05) compared to the least preferred insole. Height and foot anthropometrics were related to insole preference. In part two, under real world conditions, insole preference changed for 65% of participants between the immediate assessment (1 min) and after a whole workday, with dorsum height related to the latter (p < 0.05). Subjective questions for self-assessed arch height and footwear feel identified 66.7% of the insole preferences after 1 day at work, compared to 36% using immediate assessment of insole preference. Conclusion: Preference for material hardness varies underneath the medial arch of the foot and is time dependent. Simple foot measures and questions about comfort can guide selection of preferred insoles. [ABSTRACT FROM AUTHOR]

Background: Medial wedged foot orthoses are frequently prescribed to reduce retropatellar stress in patients with patellofemoral pain (PFP) by controlling calcaneal eversion and internal rotation of the tibia. During activities of daily living, the highest patella loads occur during stair descent, but the effect of foot orthoses during stair descent remains unclear.Research Question: The purpose of this study was to compare the kinematics, kinetics and muscle activation during a step descent task in healthy volunteers using three designs of foot orthoses (insoles).Methods: Sixteen healthy subjects with a mean age of 25.7 years, BMI of 23.3, and +5 Foot Posture Index were recruited. Subjects performed a step down task from 20 cm using a 5o rearfoot medial wedge (R), a 5o rearfoot and forefoot medial wedge (R/F), and a control flat insole (C).Results: Significant improvements in control were seen in the R and R/F insoles over the C insole in the foot and at the ankle and hip kinematics. The R and R/F insoles increased the knee adduction moments, but reduced knee internal rotation moment compared to the C insole. Abductor hallucis (AH) activity was reduced with both insoles, whereas tibialis anterior (TA) activity was reduced with the R insole only.Significance: Foot orthoses can change joint mechanics in the foot and lower limbs providing greater stability and less work done by AH and TA muscles. This data supports the use of foot orthoses to provide functional benefits during step descent, which may benefit patients with PFP. [ABSTRACT FROM AUTHOR]

Background: Long-distance walking is a convenient way for prompting physical activity of elderly people. However, walking ability declines with aging.Research Question: This study assessed if silicone insoles with heel lifts (named here the prescribed insoles) could facilitate long-distance walking of older adults.Methods: Fifteen adults aged over 65, who did not have obvious lower-limb problems, walked on a treadmill for totally 60 min in two separate walking sessions: 1) with the prescribed insoles, and 2) with original insoles of the standardized shoes. Gait tests using force plates and a motion analysis system, and subjective evaluation using visual analog and Borg's CR10 scales were conducted at different time points of the treadmill walking.Results: Objective gait anaylsis showed that without using the prescribed insoles, there were significant reductions (p < 0.05) in stance time, vertical ground reaction force, ankle dorsiflexion angle and ankle power generation of the dominant leg after the 60-minute treadmill walk. Such significant reductions were not observed in the same group of subjects upon using the prescribed insoles. Meanwhile, significant improvements in subjective perception of physical exertion, pain and fatigue were observed.Significance: Heel lifts and silicone insoles are generally used to relieve plantar pain and reduce strain of plantar flexors in patients. This study showed they might also be solutions to facilitate long-distance walking of older adults, an approach which could prompt their physical activity. [ABSTRACT FROM AUTHOR]

Previous work regarding the effects of insole use on spatio-temporal gait parameters has yielded inconsistent results. While most studies have employed passive insoles, insoles that encompass a system of progressively increasing arch support may present different effects on gait parameters. Therefore, the aim of this study was to investigate changes in spatio-temporal gait parameters before and immediately after insertion of the insoles into the shoes; and before and after eight weeks of insole use. Twenty (10 male/10 female) healthy individuals were tested in two sessions (eight weeks apart) while walking over a GAITRite® system, in their own shoes (no insoles) and with the insoles inserted in their own shoes (both feet). Spatio-temporal gait parameters (step length, stride length, step time, single support time, double support time, and gait velocity) were obtained from the GAITRite® system, and symmetry ratios were calculated. Decreases in step length and single support time were identified in shod-insoles walking compared to shod walking in the baseline session, while single support time increased from the baseline session to the final session. The results of this study suggest that in healthy young adults, the use of insoles with a system of progressive arch support contributed to altered gait parameters both immediately and following eight weeks of sustained insole use. Future work should determine whether similar effects are observed in clinical populations and whether these changes are beneficial in both healthy and clinical populations. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Laterally wedged insoles have controversial effect in treating medial compartment knee osteoarthritis. This study examined the effects of unilateral and bilateral use of insoles having medial arch supports and of different inclinations on the frontal plane external hip, knee, subtalar moments and pelvic alignment. Methods: Kinetic and kinematic gait parameters were collected from 21 patients with primary medial knee osteoarthritis. The insoles'' inclinations were 0, 6 and 11°, where each of the 6° and 11° was used once unilaterally and another bilaterally while the 0° was used bilaterally as a control. Findings: The Multivariate Analysis of Variance revealed significant increase in the external subtalar eversion moment using either of the 6° or 11° laterally wedged vs the 0° non-wedged insole conditions (P =0.003). Moreover, there were significant increases in the external eversion moment using the 11° vs the 6° insole conditions (P <0.05). However, there were no significant differences for the remaining tested variables (P >0.05). The bivariate correlations revealed significant negative correlations between the subtalar eversion and knee adduction moments (r=−0.409, P =0.000) and the subtalar eversion and hip adduction moments (r=−0.226, P =0.049), and positive correlation between the hip and knee adduction moments (r=0.268, P =0.019). Interpretation: The non-significant reduction in the external knee adduction moment may question the efficacy of using wedged insoles having medial arch supports in treating patients with medial knee osteoarthritis. Additionally, using such insoles did not produce appreciable mechanical effects on remote articulations as the hip and pelvis. [Copyright &y& Elsevier]

The effects of two insole materials within the shoe are compared using neural network analysis. Seven male subjects without locomotor disorders walk on a treadmill at a controlled speed and cadence wearing a common shoe and no socks, under three conditions; these are two types of insole of the same thickness, and a no insole condition. Pressure-related data from under the foot, within the shoe, are obtained by the MICRO-EMED system during walking. A back-propagation neural network is trained to associate sets of pressure-related data with the insole conditions. Subsequently neural network analysis is performed to reveal the abstract rules that govern the decision-making processes within the neural network, based on the synergistic interactions between the measured variables. Data are also analysed using ANOVA. The neural network analysis finds trends in the way in which the trained neural network responds. The interpretation of those trends gives a delicate description of the dynamic behaviour of the insoles despite the fact that no significant differences are found using ANOVA. It is concluded that neural network analysis can distinguish between insole behaviour during use, even though these differences are not significantly different based on statistical tests. [ABSTRACT FROM AUTHOR]