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Background: This study examines the effect of two types of custom-made foot orthoses (CFOs) in patients with structural hallux limitus (SHL). Methods: In this quasi-experimental, repeated measures study, 24 participants with SHL were sampled. Two CFOs—cut-out CFO and anterior stabilizer element (AFSE) CFO—were compared using minimalist SAGURO neoprene shoes: no foot orthoses (FO), cut-out CFO, and AFSE CFO. Plantar pressures and center of pressure (CoP) displacement were measured using a Podoprint® platform. Results: Both CFOs shifted the CoP medially during midstance (p < 0.001 with AFSE CFO and p = 0.0036 with cut-out CFO). The AFSE CFO showed a more anterior CoP in midstance, while the cut-out CFO affected anterior CoP in midstance and pre-swing. The AFSE CFO significantly increased pressure in the second toe, lesser metatarsal heads (MTH), midfoot, and rearfoot. In contrast, the cut-out CFO decreased pressure in the second MTH and lesser toe regions, increasing pressure in the midfoot and heel. Both CFOs lowered the hallux/first MTH ratio compared to shod without CFO. Conclusions: The cut-out CFO led to medial and anterior CoP displacement, reducing lateral foot and hallux pressure while transferring loads to the first MTH. The AFSE CFO caused a similar shift by increasing loads on the first MTH. [ABSTRACT FROM AUTHOR]

The first metatarsophalangeal joint (MTPJ) and the first ray are crucial in walking, particularly during propulsion. Limitation in this joint's sagittal plane motion, known as hallux limitus, can cause compensatory movements in other joints. Some studies assessed the impact of various foot orthoses designs on the foot biomechanics; however, a comprehensive understanding is lacking. This study compared the effects of two custom-made foot orthoses (CFOs) on the foot joint kinematics and kinetics in patients with structural hallux limitus (SHL). In this quasi-experimental study, 24 patients with hallux limitus were assessed in three conditions: (i) barefoot, (ii) shod with a cut-out custom foot orthosis (cut-out CFO), and (iii) shod with an anterior forefoot-stabilized element custom foot orthosis (AFSE CFO), fitted into a minimalist neoprene shoe. Multi-segment foot kinematics and kinetics were assessed during the stance phase of the gait. A decrease in ankle and midfoot inversion, as well as in ankle plantarflexion, was found in both orthotic conditions. Regarding the first MTPJ, a greater dorsiflexion was observed with the patient being barefoot compared to both of the conditions under study. From the current finding, it should be concluded that neither of the custom foot orthoses produced the predefined functional effects. [ABSTRACT FROM AUTHOR]

Purpose: Symptomatic flexible pes planus (SFPP) can cause pain and discomfort when walking or engaging in sportive activities in children and adolescents. SFPP can be treated conservatively with foot orthoses, such as the University of California Berkeley Laboratory (UCBL) foot orthosis, which can improve foot function and reduce pain. Kinesio Tape (KT) has also been used as an adjunct to foot orthoses in the treatment of pes planus. This study aims to compare the effectiveness of the UCBL foot orthosis with and without KT in the treatment of SFPP among amateur juvenile and adolescent athletes. Methods: Fifty patients with SFPP were included in the study. In 27 patients UCBL foot orthosis with KT (group 1) was used whereas in 23 UCBL (group 2) was preferred only. The patients were evaluated with AOFAS and radiological measurements. Results: The mean follow-up period was 28.6 ± 4.3(26) months. At the final follow-up AOFAS of group 1 was significantly higher than group 2. In group 2, 12 patients (%52,17) had pressure sores that caused superficial dermabrasion. Lateral TFMAs and talocalcaneal angle in group 1 was significantly better than group 2. Conclusions: This study attempted to determine if using KT with the UCBL foot orthosis was beneficial to the treatment of SFPP compared to simply wearing the orthosis. Our results suggest that KT is effective in reducing pronation and improving the AOFAS score. The use of UCBL with KT seems to be preferable in children and adolescents with SFPP since it is associated with a lower rate of complication, a higher degree of patient compliance and faster improvement in the radiological and clinical findings, compared to the use of the UCBL orthosis alone. [ABSTRACT FROM AUTHOR]

Purpose: Congenital accessory navicular bone (ANB) is a common variant in the foot and is prone to cause several clinical symptoms. Wearing custom-made foot orthosis is considered a desirable option; however, there is limited evidence of its effectiveness. This study aims to report the mid-term effect of foot orthosis for symptomatic pediatric ANBs. Methods: School-age children with symptomatic ANBs combined with flexible flatfoot in the authors' institute were recruited and got custom-made foot orthosis treatment. They were followed up over 4 years. The general characteristics of these children were collected before treatment, including age, gender, and body mass index (BMI). The indicators of foot symptoms, including frequency and location of pain, visual analogue scale (VAS), arch index (AI), and hind foot valgus angle (HVA), were measured during pretreatment and at the last follow-up. Results: Twenty-seven children were recruited for this study. After 4 years of custom-made foot orthosis treatment, significant improvements showed in pain frequency, VAS, AI, and HVA (P < 0.001). Type II ANBs showed a higher pain index pretreatment (P < 0.001) and reduced after treatment (P < 0.001). Conclusion: Mid-term effect of custom-made foot orthosis is inspiring in clinical symptoms of pediatric congenital ANBs combined with flexible flatfoot and may be an optional nonoperative treatment. [ABSTRACT FROM AUTHOR]

Healthcare practitioners will encounter children who use orthoses to improve or maintain body structures and functions, activities and participation. Orthotic interventions involve complex science and the benefits need to outweigh the burden. Interdisciplinary collaborative family centred goal setting, from birth to adulthood is essential. An understanding of why and when orthoses are helpful allows a deeper discussion with families and can improve adherence. This article presents a systematic 'Inside-Out Approach' incorporating the International Classification of Functioning, Disability and Health and the International Organization for Standardization objectives for orthotic interventions. Pictorial and Table Tools identify potential goals for bones and joints, muscles, motor control of standing and walking, activities and participation, and prevention of pain which is an indicator of quality of life. Achieving short and long term goals requires early intervention. The design, alignments and dosage, the duration and frequency the child needs to wear the orthosis, required to achieve goals will be determined by an understanding of natural history and prognosis, the agreed goals and the child's schedule of activities. A Dosage Tool is presented. Recent improved understanding of the contribution of the footwear, individualized and optimized joint and segment alignments and segment proportion is discussed. [ABSTRACT FROM AUTHOR]

The finite element (FE) foot model can help estimate pathomechanics and improve the customized foot orthoses design. However, the procedure of developing FE models can be time-consuming and costly. This study aimed to develop a subject-specific scaled foot modelling workflow for the foot orthoses design based on the scanned foot surface data. Six participants (twelve feet) were collected for the foot finite element modelling. The subject-specific surface-based finite element model (SFEM) was established by incorporating the scanned foot surface and scaled foot bone geometries. The geometric deviations between the scaled and the scanned foot surfaces were calculated. The SFEM model was adopted to predict barefoot and foot-orthosis interface pressures. The averaged distances between the scaled and scanned foot surfaces were 0.23 ± 0.09 mm. There was no significant difference for the hallux, medial forefoot, middle forefoot, midfoot, medial hindfoot, and lateral hindfoot, except for the lateral forefoot region (p = 0.045). The SFEM model evaluated slightly higher foot-orthoses interface pressure values than measured, with a maximum deviation of 7.1%. These results indicated that the SFEM technique could predict the barefoot and foot-orthoses interface pressure, which has the potential to expedite the process of orthotic design and optimization. [ABSTRACT FROM AUTHOR]

Background: This study examines the effect of two types of custom-made foot orthoses (CFOs) in patients with structural hallux limitus (SHL). Methods: In this quasi-experimental, repeated measures study, 24 participants with SHL were sampled. Two CFOs—cut-out CFO and anterior stabilizer element (AFSE) CFO—were compared using minimalist SAGURO neoprene shoes: no foot orthoses (FO), cut-out CFO, and AFSE CFO. Plantar pressures and center of pressure (CoP) displacement were measured using a Podoprint® platform. Results: Both CFOs shifted the CoP medially during midstance (p < 0.001 with AFSE CFO and p = 0.0036 with cut-out CFO). The AFSE CFO showed a more anterior CoP in midstance, while the cut-out CFO affected anterior CoP in midstance and pre-swing. The AFSE CFO significantly increased pressure in the second toe, lesser metatarsal heads (MTH), midfoot, and rearfoot. In contrast, the cut-out CFO decreased pressure in the second MTH and lesser toe regions, increasing pressure in the midfoot and heel. Both CFOs lowered the hallux/first MTH ratio compared to shod without CFO. Conclusions: The cut-out CFO led to medial and anterior CoP displacement, reducing lateral foot and hallux pressure while transferring loads to the first MTH. The AFSE CFO caused a similar shift by increasing loads on the first MTH.

The first metatarsophalangeal joint (MTPJ) and the first ray are crucial in walking, particularly during propulsion. Limitation in this joint’s sagittal plane motion, known as hallux limitus, can cause compensatory movements in other joints. Some studies assessed the impact of various foot orthoses designs on the foot biomechanics; however, a comprehensive understanding is lacking. This study compared the effects of two custom-made foot orthoses (CFOs) on the foot joint kinematics and kinetics in patients with structural hallux limitus (SHL). In this quasi-experimental study, 24 patients with hallux limitus were assessed in three conditions: (i) barefoot, (ii) shod with a cut-out custom foot orthosis (cut-out CFO), and (iii) shod with an anterior forefoot-stabilized element custom foot orthosis (AFSE CFO), fitted into a minimalist neoprene shoe. Multi-segment foot kinematics and kinetics were assessed during the stance phase of the gait. A decrease in ankle and midfoot inversion, as well as in ankle plantarflexion, was found in both orthotic conditions. Regarding the first MTPJ, a greater dorsiflexion was observed with the patient being barefoot compared to both of the conditions under study. From the current finding, it should be concluded that neither of the custom foot orthoses produced the predefined functional effects.

BackgroundObjectivesMethodsResultsConclusionsA link between pronated feet (PF) and chronic low back pain (CLBP) has been reported in the literature. However, physical interventions (PI) like physiotherapy and orthotics mainly target the lower back, neglecting the broader biomechanical impacts of PF that affect the feet, ankles, and overall posture. Currently, there is a lack of comprehensive meta-analyses or systematic reviews on this subject.This systematic review with a meta-analysis aimed to evaluate the effects of PI on pain and disability in patients having CLBP with PF.From inception until October 15, 2023, Medline/PubMed, Web of Science, and Scopus databases were searched using the desired keywords for randomized control trials (RCTs). The quality of the RCTs was evaluated using the PEDro scale and risk of bias tool.Four studies involving 268 patients were identified, two compared custom-made foot orthoses to non-biomechanical foot insoles, while the other two used exercises. The meta-analysis included four studies for pain and three for disability. The results showed a significant change in pain [−2.43 (95% CI −2.73 to −2.13, p < .001)] and disability of −6.69 (95% CI −8.04 to −5.33, p < .001)].This systematic review and meta-analysis of four RCTs elucidates that PI, specifically targeting PF, significantly alleviate pain and reduce disability in patients having CLBP with PF. These findings advocate for integrating foot-based PI within the treatment protocols for patients suffering from CLBP accompanied by PF. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to compare the clinical evaluations, disease impact, disability and foot function of symptomatic flexible pes planus (SFPP) deformity patients treated with the University of California at Berkeley Laboratory (UCBL) foot orthosis and Kinesio tape (KT) to those treated only with the UCBL orthosis. Methods: A total of 100 feet in 50 subjects with a mean age of 77.10 months were included in the study. The subjects were divided into two groups: Group 1 (UCBL foot orthosis with KT, n=27) and Group 2 (UCBL-alone, n=23). Group 1 consisted of 27 patients (14 girls, 13 boys) with an average age of 62 months (range: 25 to 165), while Group 2 consisted of 23 patients (10 girls, 13 boys) with an average age of 63 months (range: 30 to 166). Various assessments, including American Orthopaedic Foot and Ankle Society (AOFAS) scores, anteroposterior and lateral talocalcaneal and talo-first metatarsal angles, talonavicular angle, calcaneal pitch angle and clinical examinations, were conducted to foot-specific disease activity, and foot function. Results: Group 1 exhibited mild-to-moderate foot disability and impairments, along with low levels of disease activity. Treatment with UCBL orthosis and Kinesio tape led to significant improvements in all AOFAS scores and foot angles. Substantial improvement in AOFAS scores was observed during the follow-up examination, except for the midfoot score. Discussion: The use of UCBL foot orthosis in conjunction with Kinesio tape appears to be a preferable treatment strategy for children and adolescents with SFPP. This combined approach is associated with a lower rate of complications, higher patient comfort levels, and faster improvement in both radiological and clinical findings when compared to the use of the UCBL orthosis alone. [ABSTRACT FROM AUTHOR]

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Featured Application: This research offers insights into the performance and durability of 3D-printed foot orthoses made from various thermoplastic polyurethane filaments with different shore A hardness levels. The research involved conducting tests on insoles using specialized equipment to simulate cyclic flexion stress in the metatarsophalangeal area, as well as evaluating their performance in real-world conditions. A new filament, varioShore, based on foaming technology, was also investigated for this type of application. This research examines the flexural fatigue response of 3D-printed foot orthoses produced from various thermoplastic polyurethane (TPU) filaments, including Filaflex 60A, Filaflex 70A, Filaflex 82A, PolyFlex 90A, and varioShore. To subject the insoles to repeated flexion in the metatarsophalangeal area, specialized equipment was developed. A real-world testing scenario was applied to the Filaflex 82A insole, demonstrating that it can sustain over 1,400,000 steps over several months of normal walking (a cadence of approximately 120 steps per minute). Consequently, the experimental conditions were adjusted to double this pace to obtain pertinent results within a shorter testing timeframe. The insoles were subjected to 250 cycles per minute at constant clamping pressures of 176 kPa in the forefoot region. The objective of the evaluation was to determine if 700,000 testing cycles, equivalent to more than two and a half months of daily walking, would induce any damages in the internal structure (infill failure) or external condition (delamination, cracks) of the insoles. Except for compression marks, particularly notable on the foamed material (varioShore TPU) within the clamping zones of the testing device, none of the tested insoles exhibited any signs of external damage after 700,000 cycles. Moreover, the deformations observed in the insoles were non-permanent and nearly entirely disappeared within a few days of rest. The only insole that displayed deterioration of the infill structure was a TPU 82A insole that had been previously worn and then left on a shelf for approximately one year in uncontrolled conditions before being tested at repeated flexion on the apparatus. Additionally, a fifteen-minute walking test was carried out to assess the comfort of each insole, and it was found that the varioShore model, which had a 20% infill density and was 3D-printed at a temperature of 220 °C, stood out as the most comfortable among the tested insoles. [ABSTRACT FROM AUTHOR]

The prevalence of individuals with flat feet and high arches is very high (between 15% to 37%), which can often lead to other orthopedic complications. Three-dimensional-printed insoles are being studied and validated for their effects in correcting these highly prevalent foot disorders. Highly customizable parameters while printing the insole allows for precise correction of foot biomechanics. In this study, 200 patients suffering from various foot-related problems and joint pain were given 3d-printed insoles (designed using plantar pressure systems and clinical practitioner’s assessment) to use in their footwear. Tested activities included standing, walking, running, sports, and gym workout. Customization of insoles included custom density, heel cup, heel rise, medial arch height, and lateral wedge. Based on the patient history, additional podiatry elements were provided for patients with diabetes. Each insole was designed as per the insole profile of the shoe with a comfortable fit. These insoles were found to be effective in alleviating pain for more than 90% of the patients and provided a longer life cycle with effective orthotic correction (for >16 months of daily use). This paper presents the post-use effects (6–18 months) of custom 3D-printed insoles.

Pediatric flat foot (PFF) is a very frequent entity and a common concern for parents and health professionals. There is no established definition, diagnostic method, or clear treatment approach. There are multiple conservative and surgical treatments, the implantation of foot orthoses (FO) being the most used treatment. The evidence supporting FO is very thin. It is not clearly known what the effect of these is, nor when it is convenient to recommend them. The main objective of this protocol is to design a randomized controlled trial to determine if personalized FO, together with a specific exercise regimen, produce the same or better results regarding the signs and symptoms of PFF, compared to only specific exercises. In order to respond to the stated objectives, we have proposed a randomized controlled clinical trial, in which we intend to evaluate the efficacy of FO together with strengthening exercises, compared to a control group in which placebos will be implanted as FO treatment along with the same exercises as the experimental group. For this, four measurements will be taken throughout 18 months (pre-treatment, two during treatment and finally another post-treatment measurement). The combination of FO plus exercise is expected to improve the signs and symptoms (if present) of PFF compared to exercise alone and the placebo FO group. In addition, it is expected that in both conditions the biomechanics of the foot will improve compared to the initial measurements. [ABSTRACT FROM AUTHOR]

Introduction: Patients with partial foot amputations are prone to skin breakdown due to concentrated contact stress and shearing. A custom silicone foot orthosis (FO) can be used to redistribute the concentrated stress and reduce the shearing and discomfort of the skin of a patient with partial calcanectomy. This study presents a custom silicone FO, which is molded using a 3D-printed mold. Methods: The subject's left (amputated) partial foot and right (intact) foot were scanned using a 3D scanner. A custom silicone FO was designed by modifying the models of both feet. A mold for the FO was designed using computer-aided design software and fabricated by 3D printing. Room temperature vulcanization silicone was molded to fabricate the FO. The fit of the FO was clinically evaluated by the subject walking with the FO. Results: A custom silicone FO was fabricated using a 3D-printed mold. Conclusions: The custom silicone FO follows the contour of the residual foot to distribute pressure away from bony prominences during standing and ambulation. 3D printing of the mold can reduce labor time and material cost while facilitating the digital record when compared with a conventional plaster casting approach. Clinical Relevance: The 3D printing approach used to fabricate the custom silicone FO may be applied to develop custom silicone orthotic/prosthetic devices for other types of partial foot amputations. [ABSTRACT FROM AUTHOR]

Background and Aims Numerous treatment modalities have been suggested for patients with medial tibial stress syndrome (MTSS), but the effectiveness of these interventions is still unknown. Therefore, this study aimed to provide a systematic review of the therapeutic efficacy of kinesio taping (KT) and foot orthosis for patients with MTSS.Methods The related articles were searched using selected keywords in Embase, Scopus, Medline, SPORTDiscus, Web of Science, Biomed Central, and PubMed databases from inception to May 2021. After deleting duplicate and unrelated articles, the full text of 9 articles was received from the databases. Results According to the inclusion and exclusion criteria, only 9 articles were eligible for the present review study, of which 5 articles examined the effectiveness of KT and 4 articles the effectiveness of plantar orthosis for people with MTSS. Previous studies showed that using anti-pronation KT can help reduce peak plantar pressure and pain and improve the function of patients with MTSS. Additionally, using the arch support foot orthosis can help correct the pressure distribution pattern under the foot and reduce the foot contact time, resulting in faster pain relief and the physical limitations caused by the MTSS.Kinesio taping, Foot orthosis, Medial tibial stress syndrome, Shin splintBased on the review articles, results indicate that both therapeutic interventions can be used to correct the pressure distribution pattern under the foot, reduce the pain and eliminate physical limitations caused by injuries in individuals with MTSS.

Abstract Aims/Introduction Neuropathy is a common complication of diabetes that reduces balance by disrupting vision, and the sensory and vestibular systems. This is important in older adults who are more at risk of falling. Studies show that improving the sensory mechanisms through insoles can improve balance in people with balance disorders. As textured insoles have recently been considered for improving balance disorders, this study aimed to investigate the immediate effect of textured insoles on the balance of patients with diabetic neuropathy. Materials and Methods A total of 17 patients with diabetic neuropathy participated in this quasi‐experimental study. The studied variables were the general balance index, posterior–anterior balance index and medial‐lateral balance index, which were measured in three conditions: (i) soft textured insoles; (ii) hard textured insoles; and (iii) without textured insoles. A Biodex balance device was used for this purpose. Results In the general balance index, there was a significant difference between all the studied conditions. In the posterior–anterior balance index, there was a significant difference between without textured insole and hard textured insoles, and also soft and hard textured insoles. In the medial‐lateral balance index, there was a significant difference between the hard textured insoles and without textured insoles, and also soft and hard textured insoles (P

Plantar foot pain is one of the most common musculoskeletal conditions affecting the foot. It is regularly experienced by the population with occupations that require prolonged standing hours, especially in nurses. The etiology of plantar foot pain remains unclear, but it is likely to be multi-factorial, with many associated risk factors including increased hours of standing. Orthoses and insoles are often recommended to plantar foot pain patients, however with minimal scientific advancements and limited customizations. In this study, a novel 3D-printed multi-material customized foot orthosis was developed, and its effectiveness on plantar foot pain reduction and functional ability improvement was studied in the nursing population. A total of thirty-six subjects were recruited and were randomized into two groups. The experimental group received the novel 3D-printed multi-material customized foot orthosis, whereas the control group received the standard-of-care (or traditional) intervention. Pre-test and the post-test scores of pains, functional ability and plantar pressure were observed using SPSS software. Improvements were observed in both of the groups; however, better improvements were seen in the experimental group. Overall, the novel 3D printing-based customized foot orthosis showed significant efficacy in reducing plantar foot pain and pressure, and also in increasing functional ability in the nursing population as compared to the traditional method.

Abstract Background The effect of medial arch support foot orthoses on kinematics and kinetics of the knee joint has remained unknown. Methods Sixteen female collegiate-level athletes volunteered to participate. Participants were asked to perform a 30° sidestep cut using orthoses of 3 different medial arch heights, comprising of the following: (1) “low,” a full flat foot orthosis without arch support, (2) “mid,” a commercially available foot orthosis with general height arch support, and (3) “high,” a foot orthosis with double the commercially available height for arch support to observe the effect on the knee when overcorrected. Kinematics and kinetics of the knee joint were collected by a markerless motion capture system with 2 force plates and compared between orthosis types using linear regression analysis, assuming a correlation between the measurements of the same cases in the error term. Results The knee valgus angle at initial contact was 2.3 ± 5.2 degrees for “low” medial arch support height, 2.1 ± 5.8 degrees for “mid,” and 0.4 ± 6.6 degrees for “high”. Increased arch support height significantly decreased the knee valgus angle at initial contact (p = 0.002). Other kinematic and kinetic measurements did not differ between groups. Conclusions The valgus angle of the knee at initial contact was decreased by the height of the medial arch support provided by foot orthosis during cutting manoeuvres. Increasing the arch support height may decrease knee valgus angle at initial contact. Medial arch support of foot orthosis may be effective in risk reduction of ACL injury. Clinical trial registration numbers and date of registration: UMIN000046071, 15/11/2021.

The prevalence of individuals with flat feet and high arches is very high (between 15% to 37%), which can often lead to other orthopedic complications. Three-dimensional-printed insoles are being studied and validated for their effects in correcting these highly prevalent foot disorders. Highly customizable parameters while printing the insole allows for precise correction of foot biomechanics. In this study, 200 patients suffering from various foot-related problems and joint pain were given 3d-printed insoles (designed using plantar pressure systems and clinical practitioner's assessment) to use in their footwear. Tested activities included standing, walking, running, sports, and gym workout. Customization of insoles included custom density, heel cup, heel rise, medial arch height, and lateral wedge. Based on the patient history, additional podiatry elements were provided for patients with diabetes. Each insole was designed as per the insole profile of the shoe with a comfortable fit. These insoles were found to be effective in alleviating pain for more than 90% of the patients and provided a longer life cycle with effective orthotic correction (for >16 months of daily use). This paper presents the post-use effects (6–18 months) of custom 3D-printed insoles. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Neuropathy is a common complication of diabetes that reduces balance by disrupting vision, and the sensory and vestibular systems. This is important in older adults who are more at risk of falling. Studies show that improving the sensory mechanisms through insoles can improve balance in people with balance disorders. As textured insoles have recently been considered for improving balance disorders, this study aimed to investigate the immediate effect of textured insoles on the balance of patients with diabetic neuropathy. Materials and Methods: A total of 17 patients with diabetic neuropathy participated in this quasi‐experimental study. The studied variables were the general balance index, posterior–anterior balance index and medial‐lateral balance index, which were measured in three conditions: (i) soft textured insoles; (ii) hard textured insoles; and (iii) without textured insoles. A Biodex balance device was used for this purpose. Results: In the general balance index, there was a significant difference between all the studied conditions. In the posterior–anterior balance index, there was a significant difference between without textured insole and hard textured insoles, and also soft and hard textured insoles. In the medial‐lateral balance index, there was a significant difference between the hard textured insoles and without textured insoles, and also soft and hard textured insoles (P < 0.05). Conclusions: Wearing textured insoles can increase the balance in patients with diabetic neuropathy. This can be due to its effect on the sensory feedback of the soles, improving the proprioception and tactile sensors that are the main sources of balance. [ABSTRACT FROM AUTHOR]

Plantar foot pain is one of the most common musculoskeletal conditions affecting the foot. It is regularly experienced by the population with occupations that require prolonged standing hours, especially in nurses. The etiology of plantar foot pain remains unclear, but it is likely to be multi-factorial, with many associated risk factors including increased hours of standing. Orthoses and insoles are often recommended to plantar foot pain patients, however with minimal scientific advancements and limited customizations. In this study, a novel 3D-printed multi-material customized foot orthosis was developed, and its effectiveness on plantar foot pain reduction and functional ability improvement was studied in the nursing population. A total of thirty-six subjects were recruited and were randomized into two groups. The experimental group received the novel 3D-printed multi-material customized foot orthosis, whereas the control group received the standard-of-care (or traditional) intervention. Pre-test and the post-test scores of pains, functional ability and plantar pressure were observed using SPSS software. Improvements were observed in both of the groups; however, better improvements were seen in the experimental group. Overall, the novel 3D printing-based customized foot orthosis showed significant efficacy in reducing plantar foot pain and pressure, and also in increasing functional ability in the nursing population as compared to the traditional method. [ABSTRACT FROM AUTHOR]

Background: Dynamic balance plays a key role in high-impact sports, such as CrossFit, where athletes are required to maintain balance in various weightlifting exercises. The loss of balance in these sport-specific movements may not only affect athlete performance, but also increase the risk of injuries. Objectives: The aim of the study is to achieve greater insight into the balance and athlete position during the CrossFit training by means of inertial sensors, with a particular focus on the role of different custom foot orthoses (CFOs) in order to detect correlations with the role of the cavus foot. Methods: A total of 42 CrossFit® athletes, aged 25 to 42 years, were enrolled in this study. One-way ANOVA tests with post-hoc analysis of variance were used to compare foot posture groups and effects of different types of customized foot orthoses. Results: When comparing the effects of CFOs with the respective balance basal level during the pistol squat exercise, we observed a significant (p = 0.0001) decrease in the sway area, antero-posterior displacement (APD) and medio-lateral displacement (MLD) compared to the basal using both types of CFOs. Conclusion: No significant positive effects of CFOs were observed in some static tests. On the contrary, positive effects of CFOs and, in particular, postural insoles, are relevant to dynamic balance. [ABSTRACT FROM AUTHOR]

Background: Greater trochanteric pain syndrome (GTPS), including gluteal tendinopathy and bursitis, is a common, painful and debilitating condition. It is thought to involve overload of the gluteal tendons, which may be amplified through increased hip adduction moment (HAM) seen during gait in these individuals. Reducing the aberrant HAM may improve pain and function in this population. We aimed to determine if medially-posted foot orthoses immediately reduce HAM and pain in females with GTPS during walking gait.Methods: A double-blind, repeated-measures trial with randomised intervention order compared three conditions in 53 women with GTPS. Participants acted as their own control during baseline (everyday-shoe insole), medially-posted (active) orthosis, or flat insert (sham orthosis) walking. Data were collected via three-dimensional gait analysis for HAM, hip, pelvic, and thorax kinematics; as well as ground reaction force; and pain via the numerical rating scale. Subgroup analysis was performed based on a pronated foot-posture defined by the Foot Posture Index.Results: A small pain reduction was found between the active orthosis and flat insert (mean difference = -0.444, p = 0.017). No difference was detected for pain between other condition comparisons. Thoracic lateral flexion increased at second-peak HAM between the baseline and active conditions (mean difference = -0.917, p = 0.040). No differences were detected for HAM, remaining kinematic or kinetic variables, or ground reaction force data across the three conditions. No significant differences were detected between any of the three conditions for biomechanical or pain data in the pronated-foot subgroup.Significance: A medially-posted foot orthosis did not immediately alter gait biomechanics or provide a clinically meaningful pain reduction in women with GTPS. There is uncertainty regarding the clinical benefit of orthoses in the management of GTPS. Longer-term follow-up or the use of customised orthoses may produce different outcomes and should be explored in future research. [ABSTRACT FROM AUTHOR]

This research examines the flexural fatigue response of 3D-printed foot orthoses produced from various thermoplastic polyurethane (TPU) filaments, including Filaflex 60A, Filaflex 70A, Filaflex 82A, PolyFlex 90A, and varioShore. To subject the insoles to repeated flexion in the metatarsophalangeal area, specialized equipment was developed. A real-world testing scenario was applied to the Filaflex 82A insole, demonstrating that it can sustain over 1,400,000 steps over several months of normal walking (a cadence of approximately 120 steps per minute). Consequently, the experimental conditions were adjusted to double this pace to obtain pertinent results within a shorter testing timeframe. The insoles were subjected to 250 cycles per minute at constant clamping pressures of 176 kPa in the forefoot region. The objective of the evaluation was to determine if 700,000 testing cycles, equivalent to more than two and a half months of daily walking, would induce any damages in the internal structure (infill failure) or external condition (delamination, cracks) of the insoles. Except for compression marks, particularly notable on the foamed material (varioShore TPU) within the clamping zones of the testing device, none of the tested insoles exhibited any signs of external damage after 700,000 cycles. Moreover, the deformations observed in the insoles were non-permanent and nearly entirely disappeared within a few days of rest. The only insole that displayed deterioration of the infill structure was a TPU 82A insole that had been previously worn and then left on a shelf for approximately one year in uncontrolled conditions before being tested at repeated flexion on the apparatus. Additionally, a fifteen-minute walking test was carried out to assess the comfort of each insole, and it was found that the varioShore model, which had a 20% infill density and was 3D-printed at a temperature of 220 °C, stood out as the most comfortable among the tested insoles.

Background: The effect of medial arch support foot orthoses on kinematics and kinetics of the knee joint has remained unknown. Methods: Sixteen female collegiate-level athletes volunteered to participate. Participants were asked to perform a 30° sidestep cut using orthoses of 3 different medial arch heights, comprising of the following: (1) "low," a full flat foot orthosis without arch support, (2) "mid," a commercially available foot orthosis with general height arch support, and (3) "high," a foot orthosis with double the commercially available height for arch support to observe the effect on the knee when overcorrected. Kinematics and kinetics of the knee joint were collected by a markerless motion capture system with 2 force plates and compared between orthosis types using linear regression analysis, assuming a correlation between the measurements of the same cases in the error term. Results: The knee valgus angle at initial contact was 2.3 ± 5.2 degrees for "low" medial arch support height, 2.1 ± 5.8 degrees for "mid," and 0.4 ± 6.6 degrees for "high". Increased arch support height significantly decreased the knee valgus angle at initial contact (p = 0.002). Other kinematic and kinetic measurements did not differ between groups. Conclusions: The valgus angle of the knee at initial contact was decreased by the height of the medial arch support provided by foot orthosis during cutting manoeuvres. Increasing the arch support height may decrease knee valgus angle at initial contact. Medial arch support of foot orthosis may be effective in risk reduction of ACL injury. Clinical trial registration numbers and date of registration: UMIN000046071, 15/11/2021. [ABSTRACT FROM AUTHOR]

Recent scientific evidence supports the idea that foot plantar stimulation increases the functional connectivity of brain regions involved in visuo-spatial and sensory-motor integration. In this before–after, non-randomised intervention study we assessed the change in several gait and postural parameters using inertial sensor measurements after acute plantar stimulation using custom 3D-printed insoles. The pilot study was performed on 22 institutionalised, older individuals with a high comorbidity burden who either walked autonomously or with the help of a cane. The intensity of the effects in the first mechanical plantar stimulation session (at one week) strongly predicted a change in the 180° turn duration (p < 0.05) and the standard deviation of the step duration (p < 0.05) during the timed up-and-go test. Based on these effects, researchers also predicted decreases in some postural parameters such as the root mean square of displacement on the anterior–posterior axis (p < 0.01). Thus, these preliminary findings provide a strong rationale for performing controlled clinical trials with larger samples to investigate the efficacy and mechanisms of mechanical plantar stimulation in frail elderly individuals. [ABSTRACT FROM AUTHOR]

The diabetic prevalent population is increasing day by day, which further increases the cases of diabetic ulceration, loss of sensation in the plantar region of the foot, and amputations in severe patients. These complications can be managed up to some extent by using modified shoes, offloading orthosis, etc. In recent advances, the use of additive manufacturing (i.e., 3D printing) to fabricate orthosis for diabetic patients is pioneering. The method of 3D printing of the foot orthosis for the diabetic foot management can be used along with the traditional methods. This review article will provide extensive literature on the pathophysiology of diabetes, the related complications and management techniques, and the use of additive manufacturing in the orthosis fabrication methods and its progress.

Objectives: Flexible Flat Foot (FFF), a common foot deformity decreasing medial longitudinal arch height is often comorbid with subtalar joint pronation causing physical activity difficulties in this population. Among the orthotic insoles prescribed for improving foot function, foot orthoses with medial heel skive technique have a limited research background. The present study aimed to investigate the effects of the custom-mold insole with medial heel skive technique on physical function in FFF. Methods: Eighteen adults with FFF from the University of Social Welfare and Rehabilitation Sciences students and staff participated in this study. Custom-Mold insole with medial heel skive was fabricated for all research participants. Physical function in the activities of daily living and sports was assessed by the Foot and Ankle Ability Measure (FAAM), Activities of Daily Living (ADL) subscale (ADL-FAAM), and SPORT-FAAM questionnaires at the beginning of the study and 6 weeks after. Paired Samples t-test and nonparametric tests were used to compare the collected results. Results: After 6 weeks of using the insole with medial heel skive technique, scores in both ADL and SPORTS activities were significantly improved. Discussion: Foot function improvement was not found in all of the studies assessing foot function in flat feet after using different orthotic insoles, by different questionnaires or other systems. In this study, foot and ankle function was significantly improved per FAAM questionnaire- which had highly limited use in orthotic interventions in flat feet population- using medial heel skive technique; however, further studies are required to accentuate medial heel skive technique effect on flat feet function by comparing this technique with other positive cast modifications to control the flat foot. According to the present study results, custom-mold insole with medial heel skive may improve physical function in FFF and can be prescribed in this group.

Background: In clinical practice, specific customization is needed to address foot pathology, which must be disease and patient-specific. To date, the traditional methods for manufacturing custom functional Foot Orthoses (FO) are based on plaster casting and manual manufacturing, hence orthotic therapy depends entirely on the skills and expertise of individual practitioners. This makes the procedures difficult to standardize and replicate, as well as expensive, time-consuming and material-wasting, as well as difficult to standardize and replicate. 3D printing offers new perspectives in the development of patient-specific orthoses, as it permits addressing all the limitations of currently available technologies, but has been so far scarcely explored for the podiatric field, so many aspects remain unmet, especially for what regards customization, which requires the definition of a protocol that entails all stages from patient scanning to manufacturing. Methods: A feasibility study was carried out involving interdisciplinary cooperation between industrial engineers and podiatrists. To that end: (i) For patient-specific data acquisition, 3D scanning of the foot is compared to traditional casting. (ii) a modelling GD workflow is first created to design a process permitting easy creations of customized shapes, enabling the end user (the podiatrist) to interactively customize the orthoses. Then, (iii) a comparison is made between different printing materials, in order to reproduce the same mechanical behavior shown by standard orthoses. To do this, the mechanical properties of standard materials (Polycarbonate sheets), cut and hand-shaped, are compared with four groups of 3D printed samples: poly(ethylene glycol) (PETG), poly(acrylonitrile-butadiene.styrene) (ABS), polycarbonate (PC) and poly(lactic acid) (PLA) obtained by Fused Filament Fabrication (FFF). Results: Differences found between the foot plaster model obtained with the plaster slipper cast in a neutral position and the model of the real foot obtained with 3D scanning in the same position can be ascribed to the non-stationarity of the patient during the acquisition process, and were limited by a locking system with which no substantial differences in the almost entire sole of the foot scan were observed. Conclusions: Using the designed GD workflow, podiatrists with limited CAD skills can easily design and interactively customize foot orthoses to adapt them to the patients' clinical needs. 3D printing enables the complex shape of the orthoses to be reproduced easily and quickly. Compared to Polycarbonate sheets (gold standard), all the printed materials were less deformable and reached lower yield stress for comparable deformation. No modifications in any of the materials as a result of printing process were observed. [ABSTRACT FROM AUTHOR]

Background: Collapse of the foot arch is a one of the risk factors in medial tibial stress syndrome. Custom-made foot orthoses are used to reduce the collapse of foot arch, but the orthoses are designed for a specific shoe and cannot be used in other shoes. We developed an elastic foot orthosis that is highly fitted on the foot using thin films, is lightweight, and can be used with any shoe or without shoes. The purpose of this study was to investigate foot kinematics with our elastic foot orthosis during walking and running.Methods: We recruited 30 participants with asymptomatic flatfoot for this study. Foot kinematic data were recorded for treadmill walking, treadmill running, and over-ground walking. Foot kinematics were recorded in three conditions, barefoot (BF), with the elastic foot orthosis (EFO), and with sham foot orthosis (SFO), and foot strain was measured using a stretch strain sensor. The difference in foot strain from initial contact to maximum strain during gait was calculated as loading arch strain, which was reflected as forefoot eversion excursion. A one-way analysis of variance with Bonferroni test was performed to compare the loading arch strain among the three conditions.Results: In all tasks, loading arch strain with the EFO was significantly less than that in the BF and SFO conditions. Loading arch strain with the SFO was significantly more than that of BF in the treadmill gait condition.Conclusion: Our results indicate that the EFO decreased foot strain during locomotion compared to without the EFO and is capable of supporting the foot arch during locomotion. [ABSTRACT FROM AUTHOR]

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The aim of this scoping review was to identify information on compliance with wearing orthoses and other supportive devices, to discuss the barriers to adherence, and to suggest strategies for improvement based on these findings. Online databases of PubMed, Web of Science, and the Cochrane Library were searched for articles about patients' compliance with regard to lower limb assistive devices. In addition, a methodological quality control process was conducted. Studies were included if in the English language and related to compliance and adherence to the lower limb assistive device. Exclusion was based on first reading the abstract and then the full manuscript confirming content was not related to orthotic devices and compliance. Twelve studies were included. The data revealed between 6% and 80% of patients were not using a prescribed device. Barriers to the use of the orthotic device included medical, functional, device properties and lack of proper fit. Strategies for improved compliance included better communication between patient and clinician, patient education, and improved comfort and device esthetics. Individualized orthotic adjustments, rehabilitation, and patient education were promising for increasing adherence. Despite positive aspects of improvements in gait, balance in elderly, and a sense of security produced by using assistive devices, compliance remains less than ideal due to barriers. As compliance in recent studies has not improved, continued work in this area is essential to realize the benefits of technological advances in orthotic and assistive devices. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the effects of a foot orthosis on balance, hallux strength, reduction in perception of pain and hallux deviation in female athletes. The study included nine dancers and fourteen soccer players who wore the foot orthosis for a span of four weeks, returning for final measurements after a week for post measures. The device was worn each night and the total hours worn were logged. We found that the use of the foot orthosis led to significant reduction in perception of pain, improvement of hallux strength and deviation, and positive redistribution of foot pressure in female athletes. These findings suggest that this foot orthosis can be used as an intervention to reduce the potential negative effects of hallux valgus. [ABSTRACT FROM AUTHOR]

Abstract Background Plantar fasciopathy is a common cause of plantar heel pain, with a reported prevalence of up to 10%. The choice of best practice in these patients is debated. Two randomised studies reported that radial extracorporeal shock wave therapy is effective, but a meta-analysis concluded that due to methodological limitations, the evidence is questionable. There are few studies reporting the effect of exercise programs with high-load strength training, despite widespread use. The objective of this placebo-controlled, observer-blinded and partly patient blinded trial is to compare rESWT, sham-rESWT, standardised exercise programme and usual care for alleviating heel pain at 6 and 12 months follow-up. Methods/design A double-blind, randomised, sham-controlled trial is conducted at a hospital outpatient clinic of physical medicine and rehabilitation. Patients with chronic (> 3 months) pain due to plantar fasciopathy, aged 18 to 70 years old, are eligible for inclusion in the trial. Patients will be randomly allocated in 1:1 ratio to receive rESWT, sham-rESWT, standardised exercises or usual care. The sample size is estimated to 200 patients, 50 in each group. rESWT or sham-rESWT will be given once a week for 3 weeks. A physiotherapist will supervise the exercises, with a total of 8 sessions over 12 weeks. The patients in the usual care group will receive information, advice and foot orthosis only. All patients, regardless of group, will receive the same information and get an individual customised foot orthosis made by an orthopaedic technician. The primary outcome measure is heel pain intensity during activity in the last week, using a numeric rating scale (NRS, 0 to 10) at the 6 months follow-up adjusted for baseline pain intensity. The secondary outcomes are at the 6- and 12-month follow-up and include Foot Functional Index Revised Short Version (FFI-RS), Patient Global Impression of Change Scale (7-point Likert scale), RAND-12 Health Status Inventory (RAND-12), NRS during rest and NRS during activity (12 months). The patients receiving rESWT/sham-rESWT and the outcome assessor will be blinded to the group assignment. Discussion This trial is designed in order to provide results important for future clinical practice. Trial registration ClinicalTrials.gov NCT03472989 . Registered on 14 March 2018

Some studies have found that patients with asthma have bilateral foot dorsal flexion limitations, contributing to impaired quality of life. The authors hypothesised that foot misalignments could also occur in patients with chronic obstructive pulmonary disease (COPD), and that foot orthoses could increase the motor benefits of their pulmonary rehabilitation (PR). Presented herein are the results from a nonrandomised controlled study in 40 patients with COPD. Twenty patients had foot misalignment (Group 1) and wore foot orthoses for a 1-month PR period. Their data were compared to those obtained in 20 other patients with COPD who had no foot misalignment and did not wear foot orthoses (Group 2). Bodily fatigue, 6-minute walk test (6MWT) distance, peak plantar flexion force (PFF), and oscillations of the centre of pressure (CoP) were measured. Measurements were performed prior to and following completion of PR (Groups 1 and 2), immediately after wearing the foot orthosis (Group 1), and after completion of PR plus foot orthoses (Group 1). In Group 2, PR increased the 6MWT distance, but did not increase PFF nor reduce CoP oscillations and fatigue scale. Wearing the foot orthosis for the first time significantly increased the 6MWT distance (+98+12 m). Following PR with foot orthoses (Group 1), a further increase in 6MWT distance occurred (+120+13 m), bodily fatigue was reduced, PFF increased, and CoP oscillations decreased. In patients with COPD and foot misalignment, foot orthoses enhanced the functional capacity and improved the postural control.

Customized foot orthosis is commonly used to modify foot posture and relieve foot pain for adult acquired flexible flatfoot. However, systematic investigation of the influence of foot orthotic design parameter combination on the internal foot mechanics remains scarce. This study aimed to investigate the biomechanical effects of different combinations of foot orthoses design features through a muscle-driven flatfoot finite element model. A flatfoot-orthosis finite element model was constructed by considering the three-dimensional geometry of plantar fascia. The plantar fascia model accounted for the interaction with the bulk soft tissue. The Taguchi approach was adopted to analyze the significance of four design factors combination (arch support height, medial posting inclination, heel cup height, and material stiffness). Predicted plantar pressure and plantar fascia strains in different design combinations at the midstance instant were reported. The results indicated that the foot orthosis with higher arch support (45.7%) and medial inclination angle (25.5%) effectively reduced peak plantar pressure. For the proximal plantar fascia strain, arch support (41.8%) and material stiffness (37%) were strong influencing factors. Specifically, higher arch support and softer material decreased the peak plantar fascia strain. The plantar pressure and plantar fascia loading were sensitive to the arch support feature. The proposed statistics-based finite element flatfoot model could assist the insole optimization and evaluation for individuals with flatfoot.

Background: Dynamic balance plays a key role in high-impact sports, such as CrossFit, where athletes are required to maintain balance in various weightlifting exercises. The loss of balance in these sport-specific movements may not only affect athlete performance, but also increase the risk of injuries. Objectives: The aim of the study is to achieve greater insight into the balance and athlete position during the CrossFit training by means of inertial sensors, with a particular focus on the role of different custom foot orthoses (CFOs) in order to detect correlations with the role of the cavus foot. Methods: A total of 42 CrossFit® athletes, aged 25 to 42 years, were enrolled in this study. One-way ANOVA tests with post-hoc analysis of variance were used to compare foot posture groups and effects of different types of customized foot orthoses. Results: When comparing the effects of CFOs with the respective balance basal level during the pistol squat exercise, we observed a significant (p = 0.0001) decrease in the sway area, antero-posterior displacement (APD) and medio-lateral displacement (MLD) compared to the basal using both types of CFOs. Conclusion: No significant positive effects of CFOs were observed in some static tests. On the contrary, positive effects of CFOs and, in particular, postural insoles, are relevant to dynamic balance.

Introduction: The purpose of this study was to compare the impact of three types of orthoses (knee orthosis, ankle foot orthosis (AFO), and foot orthosis) on knee alignment, pain, function, and quality of life in individuals with medial knee osteoarthritis (MKOA)., Method: Thirty patients took part in this study and were randomly assigned to three groups ( n = 10 in each group) based on the type of intervention. Knee function was assessed using the knee injury and osteoarthritis outcome score (KOOS) questionnaire, and knee alignment was evaluated by measuring angles using the images of bony prominence (AMI) method., Results: After using knee orthosis and AFO, all subscales of KOOS showed significant improvement ( p < .05). However, there was no significant difference in the results after using foot orthosis ( p > .05)., Conclusion: The findings indicate that knee orthosis or AFO for 6 weeks can improve clinical outcomes for individuals with MKOA. This suggests that clinicians can consider using knee orthosis and AFO among the available treatment options to improve clinical outcomes., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Foot orthoses are prescribed to reduce forefoot plantar pressures and pain in people with rheumatoid arthritis. Computational modelling can assess how the orthoses affect internal tissue stresses, but previous studies have focused on a single healthy individual. This study aimed to ascertain whether simplified forefoot models would produce differing biomechanical predictions at the orthotic interface between people with rheumatoid arthritis of varying severity, and in comparison to a healthy control. The forefoot models were developed from magnetic resonance data of 13 participants with rheumatoid arthritis and one healthy individual. Measurements of bony morphology and soft tissue thickness were taken to assess deformity. These were compared to model predictions (99th% shear strain and plantar pressure, max. pressure gradient, volume of soft tissue over 10% shear strain), alongside clinical data including body mass index and Leeds Foot Impact Scale–Impairment/Footwear score (LFIS-IF). The predicted pressure and shear strain for the healthy participant fell at the lower end of the rheumatoid models’ range. Medial first metatarsal head curvature moderately correlated to all model predicted outcomes (0.529 < r < 0.574, 0.040 < p < 0.063). BMI strongly correlated to all model predictions except pressure gradients (0.600 < r < 0.652, p < 0.05). There were no apparent relationships between model predictions and instances of bursae, erosion and synovial hypertrophy or LFIS-IF score. The forefoot models produced differing biomechanical predictions between a healthy individual and participants with rheumatoid arthritis, and between individuals with rheumatoid arthritis. Models capable of predicting subject specific biomechanical orthotic interactions could be used in the future to inform more personalised devices to protect skin and soft tissue health. While the model results did not clearly correlate with all clinical measures, there was a wide range in model predictions and morphological measures across the participants. Thus, the need for assessment of foot orthoses across a population, rather than for one individual, is clear.

Objectives: Foot impairment in rheumatoid arthritis (RA) may exacerbate sarcopenia from physical inactivity because of foot pain while walking. The present study aimed to investigate the prevalence of sarcopenia in patients with RA-associated foot impairment, and whether treatment with a foot orthosis improved physical activity and muscle quantity. Methods: Thirty-two patients with RA were diagnosed as sarcopenic or nonsarcopenic, and the prevalence of sarcopenia was determined. Eleven patients with sarcopenia were treated with a foot orthosis. The following parameters were compared between baseline and after 6 months of treatment: physical activity (walking, moderate-intensity activity, and vigorous-intensity activity), foot pain while walking, Health Assessment Questionnaire (HAQ) score, and body composition parameters, including muscle quantity. Results: Sarcopenia was present in 25/32 patients (78.1%). The use of a foot orthosis improved walking activity (p=.02), foot pain while walking (p=.02), and HAQ score (p=.02). However, there were no significant changes in moderate- or vigorous-intensity activities or body composition parameters, including muscle quantity. Conclusion: Patients with RA-associated foot impairment had a high rate of sarcopenia. Treatment with a foot orthosis increases light-intensity physical activity such as walking, but does not enhance moderate-to-vigorous-intensity activities or increase muscle quantity. [ABSTRACT FROM AUTHOR]

Partial Foot Amputation is commonly seen in people with diabetes, soldiers who have fought the war and vascular deficiency. A Variety of interventions have been in practice to manage Partial Amputee Foot, evaluating their efficiency and making them easily available in developing counties and affordable at a primitive stages has been the interest of research. Further investigation is required to better understand the influence of prosthetic intervention in a number of areas so that clients and clinicians can make better informed decisions about treatment options. In this paper foot plate is designed using composite material to assist people with PFA disorder with the weight using basic consideration of force for 78 kg. A basic model has been designed and validated of same using ANSYS as well as theoretical formulation shows that there is effective restoration of foot length and reduces pressure from the sensitive distal end of the residuum by redistributing body weight to other parts of the foot or even the leg. [ABSTRACT FROM AUTHOR]

Scoliosis is a 3-dimensional spinal deformity defined as lateral curvature of the spine in the coronal plane of more than 10°. This study describes a case of functional scoliosis after hip injury. In this case, the patient fell whilst inline skating (June 2015) causing severe tilting of her spine, and left hip pain. She received outpatient treatment from July 14, 2015 to December 28, 2015. For approximately 5 months, acupuncture therapy was performed to relax the tension in both hips, Chuna therapy, and foot orthosis were applied to reduce the body’s imbalance. Based on X-ray images, the Cobb angle had decreased from 14.73° (pretreatment) to 1.90° (posttreatment). This case report suggested that Korean medicine treatment could be an effective therapeutic choice for functional scoliosis.

Background: The rearfoot varus wedge (RVW) is a common treatment for foot pain and valgus deformity. There is research on its effects in the calcaneus, but there is little research on the navicular. More research is needed with the use of RVW due to the relationship that exists between the position of the navicular and the risk of suffering an injury. Objectives: this study sought to understand how RVW can influence the kinematics of the navicular bone, measuring their movement with the 6 SpaceFastrak system. Methods: a total of 60 subjects participated in the study. Two sensors were used to measure the movement of the calcaneus and navicular using RVWs as compared in the barefoot position in a static way. Results: there were statistically significant differences, the use of RVWs caused changes in the navicular bone, with subjects reaching the maximum varus movement with the use of RVW 7 mm of 1.35 ± 2.41° (p < 0.001), the maximum plantar movement flexion with the use of RVW 10 mm of 3.93 ± 4.44° (p < 0.001). Conclusions: when RVWs were placed under the calcaneus bone, the navicular bone response was in varus movement too; thus, the use of rearfoot varus wedge can influence the movement of the navicular bone.

The paper presents the effects of the application of a new technical solution along with medical procedures. This approach aims to correct the collapsed transverse arch of the foot and thus restore the physiological course of the anatomical structures. In this way, the alignment of the toes is achieved, thus also eliminating valgus of the big toe. In the article are presented results for 19 patients with stage I and 22 patients with stage II of the foot deformities. Patients applied the orthosis at 5−7 h daily per one year. Physical examination and X-ray scans were used to assess correction progress. Angles between individual bones of the foot were compared. Correction of the transverse arch of the foot reduces the remain toes deformities of the foot (II–V). The HV angle in the group of patients with the degree I deformity before and after the therapy was 18.3° (3.1°) and 15.2° (±2.6°), respectively, and for patients with degree II deformity it was 19.2° (±2.9°) and 16.3. (±3.2°). The correction deficit was reduced in stage I from 22% to 1.33% and in stage II from 28% to 8.6% (p <.05). The proposed approach to treating feet with the developed device, ie Forefoot arch-type orthosis: (1) restores spatial arrangement of tendons, bones, and ligaments and prevents the development of foot contractures (2) enables gradual stretching of extra-articular and capsular contractures (3) can reduce forefoot pain and improves the quality of life. [ABSTRACT FROM AUTHOR]