Relationship between the medial longitudinal arch, foot dorsiflexion range of motion, and dynamic gait parameters

Orthotics

10.1093/med/9780199533909.003.0017 ◽

2013 ◽

Author(s):

Sharon Dixon ◽

Sophie Roberts

Keyword(s):

Lower Limb ◽

Movement Pattern ◽

Fundamental Principle ◽

Tibialis Posterior ◽

Medial Longitudinal Arch ◽

Firing Patterns ◽

Tibialis Posterior Tendon ◽

Longitudinal Arch ◽

Custom Made ◽

Dynamic Gait

An orthotic is a custom-made insole which fits inside a shoe with the purpose of changing the way in which the foot functions during both standing and dynamic gait. There are many theories regarding the influence of these devices on the foot and lower limb. It is widely accepted that the fundamental principle is that an orthotic encourages a change in the movement pattern of the foot, aiming to alleviate stress to musculoskeletal structures, and produce changes in muscle firing patterns. An example of how an orthotic works is when one is used to change the functioning position of the medial longitudinal arch of the foot by altering the orientation of the calcaneus and potentially reducing the demand on the tibialis posterior tendon....

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Hard, soft and off-the-shelf foot orthoses and their effect on the angle of the medial longitudinal arch: A biplane fluoroscopy study

Prosthetics and Orthotics International ◽

10.1177/0309364619825607 ◽

2019 ◽

Vol 43 (3) ◽

pp. 331-338 ◽

Cited By ~ 1

Author(s):

Megan Balsdon ◽

Colin Dombroski ◽

Kristen Bushey ◽

Thomas R Jenkyn

Keyword(s):

Study Design ◽

Foot Orthoses ◽

Medial Longitudinal Arch ◽

Level Of Evidence ◽

Cross Sectional ◽

Longitudinal Arch ◽

Significant Difference ◽

Skeletal Kinematics ◽

Dynamic Gait ◽

Foot Orthosis

Background: Foot orthoses have proven to be effective for conservative management of various pathologies. Pathologies of the lower limb can be caused by abnormal biomechanics such as irregular foot structure and alignment, leading to inadequate support. Objectives: To compare biomechanical effects of different foot orthoses on the medial longitudinal arch during dynamic gait using skeletal kinematics. Study design: This study follows a prospective, cross-sectional study design. Methods: The medial longitudinal arch angle was measured for 12 participants among three groups: pes planus, pes cavus and normal arch. Five conditions were compared: three orthotic devices (hard custom foot orthosis, soft custom foot orthosis and off-the-shelf Barefoot Science©), barefoot and shod. An innovative method, markerless fluoroscopic radiostereometric analysis, was used to measure the medial longitudinal arch angle. Results: Mean medial longitudinal arch angles for both custom foot orthosis conditions were significantly different from the barefoot and shod conditions ( p < 0.05). There was no significant difference between the off-the-shelf device and the barefoot or shod conditions ( p > 0.05). In addition, the differences between hard and soft custom foot orthoses were not statistically significant. All foot types showed a medial longitudinal arch angle decrease with both the hard and soft custom foot orthoses. Conclusion: These results suggest that custom foot orthoses can reduce motion of the medial longitudinal arch for a range of foot types during dynamic gait. Level of evidence: Therapeutic study, Level 2. Clinical relevance Custom foot orthoses support and alter the position of the foot during weightbearing. The goal is to eliminate compensation of the foot for a structural deformity or malalignment and redistribute abnormal plantar pressures. By optimizing the position of the foot, the medial longitudinal arch (MLA) will also change and quantifying this change is of interest to clinicians.

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Effect of the Low-Dye Strap on Pronation-Sensitive Mechanical Attributes of the Foot

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-93-2-118 ◽

2003 ◽

Vol 93 (2) ◽

pp. 118-123 ◽

Cited By ~ 15

Author(s):

Jeffrey M. Whitaker ◽

Kazuto Augustus ◽

Suzanne Ishii

Keyword(s):

Range Of Motion ◽

Metatarsophalangeal Joint ◽

Medial Longitudinal Arch ◽

Arch Height ◽

First Metatarsophalangeal Joint ◽

Joint Range Of Motion ◽

Longitudinal Arch ◽

Before And After ◽

Joint Range ◽

State 1

The low-Dye strap is used routinely to temporarily control pronation of the foot and, thereby, to diagnose and treat pronatory sequelae. However, the exact biomechanical effects of this strapping technique on the foot are not well documented. The main purpose of this study was to establish the specific mechanical effects of the low-Dye strap on the pronatory foot. Within this context, the specific aim was to assess the effect of the low-Dye strap on three distinct pronation-sensitive mechanical attributes of the foot in the weightbearing state: 1) calcaneal eversion, 2) first metatarsophalangeal joint range of motion, and 3) medial longitudinal arch height. Weightbearing measurements of these three attributes were made before and after application of a low-Dye strap, and statistical comparisons were made. The results of this study indicate that the low-Dye strap is effective in reducing calcaneal eversion, increasing first metatarsophalangeal joint range of motion, and increasing medial longitudinal arch height in the weightbearing state. Knowledge of the exact mechanisms of action of the low-Dye strap will provide practitioners with greater confidence in the use of this modality. (J Am Podiatr Med Assoc 93(2): 118-123, 2003)

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Rehabilitation following Surgery for Reconstruction of a Foot Defect

Clinical Medicine Case Reports ◽

10.4137/ccrep.s726 ◽

2008 ◽

Vol 1 ◽

pp. CCRep.S726

Author(s):

Susan Faber West ◽

Peter E. Pidcoe

Keyword(s):

Range Of Motion ◽

Muscle Force ◽

Weight Bearing ◽

Force Production ◽

Medial Longitudinal Arch ◽

Talocrural Joint ◽

Longitudinal Arch ◽

Patient Goals ◽

Av Malformation ◽

Muscle Force Production

Background This report illustrates the use of pressure for scar management to aid in foot re-shaping following a surgical intervention to repair an arterio-venous (AV) malformation. Methods This report describes the rehabilitation of a 13-year-old girl after surgical reconstruction of a defect in her left foot following the removal of an AV malformation. Early surgical attempts to repair the problem resulted in complications that required the amputation of toes 2, 3, and 4, and the use of a split thickness skin graft to cover the plantar surface of the medial longitudinal arch on the left foot. Following surgery, the patient had an antalgic gait pattern with decreased weight bearing on the left. The graft obliterated the left medial longitudinal arch and the patient would only weight bear on the heel. The patient had decreased metatarsal joint mobility on the affected side and no movement in the remaining toes. Left talocrural joint active range-of-motion (AROM) was within normal limits and gross ankle muscle force production was assessed to have a grade of 3/5. Results Treatment included reshaping the left foot using a pressure garment and orthotic, followed by interventions to address range-of-motion and muscle force production deficiencies. All treatment objectives were achieved and all patient goals were achieved. Conclusions Pressure was effective in re-shaping the foot to promote normal gait mechanics.

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