Influence of Foot Type and Orthotics on Static and Dynamic Postural Control

2004 ◽  
Vol 13 (1) ◽  
pp. 54-66 ◽  
Author(s):  
Lauren C. Olmsted ◽  
Jay Hertel

Context:The effects of custom-molded foot orthotics on neuromuscular processes are not clearly understood.Objective:To examine these effects on postural control in subjects with different foot types.Design:Between-groups, repeated-measures design.Setting:Athletic training laboratory.Subjects:30 healthy subjects assigned to groups by foot type: planus (n = 11), rectus (n = 12), or cavus (n = 7).Interventions:Custom-fit semirigid orthotics.Main Outcome Measures:Static postural control was measured on a force plate. Dynamic postural control was measured using the Star Excursion Balance Test. Both measurements were assessed with and without orthotics at baseline and 2 weeks later.Results:For static postural control, a significant condition-by-group interaction was found. Subjects with cavus feet had a decreased center-of-pressure velocity while wearing orthotics. For dynamic postural control, a significant condition-by-direction-by-group interaction was found. Subjects with cavus feet had increased reach distances in 3 of 8 directions while wearing orthotics.Conclusions:Custom orthotics were associated with some improvements in static and dynamic postural control in subjects with cavus feet.

Author(s):  
Elżbieta Piątek ◽  
Michał Kuczyński ◽  
Bożena Ostrowska

Due to balance deficits that accompany adolescent idiopathic scoliosis (AIS), the potential interaction between activities of daily living and active self-correction movements (ASC) on postural control deserves particular attention. Our purpose was to assess the effects of ASC movements with or without a secondary mental task on postural control in twenty-five girls with AIS. It is a quasi-experimental within-subject design with repeated measures ANOVA. They were measured in four 20-s quiet standing trials on a force plate: no task, ASC, Stroop test, and both. Based on the center-of-pressure (COP) recordings, the COP parameters were computed. The ASC alone had no effect on any of the postural sway measures. Stroop test alone decreased COP speed and increased COP entropy. Performing the ASC movements and Stroop test together increased the COP speed and decreased COP entropy as compared to the baseline data. In conclusion, our results indicate that AIS did not interfere with postural control. The effects of the Stroop test accounted for good capacity of subjects with AIS to take advantage of distracting attentional resources from the posture. However, performing both tasks together exhibited some deficits in postural control, which may suggest the need for therapeutic consultation while engaging in more demanding activities.


2012 ◽  
Vol 21 (4) ◽  
pp. 327-333 ◽  
Author(s):  
Scott K. Lynn ◽  
Ricardo A. Padilla ◽  
Kavin K.W. Tsang

Context:Proper functioning of the intrinsic foot musculature (IFM) is essential in maintaining the integrity of the medial longitudinal arch (MLA). Improper functioning of the IFM leads to excessive pronation of the foot, which has been linked to various pathologies. Therefore, training the IFM to avoid excessive pronation may help prevent some of these pathologies; however, it is not clear how to train these muscles optimally.Objective:To investigate the effects of 2 different types of IFM training on the height of the MLA and static- and dynamic-balance task performance.Design:Randomized controlled trial, repeated-measures mixed-model design.Setting:University biomechanics laboratory for testing and a home-based training program.Participants:24 healthy, university-age volunteers (3 groups of 8) with no history of major lower limb pathology or balance impairment.Interventions:One experimental group performed 4 wk of the short-foot exercise (SFE) and the other performed 4 wk of the towel-curl exercise (TCE). Participants were asked to perform 100 repetitions of their exercise per day.Main Outcome Measures:Navicular height during weight bearing, the total range of movement of the center of pressure (COP) in the mediolateral (ML) direction for a static-balance test and a dynamic-balance test.Results:There were no differences in the navicular height or static-balance tests. For the dynamic-balance test, all groups decreased the ML COP movement on the dominant limb by a small amount (~5 mm); however, the SFE group was able to decrease COP movement much more than the TCE group in the nondominant limb.Conclusions:The SFE appeared to train the IFM more effectively than the TCE; however, there were differing results between the dominant and nondominant legs. These imbalances need to be taken into consideration by clinicians.


2014 ◽  
Vol 23 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Matthew C. Hoch ◽  
David R. Mullineaux ◽  
Richard D. Andreatta ◽  
Robert A. English ◽  
Jennifer M. Medina-McKeon ◽  
...  

Context:A single talocrural joint-mobilization treatment has improved spatiotemporal measures of postural control but not ankle arthrokinematics in individuals with chronic ankle instability (CAI). However, the effects of multiple treatment sessions on these aspects of function have not been investigated.Objective:To examine the effect of a 2-wk anterior-to-posterior joint-mobilization intervention on instrumented measures of single-limb-stance static postural control and ankle arthrokinematics in adults with CAI.Design:Repeated measures.Setting:Research laboratory.Participants:12 individuals with CAI (6 male, 6 female; age 27.4 ± 4.3 y, height 175.4 ± 9.78 cm, mass 78.4 ± 11.0 kg).Intervention:Subjects received 6 treatments sessions of talocrural grade II joint traction and grade III anterior-to-posterior joint mobilization over 2 wk.Main Outcome Measures:Instrumented measures of single-limb-stance static postural control (eyes open and closed) and anterior and posterior talar displacement and stiffness were assessed 1 wk before the intervention (baseline), before the first treatment (preintervention), 24–48 h after the final treatment (postintervention), and 1 wk later (1-wk follow-up). Postural control was analyzed as center-of-pressure velocity, center-of-pressure range, the mean of time-to-boundary minima, and standard deviation of time-to-boundary minima in the anteroposterior and mediolateral directions for each visual condition.Results:No significant differences were identified in any measures of postural control (P > .08) or ankle arthrokinematics (P > .21).Conclusions:The 2-wk talocrural joint-mobilization intervention did not alter instrumented measures of single-limb-stance postural control or ankle arthrokinematics. Despite the absence of change in these measures, this study continues to clarify the role of talocrural joint mobilization as a rehabilitation strategy for patients with CAI.


2015 ◽  
Vol 24 (3) ◽  
pp. 252-260 ◽  
Author(s):  
Nathan J. Crockett ◽  
Michelle A. Sandrey

Context:Few studies have evaluated the long-term effects of prophylactic ankle-brace use during a sport season.Objective:To determine the effects of prophylactic ankle-brace use during a high school basketball season on dynamic postural control and functional tests.Design:Prospective repeated-measures design.Setting:High school athletic facility.Participants:21 healthy high school basketball athletes (13 girls, 8 boys).Interventions:The order of testing was randomized using the Star Excursion Balance Test (SEBT) for posteromedial (PM), medial (M), and anteromedial (AM) directions and 3 functional tests (FT) consisting of the single-leg crossover hop, single-leg vertical jump, and the single-leg 6-m hop for time at pre-, mid-, and postseason. After pretesting, the ankle brace was worn on both limbs during the entire 16-wk competitive basketball season.Main Outcome Measures:SEBT for PM, M, and AM and 3 single-leg FTs.Results:Dynamic postural control using the SEBT and the 3 FTs improved over time, notably from pretest to posttest. The left limb was different from the right limb during the single-leg vertical jump. Effect sizes were large for pretest to posttest for the 3 SEBT directions and 2 of the 3 FTs.Conclusions:The 16-wk basketball prophylactic ankle-brace intervention significantly improved dynamic postural control and single-limb FTs over time.


2004 ◽  
Vol 13 (3) ◽  
pp. 255-268 ◽  
Author(s):  
Lyn Nakagawa ◽  
Mark Hoffman

Objective:To evaluate postural control in individuals with recurrent ankle sprains with static, dynamic, and clinical balance tests and to examine the relationships between performances in each of these tests.Design:Postural control was evaluated with 3 different balance tests in individuals with and without recurrent ankle sprains.Participants:19 volunteers with recurrent ankle sprains and 19 uninjured control subjects.Interventions:None.Setting:University sports-medicine research laboratory.Main Outcome Measures:Total excursion of the center of pressure (COP) was calculated for the static and dynamic balance tests. Total reach distance was measured for the Star Excursion Balance Test.Results:Subjects with recurrent ankle sprains demonstrated significantly greater excursion of the COP in both the static and dynamic balance tests. Correlations between performances in all tests were very low.Conclusions:Recurrent ankle sprains might be associated with reduced postural control as demonstrated by decreased performance in static and dynamic balance tests.


2015 ◽  
Vol 4 (3) ◽  
pp. 82-89
Author(s):  
Seyed Mojtaba Ojaghi ◽  
Fahimeh Kamali ◽  
Ali Ghanbari ◽  
Samaneh Ebrahimi ◽  
Ahmad Reza Nematollahi

Background: Patellofemoral pain syndrome (PFPS) is the most common overuse syndrome in athletes. The aim of this study was to compare the effects of taping and elastic bandage on postural control in athletes with PFPS. Materials and Methods: Fifteen males and 19 females with PFPS participated in this clinical trial study for more than 1 month and were randomly divided into two groups; group 1 was taped based on McConnell method and in group 2 elastic bandage was used. The static postural control in both groups was measured before and after interventions using the force- plate through measuring the center of pressure (COP) and estimation of differences between center of pressure and center of mass (COP-COM moment arms) in AP and ML directions. Moreover, dynamic postural control was measured by star excursion balance test (SEBT). Paired t-test and covariance analysis were used for analysis of the data. Results: Results indicated that after taping reach distances increased significantly (p< 0.05) in anterior, anterolateral, lateral and posterior directions but after elastic bandage reach distances increased in posterior, posteromedial and medial directions. After both taping and bandage, COP and COP-COM moment arm measures did not show significant differences. Conclusion: The findings of this investigation showed that in athletes with patellofemoral pain, taping and elastic bandage improved dynamic postural control. However, dynamic methods are successfully used to assess the effects of taping and bandage on postural control. Static variables compared with dynamic measures potentially lack the ability to detect subtle differences of postural control in athletes with PFPS. [GMJ. 2015;4(3):82-89]


2018 ◽  
Vol 27 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Johanna M. Hoch ◽  
Cori W. Sinnott ◽  
Kendall P. Robinson ◽  
William O. Perkins ◽  
Jonathan W. Hartman

Context: There is a lack of literature to support the diagnostic accuracy and cut-off scores of commonly used patient-reported outcome measures (PROMs) and clinician-oriented outcomes such as postural-control assessments (PCAs) when treating post-ACL reconstruction (ACLR) patients. These scores could help tailor treatments, enhance patient-centered care and may identify individuals in need of additional rehabilitation. Objective: To determine if differences in 4-PROMs and 3-PCAs exist between post-ACLR and healthy participants, and to determine the diagnostic accuracy and cut-off scores of these outcomes. Design: Case control. Setting: Laboratory. Participants: A total of 20 post-ACLR and 40 healthy control participants. Main Outcome Measures: The participants completed 4-PROMs (the Disablement in the Physically Active Scale [DPA], The Fear-Avoidance Belief Questionnaire [FABQ], the Knee Osteoarthritis Outcomes Score [KOOS] subscales, and the Tampa Scale of Kinesiophobia [TSK-11]) and 3-PCAs (the Balance Error Scoring System [BESS], the modified Star Excursion Balance Test [SEBT], and static balance on an instrumented force plate). Mann-Whitney U tests examined differences between groups. Receiver operating characteristic (ROC) curves were employed to determine sensitivity and specificity. The Area Under the Curve (AUC) was calculated to determine the diagnostic accuracy of each instrument. The Youdin Index was used to determine cut-off scores. Alpha was set a priori at P < 0.05. Results: There were significant differences between groups for all PROMs (P < 0.05). There were no differences in PCAs between groups. The cut-off scores should be interpreted with caution for some instruments, as the scores may not be clinically applicable. Conclusions: Post-ACLR participants have decreased self-reported function and health-related quality of life. The PROMs are capable of discriminating between groups. Clinicians should consider using the cut-off scores in clinical practice. Further use of the instruments to examine detriments after completion of standard rehabilitation may be warranted.


2010 ◽  
Vol 19 (1) ◽  
pp. 71-85 ◽  
Author(s):  
Lacey Nordsiden ◽  
Bonnie L. Van Lunen ◽  
Martha L. Walker ◽  
Nelson Cortes ◽  
Maria Pasquale ◽  
...  

Context:Many styles of foot pads are commonly applied to reduce immediate pain and pressure under the foot.Objective:To examine the effect of 3 different foot pads on peak plantar pressure (PPP) and mean plantar pressure (MPP) under the first metatarsophalangeal joint (MTPJ) during slow running.Design:A 4 (pad) × 4 (mask) repeated-measures design.Setting:University athletic training clinic and fitness facility.Participants:20 physically active participants, 12 men (19.7 ± 1.3 y, 181.5 ± 6.3 cm, 83.6 ± 12.3 kg) and 8 women (20.8 ± 1.5 y, 172.7 ± 11.2 cm, 69.9 ± 14.2 kg) with navicular drop greater than or equal to 10 mm, no history of surgery to the lower extremity, and no history of pain or injury to the first MTPJ in the past 6 months.Interventions:PPP and MPP were evaluated under 4 areas of the foot: the rear foot, lateral forefoot, medial forefoot, and first MTPJ. Four pad conditions (no pad, metatarsal dome, U-shaped pad, and donut-shaped pad) were evaluated during slow running. All measurements were taken on a standardized treadmill using the Pedar in-shoe pressure-measurement system.Main Outcome Measures:PPP and MPP in 4 designated foot masks during slow running.Results:The metatarsal dome produced significant decreases in MPP (163.07 ± 49.46) and PPP (228.73 ± 63.41) when compared with no pad (P < .001). The U-shaped pad significantly decreased MPP (168.68 ± 50.26) when compared with no pad (P < .001). The donut-shaped pad increased PPP compared with no pad (P < .001).Conclusions:The metatarsal dome was most effective in reducing both peak and mean plantar pressure. Other factors such as pad comfort, type of activity, and material availability must also be considered. Further research should be conducted on the applicability to other foot types and symptomatic subjects.


2021 ◽  
pp. 1-9
Author(s):  
Evan V. Papa ◽  
Rita M. Patterson ◽  
Nicoleta Bugnariu

BACKGROUND: Nearly half of persons with Parkinson disease (PD) report fatigue as a factor in their fall history. However, it is unknown whether these self-reported falls are caused by a sensation of fatigue or performance fatigue. OBJECTIVE: We sought to investigate the influences of performance fatigue and age on postural control in persons with PD. METHODS: Individuals with PD (n = 14) underwent postural control assessments before (T0) and immediately after (T1) fatiguing exercise. Biomechanical data were gathered on participants completing a treadmill-induced, posterior-directed fall. Performance fatigue was produced using lower extremity resistance exercise on an isokinetic ergometer. Repeated measures ANCOVAs were used with age as a covariate to determine the effects of performance fatigue on biomechanical variables. RESULTS: After adjustment for age, there was a statistically significant difference in peak center of pressure (COP) latency during the support phase of recovery. Pairwise comparisons demonstrated a decrease in peak ankle displacement from T0 to T1. Age was also found to be significantly related to reaction time and peak knee displacement while participants were fatigued. CONCLUSIONS: The decreased peak COP latency, along with decreased ankle angular displacement, suggest that persons with PD adopt a stiffening strategy in response to backward directed falls. Postural stiffening is not uncommon in persons with PD and could be a risk factor for falls. Older individuals with PD demonstrate slower mobility scores and decreased reaction times in the setting of fatigue, suggesting a combined effect of the aging and fatigue processes.


2012 ◽  
Vol 47 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Hayley Ericksen ◽  
Phillip A. Gribble

Context: Hormonal fluctuation as a risk factor in anterior cruciate ligament injury has been investigated with conflicting results. However, the influence of hormone fluctuations on ankle laxity and function has not been thoroughly examined. Objective: To examine the potential hormone contributions to ankle laxity and dynamic postural control during the preovulatory and postovulatory phases of the menstrual cycle using an ankle arthrometer and the Star Excursion Balance Test in healthy women. The cohort group consisted of male control participants. Design: Cohort study. Setting: Research laboratory. Patients or Other Participants: Twenty healthy women (age = 23.8 ± 6.50 years, height = 163.88 ± 8.28 cm, mass = 63.08 ± 12.38 kg) and 20 healthy men (age = 23.90 ± 4.15 years, height = 177.07 ± 7.60 cm, mass = 80.57 ± 12.20 kg). Intervention(s): Ankle stability was assessed with anterior-posterior and inversion-eversion loading. Dynamic postural control was assessed with the posteromedial reaching distance of the Star Excursion Balance Test. Main Outcome Measure(s): Female participants used ovulation kits for 3 months to determine the time of ovulation; during their preovulatory and postovulatory phases, they were tested in the laboratory with an ankle arthrometer and the Star Excursion Balance Test. Male participants were tested on similar dates as controls. For each dependent variable, a time by side by sex repeated-measures analysis of variance was performed. Statistical significance was set a priori at P &lt; .05. Results: For anterior-posterior laxity, a side main effect was noted (F1,38 = 10.93, P = .002). For inversion-eversion laxity, a sex main effect was seen (F1,38 = 10.75, P = .002). For the posteromedial reaching task, a sex main effect was demonstrated (F1,38 = 8.72, P = .005). No influences of time on the dependent variables were evident. Conclusions: Although women presented with more ankle inversion-eversion laxity and less dynamic postural control, hormonal fluctuations during the menstrual cycle (preovulatory compared with postovulatory) did not affect ankle laxity or dynamic postural control, 2 factors that are associated with ankle instability.


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