Does Flexible Flatfoot Require Treatment?: Plantar Pressure Effects of Wearing Over-the-Counter Insoles when Walking on a Level Surface and Up and Down Stairs in Adults with Flexible Flatfoot

2019 ◽  
Vol 109 (4) ◽  
pp. 299-304
Author(s):  
JunNa Zhai ◽  
YuSheng Qiu ◽  
Jue Wang

Background: Orthotic insole is a popular physiotherapy for flatfoot. However, the effects and whether flexible flatfoot needs orthotic insole treatment are not clear, and how the plantar pressure changes while walking up and down stairs has not been studied. Therefore, this study observed the plantar pressures of different walking conditions to find the answers. Methods: Fifteen adults with flexible flatfoot and 15 adults with normal foot were examined while walking on a level surface and while walking up and down 10- and 20-cm stairs before treatment. The maximum force and the arch index were acquired with a force plate system. Participants with flexible flatfoot were instructed to wear the orthotic insoles for 3 months, and plantar pressures were measured again after treatment. The repeated measure was performed to analyze the data. Results: The maximum force and the arch index of flatfoot after treatment were significantly decreased under different walking conditions (P < .01). When walking down 10- and 20-cm stairs, the plantar data of normal foot and flatfoot were significantly increased (P < .05). Conclusions: Orthotic insoles could effectively improve the plantar pressure of flatfoot under different walking conditions. In addition, the arches of normal foot and flatfoot were obviously influenced when walking down stairs. It is, therefore, necessary to wear orthotic insoles for flexible flatfoot to prevent further deformation.

2009 ◽  
Vol 99 (4) ◽  
pp. 330-338 ◽  
Author(s):  
Joseph M. Molloy ◽  
Douglas S. Christie ◽  
Deydre S. Teyhen ◽  
Nancy S. Yeykal ◽  
Bradley S. Tragord ◽  
...  

Background: Research addressing the effect of running shoe type on the low- or high-arched foot during gait is limited. We sought 1) to analyze mean plantar pressure and mean contact area differences between low- and high-arched feet across three test conditions, 2) to determine which regions of the foot (rearfoot, midfoot, and forefoot) contributed to potential differences in mean plantar pressure and mean contact area, and 3) to determine the association between the static arch height index and the dynamic modified arch index. Methods: Plantar pressure distributions for 75 participants (40 low arched and 35 high arched) were analyzed across three conditions (nonshod, motion control running shoes, and cushioning running shoes) during treadmill walking. Results: In the motion control and cushioning shoe conditions, mean plantar contact area increased in the midfoot (28% for low arched and 68% for high arched), whereas mean plantar pressure decreased by approximately 30% relative to the nonshod condition. There was moderate to good negative correlation between the arch height index and the modified arch index. Conclusions: Cushioning and motion control running shoes tend to increase midfoot mean plantar contact area while decreasing mean plantar pressure across the low- or high-arched foot. (J Am Podiatr Med Assoc 99(4): 330–338, 2009)


2020 ◽  
Author(s):  
JunNa Zhai ◽  
YuSheng Qiu ◽  
Lina Shao

Abstract Background: It is still controversial that if juveniles with flexible flatfeet need to be treated. Some believed they did not need the treatment unless they felt pain after exercise. However, as living standards rise, the amount of exercise among teenagers is declining. The juveniles with flexible flatfeet don’t feel pain not because they don’t have symptoms, but because they rarely walk. This study recruited juveniles with flexible flatfoot to find out if there was other determinant of treatment. Methods: We recruited an experimental group with 20 severe flexible flatfeet and a control group with 20 severe flexible flatfeet. The contact area and load rate were measured separately. Then the subjects of experimental group were treated by exercise therapy for 8 weeks, and the plantar pressure data were measured again. The repeated measure was used to analyze the data. Results: The contact area and load rate of mid foot decreased significantly in experimental group after 8-week treatment. All the subjects of experimental group did not feel any uncomfortable during the treatment. While the two kinds of data in control group were not changed much between pre-after measurements. Conclusion: Exercise therapy could effectively improve the severe flexible flatfoot. If the juveniles with flexible flatfoot need the treatment should not depend on the symptoms only, but also on the severity. The juveniles with severe flexible flatfoot should be treated as soon as diagnosed.


2013 ◽  
Vol 38 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Farnaz Alimerzaloo ◽  
Reza V Kashani ◽  
Hassan Saeedi ◽  
Marjan Farzi ◽  
Nader Fallahian

Background: Heel clearance and ankle status (free or locked) are of major determinants affecting peak plantar pressures and contact area in patellar tendon bearing brace and have been separately studied by many researchers. This study investigated the combined effect of ankle status and heel clearance on contact area and peak plantar pressure in different areas of foot (hindfoot, midfoot, and forefoot). Study design: Before–after repeated measurement trial. Methods: Nine healthy male volunteers walked 8 m with normal shoe and four conditions of patellar tendon bearing brace wear. Repeated-measure analysis of variance test was used to compare contact area and plantar pressure changes in three areas of the foot. Results: Application of patellar tendon bearing brace significantly reduced overall plantar pressure and contact area ( p < 0.01). Although both contact area and plantar pressure significantly decreased in hindfoot and midfoot, plantar pressure increased in forefoot area ( p < 0.05). Conclusions: Application of the patellar tendon bearing brace can reduce the overall peak plantar pressure in the foot but increases focal plantar pressure in forefoot. Excessive lifting of the heel seems to minimize the contact area, thus increase focal pressure in forefoot. Overall, plantar pressure seems to be more effectively off-loaded by combining maximum heel clearance and restriction of the ankle joint. Clinical relevance Although effective parameters of patellar tendon bearing brace have been separately addressed in previous studies, no study was found that investigated the combined effect of ankle status and heel clearance. This study investigates the combined effect of these parameters and provides detailed information on clinical application of the patellar tendon bearing brace.


Author(s):  
Muge Kirmizi ◽  
Yesim Salik Sengul ◽  
Salih Angin

BACKGROUND: Flexible flatfoot is associated with altered plantar pressure distribution, but it is not clear how muscle fatigue affects plantar pressure characteristics in flexible flatfoot and normal foot. OBJECTIVE: To investigate the effects of calf muscles fatigue on plantar pressure variables in flexible flatfoot and normal foot. METHODS: Twenty-five people with flexible flatfoot and twenty-five people with normal foot were included. The unilateral heel-rise test was used to induce calf muscles fatigue. Plantar pressure variables were collected during preferred walking immediately before and after fatigue. The two-way mixed-design ANOVA was used to determine the main effect of fatigue and the interaction between foot posture and fatigue. RESULTS: Fatigue causes medialization of the contact area under the forefoot and the maximum force under the heel and forefoot (p< 0.05). When examining the differences in the effects of fatigue between groups, the contact area under the medial heel increased with fatigue in flexible flatfoot but decreased in normal foot; moreover, the contact area and maximum force under the midfoot and the maximum force under the third metatarsal decreased with fatigue in flexible flatfoot but increased in normal foot (p< 0.05). CONCLUSIONS: Calf muscles fatigue causes medialization of the maximum force and contact area. Especially the midfoot was affected differently by fatigue in flexible flatfoot and normal foot.


2012 ◽  
Vol 37 (3) ◽  
pp. 227-232 ◽  
Author(s):  
Gholamreza Aminian ◽  
Zahra Safaeepour ◽  
Mahboobeh Farhoodi ◽  
Abbas Farjad Pezeshk ◽  
Hassan Saeedi ◽  
...  

Background:Previous studies have suggested that orthoses with different constructions could alter gait parameters in flexible flatfoot. However, there is less evidence about the effect of insoles with proprioceptive mechanism on plantar pressure distribution in flatfoot.Objectives:To assess the effect of orthoses with different mechanisms on plantar pressure distribution in subjects with flexible flatfoot.Study Design:Quasi-experimental.Methods:In total, 12 flatfoot subjects were recruited for this study. In-shoe plantar pressure in walking was measured by Pedar-X system under three conditions including wearing the shoe only, wearing the shoe with a proprioceptive insole, and wearing the shoe with a prefabricated foot insole.Results:Using the proprioceptive insoles, maximum force was significantly reduced in medial midfoot, and plantar pressure was significantly increased in the second and third rays (0.94 ± 0.77 N/kg, 102.04 ± 28.23 kPa) compared to the shoe only condition (1.12 ± 0.88 N/kg and 109.79 ± 29.75 kPa). For the prefabricated insole, maximum force was significantly higher in midfoot area compared to the other conditions ( p < 0.05).Conclusions:Construction of orthoses could have an effect on plantar pressure distribution in flatfeet. It might be considered that insoles with sensory stimulation alters sensory feedback of plantar surface of foot and may lead to change in plantar pressure in the flexible flatfoot.Clinical relevanceBased on the findings of this study, using orthoses with different mechanisms such as proprioceptive intervention might be a useful method in orthotic treatment. Assessing plantar pressure can also be an efficient quantitative outcome measure for clinicians in evidence-based foot orthosis prescription.


2018 ◽  
Vol 108 (1) ◽  
pp. 33-44 ◽  
Author(s):  
Tong-Hsien Chow ◽  
Yih-Shyuan Chen ◽  
Jia-Chang Wang

Background: Plantar pressure measurement is effective for assessing plantar loading and can be applied to evaluating foot performance. We sought to explore the characteristics of plantar pressures in elite sprinters and recreational runners during static standing and walking. Methods: Arch index (AI) values, regional plantar pressure distributions (PPDs), and footprint characteristics were examined in 80 elite sprinters and 90 recreational runners using an optical plantar pressure measurement system. Elite sprinters' pain profiles were examined to evaluate their most common pain areas. Results: In recreational runners, AI values in males were in the normal range and in females were high arch type. The AI values were significantly lower in elite sprinters than in recreational runners. In elite sprinters, particularly males, the static PPD of both feet was higher at the medial metatarsal bone and the lateral heel and lower at the medial and lateral longitudinal arches. Elite male sprinters' PPD of both feet was mainly transferred to the medial metatarsal bone and decreased at the lateral longitudinal arch and the medial heel during the midstance phase of walking. The lateral knee joint and biceps femoris were the most common sites of musculoskeletal pain in elite sprinters. Conclusions: Elite sprinters' AI values could be classified as high arches, and their PPD tended to parallel the features of runners and high-arched runners. These findings correspond to the profile of patellofemoral pain syndrome (PFPS)–related plantar pressure. The pain profiles seemed to resonate with the symptoms of high-arched runners and PFPS. A possible link between high-arched runners and PFPS warrants further study.


2020 ◽  
Vol 22 (3) ◽  
Author(s):  
Muge Kirmizi ◽  
Yesim S. Sengul ◽  
Salih Angin

Purpose: It is not known how gait speed affects plantar pressure characteristics in flatfoot. The aim of this work was to investigate the effects of gait speed on plantar pressure variables in flatfoot by comparing it to normal foot posture. Methods: Thirty individuals with flatfoot and 30 individuals with normal foot posture were recruited. Plantar pressure variables were obtained by a pressure-sensitive mat at self-selected slow, normal, and fast speeds. All assessments were performed on the dominant foot, and three satisfactory steps were obtained for each gait speed condition. The order of gait speeds was randomized. Results: In the flatfoot group, the contact area was higher in the midfoot, third metatarsal, and hallux at all speeds, also in the second metatarsal at slow and normal speeds than the normal foot posture group (p < 0.05). The maximum force was higher in the midfoot and hallux at all speeds in the flatfoot group (p < 0.05). Also, the maximum force was lower in the first metatarsal at normal and fast speeds, and in the lateral heel at fast speed (p < 0.05). In the flatfoot group, the peak pressure was found to be higher in the hallux at slow speed, but to be lower in the first metatarsal at fast speed (p < 0.05). Further, plantar pressure distribution was affected by gait speed in both feet. Conclusions: Analysis of plantar pressure variables should be performed at different gait speeds.


2018 ◽  
Vol 16 (12) ◽  
pp. 975-983
Author(s):  
Sunee BOVONSUNTHONCHAI ◽  
Pichaya HENGSOMBOON ◽  
Sitapa TANGLUANG ◽  
Pran ANUSRI ◽  
Pavitta CHOTIKUL ◽  
...  

Postural balance is influenced by alteration of somatosensory inputs. Sound and vibratory senses, one of several human senses may assist the postural control in a specific impaired situation. The aim of this pilot study was to quantify the effect of sound and vibration on postural balance in healthy young adults. Ten healthy young subjects volunteered to participate in the study. The average age, weight, height, and body mass index were 21.88 ± 0.42 years, 56.21 ± 9.80 kg, 159.75 ± 5.20 cm, and 21.99 ± 3.52 kg/m2. They were assessed for standing postural balance on a force plate over 6 conditions of sound and vibration applications under vision was excluded by using a blindfold. Postural balance variables consisted of planar deviation of Center of Pressure (CoP) and the maximum ranges of CoP in the medio-lateral (ML) and antero-posterior (AP) directions. Two-way ANOVA was used to find the effect and interaction effect of sound and vibration on the postural balance variables. Further analyses of the variables were performed on a basis of each factor. Between sound conditions (no sound and open sound), the variables were analyzed by the paired t-test. In addition, the effect of vibration (no vibration, vibration on quadriceps, and vibration on gastrocnemius) on the variables were analyzed by the one-way repeated measure ANOVA. Results demonstrated no interaction effect and main effect of sound and vibration on the postural balance variables (p > 0.05). In addtion, no significant difference of the postural balance variables between sound conditions (p > 0.05) as well as among vibration conditions (p > 0.05). In conclusion, sound and vibration did not effect to the postural balance during standing in healty young adults.


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