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Moisan G, Dami A, Ghabdian T, Payen E, Isabelle PL, Farahpour N, McBride S. The relationship between the supination resistance test, lower limb biomechanics and the effects of foot orthoses on foot and ankle biomechanics in individuals with posterior tibialis tendon dysfunction during gait. Gait Posture 2025; 117:300-305. [PMID: 39827773 DOI: 10.1016/j.gaitpost.2025.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 01/09/2025] [Accepted: 01/16/2025] [Indexed: 01/22/2025]
Abstract
BACKGROUND Posterior tibialis tendon dysfunction (PTTD) is a debilitating condition that leads to biomechanical changes, for which foot orthoses are often prescribed to attenuate. There is a need to improve the ability to predict these biomechanical alterations, determine the biomechanical effectiveness of foot orthoses, and anticipate their effects on individuals with PTTD during gait. RESEARCH QUESTION Is the supination resistance test (SRT) reliable, and capable of predicting foot and ankle biomechanics, as well as the biomechanical effects of foot orthoses in individuals with PTTD during gait? METHODS Twenty-one individuals with PTTD participated with supination resistance measured over two sessions. Midfoot and ankle angles, and moments, were analyzed during gait. SRT test-retest reliability was evaluated, and the biomechanical effects of foot orthoses were assessed using statistical parametric mapping. SRT correlations with foot and ankle biomechanics and foot orthoses effects were examined. RESULTS The SRT demonstrated excellent intrarater reliability. Positive correlations were noted between the SRT and midfoot sagittal and frontal angles, while a negative correlation was observed with ankle sagittal and frontal angles. In the foot orthoses condition, midfoot dorsiflexion, external rotation, ankle eversion angles, and inversion moments were reduced. A negative correlation was identified between SRT and foot orthoses effects on the ankle frontal angle. SIGNIFICANCE The SRT is useful for predicting foot and ankle biomechanics, as well as the effects of foot orthoses on ankle frontal angles during gait in individuals with PTTD. These findings emphasize the clinical and research relevance of assessing supination resistance in PTTD management.
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Affiliation(s)
- Gabriel Moisan
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada.
| | - Ahmed Dami
- Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Department of Anatomy, Université du Québec à Trois-Rivières, 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Tahereh Ghabdian
- Department of Sport Biomechanics, Faculty of Sport Sciences, Bu Ali Sina University, Hamedan, Iran
| | - Eléna Payen
- Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Department of Anatomy, Université du Québec à Trois-Rivières, 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Pier-Luc Isabelle
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Nader Farahpour
- Department of Sport Biomechanics, Faculty of Sport Sciences, Bu Ali Sina University, Hamedan, Iran
| | - Sean McBride
- Deparment of Rehabilitation Sciences, Division of Physical Therapy, Medical University of South Carolina, 151-B Rutledge Avenue, MSC 339, Charleston, SC 29425, United States of America
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Palomo-Fernández I, Martín-Casado L, Marcos-Tejedor F, Aldana-Caballero A, Rubio-Arias JÁ, Jiménez-Díaz JF. Lateral wedge insoles and their use in ankle instability. Scand J Med Sci Sports 2023; 33:1716-1725. [PMID: 37265052 DOI: 10.1111/sms.14414] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/09/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
The aim of the present study is to assess the immediate effects of applying lateral wedge insoles of different heights (0.00, 0.3, 0.4, and 0.6 cm) in patients with chronic ankle instability (CAI) in normal and supinated feet during a Star Excursion Balance Test (SEBT) and in the reflex response of Peroneus Longus (PL), Peroneus Brevis (PB), and Tibialis Anterior (TA) over a 30° inversion of the feet. The effects of the height of the wedges were assessed using a double-blind, crossover design. In total, 25 participants were allocated into two groups, depending on the foot posture (Normal = 12, Supinated = 13) and performed the tests in a random fashion. Reaction time (RT) of stabilizing muscles of the ankle was measured using superficial electromyography (EMG) and postural balance with the SEBT. Foot posture did not show any significant effects on the analyzed variables. Nonetheless, the use of a 0.3 cm external rearfoot wedge (PB p = 0.002; PL p = 0.066 and TA p = 0.006) and 0.6 cm (PB p = 0.043; PL p = 0.058 and TA p = 0.071) reduces RT in stabilizing muscles of the ankle and improves results in SEBT, except for the anterolateral direction, in subjects with CAI. Therefore, our results suggest that the use of lateral wedge insoles could reduce RT and improve dynamic balance in chronic ankle instability.
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Affiliation(s)
- Inés Palomo-Fernández
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Laura Martín-Casado
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Félix Marcos-Tejedor
- Department of Medical Sciences, Faculty of Health Sciences University of Castilla-La Mancha, Toledo, Spain
| | - Alberto Aldana-Caballero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Jacobo Á Rubio-Arias
- Department of Education, Health Research Center, University of Almeria, Almería, Spain
| | - J Fernando Jiménez-Díaz
- Laboratory of Physical Performance and Readaptation Injuries, University of Castilla-La Mancha, Toledo, Spain
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Qin B, Wu S, Zhang H. Evaluation and Management of Cavus Foot in Adults: A Narrative Review. J Clin Med 2022; 11:jcm11133679. [PMID: 35806964 PMCID: PMC9267353 DOI: 10.3390/jcm11133679] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: Cavus foot is a deformity defined by the abnormal elevation of the medial arch of the foot and is a common but challenging occurrence for foot and ankle surgeons. In this review, we mainly aim to provide a comprehensive evaluation of the treatment options available for cavus foot correction based on the current research and our experience and to highlight new technologies and future research directions. Methods: Searches on the PubMed and Scopus databases were conducted using the search terms cavus foot, CMT (Charcot–Marie–Tooth), tendon-transfer, osteotomy, and adult. The studies were screened according to the inclusion and exclusion criteria, and the correction of cavus foot was analyzed based on the current research and our own experience. At the same time, 3D models were used to simulate different surgical methods for cavus foot correction. Results: A total of 575 papers were identified and subsequently evaluated based on the title, abstract, and full text. A total of 84 articles were finally included in the review. The deformities involved in cavus foot are complex. Neuromuscular disorders are the main etiologies of cavus foot. Clinical evaluations including biomechanics, etiology, classification, pathophysiology and physical and radiological examinations should be conducted carefully in order to acquire a full understanding of cavus deformities. Soft-tissue release, tendon-transfer, and bony reconstruction are commonly used to correct cavus foot. Surgical plans need to be customized for different patients and usually involve a combination of multiple surgical procedures. A 3D simulation is helpful in that it allows us to gain a more intuitive understanding of various osteotomy methods. Conclusion: The treatment of cavus foot requires us to make personalized operation plans according to different patients based on the comprehensive evaluation of their deformities. A combination of soft-tissue and bony procedures is required. Bony procedures are indispensable for cavus correction. With the promotion of digital orthopedics around the world, we can use computer technology to design and implement cavus foot operations in the future.
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Moisan G, Robb K, Mainville C, Blanchette V. Effects of foot orthoses on the biomechanics of the lower extremities in adults with and without musculoskeletal disorders during functional tasks: A systematic review. Clin Biomech (Bristol, Avon) 2022; 95:105641. [PMID: 35429692 DOI: 10.1016/j.clinbiomech.2022.105641] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Foot orthoses are among the most commonly used external supports to treat musculoskeletal disorders. It remains unclear how they change the biomechanics of the lower extremities during functional tasks. This systematic review aimed to determine the effects of foot orthoses on primary outcomes (i.e., kinematics, kinetics and electromyography of the lower extremities) in adults with and without musculoskeletal disorders during functional tasks. METHODS A literature search was conducted for articles published from inception to June 2021 in Medline, CINAHL, SPORTDiscus, Cochrane libraries and PEDro electronic databases. Two investigators independently assessed the titles and abstracts of retrieved articles based on the inclusion criteria. Of the 5578 citations, 24 studies were included in the qualitative synthesis as they reported the effects of foot orthoses on the primary outcomes. Risk of bias of included studies was determined using the modified Downs and Black Quality Index. FINDINGS During low impact tasks, foot orthoses decrease ankle inversion and increase midfoot plantar forces and pressure. During higher impact tasks, foot orthoses had little effects on electromyography and kinematics of the lower extremities but decreased ankle inversion moments. INTERPRETATION Even though the effects of foot orthoses on the biomechanics of the lower extremities seem task-dependent, foot orthoses mainly affected the biomechanics of the distal segments during most tasks. However, few studies determined their effects on the biomechanics of the foot. It remains unclear to what extent foot orthoses features induce different biomechanical effects and if foot orthoses effects change for different populations.
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Affiliation(s)
- Gabriel Moisan
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada 3351 Boul des Forges, Trois-Rivières, PQ G9A 5H7, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Trois-Rivières, PQ, Canada.
| | - Kelly Robb
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Canada 75 University Ave., West Waterloo, ON N2L 3C5, Canada.
| | - Camille Mainville
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada 3351 Boul des Forges, Trois-Rivières, PQ G9A 5H7, Canada.
| | - Virginie Blanchette
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada 3351 Boul des Forges, Trois-Rivières, PQ G9A 5H7, Canada; Groupe Interdisciplinaire de Recherche Appliquée en Santé (GIRAS), Université du Québec à Trois-Rivières, Trois-Rivières, PQ, Canada.
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Sanchez-Gomez R, Gomez-Carrion A, Martinez-Sebastian C, Alou L, Sevillano D, Nuñez-Fernandez A, Sanz-Wozniak P, de la Cruz-Torres B. Innovative Medial Cushioning Orthoses Affect Peroneus Longus Electromyographic Activity during Running. J Clin Med 2022; 11:1339. [PMID: 35268430 PMCID: PMC8911408 DOI: 10.3390/jcm11051339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/11/2022] [Accepted: 02/25/2022] [Indexed: 12/26/2022] Open
Abstract
Background: Over-supination processes of the foot and ankle involving peroneus longus (PL) damage during running sports have been treated conservatively with passive control tools, such as tapes, braces, or external ankle supports, but the effect of orthoses with typical lateral wedging orthoses (TLWO) on the muscular activity of PL during running remains unclear. Here we investigate the effects of innovative medial cushioning orthoses (IMCO) on PL activity during the full running gait cycle. In addition, we wished to ascertain the effects of innovative medial cushioning orthoses (IMCO) on PL activity during running. Methods: Thirty-one healthy recreational runners (mean age 34.5 ± 3.33) with neutral foot posture index scores, were selected to participate in the present study. They ran on a treadmill at 9 km/h wearing seven different orthoses (NRS, IMCO 3 mm, IMCO 6 mm, IMCO 9 mm, TLWO 3 mm, TLWO 6 mm and TLWO 9 mm), randomly performed on the same day while electromyographic activity of the PL muscle was recorded. Statistical intraclass correlation coefficient (ICC) to test reliability was carried out and the Wilcoxon test with Bonferroni’s correction was developed to analyze the differences between the conditions. Results: the reliability of all assessments showed data higher than 0.81, that is, “almost perfect reliability”; all EMG PL values wearing either TLWO or IMCO showed a statistically significant reduction versus NRS during the fully analyzed running gait cycle; the highest difference was set on NRS 23.08 ± 6.67 to TLWO 9 mm 17.77 ± 4.794 (p < 0.001). Conclusions: Muscular EMG activity of the PL during the full running gait cycle decreases when wearing either TLWO or IMCO relative to NRS; therefore, these orthoses could be prescribed to treat the strain and overload pathologies of PL. In addition, IMCO—as it less thick, compared with TLWO—can be used when aiming to achieve better running economy.
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Affiliation(s)
- Ruben Sanchez-Gomez
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.G.-C.); (C.M.-S.); (A.N.-F.); (P.S.-W.)
| | - Alvaro Gomez-Carrion
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.G.-C.); (C.M.-S.); (A.N.-F.); (P.S.-W.)
| | - Carlos Martinez-Sebastian
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.G.-C.); (C.M.-S.); (A.N.-F.); (P.S.-W.)
| | - Luis Alou
- Microbiology Division, Department of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (L.A.); (D.S.)
| | - David Sevillano
- Microbiology Division, Department of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (L.A.); (D.S.)
| | - Almudena Nuñez-Fernandez
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.G.-C.); (C.M.-S.); (A.N.-F.); (P.S.-W.)
| | - Paola Sanz-Wozniak
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.G.-C.); (C.M.-S.); (A.N.-F.); (P.S.-W.)
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