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Chen HY, Chang CK, Wang FT, Yen CH, Chuang HC, Wang TY, Chiu FY, Peng HT. Effects of Customized Full-Contact Insoles Crafted with Polyester Fabric Sheets on Plantar Pressure and Gait in Hallux Valgus. Bioengineering (Basel) 2025; 12:103. [PMID: 40001623 PMCID: PMC11851489 DOI: 10.3390/bioengineering12020103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 01/02/2025] [Accepted: 01/14/2025] [Indexed: 02/27/2025] Open
Abstract
This study investigates the benefits of innovative full-contact insoles, crafted using polyester fabric sheets of thermoplastic extruded materials, for individuals with hallux valgus-induced plantar pain. Thirty-five individuals with hallux valgus-induced foot pain were randomly allocated to either the experimental group, wearing innovative full-contact insoles 6 h daily, or the control group, using regular foot insoles, over a period of 12 weeks. Data collection occurred at baseline, and at 1 week, 2 months, and 3 months after the initial fitting. Results indicated that the innovative full-contact insoles significantly reduced anteroposterior displacement by an average of 0.9 cm (p = 0.025) and displacement area by 0.79 cm2 (p = 0.012). Gait improvements included an increase in the swing phase (36.46%, p = 0.008) and a reduction in stance phase duration (63.54%, p = 0.019). Pressure peaks at critical foot regions like the second metatarsal and medial heel were reduced by up to 39.45 kPa (p = 0.016) and 104.07 kPa (p = 0.031), while contact areas in the midfoot increased by 6.17 cm2 (p = 0.039). Foot pain decreased by an average score of 1.28 points on a 10-point scale across various measures (p = 0.041). These findings suggest that the innovative full-contact insoles effectively enhance pressure distribution and gait dynamics in patients with hallux valgus, providing a viable option for managing foot discomfort.
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Affiliation(s)
- Hsin-Yu Chen
- Rehabilitation and Technical Aid Center, Taipei Veterans General Hospital, Taipei 112, Taiwan; (H.-Y.C.); (C.-K.C.); (F.-T.W.); (C.-H.Y.); (H.-C.C.); (T.-Y.W.)
| | - Chin-Kang Chang
- Rehabilitation and Technical Aid Center, Taipei Veterans General Hospital, Taipei 112, Taiwan; (H.-Y.C.); (C.-K.C.); (F.-T.W.); (C.-H.Y.); (H.-C.C.); (T.-Y.W.)
| | - Fu-Ting Wang
- Rehabilitation and Technical Aid Center, Taipei Veterans General Hospital, Taipei 112, Taiwan; (H.-Y.C.); (C.-K.C.); (F.-T.W.); (C.-H.Y.); (H.-C.C.); (T.-Y.W.)
| | - Chia-Hao Yen
- Rehabilitation and Technical Aid Center, Taipei Veterans General Hospital, Taipei 112, Taiwan; (H.-Y.C.); (C.-K.C.); (F.-T.W.); (C.-H.Y.); (H.-C.C.); (T.-Y.W.)
| | - Hsiang-Chun Chuang
- Rehabilitation and Technical Aid Center, Taipei Veterans General Hospital, Taipei 112, Taiwan; (H.-Y.C.); (C.-K.C.); (F.-T.W.); (C.-H.Y.); (H.-C.C.); (T.-Y.W.)
| | - Tsung-Yang Wang
- Rehabilitation and Technical Aid Center, Taipei Veterans General Hospital, Taipei 112, Taiwan; (H.-Y.C.); (C.-K.C.); (F.-T.W.); (C.-H.Y.); (H.-C.C.); (T.-Y.W.)
| | - Fang-Yao Chiu
- Department of Orthopedics, Taipei Veterans General Hospital, Taipei 112, Taiwan;
| | - Hsien-Te Peng
- Department of Physical Education, Chinese Culture University, Taipei 111, Taiwan
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Jor A, Lau NWK, Daryabor A, Koh MWP, Lam WK, Hobara H, Kobayashi T. Effects of foot orthoses on running kinetics and kinematics: A systematic review and meta-analysis. Gait Posture 2024; 109:240-258. [PMID: 38367456 DOI: 10.1016/j.gaitpost.2024.02.003] [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: 07/13/2023] [Revised: 01/14/2024] [Accepted: 02/03/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Foot orthoses (FOs) are often prescribed by clinicians to treat foot and ankle conditions, prevent running injuries, and enhance performance. However, the lack of higher-order synthesis of clinical trials makes it challenging for clinicians to adopt an evidence-based approach to FOs' prescriptions. RESEARCH QUESTION Do FOs with different modifications alter lower extremity running kinematics and kinetics? METHODS A systematic search of seven databases was conducted from inception to February 2023. The analysis was restricted to healthy adults without foot musculoskeletal impairments and studies that compared the FOs effects with the controls. The methodological quality of the 35 studies that met the eligibility criteria was evaluated using the modified Downs and Black checklist. The random effects model estimated the standardized mean difference (SMD) with 95% confidence intervals and effect sizes. Sub-group analyses based on FOs type were performed to assess the potential effects of the intervention. RESULTS Our findings indicated that both custom and off-the-shelf arch-support FOs reduced peak plantar pressure at the medial heel (SMD=-0.35, and SMD=-1.03), lateral heel (SMD=-0.50, and SMD=-0.53), and medial forefoot (SMD=-0.20, and SMD=-0.27), but increased plantar pressure at the mid-foot (SMD=0.30, and SMD=0.56). Compared with the controls, significant increases (SMD=0.36) in perceived comfort were found with custom FOs. A reduction (SMD=-0.58) in initial ankle inversion was found when a raised heel cup was integrated with arch-support FOs. A medial post integrated with arch support exhibited a reduced ankle (SMD=-1.66) and tibial (SMD=-0.63) range of motion. Custom FOs, however, unfavorably affected the running economy (SMD=-0.25) and perceived exertion (SMD=0.20). SIGNIFICANCE Although FOs have been reported to have some positive biomechanical effects in healthy populations without musculoskeletal impairments or running-related issues, they need to be optimized and generalized to achieve better running performance and prevent injury.
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Affiliation(s)
- Abu Jor
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China; Department of Leather Engineering, Faculty of Mechanical Engineering, Khulna University of Engineering & Technology, Khulna, Bangladesh
| | - Noelle W K Lau
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Aliyeh Daryabor
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mark W P Koh
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong, China
| | - Hiroaki Hobara
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
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Dierickx EE, Butler CR, Huggins RA, Zuk EF, Mason LC, Distefano LJ, Casa DJ. Carbon Fiber Insoles Enhance Perception of Performance Despite Variable Objective Outcomes: Specific to the Moderately Active Individual. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2023; 16:885-897. [PMID: 37637238 PMCID: PMC10449319 DOI: 10.70252/egdu7320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/15/2025]
Abstract
Carbon fiber insoles (CFIs) may benefit performance in elite athletes, however, their use in moderately active individuals has been adopted without evidence supporting such enhancements in this population. Fifteen male subjects performed vertical jump (VJ) and repeat treadmill sprint tests before and after a VO2peak while wearing 1) CFIs and 2) control insoles (CON). Subjects completed a subjective survey regarding their perceived performance abilities for both conditions. There were no significant differences between CFIs and CON in VJ height, sprint distance, heart rate following sprints; and rate of oxygen consumption, perceived fatigue, and perceived exertion at 85% of maximal speed (p > 0.05) during the VO2peak. At maximal speed, although there was no difference between conditions in peak rate of oxygen consumption (95%CI [-4.85, 0.21]) and respiratory exchange ratio (95%CI [-0.01, 0.03]), CFIs resulted in a reduced level of perceived fatigue (95%CI [-1, 0]) and perceived exertion (95%CI [-2, 0]) compared to CON. Subjects subjectively reported increased feelings of "propulsion or explosiveness" (p = 0.026) and being able to "perform better while jumping" (p = 0.029) while wearing CFIs. Heightened perceptions of performance enhancements when wearing CFIs indicate, in the moderately active, perceptual benefits could be more influential for determining CFI use.
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Affiliation(s)
- Erin E Dierickx
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Cody R Butler
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Robert A Huggins
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Emma F Zuk
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Lea C Mason
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | | | - Douglas J Casa
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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Fortune AE, Sims JMG, Ampat G. Does orthotics use improve comfort, speed, and injury rate during running? A randomised control trial. World J Orthop 2023; 14:348-361. [PMID: 37304196 PMCID: PMC10251264 DOI: 10.5312/wjo.v14.i5.348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/02/2023] [Accepted: 04/06/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Running is a hugely popular sport. Unfortunately, running-related injury (RRI) rates are high, particularly amongst amateur and recreational runners. Finding ways to reduce RRI rates and maximise comfort and performance for runners is important. Evidence regarding whether orthotics can successfully improve these parameters is limited and contradicting. Further research is required to provide runners with clearer guidance on the usefulness of orthotics.
AIM To investigate the effect of Aetrex Orthotics on comfort, speed and RRI rates during recreational running.
METHODS One hundred and six recreational runners were recruited on a voluntary basis via running clubs and social media pages and randomised into either the intervention or control group. Participants in the intervention group ran with Aetrex L700 Speed Orthotics inserted in their usual running shoes, whilst participants in the control group ran in their usual running shoes with no orthotics. The study ran for an 8-wk period. Participants provided data relating to running comfort, distance, and time during weeks 3-6. Participants provided data relating to any RRIs they sustained during all 8 wks. Running distance and time were used to calculate running speed in miles per hour (mph). For each outcome variable, 95% confidence intervals and P values were calculated to assess the statistical significance between the groups. For comfort and speed data, univariate multi-level analysis was performed, and for outcome variables with significant between group differences, multi-level multivariate analysis was performed to evaluate any confounding effects of gender and age.
RESULTS Ninety-four participants were included in the final analysis (drop-out rate = 11%). Comfort and speed from 940 runs and 978 injury data reports were analysed. Participants who ran with orthotics reported, on average, speeds 0.30 mph faster (P = 0.20) and comfort scores 1.27 points higher (P ≤ 0.001) than participants who ran with no orthotics. They were also 2.22 times less likely to sustain an injury (P = 0.08) than participants who ran with no orthotics. However, findings were only significant for comfort and not for speed or injury rates. Age and gender were found to be significant predictors of comfort. However, the improvements in comfort reported by participants who ran with orthotics were still significant after adjusting for age and gender.
CONCLUSION This study found orthotics to improve comfort and speed and prevent RRIs whilst running. However, these findings were only statistically significant for comfort.
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Affiliation(s)
- Alice E Fortune
- School of Medicine, University of Liverpool, Liverpool L69 3GE, United Kingdom
| | | | - George Ampat
- School of Medicine, University of Liverpool, Liverpool L69 3GE, Merseyside, United Kingdom
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No Effect of EVA and TPU Custom Foot Orthoses on Mechanical Asymmetries during Acute Intense Fatigue. Symmetry (Basel) 2023. [DOI: 10.3390/sym15030705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
This study examined the impact of custom foot orthoses made of ethyl-vinyl acetate (EVA) and expanded thermoplastic polyurethane (TPU) materials, both compared to a control condition (CON; shoes only), on mechanical asymmetries during repeated treadmill sprints. Eighteen well-trained male runners executed eight, 5-s sprints (rest: 25 s) on an instrumented motorized treadmill in three footwear conditions (EVA, TPU, and CON). We evaluated the group mean asymmetry scores using the ‘symmetry angle’ (SA) formula, which assigns a score of 0% for perfect symmetry and a score of 100% for perfect asymmetry. There was no condition (all p ≥ 0.053) or time (p ≥ 0.074) main effects, nor were there any significant time × condition interactions on SA scores for any variables (p ≥ 0.640). Mean vertical, horizontal, and total forces presented mean SA values (pooled values for the three conditions) of 2.6 ± 1.9%, 2.9 ± 1.6%, and 2.4 ± 1.8%, respectively. Mean SA scores were ~1–3% for contact time (1.5 ± 0.5%), flight time (3.0 ± 0.3%), step frequency (1.1 ± 0.5%), step length (1.9 ± 0.7%), vertical stiffness (2.1 ± 0.9%), and leg stiffness (2.4 ± 1.1%). Mean SA scores were ~2–6.5% for duration of braking (4.1 ± 1.6%) and propulsive (2.4 ± 1.0%) phases, and peak braking (6.2 ± 2.9%) and propulsive (2.1 ± 1.4%) forces. In well-trained runners facing intense fatigue, wearing custom foot orthoses did not modify the observed low-to-moderate natural stride mechanical asymmetries.
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Van Alsenoy K, Ryu JH, Girard O. Acute intense fatigue does not modify the effect of EVA and TPU custom foot orthoses on running mechanics, running economy and perceived comfort. Eur J Appl Physiol 2022; 122:1179-1187. [PMID: 35201416 PMCID: PMC9012714 DOI: 10.1007/s00421-022-04903-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/29/2022] [Indexed: 12/30/2022]
Abstract
We determined whether fatigue modifies the effect of custom foot orthoses manufactured from ethyl-vinyl acetate (EVA) and expanded thermoplastic polyurethane (TPU) materials, both compared to standardized footwear (CON), on running mechanics, running economy, and perceived comfort. Eighteen well-trained, males ran on an instrumented treadmill for 6 min at the speed corresponding to their first ventilatory threshold (13.8 ± 1.1 km/h) in three footwear conditions (CON, EVA, and TPU). Immediately after completion of a repeated-sprints exercise (8 × 5 s treadmill sprints, rest = 25 s), these run tests were replicated. Running mechanics, running economy and perceived comfort were determined. Two-way repeated measures ANOVA [condition (CON, EVA, and TPU) × fatigue (fresh and fatigued)] were conducted. Flight time shortened (P = 0.026), peak braking (P = 0.016) and push-off (P = 0.032) forces decreased and vertical stiffness increased (P = 0.014) from before to after the repeated-sprint exercise, independent of footwear condition. There was a global fatigue-induced deterioration in running economy (- 1.6 ± 0.4%; P < 0.001). There was no significant condition × fatigue [except mean loading rate (P = 0.046)] for the large majority of biomechanical, cardio-respiratory [except minute ventilation (P = 0.020) and breathing frequency (P = 0.019)] and perceived comfort variables. Acute intense fatigue does not modify the effect of custom foot orthoses with different resilience characteristics on running mechanics, running economy and perceived comfort.
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Affiliation(s)
- Ken Van Alsenoy
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.
- Centre for Health, Activity and Rehabilitation Research (CHEARR), Queen Margaret University, Edinburgh, UK.
| | | | - Olivier Girard
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia.
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