Influence of foot posture on immediate biomechanical responses during walking to variable-stiffness supported lateral wedge insole designs |
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Institution: | 1. Graduate Programs in Rehabilitation Sciences, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada;2. Motion Analysis and Biofeedback Laboratory, University of British Columbia, 212 – 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada;3. Kintec Footlabs, 13645 King George Blvd., Surrey, BC V3T 2TB, Canada;4. Biomedical Physiological and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada;5. Department of Physical Therapy, University of British Columbia, 212 – 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3;1. Graduate Programs in Rehabilitation Sciences, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada;2. Motion Analysis and Biofeedback Laboratory, University of British Columbia, 212 – 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada;3. Kintec Footlabs, 13645 King George Blvd., Surrey, BC V3T 2TB, Canada;4. Biomedical Physiological and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada;5. Department of Physical Therapy, University of British Columbia, 212 – 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3;1. Digital Sports Group, Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Martensstrasse 3, 91058 Erlangen, Germany;2. Department of Trauma Surgery, University Hospital Erlangen, Krankenhausstraße 12, 91054 Erlangen, Germany;3. Institute of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058 Erlangen, Germany;1. School of Occupational Therapy, National Taiwan University, Taipei City, Taiwan, ROC;2. Department of Physical Medicine and Rehabilitation, Taoyuan Armed Forces General Hospital, Taoyuan County, Taiwan, ROC;3. Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, Taiwan, ROC;4. Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei City, Taiwan, ROC;5. Institute of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan, ROC;6. Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei City, Taiwan, ROC;7. School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC;1. Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Department of Musculoskeletal Medicine, Swiss BioMotion Lab, Lausanne, Switzerland;2. Ecole Polytechnique Fédérale de Lausanne (EPFL), Institute of Microengineering, Lausanne, Switzerland;1. Nova Southeastern University, Davie, FL, United States;2. Carré Technologies, Montreal, Canada;1. Department of Industrial Engineering, Faculty of Engineering, Khon Kaen University, Khon Kaen, Thailand;2. Program of Production Technology, Faculty of Technology, Khon Kaen University, Khon Kaen, Thailand;3. Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen, Thailand;4. Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, NC, USA;5. School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand;6. Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA;1. Physical Therapy Dept., University of Pernambuco, PE, Brazil;2. Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil;3. Faculdade de Medicina, Universidade de São Paulo, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, SP, Brazil |
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Abstract: | BackgroundNovel designs of lateral wedge insoles with arch support can alter walking biomechanics as a conservative treatment option for knee osteoarthritis. However, variations in foot posture may influence individual responses to insole intervention and these effects are not yet known.Research questionHow does foot posture influence biomechanical responses to novel designs of lateral wedge insoles with arch support?MethodsThis exploratory biomechanical investigation categorized forty healthy volunteers (age 23–34) into pronated (n = 16), neutral (n = 15), and supinated (n = 9) foot posture groups based on the Foot Posture Index. Three-dimensional gait analysis was conducted during walking with six orthotic insole conditions: flat control, lateral wedge, uniform-stiffness arch support, variable-stiffness arch support, and lateral wedge + each arch support. Frontal plane knee and ankle/subtalar joint kinetic and kinematic outcomes were compared among insole conditions and foot posture groups using a repeated measures analysis of variance.ResultsThe lateral wedge alone and lateral wedge + variable-stiffness arch support were the only insole conditions effective at reducing the knee adduction moment. However, the lateral wedge + variable-stiffness arch support had a smaller increase in peak ankle/subtalar eversion moment than the lateral wedge alone. Supinated feet had smaller ankle/subtalar eversion excursion and moment impulse than neutral and pronated feet, across all insole conditions.SignificanceSupinated feet have less mobile ankle/subtalar joints than neutral and pronated feet and, as a result, may be less likely to respond to biomechanical intervention from orthotic insoles. Supported lateral wedge insoles incorporating an arch support design that is variable-stiffness may be better than uniform-stiffness since reductions in the knee adduction moment can be achieved while minimizing increases in the ankle/subtalar eversion moment. |
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Keywords: | Foot posture Lateral wedge Biomechanical response Variable-stiffness Knee Ankle |
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