Efficacy of Customized Foot Orthoses in Children Aged 6 - 7 Years Old with Symptomatic Flexible Flat Foot (SFFF)

Introduction: Pediatric Flat Foot (PFF) is a deviation consisting of loss of the Medial Longitudinal Arch in children. Purpose: Aim of this study is to collect information on the recent literature and to investigate through clinical assessment and parental observations the effectiveness of the use of foot orthotics by children with SFFF. Method: 20 children aged 6 - 7 years old with mobility difficulties were evaluated before and after a six-month treatment with orthotics regarding pain, post-game pain, fatigue during game, balance impairment, gait deviations, falls, clumsiness, activity avoidance and worn soles. Results: Study results indicate that foot orthotics (FOs) appears to have a positive impact on the advance of pain, post game pain, gait deviations and worn insoles. It is implied that orthoses have a great potential as a treatment for SFFF. Thorough comprehension of the literature evidence, as well as composition of supplementary studies of larger pediatric populations is essential in order to reach a consensus on the use of foot orthotics (FOs) by children SFFF.

Effectiveness of Different Orthoses on Joint Moments in Patients with Early Knee Osteoarthritis:Lateral Wedge Versus Valgus Knee Bracing

The purpose of the study was to test the biomechanical differences between a lateral wedge and a valgus knee bracing on the knee joint moment during walking in patients with early stage of medial compartment knee osteoarthritis(OA).We conducted a crossover randomized design to compare gait parameters of 32 patients(with early stage medial compartment knee OA) in three different conditions during walking:with a custom-made lateral wedge of 5(in standard shoes),with a valgus knee bracing(in standard shoes),and with control condition(in standard shoes).Both two-orthose conditions showed decreased loading patterns(knee adduction moment and knee adduction angular impulse) on the knee joint in dynamic condition(statistic probability P < 0.05).The decreased loading on OA knee in wedge condition was associated with a laterally shifted location of centre of pressure and increased ankle valgus degree and moment at the same foot(P < 0.05).It was not found significant differences in loading of the knee between these two-orthose conditions.These results indicated that,under dynamic condition,patients wearing lateral wedge and valgus knee bracing showed changes of moments on knee joints.Lateral wedge was as effective as valgus knee bracing in the treatment of early stage of knee OA.

Does orthotics use improve comfort,speed,and injury rate during running?A randomised control trial

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.

Use of orthotics with orthotic sandals versus the sole use of orthotics for plantar fasciitis:Randomised controlled trial

BACKGROUND Plantar fasciitis(PF)affects around 10%of the population.Prefabricated orthotics with arch support has been shown to provide symptom relief in PF by decreasing the repetitive stress sustained by the plantar fascia.However,prefabricated orthotics are only effective when shoes are worn,meaning the foot may be left unsupported when it is impractical to wear shoes.Using orthotic sandals in conjunction with prefabricated orthotics may increase PF symptom relief,as they can be worn inside the home,extending the period in which the foot is supported.AIM To compare the combined use of prefabricated orthotics and orthotic sandals vs the sole use of prefabricated orthotics in the treatment of PF.METHODS 98 participants with PF were randomised into two groups.The intervention group received the Aetrex L420 Compete orthotics and the Aetrex L3000 Maui Flips(orthotic sandals),whilst the control group received the Aetrex L420 Compete orthotics only.Foot pain was assessed both by the numerical rating scale(NRS)and the pain sub-scale of the foot health status questionnaire(FHSQ).Foot functionality was measured using the function sub-scale of the FHSQ.Symptom change was measured using the global rating of change scale(GROC).RESULTS Foot pain scores measured both by NRS and FHSQ pain sub-scale showed statistically significant reductions in foot pain in both groups(P<0.05)at six months.Both groups also reported statistically significant improvements(P<0.05)in function as measured by the FHSQ function subscale and improvement of symptoms as measured by the GROC scale.Between-group analysis showed that the intervention group with the combined use of orthotics and orthotic sandals scored better on all four outcome measures as compared to the control group with the sole use of orthotics.However,the between-group analysis only reached statistical significance on the NRS pain score(P<0.05).CONCLUSION Combined use of prefabricated orthotics and orthotic sandals provides a greater decrease in foot pain and improvement in foot function in PF compared to using prefabricated orthotics alone.

A Review of the Application of Additive Manufacturing in Prosthetic and Orthotic Clinics from a Biomechanical Perspective

Prostheses and orthoses are common assistive devices to meet the biomechanical needs of people with physical disabilities.The traditional fabrication approach for prostheses or orthoses is a materialwasting,time-consuming,and labor-intensive process.Additive manufacturing(AM)technology has advantages that can solve these problems.Many trials have been conducted in fabricating prostheses and orthoses.However,there is still a gap between the hype and the expected realities of AM in prosthetic and orthotic clinics.One of the key challenges is the lack of a systematic framework of integrated technologies with the AM procedure;another challenge is the need to design a prosthetic or orthotic product that can meet the requirements of both comfort and function.This study reviews the current state of application of AM technologies in prosthesis and orthosis fabrication,and discusses optimal design using computational methods and biomechanical evaluations of product performance.A systematic framework of the AM procedure is proposed,which covers the scanning of affected body parts through to the final designed adaptable product.A cycle of optimal design and biomechanical evaluation of products using finite-element analysis is included in the framework.A mature framework of the AM procedure and sufficient evidence that the resulting products show satisfactory biomechanical performance will promote the application of AM in prosthetic and orthotic clinics.

Does orthotics use improve comfort,speed and injury rate during running?Preliminary analysis of a randomised control trial

BACKGROUND Evidence regarding the effectiveness of using orthotics in improving comfort,increasing running speed and helping to reduce injury rate during running is limited and mixed.Alongside the increasing popularity of running is the increasing rate of running-related injuries(RRIs).Further research into whether orthotics could be used to help reduce RRIs would be highly beneficial for those affected.Additionally,there is a need to clarify whether orthotics use increases comfort during running and helps improve running speed.AIM To investigate whether running with Aetrex Orthotics improves comfort and performance and reduces injury whilst running.METHODS Runners were recruited on a voluntary basis if they were 18 or older with no serious health conditions,ongoing foot pain or deformity,previous foot surgery in their lifetime or any surgery in the past 6 mo.Participants were randomly assigned to either an intervention group or a control group.All participants were asked to complete runs and provide quantitative data regarding comfort during running,running time and distance,and any RRIs over an 8-wk study period.Participants in the intervention group ran with Aetrex L700 Speed Orthotics,whilst participants in the control group ran without orthotics.Other than the addition of orthotics for participants in the intervention group,all participants were asked to run as they usually would.This report presents preliminary data from the first 47 participants recruited for this study.Running speed was calculated from running distance and time and given in miles per hour.For each outcome variable,the mean for each group,effect size and 95%confidence interval were calculated,and a t-test was performed to determine if between-group differences were statistically significant.RESULTS Data for all three primary outcomes was provided from a total of 254 runs by the 23 participants in the intervention group and a total of 289 runs by the 24 participants in the control group.Participants in the intervention group reported higher comfort scores(8.00±1.41 vs 6.96±2.03,P≤0.0001),faster running speeds(6.27±1.03 vs 6.00±1.54,P=0.013),and lower RRI rates(0.70±1.01 vs 1.21±1.53,P=0.18)than those in the control group.These findings were statistically significant for comfort and running speed but not for RRI rate,with statistical significance considered if P<0.05.No adjustments were made for group differences in age,gender,tendency for RRIs or usual running speed.CONCLUSION This preliminary report provides evidence for orthotics use in increasing comfort levels and running speed,but no significant difference in RRI rate.

The Role of Orthotic Service in Modern Rehabilitation of Patients with Charcot-Marie-Tooth Disease

Charcot-Marie-Tooth (CMT) disease, which encompasses several hereditary motor and sensory neuropathies, is one of the most common neuro-muscular disorders. 80% of patients having CMT disease are diagnosed with per cavus deformity. Orthosis is widespread and varies widely in forms. The paper arises the necessity of habilitation at the earliest possible stage as only a few patients use it. The meta-analysis of 412 scientific papers concerning this problem demonstrates the getting better gate, balance and the stopping CMT progression which is scientifically proven. It is also shown that patients with CMT use low prevalence of orthotics, and demonstrate low compliance of patients (for various reasons), high expectations from this habilitation technique.