Abstract | OBJECTIVE: DESIGN: Experimental, paired comparisons. SETTING: Biomechanics laboratory. CADAVERS: Nine cadaveric lower-extremity specimens with no abnormalities. INTERVENTIONS: To evaluate the performance of 2 orthoses specimens were tested in 4 combinations: intact, flatfoot, flatfoot with shoe and orthosis 1, and flatfoot with shoe and orthosis 2. To simulate the midstance phase of gait, loads were applied to 5 tendons and an axial load equivalent to two thirds of the standing load was applied to the foot's plantar surface. MAIN OUTCOME MEASURES: Arch height and tarsal bone positions before and after a flatfoot deformity created by ligament sectioning; tarsal bone positions determined with a magnetic tracking system. RESULTS: After ligament sectioning, the average decrease in arch height with a shoe applied was 4.6+/-1.6mm (8%); with orthosis 1, mean arch height increased 0.7+/-0.6mm (P=.008); with orthosis 2, it increased 0.3+/-0.5mm (P=.05). With both orthoses, arch height after sectioning was significantly less than that of the normal arch. Compared with the flatfoot condition, metatarsal-talar alignment improved in plantar flexion and inversion with both orthoses but did not approximate normal with either orthosis. Calcaneal-tibial position did not improve with either orthosis and was markedly different from that in the intact foot with either orthosis. No difference was found between the 2 orthoses except for metatarsal-talar motion in external rotation (P=.014) and eversion (P=.026). CONCLUSIONS: Arch alignment improved significantly but to a limited degree (<2%) in cadaveric feet with the use of orthoses. Hindfoot valgus malalignment did not consistently improve by the use of shoe inserts.
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Authors | Harold B Kitaoka, Zong-Ping Luo, Hideji Kura, Kai-Nan An |
Journal | Archives of physical medicine and rehabilitation
(Arch Phys Med Rehabil)
Vol. 83
Issue 6
Pg. 876-9
(Jun 2002)
ISSN: 0003-9993 [Print] United States |
PMID | 12048672
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation |
Topics |
- Aged
- Aged, 80 and over
- Biomechanical Phenomena
- Cadaver
- Female
- Flatfoot
(physiopathology, rehabilitation)
- Foot Bones
(physiology)
- Gait
- Humans
- Male
- Middle Aged
- Orthotic Devices
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