Effect of 3D printed insoles for people with flatfeet: A systematic review.

This systematic review aimed to evaluate custom-made 3D printed insoles for people with flatfeet. PubMed, Embase, ISI web of knowledge, ProQuest, Scopus, and Cochrane databases, were searched from inception until January 2022. The quality assessment of included studies was performed through the Downs and Black checklist. A narrative analysis was performed since a meta-analysis could not be conducted. Ten studies including 225 subjects with flexible flatfeet were chosen for final evaluation. Although the evidence from selected literature was generally weak, using insoles with 3D printing technology may positively affect pain (comfort score) and foot function, with no significant change in vertical loading rate during walking or running. There were discrepancies among studies for plantar pressures, center of pressure trajectories, 3D ankle joint kinematics and kinetics of gait while wearing these insoles. Dose-response effects of medial posting on 3D printed insoles suggested beneficial effects on lower limb gait biomechanics in people with flatfeet. There was insufficient evidence to conclude the comparison between 3D printed insoles and other types of insoles. In conclusion, using a 3D printed insole may improve comfort score and foot function in people with flatfeet.

Analysis of limb kinetic asymmetry during a drop vertical jump in adolescents post anterior cruciate ligament reconstruction.

BACKGROUND: Limb asymmetry after ACL reconstruction is often cited as a risk factor for ACL reinjury. We assessed ground reaction forces on each limb during a drop vertical jump, and compared kinetic symmetry between limbs in adolescents post-ACL reconstruction versus healthy controls. METHODS: Forty-four participants who underwent an ACL reconstruction (16 male/28 female, mean age 16.1 ± 1.5, mean 7.3 ± 0.9 months post-ACL reconstruction) and 34 controls (20 male/14 female, mean age 14.9 ± 1.1) completed a drop vertical jump captured on a Vicon system and Bertec force plates. Kinetic variables were calculated individually for each limb. Inter-limb asymmetry was calculated as an index between each limb (involved versus uninvolved for the ACL reconstruction group, and left versus right for controls), and was compared between groups using independent t-tests. FINDINGS: Asymmetry was significantly more pronounced in the ACL reconstruction group versus the controls for peak contact ground reaction force (11.6% vs 4.4%, p = 0.009), eccentric impulse (8.8% vs 3.8%, p = 0.009), eccentric mean force (8.0% vs 3.4%, p = 0.006), concentric peak ground reaction force (4.1% vs 0.8%, p = 0.003), concentric impulse (5.1% vs 1.1%, p = 0.001), and peak landing ground reaction force (12.7% vs 1.7%, p < 0.001). INTERPRETATION: Limb kinetic asymmetry during a drop vertical jump was more pronounced in adolescents post-ACL reconstruction versus controls for both eccentric- and concentric-phase variables, which may indicate the use of compensatory strategies to offload the post-operative limb. Targeted interventions to produce more symmetric loading and unloading during jumping tasks should be developed, tested, and monitored to determine the impact on rehabilitation programs, return-to-sport evaluations, and injury prevention outcomes.

Effect of ankle-foot orthoses on functional outcome measurements in individuals with stroke: a systematic review and meta-analysis.

PURPOSE: To determine and compare the effect of ankle-foot orthosis (AFOs) types on functional outcome measurements in individuals with (sub)acute or chronic stroke impairments. METHODS: PubMed, Web of Knowledge, Embase, Scopus, ProQuest, and Cochrane were searched from inception until September 2020. Methodological quality assessment of 30 studies was conducted based on the Downs and Black checklist. Functional indices were pooled according to their standardized mean difference (SMD) and 95% confidence intervals (CI) in a random-effect model. A narrative analysis was performed where data pooling was not feasible. RESULTS: Overall pooled results indicated improvements in favor of AFOs versus without for the Berg Balance Scale (SMD: 0.54, CI: 0.19-0.88), timed-up and go test (SMD: -0.45, CI: -0.67 to -0.24), Functional Ambulatory Categories (SMD: 1.72, CI: 1.25-2.19), 6-Minute Walking Test (SMD: 0.91, CI: 0.53-1.28), Timed Up-Stairs (SMD: -0.35, CI: -0.64 to 0.05), and Motricity Index (SMD: 0.65, CI: 0.38-0.92). Heterogeneity was non-significant for all outcomes (I2 < 50%, p > 0.05) except the Berg Balance Scale and Functional Ambulatory Categories. Additionally, there was not sufficient evidence to determine the effectiveness of specific orthotic designs over others. CONCLUSIONS: An AFO can improve ambulatory function in stroke survivors. Future studies should explore the long-term effects of rehabilitation using AFOs and compare differences in orthotic designs.IMPLICATIONS FOR REHABILITATIONAn AFO can improve functional performance and ambulation in survivors of strokes.Wearing an AFO in rehabilitation care during the subacute phase post stroke may have beneficial effects on functional outcomes measured.There was no evidence as to the effectiveness of specific AFO designs over others.