An exploration of the effects of prefabricated and customized insoles on lower limb kinetics and kinematics during walking, stepping up and down tasks: A time series analysis.

BACKGROUND: Prefabricated and customized insoles are used in clinical practice to reduce foot pronation. Although data exist on the effects at key points within the stance phase, exploring the impact of different insoles using time series analysis may reveal more detail about their efficacy. RESEARCH QUESTION: What are the effects revealed by a time series analysis of arch-supported prefabricated insoles (PREFABRICATED) versus arch-supported prefabricated insoles customized with a 6º medial wedge (CUSTOMIZED) on the lower limb biomechanics during walking, stepping up and down tasks in individuals with pronated feet? METHODS: Nineteen individuals with excessive foot pronation performed walking, stepping up and down tasks using three insoles: CONTROL (flat insole), CUSTOMIZED, and PREFABRICATED. Angles and moments of ankle and knee coronal and hip transverse planes were compared between conditions using statistical parametric mapping (SPM). RESULTS: For walking, CUSTOMIZED reduced ankle eversion moment compared to CONTROL during midstance and PREFABRICATED during propulsion. CUSTOMIZED decreased KAM during midstance and propulsion compared to PREFABRICATED. Compared to CONTROL, CUSTOMIZED and PREFABRICATED reduced hip internal rotation during propulsion and loading response, respectively. CUSTOMIZED decreased eversion movement during midstance and propulsion for the stepping up task. PREFABRICATED reduced eversion movement during midstance in comparison to CONTROL. For the stepping down task, CUSTOMIZED increased eversion movement during propulsion compared to PREFABRICATED. CUSTOMIZED reduced hip internal rotation angle for stepping up task during propulsion, decreased medial rotation movement during midstance compared to CONTROL, and reduced medial rotation during midstance compared to PREFABRICATED. CUSTOMIZED increased KAM for stepping up and down tasks during propulsion. SIGNIFICANCE: These findings suggest that both CUSTOMIZED and PREFABRICATED reduce foot pronation. However, non-local effects, such as changes in KAM and hip internal rotation, were seen only in the CUSTOMIZED. Therefore, CUSTOMIZED may be preferable if the objective is to modify the knee and hip mechanics.

Is there a dose-response of medial wedge insoles on lower limb biomechanics in people with pronated feet during walking and running?

BACKGROUND: Although the effects of medial wedge insoles on lower limb biomechanics have been investigated, information about the effects of different magnitudes of medial posting is still lacking. RESEARCH QUESTION: What are the dose-response effects of medial wedge insoles with postings varying between 0 °, 3 °, 6 °, and 9 ° of inclination on the lower limb biomechanics during walking and running in individuals with pronated feet? METHODS: Sixteen participants with an FPI ≥ 6 were recruited. Four arch-supported insole conditions with varying degrees of medial heel wedge were tested (0°, 3°, 6°, and 9°). A 3D motion analysis system with force plates was used to obtain the kinetics and kinematics of walking and running at self-selected speeds. To compare the ankle, knee, and hip angles and moments among conditions, a time series analysis was performed using Statistical Parametric Mapping (SPM). RESULTS: A reduction in ankle eversion angle was observed during walking for all insoles. For running, the 6° and 9° insoles decreased the ankle eversion angle during early stance and increased this angle during the propulsive phase. A decrease in ankle eversion moment was observed in walking and running for 6° and 9° insoles. An increase in knee adduction moment occurred in walking and running for all insoles. For hip, the 6° and 9° insoles showed, during walking, a decrease in hip adduction angle and an increase in hip adduction and external rotation moments. For most variables, statistical differences were found for a greater period across the stance phase as the medial wedge increased, except for ankle eversion moment and hip external rotation moment during walking. SIGNIFICANCE: The biomechanical effects over the time series for many of the parameters increased with the addition of insole inclination, showing a dose-response effect of medial wedge insoles on the lower limb biomechanics during walking and running in adults with excessive foot pronation.