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A radiographic and anthropometric study of the effect of a contoured sandal and foot orthosis on supporting the medial longitudinal arch.

Escalona-Marfil C, McPoil TG, Mellor R, Vicenzino B - J Foot Ankle Res (2014)

Bottom Line: The contoured sandal significantly increased dorsal arch height compared to barefoot and flat sandal in both the anthropometric and radiographic experiments with SMD ranging from 0.95 (mean difference 5.1 mm (CI: 0.3, 1.6)) to 1.8 (4.3 mm (1.9, 6.6)).Medial longitudinal arch height is elevated by contoured sandals and approximates subtalar joint neutral position of the foot and that achieved by an orthosis.Practitioners wanting to increase the medial longitudinal arch can do so with either an orthosis or a contoured sandal that includes the raised arch profile form of an orthosis.

View Article: PubMed Central - PubMed

Affiliation: Universitat Internacional de Catalunya, Facultad de Medicina y Ciencias de La Salud, Barcelona, Spain.

ABSTRACT

Background: In-shoe foot orthoses improve conditions such as plantar heel pain (fasciitis), probably due to their ability to raise the medial longitudinal arch of the foot and lower the stress on the plantar tissues. Increasingly the arch-profile form of the in-shoe foot orthosis is being incorporated into sandal footwear, providing an alternative footwear option for those who require an orthosis. The purpose of this study was to evaluate if a sandal that incorporates the arch-profile of an in-shoe foot orthosis does indeed raise the medial longitudinal arch.

Methods: Three commercially available non-medical devices (contoured and flat sandal, prefabricated in-shoe orthosis) worn by healthy individuals were studied in two independent experiments, one using radiographic measurements in Australia (n = 11, 6 female, age 26.1 ± 4.3 yrs, BMI 22.0 ± 2.4 kg/m(2)) and the other utilising anthropometric measures in the USA (n = 10, 6 female, age 26.3 ± 3.8 yrs, BMI 23.5 ± 3.7 kg/m(2)). A barefoot condition was also measured. Dorsal arch height was measured in both experiments, as well as in subtalar neutral in the anthropometric experiment. One way repeated measures ANOVA with follow up Bonferroni-corrected pairwise comparisons were used to test differences between the conditions (contoured and flat sandal, orthosis, barefoot). Mean difference and 95% confidence intervals (CI) and standardised mean differences (SMD) were also calculated.

Results: The contoured sandal significantly increased dorsal arch height compared to barefoot and flat sandal in both the anthropometric and radiographic experiments with SMD ranging from 0.95 (mean difference 5.1 mm (CI: 0.3, 1.6)) to 1.8 (4.3 mm (1.9, 6.6)). There were small differences between the contoured sandal and orthosis of 1.9 mm (0.6, 3.3) in the radiographic experiment and 1.2 mm (-0.4, 0.9) in the anthropometric experiment. The contoured sandal approximated the subtalar neutral position (0.4 mm (-0.5, 0.7)).

Conclusions: Medial longitudinal arch height is elevated by contoured sandals and approximates subtalar joint neutral position of the foot and that achieved by an orthosis. Practitioners wanting to increase the medial longitudinal arch can do so with either an orthosis or a contoured sandal that includes the raised arch profile form of an orthosis.

No MeSH data available.


Related in: MedlinePlus

Platform used to standardize the placement of the devices and feet as well as to measure foot length by means of the ruler and a sliding bar.
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Fig4: Platform used to standardize the placement of the devices and feet as well as to measure foot length by means of the ruler and a sliding bar.

Mentions: Each participant was asked to stand on an elevated table that was positioned approximately 61 cm from the floor and to place their feet onto a specially constructed Foot Assessment Platform previously described (Figure 4) [9]. The participant was positioned on the platform with both heels placed in left and right heel cups that were 15.24 cm apart. Next, the medial prominences of the first metatarsal heads of both feet were positioned so they were just touching a plastic bar to ensure consistent forefoot placement on the platform. Once the participant was properly positioned on the platform, the participant was instructed to relax and place equal weight on both feet so that the weight bearing measurements could be obtained. Total foot length was first measured by placing the sliding bar on the centered metal ruler attached to the platform and moving the bar to just touch the longest toe, usually the hallux, of each foot (see Figure 4). Next, the dorsal arch height at 50% of total foot length was measured bilaterally using the weight bearing arch height gauge previously described. To determine 50% of total foot length, the previously measured total foot length was divided in half and the dorsum of both feet were marked at the 50% length point using a water-soluble pen. The sliding metal rod of the weight bearing height gauge was then positioned over the 50% length for both feet (see Figure 3) and the dorsal arch height measured. Each participant’s foot was then placed in subtalar joint neutral by asking the participant to elevate and lower the medial longitudinal arch of one foot followed by the other foot while the investigator palpated the medial and lateral aspect of the head of the talus in relation to the navicular bone. When the investigator felt congruency between the head of the talus and the navicular bone (subtalar joint neutral position) in both feet, the participant was instructed to maintain that position while the dorsal arch height was measured for both feet.Figure 4


A radiographic and anthropometric study of the effect of a contoured sandal and foot orthosis on supporting the medial longitudinal arch.

Escalona-Marfil C, McPoil TG, Mellor R, Vicenzino B - J Foot Ankle Res (2014)

Platform used to standardize the placement of the devices and feet as well as to measure foot length by means of the ruler and a sliding bar.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4196133&req=5

Fig4: Platform used to standardize the placement of the devices and feet as well as to measure foot length by means of the ruler and a sliding bar.
Mentions: Each participant was asked to stand on an elevated table that was positioned approximately 61 cm from the floor and to place their feet onto a specially constructed Foot Assessment Platform previously described (Figure 4) [9]. The participant was positioned on the platform with both heels placed in left and right heel cups that were 15.24 cm apart. Next, the medial prominences of the first metatarsal heads of both feet were positioned so they were just touching a plastic bar to ensure consistent forefoot placement on the platform. Once the participant was properly positioned on the platform, the participant was instructed to relax and place equal weight on both feet so that the weight bearing measurements could be obtained. Total foot length was first measured by placing the sliding bar on the centered metal ruler attached to the platform and moving the bar to just touch the longest toe, usually the hallux, of each foot (see Figure 4). Next, the dorsal arch height at 50% of total foot length was measured bilaterally using the weight bearing arch height gauge previously described. To determine 50% of total foot length, the previously measured total foot length was divided in half and the dorsum of both feet were marked at the 50% length point using a water-soluble pen. The sliding metal rod of the weight bearing height gauge was then positioned over the 50% length for both feet (see Figure 3) and the dorsal arch height measured. Each participant’s foot was then placed in subtalar joint neutral by asking the participant to elevate and lower the medial longitudinal arch of one foot followed by the other foot while the investigator palpated the medial and lateral aspect of the head of the talus in relation to the navicular bone. When the investigator felt congruency between the head of the talus and the navicular bone (subtalar joint neutral position) in both feet, the participant was instructed to maintain that position while the dorsal arch height was measured for both feet.Figure 4

Bottom Line: The contoured sandal significantly increased dorsal arch height compared to barefoot and flat sandal in both the anthropometric and radiographic experiments with SMD ranging from 0.95 (mean difference 5.1 mm (CI: 0.3, 1.6)) to 1.8 (4.3 mm (1.9, 6.6)).Medial longitudinal arch height is elevated by contoured sandals and approximates subtalar joint neutral position of the foot and that achieved by an orthosis.Practitioners wanting to increase the medial longitudinal arch can do so with either an orthosis or a contoured sandal that includes the raised arch profile form of an orthosis.

View Article: PubMed Central - PubMed

Affiliation: Universitat Internacional de Catalunya, Facultad de Medicina y Ciencias de La Salud, Barcelona, Spain.

ABSTRACT

Background: In-shoe foot orthoses improve conditions such as plantar heel pain (fasciitis), probably due to their ability to raise the medial longitudinal arch of the foot and lower the stress on the plantar tissues. Increasingly the arch-profile form of the in-shoe foot orthosis is being incorporated into sandal footwear, providing an alternative footwear option for those who require an orthosis. The purpose of this study was to evaluate if a sandal that incorporates the arch-profile of an in-shoe foot orthosis does indeed raise the medial longitudinal arch.

Methods: Three commercially available non-medical devices (contoured and flat sandal, prefabricated in-shoe orthosis) worn by healthy individuals were studied in two independent experiments, one using radiographic measurements in Australia (n = 11, 6 female, age 26.1 ± 4.3 yrs, BMI 22.0 ± 2.4 kg/m(2)) and the other utilising anthropometric measures in the USA (n = 10, 6 female, age 26.3 ± 3.8 yrs, BMI 23.5 ± 3.7 kg/m(2)). A barefoot condition was also measured. Dorsal arch height was measured in both experiments, as well as in subtalar neutral in the anthropometric experiment. One way repeated measures ANOVA with follow up Bonferroni-corrected pairwise comparisons were used to test differences between the conditions (contoured and flat sandal, orthosis, barefoot). Mean difference and 95% confidence intervals (CI) and standardised mean differences (SMD) were also calculated.

Results: The contoured sandal significantly increased dorsal arch height compared to barefoot and flat sandal in both the anthropometric and radiographic experiments with SMD ranging from 0.95 (mean difference 5.1 mm (CI: 0.3, 1.6)) to 1.8 (4.3 mm (1.9, 6.6)). There were small differences between the contoured sandal and orthosis of 1.9 mm (0.6, 3.3) in the radiographic experiment and 1.2 mm (-0.4, 0.9) in the anthropometric experiment. The contoured sandal approximated the subtalar neutral position (0.4 mm (-0.5, 0.7)).

Conclusions: Medial longitudinal arch height is elevated by contoured sandals and approximates subtalar joint neutral position of the foot and that achieved by an orthosis. Practitioners wanting to increase the medial longitudinal arch can do so with either an orthosis or a contoured sandal that includes the raised arch profile form of an orthosis.

No MeSH data available.


Related in: MedlinePlus