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Predictors of the Biomechanical Effects of Customized Foot Orthoses in Adults With Flat-Arched Feet

Arnold, John B., PhD*,†; May, Thomas, MPod; Bishop, Christopher, PhD*

Clinical Journal of Sport Medicine: July 2018 - Volume 28 - Issue 4 - p 398–400
doi: 10.1097/JSM.0000000000000461
Brief Report

Objective: To determine the potential presence and characteristics of biomechanical responders to customized foot orthoses during walking in adults with flat-arched feet.

Design: Experimental, repeated-measures.

Setting: University clinic and laboratory.

Participants: Eighteen symptom-free adults with flat-arched feet.

Interventions: Customized foot orthoses.

Main Outcome Measures: In-shoe foot biomechanics were measured during walking with and without customized foot orthoses using 3D analysis. Selected kinematic and kinetic variables during baseline walking were compared between subgroups who displayed reductions in calcaneal eversion with foot orthoses to those with no change or increases.

Results: Biomechanical responders displayed significantly greater peak calcaneal eversion (+2.2 degrees, P = 0.009). Time to peak calcaneal eversion (−11%, P = 0.006), peak dorsiflexion of the hallux (−6 degrees, P = 0.001), and medial–lateral excursion of the center of pressure during loading response were all reduced in the responder subgroup (−2 mm, P ≤ 0.001). Variables significantly different between subgroups were moderately associated with the response to foot orthoses (canonical correlation = 0.687, effect size = 0.47, P = 0.063).

Conclusions: Individuals with increased dynamic foot pronation were more likely to show a favorable biomechanical response to customized foot orthoses, providing preliminary evidence to support the stratified use of foot orthoses to optimize their effectiveness.

*Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, Australia; and

School of Health Sciences, University of South Australia, Adelaide, Australia.

Corresponding Author: John B. Arnold, PhD, School of Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide SA 5001, Australia (john.arnold@unisa.edu.au).

Supported by a grant from the Sports Medicine Australia (SMA) Research Foundation. Footwear was donated by ASICS Oceania.

One author (C.B.) is currently a paid consultant to ASICS Oceania. The remaining authors report no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.cjsportmed.com).

ASICS Oceania had no input into the design, analysis of results, or decision to submit the results for publication.

Received July 27, 2016

Accepted February 14, 2017

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.