Document Detail

Evolution of foot orthotics--part 2: research reshapes long-standing theory.
MedLine Citation:
PMID:  11896382     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To challenge casual understanding of the causal mechanisms of foot orthotics. Although the classic orthotic paradigm of Merton L. Root and his colleagues is often acknowledged, the research attempting to explain and validate these mechanisms is far less clear in its appraisal. DATA SOURCES: Studies evaluating the relationship of foot type (medial arch height) and use of foot orthoses to the motions of the foot and ankle were compared and contrasted. A search was conducted to evaluate other possible mechanisms of orthotic intervention. RESULTS: Although Root's methods of foot evaluation (subtalar neutral position) and casting (non-weight-bearing) are well referenced, these methods have poor reliability, unproven validity, and are, in fact, seldom strictly followed. We challenge 2 widely held concepts: that excessive foot eversion leads to excessive pronation and that orthotics provide beneficial effects by controlling rearfoot inversion/eversion. Numerous studies show that patterns of rearfoot inversion/eversion cannot be characterized either by foot type or by orthotics use. Rather, subtle control of internal/external tibial rotation appears to be the most significant factor in maintaining proper supination/pronation mechanics. Recent evidence also suggests that proprioceptive influences play a large, and perhaps largely unexplored, role. CONCLUSIONS: Considerable evidence supports the exploration of new theories and paradigms of orthotics use. Investigations of flexible orthotic designs, proprioceptive influences, and the 3-dimensional effects of subtalar joint motion on the entire kinetic chain are areas of research that show great promise.
Kevin Arthur Ball; Margaret J Afheldt
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of manipulative and physiological therapeutics     Volume:  25     ISSN:  0161-4754     ISO Abbreviation:  J Manipulative Physiol Ther     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-03-15     Completed Date:  2002-08-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7807107     Medline TA:  J Manipulative Physiol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  125-34     Citation Subset:  IM    
Biomechanics/Gait Research Laboratory, Foot Levelers Gait Research Program, New York Chiropractic College, Seneca Falls, NY 14450, USA.
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MeSH Terms
Equipment Design / economics
Evaluation Studies as Topic
Foot / physiology*,  radiography
Orthotic Devices / economics,  trends*
Subtalar Joint / anatomy & histology,  physiology*,  radiography

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