• Physical Therapy Korea
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• v.26 no.4
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• pp.70-76
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• 2019

Background: An excessive pronated foot is defined as a flattening or complete loss of the medial longitudinal arch. Excessive foot pronation is considered to have high risk factors of overuse injuries in the lower limb. Various treatments have been investigated in attempts to control excessive pronation. Objects: This meta-analysis identifies the effects of an anti-pronation taping technique using different materials. Methods: The electronic databases used include MEDLINE, the Physiotherapy Evidence Database (PEDro), Science Direct, the Korean Studies Information Service System (KISS), the Research Information Sharing Service (RISS), the Korea National Library, and the Korean Medical Database (studies published up to July 31, 2019). The database search used the following keywords: "foot drop" OR "foot arch" OR "foot pronation" OR "flat foot (pes planus)" AND "taping" OR "support." Eight eligible studies were analyzed to determine the effectiveness of anti-pronation taping in study and control groups. Results: The overall random effect size (Hedges'g) of the anti-pronation taping technique was 0.147 (95% confidence interval [CI]: -.214 to .509). When the effect (Hedges' g) was compared by the type of tape material, rigid tape (RT; Lowdye taping) was .213 (95% CI: -.278 to .704) and kinesiotape (KT; arch support taping) was -.014 (95% CI: -.270 to .242). Based on this meta-analysis, it was not possible to identify the extent to which anti-pronation taping was effective in preventing navicular drop, improving balance, or changing foot pressure. Only three of the eight eligible studies applied KT on excessive pronated feet, and the outcome measure areas were different to those of the RT studies. The KT studies used EMG data, overall foot posture index (FPI) scores, and rear foot FPI scores. In contrast, the RT studies measured navicular heights, various foot angles, and foot pressure. Conclusion: This review could not find any conclusive evidence about the effectiveness of any taping method for patients with pronated feet. Future studies are needed to develop the anti-pronation taping technique based on the clinical scientific evidence.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.2
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• pp.77-85
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• 2021

BACKGROUND: This study aimed to determine the changes in muscle strength and walking ability in patients who complained of knee instability due to excessive pronation of the foot. METHODS: Twenty patients (ten men and ten women) who complained of instability of the knee joint due to excessive pronation of the foot participated in the experiment. In the experimental group, the internal rotation of the tibia caused by excessive adduction of the foot was maintained as external rotation, and the joint state was to recognize the movement of the joint position changed through maintenance of the muscle. This exercise was performed five times for each patient, and the muscle strength maintenance was performed for 20 seconds. In the control group, stretching and range of motion (ROM) exercises were performed. For the stretching exercise, one specific motion was performed for 20 second, and the ROM exercise was performed to confirm the change in muscle strength in the knee joint area and walking ability. RESULTS: The knee flexion and extension strength in the patients with excessive pronation of the foot differed significantly from those in the subjects from the control group (p<.05). Further, the before-after comparison of the step time and length in the evaluation of walking ability, which affects overall postural movement due to knee joint instability, revealed a significant difference between the experimental and control groups (p<.05). CONCLUSION: The patients that were subjected to manual therapy and ROM exercise for the knee joint showed improved knee joint muscle strength and walking ability compared to the subjects from the control group.

• Journal of the Ergonomics Society of Korea
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• v.20 no.1
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• pp.63-72
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• 2001

Rearfoot control can be defined as the relative ability of a shoe to limit the amount of subtalar joint pronation immediately following footstrike. A normal amount of pronation provides a means of decreasing peak forces experienced by the leg, but excessive pronation of the foot can be arised its injures. The purpose of this study is to compare amount of pronation according to a difference between medial and later hardness of shoe midsole for better design of running shops. The experiment is examined for 7 running shoes. 8 males. to measure the Achilles tendon angle and rearfoot angle using high speed camera. The results is conducted that the changes of Achilles tendon angle significantly differ at each test shoe with increased running speed. And, a difference between medial and lateral hardness of midsole affects rearfoot motion of runner. The displacements of maximal Achilles tendon angle described a amount of pronation motion is decreased when medial hardness of midsole is large more than lateral.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.2
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• pp.127-133
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• 2008

Purpose : The purpose of this study was carried out to review the correlation between foot shape(supination foot, pronation foot) and low back pain, hip abduction muscle and ankle lateral sprain. Methods : By using internet, we research the PubMed, Science Direct, KISS, DBpia We selected the article between 1990 and 2007. Key words were supination foot, pronation foot, balance. Results : Normal control balance of human body needs a optimal anatomical alignment and function of musculoskeletal and central nerve system that control continuously to integrate. Especially ankle and foot complex play an important role in postural control because it is located distal part in human body. Supination foot brings to chronic ankle sprain or chronic ankle instability and range of motion limitation due to the weakness of lateral ankle muscle. Pronation foot brings to knee injury because of lower leg internal rotation force. Conclusion : Excessive supination and pronation foot happen to muscle imbalance. Especially weakness of hip abduction or injury of ankle lateral muscle or low back pain are due to abnormal balance and anatomical alignment.

• Korean Journal of Applied Biomechanics
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• v.16 no.1
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• pp.65-79
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• 2006

The purpose of this study was firstly to investigate correctional function of custom semi-rigid foot orthotics for excessively pronated people during gait by observing comfort, navicular movement and leg muscles' activity according to short-term and mid-term wearing duration and secondly to understand positive and/or negative point of view of a recently proposed paradigm related to foot orthotics more profoundly. Sixteen subjects who showed excessive pronation at navicular drop test were recruited for this study. Custom semi-rigid foot orthotics were made fitting for foot characteristics of the subjects by podiatry division of Otto Bock Korea company. While wearing the foot orthotics for two months, comfort of wearing were questioned and vertical navicular movement and electromyography of leg muscles during gait were measured at the condition of both immediately after and 2 months after including a control condition, respectively. The subjects were required to walk on a treadmill at the speed of 1.5m/s and four digital video camera filmed the movement of navicular process at the speed of 60 frames/s. In conclusion, in excessively pronated group continuous increase of comfort from short-term to mid-term wearing of custom foot orthotics is assumed to be closely related with short-term and mid term correctional action, of which are consisted the decrease of the range of navicular drop and navicular raisins- the faster timing of minimum navicular position occurring, and the decrease of leg muscles' activities. This conclusion could lead to positively accept new paradigm related to foot orthotics suggested by Nigg and the author suggest that in the future study the variable which could observe navicular movement would be one of major variables to study preferred path of skeleton in the paradigm.

• The Journal of Korean Physical Therapy
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• v.14 no.3
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• pp.203-225
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• 2002

An excessive Q-angle has been implicated in the development of knee injuries by altering the lower-extremity locomotion kinematics. The purpose of this study was performed to examine the correlation between the Q-angle and the CTA during pronation and supination of the foot in the standing status. The participants of this examination were 60 adult(30 men and 30 women) who had no orthopaedic and neurological impairment, aged between 20 and 40years. The foot tilt(FT1)is made of acrylic plate and the slope of the surface is altered as $0^{\circ}$ pronation$(10^{\circ},\;20^{\circ},\;30^{\circ})$ and supination $(10^{\circ},\;20^{\circ},\;30^{\circ})$. The results were as follows : 1. The result about the Q-angle and the CTA by comparing pronation and supination of the foot There was statistical significance difference in the left /right Q-angle and the left/right CTA with pronation and supination of the foot(P<0.05). 2. The result about correlation in the left /right lower-extremity There were positive correlation between the right Q-angle and the right CTA and negative correlation except the supination$(30^{\circ})$ between the left Q-angle and the left CTA.

• The Journal of Korean Physical Therapy
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• v.14 no.4
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• pp.342-366
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• 2002

An excessive Q-angle has been implicated in the development of knee injuries by altering the lower-extremity locomotion kinematics. The purpose of this study was measured the Q-angle and the CTA when the foot moves pronation and supination of the foot in the standing status. The participants of this examination were 60 adult(30 men and 30 women) who had no orthopaedic and neurological impairment, aged between 20 and 40years. The foot tilt(FT 1)is made of acrylic plate and the slope of the suface is altered as $0^{\circ}$, pronation ($10^{\circ},20^{\circ},30^{\circ}$)and supination($10^{\circ},20^{\circ},30^{\circ}$). The results were as follows : 1. The result about the left/right Q-angle and the left/right CAT There was no statistical significant difference between the left and the right side of the Q-angle with different position of the foot(P > 0.05). While significant difference in the left CTA at the $0^{\circ}$, pronation($10^{\circ},20^{\circ},30^{\circ}$) and supination($10^{\circ},20^{\circ}$) has been observed(P < 0.05). 2. The result about the Q-angle and the CTA between male and female There was significant difference in the Q-angle between male and female with different position of the foot(P < 0.05). while significant different in the right CTA at the $0^{\circ}$ pronation ($20^{\circ}$)(P < 0.05), no significant difference in the left CTA have been observed(P > 0.05). 3. The result about correlation between the left/right Q-angle and the left/right CAT There was statistical significant positive correlation between the left/right Q-angle and the left/right CAT with the different position of the foot(P < 0.01).

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.19-22
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• 2013

Background: Excessive pronation of the feet can cause excessive inner rotation of the femur, followed by increased stress in the gluteus maximum, increased front slope of the pelvis, and lumbar lordosis, which leads to lumbar pain. The aim of the present study was to use the navicular drop test to examine foot pronation that can cause lumbar lordosis and to determine whether the navicular drop is lower in patients diagnosed with lumbar disc than in patients without this diagnosis. Methods: The Navicular Drop score was set by subtracting the navicular height at a standing position from the navicular height in a sitting position. The Navicular Drop measurements for college student with and without Lumbar Herniated Intervertebral Disc were compared using an independent t-test. Results: The control group were measured right $7.44{\pm}2.96$ and left $8.04{\pm}3.23$. The experimental group were measured right $2.12{\pm}1.33$ and left $2.80{\pm}1.29$. Therefore significant difference was found between the two groups (p<0.05). Conclusions: The navicular drop affected lumbar herniated intervertebral disc.

• Physical Therapy Korea
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• v.16 no.2
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• pp.9-15
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• 2009

The purposes of this study were to compare abductor hallucis (AbdH) muscle activity during toe curl exercise according to position of interphalangeal joint (IPJ). Fifteen healthy subjects with neutral foot were recruit for this study. All subjects performed toe curl exercise with towel while maintaining the IPJ in flexion (condition 1) and extension (condition 2). Toe curl exercise with towel was perform three trials for five second periods in each condition. Surface electromyography (EMG) activities were recorded from three muscles (AbdH, tibialis anterior, peroneous longus) in each condition. EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities acoording to position of IPJ were compared using a paired t-test. This study showed that the EMG activity of AbdH during toe curl exercise with IPJ extension significantly increased compared to those during toe curl exercise with IPJ flexion (p<.05). However, the EMG activity of tibialis anterior and peroneus longus were not significantly different between the conditions (p>.05). These results suggest that toe curl exercise with towel must be performed with extension of IPJ in order to strengthen intrinsic muscle in subjects with overuse injuries related to excessive pronation.

• Korean Journal of Applied Biomechanics
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• v.18 no.2
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• pp.115-124
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• 2008

The purpose of this study was to examine the effects of customized foot orthotics on lower extremity muscle activity and fatigue during march in combat boots. Four volunteers with normal foot and five volunteers with excessive pronation foot among soldiers on service were fitted with foot orthotics. The electromyography signal from activity of low extremity muscles were collected with surface electromyography device during walking on the treadmill. The walk on the treadmill was performed with a speed of 4.5 km/h. The experiment design for reseach wes composed two experimentation. The first experiment was to examine the muscle activity of lower extremity between normal foot and excessive pronator foot during march. The second experiment was to examine the muscle activity of lower extremity between wearing orthotics and no wearing orthotics. These data were analyzed by the averaged integral EMG and the mean power frequency. The analyzed results were compared by independent T-test method and paired T-test method of SPSS(windows version 12.0). The result of the study were the muscle activity on pronator foot tend to increase during march but a statistically significant increase in muscle fatigue of vastus lateralis and fibularis longus. A statistically significant decrease in muscle activity of anterior tibialis and fibularis longus and fatigue occurred using the customized foot orthotics in volunteers with excessive pronation foot compared to volunteers with normal foot. Clinically, the application of orthotics for the soldiers with excessive pronation foot appears to delay muscle fatigue and prevent from variable foot injuries. This may contribute to enhancing fighting efficiency.