Purpose: The author evaluated the clinical and radiological results after wearing the medial arch supports in children. Materials and Methods: 103 patients who had symptomatic flat feet were evaluated from march, 2002 to may 2009. All patients wore the medial arch supports according to the symptoms. We measured parameters at weight-bearing radiographs before and after medial arch support were worn. We also evaluated the clinical scores using the AOFAS score. Results: Mean age of patients was 97 months (11-204 months), all foot of patients involved bilaterally. Mean talo-first metatarsal angle of right foot was $17.7{\pm}9.4$ and left foot was $19.96{\pm}9.5$ degrees at AP radiograph in pre-wearing state. Mean calcaneal pitch angle of right foot was $12.0{\pm}5.3$ and left foot was $11.9{\pm}5.8$ degrees at lateral radiograph in pre-wearing state. Mean talo-first metatarsal angle of right foot was $14.4{\pm}8.05$ and left foot was $13.1{\pm}8.77$ degrees at AP radiograph in post-wearing state. Mean calcaneal pitch angle of right foot was $16.4{\pm}5.75$ left foot was $16.5{\pm}5.6$ degrees at lateral radiograph in post-wearing state. The radiographic angles between pre-wearing and post-wearing state were statistically significant (p<0.05). Mean pre-wearing AOFAS hindfoot score was $66.7{\pm}9.25$, midfoot score was $60.0{\pm}9.34$ forefoot score was $57.1{\pm}11.8$. Mean post-wearing AOFAS hindfoot score was $73.2{\pm}9.73$, midfoot score was $68.1{\pm}10.1$, forefoot score was $67.2{\pm}11.4$. The forefoot score was highest improving scores among the AOFAS scores. Conclusion: From our study, we concluded that medial arch support was effective for symptomatic flat feet of children in radiological and clinical results from our study.
Objective: The aim of this study is to analyze the effect of the strength of the ankle support on the walking characteristics and ankle joints when men with flexible flat feet walk. Method: 13 adult male subjects (age: 23.9 ± 2.4 yrs, height: 173.0 ± 5.0 cm, weight: 76.9 ± 13.2 kg, Navicular Drop Test (NDT): 10.2 ± 0.8 mm) participated in this study. Each participant had to walk with the 3 conditions, barefoot, soft arch support and hard arch support, along a walkway while their kinematics was recorded at 100 Hz. Results: Based on the results of this study, it is considered that men with flexible flat feet should use hard arch support rather than bare feet to induce normal arch shape, relieve foot damage caused by excessive ankle joint abnormalities and improve stability. Conclusion: Our results for men with flat flexibility, there was a significant difference in the value of step length when walking was performed using two arch supports with different strengths. The angle of ankle dorsiflexion was significantly increased, and the ankle eversion angle was significantly decreased.
This study aimed to create 3D-printed insoles for flat-footed senior men using 3D systems. 3D systems are product-manufacturing systems that use 3-dimensional technologies like 3D scanning, 3D modeling, and 3D printing. This study used a 3D scanner (NexScan2), 3D CAD programs including Rapidform, AutoCAD, SolidWorks, Nauta+ compiling program, and a 3D printer. In order to create insoles for flat-footed senior men, we analyzed horizontal sections of 3D foot scans We selected 20 flat-footed and 20 normal-footed subjects. To make the 3D insole models, we sliced nine lines on the surface of the subjects' 3D foot scans, and plotted 144 points on the lines. We calculated the average of these 3D coordinates, then located this average within the 3D space of the AutoCAD program and created 3D sole models using the loft surface tools of the SolidWorks program. The sole models for flat feet differed from those of normal feet in the depth of the arch at the inner sideline and the big toe line. We placed the normal-footed sole model on a flat-footed sole model, and the combination of the two models resulted in the 3D insole for flat feet. We printed the 3D modeled insole using a 3D printer. The 3D printing material was an acrylic resin similar to rubber. This made the insole model flexible and wearable. This study utilized 3D systems to create 3D insoles for flat-footed seniors and this process can be applied to manufacture other items in the fashion industry as well.
Kim, Seung-Jae;Kim, Jang-Hwan;Tack, Gye-Rae;Bae, Sang-Woo;Park, Yeong-Ki
Korean Journal of Applied Biomechanics
/
v.17
no.3
/
pp.81-94
/
2007
The purpose of this study was to critically review biomechanical studies on foot orthoses (FO) in normal and diseased foot and provide beneficial information obtained from researches until now and future researching focus. The search was performed by Medline and Embase database including studies published in English from January 1980 to April 2007. The searching terms were foot orthoses, foot orthotics, insoles and shoe insert. 57 studies including 54 journal articles and 3 abstracts were finally selected under the conditions of having clinical trials, FO, control condition, movement, scientific measuring system. The reviewed studies were divided into 10 categories according to subject characteristics; healthy normal, excessive pronation or flexible flat foot, rheumatoid arthritis, diabetes, medial knee osteoarthritis, forefoot varus, plantar fasciitis, patellofemoral syndrome, cavus foot and finite element model. In summary, first, soft and semirigid FOs with some degree of cushioning showed much higher comfort and efficacy than rigid FO. Second, no big differences between prefabricated and custom FO were shown. Third, the full length's FO was preferable to the half length's FO or simple arch supports. Fourth, the wearing of FO combining medial arch supports and metatarsal dome made positive roles to enhance comfort and functionality and redistribute plantar pressure under the foot. Fifth, for patients with knee-related diseases lateral wedges were preferable. Sixth, measuring systems were properly applied according to the types of foot diseases.
This study was a convergence study of pre- and post-treatment clinical outcomes and radiologic results of school aged flexible flat foot using insole inserted indoor sandal. Thirty five subjects were asked to wear insole inserted indoor sandals at least five times a week and at least four hours a day. Before and after the $4^{th}$ and $8^{th}$ week of the treatment, foot radiography and FAOS questionnaire were performed. Statistical analysis was performed using repeated measure ANOVA. The clinical results showed statistically significant improvement in FAOS symptom and pain category. Radiological results showed a tendency of improvement in the Anterioposterior Talo-$1^{st}$ Metatarsal angle, the Lateral Talo-$1^{st}$ Metatarsal angle, and the Talo-Horizontal angle, but no statistical significance was found. In this study, the use of insole inserted indoor sandal during the majority of the indoor life in school aged flexible flat foot patients is effective in alleviating symptoms and pain relief in the short term.
Purpose: To determine the clinical and radiographic results of arthroereisis using the $Kalix^{(R)}$ implant (Newdeal, Lyon, France) for the treatment of flexible flatfoot deformity. Materials and Methods: From February 2005 to February 2007, we performed the subtalar arthroereisis on 8 patients (9 feet) of symptomatic flexible flat feet after more than 6 months of conservative treatment. Average age was 14.5 years ($11{\sim}29$ years) old. We checked the functional status with AOFAS functional score pre-operatively and at final follow-up. Radiologically, we took weight bearing anterior to posterior and lateral view of the feet, and measured the talo-first metatarsal angle, calcaneal pitch angle in pre-operatively and at final follow-up. Results: Mean follow up period was 34.4 months. Average AOFAS score improved from preoperatively 65.6 to postoperatively 94.8. Average lateral talo-first metatarsal angle reduced from $12.8^{\circ}$ preoperatively to $1.6^{\circ}$ at final follow-up. Average anterior to posterior talo-first metatarsal angle was reduced from $15.1^{\circ}$ preoperatively to $8.3^{\circ}$ at final follow-up. Average calcaneal pitch angle was increased from $9.5^{\circ}$ preoperatively to $12.0^{\circ}$ at final follow-up. Conclusions: Subtalar arthroereisis with Kalix$K^{(R)}$ implant can be considered to be one of treatment options symptomatic flatfoot deformity patients.
Journal of the Korean Society of Physical Medicine
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v.18
no.2
/
pp.61-70
/
2023
PURPOSE: This study evaluated an intrinsic foot strengthening exercise method for flat feet by comparing the effects of intrinsic exercises on a stable surface and intrinsic exercises on an unstable surface. METHODS: Twenty-four people with flat feet were divided into two groups. The control group performed short foot exercises and toe towel curl exercises on the stable support surface. The experimental group performed short foot exercises and toe towel curl exercises on an unstable support surface using Aerostep. The navicular drop test, and the static and dynamic balance were measured before and after the intervention. RESULTS: In the experimental and control groups, there was a significant difference in the navicular drop test and static balance before and after the intervention (p < .05). On the other hand, there was no significant difference between the two groups (p > .05). In the dynamic balance, the experimental group showed significant differences in all directions after the intervention (p < .05). The control group showed significant differences in the postero-lateral direction and posteromedial direction (p < .05). In particular, in the forward direction, the experimental group had a more significant change than the control group (p < .05). CONCLUSION: Intrinsic foot muscle strengthening exercises performed on unstable surfaces can be an effective clinical exercise method to improve the dynamic balance ability of people with flat feet.
Purpose: We evaluate the results of subtalar arthroereisis with $Kalix^{(R)}$ implant (Newdeal, Lyon, France) that were performed in painful flatfoot deformity. Materials and Methods: We performed the subtalar arthroereisis on 16 feet of children symptomatic flexible flat feet after more than 6 months of conservative treatment. Average age was 11 years (8-14 years) old. We checked the functional status with AOFAS functional score in pre-operatively and at final follow-up. Radiologically, we took weight bearing anterior to posterior and lateral view of the feet, and measured the talo-$1^{st}$ metatarsal angle, calcaneal pitch angle, cuboid-surface height. Finally, we asked to patient's parents for satisfaction of the surgery. Results: Mean follow up period was 34.1 months. Average AOFAS score improved from preoperatively 71.9 to postoperatively 91.3. Only one patient has subtalar pain. Average lateral $1^{st}$ metatarsal angle reduced from $-18.2^{\circ}$ preoperatively to $-4.6^{\circ}$ at final follow-up. Average anterior to posterior $1^{st}$ metatarsal angle was reduced from $18.9^{\circ}$ preoperatively to $6.5^{\circ}$ at final follow-up. Average calcaneal pitch angle was increased from $8.6^{\circ}$ preoperatively to $12.6^{\circ}$ at final follow-up. Average cuoboid-surface height was improved from 12.1 mm preoperatively to 16.0 mm at final follow-up. All patients had excellent or good satisfaction. Conclusions: Subtalar arthroereisis with $Kalix^{(R)}$ implant is a viable surgical alternative for painful flatfoot deformity of children.
Purpose: The author modified the technique of Grice-Green, for managing flexible flat foot, with severe hindfoot valgus and possible dorsiflexion more than $15^{\circ}$. The purpose of this study was to evaluate the efficacy and results of this modified technique. Material and Methods: Total of 6 patients, 11 cases of pes planovalgus were operatively managed with Modified Grice-Green procedure from Nov. 1996 to April 2002. Total 11 cases in 6 patients were managed; 9 cases in 5 males, 2 cases in one female. The average age of the patients were 7.3 years (5.1-13.3 years). Average follow up period was 3.9 years (1.2-6.7 years). Patients were evaluated preoperatively and at last follow up radiologically and clinically. Radiologic evaluation were done by measuring the talocalcaneal and talo-$1^{st}$ metatarsal angles with the anteroposterior view; and by measuring the talo-$1^{st}$ metatarsal angles with the lateral view. The clinical outcome were rated by subjective and objective improvement level. Results: On follow up, 9 cases were complete satisfied, 2 cases were satisfied with minor reservation and no case had major reservations or dissatisfaction. Objective results were rated as excellent in 9 cases, good in 2 cases. Average preoperative talo-calcaneal and talo-$1^{st}$ metatarsal angles on anteroposterior radiograms were $34.4^{\circ}$ ($16-40^{\circ}$) and $32^{\circ}$ ($8-48^{\circ}$) respectively; which postoperatively on last follow up were $20^{\circ}$ ($3-37^{\circ}$) and $15.6^{\circ}$ ($3-34^{\circ}$) respectively. Average Preoperative talo-$1^{st}$ metatarsal angle on lateral radiogram was $18.4^{\circ}$ ($6-30^{\circ}$); which postoperatively on last follow up was $6.7^{\circ}$ ($-6-17^{\circ}$). Conclusion: Modified Grice-Green operative procedure is effective and satisfactory procedure for planovalgus deformity in children. but for more accurate results, more patients and further follow up period are needed.
Sihyun Ryu;Young-Seong Lee;Soo-Ji Han;Sang-Kyoon Park
Korean Journal of Applied Biomechanics
/
v.33
no.1
/
pp.25-33
/
2023
Objective: The purpose of this study was to investigate the differences in static arch height and ankle stability according to the preference for insole height and hardness in the arch area. Method: The study participants were 20 adult males (age: 22.7 ± 1.8 yrs., height: 175.3 ± 4.3 cm, body weight: 72.5 ± 7.7 kg). First, the arch heights of all subjects were measured in static postures (sitting and standing). The inversion and eversion movements of the ankle joint were analyzed during walking (1.3 m/s & 1.7 m/s) and running (2.7 m/s & 3.3 m/s). The variables (static arch height, and inversion and eversion angle of ankle joint) were compared by classifying groups according to the preference for the height and hardness of the arch of the insole. First, it was divided into a high arch insole preference group (HAG, n=8) and a low arch insole preference group (LAG, n=12) according to the preference for the arch height of the insole. Second, it was divided into a high hardness insole preference group (HHG, n=7), medium hardness insole preference group (MHG, n=7), and low hardness insole preference group (LHG, n=6), according to the preference for the arch hardness of the insole. Results: First, the range of motion (ROM) of inversion-eversion at the ankle joint during walking was statistically smaller in HAG than in LAG (p<.05). Second, the arch height change of HHG was statistically greater than that of MHG and LHG (p<.05). Conclusion: In the case of flexible flat feet with a large change in arch height, providing a high hardness arch insole that can disperse foot pressure can improve comfort. It was found that people with high medial and lateral sway of the ankle joint preferred a low arch insole, but it is necessary to differentiate and compare the insole heights of the arch part in detail. In addition, in the case of fast motion such as running, the preference for the arch height and hardness of the insole was not related to the static arch height and ankle stability.
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