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Hylton B Menz - One of the best experts on this subject based on the ideXlab platform.
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immediate effects of Foot Orthoses on lower limb biomechanics pain and confidence in individuals with patellofemoral osteoarthritis
Gait & Posture, 2020Co-Authors: Kane J Middleton, Shannon E Munteanu, Natalie J. Collins, Kay M. Crossley, Hylton B Menz, Harvi F HartAbstract:Abstract Background Foot Orthoses are a recommended treatment for patellofemoral (PF) pain and a number of lower limb osteoarthritic (OA) conditions. However, their mechanism of effect is poorly understood. Research question To compare the immediate effects of Foot Orthoses and flat inserts on lower limb biomechanics, knee pain and confidence in individuals with PFOA. Methods Twenty-one participants (14 females; mean ± SD age 58 ± 8 years) with PFOA underwent three-dimensional motion analysis during level-walking, stair ascent, and stair descent under three Footwear conditions: (i) their own shoes; (ii) prefabricated Foot Orthoses; and (iii) flat shoe inserts. Participants reported their average levels of knee pain and confidence after each task. Data were analysed with repeated-measures analysis of variance (ANOVA), effect sizes (partial eta squared), and Bonferroni post-hoc tests. Results During level-walking, there was a significant main effect of Foot Orthoses on peak ankle dorsiflexion angle (F2 = 0.773, p Significance Prefabricated Foot Orthoses altered sagittal plane biomechanics of the ankle during level-walking and stair descent in individuals with PFOA. Further research is required to determine whether these changes are clinically beneficial.
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Foot Orthoses for plantar heel pain a systematic review and meta analysis
British Journal of Sports Medicine, 2018Co-Authors: Glen A Whittaker, Shannon E Munteanu, Hylton B Menz, Chantel L Rabusin, Karl B LandorfAbstract:Objective To investigate the effectiveness of Foot Orthoses for pain and function in adults with plantar heel pain. Design Systematic review and meta-analysis. The primary outcome was pain or function categorised by duration of follow-up as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks). Data sources Medline, CINAHL, SPORTDiscus, Embase and the Cochrane Library from inception to June 2017. Eligibility criteria for selecting studies Studies must have used a randomised parallel-group design and evaluated Foot Orthoses for plantar heel pain. At least one outcome measure for pain or function must have been reported. Results A total of 19 trials (1660 participants) were included. In the short term , there was very low-quality evidence that Foot Orthoses do not reduce pain or improve function. In the medium term , there was moderate-quality evidence that Foot Orthoses were more effective than sham Foot Orthoses at reducing pain (standardised mean difference −0.27 (−0.48 to −0.06)). There was no improvement in function in the medium term. In the longer term , there was very low-quality evidence that Foot Orthoses do not reduce pain or improve function. A comparison of customised and prefabricated Foot Orthoses showed no difference at any time point. Conclusion There is moderate-quality evidence that Foot Orthoses are effective at reducing pain in the medium term, however it is uncertain whether this is a clinically important change.
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effectiveness of Foot Orthoses for the prevention of lower limb overuse injuries in naval recruits a randomised controlled trial
British Journal of Sports Medicine, 2018Co-Authors: Daniel R Bonanno, Shannon E Munteanu, Karl B Landorf, George S Murley, Hylton B MenzAbstract:Objectives To evaluate the effectiveness of prefabricated Foot Orthoses for the prevention of lower limb overuse injuries in naval recruits. Methods This study was a participant-blinded and assessor-blinded, parallel-group randomised controlled trial. Three-hundred and six participants aged 17–50 years who undertook 11 weeks of initial defence training at the Royal Australian Navy Recruit School (Cerberus, Australia) were randomised to a control group (flat insoles, n=153) or an intervention group (contoured, prefabricated Foot Orthoses, n=153). The combined incidence of medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy and plantar fasciitis/plantar heel pain during the 11-week training period were compared using incidence rate ratios (IRR). Data were analysed using the intention-to-treat principle. Results Sixty-seven injuries (21.9%) were recorded. The control and intervention group sustained 40 (26.1%) and 27 (17.6%) injuries, respectively (IRR 0.66, 95% CI 0.39 to 1.11, p=0.098). This corresponds to a 34% reduction in risk of developing medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy or plantar fasciitis/plantar heel for the intervention group compared with the control group. Participants in the prefabricated Orthoses group were more likely to report at least one adverse event (20.3% vs 12.4%; relative risk (RR) 1.63, 95% CI 0.96 to 2.76; p=0.068; number needed to harm 13, 95% CI 6 to 253). The most common adverse events were Foot blisters (n=20, 6.6%), arch pain (n=10, 3.3%) and shin pain (n=8, 2.6%). Conclusion Prefabricated Foot Orthoses may be beneficial for reducing the incidence of lower limb injury in naval recruits undertaking defence training. Trial registration number Australian New Zealand Clinical Trials Registry: ACTRN12615000024549.
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effectiveness of Foot Orthoses and shock absorbing insoles for the prevention of injury a systematic review and meta analysis
British Journal of Sports Medicine, 2017Co-Authors: Daniel R Bonanno, Shannon E Munteanu, Karl B Landorf, George S Murley, Hylton B MenzAbstract:Objective To investigate the evidence relating to the effectiveness of Foot Orthoses and shock-absorbing insoles for the prevention of musculoskeletal injury. Design Systematic review and meta-analysis. Eligibility criteria for selecting studies Clinical trials evaluating the effectiveness of Foot Orthoses and shock-absorbing insoles for the prevention of injury. Data sources Cochrane Library, CINAHL, EMBASE, MEDLINE and SPORTDiscus from their inception up to the first week of June 2016. Results 11 trials that had evaluated Foot Orthoses and 7 trials that had evaluated shock-absorbing insoles were included. The median Physiotherapy Evidence Database (PEDro) score for trials that had evaluated Foot Orthoses and shock-absorbing insoles was 5 (range 3–8/10) and 3 (range 1–7/10), respectively. Meta-analysis found that Foot Orthoses were effective for preventing overall injuries (risk ratio (RR) 0.72, 95% CI 0.55 to 0.94) and stress fractures (RR 0.59, 95% CI 0.45 to 0.76), but not soft-tissue injuries (RR 0.79, 95% CI 0.55 to 1.14). In contrast, shock-absorbing insoles were not effective for preventing overall injuries (RR 0.92, 95% CI 0.73 to 1.16), stress fractures (RR 1.15, 95% CI 0.57 to 2.32) or soft-tissue injuries (RR 0.92, 95% CI 0.74 to 1.15). Conclusions Foot Orthoses were found to be effective for preventing overall injuries and stress fractures but not soft-tissue injuries, while shock-absorbing insoles were not found to be effective for preventing any injury. However, further well-designed trials will assist the accuracy and precision of the estimates of risk reduction as the quality of the included trials varied greatly.
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effectiveness of Foot Orthoses versus rocker sole Footwear for first metatarsophalangeal joint osteoarthritis randomized trial
Arthritis Care and Research, 2016Co-Authors: Hylton B Menz, Pazit Levinger, Maria Auhl, Jade M Tan, Edward Roddy, Shannon E MunteanuAbstract:Objective To compare the effectiveness of prefabricated Foot Orthoses to rocker-sole Footwear in reducing Foot pain in people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). Methods Participants (n = 102) with first MTP joint OA were randomly allocated to receive individualized, prefabricated Foot Orthoses or rocker-sole Footwear. The primary outcome measure was the pain subscale on the Foot Health Status Questionnaire (FHSQ) at 12 weeks. Secondary outcome measures included the function, Footwear, and general Foot health subscales of the FHSQ; the Foot Function Index; severity of pain and stiffness at the first MTP joint; perception of global improvement; general health status; use of rescue medication and co-interventions to relieve pain; physical activity; and the frequency of self-reported adverse events. Results The FHSQ pain subscale scores improved in both groups, but no statistically significant difference between the groups was observed (adjusted mean difference 2.05 points, 95% confidence interval [95% CI] −3.61, 7.71; P = 0.477). However, the Footwear group exhibited lower adherence (mean ± SD total hours worn 287 ± 193 versus 448 ± 234; P < 0.001), were less likely to report global improvement in symptoms (39% versus 62%; relative risk [RR] 0.63, 95% CI 0.41, 0.99; P = 0.043), and were more likely to experience adverse events (39% versus 16%; RR 2.47, 95% CI 1.12, 5.44; P = 0.024) compared to the Orthoses group. Conclusion Prefabricated Foot Orthoses and rocker-sole Footwear are similarly effective at reducing Foot pain in people with first MTP joint OA. However, prefabricated Foot Orthoses may be the intervention of choice due to greater adherence and fewer associated adverse events.
Shannon E Munteanu - One of the best experts on this subject based on the ideXlab platform.
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immediate effects of Foot Orthoses on lower limb biomechanics pain and confidence in individuals with patellofemoral osteoarthritis
Gait & Posture, 2020Co-Authors: Kane J Middleton, Shannon E Munteanu, Natalie J. Collins, Kay M. Crossley, Hylton B Menz, Harvi F HartAbstract:Abstract Background Foot Orthoses are a recommended treatment for patellofemoral (PF) pain and a number of lower limb osteoarthritic (OA) conditions. However, their mechanism of effect is poorly understood. Research question To compare the immediate effects of Foot Orthoses and flat inserts on lower limb biomechanics, knee pain and confidence in individuals with PFOA. Methods Twenty-one participants (14 females; mean ± SD age 58 ± 8 years) with PFOA underwent three-dimensional motion analysis during level-walking, stair ascent, and stair descent under three Footwear conditions: (i) their own shoes; (ii) prefabricated Foot Orthoses; and (iii) flat shoe inserts. Participants reported their average levels of knee pain and confidence after each task. Data were analysed with repeated-measures analysis of variance (ANOVA), effect sizes (partial eta squared), and Bonferroni post-hoc tests. Results During level-walking, there was a significant main effect of Foot Orthoses on peak ankle dorsiflexion angle (F2 = 0.773, p Significance Prefabricated Foot Orthoses altered sagittal plane biomechanics of the ankle during level-walking and stair descent in individuals with PFOA. Further research is required to determine whether these changes are clinically beneficial.
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the Footpath study protocol for a multicentre participant and assessor blind parallel group randomised clinical trial of Foot Orthoses for patellofemoral osteoarthritis
BMJ Open, 2019Co-Authors: Hylto Menz, Trevo Russell, Anne Smith, Ill Vicenzino, Rana S Hinma, Shannon E Munteanu, Natalie J. Collins, Terry P HainesAbstract:Introduction Patellofemoral (PF) osteoarthritis (OA) is a common and burdensome subgroup of knee OA, with very little evidence for effective treatments. Prefabricated Foot Orthoses are an affordable and accessible intervention that have been shown to reduce PF pain in younger adults. Similarities between PF pain and PFOA, as well as our pilot work, suggest that Foot Orthoses may also be an effective intervention for PFOA. The primary objective of this study is to compare the 3 month efficacy of prefabricated Foot Orthoses and flat shoe inserts in people with PFOA, on knee pain severity. Methods and analysis The FootPATH Study (Foot Orthoses for PAtellofemoral osteoarTHritis) is a multicentre, randomised, participant- and assessor-blinded superiority trial with two parallel groups, a 3 month observation period (pre-randomisation) and 12 month follow-up. 160 participants with a clinical diagnosis of PFOA will be recruited from three sites in Australia, and randomised to one of two groups (prefabricated Foot Orthoses or flat shoe inserts). The primary outcome is worst knee pain severity during a self-nominated aggravating activity in the previous week (100 mm visual analogue scale) at 3 months, with a secondary endpoint at 12 months. Secondary outcomes include global rating of change, symptoms, function, health-related quality of life, kinesiophobia, self-efficacy and use of co-interventions for knee pain. Blinded, intention-to-treat analyses of primary and secondary patient-reported outcomes will be performed, as well as economic analyses. Ethics and dissemination Ethical approval has been granted by La Trobe University’s Human Ethics Committee and The University of Queensland’s Medical Research Ethics Committee. Study outcomes will be disseminated via peer-reviewed journals, conference presentations targeting a range of healthcare disciplines and an open access website with clinician resources. Trial registration number ANZCTRN12617000385347; Pre-results.
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Foot Orthoses for plantar heel pain a systematic review and meta analysis
British Journal of Sports Medicine, 2018Co-Authors: Glen A Whittaker, Shannon E Munteanu, Hylton B Menz, Chantel L Rabusin, Karl B LandorfAbstract:Objective To investigate the effectiveness of Foot Orthoses for pain and function in adults with plantar heel pain. Design Systematic review and meta-analysis. The primary outcome was pain or function categorised by duration of follow-up as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks). Data sources Medline, CINAHL, SPORTDiscus, Embase and the Cochrane Library from inception to June 2017. Eligibility criteria for selecting studies Studies must have used a randomised parallel-group design and evaluated Foot Orthoses for plantar heel pain. At least one outcome measure for pain or function must have been reported. Results A total of 19 trials (1660 participants) were included. In the short term , there was very low-quality evidence that Foot Orthoses do not reduce pain or improve function. In the medium term , there was moderate-quality evidence that Foot Orthoses were more effective than sham Foot Orthoses at reducing pain (standardised mean difference −0.27 (−0.48 to −0.06)). There was no improvement in function in the medium term. In the longer term , there was very low-quality evidence that Foot Orthoses do not reduce pain or improve function. A comparison of customised and prefabricated Foot Orthoses showed no difference at any time point. Conclusion There is moderate-quality evidence that Foot Orthoses are effective at reducing pain in the medium term, however it is uncertain whether this is a clinically important change.
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effectiveness of Foot Orthoses for the prevention of lower limb overuse injuries in naval recruits a randomised controlled trial
British Journal of Sports Medicine, 2018Co-Authors: Daniel R Bonanno, Shannon E Munteanu, Karl B Landorf, George S Murley, Hylton B MenzAbstract:Objectives To evaluate the effectiveness of prefabricated Foot Orthoses for the prevention of lower limb overuse injuries in naval recruits. Methods This study was a participant-blinded and assessor-blinded, parallel-group randomised controlled trial. Three-hundred and six participants aged 17–50 years who undertook 11 weeks of initial defence training at the Royal Australian Navy Recruit School (Cerberus, Australia) were randomised to a control group (flat insoles, n=153) or an intervention group (contoured, prefabricated Foot Orthoses, n=153). The combined incidence of medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy and plantar fasciitis/plantar heel pain during the 11-week training period were compared using incidence rate ratios (IRR). Data were analysed using the intention-to-treat principle. Results Sixty-seven injuries (21.9%) were recorded. The control and intervention group sustained 40 (26.1%) and 27 (17.6%) injuries, respectively (IRR 0.66, 95% CI 0.39 to 1.11, p=0.098). This corresponds to a 34% reduction in risk of developing medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy or plantar fasciitis/plantar heel for the intervention group compared with the control group. Participants in the prefabricated Orthoses group were more likely to report at least one adverse event (20.3% vs 12.4%; relative risk (RR) 1.63, 95% CI 0.96 to 2.76; p=0.068; number needed to harm 13, 95% CI 6 to 253). The most common adverse events were Foot blisters (n=20, 6.6%), arch pain (n=10, 3.3%) and shin pain (n=8, 2.6%). Conclusion Prefabricated Foot Orthoses may be beneficial for reducing the incidence of lower limb injury in naval recruits undertaking defence training. Trial registration number Australian New Zealand Clinical Trials Registry: ACTRN12615000024549.
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effectiveness of Foot Orthoses and shock absorbing insoles for the prevention of injury a systematic review and meta analysis
British Journal of Sports Medicine, 2017Co-Authors: Daniel R Bonanno, Shannon E Munteanu, Karl B Landorf, George S Murley, Hylton B MenzAbstract:Objective To investigate the evidence relating to the effectiveness of Foot Orthoses and shock-absorbing insoles for the prevention of musculoskeletal injury. Design Systematic review and meta-analysis. Eligibility criteria for selecting studies Clinical trials evaluating the effectiveness of Foot Orthoses and shock-absorbing insoles for the prevention of injury. Data sources Cochrane Library, CINAHL, EMBASE, MEDLINE and SPORTDiscus from their inception up to the first week of June 2016. Results 11 trials that had evaluated Foot Orthoses and 7 trials that had evaluated shock-absorbing insoles were included. The median Physiotherapy Evidence Database (PEDro) score for trials that had evaluated Foot Orthoses and shock-absorbing insoles was 5 (range 3–8/10) and 3 (range 1–7/10), respectively. Meta-analysis found that Foot Orthoses were effective for preventing overall injuries (risk ratio (RR) 0.72, 95% CI 0.55 to 0.94) and stress fractures (RR 0.59, 95% CI 0.45 to 0.76), but not soft-tissue injuries (RR 0.79, 95% CI 0.55 to 1.14). In contrast, shock-absorbing insoles were not effective for preventing overall injuries (RR 0.92, 95% CI 0.73 to 1.16), stress fractures (RR 1.15, 95% CI 0.57 to 2.32) or soft-tissue injuries (RR 0.92, 95% CI 0.74 to 1.15). Conclusions Foot Orthoses were found to be effective for preventing overall injuries and stress fractures but not soft-tissue injuries, while shock-absorbing insoles were not found to be effective for preventing any injury. However, further well-designed trials will assist the accuracy and precision of the estimates of risk reduction as the quality of the included trials varied greatly.
Richard R Neptune - One of the best experts on this subject based on the ideXlab platform.
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the influence of solid ankle Foot Orthoses on forward propulsion and dynamic balance in healthy adults during walking
Clinical Biomechanics, 2014Co-Authors: Arian Vistamehr, Steven A Kautz, Richard R NeptuneAbstract:Background In post-stroke hemiparetic subjects, solid polypropylene ankle-Foot-Orthoses are commonly prescribed to assist in Foot clearance during swing while bracing the ankle during stance. Mobility demands, such as changing walking speed and direction, are accomplished by accelerating or decelerating the body and maintaining dynamic balance. Previous studies have shown that the ankle plantarflexors are primary contributors to these essential biomechanical functions. Thus, with ankle-Foot-Orthoses limiting ankle motion and plantarflexor output during stance, execution of these walking subtasks may be compromised. This study examined the influence of a solid polypropylene ankle-Foot-orthosis on forward propulsion and dynamic balance in healthy adults.
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Selective Laser Sintered Versus Carbon Fiber Passive-Dynamic Ankle-Foot Orthoses: A Comparison of Patient Walking Performance
Journal of Biomechanical Engineering, 2014Co-Authors: Nicole G. Harper, Jason M Wilken, Elizabeth M Russell, Richard R NeptuneAbstract:Selective laser sintering (SLS) is a well-suited additive manufacturing technique for generating subject-specific passive-dynamic ankle-Foot Orthoses (PD-AFOs). However, the mechanical properties of SLS PD-AFOs may differ from those of commonly prescribed carbon fiber (CF) PD-AFOs. Therefore, the goal of this study was to determine if biomechanical measures during gait differ between CF and stiffness-matched SLS PD-AFOs. Subject-specific SLS PD-AFOs were manufactured for ten subjects with unilateral lower-limb impairments. Minimal differences in gait performance occurred when subjects used the SLS versus CF PD-AFOs. These results support the use of SLS PD-AFOs to study the effects of altering design characteristics on gait performance.
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manufacture of passive dynamic ankle Foot Orthoses using selective laser sintering
IEEE Transactions on Biomedical Engineering, 2008Co-Authors: Mario Faustini, Richard R Neptune, Richard H Crawford, Steven J StanhopeAbstract:Ankle-Foot orthosis (AFO) designs vary in size, shape, and functional characteristics depending on the desired clinical application. Passive Dynamic (PD) Response ankle-Foot Orthoses (PD-AFOs) constitute a design that seeks to improve walking ability for persons with various neuromuscular disorders by passively (like a spring) providing variable levels of support during the stance phase of gait. Current PD-AFO manufacturing technology is either labor intensive or not well suited for the detailed refinement of PD-AFO bending stiffness characteristics. The primary objective of this study was to explore the feasibility of using a rapid freeform prototyping technique, selective laser sintering (SLS), as a PD-AFO manufacturing process. Feasibility was determined by replicating the shape and functional characteristics of a carbon fiber AFO (CF-AFO). The study showed that a SLS-based framework is ideally suited for this application. A second objective was to determine the optimal SLS material for PD-AFOs to store and release elastic energy; considering minimizing energy dissipation through internal friction is a desired material characteristic. This study compared the mechanical damping of the CF-AFO to PD-AFOs manufactured by SLS using three different materials. Mechanical damping evaluation ranked the materials as Rilsantrade D80 (best), followed by DuraFormtrade PA and DuraFormtrade GF. In addition, Rilsantrade D80 was the only SLS material able to withstand large deformations.
Nollet Frans - One of the best experts on this subject based on the ideXlab platform.
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Description of orthotic properties and effect evaluation of ankle-Foot Orthoses in non-spastic calf muscle weakness
'Acta Dermato-Venereologica', 2020Co-Authors: Waterval, Niels F.j., Brehm, Merel Anne, Harlaar J., Nollet FransAbstract:Objective: To describe the orthotic properties and evaluate the effects of ankle-Foot Orthoses for calf muscle weakness in persons with non-spastic neuromuscular disorders compared with shoes-only. Design: Cross-sectional study. Subjects: Thirty-four persons who used ankle-Foot Orthoses for non-spastic calf muscle weakness. Methods: The following orthotic properties were measured: ankle-Foot orthosis type, mass, and ankle and Footplate stiffness. For walking with shoes- only and with the ankle-Foot Orthoses, walking speed, energy cost and gait biomechanics were assessed. Results: Four types of ankle-Foot orthosis were identified: shaft-reinforced orthopaedic shoes (n = 6), ventral ankle-Foot Orthoses (n = 10), dorsal leaf ankle-Foot Orthoses (n = 12) and dorsiflexion-stop ankle-Foot Orthoses (n = 6). These types differed significantly with regards to mass, ankle-and Footplate stiffness. Compared with shoes-only, all ankleFoot Orthoses/orthopaedic shoes groups combined increased walking speed by 0.18 m/s (95% confidence interval (95% CI) 0.13-0.23), reduced energy cost by 0.70 J/kg/m (95% CI 0.48-0.94) and limited ankle dorsiflexion by -3.0° (95% CI 1.3-4.7). Higher ankle-Foot Orthoses ankle stiffness correlated with greater reductions in walking energy cost and maximal ankle dorsiflexion angle. Conclusion: Ankle-Foot Orthoses for persons with non-spastic calf muscle weakness vary greatly in properties and effects on gait. The large variation in effectiveness may be due to differences in ankle stiffness, although this requires further prospective evaluation.Biomechatronics & Human-Machine Contro
Karl B Landorf - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of Foot Orthoses for the prevention of lower limb overuse injuries in naval recruits a randomised controlled trial
British Journal of Sports Medicine, 2018Co-Authors: Daniel R Bonanno, Shannon E Munteanu, Karl B Landorf, George S Murley, Hylton B MenzAbstract:Objectives To evaluate the effectiveness of prefabricated Foot Orthoses for the prevention of lower limb overuse injuries in naval recruits. Methods This study was a participant-blinded and assessor-blinded, parallel-group randomised controlled trial. Three-hundred and six participants aged 17–50 years who undertook 11 weeks of initial defence training at the Royal Australian Navy Recruit School (Cerberus, Australia) were randomised to a control group (flat insoles, n=153) or an intervention group (contoured, prefabricated Foot Orthoses, n=153). The combined incidence of medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy and plantar fasciitis/plantar heel pain during the 11-week training period were compared using incidence rate ratios (IRR). Data were analysed using the intention-to-treat principle. Results Sixty-seven injuries (21.9%) were recorded. The control and intervention group sustained 40 (26.1%) and 27 (17.6%) injuries, respectively (IRR 0.66, 95% CI 0.39 to 1.11, p=0.098). This corresponds to a 34% reduction in risk of developing medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy or plantar fasciitis/plantar heel for the intervention group compared with the control group. Participants in the prefabricated Orthoses group were more likely to report at least one adverse event (20.3% vs 12.4%; relative risk (RR) 1.63, 95% CI 0.96 to 2.76; p=0.068; number needed to harm 13, 95% CI 6 to 253). The most common adverse events were Foot blisters (n=20, 6.6%), arch pain (n=10, 3.3%) and shin pain (n=8, 2.6%). Conclusion Prefabricated Foot Orthoses may be beneficial for reducing the incidence of lower limb injury in naval recruits undertaking defence training. Trial registration number Australian New Zealand Clinical Trials Registry: ACTRN12615000024549.
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Foot Orthoses for plantar heel pain a systematic review and meta analysis
British Journal of Sports Medicine, 2018Co-Authors: Glen A Whittaker, Shannon E Munteanu, Hylton B Menz, Chantel L Rabusin, Karl B LandorfAbstract:Objective To investigate the effectiveness of Foot Orthoses for pain and function in adults with plantar heel pain. Design Systematic review and meta-analysis. The primary outcome was pain or function categorised by duration of follow-up as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks). Data sources Medline, CINAHL, SPORTDiscus, Embase and the Cochrane Library from inception to June 2017. Eligibility criteria for selecting studies Studies must have used a randomised parallel-group design and evaluated Foot Orthoses for plantar heel pain. At least one outcome measure for pain or function must have been reported. Results A total of 19 trials (1660 participants) were included. In the short term , there was very low-quality evidence that Foot Orthoses do not reduce pain or improve function. In the medium term , there was moderate-quality evidence that Foot Orthoses were more effective than sham Foot Orthoses at reducing pain (standardised mean difference −0.27 (−0.48 to −0.06)). There was no improvement in function in the medium term. In the longer term , there was very low-quality evidence that Foot Orthoses do not reduce pain or improve function. A comparison of customised and prefabricated Foot Orthoses showed no difference at any time point. Conclusion There is moderate-quality evidence that Foot Orthoses are effective at reducing pain in the medium term, however it is uncertain whether this is a clinically important change.
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effectiveness of Foot Orthoses and shock absorbing insoles for the prevention of injury a systematic review and meta analysis
British Journal of Sports Medicine, 2017Co-Authors: Daniel R Bonanno, Shannon E Munteanu, Karl B Landorf, George S Murley, Hylton B MenzAbstract:Objective To investigate the evidence relating to the effectiveness of Foot Orthoses and shock-absorbing insoles for the prevention of musculoskeletal injury. Design Systematic review and meta-analysis. Eligibility criteria for selecting studies Clinical trials evaluating the effectiveness of Foot Orthoses and shock-absorbing insoles for the prevention of injury. Data sources Cochrane Library, CINAHL, EMBASE, MEDLINE and SPORTDiscus from their inception up to the first week of June 2016. Results 11 trials that had evaluated Foot Orthoses and 7 trials that had evaluated shock-absorbing insoles were included. The median Physiotherapy Evidence Database (PEDro) score for trials that had evaluated Foot Orthoses and shock-absorbing insoles was 5 (range 3–8/10) and 3 (range 1–7/10), respectively. Meta-analysis found that Foot Orthoses were effective for preventing overall injuries (risk ratio (RR) 0.72, 95% CI 0.55 to 0.94) and stress fractures (RR 0.59, 95% CI 0.45 to 0.76), but not soft-tissue injuries (RR 0.79, 95% CI 0.55 to 1.14). In contrast, shock-absorbing insoles were not effective for preventing overall injuries (RR 0.92, 95% CI 0.73 to 1.16), stress fractures (RR 1.15, 95% CI 0.57 to 2.32) or soft-tissue injuries (RR 0.92, 95% CI 0.74 to 1.15). Conclusions Foot Orthoses were found to be effective for preventing overall injuries and stress fractures but not soft-tissue injuries, while shock-absorbing insoles were not found to be effective for preventing any injury. However, further well-designed trials will assist the accuracy and precision of the estimates of risk reduction as the quality of the included trials varied greatly.
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effectiveness of customised Foot Orthoses for achilles tendinopathy a randomised controlled trial
British Journal of Sports Medicine, 2015Co-Authors: Shannon E Munteanu, Karl B Landorf, Lisa A Scott, Daniel R Bonanno, Tania Pizzari, Jillianne Leigh Cook, Hylton B MenzAbstract:Aim To evaluate the effectiveness of customised Foot Orthoses in chronic mid-portion Achilles tendinopathy. Methods This was a participant-blinded, parallel-group randomised controlled trial at a single centre (La Trobe University, Melbourne, Australia). One hundred and forty participants aged 18–55 years with mid-portion Achilles tendinopathy were randomised to receive eccentric calf muscle exercises with either customised Foot Orthoses (intervention group) or sham Foot Orthoses (control group). Allocation to intervention was concealed. The Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire was completed at baseline, then at 1, 3, 6 and 12 months, with 3 months being the primary end point. Differences between groups were analysed using intention to treat with analysis of covariance. Results After randomisation into the customised Foot Orthoses group (n=67) or sham Foot Orthoses group (n=73), there was 70.7% follow-up of participants at 3 months. There were no significant differences between groups at any time point. At 3 months, the mean (SD) VISA-A score was 82.1 (16.3) and 79.2 (20.0) points for the customised and sham Foot orthosis groups, respectively (adjusted mean difference (95% CI)=2.6 (−2.9 to 8.0), p=0.353). There were no clinically meaningful differences between groups in any of the secondary outcome measures. Conclusions Customised Foot Orthoses, prescribed according to the protocol in this study, are no more effective than sham Foot Orthoses for reducing symptoms and improving function in people with mid-portion Achilles tendinopathy undergoing an eccentric calf muscle exercise programme. Trial Registration Number Australian New Zealand Clinical Trials Registry: number ACTRN12609000829213.
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the effect of customised and sham Foot Orthoses on plantar pressures
Journal of Foot and Ankle Research, 2013Co-Authors: Chris J Mccormick, Daniel R Bonanno, Karl B LandorfAbstract:The effectiveness of Foot Orthoses has been evaluated in many clinical trials with sham Foot Orthoses used as the control intervention in at least 10 clinical trials. However, the mechanical effects and credibility of sham Orthoses has been rarely quantified. This study aimed to: (i) compare the effects on plantar pressures of three sham Foot Orthoses to a customised Foot orthosis, and (ii) establish the perceived credibility and the expected benefit of each orthotic condition. Thirty adults aged between 18 and 51 participated in this study. At 0 and 4 weeks, plantar pressure data were collected for the heel, midFoot and foreFoot using the pedar®-X in-shoe system for the following five randomly assigned conditions: (i) shoe alone, (ii) customised Foot orthosis, (iii) contoured polyethylene sham Foot orthosis, (iv) contoured EVA sham Foot orthosis, and (v) flat EVA sham Foot orthosis. At the initial data collection session, each participant completed a Credibility/Expectancy Questionnaire (CEQ) to determine the credibility and expected benefit of each orthotic condition. Compared to the shoe alone at week 0, the contoured polyethylene sham orthosis was the only condition to not significantly effect peak pressure at any region of the Foot. In contrast, the contoured EVA sham orthosis, the flat EVA sham orthosis and the customised orthosis significantly reduced peak pressure at the heel. At the medial midFoot, all sham Orthoses provided the same effect as the shoe alone, which corresponded to effects that were significantly different to the customised orthosis. There were no differences in peak pressure between conditions at the other mask regions, the lateral midFoot and foreFoot. When the conditions were compared at week 4, the differences between the conditions were generally similar to the findings observed at week 0. With respect to credibility and expected benefit, all orthotic conditions were considered the same with the exception of the contoured polyethylene sham orthosis, which was perceived as being less credible and less likely to provide benefits. The findings of this study indicate that all of the sham Orthoses tested provided the same effect on plantar pressures at the midFoot and foreFoot as a shoe alone. However, the contoured EVA sham orthosis and the flat EVA sham orthosis significantly reduced peak pressure under the heel, which was similar to the customised orthosis. In contrast, the contoured polyethylene sham orthosis had no significant effect on plantar pressure and was comparable to the shoe alone at all regions of the Foot. Hence, lower plantar pressures were found under the heel with some sham Orthoses, but not with others. Importantly, participants perceived the polyethylene sham orthosis – the sham that had no effect on plantar pressure – to be the least credible orthosis and the least likely to provide benefits. This may be critical for the design of future clinical trials as it may introduce confounding effects that produce inaccurate results. These findings provide some evidence for the mechanical effects, treatment credibility and expected benefit of sham Foot Orthoses, which should be considered when they are used as a control intervention in a clinical trial.