Foot orthoses and gait: a systematic review and meta-analysis of literature pertaining to potential mechanisms

C Mills, Andrew Chapman, T McPhoil, Bill Vicenzino

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

This article systematically reviews the available literature to improve our understanding of the physiological basis for orthoses under the kinematic, shock attenuation and neuromotor control paradigms. The propositions made under these three paradigms have not been systematically reviewed collectively, and as such, there is no single-point synthesis of this clinically relevant body of evidence and somewhat disparate fi ndings. Our comprehensive search strategy yielded 22 papers. Under each paradigm, the role of orthoses with different design features including combinations of posting, moulding and density was analysed. Where possible, data have been pooled to provide an increased level of confi dence in fi ndings. The main fi ndings in the kinematic paradigm were that posted non-moulded orthoses systematically reduced peak rearfoot eversion (2.12° (95% CI 0.72 to 3.53)) and tibial internal rotation (1.33° (0.12 to 2.53)) in non-injured cohorts. In the shock attenuation paradigm, it was found that non-posted moulded and posted moulded orthoses produced large reductions in loading rate and vertical impact force when compared with a control and to a posted non-moulded orthosis. The neuromotor control paradigm seems to be the least conclusive in its outcome. Based on our review, this paper concludes with rudimentary guidelines for the prescription of orthosis, that sports medicine practitioners may use in their clinical decision-making process. The need for further research focusing on the role of injury, particularly in neuromotor control modifi cation and long-term adaptation to orthoses, was highlighted.
Original languageEnglish
Pages (from-to)1035-1046
Number of pages12
JournalBritish Journal of Sports Medicine
Volume44
Issue number14
DOIs
Publication statusPublished - 2010
Externally publishedYes

Fingerprint

Foot Orthoses
Orthotic Devices
Gait
Meta-Analysis
Biomechanical Phenomena
Shock
Sports Medicine
Prescriptions
Cations
Guidelines
Wounds and Injuries

Cite this

Mills, C ; Chapman, Andrew ; McPhoil, T ; Vicenzino, Bill. / Foot orthoses and gait: a systematic review and meta-analysis of literature pertaining to potential mechanisms. In: British Journal of Sports Medicine. 2010 ; Vol. 44, No. 14. pp. 1035-1046.
@article{f219b72cd36c4fde95311a6ba9872dda,
title = "Foot orthoses and gait: a systematic review and meta-analysis of literature pertaining to potential mechanisms",
abstract = "This article systematically reviews the available literature to improve our understanding of the physiological basis for orthoses under the kinematic, shock attenuation and neuromotor control paradigms. The propositions made under these three paradigms have not been systematically reviewed collectively, and as such, there is no single-point synthesis of this clinically relevant body of evidence and somewhat disparate fi ndings. Our comprehensive search strategy yielded 22 papers. Under each paradigm, the role of orthoses with different design features including combinations of posting, moulding and density was analysed. Where possible, data have been pooled to provide an increased level of confi dence in fi ndings. The main fi ndings in the kinematic paradigm were that posted non-moulded orthoses systematically reduced peak rearfoot eversion (2.12° (95{\%} CI 0.72 to 3.53)) and tibial internal rotation (1.33° (0.12 to 2.53)) in non-injured cohorts. In the shock attenuation paradigm, it was found that non-posted moulded and posted moulded orthoses produced large reductions in loading rate and vertical impact force when compared with a control and to a posted non-moulded orthosis. The neuromotor control paradigm seems to be the least conclusive in its outcome. Based on our review, this paper concludes with rudimentary guidelines for the prescription of orthosis, that sports medicine practitioners may use in their clinical decision-making process. The need for further research focusing on the role of injury, particularly in neuromotor control modifi cation and long-term adaptation to orthoses, was highlighted.",
author = "C Mills and Andrew Chapman and T McPhoil and Bill Vicenzino",
year = "2010",
doi = "10.1136/bjsm.2009.066977",
language = "English",
volume = "44",
pages = "1035--1046",
journal = "British Journal of Sports Medicine",
issn = "0306-3674",
publisher = "BMJ Publishing Group",
number = "14",

}

Foot orthoses and gait: a systematic review and meta-analysis of literature pertaining to potential mechanisms. / Mills, C; Chapman, Andrew; McPhoil, T; Vicenzino, Bill.

In: British Journal of Sports Medicine, Vol. 44, No. 14, 2010, p. 1035-1046.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Foot orthoses and gait: a systematic review and meta-analysis of literature pertaining to potential mechanisms

AU - Mills, C

AU - Chapman, Andrew

AU - McPhoil, T

AU - Vicenzino, Bill

PY - 2010

Y1 - 2010

N2 - This article systematically reviews the available literature to improve our understanding of the physiological basis for orthoses under the kinematic, shock attenuation and neuromotor control paradigms. The propositions made under these three paradigms have not been systematically reviewed collectively, and as such, there is no single-point synthesis of this clinically relevant body of evidence and somewhat disparate fi ndings. Our comprehensive search strategy yielded 22 papers. Under each paradigm, the role of orthoses with different design features including combinations of posting, moulding and density was analysed. Where possible, data have been pooled to provide an increased level of confi dence in fi ndings. The main fi ndings in the kinematic paradigm were that posted non-moulded orthoses systematically reduced peak rearfoot eversion (2.12° (95% CI 0.72 to 3.53)) and tibial internal rotation (1.33° (0.12 to 2.53)) in non-injured cohorts. In the shock attenuation paradigm, it was found that non-posted moulded and posted moulded orthoses produced large reductions in loading rate and vertical impact force when compared with a control and to a posted non-moulded orthosis. The neuromotor control paradigm seems to be the least conclusive in its outcome. Based on our review, this paper concludes with rudimentary guidelines for the prescription of orthosis, that sports medicine practitioners may use in their clinical decision-making process. The need for further research focusing on the role of injury, particularly in neuromotor control modifi cation and long-term adaptation to orthoses, was highlighted.

AB - This article systematically reviews the available literature to improve our understanding of the physiological basis for orthoses under the kinematic, shock attenuation and neuromotor control paradigms. The propositions made under these three paradigms have not been systematically reviewed collectively, and as such, there is no single-point synthesis of this clinically relevant body of evidence and somewhat disparate fi ndings. Our comprehensive search strategy yielded 22 papers. Under each paradigm, the role of orthoses with different design features including combinations of posting, moulding and density was analysed. Where possible, data have been pooled to provide an increased level of confi dence in fi ndings. The main fi ndings in the kinematic paradigm were that posted non-moulded orthoses systematically reduced peak rearfoot eversion (2.12° (95% CI 0.72 to 3.53)) and tibial internal rotation (1.33° (0.12 to 2.53)) in non-injured cohorts. In the shock attenuation paradigm, it was found that non-posted moulded and posted moulded orthoses produced large reductions in loading rate and vertical impact force when compared with a control and to a posted non-moulded orthosis. The neuromotor control paradigm seems to be the least conclusive in its outcome. Based on our review, this paper concludes with rudimentary guidelines for the prescription of orthosis, that sports medicine practitioners may use in their clinical decision-making process. The need for further research focusing on the role of injury, particularly in neuromotor control modifi cation and long-term adaptation to orthoses, was highlighted.

U2 - 10.1136/bjsm.2009.066977

DO - 10.1136/bjsm.2009.066977

M3 - Article

VL - 44

SP - 1035

EP - 1046

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

IS - 14

ER -