Hemiplegic patients with an ankle foot orthosis (AFO) has a tendency to show external rotation of affected side foot. External rotation inhibiting shoes (ERIS) were designed to inhibit excessive rotation of hemiplegic foot. ERIS were applied to two hemiplegic patients who were able to walk independently with a plastic AFO. Both of them showed an excessive external rotation of hemiplegic foot after AFO apply. Each patient tried to walk with a pair of common shoes first and ERIS later. The external rotation angle, step length, stride length, cadence, speed were measured by footprint method. The external rotation angle of hemiplegic foot was significantly decreased with ERIS than with common shoes. However they did not show consistent improvement in the step length, stride length, cadence and speed. We reported that hemiplegic patients who walked with ERIS showed remarkable reduction in excessive external rotation of hemiplegic foot.
Ankle* ; Foot Orthoses* ; Foot* ; Humans ; Plastics* ; Shoes*

OBJECTIVE: To identify change of the radiologic indicators known to reflect height of medial longitudinal arch between with and without foot orthosis on flatfoot in children with cerebral palsy. METHOD: 15 children with cerebral palsy, which were diagnosed as pes planus by bio-mechanical examination and foot print test, were participated in this study. Initial radiologic study (foot anteroposterior and lateral view with standing position) had been done with shoe only and then second radiologic study with shoe and foot orthosis as same method. 3 months after, third radiologic study were performed with shoe only. Radiologic indicators were measured at each radiologic studies. Radiologic indicators measured at intial study were compared with both second and third study. RESULTS: In comparing initial radiologic study with second, consistently changed radiologic indicators toward corrective direction were calcaneometatarsal angle, navicular height, arch height ratio, arch height angle, talometatarsal angle in anteroposterior view. The other five indicators were variable in increase or decrease of change. There were no interval changes of radiologic indicators comparing at initial study with third study. CONCLUSION: Calcaneometatarsal angle, arch height ratio, arch height angle, and talometatarsal angle were consistently changed, simply measurable radiologic indicators for evaluation of pes planus in children with cerebral palsy.
Cerebral Palsy* ; Child* ; Flatfoot* ; Foot Orthoses* ; Foot* ; Humans ; Shoes

OBJECTIVE: To evaluate the therapeutic effect of a Tibia Counter Rotator (TCR) with toe-out gait plate (GP) upon tibial internal torsion by a comparative analysis of transmalleolar angle (TMA) and gait analysis with GP alone. METHODS: Twenty participants with tibial internal torsion were recruited for this study. Each 10 participants were included in group A with TCR and GP application and in group B with GP application only. The TMA and the kinematic results were used for the evaluation of the therapeutic effects of orthoses. RESULTS: Within each group, TMA showed a significant increase after treatment. Group A showed a continuous improvement up to six months, however, group B showed an improvement up to five months only. Group A showed a significantly higher correction effect than group B after treatment. Regarding kinematic data, both groups showed a significantly decreased mean ankle adduction angle after treatment. However, group A showed a significantly lower mean ankle adduction angle than group B after six months. CONCLUSION: The group with TCR and GP showed a significantly better outcome and continued correction force compared to the group with GP only. Our results suggest that TCR with GP may be useful therapeutic orthoses for children with tibial internal torsion.
Ankle ; Child* ; Foot Orthoses ; Gait* ; Humans ; Orthotic Devices ; Tibia*

OBJECTIVE: To evaluate the therapeutic effect of a Tibia Counter Rotator (TCR) with toe-out gait plate (GP) upon tibial internal torsion by a comparative analysis of transmalleolar angle (TMA) and gait analysis with GP alone. METHODS: Twenty participants with tibial internal torsion were recruited for this study. Each 10 participants were included in group A with TCR and GP application and in group B with GP application only. The TMA and the kinematic results were used for the evaluation of the therapeutic effects of orthoses. RESULTS: Within each group, TMA showed a significant increase after treatment. Group A showed a continuous improvement up to six months, however, group B showed an improvement up to five months only. Group A showed a significantly higher correction effect than group B after treatment. Regarding kinematic data, both groups showed a significantly decreased mean ankle adduction angle after treatment. However, group A showed a significantly lower mean ankle adduction angle than group B after six months. CONCLUSION: The group with TCR and GP showed a significantly better outcome and continued correction force compared to the group with GP only. Our results suggest that TCR with GP may be useful therapeutic orthoses for children with tibial internal torsion.
Ankle ; Child* ; Foot Orthoses ; Gait* ; Humans ; Orthotic Devices ; Tibia*

OBJECTIVE: This study was designed to analyse quantitatively the change in rigidity of plastic ankle foot orthoses (AFOs) corresponding with regulated ankle width and to find the appropriate ankle width for spastic ankles. METHOD: Five different plastic AFOs were fabricated according to the regulated ankle width. The resistance to dorsiflexion and plantar flexion movements was measured by bending the plastic AFOs at intervals of 2 degrees with the measuring device. Plantar flexion moments of hemiplegic spastic ankles were also measured. RESULTS: The rigidity of plastic AFOs increased nearly in proportion to the increase of the ankle width. The plantar flexion moments of hemiplegic spastic ankles increased in proportion to the severity of the spasticity. If the plastic AFOs would be used only for the prevention of toe dragging in swing phase, the ankle width of plastic AFOs could be reduced up to 60% which was enough to support the ankle in swing phase. CONCLUSION: These findings suggested that the degree of rigidity of plastic AFOs could be adjusted by trimming about the ankle to meet the individual patient's requirement. And this study could be helpful to quantify empirical approach of the prescription of plastic AFOs.
Ankle* ; Foot Orthoses ; Muscle Spasticity ; Orthotic Devices* ; Plastics* ; Prescriptions ; Toes

OBJECTIVE: To evaluate the effect of custom-molded foot orthoses on foot pain and balance in children with symptomatic flexible flat foot 1 month and 3 months after fitting foot orthosis. METHOD: A total of 24 children over 6 years old with flexible flat feet and foot pain for at least 6 months were recruited for this study. Their resting calcaneal stance position and calcaneal pitch angle were measured. Individual custom-molded rigid foot orthoses were prescribed using inverted orthotic technique to control foot overpronation. Pain questionnaire was used to obtain pain sites, degree, and frequency. Balancing ability was determined using computerized posturography. These evaluations were performed prior to custom-molded foot orthoses, 1 month, and 3 months after fitting foot orthoses. RESULT: Of 24 children with symptomatic flexible flat feet recruited for this study, 20 completed the study. Significant (p<0.001) improvements in pain degree and frequency were noted after 1 and 3 months of custom-molded foot orthoses. In addition, significant (p<0.05) improvement in balancing ability was found after 3 months of custom-molded foot orthoses. CONCLUSION: Short-term use of custom-molded foot orthoses significantly improved foot pain and balancing ability in children with symptomatic flexible flat foot.
Child* ; Flatfoot* ; Foot Orthoses* ; Foot* ; Humans ; Musculoskeletal Pain ; Pediatrics ; Postural Balance

Biomechanical abnormalities of pronated feet accompanied by functional leg length disparity may increase the risk of skeletal muscle injury. Objective of the study is to prove that correction of pronated feet by the foot orthoses will reduce the creatine kinase-MM (CK-MM) concentrations as the muscle injury indicator. The design study was double blind randomized clinical trials with control. Research subjects were divided into two groups, group 1 used the foot orthoses while group 2 did not used the foot orthoses. The whole subject examined the concentrations of the CK-MM enzyme before, and 24–72 hours after the walking test. The walking test was conducted 15 minutes with maximum speed. The concentration of the CK-MM enzyme before walking test on treatment group was 70.07±15.33 International Unit (IU), similar with the control group was 69.85±17.03 IU (P=0.971). The increased in CK-MM enzyme concentrations 45 hours after the walking test was lower in the treatment group (7.8±9 IU) than the control group (22.0±11.5 IU) (P=0.001). The CK-MM enzyme concentrations continued to decline in the treatment group after the second walking test (77.21±17.47 IU), and after the third walking test (69.86±11.88 IU) (P=0.018). The foot orthoses for correcting the pronated feet on the young women with biomechanical abnormalities is able to reduce the degree of the skeletal muscle injury after walking activity.
Creatine ; Female ; Foot Orthoses ; Foot* ; Humans ; Leg ; Muscle, Skeletal* ; Research Subjects ; Walking

PURPOSE: The purpose of this study was to evaluate pressure distribution on the foot with the use of custom made foot orthosis and evaluate influential factors in young people using custom orthosis. MATERIALS AND METHODS: 22 individuals comprised of young males and females were evaluated by radiograph, pedobarograph, and satisfaction rate and VAS score. The data was analyzed statistically to find influential factors for satisfaction after wearing the foot orthosis. RESULTS: Around 50% of participants were satisfied in wearing the custom made foot orthosis. Initial VAS score of satisfaction of 36.2+/-19.7 improved to 73.1+/-15.6 after application of foot orthosis. There was a statistically significant difference. Talo-second metatarsal angle on AP radiograph after orthosis application was significantly related to satisfaction. On analysis of pedobarograph data, total contact area was increased and weight distribution was transferred medially on ambulation with the orthosis applied. CONCLUSION: Before designing the foot orthosis, individual foot factors such as foot anatomy and foot pressure distribution should be evaluated for foot comfort and better patient satisfaction.
Female ; Foot Orthoses* ; Foot* ; Humans ; Male ; Metatarsal Bones ; Orthotic Devices ; Patient Satisfaction ; Walking

Stroke survivors with gait disturbances may use ankle foot orthoses (AFOs). However, most AFOs come in one-piece styles, which make it difficult for spasticity-affected stroke survivors to don. AFOs are also limited since they do not properly prevent ankle joint for foot drop by itself. Therefore, the present study developed a novel hinged AFO by adding a locking device to a hinged joint. We then tested its feasibility in 9 hemiplegic stroke survivors by investigating temporal–spatial gait parameters using the GAITRite in the following 3 conditions: no AFO, traditional AFO, and novel hinged AFO. There was no significant difference in spatiotemporal gait parameters among the different conditions. There were greater decreases in gait velocity, cadence, step length, and stride length in the novel hinged AFO group than in the no AFO and traditional AFO groups. This novel hinged AFO was developed to prevent foot drop. However, the AFO did not show significant differences in gait parameters because it consists of metal with extra weight and volume. Functionally, it prevented foot drop. It also improved convenience by its releasable design. Thus, further studies are needed to develop an AFO that improves gait and is convenient to use for hemiplegic stroke survivors.
Ankle Joint ; Ankle* ; Feasibility Studies* ; Foot Orthoses* ; Foot* ; Gait* ; Humans ; Joints ; Stroke* ; Survivors*

OBJECTIVE: To evaluate the long-term effect of a custom-made rigid foot orthosis (RFO) in children older than 6 years with pes planus (flat foot). METHODS: Medical records of 42 children diagnosed with flexible pes planus who were fitted with RFOs based on the inverted technique and underwent more than four consecutive radiological studies were reviewed. Resting calcaneal stance position (RCSP), anteroposterior talocalcaneal angle, lateral talocalcaneal angle, lateral talometatarsal angle, and calcaneal pitch were initially measured in both feet to evaluate alignment. Followup clinical and radiological evaluations were then performed at 12–18, 24–30, 36–42, and ≥48 months after RFO application. Repeated measures analysis of variance was used to evaluate significant differences. RESULTS: Significant improvements in all radiological indicators and significant progression of RCSP toward the corrective direction were observed after RFO application relative to baseline measurements. CONCLUSION: According to our findings, RFO can induce significant improvements in calcaneus-related radiographic indices and subsequently improve talus-related radiologic indices.
Child ; Flatfoot ; Follow-Up Studies ; Foot Orthoses ; Foot ; Humans ; Medical Records