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Effects of a contoured foot orthosis versus a flat sham insert on plantar loading in midfoot osteoarthritis

Review written by Ian Griffiths info

Key Points

  1. A shaped, arch-contouring insole redistributes plantar load in a targeted and meaningful way in midfoot OA.
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BACKGROUND & OBJECTIVE

Midfoot osteoarthritis (OA) is a common and often debilitating condition, affecting approximately 12-17% of adults aged 50 and over (1-3). Compared to OA affecting other regions of the foot, midfoot OA is particularly associated with chronic pain and reduced physical function (3) and can significantly impact a person's ability to walk and perform everyday activities. Foot orthoses (FO) are recommended as part of conservative management, with the aim of reducing pain and improving function (4).

Previous work has shown that FO not only reduce pain, but also any associated medial midfoot bone marrow lesions in people with foot pain (5). Biomechanical research has shown that increased plantar loading at the medial midfoot is associated with pain and disability in people with midfoot OA (6) providing a theoretical basis for the use of arch-contouring FO designs.

The aim of this study was to compare the effects of arch contouring FO with flat sham inserts with respect to the plantar loading during walking in a population of adults with symptomatic midfoot OA.

Midfoot osteoarthritis (OA) is a common and often debilitating condition, affecting approximately 12-17% of adults aged 50 and over.
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Prefabricated arch-contouring orthoses are a biomechanically reasonable first-line choice for midfoot OA, and the medial midfoot should probably be the target.

METHODS

  • This was a plantar pressure sub-study nested within a participant and assessor-blinded, parallel-group randomized controlled trial (RCT) (7). 42 adults (38 women, four men; mean age 66 years) with radiographically confirmed, symptomatic midfoot OA were included from a larger trial
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