BASIC SCIENCE REVIEW

Foot Orthoses
A Review Focusing on Kinematics
Thierry Larose Chevalier, BSc*
Nachiappan Chockalingam, PhD*

Orthoses have been broadly used by clinicians to treat mechanical misalignments, such
as abnormal foot pronation. As such, the influences of orthoses on lower-limb kinematics
have been studied numerous times, with many articles reporting nonsystematic results;
the aim of this review, therefore, was to examine the recognized effects of foot orthoses
on lower-limb kinematics. The findings from this review suggest that foot orthoses seem
to have certain generic and common effects on the lower limb when designed to control
rearfoot pronation. We also discuss the possible reasons behind the lack of consistent
results between studies. Based on the findings, a list of recommendations is presented
for future research on foot orthoses to facilitate comparisons between studies and
enable the scientific and clinical communities to better comprehend the effects that these
variables might have on the kinematics and, possibly, the treatment outcomes. (J Am
Podiatr Med Assoc 101(4): 341-348, 2011)

Over time, what can be considered a small deviation induce an actual change in musculoskeletal func-
from normal gait can lead to a variety of lower-limb tion. Other devices are referred to as prefabricated
disorders.1 Orthoses have been broadly used by FOs (PFOs) to differentiate the two manufacturing
clinicians in an attempt to treat these mechanical processes and their potential effects. While outlin-
misalignments, which include abnormal foot prona- ing the effectiveness of FOs, this study looked at the
tion. As such, the influences of orthoses on lower- research evidence leading to the influence of FOs on
limb kinematics have been studied numerous times. rearfoot inversion/eversion, dorsiflexion/plantar-
However, their effects are still thought to be flexion, and tibial rotation.
equivocal and not fully understood. The aim of this
review, therefore, was to examine the known Methods
effects of foot orthoses on lower-limb kinematics.
Foot orthosis (FO) is a generic term describing For the purposes of this review, the following
any type of foot device (eg, cushioned footbeds, databases were searched for articles published in
forefoot/rearfoot posts, and molded heel cups). English and French between 1990 and 2009:
Although FO can be used as an umbrella term, PubMed, MEDLINE, Scholars Portal, and SPORT-
more specific terminology should be used to allow Discus. The following key words were used:
any type of comparison between devices. It is, thus, orthosis (and its derivatives), foot, prefabricated,
imperative that the type of FOs used and assessed in and kinematics. Owing to the nature of the field of
each study be specified and described in detail to research, no strict inclusion/exclusion criteria were
enable the reader to associate a specific type of used to select the studies.
device with its potential effects. The available
definitions from the International Organization for
Standardization are given in Table 1.2-4
Are They Effective?
On the basis of these definitions, this review Foot orthoses are commonly used to treat a variety
considers only custom-fabricated FOs (CFOs) that of lower-limb problems, pain symptoms, and inju-
*Faculty of Health, Staffordshire University, Stoke on Trent, ries and are broadly considered to be effective in
United Kingdom. treating many lower-limb abnormalities. Indeed,
Corresponding author: Thierry Larose Chevalier, BSc,
Faculty of Health, Staffordshire University, Leek Road,
there is an overwhelming amount of clinical and
Stoke on Trent, ST4 2DF, United Kingdom. (E-mail: scientific evidence demonstrating the efficacy of
t.larosechevalier@staffs.ac.uk) FOs in treating a wide range of lower-extremity

Journal of the American Podiatric Medical Association  Vol 101  No 4  July/August 2011 341
Table 1. Terminology and Corresponding Definitions as Established by the International Organization for Standardization
Terminology Definition

Orthosis, orthotic device Externally applied device used to modify the structural and functional characteristics of the
neuromuscular and skeletal systems
Foot orthosis Orthosis that encompasses the whole or part of the foot
Custom-fabricated orthosis Device that is designed and manufactured to meet the functional requirements of the individual
user based on information such as molds, models, measurements, and images
Prefabricated orthosis Device that has been designed to meet particular functional requirements and is normally
available in a range

abnormalities. Since 2000, positive outcomes have etal control and seem to influence only the energy
been reported using various FO designs to treat absorption properties of the shoe’s original insoles.
patellofemoral pain syndrome,5, 6 plantar fasciitis,7 It is difficult to evaluate the extent to which
rheumatoid arthritis,8 and even juvenile idiopathic commercially available FOs resemble or differ from
arthritis.9 Most studies6-9 also reported a success CFOs because there are many different PFO
rate greater than 60% when patients were ques- designs, each with different characteristics. Never-
tioned about overall pain reduction. Through a theless, based on the promising results of the
satisfaction survey sent to patients (n = 275) with a previously mentioned studies, PFOs deserve to be
variety of pain symptoms and conditions, Walter et examined in more detail.
al10 established that only a small percentage (9%)
had not been satisfied with their CFOs, again Kinematics
providing a clinically sound basis for using such
treatment in a diversity of patients. Rearfoot Inversion-Eversion
Based on these references and also supported by
previous anecdotal evidence and clinical case Foot orthoses are often prescribed to modify the
studies, there seems to be sufficient evidence frontal plane movement in the rearfoot and, thus,
available in the literature suggesting the usefulness correct foot misalignments. Part of the treatment
of such devices in treating lower-extremity disor- can be to place the subtalar joint in a position to
ders. Nonetheless, further research is still warrant- decrease rearfoot eversion29, 30 by supporting the
ed in cases where patients do not achieve the medial longitudinal arch or by medially posting the
desired treatment outcomes to understand the rearfoot portion of the FO. Kitaoka et al31 examined
causes of the lack of success. the effects of two types of PFOs on arch height and
tarsal bone position during simulated midstance
using cadaveric feet. A significant decrease in
Prefabricated Orthoses rearfoot eversion was achieved using one of the
PFOs and a trend toward significance (P = .051)
Although several studies have focused on the effects with the other one. The authors, however, recom-
of lateral/medial wedges11-18 or CFOs,9, 10, 19-26 com- mended interpreting the results with caution be-
mercially available insoles, so-called PFOs, can cause the improvements were very small and might
potentially be a cost-effective way to obtain FOs. not be clinically significant. Rather, the results
Dixon27 investigated the effects of commercially suggest that additional mechanisms, such as kinetic,
available FOs on running in combat assault boots kinematic, and proprioceptive adaptations, could, in
and suggested that they could be used as a less part, be responsible for the positive treatment
expensive alternative to the more expensive CFOs. outcomes when using corrective devices. Other
Ramanathan et al28 studied six different PFO heel studies32, 33 have also examined the effects of PFO
inserts and found no significant differences between on rearfoot eversion during static stance. A signif-
the more expensive and the less expensive insoles (P icant decrease in rearfoot eversion was observed in
, .01). However, owing to design and construction three of the six PFOs tested.32 Matching results
differences between the inserts and according to the were also recorded with another type of PFO,33
present definition of FOs, some of the more simple confirming the findings from the previous studies.
inserts used in this study cannot be considered Contrary to the previously mentioned studies,
orthoses because they do not offer any musculoskel- where the devices were tested without any foot-

342 July/August 2011  Vol 101  No 4  Journal of the American Podiatric Medical Association
wear, Winkelmeyer et al34 compared the effects of functions, several other studies have found similar
CFOs with and without a standardized shoe and results regarding the effects of FOs on rearfoot
found significant differences between unshod and eversion kinematics. Whereas one study40 conclud-
shod (P  .01) and between unshod and shod with ed that CFOs significantly decreased rearfoot
orthoses (P  .01) but not between shod with and eversion throughout stance, two additional stud-
without orthoses (P . .05). ies36, 41 reported that maximum rearfoot eversion
It is, nevertheless, not clear what is the primary was also reduced in symptomatic patients wearing
cause of the reported change in rearfoot eversion CFOs. Note that these studies performed two-
and whether the orthoses used in the study had any dimensional analyses only, suggesting that addition-
effects on this measurement outcome. Without a al information, such as kinematics in all planes of
detailed description of individual FOs and their movement and other coupling movements, could
design, it is difficult to draw conclusions from these have been recorded using a three-dimensional
results. Nonetheless, these findings were substanti- method. The results of two-dimensional analysis
ated by two other studies35, 36 in which no differ- studies should, thus, be considered with caution
ence in rearfoot eversion was recorded when using owing to the inherent limitations of this method,
CFOs. Pascual Huerta et al37 suggested that the such as perspective errors.
actual response to CFOs varies according to the In addition, other studies focused on laterally
level of pronation of the wearer. The results showed wedged devices, where the lateral posterior aspect
that rearfoot wedging has a greater effect on of the device is raised compared with the medial
nonmaximally pronated feet compared with maxi- aspect, which is a common treatment for medial
mally pronated feet. Although the authors explain compartment osteoarthritis of the knee. In one case,
that the maximally pronated feet may need greater an increase in rearfoot eversion and eversion
external supinatory moment to correct the mis- excursion was recorded as expected.15 In another,
alignment, the conclusions from such a study the reported results were inconclusive, suggesting
suggest that the contradicting effects of CFOs and that additional research should be undertaken to
PFOs on rearfoot eversion could be caused by further analyze this treatment strategy.16 Further
different foot types or orthoses designs, such as research could explore whether this is the result of
component (arch cookies, posting, etc) place- patient-specific responses to this treatment strategy,
ment.14 thus preventing conclusions from being generalized.
Because FOs are mainly prescribed for dynamic Perry and Lafortune42 indicated that during
movements, it is imperative to study their effects running, conflicting results subsist regarding the
not only during simulated midstance but also during effects of orthoses on rearfoot kinematic. Stacoff et
normal gait. Stacoff et al38 tested the biomechanical al43 examined the effects of FOs (arch cookies)
effects of three different types of FOs (posting, during running on rearfoot kinematics using intra-
molding and posting combined, and proprioceptive cortical bone pins. Using three experimental condi-
feedback) during walking. It was found that the FOs tions (normal insole and posterior and anterior arch
that combined molding and posting were the most cookies), no systematic effects were found between
effective at reducing rearfoot eversion. Comparing conditions, with variations between individuals
the effects of semi-CFOs and CFOs on rearfoot being greater. It should, however, be noted that a
eversion excursion and velocity in healthy individ- dual-density running shoe was used as standardized
uals, it was found that rearfoot eversion excursion footwear, which has been shown to affect foot
and velocity were again reduced with the CFO.20 kinematics.44
The semi-CFOs significantly reduced eversion ex- A later study45 using a combination of either half-
cursion and displayed a trend (P = .054) toward a or full-length medial or lateral postings (4.5 mm)
reduction in velocity compared with the no-orthoses also found small and nonsystematic results across
condition. An earlier study39 found concurring individuals. Healthy individuals were used in both
results as the maximum eversion angle was also cases. These studies, therefore, suggest that FOs do
reduced using PFOs, but there were no significant not have systematic or clinically relevant effects on
differences in rearfoot eversion velocity. However, rearfoot motion.
Zifchock and Davis20 rightly pointed out that the Moreover, a study27 focusing on the use of PFOs
actual definition of eversion varies from one during running in military footwear found no
research to another, making it even more difficult significant differences between conditions. Al-
to compare findings between studies. though the devices did not have any significant
Using individuals with a variety of abnormal foot effects on rearfoot motion, a systematic effect was

Journal of the American Podiatric Medical Association  Vol 101  No 4  July/August 2011 343
observed in seven of eight individuals, resulting in a wedged orthoses. The FOs used in the previously
greater rearfoot range of motion. Also, the PFOs mentioned study were aggressive in design, using
increased the time to peak eversion compared with rigid carbon-graphite, deep heel cups, and forefoot
the generic insole, confirming that the device did and rearfoot intrinsic medial posting. It was,
have an effect. Donoghue et al,46 while studying the however, reported that ‘‘simple’’ PFO biplanar and
effects of CFOs on chronic Achilles tendon injuries, cobra insoles do not seem to alter the maximum
observed unexpected effects on rearfoot motion. dorsiflexion angle during normal walking because
Although all of the devices were designed to control none of the individuals exhibited differences of
pronation, a significant increase in maximum more than 28 of dorsiflexion between conditions.39
eversion was recorded for all of the individuals. Furthermore, two other separate studies22, 46
The same effect has also been observed for some documented the effects of CFOs on sagittal plane
individuals in other studies.47 These results, thus, ankle motion during running. Although one study
suggest that CFOs do have effects on eversion, used healthy female patients22 and the other used
however unexpected they may be. Other studies patients with Achilles tendon pain,33 both observed
examined the influence of FOs on healthy young a decrease in maximal dorsiflexion when running
female runners. In contradiction with the previous with CFOs. It is worth noting that the differences in
study, wearing FOs did, in fact, result in a significant findings between studies may be the result of CFO
decrease in maximum rearfoot eversion angle, design and the variation in methods used to assess
rearfoot eversion velocity, and calcaneal ever- their effects.
sion.22, 23, 26 The authors, however, questioned the
clinical significance of these findings because the Tibial Rotation
observed changes were quite small (1.08).22 More
recently, Eslami et al48 reported a greater decrease Because excessive tibial rotation has been linked to
in rearfoot eversion, ie, by as much as 4.18, various knee injuries49 (patellofemoral and tibio-
suggesting that the semirigid CFO could have a femoral joints), and FOs are used as part of the
clinically significant effect on rearfoot kinematics. treatment of knee injuries, studying their effects on
tibial rotation can help clinicians improve the
Plantarflexion and Dorsiflexion treatment strategies and device prescriptions. Al-
though Stacoff et al43 reported nonsystematic CFO
Although it may seem logical to assume that effects across their patients, a significant decrease
wearing FOs can affect sagittal plane ankle move- in total internal tibial rotation was found. Other
ment, only a handful of studies have actually studies21, 23 have reported CFOs having the same
reported their effects. A small increase in maximal effects on internal tibial rotation. Although not
plantarflexion has been associated with FO com- statistically significant, a similar trend was also
fort.24 In 2003, Nigg et al45 reported a minimal observed in another study48 where a trend toward a
increase in initial plantarflexion and a decrease in reduction in internal tibial rotation was found
total plantarflexion movement when using full during running with CFOs. Similar findings were
medially posted PFOs while running. However, observed during walking.50 McPoil and Cornwall51
most of the results of this study were nonsystem- also observed comparable reductions in maximum
atic, the patients were asymptomatic, and only a internal tibial rotation angle and acceleration using
generic description of the shoe inserts used was two different types of PFOs, premolded and
provided. wedged, during walking.
A previous study40 of the effects of medially Coupling mechanisms are known to occur in the
posted CFOs on patients with rheumatoid arthritis lower limbs, and, as such, internal tibial rotation has
examined sagittal plane ankle movement and found been directly associated with rearfoot eversion
that although the trends between conditions were through the ankle joint complex.52 Accordingly, in
similar, wearing FOs produced greater range of all of the previously mentioned studies where
motion and a negatively shifted curve, suggesting internal tibial rotation was decreased through the
greater plantarflexion. Similar results, with a de- use of orthoses, a decrease in rearfoot eversion was
crease in maximal dorsiflexion and an increase in also recorded. In fact, high correlations between the
maximal plantarflexion, have also been reported two movements have been established for running
using laterally wedged FOs on healthy individuals.13 (r = 0.991) and walking (r = 0.953). This coupling
An increase in total sagittal plane ankle range of mechanisms is so fundamental that some authors
motion was, however, observed only with medially have even proposed using internal tibial rotation as

344 July/August 2011  Vol 101  No 4  Journal of the American Podiatric Medical Association
an alternative measurement when rearfoot eversion involved, which could, in part, explain the conflict-
could not be measured directly, such as when ing results. In addition, Mundermann et al21 showed
wearing footwear.53 Bellchamber and van den that posted, molded, and posted-molded orthoses
Bogert,52 however, questioned the idea that FOs have different effects on lower-limb kinematics
should be used to correct knee pain associated with during running. It was also noted that the effects
tibial rotation. Their study focused on the cause- of molded and molded-posted orthoses were simi-
and-effect relationship in the coupling mechanism lar. Considering that the exact design of the device
of the ankle joint complex. They concluded that and the way it is made are rarely standardized
except for a brief period between 20% and 60% of between studies, and considering the effects that
stance phase during running, tibial rotation was, for these uncontrolled variables have on the results,
the most part, proximally driven. These findings conflicting conclusions are nearly inevitable.
suggest that the rearfoot eversion is generated by Footwear, when used in conjunction with ortho-
the internal tibial rotation and not the opposite. The ses, need to accommodate for FOs for the user to be
results also underline the nontransferability of FOs comfortable and to want to use them altogether.
designed for running to walking and vice versa. The The selection of footwear can, therefore, be
authors, therefore, concluded that FOs could have a considered of great importance. When studying the
beneficial effect during this brief moment during influences of FOs on gait, researchers are faced
running. As is the case in most studies involving with a methodological problem. Although the
orthoses, the authors also suggested that responses objective would be to examine the effects of FOs
to FOs are potentially patient specific. Because on lower limbs, it is difficult to record the foot’s
these are apparent examples of coupling mecha- movement hidden in the shoe. The main approaches
nisms, the question remains as to what other have been to use sandals (walking and running) or
coupling mechanisms occur in the lower limb to modify the footwear by cutting a small window in
during normal walking. the heel cup to allow access to the rearfoot.
However, testing patients wearing sandals instead
Discussion of running shoes makes it difficult to translate the
findings to real-life settings; no practitioner would
Many scientific publications on FOs have stated that recommend jogging in anything but purpose-built
their effects are either anecdotal or contradicto- shoes. Also, to standardize the testing protocols and
ry.21, 22, 31, 34, 36, 37, 41, 50, 54 Although we agree that to allow for valid comparisons between conditions,
contradictions exist in the current literature, we researchers have, within each study, mainly used
believe that these contradictions can, for the most one type of shoe. Although this is logical reasoning,
part, be explained by the type of device, footwear, the footwear itself can affect the outcome measure-
patients, intervention, and protocol used in each ment,23, 57-60 thus suggesting that the reported
study. The lack of standardization of methodology results in fact reflect the combined effects of the
between studies prevents results from being com- footwear and the FO. It can be difficult to
pared between studies and conclusions generalized differentiate the effects of the FO from the effects
to even a specific population. of the footwear without using complex and time-
Plausible explanations have been suggested as to consuming methodological approaches.
why there are contradicting conclusions on the Another important aspect to consider is the
effects of FOs.55 First was the variation in FO fitting characteristics of the individuals used in each
methods. Although many studies have reported that study. A wide range of individuals have been
CFOs can yield good results in the treatment of included in FO research, from healthy individuals
lower-limb disorders and injuries,21, 38, 56 the way to those typically experiencing pes cavus, osteoar-
that these orthoses are made and the technique by thritis, and patellofemoral pain syndrome. Pascual
which the patient’s feet are casted are seldom Huerta et al37 reported that pronated and non-
described in great detail, and in some cases the maximally pronated feet do not respond in the same
authors provide little or no detail.41 Consequently, way to rearfoot frontal plane wedging. Zifchock and
the exact method used to make these FOs remains Davis20 also showed that high- and low-arched
unclear, and replicating the devices/study is almost individuals may react in different ways to FOs
impossible. Based on the results of previous during walking. Because it is important to study the
studies,19, 21, 42 one could possibly assume that effects of FOs on each type of pathologic abnor-
prescription and casting methods could differ malities, the results should not be generalized to
between studies depending on the practitioner any others because their causes and symptoms

Journal of the American Podiatric Medical Association  Vol 101  No 4  July/August 2011 345
could have an influence on their coping mecha- 2. ‘‘Prosthetics and Orthotics,’’ in ISO 8549–1: 1989, ISO,
nisms. Geneva, 1989.
Based on the current review of the literature, FOs 3. ‘‘Prosthetics and Orthotics,’’ in ISO 8549–3: 1989, ISO,
seem to have certain generic and common effects Geneva, 1989.
4. ‘‘Prosthetics and Orthotics,’’ in ISO 13404: 2007, ISO,
on the lower limb when designed to control rearfoot
Geneva, 2007.
pronation: a decrease in rearfoot eversion, a
5. GROSS MT, FOXWORTH JL: The role of foot orthoses as an
decrease in ankle dorsiflexion, an increase in ankle intervention for patellofemoral pain. J Orthop Sports
plantarflexion, and a decrease in internal tibial Phys Ther 33: 661, 2003.
rotation. Although the decrease in internal tibial 6. SAXENA A, HADDAD J: The effect of foot orthoses on
rotation is most likely a result of the decreased patellofemoral pain syndrome. JAPMA 93: 264, 2003.
rearfoot eversion, the effects of FOs on sagittal 7. LANDORF K, KEENAN AM, HERBERT RD: Effectiveness of
plane movement of the ankle are, perhaps, a by- different types of foot orthoses for the treatment of
product of the elevated heel in the shoe caused by plantar fasciitis. JAPMA 94: 542, 2004.
the additional material under the heel. 8. MEJJAD O, VITTECOQ O, POUPLIN S, ET AL: Foot orthotics
Nonetheless, we acknowledge that there is still a decrease pain but do not improve gait in rheumatoid
great need for further research on all of the arthritis patients. Joint Bone Spine 71: 542, 2004.
9. POWELL M, SEID M, SZER IS: Efficacy of custom foot
variables that influence the clinical outcomes.
orthotics in improving pain and functional status in
Hence, it is strongly recommended that researchers
children with juvenile idiopathic arthritis: a randomized
interested in FOs clearly state in as much detail as trial. J Rheumatol 32: 943, 2005.
possible the following: type of FO (CFO, PFO, or 10. WALTER JH, NG G, STOLTZ JJ: A patient satisfaction survey
CFO-PFO), manufacturing process and material on prescription custom-molded foot orthoses. JAPMA
used, footwear design and mechanical properties, 94: 363, 2004.
and patient’s characteristic. Including detailed 11. MARKS R, PENTON L: Are foot orthotics efficacious for
descriptions of these variables would, thus, facili- treating painful medial compartment knee osteoarthri-
tate comparisons between studies and enable the tis? a review of the literature. Int J Clin Pract 58: 49,
scientific and clinical communities to better com- 2004.
prehend the effects that these variables might have 12. SCHARFBILLIG R, EVANS AM, COPPER AW, ET AL: Criterion
on the kinematics and, possibly, the treatment validation of four criteria of the foot posture index.
JAPMA 94: 31, 2004.
outcomes. It would also allow new researchers to
13. NESTER CJ, VAN DER LINDEN ML, BOWKER P: Effect of foot
more accurately base their protocols on previous
orthoses on the kinematics and kinetics of normal
studies. Finally, because the effects of FOs on walking gait. Gait Posture 17: 180, 2003.
certain kinematic variables seem to be small, 14. ESLAMI M, TANAKA C, HINSE S, ET AL: Effect of foot wedge
questioning the clinical relevancy of such results positions on lower-limb joints, pelvis and trunk angle
is warranted. variability during single-limb stance. The Foot 16: 208,
2006.
Conclusions 15. BUTLER RJ, BARRIOS JA, ROYER T, ET AL: Effect of laterally
wedged foot orthoses on rearfoot and hip mechanics in
Although there is a vast amount of literature on patients with medial knee osteoarthritis. Prosthet
Orthot Int 33: 107, 2009.
FOs, providing some insight into their effects on the
16. KAKIHANA W, AKAI M, NAKAZAWA K, ET AL: Effects of
kinematics of walking and running, many questions
laterally wedged insoles on knee and subtalar joint
persist about their potential use and clinical moments. Arch Phys Med Rehabil 86: 1465, 2005.
efficacy. Additional research is, therefore, needed 17. GELIS A, COUDEYRE E, ABOUKRAT P, ET AL: Feet insoles and
to explore what other underlying mechanisms are knee osteoarthritis: evaluation of biomechanical and
responsible for the positive outcomes reported by clinical effects from a literature review [in French]. Ann
so many clinicians, informing the ongoing debate in Readapt Med Phys 48: 682, 2005.
this area. 18. PHAM T, MAILLEFERT J-F, HUDRY C, ET AL: Laterally elevated
wedged insoles in the treatment of medial knee
Financial Disclosure: None reported. osteoarthritis: a two-year prospective randomized con-
Conflict of Interest: None reported. trolled study. Osteoarthritis Cartilage 12: 46, 2004.
19. GULDEMOND NA, LEFFERS P, SANDERS AP, ET AL: Casting
methods and plantar pressure: effects of custom-made
References
foot orthoses on dynamic plantar pressure distribution.
1. PRATT DJ, SANNER WH: Paediatric foot orthoses. The Foot JAPMA 96: 9, 2006.
6: 99, 1996. 20. ZIFCHOCK RA, DAVIS I: A comparison of semi-custom and

346 July/August 2011  Vol 101  No 4  Journal of the American Podiatric Medical Association
 custom foot orthotic devices in high- and low-arched 38. STACOFF A, QUERVAIN IK, DETTWYLER M, ET AL: Biomechan-
individuals during walking. Clin Biomech 23: 1287, 2008. ical effects of foot orthoses during walking. The Foot
21. MUNDERMANN A, NIGG BM, HUMBLE RN, ET AL: Foot 17: 143, 2007.
orthotics affect lower extremity kinematics and kinetics 39. BRANTHWAITE HR, PAYTON CJ, CHOCKALINGAM N: The effect
during running. Clin Biomech 18: 254, 2003. of simple insoles on three-dimensional foot motion
22. MACLEAN C, DAVIS IM, HAMILL J: Influence of a custom foot during normal walking. Clin Biomech 19: 972, 2004.
orthotic intervention on lower extremity dynamics in 40. WOODBURN J, HELLIWELL PS, BARKER S: Changes in 3D joint
healthy runners. Clin Biomech 21: 623, 2006. kinematics support the continuous use of orthsoes in
23. MACLEAN C, DAVIS IS, HAMILL J: Influence of running shoe the management of painful rearfoot deformity in
midsole composition and custom foot orthotic interven- rheumatoid arthritis. J Rheumatol 30: 2356, 2003.
tion on lower extremity dynamics during running. J Appl 41. ZAMMIT GV, PAYNE CB: Relationship between positive
Biomech 25: 54, 2009. clinical outcomes of foot orthotic treatment and
24. MUNDERMANN A, NIGG BM, HUMBLE RN, ET AL: Orthotic changes in rearfoot kinematics. JAPMA 97: 207, 2007.
comfort is related to kinematics, kinetics, and EMG in 42. PERRY SD, LAFORTUNE MA: Influences of inversion/
recreational runners. Med Sci Sports Exerc 35: 1710, eversion of the foot upon impact loading during
2003. locomotion. Clin Biomech 10: 253, 1995.
25. BUS SA, ULBRECHT JS, CAVANAGH PR: Pressure relief and 43. STACOFF A, REINSCHMIDT C, NIGG BM, ET AL: Effects of foot
load redistribution by custom-made insoles in diabetic orthoses on skeletal motion during running. Clin
patients with neuropathy and foot deformity. Clin Biomech 15: 54, 2000.
Biomech 19: 629, 2004. 44. STACOFF A, DENOTH J, KAELIN X, ET AL: Running injuries and
26. MACLEAN C, DAVIS IS, HAMILL J: Short- and long-term shoe construction: some possible relationships. J Appl
influences of a custom foot orthotic intervention on Biomech 4: 342, 1988.
lower extremity dynamics. Clin J Sport Med 18: 338, 45. NIGG BM, STERGIOU P, COLE G, ET AL: Effect of shoe inserts
2008. on kinematics, center of pressure, and leg joint
27. DIXON S: Influence of a commercially available orthotic moments during running. Med Sci Sports Exerc 35:
device on rearfoot eversion and vertical ground reaction 314, 2003.
force when running in military footwear. Mil Med 172: 46. DONOGHUE OA, HARRISSON AJ, LAXTON P, ET AL: Orthotic
446, 2007. control of rear foot and lower limb motion during
28. RAMANATHAN AK, JOHN MC, ARNOLD GP, ET AL: Off-the-shelf running in participants with chronic Achilles tendon
in-shoe heel inserts: does cost matter? Br J Sports Med injury. Sports Biomech 7: 194, 2008.
42: 750, 2008. 47. WILLIAMS DS III, MCCLAY DAVIS I, BAITCH SP: Effect of
29. PERRY J: Gait Analysis: Normal and Pathological inverted orthoses on lower-extremity mechanics in
Function, p 524, McGraw-Hill Inc, New York, 1992. runners. Med Sci Sports Exerc 35: 2060, 2003.
30. ROOT M, ORIEN W, WEED J: Normal and Abnormal 48. ESLAMI M, BEGON M, HINSE S, ET AL: Effect of foot orthoses
Function of the Foot, Clinical Biomechanics Corp, Los on magnitude and timing of rearfoot and tibial motions,
Angeles, 1977. ground reaction force and knee moment during running.
31. KITAOKA HB, LUO Z-P, KURA H, ET AL: Effect of foot J Sci Med Sport 12: 679, 2009.
orthoses on 3-dimensional kinematics of flatfoot: a 49. VAN MECHELEN W: Running injuries: a review of the
cadaver study. Arch Phys Med Rehabil 83: 876, 2002. epidemiological literature. Sports Med 14: 320, 1992.
32. PAYNE C, OATES M, NOAKES H: Static stance response to 50. LANDORF K, KEENAN AM: Efficacy of foot orthoses: what
different types of foot orthoses. JAPMA 93: 492, 2003. does the literature tell us? JAPMA 90: 149, 2000.
33. SPRINGETT KP, OTTER S, BARRY A: A clinical longitudinal 51. MCPOIL TG, CORNWALL MW: The effect of foot orthoses on
evaluation of pre-fabricated, semi-rigid foot orthoses transverse tibial rotation during walking. JAPMA 90: 2,
prescribed to improve foot function. 17: 184, 2007. 2000.
34. WINKELMEYER M, NELSON B, SOUTHWORTH T, ET AL: Effect of 52. BELLCHAMBER TL, VAN DEN BOGERT AJ: Contributions of
orthotics and footwear on static rearfoot kinematics. J proximal and distal moments to axial tibial rotation
Sports Sci Med 5: 466, 2006. during walking and running. J Biomech 33: 1397, 2000.
35. ESLAMI M, TANAKA C, HINSE S, ET AL: Acute effect of 53. CORNWALL MW, MCPOIL TG: Foot wear and foot orthotic
orthoses on foot orientation and perceived comfort in effectiveness research: a new approach. J Orthop Sports
individuals with pes cavus during standing. The Foot 19: Phys Ther 21: 337, 1995.
1, 2009. 54. VICENZINO B, MCPOIL T, BUCKLAND S: Plantar foot pressures
36. GENOVA lM, GROSS MT: Effect of foot orthotics on after the augmented low dye taping technique. J Athl
calcaneal eversion during standing and treadmill walk- Train 42: 374, 2007.
ing for subjects with abnormal pronation. J Orthop 55. HEIDERSCHEIT B, HAMILL J, TIBERIO D: A biomechanical
Sports Phys Ther 30: 664, 2000. perspective: do foot orthoses work? Br J Sports Med 35:
37. PASCUAL HUERTA J, ROPA MORENO JM, KIRBY KA: Static 4, 2001.
response of maximally pronated and nonmaximally 56. COLLINS N, BISSET L, MCPOIL T, ET AL: Foot orthoses in
pronated feet to frontal plane wedging of foot orthoses. lower limb overuse conditions: a systematic review and
JAPMA 99: 13, 2009. meta-analysis. Foot Ankle Int 28: 396, 2007.

Journal of the American Podiatric Medical Association  Vol 101  No 4  July/August 2011 347
57. BISHOP M, FIOLKOWSKI P, CONRAD B, ET AL: Athletic 59. BUTLER RJ, HAMILL J, DAVIS I: Effect of footwear on high
footwear, leg stiffness, and running kinematics. J Athl and low arched runners’ mechanics during a prolonged
Train 41: 387, 2006.
run. Gait Posture 26: 219, 2007.
58. BUTLER RJ, DAVIS IS, HAMILL J: Interaction of arch type and
footwear on running mechanics. Am J Sports Med 34: 60. CHEUNG RT, NG GY: Influence of different footwear on
1998, 2006. force of landing during running. Phys Ther 88: 620, 2008.

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