Effects of Foot Sole on Ground Reaction Forces During Walking in Male Athletes With Flexible Flat Foot

Document Type : Original article

Authors

1 Department of Biomechanics and Sport Injuries, Faculty of Physical Education and Sport Science, Kharazmi University, Tehran, Iran.

2 Department of Sport Biomechanics, Faculty of Physical Education and Sport Science, Tehran-Center Branch, Azad Islamic University, Tehran, Iran.

3 Department of Exercise Physiology, Faculty of Physical Education and Sport Science, Tehran-Center Branch, Azad Islamic University, Tehran, Iran.

Abstract

Background and Aims: Flatfoot is a structural disorder in which the height of medial longitudinal arch are declined and subsequently causes biomechanical changes in foot. The common treatment method is the use of medial soles. This study aims to compare the effects of medial soles on Ground Reaction Forces (GRFs) during walking in male athletes with a flexible flatfoot.
Methods: Participants were 15 male athletes with flexible flatfoot (Mean±SD age= 21.33±3.39 years, Mean±SD height=178.72±5.28 cm, and Mean±SD weight= 71.76±8.04 kg). Vertical and anterior-posterior GRFs were evaluated during walking in 3 conditions (barefoot, shoe without sole, and shoe with sole). Data analysis was performed in SPSS software using repeated measures ANOVA with and Bonferroni post hoc test, considering the significance level at 0.05.
Results: GRF changed when using shoes with medical soles at both vertical and anterior-posterior directions compared to two other conditions, such that as the heel raised from the ground, GRF increased (P=0.00) and the vertical GRF decreased at mid-stance phase (P=0.02). In comparing the anterior-posterior GRF in three conditions, results showed that the posterior force was significantly higher when using shoes with medical soles compared to the barefoot condition (P=0.001), while the difference was not significant for the anterior force (P=1.16).
Conclusion: By controlling the amount of pronation and eversion in the foot while walking using sandals with custom medical soles, the pattern of reaction force distribution can be changed at the vertical and anterior-posterior directions compared to the barefoot condition, indicating the effect of using a custom medical sole on the force distribution in the sole of the foot and subsequently on other joints. Therefore, it is recommended to study the kinetic changes of the joints following the use of medical soles.

Keywords

Main Subjects


  1. Harrison PL, Littlewood C. Relationship between pes planus foot type and postural stability. Indian Journal of Physiotherapy and Occupational Therapy. 2010; 4(3):21-4. http://www.i-scholar.in/index.php/ijpot/article/view/48142
  2. Noh B, Masunari A, Akiyama K, Fukano M, Fukubayashi T, Miyakawa S. Structural deformation of longitudinal arches during running in soccer players with medial tibial stress syndrome. European Journal of Sport Science. 2015; 15(2):173-81. [DOI:10.1080/17461391.2014.932848] [PMID]
  3. Farahpour N, Jafarnezhadgero A, Allard P, Majlesi M. Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain. Journal of Electromyography and Kinesiology. 2018; 39(1):35-41. [DOI:10.1016/j.jelekin.2018.01.006] [PMID]
  4. Roth S, Roth A, Jotanovic Z, Madarevic T. Navicular index for differentiation of flatfoot from normal foot. International Orthopaedics. 2013; 37(6):1107-12. [DOI:10.1007/s00264-013-1885-6] [PMID] [PMCID]
  5. Chuckpaiwong B, Nunley JA, Queen RM. Correlation between static foot type measurements and clinical assessments. Foot and Ankle International. 2009; 30(3):205-12. [DOI:10.3113/FAI.2009.0205] [PMID]
  6. Bourdet C, Seringe R, Adamsbaum C, Glorion C, Wicart P. Flatfoot in children and adolescents. Analysis of imaging findings and therapeutic implications. Orthopaedics and Traumatology: Surgery and Research (OTSR). 2013; 99(1):80-7. [DOI:10.1016/j.otsr.2012.10.008] [PMID]
  7. Prachgosin T, Chong DY, Leelasamran WI, Smithmaitrie P, Chatpun SU. Medial longitudinal arch biomechanics evaluation during gait in subjects with flexible flatfoot. Acta of Bioengineering and Biomechanics. 2015; 17(4);121-30. https://pubmed.ncbi.nlm.nih.gov/26898763/
  8. Aminian G, Safaeepour Z, Farhoodi M, Pezeshk AF, et al. The effect of prefabricated and proprioceptive foot orthoses on plantar pressure distribution in patients with flexible flatfoot during walking. Prosthetics and Orthotics International. 2013; 37(3):227-32. [DOI:10.1177/0309364612461167] [PMID]
  9. Cote KP, Brunet ME, II BM, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. Journal of Athletic Training. 2005; 40(1):41-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1088344/
  10. Kido M, Ikoma K, Hara Y, Imai K, et al. Effect of therapeutic insoles on the medial longitudinal arch in patients with flatfoot deformity: A three-dimensional loading computed tomography study. Clinical Biomechanics (Bristol, Avon). 2014; 29(10):1095-8. [DOI:10.1016/j.clinbiomech.2014.10.005] [PMID] [PMCID]
  11. Simkin A, Leichter I, Giladi M, Stein M, Milgrom C. Combined effect of foot arch structure and an orthotic device on stress fractures. Foot and Ankle. 1989; 10(1):25-9. [DOI:10.1177/107110078901000105] [PMID]
  12. Goonetilleke RS. The science of footwear, 1st edition. Boca Raton, Florida: CRC Press; 2012. [DOI:10.1201/b13021]
  13. Blake RL, Ferguson H. Foot orthosis for the severe flatfoot in sports. Journal of the American Podiatric Medical Association. 1991; 81(10):549-55. [DOI:10.7547/87507315-81-10-549] [PMID]
  14. Jafarnezhadgero AA, Shad MM, Majlesi M. Effect of foot orthoses on the medial longitudinal arch in children with flexible flatfoot deformity: A three-dimensional moment analysis. Gait and Posture. 2017; 55:75-80. [DOI:10.1016/j.gaitpost.2017.04.011] [PMID]
  15. Ho M, Kong PW, Chong LJ, Lam WK. Foot orthoses alter lower limb biomechanics but not jump performance in basketball players with and without flat feet. Journal of Foot and Ankle Research. 2019; 12(1):12-24. [DOI:10.1186/s13047-019-0334-1] [PMID] [PMCID]
  16. Chen YC, Lou SZ, Huang CY, Su FC. Effects of foot orthoses on gait patterns of flat feet patients. Clinical Biomechanics (Bristol, Avon). 2010; 25(3):265-70. [DOI:10.1016/j.clinbiomech.2009.11.007] [PMID]
  17. Han JT, Koo HM, Jung JM, Kim YJ, Lee JH. [Differences in plantar foot pressure and COP between flat and normal feet during walking (Persian)]. Journal of Physical Therapy Science. 2011; 23(4):683-5. [DOI:10.1589/jpts.23.683]
  18. Aboutorabi A, Saeedi H, Kamali M, Farahmand B, et al. Immediate effect of orthopedic shoe and functional foot orthosis on center of pressure displacement and gait parameters in juvenile flexible flat foot. Prosthetics and Orthotics International. 2014; 38(3):218-23. [DOI:10.1177/0309364613496111] [PMID]
  19. Morrison SC, Ferrari J. Inter-rater reliability of the Foot Posture Index (FPI-6) in the assessment of the paediatric foot. Journal of Foot and Ankle Research. 2009; 2(1):26-45. [DOI:10.1186/1757-1146-2-26] [PMID] [PMCID]
  20. Mosca VS. Flexible flatfoot and skewfoot. The Journal of Bone and Joint Surgery. 1995; 77(12):1937-45. [DOI:10.2106/00004623-199512000-00021]
  21. Winter DA. Biomechanics of human movement with applications to the study of human locomotion. Critical Reviews in Biomedical Engineering. 1984; 9(4):287-314. https://pubmed.ncbi.nlm.nih.gov/6368126/
  22. Keenan GS, Franz JR, Dicharry J, Della Croce U, Kerrigan DC. Lower limb joint kinetics in walking: the role of industry recommended footwear. Gait and Posture. 2011; 33(3):350-5. [DOI:10.1016/j.gaitpost.2010.09.019] [PMID]
  23. Yung-Hui L, Wei-Hsien H. Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking. Applied Ergonomics. 2005; 36(3):355-62. [DOI:10.1016/j.apergo.2004.11.001] [PMID]
  24. Razeghi M, Batt ME. Biomechanical analysis of the effect of orthotic shoe inserts. Sports Medicine. 2000; 29(6):425-38. [DOI:10.2165/00007256-200029060-00005] [PMID]
  25. Hunt AE, Smith RM. Mechanics and control of the flat versus normal foot during the stance phase of walking. Clinical Biomechanics. 2004; 19(4):391-7. [DOI:10.1016/j.clinbiomech.2003.12.010] [PMID]
  26. Levinger P, Murley GS, Barton CJ, Cotchett MP, et al. A comparison of foot kinematics in people with normal-and flat-arched feet using the Oxford Foot Model. Gait & Posture. 2010; 32(4):519-23. [DOI:10.1016/j.gaitpost.2010.07.013] [PMID]
  27. Mantashloo Z, Sadeghi H, Khaleghitazji M. [Comparison of ground reaction forces and muscles electrical activity of the ankle during running in young men with pronation and normal foot (Persian)]. Journal of Rafsanjan University of Medical Sciences. 2017; 16(4):353-64. http://journal.rums.ac.ir/browse.php?a_id=3744&sid=1&slc_lang=fa&html=1
  28. Gijon-Nogueron G, Palomo-Toucedo I, Gil-Tinoco A, Ortega-Avila AB, Munuera-Martínez PV. Effect produced on ground reaction forces by a prefabricated, weight-bearing and non-weight-bearing foot orthosis in the treatment of pronated foot: Pilot study. Medicine. 2018; 97(22):1-7. [DOI:10.1097/MD.0000000000010960] [PMID] [PMCID]
  29. Eslami M, Begon M, Hinse S, Sadeghi H. Effect of foot orthoses on magnitude and timing of rearfoot and tibial motions, ground reaction force and knee moment during running. Journal of Science and Medicine in Sport. 2009; 12(6):679-84. [DOI:10.1016/j.jsams.2008.05.001] [PMID]
  30. Neumann DA. Kinesiology of the musculoskeletal system: Foundations for rehabilitation. e-book, 3rd edition. Elsevier Health Sciences; 2013. https://www.elsevier.com/books/kinesiology-of-the-musculoskeletal-system/neumann/978-0-323-28753-1
  31. Queen RM. The effect of positive posterior heel flare on muscle activation, kinetics, and kinematics during running gait. [PhD. dissertation]. Carolina: The University of North Carolina at Chapel Hill, 2004. https://www.proquest.com/openview/7b4485a1b7ab2f391ede3fcf30f20d81/1?pq-origsite=gscholar&cbl=18750&diss=y
  32. Sacco IC, Akashi PM, Hennig EM. A comparison of lower limb EMG and ground reaction forces between barefoot and shod gait in participants with diabetic neuropathic and healthy controls. BMC Musculoskeletal Disorders. 2010; 11(1):24-38. [DOI:10.1186/1471-2474-11-24] [PMID] [PMCID]
  33. Hamill J, Knutzen KM. Biomechanical basis of human movement. Philadelphia: Lippincott Williams & Wilkins; 2006. https://www.amazon.com/Biomechanical-Basis-Movement-Joseph-Hamill/dp/1451177305