Quantifying lower limb inter-joint coordination and coordination variability after four-month wearing arch support foot orthoses in children with flexible flat feet

AmirAli Jafarnezhadgero; Seyed Hamed Mousavi; Morteza Madadi-Shad; Juha M Hijmans

doi:10.1016/j.humov.2020.102593

Quantifying lower limb inter-joint coordination and coordination variability after four-month wearing arch support foot orthoses in children with flexible flat feet

Hum Mov Sci. 2020 Apr:70:102593. doi: 10.1016/j.humov.2020.102593. Epub 2020 Feb 28.

Authors

AmirAli Jafarnezhadgero¹, Seyed Hamed Mousavi², Morteza Madadi-Shad³, Juha M Hijmans⁴

Affiliations

¹ University of Mohaghegh Ardabili, Faculty of Educational Sciences and Psychology, Department of Physical Education and Sport Sciences, Ardabil, Iran.
² University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran. Electronic address: s.h.mousavi@umcg.nl.
³ Bu-Ali Sina University, Department of Sport Biomechanics, Hamedan, Iran.
⁴ University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.

PMID: 32217211
DOI: 10.1016/j.humov.2020.102593

Abstract

Introduction: Flat feet in children negatively affect lower limb alignment and cause adverse health-related problems. The long-term application of foot orthoses (FOs) may have the potential to improve lower limb coordination and its variability.

Aim: To evaluate the effects of long-term use of arch support FOs on inter-joint coordination and coordination variability in children with flexible flat feet.

Methods: Thirty boys with flexible flat feet were randomly assigned to the experimental (EG) and control groups. The EG used medial arch support FOs during daily activities over a four-month period while the control group received a flat 2-mm-thick insole for the same time period. Lower-limb coordination and variability during the 3 sub-stance phases were quantified using a vector coding technique.

Results: Frontal plane ankle-hip coordination in EG during mid-stance changed to an anti-phase pattern (156.9^°) in the post-test compared to an in-phase (221.1^°) in the pre-test of EG and post-test of CG (222.7). Frontal plane knee-hip coordination in EG during loading response (LR) changed to an anti-phase pattern (116^°) in the post-test compared to an in-phase (35.5^°) in the pre-test of EG and post-test of CG (35.3). Ankle inversion/eversion-knee internal/external rotation joint coupling angle in EG changed to an in-phase pattern (59^°) in the post-test compared to a proximal phase (89^°) in the pre-test. Coupling angle variability increased in the post-test of EG for sagittal plane ankle-hip during push-off, transverse plane ankle-hip during LR and mid-stance, and transverse plane knee-hip during LR and mid-stance compared to pre-test of EG and post-test of CG.

Conclusion: The long-term use of arch support FOs proved to be effective to alter lower limb coordination and coordination variability during walking in children with flexible flat feet. This new insight into coordinative function may be useful for improving corrective exercise strategies planned for children with flat feet.

Keywords: Coupling angle; Insole; Long-term wearing; Pes planus; Pronation.

Publication types

Randomized Controlled Trial

MeSH terms

Ankle Joint / physiopathology
Biomechanical Phenomena
Child
Flatfoot / physiopathology*
Flatfoot / therapy*
Foot Deformities / physiopathology*
Foot Deformities / rehabilitation*
Foot Orthoses*
Gait
Hip Joint / physiopathology
Humans
Joints / physiopathology*
Lower Extremity / physiopathology*
Male
Pronation
Treatment Outcome