Flat Feet Clinical Trial
Official title:
Effect of the Prefabricated Plantar Insoles to Control Pronation Measured With Foot Posture Index
Pronation is a very common foot deformity in population. Plantar insoles are one way to treat it, and even correct it, but there are several kind of treatments. In this study we try to prove if prefabricated foot insoles are a solution to correct pronation in adults. It has been tested by Foot Posture Index, that it is an objetive clinical test to measure the posture of feet. Foot is clasified in supinated , pronated and neutral.
Nowadays several treatments have been described to treat pronation foot posture, althought
these ones heven´t proved objetively the improvement and progression of foot deformity like
"Foot Posture Index" does,. Foot pronation during walking is a physiological movement at the
beginning of stance phase. It is a needed mechanism which allows the lower limb muscles to
support the reaction forces from the ground and to give the forefoot wider range of movement
. When there is pronation movement in weight bearing of subtalar joint, the calcaneus does a
movement of eversión while talus does a plantarflexion and movement of aduction .The movement
is raised due to the paralelism of midfoot joints and the forefoot is forced to compensate
the rearfoot position, gettting into dorsiflexion and abduction which leads to a flattening
of the medial arch. it is known pronation or flatfoot. Pronation movement is a pathology when
it happens during the second part of the stance phase, the 25% at the beginning or when
deformity is abnormal provoking an excessive rearfoot eversion with flattenig of the medial
arch which will lead to a lower limb misalignment . This doesn´t allow the foot to be a rigid
part needed to propulsion phase, so muscles must work excessively to give balance. The
pronated foot etiology can be congenital or laxity or due to triceps sural shortening, or
functional etiology like varus forefoot, metatarsus aductus or tibial posterior
insufficiency. There are some secundary painful pathologies which are the most frequent
reason of podiatric appointment.. Plantar fascitis is one of the pathologies, and adquired
deformities like Hallux Abductus Valgus, Hallux Límitus/Rigidus and other lower limb
deformities like medial compatiment ostheoartritis of knee or patellofemoral syndrome.
Pronated foot can be defined like a foot that has rearfoot eversion and medial protusion of
the head of talus, forefoot abduction, flatted medial arch and joint movement greater. This
shows a flat foot aspect, depending on the grades of pronation deformity that pacient
presents. Both situations are linked and their behaviour are functionally similar.
Attending on consequences and the pathologies derivated of this deformity there are some
treatments to stop it and avoid structural alterations of leg and foot. For instance, hallux
abductus Valgus, the pathological pronation is the first ray´s extrinsic ethilogic factor,
both frequency and capacity to produce pathology.
The compensation of pathological pronation of rearfoot is important to control the deformity
evolution. Is commonly accepted by podiatric scientific community that control of pronation
can avoid the deformity progression when it is presented (or this progression was slower) and
avoid when it wasn´t present yet. Foot Posture Index is a clinical diagnostics tool compounds
by 6 criteria that allow to asses reliability the weightbearing foot posture. It is a
inexpensive and simple method that doesn´t imply risks to people.
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