Rev Esp Podol. 2018;29(1):2-12 / DOI: 10.20986/revesppod.2018.1507/2018
Moisés Pardos Barrado
Doctor por la Universidad de Zaragoza. Diplomado en Podología y Enfermería. Clínica del pie Moisés Pardos. Zaragoza. España
ABSTRACT
Introduction: There is controversy regarding the eff ectiveness of conservative treatment by means of foot orthoses for the flexible pediatric fl atfoot deformity condition. The present study aims to investigate the eff ect of diff erent types of orthoses in the kinematics of tarsal joints and hip joint during gait.
Patients and methods: A total of 167 pediatric students between 9 and 11 years were initially evaluated and 24 subjects with flexible pediatric fl atfoot deformity were finally selected (foot posture index 9.81 ± 1.24). Gait analysis was performed by means of 9 infrared Optitrack cameras with a randomized and controlled type design of the study. The effect of three diff erent orthoses (Lelièvre orthoses, Polyester resin orthoses and polypropylene inverted orthoses) on subtalar-rearfoot (STJ) and midtarsal (MTJ)
joints in the frontal plane and coxofemoral joint in the frontal and transverse plane were evaluated. The eff ect of shoe, deformity, sex and limb were also analyzed.
Results: Both shoe and orthoses reduced maximal pronation of MTJ (p < 0.001) but only orthoses reduced maximal pronation on STJ (p < 0.001). Inverted orthoses and Lelièvre orthoses reduced maximal eversion of rearfoot compared to resin orthoses (p = 0.005 and p = 0.003). Lelièvre orthoses and resin orthoses reduced maximal eversion of midfoot compared to polypropylene inverted orthoses (p = 0.011 and p = 0.010).
Conclusions: Foot orthoses have shown changes in kinematics parameters in tarsal joints in patients with fl exible pediatric flatfoot deformity but not in hip joint with possible interference of soft tissues around the thigh.
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