ORTHOTIC MANAGEMENT OF THE
FOOT AND LOWER LIMB
ARTICLES/RESOURCES EXAM 2025
QUESTIONS AND ANSWERS
Article:
Biomechanical Effects of Prefabricated
Foot Orthoses and Rocker-Sole Footwear in
Individuals With First Metatarsophalangeal
Joint Osteoarthritis - ANS Results:
The orthoses had minimal effect on spatiotemporal or kinematic parameters, while the rocker-
sole footwear resulted in reduced cadence, percentage of the gait cycle spent in stance phase,
and sagittal plane hip range of motion. The orthoses increased peak pressure under the
midfoot and lesser toes. Both interventions significantly reduced peak pressure under
the 1st MTPJ, and the rocker-sole shoes also reduced peak pressure under the 2nd through 5th
MTPJ and heel.
When the effects of the orthoses and rocker-sole shoes were directly compared, there was no
difference in peak pressure under the hallux, 1st MTPJ, or heel; however, the rocker-sole shoes
exhibited lower peak pressure under the lesser toes, 2nd through 5th MTPJ, and midfoot.
Discussion:
indicate that both interventions were effective at reducing peak pressure beneath the first MTP
joint, which may be one of the mechanisms responsible for their apparent beneficial effects in
the treatment of OA affecting this joint. However, they appear to achieve this through different
mechanisms.
1 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
, The prefabricated orthoses in this study were modified
by the addition of a cut-out section beneath the 1st MTS, as described by Welsh et al (8). The
rationale behind this approach is to facilitate 1st ray plantarflexion, thereby allowing the
proximal phalanx to dorsiflex on
the 1st Met head and minimize joint compression
during propulsion. - ANS However, the gait analysis component of the study by Welsh et al
found no differences in 1st MTPJ dorsiflexion when orthoses were worn, despite participants
reporting a reduction in symptoms.
Our in-shoe plantar pressure data suggest that orthoses may instead achieve their apparent
beneficial effects by redistributing load away from the 1st MTPJ, possibly by shifting it toward
the medial longitudinal arch during midstance and toward the lesser toes during propulsion.
In our study, stride length was not significantly altered when wearing the
rocker-sole shoes. However, there was a reduction in cadence and a trend (P=0.08) toward
reduced velocity, both of which may reflect the adoption of a "cautious" gait pattern that has
been shown to result in reduced sagittal plane hip motion during gait
Article:
EFFECT OF FOOTWEAR ON BALANCE - ANS The results of this study indicate that dynamic
balance assessed during a single-leg jump landing task is better in bare feet than in standard
running shoes, and is not significantly different between Vibrams and standard running shoes.
These results are consistent with the hypothesis that filtering or masking of sensory input by
footwear can affect dynamic postural stability.
Article:
A comparison of gait biomechanics of flip-flops,
2 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
FOOT AND LOWER LIMB
ARTICLES/RESOURCES EXAM 2025
QUESTIONS AND ANSWERS
Article:
Biomechanical Effects of Prefabricated
Foot Orthoses and Rocker-Sole Footwear in
Individuals With First Metatarsophalangeal
Joint Osteoarthritis - ANS Results:
The orthoses had minimal effect on spatiotemporal or kinematic parameters, while the rocker-
sole footwear resulted in reduced cadence, percentage of the gait cycle spent in stance phase,
and sagittal plane hip range of motion. The orthoses increased peak pressure under the
midfoot and lesser toes. Both interventions significantly reduced peak pressure under
the 1st MTPJ, and the rocker-sole shoes also reduced peak pressure under the 2nd through 5th
MTPJ and heel.
When the effects of the orthoses and rocker-sole shoes were directly compared, there was no
difference in peak pressure under the hallux, 1st MTPJ, or heel; however, the rocker-sole shoes
exhibited lower peak pressure under the lesser toes, 2nd through 5th MTPJ, and midfoot.
Discussion:
indicate that both interventions were effective at reducing peak pressure beneath the first MTP
joint, which may be one of the mechanisms responsible for their apparent beneficial effects in
the treatment of OA affecting this joint. However, they appear to achieve this through different
mechanisms.
1 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
, The prefabricated orthoses in this study were modified
by the addition of a cut-out section beneath the 1st MTS, as described by Welsh et al (8). The
rationale behind this approach is to facilitate 1st ray plantarflexion, thereby allowing the
proximal phalanx to dorsiflex on
the 1st Met head and minimize joint compression
during propulsion. - ANS However, the gait analysis component of the study by Welsh et al
found no differences in 1st MTPJ dorsiflexion when orthoses were worn, despite participants
reporting a reduction in symptoms.
Our in-shoe plantar pressure data suggest that orthoses may instead achieve their apparent
beneficial effects by redistributing load away from the 1st MTPJ, possibly by shifting it toward
the medial longitudinal arch during midstance and toward the lesser toes during propulsion.
In our study, stride length was not significantly altered when wearing the
rocker-sole shoes. However, there was a reduction in cadence and a trend (P=0.08) toward
reduced velocity, both of which may reflect the adoption of a "cautious" gait pattern that has
been shown to result in reduced sagittal plane hip motion during gait
Article:
EFFECT OF FOOTWEAR ON BALANCE - ANS The results of this study indicate that dynamic
balance assessed during a single-leg jump landing task is better in bare feet than in standard
running shoes, and is not significantly different between Vibrams and standard running shoes.
These results are consistent with the hypothesis that filtering or masking of sensory input by
footwear can affect dynamic postural stability.
Article:
A comparison of gait biomechanics of flip-flops,
2 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
