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The effect of rearfoot correction on lower limb kinematics during the dynamic activity of a step up and over in asymptomatic pronators.

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posted on 2011-10-27, 10:14 authored by Sinead O'Sullivan
Introduction: Pronation occurs at the subtalar joint of the ankle when the foot is in a combination of eversion, abduction and dorsi-flexion. Over pronation transfers into increased tibial rotation and increases the stresses upon the knee (Tiberio et al 1997). There is a dearth in evidence involving the application of rearfoot correction during dynamic activities such as step up (S.U) and over. Aims: To investigate what biomechanical changes occur in the lower limb following the application of rearfoot correction to asymptomatic over pronators during a step up and over. Methods: Healthy female (n=8) over pronators (navicular drop 5-10mm) carried out a S.U. and over three times bilaterally in three test conditions. Conditions included; barefoot, with a standardised shoe, with a standardised shoe and insole with the required degree of rearfoot correction. Data was recorded using the CODA motion analysis and analysised using one-way repeated-measures ANOVA/Friedman‟s tests and Wilcoxon Signed ranks test. Results: In both s.u and step down (s.d) rearfoot correction caused significant changes in peak ankle dorsiflexion (p=0.031 s.u., 0.000 s.d.) and peak ankle pronation (p=0.001 s.u., 0.000 s.d.). Significant changes were noted in hip flexion (p=0.002) and knee flexion (p=0.021) on s.d. No significant differences were noted on the other variables assessed. Conclusion: Significant changes were noted in the lower limb kinematics during S.U and over. As expected peak angles at the ankle were altered by the use of rearfoot correction. Further studies are required to determine if the use of rearfoot correction is beneficial in symptomatic pronators.

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