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Flatfoot is characterized by the collapse of the medial longitudinal arch, eversion of the rearfoot and abduction of the loaded forefoot. Orthopedic insoles are the frequently recommended treatment to support the arch of the foot, adjust the structure of the foot, reduce pain, improve stability and new techniques have been applied to the design of orthopedic insoles in recent years. However, the effectiveness of orthopedic insoles in different motions is still debated from the perspective of biomechanics. Therefore, this study aimed to explore the impact of orthopedic insoles on the kinematics and kinetics of lower limb motion, and to verify effectiveness and propose possible future research directions. We conducted a literature search across three databases employing Boolean operations and filtered results based on eligibility criteria. A total of 671 relevant literature were searched in this review, and 19 literature meeting the requirements were finally included. The results showed that: 1) orthopedic insoles were effective when patients walk, run and jump from the perspective of biomechanics; 2) orthopedic insoles had different result on the change of ankle sagittal angle, moment and peak pressure in the metatarsal region; 3) Whether the effect of insoles, which uses new techniques such as different 3D printed technologies and adds various accessories, can be further improved remains to be further studied; 4) Follow-up studies can pay more attention to the differences between diverse populations, increase the breadth of running and jumping and other movements research and long-term intervention.

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Objective: To observe the effects of scoliosis-specific exercise therapy combined with braces and orthopedic insoles on improved spinal deformity and walking ability in adolescents with idiopathic scoliosis (AIS). Method: From September 2019 to September 2020, 60 outpatient AIS patients were distributed into brace group (n = 30) at random and brace combined orthopedic insole group (n = 30). Both groups underwent brace dryness, and the observation group used scoliosis-specific exercise therapy combined with brace therapy, and on this basis, orthopedic insole intervention was added for 8 h per day for 2 months. At the same time, 20 adolescents of the same age with normal spinal development were recruited as a healthy group. GaitScan instruments were used to collect gait and plantar pressure measurements from study subjects. First, the gait and plantar pressure data of AIS patients and healthy groups were compared horizontally to ascertain the abnormal indicators, and then the spinal deformity and the above abnormal indicators were compared between the brace group and the brace combined orthopedic insole group. Outcome: The plantar pressure center drift index (CPEI) in the AIS group was higher than that in the healthy group (F = 3.120, P < 0.05), and there were significant differences in the ratio of medial and lateral heel pressure (M/l) and total foot pressure (P < 0.05) between the AIS group and the healthy group, and no noticeable variations were found in the support phase period, walking speed, and proportion of each phase (P > 0.05). After treatment, the Cobb angle was significantly reduced in both the brace group and the brace combined with orthopedic insole group (P < 0.05), and there was no significant difference between the groups (P > 0.05). There were no significant changes in the pressure ratio of CPEI, M/l and bilateral full foot in the brace group (P > 0.05). The CPEI decreased in the brace combined with orthopedic insole group (P < 0.05), and the pressure ratio of M/l and bilateral full foot tended to 1 (P < 0.05), and was better than that in the brace group (P < 0.05). Conclusion: Patients with AIS may have local and worldwide asymmetric changes in plantar pressure distribution. The addition of orthopedic insoles has limited effect on improving scoliosis deformity in patients with AIS, but it can effectively improve the abnormal biomechanics of patients with AIS, so that the patient's force tends to be balanced.

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BACKGROUND: The foot is an important part of the human motor system. Foot diseases and injuries have become a troubling problem. Orthopedic insoles can effectively treat and prevent foot diseases and injuries and reduce the risk of injuries. It has become the main method of physical correction. OBJECTIVE: To clarify the design principles of orthopedic insoles, to classify orthopedic insoles according to the production methods, to sort out the rehabilitation function of orthopedic insoles to human joint-related diseases, children’s hemiplegia, and sports injuries, to explore the current research status and shortcomings of orthopedic insoles, and to make suggestions for future research and development. METHODS: A search of CNKI, WanFang, Baichain, Baidu Library, and PubMed was performed for relevant literature published from 2005 to 2019. Search terms were “Orthopedic insoles,” “valgus hallux, flat feet, high arch, plantar fasciitis,” “knee varus, knee valgus, knee osteoarthritis,” “scoliosis,” “foot and ankle injury,” “gait,” and “abnormal gaits” in Chinese and “Orthopedic insoles, Corrective effect, Motion pattern characteristics” in English. Included articles were screened, summarized and analyzed. RESULTS AND CONCLUSION: The design principles of the insoles include four aspects: adjusting the force bearing point of the vola and dispersing plantar pressure; supporting the arch of the foot, improving cushioning ability; improving the force line of the l ower limb, providing a stable support; improving proprioception and foot comfort. Orthopedic insoles can be divided into three types: prefabricated, semi-customized and customized. Orthopedic insoles can play an effective prevention and rehabilitation function in ankle, knee, spinal deformity, hemiplegia-type cerebral palsy in children, and sports injuries. Orthopedic insoles have certain limitations in clinical application and in therapeutic effects. In the development and evaluation of orthopedic insoles, the changes in foot shape and shoe shape during human movement should be considered to reflect the concept of “foot-shoe integration.” Different shapes, materials, and hardness of orthopedic insoles can be used to conduct more in-depth research on the effects of orthopedic insoles to prevent and treat injuries and improve exercise capacity.

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Surgical management of rheumatic feet has dramatically changed over the last decades influenced by the development of new pharmacological drugs and tissue-preserving surgical procedures. It has switched from joint resection to joint-sparing procedures as the method of choice. Nevertheless, the surgical interventions commonly used for non-rheumatic patients cannot be applied to rheumatic patients without reflection: in addition to the basic treatment, comorbidities, degree of mobilization of the patient, orthopedic shoe engineering and orthotic treatment play a major role. Due to the decreasing incidence of the classical rheumatic foot, it has become even more important for physicians, physiotherapists and ergotherapists to recognize the development of such a disease as early as possible and immediately start the appropriate treatment.

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BACKGROUND: The wearing of socks and insoles may affect the ability of the foot to detect tactile input influencing postural balance. OBJECTIVES: The aim of this study was to investigate whether (1) thick socks adversely affected the elderly postural balance and (2) orthopedic insoles could improve the elderly postural balance while wearing thick socks. STUDY DESIGN: Repeated-measures study design. METHODS: In total, 14 healthy older adults were recruited. A monofilament test was conducted to evaluate foot plantar sensation with and without thick socks. Subjects then performed the Romberg tests under three conditions: (1) barefoot, (2) with socks only, and (3) with both socks and insoles. Postural balance was assessed by measuring the center of pressure movement during standing in each experimental condition. RESULTS: Thick socks significantly decreased the monofilament score ( p < 0.001), suggesting reduction in ability to detect external forces. All center of pressure parameters increased significantly while wearing thick socks ( p < 0.017), implying reduction of postural stability. They then decreased significantly with the additional use of insoles ( p < 0.017). CONCLUSION: Previous studies have documented the changes in plantar pressure distribution with the use of orthopedic insoles. This study further suggests that such changes in contact mechanics could produce some balance-improving effects, which appears not to have been reported earlier. Clinical relevance Wearing thick socks reduces plantar pressure sensitivity and increases postural sway which may increase risk of falls. Orthopedic insoles and footwear with similar design could potentially be a cost-effective method in maintaining postural balance when wearing thick socks.

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