Pedobarographic evaluation of five commonly used orthoses for the lower extremity

• Published in: Archives of orthopaedic and trauma surgery 2023-07, Vol.143 (7), p.4249-4256
• Main Authors: Ehrnthaller, C., Rellensmann, K., Baumbach, S. F., Wuehr, M., Schniepp, R., Saller, M. M., Böcker, W., Polzer, Hans
• Format: Article
• Language: English
• Subjects: Adult; Braces; Foot; Foot Orthoses; Humans; Lower Extremity; Medicine; Medicine & Public Health; Orthopedics; Orthotic Devices; Pressure; Pressure distribution; Trauma Surgery
• ISSN: 1434-3916; 0936-8051; 1434-3916
• DOI: 10.1007/s00402-022-04729-2

Introduction Orthoses are designed to achieve immobilization or off-loading of certain regions of the foot. Yet, their off-loading capacity for the specific regions has not yet been studied. Therefore, the aim of this study was to analyze the plantar pressure distribution of five commonly applied orthoses for foot and ankle in a healthy population. Materials and Methods Five orthoses (postoperative shoe, forefoot relief shoe, short walker boot, high walker boot, and calcaneus fracture orthosis) were compared pedobarographically using insoles on a treadmill to a ready-made running shoe in eleven healthy subjects (median age 29 years). Peak pressure, maximum force, force–time integral, contact time, and contact area were evaluated separately for the forefoot, midfoot, and hindfoot. Results The forefoot relief shoe, the short- and high walker boot significantly reduced the peak pressure at the forefoot with no significant differences between these orthoses. None of the five orthoses off-loaded the midfoot, but the calcaneus fracture orthosis and the short walker boot instead increased midfoot load. For the hindfoot, the calcaneus fracture orthosis was the only device to significantly reduce the peak pressure. Conclusions This is the first study to investigate the specific off-loading capacities of different orthoses for specific foot regions in a healthy collective. The knowledge of absolute and relative load shifts for the different orthoses is of fundamental interest for targeted clinical decision-making of physicians.