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Effect of 3D printed foot orthoses stiffness on muscle activity and plantar pressures in individuals with flexible flatfeet: A statistical non-parametric mapping study

  • Yosra Cherni
    Correspondence
    Corresponding author at: Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, 525 boul. Wilfried-Hamel, Québec, QC G1M 2S8, Canada.
    Affiliations
    School of Kinesiology and Exercise Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada

    Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Québec, Canada

    Department of Rehabilitation, Laval University, Quebec City, Québec, Canada
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  • Gauthier Desmyttere
    Affiliations
    School of Kinesiology and Exercise Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada

    Orthodynamica Center, Mathilde Hospital 2, Rouen, France
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  • Maryam Hajizadeh
    Affiliations
    Institute of Biomedical Engineering, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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  • Jacinte Bleau
    Affiliations
    Medicus Orthopedic Laboratory, Montréal, Québec, Canada
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  • Catherine Mercier
    Affiliations
    Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Québec, Canada

    Department of Rehabilitation, Laval University, Quebec City, Québec, Canada
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  • Mickael Begon
    Affiliations
    School of Kinesiology and Exercise Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada

    Marie-Enfant Rehabilitation Center, UHC Sainte-Justine, Montréal, Québec, Canada
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      Highlights

      • Customized 3D printed foot orthoses did not change lower limb muscle activity.
      • Plantar pressures were modulated by the foot orthoses and the addition of posting.
      • Increasing foot orthoses stiffness altered plantar pressure distribution.
      • Foot orthoses had little effect on center of pression displacements during walking.

      Abstract

      Background

      The 3D printing technology allows to produce custom shapes and add functionalities to foot orthoses which offers better options for the treatment of flatfeet. This study aimed to assess the effect of 3D printed foot orthoses stiffness and/or a newly design posting on muscle activity, plantar pressures, and center of pressure displacement in individuals with flatfeet.

      Methods

      Nineteen individuals with flatfeet took part in this study. Two pairs of foot orthoses with different stiffness were designed for each participant and 3D printed. In addition, the flexible foot orthoses could feature an innovative rearfoot posting. Muscle activity, plantar pressures, and center of pressure displacement were recorded during walking.

      Findings

      Walking with foot orthoses did not alter muscle activity time histories. Regarding plantar pressures, the most notable changes were observed in the midfoot area, where peak pressures, mean pressures and contact area increased significantly during walking with foot orthoses. The latter was reinforced by increasing the stiffness. Concerning the center of pressure displacement, foot orthoses shifted the center of pressure forward and medially at early stance. At the end of the stance phase, a transition of the center of pressure in posterior direction was observed during the posting condition. No effect of stiffness was observed on center of pressure displacement.

      Interpretation

      The foot orthoses stiffness and the addition of posting influenced plantar pressures during walking. The foot orthoses stiffness mainly altered the plantar pressures under the midfoot area. However, posting mainly acted on peak and mean pressures under the rearfoot area.

      Keywords

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