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Introduction: Medical insoles play an important role in correcting the biomechanical characteristics of the foot in people with flat foot. The design and construction of the insole determines how it affects the foot. The aim of this study was to compare the effect of two types of semi-custom insole and custom molded insole made based on three-dimensional scanning technology on the distribution of surface and pressure in different areas of the sole of the foot.Materials and Methods: This quasi-experimental study was performed on 16 children with plantar fasciitis at the Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Participants were selected by simple non-probability method and randomly divided into two equal groups for intervention with semi-custom insoles and insoles made based on foot scans. The area of the parts involved in foot sole pressure and the size of the foot sole pressure and its location were measured before the intervention, immediately, and 6 weeks after continuous use of the insoles. Shapiro-Wilk test was used to examine the data distribution and two-way analysis of variance (ANOVA) was used for data analysis.Results: Both types of insoles showed the maximum pressure in the whole sole of the foot after 6 weeks (P = 0.04) and the maximum pressure in the middle of the sole of the foot increased significantly for both types of insoles, while a significant decrease was observed in the front sole of the foot (P = 0.07). The results also showed that the use of custom insoles in comparison with semi-custom insoles did not lead to a significant difference in the average of the maximum pressure applied to the front of the foot sole (P = 0.63).Conclusion: Although both custom insoles using Computer-aided design-Computer-aided manufacturing (CAD-CAM) and semi-custom insoles were effective in biomechanical effects such as pressure on the soles of the feet in children with flat feet, the custom insole was more effective. Since it is necessary to choose an advanced, uniform, and fixed method for designing and manufacturing medical insoles for children with flat feet, it is recommended that this study be performed with the help of scanners or other different and related design software.

Pressure coupled with shear stresses are the critical external factors for diabetic foot ulceration assessment and prevention. To date, a wearable system capable of measuring in-shoe multi-directional stresses for out-of-lab analysis has been elusive. The lack of an insole system capable of measuring plantar pressure and shear hinders the development of an effective foot ulcer prevention solution that could be potentially used in a daily living environment. This study reports the development of a first-of-its-kind sensorised insole system and its evaluation in laboratory settings and on human participants, indicating its potential as a wearable technology to be used in real-world applications. Laboratory evaluation revealed that the linearity error and accuracy error of the sensorised insole system were up to 3% and 5%, respectively. When evaluated on a healthy participant, change in footwear resulted in approximately 20%, 75% and 82% change in pressure, medial–lateral and anterior–posterior shear stress, respectively. When evaluated on diabetic participants, no notable difference in peak plantar pressure, as a result of wearing the sensorised insole, was measured. The preliminary results showed that the performance of the sensorised insole system is comparable to previously reported research devices. The system has adequate sensitivity to assist footwear assessment relevant to foot ulcer prevention and is safe to use for people with diabetes. The reported insole system presents the potential to help assess diabetic foot ulceration risk in a daily living environment underpinned by wearable pressure and shear sensing technologies.

Abstract Background Forefoot pads such as metatarsal domes are commonly used in clinical practice for the treatment of pressure-related forefoot pain, however evidence for their effects is inconsistent. This study aimed to evaluate the effects on plantar pressures of metatarsal domes in different positions relative to the metatarsal heads. Methods Participants in this study included 36 community-dwelling adults aged 65 or older with a history of forefoot pain. Standardised footwear was used and plantar pressures were measured using the pedar®-X in-shoe plantar pressure measurement system. Peak pressure, maximum force and contact area were analysed using an anatomically-based masking protocol that included three forefoot mask sub-areas (proximal to, beneath, and distal to the metatarsal heads). Data were collected for two different types of prefabricated metatarsal domes of different densities (Emsold metatarsal dome and Langer PPT metatarsal pad) in three different positions relative to the metatarsal heads. Seven conditions were tested in this study: (i) control (no pad) condition, (ii) Emsold metatarsal dome positioned 5 mm proximal to the metatarsal heads, (iii) Emsold metatarsal dome positioned in-line with the metatarsal heads, (iv), Emsold metatarsal dome positioned 5 mm distal to the metatarsal heads, (v) Langer PPT metatarsal pad positioned 5 mm proximal to the metatarsal heads, (vi) Langer PPT metatarsal pad positioned in-line with the metatarsal heads, and (vii) Langer PPT metatarsal pad positioned 5 mm distal to the metatarsal heads. Results When analysed with the mask that was distal to the metatarsal heads, where the plantar pressure readings were at their highest, all metatarsal dome conditions led to significant reductions in plantar pressure at the forefoot compared to the control (no pad) condition (F3.9, 135.6 = 8.125, p

Introduction: Rehabilitation robots have the ability to assist the patients with paralysis and semi-paralysis. Besides, these robots are capable of being programmed to perform various rehabilitation methods. However, evaluating their functions and their effects on human’s body are still two of the main challenges of theses robots. The purpose of the present study was to introduce a method for assessing the function of a rehabilitation robot in modifying the crouch gait to normal gait, by using online biomechanics and computational software. Materials and Methods: Rehabilitation robot and human leg were simulated using Inventor (Autodesk, Inc.) and OpenSim (Stanford University) software. User’s muscle strength was calculated according to a crouch gait. The system got the position of each joint and muscle strength as input, and determined the torque required for each hip and knee joints. Results: The performance of rehabilitation robot on human body was evaluated by relating the simulation in biomechanical and computational software. The kinematic and kinetic effects of robots on model of human model with crouch gait pattern was confirmed. In addition, the error of tracking normal gait with wearable robot was less than 0.06 rad for user with crouch gait. Conclusion: By using a simulation method and analyzing the motion data of a person gait pattern, an optimal path can be defined individually for each person, which reduces the risk and error of tracking while using the rehabilitation robot. It is also possible to change the mechanical and control structure of wearable robots in simulation without the cost and risk of laboratory evaluation.

Abstract Background Fear of falling is multifactorial in etiology and is associated with falls. It has been demonstrated that foot problems increase the risk of falls in older people. Therefore, the objective of this study was to investigate the associations of foot and ankle characteristics with fear of falling and mobility in community‐dwelling older people. Method One hundred and eighty‐seven community‐dwelling older adults (106 females) aged 62–90 years (mean 70.5 ± 5.2) from Isfahan, Iran, were recruited. Foot and ankle characteristics (including foot posture, range of motion, muscle strength, deformity, tactile sensation, pain and dynamic function), fear of falling (Fall Efficacy Scale International) and mobility (Timed Up and Go Test) were measured. Two multivariate linear regression analyses identified variables independently associated with fear of falling and mobility. Results Linear regression analysis revealed that less ankle plantarflexor muscle strength, greater pressure‐time integral, foot pain, and reduced tactile sensitivity of the ankle were significantly and independently associated with increased fear of falling. The total variance explained by the model was 59%. Less ankle plantarflexor muscle strength, greater pressure‐time integral, and slower centre of pressure velocity were significantly and independently associated with poorer mobility. The total variance explained by the model was 48%. Conclusion Several foot and ankle characteristics are associated with fear of falling and mobility in older people. Targeting these modifiable risk factors may play a role in reducing fear of falling and enhancing mobility performance in this population.

Introduction: Balance impairment and related injuries are common in elderly and patients with neurologic disorders. Ankle foot orthosies can influence on balance via improvement of movement disorders. Therefore the aim of this study was to investigate the effects of modified ankle-foot orthosis on balance performance in healthy elderly. Materials & Methods: The research was conducted on ten healthy elderly aged above 60. The conventional ankle-foot orthosis and modified ankle-foot orthosis were used in this study (the posterior part of the orthosis in the heel region was removed to provide free movements in the subtalar joint). Balance parameters were measured with a force plate during double limb standing in opened eyes and closed eyes under three different conditions: conventional ankle foot orthosies, modified ankle foot orthosies and barefoot. Also functional balance was assessed using Timed Up and Go test. Ethics code: IR.MUI.REC.1396.3.345. Findings: The results of this study indicated that using modified ankle-foot orthosis did not significantly change standing balance parameters compared to barefoot condition (P>0.05). However, wearing conventional ankle-foot orthosis resulted in a significant reduction of the center of pressure excursion in the mediolateral direction (16%) compared to the barefoot condition (P=0.02). Discussion & Conclusions: A simple modification in conventional ankle-foot orthosis did not impair standing balance performance of healthy elderly people. Additionally, the modified ankle-foot orthosis improved balance abilities compared to conventional ankle-foot orthosis. These observations could be attributed to the increased sensory feedback and using subtalar movements. It is recommended to study the effects of this modified orthosies on balance in the patients with neurological impairments who have foot and ankle movement disorders.

Background: Orthotic interventions such as different types of ankle foot orthoses have been widely suggested to either prevent or treat restricted ankle joint dorsiflexion and consequent equinus or equinovarus foot deformities in people with stroke. However, it is not clear whether orthotic interventions are effective against spasticity or stiffness. Therefore, this systematic review aimed to systematically review the effect of orthotic interventions on restricted ankle joint dorsiflexion due to plantarflexor stiffness. Review of literature: An electronic database search was performed using PubMed, ISI web of sciences, Scopous within 1990-2018. A set of search terms were derived from medical subject heading (MESH). A total of 486 potential articles were identified through database search. Following title screening and reviewing abstract, 60 articles were potentially relevant to undergo full consideration. Full text article review counted this number down to 2. Discussion: Studies found significant decreased plantarflexor stiffness indicated by increased ankle passive dorsiflexion range of motion after orthotic interventions. Conclusion: There are only a few studies which have objectively assessed the effects of orthotic interventions on restricted ankle joint dorsiflexion due to plantarflexor stiffness in stroke. A comprehensive study would provide insight into the effectiveness of orthotic interventions on restricted ankle joint dorsiflexion due to plantarflexor stiffness.

Introduction: Rehabilitation of people with disability has ethical dimensions. Therefore, the aim of this study was to review the codes of ethics for rehabilitation in English-speaking countries through a narrative review. Materials and Methods: In this study, the ethical codes in Australia, Canada, the Unite States, and the United Kingdom were searched electronically through the google search engine, because the language was understandable for researchers. Accordingly, the codes of ethics for rehabilitation (including Orthotics and Prosthetics, occupational therapy, and physiotherapy) were extracted and studied by two researchers independently. Results: A set of professional responsibilities for the rehabilitation services were categorized according to four principles of biomedical ethics and presented as ethical codes for rehabilitation services. Conclusion: As the first step in developing a reliable framework for professional ethics, professional ethics codes for rehabilitation in Australia, Canada, the United States, and the United Kingdom were reviewed through a narrative review, in order to provide the basis for professional ethics in rehabilitation services based on Iranian Islamic teachings.

Background: People with stroke often suffer abnormal foot posture including structural and movement deficiencies in the intrinsic foot segments on the affected side, which are associated with limitation in mobility. As part of a programme of research examining foot and ankle biomechanics after stroke, we investigated plantar pressure distribution under the affected foot of people with stroke and the relationship with functional mobility. Methods: Plantar pressure distribution was investigated while standing and walking on the affected side of twenty stroke and fifteen healthy sex and agematched participants, using a Medilogic platform system at a frequency of 20 HZ. Functional mobility in real life was measured using the Walking Handicap Scale. Results: While standing, people with stroke bore greater pressure on the affected side through the lateral heel and lesser toes (P

Introduction: Rehabilitation is one of the most important components of health, and includes a set of services to empower people with disability. The first step in providing a secure framework for professional ethics, is identifying the needs and rights of persons with disabilities based on the evidence and scientific documentation, and also the use of experiences from developed countries. Therefore, the aim of this study was to examine the available evidence of professional ethics through a narrative systematic review study designed to provide the basis for professional ethics in Iranian rehabilitation services. Materials and Methods: This was a narrative systematic evidence-based review study. All Persian and English articles published in the past 10 years with the main focus of ethical issues related to the provision of rehabilitation services in physiotherapy, occupational therapy, and orthotics and prosthetics were considered. A structured search of the peer-reviewed literature catalogued in major electronic databases (Scopus, PubMed, and Web of Science) was conducted using the following words and their derivatives (Rehabilitation, Human right, Patient right, Professionalism, Justice, Autonomy, Responsibility, Ethics, Bioethics) Results: The initial search by two reviewers yielded 1260 papers. Following review of title and abstract, 98 articles were considered relevant. 67 articles had full text. Full text review reduced this number to 24. To categorize the articles, four principles of biomedical ethics in principlism method. Conclusion: A set of professional responsibilities for the rehabilitation services were categorized in four principles of respect for autonomy, beneficence, non-maleficence, and justice, and also 10 titles outlined in the charter of physicians.

The authors, based on the experience of working with the World Health Organization in developing international standards for providing rehabilitation services, have developed a conceptual model for institutionalization, deployment, and access to quality rehabilitation services. This model focuses on four essential elements of service delivery (including policies, provision, products, and personnel) to develop quantitative and qualitative rehabilitation services in the Iranian community. The authors believe that scientific studies and researches in this conceptual model can provide a coherent backing for needs assessment, planning, action, and supervision in rehabilitation services. It can also provide the convergence and complementarity of academics and experts in institutions related to disability issues and rehabilitation, and provide the fulfillment of the highest goals in distributing services to the people with disability.

Abstract Background The area beneath the metatarsal heads is a common location of foot pain, which is often associated with high plantar pressures. Current plantar pressure assessment protocols focus mainly on the gross area of the forefoot with minimal attention paid to specific areas such as the metatarsal heads. The aim of this study was to develop and assess a new anatomically-based masking protocol that is clinically relevant to measure forefoot plantar pressure during shod conditions based on the anatomical positions of the metatarsal heads. Methods Initially, we developed a masking protocol to measure forefoot plantar pressure during shod conditions based on the anatomical positions of the metatarsal heads. This new masking protocol divided the forefoot into three sub-areas (proximal, beneath, and distal to the metatarsal heads) as determined by the position of each metatarsal head. Following development of the new masking protocol, we compared the new protocol against a traditional protocol, which defines the forefoot as between 51 and 81% of the foot length. To compare the two masking protocols, we tested two experimental conditions: (i) a control condition (i.e. no metatarsal pad), and (ii) a metatarsal pad condition. We then compared plantar pressure differences between the two experimental conditions for the two masking protocols. Participants for this component of the study included 36 community dwelling older adults (mean age 75.6 years ±5.4) with a history of forefoot pain. Forefoot plantar pressure data were measured while walking using the pedar®-X in-shoe system. Peak pressure, maximum force and contact area at the time of peak pressure were determined and results were compared between the two masking protocols. Results The traditional masking protocol showed that the metatarsal pad significantly decreased peak pressure and increased contact area in the forefoot area (i.e. within the entire mask area), but maximum force was not significantly different between the two conditions. In contrast, the newly developed anatomically-based masking protocol indicated that the metatarsal pad decreased peak plantar pressures distal to and beneath the metatarsal heads by increasing force and contact area proximal to the metatarsal heads. Conclusions An anatomically-based masking protocol that is clinically relevant was developed to assess forefoot plantar pressure during shod conditions based on the anatomical positions of metatarsal heads. We propose that the new forefoot masking protocol will provide greater interpretability of forefoot plantar pressure data, which will aid clinicians and researchers for diagnostic, prognostic and therapeutic purposes.

Abstract Background The aim of this study was to compare centre of pressure (COP) characteristics between healthy adults with normal, planus or cavus feet who were allocated to groups based on reliable foot posture measurement techniques. Methods Ninety-two healthy adult participants (aged 18 to 45) were recruited and classified as either normal (n = 35), pes planus (n = 31) or pes cavus (n = 26) based on Foot Posture Index, Arch Index and normalised navicular height truncated measurements. Barefoot walking trials were conducted using an emed®-x 400 plantar pressure system (Novel GmbH, Munich, Germany). Average, maximum, minimum and range (difference between maximum and minimum) values were calculated for COP velocity and lateral-medial force index during loading response, midstance, terminal stance and pre-swing phases of stance. The COP excursion index was also calculated. One-way analyses of variance were used to compare the three foot posture groups. Results The cavus foot exhibited the slowest average and minimum COP velocity during terminal stance, but this pattern was reversed during pre-swing, when the cavus foot exhibited the fastest maximum COP velocity. The planus foot exhibited the smallest lateral medial force index range during terminal stance. There were no differences between the groups for COP excursion index. Conclusion These findings indicate that there are differences in COP characteristics between foot postures, which may represent different mechanisms for generating force to facilitate forward progression of the body during the propulsive phases of gait.

Objective Some individuals with Chronic Ankle Instability (CAI) termed as functional ankle instability (FAI) suffer from repetitive ankle giving way and feeling of ankle joint instability during dynamic activities like walking. Walking, as a postural task, requires some central attention to integrate sensory inputs, estimate, and plan and produce proper motor outputs. Attention demanding cognitive task has the ability to influence walking control and may increase the risk of giving way and ankle sprain. The purpose of this study was to investigate the effect of dual-tasking on dynamic balance in people with FAI. Materials & Methods Twelve physically active with clinically diagnosed FAI and 12 matched controls completed trials of normal walking in isolation or with a concurrent cognitive task, which is repeatedly subtracting seven from a randomly selected number (between 200 and 250) and the same cognitive task while sitting. Spatiotemporal parameters (measured by a seven-camera motion capture system) were calculated by visual3D during gait cycles. Gait velocity, step time, step length, stance time, and swing time were calculated. Independent t-test was used to compare the data for FAI and control groups, and comparisons between the single and dual task conditions were made using the paired t-test. Step time variability was calculated using Intraclass Correlation (ICC). Results The results indicated that step velocity was decreased and that stance, swing, and step time were increased significantly during dual task walking in FAI people (P

Introduction: Sagittal rocker profiles are one of the most commonly prescribed therapeutic footwear interventions to alter or adapt lower limb joints’ kinematics and kinetics. However, the prescription criteria for rocker profiles are commonly based on theoretical considerations. Thus, conducting experimental studies and experiment and error may result in their better prescription and use. A complementary approach is to use intelligent technology to predict curve profile to suit a specific joint position. The aim of this study was to predict sagittal curve profile of the rollover footwear from ankle kinematics while walking by applying an artificial neural network (ANN). Materials and Methods: In the present study, 20 healthy participants (with mean age of 33.1 years) walked on a straight path for 10 meters wearing two different shoes with two different sole curved profiles and ankle kinematic data were collected using reflective markers. The ANN was trained to associate set of ankle sagittal plane motions during stance phase with outsole curve profiles, and then, predict the latter based on the former. The ANN was trained using the data from 13 participants (control group) to obtain the model and the data from the remaining participants (intervention group) was used for the validation of the study purposes. Results: The achieved accuracy was very satisfactory, since the correlation coefficients between the predicted output and the actual curve profile in the validation data were higher than 0.95 for both types of rollover footwear. Conclusion: In this study, a novel algorithm was proposed for sole curve profile characterization of rollover footwear using an ANN model. The results of this study may be useful to designers of footwear, lower limb prostheses, orthoses, and walking casts/boots.

مقدمه: کفش‌های غلتکی به طور وسیعی در سراسر دنیا به منظور اهداف درمانی مورد استفاده قرار می‌گیرند. ایده‌ی اصلی طراحی این کفش‌ها، افزایش فعالیت عضلات پا و بهبود تعادل می‌باشد. مطالعات بسیاری در مورد تأثیر این کفش‌ها بر تعادل انجام گرفته است، اما نتایج حاصل، با یکدیگر در تناقضند و اطلاعات دقیقی را از تأثیر این کفش‌ها بر تعادل در اختیار نمی‌گذارد. علاوه بر آن، در این تحقیقات بازه‌ی زمانی کوتاهی ارزیابی شده است که برای نتیجه‌گیری در مورد تعادل افراد، کافی نمی‌باشد. بنابراین، هدف از این مطالعه، بررسی تأثیر کفش غلتکی بر تعادل ایستا در طی ایستادن طولانی مدت می‌باشد. روش‌ها: در این مطالعه، 30 فرد سالم با دامنه‌ی سنی 30-20 سال شرکت نمودند و تعادل ایستایی این افراد، در چهار وضعیت پا برهنه و چشم باز، پا برهنه و چشم بسته، کفش غلتکی و چشم باز و نیز کفش غلتکی و چشم بسته مورد بررسی قرار گرفت. برای اندازه‌گیری تعادل از یک صفحه‌ی نیروی کیسلر، استفاده شد و افراد در حالت راحتی و سکون به مدت 5 دقیقه بر روی صفحه ایستادند. سپس، هر آزمون 5 دقیقه‌ای به 15 فریم 20 ثانیه‌ای تبدیل شد و پس از حذف فریم اول، متغیرهای مورد نظر در 14 فریم بعدی به دست آمد. متغیرهای مورد بررسی شامل دامنه‌ی تغییرات مرکز فشار (COP یا Center of pressure) و سرعت آن در راستای قدامی- خلفی و داخلی- خارجی و طول کلی مسیر مرکز فشار بود. یافته‌ها: کفش غلتکی سبب ایجاد افزایش معنی‌داری در دامنه و سرعت مرکز فشار در راستای قدامی- خلفی در تمام فریم‌ها می‌شود (001/0 > P)؛ اما در راستای داخلی- خارجی، در برخی از فریم‌ها تفاوت معنی‌داری مشاهده نشد. طول کلی مسیر مرکز فشار نیز با استفاده از کفش غلتکی، به طور معنی‌داری در تمام فریم‌ها از وضعیت پا برهنه بیشتر بود (002/0 = P). در مورد اثر بینایی بر تعادل، به طور کلی اثر معنی‌داری مشاهده نشد. نتیجه‌گیری: طی ایستادن طولانی مدت در این گروه از افراد، استفاده از کفش غلتکی سبب ایجاد بی‌ثباتی قابل توجهی، به ویژه در راستای قدامی- خلفی می‌شود و ممکن است خطر زمین خوردن فرد را افزایش دهد. لازم است اثر بی‌ثباتی این کفش‌ها در تجویز آن در افراد مبتلا به اختلال تعادل، مورد توجه قرار گیرد.

Abstract Background: .Low back pain (LBP) is one of the most common musculoskeletal disorders. Exercise therapy is often advised but it requires a significant time commitment, can rely on equipment or health professionals and risks low compliance. As an alternative or adjunct, shoes with a curved sole profile are thought to produce beneficial changes in ankle, knee, and hip and back position and posture .Therefore, the aim of this preliminary study was to investigate the effect of rollover footwear and McKenzie extension exercise on pain, disability and lumbar posture in people with sub acute Low back pain Material and Method: In this quasi-experimental study 20 people (age: 32.15±10.45 years) with LBP that decreased with extension movements , after signing informed consent , were assigned to a rollover footwear and McKenzie extension exercise group (n=10) or a McKenzie extension exercise only group (n=10). Baseline and post intervention measures were pain (visual analog pain scale), disability (Oswestry LBP disability) and lumbar posture when standing (via 7 -camera Qualisys motion capture system. Result: Participants in the rollover footwear and McKenzie extension exercise group had significantly greater decreases (58/9 %) in pain compared to the McKenzie extension exercise group (P=0.04). Disability reduction, comparison between two groups did not show statistical significance (P>0.05). The radius of lumbar curve was not significantly (P>0.05) and there was no significant difference in the change in the radius of lumbar curve between two groups (P>0.05). Conclusion: This result suggests that the rollover footwear could be part of a treatment protocol for greater reduction in pain level in patients with low back pain. Keywords: Low back Pain, McKenzie exercise, Rollover footwear, Posture

مقدمه: اختلالات تعادل یکی از مشکلات مهم در افراد با بی ثباتی عملکردی مچ می باشد که ارتباط آن با آسیب گیرنده های مکانیکی مفصل گزارش شده است. کفی بافت دار با تاثیر بر روی پوست پلانتار پا ها ممکن است تعادل را بهبود بخشد و ریسک آسیب در افراد با بی ثباتی عملکردی را کاهش دهد. بنابراین هدف این مطالعه بررسی تاثیر کفی بافت دار بر تعادل ایستادن در افراد با بی ثباتی عملکردی بود. مواد و روش ها: تعادل ایستادن بر روی دو پا در 20 ورزشکار با علائم بی ثباتی عملکردی با استفاده از صفحه نیرو طی دو مداخله: 1) کفی ساده 2) کفی بافت دار از جنس اتیل ونیل استات تست شد. متغیرهای تعادل ایستادن شامل: متوسط مسافت طی شده مرکز فشار، متوسط سرعت مرکز فشار در صفحات قدامی- خلفی و داخلی خارجی، مساحت ناحیه دایره ای محاط بر محدوده ی حرکت مرکز فشار( با اطمینان 95درصد) و مساحت ناحیه چرخش مرکز فشار در واحد زمان بود. تحلیل آماری داده ها با استفاده از تست آماری nonparametric Wilcoxon Signed Rank انجام گرفت. یافته ها: همه متغیرهای تعادل ایستادن حین پوشیدن کفی بافت دار در مقایسه با کفی ساده کاهش یافتند، اما فقط از نظر آماری کاهش معناداری در مساحت ناحیه دایره ای محاط بر محدوده ی حرکت مرکز فشار( با اطمینان 95درصد) بدست آمد (

Background: Increased ankle movement variability has been reported in people with functional ankle instability (FAI). The purpose of this study was to investigate the effect of textured insole, lateral wedge, and textured lateral wedge insole on ankle movement variability during walking in athletes with FAI. Materials and Methods: Twenty-one athletes diagnosed with FAI participated in this before-after study. Kinematic data were collected during four conditions (5 repeated trials per condition): (1) flat ethylene-vinyl acetate (EVA) insole, (2) textured flat EVA insole, (3) prefabricated lateral heel and sole wedge insole, and (4) textured lateral heel and sole wedge. The analysis of ankle movement variability was conducted during stance phase and 200 ms before initial contact to 200 ms after initial contact. The coefficient of multiple correlations (CMC) was calculated to investigate pattern variability and intraclass correlation (ICC) was used to investigate variability at the points of interest. Results: In terms of pattern variability, wearing textured lateral wedge increased CMC compared to other insoles. However, statistically significant differences were observed only in the frontal plane during stance phase (P < 0.05). In terms of variability at the points of interest, in the frontal plane and in all points of interest, wearing textured lateral wedge increased ICC compared to other insoles. The effects of other insoles on ankle movement variability were inconsistent. Conclusions: The results of this study showed that textured insole has the potential to decrease variability and the use of texture with lateral wedge may more improve variability in athletes with FAI.

Introduction: Shin splint is one of the common injuries in most athletes. Although the relationship between abnormal foot posture and shin splint has been reported previously but, the relation between foot posture and shin splint has not been well documented. The aim of this study was to explore the relationship between foot postures in basketball players and the history of shin splint. Materials and Methods: Thirty Iranian male basketball players who had experience of shin splint during last three months were participated in this study. Foot Posture Index (FPI-6) was used as the measure of foot posture. Talar head palpation, curvature at the lateral malleoli, inversion/eversion of the calcaneus, prominence in the region of the talonavicular joint, congruence of the medial longitudinal arch, abduction /adduction of the forefoot on the rear foot were 6 items which were assessed with FPI in the standing position. Foot posture was defined as ‘normal’, ‘supinated’ or ‘pronated. Data were collected and analyzed by SPSS, version16. Results: Most participants showed abnormal foot posture (%80). Fifty-three percent of subjects had pronated foot (%53) and 10% did hyper-pronation. The foot postures of 17% of participants were in supination. The results of this study did not show a significant difference in foot posture between right and left foot (P > 0.05). Conclusion: abnormal foot posture were common (%80) in basketball players with the history of shin splints. These findings could support this idea that the footwear and orthotic prescription both can prevent and treat basketball players with history of shin splints. Keywords: Foot posture, Shin splints, Basketball

Abstract Introduction: Knee osteoarthritis in the medial compartment is one of leading cause of limited activity in adults. Balance impairment has been reported in this group of patients. Laterally wedged insoles or footwear components have generally been shown to have immediate and long term beneficial effects on knee loading, pain and physical performance which may affect standing balance and posture control. Therefore the aim of this study was to investigate the effects of four different designs of lateral wedges on static balance in patients with ‎knee osteoarthritis. Materials and Methods: 18 females (age 59.6 ± 5.8 years) with painful knee OA were recruited. Static balance was assessed using a force plate (AMTI, 1000 Hz) during 60s double leg standing. Movement of the center-of-pressure (COP) was measured under five shod randomized conditions: (1) no wedge; (2) 8.5 lateral heel wedge (inside shoe); (3) 8.5 ° lateral heel and forefoot wedge (inside shoe); (4) 8.5 ° lateral heel wedge (shoe sole); (5) 8.5 ° lateral heel and forefoot wedge (shoe sole). Balance control was quantified using the amplitude and velocity of centre of pressure (COP) data. Results: Whilst there was a trend for COP parameters to decrease when wearing of the various lateral wedges compared to no-wedge condition, differences did not reach significance (p>0.05). The total mean distance over the 20 seconds, ‎the 95% confidence circle area and ‎95% confidence ellipse area were all statistically significantly reduced when wearing the shoe sole lateral wedges ‎ compared to lateral heel wedge (inside shoe) (p

Abstract Introduction: Aging has been associated with increasing foot pronation and changes in foot mobility which may influence standing balance. Orthotic interventions change foot posture and load distribution under the foot and therefore may have important effects on balance in older people. To investigate whether a pronated foot posture is associated with poorer standing balance in older people and whether medial heel and sole wedge orthoses affect their standing balance. Materials and Methods: Nine healthy older people with a pronated foot posture (age 67.1± 5.7 years) and Fourteen healthy elderly with normal foot posture (age 67.1± 6.4 years) were recruited.The Foot Posture Index was used to determine the pronated (FPI 7.5 ± 0.7) and normal (FPI 3.8 ± 1.5) foot posture. Static balance in double limb stance was assessed using Kistler force plate measures during four random shod conditions:1) 5° medial heel and sole wedge; 2) 8° medial heel and sole wedge; 3) 5°flat EVA base insole; 5) 8°flat EVA base insole. Each of the four cases was completed with eyes open (three trials) and eyes closed (three trials). The center-of-pressure (COP) mean excursion, total path length of COP, mean velocity of COP and area of 95% confidence ellipse were derived as measures of standing balance. Results: Participants with a pronated foot type demonstrated higher total and mean velocity excursion data in AP and ML directions, and larger ellipse, during normal standing, but this did not reach statistical significance (P>0.05). There were no statistically significant effects from the four orthoses designs in the pronated nor the normal foot types (P

Abstract Introduction: The aim of this study was to investigate facilitating and deterrent factors in learning practical skills from the viewpoints of the rehabilitation students of Isfahan University of medical sciences, third year onwards. Materials and Methods: In this descriptive cross-sectional study, 100 senior students (third year onwards) of Orthotics and Prosthetics; Physiotherapy; Speech therapy and Occupational therapy selected through census sampling method. The data collection tool was a questionnaire consisted 62 questions related to facilitating and deterrent factors in learning practical skills which contained 8 general areas. Questions were scored based on a five point likert scale. The data was analyzed by SPSS 18 software. Results: 100 senior students were recruited who had a mean age of 22.2 ± 0.8 years. In terms of facilitating factors, students rated the areas of “Individual positive features of clinical teachers (85%)” and “Clinical teacher-student effective relationship (85%)” more effective in learning practical skills comparing to other facilitating areas. In terms of deterrent factors, students rated the areas of “Inadequate teaching resources of clinical departments (76%)” more deterrent in learning practical skills comparing to other deterrent areas. Conclusion: The most important facilitating factor in learning practical skills from the viewpoints of the rehabilitation students of Isfahan University of medical sciences was individual positive features of clinical teachers. Therefore planning to use experienced teachers for providing clinical training and also to develop structured continuing education programs for new clinical teachers is advised. The most important deterrent factor from the viewpoints of the rehabilitation students was inadequate teaching resources of clinical department and therefore planning to provide necessary equipments and other required teaching resources is crucial. Keywords: Practical Skills, rehabilitation students, Facilitating Factors, deterrent Factors