Date of Award

2005

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Thomas Mohr

Keywords

Foot -- physiology; Orthotic Devices

Abstract

Researchers have been trying to understand the complexity of foot biomechanics for over 100 years, and this has lead to an increase in more sensitive technology. Abnormal foot biomechanics are commonly corrected using orthotics. Pressure mapping systems, such as the Force Sensitive Application (FSA) and Teckscan, are becoming more prevalent in both clinical settings and in research to assist clinicians in making proper fitting orthotics. FSA allows clinicians the ability to measure the amount of pressure on patients' feet with and without orthotics. The purpose of this study is to determine the effectiveness of semi-rigid custom foot orthotics in correcting abnormal foot positions.

The fourteen subjects in this study were past or present patients of a local physical therapist's. Subjects stood on the FSA pressure mapping system with and without their orthotics to record visual pressure distribution. They were also asked to complete a subjective questionnaire and consent to a chart review.

The foot was divided into five regions: medial/lateral heel, lateral midfoot, and medial/lateral forefoot. Data was analyzed using the SPSS program for the statistical data from the pressure mapping system. Significance of pressure changes with and without orthotics was determined by paired t-tests. A two-tailed alpha level of 0.05 was used to determine significance. There was a significant difference found in all sections of the feet. Pressure decreased with orthotics in the lateral/medial forefoot (t(13)=-4.256, p=.OOl/ t(13)=-3.313, p=.OOl respectively) and rearfoot (t(13)=-3.749, p=.002/ t(13)= -3.774, p=.002 respectively) sections, while pressure increased in the lateral midfoot section (t(13)=2.632, p=.021). Questionnaire data was reviewed for subjective data patterns.

The results demonstrated that orthotics reduce peak pressure by distributing pressure throughout the foot. Clinical researchers were able to identify positive outcomes in 13114 feet. Pressure mapping systems can be functional in clinical settings when used for visual description of pressure distribution.

Findings suggest orthotics do decrease pressure from the foot. The pressure mapping system is a helpful tool in evaluating if pressure change is relevant to the goal of the orthotic. Additional research is needed to determine if pressure mapping systems can decrease costs associated with multiple orthotic fittings.

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