How Prefabricated Plantar Insoles Can Reduce the Pronation
Condition: Flat Feet
MeSH terms: Flatfoot
Study type: Observational [Patient Registry]

Summary: 
      Pronation is a very common foot deformity in population. Plantar insoles are one way to treat
      it, and even correct it, but there are several kind of treatments. In this study we try to
      prove if prefabricated foot insoles are a solution to correct pronation in adults. It has
      been tested by Foot Posture Index, that it is an objetive clinical test to measure the
      posture of feet. Foot is clasified in supinated , pronated and neutral.
    

Detailed description: 
      Nowadays several treatments have been described to treat pronation foot posture, althought
      these ones heven´t proved objetively the improvement and progression of foot deformity like
      "Foot Posture Index" does,. Foot pronation during walking is a physiological movement at the
      beginning of stance phase. It is a needed mechanism which allows the lower limb muscles to
      support the reaction forces from the ground and to give the forefoot wider range of movement
      . When there is pronation movement in weight bearing of subtalar joint, the calcaneus does a
      movement of eversión while talus does a plantarflexion and movement of aduction .The movement
      is raised due to the paralelism of midfoot joints and the forefoot is forced to compensate
      the rearfoot position, gettting into dorsiflexion and abduction which leads to a flattening
      of the medial arch. it is known pronation or flatfoot. Pronation movement is a pathology when
      it happens during the second part of the stance phase, the 25% at the beginning or when
      deformity is abnormal provoking an excessive rearfoot eversion with flattenig of the medial
      arch which will lead to a lower limb misalignment . This doesn´t allow the foot to be a rigid
      part needed to propulsion phase, so muscles must work excessively to give balance. The
      pronated foot etiology can be congenital or laxity or due to triceps sural shortening, or
      functional etiology like varus forefoot, metatarsus aductus or tibial posterior
      insufficiency. There are some secundary painful pathologies which are the most frequent
      reason of podiatric appointment.. Plantar fascitis is one of the pathologies, and adquired
      deformities like Hallux Abductus Valgus, Hallux Límitus/Rigidus and other lower limb
      deformities like medial compatiment ostheoartritis of knee or patellofemoral syndrome.

      Pronated foot can be defined like a foot that has rearfoot eversion and medial protusion of
      the head of talus, forefoot abduction, flatted medial arch and joint movement greater. This
      shows a flat foot aspect, depending on the grades of pronation deformity that pacient
      presents. Both situations are linked and their behaviour are functionally similar.

      Attending on consequences and the pathologies derivated of this deformity there are some
      treatments to stop it and avoid structural alterations of leg and foot. For instance, hallux
      abductus Valgus, the pathological pronation is the first ray´s extrinsic ethilogic factor,
      both frequency and capacity to produce pathology.

      The compensation of pathological pronation of rearfoot is important to control the deformity
      evolution. Is commonly accepted by podiatric scientific community that control of pronation
      can avoid the deformity progression when it is presented (or this progression was slower) and
      avoid when it wasn´t present yet. Foot Posture Index is a clinical diagnostics tool compounds
      by 6 criteria that allow to asses reliability the weightbearing foot posture. It is a
      inexpensive and simple method that doesn´t imply risks to people.
    

Intervention name(s): prefabricated insoles
Intervention type(s): Device
Observational model: Cohort
Time perspective: Other
Sampling method: Probability Sample
Study population: 
        'Participant were pupils of Podiatric, Nursing, Forestry and Economic grades of University
        of Extremadura in Plasencia Campus, Spain. All of the came to Podiatric University Clinic
        Of University of Extremadura, Spain to be recruided in the present study. After to be
        informed of the features and targets of this study, they were be given an informed consent,
        answering the doubts. All of them signed the informed consent and they were asked to be
        engaged to use the right shoes with plantar insoles all the week , 8 hours at least for 6
        months.
      
Keywords: Foot posture index, foot pronation ,foot orthoses