Effect of orthotics on postural sway after fatigue of the plantar flexors and dorsiflexors.

OBJECTIVE To examine the effects of orthotic intervention on unilateral postural sway after fatigue of the plantar flexor and dorsiflexor muscle groups. DESIGN AND SETTING Subjects were assigned to both orthotic and nonorthotic testing conditions in a counterbalanced order, then assessed for postural sway before and after isokinetic fatiguing contractions of the plantar flexors and dorsiflexors. Postural stability was measured on the motor-dominant extremity. (Motor dominance was assessed as the foot the subject used to kick a ball.) SUBJECTS Eleven active, healthy male subjects (mean age = 24 +/- 2.0 years, wt = 74.5 +/- 8.8 kg, ht = 180.3 +/- 8.4 cm) volunteered to participate in the study. MEASUREMENTS Center-of-pressure postural sway was assessed via the force platforms of a Chattecx Dynamic Balance System and transformed via 4 transducers as values indicative of sway in the anterior-posterior and medial-lateral directions. The dependent measure was postural sway in centimeters. Fatigue was induced by consecutive concentric plantar flexiondorsiflexion contractions on a Kin-Com II isokinetic dynamometer. RESULTS A repeated-measures analysis of variance revealed a significant orthotic-by-test interaction. Post hoc analysis with the Tukey honestly significant difference method revealed that postural sway values of the postfatigue nonorthotic condition were significantly greater when compared with the prefatigue orthotic, prefatigue nonorthotic, and postfatigue orthotic conditions. CONCLUSIONS Our results suggest that molded orthotics may be an effective means of decreasing postural sway after an isokinetic fatigue protocol. Further research is needed to determine the exact mechanism of this improvement and whether orthotics are an effective means of preventing ankle injury.

[1]  L. Konradsen,et al.  Prolonged peroneal reaction time in ankle instability. , 1991, International journal of sports medicine.

[2]  R. B. Johnston,et al.  Effect of lower extremity muscular fatigue on motor control performance. , 1998, Medicine and science in sports and exercise.

[3]  V. G. Payne,et al.  The effects of proprioceptive ankle disk training on healthy subjects. , 1995, The Journal of orthopaedic and sports physical therapy.

[4]  A. Nitz,et al.  Dynamic Ankle Stability: Mechanical and Neuromuscular Interrelationships , 1994 .

[5]  Orteza Lc,et al.  The Effect of Molded and Unmolded Orthotics on Balance and Pain While Jogging Following Inversion Ankle Sprain , 1992 .

[6]  H Tropp,et al.  Stabilometry in functional instability of the ankle and its value in predicting injury. , 1984, Medicine and science in sports and exercise.

[7]  H. Skinner,et al.  Effect of fatigue on joint position sense of the knee , 1986, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[8]  D H Perrin,et al.  Intertester reliability of assessing postural sway using the chattecx balance system. , 1995, Journal of athletic training.

[9]  D Brunt,et al.  The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. , 1993, The Journal of orthopaedic and sports physical therapy.

[10]  P. V. Komi,et al.  Neuromuscular fatigue and recovery in maximal compared to explosive strength loading , 1997, European Journal of Applied Physiology and Occupational Physiology.

[11]  A. Gollhofer,et al.  Orthotic Devices in Functional Treatment of Ankle Sprain , 1993, International journal of sports medicine.

[12]  Mark D. Grabiner,et al.  Effect of Plantar Flexor and Dorsiflexor Fatigue on Unilateral Postural Control , 1993 .

[13]  K. An,et al.  Stability of the loaded ankle , 1985, The American journal of sports medicine.

[14]  M. R. Walters,et al.  The Relationship between Muscle Function and Ankle Stability. , 1990, The Journal of orthopaedic and sports physical therapy.

[15]  D H Perrin,et al.  Effect of orthotics on postural sway following inversion ankle sprain. , 1996, The Journal of orthopaedic and sports physical therapy.

[16]  K. Bennell,et al.  The differential effects of external ankle support on postural control. , 1994, The Journal of orthopaedic and sports physical therapy.

[17]  D L Kelley,et al.  Position and Movement Changes of the Foot with Orthotic Intervention during the Loading Response of Gait. , 1990, The Journal of orthopaedic and sports physical therapy.

[18]  G. Davies,et al.  Orthopaedic and sports physical therapy , 1985 .

[19]  L. McGuire,et al.  The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional instability of the ankle. , 1995, The Journal of orthopaedic and sports physical therapy.

[20]  P N Sperryn,et al.  Podiatry and the sports physician--an evaluation of orthoses. , 1983, British journal of sports medicine.