Foot deformities, biomechanical and pathomechanical changes associated with aging including orthotic considerations, part II

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Biomechanical evaluation

The goal of the biomechanical evaluation is for the practitioner to gain a better understanding of the compensatory patterns associated with mild to moderate foot and limb deformity. As a result of the triplanar nature of the foot and the various congenital or acquired foot architectures, each foot type will exhibit distinctly different compensatory patterns. The concept of planal dominance, described by Green and Carol [3], states that triplanar joints will generally exhibit greater amounts of

Pathomechanics

The foot and ankle comprise a highly complex set of joints that can adapt to both internal and external influences. The foot is able to compensate for changes in the external environment such as varied surfaces and terrains by way of mobile joint adaptation and proprioceptive input to optimize balance [8]. The foot and ankle are also able to tolerate and compensate for milder deformity or dysmorphism affecting one or more segments of the lower extremity. It is only when joints are required to

Orthosis/shoe considerations

Many of the abnormal stance and gait patterns associated with compensation for structural and positional deformities of the foot may be eliminated or minimized with correctly balanced orthoses. By modifying foot motion during gait, orthoses help to relieve symptomatic stress on the lower extremities by controlling excessive or inadequate motion at specific joints. Realignment of the pronating foot with a posted orthotic device placed in an appropriate shoe can help to reduce excessive demands

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