Original research
Hardness and posting of foot orthoses modify plantar contact area, plantar pressure, and perceived comfort when cycling

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Abstract

Objectives

To evaluate the effects of hardness and posting of orthoses on plantar profile and perceived comfort and support during cycling.

Design

A repeated measures study with randomised order of orthoses, hardness, and posting conditions.

Methods

Twenty-three cyclists cycled at a cadence of 90 rpm and a perceived exertion rating of twelve. Contoured soft and hard orthoses with or without a medial forefoot or lateral forefoot post were evaluated. Plantar contact area, mean pressure and peak pressure were measured for nine plantar regions using the pedar®-X system and represented as a percentage of the total (CA%, MP%, and PP% respectively). Perceived comfort and support was rated on a visual analogue scale.

Results

The softer orthosis significantly increased CA% (p = 0.014) across the midfoot and heel with a decrease in the toe region and forefoot. MP% (p = 0.034) and PP% (p = 0.012) were significantly increased at the mid and lateral forefoot with reductions in MP% at the midfoot and in PP% at the hallux and toes. Forefoot posting significantly increased CA% (p = 0.018) at the toes and forefoot and decreased it at the heel. PP% was significantly altered (p = 0.013) based on posting position. Lateral forefoot posting significantly decreased heel comfort (p = 0.036).

Conclusion

When cycling, a soft, contoured orthosis increased contact across the midfoot and heel, modulating forefoot and midfoot plantar pressures but not altering comfort or support. Forefoot postings significantly modified contact areas and plantar pressures and reduced comfort at the heel.

Section snippets

Background

In cycling, the majority of the energy imparted to the bike is provided by the lower limb. With the foot-shoe-pedal interface being the single propulsive link enabling power transmission, there is potential for high reactive and repetitive forces at this site.1, 2 Previous investigations have demonstrated that plantar pressure patterns are consistent when cycling. The greatest pressures occur beneath the head of the first metatarsal phalangeal joint and the hallux which are situated directly

Methodology

Twenty-three participants, fourteen male and nine female, completed the study (age = 35.2 (±7.9) years, height = 175.4 (±7.7) cm, and mass = 71.2 (±10.9) kg). All participants were competitive or recreational road cyclists with an average weekly training/riding distance of 275.0 km (±95.7). Participants were required to have been using the bike, cycling shoes, pedals, and set-up position used during the testing period for a minimum of three months prior. At the time of testing, participants were

Results

As expected from previous investigations,2, 3, 6 the plantar pressure during the downstroke was demonstrated to occur predominantly in the forefoot region followed by the midfoot, with the least amount of plantar pressure noted through the heel.

No statistically significant three-way interaction effects were observed. Consequently, the effects of hardness and posting were investigated across plantar regions.

For the CA% data, the repeated measure ANOVA results indicated that there was a

Discussion

Effectively, a softer orthosis appears to provide increased conformity to the contours through the mid and rear foot, creating contact with a larger overall plantar surface area while modulating pressures across the forefoot. This was borne out by the finding that softer orthoses created greater contact with the plantar surface at the midfoot and heel while reducing contact through the front of the foot with the exception of the medial forefoot. The change in plantar contact coincided with

Conclusion

Varying orthosis properties, such as hardness and posting, influences the plantar surface characteristics of the foot during steady state seated cycling. A softer orthosis created greater contact with the plantar surface of the foot and modulated plantar pressures across the forefoot region, but did not influence the perception of comfort and support. Posting at the forefoot increased plantar contact through the posted region and reduced it across the rearfoot with plantar pressures altering

Practical implications

  • A softer, contoured orthosis in a cycling shoe reduces plantar contact area and pressures distal to the midfoot while increasing plantar contact area through the midfoot and heel.

  • A softer, contoured orthosis may beneficially shift plantar pressures away from the first metatarsophalangeal joint, which is a common site of foot pain and paraesthesia in cyclists.

  • Plantar pressures were increased in areas of the foot where posting was positioned.

  • Altering orthosis hardness or adding forefoot postings

Acknowledgements

Vasyli International® provided the inserts used for this study and had no involvement in the study design, analysis, and reporting. Jaquelin Bousie was supported by an adjunct research scholarship from The University of Queensland and the Australian Institute of Sport. The authors declare that they have no competing interests relevant to this study.

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