The effect of simple insoles on three-dimensional foot motion during normal walking Helen R. Branthwaite a , Carl J. Payton b , Nachiappan Chockalingam c, * a Pennine Acute NHS Trust, Rochdale, Oldham OL12 9QB, UK b Department of Exercise and Sports Science, Manchester Metropolitan University, Alsager ST7 2HL, UK c Faculty of Health and Sciences, Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, UK Received 29 September 2003; accepted 8 June 2004 Abstract Background. The purpose of this study was to establish the effect of simple non moulded flat based insoles on three-dimensional foot motion during normal walking. Excessive foot pronation is considered a major contributing factor to lower limb injuries. Moulded foot orthoses have been shown to decrease maximum foot eversion. Simple insoles are widely used in clinical practice as an alternative to moulded orthoses. However, there has been little research into the kinematic effects of simple insoles. Methods. All subjects had an inverted rearfoot and forefoot position when the subtalar joint was placed in neutral, which was assessed by a weight bearing goniometer. Rotations of the whole foot about three orthogonal axes relative to the shank were esti- mated using a five camera motion analysis system. Findings. Biplanar insoles significantly (P < 0.05) reduced maximum eversion by an average of 3.1° when compared to the no insole condition. The cobra insole reduced maximum eversion by an average of 2.1° when compared to the no insole condition. This difference approached statistical significance (P = 0.058). Interpretation. Biplanar and cobra insoles had no significant effect on maximum dorsiflexion, abduction or rate of eversion, when compared to the no insole condition. These results provide some limited support for the use of simple insoles to control for excessive foot pronation during walking. Ó 2004 Elsevier Ltd. All rights reserved. Keywords: Gait analysis; Orthotic; Pronation 1. Introduction Various studies have investigated abnormal prona- tion which is a combined movement made up of three planar movements namely, eversion, dorsiflexion and abduction. These studies have further indicated that this is a major contributing aetiological factor to lower limb musculoskeletal pathologies (Landorf and Keenen, 1999; Stacoff et al., 2000). Repetitive activities, which in- clude excessive pronation of the subtalar and tarsal joints during midstance phase of gait, may lead to an in- crease in the load applied to the footÕs ligaments, mus- cles and tendons, often resulting in chronic injuries. This pathological pronation of the foot has been sug- gested to increase joint range of motion and reduces the propulsive leverage needed to complete the gait cycle efficiently (Dennis et al., 1985; McCulloh et al., 1993). Moulded foot orthotics have been shown to be a suc- cessful means of injury treatment, aiding in the dramatic reduction of patientsÕ symptoms (Landorf and Keenen, 1999; McCourt, 1992). Donatelli et al. (1988) surveyed 53 patients after orthotic treatment and found that 96% reported pain relief and 52% of the patients would 0268-0033/$ - see front matter Ó 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.clinbiomech.2004.06.009 * Corresponding author. E-mail address: n.chockalingam@staffs.ac.uk (N. Chockalingam). www.elsevier.com/locate/clinbiomech Clinical Biomechanics 19 (2004) 972–977