%0 Journal Article
%T The Biomechanical Effect of the Sensomotor Insole on a Pediatric Intoeing Gait
%A Akiyoshi Mabuchi
%A Hiroshi Kitoh
%A Masato Inoue
%A Mitsuhiko Hayashi
%A Naoki Ishiguro
%A Nobuharu Suzuki
%J ISRN Orthopedics
%D 2012
%R 10.5402/2012/396718
%X Background. The sensomotor insole (SMI) has clinically been shown to be successful in treating an intoeing gait. We investigated the biomechanical effect of SMI on a pediatric intoeing gait by using three-dimensional gait analysis. Methods. Six patients with congenital clubfeet and four patients with idiopathic intoeing gait were included. There were five boys and five girls with the average age at testing of 5.6 years. The torsional profile of the lower limb was assessed clinically. Three-dimensional gait analysis was performed in the same shoes with and without SMI. Results. All clubfeet patients exhibited metatarsal adductus, while excessive femoral anteversion and/or internal tibial torsion was found in patients with idiopathic intoeing gait. SMI showed significant decreased internal rotation of the proximal femur in terminal swing phase and loading response phase. The internal rotation of the tibia was significantly smaller in mid stance phase and terminal stance phase by SMI. In addition, SMI significantly increased the walking speed and the step length. Conclusions. SMI improved abnormal gait patterns of pediatric intoeing gait by decreasing femoral internal rotation through the end of the swing phase and the beginning of the stance phase and by decreasing tibial internal rotation during the stance phase. 1. Introduction Gait disorders have become the most prevalent orthopedic problems in children. One of the most common complaints of the gait disorders in infants and children is an intoeing gait, which is caused by excessive anteversion of the proximal femur, internal tibial torsion, and/or metatarsal adductus [1¨C5]. A careful evaluation of the children is essential to rule out serious pathological conditions such as cerebral palsy, infantile BlountĄ¯s disease, metabolic bone diseases, and skeletal dysplasias. An intoeing gait in the majority of patients without these pathological conditions is a minor problem and is observed to spontaneously improve with time [2]. The condition, however, sometimes produces functional problems such as frequent tripping. The parents or grandparents are concerned that the child will have a permanent disability or that the condition will interfere with the childĄ¯s physical performance; thus they sometimes hope for some treatments [5]. A shoe modification with wedges or arch supports is one of the tolerable nonsurgical treatments for children to correct an intoeing gait and modify the gait pattern. The sensomotor insole (SMI), which had been introduced by the German shoemaker Jarhling, was originally developed to
%U http://www.hindawi.com/journals/isrn.orthopedics/2012/396718/