ORTHOSES AND BALANCE IN THE AGING PATIENT
to compensate. A study by Budiman-Mak et al.,
they found that foot orthoses may be able to
prevent or slow the progression of hallux valgus
deformity in patients with rheumatoid arthritis.
In addition, a Cochrane review concluded
that although there is limited evidence on
which to base clinical decisions regarding the
prescription of custom-made foot orthoses for
the treatment of foot pain alone, there is gold
level evidence for treating painful pes cavus and
silver level evidence for treating foot pain in JIA,
rheumatoid arthritis, plantar fasciitis and hallux
valgus.
Research and development as well as
technological advancements since the 1940s
have paved way for significant advancement
in not only understanding how orthoses work
but also how to make custom orthoses that fit
the individual's needs. University of California
(Berkeley and San Francisco) have conducted
studies on human ambulation patterns which
have become the standards in studying gait
patterns as well as orthotic production.
New advances in biomechanics have helped
practitioners tailor orthotic materials and
designs to address the specific imbalances and
abnormalities see in the aging population, not to
mention the numerous over the counter devices
now available to the public.
Foot orthoses to improve balance and
postural stability
Foot orthoses are custom made or custom fit
foot shoe interfaces that allow for control of
abnormal biomechanics that may be producing
pain with standing and ambulation. In other
words, foot orthoses provide a balanced foot
shoe interface that reduces compensations made
by the foot and ankle complex for abnormal
positions or movements that are causing pain.
The concept of restoring the foot to a neutral
or “normal” position has been replaced with
providing a balanced position that allows
for pain free standing and ambulation. This
"balanced position" will allow the foot to move
and work with the rest of the body by providing
appropriate pain free proprioceptive input for
better posture and balance. By decreasing the
amount of pressure and force on any one area
of foot, orthoses allow for the redistribution
of pressure across the entire plantar surface.
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