Clinical Biomechanics最新文献

{"title":"Micromotion at a femoral osteotomy stabilized with a retrograde interlocking intramedullary nail","authors":"Rachel L. Lenhart ,&nbsp;Mei Wang ,&nbsp;Gregory J. Schmeling","doi":"10.1016/j.clinbiomech.2026.106749","DOIUrl":"10.1016/j.clinbiomech.2026.106749","url":null,"abstract":"<div><h3>Background</h3><div>Retrograde nails are becoming used increasingly in the trauma setting and the indications are expanding. The goal of this study was to evaluate micromotion at fracture sites in the proximal half of the femur stabilized with a retrograde intramedullary nail to determine the effects of fracture location, canal fill, and screw configuration.</div></div><div><h3>Methods</h3><div>Composite femurs were loaded in simulated single-leg stance while measurements of micromotion were made using linear variable differential transducers and motion analysis. Part one of the study compared differences by fracture location (subtrochanteric vs. proximal third vs. mid-shaft). Part two determined the effects of canal fill (13 vs. 10 mm nail) and proximal interlocking screw configuration on micromotion in the setting of subtrochanteric fracture.</div></div><div><h3>Findings</h3><div>Subtrochanteric fracture location led to significantly more axial displacement compared to the other locations (<em>p</em> &lt; 0.05). Reduced canal fill led to more coronal rotation (p &lt; 0.05) and likely more axial displacement (<em>p</em> = 0.06). Screw configuration was important for axial displacement (<em>p</em> &lt; 0.05), particularly in the non-canal filling condition where the proximal screw configuration with only one screw in the more proximal location had increased micromotion compared to one distal.</div></div><div><h3>Interpretation</h3><div>Fracture location, nail size, and proximal locking screw configuration are all important to the stability of the fracture construct. In subtrochanteric fractures, surgeons should consider using a canal filling nail with either two screws or the distal screw only, or using a different nail design.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106749"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Threshold screw insertion torque for carbon fibre-reinforced polyetheretherketone and titanium (Ti-6Al-4V) locking plate constructs","authors":"Ramzi Nasr ,&nbsp;Elise Pegg ,&nbsp;Fedra Zaribaf ,&nbsp;James Fletcher","doi":"10.1016/j.clinbiomech.2026.106769","DOIUrl":"10.1016/j.clinbiomech.2026.106769","url":null,"abstract":"<div><h3>Background</h3><div>Locking plate constructs are integral to modern fracture fixation, particularly in osteoporotic bone. Carbon-fibre reinforced polyetheretherketone (CFR-PEEK) plates offer a stiffness profile closer to cortical bone than titanium, potentially improving the mechanical environment for healing. However, the optimal insertion torque for locking screws in CFR-PEEK plates is unclear. This study investigated the influence of insertion torque on construct performance in CFR-PEEK plates compared to titanium alloy (Ti-6Al-4V) plates.</div></div><div><h3>Methods</h3><div>Locking screws (3.5 mm, Ti-6Al-4V) were inserted into Ti-6Al-4V and CFR-PEEK plates at six torque levels (0.5–3.0 Nm). Construct strength was assessed via axial push-out and cantilever bending tests. Video analysis was used to correlate insertion torque with screw rotation. Additional testing was performed on two-screw CFR-PEEK constructs at three torque levels (0.5, 1.5, 2.5 Nm).</div></div><div><h3>Findings</h3><div>Insertion torque was linearly related to screw rotation within the tested range (0.5–3.0 Nm). In CFR-PEEK single screw constructs, higher torque (≥2 Nm) improved push-out strength (<em>p</em> &lt; 0.05), while 1.5 Nm yielded the highest cantilever strength (p &lt; 0.05). Ti-6Al-4V constructs showed a similar trend. In two-screw CFR-PEEK constructs, no significant differences were found in performance across torques for either push-out or cantilever testing (<em>p</em> &gt; 0.5).</div></div><div><h3>Interpretation</h3><div>Beyond an initial threshold (∼0.5 Nm), increased insertion torque did not consistently enhance construct performance. These findings indicate that moderate torques (∼1.5 Nm) optimise performance while reducing the risk of implant damage, support the mechanical reliability of CFR-PEEK plates.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106769"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of age on muscle and kinematic responses following an unpredictable forward slip while walking","authors":"Steven Phu ,&nbsp;Daina L. Sturnieks ,&nbsp;Stephen R. Lord ,&nbsp;Yoshiro Okubo","doi":"10.1016/j.clinbiomech.2026.106779","DOIUrl":"10.1016/j.clinbiomech.2026.106779","url":null,"abstract":"<div><h3>Background</h3><div>Slips lead to many falls in older adults. This study aimed to determine the impact of age on muscle and kinematic responses following an unpredictable forward slip while walking.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 127 adults (25 young and 102 older) exposed to a single unpredictable forward slip, induced at foot-strike while walking. Bilateral lower limb muscle activity was measured via electromyography and gait kinematics were measured via motion capture.</div></div><div><h3>Findings</h3><div>Compared to young, older adults displayed greater relative muscle activity and higher relative centre of mass during walking prior to the slip onset (<em>P</em> &lt; 0.05). Following the slip, older adults experienced slips with greater velocity, displayed longer muscle onset latency and time to peak activity of the hamstrings on the non-slipped (contralateral) limb and greater peak activity magnitudes of the gastrocnemius bilaterally (<em>P</em> &lt; 0.05). Older adults also spent more time in double-limb stance (<em>P</em> = 0.001), took a slower second recovery step (<em>P</em> = 0.006), and displayed greater harness loading (<em>P</em> = 0.005).</div></div><div><h3>Interpretation</h3><div>Older adults had inferior muscle and kinematic responses to an unpredictable forward slip compared to young. Delayed activation of the contralateral limb knee flexors and hip extensors may lead to greater instability, more severe slips and an increased risk of falls in older adults.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106779"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulated wrist fractures displace in well molded casts and splints under fall simulation forces: A cadaveric study","authors":"Joshua T. Bram ,&nbsp;Julia S. Retzky ,&nbsp;Kathleen N. Meyers ,&nbsp;Olivia C. Tracey ,&nbsp;Nicolas Pascual-Leone ,&nbsp;Keza R. Levine ,&nbsp;Margaret V. Darko ,&nbsp;Erikson Nichols ,&nbsp;Emily R. Dodwell","doi":"10.1016/j.clinbiomech.2026.106752","DOIUrl":"10.1016/j.clinbiomech.2026.106752","url":null,"abstract":"<div><h3>Background</h3><div>Distal radius fractures are commonly treated with cast/splint immobilization, but variations exist in activity restrictions.</div></div><div><h3>Methods</h3><div>Fractures of the distal radius/ulna were created in cadaveric forearms. A force was applied through the long axis of the forearm simulating a ground-level fall. Each sample underwent testing in a short-arm well-molded fiberglass cast and a commercial fracture splint. Initial and final position lateral radiographs at 0 N and 400 N of force and dynamic fluoroscopy were taken for calculation of the primary outcome, change in volar tilt. Secondary outcomes were change in radial height and inclination, with comparison of these parameters between cast and splint testing. Statistical analysis employed paired <em>t</em>-tests.</div></div><div><h3>Findings</h3><div>Ten adult cadaveric forearms (6 female, mean age 58.5 ± 17.4 years, BMI 25.7 ± 5.9) were included. Mean overall change in volar tilt, radial height, and radial inclination was 13.3°, 6.3 mm, and 0.5°, respectively. Alignment was similar pre-and-post testing between casted and splinted specimens across all forces. Change in dorsal angulation of fractures from 0 to 400 N of force was comparable when casted and splinted (13.3 ± 9.2° vs 13.2 ± 8.7°, <em>P</em> = 0.945). Fracture displacement reached &gt;10° of dorsal tilt in both groups at 29.2% and 40.8% of idealized adult (70 kg) and adolescent (50 kg) body weights, respectively.</div></div><div><h3>Interpretation</h3><div>Mean change in volar tilt suggests immobilized fractures in cast or splint may displace with ground-level fall mechanisms. Fracture displacement was similar between short-arm casts and wrist splints. Clinical practice guidelines should be developed for patients with cast-immobilized healing fractures.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106752"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An in vitro parametric study of maxillary sinus ventilation using transparent 3D-printed sinonasal models","authors":"Amr Seifelnasr ,&nbsp;Xiuhua April Si ,&nbsp;Jinxiang Xi","doi":"10.1016/j.clinbiomech.2026.106772","DOIUrl":"10.1016/j.clinbiomech.2026.106772","url":null,"abstract":"<div><h3>Background</h3><div>Impaired maxillary sinus ventilation promotes secretion stasis and infection risk. How anatomical parameters (ostial diameter (D), length (L), and sinus volume (V)) interact with breathing pattern to shape ventilation has not been systematically studied in anatomically realistic settings.</div></div><div><h3>Methods</h3><div>Fifteen transparent sinonasal casts were 3D printed spanning three levels of D, L, and V (D1-D3, L1-L3, V1-V3). <em>E</em>-vapor was used to visualize and quantity sinus ventilation under three conditions: breath-hold, quiet breathing, and panting. Two time metrics were quantified: (i) total vapor escape-settling time; and (ii) escape time for the vapor cloud to reach a reference line. Full factorial ANOVA assessed the main effects of anatomical factors and breathing modes and their interactions.</div></div><div><h3>Findings</h3><div>Breathing mode was the strongest determinant of total clearance (<em>p</em> &lt; 0.001), with panting markedly reducing the ventilation time than quiet breathing and breath-hold (by &gt; two-thirds). Longer canals and larger sinus volumes prolonged retention. For early-stage transport (time to reference line), ostial length had the most influential main effect (<em>p</em> &lt; 0.001), followed by breathing mode, ostial diameter, and sinus volume. Significant two-way interactions were observed, whereas higher-order interactions were limited. Visualizations and pooled distributions (violin plots) corroborated these hierarchies across the parametric space.</div></div><div><h3>Interpretation</h3><div>Maxillary sinus ventilation reflects coupled anatomical and physiological constraints. Breathing mode dominates sinus ventilation, whereas ostial canal length most strongly governs early escape near the ostium. These results have implications for surgical planning to increase ostial patency and for optimizing breathing maneuvers to promote sinus aeration and clearance.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106772"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of elbow posture on biceps function at the shoulder in brachial plexus birth injuries: A computational sensitivity analysis","authors":"T.R. Goins ,&nbsp;Jane E. Sullivan ,&nbsp;John Fox ,&nbsp;Cindy Servello ,&nbsp;Katherine Saul","doi":"10.1016/j.clinbiomech.2026.106761","DOIUrl":"10.1016/j.clinbiomech.2026.106761","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with a brachial plexus birth injury have changes in optimal muscle length of affected muscles and diminished motion at the elbow and shoulder, impacting active shoulder elevation. The long head of the biceps, a bi-articular muscle, is of particular interest in this population due to its reduced optimal muscle length and simultaneous shortening at the shoulder and elbow during active shoulder elevation. Prior studies have shown immobilization of a joint may improve the moment-generating capacity of a biarticular muscle crossing that joint. The aim of this study was to investigate the impact of joint stabilization on shoulder elevation isometric moment-generating capacity and active and passive fiber force of the long head of the biceps in simulated elbow postures and altered optimal fiber length of the biceps.</div></div><div><h3>Methods</h3><div>Simulations, via a musculoskeletal model, were used to predict maximum isometric shoulder elevation moment, active-fiber force, and passive-fiber force versus shoulder elevation in stabilized elbow postures from 10° to 120° with a range of optimal muscle lengths from typical to reduced longitudinal length by 30%, 20%, and 10% to the long head of the biceps.</div></div><div><h3>Findings</h3><div>The highest shoulder elevation moment was produced with optimal fiber length reduced 30% for biceps long head and the elbow stabilized in 30°, causing lower active fiber force, but higher passive fiber force.</div></div><div><h3>Interpretation</h3><div>Understanding the biomechanical advantage of immobilizing the elbow in a specified posture that improves shoulder elevation in this population, establishes future directions for therapeutic interventions for birth brachial plexus injuries.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106761"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fear of movement, obesity and physical activity in knee osteoarthritis","authors":"Huaning Liu ,&nbsp;Lauren Straatman ,&nbsp;Kathryn F. Webster ,&nbsp;Patrick Ippersiel ,&nbsp;Daniel J. Currie ,&nbsp;Dalia Grad ,&nbsp;Emily G. Wiebenga ,&nbsp;Kaylena Ehgoetz Martens ,&nbsp;Stacey M. Acker ,&nbsp;Monica R. Maly","doi":"10.1016/j.clinbiomech.2026.106770","DOIUrl":"10.1016/j.clinbiomech.2026.106770","url":null,"abstract":"<div><h3>Background</h3><div>Fear of movement is common in knee osteoarthritis but its role in reducing physical activity, and how it interacts with pain, remain unclear. The purpose of this study was to investigate how fear of movement affects the relationships between daily step count with each of pain intensity and pain sensitivity in symptomatic knee osteoarthritis.</div></div><div><h3>Methods</h3><div>Thirty-one participants with symptomatic knee osteoarthritis were included (17 female, 14 male, 0 intersex; age 65.3 [7.0] years, body mass index (BMI) 30.0 [5.0] kg/m^2). Mean daily step count was captured using a commercial 3-axis accelerometer over 7 days. Pain intensity was measured with the pain subscale of the Knee Injury and Osteoarthritis Outcome Score. Pain sensitivity was measured with pressure pain threshold. Fear of movement was self-reported on the Brief Fear of Movement Scale. After adjusting for covariates (age, BMI), regressions tested the associations between step count and pain intensity without, then with, fear of movement and its interactions. The analysis was repeated using pain sensitivity.</div></div><div><h3>Findings</h3><div>Step count was not significantly associated with pain intensity (R² = 0.199, <em>p</em> = 0.107) nor with pain sensitivity (R² = 0.217, <em>p</em> = 0.091). After adding fear of movement and its interactions to the model, the BMI x fear of movement interaction (<em>p</em> = 0.003) explained variance in step count (R² = 0.512, <em>p</em> = 0.011). Those with greater fear of movement and larger BMI completed fewer steps compared to their peers.</div></div><div><h3>Interpretation</h3><div>Managing fear of movement may enhance rehabilitation to promote physical activity in knee osteoarthritis.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106770"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicted effects of hip distraction on knee ligament mechanics following total knee arthroplasty: A finite element analysis","authors":"Sophia Soehnlen ,&nbsp;Yogesh Kumaran ,&nbsp;Sara Sadeqi ,&nbsp;Sudharshan Tripathi ,&nbsp;Angela C. Collins ,&nbsp;Carmen E. Quatman","doi":"10.1016/j.clinbiomech.2026.106763","DOIUrl":"10.1016/j.clinbiomech.2026.106763","url":null,"abstract":"<div><h3>Background</h3><div>Hip distraction is essential for hip arthroscopy and other orthopaedic surgeries, but high traction forces often lead to complications like nerve injury and soft tissue impairment. Patients with total knee arthroplasties (TKAs) may face increased risk due to altered joint mechanics; however, the impact of specific TKA configurations on knee behavior during distraction is poorly understood.</div></div><div><h3>Methods</h3><div>A validated finite element model of the pelvis and lower extremity was developed from patient CT and MRI data. Three configurations were modeled: bi-cruciate retaining (BCR), posterior-cruciate retaining (PCR; lacking ACL), and posterior-stabilized (PS; lacking both cruciates). Hip distraction was simulated with axial traction forces (100–500 N) applied to the distal tibia/fibula with the pelvis fixed proximally. Knee and hip joint displacement and ligament strains were evaluated.</div></div><div><h3>Findings</h3><div>The BCR model demonstrated the highest knee stiffness. ACL removal (PCR) reduced stiffness more compared to PCL removal. While the amount of hip distraction was consistent across models, PCR and PS knees experienced excessive knee distraction (&gt;12 mm) and ligament strains exceeding 20% before achieving 10 mm of hip distraction. Conversely, the BCR model remained under 10 mm of knee distraction and 15% strain at equivalent hip distraction levels.</div></div><div><h3>Interpretation</h3><div>Finite element analysis revealed that PCR and PS configurations exhibit knee instability, exceeding soft tissue injury thresholds (&gt;20% strain) within standard clinical traction ranges (250–350 N). The ACL contributed greater to knee complex stiffness in axial traction compared to the PCL. Standard traction forces may pose an iatrogenic risk to PCR and PS patients, suggesting a need for TKA-specific distraction protocols to prevent soft tissue failure<em>.</em></div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106763"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postural control anomalies and gait dysfunction in Tourette's syndrome: a systematic review and meta-analysis","authors":"Giorgio Guido ,&nbsp;Fabio Zeoli ,&nbsp;Giorgia Carlin ,&nbsp;Alessio Sarnataro ,&nbsp;Vittorio Oteri ,&nbsp;Sagari Betté","doi":"10.1016/j.clinbiomech.2026.106750","DOIUrl":"10.1016/j.clinbiomech.2026.106750","url":null,"abstract":"<div><h3>Background</h3><div>Alongside typical manifestations such as motor and vocal tics, recent research has unveiled abnormalities in postural control and gait in patients with Tourette's syndrome (TS).</div></div><div><h3>Methods</h3><div>To investigate abnormalities in postural control and gait in patients with TS an extensive search of the literature was performed on PubMed, EMBASE, and Cochrane Library, following PRISMA guidelines. The ROBINS-I tool was used for risk of bias assessment. The Newcastle Ottawa scale was used to evaluate the certainty of evidence. Meta-analysis was conducted using a random-effects model to calculate the Standardized Mean Difference of Center of Pressure velocity and range across four clinical studies comparing children with TS to healthy controls.</div></div><div><h3>Findings</h3><div>Six case-control studies were included. Analysis of the selected studies revealed consistent findings of subclinical postural control deficits in patients with TS, characterized by increased sway area and increased range and velocity of center of pressure displacements. Reduced postural stability was found upon altered sensory or attention-demanding tasks. Minor gait dysfunctions were also found, including irregular step length and a larger step length differential. Importantly, these abnormalities appeared to be independent of tic severity, medications and comorbidities, suggesting their intrinsic nature in the context of TS.</div></div><div><h3>Interpretation</h3><div>Postural control deficit and gait dysfunction may be additional phenotypic correlates of cortical connectivity abnormalities in TS. Consequently, testing these domains in the overall assessment of patients with TS is warranted, also to develop effective and targeted therapeutic interventions addressing these aspects of the disease.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106750"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a contoured foot orthosis versus a flat sham insert on plantar loading in midfoot osteoarthritis","authors":"Yuet Yee Or ,&nbsp;Hylton B. Menz ,&nbsp;Shannon E. Munteanu ,&nbsp;Karl B. Landorf ,&nbsp;Michelle R. Kaminski ,&nbsp;Polly Q.X. Lim","doi":"10.1016/j.clinbiomech.2026.106764","DOIUrl":"10.1016/j.clinbiomech.2026.106764","url":null,"abstract":"<div><h3>Background</h3><div>Midfoot osteoarthritis is common and results in pain and disability. We compared the effects of an arch contouring foot orthosis and a flat sham insert on plantar loading in people with midfoot osteoarthritis.</div></div><div><h3>Methods</h3><div>Plantar loading was collected while walking with: (i) shoe-only, and either (ii) a flat sham insert or (iii) an arch contouring orthosis. Differences within groups were tested using paired samples <em>t</em>-tests, and differences between groups were tested using analyses of covariance. Effect sizes for within-group comparisons were calculated using Cohen's <em>d</em>.</div></div><div><h3>Findings</h3><div>Forty-two adults were analysed (38 women and 4 men, mean ± SD age 66.3 ± 6.7 years). The arch contouring orthosis significantly increased contact area (adjusted mean difference [MD] 3.0 cm², 95% confidence interval [95% CI] 0.0 to 5.9; <em>p</em> = 0.047) and maximum force (MD 30.3 N, 95% CI 16.0 to 44.7; <em>p</em> &lt; 0.001) at the medial midfoot, decreased maximum force at the lateral forefoot (MD <strong>-</strong>28.2 N, 95% CI <strong>-</strong>42.9 to <strong>−</strong>13.5; <em>p</em> &lt; 0.001), decreased peak pressure at the heel (MD <strong>-</strong>36.2 kPa, 95% CI <strong>-</strong>65.1 to <strong>−</strong>7.4; <em>p</em> = 0.015) and increased peak pressure at the medial midfoot (MD 19.8 kPa, 95% CI 7.0 to 32.5; p = 0.003). Within the arch contouring orthosis group, increases in maximum force and peak pressure at the medial midfoot were large and very large (<em>d</em> = 0.90 and 1.21, respectively).</div></div><div><h3>Interpretation</h3><div>The arch contouring orthosis increased plantar loading at the medial midfoot and decreased loading at the heel. Further studies are required to investigate if these effects are related to symptomatic improvements.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106764"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}