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The biomechanical effect of the sensomotor insole on a pediatric intoeing gait
Akiyoshi Mabuchi1, Hiroshi Kitoh1, Masato Inoue2
1Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.
Insights
The sensomotor insole (SMI) effectively treats pediatric intoeing gait by reducing abnormal internal rotation in the femur and tibia. This intervention also improves walking speed and step length in children.
Area of Science:
- Biomechanics
- Pediatric Orthopedics
- Gait Analysis
Background:
- Intoeing gait is a common pediatric condition.
- Sensomotor insoles (SMI) have shown clinical success in treating intoeing gait.
- Biomechanical effects of SMI on pediatric intoeing gait require further investigation.
Purpose of the Study:
- To investigate the biomechanical effects of sensomotor insoles (SMI) on pediatric intoeing gait.
- To analyze changes in lower limb kinematics using three-dimensional gait analysis.
Main Methods:
- Study included six patients with congenital clubfeet and four with idiopathic intoeing gait.
- Three-dimensional gait analysis was performed with and without SMI.
- Clinical assessment of lower limb torsional profile was conducted.
Main Results:
- SMI significantly decreased proximal femur internal rotation during terminal swing and loading response phases.
- SMI significantly reduced tibial internal rotation during mid-stance and terminal stance phases.
- Walking speed and step length were significantly increased with SMI use.
Conclusions:
- SMI effectively improves abnormal gait patterns in pediatric intoeing gait.
- The mechanism involves reducing femoral and tibial internal rotation during key gait phases.
- SMI enhances gait parameters such as walking speed and step length.
Abstract:
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.
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