Effects of three different posting methods on controlling abnormal subtalar pronation

The purpose of this study was to determine the effects of different orthotic posting methods on controlling abnormal foot pronation during ambulation.

Twenty-two individuals with forefoot varus deformities of at least 8 degrees (13 women, aged 21-40 years, and 9 men, aged 20-50 years) participated in the study. The female subjects had an average height and weight of 162.6 cm (64 in) and 55.3 kg (122 lb), and the male subjects had an average height and weight of 175.3 cm (69 in) and 80.7 kg (178 lb).

The subjects were examined with a computerized video motion analysis system. A control trial consisted of walking at 4.0 km/h in running shoes. Experimental trials included walking at 4.0 km/h in running shoes with unposted orthotic shells and with orthotic shells posted in the forefoot, the rear foot, and both forefoot and rear foot.

Maximal calf-to-calcaneus and calcaneus-to-vertical angles were decreased more by orthoses posted in both the forefoot and the rear foot than by orthoses posted only in the forefoot. No difference in maximal calf-to-calcaneus and calcaneus-to-vertical angles were found with combined forefoot and rear-foot posting compared with posting in the rear foot alone. The maximal calf-to-calcaneus angle was decreased by orthoses posted in any of the three methods and by the orthotic shell alone when compared with shoes alone. The maximal calcaneus-to-vertical angle was decreased by orthoses posted in any of the three methods, but not by the orthotic shell alone when compared with shoes alone.

Clinicians should consider combined posting or rear-foot posting alone when maximal control of rear-foot frontal-plane pronation is desired, though forefoot posting alone and the orthotic shell also provide control of rear-foot frontal-plane pronation.