The effects of enhanced plantar sensory feedback and foot orthoses on midfoot kinematics and lower leg neuromuscular activation

Excessive foot pronation has been associated with injuries of the lower extremity. No research has investigated the effect of enhancing plantar sensory feedback on foot pronation. The aim of this study was to determine whether a shoe with enhanced plantar sensory feedback reduces midfoot pronation. Midfoot kinematics and electromyography of the peroneus longus, tibialis anterior and medial gastrocnemius of 21 males (age: 21.0 ± 4.0 years, height: 176.8 ± 5.0 cm, mass: 73.3 ± 6.5 kg) were recorded whilst walking in a neutral shoe, a neutral shoe with a prefabricated foot orthotic and a neutral shoe with nodules located on the plantar-medial insole (experimental shoe). Friedman's ANOVA and Wilcoxon tests were used to evaluate differences between shoe conditions. Mean midfoot-tibia angles during ground contact were significantly more supinated when wearing the experimental shoe (+7.14°, p = 0.023) or orthotic (+3.83°, p = 0.006) compared to the neutral shoe. During the loading phase, midfoot angles were significantly more supinated when wearing the experimental shoe compared to the orthotic (+5.53°, p = 0.008) or neutral shoe (+6.20°, p = 0.008). In the midstance phase, midfoot supination was significantly higher in the orthotic compared to the neutral shoe (+2.79°, p = 0.006). Finally, supination was increased during the propulsive phase when wearing the experimental shoe compared to the orthotic (+7.43°, p = 0.010) or neutral shoe (+10.83°, p = 0.009). No significant (p < 0.05) differences in muscle activation were observed. These results suggest that increasing plantar sensory feedback to the medial aspect of the foot reduces midfoot pronation during an acute bout of walking. Further work is needed to explore whether these effects remain over longer time periods.