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 Background and Aim: The common mechanism for lateral ankle sprain is inversion, plantar flexion, or the combination of both, if untreated successfully can lead to chronic ankle instability. It seems that the foot position, while touching the ground, has an effective role to cause ankle sprain. Thus it is possible to prevent ankle sprain through limiting foot position. Therefore the aim of this research is to study the effect of plantar flexion and eversion on mediolateral ground reaction force while landing in individuals who suffering from functional ankle instability.

Materials and Methods: In this case-control research study 32 subjects (17 subjects with unilateral functional ankle instability (FAI) and 15 control subjects), aged from 18 to 35 years, were tested. All subjects in instability group were selected by the orthopedic physician, then the anterior drawer and talar tilt tests were  performed for diagnosis of functional ankle instability and other physical examinations. Control group were matched with instability group by age, weight, height, gender and body mass index. The subjects standing with single leg on a 40 cm high platform in 25 cm front of a force-plate while the test leg relaxed and non-weight bearing. The subject landed on the test leg on the center of the force-plate. The subjects landed according to four types of position: A: neutral position of ankle and lateral foot wedge, B: neutral position of ankle, C: positive heel and lateral foot wedge and D: positive heel. 

Results: Among control group, medial ground reaction force increased in the "C" position relative to "B" position (p=0.007) and "C" position relative to "D" position (p=0.018). In FAI group, lateral ground reaction force increased in "C" position relative to "B" position (p=0.001) and "C" position relative to "A" position (p=0.002). Also in FAI group medial ground reaction force decreased in "D" position relative to "A" position (p=0.014). 

Conclusion: According to the findings, applying lateral foot wedge, while the ankle is in plantar flexion, increases the mediolateral ground reaction forces. Based on the results, position of plantar flexion is more possibly effective than inversion in ankle sprain. According to the study, the lateral foot wedge in ankle plantar flexion position may be more effective than in neutral one to change mediolateral ground reaction forces. 

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Background and Aim: The effects of lateral wedge insole with and without sub-talar strap on pain, arthritic symptoms, functional performance, sports and recreational activities, and knee related quality of life in patients with medial compartment knee osteoarthritis were compared.

Materials and Methods: Community-dwelling men and women aged over 40 years with medial compartment knee osteoarthritis, grades I or II based on Kellgrene and Lawrence grading system were participated in this study. They were randomly allocated in two different groups lateral wedge insole with and without sub-talar strap. Both groups were required to wear the insoles at home for the duration of four weeks, approximately 5 to 10 hours per day. Participants were asked to complete the Farsi version of Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire at baseline and at follow-up. The reliability of KOOS for measuring short term and long term symptoms and function in Iranian patients with knee injuries and osteoarthritis has been reported previously.

Results: The changes in KOOS subscales were significantly different in both groups over time. Contrary to our hypothesis, the interaction effect was significant between the two groups following our intervention in terms of symptoms, daily living functions, sports and recreational activities, and knee related quality of life, unless pain score. 

Conclusion: The result of this study suggests that both of the insoles improved pain, symptoms, function in daily living, sports and recreation activities and knee related quality of life in patients with mild medial compartment knee osteoarthritis. However, use of sub-talar strap with lateral wedge insole would be the better prescription for insoles in these patients. 

 

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Background and Aim: The effect of rocker soles on improvement of foot plantar pressure distribution is well documented. Rockers are commonly prescribed for diabetic patients with neuropathy in order to offloading the particular area of the foot sole thereby decreasing the chance of the foot ulcers. On the other hand, these patients may experience balance problems because of the somatosensory defects due to peripheral neuropathy. There is an evidence of postural destabilizing effect of rocker soles in healthy adults. The purpose of the current study was to investigate the postural responses to the rocker sole in diabetic patients with neuropathy. 

Materials and Methods: Seventeen diabetic patients with neuropathy participated in this study. Canvas shoes were modified by addition of toe only rocker soles made of EVA (Ethyl Vinyl Acetate). The motor control test was conducted by the use of Neurocom system to evaluate postural stability with and without rocker sole. The Center of force displacement, response latency and response strength were measured.

Results: No significant difference was observed between the toe only rocker sole and without it in center of force displacement and response latency of the patients (P› 0.05). The results also indicated a significant increase in the response strength of patients by the rocker shoe, only in medium perturbations (P‹ 0.05).

Conclusion: The results of this study demonstrated that the postural stability of diabetic patients with neuropathy in response to the toe only rocker shoe is the same as the shoe without any rocker profiles. However, rocker shoes increase the need for generating active force during the automatic postural response of these patients which may indicate a training effect on diabetic patients with neuropathy.

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Background and Aim: Neck pain is one of the most prevalent disorders in the world and became a major public health problem. It is a common condition affecting as much as two-thirds or more of the general population at one point of time during their life. Cervical collars have been approved to be effective on neck pain and disability as a conservative treatment. Actually most of patients refused to use them because of their appearance and raise temperature by wearing them. So we introduced a new design of cervical collar called Open-design collar, it seems that could be accepted better by patients because of its different appearance. The purpose of the current study was to investigate the effect of Open-design collar on user’s acceptance and cervical range of motion in asymptomatic adults.

  

Materials and Methods: Seventy-two healthy subjects (36 women and 36 men) aged 18 to 29 years oldwere recruited for this study. Neck movements were measured using JTECH Medical Dual Digital Inclinometer . Active flexion, extension, right and left lateral flexion, and right and left rotation were assessed in each subject 3 times with and without Open-design collar. To assessthe acceptance of wearing Open-design collar, each subject was asked to fill an acceptance questionnaire of five criteria about the Open-design collar.

 

Results: Open-design collar significantly reduced cervical motions. It reduced flexion and extension on average by 78.24 ± 8.03%, 79.91 ± 8.02%, and right lateral flexion and left lateral flexion by 56.70 ± 13.91%, 54.34 ± 13.39% and right axial rotation and left axial rotation on average by 82.22 ± 5.48 and 82.60 ± 6.77.

  

Conclusion: Based on the data of the 72 subjects presented in this study, the Open-design collar adequately immobilized the cervical spine as a semi-rigid collar while the subjects accepted it by a good score.

  

Keywords: Neck orthoses, Collar, Range of motion, Acceptance