Gait Efficiency and the Use of Insolia® Flex to Promote First Metatarsophalangeal Joint Dorsiflexion

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The Foot and Ankle Online Journal 4 (4): 2 Background: Dorsiflexion of the first metatarsophalangeal (MTP) joint during walking is an important characteristic that assists efficient forward progression.In spite of a range of foot orthoses used to encourage motion at this joint, little is known how they influence energy efficiency during walking.The aim of this study was to determine if a mass market, insole modification (Insolia ® Flex) influenced energy consumption and improved forefoot comfort.Materials and Method: Fifteen healthy male volunteers (mean age 29 years) were randomly assigned 2 pairs of identical and commercially available footwear, one of which contained the Insolia ® Flex.Heart rate (HR), volume of oxygen consumed in liters per kilogram (VO 2 /kg), respiration exchange ratio (RER), physiological cost index (PCI) and the number of steps (NoS) were monitored whilst walking on a treadmill at a speed of 4.2km/hour and 0% incline for 20 minutes.The Footwear Comfort Scale was also completed following each condition.Results: Paired t tests showed that HR, VO 2 /kg and the PCI were significantly reduced for the Insolia  Flex condition (p<0.001).No significant differences (p>0.05) were noted for the RER (p<0.05), but significantly less NoS were taken during the Insolia  Flex condition (p<0.001).A significantly improved overall and forefoot comfort rating (p<0.001) was noted for the Footwear Comfort Scale.Conclusions: The findings of this study show that energy consumption measures (i.e.HR and VO2/kg) and the PCI (a proxy measure) are influenced by first MTP joint function and suggests that efficiency is improved with the use of a modified insole that promotes function at this joint.Further research is required to clarify these findings.