The purpose of this review was to find how ultrasonography (US) could be used in order to evaluate the efficacy of foot orthotics therapy in the conservative treatment of foot pathomechanics.
The muscle-tendon’s architecture is consistent with the measurement of geometrical parameters as muscle length and thickness, fibre and fascicle length, pennation angle, physiological cross-sectional area, and myotendinous junction displacement.
US indentation methods were used for evaluating the mechanical properties of the plantar soft tissue (thickness, stiffness), providing useful information regarding mechanical behavior under vertical loading and an indication for the selection of the properties of the orthotic devices materials.
The influence of tissue’s properties (as bulk modulus and density) on the speed of the axial transmission of ultrasound waves was used for the study of the human Achilles’ tendon tension as an effect of wearing footwear and orthotic heel lifts.
Some sections from the reviewed articles also demonstrated the interest in using US in the study of foot orthotic therapy outcomes.
Musculoskeletal ultrasound methods play an important role in the diagnosis and the scoring and monitoring of some pathological conditions of different anatomical layers.
These techniques, successfully applied in other clinical fields, have a great potential to be used in the study of foot orthotics effectiveness.
Main ultrasound measurements associated with tissue loading and identified to be involved in the study of the effectiveness of foot orthotic therapy are: CSA, thickness, strain, length, moment arm, soft tissue compression, stiffness, energy dissipation area, and displacement of the myotendinous junction.
Other complex ultrasound measurements are those that resulted from texture analysis, tissue composition, muscle’s pennation angle, detection of latent in inflammation.
Those measurements have the potential to produce evidence of the modifying internal pathological tissue stress as a result of implementing foot orthotic therapy.
The authors concluded that in combination with advanced texture analysis and with pattern recognition methods, US could lead to a highly accurate, powerful technique for computer assisted and automatic diagnosis, which is also non-invasive, safe, and inexpensive.
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