Sensorimotor insoles

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A sensorimotor insert is also known under the name proprioceptive insert or afference-stimulating insert. With this special insert , the body's biomechanics are supported by targeted sensory impulses. The aim is to change the activity of individual muscles or muscle groups when walking, running or standing by increasing (toning) or reducing (detonating) muscle tension. The effectiveness is currently only partially proven and for some manufacturing concepts, although there are probably a number of subjective successes in the treatment of orthopedic misalignments and imbalances. One difficulty lies in the fact that a large number of different insert concepts are subsumed under the generic terms mentioned, which differ in the type of manual production and in the postulated mode of operation.

Typical areas of application for sensorimotor insoles are, for example:

  • Paralysis or spasticity
  • Rotational malalignment of the legs
  • Foot deformities such as drop foot , flat foot , skew foot and clubfoot
  • Toe misalignment
  • Achilles tendon discomfort
  • Heel spur problems
  • Tiptoe

effectiveness

A manufacturer-financed study from March 2013 examined the influence of an insole with a specially shaped sensorimotor element on the activity of the M. peroneus longus in the stance phase and came to the conclusion that “a step phase-dependent increase in the activity of the M. peroneus longus by a lateral pressure-generating insert element is possible. This opens up interesting therapeutic starting points for patients with instability of the ankle joints or malformed feet, who tend towards increased supination and could complement previous conservative approaches ”.

There are practical insights into the "normal" sensorimotor insoles prescribed by the orthopedic surgeon and supplied by the medical supply store, which prove their ineffectiveness. In the children's foot practice in Woltersdorf (owner Andreas Herr), 75 children's feet were examined in which no progress was made with the use of sensorimotor insoles or the condition even deteriorated, especially with flat arched feet. The reason for this is the following explanation: The foot reacts to different pressure points against the sole of the foot. In theory, the pads that are attached to the sensorimotor insoles provide these pressure points. Now the foot gets used to these pads very quickly and this means that the muscles no longer react to them after only a short time. Since the "cash register inserts" are mostly made of soft foam, this very often favors the articulated foot, which can buckle much more easily on soft foam inserts.

The advisory committee of the German Society for Orthopedics and Orthopedic Surgery (DGOOC) for orthopedic shoe technology was able to prove the effect of stimulating the foot with effects on muscle and gait activities in a metal literature analysis in 2016. Possible approaches to action could be identified: changes in the tone of the muscles, changes in joint positions, relief in certain areas and reactions through periosteal irritation. Sensomothorical insoles can therefore play a role in the therapy of various orthopedic diseases, e.g. B. in the arched feet of the child or in adults. The evidence on the effectiveness of this care is still sparse and requires close therapeutic support.

The guideline "Children's flat feet", adopted in 2017 under the leadership of the German Society for Orthopedics and Orthopedic Surgery (DGOOC), makes a strong recommendation as part of the conservative treatment of children's flat feet, sensorimotor insoles / foot orthoses preferable because of their proprioceptive stimulation. However, this requires a reactive nervous, muscular and skeletal system.

Further studies

  • Acute effects of a sensorimotor insole on posture indicators of the axillary skeleton.
  • U. Hafkemeyer, D. Poppenborg, C. Müller-Hliemann: Afference -enhancing insoles for the therapy of the functional spastic equinus. Special issue “Insoles”, Orthopädieschuhtechnik 5/2004, pp. 64–65.
  • U. Hafkemeyer, D. Poppenborg, B. Drerup, M. Möller, HH Wetz: Improvements of Gait in paraplegic patients using proprioceptive insoles. Gait and Posture. Vol. 16, Supplement 1, 2002, pp. 157-158.
  • O. Ludwig, R. Quadflieg, M. Koch: Sensori-motor insoles may increase peroneus longus activity during the stance phase of human gait. In: Br. J. Sports Med. (47), 2013, pp. E3 – e3. doi: 10.1136 / bjsports-2013-092558.95
  • M. Janin: Treatment of Nociceptive Capacity of Plantar Irritating Stimulus by Sensorimotor Orthoses improves postural performances and balance . In: Foot and Ankle Surgery , 2016 p. 18. doi: 10.1016 / j.fas.2016.05.032
  • O. Ludwig, J. Kelm, M. Fröhlich: The influence of insoles with a peroneal pressure point on the elecromyographic activity of tibialis anterior and peroneus longus during gait . In: Journal of Foot and Ankle Research , 2016, 9:33. doi: 10.1186 / s13047-0160-0162-5

Methods

For the creation of sensorimotor insoles there are various manufacturer-specific methods u. a .:

  • Derks method
  • Jahrling (after Lothar Jahrling)
  • Nancy Hylton
  • Woltring / Springer
  • Pfaff
  • Sensoped

The Derks Method

The Derks method is a protected method in podiatry . The therapy is based on a calculation method for the creation of insoles. Input variables are dynamic footprints and foot pressure measurements. The founder is the Dutchman K. Derks.

A frequently cited scientific study that is supposed to prove the effectiveness of this method is not available for evaluation on the Internet.

Individual evidence

  1. ↑ Contribution to the topic of foot problems and sensorimotor insoles. ( Memento from May 20, 2019 in the Internet Archive ) Bavarian television
  2. ↑ Oliver Ludwig, Roman Quadflieg, Michael Koch: Influence of a sensorimotor insert on the activity of the m. peroneus longus in the stance phase. ( Memento from November 27, 2014 in the Internet Archive ; PDF; 379 kB) In: Dtsch Z Sportmed. 64 (3), 2013, pp. 77-82.
  3. ↑ kinderbeine.de
  4. ↑ Statement on foot orthoses with a sensorimotor effect (SMFO) . (PDF) In: Medizin & Technik 4/2016, pp. 26–32.
  5. ↑ DGOOC guideline Infantile planotransversus foot " . On awmf.org
  6. ↑ Jan Schröder, Meike Gerkens, Rüdiger Reer, Klaus Mattes: Acute effects of a sensorimotor insole on posture indicators of the axillary skeleton. ( Memento from April 23, 2013 in the Internet Archive ; PDF; 290 kB) 2010
  7. ↑ Derks podiatry calculation method is protected by copyright and is the foundation of Derks podiatry method! on podologen.at
  8. ↑ Podologie K. Derks
  9. ↑ Marcel Maetzler, Thomas Bochdansky, Rami J Abboud: Accuracy and Repeatability of a semi-quantitative barefoot pressure measurement method for clinical use: The Derks Calculation Method. Gait & Posture Netherlands NL.