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Table 3 Summary of the studies that have investigated the effects foot orthoses provide during cycling

From: The effect of foot orthoses and in-shoe wedges during cycling: a systematic review

Author Participants Shoe, cleat and pedal characteristics Intervention Measures collected Study design Outcomes
Anderson & Sockler, 1990. [19] Ten healthy adult subjects (six males, four females). Three males and three females wore stiff-soled cycling shoes with cleats. Four remaining subjects wore flexible-soled running shoes without cleats. Participants were tested with custom-made foot orthoses (CFO) or without any orthoses. The CFOs were made from Rohadur®. Orthoses were molded using a non-weightbearing, netural position casting technique and included a rearfoot 4° inverted post and an intrinsic forefoot post with 4° motion. Oxygen consumption, expired ventilatory volume, and heart rate. Randomised, repeated measures, non-controlled study. There were no significant differences in oxygen consumption, expired ventilatory volume, or heart rate between both conditions (p > 0.05).
Mean age: 29.1 years (±2.1)
Mean height: 176.0 cm (±3.1)
Mean mass: 65.5 kg (±3.2)
Bousie et al., 2013. [17] Twelve competitive or recreational cyclists (eight males or four females). Each participant wore their personal cycling specfic cleated road cycling shoes with a rigid sole, and used their personal pedals. Participants used commercially available contoured orthoses and a flat non-contoured insert (Vasyli International Australia). Both orthoses and flat inserts were made of ethylene vinyl acetate (EVA), with the same hardness. Plantar contact area, peak pressure, perceived comfort, and support of foot plantar surface. Randomised, repeated measures, control study. Compared to flat non-contoured inserts, the use of contoured orthoses led to a statistically significant increase in the contact area of the medial midfoot (p = 0.001; MD 5.7, 95% CI 3.0 to 8.4; SMD = 1.3) and lateral midfoot (p = 0.009; MD 4.6, 95% CI 1.4 to 7.8; SMD = 0.9). Contoured orthoses also produced a statistically significant increase in plantar pressures under the hallux (p = 0.003; MD 21.4, 95% CI 9.1 to 33.6; SMD = 1.1). Compared to the flat insert, the contoured orthoses was perceived to better support the arch (p < 0.001; MD 3.2, 95% CI 1.8 to 4.6; SMD = 1.5) and heel region (p = 0.013; MD 1.3, 95% CI 0.3 to 2.3; SMD = 0.9) but no difference was reported for perceived comfort.
Mean age: 35.1 years (±10.6)
Mean height: 174.7 cm (±8.7)
Mean mass: 70.0 kg (±9.8)
Weekly riding distance: 285.4 km (±82.9)
Hice et al., 1985. [18] Five healthy adult cyclists (three males, two females) who cycle at least 3 hrs weekly. All participants wore flexible soled shoes and used flat pedals. Participants were tested with custom-made foot orthoses or without any orthoses. The CFO was made from rigid thermoplastic and were ¾ length. A neutral suspension casting technique was used to make the orthoses. Forefoot posting was applied to each CFO to achieve forefoot-rearfoot alignment. Oxygen consumption and heart rate. Non-randomised, repeated measures, non-controlled study. A statistically significant decrease in oxygen consumption was found during the orthoses intervention when compared to no orthoses (p < 0.05). A decrease in heart rate was also observed when the subjects wore the orthoses compared to not wearing them, although only measurements at rest were statistically significant (p < 0.05).
Koch et al., 2013. [7] Eighteen competitive male cyclists and triathletes. There was no report of shoe, cleat and pedal characteristics that each participant used. Participants were tested with cycling specific, commercially available, carbon-fibre cycling orthoses (Solestar, GmbH, Berlin) or non-contoured inserts. Mean power production, peak power production. Randomised, repeated measures, single blinded, controlled study. There were no significant differences mean power production (p = 0.76) and peak power production (p = 0.53) between both conditions.
Mean age: 26.3 years (±5.6)
Mean height: 181.9 cm (±4.7)
Mean mass: 76.7 kg (±4.4)
Foot length: 28.2 cm (±0.8)
O’Neill et al., 2011. [20] Twelve competitive cyclists (nine males and three females) There was no report of shoe, cleat and pedal characteristics that each participant used. Participants were tested with their own cycling-specific custom-made foot orthoses or without any orthoses. A variety of materials were used for each participant’s CFO, such as carbon fiber, polyvinyl alcohol (PVA) and plastic material. 10 of these orthoses were full length, while the remaining 2 were ¾ length. There were also a variety of modifications added to each orthoses, such as rearfoot and forefoot wedges, 1st metatarsophalangeal (MTPJ) cut out, metatarsal domes. Maximum hip adduction, maximum knee abduction angle, total range of motion of tibial rotation, and coronal plane knee movement during the power phase of pedal stroke. Non-randomised, repeated measures, non-controlled study. No systemic effects from the CFOs were seen. Statistically significant subject specific effects, such as reduced tibial internal rotation motion, increased knee-to-bike distance and reduced knee abduction angle, from the CFO were reported (p < 0.05). All subjects had significant left to right leg differences during the power phase of pedalling.
Mean age: 40.0 years (±14.8)
Mean height: 179.4 cm (±7.6)
Mean mass: 82.7 kg (±8.0)
Cycling experience: 14.0 years (±9.7)
Mean age: 29.0 years (±4.0)
Mean height: 169.7 cm (±7.3)
Mean mass: 63.6 kg (±7.5)
Cycling experience: 8.3 years (±3.1)
  1. Note: All available statistical data (i.e. mean differences, confidence intervals, p values) from the studies have been provided. All available information on shoe, pedal, cleat, and orthoses used by participants have also been provided.
  2. Abbreviations: MD mean difference, SMD standardised mean difference (greater than 1.2 defined as large differences, 0.6 to 1.2 defined as moderate differences, and less than 0.6 defined as small differences).