Effectiveness of gait plate insole and lateral sole wedged shoes on foot progression angle in children with in-toeing gait: A prospective randomized control trial

Background: In-toeing gait is defined as the internal rotation of the long axis of the foot to the line of progression. Although most of the time it is corrected spontaneously but sometimes causes torsional misalignment syndrome and maybe patellofemoral instability and arthritis of the knee. Research question: What is the effect of gait plate insoles and lateral sole wedged shoes on foot progression angle (FPA) in children with in-toeing? Method: In this study, a randomized control trial was conducted with 11 participants (18 feet) who were girls aged between seven and ten years old. They were randomly assigned to either the gait plate group (6 girls, 11 feet) or the lateral sole wedge group (5 girls, 11 feet). The foot progression angle was measured using the RS scanner pressure platform before and after four weeks of intervention, both with and without interventions. The interaction effects of time and group on outcomes were analyzed using Mixed ANOVA and post-hoc complementary tests with a confidence interval of 95%. Results: It was observed that none of the interventions had an immediate impact on the FPA (P > 0.05). However, after four weeks, the FPA increased by 9.96 degrees with the lateral sole wedge and by 3.51 degrees with the gate plate insole. During the immediate and short-term evaluation, no significant difference was noticed between the two groups (P > 0.05). However, there was a large effect size (eta square = 0.269) observed in the time group interaction between the two groups (P = 0.028). Significance: Conservative methods like using a gait plate insole or modifying shoes with a lateral sole wedge can improve the foot progression angle in children with in-toeing gait. However, longer studies with larger sample sizes are needed to reach a conclusion.