{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T23:19:29Z","timestamp":1770765569418,"version":"3.50.0"},"reference-count":26,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science (JSPS) KAKENHI","doi-asserted-by":"publisher","award":["19K19815"],"award-info":[{"award-number":["19K19815"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Excessive foot pronation may be attributed to an increasing burden on leg muscles during running, which might be a factor in medial tibial stress syndrome. We developed an elastic foot orthosis (EFO) that can decrease foot pronation and aimed to identify whether this orthosis could limit the increase in lower leg muscle hardness after running. Methods: Twenty-one healthy volunteers participated in this randomized crossover trial with an elastic or sham foot orthosis (SFO). All volunteers ran on a treadmill for 60 min while wearing either orthosis. Muscle hardness of the posterior lower leg was assessed using shear wave elastography before and after running. The Wilcoxon signed rank test was used to compare muscle hardness between the two orthotic conditions. Results: No significant differences were observed between the two orthotic conditions before running (p &gt; 0.05). After running, the flexor digitorum longus (FDL) hardness in the EFO group was significantly lower than that in the SFO group (p &lt; 0.01). No significant changes were observed in the other muscles. Conclusion: The results suggest that the EFO can restrict the increase in FDL hardness with running. The EFO may be an effective orthotic treatment for medial tibial stress syndrome.<\/jats:p>","DOI":"10.3390\/ijerph192215212","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T03:31:10Z","timestamp":1668742270000},"page":"15212","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An Elastic Foot Orthosis for Limiting the Increase of Shear Modulus of Lower Leg Muscles after a Running Task: A Randomized Crossover Trial"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5383-3466","authenticated-orcid":false,"given":"Kodai","family":"Sakamoto","sequence":"first","affiliation":[{"name":"Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, Osaka 559-8611, Japan"},{"name":"Mikage Gokigen Clinic, Kobe 658-0048, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megumi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Yanase Orthopedic Clinic, Utsunomiya-shi 329-1115, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chie","family":"Tsujioka","sequence":"additional","affiliation":[{"name":"Kiba Hospital, Tokyo 135-0042, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9483-1830","authenticated-orcid":false,"given":"Shintarou","family":"Kudo","sequence":"additional","affiliation":[{"name":"Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, Osaka 559-8611, Japan"},{"name":"Graduate School of Health Science, Morinomiya University of Medical Sciences, Osaka 559-8611, Japan"},{"name":"AR-Ex Medical Research Center, Tokyo 158-0082, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"523","DOI":"10.2165\/00007256-200939070-00002","article-title":"Medial tibial stress syndrome: A critical review","volume":"39","author":"Moen","year":"2009","journal-title":"Sports Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1249\/01.mss.0000247001.94470.21","article-title":"Gait-related risk factors for exercise-related lower-leg pain during shod running","volume":"39","author":"Willems","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.2106\/00004623-199407000-00015","article-title":"Medial tibial stress syndrome: The location of muscles in the leg in relation to symptoms","volume":"76","author":"Beck","year":"1994","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1177\/0095399703258776","article-title":"The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits","volume":"32","author":"Yates","year":"2004","journal-title":"Am. J. Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"164","DOI":"10.2165\/00007256-199724030-00003","article-title":"Sports injury surveillance systems. \u2018One size fits all\u2019?","volume":"24","year":"1997","journal-title":"Sports Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1249\/MSS.0000000000001674","article-title":"Factors contributing to medial tibial stress syndrome in runners","volume":"50","author":"Becker","year":"2018","journal-title":"Med. Sci. Sport Exerc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2350","DOI":"10.1080\/02640414.2020.1785186","article-title":"Is high soleus muscle activity during the stance phase of the running cycle a potential risk factor for the development of medial tibial stress syndrome? A prospective study","volume":"38","author":"Naderi","year":"2020","journal-title":"J. Sports Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1002\/jor.24223","article-title":"Forefoot and hindfoot kinematics in subjects with medial tibial stress syndrome during walking and running","volume":"37","author":"Okunuki","year":"2019","journal-title":"J. Orthop. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1136\/bjsports-2014-093462","article-title":"Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: A systematic review and meta-analysis","volume":"49","author":"Bliven","year":"2015","journal-title":"Br. J. Sports Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Men\u00e9ndez, C., Batalla, L., Prieto, A., Rodr\u00edguez, M.\u00c1., Crespo, I., and Olmedillas, H. (2020). Medial tibial stress syndrome in novice and recreational runners: A systematic review. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17207457"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13047-017-0238-x","article-title":"The effect of a running task on muscle shear elastic modulus of posterior lower leg","volume":"10","author":"Ohya","year":"2017","journal-title":"J. Foot Ankle Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/sms.12862","article-title":"Muscle stiffness of posterior lower leg in runners with a history of medial tibial stress syndrome","volume":"28","author":"Saeki","year":"2018","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e8714","DOI":"10.1097\/MD.0000000000008714","article-title":"Short-term effects of sports taping on navicular height, navicular drop and peak plantar pressure in healthy elite athletes A within-subject comparison","volume":"96","author":"Kim","year":"2017","journal-title":"Medicine"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1249\/MSS.0000000000000807","article-title":"Effects of Taping and Orthoses on Foot Biomechanics in Adults with Flat-Arched Feet","volume":"48","author":"Bishop","year":"2016","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.jbiomech.2017.01.041","article-title":"Effects of medially posted insoles on foot and lower limb mechanics across walking and running in overpronating men","volume":"21","author":"Kosonen","year":"2017","journal-title":"J. Biomech."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.clinbiomech.2010.05.001","article-title":"Do foot orthoses change lower limb muscle activity in flat-arched feet towards a pattern observed in normal-arched feet?","volume":"25","author":"Murley","year":"2010","journal-title":"Clin. Biomech."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.gaitpost.2022.01.016","article-title":"Influence of a novel elastic foot orthosis in foot motion during locomotion in adults with mild flatfoot","volume":"93","author":"Kudo","year":"2022","journal-title":"Gait Posture"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Chino, K., Akagi, R., Dohi, M., Fukashiro, S., and Takahashi, H. (2012). Reliability and validity of quantifying absolute muscle hardness using ultrasound elastography. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0045764"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1002\/jum.15842","article-title":"Lower Leg Muscle Stiffness on Two-Dimensional Shear Wave Elastography in Subjects with Medial Tibial Stress Syndrome","volume":"41","author":"Zhang","year":"2022","journal-title":"J. Ultrasound Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1080\/17461391.2018.1503337","article-title":"Arch-support foot-orthoses normalize dynamic in-shoe foot pressure distribution in medial tibial stress syndrome","volume":"19","author":"Naderi","year":"2019","journal-title":"Eur. J. Sport Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.gaitpost.2021.05.009","article-title":"Extrinsic foot muscle forces and joint contact forces in flexible flatfoot adult with foot orthosis: A parametric study of tibialis posterior muscle weakness","volume":"88","author":"Peng","year":"2021","journal-title":"Gait Posture"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"15218","DOI":"10.1038\/s41598-022-19543-4","article-title":"Signifcance of the anatomical relationship between the flexor digitorum longus and sustentaculum tali for reconsideration of the talocalcaneonavicular joint stability mechanism","volume":"12","author":"Tsutsumi","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1053\/j.jfas.2020.03.019","article-title":"Effect of Gender and Load Conditions on Foot Arch Height Index and Flexibility in Japanese Youths","volume":"59","author":"Takabayashi","year":"2020","journal-title":"J. Foot Ankle Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.foot.2011.08.002","article-title":"Gender-based differences in the functional deformation of the foot longitudinal arch","volume":"22","author":"Fukano","year":"2012","journal-title":"Foot"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/sms.12639","article-title":"Gender differences of muscle and crural fascia origins in relation to the occurrence of medial tibial stress syndrome","volume":"27","author":"Edama","year":"2017","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"31","DOI":"10.7547\/0970031","article-title":"Medial tibial stress syndrome (tibial fasciitis): A proposed pathomechanical model involving fascial traction","volume":"97","author":"Bouche","year":"2007","journal-title":"J. Am. Podiatr. Med. 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