{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T11:42:43Z","timestamp":1764070963238,"version":"3.45.0"},"reference-count":34,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>Background: Cavus foot, defined by an increased medial longitudinal arch and often forefoot plantarflexion, alters biomechanics and increases peak plantar pressures, raising the risk of musculoskeletal disorders such as metatarsalgia, Achilles tendinopathy, and gait instability. Custom foot orthoses are the preferred conservative treatment, offering plantar support, pressure redistribution, and reduction in compensatory muscle activity. This study evaluated the medium- and long-term effectiveness of custom orthoses in 71 patients with cavus feet using surface electromyography (sEMG) and the same shoes. Methods: Muscle activity of the peroneus longus, peroneus brevis, and gastrocnemius was recorded during treadmill gait after one and four months of orthotic use. Results: Significant reductions in muscles were observed, especially after four months, confirming greater long-term effectiveness. No residual benefits were found when participants walked without orthoses. Conclusions: These findings support the clinical value of insoles in reducing the compensatory muscle activity in cavus feet and emphasize the importance of investigating their long-term role in biomechanics and potential pathology risk reduction.<\/jats:p>","DOI":"10.3390\/jfmk10040461","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T10:46:18Z","timestamp":1764067578000},"page":"461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medium- and Long-Term Effectiveness of Custom Insoles for Cavus Foot: A Surface Electromyography Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8122-7612","authenticated-orcid":false,"given":"Sara","family":"Garc\u00eda-Bautista","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4005-9835","authenticated-orcid":false,"given":"Antonio","family":"G\u00f3mez-Bernal","sequence":"additional","affiliation":[{"name":"Podoactiva Biomechanical Unit, Research & Development Department, Parque Tecnol\u00f3gico Walqa, Ctra. N330a Km 566, 22197 Cuarte, Spain"},{"name":"Department of Podiatry, Faculty of Health Sciences, Manresa University, 08243 Manresa, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7651-8725","authenticated-orcid":false,"given":"Javier","family":"Alfaro-Santaf\u00e9","sequence":"additional","affiliation":[{"name":"Podoactiva Biomechanical Unit, Research & Development Department, Parque Tecnol\u00f3gico Walqa, Ctra. N330a Km 566, 22197 Cuarte, Spain"},{"name":"Department of Podiatry, Faculty of Health Sciences, Manresa University, 08243 Manresa, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1113-9169","authenticated-orcid":false,"given":"Jose Luis","family":"Perez-Lasierra","sequence":"additional","affiliation":[{"name":"Podoactiva Biomechanical Unit, Research & Development Department, Parque Tecnol\u00f3gico Walqa, Ctra. N330a Km 566, 22197 Cuarte, Spain"},{"name":"Facultad de Ciencias de la Salud, Universidad San Jorge, Villanueva de G\u00e1llego, 50830 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S1286-935X(14)68515-4","article-title":"Pies cavos, etiopatogenia y enfoque terap\u00e9utico","volume":"47","author":"Delagoutte","year":"2014","journal-title":"EMC Apar. Locomot."},{"key":"ref_2","first-page":"142","article-title":"Pes planus and pes cavus in Southern Italy: A 5 years study","volume":"53","author":"Troiano","year":"2017","journal-title":"Ann. Ist. Super. Sanit\u00e0"},{"key":"ref_3","first-page":"75","article-title":"Ballenhohlfu\u00df","volume":"50","author":"Harrasser","year":"2021","journal-title":"Orthop\u00e4de"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.fcl.2015.07.007","article-title":"Cavus Foot","volume":"20","author":"Nogueira","year":"2015","journal-title":"Foot Ankle Clin."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Qin, B., Wu, S., and Zhang, H. (2022). Evaluation and Management of Cavus Foot in Adults: A Narrative Review. J. Clin. Med., 11.","DOI":"10.3390\/jcm11133679"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"R\u00f6hrle, O., Yavuz, U.\u015e., Klotz, T., Negro, F., and Heidlauf, T. (2019). Multiscale modeling of the neuromuscular system: Coupling neurophysiology and skeletal muscle mechanics. WIREs Syst. Biol. Med., 11.","DOI":"10.1002\/wsbm.1457"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1177\/107110070502600313","article-title":"The Subtle Cavus Foot, \u201cthe Underpronator,\u201d a Review","volume":"26","author":"Manoli","year":"2005","journal-title":"Foot Ankle Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jbiomech.2019.07.032","article-title":"Segmental foot and ankle kinematic differences between rectus, planus, and cavus foot types","volume":"94","author":"Kruger","year":"2019","journal-title":"J. Biomech."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.mcna.2013.10.008","article-title":"The cavus foot","volume":"98","author":"Rosenbaum","year":"2014","journal-title":"Med. Clin. N. Am."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.fcl.2013.08.006","article-title":"Flexible cavovarus foot in children and adolescents","volume":"18","author":"VanderHave","year":"2013","journal-title":"Foot Ankle Clin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"205","DOI":"10.7547\/0960205","article-title":"Effective Orthotic Therapy for the Painful Cavus Foot","volume":"96","author":"Burns","year":"2006","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"12431","DOI":"10.3390\/s130912431","article-title":"Surface Electromyography Signal Processing and Classification Techniques","volume":"13","author":"Chowdhury","year":"2013","journal-title":"Sensors"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1080\/03091902.2019.1609610","article-title":"Methodology of surface electromyography in gait analysis: Review of the literature","volume":"43","author":"Papagiannis","year":"2019","journal-title":"J. Med. Eng. Technol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"102363","DOI":"10.1016\/j.jelekin.2019.102363","article-title":"Tutorial. Surface EMG detection in space and time: Best practices","volume":"49","author":"Merletti","year":"2019","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.55730\/1300-0144.5667","article-title":"Current developments in surface electromyography","volume":"53","author":"Alcan","year":"2023","journal-title":"Turk. J. Med. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Molina-Molina, A., Ruiz-Malag\u00f3n, E.J., Carrillo-P\u00e9rez, F., Roche-Seruendo, L.E., Damas, M., Banos, O., and Garc\u00eda-Pinillos, F. (2020). Validation of mDurance, A Wearable Surface Electromyography System for Muscle Activity Assessment. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.606287"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"13159","DOI":"10.3390\/s150613159","article-title":"mDurance: A Novel Mobile Health System to Support Trunk Endurance Assessment","volume":"15","author":"Banos","year":"2015","journal-title":"Sensors"},{"key":"ref_18","unstructured":"Biomedical Health and Research Program (BIOMED II) of the European Union (2025, November 11). SENIAM (Surface ElectroMyoGraphy for the Non-Invasive Assessment of Muscle). Available online: http:\/\/seniam.org\/."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.apergo.2004.11.001","article-title":"Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking","volume":"36","year":"2005","journal-title":"Appl. Ergon."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Moisan, G., Descarreaux, M., and Cantin, V. (2021). Biomechanical effects of foot orthoses with and without a lateral bar in individuals with cavus feet during comfortable and fast walking. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0248658"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.mcna.2013.10.009","article-title":"Plantar Heel Pain","volume":"98","author":"Rosenbaum","year":"2014","journal-title":"Med. Clin. N. Am."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.otsr.2012.09.003","article-title":"Cavus foot, from neonates to adolescents","volume":"98","author":"Wicart","year":"2012","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1177\/1071100712465817","article-title":"Effect of Shoe Heel Height and Total-Contact Insert on Muscle Loading and Foot Stability While Walking","volume":"34","author":"Hong","year":"2013","journal-title":"Foot Ankle Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1123\/jab.13.2.135","article-title":"The Use of Surface Electromyography in Biomechanics","volume":"13","author":"Luca","year":"1997","journal-title":"J. Appl. Biomech."},{"key":"ref_25","first-page":"S705","article-title":"Effects of custom-made insoles on idiopathic pes cavus foot during walking","volume":"26","author":"Choi","year":"2015","journal-title":"Bio-Med. Mater. Eng."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kelly, A., and Robb, S.D.P. (2024). The importance of foot posture when recording lower leg electromyography when walking in non-textured and textured foot orthoses. J. Biomech., 165.","DOI":"10.1016\/j.jbiomech.2024.111999"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1007\/s00221-024-06904-w","article-title":"The suppression of lower leg electromyography when walking in textured foot orthoses","volume":"242","author":"Robb","year":"2024","journal-title":"Exp. Brain Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jelekin.2018.08.002","article-title":"Muscle activation during fast walking with two types of foot orthoses in participants with cavus feet","volume":"43","author":"Moisan","year":"2018","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_29","first-page":"7","article-title":"Reliability and Repeatability of the Footwork Plantar Pressure Plate System","volume":"111","year":"2021","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki","volume":"310","author":"Holstila","year":"2013","journal-title":"JAMA"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lux, R.L., Sower, C.T., Allen, N., Etheridge, S.P., Tristani-Firouzi, M., and Saarel, E.V. (2014). The Application of Root Mean Square Electrocardiography (RMS ECG) for the Detection of Acquired and Congenital Long QT Syndrome. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0085689"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/0021-9290(87)90255-7","article-title":"The arch index: A useful measure from footprints","volume":"20","author":"Cavanagh","year":"1987","journal-title":"J. Biomech."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s13047-016-0162-5","article-title":"The influence of insoles with a peroneal pressure point on the electromyographic activity of tibialis anterior and peroneus longus during gait","volume":"9","author":"Ludwig","year":"2016","journal-title":"J. Foot Ankle Res."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Sadler, S., Spink, M., De Jonge, X.J., and Chuter, V. (2020). An exploratory study investigating the effect of foot type and foot orthoses on gluteus medius muscle activity. BMC Musculoskelet. Disord., 21.","DOI":"10.1186\/s12891-020-03683-7"}],"container-title":["Journal of Functional Morphology and Kinesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5142\/10\/4\/461\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T11:37:49Z","timestamp":1764070669000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5142\/10\/4\/461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jfmk10040461"],"URL":"https:\/\/doi.org\/10.3390\/jfmk10040461","relation":{},"ISSN":["2411-5142"],"issn-type":[{"value":"2411-5142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,25]]}}}