title: Clinical improvement in functional hallux limitus using a cut-out orthosis.
abstract: BACKGROUND
  Functional hallux limitus (FHL) has been implicated in the development of metatarsophalangeal joint osteoarthritis.
  
  
  OBJECTIVE
  To determine whether cut-out orthosis treatment increases plantarflexion of the first metatarsal by increasing its declination angle.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A total of 46 female volunteers with an average age of 25.66 ± 5.70 years (range: 19-42 years) and FHL participated in the study. We assessed the degrees of movement of the first metatarsal and proximal phalanx bones at the first metatarsophalangeal joint without and while wearing the cut-out orthosis using the 3Space Fastrak® via sensors.
  
  
  RESULTS
  The movement of the plantarflexión declination angle of the first metatarsal bone was higher using the orthosis 29.84° ± 5.98° versus without orthosis 27.69° ± 5.91° (p < 0.031°). Use of sandals may have minimized the magnitude of movement changes associated with orthosis versus non-orthosis use.
  
  
  CONCLUSIONS
  The cut-out orthosis demonstrated a beneficial effect on non-fixed first metatarsophalangeal and metatarsal cuneiform joints affected by FHL, significantly increasing the declination of the metatarsal angle. Furthermore, use of the cut-out orthosis significantly reduced adduction movement of the first metatarsal bone in the transverse plane.
  
  
  CONCLUSIONS
  The cut-out orthosis demonstrated a beneficial effect on non-fixed first metatarsophalangeal and metatarsal cuneiform joints affected by FHL, significantly increasing the declination of the metatarsal angle. Furthermore, use of the cut-out orthosis significantly reduced adduction movement of the first metatarsal bone in the transverse plane.
authors.affiliation: Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Becerro de Bengoa Vallejo
authors.affiliation: Centro Ortopédico y Quirúrgico de Madrid, Madrid, Spain.
authors.forename: Rubén
authors.initials: R
authors.lastname: Sanchez Gómez
authors.affiliation: Universidad Rey Juan Carlos, Alcorcon, Spain marta.losa@urjc.es.
authors.forename: Marta Elena
authors.initials: ME
authors.lastname: Losa Iglesias
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D061826:Foot Orthoses; D020857:Hallux Limitus / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008683:Metatarsophalangeal Joint / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology; D055815:Young Adult
keywords: Functional hallux limitus; cut-out orthosis; metatarsophalangeal joint osteoarthritis