Prescriptive proprioceptive insoles and dental orthotics change the frontal plane position of the atlas (C1), mastoid, malar, temporal, and sphenoid bones: a preliminary study.

The purpose of this series of case studies was to determine if the frontal plane position of the cranial bones and atlas could be altered using dental orthotics, prescriptive insoles, or both concurrently. The cranial radiographs of four patients were reviewed for the study. Three of the patients were diagnosed as having a temporomandibular joint (TMJ) dysfunction and a preclinical clubfoot deformity. The fourth patient was diagnosed as having a TMJ dysfunction, a preclinical clubfoot deformity and a Catetgory II sacral occipital subluxation, as designated in the chiropractic's Sacro Occipital Technique (SOT). Each patient had a series of four cranial radiographs taken using a modified orthogonal protocol. In two patients, improvement towards orthogonal was achieved when using both prescriptive dental orthotics and prescriptive insoles concurrently. Improvement towards orthogonal was less apparent when using only the prescriptive dental orthotic. No improvement or a negative frontal plane shift was noted when using only the prescriptive proprioceptive insoles. In the third patient, the frontal plane position of the cranial bones and atlas increased (away from orthogonal) when using the generic proprioceptive insoles alone or in combination with a prescriptive dental orthotic. In the fourth patient, the frontal plane position of the cranial bones improved using the dental orthotic. However, the proprioceptive insoles, when used alone or in combination with the dental orthotic, increased the frontal plane position of the cranial bones and atlas. This study demonstrates that changes in the frontal plane position of the cranial and atlas bones can occur when using proprioceptive insoles and/or dental orthotics.

Vertical facial dimensions linked to abnormal foot motion.

BACKGROUND: Twenty-two children from Jiutepec, Mexico, were studied to determine whether a correlation exists among foot motion, the position of the innominates, and vertical facial dimensions (ie, the distances between the outer corners of the eyes [the exocanthions] and the ipsilateral outer margins of the lips). METHODS: Three null hypotheses were constructed and tested using the one-sample t test. Hypothesis A: there is no relationship between abnormal foot pronation and hip position; Hypothesis B: there is no relationship between hip position and vertical facial dimensions; and Hypothesis C: there is no relationship between abnormal foot pronation and vertical facial dimensions. RESULTS: The three null hypotheses were rejected. CONCLUSIONS: An ascending foot cranial model was theorized to explain the findings generated from this study: 1) due to the action of gravity on the body, abnormal foot pronation (inward, forward, and downward rotation) displaces the innominates anteriorly (forward) and downward, with the more anteriorly rotated innominate corresponding to the more pronated foot; 2) anterior rotation of the innominates draws the temporal bones into anterior (internal) rotation, with the more anteriorly rotated temporal bone being ipsilateral to the more anteriorly rotated innominate bone; 3) the more anteriorly rotated temporal bone is linked to an ipsilateral inferior cant of the sphenoid and superior cant of the maxilla, resulting in a relative loss of vertical facial dimensions; and 4) the relative loss of vertical facial dimensions is on the same side as the more pronated foot.

Relationship of functional leg-length discrepancy to abnormal pronation.

The objective of this study was to determine whether a correlation exists between abnormal pronation and functional leg-length discrepancies. Visual assessment and a pelvic thrust maneuver were used to identify the functionally short leg in 56 indigenous Mexicans (20 males and 36 females; mean age, 33 years; mean weight, 59 kg; and mean height, 1.60 m). The Foot Posture Index was used with a modified stance position to identify the more pronated foot. The posterosuperior iliac spines were used to identify the "relative" position of the innominate bones. The raw data obtained from this study were evaluated using the McNemar test for paired proportions. A significant positive correlation was found between abnormal pronation and hip position and between hip position and functional leg-length discrepancy. These results are consistent with a theoretical ascending dysfunctional pelvic model: Abnormal pronation pulls the innominate bones anteriorly (forward); anterior rotation of the innominate bones shifts the acetabula posteriorly and cephalad (backward and upward); and this shift in the acetabula hyperextends the knees and shortens the legs, with the shortest leg corresponding to the most pronated foot.