***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The effectiveness of foot orthoses has been evaluated in many clinical trials with sham foot orthoses used as the control intervention in at least 10 clinical trials . However , the mechanical effects and credibility of sham orthoses has been rarely quantified . This study aim ed to : ( i ) compare the effects on plantar pressures of three sham foot orthoses to a customised foot orthosis , and ( ii ) establish the perceived credibility and the expected benefit of each orthotic condition . Methods Thirty adults aged between 18 and 51 participated in this study . At 0 and 4 weeks , plantar pressure data were collected for the heel , midfoot and forefoot using the pedar ® -X in-shoe system for the following five r and omly assigned conditions : ( i ) shoe alone , ( ii ) customised foot orthosis , ( iii ) contoured polyethylene sham foot orthosis , ( iv ) contoured EVA sham foot orthosis , and ( v ) flat EVA sham foot orthosis . At the initial data collection session , each participant completed a Credibility/Expectancy Question naire ( CEQ ) to determine the credibility and expected benefit of each orthotic condition . Results Compared to the shoe alone at week 0 , the contoured polyethylene sham orthosis was the only condition to not significantly effect peak pressure at any region of the foot . In contrast , the contoured EVA sham orthosis , the flat EVA sham orthosis and the customised orthosis significantly reduced peak pressure at the heel . At the medial midfoot , all sham orthoses provided the same effect as the shoe alone , which corresponded to effects that were significantly different to the customised orthosis . There were no differences in peak pressure between conditions at the other mask regions , the lateral midfoot and forefoot . When the conditions were compared at week 4 , the differences between the conditions were generally similar to the findings observed at week 0 . With respect to credibility and expected benefit , all orthotic conditions were considered the same with the exception of the contoured polyethylene sham orthosis , which was perceived as being less credible and less likely to provide benefits . Conclusion The findings of this study indicate that all of the sham orthoses tested provided the same effect on plantar pressures at the midfoot and forefoot as a shoe alone . However , the contoured EVA sham orthosis and the flat EVA sham orthosis  significantly reduced peak pressure under the heel , which was similar to the customised orthosis . In contrast , the contoured polyethylene sham orthosis had no significant effect on plantar pressure and was comparable to the shoe alone at all regions of the foot . Hence , lower plantar pressures were found under the heel with some sham orthoses , but not with others . Importantly , participants perceived the polyethylene sham orthosis – the sham that had no effect on plantar pressure – to be the least credible orthosis and the least likely to provide benefits . This may be critical for the design of future clinical trials as it may introduce confounding effects that produce inaccurate results . These findings provide some evidence for the mechanical effects , treatment credibility and expected benefit of sham foot orthoses , which should be considered when they are used as a control intervention in a clinical trial BACKGROUND To compare kinematics , kinetics and muscle activity during  st and ing and walking for healthy subjects using an  unstable test shoe  ( Masai Barefoot Technology , MBT ) and a stable control shoe . METHODS Eight subjects volunteered for this study . During quiet st and ing , center of pressure excursion and muscle activity were determined . During walking , lower extremity kinematics , kinetics , and muscle electromyographic ( EMG ) signals were determined . Data were collected for the two shoe conditions after a 2week accommodation period . Statistics included repeated measures ANOVAs ( alpha = 0.05 ) and post hoc tests where appropriate . FINDINGS During quiet st and ing , the center of pressure excursion was significantly and substantially greater in the unstable compared to the control shoe . Electromyographic intensity increased in the unstable test shoe for all tested muscles , but only significantly for the tibialis anterior . During locomotion , kinematics were similar in the two shoe conditions except for the initial plantar-dorsiflexion , which showed a significant more dorsiflexed position during the first half of stance in the unstable test shoe compared to the stable control shoe . The angular impulses did not show any significant differences between the two shoe conditions for all three joints but some trends towards a reduction for the knee and hip joint . There were no significant differences in electromyographic activities between the control and the unstable shoe . However , several muscles showed some trends . INTERPRETATION The unstable shoe produced changes and trends in kinematic , kinetic and electromyographic characteristics that seemed to be advantageous for the locomotor system . Further studies should investigate muscle strength , dynamic stability , pain reduction for arthritic knees and injury prevention for high performance athletes when using the unstable shoes Despite the widespread use of customised foot orthoses ( FOs ) for the pronated foot type there is a lack of reliable information on the dose-response effect on lower limb mechanics . This study investigated these effects in subjects with normal and pronated foot types .  Customised FOs were administered to 12 participants with symptomatic pronated foot type and 12 age and gender matched controls . A computer-aided design ( CAD ) software was used to design nine FOs per participant with dose incrementally changed by varying only the rearfoot post angle . This was done in 2 ° increments from 6 ° lateral to 10 ° medial posting . A 3D printing method was used to manufacture the FOs . Quantification of the dose-response effect was performed using three-dimensional gait analyses for selected rearfoot and knee kinematics and kinetics . Under these experimental conditions , significant and linear effects of posting were seen for the peak ( p<0.001 ) and mean ( p<0.001 ) rearfoot eversions , peak ( p=0.003 ) and mean ( p<0.001 ) ankle eversion moments and peak ( p=0.017 ) and mean ( p=0.005 ) knee adduction moment variables . Group effects were observed for the peak ( p=0.007 ) and mean ( p=0.007 ) forefoot abduction and for the peak ( p=0.007 ) knee adduction moment . A significant interaction between posting and group was seen for internal tibial rotation ( p=0.004 ) . These data indicate that a dose-response effect , with a linear trend for both the rearfoot and knee , exists for customised FOs used to treat pronated foot type OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity Over-pronation has been cited as a key contributor to many types of running injuries . However , the roles of the extrinsic foot muscles during running have not been adequately identified . The purpose of this study was to examine the muscle functional ( mf ) MRI and EMG responses to perturbations of the foot by running in varus , neutral and valgus wedged shoes . Ten males ran at 3.6 m/s in specially constructed shoes for 5 min with T2-weighted mfMRI collected before and after each run . The change in T2 from before to after each run characterized the level of metabolic activity in each of muscle . Kinematic and EMG data were also collected while subjects ran on a treadmill . There were no T2 differences across the three shoe conditions . In contrast , there was significantly less EMG activity in the tibialis anterior and soleus while wearing the neutral shoe . Overall , the results did not support the theory that muscle activity would increase as the degree of eversion increased . It also appears that surface EMG was more sensitive to differences between conditions than mfMRI . However , this study illustrated that mfMRI may be a useful tool for quantifying muscle activity in cases where surface EMG is inadequate The purpose of this study was to determine the reliability of investigating  electromyography ( EMG )  of selected leg muscles during walking .  Tibialis posterior and peroneus longus EMG activity were recorded via intramuscular electrodes . Tibialis anterior and medial gastrocnemius EMG activity were recorded with surface electrodes .  Twenty-eight young adults attended two test-sessions approximately 15 days apart . Relative and absolute measures of reliability were calculated for EMG timing and amplitude parameters during specific phases of the gait cycle . Maximum contractions and sub-maximal contractions were obtained via maximum isometric voluntary contractions and a very fast walking speed , respectively . Time of peak EMG amplitude for all muscles displayed relatively narrow limits of r and om error . However , reliability of peak and root mean square amplitude parameters for tibialis posterior and peroneus longus displayed unacceptably wide limits of r and om error , regardless of the normalisation reference technique . Whilst some amplitude parameters for tibialis anterior and medial gastrocnemius displayed good to excellent relative reliability , the corresponding values for absolute error were generally large . Timing and amplitude EMG parameters for all muscles displayed low to moderate coefficient of variation within each test session ( range : 7 - 25 % ) . Overall , between-participant variability was minimised with sub-maximal normalisation values . These results demonstrate that re-application of electrodes results in large r and om error between sessions , particularly with tibialis posterior and peroneus longus . Research ers planning studies of these muscles with a repeated-test design ( e.g. to evaluate the effect of an intervention ) must consider whether this level of error is acceptable PURPOSE Foot orthoses are a st and ard option to treat overuse injury . Biomechanical data providing mechanisms of foot orthoses ' effectiveness are sparse . Stability of the ankle joint complex might be a key factor . The purpose was therefore to analyze neuromuscular activity of the musculus peroneus longus in runners with overuse injury symptoms treated with foot orthoses .  METHODS A total of 99 male and female runners with overuse injury symptoms r and omized in a control group ( CO ) and an orthoses group ( OR ) were analyzed on a treadmill at 3.3 m·s(-1 ) before and after an 8-wk foot orthoses intervention . Muscular activity of the musculus peroneus longus was measured and quantified in the time domain ( initial onset of activation ( T(ini ) ) , time of maximal activity ( T(max ) ) , total time of activation ( T(tot ) ) ) and amplitude domain ( amplitude in preactivation ( A(pre ) ) , weight acceptance ( A(wa ) ) , push-off ( A(po ) ) ) . RESULTS Peroneal activity in the time domain did not differ initially between CO and OR , and no effect was observed after therapy ( T(ini ) : CO = -0.88 ± 0.09 , OR = -0.88 ± 0.08/T(max ) : CO = 0.14 ± 0.06 , OR = 0.15 ± 0.06/T(tot ) : CO = 0.40 ± 0.09 , OR = 0.41 ± 0.09 ; P > 0.05 ) . In preactivation ( A(pre ) ) , muscle activity was higher in OR after intervention ( CO = 0.97 ± 0.32 , 95 % confidence interval = 0.90 - 1.05 ; OR = 1.18 ± 0.43 , 95 % confidence interval = 1.08 - 1.28 ; P = 0.003 ) . There was no group or intervention effect during stance ( A(wa ) : CO = 2.33 ± 0.66 , OR = 2.33 ± 0.74/A(po ) : CO = 0.80 ± 0.41 , OR = 0.88 ± 0.40 ; P > 0.05 ) . CONCLUSIONS Enhanced muscle activation of the musculus peroneus longus in preactivation suggests an altered preprogrammed activity , which might lead to better ankle stability providing a possible mode of action for foot orthoses therapy A proposed benefit of minimalist shoe running is an increase in intrinsic foot muscle strength . This study examined change in intrinsic foot muscle size in runners transitioning to Vibram FiveFingers ™ minimalist shoes  compared to a  
    Output:
    
Conclusion : Modifications in shoe or orthosis design in the sagittal or frontal plane can alter activation in walking of muscles acting primarily in these planes .
Clinical relevance This review provides some evidence that foot orthoses can reduce tibialis posterior activity , potentially benefitting specific musculoskeletal pathologies