Effect of Neutral-Cushioned Running Shoes on Plantar Pressure Loading and Comfort in Athletes with Cavus Feet

2008 ◽  
Vol 36 (11) ◽  
pp. 2139-2146 ◽  
Author(s):  
Caleb Wegener ◽  
Joshua Burns ◽  
Stefania Penkala ◽  
Grad Dip Ex Spr Sc

Background High injury rates observed in athletes with cavus feet are thought to be associated with elevated plantar pressure loading. Neutral-cushioned running shoes are often recommended to manage and prevent such injuries. Purpose To investigate in-shoe plantar pressure loading and comfort during running in 2 popular neutral-cushioned running shoes recommended for athletes with cavus feet. Study Design Controlled laboratory study. Methods Plantar pressures were collected using the in-shoe Novel Pedar-X system during overground running in 22 athletes with cavus feet in 2 neutral-cushioned running shoes (Asics Nimbus 6 and Brooks Glycerin 3) and a control condition (Dunlop Volley). Comfort was measured using a validated visual analog scale. Results Compared with the control, both neutral-cushioned running shoes significantly reduced peak pressure and pressure-time integrals by 17% to 33% ( P < .001). The Brooks Glycerin most effectively reduced pressure beneath the whole foot and forefoot ( P < .01), and the Asics Nimbus most effectively reduced rearfoot pressure ( P < .01). Both neutral-cushioned running shoes reduced force at the forefoot by 6% and increased it at the midfoot by 12% to 17% ( P < .05). Contact time and area increased in both neutral-cushioned running shoes ( P < .01). The Asics Nimbus was the most comfortable, although both neutral-cushioned running shoes were significantly more comfortable than the control ( P < .001). Conclusion Two popular types of neutral-cushioned running shoes were effective at reducing plantar pressures in athletes with cavus feet. Clinical Relevance Regional differences in pressure reduction suggest neutral-cushioned running shoe recommendation should shift from being categorical in nature to being based on location of injury or elevated plantar pressure.

2001 ◽  
Vol 91 (7) ◽  
pp. 337-342 ◽  
Author(s):  
R. Scott VanZant ◽  
Thomas G. McPoil ◽  
Mark W. Cornwall

The purpose of this study was to determine the degree of symmetry for in-shoe plantar pressure and vertical force patterns between the left and right feet of healthy subjects during walking. Thirty subjects with a mean age of 29.6 years participated in the study. Each subject walked a distance of 8 m three times while in-shoe plantar pressure and vertical force data were collected. A total of 12 steps were analyzed for both feet, and maximum vertical force, peak pressure, and pressure-time integrals were calculated for four plantar regions of the foot. No differences in the three variables were noted between male and female subjects. Plantar pressure and vertical force patterns were found to be symmetrical between the left and right feet, except for two of the four plantar regions studied. Only the forefoot and rearfoot regions were found to show significant differences between the left and right feet for plantar pressure and vertical force, respectively. The degree of asymmetry for these two plantar regions in the same foot, however, was minimal. (J Am Podiatr Med Assoc 91(7): 337-342, 2001)


Author(s):  
Umangi K. Bhatt ◽  
Hui Ying Foo ◽  
Mahalia P. McEvoy ◽  
Sarah J. Tomlinson ◽  
Cara Westphal ◽  
...  

Background The total-contact cast (TCC) is the gold standard for off-loading diabetic foot ulcers (DFUs) given its nonremovable nature. However, this modality remains underused in clinical settings due to the time and experience required for appropriate application. The TCC-EZ is an alternative off-loading modality marketed as being nonremovable and having faster and easier application. This study aims to investigate the potential of the TCC-EZ to reduce foot plantar pressures. Methods Twelve healthy participants (six males, six females) were fitted with a removable cast walker, TCC, TCC-EZ, and TCC-EZ with accompanying brace removed. These off-loading modalities were tested against a control. Pedar-X technology measured peak plantar pressures in each condition. Statistical analysis of four regions of the foot (rearfoot, midfoot, forefoot, and hallux) was conducted with Friedman and Wilcoxon signed rank tests. Significance was set at P &lt; .05. Results All of the off-loading conditions significantly reduced pressure compared with the control, except the TCC-EZ without the brace in the hallux region. There was no statistically significant difference between TCC-EZ and TCC peak pressure in any foot region. The TCC-EZ without the brace obtained significantly higher peak pressures than with the brace. The removable cast walker produced similar peak pressure reduction in the midfoot and forefoot but significantly higher peak pressures in the rearfoot and hallux. Conclusions The TCC-EZ is a viable alternative to the TCC. However, removal of the TCC-EZ brace results in minimal plantar pressure reduction, which might limit clinical applications of the TCC-EZ.


2009 ◽  
Vol 99 (4) ◽  
pp. 330-338 ◽  
Author(s):  
Joseph M. Molloy ◽  
Douglas S. Christie ◽  
Deydre S. Teyhen ◽  
Nancy S. Yeykal ◽  
Bradley S. Tragord ◽  
...  

Background: Research addressing the effect of running shoe type on the low- or high-arched foot during gait is limited. We sought 1) to analyze mean plantar pressure and mean contact area differences between low- and high-arched feet across three test conditions, 2) to determine which regions of the foot (rearfoot, midfoot, and forefoot) contributed to potential differences in mean plantar pressure and mean contact area, and 3) to determine the association between the static arch height index and the dynamic modified arch index. Methods: Plantar pressure distributions for 75 participants (40 low arched and 35 high arched) were analyzed across three conditions (nonshod, motion control running shoes, and cushioning running shoes) during treadmill walking. Results: In the motion control and cushioning shoe conditions, mean plantar contact area increased in the midfoot (28% for low arched and 68% for high arched), whereas mean plantar pressure decreased by approximately 30% relative to the nonshod condition. There was moderate to good negative correlation between the arch height index and the modified arch index. Conclusions: Cushioning and motion control running shoes tend to increase midfoot mean plantar contact area while decreasing mean plantar pressure across the low- or high-arched foot. (J Am Podiatr Med Assoc 99(4): 330–338, 2009)


1999 ◽  
Vol 89 (10) ◽  
pp. 495-501 ◽  
Author(s):  
TG McPoil ◽  
MW Cornwall ◽  
L Dupuis ◽  
M Cornwell

The number of trials required to obtain a reliable representation of the plantar pressure pattern is an important factor in the assessment of people with insensate feet or the use of plantar pressure data as a basis for fabrication of foot orthoses. Traditionally, the midgait method has been used for the collection of pressure data, but the large number of walking trials required by this method can increase the risk of injury to the plantar surface of the insensate foot. As a result, the two-step method of plantar pressure data collection has been advocated. The purpose of this investigation was to determine the degree of variability in regional plantar pressure measurements using the midgait and two-step methods of data collection. Plantar pressure data were collected from ten volunteers (five men and five women) between the ages of 20 and 35 years in 20 trials using both data-collection protocols. The results of the study indicate that three to five walking trials are needed to obtain reliable regional peak pressure and pressure-time integral values when the two-step data-collection protocol is used. Although either method can be used for pressure data collection, one method should be used consistently when repeated assessments are required.


2009 ◽  
Vol 99 (4) ◽  
pp. 285-294 ◽  
Author(s):  
Isabel C. N. Sacco ◽  
Tatiana Almeida Bacarin ◽  
Maíra Grizzo Canettieri ◽  
Ewald M. Hennig

Background: Diabetic neuropathy leads to progressive loss of sensation, lower-limb distal muscle atrophy, autonomic impairment, and gait alterations that overload feet. This overload has been associated with plantar ulcers even with consistent daily use of shoes. We sought to investigate and compare the influence of diabetic neuropathy and plantar ulcers in the clinical history of diabetic neuropathic patients on plantar sensitivity, symptoms, and plantar pressure distribution during gait while patients wore their everyday shoes. Methods: Patients were categorized into three groups: a control group (CG; n = 15), diabetic patients with a history of neuropathic ulceration (DUG; n = 8), and diabetic patients without a history of ulceration (DG; n = 10). Plantar pressure variables were measured by Pedar System shoe insoles in five plantar regions during gait while patients wore their own shoes. Results: No statistical difference between neuropathic patients with and without a history of plantar ulcers was found in relation to symptoms, tactile sensitivity, and duration of diabetes. Diabetic patients without ulceration presented the lowest pressure–time integral under the heel (72.1 ± 16.1 kPa × sec; P = .0456). Diabetic patients with a history of ulceration presented a higher pressure–time integral at the midfoot compared to patients in the control group (59.6 ± 23.6 kPa × sec × 45.8 ± 10.4 kPa × sec; P = .099), and at the lateral forefoot compared to diabetic patients without ulceration (70.9 ± 17.7 kPa sec × 113.2 ± 61.1 kPa × sec, P = .0193). Diabetic patients with ulceration also presented the lowest weight load under the hallux (0.06 ± 0.02%, P = .0042). Conclusions: Although presenting a larger midfoot area, diabetic neuropathic patients presented greater pressure–time integrals and relative loads over this region. Diabetic patients with ulceration presented an altered dynamic plantar pressure pattern characterized by overload even when wearing daily shoes. Overload associated with a clinical history of plantar ulcers indicates future appearance of plantar ulcers. (J Am Podiatr Med Assoc 99(4): 285–294, 2009)


2011 ◽  
Vol 32 (11) ◽  
pp. 1075-1080 ◽  
Author(s):  
Heather Schmidt ◽  
Lindsay D. Sauer ◽  
Sae Yong Lee ◽  
Susan Saliba ◽  
Jay Hertel

Background: Previous plantar pressure research found increased loads and slower loading response on the lateral aspect of the foot during gait with chronic ankle instability compared to healthy controls. The studies had subjects walking barefoot over a pressure mat and results have not been confirmed with an in-shoe plantar pressure system. Our purpose was to report in-shoe plantar pressure measures for chronic ankle instability subjects compared to healthy controls. Methods: Forty-nine subjects volunteered (25 healthy controls, 24 chronic ankle instability) for this case-control study. Subjects jogged continuously on a treadmill at 2.68 m/s (6.0 mph) while three trials of ten consecutive steps were recorded. Peak pressure, time-to-peak pressure, pressure-time integral, maximum force, time-to-maximum force, and force-time integral were assessed in nine regions of the foot with the Pedar-x in-shoe plantar pressure system (Novel, Munich, Germany). Results: Chronic ankle instability subjects demonstrated a slower loading response in the lateral rearfoot indicated by a longer time-to-peak pressure (16.5% ± 10.1, p = 0.001) and time-to-maximum force (16.8% ± 11.3, p = 0.001) compared to controls (6.5% ± 3.7 and 6.6% ± 5.5, respectively). In the lateral midfoot, ankle instability subjects demonstrated significantly greater maximum force (318.8 N ± 174.5, p = 0.008) and peak pressure (211.4 kPa ± 57.7, p = 0.008) compared to controls (191.6 N ± 74.5 and 161.3 kPa ± 54.7). Additionally, ankle instability subjects demonstrated significantly higher force-time integral (44.1 N/s ± 27.3, p = 0.005) and pressure-time integral (35.0 kPa/s ± 12.0, p = 0.005) compared to controls (23.3 N/s ± 10.9 and 24.5 kPa/s ± 9.5). In the lateral forefoot, ankle instability subjects demonstrated significantly greater maximum force (239.9N ± 81.2, p = 0.004), force-time integral (37.0 N/s ± 14.9, p = 0.003), and time-to-peak pressure (51.1% ± 10.9, p = 0.007) compared to controls (170.6 N ± 49.3, 24.3 N/s ± 7.2 and 43.8% ± 4.3). Conclusion: Using an in-shoe plantar pressure system, chronic ankle instability subjects had greater plantar pressures and forces in the lateral foot compared to controls during jogging. Clinical Relevance: These findings may have implications in the etiology and treatment of chronic ankle instability. Level of Evidence: III, Retrospective Case Control Study


Author(s):  
Yao Meng ◽  
Li Yang ◽  
Xin Yan Jiang ◽  
Bíró István ◽  
Yao Dong Gu

The objective of this study was to investigate the effectiveness of different hardness of personalized custom insoles on plantar pressure redistribution in healthy young males during walking and running. Six males participated in the walking and running test (age: 24±1.6 years, weight: 67.9±3.6 kg, height: 175.5±4.7 cm). All subjects were instructed to walk and run along a 10m pathway wearing two different hardness insoles (i.e., hard custom insoles (CHI) and soft custom insole (CSI)) and control insole (CI) at their preferred speed. Peak pressure, mean pressure, maximum force, pressure-time integral were collected to analyze using SPSS. The plantar pressure of forefoot and medial midfoot were significantly increased and of lateral forefoot and lateral midfoot were decreased by both kinds of custom insoles in running tests. While the CHI significantly increased plantar pressure of the medial forefoot compared with the CSI and CI both in walking and running tests. The custom insoles showed significantly higher plantar pressure on medial midfoot. But CSI seems better than CHI because of redistributing the plantar pressure by increasing the plantar pressure of whole forefoot. Moreover, CSI showed significantly lower plantar pressure than CI and CHI at lateral midfoot during running test. The CHI causes significant high pressure at medial forefoot (MF), which may raise the risk of forefoot pain.


2016 ◽  
Vol 106 (6) ◽  
pp. 398-405 ◽  
Author(s):  
Jeanne Bertuit ◽  
Clara Leyh ◽  
Marcel Rooze ◽  
Véronique Feipel

Background: During pregnancy, physical and hormonal modifications occur. Morphologic alterations of the feet are found. These observations can induce alterations in plantar pressure. This study sought to investigate plantar pressures during gait in the last 4 months of pregnancy and in the postpartum period. A comparison with nulliparous women was conducted to investigate plantar pressure modifications during pregnancy. Methods: Fifty-eight women in the last 4 months of pregnancy, nine postpartum women, and 23 healthy nonpregnant women (control group) performed gait trials on an electronic walkway at preferred speeds. The results for the three groups were compared using analysis of variance. Results: During pregnancy, peak pressure and contact area decreased for the forefoot and rearfoot. These parameters increased significantly for the midfoot. The gait strategy seemed to be lateralization of gait with an increased contact area of the lateral midfoot and both reduced pressure and a later peak time on the medial forefoot. In the postpartum group, footprint parameters were modified compared with the pregnant group, indicating a trend toward partial return to control values, although differences persisted between the postpartum and control groups. Conclusions: Pregnant women had altered plantar pressures during gait. These findings could define a specific pattern of gait footprints in late pregnancy because plantar pressures had characteristics that could maintain a stable and safe gait.


Author(s):  
Elena Escamilla-Martínez ◽  
Beatriz Gómez-Martín ◽  
Lourdes María Fernández-Seguín ◽  
Alfonso Martínez-Nova ◽  
Juan Diego Pedrera-Zamorano ◽  
...  

Running shoes typically have a lifespan of 300–1000 km, and the plantar pressure pattern during running may change as the shoe wears. So, the aim of this study was to determine the variation of plantar pressures with shoe wear, and the runner’s subjective sensation. Maximun Plantar Pressures (MMP) were measured from 33 male recreational runners at three times during a training season (beginning, 350 km, and 700 km) using the Biofoot/IBV® in-shoe system (Biofoot/IBV®, Valencia, Spain). All the runners wore the same shoes (New Balance® 738, Boston, MA, USA) during this period, and performed similar training. The zones supporting most pressure at all three study times were the medial (inner) column of the foot and the forefoot. There was a significant increase in pressure on the midfoot over the course of the training season (from 387.8 to 590 kPa, p = 0.003). The runners who felt the worst cushioning under the midfoot were those who had the highest peak pressures in that area (p = 0.002). The New Balance® 738 running shoe effectively maintains the plantar pressure pattern after 700 km of use under all the zones studied except the midfoot, probably due to material fatigue or deficits of the specific cushioning systems in that area.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mike Frecklington ◽  
Nicola Dalbeth ◽  
Peter McNair ◽  
Alain Vandal ◽  
Peter Gow ◽  
...  

Abstract Background In clinical trials, good quality athletic shoes offer short-term improvements (two-months) in foot pain and disability in people with gout, but these improvements are not sustained over time. This may be due to wear and subsequent changes to the structural integrity of the shoe. The aim of this study was to examine the effects of wear on plantar pressures and footwear characteristics in shoes over six-months in people with gout. Methods Forty people with gout participated in a cross-sectional repeated measures study. Participants wore a pair of commercially available athletic footwear for six-months. Participants then attended a study visit where the worn footwear was compared with a new pair of the same model and size of footwear. Wear characteristics (upper, midsole, outsole) and plantar pressure were measured in the two footwear conditions. Wear characteristics were analysed using paired t-tests and Fisher’s exact tests. Plantar pressure data were analysed using linear mixed models. Results Increases in medial midsole (P < 0.001), lateral midsole (P < 0.001) and heel midsole (P < 0.001) hardness were observed in the worn shoes. Normal upper wear patterns (P < 0.001) and outsole wear patterns (P < 0.001) were observed in most of the worn shoes. No differences in peak plantar pressures (P < 0.007) were observed between the two footwear conditions. Reduced pressure time integrals at the first metatarsophalangeal joint (P < 0.001), second metatarsophalangeal joint (P < 0.001) and hallux (P = 0.003) were seen in the worn shoes. Conclusions The study found signs of wear were observed at the upper, midsole and outsole in the worn footwear after six-months. These changes to the structural properties of the footwear may affect forefoot loading patterns in people with gout.


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