Plantar Pressure Differences Between Nordic Walking Techniques

AbstractHigh plantar pressure has been associated with increased risk of injury. The characteristics of each physical activity determine the load on the lower limbs. The influence of Nordic Walking (NW) technique on plantar pressure is still unknown. The aim of this study was to analyze the differences between plantar pressure during NW with the Diagonal technique (DT) versus Alpha technique (AT) and compare them with the pressure obtained during normal walking (W). The normality and sphericity of the plantar pressure data were checked before performing a two-way repeated measures ANOVA in order to find differences between speeds (preferred, fast) and the gait (NW, W) as within-subject factors. Then, a t-test for independent measures was used to identify the specific differences between NW techniques. The strength of the differences was calculated by means of the effect size (ES). The results demonstrated that during NW with AT at preferred speed the pressure was lower under the Calcaneus, Lateral Metatarsal and Toes compared to the DT group (p = 0.046, ES = 1.49; p = 0.015, ES = 1.44; p = 0.040, ES = 1.20, respectively). No differences were found at the fast speed (p > 0.05). Besides the increase in walking speed during NW (p < 0.01), both technique groups showed lower pressure during NW compared to W under the Hallux and Central Metatarsal heads (F = 58.321, p = 0.000, ES = 2.449; F = 41.917, p = 0.012, ES = 1.365, respectively). As a practical conclusion, the AT technique may be the most effective of the NW techniques at reducing plantar pressure while allowing NW practitioners to achieve the physiological benefits of NW.

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Changes in Dynamic Plantar Pressure During Loaded Gait

Physical Therapy ◽

10.2522/ptj.20120103 ◽

2013 ◽

Vol 93 (9) ◽

pp. 1175-1184 ◽

Cited By ~ 11

Author(s):

Stephen L. Goffar ◽

Rett J. Reber ◽

Bryan C. Christiansen ◽

Robert B. Miller ◽

Jacob A. Naylor ◽

...

Keyword(s):

Plantar Pressure ◽

Repeated Measures ◽

Load Carriage ◽

Relative Distribution ◽

Arch Height ◽

Great Toe ◽

Pressure Distributions ◽

Increased Risk ◽

The Impact ◽

Load Conditions

Background Lower extremity overuse injuries are detrimental to military readiness. Extremes of arch height and heavy loads carried by military personnel are associated with increased risk for overuse injury. Little is known regarding the impact of load carriage on plantar pressure distributions during gait. Objective The objective of this study was to determine how load carriage affects plantar pressure distributions during gait in individuals with varying arch types. Design A cross-sectional, repeated-measures design was used for the study. Methods The study was performed at a research laboratory at Fort Sam Houston, Texas. Service members who were healthy and weighing ≥70 kg were enrolled in the study. The participants (97 men, 18 women; mean age=31.3 years, SD=5.6; mean weight=86.0 kg, SD=11.0) were categorized as having high-, normal-, or low-arched feet on the basis of published cutoff values for the arch height index. Plantar pressure measurements were obtained with the use of an in-shoe pressure measurement system while participants wore combat boots and walked on a treadmill under 3 loaded conditions (uniform, 20-kg load, and 40-kg load). Maximal force (MaxF) and force-time integral (FTI) were assessed with the use of a 9-sector mask to represent regions of the foot. A 3 × 3 repeated-measures analysis of variance was used for analysis across the levels of load and arch type. Results A significant interaction existed between arch type and load for MaxF and FTI in the medial midfoot, with greater force in low-arched feet. In the medial forefoot, MaxF and FTI were greatest in high-arched feet across all load conditions. In the great toe region, low-arched and normally arched feet had greater MaxF and FTI. The relative distribution of FTI increased proportionately in all regions of the foot regardless of arch type for all load conditions. Limitations The influence of fatigue, greater loads, and different walking speeds was not assessed. Conclusions Regardless of arch type, increases in load did not alter the relative distribution of force over the plantar foot during gait. Participants with high-arched feet had greater force in the medial forefoot region, whereas those with normally arched or low-arched feet had greater force in the great toe region, regardless of load. These differences in force distribution may demonstrate different strategies to generate a rigid lever during toe-off.

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Influence of barefoot, barefoot inspired and conventional shoes on tibial accelerations and loading kinetics during running in natural rearfoot strikers

Comparative Exercise Physiology ◽

10.3920/cep13023 ◽

2013 ◽

Vol 9 (3-4) ◽

pp. 161-167 ◽

Cited By ~ 4

Author(s):

J. Sinclair ◽

P.J. Taylor ◽

S. Andrews

Keyword(s):

Impact Loading ◽

Repeated Measures ◽

Impact Force ◽

Barefoot Running ◽

Risk Of Injury ◽

Increased Risk ◽

Tibial Acceleration ◽

Main Effects

Running barefoot and in footwear designed to mimic barefoot locomotion, has received considerable attention in footwear research. This study examined the differences in impact force and tibial acceleration parameters. Ten male participants completed 10 trials when running barefoot, in vibram five-fingers and in conventional footwear at three locomotion velocities: walk, jog and run (1.25, 3.5 and 5.0 m/s, respectively). Impact force and tibial acceleration parameters were synchronously obtained and contrasted between footwear and velocities using 3 (footwear) x 3 (velocity) repeated measures ANOVA's. Significant main effects were obtained for both footwear and velocity which suggest that barefoot running at higher velocities is associated with increases in impact loading magnitude. This leads to the conclusion that barefoot locomotion may be associated with increased risk of injury regardless of running velocity and that more specifically running barefoot at higher velocities should be undertaken with caution.

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Variability of plantar pressure data. A comparison of the two-step and midgait methods

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-89-10-495 ◽

1999 ◽

Vol 89 (10) ◽

pp. 495-501 ◽

Cited By ~ 114

Author(s):

TG McPoil ◽

MW Cornwall ◽

L Dupuis ◽

M Cornwell

Keyword(s):

Data Collection ◽

Plantar Pressure ◽

Peak Pressure ◽

Pressure Data ◽

Step Method ◽

Plantar Surface ◽

Time Integral ◽

Risk Of Injury ◽

Pressure Time ◽

Reliable Representation

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.

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The Analysis of Plantar Pressure Data Based on Multimodel Method in Patients with Anterior Cruciate Ligament Deficiency during Walking

BioMed Research International ◽

10.1155/2016/7891407 ◽

2016 ◽

Vol 2016 ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Xiaoli Li ◽

Hongshi Huang ◽

Jie Wang ◽

Yuanyuan Yu ◽

Yingfang Ao

Keyword(s):

Anterior Cruciate Ligament ◽

Human Body ◽

Plantar Pressure ◽

Cruciate Ligament ◽

Lower Limbs ◽

Pressure Data ◽

Anterior Cruciate Ligament Deficiency ◽

Gait Characteristics ◽

Motion Function ◽

Anterior Cruciate

The movement information of the human body can be recorded in the plantar pressure data, and the analysis of plantar pressure data can be used to judge whether the human body motion function is normal or not. A two-meter footscan® system was used to collect the plantar pressure data, and the kinetic and dynamic gait characteristics were extracted. According to the different description of gait characteristics, a set of models was established according to various people to present the movement of lower limbs. By the introduction of algorithm in machine learning, the FCM clustering algorithm is used to cluster the sample set and create a set of models, and then the SVM algorithm was used to identify the new samples, so as to complete the normal and abnormal motion function identification. The multimodel presented in this paper was carried out into the analysis of the anterior cruciate ligament deficiency. This method demonstrated being effective and can provide auxiliary analysis for clinical diagnosis.

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Influence of application of the inelastic taping in plantar pressure of runners pronators.

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2014.12.160 ◽

2014 ◽

Vol 12 ◽

pp. 160 ◽

Cited By ~ 1

Author(s):

Juliana Rocha Rodrigues ◽

Wesley Albuquerque Craveiro ◽

Thiago Vilela Lemos ◽

Fábio Alessandro Galvão Passos ◽

Osmair Gomes De Macedo ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Practice ◽

Plantar Pressure ◽

Repeated Measures ◽

Peak Pressure ◽

Test Results ◽

Pressure Data ◽

Plantar Pressure Distribution ◽

Contact Pressures ◽

Paired T Test

Background: The excessive motion of subtalar pronation of the foot, can cause stress and burden in tissues of the region, giving origin to aches and microtrauma. In clinical practice, excessive movement has been limited to the use of techniques of bandages applied to the plantar arch. Objective: Was to analyze the influence of rigid bandage in plantar pressure distribution corridors pronators. Method: This is a randomized clinical trial, blinded, with twenty runners pronators (33±7 y, 71±7 kg, 174±6 cm). Technique was applied bandage (rigid - BR) to support the plantar arch, described as antipronation. Plantar pressure data were collected using the F -scan system in three tests run at 9 km/h being: no bandages, rigid taping. We considered seven areas of pressure for data analysis, performed by means of ANOVA for repeated measures followed by paired t test. Results: BR resulted in significant reductions (p<0.05) in contact pressures and peak pressure rearfoot. Conclusion: Thus, we conclude that BR provided decrease in contact pressures and peak pressure foot, being significant on the hindfoot than in the midfoot.

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Antithrombotic Therapy in Lower Extremity Artery Disease

Current Vascular Pharmacology ◽

10.2174/1570161117666190206230516 ◽

2020 ◽

Vol 18 (3) ◽

pp. 215-222 ◽

Cited By ~ 1

Author(s):

Mislav Vrsalovic ◽

Victor Aboyans

Keyword(s):

Lower Extremity ◽

Antiplatelet Therapy ◽

Antithrombotic Therapy ◽

Cardiovascular Events ◽

Cardiovascular Outcomes ◽

Lower Limbs ◽

Stent Type ◽

Increased Risk ◽

Artery Disease ◽

Lower Extremity Artery Disease

Lower extremity artery disease (LEAD) is a marker of a more advanced atherosclerotic process often affecting multiple vascular beds beyond the lower limbs, with a consequent increased risk for all-cause and cardiovascular mortality. Antithrombotic therapy is the cornerstone of management of these patients to prevent ischaemic cardiovascular and limb events and death. In patients with symptomatic LEAD, the efficacy of aspirin has been established long ago for the prevention of cardiovascular events. In the current guidelines, clopidogrel may be preferred over aspirin following its incremental ability to prevent cardiovascular events, while ticagrelor is not superior to clopidogrel in reducing cardiovascular outcomes. Dual antiplatelet therapy (DAPT, aspirin with clopidogrel) is currently recommended for at least 1 month after endovascular interventions irrespective of the stent type. Antiplatelet monotherapy is recommended after infra-inguinal bypass surgery, and DAPT may be considered in below-the-knee bypass with a prosthetic graft. In symptomatic LEAD, the addition of anticoagulant (vitamin K antagonists) to antiplatelet therapy increased the risk of major and life-threatening bleeding without benefit regarding cardiovascular outcomes. In a recent trial, low dose of direct oral anticoagulant rivaroxaban plus aspirin showed promising results, not only to reduce death and major cardiovascular events, but also major limb events including amputation. Yet, this option should be considered especially in very high risk patients, after considering also the bleeding risk. Despite all the evidence accumulated since >40 years, many patients with LEAD remain undertreated and deserve close attention and implementation of guidelines advocating the use of antithrombotic therapies, tailored according to their level of risk.

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One-Stage Soft Tissue Reconstruction Following Sarcoma Excision: A Personalized Multidisciplinary Approach Called “Orthoplasty”

Journal of Personalized Medicine ◽

10.3390/jpm10040278 ◽

2020 ◽

Vol 10 (4) ◽

pp. 278

Author(s):

Andrea Angelini ◽

Cesare Tiengo ◽

Regina Sonda ◽

Antonio Berizzi ◽

Franco Bassetto ◽

...

Keyword(s):

Surgical Resection ◽

Lower Limbs ◽

Surgical Approaches ◽

Soft Tissue Reconstruction ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society ◽

One Stage ◽

Unplanned Excision ◽

Increased Risk ◽

Toronto Extremity Salvage Score

Background and Objectives. Wide surgical resection is a relevant factor for local control in sarcomas. Plastic surgery is mandatory in demanding reconstructions. We analyzed patients treated by a multidisciplinary team to evaluate indications and surgical approaches, complications and therapeutic/functional outcomes. Methods. We analyzed 161 patients (86 males (53%), mean age 56 years) from 2006 to 2017. Patients were treated for their primary tumor (120, 75.5%) or after unplanned excision/recurrence (41, 25.5%). Sites included lower limbs (36.6%), upper limbs (19.2%), head/neck (21.1%), trunk (14.9%) and pelvis (8.1%). Orthoplasty has been considered for flaps (54), skin grafts (42), wide excisions (40) and other procedures (25). Results. At a mean follow-up of 5.3 years (range 2–10.5), patients continuously showed no evidence of disease (NED) in 130 cases (80.7%), were alive with disease (AWD) in 10 cases (6.2%) and were dead with disease (DWD) in 21 cases (13.0%). Overall, 62 patients (38.5%) developed a complication (56 minor (90.3%) and 6 major (9.7%)). Flap loss occurred in 5/48 patients (10.4%). The mean Musculoskeletal Tumor Society (MSTS) and Toronto Extremity Salvage Score (TESS) was 74.8 ± 14 and 79.1 ± 13, respectively. Conclusions. Orthoplasty is a combined approach effective in management of sarcoma patients, maximizing adequate surgical resection, limb salvaging and functional recovery. One-stage reconstructions are technically feasible and are not associated with increased risk of complications.

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What Is Currently the Role of TcPO2 in the Choice of the Amputation Level of Lower Limbs? A Comprehensive Review

Journal of Clinical Medicine ◽

10.3390/jcm10071413 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1413

Author(s):

Judith Catella ◽

Anne Long ◽

Lucia Mazzolai

Keyword(s):

Arterial Disease ◽

Major Amputation ◽

Lower Limbs ◽

Limb Amputation ◽

Quality Of Data ◽

Amputation Level ◽

Increased Risk ◽

Transcutaneous Oximetry ◽

Peripheral Arterial

Some patients still require major amputation for lower extremity peripheral arterial disease treatment. The purpose of pre-operative amputation level selection is to determine the most distal amputation site with the highest healing probability without re-amputation. Transcutaneous oximetry (TcPO2) can detect viable tissue with the highest probability of healing. Several factors affect the accuracy of TcPO2; nevertheless, surgeons rely on TcPO2 values to determine the optimal amputation level. Background about the development of TcPO2, methods of measurement, consequences of lower limb amputation level, and the place of TcPO2 in the choice of the amputation level are reviewed herein. Most of the retrospective studies indicated that calf TcPO2 values greater than 40 mmHg were associated with a high percentage of successful wound healing after below-knee-amputation, whereas values lower than 20 mmHg indicated an increased risk of unsuccessful healing. However, a consensus on the precise cut-off value of TcPO2 necessary to assure healing is missing. Ways of improvement for TcPO2 performance applied to the optimization of the amputation-level are reported herein. Further prospective data are needed to better approach a TcPO2 value that will promise an acceptable risk of re-amputation. Standardized TcPO2 measurement is crucial to ensure quality of data.

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Myofascial Release of the Hamstrings Improves Physical Performance—A Study of Young Adults

Healthcare ◽

10.3390/healthcare9060674 ◽

2021 ◽

Vol 9 (6) ◽

pp. 674

Author(s):

Keisuke Itotani ◽

Kanta Kawahata ◽

Wakana Takashima ◽

Wakana Mita ◽

Hitomi Minematsu ◽

...

Keyword(s):

Young Adults ◽

Physical Performance ◽

Walking Speed ◽

Quadriceps Muscle ◽

Lower Limbs ◽

Joint Movement ◽

Myofascial Release ◽

Functional Reach Test ◽

Hamstring Flexibility ◽

Walking Speeds

Physical performance is mainly assessed in terms of gait speed, chair rise capacity, and balance skills, and assessments are often carried out on the lower limbs. Such physical performance is largely influenced by the strength of the quadriceps and hamstrings muscles. Flexibility of the hamstrings is important because quadriceps muscle activity influences the hip flexion angle. Therefore, hamstring flexibility is essential to improve physical performance. In this study, Myofascial Release (MFR) was applied to the hamstrings to evaluate its effects. MFR on the hamstrings was performed on 17 young adults. Physical function and physical performance were measured before, immediately after, and 5 days after the MFR intervention: finger floor distance (FFD), range of motion (ROM) of the straight leg raising test (SLR), standing long jump (SLJ), squat jump (SJ), functional reach test (FRT), comfortable walking speeds (C-walking speed), and maximum walking speeds (M-walking speed). The results of the analysis show a significant increase in FFD (−2.6 ± 8.9 vs. 0.4 ± 9.4 vs. 2.4 ± 8.9, p < 0.01), SLJ (185.6 ± 44.5 vs. 185.0 ± 41.8 vs. 196.6 ± 40.1, p < 0.01), and M-walking speed (2.9 ± 0.6 vs. 3.0 ± 0.6 vs. 3.3 ± 0.6, p < 0.01). This study has shown that MFR for hamstrings not only improves flexibility but also increases M-walking speed and physical performance of the SLJ. As MFR is safe and does not involve joint movement, it may be useful for maintaining and improving performance and flexibility during inactivity and for stretching before exercise.

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Social Jetlag and Prostate Cancer Incidence in Alberta’s Tomorrow Project: A Prospective Cohort Study

Cancers ◽

10.3390/cancers12123873 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3873

Author(s):

Liang Hu ◽

Andrew Harper ◽

Emily Heer ◽

Jessica McNeil ◽

Chao Cao ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Risk ◽

Cancer Incidence ◽

Repeated Measures ◽

Prospective Cohort ◽

Prostate Cancer Risk ◽

Absolute Difference ◽

Prostate Cancer Incidence ◽

Social Jetlag ◽

Increased Risk

We investigated the association of social jetlag (misalignment between the internal clock and socially required timing of activities) and prostate cancer incidence in a prospective cohort in Alberta, Canada. Data were collected from 7455 cancer-free men aged 35–69 years enrolled in Alberta’s Tomorrow Project (ATP) from 2001–2007. In the 2008 survey, participants reported usual bed- and wake-times on weekdays and weekend days. Social jetlag was defined as the absolute difference in waking time between weekday and weekend days, and was categorized into three groups: 0–<1 h (from 0 to anything smaller than 1), 1–<2 h (from 1 to anything smaller than 2), and 2+ h. ATP facilitated data linkage with the Alberta Cancer Registry in June 2018 to determine incident prostate cancer cases (n = 250). Hazard ratios (HR) were estimated using Cox proportional hazards regressions, adjusting for a range of covariates. Median follow-up was 9.57 years, yielding 68,499 person-years. Baseline presence of social jetlag of 1–<2 h (HR = 1.52, 95% CI: 1.10 to 2.01), and 2+ hours (HR = 1.69, 95% CI: 1.15 to 2.46) were associated with increased prostate cancer risk vs. those reporting no social jetlag (p for trend = 0.004). These associations remained after adjusting for sleep duration (p for trend = 0.006). With respect to chronotype, the association between social jetlag and prostate cancer risk remained significant in men with early chronotypes (p for trend = 0.003) but attenuated to null in men with intermediate (p for trend = 0.150) or late chronotype (p for trend = 0.381). Our findings suggest that greater than one hour of habitual social jetlag is associated with an increased risk of prostate cancer. Longitudinal studies with repeated measures of social jetlag and large samples with sufficient advanced prostate cancer cases are needed to confirm these findings.

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