A Pilot Study of Muscle Force between Normal Shoes and Bionic Shoes during Men Walking and Running Stance Phase Using Opensim

The original idea for bionic shoes (BSs) involves combining the function of unstable foot conditions and the structure of the human plantar. The purpose of this study was to investigate the differences between the normal shoes (NS) and the BS during the stance phases of walking and running. A total of 15 Chinese males from Ningbo University were recruited for this study (age: 24.3 ± 2.01 years; height: 176.25 ± 7.11 cm, body weight (BW): 75.75 ± 8.35 kg). The participants were asked to perform a walking and running task. Statistical parametric mapping (SPM) analysis was used to investigate any differences between NSs and BSs during the walking and running stance phases. The results demonstrated that there were significant differences found (21.23–28.24%, p = 0.040; 84.47–100%, p = 0.017) in hip extension and flexion between the NS and the BS during the walking stance phase. There were no significant differences found in ankle and moment during the running stance phase. Significant differences were found in the rectus femoris (5.29–6.21%; p = 0.047), tibialis anterior (14.37–16.40%; p = 0.038), and medial gastrocnemius (25.55–46.86%; p < 0.001) between the NS and the BS during the walking stance phase. Significant differences were found in rectus femoris (12.83–13.10%, p = 0.049; 15.89–80.19%, p < 0.001), tibialis anterior (15.85–18.31%, p = 0.039; 21.14–24.71%, p = 0.030), medial gastrocnemius (80.70–90.44%; p = 0.007), and lateral gastrocnemius (11.16–27.93%, p < 0.001; 62.20–65.63%, p = 0.032; 77.56–93.45%, p < 0.001) between the NS and the BS during the running stance phase. These findings indicate that BSs are more efficient for muscle control than unstable shoes and maybe suitable for rehabilitation training.

Pelvic floor muscles after birth: Do unstable shoes have an effect on pelvic floor activity and can this be measured reliably? – A feasibility study / Der Beckenboden nach der Geburt: Verändern instabile Schuhe die Aktivität und kann diese reliabel gemessen werden? – Eine Machbarkeitsstudie

Background Women often suffer from urinary incontinence after childbirth. Pelvic floor muscle training is an evidenced-based intervention to prevent urinary incontinence and improve its symptoms Aim The primary purpose of this study was to determine if there is a change in the activation of the pelvic floor muscles with different extrinsic parameters (barefoot versus unstable shoe). Second, we wanted to define variables that can be measured reliably and correlated with pelvic floor activity. Methods Data of 15 women who were 8 weeks to 6 months postpartum were analyzed. Two conditions (“barefoot” and “kyBoot”) were tested, with each participant performing three different tasks: walking, standing with an active pelvic floor, and standing with a passive pelvic floor. Three-dimensional kinematics of the body were recorded. Activity of the abdominal, back, and gluteal muscles was measured using surface electromyography (EMG). The activity of the pelvic floor was recorded using a vaginal electrode. Maximum pelvic floor activity was compared for each condition, and correlations among pelvic floor activity, kinematic variables, and skeletal muscle activity were determined. Results The maximum activity of the pelvic floor while walking was significantly higher when participants were barefoot than when they were wearing kyBoot shoes. For the standing trials, no significant differences between the conditions were detected. No surrogate marker was found to measure the pelvic floor activity. Conclusion With regard to the pelvic floor musculature, no recommendation is possible in favor of or against wearing unstable shoes. Technical developments are necessary to provide solutions to reliably measure the pelvic floor activity.

Unstable shoes for the treatment of lower back pain: a meta-analysis of randomized controlled trials

Objective: We aimed to perform a systematic review and meta-analysis to compare the treatment effects of unstable shoes and flat shoes on lower back pain patients. Data sources: Literature databases, including PubMed, Web of Science, and EMBASE (up to June 2019), were searched systematically. Review methods: Two authors independently screened the retrieved records and identified the randomized controlled trials where patients with lower back pain who wore unstable shoes as intervention and wore flat shoes as a control. Relevant data were extracted for meta-analysis using Review Manager 5.3 software. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the pooled outcome evidence levels. Results: Five randomized controlled trials and 251 patients were included in the analysis. The meta-analysis results showed that there was a tendency toward a reduction in the Roland–Morris disability questionnaire score (mean difference (MD) –2.16, 95% confidence interval (CI) –4.28 to −0.03, I2 = 53%) and pain score (MD −0.84, 95% CI −1.66 to −0.02, I2 = 84%) in patients wearing unstable shoes compared to those wearing flat shoes. There was no significant difference in the life quality scores between the unstable shoe and flat shoe groups (MD −0.59, 95% CI −6.18 to 5.01, I2 = 0%). Functional disability and pain scores were determined to have very low-quality evidence, and life quality scores were determined to have low-quality evidence according to the Grading of Recommendations Assessment, Development and Evaluation analysis. Conclusion: Unstable shoes may be effective in treating lower back pain in the clinic, but the conclusion was limited by the current low-quality studies.

Effects and underlying mechanisms of unstable shoes on chronic low back pain: a randomized controlled trial

Objective: To investigate the effects that wearing unstable shoes has on disability, trunk muscle activity, and lumbar spine range of motion (ROM) in patients with chronic lower back pain (CLBP). Design: Randomized controlled trial. Setting: Orthopedic Surgery Service. Participants: We randomized 40 adults with nonspecific CLBP either to an unstable shoes group ( n = 20) or to the control group ( n = 20). Intervention: The participants in the unstable shoes group were advised to wear these shoes for a minimum of six hours a day for four weeks. Control group participants were asked to continue wearing their regular shoes. Outcome measures: Our primary outcome was measurement of back-related dysfunction, assessed using the Roland-Morris Disability Questionnaire. Secondary outcomes included changes in electromyographic (EMG) activity of erector spinae (ES), rectus abdominis (RA), internus obliquus (IO), and externus obliquus (EO) muscles, and changes in lumbar spine ROM. Results: Between-group analysis highlighted a significant decrease in disability in the unstable shoes group compared to the control (−5, 95% confidence interval (CI) = −8.4 to −1.6). Our results revealed a significant increase in the percentage of RA, ES, IO, and EO EMG activity and in lumbar spine ROM in the unstable shoes group compared to the control group. Moreover, our results showed a significant negative correlation between disability and the percentage of ES, RA, and IO muscle activity at the end of the intervention. Conclusion: This study shows that the use of unstable shoes contributes to improvements in disability, which are likely related to increased trunk muscle activity and lumbar spine ROM.