Cargando…
An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs
BACKGROUND: Lateral wedge insoles (LWI), standalone or with medial arch support (supported-LWI), have been thoroughly investigated for their effects on modifying gait biomechanics for people with knee osteoarthritis. However, plantar pressure distribution between these insole types has not been inve...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493692/ https://www.ncbi.nlm.nih.gov/pubmed/34615545 http://dx.doi.org/10.1186/s13047-021-00493-5 |
_version_ | 1784579167712444416 |
---|---|
author | Tse, Calvin T. F. Ryan, Michael B. Dien, Jason Scott, Alex Hunt, Michael A. |
author_facet | Tse, Calvin T. F. Ryan, Michael B. Dien, Jason Scott, Alex Hunt, Michael A. |
author_sort | Tse, Calvin T. F. |
collection | PubMed |
description | BACKGROUND: Lateral wedge insoles (LWI), standalone or with medial arch support (supported-LWI), have been thoroughly investigated for their effects on modifying gait biomechanics for people with knee osteoarthritis. However, plantar pressure distribution between these insole types has not been investigated and could provide insight towards insole prescription with concomitant foot symptoms taken into consideration. METHODS: In a sample of healthy individuals (n = 40), in-shoe plantar pressure was measured during walking with LWI, with or without medial arch support (variable- and uniform-stiffness designs), and a flat control insole condition. Pressure data from the plantar surface of the foot were divided into seven regions: medial/lateral rearfoot, midfoot, medial/central/lateral forefoot, hallux. Plantar pressure outcomes assessed were the medial-lateral pressure index (MLPI) for the whole foot, and the peak pressure, pressure-time integral (PTI), and contact area in each plantar region. Comfort in each insole condition was rated as a change relative to the flat control insole condition. Repeated-measures analyses of variance were calculated to compare the plantar pressure outcomes between insole conditions. RESULTS: Regionally, medial rearfoot and forefoot pressure were reduced by all wedged insoles, with the variable-stiffness supported-wedge showing greater reductions than the standalone wedge. Lateral rearfoot and forefoot pressure were reduced by both supported-LWI, but unchanged by the standalone wedge. In the midfoot, the standalone wedge maintained pressure but reduced regional contact area, while both supported-LWI increased midfoot pressure and contact area. All LWI increased the MLPI, indicating a lateral shift in plantar pressure distribution throughout the weightbearing phase of gait. Comfort ratings were not significantly different between insole conditions. CONCLUSIONS: Regional differences in plantar pressure may help determine an appropriate lateral wedge insole variation to avoid exacerbation of concomitant foot symptoms by minimizing pressure in symptomatic regions. Lateral shifts in plantar pressure distribution were observed in all laterally wedged conditions, including one supported-LWI that was previously shown to be biomechanically ineffective for modifying knee joint load distribution. Thus, shifts in foot centre of pressure may not be a primary mechanism by which LWI can modify knee joint load distribution for people with knee osteoarthritis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13047-021-00493-5. |
format | Online Article Text |
id | pubmed-8493692 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-84936922021-10-06 An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs Tse, Calvin T. F. Ryan, Michael B. Dien, Jason Scott, Alex Hunt, Michael A. J Foot Ankle Res Research BACKGROUND: Lateral wedge insoles (LWI), standalone or with medial arch support (supported-LWI), have been thoroughly investigated for their effects on modifying gait biomechanics for people with knee osteoarthritis. However, plantar pressure distribution between these insole types has not been investigated and could provide insight towards insole prescription with concomitant foot symptoms taken into consideration. METHODS: In a sample of healthy individuals (n = 40), in-shoe plantar pressure was measured during walking with LWI, with or without medial arch support (variable- and uniform-stiffness designs), and a flat control insole condition. Pressure data from the plantar surface of the foot were divided into seven regions: medial/lateral rearfoot, midfoot, medial/central/lateral forefoot, hallux. Plantar pressure outcomes assessed were the medial-lateral pressure index (MLPI) for the whole foot, and the peak pressure, pressure-time integral (PTI), and contact area in each plantar region. Comfort in each insole condition was rated as a change relative to the flat control insole condition. Repeated-measures analyses of variance were calculated to compare the plantar pressure outcomes between insole conditions. RESULTS: Regionally, medial rearfoot and forefoot pressure were reduced by all wedged insoles, with the variable-stiffness supported-wedge showing greater reductions than the standalone wedge. Lateral rearfoot and forefoot pressure were reduced by both supported-LWI, but unchanged by the standalone wedge. In the midfoot, the standalone wedge maintained pressure but reduced regional contact area, while both supported-LWI increased midfoot pressure and contact area. All LWI increased the MLPI, indicating a lateral shift in plantar pressure distribution throughout the weightbearing phase of gait. Comfort ratings were not significantly different between insole conditions. CONCLUSIONS: Regional differences in plantar pressure may help determine an appropriate lateral wedge insole variation to avoid exacerbation of concomitant foot symptoms by minimizing pressure in symptomatic regions. Lateral shifts in plantar pressure distribution were observed in all laterally wedged conditions, including one supported-LWI that was previously shown to be biomechanically ineffective for modifying knee joint load distribution. Thus, shifts in foot centre of pressure may not be a primary mechanism by which LWI can modify knee joint load distribution for people with knee osteoarthritis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13047-021-00493-5. BioMed Central 2021-10-06 /pmc/articles/PMC8493692/ /pubmed/34615545 http://dx.doi.org/10.1186/s13047-021-00493-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Tse, Calvin T. F. Ryan, Michael B. Dien, Jason Scott, Alex Hunt, Michael A. An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs |
title | An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs |
title_full | An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs |
title_fullStr | An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs |
title_full_unstemmed | An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs |
title_short | An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs |
title_sort | exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493692/ https://www.ncbi.nlm.nih.gov/pubmed/34615545 http://dx.doi.org/10.1186/s13047-021-00493-5 |
work_keys_str_mv | AT tsecalvintf anexplorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns AT ryanmichaelb anexplorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns AT dienjason anexplorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns AT scottalex anexplorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns AT huntmichaela anexplorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns AT tsecalvintf explorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns AT ryanmichaelb explorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns AT dienjason explorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns AT scottalex explorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns AT huntmichaela explorationofchangesinplantarpressuredistributionsduringwalkingwithstandaloneandsupportedlateralwedgeinsoledesigns |