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Li B, Zhang X. The dynamic characteristics of the center of pressure for toe-out gait: implications for footwear design. JOURNAL OF LEATHER SCIENCE AND ENGINEERING 2022. [DOI: 10.1186/s42825-022-00088-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Toe-out gait is often used as a conservative technique to reduce knee adduction moment, which has been targeted to modify knee osteoarthritis progression. The center of pressure (COP) can not only be used to evaluate gait stability, but is also more reliable and practical than local plantar pressures as it does not depend on accurate foot zone divisions. However, to the authors’ knowledge, few study has reported the influence of the foot progression angle on the dynamic characteristics of the COP.
Research question
The aim of the study was to investigate the effects of the deliberately toe-out gait on the COP trajectory and stability during walking in healthy individuals.
Methods
Thirty healthy young adults were asked to walk along an 8-m walkway. A Footscan 1 m pressure plate was used to measure the center of pressure during walking.
Results
Compared to the normal gait, the COP of the toe-out gait shifted laterally during the initial contact phase, and shifted laterally and anteriorly during the forefoot contact phase. The mean anterior–posterior velocity of COP reduced by 0.109 m/s during the foot flat phase and the duration of the foot flat phase and forefoot push off phase increased by 4.5% and reduced by 7.0%, respectively.
Significance
Compared to the normal gait, the findings of this study suggest that biomechanical alteration of foot under our experimental conditions may decrease gait stability and increase forefoot load during toe-out walking. The situation may be improved by well-designed footwear or custom-made insole and the biomechanics analysis method can be used to test the efficacy of therapeutic footwear or insole for individuals with deliberately toe-out walking.
Graphical Abstract
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Sánchez-Gómez R, Becerro-de-Bengoa-Vallejo R, Romero Morales C, Losa-Iglesias ME, Castrillo de la Fuente A, López-López D, Díez Vega I, Calvo-Lobo C. Muscle Activity of the Triceps Surae With Novel Propulsion Heel-Lift Orthotics in Recreational Runners. Orthop J Sports Med 2020; 8:2325967120956914. [PMID: 33150189 PMCID: PMC7580173 DOI: 10.1177/2325967120956914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 04/24/2020] [Indexed: 11/20/2022] Open
Abstract
Background: The triceps surae muscle has been identified with propulsion during running gait, and typical heel-lift orthotics (THOs) have been used to treat some sports injuries of this structural-biomechanical unit. The effects of a novel propulsion heel-lift orthotic (PHO) on surface electromyography (EMG) activity of the gastrocnemius during a full cycle of running have yet to be tested. Purpose/Hypothesis: We aimed to assess EMG changes in gastrocnemius medialis and lateralis muscle activity when wearing THOs, PHOs, or neutral sports shoes only (SO) during running. We hypothesized that EMG activity of the triceps surae muscle would be lower for PHOs than THOs or SO during running. Study Design: Controlled laboratory study. Methods: A total of 26 healthy, regular recreational runners of both sexes (mean age, 33.58 ± 6.02 years) with a neutral Foot Posture Index and rearfoot strike pattern were recruited to run on a treadmill at 9 km/h using aleatory THOs of 6 and 9 mm, PHOs, and SO while EMG activity of the gastrocnemius medialis and lateralis muscles was recorded over a 30-second period. Intraclass correlation coefficients were calculated to assess reliability. Results: The intraclass correlation coefficient values indicated near perfect reliability, ranging from 0.801 for 6-mm THOs to 0.959 for SO in the gastrocnemius lateralis muscle. EMG activity of the gastrocnemius lateralis muscle was greater for PHOs (25.516 ± 4.780 mV) than for SO (23.140 ± 4.150 mV) (P < .05), but EMG activity of the gastrocnemius medialis muscle did not show any statistically significant difference between conditions (23.130 ± 2.980 mV vs 26.315 ± 2.930 mV, respectively) (P = .3). Conclusion: A novel PHO may increase muscle activity of the gastrocnemius lateralis during a full cycle of running gait; consequently, its prescription to treat triceps surae muscle injuries is cautioned. Clinical Relevance: The prescription of novel PHOs could increase EMG activity, which has not been previously described.
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Affiliation(s)
- Rubén Sánchez-Gómez
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Carlos Romero Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | | | | | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
| | - Ignacio Díez Vega
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - César Calvo-Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
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Huang YP, Peng HT, Wang X, Chen ZR, Song CY. The arch support insoles show benefits to people with flatfoot on stance time, cadence, plantar pressure and contact area. PLoS One 2020; 15:e0237382. [PMID: 32817709 PMCID: PMC7446821 DOI: 10.1371/journal.pone.0237382] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/24/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Pes planus (flatfoot) is a common deformity characterized by the midfoot arch collapses during walking. As the midfoot is responsible for shock absorption, persons with flatfoot experience increased risk of injuries such as thumb valgus, tendinitis, plantar fasciitis, metatarsal pain, knee pain, lower-back pain with prolonged uphill, downhill, and level walking, depriving them of the physical and mental health benefits of walking as an exercise. METHODS Fifteen female college students with flatfoot were recruited. A wireless plantar-pressure system was used to measure the stance time, cadence, plantar pressure, and contact area. Parameters were compared between wearing flat and arch-support insoles using a two-way repeated measures ANOVA with on an incline, decline, and level surface, respectively. The significance level α was set to 0.05. The effect size (ES) was calculated as a measure of the practical relevance of the significance using Cohen's d. RESULTS On the level surface, the stance time in the arch-support insole was significantly shorter than in the flat insole (p<0.05; ES = 0.48). The peak pressure of the big toe in the arch-support insole was significantly greater than in the flat insole on the uphill (p<0.05; ES = 0.53) and level surfaces (p<0.05; ES = 0.71). The peak pressure of the metatarsals 2-4 and the contact area of the midfoot in the arch-support insole were significantly greater than in the flat insole on all surfaces (all p< 0.05). CONCLUSIONS These results imply that wearing an arch-support insole provides benefits in the shortened stance time and generation of propulsion force to the big toe while walking on uphill and level surfaces and to the metatarsals 2-4 while walking on the level surface. More evenly distributed contact areas across the midfoot may help absorb shock during uphill, downhill and level walking.
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Affiliation(s)
- Yu-ping Huang
- School of Sports Science, Nantong University, Jiangsu, China
- Graduate Institute of Sport Coaching Science & Department of Physical Education, Chinese Culture University, Taipei, Taiwan
| | - Hsien-Te Peng
- Graduate Institute of Sport Coaching Science & Department of Physical Education, Chinese Culture University, Taipei, Taiwan
| | - Xin Wang
- Department of Sports Human Science, Shenyang Sport University, Shenyang, China
| | - Zong-Rong Chen
- Graduate Institute of Sport Coaching Science & Department of Physical Education, Chinese Culture University, Taipei, Taiwan
- Department of Athletic Performance, National University of Kaohsiung, Kaohsiun, Taiwan
| | - Chen-Yi Song
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- * E-mail:
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Li B, Xiang Q, Zhang X. The center of pressure progression characterizes the dynamic function of high-arched feet during walking. JOURNAL OF LEATHER SCIENCE AND ENGINEERING 2020. [DOI: 10.1186/s42825-019-0016-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The medial longitudinal arch height has an effect on kinetic parameters during gait and might be related to the risk of injury. For the assessment of foot structures, the center of pressure (COP) trajectory is a more reliable and practical parameter than plantar pressure. This study aimed to clarify the COP trajectory and velocity characteristics in the medial-lateral and anterior-posterior direction of individuals with a high-arched foot during barefoot walking.
Methods
Sixty-two healthy young adults were asked to walk over a Footscan pressure plate to record the COP parameters during the stance phase of walking.
Results
Compared to normal arched feet, the COP during forefoot contact and foot flat phases of high-arched feet shifted anteriorly (19.9 mm and 15.1 mm, respectively), and the mean velocity of COP in anterior-posterior direction decreased by 0.26 m/s and increased by 0.044 m/s during these two phases respectively.
Conclusions
The findings of this study suggest that the displacement and velocity of COP in anterior-posterior direction was different between high-arched and normal-arched subjects during barefoot walking, which can be used for the assessment of gait characteristics for high-arched individuals. The results of this study may provide insights into modifying clinical intervention for individuals with high-arched feet to enhance rehabilitation and prevent injuries and have implications for assessing the design of footwear and foot orthotics.
Graphical abstract
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Jin H, Xu R, Wang S, Wang J. Use of 3D-Printed Heel Support Insoles Based on Arch Lift Improves Foot Pressure Distribution in Healthy People. Med Sci Monit 2019; 25:7175-7181. [PMID: 31549689 PMCID: PMC6777389 DOI: 10.12659/msm.918763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background 3D-printed insoles are widely used. This study was conducted to test a customized three-dimensional (3D)-printed heel support insole based on arch lift and to investigate whether the pressure distribution on the sole was improved while maintaining foot function. Material/Methods The design was based on a 3D plantar contour scanning modeling technique. Thirty healthy male participants walked along a 10-m track under 3 self-controlled interventions. A customized 3D-printed heel support insole based on arch lift was inserted into the socks for the experimental condition A. For condition B, a customized 3D-printed heel-supporting insole was inserted into the socks, and a standardized pre-made heel-supporting insole was inserted into the socks as a control (condition C). We used the Footscan® pressure plate to measure the plantar parameters in the forefoot contact and foot flange phases in each condition. Results Compared with condition B and the control condition, the peak pressure under the heel was significantly lower in condition A (P<0.05), and the peak pressure in the midfoot region was not significantly increased (P>0.05). Conclusions The biomechanical properties of the customized 3D-printed heel support are better than those of the traditional heel support insole, especially when there is a need for an additional increase in heel height. Patients do not decrease midfoot motion function while using this customized insole.
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Affiliation(s)
- Hui Jin
- Department of Pain Medicine, Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Rui Xu
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Shuxin Wang
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Jincheng Wang
- Orthopedic Medical Center, Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
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Rabusin CL, Menz HB, McClelland JA, Tan JM, Whittaker GA, Evans AM, Munteanu SE. Effects of heel lifts on lower limb biomechanics and muscle function: A systematic review. Gait Posture 2019; 69:224-234. [PMID: 30870745 DOI: 10.1016/j.gaitpost.2019.01.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 01/08/2019] [Accepted: 01/14/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Heel lifts, placed inside footwear are recommended for the management of numerous musculoskeletal conditions. Despite the potential therapeutic benefit of heel lifts, the mechanism(s) by which they exert their effects is unclear. The aim of this systematic review was to synthesise reported findings and summarise the effects of heel lifts on lower limb biomechanics and muscle function. RESEARCH QUESTION Do heel lifts affect lower limb biomechanics and muscle function during walking and running? METHODS Electronic databases (MEDLINE, EMBASE, CINAHL, SPORTDiscus, AMED) were searched from inception to April 2018. Studies were included if they (i) included participants without a limb length discrepancy or neurological condition, (ii) evaluated the effect of bilateral heel lifts that were removable (attached to the participants' foot (barefoot) or inserted inside footwear) or an existing feature of a shoe, and (iii) assessed lower limb biomechanics or muscle function during walking or running in asymptomatic or symptomatic participants. RESULTS A total of 23 studies (377 participants) were included. Study quality, assessed using a Modified Quality Index, ranged from 5 to 13 out of 15. A large number of biomechanical parameters were assessed, but few effects were statistically significant. The differences that were significant and had a large effect size are described below. In asymptomatic participants, heel lifts of 10 mm decreased duration of swing phase (standardised mean difference [SMD] = -1.3) and heel lifts of at least 5 cm decreased velocity (SMD = -0.93) during walking. In asymptomatic participants, heel lifts of 15 mm decreased maximum ankle dorsiflexion angle (SMD = -1.5) and heel lifts of 12 and 18 mm decreased gastrocnemius muscle tendon unit length (SMD = -0.96) during running. In participants with restricted ankle joint dorsiflexion, heel lifts of 6 and 9 mm increased medial gastrocnemius electromyography amplitude (SMD between 0.68 and 0.98) during walking. In participants with haemophilia, heel lifts of 9 mm increased ankle joint maximum range of motion (SMD = 1.6) during walking. SIGNIFICANCE Heel lifts affect specific lower limb biomechanical and muscle function parameters during walking and running. The clinical relevance and potential therapeutic benefits of these effects needs further investigation.
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Affiliation(s)
- Chantel L Rabusin
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia.
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Jodie A McClelland
- Discipline of Physiotherapy, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Jade M Tan
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Glen A Whittaker
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Angela M Evans
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia
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Zhang X, Chai R, Wang H, Ye X. A Plantar Pressure Sensing System with Balancing Sensitivity Based on Tailored MWCNTs/PDMS Composites. MICROMACHINES 2018; 9:E466. [PMID: 30424399 PMCID: PMC6187450 DOI: 10.3390/mi9090466] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 11/18/2022]
Abstract
This paper presents a flexible plantar pressure sensor with a simple structure and easy accessibility, suitable for everyday use. In this study, the design, fabrication, and characteristics of both the composite and the sensor were involved. By using the solution method, the piezoresistive composite was fabricated by uniform dispersion of multiwall carbon nanotubes (MWCNTs) into the polydimethylsiloxane (PDMS) matrix. The proposed sensor consists of eight sensing elements with a laminated structure. The upper layer is a sensing layer made of the piezoresistive composite, and the lower layer is a flexible printed circuit-board working as electrodes. A particular design of sensing elements was carried out by using different doping concentrations according to arrangement positions under the feet to obtain balancing sensitivity. A signal processing system to convert the variable resistance signal into voltages by the current-to-voltage method was designed. Experimental results prove that the designed sensor shows a repeatable response with a sensitivity of 11.5 mV/kPa within the range of 265 kPa. Also, an actual application verifies that the designed plantar pressure sensor can measure the pressure under the foot and can be used for gait detection and disease diagnosis purposes.
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Affiliation(s)
- Xuefeng Zhang
- Shaanxi Key Laboratory of Nano Materials and Technology, Xi'an University of Architecture and Technology, Xi'an 710055, Shaanxi, China.
| | - Running Chai
- Shaanxi Key Laboratory of Nano Materials and Technology, Xi'an University of Architecture and Technology, Xi'an 710055, Shaanxi, China.
| | - Haitao Wang
- School of Mechanical and Electrical Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, Shaanxi, China.
| | - Xiangdong Ye
- Shaanxi Key Laboratory of Nano Materials and Technology, Xi'an University of Architecture and Technology, Xi'an 710055, Shaanxi, China.
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Zhang X, Li B, Hu K, Wan Q, Ding Y, Vanwanseele B. Adding an arch support to a heel lift improves stability and comfort during gait. Gait Posture 2017; 58:94-97. [PMID: 28763715 DOI: 10.1016/j.gaitpost.2017.07.110] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 06/28/2017] [Accepted: 07/20/2017] [Indexed: 02/02/2023]
Abstract
Heel lifts have been widely used as a conservative treatment for some musculoskeletal problems and complaints. However, the heel rise caused by heel lifts may also affect the plantar pressure distribution and stability during walking. This study aimed to test whether adding an arch support to a heel lift would improve its stability and comfort through comparing the center of pressure (COP) during walking and subjective ratings between heel lifts with and without an arch support. Fifteen healthy male participants were asked to walk along an 8m walkway while wearing high-cut footwear with the control heel lifts and the heel lifts with an arch support. A Footscan pressure plate was used to measure the COP during walking. Subjective ratings including medial-lateral control, dynamic foot/shoe fitting and overall comfort were assessed for each participant. The results showed that compared to the control condition, the COP trajectory was medially shifted during stance phase of gait in the arch support condition. The maximum displacements and velocity of medial-lateral COP in the forefoot contact phase were smaller in the arch support condition than in the control condition. Adding an arch support to a heel lift also significantly improved the subjective ratings in terms of the medial-lateral control, dynamic foot/shoe fitting and overall comfort. The findings of this study suggest that adding an arch support to a heel lift could improve its stability and comfort during walking.
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Affiliation(s)
- Xianyi Zhang
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu, PR China; Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Bo Li
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu, PR China.
| | - Kun Hu
- Guangdong Huizhou Quality & Measuring Supervision Testing Institute, Huizhou, PR China
| | - Qiufeng Wan
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu, PR China
| | - Yuhao Ding
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu, PR China
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