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Malus J, Urbaczka J, Hamill J, Rygelova M, Monte A, Horka V, Uchytil J. Does an acute transition to different footwear conditions affect walking patterns in people with different experiences of minimalist footwear? Gait Posture 2024; 113:258-264. [PMID: 38968820 DOI: 10.1016/j.gaitpost.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 06/21/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Minimalistic footwear provides adequate toe space, tripod function, improving foot function, muscle activation and stability during walking similarly to barefoot walking. Due to the increasing popularity of this specific footwear, there is a lack of research focusing on general users of minimalistic footwear. RESEARCH QUESTION Does annual walking in minimalistic footwear affect gait biomechanics? METHODS Cross-sectional study involving twenty participants in a minimalistic footwear group with both experience (MFE) and no experience (NMFE). Participants walked in three different conditions (barefoot, minimalistic, and neutral footwear) in the laboratory at normal human walking speed. RESULTS A significant main effect of groups regardless of footwear conditions show significantly greater values during walking in minimalistic footwear and barefoot in the stride length (p=0.035, p=0.003, respectively), and stride width (p=0.047, p=0.028, respectively) in the NMFE group compared to MFE group. The significant differences in the main effects of footwear regardless of experience were found in stance time (p<0.001), steps per minute (p<0.001), stride length (<0.001), foot adduction in TO (p<0.001), foot eversion angle in IC and TO (p<0.001, p<0.001, respectively), foot progression angle (p<0.001), ankle dorsiflexion angle in IC and TO (p<0.001, p<0.001, respectively), in ankle eversion angle in IC and TO (p<0.001, p<0.001, respectively), knee flexion angle in IC and TO (p<0.001; p<0.001, respectively), and in knee flexion range of motion (p<0.001). SIGNIFICANCE Based on our findings, barefoot walking should be used primarily during daily activities if the environment is conducive. Only one year of experience with minimalistic footwear seems insufficient and an intervention should be incorporated to change the gait pattern when transitioning to full minimalistic footwear walking.
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Affiliation(s)
- Jan Malus
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
| | - Jan Urbaczka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
| | - Joseph Hamill
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic; Department of Kinesiology, University of Massachusetts, Amherst, USA.
| | - Marketa Rygelova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
| | - Andrea Monte
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Veronika Horka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
| | - Jaroslav Uchytil
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
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Sacco ICN, Trombini-Souza F, Suda EY. Impact of biomechanics on therapeutic interventions and rehabilitation for major chronic musculoskeletal conditions: A 50-year perspective. J Biomech 2023; 154:111604. [PMID: 37159980 DOI: 10.1016/j.jbiomech.2023.111604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/12/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
The pivotal role of biomechanics in the past 50 years in consolidating the basic knowledge that underpins prevention and rehabilitation measures has made this area a great spotlight for health practitioners. In clinical practice, biomechanics analysis of spatiotemporal, kinematic, kinetic, and electromyographic data in various chronic conditions serves to directly enhance deeper understanding of locomotion and the consequences of musculoskeletal dysfunctions in terms of motion and motor control. It also serves to propose straightforward and tailored interventions. The importance of this approach is supported by myriad biomechanical outcomes in clinical trials and by the development of new interventions clearly grounded on biomechanical principles. Over the past five decades, therapeutic interventions have been transformed from fundamentally passive in essence, such as orthoses and footwear, to emphasizing active prevention, including exercise approaches, such as bottom-up and top-down strengthening programs for runners and people with osteoarthritis. These approaches may be far more effective inreducing pain, dysfunction, and, ideally, incidence if they are based on the biomechanical status of the affected person. In this review, we demonstrate evidence of the impact of biomechanics and motion analysis as a foundation for physical therapy/rehabilitation and preventive strategies for three chronic conditions of high worldwide prevalence: diabetes and peripheral neuropathy, knee osteoarthritis, and running-related injuries. We conclude with a summary of recommendations for future studies needed to address current research gaps.
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Affiliation(s)
- Isabel C N Sacco
- Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Francis Trombini-Souza
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil; Master's and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | - Eneida Yuri Suda
- Postgraduate Program in Physiotherapy, Universidade Ibirapuera, São Paulo, Brazil
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Dantas G, Sacco ICN, Dos Santos AF, Watari R, Matias AB, Serrao PRMS, Pott-Junior H, Salvini TF. Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial. BMJ Open 2020; 10:e039279. [PMID: 32978204 PMCID: PMC7520828 DOI: 10.1136/bmjopen-2020-039279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Studies have indicated that hip and knee muscle strengthening are effective in reducing pain, improving self-reported function and increasing lower limb strength, without, however, decreasing knee joint overload during gait in patients with knee osteoarthritis (KOA). Recent research has shown that strengthening the foot-ankle muscles improved function in diabetic patients and reduced patellofemoral pain. The aim of this paper is to investigate whether an 8-week therapeutic foot-ankle exercise programme improves pain, functionality, foot strength, foot kinematics and knee joint overload during gait, and decreases medication intake in individuals with KOA. METHODS AND ANALYSIS This two-arm, prospectively registered, randomised controlled trial with blinded assessors will involve 88 patients with medial tibiofemoral osteoarthritis. Subjects will be randomly allocated to a control group that will receive no specific foot intervention and will follow treatment recommended by the medical team; or an intervention group that will undergo an 8-week physiotherapist-supervised strengthening programme for extrinsic and intrinsic foot muscles, three times a week. The primary outcome will be the pain domain of the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC). The secondary outcomes include WOMAC stiffness and function domains, total WOMAC score, physical function, foot muscle isometric strength, foot kinematics and knee kinetics during gait, and medication intake. Data will be analysed on intention-to-treat principles and a per protocol basis. ETHICS AND DISSEMINATION Investigators and sponsors will communicate trial results to participants and healthcare professionals through scientific databases and social media. In addition, findings will be reported in peer-review publications, and at national and international conference presentations. Ethics approval: Ethics Committee of the Universidade Federal de São Carlos, São Carlos, SP, Brazil (N° 3.488.466). TRIAL REGISTRATION NUMBER NCT04154059.
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Affiliation(s)
- Glauko Dantas
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Isabel C N Sacco
- Department of Physical Therapy, Speech, and Occupational Therapy, USP, Sao Paulo, Brazil
| | | | - Ricky Watari
- Department of Physical Therapy, Speech, and Occupational Therapy, USP, Sao Paulo, Brazil
| | - Alessandra B Matias
- Department of Physical Therapy, Speech, and Occupational Therapy, USP, Sao Paulo, Brazil
| | - Paula R M S Serrao
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Henrique Pott-Junior
- Department of Medicine, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Tania F Salvini
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
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Zafar AQ, Zamani R, Akrami M. The effectiveness of foot orthoses in the treatment of medial knee osteoarthritis: A systematic review. Gait Posture 2020; 76:238-251. [PMID: 31874456 DOI: 10.1016/j.gaitpost.2019.12.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/22/2019] [Accepted: 12/12/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Knee osteoarthritis is a disease of the joint causing decreased function and pain. Currently, treatments range from medication to surgery, with the use of different insoles and footwear recommended. These methods are effective by either correcting the position of the knee or providing shock absorption. However, there is little understanding of the effective characteristics of these devices. RESEARCH QUESTION This paper aims to investigate this question and provide future areas of research to help better define treatment guidelines. Foot orthoses are an example of non-pharmacological conservative treatments mentioned in National Institute for Health and Care Excellence (NICE) guidelines to treat knee osteoarthritis (OA). These include lateral wedge insoles (LWI), developed with the intention of load reduction of the knee. Different footwear has also been shown to affect pain, biomechanical and functional outcomes in knee OA patients. METHODS To address what features of LWIs and footwear make them effective in the treatment of knee OA, scientific databases were used to search for papers on this topic and then selected to be included based on pre-defined criteria. Data were extracted and analysed from these studies to provide a basis for possible areas for future development of these foot orthoses, and research required to improve clinical treatment guidelines. Databases used were PubMed, Scopus and Web of Science. RESULTS AND SIGNIFICANCE Thirty-four out of 226 papers were included after application of inclusion and exclusion criteria. Regarding LWIs, the characteristics showing the most beneficial effect on either biomechanical, functional or pain outcomes were customisation, full-length, 5° elevation, shock absorption and arch support. For footwear, barefoot mimicking soles produced the most favourable biomechanics. Results also showed that insoles work in correcting the position of the knee, but it may or may not affect patients' pain and function.
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Affiliation(s)
| | - Reza Zamani
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Mohammad Akrami
- Department of Engineering, College of Engineering, Mathematics, and Physical Sciences University of Exeter, Exeter, United Kingdom.
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Zhang B, Yu X, Liang L, Zhu L, Dong X, Xiong Y, Pan Q, Sun Y. Is the Wedged Insole an Effective Treatment Option When Compared with a Flat (Placebo) Insole: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:8654107. [PMID: 30622616 PMCID: PMC6304499 DOI: 10.1155/2018/8654107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/24/2018] [Accepted: 11/25/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Using the lateral wedge insole is a conservative management strategy for knee osteoarthritis. The theoretical basis for this intervention is to correct femorotibial angle, thereby reducing pain and optimising function. OBJECTIVE This systematic review evaluates the evidence on the effectiveness of wedge insole compared with flat insole for the treatment of knee osteoarthritis. METHODS A systematic review was performed, searching published (MEDLINE, EMBASE, CNKI, Cochrane Library, and Web of Science) and unpublished literature from their inception to April 2018. Randomized controlled trials (RCTs) that compared the use of wedge insole with a flat insole were included. Risk of bias and clinical relevance were assessed, and outcomes were analysed through meta-analysis. RESULT From a total of 413 citations, 8 studies adhered to the a priori eligibility criteria. The WOMAC pain was shown to be statistically nonsignificant change with the use of wedge insole (SMD=0.07), and low heterogeneity (I2=22%) and a 95% CI that crossed zero (95% CI: -0.09 to 0.24). The 5 independent trials were not significant in improving pain score (SMD = -0.02, 95% CI: -0.19 to 0.16). This review also revealed no significance in improving Lequesne index (SMD = -0.27, 95% CI: -0.72 to 0.19). The meta-analysis from the 2 independent trials was significant in improving femorotibial angle (SMD = -0.41, 95% CI: -0.73 to -0.09). In conclusion, this meta-analysis suggested that lateral wedge insoles can improve femorotibial angle but are of no benefit with pain and functions in knee osteoarthritis.
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Affiliation(s)
- Bingbing Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Xing Yu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Long Liang
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Liguo Zhu
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Xiaopeng Dong
- First Affiliated Hospital of Anhui University of Chinese Medicine, Anhui 230031, China
| | - Yang Xiong
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Quan Pan
- Dezhou People's Hospital, Dezhou, Shandong 253000, China
| | - Yongsheng Sun
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
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Azevedo APDS, Mezêncio B, Amadio AC, Serrão JC. 16 Weeks of Progressive Barefoot Running Training Changes Impact Force and Muscle Activation in Habitual Shod Runners. PLoS One 2016; 11:e0167234. [PMID: 27907069 PMCID: PMC5132300 DOI: 10.1371/journal.pone.0167234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 11/08/2016] [Indexed: 12/03/2022] Open
Abstract
Short-term effects of barefoot and simulated barefoot running have been widely discussed in recent years. Consequences of adopting barefoot running for a long period, including as a training approach, still remain unknown. The present study evaluated the influence of 16 weeks of progressive barefoot running training on impact force and muscle activation in habitual shod runners. Six habitual shod runners (3 men and 3 women, 29.5 ± 7.3 years) were tested barefoot (BF) and shod (SH), before and after 16 weeks of progressive barefoot running training. Tests consisted of running on instrumented treadmill at 9 km/h, for 10 minutes in each experimental condition. Nine data acquisitions (10 s) of vertical ground reaction force (VGRF) and electromyographic (EMG) signal were conducted in each experimental condition for each test. BF training was effective to alter VGRF and EMG parameters of running in habitual shod runners, regardless of footwear condition (SH or BF). The magnitude of first peak of VGRF (Fy1) and the impulse of the first 50 ms decreased after training for BF and SH (p<0.01). The activation reduced from PRE to POST training for four muscles in BF running (p<0.001), whereas only muscle gastrocnemius lateralis decreased significantly its activation (p<0.01) in SH running. A 16-week progressive barefoot running training seems to be an effective training strategy to reduce impact force, improve shock attenuation and to decrease muscle activation intensity, not only in BF running, but also in SH running, although BF condition seems to be more influenced by BF training.
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Affiliation(s)
- Ana Paula da Silva Azevedo
- Laboratory of Biomechanics, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
- * E-mail:
| | - Bruno Mezêncio
- Laboratory of Biomechanics, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Alberto Carlos Amadio
- Laboratory of Biomechanics, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Julio Cerca Serrão
- Laboratory of Biomechanics, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
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Chen TLW, Sze LKY, Davis IS, Cheung RTH. Effects of training in minimalist shoes on the intrinsic and extrinsic foot muscle volume. Clin Biomech (Bristol, Avon) 2016; 36:8-13. [PMID: 27195735 DOI: 10.1016/j.clinbiomech.2016.05.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 05/09/2016] [Accepted: 05/09/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Minimalist shoes have gained popularity recently because it is speculated to strengthen the foot muscles and foot arches, which may help to resist injuries. However, previous studies provided limited evidence supporting the link between changes in muscle size and footwear transition. Therefore, this study sought to examine the effects of minimalist shoes on the intrinsic and extrinsic foot muscle volume in habitual shod runners. The relationship between participants' compliance with the minimalist shoes and changes in muscle õvolume was also evaluated. METHODS Twenty habitual shod runners underwent a 6-month self-monitoring training program designed for minimalist shoe transition. Another 18 characteristics-matched shod runners were also introduced with the same program but they maintained running practice with standard shoes. Runners were monitored using an online surveillance platform during the program. We measured overall intrinsic and extrinsic foot muscle volume before and after the program using MRI scans. FINDINGS Runners in the experimental group exhibited significantly larger leg (P=0.01, Cohen's d=0.62) and foot (P<0.01, Cohen's d=0.54) muscle after transition. Foot muscle growth was mainly contributed by the forefoot (P<0.01, Cohen's d=0.64) but not the rearfoot muscle (P=0.10, Cohen's d=0.30). Leg and foot muscle volume of runners in the control group remained similar after the program (P=0.33-0.95). A significant positive correlation was found between participants' compliance with the minimalist shoes and changes in leg muscle volume (r=0.51; P=0.02). INTERPRETATION Habitual shod runners who transitioned to minimalist shoes demonstrated significant increase in leg and foot muscle volume. Additionally, the increase in leg muscle volume was significantly correlated associated with the compliance of minimalist shoe use.
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Affiliation(s)
- Tony Lin-Wei Chen
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Louis K Y Sze
- Industrial Centre, The Hong Kong Polytechnic University, Hong Kong
| | - Irene S Davis
- Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, The Harvard University, MA, Cambridge, USA
| | - Roy T H Cheung
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
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Matias AB, Taddei UT, Duarte M, Sacco ICN. Protocol for evaluating the effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: a randomized controlled trial. BMC Musculoskelet Disord 2016; 17:160. [PMID: 27075480 PMCID: PMC4831173 DOI: 10.1186/s12891-016-1016-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 04/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overall performance, particularly in a very popular sports activity such as running, is typically influenced by the status of the musculoskeletal system and the level of training and conditioning of the biological structures. Any change in the musculoskeletal system's biomechanics, especially in the feet and ankles, will strongly influence the biomechanics of runners, possibly predisposing them to injuries. A thorough understanding of the effects of a therapeutic approach focused on feet biomechanics, on strength and functionality of lower limb muscles will contribute to the adoption of more effective therapeutic and preventive strategies for runners. METHODS/DESIGN A randomized, prospective controlled and parallel trial with blind assessment is designed to study the effects of a "ground-up" therapeutic approach focused on the foot-ankle complex as it relates to the incidence of running-related injuries in the lower limbs. One hundred and eleven (111) healthy long-distance runners will be randomly assigned to either a control (CG) or intervention (IG) group. IG runners will participate in a therapeutic exercise protocol for the foot-ankle for 8 weeks, with 1 directly supervised session and 3 remotely supervised sessions per week. After the 8-week period, IG runners will keep exercising for the remaining 10 months of the study, supervised only by web-enabled software three times a week. At baseline, 2 months, 4 months and 12 months, all runners will be assessed for running-related injuries (primary outcome), time for the occurrence of the first injury, foot health and functionality, muscle trophism, intrinsic foot muscle strength, dynamic foot arch strain and lower-limb biomechanics during walking and running (secondary outcomes). DISCUSSION This is the first randomized clinical trial protocol to assess the effect of an exercise protocol that was designed specifically for the foot-and-ankle complex on running-related injuries to the lower limbs of long-distance runners. We intend to show that the proposed protocol is an innovative and effective approach to decreasing the incidence of injuries. We also expect a lengthening in the time of occurrence of the first injury, an improvement in foot function, an increase in foot muscle mass and strength and beneficial biomechanical changes while running and walking after a year of exercising. TRIAL REGISTRATION Clinicaltrials.gov Identifier NCT02306148 (November 28, 2014) under the name "Effects of Foot Strengthening on the Prevalence of Injuries in Long Distance Runners". Committee of Ethics in Research of the School of Medicine of the University of Sao Paulo (18/03/2015, Protocol # 031/15).
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Affiliation(s)
- Alessandra B. Matias
- />Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, 05360-160 São Paulo, São Paulo Brazil
| | - Ulisses T. Taddei
- />Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, 05360-160 São Paulo, São Paulo Brazil
| | - Marcos Duarte
- />Federal University of ABC, Biomedical Engineering, São Bernardo, São Paulo Brazil
| | - Isabel C. N. Sacco
- />Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, 05360-160 São Paulo, São Paulo Brazil
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Bettoni E, Ferriero G, Bakhsh H, Bravini E, Massazza G, Franchignoni F. A systematic review of questionnaires to assess patient satisfaction with limb orthoses. Prosthet Orthot Int 2016; 40:158-69. [PMID: 25428901 DOI: 10.1177/0309364614556836] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 10/02/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND Assessment of patient satisfaction with orthosis is a key point for clinical practice and research, requiring questionnaires with robust psychometric properties. OBJECTIVES To identify which validated questionnaires are used to investigate patient satisfaction with orthosis in limb orthotics and to analyse (1) their main fields of clinical application, (2) the orthosis-related features analysed by the questionnaires and (3) the strength of their psychometric properties. STUDY DESIGN Systematic review. METHODS A literature search using MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus databases for original articles published within the last 20 years was performed. RESULTS A total of 106 papers pertaining to various clinical fields were selected. The main features of patient satisfaction with orthosis analysed were as follows: aesthetic, ease in donning and doffing the device, time of orthotic use and comfort. CONCLUSION Of the questionnaires used to investigate patient satisfaction with orthosis, only four are adequately validated for this purpose: two for generic orthotic use (Quebec User Evaluation of Satisfaction with assistive Technology 2.0 and Client Satisfaction with Device of Orthotics and Prosthetic Users' Survey) and two for specific application with orthopaedic shoes (Questionnaire for the Usability Evaluation of orthopaedic shoes and Monitor Orthopaedic Shoes). Further development, refinement and validation of outcome measures in this field are warranted. CLINICAL RELEVANCE Given the importance of analysing patient satisfaction with orthosis (PSwO), appropriate instruments to assess outcome are needed. This article reviews the currently available instruments and reflects on how future studies could be focused on the development, refinement and validation of outcome measures in this field.
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Affiliation(s)
| | - Giorgio Ferriero
- Scientific Institute of Veruno, Fondazione Salvatore Maugeri, Veruno, Italy
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Trombini-Souza F, Matias AB, Yokota M, Butugan MK, Goldenstein-Schainberg C, Fuller R, Sacco ICN. Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: A randomized controlled trial. Clin Biomech (Bristol, Avon) 2015; 30:1194-201. [PMID: 26307181 DOI: 10.1016/j.clinbiomech.2015.08.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 08/05/2015] [Accepted: 08/06/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Efforts have been made to retard the progressive debilitating pain and joint dysfunction in patients with knee osteoarthritis. We aimed to evaluate the therapeutic effect of a low-cost minimalist footwear on pain, function, clinical and gait-biomechanical aspects of elderly women with knee osteoarthritis. METHODS Throughout a randomized, parallel and controlled clinical trial, fifty-six patients with medial knee osteoarthritis were randomly allocated to an intervention (n=28) or control group (n=28), and assessed at baseline and after three and six months. The intervention involved wearing Moleca(®) footwear for at least 6h/day, 7 days/week, over 6 months. The pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index was the primary outcome. The secondary outcomes were the other subscales, Lequesne score, distance walked in 6 min, knee oedema and effusion, knee adduction moment and paracetamol intake. Intention-to-treat analysis was performed using two-way casewise ANOVA (< .05) and Cohen's d coefficient. FINDINGS Intervention group showed improvement in pain (effect size: 1.41, p<.001), function (effect size: 1.22, p=.001), stiffness (effect size: 0.76, p=.001), Lequesne score (effect size: 1.07, p<.001), and reduction by 21.8% in the knee adduction moment impulse (p=.017) during gait wearing Moleca(®). The analgesic intake was lower in the intervention group. INTERPRETATION The long-term use of Moleca(®) footwear relieves pain, improves self-reported function, reduces the knee loading while wearing Moleca(®), refrains the increase of analgesic intake in elderly women with knee osteoarthritis and can be considered as a conservative mechanical treatment option. ClinicalTrials.gov (NCT01342458).
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Affiliation(s)
- Francis Trombini-Souza
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Brazil
| | - Alessandra B Matias
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Brazil
| | - Mariane Yokota
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Brazil
| | - Marco K Butugan
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Brazil
| | | | - Ricardo Fuller
- Rheumatology Division, School of Medicine, University of São Paulo, Brazil
| | - Isabel C N Sacco
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Brazil.
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Abstract
The running shoe has gone through significant changes since its inception. The purpose of this paper is to review these changes, the majority of which have occurred over the past 50 years. Running footwear began as very minimal, then evolved to become highly cushioned and supportive. However, over the past 5 years, there has been a reversal of this trend, with runners seeking more minimal shoes that allow their feet more natural motion. This abrupt shift toward footwear without cushioning and support has led to reports of injuries associated with minimal footwear. In response to this, the running footwear industry shifted again toward the development of lightweight, partial minimal shoes that offer some support and cushioning. In this paper, studies comparing the mechanics between running in minimal, partial minimal, and traditional shoes are reviewed. The implications for injuries in all 3 conditions are examined. The use of minimal footwear in other populations besides runners is discussed. Finally, areas for future research into minimal footwear are suggested.
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