Influence of different safety shoes on gait and plantar pressure: a standardized examination of workers in the automotive industry

What's the Impact of Safety Footwear on Workers Concerning Foot-Related Problems? A Systematic Review

BACKGROUND

This study aims to assess the impact of safety footwear (SF) on workers concerning foot-related problems, especially regarding discomfort, foot pain, and skin lesions.

METHODS

A literature search of PubMed, Embase, Scopus, and Cochrane databases was performed according to PRISMA guidelines. Studies reporting foot-related problems in workers wearing SF were included. Exclusion criteria included non-English papers, reviews, laboratory and animal studies, expert opinions, letters to the editor, and grey literature. The quality assessment was performed using the Newcastle-Ottawa Scale. Descriptive statistic was used to present data.

RESULT

The initial search results yielded 483 articles; 7 articles were included in the review process. Despite the extensive variety of SF, all studies consistently reported symptomatic discomfort and pain. The discomfort factors included heat, sweating, heaviness, and footwear flexibility, with primary issues in the toes, toecaps, or metatarsal-toe crease region. The pain prevalence ranged from 42.3% to 60.8% in various anatomical regions. Irritant Contact Dermatitis was the most common (97.9%) foot dermatosis, but other foot lesions were reported: dry skin (30.2%), calluses (30%), hard nails (28%), corns (27%), and blisters.

CONCLUSIONS

Current SFs are designed to comply with safety regulations but are influenced by the frequent occurrence of discomfort and foot problems. The literature review identified weaknesses in certain design features. Recommendations have been proposed to improve SF development. These include addressing issues such as the selection of specific types and designs of SF based on task performance and the working environment, footwear weight, and breathable materials for moisture permeation. Considerations should also encompass distinct sizing for an optimal fit, insole application, especially for prolonged standing users, and education programs to prevent foot-related issues.

Impact of Fatigue on Ergonomic Risk Scores and Foot Kinetics: A Field Study Employing Inertial and In-Shoe Plantar Pressure Measurement Devices

(1) Background: Occupational fatigue is a primary factor leading to work-related musculoskeletal disorders (WRMSDs). Kinematic and kinetic experimental studies have been able to identify indicators of WRMSD, but research addressing real-world workplace scenarios is lacking. Hence, the authors of this study aimed to assess the influence of physical strain on the Borg CR-10 body map, ergonomic risk scores, and foot pressure in a real-world setting. (2) Methods: Twenty-four participants (seventeen men and seven women) were included in this field study. Inertial measurement units (IMUs) (n = 24) and in-shoe plantar pressure measurements (n = 18) captured the workload of production and office workers at the beginning of their work shift and three hours later, working without any break. In addition to the two 12 min motion capture processes, a Borg CR-10 body map and fatigue visual analog scale (VAS) were applied twice. Kinematic and kinetic data were processed using MATLAB and SPSS software, resulting in scores representing the relative distribution of the Rapid Upper Limb Assessment (RULA) and Computer-Assisted Recording and Long-Term Analysis of Musculoskeletal Load (CUELA), and in-shoe plantar pressure. (3) Results: Significant differences were observed between the two measurement times of physical exertion and fatigue, but not for ergonomic risk scores. Contrary to the hypothesis of the authors, there were no significant differences between the in-shoe plantar pressures. Significant differences were observed between the dominant and non-dominant sides for all kinetic variables. (4) Conclusions: The posture scores of RULA and CUELA and in-shoe plantar pressure side differences were a valuable basis for adapting one-sided requirements in the work process of the workers. Traditional observational methods must be adapted more sensitively to detect kinematic deviations at work. The results of this field study enhance our knowledge about the use and benefits of sensors for ergonomic risk assessments and interventions.

The Impact of Footwear on Occupational Task Performance and Musculoskeletal Injury Risk: A Scoping Review to Inform Tactical Footwear

The aim of this scoping review was to investigate the impact of footwear on worker physical task performance and injury risk. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol and registered in the Open Science Framework. Key search terms were entered into five academic databases. Following a dedicated screening process and critical appraisal, data from the final articles informing this review were extracted, tabulated, and synthesised. Of 19,614 identified articles, 50 articles informed this review. Representing 16 countries, the most common populations investigated were military and firefighter populations, but a wide range of general occupations (e.g., shipping, mining, hairdressing, and healthcare workers) were represented. Footwear types included work safety boots/shoes (e.g., industrial, gumboots, steel capped, etc.), military and firefighter boots, sports shoes (trainers, tennis, basketball, etc.) and various other types (e.g., sandals, etc.). Occupational footwear was found to impact gait and angular velocities, joint ranges of motion, posture and balance, physiological measures (like aerobic capacity, heart rates, temperatures, etc.), muscle activity, and selected occupational tasks. Occupational footwear associated with injuries included boots, conventional running shoes, shoes with inserts, harder/stiffer outsoles or thin soles, and shoes with low comfort scores-although the findings were mixed. Occupational footwear was also linked to potentially causing injuries directly (e.g., musculoskeletal injuries) as well as leading to mechanisms associated with causing injuries (like tripping and slipping).

The effects of shoe type on lower limb venous status during gait or exercise: A systematic review

This systematic review evaluated the literature pertaining to the effect of shoes on lower limb venous status in asymptomatic populations during gait or exercise. The review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed-NCBI, EBSCO Host, Cochrane Library and Science Direct databases were searched (March 2019) for words around two concepts: shoes and venous parameters. The inclusion criteria were as follows: (1) the manuscript had to be published in an English-language peer-reviewed journal and the study had to be observational or experimental and (2) the study had to suggest the analysis of many types of shoes or orthotics on venous parameters before, during and/or after exercise. Out of 366 articles, 60 duplications were identified, 306 articles were analyzed, and 13 articles met the eligibility criteria after screening and were included. This review including approximately 211 participants. The methodological rigor of these studies was evaluated with the modified Downs and Black quality index. Nine studies investigated the effect of shoes on blood flow parameters, two on venous pressure and two on lower limb circumferences with exercise. Evidence was found that unstable shoes or shoes with similar technology, sandals, athletic or soft shoes, and customized foot orthotics elicited more improvement in venous variables than high-heeled shoes, firm shoes, ankle joint immobilization and barefoot condition. These venous changes are probably related to the efficiency of muscle pumps in the lower limbs, which in turn seem to be dependent on shoe features associated with changes in the kinetics, kinematics and muscle activity variables in lower limbs during gait and exercise.

Effects of Lifting Method, Safety Shoe Type, and Lifting Frequency on Maximum Acceptable Weight of Lift, Physiological Responses, and Safety Shoes Discomfort Rating

This study aimed to investigate the physical effects of precision lifting tasks on the maximal acceptable weight of a lift (i.e., psychophysiological lifting capacity where the workers adjust the lifting weight in order to work without any fatigue or strain at the end of the work while wearing common safety shoe types). Additionally, the physical difference between the precise and non-precise lifting conditions associated with wearing safety shoes were assessed by respiration responses and shoe discomfort ratings. To achieve the objective of the study, ten healthy male workers were selected by age (between 25 to 35 years old). Their anthropometric characteristics, including knuckle height, knee height, and body mass index (BMI), were measured. A three-way repeated measures design with three independent variables was used; the variables included-the (1) lifting method (precise and non-precise), (2) lifting frequency (1 and 4 lifts per min), and (3) safety shoe type (light-duty, medium-duty, and heavy-duty). The physiological response variables and one of the subjective factors of this study were-(1) respiration responses, and (2) shoe discomfort rating, respectively. The data were analyzed using the Mauchly's test of sphericity, Shapiro-Wilk normality test, and analysis of variance (ANOVA). The results showed that the use of heavy-duty safety shoes typically increased the shoe discomfort rating under precise lifting methods. Additionally, the lifting frequency was determined to be one of the main factors affecting respiratory responses and shoe discomfort rating. This study also found that respiration responses rose on four lifts per min as compared to 1 lift per min, regardless of the lifting method type. This study indicated that the replacement of some types of ordinary safety shoes used in some workplaces with those selected appropriately might significantly reduce the rating effort required to lift objects or tools. However, the benefits should be carefully evaluated before replacing the safety shoes.

Motorized Shoes Induce Robust Sensorimotor Adaptation in Walking

The motor system has the flexibility to update motor plans according to systematic changes in the environment or the body. This capacity is studied in the laboratory through sensorimotor adaptation paradigms imposing sustained and predictable motor demands specific to the task at hand. However, these studies are tied to the laboratory setting. Thus, we asked if a portable device could be used to elicit locomotor adaptation outside the laboratory. To this end, we tested the extent to which a pair of motorized shoes could induce similar locomotor adaptation to split-belt walking, which is a well-established sensorimotor adaptation paradigm in locomotion. We specifically compared the adaptation effects (i.e. after-effects) between two groups of young, healthy participants walking with the legs moving at different speeds by either a split-belt treadmill or a pair of motorized shoes. The speeds at which the legs moved in the split-belt group was set by the belt speed under each foot, whereas in the motorized shoes group were set by the combined effect of the actuated shoes and the belts' moving at the same speed. We found that the adaptation of joint motions and measures of spatial and temporal asymmetry, which are commonly used to quantify sensorimotor adaptation in locomotion, were indistinguishable between groups. We only found small differences in the joint angle kinematics during baseline walking between the groups - potentially due to the weight and height of the motorized shoes. Our results indicate that robust sensorimotor adaptation in walking can be induced with a paired of motorized shoes, opening the exciting possibility to study sensorimotor adaptation during more realistic situations outside the laboratory.

Baropodometric evaluation of foot load distribution during gait in the group of professionally active nurses

OBJECTIVES

Nurses are extremely exposed to musculoskeletal overloads. Prolonged standing postural balance distributions, functional deficits and pain may affect the symmetry of the load on the feet. The study aimed to assess the distribution of foot load during gait among nurses.

METHODS

The sample of this prospective and observational study consisted of 37 female nurses with mean age of 39 years. The Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate musculoskeletal disturbances and baropodometric gait analysis (BGA) was performed to register distribution of foot load during gait.

RESULTS

We showed that 68% of nurses declare that they know the principles of workplace ergonomics, but only 14% comply with them. NMQ results indicate that as many as 73% of the respondents feel ailments in the "lower back" area. An asymmetry was observed in the load of IV-V of the metatarsal head between the left and right foot (P = .000) and in the load of the left and right lateral part of the heel (P = .028) in the BGA test. Correlations between ailments occurring in the neck area and loading of the lateral arch of the right foot (P = .032) were found. Moreover, the load in this area correlated positively with the occurrence of "lower back" pain (P = .045).

CONCLUSIONS

Nurses have asymmetric distribution of foot load during gait, which results in a discrepancy between the loads on the three main support points of the foot and which may affect nurses' work productivity.

Biochemical changes among municipal solid waste sorting workers: implications for personal protective equipment availability and use

Background. Solid waste management has emerged as one of the greatest challenges facing human and environmental health. Municipal solid waste workers are potentially exposed to a variety of occupational biohazards and safety risks in the workplace. Objective. This study aimed to evaluate the availability and use of personal protective equipment (PPE) and some biochemical changes among solid waste sorting workers. Methods. A group of solid waste sorting workers was interviewed and checked for availability, use and appropriateness of PPE using a structured questionnaire and checklist. Workers were tested for hepatic and renal function parameters and biomarkers of allergy and inflammation. Results. The level of high-sensitivity C-reactive protein (hsCRP) as a biomarker of inflammation was elevated in 12.9% while total serum immunoglobulin E was obviously high among most workers (79.2%). Workers with inadequately available, used or effective PPE were more likely to have morbidities and showed elevated serum levels of serum glutamic pyruvic transaminase, serum glutamic-oxaloacetic transaminase, urea, creatinine, hsCRP and total immunoglobulin E. Conclusions. Elevated biomarkers of allergy and inflammation herald preclinical disease risks that should be included in basic health surveillance. Use of PPE should be emphasized for workers involved in solid waste sorting to effectively protect their health.