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Gimunová M, Kolářová K, Vodička T, Bozděch M, Zvonař M. How barefoot and conventional shoes affect the foot and gait characteristics in toddlers. PLoS One 2022; 17:e0273388. [PMID: 35998149 PMCID: PMC9398026 DOI: 10.1371/journal.pone.0273388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives Barefoot shoes have recently become a popular alternative to conventional shoes among the parents of pre-school children. As the long-term effect of habitual shoe-wearing on the foot is still unclear, the aim of this study was to compare the arch index, dynamic foot anthropometry and gait parameters in toddlers who had been habitually wearing barefoot shoes or conventional shoes since their first steps. Methods 30 toddlers– 15 habitually wearing barefoot shoes (BF group) and 15 habitually wearing conventional shoes (N-BF group)–participated in this study. Each child was measured twice during the study. The first data collection session occurred within one month after the first five consecutive unsupported steps were performed by the toddler. The second data collection session occurred seven months after this event. At each data collection session, the toddler was instructed to walk barefooted at its natural speed over an Emed® platform (Novel GmbH, Germany). The Emed ® software generated data regarding the arch index, dynamic foot anthropometry, foot progression angle, contact area, contact time, peak pressure and maximum force. The Wilcoxon signed-rank test was used to compare the differences between the 1st and 2nd data collections. The Mann-Whitney U test was used to compare the differences between the BF and N-BF groups. Results The results of this study show a higher plantar arch and a smaller foot progression angle in the BF group. The forefoot width in both the BF and N-BF groups remained proportional to the foot length after seven months of independent walking. Conclusions These findings may encourage parents and caregivers to introduce barefoot shoes or create a habitual barefoot time for their child.
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Affiliation(s)
- Marta Gimunová
- Department of Kinesiology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
- * E-mail:
| | - Kateřina Kolářová
- University Sport Centre, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
| | - Tomáš Vodička
- Department of Kinesiology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
| | - Michal Bozděch
- Department of Kinesiology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
| | - Martin Zvonař
- Department of Kinesiology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
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Wang Z, Peng S, Zhang H, Sun H, Hu J. Gait Parameters and Peripheral Neuropathy in Patients With Diabetes: A Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:891356. [PMID: 35721708 PMCID: PMC9199374 DOI: 10.3389/fendo.2022.891356] [Citation(s) in RCA: 1] [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: 03/07/2022] [Accepted: 04/27/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To investigate the relationship between diabetic peripheral neuropathy (DPN) and gait abnormality in diabetic patients. METHODS Related research concerning the gait of diabetic patients with and without DPN was collected and analyzed by searching PubMed, Embase, and Web of Science. Statistical analysis was performed by using RevMan 5.3 software. RESULTS Twenty-one studies were included in this meta-analysis, consisting of 499 diabetic neuropathy patients and 467 diabetes controls without neuropathy. Meta-analysis results showed lower gait velocity, shorter stride length, longer stride time, longer stance time, and higher maximum knee extension moment in the DPN group, compared with their counterparts. CONCLUSION Among diabetic patients, those complicated with DPN possess lower gait velocity, shorter stride length, longer stride time, longer stance time, and higher maximum knee extension moment.
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Affiliation(s)
- Zhenchao Wang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Si Peng
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Endocrinology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Honghong Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hong Sun
- Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Hong Sun, ; Ji Hu,
| | - Ji Hu
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Hong Sun, ; Ji Hu,
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Schelhaas R, Hajibozorgi M, Hortobágyi T, Hijmans JM, Greve C. Conservative interventions to improve foot progression angle and clinical measures in orthopedic and neurological patients - A systematic review and meta-analysis. J Biomech 2021; 130:110831. [PMID: 34741811 DOI: 10.1016/j.jbiomech.2021.110831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 01/03/2023]
Abstract
To establish the comparative effects of conservative interventions on modifying foot progression angle (FPA) in children and adults with orthopaedic and neurological disease was the main aim of the literature review. Pubmed, Embase, Cinahl, and Web of Science were systematically searched for studies evaluating the effects of conservative interventions on correcting the FPA. The study protocol was registered with PROSPERO (CRD42020143512). Two reviewers independently assessed studies for inclusion and quality. Studies that assessed conservative interventions that could have affected the FPA and objectively measured the FPA were included. Within group Mean Differences (MD) and Standardized Mean Differences (SMDs) of the interventions were calculated for the change in FPA and gait performance (walking speed, stride/step length) and clinical condition (pain). Intervention effects on FPA were synthesized via meta-analysis or qualitatively. 41 studies were identified. For patients with knee osteoarthritis gait training interventions (MD = 6.69° and MD = 16.06°) were significantly more effective than mechanical interventions (MD = 0.44°) in modifying the FPA towards in-toeing (p < 0.00001). Increasing or decreasing the FPA significantly improved pain in patients with medial knee OA. Results were inconclusive for the effectiveness of gait training and mechanical devices in patients with neurological diseases. Gait feedback training is more effective than external devices to produce lasting improvements in FPA, reduce pain, and maintain gait performance in patients with medial knee OA. However, in neurological patients, the effects of external devices on improvements in FPA depends on the interaction between patient-specific impairments and the technical properties of the external device.
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Affiliation(s)
- Reslin Schelhaas
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands
| | - Mahdieh Hajibozorgi
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Tibor Hortobágyi
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands
| | - Juha M Hijmans
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Christian Greve
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.
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Plantar Pressure Evaluation during the Season in Five Basketball Movements. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sports activity is extremely important in the health context, with a clear motivation for its practice. One of the sports that involve more athletes is basketball, where the human body undergoes rapid reactions, emphasizing the contact of the foot with the ground. The main goal of the present study is to evaluate the distribution of plantar pressure in five different basketball movements. Supported by a group of nine volunteer female athletes from a senior basketball team, a data acquisition protocol was defined to identify the changes that occur throughout the sports season. In this study, the maximum values of plantar pressure were evaluated for both feet. The five movements that were defined and studied are all movements that might be performed during the basketball practice period. To guarantee the necessary conditions of data reliability and repeatability, at least seven repetitions were performed for each movement, which occurred at two different moments of the sports season: at the beginning of the competition in November, and at season peak, four months later, in March. Overall, the results obtained did not present statistically significant changes between the two seasons in this study. However, a slight decrease was observed throughout the sporting season for all movements, except for the rebound, where there was a contrary evaluation. Additionally, athletes with a higher level of experience show higher values of plantar pressure than less experienced athletes.
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Fernando ME, Crowther RG, Lazzarini PA, Sangla KS, Wearing S, Buttner P, Golledge J. Gait in People With Nonhealing Diabetes-Related Plantar Ulcers. Phys Ther 2019; 99:1602-1615. [PMID: 31411324 DOI: 10.1093/ptj/pzz119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/26/2019] [Accepted: 04/20/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Abnormalities in gait have been associated with high plantar pressures and diabetes-related plantar foot ulcers. Whether these are a transient response to the ulcer or are representative of long-term lower limb biomechanical abnormalities is currently unknown. OBJECTIVE The aim of this study was to examine whether 12 gait parameters identified as being associated with nonhealing diabetes-related plantar foot ulcers at baseline remained associated during a 6-month follow-up period. DESIGN This was a longitudinal observational case-control study. METHODS Gait assessments were performed at entry and twice during follow-up over a 6-month period in 12 participants with nonhealing diabetes-related plantar foot ulcers (case participants) and 62 people with diabetes and no history of foot ulcers (control participants) using a standardized protocol. Linear mixed-effects random-intercept models were used to identify gait parameters that consistently differed between case participants and control participants at all assessments after adjustment for age, sex, body mass index, presence of peripheral neuropathy, and follow-up time. Standardized mean differences (SMD) were used to measure effect sizes. RESULTS Five of the 12 gait parameters were significantly different between case participants and control participants at all 3 time points. Case participants had a more abducted foot progression angle (SMD = 0.37), a higher pelvic obliquity at toe-off (SMD = -0.46), a greater minimum pelvic obliquity (SMD = -0.52), a lower walking speed (SMD = -0.46), and a smaller step length (SMD = -0.46) than control participants. LIMITATIONS The limitations included a small sample size, the observational nature of the study, and the inability to evaluate the impact of gait on wound healing. CONCLUSIONS This study identified abnormal gait parameters consistently associated with nonhealing diabetes-related plantar foot ulcers. Further research is needed to test the clinical importance of these gait characteristics.
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Affiliation(s)
- Malindu E Fernando
- Ulcer and Wound Healing Consortium (UHEAL), Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, Australian Institute of Tropical Health Medicine, Townsville, Queensland, Australia; School of Clinical Sciences, Queensland University of Technology, Queensland, Australia; and Movement Analysis Laboratory, Sports and Exercise Science, James Cook University, Townsville, Australia
| | - Robert G Crowther
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia, and Movement Analysis Laboratory, Sports and Exercise Science, James Cook University
| | - Peter A Lazzarini
- School of Clinical Sciences, Queensland University of Technology and Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Australia
| | - Kunwarjit S Sangla
- Department of Diabetes and Endocrinology, Townsville Hospital, Queensland, Australia
| | - Scott Wearing
- School of Clinical Sciences, Queensland University of Technology and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; and Conservative and Rehabilitative Orthopaedics, Faculty for Sport and Health, Technische Universität München, Germany
| | - Petra Buttner
- Centre for Chronic Disease Prevention, James Cook University, Cairns, Australia
| | - Jonathan Golledge
- Ulcer and Wound Healing Consortium (UHEAL), Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, Australian Institute of Tropical Health Medicine, James Cook University, 1 James Cook Drive, Douglas, QLD 4814, Australia; and Department of Vascular and Endovascular Surgery, The Townsville Hospital
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Telfer S, Bigham JJ. The influence of population characteristics and measurement system on barefoot plantar pressures: A systematic review and meta-regression analysis. Gait Posture 2019; 67:269-276. [PMID: 30391749 DOI: 10.1016/j.gaitpost.2018.10.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/17/2018] [Accepted: 10/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The measurement of plantar pressure distributions during gait can provide insights into the effects of musculoskeletal disease on foot function. A range of hardware, software, and protocols are available for the collection of this type of data, with sometimes disparate and conflicting results reported between individual studies. In this systematic review and meta-regression analysis of dynamic regional peak pressures, we aimed to test if 1) the system used to obtain the pressure measurements and 2) the characteristics of the study populations had a significant effect on the results. METHODS A systematic review of the literature was undertaken to identify articles reporting regional peak plantar pressures during barefoot walking. A mixed-effects modeling approach was used to analyze the extracted data. Initially, the effect of the system used to collect the data was tested. Following this, the effect of participant characteristics on the results were analyzed, using moderators of cohort type (defined as the primary health characteristic of the participants), age, sex, and BMI. RESULTS 115 participant groups were included in the analysis. Sufficient cohorts were available to test those that consisted of healthy individuals, and those with diabetes and diabetic neuropathy. Significant differences were found between results reported by studies using different pressure measurement systems in 8 of the 16 regions analyzed. The analysis of participant characteristics revealed a number of significant relationships between regional peak pressures and participant characteristics, including: BMI and midfoot plantar pressures; elevated forefoot pressures as a result of diabetic neuropathy; and sex-differences in regional loading patterns. CONCLUSIONS At the level of the literature, we confirmed significant effects of disease status, age, BMI, and sex on regional peak plantar pressures. Researchers and clinicians should be aware that measurements of peak plantar pressure variables obtained from different collection equipment are not directly comparable.
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Affiliation(s)
- S Telfer
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, United States.
| | - J J Bigham
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, United States
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