Single-textured insole for the less affected leg in freezing of gait: A hypothesis

Freezing of gait (FoG) is one of the most widely distributed and disabling gait phenomena in people with Parkinson's disease (PD). The current therapeutic interventions show suboptimal efficacy in FoG. Lower extremity proprioception impairments, especially in the most affected leg, gait initiation hesitation, and gait asymmetry are FoG factors, and there is a need to accurately consider them in terms of therapeutic approaches. Accordingly, we hypothesize that using a single-textured insole for the less affected leg may improve FoG by providing proprioceptive stimulation that enhances sensory processing and reduces gait hesitation and asymmetry. Proprioceptive sensory stimulation for the less affected limb could be more effective than for the double legs that are currently used in rehabilitation settings due to the sensory processing in the less affected basal ganglia being better.

Effects of Artificial Texture Insoles and Foot Arches on Improving Arch Collapse in Flat Feet

The arches of the foot play a vital role in cushioning the impact and pressure generated from ground reaction forces due to body weight. Owing to a lack of normal human arch structure, people diagnosed as having flat feet often have discomfort in the soles of their feet. The results may not only cause inappropriate foot pressure distribution on the sole but also further cause foot injuries. This study heavily relies on a homemade foot pressure sensing device equipped with textured insoles of different heights and artificial arches. This was to explore the extent to which the pressure distribution of the foot in people with flat feet could be improved. A further comparison was made of the effects of using the textured insoles with different heights on two different groups of people diagnosed with flat and normal feet respectively. Sixty-five undergraduate and postgraduate volunteers were invited to receive the ink footprint test for measuring their degrees of arch index. Nine of these 65 had 2 flat feet, 3 had a left flat foot, 5 had a right flat foot, and 48 had 2 normal feet. To ensure the same number of subjects in both the control and the experimental groups, 9 of the 48 subjects who had normal feet were randomly selected. In total, 26 subjects (Male: 25, Female: 1; Age: 22 ± 1 years; height: 173.6 ± 2.5 cm; body mass: 68.3 ± 5.4 kg; BMI: 22.6 ± 1.2) were invited to participate in this foot pressure sensing insoles study. The experimental results showed that the use of textured insoles designed with different heights could not effectively improve the plantar pressure distribution and body stability in subjects with flat feet. Conversely, the use of an artificial arch effectively improved the excessive peak in pressure and poor body stability, and alleviated the problem of plantar collapse for patients with flat feet, especially in the inner part of their hallux and forefoot.

Footwear Alters Lower Extremity Coordination Variability

Footwear has been shown to have a significant effect on numerous kinematic and kinetic variables during walking and running. While footwear mass is an indisputably important influence on gait patterns, we suspected that the amount of outsole material on most footwear would likely diminish or delay the integration of tactile feedback in motor control strategies during gait. Thus, we designed this study to investigate the influence of footwear and augmented tactile feedback on lower extremity coordination patterns during walking. A secondary purpose of the study was to examine gender differences in response to altered footwear conditions. Forty-eight participants (24 male and 24 females) walked during four standardized footwear conditions (barefoot, shod, barefoot with augmented tactile feedback, and shod with augmented tactile feedback), and we collected three-dimensional kinematic data and calculated continuous relative phase values for two adjacent lower extremity joints to determine interjoint coordination patterns. We used deviation phase and the mean of the continuous relative phase to compare motor coordination patterns across conditions. We found significant footwear and gender effects for spatiotemporal variables but only significant footwear effects for motor coordination patterns. Females displayed a significantly higher cadence and shorter height-normalized stride length as compared to males. Participants displayed significantly greater thigh-shank coordination variability in the shod, as compared to the unshod, conditions. Thus, footwear results in a diminished or delayed tactile feedback that alters neuromuscular control strategies during walking.

A textured insole improves gait symmetry in individuals with stroke

PURPOSE

Gait asymmetry is a common consequence of stroke and improving gait symmetry is an important goal of rehabilitation. We investigated the effect of a single textured insole in improving gait symmetry in individuals with stroke.

METHOD

Seventeen individuals with stroke who had asymmetrical gait were recruited and required to walk with a textured insole positioned in the shoe on the unaffected side or without the insole. Gait parameters were evaluated using the instrumented walkway. Gait velocity, cadence, and symmetry indices for the spatial and temporal parameters of gait and center of pressure displacements were obtained.

RESULTS

When walking with a textured insole, symmetry indexes for stance, single support phases of gait, as well as center of pressure displacements improved significantly. While using a textured insole, the duration of the stance phase and a single support phase decreased on the unaffected side and increased on the affected side significantly. Gait velocity and cadence were not affected by the use of the insole.

CONCLUSIONS

Individuals with stroke walking with a textured insole placed in the shoe on the unaffected side improved the symmetry of their gait. The outcome provides a foundation for future investigations of the efficacy of using a single textured insole in gait rehabilitation of individuals with unilateral impairment. Implications for Rehabilitation A single textured insole positioned in the shoe on the unaffected side improved gait symmetry in individuals with stroke. Gait velocity and cadence were not affected by the use of the insole.