The complex functions of feet require a specific composition, which is progressively achieved by developmental processes. This development should take place without being affected by footwear. The aim of this study is to evaluate differences between static and dynamic foot morphology in developing feet. Feet of 2554 participants (6-16 years) were recorded using a new scanner system (DynaScan4D). Each foot was recorded in static half and full weight-bearing and during walking. Several foot measures corresponding to those used in last construction were calculated. The differences were identified by one-way ANOVA and paired Student's t-test. Static and dynamic values of each foot measure must be considered to improve the fit of footwear. In particular, footwear must account for the increase of forefoot width and the decrease of midfoot girth. Furthermore, the toe box should have a more rounded shape. The findings are important for the construction of footwear for developing feet.
The amount of toe allowance (TA, the space in front of the toes) in children's shoes is physiologically important and often estimated by the rule-of-the-parent's-thumb. Besides this, other rules-of-thumb exist mainly based on experiences or footprint analysis. The aim of this study is to scientifically evaluate these rules-of-thumb. TA was calculated as a function of growth rate, foot extension, and walking advance based on three-dimensional (3D) foot scans of 2554 children (6À16 years) during standing and walking. Foot extension was determined as the difference in foot length between static and dynamic weight-bearing, walking advance as movement of the most anterior point of toes, and growth rate as semi-annual foot growth. TA was smaller than all rules-of-thumb and was influenced by gender and foot length. These findings primarily present TA based on 3D foot scans which is important for shoe construction. It is recommended to use 90th percentiles instead of mean values for the construction of TA.
BackgroundMotor assessments are important to determine effectiveness of physical activity in individuals with dementia (IWD). However, inappropriate and non-standardised assessments without sound psychometric properties have been used. This systematic review aims to examine psychometric properties of motor assessments in IWD combined with frequency of use and effect sizes and to provide recommendations based on observed findings.We performed a two-stage systematic literature search using Pubmed, Web of Science, Cochrane Library, ALOIS, and Scopus (inception - July/September 2018, English and German). The first search purposed to identify motor assessments used in randomised controlled trials assessing effectiveness of physical activity in IWD and to display their frequency of use and effect sizes. The second search focused on psychometric properties considering influence of severity and aetiology of dementia and cueing on test-retest reliability. Two reviewers independently extracted and analysed findings of eligible studies in a narrative synthesis.ResultsLiterature searches identified 46 randomised controlled trials and 21 psychometric property studies. While insufficient information was available for validity, we observed sufficient inter-rater and relative test-retest reliability but unacceptable absolute test-retest reliability for most assessments. Combining these findings with frequency of use and effect sizes, we recommend Functional Reach Test, Groningen Meander Walking Test (time), Berg Balance Scale, Performance Oriented Mobility Assessment, Timed Up & Go Test, instrumented gait analysis (spatiotemporal parameters), Sit-to-Stand assessments (repetitions> 1), and 6-min walk test. It is important to consider that severity and aetiology of dementia and cueing influenced test-retest reliability of some assessments.ConclusionThis review establishes an important foundation for future investigations. Sufficient relative reliability supports the conclusiveness of recommended assessments at group level, while unacceptable absolute reliability advices caution in assessing intra-individual changes. Moreover, influences on test-retest reliability suggest tailoring assessments and instructions to IWD and applying cueing only where it is inevitable. Considering heterogeneity of included studies and insufficient examination in various areas, these recommendations are not comprehensive. Further research, especially on validity and influences on test-retest reliability, as well as standardisation and development of tailored assessments for IWD is crucial.This systematic review was registered in PROSPERO (CRD42018105399).
Safety shoe development is based on static foot measures, which are transferred to last design. However, workplaces are not just static ('standing workplaces only'). The aim of the present study is to examine static and dynamic foot loading of workers to determine whether foot morphology changes between different loading situations. The results could be used to improve last and shoe design to improve the fit of safety shoes. 1024 workers at different industrial locations in Germany took part in the study. The DynaScan4D dynamic scanner system was used to measure static and dynamic foot morphology during different phases of ground contact. All scan variables were selected based on measures required in the last development process. Cohen's d (effect size) was calculated to identify individual differences between maximum values during the stance phase of walking and static values in standing. Stepwise multiple linear regression analysis was performed to identify possible influencing variables with regard to differences between static and dynamic values. Several foot measures showed relevant differences between dynamic and static loading. Interestingly, most length, width, height, and angular measures increased during dynamic loading (compared to static loading), whereas all circumference measures decreased. None of the tested variables (age, BMI, gender) predicted the differences between the two loading situations. Most dynamic changes are practical relevant changes between static and dynamic loading. Regarding the fit of safety shoes, it seems appropriate to adapt these changes to the last or shoe design.
BackgroundThe increasing prevalence of dementia in the next decades is accompanied by various societal and economic problems. Previous studies have suggested that physical activity positively affects motor and cognitive skills in individuals with dementia (IWD). However, there is insufficient evidence probably related to several methodological limitations. Moreover, to date adequate physical activity interventions specifically developed for IWD are lacking.ObjectiveThis study aims to investigate the effectiveness of a multimodal exercise program (MEP) on motor and cognitive skills in IWD in a high-quality multicenter trial.MethodsA multicenter randomized controlled trial with baseline and postassessments will be performed. It is planned to enroll 405 participants with dementia of mild to moderate stage, aged 65 years and older. The intervention group will participate in a 16-week ritualized MEP especially developed for IWD. The effectiveness of the MEP on the primary outcomes balance, mobility, and gait will be examined using a comprehensive test battery. Secondary outcomes are strength and function of lower limbs, activities of daily living, and cognition (overall cognition, language, processing speed, learning and memory, and visual spatial cognition).ResultsEnrollment for the study started in May 2015. It is planned to complete postassessments by the beginning of 2017. Results are expected to be available in the first half of 2017.ConclusionsThis study will contribute to enhancing evidence for the effects of physical activity on motor and cognitive skills in IWD. Compared to previous studies, this study is characterized by a dementia-specific intervention based on scientific knowledge, a combination of motor and cognitive tasks in the intervention, and high standards regarding methodology. Findings are highly relevant to influence the multiple motor and cognitive impairments of IWD who are often participating in limited physical activity.Trial RegistrationGerman Clinical Trials Register DRKS00010538; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00010538 (Archived by WebCite at http://www.webcitation.org/6oVGMbbMD)
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