A study of the skin of the sole of the foot using high-frequency ultrasonography and histology

Thoolen, M.; Ryan, Terence J.; Bristow, Ivan

doi:10.1054/foot.1999.0568

Cited by 27 publications

(20 citation statements)

References 6 publications

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“…1.4 mm for plantar foot vs. approx. 0.1 mm on foot dorsum; Thoolen et al 2000), then it is to be expected that all locations on the plantar surface of foot have a potentially higher PPT than those on the foot dorsum. Thus, the inter-location differences may not be purely due to thickness but could be due to the variations in sensitivity as a result of the varying density of nociceptors.…”

Section: Effects Of Test Location On Pdt and Pptmentioning

confidence: 98%

Pressure thresholds of the human foot: measurement reliability and effects of stimulus characteristics

2011

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Information related to reliable values of discomfort thresholds can help to improve the designs of various products. This study aimed to investigate the measurement reliabilities associated with pressure thresholds, while determining the effects of stimulus characteristics (stimulus area, indentation speed) of the human foot. An indentation apparatus was used with four sizes of indentation probes and three indentation speeds. In total, 13 locations on the right foot of 10 male and 10 female participants were tested to determine the pressure discomfort thresholds (PDT) and pressure pain thresholds (PPT). Results show that the tests had very good measurement reliability with intra-class correlations (ICC) greater than 0.8 for the PPT measurements and acceptable reliability (most ICC > 0.75, with a few between 0.5 and 0.75) for the PDT measurements, demonstrating that participants are capable of judging their pain and discomfort thresholds. Pressure sensitivity differs across locations of the foot, with the medial plantar arch of the foot being the most sensitive, followed by the dorsal surface of the foot. The heel area was the least sensitive. PPT and PDT are dependent on the stimulus characteristics of the area and the speed of indentation. A smaller area has a higher PPT and PDT, indicating significant effects of spatial summation. The increase of PDT and PPT at higher speeds may be partially explained by the increase in stiffness because foot tissue exhibits viscoelastic properties. The findings can have a significant impact on the design of footwear and other accessories for improved foot health and comfort. Statement of Relevance: This study investigated the threshold measurement reliability while determining the pressure sensitivity on the surface of the foot with varying stimulus characteristics. The findings may be very useful in the design of footwear and other accessories for improved comfort and reduced injuries.

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Section: Effects Of Test Location On Pdt and Pptmentioning

confidence: 98%

Pressure thresholds of the human foot: measurement reliability and effects of stimulus characteristics

2011

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“…Several studies have suggested that age-related changes in plantar skin properties might predispose older adults to develop foot problems such as hyperkeratosis, foot pain, and foot deformity. Thoolen et al (2000) [25] described the need for hydration to preserve the resiliency on the sole of the foot. The increase in localized areas of hardness and thickening (keratosis) of the skin can increase the risk of a person developing…”

Section: Figure 1 Pathway For Age-related Changes In Plantar Skin Anmentioning

confidence: 99%

Lower-Limb Factors Associated with Balance and Falls in Older Adults: A Systematic Review and Clinical Synthesis

Neville¹,

Nguyen²,

Ross³

et al. 2020

Journal of the American Podiatric Medical Association

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Background: Despite evidence suggesting that lower-limb related factors may contribute to fall-risk in older adults, lower-limb and footwear influences on fall-risk have not been systematically summarized. This study was undertaken to systematically review the literature related to lower-limb and footwear factors that may increase fall-risk among community-dwelling older adults. To facilitate the transfer of findings to clinical care, the literature was synthesized and used to inform recommendations as well as the development of clinical pathways for each factor found to be an influence on fall risk. Methods: PubMed, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Library, and AgeLine were searched for articles pertaining to age-related changes in the lower-limb and their association with fall-risk. To describe the trajectory leading or potentially leading to increased fall-risk, we examined articles that linked age-related changes in the lower-limb, footwear and orthoses to evidence-based fall-risk factors (e.g., balance impairment) or prospectively demonstrated a relationship with falls. Results: The systematic review consisted of 81 articles that met the inclusion criteria. Our results reflect a narrative review of the appraised literature for 8 pathways of lower-limb related influences on fall-risk in older adults. Six out of the eight pathways, including range of motion, orthoses, strength, footwear, pain, and deformity support a direct link with fall-risk. The two other pathways, including plantar skin/soft-tissue and sensory-loss, are connected via intermediate factors but lack studies that provide evidence of a direct link. The overall strength of the evidence available varied considerably for the 8 pathways presented. Conclusions: Findings provide much needed guidance supporting the identification and management of lower-limb and footwear-related influences on fall risk among older adults. Due to the lack or low quality of the evidence in specific areas, some recommendations should be applied with caution until more robust evidence is available.

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“…Most notably, plantar skin is hairless and, although it contains a high density of eccrine sweat glands, it has no sebaceous glands. 3 The plantar epidermis is considerably thicker (approximately 1.5 mm thick, compared to 0.1 mm in other regions of the body) and demonstrates a pattern of ridges that assist in generating suffi cient friction when standing and walking barefoot. The plantar dermis is approximately 3 mm thick and is penetrated by adipose tissue, which provides resilience to shear stresses.…”

Section: Epidermis and Dermismentioning

confidence: 99%

“…The plantar dermis is approximately 3 mm thick and is penetrated by adipose tissue, which provides resilience to shear stresses. 3,4 Plantar skin is also highly adaptable, as evidenced by the considerably thicker epidermis and dermis observed in people who do not wear shoes. 5 Because of this adaptability, it is sometimes diffi cult to delineate age-related changes from the effects of weightbearing activity and footwear.…”

Section: Epidermis and Dermismentioning

confidence: 99%

Physiological changes in the ageing foot

Menz

2004

Foot Problems in Older People

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A study of the skin of the sole of the foot using high-frequency ultrasonography and histology

Cited by 27 publications

References 6 publications

Pressure thresholds of the human foot: measurement reliability and effects of stimulus characteristics

Pressure thresholds of the human foot: measurement reliability and effects of stimulus characteristics

Lower-Limb Factors Associated with Balance and Falls in Older Adults: A Systematic Review and Clinical Synthesis

Physiological changes in the ageing foot

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