Comparison of two different designs of forefoot off-loader shoes and their influence on gait and spinal posture

Michalik, Roman; Siebers, Hannah Lena; Claßen, Tim; Gatz, Matthias; Rohof, Ben; Eschweiler, Jörg; Quack, Valentin; Betsch, Marcel

doi:10.1016/j.gaitpost.2019.02.007

Cited by 8 publications

(7 citation statements)

References 28 publications

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“…As expected, orthopedic shoes sold in pairs may limit the problems of limb length discrepancies created by wearing a single orthopedic shoe. [ 16 - 18 , 20 , 21 ] There is also existing evidence for the use of heeled shoes, which provide significantly more forefoot offloading (between 2.5 and 4 times more depending on the design) compared to rocker bottom soles. [ 22 ] The findings of this study support the use of heel offloading shoes to acquire the highest degree of forefoot offloading, although rocker bottom shoes provided more speed in pairs.…”

Section: Discussionmentioning

confidence: 99%

“…Back and hip pain are the most frequently reported effects of the limb length discrepancies created by inequal orthopedic shoes. [ 18 ] Michalik et al[ 16 ] compared a rocker bottom sole shoe to an offloading heel shoe and found a statistically significant difference in the oblique angle of the pelvis and the lateral deviation of the spine compared to a regular shoe. Furthermore, they found hardly any difference in gait between the two orthopedic sole designs that were evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…They concluded that whatever the design of the shoe, a compensating shoe on the contralateral side should be used to transfer the pressure to the lateral side of the operated heel. [ 16 ] Pairs of orthopedic shoes may not only be beneficial for proper transfer of load but also decrease falling risk in the elderly subjects caused by unbalanced shoes. [ 23 ]…”

Section: Discussionmentioning

confidence: 99%

“…Overcoming the leg length discrepancy might increase the comfort and speed of walking while decreasing the postoperative falling rates. [ 16 - 18 ] However, prescription of bilateral shoes is not a part of daily practice, probably due to economic concerns and refusal of refund by the assurance for the healthy side.3…”

Section: Introductionmentioning

confidence: 99%

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Baropodometric comparison of orthopedic footwear to assess the effectiveness of pairs of orthopedic shoes for reducing the forefoot pressure

Sezer¹,

Hardy²,

Lopes³

2022

Jt Dis Relat Surg

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Objectives This study aimed to evaluate the distribution of foot pressure with the most frequently used orthopedic shoes and demonstrate the effect of offloading philosophy on the pressure distributions of rocker bottom or heel support shoes applied unilaterally or bilaterally. Materials and methods Three bilateral and four unilateral, a total of seven shoe designs with sensors included in the insole were tested by the same subject in a standard acquisition protocol. Two of the unilateral and one of the bilateral shoes had heel support, while others had a rocker bottom design. A descriptive analysis was performed for each shoe and compared to a reference value obtained from a standard shoe. Results Shoes with an offloading heel resulted in a greater reduction in pressure on the forefoot than other models. All other shoes increased pressure on the first metatarsophalangeal joint. Heel offloading models performed the best in forefoot offloading, and bilateral heel offloading shoes performed the best in first metatarsal offloading, with the highest scores of 83% and 82%, respectively. Conclusion This study showed that orthopedic shoes sold in pairs could reduce pressure on the forefoot at a comparable level to unilateral shoes. It supports their use to limit the disadvantages of single orthopedic shoes, such as limb length discrepancies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Baropodometric comparison of orthopedic footwear to assess the effectiveness of pairs of orthopedic shoes for reducing the forefoot pressure

Sezer¹,

Hardy²,

Lopes³

2022

Jt Dis Relat Surg

View full text Add to dashboard Cite

show abstract

“…Gait phases were analyzed based on the gait phases described by Perry et al and previous work (12,22,23). The stance phase of each leg was subdivided into initial contact of the foot touching the ground (t0), mid-stance when the whole foot has contact (t1) and the terminal contact phase before the foot lifts off the ground (t2).…”

Section: Measurement Protocolmentioning

confidence: 99%

Biomechanical Evaluation and Comparison of Clinically Relevant versus Non-relevant Leg Length Inequalities

Michalik

Rissel

Miglorini

et al. 2021

Preprint

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BackgroundLeg length inequalities (LLIs) are a frequent condition in every population. It is common clinical practice to consider LLIs of 2cm and more as relevant and to treat those. However, the amount of LLIs that need treatment is not clearly defined in literature and the effect of real LLIs on the musculoskeletal system above and below 2cm have not been studied biomechanically before.Research question: Are the spine and pelvis affected differently in patients with LLIs <2cm and ≥2cm.MethodsBy using surface topography, we evaluated 32 patients (10 females, 22 male) with real LLIs of ≥2cm (mean: 2.72cm; n=10) and compared their pelvic position and spinal posture to patients with LLIs <2cm (mean: 1.24cm; n=22) while standing and walking. All patients were measured with a surface topography system during standing and while walking on a treadmill. To compare patient groups, we used Student t-tests for independent samples.ResultsPelvic obliquity was significantly higher in patients with LLI ≥2cm during the standing trial (p=0.045) and during the midstance phase of the longer leg (p=0.023) while walking. Further measurements did not reveal any significant differences (p=0.06-0.706).ConclusionThe results of our study suggest that relevant LLIs of ≥2cm mostly affect pelvic obliquity and do not lead to significant alterations in the spinal posture during a standing trial. Additionally, we demonstrated that LLIs are better compensated when walking, showing almost no significant differences in pelvic and spinal posture between patients with LLIs smaller and greater than 2 cm. This study shows that LLIs ≥2cm can still be compensated; however, we do not know if the compensation mechanisms may lead to long-term clinical pathologies.

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The Effect of Breast Size on Spinal Posture

Michalik

Kühlmann²,

Wild³

et al. 2022

Aesth Plast Surg

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Macromastia can cause various clinical symptoms, such as low back and shoulder pain as well as sacro-iliac disorders. Because of these symptoms, some women consider breast reduction surgery. So far there does not exist a clear correlation between breast size and back pain. Purpose of this study was to evaluate if increasing breast size has a measurable effect on women’s posture using radiation free surface topography.A total of 100 women were grouped according to their breast cup size into four groups (Cup Size: A, B, C, D). All female subjects were measured with a surface topography system, and their spinal posture and pelvic position were analysed accordingly.Our results showed that cup size affects kyphotic angle (p = 0.027) and surface rotation (p = 0.039) significantly. Kyphotic angle increased with cup size. Multiple linear regression analysis, however, revealed that the body mass index has the greatest influence on woman’s posture, showing significant correlation to kyphotic and lordotic angle (p < 0.01), as to trunk (p < 0.01) and pelvic inclination (p = 0.02).This is the first study that evaluates the influence of increasing breast size on posture using surface topography. The results match with previous studies using different measuring techniques. However, the great influence of BMI on posture is also confirmed. Therefore, in clinical practice these factors should be taken into account and be approached. Surface topography seems to be a promising tool to further investigate the influence of breast size on posture.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Comparison of two different designs of forefoot off-loader shoes and their influence on gait and spinal posture

Cited by 8 publications

References 28 publications

Baropodometric comparison of orthopedic footwear to assess the effectiveness of pairs of orthopedic shoes for reducing the forefoot pressure

Baropodometric comparison of orthopedic footwear to assess the effectiveness of pairs of orthopedic shoes for reducing the forefoot pressure

Biomechanical Evaluation and Comparison of Clinically Relevant versus Non-relevant Leg Length Inequalities

The Effect of Breast Size on Spinal Posture

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