Introduction of a neutral shoe to assess reference values for dynamic pedobarography

Kluger, Anna Katharina; Carl, Hans-Dieter; Jendrissek, Andreas; Swoboda, B.; Hotfiel, Thilo

doi:10.1515/bmt-2013-0078

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…2a) to define baseline values and equalize conditions of full weight‐bearing. The shoe was established as a reference shoe for dynamic pedobarography (Kluger et al, 2014). It is composed of 4 mm polyethylene‐vinyl acetate and has a heel pitch of 0 mm; elastic velcro buckles allow adjustment and fixation around the foot.…”

Section: Methodsmentioning

confidence: 99%

“…During the second and the third trial a conventional available running shoe (The Faas 500, Puma Inc., Herzogenaurach, Germany), categorised as a “neutral running shoe”, was applied at the contralateral side (Kluger et al, 2014). According to the manufacturer this shoe has no pronation or supination support.…”

Section: Methodsmentioning

confidence: 99%

“…Dynamic pedobarography is a modality that has been widely validated as a method to evaluate plantar pressure under dynamic conditions (Skopljak et al, 2014). Owing the ability to record consecutive steps in one measurement, insole‐based pedobarography has become an important tool for the evaluation of foot loads during the application of insoles, orthoses or other types of footwear (Skopljak et al, 2014; Westphal et al, 2016; Kluger et al, 2014; Lorkowski et al, 2015). By this approach, the offloading effects of forefoot relief shoes in surgical or non‐surgical terms have been extensively investigated (Carl et al, 2006; Kraus et al, 2014; Bus et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Plantar pressure changes in hindfoot relief devices of different designs

et al. 2019

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Background It is frequently observed that overloading the foot can impair bone and soft tissue healing and can lead to harmful sequelae (i.e. ulcers, stress reactions) in context of pre-existing tissue disabilities. In terms of offloading, hindfoot relief devices are commonly applied as a non-operative treatment as well as after various surgical procedures for hindfoot disorders. Despite their common use, there is a paucity of data comparing different orthotic devices with respect to changes in plantar pressure distributions. The aim of this study was to investigate plantar loadings in hindfoot relief devices of different designs. Methods Twenty-five healthy participants (13 women, 12 men; (mean ± SD) age 37 ± 14 years; BMI 23 ± 4 kg/m 2 ) were recruited. Plantar pressure distributions were collected using i.) a neutral shoe, ii.) a hindfoot relief shoe (HRS) and iii.) a hindfoot relief orthosis (HRO). Peak pressure values were measured via dynamic pedobarography during walking and were analysed from four different plantar regions: the hindfoot, midfoot, metatarsal I-V and forefoot. As a reference standard, the normal walk using neutral shoes served as the condition for full weight-bearing. Results Concerning the hindfoot, using the HRS as well as the HRO resulted in significant decreases in plantar pressures compared to baseline values that were obtained with the neutral shoe (− 52% for the HRS and − 52% for the HRO, p < 0.001). Significant increases in peak pressures were found in the midfoot region for both devices (HRS: 32%, p = 0.002; HRO: 47%, p < 0.001). For the metatarsal region, peak pressures were found to decrease significantly (HRS: − 52%, p < 0.001; HRO: -17%, p = 0.034). With respect to the forefoot, a significant reduction in peak pressures using the HRS (− 41%, p < 0.001) was detected, whereas the HRO did not lead to significant changes (− 4%, p = 0.691). Conclusions Both the HRO and HRS significantly reduced plantar hindfoot pressure, corresponding to a relative decrease of nearly 50% of the baseline. Nevertheless, the adjacent midfoot zone displayed a significant increase in plantar pressure values for both devices. Supported by these findings, physicians should cautiously consider a substantial increase in midfoot loading, especially in patients affected by additional midfoot injuries or accompanying impairments of tissue healing. Level of evidence IV, Case series.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Plantar pressure changes in hindfoot relief devices of different designs

et al. 2019

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“…A so-called "neutral shoe" (Fuss und Schuh Breidbach ® Inc., Fulda, Germany, ▶ Fig. 3) was utilized, which has recently been described as a reference shoe for insole-based pedobarography [22]. This shoe is made of Aerolastic ® (Nora Systems GmbH, Weinheim, Germany).…”

Section: Data Acquisitionmentioning

confidence: 99%

“…Although this definition is widely accepted and pedobarography has been established to monitor foot loads in context of limited weight bearing [32,33,35,43], there is no clear-cut evidence that foot load actually is a sufficient surrogate parameter for weight bearing, in particular, for the intraarticular joint conditions. Dynamic pedobarography was chosen for the assessment of foot loading because it has been established as a useful adjunct to clinical research for the recognition of plantar force conditions in a non-invasive way [44][45][46]. Due to the ability to record consecutive steps and cycles in one measurement, insole-based pedobarography has become an important tool for the recognition of plantar force conditions in the context of partial weight bearing after total hip arthroplasty [47], wearing forefoot or hindfoot relief shoes [43,48] or performing rehabilitation exercises [35].…”

Section: Study Limitationsmentioning

confidence: 99%

Assessing Foot Loads in Continuous Passive Motion (CPM) and Active Knee Joint Motion Devices

Stolz

Grim

Lutter

et al. 2019

Sportverletz Sportschaden

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Background Continuous passive motion (CPM) and active knee joint motion devices are commonly applied after various surgical procedures. Despite the growing use of active motion devices, there is a paucity of data comparing plantar loads between the different mobilization techniques. The aim of this study was to investigate foot loads during knee joint mobilization in continuous passive and active knee joint motion devices and to compare this data to the physiological load of full weight-bearing. Patients/Material and Methods Fifteen healthy participants (7 women and 8 men, 25 ± 3 years, 66 ± 6 kg, 175 ± 10 cm, BMI 21.9 ± 2) were recruited. Plantar loads were measured via dynamic pedobarography using a continuous passive motion device (ARTROMOT-K1, ORMED GmbH, Freiburg, Germany) and an active motion device (CAMOped, OPED AG, Cham, Switzerland), each with a restricted range of motion of 0-0-90° (ex/flex) and free ROM for the knee joint. For the active motion device, cycles were performed at four different resistance levels (0-III). Data were assessed using the pedar® X system (Novel Inc., Munich, Germany), which monitors loads from the foot-sole interface. Force values were compared between motion devices and normal gait, which served as the reference for conditions of full weight-bearing. P-values of < 0.05 were considered statistically signiﬁcant. Results Normal gait revealed peak forces of 694 ± 96 N, defined as 100 %. The CPM device produced plantar forces of less than 1.5 N. Using the active motion device in the setting of 0-0-90° produced foot loads of < 1.5 N (resistance 0-II) and 3.4 ± 9.3 N with a resistance of III (p < 0.001). Conditions of free ROM resulted in foot loads of 4.5 ± 4.5 N (resistance 0), 7.7 ± 10.7 N (resistance I), 6.7 ± 10.4 (resistance II) and 6.7 ± 6.9 N with a resistance of III (p < 0.001), corresponding to 0.6 %, 1.1 %, 1.0 % and 1.0 % of full weight-bearing, respectively. Conclusion Motion exercises of the knee joint can be performed both with passive and active devices in accordance with strict weight-bearing restrictions, which are often recommended by surgeons. Also, active motion devices can be used when the ankle joint or foot have to be offloaded. Further studies assessing intraarticular joint load conditions have to be performed to confirm the findings obtained in this study.

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Einlagenversorgung im Leistungssport – Indikationen, Wirkungsweise, sportspezifische Versorgungsstrategien

Hotfiel

Hotfiel²,

Gelse

et al. 2016

Sports Orthopaedics and Traumatology

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Introduction of a neutral shoe to assess reference values for dynamic pedobarography

Abstract: The neutral shoe is a feasible tool to assess reference values for dynamic pedobarography. Such a reference tool may help to standardise several steps in the development and construction of shoes and orthotic devices.

Cited by 7 publications

References 15 publications

Plantar pressure changes in hindfoot relief devices of different designs

Plantar pressure changes in hindfoot relief devices of different designs

Assessing Foot Loads in Continuous Passive Motion (CPM) and Active Knee Joint Motion Devices

Einlagenversorgung im Leistungssport – Indikationen, Wirkungsweise, sportspezifische Versorgungsstrategien

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