The influence of walking speed and footwear on plantar pressures in older adults

Burnfield, Judith M.; Few, Courtney D.; Mohamed, Olfat; Perry, Jacquelin

doi:10.1016/j.clinbiomech.2003.09.007

Cited by 265 publications

(184 citation statements)

References 23 publications

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“…Linear polynomial contrast within an ANOVA (SPSS 11) was used to investigate the trend of the gait parameters across the four groups. Considering the influence of gait velocity on MPP [24], one-way analysis of covariance was used to compare the means of the MPPs of the adjusted groups with gait velocity as a covariate [25]. Gait velocity was used as a covariate in the analysis of peak plantar pressures because slower walking speed is known to coincide with decreased pressures over some areas of the foot [26].…”

Section: Discussionmentioning

confidence: 99%

Walking performance in people with diabetic neuropathy: benefits and threats

et al. 2006

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Aims/hypothesis Walking is recommended as an adjunct therapy to diet and medication in diabetic patients, with the aim of improving physical fitness, glycaemic control and body weight reduction. Therefore we evaluated walking activity on the basis of capacity, performance and potential risk of plantar injury in the diabetic population before it can be prescribed safely. Subjects, materials and methods Twenty-three subjects with diabetic neuropathy (DMPN) were compared with 23 patients with current diabetic foot ulcers, 16 patients with partial foot amputations and 22 patients with trans-tibial amputations. The capacity for walking was measured using a total heart beat index (THBI). Gait velocity and average daily strides were measured to assess the performance of walking, and its impact on weight-bearing was studied using maximum peak pressure. Results THBI increased (p<0.01) and gait velocity and daily stride count fell (p<0.001 for both) with progression of foot complications. The maximum peak pressures over the affected foot of patients with diabetic foot ulcers (p<0.05) and partial foot amputations (p<0.01) were higher than in the group with DMPN. On the contralateral side, the diabetic foot ulcer group showed higher maximum peak pressure over the total foot (p<0.05), and patients with partial foot amputations (p<0.01) and trans-tibial amputations (p<0.05) showed higher maximum peak pressure over the heel. Conclusions/interpretation Walking capacity and performance decrease with progression of foot complications. Although walking is recommended to improve fitness, it cannot be prescribed in isolation, considering the increased risk of plantar injury. For essential walking we therefore recommend the use of protective footwear. Walking exercise should be supplemented by partial or non-weightbearing exercises to improve physical fitness in diabetic populations.

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Section: Discussionmentioning

confidence: 99%

Walking performance in people with diabetic neuropathy: benefits and threats

et al. 2006

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“…Walking speed was controlled in this study because the self-selected walking speeds in subjects with DM and neuropathy are typically significantly slower than non-diabetic controls [12,28,29]. Walking speed influences ankle kinematics and kinetics [14,15] and also differentially affects plantar pressures in different regions of the foot [16][17][18].…”

Section: Gait Testingmentioning

confidence: 99%

“…However, these studies do not control walking speed, which can influence both ankle motion [14,15] and plantar loading during gait [16][17][18]. Walking speed thus emerges as a confounding factor, rendering interpretation of purported results difficult.…”

Section: Introductionmentioning

confidence: 99%

Ankle ROM and stiffness measured at rest and during gait in individuals with and without diabetic sensory neuropathy

2006

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Introduction-The purpose of our study was to examine the relationship between ankle dorsiflexion (DF) range of motion (ROM) and stiffness measured at rest (passively) and plantar loading during gait in individuals with and without diabetes mellitus (DM) and sensory neuropathy. Specifically, we sought to address three questions for this at-risk patient population: (1) Does peak passive DF ROM predict ankle DF ROM used during gait? (2) Does passive ankle stiffness predict ankle stiffness used during gait? (3) Are any of the passive or gait-related ankle measures associated with plantar loading?Methods-Ten subjects with DM and 10 age and gender matched non-diabetic control subjects participated in this study. Passive ankle DF ROM and stiffness were measured with the Iowa Ankle ROM device. Kinematic, kinetic and plantar pressure data were collected as subjects walked at 0.89 m/s.Results-We found that subjects with DM have reduced passive ankle DF ROM and increased stiffness compared to non-diabetic control subjects, however, subjects with DM demonstrated ankle motion, stiffness and plantar pressures, similar to control subjects, while walking at the identical speed, 0.89 m/s (2 mph). These data indicate that clinical measures of heel cord tightness and stiffness do not represent ankle motion or stiffness utilized during gait. Our findings suggest that subjects with DM utilize strategies such as shortening their stride length and reducing their push-off power to modulate plantar loading.

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“…The athletes have shown even highest values of HPT (15.15 and 15.18mm for right and left sides respectively) which may be due to associated increased plantar pressure in faster paces (fast walking and running) as has been documented by Burnfield et al 11 and this predisposes the subjects to tissue injury, ulceration and pain. Another reason that may have accounted for the significant difference in values between the athletes and the control groups may be the fact that these subjects undergo a minimum of 5 hours/day of intense physical activities in a relatively unfriendly turf with very inappropriate or inferior and consistently worn podiatric wears that may inadvertently induce structural biomechanical deviation of the human heel pad.…”

Section: Discussionmentioning

confidence: 63%

“…These women and some few men are always continuously lifting building materials, at times without appropriate podiatric wears. These individuals, earning a living in this case, are most likely to induce plantar pressure on their feet 11 .…”

Section: Study Populationmentioning

confidence: 99%