Effect of revised high-heeled shoes on foot pressure and static balance during standing

[Purpose] The purpose of this study was to investigate the effects of revised high-heeled shoes on the foot pressure ratio and static balance during standing. [Subjects and Methods] A single-subject design was used, 15 healthy women wearing revised high-heeled shoes and general high-heeled shoes in a random order. The foot pressure ratio and static balance scores during standing were measured using a SpaceBalance 3D system. [Results] Forefoot and rearfoot pressures were significantly different between the 2 types of high-heeled shoes. Under the 3 conditions tested, the static balance score was higher for the revised high-heeled shoes than for the general high-heeled shoes, but this difference was not statistically significant. [Conclusion] Revised high-heeled shoes are preferable to general high-heeled shoes, as they result in normalization of normalized foot pressure and a positive effect on static balance.Key words: Revised high-heeled shoes, Foot pressure, Static balance     

Effect of changes in postural alignment on foot pressure and walking ability of stroke patients

[Purpose] The aims of this study were to determine (1) the significance of walking and foot pressure in stroke patients, and (2) the association between changes in postural alignment of stroke patients. [Subjects and Methods] Foot pressure and walking ability based on postural alignment were measured in 50 stroke patients. Trunk imbalance, trunk rotation, pelvic tilt, kyphosis, lordosis were measured using DIERS formetric4D (DIERS International GmbH, Schlangenbad, Germany), which anlalyzes 3-dimensional spinal structure in order to measure postural alignment. To determine foot pressure, the support rate of weight and, average foot pressure were measured using DIERS pedoscan (DIERS International GmbH, Schlangenbad, Germany) apparatus as a pressure platform. [Results] DIERS formetric 4D, DIERS pedoscan, and a 10 m walking test were utilized to measure foot pressure and walking ability relative to changes in postural alignment in participating stroke patients. [Conclusion] This study confirmed the significance of foot pressure and walking ability as related postural alignment, indicating that postural alignment education and a recovery therapy program for functional improvement of stroke patients should be provided together.Key words: Postural alignment, Foot pressure, Walking ability     

Effects of the ankle angle of an ankle foot orthosis on foot pressure during the gait in healthy adults

[Purpose] The purpose of this study was to investigate the effects of the ankle angle of an ankle foot orthosis (AFO) on foot pressure during the gait in healthy adults. [Subjects] Sixteen healthy males with neither orthopedic nor neurological problems participated in this study. [Methods] Subjects walked on a walkway at a self-selected pace with an AFO set at four different ankle angles (−5°, 0°, 5°, and 10°). Foot pressure was measured randomly according to the ankle angle of the AFO using an F-scan system. Three trials were measured and averaged for data analysis. [Results] The peak foot pressure of the hallux, 2nd–5th toes, 2nd and 3rd metatarsal heads, 4th and 5th metatarsal heads, and the heel showed significant differences among the AFO ankle angles: angles of 0° and −5° increased the foot pressure of the lateral legions, and the peak foot pressure of the heel at an AFO ankle angle of 10° was significantly greater than those of the other angles. [Conclusion] The ankle angle of the AFO affected foot pressure and gait patterns during gait. The results suggest that the appropriate angle for an AFO is between 5° and 10° when AFOs are prescribed by clinicians.Key words: Ankle foot orthosis, Ankle angle, Gait     

The effects of dual-task gait training on foot pressure in elderly women

[Purpose] The purpose of this study was to evaluate the effect of dual-task gait training on foot pressure in elderly women. [Subjects and Methods] Twenty elderly people in local communities performed dual-task gait training for 20 minutes three times per week for 8 weeks. Foot pressure was measured using an F-scan System (Tekscan, South Boston, MA, USA) before the intervention and in the 4th and 8th weeks of the intervention. [Results] Foot pressure increased significantly between the 4th and 8th weeks of the intervention in the CFF (central forefoot); between before the intervention and the 4th week, between the 4th and 8th weeks, and between before the intervention and the 8th week in the MF (midfoot); and between before the intervention and the 4th and 8th weeks in the HL (heel). [Conclusion] The results of this study indicate that dual-task gait training may improve the gait ability of elderly persons residing in the community.Key words: Aging, Gait, Dual tasks     

The influence of revised high-heeled shoes on foot pressure and center of pressure during standing in young women

[Purpose] Revised high-heeled shoes were developed to minimize foot deformities by reducing excessive load on the forefoot during walking or standing in adult females, who frequently wear standard high-heeled shoes. Specifically, this study aimed to investigate the effects of revised high-heeled shoes on foot pressure distribution and center of pressure distance during standing in adult females. [Subjects and Methods] Twelve healthy adult females were recruited to participate in this study. Foot pressures were obtained under 3 conditions: barefoot, in revised high-heeled shoes, and in standard 7-cm high-heeled shoes. Foot pressure was measured using the Tekscan HR mat scan system. One-way repeated analysis of variance was used to compare the foot pressure distribution and center of pressure distance under these 3 conditions. [Results] The center of pressure distance between the two lower limbs and the fore-rear distribution of foot pressure were significantly different for the 3 conditions. [Conclusion] Our findings support the premise that wearing revised high-heeled shoes seems to provide enhanced physiologic standing posture compared to wearing standard high-heeled shoes.Key words: Revised high-heeled shoes, Centre of pressure, Standing     

Effect of backpack position on foot weight distribution of school-aged children

[Purpose] In the present study, we aimed to determine the effects of backpack position on foot weight distribution of standing school-aged children. [Subjects] Thirty school-aged children volunteered to participate in this study. [Methods] The subjects randomly performed four types of carrying a backpack: no backpack (condition-1), carrying a backpack at C7 (condition-2), carrying a backpack at 10 cm below C7 (condition-3), and carrying a backpack at 20 cm below C7 (condition-4). [Results] Statistically significant differences were noted in the anterior and posterior pressure values, and in the anterior-to-posterior ratio, among the four conditions (p < 0.05). Post-hoc analysis indicated that the pressure value of condition-4 was significantly lower in the anterior foot region and higher in the posterior foot region than in condition-2 and condition-3. In addition, the anterior-to-posterior ratio was lower in condition-4 than in condition-2 and condition-3. [Conclusion] These findings suggest that carrying a backpack in a higher position, with fastening of the shoulder strap, may be more favorable for normalizing the foot weight distribution.Key words: Backpack position, Weight distribution, Children     

Comparison of foot pressure in stretching exercises according to the type of ankle ramp

[Purpose] This study compared and analyzed use of an existing ankle ramp and a newly developed ankle ramp for stretching exercises. [Subjects] Fourteen subjects were included; they were stroke patients more than 6 months after onset, with no orthopedic or biological problems in the legs, so independent gait was possible. [Methods] The subjects performed stretching exercises for 5 min with an existing ankle ramp and a newly developed ankle ramp; foot pressure was then measured. [Results] The averaged percentage and kilopascal data for weight bearing and foot pressure on the affected side with the newly developed ankle ramp for stretching exercises were significantly higher than those with the existing ankle ramp. [Conclusion] Our results suggest that stretching exercises using the newly developed ankle ramp more effectively increase foot pressure than the existing ankle ramp.Key words: Ankle ramp, Foot pressure, Stroke     

The effects of lumbar stabilization exercises on foot pressure of older individuals while walking

[Purpose] The purpose of this study was to examine the effect of lumbar stabilization on pressure distribution in old women. [Subjects] The subjects of this study were 14 women aged 65 or older who agreed to participate in this study. They had a sufficient range of motion and muscle strength to perform the postures in this study’s program and were without gait problems, congenital deformity, orthopedic disorder, or neurological disorder. [Methods] The participants performed a group exercise program that promotes lumbar stabilization for 50 minutes per session by following the instructions of a physical therapist. Gait Analyzer was used to measure the foot pressure of individual participants from three measurements for each lumbar stabilization exercise, and the mean values were used. The mean values were then compared between before and after the exercises by paired t-test. [Results] Pressure in F3 and F6 statistically significantly decreased from 2.06±1.23% N/cm² to 1.55±1.02% N/cm² and from 7.40±1.52% N/cm² to 5.95±1.76% N/cm², respectively, after the intervention, but no significant differences were found in the other foot areas. [Conclusion] The lumbar stabilization exercises affected the pressure evenly over the entire foot and, in particular, in the inner area of the forefoot.Key words: Lumbar stabilization exercise, Foot pressure, Gait Analyzer     

The effect of active core exercise on fitness and foot pressure in Taekwondo club students

[Purpose] The effects of core training using slings and Togus on the improvement of posture control in Taekwondo club students, that is, balance ability, were investigated. To that end, changes in the Taekwondo players’ balance ability resulting from active core training for eight weeks were examined through fitness and foot pressure. [Subjects] The present study was conducted with 13 male Taekwondo players of K University in Deagu, South Korea. Once the experiment process was explained, consent was obtained from those who participated voluntarily. [Methods] Air cushions (Germany), Jumpers (Germany), and Aero-Steps (Germany) were used as lumbar stabilization exercise tools. As a method of training proprioceptive senses by stimulating somatesthesia in standing postures, the subjects performed balance squats, supine pelvic lifts, and push-up plus exercise using slings while standing on an Aero-Step and performed hip extension parallel squats (Wall Gym Ball), and standing press-ups on a Togu using their own weight. The subjects performed four sets of these isometric exercises while maintaining an exercise time per set at 30 seconds in each session and repeated this session three times per week. [Result] Left grip strength significantly increased and number of sit-ups, which indicates muscle endurance, also significantly increased after the eight weeks exercise compared with before the exercise. The values measured during the sit and reach test, which indicate flexibility, also significantly increase after the eight weeks of exercise compared with before the exercise but only in the left foot. [Conclusion] The result of present study suggest that active core exercise using Slings and Togus can be applied as a very effective exercise program for enhancing balance, which is an important physical factor for Taekwondo club students.Key words: Sling, Togu, Foot pressure     

Sonography of the first dorsal metatarsal artery of the foot

PURPOSE: To describe the gray-scale and Doppler sonographic examination technique and appearances of the first dorsal metatarsal artery (FDMA) of the foot and discuss its clinical significance. METHODS: The dorsal arteries of foot-including the FDMA and the first plantar metatarsal artery-of 374 feet were studied using gray-scale and color Doppler sonography. Due to the difficulty of detecting the FDMA, a majority of them were identified by studying the web area just distal to the intermetatarsal space. The interosseous muscle was identified to determine the classification of the anatomic type of the FDMA. The sonographic results of 152 feet were compared with surgical findings. RESULTS: The average caliber of the FDMA was 1.0 +/- 0.5 mm. The FDMA was classified into 3 groups of variants based on its relationship with the first dorsal interosseous muscle. The groups were identified as the superficial artery (54.5%), intramuscular artery (39.6%), and submuscular artery (9%) variants. The rates of visualization of the distal and proximal portions of the FDMA were 86.6% and 47%, respectively. In the first intermetatarsal space, there were anastomoses between the FDMA and the first plantar metatarsal arteries in 87.6% of the feet. CONCLUSIONS: The FDMA varies greatly; however, sonography can clearly show its morphologic characteristics, such as caliber and location. Sonography also provides valuable preoperative information in microsurgery of the foot.     

Comparison between a center of mass and a foot pressure sensor system for measuring gait parameters in healthy adults

[Purpose] The purpose of this study was to determine the relationship between an accelerometer system and a foot pressure sensor system for measuring gait characteristics during walking in healthy adults. [Subjects and Methods] Thirty-five healthy participants with no neurological, musculoskeletal, or cardiopulmonary disorders volunteered for this study. Gait characteristics were measured while participants walked freely along a 10-m walkway using two different measurement systems simultaneously. The first analysis system was based on center of mass using a wireless tri-axial accelerometer and the second system was a foot pressure sensor system. [Results] There was a significant and high correlation between the two systems with respect to gait velocity and cadence. The stride length as a percentage of the stride height measured with the center of mass system was significantly and highly correlated with stride length and stride velocity that was measured with the foot pressure system. Furthermore, stride length from the center of mass system was significantly and highly correlated with stride length and stride velocity from the foot pressure system. [Conclusion] A gait analysis based on a center of mass system is a valid method to assess the effectiveness of therapeutic interventions in a clinical setting.Key words: Accelerometer, Center of mass, Gait     

Effect of the application of local vibration in scaption on joint stability

[Purpose] The aim of this study was to determine the initial effect of local vibration on the stability of the shoulder joints by applying local vibration to the shoulder joints. [Subjects and Methods] For the test, the subjects held a FlexBar with one hand, at about 10 cm from one end, and performed the oscillation movement with the shoulder at 90° flexion and the elbow in the full-extension position in scaption; the vibration stimulus was set to 5 Hz. Then, the subjects underwent the Upper Quarter Y Balance Test to evaluate the stability of the shoulder joints. [Results] The moving distances in the left, right, and upper directions after the oscillation movement were increased significantly compared with the results before the oscillation movement. [Conclusion] A vibration stimulus is effective as an exercise method to increase the stability of the shoulder joints.Key words: Local vibration, Shoulder joint, Stability     

The effects of plantar flexor static stretching and dynamic stretching using an aero-step on foot pressure during gait in healthy adults: a preliminary study

[Purpose] The aim of this study was to examine whether plantar flexor static stretching and dynamic stretching using an Aero-Step results in changes in foot pressure during gait in healthy adults. [Subjects] Eighteen normal adults were randomly allocated to either a dynamic stretching using an Aero-Step group (DSUAS) group (n = 8) or a static stretching (SS) group (n = 10). [Methods] The DSUAS and SS participants took part in an exercise program for 15 minutes. Outcome measures were foot plantar pressure, which was measured during the subject’s gait stance phase; the asymmetric ratio of foot pressure for both feet; and the visual analogue scale (VAS) measured during the interventions. [Results] There were significant differences in the asymmetric ratio of foot pressure for both feet and VAS between the two groups after intervention. However, there were no significant differences in foot plantar pressure during the gait stance phase within both groups. [Conclusion] DSUSAS is an effective stretching method, as pain during it is lower than that with SS, which can minimize the asymmetric ratio of foot pressure for both feet during gait due to asymmetric postural alignment.Key words: Static stretching, Dynamic stretching using Aero-Step, Foot pressure     

Repetitive sit-to-stand training with the step-foot position on the non-paretic side,and its effects on the balance and foot pressure of chronic stroke subjects

[Purpose] This study aimed to improve the asymmetrical weight-bearing ratio by applying repetitive sit-to-stand training methods that feature a step-foot position to the paretic-side foot of hemiplegic patients; it sought also to provide the information needed to apply weight-bearing and balance training to hemiplegic patients. [Subjects and Methods] The subjects were divided into two groups: a spontaneous group and a step group. They all performed repetitive sit-to-stand training five times per week for a total of six weeks. The Biodex Balance System, TUG, and 5XSST were used to measure the static and dynamic standing balance of each patient. A foot mat system was used to measure foot pressure. [Results] In the balance measurements, differences in the Overall index, Ant-post index, Med-lat index, Fall risk index, TUG, and 5XSST after training was significantly different between the two study groups. In evaluating foot pressure measurements, we found that the COP (Ant-post), Peak pressure: hind foot, and Contact area: hind foot measurements significantly differed between the groups after the training. [Conclusion] Repetitive sit-to-stand training that involves positioning the non-paretic leg upward can be considered a significant form of training that improves the symmetric posture adjustment and balance of hemiplegic patients following a stroke.Key words: Step-foot position, Balance, Foot pressure     

The effects of backpack loads and spinal stabilization exercises on the dynamic foot pressure of elementary school children with idiopathic scoliosis

[Purpose] The purpose of this study was to measure and observe the changes in dynamic plantar pressures when school children carried specific bag loads, and to determine whether improved physical balance after an eight-week spinal stabilization exercise program can influences plantar pressures. [Subjects] The subjects were 10 school students with Cobb angles of 10° or greater. [Methods] Gait View Pro 1.0 (Alfoots, Korea) was were based on to measure the pressure of the participants’ feet. Spinal stabilization exercises used TOGU Multi-roll Functional (TOGU, Germany) training. Dynamic plantar pressures were measured with bag loads of 0% no bag and 15% of subjects’ body weight. The independent t test was performed to analyze changes in plantar pressures. [Results] The plantar pressure measurements of bag load of 0% of subjects’ body weight before and after the spinal stabilization exercise program were not significantly different, but those of two foot areas with a 15% load were statistically significant (mt5, 67.32±24.25 and 51.77±25.52 kPa; lat heel, 126.00±20.46 and 102.08±23.87 kPa). [Conclusion] After performance of the spinal stabilization exercises subjects’ overall plantar pressures were reduced, which may suggest that physical balance improved.Key words: Idiopathic scoliosis, Dynamic foot pressure, Backpack load     

防足部压疮装置的研制及应用效果

压疮是指身体局部组织长期受压,血液循环受到障碍,不能适当供给皮肤和皮下组织所需营养,以致局部失去了正常功能而溃烂和坏死.对于骨科需长期卧床不能自主改变体位病人,如下肢骨折或骨外伤需行下肢皮牵引的病人,压疮是其临床最常见的并发症之一,尤其好发于足跟和内外踝.对这些病人压疮的预防护理工作非常重要,一旦病人发生压疮,将给病人及其家属带来痛苦,同时也增加了护理工作量及难度.目前,防止下肢皮牵引病人发生足部压疮的措施主要是护理人员定时对病人足部行皮肤护理、保持清洁干燥、定时按摩受压部位等,但这些措施的实施费时、费力.为解决这一问题,我们自行设计了与下肢皮牵引带配合使用的防足部压疮装置,经临床应用,有效地预防了足部压疮的发生,减轻了护理人员的工作量.     

The effect of superficial trunk muscle exercise and deep trunk muscle exercise on the foot pressure of healthy adults

[Purpose] The purpose of this study was to analyze the effect of superficial trunk muscle exercise and deep trunk muscle exercise on the foot pressure of healthy adults. [Subjects] The subjects were 30 healthy females and males who agreed to participate in this study. There were two groups, a superficial trunk muscle exercise group and a deep trunk muscle exercise group, with 15 participants in each. [Methods] The exercises were conducted 5 times a week for 4 weeks for both groups. A gait analyzer was used to measure foot plantar pressure while walking on a plate. Participants were measured before starting the exercise and after 4 weeks. The paired t-test was used to analyze the pre-and post-test results. [Results] There were no significant differences in foot pressure in any region in the superficial trunk muscle exercise group. In the deep trunk muscle exercise group, there were statistically significant increase in F1, F4, F5, R1 and R3. In addition, there were significant decreases in R2 and R4. [Conclusion] After the 4-week deep trunk muscle exercise group decreases in foot pressure on the inner foot and increases on the outside of the feet indicate normal and overall even distribution of body weight on the feet.Key words: Superficial trunk muscle exercise, Deep trunk muscle exercise, Foot pressure     

Effect of prosthetic design on center of pressure excursion in partial foot prostheses

Investigations into the gait of persons with partial foot amputation (PFA) suggest that the effective foot length can be restored when the prosthesis incorporates a relatively stiff forefoot, restricts dorsiflexion, and includes a mechanism whereby forces caused by loading the toe lever can be comfortably distributed to the leg (e.g., an anterior tibial shell). The purpose of this investigation was to systematically alter these variables to understand which design elements are responsible for restoration of the effective foot length. By manipulating features of the prosthesis design in two persons with PFA, we demonstrated using three-dimensional motion analysis that the prosthesis must incorporate each of these design elements to restore the effective foot length. When these design elements were used in concert, the persons with PFA adopted a gait pattern more consistent with nondisabled persons. Further work is required on a larger cohort to ensure the observations are generalizable.     

Effect of proprioceptive training on foot posture,lower limb alignment,and knee adduction moment in patients with degenerative knee osteoarthritis: a randomized controlled trial

[Purpose] The purpose of this study was to determine the effect of proprioceptive training on foot progression angle, weight-bearing ratio, and knee adduction moment in patients with degenerative osteoarthritis of the knee. [Subjects] The subjects were 37 patients diagnosed with Kellgren-Lawrence grade 2 or 3 degenerative knee osteoarthritis. They were randomly allocated to three groups: a proprioceptive training group (PT group), quadriceps strengthening group (QS group), and control group. [Methods] The study parameters of the three groups were compared before and after a 12-week training period. Therapeutic exercises were performed twice per week for 12 weeks. Outcomes included the foot progression angle, weight-bearing ratio, and knee adduction moment. [Results] First, a significant difference in the foot progression angle was observed among the groups, significantly increasing in the PTG compared with the CG. Second, a significant difference in the weight-bearing ratio was observed among the groups, significantly increasing in the PTG compared with the CG. Third, a significant difference in the first peak knee adduction moment was observed among the groups, significantly decreasing in the PTG compared with the CG. [Conclusion] The results of the present study indicate that proprioceptive training increased the foot progression angle and weight-bearing ratio and decreased the first peak knee adduction moment. Moreover, incorporating proprioceptive training into a physical therapy exercise program could improve functional ability and delay the progression of degenerative osteoarthritis.Key words: Knee osteoarthritis, Knee adduction moment, Proprioceptive training