Abstract
BackgroundUnstable sole designs have been used as functional or therapeutic tools for improving body stability during locomotion. It has been suggested that the narrow base of support under the feet generate perturbations that challenge the instability of different joints during motion, thereby forcing the body to modify its movement in order to maintain a stable gait. The purpose of the present study was to explore the correlation between the stability of the footwear-device and the magnitude of perturbation conveyed during gait.MethodsVarious levels of dynamic instability were achieved using a novel foot-worn platform with two adjustable convex rubber elements attached to its sole. A total of 20 healthy male adults underwent direct in-shoe pressure measurements while walking with the footwear device. Foot center of pressure (COP) and stride to stride variability measures were extracted to examine the correlation between the magnitude of the instability and the imposed perturbations during gait.ResultsA counterintuitive but significant correlation was found between stride to stride variability and the instability of the biomechanical elements. Moreover, there was significant correlation between the instability of the elements and the perturbations found in the COP trajectory. The linear model describing this correlation was found to be statistically significant.ConclusionThere was significantly negative correlation between the level of instability induced by the shoe design and the amount of perturbations conveyed during gait. This suggests that the external perturbation must remain within a certain range limit. Exceeding this limit can negatively affect the treatment and probably lead to opposite results.
Highlights
Unstable sole designs have been used as functional or therapeutic tools for improving body stability during locomotion
In recent years, a novel therapeutic approach to musculoskeletal pathologies, centered on neuromuscular reeducation, has emerged and has been the focus of a vast amount of research [1–3]. The principal behind these therapeutic interventions is that the neurological system controlling locomotion is plastic and, given accurate stimuli, can generate enhanced motor activation patterns that can compensate for anatomical pathologies which compromise gait [4]
We found that controlled shifts of the elements can significantly alter the location of the foot center of pressure (COP) [11], thereby influencing kinetic and kinematic parameters of gait for both healthy individuals and OA patients [12]
Summary
Unstable sole designs have been used as functional or therapeutic tools for improving body stability during locomotion. A novel therapeutic approach to musculoskeletal pathologies, centered on neuromuscular reeducation, has emerged and has been the focus of a vast amount of research [1–3] The principal behind these therapeutic interventions is that the neurological system controlling locomotion is plastic and, given accurate stimuli, can generate enhanced motor activation patterns that can compensate for anatomical pathologies which compromise gait [4]. Acting as an interface between the feet and the ground, footwear can manipulate sensory feedback information originating from the plantar surface of the foot and generate these stimuli The idea behind these designs is to introduce controlled diminished support, thereby challenging joint stability and balance control, a strategy that may allow users to develop motor skills adequate to protect their joints from potentially harmful loads during functional activities [6]
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