Leg Compression Research Articles

Effect of lower leg compression application during Cesarean Section- on women's physiological parameters and neonatal outcome.

Effect of lower leg compression application during Cesarean Section- on women's physiological parameters and neonatal outcome.

Micromassage Compression Leggings Associated with Physical Exercise: Pilot Study and Example of Evaluation of the Clinical and Instrumental Effectiveness of Conservative Treatment in Lipedema.

We evaluated the effect of compression leggings with micromassage in association with physical activity on women with lipedema, not previously treated and without recent changes in body weight. The treatment resulted in an improvement in all subjective parameters, in spontaneous and evoked pain, in the volume of the limbs, in the absence of significant changes in body weight, and regardless of the duration of use, age, years of illness, the clinical stage, and body mass index (BMI). Evoked pain did not improve in areas affected by untreated lipedema; foot circumferences did not increase. We found a significant reduction in the thickness of subcutaneous adipose tissue (SAT) and skin evaluated in multiple points of the lower limb. Micromassage compression leggings are proposed as an integral part of conservative treatment. A method is proposed for the clinical evaluation of evoked pain, called the Progressive Pain Check (PPC), which allows for the calculation of a numerical score called the Ricolfi-Patton Score (RPS) and for the ultrasound evaluation of tissues. The method is simple and repeatable and allows for completion of the clinical evaluation of the patient at diagnosis and for an evaluation of the effects of various treatments, even applied to just one side of the body.

Effect of blood flow restriction training on health promotion in middle-aged and elderly women: a systematic review and meta-analysis.

Background: Physical activities play an important role in alleviating the aging problem and improving the physical fitness of middle-aged and elderly people. Blood flow restriction (BFR) training, also known as pressure training, has been widely used to improve athletes' performance and rehabilitation, which is a relatively novel exercise method for improving the physical fitness of middle-aged and elderly people. The purpose of this study is to conduct a systematic review and meta-analysis of domestic and foreign randomized controlled trial studies on BFR training for middle-aged and elderly women, further explore the impact of BFR training on health status. Methods: Meta-analysis was performed according to PRISMA standards, and charts were drawn using Review Manager 5.4 and Stata 17 software. In this study, the keywords such as "pressure training", "blood restriction training", "elderly women", "KAATSU", "blood flow restriction training" were used on CNKI, China Science and Technology Journal Database, PubMed, Embase, Web of Science, Cochrane Library, EBSCO, Scopus, and randomized controlled trials were searched in all languages. The search was performed from the establishment of database to 2 January 2024. The results of the combined effect were represented by standard mean differences. Results: Among the 681 literature retrieved, six eligible English articles were included in this meta-analysis. The overall effect test of the combined effect was performed on 10 groups of data, and the results were SMD = -0.18 (95%CI: -0.91 to 0.56; p > 0.05), the maximum dynamic force of 1RM SMD = 0.97 (95%CI: 0.35 to 1.58; p < 0.05), leg compression force SMD = -0.10 (95%CI: -0.78 to 0.57; p > 0.05), heart rate SMD = 0.33 (95%CI: -2.50 to 3.17; p > 0.05), systolic blood pressure (SBP) SMD = -1.44 (95%CI: -2.17 to -0.70; p < 0.05), diastolic blood pressure (DBP) SMD = -0.69 (95%CI: 2.54 to 1.15; p > 0.05). Conclusion: BFR training had a significant effect on the increase of the maximum dynamic force of 1RM and decrease of blood pressure in middle-aged and elderly women, but there was no significant difference found in heart rate and leg compression force. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024491642.

Intrinsic toe joint stabilization in foot-slip turning motion of musculoskeletal robot with DSP-SLIP model

This paper introduces the foot-slip turning motion by combining a slider-like mechanism with the double-support parallel spring-loaded inverted pendulum model, in which the musculoskeletal robot uses the model to simplify the slip-turning motion with its compliant structure and utilizes the foot muscle to improve its postural stability. The slip-turning motion, characterized by slight movements for swift turning via foot slippage, is advantageous for musculoskeletal robots due to their limited range of movement. The challenge lies in the reduced support area during the motion, which impacts stability. In our previous study, the robot ‘PneuTurn-T’ successfully executed said motion, whereas the details of the turning mechanism were lacking. This study investigated the utilization of leg compliance in the motion and its static postural stability in the landing stance. Experimental results exhibited a leg compression rate derived from the collected data in the early phase of the motion and validated intrinsic toe joint stabilization with foot muscle for passive postural control. The ground reaction force proves the capability to maintain the posture for 130% longer in the foot with plantar intrinsic muscle. Despite structural challenges, this approach shows promise for musculoskeletal robots, highlighting their ability to handle a turning task with simple control.

Effect of pneumatic leg compression on phenylephrine dose for hypotension prophylaxis via variable rate infusion at cesarean delivery: an unblinded randomized controlled trial

BackgroundPhenylephrine infusion is recommended to prevent spinal hypotension during cesarean delivery (CD) but may be associated with dose-dependent side effects. We hypothesized that adding intermittent pneumatic compression (IPC) of the lower legs to a variable-rate phenylephrine infusion will reduce the dose of phenylephrine required during CD. MethodsSeventy-six healthy women undergoing elective CD under combined spinal-epidural anesthesia were randomly assigned to IPC or control groups (n = 38 per group). After spinal anesthesia, IPC of the lower legs was initiated in the IPC group, and all women received a phenylephrine infusion starting at 25 μg·min−1 and increasing by 16.7 μg·min−1 for systolic blood pressure (SAP) < 90% baseline. If hypotension (SAP < 80% baseline) occurred, 100 μg phenylephrine bolus was administered. The primary outcome was the dose of phenylephrine per minute. ResultsThe dose of phenylephrine per minute (34.4 ± 7.3 μg·min−1 vs. 40.9 ± 9.5 μg·min−1, P = 0.001; mean difference −6.6 μg·min−1, 95% CI −10.5 to −2.7 μg·min−1) and the incidence of hypotension (24% vs. 55%, P = 0.005) were lower in the IPC group than in the control group. There were no significant differences between the two groups in the total dose of phenylephrine (603.2 ± 217.1 μg vs. 706.2 ± 247.5 μg, P = 0.058; mean difference −102.9 μg, 95% CI −209.4 to 3.5 μg), maternal side effects, or neonatal outcomes. ConclusionsIntermittent pneumatic compression combined with a variable-rate phenylephrine infusion reduced the phenylephrine dose per minute and the incidence of hypotension during CD under spinal anesthesia.

High Pressure 3 × 30 Minute Compression Methods for Advanced Lower Limb Lymphedema Patients.

Introduction: In advanced lymphedema of lower limbs, stage III bandaging under the routinely applied pressure of 40-60 mmHg remains largely ineffective. This is caused by skin and subcutaneous tissue stiffness due to fibrosis. Edema fluid accumulates deep in the subcutaneous tissue. Evacuating this fluid requires a high external compression force to overcome the resistance of fibrous tissue. We aimed to investigate the effectiveness of the compression method, with high pressure lasting for 3 days. Methods and Results: Twenty-one patients with lower limb lymphedema, stage III, of the postinflammatory type were included. Patients with acute inflammatory symptoms, venous thrombosis, profuse varicose veins, diabetes, and cardiac insufficiency with edema were excluded. A 10-cm-wide rubber bandage was applied to the foot and calf. The interface pressure measured using PicoPress ranged from 58 to 120 mmHg. Skin and deep tissue tonometry, skin water concentration, leg circumference, and drop of interface pressure were measured. Ultrasound examination was done before and after each compression session. The calf circumference decreased by 15.9 ± 5.4%, deep tissue stiffness by 58.9 ± 18.9%, skin stiffness by 69.6 ± 13.5%, and skin water concentration by 43.8 ± 11.5%. Interface pressure dropped to 66.3 mmHg (28-110 mmHg); ultrasonography images showed less fluid in the tissue. Conclusions: High-pressure 30-minute leg compression can remove excess edema fluid within 3 days and enable adjustment of nonstretch compression stockings. This method is more effective in advanced lymphedema at the beginning of therapy than the standard 30-50-mmHg bandaging as it provides an immediate effect.

Mind to move: Differences in running biomechanics between sensing and intuition shod runners.

Delving into the complexities of embodied cognition unveils the intertwined influence of mind, body, and environment. The connection of physical activity with cognition sparks a hypothesis linking motion and personality traits. Hence, this study explored whether personality traits could be linked to biomechanical variables characterizing running forms. To do so, 80 runners completed three randomized 50-m running-trials at 3.3, 4.2, and 5m/s during which their running biomechanics [ground contact time (tc), flight time (tf), duty factor (DF), step frequency (SF), leg stiffness (kleg), maximal vertical ground reaction force (Fmax), and maximal leg compression of the spring during stance (ΔL)] was evaluated. In addition, participants' personality traits were assessed through the Myers-Briggs Type Indicator (MBTI) test. The MBTI classifies personality traits into one of two possible categories along four axes: extraversion-introversion; sensing-intuition; thinking-feeling; and judging-perceiving. This exploratory study offers compelling evidence that personality traits, specifically sensing and intuition, are associated with distinct running biomechanics. Individuals classified as sensing demonstrated a more grounded running style characterized by prolonged tc, shorter tf, higher DF, and greater ΔL compared to intuition individuals (p≤0.02). Conversely, intuition runners exhibited a more dynamic and elastic running style with a shorter tc and higher kleg than their sensing counterparts (p≤0.02). Post-hoc tests revealed a significant difference in tc between intuition and sensing runners at all speeds (p≤0.02). According to the definition of each category provided by the MBTI, sensing individuals tend to focus on concrete facts and physical realities while intuition individuals emphasize abstract concepts and patterns of information. These results suggest that runners with sensing and intuition personality traits differ in their ability to use their lower limb structures as springs. Intuition runners appeared to rely more in the stretch-shortening cycle to energetically optimize their running style while sensing runners seemed to optimize running economy by promoting more forward progression than vertical oscillations. This study underscores the intriguing interplay between personality traits of individuals and their preferred movement patterns.

Whole leg compression garments influence lower limb kinematics and associated muscle synergies during running.

The utilization of compression garments (CGs) has demonstrated the potential to improve athletic performance; however, the specific mechanisms underlying this enhancement remain a subject of further investigation. This study aimed to examine the impact of CGs on running mechanics and muscle synergies from a neuromuscular control perspective. Twelve adult males ran on a treadmill at 12km/h, while data pertaining to lower limb kinematics, kinetics, and electromyography were collected under two clothing conditions: whole leg compression garments and control. The Non-negative matrix factorization algorithm was employed to extract muscle synergy during running, subsequently followed by cluster analysis and correlation analysis. The findings revealed that the CGs increased knee extension and reduced hip flexion at foot strike compared with the control condition. Moreover, CGs were found to enhance stance-phase peak knee extension, while diminishing hip flexion and maximal hip extension during the stance-phase, and the ankle kinematics remained unaltered. We extracted and classified six synergies (SYN1-6) during running and found that only five SYNs were observed after wearing CGs. CGs altered the structure of the synergies and changed muscle activation weights and durations. The current study is the first to apply muscle synergy to discuss the effect of CGs on running biomechanics. Our findings provide neuromuscular evidence for the idea of previous studies that CGs alter the coordination of muscle groups, thereby affecting kinematic characteristics during running.

The effects of lower leg compression garments on lower extremity sports injuries, subjective fatigue and biomechanical variables: a systematic review with meta-analysis

The effects of lower leg compression garments on lower extremity sports injuries, subjective fatigue and biomechanical variables: a systematic review with meta-analysis

The effects of fixed and graduated application percentage-type compression leggings in adult women with mild in-toeing gait

This study examined the effects of fixed and graduated application percentage-type compression leggings for intervention in adult women with mild in-toeing gait. Participants wore these leggings while walking on a treadmill under three conditions: the control group, compression leggings with a graduated application percentage, and compression leggings with a fixed application percentage. Pressure, foot progression angle, skin blood flow, joint angle, and user evaluation scores were measured for legs affected by in-toeing gait ( n = 11). Statistical analysis compared these parameters among the three conditions. In the results, both compression leggings with a graduated application percentage and compression leggings with a fixed application percentage provided a partially graduated compression, resulting in pressure differences of 4.60 and 9.70 mmHg, respectively. Foot progression angle showed significant increases – 14.3% ( p = 0.000) with compression leggings with a graduated application percentage and 31.1% ( p = 0.000) with compression leggings with a fixed application percentage – compared with the control group condition. Skin blood flow also showed notable rises – 30.5% with compression leggings with a graduated application percentage and 61.1% ( p = 0.000) with compression leggings with a fixed application percentage – compared with the control group, indicating the superior effectiveness of compression leggings with a fixed application percentage. Both compression leggings with a graduated application percentage ( p = 0.000) and compression leggings with a fixed application percentage ( p = 0.000) positively impacted the hip joint angle in the transverse plane, nearing the normal range when compared with controls. Acceptance of both compression leggings was high, with compression leggings with a fixed application percentage proving advantageous for gait correction and compression leggings with a graduated application percentage for ease of use during donning and doffing. The study confirmed the benefits of functionality, usability, and acceptance of the two types of leggings in adult women with mild in-toeing gait.

Using advances in technology to develop sizing methodology for women’s sports compression garments

ABSTRACT The aim of this study was to evaluate the suitability of current sizing systems adopted by brands, for an athletic female population and try to identify areas of improvement in current sizing and grading methods used. This information can be used to engineer accurately fitting lower-body sports compression leggings for the target demographic. Size and shape data of sixty-three athletic females was collected using 3D body scanning. The data was compared to size charts of three commercially available sports compression leggings manufactured by different brands as well as Alvanon's UK sizing and grading standards. Results show that athletic females are not catered for by current products. 28 women (44.44%) fell between sizes for at least one measurement across the three brands. Participant's measurements indicate differing body shapes to the standard ‘hourglass’ shape presented by the Alvanon UK sizing standards, used by companies as a basis for their sizing systems.

The effects of the support panel of compression leggings on the provision of low pressure for foot progression angle correction

This study developed compression leggings (CLs) with a support panel for foot progression angle (FPA) correction to improve the fit without restricting the user's movement while providing an appropriate external force. This study aimed to examine the effects of FPA correction concerning the functionality and usability of the support panel of CLs that ensure low pressure. Clothing pressure (CP), FPA, skin blood flow (SBF), perceived strength, and usability of OCLs during treadmill walking were compared with the normal leggings (NLs). Differences in CP, FPA, SBF, and user evaluation results were analyzed according to different wearing conditions. Despite the low CP generated by the support panel (≤3.21 mmHg), there was a significant positive orthotic effect with an 11.6–18.0% increase in FPA for external rotation and a 10.5% increase in SBF. The users felt pressure and support around the thigh where the support panel was placed and directional tensile strength throughout their lower extremities while recognizing the usefulness in gait correction. Pressure and support provided by the support panel assured appearance satisfaction, dimension satisfaction, compression satisfaction, ease of movement, and safety. This study demonstrated that the support panel of CLs provided an FPA correction effect concerning functionality and usability.

Compression therapy for NHS inpatients with leg ulcers: a literature review.

Leg ulcers are common, distressing and painful for patients, and are a significant financial burden to healthcare providers. Compression therapy is the mainstay of treatment for venous leg ulceration. Several studies have evaluated leg ulcer management and compression therapy in the community. However, little is known about the prevalence of leg ulceration and use of compression therapy in acute hospitals. The aim of this study was to explore the published literature on the use of compression therapy for inpatients with leg ulcers in UK National Health Service hospital settings. A literature search was undertaken to identify published papers reporting on inpatient leg ulcer populations and the use of compression therapy in hospitals using the following databases: CINAHL, MEDLINE Complete, Embase and PubMed. The literature review identified 364 articles, of which three met the eligibility criteria. These studies reported on the prevalence of leg ulceration, the number of Doppler assessments conducted for patients and the use of compression therapy. This review confirmed a lack of information on the prevalence of hospital inpatients with leg ulcers, and identified the need to conduct prevalence audits, establish leg ulcer services to streamline inpatient leg ulcer care and provide staff and patient education programmes.

Nursing students' skills in applying short-stretch compression bandages using the control of compression bandaging score.

To assess the feasibility using the Control of Compression Bandaging (CCB) score to measure skills development on short-stretch compression therapy during a second-year nursing students' workshop. A quasi-experimental pilot study with one group. All students followed a blended learning unit comprising an e-learning unit on leg ulcers and compression therapy including videos, followed by hands-on workshops where they could exercise how to apply short-stretch compression bandages. Clinical nurse specialists in wound care collected pre- and post-workshop measures. Data collection included feasibility, absolute pressure under compression bandages and the CCB score. Six clinical nurse specialists (CNSs) collected data and 16 students participated in this pilot study. The mean application time was 8.02 minutes (min=2, max=20) pre and 9.25 minutes (min=5, max=17) post workshop. Pressure under compression bandages increased at the forefoot (P=0.01) and the calf muscle base (P=0.03) post workshop. One extreme outlier was observed. In addition, the CCB score increased from 3.57 to 4.47 (P=0.16). Using pressure measuring devices was described as essential by all the CNSs and the CCB score was easy to use. Using the CCB score and pressure measuring devices were feasible during an undergraduate education session. Recruitment procedure and modality of data collection were satisfactory. This score may be a valuable way to assess students' skills in short-stretch compression therapy. If used for formal assessment, a passing score should be defined.

Pneumatic Compression Combined with Standard Treatment after Total Hip Arthroplasty and Its Effects on Edema of the Operated Limb and on Physical Outcomes: A Pilot Clinical Randomized Controlled Study.

Total hip arthroplasty (THA) is one of the most successful orthopedic procedures and is highly effective at improving function and quality of life. However, patients commonly experience edema immediately after hospitalization and also after discharge, which can lead to health consequences and a lower quality of life. For these reasons, the aim of this study (NCT05312060) was to evaluate the effectiveness of a specific intermittent leg pneumatic compression on lower limb edema and physical outcomes in patients after total hip arthroplasty, compared to standard conservative treatment. A total of 47 patients were enrolled and randomly allocated into two groups: the pneumatic compression group (PG = 24) and the control group (CG = 23). The CG performed the standard venous thromboembolism therapy, which included pharmacological prophylaxis, compressive stockings, and electrostimulation, while the PG combined pneumatic compression with standard VTE therapy. We evaluated thigh and calf circumferences, knee and ankle ranges of motion, pain, and walking autonomy. Our results showed a greater reduction in thigh and calf circumferences for PG (p < 0.001), while other outcomes were similar for the two groups (p > 0.05). The combination of standard therapy with pneumatic leg compression was more effective at reducing lower limb edema and thigh and calf circumferences than standard treatment. Our results suggest that pressotherapy treatment is a valuable and efficient option for managing lower limb edema after THA.

Prevalence of perioperative asymptomatic venous thromboses of the lower extremity in 30 consecutive patients undergoing transsphenoidal surgery for Cushing’s disease

Cushing´s disease is a rare endocrinological disorder which is caused by an adrenocorticotropic hormone secreting pituitary adenoma. The condition is associated with an increased risk for venous thromboembolism. While there exist reports on symptomatic venous thromboses complicating Cushing’s disease, the prevalence of incidental leg vein thromboses accompanying pituitary surgery for Cushing’s disease is yet unknown. 30 consecutive patients (9 male; age 25–77 years) with histologically confirmed Cushing’s disease underwent transsphenoidal adenomectomy between October 2018 and September 2019. All patients received perioperative pharmacological thromboprophylaxis. Whole leg compression ultrasound was performed within one week after surgery (median 2 days) to exclude leg vein thromboses (primary endpoint). Preoperative laboratory values including plasma cortisol and various coagulation parameters were evaluated as secondary outcome measures. A comparison was made between patients with and without thrombotic events (p value ≤ 0.05). A total of 2 out of 30 patients (6.7%; CI 0.8–24.1%) presented with asymptomatic perioperative deep vein thromboses of the lower legs. Thrombosis patients differed not significantly from their counterparts with respect to age, sex, and comorbidities, but preoperative morning plasma cortisol was significantly higher in patients with venous thromboses (421.0 ± 49.5 μg/l vs. 188.1 ± 78.2 μg/l; p = 0.01). Moreover, von Willebrand factor activity was markedly increased in one case (409.0%) compared to the mean value obtained from 28 patients without phlebothromboses (146.9 ± 60.7%; p < 0.01). Perioperative asymptomatic leg vein thrombosis can be found with the aid of compression ultrasound in a considerable proportion of patients undergoing transsphenoidal adenomectomy for Cushing’s disease despite the administration of pharmacological thromboprophylaxis.

Hospital clinicians' perspectives of using compression therapy on venous leg ulcers: a systematic qualitative review

To identify, from the published literature, reasons for variable implementation. Systematic review with narrative synthesis, including full papers in English with empirical qualitative data. Synonyms for venous leg ulcer, compression therapy and secondary care were searched across a range of health-related databases. The Critical Appraisal Skills Programme (CASP) checklist determined study quality, and meta-ethnography was used for data synthesis. 7040 titles and abstracts and 41 full-text papers were screened with four papers selected. Three key themes were generated: educational needs surrounding implementation of compression therapy, patient factors regarding adherence and organisational resources including availability of appropriate equipment and trained staff. Barriers at the ward level were identified. There is a need to better understand why hospitals are not addressing them.

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis.

Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening sequelae. While whole leg compression ultrasound with color and spectral Doppler is commonly performed in radiology and vascular labs, point-of-care ultrasound (POCUS) is becoming more common in the acute care setting. Providers appropriately trained in focused POCUS can perform a rapid bedside examination with high sensitivity and specificity in critically ill patients. This paper describes a simplified yet validated approach to POCUS by describing a three-zone protocol for lower extremity DVT POCUS image acquisition. The protocol explains the steps in obtaining vascular images at six compression points in the lower extremity. Beginning at the level of the proximal thigh and moving distally to the popliteal space, the protocol guides the user through each of the compression points in a stepwise manner: from the common femoral vein to the femoral and deep femoral vein bifurcation, and, finally, to the popliteal vein. Further, a visual aid is provided that may assist providers during real-time image acquisition. The goal in presenting this protocol is to help make proximal lower extremity DVT exams more accessible and efficient for POCUS users at the patient's bedside.

The Usefulness of the Application of Compression Therapy among Lipedema Patients-Pilot Study.

(1) Background: Although lipedema has gained more interest among researchers, specific treatment methods are still unknown. This study aims to identify the effects of compression therapy combined with exercises compared to exercising only. Moreover, the aim is to assess the methodology and outcome measurements before conducting a larger study. (2) Methods: Six women with lipedema were enrolled in the study; three were undergoing exercise program and compression therapy using compression leggings, and the remaining three were undergoing exercises only. During the first 4 weeks, intervention was under the supervision of a physiotherapist, and in the remaining weeks, participants were exercising independently. Measurements of circumference, weight, thickness of the skin and adipose tissue, symptom severity, and quality of life were taken at baseline, after 4 weeks and after 6 weeks; (3) Results: There was a significant decrease in the subjectively reported tendency for bruising and pain at palpation among patients that received compression therapy. Additionally, there was a tendency to reduce or maintain the circumference of the legs in patients using compression, while it tended to increase in patients without compression. (4) Conclusions: Preliminary results indicate that compression therapy, combined with exercises, could improve the quality of life and decrease the severity of lipedema symptoms. Further studies on a large clinical group are advisable.

Grip Strength and Body Balance in Static and Dynamic Push Walkers Measurement Using Force Sensing Resistors and Kinect System

Most parents use push walkers to encourage toddlers in gross and fine motor stimulation to develop basic walking skills. Push walkers are a choice for parents other than baby walkers to help toddlers under one year learn to walk. The push walker options for toddlers include static (the shaft moves in place) and dynamic (moving mobile). This study aimed to compare the effect of push walkers between static and dynamic types on motor stimulation of toddlers using biomechanics by measuring hand grip strength and body balance. This research contributes to selecting a push walker for parents to support gross and fine motor development after agreeing on the consideration of the toddler expert panel for the toddler walking task simulation using a push walker involving nine toddlers according to body mass index. Simulation of toddler walking in two experimental sessions using static and dynamic push walkers in measuring hand grip strength using force-sensing resistors and body balance using the Kinect system with Vitruvius software. The grip strength value was tested by paired t-test to determine the significance of the grip strength value. Body balance values were tested by paired t-test to determine the significance of leg compression force and leg moment. Dynamic push walker has a greater value of grip strength than static, and p-value = 0.001 (&lt; 0.005), providing good motor stimulation to toddlers when pushing with more muscular grip strength, allowing the toddler's hand muscles to tighten up. Static push walkers have a greater compression force and foot moment than dynamic and p-value = 0.001 (&lt; 0.005), providing gross motoric stimulation to toddlers while walking in a balanced and stable manner, allowing the toddler's leg muscles to tighten up.