Neutral Shoe Research Articles

Functional impact of custom‐made foot orthoses in patients with haemophilic ankle arthropathy

Although foot orthoses are often prescribed to patients with haemophilia (PWH) and ankle arthropathy, the efficacy and biomechanical effects of such devices are not fully understood. We experimentally investigated the effects of orthopedic insoles (OI) and shoes (OS) in PWH presenting ankle arthropathy, with specific attention being paid to pain, spatiotemporal parameters, kinematics and kinetics of lower limb joints, as well mechanical and energetic variables. Using three-dimensional gait analysis (3DGA), synchronous kinematics, kinetics, spatiotemporal, mechanics, and metabolic gait parameters were measured in 16 PWH with ankle arthropathy. The revised Foot Function Index (FFI-R) and 3DGA were determined in patients wearing neutral running shoes at two time points (T0 and T1), with OI (n = 11) or OS (n=5) being subsequently prescribed. Patients, while wearing their orthoses, were re-evaluated using 3DGA, FFI-R, and satisfaction questionnaires (T2). OI and OS provided significant pain relief and comfort improvement in more than half of the patients, with minimal side effects. OI had limited impact on gait pattern, whereas OS significantly improved the propulsive function of the ankle. Biomechanical changes induced by OI and OS were independent of their ability to improve comfort, while being insufficient to influence knee and hip kinematics and kinetics, or mechanical and energetic variables. These findings suggest that OI and OS may have beneficial effects on ankle joints in PWH. Self-reported clinical tools such as FFI-R and satisfaction questionnaires are sufficiently sensitive for assessing the efficacy of foot orthoses in PWH.

Determining the maximum diameter for holes in the shoe without compromising shoe integrity when using a multi-segment foot model

Measuring individual foot joint motions requires a multi-segment foot model, even when the subject is wearing a shoe. Each foot segment must be tracked with at least three skin-mounted markers, but for these markers to be visible to an optical motion capture system holes or ‘windows’ must be cut into the structure of the shoe. The holes must be sufficiently large avoiding interfering with the markers, but small enough that they do not compromise the shoe's structural integrity. The objective of this study was to determine the maximum size of hole that could be cut into a running shoe upper without significantly compromising its structural integrity or changing the kinematics of the foot within the shoe. Three shoe designs were tested: (1) neutral cushioning, (2) motion control and (3) stability shoes. Holes were cut progressively larger, with four sizes tested in all. Foot joint motions were measured: (1) hindfoot with respect to midfoot in the frontal plane, (2) forefoot twist with respect to midfoot in the frontal plane, (3) the height-to-length ratio of the medial longitudinal arch and (4) the hallux angle with respect to first metatarsal in the sagittal plane. A single subject performed level walking at her preferred pace in each of the three shoes with ten repetitions for each hole size. The largest hole that did not disrupt shoe integrity was an oval of 1.7 cm × 2.5 cm. The smallest shoe deformations were seen with the motion control shoe. The least change in foot joint motion was forefoot twist in both the neutral shoe and stability shoe for any size hole. This study demonstrates that for a hole smaller than this size, optical motion capture with a cluster-based multi-segment foot model is feasible for measure foot in shoe kinematics in vivo.

Quantifying lower limb gait coordination in off-the-shelf orthotic shoes

Orthotics are thought to alter the relationship between the motion of lower extremity segments during walking. Recently, off-the-shelf foot orthotics incorporated into a shoe have been offered as alternatives to customized orthotics. The aim of this study was to investigate the use of ‘off-the-shelf’ orthotic shoes using the quantification of segmental coordination. Eleven healthy male subjects (age: 28 ± 5 years, mass: 60 ± 6 kg, height: 1.7 ± 0.3 m) consented to participated in this study. Subjects walked in the Non-ortho condition (i.e. their own normal pair of neutral business shoes) or, in the Ortho condition (i.e. the orthotic business shoes) on a motorized treadmill. Joint coordination coupling between the calcaneus (inversion/eversion) and the tibia (internal/external rotation) was evaluated using a modified vector coding technique. Angles, γ, from 0° to 360° were computed to examine both angle–angle and angular speed–angular speed coordination. Results indicated that the coupling patterns were not significantly different for angle–angle coordination but were significantly different for angular speed–angular speed coordination when comparing Ortho and Non-ortho conditions. The two conditions were similar throughout the Early, Mid, and Late portion of the stance phase. Greater variability with out-of-phase couplings was observed during the Early and Late periods in angular speed–angular speed coordination for the Ortho condition. These results indicate that an off-the-shelf orthotic shoe can alter calcaneal–tibial coordination and coordination variability significantly. While increased coordination and coordination variability is associated with a potentially healthier gait, it should be noted that the subjects in this study had no injury or pathology that would have caused them to use orthotics.

Protocol for the dano-run study: a 1-year observational follow up study on running related injuries in 1000 novice runners

BackgroundThe knowledge on the relation between running patterns and Running Related Injuries (RRIs) is sparse. Studies have tried to document a relationship. However, no firm conclusions can be made. Still...

The effects of enhanced plantar sensory feedback and foot orthoses on midfoot kinematics and lower leg neuromuscular activation

Excessive foot pronation has been associated with injuries of the lower extremity. No research has investigated the effect of enhancing plantar sensory feedback on foot pronation. The aim of this study was to determine whether a shoe with enhanced plantar sensory feedback reduces midfoot pronation. Midfoot kinematics and electromyography of the peroneus longus, tibialis anterior and medial gastrocnemius of 21 males (age: 21.0±4.0 years, height: 176.8±5.0cm, mass: 73.3±6.5kg) were recorded whilst walking in a neutral shoe, a neutral shoe with a prefabricated foot orthotic and a neutral shoe with nodules located on the plantar-medial insole (experimental shoe). Friedman's ANOVA and Wilcoxon tests were used to evaluate differences between shoe conditions. Mean midfoot-tibia angles during ground contact were significantly more supinated when wearing the experimental shoe (+7.14°, p=0.023) or orthotic (+3.83°, p=0.006) compared to the neutral shoe. During the loading phase, midfoot angles were significantly more supinated when wearing the experimental shoe compared to the orthotic (+5.53°, p=0.008) or neutral shoe (+6.20°, p=0.008). In the midstance phase, midfoot supination was significantly higher in the orthotic compared to the neutral shoe (+2.79°, p=0.006). Finally, supination was increased during the propulsive phase when wearing the experimental shoe compared to the orthotic (+7.43°, p=0.010) or neutral shoe (+10.83°, p=0.009). No significant (p<0.05) differences in muscle activation were observed. These results suggest that increasing plantar sensory feedback to the medial aspect of the foot reduces midfoot pronation during an acute bout of walking. Further work is needed to explore whether these effects remain over longer time periods.

Effect of motion control running shoes compared with neutral shoes on tibial rotation during running

Objective To determine whether a motion control running shoe reduces tibial rotation in the transverse plane during treadmill running. Design An experimental study measuring tibial rotation in volunteer participants using a repeated measures design. Setting Human Movement Laboratory, School of Health Professions, University of Brighton. Participants Twenty-four healthy participants were tested. The group comprised males and females with size 6, 7, 9 and 11 feet. The age range for participants was 19 to 31 years. Main outcome measures The total range of proximal tibial rotation was measured using the Codamotion 3-D Movement Analysis System. Results A one-tailed paired t-test indicated a statistically significant decrease in the total range of proximal tibial rotation when a motion control shoe was worn (mean difference 1.38°, 95% confidence interval 0.03 to 2.73, P = 0.04). Conclusions There is a difference in tibial rotation in the transverse plane between a motion control running shoe and a neutral running shoe. The results from this study have implications for the use of supportive running shoes as a form of injury prevention.

Acute effects of a shoe with enhanced plantar sensory feedback on midfoot kinematics whilst walking

Background Excessive foot pronation has been associated with injuries of the lower extremity. No research has investigated the effect of altering plantar sensation on foot pronation. The aim of this study was to determine whether a shoe with enhanced plantar sensory feedback could reduce midfoot pronation. Methods The midfoot kinematics of 21 males were recorded whilst walking in a neutral shoe, a neutral shoe with a foot orthotic and a neutral shoe with nodules located on the plantar medial aspect of the foot (experimental shoe). Electromyography of the peroneus longus, tibialis anterior and medial gastrocnemius was also recorded and analysed. A Friedman’s ANOVA was used to evaluate differences between shoe conditions, and a Wilcoxon signed ranks test was conducted to establish where the differences occurred. Results The results demonstrated that midfoot-tibia angles were significantly more supinated during the loading phase when wearing the experimental shoe (median = 47.70°) than when wearing a neutral shoe (median = 41.50°; p =0.008) or a neutral shoe with a foot orthotic (median =42.17°; p=0.008). In the midstance phase, supination angles in both the orthotic and experimental shoes were higher than that of the neutral shoe, with the former reaching significance (median = 19.56°; p = 0.006). During the propulsive phase findings were similar, with a significantly more supinated position in the experimental shoe (median = 48.30) than the neutral shoe (median = 37.47°; p = 0.006) or the neutral shoe with a foot orthotic (median = 40.87°; p=0.010). No significant differences were observed for any muscle group at any stage of the gait cycle. Conclusions Increasing plantar sensory feedback to the medial aspect of the foot reduces midfoot pronation during an acute bout of walking.this may have important implications in relation to our prescription of both athletic footwear and orthotic devices. Further work is needed to explore whether these effects remain over longer time periods.

The effect of sports shoe design on lower limb function in a neutral foot type

significant difference in peak rearfoot eversion or peak inversion moment was found between footwear conditions however the neutral shoe was associated with a non-significant increase in peak inversion moment. Time series data demonstrated earlier onset and longer duration of inversion moment in both walking and running gait in the barefoot condition. Conclusion The results of this study indicate that dual density and neutral sports shoes do not have a statistically significant effect on kinematics of the tibia or rearfoot, however there is evidence to suggest ad ual density shoe may reduce peak rearfoot eversion. The reduction in inversion moment associated with both types of footwear suggests there may be less demand on anti-pronatory muscles associated with footwear use.

The effect of three different levels of footwear stability on pain outcomes in women runners: a randomised control trial

BackgroundThe present study examines the injury status in women runners who are randomised to receive a neutral, stability or motion control running shoe.Methods81 female runners were categorised into three different...

Motion Control Shoe Delays Fatigue of Shank Muscles in Runners with Overpronating Feet

Background The motion control shoe is a well-developed technology in running shoe design for controlling excessive rearfoot pronation and plantar force distribution. However, there is little information on the leg muscle activation with different shoe conditions. Hypothesis The motion control shoe can prevent excessive shank muscle activation and delay fatigue. Study Design Controlled laboratory study. Methods Twenty female recreational runners with excessive rearfoot pronation were tested with running 10 km on a treadmill on 2 days. Participants wore either a motion control running shoe or neutral running shoe on each day. Activities of their right tibialis anterior and peroneus longus were recorded with surface electromyography. The normalized root-mean-square electromyography and median frequency were compared between the 2 shoe conditions. Results Significant positive correlations were found between the root-mean-square eletromyography and running mileage in both the tibialis anterior and peroneus longus in the neutral shoe condition (P < .001). The median frequency dropped in both shoe conditions with mileage, but paired t tests revealed a significantly larger drop in the neutral shoe (P < .001 for peroneus longus, P = .074 for tibialis anterior). Conclusion The motion control shoe may facilitate a more stable activation pattern and higher fatigue resistance of the tibialis anterior and peroneus longus in individuals with excessive rearfoot pronation during running. Clinical Relevance The motion control shoe may increase the running endurance, thus reduce overuse injuries, in athletes with unstable feet during long-distance running.

Extrinsic foot muscle forces when running in varus, valgus and neutral wedged shoes

The role of the extrinsic foot muscles in controlling the foot during the period of eversion is not well understood. The major extrinsic muscles are: tibialis anterior, tibialis posterior, gastrocnemius, peroneals, soleus and extensor digitorum longus. The purpose of this study was to investigate the role of the extrinsic foot muscles in running in response to perturbations caused by neutral, varus and valgus wedged footwear. Twelve healthy, college aged males ran with a heel–toe footfall pattern at 3.6 m s−1± 5% in the specially constructed footwear. Three-dimensional kinematic and kinetic data were collected and used in a Newton–Euler inverse dynamics calculation to determine 3D joint moments. We used a static optimization approach which employed the ankle joint moments and a minimization cost function to determine the individual muscle forces. Of the six extrinsic foot muscles, only the extensor digitorum longus (dorsiflexor) and the peroneals (evertor) resulted in force differences among footwear conditions. Neither of these muscles act to resist the eversion action. There were differences in the muscle force between wedge conditions in the extensor digitorum longus, peroneals and the tibialis anterior and posterior. Again, none of these muscles resist eversion. These results indicate that the extrinsic foot muscles experience small alterations as a result of the wedged footwear during the support phase of running.

Repeatability of the Pedar-X® in-shoe pressure measuring system

The Pedar-X is one of the newer versions of in-shoe pressure measuring devices and the current study aimed to assess the repeatability of this device. Twenty-seven healthy male volunteers were recruited and requested to walk on a 26-feet walkway wearing appropriate sized standardised off-the-shelf neutral running shoes (Donnay International). The Pedar-X insole was sandwiched between the foot and the shoe. Data were collected on two occasions, one week apart. Clinically relevant parameters studied were contact area, contact time in percentage roll over process, maximum force, pressure-time integral, force-time integral, peak pressure, mean force and mean area. Repeatability was analysed using the coefficient of variation. Of the 160 parameters considered, 93.1% revealed a coefficient of variation value of less than 25. Heel and the metatarsal head areas were the most repeatable. The Pedar-X in-shoe pressure measuring system is repeatable and as such can be used as a valuable tool in the assessment of in-shoe plantar pressure distribution.

축구화 스터드 형태에 따른 무릎 모멘트의 변화

The purpose of this study was to determine the relationship between different soccer cleat designs and knee joint moments. Twelve physically active males (mean(SD): age: 26.4(6.2)yrs; height: 176.4(4.1)cm; mass: 74.0 (7.4)kg) were recruited Kinematic and force plate data were collected for all subjects during normal running and a <TEX>$45^{\circ}$</TEX> cutting maneuver, called a v-cut. Both motions were performed at <TEX>$4.0{\pm}0.2\;m/s$</TEX> on infilled artificial turf with three pairs of soccer cleats of different sole plate designs, and one pair of neutral running shoes. Inverse dynamics were used to calculate three dimensional knee joint moments, with repeated measures ANOVA and post hoc paired Student's t-test used to determine significance between shoe conditions. Significant differences were found in the extension moments of the knee for running trials, and for external rotation and adduction moments in the v-cutting trials. Knee moments were greater in v-cut than running, and the traditional soccer cleats (Copa Mondial and World Cup) tended to result in greater knee moments than the Nova runner or TRX soccer cleat. Cleat design was found to influence 3-dimensional knee moments in a v-cut maneuver. In the translational traction test, there were significant differences between all conditions. In the rotational traction test, friction with soccer shoes were greater than friction with running shoes. However, no differences were found between soccer shoes. Higher moments may lead to increased loads and stresses on knee joint structures, and thus, greater injury rates.

Extrinsic foot muscle forces when running in varus, valgus and neutral shoes

Extrinsic foot muscle forces when running in varus, valgus and neutral shoes

Motion control shoe affects temporal activity of quadriceps in runners

Objective:Delay onset of the vastus medialis obliquus (VMO) has often been reported to happen in people with patellofemoral pain (PFP). Previous studies revealed that a motion control shoe could check...

Influence of orthotic devices prescribed using pressure data on lower extremity kinematics and pressures beneath the shoe during running

Background Orthotic devices are frequently prescribed as a conservative treatment of lower extremity injury. The purpose of this study was to investigate the influence of orthotic devices prescribed using pressure data on lower extremity movement and loading patterns. Methods Twenty-two subjects ran barefoot over a pressure plate for the prescription of orthotic devices. The influence of the prescribed orthoses on lower extremity kinematics and pressure beneath the shoe was assessed by collection of data for 10 running trials with a neutral shoe and 10 with the addition of the orthotic device. For each running trial, initial and peak angles were determined for rearfoot inversion–eversion, lower leg internal rotation, ankle dorsi-plantar flexion, knee flexion and rearfoot eversion velocity. In addition, the relative pressure on the lateral side to medial side of the shoe (pressure balance) was determined by dividing the foot into areas of medial and lateral heel and five metatarsals. Peak lateral and medial heel and foot balance were determined during early stance to indicate differences in balance during this phase. Findings The orthotic devices resulted in a significant reduction in peak eversion and eversion velocity and a significant increase in the initial inversion angle ( P < 0.05). In addition, the peak ankle dorsi-flexion and initial dorsi-flexion angle were significantly increased ( P < 0.05). Consistent with the observed increase in initial inversion, the early pressure balance data revealed a significantly more lateral (less medial) concentration of pressure ( P < 0.05). Interpretation It is concluded that the devices used in the present study have resulted in the production of shoe inserts that successfully lower peak eversion and eversion velocity by encouraging the foot to operate in a more inverted orientation throughout the initial stance phase of running. In addition, there is evidence that orthotic effects can be detected through the use of pressure data collected from beneath the shoe.

Influence of Different Footwear on Force of Landing During Running

Previous studies have demonstrated an increase in foot pronation with mileage in runners. Motion control footwear was designed to check excessive foot motions, but its clinical efficacy, especially in terms of pedographic analysis, has not been well reported. The purposes of this study were to investigate the changes in plantar force in people when running with motion control shoes and to compare pedographic measurements obtained in 2 footwear testing conditions (wearing motion control shoes and wearing neutral shoes) at the beginning and end of a 1.5-km running session. Twenty-five recreational runners who had > or = 6 degrees of foot pronation participated in the study. An insole sensor was used to register the plantar force of the subjects before and after running 1.5 km in different shoe conditions. There was no change in the magnitude and distribution pattern of plantar force with the motion control shoes after the 1.5-km run. With the neutral shoes, however, there was an increase in mean peak force under the medial midfoot (364-418 N, 15% increase) and first metatarsal head (524-565 N, 8% increase) toward the end of the running bout. The plantar force on the medial foot structures increased with mileage of running with neutral shoes but not with motion control shoes. This finding has implications for injury prevention with footwear selection for recreational runners who have more than 6 degrees of foot pronation.

Biomechanical response to systematic changes in impact interface cushioning properties while performing a tennis-specific movement

It is currently not known whether human responses across typical sports surfaces are dependent on cushioning or frictional properties of the interface. The present study assessed systematic changes in surface cushioning (baseline acrylic, rubber, thin foam, and thick foam) as participants performed tennis running forehand foot plants wearing a basic neutral shoe (plimsolls). It was hypothesized that systematic decreases in peak rates of loading, heel pressures, and perceived hardness would be yielded as surface cushioning increased (impact test device). A common acrylic top surface provided consistent frictional properties across surfaces. Kinetics (AMTI, 960 Hz and Footscan Pressure Insoles, 500 Hz), kinematics (Peak MOTUS, 120 Hz), and cushioning perception were assessed. Peak and mean loading rates of vertical ground reaction force, peak horizontal force, peak heel pressure, and rates of loading demonstrated significant correlations (P < 0.05) with the participants' perceived levels of cushioning and matched mechanical rankings of surface cushioning. In contrast, peak impact force was lowest on the least cushioned surface. Kinematic responses were not significantly different between surfaces. Present evidence supports ‘‘peak rate of loading'' as a more suitable indicator of surface cushioning than peak impact force. Although cautionary, biomechanical support is also provided for mechanical methods of surface cushioning assessment.

Muscular activity in treadmill and overground running

It still remains unclear whether muscular activity on the treadmill (T) differs compared to overground (0) running. The purpose of this study was therefore to examine possible differences in muscular activation between T and 0. 14 healthy runners were analyzed in a neutral running shoe at 12 km·h -1 on a treadmill and in a field test. Muscular activity (EMG) of the tibialis anterior, peroneus longus, and soleus were measured. Time and amplitude quantities were assessed during the gait cycle. The EMG of the peroneus longus exhibited a later onset, a later maximum and shorter total time of activation (p < 0.05) in 0. The soleus showed a higher amplitudes in 0 during the push-off phase (p < 0.05). Altered peroneus longus activity may indicate its role as an ankle stabilizer and demonstrates a compensatory response due to changing mechanical conditions. Weaker amplitudes of the soleus in the push-off during T suggest adaptation to the movement of the treadmill belt, and/or changes in load receptor input. Differences in muscle activity between T and 0 running must thus be taken into consideration in studies of neuromuscular control of movement.

Efficacy of motion control shoes for reducing excessive rearfoot motion in fatigued runners

Objectives Excessive foot pronation and fatigue in running are possible risk factors for injuries. Motion control footwear was designed to limit excessive foot motion in runners, but its clinical efficacy has not been well reported. This study investigated the rearfoot kinematics in runners when running with different footwear before and after fatigue of the lower leg muscles. Design Within subjects repeated measures. Setting University gait laboratory. Participants 25 female recreational runners. Main outcome measures A Vicon three-dimensional motion analysis system was used to capture the rearfoot motions of 25 recreational runners who had excessive foot pronation, when running with motion control shoes and neutral shoes before and after fatigue of the lower leg muscles. Results The findings with neutral shoe testing revealed a significant increase in rearfoot angle of 6.5° (95% CI 4.7–8.2°) ( p<0.01) when the muscles were fatigued. However, the findings with motion control shoes revealed that rearfoot angle was marginally insignificant ( p=0.06) in subjects before and after muscle fatigue. Moreover, rearfoot motion when running with neutral shoes was higher than that with motion control shoes in both pre- ( p<0.01) and post-fatigue states ( p<0.01). Conclusions Motion control shoes can control excessive rearfoot movements in runners with over-pronation regardless of the state of leg muscle fatigue.