The Influence of Negative Heels on Plantar Foot Pressures during Treadmill Walking
Miller, Taavy A.
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Introduction: Plantar pressures reflect the general loading pattern of the foot during dynamic situations like walking. When we deviate from walking on a flat, planar surface the pressure pattern changes and understanding these differences can have a therapeutic value if controlled and understood. Many factors play a role in plantar pressures two notable influences are velocity and footwear. Purpose: The main objective of this study was to evaluate the influence of a negative heel on plantar foot pressures during treadmill walking in healthy subjects. Our secondary objective was to observe the mechanics of how the foot responds with regard to loading redistribution. Methods â€“ Ten subjects were evaluated walking in two different negative heel conditions at two different velocities. The test conditions were compared against a control, flat over ground condition. All subjects were free of any neurological or orthopedic disorders. Pedar mobile by Novel was used to collect plantar pressures. Peak pressure was the metric used to evaluate and compare the differences among conditions. Results: The four-degree negative heel condition yielded significant peak pressure reductions in plantar pressures at the regions defined as mid-forefoot and lateral toes. Of note, we saw a similar trend of peak pressure reduction at the lateral forefoot, yet these were not significant. Conclusion: It appears that when the foot is subjected to a negative heel condition it tends towards a posterior shift in weight. A negative heel results in a decrease in peak pressures at the 2nd - 3rd metatarsal heads, and lateral toes compared to a planar level surface without a negative heel during treadmill walking. Therefore the foot responds mechanically when the shoe is altered which can be evaluated quantitatively by plantar pressures and used clinically to evaluate load redistribution. References â€“ 1. Burnfield, J.M.; Few, C.D.; Mohamed, O.S.; Perry, Jacquelin. The Influence of walking speed and footwear on plantar pressures in older adults. J Clinical Biomech 2004; 19: 78-84. 2. Cavanagh, P.R., Hewitt, F.G., Perry, J.E. In-Shoe Plantar Pressure Measurement: A Review. The Foot 1992; 2:185-194. 3. Hughs J., Pratt L., Linge K., Clark K., Klenerman L. Reliability of Pressure Measurements: the EMED F system. Clinical Biomech 1991; 6:14-18. 4. Janisse D.J., Janisse E. Shoe Modification and the Use of Orthoses in the Treatment of Foot and Ankle Pathology. J Am Acad Orthop Surg 2008; 16(3):152-158. 5. Kogler GF, Veer F, Solomonidis SE, Paul JP. The Influence of Medial and Lateral Placement of Orthotic Wedges on Loading of the Plantar Aponeurosis. In vitro study. J of Bone & Joint Surgery 1999; 81A: 1403-1413 6. Mandato M.G., Nester E. The Effects of Increasing Heel Height on Forefoot Peak Pressure. J Am Podiatr Med Assoc 1999; 89(2):75-80. 7. Neumann, Donald. Kinesiology of the Musculoskeletal System Foundations for Physical Rehabilitation. St. Louis: Mosby, Inc.; 2002. 8. Praet, Stephan; Louwerens, Jan-Willem. The Influence of Shoe Design on Plantar Pressures in Neuropathic Feet. Diabetes Care 2003; 26(2):441-445. 9. Ramanathan A.K., John, M.C., Arnold, G.P., Cochrane L., Abboud R.J. The Effects of Off-the-Shelf Heel Inserts on Forefoot Plantar Pressure. Gait & Posture 2008; 28:533-537. 10. Witana, Channa, Goonetilleke, R.S., Yim Lee Au, E., Xiong, S., Lu, X. Footbed Shapes for Enhanced Footwear Comfort. Ergonomics 2009; 52(5):617-628.