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Assistive Tech > O - Footwear Recs > Flashcards

O - Footwear Recs Flashcards

1
Q

what type of shoe is needed if pt having trouble w GRF

A

cushion

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2
Q

what type of shoe is needed if pt’s foot is moving too much

A

stability

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3
Q

what are the 3 footwear categories

A

dress
casual
athletic/sport

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4
Q

what are the 2 main things that your footwear rec will be based on

A

individual needs of pt (ADLs, work, sport/rec)

biomechanical exam findings

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5
Q

what are the 4 goals of footwear

A
  1. protection from ground
  2. provide traction
  3. motion control
    * heel stabilization
    * midfoot support
    * forefoot control
  4. shock absorption (GRF)
    * midsole dampens forces
    * energy return
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6
Q

what is the primary part of the shoe that absorbs GRF and controls that force

A

midsole

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7
Q

what are the functions of the heel counter

A

keep calcaneus stable
don’t let it move too much

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8
Q

where are the most common areas to find deficits in

A

areas that the shoe is constructed/sewn together

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9
Q

what are the 5 upper footwear components

A

toe box
vamp
quarter panels
throat
heel counter

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10
Q

what does the toe box do

A

length, width, depth
accommodates toe deformities

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11
Q

what does the vamp do

A

covers forefoot and toes including tongue

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12
Q

what does the quarter panels do

A

contains eyelets for laces
covers midfoot and heel

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13
Q

what does the throat do

A

where vamp and quarter panels stitched together
dictates maximum girth

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14
Q

what are 2 materials the heel counter often made of

A

pressed cardboard
thermoplastic

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15
Q

what are the 3 lower footwear components seen in dress shoes

A

shank
heel
outsole

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16
Q

lower (dress shoes)

what are 3 functions of the shank

A
  1. steel piece that provides rigidity to midsection (not comfortable)
  2. less breakdown of shoe
  3. determines where flexpoint is with activity
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17
Q

lower (dress shoes)

how tall is the heel in mens dress shoes

A

1’’

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18
Q

lower (dress shoes)

what is the outsole often made of

A

leather or hard composite material

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19
Q

lower (dress shoes)

what are the 2 functions of the outsole

A
  1. abrasion resistant
  2. less breakdown
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20
Q

what are the 3 lower footwear components to athletic shoes

A

outsole
midsole
insole/inlay/sockliner

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21
Q

lower (athletic shoes)

what are 4 types of materials the outsole can be made of

A
  1. polyurethane
  2. blown or gum rubber
  3. high density carbon rubber
  4. cleated sole
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22
Q

lower (athletic shoes)

what are the characteristics of high density carbon rubber vs polyurethane blown/gum rubber

A

high density carbon rubber
* abrasion resistant
* most durable
* for high impact sites

polyurethant blown/gum rubber
* lighter
* breaks down faster

usually have a mix of these making up the outsole

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23
Q

lower (athletic shoe)

what format is recommended for a cleated sole

A

12-17 round total
* 8+ in front
* 4+ in rear

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24
Q

lower (athletic shoes)

how has cleated sole recommendations changed and why

A

used to rec 90deg square cleat
* great traction and grip
* but translated load up to knee and saw ligamentous injuries bc lack of give

round ones recommended now

might still see 90deg square today, but prob in track/field bc running in one plane

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25
Q

lower (athletic shoe)

what are the 2 main functions of the midsole

A
  1. attenuate shock at impact
  2. energy return
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26
Q

what dictates the lifespan of the shoe

A

midsole

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27
Q

lower (athletic shoe)

what are the components contributing to midsole energy return

A

EVA (ethylene vinyl acetate)
* variable density
* stiffer

composite
* foam and rubber blend
* softer (more mobility allowed)

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28
Q

lower (athletic shoes)

what are extras that can be added inside the midsole

A

cushioning units (fluid, air, gel)
stabilizing units for motion control (plastic)

not a lot of evidence to support cushion units

29
Q

lower (athletic shoes)

single vs duo density midsole

A

single density (whiter) = cushion, softer
duo density (darker) = stability, durability, stiffness

darker color is a barometer for density

30
Q

lower (athletic shoes)

why is midsole cushioning important

A

improtant to absorb shock
* walking GRF = 1.25xBW
* running GRF = 2-3x BW
* 800-1200 impacts per mile on each leg

31
Q

lower (athletic shoe)

what are the 3 functions of an insole/inlay/sockliner

A
  1. dec friction b/w sock and shoe
  2. absorbs perspiration
  3. dec plantar pressure by inc surface area in contact areas
32
Q

lower (athletic shoe)

why is it good for the insole/inlay/sockliner to be removeable (2)

A

can see construction of shoe
would take it out to put orthotic in

33
Q

lower (athletic shoes)

if you note that a pt has a lot of motion in their foot what is your next move

A

can provide stability w footwear or orthotic
* try a firm shoe first

34
Q

lower (athletic shoes)

how will the outsole/midsole impact foot orthoses (3)

A
  1. firm sole will inc stiffness of orthosis
  2. soft sole will dec stiffness of orthosis
  3. rigid orthosis will lead to faster breakdown of soft sole

needd to consider orthosis and footwear together

35
Q

what is the last

A

shape and construction of the shoe

36
Q

what are the 3 types of shapes to a last

A
  1. straight
  2. semi-curved
  3. curved
37
Q

who is a straight last more appropriate for and why

A

pronated foot
more stable

38
Q

who is a semi-curved last more appropriate for

A

neutral or pronated foot type

most common

39
Q

who is a curved last more appropriate for and why

A

supinated
less stable

40
Q

what is the goal of the shape of the last

A

to model the shape of the foot

41
Q

what is the construction of the last

A

method of attaching upper to lower

42
Q

what are the 3 main types of last constructions

A
  1. board
  2. slip (central or peripheral)
  3. combination
43
Q

what are the 2 components which contribute to dress shoes being so rigid and uncomfortable

A

board and shank

44
Q

last construction (board)

board location
function
type of shoe

A

runs from rearfoot to toes
* upper cemented to insole board

stabile shoe, more rigid
* limited flexibility in forefoot

seen in dress shoes

45
Q

last construction (slip)

central vs peripheral

A

central: upper stitched together to form slipper

peripheral: upper stitched to felt material
* “more stiffness than central”

he doesn’t buy that peripheral is much more stiff than central
* yes something but it is a thin piece of felt so isn’t changing things too drastically

46
Q

last construction (combination)

structure
function
who is this appropriate for

A
  • board last to forefoot
    • (making rearfoot more firm)
  • stitched to toe box

ideal for motion control
increases stability

aggressive pronators

47
Q

what is an important consideration if prescribing shoe based on foot type

A

this is oversimplistic
* need to look at LE kinetic chain and do biomechanical assessment
* need to address proximal issues

48
Q

what are the 4 types of running shoes and their respective function

A

neutral
* cushion

stability
* support to control pronation

motion control
* added support for maximal pronation control

minimal
* minimal bulk, no heel built in
* 0mm RF - FF drop (most shoes will have slight heel lift)

49
Q

what are components for proper fitting

A

time of day - mid day ideal
* morning = short
* evening = splayed

allow 1 thumb breadth of space b/w tip of longest toe and end of shoe

laces should be parallel when shoe is fully laced

50
Q

what are 3 ways to assess for defects

A

glue/cement/stitching should appear durable
* where you see most break down

heel of shoe should be perpendicular when placed on firm surface
* shouldn’t rock, stay flat on table

when pressure applied to toe and heel of shoe, the shoe should break at toes

51
Q

what are 4 tips for running shoe care

A
  1. always untie shoes when taking them off
  2. avoid running in wet shoes
  3. don’t wash shoes in clothes washer or in dryer
  4. may be appropriate to have 2 pairs
52
Q

what are the 2 factors that break down the shoe the most

A

water and heat

53
Q

why should you avoid running in wet shoes

A

wet midsole loses 50% of shock absorption

54
Q

what is the thought behind having 2 pairs of running shoes

A

footwear doesn’t have same shockwear capability if you run every day
* alternate shoes b/w days

he doesn’t know how much he buys this unless you are a pro runner

55
Q

what are the 2 main points guiding replacement considerations

A

integrity of midsole
hoke’s law for mileage

56
Q

what 4 factors into the integrity of the midsole when considering a replacement

A

body weight
#of miles (inc impact = inc heat buildup)
running style
running surface and environment

heat and moisture are what wears out the midsole

57
Q

what is hoke’s law

A

75,000 / BW = miles

that is the amt of miles those shoes would last
* if running more miles, drop the number
* if running outside, drop down
* running style - factor that in

this is a good place to start
tell pts to keep track of when buy shoes and how far they run, if start getting sx - maybe time to replace

58
Q

heel strike vs forefoot strike

A

cushioning in shoes is what allows for heel strike
* high rate of loading = “impact peak”
* rate of loading is faster

forefoot strike is more gradual
* this is the running form seen when you run barefoot

59
Q

why can’t you run w a heel strike unless you have running shoes on and why was this thought to be significant

A

without shoes, a heel strike form would have you be banging into the calcaneus

thought that running shoes cause running issues bc impacting the mechancis of the runner

60
Q

what is different about the forefoot strike pattern when barefoot

A

changes shock absorption from RF motion to GS-complex working eccentrically to absorb the load
* takes a lot of strength
* allows body to adjust and absorb forces evenly

61
Q

what type of running form is seen when you run barefoot

A

fore foot strike

62
Q

what is concerning ab limited subtalar motion and heel strike

A

when hit ground, first thing is calcaneal eversion –> unable to absorb it

63
Q

how does a heel vs forefoot strike change the stride mechanics

A

forefoot = leg underneath you
heel = breaking component w leg in front

64
Q

what is important about a gradual transition (~6mo) from heel strike to forefoot strike

A

need to get GS-complex stronger bc forefoot strike takes a lot of eccentric strength
* when gastroc not strong enough, see achilles problems

65
Q

does barefoot reduce injuries?

A

the form is the most important!

(barefoot forces you to run w better form)

66
Q

what are 4 components to preventing injuries thru improving form

A
  1. gradual retraining gait
  2. avoid over striding
  3. inc stride frequency
  4. maintain upright body posture
67
Q

what happens biomechanically as a result of shortening your stride

A

inc stride frequency, get more vertical force w leg underneath you

68
Q

can shoes make your feet lazy? how do we combat this?

A

some people’s feet can become reliant on footwear

have them train balance and things barefoot in PT, so they can work on foot strength
* toe yoga, intrinsic strengthening

little babies should walk around without shoes to build up intrinsics

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