wk 12- footwear on gait

Question 1

look at topics in PODMED1

Question 2

purpose of running shoes

Answer 2

1. decrease injury
2. increase performance

Question 3

design parameters (5)

Answer 3

1. cushioning
2. longitudinal bending stiffness
3. Heel-toe drop
4. Heel flare
5. Minimal vs conventional shoes

Question 4

cushioning, what is it

Answer 4

Attenuating impact force peak or loading rate
* Thought to reduce impact-related injuries
* BUT evidence does not support any link
between injury and high impact peaks/high
loading rates
* The body has it’s own spring-like mechanisms to
absorb the impact of landing (Kelly et al. 2016)
* Hip, knee flexion, ankle DF + compression of
the longitudinal arch

-in research it was found that runners stiffen up and engage muscles more

Question 5

longitudinal bending stiffness

Answer 5

Increase in midsole stiffness relates to running performance:
* Reduced energy lost at MPJ (more effective lever)
* Increased stride length and contact time
* Improved running economy, especially at higher speeds
* Improved running economy when a ‘curved plate’ added
* Note: shoe mass needs to be taken into account

Question 6

effects of heel toe drop

Answer 6

Shoes with increased pitch were found to affect kinematics:
* Increase knee adduction, knee excursion, knee flexion at midstance, and stance time,
* Decrease tibial acceleration, initial ankle plantarflexion and initial knee
extension angle

Question 7

heel flare

Answer 7

• Midsole flare was thought to have an effect
  on how quickly the rearfoot pronates
  during loading response
• Effects of heel flare not supported by
  research

Question 8

theory of barefoot running

Answer 8

with shoe you increase moment arm and increase pronation of ankle

minimal and conventional running shoe differences

Question 9

minimalist shoes compared to conventional

Answer 9

Compared to conventional shoes, minimalist shoes have been shown to:
* Improve running economy
* Increase cross-sectional area and stiffness of Achilles tendon
* Encourage midfoot/forefoot strike pattern
* Anterior shift of CoP
* Greater loading at ankle and MPJ
* Smaller knee loading

Question 10

rearfoot strike pattern

Answer 10

Foot is DF and slightly inverted at IC
Contact point of the shoe is on lateral border of heel

Question 11

forefoot strike pattern

Answer 11

Foot lands in PF and inversion (> INV than RF strike pattern)
Then DF and eversion as the heel lowers
Eversion excursion and velocity may be greater than RF strike
pattern due to > INV

Question 12

TSP barefoot walking vs shoes

Answer 12

reduced step/stride length
increased cadence
flatter foot
increased knee flexion
reduced peak vertical GRF at initial contact

and more in slides

Question 13

design parameters affecting gait 5

Answer 13

1. Heel height
2. Rocker sole
3. Heel bevel
4. Insole contours/cushioning
5. Sole hardness

Question 14

heel height

Answer 14

• Walking speed decreases with increasing heel height
• Utilised coefficient of friction during walking increases with shoe heel height,
  thereby increasing the risk of slips and falls
• Peak joint moments increased as heel height increased
• Increased internal abduction moment at the knee = greater medial knee loading
• Authors concluded that wearing high heels may increase risk of medial
  compartment knee OA
  -muscle activity- fibularis longus, soleus and rectus femoris become more active instead of usual mm activity

Question 15

rocker sole

Answer 15

• Varied designs depending upon the therapeutic goal
• Specific shape combined with rigid/stiff sole material
• Can offload heel or forefoot
• Useful for sagittal plane restrictions (e.g. OA or joint arthrodesis)
• Not suitable for patients with gait instability/poor
  balance/falls risk
  -can help with people with bad heel, ankle or toe rockers

Question 16

rocker sole can be a therapy for who?

Answer 16

frist MTP joint OA

reduced cadence
reduced hip ROM
reduced peak pressures under MTP joints

Question 17

heel bevel

Answer 17

• Has the potential to modify impact loads at heel strike
  -increases contact area at heel strike (coefficient of friction increased, good for people at risks of falls too)

Question 18

Insole contour/cushioning

Answer 18

• Insoles are a standard part of the ‘shoe anatomy’ but may vary in thickness, contouring and cushioning properties
• Use of a contoured heel cup has been shown to reduce the loading and deformation of the central portion of the heel pad during gait
  -redistribute load and decrease peak pressures under calc

Question 19

sole hardness

Answer 19

• Increased shoe sole hardness is
  associated with higher plantar
  pressures, thus softer sole materials
  can reduce peak plantar pressures
• No difference in comfort was
  observed by participants in this study

Question 20

textured insoles can help with what

Answer 20

improve proprioceptive feedback in
populations with neuropathy and neurological conditions
Textured insoles compared to barefoot led to reductions in CoP velocity
when standing on foam

Question 21

harder/thinner midsoles do what

Answer 21

improve balance and postural control

Question 22

softer/thicker midsoles do what

Answer 22

may reduce proprioception (joint position sense)

Question 23

is barefoot walking or shod walking better for falls?

Answer 23

appears that wearing shoes
increases walking stability
* Falls prevention guidelines suggest
shoes with flat, thin soles

Question 24

effect of footwear on children

Answer 24

• walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity
• Shoes reduce foot motion and increase the support phases of the gait cycle
• During running, shoes reduce swing phase leg speed, attenuate some shock and encourage a
  rearfoot strike pattern