wk 12- footwear on gait Flashcards
look at topics in PODMED1
purpose of running shoes
- decrease injury
- increase performance
design parameters (5)
- cushioning
- longitudinal bending stiffness
- Heel-toe drop
- Heel flare
- Minimal vs conventional shoes
cushioning, what is it
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
longitudinal bending stiffness
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
effects of heel toe drop
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
heel flare
- 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
theory of barefoot running
with shoe you increase moment arm and increase pronation of ankle
minimal and conventional running shoe differences
minimalist shoes compared to conventional
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
rearfoot strike pattern
Foot is DF and slightly inverted at IC
Contact point of the shoe is on lateral border of heel
forefoot strike pattern
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
TSP barefoot walking vs shoes
reduced step/stride length
increased cadence
flatter foot
increased knee flexion
reduced peak vertical GRF at initial contact
and more in slides
design parameters affecting gait 5
- Heel height
- Rocker sole
- Heel bevel
- Insole contours/cushioning
- Sole hardness
heel height
- 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
rocker sole
- 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
rocker sole can be a therapy for who?
frist MTP joint OA
reduced cadence
reduced hip ROM
reduced peak pressures under MTP joints
heel bevel
- 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)
Insole contour/cushioning
- 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
sole hardness
- 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
textured insoles can help with what
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
harder/thinner midsoles do what
improve balance and postural control
softer/thicker midsoles do what
may reduce proprioception (joint position sense)
is barefoot walking or shod walking better for falls?
appears that wearing shoes
increases walking stability
* Falls prevention guidelines suggest
shoes with flat, thin soles
effect of footwear on children
- 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
