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Zhang X, Vanwanseele B. Immediate effects of forefoot wedges on multi-segment foot kinematics during jogging in recreational runners with a symptomatic pronated foot. Front Physiol 2023; 13:1064240. [PMID: 36699670 PMCID: PMC9868581 DOI: 10.3389/fphys.2022.1064240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
Background: Foot orthoses (FOs) have been used to alter lower limb kinematics and kinetics in pronated feet. A clear relationship between FOs' features, e.g., the amount of wedging and support, and the corresponding biomechanical responses is vital for the design and prescription of FOs. In this study, we sought to determine if changing the level of the forefoot wedge would cause a linear response in the multi-segment foot kinematics during jogging, and if this effect would be enhanced by an arch support. Methods: Ten pairs of 3D printed FOs with five levels of forefoot wedges and two levels of arch supports were tested on 12 recreational runners with a symptomatic pronated foot. Multi-segment foot kinematic data during jogging was measured using the Oxford Foot Model. Two-way ANOVAs were performed to examine the main effect of the forefoot wedge and arch support, as well as their interaction on peak joint angles. Statistical parametric mapping and paired-t tests were used to identify differences in the foot kinematic traces and the joint range of motion (ROM) between each FO and the control, respectively. Results: Linear main effects for the forefoot wedge level were found in the forefoot peak dorsiflexion, eversion and rearfoot peak dorsiflexion of jogging. FOs with a medial forefoot wedge caused an average of 2.5° reduction of the forefoot peak abduction during jogging. Furthermore, forefoot wedges showed an opposite effect on the sagittal ROM of the forefoot and rearfoot. Adding an arch support did not improve the kinematic performance of a forefoot wedge during jogging. Conclusion: This study highlights a linear dose-response effect of a forefoot wedge on forefoot kinematics during jogging, and suggests using a medial forefoot wedge as an anti-pronator component for controlling forefoot motion of a pronated foot.
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Affiliation(s)
- Xianyi Zhang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, China,Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China,*Correspondence: Xianyi Zhang,
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Simonsen MB, Cancino EE, de Brito Silva P, Sørensen LB, Hirata RP, Christensen SWM. The impact of prolonged experimental neck pain on walking stability and gait kinematics - A parallel-group study. Clin Biomech (Bristol, Avon) 2023; 101:105869. [PMID: 36584579 DOI: 10.1016/j.clinbiomech.2022.105869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Neck pain is a common problem in the general population, and movement adaptations are a natural response to pain. Previous studies have reported reduced trunk rotation during walking in those suffering from clinical neck pain. However, it is unknown how soon after the onset of pain, movement adaptations are adopted. This study investigated the effect of prolonged experimental neck pain four days after pain onset on gait kinematics during walking. METHODS Forty healthy participants were randomized to receive injections of nerve-growth-factor or a control injection of isotonic saline into the right splenius capitis muscle at the end of days 0 and 2. Participants performed two walking tasks, walking and walking while reading on a smartphone, on days 0, 4, and 15. Gait kinematics, spatiotemporal parameters, and gait stability were measured using Xsens Awinda. FINDINGS The nerve-growth-factor group reported increased neck pain intensity (median VAS 17.5 [IQR: 2.75-25.75]) on day 4 compared to day 0 and day 15. No pain intensity changes between days were reported for the isotonic-group. For gait kinematics, a main effect of the task was identified, showing that during the smartphone condition, participants had shorter stride lengths and reduced RoM for the trunk, hip, knee, and ankle compared to normal waking (P < 0.006). INTERPRETATION Walking while reading on a smartphone, but not mild neck muscle pain, caused changes in the gait kinematics compared to normal walking without neck pain. This finding suggests that movement alterations during walking are not an early feature of prolonged experimental neck pain.
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Affiliation(s)
| | - Edith Elgueta Cancino
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; Center of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Priscila de Brito Silva
- Center of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Line Bay Sørensen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Steffan Wittrup McPhee Christensen
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Simonsen MB, Næsborg-Andersen K, Leutscher PDC, Hørslev-Petersen K, Woodburn J, Andersen MS, Hirata RP. The effect of foot orthoses on gait biomechanics and pain among people with rheumatoid arthritis: A quasi-experimental study. Gait Posture 2022; 95:121-128. [PMID: 35487019 DOI: 10.1016/j.gaitpost.2022.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/24/2022] [Accepted: 04/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Foot pain is frequent among people with rheumatoid arthritis (RA). Foot orthoses (FO) are commonly prescribed with the intention to reduce pain symptoms and improve function. RESEARCH QUESTION How do a custom-made FO affect pain, gait biomechanics and daily activity among people with RA? METHODS Twenty-five participants with RA and foot pain completed this quasi-experimental study using a control insole for four weeks and then a custom-made FO in the following four weeks. The foot orthoses were customized by plantar foot shape targeting optimal restoration of normal arch height. A visual analog scale was used to monitor changes in ankle/foot, knee, hip joints, and global arthritis pain. In addition, the perceived pain area was measured using a body chart analysis. Kinematics and kinetics of the hip, knee and ankle joints during gait were analyzed using 3D-motion capture. Daily steps were measured with a wrist-based activity tracker for both the control insole and custom-made FO period, respectively. RESULTS In comparison to the control insole, the custom-made FO reduced ankle/foot pain intensity (p < 0.001) in addition to a reduction of the perceived pain areas in the feet (p < 0.001), legs (p = 0.012), as well as the arms and hands (p = 0.014). Ankle plantar flexion and eversion moments were also reduced (p < 0.001). No difference in daily steps was observed between the two periods (p = 0.657). SIGNIFICANCE This study has demonstrated an ankle/foot pain-relieving effect in conjunction with alterations of the ankle joint moments in people with RA using custom-made FO. The pain relief is plausibly attributed to alterations of the ankle joint moments when using the custom-made FO. However, future studies are needed to explore further into therapeutic implication of custom-made FO in pain management of people with RA.
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Affiliation(s)
- Morten Bilde Simonsen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark; Department of Materials and Production, Aalborg University, Aalborg, Denmark
| | | | - Peter Derek Christian Leutscher
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Kim Hørslev-Petersen
- Danish Hospital for Rheumatic Diseases, University of Southern Denmark, Sønderborg, Denmark
| | - James Woodburn
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | | | - Rogerio Pessoto Hirata
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
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Kramer PA, Feuerriegel EM, Lautzenheiser SG, Sylvester AD. Sensitivity of musculoskeletal models to variation in muscle architecture parameters. EVOLUTIONARY HUMAN SCIENCES 2022; 4:e6. [PMID: 37588892 PMCID: PMC10426084 DOI: 10.1017/ehs.2022.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Musculoskeletal models, like all theoretical models of physical processes, depend on the assumptions needed to construct the model. For musculoskeletal models, these assumptions include, among other things, the kinematic data, the kinetic data and the muscle parameters. The former (dynamic) data can be acquired relatively easily from living subjects, but the latter are usually based on limited information, frequently determined from cadaver studies performed on elderly individuals. Previously, we determined the sensitivity of forces to dynamic differences among 10 humans walking on a straight path. Here, we assess the sensitivity of the muscle and joint reaction forces developed in human walking to variable muscle parameters obtained from 10 living adults, whose data were recently reported, and compared the results with the values from a standard model that depends on cadaveric data. We found that, while the force patterns across the stance cycle were similar among muscle parameter models, differences of as much as 15% in the force magnitude were produced. Whether or not the variation between the standard model and other muscle parameters is important depends on why the forces are required.
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Affiliation(s)
- Patricia Ann Kramer
- Department of Anthropology, University of Washington, Denny Hall, Seattle, WA98195, USA
| | - Elen M. Feuerriegel
- Department of Anthropology, University of Washington, Denny Hall, Seattle, WA98195, USA
- Evolutionary Studies Institute, University of Witwatersrand, Private Bag 3, Wits, 2050, South Africa
| | - Steven G. Lautzenheiser
- Department of Anthropology, University of Washington, Denny Hall, Seattle, WA98195, USA
- Department of Anthropology, The University of Tennessee, Knoxville, Strong Hall, Knoxville, TN37996, USA
| | - Adam D. Sylvester
- Center for Functional Anatomy and Evolution, The Johns Hopkins University School of Medicine, 1830 E. Monument Street, Baltimore, MD21205, USA
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Kelly ES, Worsley PR, Bowen CJ, Cherry LS, Keenan BE, Edwards CJ, O'Brien N, King L, Dickinson AS. Predicting Forefoot-Orthosis Interactions in Rheumatoid Arthritis Using Computational Modelling. Front Bioeng Biotechnol 2022; 9:803725. [PMID: 35004656 PMCID: PMC8733946 DOI: 10.3389/fbioe.2021.803725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
Foot orthoses are prescribed to reduce forefoot plantar pressures and pain in people with rheumatoid arthritis. Computational modelling can assess how the orthoses affect internal tissue stresses, but previous studies have focused on a single healthy individual. This study aimed to ascertain whether simplified forefoot models would produce differing biomechanical predictions at the orthotic interface between people with rheumatoid arthritis of varying severity, and in comparison to a healthy control. The forefoot models were developed from magnetic resonance data of 13 participants with rheumatoid arthritis and one healthy individual. Measurements of bony morphology and soft tissue thickness were taken to assess deformity. These were compared to model predictions (99th% shear strain and plantar pressure, max. pressure gradient, volume of soft tissue over 10% shear strain), alongside clinical data including body mass index and Leeds Foot Impact Scale–Impairment/Footwear score (LFIS-IF). The predicted pressure and shear strain for the healthy participant fell at the lower end of the rheumatoid models’ range. Medial first metatarsal head curvature moderately correlated to all model predicted outcomes (0.529 < r < 0.574, 0.040 < p < 0.063). BMI strongly correlated to all model predictions except pressure gradients (0.600 < r < 0.652, p < 0.05). There were no apparent relationships between model predictions and instances of bursae, erosion and synovial hypertrophy or LFIS-IF score. The forefoot models produced differing biomechanical predictions between a healthy individual and participants with rheumatoid arthritis, and between individuals with rheumatoid arthritis. Models capable of predicting subject specific biomechanical orthotic interactions could be used in the future to inform more personalised devices to protect skin and soft tissue health. While the model results did not clearly correlate with all clinical measures, there was a wide range in model predictions and morphological measures across the participants. Thus, the need for assessment of foot orthoses across a population, rather than for one individual, is clear.
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Affiliation(s)
- Emily S Kelly
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Peter R Worsley
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Catherine J Bowen
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Lindsey S Cherry
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Bethany E Keenan
- Cardiff School of Engineering and Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, United Kingdom
| | | | - Neil O'Brien
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Leonard King
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Alex S Dickinson
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
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