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Fitria N, Karisa P, Prabowo T, Ramadhan AK, Al Fajar MG, Setiawan, Ibrahim K, Salya A, Susanti RD. The Effect of Anthropometric Shoes on Lactic Acid Reduction in Nurses: A Mixed-Methods Study from Indonesia. J Multidiscip Healthc 2023; 16:4227-4238. [PMID: 38162413 PMCID: PMC10757786 DOI: 10.2147/jmdh.s437177] [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: 08/25/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024] Open
Abstract
Background The mobilization characteristics of nurses' work, such as standing, walking, and transferring patients for a long time, can increase the risk of musculoskeletal disorders. Repetitive activities nurses perform can cause foot problems such as discomfort and insecurity, characterized by increased lactic acid levels. Anthropometric shoes are specifically designed to reduce complaints on nurses' feet. Purpose This study aimed to determine the effect of individual anthropometric shoes on lactic acid levels in nurses at the hospital. Methods This study used a mixed-method study design. This study involved 71 nurses in the quantitative study and 15 nurses in the qualitative study. Nurses in Emergency Room, Central Surgical Installation, Inpatient Room, Intensive Care Unit, and Outpatient Installation were randomly selected using a stratified random sampling technique. The instruments used were the Accutrend Lactacyd tool, demographic questionnaire and interview questionnaire. Bivariate data analysis was using Statistical Package for Social Sciences (SPSS) and qualitative data analysis using thematic analysis. Results This mixed-method study shows that anthropometric shoes can reduce nurses' lactic acid levels. In the quantitative study; there was a significant difference in lactic acid levels of nurses before and after using anthropometric shoes with the average results of measuring lactic acid levels, namely pre-test (22.48 mg/dL) and post-test (16.27 mg/dL), with a p-value (0.000). The qualitative study data revealed positive results related to increased nurse knowledge, positive views on the effect of shoes on nurse performance, and the impact of using anthropometric shoes in providing comfort and safety, such as decreased muscle fatigue and pain. Conclusion The findings of this study highlight the effect of individualized anthropometric shoes on lactic acid levels in nurses in Indonesian hospitals. It is essential to conduct further research and evaluate the results in a broader setting to ensure that anthropometric shoes can directly affect lactic acid levels.
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Affiliation(s)
- Nita Fitria
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Putri Karisa
- Professional Nursing Student, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Tertianto Prabowo
- Department of Physical Medicine & Rehabilitation, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Ahmad Kharisma Ramadhan
- Department of Design Product, Faculty of Art and Design, Bandung Institute of Technology, Bandung, West Java, Indonesia
| | - Muhamad Gustaf Al Fajar
- Professional Nursing Student, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Setiawan
- Department of Basic Medical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia
| | - Kusman Ibrahim
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Aditya Salya
- Department of Management, Faculty of Economic and Business, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Raini Diah Susanti
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
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Kinematic Strategies for Sustainable Well-Being in Aging Adults Influenced by Footwear and Ground Surface. Healthcare (Basel) 2022; 10:healthcare10122468. [PMID: 36553993 PMCID: PMC9777996 DOI: 10.3390/healthcare10122468] [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: 11/01/2022] [Revised: 11/15/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Falls are an inescapable problem influencing the health and threatening the safety of older adults. Exploring the kinematic strategies of aging adults can help reduce the risk of falls. To study kinematic strategies of aging adults in response to footwear (flat shoes, toe spring shoes, rocker sole shoes) and ground surfaces (level ground, grassland and rock road), a 3D motion capture system and subjective stability evaluation, with 14 female participants, were performed. Results indicated that footwear and ground surfaces significantly impacted joint dynamics during walking. Compared with young adults, aging adults tended to adopt a more conservative walking pattern. Wearing different shoes on the three ground surfaces mainly reduced the ROM (range of motion) of the ankle (p < 0.05). By analyzing the objective and subjective results, rocker sole shoes gave aging adults a stronger sense of instability, so they controlled the movement of ankle joint initiatively. When walking on grassland and rock road, aging adults adjusted the movements of hip, knee and ankle joints to maintain gait stability. Aging adults are recommended to strengthen flexibility training of the ankle joint, perform hip adduction and abduction exercises, and wear rocker sole shoes to improve their balance ability and sustainable well-being.
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Orr R, Maupin D, Palmer R, Canetti EFD, Simas V, Schram B. The Impact of Footwear on Occupational Task Performance and Musculoskeletal Injury Risk: A Scoping Review to Inform Tactical Footwear. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710703. [PMID: 36078419 PMCID: PMC9518076 DOI: 10.3390/ijerph191710703] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 05/19/2023]
Abstract
The aim of this scoping review was to investigate the impact of footwear on worker physical task performance and injury risk. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol and registered in the Open Science Framework. Key search terms were entered into five academic databases. Following a dedicated screening process and critical appraisal, data from the final articles informing this review were extracted, tabulated, and synthesised. Of 19,614 identified articles, 50 articles informed this review. Representing 16 countries, the most common populations investigated were military and firefighter populations, but a wide range of general occupations (e.g., shipping, mining, hairdressing, and healthcare workers) were represented. Footwear types included work safety boots/shoes (e.g., industrial, gumboots, steel capped, etc.), military and firefighter boots, sports shoes (trainers, tennis, basketball, etc.) and various other types (e.g., sandals, etc.). Occupational footwear was found to impact gait and angular velocities, joint ranges of motion, posture and balance, physiological measures (like aerobic capacity, heart rates, temperatures, etc.), muscle activity, and selected occupational tasks. Occupational footwear associated with injuries included boots, conventional running shoes, shoes with inserts, harder/stiffer outsoles or thin soles, and shoes with low comfort scores-although the findings were mixed. Occupational footwear was also linked to potentially causing injuries directly (e.g., musculoskeletal injuries) as well as leading to mechanisms associated with causing injuries (like tripping and slipping).
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Sun W, Zhang H, Lv C, Tang L, Tian S. Comparative efficacy of 12 non-drug interventions on non-specific chronic low back pain in nurses: A systematic review and network meta-analysis. J Back Musculoskelet Rehabil 2021; 34:499-510. [PMID: 33896808 DOI: 10.3233/bmr-200147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Many non-drug interventions for decreasing non-specific chronic low back pain (NSCLBP) in nurses have been extensively studied, but the most effective approach is still unclear. OBJECTIVE This systematic review and network meta-analysis evaluated the efficacies of 12 non-drug interventions in reducing NSCLBP in nurses. METHODS PubMed, ScienceDirect, Web of Science, Cochrane, EMBASE, CINAHL, Medline, WANFANG, VIP, China Knowledge Integrated, and SinoMed were searched from their establishment to July 2019. Randomized controlled trials (RCTs) comparing non-drug interventions for NSCLBP in nurses were included and analyzed using Stata v15 statistical software. RESULTS A total of 31 RCTs (n= 7116) and 12 non-drug interventions were included. The first three results with the highest surface areas under the curve ranking area (SUCRAs) were low back exercise plus healthy education, single low back exercise, and yoga (SUCRAs: 79.4%, 76.2%, and 75.1%, respectively). In addition, single yoga was inferior to protective equipment (standardized mean difference [SMD] = 3.88, 95% confidence interval [CI]: 0.92 to 6.84) and multidisciplinary intervention (SMD =-4.06, 95% CI: -7.33 to -0.78). CONCLUSIONS Low back exercise plus health education may be the best approach to reduce NSCLBP in nurses. Considering the heterogeneity, our findings need to be confirmed in future multicenter large sample RCTs in different countries.
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Kong L, Zhou X, Huang Q, Zhu Q, Zheng Y, Tang C, Li JX, Fang M. The effects of shoes and insoles for low back pain: a systematic review and meta-analysis of randomized controlled trials. Res Sports Med 2020; 28:572-587. [PMID: 32954802 DOI: 10.1080/15438627.2020.1798238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this review was to examine the effects of shoes and insoles on low back pain (LBP). Seven electronic databases were searched from their inception to May 2020. The methodological quality of the 14 included studies was assessed by PEDro scale. Quality of evidence was assessed using GRADE. Moderate evidence on the disability questionnaire score (SMD, 0.52; 95% CI, 0.28 to 0.77; P < 0.001) and pain score (SMD, 0.61; 95% CI, 0.36 to 0.85; P < 0.001) of the custom-made orthotics for chronic LBP compared with no orthotics/insoles intervention was found. Meta-analysis results also showed moderate evidence on the disability questionnaire score (SMD, 0.44; 95% CI, 0.05 to 0.82; P =0.03) in patients who wore unstable shoes compared with regular shoes. Pain and life quality scores showed low-quality evidence of unstable shoes for chronic LBP. Custom-made orthotics and unstable shoes can be recommended to patients as a management option of chronic LBP.
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Affiliation(s)
- Lingjun Kong
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine , Shanghai, China.,Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine , Shanghai, China
| | - Xin Zhou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine , Shanghai, China
| | - Qian Huang
- Department of Acupuncture and Tuina, Lianyungang Hospital of Traditional Chinese Medicine , Lianyungang, China
| | - Qingguang Zhu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine , Shanghai, China.,Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine , Shanghai, China
| | - Yu Zheng
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine , Shanghai, China
| | - Cheng Tang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine , Shanghai, China
| | - Jing Xian Li
- School of Human Kinetics, University of Ottawa , Ottawa, Canada
| | - Min Fang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine , Shanghai, China.,Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine , Shanghai, China.,College of Acupuncture and Tuina, Shanghai University of Traditional Chinese Medicine , Shanghai, China
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6
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Bai DY, Yuan ZG, Shao JJ, Zhu T, Zhang HJ. Unstable shoes for the treatment of lower back pain: a meta-analysis of randomized controlled trials. Clin Rehabil 2019; 33:1713-1721. [PMID: 31328545 DOI: 10.1177/0269215519863840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We aimed to perform a systematic review and meta-analysis to compare the treatment effects of unstable shoes and flat shoes on lower back pain patients. DATA SOURCES Literature databases, including PubMed, Web of Science, and EMBASE (up to June 2019), were searched systematically. REVIEW METHODS Two authors independently screened the retrieved records and identified the randomized controlled trials where patients with lower back pain who wore unstable shoes as intervention and wore flat shoes as a control. Relevant data were extracted for meta-analysis using Review Manager 5.3 software. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the pooled outcome evidence levels. RESULTS Five randomized controlled trials and 251 patients were included in the analysis. The meta-analysis results showed that there was a tendency toward a reduction in the Roland-Morris disability questionnaire score (mean difference (MD) -2.16, 95% confidence interval (CI) -4.28 to -0.03, I2 = 53%) and pain score (MD -0.84, 95% CI -1.66 to -0.02, I2 = 84%) in patients wearing unstable shoes compared to those wearing flat shoes. There was no significant difference in the life quality scores between the unstable shoe and flat shoe groups (MD -0.59, 95% CI -6.18 to 5.01, I2 = 0%). Functional disability and pain scores were determined to have very low-quality evidence, and life quality scores were determined to have low-quality evidence according to the Grading of Recommendations Assessment, Development and Evaluation analysis. CONCLUSION Unstable shoes may be effective in treating lower back pain in the clinic, but the conclusion was limited by the current low-quality studies.
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Affiliation(s)
- Deng-Yan Bai
- Department of Orthopedics, Gansu Second People's Hospital, Lanzhou, P.R. China
| | - Zhi-Guo Yuan
- Department of Orthopedics, Gansu Second People's Hospital, Lanzhou, P.R. China
| | - Jian-Jun Shao
- Department of Orthopedics, Gansu Second People's Hospital, Lanzhou, P.R. China
| | - Tao Zhu
- Department of Orthopedics, Gansu Second People's Hospital, Lanzhou, P.R. China
| | - Hai-Jun Zhang
- Department of Orthopedics, Gansu Second People's Hospital, Lanzhou, P.R. China
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Richardson A, Gurung G, Derrett S, Harcombe H. Perspectives on preventing musculoskeletal injuries in nurses: A qualitative study. Nurs Open 2019; 6:915-929. [PMID: 31367415 PMCID: PMC6650664 DOI: 10.1002/nop2.272] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 03/04/2019] [Indexed: 11/21/2022] Open
Abstract
AIMS AND OBJECTIVES To explore the perspectives of nursing and physiotherapy academics regarding techniques designed to prevent musculoskeletal pain and injury in nurses. BACKGROUND High rates of musculoskeletal injuries are evident in nurses, yet there is an absence of research identifying effective interventions to address this problem. Exploring the perspectives of individuals with specialist knowledge in the area could help identify barriers to musculoskeletal injury prevention, and innovative strategies to investigate in future studies. DESIGN Cross-sectional qualitative descriptive study. METHODS Between October-December 2017, group and individual face-to-face semi-structured interviews were used to collect data. All interviews were audio-recorded. A thematic analysis was performed, with two researchers coding audio files using NVivo software. The Consolidated Criteria for Reporting Qualitative Research Checklist was consulted to ensure complete reporting of all methods and findings. RESULTS Nursing and physiotherapy academics (N = 10) were aware of a range of techniques to prevent musculoskeletal injuries in nurses, including education, equipment, health and safety policy and multi-disciplinary collaboration. However, several barriers to using these techniques were identified, including age, knowledge and availability of equipment, personal and contextual factors, staffing and time pressures. Several strategies were recommended for further investigation and implementation in clinical practice, such as the sharing of personal experiences, orthopaedic assessments and changes to workplaces that foster a culture of safety. CONCLUSIONS Further research is required to reduce musculoskeletal pain and injury among nurses. This research should account for the barriers to current prevention strategies and consider investigating novel interventions. RELEVANCE TO CLINICAL PRACTICE These findings highlight strategies for preventing musculoskeletal injuries among nurses that are likely to be most effective in clinical practice.
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Affiliation(s)
- Amy Richardson
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
| | - Gagan Gurung
- Department of Preventive and Social Medicine, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
| | - Helen Harcombe
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
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Riley SP, Swanson BT, Brismée JM, Sawyer SF, Dyer EJ. Low reproducibility of randomized clinical trials methodology related to sampling: a systematic methodological review. J Man Manip Ther 2019; 27:258-266. [PMID: 30935323 DOI: 10.1080/10669817.2019.1587134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives: The reporting of sampling methods in Randomized Clinical Trials (RCTs) allows for research quality assessment, determination of sampling bias, and assures the presence of details necessary for reproducibility in future trials. The purpose of this study was to: (1) determine if sampling methodology was reproducible in RCTs related to musculoskeletal physical therapy (MSKPT) interventions to treat non-specific low back pain (NSLBP) and (2) establish if there was a relationship between sample reproducibility and established measures of research quality.Methods: Data were collected through a systematic review by a professional librarian. The identified RCTs were assessed for methodological quality by two blinded individual reviewers. Data analysis was performed by a third, blinded researcher; additional comparisons were made based on Journal Impact Factor and PEDro score.Results: Ninety-nine published peer-reviewed RCTs were identified that met inclusion criteria. Only 29% of the articles were judged to be reproducible based on the reported sampling methodology. There were meaningful correlations between two out of ten of the sampling reporting criteria and the judgement made if the sample was reported in significant detail to allow for replication. There was no relationship between sampling reporting criteria, Journal Impact Factors (JIFs), and Physiotherapy Evidence Database (PEDro) scores.Discussion: The reporting of sampling methodology needs to be considered to ensure reproducibility and avoid sampling bias. Despite the proliferation of measures of research quality, the overall reporting quality of RCTs continues to be inadequate to allow widespread reproducibility of trials.Level of Evidence: 1a.
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Affiliation(s)
- Sean P Riley
- Physical Therapy Program, Sacred Heart University, Fairfield, CT, USA
| | - Brian T Swanson
- Department of Physical Therapy, University of New England, Portland, ME, USA
| | - Jean-Michel Brismée
- Department of Rehabilitation Sciences and Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Steven F Sawyer
- Department of Rehabilitation Sciences and Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Elizabeth J Dyer
- Department of Physical Therapy, University of New England, Portland, ME, USA
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Effects of unstable shoes on trunk muscle activity in patients with chronic low back pain. Gait Posture 2018; 64:165-168. [PMID: 29909231 DOI: 10.1016/j.gaitpost.2018.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/24/2018] [Accepted: 06/11/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Unstable shoes were developed as a walking device to strengthen the lower extremity muscles and reduce joint loading. Many studies have reported increased muscle activity throughout the gait cycle in most of the lower limb muscles in healthy adults using these shoes. However, no previous studies have explored the effects of wearing unstable shoes on trunk muscle activity in patients with chronic low back pain (CLBP). Therefore, the aim of the present study was to compare the activity of selected trunk muscles in patients with CLBP during a gait test while walking wearing unstable shoes or conventional flat shoes (control). METHODS Thirty-five CLBP patients (51.1 ± 12.4 y; 26 ± 3.8 kg/m2; 9.3 ± 5.2 Roland Morris Disability Questionnaire score) were recruited from the Orthopedic Surgery Service at the Hospital to participate in this cross-sectional study. All the participants underwent gait analysis by simultaneously collecting surface electromyography (EMG) data from erector spinae (ES), rectus abdominis (RA), obliquus internus (OI), and obliquus externus (OE) muscles, while walking on a treadmill with flat control shoes or experimental unstable shoes. RESULTS The results showed significantly higher %EMG activity in the ES (mean difference: 1.8%; 95% CI: 1.3-2.2), RA (mean difference: 1.5%; 95% CI: 0.3-2.7), and OI (mean difference: 1.5%; 95% CI: 0.2-2.8) in the unstable versus the flat-shoe condition, with a large effect size for the ES (Cohen's d = 1.27). CONCLUSIONS Based on these findings, the use of unstable shoes may be implicated in promoting spine stability, particularly in improving neuromuscular control of the trunk muscles in CLBP treatment.
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Fırıncı B, Pehlivan E, Durmuş GN, Özer A. Hasta Bakıcılarda Bel Ağrısı ve Yaşam Kalitesinin Değerlendirilmesi, Turgut Özal Tıp Merkezi Örneği. ACTA ACUST UNITED AC 2018. [DOI: 10.31832/smj.411881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Richardson A, McNoe B, Derrett S, Harcombe H. Interventions to prevent and reduce the impact of musculoskeletal injuries among nurses: A systematic review. Int J Nurs Stud 2018; 82:58-67. [DOI: 10.1016/j.ijnurstu.2018.03.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/21/2018] [Accepted: 03/21/2018] [Indexed: 11/27/2022]
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Lisón JF, Ortega-Santana B, Antón-Nogués Á, González-Requena P, Vera-Hervás C, Doménech-Fernández J, Sánchez-Zuriaga D, Salvador-Coloma P. Effects and underlying mechanisms of unstable shoes on chronic low back pain: a randomized controlled trial. Clin Rehabil 2018; 32:654-662. [PMID: 29333872 DOI: 10.1177/0269215517753972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effects that wearing unstable shoes has on disability, trunk muscle activity, and lumbar spine range of motion (ROM) in patients with chronic lower back pain (CLBP). DESIGN Randomized controlled trial. SETTING Orthopedic Surgery Service. PARTICIPANTS We randomized 40 adults with nonspecific CLBP either to an unstable shoes group ( n = 20) or to the control group ( n = 20). INTERVENTION The participants in the unstable shoes group were advised to wear these shoes for a minimum of six hours a day for four weeks. Control group participants were asked to continue wearing their regular shoes. OUTCOME MEASURES Our primary outcome was measurement of back-related dysfunction, assessed using the Roland-Morris Disability Questionnaire. Secondary outcomes included changes in electromyographic (EMG) activity of erector spinae (ES), rectus abdominis (RA), internus obliquus (IO), and externus obliquus (EO) muscles, and changes in lumbar spine ROM. RESULTS Between-group analysis highlighted a significant decrease in disability in the unstable shoes group compared to the control (-5, 95% confidence interval (CI) = -8.4 to -1.6). Our results revealed a significant increase in the percentage of RA, ES, IO, and EO EMG activity and in lumbar spine ROM in the unstable shoes group compared to the control group. Moreover, our results showed a significant negative correlation between disability and the percentage of ES, RA, and IO muscle activity at the end of the intervention. CONCLUSION This study shows that the use of unstable shoes contributes to improvements in disability, which are likely related to increased trunk muscle activity and lumbar spine ROM.
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Affiliation(s)
- Juan Francisco Lisón
- 1 Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Borja Ortega-Santana
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Álvaro Antón-Nogués
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Palmy González-Requena
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Cristina Vera-Hervás
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | | | - Daniel Sánchez-Zuriaga
- 4 Department of Human Anatomy and Embryology, Faculty of Medicine and Odontology, Universitat de València, Valencia, Spain
| | - Pablo Salvador-Coloma
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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13
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Svenningsen FP, Kaalund E, Christensen TÅ, Helsinghoff PH, Gregersen NYJB, Kersting UG, Oliveira AS. Influence of anterior load carriage on lumbar muscle activation while walking in stable and unstable shoes. Hum Mov Sci 2017; 56:20-28. [PMID: 29096180 DOI: 10.1016/j.humov.2017.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 09/28/2017] [Accepted: 10/19/2017] [Indexed: 11/19/2022]
Abstract
Load carriage can be harmful for workers, and alternative interventions to reduce back pain while walking and carrying loads are necessary. Unstable shoes have been used to improve balance and reduce back pain, but it is unknown whether walking wearing unstable shoes while carrying loads anteriorly causes excessive trunk extensors muscle activation. The aim of this study was to investigate the effects of different shoe types and anterior load carriage on gait kinematics and lumbar electromyographic (EMG) activity. Fourteen adults that predominantly walk or stand during the work day were asked to walk with and without carrying 10% of body mass anteriorly while wearing regular walking shoes (REG) and unstable shoes (MBT). The effects of shoe type, load carriage, and shoe × load interactions on the longissimus thoracis (LT) and iliocostalis lumborum (IC) EMG, stride duration, and stride frequency were assessed. MBT shoes induced a significant increase in LT (44.4 ± 35%) and IC EMG (33.0 ± 32%, p < .005), while load carriage increased LT (58.5 ± 41%) and IC EMG (55.1 ± 32%, p < .001). No significant shoe × load interaction was found (p>.05). However, walking wearing MBT shoes while carrying loads induced a 46 ± 40% higher EMG activity compared to walking wearing MBT shoes without load carriage. No effects of shoes or load carriage were found on stride duration and stride frequency. It was concluded that walking wearing MBT shoes and carrying 10% of total body mass induced greater activation of trunk extensors muscle compared to these factors in isolation, such a combination may not influence gait patterns.
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Affiliation(s)
| | - Emma Kaalund
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | | | | | - Uwe Gustav Kersting
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Dixon RG, Khiatani V, Statler JD, Walser EM, Midia M, Miller DL, Bartal G, Collins JD, Gross KA, Stecker MS, Nikolic B. Society of Interventional Radiology: Occupational Back and Neck Pain and the Interventional Radiologist. J Vasc Interv Radiol 2016; 28:195-199. [PMID: 27993508 DOI: 10.1016/j.jvir.2016.10.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 10/22/2016] [Accepted: 10/22/2016] [Indexed: 12/16/2022] Open
Affiliation(s)
- Robert G Dixon
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina.
| | - Vishal Khiatani
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina
| | - John D Statler
- Virginia Interventional and Vascular Associates, Fredericksburg, Virginia
| | - Eric M Walser
- Department of Radiology, University of Texas Medical Branch, Galveston, Texas
| | - Mehran Midia
- Department of Interventional Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Donald L Miller
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring
| | - Gabriel Bartal
- Department of Radiology, Meir Medical Center, Kfar Saba, Israel
| | - Jeremy D Collins
- Department of Radiology, Northwestern University, Chicago, Illinois
| | - Kathleen A Gross
- Department of Interventional Radiology, Greater Baltimore Medical Center, Baltimore, Maryland
| | - Michael S Stecker
- Division of Angiography Interventional Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Boris Nikolic
- Department of Radiology, Stratton Medical Center, Albany, New York
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Vieira ER, Brunt D. Does wearing unstable shoes reduce low back pain and disability in nurses? A randomized controlled pilot study. Clin Rehabil 2015; 30:167-73. [PMID: 25780261 DOI: 10.1177/0269215515576812] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 02/18/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate if wearing unstable shoes reduces low back pain and disability in nurses. DESIGN A randomized controlled trial. SETTING Hospitals and homecare. SUBJECTS A total of 20 matched female registered nurses with low back pain. The mean (standard deviation) age was 31 years (5) for the control and 34 years (6) for the intervention group; height was 161 cm (5) and 165 cm (7), respectively. INTERVENTIONS The intervention group received unstable shoes at Week 2 to wear for at least 36 h/week for a month. MAIN MEASURES The Oswestry Low Back Pain Disability Questionnaire and a visual analogue pain scale. RESULTS The mean (standard deviation) pain level was 6 (1) at baseline vs. 6 (2) at Week 6 for the control group, and 5 (1) vs. 1 (1) for the intervention group. The mean (standard deviation) disability level was 31% (9) at baseline vs. 28% (7) at Week 6 for the control, and 27% (12) vs. 13% (5) for the intervention group. There were no significant changes over time on pain or disability levels for the control group. The intervention group reported lower levels of pain on Weeks 4 (mean difference ⩾-1.4, p ⩽ 0.009) and 6 (mean difference ⩾-3.1, p < 0.001). Disability levels were also lower on Weeks 4 (mean difference = -4.5%, p NS) and 6 (mean difference = -14.1%, p = 0.020). CONCLUSIONS Wearing unstable shoes reduced low back pain and disability in nurses and might be helpful as part of the back pain rehabilitation process.
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Affiliation(s)
- Edgar R Vieira
- Department of Physical Therapy, Florida International University, Miami, FL, USA Department of Neuroscience, Florida International University, Miami, FL, USA
| | - Denis Brunt
- Department of Physical Therapy, Florida International University, Miami, FL, USA
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