Symmetry of plantar pressures and vertical forces in healthy subjects during walking

The purpose of this study was to determine the degree of symmetry for in-shoe plantar pressure and vertical force patterns between the left and right feet of healthy subjects during walking. Thirty subjects with a mean age of 29.6 years participated in the study. Each subject walked a distance of 8 m three times while in-shoe plantar pressure and vertical force data were collected. A total of 12 steps were analyzed for both feet, and maximum vertical force, peak pressure, and pressure-time integrals were calculated for four plantar regions of the foot. No differences in the three variables were noted between male and female subjects. Plantar pressure and vertical force patterns were found to be symmetrical between the left and right feet, except for two of the four plantar regions studied. Only the forefoot and rearfoot regions were found to show significant differences between the left and right feet for plantar pressure and vertical force, respectively. The degree of asymmetry for these two plantar regions in the same foot, however, was minimal.

The distribution of plantar pressures in American Indians with diabetes mellitus

The primary purpose of this study was to determine the magnitude and duration of plantar pressures acting on the feet of American Indians with diabetes mellitus. A secondary purpose was to determine whether differences in the range of motion of the ankle and first metatarsophalangeal joints existed between American Indians with and without diabetes. Three groups of American Indian subjects were tested: a control group (n = 20); a group with diabetes but no peripheral neuropathy (n = 24); and a group with diabetes and peripheral neuropathy (n = 21). A floor-mounted pressure sensor platform was used to collect plantar pressure data while subjects walked barefoot. The results indicated that American Indians with diabetes have 1) a pattern of peak plantar pressure similar to patterns previously reported for non-American Indians with diabetes and 2) a reduction in ankle and first metatarsophalangeal joint range of motion in comparison with nondiabetic American Indians.

Athletic footwear: design, performance and selection issues

The purpose of this paper is to assist the practitioner in understanding the various advantages and disadvantages associated with the use of athletic footwear. In addition, the various components of a typical athletic shoe are described, including the upper, the midsole/outsole, the last, as well as the lasting process. Since the various models of athletic shoes that are available to the consumer can change in a very rapid and unpredictable manner, it is extremely difficult for the clinician to maintain a database of current shoe models and features. This paper stresses the importance of the clinician providing the athlete a list of footwear features and components based on their particular foot classification or problem, rather than attempting to recommend a specific model of athletic shoe. A detailed explanation of these features is provided to assist the practitioner in helping the athlete select the most appropriate shoe.

Velocity of the center of pressure during walking

The purpose of this study was to describe the velocity of the center of pressure during walking in a sample of young, healthy individuals. The velocity of the center of pressure was recorded in 60 subjects while they walked barefoot over a floor-mounted pressure platform. The results of this study indicate that the velocity of the center of pressure follows a predictable pattern during the stance phase of walking. Intraclass correlation coefficients calculated to measure between-trial reliability for specific parameters of the velocity of the center of pressure ranged from 0.361 to 0.912. These study results suggest that velocity of the center of pressure may be a useful measurement in future gait research.

The effect of foot orthoses on transverse tibial rotation during walking

The purpose of this study was to determine the effectiveness of two types of foot orthoses in controlling the magnitude and rate of internal tibial rotation, measured by the tibial pointer device, during walking. Ten subjects between the ages of 23 and 43 years volunteered to participate in the study. Prior to data collection, each subject was issued two types of foot orthoses: a pair of rigid, plastic orthoses with posting in either the forefoot or the rearfoot, and a pair of soft, accommodative, premolded orthoses with no posting. All subjects wore standardized footwear. Following a controlled break-in period for both footwear and orthoses, each subject was asked to walk at a self-selected speed over a 12-m walkway while the movement of internal tibial rotation was recorded with a video camera during five trials. The results indicated that both the rigid plastic and the accommodative foot orthoses significantly reduced the magnitude and the rate of internal tibial rotation. No significant difference was noted between the soft and rigid foot orthoses conditions.

Plantar fasciitis: etiology and treatment

Plantar fasciitis is a common pathological condition of the foot and can often be a challenge for clinicians to successfully treat. The purpose of this article is to present and discuss selected literature on the etiology and clinical outcome of treating plantar fasciitis. Surgical and nonsurgical techniques have been used in the treatment of plantar fasciitis. Nonsurgical management for the treatment of the symptoms and discomfort associated with plantar fasciitis can be classified into 3 broad categories: reducing pain and inflammation, reducing tissue stress to a tolerable level, and restoring muscle strength and flexibility of involved tissues. Each of these treatments has demonstrated some level of effectiveness in alleviating the symptoms of plantar fasciitis. Previous studies have grouped all forms of nonsurgical therapy together. It is, therefore, difficult to determine if one type of treatment is more effective compared with another. Until such research is available, the clinician would be wise to include treatments from all 3 categories.

Variability of plantar pressure data. A comparison of the two-step and midgait methods

The number of trials required to obtain a reliable representation of the plantar pressure pattern is an important factor in the assessment of people with insensate feet or the use of plantar pressure data as a basis for fabrication of foot orthoses. Traditionally, the midgait method has been used for the collection of pressure data, but the large number of walking trials required by this method can increase the risk of injury to the plantar surface of the insensate foot. As a result, the two-step method of plantar pressure data collection has been advocated. The purpose of this investigation was to determine the degree of variability in regional plantar pressure measurements using the midgait and two-step methods of data collection. Plantar pressure data were collected from ten volunteers (five men and five women) between the ages of 20 and 35 years in 20 trials using both data-collection protocols. The results of the study indicate that three to five walking trials are needed to obtain reliable regional peak pressure and pressure-time integral values when the two-step data-collection protocol is used. Although either method can be used for pressure data collection, one method should be used consistently when repeated assessments are required.

Relative movement of the navicular bone during normal walking

The purpose of this study was to determine the pattern and magnitude of navicular bone (NB) movement during walking as well as the relationship between dynamic NB and rearfoot movement. The angle of rearfoot and displacement of the NB was recorded in 106 subjects using the 6D Research electromagnetic tracking system. The relative change in the height of the NB between foot flat and heel-off was 7.9 mm. The NB seems to undergo significant vertical as well as medial displacement during the stance phase of normal walking. This motion is also correlated with rearfoot motion during walking.

Effect of ankle dorsiflexion range of motion on rearfoot motion during walking

The purpose of this study was to investigate whether the amount of ankle passive dorsiflexion range of motion influences the pattern of frontal plane rearfoot motion during walking. Three-dimensional motion of the rearfoot was measured in two groups of subjects, those with ankle passive dorsiflexion range of motion less than or equal to 10 degrees, and those with ankle passive dorsiflexion range of motion greater than 15 degrees, while they walked along a 6.1-m walkway. The results indicated that the only statistically significant differences between the two groups were in the time to reinversion of the rearfoot and the time to heel-off. Slight-to-moderate limitation of ankle passive dorsiflexion range of motion significantly alters the timing, but not the magnitude, of frontal plane rearfoot motion during walking.

Three-dimensional movement of the foot during the stance phase of walking

This study presents research on typical movement of the rearfoot during walking. The data demonstrate the global nature of foot pronation and supination during gait. Study participants (N = 153) walked along a walkway while the angular displacement of the calcaneus, navicular, and first metatarsal relative to the tibia was measured; three-dimensional movement patterns for all three bones were very similar. This study provides additional information on how the foot functions during walking. This information should help to define and refine clinical management strategies for treating foot dysfunction.

Variability of the center of pressure pattern integral during walking

The objective of this study was to measure the between-trial variability of the center of pressure pattern integral (COPPI) at the shoe-floor interface and within the shoe. Ten trials of the COPPI were recorded simultaneously at the shoe-floor interface and within the shoe as ten subjects walked over ground in standardized footwear and with two types of foot orthoses. While the results showed that the within-shoe shoe-only and soft orthoses conditions caused the greatest decrease in the COPPI, it was extremely inconsistent-between trials, whether measured at the shoe-floor interface or within the shoe. This suggests that the COPPI is not an acceptable method of assessing the effectiveness of foot orthoses.

A comparison of two motion analysis systems for the measurement of two-dimensional rearfoot motion during walking

The purpose of this study was to compare two-dimensional rearfoot motion during walking measured by a traditional video-based motion analysis system to that of an electromagnetic analysis system. Twenty-five individuals (15 men, 10 women) with a mean age of 29.8 years served as subjects for this study. The results of the study showed that there was a high correlation (r = 0.945) between the mean motion paths produced by the two systems, indicating that they were very similar. The electromagnetic motion analysis system was able to produce these similar results in a fraction of the time required by the video-based system.

The effect of foot orthotics on the initiation of plantar surface loading

INTRODUCTION:: Little information exits concerning the effect, if any, foot orthoses have upon how the foot is loaded during normal walking. The purpose of this study was to determine if there was a difference in the initiation of forefoot loading with different densities of foot orthoses. METHODS:: Ten volunteers (5 men, 5 women) between the age of 23 and 43 years (mean=30.3 yrs) participated in this study. None of the subjects had a history of congenital deformity, hallux valgus, malleolar torsion or a history of injury or pain to either lower extremity 12 months prior to the start of the investigation. Two different pair of foot orthoses were provided to each subject in the study. One pair consisted of UCO-BKS medium width foot orthoses with a durometer rating of 55-60 (Shore A gauge). Forefoot and/or rearfoot wedging was applied to these orthoses if indicated from a physical examination. This orthotic condition was labeled RIGID. The second pair consisted of UCO-BF foot orthoses with a durometer rating of 30-35 (Shore A gauge). This orthotic condition was labeled SOFT. In addition to the foot orthoses, each of the 10 subjects were fitted with the same type of footwear (Reebok Boston Road). Following a 'break-in' period for the footwear and orthotics, each subject walked along a 12 m walkway with the EMED PEDAR insole placed inside their shoes. A total of 10 consecutive walking trials were collected at each subject's self-selected speed. Using the NOVELWin MASKS program, the plantar surface of the forefoot was divided into 3 different areas, Lateral, Central and Medial. The time of initiation of loading for each of these masks was then determined. Reliability of the loading initiation times was determined using type (2,1) intraclass correlation coefficients. Differences between the three forefoot areas were determined using a one-way, repeated measuresANOVA and Tukey's post hoc analysis, if indicated. An alpha level of 0.05 was used for all tests of statistical significance. RESULTS:: The ICC values for the initiation of loading in the forefoot were in excess of.936. The result of theANOVA test revealed that the medial forefoot is loaded significantly earlier with a RIGID foot orthotic compared to either the SHOE ONLY or SOFT foot orthotic condition. This earlier loading caused a reversal of the normal loading sequence of plantar pressure in the forefoot during walking. DISCUSSION:: Previous studies have reported that approximately 10 degrees of forefoot movement, independent to hindfoot motion occurs during the loading response of walking. An additional 3 degrees has been shown to occur from the end of the loading response to mid-stance. It would appear from the findings of this study that rigid orthoses prevent this normal independent movement between the forefoot and hindfoot, since the rigid orthoses cause earlier loading of the medial forefoot. The soft orthoses permitted the same lateral to medial forefoot loading pattern also observed in barefoot walking. CONCLUSION:: The results of this study indicate that the use of a rigid foot orthosis inside a shoe, alters the timing of forefoot loading during walking. These findings suggest that the use of soft orthoses permit a more normal forefoot to hindfoot movement pattern during the loading phase of walking.

The variability of the centre of pressure pattern

INTRODUCTION:: The centre of pressure pattern (COPP), or force line, has been used to describe abnormal foot movement during gait and as a method to assess foot orthoses effectiveness. The purpose, therefore, of this study was to measure the between-trial variability of the COPP as well as explore possible differences between shoe-floor and within-shoe measurements. METHODS:: Ten healthy individuals from a pool of 110 volunteers were selected for this study based upon their willingness to participate and the presence of a forefoot and/or rearfoot valgus or varus deformity. An EMED-SF pressure platform was used to collect COPP data at the shoe-floor interface. The EMED PEDAR insole pressure system was used to collect COPP data within-the-shoe. Ten trials of COPP were recorded simultaneously using the two systems as the subjects walked over ground in standardized footwear and two different types of foot orthoses. The footwear used consisted of the Reebok Boston Road running shoe. The two types of orthoses studied were a rigid orthotic with forefoot and/or rearfoot posts and soft orthotic without any posts. Quantification of the COPP was achieved by calculating its absolute integral. RESULTS:: The result of a one-way repeated measuresANOVA and subsequent post-hoc analysis showed that the rigid orthoses condition was significantly different from the soft orthoses or no orthosis conditions. Analysis of the between-trial reliability for COPP integral calculation, however, indicated that there was 43.4 to 48.6% variability. The intraclass correlation coefficients were found to be less than 0.504. DISCUSSION:: While the results showed that the within-shoe shoe only condition and the soft orthoses condition caused the greatest decrease in the COPP integral, the COPP integral was extremely inconsistent, whether measured at the shoe-floor interface or within-the-shoe. CONCLUSION:: The results of this investigation indicate that COPP is highly variable when measured either at the shoe-floor interface or within-the-shoe over multiple trials. Based upon these findings, the COPP, as measured by its absolute integral, would be a poor representation of foot movement and, as such, would not be an acceptable method for the assessment of foot orthoses effectiveness.

The relationship between static lower extremity measurements and rearfoot motion during walking

Despite the fact that clinicians regularly perform static lower extremity measurements on their patients, to date, little research has been published supporting their ability to predict dynamic rearfoot motion. The abilities of static measurements to predict dynamic foot motion could have important implications considering the fact that excessive rearfoot motion has been associated with various injuries of the lower extremity. The purpose of this study, therefore, was to determine if static lower extremity measurements could be used to predict the magnitude of rearfoot motion during walking. Rearfoot motion of each lower extremity was measured from videotape in 27 healthy young adult subjects with a mean age of 26.1 years. In addition, 17 static measurements were measured and recorded bilaterally for each subject. The results of a multiple regression analysis indicated that the only variable that was able to predict maximum rearfoot pronation was the "difference in navicular height" (r2 = .17). None of the 17 measurements were found to predict time to maximum pronation. These results indicate that static measurements of the lower extremity and foot are poor predictors of dynamic rearfoot motion as measured by maximum pronation or time to maximum pronation in healthy individuals without severe foot deformities.

Relationship between three static angles of the rearfoot and the pattern of rearfoot motion during walking

The purpose of this study was to determine the relationship of the static angle of the rearfoot during single leg standing, relaxed standing foot posture, and subtalar joint neutral position with the pattern of rearfoot motion during walking. The authors felt that this study was important to gain a better understanding of the relationship between dynamic rearfoot motion and three static rearfoot angles which are often included in foot examination procedures. The pattern of rearfoot motion was assessed using two-dimensional video recordings for each lower extremity of 31 healthy young adult subjects with a mean age of 25.2 years. The mean path of rearfoot motion during walking crossed relaxed standing foot posture but did not cross single leg standing or subtalar neutral position. These findings suggest that the mean path of rearfoot motion during the first 60% of the walking cycle occurs between the static angles of relaxed standing foot posture and single leg standing. In addition, the static angle of the rearfoot in single leg standing may serve as a clinical indicator of the degree of maximum rearfoot eversion occurring during the walking cycle.

A comparison of the dynamic pedobarograph and EMED systems for measuring dynamic foot pressures

The purpose of this study was to compare the peak pressure and peak force values obtained from two pressure assessment systems, the Dynamic Pedobarograph and the EMED SF. Twenty-one individuals with a mean age of 31.6 years walked barefoot over both systems using a two-step data collection protocol. Peak plantar pressures and peak vertical force values were measured under the heel, central forefoot, hallux, and entire foot for both systems. The results of this study demonstrated that the EMED SF system produced larger peak pressures under the central forefoot and hallux. The Pedobarograph, on the other hand, produced greater pressures under the heel and entire foot. With respect to peak vertical forces, the Pedobarograph showed significantly greater values under the heel and central forefoot compared with the EMED SF, but were significantly lower under the hallux and entire foot.

Evaluation and management of foot and ankle disorders: present problems and future directions

Recent research has raised serious concerns regarding the reliability and validity of the evaluation and treatment scheme proposed by Root et al. Although the Root et al theory is widely referenced in the physical therapy literature and commonly taught in continuing education courses, current issues of concern include: 1) measurement technique reliability, 2) the criteria proposed for normal foot alignment, and 3) the position of the subtalar joint between midstance and heel-off during walking. The intent of this paper is to review these three problem areas which have been identified with the Root et al theory as well as to propose the use of a "tissue stress model" which the authors have found to be an effective alternative for evaluating and treating foot disorders.

Footwear and foot orthotic effectiveness research: a new approach

Measurement of calcaneal inversion and eversion during walking is limited when subjects wear shoes. The authors of this study propose the use of transverse tibial rotation as a viable alternative measurement when barefoot assessment is not possible. The purpose of this study, therefore, was to: 1) determine the relationship between transverse tibial rotation and rearfoot motion during the stance phase of normal walking and 2) demonstrate the usefulness of measuring transverse tibial rotation when evaluating the effect of footwear and insole foot orthotic devices. Part 1 consisted of eight volunteers (five women, three men) whose rearfoot and transverse tibial motion was videotaped while they walked along a 12-m walkway. The results of this study showed that although absolute values were not comparable, the two motion patterns are related to each other. The correlation between the mean rearfoot and tibial motion patterns of all 16 feet was r = .953. Part 2 investigated the effect of footwear and orthotics on transverse tibial rotation using two case presentations. A video camera was positioned in front of each subject as they walked at a self-selected speed under various footwear or orthotic conditions. The results of the case studies revealed that footwear or foot orthotics decrease maximum tibial internal rotation compared with barefoot walking. In addition, internal tibial rotation velocity and acceleration were decreased by the use of shoes, an accommodative orthosis, and an inflatable medial longitudinal arch support. A rigid orthotic produced a slight increase in transverse tibial rotation and a dramatic increase in transverse tibial acceleration.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of rearfoot motion in overground versus treadmill walking

The purpose of this study was to determine whether walking on a treadmill is a valid simulator of overground walking with respect to rearfoot motion. The tibial, calcaneal, and rearfoot motions of 10 subjects (2 males, 8 females) were videotaped while they walked on a treadmill and overground. The results of a series of t-tests showed that there was no statistically significant difference between the two conditions on any of the variables measured.

Motion of the first metatarsophalangeal joint. Reliability and validity of four measurement techniques

The purpose of this study was to first determine the intra-rater reliability of four different static measurement procedures used to assess first metatarsophalangeal joint extension range of motion and, second, determine which of the four static procedures provided a valid measure of the amount of first metatarsophalangeal joint extension required for normal walking. Twenty healthy adult subjects between the ages of 21 and 43 years participated in the study. Four static techniques were evaluated and dynamic first metatarsophalangeal joint extension was also determined from video recordings during walking. The results indicate that 1) all static measurement techniques were reliable; 2) the degree of first metatarsophalangeal joint extension obtained for each of the four static measurement techniques exceeded the amount of first metatarsophalangeal joint extension required for walking; 3) although each of the static measurement techniques was reliable, they should not be considered interchangeable; and 4) approximately 65 degrees of first metatarsophalangeal joint extension are required for normal walking.

Comparison of 2-dimensional and 3-dimensional rearfoot motion during walking

The purpose of this study was to investigate the validity of two-dimensional (2-D) analysis with respect to three-dimensional (3-D) analysis for recording rearfoot motion during walking. The results of this study indicated that rearfoot motion measured with either 2-D or 3-D analysis is essentially the same for the initial 60% of the stance phase. There was no significant difference between the two methods on variables typically measured in studies dealing with rearfoot motion. RELEVANCE: The assessment of rearfoot motion during walking in a clinical situation is frequently desirable yet the high cost of equipment and time required for 3-D analysis makes it unreasonable or impractical. The results of this study show that 2-D analysis can be used to measure rearfoot motion accurately and therefore is feasible for use in the clinic.

Plantar pressures during level walking compared with other ambulatory activities

This study was designed to determine the magnitude of plantar pressures during level walking in comparison to other activities. These activities included climbing up stairs, going down stairs, a simple pivot while walking, and a crossover pivot while walking in normal individuals. Twelve volunteers, six men and six women, mean age 28 years, served as subjects. Data were collected on the dominant foot with an EMED-SF pressure sensor platform as each subject walked barefoot and did each of the five activities. Maximum plantar pressure (MPP) and pressure-time integral (PTI) was found in the metatarsal and heel regions. The results of repeated-measures analysis of variance tests showed that the five experimental conditions were statistically different for both MPP and PTI in the metatarsal and heel regions. Post hoc analysis indicated that MPP and PTI were decreased during the going down stairs condition in the heel and increased during the crossover pivot while walking and pivot while walking conditions for the metatarsal region.

The influence of tibialis anterior muscle activity on rearfoot motion during walking

The purpose of this study was to determine whether tibialis anterior muscle activity influences the rate of rearfoot motion during walking. Two-dimensional rearfoot motion was recorded from 23 feet. The feet were assigned to one of two experimental groups. Muscle activity was recorded from the tibialis anterior muscle using surface electrodes. The early pronators (N = 12) reached maximal pronation within the first 20% of the stance phase. The late pronators (N = 11) reached maximal pronation only after 40% of the stance phase. The results of a t-test showed that there was a significant difference (P < .05) in the time to minimal tibialis anterior muscle activity between the two groups. These results indicate that tibialis anterior muscle activity can influence rearfoot motion during the stance phase of walking. A clinician should consider the muscular system when evaluating and designing a treatment program for patients with foot-related problems. The results of this study also indicate that static nonweightbearing evaluations alone may not provide an accurate picture of the foot during walking.

Vertical forces and plantar pressures in selected aerobic movements versus walking

Ten subjects between the ages of 19 and 29 years walked and performed four aerobic movements over a force and pressure platform. Peak plantar pressure and peak vertical force data were collected three times on the dominant leg as each subject performed all of the five activities. Peak vertical forces acting on the lower extremities for the low impact aerobic movements were significantly less when compared with the high impact movements. As was expected, no differences were found in peak vertical forces between walking and the low impact aerobic movements. Peak plantar pressures for walking were not significantly different when compared with any of the four aerobic movements studied.

Reducing two-dimensional rearfoot motion variability during walking

Although three-dimensional movement analysis is the preferred method of assessing rearfoot motion during gait, the high cost of equipment and the time required to use it often make it unreasonable or impractical in a clinical setting. The authors discuss a method of minimizing the variability of rearfoot motion measurements during walking, using two-dimensional analysis when three-dimensional is not available to the clinician.

Effect of insole material on force and plantar pressures during walking

Twelve subjects between the ages of 24 and 35 years walked barefoot over a pressure platform with the following insole materials placed directly on top of the platform: 1) PPT, 2) Spenco, and 3) Viscolas. Maximum vertical force, vertical force-time integral as well as maximum plantar pressure data were collected for the rearfoot, midfoot, and forefoot regions. The results were not significant for maximum vertical force and vertical force-time integral among the three insole materials when compared to barefoot-only walking. There was, however, a significant reduction in forefoot maximum plantar pressure among the three materials compared to barefoot-only walking. In the rearfoot region, a reduction in maximum plantar pressure was seen only with PPT and Spenco.

Effect of rearfoot posts in reducing forefoot forces. A single-subject design

The purpose of this study was to assess the effectiveness of a semirigid foot orthosis with a varus wedge on forefoot vertical forces in a 24-year-old female with a compensated rearfoot varus deformity. The results of this study indicate that the use of total contact semirigid foot orthoses reduces the forefoot force-time integral during walking, whether a rearfoot varus wedge was or was not used. The authors recommend that total contact construction of the foot orthoses be considered when a reduction of the forces acting on the forefoot is the goal of treatment.

Rigid versus soft foot orthoses. A single subject design

The purpose of this study was to compare the effects of rigid and soft foot orthoses on forefoot and rearfoot forces in a 20-year-old female runner with a history of tibial and metatarsal stress fractures. The results of this study indicate that a soft orthosis significantly reduced vertical forces through the foot during both walking and running. The authors recommend that proper fabrication materials be considered for those patients with a history of foot or lower extremity problems caused by reduced shock attenuation.

Incidence of sacroiliac joint malalignment in leg length discrepancies

The purpose of this study was to ascertain the incidence of leg length discrepancies in a sample of asymptomatic female college students, and then to determine the incidence of sacroiliac joint malalignment within that same sample. Structural leg length, functional leg length, and sacroiliac position were determined for each subject. The results indicate a high incidence of leg length discrepancies within the sample, and also a fairly high incidence of asymptomatic sacroiliac joint malalignment when leg length discrepancies are present.

Comparison of three methods used to obtain a neutral plaster foot impression

The purpose of our study was to compare the forefoot-to-hindfoot angles obtained from three methods used to obtain a neutral plaster impression of the foot. The three methods were 1) supine nonweight-bearing (S), 2) prone nonweight-bearing (P), and 3) sitting semiweight-bearing (SW). We obtained foot casts from both feet of 11 female subjects for each of the three methods and used a manual goniometer to measure the forefoot-to-hindfoot angle for each pair of casts. The F ratios were significant for the variables left-right foot (p less than .0001) and impression method (p less than .001) using a within-subject two-factor analysis of variance. The impression methods S and P were found to be significantly different from SW, but not significantly different from each other, using a Tukey's post hoc comparison. The results indicate that the same forefoot-to-hindfoot alignment can be obtained using either the S or P method but not with the SW method.

Effects of foot orthoses on center-of-pressure patterns in women

The purpose of this study was to determine the effects of foot orthoses on the pattern of center of pressure in women with forefoot deformities during walking. Nine subjects with a forefoot varus and nine subjects with a forefoot valgus walked across a force platform three times for each of the following five treatment conditions: 1) barefoot, 2) shoes only, 3) rigid orthoses with shoes, 4) semi-rigid orthoses with shoes, and 5) soft orthoses with shoes. Force data were analyzed to determine the area under the center-of-pressure curve. A significant omnibus F ratio was obtained for treatments (p less than .001) and the deformity X treatments interaction (p less than .05) using a two-factor, mixed analysis of variance for repeated measures. Tukey's post hoc comparisons for the Varus Group resulted in significant differences (p less than .05) between the following treatment conditions: 1) barefoot and shoes only, 2) barefoot and rigid orthoses with shoes, 3) barefoot and semi-rigid orthoses with shoes, and 4) barefoot and soft orthoses with shoes. Tukey's post hoc comparisons for the Valgus Group resulted in significant differences (p less than .05) between the following treatment conditions: 1) barefoot and rigid orthoses with shoes, 2) barefoot and semi-rigid orthoses with shoes, and 3) barefoot and soft orthoses with shoes. The shoes-only treatment condition, in comparison with the barefoot condition, significantly reduced the center-of-pressure area for the Varus Group only.(ABSTRACT TRUNCATED AT 250 WORDS)

Footwear

The purpose of this article is to provide information that will assist the physical therapist in recommending appropriate shoewear for patients with foot disorders. The discussion is divided into the following areas: 1) purposes of footwear, 2) shoe anatomy, 3) the last, 4) shoe construction, and 5) shoe sizing and fitting. Throughout the discussion, variations are noted between the terminology used to describe nonathletic and athletic footwear. Recommendations for both nonathletic and athletic footwear are provided.