Changes in gait characteristics of a normal healthy Changes

  • Changes in gait characteristics of a normal healthy  in gait characteristics of a normal healthy population due to an unstable shoe construction.
    unstable shoe construction.     
    The centre for Sports and Exercise Science, Sheffield Hallam University, Sheffield UK.
    Internal Report.
    Dr. Rav Naik, Tim Vernon, Jonathan Wheat, Grace Petit
    August 2004
         
     Publication: unpublished.
     
    MBT Model: sole 2004
     
    ABSTRACT
    INTRODUCTION: Back pain is the third most common bodily symptom after headache and  tiredness with 60-80 % of people  suffering  low back pain at  some  time  in  their
    lives  (Croft  et  al.). Osteoarthritis  is  another  common  cause  of  pain  and  disability  in older adults (Peterson IF, Feldson DT). 
    The average UK citizien walks  in  the  region of 183 miles  (305 km) per year on  the pubic  highway  or  other  unrestricted  areas which  are  paved  or  tarred  and  over  50 yards. 
    This  equates  to  a  huge  number  of  footfalls  every  year,  each  of  which  results  in  a loading effect of  the  structures  that comprise  these  joints will have a  significant affect on the accumulation of microdamage.
    Anecdotal  evidence  has  suggested  that  the  frequent  use  of  an  unstable  shoe construction  can  help  in  rehabilitation  and  even  prevention  of  many  of  these complaints.
    If  the MBT shoe can be shown  to reduce  loading  through  the hip, knee and ankle as suggested by a preliminary study  from The Human Performance Laboratory University
    of Calgary (Nigg B et al.) the potential beneficial impact the shoe could have as a tool for treating osteoarthritic hip and knee is significant. If  the MBT  shoe  can be demonstrated  to alter  loading or posture of  the  lumbosacral spine its application as a tool in the treatment of back pain will be significant.
    METHODS: 
       Twenty  two  participants  (11 male, 11  female); Age 30  – 35  take  partPhysically active and free from musculoskeletal injury at the time of testing.Eight-camera digital motion  capture  system  (Motion  Analysis  Corporation,  Santa  Rosa,  CA,  USA) sampling at 200 Hz. Kistler  Type 9281CA  force platform  (Kistler  Instrumente AG Winterthur, Switzerland) sampling at 1000Hz. 
       Each participant underwent a tutorial session (10 minutes)
       Tested in the lab under normal conditions and then in the MBT condition.
       Helen Hayes marker set incorporating a static calibration trial.
       Data  analysed  using  OrthoTrak  software  (MAC)  and  custom  MATLAB  software
    (SHU).
       Series of three-factor (condition, foot, gender) ANOVA, with repeated measures on
    the factors condition and foot.
       Alpha level of significance was set at the 0.05 level for all statistics. 
    RESULTS: Many of the kinematic variables remained unchanged, there were significant
    differences  in both  the  trunk and  the ankle angles. MBT  shoes promote  less  forward
    lean during locomotion suggesting a more upright posture. Although not confirmed by
    the present study, the probable effect is a shift in the centre of mass position closer to
    the  centre  of  the  base  of  support,  possibly  aligning  the  body  more  optimally  for
    locomotion. This,  in conjunction with  the  lower hip moments experienced  in  the MBT
    condition may suggest reduced loading of the lower back. 
         
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    ant
    post
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      - - - - -   MBT Figure 1 Figure 1 Figure 1 Figure 1: Trunk angle during the stance phase of gait for the MBT and normal condition.
     
    The changes in the ankle plantar flexion/ dorsiflexion angle at the ankle, was primarily due  to  the  reduced plantar  flexion  following  initial  contact during  the MBT  condition when compared to the normal condition.
    Kinetics at  each of  the  joints of  the  lower  limb were different between  the MBT and normal conditions. The lower moments experienced at these joints suggests a resultant decrease in joint loading.
    The major finding from analysis of the ground reaction force data is the suggestion that there is a higher incidence of transient peaks when wearing normal shoes compared to MBTs. There  is some evidence suggesting  that  transient  forces  transmitted  through  the skeleton  are  the  primary  aetiological  factor  in  the  development  of  many musculoskeletal disorders. These include, osteoarthritis, stress fractures, plantar fascilitis and Achilles tendonitis and low back pain (Whittle, 1999).
     
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    Figure 2 Figure 2 Figure 2 Figure 2: Vertical ground  reaction  force  trace during  the stance phase of gait  for  the
    MBT and normal condition.
     
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     Figure 3: Anterior  - posterior ground  reaction  force  trace during  the  stance phase of gait  for  the MBT and normal condition.
     
     CONCLUSION:  This  initial  study  into  the  effects  of  an  unstable  shoe  construction suggests that MBTs alter certain gait characteristics and that with frequent use they may reduce the incidence of some musculoskeletal problems. In those already suffering from such disorders, MBTs may allow patients to remain mobile by reducing cyclic loading of the already damaged joint.
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