The MBT shoe and ist biomechanical/ therapeutical effects
  • The MBT shoe and ist biomechanical/ therapeutical effects 
    Human Performance Laboratory, University of Calgary, Canada
    Benno M. Nigg, Dr.sc.nat., Prof. of Biomechanics
    June 2004
         
    Publication Publication Publication Publication: Benno Nigg, Sabrina Hintzen, Reed Ferber: Effect of an unstable shoe
    construction on lower extremity gait characteristics. Clinical Biomechanics 21 (2006)
    82-88.
         
    MBT Model: Sole 2004
     
    ABSTRACT
    THE  HUMAN  PERFORMANCE  LABORATORY  (HPL):  The  Human  Performance
    Laboratory  (HPL)  is  one  of  the world  leaders  in basic and applied  research  related  to human neuro-musculo-skeletal health and well being  from birth to old age. The HPL  is a multidisciplinary  research  group  consisting  of  nine  full-time  and  seven  adjunct  faculty members  (professors)  with  research  backgrounds  in  anatomy,  muscle  mechanics, physiology, motor control, biochemistry and biomechanics.  The total working force of the HPL includes approximately 100 full-time equivalent researchers, visiting professors, post-doctoral  fellows, graduate students, as well as secretarial and  technical assistance. The HPL  has  an  international  flavour  with  a  constant  presence  of  students,  fellows  and professors visiting, studying and participating in collaborative research from all over the world.
    Last  year,  the  research  activities  of  the  HPL  have  been  assessed  by  an  independent external reviewer as  “…. the best in the world in Clinical Biomechanical Research.”
    The  HPL  is  specialized  to  study  the  mechanical  and  neuro-physiological  effects  of medical devices for prevention and rehabilitation of movement related problems.
    CONCEPT CONCEPT CONCEPT CONCEPT: Stability during locomotion is important for all age groups. Two strategies are available  to  improve  stability during  locomotion,  constructing  shoes  that provide support  and/or  strengthening  lower  extremity  muscles.  However,  when  using  shoes that  provide  stability,  the  muscles  contributing  to  static  and  dynamic  stability  get weaker  because  they are  not  used.  For  this  reason, many people  train  these  under-activated muscles,  using  unstable  situations  (e.g.  a wobble  board).  Conceptually,  it does  not  seem  logical  to  separate  the  functions  of  static  and  dynamic  stability  and
    mechanical muscle training. One may suggest that training of lower extremity muscles should be combined with the actual locomotion activities. 
    A  mechano-therapeutic  training  device  has  recently  been  developed  by  Masai Barefoot  Technologies  (MBT).  The MBT  device  has  a  rounded  sole  in  the  anterior-posterior  direction,  thus  providing  an  unstable  base.  These  shoes  act  as  a  training device  for  lower extremity muscles and  frequent use of  this device  is associated with several positive medical and health benefits.
    The  theoretical  concept behind  this  unstable  construction  is  to  strengthen  the muscles close  to  the movement axes because  strong  forces  close  to  the  joint axes  reduce  the resultant  joint  loading  substantially  (Fig.  1).  Reduced  joint  loading,  however,  has  a beneficial effect on lower extremity joint pain. 
     
     
     
    Fig. 1  Illustration of  the calculated effect of  the  inclusion of  strong  forces close  to  the joint axis (right picture) on the joint and insertion loading for a mast with large and small springs, oscillating around its equilibrium position. The spheres at the insertion of the springs and at the joint of the mast indicate the magnitude of the forces at these locations. METHOD METHOD METHOD METHOD:  In a comprehensive  study with 8  test  subjects  that used  the MBT device  in the average 9.5 hours per day for two weeks, the HPL studied the mechanical effects
    of  the  MBT  device.  Specifically,  kinematics,  kinetics,  muscle  activity,  soft  tissue vibrations and oxygen consumption during standing and/or walking were assessed for
    healthy subjects using an unstable MBT device and a conventional control shoe.
    RESULTS RESULTS RESULTS RESULTS:  : :  : The results of this study revealed the following facts:
       During  standing quietly,  the MBT device  increased  the movement of  the  center of pressure,  producing  an  increased  demand  of  muscle  activity  in  the  lower extremities  to balance  the body. Thus, during  standing,  the MBT device acts as a mechanical muscle training device.
       During  walking,  the  MBT  device  produces  an  increased  rotational  ankle  joint impulse  for  foot  plantar-flexion  and  foot  inversion  for  the  first  half  of  ground contact. Thus, the MBT device acts as a mechanical training device for the muscles crossing the ankle joint.
       During walking,  the MBT device reduces  the rotational ankle  joint  impulses  for  the knee  joint  (average  reduction 27 %). Thus,  the MBT device  reduces mechanically the  forces  at  the  knee  and  hip  joint.  This  result  is  typically  associated  with  a reduction of joint pain.
       During walking, the MBT device required 2.5 % more oxygen consumption for the same walking task, thus requiring more mechanical energy, which translates into a mechanical training effect.
       Based on the results of this study it is concluded that the MBT device strengthens the small  muscles  with  small  levers  with  respect  to  the  rotational  axes.  This  would reduce  the  joint  loading  (Fig.  1),  which  explains  the  results  of  less  pain  and discomfort when using this training device. 
    CONCLUSIONS 

    o  The MBT device when applied as described in the user’s instructions is a device for mechano-therapy. 
    o  The mechano-therapy with  the MBT  device  influences  the  patient  during  standing and  walking.  During  standing,  the  MBT  device  increases  the  muscle  activity, therefore  increasing  the  muscle  forces  and  producing  a  training  effect.  During walking,  the MBT  device  reduces  the  joint  loading,  therefore  reducing  the  joint pain. 
    o  The MBT device is, therefore, an effective device for mechano-therapy.