Do orthopaedic shoes improve local dynamic stability of gait? An observational study in patients with chronic foot and ankle injuries.

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Serval ID
serval:BIB_69B7D341E3AE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Do orthopaedic shoes improve local dynamic stability of gait? An observational study in patients with chronic foot and ankle injuries.
Journal
Bmc Musculoskeletal Disorders
Author(s)
Terrier P., Luthi F., Dériaz O.
ISSN
1471-2474 (Electronic)
ISSN-L
1471-2474
Publication state
Published
Issued date
2013
Volume
14
Number
94
Pages
1-8
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish. PDF type: Research article
Abstract
BACKGROUND: Complex foot and ankle fractures, such as calcaneum fractures or Lisfranc dislocations, are often associated with a poor outcome, especially in terms of gait capacity. Indeed, degenerative changes often lead to chronic pain and chronic functional limitations. Prescription footwear represents an important therapeutic tool during the rehabilitation process. Local Dynamic Stability (LDS) is the ability of locomotor system to maintain continuous walking by accommodating small perturbations that occur naturally during walking. Because it reflects the degree of control over the gait, LDS has been advocated as a relevant indicator for evaluating different conditions and pathologies. The aim of this study was to analyze changes in LDS induced by orthopaedic shoes in patients with persistent foot and ankle injuries. We hypothesised that footwear adaptation might help patients to improve gait control, which could lead to higher LDS:
METHODS: Twenty-five middle-aged inpatients (5 females, 20 males) participated in the study. They were treated for chronic post-traumatic disabilities following ankle and/or foot fractures in a Swiss rehabilitation clinic. During their stay, included inpatients received orthopaedic shoes with custom-made orthoses (insoles). They performed two 30s walking trials with standard shoes and two 30s trials with orthopaedic shoes. A triaxial motion sensor recorded 3D accelerations at the lower back level. LDS was assessed by computing divergence exponents in the acceleration signals (maximal Lyapunov exponents). Pain was evaluated with Visual Analogue Scale (VAS). LDS and pain differences between the trials with standard shoes and the trials with orthopaedic shoes were assessed.
RESULTS: Orthopaedic shoes significantly improved LDS in the three axes (medio-lateral: 10% relative change, paired t-test p < 0.001; vertical: 9%, p = 0.03; antero-posterior: 7%, p = 0.04). A significant decrease in pain level (VAS score -29%) was observed.
CONCLUSIONS: Footwear adaptation led to pain relief and to improved foot & ankle proprioception. It is likely that that enhancement allows patients to better control foot placement. As a result, higher dynamic stability has been observed. LDS seems therefore a valuable index that could be used in early evaluation of footwear outcome in clinical settings.
Keywords
Accelerometry, Adaptation, Physiological, Adult, Ankle Injuries/diagnosis, Ankle Injuries/physiopathology, Biomechanics, Chronic Pain/diagnosis, Chronic Pain/physiopathology, Equipment Design, Exercise Test, Female, Foot Injuries/diagnosis, Foot Injuries/physiopathology, Foot Orthoses, Fractures, Bone/diagnosis, Fractures, Bone/physiopathology, Gait, Humans, Inpatients, Male, Middle Aged, Pain Measurement, Proprioception, Shoes, Switzerland, Time Factors, Treatment Outcome, Walking
Pubmed
Web of science
Open Access
Yes
Create date
25/04/2013 18:02
Last modification date
20/08/2019 15:24
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