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Contralateral Peak Plantar Pressures with a Postoperative Boot

A Preliminary Study

Jamie N. Mieras Scripps Mercy-Kaiser Residency Program, San Diego, CA.

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Tanya J. Singleton San Francisco Bay Area Foot & Ankle Residency Program, Kaiser Permanente Medical Center, San Francisco, Oakland, and Walnut Creek, CA.

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Stephen L. Barrett Midwestern University, College of Health Sciences, Arizona Podiatric Medicine Program, Glendale, AZ.

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Background: Frequent use of walking boots in podiatric medicine often elicits patient complaints and sequelae from the imposed limb-length discrepancy. This study was designed primarily to determine whether peak plantar pressures are decreased in the contralateral foot when a moderately worn athletic shoe is worn opposite a high-calf walking boot and, if so, secondarily to determine whether a specialized surgical shoe worn on the contralateral foot can also effectively reduce this pressure. The pressure reductions were then compared to determine whether significantly greater plantar pressure reduction was provided by either the athletic shoe or the surgical shoe.

Methods: Participants without a foot abnormality walked on a treadmill in four footwear combinations: barefoot bilaterally, high-calf rocker-bottom sole (HCRB) walking boot/ barefoot, HCRB walking boot/athletic shoe, and HCRB walking boot/modified walking boot shoe. Measurements were taken with the participants wearing socks. Peak plantar calcaneal pressures were collected.

Results: Peak plantar pressures under the calcaneus opposite the HCRB walking boot were significantly reduced from barefoot pressures when either an athletic shoe or the modified walking boot shoe was worn. However, no significant difference was seen when comparing the reduction by the athletic shoe with that by the modified walking boot.

Conclusions: Wearing an athletic shoe on the foot opposite an HCRB walking boot reduces calcaneal pressures; however, wearing a modified device with structural properties of an HCRB walking boot sole is no better than an athletic shoe at reducing peak calcaneal pressures. (J Am Podiatr Med Assoc 101(2): 127–132, 2011)

Corresponding author: Jamie N. Mieras, DPM, Scripps Mercy-Kaiser Residency Program, MER-35, 4077 Fifth Ave, San Diego, CA 92103. (E-mail: jmieras@gmail.com)