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Assessment of Plantar Pressure in Hindfoot Relief Shoes of Different Designs

Thomas Hahn Division of Orthopaedic Rheumatology, University of Erlangen-Nuremberg, Erlangen, Germany.

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Hans-Dieter Carl Division of Orthopaedic Rheumatology, University of Erlangen-Nuremberg, Erlangen, Germany.

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Andreas Jendrissek Division of Orthopaedic Rheumatology, University of Erlangen-Nuremberg, Erlangen, Germany.

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Matthias Brem Division of Orthopaedic Rheumatology, University of Erlangen-Nuremberg, Erlangen, Germany.

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Bernd Swoboda Division of Orthopaedic Rheumatology, University of Erlangen-Nuremberg, Erlangen, Germany.

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Philipp Rummel Division of Orthopaedic Rheumatology, University of Erlangen-Nuremberg, Erlangen, Germany.

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Johannes Pauser Division of Orthopaedic Rheumatology, University of Erlangen-Nuremberg, Erlangen, Germany.

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Background

Although there are several different concepts of hindfoot relief footwear, there are no studies on the extent of pressure reduction to be achieved by this footwear. Therefore, we sought to evaluate the reduction in plantar pressure to be achieved with two different hindfoot relief shoes.

Methods

Ten healthy volunteers performed three trials at a self-selected speed. Peak pressure values in mass-produced shoes (normal gait) were considered as 100% and were compared with measurements in two differently designed hindfoot relief shoes. Foot portions were defined as heel (0%–15% of total insole length), hindfoot (16%–30%), midfoot (31%–60%), and forefoot (61%–100%).

Results

Heel and hindfoot peak pressures were significantly reduced in both shoes compared with normal gait (P < .05), but the extent of peak pressure reduction under the heel and hindfoot varied significantly between the tested shoes. Midfoot peak pressure was not significantly reduced in tested shoes compared with baseline (P > .05) but differed significantly between the two shoes. Forefoot peak pressure was significantly reduced with one of the tested shoes (to a median 73% baseline; P = .004) but not with the other (median, 88% baseline).

Conclusions

Hindfoot relief shoes leave a considerable amount of peak pressure, predominantly under the hindfoot. The extent of peak pressure reduction for the heel and the hindfoot varies between different hindfoot relief shoes. Depending on the affected foot area, the kind of hindfoot relief shoe should be carefully chosen.

Corresponding author: Johannes Pauser, MD, Division of Orthopaedic Rheumatology, University of Erlangen-Nuremberg, Rathsberger Str. 57, D-91054 Erlangen, Germany. (E-mail: Johannes.pauser@ortho-rheuma.med.uni-erlangen.de)
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