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- Author or Editor: Thomas W. Kernozek x
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Background:
We investigated plantar loading asymmetry during gait in American Indians with and without diabetes and with diabetes and peripheral neuropathy.
Methods:
A convenience sample of 96 American Indians with and without diabetes was divided into three groups: 20 with diabetes and peripheral neuropathy, 16 with diabetes without peripheral neuropathy, and 60 with no history of diabetes (control group). Plantar loading was measured during barefoot walking across a pressure platform. Five trials were collected per foot during level walking at a self-selected speed using the two-step method. Asymmetry in peak pressure-time integral and peak plantar pressure were calculated from ten plantar regions and compared among groups.
Results:
Significant pressure-time integral asymmetry occurred across the forefoot regions in American Indians with diabetes and peripheral neuropathy compared with the other two groups. Significant peak plantar pressure asymmetry occurred in the third metatarsal region in both groups with diabetes (with and without peripheral neuropathy) compared with the control group.
Conclusions:
Overall, American Indians with diabetes seemed to show greater asymmetry in plantar loading variables across the forefoot region compared with those in the control group. Specifically, individuals with diabetes and peripheral neuropathy had the greatest amount of forefoot pressure-time integral asymmetry. Significant peak plantar pressure asymmetry occurred in the third metatarsal region of the forefoot in those with diabetes with and without peripheral neuropathy. Loading asymmetry may play a role in the development of foot ulcers in the forefoot region of American Indians with peripheral neuropathy and diabetes. (J Am Podiatr Med Assoc 103(2): 106–112, 2013)
The purpose of this study was to identify the clinical and plantar loading variables related to hallux valgus. Fifty-one healthy control subjects and 40 subjects with a diagnosis of moderate hallux valgus deformity of similar age and body weight were recruited for this study. Clinical measurements of pain, first metatarsophalangeal joint range of motion, and single-leg resting calcaneal stance position were obtained. Biomechanical measurements were obtained using a capacitive pressure platform. Plantar loading variables were calculated for seven regions of the plantar surface. A univariate analysis followed by a stepwise logistic regression was used to analyze the data. The results indicated that high values for pain, single-leg resting calcaneal stance position, hallux region peak pressure and force–time integral, and central forefoot region force–time integral increased the likelihood of hallux valgus. (J Am Podiatr Med Assoc 93(2): 97-103, 2003)
Background
Patellofemoral pain (PFP) is a common injury, particularly in females. Foot pronation may promote knee and hip transverse plane joint kinematics during gait thought to contribute to PFP. Greater knowledge of plantar loading characteristics in females with PFP may be valuable to provide a basis for clinical decisions regarding footwear and foot orthoses. The purpose of this study was to compare plantar loading distribution in females with and without PFP during gait.
Methods
Plantar pressure during walking was recorded from 19 females with PFP and 20 females without PFP. Contact area, peak force, and force-time integral were evaluated in ten plantar areas. Arch index was also calculated from contact area data during gait.
Results
Contact area in females with PFP was 9% smaller in the first metatarsal region (P = .039) and 20% smaller in the midfoot region (P = .042) than in females without PFP. Peak force was 31% lower in the midfoot region for females with PFP (P = .027) and 13% lower in the first metatarsal region (P = .064). Force-time integral was 18% lower in the first metatarsal region in females with PFP (P = .024). Females with PFP demonstrated a lower arch index (suggesting a higher arch) (P = .028).
Conclusions
Decreased medial forefoot loading and decreased midfoot contact suggest decreased foot pronation during gait in females with PFP relative to females without PFP. Decreased foot pronation may foster increased patellofemoral joint loading rates. These data contribute to rationale for footwear modifications to modify plantar loading characteristics in people experiencing PFP.
