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Comparison of the pressure-relieving properties of various types of forefoot pads in older people with forefoot pain.

Lee PY, Landorf KB, Bonanno DR, Menz HB - J Foot Ankle Res (2014)

Bottom Line: However, studies have found inconsistent effects for different forefoot pads on plantar pressure reduction, and optimum forefoot pad placement is still not clear.The metatarsal dome positioned 5 mm distal to the metatarsal heads and the plantar cover were most effective for reducing peak pressure (17%, p < 0.001 and 19%, p < 0.001, respectively).These findings indicate that forefoot pads are effective for reducing forefoot pressures in older people with forefoot pain, and that the position of the pad relative to the metatarsal heads may be more important than the shape of the pad.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Podiatry, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria 3086, Australia. k.landorf@latrobe.edu.au.

ABSTRACT

Background: Plantar forefoot pain is commonly experienced by older people and it is often treated with forefoot pads to offload the painful area. However, studies have found inconsistent effects for different forefoot pads on plantar pressure reduction, and optimum forefoot pad placement is still not clear. The aim of this study was to compare the effects of different forefoot pads on plantar pressure under the forefoot in older people with forefoot pain.

Methods: Thirty-seven adults (31 females, 6 males) with a mean age of 73.5 (SD 4.8) participated. Forefoot plantar pressure data were recorded using the pedar®-X in-shoe system while participants walked along an 8 m walkway. Five conditions were tested in a standardised shoe: (i) no padding (the control), (ii) a metatarsal dome positioned 10 mm proximal to the metatarsal heads, (iii) a metatarsal dome positioned 5 mm distal to the metatarsal heads, (iv) a metatarsal bar, and (v) a plantar cover.

Results: Compared to the shoe-only control condition, each of the forefoot pads significantly reduced forefoot peak pressure and maximum force. The metatarsal dome positioned 5 mm distal to the metatarsal heads and the plantar cover were most effective for reducing peak pressure (17%, p < 0.001 and 19%, p < 0.001, respectively).

Conclusions: These findings indicate that forefoot pads are effective for reducing forefoot pressures in older people with forefoot pain, and that the position of the pad relative to the metatarsal heads may be more important than the shape of the pad.

No MeSH data available.


Related in: MedlinePlus

Masks used for the data analysis.
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Figure 2: Masks used for the data analysis.

Mentions: The 16 steps (4 steps x 4 trials) for each condition were averaged and analysed using the Novel-win program (version 20.3.30). Percentage masks were applied to each averaged step, with the forefoot mask being either 31% (small and large pedar®-X insoles) or 30.5% (medium pedar®-X insole) of the total foot length (Figure 2). This ensured that the distal aspect of the forefoot mask was at the junction between two rows of sensors in the forefoot and that all of the sensors of the distal aspect of the metatarsal region of the forefoot were fully included in the mask. The 0.5% difference in the percentage mask between the pedar®-X insoles was not considered to affect the validity of the pooled data as peak pressure values were based on the size of each individual sensor unit [31] and the masking ensured a complete row of sensor units in the distal forefoot. Moreover, because the masking remained constant for each participant and this study was interested in within-participant comparisons, this adjustment was considered appropriate.


Comparison of the pressure-relieving properties of various types of forefoot pads in older people with forefoot pain.

Lee PY, Landorf KB, Bonanno DR, Menz HB - J Foot Ankle Res (2014)

Masks used for the data analysis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016518&req=5

Figure 2: Masks used for the data analysis.
Mentions: The 16 steps (4 steps x 4 trials) for each condition were averaged and analysed using the Novel-win program (version 20.3.30). Percentage masks were applied to each averaged step, with the forefoot mask being either 31% (small and large pedar®-X insoles) or 30.5% (medium pedar®-X insole) of the total foot length (Figure 2). This ensured that the distal aspect of the forefoot mask was at the junction between two rows of sensors in the forefoot and that all of the sensors of the distal aspect of the metatarsal region of the forefoot were fully included in the mask. The 0.5% difference in the percentage mask between the pedar®-X insoles was not considered to affect the validity of the pooled data as peak pressure values were based on the size of each individual sensor unit [31] and the masking ensured a complete row of sensor units in the distal forefoot. Moreover, because the masking remained constant for each participant and this study was interested in within-participant comparisons, this adjustment was considered appropriate.

Bottom Line: However, studies have found inconsistent effects for different forefoot pads on plantar pressure reduction, and optimum forefoot pad placement is still not clear.The metatarsal dome positioned 5 mm distal to the metatarsal heads and the plantar cover were most effective for reducing peak pressure (17%, p < 0.001 and 19%, p < 0.001, respectively).These findings indicate that forefoot pads are effective for reducing forefoot pressures in older people with forefoot pain, and that the position of the pad relative to the metatarsal heads may be more important than the shape of the pad.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Podiatry, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria 3086, Australia. k.landorf@latrobe.edu.au.

ABSTRACT

Background: Plantar forefoot pain is commonly experienced by older people and it is often treated with forefoot pads to offload the painful area. However, studies have found inconsistent effects for different forefoot pads on plantar pressure reduction, and optimum forefoot pad placement is still not clear. The aim of this study was to compare the effects of different forefoot pads on plantar pressure under the forefoot in older people with forefoot pain.

Methods: Thirty-seven adults (31 females, 6 males) with a mean age of 73.5 (SD 4.8) participated. Forefoot plantar pressure data were recorded using the pedar®-X in-shoe system while participants walked along an 8 m walkway. Five conditions were tested in a standardised shoe: (i) no padding (the control), (ii) a metatarsal dome positioned 10 mm proximal to the metatarsal heads, (iii) a metatarsal dome positioned 5 mm distal to the metatarsal heads, (iv) a metatarsal bar, and (v) a plantar cover.

Results: Compared to the shoe-only control condition, each of the forefoot pads significantly reduced forefoot peak pressure and maximum force. The metatarsal dome positioned 5 mm distal to the metatarsal heads and the plantar cover were most effective for reducing peak pressure (17%, p < 0.001 and 19%, p < 0.001, respectively).

Conclusions: These findings indicate that forefoot pads are effective for reducing forefoot pressures in older people with forefoot pain, and that the position of the pad relative to the metatarsal heads may be more important than the shape of the pad.

No MeSH data available.


Related in: MedlinePlus