The effect of textured insoles on gait patterns of people with multiple sclerosis
ABSTRACT Somatosensory deficit is a common feature of MS. One method serving to combat impaired plantar sensation may be to provide enhanced sensory feedback from the sole of the foot by changing the characteristics of a shoe sole or surface. This study aimed to inspect the effect of textured insoles on gait patterns in a group of MS patients.
14 patients with MS and 10 healthy control subjects were recruited for this study. Plantar sensation was evaluated using Semmes-Weinstein monofilaments. Kinematic, kinetic and EMG gait data were collected for MS patients walking with flat shoes only and again with shoes and a textured insole in contact with the sole of patients' feet.
A reduction in plantar sensation was identified in the MS patient group compared to the control group. Wearing the textured insoles there was a significant increase in hip and knee sagittal plane excursion, maximum ankle dorsiflexion, knee flexion and in peak acceleration ground reaction force. Throughout the stance phase, EMG activity of shank muscles was typically found to increase whilst wearing the textured insoles.
Despite some positive changes in gait patterns when wearing textured insoles, an increased foot-shank angle in terminal stance suggests that patients did not propel their swing limb through increased contribution of ankle plantarflexor muscles, perhaps favouring more proximal muscle groups. Whilst the textured insoles may alter gait patterns in MS patients, their contribution to achieving a more regular gait pattern with sufficient propulsion from ankle plantarflexors remains uncertain.
- SourceAvailable from: Timo Jaakkola[Show abstract] [Hide abstract]
ABSTRACT: Simple deformation of the skin surface with textured materials can improve human perceptual-motor performance. The implications of these findings are inexpensive, adaptable and easily integrated clothing, equipment and tools for improving perceptual-motor functionality. However, some clarification is needed because mixed results have been reported in the literature, highlighting positive, absent and/or negative effects of added texture on measures of perceptual-motor performance. Therefore the aim of this study was to evaluate the efficacy of textured materials for enhancing perceptual-motor functionality. The systematic review uncovered two variables suitable for sub-group analysis within and between studies: participant age (groupings were 18-51 years and 64.7-79.4 years) and experimental task (upright balance and walking). Evaluation of studies that observed texture effects during upright balance tasks, uncovered two additional candidate sub-groups for future work: vision (eyes open and eyes closed) and stability (stable and unstable). Meta-analysis (random effects) revealed that young participants improve performance by a small to moderate amount in upright balance tasks with added texture (SMD = 0.28, 95%CI = 0.46-0.09, Z = 2.99, P = 0.001; Tau(2) = 0.02; Chi(2) = 9.87, df = 6, P = 0.13; I(2) = 39.22). Significant heterogeneity was found in, the overall effect of texture: Tau(2) = 0.13; Chi(2) = 130.71, df = 26, P<0.0001; I(2) = 85.98%, pooled samples in upright balance tasks: Tau(2) = 0.09; Chi(2) = 101.57, df = 13, P<0.001; I(2) = 72.67%, and in elderly in upright balance tasks: Tau(2) = 0.16; Chi(2) = 39.42, df = 5, P<0.001; I(2) = 83.05%. No effect was shown for walking tasks: Tau(2) = 0.00; Chi(2) = 3.45, df = 4, P = 0.27, I(2) = 22.99%. Data provides unequivocal support for utilizing textured materials in young healthy populations for improving perceptual-motor performance. Future research is needed in young healthy populations under conditions where visual and proprioceptive information is challenged, as in high-speed movements, or where use of equipment mediates the performer-environment interaction or where dysfunctional information sources 'compete' for attention. In elderly and ailing populations data suggests further research is required to better understand contexts where texture can facilitate improved perceptual-motor performance.PLoS ONE 04/2013; 8(4):e60349. DOI:10.1371/journal.pone.0060349
Dataset: 116 AlRo NSL2011b
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ABSTRACT: The foot sole is loaded during stance and gait and plantar cutaneous mechanoreceptors sense the local stress distribution. It is not clear whether the perception thresholds of these mechanoreceptors change during the day and how they respond to walking activities. The primary aim of the present study was to investigate diurnal changes of plantar sensitivity. Furthermore, the aim was to find out whether daily changes depend on the individual level of step activity. Twenty-six healthy subjects, 17 women and 9 men, aged 28.6±6.7 years participated in the study. Detection thresholds to light touch were measured in six plantar regions with Semmes-Weinstein monofilaments in the morning, noon and afternoon. Step activity was recorded with a StepWatch™ Activity Monitor and analyzed for three periods (8 a.m.-4 p.m., 8 a.m.-12 p.m., 12 p.m.-4 p.m.). The hallux, the 3rd metatarsal head and the heel showed significantly decreased detection thresholds from 8 a.m. to 4 p.m. (p≤0.05). A fair correlation between the decrease of detection threshold and the total number of steps was found for the 3rd metatarsal head and the heel (p≤0.05). Foot sole sensation appears to improve during the day and seems to be associated with the step activity. This may reflect an improving transfer of afferent information to the central nervous system during the day as well as an adaptation of receptors to gait activity.Neuroscience Letters 09/2011; 504(3):247-51. DOI:10.1016/j.neulet.2011.09.037