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: Marcin Kacper Uszynski[Show abstract] [Hide abstract]
ABSTRACT: The aim of this study was to investigate the relationship between foot vibration threshold and walking and balance functions in people with Multiple Sclerosis (PwMS). The study sample consisted of 34 participants with mean age of 49.5 years (SD 11.13). Participants were able to walk independently or with an assistive device. Participants underwent vibration threshold testing using the Neurothesiometer (NT), followed by the 6 minute walking test (6MWT), the Timed up and go test (TUG) and the Berg balance scale (BBS). We found a statistically significant relationship between foot vibration threshold and all outcome measures used. The first metatarsophalangeal joint had the strongest correlation with BBS (-0.585, p < 0.01), 6MWT (-0.557, p < 0.01) and TUG (0.498, p < 0.01). We also found that vibration threshold scores differed between those people with MS with and without walking limitations (Mann-Whitney U test, p < 0.01 for all testing points). In conclusion, these findings confirm the relationship between foot vibration threshold and clinical measures of walking and balance in PwMS and add to literature predictive validity of foot vibration threshold. They also suggest that vibration threshold may be important to consider when identifying people in need of intervention or when evaluating the effect of rehabilitation and exercise interventions.Gait & Posture 10/2014; · 2.30 Impact Factor
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ABSTRACT: To investigate the immediate effects of textured insoles on balance and gait in people with multiple sclerosis (MS), and to explore any effects after 2 weeks of wear. Within-session repeated-measures design with an exploratory follow-up period. Hospital gait laboratory. Forty-six individuals with MS (34 females, 12 males), with a mean (SD) age of 49 (7) years, who could walk 100m unassisted or using one stick/crutch. Participants were tested wearing three types of insoles in a random order: control (smooth), Texture 1 (Algeos) or Texture 2 (Crocs™). Participants were allocated at random to wear one type of textured insoles for 2 weeks, after which they were retested. Standing balance (centre of pressure excursions and velocity) was measured with eyes open and eyes closed on a Kistler force platform. Spatio-temporal parameters of gait were measured using a GAITRite system. The textured insoles had no significant immediate effects on balance or gait, apart from an increase in anteroposterior sway range with eyes open for Texture 2 insoles [mean difference 4.5 (95% confidence interval 0.6 to 8.4)mm]. After 2 weeks, balance was not significantly different, but both types of textured insoles showed significant effects on spatio-temporal parameters of gait, with mean stride length increases of 3.5cm (Texture 1) and 5.3cm (Texture 2) when wearing the insoles. After 2 weeks of wear, there were improvements in spatio-temporal parameters of gait. However, it is unclear whether this was a placebo effect or a learning effect.Physiotherapy 09/2013; · 2.11 Impact Factor
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ABSTRACT: Asymmetry of standing balance and gait is common in individuals with neurological disorders, and achieving symmetrical stance and gait is an important goal of rehabilitation. The purpose of this study was to investigate the effect of a novel discomfort-induced approach (that is based on using a single textured insole) on the alteration in the symmetry of gait and balance. Eleven healthy subjects (6 females and 5 males, mean age of 28.0 ± 4.1 years) were tested using the Computerized Dynamic Posturography and GaitRite systems when standing or walking while wearing standard footwear with the textured insole positioned either in the left or in the right shoe, and without the insole. Significant immediate effect of the textured insole was seen in the outcome measures of static (weight bearing) and dynamic (weight symmetry index, strength symmetry) balance tests (p < 0.05) as well as in gait symmetry (single support and swing phases) (p < 0.05). The results of the study indicate that a textured insole can significantly modify the symmetry of stance and gait in healthy individuals. Pilot data from individuals with stroke also showed a reduction in the asymmetry of gait when walking with the single textured insole in the shoe on the unaffected side. This outcome provides support for future studies on the efficacy of the textured insole in minimizing asymmetry of gait and posture in individuals in need.Experimental Brain Research 08/2013; 231(2). · 2.17 Impact Factor