Article

The Effect of Padded Hosiery in Reducing Forefoot Plantar Pressures

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  • Moving Into Harmony
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Abstract

The purpose of this study was to determine if the use of padded hosiery caused a significant reduction in planter pressures measured at the sock-shoe interface compared to a control sock, when initially fitted and after 8 weeks of continuous wear. Testing was conducted on eight healthy subjects under the following conditions: a nonpadded control sock, a wash-only padded sock, and a padded test sock. Pressure data were collected within the shoe for the three conditions using the EMED Mikro system (NOVEL Gmbh, Munich, Germany) on the initial day of fitting and after 8 weeks of wear. Data were also collected on the test sock at the time of initial donning and again after 4 hours of activity. The results indicate that padded hosiery can significantly decrease forefoot plantar pressures when initially donned, after wearing for 4 hours of activity, and over a period of g weeks of wear. The pressure reductions that were found, however, were not uniform across the entire forefoot.

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... 4 Considerable research has also been conducted on specialized sports hosiery to determine physiologic benefits. This research has suggested that athletic socks can significantly reduce plantar pressures, [5][6][7][8][9][10][11][12][13] impact shock, 14 incidence of friction blisters, 15,16 and symptoms of venous insufficiency. 17,18 These medical benefits, validated by scientific study, gave rise to a new category of socks-therapeutic hosierydesigned for athletes and patients with diabetes. ...
... 19 For these reasons, most researchers have focused on the FF region. 1,2,5,7,8,11,19 They have reported that ulcer risk is greater under the hallux and the first and second metatarsals. The critical loading of the hallux occurs when people are not walking straight ahead, and then the range of motion of the first metatarsophalangeal joint is important in determining pressures under the hallux. ...
Article
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Background: The major goal of investigating plantar pressure in patients with pain or those at risk for skin injury is to reduce pressure under prominent metatarsal heads, especially the first and second metatarsals. In research, the insole is used to reduce plantar pressure by increasing the contact area in the midfoot region, which, in turn, induces an uncomfortable feeling near the arch during walking. It is deduced that sock structure can redistribute plantar pressure distribution. Methods: Seven sock types with seven structures (plain, single cross tuck, mock rib inlay, cross miss, mock rib, double cross tuck, and double cross miss) for the sole area were produced. A plantar pressure measurement device was used to measure plantar static pressure in ten participants. The barefoot plantar pressure distribution was compared with the plantar pressure distribution with socks. Results: In the seven sock samples, the mean plantar pressure of the cross miss and mock rib structures at high plantar pressure zones (toe and first through fourth metatarsal bone regions) were decreased, and, as a result, the pressure shifted to relatively low pressure zones (fifth metatarsal bone and midfoot regions). Conclusions: These results indicate that wearing socks with cross miss and mock rib structures will reduce mean plantar pressure values compared with the barefoot condition in high plantar pressure zones. In general, the results suggest that mean plantar pressure is redistributed from high to low plantar pressure zones.
... In addition, 51% of pain relief was observed after wearing the padded socks for 3 months. Flot et al. 10 perceived a considerable decrement in forefoot pressures at the hallux and central regions when wearing the specially padded socks at the interface between the socks and the shoe. Donaghue et al. 11 investigated the effect of using specialized padded socks in combination with specialized appropriate footwear to reduce the plantar pressure. ...
Article
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A major purpose of investigating the plantar pressure in patients with pain or those at risk for skin injury is to reduce the pressure below metatarsal heads, specially first and second metatarsal heads. The aim of this article is to evaluate the effects of the socks structures on the changes in plantar dynamic pressure. In this study, seven socks types with different structures for the sole area were produced. The Gaitview® AFA-50 system, a force plate, was used to measure the plantar dynamic pressure of 10 participants. The barefoot plantar dynamic pressure distribution was compared with the plantar dynamic pressure distribution with socks by two independent samples test on various zones of the foot and on different genders using SPSS software. Mann–Whitney tests were used to determine specific significant differences. The obtained results showed that the main trend was to redistribute the plantar dynamic pressure from the higher plantar pressure zones (toe and first through forth metatarsal bone regions) were decreased and as a result the plantar pressure toward the relatively lower pressure zones (fifth metatarsal bone and midfoot regions). In comparison with the barefoot condition, the cross miss structure reduced the mean pressure in the critical region of the foot (first metatarsal) for male and female subjects (p < 0.05) and also the mock rib structure reduced the mean pressure for female subjects (p < 0.05). In general, the results suggested wearing the socks because the socks make the plantar pressure redistributed from high to low plantar pressure zones. The results of this research indicated that wearing socks with cross miss and mock rib structures will reduce the mean plantar pressure values in forefoot area in comparison with the barefoot condition.
... A total of 81 articles were retrieved, but we identified only seven prospective studies [34][35][36][37][38][39][40] that met the inclusion criteria. A further five papers [41][42][43][44][45] considered the role of protective socks in other populations (e.g. athletes' or rheumatoid arthritis). ...
Article
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Padded socks to protect the at-risk diabetic foot have been available for a number of years. However, the evidence base to support their use is not well known. We aimed to undertake a systematic review of padded socks for people with diabetes. Additionally, a narrative analysis of knitted stitch structures, yarn and fibres used together with the proposed benefits fibre properties may add to the sock. Assessment of the methodological quality was undertaken using a quality tool to assess non-randomised trials. From the 81 articles identified only seven met the inclusion criteria. The evidence to support to use of padded socks is limited. There is a suggestion these simple-to-use interventions could be of value, particularly in terms of plantar pressure reduction. However, the range of methods used and limited methodological quality limits direct comparison between studies. The socks were generally of a sophisticated design with complex use of knit patterns and yarn content. This systematic review provides limited support for the use of padded socks in the diabetic population to protect vulnerable feet. More high quality studies are needed; including qualitative components of sock wear and sock design, prospective randomized controlled trials and analysis of the cost-effectiveness of protective socks as a non-surgical intervention. Electronic supplementary material The online version of this article (doi:10.1186/s13047-015-0068-7) contains supplementary material, which is available to authorized users.
... Various studies have been conducted to investigate the effects of sock materials; however, unequivocal outcome on foot skin temperature and on whole body thermoregulation have been reported (Gavin et al., 2001;Purvis & Tunstall, 2004;House et al., 2003). In addition, socks assist in minimizing shear forces that lead to blistering of skin (Sulzberger et al., 1966;Bush et al., 2000;Herring & Richie, 1993;Flot et al., 1995;Wong et al., 1998;Howarth & Rome, 1996). ...
... The pads can differ in shape, thickness, hardness, and location. The use of pads results in a considerable reduction of plantar pressure, mainly at the heads of the metatarsalia II, III, and IV and an increase of pressure at the metatarsal shaft region (Chang et al., 1994; Flot et al., 1995; Holmes and Timmerman, 1990). @BULLET Custom moulded insert. ...
Article
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The effects of a custom moulded insole and a rockerbar on peak pressure and force impulse as well as on pain scores in subjects with a history of metatarsalgia were studied. In addition the subjects' preference for the type of intervention was determined. Forty-two subjects with a history of primary metatarsalgia were selected. They were all provided with the same brand of extra depth shoes with a ready made insole. The effect of custom moulded insoles, a rockerbar and the interaction between the two interventions were studied by testing the four possible combinations: ready made insole without a rockerbar, ready made insole with a rockerbar, custom moulded insole without a rockerbar and custom moulded insole with rockerbar. At the most important region, the central distal forefoot, a rockerbar caused a decrease in force impulse of 15.1% and a decrease in peak pressure of 15.7%. The custom moulded insole produced a decrease of 10.1% in force impulse and of 18.2% in peak pressure. Pain scores were significantly lower for interventions with a custom moulded insole, while the rockerbar showed no influence on pain scores. Subjects with pain preferred a custom moulded insole more often than subjects without pain. Decrease of peak pressure or force impulse was not correlated to pain scores. The use of either a custom moulded insole or a rockerbar proudced an important decrease of peak pressure and force impulse at the central distal forefoot and, therefore, either is suitable in any situation which a decrease of pressure is vital.
... 144 The shoe, stocking, and orthosis work together as a unit in protecting a patient with a partially amputated foot. 145,146 For example, silicone-insole socks have been shown to be more effective in reducing horizontal shear than cotton socks (Fig. 10). 145 Amputations involving one or more digits or a lateral ray usually can be managed with just a good shoe and insert. ...
Article
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Orthotic management is helpful in the treatment of most orthopedic conditions involving the rearfoot, including plantar fasciitis, Achilles tendon disorders, posterior tibial tendon dysfunction, flatfoot, ankle sprains, and problems associated with diabetes, arthritis, and equinus disorders. A review of the effectiveness of orthoses in the treatment of these conditions is presented here. An in-depth analysis of the orthotic management of plantar fasciitis and a critical review of foot orthoses for the pronated foot are presented. Also discussed are the rationale and effectiveness of the tension night splint in the treatment of plantar fasciitis, orthotic devices for the different stages of posterior tibial tendon dysfunction, and the various categories of orthoses for off-loading the diabetic foot. The modern ankle brace, the effectiveness of prefabricated versus prescription foot orthoses, and recent developments in the ankle-foot orthosis are also reviewed.
Chapter
Socks are an essential component of footwear for the athlete. Previously considered a commodity item, athletic socks are now designed to provide significant functional and protective benefits for the active person. This chapter will provide an overview of the key factors in the recommendation of proper socks (hosiery) for the athlete.
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One of the aims of the sock/shoe unit is to reduce the severity of impact forces on the lower extremity although the injury prevention potential of the sock through the attenuation of impact force has yet to be established. This study aims to determine the effect of athletic socks and a sock/shoe unit on peak impact force, time to peak impact force and loading rate using an impact testing methodology. An impact testing system with a gravity driven vertical impact striker (8.5kg) fitted with a load cell (10,000Hz) which was released from 0.05m to impact the specimen on the vertical axis (impact velocity=0.99m·s(-1)) was used throughout the study. All socks reduced peak impact force by between 6% and 20% when compared to a no sock control condition. Furthermore, large significant correlation coefficients (r=.62 to .72) were observed between thickness and peak impact force, time to peak impact force and loading rate in the sock only condition. Athletic socks demonstrate cushioning properties under impact testing conditions.
Chapter
Full-text available
considered a commodity item, athletic socks are now designed to provide significant functional and protective benefits for the active person. This chapter provides an overview of the key factors in the recommendation of proper socks (hosiery) for the athlete. KeywordsAthletic socks-Sport-specific socks-Athletic sock construction-composition
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There is evidence to indicate that therapeutic footwear can help prevent lower extremity amputation in patients with diabetes. The primary means of preventing amputation is to protect the insensitive foot from unnoticed trauma and excessive plantar pressures that occur during walking. The specific prescription of the shoe will depend on many foot risk criteria, but particularly on the patient's level of sensation, history of ulceration, and the amount of foot deformity. This article describes the type of footwear recommended for each of these increasing levels of foot risk categories.
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Measurements of plantar pressure provide an indication of foot and ankle function during gait and other functional activities, because the foot and ankle provide both the necessary support and flexibility for weight bearing and weight shifting while pet-forming these activities.(1-3) Although plantar pressure data have been recognized as an important element in the assessment of clients with diabetes and peripheral neuropathy, information derived from plantar pressure data also can assist in determining and managing the impairments associated with various musculoskeletal, integumentary, and neurological disorders. The use of force platforms is the method most commonly used to assess the interaction of the foot and the supporting surface. Although the force platform provides valuable information regarding both the vertical and shear components of the ground reaction force, it provides little information on how the plantar surface of the foot is loaded with respect to the supporting surface. When evaluating patients, atypical amounts of loading or patterns of loading may be reflective of a systemic or localized lower-extremity pathology and may be indicators (risk factors) for or predictors of further pathology or worsening of the existing pathology.(4) In addition, force platforms have very specific requirements for attachment to the supporting surface on which data collection will occur. Such is not the case with numerous commercially available systems for measuring plantar pressure (eg, Emed sensor platform,* Pedar insole system,* F-Scan system,(dagger) Musgrave footprint system double dagger). Thus, plantar pressure measurement systems offer the clinician a high degree of portability, permitting utilization among multiple clinic sites.
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This article reviews the most common foot deformities and pedal pathomechanical conditions that often result in pain and disability in the elderly. A description of the deformity or condition, its etiology, presenting symptoms, and various nonsurgical approaches to treatment are explored. The primary goal in all cases is to maintain or improve the patient's ability for comfortable, independent ambulation.
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