Effect of a Metatarsal Pad on the Forefoot During Gait

2012 ◽  
Vol 102 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Koen L. M. Koenraadt ◽  
Niki M. Stolwijk ◽  
Dorine van den Wildenberg ◽  
Jaak Duysens ◽  
Noël L. W. Keijsers
Keyword(s):  
Plantar Pressure ◽  
Stance Phase ◽  
Alternative Hypothesis ◽  
Metatarsal Head ◽  
Pain Reduction ◽  
Motion Analysis System ◽  
Extra Space ◽  
Second Metatarsal ◽  
The Mean ◽  
Analysis System

Background: Metatarsal pads are frequently prescribed for patients with metatarsalgia to reduce pain under the distal metatarsal heads. Several studies showed reduced pain and reduced plantar pressure just distal to the metatarsal pad. However, only part of the pain reduction could be explained by the decrease in plantar pressure under the forefoot. Therefore, an alternative hypothesis is proposed that pain relief is related to a widening of the foot and the creation of extra space between the metatarsal heads. This study focused on the effect of a metatarsal pad on the geometry of the forefoot by studying forefoot width and the height of the second metatarsal head. Methods: Using a motion analysis system, 16 primary metatarsalgia feet and 12 control feet were measured when walking with and without a metatarsal pad. Results: A significant mean increase of 0.60 mm in forefoot width during the stance phase was found when a metatarsal pad was worn. During midstance, the mean increase in forefoot width was 0.74 mm. In addition, walking with a metatarsal pad revealed an increase in the height of the second metatarsal head (mean, 0.62 mm). No differences were found between patients and controls. Conclusions: The combination of increased forefoot width and the height of the second metatarsal head produced by the metatarsal pad results in an increase in space between the metatarsal heads. This extra space could play a role in pain reduction produced by a metatarsal pad. (J Am Podiatr Med Assoc 102(1): 18–24, 2012)

scholarly journals Dynamic Pedobarography Shows Pain Avoidance Gait of Symptomatic Severe Flatfoot Patient

2018 ◽  
Vol 3 (2) ◽  
pp. 2473011418S0001
Author(s):  
Woo-Chun Lee ◽  
Chihoon Ahn ◽  
Ji-Beom Kim ◽  
Mu Hyun Kim
Keyword(s):  
Plantar Pressure ◽  
Weight Bearing ◽  
Metatarsal Head ◽  
Assessment System ◽  
Medial Longitudinal Arch ◽  
Head Elevation ◽  
Radiographic Parameters ◽  
Longitudinal Arch ◽  
Bearing Load ◽  
The Mean

Category: Basic Sciences/Biologics, Midfoot/Forefoot Introduction/Purpose: In the flatfoot patients, collapsed medial longitudinal arch during gait induced pain and it results decreased center of progression excursion index(CPEI) in dynamic pedobarography. Although the CPEI decreased is pathologic gait of flatfoot patients, range of the CPEIs is wide even in similar severity of flatfoot patients. We hypothesized that some flatfoot patients inverted forefoot or elevated first metatarsal head during gait for avoiding the pain from collapsed medial longitudinal arch, which resulted wide range of the CPEIs in flatfoot patients. The purposes of this study were to investigate the incidence of forefoot inversion and 1st metatarsal head elevation during gait in severe symptomatic flatfoot patients, and to confirm whether forefoot inversion and 1st metatarsal head elevation increases the CPEI, by using the dynamic pedobarography. Methods: We retrospectively evaluated patients who underwent surgery for flatfoot in our clinic from January, 2017 to May, 2017. Before surgery, all patients underwent plain weight-bearing radiographs and dynamic pedobarography by using in-shoe plantar pressure assessment system (Tekscan, Inc., South Boston, MA). Radiographic parameters, talonavicular coverage angle, Meary angle and moment arm, and the CPEI in dynamic pedobarogrpahy were measured. The forefoot inversion and the 1st metatarsal head elevation were defined when sum of 3rd-4th and 5th submetatarsal plantar pressure was higher than sum of 1st and 2nd submetatarsal plantar pressure, and when 2nd submetatarsal plantar pressure was higher than 1st submetatarsal plantar pressure, respectively. Correlations between the radiographic parameters and the CPEI were investigated. Incidence of the forefoot inversion and the 1st metatarsal head elevation was investigated. The CPEIs in flatfeet with forefoot inversion or 1st metatarsal head elevation were compared with those in flatfeet without these pain avoidance gait. Results: Twenty-eight flatfeet from 28 patients were included in the present study. The average age of patients was 42.3 years (range: 19-71). Means of the three radiographic parameters and the CPEI of the 28 flatfeet were listed at table.1. There was no significant correlation between the CPEI and the three radiographic parameters.(Table.2) The incidence of forefoot inversion and 1st metatarsal head elevation were 11%(3 feet), 54%(15 feet) respectively. The mean CPEI of the flatfeet with forefoot inversion or 1st metatarsal head elevation was 8(range: -10 – 18), and the mean CPEI of the flatfeet without these two compensations was 5 (range: -3 – 12). The CPEI in the flatfeet with the two compensations was significant larger than that of the flatfeet without the two compensations. (P=0.027) Conclusion: In the present study, forefoot inversion or 1st metatarsal head elevation were happened in 65% of symptomatic flatfoot patients. These two pain avoidance gait shifts weight-bearing load laterally, which decreases collapsing medial longitudinal arch and pain on the flatfoot. Because lateral shifting of weight-bearing load increases the CPEI, flatfoot patients with these two gaits showed high the CPEI. Therefore, the degree of the CPEIs are various even in similar severity of flatfoot and are not correlated with the severity of the flatfoot. Clinicians should consider these pain avoidance gait of flatfoot patients when they interpret a dynamic pedobarography of flatfoot.

Effect of Orthotic Therapy on Claw Toe Loading

2004 ◽  
Vol 94 (3) ◽  
pp. 246-254 ◽  
Author(s):  
Penny J. Claisse ◽  
Jodi Binning ◽  
Julia Potter
Keyword(s):  
Pressure Measurement ◽  
Plantar Pressure ◽  
Metatarsal Head ◽  
Plantar Surface ◽  
Time Integral ◽  
Pressure Time ◽  
Second Metatarsal ◽  
Plantar Pressure Measurement ◽  
Access To Data ◽  
Toe Deformity

This study demonstrates the effect of orthotic therapy for toe deformity on toe and metatarsal head pressures using a new analysis method facilitated by an in-shoe pressure-measurement system’s ability to export detailed data. Plantar pressure–time integrals in 11 individuals (22 feet) with claw deformity of the lesser toes were measured with and without toe props. Differences in pressure–time integrals at every individual sensor unit were then calculated for the two conditions, and significance was tested using the paired t-test. Plantar surface charts with contours of equal significant pressure–time integral change showed significant reduction under 17 second toes (77%), 22 third toes (100%), 15 fourth toes (68%), 13 second metatarsal heads (59%), 16 third metatarsal heads (73%), and 16 fourth metatarsal heads (73%). All 22 feet showed increases under the prop in the area of the third toe sulcus. This innovative approach to plantar pressure analysis could improve access to data that show significant pressure–time integral changes and, therefore, could advance the clinical application of plantar pressure measurement. (J Am Podiatr Med Assoc 94(3): 246–254, 2004)

Effectiveness of the Fixtoe Device® in Plantar Pressure Reduction: A Preliminary Study.

2021 ◽  
Author(s):  
Maria Ruiz-Ramos ◽  
Ángel Manuel Orejana-García ◽  
Ignacio Vives-Merino ◽  
Carmen Bravo-Llatas ◽  
José Luis Lázaro-Martínez ◽  
...  
Keyword(s):  
Plantar Pressure ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Clinical Results ◽  
Cross Sectional ◽  
Time Integral ◽  
Pressure Time ◽  
Second Metatarsal ◽  
Maximal Pressure ◽  
Taping Technique

Abstract Background: Metatarsalgia is a common foot condition. The metatarsophalangeal stabilizing taping technique described by Yu et al. has shown good clinical results as a provisional treatment in propulsive metatarsalgia. 35 The Fixtoe Device®, a novel orthopedic device, intends to simulate stabilizing tape. However, to date, there is no evidence of its effectiveness.Methods: The aim of this study was to assess plantar pressure changes using the Fixtoe Device®, in comparison with the traditional method (stabilizing tape) in a young, healthy sample thorough a cross-sectional study. Maximal pressure (Kpa) and pressure-time integral (Kpa/s) in the second metatarsal head were measured in twenty-four healthy volunteers. Registers were taken in four different conditions: barefoot, traditional stabilizing tape, Fixtoe Device® without metatarsal pad, and Fixtoe Device® with metatarsal pad. Results: Mean second metatarsal head maximal pressure and mean pressure-time integral showed statistical difference among the four analyzed conditions (p < 0.0001 in both cases). The improvement in maximal pressure and pressure-time integral obtained in each intervention also showed significance (p < 0.0001 in both cases). Comparing the improvement of the Fixtoe Device® with and without metatarsal pad with that of tape condition showed a moderate to high and moderate effect size for both peak pressure and pressure-time integral reduction.Conclusions: The Fixtoe Device® reduces median maximal pressure and median pressure-time integral under the second metatarsal head in healthy young individuals. The Fixtoe Device® shows higher effectiveness than the traditional second metatarsophalangeal joint stabilizing taping technique. To our knowledge, this is the first investigation proving the effectiveness of the recently developed Fixtoe Device® in terms of plantar pressure modification, which leads the way to its use in clinics.

Classification of Frontal Plane Rearfoot Motion Patterns During the Stance Phase of Walking

2009 ◽  
Vol 99 (5) ◽  
pp. 399-405 ◽  
Author(s):  
Mark W. Cornwall ◽  
Thomas G. McPoil
Keyword(s):  
Stance Phase ◽  
Frontal Plane ◽  
Visual Observation ◽  
Motion Analysis System ◽  
Multiple Correlation ◽  
Motion Patterns ◽  
Analysis System ◽  
Asymptomatic Individuals ◽  
Rearfoot Motion

Background: Classification of rearfoot motion patterns would assist in understanding normal rearfoot motion and would facilitate the identification of abnormal motion. We sought to identify common frontal plane rearfoot motion patterns in an asymptomatic population. Methods: Frontal plane rearfoot motion was measured with an electromagnetic motion analysis system in 279 asymptomatic individuals during barefoot walking. The coefficient of multiple correlation and visual observation were used to identify similar patterns of rearfoot motion. Results: Four distinct rearfoot motion patterns were identified: pattern 1 consisted of 176 individuals (63.1%) and was labeled “typical” eversion, pattern 2 consisted of 87 individuals (31.2%) and was labeled “prolonged eversion,” pattern 3 consisted of nine individuals (3.2%) and was labeled “delayed eversion,” and pattern 4 consisted of seven individuals (2.5%) and was labeled “early eversion.” Conclusions: Asymptomatic frontal plane rearfoot motion can be classified into four distinct patterns, but most individuals (94.3%) exhibit one of two motion patterns (typical or prolonged eversion). (J Am Podiatr Med Assoc 99(5): 399–405, 2009)

The Amount of Rearfoot Motion Used During the Stance Phase of Walking

2005 ◽  
Vol 95 (4) ◽  
pp. 376-382 ◽  
Author(s):  
Linda Dowdy Youberg ◽  
Mark W. Cornwall ◽  
Thomas G. McPoil ◽  
Patrick R. Hannon
Keyword(s):  
Range Of Motion ◽  
Motion Analysis ◽  
Clinical Implication ◽  
Stance Phase ◽  
Three Dimensional ◽  
Frontal Plane ◽  
Motion Analysis System ◽  
Analysis System ◽  
Rearfoot Motion ◽  
Rearfoot Eversion

The purpose of this study was to determine the proportion of available passive frontal plane rearfoot motion that is used during the stance phase of walking. Data were collected from 40 healthy, asymptomatic volunteer subjects (20 men and 20 women) aged 23 to 44 years. Passive inversion and eversion motion was measured in a nonweightbearing position by manually moving the calcaneus. Dynamic rearfoot motion was referenced to a vertical calcaneus and tibia and was measured using a three-dimensional electromagnetic motion-analysis system. The results indicated that individuals used 68.1% of their available passive eversion range of motion and 13.2% of their available passive inversion range of motion during walking. The clinical implication of individuals’ regularly operating at or near the end point of their available rearfoot eversion range of motion is discussed. (J Am Podiatr Med Assoc 95(4): 376–382, 2005)

A Comparison of Two Motion Analysis Systems for the Measurement of Two-Dimensional Rearfoot Motion During Walking

1997 ◽  
Vol 18 (7) ◽  
pp. 427-431 ◽  
Author(s):  
Kori Mannon ◽  
Tonya Anderson ◽  
Phil Cheetham ◽  
Mark W. Cornwall ◽  
Thomas G. McPoil
Keyword(s):  
Motion Analysis ◽  
Electromagnetic Analysis ◽  
Motion Analysis System ◽  
Two Dimensional ◽  
Mean Motion ◽  
Motion Paths ◽  
The Mean ◽  
Analysis System ◽  
Time Required ◽  
Rearfoot Motion

The purpose of this study was to compare two-dimensional rearfoot motion during walking measured by a traditional video-based motion analysis system to that of an electromagnetic analysis system. Twenty-five individuals (15 men, 10 women) with a mean age of 29.8 years served as subjects for this study. The results of the study showed that there was a high correlation ( r = 0.945) between the mean motion paths produced by the two systems, indicating that they were very similar. The electromagnetic motion analysis system was able to produce these similar results in a fraction of the time required by the video-based system.

scholarly journals Analysis of Plantar Pressure Pattern after Metatarsal Head Resection. Can Plantar Pressure Predict Diabetic Foot Reulceration?

2021 ◽  
Vol 10 (11) ◽  
pp. 2260
Author(s):  
Marta García-Madrid ◽  
Yolanda García-Álvarez ◽  
Francisco Javier Álvaro-Afonso ◽  
Esther García-Morales ◽  
Aroa Tardáguila-García ◽  
...  
Keyword(s):  
Plantar Pressure ◽  
Metatarsal Head ◽  
First Metatarsal ◽  
Metatarsal Bones ◽  
Second Metatarsal ◽  
Patients With Diabetes ◽  
Peak Plantar Pressure ◽  
One Year ◽  
The Moment ◽  
A Minor

To evaluate the metatarsal head that was associated with the highest plantar pressure after metatarsal head resection (MHR) and the relations with reulceration at one year, a prospective was conducted with a total of sixty-five patients with diabetes who suffered from the first MHR and with an inactive ulcer at the moment of inclusion. Peak plantar pressure and pressure time integral were recorded at five specific locations in the forefoot: first, second, third, fourth, and fifth metatarsal heads. The highest value of the four remaining metatarsals was selected. After resection of the first metatarsal head, there is a displacement of the pressure beneath the second metatarsal head (p < 0.001). Following the resection of the minor metatarsal bones, there was a medial displacement of the plantar pressure. In this way, plantar pressure was displaced under the first metatarsal head following resection of the second or third head (p = 0.001) and under the central heads after resection of the fourth or fifth metatarsal head (p < 0.009 and p < 0.001 respectively). During the one-year follow-up, patients who underwent a metatarsal head resection in the first and second metatarsal heads suffered transfer lesion in the location with the highest pressure. Patients who underwent a minor metatarsal head resection (second–fifth metatarsal heads) showed a medial transference of pressure. Additionally, following the resection of the first metatarsal head there was a transference of pressure beneath the second metatarsal head. Increase of pressure was found to be a predictor of reulceration in cases of resection of the first and second metatarsal heads.

Motion of the Calcaneus, Navicular, and First Metatarsal During the Stance Phase of Walking

2002 ◽  
Vol 92 (2) ◽  
pp. 67-76 ◽  
Author(s):  
Mark W. Cornwall ◽  
Thomas G. McPoil
Keyword(s):  
Stance Phase ◽  
Three Dimensional ◽  
Linear Displacement ◽  
Human Walking ◽  
Motion Analysis System ◽  
First Metatarsal ◽  
History Of ◽  
Foot Problems ◽  
Normal Human ◽  
Analysis System

One hundred fifty-three subjects between the ages of 18 and 41 years (mean age, 26.2 years) with no history of congenital or traumatic deformity or foot problems walked along a 6-m walkway while the angular and linear displacement of the tibia, calcaneus, navicular, and first metatarsal was measured by means of an electromagnetic motion analysis system. Three-dimensional movement of the calcaneus relative to the tibia, of the navicular relative to the calcaneus, and of the first metatarsal relative to the navicular during the stance phase of gait was calculated. The results of this study provide information on, and an understanding of, how the calcaneus, navicular, and first metatarsal function during the stance phase of normal human walking. (J Am Podiatr Med Assoc 92(2): 67-76, 2002)

The Stance Phase of Walking During Late Pregnancy

2005 ◽  
Vol 95 (3) ◽  
pp. 247-253 ◽  
Author(s):  
Janelle K. Lymbery ◽  
Wendy Gilleard
Keyword(s):  
Ground Reaction Force ◽  
Stance Phase ◽  
Center Of Pressure ◽  
Reaction Force ◽  
Late Pregnancy ◽  
Camera Motion ◽  
Motion Analysis System ◽  
Step Width ◽  
Analysis System ◽  
Camera Motion Analysis

The purpose of this study was to investigate temporospatial and ground reaction force variables in the stance phase of walking during late pregnancy. An eight-camera motion-analysis system was used to record 13 pregnant women at 38 weeks’ gestation and again 8 weeks after birth. In late pregnancy, there was a wider step width, and mediolateral ground reaction force tended to be increased in a medial direction. The center of pressure moved more medially initially and less anteriorly at 100% of stance in late pregnancy. The differences suggest that women may adapt their gait to maximize stability in the stance phase of walking and to control mediolateral motion. (J Am Podiatr Med Assoc 95(3): 247–253, 2005)

Sign in / Sign up

Export Citation Format

Share Document