Details

Autor(en) / Beteiligte

• MUELLER, M. J
• SINACORE, D. R
• HOOGSTRATE, S
• DALY, L

Titel

Hip and ankle walking strategies : effect on peak plantar pressures and implications for neuropathic ulceration

Ist Teil von

• Archives of physical medicine and rehabilitation, 1994-11, Vol.75 (11), p.1196-1200

Ort / Verlag

New York, NY: Elsevier

Erscheinungsjahr

1994

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Treatment of neuropathic plantar ulcers often is directed at reducing excessive, repeated peak plantar pressures (PPP). The purposes of this study were to determine whether instructing a subject to walk using a hip strategy would reduce forefoot PPP and change the kinematics of walking during a single session of testing. Thirteen subjects, 7 with peripheral neuropathy and a history of a recent plantar ulcer, and 6 controls participated. PPPs were measured with an in-shoe pressure monitoring system. Kinematics were measured with a computer-assisted motion analysis system. After data were collected as subjects walked using their normal walking pattern, subjects were instructed to walk using the hip strategy by decreasing their push-off, pulling their leg forward from their hips, decreasing step length, and maintaining their normal walking velocity. Compared with using the normal (ankle) strategy, using the hip strategy showed a significant 27% decrease in forefoot PPP and a 24% increase in heel PPP. Kinematic changes were decreased plantar flexion angular velocity, hip extension range-of motion (ROM), and step length, increased dorsiflexion ROM, and hip flexion ROM, but no change in walking velocity. These findings indicate that a change in walking pattern can result in lower forefoot PPP during a single session. Assuming patients can maintain the alterations in their walking pattern, these adaptations may help to heal plantar ulcers in some patients with peripheral neuropathy.