Insole configuration and plantar pressures

NewsBot · Oct 19, 2006

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The effects of insole configurations on forefoot plantar pressure and walking convenience in diabetic patients with neuropathic feet
Clin Biomech (Bristol, Avon). 2006 Oct 12;
Guldemond NA, Leffers P, Schaper NC, Sanders AP, Nieman F, Willems P, Walenkamp GH

BACKGROUND: The aim of this study was to evaluate the effects of insole configurations on plantar pressures and on walking convenience in patients with diabetic neuropathy.

METHODS: Twelve different insole configurations were constructed for each of 20 patients with diabetic neuropathy. For this, different combinations of a metatarsal dome, varus and valgus wedges and arch supports with different heights were added on a fitted basic insole. Foot orthoses were evaluated while patients walked on a treadmill. Plantar pressure was measured with a Pedar Insole-system. Walking convenience was scored on a 10-point scale.

FINDINGS: For the central and medial regions, plantar pressure reductions (up to 36% and 39%, respectively) were found when using a dome, standard and extra supports. The largest reductions were achieved with combination of a dome and extra support. There were no statistically significant pressure reducing effects of the insole configurations in the big toe and lateral regions, except for the effect of the combination extra support/varus wedge (21%), and for a dome (10%), respectively. The basic insole and a standard support received the best ratings for walking convenience and gradually worsened by adding extra support, a varus wedge and a dome.

INTERPRETATION: A dome and the supports reduce plantar pressure in the central and medial forefoot. The combination of a dome and extra support seems to be the best choice for the construction of insoles. The results of this study are a step towards developing an evidence-based algorithm for the construction of optimal orthoses in therapeutic shoe design.
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NewsBot · Mar 17, 2010

The effect of 3 foot pads on plantar pressure of pes planus foot type.
Nordsiden L, Van Lunen BL, Walker ML, Cortes N, Pasquale M, Onate JA.
J Sport Rehabil. 2010 Feb;19(1):71-85.

CONTEXT: Many styles of foot pads are commonly applied to reduce immediate pain and pressure under the foot. OBJECTIVE: To examine the effect of 3 different foot pads on peak plantar pressure (PPP) and mean plantar pressure (MPP) under the first metatarsophalangeal joint (MTPJ) during slow running. DESIGN: A 4 (pad) x 4 (mask) repeated-measures design. SETTING: University athletic training clinic and fitness facility.

PARTICIPANTS: 20 physically active participants, 12 men (19.7 +/- 1.3 y, 181.5 +/- 6.3 cm, 83.6 +/- 12.3 kg) and 8 women (20.8 +/- 1.5 y, 172.7 +/- 11.2 cm, 69.9 +/- 14.2 kg) with navicular drop greater than or equal to 10 mm, no history of surgery to the lower extremity, and no history of pain or injury to the first MTPJ in the past 6 months.

INTERVENTIONS: PPP and MPP were evaluated under 4 areas of the foot: the rear foot, lateral forefoot, medial forefoot, and first MTPJ. Four pad conditions (no pad, metatarsal dome, U-shaped pad, and donut-shaped pad) were evaluated during slow running. All measurements were taken on a standardized treadmill using the Pedar in-shoe pressure-measurement system. MAIN OUTCOME MEASURES: PPP and MPP in 4 designated foot masks during slow running.

RESULTS: The metatarsal dome produced significant decreases in MPP (163.07 +/- 49.46) and PPP (228.73 +/- 63.41) when compared with no pad (P < .001). The U-shaped pad significantly decreased MPP (168.68 +/- 50.26) when compared with no pad (P < .001). The donut-shaped pad increased PPP compared with no pad (P < .001).

CONCLUSIONS: The metatarsal dome was most effective in reducing both peak and mean plantar pressure. Other factors such as pad comfort, type of activity, and material availability must also be considered. Further research should be conducted on the applicability to other foot types and symptomatic subjects.
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NewsBot · Mar 4, 2022

Design and Preliminary Validation of Individual Customized Insole for Adults with Flexible Flatfeet Based on the Plantar Pressure Redistribution
Yangzheng Jiang et al
Sensors (Basel). 2021 Mar 4;21(5):1780

Flatfoot is a common musculoskeletal deformity. One of the most effective treatments is to wear individually customized plantar pressure-based insoles to help users change the abnormally distributed pressure on the pelma. However, most previous studies were divided only into several plantar areas without detailed plantar characteristic analysis. In this study, a new insole is designed which redistributes pressure following the analysis of characteristic points of plantar pressure, and practical evaluation during walking of subjects while wearing the insole. In total, 10 subjects with flexible flatfeet have participated in the performance of gait experiments by wearing flat insoles, orthotic insoles, and plantar pressure redistribution insoles (PPRI). The results showed that the stance time of PPRI was significantly lower than that of the flat insoles under slow gait. PPRI in the second to third metatarsal and medial heel area showed better unloading capabilities than orthotic insoles. In the metatarsal and heel area, the PPRI also had its advantage in percentage of contact area compared to flat insole and orthotic insole. The results prove that PPRI improves the plantar pressure distribution and gait efficiency of adults with flexible flatfeet, and can be applied into clinical application.
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