In-shoe plantar pressure distributions and comfort assessments for different insole materials in walking

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In-shoe plantar pressure distributions and comfort assessments for different insole materials in walking


Author: Kwan, Yu-on
Title: In-shoe plantar pressure distributions and comfort assessments for different insole materials in walking
Degree: M.Sc.
Year: 2011
Subject: Hong Kong Polytechnic University -- Dissertations
Shoes -- Design
Walking -- Physiological aspects
Walking -- Health aspects
Foot -- Care and hygiene
Department: Dept. of Health Technology and Informatics
Pages: x, 84 leaves : col. ill. ; 31 cm.
InnoPac Record:
Abstract: Cushioning insole is frequently used by podiatrists as a mechanical therapy to treat pressure induced foot problems, particularly in managing neuropathic foot ulceration in diabetes. There is a general belief from public and even clinicians that cushioning insole would enhance the degree of shoe comfort in walking. However, perceived comfort is often limited to descriptive terms which cannot be quantified and has seldom been systematically evaluated. To date, the choices of insole materials are based exclusively on a clinician's subjective experience, self preference and cost in many cases. Literatures on evaluating in-shoe plantar pressure distribution characteristics and perceived comforts for various insole materials are very limited. Although custom made moulded insoles have significant effects in plantar pressure redistribution, researches on simple flat insoles are even more limited. The purpose of this study is to evaluate and compare in-shoe plantar peak pressure, pressure-time integral and perceived comfort in walking under the conditions of no insole and when wearing various contemporary flat insole materials. Ten healthy subjects were recruited through convenience sampling. Peak pressure and pressure-time integral were measured using F-scan® Mobile System 3000 (Tekscan Inc., Boston, USA). Perceived comforts were evaluated using a validated visual analogue scale. Forefoot, midfoot, rearfoot and whole foot regions were separately analyzed under the conditions of no insole and when wearing different kinds of flat insole materials including PPT®, Poron® 4400, Poron® 94, Neolon®, Plastazote®, Lunairmed®, Evazote® and polymer gel. One-way repeated measures ANOVA with post-hoc Tukey LSD pairwise comparison was used to analyze for any significant difference with level of significance at p<0.05. All insole materials evaluated were ineffective in alleviating the plantar peak pressure for no insole. But they could reduce pressure-time integral over forefoot and whole foot except Neolon® which was only able to achieve that over forefoot. Regarding the degrees of effectiveness among materials, no difference existed over forefoot whereas differences were observed over whole foot. All materials, except Plastazote® and Lunairmed®, could enhance walking comfort over one or more than one foot region. The degrees of comfort varied among materials. Open-cell polyurethane foams (PPT®, Poron® 4400 and Poron® 94) were generally more comfortable than closed-cell foams (Neolon®. Plastazote®. Lunairmed® and Evazote®) and non-porous polymer gel. Less popular Poron® 94 can be considered as a good alternative to other popular conventional materials, such as PPT®, Poron® 4400 and Plastazote®, for its relatively high pressure-time integral alleviating capabilities and comfort levels. It is expected that this study can increase clinicians' understandings on pressure distribution and comfort characteristics of different contemporary insole materials. Clinicians may use the results as objective reference to choose the most appropriate insole materials in managing those pressure induced foot problems and increasing the walking comforts for patients.

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