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BackgroundShock waves caused by ground reaction force dissipate through the body during walking, which brings about dynamic loading on bones and soft tissues. It was showed that individuals with neck pain walk with a stiffer spine due to protective movement strategy against pain. Degenerative changes, pain and increased stiffness decrease the shock absorption capacity of the spine and cause an increase in dynamic loading affecting the spine. It was known that chronic idiopathic neck pain (CINP) causes alternations in gait parameters, but it is still unclear if using flat cushioning insole affects gait parameters in individuals with CINP.ObjectivesThe aim of the study was to investigate the effects of flat cushioning insole on neck pain during walking and gait parameters in individuals with CINP.MethodsTwenty-one individuals with CINP (15 female – 6 male, mean age: 35,67±12,64) and 21 healthy controls (15 female – 6 male, mean age: 35,33±12,51) recruited into this study. Assessment of gait parameters and pain were carried out in two sessions, standard shoe only and standard shoe with flat cushioning. In both sessions, all participants performed the 10-metre walking test in two walking conditions: normal walking (PW), walking at maximum speed (MAXW). The order of sessions and walking conditions were randomised. Plantar pressure parameters were assessed using pressure sensitive insoles and spatiotemporal parameters were assessed using video analysis method involving slow motion camera (120fps). Pain severity was assessed using Visual Analogue Scale at the beginning of both sessions and immediately following the end of the walking conditions in individuals with CINP. Paired sample t-test was used to determine the effects of flat cushioning insole on gait parameters for both groups and on neck pain for the only neck pain group.ResultsOur findings indicated that the flat cushioning insole results in a decrease in the maximum force, peak pressure, force-time integral, pressure-time integral and an increase in the contact area in both groups (p<0.05). In individuals with CINP, flat cushioning insole increased walking speed and step length in both walking conditions (p<0.05), however, it had no impact on cadence (p>0.05). Flat cushioning insole reduced the severity of neck pain during MAXW (p<0.05), but there was no difference in neck pain at beginning of both sessions and during PW conditions (p>0.05). In healthy individuals, no difference was found in spatiotemporal gait parameters between two sessions (p>0.05).ConclusionsThe study suggested that the flat cushioning insole reduces neck pain severity during walking and has positive effects on gait parameters in individuals with CINP. Flat cushioning insole may be used to decrease neck pain during walking and improve spatiotemporal gait parameters in individuals with CINP.References[1] Helliwell P, Smeathers J, Wright V. Shock absorption by the spinal column in normals and in ankylosing spondylitis. Journal of Engineering in Medicine1989;203(4):187–90.[2] Falla D, Gizzi L,...

Objective The aim of study was to analyze the association between Quadriceps Angle (QA) and plantar pressure, navicular height (NH), and calcaneo-tibial angle (CTA). Methods A total of 64 volunteers (mean age: 22.25 ± 2.54 (range:19–33)) participated in this cross sectional study. EMED-m (Novel GmbH, Germany) electronic pedobarograph was employed for dynamic plantar pressure measurement using two step protocol. The angle between the vertical axis of calcaneus and the long axis of Achilles tendon for CTA. The height of navicular tubercle from the ground was measured while the subject was standing on both feet for NH. QA was measured while the subject was standing in a relaxed posture where both feet bearing equal weight. Results There were significant negative correlations between QA and maximum force (MxF) under the 4th. metatarsal head (MH4). The QA was also significantly correlated with MxF and force-time integral (FTI) under the bigtoe (BT). FTI under the 3rd. metatarsal head (MH3), MH4 and 5th. metatarsal head (MH5) were significantly negatively correlated with QA. Pressure-time integral (PTI) under the MH4 and MH5 were found to be significantly negatively correlated with QA. A significant correlation was also found between QA and NH (p < 0.0001), whilst there was no correlation between QA and CTA. Regression analysis showed that NH was appeared as the major contributor for the QA (β = −0.49, p < 0.001) in the dynamic condition, followed by BT-FTI (β = 0.37, p < 0.001) and MH5-MxF (β = −0.21, p < 0.037). Conclusion These findings may imply that the NH which can at least be controlled by appropriate shoe inserts may affect QA. This way, loading pattern of both plantar region and whole lower extremity may be altered. Level of evidence Level III, Diagnostic Study.

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