AB1435-HPR Effects of flat cushioning insole on gait parameters of individuals with chronic idiopathic neck pain

Abstract

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,...

The impact of neck pain on gait health: a systematic review and meta-analysis

“…Other specific inclusion criteria regarding frequency, intensity, and duration of pain as well as criteria pertaining to limb dominance and cognitive ability are further summarized in Table 1 . Five studies defined inclusion criteria for participants in the control group as those with no history of, or current neck pain [ 26 , 46 , 48 , 50 , 54 ], and one recruited participants specifically with no additional history of whiplash injury [ 51 ]. Five studies used healthy controls with no specific inclusion criteria described [ 23 , 47 , 49 , 52 , 53 ].…”

“…Ten excluded participants with musculoskeletal, vestibular, or other diagnosed conditions that could affect gait or balance [ 23 , 24 , 26 , 47 , 49 – 55 ]. Other specific exclusion criteria are detailed in Table 1 and included the history or presence of lower extremity injury or surgery [ 24 , 48 , 49 , 52 ], taking more than four medications [ 23 , 46 , 49 , 50 , 54 ], alterations in vision [ 50 , 53 ], cognitive impairment [ 23 , 50 , 52 ], diagnosis of diabetes [ 26 , 47 – 49 , 52 ], pregnancy [ 24 , 46 ], and cervical radiculopathy [ 53 ]. One study assessing whiplash injury specifically excluded participants with a history of dizziness prior to the injury, and those who reported unconsciousness due to the injury [ 51 ].…”

“…Tested walking conditions varied by study and included preferred (self-selected) walking speed, fast walking speed, and preferred walking speed while performing a dual task (e.g., horizontal head movement, vertical head movement, or cognitive dual task). Eleven studies that reported gait speed were pooled, with 10 using a preferred walking speed condition [ 23 , 24 , 26 , 47 – 53 ], seven using a preferred speed with a dual task [ 23 , 26 , 48 – 52 ], and six using a fast speed condition [ 23 , 26 , 47 , 48 , 54 ]. Seven studies reported measures of cadence, all of which used a preferred walking speed condition [ 23 , 24 , 46 – 49 , 52 ], five used a preferred speed with a dual task [ 23 , 46 , 48 , 49 , 52 ], four used a fast speed condition [ 23 , 46 , 47 , 47 ], and one used a fast speed condition with a dual task [ 46 ].…”

“…Eleven studies that reported gait speed were pooled, with 10 using a preferred walking speed condition [ 23 , 24 , 26 , 47 – 53 ], seven using a preferred speed with a dual task [ 23 , 26 , 48 – 52 ], and six using a fast speed condition [ 23 , 26 , 47 , 48 , 54 ]. Seven studies reported measures of cadence, all of which used a preferred walking speed condition [ 23 , 24 , 46 – 49 , 52 ], five used a preferred speed with a dual task [ 23 , 46 , 48 , 49 , 52 ], four used a fast speed condition [ 23 , 46 , 47 , 47 ], and one used a fast speed condition with a dual task [ 46 ]. Four studies reported measures of stride length under a preferred speed condition [ 23 , 24 , 46 , 49 ], three with dual tasks [ 23 , 46 , 49 ], two under a fast speed condition [ 23 , 46 ], and one used a fast speed condition with a dual task [ 46 ].…”

“…Four studies reported measures of stride length under a preferred speed condition [ 23 , 24 , 46 , 49 ], three with dual tasks [ 23 , 46 , 49 ], two under a fast speed condition [ 23 , 46 ], and one used a fast speed condition with a dual task [ 46 ]. Four studies reported measures of step length under a preferred speed condition [ 23 , 47 , 48 , 53 ], two used dual tasks [ 23 , 48 ], and three used a fast speed condition [ 23 , 47 , 48 ]. Two studies reported step width under a preferred speed condition [ 23 , 24 ], one of which also reported step width under dual task and fast speed conditions [ 23 ].…”