Effects of Attrition Shoes on Kinematics and Kinetics of Lower Limb Joints During Walking

Chen, Shane Fei; Wang, Yan; Peng, Yonghan; Zhang, Ming

doi:10.3389/fbioe.2022.824297

Cited by 5 publications

(5 citation statements)

References 30 publications

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“…For example, Helton et al found that shoes with mild to moderate lateral-torsional stiffness were effective in reducing the lower extremity injury risk among military cadets [36]. Shoe attrition was not analyzed in this study; however, Chen et al recently postulated that shoe attrition has signi cant impacts on the kinematics and kinetics of lower extremity joints [23]. Our study subjects have been tested in already worn shoes that could have in uenced the results; thus, in Latvian Land Forces footwear has been changed regularly if visible shoe attrition persists; before marker placement, no visual damage (eg, asymmetrical shoe heel abrasion) to the combat boots was found.…”

Section: Discussionmentioning

confidence: 95%

“…To de ne the shank and foot segments, anatomical markers (n = 12) were attached to the middle shank, the lateral and medial femoral epicondyles, the lateral and medial malleoli, and the head of the 1st, 2nd, and 5th metatarsals, and the posterior calcaneus. The placement of the markers was the same as in previous studies for barefoot and shod conditions [22,23]. For the shod condition, markers were placed after palpation of the anatomical landmark through the shoe.…”

Section: Gait Assessmentmentioning

confidence: 99%

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Increased stride variability may predict lower leg overuse injuries among infantry soldiers

Nesterovica

Vaivads²,

Stepens

2022

Preprint

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Background A high incidence of lower leg overuse injury has been observed among military populations. Footwear usage could be promising in reducing the risk of injury from overuse of the lower extremities. The purpose of this study was to identify possible gait-related risk factors for lower leg overuse injuries when walking barefoot and in military boots. MethodsCases (n=32) were active-duty infantry soldiers from Latvian Land Forces with a history of overuse injury during the last 6 months of service before entering the study. During the study period, the cases recovered completely from the injury, did not report any functional limits, and were able to participate in all kinds of physical activities. Controls (n=32) of the same age and gender were free of injury in the same time period. Study participants were instructed to walk on a 5-meter walkway in the gait laboratory. Joint angle calculations and spatiotemporal gait parameters were evaluated for barefoot and shod conditions.Results Gait-related parameters during shod and barefoot conditions differ in both groups. The barefoot stride time and the stride time variability were statistically different between cases and controls. Conditional regression analysis showed that stride time variability during barefoot gait statistically significantly predicted the risk of lower leg overuse injury. ROC analysis showed an AUC of 0.77 (p<0.01; 95% CI 0.65-0.88), a sensitivity of 56%, and a specificity of 88%, with an optimal cut-off value for stride time variability of 1.95%.ConclusionsThe risk of injury was independent of the gait-related characteristics during shod gait. Stride time variability has low sensitivity, but if the variability value during the barefoot walk is less than 1.95%, it can be considered a negative risk factor for lower leg overuse injury among infantry soldiers.

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Section: Discussionmentioning

confidence: 95%

Section: Gait Assessmentmentioning

confidence: 99%

Increased stride variability may predict lower leg overuse injuries among infantry soldiers

Nesterovica

Vaivads²,

Stepens

2022

Preprint

View full text Add to dashboard Cite

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“…Additionally, we did not analyze shoe attrition, but Chen et al recently postulated that running shoe attrition impacts the kinematics and kinetics of lower extremity joints [36], and we do not know if it is the same for the infantry boot. Footwear in the Latvian Land Forces is changed regularly if visible shoe attrition persists, and no visual damage (e.g., asymmetrical shoe heel abrasion) of the infantry boots was found before marker placement during the study period.…”

Section: Discussionmentioning

confidence: 99%

“…The marker set used in this study is similar to the conventional lower-limb gait model marker set (n = 8) and showed good test-retest reliability (ICC > 0.80) [34]. The markers were placed in the same locations as in previous studies for barefoot and shod conditions [35,36].…”

Section: Gait Assessmentmentioning

confidence: 99%

Increased Barefoot Stride Variability Might Be Predictor Rather than Risk Factor for Overuse Injury in the Military

Nesterovica

Vaivads²,

Stepens

2023

IJERPH

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Footwear usage could be a promising focus in reducing musculoskeletal injury risk in lower extremities commonly observed among the military. The goal of this research was to find potential gait-related risk factors for lower leg overuse injuries. Cases (n = 32) were active-duty infantry soldiers who had suffered an overuse injury in the previous six months of service before enrolling in the study. The control group (n = 32) included infantry soldiers of the same age and gender who did not have a history of lower leg overuse injury. In the gait laboratory, individuals were asked to walk on a 5-m walkway. Rearfoot eversion, ankle plantar/dorsiflexion and stride parameters were evaluated for barefoot and shod conditions. Barefoot walking was associated with higher stride time variability among cases. According to the conditional regression analysis, stride time variability greater than 1.95% (AUC = 0.77, 95% CI (0.648 to 0.883), p < 0.001) during barefoot gait could predict lower leg overuse injury. Increased barefoot gait variability should be considered as a possible predictive factor for lower leg overuse injury in the military, and gait with military boots masked stride-related differences between soldiers with and without lower leg overuse injury.

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“…The boots were eligible for gait evaluation unless visible signs of attrition were observed.During the gait cycle and the analysis of lower extremity movement, all study participants were fitted with retroreflective spherical markers (n = 12) using double-sided tape. A single examiner marked the subject's anatomical landmarks of the bare foot and shank bilaterally according to the previously used marker set: the middle shank, lateral and medial femoral epicondyles, lateral and medial malleoli, first, second and fifth metatarsal heads, and posterior calcaneus(Chen et al, 2022;Peng et al, 2020). After palpation of the anatomical landmarks through the military boot, markers were attached for shod gait assessment.…”

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confidence: 99%

Biomechanical Aspects of Military Footwear Usage and their Relationship with Lower Extremity Overuse Injuries. Summary of the Doctoral Thesis

Ņesteroviča

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Professional military service involves high-intensity physical training, including field training exercises and marching, which increase the risk of musculoskeletal injuries (MSKIs). In the military, MSKIs represent a significant medical concern, leading to an increased financial strain on military healthcare and a decrease in military preparedness. Acute and overuse lower extremity MSKIs are more common in the knee, lower leg, and foot. The role of military footwear in the development of overuse injuries is currently unresolved, and more research is suggested on the relationship between military footwear and overuse injuries. The purpose of this work was to determine the incidence of overuse MSKI in the lower and investigate its possible relationship with military footwear usage among the Latvian Land Forces. The research was carried out on infantry soldiers during their annual medical examinations at the Military Medical Support Centre of the Latvian National Army Logistic Command from 2018 to 2020. In a cross-sectional study on the epidemiology of MSKI, a total of n = 227 active duty infantry soldiers participated. Among study participants, 42.7 % had a history of lower extremity injuries, with a higher prevalence of overuse injuries in the lower leg. Study participants who wore inappropriate size of military boots reported lower comfort ratings for all parameters, irrespective of their history of injuries. Gait analysis was performed barefoot and wearing military boots during the case-control study (n = 66) where subjects were divided into groups according to their history of overuse injuries. Both groups showed an elevation in the foot contact angle, while simultaneously showing a reduction in the eversion of the rearfoot and the angular velocities of the ankle when wearing military footwear. The conditional logistic regression model revealed that stride time variability (OR = 2.71, 95 % CI 1.31 – 5.60) during barefoot gait demonstrated statistical significance in predicting the risk of lower leg overuse injury. The optimal threshold for stride time variability was determined to be 1.95 %, which could effectively predict the occurrence of lower leg overuse injuries, showing a sensitivity of 56 % and a specificity of 88 %. Based on research findings, walking in military footwear improves stability and encourages gait symmetry, and the risk of overuse injuries to the lower extremities does not appear to be influenced by gait with footwear. The research results support the importance of further investigating gait variability as a possible risk factor for MSKI and lay the groundwork for the establishment of guidelines for medical gait and foot screening in the military. The Doctoral Thesis was developed at the Rehabilitation Research Laboratory of Rīga Stradiņš University and the Latvian National Army Logistic Command Military Medical Support Centre Defence: at the public session of the Promotion Council Basic Medicine on 2 April 2024 at 10.00 remotely via online platform Zoom. 3.1 Basic Medicine; Sub-Sector – Medical Biomechanics. Keywords: gait analysis; infantry boot; military personnel; musculoskeletal injuries; stride variability.

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Effects of Attrition Shoes on Kinematics and Kinetics of Lower Limb Joints During Walking

Cited by 5 publications

References 30 publications

Increased stride variability may predict lower leg overuse injuries among infantry soldiers

Increased stride variability may predict lower leg overuse injuries among infantry soldiers

Increased Barefoot Stride Variability Might Be Predictor Rather than Risk Factor for Overuse Injury in the Military

Biomechanical Aspects of Military Footwear Usage and their Relationship with Lower Extremity Overuse Injuries. Summary of the Doctoral Thesis

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