Hip and ankle walking strategies: effect on peak plantar pressures and implications for neuropathic ulceration

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Bibliographische Detailangaben
Deutscher übersetzter Titel:Gehen aus der Huefte versus Gehen aus dem Sprunggelenk: Auswirkung auf die maximalen Fuszsohlen-Druckwerte und Bezug zu neuropathischer Geschwuerbildung
Autor:Mueller, M.J.; Sinacore, D.R.; Hoogstrate, S.; Daly, L.
Erschienen in:Archives of physical medicine and rehabilitation
Veröffentlicht:75 (1994), 11, S. 1196-1200, Lit.
Format: Literatur (SPOLIT)
Publikationstyp: Zeitschriftenartikel
Medienart: Gedruckte Ressource
Sprache:Englisch
ISSN:0003-9993, 1532-821X
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Erfassungsnummer:PU199704204299
Quelle:BISp

Abstract des Autors

Treatment of neuropathic plantar ulcers often is directed at reducing excessive, repeated peak plantar pressures (PPP). The purposes of this study were to determine whether instructing a subject to walk using a hip strategy would reduce forefoot PPP and change the kinematics of walking during a single session of testing. Thirteen subjects, 7 with peripheral neuropathy and a history of a recent plantar ulcer, and 6 controls participated. PPPs were measured with an in-shoe pressure monitoring system. Kinematics were measured with a computer-assisted motion analysis system. After data were collected as subjects walked using their normal walking pattern, subjects were instructed to walk using the hip strategy by decreasing their push-off, pulling their leg forward from their hips, decreasing step length, and maintaining their normal walking velocity. Compared with using the normal (ankle) strategy, using the hip strategy showed a significant 27% decrease in forefoot PPP and a 24% increase in heel PPP. Kinematic changes were decreased plantar flexion angular velocity, hip extension range-of motion (ROM), and step length, increased dorsiflexion ROM, and hip flexion ROM, but no change in walking velocity. These findings indicate that a change in walking pattern can result in lower forefoot PPP during a single session. Assuming patients can maintain the alterations in their walking pattern, these adaptations may help to heal plantar ulcers in some patients with peripheral neuropathy. Verf.-Referat