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Physical match: insole and shoe.

In this case report, the authors show an interesting case of a physical match between an insole and a suspect shoe that was connected to the crime scene by a blood drop. Several pairs of shoes were seized and inspected. On the insoles of the main suspect's shoes, two different types of prints were seen, one was clear and the other image was faint. A physical match examination was conducted and the authors could place the right insole inside the right shoe. The insole was apparently glued to the shoe by the sweat, heat and dirt inside the shoe, and not by the manufacturer. In this case, the critical questions were how conclusive can the complexity of the random contours be, and whether the physical match between the two objects could pass the "Daubert challenge."

Blood Stains↗

[Epidemiologic studies on carcinogenic risk and occupational activities in tanning, leather and shoe industries].

A review is made of the epidemiological studies of occupational cancer risks among tannery, leather and shoe industry workers. The risk of nasal cancer associated with exposure to leather dust, which had already been stressed at the beginning of the 1970's, was confirmed in recent studies. However, a decreasing trend of RR was observed among shoe industry workers. The excess of leukemia among shoe workers, which was mainly based on the description of numerous cases of acute myeloblastic leukemia, has also been confirmed by two cohort studies carried out in Italy and the U.K. In addition to the evident increase in these two diseases, there are indications of an excess of cancer of other sites among leather and shoe workers, particularly bladder cancer, both among workers assigned to leather finishing operations and in leather goods and shoe production workers. Another interesting result is the excess of lung cancer among tannery workers. This evidence is unanimous in the studies carried out in Italy but is not supported by the majority of studies performed in other countries. For this reason, we consider it extremely important to carry out a multicentric study in Italy, with particular attention to the definition of occupational exposures to carcinogens. There are also other isolated reports of excesses of other cancers in the shoe and leather industries but in our opinion they are of dubious interpretation.

Dust↗

In-shoe foot pressure measurements in diabetic patients with at-risk feet and in healthy subjects.

OBJECTIVE: To measure in-shoe foot pressures in diabetic patients and healthy subjects and compare them with the foot pressures when they walked without their shoes. RESEARCH DESIGN AND METHODS: Forty-four diabetic patients at risk of foot ulceration and 65 healthy subjects were matched for age, sex, race, and weight. Neuropathy was evaluated clinically, and the F-Scan program was used to measure the foot pressures. Foot pressures were measured with the sensors placed in the shoes (S measurements), between the foot and the sock with shoes (H measurements) or with their socks alone (B measurements). RESULTS: In the control group, significant differences were found between S (4.77 +/- 1.87 kg/cm2) and H measurements (5.12 +/- 1.87 kg/cm2, P < 0.001), between S and B (7.23 +/- 2.95 kg/cm2, P < 0.0001), and between H and B (P < 0.0001). In the diabetic group, no difference was found between S and H measurements (5.28 +/- 2.22 vs. 5.27 +/- 2.39 kg/cm2, NS). In contrast, the B pressure was significantly higher when compared with both (8.77 +/- 4.67 kg/cm2, P < 0.02). When compared with the control group, the S and H pressures did not differ significantly, but the B pressure in the diabetic group was significantly higher (P < 0.02). The peak S pressure was above the normal limit in 24 (27%) diabetic and 21 (16%) control feet (P < 0.05), the H pressure in 17 (19%) diabetic feet and 22 (17%) control feet (NS), and the B pressure in 24 (27%) diabetic and 21 (16%) control feet (P < 0.05). CONCLUSIONS: In-shoe foot pressure measurements are significantly lower than the ones measured when walking with the socks only in both diabetic patients and healthy subjects. The shoes of diabetic patients provided a higher pressure reduction than did those of the control group, but the number of feet with abnormally high pressures did not change. The F-Scan system may be particularly helpful in designing footwear suitable for diabetic patients with at-risk feet.

Adult↗

Hoof growth between two shoeing sessions leads to a substantial increase of the moment about the distal, but not the proximal, interphalangeal joint.

REASONS FOR PERFORMING STUDY: There is little insight into the effects of routine farriery on the internal structures of the distal limb in sound horses. OBJECTIVES: To measure the effect of change in hoof conformation during a shoeing interval on the moments about the proximal and distal interphalangeal joints (PIPJ, DIPJ) and to determine whether and how the horse compensates for this change in hoof conformation. METHODS: Both front feet of 9 sound Warmblood horses were measured while standing on a pressure-force measuring system and radiographed in a lateromedial direction shortly after shoeing and 8 weeks later. From these data, ground reaction forces (GRF) and lever arms were measured in order to calculate joint moments. RESULTS: After 8 weeks, the moment about the PIPJ did not increase significantly, but the moment about the DIPJ did so, indicating a compensatory mechanism for a change in hoof conformation in the DIPJ. CONCLUSIONS: Standing horses compensate for hoof conformation change during an 8-week shoeing interval, which leads to increased DIPJ extension and consequently an increased loading of the deep digital flexor tendon. POTENTIAL RELEVANCE: This study quantifies the effect of a shoeing interval on the internal structures of the foot and helps to determine an appropriate shoeing interval for individual horses in which the hoof with the lowest hoof angle is the best indicator. The exact determination of an optimal individual shoeing interval requires further study.

Animals↗

Liver damage among shoe repairers.

BACKGROUND: The risk of hepatotoxicity in the shoe industry has already been suggested, however, there has been no investigation among the craftsmen who repair shoes. METHODS: A group of 33 shoe repairers who work in supermarkets, and who use the same glues which contain mixtures of potentially hepatotoxic solvents were identified. A control group of 61 workers not exposed to hepatotoxic substances was also examined. All participants completed a questionnaire designed to identify potential risk factors and the main non-occupational confounding factors for hepatotoxicity. Laboratory tests, commonly used in clinical practice, were done to check whether they were useful markers of hepatotoxicity due to exposure to solvent mixtures, and to investigate which tests should be used in the screening campaigns. RESULTS: The exposed workers had a higher prevalence of elevated mean alanine aminotransferase (ALT), aspartate aminotransferase (AST), conjugated bilirubin (P=0.0001), and alkaline phosphatase (AP) (P=0.004) than controls did. The number of workers who had values outside the upper limit of normal for our laboratory was significantly higher (ALT P=0.034, AST P=0. 037, conjugated bilirubin P=0.014). Exposed workers all had a ratio of ALT to AST greater than 1, with a mean of 1.5; it was > 1.6 in more than half the exposed workers. CONCLUSIONS: The findings suggest that there is the possibility of liver involvement among even asymptomatic shoe repairers, and that periodic liver screening may be useful; furthermore, use of these tests (especially the ratio of ALT to AST) for craftsmen who repair shoes, and are exposed to solvent mixtures, is advisable even when environmental monitoring indicates levels below the threshold limit values (TLVs).

Acetates↗

Acute postural adaptations induced by a shoe lift in idiopathic scoliosis patients.

The objective of this study was to identify acute spinal and three-dimensional postural adaptations induced by a shoe lift in a population of idiopathic scoliosis (IS) patients. Forty-six IS patients (mean age: 12 +/- 2 years) were evaluated radiologically and with a stereovideographic system for pelvic obliquity. Based on the initial postural and radiological evaluation, a pertinent shoe lift height was chosen for each with the result that 12 patients were tested with 5-mm (S5) lifts, 20 patients were tested with 10-mm (S10) lifts, and 14 patients with 15-mm (S15) lifts. The posture for all 46 patients was then re-evaluated and a spinal radiograph obtained for 14 patients. The implementation of a shoe lift independent of the type of curve and amplitude significantly decreased the Cobb angle. As expected there was a change in the vertical height of the left tibial plateau and greater trochanter that induced a change in pelvic tilt. There was also a significant increase in the vertical height of S1 and T1. There was a significant change in the left and right iliac bone version, as well as a decrease in the difference in version between these two bones. The implementation of the shoe lifts also changed the lateral shift of the pelvis. A relative change between the shoulders and pelvis for tilt and anteroposterior shift was also found to be significant. In conclusion, using a shoe lift resulted in acute postural adaptations which specifically affected the spine and the three-dimensional position and orientation of the pelvis and shoulder girdle.

Adaptation, Physiological↗

Acute systematic and variable postural adaptations induced by an orthopaedic shoe lift in control subjects.

A small leg length inequality, either true or functional, can be implicated in the pathogenesis of numerous spinal disorders. The correction of a leg length inequality with the goal of treating a spinal pathology is often achieved with the use of a shoe lift. Little research has focused on the impact of this correction on the three-dimensional (3D) postural organisation. The goal of this study is to quantify in control subjects the 3D postural changes to the pelvis, trunk, scapular belt and head, induced by a shoe lift. The postural geometry of 20 female subjects (X = 22, sigma = 1.2) was evaluated using a motion analysis system for three randomised conditions: control, and right and left shoe lift. Acute postural adaptations were noted for all subjects, principally manifested through the tilt of the pelvis, asymmetric version of the left and right iliac bones, and a lateral shift of the pelvis and scapular belt. The difference in the version of the right and left iliac bones was positively associated with the pelvic tilt. Postural adaptations were noted to vary between subjects for rotation and postero-anterior shift of the pelvis and scapular belt. No notable differences between conditions were noted in the estimation of kyphosis and lordosis. The observed systematic and variable postural adaptations noted in the presence of a shoe lift reflects the unique constraints of the musculoskeletal system. This suggests that the global impact of a shoe lift on a patient's posture should also be considered during treatment. This study provides a basis for comparison of future research involving pathological populations.

Adaptation, Physiological↗

Reduced customary activity in chronic heart failure: assessment with a new shoe-mounted pedometer.

Although many methods exist to assess the degree of incapacity of patients with chronic heart failure during normal daily activities, all have their limitations. In this study we describe a new shoe-mounted pedometer and compare it with body worn pedometers in normal volunteers and in patients with chronic heart failure. Ten young normal healthy volunteers participated in a comparison of the new shoe-mounted device with body born pedometers and counting a direct footfall. Seventeen patients with chronic heart failure and 10 aged-matched healthy elderly subjects participated in a comparison of both pedometers over 7 days. In the young volunteers the shoe-mounted pedometers were more accurate than the body-borne devices. With both pedometers the patients with chronic heart failure had a reduced level of activity compared with the normal volunteers over the 1 week period (P = 0.01). In both the patients and volunteers the shoe-mounted device recorded a higher score than the body borne pedometers (P < 0.01). The electronic shoe mounted pedometers are a more accurate way of assessing customary activity. In patients with chronic heart failure customary activity is substantially reduced compared with fit healthy elderly subjects.

Activities of Daily Living↗

Women's shoes and knee osteoarthritis.

We assessed whether wearing wide-heeled shoes has a similar effect on knee torque to narrow-heeled shoes by measuring the joint torques of 20 healthy women during walking. Wearing wide-heeled shoes had a 30% greater effect on peak external knee flexor torque than walking barefoot. Walking with wide-heeled and narrow-heeled shoes increased peak knee varus torque by 26% and 22%, respectively. Our findings imply that wide-heeled shoes cause abnormal forces across the patellofemoral and medial compartments of the knee, which are the typical anatomical sites for degenerative joint changes.

Adult↗

Memory for faces, shoes, and objects by deaf and hearing signers and hearing nonsigners.

The visual spatial memory of 15 deaf signers, 15 hearing signers, and 15 hearing nonsigners for shoes, faces, and verbalizable objects was measured using the game Concentration. It was hypothesized that the deaf and hearing signers would require fewer attempts than the hearing nonsigners on the shoes and faces tasks because of their experience of using a visual-spatial language; and, in the case of the Deaf, also possibly, due to a compensatory mechanism. It was also hypothesized that memory for shoes would be more like that for faces than for simple objects. It was also anticipated that there would be no difference between the three group's memories for verbalizable objects. Deaf signers were found to be similar to hearing signers, both of whom were better than hearing nonsigners on the faces and shoes tasks. Generally, performance on the faces and shoes tasks was similar and followed the same pattern for the three groups. The three groups performed at a similar level on the objects task. There were no gender differences.

Adolescent↗

Can shoe size predict penile length?

OBJECTIVE: To establish if the 'myth' about whether the size of a man's penis can be estimated from his shoe size has any basis, in fact. SUBJECTS AND METHODS: Two urologists measured the stretched penile length of 104 men in a prospective study and related this to their shoe size. RESULTS: The median stretched penile length for the sampled population was 13 cm and the median UK shoe size was 9 (European 43). There was no statistically significant correlation between shoe size and stretched penile length. CONCLUSION: The supposed association of penile length and shoe size has no scientific basis.

Adolescent↗

The effect of shoe lifts on static and dynamic postural control in individuals with hemiparesis.

OBJECTIVE: To determine the effect of lifts to the shoe of the nonaffected leg on weight symmetry and dynamic posturography in individuals with hemiparesis. DESIGN: Quantitative posturography was performed to determine subjects' response to sudden perturbations. Subjects received graded forward and backward perturbations while standing on a movable force platform. Compelled shift of the body weight was induced with sized lifts to the shoe of the nonaffected leg. Balance responses were analyzed in terms of latency and strength of neuromuscular response. Symmetry scores were used to characterize the symmetry of stance. SETTING: Free-standing acute inpatient rehabilitation hospital. PARTICIPANTS: Ten individuals with hemiparesis as a result of unilateral stroke. MAIN OUTCOME MEASURES: Weight symmetry scores, latencies of each leg's active response to the support surface translations, and response strength scores of each leg to the platform translations. RESULTS: When no lift was used, weight symmetry was characterized by underloading of the affected limb, as well as by longer onset latencies for the affected limb compared with the stronger one (158.5 +/- 3.9 vs 151.1 +/- 3.5 ms; p < .01 for large backward translations; 165.7 +/- 7.2 vs 158.0 +/- 5.1 ms; p < .01 for large forward translations). Response strength of the nonparetic limb was 2 times greater than the response strength of the weaker extremity (p < .05). Compelled weight shift induced by lifts applied to the shoe of the nonparetic limb promoted improved weight symmetry, shortened latencies, and increased magnitudes of the response strength. CONCLUSION: Lifts applied to the shoe of the stronger limb induced a body weight shift toward the paretic limb and resulted in improved symmetry of stance and postural control of individuals with hemiparesis. We suggest that compelled weight distribution induced by lifts to the shoe of the stronger limb could help treat ambulatory individuals with asymmetric stance and hemiparesis caused by unilateral stroke.

Adult↗

[Treadmill versus field trial. Movement analysis and pressure distribution in the athletic shoe].

Our current knowledge on interactions between runner and runningshoe is mainly based on treadmill measurements. In order to reveal stress load and adaptation on playing surfaces it was necessary to develop a combined measuring device out of 3-D video motion analysis and portable pressure measurement system. By means of a motor driven cart moving parallel to the subject with comparable position of cameras to the treadmill test it was possible to set up an identical trial for track and field. 12 subjects (male, age 24-32, size 9) were tested at a speed of 2.8 m/s. The varying conditions were treadmill and grass and two different constructed running shoes. 200 cycles and over 1000 steps were analyzed. The quantitative analysis of 37 parameters describing the contact phase was performed using the wilcoxon test for paired samples.-A qualitative comparison of running styles was introduced by using angle-angle-diagrams (knee and ankle by 3-D data) similar to those first described for 2-D by P.R. Cavanagh in 1973. It showed a huge interindividual variability under same conditions. Comparing the angle-angle-diagrams for the four different running conditions it was possible to classify them into three characteristic groups: non-adaptors, surface-adaptors and shoe-adaptors. Comparing track and field to treadmill measurements significant differences were found for the knee at impact: On treadmill the initial knee angle was 4.6 degrees more extended at a 13% higher angle velocity and a 30% higher angle deceleration (sig. p less than 0.05). A 7.3% higher impulse was found on grass at a 5.9% higher step length. No difference in maximum pressure was found. These results show that adaptation is performed mainly by the knee. Changing the motion pattern the knee seems to be capable of homogenizing the different stress loads to the foot. Comparing the running shoes significant differences were found in the motion of the ankle: a controversial behaviour was found to be on treadmill and grass. The pressure data revealed significant differences for the treadmill test to be in the heel area, for grass in the arch area. This points to an--up to now--unknown importance of the arch on unplain surfaces that are obviously influenced by the construction of the shoe and are not accessible by treadmill tests. The described different behaviour of shoes in treadmill and track and field tests points out the reduced validity of single treadmill tests.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Interaction between man and shoe in running: considerations for a more comprehensive measurement approach.

Man-shoe-surface interaction in running is a complex phenomenon, and its investigation gives specific requirements for the measuring system. This study was designed to make an effort to develop a methodology for measuring the interaction between the first two components (man and shoe) under normal heel running conditions both on the force plate and on an asphalt road. The force plate system consisted of a series of 1.5-m long plates with a total length of 12 m. This allowed recordings of several natural ground contact phases in one run. By repeating the runs several times at constant velocity (3 m X s-1 and 5 m X s-1), altogether 10-30 Fz and Fx force curves could be obtained for further computerized averaging. The running shoes were equipped with special heel and toe contact sensors, which were used for recordings of even more cycles at constant velocity on the road running conditions. Telemetered EMG technique was employed to examine the response of the selected lower extremity muscles on the varying shoe and running velocity conditions. The results indicated preliminarily that the changes in ground reaction forces were more velocity than shoe (hard/soft) dependent and that EMG activation patterns were muscle specific with regard to preinnervation and impact and push-off phases for the gastrocnemius, rectus femoris, vastus lateralis, and tibialis anterior muscles. Although the actual measurements were not yet designed for comprehensive recording of each parameter, the results obtained suggest that the major leg extensor muscles change their activation patterns with the varying impact load conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[The running shoe--a means of preventing running complaints].

One possible means of influencing and reducing the load on the human locomotive apparatus is the running shoe. Taking this as an example it can be shown how strategies for achieving this goal can be selected. The running shoe has three important characteristics: cushioning, support, and guidance. To achieve ideal cushioning, it is important to consider not so much the material of the inner sole, but rather the geometry of the shoe sole and the entire shoe. An analogous commentary may be made as regards support. By modifying the heel part of the shoe to approximate the human heel, pronation movement can be reduced. Lateral supports in the forefoot make it possible to control the propulsive movement (guidance). Consistent application of these considerations should bring about a reduction in the load on the locomotor apparatus and thus help prevent overstrain phenomena.

Ankle Joint↗

The influence of cadence and power output on force application and in-shoe pressure distribution during cycling by competitive and recreational cyclists.

The aim of this study was to determine the response of cyclists to manipulations of cadence and power output in terms of force application and plantar pressure distribution. Two groups of cyclists, 17 recreational and 12 competitive, rode at three nominal cadences (60, 80, 100 rev x min(-1)) and four power outputs (100, 200, 300, 400 W) while simultaneous force and in-shoe pressure data were collected. Two piezoelectric triaxial force transducers mounted in the right pedal measured components of the pedal force and orientation, and a discrete transducer system with 12 transducers recorded the in-shoe pressures. Force application was characterized by calculating peak resultant and peak effective pedal forces and positive and negative impulses. In-shoe pressures were analysed as peak pressures and as the percent relative load. The force data showed no significant group effect but there was a cadence and power main effect. The impulse data showed a significant three-way interaction. Increased cadence resulted in a decreased positive impulse, while increased power output resulted in an increased impulse. The competitive group produced less positive impulse but the difference became less at higher cadences. Few between-group differences were found in pressure, notable only in the pressure under the first metatarsal region. This showed a consistent pattern of in-shoe pressure distribution, where the primary loading structures were the first metatarsal and hallux. There was no indication that pressure at specific sites influenced the pedal force application. The absence of group differences indicated that pressure distribution was not the result of training, but reflected the intrinsic relationship between the foot, the shoe and the pedal.

Adult↗

Orthopaedic shoes improve gait in a Charcot-Marie-Tooth patient: a combined clinical and quantified case study.

The aim of this study was to assess the extent to which orthopaedic shoes improved gait in a patient with Charcot-Marie-Tooth (CMT) disease and to show how the latest gait analysis tools available can help to assess and quantify the efficacy of this treatment. The case of a 55-year-old woman with CMT disease is described. She complained mainly of pain and frequent falling. The physical examination and the clinical gait analysis showed the presence of bilateral foot drop, high-stepping and varus. Treatment based on physical therapy and orthopaedic shoes was prescribed. In order to assess the clinical efficacy of the treatment, a complete physical examination was carried out after the patient had been wearing the orthopaedic shoes for one month. The quantified assessment was performed with a Gaitrite system, which can be used to record the spatio-temporal parameters of gait. It was concluded that orthopaedic shoes provide specialists in physical and rehabilitation medicine with an excellent means of treating gait disabilities in patients with CMT disease. With the made-to-measure orthopaedic shoes used, the falling and pain disappeared; the patient's walking speed increased and the foot support base decreased in size. Both the clinical and quantified data confirmed the subjective improvement perceived by the patient. The latest tools available for performing quantified gait analysis in clinical practice provide useful means of objectively assessing the success of treatment.

Charcot-Marie-Tooth Disease↗

Detailed exposure assessment for a molecular epidemiology study of benzene in two shoe factories in China.

OBJECTIVES: We carried out a detailed exposure assessment of benzene and toluene in two shoe factories in Tianjin, China. Our goal was to identify workers with a broad range of benzene exposures, for an epidemiologic study relating exposure to early biologic effects. METHODS: A comprehensive exposure survey program was initiated. Over a period of 16 months, 2783 personal solvent exposure samples were collected in two workplaces from 250 workers. Mixed-effects models were used to identify factors affecting exposure. Principal component analyses (PCA) and subsequent regression analyses on the scores of the identified principal components were used to relate potential co-exposures to various exposure sources present in the workplace. RESULTS: The mean benzene exposure level was 21.86 p.p.m. (10th-90th percentiles 5.23-50.63 p.p.m.) in the smaller shoe factory (factory A) and 3.46 p.p.m. (10th-90th percentiles 0.20-7.00 p.p.m.) in the larger shoe factory (factory B). Within-factory exposure levels differed among job titles and were higher for subjects directly involved in handling glues. In contrast, mean toluene levels were relatively similar in the two factories (factory A, 9.52 p.p.m.; factory B, 15.88 p.p.m.). A seasonal trend was identified for both benzene and toluene in factory B. This could be explained in part by changes in air movement and ventilation patterns occurring during the year. A seasonal trend was not present in the smaller shoe factory, where general ventilation was absent. Supplemental analysis showed that exposure levels to other hydrocarbons were low (< or =5 p.p.m.), less than 5% of their respective ACGIH threshold limit values, and generally comparable in the two factories. PCA showed that co-exposures in factory B could largely be explained by glue sources that were used in distinct areas in the workplace. CONCLUSIONS: We demonstrated the occurrence of a broad range of benzene exposure levels in two shoe manufacturing factories in Tianjin, China. Benzene and toluene exposures were determined in part by the degree of contact with glues, the benzene and toluene content of each glue, air movement and ventilation patterns. The availability of long-term monthly personal monitoring data provides an excellent opportunity to estimate individual exposures at different times during the 1 yr period of observation.

Adhesives↗