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Shoe gear for the insensitive foot.

People with insensitive feet have lost most of the natural mechanisms that the rest of us use to protect our feet from injury. With normal sensation, we feel discomfort which causes us to change our gait pattern or to remove our shoes. These incidents which seem so minor are the exact occurrences which are unfelt by the insensate person and are responsible for the vast majority of foot injuries. Since these patients cannot tell where injury is occurring, precise shoe fitting is essential. Also, to effectively maintain the insensitive feet intact, additional objective evaluations should be included during the examination of these patients. Shoe pressure testing and thermometry help to identify regions of excessive pressure on the foot before ulceration occurs. A person with sensory loss in the foot often does not seek consultation for foot care until an open wound or neuropathic fracture is already present. These people need a regular schedule of prophylactic management. Their shoes need to be prescribed and worn, not after an ulcer has occurred, but to prevent it from ever forming.

Diabetic Neuropathies↗

'False feet': an alternative to expensive surgical shoes.

A method of 'equalising' unequal sized and shaped feet to allow the use of normal shoes of equal size, and permit the purchase of a 'pair' of shoes is described. This makes available a greater choice of normal styles and colours for patients with deformed and unequal feet. It is contrasted with the provision of custom-made surgical shoes and the purchase of two pairs of unequal size shop shoes. The patients and their parents were pleased with the results and the cost savings were considerable.

Adolescent↗

Manufacturing processes for athletic shoe outsoles and their significance in the examination of footwear impression evidence.

The most common methods of manufacturing athletic shoe outsoles are given and how each method can influence the examination of footwear impression evidence. Several processes for manufacturing athletic shoe outsoles are described. Significant factors of each process that are relevant to the examination of footwear impressions are explained. Some manufacturing processes result in distinguishing random characteristics which can assist in the identification of a shoe sole, even when new. These characteristics, together with the traditionally observed wear patterns and random cuts on the shoe outsoles, enable the examiner a stronger basis for expert opinion.

Foot↗

Effects on traction of outsole composition and hardnesses of basketball shoes and three types of playing surfaces.

The purposes of this investigation were to determine the effects of outsole composition and hardness, playing surfaces and player weight on the dynamic torque, traction forces and static drag developed at the shoe-surface interface. Basketball shoes of polyurethane and elastomer outsoles, each of three different hardnesses, were tested on clean and dusty hardwood floor samples, and on a sample of an artificial gymnasium flooring. The tests were conducted using a laboratory apparatus which included a player leg assembly with simulation of two player weights. Dynamic torque, traction forces from side and rear impacts and static drag were measured at the shoe surface interface. The results indicated that in basketball the magnitude of the resistance forces and torques are influenced by the outsole material and outsole hardness of the shoes, the playing surface and player weights.

Body Weight↗

An improved technique to enable 2-dimensional shoe sole impression evidence to be photographically recorded "to scale".

An improved technique to photographically record 2-Dimensional shoe sole impressions "to scale" is described. This technique was developed as a result of continual attacks in court in relation to the question of precise SCALE. Staff at our laboratory are routinely required to examine shoe sole impressions evidence that has been collected by our Scenes of Crime Officers. The Scenes of Crime Officers have been instructed in the appropriate photographic techniques which should be used to record 2-Dimensional shoe sole impressions, however, for one reason or another, including inexperience, this technique is not rigidly adhered to. We have seventy-five (75) Scenes of Crime Officers throughout Queensland, and nearly all of the shoe sole interpretation work is done in the Brisbane Headquarters. It is the case that the Scenes of Crime Officers record the scene and other photographers record the Test Impression. There are three problems that affect the quality of the scale photographs submitted. 1. The camera is not directly over the center of the subject. 2. The camera is not exactly parallel to the subject. 3. The designs of the camera lens. These problems are highlighted when barristers compare the scale photos of the test impressions made in the laboratory, with the scale photos of the scene impressions. Barristers actually measure the distance between features and usually a discrepancy (albeit slight) is found. The GRID allows us to demonstrate to Lay persons and Lawyers the interrelationship of identification features, by reference to a particular GRID.

Australia↗

Custom shoe therapy. Current concepts, designs, and special considerations.

Custom orthopedic shoes represent the ultimate combination of function and aesthetics. Incorporating biomechanics and craftsmanship, shoes can redistribute weight, restrict joint motion, facilitate ambulation, and decrease the probability of neuropathic ulceration. Despite these advantages, many podiatrists know little about shoe therapy and consequently underuse it. This article describes the various types of therapeutic shoe modalities available and presents a systematic method of their application. Some of the latest developments in technology and health care reform also are revealed.

Equipment Design↗

Functional components of a sport shoe.

The anatomy and construction of a sport shoe are so specific for its designated activity that injury may result from wearing an inappropriate shoe. It is important to understand the biomechanics of the foot as well as sport shoe construction to choose the right shoe for the right sport.

Biomechanical Phenomena↗

A preliminary objective evaluation of leprosy footwear using in-shoe pressure measurement.

The primary function of leprosy shoes, insoles and podiatric orthoses is to provide an underfoot environment capable of distributing the inevitable vertical forces, so reducing areas of peak pressure and ideally the period through which they are applied. Many patients with Hansen's disease have both skeletal deformity and anesthetised feet and the presence of high plantar pressures is the key reason for foot ulceration. This objective investigation using in-shoe dynamic pressure measurements showed that the addition of a shank to control insole rigidity reduced the overall peak pressures under the foot. When a deep canvas shoe was used to test single- and double-thickness insoles of two different types of material it was found in each case that the double-thickness mode was advantageous overall. Microcellular rubber insoles in two types of leprosy shoe were replaced by the polymer Poron. The Poron proved to be superior to both microcellular rubbers. The peak pressure and pressure-time integral should be considered as complimentary variables when determining the efficacy of footwear.

Foot↗

[Orthopedic shoes and their modifications].

The bone structure of the foot, knee and hip and their principle deformities are presented. With this in mind, the orthopedic shoe and its modifications are discussed as an extremely important element in correcting deformities that cause walking alterations, pain, etc.... How the shoes are made, the basic characteristics they should possess, which shoes are appropriate for which age, and problems the wrong shoe type can provoke are also discussed.

Equipment Design↗

Effects of platform fashion shoes on brake response time.

The purpose of the present investigation was to examine the effects of 'platform' fashion shoes on response time in vehicle braking. Seventeen subjects participated in two test sessions: in one they wore platform shoes and in the other normal footwear. Although all subjects were accustomed to wearing either type of footwear, platform shoes significantly slowed their braking responses, compared with normal shoes (0.91 vs 0.81 s, respectively). This differential response time represents an increased stopping distance of 1.42 ft (433 mm) for each 10 mile/h (16 km/h) of vehicle speed.

Journal Article↗

Physiological and ergonomics factors in running shoe design.

Various features of the design of running shoes have been known to affect the performance and safety of athletes. The performance related effects of shoe design on traction and on the economy of locomotion are reviewed in this paper. Traction measurements in various types of running shoes and on various surfaces appear adequate for all but running on wet asphalt roads. Future designs should improve traction for those conditions. Effects on the economy of locomotion as small as 1% can be determined using conventional oxygen uptake measurements. The effect of carrying extra weight on the foot during running has been measured at 1% per 100 g per foot. The cost of carrying similar weights is much lower for walking or for running when the weight is carried nearer the body's centre of mass. Cushioning and other features of shoe design besides weight have been shown to have significant effects on the economy of locomotion. Optimum designs for maximising running performance should provide sufficient traction, minimal weight and maximum cushioning.

Journal Article↗

Slipperiness of the shoe-floor interface: comparison of objective and subjective assessments.

Tribollogically and biomechanically valid slip-resistance measurement methods are needed urgently to facilitate new developments for improving the safety of footwear and floor coverings. Objective coefficient-of-friction measurements and subjective walking experiments were compared to scrutinize and validate anti-slip assessments of the shoe-floor interface. Four shoe types were tested on a smooth stainless steel floor contaminated with viscous glycerol. The friction utilization ratio during one step, the sliding distance, and the subjective rating of slipperiness were evaluated by seven test subjects in 420 walking trials. All subjects assessed the footwear in the same rank of slipperiness. The friction utilization ratios during the walking trial were a poor indicator for anti-slip assessments. The apparatus-based kinetic friction values mu(k1), however, were more valid and, in particular, more reproducible. The safe level of mu(k1) was approximately 0.22, which is in accordance with previous slip-resistance clasification of shoes and floors. Futher trials in other shoe-contaminant-floor conditions and walking tasks are needed to verify the findings in this study.

Journal Article↗

Maternal height and shoe size as predictors of pelvic disproportion: an assessment.

A total of 351 women who gave birth in the Paddington and North Kensington Health District were studied in order to establish a factual basis for recording height and shoe size as indicators of pelvic adequacy. Because only 19 women had radiological pelvimetry assessment, type of delivery and length of labour were used as proxy measures of disproportion. Of the 57 women with a shoe size less than 4 1/2, 21% were delivered by caesarean section compared with 10% of the group with shoe size between 4 1/2 and 6 and only 1% of the group with shoe size greater than or equal to 6 1/2. Similar relations with height were not generally found. The data were further examined using logistic regression models of the expected percentages of mothers having an adverse delivery. The models confirmed and extended the more simple analysis.

Body Height↗

Prevention of injuries in excessive pronators through proper soccer shoe fit.

OBJECTIVE: Properly fitting shoes are important in the prevention of injuries. When it involves the lower extremity and pronation, proper fitting of shoes is considered as a treatment for gender variations in shoe fit and excessive pronators. The purpose of the study therefore, is to compare static and dynamic foot tracings in excessive pronators to determine if there were differences between right and left feet of male and female soccer athletes. DESIGN AND SETTING: Multivariate analysis with static and dynamic foot tracing measurements of foot length, first metatarsal length, fifth metatarsal length, metatarsal width, and heel width as the dependent variables and male and female (gender) as the effect. Interscholastic soccer players who were excessive pronators were used in the study. SUBJECTS: Volunteers were solicited from a boys and girls interscholastic soccer team (level C to varsity). From this pool of 40 subjects, a group of 20 (10 males and 10 females, n = 40 feet), with excessive pronation were used in the study. Criteria for selection was based on navicular height (? 10 mm) and arch index (? .26). MEASUREMENTS: Static and dynamic foot tracings were determined. From these tracings, foot length, first metatarsal length, fifth metatarsal length, metatarsal width, and heel width were determined. Multivariate analysis of variance (MANOVA; p < .05), one-way repeated measures analysis of variance (ANOVA; p < .05), and pairwise comparisons (p < .05) were performed to determine significance, as well as intraclass correlation coefficients for intraclass reliability of the measurements. RESULTS: For between genders, male foot tracings for static and dynamic right and/or left feet were statistically greater in all foot parameters except heel width. Comparison of same side static and dynamic measurements for the right or left foot indicated differences for foot length, metatarsal width, and heel width for males, and foot length, fifth metatarsal width, metatarsal width, and heel width for females. There were no significant differences between static and dynamic foot measurements for either foot between genders and within genders. CONCLUSIONS: Foot length should not be the only consideration used for determining proper shoe fit. Static and dynamic measurements for the right or left foot, as well as metatarsal width, fifth metatarsal length, and heel width should also be included.

Journal Article↗

Shoeing principles for the management of navicular disease in horses.

Navicular disease was diagnosed in 36 horses. Each horse was treated, using shoeing as the only major means of treatment. Phenylbutazone was used initially for 10 days after shoeing. Shoeing was designed to correct preexisting problems, enhance physiologic function of the foot, and ease breakover of the foot. The horses were evaluated over a period ranging from 12 to 54 months. The lameness improved in all horses. Thirty-one of the 36 horses treated were not lame when last evaluated. Shoeing was most effective when performed within 8 months of the first signs of lameness. Also, horses used for show ring performance classes had a better response to treatment than did horses used for gaming or jumping.

Animals↗

Respiratory function in shoe manufacturing workers.

A study of respiratory findings was performed on 376 female workers employed in a shoe manufacturing plant. The mean age of the workers was 32 years and the mean duration of their employment was 12 years. These workers were predominantly nonsmokers. Acute and chronic respiratory symptoms were recorded for each worker, and lung function was measured before and after the work shift. Maximum expiratory flow-volume (MEFV) curves were performed on which forced vital capacity (FVC), 1-second forced expiratory volume (FEV1), and flow rates at 50% and the last 25% (FEF50, FEF25) were measured. Significantly higher prevalences of all chronic respiratory symptoms were recorded in exposed compared to control workers; in particular, chest tightness (exposed: 44.7%; control: 0%), dyspnea (exposed: 42.6%; control: 2.0%), and rhinitis (exposed: 46.3%; control: 2.4%) were far more prevalent in workers than in controls. Among the shoe workers, there was also a high prevalence of acute symptoms that developed during the work shift, being most pronounced for nose and throat irritation (61.4%). The prevalence of acute and chronic respiratory symptoms increased with duration of employment. Statistically significant across-shift reductions were recorded for all ventilatory capacity tests for the group as a whole. In comparison to predicted, the measured ventilatory capacity parameters were significantly lower for all workers (p < 0.01). Lung function abnormalities increased with duration of employment. Environmental measurements demonstrated that benzene, fur, and synthetic fibers were found at higher than allowable maximal concentrations (Croatian standards). The data suggest that work in the shoe manufacturing industry may be responsible for the development of acute and chronic respiratory impairment.

Acute Disease↗

Comparison of shoe insole materials by neural network analysis.

The effects of two insole materials within the shoe are compared using neural network analysis. Seven male subjects without locomotor disorders walk on a treadmill at a controlled speed and cadence wearing a common shoe and no socks, under three conditions; these are two types of insole of the same thickness, and a no insole condition. Pressure-related data from under the foot, within the shoe, are obtained by the MICRO-EMED system during walking. A back-propagation neural network is trained to associate sets of pressure-related data with the insole conditions. Subsequently neural network analysis is performed to reveal the abstract rules that govern the decision-making processes within the neural network, based on the synergistic interactions between the measured variables. Data are also analysed using ANOVA. The neural network analysis finds trends in the way in which the trained neural network responds. The interpretation of those trends gives a delicate description of the dynamic behaviour of the insoles despite the fact that no significant differences are found using ANOVA. It is concluded that neural network analysis can distinguish between insole behaviour during use, even though these differences are not significantly different based on statistical tests.

Adult↗

[Effect of walking speed on pressure distribution of orthopedic shoe technology].

Lesions to the diabetic foot have various causes. However, there is broad consensus that excessive plantar pressure plays a major role in the chain of events leading to ulcerations and gangrenes. During walking, on the other hand, peak values of plantar pressure are likely to increase with velocity even in therapeutic shoes. Therefore, the question arises whether a moderate velocity should be recommended to diabetic patients to reduce the risk of foot lesions. In this study, two velocities were compared for different types of therapeutic footwear. The velocities selected were considered moderate (0.7 m/s) and normal (1.3 m/s) for diabetic patients. A specially designed mathematical algorithm (velocity normalization) provided the pressure distributions from a common set of measurements: seven trials at different velocities for each subject and each type of footwear. Ten test subjects with healthy feet were studied. The shoes were ready-made and all had a midfoot rocker. The following four conditions were tested: flexible or rigid outsole respectively in combination with a flat insole or molded foot bed respectively. Pressure distribution measurements were performed with the Pedar in-shoe system, and the Pedar software package was used for analysis. The foot was divided into six regions: first toe, second to fifth toes, metatarsal region, medial midfoot, lateral midfoot, and heel. Only peak pressures were taken into account. Gait velocity was found to have an effect on plantar pressure distribution, mainly in the toes and heel region. Peak pressure in the heels increased significantly by about 20%. In the toe region, the increase was about the same, but was not statistically significant. At a higher velocity, pressure even slightly decreased in the midfoot region. The percentage variation was similar for all four conditions. Thus, walking slowly prevented the foot from high peak pressures, and the combination of rigid outsole and molded foot bed was best suited for both slow and higher velocities.

Acceleration↗