title: Does footwear type impact the number of steps required to reach gait steady state?: an innovative look at the impact of foot orthoses on gait initiation.
abstract: Many studies have attempted to better elucidate the effect of foot orthoses on gait dynamics. To our knowledge, most previous studies exclude the first few steps of gait and begin analysis at steady state walking. These unanalyzed steps of gait may contain important information about the dynamic and complex processes required to achieve equilibrium for a given gait velocity. The purpose of this study was to quantify gait initiation and determine how many steps were required to reach steady state walking under three footwear conditions: barefoot, habitual shoes, and habitual shoes with a prefabricated foot orthoses. Fifteen healthy subjects walked 50m at habitual speed in each condition. Wearing habitual shoes with the prefabricated orthoses enabled subjects to reach steady state walking in fewer steps (3.5 steps+/-2.0) compared to the barefoot condition (5.2 steps+/-3.0; p=0.02) as well as compared to the habitual shoes condition (4.7 steps+/-1.6; p=0.05). Interestingly, the subjects' dynamic medial-lateral balance was significantly improved (22%, p<0.05) by using foot orthoses compared to other footwear conditions. These findings suggest that foot orthoses may help individuals reach steady state more quickly and with a better dynamic balance in the medial-lateral direction, independent of foot type. The findings of this pilot study may open new avenues for objectively assessing the impact of prescription footwear on dynamic balance and spatio-temporal parameters of gait. Further work to better assess the impact of foot orthoses on gait initiation in patients suffering from gait and instability pathologies may be warranted.
authors.affiliation: Center for Lower Extremity Ambulatory Research (CLEAR) at Scholl College of Podiatric Medicine of Rosalind Franklin University of Medicine & Science, 3333 Green Bay Road North Chicago, IL USA. Bijan.Najafi@rosalindfranklin.edu
authors.forename: Bijan
authors.initials: B
authors.lastname: Najafi
authors.forename: Daniel
authors.initials: D
authors.lastname: Miller
authors.forename: Beth D
authors.initials: BD
authors.lastname: Jarrett
authors.forename: James S
authors.initials: JS
authors.lastname: Wrobel
mesh_terms: D000328:Adult; D000465:Algorithms; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008124:Locomotion / Q000502:physiology; D008297:Male; D009989:Orthotic Devices; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D012775:Shoes; D016138:Walking / Q000502:physiology*