title: Increased forefoot loading is associated with an increased plantar flexion moment.
abstract: The aim of this study was to identify the cascade of effects leading from alterations in force generation around the ankle joint to increased plantar pressures under the forefoot. Gait analysis including plantar pressure measurement was performed at an individually preferred and a standardized, imposed gait velocity in diabetic subjects with polyneuropathy (n=94), without polyneuropathy (n=39) and healthy elderly (n=19). The plantar flexion moment at 40% of the stance phase was negatively correlated with the displacement rate of center of pressure (r=-.749, p<.001 at the imposed, and r=-.693, p<.001 at the preferred gait velocity). Displacement rate of center of pressure was strongly correlated with forefoot loading (r=-.837, p<.001 at the imposed, and r=-.731, p<.001 at the preferred gait velocity). People with a relatively high plantar flexion moment at 40% of the stance phase, have a faster forward transfer of center of pressure and consequently higher loading of the forefoot. This indicates that interventions aimed at increasing the control of the roll-off of the foot may contribute to a better plantar pressure distribution.
authors: Department of Health Innovation & Technology, Institute of Allied Health Professions, Fontys University of Applied Sciences, Eindhoven, The Netherlands; Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors: Tom
authors: T
authors: Melai
authors: Nicolaas C
authors: NC
authors: Schaper
authors: T Herman
authors: TH
authors: Ijzerman
authors: Ton L H
authors: TL
authors: de Lange
authors: Paul J B
authors: PJ
authors: Willems
authors: Kenneth
authors: K
authors: Meijer
authors: Aloysius G
authors: AG
authors: Lieverse
authors: Hans H C M
authors: HH
authors: Savelberg
mesh_terms: D000054:Acceleration; D000367:Age Factors; D000368:Aged; D000843:Ankle Joint / Q000294:innervation* / Q000503:physiopathology*; D001696:Biomechanical Phenomena / Q000502:physiology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D005545:Forefoot, Human / Q000502:physiology*; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology; D012016:Reference Values; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology*
keywords: 3380; Diabetes; Gait analysis; Lower extremity; Plantar pressure; Polyneuropathy; Pressure time integral