Silva de Souza T1, Luis Kemp V2, Santos Novaes B3, Rodrigo do Carmo A4, Ribeiro AP5
1University Santo Amaro, Post Graduation, Health Science Department and School of Medicine, Musculoskeletal Rehabilitation and Biomechanics Laboratory, University Santo Amaro, São Paulo, Brazil, 2School of Medicine, University Santo Amaro, Post Graduation, Health Science Department, São Paulo, Brazil, 3University Santo Amaro, Physical Therapy and Post Graduation in Health Science Department, São Paulo, Brazil, 4University Santo Amaro, Post Graduation, Health Science Department, São Paulo, Brazil, 5School of Medicine, University of São Paulo, Physical Therapy, Speech and Occupational Therapy Department, Sao Paulo, Brazil
Background: Foot posture and overload plantar are risk factors for some lower limb injuries. The planus and cavus feet display abnormal biomechanical parameters that may predispose an individual to injury and fall. However, the biomechanical mechanisms that link foot posture to injury is still unclear, so there remains a need to further understand the interaction between foot posture and the plantar load over the foot, especially in physically active elderly.
Purpose: Investigate the relationship between foot posture and plantar pressure during gait of the physically active elderly.
Methods: Forty-five physically active elderly (aged 60 to 85) were classified as feet: normal (n=15), planus (n=15) or cavus (n=15), based on the Arch Index. The elderly walked freely through a 20-meter walkway and plantar pressure was evaluated using pressure platform system (Loran®-x100mps, Kinetec, Italy) fixed in the center of this walkway. Barefoot walking three trials were measurement and the cadence was monitored by a metronome, but not controlled, ranging from 100 to 125 steps per minute. Multiple-regression analysis was used to examine the effect of Arch Index (normal, cavus and planus) and plantar pressure distribution of the foot.
Results: The multiple regression analyses indicated that in physically active elderly the contact area (R2=0.98, p= 0.001), peak pressure (R2=0.65, p=0.010) and maximum force (R2=0.86, p=0.044) over the forefoot were predicted by an normal arch index. The planus arch index predicted the contact area over the midfoot and medial rearfoot (R2=0.94, p=0.001 and p=0.011) and maximum force over the midfoot (R2=0.63, p=0.001). The cavus arch index predicted higher contact area over forefoot and lateral rearfoot (R2=0.52, p=0.003 and p=0.020) and maximum force over forefoot (R2=0.27, p=0.010).
Conclusion(s): Arch index was found to be a significant predictor of plantar pressure of the physically active elderly. The normal arch predicts contact area, peak pressure and maximum force over forefoot. The planus arch predicted the contact area over the midfoot and medial rearfoot and maximum force over the midfoot. The cavus arch index predicted higher contact area over forefoot and lateral rearfoot and maximum force over forefoot. This indicates that control of the foot posture may help decrease plantar pressure on the foot, which may potentially prevent injuries and fall risk.
Implications: An planus arch index was show to predict higher plantar loads over the midfoot and medial rearfoot and cavus arch index was to predict plantar loads over the forefoot and lateral rearfoot. Both clinical measurements showed relationships with the plantar loads, and may contribute to the injuries prevention of the foot and ankle, well as a falls in elderly that results in femur fractures.
Keywords: elderly, footwear, overload
Funding acknowledgements: The National Council of the Scientific and Technological Development (CNPq) provided support for Tatiana Silva de Souza´s scholarship (159403/2018-9).
Purpose: Investigate the relationship between foot posture and plantar pressure during gait of the physically active elderly.
Methods: Forty-five physically active elderly (aged 60 to 85) were classified as feet: normal (n=15), planus (n=15) or cavus (n=15), based on the Arch Index. The elderly walked freely through a 20-meter walkway and plantar pressure was evaluated using pressure platform system (Loran®-x100mps, Kinetec, Italy) fixed in the center of this walkway. Barefoot walking three trials were measurement and the cadence was monitored by a metronome, but not controlled, ranging from 100 to 125 steps per minute. Multiple-regression analysis was used to examine the effect of Arch Index (normal, cavus and planus) and plantar pressure distribution of the foot.
Results: The multiple regression analyses indicated that in physically active elderly the contact area (R2=0.98, p= 0.001), peak pressure (R2=0.65, p=0.010) and maximum force (R2=0.86, p=0.044) over the forefoot were predicted by an normal arch index. The planus arch index predicted the contact area over the midfoot and medial rearfoot (R2=0.94, p=0.001 and p=0.011) and maximum force over the midfoot (R2=0.63, p=0.001). The cavus arch index predicted higher contact area over forefoot and lateral rearfoot (R2=0.52, p=0.003 and p=0.020) and maximum force over forefoot (R2=0.27, p=0.010).
Conclusion(s): Arch index was found to be a significant predictor of plantar pressure of the physically active elderly. The normal arch predicts contact area, peak pressure and maximum force over forefoot. The planus arch predicted the contact area over the midfoot and medial rearfoot and maximum force over the midfoot. The cavus arch index predicted higher contact area over forefoot and lateral rearfoot and maximum force over forefoot. This indicates that control of the foot posture may help decrease plantar pressure on the foot, which may potentially prevent injuries and fall risk.
Implications: An planus arch index was show to predict higher plantar loads over the midfoot and medial rearfoot and cavus arch index was to predict plantar loads over the forefoot and lateral rearfoot. Both clinical measurements showed relationships with the plantar loads, and may contribute to the injuries prevention of the foot and ankle, well as a falls in elderly that results in femur fractures.
Keywords: elderly, footwear, overload
Funding acknowledgements: The National Council of the Scientific and Technological Development (CNPq) provided support for Tatiana Silva de Souza´s scholarship (159403/2018-9).
Topic: Older people; Musculoskeletal: lower limb
Ethics approval required: Yes
Institution: University Santo Amaro
Ethics committee: Human Research Board of the University Santo Amaro
Ethics number: approval the protocol of research, number: 2.661.025
All authors, affiliations and abstracts have been published as submitted.
