Contribution of various forefoot areas to push-off peak at different speeds and slopes during walking.

Forefoot amputation Gait Propulsion Push-off peak Toe function

Journal

Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830

Informations de publication

Date de publication:
22 Dec 2023
Historique:
received: 12 09 2023
revised: 24 11 2023
accepted: 20 12 2023
medline: 28 12 2023
pubmed: 28 12 2023
entrez: 27 12 2023
Statut: aheadofprint

Résumé

Push-off during the terminal stance phase has a major impact on forward progression during walking. During this phase, the ground reaction force is applied to a small area under the forefoot. A better understanding of how single forefoot areas contribute to push-off peak in healthy subjects is needed to develop biomimetic orthopedic devices for forefoot amputees. What is the contribution of different forefoot sole areas to push-off peak as a function of speed and slope? In this analytical study, 15 healthy subjects walked on a treadmill at different speeds (0.8 m/s; 1.2 m/s; 1.6 m/s; max. gait speed) without de-/inclination and on different slopes (-10°; -5°; 0°; 5°; 10°) with normal walking speed. The Novel Pedar-X System was used to measure vertical sole force. Push-off peak of the entire sole was determined and relative contributions of the areas under the hallux, first ray, and toes (I-V) were calculated and analyzed using separate repeated-measures ANOVA (α = 0.05). Push-off peak increases with faster walking speeds as well as with 10° inclination. Downhill walking is associated with a reduced push-off peak. The contribution of all forefoot areas increases with faster walking speeds and at a declination of -10°. Push-off contribution of the area under the hallux increases by about 64.6% at fast walking compared to slow walking and this increase is higher than that of the area under the first ray and toes (p < 0.05). These findings indicate the major role of the hallux in speed generation and the importance of the forefoot during downhill walking. The results show the need for an adequate assistive device even in hallux amputation cases to compensate for deficits in the push-off phase.

Sections du résumé

BACKGROUND BACKGROUND
Push-off during the terminal stance phase has a major impact on forward progression during walking. During this phase, the ground reaction force is applied to a small area under the forefoot. A better understanding of how single forefoot areas contribute to push-off peak in healthy subjects is needed to develop biomimetic orthopedic devices for forefoot amputees.
RESEARCH QUESTION OBJECTIVE
What is the contribution of different forefoot sole areas to push-off peak as a function of speed and slope?
METHODS METHODS
In this analytical study, 15 healthy subjects walked on a treadmill at different speeds (0.8 m/s; 1.2 m/s; 1.6 m/s; max. gait speed) without de-/inclination and on different slopes (-10°; -5°; 0°; 5°; 10°) with normal walking speed. The Novel Pedar-X System was used to measure vertical sole force. Push-off peak of the entire sole was determined and relative contributions of the areas under the hallux, first ray, and toes (I-V) were calculated and analyzed using separate repeated-measures ANOVA (α = 0.05).
RESULTS RESULTS
Push-off peak increases with faster walking speeds as well as with 10° inclination. Downhill walking is associated with a reduced push-off peak. The contribution of all forefoot areas increases with faster walking speeds and at a declination of -10°. Push-off contribution of the area under the hallux increases by about 64.6% at fast walking compared to slow walking and this increase is higher than that of the area under the first ray and toes (p < 0.05).
SIGNIFICANCE CONCLUSIONS
These findings indicate the major role of the hallux in speed generation and the importance of the forefoot during downhill walking. The results show the need for an adequate assistive device even in hallux amputation cases to compensate for deficits in the push-off phase.

Identifiants

pubmed: 38150947
pii: S0966-6362(23)01520-5
doi: 10.1016/j.gaitpost.2023.12.016
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

264-269

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Frithjof Doerks (F)

Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany.

Lisa Riedel (L)

Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany.

Ann-Kathrin Einfeldt (AK)

Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany.

Henning Windhagen (H)

Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany.

Christof Hurschler (C)

Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany.

Eike Jakubowitz (E)

Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany. Electronic address: Jakubowitz.Eike@mh-hannover.de.

Classifications MeSH