Document Detail

Hip and ankle walking strategies: effect on peak plantar pressures and implications for neuropathic ulceration.
MedLine Citation:
PMID:  7979928     Owner:  NLM     Status:  MEDLINE    
Treatment of neuropathic plantar ulcers often is directed at reducing excessive, repeated peak plantar pressures (PPP). The purposes of this study were to determine whether instructing a subject to walk using a hip strategy would reduce forefoot PPP and change the kinematics of walking during a single session of testing. Thirteen subjects, 7 with peripheral neuropathy and a history of a recent plantar ulcer, and 6 controls participated. PPPs were measured with an in-shoe pressure monitoring system. Kinematics were measured with a computer-assisted motion analysis system. After data were collected as subjects walked using their normal walking pattern, subjects were instructed to walk using the hip strategy by decreasing their push-off, pulling their leg forward from their hips, decreasing step length, and maintaining their normal walking velocity. Compared with using the normal (ankle) strategy, using the hip strategy showed a significant 27% decrease in forefoot PPP and a 24% increase in heel PPP. Kinematic changes were decreased plantar flexion angular velocity, hip extension range-of motion (ROM), and step length, increased dorsiflexion ROM, and hip flexion ROM, but no change in walking velocity. These findings indicate that a change in walking pattern can result in lower forefoot PPP during a single session. Assuming patients can maintain the alterations in their walking pattern, these adaptations may help to heal plantar ulcers in some patients with peripheral neuropathy.
M J Mueller; D R Sinacore; S Hoogstrate; L Daly
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  75     ISSN:  0003-9993     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1994-12-08     Completed Date:  1994-12-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1196-200     Citation Subset:  AIM; IM    
Program of Physical Therapy, Washington University School of Medicine, St. Louis, MO 63110.
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MeSH Terms
Ankle Joint / physiopathology
Diabetic Foot / physiopathology,  rehabilitation
Foot / physiopathology*
Foot Ulcer / physiopathology*,  rehabilitation
Gait / physiology
Hip Joint / physiopathology
Middle Aged
Range of Motion, Articular
Walking / physiology*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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