Article

A proof of concept study to investigate the effect of shoe lacing on the
plantar pressure distribution and in-shoe displacement of the foot during walking. METHODS:
Three randomized shoe-lacing conditions, which differed in
lacing tightness (comfortable, loosened, and completely loose) were investigated
in 20 healthy adults. On a 10-m walking test, plantar pressures were assessed
with the Pedar((R))-X in-shoe measurement system. Perceived in-shoe displacement
was scored on a numerical rating scale. RESULTS: With respect to the pressure
time integral statistically significant effects were found in the hallux, toes
2-5, first metatarsal head, and lateral midfoot regions. Post hoc comparison
showed for the hallux: mean increase of 45.5 kPa s (95% confidence interval [CI]:
3.2-87.8 kPa s), and toes 2-5: mean increase of 23.5 kPa s (95% CI: 0.1-46.9 kPa
s) between comfortably secured and completely loosened laces; lateral midfoot:
mean decrease of -18.1 kPa s (95% CI: -31.5 to -4.8 kPa s) between comfortably
secured and loosened laces. No significant effect was found on peak pressure, and
average pressure. Participants reported a significant increase in heel slipping
and in slipping back and forth of the foot as the laces were loosened.
CONCLUSIONS: Looser lacing techniques resulted in small peak and average plantar
pressure changes (less than 3% and 6.5% respectively). Pressure time integral
under the hallux and toes 2-5 increased 16.3% and 14.5% respectively, and
perceived in-shoe displacement increased as compared to comfortably secured
laces. These results suggest that diabetes patients should be advised to
comfortably tighten their shoelaces during the whole day.
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Langue : ANGLAIS