Background Several footwear design characteristics are known to have detrimental effects on the foot. However, one characteristic that has received relatively little attention is the point where the sole flexes in the sagittal plane. Several footwear assessment forms assume that this should ideally be located directly under the metarsophalangeal joints (MTPJs), but this has not been directly evaluated. The aim of this study was therefore to assess the influence on plantar loading of different locations of the shoe sole flexion point. Method Twenty-one asymptomatic females with normal foot posture participated. Standardised shoes were incised directly underneath the metatarsophalangeal joints, proximal to the MTPJs or underneath the midfoot. The participants walked in a randomised sequence of the three shoes whilst plantar loading patterns were obtained using the Pedar® in-shoe pressure measurement system. The foot was divided into nine anatomically important masks, and peak pressure (PP), contact time (CT) and pressure time integral (PTI) were determined. A ratio of PP and PTI between MTPJ2-3/MTPJ1 was also calculated. Results Wearing the shoe with the sole flexion point located proximal to the MTPJs resulted in increased PP under MTPJ 4–5 (6.2%) and decreased PP under the medial midfoot compared to the sub-MTPJ flexion point (−8.4%). Wearing the shoe with the sole flexion point located under the midfoot resulted in decreased PP, CT and PTI in the medial and lateral hindfoot (PP: −4.2% and −5.1%, CT: −3.4% and −6.6%, PTI: −6.9% and −5.7%) and medial midfoot (PP: −5.9% CT: −2.9% PTI: −12.2%) compared to the other two shoes. Conclusion The findings of this study indicate that the location of the sole flexion point of the shoe influences plantar loading patterns during gait. Specifically, shoes with a sole flexion point located under the midfoot significantly decrease the magnitude and duration of loading under the midfoot and hindfoot, which may be indicative of an earlier heel lift.
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Inmiddels is er al weer een jaar verstreken sinds het project "These Shoes are made for walking" is gestart. Een project dat onderwijs ontwikkelt en uitvoert om orthopedische schoentechnici op te leiden voor de regio Zuidoost-Azië in Hanoi, Vietnam. Fontys paramedische hogeschool werkt hier samen met de universiteit voor Labour and Social Affairs (ULSA) in Hanoi, de Leprastichting en het Lilianne Fonds. Het project is mogelijk gemaakt door de deelnemers aan de Nationale Postcode Loterij.
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Vorig jaar november heeft een kwartiermakersbezoek plaatsgevonden aan het Vietnamese Centre for Orthopaedic Technologists (VietCot) in Hanoi, Vietnam. Het Vietcot is onderdeel van de universiteit voor sociale zaken in Hanoi. Zij verzorgt internationale opleidingen op het gebied van protheses en ortheses. Het kwartiermakersbezoek vond plaats in het kader van het project "These Shoes are made for Walking" met als doel de opzet en realisatie van een orthopedische schoen technische opleiding. In de vorige uitgaven van het vakblad Orthopedische Technologie is hier uitvoerig over verteld.
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