The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
권호 표지

The Effect of Changes in Foot Cutaneous Sensation on Plantar Pressure Distribution during Gait

발바닥의 피부 감각 변화가 보행 중에 족저압 분포에 미치는 영향

  • Seong, Dae-Young (Department of Physical Therapy, Graduate School of Health & Medical Science, Catholic University of Daegu) ;
  • Kim, Joong-Hwi (Department of Physical Therapy, College of Medical Science, Catholic University of Daegu) ;
  • Park, Ji-Won (Department of Physical Therapy, College of Medical Science, Catholic University of Daegu)
  • 성대영 (대구가톨릭대학교 보건의료과학대학원 물리치료학과) ;
  • 김중휘 (대구가톨릭대학교 물리치료학과) ;
  • 박지원 (대구가톨릭대학교 물리치료학과)
  • Received : 2012.10.10
  • Accepted : 2012.10.19
  • Published : 2012.10.25
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to examine the effect of changes in foot cutaneous sensation on plantar pressure distribution during gait. Methods: Sixteen healthy young subjects participated in this experiment. All subjects performed two trials of walking under three somatosensory conditions induced by a normal facilitatory insole that provides increased plantar sensory stimulation, and application of lidocaine cream to the plantar surface of the foot to reduce the sensitivity of the soles. Semmes-Weinstein monofilaments were used for evaluation of reduced plantar sensation. The Pedar system was used for measurement of pressure distribution at the plantar surface of the foot. Results: Pressure in the lateral midfoot area showed an increase with increasing and decreasing sensory inputs. When sensory input was increased, plantar pressure showed a decrease in the forefoot area. When sensory input was decreased, plantar pressure showed an increase in the lateral forefoot area and a decrease in the hallux area. Conclusion: By altering sensory feedback, plantar pressure distribution is changed during gait. Plantar cutaneous afferents play an important role in plantar distribution.

Keywords

Acknowledgement

Supported by : 한국연구재단

References

  1. Eils E, Behrens S, Mers O et al. Reduced plantar sensation causes a cautious walking pattern. Gait Posture. 2004;20(1):54-60. https://doi.org/10.1016/S0966-6362(03)00095-X
  2. Kavounoudias A, Roll R, Roll JP. The plantar sole is a 'dynamometric map' for human balance control. Neuroreport. 1998;9(14):3247-52. https://doi.org/10.1097/00001756-199810050-00021
  3. Simoneau GG, Ulbrecht JS, Derr JA et al. Role of somatosensory input in the control of human posture. Gait Posture. 1995;3(3):115-22. https://doi.org/10.1016/0966-6362(95)99061-O
  4. Citaker S, Gunduz AG, Guclu MB et al. Relationship between foot sensation and standing balance in patients with multiple sclerosis. Gait Posture. 2011;34(2):275-8. https://doi.org/10.1016/j.gaitpost.2011.05.015
  5. Nurse MA, Hulliger M, Wakeling JM et al. Changing the texture of footwear can alter gait patterns. J Electromyogr Kinesiol. 2005;15(5):496-506. https://doi.org/10.1016/j.jelekin.2004.12.003
  6. Perry SD, McIlroy WE, Maki BE. The role of plantar cutaneous mechanoreceptors in the control of compensatory stepping reactions evoked by unpredictable, multi-directional perturbation. Brain Res. 2000;877(2):401-6. https://doi.org/10.1016/S0006-8993(00)02712-8
  7. Rosen B, Bjorkman A, Weibull A et al. Improved sensibility of the foot after temporary cutaneous anesthesia of the lower leg. Neuroreport. 2009;20(1):37-41. https://doi.org/10.1097/WNR.0b013e32831b4486
  8. Meyer PF, Oddsson LI, De Luca CJ. Reduced plantar sensitivity alters postural responses to lateral perturbations of balance. Exp Brain Res. 2004;157(4):526-36.
  9. Kelleher KJ, Spence WD, Solomonidis S et al. The effect of textured insoles on gait patterns of people with multiple sclerosis. Gait Posture. 2010;32(1):67-71. https://doi.org/10.1016/j.gaitpost.2010.03.008
  10. McDonnell M, Warden-Flood A. Effect of partial foot anaesthesia on normal gait. Aust J Physiother. 2000;46(2):115-20.
  11. Höhne A, Stark C, Brüggemann GP. Plantar pressure distribution in gait is not affected by targeted reduced plantar cutaneous sensation. Clin Biomech (Bristol, Avon). 2009;24(3):308-13. https://doi.org/10.1016/j.clinbiomech.2009.01.001
  12. Frykberg RG, Lavery LA, Pham H et al. Role of neuropathy and high foot pressures in diabetic foot ulceration. Diabetes Care. 1998;21(10):1714-9. https://doi.org/10.2337/diacare.21.10.1714
  13. Jenkins ME, Almeida QJ, Spaulding SJ et al. Plantar cutaneous sensory stimulation improves single-limb support time, and EMG activation patterns among individuals with Parkinson's disease. Parkinsonism Relat Disord. 2009;15(9):697-702. https://doi.org/10.1016/j.parkreldis.2009.04.004
  14. Pradels A, Pradon D, Vuillerme N. Effects of experimentally induced pain of the plantar soles on centre of foot pressure displacements during unperturbed upright stance. Clin Biomech (Bristol, Avon). 2011;26(4):424-8. https://doi.org/10.1016/j.clinbiomech.2010.11.016
  15. McPoil TG, Cornwall MW. Plantar tactile sensory thresholds in healthy men and women. The Foot. 2006;16:192-7. https://doi.org/10.1016/j.foot.2006.07.001
  16. Meyer PF, Oddsson LI, De Luca CJ. The role of plantar cutaneous sensation in unperturbed stance. Exp Brain Res. 2004;156(4):505-12. https://doi.org/10.1007/s00221-003-1804-y
  17. Fiolkowski P, Bishop M, Brunt D et al. Plantar feedback contributes to the regulation of leg stiffness. Clin Biomech (Bristol, Avon). 2005; 20(9):952-8. https://doi.org/10.1016/j.clinbiomech.2005.03.013
  18. Kamei N, Yamane K, Nakanishi S et al. Effectiveness of Semmes- Weinstein monofilament examination for diabetic peripheral neuropathy screening. J Diabetes Complications. 2005;19(1):47-53. https://doi.org/10.1016/j.jdiacomp.2003.12.006
  19. Pham H, Armstrong DG, Harvey C et al. Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care. 2000;23(5):606-11. https://doi.org/10.2337/diacare.23.5.606
  20. Melai T, IJzerman TH, Schaper NC et al. Calculation of plantar pressure time integral, an alternative approach. Gait Posture. 2011; 34(3):379-83. https://doi.org/10.1016/j.gaitpost.2011.06.005
  21. Taylor AJ, Menz HB, Keenan AM. Effects of experimentally induced plantar insensitivity on forces and pressures under the foot during normal walking. Gait Posture. 2004;20(3):232-7. https://doi.org/10.1016/j.gaitpost.2003.02.001
  22. Nurse MA, Nigg BM. The effect of changes in foot sensation on plantar pressure and muscle activity. Clin Biomech (Bristol, Avon). 2001;16(9):719-27. https://doi.org/10.1016/S0268-0033(01)00090-0
  23. Chen H, Nigg BM, Hulliger M et al. Influence of sensory input on plantar pressure distribution. Clin Biomech (Bristol, Avon). 1995;10(5):271-4. https://doi.org/10.1016/0268-0033(95)99806-D
  24. Bus SA, van Deursen RW, Kanade RV et al. Plantar pressure relief in the diabetic foot using forefoot offloading shoes. Gait Posture. 2009;29(4):618-22. https://doi.org/10.1016/j.gaitpost.2009.01.003
  25. Eils E, Nolte S, Tewes M et al. Modified pressure distribution patterns in walking following reduction of plantar sensation. J Biomech. 2002;35(10):1307-13. https://doi.org/10.1016/S0021-9290(02)00168-9
  26. Caselli A, Pham H, Giurini JM et al. The forefoot-to-rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration. Diabetes Care. 2002;25(6):1066-71. https://doi.org/10.2337/diacare.25.6.1066