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The online version of this article (doi:10.1186/1757-1146-7-18) contains supplementary material, which is available to authorized users.
The authors have none to declare. HBM and KBL are Editor-in-Chief and Deputy Editor-in-Chief, respectively, of the Journal of Foot and Ankle Research. It is journal policy that editors are removed from the peer review and editorial decision making processes for papers they have co-authored.
KBL had full access to the data and takes responsibility for the integrity of the data and the accuracy of its analysis. Study concept and design: KBL, HBM and PYL. Acquisition of the data: PYL. Analysis and interpretation of the data: KBL, PYL, DRB and HBM. Drafting of manuscript: KBL, PYL, DRB and HBM. All authors read and approved the final manuscript.
Plantar forefoot pain is commonly experienced by older people and it is often treated with forefoot pads to offload the painful area. However, studies have found inconsistent effects for different forefoot pads on plantar pressure reduction, and optimum forefoot pad placement is still not clear. The aim of this study was to compare the effects of different forefoot pads on plantar pressure under the forefoot in older people with forefoot pain.
Thirty-seven adults (31 females, 6 males) with a mean age of 73.5 (SD 4.8) participated. Forefoot plantar pressure data were recorded using the pedar®-X in-shoe system while participants walked along an 8 m walkway. Five conditions were tested in a standardised shoe: (i) no padding (the control), (ii) a metatarsal dome positioned 10 mm proximal to the metatarsal heads, (iii) a metatarsal dome positioned 5 mm distal to the metatarsal heads, (iv) a metatarsal bar, and (v) a plantar cover.
Compared to the shoe-only control condition, each of the forefoot pads significantly reduced forefoot peak pressure and maximum force. The metatarsal dome positioned 5 mm distal to the metatarsal heads and the plantar cover were most effective for reducing peak pressure (17%, p < 0.001 and 19%, p < 0.001, respectively).
These findings indicate that forefoot pads are effective for reducing forefoot pressures in older people with forefoot pain, and that the position of the pad relative to the metatarsal heads may be more important than the shape of the pad.
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- Comparison of the pressure-relieving properties of various types of forefoot pads in older people with forefoot pain
Pei Y Lee
Karl B Landorf
Daniel R Bonanno
Hylton B Menz
- BioMed Central