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      The Effect of Backpack Load on Muscle Activities of the Trunk and Lower Extremities and Plantar Foot Pressure in Flatfoot

      research-article
      , PhD, PT 1
      Journal of Physical Therapy Science
      The Society of Physical Therapy Science
      Flatfoot, Backpack, Plantar pressure

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          Abstract

          [Purpose] The purpose of this study was to investigate the changes in muscle activation of the trunk and lower extremities and plantar foot pressure due to backpack loads of 0, 10, 15, and 20% of body weight during level walking in individuals with flatfoot. [Methods] Fourteen young flatfoot subjects and 12 normal foot subjects participated in this study. In each session, the subjects were assigned to carry a backpack load, and there were four level walking modes: (1) unloaded walking (0%), (2) 10% body weight (BW) load, (3) 15% BW load, and (4) 20% BW load. Trunk and lower extremity muscle activities were recorded by surface EMG, and contact area and plantar foot pressure were determined using a RS scan system. [Results] The erector spinae, vastus medialis, tibialis anterior and gastrocnemius muscle activities, but not the rectus femoris and rectus abdominis muscle activities of flatfoot subjects significantly and progressively increased as load increased in flatfoot subjects. Contact area and pressure of the lateral and medial heel zones were significantly increased too. [Conclusion] Based on this data, the weight of a backpack could influence muscle activation and plantar foot pressure in flatfoot.

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          Most cited references16

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          Foot pressure distribution during walking in young and old adults

          Background Measurement of foot pressure distribution (FPD) is clinically useful for evaluation of foot and gait pathologies. The effects of healthy aging on FPD during walking are not well known. This study evaluated FPD during normal walking in healthy young and elderly subjects. Methods We studied 9 young (30 ± 5.2 years), and 6 elderly subjects (68.7 ± 4.8 years). FPD was measured during normal walking speed using shoe insoles with 99 capacitive sensors. Measured parameters included gait phase characteristics, mean and maximum pressure and force, and relative load. Time-series measurements of each variable for all sensors were grouped into 9 anatomical masks. Results Elderly subjects had lower normalized maximum pressure for the medial and lateral calcaneal masks, and for all medial masks combined. In the medial calcaneus mask, the elderly group also had a lower absolute maximum and lower mean and normalized mean pressures and forces, compared to young subjects. Elderly subjects had lower maximum force and normalized maximum force and lower mean force and normalized mean forces in the medial masks as well. Conclusion FPD differences between the young and elderly groups were confined to the calcaneus and hallux regions and to the medial side of the foot. In elderly subjects, weight bearing on the lateral side of the foot during heel touch and toe-off phases may affect stability during walking.
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            The effect of foot structure and range of motion on musculoskeletal overuse injuries.

            The purpose of this prospective study was to determine whether an association exists between foot structure and the development of musculoskeletal overuse injuries. The study group was a well-defined cohort of 449 trainees at the Naval Special Warfare Training Center in Coronado, California. Before beginning training, measurements were made of ankle motion, subtalar motion, and the static (standing) and dynamic (walking) characteristics of the foot arch. The subjects were tracked prospectively for injuries throughout training. We identified risk factors that predispose people to lower extremity overuse injuries. These risk factors include dynamic pes planus, pes cavus, restricted ankle dorsiflexion, and increased hindfoot inversion, all of which are subject to intervention and possible correction.
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              The effect of foot type on in-shoe plantar pressure during walking and running.

              The purpose of this study was to determine if low arch feet have altered plantar loading patterns when compared to normal feet during both walking and running. Fifty healthy subjects (34 normal feet, 16 flat feet) walked and ran five trials each at standard speeds. In-shoe pressure data were collected at 50 Hz. Contact area, peak pressure, maximum force, and force-time integral were analyzed in eight different regions of the foot. Foot type was determined by examining navicular height, arch angle, rearfoot angle, and a clinical score. A series of 2 x 2 repeated measures ANOVAs were used to determine statistical differences (alpha<0.05). A significant interaction existed between foot type and movement type for the maximum force in the medial midfoot. Total foot contact area, maximum force and peak pressure were significantly increased during running. Contact area in each insole area, except for the rearfoot, was significantly increased during running. Peak pressure and maximum force were significantly increased during running in each of the foot regions. However, the force-time integral was significantly decreased during running in the rearfoot, lateral midfoot, middle forefoot, and lateral forefoot. Significant differences between foot types existed for contact area in the medial midfoot and maximum force and peak pressure in the lateral forefoot. The maximum force and peak pressures were significantly decreased for the flat foot type. Therefore, individuals with a flat foot could be at a lower risk for lateral column metatarsal stress fractures, indicating that foot type should be assessed when determining an individual's risk for metatarsal stress fractures.
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                Author and article information

                Journal
                J Phys Ther Sci
                J Phys Ther Sci
                JPTS
                Journal of Physical Therapy Science
                The Society of Physical Therapy Science
                0915-5287
                2187-5626
                11 December 2013
                November 2013
                : 25
                : 11
                : 1383-1386
                Affiliations
                [1) ] Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Republic of Korea
                Author notes
                [* ]Corresponding author. Hohee Son, Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan: 57 Oryundae-ro, Geumjeong-gu, Busan 609-757, Republic of Korea. (e-mail: sonhh@ 123456cup.ac.kr )
                Article
                jpts-2013-189
                10.1589/jpts.25.1383
                3881460
                24396193
                8c99827a-7e29-4735-8d72-62c709b3b859
                2013©by the Society of Physical Therapy Science

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

                History
                : 25 April 2013
                : 31 May 2013
                Categories
                Original

                flatfoot,backpack,plantar pressure
                flatfoot, backpack, plantar pressure

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