Browsing by Person "Jagadamma, Kavi"

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A clinical audit of the Emergency Department: Doctors' opinions on the diagnosis and management of cervical spine radiculopathy
(2024-03-29) McDonnell, Patricia; Jagadamma, Kavi; Rangra, Prateek
Objective: A clinical audit was carried out on the opinions of doctors working in the Emergency Department (ED) of a large urban hospital regarding the diagnosis and management of cervical spine radiculopathy (CSR). Using international guidelines and current research, it aimed to determine if patients attending this ED were diagnosed and managed in line with best practice, and to identify any discrepancies or areas for improvement in relation to this. Method: Doctors working in this ED were sent an online questionnaire and descriptive analysis was performed on the results to ascertain how they diagnose and manage patients who present with symptoms of CSR. It covered; presentation and definitions of CSR, identification of red flags, clinical tests used, diagnostic test criteria, appropriate management, education and advice given, and the criteria for further management. Additionally, it looked at their opinion on the services' needs. Results: Most agreed that CSR will improve within 4 weeks with non‐operative management; however, there was a lack of consensus regarding the most affected nerve root, differential diagnosis and appropriate diagnostic tests. Opinions aligned regarding the identification of red flags and early management, especially with widespread neurological deficits. However, the management of ongoing pain or new neurological signs, differed between clinicians. Most participants strongly agreed that access to MRIs affected referrals within an ED episode. Conclusion: Overall, the opinions matched recommended guidelines; however, some gaps in knowledge and differing management approaches were identified, indicating the need for ongoing education and standardisation of management.
Acquisition of procedural skills in pre-registration physiotherapy education comparing mental practice against no mental practice: The Learning of Procedures in Physiotherapy Education Trial - a development of concept study
(SAGE, 2020-09-10) Sattelmayer, Karl; Jagadamma, Kavi; Hilfiker, Roger; Baer, Gill
Introduction: Procedural skills are a central element in the education of physiotherapists. Procedural skills relate to the execution of a practical task. An educational intervention, which can be used to support skill acquisition of procedural skills, is mental practice (MP). Several studies have investigated the use of MP or imaging in medical education. This pilot study evaluated the application of MP on the acquisition of procedural skills in physiotherapy education.
The assessment of procedural skills in physiotherapy education: A measurement study using the Rasch model
(BMC, 2020-05-25) Sattelmayer, Martin; Jagadamma, Kavi; Sattelmayer, Franziska; Hilfiker, Roger; Baer, Gill
Background: Procedural skills are a key element in the training of future physiotherapists. Procedural skills relate to the acquisition of appropriate motor skills, which allow the safe application of clinical procedures to patients. In order to evaluate procedural skills in physiotherapy education validated assessment instruments are required. Recently the assessment of procedural skills in physiotherapy education (APSPT) tool was developed. The overall aim of this study was to establish the structural validity of the APSPT. In order to do this the following objectives were examined: i) the fit of the items of APSPT to the Rasch-model, ii) the fit of the overall score to the Rasch model, iii) the difficulty of each test item and iv) whether the difficulty levels of the individual test items cover the whole capacity spectrum of students in pre-registration physiotherapy education.
Chapter 13: Critical conversations on decolonising the physiotherapy curriculum
(Critical Publishing, 2023-05-26) Jagadamma, Kavi; Lane, Judith; Culpan, Jane; Marcus, Geetha; Van de Peer, Stefanie
A community-based exercise program for ambulant adolescents and young adults with cerebral palsy, a feasibility study
(European Federation of Adapted Physical Activity, 2021-11-22) Zanudin, Asfarina; Mercer, Tom; Samaan, Cynthia; Jagadamma, Kavi; McKelvie, Gillian; van der Linden, Marietta
The aim of this study was to investigate the feasibility of an 18-week exercise program for adolescents and young adults with cerebral palsy (CP). Fourteen individuals aged 16-25 (GMFCS I-III) performed aerobic and strength exercises at their community leisure center up to three times a week. A physiotherapist provided instruction at the first session and between 2-4 times thereafter. The fitness instructor on duty provided supervision when required. Feasibility of the exercise program was explored through an exercise logbook and participant feedback survey. Gross motor function, muscle strength, aerobic capacity and Timed Up and Go test were assessed at baseline, 6, 12 and 18 weeks and quality of life and self-esteem at baseline and 12 weeks. Participants completed on average 14.8 (range 5-23) weeks of the exercise program and an average of 31 (range 10-52) sessions. The feedback survey indicated that the exercise program was mostly well accepted, adverse effects were reported by three participants. Moderate effects (d=0.57-0.64) were found for leg muscle strength increase at week 12. Other measures showed small or negligible effects. This study indicated the feasibility of a community exercise program for young people with CP and provides recommendations for sustainable exercise programs for this group.
Effect of RaceRunning on cardiometabolic disease risk factors and functional mobility in young people with moderate-to-severe cerebral palsy: Protocol for a feasibility study
(BMJ Publishing Group, 2020-07-01) Ryan, Jennifer; Theis, Nicola; Koufaki, Pelagia; Phillips, Shaun; Anokye, Nana; Andreopoulou, Georgia; Kennedy, Fiona; Jagadamma, Kavi; vanSchie, Petra; Dines, Hannah; van der Linden, Marietta; Funder: Chartered Society of Physiotherapy Charitable Trust; FundRef: http://dx.doi.org/10.13039/100011698; Grant(s): GN2767; Funder: Action Medical Research; FundRef: http://dx.doi.org/10.13039/501100000317; Grant(s): GN2767
Introduction: There is consistent evidence that people with cerebral palsy (CP) do not engage in the recommended physical activity guidelines for the general population from a young age. Participation in moderate-to-vigorous physical activity is particularly reduced in people with CP who have a moderate-to-severe disability. RaceRunning is a growing disability sport that provides an opportunity for people with moderate-to-severe disability to participate in physical activity in the community. It allows those who are unable to walk independently to propel themselves using a RaceRunning bike, which has a breastplate for support but no pedals. The aim of this study is to examine the feasibility and acceptability of RaceRunning for young people with moderate-to-severe CP and the feasibility of conducting a definitive study of the effect of RaceRunning on cardiometabolic disease risk factors and functional mobility. Methods and analysis: Twenty-five young people (age 5–21 years) with CP or acquired brain injury affecting coordination will be included in this single-arm intervention study. Participants will take part in one RaceRunning session each week for 24 weeks. Outcomes assessed at baseline, 12 and 24 weeks include body mass index, waist circumference, blood pressure, muscle strength, cardiorespiratory fitness, physical activity and sedentary behaviour, functional mobility, activity competence and psychosocial impact. Adverse events will be systematically recorded throughout the 24 weeks. Focus groups will be conducted with participants and/or parents to explore their views and experiences of taking part in RaceRunning. Ethics and dissemination: Approval has been granted by Queen Margaret University Research Ethics Committee (REC) and the South East of Scotland REC. Results will be disseminated through peer-reviewed journals and distributed to people with CP and their families through RaceRunning and Athletic Clubs, National Health Service trusts and organisations for people with disabilities. Trial registration number: NCT04034342; pre-results.
Effects of tuning of ankle foot orthoses-footwear combination using wedges on stance phase knee hyperextension in children with cerebral palsy-Preliminary results
(Taylor & Francis, 2009-10-12) Jagadamma, Kavi; Coutts, Fiona; Mercer, Tom; Herman, J.; Yirrell, Jacqueline; Forbes, L.; van der Linden, Marietta
Purpose. This pilot study investigated the feasibility of reducing stance phase knee hyperextension in children with cerebral palsy by tuning the ankle foot orthoses-footwear combination (AFO-FC) using different sizes of wedges. Methods. Five children with cerebral palsy underwent three dimensional gait analysis and tuning of their AFO-FC using wedges. Data analysis was carried out by comparing relevant gait parameters between the non-tuned and tuned prescription. Results. Knee hyperextension during stance significantly decreased, and the shank to vertical angle was closer to normal after tuning. Although none of the other parameters showed statistically significant changes, the wide confidence intervals and lack of power indicated the likelihood of a type II error. Further, it was noted that the influence of tuning on temporalspatial parameters was different between children with diplegia and those with hemiplegia. It was estimated that a sample size of 15 is required to detect significant changes at p_0.05 and power of 0.8. Conclusions. The findings of this study clearly indicate the potential clinical utility of tuning using wedges to correct knee hyperextension during the stance phase in children with cerebral palsy. However, observations support the need for an adequately powered study to assess the long-term effects of tuning on gait parameters, activity level and quality of life.
Effects of tuning of the Ankle Foot Orthoses Footwear Combination (AFOFC) on the stance phase knee kinematics of children with cerebral palsy(CP) during gait.
(Edizioni Minerva Medica, 2008) Jagadamma, Kavi; Coutts, Fiona; Mercer, Tom; Herman, J.; Yirrell, Jacqueline; Hogg, L.; van der Linden, Marietta
Exploring decolonising the curriculum in physiotherapy: our learning stories as dedicated novices.
(Foundation of Nursing Studies, 2022-11-23) Lane, Judith; Jagadamma, Kavi; Culpan, Jane; Bulley, Catherine
Background: There is increasing awareness that we must engage with decolonising physiotherapy curricula to respect plurality of knowledge and become more consistent with global priorities towards humanising healthcare. Aim: By reflecting on our discomfort and vulnerabilities, we strove to understand and engage in decolonising the physiotherapy curriculum. Through this we hope to motivate others and contribute to this important transformation. Conclusions: Using Mezirow’s transformative learning theory, we reflected on our struggle with our disorienting dilemmas regarding the need to engage in decolonising the physiotherapy curriculum. We have become alert to insecurities about our knowledge and ability to engage sensitively in the necessary conversations. As we progress towards ‘full’ transformation, we have concluded that we must take action to generate change while continuing to learn and reflect.
Frame Running as a community-based exercise option for young people with moderate-to-severe walking impairments: a feasibility study
(Taylor & Francis Group, 2024-12-29) Andreopoulou, Georgia; van der Linden, Marietta; Theis, Nicola; Thacker, Elizabeth; McEwan, Gary; Koufaki, Pelagia; Jagadamma, Kavi; Curnow, Eleanor; Phillips, Shaun; van Schie, Petra E.M.; Ryan, Jennifer M.
Frame Running is an adapted community-based exercise option for people with moderate-to-severe walking impairments. This mixed-methods study aimed to examine the feasibility of 1) community-based Frame Running by young people with moderate-to-severe walking impairments and 2) conducting future studies on the impact of Frame Running on functional mobility and cardiometabolic disease risk factors. Weekly training sessions and data collection occurred in two sites. Quantitative data were collected at baseline, and after 12 (both sites) and 24 (one site) weeks of training, followed by interviews or focus groups. Consent and retention rates, attendance and outcome measure completion rates were calculated. Qualitative data were analysed abductively using concurrent inductive and deductive thematic content analysis. Data for the assessments at baseline, 12 and 24 weeks were available for 23, 15 and 5 participants respectively. Participants were aged 5-25 with most diagnosed with cerebral palsy (GMFCS II-IV). Consent, intervention drop-out and adherence rates were 55%, 17% and 83% respectively with no serious adverse events. Outcome measure completion rates ranged between 60% and 98%. Themes related to facilitators to participating in Frame Running were mostly identified in the personal and social domains with barriers more common in the environmental and policy domains. The study results support the existing evidence that Frame Running is a safe and acceptable community-based exercise option for those with moderate-to-severe walking impairments. Themes identified in personal, social, environmental, and policy domains can guide the implementation of community-based Frame Running participation. Our feasibility data can inform the design of future definitive studies.
Leisure time physical activity in children and young people with cerebral palsy, a population-based study
(Wolters Kluwer, 2022-03-18) van der Linden, Marietta; Wordie, Sarah J.; Dufton, Bethany K.; Jagadamma, Kavi; Hunter, Cathleen; Mercer, Tom; Gaston, Mark S.; Robb, James E.
Purpose To describe leisure time physical activity (LTPA) in children and young people with cerebral palsy (CP) and identify barriers and facilitators to participation. Methods. LTPA participation (‘at least one club’, ‘not in club’, ‘any type’) was derived from a national CP register and associated factors were analysed. Barriers and facilitators to participation were investigated through a survey. Results. LTPA participation (‘any type’) was recorded for 54% (n=977) of the total sample. All outcomes of participation decreased with increasing Gross Motor Function Classification System (GMFCS) level. LTPA not in club for 11-18 year-olds was significantly lower than those aged 5-10 for GMFCS level II. The survey (n=55) showed that disability and disliking help were common barriers whilst parental encouragement and enjoyment were common facilitators. Conclusions. Data from the register and survey provide insight into factors influencing LTPA participation in young people with CP and what may help to increase this.
Optimising the effects of rigid ankle foot orthoses on the gait of children with cerebral palsy (CP) - an exploratory trial
(Informa Healthcare, 2014-04-24) Jagadamma, Kavi; Coutts, Fiona; Mercer, Tom; Herman, J.; Yirrell, Jacqueline; Forbes, L.; van der Linden, Marietta
Purpose: This exploratory trial investigated the effects of rigid ankle foot orthoses (AFO) with an optimally cast Angle of the Ankle in the AFO (AAAFO) on the gait of children with Cerebral Palsy (CP), and whether tuning of the AFO - Footwear Combination (AFO-FC) further affected gait. Methods: Eight children with CP underwent gait analysis and tuning of their AFO-FCs using a 3-D motion analysis system. Comparisons were carried out for selected gait parameters between three conditions - barefoot, non-tuned AFO-FC and tuned AFO-FC. Results: In comparison to barefoot gait, walking with a non-tuned AFO-FC produced significant (p50.05) improvements in several key gait parameters. Compared to the non-tuned AFO-FC, on average a tuned AFO-FC produced a significant reduction in peak knee extension and knee ROM during gait. However, when examined as case studies, it was observed that the type of gait pattern demonstrated while wearing a non-tuned AFO-FC affected the outcomes of tuning. Conclusions: The findings of the current study indicate the potential benefits of using rigid AFO-FC with optimal AAAFO and tuning of AFO-FCs. This study emphasises the need for categorising children with CP based on their gait patterns when investigating the effects of interventions such as AFOs.
Physical activity and exercise interventions in adults with cerebral palsy: a systematic review of quantitative and qualitative studies
(Taylor and Francis Group, 2024-08-24) Andreopoulou, Georgia; Meharry, John Buchanan; Jagadamma, Kavi; van der Linden, Marietta
Background and purpose Participating in physical activity may benefit health-related outcomes for adults with cerebral palsy (CP). The aim of this review is to provide a synthesis of the evidence from both qualitative and quantitative studies on the impact of physical activity and exercise interventions in adults with CP. Methods Literature searches were conducted from inception to November 2023 in nine electronic databases. A meta-analysis was carried out to evaluate the efficacy of the interventions on walking speed related outcomes and muscle strength. Results Twenty-two studies met the inclusion criteria. The interventions of the 9 studies included in the meta-analysis did not improve walking speed over a distance of 10 meters (SMD=-0.03, 95% CI:-0.34-0.40, p=0.88, I2=0%) or endurance (distance covered in 2 or 6 minutes) (SMD=0.25, 95% CI :-0.10-0.59, p=0.16, I2=0%), but there was an improvement in lower limb muscle strength in favour of the experimental groups (SMD =0.59, 95% CI:0.19-0.99, p=0.004. I2=20%). Only a few studies reported on psychosocial outcomes, quality of life or intervention sustainability. Discussion and Conclusions Further research is needed to explore the impact on psychosocial outcomes and quality of life in adults with CP and the sustainability of physical activity participation.
Physiotherapists with musculoskeletal training in an emergency department for patients with non-specific low back pain: A service evaluation
(Wiley, 2022-05-01) Davies, Franco; Pace, Josef; Angus, Michelle; Chan-Braddock, Sharon; Jagadamma, Kavi
Objectives: To evaluate the effectiveness of musculoskeletal physiotherapy management of non-specific low back pain in an emergency department. Design: Observational retrospective analysis of data from emergency department database collected during a period of 6 months. Setting: The emergency department in Malta’s main acute general hospital. Participants: All adults that visited the emergency department with non-specific low back pain, excluding admissions, fractures and serious pathology. Interventions: Management of non-specific low back pain by musculoskeletal physiotherapists was compared to management by emergency medical doctors. Mean percentages were calculated relative to total number of patients for equal comparison. Main Outcome Measures: (1) referrals for x-rays, (2) referrals to orthopaedic out-patients, (3) return rates with the same condition during the study period. Results: Out of 1125 patients admitted to the emergency department with non-specific low back pain in 6 months, 14.6% were seen by a physiotherapist with 49.1% attending after physiotherapy service hours. Outcome comparison revealed minimal difference for x-ray and orthopaedic referrals but a noticeable difference in return rates with 1% of patients returning after seeing a physiotherapist and 5.7% when seen by a medical doctor only. Conclusion: Findings suggest that physiotherapy management of non-specific low back pain in an emergency department have similar outcomes to medical management with less referrals for x-rays and lower return rates and more referrals for orthopaedic follow-up. It is noteworthy that medical doctors and physiotherapists have similarly low referral rates to orthopaedic follow-up and x-rays. Current study only used data from one centre which affects the generalisability of the findings. Further patient-oriented research would reveal clearer outcomes on the quality of the service.
Psychometric properties of measures of gait quality and walking performance in young people with Cerebral Palsy: A systematic review
(Elsevier, 2017-07-04) Zanudin, Asfarina; Mercer, Tom; Jagadamma, Kavi; van der Linden, Marietta
Availability of outcome measures (OMs) with robust psychometric properties is an essential prerequisite for the evaluation of interventions designed to address gait deterioration in young people with Cerebral Palsy (CP). This review evaluates evidence for the reliability, validity and responsiveness of outcome measures of gait quality and walking performance in young people with CP. A systematic search was performed in MEDLINE, CINAHL, PubMed and Scopus. Articles that met the eligibility criteria were selected. Methodological quality of studies was independently rated by two raters using the modified COnsensus-based Standard for the selection of health status Measurement INstruments checklist. Strength of evidence was rated using standardised guidelines. Best evidence synthesis was scored according to Cochrane criteria. Fifty-one articles reporting on 18 distinct OMs were included for review. Best evidence synthesis indicated a moderate to strong evidence for the reliability for OMs of walking performance but conflicting evidence for the reliability of OMs of gait quality. The evidence for responsiveness for all OMs included in this review was rated as 'unknown'. The limitations of using the modified COSMIN scoring for small sample sizes are acknowledged. Future studies of high methodological quality are needed to explore the responsiveness of OMs assessing gait quality and walking performance in young people with CP. 2017 Elsevier B.V.
Service evaluation of telehealth in a physiotherapy musculoskeletal setting: Patient outcomes and results from risk stratification
(Wiley, 2022-02-26) Slattery, Brian; Ackerman, Lyndsey; Jagadamma, Kavi
Introduction Due to COVID-19 the ability to see all patients face-to-face (FTF) was removed. Services implemented telehealth to cater for patients requiring musculoskeletal care. A service evaluation was undertaken to assess the effectiveness of a mixed telehealth/FTF approach and identify if stratifying patients could help tailor intervention.
Service evaluation: Three subjective questions that aid in identifying frozen shoulder—Within a multi‐centre musculoskeletal physiotherapy department in primary care
(Wiley, 2024-04-21) Rangra, Prateek; Dickson, Louise; Jagadamma, Kavi
Frozen shoulder is a prevalent condition seen in primary care in the UK, 2%–10% of the general population and up to 20% of the diabetic population (Hanchard et al., 2020; Rae et al., 2019; Walker-Bone et al., 2004). Frozen shoulder is characterised by stiffness, pain, and limitation in function. Frozen shoulder is associated with variable prognosis and management strategies (Pandey & Madi, 2021; Rangan et al., 2020; Rex et al., 2021). It can be difficult to assess, diagnose and differentiate from other shoulder pathologies (Lyne et al., 2022). This is mainly due to commonality in aetiology and subjective findings in people presenting with shoulder pain. Physical examination is an integral part of frozen shoulder diagnosis. Therefore, an early identification is important to deliver good quality of care. The delivery of care in primary care settings is changing in the UK, with remote consultations on first contact becoming more prevalent in MSK settings (Rennie et al., 2022). It is also important to note that telephone assessments remain far more in number than assessments over video-based platforms in primary care settings (Murphy et al., 2021). This presents with a new set of challenges in diagnosing frozen shoulder and may cause delay in delivery of care. There are subjective pain related complaints of frozen shoulder originally described by Codman in the 1930s and more recently by Atkin et al. (2016). These include pain constant in nature, pain on lying on the side at night and no radiating pain below the elbow. With stiffness in the shoulder being a common underlying feature. There has been a lot of research on aetiology, pathophysiology, and physical examination of frozen shoulder. However, there is a gap in the literature on exploring the relationship between key pain related subjective complaints and diagnosis of frozen shoulder. The musculoskeletal physiotherapy service in East Lothian National Health Service, Scotland, consists of a telephone consultation to triage on first contact for self-referring patients. It was noted that pain related questions were regularly asked in these remote consultations when assessing shoulder pain; however, as discussed before, their relevance has not been evaluated in the literature in depth. Therefore, a service evaluation was carried out to investigate the relationship between three questions related to pain (i.e., Is the pain constant? Is there pain lying on the side at night? Does the pain radiate below the elbow?) and a diagnosis of frozen shoulder was made following face to face assessment. Additionally, this may help to provide some insight into whether frozen shoulder and other shoulder pathologies can be differentiated based on these pain related questions.
The biomechanical optimisation (tuning) of the Ankle Foot Orthosis - Footwear Combination (AFO-FC) of children with Cerebral Palsy - the effects on sagittal gait characteristics, muscle and joint characteristics and quality of life.
(Queen Margaret University, 2010) Jagadamma, Kavi
The current study aimed to investigate influences of rigid Ankle Foot Orthoses (AFOs) on gait in children with Cerebral Palsy (CP), immediate effects of tuning of AFO-FC (AFO-Footwear Combination) on gait of children with CP, short-term effects of tuning of AFO-FC on gait, muscle and joint characteristics and quality of life in children with CP, and the feasibility of conducting a larger trial. The study included 11 healthy children and 8 children with CP. Outcome measurements included sagittal plane kinematics and kinetics derived using 3D motion analysis, Gait Deviation Index (GDI), physical examination, and quality of life using the PedsQL™ questionnaire. Data from healthy children demonstrated influences of shoes on gait parameters and the role of the ankle joint in adapting to various wedges and rockers during gait. When studying children with CP, beneficial effects of rigid AFO-FC on gait parameters were evident; these were thought to relate to the appropriateness of the AFO-FC and familiarisation with the prescription. Immediate effects of tuning varied according to gait patterns previously demonstrated with non-tuned AFO-FC; benefits to knee kinematics and kinetics were largely seen in legs with extended knee gait, followed by jump knee gait, and with poorest responses in legs with crouch knee gait. Short-term effects of tuning were evident when comparing measurements taken before and after two-to-four months of wearing the tuned AFO-FC. Barefoot walking demonstrated significantly improved walking speed. Stride-length improved when comparing tuned AFO-FC at baseline with the tuned AFO-FC following the intervention period. No short-term changes were seen in PedsQL™ scores, muscle and joint characteristics, and GDI. Feasibility issues were also identified. It was concluded from this exploratory trial that tuning of AFO-FC improved gait for children with CP, although initial gait pattern affected the amount of benefit. This was evident immediately after tuning and some parameters improved further after short-term intervention. A randomised controlled trial is required; power analysis indicates the need for a larger sample of 18 in each group to detect change in GDI with a medium effect size and at a power of 0.8 and p <0.05.
The effects of tuning an Ankle-Foot Orthosis Footwear Combination on kinematics and kinetics of the knee joint of an adult with hemiplegia
(2010) Jagadamma, Kavi; Owen, Elaine; Coutts, Fiona; Herman, J.; Yirrell, Jacqueline; Mercer, Tom; van der Linden, Marietta
The effects of tuning the AFO footwear combination (AFOFC) for an adult with post-stroke hemiplegia were investigated. Gait analysis and tuning were carried out using a Vicon 3D motion analysis system and two force plates. Tuning of the AFOFC was accomplished by gradually modifying its design over a number of gait trials, to achieve optimal (i.e., as close as possible to normal, within the capability of the patient) knee kinematics and alignment of the Ground Reaction Force vector (GRF) relative to the knee joint. Heel wedges and a stiff rocker were used to tune mid-stance and terminal stance, respectively. Temporal-spatial parameters and selected kinetic and kinematic variables were compared between the non-tuned AFOFC, the tuned AFOFC immediately after tuning, and the tuned AFOFC after three months. There were several changes after three months compared to the non-tuned AFOFC, including improvement in stride length and a reduction in knee hyperextension. A subjective reduction in knee pain and improvement in function were also reported. The feasibility and the lack of objective evidence of tuning AFOFCs as a part of a clinical service need to be addressed in future research. 2010 ISPO.
The Influence of Walking Speed and Heel Height on Peak Plantar Pressure in the Forefoot of Healthy Adults: A Pilot Study
(OMICS International, 2017-07-18) Rangra, Prateek; Santos, Derek; Coda, A.; Jagadamma, Kavi
Background: The body of empirical research is suggestive of the fact that faster walking speed and increasing heel height can both give rise to elevated plantar pressures. However, there is little evidence of the interaction between walking speed and heel height on changes in plantar pressure. Therefore, the aim of this study was to investigate whether the effect of heel height on plantar pressure is the same for different walking speeds Methodology: Eighteen healthy adults, between the ages of 18 and 35 were assessed for changes in peak plantar pressure at walking speeds of 0.5 mph, 0.8 mph, 1.4 mph and 2.4 mph on a treadmill, wearing heels of 2 cm, 3 cm, 6 cm and 9 cm. Both the speed of walking and heels were randomly assigned to each participant. Peak plantar pressure values were determined in the forefoot region using the F-scan system which made use of in-shoe insoles. Data were analysed using two-way ANOVA. Results: Increasing heel height and walking speed resulted in significantly higher peak plantar pressure in the forefoot. Post-hoc analysis also confirmed the findings of two-way ANOVA of significant increase in peak plantar pressure with increments in heel height and walking speed. The two-way ANOVA illustrated significantly higher peak plantar pressures in both the forefeet due to interaction of walking speed and increasing heel heights. Conclusion: This study suggests that an interaction of walking speed and footwear design on distribution of plantar pressure exists. Therefore it is necessary to standardize walking speed and shoe design in future studies evaluating plantar pressures.