PTOtherJournal of physical therapy science2019

Particular protrusion perception arising from plantar sensory input and task guidance enhances lower limb joint dynamics during gait.

Ryota Okoba, Masaki Hasegawa, Hisayoshi Yoshizuka and 3 others

PMID 30936642

WHAT IT FOUND

Attaching small protrusions to the heel or big toe changed muscle activity and foot angles during walking in healthy adults.

Heel protrusions increased toe clearance and ankle dorsiflexion, while toe protrusions increased plantarflexion. This sensory cue altered mechanics but did not test clinical outcomes.

Key findings

01Heel protrusions significantly increased toe clearance during the swing phase and ankle dorsiflexion at initial contact compared to walking without protrusions.

02Hallucal (big toe area) protrusions significantly increased gastrocnemius muscle activity and ankle plantarflexion angle during pre-swing compared to control and heel conditions.

03The study could not separate the effects of the physical protrusion from the verbal instructions given to participants.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Participants were all healthy young adults (average age 21-24), so findings may not apply to older or impaired populations. The study did not separate the effect of the physical protrusion from the verbal task instructions, so it is unclear if the sensation or the instruction caused the change. This was a short-term biomechanical analysis, not a clinical trial, so no patient outcomes like fall rates or functional independence were measured.

Declared interests

Funded by JSPS KAKENHI Grant number JP18H06442. The authors declared no conflicts of interest.

The easy way to misread this

Do not assume these mechanical changes will improve walking in patients with disabilities. The study was conducted on healthy adults and did not test whether these protrusions reduce falls or improve function in a clinical population.

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