Article

The ability to measure the functional behaviour of the plantar heel pad is
clinically relevant in dystrophic or pathological heel conditions and may help to
inform the design and development of interventions that attempt to restore normal
function. In this study we present a novel technique which utilises orthotic heel
inserts with an embedded ultrasound (US) transducer to allow the functional,
dynamic behaviour of the heel pad to be measured in-shoe during gait. The aim of
this study was to demonstrate feasibility of the technique, determine the
reproducibility of measurements, and to compare the effects of two orthotic
inserts: (i) a flat orthotic heel raise and (ii) a contoured heel cup insert on
the behaviour of the heel pad during gait. Dynamic compression of the heel pads
of 16 healthy participants was recorded during treadmill walking and combined
with plantar pressure measurements to allow stiffness and energy disappation
ratio (EDR) to be estimated. Inter-session reliability of the US measurements was
found to be excellent (ICC2,1=0.94-0.95), as was inter-rater reliability
(ICC2,1=0.89). Use of the heel cup insert significantly reduced the maximum
compression of the heel pad (p<0.0001) as well as the overall stiffness of the
pad (p<0.001). There was no change in EDR (p=0.949). In-shoe embedded US is a
reliable method to establish person-specific functional geometry of plantar soft
tissues. Use of a contoured heel cup reduces the compression of the mid portion
of the heel pad.
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Langue : ANGLAIS