Article

Windlass effect occurs during the pre-swing phase of gait cycle in which the peak
tensile strain and force of the plantar aponeurosis (PA) is reached. The
increased dorsiflexion angle of the 1st metatarsophalangeal (MTP) joint is the
main causing factor. The aim of this study was to investigate thoroughly in
finding the appropriate shoe and insole combination that can effectively decrease
the windlass effect. Foot kinematic analyses of 10 normal volunteers (aged
25.2+/-2.1 years, height of 167.4+/-9.1 cm, and weight of 66.2+/-18.1 kg) were
performed during gait under the conditions of barefoot, standard shoe (SS) with
flat insole (FI) or carbon fiber insole (CFI), and rocker sole shoe (RSS) with FI
or CFI. The shoe cover consisting of transparent polymer was used for accurate
measurement of kinematic data as specific areas on the cover can be cut away for
direct placement of reflective markers onto the skin. Under barefoot condition,
the mean of maximum dorsiflexion angle of the 1st MTP joint was measured to be
48.0+/-7.3 degrees , and decreased significantly to 28.2+/-5.7 degrees when
wearing SS with FI, and 24.1+/-5.7 degrees when wearing SS with CFI. This angle
was further decreased to around 13 degrees when wearing RSS with FI or CFI.
Subjects wearing footwear alone can increase the minimum medial longitudinal
angle and decrease the maximum plantarflexion angle of metatarsus related to the
calcaneus as compared with barefoot condition, resulting in flatter medial foot
arch. Results suggested that RSS is the effective footwear in reducing the
windlass effect regardless the type of insole inserted.
The findings in this
study provided us with the evidences in finding the appropriate footwear for
treating foot disorders such as plantar fasciitis by effectively reducing the
windlass effect.
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Langue : ANGLAIS