RESUMO
INTRODUCTION/PURPOSE: Shoe longitudinal bending stiffness (LBS) is often considered to influence running economy (RE) and thus, running performance. However, previous results are mixed and LBS levels have not been studied in advanced footwear technology (AFT). The purpose of this study was to evaluate the effects of increased LBS from curved carbon fiber plates embedded within an AFT midsole compared to a traditional running shoe on RE and spatiotemporal parameters. METHODS: Twenty-one male trained runners completed three times 4 min at 13 km/h with two experimental shoe models with a curved carbon fiber plate embedded in an AFT midsole with different LBS values (Stiff: 35.5 N/mm and Stiffest: 43.1 N/mm), and a Control condition (no carbon fiber plate: 20.1 N/mm). We measured energy cost of running (W/kg) and spatiotemporal parameters in one visit. RESULTS: RE improved for the Stiff shoe condition (15.71 ± 0.95 W/kg; p < 0.001; n2 = 0.374) compared to the Control condition (16.13 ± 1.08 W/kg; 2.56%) and Stiffest condition (16.03 ± 1.19 W/kg; 1.98%). However, we found no significant differences between the Stiffest and Control conditions. Moreover, there were no spatiotemporal differences between shoe conditions. CONCLUSION: Changes in LBS in AFT influences RE suggesting that moderately stiff shoes have the most effective LBS to improve RE in AFT compared to very stiff shoes and traditional, flexible shoe conditions while running at 13 km/h.
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Metabolismo Energético , Desenho de Equipamento , Corrida , Sapatos , Humanos , Corrida/fisiologia , Masculino , Metabolismo Energético/fisiologia , Adulto , Fenômenos Biomecânicos , Adulto Jovem , Fibra de CarbonoRESUMO
PURPOSE: Determine the effects of advanced footwear technology (AFT) in track spikes and road-racing shoes on running economy (RE). METHODS: Four racing shoes (3 AFT and 1 control) and 3 track spikes (2 AFT and 1 control) were tested in 9 male distance runners on 2 visits. Shoes were tested in a random sequence over 5-minute trials on visit 1 (7 trials at 16 km·h-1; 5-min rest between trials) and in the reverse/mirrored order on visit 2. Metabolic data were collected and averaged across visits. RESULTS: There were significant differences across footwear conditions for oxygen consumption (F = 13.046; P < .001) and energy expenditure (F = 14.710; P < .001). Oxygen consumption (in milliliters per kilogram per minute) in both the first AFT spike (49.1 [1.7]; P < .001; dz = 2.1) and the other AFT spike (49.3 [1.7]; P < .001; dz = 1.7) was significantly lower than the control spike (50.2 [1.6]), which represented a 2.1% (1.0%) and 1.8% (1.0%) improvement in RE, respectively, for the AFT spikes. When comparing the subjects' most economic shoe by oxygen consumption (49.0 [1.5]) against their most economic spike (49.0 [1.8]), there were no statistical differences (P = .82). Similar statistical conclusions were made when comparing energy expenditure (in watts per kilogram). CONCLUSIONS: AFT track spikes improved RE â¼2% relative to a traditional spike. Despite their heavier mass, AFT shoes resulted in similar RE as AFT spikes. This could make the AFT shoe an attractive option for longer track races, particularly in National Collegiate Athletic Association and high school athletics, where there are no stack-height rules.
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Metabolismo Energético , Desenho de Equipamento , Consumo de Oxigênio , Corrida , Sapatos , Equipamentos Esportivos , Humanos , Masculino , Corrida/fisiologia , Adulto Jovem , AdultoRESUMO
Technologically advanced running shoes (TARS) improve performance compared to classical running shoes (CRS). Improved race performance has been attributed to metabolic savings in male runners, but it remains unclear if these same benefits are experienced among females and in recreational runners. The mechanisms behind these benefits are still not fully understood despite the need for optimisation, and their influence on injury mechanisms has not been explored. Here we combined biomechanical, physiological, and modelling approaches to analyse joint mechanics, oxygen uptake, and tibial load in nineteen male and female recreational runners running with CRS and TARS at their individual lactate threshold speed (12.4 ± 1.9 km/h). Oxygen uptake was 3.0 ± 1.5% lower in TARS than in CRS. Ankle dorsiflexion, joint moment and joint power were reduced in TARS compared to CRS at various phases of stance including midstance, while knee joint mechanics were mostly similar throughout. There were no significant differences for tibial bending moment during the stance phase but cumulative tibial damage per kilometre was 12 ± 9% lower in TARS compared to CRS. Our results suggest that running with TARS reduces oxygen cost in recreational female and male runners, which may partly be explained by differences in lower limb joint mechanics. The lower cumulative tibial bone load with TARS may allow runners to run longer distances in this type of shoe compared to CRS.
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Consumo de Oxigênio , Corrida , Sapatos , Tíbia , Humanos , Corrida/fisiologia , Masculino , Feminino , Adulto , Fenômenos Biomecânicos , Tíbia/fisiologia , Consumo de Oxigênio/fisiologia , Adulto Jovem , Articulação do Joelho/fisiologia , Oxigênio/metabolismoRESUMO
Individuals with Parkinson's disease (PD) are characterized by gait and balance disorders limiting their independence and quality of life. Home-based rehabilitation programs, combined with drug therapy, demonstrated to be beneficial in the daily-life activities of PD subjects. Sensorized shoes can extract balance- and gait-related data in home-based scenarios and allow clinicians to monitor subjects' activities. In this study, we verified the capability of a pair of sensorized shoes (including pressure-sensitive insoles and one inertial measurement unit) in assessing ground-level walking and body weight shift exercises. The shoes can potentially be combined with a sensory biofeedback module that provides vibrotactile cues to individuals. Sensorized shoes have been assessed in terms of the capability of detecting relevant gait events (heel strike, flat foot, toe off), estimating spatiotemporal parameters of gait (stance, swing, and double support duration, stride length), estimating gait variables (vertical ground-reaction force, vGRF; coordinate of the center of pressure along the longitudinal axes of the feet, yCoP; and the dorsiflexion angle of the feet, Pitch angle). The assessment compared the outcomes with those extracted from the gold standard equipment, namely force platforms and a motion capture system. Results of this comparison with 9 PD subjects showed an overall median absolute error lower than 0.03 s in detecting the foot-contact, foot-off, and heel-off gait events while performing ground-level walking and lower than 0.15 s in body weight shift exercises. The computation of spatiotemporal parameters of gait showed median errors of 1.62 % of the stance phase duration and 0.002 m of the step length. Regarding the estimation of vGRF, yCoP, and Pitch angle, the median across-subjects Pearson correlation coefficient was 0.90, 0.94, and 0.91, respectively. These results confirm the suitability of the sensorized shoes for quantifying biomechanical features during body weight shift and gait exercises of PD and pave the way to exploit the biofeedback modules of the bidirectional interface in future studies.
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Doença de Parkinson , Humanos , Sapatos , Qualidade de Vida , Marcha , Caminhada , Peso Corporal , Fenômenos BiomecânicosRESUMO
Personalised footwear could be used to enhance the function of the foot-ankle complex to a person's maximum. Human-in-the-loop optimization could be used as an effective and efficient way to find a personalised optimal rocker profile (i.e., apex position and angle). The outcome of this process likely depends on the selected optimization objective and its responsiveness to the rocker parameters being tuned. This study aims to explore whether and how human-in-the-loop optimization via different cost functions (i.e., metabolic cost, collision work as measure for external mechanical work, and step distance variability as measure for gait stability) affects the optimal apex position and angle of a rocker profile differently for individuals during walking. Ten healthy individuals walked on a treadmill with experimental rocker shoes in which apex position and angle were optimized using human-in-the-loop optimization using different cost functions. We compared the obtained optimal apex parameters for the different cost functions and how these affected the selected gait related objectives. Optimal apex parameters differed substantially between participants and optimal apex positions differed between cost functions. The responsiveness to changes in apex parameters differed between cost functions. Collision work was the only cost function that resulted in a significant improvement of its performance criteria. Improvements in metabolic cost or step distance variability were not found after optimization. This study showed that cost function selection is important when human-in-the-loop optimization is used to design personalised footwear to allow conversion to an optimum that suits the individual.
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Sapatos , Caminhada , Humanos , Marcha , Extremidade Inferior , Fenômenos Biomecânicos , Desenho de EquipamentoRESUMO
The habitual use of high-heeled footwear may structurally remodel user leg muscle tendons, thereby altering their functional capabilities. High heels set users' ankles in relatively plantarflexed positions, causing calf muscle tendons to operate at relatively short lengths. Habitually operating muscle tendons at relatively short lengths induces structural remodeling that theoretically affects muscle metabolism. Because structural changes occur within the body, the user's locomotor metabolism may change in any footwear condition (e.g., conventional shoes, barefoot). Here, we studied the influence of habitual high-heel use on users' leg muscle-tendon structure and metabolism during walking in flat-soled footwear. We tested eight participants before and after 14 wk of agreeing to wear high heels as their daily shoes. Overall, participants who wore high heels >1,500 steps per day, experienced a 9% decrease in their net metabolic power during walking in flat-soled footwear (d = 1.66, P ≤ 0.049), whereas participants who took <1,000 daily steps in high heels did not (d = 0.44; P = 0.524). Across participants, for every 1,000 daily steps in high heels, net metabolic power during walking in flat-soled footwear decreased 5.3% (r = -0.73; P = 0.040). Metabolic findings were partially explained (r2 = 0.43; P = 0.478) by trending shorter medial gastrocnemius fascicle lengths (d = 0.500, P = 0.327) and increased Achilles tendon stiffness (d = 2.889, P = 0.088). The high-heel intervention did not alter user walking stride kinematics in flat-soled footwear (d ≤ 0.567, P ≥ 0.387). While our limited dataset is unable to establish the mechanisms underlying the high-heel-induced walking economy improvement, it appears that prescribing specific footwear use can be implemented to alter user muscle-tendon properties and augment their function in any shoes.NEW & NOTEWORTHY Habitually wearing high-heeled footwear structurally remodels leg muscle tendons and improves user walking economy, regardless of worn attire.
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Tendão do Calcâneo , Calcanhar , Humanos , Calcanhar/fisiologia , Caminhada/fisiologia , Músculo Esquelético/fisiologia , Tendão do Calcâneo/fisiologia , Perna (Membro) , Sapatos , Fenômenos BiomecânicosRESUMO
In the quest to uncover the underlying mechanisms responsible for the performance-enhancing benefits imparted by advanced footwear technology (AFT), footwear researchers are employing an individual-level approach. In doing so, they hope to unveil individual-specific responses to AFT otherwise masked by a group-level approach. Classifying an individual's response on the basis of running economy (RE) is a logical strategy given that the intended purpose of AFT is to enhance performance; however, caution should be taken when doing so. Metabolic measurement devices are far from perfect, and given the known errors associated with metabolic measurements we would like to reiterate a suggestion first made 40 years ago: when seeking to quantify the interindividual variability of improvement in RE associated with running in AFT, the best practice is to rely on a minimum of two same-day measurements of RE.
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Corrida , Sapatos , Humanos , Corrida/fisiologia , Metabolismo Energético , Fenômenos Biomecânicos , Desenho de EquipamentoRESUMO
PURPOSE: The objective of this study is to assess the influence of "super-shoes" on metabolic cost and joint mechanics in competitive female runners and to understand how foot strike pattern may influence the footwear effects. METHODS: Eighteen competitive female runners ran four 5-min bouts on a force instrumented treadmill at 12.9 km·h -1 in 1) Nike Vaporfly Next% 2™ (SUPER) and 2) Nike Pegasus 38™ (CON) in a randomized and mirrored order. RESULTS: Metabolic power was improved by 4.2% ( P < 0.001; d = 0.43) and metatarsophalangeal (MTP) negative work ( P < 0.001; d = 1.22), ankle negative work ( P = 0.001; d = 0.67), and ankle positive work ( P < 0.001; d = 0.97) were all smaller when running in SUPER compared with CON. There was no correlation between foot strike pattern and the between-shoe (CON to SUPER) percentage change for metabolic power ( r = 0.093, P = 0.715). CONCLUSIONS: Metabolic power improved by 4.2% in "super-shoes" (but only by ~3.2% if controlling for shoe mass differences) in this cohort of competitive female runners, which is a smaller improvement than previously observed in men. The reduced mechanical demand at the MTP and ankle in "super-shoes" are consistent with previous literature and may explain or contribute to the metabolic improvements observed in "super-shoes"; however, foot strike pattern was not a moderating factor for the metabolic improvements of "super-shoes." Future studies should directly compare the metabolic response among different types of "super-shoes" between men and women.
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Metabolismo Energético , Pé , Corrida , Sapatos , Humanos , Feminino , Corrida/fisiologia , Fenômenos Biomecânicos , Metabolismo Energético/fisiologia , Adulto , Pé/fisiologia , Adulto Jovem , Articulação do Tornozelo/fisiologia , Marcha/fisiologia , Consumo de Oxigênio/fisiologiaRESUMO
Artificial intelligence (AI) technology represents a disruptive innovation that has garnered significant interest among researchers for its potential applications in ecological and environmental management. While many studies have investigated the impact of AI on carbon emissions, relatively few have delved into its relationship with air pollution. This study sets out to explore the causal mechanisms and constraints linking AI technologies and air pollution, using provincial panel data collected from 2007 to 2020 in China. Furthermore, this study examines the distinct pathways through which AI technology can ameliorate air pollution and reduce carbon emissions. The findings reveal the following key insights: (1) AI technologies have the capacity to significantly reduce air pollution, particularly in terms of PM2.5 and SO2 levels. (2) AI technologies contribute to enhanced air quality by facilitating adjustments in energy structures, improving energy efficiency, and strengthening digital infrastructure. Nonetheless, it is important to note that adjusting the energy structure remains the most practical approach for reducing carbon emissions. (3) The efficacy of AI in controlling air pollution is influenced by geographical location, economic development level, level of information technology development, resource dependence, and public attention. In conclusion, this study proposes novel policy recommendations to offer fresh perspectives to countries interested in leveraging AI for the advancement of ecological and environmental governance.
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Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Carbono , Inteligência Artificial , Conservação dos Recursos Naturais , Sapatos , Política Ambiental , Poluição do Ar/prevenção & controle , Poluição do Ar/análise , China , Tecnologia , Desenvolvimento EconômicoRESUMO
To better understand stress-related foot ulceration in diabetes, the cumulative plantar tissue stress (CPTS) should be quantified accurately, but also feasibly for clinical use. We developed multiple CPTS models with varying complexity and investigated their agreement with the most comprehensive reference model available. We assessed 52 participants with diabetes and high foot ulcer risk for barefoot and in-shoe plantar pressures during overground walking at different speeds, standing, sit-to-stand transitions, and stair walking. Level of these weight-bearing activities along with footwear adherence were objectively measured over seven days. The reference CPTS-model included the pressure-time integrals of each walking stride (barefoot and shod), specified for speed; standing period (barefoot and shod); transition and stair walking stride. We compared four CPTS-models with increasing number of input parameters (models 1-4) with the reference model, using repeated measures ANOVA, Pearson's correlation and Bland-Altman plots. For the clinically-relevant metatarsal 1 region, calculated CPTS was lower for the four CPTS-models compared to reference (Δ770, Δ466, Δ24 and Δ12 MPa.s/day, respectively). CPTS associated moderately with the reference model for model 1 (r = 0.551) and very strongly for models 2-4 (r ≥ 0.937). Limits of agreement were large for models 1 and 2 (-728;2269 and -302;1233 MPa.s/day), and small for models 3 and 4 (-43;92 and -54;78 MPa.s/day). CPTS in models 3 and 4 best agreed with the reference model, where model 3 required fewer parameters, i.e., pressure-time integrals of each walking stride and standing period while barefoot and shod. These parameters need to be included for accurate and feasible CPTS assessment.
Assuntos
Diabetes Mellitus , Ossos do Metatarso , Humanos , Pé , Pressão , Caminhada , Sapatos , Fenômenos BiomecânicosRESUMO
BACKGROUND: An increasing number of commercially available wearables provide real-time feedback on running biomechanics with the aim to reduce injury risk or improve performance. OBJECTIVE: Investigate whether real-time feedback by wearable insoles (ARION) alters running biomechanics and improves running economy more as compared to unsupervised running training. We also explored the correlation between changes in running biomechanics and running economy. METHODS: Forty recreational runners were randomized to an intervention and control group and performed ~6 months of in-field training with or without wearable-based real-time feedback on running technique and speed. Running economy and running biomechanics were measured in lab conditions without feedback pre and post intervention at four speeds. RESULTS: Twenty-two individuals (13 control, 9 intervention) completed both tests. Both groups significantly reduced their energetic cost by an average of -6.1% and -7.7% for the control and intervention groups, respectively. The reduction in energy cost did not significantly differ between groups overall (-0.07 ± 0.14 Jâkgâm-1 , -1.5%, p = 0.63). There were significant changes in spatiotemporal metrics, but their magnitude was minor and did not differ between the groups. There were no significant changes in running kinematics within or between groups. However, alterations in running biomechanics beyond typical session-to-session variation were observed during some in-field sessions for individuals that received real-time feedback. CONCLUSION: Alterations in running biomechanics as observed during some in-field sessions for individuals receiving wearable-based real-time feedback did not result in significant differences in running economy or running biomechanics when measured in controlled lab conditions without feedback.
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Corrida , Dispositivos Eletrônicos Vestíveis , Humanos , Retroalimentação , Fenômenos Biomecânicos , SapatosRESUMO
Benzene, toluene, ethyl benzene, and xylene (BTEX) are prevalent pollutants in shoe industry-related workplaces. The aim of this study was to assess exposure to BTEX and their carcinogenic and non-carcinogenic risks in shoe-industry-related workplaces. This study was carried out at different shoe manufactures, small shoe workshop units, shoe markets, and shoe stores in Tabriz, Iran in 2021. Personal inhalation exposure to BTEX was measured using the National Institute for Occupational Safety and Health (NIOSH) 1501 method. Carcinogenic and non-carcinogenic risks due to inhalation exposure to BTEX were estimated by United States Environmental Protection Agency (U.S. EPA) method based on Mont Carlo simulation. Results showed that the concentrations of benzene and toluene were higher than the threshold limit value (TLV) in both gluing and non-gluing units of shoe manufactures. The total carcinogenic risk (TCR) due to exposure to benzene and ethyl benzene was considerable in all shoe industry-related workplaces. Also, the hazard index (HI) as a non-carcinogenic index was higher than standard levels in all shoe industry-related workplaces. Therefore, shoe industry-related workers are at cancer and non-cancer risks due to exposure to BTEX. Prevention measures need to be implemented to reduce the concentration of BTEX in shoe industry-related workplaces.
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Poluentes Atmosféricos , Benzeno , Humanos , Benzeno/toxicidade , Benzeno/análise , Xilenos/toxicidade , Xilenos/análise , Tolueno/toxicidade , Tolueno/análise , Sapatos , Monitoramento Ambiental/métodos , Poluentes Atmosféricos/análise , Derivados de Benzeno/toxicidade , Derivados de Benzeno/análise , Carcinógenos , Local de Trabalho , Carcinogênese , Medição de RiscoRESUMO
BACKGROUND: Ethylene and vinyl acetate (EVA) and polyether block amide (PEBA) are recently the most widely used materials for advanced footwear technology (AFT) that has been shown to improve running economy (RE). This study investigated the effects of these midsole materials on RE and biomechanics, in both fresh and worn state (after 450 km). METHODS: Twenty-two male trained runners participated in this study. Subjects ran four 4-min trials at 13 kmâ§h-1 with both fresh EVA and PEBA AFT and with the same models with 450 km of wear using a randomized crossover experimental design. We measured energy cost of running (W/kg), spatiotemporal, and neuromuscular parameters. RESULTS: There were significant differences in RE between conditions (p = 0.01; n2 = 0.17). There was a significant increase in energy cost in the worn PEBA condition compared with new (15.21 ± 1.01 and 14.87 ± 0.99 W/kg; p < 0.05; ES = 0.54), without differences between worn EVA (15.13 ± 1.14 W/kg; p > 0.05), and new EVA (15.15 ± 1.13 w/kg; ES = 0.02). The increase in energy cost between new and worn was significantly higher for the PEBA shoes (0.32 ± 0.38 W/kg) but without significant increase for the EVA shoes (0.06 ± 0.58 W/kg) (p < 0.01; ES = 0.51) with changes in step frequency and step length. The new PEBA shoes had lower energy cost than the new EVA shoes (p < 0.05; ES = 0.27) with significant differences between conditions in contact time. CONCLUSION: There is a clear RE advantage of incorporating PEBA versus EVA in an AFT when the models are new. However, after 450 km of use, the PEBA and EVA shoes had similar RE.
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Ácidos Borônicos , Corrida , Humanos , Masculino , Fenômenos Biomecânicos , Estudos Cross-Over , SapatosRESUMO
Shoe outsole design strongly influences slip and fall risk. Certain tread features that can be readily measured have been shown to predict friction performance. This research aimed to replicate those findings and quantify their ability to predict slipping. Participants (n = 34) were exposed to a low friction oil-coated floor surface, while wearing slip-resistant shoes. The coefficient of friction (COF) of each shoe were predicted based on tread surface area, the presence of a bevel, and hardness. The COF was measured, and the slip outcome was determined. Predicted and measured COF were correlated, and measured COF was a sensitive predictor of slip outcome. The relationship of predicted COF on slip outcome was weaker than anticipated and was not statistically significant. This study partially confirmed the ability of previous regression equations to predict COF. However, the effect size was weaker than previously reported and predicted COF was not sensitive for predicting slips.
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Pisos e Cobertura de Pisos , Sapatos , Humanos , Fricção , Estudos ProspectivosRESUMO
This paper presents a novel low-cost and fully-portable instrumented shoe system for gait phase detection. The instrumented shoe consists of 174 independent sensing units constructed based on an off-the-shelf force-sensitive film known as the Velostat conductive copolymer. A zero potential method was implemented to address the crosstalk effect among the matrix-formed sensing arrays. A customized algorithm for gait event and phase detection was developed to estimate stance sub-phases including initial contact, flat foot, and push off. Experiments were carried out to evaluate the performance of the proposed instrumented shoe system in gait phase detection for both straight-line walking and turning walking. The results showed that the mean absolute time differences between the estimated phases by the proposed instrumented shoe system and the reference measurement ranged from 45 to 58 ms during straight-line walking and from 51 to 77 ms during turning walking, which were comparable to the state of art.Clinical and Translational Impact Statement-By allowing convenient gait monitoring in home healthcare settings, the proposed system enables extensive ADL data collection and facilitates developing effective treatment and rehabilitation strategies for patients with movement disorders.
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Pé , Sapatos , Humanos , Marcha , Extremidade Inferior , CaminhadaRESUMO
Snakebite envenomation (SBE) is endemic to sub-Saharan Africa and generally over-represented in rural, remote, and impoverished agricultural communities. While poverty is an established risk factor, little research has been done to investigate the economic consequences of SBE. This cross-sectional, quantitative study aimed to measure out-of-pocket spending and lost income when a household member was bitten by a snake. In 2020, 732 snakebite survivors from Eastern Province (Rwanda) agreed to complete a survey administered by telephone. The survey focused on participant demographics, income, direct medical and non-medical costs, care-seeking decisions, and lost work during convalescence. Our results suggested that patients incurred the highest mean expenses when they sought care from hospitals (11 307 RWF or 12 USD) or traditional healers (5 836 RWF or 6 USD) but that the highest maximum cost was incurred from traditional healers (300 000 RWF or 313 USD). Across all victims, the total amount paid to traditional healers (3.4 million RWF or 3 537 USD) was 4.7 times higher than all other care providers combined. On average, families lost 111 814 RWF (117 USD) per snakebite in direct treatment costs and indirect productivity losses. Many victims sought care from traditional healers despite being eligible for free medical care. Altogether, this study serves as a reminder of the serious physical and financial consequences associated with SBE and provides justification for new investments into SBE prevention and care.
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Mordeduras de Serpentes , Humanos , Mordeduras de Serpentes/terapia , Profissionais de Medicina Tradicional , Ruanda , Estudos Transversais , SapatosRESUMO
BACKGROUND: Preventing foot ulcers in people with diabetes can increase quality of life and reduce costs. Despite the availability of various interventions to prevent foot ulcers, recurrence rates remain high. We hypothesize that a multimodal treatment approach incorporating various footwear, self-management, and education interventions that matches an individual person's needs can reduce the risk of ulcer recurrence with beneficial cost-utility. The aim of this study is to assess the effect on foot ulcer recurrence, footwear adherence, and cost-utility of an integrated personalized assistive devices approach in high-risk people with diabetes. METHODS: In a parallel-group multicenter randomized controlled trial, 126 adult participants with diabetes mellitus type 1 or 2, loss of protective sensation based on the presence of peripheral neuropathy, a healed plantar foot ulcer in the preceding 4 years, and possession of any type of custom-made footwear will be included. Participants will be randomly assigned to either enhanced therapy or usual care. Enhanced therapy consists of usual care and additionally a personalized treatment approach including pressure-optimized custom-made footwear, pressure-optimized custom-made footwear for indoor use, at-home daily foot temperature monitoring, and structured education, which includes motivational interviewing and personalized feedback on adherence and self-care. Participants will be followed for 12 months. Assessments include barefoot and in-shoe plantar pressure measurements; questionnaires concerning quality of life, costs, disease, and self-care knowledge; physical activity and footwear use monitoring; and clinical monitoring for foot ulcer outcomes. The study is powered for 3 primary outcomes: foot ulcer recurrence, footwear adherence, and cost-utility, the primary clinical, patient-related, and health-economic outcome respectively. DISCUSSION: This is the first study to integrate multiple interventions for ulcer prevention into a personalized state-of-the-art treatment approach and assess their combined efficacy in a randomized controlled trial in people with diabetes at high ulcer risk. Proven effectiveness, usability, and cost-utility will facilitate implementation in healthcare, improve the quality of life of high-risk people with diabetes, and reduce treatment costs. TRIAL REGISTRATION: ClinicalTrials.gov NCT05236660. Registered on 11 February 2022.
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Diabetes Mellitus Tipo 1 , Pé Diabético , Úlcera do Pé , Adulto , Humanos , Pé Diabético/diagnóstico , Pé Diabético/prevenção & controle , Úlcera , Qualidade de Vida , Diabetes Mellitus Tipo 1/terapia , Úlcera do Pé/diagnóstico , Úlcera do Pé/prevenção & controle , Sapatos , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como AssuntoRESUMO
Background: Identification of athletic shoes for patients with contact allergy is difficult. Company reports of allergen content are often incorrect. Objectives: To determine whether chemical analysis of 4 athletic shoes, previously reported to be free of the most common contact allergens, contain quantifiable allergen levels. Methods: Samples from the uppers and insoles of 4 shoes believed to be free of common allergens were assessed by mass spectrometry. A total of 4 rubber accelerators and 2 adhesives were directly quantified and additional 7 rubber accelerators were assessed using semiquantitative measures. Results: Aside from carbamates (assayed as 59 ppm zinc in insoles) in SeaVee's Sixty-Six sneakers, para-tertiarybutylphenol formaldehyde resin (PTBFR) (assayed as 7.6 ppm paratertiary butylphenol or 4-tertiary butylphenol [4TBP] in uppers) in Allbirds Tree Runners and rosin (assayed as 628 ppm sodium abietate in uppers) and carbamates (24 ppm zinc in uppers) in Saucony Jazz sneakers, these shoes had low levels of all allergens assayed in this study. Tom's Carlo sneakers contained rosin (127 ppm sodium abietate in insoles), PTBFR (6.5 ppm 4TBP in uppers), and carbamates (112 ppm sodium abietate in insoles) but had low levels of all other assayed allergens. Conclusions: Although identifying allergen-free shoes is challenging, the results of this analysis will help patch testing physicians recommend athletic shoes to patients with specific allergies.
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Dermatite Alérgica de Contato , Esportes , Humanos , Alérgenos/efeitos adversos , Alérgenos/análise , Sapatos , Borracha , Cromatografia Gasosa-Espectrometria de Massas , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Carbamatos , Testes do Emplastro/métodos , Espectrometria de Massas , Sódio , ZincoRESUMO
INTRODUCTION/PURPOSE: Previous results about shoe longitudinal bending stiffness (LBS) and running economy (RE) show high variability. This study aimed to assess the effects of shoes with increased LBS on RE and performance in trained and national runners. METHODS: Twenty-eight male runners were divided into two groups according to their 10-km performance times (trained, 38-45 min and national runners, <34 min). Subjects ran 2 × 3 min (at 9 and 13 km·h -1 for trained, and 13 and 17 km·h -1 for national runners) with an experimental shoe with carbon fiber plate to increase the LBS (Increased LBS) and a control shoe (without carbon fiber plate). We measured energy cost of running (W·kg -1 ) and spatiotemporal parameters in visit one and participants performed a 3000 m time trial (TT) in two successive visits. RESULTS: Increased LBS improved RE in the trained group at slow (11.41 ± 0.93 W·kg -1 vs 11.86 ± 0.93 W·kg -1 ) and fast velocity (15.89 ± 1.24 W·kg -1 vs 16.39 ± 1.24 W·kg -1 ) and only at the fast velocity in the national group (20.35 ± 1.45 W·kg -1 vs 20.78 ± 1.18 W·kg -1 ). The improvements in RE were accompanied by different changes in biomechanical variables between groups. There were a similar improvement in the 3000 m TT test in Increased LBS for trained (639 ± 59 vs 644 ± 61 s in control shoes) and national runners (569 ± 21 vs 574 ± 21 s in control shoes) with more constant pace in increased LBS compared with control shoes in both groups. CONCLUSIONS: Increasing shoe LBS improved RE at slow and fast velocities in trained runners and only at fast velocity in national runners. However, the 3000 m TT test improved similarly in both levels of runners with increased LBS. The improvements in RE are accompanied by small modifications in running kinematics that could explain the difference between the different levels of runners.
Assuntos
Corrida , Sapatos , Humanos , Masculino , Fibra de Carbono , Fenômenos BiomecânicosRESUMO
Frailty poses a threat to the daily lives of healthy older adults, highlighting the urgent need for technologies that can monitor and prevent its progression. Our objective is to demonstrate a method for providing long-term daily frailty monitoring using an in-shoe motion sensor (IMS). We undertook two steps to achieve this goal. Firstly, we used our previously established SPM-LOSO-LASSO (SPM: statistical parametric mapping; LOSO: leave-one-subject-out; LASSO: least absolute shrinkage and selection operator) algorithm to construct a lightweight and interpretable hand grip strength (HGS) estimation model for an IMS. This algorithm automatically identified novel and significant gait predictors from foot motion data and selected optimal features to construct the model. We also tested the robustness and effectiveness of the model by recruiting other groups of subjects. Secondly, we designed an analog frailty risk score that combined the performance of the HGS and gait speed with the aid of the distribution of HGS and gait speed of the older Asian population. We then compared the effectiveness of our designed score with the clinical expert-rated score. We discovered new gait predictors for HGS estimation via IMSs and successfully constructed a model with an "excellent" intraclass correlation coefficient and high precision. Moreover, we tested the model on separately recruited subjects, which confirmed the robustness of our model for other older individuals. The designed frailty risk score also had a large effect size correlation with clinical expert-rated scores. In conclusion, IMS technology shows promise for long-term daily frailty monitoring, which can help prevent or manage frailty for older adults.