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Neuromechanics of the Foot, Footwear and Orthotics Stephen Perry, Phd Neuromechanics of the Foot, Footwear and Orthotics Stephen Perry, PhD Department of Kinesiology and Physical Education, Wilfrid Laurier University Department of Physical Therapy, Rehabilitation Science Institute, University of Toronto Toronto Rehabilitation Institute © Stephen D. Perry, PhD Areas of Research Foot Disorders Footwear, Orthotic Characteristics Plantar Surface Sensation Muscle Activation Balance Control Mobility © Stephen D. Perry, PhD Sensory Role Mechanical Role Central Nervous System Impingement Impingement of pathways of pathways inaccurate information decline in muscle strength Sensory Musculoskeletal damage to System receptors System deformities change in strategies available pain Inappropriate detection fatigue of pressure levels impedes transfer of forces shearing forces and reduction in sensitivity Balancing Reactions masking or potential for additional change in mechanical insulating signals postural disturbances properties (e.g. weight, shape) © Stephen D. Perry, PhD Take Home Message Structural and material alterations, such as footwear and orthotic characteristics, fit, integrity and interface (cushioning, sock‐insole, impingements) can affect both sensory and mechanical foot functions. There is also a need to identify and treat mechanical foot misalignments early with all of this taken into consideration. This research is in its early stages. © Stephen D. Perry, PhD References 1. Antonio, P.J. and S.D. Perry, 2019. Commercial pressure offloading insoles: dynamic stability and plantar pressure effects while negotiating stairs. Footwear Science. In Press. 2. Antonio, P.J., Investigating balance, plantar pressure, and foot sensitivity of individuals with diabetes during stair gait, Rehabilitation Science Institute. 2019, University of Toronto. 3. Antonio, P. J., and S. D. Perry. 2014. "Quantifying stair gait stability in young and older adults, with modifications to insole hardness." Gait Posture 40 (3):429‐34. doi: 10.1016/j.gaitpost.2014.05.009. 4. Chisholm, A. E., and S. D. Perry. 2012. "Ankle‐foot orthotic management in neuromuscular disorders: recommendations for future research." Disabil Rehabil Assist Technol 7 (6):437‐49. doi: 10.3109/17483107.2012.680940. 5. Jenkins, M. E., Q. J. Almeida, S. J. Spaulding, R. B. van Oostveen, J. D. Holmes, A. M. Johnson, and S. D. Perry. 2009. "Plantar cutaneous sensory stimulation improves single‐limb support time, and EMG activation patterns among individuals with Parkinson's disease." Parkinsonism Relat Disord 15 (9):697‐702. doi: 10.1016/j.parkreldis.2009.04.004. 6. Kennedy, P. M., and J. T. Inglis. 2002. "Distribution and behaviour of glabrous cutaneous receptors in the human foot sole." J Physiol 538 (Pt 3):995‐1002. 7. Maki, B. E., and W. E. McIlroy. 2005. "Change‐in‐support balance reactions in older persons: An emerging research area of clinical importance." Neurologic Clinics 23 (3):751‐+. doi: 10.1016/j.ncl.2005.01.002. 8. Menant, J. C., S. D. Perry, J. R. Steele, H. B. Menz, B. J. Munro, and S. R. Lord. 2008. "Effects of shoe characteristics on dynamic stability when walking on even and uneven surfaces in young and older people." Arch Phys Med Rehabil 89 (10):1970‐6. doi: 10.1016/j.apmr.2008.02.031. 9. Nazarko, L. 2006. "Falls prevention in practice: guidance and case study." Br J Community Nurs 11 (12):527‐9. doi: 10.12968/bjcn.2006.11.12.22422. 10. Novak, A. C., D. J. Mayich, S. D. Perry, T. R. Daniels, and J. W. Brodsky. 2014. "Gait analysis for foot and ankle surgeons‐‐ topical review, part 2: approaches to multisegment modeling of the foot." Foot Ankle Int 35 (2):178‐91. doi: 10.1177/1071100713511435. 11. Perry, S. D. 2006. "Evaluation of age‐related plantar‐surface insensitivity and onset age of advanced insensitivity in older adults using vibratory and touch sensation tests." Neurosci Lett 392 (1‐ 2):62‐7. doi: 10.1016/j.neulet.2005.08.060. 12. Perry, S.D., E. A. Cunningham, and K Goodwin. 2009. "Orthotics: Management of functional flat foot." Lower Extremity Review September. 13. Perry, S. D., W. E. McIlroy, and B. E. Maki. 2000. "The role of plantar cutaneous mechanoreceptors in the control of compensatory stepping reactions evoked by unpredictable, multi‐directional perturbation." Brain Res 877 (2):401‐6. 14. Perry, S. D., A. Radtke, and C. R. Goodwin. 2007. "Influence of footwear midsole material hardness on dynamic balance control during unexpected gait termination." Gait Posture 25 (1):94‐8. doi: 10.1016/j.gaitpost.2006.01.005. 15. Perry, S. D., A. Radtke, W. E. McIlroy, G. R. Fernie, and B. E. Maki. 2008. "Efficacy and effectiveness of a balance‐enhancing insole." J Gerontol A Biol Sci Med Sci 63 (6):595‐602. 16. Perry, S. D., L. C. Santos, and A. E. Patla. 2001. "Contribution of vision and cutaneous sensation to the control of centre of mass (COM) during gait termination." Brain Res 913 (1):27‐34. 17. Protopapas, K., The Effects of a 12‐Week Custom Foot Orthotic Intervention on the Intrinsic Muscles of the Foot, and Dynamic Stability During Unexpected Gait Termination in Healthy Young Adults, in Kinesiology & Physical Education. 2017, Wilfrid Laurier University. 18. Robb, K., The effects of orthotics and increased plantar sole mechanoreceptor activation on turning performance in individuals with Parkinson’s disease, in Kinesiology & Physical Education. 2017, Wilfrid Laurier University. 19. Rubenstein, L. Z. 2006. "Falls in older people: epidemiology, risk factors and strategies for prevention." Age Ageing 35 Suppl 2:ii37‐ii41. doi: 10.1093/ageing/afl084. 20. Zehr, E. P., and R. B. Stein. 1999. "What functions do reflexes serve during human locomotion?" Prog Neurobiol 58 (2):185‐205. © Stephen D. Perry, PhD.
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