Effects of orthopedic footwear on postural stability and walking in individuals with Hereditary Motor Sensory Neuropathy

Abstract

Background: Orthopedic footwear is often prescribed to improve postural stability during standing and walking in individuals with Hereditary Motor Sensory Neuropathy. However, supporting evidence in literature is scarce. The aim of this study was to investigate the effect of orthopedic footwear on quiet standing balance, gait speed, spatiotemporal parameters, kinematics, kinetics and dynamic balance in individuals with Hereditary Motor Sensory Neuropathy.Methods: Fifteen individuals with Hereditary Motor Sensory Neuropathy performed a quiet standing task and 2 -min walk test on customized orthopedic footwear and standardized footwear. Primary outcome measures were the mean velocity of the center of pressure during quiet standing and gait speed during walking. Secondary outcome measures included center of pressure amplitude and frequency during quiet standing, and spatiotem-poral parameters, kinematics, kinetics, and dynamic balance during walking. Two-way repeated measures ANOVA and paired t-tests were performed to identify differences between footwear conditions.Findings: Neither quiet standing balance nor dynamic balance differed between orthopedic and standardized footwear, but orthopedic footwear improved spatiotemporal parameters (higher gait speed, longer step length, shorter step time and smaller step width) during walking. Moreover, less sagittal shank-footwear range of mo-tion, more frontal shank-footwear range of motion, more dorsiflexion of the footwear-to-horizontal angle at initial contact and more hip adduction during the stance phase were found.Interpretation: Orthopedic footwear improved walking in individuals with Hereditary Motor Sensory Neuropathy, whereas it did not affect postural stability during quiet standing or dynamic balance. Especially gait speed and spatiotemporal parameters improved. An improved heel landing at initial contact for all footwear and reduced foot drop during swing for mid and high orthopedic footwear contributed to the gait improvements wearing orthopedic footwear.