Elsevier

Gait & Posture

Volume 58, October 2017, Pages 495-497
Gait & Posture

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Continuous use of textured insole improve plantar sensation and stride length of people with Parkinson’s disease: A pilot study

https://doi.org/10.1016/j.gaitpost.2017.09.017Get rights and content

Highlights

  • Textured insoles benefit plantar sensation and gait of people with PD.

  • The enhanced feedback to the sensory system result in an improved motor output.

  • Longer wearing periods of the textured insoles may be required to prolong the retention of benefits.

Abstract

Findings involving the acute benefits of textured insoles on gait in people with Parkinson’s disease (PD) are still controversial. To our best acknowledge, the continuous use of textured insoles on gait in people with PD has not been investigated yet. The aim of this pilot study was to obtain preliminary data of the effects of textured insoles on gait and plantar sensation in people with PD after one-week intervention and one-week follow-up period. Nineteen patients with PD were distributed into two groups: experimental group and control group. Initially, the plantar sensation was assessed through Semmes-Weinstein Monofilaments. Then, participants performed 5 trials of walking (without insoles) at a self-selected speed. Gait data were collected using an optoelectronic system. Plantar sensation and gait assessments were repeated in three moments: before and after one-week wearing the group-specific insoles, and after one week wearing conventional insoles (follow-up). The textured insole had half-sphere elevations placed in the distal phalanx of the hallux, heads of metatarsophalangeal joints and heel. Results revealed that the use of textured insole for one week improved plantar sensation and stride length. However, only benefits on plantar sensation were maintained after the follow-up period. Our results suggest that the continuous use of textured insoles for one week benefits plantar sensation and gait in patients with PD. These results support the hypothesis that enhanced somatosensory feedback to the sensory system result in an improved motor output of gait.

Introduction

Gait impairments in Parkinson’s disease (PD) are, at least in part, associated to somatosensory deficits such as decreased plantar sensation of the feet [1]. Increasing evidence suggest that augmented stimulation of the plantar surface, by wearing textured insoles, benefit gait in both healthy and clinical populations [2]. However, the few existing studies involving people with PD found controversial results. While Jenkins et al. observed acute benefit [3], our group observed no change when people with PD wore textured insoles [4]. It’s important to highlight that Jenkins et al. found a trial by trial benefit on single-limb support time and those benefits were more pronounced at the last trials. These results suggest that a long-term exposure to textured insoles may cause more pronounced benefits to gait. However, the effects of long-term use of textured insoles on gait have not been investigated yet.

The aim of this pilot study was to investigate the effects of continuous use of textured insoles on gait and plantar sensation of people with PD. We also investigated if potential effects are maintained after a follow-up period.

Section snippets

Participants

Nineteen patients with idiopathic PD were recruited according to the following inclusion criteria: stage 1 to 3 on the Hoehn and Yahr Scale (H&Y [5]), independent walking and in regular use of PD-specific medication. Patients were randomly distributed in two groups: i) G1: textured insole (n = 10); ii) G2: conventional insole (control group, n = 9). The randomization procedure was carried out by draw. The exclusion criteria were: cognitive impairment based on suggestions of Brucki et al. for

Results

All participants completed the entire study protocol. The participants reported no major discomfort related to the insoles. There were no significant differences between groups for all demographic and clinical data (Table 1). A significant interaction between factors (Group X Test) was observed for plantar sensation; participants in G1 presented higher score of plantar sensation at Pre-test than Post and Follow-up tests (Table 2). For gait parameters, an interaction between factors (Group X

Discussion

This study observed benefits offered by textured insoles on plantar sensation and stride length in people with PD after continuous use. However, only plantar sensation benefits were kept after the follow-up period. Similar to studies with multiple sclerosis patients [9], [10], the continuous use of textured insoles was effective to increase stride length. Our results suggest that enhanced somatosensory feedback to the sensory system might result in an improved motor output of gait − represented

Conclusion

Continuous use of textured insoles (one week) benefits plantar sensation and gait in patients with PD. However, only the benefits in plantar sensation are maintained after a wash out period.

Conflict of interest statement

The authors have no conflicts of interest to disclose. All authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) our work and manuscript. All authors have approved the final article.

Acknowledgements

The authors thank São Paulo Research Foundation (FAPESP) [grant #2010/036500-8) for financial support and Podaly for manufacturing the insoles. The authors also acknowledge all members of the PROPARKI Group.

References (13)

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