Search Results (87)

Objectives: Spinal tumors often require complex surgical treatments, in particular en bloc vertebrectomy, and a pre-operative kinematics and functional assessment of the spine could be advised to improve surgical outcomes and patients’ quality of life. However, established protocols for stereophotogrammetry-based gait analysis are not available. This study aims at evaluating the feasibility of an experimental protocol for multi-segment trunk and spine kinematics in patients scheduled for en bloc vertebrectomy. Methods: Ten patients and ten age- and sex-matched healthy controls underwent full-body gait analysis using an established marker-set able to track the lower limbs, pelvis, thorax, shoulders, and five spine line segments. The participants completed static double leg standing, barefoot level walking, and elementary trunk movements. A preliminary within-session repeatability assessment in two individuals (one representative patient and one healthy participant) was performed (root mean square error smaller than 10% of ROM; intra-class correlation coefficients > 0.8). Results: Compared with controls, patients affected by spinal tumors showed slower gait, shorter stride length, smaller ROM at the pelvis and thorax, and reduced frontal-plane mobility between spine line segments, but physiological lower-limb joint kinematics. During elementary movements, patients exhibited reduced trunk ROM in the anatomical plane of motion, particularly at a central spine segment, and smaller pelvic mobility in axial rotations. Conclusions: The results of this study support the feasibility of the proposed protocol for gait analysis in the rare clinical population of patients affected by spinal tumors and provide descriptive functional information that may complement conventional pre-operative clinical and imaging assessments. Full article

Background: High-heeled footwear is widely used by women, yet its systemic influence on spatiotemporal gait parameters, pelvic kinematics, and propulsion across a range of heel heights remains incompletely characterised. This study aimed to quantify gait changes across four footwear conditions and assess the contribution of anthropometric characteristics to observed gait variability. Methods: A within-subject repeated-measures study was conducted with 75 healthy young adult women (mean age 24.3 years, BMI 21.3 kg/m²) assessed barefoot, in ballerina flats, 8 cm heels, and 12 cm heels using the G-WALK inertial measurement system (BTS Bioengineering). Thirty gait parameters were analysed using the Friedman test with Bonferroni-corrected Wilcoxon post hoc comparisons (α_adj = 0.0083), Spearman rank correlations, multiple linear regression, and Kruskal–Wallis tertile analysis. Results: Footwear significantly affected 22 of 30 parameters. Walking speed was higher in all shod conditions than barefoot (up to +9.2%), driven entirely by stride elongation with cadence unchanged, indicating a general effect of footwear rather than heel elevation specifically. Stride length peaked at 8 cm heel (+8.9% vs. barefoot) and declined at 12 cm. Gait symmetry decreased progressively with heel height. Ballerina shoes produced a distinctively dynamic temporal profile—shortest stance duration, lowest double support, and highest single support time—significantly different from both barefoot and heeled conditions. The propulsion index increased height-dependently with heel height, rising 23.3% from barefoot (8.20) to 12 cm heel (10.11; p < 0.001). Pelvic obliquity symmetry was disrupted at 12 cm heel, while tilt symmetry was unaffected. Anthropometric analysis identified 110/600 significant Spearman correlations (23 surviving Benjamini–Hochberg FDR correction) and 29/120 significant regression models (14 surviving FDR); age, body weight, and shoe size were the most consistent predictors, most reliably in the barefoot condition. Conclusions: Heel height exerts condition-specific effects on gait biomechanics. Ballerina shoes produce a gait pattern distinct from both barefoot and heeled walking. Propulsion demand increases height dependently with heel elevation. Because participants walked in their own footwear, the observed effects reflect the combined characteristics of each shoe type rather than heel elevation in isolation. Anthropometric characteristics—particularly age, body weight, and shoe size—are modestly associated with footwear–gait responses and may inform future biomechanical research, although clinical application requires confirmation in standardised-footwear studies and clinical populations. Full article

Cutaneous Larva Migrans (CLM) is a neglected tropical disease (NTD) caused by zoonotic Ancylostomatidae larvae, mainly Ancylostoma braziliense and Ancylostoma caninum, which infect dogs and cats. Humans are accidental hosts, acquiring infection when L3 larvae in contaminated soil penetrate the skin, producing serpiginous, pruritic lesions. We report a 24-year-old female from Quito, Ecuador, who developed a pruritic lesion on her right foot nine days after walking barefoot on wet, potentially fecally contaminated sand at Atacames Beach. Initial self-treatment with benzyl benzoate and herbal washes, followed by misdiagnoses as scabies and plantar warts, delayed proper care. Lesions progressed over three weeks with intense pruritus and functional impairment. CLM was correctly diagnosed by a podiatric technician 26 days post-exposure. Oral albendazole (400 mg/day for 4 days) led to rapid symptomatic relief within three days, with complete resolution by day 50. A survey analyzed by the McNemar Test revealed difficulties in recognizing early-stage CLM, regardless of experience or region among participants. Prevention requires personal protection, environmental sanitation, and regular anthelmintic treatment of dogs and cats. This case underscores the clinical consequences of delayed or incorrect diagnosis and highlights the need for enhanced healthcare training and One Health measures to reduce zoonotic diseases in Ecuador. Full article

Research into auxetic foams—materials with a negative Poisson’s ratio— is expanding, yet their integration into orthotics for diverse neuropathic conditions remains largely unexplored. This pilot study evaluates the feasibility of fabricating custom auxetic foam insoles and characterizing vertical ground reaction force (vGRF) trends across a heterogeneous cohort. In collaboration with the NASA/Marshall Space Flight Center, six participants, including five representing varied neuropathic etiologies and one healthy control, performed randomized walking trials under three conditions: barefoot, over-the-counter (OTC) insoles, and custom auxetic prototypes. The healthy control was retained in the cohort-level analysis to preserve methodological symmetry across experimental conditions. To maintain physical rigor, vGRF data were mass-normalized (N/kg). A Friedman test (n = 6) evaluated global differences, supplemented by a dual-bootstrap analysis (1000 resamples) to quantify effect magnitudes (r) and numerical uncertainty. Although the Friedman test revealed no statistically significant global differences (Q = 0.333, df = 2, p = 0.846), a descriptively large effect size (r = 0.58) was observed for the auxetic material versus barefoot walking. However, wide 95% bootstrap confidence intervals prevent population-level inference, reinforcing the exploratory nature of these findings. Subject-specific observations showed descriptive differences in vGRF in three participants (0.17 to 1.18 N/kg), while increases in others occurred alongside confounding factors such as self-selected walking velocity. This work demonstrates the mechanical application of auxetic insole prototypes, providing a foundational rationale for future trials utilizing standardized walking velocity to isolate material performance. Full article

Walking, a fundamental human activity, has significant implications for health. This study aimed to determine the influence of different types of footwear (boots, running shoes, and indoor court shoes) on maximum plantar force and pressure. The sample included 19 healthy male students. Plantar pressures and forces were measured with a pedobarographic device. The maximum forces on the forefoot were highest when walking barefoot and lowest when wearing boots (p < 0.05). For the midfoot, a significant difference (p < 0.01) was found between the barefoot condition and the other three conditions; forces were lowest when walking barefoot. Compared with the other conditions, the maximum forces on the hindfoot were highest when participants wore boots (p < 0.01). The maximum pressure on the forefoot was highest when participants walked barefoot compared with the footwear conditions (p < 0.01). For the midfoot, wearing running shoes resulted in the highest values, which were significantly different (p < 0.01) from those obtained when wearing indoor court shoes or walking barefoot. Compared with the other three conditions, wearing running shoes resulted in the lowest maximum pressure on the hindfoot (p < 0.01). The plantar force and pressure gait parameters indicate that cushioning has biomechanical significance during movement. Full article

Background: Long-distance hiking usually requires carrying a backpack, adding external load to the lower limbs and modifying plantar loading patterns. Excessive loads may contribute to overuse injuries, but quantitative evidence to support current recommendations on backpack weight is still scarce. This study aimed to examine how different backpack loads influence plantar pressure in long-distance hikers. Methods: A cross-sectional observational study was conducted in adults who had walked at least 20 km during the previous 24 h. Sociodemographic and clinical variables were recorded, and barefoot plantar pressure was assessed using the Podoprint^® system under four conditions: without a backpack, with the habitual backpack, and with backpacks loaded to 10% and 20% of body weight. Static and dynamic plantar pressure parameters were analyzed using repeated-measures comparisons. Results: A progressive increase in plantar force was observed in both feet as backpack load increased. Compared with the unloaded condition, static forefoot pressure rose by 5.41% with a 10% load and by 8.73% with a 20% load (p = 0.005); rearfoot pressure increased by 5.01% and 10.17% (p = 0.015); and total foot pressure by 5.04% and 9.61% (p = 0.002). Loads above 10% of body weight significantly modified static plantar pressures and were associated with measurable changes during dynamic assessment. Conclusions: In long-distance hikers, carrying a backpack that exceeds approximately 10% of body weight leads to a clear, load-dependent increase in plantar pressure. These findings provide biomechanical support for recommendations that advise limiting backpack load to around 10% of body weight to reduce plantar stress during hiking. Full article

Background: Footwear may influence paediatric gait biomechanics, yet evidence across footwear types and barefoot conditions remains heterogeneous. This review aimed to synthesise evidence on how footwear affects gait biomechanics in children and adolescents compared with barefoot walking, and to conduct exploratory meta-analyses when feasible. Methods: We performed a PRISMA-guided systematic review (PubMed and Scopus; inception to November 2025) including participants < 18 years with gait outcomes assessed under barefoot and/or defined footwear conditions. Outcomes included spatiotemporal, kinematic, kinetic, and plantar-pressure variables. Risk of bias was assessed with ROBINS-I. Random-effects meta-analyses (inverse-variance) were conducted only when ≥2 studies reported comparable outcomes. Results: Twenty-two studies were included; most were observational with overall moderate-to-serious risk of bias, mainly due to confounding and participant selection. Quantitative synthesis (exploratory): Meta-analyses were possible only for ankle plantarflexion (k = 2) and stride length (k = 3) and showed non-significant pooled effects with extreme heterogeneity (I² > 90%) and wide prediction intervals. Narrative synthesis: For other outcomes, heterogeneity in designs, footwear definitions, and measurement protocols precluded pooling; conventional footwear may reduce metatarsophalangeal mobility and alter kinematics and plantar pressure in some contexts, while minimalist/biomimetic features may approximate barefoot-like values for selected parameters without implying equivalence. Conclusions: Footwear exposure in childhood may affect several gait-related parameters, but the certainty of evidence is low to moderate due to risk of bias, inconsistency, and imprecision. Standardised footwear classifications, harmonised gait protocols, and longitudinal studies are needed to clarify developmental implications and inform evidence-based guidance. Full article

Nature-based activities have been linked to psychophysical restoration, but the role of individual baseline conditions in predicting recovery remains unclear. This study examined whether baseline stress levels and mental wellbeing influence psychophysical recovery after an immersive barefooting experience, and whether sociodemographic factors (sex and education) and access to green spaces moderate these effects. A convenience sample of 249 adults (58% female, mean age 45 years) voluntarily participated in a structured barefooting trail in two Italian parks and, after the activity, completed post-experience self-report questionnaires using validated scales (Perceived Stress Scale, Restorative Outcome Scale, and Warwick–Edinburgh Mental Wellbeing Scale). Multivariate logistic regression analyses showed that higher baseline mental wellbeing significantly predicted greater psychophysical recovery, while short-term perceived stress did not. None of the tested interactions with sex, education level, or access to green space were significant. These results suggest that mental wellbeing, rather than recent stress, may be a key factor in maximizing restorative experiences in immersive nature-based activities, and that this effect appears consistent across sociodemographic and environmental contexts. While preliminary, these findings highlight the potential of barefoot walking and similar multisensory activities as low-cost strategies to maintain and enhance psychological wellbeing. Full article

Background: The purpose of this study was to evaluate the effects of a structured barefoot walking program on menopausal symptoms, sleep quality, stress, and quality of life in middle-aged women experiencing menopausal symptoms. Methods: A quasi-experimental design with a nonequivalent control group and pretest-posttest was used. Community-dwelling women aged 45 to 65 years residing in Wonju, Republic of Korea, were recruited and assigned to either an experimental (n = 29) or control group (n = 31). The intervention consisted of 12 weeks of barefoot walking (three times per week, 60 min per session). Outcome measures included the Menopause Rating Scale (MRS), Verran and Snyder–Halpern Sleep Scale, Stress Response Inventory, and WHOQOL-BREF. In addition, changes in participants’ body composition before and after the intervention were assessed using a bioelectrical impedance analyzer (InBody 770). Data were analyzed using the Mann–Whitney U test, repeated measures ANOVA, ANCOVA, and other relevant statistical methods, with the level of significance set at p < 0.05. Results: Compared with the control group, the experimental group showed significant improvements in menopausal symptoms (z = −5.59, p < 0.001), stress (z = −3.58, p < 0.001), and quality of life (z = −3.47, p = 0.001). A significant time-by-group interaction effect was observed for sleep quality (F = 7.53, p = 0.008). No significant changes were found in body composition. Conclusion: Barefoot walking represents a promising, low-cost, community-based intervention for alleviating menopausal symptoms, enhancing sleep quality, reducing stress and improving quality of life in middle-aged women experiencing menopausal symptoms. Further randomized controlled trials are warranted to confirm these findings. Full article

Background: Foot injuries are common among Umrah pilgrims due to prolonged walking, overcrowded conditions, and inadequate preventive measures, such as inappropriate footwear or walking barefoot. Despite their potential impact on mobility and overall pilgrimage experience, these conditions remain underreported and insufficiently addressed in public health strategies. Objectives: This study aims to assess the prevalence and types of foot problems among Umrah pilgrims, examine their associations with demographic characteristics and comorbidities, analyze the utilization of medical attention for foot pain, and assess the use of preventive measures to reduce foot-related health risks during the pilgrimage. Methods: A cross-sectional study was conducted throughout the 2024 G (1445 H) Umrah season at the Grand Mosque, Makkah. The study recruited 1138 Umrah pilgrims aged 18 and older who performed the pilgrimage. A structured questionnaire was administered to collect data on demographic characteristics, chronic diseases, foot conditions, medical-attention-seeking behavior, and preventive practices. Pilgrims with pre-existing foot conditions were excluded from participation. Results: Foot diseases were reported by 46% of participants. The most common foot injuries included sprains/strains (18.7%) and muscle pain/cramps (4.9%), with the leg and forefoot being the most affected areas. Significant associations were observed between foot diseases and lower education levels (p = 0.03), chronic liver disease (p = 0.04), and cardiovascular disease (p = 0.04). Despite the high prevalence of foot-related conditions, only 9.6% sought medical attention, and 14.9% reported using preventive measures. Conclusions: The study highlights a substantial burden of foot problems among Umrah pilgrims, with limited utilization of healthcare services and preventive strategies. Targeted interventions, including educational campaigns and improved screening for high-risk individuals, are essential for enhancing foot health and ensuring a safer pilgrimage experience. Full article

Background: Marker-based motion capture is the current gold standard for three-dimensional (3D) gait analysis. This is a highly technical analysis that is time-consuming, and marker application can trigger anxiety in children. One potential solution is to use markerless camera systems instead. The objective of this study was to compare 3D lower limb gait kinematics in children using both marker-based and markerless motion capture methods. Methods: Ten typically developing children (age 6–13 yrs) completed five barefoot walks at a self-selected speed. A 10-camera marker-based system (Oqus, Qualisys) and a 7-camera markerless system (Miqus, Qualisys) captured synchronised gait data at 85 Hz. Generalised Additive Mixed Models were fitted to the data to identify the random effects of measurement systems, age, and time across the gait cycle. The root-mean-square difference (RMSD) was used to compare the differences between systems. Results: Significant interactions and differences were observed between the marker-based and markerless systems for most joint angles and planes of motion, particularly with regard to time and age. Conclusions: Despite differences across all kinematic profiles, the RMSD in this study was comparable to previously published results. Alternative model definitions and kinematic crosstalk in both systems likely explain the differences. Age differences were not consistent across joint levels, suggesting a larger sample size is required to determine how maturation may affect markerless tracking. Further investigation is required to understand the deviations and differences between systems before implementing markerless technology in a clinical setting. Full article

The foot deformation approach (FDA) estimates the ground reaction force (GRF) and moment (GRM) from kinematic data with practical accuracy, low computational cost, and no requirement for training data. Our previous study demonstrated practical estimation accuracy of the FDA under barefoot conditions. However, since the FDA estimates GRFs and GRMs based on foot deformation under body weight, there are concerns about its applicability to footwear conditions, where the foot deformation characteristics differ from those of bare feet. Following the issue, this study conducted a walking experiment at three different speeds with running shoes and sneakers to investigate the impact of footwear on GRF prediction using the FDA. The results showed that the FDA successfully provided practical accuracy when shoes were worn, comparable to that for a barefoot participant. The FDA offers advantages for estimating GRFs and GRMs for the footwear condition, while eliminating the need for collecting training data and enabling rapid analysis and feedback in clinical settings. Although the FDA cannot fully eliminate the effects of footwear and movement speed on prediction accuracy, it has the potential to serve as a convenient biomechanical-based method for estimating GRFs and GRMs during sports and daily activities with footwear. Full article

Post-op shoes (POSs) are commonly used after forefoot surgery to protect the surgical site. However, there are insufficient data on their impact on forefoot load during the rollover phase of walking. This study aims to analyze the effects of a commonly used POS on plantar pressures under the forefoot and to assess whether improper usage could affect pressure patterns. Sixteen healthy volunteers underwent three different walking tests on a straight tartan track. The test setting included walking barefoot, as well as normal walking and a modified heel-accentuated “limping” gait while wearing a common POS. The pressure distribution over the forefoot regions of interest was measured using sensor insoles and a pressure-measuring plate on the ground. Results show that only the heel-accentuated “limping” gait in the POS led to a significant reduction in pressure values over all anatomical regions compared to the normal barefoot gait. Furthermore, higher pressure values were found over the lesser toes during normal walking in the POS compared to normal barefoot walking. The findings highlight that the protective function of a POS relies on proper use, specifically the correct gait pattern. If used incorrectly, POS may even have unfavorable effects on the pressure on the operated forefoot and possibly even increase the risk of delayed healing or complications in comparison to barefoot walking. Therefore, strategies such as patient training in proper walking techniques should be incorporated into postoperative care. Full article

Background/Objectives: Minor amputations are increasingly relevant due to a growing proportion of lower limb amputations but remain underrepresented in research. These amputations impair mobility due to altered gait, and biomimetic devices could potentially address this issue. Fundamental research is needed to better understand this pathological gait pattern. The aim of this study is to analyse the holistic gait characteristics of the lower extremity during barefoot walking in individuals with different levels of minor amputations for the first time. Methods: Eight young to middle-aged subjects with minor foot amputations (four × hallux; four × forefoot) underwent instrumented gait analysis. Kinematic and kinetic data were acquired barefoot at self-selected gait speeds. Individual gait characteristics were considered relative to the physiological gait represented by the 95% confidence interval of ten unimpaired volunteers. Results: Subjects with a minor amputation show reduced walking speed and shorter stride length compared to controls. Sagittal ankle moment and ankle power are lower, with greater deficits in subjects with a forefoot amputation. Proximal joints also show variability, notably reduced knee flexion in subjects with a forefoot amputation and a more flexed hip profile in six subjects. Single-subject frontal plane kinetics also vary. Conclusions: Although the subjects with a hallux amputation exhibit smaller deviations in ankle kinetics than the subjects with a forefoot amputation, proximal joint abnormalities are present across cases. These findings highlight the need for a broad range of care to adequately address individual needs. Full article

Background/objectives: In this paper, we review and discuss epidemiological and experimental evidence on the effects of daily footwear on gait and life-long health. We consider different types of footwear, including “minimal shoes”, and their design features, comparing them to barefoot walking, with a focus on overall gait and the function of the heel pad. Methods: Narrative review. Results: We find little evidence for health benefits of most typical shoe design features (e.g., cushioning, raised heels or arch support) for normal walking in healthy individuals, and in several cases (e.g., high heels), there is evidence of detrimental health effects. Conclusions: Based on currently available evidence, we recommend minimal footwear as the default for the general population to stimulate healthy biomechanical aging, with other types of footwear used infrequently or when there is an individual or clinical need. Full article