Turkish Journal of Physical Medicine and Rehabilitation 2018 , Vol 64 , Num 3

Effect of insoles with arch support on gait pattern in patients with multiple sclerosis

Senem Güner 1 ,Sema Haghari 2 ,Serap Alsancak 1 ,Naime Uluğ 3 ,Fatma İnanıcı 3
1 Department of Prosthetics and Orthotics, Vocational School of Health Services, Ankara University, Ankara, Turkey
2 Department of Physical Medicine and Rehabilitation, Ethica Hospital, İstanbul,Turkey
3 Department of Physical Medicine and Rehabilitation, Medicine Faculty of Hacettepe University, Ankara, Turkey
DOI : 10.5606/tftrd.2018.2246 Objectives: This study aims to determine the effect of insoles with arch support on gait patterns in patients with multiple sclerosis (MS) and somatosensory impairment.

Patients and methods: Ten patients (7 females, 3 males; mean age 34.9±6.8 years; range, 48 to 35 years) with clinically definite relapsing remitting MS and age- and sex-matched 10 healthy volunteers (7 females, 3 males; mean age 33.8±3.2; range, 40 to 31 years) were included in the study between January 2011 and January 2012. A medial longitudinal arch and transverse arch supporting polyurethane insole covered with foam shaped using plantar sensory feedback was used. Three-dimensional gait analysis was performed via a Vicon 612 system with six cameras. The participants initially walked barefoot and, then, wore the insoles in their short slipper socks.

Results: All participants were evaluated in terms of kinetics, kinematics, and temporospatial parameters with a gait analysis system. The patients with MS showed improvements in cadence and walking speed when using the insoles. Sagittal plane angles of the hip and knee were increased while using insoles (p<0.05) and ankle plantar flexion was found to be decreased, compared to barefoot walking (p<0.05).

Conclusion: Our study results suggest that insole with arch support affects gait cycle, but does not improve gait impairments in patients with MS. Insoles may ensure plantar sensory feedback in feet during walking, which increases pressure in the mid-forefoot area. Keywords : Gait analysis; insole; multiple sclerosis