AB1435-HPR Effects of flat cushioning insole on gait parameters of individuals with chronic idiopathic neck pain
Authors: M KIRMIZI, I.E. SIMSEK, A. ELVAN, O. AKCALI, S. ANGIN
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Shock waves caused by ground reaction force dissipate through the body during walking, which brings about dynamic loading on bones and soft tissues. It was showed that individuals with neck pain walk with a stiffer spine due to protective movement strategy against pain. Degenerative changes, pain and increased stiffness decrease the shock absorption capacity of the spine and cause an increase in dynamic loading affecting the spine. It was known that chronic idiopathic neck pain (CINP) causes alternations in gait parameters, but it is still unclear if using flat cushioning insole affects gait parameters in individuals with CINP. <h3>Objectives</h3> The aim of the study was to investigate the effects of flat cushioning insole on neck pain during walking and gait parameters in individuals with CINP. <h3>Methods</h3> Twenty-one individuals with CINP (15 female – 6 male, mean age: 35,67±12,64) and 21 healthy controls (15 female – 6 male, mean age: 35,33±12,51) recruited into this study. Assessment of gait parameters and pain were carried out in two sessions, standard shoe only and standard shoe with flat cushioning. In both sessions, all participants performed the 10-metre walking test in two walking conditions: normal walking (PW), walking at maximum speed (MAXW). The order of sessions and walking conditions were randomised. Plantar pressure parameters were assessed using pressure sensitive insoles and spatiotemporal parameters were assessed using video analysis method involving slow motion camera (120fps). Pain severity was assessed using Visual Analogue Scale at the beginning of both sessions and immediately following the end of the walking conditions in individuals with CINP. Paired sample t-test was used to determine the effects of flat cushioning insole on gait parameters for both groups and on neck pain for the only neck pain group. <h3>Results</h3> Our findings indicated that the flat cushioning insole results in a decrease in the maximum force, peak pressure, force-time integral, pressure-time integral and an increase in the contact area in both groups (p&lt;0.05). In individuals with CINP, flat cushioning insole increased walking speed and step length in both walking conditions (p&lt;0.05), however, it had no impact on cadence (p&gt;0.05). Flat cushioning insole reduced the severity of neck pain during MAXW (p&lt;0.05), but there was no difference in neck pain at beginning of both sessions and during PW conditions (p&gt;0.05). In healthy individuals, no difference was found in spatiotemporal gait parameters between two sessions (p&gt;0.05). <h3>Conclusions</h3> The study suggested that the flat cushioning insole reduces neck pain severity during walking and has positive effects on gait parameters in individuals with CINP. Flat cushioning insole may be used to decrease neck pain during walking and improve spatiotemporal gait parameters in individuals with CINP. <h3>References</h3> [1] Helliwell P, Smeathers J, Wright V. Shock absorption by the spinal column in normals and in ankylosing spondylitis. Journal of Engineering in Medicine1989;203(4):187–90. [2] Falla D, Gizzi L, Parsa H, Dieterich A ve ark. People With Chronic Neck Pain Walk With a Stiffer Spine. Journal of orthopaedic &amp; sports physical therapy2017;47(4):268–77. <h3>Disclosure of Interest</h3> None declared