A novel footwear intervention to assist in the gait of patients with intermittent claudication

Evangelopoulou, E

Abstract

Peripheral arterial disease is characterised by blocking of the peripheral arteries. A
common symptom is intermittent claudication, a cramping pain felt intermittently
during activity such as walking. This is due to muscle oxygen demand surpassing the
available supply and can significantly reduce mobility and quality of life. One non
invasive treatment option is the use of footwear and orthoses to alter muscle
activity and delay the onset of calf pain. The aim of the research in this thesis was
to determine the gait characteristics of individuals with intermittent claudication
and to assess the effects of footwear and orthotic interventions on their gait.
Three studies were completed. The first compared gait of individuals with
intermittent claudication to that of healthy age-matched controls. The second
assessed the effectiveness of three rocker soled shoes (with and without an ankle
foot orthosis) in altering lower limb kinetics and muscle activity. The third
investigated the effectiveness of the most effective rocker soled shoe intervention
(in study two) in increasing mobility during gait and in real world situations.
People with intermittent claudication adopt a slower walking speed and shorter
step length and have reduced internal ankle moment and ankle power production
during push-off phase of gait. The peak EMG activity of their soleus muscle also
appears to be lower than healthy counterparts.
A rocker soled shoe, consisting of three curves blended into one, was found to be
the most effective at decreasing the moment, power and muscle activity demand
at the ankle during the gait of individuals with intermittent claudication. The
findings indicated the potential ability of the shoe to reduce the oxygen demand of
the calf, such that it might delay onset of intermittent claudication pain. However,
when tested under real world conditions this rocker soled shoe did not significantly
delay the onset of pain in people with intermittent claudication during over ground
gait, or increase maximum walking distance. Further modifications to the rocker
soled design will be required to further reduce oxygen required by the lower limb
muscles before a clinically significant delay in intermittent claudication pain can be
achieved.

Citation

Evangelopoulou, E. (in press). A novel footwear intervention to assist in the gait of patients with intermittent claudication. (Thesis). University of Salford

• Thesis Type: Thesis
• Acceptance Date: Mar 1, 2018
• Deposit Date: Apr 5, 2018
• Publicly Available Date: May 5, 2018