Sex differences in heel pad stiffness during in vivo loading and unloading

Ukadike C. Ugbolue; Emma L. Yates; Scott C. Wearing; Yaodong Gu; Wing Kai Lam; Stephanie Valentin; Julien Baker; Frédéric Dutheil; Nicholas F. Sculthorpe

doi:10.1111/joa.13207

Sex differences in heel pad stiffness during in vivo loading and unloading

Ukadike C. Ugbolue^*, Emma L. Yates, Scott C. Wearing, Yaodong Gu, Wing Kai Lam, Stephanie Valentin, Julien Baker, Frédéric Dutheil, Nicholas F. Sculthorpe

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › peer-review

5 Citations (Scopus)

Abstract

Due to conflicting data from previous studies a new methodological approach to evaluate heel pad stiffness and soft tissue deformation has been developed. The purpose of this study was to compare heel pad (HP) stiffness in both limbs between males and females during a dynamic unloading and loading activity. Ten males and 10 females volunteered to perform three dynamic trials to unload and load the HP. The dynamic protocol consisted of three continuous phases: foot flat (baseline phase), bilateral heel raise (unloading phase) and foot flat (loading phase) with each phase lasting two seconds. Six retroreflective markers (3 mm) were attached to the skin of the left and right heels using a customised marker set. Three-dimensional motion analysis cameras synchronised with force plates collected the kinematic and kinetic data throughout the trials. Three-way repeated measures ANOVA together with a Bonferroni post hoc test were applied to the stiffness and marker displacement datasets. On average, HP stiffness was higher in males than females during the loading and unloading phases. ANOVA results revealed no significant differences for the stiffness and displacement outputs with respect to sex, sidedness or phase interactions (p >.05) in the X, Y and Z directions. Irrespective of direction, there were significant differences in stiffness between the baseline and unloading conditions (p <.001) but no significant differences between the baseline and loaded conditions (p = 1.000). Post hoc analyses for the marker displacement showed significant differences between phases for the X and Z directions (p <.032) but no significant differences in the Y direction (p >.116). Finally, females portrayed lower levels of mean HP stiffness whereas males had stiffer heels particularly in the vertical direction (Z) when the HP was both unloaded and loaded. High HP stiffness values and very small marker displacements could be valuable indicators for the risk of pathological foot conditions.

Original language	English
Pages (from-to)	520-528
Number of pages	9
Journal	Journal of Anatomy
Volume	237
Issue number	3
DOIs	https://doi.org/10.1111/joa.13207
Publication status	Published - 1 Sept 2020

Scopus Subject Areas

Anatomy
Ecology, Evolution, Behavior and Systematics
Histology
Molecular Biology
Developmental Biology
Cell Biology

User-Defined Keywords

bilateral heel raise
foot flat
kinematics and kinetics
marker displacement
plantar flexion

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10.1111/joa.13207

Cite this

@article{f0a1791af97a470f9cdfb189a09b4abb,

title = "Sex differences in heel pad stiffness during in vivo loading and unloading",

abstract = "Due to conflicting data from previous studies a new methodological approach to evaluate heel pad stiffness and soft tissue deformation has been developed. The purpose of this study was to compare heel pad (HP) stiffness in both limbs between males and females during a dynamic unloading and loading activity. Ten males and 10 females volunteered to perform three dynamic trials to unload and load the HP. The dynamic protocol consisted of three continuous phases: foot flat (baseline phase), bilateral heel raise (unloading phase) and foot flat (loading phase) with each phase lasting two seconds. Six retroreflective markers (3 mm) were attached to the skin of the left and right heels using a customised marker set. Three-dimensional motion analysis cameras synchronised with force plates collected the kinematic and kinetic data throughout the trials. Three-way repeated measures ANOVA together with a Bonferroni post hoc test were applied to the stiffness and marker displacement datasets. On average, HP stiffness was higher in males than females during the loading and unloading phases. ANOVA results revealed no significant differences for the stiffness and displacement outputs with respect to sex, sidedness or phase interactions (p >.05) in the X, Y and Z directions. Irrespective of direction, there were significant differences in stiffness between the baseline and unloading conditions (p <.001) but no significant differences between the baseline and loaded conditions (p = 1.000). Post hoc analyses for the marker displacement showed significant differences between phases for the X and Z directions (p <.032) but no significant differences in the Y direction (p >.116). Finally, females portrayed lower levels of mean HP stiffness whereas males had stiffer heels particularly in the vertical direction (Z) when the HP was both unloaded and loaded. High HP stiffness values and very small marker displacements could be valuable indicators for the risk of pathological foot conditions.",

keywords = "bilateral heel raise, foot flat, kinematics and kinetics, marker displacement, plantar flexion",

author = "Ugbolue, {Ukadike C.} and Yates, {Emma L.} and Wearing, {Scott C.} and Yaodong Gu and Lam, {Wing Kai} and Stephanie Valentin and Julien Baker and Fr{\'e}d{\'e}ric Dutheil and Sculthorpe, {Nicholas F.}",

note = "Funding Information: The authors would like to thank Medical Research Scotland (VAC‐1085‐2017) and The Royal Society of Edinburgh and National Natural Science Foundation of China (RSE–NSFC) Joint Project (8181101592) for funding this project. Funding Information: The authors would like to thank Medical Research Scotland (VAC-1085-2017) and The Royal Society of Edinburgh and National Natural Science Foundation of China (RSE?NSFC) Joint Project (8181101592) for funding this project.",

year = "2020",

month = sep,

day = "1",

doi = "10.1111/joa.13207",

language = "English",

volume = "237",

pages = "520--528",

journal = "Journal of Anatomy",

issn = "0021-8782",

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T1 - Sex differences in heel pad stiffness during in vivo loading and unloading

AU - Ugbolue, Ukadike C.

AU - Yates, Emma L.

AU - Wearing, Scott C.

AU - Gu, Yaodong

AU - Lam, Wing Kai

AU - Valentin, Stephanie

AU - Baker, Julien

AU - Dutheil, Frédéric

AU - Sculthorpe, Nicholas F.

N1 - Funding Information: The authors would like to thank Medical Research Scotland (VAC‐1085‐2017) and The Royal Society of Edinburgh and National Natural Science Foundation of China (RSE–NSFC) Joint Project (8181101592) for funding this project. Funding Information: The authors would like to thank Medical Research Scotland (VAC-1085-2017) and The Royal Society of Edinburgh and National Natural Science Foundation of China (RSE?NSFC) Joint Project (8181101592) for funding this project.

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Due to conflicting data from previous studies a new methodological approach to evaluate heel pad stiffness and soft tissue deformation has been developed. The purpose of this study was to compare heel pad (HP) stiffness in both limbs between males and females during a dynamic unloading and loading activity. Ten males and 10 females volunteered to perform three dynamic trials to unload and load the HP. The dynamic protocol consisted of three continuous phases: foot flat (baseline phase), bilateral heel raise (unloading phase) and foot flat (loading phase) with each phase lasting two seconds. Six retroreflective markers (3 mm) were attached to the skin of the left and right heels using a customised marker set. Three-dimensional motion analysis cameras synchronised with force plates collected the kinematic and kinetic data throughout the trials. Three-way repeated measures ANOVA together with a Bonferroni post hoc test were applied to the stiffness and marker displacement datasets. On average, HP stiffness was higher in males than females during the loading and unloading phases. ANOVA results revealed no significant differences for the stiffness and displacement outputs with respect to sex, sidedness or phase interactions (p >.05) in the X, Y and Z directions. Irrespective of direction, there were significant differences in stiffness between the baseline and unloading conditions (p <.001) but no significant differences between the baseline and loaded conditions (p = 1.000). Post hoc analyses for the marker displacement showed significant differences between phases for the X and Z directions (p <.032) but no significant differences in the Y direction (p >.116). Finally, females portrayed lower levels of mean HP stiffness whereas males had stiffer heels particularly in the vertical direction (Z) when the HP was both unloaded and loaded. High HP stiffness values and very small marker displacements could be valuable indicators for the risk of pathological foot conditions.

AB - Due to conflicting data from previous studies a new methodological approach to evaluate heel pad stiffness and soft tissue deformation has been developed. The purpose of this study was to compare heel pad (HP) stiffness in both limbs between males and females during a dynamic unloading and loading activity. Ten males and 10 females volunteered to perform three dynamic trials to unload and load the HP. The dynamic protocol consisted of three continuous phases: foot flat (baseline phase), bilateral heel raise (unloading phase) and foot flat (loading phase) with each phase lasting two seconds. Six retroreflective markers (3 mm) were attached to the skin of the left and right heels using a customised marker set. Three-dimensional motion analysis cameras synchronised with force plates collected the kinematic and kinetic data throughout the trials. Three-way repeated measures ANOVA together with a Bonferroni post hoc test were applied to the stiffness and marker displacement datasets. On average, HP stiffness was higher in males than females during the loading and unloading phases. ANOVA results revealed no significant differences for the stiffness and displacement outputs with respect to sex, sidedness or phase interactions (p >.05) in the X, Y and Z directions. Irrespective of direction, there were significant differences in stiffness between the baseline and unloading conditions (p <.001) but no significant differences between the baseline and loaded conditions (p = 1.000). Post hoc analyses for the marker displacement showed significant differences between phases for the X and Z directions (p <.032) but no significant differences in the Y direction (p >.116). Finally, females portrayed lower levels of mean HP stiffness whereas males had stiffer heels particularly in the vertical direction (Z) when the HP was both unloaded and loaded. High HP stiffness values and very small marker displacements could be valuable indicators for the risk of pathological foot conditions.

KW - bilateral heel raise

KW - foot flat

KW - kinematics and kinetics

KW - marker displacement

KW - plantar flexion

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SN - 0021-8782

VL - 237

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EP - 528

JO - Journal of Anatomy

JF - Journal of Anatomy

IS - 3

ER -

Sex differences in heel pad stiffness during in vivo loading and unloading

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