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Effect of Orthotic Therapy on Claw Toe Loading

Results of Significance Testing at Pressure Sensor Units

Penny J. Claisse, BSc(Hons) ^*, Jodi Binning, MSc  and Julia Potter, PhD 

^* Mid Hampshire Primary Care Trust and North Hampshire Primary Care Trust, Andover War Memorial Hospital, Andover, England.
New Generation Project, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, England.
Podiatry Research Group, School of Health Professions and Rehabilitation Sciences, University of Southampton, Southampton, England.

Corresponding author: Penny J. Claisse, BSc(Hons), Mid Hampshire Primary Care Trust and North Hampshire Primary Care Trust, Andover War Memorial Hospital, Charlton Road, Andover, Hampshire SP10 3LB, England (e-mail: penny.claisse{at}btinternet.com).

Abstract

This study demonstrates the effect of orthotic therapy for toe deformity on toe and metatarsal head pressures using a new analysis method facilitated by an in-shoe pressure-measurement system’s ability to export detailed data. Plantar pressure–time integrals in 11 individuals (22 feet) with claw deformity of the lesser toes were measured with and without toe props. Differences in pressure–time integrals at every individual sensor unit were then calculated for the two conditions, and significance was tested using the paired t-test. Plantar surface charts with contours of equal significant pressure–time integral change showed significant reduction under 17 second toes (77%), 22 third toes (100%), 15 fourth toes (68%), 13 second metatarsal heads (59%), 16 third metatarsal heads (73%), and 16 fourth metatarsal heads (73%). All 22 feet showed increases under the prop in the area of the third toe sulcus. This innovative approach to plantar pressure analysis could improve access to data that show significant pressure–time integral changes and, therefore, could advance the clinical application of plantar pressure measurement. (J Am Podiatr Med Assoc 94(3): 246–254, 2004)