Studier af MBTs effekt på kroppen

Transcription

Studier af MBTs effekt på kroppen
Oktober 2012 • information til forhandlere
THE ORIGINAL FUNCTIONALITY!
INTRODUKTION
Moderne livsførelse kan være hårdt for
kroppen. Det er almindeligt kendt at
gener fra bevægeapparatet er blandt
de hyppigste årsager til kroniske
smerter og tab af livskvalitet. Forekomsten af lidelser relateret til bevægeapparatet forventes at stige i takt med
stadigt stigende levealder verden over
og konsekvenserne heraf vil medføre
store omkostninger for samfundet,
virksomhederne og ikke mindst den
berørte person.
En af årsagerne til gener fra bevægeapparatet er at vi ikke bevæger os nok.
Fysisk inaktivitet betragtes af WHO
som en global sundhedsudfordring.
Faktisk opnår 60 % af verdens befolkning ikke den anbefalede fysiske aktivitet i hverdagen1. Vores krop er ganske
enkelt for svag, og det medfører problemer i muskler og led, herunder også
langvarige gener som f.eks. smerter i
nakke og ryg.
Også i Danmark er gener fra bevægeapparatet på dagsordenen. 57 % af
Danmarks offentligt ansatte har ondt i
ryggen, og lige så mange har ondt i
nakken. Det viser en undersøgelse som
Videncenter for Arbejdsmiljø har gennemført blandt 4.000 offentligt ansatte2. Det samlede antal sygeuger i Danmark er steget de seneste år og
dermed også udgifterne til sygedag-
penge. Muskel- og skeletbesvær står
for ca. 25 % af dette fravær. Desuden
skyldes 20 % af alle førtidspensioner
muskel- og skeletbesvær3.
Regeringen har opsat et mål om at den
del af det samlede sygefravær, der er
relateret til belastninger på bevægeapparatet skal reduceres med 10 %.4
Det er alment kendt at fysisk aktivitet
kan forebygge muskel- og ledsmerter,
ligesom en stærk krop hurtigere vil
komme sig efter problemer. MBT har
fra begyndelsen haft et erklæret mål
om at introducere verden for genvejen
til en styrket krop. Vores mål er ganske
enkelt at skabe et produkt, der kan
hjælpe alle til at få mere fysisk aktivitet
integreret i hverdagen.
Under vores produktudvikling faldt vi
over sammenhængen mellem instabilitet og bevægelse. En viden der gav
os de biomekaniske principper, der var
nødvendige for at vi kunne fuldføre
vores mål.
Således kunne vi i 1996 introducere
verden for en helt ny kategori af fodtøj
– funktionelt fodtøj. Takket været den
patenterede teknologi i sålen kan vi nu
tilbyde alle mere bevægelse og øget
muskelaktivitet i hverdagen.
W.H.O physical inactivity:
A global public health problem, www.
who.int/dietphysicalactivity/factsheet_
inactivity/en
1
2
www.jobogkrop.dk
Det nationale forskningscenter for
arbejdsmiljø ”Hvidbog om sygefravær
og tilbagevenden til arbejde ved muskel- og skeletbesvær”. 2008
3
4
Note mangler
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VIDENSKAB FOR FOD OG KROP
Shoes made for your body
Det er nu mere end 15 år siden, MBT
skabte en helt ny kategori inden for
skobranchen, funktionelt fodtøj. Veldesignet fodtøj af høj kvalitet med den
sidegevinst at skoene virker positivt på
hele kroppen. Holdning og gang forbedres, muskler trænes, led aflastes,
kredsløb og stofskifte forbedres.
Siden begyndelsen har MBT værnet om
den videnskabelige dokumentation for
MBT’s effekter.
En række af de offentliggjorte studier,
inklusiv dem der er gengivet i denne
brochure, tyder på, at MBT ud over at
integrere fysisk aktivitet i brugerens
hverdag også kan have gavnlig effekt
på en række fysiske lidelser.
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Det internationale MBT Akademi er omdrejningspunkt for forskning og produktudvikling. Akademiet sikrer dialogen med internationale eksperter og
forskere inden for områderne biomekanik, klinisk medicin og fysioterapi.
Desuden deltager vi aktivt i internationale videnskabelige komiteer, som
f.eks. European College of Sports Science (ECSS) samt Christian Doppler
Research Association (CDA).
I samarbejde med en række internationale universiteter forestår akademiet
løbende tests, dokumentation og udvikling af MBT’s effekter på den menneskelige krop. Et aktivt Akademi er en
forudsætning for løbende udvikling,
men også troværdighed og dokumentation er vigtige parametre hos MBT.
Siden 1996 er der foretaget mere end
40 uvildige forskningsprojekter på universiteter i Europa og i Nordamerika.
Mere end 20 forskellige artikler er publiceret i internationalt anerkendte tidsskrifter.
Formålet med denne brochure
Denne brochure gengiver en række
studier, der er foretaget i relation til
MBT. Brochuren er opdelt i afsnit, der
omfatter forskellige områder af kroppen. Ved hjælp af indholdsfortegnelsen
kan man hurtigt finde frem til det område, man har interesse i.
Vi har valgt at gengive studierne, som
de er publiceret, hvilket betyder, de
ikke er oversat dansk. Til gengæld har
vi lavet en kort introduktion til hvert
afsnit samt en præsentation af studierne på dansk.
INDHOLDSFORTEGNELSE
07 Balance / sensomotorisk træning
21 Knæ- og hofteled
Functional testing of the MBT shoe compared to sensorimotor training
Korsten et al., 2008
Effectiveness of the MBT shoes in terms of
selected joint strain parameters in overweight persons while walking
Buchecker et al., 2010
Effects of an unstable shoe construction
on balance in women aged over 50 years
Ramstrand et al., 2010
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10 Kropsholdning
Effectiveness of a 10 week training intervention with the MBT in patients with hip
disorders
Krauss et al., 2007
The effects of masai Barefoot Technology
Footwear on posture: An experimental
designed study
New and Pearce, 2006
The effectiveness of the masai Barefoot
Technology (MBT) shoe in the reduction of
pain in subjects with knee osteoarthritis
Nigg et al., 2006
13 Muskelaktivitet
Knee joint loading in walking in the MBT
shoe
Nigg et al., 2008
Standing in an unstable shoe increases
postal sway and muscle activity of
selected smaller extrinsic foot muscles
Landry et al., 2010
Changes in gait and EMG when walking
with the Masai Barefoot Technology
Romkes et al., 2006
28 Fod og ankel
MBT as a therapeutic shoe for Ankle instabilities
Blazek et al., 2008
of lower extremity gait characteristics
Nigg et al., 2006
Pressure distribution of diabetic patients
after sensory-motor training with unstable
shoe construction
Maetzler et al., 2007, 2008, 2009
17 Ryg og nakke
34 Generelt velvære
Performance and low back pain in golfing
with MBT
Nigg et al., 2009
Masai Barefoot Technology in an operational setting. A randomised controlled
effect trial to measure quality of life and
well-being effects due to wearing MBTshoes in standing activities.
Bauer & Brand, 2009
Effects of selcted preventive conceptions
on functional health in persons with nonspecific chronic recurrent neck pain
Henkel et al., 2009
Sensory Motor Training for active completion of the osteopathic treatment
Maetzler et al., 2007
38 Publications of scientific research
40 Publications on congresses
BALANCE / SENSOMOTORISK TRÆNING
Stabilitet i bevægeapparatet er essentielt for os alle. Stabilitet er en vigtig
forudsætning for børn, der skal lære at
gå, for atleter, der skal præstere og for
ældre mennesker, for at sikre mobilitet
så længe som muligt. Sygdomme, der
påvirker balancen, er almindelige men
mest udbredt blandt den ældre del af
befolkningen.
kroppen hele tiden er på arbejde for at
stabilisere sig. Med MBT er det således
nemt at få sensomotorisk træning
integreret i hverdagens sædvanlige
gøremål.
MBT kan desuden supplere dynamisk
træning med stabilitetstræning og
dermed optimere effekten af træningen. MBT er velegnet som supplement
til alle kontrollerede sportsgrene som
f.eks. pilates, vægttræning, kredsløbstræning på løbebånd, body pump o.lign.
Ifør dig et par MBT, dyrk din sport og
optimer effekten heraf.
MBT’s instabile sålkonstruktion øger
muskelaktiviteten og forbedrer balancen.
MBT kan anvendes som et sensomotorisk træningsredskab i sig selv, som
man f.eks. anvender et vippebræt. Helt
konkret er der indbygget et lille vippebræt under skoen. Et vippebræt så lille,
at hjernen automatisk kompenserer for
ubalancen, men alligevel stort nok til at
MBT anbefales ikke til brug under udøvelse af sport med pludselige ”stop og
vend” bevægelser som håndbold, tennis, basketball o.lign.
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Gang på naturligt underlag - f.eks. stranden:
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4
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MBT gang:
INTRO TIL STUDIE:
Studiets formål er at sammenligne anvendelse af MBT med konventionel
sensomotorisk træning (SMT). Deltagerne i MBT-gruppen brugte MBT 4
timer dagligt i 8 uger. I SMT-gruppen trænede deltagerne 3 gange ugentligt i 45 minutter over i alt 4 uger. Deltagerne blev testet før og efter de
hhv. 4 og 8 uger. Resultaterne viser at anvendelse af MBT fører til samme
fordele som SMT.
Institute for Sport and
Sport Science, University
of Freiburg, Germany
Functional testing of the MBT shoe compared to sensorimotor training (Korsten
et al., 2008)
Authors: Katrin Korsten, Guillauime
Mornieux, Niels Walter Albert Gollhofer
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Abstract
PURPOSE:
The effects of sensorimotor training (SMT)
are well documented in the prevention
and rehabilitation of injuries. The Masai
Barefoot Technology (MBT®) is used as
a sensorimotor sports training and rehab
device. Although both methods focus on
comparable functions, a comparison of the
effects was not investigated yet. The purpose of the study was the comparison of
a MBT group, wearing the shoe for 4 h per
day for 8 weeks, with the SMT group, practicing a training 3 x per week for 45 min
over 4 weeks with sensorimotor trainingdevices like wobbling boards; spinning tops
and soft mats.
METHODS:
Parameters of postural stability, rate of
force development and the maximum of
isometric force were analysed by testing
both groups at the beginning, as well as
after 4 and 8 weeks.
RESULTS:
The results show a significant reduction of
the sway path in anterior-posterior and
medio-lateral direction on Posturomed®
for SMT and MBT. After 4 weeks, the improvement of posturalbalance of the SMT
group is considerable larger compared with
the MBT group but daily wearing of MBT
shoes for 4 h over 8 weeks improves postural stability as effectively as a 4-week
sensorimotor training. The previously in
literature described relationship between
the improvement in postural balance and
the rate of force development, reflecting the ability to generate high muscular
strength in short time, was only shown for
the SMT group. In the isolated parameters
of dorsiflexion both groups show a significant improvement, whereas in plantarflexion only the MBT group improved.
CONCLUSION:
In conclusion, the results document that
wearing MBT shoes lead to comparable
functional adaptations as with SMT but the
degree and the dynamic of adaptation are
less pronounced.
PUBLICATION:
Korsten K., Mornieux G., Walter N., & Gollhofer A., 2008 Gibt es Alternativen zum Sensomotorischen Training? Schweizerische Zeitschrift für Sportmedizin und Sporttraumatologie, 56(4), 150-155
INTRO TIL STUDIE:
Formålet med studiet er at undersøge effekten af MBT på stående balance, funktionel balance og stabilitetsgrænser (hvor langt en person kan
læne sig til siden uden at falde, tage et skridt eller gribe efter sikkerhed).
31 kvinder over 50 år blev delt i to grupper, hvor den ene gruppe fik udleveret MBT sko til så hyppig anvendelse som muligt i undersøgelsesperioden. Resultater fra test før og efter i de to grupper peger på, at anvendelse
af MBT sko giver større forbedringer på flere områder af de test, der er
udført – sammenlignet med kontrolgruppen, der ikke brugte MBT sko.
on balance in women aged over 50 years
(Ramstrand et al., 2010)
Jönköping University, Sweden
Abstract
PURPOSE:
Shoes with an unstable sole construction
are commonly used as a therapeutic tool
by physiotherapists and are widely available from shoe and sporting goods retailers. The aim of this study was to investigate the effects of using an unstable shoe
(Masai Barefoot Technology) on standing
balance, reactive balance and stability
limits.
METHODS:
Thirty-one subjects agreed to participate
in the study and underwent balance tests
on three different occasions. After test occasion one (baseline) 20 subjects received
Masai Barefoot Technology shoes and
were requested to wear them as much as
possible for the remaining eight weeks of
the study. Three specific balance tests were
administered on each test occasion using a
Authors: N. Ramstrand, A. H. Thuesen,
D. Brandborg Nielsen, D. Rusaw
Pro Balance Master (NeuroCom International Inc., Oregon, USA). Tests included; a
modified sensory organization test, reactive balance test and limits of stability test.
RESULTS:
Subjects in the intervention group significantly improved their performance on
elements of all three tests however results
on these variables were not demonstrated
to be significantly better than the control
group. No significant differences were
observed across testing occasions in the
control group.
CONCLUSION:
Results from the present study suggest
that, for this group of individuals, use of
unstable footwear may improve certain
aspects of balance.
PUBLICATION:
Ramstrand N., Thuesen A.H., Nielsen D.B., & Rusaw D., 2010. Effects of an unstable shoe construction on balance in women aged over 50 years. Clinical Biomechanics 25 (5), 455-460.
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KROPSHOLDNING
Fysisk inaktivitet er et større problem
nu end nogensinde før. Mangel på
fysisk aktivitet kan føre til svage rygog mavemuskler og muskulær ubalance, hvilket igen kan medføre dårlig
holdning.
sund ryg og nedsat risiko for rygproblemer. En mere naturlig oprejst
holdning kan spille en ikke uvæsentlig rolle ved forebyggelse af en lang
række ryg-, skulder- og nakkesmerter
samt ved muskelspændinger i ryggen.
Dårlig holdning medfører skæv belastning af ryggen, hvilket kan resultere i en lang række lidelser fra uspecifikke rygsmerter til slidgigt.
Kontrolleret rul over MBT’s balancepunkt forbedrer balance og kropsholdning uanset om man står eller
går.
MBT´s instabile sålkonstruktion sikrer
en god holdning, hvilket medfører en
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INTRO TIL STUDIE:
Studiets formål er at vurdere anatomiske forskelle i kropsholdning både
stående og ved gang ved brug af MBT sko. 12 studerende mellem 18 og
40 år deltog i studiet og blev testet både i MBT sko og konventionelle
sko. Resultatet tyder på at brug af MBT sko kan ændre forskellige elementer af kropsholdning både stående og ved gang.
School of Health Professions and Rehabilitation Sciences, University of Southampton, United Kingdom
Abstract
PURPOSE:
This study was approved by the University
of Southampton Ethics Committee. The aim
of the study was to assess the anatomical
changes to upright posture that occur in
the sagittal plane as a result of wearing
Masai Barefoot Technology (MBT) footwear
during standing and walking. MBT claims
that its innovative unstable shoes promote
a more upright posture in which musculature is strengthened and joint wear reduced (Amann and Amann, 2004). This could
be helpful in the management and prevention of conditions such as osteoarthritis
and back pain.
METHODS:
Twelve students (six male and six female),
aged between 18 and 40 years, at the University of Southampton participated in the
study. Participants attended one session at
a biomechanics laboratory. The kinematics
of posture while wearing MBT shoes during
standing and gait were examined, using a
two-dimensional motion analysis system,
and compared to a control shoe. Statistical
significance was tested by use of a paired
PUBLICATION:
The effects of Masai Barefoot Technology
Footwear on Posture: An experimental
designed study (New & Pearce, 2006)
Authors: P.R. New, J.M. Pearce
t-test and a Wilcoxon signedranks test.
RESULTS:
Students standing in MBT footwear demonstrated a statistically significant increase
in plantar flexion at the ankle joint (p =
0.025; mean flexion 3.02°; 95% confidence
interval [95% CI] -5.6 to -0.4). Walking in
MBT shoes showed a decrease in trunk
flexion (p = 0.007; mean flexion 1.44°;
95% CI -2.4 to -0.4) and a reduction in
anterior tilt of the pelvis (p = 0.003; mean
tilt 3.20°; 95% CI -5.06 to -1.35) at heel
strike. At toe-off a significant reduction
in anterior pelvic tilt (p = 0.035; mean tilt
2.35°; 95% CI) was found in the MBT shoes.
There was no significant difference found
between the two shoe conditions at midstance, pelvic tilt (p = 0.53; mean tilt 1.83
degrees) trunk flexion (p = 0.05; mean fl
exion 0.95 deg).
CONCLUSION:
MBT footwear changes certain characteristics of posture in quiet standing and
walking. These findings could have positive
implications for the management of conditions such as osteoarthritis and back pain;
however, further research is needed.
New P., & Pearce J., 2007. The effects of Masai Barefoot Technology footwear on posture: an experimental designed study. Physiotherapy Research International, 12 (4), 202-202.
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ØVELSER
Herunder findes eksempler på øvelser der med fordel kan anvendes af alle, der
ønsker at integrere mere bevægelse i hverdagen. Du kan finde flere øvelser på
www.dk.mbt.com.
Muskeltræning:
• Startposition: Stå på balancepunktet
• Stå på begge fødder og hold kroppen ret
• Rul fra hæl til tå og udnyt balancepunktet
Hæl-tå balancetræning:
• Stå på ét ben og hold kroppen ret
• Rul fra hæl balancepunktet
• Gentag med det andet ben
• Variation: Rul fra hæl til tå over balancepunktet
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Kryds-balance:
• Stå på ét ben og find balancen på det andet ben
• Kryds det frie ben skiftevis foran og bagved standbenet
Et-ben øvelse:
• Løft det ene ben og find balancen
• Bevæg det frie ben til siden, fremad og derefter bagud.
MUSKELAKTIVITET
Vi bevæger os generelt for lidt. Når vi
bevæger os, er det ofte på hårde flader
som fliser eller asfalt og vi bærer gerne
fodtøj, der stabiliserer vores bevægelser. Dette betyder en del af vores
muskler bliver svage, hvilket kan medføre problemer i bevægeapparatet.
MBT kan betragtes som træningsudstyr,
der på en nem og skånsom måde øger
muskelaktiviteten i hverdagen
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INTRO TIL STUDIE:
I studiet vil man undersøge effekten ved anvendelse af MBT sko i forhold
til at styrke de mindre muskler omkring ankelen. Dette 6 uger lange forsøg
involverede 3 testgrupper, primært med stående arbejde, der skulle bruge
hhv. MBT sko, konventionelle sko og ingen sko. De blev undersøgt for bl.a.
øget muskelaktivitet.
Resultaterne peger på at brug af MBT sko øger muskelaktiviteten i ankelleddet i forhold til konventionelle sko samt ingen sko.
BRI & Human Performance Laboratory,
University of Calgary, Canada
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Abstract
PURPOSE:
Inactivity or the under-utilization of lower
limb muscles can lead to strength and
functional deficits and potential injury.
Traditional shoes with stability and support features can overprotect the foot and
potentially contribute to the deterioration
of the smaller extrinsic foot muscles.
METHODS:
Healthy subjects (n = 28) stood in an
unstable MBT (Masai Barefoot Technology)
shoe during their work day for a 6-week
accommodation period. A two-way repeated measures ANOVA was used to determine:
A) if unstable shoe wear increased electromyographic (EMG) activity of selected extrinsic foot muscles and increased postural
sway compared to standing barefoot and
in a stable control shoe
B) if postural sway and muscle activity
across footwear conditions differed between a preand post-accommodation testing visit.
PUBLICATION:
Standing in an unstable shoe increases
postural sway and muscle activity of selected smaller extrinsic foot muscles
(Landry et al., 2010)
Authors: Scott C. Landry, Benno M. Nigg,
Karelia E. Tecante
RESULTS:
Using an EMG circumferential linear array,
it was shown that standing in the unstable
shoe increased activity of the flexor digitorum longus, peroneal (PR) and anterior
compartment (AC) muscles of the lower
leg. No activity differences for the larger
soleus (SOL) were identified between the
stable and unstable shoe conditions. Postural sway was greater while standing in
the unstable shoe compared to barefoot
and the stable control shoe.
CONCLUSION:
These findings suggest that standing in the
unstable MBT shoe effectively activates
selected extrinsic foot muscles and could
have implications for strengthening and
conditioning these muscles. Postural sway
while standing in the unstable MBT shoe
also decreased over the 6-week accommodation period.
PUBLICATION:
Landry S., Nigg B.M., & Tecante, K. Standing in
an unstable shoe increases postural sway and muscle
activity of selected smaller extrinsic foot muscles.
Conference of the Canadian Physiotherapy Association,
St. John’s, New-foundland, Canada, July 22-25, 2010.
Podium Presentation.
Landry S., Nigg B.M., & Tecante K., 2010. Standing in an unstable shoe increases postural sway
and muscle activity of selected smaller extrinsic foot muscles. Gait & Posture 32 (2), 215–219.
INTRO TIL STUDIE:
Studiets formål er at undersøge hvordan MBT påvirker gang og muskelaktivitet. 12 raske personer blev testet med 3D analyse i både MBT sko og
konventionelt fodtøj.
Resultatet viser at brug af MBT ændrer bevægelsesmønstret ved gang og
muskelaktiviteten i flere muskelgrupper.
Laboratory for Gait Analysis Basel, Children’s University Hospital Basel, Switzerland
Abstract
PURPOSE:
The Masai Barefoot Technology is used
as a treatment option within the field of
physical therapy to treat leg, back or foot
problems. No information, however, is
available on how Masai Barefoot Technology changes gait or muscle activity.
METHODS:
Twelve healthy subjects underwent 3D gait
analysis with simultaneously collecting
surface electromyography data of the leg
muscles when walking with regular shoes
and with Masai Barefoot Technologyshoes. Before data collection, subjects
were trained in Masai Barefoot Technology.
A within-subjects study-design compared
walking with regular shoes and Masai
Barefoot Technology.
RESULTS:
With Masai Barefoot Technology, subjects
walked slower with smaller steps. Movement pattern at the ankle showed major
changes with increased dorsiflexion angle at
initial contact followed by a continuous
Changes in gait and EMG when walking
with the Masai Barefoot Technique
(Romkes et al., 2006)
Authors: Jacqueline Romkes, Christian Rudmann, Reinald Brunner
plantarflexion movement until terminal
stance phase. With changed kinematics,
alterations in the activity of tibialis anterior and gastrocnemius muscles could be
observed. Smaller differences in movement
and muscle activity were seen at knee and
hip level.
CONCLUSION:
Masai Barefoot Technology has never been
documented in detail concerning changes
in movement pattern or muscle activity.
This study showed that Masai Barefoot
Technology changes movement patterns,
especially at the ankle, and increases
muscle activity. It may therefore be a useful training method for strengthening the
muscle groups of the lower leg. Knee flexion and electromyographic characteristics
around the knee joint are slightly increased
and need to be considered in patients with
knee problems. Our findings provide critical
detailed information on changes compared
to walking in regular shoes, but the clinical
relevance of those changes remains to be
determined.
PUBLICATION:
Romkes J., Rudmann C., & Brunner R., 2006. Changes in gait and EMG
when walking with the Masai Barefoot Technique. Clinical Biomechanics 21 (1), 75-81.
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INTRO TIL STUDIE:
Formålet er at sammenligne de mekaniske effekter af MBT målt på f.eks.
kinetik, kinematik og muskelaktivitet med en kontrol sko. 8 deltagere blev
testet på forskellige områder som muskelaktivitet i stående stilling og ved
gang. Resultater, fra test før og efter en to ugers periode, antyder at muskelaktiviteten kan øges i nogle muskelgrupper ved hjælp af MBT sko.
Effect of an unstable shoe construction
on lower extremity gait characteristics
(Nigg et al., 2006)
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Abstract
PURPOSE:
To compare kinematics, kinetics and muscle activity during standing and walking
for healthy subjects using an unstable test
shoe (Masai Barefoot Technology, MBT)
and a stable control shoe.
METHODS:
Eight subjects volunteered for this study.
During quiet standing, center of pressure
excursion and muscle activity were determined. During walking, lower extremity kinematics, kinetics, and muscle electromyographic (EMG) signals were determined.
Data were collected for the two shoe
conditions after a 2 week accommodation
period. Statistics included repeated measures ANOVAs (a = 0.05) and post hoc
tests where appropriate.
RESULTS:
During quiet standing, the center of pressure excursion was significantly and substantially greater in the unstable compared
to the control shoe. Electromyographic intensity increased in the unstable test shoe
for all tested muscles, but only significantly
Authors: Benno M. Nigg, Sabrina Hintzen,
Reed Ferber
for the tibialis anterior. During locomotion,
kinematics were similar in the two shoe
conditions except for the initial plantardorsiflexion, which showed a significant
more dorsiflexed position during the first
half of stance in the unstable test shoe
compared to the stable control shoe. The
angular impulses did not show any significant differences between the two shoe
conditions for all three joints but some
trends towards a reduction for the knee
and hip joint. There were no significant
differences in electromyographic activities between the control and the unstable
shoe. However, several muscles showed
some trends.
CONCLUSIONS:
The unstable shoe produced changes and
trends in kinematic, kinetic and electromyographic characteristics that seemed to
be advantageous for the locomotor system.
Further studies should investigate muscle
strength, dynamic stability, pain duction for
arthritic knees and injury prevention for
high performance athletes when using the
unstable shoes.
PUBLICATION:
Nigg B.M., Hintzen S., & Ferber R., 2006. Effect of an unstable shoe construction on lower extremity
gait characteristics. Clinical Biomechanics 21 (1), 82-88
RYG OG NAKKE
Kroniske smerter i nakke og uspecifikke
smerter i lænd er hyppige i hele verden.
Nakkesmerter er en gængs årsag til
lægebesøg, og antallet af mennesker
med kroniske nakkesmerter vokser
fortsat.
Man regner med at 80 % af alle mennesker på et tidspunkt i deres liv vil
opleve lændesmerter og i mange tilfælde vil det være kronisk. De sociale og
økonomiske samfundsomkostninger er
enorme, ikke mindst de alarmerende
hyppige inddirekte omkostninger, som
følge af f.eks. sygefravær og førtidspension.
Studierne i dette afsnit omhandler
nakke- og lændesmerter og de mulige
effekter ved anvendelse af MBT sko.
17
INTRO TIL STUDIE:
Studiet er et 6 ugers forsøg, hvor formålet er at undersøge MBT fodtøjs
indflydelse på lændesmerter. To grupper af golfspillere brugte hhv. MBT
sko og sædvandlige golfsko i 6 uger. Lændesmerter og balance blev vurderet før og efter.
Umiddelbart peger resultatet på at MBT kan bruges til at mindske lændesmerter.
Performance and Low Back Pain in Golfing
with MBT (Nigg et al., 2009)
Abstract
PURPOSE:
The objectives of this study were to assess
the effect of unstable sandals on
18
A) low back pain (LBP) in golfers with undiagnosed moderate LBP
B) static and dynamic balance
C) golf performance.
METHODS:
This was a 6-week prospective study where
subjects were randomized to a control
group and an intervention group. Baseline
measurements were recorded in the Human Performance Laboratory. Forty male
golfers with nonspecific moderate LBP. The
intervention group wore unstable shoes for
6 weeks, and the control group wore their
regular golf shoes. Low back pain, timed
balance, and golf performance were assessed at baseline and at 6 weeks. Changes
were compared through independent
samples t tests.
Authors: Benno M. Nigg, Elysia M. Davis,
David Lindsay, Carolyn Emery
RESULTS:
1) There was a significant difference between groups in the change of perceived
LBP scores in the laboratory (test group:
217.5/100 mm, control: 23.6/100 mm) and
in the comparison of the first week entries
to the last week entries recorded in logbooks (test group: 210.7/100 mm, control
group: +2.6/100 mm).
2) There was no significant change in the
static or dynamic balance times.
3) There was no significant change in golf
performance between the intervention and
control groups.
CONCLUSION:
The results indicate that unstable sandals
can be used to reduce moderate lower back
pain in this population of golfers without
negatively affecting performance.
PUBLICATION:
Nigg B.M., Davis E.M., & Emery C., 2009. The Effectiveness of an unstable shoe on golf performance
and a reduction of low back pain. Clinical Journal of Sports Medicine 19 (6), 464-470.
INTRO TIL STUDIE:
Studiet sammenligner resultaterne af 3 forskellige 12-ugers helseprogrammer, hvor deltagerne var personer med kronisk tilbagevendende
nakkesmerter. Et af programmerne inkluderer brugen af MBT.
Resultatet tyder på, at træning generelt medfører forbedringer for denne
gruppe.
Institution for Physiotherapy, FriedrichSchiller University of
Jena, Germany
Effects of selected preventive conceptions
on functional health in persons with nonspecific chronic recurrent neck pain (Henkel et al., 2009)
Authors: J. Henkel, P. Bak, R. Otto,
U. C. Smolenski
Abstract
PURPOSE:
The number of people with chronic neck
pain is growing continuously even though
exact epidemiologic numbers and cost
analyses for Germany do not yet exist. It
has been extensively confirmed that chronic
neck pain is caused by fear, agitation, anxiety and depression. The aim of this secondary preventive study was to clarify if three
standardized 12-week health programs,
back school, Nordic walking and Masai
Barefoot Technology (MBT) shoes, show
positive effects on functional health for
people in the chronication phase of neck
pain.
METHODS:
A clinical, randomized, prospective, interventional trial with baseline design was established. A total of 85 participants (mean
50.7 ± 11.1) were randomized into 3 intervention groups: 27 (52.6 ± 11.6) were included in the back school, 28 (52.5 ±11.3)
participated in Nordic walking and 30
(47.4 ± 9.9) were assigned to MBT. Analyses
were carried out from the assessments SF36, EQ-5D, FFbH-R and NDI.
RESULTS:
Neck pain (NDI) and functional spine impairment (FFbH-R) were significantly alleviated in all groups. The results of health
quality (SF-36) indicated that back school
and Nordic walking performed better than
MBT. Nordic walking had worse results in
state of health (EQ-5D).
CONCLUSION:
The study confirmed that continuous training in groups shows significant improvements in all three programs. The small
numbers of participants allow no generalizations. Further studies must be carried
out to clarify the situation, because many
other programs are on market where the
effectiveness is unexplained.
PUBLICATION:
Henkel J., Bak P., Otto R., & Smolenski U.C., 2009. Effects of selected preventive concepts on functional health in persons with non-specific chronic recurrent neck pain. Manuelle Medizin, 47 (1), 57-66.
19
INTRO TIL STUDIE:
I dette studie undersøger man effekten af MBT sko på en Standard Flexion Test (SFT). Deltagerne bestod af raske personer samt personer med
diabetes og kendt nervepåvirkning i fødderne.
Resultatet viser, at brug af MBT sko tilsyneladende har en betydning for
SFT resultater på lang sigt.
Dept. Physical Medicine &
Rehabilitation, University
Teaching Hospital Feldkirch.
TORT Centre, Ninewells
Hospital Medical School &
Institute of Motion Analysis Research,University of
Dundee.
20
Abstract
PURPOSE:
The purpose of this study was to investigate the influence of sensory motor training
(realised by an unstable shoe construction)
on the iliosacral Standing Flexion Test (SFT)
in several investigation groups. In a prephase study, the functional improvement
of the iliosacral suspension system in a
patient group with low back pain treated by
a combined osteopathic and sensory motor
training approach was verified in comparison to controls.
METHODS:
A single blinded randomised controlled trial
was designed for two groups of subjects: a
reference group comprising 41 subjects
with no history of recent musculo-skeletal
problems and a group of 46 diabetic patients with known mild to moderate polyneuropathy. Approximately half of each of
the reference and control groups underwent a six week period of sensory motor
training with an unstable shoe construction.
Sensory Motor Training for Active Completion of the osteopathic Treatment
(Maetzler et al., 2007)
Authors: Marcel Maetzler (1,2),
Thomas Bochdansky (1), Rami Aboud (2)
The remainder acted as controls. The SFT
was carried out prior to treatment and after
six weeks.
RESULTS:
The SFT results indicated that there was a
positive effect of sensory motor training on
iliosacral function. After a six week period
of training, initially positive SFTs were negative in 50% of the reference intervention
group and 62% of diabetic intervention
cases. There were no SFT changes in either
of the control groups.
CONCLUSION:
Sensory motor function is important in the
treatment of the iliosacral suspension system. A combination of osteopathic treatment and sensory motor training with an
unstable shoe construction seems to improve the long-term results for the SFT in
over 30% of cases.
PUBLICATION:
Mätzler M., Bochdansky T., Cochrane L., & Abboud R., 2007. Sensory Motor Training for Active
Completion of Osteopathic Treatment. Phys Med Rehab Kuror 17, 1-4.
KNÆ- OG HOFTELED
Slidgigt er blandt de mest udbredte
lidelser i bevægeapparatet og er en
væsentlig årsag til invaliditet blandt den
ældre del af befolkningen.
I aldersgruppen 55-74 år lider 40 %
af slidgigt i foden, 10 % af slidgigt i
knæet og 3 % af slidgigt i hoften. Hyppigheden stiger med alderen, og 40 %
af personer over 70 år lider af slidgigt i
knæet.
Klinisk er lidelsen kendetegnet ved
ledsmerter, begrænset bevægelighed
og stivhed efter at have siddet stille.
Den økonomiske byrde for samfundet
som følge af slidegigt forventes at stige
betragteligt i fremtiden.
Studierne i dette afsnit omhandler
lidelser i knæ- og hofteled og de mulige
effekter ved anvendelse af MBT sko.
21
INTRO TIL STUDIE:
Undersøgelsen handler om effekten af MBT sko på belastning af led i
benene hos overvægtige mænd. 10 overvægtige mænd blev testet for
forskellige ting under gang med MBT sko og konventionelle sko.
Resultatet tyder på, at brug af MBT sko reducerer belastningen af visse
led uden samtidigt at overbelaste andre led.
Effectiveness of the MBT shoe in terms of
selected joint strain parameters in overweight
persons while walking (Buchecker et al. 2010)
Department of Sport Science and Kinesiology, University of Salzburg, Austria
22
Abstract
PURPOSE:
The purpose of this study was to evaluate
the effects of Masai Barefoot Technology
(MBT) shoes on lower extremity joint loading in overweight males during level walking.
METHODS:
Therefore, lower extremity kinematics,
kinetics, and muscle electromyographic
signals of the vastus lateralis (VL), biceps
femoris (BF), and gastrocnemius medialis
(GM) were recorded in 10 overweight males
at a self-chosen walking speed with MBT
shoes and conventional shoes. Selected
peak joint moments, maximal joint force
loading rates, mean muscle intensities,
and co-activation indices of the VL/BF, as
well as of the VL/GM were analyzed and
compared for the two shoe conditions using paired Student’s t-tests (a50.05).
Authors: Michael Buchecker, Herbert Wagner,
Jürgen Pfusterschmied, Thomas Stöggl, Erich
Müller
RESULTS:
Results showed that walking with MBT
shoes reduced first peak knee adduction
moments in overweight subjects. During
midstance and terminal stance, increases
in VL/GM co-activation, accompanied by increases in VL and GM (only terminal stance)
intensities were found for the MBT situation. Kinetic variables analyzed to assess
ankle and hip joint loading did not exhibit
any statistical differences.
CONCLUSION:
These results suggest that using MBT shoes
diminishes medial compartment loads at
the knee without overloading hip or ankle
joints in overweight males. However, the
additional muscle loading should not be
overlooked, and warrants further investigation.
PUBLICATION:
Buchecker M., Wagner H., Pfusterschmied J., Stöggl T.L., & Müller E., 2010. Lower extremity
joint loading during level walking with Masai Barefoot Technology shoes in overweight males. Scand J Med
Sci Sports, Article first published online: 30 AUG 2010.
INTRO TIL STUDIE:
Studiets formål er at teste brugen af MBT sko og træning hos personer
med hofteproblemer.
Resultatet viser ingen forskel mellem grupperne på områder som styrke,
mobilitet og gang, men der ses en forskel på livskvalitet før og efter den
10 ugers forsøgsperiode.
Effectiveness of a 10-week training intervention with the MBT in patients with hip disorders (Krauss et al., 2006)
University Hospital, Tuebingen, Department
of Sports Medicine, Germany
Abstract
PURPOSE:
The aim of this study was to assess the
effect of a 10-week training program with
a novel training device on health-related
quality of life for patients with osteoarthritis of the hip (OAH) or after total hip replacement.
METHODS:
One group (n=30) took part in a weekly
exercise program and was also told to use
the special training device at home. The
other group (n=29) received no intervention. Before and after the training period,
participants had to fill out the SF-36 Health
Survey. Data were analyzed using descriptive statistics. Effect size of the intervention
and a comparison to the German norm population was computed. Whereas the control
group showed no differences in the ratings
on the SF-36, the training group improved
with regard to Vitality (ε=0.5), Bodily Pain
(ε=0.4) and General Health (ε =0.4). In
comparison to the German norm population, participants had lower score values
Authors: I. Krauss, A. Bendig, J. Mayer,
D. Axmann, O. Müller, T. Horstmann
in all physical ratings whereas there were
almost no differences in Social Functioning,
Emotional Well-Being and Mental Health.
After 10 weeks of training, the Vitality of
the training group increased to levels higher
than the German norm population (z=0.2).
RESULTS:
Results of the investigation show a clinically
relevant improvement in health-related
quality of life after 10-week intervention
with the novel training device.
CONCLUSION:
The study found no improvements with
respect to strength, mobility and walking
speed; however, progress was achieved
especially in the area of coordinative skills.
In addition, healthrelated quality of life
was enhanced markedly. When used purposefully, the MBT appears to be capable
of supporting the therapy of patients with
hip joint osteoarthritis or already implanted
joint replacement.
PUBLICATION:
Kraus I., Bendig A., Mayer J., Axmann D., Müller O., & Horstmann T., 2006. Wirkung einer
10-wöchigen Trainingsintervention mit einer instabilen Schuhkonstruktion auf die gesundheitsbezogene
Lebensqualität von Patienten mit Hüftarthrose oder implantiertem Hüftgelenk. Deutsche Zeitschrift für Sport medizin 57 (7/8), 195-200.
23
INTRO TIL STUDIE:
I undersøgelsen vil man bl.a vurdere, hvilken effekt MBT har på ledsmerter
hos personer med slidgigt i knæet. I alt 123 deltagere blev fordelt på 2
grupper med hhv. MBT sko og en kontrolsko. Undersøgelsen viser ikke tydlige resultater, men peger på, at MBT kan være gavnligt for nogle grupper af
patienter med slidgigt i knæet.
Human Performance Laboratory/Sport Medicine Centre, Roger Jackson Centre for Health
and Wellness Research, Faculty of Kinesiology, University of Calgary, Canada
Abstract
PURPOSE:
The purposes of this study were to assess
24
A) the effectiveness of Masai Barefoot
Technology (MBT) shoe in reducing knee
pain in persons with knee osteoarthritis
(OA)
B) changes in balance, ankle and knee
ROM, and ankle strength compared with a
high-end walking shoe for 12 wk.
METHODS:
The research design was a randomized
controlled trial (123 subjects, knee OA).
Subjects were randomized to a MBT (N =
57) or a control shoe (N = 66). A Western
Ontario and McMaster Universities (WOMAC) OA index, BMI, balance, active ROM,
and ankle torque were quantified at week
0, 3, 6, 9, and 12. Two-sample t-tests were
done for between-group comparisons.
RESULTS:
There was no significant difference between groups in total pain score. A signifi-
The effectiveness of the Masai Barefoot
Technology (MBT) shoe in the reduction of
pain in subjects with knee osteoarthritis
(Nigg et al., 2006)
Authors: Benno M. Nigg, Carolyn Emery,
Laurie Hiemstra
cant reduction over the 12-wk period was
found for both shoe conditions (-42/500
or 25.6% MBT, -46.2 or 27.1% control).
There was no significant group difference in pain during walking (t = -1.09, P =
0.28). Pain during walking was significantly
reduced by 5.2/100 mm in the MBT and
9.7/100 mm in the control group. Total
pain showed a significant reduction for the
MBT -27.4/500 (-16.6%) and the control
group j28.9/500 (-17.0%) between baseline and week 3. Between week 3 and 6,
there was a significant reduction for the
MBT group only (-27.2/500 or -20.0%).
There was a significant increase in the
static balance between baseline and 12 wk
in the MBT group only, although the difference between groups was not significant.
CONCLUSION:
The results indicate that special shoe interventions can reduce pain in subjects with
moderate knee OA.
PUBLICATION:
Nigg B.M., Emery C., & Hiemstra, L.A., 2006. Unstable Shoe Construction and Reduction of Pain in
Osteoarthritis Patients. Medicine & Science in Sports & Exercise 38 (10), 1701-1708.
INTRO TIL STUDIE:
Studiet inkluderer 19 raske deltagere. Det undersøges hvorvidt brug af MBT
sko medfører en reduktion af belastningen af knæet i forhold til en konventionel sko uden gængefunktion. Resultatet viser ikke stor forskel på de
to grupper.
Knee joint loading in walking in the MBT shoe
(Blazek et al., 2008)
Stanford University, Biomotion Laboratory, Stanford
California, USA
Abstract
PURPOSE:
Osteoarthritis (OA) is a degenerative joint
disease that is characterized by a thinning
of the articular cartilage layer, osteophyte
formation in the joint, stiffness, pain and
decreased physical function. An increasing
body of literature suggests that the mechanical environment of the knee during
ambulation has a profound influence on the
severity (Andriacchi et al., 2006), progression (Miyazaki et al., 2002) and treatment
outcome (Prodromos et al., 1985) for
osteoarthritis at the knee. Although we
cannot directly measure the force within a
healthy joint, the external joint moments,
as calculated using an inverse dynamics approach, can be used as a surrogate
measure of the joint force. The magnitude
of the load on the medial compartment of
the tibia is determined by the external knee
flexion and adduction moments. The MBT
shoe with its unstable sole construction
provides a different stimulus to the neuromotor system than a conventional shoe.
Initial evidence indicates that this stimulus
elicits changes in muscle activity of selected
muscles, joint kinematics, and joint kinetics
(Nigg et al., 2006b; Nigg et al., 2006a; Romkes et al., 2006) and thus may result in a
decreased joint load. However, the reported
Authors: Authors: Katherine Boyer, Katerina
Blazek, Thomas Andriacchi
changes in joint pain for a group OA patients was not different from a control shoe
(Nigg et al., 2006a). It thus remains unclear
if wearing the MBT shoe would be beneficial for a population with medial knee OA.
To determine if walking in the MBT shoe
results in a reduction in the knee joint force
or the joint force distribution compared to a
casual shoe.
METHODS:
19 healthy volunteers were tested, all with
no history of lower-limb injury or pain and
who had never worn the MBT shoe before:
11 women (age: 28.9 +/- 7.3 years; BMI:
22.7 +/- 2.9) and 8 men (age: 32.6 +/- 7.5
years; BMI: 23.5 +/- 1.8). Informed consent
was obtained from all subjects per Stanford
University IRB guidelines. Each subject wore
the shoe for a two week period prior to
testing. Kinematic marker data and ground
reaction forces (GRF) were collected at 120
Hz while each subject walked at a selfselected normal pace in the MBT and the
subject’s own casual shoe. Intersegmental
joint forces and moments were calculated
using inverse dynamics and a previously
published link mode. Paired Student’s ttests were carried out to determine differences in the group response between the
two shoe conditions.
25
RESULTS:
Kinematics:
1) Slight, not significant increase of cadence
with MBT
2) At heel-strike knee flexion increased
(p < 0.05)
3) At heel strike dorsiflexion increased
(p < 0.05)
4) At mid stance knee flexion increased
(p < 0.05)
5) At mid stance dorsiflexion increased
(p < 0.05)
6) At toe-off knee flexion increased
(p < 0.05)
7) At toe-off ankle plantar flexion decreased (i.e. a more flexed ankle was maintained through out all of stance) (p< 0.05)
8) In the hip no statistical differences in the
sagittal plane
26
9) The foot angle was greater in the sagital
plane (toe out angle).
Ground reaction forces:
1) The loading rate of the first peak was
greater in the MBT shoe (p < 0.05)
2) No difference in the magnitude of the
first vertical GRF peak
3) Second peak of the vertical GRF was
lower in the MBT shoe
4) No significant differences in the medial
lateral or anterior-posterio GRF peaks.
Kinetics:
1) The differences in the peak joint moment
values were not the same for all walking
speeds
2) At all walking speeds were significant
differences in the peak hip extension,
internal rotation moments, the peak ankle
plantarflexion moments
3) No difference in the peak ankle dorsiflexion moment ant any of the walking
speeds.
OTHER RESULTS:
Decrease of knee flexion moment:
1) Decrease of no change in total knee
force
2) No increase in antagonist muscle activities, lower quadriceps muscle force is
needed for walking in the MBT
3) The knee adduction moment is correlated
with the load distribution in the knee joint
4) Males are more likely to have a negative
adaptation strategy to the shoe, based on
a small population sample.
5) Subjects who increased their knee force
were older, but not significantly, than those
who showed a decrease (p = 0.3)
6) All subjects were normal weight, so it is
not clear how overweight or obese subjects
would respond to the shoes
7) All subjects were healthy, it is not clear
how knee OA patients would respond to
the shoes.
SUMMARY:
The changes in joint kinematics for walking
were small. Individual locomotion strategies
for walking in the MBT shoe were identified.
Three of the locomotion identified could be
considered “neutral or positive” changes in
terms of the medial knee joint loading. 12
of 19 subjects adopted these strategies.
Three locomotion strategies identified could
be considered “negative” in terms of the
medial knee joint loading. 7 of 19 subjects adopted these strategies. The strategies identified were for a young healthy
population. Different locomotion strategies
and percentages of subjects adopting the
“positive” or “negative” strategies might be
expected for a pathological population.
CONCLUSION:
The results of this study indicate that for
some individuals the changes in joint kinematics, kinetics and GRF’s when walking
in the MBT shoe may result in a reduction
in the forces of muscles crossing the knee
joint and thus the knee joint load. The use
of the MBT shoe as a training device to
strengthen the lower leg stability muscles
and intervention to reduce pain in walking may be beneficial for some medial knee
OA patients. The results of this study also
indicate that several different adaptation
strategies exist for a healthy population,
some positive and some negative in terms
of the change in knee joint load.
27
PUBLICATION:
Boyer K.A., & Andriacchi T., 2009. Changes in running kinematics and kinetics in response
to a rockered shoe intervention. Clinical Biomechanics, 24 (10), 872-876.
Boyer K.A., Blazek K., & Andriacchi T. Effects of an unstable shoe construction in low speed running.
North American Congress on Biomechanics 2008. Poster presentation.
Blazek K., Boyer K.A., & Andriacchi T. Subjectspecific changes in knee loading in response to an unstable shoe intervention. North American Congress on Biomechanics 2008. Poster presentation.
FOD OG ANKEL
Nutidens sko støtter, fører og stabiliserer fødder og ankler, hvilket kan
medføre problemer med fødderne. Kun
3 % af spædbørn har foddeformiteter,
mens op til 80 % af skolebørn lider af
problemer med fødderne.
Når sko stabiliserer foden sådan at de
nedre muskler omkring ankelen bliver
overset, og muskelsstabiliteten omkring ankelledet svækkes, kan det lede
til funktionsnedsættelse og potentiel
skade
Hos voksne er fodsmerter og problemer med ankelled udbredt, ligesom
knyster, platfod og hælspore er hyppigt
forekommende.
28
INTRO TIL STUDIE:
Formålet med studiet er at undersøge om brug af MBT sko kan medvirke til
på kortere eller længere sigt at stabilisere kronisk ustabile ankelled sammenlignet med konventionel terapi. 30 deltagere med ustabilt ankelled blev
tilfældigt inddelt i 2 grupper (MBT kontra konventionel terapi) og blev testet
flere gange undervejs i den 3 måneder lange undersøgelse. Resultater viser
at MBT med fordel kan integreres i den fysioterapeutiske behandling, idet
brugen af MBT i kombination med fysioterapi resulterede i øget stabilisering
af ankelledet sammenholdt med konventionel behandling.
MBT as Therapeutic Shoe for Ankle Instabilities
(Kaelin et al., 2008, 2009)
Praxisklinik Rennbahn for Orthopeadics and
Sport Medicine, Muttenz – Basel, Switzerland
Swiss Olympic Medical Center
Abstract
PURPOSE:
The top priority in the management of
chronic ankle instability is the optimal
strengthening of the muscles surrounding
the ankle joint, initially in physiotherapy,
then in daily training, so that the impaired
function of the ligaments is dynamically
compensated for, and the ankle joints can
be functionally re-stabilised. According
to previous studies, MBT has a significant
potential to train the muscles surrounding the ankle joint. Therefore, the present
study aimed at investigating whether the
use of MBT as a therapeutic training device
in cases of chronic unstable ankle joints
results in superior mid-term and long-term
dynamic stability compared to conventional
therapy.
METHODS:
30 subjects with diagnosed, chronic ankle
instabilities were randomised in an active
treatment group (therapy with MBT) and a
control group (without MBT). The active
treatment group received subsequently nine
physiotherapy sessions – each lasting
Authors: Xaver Kaelin, Bernhard Segesser,
Tanja Wasser, L. Weisskopf, U. Martin, H.-J. Rist
Assistents: Kai Leichsenring, Yves Hess, Kerstin
Greschek
30 minutes – in which MBT was used for
the various exercises. Likewise, the control
group received nine physiotherapy sessions
– each of 30 minutes duration – during
which all exercises were carried out in the
traditional way on a soft surface, without
MBT. Subsequently, the active treatment
group had to wear MBT over a period of
three months during daily living as frequently as possible. During the same period
of time, the control group had to carry out
the home training programme usually prescribed by the Praxisklinik Rennbahn every
day. The two groups were biomechanically
and functionally examined and quantified at
the following times:
A) Immediately prior to the start of physiotherapy
B) Immediately after the end of the nine
physiotherapeutic sessions and
C) three months after the end of the physiotherapeutic intervention.
29
RESULTS:
The following biomechanical relevant parameters were measured:
1) The maximum strength during inversion/
eversion of the foot and the maximum
strength during flexion/extension of the
foot, using isokinetics.
2) The extent of the pronation and supination movement of the foot while walking
barefoot on a soft, insecure surface (2-D
kinematics).
3) The fluctuations of the centre of force in
the one-legged stance, barefoot on a hard
surface using a pressure measuring system
(FootScan, ellipse area covering 50% of
measuring points and other parameters).
30
4) Maximum pressure coefficient (medial/
lateral) under the rearfoot and forefoot, respectively, while walking on a hard surface.
The results showed that immediately before
and immediately after the physiotherapeutic intervention no significant differences
between the active treatment group and
the control group were measured. However,
three months after the end of the physiotherapeutic intervention
the active treatment group showed a significantly higher maximum strength both
in the pronators (peroneal muscles) and in
the calf muscles (triceps surae). Accordingly,
a significantly smaller supination movement
in the first half of ground contact and a
significantly higher medio-lateral pressure
coefficient (higher medial pressure), both
under the heel and under the forefoot,
were found. The pronation
movements were reduced in both groups
at the end of the entire study period.
CONCLUSION:
Thus, three independent measurements
showed that the use of MBT over a period of three months after the end of the
physiotherapeutic intervention resulted
in a functionally superior stabilization of
the ankle joints compared to conventional
therapy. Thus MBT can be easily integrated
into the physiotherapeutic management of
chronic unstable ankle joints without any
negative effects, although a professional
introduction into the use of MBT is essential. However, the impressive benefits of
wearing MBT only become apparent in the
phase after the physiotherapy. At that tage,
patients have the opportunity to daily wear
the MBT over several hours. In this way, a
maximal efficient and by far better training
can be carried out compared to conventional home training programs.
PUBLICATION:
Kaelin X. The MBT as a Therapeutic Device for Ankle Joint Instabilities. Annual conference of the Association
of Chartered Physiotherapists in Sports Medicine, Belfast, Northern Ireland, November 2008. Poster presentation.
Kaelin X. The MBT as a Therapeutic Device to treat Ankle Joint Instabilities. Sports Medicine conference in
Preparation for 2010 of the Canadian Academy of Sport Medicine. June 2009, Vancouver, Canada. Podium
Presentation.
INTRO TIL STUDIE:
Nedenstående studie undersøger, hvordan trykket fordeler sig i fødderne på
diabetespatienter efter sensormotorisk træning. Forsøgspersonerne blev fordelt i 3 grupper, og elektromyografi (EMG) af muskler i underbenet blev foretaget samtidig med en måling af trykket på foden inde i skoen. Anvendelse
af MBT sko synes at have en effekt på reduktion af trykket især den mediale
forfod.
Dept. Physical Medicine &
Rehabilitation, University
Teaching Hospital Feldkirch.
TORT Centre, Ninewells
Hospital Medical School &
Institute of Motion Analysis Research,University of
Dundee.
Abstract
PURPOSE:
The purpose of this study was to investigate changes in pressure distribution after
sensorimotor training and the changes
in muscle timing in normal subjects and
diabetic patients. A portable four channel
electromyographic system (Noraxon) has
been synchronized in real time with the
PEDAR® in-shoe pressure measurement
system. Until now, peak pressures under
the diabetic foot have generally been investigated via the application of orthopaedic
insoles. To date nobody has published objective information of sensorimotor training
in relationship to foot pressure distribution
for the diabetic foot.
METHODS:
Three groups of subjects have been studied,
a normal reference group (n=23), a randomly assigned diabetic intervention
group (n=24), and a diabetic control group
(n=20), by recording electromyography of
the lower leg muscles and in-shoe foot
pressure measurements simultaneously.
Pressure Distribution of Diabetic Patients
shoe construction
(Maetzler et al., 2008)
RESULTS:
After a period of 6 weeks of daily training
with an unstable shoe construction (USC)
peak pressure under metatarsal heads 1,
2/3, and big toe were lower but higher for
metatarsal heads 4/5 in group 1. Group 2
showed a reduction in peak pressure and
the pressure-time integral under the first
metatarsal head and a tendential increase
in peak pressure in the midfoot. Group 3
did not show any significant changes in
peak pressure but a delayed peak muscle
activity for the anterior tibialis muscle.
CONCLUSION:
Sensorimotor function is an important
parameter in the study of foot pressure
distribution under the normal and the diabetic foot which can be trained to reduce
foot loading by 16%, especially in the most
endangered region of the diabetic foot, the
medial forefoot.
31
PUBLICATION:
Mätzler M., Bochdansky T., & Abboud R., 2008. Pressure distribution of diabetic patients after
sensory-motor training with unstable shoe construction. Clinical Biomechanics 23 (5), 714-715.
Mätzler M., Bochdansky T., & Abboud R. Barefoot pressure distribution of diabetic patients after
sensory-motor-training with unstable shoe construction (USC). 5th World Congress of ISPRM, Istanbul, Turkey,
June 13-17, 2009. Poster Presentation.
Mätzler M., Bochdansky T., & Abboud R. Pressure Distribution of Diabetic Patients after Sensorimotor Training with Unstable Shoe Construction. World Congress of the ISPRM (International Society of Physical
and Rehabilitation Medicine), Seoul, S. Korea, June 2007. Poster Presentation.
32
INTRO TIL STUDIE:
Undersøgelsens formål er at belyse, hvorvidt brug af MBT har indflydelse på
ankel- og fodledsfleksibilitet. 32 raske deltagere blev undersøgt ved ganganalyse dels barfodet og del med MBT. Analysen viser at MBT øger fleksibiliteten af visse ledgrupper.
1) Outpatients Department, Parkside Hospital, London, UK
2) Thames Valley University, Brentford,
Middlesex, UK.
3) University of Brighton, School of Health
Sciences, Eastbourne, UK
Abstract
PURPOSE:
Masai Barefoot Technology (MBT, Switzerland) produce footwear which they claim
simulate walking barefoot on soft undulating ground. This paper reports an investigation into the effect of MBT sandals on
the motion of the ankle and subtalar joint
complex during walking.
METHODS:
Range of motion data was collected in the
sagittal, frontal and transverse plane from
the ankle and subtalar joint complex from
32 asymptomatic subjects using the CODA
MPX30 motion analysis system during both
barefoot walking and walking in the MBT
sandal. Shod and un-shod data were compared using the Wilcoxon signed ranks test.
Comparison of ankle and subtalar joint
complex range of motion during barefoot
walking and walking in Masai Barefoot
Technology sandals (Roberts et al., 2011)
Authors: Sophie Roberts (1), Ivan Birch (2),
Simon Otter (3)
RESULTS:
A significantly greater range of motion in
the frontal and sagittal planes was recorded when walking in the MBT sandal (p
= 0.031, and p = 0.015 respectively). In the
transverse plane, no significant difference
was found (p = 0.470).
CONCLUSION:
MBT sandals increase the range of motion
of the ankle and subtalar joint complex in
the frontal and sagittal planes. MBT footwear could therefore have a role to play in
the management of musculoskeletal disorders where an increase in frontal and sagittal plane range of motion is desirable.
PUBLICATION:
Roberts S., Birch I., & Otter, S.2011. Comparison of ankle and subtalar joint complex range of motion
during barefoot walking and walking in Masai Barefoot Technology sandals. J Foot Ankle Res, 4, 1-4.
33
GENERELT VELVÆRE
Fokus har i mange år været på forbedringer af det fysiske arbejdsmiljø på
arbejdspladsen. De senere år har der
desuden været stor fokus på aktiviteter,
der fremmer de ansattes sundhed og
trivsel i al almindelighed. Trivsel giver
overskud og er tegn på balance.
MBT hjælper med at aktivere muskler
og forbedrer kropsholdningen, hvilket
kan bidrage til øget velvære blandt
ansatte der går og står meget i hverdagen.
34
INTRO TIL STUDIE:
I studiet undersøges deltagernes generelle velvære og livskvalitet ved
brug af MBT sko i deres primært stående arbejde. Deltagerne blev delt i
en MBT gruppe og en kontrolgruppe. Efter 7 ugers forsøg er resultaterne
positive, idet bl.a. generel velvære og livskvalitet var forbedret hos deltagerne i MBT gruppen. Undersøgelsen opmuntrer til flere og større
studier, der kan underbygge disse resultater.
Meisterleitung Gesundheitsmanagement.
Meisterleistung Bewegung und Coaching GmbH
(Health management, exercise and coaching),
Stuttgart, Germany
Masai Barefoot Technology in an operational
setting. A randomised controlled effect trial
to measure quality of life and well being effects due to wearing MBT-shoes in standing
activities (Bauer & Brand, 2009)
Authors: Ralf Brand, Christian Bauer
Abstract
PURPOSE:
In view of the fact that previous studies
demonstrated the clinical benefits of wearing MBT footwear (New and Pearce, 2006),
the present trial investigated the extent to
which the MBT shoes made available to the
participating enterprise had the capacity
to promote workers’ sense of well-being
and quality of life. This issue is taking on
increasing importance against the backdrop
of the aforementioned growing mental
strain to which workers are subject at the
workplace.
examined items. The study thus demonstrates the effectiveness of the MBT shoe
in increasing the quality of life and general
wellbeing of staff (with predominantly
standing jobs) in the operational setting.
This (psychological) effectiveness, in association with the medicinal-training knowledge
already gained (cf. New & Pearce, 2006),
suggests the possibility of having the MBT
shoe inspected in Germany as a refundable
“Participation programme for insured persons” (DRV, Form G100) and/or “Programme
for participating in working life” (DRV, Appendix G130).
METHODS:
This randomised controlled trial designed
study concerns the usage of MBT shoes in
an operational setting. The shoes are provided by the selected company (S&B Systemtechnik in D-70736 Fellbach; see also
Chapter 2.1) and worn as part of operational health management of staff during
working hours (predominantly standing
jobs). The effectiveness of the MBT shoe as
a means of increasing the quality of life and
general wellbeing of staff in an operational
setting is examined.
CONCLUSION:
Hence the present study clearly shows that
wearing MBT shoes in an corporate setting has beneficial health effects. Although
significant results were not obtained for all
of the measured parameters, a clear picture
emerges in every domain without exception
namely that MBT shoes are an extremely
suitable instrument when it comes to improving employees’ quality of life and sense
of well being in an corporate setting. However, further larger scale studies are needed
in order to substantiate the effects that
were observed in the present trial.
RESULTS:
The results after the 7-week intervention
are consistently positive. Significant intervention effects were found for 7 out of 12
35
PUBLICATION:
Best Practice Example at the INQA: “Gesundheitsschuhe ein ungewöhnlicher Einstieg zur Änderung
des Gesundheitsverhaltens”, published online: http://www.inqa.de/Inqa/Navigation/Gute-Praxis/ datenbankgute-praxis,eDid=6778.html, 07.07.2009.
36
MBT SÅLKONSTRUKTION
DEN BUEDE SÅL
A
B
C
D
Den buede MBT sål, teknisk
betegnet som sålkonstruktionen,
består af 4 primære komponenter, som beskrives nedenfor i
detaljer. Tilsammen udgør materialerne den rolige rullende bevægelse, som du oplever, når du
benytter MBT.
Det er kombinationen af komponenterne, som bl.a. er verdenspatenteret, der gør MBT unik og
original. Funktionen kopieres af
mange, men der findes kun én
original: MBT, som er verdens
førende funktionelle sko.
37
A: MULTIFUNKTIONELT SÅLINDLÆG
Den øverste del er det afstivende sålindlæg, som er specielt udviklet til MBT. Materialet er af plast og glasfiber, der sammen giver et formstærkt og meget holdbart produkt.
B: MELLEMSÅL MED BALANCEOMRÅDE
Den vigtigste del af PU mellemsålen er det patenterede balanceområde. Dette område sikrer konstant aktivitet og bevægelse i hvert eneste skridt.
C: MASAI SENSOR
Den bløde PU Masai sensor er hjertet i MBT. Sensoren giver den behagelige følelse,
som du også opnår, når du går barfodet ved stranden.
D: YDERSÅLEN
Ydersålen er produceret af kvalitetsmaterialer, som er “non-marking” og yderst holdbare. Ydersålen er endvidere produceret med henblik på bedst mulige greb på forskellige flader.
PUBLICATIONS OF SCIENTIFIC RESEARCH
38
2011
Roberts S., Birch I., & Otter, S.2011. Comparison of ankle and subtalar joint complex
range of motion during barefoot walking
and walking in Masai Barefoot Technology
sandals. J Foot Ankle Res, 4, 1-4.
2009
Boyer K.A., & Andriacchi T., 2009. Changes
in running kinematics and kinetics in response to a rockered shoe intervention.
Clinical Biomechanics, 24 (10), 872-876.
Nigg B.M., Karelia E., Tecante G., Federolf
P., & Landry S. C., 2010. Gender differences
in lower extremity gait biomechanics during walking using an unstable shoe. Clinical
Biomechanics 25 (10), 1047-52.
Bochdansky T., Mätzler M., & Laube W.,
2008. Pressure distribution and muscular
activity on treadmill-downhill running with
an unstable shoe construction and normal
running shoes. Clinical Biomechanics 23,
664-665.
Nigg B.M., Davis E.M., & Emery C., 2009.
The Effectiveness of an unstable shoe on
2010
Buchecker M., Wagner H., Pfusterschmied J., golf performance and a reduction of low
back pain. Clinical Journal of Sports Medicine
Stöggl T.L., & Müller E., 2010. Lower ex19 (6), 464-470.
tremity joint loading during level walking
with Masai Barefoot Technology shoes in
Henkel J., Bak P., Otto R., & Smolenski U.C.,
overweight males. Scand J Med Sci Sports,
2009. Effects of selected preventive conArticle first published online: 30 AUG 2010.
cepts on functional health in persons with
non-specific chronic recurrent neck pain.
Landry S., Nigg B.M., & Tecante K., 2010.
Standing in an unstable shoe increases pos- Manuelle Medizin, 47 (1), 57-66.
tural sway and muscle activity of selected
2008
smaller extrinsic foot muscles. Gait & PosRamstrand N., Andersson C.B., & Rusaw D.,
ture 32 (2), 215–219
2008. Effects of an unstable shoe construcRamstrand N., Thuesen A.H., Nielsen D.B., & tion on standing balance in children with
Rusaw D., 2010. Effects of an unstable shoe developmental disabilities: A pilot study.
Prothetics and Orthotics International,
construction on balance in women aged
32 (4), 422-433.
over 50 years. Clinical Biomechanics 25 (5),
455-460.
Korsten K., Mornieux G., Walter N., & Gollhofer A., 2008. Gibt es Alternativen zum
Stöggl T., Haudum A., Birklbauer J., Murrer
Sensomotorischen Training? Schweizerische
M., Müller E., 2010. Short and Long Term
Zeitschrift für Sportmedizin und SporttrauAdaptation of Variability during Walking usmatologie, 56 (4), 150-155.
ing Unstable (MBT) shoes. Clinical Biomechanics 25 (8), 816–822.
Mätzler M., Bochdansky T., & Abboud R.,
2008. Pressure distribution of diabetic
Korsten K., Mornieux G., & Gollhofer A.,
patients after sensory-motor training with
2010. The effectiveness of MBT shoes in
plyometric training with soccer players. Clini- unstable shoe construction. Clinical Biomechanics 23 (5), 714-715.
cal Journal of Sport Medicine 20 (3), 231.
van Engelen S.J., Wajer Q.E., van der Plaat
L.W., Doets H.C., van Dijk C.N., & Houdijk H.
2010. Metabolic cost and mechanical work
during walking after tibiotalar arthrodesis
and the influence of footwear. Clinical Biomechanics. 25(8), 809-15.
Romkes J., 2008. Statische Gleichgewichts/
kontrolle mit dem MBT-Schuh. Schweizerische Zeitschrift für Sportmedizin und Sporttraumatologie 56 (2), 61-65.
Lohrer H., Turbanski S., Nauck T., & Schmidtbleicher D. 2008. Balance therapy shoes – a
comparative analysis with respect to immediate training effects. Sportverletz Sportschaden. 22(4), 191-195.
2007
New P., & Pearce J., 2007. The effects of
Masai Barefoot Technology footwear on
posture: an experimental designed study.
Physiotherapy Research International, 12
(4), 202-202.
Mätzler M., Bochdansky T., Cochrane L., &
Abboud R., 2007. Sensory Motor Training
for Active Completion of Osteopathic Treatment. Phys Med Rehab Kuror 17, 1-4.
Stewart L., Gibson J.N.A., & Thomson C.E.,
2007. In-shoe pressure distribution in
“unstable” (MBT) shoes and flat-bottomed
training shoes: A comparative study. Gait &
Posture 25 (4), 648-651.
Amann F., & Lang A. 2007. Wie bewegt
sich der Fuss – barfuss auf Naturboden,
mit Schuhen und mit MBT? Orthopädieschuhtechnik. 1, 27-31.
Roggenbuck C., & Hielscher S. 2007. Naturreiz nicht vorhanden. Orthopädieschuhtechnik. 1, 22-6.
2006
Nigg B.M., Emery C., & Hiemstra, L.A., 2006.
Unstable Shoe Construction and Reduction
of Pain in Osteoarthritis Patients. Medicine
& Science in Sports & Exercise 38 (10),
1701-1708.
Kraus I., Bendig A., Mayer J., Axmann D.,
Müller O., & Horstmann T., 2006. Wirkung
einer 10-wöchigen Trainingsintervention mit
einer instabilen Schuhkonstruktion auf die
gesundheitsbezogene Lebensqualität von
Patienten mit Hüftarthrose oder implantiertem Hüftgelenk. Deutsche Zeitschrift für
Sportmedizin 57 (7/8), 195-200.
Romkes J., Rudmann C., & Brunner R.,
2006. Changes in gait and EMG when walking with the Masai Barefoot Technique. Clinical Biomechanics 21 (1), 75-81.
Nigg B.M., Hintzen S., & Ferber R., 2006.
Effect of an unstable shoe construction on
lower extremity gait characteristics. Clinical
Biomechanics 21 (1), 82-88.
2005
Amann B., & Amann F. 2005. Destabilize,
sensitize, mobilize. Orthopädieschuhtechnik.
Special edition, 3-5.
Amann B., & Amann F. 2005. New rolling techniques with disorders of the upper
ankle joint. Orthopädieschuhtechnik. Special
edition, 14-9.
Kälin X., & Segesser B. 2005. Functional
differences between MBT and conventional
shoes when walking. Orthopädieschuhtechnik. Special edition, 6-11.
Nigg B.M. 2005. Der MBT Schuh und seine
biomechanische/ therapeutische Wirkungsweise. Orthopädieschuhtechnik. Special
Edition, 377-8.
Nigg B.M. 2005. The MBT shoe and its
biomechanical/ therapeutic effectiveness.
Orthopädieschuhtechnik. Special edition,
12-3.
2004
Beyerlein C., 2004. Effekt eines neuromuskulären Trainings auf die Koordinationsfähigkeit nach Ruptur des vorderen Kreuzbandes, unter Berücksichtigung der Masai
Barfuss Technologie (MBT). Krankengymnastik Zeitschrift für Physiotherapeuten 56 (9),
1610-1627.
39
PUBLICATIONS OF CONGRESSES
2011
Röttger K., Mornieux G., & Gollhofer A.
Functional testing of MBT-shoes in a plyometric training with football players. 20th
International Conference on Sports Rehabilitation and Traumatology, Bologna, Italy,
March, 2011. Poster Presentation.
2010
Korsten K., Mornieux G., & Gollhofer A. The
effectiveness of MBT shoes in a phyometric
training with soccer players. Annual Symposium of the Canadian Academy of Sports
Medicine, Toronto, Canada, June 2010.
Poster Presentation.
40
Landry S., Nigg B.M., & Tecante, K. Standing in an unstable shoe increases postural
sway and muscle activity of selected smaller
extrinsic foot muscles. Conference of the
Canadian Physiotherapy Association, St.
John’s, Newfoundland, Canada, July 2010.
Podium Presentation.
Turbanski S., Lohrer H., Nauck T., Faulstich
M., & Schmidtbleicher D. Influence of three
different Balance Shoes on EMG activity
during walking. 14th Annual Congress of the
European College of Sport Science, Oslo,
Norway, June 2009. Oral Presentation.
Mätzler M., Bochdansky T., & Abboud R.
Barefoot pressure distribution of diabetic
patients after sensory-motor-training with
unstable shoe construction (USC). 5th World
Congress of ISPRM, Istanbul, Turkey, June
2009. Poster Presentation.
Bochdansky T., Boeckelberger M., Schnetzer B., Kollos A.L., Saely C., Kiene V., &
Drexel, H. Walking downhill with unstable
shoe constructions improves postural stability. 5th World Congress of the ISPRM (International Society of Physical and Rehabilitation Medicine), Istanbul, Turkey, June 2009.
Poster presentation.
Kälin X. The MBT as a Therapeutic Device to
treat Ankle Joint Instabilities. Sports Medi2009
Buchecker M., Wagner H., Pfusterschmied J., cine conference in Preparation for 2010 of
the Canadian Academy of Sport Medicine.
& Müller E. Knee joint loading during level
June 2009, Vancouver, Canada. Podium Prewalking with MBT shoes in overweight man.
sentation.
14th Annual Congress of the European College of Sport Science, Oslo, Norway, June
2008
2009. Oral Presentation.
Kälin X. The MBT as a Therapeutic Device
for Ankle Joint Instabilities. Annual conferRing-Dimitriou S., Stöggl T., Hehenberger
ence of the Association of Chartered PhysE., & Müller E. Unstable vs. Conventional
iotherapists in Sports Medicine, Belfast,
jogging shoe construction: Differences in
Northern Ireland, November 2008. Poster
physiological demand
presentation.
at low-intense running? 14th Annual Congress of the European College of Sport
Mätzler M., Bochdansky T., Cochrane L., &
Science, Oslo, Norway June 2009. Poster
Abboud R. Sensomotorisches Training zur
Presentation.
aktiven Ergänzung der Osteopathischen
Behandlung. Annual Congress of the ÖGPMR
Lohrer H., Turbanski S., Nauck T., &
(Austrian Society of Physical and RehabilitaSchmidtbleicher D. Influence of three different Balance Shoes on EMG acitvity during tion Medicine), Linz, Austria, October
2008. Poster presentation.
one-leg standing. 14th Annual Congress of
the European College of Sport Science, Oslo,
Norway, June 2009. Poster Presentation.
Boyer K.A., Blazek K., & Andriacchi T. Effects of an unstable shoe construction in
low speed running. North American Congress on Biomechanics, Ann Arbor, USA, Aug
2008. Poster presentation.
Blazek K., Boyer K.A., & Andriacchi T. Subjectspecific changes in knee loading in
response to an unstable shoe intervention.
North American Congress on Biomechanics,
Ann Arbor, USA, August 2008. Poster presentation.
2007
Bochdansky T., Mätzler M., Laube W., &
Abboud R. The influence of sensorimotor
training with an unstable shoe construction (MBT) and normal running shoes to the
timing and peak activity of the m. tibialis
anterior. Noraxon EMG Meeting, Vienna,
Austria, May 2007. Oral Presentation.
2006
Pressure distribution of diabetic patients
shoe construction. 10th Emed Scientific
Meeting, Munich, Germany, July 2006. Oral
presentation.
2003
Kälin X., & Segesser B. Unterschiede im
Bewegungsverhalten beim Gehen mit MBT
(High) gegenüber dem Gehen mit Strassenschuhen. 19th German-Austrian-Swiss Congress on Orthopaedic Sports Surgery and
Sports Traumatology, Munich, Germany,
June 2003. Poster presentation.
Pressure Distribution of Diabetic Patients
after Sensory-Motor Training with Unstable
Shoe Construction. World Congress of the
ISPRM (International Society of Physical and
Rehabili-tation Medicine), Seoul, S. Korea,
June 2007. Poster Presentation.
41
MBT - original funktionalitet
Opnå en række fordele for hele kroppen, når du står og går med MBT:
• Forbedret kropsholdning
• Balancen forbedres
• Anklernes stabilitet forbedres
• Belastning på knæ, ryg og hofter mindskes
• Lindring af hælspore og nedsunken forfod
• Muskelaktivitet i lår, baller, ryg og læg øges
asai Sensor skaber
M
instabilitet
Balancepunktet giver oprejst kropsholdning
Resultaterne kan variere da vi alle er individuelle individer

Studier af MBTs effekt på kroppen

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