Ağır Hadde İşçilerinde Kişiye Özel Tabanlık Kullanımının Ayak Basınç Analizi Üzerine Etkisinin İncelenmesi

Abstract

Amaç: Ayakta uzun süre çalışan bireyler için; ağrı, ayak fonksiyonelliği, taban basıncı gibi birçok olumsuz etkileri olan ayak deformiteleri; tendon, ligament, kas, sinir ve kemik-eklem dokularını ilgilendiren sorunlar ile ortaya çıkarak zincir şeklinde tüm vücudu etkiler. Kişiye özel üretilen tabanlıklar sayesinde ayak deformitelerinin meydana getirdiği negatif etkiler büyük oranda azaltılabilmektedir. Çalışmamızda ağır hadde işçilerinde kişiye özel üretilen tabanlık kullanımının, uzun süre ayakta kalmaya bağlı ve ayakta görülen deformitelerden kaynaklanan ağrı ve plantar basınç analizi üzerine olan etkisini incelemek amaçlandı. Gereç ve Yöntem: Dilovası Organize Sanayi Bölgesinde yer alan Ağır Haddecilik A.Ş.’de çalışan 89 bireyin plantar basınç analizi, anamnez formu, ayak postür analizi kaydedilerek dahil edilme kriterlerine uyan 25 kişi çalışmaya alındı. Anlık çıplak ayak ve tabanlık kullandıktan 1. ve 2. ay sonra ayak basınç analizleri tekrarlandı. Deformitelere özgü bilgisayar destekli tasarım ve üretim yöntemiyle deformiteye özel tabanlık uygulaması yapıldı. Tabanlık kullanımından önce ve sonra katılımcıların; ağrı durumlarını değerlendirmek için “McGill Ağrı Anketi”, ayak postürünü incelemek için “ Ayak Postür İndeksi” ve ayak basınç analizlerini ölçmek içinde statik pedobarografik cihazı (Sensörmedica, İtalya) kullanıldı. Bulgular: Bireylerin tabanlık kullanımı öncesi ile 8 hafta tabanlık kullanımı sonrası plantar basınç analizleri karşılaştırıldığında; anlık, 1. ve 2. ay ölçümlerinde fark bulundu (p<0,05). Anlık, 1.ve 2. ay Mcgill-Melzack Ağrı Anketi’nde anlamlı bir fark bulundu (p<0,001). Anlık, 1. ve 2. ay ayak postür indeksi medyanları bakımından anlamlı fark bulundu (p=0,022). Sonuç: Kişiye özel tabanlık kullanımının deformiteye bağlı plantar yük dağılımında meydana gelen değişikliklerin düzeltilebilmesine yardımcı olabileceği ve böylece bireylerin ağrılarının azaltılabileceği gözlemlenmiştir.

Keywords

• ağır hadde işçileri
• ayak deformitesi
• kişiye özel tabanlık
• plantar basınç analizi

Investigation of the Effect of Using Custom Made Insoles on Plantar Load Distribution, Foot Posture and Pain in Heavy Metal Workers

Abstract

Purpose: Foot deformities cause many negative effects such as pain, limitation in foot functionality, unbalanced distribution of plantar pressure. These negative effects create problems involving tendons, ligaments, muscles, nerves, and bone-joint tissues, affecting the whole body in the form of a chain. Custom made insoles can reduce the negative effects of foot deformities to a great extent. The aim of our study was to examine the effect of using custom made insoles on plantar load distribution, foot posture, and pain in heavy metalworkers. Materials and Methods: Of the 89 individuals working as heavy rolling mill workers in a factory, 25 people who met the inclusion criteria were included in the study. Insoles were applied using a computer-aided design and production method specific to deformities. Sociodemographic information of the individuals was recorded. Plantar load distribution was evaluated with bare feet using a static pedobarographic device (Sensörmedica, Italy), foot posture with the “Foot Posture Index” and pain with the “McGill Pain Questionnaire”. Measurements were repeated at the end of the 4th and 8th week in addition to the instantaneous measurement performed at the beginning of the intervention. Result: Individuals' instantaneous, 4th week and 8th week measurements were compared. There was a significant decrease in forefoot load distribution (p <0.05) and a significant increase in hindfoot load distribution (p <0.05). A positive significant difference was found between the foot posture index medians (p = 0.022). A significant difference was found in the direction of pain reduction due to the results of the Mcgill-Melzack Pain Questionnaire (p <0.001). Results: It was observed that the use of custom made insoles was effective in providing a balanced distribution of plantar load, correcting the foot posture, and reducing pain.

Keywords

• custom made insoles
• foot deformity
• heavy metal workers
• plantar load distribution

References

1. Global(https://www.agirhaddecilik.com/tr/tarihce), Ağır. (Erişim tarihi: 04/02/2020)
2. Messing K, Kilbom A. Standing and very slow walking: foot pain-pressure threshold, subjective pain experience and work activity. Applied ergonomics, Feb;2001; 32(1):81-90.
3. Halim I, Omar AR. A review on health effects associated with prolonged standing in the industrial workplaces, IJRRAS. 2011;8 (1) July . Yapıcı G. Ayakta Çalışma ve Sağlık Etkileri,Derleme. 2011; 18(3):194-8.
4. Isa NS, Deros BM, Sahani M, Ismail AR. Physical activity and low back pain among automotive industry workers in Selangor. Malays J Public Health Med. 2014; 14:34–44. Yıldırım Y. Identifying factors associated with low back pain among employees working at a package producing industry. Journal of Back and Musculoskeletal Rehabilitation. 2014; 25–32.
5. Tomei F, Baccolo TP, Tomao E, Palmi S, Rosati MV. Chronic venous disorders and occupation. American Journal of Industrial Medicine, vol. 36, pp. 1999; 653-665 .
6. Redfern M, Chaffin DB. Influence of Flooring on Standing Fatigue. First Published 1995; Vol 37, Issue 3.
7. Jannink MJ, Ijzerman MJ, Groothuis-Oudshoorn K. Use of orthopedic shoes in patients with degenerative disorders of the foot. Arch. Phys. Med. Rehabil. 2005; 86:687 – 692.
8. Burns J, Crosbie J, Hunt A, Ouvrier R. The effect of pes cavus on foot pain and plantar pressure. Clin. Biomech. 2005; 20:877 – 882.

9. Choi JK, Cha EJ, Kim KA, Effects of custom-made insoles on idiopathic pes cavus foot during walking,Biomed Mater Eng. 26 Suppl 2005; 1:S705-15.
10. Lobmann R, Kayser R, Kasten G, Kasten U, Kluge, K, Neumann W, Lehnert H. Effects of preventative footwear on foot pressure as determined by pedobarography in diabetic patients: A prospective study. Diabetic Medicine, 2001; 18(4), 314−319.
11. Almeida JS, Filho GC, Pastre CM, et al. : Comparison of plantar pressure and musculoskeletal symptoms through the use of custom footbeds and prefabricated workplace.Rev Bras Fisioter, 2009; 13: 542–548.
12. Min-ChiChiu, Professional footwear evaluation for clinical nurses, Applied Ergonomics,Volume 38, Issue 2, Pages 2007; 133-141.
13. Yurt Y, Şener G, Yakut Y. The effect of different foot orthoses on pain and health related quality of life in painful flexible flat foot: a randomized controlled trial. Eur J Phys Rehabil Med. 2019; 55(1):95-102.
14. Redmond A, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: The foot posture index. Clin Biomech. 2006; 21(1):89-98.
15. Redmond AC, Crane YZ, Menz HB. Normative values for the Foot Posture Index. J Foot Ankle Res. 2008;1(1):6.
16. Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987; 30:191-7.
17. Özaras N, Yalçın S. Normal yürüme. Yürüme analizi’nde. İstanbul,Avrupa Tıp Kitapçılık. 2001; s.1–23.
18. Caravaggia P, Giangrandea A,Lullinia G,Padulab G,Bertia L.In shoe pressure measurements during different motor tasks while wearing safety shoes: The effect of custom made insoles vs. prefabricated and off-the-shelf.Gait & Posture. 2016; V 50, p. 232-238.
19. Redmond A, Lumb PS, Landorf K. Effect of cast and noncast foot orthoses on plantar pressure and force during normal gait.Journal of the American Podiatric Medical Association. 2000; Cilt Vol No.9, pp.441-449.
20. Tarrade T,Doucet F, Saint N. Are custom-made foot orthoses of any interest on the treatment of foot pain for prolonged standing workers?. Applied Ergonomics. 2019; Volume 80, Pages 130-135.
21. Carterc M,George B. Orthotic management of plantar pressure and pain in rheumatoid arthritis.Clinical Biomechanics. 1999; Volume 14, Issue 8, Pages 567-575.
22. Mousavi EM, Zamanian Z,Hadadi M,Sobhani S.Investigating the effect of custom‐made insoles and exercises on lower limb and back discomfort in assembly‐line workers in a rubber tire factory: A randomized controlled trial. basım yeri bilinmiyor : Human Factors and Ergonomics in Manufacturing & Service Industries. 2019; Volume29, Issue6.
23. Amer AO, Jarl GM,Hermansson LN.The effect of insoles on foot pain and daily activities. Prosthet Orthot Int. 2014; 38 (6), 474-480.
24. Gijon-Nogueron G, Cortes-Jeronimo E, Cervera-Marin, JA, et al. The effects of custom-made foot orthosis using the Central Stabilizer Element on foot pain.Prosthet Orthot Int. 2014; 1-7.
25. Trotter LC,Pierrynowski MR.The short-term effectiveness of fullcontact custom-made foot orthoses and prefabricated shoe inserts on lowerextremity musculoskeletal pain: a randomized clinical trial.J Am Podiatr Med Assoc. 2008;98 (5), 357-363.
26. Zammit GV,Payne CB.Relationship between positive clinical outcomes of foot orthotic treatment and changes in rearfoot kinematics. J Am Podiatr Med Assoc. 2007; 97 (3), 207-212.
27. De Morais Barbosa M,Bertolo CB, Neto MM, Bellini JF.The effect of foot orthoses on balance, foot pain and disability in elderly women with osteoporosis: a randomized clinical trial. Rheumatology (Oxford). 2013; 52 (3), 515-522.
28. Burns J, Crosbie J,Ouvrier R, Hunt A.Effective Orthotic Therapy for the Painful Cavus Foot. Journal of the American Podiatric Medical Association. 2006; Vol. 96, No. 3, pp. 205-211.
29. Payne C, Oates M. Static Stance Response to Different Types of Foot Orthoses. Journal of the American Podiatric Medical Association, 93(6), 492–498, 2003.