Tag: Marzena Tuszkowska

The impact of individually selected PORON heel lifts, foot supination, and limb axial alignment on body balance – a multicenter study

Aleksandra Bitenc-Jasiejko, Anna Lubkowska, Ewa Stachowska, Krzysztof Konior, Alina Kirpichnikova, Marcelina Bitenc-Jasiejko, Małgorzata Barszczewska, Dominika Dachtera, Natalia Dąbrowska, Kinga Gonta, Patrycja Janta, Joanna Jarosławska, Beata Klus, Tomasz Kowalik, Marta Krysiak, Wojciech Kuliczkowski, Tomasz Kupc, Aneta Mandrosa, Rafał Michalski, Anna Morzyńska, Rafał Mosur, Natalia Pachulska, Dawid Paradziński, Izabela Plewa, Klaudia Stankowska, Marta Stelmaszczyk, Anna Szewczyk, Marta Szewczyk, Damian Szyguła, Marzena Tuszkowska, Magdalena Walasek, Anna Walińska, Mariola Wawełczyk-Polotzek, Barbara Wrocławska, Krystiana Kijak, Danuta Lietz-Kijak

 

Aleksandra Bitenc-Jasiejko et al. – The impact of individually selected PORON heel lifts, foot supination, and limb axial alignment on body balance – a multicenter study –  Fizjoterapia Polska 2025; 25(2); 317-331

DOI: https://doi.org/10.56984/8ZG00E1CVPM

Abstract
The center of pressure (COP) on the feet is a crucial parameter providing information about structural and postural balance. A disturbance in this global pattern causes or reflects dysfunctions in the distribution of tension within the body. Postural disorders that manifest as an imbalance of the center of gravity in the sagittal plane lead to multisegmental ergonomic disturbances of the musculoskeletal system, resulting in compensations, pain, and, over time, structural overload changes and defects. Early detection of anterior-posterior load imbalances and their correction is of great importance for the prevention and treatment of musculoskeletal disorders.
Objective. To assess the impact of individually selected PORON heel lifts and lower limb correction in the transverse plane on body balance.
Methods. The study included 96 participants (n=100%), including 62 women (nf% = 64.58%) and 34 men (nm% = 35.42%), aged 15 to 80 years. The average weight of the participants was 75 kg (SD = 18.244), their average height was 1.705 m (SD = 0.093), and their average BMI was 24.81 (SD = 5.009). Exclusion criteria. Individuals diagnosed with significant foot and lower limb deformities or conditions significantly affecting body balance. A pedobarographic examination (EPS R2) was conducted while participants stood barefoot. Each test lasted 20 seconds, with a sampling rate of 1 ms (20,000 samples per test). The study included four trials: trial 0 in free standing, trial 1 with a 3 mm PORON heel lift, trial 2 with a 6 mm heel lift, and trial 3 in the lower limb correction test in the transverse plane (rotation).
Results. The study demonstrated a significant effect of using a low PORON offloading heel lift on balancing anterior-posterior pressure distribution on the feet.
The median heel underload in the control test (without correction) was −7.05% (interquartile range [−11.1%; −1.2%]). The greatest change was observed with the 6 mm heel lift (−3.0%; [−7.2%; +3.0%]). The Kruskal–Wallis statistical significance test for comparing all trials showed a significant difference (χ²[3] = 15.47, p=0.001). The Wilcoxon rank sum test, used to analyze statistical significance between individual trials, indicated a significant difference between trial 0 and trial 2 (p = 0.001) and between trial 0 and trial 3 (p = 0.036). The difference between trial 0 and trial 1 was nearly significant (p=0.054). The study found no significant effect of the interventions on lateral (right–left) pressure distribution (χ²[3] = 0.87, p = 0.834). Statistical analysis of 10 body balance parameters showed a significant difference between trials only in parameters describing body oscillations in the sagittal plane. The COP–barycenter angle of the feet significantly decreased (χ²[3] = 15.01, p=0.002), while the mean COP distance along the Y-axis significantly increased (χ²[3] = 10.01, p = 0.018).
Conclusions. For postural disorders that shift the center of gravity forward and affect balance in the sagittal plane, the use of PORON heel lifts is justified. Given that the PORON material used in the study is an offloading material with a hardness of approximately 15 Shore and that our applied interventions were significantly lower than those previously studied, these solutions reduce the undesired effects of heel elevation while increasing comfort and footwear compatibility.
Manual correction of the lower limb in the transverse plane also positively influences anterior–posterior COP balance, shifting weight distribution backward. The combination of heel offloading and correction of foot overpronation has a significant impact on relieving pressure on the forefoot, improving standing posture ergonomics, and promoting postural re-education from a forward-leaning position.
Statistical analysis. Statistical analyses were performed using the R statistical software, version 4.3.0 (The R Foundation for Statistical Computing, Wirtschaftsuniversität Wien, Vienna, Austria). Given the significant non-normality of variable distribution in the trials, the Kruskal–Wallis test was applied. The Wilcoxon rank sum test (also known as the Mann–Whitney–Wilcoxon test), with Bonferroni correction for multiple comparisons, was used to identify trial pairs where significant differences occurred. Results were considered statistically significant at p<0.05.
Key words
PORON heel lifts, postural balance, foot supination, anterior-posterior pressure
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Changes in body balance due to exposure to trauma – multi-center studies

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Anna Walińska, Kinga Gonta, Elżbieta Szkiler, Milena Kraft, Alina Kirpichnikova, Karolina Trąbska, Anna Parus, Tomasz Kupc, Malwina Waleryn-Sagun, Anna Szadkowska, Rafał Mosur, Kamila Mosur, Damian Szyguła, Nicola Książek, Małgorzata Barszczewska, Patrycja Janta, Aneta Mandrosa, Joanna Jarosławska, Klaudia Smolińska, Marta Szewczyk, Agnieszka Byszewska, Anna Morzyńska, Marzena Tuszkowska, Barbara Wrocławska-Tuszkowska, Marek Gapiński, Tomasz Kowalik, Karolina Adamska, Katarzyna Pawliwiec, Jan Głodowski, Konrad Kijak, Małgorzata Kowacka, Danuta Lietz-Kijak

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Danuta Lietz-Kijak et al – Changes in body balance due to exposure to trauma – multi-center studies. Fizjoterapia Polska 2023; 23(5); 313-326

DOI: https://doi.org/10.56984/8ZG20Bb3T

Abstract
Aim. The purpose of the study was to assess the impact of a traumatic event experienced by the subject on postural balance and biomechanical parameters of gait.
Research methodology. The study involved 31 people (n = 100%), including 22 women (nk% = 70.97%), 9 men (nm% = 29.03), aged 29-60. People with diseases and dysfunctions affecting body balance and gait pattern were excluded from the study.
Balance and gait tests were performed using pedobarography (pedobarograph mod. EPS R2, Biomech Studio v2 software). The balance test was performed while standing, for 20 seconds, with sampling every 1 ms (millisecond) – the number of samples during one test is 20,000. The balance and gait assessment tests were performed twice. Test I included testing in neutral conditions, Test II included testing in conditions in which the subject was exposed
to a traumatic event he or she had experienced in the past (so-called exposure to “experienced trauma”).
Results. The obtained results of studies on the impact of exposure to experienced trauma on body balance while standing showed significant differences in body fluctuations in the most important parameters of stabilometric assessment.
The obtained results of research on the impact of exposure to trauma on the subject’s gait showed no significant differences between the test in neutral conditions and the test during exposure.
Conclusions. (1) Exposure to the trauma experienced by the subject significantly affects the body’s balance in a standing position. (2) The research showed no influence of exposure to the experienced trauma on the subject’s gait in the area of the time of contact of the feet with the ground and on the values of maximum and average pressure; The area of the plane where the feet are placed on the ground changes significantly before and after exposure to the trauma experienced by the subject. (3) In research on the impact of trauma on body posture, detailed results of studies on the range of COP fluctuations in each plane should be taken into account – the study showed that the analysis of only average results may significantly indicate an incorrect result in the assessment of body balance.

Keywords
stress, trauma, PTSD, body balance, gait, stabilometry, pedobarography

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