Investigation of the effects of flat cushioning insole on gait parameters in individuals with chronic neck pain

Individuals with chronic neck pain (CNP) walk with a stiffer spine known to cause an increase in dynamic loading on the spine. They also exhibit altered spatiotemporal gait variables, however, it is still unclear whether flat cushioning insole, which reduces dynamic loading on the musculoskeletal system by absorbing the ground reaction force, affects gait parameters in individuals with CNP. The aim of this work was to investigate the effects of flat cushioning insole on neck pain during walking and gait parameters in individuals with CNP. Methods: Twenty-one individuals with CNP and 21 asymptomatic controls were included. Assessments of gait parameters and pain were conducted in two sessions, standard shoe only and standard shoe with flat cushioning. In both sessions, all participants performed the 10-meter walk test in two walking conditions: preferred walking, walking at maximum speed. The force sensitive insoles and the video analysis method were used to assess plantar pressure variables and spatiotemporal gait variables, respectively. Pain was assessed using the Visual Analogue Scale. Results: Our results indicated that flat cushioning reduced the maximum force and force-time integral in both groups ( p < 0.05). Flat cushioning increased walking speed and step length in both walking conditions and reduced neck pain during walking at maximum speed in individuals with CNP ( p < 0.05). In asymptomatic individuals, no difference was found in spatiotemporal gait variables between two sessions ( p > 0.05). Conclusions: These results have suggested that the use of flat cushioning insole may improve neck pain during walking and spatiotemporal gait variables in individuals with CNP.