Comparisons

DST uses MBT Footwear as an unstable shoe to assist in the training of weak muscles responsible for musculo skeletal dysfuntion and gait abnormality. Dr Rav Naik, Medical Director of MBT-UK, is a major contributor to DST. Visit Dr Naik's website link (left) for more information on the medical effects of MBT footwear.

Sheffield Hallam University Centre for Sport and Exercise Science

Study Summary:

Changes in gait characteristics of a normal, healthy population due to an unstable shoe construction
(A Summary)

Dr Rav Naik
Joshua Isaac Smith

Study authors: Tim Vernon, Jonathon Wheat, Dr Rav Naik and Grace Pettit

BACKGROUND

• Back pain is the third most common bodily symptom after headache and tiredness:
• 60 - 80% of people suffer low back pain at some time in their lives.
• 15 - 30% of people have some low back pain symptoms everyday.
• In 1995/ 96, 117, 560, 500 days invalidity or sickness benefit were claimed as a result of back incapacity in the UK.
• Chronic back problems account for 85% of absenteeism due to back pain.
• Radiographic changes are seen in some joints in the majority of people aged 60 or older.
• 20% of these older populations develop a significant clinical disease.
• Equates to approximately 2million people presenting with osteoarthritis each year.
• Both complaints can be associated with overuse (wear and tear).
• Microdamage to joint structures caused by cyclic loading at loads below those that would normally cause traumatic injury.
• The rate of tissue repair does not match the rate of damage accumulation.
• The average UK citizen walks in the region of 183 miles (305 km) per year.
• Each footfall results in a loading effect on the lower limb and back.
• Reduction in the cyclic loading of the structures that comprise these joints will have a significant affect on the accumulation of microdamage.

METHOD

• · 22 participants (11 male, 11 female); Age 30 - 35.
• Physically active and free from musculoskeletal injury at the time of testing.
• 8-camera digital motion capture system (Motion Analysis Corporation, Santa Rosa, CA, USA) sampling at 200 Hz.
• Kistler Type 9281CA force platform (Kistler Instrumente AG Winterthur, Switzerland ) sampling at 1000Hz.
• Each participant underwent a tutorial session in Dynamic Stability Training (DST)
• Tested in the lab under normal conditions and then in the MBT condition.
  Helen Hayes marker set incorporating a static calibration trial.
• Data analysed using OrthoTrak software (MAC) and custom MATLAB software (SHU).
  

RESULTS

1. MBT promote a more upright walking posture.

• - Possible shift in the centre of mass position above the base of
  support.
• More optimal alignment for locomotion.
• Coupled with lower loading at the hip could indicate reduced loading of the lower back.

 

2. Reduced plantar flexion at the ankle immediately following initial contact in MBTs.

• Due to rolling over the pivot point rather than dropping of the forefoot.
  
  

3. MBT elicit lower joint movements at the hip, knee and ankle.

• The lower movements experienced at these joints suggests a resultant decrease in joint loading during locomotion. This is extremely beneficial in those individuals who have degenerative joint disease.

4. MBTs decrease the occurrence of transient force peaks.

• Clinical evidence has shown that high transient force peaks are the primary aetiological factor in the development of many musculoskeletal disorders.

5. MBT gait produces higher negative A-P forces, thereby promoting a forward propulsive force.

• Increases in the forward propulsion are probably due to the dragging motion during walking in MBTs.

Study download -

Exercise tables -

dvd download - coming soon!

DST Biomechanics Seminar

HALLAM UNIVERSITY – Center for Sport and Exercise Science Biomechanics of Dynamic Stability Training (DST) using MBT Footwear

Tim Vernon, MSc and Dr Rav Naik available for presentation of biomechanical effects of DST using MBT footwear, and demonstrating posture and gait abnormalities with accompanying DST exercises to improve balance, coordination, speed and proprioception.

Calgary Study -

Study Summary:

Effect of an Unstable Shoe Construction on Lower Extremity Gait Characteristics (A Summary)
Dr Rav Naik
Joshua Isaac Smith

Human Performance Laboratory
University of Calgary
Calgary, Canada

A project report for Masai Switzerland comparing selected biomechanical characteristics of the MBT and a control shoe.

Submitted June 30, 2004
Nigg, Benno M.
Ferber, Reed
Gormley, Tim

Human Performance Laboratory
The University of Calgary
2500 University Drive N.W.
Calgary, Alberta, Canada T2N 1N4

Methods
Eight subjects participated in this study performing tests in a control shoe (Adidas SuperNova)
and the MBT shoe. A first test battery was performed during quiet standing, quantifying the movement of the center of pressure and the corresponding muscle activity. A second test battery was performed during walking, quantifying kinematics, kinetics, muscle
activity (EMG), soft tissue vibrations and oxygen consumption for the two shoe conditions for walking in an initial testing session at the start of the project and two weeks later in a second session. Subjects were asked to wear the unstable test shoe as much as possible for the two weeks (9.5 ± 2.1 h) as suggested by the manufacturer.

Results
The results of this study revealed the following facts:

• During standing quietly, the MBT device increased the movement of the center of pressure, producing an increased demand of muscle activity in the lower extremities to balance the body. Thus, during standing, the MBT device acts as a mechanical muscle training device.

• During walking, the MBT device produces an increased rotational ankle joint impulse for foot
  plantar-flexion and foot inversion for the first half of ground contact. Thus, the MBT device
  acts as a mechanical training device for the muscles crossing the ankle joint.

• During walking, the MBT device reduces the rotational ankle joint impulses for the knee joint (average reduction 27 %). Thus, the MBT device reduces mechanically the forces at the
  knee and hip joint. This result is typically associated with a reduction of joint pain.

• During walking, the MBT device required 2.5 % more oxygen consumption for the samewalking task,
  thus requiring more mechanical energy, which translates into a mechanical training effect

• Based on the results of this study it is concluded that the MBT device strengthens the smallmuscles
  with small levers with respect to the rotational axes. This would reduce the jointloading,
  which explains the results of less pain and discomfort when using this training device.

Conclusions
The MBT device when applied as described in the user’s instructions is a device for
mechano-therapy.

The mechano-therapy with the MBT device influences the patient during standing and
walking. During standing, the MBT device increases the muscle activity, therefore increasing
the muscle forces and producing a training effect. During walking, the MBT device reduces
the joint loading, therefore reducing the joint pain.

The MBT device is, therefore, an effective device for mechano-therapy.

Summary
The results of this study showed the following results:

• Standing in the MBT shoe produced more movement of the center of pressure and required more muscle activity in the lower extremity to balance the body. Thus, during standing, the MBT shoe acts as a muscle training device.

• The general walking kinematics were not changed by the MBT shoe except for the landing kinematics (flat foot) and the stride frequency (higher) and stride length (shorter).

• The rotational ankle joint impulse for plantar-flexion for the first half of stance is higher for
  the MBT shoe. However, the actual plantar flexion moments are small during the first half of contact time. Thus, this increase should not be of any concern.

• The rotational ankle joint inversion impulse for the first half of stance is substantially higher
  for the MBT shoe. Small changes in shoe construction could change this situation if desired.

• The rotational ankle joint impulses for all other joints and axes are slightly decreased with
  the MBT shoe. The reduction is consistent for the knee joint and is on the average for all
  axes 19%. This result and the results for the reduced or maintained muscle activity during
  walking are evidence that the MBT shoe produces movement close to the preferred
  movement path.

• The muscle activity of the major muscle groups shortly before and after heel strike was not
  changed with the MBT shoe with the exception of reduction of the tibialis anterior and biceps
  femoris muscles.

• The MBT shoe required 2.5% more oxygen consumption for the same walking task, a
  difference that can be explained primarily by the additional weight of the MBT shoe.

• The onset and the frequency of the soft tissue vibrations were influenced by the MBT shoe.

• It is speculated that the MBT shoe strengthens the small muscles with small levers with
  respect to the rotational axes. This would reduce the joint loading which could explain some
  anecdotal results of less pain and discomfort.

In summary, the results of this study showed that the MBT shoe acts as a muscle training device during standing and quasistatic activities and reduces knee and hip joint loading during walking.

Study Download -
Web site download - CLICK HERE

Edinburgh Study -

Study Summary:
by Joshua Isaac Smith and Helen McNutt

• MBTs altered the distribution of plantar pressure with increases and decreases of pressure in certain regions of the foot.

• Overall decreases in plantar pressure were found in the posterior half of the foot, and increased pressure in the forefoot and toes. Standing in MBTs resulted in lower peak pressure in the midfoot (21%) and heel (11%) compared to the control shoe, and increased pressure in the toes (76%).

• Overall, compared to the control shoe, MBTs pattern of pressure distribution was shifted towards the front foot. The results are more common with those obtained by studies on high heeled shoes.

• MBTs appear to more closely resemble the pattern of load bearing as values for bare feet. According to Anderson et al, the average contact area of the foot when standing barefoot is 100cm2. This study found lower values than this in both types (high heels and flat shoes) of shoes tested, but the MBT produced the largest value, closest to the barefoot value.

• The forward shift of pressure in MBTs is due to the sloping design of the shoe base displacing the weight away from the heel. The curve away from the heel in the MBT sole means that the rear foot is only briefly in contact with the surface.

• Heel and midfoot pressure are affected by arch structure, body weight, and the thickness of plantar soft tissue. As MBTs were found to reduce pressure in these areas they may be useful in Pes Planus or other arch problems, obesity and degeneration of the calcaneal foot pad with aging.

• Existing therapeutic measures for calcaneal spurs (orthotic support from heel base of metatarsals) and plantar fasciitis, aim to relieve pressure in the mid foot and longitudinal arch, so MBTs may also be of use to these patients.

• Rocker-soled shoes that are used to prevent ulcers or skin breakdown in neuropathic/diabetic feet (distribute pressure in the opposite way to MBTs) only work if the patient is most susceptible to skin breakdown is in the usual lateral forefoot/toes area. If the problem is mainly in the rear foot then MBTs may be useful.

• MBTs produced a different profile of pressure distribution to flat-soled trainers. Further testing with more subjects and different shoe types is required but these preliminary results indicate that the shoe design can have an effect on how pressure occurs through the feet and so advice about footwear could be tailored to relieve pressure in the targeted areas.

Study Download -