Hi all,

Sylvia wrote:

>I share your interest in the issue of the effect of sensory feedback and
>its effect on gait and stance.In particular , how this is used consciously
>or unconsciously by both practitioners and orthotic consumers as we wear
>and prescribe in-shoe devices . And what of the same effects of the shoes
>themselves and their moulded inserts?
>Does anyone know of research mapping the innervation of the sole of the
>foot in terms of the distribution, concentration and different types of
>nerve endings in different areas of the foot? What is the relative
>distribution of light touch receptors and Pacinian- pressure sensing
>corpuscles?

To answer the question of relationship between change in proprioception/
sensory feedback on changes in gait, I think you should look a little
higher than the sensor organs on the plantar surface of the foot.  The
question here is does sensory input change motor output.  Gait is motor
output.  The options for the pathway for this effect are spinal reflex.
cerebellar or higher CNS integration.  It would seem really unlikely that
this would be hard wired as a spinal reflex, because evolutionarily, we
need to perform many different movements with same feet to survive.  So, if
we start looking at the Central Nervous System to explain how the gait
changes occur I don't see how factors like balance, pain avoidance, energy
efficiency and looking cool will not be part of the final motor
output.  Yes, sensory input will be one of the factors that effects gait,
but sometimes the CNS will decide that looking cool, or something else,
will be more important in deciding which muscles will receive greater
activation.

This makes sense in relation to Craig's finding that anesthetized feet
don't exhibit any kinematic changes when wearing orthoses.  A question for
Craig: Were there kinematic changes before and after orthoses?




Cheers,

Eric Fuller

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