We are all constantly on our feet. We walk, run, jog, stand, and depend on our feet to support body weight. A research study originating out of Keller Army Community Hospital at West Point is seeking to profile the incidence of arch height and stiffness in military trainees and the correlation to overuse injury. The foot study involves more than 1,000 cadet volunteers and their Army-issued boots.
The study, initiated by Col. Michael Neary, a podiatric surgeon at Keller Army Community Hospital, and Dr. William Brechue, a Department of Physical Education professor, involves researchers from the U.S. Military Academy, New York College of Podiatric Medicine, the Hospital for Special Surgery in New York, Temple University in Philadelphia, and Novel Electronics.
When Neary arrived at West Point in 2010, he soon realized the instruments he used were somewhat limited. "I knew the instrument we used for prior boot fitting efforts wasn't functional (to study foot structure)," says Neary. He came to this conclusion while considering the relationship between proper boot fit and injuries he would see as a podiatrist on post. This concern was urgent because he also inherited the task of setting up the boot fitting for the next incoming class.
The study design began to take shape when Rebecca Zifchock, an associate professor in West Point's Civil and Mechanical Engineering Department, and Dr. Howard Hillstrom from the Hospital of Special Surgery in New York, came on board to discuss a possible foot structure study and thought an arch height measuring device they previously used might be a better method of measuring the incoming cadets for footwear.
"The arch height measuring device gives an objective measure on arch height," said Neary. "What Lt. Gen. David Huntoon Jr. (former USMA Superintendent of West Point) wanted was a good fitting boot. If the boot doesn't fit right, it can slow the cadets down and cause injuries. We knew we couldn't pass this study by."
Funding for the measuring devices came from the Center for Innovation and Engineering, directed by Lt. Col. Bruce Floersheim. In addition to investigating a more effective method for fitting footwear, the team set out to collect data from the cadet volunteers on their foot structure and function.
"We are measuring static and dynamic characteristics of foot structure and function in the incoming cadet class in order to understand what this population generally looks like in terms of the proportion of high and low arches, flexible, and rigid feet," Zifchock said. "We will then track their incidence of overuse injury to see if this correlates to their foot structure and function."
Hillstrom said a cadet will carry an additional 60-90 lbs. during a ruck march, a significant increase in body loading that only gets higher as training progresses. "It is an important question to find out if the cadets have changes in foot structure and function, and if the changes are temporary or permanent," said Hillstrom. "The extra weight and the training cadets go through predispose cadets to injury."
The team will follow the cadets and measure their feet at regular intervals throughout their time at West Point to check for changes in foot structure resulting from training.
The arch measuring device provides information on arch height and stiffness, and functional data on how the foot reacts to the load of walking. The data was collected by pressure sensor mats from industry collaborators at Novel Electronics.
"Novel gave us two pressure sensor machines and Temple University and the Hospital for Special Surgery had three additional systems we could use,"said Neary. "The collaborators also provided the manpower to run the software and hardware."
The new cadets' feet were measured by students and faculty from Temple University, the New York College of Podiatric Medicine and the Hospital for Special Surgery. Eighty volunteers organized the research in coordination with the boot fit.
"For some perspective, it takes about 10 years to gather that many subjects for a study," Neary said. "We did it in two days with our team.
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