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Novel screening method has potential to reduce lower back/limb injuries

Clocktower at night

Monday 11 July 2011 9:24am

Photo of Marian Baxter
Ms Marian Baxter

A promising University of Otago student who developed an innovative screening procedure to identify New Zealand army personnel most at risk of lower leg and back injuries has been recognised with a scholarship to develop her concept further.

This is because the screening procedure has the potential to benefit not only the military, but all people at risk of such injuries.

Over the past four years, as part of an honours undergraduate degree in biomechanics, Otago Department of Preventive and Social Medicine PhD student Marian Baxter has studied the feet and walking gait of more than 1000 New Zealand Army soldiers.

Now, with the help of a scholarship from the company Foot Science International, a company specialising in footwear technology, she plans to bullet-proof her procedure by more extensive testing of the protocol on a wider cross section of the population.

Evidence from ACC shows that lower back and lower limb injuries can be a problem among military personnel. As a former New Zealand Army territorial herself, her “hunch” was that the soldier’s boots were often mismatched to their particular foot-shape or their gait.

Ms Baxter also found the use of orthotics for army personnel once they had already suffered an injury had limited success in injury reduction. She found it was likely to be more beneficial to target those most at risk before they suffered an injury in the first place.

Her background in biomechanics led her to investigate the possibility that these injuries were related to movements.

“I identified that those who were developing these injuries had an observable type of movement style when they walking or running,” she says.

“So based on this injury-causing movement style, a new screening protocol was developed which attempted to identify between those who should and should not wear orthotics.”

The screening protocol was tested on NZ army recruits over a three month period and included over 300 participants.

“The study was very successful, and injuries of the lower limb and lower back were reduced based on this procedure,” she says.

“The real strength of this study was that it had the support of the military: this makes the results so much more convincing. This is because everyone in the army wears the same boots, walks with the same load, and does the same routine over a long period of time,” she says.

“We will be refining this protocol to ensure that our method is bullet proof. If we are correct, we could potentially save any member of the public a lot of time, money and discomfort caused by these common injuries.”

Ms Baxter praised the army’s cooperation with her research aims.

“The military’s involvement so far has meant that the whole population could eventually benefit from this research. Many people do not wear the right shoes to suit their feet or their gait,” she says.

She found that the rate of lower limb and back injuries was particularly high among Pacific Island and Maori army personnel. This was because, at the time the research was conducted, their feet had been too wide for the standard-issue army boots.

Ms Baxter’s PhD supervisor, Associate Professor Stephan Milosavljevic, of Otago’s School of Physiotherapy, says the study highlights that everyone’s foot morphology is different.

Previous studies have shown that Pacific Island and Maori people tend to have flatter, wider feet that are better designed for dexterity while bare-foot.

“So the ‘one-size-fits-all’ philosophy does not necessarily work because everybody’s feet are different, and this has implications for learning how best to protect against injuries down the line,” he says.

For further information, contact

Marian Baxter
Tel +64 27 378 2757

Associate Professor Steve Milosavljevic
University of Otago
School of Physiotherapy
Tel +64 3 479 7193