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Effects of metatarsal domes on plantar pressures in older people with a history of forefoot pain

Karl B. Landorf, Claire A. Ackland, Daniel R. Bonanno, Hylton B. Menz and Saeed Forghany

Forefoot pain, defined as pain in the metatarsal head area, is common in older people and it can affect mobility, gait and balance.  Metatarsal domes are often used in clinical practise for the treatment of pressure-related forefoot pain but evidence of their effectiveness is limited. 

The aims of this study were to evaluate the effects of plantar pressures of metatarsal domes in different positions relative to the metatarsal heads.  Two brands of metatarsal domes were used, one made of a slightly harder material than the other (a shore hardness of 11 durometers vs 20 durometers). Both brands of dome were placed in three positions - 5mm proximal to the metatarsal heads, in-line with metatarsal heads or 5mm distal to metatarsal heads. 

Results showed both metatarsal domes provided a significant reduction in plantar pressure at the forefoot, with the greatest reduction observed when the dome was placed 5mm proximal to the metatarsal head.  The dome with less shore hardness appeared to be better than the harder dome material. 

In conclusion, the softer metatarsal dome could be cautiously recommended for use in the forefoot in a proximal position.

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