{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:03:25Z","timestamp":1792649005192,"version":"4.5.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2006,12,1]],"date-time":"2006-12-01T00:00:00Z","timestamp":1164931200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Metatarsalgia is related to repetitive high-pressure loading under the metatarsal head (MH) that causes pain. The high pressure under the MH can be reduced by adequately applying metatarsal pads (MPs). Plantar pressure measurements may provide a method to objectively evaluate pressure loading under the MH. However, it is still unclear if the decrease in plantar pressure under the MH after MP treatment is associated with subjective improvement. This study aims to explore the correlations between subjective pain improvement and outcome rating, and the plantar pressure parameters in metatarsalgia patients treated using MPs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Thirteen patients (a total of 18 feet) with secondary metatarsalgia were included in this study. Teardrop-shaped MPs made of polyurethane foam were applied just proximal to the second MH by an experienced physiatrist. Insole plantar pressure was measured under the second MH before and after MP application. Visual analog scale (VAS) scores of pain were obtained from all subjects before and after 2 weeks of MP treatment. The subjects rated using four-point subjective outcome scales. The Wilcoxon signed-rank test was used to analyze the difference between the plantar pressure parameters and VAS scores before and after treatment. The Kruskal-Wallis test was applied to compare the plantar pressure parameters in each outcome group. Pearson's correlation was applied to analyze the correlation between the changes in plantar pressure parameters and VAS scores. Statistical significance was set as p &lt; 0.05.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>MP application decreased the maximal peak pressure (MPP) and pressure-time integral (PTI) under the second MH and also statistically improved subjective pain scores. However, neither the pre-treatment values of the MPP and PTI shift in the position of the MPP after treatment, nor the age, gender and body mass index (BMI) of the subjects were statistically correlated with subjective improvement. Declines in the PTI and MPP values after MP application were statistically correlated with the improvement in VAS scores (<jats:italic>r<\/jats:italic> = 0.77, <jats:italic>R<\/jats:italic>\n              <jats:sup>2<\/jats:sup> = 0.59, <jats:italic>p<\/jats:italic> &lt; 0.001; <jats:italic>r<\/jats:italic> = 0.60, <jats:italic>R<\/jats:italic>\n              <jats:sup>2<\/jats:sup> = 0.36, <jats:italic>p<\/jats:italic> = 0.009).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We found that the successful decline in the PTI and MPP under the second MH after MP application was correlated to subjective pain improvement. This study provides a strategy for the further design and application of MPs for metatarsalgia treatment.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2474-7-95","type":"journal-article","created":{"date-parts":[[2006,12,5]],"date-time":"2006-12-05T19:16:55Z","timestamp":1165346215000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["Correlations between subjective treatment responses and plantar pressure parameters of metatarsal pad treatment in metatarsalgia patients: a prospective study"],"prefix":"10.1186","volume":"7","author":[{"given":"Jiunn-Horng","family":"Kang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Der","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Ching","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Li","family":"Hsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2006,12,5]]},"reference":[{"key":"269_CR1","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1080\/00325481.1984.11697998","volume":"75","author":"RA Mann","year":"1984","unstructured":"Mann RA: Metatarsalgia. Common causes and conservative treatment. Postgrad Med. 1984, 75: 150-8. 163","journal-title":"Postgrad Med"},{"key":"269_CR2","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1097\/00002281-200003000-00007","volume":"12","author":"KK Wu","year":"2000","unstructured":"Wu KK: Morton neuroma and metatarsalgia. Curr Opin Rheumatol. 2000, 12: 131-142. 10.1097\/00002281-200003000-00007.","journal-title":"Curr Opin Rheumatol"},{"key":"269_CR3","first-page":"1","volume":"48","author":"RT Pyasta","year":"1999","unstructured":"Pyasta RT, Panush RS: Common painful foot syndromes. Bull Rheum Dis. 1999, 48: 1-4.","journal-title":"Bull Rheum Dis"},{"key":"269_CR4","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1055\/s-2002-32356","volume":"6","author":"JS Yu","year":"2002","unstructured":"Yu JS, Tanner JR: Considerations in metatarsalgia and midfoot pain: an MR imaging perspective. Semin Musculoskelet Radiol. 2002, 6: 91-104. 10.1055\/s-2002-32356.","journal-title":"Semin Musculoskelet Radiol"},{"key":"269_CR5","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3109\/03093649809164455","volume":"22","author":"K Postema","year":"1998","unstructured":"Postema K, Burm PE, Zande ME, Limbeek J: Primary metatarsalgia: the influence of a custom moulded insole and a rocker bar on plantar pressure. Prosthet Orthot Int. 1998, 22: 35-44.","journal-title":"Prosthet Orthot Int"},{"key":"269_CR6","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1177\/107110079001100304","volume":"11","author":"GB Holmes Jr","year":"1990","unstructured":"Holmes GB, Timmerman L: A quantitative assessment of the effect of metatarsal pads on plantar pressures. Foot Ankle. 1990, 11: 141-145.","journal-title":"Foot Ankle"},{"key":"269_CR7","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1177\/107110079401501008","volume":"15","author":"R Hayda","year":"1994","unstructured":"Hayda R, Tremaine MD, Tremaine K, Banco S, Teed K: Effect of metatarsal pads and their positioning: a quantitative assessment. Foot Ankle Int. 1994, 15: 561-566.","journal-title":"Foot Ankle Int"},{"key":"269_CR8","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1097\/01.phm.0000167680.70092.29","volume":"84","author":"WL Hsi","year":"2005","unstructured":"Hsi WL, Kang JH, Lee XX: Optimum position of metatarsal pad in metatarsalgia for pressure relief. Am J Phys Med Rehabil. 2005, 84: 514-520. 10.1097\/01.phm.0000167680.70092.29.","journal-title":"Am J Phys Med Rehabil"},{"key":"269_CR9","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1007\/s00132-005-0829-2","volume":"34","author":"H Stinus","year":"2005","unstructured":"Stinus H, Weber F: [Inserts for foot deformities]. Orthopade. 2005, 34: 776-778. 10.1007\/s00132-005-0829-2. 780\u2013781.","journal-title":"Orthopade"},{"key":"269_CR10","doi-asserted-by":"publisher","first-page":"239","DOI":"10.7547\/0940239","volume":"94","author":"L Jackson","year":"2004","unstructured":"Jackson L, Binning J, Potter J: Plantar pressures in rheumatoid arthritis using prefabricated metatarsal padding. J Am Podiatr Med Assoc. 2004, 94: 239-245.","journal-title":"J Am Podiatr Med Assoc"},{"key":"269_CR11","doi-asserted-by":"publisher","first-page":"73","DOI":"10.7547\/87507315-81-2-73","volume":"81","author":"K Rome","year":"1991","unstructured":"Rome K: A study of the properties of materials used in podiatry. J Am Podiatr Med Assoc. 1991, 81: 73-83.","journal-title":"J Am Podiatr Med Assoc"},{"key":"269_CR12","doi-asserted-by":"publisher","first-page":"418","DOI":"10.7547\/87507315-81-8-418","volume":"81","author":"G Lewis","year":"1991","unstructured":"Lewis G, Tan T, Shiue YS: Characterization of the performance of shoe insert materials. J Am Podiatr Med Assoc. 1991, 81: 418-424.","journal-title":"J Am Podiatr Med Assoc"},{"key":"269_CR13","first-page":"540","volume":"103","author":"WL Hsi","year":"2004","unstructured":"Hsi WL, Kang JH, Lai JS: Distribution of plantar pressure on the second metatarsal head during walking. J Formos Med Assoc. 2004, 103: 540-545.","journal-title":"J Formos Med Assoc"},{"key":"269_CR14","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/S0268-0033(99)00034-0","volume":"14","author":"MC Hodge","year":"1999","unstructured":"Hodge MC, Bach TM, Carter GM: novel Award First Prize Paper. Orthotic management of plantar pressure and pain in rheumatoid arthritis. Clin Biomech (Bristol, Avon). 1999, 14: 567-575. 10.1016\/S0268-0033(99)00034-0.","journal-title":"Clin Biomech (Bristol, Avon)"},{"key":"269_CR15","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1177\/107110079401501205","volume":"15","author":"AH Chang","year":"1994","unstructured":"Chang AH, bu-Faraj ZU, Harris GF, Nery J, Shereff MJ: Mult-istep measurement of plantar pressure alterations using metatarsal pads. Foot Ankle Int. 1994, 15: 654-660.","journal-title":"Foot Ankle Int"},{"key":"269_CR16","doi-asserted-by":"publisher","first-page":"328","DOI":"10.2519\/jospt.1995.21.6.318","volume":"21","author":"MJ Mueller","year":"1995","unstructured":"Mueller MJ: Use of an in-shoe pressure measurement system in the management of patients with neuropathic ulcers or metatarsalgia. J Orthop Sports Phys Ther. 1995, 21: 328-336.","journal-title":"J Orthop Sports Phys Ther"},{"key":"269_CR17","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1093\/brain\/99.1.123","volume":"99","author":"PW Nathan","year":"1976","unstructured":"Nathan PW: The gate-control theory of pain. A critical review. Brain. 1976, 99: 123-158.","journal-title":"Brain"},{"issue":"Suppl 2","key":"269_CR18","doi-asserted-by":"publisher","first-page":"58","DOI":"10.2106\/JBJS.E.01286","volume":"88","author":"JA DeLeo","year":"2006","unstructured":"DeLeo JA: Basic science of pain. J Bone Joint Surg Am. 2006, 88 (Suppl 2): 58-62. 10.2106\/JBJS.E.01286.","journal-title":"J Bone Joint Surg Am"},{"key":"269_CR19","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/S0894-1130(97)80062-2","volume":"10","author":"JD Greenspan","year":"1997","unstructured":"Greenspan JD: Nociceptors and the peripheral nervous system's role in pain. J Hand Ther. 1997, 10: 78-85.","journal-title":"J Hand Ther"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2474-7-95.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2474-7-95\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2474-7-95","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2474-7-95.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:33:05Z","timestamp":1630456385000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/1471-2474-7-95"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,12]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2006,12]]}},"alternative-id":["269"],"URL":"https:\/\/doi.org\/10.1186\/1471-2474-7-95","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,12]]},"assertion":[{"value":"25 July 2006","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 December 2006","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 December 2006","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"95"}}