One aspect of our research describes and explains how specific foot and knee structures (e.g. ligaments, bone structures, muscles and tendons) contribute to foot and knee function during walking, running and other important weight bearing tasks (e.g. sport). This includes how the size and form of foot and leg muscles relate to foot type, and how ACL injury relates to landing and jumping tasks. Other work has been concerned with mechanical properties of tendons and plantar fat pads. We are continuing work on how children’s feet develop.
How the foot and knee change their function due to disease, injury and aging is a prerequisite for the development and implementation of effective therapies. We have investigated changes in foot structure and function in people with diabetes, in stroke and in older people plus foot shape in those who are obese. We have also completed multiple studies evaluating the forces acting on the foot and knee in knee arthritis and patello femoral pain and how screening for certain biomechanical and clinical attributes could reduce injury and re-injury. A new focus is on the effect of lateral ankle sprains on ankle structures and function.
Developing and implementing quality interventions requires that we understand the mechanism of action of any intervention, so that its design and implementation is optimised. We have used biomechanical analysis to support improvements in footwear and foot orthotic design for people with diabetes, intermittent claudication, and general musculoskeletal disorders of the foot and knee (including in the workplace). In cases of knee arthritis work has focussed on evaluation of exercise, knee braces and foot orthoses, in terms of how these affect the joints, but also how patients’ lives are improved by the interventions (e.g. activity monitoring).
Throughout all this research a growing theme is the voice of patients and application of qualitative methods to investigate health beliefs, behaviours and how interventions might better reflect patient perspectives. This includes work with patients on their understanding of foot health issues in specific diseases, their approach to use of footwear and orthoses, and how parents develop knowledge related to children’s foot health. We have worked directly with clinicians and the NHS to allow first hand insight to inform our research activities and the development of devices (such as orthoses). We are increasing looking at how digital technologies offer new opportunities for clinicians and services.
The research is supported by a wide range of NHS, clinical and industry partners. This includes East Lancashire NHS, Wrightington, Wigan and Leigh NHS, Salfordinsole Ltd, Toffeln Footwear Ltd, and FDM Digital Solutions Ltd.
Recently, the research has expanded out of the University to run projects within the National Institute for Health Research Clinical research Facility in Manchester and the new Manchester Institute of Health and Performance (www.mihp.co.uk). The MIHP is a strategic development alongside Manchester City Council, Sport England and Manchester City Football Group, and is being led by Professor Richard Jones.The research is supported by active international collaborations including multiple partners across the EU, USA, Brazil and Australia.