Search

Patients with lower lumbar stenosis and disc herniation report disability in standing and ambulation, despite normal neurological examination. The L5 and S1 nerve roots support the entire motor and sensory function of the foot, and their radiculopathy can affect foot loading during standing and walking. This has not been quantified before. To quantify alterations in static and dynamic foot pressure transfers in patients with lower lumbar nerve root compression, and document any beneficial effects of surgical decompression. Prospective, case-control study. Cases—Patients with unilateral radiculopathy (L5/S1) with normal neurology (n=50); Controls - Healthy volunteers (n=50). The volunteers and patients underwent pedobarographic analysis during standing (static) and walking (dynamic), and fifteen (12 dynamic and three static) parameters were documented. The patient's preoperative values were compared with that of the healthy volunteers. All the 50 patients underwent surgical decompression, and clinical outcome measures (VAS/ODI at 3 months) were documented. Pedobarographic analysis was repeated in the postoperative period (48 hours) and 3-month follow-up and compared with the preoperative scores. In healthy controls, the mean values of all 15 parameters were comparable between the right and the left side (p>.05). When compared to controls, the patients had significantly lower maximum foot loads (p=.01) and average foot loads (p=.05) on the affected side during walking indicating lesser load transmission, in the preoperative period. Within the affected foot, the load transfer was higher on the first metatarsal/ medial arch while significantly less on the lateral metatarsals (p=.04). The percentage load on whole foot and forefoot was significantly less on standing (p=.01). Significant improvements were noted in the postoperative period, especially in the maximum foot surface area (p=.01), maximum and average foot loads, and improved weight transfers on lateral arch and forefoot (p=.02). The load on whole foot increased significantly from 46.1%±5.5% (preoperative) to 48.1%±5.5% (postoperative) and 49.9%±3.3% at follow-up (p=.01). This is the first study using pedobarography to document altered foot pressure patterns during ambulation in patients with disc herniation and stenosis. Decreased load transfer, asymmetrical and unphysiological distribution of pressures on the affected foot were observed during weight bearing, which improved after surgical decompression. [ABSTRACT FROM AUTHOR]

In the dynamic world of fashion, high-heeled footwear is revered as a symbol of style, luxury and sophistication. Yet, beneath the facade of elegance of classy footwear lies the harsh reality of discomfort and pain. Thus, this study aims to investigate the influence of wearing high-heeled shoes on the sensation of pain across different body regions over a period of 6 h. It involved fifty female participants, all habitual wearers of high-heeled shoes, aged between 20 and 30 years. Each participant kept a record of their perceptions of pain and discomfort every hour for a total of 6 h using a 0–10 pain scale with 0 indicating no pain and 10 indicating severe pain. The findings reveal a progressive rise in pain throughout wear, with the most intense pain reported in the back, calcaneus, and metatarsals. The analysis shows that after approximately 3.5 h, participants experience significant increases in pain levels. However, the relationship between heel height and pain is not linear. It appears that a heel height of 7.5 cm is the threshold where overall body pain becomes significant. The study suggests that a duration of 3.5 h of wear and a heel height of 7.5 cm serve as critical points to decrease overall body pain. Moreover, beyond this heel height, knee pain diminishes compared to other body areas possibly due to the shift towards a more neutral posture. The study findings, coupled with the recommendations, can assist footwear designers in crafting not only stylish but also comfortable shoes. [ABSTRACT FROM AUTHOR]

Background: The correspondence between various aspects of human postural parameters and the spatial relation of the jaws is of increasing interest among scientists. Emerging research suggests that the stomatognathic system and posture play, in a broad sense, significant roles. Objectives: The aim of the study was to analyze the relationship between various malocclusion types and gait parameters, the distribution of foot pressure on the ground, and body balance. Methods: The study involved 155 patients aged 12-16. The subjects were divided into groups according to their malocclusion—Angle's class II (n = 32), Canine class II (n = 31), and Overbite (n = 46). The control group (n = 46) comprised children not demonstrating any defects. The study data were collected by direct observation of the oral cavity. Gait analysis was carried out using the Wiva® Science sensor, and the distribution of foot forces on the ground and body balance was determined via the E.P.S R/1 pedobarographic mat. The non-parametric Mann–Whitney U test was applied for statistical analysis. Results: Analysis of the results obtained showed statistically significant differences in left step duration (p = 0.042) and the duration of the right step (p = 0.021), as well as the projection of the body's center of gravity on the left foot (p = 0.027). Conclusions: Distoocclusion in the anterior part of the mandible may cause different positioning of the head and neck, as well as varying tension of the muscles, further leading to balance disorders while walking. [ABSTRACT FROM AUTHOR]

Background: The presence of hallux limitus in adulthood is frequently encountered in clinical practice, generating other biomechanical, structural, and functional compensations in dynamics secondary to blockage of the main pivot in the sagittal plane, the first metatarsophalangeal joint. In addition, the presence of functional hallux limitus (FHL) in school-age children is also increasing. Currently, there is a lack of scientific literature about this condition in the pediatric population, and early diagnosis is necessary to reduce future biomechanical disorders and avoid the development of foot arthritis. The purpose of this research was to identify static plantar pressures in school-age children with and without hallux limitus. Methods: A total sample of 106 children aged between six and twelve years old was divided into two groups: the case group (53 subjects with functional hallux limitus) and the control group (53 subjects without functional hallux limitus). Data were acquired with the participants in a standing barefoot position on the pressure platform, and the hallux limitus functional test was performed in a sitting position to classify the individuals into the determined study group. The variables analyzed in the research were: plantar pressure, bilateral forefoot and rearfoot surface area, bilateral forefoot and rearfoot ground reaction forces, bilateral forefoot and rearfoot distribution of body weight, total left and right surface area, maximum pressure of the left foot and right foot, medium pressure of the left foot and right foot, ground reaction forces of the left foot and right foot, and the weight of each foot. Results: Age was the only descriptive quantitative variable that showed a significant difference between the two study groups, with a p-value of 0.031. No statistically significant differences were found between groups in the bilateral forefoot and rearfoot surface area, ground reaction forces, distribution of body weight, or maximum and medium plantar pressure in the left and right foot. Conclusions: Changes in the location of the maximum pressure were observed, particularly in older participants with FHL, but these results were not significant. The findings of this study did not show significant differences between the static plantar pressures of school-age individuals with and without functional hallux limitus. [ABSTRACT FROM AUTHOR]

Identifying elderly individuals with locomotive syndrome is important to prevent disability in this population. Although screening tools for locomotive syndrome are available, these require time commitment and are limited by an individual's ability to complete questionnaires independently. To improve on this limitation, we developed a screening tool that uses information on the distribution of pressure on the plantar surface of the foot with an artificial intelligence (AI)-based decision system to identify patients with locomotor syndrome. Herein, we describe our AI-based system and evaluate its performance. This was a cross-sectional study of 409 participants (mean age, 73.5 years). A foot scan pressure system was used to record the planter pressure distribution during gait. In the image processing step, we developed a convolutional neural network (CNN) to return the logit of the probability of locomotive syndrome based on foot pressure images. In the logistic regression step of the AI model, we estimated the predictor coefficients, including age, sex, height, weight, and the output of the CNN, based on foot pressure images. The AI model improved the identification of locomotive syndrome among elderly individuals compared to clinical data, with an area under curve of 0.84 (95% confidence interval, 0.79–0.88) for the AI model compared to 0.80 (95% confidence interval, 0.75–0.85) for the clinical model. Including the footprint force distribution image significantly improved the prediction algorithm (the net reclassification improvement was 0.675 [95% confidence interval, 0.45–0.90] P < 0.01; the integrated discrimination improvement was 0.059 [95% confidence interval, 0.039–0.088] P < 0.01). The AI system, which includes force distribution over the plantar surface of the foot during gait, is an effective tool to screen for locomotive syndrome. [ABSTRACT FROM AUTHOR]

The number of incidents related to walking while using smartphones is rising. However, it is not clear how smartphone usage might affect a gait pattern in terms of the foot pressure, and this may address the mechanism leading to incidents while using smartphones. How do the characteristics of walking while using a smartphone affect foot pressure patterns? In this cross-sectional study, we recruited 40 healthy young participants and investigated the walking speed, step length, coefficient of variance of the walking cycle (CV), anteroposterior length of the center of pressure (COP) trajectory (%Long), partial foot pressure ratios (% partial foot pressure [%PFP]), and COP existence time (COPexT) under the following four conditions: normal walking, screen gazing, while using social networking services (SNS), and while using a cognitive application. Parameters were compared among the four conditions using a repeated-measures ANOVA. Further, according to the presence or absence of an incident history (e.g. stumbles, collisions), participants were divided into either the incident or non-incident group. Parameters were compared between the two groups using a two-way repeated-measures ANOVA. Under the SNS and cognitive application conditions, the walking speed, step length, %Long, %PFP, and COPexT in the heel were significantly lower, and the CV and %PFP in the metatarsal region were higher than those under normal walking or screen gazing. %PFP in the heel and metatarsal regions showed a significant group-by-condition interaction; the incident group had lower %PFP in the heel region and higher %PFP in the metatarsal region than the non-incident group. These findings indicate a trend of loading more pressure on the forefoot than on the heel. This pattern was markedly evident in individuals with a history of incidents related to the smartphone usage and may be one of the factors causing stumbles and collisions. • Effects of smartphone use on walking parameters and foot pressure were examined. • Dual-task walking with smartphone use increases CV of walking cycle significantly. • Trend of disproportionate load pressure on the forefoot was observed. • Cognitive load was greater on those with prior experience of related incidents. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the variables of foot pressure according to glycated hemoglobin level during walking in diabetic patients with pes rectus. The subjects of this study were 39 people (78 feet) in their 40s and 60s, and they were divided into 11 pre-diabetic patients (22 feet) and 14 diabetic patients (28 feet) based on glycated hemoglobin; 14 patients without diabetes (28 feet) was used as a control. Foot pressure was measured using the EMED-LE Measurement system. The sole of the foot was divided into 12 parts, each of which was analyzed for pressure, force, contact area, and grounding time. For statistics, nonparametric Kruskal–Wallis and Wilcoxon signed rank test were used. Prediabetic and diabetic patients had lower hindfoot and second and third metatarsal foot pressure but higher first and third toe pressure compared to those without diabetes. In addition, the maximum and minimum force were high in all parts of the sole, and the contact time was long, signifying strong downward force for a long duration. Measurement of foot pressure by parts allowed detailed analysis of abnormal foot pressure and is valuable as basic data for diagnosis, prediction, and treatment of diabetic foot. Based on these data, maximum and minimum pressure better explain the problem of plantar pressure distribution rather than mean maximum pressure. [ABSTRACT FROM AUTHOR]

Lack of stability during stance negatively impacts gait and motor function for children with unilateral cerebral palsy. Improving stability and balance are the focus for gait rehabilitation). The One-Leg-Standing-Test may give valuable information about motor function and stability of stance for patients with unilateral cerebral palsy. This study aimed to investigate the relationship between the One-Leg-Standing-Test and the gross-motor-function-measurement and single-limb support time. The study included 18 patients with unilateral cerebral palsy (age 11.08 [SD 2.84] years old). The One-Leg-Standing-Test and pedobarographic evaluation were performed. Sections D and E of the gross-motor-function-measurement were assessed, and in pedobarographic evaluation, the single-limb support time (the total duration of mid-stance and terminal-stance during walking) was calculated to describe stability during stance. For patients, the One-Leg-Standing-Test scores and single-limb support time values were lower on the affected side than on the unaffected side. The One-Leg-Standing-Test was correlated with single-limb support time (p =.02, r = 0.60) and section E (p <.01, r = 0.59) values. The One-Leg-Standing-Test was also correlated to total stance phase and section D. The One-Leg-Standing-Test gives valuable information about gross-motor-function but cannot be substituted for motor function tests. The single-limb support time value may be used to describe stability in stance during walking. [ABSTRACT FROM AUTHOR]

Purpose: To compare the clinical outcomes, rate of return to sports, postural control, and muscle strength between the arthroscopic and open modified Broström procedure for chronic lateral ankle instability (CLAI) patients.Methods: From September 2018 to April 2019, 70 patients diagnosed with CLAI were prospectively included with arthroscopic modified Broström procedure (n = 36) and open modified Broström procedure (n = 34). They were evaluated at five time points (preoperation and 3 months, 6 months, 1 year and 2 years postoperatively). The main results examined the rate of return to sports, American Orthopaedic Foot and Ankle Society Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS), centre of pressure (COP) excursion velocity, time to boundary (TTB), plantar pressure, isokinetic muscle strength and complications.Results: Compared with the open group, the arthroscopic group demonstrated a significantly shorter period of return to the preinjury sport (13.2 ± 2.4 weeks vs. 18.7 ± 3.1 weeks, P = 0.023) and a higher early sport ratio (80.6 vs. 61.8%, P = 0.011) combined with better FAAM sports and AOFAS at 3 months and 6 months postoperatively and VAS at 3 months postoperatively. In addition, better anterior-posterior postural control stability, less time to peak force under lateral hindfoot and better dorsiflexion strength were shown in the arthroscopic group at 6 months postoperatively. No significant difference was found in clinical scores, posture control or muscle strength at the 1- or 2-year follow-up between the two groups.Conclusions: Shorter period and higher rates of return to sport activities and better clinical scores, posture control and muscle strength were achieved in the arthroscopic group at 6 months postoperatively, and no clinical differences were found between arthroscopic and open modified Broström procedure 1 year or 2 years postoperatively. Arthroscopic modified Broström procedure is a reliable procedure for CLAI injuries with the demand for fast exercise recovery.Clinical Registration: ChiCTR1900023999.Level Of Evidence: II. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Pedobarography has been widely used in developed countries for few decades. However, in Malaysia it is still in its infancy. Studies showed that the normal values of pedobarography vary between races. To the best our knowledge there is no standard value available for Malaysian or Southeast Asia. This study is designed to measure the pressure values in the normal foot of Malays in Pahang, Malaysia and its difference between different gender and body mass index (BMI). MATERIALS AND METHODS: A total of 400 feet of adult Malay subjects with no existing diabetes mellitus, lower limb and spine pain or problem are measured using Emed-q100 pedobarography device. RESULTS: 226 (56.5%) were females. 44.5% were with normal BMI followed by overweight (31.5%), and obese (24%). The mean-maximum-peak pressure (MPP) is 509kPa (SD 167) with no significant difference among gender and BMI. Most (38.5%, n=154) of the peak pressure area (PPA) are observed in 1st metatarsal head and big toe region (1MH&T), followed by 2nd metatarsal head (2MH) (34.3%, n=137). In the normal BMI group, 48.3% were in 1MH&T region while in the overweight and obese groups, 42.1% and 43.8%, respectively were in 2MH. This difference is significant (x2(df=8) =36.963, p<0.001). There was no significant difference between PPA and gender. CONCLUSION: The MPP among Malays in this study was 509kPa(SD 167) and it is not affected by different genders or BMI. The PPA are most commonly fall on 1MH&T. There is a significant shift in the overweight and obese groups to the 2MHT. This finding can be used as initial reference for further studies, in Malaysia particularly. [ABSTRACT FROM AUTHOR]

Background: Isolated gastrocnemius tightness (IGT) has been suggested as an etiologic factor in mechanical disorders of the foot and ankle without a clear pathophysiological mechanism in the literature. We hypothesized that restricted ankle dorsiflexion inducing increased forefoot pressure in IGT patients could be this pathophysiological mechanism.Methods: Case/control experimental observational investigation. Forty lower limbs in 20 asymptomatic IGT patients were included and compared to controls. Quantitative gait analyses coupled with dynamic baropodometry were used for comparison between groups. The primary outcome was maximum ankle dorsiflexion during stance phase. Secondary outcomes were knee flexion and forefoot pressure.Results: Maximum ankle dorsiflexion and maximum forefoot pressure were similar between groups. Increased knee flexion was found in the asymptomatic IGT group.Conclusions: IGT induced compensatory knee flexion during stance phase, which probably prevents increased pressure on the forefoot by allowing ankle dorsiflexion.Level Of Evidence: Level IV, Case/control experimental observational investigation. [ABSTRACT FROM AUTHOR]

Plantar pressure refers to the interfacial contact pressure between the foot and the supporting surface during daily locomotor activities. Information derived from plantar pressure measures is essential in gait and posture research for diagnosing patho-mechanics associated with the musculoskeletal diseases. In particular, it is compulsory to reduce the abnormally high plantar pressure in people with diabetes for the prevention and treatment of foot ulcerations in this population. In this study, a portable biofeedback-based gait training device is developed to advocate able-bodied subjects to adopt different movement patterns in walking to manipulate the plantar pressure distribution under the foot. Through the simultaneous detection of the plantar pressure pattern and the kinematics of the lower extremity joints, it was revealed that the unloading effects for the plantar site in particular to the lateral forefoot subareas were more abundant through biofeedback-assisted gait alterations than the self-awareness control for gait adjustment. In addition, the corresponding relationship between joint coordination and pressure redistribution pattern was obtained, which could potentially be used in gait retraining interventions to correct abnormal plantar pressure patterns in people with diabetes. [ABSTRACT FROM AUTHOR]

Mobile rehabilitation systems for patients with gait disorder are being developed. Safety functions to prevent patients from falling are considered during product development; however, few studies have been conducted on systems that have been prevalidated for healthy adults prior to application to patients. This study analyzed the characteristics of lower extremity muscles and foot pressure in healthy adults during unbalanced walking with differences in the speed of left and right speed using a two-belt treadmill. Twenty subjects performed gait motions with a difference in the weight support conditions (0% and 30%) and the left and right lower limb speeds (1–3 km/h). Each subject’s muscular activities and foot pressure signals were collected. The gait patterns of the faster side exhibit similar characteristics to the paralyzed leg, and the slower side is similar to the non-paralyzed leg. Weight-supporting healthy subjects showed asymmetric gait patterns, similar to hemiplegic patients, because of the difference in the speed of the left and right side. The quantitative results can be used to develop a training protocol for two-belt treadmills with differently controlled left and right speeds for gait rehabilitation in hemiplegic patients. [ABSTRACT FROM AUTHOR]

Purpose: The ageing process can be accompanied by a degeneration of the spine and increase the risk of thoracic hyperkyphosis (excessive spinal forward curvature) amongst elderly people. This condition can in turn impair mobility, reduce balance, and increase the risk of falling and mortality in affected individuals. The use of corrective orthotic bracing has been shown to improve spinal posture, and increase stability and balance amongst the elderly. However, there is little evidence that evaluates the use of corrective braces on foot pressure changes in these subjects. Methods: In this study, we evaluated the use of a thoracolumbosacral orthosis (TLSO) on 19 subjects over 60 years old who presented with hyperkyphosis. We measured foot pressure using the Pedar-X system before (without brace) and after (with brace) immediate using a TLSO in both static (quite standing) and dynamic (walking on a 5 meters freeway) scenarios. Results: The results demonstrated that using a TLSO immediately decreases forefoot pressures in stasis, and around the first metatarsal, as well as pressures relating to the second to fifth metatarsals under dynamic conditions. Hindfoot pressures were increased, but not significantly. Conclusion: This study showed that using a TLSO can be beneficial for elderly people with hyperkyphosis. The ageing process can be accompanied by a degeneration of the spine and increase the risk of thoracic hyperkyphosis. The use of corrective orthotic bracing has been shown to improve spinal posture, and increase stability and balance amongst the elderly. Using a TLSO decreases forefoot pressures in stasis, and around the first metatarsal, as well as pressures relating to the second to fifth metatarsals under dynamic conditions. [ABSTRACT FROM AUTHOR]

The science of foot pressure studies the forces acting on the bottom and different regions of the foot along with the pressure exerted on the plantar surface with the interacting surface in contact. The information derived gave impact to human biomechanical assessment on body balance and ergonomics posture during gait. Various experiments designed at generating foot pressure data returns only with limited knowledge generated. Obviously, the procedure for experiment design needs to be properly understood from the foot morphology aspects; healthiness, footwear, surface in contact, load and forces impacts, and the foot sensitivity as well as the specification for the foot pressure. This paper reviews the proper preliminary experimental setups for foot pressure measurement analysis during static or dynamic gait. The strength and limitations of recent devices used and considerable variables are also discussed. The overall review explains that the comfortable natural gait in relation to the aspects of sensitivity, load, time duration, and stability are the standard considerations for plantar pressure experiments. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of insole slope on bone joint stress, foot bone stress, and foot pressure distribution by means of finite element (FE) methods. A three-dimensional (3D) FE model was reconstructed from computed tomography data using image processing and computer aided design software. A model of an insole placed under the foot skin in 3D FE model geometry was based on a Smile Feet insole. Four conditions for the analysis included one barefoot biomechanical analysis and three biomechanical analyses with 0-, 5-, and 10-degree insole slopes. In the barefoot analysis, high foot pressure was concentrated on the forefoot and heel regions. The insole redistributed the foot pressure to the mid-foot region and reduced stress at the intervertebral discs of L4-L5 and L5-S1, and at the hip joint. The slope of the in-sole resulted in changes in the stress exhibited in various joints and bones. Higher insole slopes tended to increase the stress, especially at the ankle joint and foot bones. [ABSTRACT FROM AUTHOR]

Arthroscopic cartilage regeneration facilitating procedure (ACRFP) has been reported with satisfactory results, yet there is limited research on the biomechanics in these patients. The purpose of this study is to assess the change on the biomechanics after ACRFP, in terms of foot pressure and gait pattern. Patients with chronic knee pain due to osteoarthritis and received ACRFP were recruited, and the knee joints in each patient were divided into either study or control group according to radiographical or symptomatic severity. Assessments were done with Knee injury and Osteoarthritis Outcome Score (KOOS) and dynamic foot pressure at the time before surgery, three months and six months postoperatively. A total of 24 patients completed the study. Significant improvement was found of KOOS, at both three and six months postoperatively. No much change in the gait parameters was noted, but there was a significant decrease of foot pressure over lateral side of hindfoot at six months postoperatively. In conclusion, significant clinical improvements could be achieved with surgical results of ACRFP, and shifting of the foot pressure medially may be related to decrease in the knee adduction moment, which is more favorable for the knee joints. [ABSTRACT FROM AUTHOR]

This survey clarified foot pressure patterns and hindfoot deformities in individuals with advanced knee osteoarthritis (OA) and analyzed their associations with foot pain. Sixty-four individuals with unilateral knee OA who underwent total knee arthroplasty (TKA) were divided into the following groups: no foot pain (n=26; men:women, 4:22; mean age, 73.7 years), foot pain resolved after TKA (12; 2:10; 75.8), and foot pain remaining after TKA (26; 4:22; 74.7). Elderly individuals without pain or deformity in either knee (54; 10:44; 74.3) were controls. Navicular height ratio of the medial longitudinal arch, leg-heel angle, and partial foot pressure as the percentage of body weight (%PFP) were calculated.%PFPs of the medial and lateral heel regions before TKA were significantly lower for the no foot pain group than for controls. One year after TKA, %PFP improved significantly. In the foot pain resolved group, before TKA, the leg-heel angle was significantly higher, and%PFPs of the medial and lateral heel regions and navicular height ratio before TKA were significantly lower than those of controls. One year after TKA, all parameters improved significantly. In the foot pain remaining group, similar abnormalities were observed before TKA; however, significant improvement was only observed for%PFP of the medial heel region 1year after TKA. More than half of the patients with advanced knee OA had foot pain. This improved in approximately one-third, 1year after TKA. Hindfoot deformities are probably associated with foot pain in individuals with advanced knee OA. [ABSTRACT FROM AUTHOR]

People suffering from locomotor impairment find turning manoeuvres more challenging than straight-ahead walking. Turning manoeuvres are estimated to comprise a substantial proportion of steps taken daily, yet research has predominantly focused on straight-line walking, meaning that the basic kinetic, kinematic and foot pressure adaptations required for turning are not as well understood. We investigated how healthy subjects adapt their locomotion patterns to accommodate walking along a gently curved trajectory (radius 2.75 m). Twenty healthy adult participants performed walking tasks at self-selected speeds along straight and curved pathways. For the first time for this mode of turning, plantar pressures were recorded using insole foot pressure sensors while participants’ movements were simultaneously tracked using marker-based 3D motion capture. During the steady-state strides at the apex of the turn, the mean operating point of the inside ankle shifted by 1 degree towards dorsiflexion and that for the outside ankle shifted towards plantarflexion. The largest change in relative joint angle range was an increase in hip rotation in the inside leg (>60%). In addition, the inside foot was subject to a prolonged stance phase and a 10% increase in vertical force in the posteromedial section of the foot compared to straight-line walking. Most of the mechanical change required was therefore generated by the inside leg with hip rotation being a major driver of the gentle turn. This study provides new insight into healthy gait during gentle turns and may help us to understand the mechanics behind some forms of impairment. [ABSTRACT FROM AUTHOR]

The characterization of activity patterns of overweight and obese (OW) children and adolescents is essential, and should be carried out before they join an exercise training programme and increase their physical activity in order to maintain or reduce body weight. The purpose of this study is to verify whether the biomechanical parameters characterizing frequently used walking and running speeds vary between OW and normal-weight (NW) children. Thirty-one prepubescent OW children (9.9 y ± 1.3) and 10 prepubescent NW children (9.9 y ± 1.2) participated in this study. All participants were evaluated for temporal parameters (e.g. cycle length, cycle time, stance phase time, double support phase time, etc.) and for foot pressure parameters (e.g. contact area, duration of contact, peak pressure, etc.) in six different foot areas, at three walking velocities, and two running velocities. A group effect (p< .05) was found for the peak pressure, duration of contact percentile, maximum force, foot pressure–time integral, cycle length, cycle time, stance phase time, double support phase time, relative stance phase, and relative double support phase, indicating that the OW children manifested significantly higher values compared with the NW children. Assessment of the movement characteristics of OW children indicated an elongation of gait parameters, such as step cycle and support stage, compared to NW children, in different walking and running speeds. These changes suggest that OW children develop different walking/running patterns with increased foot pressure, which may predispose them to foot pain and overuse injuries. [ABSTRACT FROM PUBLISHER]

This paper presents application of polyvinylidene fluoride (PVDF) foil for sensors of foot plantar pressure for measurements in natural conditions (i.e. outside laboratory). The material has been evaluated for this application based on investigation of material resistivity, current and activation energy of electret depolarization process, and relationship between pressure and electrical signal. The investigation shows that PVDF foils can operate at temperatures up to 85 °C, have high activation energy of 5.2 eV and a linear dependence between pressure and piezoelectric signal, which makes them suitable candidates for foot plantar pressure transducers. Influence of foil stretching is eliminated via a design of the shoe insole, which prevents deformations. Design of an input amplifier which eliminates pyroelectric effect is also presented. For applications in measuring foot plantar pressure, sensor calibration can be eliminated by placing several pressure sensors in the shoe insole and expressing pressure as relative values between sensors. The paper also describes a wireless system for measurement of foot plantar pressure, and obtained measurements. [ABSTRACT FROM AUTHOR]

This study investigated the feasibility of the Infrared (IR) sensor-based walking aids for detecting the gait intention. To compensate for the defects of Force Sensing Resistors (FSRs) or force sensors, such as the velocity control problem on gait slopes, we used IR sensors to investigate knee joint anterior displacement in order to recognize the gait intention. We also measure leg muscle activities and foot pressure, in order to verify our investigation. We placed two IR sensors on the rollator center to sense left and right leg walking intentions. We took EMG signals of four leg muscles, and analyzed them. Foot pressure analysis parameters were the measured force and mean pressure. We conducted experiments on twenty young healthy adults. The results show that knee joint anterior displacement increases according to gait slope and velocity. We confirm similar results of knee joint anterior displacement through the IR sensors. [ABSTRACT FROM AUTHOR]

Objective The aim of the present study was to examine the effect of gait training using obstacle on the plantar pressure and contact time in elderly women. Methods A total of 24 elderly women who were residing in communities in D city, South Korea aged 79.9 ± 2.2, 154.5 ± 7.6 cm in height, and 56.2 ± 5.2 kg in weight participated in this study. The participants conducted obstacle gait training for 8 weeks and foot contact time and foot pressure right before and after crossing the obstacle were measured for 3 times: before the intervention, at the 4 weeks, and 8 weeks using F-scan (Tekscan, USA). Results The results show that foot contact time did not decrease right before crossing the obstacle but decreased right after crossing the obstacle ( p < 0.05). Foot pressure moved from the end of the frontal foot to the midfoot (MF) and heel (HL) right before crossing the obstacle ( p < 0.05). Foot pressure increased in lesser toe (LT) right after crossing the obstacle ( p < 0.05). Conclusion These results indicate proper weight distribution in feet, increased foot stability due to increased muscle power and flexibility, and improved strategy to cope with the obstacle. The obstacle gait training may be helpful to the elderly who would either fear for or limit outdoor activities due to the risk of falls based on the result of this study. [ABSTRACT FROM AUTHOR]

The purpose of this study is to evaluate the therapeutic effect of total contact insole with forefoot medial posting (TCIFMP) orthosis in patients with flexible flatfoot. The TCIFMP insole was custom-mode, made from semi-rigid plastazote and PPT. Using the gait analysis and the plantar-pressure measure systems, we investigate rearfoot motion and plantar pressure redistribution in these patients. The results of this study showed that the excessive valgus movement of the rearfoot can be reduced significantly by the TCIFMP insole in these patients. Besides, there were significant decreases in the peak pressure under the toe, lateral metatarsal, lateral foot and heel areas. Therefore, we suggested that the TCIFMP insole is an effective orthotic device for rearfoot motion control, plantar pressure reduction and re-distribution in patients with flexible flatfoot. [ABSTRACT FROM AUTHOR]

Background Motion characteristics of CoP (Centre of Pressure, the point of application of the resultant ground reaction force acting on the plate) are useful for foot type characteristics detection. To date, only few studies have investigated the nonlinear characteristics of CoP velocity and acceleration during the stance phase. The aim of this study is to investigate whether CoP regularity is different among four foot types (normal foot, pes valgus, hallux valgus and pes cavus); this might be useful for classification and diagnosis of foot injuries and diseases. To meet this goal, sample entropy, a measure of time-series regularity, was used to quantify the CoP regularity of four foot types. Methods One hundred and sixty five subjects that had the same foot type bilaterally (48 subjects with healthy feet, 22 with pes valgus, 47 with hallux valgus, and 48 with pes cavus) were recruited for this study. A Footscan® system was used to collect CoP data when each subject walked at normal and steady speed. The velocity and acceleration in medial-lateral (ML) and anteriorposterior (AP) directions, and resultant velocity and acceleration were derived from CoP. The sample entropy is the negative natural logarithm of the conditional probability that a subseries of length m that matches pointwise within a tolerance r also matches at the next point. This was used to quantify variables of CoP velocity and acceleration of four foot types. The parameters r (the tolerance) and m (the matching length) for sample entropy calculation have been determined by an optimal method. Results It has been found that in order to analyze all CoP parameters of velocity and acceleration during the stance phase of walking gait, for each variable there is a different optimal r value. On the contrary, the value m=4 is optimal for all variables. Sample entropies of both velocity and acceleration in AP direction were highly correlated with their corresponding resultant variables for r>0.91. The sample entropy of the velocity in AP direction was moderately correlated with the one of the acceleration in the same direction (r⩾0.673), as well as with the resultant acceleration (r⩾0.660). The sample entropy of resultant velocity was moderately correlated with the one of the acceleration in AP direction, as well as with the resultant acceleration (for the both r⩾0.689). Moderate correlations were found between variables for the left foot and their corresponding variables for the right foot. Sample entropies of AP velocity, resultant velocity, AP acceleration, and resultant acceleration of the right foot as well as AP velocity and resultant velocity of the left foot were, respectively, significantly different among the four foot types. Conclusions It can be concluded that the sample entropy of AP velocity (or the resultant velocity) of the left foot, ML velocity, resultant velocity, ML acceleration and resultant acceleration could serve for evaluation of foot types or selection of appropriate footwear. [ABSTRACT FROM AUTHOR]

Background: Ill-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort. Studies on footwear have primarily examined sports or orthopaedic prescription shoes and little is known about the effects that everyday flat shoes have on the forefoot. The aim of this study was to investigate the effect of toe box shape in a popular slip-on pump on dorsal and plantar pressures with particular interest around the forefoot in a healthy female population. Method: A convenience sample of 27 female participants with no known foot pathologies was recruited. After assessment of foot size, plantar foot pressure and interdigital pressures were recorded for each of the 3 different toe box styles; round, square and pointed. Participants walked at a self-selected speed over a 10 m walkway whilst wearing each of the 3 styles of shoe and also whilst barefoot. Processed and analysed data extracted included peak pressure, time to peak pressure, contact time and pressure time integral. ANOVA and Freidman analysis was used to test for statistical significance. Results: Shoes with a round toe showed least pressure around the medial aspect of the toes whilst the pointed shoe had least pressure on the lateral toes. Contact times for the plantar regions were not altered in any shoe condition yet contact around the medial aspect of the toes was highest in the pointed shoe. Conclusion: This study highlights that the shape of the toe box in footwear can significantly influence the amount of pressure applied to the forefoot. Furthermore, the contours of the shoe also have an impact on the contact time and pressure time integral around the forefoot and also the peak plantar pressure in the toe region. The changes observed could be significant in the development of pathology in certain footwear toe box shapes. Consideration should be given to footwear design around the toe box to improve fit and reduce pressure. Further work is required to investigate the effect of toe box shape and volume on a pathological population with pressure related lesions. [ABSTRACT FROM AUTHOR]

An intense program of physical activity, typical of elite athletes, results in a series of modifications of the posture that in a short period of time can have a negative impact on both their health and performance. These negative effects can be prevented and corrected by an integrated approach that encompasses anthropometry and posture evaluation. The aim of this study is the assessment of the anthropometric and postural parameters of elite athletes of different sports specialities to identify discipline(s) potentially associated with unbalanced postural attitudes. Height, weight, body mass index, stabilometric analysis, foot load, and center of pressure distribution were evaluated to identify which parameters are mainly correlated with postural aspects in professional athletes compared to amateur, age-matched subjects. We found a permanently unbalanced postural attitude in rugby players, skiers, and judokas, which are not, by definition, asymmetric sport disciplines. On the contrary, motorcyclists showed an overall balanced load distribution, probably due to the absence of any special performance required from lower limbs, potentially forcing a specific postural shape. This data is the basis to identify anthropometric and postural parameters mostly modified in different sport disciplines, which need to be always monitored to counteract the establishment of sport-specific imbalances. [ABSTRACT FROM AUTHOR]

Recognizing individuals by their gait is a new biometric methodology, which employs dynamic features derived from tracking gait. Instead of the image processing techniques used in most existing studies, our previous study initialized the work of investigating gait recognition in terms of biomechanics. The experimental results showed that the angles and forces of the lower limb joints were reliable features for recognition of individuals, which can provide us with a considerable amount of information in the field of computer science and thus help in developing a more efficient recognition method, which is also more computationally efficient than current image processing methods. Encouraged by the early results, in this study, we proposed a people recognition method based on plantar pressure patterns, which can be used in a concealed manner. We hoped to prove the feasibility of using foot pressure for individual recognition. Two different plantar pressure parameter measurement schemes are discussed: (1) the characteristic parameters and (2) the pressure values of each sensor cell in each frame. The self-organizing map (SOM) neuron network algorithm was used in both schemes for data classification. In order to improve the recognition rate, a support vector machine (SVM) was used as the data classification algorithm for the all-sensor-values method. High recognition rates were achieved with the second method, i.e., using all the sensor cell values of the foot pressure pattern during walking, regardless of the algorithm used. It is suggested that the foot pressure distribution of gait is a suitable feature for gait recognition. Both SOM and SVM can be feasible classifiers for foot pressure-based features. [ABSTRACT FROM AUTHOR]

This study compares the changes in pathway and center of gravity (COG) on the calcaneus of non-involved and involved sides according to eccentric and concentric strengthening in patients with unilateral Achilles tendinopathy. The goal was to define the biomechanical changes according to eccentric strengthening for the development of clinical guidelines. Eighteen patients with Achilles tendinopathy were recruited at the K Rehabilitation Hospital in Seoul. The subjects were instructed to perform 5 sessions of concentric strengthening. The calcaneal pathway was measured using a three-dimensional (3D) motion analyzer, and COG was measured by a force plate. Subsequently, eccentric strengthening was implemented, and identical variables were measured. Concentric and eccentric strengthening was carried out on both the involved and non-involved sides. There was no significant difference in the calcaneal pathway in patients with Achilles tendinopathy during concentric and eccentric strengthening. However, during eccentric strengthening, the calcaneal pathway significantly increased on the involved side compared to the non-involved side for all variables excluding the z-axis. COG significantly decreased on the involved side when compared to the non-involved side in patients with Achilles tendinopathy during eccentric and concentric strengthening. During concentric strengthening, all variables of the COG significantly increased on the involved side compared to the non-involved side. Compared with eccentric strengthening, concentric strengthening decreased the stability of ankle joints and increased the movement distance of the calcaneus in patients with Achilles tendinopathy. Furthermore, eccentric strengthening was verified to be an effective exercise method for prevention of Achilles tendinopathy through the reduction of forward and backward path length of foot pressure. The regular application of eccentric strengthening was found to be effective in the secondary prevention of Achilles tendinopathy in a clinical setting. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate how acute pain changes the postural control and stability during quiet standing and after unexpected perturbations. Methods: Nine subjects stood as quiet as possible on a movable force platform that recorded the centre of pressure position and provided unexpected floor perturbations, before, during and after experimental calf muscle pain. Bilateral surface electromyography from the tibialis anterior and medial gastrocnemius muscles was recorded. The foot pressure distributions were measured using pressure insoles. Intramuscular injections of hypertonic saline were administrated (right leg) to induce acute pain in the tibialis anterior and/or medial gastrocnemius muscles, and an isotonic injection was used as control. Findings: Simultaneous pain in tibialis anterior and medial gastrocnemius altered the postural control. During quiet standing: higher medial-lateral centre of pressure speed and increased total sway displacement (P <0.05), weight moved to the non-painful side, (P <0.05) and plantar centre of pressure of the left foot was shifted towards the heel’s direction (P <0.05). During forward perturbation: higher mean displacement in the medial-lateral direction (P <0.05). After the perturbation: larger sway area (P <0.05). Pain only in the medial gastrocnemius muscle increased medial-lateral centre of pressure speed (P <0.05) during the quiet standing. Pain only in the tibialis anterior muscle increased peak pressure on the contralateral foot (P <0.05). Interpretation: These findings suggest that large acute painful areas on the calf muscles impair the postural control and potentially increase the risk factors for falls. Further strategies aiming to reduce pain in patients may lead to improvement in balance. [Copyright &y& Elsevier]

Abstract: Background: The Pedar-X® is one of the newer versions of in-shoe pressure measuring devices and the current study aimed to assess the repeatability of this device. Methods: Twenty-seven healthy male volunteers were recruited and requested to walk on a 26-feet walkway wearing appropriate sized standardised off-the-shelf neutral running shoes (Donnay® International). The Pedar-X® insole was sandwiched between the foot and the shoe. Data were collected on two occasions, one week apart. Clinically relevant parameters studied were contact area, contact time in percentage roll over process, maximum force, pressure–time integral, force–time integral, peak pressure, mean force and mean area. Results: Repeatability was analysed using the coefficient of variation. Of the 160 parameters considered, 93.1% revealed a coefficient of variation value of less than 25. Heel and the metatarsal head areas were the most repeatable. Conclusion: The Pedar-X® in-shoe pressure measuring system is repeatable and as such can be used as a valuable tool in the assessment of in-shoe plantar pressure distribution. [Copyright &y& Elsevier]

Context: The relationship between generalized joint laxity and plantar pressure distribution of the foot and the potential implications for lower extremity injury have not been studied. Objective: To determine the relationship between generalized joint laxity and dynamic plantar pressure distribution. We hypothesized that individuals with greater generalized joint laxity, or hypermobility, would have greater dynamic medial midfoot pressure and loading during walking than nonhypermobile individuals. Design: Case control. Setting: Institutional biomechanics laboratory. Patients or Other Participants: Participants included 112 female soccer players between 11 and 21 years of age. Main Outcome Measure(s): Each participant was tested for generalized joint laxity using the Beighton and Horan Joint Mobility Index (BHJMI; range, 0-9) and was categorized as having either high (BHJMI score ⩾4) or low (BHJMI score <4) generalized joint laxity. Peak pressure and maximum force were calculated from a dynamic, barefoot plantar pressure distribution system. Results: Peak pressure and maximum force were greater in the 27 participants categorized as having high generalized joint laxity than in the 85 participants categorized as having low generalized joint laxity. The midfoot region exhibited greater loading in participants with high generalized joint laxity than in the other participants. We found an effect of BHJMI classification in the medial midfoot; peak pressure in the dominant (F1109 = 11.262, P = .001) and nondominant (F1109 = 14.32, P < .001) sides and maximum force in the dominant (F1109 = 7.88, P = .006) and nondominant (F1109 = 9.18, P = .003) sides were greater in the high generalized joint laxity group than in the low generalized joint laxity group. Conclusions: Athletes classified as having high generalized joint laxity demonstrated increased midfoot loading. Delineation of risk factors for medial collapse of the foot, which include hypermobility in athletes, may help clinicians evaluate and prevent lower extremity injury with treatments, such as orthoses. [ABSTRACT FROM AUTHOR]

Insole pressure systems are often more appropriate than force platforms for analysing center of pressure (CoP) as they are more flexible in use and indicate the position of the CoP that characterizes the contact foot/shoe during gait with shoes. However, these systems are typically not synchronized with 3D motion analysis systems. The present paper proposes a direct method that does not require a force platform for synchronizing an insole pressure system with a 3D motion analysis system. The distance separating 24 different CoPs measured optically and their equivalents measured by the insoles and transformed in the global coordinate system did not exceed 2 mm, confirming the suitability of the method proposed. Additionally, during static single limb stance, distances smaller than 7 mm and correlations higher than 0.94 were found between CoP trajectories measured with insoles and force platforms. Similar measurements were performed during gait to illustrate the characteristics of the CoP measured with each system. The distance separating the two CoPs was below 19 mm and the coefficient of correlation above 0.86. The proposed method offers the possibility to conduct new experiments, such as the investigation of proprioception in climbing stairs or in the presence of obstacles. [ABSTRACT FROM AUTHOR]

Abstract: Relapse may occur in severe clubfeet deformities whether treated surgically or nonsurgically. In this study, we evaluate the results of correction of residual and recurrent congenital clubfoot using soft tissue distraction or osteotomy using the Ilizarov external fixation system. This study included 35 feet in 28 patients who were treated between 1999 and 2007. Of these 16 feet in 13 patients with an average age of 13.7 years (range from 11 to 29 years) were treated by percutaneous calcaneal V-osteotomy and gradual correction by the Ilizarov method. Nineteen feet in 15 patients with an average age 10.5 years (range from 4 to 22 years) were treated by soft tissue distraction by the Ilizarov technique. The mean average follow up period was 5.6 years (range from 1 to 8 years). At the time of fixator removal, a plantigrade foot was achieved in 30 feet. Mild residual varus and equinus deformities were present in five feet. At the final follow foot pressure measurement showed recurrent or residual deformity in 10 feet (7 treated by osteotomy and 3 treated by soft tissue distraction). Recurrence may occur with both techniques, depending on many factors such as bone morphology, the number of the pervious operations and the degree of stiffness of the foot prior to the operation. [Copyright &y& Elsevier]

Abstract: Purpose: Foot deformity is a well-recognised impairment in patients with rheumatoid arthritis (RA) which results in functional disability. Deformity can occur at the rearfoot, midfoot, forefoot or in combination and the impact that site-specific foot deformities has on functional disability is largely unknown. The aim of this study was to describe the clinical and biomechanical characteristics of patients with severe rearfoot, forefoot or combined deformities and determine localised disease impact. Methods: Twenty-eight RA patients with severe forefoot (FF group n =12), rearfoot (RF group n =10) or combined deformities (COMB group n =6) were recruited. Each patient underwent 3D gait analysis and plantar pressure measurements. Localised disease impact and foot-specific disease activity were determined using the Leeds Foot Impact Scale and clinical examination respectively. Comparison was made against a normative control group (n =53). Results: Patients in the COMB group walked slowest and the double-support time was longer in the RF and COMB groups compared to those in the FF group. Patients in the RF and COMB group had higher levels of foot-related disability and demonstrated excessive rearfoot eversion and midfoot collapse compared to those in the FF group. Forefoot deformity was associated with reduced toe contact, high forefoot pressures and delayed heel lift. Conclusions: Abnormal gait patterns were identified and were distinguishable among those patients with predominantly forefoot, rearfoot or combined foot deformity. [Copyright &y& Elsevier]

Abstract: In order to establish the clinical utility of pedobarography in the treatment of childhood foot pathology, a reliable set of pedobarograph data describing non-pathologic feet is required. The purpose of this study was to describe the pedobarographic profiles of normal children across all ages, with specific focus on young children and explore age-related differences in foot pressure patterns. The Tekscan HR Mat™ pressure measurement system was used in a protocol involving a dynamic test at self-selected speed and walking pattern of 146 normal children (age range 1.6–14.9 years). Relative force and timing data were obtained across five foot segments (heel, lateral midfoot, medial midfoot, lateral forefoot, and medial forefoot). Analysis of variance (ANOVA) techniques were applied to determine if there were any age-related differences in foot pressure profiles in children across four a priori pedobarograph variables: % of stance at initiation at the heel, % of stance at initiation at the medial midfoot, maximum % force at the heel, maximum % force at the medial midfoot. Differences in foot pressure profiles were distinguished across three age groups: (1) Group 1: <2 years; (2) Group 2: 2–5 years; and (3) Group 3: >5 years. Age-related differences in initiation patterns, force transmission, and the amount of time spent on each foot segment provide evidence for maturation of children''s foot pressure profiles from a flatfoot pattern in the young child to a curvilinear pattern in the older child. [Copyright &y& Elsevier]

Aim The aim of the study was to determine whether areas of the diabetic foot that experience high pressures during normal activity also demonstrate reductions in cutaneous microvascular flow and/or endothelial function. Methods Sixteen patients with diabetes mellitus and eight healthy, age-matched control subjects were recruited. Maps of dynamic pressure on the plantar aspect of both feet were recorded during a normal gait cycle, and the skin microvascular blood flow response to the endothelium-dependent vasodilator acetylcholine was assessed at the sites of highest and lowest plantar pressure over the metatarsal heads. Results Patients with diabetes had higher plantar pressures than control subjects ( P = 0.002), but there were no significant differences in basal skin blood flow or acetylcholine response between the groups. In the patients, baseline flow was increased ( P = 0.041) but the acetylcholine response reduced ( P = 0.03) at the high-pressure compared with the low-pressure site; this was most apparent in those who were particularly at risk of ulceration due to high plantar pressures. Conclusions Chronically raised plantar pressure in the diabetic foot is associated with increased basal skin blood flow, compared with lower pressure areas on the same foot. Further work is required to determine whether, and under what conditions, this additional hyperaemia is protective or maladaptive. In addition, high-pressure areas have a reduced responsiveness to an endothelium-dependent vasodilator, although the clinical significance of these changes is not clear. [ABSTRACT FROM AUTHOR]

After analysis of the advantages and disadvantages of each existing system, we propose a homemade shoe with an “instrumented sole”. This sole contains several holes designed to receive force transducers. Each homemade transducer is composed of one dynamometric ring and one strain gauge. When defined forces are exerted on each transducer separately, the responses are very linear and the absolute error is less than 2%. This instrumented shoe is a robust tool to assess the instantaneous vertical forces and plantar pressures exerted during gait over a great number of steps. [Copyright &y& Elsevier]

To analyze the effect of lower-limb rotation on foot pressure distribution, 16 patients (23 feet) with neuromuscular diseases who received derotation osteotomy of lower limbs without concomitant foot–ankle procedures were included in this retrospective study. The cross-correlation analysis showed that the interval change of the foot progression angle was correlated with the interval change of the medial–lateral foot pressure impulse distribution. The externally rotated foot progression angle tends to introduce higher loading on the medial foot, and the internally rotated foot progression angle shifts the loading to lateral side of the foot. This study provides evidence that the rotational profile of the lower limb has a substantial impact on foot pressure distribution. [Copyright &y& Elsevier]

Aim: To investigate the association of limited joint mobility (LJM) and plantar foot pressure in Asian Indian diabetic subjects. Subjects and methods: The LJM and plantar pressure were measured in 345 consecutive subjects attending the foot clinic. The study groups were: Control—non-diabetic controls (n=50), DM—diabetic patients without neuropathy (n=100), DM+N—diabetic neuropaths (n=110) and DM+NU—diabetic neuropaths with past history of foot ulceration (n=85). Joint mobility was assessed using a goniometer. Plantar pressure was measured using the RS-Scan platform system. All subjects were able to walk comfortably unaided at their own pace. Data obtained on the metatarsal heads were used for analysis. Neuropathy status was assessed using the biothesiometer. Results: The diabetic patients had higher prevalence of LJM and higher plantar pressure than control subjects (P<0.0001). Among the diabetic patients, those with neuropathy and history of plantar ulceration had higher LJM and plantar pressure compared to non-neuropaths (P<0.001). Conclusions: Both LJM and high plantar pressure appear to be important determinants of foot ulceration in susceptible neuropathic South Indian diabetic patients. [Copyright &y& Elsevier]

Summary The aim was to study the outcome of the two most common foot problems in children—i.e. pes adductus (PA) and pes planus (PP)—at the end of the growth period. From one age group of 4039 preschool children, 81 were referred for PA and 65 for PP. The criterion for inclusion was that the referral diagnosis had been confirmed by an orthopaedist. At the age of 16, 50 of these children were evaluated by dynamic foot pressure registration (EMED), lower extremity alignment and a questionnaire concerning pain and physical activity. Additional information was collected from the medical records and questionnaires from 23 subjects. The results showed that at the age of 16 peak plantar pressure did not differ between the two diagnoses but those in the PA group walked with the centre of pressure progressively more inwardly rotated than those in the PP group. In the forefoot, peak pressure was greatest under the second and third metatarsal heads. At the age of 16 occasional pain in the lower extremity was very frequent but not associated with type of initial foot deformity, sex, physical activity or body weight. All children except two considered their feet to be normal at the end of the growth period. [ABSTRACT FROM AUTHOR]

Plantar pressure, the pressure exerted between the sole and the supporting surface, has great potentialities in various research fields, including footwear design, biometrics, gait analysis and the assessment of patients with diabetes. This research designs an optical-based foot plantar pressure measurement system aimed for human postural control and person identification. The proposed system consists of digital cameras installed underneath an acrylic plate covered by glossy white paper and mounted with LED strips along the side of the plate. When the light is emitted from the LED stripes, it deflects the digital cameras due to the pressure exerted between the glossy white paper and the acrylic plate. In this way, the cameras generate color-coded plantar pressure images of the subject standing on the acrylic-top platform. Our proposed system performs personal identification and postural control by extracting static and dynamic features from the generated plantar pressure images. Plantar pressure images were collected from 90 individuals (40 males, 50 females) to develop and evaluate the proposed system. In posture balance evaluation, we propose the use of a posture balance index that contains both magnitude and directional information about human posture balance control. For person identification, the experimental results show that our proposed system can achieve promising results, showing an area under the receiver operating characteristic (ROC) curve of 0.98515 (98.515%), an equal error rate (EER) of 5.8687%, and efficiency of 98.515%. [ABSTRACT FROM AUTHOR]

The present study aimed to elucidate the effects of heel lifts on spinal alignment, walking, and foot pressure pattern in elderly individuals with spinal kyphosis. The spinal alignment, walking speed, step length and foot pressure of 33 community-dwelling elderly individuals with spinal kyphosis (3 men, 30 women; mean age 77.3 years) were examined before and after the application of 10-mm moderately elastic heel lifts. Spinal alignment of total inclination (mean value 6.9°vs 4.5°) and thoracic angle (43.6°vs 36.2°) were significantly lower after the application of heel lifts than before the application. The lumbar angle (7.3°vs 10.0°) was significantly higher after the application than before the application. Walking speed (0.78 vs 0.88 m/s) and step length (0.42 m vs 0.45 m) were significantly higher after the application. The partial foot pressure as a percentage of body weight of the hallux (6.7% vs 9.0%) and lateral toes (6.5% vs 9.0%) was significantly higher after the application of heel lifts than before the application. The partial foot pressure as a percentage of body weight of the heel (68.9% vs 57.5%) was significantly lower after the application than before the application. In conclusion, heel lifts influenced the sagittal spinal alignment of elderly individuals. Walking speed and step length increased after the application of these devices. Increase in foot pressure in the hallux and lateral toe areas was probably related to these improvements in walking parameters. • Effects of 10-mm heel lifts on spinal kyphosis were investigated. • The devices improved the spinal total inclination, and thoracic and lumbar angles. • Walking speed and step length immediately improved after their application. • Foot pressure in the hallux and lateral toe areas increased after the application. • Heel lifts are easy and effective for elderly individuals with spinal kyphosis. [ABSTRACT FROM AUTHOR]

Background: Muscle weakness is an important etiological factor in plantar fasciitis (PF), but available data on the role of the quadriceps, hamstring, and gastrocnemius (GCM) muscles are limited. The aim of this study was to compare the strength and reaction time of the quadriceps, hamstring, and GCM muscles and foot pressure between patients with PF and normal controls.Methods: A total of 21 PF patients and 21 normal controls were enrolled. Muscle strength was measured by the peak torque per body weight (Nmkg- 1 × 100). Muscle reaction time was evaluated by the acceleration time (AT, milliseconds). Foot pressure and posture were assessed by pedobarography [valgus/varus index (VV index), %].Results: The strength of the quadriceps was significantly lower in the affected ankles of the PF group than in the control group (p = 0.005). The AT of the quadriceps and hamstring muscles was significantly increased in the affected ankles of the PF group than in the control group (quadriceps: p = 0.012, hamstring: p = 0.001), while the AT of the GCM muscle was significantly decreased (p = 0.009) and significantly correlated negatively with quadriceps muscle strength (r = -.598, p = 0.004) and AT (r = -.472, p = 0.031). Forefoot (p = 0.001) and hindfoot (p = 0.000) pressure were significantly greater, with the VV index showing hindfoot valgus, in the affected ankles in the PF group compared to the control group (p = 0.039).Conclusions: This study demonstrated weakness and delayed reaction time of the quadriceps and hamstring muscles, with a rapid reaction time of the GCM muscle, in patients with PF.Clinical Relevance: Clinicians and therapists should assess the function of the quadriceps and hamstring muscles when planning the management of PF patients without muscle tightness. [ABSTRACT FROM AUTHOR]

Abstract: A common plantar pressure analysis technique requires dividing the pressure distribution into regions based on key landmarks of the foot. Typically, this is done using visual inspection of the footprint and is subject to error when there is abnormal foot contact. A novel, robust method of synchronizing motion capture and plantar pressure data was created that allows for motion capture markers to be projected onto the plantar pressure mat for accurate subdivision of the foot. Validation studies showed that spatial synchronization of the plantar pressure and motion capture systems was determined to be accurate within 1 sensel. [Copyright &y& Elsevier]

Yang, W.B.; Yang, Z., and Dong, J.Y., 2020. The study of correlation between genu anklebone varus angle and plantar pressure. In: Guido Aldana, P.A. and Kantamaneni, K. (eds.), Advances in Water Resources, Coastal Management, and Marine Science Technology. Journal of Coastal Research, Special Issue No. 104, pp. 972–977. Coconut Creek (Florida), ISSN 0749-0208. In this paper, data acquisition is carried out with the help of Codamotion three-dimensional motion capture system and footscan plantar pressure acquisition system. The lower limb posture characteristics and plantar pressure data of subjects walking at different walking speeds of slow, medium and fast speed are collected and analyzed. Spearman correlation analysis method is used to analyze the correlation of the pressure knee and ankle joint valgus angle in ten areas of the sole of the foot in the process of walking, to judge whether there is a correlation between the characteristics and analyze the strength of the correlation. Through the analysis, in the process of walking, there is a good correlation between the knee varus angle and the pressure of the first metatarsal area, the second metatarsal area, the third metatarsal area, and the ankle varus angle and the pressure of the fourth metatarsal area, the fifth metatarsal area. Secondly, there is a certain correlation between the varus angle of the knee and ankle and the pressure of the thumb area, and the pressure of the heel inside and outside, while the correlation between the varus angle of the knee and ankle is poor. The correlation coefficients between the pressure of the first metatarsal area and the angle of the ankle varus, the third metatarsal area and the angle of the knee and ankle varus, the fifth metatarsal area and the angle of the ankle varus are small when the speed increases or decreases. Speed has little effect on the correlation between these features. The correlation coefficients of thumb area pressure and genu varus angle, second metatarsal area pressure and genu varus angle, fifth metatarsal area pressure and genu varus angle are different when the speed increases or decreases. Speed has a great influence on the correlation between these features. [ABSTRACT FROM AUTHOR]