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[Abstract] Abstract: 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.

Introduction: Many occupations require prolonged standing during exercise, which is one of the most important causes of musculoskeletal disorders, causing pain and discomfort in the back, lower limbs, and especially the soles of the feet, resulting in improper distribution of pressure in the soles of the feet. Epidemiological studies also show a strong association between prolonged standing and pressure on the lower back and lower limbs. One of the ergonomic solutions to reduce the problems caused by long-standing activities is to correct the surface under the fee. Therefore, this study investigates the effect of ergonomic flooring and conventional flooring on the distribution of foot pressure in healthy individuals; based on that, the effect of using ergonomic flooring in comparison with conventional flooring, more appropriate distribution, and reduction of pressure in the sole can be determined. Materials and Methods: This descriptive-analytical study was performed on 16 students with a mean age of 27.87±7.31 and a body mass index of 24.15±4.31. According to previous comparative studies and data analysis obtained from pilot samples, by considering the 95% confidence interval, the samples were determined by the convenience sampling method. Each participant was measured at eight anatomical points for one hour at two different surfaces of ergonomic and ordinary floor. Foot pressure distribution using a pedar-x device while the volunteers were barefoot. Data were analyzed by paired t-test and Wilcoxon using SPSS software. Results: This study showed that the ergonomic flooring significantly reduced the mean pressure on the plantar pressure (p≤0.001). Also, there is a significant difference in the mean pressure of left and right legs in different anatomical points when using ordinary surfaces and flooring (p≤0.001). Conclusion: There is a difference between the distribution of plantar pressure in ergonomic flooring and conventional flooring. Ergonomic flooring has better distribution than the ground and reduces the pressure on the sole during static activities.

The aim of this study was to investigate the biomechanics of foot after wearing different footwear types incorporated with insole using Finite Element (FE) analysis. The studied models included barefoot, combination of insole and rigid footwear, combination of insole and elastic footwear without mid-foot cavity, and combination of insole and elastic footwear with mid-foot cavity. The results showed that insole and rigid footwear could reduce foot pressure, ankle joint pressure, and bone stress, but still not redistributing the foot pressure. The insole and elastic footwear without mid-foot cavity could significantly reduce forefoot pressure while the foot pressure was shifted toward mid-foot region instead. The insole and elastic footwear with mid-foot cavity could alleviate pressure in the mid-foot region better than footwear without mid-cavity.

Abnormal foot posture and poor muscle performance are potential causes of plantar fasciitis (PF). However, no study has compared the differences between lower extremity muscle performance and foot pressure in patients who have PF with and without abnormal foot postures. This study aimed to compare the differences in lower extremity muscle performance, such as in the hip, quadriceps, hamstring, and plantar flexor, and foot pressure in patients who have PF with and without flat foot postures. Seventy patients with plantar heel pain were enrolled (37 flat feet and 33 without flat feet). The hip muscle strength was measured using a handheld digital dynamometer. The strength and reaction time of the quadriceps, hamstring, and plantar flexor muscles were evaluated using an isokinetic device. Foot pressure parameters were assessed using pedobarography. The strength of the plantar flexor muscles was significantly lower (p = 0.008), while the reaction time of the plantar flexor muscles was significantly faster (p = 0.007) for the involved feet of PF patients with flat feet than in those without flat feet. This study confirmed the differences in muscle performance between patients who have PF with different foot postures. Therefore, clinicians and therapists should plan treatment considering the differences in these characteristics for the management of these patients.

PURPOSE: This study examined the effects of changes in the head direction (forward, upward 10° and downward 10°) on the quadriceps, center of pressure (COP), and foot pressure during squat exercises. The aim was to determine if the head direction could better activate the quadriceps muscle and provide a safer and stable squat posture during squat exercise. METHODS: Fifteen healthy college students were asked to stand on a Zebris, and three electrodes for sEMG were attached to their vastus medialis oblique (VMO), vastus lateralis (VL), and rectus femoris (RF) muscles. The participants then performed squatting exercises under three head directions (forward, upward 10°, and downward 10°). Surface electrodes were then used to record the EMG data during exercise. The Zebris FDM-SX was used to measure the foot pressure and COP of the participants. RESULTS: In squat exercise, the upward head direction group showed significantly higher VL activation than the downward head direction group (p < .05). The upward head direction group showed a significant backward change in the deviation of the COP than the downward and forward groups (p < .05). The upward head direction group showed a significant decrease in forefoot pressure than the downward and forward groups (p < .05) and an increase in the hindfoot pressure compared to the downward and forward groups (p < .05). CONCLUSION: The head direction upward in squat exercise has a positive effect on the quadriceps.

Background: 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. Objective: This study aimed to investigate the relationship between the One-Leg-Standing-Test and the gross-motor-function-measurement and single-limb support time. Methods: 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. Results: 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. Conclusion: 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.

Background Gymnastics training enhances the development of postural control in children and adolescents. In competitive gymnastics, the training regimen is specific to the given gymnastic discipline and is usually followed from the early years of practicing. This study aimed to determine whether postural steadiness differed between young gymnasts practicing two distinct disciplines, and whether it was related to the duration of their training experience, age, and their anthropometric characteristics. Methods Thirty 10–13-year-old females ̶ ten artistic gymnasts, ten acrobatic gymnasts (training as “tops”), and ten non-athletes ̶ were examined during 60-s quiet standing trials on a force platform with the eyes open and closed. Their postural sway was represented by directional components of centre of foot pressure mean velocity. Mann-Whitney U, Wilcoxon and Spearman’s ρ tests were used for analyses. Results Anterior-posterior and medial-lateral centre of foot pressure mean velocities were not different between the artistic and acrobatic gymnasts (p > 0.05). In the artistic gymnasts, the duration of training experience, age, body height, body mass, and maturity offset were negatively correlated with the anterior-posterior centre of foot pressure mean velocity under eyes-open conditions. The acrobatic gymnasts’ body mass and BMI percentiles were negatively correlated with their anterior-posterior and medial-lateral centre of foot pressure mean velocities under both visual conditions (r ranged from − 0.64 to − 0.93; p p > 0.05). Conclusions The artistic gymnasts’ longer training experience, greater age, body height, body mass, and biological maturity were associated with better anterior-posterior postural steadiness when vision was available; the acrobatic gymnasts’ greater body mass and BMI percentiles were associated with better overall postural steadiness regardless of visual conditions. Relationships were observed between postural steadiness and discipline-specific training experience and anthropometric characteristics; however, causes and effects were not proven.

Classification of pathological gaits has an important role in finding a weakened body part and diagnosing a disease. Many machine learning-based approaches have been proposed that automatically classify abnormal gait patterns using various sensors, such as inertial sensors, depth cameras and foot pressure plates. In this paper, we present a deep learning-based abnormal gait classification method employing both a 3D skeleton (obtained with a depth camera) and plantar foot pressure. We collected skeleton and foot pressure data simultaneously for 1 normal and 5 pathological (antalgic, lurching, steppage, stiff-legged, and Trendelenburg) gaits and classified them by using a multimodal hybrid model fed both data types together. In the proposed method, we fed the sequential skeleton and average foot pressure data into recurrent neural network (RNN)-based encoding layers and convolutional neural network (CNN)-based encoding layers, respectively, to effectively extract features from different data types. Their output features were concatenated and fed to fully connected layers for classification. The pressure-based and skeleton-based single-modal models achieved classification accuracies of 68.82% and 93.40%, respectively. The proposed multimodal hybrid model showed improved performance with an accuracy of 95.66%. We fine-tuned the hybrid model by applying a 3-step training methodology and ultimately increased the accuracy to 97.60%. This study indicates that the integrated features of the skeleton and foot pressure data represent both the spatiotemporal motion information and weight distribution, so data fusion can generate a positive effect in pathological gait classification.

Background and Purpose: Plantar Fasciitis (PF) is a condition that affects the foot and causes complaints such as pain and stiffness. The most common symptom of this condition is pain. There are many treatment options to deal with this condition, such as conservative therapy, medications, and surgical interventions in rare cases. This case study aims to investigate the potential impact of pain neuroscience education (PNE), combined with a conventional Physical Therapy (PT) program on a 37-year-old-patient with chronic plantar fasciitis. Case description: A 37-year-old male health care professional presented to an outpatient physical therapy clinic with a diagnosis of chronic PF for around two years. The participant had tried several treatment options with no improvement of his symptoms. After undergoing a physical therapy evaluation, he was given a plan of care for twelve sessions by a skilled physical therapist for a six-week period, with each session consisting of 30 minutes of conventional PT, followed by 5 to 15 minutes of PNE. Results: After completing the prescribed plan of care, the patient reported a reduction in subjective symptoms via the Visual Analog Scale (VAS). He also reported improvement with symptoms and functional independence via the Foot Function Index (FFI). The patient reported no change in the quality of sleep via Pittsburg Sleep Quality Index (PSQI). Lastly, he demonstrated no objective improvement in foot pressure with the Navicular Drop Test. Discussion: This case report indicates that PNE, combined with conventional PT for PF can have a positive impact on subjective pain and foot function. PNE should involve many topics about the physiology of pain and the nervous system and should be administered by a certified therapeutic pain specialist. Further studies are recommended to investigate the impact of this intervention in combination with traditional PT for PF in larger populations.

Background Incidence and clinical characteristics of foot pressure ulcers (FPU) in hospitalized elderly patients are not well known. The aim of the study was to determine the incidence of FPU during hospitalization, to describe main FPU characteristics and to assess main risk factors for FPU in hospitalised elderly subjects. Methodology An observational prospective study was performed in which patients 65 years or older admitted to Vascular Surgery, Orthopaedic or Geriatric departments were followed from admission to discharge. Trained nurses evaluated all recruited patients on a daily basis for possible FPU. Main characteristics of the patient (age, sex and co-morbidities) and the ulcer (location, grade) were registered. Results 299 patients were recruited (62.2% women, mean age 82.3 years, mean number of co-morbidities 2.8). Prevalence of FPU was 30.1% at admission and 73.9% at discharge. Incidence of FPU during hospitalization was 9.5 new FPU/100 person-day. 97.0% of the new FPU were grade 1 (erythema) and the most common locations were in the heel (57.6%), the external lateral part of the foot (13.1%), and the hallux of the fist toe (11.8%). Apart from immobility, main risk factors for FPU are age, geriatric residence origin and not able to outdoor life. Conclusions FPU has a high incidence among hospitalised elderly patients; most of them are grade 1 and located in the heel. More attention must be paid in the prevention of pressure ulcers in hospitalized frail subjects.

Diabetic foot ulcer leads to several problems to the patients. It engenders illness and sometimes deals that. Those wounds lead to nervous problem along with the development of ulcer and amputation which produces high pressure in legs. Perpendicular slope and applied mathematics operation analyzing will be utilized to get foot malformation. The experiential showed a fragile one- dimensionality and an important division in weigh acceptance. Systems can be applied to evade ulceration during the shoe monitoring. Ulceration is the endpoint of the diabetics. The main etiological factors in foot ulceration are diabetic neuropathy and peripheral vascular disease.

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.

Made available in DSpace on 2021-06-25T10:35:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Purpose: The aim of the present study was to investigate the effects of muscular fatigue on the interaction between posture and movement during a lower limb pointing task. Methods: Participants (n = 16), aged 18–30 years, kicked a ball toward a target in four conditions of fatigue: No muscular fatigue (NF), fatigue in the kicking (FM) or postural limb (FP) alone, and fatigue in both limbs (FMP). The mean amplitude and speed of the centre of foot pressure (CoP) and centre of mass (CoM) displacements were estimated through a force platform and an optoelectronic system, respectively. In addition, surface electromyography (EMG) of the biceps femoris, rectus femoris, medial gastrocnemius, and peroneus longus was recorded to investigate the anticipatory postural adjustments (APAs). Results: Muscular fatigue yielded a decreased kicking accuracy (p < 0.001) and an increased time to perform the movement (p < 0.001), mainly during the backswing motion. In addition, significant increases in the mean amplitude and speed of the CoP and CoM displacement were found in the anteroposterior (AP) and mediolateral (ML) axes (ps < 0.001), especially when both limbs were fatigued. The EMG analysis confirmed that fatigue modified the way APAs were generated. During fatigue, postural muscle activity increased, but was delayed with respect to movement onset (ps < 0.001). This pattern of response was more consistent when both limbs were fatigued (p < 0.001). Conclusion: The present results suggested an additive effect of fatigue and a functional adaptation and subsequent decrease in the overall variability of APAs, indicating that postural and motor processes are interdependent. CAPES Foundation Ministry of Education of Brazil Laboratorio de Biomecânica Departamento Mecânica UNESP Univ Estadual Paulista Campus Guaratinguetá, Av. Dr. Ariberto Pereira da Cunha, 333 Univ. Grenoble Alpes CNRS CHU-Grenoble Alpes Grenoble INP Institute of Engineering Univ. Grenoble Alpes TIMC-IMAG Laboratorio de Biomecânica Departamento Mecânica UNESP Univ Estadual Paulista Campus Guaratinguetá, Av. Dr. Ariberto Pereira da Cunha, 333

The purpose of this study was to investigate the effect of fore-medial-side thin insole on lower extremities kinematics and kinetics in college male basketball players. Seven male college basketball players voluntarily participated in the study (heights= 173.1 ± 3.1 cm; weights= 68.6 ± 5.7 kg; age= 21.1 ± 2.0 yrs.). They wore the same basketball shoes with 2 types of insoles: one type was original insole (OI); another one was fore-medial-side gradually thin insole (TI). Participants were asked to perform L-cut, V-cut, Backdoor-cut, walk, shuttle run of basketball movement in a 5-meter running way with their maximum speed. They were instructed to step with their right leg when they changed direction. The kinematic and kinetic data were collected during support phase. Non-parametric Wilcoxon signed rank test and the effect size were used to determine the difference of the variables of interest between the original and fore-medial-side thin insoles. The fore-medial-side thin insole showed less foot inversion angle at contact, peak ankle lateral shear force and ankle dorsiflexion moment than the original insole in L-cut (p

Background 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. Objective 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. Methods 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. Results 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. Conclusions 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.

The purpose of this study was to investigate the differences in plantar pressure under the lead and trail foot between two lunge tasks to the net in the dominant (LD) and non-dominant (LND) directions, and to explore how fatigue affects the plantar pressure patterns whilst performing movements before and after a competitive match. Peak and mean pressure were measured with the Biofoot-IBV in-shoe system from five repetitions of each task, with sensors positioned under the calcaneus, midfoot and phalanges on the lead and trail foot. Data were collected pre and immediately post-playing an official first national league competition match. The study was conducted with a sample of thirteen first league badminton players. A 2 × 2 repeated ANOVA found significant differences between the two tasks and between pre- and post-match (fatigued state). Players also had different foot pressure distributions for the LD and LND tasks, which indicated a difference in loading strategy. In a fatigued state, the plantar pressure shifted to the medial aspect of the midfoot in the trail limb, indicating a reduction in control and a higher injury risk during non-dominant lunge tasks.

This study was performed to comprehensively investigate whether there is a difference in the biomechanical characteristics according to the habituation by heights of shoes of those who habituate to high heeled shoes and low heeled shoes. The women with low heeled habituation show significantly higher values of peak pressures in the lateral forefoot and midfoot areas, and wider contact areas in toes and midfoot than the women with high heeled habituation for the contact area. From the EMG comparison, the women with high heeled habituation show significantly higher maximum peak EMG in GM, and from the percentage of maximum voluntary isometric contraction (%MVIC), the women with high heeled habituation show significantly higher values of the plantarflexion in GM the low heeled shoe user. For the static balance, the women with high heeled habituation show significantly greater values with eyes open. The study was able to verify that there is a significant difference in biomechanical fitness such as foot pressure, %MVIC, etc. Based on the result, this study can be utilized as base data to develop a customized insole that disperses pressure and softens shock absorption of the high heeled shoes.

The purpose of this study was to investigate the effects of changes in forefoot pressure on postural responses to vibrations of the neck muscles in healthy humans. Previous studies showed that balance instability in upright posture alters the role of proprioceptive information and the state of system balance. For example, it was reported that proprioceptive information resulting from vibrational stimulation is blocked during dynamic motor tasks. In this study, we hypothesized that proprioceptive information would be blocked during static movement tasks on receiving multiple sensory inputs, affecting postural responses. Subjects consisted of 15 healthy individuals, standing upright on a force platform for 30 seconds with their eyes closed. To change the pressure of the forefoot as cutaneous sensor information, the posture response without heel lift, with 7 cm heel lift, and with 14 cm heel lift to one side vibration stimulation or bilateral stimulation of the neck muscles given as proprioceptive information was compared with muscle stimulation. In this study, a root mean square value was calculated from the center of pressure as a measure of body sway, and a two-way repeated-measures ANOVA was performed. There was a significant interaction between the heel height and vibration stimulation, indicating that increasing the forefoot pressure on both sides of the muscle resulted in a decrease in the root mean square value. The results of this study suggest that increasing the forefoot pressure and location of vibration stimuli causes vibration-induced suppression of sensory information input and reduces body sway.

Summary The purpose of this study was to assess plantar pressure and static balance alterations after jumping and landing. According to the importance of devastating impact of improper distribution of plantar forces on the incidence of abnormal movements and stresses in the foot structure of volleyball players, studying the effect of fatigue on plantar pressure and static balance can lead to significant achievements in the evaluation of this organ's performance. In this study, 12 male adolescent volleyball players with a history of unilateral ankle injury and 12 male adolescent volleyball players without a history of unilateral ankle injury was participated. Plantar pressure characteristics and static balance in volleyball players with and without history of unilateral ankle injury was recorded before and after a fatigue from consecutive jumping and landing protocol while standing static on foot pressure. maximum pressure, mean pressure, pressure distribution, surface and romberg open and close eyes balance registered. There was a significant difference between the maximum and the mean plantar pressure and the contact surface of the right foot before and after fatigue and significant difference between the mean pressure and the pressure distribution of the healthy foot and the injured leg in individuals with a history of ankle injury also fatigue cause reduce balance in adolescent volleyball players without history of unilateral ankle injury in open eyes mode and reduce balance in adolescent volleyball players with history of unilateral ankle injury in open and closed eyes. These changes could lead to lower limb injuries.

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.

Research on high-tech running shoes is increasing but few studies are available about the use of high-tech track spike shoes (super spikes), despite their growing popularity among running athletes. The aim of this case study was to investigate kinematics, kinetics, and plantar pressures of an Olympic running athlete using two different types of shoes, to provide an easy and replicable method to assess their influence on running biomechanics. The tested athlete performed six running trials, at the same speed, wearing a pair of normal spikes shoes (NSS) and a super spikes shoe (SSS), in random order. SSS increased contact time, vertical impact, and swing force (Effect Size 3.70, 7.86, and 1.31, respectively), while it reduced foot-strike type and vertical ground reaction force rate (Effect Size 3.62 and 7.21, respectively). Moreover, a significant change was observed in medial and lateral load, with SSS inducing a more symmetrical load distribution between the left and right feet compared to the NSS (SSS left medial load 57.1 ± 2.1%, left lateral load 42.9 ± 1.4%, right medial load 55.1 ± 2.6%, right lateral load 44.9 ± 2.6%; NSS left medial load 58.4 ± 2.6%, left lateral load 41.6 ± 2.1%, right medial load 49.2 ±3.7%, right lateral load 50.8 ± 3.7%). The results of this case study suggest the importance of using individual evaluation methods to assess shoe adaptations in running athletes, which can induce biomechanical modifications and should be considered by coaches to ensure optimal running performance.

Background: Flexible flat foot is that the medial longitudinal arch collapses in weight bearing and returns normal arch when weight is removed and the weight bearing shifts toward medial part of the foot, which can cause patho­logical problems in the alignment of the lower extremities and the entire body. Objective: To compare the foot pressure for adults with flexible flat foot. Design: Quasi-Experimental Study Methods: 24 participants with flexible flat foot were recruited and were ran­domly divided into Visual feedback Short Foot Exercise (VSFE) group and Short Foot Exercise (SFE) group. To compare changes of foot pressure about pre and post intervention, the contact pressure measurement was conducted. Results: In the VSFE, significant differences were observed for the foot pres­sure of the 1st toe, 1st, 3rd and 4-5th metatarsal, midfoot, medial and lateral heel (p

Purpose: The purpose of this study was to investigate the effects of calf tightness on gait, plantar pressure, and balance in adults. Methods: A total of 60 participants were divided into a normal group of 30 subjects with normal dorsiflexion angle (20-25 degrees) and an experimental group of 30 subjects with limited dorsiflexion angle (0-15 degrees) due to calf tightness. Gait ability and foot pressure of the subjects was measured with a treadmill, and the balance ability was measured by PROKIN system. Results: A significant difference in COP length, loading response, and single limb support was observed between groups. The COP length and single limb support ratio in the normal group was greater than in the experimental group, but the experimental group showed a higher ratio for loading response in the gait ratio. Conclusion: Our results indicated that calf tightness was negative effects on balance and gait ability, so assessment of the muscle tight ­ness should be considered during exercise and treatment.

Introduction: The study that measures the existing elds of pressure between a surface that is used to support, and foot surface that is plantar, is called Pedobarography. It has important applications in the analysis of Gait and other Foot Health problems. The requirement of foot pressure measurement sensors, are that they must have mobility with limited cabling. Materials And Methods: This was a prospective study done as an outpatient procedure at Chettinad Hospital and Research Institute, Kelambakkam, Chengalpattu district of Tamil Nadu, from January 2019 to December 2019, for foot related ailments of outpatients presenting in the Department of Orthopaedics. The foot mapping was done by standard static mapping and gait analytical mapping systems. The ndings were recorded and analyzed by a computer and the patients were prescribed custom made foot-wear. Results: 945 cases were included in the study of which 575 patients had foot related orthopaedic pain pathology in the age group of 28 to 57years. Only for the 170 patients in the plantar fasciitis group was Hydrocortisone Injection administered. Remaining foot pathologies were treated with wax bath and ultrasound therapy. For the neurological foot pain segment comprising of 114 patients, neurologist consultation was sought, of which 36 cases turned out to be, due to lumbar canal stenosis and were surgically intervened upon. Of the 208 patients with Achilles tendonitis, 165 patients resolved with a heel and sole raise, with physiotherapy and the remaining 43 patient required spur and bursal surgical exploration and excision. Conclusion: Plantar foot pressure mapping, should be an integral part of the list of investigations, while trying to diagnose and treat the problems related to foot abnormalities and pathologies.

Feet play a very important and indispensable role in people’s lives. Patients with lymphedema often suffer from collapsed (or even deformed) foot arches as a result of lower extremity edema. This result will change the normal pressure distribution on the soles of their feet, which will affect their mobility and physical health. When the patient does not know that the distribution of pressure on the sole of the foot has changed significantly, the deformation of the sole of the foot will become severe. In response to this problem, this research team hopes to use a set of self-made sensor insoles to help to understand the plantar pressure points in different situations or actions. The subject invited in this study was a patient with lower extremity edema. The entire study was carried out with the consent of the patient, the guidance of the physician and the approval of the Ethics Committee of National Taiwan University Hospital (No: 201805068 RINB, date: 18 June 2018). This study uses this self-made sensor insole to analyze the plantar pressure distribution of the patient before and after the operation of lower extremity edema. The results show that the operation can effectively improve the high foot pressure in the center and rear of the foot area during different sports (standing, walking and biking). This not only increases its stability when standing and walking, but also significantly and effectively improves its walking speed and step distance.

There are growing demands for daily gait-monitoring smart insoles which are light, soft, and comfortable both in the general population interested in sports and people with disabilities, such as children with cerebral palsy or Autistic Spectrum Disorder. Currently available technologies are basically battery-powered systems, which are bulky, heavy, and not ideal for in-home and everyday use. This study introduces RFInsole, a battery-less smart insole based on RFID (Radio Frequency Identification), tracking the sequence of foot pressures within a stance. RFInsole utilizes passive RFID tags and push button switches, so that the foot pressure can activate the tags at each location. Soft, thin, affordable, and simple structure of the device open broad possibilities to implement the same system into lighter and soft applications such as socks or pressure-sensing garments.

Introduction: Many occupations require prolonged standing during exercise, which is one of the most important causes of musculoskeletal disorders, causing pain and discomfort in the back, lower limbs, and especially the soles of the feet, resulting in improper distribution of pressure in the soles of the feet. Epidemiological studies also show a strong association between prolonged standing and pressure on the lower back and lower limbs. One of the ergonomic solutions to reduce the problems caused by long-standing activities is to correct the surface under the fee. Therefore, this study investigates the effect of ergonomic flooring and conventional flooring on the distribution of foot pressure in healthy individuals; based on that, the effect of using ergonomic flooring in comparison with conventional flooring, more appropriate distribution, and reduction of pressure in the sole can be determined. Materials and Methods: This descriptive-analytical study was performed on 16 students with a mean age of 27.87±7.31 and a body mass index of 24.15±4.31. According to previous comparative studies and data analysis obtained from pilot samples, by considering the 95% confidence interval, the samples were determined by the convenience sampling method. Each participant was measured at eight anatomical points for one hour at two different surfaces of ergonomic and ordinary floor. Foot pressure distribution using a pedar-x device while the volunteers were barefoot. Data were analyzed by paired t-test and Wilcoxon using SPSS software. Results: This study showed that the ergonomic flooring significantly reduced the mean pressure on the plantar pressure (p≤0.001). Also, there is a significant difference in the mean pressure of left and right legs in different anatomical points when using ordinary surfaces and flooring (p≤0.001). Conclusion: There is a difference between the distribution of plantar pressure in ergonomic flooring and conventional flooring. Ergonomic flooring has better distribution than the ground and reduces the pressure on the sole during static activities.

The purpose of this study was to investigate and evaluate balance ability, isokinetic moments, and physical fitness according to the growth period from middle school to university in male taekwondo players. Thirtyfive taekwondo players (middle school, n= 11; high school, n= 15; university, n= 9) participated in this study. The anteriorposterior and medial-lateral CoP displacement at balance ability was better in university players than in high school and middle school players. The isokinetic knee joint muscle strength of the right extension and flexion % body weight (BW) at 60°/s was higher in university players than in high school players. The average power of right flexion BW at 180°/sec was higher in middle school players than in high school players. Back strength was higher in university players than in middle and high school players. The repeated jump was higher in high school players than in middle school players. The standing broad jump was higher in university players than in middle school players. The side-step was higher in university players than in high school players. The average power and total energy of anaerobic power were higher in university and high school players than in middle school players. The peak drop in anaerobic power was higher in middle school players than in high school players. Based on the results of the present study, the growth period should be considered when applying training such as balance, isokinetic moments, and physical fitness to male taekwondo players.

Background: Glaucoma, is the most common cause of irreversible visual deficits, presents as an injury to the optic nerve and it is mainly associated with elevated intraocular pressure. The main symptom of glaucoma is a reduction of the visual field, which is usually a source of complaint at the advanced stage of disease. Because of visual deficit, gait dysfunctions, including low gait speed and increased bumping into objects, postural sway, and falling are occurred. Many studies have used stopwatch or motion-sensing devices to report on gait function following glaucoma. However, there are few reports on gait dysfunction assessed by examining foot pressure. This study investigated gait ability following glaucoma according to different gait conditions by assessing foot pressure. Methods: Thirty older adults (15 in the sex- and age-matched normal group and 15 in the glaucoma group) were recruited for this study. All participants were walked under 2 different gait conditions in an F-scan system and the subject’ assessments were randomly assigned to rule out the order effect. Conditions included: gait over an obstacle in a straight 6 m path, gait in a straight path without an obstacle in the 6 m path. Gait variables included cadence, gait cycle, stance time, center of force (COF) deviation, and COF excursion. About 10 minutes were taken for gait evaluation. Results: When walking without an obstacle on a 6 m path, there were significant differences between the 2 groups in gait speed, cadence, gait cycle, and stance time (P

Pedobarography is a safe, non-invasive diagnostic method that enables estimation of plantar pressure distribution. This article aims to describe the symmetry between right and left toes in the Polish adult population using data obtained during postural pedobarographic examinations. Eighty-two patients, both sexes, with a mean age of 42.12 (range 19–70), without significant pathologies, participated in the study. Plantar pressure was evaluated using a PEL38 pressure plate. The study applies the elements of Cavanagh’s classification to identify the foot sole regions: Hallux, Second Toe and Lateral Toe areas and the entire foot surface. The parameters measured included maximal and average pressures, total support area for each foot, and contact area of the foot with the ground at individual moments of standing. The results showed significantly greater loading under the right Hallux in women. As regards men, higher values in the whole foot pressure distribution were noted on the left side. Plantar pressure distribution does not increase along with the global factors such as age and body mass. The findings suggest that the asymmetry in the morphological structure of the foot does not determine the asymmetry in the plantar pressure distribution. None of the feet studied had full symmetry on the entire surface.

Soldiers are often required to carry heavy loads during long distance march. Such load carriage can easily induce joint injuries and foot blisters, which further reduce the wearer’s task performance. To assist human walking with load carriage, various types of robotic devices are proposed, such as powered exoskeletons, supernumerary robotic limbs and suspended backpacks. However, these devices have individual shortcomings. This paper proposes a non-anthropomorphic passive load-carrying exoskeleton, which can dynamically support the carried load during the walking rhythm via a passive legged structure. This exoskeleton can reduce the load borne by human without energy input. The simple and passive structure design brings the highest robustness and flexibility. The simulation based on the mathematic model shows that the exoskeleton can reduce the foot pressure of the users. Such analysis results are also verified by the walking experiment. The experiment results show that the exoskeleton can transfer on average 68.0% of the load to the ground while standing, and 24.6% of the load while walking. The maximum load is reduced by 22.1% during walking.

With the development of societies, diabetic foot ulcers have become one of the most common diseases requiring lower extremity amputation. The early treatment and prevention of diabetic foot ulcers can considerably reduce the possibility of amputation. Using footwear to redistribute and relieve plantar pressure is one of the important measures for the treatment and prevention of diabetic foot ulcers. Thus, the evaluation and prediction of the distribution of plantar pressure play an important role in designing footwears. Herein, the finite element method was used to study plantar pressure under two kinds of foot models, namely, the skeletal structure foot model and the whole foot model, to explore the influence of human bones on the pressure of the soles of the feet and obtain accurate foot pressure. Simulation results showed that under the two models, the plantar pressure and the pressure from the footwear with ethylene vinyl acetate were all reduced. The total deformation demonstrated a slight increase. These stresses are very useful as they enable the design of suitable orthotic footwear that reduces the amount of stress in individuals with diabetic foot ulcers.

A foot pressure sensor with an impedance adaptive RFID chip is proposed in this paper. It is used as a shoe pad and is easy to wear. The newly designed sensor consists of three components: RFID chip and antenna, supporting layer, and reflective surface. The distance between the RFID antenna and the reflective surface corresponds to the impedance sensor code of the RFID chip, and the supporting layer transforms the foot pressure into the distance. The detective device is portable as the designed antenna is only in a baby foot size (90x24x 0.03mm). The simulations and the test validate the effectiveness of such a sensor.

This paper aims to present a system that can accurately measure the flat pressure using mainly the force applied during various movements of a body. To create an accurate measuring device, we have studied the possibility to put a supplementary sensor-base between the foot and the shoe. We have begun studying human mobility after seeing that the modern systems used the diagnostic feet healthiness are discovering more affection worldwide. This type of device is accurate and offers a variety of results for standing, walking, climbing stairs, or even working out if the suggested limit is not passed. The major problem pointed was the client usage because points must be calculated and remapped for both feet of any user. This procedure makes possible either the flat pressure measurements or even the basis of a system used to harness kinetic energy and store it for various mobility purposes.

Objective:The purpose of the present study was to investigate plantar pressure distribution during static standing in asymptomatic individuals with mild hallux valgus and to compare the results with healthy controls group.Methods:This study included a total of 25 asymptomatic individuals with hallux valgus (22 females, 3 males) between the ages of 19 and 51 years. The controls group comprised of 28 health individuals without hallux valgus (25 females, 3 males) between the ages of 20-51 years. Static plantar pressure distribution and force measurement during static standing in individuals were assessed using Tecscan MatScan System (Tekscan, Inc., South Boston, Massachusetts, USA).Results:It was found that both groups have similar maximum pressure (p=0.669), mean pressure (p=0.950), heel maximum force (p=0.660), midfoot maximum force (p=0.894), metatarsal maximum force (p=0.824), contact area (p=0.695), force-time integral (0.498), pressure-time integral (p=0.769) and center of force (p=0.178).Conclusion:The results of the present study show that asymptomatic individuals with or without mild hallux valgus have similar plantar pressure distribution. These results suggest that plantar pressure distribution do not affect the development of hallux valgus or changes of hallux position do not change plantar pressure distribution in asymptomatic individuals with mild hallux valgus.

BACKGROUND 3D-printed insoles are widely used. This study was conducted to test a customized three-dimensional (3D)-printed heel support insole based on arch lift and to investigate whether the pressure distribution on the sole was improved while maintaining foot function. MATERIAL AND METHODS The design was based on a 3D plantar contour scanning modeling technique. Thirty healthy male participants walked along a 10-m track under 3 self-controlled interventions. A customized 3D-printed heel support insole based on arch lift was inserted into the socks for the experimental condition A. For condition B, a customized 3D-printed heel-supporting insole was inserted into the socks, and a standardized pre-made heel-supporting insole was inserted into the socks as a control (condition C). We used the Footscan® pressure plate to measure the plantar parameters in the forefoot contact and foot flange phases in each condition. RESULTS Compared with condition B and the control condition, the peak pressure under the heel was significantly lower in condition A (P0.05), and the peak pressure in the midfoot region was not significantly increased (P0.05). CONCLUSIONS The biomechanical properties of the customized 3D-printed heel support are better than those of the traditional heel support insole, especially when there is a need for an additional increase in heel height. Patients do not decrease midfoot motion function while using this customized insole.

Introduction: A Backpack is an essential tool for anyone, such as students who have to carry their daily necessities and supplies for long hours. Aims: Studies have shown that inappropriate backpack types not only cause injuries to the musculoskeletal system but also cause the poor distribution of force and excessive pressure on the feet and thus discomfort for people. Methods: In order to improve the comfort of backpack users and reduce the pressure on the foot, 18- to 25-year-old female students with normal body mass were selected for the study. The backpack was designed and made according to the Schoone-Harmsen method and ergonomic criteria. The sample was compared with current and existing backpacks in the market in terms of design and ergonomic features. Results: The results showed that the new backpack using a medical belt based on ergonomic features with appropriate features provides a greater sense of comfort for users and it is improved compared to existing backpacks which are available in the Iranian market and designs based on previous studies. Conclusion: For designing a backpack for people with different anthropometric sizes, a more accurate assessment of the larger sample, particularly measurements on the lumbar region and back, is required. It is recommended to evaluate the results in a larger sample and its effect on the dimples of Venus. However, the results had a positive evaluation at this stage.

To determine prevalence, incidence and risk factors for foot pressure ulcers in ambulatory children with spina bifida.Retrospective cohort study of 72 ambulatory children (age range 0-23.9 years) with spina bifida treated at a pediatric tertiary care facility. Data on foot pressure ulcers were recorded and analyzed to determine prevalence, incidence and predictive factors.Foot pressure ulcers occurred in 50/143 limbs (35%) over 10.5 ± 3.5 years. Average incidence was 0.10 foot pressure ulcer incidents per person-year, and prevalence in years with complete follow-up was 8.8%. Prevalence was related to age [higher for ages 11-15 (17%), than ages 0-10 (5%) and 16+ years (7%),Foot pressure ulcers occur in nearly 1 out of 10 ambulatory children with spina bifida, most often in pre-teens or young teen-agers with foot deformities, who use braces. This information can help direct skin care education and prevention to those most vulnerable.Implications for RehabilitationFoot pressure ulcers occur in children and adolescents with spina bifida, most commonly in those aged 11-15 years, with foot deformities and who use braces.Ulcer development was unrelated to stiffness of foot deformity, body mass index, lesion or functional level, or presence of comorbidities such as Arnold-Chiari malformation, syringomyelia or shunted hydrocephalus.Skin care education and preventative measures should be provided to all patients, but with particular emphasis for those with these risk factors.