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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]

Background: Both proprioceptive training and modified Broström-Gould surgery can improve ankle stability in patients with chronic ankle instability (CAI), but further biomechanical evaluation is necessary to determine the optimal treatment. Purpose: To compare the clinical outcomes and biomechanical changes after proprioceptive training versus modified Broström-Gould surgery in patients with CAI. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 56 patients with CAI were assigned randomly to either a nonoperative group (n = 28) who underwent 3 months of proprioceptive training or an operative group (n = 28) who underwent modified Broström-Gould surgery. Foot and Ankle Ability Measure (FAAM) scores, foot pressure during walking, center of pressure (COP) velocity, and time for the COP to reach the balance boundary (time to boundary [TTB]) during single-leg standing were collected before the intervention (baseline) and at 3, 6, and 12 months after the intervention. Two-way repeated-measures analysis of variance was used to compare group differences and changes over time. Results: The nonoperative group had significant improvements from baseline in FAAM-Sports score and significantly decreased TTB in both the anterior-posterior and medial-lateral directions at all timepoints, while the operative group showed significant improvements only in FAAM-Sports scores and TTB and COP velocity in the anterior-posterior direction at 6 and 12 months postintervention. During walking, the nonoperative group had significantly increased peak force under the medial foot at 3 months, which dropped back to baseline levels at 12 months, while the operative group had significantly increased peak force under the medial midfoot and hindfoot that persisted until 12 months (P <.05). Conclusion: In this study, both proprioceptive training and modified Broström-Gould surgery led to improved subjective functional scores, foot pressure distribution during walking, and postural stability during standing for patients with CAI but with different biomechanical patterns. Proprioceptive training led to an earlier recovery of sports function and better medial-lateral stability recovery, while surgery provided more persistent results. Registration: ChiCTR1900023999 (Chinese Clinical Trial Registry). [ABSTRACT FROM AUTHOR]

Aims: Adherence to therapeutic footwear is vital for effective diabetic foot ulcer prevention and treatment. Understanding the key adherence factors and potential barriers is important for footwear design and implementation. Our team is creating intelligent offloading footwear to prevent lower extremity amputations in people living with diabetes (PLwD). This exploratory study assessed the ability of the established Unified Theory of Acceptance and Use of Technology (UTAUT) model to predict behavioral intention to use or recommend this intelligent offloading footwear by PLwD, caregivers of PLwD, or medical professionals treating PLwD. Methods: Online and paper questionnaires were implemented to assess the impact of the UTAUT model factors (performance expectancy, effort expectancy, social influence, facilitating conditions) and psychosocial factors (attitude, anxiety, self-efficacy) on the overall behavioral intention to use the footwear. Furthermore, factors influencing potential acceptance and rejection of the footwear were explored. Results: Patients (4.0/5) and medical professionals (4.1/5) showed a behavioral intention to "agree" to use or recommend the footwear when it becomes available. Structural equation modeling showed that the UTAUT constructed model may not be the best indicator for behavioral intention here based on a lack of statistical significance. However, the logistic regression modeling showed that the social influence for PLwD (p=0.004) and the attitude toward the footwear for medical professionals (p=0.001) may be the most important when designing and implementing the footwear, though several other factors (performance expectancy, effort expectancy, facilitating conditions, and self-efficacy) were also important for one or both of these populations. Additionally, cost and clinician support were shown to be important factors influencing potential acceptance of the footwear. Conclusions: The study found promising intention to use the intelligent footwear in the future. This highlights the need to continue future development and implementation of the footwear to incorporate these results, thus improving the likelihood of high adherence of the footwear. [ABSTRACT FROM AUTHOR]

Backgrounds: Freezing of gait (FoG) is a common and debilitating symptom of Parkinson's disease (PD) that can lead to falls and reduced quality of life. Wearable sensors have been used to detect FoG, but current methods have limitations in accuracy and practicality. In this paper, we aimed to develop a deep learning model using pressure sensor data from wearable insoles to accurately detect FoG in PD patients. Methods: We recruited 14 PD patients and collected data frommultiple trials of a standardized walking test using the Pedar insole system. We proposed temporal convolutional neural network (TCNN) and applied rigorous data filtering and selective participant inclusion criteria to ensure the integrity of the dataset. We mapped the sensor data to a structured matrix and normalized it for input into our TCNN. We used a train-test split to evaluate the performance of the model. Results: We found that TCNN model achieved the highest accuracy, precision, sensitivity, specificity, and F1 score for FoG detection compared to othermodels. The TCNN model also showed good performance in detecting FoG episodes, even in various types of sensor noise situations. Conclusions: We demonstrated the potential of using wearable pressure sensors andmachine learningmodels for FoG detection in PD patients. The TCNNmodel showed promising results and could be used in future studies to develop a real-time FoG detection system to improve PD patients' safety and quality of life. Additionally, our noise impact analysis identifies critical sensor locations, suggesting potential for reducing sensor numbers. [ABSTRACT FROM AUTHOR]

This research presents a comprehensive study focused on the design, implementation, and analysis of an innovative fiber Bragg grating (FBG) based foot pressure assessment system. FBG sensors strategically placed on the great toe, metatarsal 1, metatarsal 2, and heel provided distinct peak resonant wavelengths, strains, and pressures during experimental cycles. Participant 1 exhibited peak resonant wavelength of 1537.745 nm for great toe, 1537.792 nm for metatarsal 1, 1537.812 nm for metatarsal 2, and 1537.824 nm for heel. Participant 2 showcased distinct graphical representations with peak resonant wavelengths ranging from 1537.903 to 1537.917 nm. In a fracture patient condition, the FBG‐based system monitored weight‐bearing capacity, integrated with real‐time X‐ray imaging for dynamic insights of rehabilitation as distinct approach. The strains and pressures at each position exhibited notable variations along with the sensitivity of 1.31με obtained across all positions, underscoring the FBG‐based system's reliability in capturing subtle foot pressure. [ABSTRACT FROM AUTHOR]

AimsAdherence to therapeutic footwear is vital for effective diabetic foot ulcer prevention and treatment. Understanding the key adherence factors and potential barriers is important for footwear design and implementation. Our team is creating intelligent offloading footwear to prevent lower extremity amputations in people living with diabetes (PLwD). This exploratory study assessed the ability of the established Unified Theory of Acceptance and Use of Technology (UTAUT) model to predict behavioral intention to use or recommend this intelligent offloading footwear by PLwD, caregivers of PLwD, or medical professionals treating PLwD.MethodsOnline and paper questionnaires were implemented to assess the impact of the UTAUT model factors (performance expectancy, effort expectancy, social influence, facilitating conditions) and psychosocial factors (attitude, anxiety, self-efficacy) on the overall behavioral intention to use the footwear. Furthermore, factors influencing potential acceptance and rejection of the footwear were explored.ResultsPatients (4.0/5) and medical professionals (4.1/5) showed a behavioral intention to “agree” to use or recommend the footwear when it becomes available. Structural equation modeling showed that the UTAUT constructed model may not be the best indicator for behavioral intention here based on a lack of statistical significance. However, the logistic regression modeling showed that the social influence for PLwD (p=0.004) and the attitude toward the footwear for medical professionals (p=0.001) may be the most important when designing and implementing the footwear, though several other factors (performance expectancy, effort expectancy, facilitating conditions, and self-efficacy) were also important for one or both of these populations. Additionally, cost and clinician support were shown to be important factors influencing potential acceptance of the footwear.ConclusionsThe study found promising intention to use the intelligent footwear in the future. This highlights the need to continue future development and implementation of the footwear to incorporate these results, thus improving the likelihood of high adherence of the footwear.

Abstract 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 This study compared muscle strength and foot pressure among patients with metatarsalgia, patients with plantar fasciitis, and healthy controls. A total of 31 patients with foot pain (14 metatarsalgia and 17 plantar fasciitis) and 29 healthy controls participated in the study. The strengths of the plantar flexor and hip muscles were measured using isokinetic and handheld dynamometers, respectively. Foot pressure parameters, including the pressure–time integral (PTI) and foot arch index (AI), were assessed using pedobarography. Compared with the healthy control group, plantar flexor strength was significantly reduced in the affected feet of the metatarsalgia and plantar fasciitis groups (F = 0.083, all p

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]

Prolonged standing at work is associated with health risks. The appearance of lower-limb and lower-back discomfort is one of the most prevalent factors in prolonged standing workers. The aim of this research was to evaluate the effect of an eight-hour workday on foot pressure and musculoskeletal discomfort in standing workers. Thirty-six assembly-line workers (six women) were recruited to participate in a cross-sectional study to assess foot pressure and surface, foot, knee, and lower-back discomfort before and after a real workday. Baropodometry outcomes (surface and pressure) were evaluated by the pressure platform SensorMedica and musculoskeletal discomfort was evaluated by Cornell's Musculoskeletal Discomfort Questionaire. Total foot surface (p = 0.01) and foot discomfort (p = 0.03) increased significantly at the end of the workday. Prolonged standing during 8 h workday increased the foot discomfort and total foot surface in assembly-line workers. No foot pressure variable (forefoot, rearfoot, or total) was significantly modified after the workday in assembly-line workers. [ABSTRACT FROM AUTHOR]

Hatem A Emara,1,2,&ast; Ahmed H Al-Johany,3 Osama A Khaled,1,4 Abdullah M Al-Shenqiti,1 Abdul Rahman H Ali,5 Marwan M Aljohani,1 Eman Sobh6,7,&ast; 1Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia; 2Department of Physical Therapy for Growth and Developmental Disorders in Children and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt; 3Medical Rehabilitation Hospital, Ministry of Health, Medina, Saudi Arabia; 4Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt; 5College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia; 6Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia; 7Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt&ast;These authors contributed equally to this workCorrespondence: Hatem A Emara, Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, P.O 344, Medina, 41411, Saudi Arabia, Tel +966564156262, Fax +966148618888, Email drhatem_emara@yahoo.comPurpose: To investigate the effect of dynamic orthotic garments (Thera togs) on foot pressure distribution, postural control, and endurance in children with spastic diplegic CP.Patients and Methods: This is a single-blind randomized controlled clinical trial involving 34 (8– 10 years) with spastic diplegic CP. The control group received conventional physical therapy (CPT), whereas the study group received CPT in addition to wearing TheraTogs. We recorded foot pressure distribution, trunk control measurement scale, trunk position sense, Pediatric Berg Balance Scale (PBS), and six-minute walking distance (6MWD).Results: Both groups showed improvement. The study group had significant improvement in foot pressure distribution (p-value 0.003, 0.001, < 0.001 for forefoot, midfoot, and rearfoot mean pressures respectively, and 0.005, < 0.001, and 0.005 for forefoot, midfoot, and rearfoot peak pressures respectively), Pediatric balance scale, The trunk control measurement scale, and Trunk position sense (p-value < 0.001) and six-minute walking distance (p-value 0.029). Our data suggest that adding TheraTogs to conventional physiotherapy improves foot pressure, postural control, and endurance in children with spastic diplegic cerebral palsy.Conclusion: Both TheraTogs and conventional physical therapy corrected foot pressure distribution, trunk control, improved balance, and increased 6MWD in children with spastic diplegic CP but the improvement was more significant in TheraTogs group.Clinical Trial Registration: NCT05271149.Keywords: children with disability, theratogs, foot pressure, balance score, orthotic devices

Classifying pathological gaits is crucial for identifying impairments in specific areas of the human body. Previous studies have extensively employed machine learning and deep learning (DL) methods, using various wearable (e.g., inertial sensors) and non-wearable (e.g., foot pressure plates and depth cameras) sensors. This study proposes early and late fusion methods through DL to categorize one normal and five abnormal (antalgic, lurch, steppage, stiff-legged, and Trendelenburg) pathological gaits. Initially, single-modal approaches were utilized: first, foot pressure data were augmented for transformer-based models; second, skeleton data were applied to a spatiotemporal graph convolutional network (ST-GCN). Subsequently, a multi-modal approach using early fusion by concatenating features from both the foot pressure and skeleton datasets was introduced. Finally, multi-modal fusions, applying early fusion to the feature vector and late fusion by merging outputs from both modalities with and without varying weights, were evaluated. The foot pressure-based and skeleton-based models achieved 99.04% and 78.24% accuracy, respectively. The proposed multi-modal approach using early fusion achieved 99.86% accuracy, whereas the late fusion method achieved 96.95% accuracy without weights and 99.17% accuracy with different weights. Thus, the proposed multi-modal models using early fusion methods demonstrated state-of-the-art performance on the GIST pathological gait database. [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]

Payal Mehta, Sandeep Pattnaik, Sunanda Bhowmik Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, 133207, IndiaCorrespondence: Sunanda Bhowmik, Email sunandabhowmik@mmumullana.org

Gait disorders are a fundamental challenge in Parkinson’s disease (PD). The use of laser-light visual cues emitted from shoes has demonstrated effective in improving freezing of gait within less restrictive environments. However, the effectiveness of shoes-based laser-light cueing may vary among individuals with PD who have different types of impairments. We introduced an innovative laser-light visual shoes system capable of producing alternating visual cues for the left and right feet through one-side cueing at a time, while simultaneously recording foot inertial data and foot pressures. The effects of this visual cueing system on gait patterns were assessed in individuals with PD, both those with well-gait and those with worse-gait. Our device successfully quantified gait characteristics, including the asymmetry in the center of pressure trajectory, in individuals with PD. Furthermore, visual cueing prolonged stride times and increased the percentage of stance phase, while concurrently reducing stride length in PD individuals with well-gait. Conversely, in PD individuals with worse-gait, visual cueing resulted in a decreased freeze index and a reduction in the proportion of intervals prone to freezing episodes. The effects of visual cueing varied between PD individuals with well-gait and those with worse-gait. Visual cueing slowed down gait in the well-gait group while it appeared to mitigate freezing episodes in worse-gait group. Future researches, including enhancements to extend the projection distance of visual cues and clinical assessments conducted in real-world settings, will help establish the clinical utility of our proposed visual cueing system.

Prolonged standing at work is associated with health risks. The appearance of lower-limb and lower-back discomfort is one of the most prevalent factors in prolonged standing workers. The aim of this research was to evaluate the effect of an eight-hour workday on foot pressure and musculoskeletal discomfort in standing workers. Thirty-six assembly-line workers (six women) were recruited to participate in a cross-sectional study to assess foot pressure and surface, foot, knee, and lower-back discomfort before and after a real workday. Baropodometry outcomes (surface and pressure) were evaluated by the pressure platform SensorMedica and musculoskeletal discomfort was evaluated by Cornell’s Musculoskeletal Discomfort Questionaire. Total foot surface (p = 0.01) and foot discomfort (p = 0.03) increased significantly at the end of the workday. Prolonged standing during 8 h workday increased the foot discomfort and total foot surface in assembly-line workers. No foot pressure variable (forefoot, rearfoot, or total) was significantly modified after the workday in assembly-line workers.

Introduction: Anterior Cruciate Ligament (ACL) plays a vital role in gait balancing and lower limb kinematics. Any injury to the ACL leads to gait imbalance and alterations in foot pressure distribution. The stability and biomechanics of the lower limb after ACL Reconstruction (ACLR) can be measured through foot pressure analysis, gait analysis, and percentage contact area of the foot, among others. Aim: To evaluate the static foot pressure and percentage contact area of the foot in ACL deficient group, comparing it with the ACLR group and the normal healthy individual group. Materials and Methods: An analytical cross-sectional study was conducted at the Department of Sports Medicine, King George Medical University, Lucknow, Uttar Pradesh, India from March 10, 2021 to March 15, 2023. A total of 15 patients in each group (ACL injury, ACLR patients, and normal healthy individuals) were included in this study. Foot pressures (static) were recorded in all three groups using the BTS P-WALK system with BTS Biomedical software, which included high-density sensors and a plate size of 700 × 500 × 5 mm. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software version 26.0. Chi-square and linear regression tests were used to analyse the differences between the groups. Results: In the intragroup analysis, ACL deficient patients’ ipsilateral limbs showed lower foot pressure in the mid-foot (7±3.4), hind-foot (40.33±10.08), and whole foot pressure (110.19±34.7 Pascal (N/M2)) (p-value>0.05) compared to normal healthy individuals (126.06±19.4 Pascal (N/M2) (p>0.05) and ACLR (125.06±14.3 Pascal (N/M2)) (p-value>0.05) groups, which suggested insignificant differences. The percentage contact area of the foot was significantly lower (43.15±3.4) (p-value

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]

Background: Diabetic foot neuropathy is one of the complications of diabetes that affects around 50% of diabetic people. Because peripheral neuropathy involves nerve loss around the foot areas, patients with diabetic neuropathy frequently lose sensation in their feet while walking or standing. Furthermore, since sensory nerves are damaged, the area that holds the majority of the foot pressure and temperature is at high risk of injury. If not diagnosed and treated properly, it can cause foot injury and eventually lead to edema, gangrene, ulcers, amputation, and even death. There are now several techniques of detecting diabetic neuropathy, but they are limited in their availability, cost-effectiveness, and complexity. Aims: The primary goal of this research was to develop devices for early detection and treatment of diabetic foot neuropathy. Methods: The proposed device combines a foot pressure monitoring method and a foot temperature measurement method to diagnose diabetic neuropathy early on, with red light therapy added as a treatment method. For 2 weeks, the device measures the patient's foot pressure and temperature, and light therapy is provided if a change in pressure or temperature at a specific area is observed. Results: The device prototype was successfully developed, and numerous tests were carried out in accordance with the design specifications. For pressure measurement and temperature measurement, measurement accuracy of 99.05% and 99.30%, respectively, were attained. Conclusion: The early detection and treatment device developed in this study could be used at home by diabetic patients as well as in hospitals to test for and treat diabetic foot neuropathy at an early stage. The device incorporates two different methods of diabetic foot neuropathy detection with high measurement accuracy which makes it suitable for use in resource-limited areas at low cost. The incorporation of red light therapy together with the two methods of diabetic neuropathy detection gives another unique feature for our device. [ABSTRACT FROM AUTHOR]

Objective: To explore the characteristics of Non-Negative Matrix Factorization (NNMF) in analyzing the mechanical characteristics of foot functional units during walking and running.Methods: Eighteen subjects (9 males and 9 females) were recruited, and the ground reaction force curves of each foot region during walking and running were collected using a plantar pressure measurement system. NNMF was used to extract the mechanical features of different foot regions and to determine the number of foot functional units. The differences between the base matrices of walking and running were compared by traditional t-tests, and the differences in coefficient matrices were compared by one-dimensional statistical parameter mapping.Results: 1) When the number of foot functional units for walking and running were both 2, the Variability Accounted For (VAF) by the matrix exceeded 0.90 (VAF walk = 0.96 ± 0.02, VAF run = 0.95 ± 0.04); 2) In foot functional unit 1, both walking and running exhibited buffering function, with the heel region being the main force-bearing area and the forefoot also participating in partial buffering; 3) In foot functional unit 2, both walking and running exhibited push-off function, with the middle part of the forefoot having a higher contribution weight; 4) In foot functional unit 1, compared to walking, the overall force characteristics of the running foot were greater during the support phase of the 0%–20% stage, with the third and fourth metatarsal areas having higher contribution weights and the lateral heel area having lower weights; 5) In foot functional unit 2, compared to walking, the overall force was higher during the beginning and 11%–69% stages of running, and lower during the 4%–5% and 73%–92% stages. During running, the thumb area, the first metatarsal area and the midfoot area had higher contribution weights than during walking; in the third and fourth metatarsal areas, the contribution weights were lower during running than during walking.Conclusion: Based on the mechanical characteristics of the foot, walking and running can both be decomposed into two foot functional units: buffering and push-off. The forefoot occupies a certain weight in both buffering and push-off functions, indicating that there may be a complex foot function transformation mechanism in the transverse arch of foot. Compared to walking, running completes push-off earlier, and the force region is more inclined towards the inner side of the foot, with the hallux area having a greater weight during push-off. This study suggests that NNMF is feasible for analyzing foot mechanical characteristics.

Classifying pathological gaits is crucial for identifying impairments in specific areas of the human body. Previous studies have extensively employed machine learning and deep learning (DL) methods, using various wearable (e.g., inertial sensors) and non-wearable (e.g., foot pressure plates and depth cameras) sensors. This study proposes early and late fusion methods through DL to categorize one normal and five abnormal (antalgic, lurch, steppage, stiff-legged, and Trendelenburg) pathological gaits. Initially, single-modal approaches were utilized: first, foot pressure data were augmented for transformer-based models; second, skeleton data were applied to a spatiotemporal graph convolutional network (ST-GCN). Subsequently, a multi-modal approach using early fusion by concatenating features from both the foot pressure and skeleton datasets was introduced. Finally, multi-modal fusions, applying early fusion to the feature vector and late fusion by merging outputs from both modalities with and without varying weights, were evaluated. The foot pressure-based and skeleton-based models achieved 99.04% and 78.24% accuracy, respectively. The proposed multi-modal approach using early fusion achieved 99.86% accuracy, whereas the late fusion method achieved 96.95% accuracy without weights and 99.17% accuracy with different weights. Thus, the proposed multi-modal models using early fusion methods demonstrated state-of-the-art performance on the GIST pathological gait database.

Introduction: Recent studies found that wearable exoskeletons can reduce physical effort and fatigue during squatting. In particular, subject-specific assistance helped to significantly reduce physical effort, shown by reduced metabolic cost, using human-in-the-loop optimization of the exoskeleton parameters. However, measuring metabolic cost using respiratory data has limitations, such as long estimation times, presence of noise, and user discomfort. A recent study suggests that foot contact forces can address those challenges and be used as an alternative metric to the metabolic cost to personalize wearable robot assistance during walking.Methods: In this study, we propose that foot center of pressure (CoP) features can be used to estimate the metabolic cost of squatting using a machine learning method. Five subjects’ foot pressure and metabolic cost data were collected as they performed squats with an ankle exoskeleton at different assistance conditions in our prior study. In this study, we extracted statistical features from the CoP squat trajectories and fed them as input to a random forest model, with the metabolic cost as the output.Results: The model predicted the metabolic cost with a mean error of 0.55 W/kg on unseen test data, with a high correlation (r = 0.89, p < 0.01) between the true and predicted cost. The features of the CoP trajectory in the medial-lateral direction of the foot (xCoP), which relate to ankle eversion-inversion, were found to be important and highly correlated with metabolic cost.Conclusion: Our findings indicate that increased ankle eversion (outward roll of the ankle), which reflects a suboptimal squatting strategy, results in higher metabolic cost. Higher ankle eversion has been linked with the etiology of chronic lower limb injuries. Hence, a CoP-based cost function in human-in-the-loop optimization could offer several advantages, such as reduced estimation time, injury risk mitigation, and better user comfort.

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]

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. [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: 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.

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: 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]

Abstract 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.

Background: A better understanding of plantar pressure while standing and walking would help in improving balance and gait performance across different age ranges. Objective: To clarify the differences of plantar pressure while standing and walking among children, adults, and the elderly. Materials and Methods: Fifty-three participants including eleven aged 3 to 8 years, thirty aged 20 to 40 years, and twelve aged 60 to 90 years were included in the present study. Plantar pressure and related parameters while quiet standing and walking with self-selected speed were assessed. Results: In static plantar pressure, no significant differences were observed of mean different pressure and mean different contact area between dominant and non-dominant limbs among the three groups, while center of pressure (COP) displacement was shown as significantly greater between children and adults (p<0.05). For dynamic plantar pressure, no significant differences in COP velocity were found among the three groups. The elderly showed significant lower normalized maximum plantar pressure in areas of the second and third metatarsal, and internal heel compared with the young adults (p<0.05). Additionally, normalized maximum plantar pressures among children seemed to differ from adults. Conclusion: Plantar pressure characteristics could indicate that children develop gait ability in braking and propulsion phases with greater heel and toe function, while the ability of braking and propulsion declined with aging. These could reflect balance ability while standing or walking. [ABSTRACT FROM AUTHOR]

Backgrounds: Freezing of gait (FoG) is a common and debilitating symptom of Parkinson's disease (PD) that can lead to falls and reduced quality of life. Wearable sensors have been used to detect FoG, but current methods have limitations in accuracy and practicality. In this paper, we aimed to develop a deep learning model using pressure sensor data from wearable insoles to accurately detect FoG in PD patients., Methods: We recruited 14 PD patients and collected data from multiple trials of a standardized walking test using the Pedar insole system. We proposed temporal convolutional neural network (TCNN) and applied rigorous data filtering and selective participant inclusion criteria to ensure the integrity of the dataset. We mapped the sensor data to a structured matrix and normalized it for input into our TCNN. We used a train-test split to evaluate the performance of the model., Results: We found that TCNN model achieved the highest accuracy, precision, sensitivity, specificity, and F1 score for FoG detection compared to other models. The TCNN model also showed good performance in detecting FoG episodes, even in various types of sensor noise situations., Conclusions: We demonstrated the potential of using wearable pressure sensors and machine learning models for FoG detection in PD patients. The TCNN model showed promising results and could be used in future studies to develop a real-time FoG detection system to improve PD patients' safety and quality of life. Additionally, our noise impact analysis identifies critical sensor locations, suggesting potential for reducing sensor numbers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Park, Moon, Lee, Oh, Lee, Jang, Cho and Lee.)

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]

Elevated foot pressure and high temperatures have been proposed as predictive factors for diabetic foot ulceration; however, on their own, their predictive value is still questionable. This pilot study hypothesized that combining these two measurements in a thermo-pressure model could result in a more reliable risk assessment tool for providing risk categorization aimed to determine whether there is a correlation between foot plantar pressure and temperature in patients living with diabetes mellitus (DM) when compared with healthy individuals following a 15 min walk. Foot pressure and thermographic images were taken from 48 participants who were categorised into four groups following clinical evaluation into healthy individuals (Group A), living with DM with no complications (Group B), DM with peripheral arterial disease (Group C) and DM patients with neuropathy (Group D). This study demonstrated a positive correlation between pressure and temperature; as pressure increases, so does temperature. This was more pronounced in the groups with DM when compared to the healthy group. More research is warranted to further develop this innovative thermo-pressure model, which could hopefully be more sensitive in categorizing and identifying patients living with DM who are at risk of developing foot ulceration to initiate prompt care. [ABSTRACT FROM AUTHOR]

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.

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.

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]

Patients with knee osteoarthritis (KOA) usually experience pain in the medial compartment of their knee which accompany varus postures. This causes much larger lateral-side foot pressure than that of the medial side which may lead to functional limitation in their daily life. Reducing knee loading during gait could help patients with KOA alleviate pain and improve walking functions. In this study, a prototype for a new pneumatic knee orthosis (PKO) is developed to support the knee by increasing the pneumatic pressure of the PKO during the stance period of walking using foot pressure feedback in real time. Force-sensing resistor sensors in the PKO were used to detect the gait phase and monitor the foot pressures in real time. To investigate the feasibility of the system, walking tests on a treadmill were performed at 2 km/h and 3 km/h by healthy subjects. The results show that the developed PKO can reduce lateral-side foot pressure during stance phase. The PKO in this study could be used as a research tool to investigate the relationship between foot pressure and knee loading as well as therapeutic purposes to reduce medial compartment loading in the knee. [ABSTRACT FROM AUTHOR]

Background: Increase age is one of the main factors influencing spatiotemporal and pressure parameters. Adolescence and young adulthood are unique periods in the life span that present opportunities and challenges in improving health. Meantime, this age span involve significant growth and development. But the previous studies seldom examine the adolescents gait characteristics and pay attention to the plantar pressure changes between this age span. Purpose: Given the complex variation of these transitional ages and their implications to the foot care, the primary aim of this study was to investigate plantar pressure differences between teenager girls and young female adults during walking using an EMED pressure plate (Novel, Germany). Method: Nineteen young female adults (YFA) age at 24.7 (±2.21) and nineteen teenager girls (TG) age at 18.25 (±1.23) were participated this study. Data collections including peak pressure, contact area, pressure time integral were performed with an EMED pressure plate. The measurement protocol was barefoot walking across the platform along a 10m long straight trail. Pressures were evaluated for seven plantar areas on the foot according to the anatomical structure. Result and Conclusion: The result showed that walking speed was similar in both teenager girls and young female adults. The teenager girls shown higher peak pressure in the first metatarsal (FM), fourth and fifth metatarsals (FAFM), middle foot (MF) and rear-foot (RF) areas while the YFA shown larger pressure time integral at big toe (BT) and other toes (OT). Contact area was lower in the YFA for the several foot regions compared to the TG BT, OT, FAFM and MF. Greater pressure time integrals of the FM, FAFM and MF were found in the TG compared to the YFA, while the YFA shown larger pressure time integral at BT, OT and RF. The TG shown greatest peak pressure and pressure time integral in the FM while the YFA shown biggest peak pressure and pressure time integral in the BT. This normative data will provide a basis to assess pediatric pathologic foot deformities more accurately and to distinguish dynamic foot deformities from anatomic foot deformities.

The present study examined the technical characteristics of sliding performance from push-off until stone release in curling delivery. Five elite performance level curlers (> 7 years experience) and five subelite level curlers (< 3 years experience) were analyzed during the action of delivery of a curling stone. The joint angles, angular velocities, and moments of the body center of mass (COM) were determined based on three-dimensional kinematic data. The plantar pressure data were measured using a validated in-shoe system. The results indicated that the gliding time and horizontal velocity of the mass center of the body during the sliding phase were not significantly different between the elite and subelite groups. However, there were significant differences in the gliding distance and the rate of changes in velocity profiles of body COM between the two groups. The moment of the body COM from its relative position to the ankle of the support limb in the anterior/posterior direction was positive in elite curlers and negative in subelite curlers. In addition, larger ankle dorsiflexion and greater contact area of the sliding foot were observed in elite curlers. These data suggest a superior ability of elite curlers to maintain a regulated movement speed and balance control during the performance of a curling stone delivery. [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]

Elevated foot pressure and high temperatures have been proposed as predictive factors for diabetic foot ulceration; however, on their own, their predictive value is still questionable. This pilot study hypothesized that combining these two measurements in a thermo-pressure model could result in a more reliable risk assessment tool for providing risk categorization aimed to determine whether there is a correlation between foot plantar pressure and temperature in patients living with diabetes mellitus (DM) when compared with healthy individuals following a 15 min walk. Foot pressure and thermographic images were taken from 48 participants who were categorised into four groups following clinical evaluation into healthy individuals (Group A), living with DM with no complications (Group B), DM with peripheral arterial disease (Group C) and DM patients with neuropathy (Group D). This study demonstrated a positive correlation between pressure and temperature; as pressure increases, so does temperature. This was more pronounced in the groups with DM when compared to the healthy group. More research is warranted to further develop this innovative thermo-pressure model, which could hopefully be more sensitive in categorizing and identifying patients living with DM who are at risk of developing foot ulceration to initiate prompt care.

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%.

Gait disorders are a fundamental challenge in Parkinson's disease (PD). The use of laser-light visual cues emitted from shoes has demonstrated effective in improving freezing of gait within less restrictive environments. However, the effectiveness of shoes-based laser-light cueing may vary among individuals with PD who have different types of impairments. We introduced an innovative laser-light visual shoes system capable of producing alternating visual cues for the left and right feet through one-side cueing at a time, while simultaneously recording foot inertial data and foot pressures. The effects of this visual cueing system on gait patterns were assessed in individuals with PD, both those with well-gait and those with worse-gait. Our device successfully quantified gait characteristics, including the asymmetry in the center of pressure trajectory, in individuals with PD. Furthermore, visual cueing prolonged stride times and increased the percentage of stance phase, while concurrently reducing stride length in PD individuals with well-gait. Conversely, in PD individuals with worse-gait, visual cueing resulted in a decreased freeze index and a reduction in the proportion of intervals prone to freezing episodes. The effects of visual cueing varied between PD individuals with well-gait and those with worse-gait. Visual cueing slowed down gait in the well-gait group while it appeared to mitigate freezing episodes in worse-gait group. Future researches, including enhancements to extend the projection distance of visual cues and clinical assessments conducted in real-world settings, will help establish the clinical utility of our proposed visual cueing system., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chan, Chen, Kuo, Chen, Liaw, Liao, Lin, Chien and Chang.)