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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.

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

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.

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.

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

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.

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.

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.

[Purpose] Studies have demonstrated a relationship between plantar pressure distribution and proximal fifth metatarsal fracture. We aimed to investigate the plantar pressure patterns of soccer players with or without a history of proximal fifth metatarsal fracture. [Participants and Methods] Fifty-one male soccer players (31 professional, 20 high-school) participated in this study (mean age, weight, and height ± SD: 21.1 ± 4.7 years, 68.8 ± 5.8 kg, and 175.4 ± 5.9 cm, respectively). Seven of them had a history of proximal fifth metatarsal fracture before this study (the fracture group) and 44 had no history of fracture (the control group). A Win-Pod (Medicapteurs) platform was used to measure foot pressure forces. The center of plantar pressure was measured during double and single-limb stances for 25 seconds. Fifth metatarsal pressure and the center of plantar pressure angle was calculated from the walking footprint. The calculated data were compared between the fracture group and the control group. [Results] Comparisons between the fracture and control groups in terms of morphology and the center of plantar pressure length showed no significant differences. However, the fifth metatarsal pressure and the center of plantar pressure angle were significantly higher in the fracture group. [Conclusion] The results of this study revealed that players with excessive loading in the lateral areas of the foot while walking have a risk of developing proximal fifth metatarsal fracture.

Following 1st metatarsophalangeal joint replacement, there is a normalisation of foot pressure distribution as demonstrated by peak pressures of the 1st and 5th metatarsal heads and their ratio as measured by pedobarographs. This compares favourably with the unaffected foot. Functional dorsiflexion range of motion is maintained and there is a significant improvement in the reported patient outcome measure.

Background Previous reliability studies on peak plantar pressure measurements in patients with previous diabetic foot ulceration (DFU) did not stratify their analyses according to whether the foot had a previous ulcer. Research question Does test-retest reliability of peak foot pressure measurements from the various foot regions differ between the ulcerated and non-ulcerated feet? Methods Data from 23 participants with peripheral neuropathy and healed plantar DFU were analysed in this test-retest reliability comparison study. Plantar pressure was evaluated on two sessions using Pedar®-X in-shoe system, with a mean of 7.2 days (SD = 1.6) between sessions. Results The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated for 10 foot regions. Overall, test-retest reliability was excellent (ICCs, 0.82 to 0.95) for all peak pressure variables. CV ranged between 6.3% and 18.3%, and exceeded 15% over the hallux and medial forefoot regions in the ulcer foot (18.3% and 16.4%, respectively). Hallux peak pressure CV was significantly higher over the ulcer foot than over the non-ulcer foot (5.7%, 95% CI, 1.7%–10.2%). Peak pressure CV over the forefoot also tended to be higher over the ulcer foot (medial forefoot: 6.1%, 95% CI, -0.5%–14.5%; lateral forefoot: 4.1%, 95%CI, -0.7%–11.1%). Significance Peak plantar foot pressure may be useful to distinguish between groups of patients with peripheral neuropathy and healed plantar DFU. However, clinical decisions based on ulcer foot hallux and forefoot peak pressure measurements should be interpreted with caution.

Diabetic peripheral neuropathy (DPN) is a dysfunction of the peripheral nerves that restricts sensation from the feet, compromising an individual’s mobility and balance. Individuals with DPN generate elevated (from typical) values of foot pressure while walking often leading to tissue ulcerations. Currently, there are commercial pressure offloading (CPO) insoles that claim to reduce foot pressure and limit ulcer formation; however, the insoles’ capacity to reduce pressures during common activities have not been examined. The aim of this study was to observe the effects of various insoles on balance and plantar pressure while negotiating stairs, in individuals with diabetes. Twenty-nine (29) participants (14 individuals with diabetes, and 15 age-matched controls) were instructed to traverse a seven-step staircase while wearing three CPO insoles and one normal insole. Spatial and temporal balance (COM-BOS) and foot peak pressures (overall foot and regions of interest) were recorded using pressure insoles pl...

Objective: The aim of this study was to perform the static and dynamic biomechanical assessment of postural structure and analyze variations of foot pressure in elite golfers. Methods: A total of 8 golfers (3 female, mean age 15.33 ± 0.57 years; mean height 167 ± 3.61 cm and mean weight 59.3 ± 11.71 kg; 5 male, mean age 17 ± 0.83 years; mean height 177.2 ± 8.61 cm; mean weight 72.8 ± 15.61 kg) from Turkish National Team were participated to this study. Digital Biometry Images Scanning (DBIS) system was used for BioPostural analyses. All participants were applied Modular Electronic Baropodometric test for foot pressure evaluation and Stabilometry for body balance evaluation. Results were analyzed by SPSS 16.0 (SPSS Inc., Chicago, IL, USA) program, using Wilcoxon test. Results: In static evaluation, there were significant differences in forefoot and rearfoot surface (cm2) (p

Foot pressure analysis is a valuable tool that can be used to quantify foot function in children. For researchers and clinicians who use foot pressure analysis, data from a typically developing population is used for comparison with subjects that have musculoskeletal conditions. However, differences between foot pressure data collection technology, data collection procedures and post-processing techniques make comparisons between devices, as well as direct comparisons of pediatric foot pressure data, difficult. When comparing data from multiple studies it is imperative that the studies utilize the same data collection and processing techniques, otherwise the data should not be directly compared. The purpose of this paper is to provide a summary of typically developing foot pressure data, explore factors that affect foot pressure data collection and provide suggestions for the standardization of foot pressure data collection and post processing. The results of this review demonstrate that the minimum data collection and processing recommendations for foot pressure data collection and post-processing are: using a midgait or two-step approach, allowing subjects to walk at their self-selected speed, collecting a minimum of three trials per foot, identifying at minimum medial and lateral hindfoot, forefoot, midfoot, the hallux and toes, and that parameters be reported in standard units.

BACKGROUND: Foot pain and paresthesia are common in cycling, due to plantar pressure and repetitive loading. OBJECTIVES: The aim was to investigate the effect of foot insoles on plantar pressure of the foot in motorcycling, as well as self-reported comfort. STUDY DESIGN: A randomized crossover clinical trial. METHODS: A flexible foot pressure mat (GP MobilData WiFi® Gebiomized®) with different sizes was utilized. RESULTS: Maximum pressure values occurred predominantly in the hallux with 4.90 ± 1.19 N/cm2, followed by second and third metatarsal areas with 4.57 ± 0.73 N/cm2, followed by the first metatarsal area with 4.30 ± 0.96 N/cm2, and followed by the fourth and fifth metatarsal areas with 3.22 ± 0.89 N/cm2 when using the control foot insole and using aluminum foot insole, which reduces maximum pressure to 1.55 ± 0.34, 1.56 ± 0.75, 1.09 ± 0.43, and 1.07 ± 0.59 N/cm2, respectively ( p

Body feature, body movement such as gait characteristics, and anthropometric measures are commonly utilised to identify perpetrators. In the past, CCTV was the main device suited to obtain these, important particulars of perpetrators. However, advances in electronic pressure sensors in medical field, podiatry, physiotherapy and sport sciences have resulted in the availability of these sensors for crime surveillance applications. A research was carried out to develop a novel surveillance method of combining CCTV cameras and under-carpet floor pressure sensors to obtain certain body movement characteristics of crime perpetrator based on force/pressure distribution under the shoes. Thirteen adults were recruited and each subject was instructed to perform ten trials to obtain the needed foot force under normal shoes and foot pressure distance measures. To evaluate these novel measures' confidence, the mean within group and between group significant scores (P) were determined as: (1) 1.0; and (2) 0.001 respectively. These initial results showed that the novel method could be suitable for identifying perpetrators successfully.

Although the foot is involved in load-bearing and shock absorption, foot pressure (FP), ground contact area (CA), and gait cycle (GC) in flatfeet (FF) have not been examined in detail. We aimed to analyze the influence of FF on FP, CA, and GC. We included 20 and 21 women with FF and normal feet (NF), respectively. A Footscan plantar pressure plate (RsScan International, Belgium) was used to analyze FP, CA, and GC. FP was applied to the unit area of 10 compartments. GC analysis was performed using phase-time measurements by dividing the GC into four phases. In the analysis, FP and CA were compared between the FF and NF groups. A comparison of GC was similarly performed between the two groups. The data provided in this article will be useful when designing studies on the effect of foot shape on FP, CA, and GC during gait.

Gait analysis plays an important role in various applications such as health care, clinical rehabilitation, sport training and pedestrian navigation. In order to monitor the human gait, an interesting approach is to analyze the foot plantar pressure distribution between the foot and the ground. In recent years, the emergence of flexible, soft and lightweight sensors facilitates the rapid technological advances in in-shoe foot pressure measurements, thereby especially carbon nanotubes-based sensors provide an outstanding solution for the implementation of flexible, soft pressure sensors in foot pressure distribution analysis. This chapter focuses on the design and implementation of multiwalled carbon nanotubes (CNT)/polydimethylsil-oxane (PDMS) based nanocomposite pressure sensors for the analysis of the foot pressure distribution. The sensor is durable, stable and shows sensitivity of 3.3 k\({\Omega }\)/kPa and hysteresis smaller than 3.64% with maximum detectable pressure up to 217 kPa, which is suitable for the measurement of human foot pressure. The proposed sensor has been implemented in a flexible in-sole, which is designed based on normal arch foot anatomy. A total of 12 sensors are distributed in the heel, lateral back foot, midfoot and front foot. The foot pressure distribution for different persons while walking and standing using nanocomposite sensor based in-sole were investigated by measuring the changing in resistance of the pressure sensors, when pressure applied on it. It shows that foot pressure distribution is higher in the fore foot and the heel while person standing in normal position. While walking, initially the foot pressure is in the heel and then transferred to the entire foot and finally it is concentrated on the fore foot.

Objectives. Foot ulcers often occur in people with diabetes because of pressure-induced tissue ischemia. Vibration has been reported to be helpful in alleviating mechanical damage and promoting wound healing. The objective of this study is to explore whether vibration can relieve reactive hyperemia in foot tissue under occlusive compression. Methods. Thirteen healthy adults participated in the study. Each foot was placed under occlusive compression without or with vibration intervention, which was randomly assigned every other day. The dorsal foot skin blood flow (SBF) was measured pre- and postintervention for each subject in each test. Temporal variations and spectral features of SBF were recorded for comparison. Results. The results showed that subjects displayed an obvious reactive hyperemia in the foot tissue after pressure occlusion, whereas they displayed a more regular SBF when vibration was applied along with occlusive compression. Moreover, the amplitude of metabolic, neurogenic, and myogenic pathways for SBF was significantly reduced during the hyperemia process when vibration was applied. Conclusions. This study demonstrated that vibration can effectively reduce the level of hyperemia in foot tissue under occlusive compression and also induce less protective physiological regulatory activities. This is helpful for protecting foot tissue from pressure-induced ischemic injury and foot ulcers.

Background Abnormal foot contact patterns following stroke affect functional gait; however, objective analysis targeting independent walking is lacking. Research question How do walking abilities and foot pressure patterns differ between post-stroke individuals who achieved independent walking and healthy controls? Secondarily, how do the abilities and patterns in post-stroke individuals change before and after achieving independent walking? Can these changes become criteria for permitting independent walking? Methods Twenty-eight individuals with hemiplegia and 32 controls were enrolled. Motor dysfunction score (MDScore), walking speed (WSpeed), and foot pressure patterns were measured when they were first able to walk without orthosis or physical assistance (1st assessment) and when they achieved independent walking around discharge (2nd assessment). Foot pressure patterns were measured using insole-type foot pressure-measuring system. Ratios of partial foot pressure to body weight (%PFP), ratios of anteroposterior length of center of pressure (COP; %Long), and backward moving distance of COP to the foot length (%Backward) were calculated. Parameters during the 2nd assessment were compared with those of controls and those during the 1st assessment. During the 2nd assessment, relationships among the parameters, MDScore, and WSpeed were analyzed. Results During the 2nd assessment, no difference was observed in both %Long and %Backward between the non-paretic limbs and the controls. While the %Backward was higher, the %PFP of toes and %Long were lower in the paretic limb than in the controls. Although the %Backward was lower, both %PFP of toes and %Long of the paretic limb were higher in the 2nd assessment than in the 1st assessment. During the 2nd assessment, both %Long and % Backward values of the paretic limb moderately correlated with MDScore and WSpeed. Significance After improvement of foot pressure in toes, both an increase in anteroposterior length and a decrease in backward moving of COP path were objective signs permitting independent walking.

According to WHO, about 422 million people are affected with diabetics and among them 15% of diabetic patients are associated with foot problems. Due to peripheral neuropathy, the patients are unable to sense pressure pain which eventually creates calluses. Thus the aim of this study is to effectively find the risk areas which may form ulcers in the foot. The physical components required for this study are a camera which captures high-quality images of foot and a laptop capable of processing image by using MATLAB (The Mathworks Inc., USA). The algorithm which we developed extracts the high-intensity areas in the foot which are actually the areas where the patient exert high pressure compared to other areas in the foot. This method was evaluated by assessing the foot for 5 normal patients and 5 diabetic patients. It is found that this method is capable of giving the riskier areas of the foot and thereby further prevention of foot ulcer can be done. Our method is time-efficient, cost-efficient, and space-efficient and thus can be easily installed in any hospital for diabetic foot analysis. In most of the cases, the metatarsal head region and plantar medial tubercle region are mainly affected by calluses. By proper diagnosis and daily care of the foot can reduce the risk of ulcer in diabetic patients.

© 2020 Elsevier Ltd Obese people are often encouraged to lose body mass by exercise. The aim of the study was to determine the effect of body mass and ankle muscle strength on the dynamic foot-pressure distribution before and after running. Twenty-five normal weight (72.0 ± 5.3 kg), 25 overweight (80.8 ± 5.6 kg) and 25 obese (96.8 ± 6.5 kg) age- and height-matched male recreational runners joined the study. Before and after 30 min running, dynamic foot-pressure distribution during running, and ankle plantarflexor, dorsiflexor, invertor and evertor muscle strength were measured using a foot-scan pressure-plate and isokinetic dynamometer, respectively. Body mass index and percentage fat mass correlated positively to almost all components of foot-pressure distribution; this explantion was extracted from 14% (for toe 1) to 52% (for dynamic arch index) of peak foot pressure and between 21% (for metatarsal 1) to 48% (for midfoot) of the impulse underneath different foot zones. Only plantarflexor muscle strength significantly predicted plantar pressure and impulse underneath the T1, T2-5, midfoot area and the dynamic arch index. After running, plantarflexor and invertor muscle strength predicted from 30% (for metatarsal 2) to 58% (for metatarsal 1) of peak foot-pressure and impulse underneath the different foot zones. Obesity is associated with excessive plantar loading that is aggravated after running by fatigue-related reductions in plantar flexor and invertor muscle strength. To prevent foot pain and injuries related to excessive foot pressures, at the start of the weight control process non-weight bearing rather than weight-bearing exercise is advisable.

Physically we can see that there is a difference between obese and non-obese people, it’s seen from a fatter body posture. Then we can categorize the person into obese or not by calculating the Body Mass Index (BMI). But this still must be done manually because we have to check weight and height first, then calculated BMI according to the BMI formula. Therefore we need a system that can be used to detect obesity automatically. In this study, we created a system that can detect obesity automatically based on foot plantar pressure. On foot plantar pressure there is a significant change between foot pressure in obese and non-obese people. In obese people the pressure will be further increased in the metatarsal foot, heel, and midfoot. This is because the heel is part of the foot which is the main support of the body and in the midfoot there are different levels of leg curvature between obese and non-obese people. The system is built using Fuzzy Inference System based on Fuzzy Logic Concept. So, the system can provide an automatic output whether the person is categorized as thin, normal, or obese.

Two new measures of foot pressure image have been established for studying the severity of foot drop of sufferers of diabetic peripheral neuropathy (DPN). These measures are: plantar distance travelled from heel; and apparent delay in forefoot travelled from 2nd metatarsal head to toe-off. These measures were obtained by precise marking of the conjugate second metatarsal head location and the conjugate pternion location, thus establishing the medial foot axis (MFA) on the pedobarograph. Using the plantar pressure pattern and recorded time of the pedobarograph, apparent plantar distance (PDH) and apparent 2nd metatarsal head to toe-off delay (MHTOD) were calculated. Healthy and diabetic older male and female adults were recruited from diabetic clinics and retirement homes in Kuala Lumpur Malaysia. The null hypothesis of comparing the DPN group and healthy group using PDH was accepted. However, MHTOD was not statistically verified as a suitable measure for DPN foot drop detection. This small clinical validation project showed that by utilizing plantar-pressure characteristics and precisely recorded time of the pedobarograph it would be possible to detect foot-drop issues accurately.

Purpose: The aim of the study was to compare the distribution of foot plantar pressure between normal and obese adult subjects during walking. Methods: Sixty male and female adult volunteers (aged 20–40) were recruited into the study. They were equally divided into 30 normal subjects (BMI = 18.5–22.9 kg/cm2) into group I and 30 obese subjects (BMI ≥ 25.0 kg/cm2) into group II, according to their BMI. Results: There were statistically significant differences between normal and obese subjects in foot length, width, and pressure distribution in the hindfoot, midfoot, forefoot, and toes. There was a statistically significant increase in the plantar pressure of all measured areas in obese persons in comparison with the normal subjects. In addition, all measures of foot pressure showed statistically significant differences between the same sex of both groups, while the obese subjects of both genders have higher foot pressure in all measured areas. High positive correlations were detected between BMI, peak pressure, foot contact, and foot width in both groups, but there was a weak positive correlation between normal BMI and foot contact area. Conclusion: The distribution of plantar foot pressure is different in adult obese subjects than in normal adult subjects during walking activity. The obese persons have larger foot length, width, higher peak pressure, and contact area. This study can help physical therapists to understand the differences of foot pressure between normal and obese subjects, and consequently, to detect any expected foot abnormalities accompanied by obesity.

International audience; Foot ulcers are usually the consequence of a trauma associated to diabetes that could lead to amputation and shorten life expectancy. In this chapter some technologies that could prevent pressure foot ulcers for diabetic persons are presented. There are three essential components: 1) a smart sock to monitor the pressure applied to the foot, 2) a patient-specific finite element model of the foot that includes the soft tissues and bony prominences to compute the required indicators like stress and strain in the foot and 3) a reduced order model that is able to compute the results of the finite element model in real-time and with a small error. To create the reduced order model Proper Orthogonal Decomposition with Interpolation (PODI) was employed. The displacements in the foot based on the reduced order model were computed in 0.1s; although the relative error norm was 2.6% which seems acceptable from a clinical point of view

Aim. The aim of the study was to compare the longitudinal arch of the foot and foot pressure distribution (FPD) parameters in young male soccer players and controls. Methods. A group of 50 soccer players and 50 non-training controls participated in the project. Their height and weight were measured, and body fat percentage (BFP) and BMI calculated. The height of foot arches and FPD were examined. Results. Participants did not differ with age, height or BMI. However, soccer players were significantly lighter and had smaller BFP. The mean Arch Index (AI) was similar in both groups but more soccer players had very high foot arches whereas more controls a low longitudinal arch of the foot. Normal arches prevailed in controls. The AI became greater with the increase of BMI, both in soccer players and in controls. FPD was greater in controls on the head of the first metatarsal bone, whereas in soccer players on the head of the fifth metatarsal bone. A significantly greater FPD on the medial heel was found in both groups as compared to the lateral heel pressure, which was greater in controls. Conclusions. Regular soccer training changed FPD but affected the longitudinal arch of the foot less distinctly. Soccer training cannot be treated as an element supporting the process of proper foot formation in children.

This paper proposes an auditory feedback system for adjusting the foot pressure balance of runners equally between the left and right feet. A wireless shoe system that measures foot plantar pressure in real time was proposed, and two types of auditory feedback mechanisms were provided and evaluated: 1) "Footstep" with a constant 440-Hz sound presented at the time of contact and 2) "Pitch change" that adaptively changes the sound to 880 Hz for the foot when a higher foot load is detected. The results of the user studies did not show a significant change in foot pressure difference with the proposed technique. The influence of the two auditory feedbacks on foot pressure was different for each subject; however, we confirmed the change of foot pressure balance by the change of sound.

Diabetic foot ulcers have taught us the role of offloading. All neuropathic foot wounds require offloading to heal. The use of airbed or water bed for pressure sores is again an example of off loading. Foot pressure measurement and preparing proper foot wears is a new science. The whole footwear including insole and outsole requires modifications in many patients. But it should be kept in mind that for foot ulcers to heal best treatment is total contact cast and not the foot wears. To prevent toe deformities after forefoot surgery, specialized footwear with fillers in the insole is essential.

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.

This study aimed to assess the effects of plantar flexor lengthening (PFL) on dynamic foot pressures of children with cerebral palsy using pedobarographs. Of 97 enrolled, 13 children with 18 legs had PFL. Age at surgery was 4.7 (2.8-8.8) years. A significant increase in ankle dorsiflexion and heel impulse was achieved postoperatively and was maintained at 5 years. The coronal plane pressure index increased postoperatively, but reverted to preoperative levels at the 5-year follow-up. Children tend to have more valgus after PFL. In young children, there caution should be exercised to avoid over treating varus at the time of equinus correction to avoid overcorrection.

[Purpose] This study evaluated gait parameters and foot pressure in two regions of the feet among older females with different personal care support needs to analyze factors that contribute to higher support requirements. [Subjects and Methods] Thirty-two older females were divided into support-need and care-need level groups. Gait parameters (speed, cadence, step length, step width, gait angle, toe angle, double support phase, swing phase, and stance phase) and foot pressure during a 5-m walk were measured and analyzed in the two groups. [Results] The percentage of the double support phase on both feet and the right stance phase were significantly higher in the care-need level group, while that of the right swing phase was significantly lower than that of the support-need level group. Additionally, the phase showing peak pressure on the left rear foot was significantly delayed and the left forefoot pressure in the terminal stance was significantly lower in the care-need level group than in the support-need level group. [Conclusion] These findings show that the temporal duration parameters and foot pressure on a particular side were significantly different between the two groups and suggest that these differences were associated with a higher care level.

Background: There is insufficient evidence to establish the optimal treatment protocol for robot-assisted gait training. Objective: This study aimed to analyze the effects of robot-assisted gait and independent over-ground gait on foot pressure and to determine an effective training protocol for improvement of gait pattern in patients with incomplete spinal cord injury due to industrial accidents. Methods: Four patients with incomplete spinal cord injury due to an industrial accident who had gait disturbance underwent measurement of peak foot pressure and stance phase duration using a foot pressure analysis system with robot-assisted gait and independent over-ground gait. Results: The robot-assisted gait condition has lower peak foot pressure and shorter stance phase duration than the independent over-ground gait. Conclusions: In this study, robot-assisted gait was found to limit gait pattern improvement in patients with gait disturbance caused by incomplete spinal cord injury due to industrial accidents. Therefore, future research will be conducted to determine the optimal protocol for robot-assisted gait training for gait pattern improvement.

Objective: Persons with stroke have a tendency to exhibit asymmetric weight-bearing during sit-to-stand because due to the attempt to support themselves with the non-paretic foot. However, there are few devices that can assist with sit-to-stand (STS) performance. This study was designed to investiga...

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.

Background Different arch support heights of the customized foot orthosis could produce different effects on the internal biomechanics of the foot. However, quantitative evidence is scarce. Therefore, we aimed to investigate and quantify the influence of arch support heights on the internal foot biomechanics during walking stance. Methods We reconstructed a foot finite element model from a volunteer with flexible flatfoot. The model enabled a three-dimensional representation of the plantar fascia and its interactions with surrounding osteotendinous structures. The volunteer walked in foot orthosis with different arch heights (low, neutral, and high). Muscle forces during gaits were calculated by a multibody model and used to drive a foot finite element model. The foot contact pressures and plantar fascia strains in different regions were compared among the insole conditions at the first and second vertical ground reaction force (VGRF) peak and VGRF valley instants. Results The results indicated that peak foot pressures decreased in balanced standing and second VGRF as the arch support height increased. However, peak midfoot pressures increased during all simulated instants. Meanwhile, high arch support decreased the plantar fascia loading by 5%–15.4% in proximal regions but increased in the middle and distal regions. Conclusion Although arch support could generally decrease the plantar foot pressure and plantar fascia loading, the excessive arch height may induce high midfoot pressure and loadings at the central portion of the plantar fascia. The consideration of fascia-soft tissue interaction in modeling could improve the prediction of plantar fascia strains towards design optimization for orthoses.

Objective: The purpose of this study was to investigate the effect of a 12-week professional body massage program (PMP) on forward head posture, neck pain, and plantar foot pressure balance in men in their 20s. Method: A total of 20 men with musculoskeletal diseases were recruited for this study. The participants were asked to take part in a PMP twice a week for 12 weeks. The cranial vertical angle (CVA) for forward head posture and visual analogue scale (VSC) for neck pain and right/left foot plantar pressure balances were extracted to compare between pre- and post-program differences. Results: CVAs before ($56.86{\pm}4.55^{\circ}$) and after ($62.72{\pm}4.57^{\circ}$) and VSCs before ($6.95{\pm}1.70$) and after ($1.70{\pm}1.56$) PMP revealed statistically significant differences. The right foot, after PMP, showed a significant increase in the plantar pressure balance from $46.17{\pm}2.95$ to $49.44{\pm}1.29%$, while the left foot decreased significantly from $53.83{\pm}2.95%$ to $50.56{\pm}1.29%$. Therefore, based on these results, it may be said that the foot pressure balance abilities were improved after PMP because the ideal foot pressure ratio is 50%. Conclusion: Consequently, it was suggested that a 12-week PMP could be utilized for improvement of forward head posture, neck pain, and foot plantar pressure balance in men in the 20s with musculoskeletal diseases.

The characterization of activity patterns of overweight and obese (OW) children and adolescents is essential, and should be carried out before they join an exercise training programme and increase their physical activity in order to maintain or reduce body weight.The purpose of this study is to verify whether the biomechanical parameters characterizing frequently used walking and running speeds vary between OW and normal-weight (NW) children. Thirty-one prepubescent OW children (9.9 y ± 1.3) and 10 prepubescent NW children (9.9 y ± 1.2) participated in this study. All participants were evaluated for temporal parameters (e.g. cycle length, cycle time, stance phase time, double support phase time, etc.) and for foot pressure parameters (e.g. contact area, duration of contact, peak pressure, etc.) in six different foot areas, at three walking velocities, and two running velocities. A group effect (p < .05) was found for the peak pressure, duration of contact percentile, maximum force, foot pressure–time inte...

Introduction: Diabetic foot ulcer is a major source of morbidity and a leading cause of hospitalization. It is estimated that approximately 20% of hospital admissions among patients with diabetes mellitus are due to diabetic foot ulcer. It can lead to infection, gangrene, amputation, and even death if appropriate care is not provided. Overall, the lower limb amputation in diabetic patients is 15 times higher than in non-diabetics. In the majority of cases, the cause for the foot ulcer is the altered architecture of the foot due to neuropathy resulting in abnormal pressure points on the soles. Purpose: The aim of this study is to develop low cost, lightweight foot pressure scanner and check its reliability and validity which can help to prevent foot ulceration. Design/Methodology/Approach: In the present study, a low cost, lightweight foot pressure scanner is developed, and dynamic plantar pressures in a group of 110 Indian patients with diabetes with or without neuropathy and foot ulcers are measured. Practical Implications: If these pressure points can be detected, ulcers can be prevented by providing offloading footwear. Originality/Value: Differences are found in dynamic foot pressures in different study groups, namely, diabetic patients, patients with diabetic peripheral neuropathy, patients with foot ulcers, and nondiabetics. The differences are significant (P < 0.01), which showed the validity of the tool. Reliability and consistency of the tool was checked by test–retest method. Paper Type: Original Research work. Conclusion: Based on the results of the present study, it is concluded that the scanner is successfully developed and it can measure foot pressures. It is a novel device to proactively monitor foot health in diabetics in an effort to prevent and reduce diabetic foot complications.

Background In pedobarography, clinically meaningful comparison of measurements within or between subjects is limited by data variability and measurement error. This study aims to determine the components of the minimal detectable change (MDC) in impulse across all foot regions and the reliability of these measures. Methods A convenience sample of foot pressures from 108 visits by normal, healthy subjects aged 2–17 years was studied. Each subject had three pedobarograph measurements taken per foot, with six subjects returning for a second visit for assessment of day-to-day variability. Using a five-region mask, segmental impulses were determined, and from these we obtained the coronal plane pressure index (CPPI). Inter-rater, intra-rater, and day-to-day data were analyzed using intraclass correlation coefficients (ICC) to quantify reliability. Variability of the data was analyzed to quantify the MDC. Results Inter- and intra-rater reliability was high for all measurements while variability was low, indicating small direct measurement error. Generally, the largest contributing factor to the MDC was day-to-day variability. Step-to-step variability was more dependent on foot segment than age although minor age-related changes were noted. Finally, the high relative variability in the CPPI and the medial mid foot impulse resulted in very high MDCs for these measures.

Background: Foot deformities such as hallux valgus can be one of the causes of falls for the elderly. This is a serious social problem, and a quantitative method for evaluating the effects of such foot deformities is desirable. This study examines the relationship between plantar pressure during the act of walking and the presence (or absence) of hallux valgus. Method: Foot-pressure data during walking was recorded using an F-scan II system. Gait experiments over a 10-m walkway using the plantar pressure system were conducted with 28 female participants (12 with hallux valgus, and 16 without). We analyzed the entire waveform of the plantar pressure data taken during walking using principal component analysis (PCA). Data analysis was conducted using a 280 × 357 matrix of time-normalized plantar data of 7 areas during gait (5 gait trials × 2 (both feet) of 28 subjects × 51 data points × 7 plantar areas). One-way analysis of variance was conducted on the principal component scores (PCSs) of principal component vectors (PCVs) 1–37 and demographic data, each of which exhibited a variance of greater than 5%. Results: The first group comprised of subjects with hallux valgus affecting one foot only. In the second group, the unaffected foot was considered. The third group did not have hallux valgus affecting either foot. The PCA clarified that the 2nd, 7th, 11th, and 15th PCVs were related to the effects of the presence or absence of hallux valgus ( $p ). These results indicated that hallux valgus affected foot pressure during walking. Moreover, those with hallux valgus tended to have different plantar pressure variations in the entire plantar area, while those with normal feet did not experience such variations. Benefit of this research: Our results indicated the possibility of differences in the characteristics of plantar pressure during the stance phase in gait events, based on the PCVs of the presented groups. The evaluation of foot pressure during everyday walking will help in the prevention of unilateral and bilateral hallux valgus; hence, helping to prevent falls.

Foot pressure technology has been utilized to study the influence of over-weight and obesity on the ankle joint which because of gaining weight lead to change gait characteristics, particularly foot ailments, and has been used in academic teaching in the Medical and Allied Health fields for over 30 years. However, earlier sensors often required an indoor setup as they were not portable. Advanced technology provides the means to take the system outdoors, thus the having the ability to determine the impact of walking-paths terrain on foot pressure and on the ankle joint. Over-weight and obesity cause a number of adverse walking issues for the ankle as extra weight is loaded onto this vital joint component. In addition, footpath terrain may be uneven and thus plays a role in the characteristics of gait and subsequently has an impact on the ankle. In this research, simulated obesity was introduced to study foot pressure and the impact on the ankle of outdoor walking. One aspect was the potential for foot injury, particularly foot ankle rotation. This technology allows researchers and academics to demonstrate the impact of over-weight and obesity in outdoor walking.

This research introduces an innovative alternative statistical methodology to improve the way of conducting human gait analysis using advanced foot pressure capture technology. The developed approach is more efficient than the most commonly used approaches in the field. It enables experts to achieve more accurate results. In addition, it requires less efforts, cost and time. A study was carried out to approve the efficiency of that methodology. Five healthy young adults were voluntary recruited and data were recorded using 300E F-scan insole-sensors. Contact area (CA) and peak pressure (PP) from ten foot regions, i.e. heel, midfoot, first metatarsal (MTH1), second metatarsal (MTH2), third metatarsal (MTH3), fourth metatarsal (MTH4), fifth metatarsal (MTH5), hallux, second toe and third-fifth toes, were analysed. For all of the 20 parameters studied, the proposed approach achieved more accurate results than that used commonly in the literature. Moreover, our findings indicated that the heel and midfoot regions had the first two highest values of contact area (CA), while the 2nd toe and 3-5th toes regions had the lowest two values. On the other hand, the regions of the heel and hallux had the biggest values of peak pressure (PP). Whereas, the regions of the 2nd toe and 3-5th toes had the lowest two values.

Foot ulcer is a severe complication affecting about 25% of diabetes mellitus patients due to a lower blood supply and loss of foot sensitivity (neuropathy). A fast and reliable identification of foot pressure loads and temperature distributions changes on the plantar surface allows to prevent and reduce the consequences of ulceration such as foot or leg amputation. Several wearable technologies have been developed and tested by the scientific community, addressing the “diabetic foot” topic. However, the dimensions of the devices and the combined pressure/temperature monitoring capabilities don’t accommodate the requirements from both the end-users and caregivers: normally just one information—pressure loads or temperature map—is acquired, moreover the amount of thermal reading points is lower than 5 and the accuracy of thermal sensors is greater than 0.5 °C. This work presents a smart insole in which both temperature and pressure data in 8 reading points are monitored in remote way for the assessment of the health foot conditions by a caregiver. Minimally invasive and low power temperature and force sensors have been chosen and integrated into two antibacterial polyurethane-based layers architecture, designed in accordance with the typical requirements of diabetic foot. Based on the results, the developed system shows high performance in terms of temperature and pressure detection.

El objetivo del presente reporte es describir la dinámica plantar durante el servicio y durante la realización de pruebas específicas de potencia, velocidad y equilibrio en tenistas y establecer su relación. Se estableció un método descriptivo, se evaluaron a 16 deportistas realizando pruebas de potencia, velocidad, equilibrio y servicios tipo top spin, se realizaron medidas descriptivas para los resultados de las pruebas y los de la dinámica plantar, y se correlacionaron entre sí. Los resultados sugieren que el centro de presión anteroposterior del pie (COP-AP) durante las pruebas de equilibrio tuvieron un promedio de -32mm, a su vez, el promedio de potencia durante el salto en el servicio fue de 165 +35 N. Se encontró una relación (r=0,45) entre el tiempo en el aire y los centímetros saltados, además entre el tiempo de la prueba de velocidad y el tiempo del ciclo de la carrera (r=0,54), The objective of this article is to describe the foot dynamics during the service and during the performance of specific tests of power, speed and balance in tennis players and to establish their relationship. A descriptive method was established and 16 athletes were evaluated in power, velocity, balance and top spin services tests. Descriptive measures were performed for the test results and for foot dynamics, and correlated with each other. The results suggest that the center of anteroposterior foot pressure (COP-AP) during the balance tests had an average of -32, the average power during the jump in the service was 165 +35. A relation (r = 0.45) was found between the time in the air and the centimeters jumped, in addition, between the time of the test of speed and the time of the cycle of the race (r = 0.54)