Search

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.

Purpose: The aim of the experiment presented in this study was to determine the pressure distribution within the forefoot depending on the type of orthopaedic footwear used. Methods: The study included 27 women aged 20 to 25. The Zebris FDM-2 dynamographic platform was used in foot pressure measurements. The load distribution was measured in three types of orthopaedic footwear: MedSurg, MedSurgPro and OrthoWedge. The full gait cycle was recorded. The Cavanagh masks were applied to the load distribution results processed into a graphic form. The data were analysed using Statistica v.13.1. Results: In the forefoot area, i.e. the metatarsal bones and toes 1–5, the lowest loads were reported in the shoes that off-load the forefoot (0.2 N/cm2, p < 0.001). In the area of the first to fifth metatarsal bones and the hallux, the highest load was observed in the rocker shoe, accounting for 19.7 N/cm2 (p < 0.001). For comparison, high pressure in the flat shoe was found in the area of toes 2 to 5 (p < 0.001). Conclusions: In the area of the metatarsal and toe bones, the pressure exerted was highest in the commonly used rocker shoe. The flat shoe provides an even and uniform load in all areas of the forefoot, while this type of shoe does not significantly reduce the pressure forces on the forefoot. The shoe that was the most effective in off-loading was the forefoot off-loading shoe (OrthoWedge). Barefoot walking puts less load on the forefoot compared to the flat and rocker shoes used after orthopaedic procedures.

Cerebral palsy is the most common motor disability seen in childhood. Gait impairments are the most common orthopedic issue for patients with ambulatory cerebral palsy, also known as spastic diplegia. For patients with cerebral palsy, the use of telemedicine for routine follow-up and review of gait analysis studies can be particularly attractive. Common things reviewed during a typical gait analysis session include photos and videos of the patient during examination, kinematic and kinetic plots, oxygen consumption during gait, and foot pressure analysis.

Objective: To define a two-dimensional (2-D) region of stability derived by center of mass (COM) velocity, and to assess the dynamic walking stability with COM position and velocity. Methods: The 2-D base of support (BOS) was determined by the intersection between the vector of the 2-D COM velocity and the envelope of the foot pressure. The region of stability for velocity (ROSv) in 2-D were determined using normalized COM position and velocity at toe off (TO). In order to exam the utility of this new parameter, fourteen elderly females with and without history of falls participated into a walking experiment. Results: The results showed that the 2-D ROSv could distinguish the coordinates difference between two groups much better than 1-D form in antero-posterior. COM position of elderly fallers demonstrated significant closer to the foot supporting boundary than that of healthy elderly adults at TO. Conclusion: The parameter of 2-D ROSv could differentiate among dynamic stability for healthy elderly adults and fallers. The results of walking experiment revealed elderly fallers tend to walk more conservatively compared to healthy subjects, to relieve the pressure of controlling their momentum.

BACKGROUND Foot deformities result in pain and changes in plantar pressure distribution in rheumatoid arthritis (RA) patients. Medical insoles are commonly prescribed for declining pain and modifying foot pressure distribution in these patients. The purpose of this study was to evaluate the effect of a pre-fabricated insole with metatarsal pad and medial longitudinal arch support on plantar pressure distribution in rheumatoid arthritis patients. METHODS Fifteen females with RA participated in this study. All patients received a pair of pre-fabricated insoles that were individually modified using metatarsal pads and medial longitudinal arch supports. Mean peak pressure (kPa), maximum force (N), and contact area (cm2) were calculated for the heel, midfoot, metatarsophalangeal joint, and toe regions using the Pedar-X system immediately and after a month follow-up. FINDINGS In the heel and metatarsophalangeal joint regions, maximum pressure and force showed a significant reduction in the follow-up assessment (p < 0.05). The comparison showed a significant increase in maximum pressure and force in the midfoot when participants walked with insole compared to without insole condition (p < 0.001). INTERPRETATION Using a pre-fabricated insole with an individually modified metatarsal pad and medial longitudinal arch support could alter rheumatoid arthritis patients' plantar pressures after one month of follow-up. This type of insole is simple and inexpensive and showed a significant effect on decreasing pressures under the metatarsal heads.

The monitoring of human physiological signs and body functions, such as respiration rate, heart rate, foot pressure, and joint movement, plays an important role in medical advances and life quality improvements. Polymer optical fibers are made of polymer materials with attractive characteristics compared with silica fibers, such as low Young’s modulus, high failure strain levels, high flexibility, and bio-compatibility. These advantages are well-aligned with the instrumentation requirements for monitoring human physiological and body functions. In this perspective, this paper provides a comprehensive review about polymer optical fiber for human physiological and body functions monitoring, namely mechanisms, materials, and applications, which makes it possible to envisage a widespread implementation of such sensors in this research field in the next few years.

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.

Introduction: Measurement of foot pressure variables can be used to assess the loads to which the human body is subjected in normal activities, like walking, or in more demanding situations such as sports. The purpose of this study was to compare the foot pressure variables in blind and healthy individuals with open and closed eyes during walking. Methods: The present study was a quasi-experimental and laboratory study with pretest-posttest design. The statistic samples included 13 blind men with the mean age of 29.05±3.28 years and 17 healthy men with the mean age of 24.22±1.31 years participated in this study and were selected by available sampling method.. A foot scan (RS Scan International, Belgium) set was used for measuring planter pressure during walking. Variables data were recorded at a sampling frequency of 300 Hz. For data analysis, paired t-test was run to compare the means within the group; also, independent t-test run to compare the means between the groups using SPSS ver. 16 statistical software. Results: The results showed that the peak reaction time of the ground reaction force during the heel contact phase was 45.89% higher than blind people compared to the normal participants (p

At present, the typical tripod gait of a hexapod robot has a large deviation from the direction of motion. In this thesis, the characteristics and experimental results of typical tripod gait are analyzed, and the causes of tripod gait deviation are summarized; Then, the kinematics model of the robot's monopod is established, and the theoretical equation of lateral slip of the robot is obtained by combining the mechanical analysis of the foot. Finally, the essence of lateral slip of the robot is obtained by synthetically analyzing the data obtained from friction experiment and foot pressure experiment. Experiments and analysis show that when a hexapod robot walks in the plane of acrylic force plate, both the left and right sides are subjected to lateral forces, and the forces are unequal, so the robot has lateral deviation.

This article presents preliminary research in designing overlays and insoles for footwear with measurement components located in the mid-foot and the heel area. With this type of measurement components, the gait can be analysed in any place of the room that was designated for this examination. With measurement components used in separate components, the gait can be measured in its different phases. With additive manufacturing technology, the device designed can be quickly verified.

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.

In recent years, the number of patients suffering from diabetes mellitus has continued to increase. When diabetes becomes severe, ulcers may form on the feet of the patient. In the past few years, several researchers have focused on the risk factors and avoidance of ulceration. One effective method to predict the occurrence of diabetic foot ulcers is developing a machine learning model. However, few studies combine both clinical indices and mechanical data as the attributes of the training datasets. In this study, we developed a composite model of a convolutional neural network and K-means clustering to extract features from diabetic patients with or without ulceration as well as healthy individuals. Using a deep clustering model, the center of pressure (CoP) trajectory images were divided into three clusters. Furthermore, we evaluated the performance of the clustering by extracting the features from the CoP trajectory images in each cluster and combining them with the clinical indices of the patients. The results showed that patients with ulcers when walking tend to contact the ground with a narrow area of the plantar and apply a small force. Furthermore, it was found that patients undergoing diabetic neuropathy or with a toe amputation have a high potential of suffering from ulcers.

© 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.

Surgeons working in orthopedics and trauma surgery are frequently exposed to repetitive actions and non-ergonomic positions in their operative activities with the regular use of lead aprons. Musculoskeletal complaints of the neck and back among surgeons are reported in the literature as up to 80%. In this study, the effects of lead aprons on the posture of surgeons are examined using videorasterstereography, foot pressure measurement and questionnaires.All subjects (n = 31) were examined before and after exposure to wearing lead aprons during surgery using videorasterstereography and pedography. In addition, a survey with a separately created questionnaire and the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was carried out.An average duration of lead apron use of 102.6 min showed an increase in forefoot load (p = 0.002) especially in the elderly subjects and thoracic kyphosis (p 0.001) especially in the younger doctors with a significant lateral deviation (p = 0.006). In addition, the lateral deviation was shown to correlate with an increasing body size or a shorter period of employment (p = 0.008; r = 0.51/p = 0.026; r = - 0.44). Significantly fewer surgeons experienced back complaints on working days without lead apron use in the operating room compared to days in the OR (p = 0.011).The impact of wearing front covered lead aprons during operations in the field of orthopaedics and trauma surgery leads to more frequent back complaints, even among young and healthy doctors. Under an average duration of surgery of 102 min a temporary postural deviation occurs that can be demonstrated by means of videorasterstereography and foot pressure measurement. The subjects showed a shifted weight distribution on the forefoot, a gain in thoracic kyphosis and an increase in lateral deviation, which also correlated with an increasing height and shorter length of employment.Orthopädisch-unfallchirurgisch tätige Ärzte sind in ihrer operativen Tätigkeit häufig repetitiven Bewegungen und unergonomischen Positionen unter regelmäßigem Einsatz von Röntgenschürzen ausgesetzt. Muskuloskelettale Beschwerden des Nackens und Rückens unter Chirurgen werden in der Literatur mit bis zu 80% angegeben. Wie sich der Einfluss der Frontröntgenschürzen auf die Haltung der Ärzte auswirkt, wird in dieser Studie mittels Videorasterstereografie, Fußdruckmessung und Fragebögen untersucht.Alle Probanden (n = 31) wurden vor und nach Belastung durch das Tragen von Röntgenschürzen bei operativen Eingriffen mittels Videorasterstereografie und Pedografie untersucht. Zusätzlich erfolgte die Durchführung einer Fragebogenanalyse zur Prävalenz von Rückenbeschwerden u. a. mit dem Cornell Musculoskeletal Discomfort Questionnaire (CMDQ).Unter einer mittleren Belastungszeit von 102,6 min zeigt sich eine Zunahme der Vorfußbelastung (p = 0,002) vor allem bei älteren Probanden und der thorakalen Kyphose (p 0,001) vor allem bei den jüngeren Ärzten bei einer generellen Lotabweichung (p = 0,006). Zudem zeigte sich die Lotabweichung abhängig von einer zunehmenden Körpergröße oder einer kürzeren Beschäftigungsdauer (p = 0,008; r = 0,51/p = 0,026; r = − 0,44). Signifikant weniger Probanden verspüren Rückenbeschwerden an Arbeitstagen ohne Einsatz im Operationssaal im Vergleich zu OP-Tagen (p = 0,011).Die Belastung durch das Tragen von Frontröntgenschürzen während operativer Eingriffe im Fach Orthopädie und Unfallchirurgie führt zu häufigeren Rückenbeschwerden auch bereits bei jungen gesunden Ärzten. So kann bei einer mittleren Operationsdauer von 102 min eine videorasterstereografisch und pedografisch nachweisbare temporäre Haltungsabweichung mit Mehrbelastung des Vorfußes, Lotabweichung und Zunahme der thorakalen Kyphose nachgewiesen werden, die zudem mit zunehmender Körpergröße und kürzerer Beschäftigungsdauer korrelieren.

Uvod: Visoke pete se nosijo že več stoletij in kljub številnim opozorilom o škodljivih posledicah ostajajo še vedno izjemno priljubljene. Raziskave ugotavljajo, da redna nošnja čevljev z visokimi petami neugodno vpliva na mišično-skeletni sistem ter povzroča občutke nelagodja in zvine gležnjev. Prav tako se spremenijo biomehanski parametri med hojo, ki vključujejo spremembe obremenitev spodnjih okončin, povečanje stopalnih pritiskov in spremembe vzorca hoje. Namen: Namen diplomskega dela je bil ugotoviti vpliv čevljev z visoko peto na bolečine v stopalih in spodnjem delu hrbta ter posledične težave in/ali omejitve pri vsakodnevnih aktivnostih. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda s pregledom obstoječe literature in empirična metoda dela. V raziskavi je sodelovalo 14 preiskovank, ki so izpolnile vprašalnik sestavljen iz treh delov: demografski podatki, bolečine v spodnjem delu hrbta in bolečine v stopalih ter omejitve aktivnosti zaradi nošnje čevljev z visokimi petami. Za izdelavo tabel in grafični prikaz rezultatov smo uporabili Microsoft Office Excel 2016. Za statistično obdelavo podatkov smo uporabili IBM SPSS 26. Rezultati: Večina preiskovank ima ob nošnji čevljev z visokimi petami več težav s stopali in vsakodnevnimi aktivnostmi kot z bolečinami v spodnjem delu hrbta. Povprečen čas nošnje visokih pet je bil 7 ur na dan. Skupna povprečna ocena Modificirane lestvice indeksa bolečine v stopalih je 17/100, skupna povprečna ocena Roland-Morisovega vprašalnika pa 3/21. Rezultati so pokazali statistično značilno zmerno pozitivno povezanost (rs = 0,584 p = 0,028) med telesno maso in težavami z aktivnostmi zaradi bolečin v stopalih in tudi z oceno omejitve aktivnosti (rs = 0,588 p = 0,027). Poleg tega se kaže tudi statistično značilna močna pozitivna povezanost med skupno oceno Modificirane lestvice indeksa bolečine v stopalih in oceno Roland-Morisovega vprašalnika (rs = 0,695 p = 0,006). Razprava in zaključek: Nošnja čevljev z visokimi petami pri osebah s povečano telesno maso omeji in povzroča težave pri aktivnostih zaradi bolečin v stopalih. Z uporabo ortopedskih vložkov lahko povečamo udobnost med nošnjo čevljev z visokimi petami. Bolečine in deformacije, ki jih povzroča nošnja čevljev z visokimi petami, pa lahko omilimo z uporabo primernih ortoz ali opornic. Introduction: High heels have been worn for centuries and despite numerous warnings about their harmful effects, they still remain extremely popular. Research indicates that regular wearing of high-heeled shoes affects the musculoskeletal system and causes discomfort and ankle sprains. Biomechanical factors also change during walking, including changes in the lower limb loads, increased foot pressure, and altered gait pattern. Purpose: The aim of the research was to determine the impact of high-heeled shoes on pain in the feet and lower back and the consequent problems and/or limitations in daily activities. Methods: Descriptive method with review of existing literature and empirical research method were employed. The study sample consisted of 14 respondents who completed a three-part questionnaire, addressing demographics, lower back and foot pain, and activity limitations due to wearing high-heeled shoes. The Microsoft Office Excel 2016 was used to produce tables and graphically display the results. The data were statistically analysed by the IBM SPSS 26. Results: Most of the respondents reported that wearing high-heeled shoes caused more problems in their feet and daily activities than in the lower back. The average time of wearing high heels was 7 hours a day. The overall average score of the Modified Foot Pain Index Scale is 17/100 and the average score of the Roland-Morris questionnaire is 3/21. The results show a statistically significant moderately positive correlation (rs = 0.584 p = 0.028) between body weight and activity problems due to foot pain and the activity limitation assessment (rs = 0.588 p = 0.027). In addition, there is also a statistically significant strong positive correlation between the overall score of the Modified Foot Pain Index Scale and the score of the Roland-Morris questionnaire (rs = 0,695 p = 0,006). Discussion and conclusion: Wearing high-heeled shoes in overweight people limits and causes difficulty in their daily activities due to foot pain. The discomfort caused by the use of high-heeled shoes can be decreased by orthopedic insoles. Moreover, pain and deformities caused by wearing high-heeled shoes can be alleviated by using appropriate orthoses or splints.

OBJECTIVE The aim of this study was to determine the clinical significance of the anterior-posterior displacement of the center of pressure in the foot (apCoP) in post-stroke gait rehabilitation. DESIGN This observational study was conducted in a tertiary hospital. Forty-two subacute post-stroke patients were included. The apCoP was measured twice with a wearable insole foot pressure measurement system, time interval more than 7 days. The results were compared between the first and second tests. The relationship between apCoP changes and spatiotemporal parameter changes were investigated. RESULTS The apCoP increased significantly between tests. The change in walking speed was significantly predicted by the change in the apCoP on the less affected side. The change in asymmetry of the single support phase was significantly correlated with the change in the apCoP on the more affected side. CONCLUSION The change in apCoP provides information about the restoration of body support, body forward progression control, and propulsion in the more affected lower limb during early post-stroke rehabilitation. The apCoP can be a useful parameter for the monitoring of functional changes in the more affected lower limb during post-stroke gait rehabilitation.

The present paper reviews, for the first time, to the best of our knowledge, the most recent advances in research concerning two popular devices used for foot motion analysis and health monitoring: smart socks and in-shoe systems. The first one is representative of textile-based systems, whereas the second one is one of the most used pressure sensitive insole (PSI) systems that is used as an alternative to smart socks. The proposed methods are reviewed for smart sock use in special medical applications, for gait and foot pressure analysis. The Pedar system is also shown, together with studies of validation and repeatability for Pedar and other in-shoe systems. Then, the applications of Pedar are presented, mainly in medicine and sports. Our purpose was to offer the researchers in this field a useful means to overview and select relevant information. Moreover, our review can be a starting point for new, relevant research towards improving the design and functionality of the systems, as well as extending the research towards other areas of applications using sensors in smart textiles and in-shoe systems.

The human foot is easily deformed owing to the innate form of the foot or an incorrect walking posture. Foot deformations not only pose a threat to foot health but also cause fatigue and pain when walking, therefore, accurate diagnoses of foot deformations are required. However, the measurement of foot deformities requires specialized personnel, and the objectivity of the diagnosis may be insufficient for professional medical personnel to assess foot deformations. Thus, it is necessary to develop an objective foot deformation classification model. In this study, a model for classifying foot types is developed using image and numerical foot pressure data. Such heterogeneous data are used to generate a fine-tuned visual geometry group-16 (VGG16) and K&minus, nearest neighbor (k-NN) models, respectively, and a stacking ensemble model is finally generated to improve accuracy and robustness by combining the two models. Through k-fold cross-validation, the accuracy and robustness of the proposed method have been verified by the mean and standard deviation of the f1 scores (0.9255 and 0.0042), which has superior performance compared to single models generated using only numerical or image data. Thus, the proposed model provides the objectivity of diagnosis for foot deformation, and can be used for analysis and design of foot healthcare products.

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.

Background: A nanomaterial-based electronic-skin (E-Skin) wearable sensor has been successfully used for detecting and measuring body movements such as finger movement and foot pressure. The ultrathin and highly sensitive characteristics of E-Skin sensor make it a suitable alternative for continuously out-of-hospital lumbar&ndash, pelvic movement (LPM) monitoring. Monitoring these movements can help medical experts better understand individuals&rsquo, low back pain experience. However, there is a lack of prior studies in this research area. Therefore, this paper explores the potential of E-Skin sensors to detect and measure the anatomical angles of lumbar&ndash, pelvic movements by building a linear relationship model to compare its performance to clinically validated inertial measurement unit (IMU)-based sensing system (ViMove). Methods: The paper first presents a review and classification of existing wireless sensing technologies for monitoring of body movements, and then it describes a series of experiments performed with E-Skin sensors for detecting five standard LPMs including flexion, extension, pelvic tilt, lateral flexion, and rotation, and measure their anatomical angles. The outputs of both E-Skin and ViMove sensors were recorded during each experiment and further analysed to build the comparative models to evaluate the performance of detecting and measuring LPMs. Results: E-Skin sensor outputs showed a persistently repeating pattern for each movement. Due to the ability to sense minor skin deformation by E-skin sensor, its reaction time in detecting lumbar&ndash, pelvic movement is quicker than ViMove by ~1 s. Conclusions: E-Skin sensors offer new capabilities for detecting and measuring lumbar&ndash, pelvic movements. They have lower cost compared to commercially available IMU-based systems and their non-invasive highly stretchable characteristic makes them more comfortable for long-term use. These features make them a suitable sensing technology for developing continuous, out-of-hospital real-time monitoring and management systems for individuals with low back pain.

BACKGROUND Calcaneal apophysitis is a self-limiting disorder that often affects adolescents with a high level of activity and leads to increased pain severity, impairments in gait parameters, and poor health-related quality of life. OBJECTIVE To investigate the combination of custom-made insoles and exercise on foot pressure distribution, spatial-temporal gait parameters, and pain intensity in patients with calcaneal apophysitis. STUDY DESIGN A one-group pretest-posttest design. METHODS Forty patients, aged between 8 and 15 years, diagnosed with calcaneal apophysitis, were included in this study. Patients were asked to use the custom-made insoles and to perform a home exercise program for 3 days a week. The duration of treatment was 4 weeks. The pain severity was evaluated with the Visual Analog Scale. The spatial-temporal gait parameters and foot pressure distribution were assessed with the Zebris FDM-THM-S treadmill system before and after the treatment. RESULTS At posttreatment assessment, there were significant changes in step length, stance phase percentage, swing phase percentage, and gait speed (P 0.05). Moreover, significant differences were found in forefoot, midfoot, and rearfoot pressure distribution (P < 0.05). There was also a significant decrease in pain intensity during activity compared to the pretreatment (P < 0.05). CONCLUSION Our study results suggest that the combination of the custom-made insoles and exercise program created improvements in spatial-temporal gait parameters and foot pressure distribution by reducing the pain severity.

The foot is an important part of the human body that helps to maintain and shift a person’s center of gravity. The roles of the toes in balancing and walking have been the focus of recent research. However, there are few methods or systems that can be used to quantitatively evaluate toe function while walking with respect to aging. Therefore, the purpose of this study is to develop an evaluation method for toe function based on the plantar pressure distribution while walking and evaluate how it relates to general gait parameters. Herein, we propose a method to identify the boundary position between the toe and foot based on the foot pressure distribution matrix. This technique was applied to gait analysis for 1774 female and 1553 male participants aged 20–90 years. The results of the statistical analysis suggest that the toe area ratio may reflect gait function and aging.

The change of balance control mechanism caused by lumbar disc herniation (LDH) has not been well understood. The aim of the study was to investigate the effects of LDH on the dynamical coordinations of center of pressure (COP) during standing on sloped surfaces. Eight LDH patients and 8 gender- and age-matched healthy subjects were recruited to participant in the experiment. Three surface conditions (declining, level and inclining) were set up. Limb load asymmetry (LLA) and individual leg COP (COP more-affected and COP less-affected ) were calculated from the foot pressure distributions which recorded during quiet standing by a force plate. Cross recurrence quantification analysis (CRQA) was applied to assess the coordination of COP trajectories. Linear cross-correlation was applied to measure the correlation between CRQA parameters and COP area. LDH patients showed higher LLA and more deterministic structure of less-affected leg, especially on sloped surfaces, but there is not much difference in more-affected leg. CRQA parameters showed positive correlation with COP area on sloped surfaces. This study reveals that the LDH patients alter the postural control mechanism by magnifying the inter-limb asymmetry and reinforcing feedforward mechanism. The sloped surfaces magnified the changes of more deterministic and rigid patterns in less-affected side in the LDH. This study may provide a new strategy for clinical diagnosis and evaluation of LDH.

This chapter introduces the experimental and computational biomechanical analysis of knee joints of athletes during the different jumps and walking. The force plate platform was used for experimental jumping analysis. The high-speed cameras are analyzing different aspects of jumping and walking. Foot pressure distribution was presented for walking of the subjects. Computer modeling was used to determine parameters of the cartilage in the knee, the distribution of the deformation load stress, and modeling of the knee joint in various kinds of jumping athletes. The main focus of this chapter is to determine the forces and deformation of cartilage during jumps of top class athletes with the aim of exact insight into the forces that the knee suffers during the various segments of the jump and complete explanation of the correlation with the forces, stress, and contraction abilities of muscle-joint system responsible for jumping in both types of contractions and how these forces and deformations affecting the state of the segments of the knee joint and cause injuries. We have make correlation between maximal force during jump and average value maximal von Mises stress in the contact period. It has been found that peak of force is not always in correlation with average of maximal von Mises stress due to different contact times and exposure of body by the ground reaction force. The chapter ends with not only conclusions but also issues that open up new areas and make recommendations for future research topics in this field of research, depending on the specifics of given branches of sport discipline.

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.

This study examined the effects of pressure and other kinetic variables on freestyle flip turn performance. It was hypothesized that an increase in average and peak pressure, and a decrease in the magnitude difference between left and right foot pressure, would result in an improved performance of a swimmer as they performed a flip turn. Ten University level (varsity) swimmers performed five freestyle flip turns using their competition technique. Data were collected from a pressure pad mounted to the vertical wall of the pool and from an underwater camera in the sagittal plane. A negative correlation of .58 and .67 was seen for average and peak pressures respectively when compared to five-meter performance times. Average contact area throughout the push-off phase compared to average and maximum load was .94 and .88. An increase in average contact area from 40 cm 2 to 50 cm 2 resulted in a 26% increase in maximum load. No difference in performance was seen for varying maximum knee flexion angles. Differences between pressure magnitudes between left and right foot did not impact the five-meter performance time. Therefore, increased average contact area throughout the push-off phase caused higher average and maximum loads, and to a lesser extent average and peak pressures. Increases in pressure and load resulted in an improved five-meter performance time. It is concluded that flip turn performance increases through higher contact area with the feet when pushing off the wall.

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

Archery can improve its score by keeping the form constant. Therefore, the position where the center of gravity is arranged becomes important. It is also difficult for the center of gravity to be judged by human eyes and for players to always be conscious. The movement of the center of gravity can be estimated from the head movement and the foot pressure. This system uses an acceleration sensor and a foot pressure sensor to support the form. Since archery forms vary by skeleton, the system determines the optimal form for the individual from the accumulated data.

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.

Dancers are highly trained athletes who are at significant risk of injury due to the repetitive nature of their movement patterns. Most ballet injuries result from overuse and occur in the lower limbs. Therefore, the behavior of the lower limbs during a basic ballet movement should be studied in order to identify and subsequently correct mechanical factors that may contribute to injuries. This study analyzed a cou-de-pied derrière with demi-plié to piqué arabesque gesture executed by 18 ballet dancers identified in two groups: experienced dancers (EDs) and beginner dancers (BDs). Kinematic, baropodometric, and electromyographic analyses enabled the observation of differences between these study groups with regard to joint angles, velocities, foot pressure behavior, and muscle activation during execution of the gesture. Experienced dancers reached greater hip and lumbar spine hyperextension and demonstrated less forward torso flexion, which enables better execution of the gesture compared to BDs. The highest foot pressure in both groups was found in the first metatarsal, with a tendency toward the great toe. In terms of muscular activation, BDs exhibited lower electrical activity than EDs. It is concluded that: 1. ankle and knee angles in demi-plié are not defined by dancers' expertise; 2. the faster the leg is raised during piqué-arabesque the better the gesture; 3. special attention to the metatarsal heads is required due to the high pressures found in this study; and 4. activation of different muscle groups depends on the complexity of the gesture and dancer's expertise.

IoT helps the society to solve various problems in medicine. There are many problems, which can be solved using IOT healthcare such as detection of diabetes, detection of diabetic foot ulcer, abnormality in heart rate and many more. This paper presents the design and implementation of IoT-based system to be used in healthcare for detection of diabetic foot ulcer. The model will monitor the health of diabetic foot ulcer patient and will send alerts if found any abnormality. The development of this model will be done on Node MCU development board. This model enables users to record, analyze and send large data to the users in real time and efficiently. This will help in reducing visits to doctors and will help in live alerts and the abnormality in the patient.

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.

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.