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Introduction: Peroneus longus has proved to be a promising graft for ACL reconstruction due to its high tensile strength, and ease of harvesting. While multiple studies have assessed the functional outcomes of the knee after ACL reconstruction using peroneus longus autograft, we aimed to evaluated donor site morbidity among the Indian population. Matreials and methods: This was a prospective, longitudinal, descriptive study conducted at a tertiary care hospital. Preoperative AOFAS and Karlsson-Peterson scores were obtained, and patients were followed up after surgery for a period of 6-months using the same scoring systems and strength testing with a hand-held Chatillon MSE-100-M dynamometer. Pedobarographs were done using Diers Pedoscan Plantar Pressure Measurement System on a subset of seven patients. Results: 20 patients participated in the study. Mean AOFAS and Karlsson-Peterson scores pre-operatively were 99.7 ± 1.34 and 98.5 ± 4.62 respectively. On completing 6- months of follow-up these scores were found to be 95.6 ± 9.43 and 88.75 ± 18.42 respectively. Deterioration of mean evertor strength was noted at all follow-ups compared to the opposite side. Static pedobarographs showed significant decreased in total surface area of contact and pressure over the posterior aspect of the operated side by 3-months which improved later at 6-months. Dynamic pedobarographs showed decreased mean average plantar pressure while walking on the operated side and significant increase in mean surface area of contact of the operated side (191.886±22.678 cm2) at 6-months of follow-up compared to the opposite side (184.471 ± 22.218 cm2). Five patients showed deviation of the point of maximum pressure while walking on the operated foot making it lateral to the COP with increased lateral plantar/ medial plantar pressure ratio. Conclusion: While the use of peroneus longus tendon autografts in arthroscopic ACL reconstruction does not seem problematic on short-term subjective assessment, there is objective evidence in keeping with evertor weakness, weakness of first ray plantar flexion and possible ankle instability. Level of Evidence: Level lll. [ABSTRACT FROM AUTHOR]

Gymnastics is a basic sport branch consisting of eight disciplines and is recommended to be taught to children at an early age. Our study aimed to evaluate the foot biomechanics and static plantar pressure of children aged 5-15 years who were performing rhythmic and artistic gymnastics. The study included 58 (19 Men/39 Women) child gymnasts and aged 5-15 years. Sociodemographic form, static plantar pressure analysis in bipedal position with pedobarography device, hallux valgus angle measurement (HVA), navicular drop test (NDT) and subtalar pronation angle measurement were performed respectively. The measurements were performed in the same way by an experienced expert. IBM Statistical Package for Social Sciences Version 26.0 (SPSS inc, Chicago, IL, USA) statistical programme was used. Tests were analyzed pairwise with Pearson correlation (p ≤ 0.05). The mean age was 7.43±2.37 years, height 124.68±16.97 cm, weight 27.39±11.39 kg and body mass index (BMI) 16.99±3.22 kg/m2. There was no significant difference between weighted and unweighted in NDT results. In pedobarography analysis, hindfoot percentages were higher than forefoot percentages in static bipedal positions. A positive correlation was found between HVA and subtalar angles (p=0.00). In children performing artistic and rhythmic gymnastics, lateral ankle sprain may be observed due to a pronation tendency in subtalar angles. In addition, in the static bipedal position, distortions occurred in the bipedal static force center because the percentage of hindfoot pressure in plantar pressures was higher than the forefoot. Studies with foot-ankle exercises are needed for these.

BACKGROUND: Hip osteoarthritis is a major civilizational challenge of the ageing population, usually due to the reduced function of gait. In the light of this fact, gait analysis has become an important issue for the doctor, the physiotherapist and the patient, as it serves as a useful tool in diagnosis, recovery, and rehabilitation. Pedobarography is one of the most modern gait analysis methods. OBJECTIVE: The aim of this study is to assess the distribution of pressure forces of the foot on the ground during gait in patients with hip osteoarthritis. METHODS: Dynamic foot tests were performed by means of a two-meter RSscan® International platform, equipped with 16.384 sensors with the scanning frequency level exceeding 500 Hz. Patients were divided into two groups: the research group of N = 60 individuals with hip osteoarthritis, aged 52–84; and the control group of N = 32 individuals without hip osteoarthritis, aged 50–74. Data distribution analysis was performed with the Shapiro-Wilk test, followed by a non-parametric Mann-Whitney U test. RESULTS: The differences between the mean results of maximal peak values of pressure and force in such areas as the big toe, metatarsal I, III, IV, V, lateral and medial heel are significantly lower in the research group than in the control group. Only in the area of metatarsal II, the mean value of pressure is higher in the research group than in the control group. For all metatarsals, the midfoot and medial heel mean results of the contact area are significantly higher in the research group than in the control group. The differences between mean load rate were also tested. The test revealed statistical significance of metatarsal II and III, and the medial heel while metatarsal II displayed a higher mean value in the research group than in the control group. CONCLUSION: The distribution of the pressure forces of the foot can indicate imbalances which cause degenerative changes. Therefore, early detection of changes can help in prevention or delay of hip osteoarthritis in conjunction with proper therapy. [ABSTRACT FROM AUTHOR]

Purpose: Foot pressure measurement devices are used widely in clinical settings for plantar pressure assessments. Despite the availability of various devices, studies evaluating the inter-device reliability are limited. This study compared plantar pressure measurements obtained from HR Mat (Tekscan Inc.) and EMED-n50 (Novel GmbH). Materials and Methods: The study involved 38 healthy male volunteers. The participants were categorized into two groups based on the Meary's angle in standing foot lateral radiographs: those with normal feet (angles ranging from -4° to 4°) and those with mild flatfeet (angles from -8° to -15°). The static and dynamic plantar pressures of the participants were measured using HR Mat and EMED-n50. The reliability of the contact area and mean force was assessed using the interclass correlation coefficient (ICC). Furthermore, the differences in measurements between the two devices were examined, considering the presence of mild flatfoot. Results: The ICC values for the contact area and mean force ranged from 0.703 to 0.947, indicating good-to-excellent reliability across all areas. EMED-n50 tended to record higher contact areas than HR Mat. The mean force was significantly higher in the forefoot region when measured with EMED-n50, whereas, in the hindfoot region, this difference was observed only during static measurements with HR Mat. Participants with mild flatfeet exhibited significantly higher contact areas in the midfoot region for both devices, with no consistent differences in the other parameters. Conclusion: The contact area and mean force measurements of the HR Mat and EMED-n50 showed high reliability. On the other hand, EMED-n50 tended to record higher contact areas than HR Mat. In cases of mild flatfoot, an increase in contact area within the midfoot region was observed, but no consistent impact on the differences between the two devices was evident. [ABSTRACT FROM AUTHOR]

The aim was to find if foot orthotics alone can improve flat feet in children and analyze how the addition of Zukunft-Huber manual therapy and corrective bandaging changes the outcome. Forty-nine children aged 5 to 10 with asymptomatic flexible flat feet were divided into 2 groups. The first was treated with foot orthoses alone, in the second wearing foot orthoses was supplemented with Zukunft-Huber manual therapy and corrective bandaging. Pedobarography during gait was performed before the therapy and after a year. In the first group decrease in arch index, width, force, and area of midfoot, increase in force MH2 and area hindfoot was found, in the second decrease in arch index, width, force, and area of midfoot, increase in force under metatarsal head second, third, fourth, and fifth, area metatarsal head fourth and area hindfoot. Both methods showed positive changes, but foot orthoses with additional intervention were more effective. [ABSTRACT FROM AUTHOR]

Lower extremity injuries rank among the most common injuries affecting young population, and numerous factors affect the outcomes of plantar pressure and balance assessment. Does a correlation exist between plantar pressure and postural balance in healthy subjects and are there any difference in the results based on gender and limb dominance? This study involved thirty healthy recreationally active young adults (15 females, 15 males). Plantar pressures were analyzed using the MatScan Pressure Mat System, and postural balance was evaluated using Biodex Balance System. All assessments conducted under both static and dynamic conditions. Correlations were tested by Spearman Correlation Coefficient, and comparative tests were performed for gender and limb dominance. Correlations were observed between plantar pressure parameters and balance scores, particularly in the dynamic conditions (p < 0.05). Gender-based differences were noted in plantar pressure parameters (p < 0.05), with females demonstrating improved balance stability scores. No significant differences were found based on limb dominance in plantar pressure and postural balance data (p > 0.05). This study provides valuable detailed insights into the existing literature concerning plantar pressure and postural balance assessments within the healthy population. A strong correlation was observed between plantar pressure and postural balance, and the comparisons of these assessments were affected by gender but not by limb dominance. These results could lead the way for better rehabilitation approaches by considering the correlations and differences across diverse populations. • Plantar pressure parameters in young healthy adults are correlated with postural balance scores. • Plantar pressure and postural balance variables are affected by gender. • Limb dominance has no effect on plantar pressure and postural balance variables. [ABSTRACT FROM AUTHOR]

BackgroundOsteoarthritis (OA) is a highly prevalent global musculoskeletal disorder, and knee OA (KOA) accounts for four-fifths of the cases worldwide. It is a degenerative disorder that greatly affects the quality of life. Thus, it is managed through different methods, such as weight loss, physical therapy, and knee arthroplasty. Physical therapy aims to strengthen the knee periarticular muscles to improve joint stability.MethodsPedobarographic data and pelvis and trunk motion of 56 adults are recorded. Among them, 28 subjects were healthy, and 28 subjects were suffering from varying degrees of KOA. Age, sex, BMI, and the recorded variables are used together to identify subjects with KOA using machine learning (ML) models, namely, logistic regression, SVM, decision tree, and random forest. Surface electromyography (sEMG) signals are also recorded bilaterally from two muscles, the rectus femoris and biceps femoris caput longus, bilaterally during various activities for two healthy and six KOA subjects. Cluster analysis is then performed using the principal components obtained from time-series features, frequency features, and time–frequency features.ResultsKOA is successfully identified using the pedobarographic data and the pelvis and trunk motion with the highest accuracy and sensitivity of 89.3% and 85.7%, respectively, using a decision tree classifier. In addition, sEMG data have been successfully used to cluster healthy subjects from KOA subjects, with wavelet analysis features providing the best performance for the standing activity under different conditions.ConclusionKOA is detected using gait variables not directly related to the knee, such as pedobarographic measurements and pelvis and trunk motion captured by pedobarography mats and wearable sensors, respectively. KOA subjects are also distinguished from healthy individuals through clustering analysis using sEMG data from knee periarticular muscles during walking and standing. Gait data and sEMG complement each other, aiding in KOA identification and rehabilitation monitoring. It is important because wearable sensors simplify data collection, require minimal sample preparation, and offer a non-radiographic, safe method suitable for both laboratory and real-world scenarios. The decision tree classifier, trained with stratified k-fold cross validation (SKCV) data, is observed to be the best for KOA identification using gait data.

Abstract Background Neurological gait disorders are mainly classified based on clinical observation, and therefore difficult to objectify or quantify. Movement analysis systems provide objective parameters, which may increase diagnostic accuracy and may aid in monitoring the disease course. Despite the increasing wealth of kinematic movement and balance parameter data, the discriminative value for the differentiation of neurological gait disorders is still unclear. We hypothesized that kinematic motion and balance parameter metrics would be differently altered across neurological gait disorders when compared to healthy controls. Methods Thirty one patients (9 normal pressure hydrocephalus , 16 cervical myelopathy , 6 lumbar stenosis ) and 14 healthy participants were investigated preoperatively in an outpatient setting using an inertial measurement system (MyoMotion) during 3 different walking tasks (normal walking, dual-task walking with simultaneous backward counting, fast walking). In addition, the natural postural sway of participants was measured by pedobarography, with the eyes opened and closed. The range of motion (ROM) in different joint angles, stride time, as well as sway were compared between different groups (between-subject factor), and different task conditions (within-subject factor) by a mixed model ANOVA. Results Kinematic metrics and balance parameters were differently altered across different gait disorders compared to healthy controls. Overall, NPH patients significantly differed from controls in all movement parameters except for stride time, while they differed in balance parameters only with regard to AP movement. LST patients had significantly reduced ROMs of the shoulders, hips, and ankles, with significantly altered balance parameters regarding AP movement and passed center-of-pressure (COP) distance. CM patients differed from controls only in the ROM of the hip and ankle, but were affected in nearly all balance parameters, except for force distribution. Conclusion The application of inertial measurement systems and pedobarography is feasible in an outpatient setting in patients with different neurological gait disorders. Rather than defining singular discriminative values, kinematic gait and balance metrics may provide characteristic profiles of movement parameter alterations in the sense of specific ´gait signatures´ for different pathologies, which could improve diagnostic accuracy by defining objective and quantifiable measures for the discrimination of different neurological gait disorders. Trial registration The study was retrospectively registered on the 27th of March 2023 in the ‘Deutsches Register für Klinische Studien’ under the number DRKS00031555.

Background: Neurological gait disorders are mainly classified based on clinical observation, and therefore difficult to objectify or quantify. Movement analysis systems provide objective parameters, which may increase diagnostic accuracy and may aid in monitoring the disease course. Despite the increasing wealth of kinematic movement and balance parameter data, the discriminative value for the differentiation of neurological gait disorders is still unclear. We hypothesized that kinematic motion and balance parameter metrics would be differently altered across neurological gait disorders when compared to healthy controls. Methods: Thirty one patients (9 normal pressure hydrocephalus < NPH > , 16 cervical myelopathy < CM > , 6 lumbar stenosis < LST >) and 14 healthy participants were investigated preoperatively in an outpatient setting using an inertial measurement system (MyoMotion) during 3 different walking tasks (normal walking, dual-task walking with simultaneous backward counting, fast walking). In addition, the natural postural sway of participants was measured by pedobarography, with the eyes opened and closed. The range of motion (ROM) in different joint angles, stride time, as well as sway were compared between different groups (between-subject factor), and different task conditions (within-subject factor) by a mixed model ANOVA. Results: Kinematic metrics and balance parameters were differently altered across different gait disorders compared to healthy controls. Overall, NPH patients significantly differed from controls in all movement parameters except for stride time, while they differed in balance parameters only with regard to AP movement. LST patients had significantly reduced ROMs of the shoulders, hips, and ankles, with significantly altered balance parameters regarding AP movement and passed center-of-pressure (COP) distance. CM patients differed from controls only in the ROM of the hip and ankle, but were affected in nearly all balance parameters, except for force distribution. Conclusion: The application of inertial measurement systems and pedobarography is feasible in an outpatient setting in patients with different neurological gait disorders. Rather than defining singular discriminative values, kinematic gait and balance metrics may provide characteristic profiles of movement parameter alterations in the sense of specific ´gait signatures´ for different pathologies, which could improve diagnostic accuracy by defining objective and quantifiable measures for the discrimination of different neurological gait disorders. Trial registration: The study was retrospectively registered on the 27th of March 2023 in the 'Deutsches Register für Klinische Studien' under the number DRKS00031555. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is a growing health problem that affects a high percentage of the population. In podiatry context, few studies have addressed obesity because most pedobarographic systems are unable to bear the weight of patients with obesity, making it difficult to examine and manage these patients. The objective of this study was analyzed the sociodemographic characteristics, quality of life, foot disorders, and pedobarographic parameters of patients with extreme obesity who are candidates for bariatric surgery and determine the changes after weight loss post-surgery. Materials and Methods: We conducted a foot examination, a pedobarographic study using a Podoprint® pressure platform, and a quality of life questionnaire (EQ-5D) on 23 patients with extreme obesity and analyzed the changes 12–18 months after surgery in 11 of them. Results: We observed foot disorders, high plantar pressure, greater rearfoot contact, flat footprint, asymmetries, and alterations in toe contact. Almost 73.9% of participants said they had foot pain, 56.5% said they had impaired mobility, and more than 40% said they had limitations in carrying out daily activities and suffered from anxiety. After weight loss, we observed improved quality of life; more foot disorders; changes in total contact area, plantar pressures, barycenter, contact time, and footprint; decreased pain perception, walking problems and anxiety situations. Moreover, medication decreased, but they need to take more vitamins and calcium. Conclusion: Weight loss improved the quality of life of the participating patients but altered their foot disorders. All parameters need regular reassessment to detect changes and modify initially prescribed treatments. [ABSTRACT FROM AUTHOR]

Background: Foot pathologies can affect the kinetic chain during gait, leading to altered loading at other joints that can lead to subsequent pathologies. Although hallux valgus is the most common foot disease, little has been discussed about the biokinetic effects of hallux valgus on the foot and lower limb. This systematic review evaluated the kinematic, kinetic, and pedobarographic changes of the hallux valgus foot compared to a healthy one. Methods: Several electronic databases were searched up to January 2022, including only cross-sectional studies with clearly defined isolated hallux valgus diseases and healthy groups. Two investigators independently rated studies for methodological quality using the NIH Study Quality Assessment Tool for cross-sectional studies. Kinetic data were extracted, including temporal data, kinematics of the foot joint, kinematics of the proximal lower limb, and pedobarography. We did meta-analyses tests with a random effects model using the metafor package in R. Results: Hallux valgus patients walk slower compared to a disease-free control group −0.16 m/s (95% CI −0.27, −0.05). Hallux valgus patients exhibited significantly reduced coronal plane motion of the hindfoot-shank during preswing 1.16 degrees (95% CI 0.31, 2.00). Hallux valgus patients generated less force in the hallux region 33.48 N (95% CI 8.62, 58.35) but similar peak pressures in the hallux compared to controls. Hallux valgus patients generated less peak pressure at the medial and lateral hindfoot as compared to controls: 8.28 kPa (95% CI 2.92, 13.64) and 8.54 kPa (95% CI 3.55, 13.52), respectively. Conclusion: Although hallux valgus is a deformity of the forefoot, the kinematic changes due to the pathology are associated with significant changes in the range of motion at other joints, underscoring its importance in the kinetic chain. This is demonstrated again with the changes of peak pressure. Nevertheless, more high-quality studies are still needed to develop a fuller understanding of this pathology. [ABSTRACT FROM AUTHOR]

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

Introduction: Orthoses are designed to achieve immobilization or off-loading of certain regions of the foot. Yet, their off-loading capacity for the specific regions has not yet been studied. Therefore, the aim of this study was to analyze the plantar pressure distribution of five commonly applied orthoses for foot and ankle in a healthy population. Materials and Methods: Five orthoses (postoperative shoe, forefoot relief shoe, short walker boot, high walker boot, and calcaneus fracture orthosis) were compared pedobarographically using insoles on a treadmill to a ready-made running shoe in eleven healthy subjects (median age 29 years). Peak pressure, maximum force, force–time integral, contact time, and contact area were evaluated separately for the forefoot, midfoot, and hindfoot. Results: The forefoot relief shoe, the short- and high walker boot significantly reduced the peak pressure at the forefoot with no significant differences between these orthoses. None of the five orthoses off-loaded the midfoot, but the calcaneus fracture orthosis and the short walker boot instead increased midfoot load. For the hindfoot, the calcaneus fracture orthosis was the only device to significantly reduce the peak pressure. Conclusions: This is the first study to investigate the specific off-loading capacities of different orthoses for specific foot regions in a healthy collective. The knowledge of absolute and relative load shifts for the different orthoses is of fundamental interest for targeted clinical decision-making of physicians. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the effects of tibialis posterior muscle (TP) fatigue on dynamic plantar pressure (DPP) characteristics during different walking speeds. Materials and Methods: Thirty healthy volunteers walked at normal and fast paces in three trials. The Footscan® 3D system was used to obtain the distribution of dynamic plantar pressure before and after the TP fatigue protocol. The study measured the peak pressure (PP) of the hallux, toes 2-5, metatarsals (Meta 1-5), midfoot (MF), medial heel (MH) and lateral heel (LH), as well as the percentage of contact area (CA%) of the forefoot (FF), MF and hindfoot (HF), foot progression angle (FPA) and the minimum and maximum values of the subtalar angle. Results: The results showed significant differences in the PP of Meta 4, MH and MF at a normal pace after the tibialis posterior muscle fatigue protocol. At a fast pace, significant differences were found in the PP of the MF and CA% of FF and MF. Before the fatigue protocol, there were significantly different values in the peak pressure of the hallux, toes 2-5 and MH between the two walking speeds. After the fatigue protocol, there were significantly different values in the peak pressure of toes 2-5, MH and LH between the two walking speeds. The study also found a significant difference in FPA between the two walking speeds (p<0.05). Conclusion: The study provides evidence that TP fatigue may lead to injuries during long-term walking or sports activities. These results highlight the importance of endurance training and minimizing its negative effects on foot biomechanics by reducing fatigue. [ABSTRACT FROM AUTHOR]

The pedobarography method makes it possible to objectify the dynamics of restoring the functional capacity of an injured limb. The value of the method is gaining popularity in determining the functional results of surgical treatment of the patients with ankle joint injuries. The details of pedobarographic monito­ring during the treatment allow to obtain digital indices, which with careful statistical analysis can significantly improve not only the diagnostic process, but also control the process of functional reco­very of the patients with injuries of the lower extremities. Changes in quantitative digital static and dynamic indices of pedobarography mean progress in the functional restoration of the injured limb or the need in the correction of the rehabilitation process. Howe­ver, there is a problem in the interpretation and specification of the known indices and indices in accordance with the pathology. A review of the scientific publications based on the Scopus, Web of Science and The Cochrane Library databases is designed to analyze the possibilities of using the pedobarography method in the diagnosis of ankle joint injuries, tibial bone fractures, which in accordance with quantitative indices make 20-28 % of all fractures of human bones. The kinematic features of the human body in normal and pathological conditions should be carefully analyzed and practically used in the monitoring process of the recovery of wal­king during the rehabilitation period in the patients with ankle joint fractures and not only. Control and detection of the deviations of pedobarographic indices should be analyzed in details with the aim of early detection of an unresolved problem before the appearance of clinical signs of chronic instability. The literature search proves that the analysis of the entire range of static and dynamic indices of pedobarography of damaged and healthy limbs during the period of postoperative recovery of walking makes it possible to evaluate the effectiveness of rehabilitation measures aimed at functional restoration of unstable injuries of the ankle joint.

While hallux valgus (HV) surgeries are useful for correcting skeletal alignment problems, their effects on plantar load, which reflects forefoot functions, are less understood. The objective of this study is to conduct a systematic review and meta-analysis on the plantar load change after HV surgeries. A systematic search of Web of Science, Scopus, PubMed, CENTRAL, EMBASE, and CINAHL was performed. Studies that assessed the pre- and post-operative plantar pressure of HV patients undergoing surgeries and reported load-related parameters over the hallux, medial metatarsal, and/or central metatarsal regions were included. Studies were appraised by using the modified NIH quality assessment tool for before-after study. Studies suitable for meta-analysis were pooled with the random-effects model, using the standardized mean difference of the before-after parameters as an effect measure. Twenty-six studies containing 857 HV patients and 973 feet were included for the systematic review. Meta-analysis was conducted on 20 of them, and most studies did not favor HV surgeries. Overall, HV surgeries reduced the plantar load over the hallux region (SMD −0.71, 95% CI, −1.15 to −0.26), indicating that forefoot function worsened after surgeries. For the other five outcomes, the overall estimates were not statistically significant, indicating that surgeries did not improve them either. There was substantial heterogeneity among the studies, which in most cases could not be resolved by pre-planned subgroup analyses by surgical classification, year of publication, median age of patients, and length of follow-up. Sensitivity analysis removing lower-quality studies showed that the load integrals (impulse) over the central metatarsal region significantly increased (SMD 0.27, 95% CI, 0 to 0.53), indicating that surgeries increased the risk of transfer metatarsalgia. There is no solid evidence that HV surgeries could improve forefoot functions from a biomechanical point perspective. Currently available evidence even suggests that surgeries might reduce the plantar load over the hallux and adversely affect push-off function. The reasons behind and the effectiveness of alternative surgical methods warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: Karate consists of two somewhat different disciplines, kata, and kumite; each one may have a different effect on foot structure and dynamics in the longterm. Aim: As pedobarography is indicative of foot function, the present study aimed to compare pedobarographic profile during gait between young females participating in international kata and kumite competitions and non-karateka females. Materials and Methods: Displacement and velocity of the center of pressure, and peak pressure in ten regions of the foot of 10 kata-ka, 12 kumite-ka, and 16 non-karate-ka were measured with a pressure platform during barefoot walking. Results: Peak pressure in the lateral-heel and lateral-toes of kata-ka and kumite-ka was significantly lower than non-karate-ka (P<0.05). Furthermore, peak pressure in the kata-ka midfoot was lower than nonkarate- ka (P=0.01 in medial-foot, P=0.01 in lateral-midfoot). In the anteroposterior direction, center of pressure velocity and displacement were significantly different among the three groups (P<0.05). Conclusion: It can be concluded that the practice of repeated intensive karate exercises has a demonstrable effect on foot progression, dynamic loading velocity, and plantar load distribution during gait. Moreover, practicing kata probably has a greater impact on the measured parameters. [ABSTRACT FROM AUTHOR]

The ligaments implicated in the earliest stages of developing a progressive collapsing foot deformity are poorly understood. Commonly employed cadaveric flatfoot models are created from simultaneous transection of multiple ligaments, making it difficult to assess early changes in pressure distribution from ligaments critical for maintaining load distribution. A serial transection of ligaments may provide insight into changes in pressure distribution under the foot to identify a potential combination of ligaments that may be involved in early deformities. Specimens were loaded using a custom designed axial and tendon loading system. Plantar pressure data for the forefoot and hindfoot were recorded before and after six sequential ligament complex transections. Sectioning the plantar fascia (first) and short/long plantar ligaments (second) failed to generate appreciable differences in load distribution. Dividing the spring ligament (third) led to changes in hindfoot load distribution with a shift towards the lateral column indicative of hindfoot valgus angulation. All subsequent conditions resulted in similar patterns in hindfoot plantar load distribution. An anterior shift in the center of pressure only occurred after transection of all six ligament complexes. Loss of the plantar fascia and short/long plantar ligaments are not critical in maintaining plantar load distribution or contact area. However, the additional loss of the spring ligament caused notable changes in hindfoot load distribution, indicating the combination of these three ligament complexes is particularly critical for preventing peritalar subluxation. Minimal changes in load distribution occurred when performing additional transections to reach a complete flatfoot deformity. • The ligaments involved in early flatfoot development are poorly understood. • There is limited pedobarographic data for ex vivo flatfoot deformity models. • Loss of plantar and spring ligaments mimics complete flatfoot in load distribution. • Flatfoot involves hindfoot valgus, causing increased load on its lateral aspect. [ABSTRACT FROM AUTHOR]

Introduction Lisfranc injuries are rare, often missed, and may cause permanent structural deterioration of tarsometatarsal joint, despite optimal management. Consequently, a Lisfranc injury may lead to disruption of the biomechanics of the normal foot during walking and may alter the plantar pressure distribution, which is essential for proper gait mechanics. Therefore, the main purpose of the study was to specify the dynamic plantar pressure, radiographic and clinical features, after surgically managed Lisfranc injuries. Methods This study was carried out over a period of 10 years and included 62 patients who were surgically treated for Lisfranc injury, with mean 57-month follow-up. Radiological (intermetatarsal, Kite’s, first metatarsophalangeal, Meary’s, Hibbs’ and calcaneal pitch angles, and medial cuneiform–fifth metatarsal distance), pedobarographical, and clinical results with the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score assessments for both feet were assessed. Results In the radiological assessment, the mean first intermetatarsal (p = 0.006) and Meary’s angle (p = 0.000) were decreased on the injured feet compared to the uninjured feet on the anteroposterior and lateral radiographs. In the pedobarographic assessment, the injured feet midfoot contact time increased (p = 0.03), and maximum force (p = 0.001), total peak pressure (p = 0.008), and contact area (p = 0.017) decreased, compared to the uninjured feet. The mean AOFAS score was 75/100 at the final follow-up visit. There was seen to be reduced both contact surface area and time of the midfoot. Conclusion Despite surgical management of Lisfranc injuries, the injured foot does not regain functional, radiological, or pedobarographical levels as compared to the uninjured foot for ≥ 57 months.

On June 30, 2021, 23 years after its establishment, the activity of "Zdrowie" [Eng. Health] Rehabilitation Centre in Kraków came to an end. At the “Zdrowie” Rehabilitation Centre, this was done through appropriate personalised treatment, mainly rehabilitation, and since its inception, the centre had promoted not only the treatment of diseases, the consequences of traumatic injuries and the resulting disability, but most of all, their prevention. In 1998, as one of the first centres in Poland, the “Zdrowie” Rehabilitation Centre began routinely carrying out pedobarographic examinations, to an extent not found in other places at that time. Since 2006, photogrammetric testing has also been performed. What definitely distinguished the Centre, not only in Kraków, but also on the Polish medical market, was, among others, its scientific activity. Based on the Centre's professional and scientific achievements, sixteen M.A. one B.A, three doctoral dissertations, articles published in reputable journals with the Impact Factor (IF) index and scores from the Ministry of Science and Higher Education (MNiSW) or the Ministry of Science and Education (MNiE) were prepared.

Background: The feet play an essential role in shock absorption, and foot posture is closely related to gait. The compensatory mechanism under heavy-load conditions in individuals with mild flatfoot is poorly understood. In the authors' country, individuals with mild flatfoot are drafted as active-duty soldiers and participate in military rucking wearing heavy backpacks. This study investigated the effect of backpack load on gait and foot plantar pressure and possible differences in participants with mild flatfoot. The average weight of the backpack during military rucking (approximately 20 kg), was simulated in this study. Methods: This study prospectively enrolled 30 healthy young males, divided into a control group (CON, n = 15) and a mild low-arched group (MLA, n = 15), based on the presence of flatfoot. Segmental foot kinematics were evaluated using a three-dimensional multi-segment foot model, and gait data of the temporal and spatial parameters were obtained. The dynamic plantar pressure was simultaneously measured using a pedobarography platform with gait trials. The protocol was repeated with all participants wearing 20 kg backpacks. Comparisons between the baseline and loaded states, as well as comparison between groups, were conducted. Results: Although the cadence, gait speed, and stride length decreased in the loaded condition, step time and proportion of the stance phase increased in both groups. Although the MLA group showed more supinated and abducted positions of the forefoot and more pronated positions of the hindfoot than the CON group, the change in intersegmental foot and ankle motion in each group after backpack loading was minimal. However, the former showed a larger step width and a greater increase in contact area in the midfoot region, while the latter demonstrated a greater increase in peak pressure. Conclusions: Individuals with mild flatfoot demonstrated significantly different gait curve patterns (waveforms) compared to the controls. In the loaded condition, the CON and MLA groups may have adopted different strategies to maintain balance during gait. We suggest that although individuals with asymptomatic mild flatfoot are drafted as active-duty soldiers, they should be thoroughly investigated under loaded conditions, and orthoses may be helpful. [ABSTRACT FROM AUTHOR]

Pertrochanteric fractures (PFs) are life threatening due to the prolonged immobilization of the elderly patient that affects, indirectly, the function of most organs. PFs may have an impact on the symmetry of the human body and contribute to poor global alignment. The aim of the study is to evaluate the functional, pedobarographic and radiological outcomes in a group of subjects with PFs treated with either a dynamic hip screw (DHS) or an intramedullary gamma nail fixation. A study group of 40 patients, admitted to hospital for pertrochanteric fractures between 2015 and 2019, at a mean age of 74.87 (range 65–99), were enrolled. A control group included 20 subjects free from significant disorders of the musculoskeletal system and any other disorders that might induce a compensatory abnormal gait pattern. Functional results were assessed by the Harris Hip Score, and the plantar pressure distribution and arch index were measured with a pedobarographic examination. Radiographic parameters were assessed based on the preoperative and postoperative standing AP pelvic radiographs and axial projection of the hip. The obtained results were evaluated at 9-month follow-up. The obtained results showed no significant difference between both study groups within the scope of the variables under study. To sum up, surgical treatment, either with DHS or intramedullary gamma nail fixation, and rehabilitation treatment support the symmetry of the musculoskeletal system. However, the full return of symmetry was not achieved at 9-month follow-up compared to the control group. [ABSTRACT FROM AUTHOR]

The pedobarography method makes it possible to objectify the dynamics of restoring the functional capacity of an injured limb. The value of the method is gaining popularity in determining the functional results of surgical treatment of the patients with ankle joint injuries. The details of pedobarographic monitoring during the treatment allow to obtain digital indices, which with careful statistical analysis can significantly improve not only the diagnostic process, but also control the process of functional recovery of the patients with injuries of the lower extremities. Changes in quantitative digital static and dynamic indices of pedobarography mean progress in the functional restoration of the injured limb or the need in the correction of the rehabilitation process. However, there is a problem in the interpretation and specification of the known indices and indices in accordance with the pathology. A review of the scientific publications based on the Scopus, Web of Science and The Cochrane Library databases is designed to analyze the possibilities of using the pedobarography method in the diagnosis of ankle joint injuries, tibial bone fractures, which in accordance with quantitative indices make 20-28 % of all fractures of human bones. The kinematic features of the human body in normal and pathological conditions should be carefully analyzed and practically used in the monitoring process of the recovery of walking during the rehabilitation period in the patients with ankle joint fractures and not only. Control and detection of the deviations of pedobarographic indices should be analyzed in details with the aim of early detection of an unresolved problem before the appearance of clinical signs of chronic instability. The literature search proves that the analysis of the entire range of static and dynamic indices of pedobarography of damaged and healthy limbs during the period of postoperative recovery of walking makes it possible to evaluate the effectiveness of rehabilitation measures aimed at functional restoration of unstable injuries of the ankle joint. [ABSTRACT FROM AUTHOR]

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

Background: Calcaneal fractures are among the most common foot injuries and sometimes develop manifold post-surgical complications. Restricted foot movement is one of the main functional limitations which often persists during long-term rehabilitation. Therefore, it is important to quantitatively monitor the biomechanical foot mobility after calcaneal fracture from an early stage in order to achieve an optimal therapeutic treatment.Research Question: Evaluation of the Center of Pressure velocity (vCOP) in patients after intrarticular calcaneal fractures during the healing progress from three to 24 months after surgery.Methods: A total of 20 patients with unilateral calcaneal fracture were investigated by means of pedobarography and marker-based gait analysis at three, six, 12 and 24 months after surgery. Data for vCOP [m/s], maximum external dorsal extension moments during stance (DEmomentstance) and tibiotalar range of motion during mid stance (MS) and terminal stance (TS) were obtained. Functional evaluation was performed using clinical examination (e.g. calf circumference measurements) and patient-reported outcome measures (SF-36).Results: When compared to the healthy side, vCOP of the injured side showed a significant reduction during MS (3 months: 48%, p < 0.001; 6 months: 13%; p = 0.040) and an significant increase during TS (3 months: 110%, p < 0.001; 6 months: 43%, p < 0.001; 12 months: 17%, p = 0.012). DEmomentstance of the fractured foot, showed a significant increase of 80% (p < 0.001) from three to 24 months after surgery, which correlated with vCOP at three and six months after surgery (p < 0.05; vCOP MS: 3 months: r = 0.876, 6 months: r = 0.685; vCOP TS: 3 months: r = -0.554, 6 months r = -0.626).Significance: vCOP might serve as an indicator for foot mobility and function during the early healing phase after calcaneal fractures. As vCOP can be obtained by pedobarography it is more readily accessible an less costly compared to foot function obtained by marker based gait analysis. [ABSTRACT FROM AUTHOR]

Static and dynamic methods can be used to assess the way a foot is loaded. The research question is how the pressure on the feet would vary depending on walking/running speed. This study involved 20 healthy volunteers. Dynamic measurement of foot pressure was performed using the Ortopiezometr at normal, slow, and fast paces of walking. Obtained data underwent analysis in a "Steps" program. Based on the median, the power generated by the sensors during the entire stride period is the highest during a fast walk, whereas based on the average; a walk or slow walk prevails. During a fast walk, the difference between the mean and the median of the stride period is the smallest. Regardless of the pace of gait, the energy released per unit time does not depend on the paces of the volunteers' gaits. Conclusions: Ortopiezometr is a feasible tool for the dynamic measurement of foot pressure. For investigations on walking motions, the plantar pressure analysis system, which uses the power generated on sensors installed in the insoles of shoes, is an alternative to force or energy measurements. Regardless of the pace of the walk, the amounts of pressure applied to the foot during step are similar among healthy volunteers. [ABSTRACT FROM AUTHOR]

Background: Patients with severe haemophilia suffer from bleeding-related joint changes in which the ankle joint is most frequently affected. In the resulting gait changes, the forefoot is involved by reducing the foot pressure. However, it is unclear which changes in foot pressure are present in the individual's foot zones.Research Question: The aim of the study was to determine whether compensation mechanisms are present in the foot zones regarding the peak pressure under dynamic conditions and to identify possible underlying mechanisms for gait changes.Methods: In a controlled cross-sectional study, a pedobarography was performed during gait with a standardized speed (3 km/h) in patients with haemophilia (PwH;n = 40) and healthy controls (Con;n = 40). Pressure pain thresholds (PPT) were detected, and Haemophilia Joint Health Score (HJHS) was performed to determine the current joint status.Results: PwH showed a decreased peak pressure in metatarsals II-IV and heel compared to Con. Patients with major-affected ankle joints (determined with the HJHS) showed a decreased single-step length, stride-length and stride-time. Accordingly, the cadence was increased by 10 ± 11 steps/min in PwH compared to Con. Furthermore, PwH showed decreased ankle range of motion (ROM) in HJHS and an altered pain perception due to reduced PPT.Significance: PwH showed a changed gait pattern in peak pressure compared to Con. A restricted rolling behavior, which might be caused by movement restrictions and pain sensation, leads to reduced pressure in the center forefoot, resulting in a shorter stride-length. Future therapies should focus on maintaining joint mobility for better rolling behavior and improving ankle joints' stability to achieve a balanced load between the midfoot, heel, and forefoot. The use of insoles adapted to our data, based on group differences between PwH and Con, could be supportive in this case. [ABSTRACT FROM AUTHOR]

Background: An exact definition is lacking for the term "weight-bearing" or different standing modalities when implementing foot radiographs for children and adults; moreover, only few studies have investigated the relationship between radiographic and pedobarographic measurements.Research Question: We hypothesized that the method of weight-bearing in single-leg and both-leg standing positions could influence the measurement results in radiographs and the distribution of foot pressure.Methods: This prospective study evaluated 33 children (66 feet) with flexible flatfoot deformities scheduled for subtalar screw arthroereisis surgery. Radiographs in the lateral and anteroposterior (AP) views were assessed independently in the single-leg and both-leg standing positions. Static pedobarography was performed as that for measuring weight-bearing. Standardized radiographic angles and pedobarographic data were analysed and correlated.Results: There were differences in radiographic measurements between the single-leg and both-leg standing positions, including the AP talocalcaneal angle (p = 0.032), AP talus-first metatarsal base angle (p = 0.003), AP talus-first metatarsal angle (p = 0.003), lateral calcaneal pitch angle (p = 0.001), talus-first metatarsal index (p = 0.004), and talocalcaneal index (p = 0.029). Moreover, differences between these two standing modalities were found in most of the static pedobarographic data, including the contact area (p = 0001), maximal force (p = 0.001), and peak pressure (p = 0.007). Overall, medial foot pressure increased more in both-leg standing than in the single-leg standing position, whereas radiographic measurements showed a more pronounced flatfoot deformity in the single-leg standing position. The AP talus-first metatarsal angle was the only angle or index with a significant association to some pedobarographic measurements in both standing modalities.Significance: As there are significant differences between single-leg standing and both-leg standing radiographic and static pedobarographic values, observers have to be precise in the definition of "weight-bearing" to gain reproducible and comparable study values in children and adults. We recommend acquiring both-leg standing foot radiographs because children with flexible flatfeet can stand more steadily in this position than in the single-leg standing position. [ABSTRACT FROM AUTHOR]

Flexible flatfoot is among the most common skeletal disorders in childhood. This study describes the dynamic and static correction effects of subtalar arthroereisis in adolescents with flexible symptomatic flatfeet in comparison to normal subjects as well as to results before and after removal of metal. Eighteen adolescents with 25 symptomatic flexible flatfeet were treated surgically with a subtalar arthroereisis at a mean of 12.5 (10-16) years. At follow-up (mean 3.9 years, range 0.4-8), patients filled out the American Orthopaedic Foot and Ankle Society questionnaire, received radiographs and were examined using dynamic and static pedobarography as well as static hindfoot axis examination. Results were compared to healthy controls (n = 13; 26 feet). Surgically treated feet (n = 25) had better questionnaire results after surgery than before, but lower scores than healthy feet. Radiological parameters improved significantly after surgery. Removal of metal did not influence post-surgical results (follow-up 2.8 years). Surgically treated feet had larger contact areas than normal feet with predominance to the midfoot region. The relative maximum force, relative peak pressure and contact time were higher in the midfoot of treated feet compared to controls. When comparing pedobarography data of treated versus untreated feet of the same patients (subgroup n = 11 feet), there were no differences. Subtalar arthroereisis was able to effectively treat symptomatic flexible flatfeet in this population. Results improved significantly evaluating a questionnaire, radiographs, dynamic and static weight distribution, but were still worse than results of healthy feet. There was no relapse after removal of metal. [ABSTRACT FROM AUTHOR]

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

The aim of the study is to examine the relationship between regional plantar pressure values and balance parameters in healthy young individuals by comparing them according to gender and body weight. Within the scope of the research, plantar pressure analysis was applied to 47 students (average age 21.78±1.94 years) studying at the Faculty of Health Sciences in Biruni University. In addition to static and dynamic pressure analysis with the pedobarography device, body mass index and balance were also evaluated, antero-posterior, medio-lateral and static total balance scores were calculated. When the relationship between plantar pressure averages and balance parameters in the fore, hind and midfoot were examined, the most significant correlation was observed between antero-posterior balance and forefoot pressure (r=0.499, p<0.001). In addition, it was observed that there was a significant correlation between the mean pressure with the hind foot and the static balance parameters (r=0.373; p<0.05). According to the results of the intergroup comparisons, it was concluded that the plantar pressure values in the forefoot of women and midfoot of men were statistically significantly higher (p<0.05). As a result of the analysis based on bodyweight, it was concluded that the forefoot plantar pressure values of individuals with normal weight and the midfoot plantar pressure values of overweight-obese individuals were significantly higher (p<0.05). Also, the relationship between the load distribution ratio and the forefoot and midfoot pressure obtained in healthy individuals can be considered as an important reference. In addition, it was concluded that the amount of pressure in the heel area during standing and walking is an important variable affecting the static balance. Finally, plantar region comparisons based on gender and bodyweight provide important data. [ABSTRACT FROM AUTHOR]

Pedobarographic examination is a non-invasive method that enables the quantitative and qualitative evaluation of plantar pressure distribution, notably the plantar pressure distribution, referring to the function of the entire musculoskeletal system. This is a scoping review that aims to update knowledge on the practical use of pedobarography in foot disorders. We also attempted to systematize the methodological principles of conducting the pedobarographic examination. We searched Medline/PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews for the articles on the methodology of pedobarography. The search encompassed clinical trials, randomized controlled trials, meta-analyses, and reviews published in English between January 1982 and February 2021. The literature distinguishes three different types of examinations: static, postural, and dynamic. The rationale for each is presented. The review pointedly shows the unique use of pedobarography for the quantitative and qualitative evaluations of the plantar pressure distribution. It also points to the need for enhancing the awareness among medical professionals of the method and advantages it provides for patient management. Shortcomings of the method are discussed of which the difficulty in establishing the cause-and-effect relationship of foot disorders is the most disturbing as it limits the comparative verification of results of different studies. There also appears a need for developing standardized algorithmic protocols and recommendations to seamlessly perform pedobarography in clinical settings, which would help make wider use of this valuable tool. [ABSTRACT FROM AUTHOR]

Lisfranc injuries are rare, often missed, and may cause permanent structural deterioration of tarsometatarsal joint, despite optimal management. Consequently, a Lisfranc injury may lead to disruption of the biomechanics of the normal foot during walking and may alter the plantar pressure distribution, which is essential for proper gait mechanics. Therefore, the main purpose of the study was to specify the dynamic plantar pressure, radiographic and clinical features, after surgically managed Lisfranc injuries. This study was carried out over a period of 10 years and included 62 patients who were surgically treated for Lisfranc injury, with mean 57-month follow-up. Radiological (intermetatarsal, Kite's, first metatarsophalangeal, Meary's, Hibbs' and calcaneal pitch angles, and medial cuneiform–fifth metatarsal distance), pedobarographical, and clinical results with the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score assessments for both feet were assessed. In the radiological assessment, the mean first intermetatarsal (p = 0.006) and Meary's angle (p = 0.000) were decreased on the injured feet compared to the uninjured feet on the anteroposterior and lateral radiographs. In the pedobarographic assessment, the injured feet midfoot contact time increased (p = 0.03), and maximum force (p = 0.001), total peak pressure (p = 0.008), and contact area (p = 0.017) decreased, compared to the uninjured feet. The mean AOFAS score was 75/100 at the final follow-up visit. There was seen to be reduced both contact surface area and time of the midfoot. Despite surgical management of Lisfranc injuries, the injured foot does not regain functional, radiological, or pedobarographical levels as compared to the uninjured foot for ≥ 57 months. [ABSTRACT FROM AUTHOR]

Abstract Purpose Stroke-related changes in foot structure and function affect balance and mobility and quantifying foot function following stroke could offer clinically useful information to inform rehabilitation. The aim of this work was to explore the feasibility of undertaking plantar pressure assessment during barefoot walking in people with stroke, and evaluate the repeatability of the assessment protocol and regional footprint analysis as a measure of dynamic foot characteristics. Materials & methods Plantar pressure analysis was undertaken using a pressure platform (Tekscan HR Mat) on two test sessions, approximately two weeks apart (mean = 15.64 ± 11.64 days). Peak plantar pressure (kPa) and contact area (cm2) for foot regions were extracted and repeatability analysis undertaken. Descriptive evaluation of field notes and experiences of the participants was undertaken to inform the feasibility of the data collection protocol. Results Twenty-one participants (61.8 ± 9.2 years; 11 male, 10 female; 8 right-sided, 13 left-sided stroke) were recruited and 18 returned for retesting. Full data capture was achieved from 14 participants. Peak pressure and contact area demonstrated moderate to good repeatability for at the toes (ICC 0.76 and 0.58 respectively) and good to excellent repeatability for the other foot regions (ICC ≥ 0.82). Conclusion The protocol adopted in this study was feasible and yielded good to excellent repeatability for the foot regions, except the toes. The challenges with data collection in our study cohort could help inform future studies adopting similar protocols. This work also has relevance for use of pressure technology in clinical practice for assessing and monitoring foot function following stroke.

Abstract Background The feet play an essential role in shock absorption, and foot posture is closely related to gait. The compensatory mechanism under heavy‐load conditions in individuals with mild flatfoot is poorly understood. In the authors' country, individuals with mild flatfoot are drafted as active‐duty soldiers and participate in military rucking wearing heavy backpacks. This study investigated the effect of backpack load on gait and foot plantar pressure and possible differences in participants with mild flatfoot. The average weight of the backpack during military rucking (approximately 20 kg), was simulated in this study. Methods This study prospectively enrolled 30 healthy young males, divided into a control group (CON, n = 15) and a mild low‐arched group (MLA, n = 15), based on the presence of flatfoot. Segmental foot kinematics were evaluated using a three‐dimensional multi‐segment foot model, and gait data of the temporal and spatial parameters were obtained. The dynamic plantar pressure was simultaneously measured using a pedobarography platform with gait trials. The protocol was repeated with all participants wearing 20 kg backpacks. Comparisons between the baseline and loaded states, as well as comparison between groups, were conducted. Results Although the cadence, gait speed, and stride length decreased in the loaded condition, step time and proportion of the stance phase increased in both groups. Although the MLA group showed more supinated and abducted positions of the forefoot and more pronated positions of the hindfoot than the CON group, the change in intersegmental foot and ankle motion in each group after backpack loading was minimal. However, the former showed a larger step width and a greater increase in contact area in the midfoot region, while the latter demonstrated a greater increase in peak pressure. Conclusions Individuals with mild flatfoot demonstrated significantly different gait curve patterns (waveforms) compared to the controls. In the loaded condition, the CON and MLA groups may have adopted different strategies to maintain balance during gait. We suggest that although individuals with asymptomatic mild flatfoot are drafted as active‐duty soldiers, they should be thoroughly investigated under loaded conditions, and orthoses may be helpful.

Background: Osteoarthritis (OA) is a highly prevalent global musculoskeletal disorder, and knee OA (KOA) accounts for four-fifths of the cases worldwide. It is a degenerative disorder that greatly affects the quality of life. Thus, it is managed through different methods, such as weight loss, physical therapy, and knee arthroplasty. Physical therapy aims to strengthen the knee periarticular muscles to improve joint stability., Methods: Pedobarographic data and pelvis and trunk motion of 56 adults are recorded. Among them, 28 subjects were healthy, and 28 subjects were suffering from varying degrees of KOA. Age, sex, BMI, and the recorded variables are used together to identify subjects with KOA using machine learning (ML) models, namely, logistic regression, SVM, decision tree, and random forest. Surface electromyography (sEMG) signals are also recorded bilaterally from two muscles, the rectus femoris and biceps femoris caput longus, bilaterally during various activities for two healthy and six KOA subjects. Cluster analysis is then performed using the principal components obtained from time-series features, frequency features, and time-frequency features., Results: KOA is successfully identified using the pedobarographic data and the pelvis and trunk motion with the highest accuracy and sensitivity of 89.3% and 85.7%, respectively, using a decision tree classifier. In addition, sEMG data have been successfully used to cluster healthy subjects from KOA subjects, with wavelet analysis features providing the best performance for the standing activity under different conditions., Conclusion: KOA is detected using gait variables not directly related to the knee, such as pedobarographic measurements and pelvis and trunk motion captured by pedobarography mats and wearable sensors, respectively. KOA subjects are also distinguished from healthy individuals through clustering analysis using sEMG data from knee periarticular muscles during walking and standing. Gait data and sEMG complement each other, aiding in KOA identification and rehabilitation monitoring. It is important because wearable sensors simplify data collection, require minimal sample preparation, and offer a non-radiographic, safe method suitable for both laboratory and real-world scenarios. The decision tree classifier, trained with stratified k-fold cross validation (SKCV) data, is observed to be the best for KOA identification using gait data., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sarmah, Boruah, Ito and Kanagaraj.)

Purpose: A fundamental understanding of plantar pressure distribution is important for prescribing an appropriate orthosis and applying nonoperative methods, such as stretching exercises, for the treatment of plantar fasciitis. Despite existing research on plantar pressure distribution, discrepancies between affected and unaffected sides in unilateral plantar fasciitis patients warrant further investigation. This study aimed to evaluate the plantar pressure distribution in patients with unilateral plantar fasciitis by comparing it with that on the contralateral unaffected side., Methods: We retrospectively reviewed records from 20 consecutive patients diagnosed with unilateral plantar fasciitis, using the unaffected side as the control. The emed ® pedobarographic system was used to measure the plantar pressure distribution during gait. The analysis was performed using a 4-mask configuration (toes, forefoot, midfoot, and hindfoot)., Results: Both sides showed no significant differences in radiographic parameters. The affected side showed a significantly higher contact area, maximum force, and force-time integrals in the midfoot. However, the unaffected side demonstrated significantly higher maximum force and force-time integrals in the hindfoot. There was no difference in the distribution of the peak pressure and pressure-time integrals between the two sides in all mask regions. The increased contact area and maximum force in the midfoot on the side with plantar fasciitis may result from heel pain-induced weight transfer from the hindfoot., Conclusion: The findings of this study provide a basic understanding of plantar pressure distribution in the treatment of plantar fasciitis and highlight the importance of considering inter-side differences when designing treatment interventions or orthotic devices., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.