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Background: Positive effects of brace treatments in adolescent idiopathic scoliosis patients on gait were proven. Aim: Therefore, this study examined whether the influence of brace therapy in combination with Schroth therapy influencing the plantar pressure distribution, pre and post intensive rehabilitative inpatient treatment. Design: Prospective cohort study, longitudinal. Setting: Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany). Population: Twenty (14f/6m) patients (12–16 years) had a medically diagnosed moderate idiopathic scoliosis (Cobb angle 20–50°, Median 30°) and an indication for combined brace and Schroth therapy with an inpatient stay (4 weeks) at the Asklepios Katharina Schroth Clinic (Germany). Methods: At the beginning (T1) and at the end of the stay (T2), the plantar pressure distribution with (A) and without wearing a brace (B) was recorded (walking distance 10 m). Results: No significant differences between the left and right foot were found at baseline (T1). The T1 - T2 comparison of one foot revealed significant differences (p ≤ 0.05 − 0.001, respectively) for (A): mean pressure right midfoot, loaded area total left foot, left midfoot, left inner ball of foot, right midfoot, impulse total right foot, right midfoot and for (B): mean pressure right midfoot, right outer ball of foot, loaded area total right foot, right heel, right midfoot, impulse right heel, right midfoot, right outer ball of foot. Conclusions: A combined brace and Schroth therapy maintains the initial symmetrical plantar pressure distribution over the duration of four weeks since the significant differences fall within the range of measurement error. Clinical rehabilitation impact: The insole measuring system can be used to objectively support therapeutic gait training as part of rehabilitation and to assess insole fitting based on foot shape. Due to its convenient handling and rapid data acquisition, it may be a suitable method for interim or follow-up diagnostics in the treatment of idiopathic scoliosis. [ABSTRACT FROM AUTHOR]

Abstract Background Positive effects of brace treatments in adolescent idiopathic scoliosis patients on gait were proven. Aim Therefore, this study examined whether the influence of brace therapy in combination with Schroth therapy influencing the plantar pressure distribution, pre and post intensive rehabilitative inpatient treatment. Design Prospective cohort study, longitudinal. Setting Scoliosis rehabilitation clinic “Asklepios Katharina-Schroth-Klinik” (Bad Sobernheim, Germany). Population Twenty (14f/6m) patients (12–16 years) had a medically diagnosed moderate idiopathic scoliosis (Cobb angle 20–50°, Median 30°) and an indication for combined brace and Schroth therapy with an inpatient stay (4 weeks) at the Asklepios Katharina Schroth Clinic (Germany). Methods At the beginning (T1) and at the end of the stay (T2), the plantar pressure distribution with (A) and without wearing a brace (B) was recorded (walking distance 10 m). Results No significant differences between the left and right foot were found at baseline (T1). The T1 - T2 comparison of one foot revealed significant differences (p ≤ 0.05 − 0.001, respectively) for (A): mean pressure right midfoot, loaded area total left foot, left midfoot, left inner ball of foot, right midfoot, impulse total right foot, right midfoot and for (B): mean pressure right midfoot, right outer ball of foot, loaded area total right foot, right heel, right midfoot, impulse right heel, right midfoot, right outer ball of foot. Conclusions A combined brace and Schroth therapy maintains the initial symmetrical plantar pressure distribution over the duration of four weeks since the significant differences fall within the range of measurement error. Clinical rehabilitation impact The insole measuring system can be used to objectively support therapeutic gait training as part of rehabilitation and to assess insole fitting based on foot shape. Due to its convenient handling and rapid data acquisition, it may be a suitable method for interim or follow-up diagnostics in the treatment of idiopathic scoliosis.

Objectives: Diabetic foot syndrome is becoming increasingly common in India with a prevalence ranging from 24.9% to 49%. Diabetic foot syndrome patients have an increased likelihood of developing ulcers in their feet. Accordingly, this study evaluates the influence of photobiomodulation on altered plantar pressure distribution and ankle biomechanics in individuals with diabetic foot syndrome. Methods: A total of 20 diabetic foot syndrome patients with an absence of 10 g monofilament in one out of six sites at the plantar surface of feet, a biothesiometer for vibration perception threshold of >20 V, and diminished or absent ankle reflexes were included. The evaluation of ankle biomechanics was performed by SIMI motion analysis. In addition, the plantar pressure distribution was measured by the WinTrack pressure platform at baseline and the end of 10 sessions. They were treated with scanning mode on the foot plantar surface and probe laser at the popliteal fossa region for three sessions per week, for ten sessions. Results: Plantar pressure parameters were significantly improved (P

Purpose: The aim of this study was to assess whether variances in Achilles tendon elongation are linked to dissimilarities in the plantar pressure distribution following two different surgical approaches for an Achilles tendon rupture (ATR). Methods: All patients who were treated with open or minimally invasive surgical repair (MIS) and were over 2 years post their ATR were eligible for inclusion. A total of 65 patients with an average age of 43 ± 11 years were included in the study. Thirty‐five patients were treated with open repair, and 30 patients were treated with MIS. Clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) and ATR Score (ATRS). Achilles tendon elongation was measured using axial and sagittal magnetic resonance imaging scans. Plantar pressure measurements for the forefoot, midfoot and hindfoot during gait were divided into percentages based on total pressure, measured in g/cm2 for each area. Results: The average AOFAS score was found 'excellent' (93 ± 2.8) in the MIS group, while it was found 'good' (87.4 ± 5.6) in the open repair group. In addition, the MIS group showed significantly superior ATRS scores (78.8 ± 7.4) compared to the open repair group (56.4 ± 15.4) (p < 0.001). The average tendon elongation in the MIS group was 11.3 ± 2 mm, while it was 17.3 ± 4.3 mm (p < 0.001) in the open repair group. While the open repair group showed significantly higher plantar pressure distribution in the initial contact and preswing phases compared to uninjured extremities, there was no significant difference between the uninjured extremities and the MIS group. Conclusion: In conclusion, the findings of this study demonstrated that minimally invasive surgery was associated with less tendon elongation, more proximity to the plantar pressure distributions of the uninjured extremity and superior clinical outcomes compared to open surgical repair. Therefore, minimally invasive surgery may be considered a more suitable option for acute Achilles tendon repair to achieve overall better outcomes. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Objectives: Diabetic foot syndrome is becoming increasingly common in India with a prevalence ranging from 24.9% to 49%. Diabetic foot syndrome patients have an increased likelihood of developing ulcers in their feet. Accordingly, this study evaluates the influence of photobiomodulation on altered plantar pressure distribution and ankle biomechanics in individuals with diabetic foot syndrome. Methods: A total of 20 diabetic foot syndrome patients with an absence of 10 g monofilament in one out of six sites at the plantar surface of feet, a biothesiometer for vibration perception threshold of >20 V, and diminished or absent ankle reflexes were included. The evaluation of ankle biomechanics was performed by SIMI motion analysis. In addition, the plantar pressure distribution was measured by the WinTrack pressure platform at baseline and the end of 10 sessions. They were treated with scanning mode on the foot plantar surface and probe laser at the popliteal fossa region for three sessions per week, for ten sessions. Results: Plantar pressure parameters were significantly improved (P<0.01) and ankle biomechanics (P<0.01) after the intervention, respectively, except for no significant difference in the total contact area and ankle midstance kinematics. Discussion: Photobiomodulation therapy can be an effective treatment for improving foot plantar pressure redistribution and ankle biomechanics in individuals with diabetic foot syndrome [ABSTRACT FROM AUTHOR]

This study aimed to compare plantar pressure distribution and muscle frequency between hydrodynamic and typical sports shoes. Twelve healthy adult males participated in this experimental study. The hydrodynamic shoe features an outer sole with a pathway for fluid flow. The typical sports shoe with Ethylene-Vinyl Acetate soles was used for the comparison. Plantar pressure distribution was measured using the Pedar insole system, and the results were analyzed using Pedar-X software. Electrical muscle activity of the Gastrocnemius, Soleus, Palmaris longus, and tibialis anterior were measured using the Myon electromyography system at a 1000Hz sampling rate. Subjects were randomly assigned to wear either hydrodynamic or typical sports shoes and walked through the end of the pathway five times at a self-selected speed. The plantar area was divided into eight regions, and plantar pressure variables were calculated within these areas. The frequency variable includes mean and median frequency, as well as the 99.5th percentile frequency, representing 99.5% of the signal. Additionally, the bandwidth frequency was calculated. Paired t-test was used for statistical comparison (p<0.05). The results indicated considerable pressure reduction in the heel, forefoot, and toe (P<0.05). However, there is no difference in the time and frequency content of muscle activity between conditions. Based on the results, it seems that hydrodynamic shoes could have an important effect on the reduction of plantar pressure without any change in muscle activity during the gait. [ABSTRACT FROM AUTHOR]

(1) Background: Flatfoot can alter the foot's ability to uniformly distribute the body weight on the plantar areas, possibly leading to biomechanical imbalances in the entire body. The purpose of the study was to determine the correlation between flatfoot and plantar pressure distribution in static conditions. (2) Material and methods: The study included a group of 23 children with flat feet (7.43±0.58 years old), which analyzed the correlations between the Foot Posture Index 6 (FPI 6) values and the plantar pressure distribution values. The instruments used were the Foot Posture Index 6 (FPI 6- a quantitative anatomical assessment under static conditions) and the Podata (device for recording images in real time of the body weight distribution on the plantar support). (3) Results: The statistical results have indicated significant correlations of strong intensity between the flat foot and the plantar pressure distribution in the midfoot, but also that the flatfoot significantly influences the values of the plantar pressure distribution in the midfoot. (4) Conclusion: The data showed that flatfeet influence the values of the plantar pressure distribution in the mid-area of the sole. [ABSTRACT FROM AUTHOR]

Fatigue has the potential to alter how impact forces are absorbed during running, heightening the risk of injury. Conflicting findings exist regarding alterations in both kinematics and plantar pressure. Thus, this systematic review and subsequent meta-analysis were conducted to investigate the impact of general and localized muscle fatigue on kinematics and plantar pressure distribution during running. Initial searches were executed on 30 November 2021 and updated on 29 April 2023, encompassing PubMed, The Cochrane Library, SPORTDiscus, and Web of Science without imposing any restrictions on publication dates or employing additional filters. Our PECOS criteria included cross-sectional studies on healthy adults during their treadmill running to mainly evaluate local muscle fatigue, plantar pressure distribution, biomechanics of running (kinematics, kinetics, and EMG results), and temporospatial parameters. The literature search identified 6626 records, with 4626 studies removed for titles and abstract screening. Two hundred and one articles were selected for full-text screening, and 20 studies were included in qualitative data synthesis. The pooled analysis showed a non-significant decrease in maximum pressure under the right forefoot's metatarsus, which was more than the left rearfoot after local muscle fatigue at a velocity of 15 km/h (p-values = 0.48 and 0.62). The results were homogeneous and showed that local muscle fatigue did not significantly affect the right forefoot's stride frequency and length (p-values = 0.75 and 0.38). Strength training for the foot muscles, mainly focusing on the dorsiflexors, is recommended to prevent running-related injuries. Utilizing a standardized knee and ankle joint muscle fatigue assessment protocol is advised. Future experiments should focus on various shoes for running and varying foot strike patterns for injury prevention. [ABSTRACT FROM AUTHOR]

Abstract Purpose The changes in the lower limb alignment were vitally important after high tibial osteotomy (HTO). Therefore, the purpose of present study was to analyze the characteristics of plantar pressure distribution after HTO, and to investigate the effect of plantar pressure distribution on postoperative limb alignment. Methods Between May 2020 and April 2021, varus knee patients undergoing HTO were evaluated in the present study. The peak pressure of plantar regions, medial-lateral pressure ratio (MLPR), foot progression angle (FTA), anteroposterior COP (AP-COP), lateral symmetry of COP (LS-COP), and the radiographic parameters were evaluated preoperatively and at the final follow-up. Compared among the slight valgus (SV), moderate valgus (MV) and large valgus (LV) groups at the final follow-up, the peak pressure of HM, HC and M5 regions, and the MLPR were compared; the Knee Injury and Osteoarthritis Outcome Score4 (KOOS4) including four subscales, and the American of orthopedic foot and ankle society (AOFAS) were evaluated. Results The WBL%, HKA and TPI angle changed significantly after HTO (P

A rollator, one of the most widely used among walking assistance devices, can assist the elderly with stable walking in their daily lives. In this study, we investigated how the structural characteristics of two types of rollators affect the upper and lower extremity muscle activity and plantar pressure of the elderly in various walking environments. We quantified muscle activity (upper and lower limbs) and plantar pressure (mean force, peak pressure, and contact area) of 11 older adults walking in various environments (flat, obstacle, uneven, and sloped terrain) using two types of rollators. Upper extremity muscle activity was highest in the obstacle terrain and the uneven terrain, and a significant difference was found due to the structural differences of the rollator. Additionally, it was observed that lower extremity muscle activity and plantar pressure patterns appeared in accordance with the gait strategy to maintain stability in an unstable or inclined walking environment. In other words, it was confirmed that the weight of the rollator, the size of the wheel, grip type, and the auxiliary tools had a great effect on the upper and lower extremity muscle activity and plantar pressure of the elderly during walking. From the results of this study, it can be suggested that it is absolutely necessary to consider the biomechanical characteristics of the elderly and the structure of the rollator, which appear differently depending on the walking environment, in the development of walking aids. In the future, more clinical data will be collected, and based on this a rollator that can safely assist the elderly in various walking environments will be developed. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the fifth metatarsal strain generation mechanism during cutting motions performed while playing soccer using a finite element foot model. Five collegiate soccer players performed the side-step cutting and the cross-step cutting motions to measure the three-dimensional foot kinematics, ground reaction force, and plantar pressure distribution. In addition, a finite-element model of a foot consisting of bony structures, ligaments, and skin was constructed from computed tomography images. Simulations were conducted to perform the cutting motions, using the measured foot motion and distributed load on the plantar surface as boundary conditions for the model. During the side-step cutting, the maximum principal strain on the fifth metatarsal was correlated to forefoot adduction angle during stepping out. For cross-step cutting, the maximum principal strain was correlated with plantar pressure at the distal end of the fifth metatarsal. Therefore, to prevent a fracture, it is necessary to take measures to reduce the lateral bending deformation of the forefoot while stepping out during side-step cutting and to reduce the plantar pressure on the distal end of the fifth metatarsal during cross-step cutting. [ABSTRACT FROM AUTHOR]

Purpose: The changes in the lower limb alignment were vitally important after high tibial osteotomy (HTO). Therefore, the purpose of present study was to analyze the characteristics of plantar pressure distribution after HTO, and to investigate the effect of plantar pressure distribution on postoperative limb alignment. Methods: Between May 2020 and April 2021, varus knee patients undergoing HTO were evaluated in the present study. The peak pressure of plantar regions, medial-lateral pressure ratio (MLPR), foot progression angle (FTA), anteroposterior COP (AP-COP), lateral symmetry of COP (LS-COP), and the radiographic parameters were evaluated preoperatively and at the final follow-up. Compared among the slight valgus (SV), moderate valgus (MV) and large valgus (LV) groups at the final follow-up, the peak pressure of HM, HC and M5 regions, and the MLPR were compared; the Knee Injury and Osteoarthritis Outcome Score4 (KOOS4) including four subscales, and the American of orthopedic foot and ankle society (AOFAS) were evaluated. Results: The WBL%, HKA and TPI angle changed significantly after HTO (P < 0.001). The preoperative group exhibited a lower peak pressure in the HM region (P < 0.05) and higher peak pressure in the M5 region (P < 0.05); the pre- and postoperative groups exhibited a lower peak pressure in the HC region (P < 0.05); the rearfoot MLPR was significantly lower and LS-COP was significantly higher in the preoperative group (P = 0.017 in MLPR and 0.031 in LS-COP, respectively). Comparison among the SV, MV and LV groups, the SV group indicated a lower peak pressure in the HM region (P = 0.036), and a lower MLPR in the rearfoot (P = 0.033). The KOOS Sport/Re score in the MV and LV groups increased significantly compared with the SV group (P = 0.042). Conclusion: Plantar pressure distribution during the stance phase in patients with varus knee OA following HTO exhibited a more medialized rearfoot plantar pressure distribution pattern than that before surgery. Compared with the small valgus alignment, a moderate to large valgus alignment allows patients to walk with a more even medial and lateral plantar pressure distribution, which is more similar to healthy adults. [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]

People with spastic cerebral palsy (CP) often experience a decline in gait function and flexion. The children's posture and hip strategy, which leads to knee flexion, predisposes these children to increased contact area in the medial foot region. This study investigated the use of DAFO (dynamic ankle-foot orthosis) prescribed to patients with cerebral palsy (CP) to determine the plantar pressure distribution with orthosis use. Eight children with spastic CP (age 4–12 years) were classified as Gross Motor Function Classification System (GMFCS) levels I-II with a maximum spasticity level of 3 in their ankle muscles according to the Modified Ashworth Scale. We assessed the plantar distribution by using eight WalkinSense sensors in each trial and exported data from the proprietary software (WalkinSense version 0.96, Tomorrow Options Microelectronics, S.A.). The plantar pressure distribution was conducted under two conditions: only shoes and DAFO with shoes. The activation percentages for sensor number 1 under the 1st metatarsal and sensor number 4 under the lateral edge of the heel were significantly different under the DAFO condition. The 1-point sensor activation percentage significantly decreased, while the 4-point sensor activation percentage increased during DAFO walking. According to our study findings, there was an increase in pressure distribution in the lateral part of the foot during the stance phase in DAFO. DAFO improved the gait cycle and influenced the plantar foot pressure in children with mild cerebral palsy. [ABSTRACT FROM AUTHOR]

Lower extremity muscle fatigue affects gait stability and increases the probability of injuries in the elderly. How does prolonged walking-induced fatigue affect lower limb muscle activity, plantar pressure distribution, and tripping risk? Eighteen elderly adults walked fast on a treadmill for 60 minutes at a fixed speed. The plantar pressure was measured with an in-shoe monitoring system, eight lower limb muscles were monitored using surface electromyography, and foot movements were tracked by a motion capture analysis system. The above data and participants' subjective fatigue level feedback were collected every 5 minutes. Statistical analysis used the Friedman one-way repeated measures analysis of variance by ranks test followed by Wilcoxon signed-ranks test with Benjamini-Hochberg stepwise correction. The subjective reported fatigue on the Borg scale increased gradually from 1 to 6 (p = 0.001) during the 60 minutes, while the EMG amplitude of vastus medialis significant decreased (p = 0.013). The results of plantar pressure demonstrated that the distribution of load and impulse shifted medially in both the heel and arch regions while shifted laterally in both the toes and metatarsal regions. The significantly increased contact area supports this shift at the medial arch (p = 0.036, increased by 6.94%, the 60th minute vs. the baseline). The symmetry of medial-lateral plantar force increased at the toes, metatarsal, and arch regions. The significantly increased parameters also include the swing time and contact time. The minimum foot clearance was reduced, increasing tripping probability, not significantly, though. This study facilitates a better understanding of changes in lower limb muscle activity and gait parameters during prolonged fast walking. Besides, this study has good guiding significance for developing smart devices based on plantar force, inertial measurement units, and EMG sensors to monitor changes in muscle activation in real-time and prevent tripping. • Plantar pressure distribution shifted laterally in the toes and metatarsal regions. • Plantar pressure distribution shifted medially in the heel and arch regions. • Increased contact area at the medial arch supports pressure distribution shift. • Symmetry of plantar force increased at the toes, metatarsal, and arch regions. • Estimated tripping probability increased though not significantly. [ABSTRACT FROM AUTHOR]

Fatigue has the potential to alter how impact forces are absorbed during running, heightening the risk of injury. Conflicting findings exist regarding alterations in both kinematics and plantar pressure. Thus, this systematic review and subsequent meta-analysis were conducted to investigate the impact of general and localized muscle fatigue on kinematics and plantar pressure distribution during running. Initial searches were executed on 30 November 2021 and updated on 29 April 2023, encompassing PubMed, The Cochrane Library, SPORTDiscus, and Web of Science without imposing any restrictions on publication dates or employing additional filters. Our PECOS criteria included cross-sectional studies on healthy adults during their treadmill running to mainly evaluate local muscle fatigue, plantar pressure distribution, biomechanics of running (kinematics, kinetics, and EMG results), and temporospatial parameters. The literature search identified 6626 records, with 4626 studies removed for titles and abstract screening. Two hundred and one articles were selected for full-text screening, and 20 studies were included in qualitative data synthesis. The pooled analysis showed a non-significant decrease in maximum pressure under the right forefoot’s metatarsus, which was more than the left rearfoot after local muscle fatigue at a velocity of 15 km/h (p-values = 0.48 and 0.62). The results were homogeneous and showed that local muscle fatigue did not significantly affect the right forefoot’s stride frequency and length (p-values = 0.75 and 0.38). Strength training for the foot muscles, mainly focusing on the dorsiflexors, is recommended to prevent running-related injuries. Utilizing a standardized knee and ankle joint muscle fatigue assessment protocol is advised. Future experiments should focus on various shoes for running and varying foot strike patterns for injury prevention.

(1) Background: Flatfoot can alter the foot's ability to uniformly distribute the body weight on the plantar areas, possibly leading to biomechanical imbalances in the entire body. The purpose of the study was to determine the correlation between flatfoot and plantar pressure distribution in static conditions. (2) Material and methods: The study included a group of 23 children with flat feet (7.43±0.58 years old), which analyzed the correlations between the Foot Posture Index 6 (FPI 6) values and the plantar pressure distribution values. The instruments used were the Foot Posture Index 6 (FPI 6- a quantitative anatomical assessment under static conditions) and the Podata (device for recording images in real time of the body weight distribution on the plantar support). (3) Results: The statistical results have indicated significant correlations of strong intensity between the flat foot and the plantar pressure distribution in the midfoot, but also that the flatfoot significantly influences the values of the plantar pressure distribution in the midfoot. (4) Conclusion: The data showed that flatfeet influence the values of the plantar pressure distribution in the mid-area of the sole.

Background and Objectives: Osteonecrosis of the femoral head (ONFH) is a progressive disease with a complex etiology and unknown pathogenesis. Gait analysis can objectively assess the functional behavior of the foot, thus revealing essential aspects and influencing factors of gait abnormalities. The aim of this study was to evaluate the differences in spatiotemporal parameters, static and dynamic plantar pressure parameters, and symmetry indices between patients with ONFH and healthy subjects. Materials and Methods: The study population consisted of 31 ONFH patients and 31 healthy volunteers. Gait parameters were obtained from the plantar pressure analysis system for both the ONFH and healthy groups. The symmetry index was calculated according to a formula, including spatiotemporal parameters, static and dynamic plantar pressure distribution, percentage of regional impulse, and percentage of the restricted contact area. Results: Compared with healthy controls, patients with ONFH had slower walking speed, shorter step length and stride length, and increased stride time, stance time, and percentage of stance. patients with ONFH had lower plantar static pressure on the affected side and higher contralateral plantar static pressure during stance than controls. During walking, the peak pressures in all regions on the affected side and the peak pressure in the toe 1 and metatarsal 3 regions on the healthy side were lower in ONFH patients than in controls. The percentage of contact area and regional impulse in the heel of both limbs were higher in ONFH patients than in the control group. The symmetry indexes of stride time, stance time, step length, maximum force, impulse and contacted area were significantly increased in ONFH patients compared to controls, with decreased symmetry. Conclusions: Osteonecrosis of the femoral head leads to characteristic changes in plantar pressure distribution. These changes may be interpreted as an attempt by patients with ONFH to reduce the load on the affected limb. Plantar pressure analysis may assist in the diagnosis of ONFH and can provide an objective quantitative indicator for the assessment of subsequent treatment outcomes. [ABSTRACT FROM AUTHOR]

A rollator, one of the most widely used among walking assistance devices, can assist the elderly with stable walking in their daily lives. In this study, we investigated how the structural characteristics of two types of rollators affect the upper and lower extremity muscle activity and plantar pressure of the elderly in various walking environments. We quantified muscle activity (upper and lower limbs) and plantar pressure (mean force, peak pressure, and contact area) of 11 older adults walking in various environments (flat, obstacle, uneven, and sloped terrain) using two types of rollators. Upper extremity muscle activity was highest in the obstacle terrain and the uneven terrain, and a significant difference was found due to the structural differences of the rollator. Additionally, it was observed that lower extremity muscle activity and plantar pressure patterns appeared in accordance with the gait strategy to maintain stability in an unstable or inclined walking environment. In other words, it was confirmed that the weight of the rollator, the size of the wheel, grip type, and the auxiliary tools had a great effect on the upper and lower extremity muscle activity and plantar pressure of the elderly during walking. From the results of this study, it can be suggested that it is absolutely necessary to consider the biomechanical characteristics of the elderly and the structure of the rollator, which appear differently depending on the walking environment, in the development of walking aids. In the future, more clinical data will be collected, and based on this a rollator that can safely assist the elderly in various walking environments will be developed.

Background: Adolescent DanceSport athletes who regularly dance in high heels have a higher possibility of developing hallux valgus deformity and foot pain. We believe that the occurrence of foot disorders may change the loading on their feet, which thus affects the athletic performance of those adolescents. Methods: A total of 63 adolescent DanceSport athletes (16 boys, 47 girls) were included. The plantar pain in the first metatarsophalangeal (1st MTP) joint was evaluated using a questionnaire, and the hallux valgus angle was evaluated using digital photographs (HVAp). The loading values of the plantar pressure while performing relève on demi-pointe were measured using sensor sheets. The participating boys and girls were analyzed separately. Results: The results showed that female adolescent DanceSport athletes with the 1st MTP joint plantar pain showed a decrease in the loading distribution and plantar pressure percentage on the hallux and an increased loading distribution and pressure distribution of the metatarsal head as the HVAp increased. Conclusion: Among adolescent DanceSport athletes with plantar pain in the 1st MTP joint and a large HVAp, the loading manner of the foot may have changed, which may be associated with a decrease in the toe function and performance. [ABSTRACT FROM AUTHOR]

Objective: This study aims to compare the variables of plantar force, pressure and impulse during walking in men and women with flat feet. Methods: The study population consists of non-athlete students with and without flat feet. Of these, 48 (male and female) were selected as study samples. The peak pressure, force and impulse on the foot were measured during walking by a foot scanner at a sampling frequency of 253 Hz. Shapiro-Wilks test was used to examine the normality of data distribution, and data analysis was performed using MANOVA in SPSS software, considering the significance level at P

Introduction: The purpose of the present study was to compare the symmetry of the distribution of plantar pressure and the center of pressure excursion index (CPEI) in active female adolescents with and without foot pronation disorder.Materials and Methods: This cross-sectional study was conducted on 34 physically active female adolescents with and without foot pronation aging 14 to 17 years. The participants were included through convenient sampling. Dominant leg was determined using blindfolded fall test and Waterloo dominant leg questionnaire. Brody method and foot pressure measurement system were used to measure navicular bone position and plantar pressure distribution, respectively. Data distribution was determined by Shapiro-Wilk test and between-group comparison of parameters concerning plantar pressure distribution was conducted using independent t-test at the significance level of α ≥ 0.05.Results: There was no significant difference in the symmetry of the distribution of plantar pressure and maximal plantar pressure between two groups (P > 0.05); however, among the symmetry indices of decuple maximal plantar pressure zones, the maximal pressure at first metatarsus (P = 0.04) and the medial heel (P = 0.05) was significantly different between groups.Conclusion: It seems that the symmetry at first metatarsus and medial heel was less in female adolescents with foot pronation disorders compared to that of healthy group. In addition, these girls showed higher pressures at medial heel and first metatarsus probably because of wider contact between the medial region of their foot and the ground. However, the pattern of distribution of plantar pressure and CPEI was almost the same in both groups without significant difference.

People with spastic cerebral palsy (CP) often experience a decline in gait function and flexion. The children’s posture and hip strategy, which leads to knee flexion, predisposes these children to increased contact area in the medial foot region. This study investigated the use of DAFO (dynamic ankle-foot orthosis) prescribed to patients with cerebral palsy (CP) to determine the plantar pressure distribution with orthosis use. Eight children with spastic CP (age 4–12 years) were classified as Gross Motor Function Classification System (GMFCS) levels I-II with a maximum spasticity level of 3 in their ankle muscles according to the Modified Ashworth Scale. We assessed the plantar distribution by using eight WalkinSense sensors in each trial and exported data from the proprietary software (WalkinSense version 0.96, Tomorrow Options Microelectronics, S.A.). The plantar pressure distribution was conducted under two conditions: only shoes and DAFO with shoes. The activation percentages for sensor number 1 under the 1st metatarsal and sensor number 4 under the lateral edge of the heel were significantly different under the DAFO condition. The 1-point sensor activation percentage significantly decreased, while the 4-point sensor activation percentage increased during DAFO walking. According to our study findings, there was an increase in pressure distribution in the lateral part of the foot during the stance phase in DAFO. DAFO improved the gait cycle and influenced the plantar foot pressure in children with mild cerebral palsy.

The purpose of this study was to investigate the influence of heel-to-toe drop (heel drop) modifications of a hiking shoe on plantar pressure distribution and perceived comfort before and after walking. Data of three shoe conditions with a low (11 mm), medium (16 mm) and high (21 mm) heel drop were obtained of twelve healthy male participants (mean age: 23.8 ± 2.8 yrs.) before (pre-test) and after a 45-minute walk in a park (post-test). Two-way repeated-measures analysis of variance (ANOVA) was applied to investigate differences between the three shoe types at the two time points and over time. Post-hoc analyses showed few significant differences in pressure and comfort parameters between shoe conditions at the two time points. Over time, however, several significant changes in comfort measures and pressure distribution were observed depending on the shoe condition. Most of the plantar pressure changes were seen in the hiking shoe with the medium heel drop showing significantly increased pressures values in the toe and forefoot area after the walk. Comfort measures deteriorated from the pre-to the post-test, in particular for the hiking shoe with the high heel drop. The results of the study showed that comfort and pressure parameters altered from walking for 45 minutes depending on the shoe condition and that the modification of the heel drop affected pressure parameters and comfort parameters in different ways. These findings may have implications for future considerations of values for the heel drop in hiking shoes. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to compare plantar pressure distribution and vertical ground reaction force between middle-aged adults with Leg Length Discrepancy (LLD) and healthy subjects. Materials and Methods: This quasi-experimental study was conducted on 21 middle-aged adults with leg length discrepancy (1.5 to 3 cm), and 10 healthy subjects participated. The plantar pressure distribution of subjects was measured using five steps with an emed platform. The data were analyzed with paired t-test, 1-way ANOVA, and symmetry index (P≤0.05). Results: While the symmetry index did not show much asymmetry in healthy subjects, in LLD subjects, it showed lower contact time in the heel region of short limb, lower pressure, and force of the middle region of short limb, the higher pressure of forefoot region of short limb and higher pressure and force of long limb. Conclusion: It seems that the primary contact time and weight acceptance of short limb reduced that results in higher pressure of forefoot region of the foot before push-off phase. Therefore, to dispel this problem, the LLD subjects could use orthotics to make reasonable height to the heel region and thus increase the contact time. [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]

Study aim: It is important for therapists to incorporate new practical methods into therapy programs when they have demonstrable efficacy in the treatment of multiple sclerosis. Investigating the acute effects of myofascial release techniques (MFR) and passive stretching (PS) on hind foot loading and the severity of spasticity in individuals with multiple sclerosis (MS) was the aim of the study.

Introduction: This study aimed to compare plantar pressure distribution and vertical ground reaction force between middle-aged adults with Leg Length Discrepancy (LLD) and healthy subjects. Materials and Methods: This quasi-experimental study was conducted on 21 middle-aged adults with leg length discrepancy (1.5 to 3 cm), and 10 healthy subjects participated. The plantar pressure distribution of subjects was measured using five steps with an emed platform. The data were analyzed with paired t-test, 1-way ANOVA, and symmetry index (P≤0.05). Results: While the symmetry index did not show much asymmetry in healthy subjects, in LLD subjects, it showed lower contact time in the heel region of short limb, lower pressure, and force of the middle region of short limb, the higher pressure of forefoot region of short limb and higher pressure and force of long limb. Conclusion: It seems that the primary contact time and weight acceptance of short limb reduced that results in higher pressure of forefoot region of the foot before push-off phase. Therefore, to dispel this problem, the LLD subjects could use orthotics to make reasonable height to the heel region and thus increase the contact time.

Background and Objectives: Osteonecrosis of the femoral head (ONFH) is a progressive disease with a complex etiology and unknown pathogenesis. Gait analysis can objectively assess the functional behavior of the foot, thus revealing essential aspects and influencing factors of gait abnormalities. The aim of this study was to evaluate the differences in spatiotemporal parameters, static and dynamic plantar pressure parameters, and symmetry indices between patients with ONFH and healthy subjects. Materials and Methods: The study population consisted of 31 ONFH patients and 31 healthy volunteers. Gait parameters were obtained from the plantar pressure analysis system for both the ONFH and healthy groups. The symmetry index was calculated according to a formula, including spatiotemporal parameters, static and dynamic plantar pressure distribution, percentage of regional impulse, and percentage of the restricted contact area. Results: Compared with healthy controls, patients with ONFH had slower walking speed, shorter step length and stride length, and increased stride time, stance time, and percentage of stance. patients with ONFH had lower plantar static pressure on the affected side and higher contralateral plantar static pressure during stance than controls. During walking, the peak pressures in all regions on the affected side and the peak pressure in the toe 1 and metatarsal 3 regions on the healthy side were lower in ONFH patients than in controls. The percentage of contact area and regional impulse in the heel of both limbs were higher in ONFH patients than in the control group. The symmetry indexes of stride time, stance time, step length, maximum force, impulse and contacted area were significantly increased in ONFH patients compared to controls, with decreased symmetry. Conclusions: Osteonecrosis of the femoral head leads to characteristic changes in plantar pressure distribution. These changes may be interpreted as an attempt by patients with ONFH to reduce the load on the affected limb. Plantar pressure analysis may assist in the diagnosis of ONFH and can provide an objective quantitative indicator for the assessment of subsequent treatment outcomes.

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.

Background: Adolescent DanceSport athletes who regularly dance in high heels have a higher possibility of developing hallux valgus deformity and foot pain. We believe that the occurrence of foot disorders may change the loading on their feet, which thus affects the athletic performance of those adolescents. Methods: A total of 63 adolescent DanceSport athletes (16 boys, 47 girls) were included. The plantar pain in the first metatarsophalangeal (1st MTP) joint was evaluated using a questionnaire, and the hallux valgus angle was evaluated using digital photographs (HVAp). The loading values of the plantar pressure while performing relève on demi-pointe were measured using sensor sheets. The participating boys and girls were analyzed separately. Results: The results showed that female adolescent DanceSport athletes with the 1st MTP joint plantar pain showed a decrease in the loading distribution and plantar pressure percentage on the hallux and an increased loading distribution and pressure distribution of the metatarsal head as the HVAp increased. Conclusion: Among adolescent DanceSport athletes with plantar pain in the 1st MTP joint and a large HVAp, the loading manner of the foot may have changed, which may be associated with a decrease in the toe function and performance.

Abstract Background The aim of the study was to evaluate changes in plantar pressure distribution in feet affected by hallux valgus compared with their contralateral non-affected feet and with the feet of healthy control subjects. Methods Thirty-six patients with unilateral hallux valgus who were indicated for surgery and 30 healthy subjects were assessed on a pedobarographic instrumented treadmill for step length and width, mean stance phase, and plantar foot pressure distribution. Plantar pressure distribution was divided into eight regions. Results Significantly higher plantar pressures were observed in hallux valgus feet under the second and third metatarsal heads (p = .033) and the fourth and fifth toes (p

The main goal of spinal cord rehabilitation is to restore walking ability and improve walking quality after spinal cord injury (SCI). The spatiotemporal parameters of walking and the parameters of plantar pressure can be obtained using a plantar pressure analysis system. Previous studies have reported step asymmetry in patients with bilateral SCI. However, the asymmetry of other parameters in patients with SCI has not been reported. This was a prospective, cross-sectional study, which included 23 patients with SCI, aged 48.1 ± 14.5 years, and 28 healthy subjects, aged 47.1 ± 9.8 years. All subjects underwent bare foot walking on a plantar pressure measurement device to measure walking speed and spatiotemporal parameters. Compared with healthy subjects, SCI patients had slower walking speed, longer stride time and stance time, larger stance phase percentage, and shorter stride length. The peak pressures under the metatarsal heads and toe were lower in SCI patients than in healthy subjects. In the heel, regional impulse and the contact area percentage in SCI patients were higher than those in healthy subjects. The symmetry indexes of stance time, step length, maximum force, impulse and contact area were increased in SCI patients, indicating a decline in symmetry. The results confirm that the gait quality, including spatiotemporal variables and plantar pressure parameters, and symmetry index were lower in SCI patients compared with healthy subjects. Plantar pressure parameters and symmetry index could be sensitive quantitative parameters to improve gait quality of SCI patients. The protocols were approved by the Clinical Research Ethics Committee of Shengjing Hospital of China Medical University (approval No. 2015PS54J) on August 13, 2015. This trial was registered in the ISRCTN Registry (ISRCTN42544587) on August 22, 2018. Protocol version: 1.0.

In this paper, three configurations of LC (inductor–capacitor) pressure sensors are developed, namely series LC pressure sensors, compact LC pressure sensors, and far‐field LC pressure sensor tags. The modified silk protein films have been chosen as substrates due to their good biocompatibility and air/water permeability, which is suitable for continuously pasting such substrates on skin. For series LC pressure sensors, conducting wire is used to connect the flexible capacitor and spiral inductor. It exhibits good cycling stability and high sensitivities, suitable for electronic skin. For compact LC pressure sensors, the spiral coil functions as inductor, antenna, and capacitor electrode simultaneously, minimizing the space cost and is suitable for array integration, while the sensitivities remain the same. By tailoring the turn of the spiral coil, the resonate frequency can be regulated continuously. An annular array of compact LC sensors with ten distinct resonate frequencies ranged from 400 to 1000 MHz is developed to remotely monitor the press of number 0–9. Finally, far‐field LC pressure sensor tags with elongated detection distances are developed in which each compact LC sensor acts as a filter. A wireless in‐shoe plantar to detect the sole pressure distribution using the far‐field LC sensor configuration is developed. [ABSTRACT FROM AUTHOR]

In this article we present a self-calibrating sensor-footwear for plantar pressure distribution measurements; the self-calibrating process is implemented to adapt the force measurement range (FMR) to the weight of the user; four FMRs were generated, 0 – 25 N, 0 – 50 N, 0 – 100 N and 0 – 200 N. This self-calibrating step improves the force resolution for each individual using the proposed system. We also demonstrate that, even when normally not considered in literature, the response of each sensor to the applied pressure is different along the footwear due to its natural difference between the sole sections, back, middle and front. Furthermore, the implemented sensors were characterized and a coefficient of variation (CV) of 2.62 % was obtained before installing the sensors in the sensor-footwear, and a CV of 16.61 % was generated when the sensors were installed in the sensor-footwear. In order to overcome these differences in response, we propose and demonstrate that in-shoe characterization of all sensors allows removing the inherent difference in sensor response; which also contribute to obtain absolute force values from all sensors. In addition, an algorithm to obtain the gait-area of interest from the acquired sensing signal is proposed. The presented sensor-footwear, used for Plantar Pressure Distribution (PPD) measurement, communicates through a wireless local area network allowing real time PPD visualization and recording intended for indoor testing. Design, construction, characterization and implementation of the proposed sensor-footwear are presented; demonstrating the importance of the in-shoe characterization for a sensor-footwear system. [ABSTRACT FROM AUTHOR]

Background: Hallux Valgus Surgery success depends not only on the operative technique, but also on the care of the foot during the postoperative period. Orthopedic shoes have been developed to decrease the weight load on the first ray, an excess of which might lead to a loss of fixation or pseudoarthrosis. The goal of this study was to determine how the load distribution changed as the forced applied to the foot increased, with and without an orthopedic shoe. Also, we compared to different shoe models.Methods: Pressure sensors were placed under the first metatarsal head and the heel of twenty specimens of fresh cadaveric adult feet. Two orthopedic shoes were chosen, a double padded (MS) and a reverse camber shoe (RCS). 10 kg loads were progressively applied, up to 60 kg. We first compared three instances: no shoe, MS and RCS. A secondary analysis comparing barefoot versus shoes was performed. A mean comparison was performed (ANOVA/T-student).Results: The mean pressure of the heed and the first metatarsal showed that there were significant differences between groups (P < .005). The secondary analysis (no shoe vs orthopedic shoes) showed that the pressure without shoe was significantly higher than with any orthopedic shoe (P < .005). There were no statistically significant differences between models of shoes (P = .402).Conclusion: After a surgical procedure for hallux valgus fixation, postoperative shoes should be indicated to decrease the pressure on the first metatarsal head and heel in order to avoid an overload of the postoperative area.Level Of Evidence: Cadaveric study. Level V. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine the influence of a total knee arthroplasty (TKA) on linked cranial and caudal structures. Methods: Thirty-five (14f/21m) subjects participated in this study: 15 subjects (9f, 6m) pre- and post- TKA and a control group of 20 subjects (5f, 15m). The measurements included: jaw condyle position and movement, back scan, plantar pressure distribution, and body sway. Results: There were no significant differences in electronic position analysis of the jaw; however, the protrusion of the TKA group improved (p = 0.001). The test group had a more anteriorly inclined thoracic spine and a less pronounced lumbar lordosis. Before and after surgery, the body sway in the test group was larger. Conclusion: The TKA affected most prominently the static mechanisms of the postural control and the spine position. The trajectories of the mandible during protrusion also changed slightly. [ABSTRACT FROM AUTHOR]

Wearable health monitoring devices allow for measuring physiological parameters without restricting individuals’ daily activities, providing information that is reflective of an individual’s health and well-being. However, these systems need to be accurate, power-efficient, unobtrusive and simple to use to enable a reliable, convenient, automatic and ubiquitous means of long-term health monitoring. One such system can be embedded in an insole to obtain physiological data from the plantar aspect of the foot that can be analyzed to gain insight into an individual’s health. This manuscript provides a comprehensive review of insole-based sensor systems that measure a variety of parameters useful for overall health monitoring, with a focus on insole-based PPD measurement systems developed in recent years. Existing solutions are reviewed, and several open issues are presented and discussed. The concept of a fully integrated insole-based health monitoring system and considerations for future work are described. By developing a system that is capable of measuring parameters such as PPD, gait characteristics, foot temperature and heart rate, a holistic understanding of an individual’s health and well-being can be obtained without interrupting day-to-day activities. The proposed device can have a multitude of applications, such as for pathology detection, tracking medical conditions and analyzing gait characteristics.

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.

Diabetes is highly prevalent throughout the world and imposes a high economic cost on countries at all income levels. Foot ulceration is one devastating consequence of diabetes, which can lead to amputation and mortality. Clinical assessment of diabetic foot ulcer (DFU) is currently subjective and limited, impeding effective diagnosis, treatment and prevention. Studies have shown that pressure and shear stress at the plantar surface of the foot plays an important role in the development of DFUs. Quantification of these could provide an improved means of assessment of the risk of developing DFUs. However, commercially-available sensing technology can only measure plantar pressures, neglecting shear stresses and thus limiting their clinical utility. Research into new sensor systems which can measure both plantar pressure and shear stresses are thus critical. Our aim in this paper is to provide the reader with an overview of recent advances in plantar pressure and stress sensing and offer insights into future needs in this critical area of healthcare. Firstly, we use current clinical understanding as the basis to define requirements for wearable sensor systems capable of assessing DFU. Secondly, we review the fundamental sensing technologies employed in this field and investigate the capabilities of the resultant wearable systems, including both commercial and research-grade equipment. Finally, we discuss research trends, ongoing challenges and future opportunities for improved sensing technologies to monitor plantar loading in the diabetic foot. [ABSTRACT FROM AUTHOR]

For visually impaired people, walking is very important in daily life because it provides independence and mobility. Visually impaired people typically use a white cane to assist them when walking, but it is difficult to detect low obstacles using a white cane. Therefore, many walking assistive devices for obstacle detection have been developed for visually impaired people. However, the gait characteristics of users have not been considered enough. Shoetype walking assistive devices have the advantage of detecting low obstacles and providing gait balance; however, no such devices have been developed yet. In this study, we developed obstacle detection shoes for visually impaired people, which can detect obstacles based on the foot angle. These obstacle detection shoes included infrared sensors, six-axis sensors, buzzers, and battery packs. The infrared sensors and six-axis sensors were attached to the upper part of the shoes to detect the distance of obstacles and the direction of the shoes. Additionally, the buzzers were placed on nearby ears to provide an alarm. All subjects were asked to walk along a corridor under two conditions: walking with a white cane and walking with the obstacle detection shoes. To evaluate the effectiveness of the developed device, the required time to pass, number of collisions, plantar pressure distribution, and lower limb muscle activity were analyzed during walking. We found that the required time to pass increased, while the number of collisions, peak pressure, and muscle activity decreased significantly when walking with the obstacle detection shoes. Consequently, we suggest that this device could be helpful in providing safety and supporting the stable walking of visually impaired people. [ABSTRACT FROM AUTHOR]

Plantar pressure distribution of the designed cushioned soles was studied and compared with that of the commercially available sport shoes. A three-dimensional motion measurement system was used to obtain the peak plantar force, the peak plantar pressure, force-time integrals and pressure-time integrals, and one-way analysis of variance was used to analyze the performance of the designed cushioned shoes. The results revealed that in normal walking and jogging states, compared with the commercially available sport shoes, the peak plantar pressure in the heel region decreased by 13.65% and 6.05%, respectively. The peak plantar force decreased by 15.98% and 15.32%, respectively. The force-time integral decreased by 4.36% and 6.83%, respectively, and the pressure-time integral decreased by 10.58% and 11.00%, respectively. In conclusion, the cushioning performance of shoes is related to the exercise mode. For normal walking, the designed cushioned soles absorbed greater impact in the heel region, which was effectively cushioned, whereas in the jogging state, the designed cushioned soles exhibited a favorable cushioning effect in the forefoot region. The designed cushioned soles exhibited cushioning performance through the coupling design of material and structure, which effectively reduced impact force when landing and could optimize plantar pressure distribution. [ABSTRACT FROM AUTHOR]

Aim: The aims of this study were to define the dynamic loading pattern of the foot in healthy adolescents and to investigate the differences between boys and girls. Material and Methods: n = 89 adolescents (n = 42 girls, n = 47 males) using right hand-preferred and have normal body mass index (18.5- 24.9 kg/m2) were included in the study. Dynamic foot pressure analysis was used to determine the foot dynamical load patterns of the participants. The results were compared by considering be male or female factor and right-left foot dynamic loading pattern. Results: In the comparison between the groups, it was seen that the contact percentages and active contact areas of the different regions of the feet were different in boys and girls (p <0.05). When the right-left foot load patterns were compared, it was seen that the load transfer in the right foot progressed to the anterior medial and the left foot showed a delay in the load transfer processes (p <0.05). Conclusion: Boys walked with a wider contact percentage in the left foot and wider metatarsal and heel active contact areas in both feet than in girls. Furthermore, on the preferred side (right) the load transfer is positioned on the anterior medial of the foot, while the main difference in the other foot is due to the delay in reaching the maximum pressure. [ABSTRACT FROM AUTHOR]