Center Of Pressure Progression Research Articles

Short-term effects of foot surgery on walking-related pain, function, and satisfaction in patients with Charcot-Marie-Tooth disease: a prospective cohort study.

Patients with Charcot-Marie-Tooth disease (CMT) often suffer from walking-related pain (WRP), muscle weakness, foot deformities, and reduced ankle dorsiflexion (DF), which affects their ability to walk and daily activities. Functional surgery (FS) can restore foot deviations, affecting the loading ability during gait. We assessed the short-term effects of FS in patients with CMT on WRP, foot and ankle structure, and function, along with patients' perceived improvement. This is a prospective cohort study on CMT patients who had undergone FS and rehabilitation. We analyzed the changes after 1 month, focusing on WRP, DF, the center of pressure progression (COPP) during walking, and measures of walking ability. The non-parametric Wilcoxon test was used. Ten patients were included. One month after FS, WRP reduced from 5.5 (IQR = 3.5) to 2 (IQR = 3.5), p = 0.063, with an effect size of 0.615. The highest decrease was found in patients with very high pre-surgical pain levels. DF almost reached 10° for both active and passive movements (p < 0.05), and COPP improved from 44 to 60% (p = 0.009) of foot length. Gait speed, lower limb functioning, and balance did not change. More than half of the sample felt improved or much improved after FS. FS can be effective in reducing WRP and restoring foot posture in CMT patients in the short-term, which allows them to wear shoes, and leads to a perceived improvement and satisfaction. Lack of improvement in functional skills may be due to muscle weakness typical of CMT. Studies with longer follow-ups may confirm these hypotheses.

Investigating the Association of Quantitative Gait Stability Metrics With User Perception of Gait Interruption Due to Control Faults During Human-Prosthesis Interaction.

This study aims to compare the association of different gait stability metrics with the prosthesis users' perception of their own gait stability. Lack of perceived confidence on the device functionality can influence the gait pattern, level of daily activities, and overall quality of life for individuals with lower limb motor deficits. However, the perception of gait stability is subjective and difficult to acquire online. The quantitative gait stability metrics can be objectively measured and monitored using wearable sensors; however, objective measurements of gait stability associated with human's perception of their own gait stability has rarely been reported. By identifying quantitative measurements that associate with users' perceptions, we can gain a more accurate and comprehensive understanding of an individual's perceived functional outcomes of assistive devices such as prostheses. To achieve our research goal, experiments were conducted to artificially apply internal disturbances in the powered prosthesis while the prosthetic users performed level ground walking. We monitored and compared multiple gait stability metrics and a local measurement to the users' reported perception of their own gait stability. The results showed that the center of pressure progression in the sagittal plane and knee momentum (i.e., residual thigh and prosthesis shank angular momentum about prosthetic knee joint) can potentially estimate the users' perceptions of gait stability when experiencing disturbances. The findings of this study can help improve the development and evaluation of gait stability control algorithms in robotic prosthetic devices.

Foot strike determines the center of pressure behavior and affects impact severity in heel-toe running

ABSTRACT This study assessed the centre of pressure (COP) behaviour and the relationship with impact severity during heel-toe running in conventional athletic footwear. We hypothesized that the COP behaviour depends on its location at foot strike, which would be associated with the vertical loading rate and peak tibial accelerations in heel-toe running. Ground reaction force and tibial acceleration were measured in 104 distance runners running level at ~3.2 m/s. High-speed plantar pressure captured at high temporal resolution (500 Hz) and spatial resolution (7.62 · 5.08 mm/sensor) allowed for localization of the COP directly in the footprint during running in self-selected athletic footwear. More lateral X-coordinates of the COP at first foot contact had, in general, more anterior Y-coordinates (adj.R2:0.609). In heel-toe running, a more anterior foot strike had a greater refined strike index, which was associated with a quicker roll-over in the rearfoot zone. This strike index contributed to greater maximum vertical loading rates (R2:0.121), and greater axial (R2:0.047) and resultant (R2:0.247) peak tibial accelerations. These findings indicate that (1) the COP progression is dependend on the COP location at foot strike; (2) more anterior rearfoot strikes are more likely to have greater impact severity than posterior rearfoot strikes.

Validation of a Novel Boxing Monitoring System to Detect and Analyse the Centre of Pressure Movement on the Boxer's Fist.

The examination of force distribution and centre of pressure (CoP) displacement is a common method to analyse motion, load, and load distribution in biomechanical research. In contrast to gait analysis, the force progression in boxing punches is a new field of investigation. The centre of pressure displacement and distribution of forces on the surface of the fist during a boxing punch is of great interest and crucial to understanding the effect of the punch on the biological structures of the hand as well as the technical biomechanical aspects of the punching action. This paper presents a new method to display the CoP progression on the boxer’s fist Therefore, this study presents the validation of the developed novel boxing monitoring system in terms of CoP displacement. In addition, the CoP progression of different punching techniques in boxing is analysed on the athlete’s fist. The accuracy of the examination method of the CoP course was validated against the gold standard of a Kistler force plate. High correlations were detected between the developed sensor system and the force plate CoP with a Pearson correlation coefficient ranging from 0.93 to 0.97. The information obtained throughout the experimental study is of great importance in order to gain further knowledge into the technical execution of boxing punches as well as to provide a novel measuring method for determining CoP on the surface of the fist, to improve the understanding of the etiology of boxing-related hand injuries.

The effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.

Familial hypercholesterolemia, a common genetic metabolic disorder characterized by high cholesterol levels, is involved in the development of atherosclerosis and other preventable diseases. Familial hypercholesterolemia can also cause tendinous abnormalities, such as thickening and xanthoma (tendon lipid accumulation) in the Achilles, which may impede tendon biomechanics. The objective of this study was to investigate the effect of cholesterol accumulation on the biomechanical performance of Achilles tendons, in vivo. 16 participants (10 men, 6 women; 37±6 years) with familial hypercholesterolemia, diagnosed with tendon xanthoma, and 16 controls (10 men, 6 women; 36±7 years) underwent Achilles biomechanical assessment. Achilles biomechanical data was obtained during preferred pace, shod, walking by analysis of lower limb kinematics and kinetics utilizing 3D motion capture and an instrumented treadmill. Gastrocnemius medialis muscle-tendon junction displacement was imaged using ultrasonography. Achilles stiffness, hysteresis, strain and force were calculated from displacement-force data acquired during loading cycles, and tested for statistical differences using one-way ANOVA. Statistical parametric mapping was used to examine group differences in temporal data. Participants with familial hypercholesterolemia displayed lower Achilles stiffness compared to the control group (familial hypercholesterolemia group: 87±20 N/mm; controls: 111±18 N/mm; p = 0.001), which appeared to be linked to Achilles loading rate rather than an increased strain (FH: 5.27±1.2%; controls: 4.95±0.9%; p = 0.413). We found different Achilles loading patterns in the familial hypercholesterolemia group, which were traced to differences in the centre of pressure progression that affected ankle moment. This finding may indicate that individuals with familial hypercholesterolemia use different Achilles loading strategies. Participants with familial hypercholesterolemia also demonstrated significantly greater Achilles hysteresis than the control group (familial hypercholesterolemia: 57.5±7.3%; controls: 43.8±10%; p<0.001), suggesting that walking may require a greater metabolic cost. Our results indicate that cholesterol accumulation could contribute to reduced Achilles function, while potentially increasing the chance of injury.

A center of pressure progression model for walking with non heeled and heeled footwear

Background:Heeled footwear benefits people with movement disorder in the form of shoe lifts, wedges and inserts while its prolonged use causes foot injury in healthy people. There lies a need to detect parameters that affect COP progression of the foot and gait stability due to footwear. Research question:Do we have bipedal models that can estimate gait parameters corresponding to different center of pressure (COP) trajectories? Method:In this study, we propose a COP translation model that can account for non heeled to heeled footwear. We describe the COP progression as a function of the center of mass (COM) state. This model is used to generate stable steady state walking solutions for different COP profiles. We compare these model solutions with experimental data on non-heeled and heeled-gait. Results:The bipedal model shows stability across different COP profiles. The model estimates GRF profile (R2=0.83 for 1.3 m/s ) for non heeled normal walking qualitatively and on the temporal scale. It estimates GRF due to heeled gait (R2=0.83 for 1.08 m/s) but is limited in estimation of heeled gait parameters. Significance:A bipedal model that can generate stable steady state walking solutions for different forward progressing COP profiles can help in design of foot orthotics for patients with gait disorder and understand injuries occurring due to prolonged wear of rigid heeled footwear.

Investigation of the relationship between plantar pressure behaviour and plantar surface sensitivity in children with idiopathic toe walking

Flatfoot has a very high incidence of obese children. Functional parameters such as plantar pressures and center of pressure (COP) are sensitive to foot type. However, previous foot biomechanical studies of obese children rarely excluded the flatfoot as a prerequisite of the participants involved.This study aimed to determine whether it is essential to define flatfoot as a subject screening criterion in the foot biomechanical study for obese children.Foot types were classified by arch index (AI). Totally 21 obese children with flatfoot (OF group) along with matched control groups of obese children with normal foot (ON group) and normal-weighted children with flatfoot (NF group) were selected from our database. Barefoot walking trails were conducted using Footscan® plate system. Peak force (PF), peak pressure (PP), pressure-time integral (PTI), contact area (CA) and COP data were recorded. Independent t-test and effect size were used to compare the data between the study group and the control groups. Intraclass correlation coefficient was used to measure the between-trail reliability for the dependent variables.In comparison with the OF group, an upward trend for PF, PP and PTI was found for the ON group, while an opposite tendency for the NF group. The OF group displayed a significant larger CA under the midfoot region than the NF group even if there is no significant difference for AI. The OF group displayed a more medial shift of COP progression compared to the ON group. But no significant differences were found for COP parameters between the OF group and the NF group.This study provided substantial evidence to support that prospective foot biomechanical research on the obese group needs to identify the flatfoot as one of the subject screening criteria to carry out more reliable results without producing confounding effects.

Ankle kinematics, center of pressure progression, and lower extremity muscle activity during a side-cutting task in participants with and without chronic ankle instability

This study assessed ankle kinematics, surface electromyography, and center-of-pressure (COP) progression relative to the medial border of the foot during a side-cutting task in individuals with and without chronic ankle instability (CAI). Thirty participants (CAI = 15; Controls = 15) performed a side-cutting task on a force platform while 3-dimentional ankle kinematics, COP position, and surface electromyography from the tibialis anterior, medial gastrocnemius, fibularis longus, fibularis brevis, vastus medialis, and semitendinosus were recorded on the testing leg. Ankle kinematics, root-mean-square muscle activity and COP position relative to the medial boarder of the foot were compared between CAI and healthy controls (p < 0.05). Significantly greater ankle internal rotation from 35–54% of the stance phase (p = 0.032) was found for the CAI group compared to controls. Furthermore, significantly greater tibialis anterior muscle activity from 86–94% of the stance phase (p = 0.022) and a more medial COP position from 81–100% (p < 0.05) and of the stance phase was also observed in the CAI group. Less lateral COP progression and increased tibialis anterior activation in the CAI group could reflect a protective movement strategy during anticipated side-cutting to avoid recurrent injury. However, greater ankle internal rotation during mid-stance highlights a potential ‘giving way’ mechanism in individuals with CAI.

Change in Center of Pressure Progression in the Foot Provides Clues for Functional Improvement of the More Affected Lower Limb During Post-stroke Gait Rehabilitation.

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

Mixed factors affecting plantar pressures and center of pressure in obese children: Obesity and flatfoot

BackgroundFlatfoot has a very high incidence of obese children. Functional parameters such as plantar pressures and center of pressure (COP) are sensitive to foot type. However, previous foot biomechanical studies of obese children rarely excluded the flatfoot as a prerequisite of the participants involved. Research questionThis study aimed to determine whether it is essential to define flatfoot as a subject screening criterion in the foot biomechanical study for obese children. MethodsFoot types were classified by arch index (AI). Totally 21 obese children with flatfoot (OF group) along with matched control groups of obese children with normal foot (ON group) and normal-weighted children with flatfoot (NF group) were selected from our database. Barefoot walking trails were conducted using Footscan® plate system. Peak force (PF), peak pressure (PP), pressure-time integral (PTI), contact area (CA) and COP data were recorded. Independent t-test and effect size were used to compare the data between the study group and the control groups. Intraclass correlation coefficient was used to measure the between-trail reliability for the dependent variables. ResultsIn comparison with the OF group, an upward trend for PF, PP and PTI was found for the ON group, while an opposite tendency for the NF group. The OF group displayed a significant larger CA under the midfoot region than the NF group even if there is no significant difference for AI. The OF group displayed a more medial shift of COP progression compared to the ON group. But no significant differences were found for COP parameters between the OF group and the NF group. SignificanceThis study provided substantial evidence to support that prospective foot biomechanical research on the obese group needs to identify the flatfoot as one of the subject screening criteria to carry out more reliable results without producing confounding effects.

Center of pressure progression patterns during level walking in adolescents with idiopathic scoliosis.

The purpose of this study was to determine whether functional walking performance measured with Timed Up-and-Go (TUG) and center of pressure (CoP) progression pattern is different across adolescents with various curve severity of idiopathic scoliosis (IS). The CoP coordinates during a stance phase for self-paced level walking between adolescent with three different severities of IS (mild IS, moderate IS, and severe IS) and age-matched normal subjects were measured with foot pressure measurement. The average data of three trials were compared among groups with repeated measure analysis of variance. Results showed that the TUG was different between normal and AIS subjects, indicating use of TUG as a marker of functional walking performance in AIS is plausible but studies with larger sample size is needed before using TUG to identify AIS with different scoliosis severity. The results also showed that the CoP displacement, velocity and acceleration during a stance phase was different across groups, and with the most prominent deviations found in the moderate IS group. The medial-lateral shifting of the CoP trajectory at mid-foot regions in all IS groups deviated the most. A tendency of asymmetry in CoP progression pattern between feet in IS groups was also found. The deviation of the spine alignment in frontal plane could change the CoP progression patterns during level walking, suggesting the risk of the locomotors subjecting to abnormal loading during daily walking. Education and conservative interventions might be needed for preservation of medical outcome and prevention of back pain and/or musculoskeletal consequences later in the lives of AIS with and without surgical correction.

P 043 – Center of pressure progression and ground reaction forces are altered in cerebral palsy crouch gait

P 043 – Center of pressure progression and ground reaction forces are altered in cerebral palsy crouch gait

A model to calculate the progression of the centre of pressure under the foot during gait analysis

Pedobarography and the centre of pressure (COP) progression is useful to understand foot function. Pedobarography is often unavailable in gait laboratories or completed asynchronously to kinematic and kinetic data collection. This paper presents a model that allows calculation of COP progression synchronously using force plate data. The model is an adjunct to Plug-In-Gait and was applied to 49 typically developing children to create reference COP data. COP progressions were noted to spend 8% of stance behind the ankle joint centre, traverse lateral of the longitudinal axis of the foot through the midfoot for 76% of stance and finishing past the second metatarsal head on the medial side for 16% of stance. It is hoped the model will bridge the information gap for gait laboratories lacking pedobarography during foot assessments and will open up the possibility of retrospective research into COP progression based indices on kinematic data.

Effects of High Heels on Centre of Pressure Progression during Walking in Young Women

Effects of High Heels on Centre of Pressure Progression during Walking in Young Women

Centre of pressure progression and gait parameter deviations may be related to second rocker dysfunction in children with flat feet

Background The Centre of Pressure Progression (COPP) is thought to be a useful measure of dynamic function of the foot [1]. The COPP has been used as an outcome measure in flat foot surgery, with an improved COPP defining a successful surgical result [2]. It is, however, unclear how the COPP varies in children with flat feet (FF) compared to those with normal arches (NA) and how this relates to dynamic function of the foot. The aim of this study was to quantify the differences in COPP between flat and normal arched children and also assess how these related to temporal-spatial gait parameters.

Center of pressure and total force analyses for amputees walking with a backpack load over four surfaces

Understanding how load carriage affects walking is important for people with a lower extremity amputation who may use different strategies to accommodate to the additional weight. Nine unilateral traumatic transtibial amputees (K4-level) walked over four surfaces (level-ground, uneven ground, incline, decline) with and without a 24.5 kg backpack. Center of pressure (COP) and total force were analyzed from F-Scan insole pressure sensor data. COP parameters were greater on the intact limb than on the prosthetic limb, which was likely a compensation for the loss of ankle control. Double support time (DST) was greater when walking with a backpack. Although longer DST is often considered a strategy to enhance stability and/or reduce loading forces, changes in DST were only moderately correlated with changes in peak force. High functioning transtibial amputees were able to accommodate to a standard backpack load and to maintain COP progression, even when walking over different surfaces.

Severity of spine malalignment on center of pressure progression during level walking in subjects with adolescent idiopathic scoliosis.

Center of pressure (CoP) progression during level walking in subjects with Adolescents Idiopathic Scoliosis (AIS) was measured. Participants were divided into three groups according to scoliosis severity. CoP progression among groups was compared quantitatively and qualitatively. The results showed that scoliosis severity affects CoP progression significantly in the hind-foot and forefoot areas. This result indicated that spine alignment might affect the control of heel, ankle and toe rockers in the ankle-foot complex. The effects of scoliosis severity is mainly on the CoP of right foot plantar surface, indicating asymmetrical influence of IS on bilateral lower limb coordination during walking. These results might contribute to musculoskeletal complains over the apparatus within trunk-foot in the later lives of this population.

Ankle-foot orthoses that restrict dorsiflexion improve walking in polio survivors with calf muscle weakness

In polio survivors with calf muscle weakness, dorsiflexion-restricting ankle-foot orthoses (DR-AFOs) aim to improve gait in order to reduce walking-related problems such as instability or increased energy cost. However, evidence on the efficacy of DR-AFOs in polio survivors is lacking. We investigated the effect of DR-AFOs on gait biomechanics, walking energy cost, speed, and perceived waking ability in this patient group.Sixteen polio survivors with calf muscle weakness underwent 3D-gait analyses to assess gait biomechanics when walking with a DR-AFOs and with shoes only. Ambulant registration of gas-exchange during a 6min walk test determined walking energy cost, and comfortable gait speed was calculated from the walked distance during this test. Perceived walking ability was assessed using purposely-designed questionnaires.Compared with shoes-only, walking with the DR-AFOs significantly increased forward progression of the center of pressure (CoP) in mid-stance and it reduced ankle dorsiflexion and knee flexion in mid- and terminal stance (p<0.05). Furthermore, walking energy cost was lower (−7%, p=0.052) and gait speed was higher (p=0.005). Patients were significantly more satisfied, felt safer, and less exhausted with the DR-AFO, compared to shoes-only (p<0.05). DR-AFO effects varied largely across patients. Patients who walked with limited forward CoP progression and persisting knee extension during the shoes-only condition seemed to have benefitted least from the DR-AFO.In polio survivors with calf muscle weakness, DR-AFOs improved gait biomechanics, speed, and perceived walking ability, compared to shoes-only. Effects may depend on the shoes-only gait pattern, therefore further study is needed to determine which patients benefit most from the DR-AFO.

Centre of pressure progression and gait parameter deviations may be related to second rocker dysfunction in children with flat feet

Background The Centre of Pressure Progression (COPP) is thought to be a useful measure of dynamic function of the foot [1]. The COPP has been used as an outcome measure in flat foot surgery, with an improved COPP defining a successful surgical result [2]. It is, however, unclear how the COPP varies in children with flat feet (FF) compared to those with normal arches (NA) and how this relates to dynamic function of the foot. The aim of this study was to quantify the differences in COPP between flat and normal arched children and also assess how these related to temporal-spatial gait parameters.

Comparison of Gait After Total Ankle Arthroplasty and Ankle Arthrodesis

Prior studies reported improved gait after total ankle arthroplasty and better parameters of gait than those reported in earlier studies of patients after ankle arthrodesis. However, there are very limited data prospectively evaluating the effects on gait after ankle arthroplasty compared with ankle arthrodesis. Controversy remains regarding the relative advantages and disadvantages of these 2 treatments and especially the differences in function between them. We performed a prospective study involving 28 patients with posttraumatic and primary ankle osteoarthritis and a control group of 14 normal volunteers. We compared gait in 14 patients who had undergone ankle arthrodesis with the gait of 14 patients who had ankle arthroplasty preoperatively and at 1 year postoperatively. Three-dimensional gait analysis was performed with a 12-camera digital-motion capture system. Temporospatial measurements included stride length and cadence. The kinematic parameters that were measured included the sagittal plane range of motion of the ankle and the coronal plane range of motion of the ankle. Double force plates were used to collect kinetic parameters such as ankle coronal and plantar flexion-dorsiflexion moments and sagittal plane ankle power. Center of pressure (CoP) and its progression in gait cycle were calculated. Baseline parameters showed comparability among the treatment and control groups. Temporospatial analysis, using time as the main effect, showed that compared with ankle arthrodesis, patients with total ankle arthroplasty had higher walking velocity attributable to both increases in stride length and cadence as well as more normalized first and second rockers of the gait cycle. Kinematic analysis, using time and intervention as the main effects, showed that patients who had ankle arthroplasty had better sagittal dorsiflexion (P = .001), whereas those undergoing ankle arthrodesis had better coronal plane eversion (P = .01). Neither ankle arthrodesis nor arthroplasty altered the CoP progression during stance phase. Total ankle arthroplasty produced a more symmetrical vertical ground reaction force curve, which was closer to that of the controls than was the curve of the ankle arthrodesis group. Patients in both the arthrodesis and arthroplasty groups had significant improvements in various parameters of gait when compared with their own preoperative function. Neither group functioned as well as the normal control subjects. Neither group was superior in every parameter of gait at 1 year postoperatively. However, the data suggest that the major parameters of gait after ankle arthrodesis in deformed ankle arthritis are comparable to gait function after total ankle arthroplasty in nondeformed ankle arthritis. Level II, prospective comparative study.