Mean Plantar Pressure Research Articles

Does plantar pressure in short-term standing differ between modular insoles selected based upon preference or matched to self-reported foot shape?

Prolonged workplace standing is commonplace and associated with a range of lower limb issues. Evaluating footwear interventions aiming to modify plantar pressure during standing is essential as the body is static, creating a different requirement for footwear. Previous research associates medial midfoot pressure with greater perceived comfort and identifies arch height as the most variable element of foot shape. Targeting footwear mass customization within this area may better address differences within the target wearers. This study aims to evaluate a modular insole system for its ability to modify plantar pressure during standing. Twenty-five participants completed a static and dynamic standing protocol for 60 seconds whilst measuring in-shoe peak and mean plantar pressure (KPa) and contact area (%). Individuals wore three insole options targeted towards different medial arch shapes (A– low arch, B– medium arch, C– high arch) and rated them for comfort. Participants received guidance to self-identify foot shape (low, medium, or high arch). Comparisons were drawn across the three insole profiles and between the insole rated as most comfortable (preferred), and the insole that matched the self-identified foot shape (matched). As insole arch height increased, medial midfoot pressure and contact area significantly increased, alongside significant reductions in first metatarsal pressure and contact. Preference was spread across insoles A, B, and C (56%, 32%, 12% of participants, respectively). Sixteen participants had different matched and preferred insoles, with significantly greater medial midfoot pressure and contact in the matched insole. The modular insole enabled different wear experiences, however, results suggest that individuals selected insoles lower than their foot shape. Providing adequate medial arch support enables redistribution of pressure which may enable greater comfort during the workday.

Foot Plantar Pressure Abnormalities in Near Adulthood Patients with Type 1 Diabetes.

Increased ulcer risk diminishes the quality of life in diabetes. This study assessed abnormalities in foot plantar pressure distribution in adolescents with T1D to detect early signs of ulcer risk. A total of 102 T1D patients, without diabetic neuropathy, were included (mean age 17.8 years, mean diabetes duration 7.4 year). Pedography was captured using Novel emed. Data from the study group were compared with reference data. The study revealed a statistically significant reduced foot contact area in both feet in the entire foot and under the head of the fifth metatarsal bone and the second toe. In both feet, the peak pressure was increased under the entire foot, hindfoot, midfoot, first metatarsal head, big toe, and second toe. There was no statistically significant difference in peak pressure. The mean plantar pressure rating was statistically significantly increased in both feet across the entire sole, in the hindfoot, midfoot, and first metatarsal head. T1D patients of age near adulthood without neuropathy have increased values in mean pressure and reduced contact area, pointing to the need of monitoring and preventive measures. These results point to the need of further research and analysis which should include various risk factor such as foot anatomy, body posture, or certain metabolic factors.

Quantitative assessment of plantar pressure patterns in relation to foot deformities in people with hereditary motor and sensory neuropathies

BackgroundHereditary motor and sensory neuropathies (HMSN), also known as Charcot-Marie-Tooth disease, are characterized by affected peripheral nerves. This often results in foot deformities that can be classified into four categories: (1) plantar flexed first metatarsal, neutral hindfoot, (2) plantar flexed first metatarsal, correctable hindfoot varus, (3) plantar flexed first metatarsal, uncorrectable hindfoot varus, and (4) hindfoot valgus. To improve management and for the evaluation of surgical interventions, a quantitative evaluation of foot function is required. The first aim of this study was to provide insight into plantar pressure of people with HMSN in relation to foot deformities. The second aim was to propose a quantitative outcome measure for the evaluation of surgical interventions based on plantar pressure.MethodsIn this historic cohort study, plantar pressure measurements of 52 people with HMSN and 586 healthy controls were evaluated. In addition to the evaluation of complete plantar pressure patterns, root mean square deviations (RMSD) of plantar pressure patterns from the mean plantar pressure pattern of healthy controls were calculated as a measure of abnormality. Furthermore, center of pressure trajectories were calculated to investigate temporal characteristics. Additionally, plantar pressure ratios of the lateral foot, toes, first metatarsal head, second/third metatarsal heads, fifth metatarsal head, and midfoot were calculated to measure overloading of foot areas.ResultsLarger RMSD values were found for all foot deformity categories compared to healthy controls (p < 0.001). Evaluation of the complete plantar pressure patterns revealed differences in plantar pressure between people with HMSN and healthy controls underneath the rearfoot, lateral foot, and second/third metatarsal heads. Center of pressure trajectories differed between people with HMSN and healthy controls in the medio-lateral and anterior-posterior direction. The plantar pressure ratios, and especially the fifth metatarsal head pressure ratio, differed between healthy controls and people with HMSN (p < 0.05) and between the four foot deformity categories (p < 0.05).ConclusionsSpatially and temporally distinct plantar pressure patterns were found for the four foot deformity categories in people with HMSN. We suggest to consider the RMSD in combination with the fifth metatarsal head pressure ratio as outcome measures for the evaluation of surgical interventions in people with HMSN.

The Use of Orthostatic Device for 90 Minutes Does Not Change Cardiovascular and Biomechanical Parameters of Patients with Spinal Cord Injury.

Background Changes in autonomic function are often caused by spinal cord injuries, which lead to limited orthostatic positioning in these patients. Objective To investigate the cardiovascular and biomechanical parameters during 90 min of postural elevation equipment usage comparing spinal cord injury and healthy subjects. Methods A device was used that allowed patients with spinal cord injuries to remain in an orthostatic posture for 90 min. During this period, the physiological parameters were measured every 15 min. Cardiovascular parameters (heart rate, oxygen saturation, blood pressure, and autonomic nervous system) and biomechanical parameters of the plantar pressure distribution were evaluated. For blood pressure, heart rate, oxygen saturation, and autonomic nervous system, a two-way analysis of variance was applied. The mixed-effect model was applied to plantar pressure. The significance level was set at p < 0.05 for all statistical analyses. Results No differences were observed between the groups in systolic blood pressure (F = 0.07), diastolic blood pressure (F = 0.14), heart rate (F = 0.56), and oxygen saturation (F = 0.23) at any of the time intervals throughout the experiment (p > 0.05). No statistical difference was observed in the mean plantar pressure values between the groups (p = 0.35) during the period in which they remained in the orthostatic position. Conclusion The present study showed the absence of differences between spinal cord injury patients and control participants using the orthostatic device in terms of cardiovascular and biomechanical parameters over 90 min.

Abstract 67: Oral: Plantar temperature and pressure distribution in subjects with diabetes mellitus and chronic charcot arthropathy – A case control study

Background: Chronic Charcot Arthropathy is a potentially limb- threatening complication of diabetes mellitus.Aim: To assess the plantar temperature and pressure variation on graded ambulation in subjects with diabetes mellitus and chronic Charcot arthropathy in comparison to healthy subjects.Results: A total of 24 cases and 26 controls were included. The mean forefoot temperature was significantly higher in the Charcot's foot of patients when compared to the controls at baseline, after 50, 100 and 200 steps. Graded ambulation resulted in reduction in the mean temperature at all regions. The mean plantar pressure was significantly higher in the Charcot's foot of the patients when compared to the controls at baseline at all three sites.Conclusion: Plantar temperature measurement with Infrared camera could be used as a surrogate marker for shear force in patients with chronic CA to see the hot spots which can be a preceding event for foot ulcer.

Perfusion, Stance and Plantar Pressure Asymmetries on the Human Foot in the Absence of Disease—A Pilot Study

Physiological perfusion asymmetries in the lower limb are known, although poorly understood, as are asymmetries reported in plantar pressure and stance. This preliminary study aims to explore potential relationships between perfusion and pressure variables in humans. A convenience sample of eight healthy individuals (25.25 ± 5.37 years old) of both sexes, was selected. Chosen variables were perfusion, plantar pressure, and stance. Perfusion was measured in both feet by laser Doppler flowmetry (LDF) and polarized light spectroscopy (PSp), and plantar pressure and stance obtained by a pressure plate. These were measured in baseline (Phase I) in a repeated squatting (Phase II), and in recovery (Phase III). A 95% confidence interval was adopted. Intraindividual significant perfusion asymmetries between both feet were detected by LDF in Phase I. These disappeared in Phase II and returned in Phase III. PSp did not detect any asymmetries. Plantar pressure was also asymmetric and differently distributed along both feet with no statistical significance except in the hindfoot. Significant correlations were found between BMI and mean Plantar Pressure in Phase I and Phase III, and an inverse correlation between LDF perfusion and Plantar Pressure in Phase I. These results seem to suggest an interesting direction for exploration and study of these asymmetries in the absence of disease.

Evaluating the effect of a water exercise routine on the postural stability of the elderly.

Background: Postural stability enables humans to maintain the center of mass of their body within their base of support. Nevertheless, over time, such stability is affected by different factors such as age, repetitive strain, and accidents. Although studies in this field have investigated the effectiveness of hydrotherapy, only a few of them have explored its influence on postural stability, which is reflected in a lack of research that estimates its impact on rehabilitation. Aim: To determine the immediate and final effects of an aquatic routine protocol on the postural stability of elderly subjects. Methods: The postural stability of 20 adults over 60 years of age was analyzed using electromyographic and baropodometric methods. Electromyographic signals were obtained from the tibialis anterior, soleus, both gastrocnemius, vastus medialis, and biceps femoris to calculate the coactivation percentage of the muscles in charge of postural stability. The baropodometric data were collected to analyze the area of the stabilometric ellipse, mean plantar pressure, and weight distribution percentage. Results: The outcome of both methods revealed improvements in the elderly patients after the aquatic routine protocol was applied, which indicates that the type of water exercises implemented in this study has positive effects on their postural stability. Conclusion: The postural stability of the elderly participants was improved after each session because their stability index decreased along with the electrical activity of some muscle pairs, their body weight was better distributed, and the area of body oscillation was reduced. However, this effect was immediate and not final.

Comparison of Plantar Pressures Between Upright and Recumbent Stationary Bicycles

The F-Scan system by Tekscan was used to compare plantar pressures at 4 locations during 30-second bouts of exercise between upright and recumbent exercise bicycles. A 2-tailed t test was used to compare the pressures at each anatomic location between each biking method for each participant. Statistical analysis demonstrated a significant difference in mean plantar pressures at the hallux, fifth metatarsal head, and the heel. The recumbent bicycle produced higher average pressures at the hallux and first metatarsal head, and the upright bicycle produced higher average pressures at the fifth metatarsal head and the heel.

Distribution of Plantar Pressure in Soccer Players.

(1) Background: The aim of this study was to evaluate differences in the static and dynamic distribution of foot pressure on the ground and to investigate the relationships between body mass index (BMI) and mean variables of plantar pressure between soccer players and their non-athlete peers. (2) Methods: The study involved 18 first-division Polish soccer players and 30 non-athlete physiotherapy students. The research experiment was conducted using the FreeMed platform. Basic descriptive statistics were calculated to summarize the variables. Additionally, in the static and dynamic tests, Spearman’s rank correlations between body mass index (BMI) and plantar load were calculated. (3) Results: Statistically significant differences between groups were observed in the loading of the dominant limb. A statistically significant correlation between BMI and loading of both limbs was found in the static test and between BMI and loading of the dominant limb in the dynamic test. (4) Conclusions: The baropodometric mat used in our study helped determine the plantar pressure distribution of soccer players and their non-athlete peers. Correlation analysis revealed that BMI was only associated with the mean plantar pressure of the dominant limb in the control group. Further research on a larger group of athletes is needed to determine how much sporting activity may affect the development to modifications within feet in soccer players.

Comparison of the Plantar Pressure and Foot Function and Range of Motion in Distance Runners With the Normal, Pronated, and Supinated Feet During Static Standing

Introduction: This study aimed to investigate the foot function, range of motion, plantar pressure, and plantar contact area in the distance runners with normal, pronated, highly-pronated, supinated, and highly-supinated foot posture groups during static standing.Materials and Methods: In this comparative cross-sectional study, a total of 75 distance runners were divided into 5 groups using the foot posture index. The foot function and knee and foot range of motion were assessed using the Foot And Ankle Ability Measure questionnaire (FAAM) and the goniometer, respectively. The mean of the plantar pressure percentage and the mean of the contact area on the forefoot and rearfoot were investigated during static standing. One-way ANOVA was used to compare the outcomes between the groups.Results: Among the groups, the normal foot group showed the highest scores in the activities of daily living subscale and sport subscale. Compared with the other groups, the highly-pronated foot group had a significantly greater range of motion in the ankle plantar flexion (P&lt;0.002), and the normal foot group showed more range of motion in the first metatarsophalangeal extension (P&lt;0.0001). In all groups, the mean plantar pressure percentage on the rearfoot was greater than the mean plantar pressure percentage on the forefoot. Of the groups, the highly-supinated foot group showed the highest plantar pressure percentage on the rearfoot (P&lt;0.0001). However, the highly-pronated foot group showed the highest plantar pressure percentage and the largest contact area on the forefoot (P&lt;0.0001) and the rearfoot (P&gt;0.0001), respectively.Conclusion: Based on the results of this study, the foot posture is an important option that could affect function and range of motion of foot and ankle and distribution of the plantar pressure and plantar contact area.

Acute effect of low-Dye taping on dynamic plantar pressure in subjects with overpronation foot.

Introduction: The pronation foot is related to numerous musculoskeletal disorders, in order to reverse this biomechanical dysfunction has often been used to low-Dye taping (LDT). Objective: Evaluate the acute effect of the application of low-Dye taping (LDT) on dynamic Baropodometric parameters (DBP) in subjects with foot overpronation. Method: They evaluated 17 feet by baropodometric dynamic by midgait protocol. The pressure measurements were obtained by planting stratification of the foot region in eight shades in LDT conditions and without taping. Results: The Student t test for paired samples showed a significant reduction of peak plantar pressure, mean plantar pressure, integral pressure / time largely masks studied without however generate substantial increases in other plantar regions. Conclusion: The application of LDT proved to be an efficient way to reduce the DPB in subjects with foot overpronation.

Association between the levels of physical activity and plantar pressure in 6-14-year-old children.

BackgroundThe main purpose of the study was to determine whether lower levels of physical activity were associated with higher plantar pressure generated under each foot.MethodsIn this cross-sectional study, we recruited 641 children aged 6–14 years (agemean ± SD = 9.7 ± 2.4 years; heightmean ± SD = 143.6 ± 15.3 cm, weightmean ± SD = 37.6 ± 13.4 kg; body-mass indexmean ± SD = 17.6 ± 3.2 kg/m2; 44.2% girls). We used EMED –XL pressure platform to measure force time integral, pressure-time integral, contact-time and contact area, peak plantar pressure and mean plantar pressure of the right and the left foot during the gait analysis. The level of physical activity was measured by using The Physical Activity Questionnaire for Older Children (PAQ–C). The associations were calculated by using generalized estimating equations with linear regression models.ResultsLower levels of physical activity were associated with higher force- and pressure-time integrals, longer contact time and higher peak and mean plantar pressures in both feet.ConclusionOur study shows that the level of physical activity is strongly and inversely associated with plantar pressure in a sample of 6–14 year olds.

The effects of fatigue on plantar pressure and balance in adolescent volleyball players with and without history of unilateral ankle injury

Summary The purpose of this study was to assess plantar pressure and static balance alterations after jumping and landing. According to the importance of devastating impact of improper distribution of plantar forces on the incidence of abnormal movements and stresses in the foot structure of volleyball players, studying the effect of fatigue on plantar pressure and static balance can lead to significant achievements in the evaluation of this organ's performance. In this study, 12 male adolescent volleyball players with a history of unilateral ankle injury and 12 male adolescent volleyball players without a history of unilateral ankle injury was participated. Plantar pressure characteristics and static balance in volleyball players with and without history of unilateral ankle injury was recorded before and after a fatigue from consecutive jumping and landing protocol while standing static on foot pressure. maximum pressure, mean pressure, pressure distribution, surface and romberg open and close eyes balance registered. There was a significant difference between the maximum and the mean plantar pressure and the contact surface of the right foot before and after fatigue and significant difference between the mean pressure and the pressure distribution of the healthy foot and the injured leg in individuals with a history of ankle injury also fatigue cause reduce balance in adolescent volleyball players without history of unilateral ankle injury in open eyes mode and reduce balance in adolescent volleyball players with history of unilateral ankle injury in open and closed eyes. These changes could lead to lower limb injuries.

Preliminary Clinical Application of Textile Insole Sensor for Hemiparetic Gait Pattern Analysis.

Post-stroke gait dysfunction occurs at a very high prevalence. A practical method to quantitatively analyze the characteristics of hemiparetic gait is needed in both clinical and community settings. This study developed a 10-channeled textile capacitive pressure sensing insole (TCPSI) with a real-time monitoring system and tested its performance through hemiparetic gait pattern analysis. Thirty-five subjects (18 hemiparetic, 17 healthy) walked down a 40-m long corridor at a comfortable speed while wearing TCPSI inside the shoe. For gait analysis, the percentage of the plantar pressure difference (PPD), the step count, the stride time, the coefficient of variation, and the phase coordination index (PCI) were used. The results of the stroke patients showed a threefold higher PPD, a higher step count (41.61 ± 10.7), a longer average stride time on the affected side, a lower mean plantar pressure on the affected side, higher plantar pressure in the toe area and the lateral side of the foot, and a threefold higher PCI (hemi: 19.50 ± 13.86%, healthy: 5.62 ± 5.05%) compared to healthy subjects. This study confirmed that TCPSI is a promising tool for distinguishing hemiparetic gait patterns and thus may be used as a wearable gait function evaluation tool, the external feedback gait training device, and a simple gait pattern analyzer for both hemiparetic patients and healthy individuals.

Variations in plantar pressure and balance in HIV-infected children in antiretroviral therapy

Balance disorders have been poorly investigated and somewhat neglected in people infected with the human immunodeficiency virus, especially in children, whose have intrinsic and extrinsic risk factors that may compromise the balance. To evaluate the foot plantar pressures and the balance in children with acquired immunodeficiency. We recruited 53 children aged between 6 and 15 years: 33 healthy children, and 20 children with positive serology for the human immunodeficiency virus. A physical examination included anthropometric, reflexes, tactile sensitivity of the foot and orthopedic evaluation. We also collected data of them using Pediatric Equilibrium Scale, baropodometry, and stabilometry. We considered significance level of 0.05 for statistics. Both groups were aged-, sex-matched and similar body mass index and scores of the Pediatric Equilibrium Scale. Three infected children had altered tactile sensitivity, and none had orthopedic or reflex alteration. Infected children had higher mean plantar pressure in the hindfoot than of the control group (p = 0.02). There was higher maximum plantar pressure in the hindfoot of the infected children than of the controls (p = 0.04). Controls had lower maximum plantar pressure in the forefoot than the infected children (p = 0.04). Infected children had larger displacement of the center of pressure (p = 0.006), larger mean velocity of displacement (p = 0.006), and longer duration between successive peaks of displacement than the controls (p = 0.02). Children living with the human immunodeficiency virus discharges great plantar pressures in the hindfoot and to present balance disturbances in the absence of neurological symptomatology.

Effects of Kinesio Taping on postural balance in patients with low back pain, a randomized controlled trial

Purpose: to identify postural balance changes in subjects with low back pain after the application of Kinesio Taping, which is then compared to a no treatment control group, using baropodometric evaluation. Methods: This randomized controlled trial was carried out on 50 individuals (both sexes) with chronic low back pain. They were then randomized into two groups: an experimental group - EG (treated with Kinesio Taping in the lumbar region) and a control group - CG (no intervention). Both groups underwent a baropodometric evaluation (mean plantar pressure, peak plantar pressure, plantar surface, mass distribution on right foot and left foot, mass distribution on forefoot and rear foot and base width) at four different moments: pre-intervention, 10 minutes, 48 hours, and 10 days after the intervention on the EG. The level of statistical significance was established at 5%. Results: Significant changes were observed in the EG compared to the CG. In the EG, peak pressure reduced on both right and left foot after Kinesio Taping application; the right base width was reduced, and the mass distribution between the forefoot and the rear foot normalized towards the ideal 50% distribution. These changes happened 48 hours after the Kinesio Taping application, with effects lasting up to 10 days. Conclusion: The use of Kinesio Taping in the lumbar region of subjects with chronic low back pain improved postural balance. This is proved by changes in peak plantar pressure, plantar surface, and mass distribution 48 h after Kinesio Taping application, with effects lasting up to 10 days.

Within and between-days repeatability and variability of plantar pressure measurement during walking in children, adults and older adults

BackgroundPrevious studies discussed the repeatability and variability in plantar pressure measurement, but a few considered different age groups. Here we determine within and between-days repeatability and variability of plantar pressure measurement during gait in participants from different age groups.MethodPlantar pressure was recorded in children, young adults and older adults walking at preferred speed in four non-consecutive days within one week. Data from 10 steps from each foot in each day were analyzed considering the different regions of the foot. Mean and peak plantar pressure and data variability were compared between the steps, foot regions and days.ResultsTo describe mean and peak pressure during gait in children and adults a single measurement can be enough, but elderly will requires more attention especially concerning peak values. Variability in mean pressure did not differ between age groups, but peak pressure variability differed across foot regions and age groups.ConclusionOne single observation can be used to describe plantar pressure during gait in children and adults. When the interest concerns older people, it might be pertinent to consider more than one day of assessment, especially when looking at peak pressure.

Static and dynamic plantar pressure distribution in amateur marathon runners.

The aim of the study was to compare the static and dynamic plantar pressure profiles of amateur marathon runners with sedentary cohorts. Are there differences in the plantar pressures of these two populations? Is there a correlation between body mass and BMI with plantar loading? The study involved 43 runners involved in marathon training and 30 age-matched untrained individuals. Plantar pressure was measured using a baropodometric system. The marathon runners showed greater forefoot plantar pressure of the dominant extremity in the static condition and reduced medial plantar pressure of both extremities in the dynamic condition. A correlation was observed between body mass and BMI with mean plantar pressure only in the marathon group and only for the dominant extremity in the dynamic condition. Marathon training may modify the forefoot plantar loading characteristics of the dominant extremity during static conditions and increase lateral plantar pressure of both extremities in a dynamic (gait) condition.

Distribuição da pressão plantar e morfologia do pé de crianças com paralisia cerebral e crianças com desenvolvimento típico

RESUMO A paralisia cerebral (PC) é caracterizada por desordens de movimento e postura, que causam limitações na execução de atividades facilmente desempenhadas por crianças com desenvolvimento típico (DT). Este estudo objetivou comparar a distribuição da pressão plantar e a morfologia do pé entre crianças com PC e DT, utilizando uma pesquisa analítica observacional transversal do tipo comparativa, com 32 crianças entre 6 e 11 anos, pareadas por sexo e idade e distribuídas em grupo estudo (GE) e grupo controle (GC). A distribuição plantar foi avaliada por meio do sistema de baropodometria eletrônica Footwork e o tipo de pé classificado pelo índice de Chippaux-Smirak. O GE obteve maior descarga de peso no sentido anterior e menor no sentido posterior (p=0,02), além de menores valores das pressões médias dos pés direito (p=0,00) e esquerdo (p=0,01) em relação ao GC. A maioria das crianças apresentou o mesmo tipo de pé bilateralmente, com prevalência de pés planos no GE e cavos no GC. Crianças com PC espástica, que apresentaram o desempenho locomotor preservado ou com alguma disfunção, revelaram antepulsão corporal, menores pressões plantares médias e prevalência do pé plano, em comparação às crianças com DT.

Plantar Static Pressure Distribution in Normal Feet Using Cotton Socks with Different Structures

The major goal of investigating plantar pressure in patients with pain or those at risk for skin injury is to reduce pressure under prominent metatarsal heads, especially the first and second metatarsals. In research, the insole is used to reduce plantar pressure by increasing the contact area in the midfoot region, which, in turn, induces an uncomfortable feeling near the arch during walking. It is deduced that sock structure can redistribute plantar pressure distribution. Seven sock types with seven structures (plain, single cross tuck, mock rib inlay, cross miss, mock rib, double cross tuck, and double cross miss) for the sole area were produced. A plantar pressure measurement device was used to measure plantar static pressure in ten participants. The barefoot plantar pressure distribution was compared with the plantar pressure distribution with socks. In the seven sock samples, the mean plantar pressure of the cross miss and mock rib structures at high plantar pressure zones (toe and first through fourth metatarsal bone regions) were decreased, and, as a result, the pressure shifted to relatively low pressure zones (fifth metatarsal bone and midfoot regions). These results indicate that wearing socks with cross miss and mock rib structures will reduce mean plantar pressure values compared with the barefoot condition in high plantar pressure zones. In general, the results suggest that mean plantar pressure is redistributed from high to low plantar pressure zones.