Plantar Pressure Changes Research Articles

Effectiveness of a web-based foot-ankle exercise program for treating ulcer risk factors in diabetic neuropathy in a randomized controlled trial

The need for strategies to prevent complications from diabetic neuropathy (DPN) is well recognized. However, foot-ankle exercise programs show weak to moderate evidence, and barriers to their implementation persist, including broad and facilitated access to exercise programs, which guarantee for equity. In this paper, we report for the first time the effectiveness of a web-based foot-ankle exercise program aiming to improve DPN-related outcomes, gait biomechanics and functional outcomes. Sixty-two participants with DPN were randomly allocated into the control group (CG; n = 31), which received the usual care, or the intervention group (IG; n = 31), which received the usual care plus a 12-week foot-ankle exercise program using a web-based software (the SOPeD software). The primary outcomes, DPN symptoms and severity, were assessed using the Brazilian version of the Michigan Neuropathy Screening Instrument and the Decision Support System for Classification of Diabetic Polyneuropathy, respectively. Secondary outcomes included tactile sensitivity (monofilaments) and vibration perception (tuning fork), functional outcomes, such as foot pain and function (Foot Health Status Questionnaire), foot muscle strength and plantar pressure during gait (emed plate), and foot-ankle kinematics and kinetics during gait. Outcomes were assessed at baseline, 12 and 24 weeks by an assessor blinded to group allocation. DPN symptoms and severity remained unchanged after the web-based foot-ankle program. However, IG showed improvements compared to CG, with greater functional reach at 12 weeks, better foot function, reduced foot pain and greater plantarflexion degree during push-off at 24 weeks. Regarding plantar loading during gait, the forefoot pressure reduced in the IG at 12 weeks compared to baseline, but at 24 weeks, forefoot load increased in the IG compared to CG. The 12-week web-based foot-ankle exercise program was feasible, acceptable, demonstrating safety with minimal adverse events, such as delayed onset muscle soreness and foot muscle cramping. While DPN-related outcomes were unaffected by the 12-week SOPeD program, modest improvements in foot pain and function, functional reach, and changes in plantar pressure and plantarflexion degree during gait were noted, mostly at 24 weeks.Trial registration: ClinicalTrials.gov, NCT04011267. Registered on 8 July 2019.

Paradoxıcal effect of body mass index ranges on pedobarographic evaluatıon

Although there is evidence suggesting that obesity alters plantar pressure distribution, the specific effects of certain body mass index (BMI) ranges on pedobarographic measures in healty individuals has been poorly investigated. A cross-sectional study with 167 healthy participants was conducted to assess plantar pressure changes across 4 BMI ranges: Under/normal weight (NW), overweight (OW), obese (OB), severe obese (SO). Subjects walked on the Footscan® pressure plate at a self-selected speed, and peak plantar pressure (PPP), load rate, and contact area values were recorded. The foot was divided into 10 zones: hallux (T1), toes 2–5 (T2-5), metatarsals 1–5 (M1-M5), midfoot (MF), medial hindfoot (MH) and lateral hindfoot (LH). PPP underneath M2-M4 was lowest in the NW group (p = 0.011), and although PPP values for the SO group were lower than those for the OW and OB groups, these differences were not statistically significant. Load rate values of M2-M3 were lower in both the NW and SO groups (p = 0.008) compared to the OW and OB groups. In addition, the metatarsal load rate values for the SO group were generally lower than those for the NW group. The total metatarsal contact area of both the NW and SO groups was lower (p = 0.019) than that of the OW and OB groups in both feet. These findings suggest that as BMI increases, PPP, load rate, and contact area in the middle metatarsal region initially increase, stabilize early in obesity, and then decrease at advanced stages, indicating a shift of the load to the midfoot.

Effects of 4 weeks of foot exercise on subjective outcome and foot plantar pressure in elite adolescent dancers with hallux valgus: a pilot study

BackgroundDancers have a higher prevalence of hallux valgus (HV) than the general population. However, no reports specifically addressing treatment strategies for HV in dancers, or their effectiveness have been published. This study aimed to determine the effects of 4 weeks of foot exercises on subjective clinical outcomes, the HV angle, and change of foot plantar pressure during specific dance techniques.MethodsThirteen female elite adolescent dancesport athletes (age: 16.4 ± 3.3 years) completed the program. The HV angle was measured based on foot photographs. Clinical assessments were performed using the visual analog scale for first metatarsophalangeal (1st MTP) joint pain, and the Foot and Ankle Outcome Score. The changes in plantar pressure during two dance techniques (demi-pointe and plié) were measured. The plantar pressure was measured in six areas of the foot. All of these parameters were compared before and after the intervention by using chi-square tests and Student’s paired t-test (statistical significance: p < 0.05).ResultsThe HV angle was significantly reduced from 20.1° to 15.4° after the intervention. Participants reported an average subjective completion rate of 70.3% ± 14.6% over 3 weeks, exhibiting no significant differences despite an apparent trend toward improvement. Significant changes were noted in 1st MTP joint pain and subjective outcomes, and toe function significantly improved in the “paper” movement. The foot-exercise program changed plantar pressure distribution during the demi-pointe and plié techniques, with increased hallux pressure and decreased 2nd-5th MTP joint pressure.ConclusionsIn elite adolescent dancesport athletes, 4 weeks of foot-exercise rehabilitation reduced the HV angle and improved in subjective outcome and function during the two dance techniques. Coaches should consider utilizing foot-exercise training programs in a dancer training program for HV.

Immediate effects of insoles applied to the sound side lower extremity of patients with chronic hemiplegia during walking.

Asymmetric gait patterns are mostly observed in hemiplegic stroke patients. These abnormal gait patterns resulting in abnormal speed, and decreased ability in daily of activity living. This study aimed to determine the immediate changes in gait parameters and plantar pressure during elevation by wearing an insole on the sound side lower extremity of patients with hemiplegia. Thirty-six participants were recruited, comprising those with a post-stroke follow-up of ≥3 months and a functional ambulation category score of ≥2. The participants were asked to walk with and without a 1 cm insole in the shoe of their sound side, and the order of wearing or not wearing the insole was randomized. Gait parameters, bilateral gait parameters, and dynamic plantar pressure were measured using the GAITRite Walkway System. Paired t-test was used to examine immediate changes in gait parameters and plantar pressure with and without insoles during walking in the same group. Overall, gait velocity and step length significantly decreased (p < 0.05), whereas step time significantly increased (p < 0.05). The swing phase of the affected sidelower extremities significantly increased (p < 0.05), and the stance phase significantly decreased (p < 0.05). Double-support unloading phase (pre-swing phase) significantly increased (p < 0.05). The changes in plantar pressure were significantly increased in some lateral zones and significantly decreased in the medial zone of the mid-hindfoot, both in terms of pressure per time and peak pressure (p < 0.05). Although this study did not show immediate positive effects on gait parameters and gait cycle, it is expected that sensory input from the sole of the foot through changes in plantar pressure may help improve gait asymmetry and regulate postural symmetry.

Preliminary Studies on Changes in Static Plantar Pressure and Stabilometry in Patients with Ankylosing Spondylitis Undergoing an Exercise Program.

Background/Objectives: Studies have reported that patients suffering from ankylosing spondylitis (AS) have decreased postural stability in comparison to healthy subjects. Our study aims to compare static plantar pressure and stabilometry parameters in AS patients who performed an 8-week exercise program (spine motion and flexibility exercises; stretching of hamstring, erector spine, and shoulder muscles; control abdominal and diaphragm breathing exercises and chest expansion exercises), in three different testing conditions (eyes open, eyes closed, and head retroflexed). Methods: Plantar pressure (the loading of the first and fifth metatarsal heads (MT1, MT5) and calcaneus) and stabilometry (CoP path length, 90% confidence ellipse area, and maximum CoP speed) were recorded in 28 AS patients (age 56.64 ± 10.3 years; body mass index 29.4 ± 4.9 kg/m2) at the beginning of rehabilitation and after 8 weeks. At first evaluation, there were significant differences (p < 0.05) for the foot loading sites (MT1, MT5, and calcaneus), both for the right and left feet, when comparing eyes open with the other two testing situations. Results: After rehabilitation, significant differences were recorded between eyes-open and head-retroflexed conditions for MT1 (p = 0.03 for right; p = 0.004 for left) and calcaneus (p = 0.014 for right; p = 0.011 for left). A significantly higher CoP path length was registered in both initial and final assessments when tested with eyes closed. The maximum CoP speed had increased values at both evaluations when tested with head retroflexed. Conclusions: The CoP path length decreased after the physical exercise program, with a better postural stability after rehabilitation.

The role of increased post-impact ball speed on plantar pressure during open and square stance groundstrokes in female tennis players

BackgroundIt is firmly established that achieving a high ball speed during the execution of groundstrokes represents a relevant factor for success in tennis. However, little is known about how plantar pressure changes as post-impact ball speed is increased during open and square stance groundstrokes. The objective of the study was to determine how tennis players change the plantar pressure in each foot when they execute open versus square stance forehand groundstrokes in order to increase post-impact ball speed.MethodsFifteen healthy female tennis players with ITN 2 or better (mean age: 22.7 ± 7.8 years) participated in this study. The players performed open and square stance longline forehand groundstrokes (topspin) at the following four post-impact ball speed levels: 80 km/h, 90 km/h, 100 km/h, and vmax. Flexible pressure-detecting insoles were used to measure plantar pressure in each foot [i.e., dominant (equals the stroke arm) and nondominant].ResultsThe repeated measures ANOVA showed significant stance style × foot dominance interactions and post-hoc analyses revealed larger maximal and mean forces during open compared to square stance for the dominant but not non-dominant foot. Further, the ball speed × stance style × foot dominance interaction reached the level of significance and post-hoc analyses showed increased/decreased mean forces in the dominant/non-dominant foot during the square but not open stance when players increased their post-impact ball speed.ConclusionLarger values in the open stance, but post-impact ball speed-adjusted values in square stance indicate different advantages in both styles, suggesting their situation-specific application.

Developing excellent plantar pressure sensors for monitoring human motions by using highly compressible and resilient PMMA conductive iongels

Based on real-time detection of plantar pressure, gait recognition could provide important health information for rehabilitation administration, fatigue prevention, and sports training assessment. So far, such researches are extremely limited due to lacking of reliable, stable and comfortable plantar pressure sensors. Herein, a strategy for preparing high compression strength and resilience conductive iongels has been proposed by implanting physically entangled polymer chains with covalently cross-linked networks. The resulting iongels have excellent mechanical properties including nice compliance (young’s modulus < 300 kPa), high compression strength (>10 MPa at a strain of 90 %), and good resilience (self-recovery within seconds). And capacitive pressure sensor composed by them possesses excellent sensitivity, good linear response even under very small stress (∼kPa), and long-term durability (cycles > 100,000) under high-stress conditions (133 kPa). Then, capacitive pressure sensor arrays have been prepared for high-precision detection of plantar pressure spatial distribution, which also exhibit excellent sensing performances and long-term stability. Further, an extremely sensitive and fast response plantar pressure monitoring system has been designed for monitoring plantar pressure of foot at different postures including upright, forward and backward. The system achieves real-time tracking and monitoring of changes of plantar pressure during different static and dynamic posture processes. And the characteristics of plantar pressure information can be digitally and photography displayed. Finally, we propose an intelligent framework for real-time detection of plantar pressure by combining electronic insoles with data analysis system, which presents excellent applications in sport trainings and safety precautions.

Design and Evaluation of the Sit-to-Stand Movement Assistive Device for Elderly

The act of standing up is one of the most important movements in daily life, but it often poses challenges for elderly individuals with declining physical functions. To address this issue, we have designed an assistive device for sit-to-stand (STS) movement. This device aids the upper limbs, allowing them to bear some of the weight during the STS movement, thereby improving the force distribution on the lower limbs and enhancing the stability of the body during movement. The connection to the user is very straightforward; one simply needs to place their hands and arms on the lifting mechanism to connect, and after the STS movement is completed, the user can easily disengage, making it very convenient to use. The device is compact, equipped with wheels and a handle, allowing it to be flexibly moved and used in confined spaces such as bedrooms, bathrooms, and balconies. ADAMS-LifeMOD simulations indicate that the use of the STS movement assistive device can significantly improve the force distribution across the joints of the lower limbs and reduce the pressure on the soles of the feet against the ground. Subsequently, a prototype was built, and four volunteers were invited to conduct further experimental validation, comparing the changes in plantar pressure during the STS movement with and without the assistive device, as well as the subjective feelings of the users. The experimental results demonstrate that the device can effectively help users to stand up more easily.

Injury of flexor halluics longus tendon in amateur marathon runners results in abnormal plantar pressure distribution: observational study

ObjectiveTo analyze the changes of plantar pressure in amateur marathon runners with flexor halluics longus (FHL) tendon injury using the Medtrack-Gait plantar pressure measurement system, and to explore whether the plantar pressure data can be used as an index for the diagnosis of injury.MethodsA total of 39 healthy amateur marathon runners without any ankle joint symptoms were recruited. Dynamic and static plantar pressure data were measured using the pressure plate of Medtrack-Gait. According to MRI imaging findings, whether the FHL tendon was injured or not was judged, and the dynamic and static data were divided into the injury group and control group. The data with statistically significant differences between the two groups were used to make the receiver operating characteristic (ROC) curve.ResultThe maximum contact area (PA) of the first metatarsal(M1) region, the maximum load-bearing peak value (PW) and the time pressure integral (PMPTI) of the second metatarsal(M2) region in the injury group were lower than those in the control group, respectively (P < 0.05). The maximum contact area (PA) of the fifth metatarsal(M5) region was higher than that in the control group (P < 0.05). The area under curve (AUC) value of the ROC curve of the PA of M1 region, the PW and PMPTI of M2 region were statistically (P < 0.05).ConclusionFHL tendon injury resulted in decreased PA in M1, decreased PW and PMPTI in M2, and increased PA in the M5 region, suggesting that FHL tendon injury resulted in a force shift from the medial to the lateral side of the foot. The PA of M1, PW and PMPTI of M2 have certain diagnostic value for early FHL injury in amateur marathon runners.

Residual effects of combined vibratory and plantar stimulation while seated influences plantar pressure and spatiotemporal gait measures in individuals with Parkinson's disease exhibiting freezing of gait.

Combined plantar pressure and vibratory stimulation has been shown to decrease freezing of gait (FOG) episodes and improve spatiotemporal gait parameters compared to single stimulation in Parkinson's disease (PD) patients with FOG. However, the effect of combined plantar stimulations on plantar pressure analysis has never been explored. Forty PD patients with frequent FOG were allocated to either FOG shoes embedded with a 100 Hz vibratory stimulation at the Achilles tendons and a soft thickened silicone pad at the hallux and sole, or sham shoes with a non-working vibratory motor and a flat non-pressure silicone pad (20 patients per arm) while seated for 96 s. The objective gait and plantar pressure analysis were measured immediately after the stimulation. Outcomes included the normalized percentage of changes in percent FOG (%FOG) and plantar pressure in the heel-strike and push-off phase that were compared between pre- and post-stimulations. The FOG shoes group showed significantly decreased %FOG (81.5 ± 28.9% vs. 6.8 ± 22.1%, p < 0.001), plantar pressure in the heel-strike (47.8 ± 43.7% vs. 4.3 ± 9.8%, p < 0.001), plantar pressure in the push-off (57.7 ± 59.6% vs. 6.2 ± 11.6%, p < 0.001), force time integral (FTI) (40.9 ± 32.5% vs. 6.6 ± 17.3%, p < 0.001), and decreased heel contact time (19.3 ± 12.3% vs. 22.7 ± 32.5%, p < 0.001) when compared to the sham group. There was a strong negative correlation between %FOG and peak plantar pressure (r = -0.440, p = 0.005), plantar pressure in the heel-strike (r = -0.847, p < 0.001). Our study demonstrated that the FOG shoe could decrease FOG episodes by improving the heel-strike pressure, toe push-off and normalized heel-to-toe plantar pressure, suggesting that modification inputs from the peripheral sensory systems might significant improvement in FOG in PD.

SMART FOOT INSOLE FOR REDUCING THE RISK OF FOOT ULCERS IN DIABETIC PATIENTS BY MEASURING PLANTAR PRESSURE

Background of the Study: The prevailing cause of Diabetes is a decline in insulin production, the outcome of which is an elevated glucose level in the blood. The superabundance of glucose in the blood can cause severe complications, damaging other body organs, including kidneys, nerves, heart, and upper and lower limbs. However, the common complication in diabetic patients is foot ulcer, which is directly associated with Diabetic peripheral neuropathy (DPN), which is the extensive cause of this. DPN is the inability of nerves to sense any external change, due to which the foot plantar pressure is altered and evolves because of the high glucose level. Methodology: This paper provides a solution in the form of a portable and cost-effective device based on force sensors for diabetic patients to monitor the change in foot plantar pressure at home and overcome the risk of foot ulceration. The device is implemented on 30 participants to characterize the plantar pressure values with flat foot and normal foot types for the Control group and diabetic group. Results: An evident difference in the value of Mid-foot pressure is observed for both the groups, Control group (Normal foot = 144+2.63 kPa, Flat foot = 150+2.72 kPa) and Diabetic Group (Normal foot = 213+2 kPa, Flat foot = 216+1 kPa). Deviation in these values discriminates the mid-foot pressure for the two groups, thus providing us a range for the individuals of the control group for the alarming situation. Conclusion: Noticing the plantar pressure through the proposed device helps diabetes patients reduce their risk. Keywords: Blood glucose, type 1 diabetes mellitus, flat foot, metatarsal, foot orthosis, diabetic neuropathy, foot ulcers.

Estimation of the knee joint load using plantar pressure data measured by smart socks: A feasibility study.

Unsupervised sports activities could cause traumas, about 70% of them are those of the low extremities. To avoid traumas, the athlete should be aware of dangerous forces acting within low extremity joints. Research in gait analysis indicated that plantar pressure alteration rate correlates with the gait pace. Thus, the changes in plantar pressure should correlate with the accelerations of extremities, and with the forces, acting in the joints. Smart socks provide a budget solution for the measurement of plantar pressure. To estimate the correlation between the plantar pressure, measured using smart socks, and forces, acting in the joints of the lower extremities. The research is case study based. The volunteer performed a set of squats. The arbitrary plantar pressure-related data were obtained using originally developed smart socks with embedded knitted pressure sensors. Simultaneously, the lower extremity motion data were recorded using two inertial measurement units, attached to the tight and the ankle, from which the forces acted in the knee joint were estimated. The simplest possible model of knee joint mechanics was used to estimate force. The estimates of the plantar pressure and knee joint forces demonstrate a strong correlation (r= 0.75, P< 0.001). The established linear regression equation enables the calculation of the knee joint force with an uncertainty of 22% using the plantar pressure estimate. The accuracy of the classification of the joint force as excessive, i.e., being more than 90% of the maximal force, was 82%. The results demonstrate the feasibility of the smart socks for the estimation of the forces in the knee joints. Smart socks therefore could be used to develop excessive joint force alert devices, that could replace less convenient inertial sensors.

The role of increased post-impact ball speed on plantar pressure during topspin and slice longline forehand groundstrokes in female tennis players.

Performing groundstrokes is a fundamental skill for tennis players. However, little is known about changes in plantar pressure when post-impact ball speed is increased during topspin and slice groundstrokes. The objective of the present study was to examine how elite (International Tennis Number ≤ 2) female tennis players (N = 15, mean age: 22.7 ± 7.8 years) change their plantar pressure in the dominant (equals the stroke arm) and non-dominant foot when executing topspin and slice longline forehand groundstrokes in order to increase post-impact ball speed (i.e., 80km/h, 90km/h, 100km/h, vmax). The repeated measures analysis of variance revealed a significant ball speed × foot dominance interaction. Post-hoc analyses showed larger mean forces during topspin compared to slice groundstrokes for the dominant foot (p ≤ .026, d ≥ 0.34) but lower values for the non-dominant foot (p ≤ .050, d ≥ 0.28). Further, with increasing post-impact ball speed, increases in mean forces in both feet during topspin could be observed but only in the dominant foot during slice groundstrokes. Varying mean forces depending on the stroke type and foot dominance imply that specific physical exercises related to these two factors are necessary to optimise plantar pressure distribution.

Effect of Hind- and Fore-Foot Eversion on Positional and Rotational Displacement of the Knee in Standing Posture.

We investigated the effects of hindfoot and forefoot eversion on the knee's positional and rotational displacement, plantar pressure, and foot discomfort in a standing posture, beyond the traditional focus on external knee adduction moments (EKAM) in lateral wedge insoles. Twenty-six healthy participants underwent hindfoot eversion from 0 to 10 degrees in 2-degree increments, and forefoot eversion from 0 degrees to the hindfoot eversion angle in 2-degree increments in a standing posture. At each eversion angle, the knee's medial displacement, EKAM's moment arm decrease, plantar pressure changes, and foot discomfort were obtained and compared across varying angles. Both hindfoot-only and entire-foot eversion led to significant medial knee displacement and the EKAM's moment arm decrease, with more pronounced effects in entire-foot eversion. At each hindfoot eversion angle, increasing forefoot eversion resulted in significant medial knee displacement and EKAM's moment arm decrease. Lower leg rotations were not significantly affected in hindfoot-only eversion but displayed significant medial tilting and internal rotation in entire-foot eversion at specific combinations. Varying eversion angles significantly influenced the forefoot pressure, with heel pressure remaining unaffected. Notably, the lateral forefoot pressure increased significantly as the forefoot eversion angle increased, particularly at higher hindfoot eversion angles. Foot discomfort increased significantly with higher eversion angles, particularly in entire-foot eversion, and also increased significantly as the forefoot eversion angle increased at higher hindfoot eversion angles. Insole configurations incorporating 6-10 degrees of hindfoot eversion and 40-60% forefoot eversion of the hindfoot angle may offer optimized biomechanical support for knee osteoarthritis patients.

Quality of Life, Pedobarographic Parameters, and Foot Disorders in Patients with Extreme Obesity: Preliminary Results on Changes After Bariatric Surgery with Gastric Bypass

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

Talar Neck Malunions: Evaluation of Kinematics, Pedobarographic Changes and Patient Reported Outcome Measures

Category: Trauma; Hindfoot Introduction/Purpose: Malunion is a disabling complication of talar neck fractures and is prevalent in approximately 17% of cases. The impact of talar neck malunions (TNM) on foot biomechanics and functional outcomes is not well established. The available evidence is primarily derived from cadaveric studies which have demonstrated that TNMs result in reduced motion and significant alterations in contact characteristics of the subtalar joint. Owing to the paucity of literature on this subject, we conducted this study to evaluate the kinematic and pedobarographic changes and functional outcomes associated with TNMs. Methods: In this study, adult patients with talar neck malunions (TNM) without ankle arthrosis were prospectively enrolled over a 5-year period. The Rammelt and Zwipp classification was utilized to categorize the deformities. Demographic data and ankle and subtalar range of motion were assessed. Weight-bearing anteroposterior (AP), lateral, and long axial radiographs, as well as CT scans of both feet, were obtained. Dynamic pedobarography was performed to evaluate gait kinematics and plantar pressure distribution. Functional outcomes were evaluated using the Manchester Oxford Foot Questionnaire (MOxFQ), Visual Analog Score, and the EQ5D questionnaire. The t-test was utilized to compare the range of motion, pedobarographic and kinematic parameters between the normal and pathologic foot. Furthermore, correlation coefficients were calculated to determine the strength of the association between changes in talar neck geometry, plantar pressures, kinematics, and functional outcomes. Results: A total of 10 patients, 6 males, and 4 females, with a mean age of 32.4 years were enrolled. On the TNM side, significant increases were observed in step length and step time, while significant decreases were noted in the single limb support time and single limb support center of pressure line. Moreover, midfoot forces were significantly increased, whereas the forefoot and hindfoot forces were significantly decreased on the TNM side. A strong positive correlation was found between midfoot force and the talar torsion angle, and a moderate negative correlation was observed between hindfoot and midfoot forces and the inclination angle. A strong positive correlation was also noted between high midfoot pressures and VAS Scores, MOxFQ scores, and the EQ5D walking and usual activities domains. Conclusion: This study demonstrates that TNMs are associated with decreased single limb support time, increased step length and time, increased midfoot pressures, and decreased forefoot and hindfoot pressures. Additionally, an increase in talar neck torsion after TNM is linked with higher midfoot pressures, which can lead to higher levels of pain and poorer function. Our findings provide valuable insights into the altered foot biomechanics after TNMs, which can assist surgeons in offering optimal management strategies for these patients.

Evaluation of in-shoe plantar pressure and shear during walking for diabetic foot ulcer prevention.

To investigate reliability and changes of in-shoe plantar pressure and shear during walking at three cadences with two insole designs. This was a precursor to the investigation of plantar loading in people with diabetes for potential foot ulcer prevention. A sensorised insole system, capable of measuring plantar pressure and shear at the heel, fifth metatarsal head (5MH), first metatarsal head (1MH) and hallux, was tested with ten healthy participants during level walking. Reliability was evaluated, using intra-class correlation coefficient (ICC), while varying the cadences and insole types. Percentage changes in pressure and shear relative to values obtained at self-selected cadence with a flat insole design were investigated. Mean±standard deviation of maximum pressure, medial-lateral and anterior-posterior shear of up to 380±24kPa, 46±2kPa and -71±4kPa, respectively, were measured. The ICC in ranges of 0.762-0.973, 0.758-0.987 and 0.800-0.980 were obtained for pressure, anterior-posterior and medial-lateral shear, respectively. Opposite anterior-posterior shear directions between 5MH and 1MH (stretching), and between 1MH and hallux (pinching) were observed for some participants. Increasing cadence increased pressure and anterior-posterior shear (by up to +77%) but reduced medial-lateral shear at the heel and hallux (by up to -34%). Slower cadence increased anterior-posterior shear (+114%) but decreased medial-lateral shear (-46%) at the hallux. The use of a flexible contoured insole resulted in pressure reduction at the heel and 5MH but an increase in anterior-posterior shear at the heel (+69%) and hallux (+75%). The insole system demonstrated good reliability and is comparable to reported pressure-only systems. Pressure measurements were sensitive to changes in cadence and insole designs in ways that were consistent with the literature. However, our plantar shear showed localised shear changes with cadences and insoles for the first time, as well as stretching and pinching effects on plantar tissue. This opens new possibilities to investigate plantar tissue viability, loading characteristics and orthotic designs aimed towards foot ulcer prevention.

Diabetic Sensory Neuropathy and Plantar Pressure Changes

Diabetic Sensory Neuropathy and Plantar Pressure Changes

Effects of left thigh blood flow restriction exercise on muscle strength and golf performance in amateur golfers.

This study aimed to investigate the effect of lower-extremity strengthening exercise (LSE) with and without blood flow restriction (BFR) on the left thigh on golf performance. Eighteen amateur golfers with more than 1 year of golf experience participated in the study and were randomly divided into two groups: LSE+BFR group (LSE with BFR on the left thigh, n=9) and LSE group (LSE without BFR, n=9). The LSEs consisted of squats, lunges, and standing leg curls. All exercises were performed 3 times a week for 6 weeks. Changes in thigh muscle strength, plantar foot pressure (weight transfer), and golf performance, such as club head speed, ball speed, and carry distance were measured before and after the exercise program. Right knee extension (P<0.001) and left knee extension and flexion (P<0.001) strength were higher in the LSE+BFR group than in the LSE group. The changes in plantar foot pressure confirmed that smooth weight transfer appeared in E1 (event 1) (address) (P<0.05) of the LSE+BFR group, which confirmed that the carry distance (P<0.05) of the LSE+BFR group improved after the exercise program. The results of this study showed that BFR muscle strengthening exercise are more effective than basic simple muscle strengthening exercise in improving golf performance through muscle strength and weight transfer improvement.

Study on the rehabilitation training effect of exoskeletal diseases based on the skeletal muscle geometry modeling method

Abstract Plantar pressure is the main mechanical parameter to understand human lower limb movement, which can fully show the health status of human spine, foot, leg and other regions.At present, researchers have carried out empirical analysis on the rehabilitation training process of lower limbs, but due to the defects of guidance methods and too vague evaluation indicators, it is impossible to conduct comprehensive monitoring and feedback on the rehabilitation process of patients. Therefore, on the basis of the modeling method based on the understanding of skeletal muscle set, the rest of the lower limbs dyskinesia patients rehabilitation training, puts forward the plantar pressure changes as the core of human lower limb rehabilitation training monitoring and feedback methods, at the same time using autoregressive model to construct the algorithm model of lower limb exoskeleton, updating method of the weighted coefficient of contrast research. The final results show that the least mean square error (LMS) algorithm can provide effective driving force for the rehabilitation training model of lower extremity exoskeleton disease, and feedback evaluation of the whole rehabilitation training process