Plantar pressure distribution during standing in women with end-stage hip osteoarthritis

Plantar Pressure Distribution Patterns During Gait and Functional Mobility in Early-Stage Knee Osteoarthritis: A Comparative Study

BACKGROUND

Knee osteoarthritis (KOA) is characterised by altered gait mechanics, which can lead to significant functional impairments. This study aims to investigate plantar pressure distribution during walking and assess functional mobility in patients with early-stage KOA, providing insights for targeted therapeutic interventions.

METHODS

Eighteen women with KOA were matched with 18 healthy controls for this study. We assessed plantar pressure distribution, relative phase durations during the stance phase, and performance on the Timed Up and Go (TUG) test. Independent sample t-tests were employed to identify group differences, with significance set at p < 0.05.

RESULTS

Patients with KOA exhibited significantly lower maximum plantar pressure in the Toe 1 (p < 0.01), medial heel (p < 0.01), and lateral heel (p < 0.01) regions, while demonstrating higher pressure in the Metatarsal 4 (p < 0.01) and midfoot (p < 0.01) areas. Furthermore, KOA patients spent less time in the initial contact (p = 0.01), foot-flat (p < 0.01), and forefoot push-off (p = 0.03) phases but more time in the forefoot plantarflexion phase (p < 0.01). Additionally, KOA patients demonstrated longer TUG times (p < 0.01), indicating reduced functional mobility.

CONCLUSIONS

Early-stage KOA patients display distinct patterns of plantar pressure distribution and impaired functional mobility compared with healthy controls. These findings highlight the necessity for interventions aimed at addressing altered gait mechanics in KOA, which could help mitigate mobility limitations and enhance patient outcomes.

The influence of pain exacerbation on rear foot eversion and plantar pressure symmetry in women with patellofemoral pain: a cross sectional study

BACKGROUND

The patellofemoral joint (PFJ) stress as a primary mechanical stimulus in the patellofemoral pain (PFP) etiology is affected by plantar pressure symmetry. This study evaluated how pain exacerbation affects rear foot eversion and plantar pressure distribution symmetry.

METHOD

Sixty women with PFP participated in this study. Pain intensity, rear foot eversion, and plantar pressure were evaluated in the two conditions with and without pain exacerbation during double-leg squats. The MANOVA test was used to compare pain intensity, rear foot eversion, and plantar pressure symmetry between the two conditions. The Pearson correlation was used to evaluate the relationship between the pain intensity with the rear foot eversion and the plantar pressure symmetry.

RESULTS

The comparison between the two conditions showed a significant difference in pain intensity (P < 0.001, η2 = 0.623), rear foot eversion (P < 0.001, η2 = 0.485), plantar pressure distribution symmetry of the right-left foot (P < 0.001, η2 = 0.438), forefoot and rear-foot of the right foot (P < 0.001, η2 = 0.607), and forefoot and rear-foot of the left foot (P < 0.001, η2 = 0.548). An excellent correlation was observed between the pain intensity with rear foot eversion (P < 0.001, r = 0.835) and plantar pressure distribution symmetry of the right-left foot (P < 0.001, r = 0.812), forefoot and rear-foot of the right foot (P < 0.001, r = 0.834), and forefoot and rear-foot of the left foot (P < 0.001, r = 0.811).

CONCLUSIONS

After the pain exacerbation, the rear foot eversion was greater, and plantar pressure asymmetrical was observed, which can help in the development of PFP severity.

Static Plantar Pressure under Different Conditions in Children with Surgically Treated Unilateral Slipped Capital Femoral Epiphysis

BACKGROUND

Slipped capital femoral epiphysis (SCFE) is the most common hip disease during infancy and adolescence. Our study aimed to analyze static plantar pressure in children with surgically treated unilateral SCFE.

METHODS

Twenty-two children with right SCFE with in situ fixation with one percutaneous screw were assessed by PoData plantar pressure analysis under three different conditions (open eyes, eyes closed, and head retroflexed).

RESULTS

The total foot loading was significantly higher on the unaffected limb compared with the affected one for all the three testing conditions (p < 0.05). When assessing the differences between testing conditions, there were no significant differences for the right and left foot loadings, or for the three sites of weight distribution, except for the right fifth metatarsal head (lower loading in eyes-closed condition in comparison to eyes open, p = 0.0068), left fifth metatarsal head (increased loading in head-retroflexed condition in comparison to eyes open, p = 0.0209), and left heel (lower loading in head-retroflexed condition in comparison to eyes open, p = 0.0293).

CONCLUSION

Even after a successful surgical procedure, differences in foot loading can impact the postural static activities in different conditions (natural eyes-open, eyes-closed, or head-retroflexed posture).

Assessment System for Predicting Maximal Safe Range for Heel Height by Using Force-Sensing Resistor Sensors and Regression Models

Women often wear high-heeled shoes for professional or esthetic reasons. However, high-heeled shoes can cause discomfort and injury and can change the body’s center of gravity when maintaining balance. This study developed an assessment system for predicting the maximal safe range for heel height by recording the plantar pressure of participants’ feet by using force-sensing resistor (FSR) sensors and conducting analyses using regression models. Specifically, 100 young healthy women stood on an adjustable platform while physicians estimated the maximal safe height of high-heeled shoes. The collected FSR data combined with and without personal features were analyzed using regression models. The experimental results showed that the regression model based on the pressure data for the right foot had better predictive power than that based on data for the left foot, regardless of the module. The model with two heights had higher predictive power than that with a single height. Furthermore, adding personal features under the condition of two heights afforded the best predictive effect. These results can help wearers choose maximal safe high-heeled shoes to reduce injuries to the bones and lower limbs.

Artificial intelligence model to identify elderly patients with locomotive syndrome: A cross-section study

BACKGROUND

Identifying elderly individuals with locomotive syndrome is important to prevent disability in this population. Although screening tools for locomotive syndrome are available, these require time commitment and are limited by an individual's ability to complete questionnaires independently. To improve on this limitation, we developed a screening tool that uses information on the distribution of pressure on the plantar surface of the foot with an artificial intelligence (AI)-based decision system to identify patients with locomotor syndrome. Herein, we describe our AI-based system and evaluate its performance.

METHODS

This was a cross-sectional study of 409 participants (mean age, 73.5 years). A foot scan pressure system was used to record the planter pressure distribution during gait. In the image processing step, we developed a convolutional neural network (CNN) to return the logit of the probability of locomotive syndrome based on foot pressure images. In the logistic regression step of the AI model, we estimated the predictor coefficients, including age, sex, height, weight, and the output of the CNN, based on foot pressure images.

RESULTS

The AI model improved the identification of locomotive syndrome among elderly individuals compared to clinical data, with an area under curve of 0.84 (95% confidence interval, 0.79-0.88) for the AI model compared to 0.80 (95% confidence interval, 0.75-0.85) for the clinical model. Including the footprint force distribution image significantly improved the prediction algorithm (the net reclassification improvement was 0.675 [95% confidence interval, 0.45-0.90] P < 0.01; the integrated discrimination improvement was 0.059 [95% confidence interval, 0.039-0.088] P < 0.01).

CONCLUSIONS

The AI system, which includes force distribution over the plantar surface of the foot during gait, is an effective tool to screen for locomotive syndrome.

Insole-Based Systems for Health Monitoring: Current Solutions and Research Challenges

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

Activity recognition using multiplex limited penetrable visibility graph

To solve the dynamic problem of different activities in human activity recognition research, an activity recognition method based on a multiplex limited penetrable visibility graph is proposed. The 21 pressure values for each sampling are mapped to nodes in the first-layer network; then the average path length of nodes in the asynchronous periodic network is obtained, and the second-layer network used to explore different activities is built. Finally, the characteristic parameters and dynamic characteristics of different activities are explored and analyzed. The experimental results demonstrate that through the joint distribution of the average clustering coefficient and the maximum degree parameter of the node, the discrimination problems of different postures can be better realized, and it has good adaptability. It provides a new approach to gait recognition research that can be used in medical clinical diagnosis, rehabilitation training, and public health.

INVESTIGATION OF PLANTAR PRESSURE AND PLANTAR IMBALANCES IN THE STATIC PHASE OF KARATE DO ATHLETES

The study aims to investigate the parameters offered by the baropodometric examination on a group of athletes practicing the martial art Karate Do (20 subjects, 16 girls and 4 boys, average age 13.55 ± 2.74, height 163 cm ± 8.47 , weight 54.50 kg ± 8.84, BMI (body index mass) of 20.46 ± 2.90 and seniority in sports activity of 5.27 years ± 2.74). The purpose of the research is to determine the changes related to the value of the plantar surfaces, the pressures for the dominant and non-dominant lower segments, the positioning of the pressure center in relation to the support polygon and the imbalances in the sole of the foot. The testing was performed using the FreeMed baropodometric platform and the FreeStep by Sensor Medica software, in the last week of February 2021, at the Research Center for Human Performance within the Faculty of Physical Education and Sports, “Dunărea de Jos” University from Galați. Results: Placing the maximum pressure point / P.max in the forefoot area is an exception, only one case being reported with this distribution, the rest having P.max located at the rearfoot level. Comparison of the averages between the variables recorded for the left foot vs. the right foot highlights higher values of the dominant / right foot, but these differences are significant only for the values of the plantar pressure in the forefoot area and for the total load on the entire plantar surface / total load (p <.05). The comparison between the averages of the surfaces and the loads of each separate foot (for the forefoot and rearfoot areas) highlights major differences only for the values of the contact surfaces, the forefoot area being significantly larger than the rearfoot area (p <.05). Close average values with small and insignificant differences are reported for each foot between the forefoot and rearfoot areas when comparing the body pressure / load percent and weight ratio percent, indicating a balanced pressure distribution between the front and back area for each leg. The investigation was also useful by detecting the existing imbalances at the plantar level, for one or both legs, being also reported cases of hollow, flat and mixed foot. These plantar disturbances can negatively affect all the overlying / upper joints, but especially the body posture, thus being able to cause pain in the lumbar region, limiting the performance activity and causing even the withdrawal of the athletes. We recommend that after identifying the syndromes at the ankle joint, to implement personalized plantar supports, which should be introduced in sports shoes in order to balance the architecture of the foot sole. Keywords: karate do, plantar pressures, baropodometric analysis, load, rearfoot, forefoot, maximum pressure,

Reprodutibilidade e concordância entre diferentes protocolos de baropodometria dinâmica durante a marcha: um estudo preliminar

RESUMO A identificação da pressão plantar durante a marcha é utilizada por clínicos e investigadores para verificar sobrecarga na estrutura podal. Neste particular, diferentes protocolos têm sido empregados para essa finalidade. O objetivo do estudo foi verificar a reprodutibilidade e a concordância de protocolos abreviados de marcha para identificar a pressão plantar dinâmica em jovens assintomáticos. Quinze voluntários foram submetidos aos protocolos abreviados one-step e three-step e ao protocolo padrão midgait em três momentos: inicial, dia seguinte e após sete dias. Para cada uma das oito máscaras podais, foram consideradas as medidas de pico de pressão plantar e integral pressão/tempo. A reprodutibilidade foi analisada mediante Anova one-way e coeficiente de correlação intraclasse, enquanto a concordância entre os protocolos foi verificada através de teste t pareado, correlação momento-produto de Pearson e plotagem de Bland-Altman. Os resultados apontaram que o protocolo three-step apresentou mais elevada reprodutibilidade em ambas as medidas de pressão plantar dinâmica. Quanto à concordância entre os protocolos, apesar de os abreviados demonstrarem tendência em subestimar as medidas produzidas pelo protocolo padrão midgait, na maioria das máscaras podais não foram identificadas diferenças estatísticas entre os escores médios. Ainda, por intermédio da técnica de Bland-Altman, constatou-se substancial capacidade de concordância entre as medidas identificadas pelos protocolos one-step, three-step e midgait. Concluindo, os protocolos abreviados devem ser selecionados de acordo com a medida de interesse da pressão plantar e a máscara podal a ser analisada, surgindo evidências de reprodutibilidade e concordância mais favoráveis para o uso do protocolo three-step.