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Sanders O, Wang B, Kontson K. Concurrent Validity Evidence for Pressure-Sensing Walkways Measuring Spatiotemporal Features of Gait: A Systematic Review and Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2024; 24:4537. [PMID: 39065933 PMCID: PMC11281155 DOI: 10.3390/s24144537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 06/29/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024]
Abstract
Technologies that capture and analyze movement patterns for diagnostic or therapeutic purposes are a major locus of innovation in the United States. Several studies have evaluated their measurement properties in different conditions with variable findings. To date, the authors are not aware of any systematic review of studies conducted to assess the concurrent validity of pressure-sensing walkway technologies. The results of such an analysis could establish the body of evidence needed to confidently use these systems as reference or gold-standard systems when validating novel tools or measures. A comprehensive search of electronic databases including MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed. The initial search yielded 7670 papers. After removing duplicates and applying study inclusion/exclusion criteria, 11 papers were included in the systematic review with 10 included in a meta-analysis. There were 25 spatial and temporal gait parameters extracted from the included studies. The results showed there was not a significant bias for nearly all spatiotemporal gait parameters when the walkway system was compared to the reference systems. The findings from this analysis should provide confidence in using the walkway systems as reference systems in future studies to support the evaluation and validation of novel technologies deriving gait parameters.
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Affiliation(s)
- Ozell Sanders
- Office of Product Evaluation and Quality, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD 20993, USA;
| | - Bin Wang
- Office of Clinical Evaluation and Analysis, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD 20993, USA;
| | - Kimberly Kontson
- Office of Science and Engineering Labs, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD 20993, USA
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Hsieh KL, Beavers KM, Weaver AA, Delanie Lynch S, Shaw IB, Kline PW. Real-world data capture of daily limb loading using force-sensing insoles: Feasibility and lessons learned. J Biomech 2024; 166:112063. [PMID: 38564846 PMCID: PMC11046963 DOI: 10.1016/j.jbiomech.2024.112063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
Force-sensing insoles are wearable technology that offer an innovative way to measure loading outside of laboratory settings. Few studies, however, have utilized insoles to measure daily loading in real-world settings. This is an ancillary study of a randomized controlled trial examining the effect of weight loss alone, weight loss plus weighted vest, or weight loss plus resistance training on bone health in older adults. The purpose of this ancillary study was to determine the feasibility of using force-sensing insoles to collect daily limb loading metrics, including peak force, impulse, and loading rate. Forty-four participants completed a baseline visit of three, 2-minute walking trials while wearing force-sensing insoles. During month two of the intervention, 37 participants wore insoles for 4 days for 8 waking hours each day. At 6-month follow-up, participants completed three, two-minute walking trials and a satisfaction questionnaire. Criteria for success in feasibility was defined as: a) > 60 % recruitment rate; b) > 80 % adherence rate; c) > 75 % of usable data, and d) > 75 % participant satisfaction. A 77.3 % recruitment rate was achieved, with 44 participants enrolled. Participants wore their insoles an average of 7.4 hours per day, and insoles recorded an average of 5.5 hours per day. Peak force, impulse, and loading rate collected at baseline and follow-up were 100 % usable. During the real-world settings, 87.8 % of data was deemed usable with an average of 1200 min/participant. Lastly, average satisfaction was 80.5 %. These results suggest that force-sensing insoles appears to be feasible to capture real-world limb loading in older adults.
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Affiliation(s)
- Katherine L Hsieh
- Department of Physical Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University.
| | | | - Ashley A Weaver
- Department of Biomedical Engineering, Wake Forest University School of Medicine
| | - S Delanie Lynch
- Department of Biomedical Engineering, Wake Forest University School of Medicine
| | - Isaac B Shaw
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University
| | - Paul W Kline
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University; Department of Physical Therapy, Virginia Commonwealth University
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3
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Lee SM, Lee HS. Correlation Between Executive Function and Walk While Crossing Over an Obstacle Under Different Gait Phases. Dement Neurocogn Disord 2023; 22:139-147. [PMID: 38025408 PMCID: PMC10654486 DOI: 10.12779/dnd.2023.22.4.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Purpose Dual walking task such as crossing over an obstacle may serve as an excellent tool for predicting early cognitive decline. Thus, this study aimed to investigate correlation between walking while crossing over an obstacle and executive functions under different gait phases to validate the use of walking with an obstacle for predicting early cognitive decline. Methods A cross-sectional study was conducted on 48 elderly individuals from 2 day-care centers and 3 welfare-centers in Seoul and Gyeonggi, Korea. Executive function tests (Trail Making Test, Stroop test) and dual walking tests (gait speed, cadence, stance time, gait cycle time) were performed and compared using partial correlation analysis. Results There were significant correlations between executive function and most of the gait variables (stance time, cadence, and gait cycle time) (p<0.05) when crossing over an obstacle while walking. Especially, stance time exhibited significant correlations with most executive functions (p<0.05). Conclusions When evaluating executive function during walking with an obstacle, post-obstacle-crossing phase and stance time need to be observed.
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Affiliation(s)
- Seung Min Lee
- Department of Physical Therapy, COMWEL Donghae Hospital, Donghae, Korea
| | - Han Suk Lee
- Department of Physical Therapy, Eulji University, Seongnam, Korea
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Thorne CS, Gatt A, DeRaffaele C, Bazena A, Formosa C. Innovative single-sensor, in-shoe pressure and temperature monitoring device: A static laboratory validation study. Gait Posture 2023; 105:35-38. [PMID: 37473491 DOI: 10.1016/j.gaitpost.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND To perform laboratory static validation of pressures from an innovative, single-sensor pressure and temperature monitoring device for the early detection of complications in the high-risk foot. RESEARCH QUESTION Can an innovative, newly developed, in-shoe pressure and temperature measuring device, detect and measure the in-shoe peak plantar pressures and skin temperature as accurately as the reference standard? METHODS A pressure generating rig, the Tekscan™ Equilibration 'bladder calibrator', was used to produce a known force, against the gold standard, FScan™ in-shoe pressure mapping system by Tekscan™ and a newly developed prototype. The F-scan® system was used to record the pressure readings and establish a baseline for the readings recorded utilising the prototype. A total of 20 pressure values were recorded with 100 samples each. RESULTS Exploratory data analysis was conducted to gain insights and analyse the prototype's behaviour at different pressure points. Pre-processing and data cleaning were also performed to remove any anomalies. Support Vector Regressor with a polynomial kernel and Grid-Search algorithm was used to fit the recorded data curve. The best combination of parameters had a Mean Squared Error of 2.59 and a Root Mean Squared Error of 1.61. A simple linear equation was used to convert raw readings to pressure values. SIGNIFICANCE The results of this study conclude that the pressure measurements taken with the prototype are congruent to the gold standard, F-scan® in-shoe system. This confirms that the prototype is a valid device that can be used safely as a low-cost alternative to current costly commercial in-shoe pressure mapping devices.
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Affiliation(s)
| | - Alfred Gatt
- Faculty of Health Sciences, University of Malta, Malta
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5
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Simonsson S, Tranberg R, Zügner R, Tang UH. Reliability of F-Scan® in-shoe plantar pressure measurements in people with diabetes at risk of developing foot ulcers. Foot (Edinb) 2023; 56:102027. [PMID: 37004466 DOI: 10.1016/j.foot.2023.102027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 02/21/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND The provision of therapeutic footwear, to prevent the development of diabetic foot ulcers by re-distributing high peak plantar pressure is frequently prescribed for patients with diabetes. Areas of interest (ROI) are identified by placing boxes on the visualised pressure movie. The aims were to evaluate the inter-reliability of the placements of seven ROI boxes and to explore how the box placement affected peak pressure in the seven ROIs. METHODS Plantar pressure movies from 20 of a total of 40 movies were selected for the analysis. Boxes were placed at ROIs, the heel, the lateral midfoot, the metatarsal phalangeal heads (5, 3-4, 2 and 1) and the hallux. The box placements were registered for the left vertical position (L) and the top horizontal position (T) for each of the ROIs, based on registrations by two certified prosthetists and orthotists. FINDINGS The inter correlation coefficient of the placement of the boxes ranged from 1.00 to 0.12 (heel_L and metatarsal phalangeal head 2_L respectively). Of the 14 positions of the boxes; four were excellent, four were good, two were moderate and four were poor. No significant differences in the mean peak pressure corresponding to the box placements were found between the CPOs. INTERPRETATION The inter-reliability of eight of the 14 registered placements, made by prosthetists and orthotists, of the boxes in Scan® was good to excellent. A variation of 1.00-0.12 was present. Despite the variation, no significant differences in the corresponding mean peak pressure between prosthetists and orthotists was found.
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Affiliation(s)
- Sigrid Simonsson
- Department of Orthopaedics, Institute of Clinical Sciences, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Roy Tranberg
- Department of Orthopaedics, Institute of Clinical Sciences, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Roland Zügner
- Department of Orthopaedics, Institute of Clinical Sciences, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Ulla Hellstrand Tang
- Department of Orthopaedics, Institute of Clinical Sciences, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden.
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6
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Askarisiahooie F, Trabia MB, Dufek JS, Mangoubi R. Automated plantar contact area estimation in a dynamic state using K-Means clustering. Foot (Edinb) 2023; 56:102021. [PMID: 37001346 DOI: 10.1016/j.foot.2023.102021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Estimation of plantar contact area (PCA) can be used for a variety of purposes such as classification of foot types and diagnosis of foot abnormalities. While some techniques have been developed for assessing static PCA, understanding dynamic PCA may improve understanding of gait biomechanics. This study aims (1) to develop an approach to estimate PCA from video images of footprints during walking and (2) to assess the accuracy and generalizability of this method. METHODS A sample of 41 ambulatory, young adults (age = 24.3 ± 3.2 years, mass = 67.2 ± 16.9 kg, height = 1.63 ± 0.08 m) completed 10 trials walking on a raised transparent plexiglass platform. Foot contact during walking was recorded using a video camera placed under the platform. An image processing algorithm, Clustering Segmentation, was developed based on identifying color intensity between the PCA and the rest of the foot and plantar contact morphology. RESULTS The proposed approach was compared to manual hand tracing, which is widely accepted as the Gold Standard, as well as with an earlier automated approach (Lidstone et al., 2019). Results showed that Clustering Segmentation followed the Gold Standard closely in all phases of gait. The maximum PCA and the maximum PCA length and width generally increased with foot size, indicating that the algorithm could successfully estimate the PCA across a wide range of foot sizes. Results also showed that the proposed approach for obtaining the PCA may be used to characterize various foot types in a dynamic state. CONCLUSION Clustering Segmentation algorithm eliminates the need for subjective interpretation of the PCA. The results showed that the algorithm was considerably faster and more accurate than the earlier automated method. The proposed algorithm will be appropriate for assessment of foot abnormalities and provides complementary information to gait analysis.
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Affiliation(s)
- Forough Askarisiahooie
- Department of Mechanical Engineering, University of Nevada, 4505 S Maryland Pkwy, Las Vegas, NV 89154, United States.
| | - Mohamed B Trabia
- Department of Mechanical Engineering, University of Nevada, 4505 S Maryland Pkwy, Las Vegas, NV 89154, United States
| | - Janet S Dufek
- Department of Kinesiology and Nutrition Sciences, University of Nevada, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, United States
| | - Rami Mangoubi
- C. S. Draper Laboratory, 555 Technology Square, Cambridge, MA 02139, United States
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7
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Cleland LD, Rowland HM, Mazzà C, Saal HP. Complexity of spatio-temporal plantar pressure patterns during everyday behaviours. J R Soc Interface 2023; 20:20230052. [PMID: 37376872 DOI: 10.1098/rsif.2023.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
The human foot sole is the primary interface with the external world during balance and walking, and also provides important tactile information on the state of contact. However, prior studies on plantar pressure have focused mostly on summary metrics such as overall force or centre of pressure under limited conditions. Here, we recorded spatio-temporal plantar pressure patterns with high spatial resolution while participants completed a wide range of daily activities, including balancing, locomotion and jumping tasks. Contact area differed across task categories, but was only moderately correlated with the overall force experienced by the foot sole. The centre of pressure was often located outside the contact area or in locations experiencing relatively low pressure, and therefore a result of disparate contact regions spread widely across the foot. Non-negative matrix factorization revealed low-dimensional spatial complexity that increased during interaction with unstable surfaces. Additionally, pressure patterns at the heel and metatarsals decomposed into separately located and robustly identifiable components, jointly capturing most variance in the signal. These results suggest optimal sensor placements to capture task-relevant spatial information and provide insight into how pressure varies spatially on the foot sole during a wide variety of natural behaviours.
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Affiliation(s)
- Luke D Cleland
- Active Touch Laboratory, Department of Psychology, University of Sheffield, Sheffield, UK
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | - Holly M Rowland
- Active Touch Laboratory, Department of Psychology, University of Sheffield, Sheffield, UK
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | - Claudia Mazzà
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
| | - Hannes P Saal
- Active Touch Laboratory, Department of Psychology, University of Sheffield, Sheffield, UK
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
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Speight S, Reel S, Stephenson J. Can the F-Scan in-shoe pressure system be combined with the GAITRite® temporal and spatial parameter-recording walkway as a cost-effective alternative in clinical gait analysis? A validation study. J Foot Ankle Res 2023; 16:30. [PMID: 37194058 DOI: 10.1186/s13047-023-00627-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 05/02/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Clinical gait analysis is widely used to aid the assessment and diagnosis of symptomatic pathologies. Foot function pressure systems such as F-scan and analysis of the spatial-temporal parameters of gait using GAITRite® can provide clinicians with a more comprehensive assessment. There are systems however, such as Strideway™ that can measure these parameters simultaneously but can be expensive. F-Scan in-shoe pressure data is normally collected whilst the person is walking on a hard floor surface. The effects of the softer Gaitrite® mat upon the F-Scan in-shoe sensor pressure data is unknown. This study therefore aimed to assess the agreement between F-Scan pressure measurements taken from a standard walkway (normal hard floor), and those from a GAITRite® walkway to establish whether these two pieces of equipment (in-shoe F-Scan and GAITRite®) can be used simultaneously, as a cost-effective alternative. METHOD Twenty-three participants first walked on a standard floor and then on a GAITRite® walkway wearing F-Scan pressure sensor insoles with same footwear. They repeated these walks three times on each surface. Mid gait protocols were utilised by analysing the contact pressure of the first and second metatarsophalangeal joint of the third, fifth and seventh step from each walk. For both joints, 95% Bland-Altman Limits of Agreement was used to determine a level of agreement between the two surfaces, using mean values from pressure data collected from participants who successfully completed all required walks. The intraclass correlation coefficient (ICC) and Lin's concordance correlation coefficient were calculated as indices of reliability. FINDINGS ICC results for the hard surface and the GAITRrite® walkway at the first and second metatarsophalangeal joints were 0.806 and 0.991 respectively. Lin's concordance correlation coefficient for the first and second metatarsophalangeal joints were calculated to be 0.899 and 0.956 respectively. Both sets of statistics indicate very good reproducibility. Bland-Altman plots revealed good repeatability of data at both joints. CONCLUSION The level of agreement in F-Scan plantar pressures observed between walking on a normal hard floor and on a GAITRite® walkway was very high, suggesting that it is feasible to use F-Scan with GAITRite® together in a clinical setting, as an alternative to other less cost-effective standalone systems. Although it is assumed combining F-Scan with GAITRite® does not affect spatiotemporal analysis, this was not validated in this study.
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Affiliation(s)
- Stephanie Speight
- Sheffield Teaching Hospitals NHS FT, Woodhouse Clinic, 3 Skelton Lane, Sheffield, England, S13 7LY
| | - Sarah Reel
- University of Huddersfield, Queensgate, Huddersfield, England, HD1 3DH.
| | - John Stephenson
- University of Huddersfield, Queensgate, Huddersfield, England, HD1 3DH
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Hu X, Tang J, Cai W, Sun Z, Zhao Z, Qu X. Characteristics of foot plantar pressure during turning in young male adults. Gait Posture 2023; 101:1-7. [PMID: 36696820 DOI: 10.1016/j.gaitpost.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/27/2022] [Accepted: 01/08/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND Turning gait is considered as a challenging motor task. However, only few existing studies reported turning biomechanics from the aspect of foot plantar pressure. RESEARCH QUESTION This study aimed to investigate turning biomechanics by studying foot plantar pressure characteristics METHODS: Twelve young male participants were involved in this experimental study. They were instructed to perform turning tasks with different turning angles (i.e., 30°, 60°, and 90°). Foot plantar pressure was quantified by the force time integral (FTI) underneath seven plantar sub-areas. Analysis was carried out for different turning strategies (spin turns versus step turns), separately. RESULTS The results showed that for small-angle spin turns, plantar pressure patterns changed at the early stage of the approaching step, suggesting a preparatory action for the increased lower limb range of motion in the transverse plane during turning; for step turns, an imbalance weight bearing mechanism was adopted when making large-angle turns to compensate for the centripetal force during turning. SIGNIFICANCE The findings provide improved knowledge about turning biomechanics. They have practical implications for motion planning of lower-limb assistive devices for those with difficulties in turning.
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Affiliation(s)
- Xinyao Hu
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, China
| | - Junpeng Tang
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, China
| | - Wenfei Cai
- Department of Sports, Shenzhen University, China
| | - Zhenglong Sun
- School of Science and Engineering, Chinese University of Hong Kong (Shenzhen), Shenzhen, China
| | - Zhong Zhao
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, China
| | - Xingda Qu
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, China.
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Saliba Thorne C, Gatt A, DeRaffaele C, Bazena A, Formosa C. Innovative single-sensor, in-shoe pressure and temperature monitoring device: A dynamic laboratory validation study. Gait Posture 2023; 100:70-74. [PMID: 36493685 DOI: 10.1016/j.gaitpost.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Available technology to detect the 2 primary predictors of ulceration is not being used as it is deemed as costly and time-consuming. Thus, the aim of this study was to determine dynamic laboratory validation, of an innovative, single-sensor in-shoe device that can read peak pressure and temperature simultaneously. RESEARCH QUESTION Can an innovative, newly developed, in-shoe pressure and temperature measuring device, detect and measure the in-shoe peak plantar pressures and skin temperature of healthy participants, as accurately as the reference standard? METHODS Five healthy adult participants were recruited. The prototype was validated against the gold standard FScan™ in-shoe system for pressures and the Flir® T630sc thermographic camera for temperatures. Participants were asked to walk at a comfortable pace on an electric treadmill for 13 min. The prototype and the FScan in-shoe sensors™ were superimposed inside the shoe of the participant, with the prototype on top, to ensure direct contact with the area of interest. Two thermographic images were captured using the Flir® T630sc thermographic camera, before and after the walk. During the trials, the participants wore 100 % cotton socks and their own sports shoes and pressures were recorded at 50 readings a second. RESULTS The raw readings of pressure were passed to the regressor, which returned the estimated kPa value. Several evaluations metrics were used to evaluate the performance of the modal. The prototype gave equal results to that of the gold standard, the FScan™ in-shoe system. With regards to temperature measurements, both devices gave similar readings. SIGNIFICANCE This innovative single-sensor, in-shoe pressure and temperature monitoring device showed similar measurements of pressure to the FScan™ system and temperature measurements were equivalent to the Flir® T630sc thermographic camera. The authors are confident that the innovative, low cost, single-sensor, in-shoe pressure and temperature monitoring device can be used as an alternative to the costly available commercial devices that measure pressure and temperature separately to detect early signs of complications in the high-risk foot.
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Affiliation(s)
| | - Alfred Gatt
- Faculty of Health Sciences, University of Malta, Malta
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11
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Parker D, Andrews J, Price C. Validity and reliability of the XSENSOR in-shoe pressure measurement system. PLoS One 2023; 18:e0277971. [PMID: 36649238 PMCID: PMC9844836 DOI: 10.1371/journal.pone.0277971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/08/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND In-shoe pressure measurement systems are used in research and clinical practice to quantify areas and levels of pressure underfoot whilst shod. Their validity and reliability across different pressures, durations of load and contact areas determine their appropriateness to address different research questions or clinical assessments. XSENSOR is a relatively new pressure measurement device and warrants assessment. RESEARCH QUESTION Does the XSENSOR in-shoe pressure measurement device have sufficient validity and reliability for clinical assessments in diabetes? METHODS Two XSENSOR insoles were examined across two days with two lab-based protocols to assess regional and whole insole loading. The whole insole protocol applied 50-600 kPa of pressure across the insole surface for 30 seconds and measured at 0, 2, 10 and 30 seconds. The regional protocol used two (3.14 and 15.9 cm2 surface area) cylinders to apply pressures of 50, 110 and 200 kPa to each insole. Three trials of all conditions were averaged. The validity (% difference and Root Mean Square Error: RMSE) and repeatability (Bland Altman, Intra-Class Correlation Coefficient: ICC) of the target pressures (whole insole) and contact area (regional) were outcome variables. RESULTS Regional results demonstrated mean contact area errors of less than 1 cm2 for both insoles and high repeatability (≥0.939). Whole insole measurement error was higher at higher pressures but resulted in average peak and mean pressures error < 10%. Reliability error was 3-10% for peak pressure, within the 15% defined as an analytical goal. SIGNIFICANCE Errors associated with the quantification of pressure are low enough that they are unlikely to influence the assessments of interventions or screening of the at-risk-foot considering clinically relevant thresholds. Contact area is accurate due to a high spatial resolution and the repeatability of the XSENSOR system likely makes it appropriate for clinical applications that require multiple assessments.
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Affiliation(s)
- Daniel Parker
- School of Health and Society, University of Salford, Salford, United Kingdom
- * E-mail:
| | - Jennifer Andrews
- School of Health and Society, University of Salford, Salford, United Kingdom
| | - Carina Price
- School of Health and Society, University of Salford, Salford, United Kingdom
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Chemello G, Salvatori B, Morettini M, Tura A. Artificial Intelligence Methodologies Applied to Technologies for Screening, Diagnosis and Care of the Diabetic Foot: A Narrative Review. BIOSENSORS 2022; 12:985. [PMID: 36354494 PMCID: PMC9688674 DOI: 10.3390/bios12110985] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/26/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Diabetic foot syndrome is a multifactorial pathology with at least three main etiological factors, i.e., peripheral neuropathy, peripheral arterial disease, and infection. In addition to complexity, another distinctive trait of diabetic foot syndrome is its insidiousness, due to a frequent lack of early symptoms. In recent years, it has become clear that the prevalence of diabetic foot syndrome is increasing, and it is among the diabetes complications with a stronger impact on patient's quality of life. Considering the complex nature of this syndrome, artificial intelligence (AI) methodologies appear adequate to address aspects such as timely screening for the identification of the risk for foot ulcers (or, even worse, for amputation), based on appropriate sensor technologies. In this review, we summarize the main findings of the pertinent studies in the field, paying attention to both the AI-based methodological aspects and the main physiological/clinical study outcomes. The analyzed studies show that AI application to data derived by different technologies provides promising results, but in our opinion future studies may benefit from inclusion of quantitative measures based on simple sensors, which are still scarcely exploited.
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Affiliation(s)
- Gaetano Chemello
- CNR Institute of Neuroscience, Corso Stati Uniti 4, 35127 Padova, Italy
| | | | - Micaela Morettini
- Department of Information Engineering, Università Politecnica delle Marche, Via Brecce Bianche, 12, 60131 Ancona, Italy
| | - Andrea Tura
- CNR Institute of Neuroscience, Corso Stati Uniti 4, 35127 Padova, Italy
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Okawara H, Sawada T, Hakukawa S, Nishizawa K, Okuno M, Nakamura M, Hashimoto T, Nagura T. Footsteps required for reliable and valid in-shoe plantar pressure assessment during gait per foot region in people with hallux valgus. Gait Posture 2022; 97:21-27. [PMID: 35858528 DOI: 10.1016/j.gaitpost.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Plantar pressure assessment is commonly performed to identify pathognomonic gait characteristics and evaluate therapeutics against them in people with various foot disorders. Little is known about the reliability and validity of this assessment in people with hallux valgus (HV) per foot region. RESEARCH QUESTION This study aimed to assess the reliability and validity of the in-shoe plantar pressure measurement method during gait in people with HV and the required number of footsteps, as an intra-subject sample size, to ensure a reliable and valid use of this method. METHODS With an inserted disposable insole plantar pressure sensor in shoes, 17 females with HV (HV angle > 15°) completed three gait trials over the ground at a comfortable speed. Peak plantar pressure data and its distribution in 15 stance phases on the foot clinically diagnosed with HV in each participant were extracted by dividing the foot into eight regions. The intraclass correlation coefficient per foot region and the number of footsteps required to produce a valid peak plantar pressure and distribution (intraclass correlation coefficient > 0.90) were used to measure reliability. Based on the limit of agreement analysis, the coefficient of variation between the averaged value from each incremental footstep (2-14 footsteps) and 15 reference footsteps was calculated. RESULTS The intraclass correlation coefficient of plantar pressure assessment with the in-shoe sensor was 0.606-0.847 in the eight foot regions in people with HV. Additionally, the number of steps required for a valid assessment ranged from two to nine. Hence, the application of averaged values from more than nine footsteps is recommended for this evaluation. SIGNIFICANCE This reference sample size is intended to be used in future studies and clinical settings to determine the efficacy of HV treatment.
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Affiliation(s)
- Hiroki Okawara
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Tomonori Sawada
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Satoshi Hakukawa
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Kohei Nishizawa
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Masahiro Okuno
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan; Rapithela Corporation, Seto, Aichi 489-0979, Japan; Tomei Brace Co., Ltd, Seto, Aichi 489-0979, Japan.
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Takeshi Hashimoto
- Sports Medicine Research Center, Keio University, Yokohama, Kanagawa 223-8521, Japan.
| | - Takeo Nagura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan; Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
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Custom-made foot orthoses with and without heel plugs and their effect on plantar pressures during treadmill walking. Prosthet Orthot Int 2022; 46:e357-e361. [PMID: 35315833 DOI: 10.1097/pxr.0000000000000101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 01/06/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Foot orthoses have consistently demonstrated an improvement in pain scores for plantar fasciitis. The fabrication of custom-made foot orthoses (CFOs) can vary between clinicians and may include the use of different materials and casting techniques. This cross-sectional study's objective was to quantify plantar pressure for two CFOs, one with a heel plug (HP) and one without. METHODS Fourteen healthy participants (8 men and 6 women; 35.4 ± 7.7 years) were cast by the same practitioner. Both CFOs were made with the same materials and specifications, except for the HP orthosis, which replaced hard material under the heel with a softer blue PORON ® plug for added cushioning. Plantar pressures were recorded during treadmill walking for both devices in a running shoe. Average pressure, peak pressure, and pressure contact area were determined for three regions of the foot: hindfoot, midfoot, and forefoot. A paired samples t -test determined differences in each region ( P < 0.05). RESULTS The HP orthosis reduced the overall means of average pressure, peak pressure, and pressure contact area in the hindfoot while tending to increase these measures in the midfoot and forefoot. The three measures showed statistically significant decreases in the hindfoot, whereas a statistically significant increase was seen in average and peak pressures in the midfoot ( P < 0.05). CONCLUSIONS CFOs with HPs are more effective than regular CFOs in offloading plantar pressures in the hindfoot while increasing pressures in the midfoot. This is an important finding because offloading the hindfoot is critical in pathologies such as plantar fasciitis to decrease pain and increase function.
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15
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Immediate Effect of Customized Foot Orthosis on Plantar Pressure and Contact Area in Patients with Symptomatic Hallux Valgus. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Foot orthotics are recommended for the treatment of hallux valgus. The effects of customized foot orthoses (FOs) designed with both medial longitudinal and transverse arch supports are poorly understood, however. This study aimed to investigate the immediate effect of customized FOs on the plantar pressure and contact area in patients with symptomatic hallux valgus. We recruited 18 patients with a mean hallux valgus angle of 27.3 ± 11.1°. Plantar pressure while walking with FOs or flat insoles (FIs) was monitored with a wireless in-shoe plantar pressure-sensing system. Peak pressure (PP), peak force (PF), pressure-time integral (PTI), force-time integral (FTI), and contact area with FOs and FIs were compared. The PF, PTI, and FTI of the midfoot were significantly higher (p < 0.05), and the PP and PTI of the rearfoot were significantly lower (p < 0.05) with the FOs than the FIs. The FOs significantly increased the contact area of the midfoot and rearfoot (p < 0.05) and reduced the contact area of the forefoot (p < 0.05). These results suggest that customized FOs redistribute plantar pressure and the contact area of the midfoot and rearfoot, improving the functional support of the midfoot for patients with hallux valgus.
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16
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Logan AA, Nielsen BD, Hallock DB, Robison CI, Popovich JM. Evaluation of within- and between- session 1 reliability of the TekscanTM Hoof System with a glue-on shoe. J Equine Vet Sci 2021; 110:103862. [PMID: 34979263 DOI: 10.1016/j.jevs.2021.103862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/21/2021] [Accepted: 12/27/2021] [Indexed: 11/18/2022]
Abstract
A current trend in equine research is technology development to minimize the subjective nature of gait analysis. One such technology is the Tekscan Hoof System, which records force and area loaded by the hooves during motion. The objective of this study was to determine the test-retest reliability of the Tekscan Hoof System between two sessions, and the recordings within those sessions. Four mature Standardbred geldings wore Tekscan Hoof System sensors on both front hooves, secured by glue-on shoes (SoundHorse Technologies). Horses were exercised in AM and PM sessions. In each session, horses walked and trotted for 3 recordings of at least 10 steps. Statistical analysis was performed in SAS 9.4 with fixed effects of gait, horse, leg, and recording nested within session (significance at P ≤ 0.05). Intraclass Correlation Coefficients (ICC; 3,k) and confidence intervals between AM and PM sessions and recordings were calculated with SPSS. Average force and area were higher in AM sessions than PM sessions (P < 0.0001). Between AM and PM sessions, ICC for the walk had good reliability (0.959, 95% CI = 0.797 - 0.992) and excellent reliability at the trot (0.982, 95% CI = 0.911-0.996). Within the AM and PM sessions, reliability was excellent at both the walk and trot (ICCs > 0.962). The Tekscan Hoof System has been found to have excellent reliability within sessions. Caution should be taken when comparing between sessions, as the system is found to have lower force and area output during later sessions due to potential sensor damage.
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Affiliation(s)
- Alyssa A Logan
- Department of Animal Science, Michigan State University, East Lansing, MI.
| | - Brian D Nielsen
- Department of Animal Science, Michigan State University, East Lansing, MI
| | | | - Cara I Robison
- Department of Animal Science, Michigan State University, East Lansing, MI
| | - John M Popovich
- Department of Osteopathic Surgical Specialties, Michigan State University, East Lansing, MI
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17
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Shen JJ, Jin XX, Bao SX, Zhou ZY, Xu FY, Xu RQ. Enhancing the differentiation of walking and standing via the ratio of plantar pressures. Proc Inst Mech Eng H 2021; 236:376-384. [PMID: 34865564 DOI: 10.1177/09544119211058914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Differentiation of standing and walking based on plantar pressures is helpful in developing strategies to reduce health risks in the workplace. In order to improve the differentiation ability, the paper proposes a new metric for posture differentiation, that is, the pressure ratio on the two anatomical plantar regions. The plantar pressures were collected from 30 persons during walking and standing. After verifying the normal distribution of the pressure ratio by the Monte Carlo method, two-way repeated-measures ANOVA was conducted for the pressure ratios. The advantage of the pressure ratio over two conventional pressure metrics (the average pressure and the peak pressure) is demonstrated by its much larger size effect. Furthermore, the pressure ratio permits to establish value ranges corresponding to walking and standing, which are less influenced by specific person factors, thus facilitating the design of a standardized posture recognition system. The underlying mechanism underlying the pressure ratio is discussed from the aspect of biomechanics of movement.
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Affiliation(s)
- Jing Jin Shen
- College of Automation, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Xiao Xiao Jin
- Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Shu Xing Bao
- College of Automation, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Zhen Yu Zhou
- College of Automation, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Feng Yu Xu
- College of Automation, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Rong Qing Xu
- College of Electronic and Optical Engineering, Nanjing University of Posts and Telecommunications, Nanjing, China
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18
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Lee HS, Lee KJ, Kim JL, Leem HS, Shin HJ, Kwon HG. Gait characteristics during crossing over obstacle in patients with glaucoma using insole foot pressure. Medicine (Baltimore) 2021; 100:e26938. [PMID: 34397944 PMCID: PMC8360450 DOI: 10.1097/md.0000000000026938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/27/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Glaucoma, is the most common cause of irreversible visual deficits, presents as an injury to the optic nerve and it is mainly associated with elevated intraocular pressure. The main symptom of glaucoma is a reduction of the visual field, which is usually a source of complaint at the advanced stage of disease. Because of visual deficit, gait dysfunctions, including low gait speed and increased bumping into objects, postural sway, and falling are occurred. Many studies have used stopwatch or motion-sensing devices to report on gait function following glaucoma. However, there are few reports on gait dysfunction assessed by examining foot pressure. This study investigated gait ability following glaucoma according to different gait conditions by assessing foot pressure. METHODS Thirty older adults (15 in the sex- and age-matched normal group and 15 in the glaucoma group) were recruited for this study. All participants were walked under 2 different gait conditions in an F-scan system and the subject' assessments were randomly assigned to rule out the order effect. Conditions included: gait over an obstacle in a straight 6 m path, gait in a straight path without an obstacle in the 6 m path. Gait variables included cadence, gait cycle, stance time, center of force (COF) deviation, and COF excursion. About 10 minutes were taken for gait evaluation. RESULTS When walking without an obstacle on a 6 m path, there were significant differences between the 2 groups in gait speed, cadence, gait cycle, and stance time (P < .05). There were significant differences when walking with an obstacle on a 6 m path (P < .05). Two-way analysis of variance showed significant effects associated with "glaucoma" not gait condition on all outcomes except for COF deviation and excursion. Also, there was no the interaction effect between "glaucoma" and "gait condition." CONCLUSION We demonstrated that glaucoma patients selected the gait strategy such as lower gait function in both gait conditions particularly, slower gait speed and cadence and longer gait cycle and stance time, as determined by examining foot pressure. We believe that our results could help to improve the quality of life of patients with glaucoma.
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Affiliation(s)
- Han-Suk Lee
- Department of Physical Therapy, Eulji University, Republic of Korea
| | - Koon-Ja Lee
- Department of Optometry, Eulji University, Republic of Korea
| | - Jeong-Lae Kim
- Department of Biomedical Engineering, Eulji University, Republic of Korea
| | - Hyun-Sung Leem
- Department of Optometry, Eulji University, Republic of Korea
| | - Hyun-Jin Shin
- Department of Ophthalmology, Konkuk University School of Medicine, Republic of Korea
| | - Hyeok Gyu Kwon
- Department of Physical Therapy, Eulji University, Republic of Korea
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19
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Sultan O, Nuhmani S, Muaidi QI. Comparison of plantar loading patterns on natural grass and artificial turf during various athletic activities. J Sports Med Phys Fitness 2021; 61:680-686. [PMID: 33472347 DOI: 10.23736/s0022-4707.21.11342-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aimed to investigate the differences in plantar pressure during various athletic activities on natural grass and artificial turf. METHODS Twenty-one athletes were fitted with properly sized soccer shoes and corresponding F-Scan system insoles and performed walking, running, vertical jumping and cutting activities to the right and left sides on both natural and artificial turf. RESULTS There were no statistically significant differences between natural grass and artificial turf in peak pressure, maximum force and force-time integral during all the athletic activities (P˃0.05). On both turfs, the highest peak pressure and maximum force values occurred during running and cutting to the right, and the highest force-time integral value occurred during cutting to the right. There were no statistically significant differences between the two turfs in peak pressure in the various anatomical regions during any of the athletic activities (P˃0.05). The peak pressure was the highest on the first metatarsal and the hallux during all five activities. A clinically meaningful difference between the surfaces in peak pressure on the second to fifth metatarsals was found during walking, indicating more loading on artificial turf than on natural grass. There was more loading on artificial turf than on natural grass during cutting left and at hallux and third toe on natural grass during cutting right. However, these differences were not statistically significant (P˃0.05). CONCLUSIONS The results of this study suggest that it is important to limit or prevent athletes from undertaking certain activities that increase the risk of re-injury during rehabilitation.
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Affiliation(s)
- Omar Sultan
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia -
| | - Qassim I Muaidi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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20
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Rogerio FRPG, Guedes DP. Reprodutibilidade e concordância entre diferentes protocolos de baropodometria dinâmica durante a marcha: um estudo preliminar. FISIOTERAPIA E PESQUISA 2020. [DOI: 10.1590/1809-2950/17018227042020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
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.
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21
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Valldecabres R, Richards J, De Benito AM. The effect of match fatigue in elite badminton players using plantar pressure measurements and the implications to injury mechanisms. Sports Biomech 2020; 21:940-957. [PMID: 32301399 DOI: 10.1080/14763141.2020.1712469] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to investigate the differences in plantar pressure under the lead and trail foot between two lunge tasks to the net in the dominant (LD) and non-dominant (LND) directions, and to explore how fatigue affects the plantar pressure patterns whilst performing movements before and after a competitive match. Peak and mean pressure were measured with the Biofoot-IBV in-shoe system from five repetitions of each task, with sensors positioned under the calcaneus, midfoot and phalanges on the lead and trail foot. Data were collected pre and immediately post-playing an official first national league competition match. The study was conducted with a sample of thirteen first league badminton players. A 2 × 2 repeated ANOVA found significant differences between the two tasks and between pre- and post-match (fatigued state). Players also had different foot pressure distributions for the LD and LND tasks, which indicated a difference in loading strategy. In a fatigued state, the plantar pressure shifted to the medial aspect of the midfoot in the trail limb, indicating a reduction in control and a higher injury risk during non-dominant lunge tasks.
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Affiliation(s)
- Raúl Valldecabres
- Doctorate School, Valencia Catholic University San Vicente Mártir, Valencia, Spain.,Physical Activity and Sports Science Faculty, Valencia Catholic University San Vicente Mártir, Valencia, Spain
| | - Jim Richards
- Allied Health Research Unit, University of Central Lancashire, Preston, UK
| | - Ana-María De Benito
- Physical Activity and Sports Science Faculty, Valencia Catholic University San Vicente Mártir, Valencia, Spain
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22
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Jones PJ, Bibb RJ, Davies MJ, Khunti K, McCarthy M, Fong DTP, Webb D. A fitting problem: Standardising shoe fit standards to reduce related diabetic foot ulcers. Diabetes Res Clin Pract 2019; 154:66-74. [PMID: 31128134 DOI: 10.1016/j.diabres.2019.05.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/15/2019] [Indexed: 12/21/2022]
Abstract
AIMS Incorrectly fitting shoes are implicated in callus formation and a significant proportion of diabetic foot ulcers, yet remain surprisingly prevalent. We review the current shoe fit guidelines for consistency and discuss ways in which technology may assist us in standardising methods of footwear assessment. METHODS Narrative review. RESULTS Incorrectly fitted shoes are implicated in the development of some diabetic foot ulcers yet surprisingly there's no consensus on shoe fit, despite substantial spending on prescription footwear. Suggested toe gaps vary from 6 to 20 mm and measurement methods also vary from Brannock Devices and callipers to manual measurement. CONCLUSIONS To prevent fit-related foot ulceration, we need to standardise our biomechanical definition of fit. Future research should (1) evaluate the potential use of 3D scanning technology to provide a standardised means of capturing foot morphology; (2) develop a working biomechanical definition of fit, including toe gap through the identification of key physiological markers that capture and predict dynamic foot shape changes during different physical activities and body weight loading conditions; and (3) determine whether changes in dynamic foot shape of those with diabetes differs from those without, impacting on their shoe fitting needs, potentially necessitating specialist footwear at an earlier stage to avoid ulceration.
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Affiliation(s)
- Petra J Jones
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK.
| | - Richard J Bibb
- Loughborough Design School, Loughborough University, Loughborough, UK
| | - Melanie J Davies
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Kamlesh Khunti
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Matthew McCarthy
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Daniel T P Fong
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - David Webb
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
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23
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Montesinos L, Castaldo R, Cappuccio FP, Pecchia L. Day-to-day variations in sleep quality affect standing balance in healthy adults. Sci Rep 2018; 8:17504. [PMID: 30504839 PMCID: PMC6269497 DOI: 10.1038/s41598-018-36053-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/10/2018] [Indexed: 11/23/2022] Open
Abstract
Acute sleep deprivation is known to affect human balance and posture control. However, the effects of variations in sleep quality and pattern over consecutive days have received less attention. This study investigated the associations between day-to-day variations in sleep quality and standing balance in healthy subjects. Twenty volunteers (12 females and 8 males; age: 28.8 ± 5.7 years, body mass index: 23.4 ± 3.4 kg/m2, resting heart rate: 63.1 ± 8.7 bpm) with no history of sleep disorders or balance impairments participated in the study. Sleep and balance were assessed over two consecutive days. Sleep quality variations were assessed using sleep diary, actigraphy and heart rate variability (HRV) measures. Sleep was monitored at home, using an unobtrusive wearable device. Balance was assessed in a gait lab using foot centre of pressure (COP) displacement during quiet standing. Subjects with a day-to-day deterioration in sleep quantity and quality (i.e., decreased duration and increased fragmentation, increased nocturnal activity and decreased HRV) exhibited significant changes in balance (i.e., larger COP area, amplitude and standard deviation). Conversely, subjects with no significant alterations in sleep quantity and quality showed no significant changes in COP displacements. These results confirmed our hypothesis that changes in sleep quality and pattern over consecutive days may affect balance.
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Affiliation(s)
- Luis Montesinos
- School of Engineering, University of Warwick, Coventry, United Kingdom
- Escuela de Ingenieria y Ciencias, Tecnologico de Monterrey, Mexico City, Mexico
| | - Rossana Castaldo
- School of Engineering, University of Warwick, Coventry, United Kingdom
- Institute of Advanced Study, University of Warwick, Coventry, United Kingdom
| | - Francesco P Cappuccio
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
| | - Leandro Pecchia
- School of Engineering, University of Warwick, Coventry, United Kingdom.
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