An insole pressure measurement system: repeatability of postural data

Pedobarographic evaluation of five commonly used orthoses for the lower extremity

INTRODUCTION

Orthoses are designed to achieve immobilization or off-loading of certain regions of the foot. Yet, their off-loading capacity for the specific regions has not yet been studied. Therefore, the aim of this study was to analyze the plantar pressure distribution of five commonly applied orthoses for foot and ankle in a healthy population.

MATERIALS AND METHODS

Five orthoses (postoperative shoe, forefoot relief shoe, short walker boot, high walker boot, and calcaneus fracture orthosis) were compared pedobarographically using insoles on a treadmill to a ready-made running shoe in eleven healthy subjects (median age 29 years). Peak pressure, maximum force, force-time integral, contact time, and contact area were evaluated separately for the forefoot, midfoot, and hindfoot.

RESULTS

The forefoot relief shoe, the short- and high walker boot significantly reduced the peak pressure at the forefoot with no significant differences between these orthoses. None of the five orthoses off-loaded the midfoot, but the calcaneus fracture orthosis and the short walker boot instead increased midfoot load. For the hindfoot, the calcaneus fracture orthosis was the only device to significantly reduce the peak pressure.

CONCLUSIONS

This is the first study to investigate the specific off-loading capacities of different orthoses for specific foot regions in a healthy collective. The knowledge of absolute and relative load shifts for the different orthoses is of fundamental interest for targeted clinical decision-making of physicians.

Clinical availability of the deep tendon reflex test using a novel apparatus in healthy subjects

[Purpose] The aim of this study was to investigate the clinical usefulness of a novel apparatus intended to improve the consistency and reliability of the deep tendon reflex (DTR) test. [Subjects] The participants included 50 healthy adults (25 male and 25 female) between 20 and 31 years of age who showed no knee abnormalities upon physical examination. [Methods] The intraclass correlation coefficient (ICC) was used to verify inter-rater reliability for two parameters examined in the DTR test using a newly designed apparatus. These parameters were the patellar reflex amplitude and first knee extension angle. Pearson's product correlation coefficient was then used to examine the correlation between these two parameters. [Results] The inter-rater reliability analysis showed a high correlation between the examiners for both DTR parameters (ICCs = 0.91-0.96). In addition, a significant positive correlation was observed between the two parameters (r = 0.91). [Conclusion] The results show that it is possible to use the novel apparatus described herein to obtain reliable results in the DTR test.

Effect of armor and carrying load on body balance and leg muscle function

This study investigated the impact of weight and weight distribution of body armor and load carriage on static body balance and leg muscle function. A series of human performance tests were conducted with seven male, healthy, right-handed military students in seven garment conditions with varying weight and weight distributions. Static body balance was assessed by analyzing the trajectory of center of plantar pressure and symmetry of weight bearing in the feet. Leg muscle functions were assessed by analyzing the peak electromyography amplitude of four selected leg muscles during walking. Results of this study showed that uneven weight distribution of garment and load beyond an additional 9 kg impaired static body balance as evidenced by increased sway of center of plantar pressure and asymmetry of weight bearing in the feet. Added weight on non-dominant side of the body created greater impediment to static balance. Increased garment weight also elevated peak EMG amplitude in the rectus femoris to maintain body balance and in the medial gastrocnemius to increase propulsive force. Negative impacts on balance and leg muscle function with increased carrying loads, particularly with an uneven weight distribution, should be stressed to soldiers, designers, and sports enthusiasts.

Plantar pressure parameters for dynamic gait stability analysis

Dynamic stability measurement is necessary to evaluate human performance over a variety of locomotor environments. In this paper, the suitability of parameters extracted from plantar-pressure measurements as input into a dynamic stability model was investigated. FScan in-shoe pressure data were collected from 15 subjects as they completed four successively more unstable walking tasks. Six parameters met the criteria of being reliably calculated from plantar pressure data, increasing as the task became more unstable, and relating to past measures from the literature: anterior/posterior centre of force (CoF) position, medio-lateral CoF position, double support time, stance time, cell triggering frequency, and maximum lateral CoF position. These parameters could be combined to create an index of dynamic gait stability.

Analyse de la marche dans la maladie de Parkinson par enregistrement baropodométrique à l’aide de semelles embarquées

INTRODUCTION

The literature reports some studies describing the walking pattern of patients with Parkinson's disease, its deterioration with disease severity and the effects of various treatments. Other studies concerned the plantar pressure distribution when walking. The aim of this study was to validate the use of baropodometric measurements for gait analysis of parkinsonian patients at various stages of disease severity and in on and off phases.

METHODS

Fifteen normal control subjects and fifteen parkinsonian patients equipped with a plantar pressure measurement system performed walking tests. The parkinsonian patients performed the walking tests in off phase then in on phase. A clinical examination was performed to score the motor handicap on the UPDRS scale.

RESULTS

Analysis of the plantar pressures of the parkinsonian subjects under various footprint areas detected significant baropodometric differences compared with controls, between groups with different UPDRS scores, and before and after L-Dopa treatment.

CONCLUSIONS

Plantar pressures measurements allow a sufficiently fine discrimination for using it to detect parkinsonism and monitor patients with Parkinson's disease.