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

Influence of motor capacity of the lower extremity and mobility performance on foot plantar pressures in community-dwelling older women

Objectives

To investigate the associations of motor capacity of the lower extremity and mobility performance in daily physical activities with peak foot plantar pressures during walking among older women.

Methods

Using the data collected among 58 community-dwelling older women (68.66 ± 3.85 years), Pearson correlation and multiple linear regression analyses were performed to analyze the associations of motor capacity of the lower extremity (the 30-s chair stand test, the timed one-leg stance with eyes closed, and the Fugl-Meyer assessment of lower extremity), mobility performance in daily physical activities (the average minutes of moderate to vigorous physical activity every day and the metabolic equivalents), and foot plantar pressures (peak force and peak pressure) with the age and body fat percentage as covariates.

Results

(1) The motor capacity of the lower extremity has higher explanatory power for peak foot plantar pressures compared with the mobility performance in daily physical activities. (2) Higher body fat percentage was positively associated with peak force and pressure, while a lower score on the Fugl-Meyer assessment of lower extremity was negatively associated with both of them. (3) The metabolic equivalents were positively associated with the peak force, while the 30-s chair stand test was negatively associated with it.

Conclusions

Mobility performance in daily physical activities can be significant predictors for peak foot plantar pressures among older women. The significant predictor variables include the Fugl-Meyer assessment of lower extremity, the 30-s chair stand test, and metabolic equivalents.

Application of Dynamic Mode Decomposition to Characterize Temporal Evolution of Plantar Pressures from Walkway Sensor Data in Women with Cancer

Pressure sensor-impregnated walkways transform a person's footfalls into spatiotemporal signals that may be sufficiently complex to inform emerging artificial intelligence (AI) applications in healthcare. Key consistencies within these plantar signals show potential to uniquely identify a person, and to distinguish groups with and without neuromotor pathology. Evidence shows that plantar pressure distributions are altered in aging and diabetic peripheral neuropathy, but less is known about pressure dynamics in chemotherapy-induced peripheral neuropathy (CIPN), a condition leading to falls in cancer survivors. Studying pressure dynamics longitudinally as people develop CIPN will require a composite model that can accurately characterize a survivor's gait consistencies before chemotherapy, even in the presence of normal step-to-step variation. In this paper, we present a state-of-the-art data-driven learning technique to identify consistencies in an individual's plantar pressure dynamics. We apply this technique to a database of steps taken by each of 16 women before they begin a new course of neurotoxic chemotherapy for breast or gynecologic cancer. After extracting gait features by decomposing spatiotemporal plantar pressure data into low-rank dynamic modes characterized by three features: frequency, a decay rate, and an initial condition, we employ a machine-learning model to identify consistencies in each survivor's walking pattern using the centroids for each feature. In this sample, our approach is at least 86% accurate for identifying the correct individual using their pressure dynamics, whether using the right or left foot, or data from trials walked at usual or fast speeds. In future work, we suggest that persistent deviation from a survivor's pre-chemotherapy step consistencies could be used to automate the identification of peripheral neuropathy and other chemotherapy side effects that impact mobility.

Pedobarographic evaluations in physical medicine and rehabilitation practice

The feet are complex structures that transmit loads transferred by other parts of the body to the ground and are involved in many static and dynamic activities, such as standing and walking. The contact area and pressure changes between the feet and the ground surface can be measured using pedobarographic devices. With pedobarographic examinations, it is possible to obtain a wide range of information needed to support clinical evaluation and diagnostic tests in physical medicine and rehabilitation practice. Foot structure and function, postural stability, lower extremity biomechanics, and gait analysis are among the areas that can be further investigated using pedobarography.

Criterion Validity of Linear Accelerations Measured with Low-Sampling-Frequency Accelerometers during Overground Walking in Elderly Patients with Knee Osteoarthritis

Sensors with a higher sampling rate produce higher-quality data. However, for more extended periods of data acquisition, as in the continuous monitoring of patients, the handling of the generated big data becomes increasingly complicated. This study aimed to determine the validity and reliability of low-sampling-frequency accelerometer (SENS) measurements in patients with knee osteoarthritis. Data were collected simultaneously using SENS and a previously validated sensor (Xsens) during two repetitions of overground walking. The processed acceleration signals were compared with respect to different coordinate axes to determine the test-retest reliability and the agreement between the two systems in the time and frequency domains. In total, 44 participants were included. With respect to different axes, the interclass correlation coefficient for the repeatability of SENS measurements was [0.93-0.96]. The concordance correlation coefficients for the two systems' agreement were [0.81-0.91] in the time domain and [0.43-0.99] in the frequency domain. The absolute biases estimated by the Bland-Altman method were [0.0005-0.008] in the time domain and [0-0.008] in the frequency domain. Low-sampling-frequency accelerometers can provide relatively valid data for measuring the gait accelerations in patients with knee osteoarthritis and can be used in the future for remote patient monitoring.

The Impact of Overweight and Obesity on Plantar Pressure in Children and Adolescents: A Systematic Review

We aimed to synthesise the results of previous studies addressing the impact of overweight and obesity on plantar pressure in children and adolescents. An electronic search of scientific literature was conducted using PubMed, Cochrane and Scopus database, with keywords: “plantar pressure” AND “children” AND “obesity”; “plantar pressure” AND “adolescents” AND “obesity”, “plantar pressure” AND “children” AND “overweight”, “plantar pressure” AND “adolescents” AND “overweight”. Twenty-two articles were included in the review and the following data were recorded: authors, publication year, type of technology (systems, software) for the determination of plantar pressure, study characteristics. Most of the articles used dynamic plantar pressure determination with only four using static plantar pressure measurement. Using ultrasonography with static plantar pressure determination, the correlation between structural and functional changes in the feet of obese children. In overweight and obese children and adolescents, important findings were recorded: higher contact area, increased maximum force beneath the lateral and medial forefoot, increased pressure–time integral beneath the midfoot and 2nd–5th metatarsal regions. Significantly increased foot axis angle and significantly flatter feet were observed in obese subjects in comparison to their normal-weight counterparts. The obese children presented increased midfoot fat pad thickness, with decreased sensitivity of the whole foot and midfoot.

Foot characteristics during walking in 6-14- year-old children

The main purpose of the study was to establish foot characteristics during walking in children. In this cross-sectional study, we recruited 1 284 primary-school students aged 6–14 years (714 boys and 570 girls) randomly selected from five schools in the city of Brno, Czech Republic. Children walked across a pressure platform (EMED-xl; Novel_GmbH, Munich, Germany) to collect the data for both left and right foot during three trials. After the procedure, the software generated several foot characteristic variables: (1) force-time integral, (2) pressure-time integral, (3) contact area, (4) contact time, (5) peak pressure and (6) average pressure for the total foot. Curves for the 5^th, 10^th, 25^th, 50^th, 75^th, 90^th and 95^th percentiles were calculated using the Lambda, Mu and Sigma (LMS) Chartmaker software. Our results showed that boys had longer force-time integral, higher contact area and contact time values, and higher peak plantar pressure, while no significant differences in pressure-time integral and average plantar pressure between sexes were observed. Older boys and girls had higher values in all measured variables. Our results provide for the first-time sex- and age-specific foot characteristics during walking in 6–14-year-old children.