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Wong DWC, Cheung JCW, Zhao JG, Ni M, Yang ZY. Forefoot Function after Hallux Valgus Surgery: A Systematic Review and Meta-Analysis on Plantar Load Measurement. J Clin Med 2023; 12:jcm12041384. [PMID: 36835920 PMCID: PMC9965975 DOI: 10.3390/jcm12041384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
While hallux valgus (HV) surgeries are useful for correcting skeletal alignment problems, their effects on plantar load, which reflects forefoot functions, are less understood. The objective of this study is to conduct a systematic review and meta-analysis on the plantar load change after HV surgeries. A systematic search of Web of Science, Scopus, PubMed, CENTRAL, EMBASE, and CINAHL was performed. Studies that assessed the pre- and post-operative plantar pressure of HV patients undergoing surgeries and reported load-related parameters over the hallux, medial metatarsal, and/or central metatarsal regions were included. Studies were appraised by using the modified NIH quality assessment tool for before-after study. Studies suitable for meta-analysis were pooled with the random-effects model, using the standardized mean difference of the before-after parameters as an effect measure. Twenty-six studies containing 857 HV patients and 973 feet were included for the systematic review. Meta-analysis was conducted on 20 of them, and most studies did not favor HV surgeries. Overall, HV surgeries reduced the plantar load over the hallux region (SMD -0.71, 95% CI, -1.15 to -0.26), indicating that forefoot function worsened after surgeries. For the other five outcomes, the overall estimates were not statistically significant, indicating that surgeries did not improve them either. There was substantial heterogeneity among the studies, which in most cases could not be resolved by pre-planned subgroup analyses by surgical classification, year of publication, median age of patients, and length of follow-up. Sensitivity analysis removing lower-quality studies showed that the load integrals (impulse) over the central metatarsal region significantly increased (SMD 0.27, 95% CI, 0 to 0.53), indicating that surgeries increased the risk of transfer metatarsalgia. There is no solid evidence that HV surgeries could improve forefoot functions from a biomechanical point perspective. Currently available evidence even suggests that surgeries might reduce the plantar load over the hallux and adversely affect push-off function. The reasons behind and the effectiveness of alternative surgical methods warrant further investigation.
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Affiliation(s)
- Duo Wai-Chi Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - James Chung-Wai Cheung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Jia-Guo Zhao
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin 300211, China
| | - Ming Ni
- Department of Science Development, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200240, China
- Department of Orthopaedics, Pudong New Area People’s Hospital, Shanghai 201299, China
| | - Zu-Yao Yang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Correspondence: ; Tel.: +852-2252-8739
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Jasiewicz B, Klimiec E, Guzdek P, Kołaszczyński G, Piekarski J, Zaraska K, Potaczek T. Investigation of Impact of Walking Speed on Forces Acting on a Foot-Ground Unit. SENSORS 2022; 22:s22083098. [PMID: 35459082 PMCID: PMC9028688 DOI: 10.3390/s22083098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 12/04/2022]
Abstract
Static and dynamic methods can be used to assess the way a foot is loaded. The research question is how the pressure on the feet would vary depending on walking/running speed. This study involved 20 healthy volunteers. Dynamic measurement of foot pressure was performed using the Ortopiezometr at normal, slow, and fast paces of walking. Obtained data underwent analysis in a “Steps” program. Based on the median, the power generated by the sensors during the entire stride period is the highest during a fast walk, whereas based on the average; a walk or slow walk prevails. During a fast walk, the difference between the mean and the median of the stride period is the smallest. Regardless of the pace of gait, the energy released per unit time does not depend on the paces of the volunteers’ gaits. Conclusions: Ortopiezometr is a feasible tool for the dynamic measurement of foot pressure. For investigations on walking motions, the plantar pressure analysis system, which uses the power generated on sensors installed in the insoles of shoes, is an alternative to force or energy measurements. Regardless of the pace of the walk, the amounts of pressure applied to the foot during step are similar among healthy volunteers.
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Affiliation(s)
- Barbara Jasiewicz
- Department of Orthopedics and Rehabilitation, Medical College, Jagiellonian University, Balzera 15, 34-500 Zakopane, Poland;
- Correspondence:
| | - Ewa Klimiec
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Piotr Guzdek
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Grzegorz Kołaszczyński
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Jacek Piekarski
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Krzysztof Zaraska
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Tomasz Potaczek
- Department of Orthopedics and Rehabilitation, Medical College, Jagiellonian University, Balzera 15, 34-500 Zakopane, Poland;
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Ling Q, Ke T, Liu W, Ren Z, Zhao L, Gu H. Tough, Repeatedly Adhesive, Cyclic Compression-Stable, and Conductive Dual-Network Hydrogel Sensors for Human Health Monitoring. Ind Eng Chem Res 2021. [DOI: 10.1021/acs.iecr.1c03358] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Qiangjun Ling
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
- National Engineering Research Center of Clean Technology in Leather Industry, Sichuan University, Chengdu 610065, China
| | - Tao Ke
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
- National Engineering Research Center of Clean Technology in Leather Industry, Sichuan University, Chengdu 610065, China
| | - Wentao Liu
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
- National Engineering Research Center of Clean Technology in Leather Industry, Sichuan University, Chengdu 610065, China
| | - Zhijun Ren
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
- National Engineering Research Center of Clean Technology in Leather Industry, Sichuan University, Chengdu 610065, China
| | - Li Zhao
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
- National Engineering Research Center of Clean Technology in Leather Industry, Sichuan University, Chengdu 610065, China
| | - Haibin Gu
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
- National Engineering Research Center of Clean Technology in Leather Industry, Sichuan University, Chengdu 610065, China
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Qian Z, Jiang Z, Wu J, Chang F, Liu J, Ren L, Ren L. Morphology and Mechanical Properties of Plantar Fascia in Flexible Flatfoot: A Noninvasive In Vivo Study. Front Bioeng Biotechnol 2021; 9:727940. [PMID: 34604187 PMCID: PMC8479101 DOI: 10.3389/fbioe.2021.727940] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/16/2021] [Indexed: 01/12/2023] Open
Abstract
Plantar fascia plays an important role in human foot biomechanics; however, the morphology and mechanical properties of plantar fascia in patients with flexible flatfoot are unknown. In this study, 15 flexible flatfeet were studied, each plantar fascia was divided into 12 positions, and the morphologies and mechanical properties in the 12 positions were measured in vivo with B-mode ultrasound and shear wave elastography (SWE). Peak pressures under the first to fifth metatarsal heads (MH) were measured with FreeStep. Statistical analysis included 95% confidence interval, intragroup correlation coefficient (ICC1,1), one-way analysis of variance (one-way ANOVA), and least significant difference. The results showed that thickness and Young's modulus of plantar fascia were the largest at the proximal fascia (PF) and decreased gradually from the proximal end to the distal end. Among the five distal branches (DB) of the fascia, the thickness and Young's modulus of the second and third DB were larger. The peak pressures were also higher under the second and third MH. This study found a gradient distribution in that the thickness and Young's modulus gradient decreased from the proximal end to the distal end of plantar fascia in the longitudinal arch of flexible flatfeet. In the transverse arch, the thickness and Young's modulus under the second and third DB were larger than those under the other three DB in flexible flatfoot, and the peak pressures under the second and third MH were also larger than those under the other three MH in patients with flexible flatfoot. These findings deepen our understanding of the changes of biomechanical properties and may be meaningful for the study of pathological mechanisms and therapy for flexible flatfoot.
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Affiliation(s)
- Zhihui Qian
- Key Laboratory of Bionic Engineering, Jilin University, Changchun, China
| | - Zhende Jiang
- Key Laboratory of Bionic Engineering, Jilin University, Changchun, China
| | - Jianan Wu
- Key Laboratory of Bionic Engineering, Jilin University, Changchun, China
| | - Fei Chang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Jing Liu
- Key Laboratory of Bionic Engineering, Jilin University, Changchun, China
| | - Lei Ren
- Key Laboratory of Bionic Engineering, Jilin University, Changchun, China.,School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, United Kingdom
| | - Luquan Ren
- Key Laboratory of Bionic Engineering, Jilin University, Changchun, China
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Comparison of the immediate effects of prefabricated soft medical insoles and custom-molded rigid medical insoles on plantar pressure distribution in athletes with flexible flatfoot: a prospective study. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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6
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Effects of taping techniques on arch deformation in adults with pes planus: A meta-analysis. PLoS One 2021; 16:e0253567. [PMID: 34214104 PMCID: PMC8253385 DOI: 10.1371/journal.pone.0253567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 06/08/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate effects of taping techniques on arch deformation in adults with pes planus. Methods The following databases were searched up to March 2020, including Web of Science, Pubmed, EBSCO, CNKI and Cochrane Library. Heterogeneity and publication bias were assessed by I2 index and funnel plots, respectively. In addition, Cochrane scale was used to evaluate the quality of research. Results Navicular height for three antipronation taping techniques significantly increased immediately post tape compared with baseline (mean difference = 4.86 mm, 95% CI = 2.86–6.87 mm, Z = 4.75, p < 0.001). The highest increase was observed in Augmented low-Dye (ALD). Modified low-Dye (MLD) was second only to ALD (p<0.001). Navicular height after walking for 10 min was much higher than baseline (p<0.001), with MLD decreased smaller than ALD. Conclusions ALD was the most effective taping technique for controlling foot arch collapse immediately post tape compared with baseline, followed by MLD. By contrast, MLD could possibly performed better than ALD in maintaining immediate navicular height after walking for 10 min. Low-Dye could make resting calcaneal stance position closer to neutral position. Although positive effects of Navicular sling, low-Dye and Double X taping interventions were observed, they could not maintain this immediate navicular height effect after a period of higher intensity weight-bearing exercise.
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Brierty A, Carty CP, Giacomozzi C, Phillips T, Walsh HPJ, Bade D, Horan S. Plantar load transfer in children: a descriptive study with two pathological case studies. BMC Musculoskelet Disord 2021; 22:521. [PMID: 34098920 PMCID: PMC8185932 DOI: 10.1186/s12891-021-04364-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/19/2021] [Indexed: 11/29/2022] Open
Abstract
Background Typical gait is often considered to be highly symmetrical, with gait asymmetries typically associated with pathological gait. Whilst gait symmetry is often expressed in symmetry ratios, measures of symmetry do not provide insight into how these asymmetries affect gait variables. To fully understand changes caused by gait asymmetry, we must first develop a normative database for comparison. Therefore, the aim of this study was to describe normative reference values of regional plantar load and present comparisons with two pathological case studies. Methods A descriptive study of the load transfer of plantar pressures in typically developed children was conducted to develop a baseline for comparison of the effects of gait asymmetry in paediatric clinical populations. Plantar load and 3D kinematic data was collected for 17 typically developed participants with a mean age of 9.4 ± 4.0 years. Two case studies were also included; a 10-year-old male with clubfoot and an 8-year-old female with a flatfoot deformity. Data was analysed using a kinematics-pressure integration technique for anatomical masking into 5 regions of interest; medial and lateral forefoot, midfoot, and medial and lateral hindfoot. Results Clear differences between the two case studies and the typical dataset were seen for the load transfer phase of gait. For case study one, lateral bias was seen in the forefoot of the trailing foot across all variables, as well as increases in contact area, force and mean pressure in the lateral hindfoot of the leading foot. For case study two, the forefoot of the trailing foot produced results very similar to the typical dataset across all variables. In the hindfoot of the leading foot, medial bias presents most notably in the force and mean pressure graphs. Conclusions This study highlights the clinical significance of the load transfer phase of gait, providing meaningful information for intervention planning. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04364-9.
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Affiliation(s)
- Alexis Brierty
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia. .,Queensland Children's Motion Analysis Service, Queensland Children's Hospital, Brisbane, QLD, 4101, Australia. .,School of Allied Health Sciences, Griffith University, Gold Coast, QLD, 4222, Australia.
| | - Christopher P Carty
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia.,Queensland Children's Motion Analysis Service, Queensland Children's Hospital, Brisbane, QLD, 4101, Australia.,Department of Orthopaedic Surgery, Queensland Children's Hospital, Brisbane, QLD, 4101, Australia.,Research Development Unit, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Gold Coast, QLD, 4510, Australia
| | - Claudia Giacomozzi
- Italian National Institute of Health (Istituto Superiore di Sanità), Viale Regina Elena, 299, 00161, Rome, RM, Italy
| | - Teresa Phillips
- Queensland Children's Motion Analysis Service, Queensland Children's Hospital, Brisbane, QLD, 4101, Australia
| | - Henry P J Walsh
- Queensland Children's Motion Analysis Service, Queensland Children's Hospital, Brisbane, QLD, 4101, Australia.,Department of Orthopaedic Surgery, Queensland Children's Hospital, Brisbane, QLD, 4101, Australia
| | - David Bade
- Queensland Children's Motion Analysis Service, Queensland Children's Hospital, Brisbane, QLD, 4101, Australia.,Department of Orthopaedic Surgery, Queensland Children's Hospital, Brisbane, QLD, 4101, Australia
| | - Sean Horan
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, 4222, Australia
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Design and Preliminary Validation of Individual Customized Insole for Adults with Flexible Flatfeet Based on the Plantar Pressure Redistribution. SENSORS 2021; 21:s21051780. [PMID: 33806449 PMCID: PMC7961547 DOI: 10.3390/s21051780] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 12/14/2022]
Abstract
Flatfoot is a common musculoskeletal deformity. One of the most effective treatments is to wear individually customized plantar pressure-based insoles to help users change the abnormally distributed pressure on the pelma. However, most previous studies were divided only into several plantar areas without detailed plantar characteristic analysis. In this study, a new insole is designed which redistributes pressure following the analysis of characteristic points of plantar pressure, and practical evaluation during walking of subjects while wearing the insole. In total, 10 subjects with flexible flatfeet have participated in the performance of gait experiments by wearing flat insoles, orthotic insoles, and plantar pressure redistribution insoles (PPRI). The results showed that the stance time of PPRI was significantly lower than that of the flat insoles under slow gait. PPRI in the second to third metatarsal and medial heel area showed better unloading capabilities than orthotic insoles. In the metatarsal and heel area, the PPRI also had its advantage in percentage of contact area compared to flat insole and orthotic insole. The results prove that PPRI improves the plantar pressure distribution and gait efficiency of adults with flexible flatfeet, and can be applied into clinical application.
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McKnight M, Tabor J, Agcayazi T, Fleming A, Ghosh TK, Huang H, Bozkurt A. Fully Textile Insole Seam-Line for Multimodal Sensor Mapping. IEEE SENSORS JOURNAL 2020; 20:10145-10153. [DOI: 10.1109/jsen.2020.2990627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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10
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Effects of Artificial Texture Insoles and Foot Arches on Improving Arch Collapse in Flat Feet. SENSORS 2020; 20:s20133667. [PMID: 32629994 PMCID: PMC7374508 DOI: 10.3390/s20133667] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/27/2020] [Accepted: 06/28/2020] [Indexed: 11/16/2022]
Abstract
The arches of the foot play a vital role in cushioning the impact and pressure generated from ground reaction forces due to body weight. Owing to a lack of normal human arch structure, people diagnosed as having flat feet often have discomfort in the soles of their feet. The results may not only cause inappropriate foot pressure distribution on the sole but also further cause foot injuries. This study heavily relies on a homemade foot pressure sensing device equipped with textured insoles of different heights and artificial arches. This was to explore the extent to which the pressure distribution of the foot in people with flat feet could be improved. A further comparison was made of the effects of using the textured insoles with different heights on two different groups of people diagnosed with flat and normal feet respectively. Sixty-five undergraduate and postgraduate volunteers were invited to receive the ink footprint test for measuring their degrees of arch index. Nine of these 65 had 2 flat feet, 3 had a left flat foot, 5 had a right flat foot, and 48 had 2 normal feet. To ensure the same number of subjects in both the control and the experimental groups, 9 of the 48 subjects who had normal feet were randomly selected. In total, 26 subjects (Male: 25, Female: 1; Age: 22 ± 1 years; height: 173.6 ± 2.5 cm; body mass: 68.3 ± 5.4 kg; BMI: 22.6 ± 1.2) were invited to participate in this foot pressure sensing insoles study. The experimental results showed that the use of textured insoles designed with different heights could not effectively improve the plantar pressure distribution and body stability in subjects with flat feet. Conversely, the use of an artificial arch effectively improved the excessive peak in pressure and poor body stability, and alleviated the problem of plantar collapse for patients with flat feet, especially in the inner part of their hallux and forefoot.
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Booth BG, Hoefnagels E, Huysmans T, Sijbers J, Keijsers NLW. PAPPI: Personalized analysis of plantar pressure images using statistical modelling and parametric mapping. PLoS One 2020; 15:e0229685. [PMID: 32106256 PMCID: PMC7046232 DOI: 10.1371/journal.pone.0229685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/11/2020] [Indexed: 11/19/2022] Open
Abstract
Quantitative analyses of plantar pressure images typically occur at the group level and under the assumption that individuals within each group display homogeneous pressure patterns. When this assumption does not hold, a personalized analysis technique is required. Yet, existing personalized plantar pressure analysis techniques work at the image level, leading to results that can be unintuitive and difficult to interpret. To address these limitations, we introduce PAPPI: the Personalized Analysis of Plantar Pressure Images. PAPPI is built around the statistical modelling of the relationship between plantar pressures in healthy controls and their demographic characteristics. This statistical model then serves as the healthy baseline to which an individual’s real plantar pressures are compared using statistical parametric mapping. As a proof-of-concept, we evaluated PAPPI on a cohort of 50 hallux valgus patients. PAPPI showed that plantar pressures from hallux valgus patients did not have a single, homogeneous pattern, but instead, 5 abnormal pressure patterns were observed in sections of this population. When comparing these patterns to foot pain scores (i.e. Foot Function Index, Manchester-Oxford Foot Questionnaire) and radiographic hallux angle measurements, we observed that patients with increased pressure under metatarsal 1 reported less foot pain than other patients in the cohort, while patients with abnormal pressures in the heel showed more severe hallux valgus angles and more foot pain. Also, incidences of pes planus were higher in our hallux valgus cohort compared to the modelled healthy controls. PAPPI helped to clarify recent discrepancies in group-level plantar pressure studies and showed its unique ability to produce quantitative, interpretable, and personalized analyses for plantar pressure images.
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Affiliation(s)
- Brian G. Booth
- imec-Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
- * E-mail:
| | - Eva Hoefnagels
- Department of Orthopaedics, Sint Maartenskliniek, Woerden, The Netherlands
| | - Toon Huysmans
- imec-Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
- Section on Applied Ergonomics & Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Jan Sijbers
- imec-Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
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Telfer S, Bigham JJ. The influence of population characteristics and measurement system on barefoot plantar pressures: A systematic review and meta-regression analysis. Gait Posture 2019; 67:269-276. [PMID: 30391749 DOI: 10.1016/j.gaitpost.2018.10.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/17/2018] [Accepted: 10/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The measurement of plantar pressure distributions during gait can provide insights into the effects of musculoskeletal disease on foot function. A range of hardware, software, and protocols are available for the collection of this type of data, with sometimes disparate and conflicting results reported between individual studies. In this systematic review and meta-regression analysis of dynamic regional peak pressures, we aimed to test if 1) the system used to obtain the pressure measurements and 2) the characteristics of the study populations had a significant effect on the results. METHODS A systematic review of the literature was undertaken to identify articles reporting regional peak plantar pressures during barefoot walking. A mixed-effects modeling approach was used to analyze the extracted data. Initially, the effect of the system used to collect the data was tested. Following this, the effect of participant characteristics on the results were analyzed, using moderators of cohort type (defined as the primary health characteristic of the participants), age, sex, and BMI. RESULTS 115 participant groups were included in the analysis. Sufficient cohorts were available to test those that consisted of healthy individuals, and those with diabetes and diabetic neuropathy. Significant differences were found between results reported by studies using different pressure measurement systems in 8 of the 16 regions analyzed. The analysis of participant characteristics revealed a number of significant relationships between regional peak pressures and participant characteristics, including: BMI and midfoot plantar pressures; elevated forefoot pressures as a result of diabetic neuropathy; and sex-differences in regional loading patterns. CONCLUSIONS At the level of the literature, we confirmed significant effects of disease status, age, BMI, and sex on regional peak plantar pressures. Researchers and clinicians should be aware that measurements of peak plantar pressure variables obtained from different collection equipment are not directly comparable.
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Affiliation(s)
- S Telfer
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, United States.
| | - J J Bigham
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, United States
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Abstract
BACKGROUND Foot posture is a risk factor for some lower limb injuries, however the underlying mechanism is not well understood. Plantar pressure analysis is one technique to investigate the interaction between foot posture and biomechanical function of the lower limb. RESEARCH QUESTION The aim of this review was to investigate the relationship between foot posture and plantar pressure during walking. METHODS A systematic database search was conducted using MEDLINE, CINAHL, SPORTDiscus and Embase to identify studies that have assessed the relationship between foot posture and plantar pressure during walking. Included studies were assessed for methodological quality. Meta-analysis was not conducted due to heterogeneity between studies. Inconsistencies included foot posture classification techniques, gait analysis protocols, selection of plantar pressure parameters and statistical analysis approaches. RESULTS Of the 4213 citations identified for title and abstract review, sixteen studies were included and underwent quality assessment; all were of moderate methodological quality. There was some evidence that planus feet display higher peak pressure, pressure-time integral, maximum force, force-time integral and contact area predominantly in the medial arch, central forefoot and hallux, while these variables are lower in the lateral and medial forefoot. In contrast, cavus feet display higher peak pressure and pressure-time integral in the heel and lateral forefoot, while pressure-time integral, maximum force, force-time integral and contact area are lower for the midfoot and hallux. Centre of pressure was more laterally deviated in cavus feet and more medially deviated in planus feet. Overall, effect sizes were moderate, but regression models could only explain a small amount of variance in plantar pressure variables. SIGNIFICANCE Despite these significant findings, future research would benefit from greater methodological rigour, particularly in relation to the use of valid foot posture measurement techniques, gait analysis protocols, and standardised approaches for analysis and reporting of plantar pressure variables.
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Sanjari MA, Boozari S, Ashraf Jamshidi A, Nikmaram MR. Fatigue Effect on Linear Center of Pressure Measures during Gait in People with Flat Feet. Asian J Sports Med 2017; 7:e34832. [PMID: 28144406 PMCID: PMC5256193 DOI: 10.5812/asjsm.34832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 05/09/2016] [Accepted: 07/10/2016] [Indexed: 11/16/2022] Open
Abstract
Background Flat foot, as one of the common foot deformities can affect gait biomechanics and risk of lower extremity injury. Fatigue, as a high load task, can also change biomechanical parameters of locomotion. Studying normal and flat footed individuals under high load tasks such as fatigue can elucidate their differences more easily. Objectives In this study, center of pressure (CoP) changes were studied between individuals with flat and normal feet after fatigue. CoP is one of the important gait measures which can show various biomechanical behaviors of different foot shapes. Methods Seventeen subjects with normal feet and 17 with flat feet walked across two force plates before and after a functional fatigue protocol. Standard deviation of CoP in mediolateral direction (SD of CoPx) and in anteroposterior direction (SD of CoPy), overall mean velocity of CoP and length of CoP construction line of both groups were analyzed. The values of SD of CoPy and length of CoP construction line were normalized to individual foot lengths prior to statistical analyses. Results There were no significant between-subject effects for all CoP measures. The only significant finding was the within-subject effect for the SD of CoPy (P = 0.008) with a large effect size (partial eta squared = 0.21). Fatigue resulted in lower SD of CoPy in both groups. Conclusions Lower SD of CoPy indicates less fluctuation of CoPy and a probable less center of mass movement which could reduce the risk of injury. Furthermore, the similar fatigue response in both groups of individuals with normal and flat feet indicates a similar biomechanical behavior despite their different foot arch height.
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Affiliation(s)
- Mohammad Ali Sanjari
- Rehabilitation Research Center, Biomechanics Lab, Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, IR Iran
| | - Sahar Boozari
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, IR Iran
| | - Ali Ashraf Jamshidi
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Ali Ashraf Jamshidi, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, IR Iran. E-mail:
| | - Mohammad Reza Nikmaram
- Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, IR Iran
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15
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Mei Z, Ivanov K, Zhao G, Li H, Wang L. An explorative investigation of functional differences in plantar center of pressure of four foot types using sample entropy method. Med Biol Eng Comput 2016; 55:537-548. [PMID: 27311606 PMCID: PMC5355506 DOI: 10.1007/s11517-016-1532-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 05/27/2016] [Indexed: 12/04/2022]
Abstract
In the study of biomechanics of different foot types, temporal or spatial parameters derived from plantar pressure are often used. However, there is no comparative study of complexity and regularity of the center of pressure (CoP) during the stance phase among pes valgus, pes cavus, hallux valgus and normal foot. We aim to analyze whether CoP sample entropy characteristics differ among these four foot types. In our experiment participated 40 subjects with normal feet, 40 with pes cavus, 19 with pes valgus and 36 with hallux valgus. A Footscan® system was used to collect CoP data. We used sample entropy to quantify several parameters of the investigated four foot types. These are the displacement in medial–lateral (M/L) and anterior–posterior (A/P) directions, as well as the vertical ground reaction force of CoP during the stance phase. To fully examine the potential of the sample entropy method for quantification of CoP components, we provide results for two cases: calculating the sample entropy of normalized CoP components, as well as calculating it using the raw data of CoP components. We also explored what are the optimal values of parameters m (the matching length) and r (the tolerance range) when calculating the sample entropy of CoP data obtained during the stance phases. According to statistical results, some factors significantly influenced the sample entropy of CoP components. The sample entropies of non-normalized A/P values for the left foot, as well as for the right foot, were different between the normal foot and pes valgus, and between the normal foot and hallux valgus. The sample entropy of normalized M/L displacement of the right foot was different between the normal foot and pes cavus. The measured variable for A/P and M/L displacements could serve for the study of foot function.
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Affiliation(s)
- Zhanyong Mei
- College of Information Science and Technology, Chengdu University of Technology, Chengdu, People's Republic of China
| | - Kamen Ivanov
- Shenzhen Institutes of Advanced Technology, The Shenzhen Key Laboratory for Low-cost Healthcare, 1068 Xueyuan Avenue, Shenzhen University Town, Shenzhen, 518055, People's Republic of China.,Graduate University of Chinese Academy of Sciences, Beijing, 100049, People's Republic of China
| | - Guoru Zhao
- Shenzhen Institutes of Advanced Technology, The Shenzhen Key Laboratory for Low-cost Healthcare, 1068 Xueyuan Avenue, Shenzhen University Town, Shenzhen, 518055, People's Republic of China
| | - Huihui Li
- Shenzhen Institutes of Advanced Technology, The Shenzhen Key Laboratory for Low-cost Healthcare, 1068 Xueyuan Avenue, Shenzhen University Town, Shenzhen, 518055, People's Republic of China
| | - Lei Wang
- Shenzhen Institutes of Advanced Technology, The Shenzhen Key Laboratory for Low-cost Healthcare, 1068 Xueyuan Avenue, Shenzhen University Town, Shenzhen, 518055, People's Republic of China.
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16
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Park JJ, Kim KH, Park SB. The Analysis of Foot Pressure and Lap Time for the Development of Korean Bobsleigh Shoes. ACTA ACUST UNITED AC 2015. [DOI: 10.5103/kjsb.2015.25.4.465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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17
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Koh DH, Lee JD, Kim K. Plantar pressures in individuals with normal and pronated feet according to static squat depths. J Phys Ther Sci 2015; 27:2833-5. [PMID: 26504304 PMCID: PMC4616105 DOI: 10.1589/jpts.27.2833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/09/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of the present study was to investigate differences in plantar
pressure between individuals with normal and pronated feet according to 3 static squat
depths. [Subjects and Methods] Study subjects were 10 young adults with normal and
pronated feet. Plantar pressures were measured in the standing position and static squat
positions at 45° (semi-squat) and 90° (half-squat) knee flexion using the F-Mat. Subjects’
plantar pressures were analyzed by dividing the foot into 4 areas: forefoot medial,
forefoot lateral, midfoot, and heel. [Results] In the half-squat position, the pronated
foot group showed a higher foot pressure in the forefoot medial than was seen in the
normal group, whereas the normal group exhibited a higher foot pressure in the heel than
was seen in the pronated foot group. [Conclusion] An increase in squat depth led to the
transfer of plantar pressure to the heel in normal feet and to the forefoot medial in
pronated feet.
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Affiliation(s)
- Da Hyun Koh
- Department of Physical Therapy, Graduate School, Daegu University, Republic of Korea
| | - Jong Dae Lee
- Department of Physical Therapy, Pohang University, Republic of Korea
| | - Kyoung Kim
- Department of Physical Therapy, Daegu University: 15 Jilyang, Gyeongsan-si, Gyeongbuk 712-714, Republic of Korea
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18
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Han J, Kim Y, Kim K. Effects of foot position of the nonparetic side during sit-to-stand training on postural balance in patients with stroke. J Phys Ther Sci 2015; 27:2625-7. [PMID: 26356809 PMCID: PMC4563329 DOI: 10.1589/jpts.27.2625] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 05/18/2015] [Indexed: 11/28/2022] Open
Abstract
[Purpose] We aimed to investigate postural balance after sit-to-stand (STS) training with
different nonparetic foot positions in stroke patients. [Subjects] Thirty-six subjects who
experienced a stroke (21 males, 15 females) participated and were divided into the
symmetric foot position (SYMM), asymmetric foot position (ASYM), and step foot (STEP)
groups. [Methods] Each group performed repetitive sit-to-stand training 5 times a week for
6 weeks. The timed up-and-go test (TUG), functional reach test (FRT), and F-mat system
correcting the anterior/posterior (A-P) and medial/lateral (M-L) distance of the center of
pressure (COP) were used to measure the static and dynamic postural balance pre- and
postintervention. ANCOVA was used to analyze differences among groups, and preintervention
variables were used as covariates. [Results] The TUG, FRT, and A-P and M-L distance of the
COP in the ASYM and STEP groups were significantly decreased after intervention compared
with the SYMM group. All parameters in the STEP group were lower than those in the ASYM
group, without a significant difference. [Conclusion] The asymmetric foot position during
STS is a good intervention to improve the static and dynamic postural balance in stroke
patients. Especially, using a step to change the foot position is effective in improving
STS performance.
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Affiliation(s)
- Jintae Han
- Department of Physical Therapy, College of Science, Kyungsung University, Republic of Korea
| | - Youngmi Kim
- Department of Rehabilitation Science, Graduate school, Daegu University, Republic of Korea
| | - Kyung Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
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19
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Lee MY, Lee HY. Analysis for Sit-to-Stand Performance According to the Angle of Knee Flexion in Individuals with Hemiparesis. J Phys Ther Sci 2014; 25:1583-5. [PMID: 24409025 PMCID: PMC3885844 DOI: 10.1589/jpts.25.1583] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 07/03/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Sit-to-stand (STS) is one of the important functional tasks
people perform throughout the day. This study investigated whether varying angles of knee
flexion affect STS patterns in individuals with hemiparesis by using a foot plantar
pressure measurement system. [Methods] Fifteen stroke patients with hemiparesis
participated for this study. They performed sit-to-stand with three angles of knee flexion
(70°, 90°, and 110°). We measured the trajectory of the center of pressure, peak plantar
pressure, and symmetry index using a Mat-scan system (Tekscan, South Boston, MA, USA).
[Results] As a result, we found that there were significant differences among the three
angle conditions (trajectory of center of pressure, peak plantar pressure on the affected
side, and symmetry index). However, there was no significant difference in peak pressure
according to the knee flexion on the unaffected side. [Conclusion] In the current study,
we found that stroke patients with hemiparesis had a compensated STS pattern according to
knee flexion angles. This indicates that the peak value of plantar pressure increased and
that the trajectory of the center of pressure widened as the angle of knee flexion
increased. We also suggest that hemiparesis patients should be more concerned about proper
knee angle for symmetrical STS pattern.
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Affiliation(s)
- Mi Young Lee
- Department of Physical Therapy, College of Health and Therapy, Daegu Haany University, Republic of Korea
| | - Hae Yong Lee
- Department of Rehabilitation Science, Graduate School, Daegu Universit, Republic of Korea
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20
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Martinásková E, Honzíková L, Janura M, Svoboda Z. The influence of valgus heel position on foot loading in a child's gait. ACTA GYMNICA 2012. [DOI: 10.5507/ag.2012.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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