Peak pressure data and pressure-time integral in the contralateral limb in patients with diabetes and a trans -tibial prosthesis

2018 ◽  
Vol 64 ◽  
pp. 55-58 ◽  
Author(s):  
Jael Borg ◽  
Stephen Mizzi ◽  
Cynthia Formosa
Keyword(s):  
Peak Pressure ◽  
Pressure Data ◽  
Contralateral Limb ◽  
Time Integral ◽  
Pressure Time ◽  
Patients With Diabetes

Variability of plantar pressure data. A comparison of the two-step and midgait methods

1999 ◽  
Vol 89 (10) ◽  
pp. 495-501 ◽  
Author(s):  
TG McPoil ◽  
MW Cornwall ◽  
L Dupuis ◽  
M Cornwell
Keyword(s):  
Data Collection ◽  
Plantar Pressure ◽  
Peak Pressure ◽  
Pressure Data ◽  
Step Method ◽  
Plantar Surface ◽  
Time Integral ◽  
Risk Of Injury ◽  
Pressure Time ◽  
Reliable Representation

The number of trials required to obtain a reliable representation of the plantar pressure pattern is an important factor in the assessment of people with insensate feet or the use of plantar pressure data as a basis for fabrication of foot orthoses. Traditionally, the midgait method has been used for the collection of pressure data, but the large number of walking trials required by this method can increase the risk of injury to the plantar surface of the insensate foot. As a result, the two-step method of plantar pressure data collection has been advocated. The purpose of this investigation was to determine the degree of variability in regional plantar pressure measurements using the midgait and two-step methods of data collection. Plantar pressure data were collected from ten volunteers (five men and five women) between the ages of 20 and 35 years in 20 trials using both data-collection protocols. The results of the study indicate that three to five walking trials are needed to obtain reliable regional peak pressure and pressure-time integral values when the two-step data-collection protocol is used. Although either method can be used for pressure data collection, one method should be used consistently when repeated assessments are required.

Immediate Effects of Weight-Bearing Calf Stretching on Ankle Dorsiflexion Range of Motion and Plantar Pressure During Gait in Patients with Diabetes Mellitus

2021 ◽  
pp. 153473462110313
Author(s):  
Noriaki Maeshige ◽  
Mikiko Uemura ◽  
Yoshikazu Hirasawa ◽  
Yoshiyuki Yoshikawa ◽  
Maiki Moriguchi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Plantar Pressure ◽  
Peak Pressure ◽  
Weight Bearing ◽  
Ankle Dorsiflexion ◽  
Diabetic Foot Ulcers ◽  
Plantar Surface ◽  
Time Integral ◽  
Pressure Time ◽  
Patients With Diabetes

High plantar pressure is a risk factor for diabetic foot ulcers, and it is known that restriction of ankle dorsiflexion range of motion (ROM) causes high plantar pressure. Stretching is a non-invasive and general means to improve ROM; however, the effect of stretching on the ROM and plantar pressure has not been clarified in patients with diabetes mellitus. We aimed to study the effects of intermittent weight-bearing stretching on ankle dorsiflexion ROM and plantar pressure during gait in patients with diabetes mellitus. Seven patients with diabetes mellitus participated, and their triceps surae was stretched using weight-bearing stretching with a stretch board. Five minutes of stretching was performed 4 times with a rest interval of 30 s. Ankle dorsiflexion ROM was measured with the knee flexed and extended. Peak pressure and pressure-time integral during gait were measured and calculated for the rearfoot, midfoot, forefoot, and total plantar surface before and after stretching. Ankle dorsiflexion ROM with the knee extended or bent increased significantly after stretching ( P < .05). Peak pressure and the pressure-time integral decreased significantly, especially in the forefoot ( P < .01), and these also decreased significantly in the total plantar surface ( P < .05). The duration of foot-flat decreased after stretching ( P < .05). Weight-bearing stretching improved ankle dorsiflexion ROM and reduced plantar pressure during gait. These results suggest that weight-bearing calf stretching may be an effective means to prevent and treat diabetic foot ulcers.

scholarly journals The Reduction of 1st Metatarsal Plantar Pressures With a Novel Offloading Device (the Mandakini) in a Singaporean Population

2021 ◽  
Author(s):  
Melissa Yan Ting Lee ◽  
Pui Wah Kong ◽  
Thanaporn Tunprasert
Keyword(s):  
Peak Pressure ◽  
Cost Effective ◽  
Target Population ◽  
Local Hospital ◽  
Plantar Pressures ◽  
Time Integral ◽  
Comfort Levels ◽  
Pressure Time ◽  
Significant Difference ◽  
Patients With Diabetes

Abstract AimsThere is an overall lack of affordable and accessible offloading modalities for diabetic foot ulceration. The Mandakini is a cheap offloading device made-up of gloves. This study aims to investigate its effectiveness in reducing plantar pressures compared to 7mm semi-compressed felt (SCF) and barefoot walking. Materials and methodsPlantar pressures of 30 healthy staff from a local hospital in Singapore were captured under three offloading conditions – the Mandakini, SCF and barefoot walking (control). Peak pressure (PP), pressure-time integral (PTI) and contact time (CT) at the 1st metatarsal and its surrounding regions were analysed. Participants rated their comfort levels in each condition on a visual analogue scale from 1 to 10.Results Statistically significant reductions in PP and PTI of 43 ± 12 kPa (14%) and 14 ± 4 kPa.s (16%) respectively were observed at the 1st metatarsal with the Mandakini compared to control (p=0.001, p=0.002). Reductions were however significantly lower than SCF which reduced PP and PTI by 83 ± 11 kPa (28%) and 28 ± 3 kPa.s (33%) respectively compared to control (p<0.001, p<0.001). No statistically significant difference in CT was observed with the Mandakini compared to control (p=0.499). Comfort levels were not significantly different between the Mandakini and SCF with means 5.7 ± 1.8 and 6.2 ± 2.1 respectively (p=0.257). Conclusion This study highlights the Mandakini’s potential in providing cost-effective offloading through pressure redistribution. Nonetheless, in barefoot conditions, SCF should remain the preferred modality. Future pressure studies on patients with diabetes will provide better representations of the Mandakini’s effectiveness on the target population.

CLEAR Cleat: A Proof-of-Concept Trial of an Aerobic Activity Facilitator to Reduce Plantar Forefoot Pressures and Their Potential in Those with Foot Ulcers

2008 ◽  
Vol 98 (4) ◽  
pp. 261-267 ◽  
Author(s):  
Erin E. Klein ◽  
Ryan T. Crews ◽  
Stephanie C. Wu ◽  
James S. Wrobel ◽  
David G. Armstrong
Keyword(s):  
Contact Area ◽  
Peak Pressure ◽  
Proof Of Concept ◽  
Aerobic Activity ◽  
Time Integral ◽  
Plantar Aspect ◽  
Pressure Time ◽  
The Right ◽  
Recumbent Bicycle ◽  
Healthy Participants

Background: Exercise has not been studied extensively in persons with active neuropathic diabetic foot wounds, primarily because a device does not exist that allows patients to exercise while sufficiently off-loading pressure at the ulcer site. The purpose of this project was to demonstrate a device that reduces cycling plantar forefoot pressure. Methods: Ten healthy participants rode a recumbent bicycle under three cycling conditions. While the left foot interaction remained constant with a standard gym shoe and pedal, the right foot was exposed to a control condition with standard gym shoe and pedal, gym shoe and specialized cleat, and gym shoe with an off-loading insole and specialized cleat. Pressure and contact area of the plantar aspect of the feet were recorded for a 10-sec interval once during each minute of each condition’s 7-min trial. Results: The off-loading insole and specialized cleat condition yielded significantly lower (P &lt; .01) peak pressure, contact area, and pressure–time integral values in the forefoot than the specialized cleat condition with gym shoe, which yielded significantly lower values (P &lt; .01) than the standard gym shoe and pedal. Conclusion: Modifications to footwear may alter plantar forefoot pressures, contact area, and pressure–time integrals while cycling. The CLEAR Cleat could play a significant role in the facilitation of fitness in patients with (or at high risk for) neuropathic wounds. (J Am Podiatr Med Assoc 98(4): 261–267, 2008)

scholarly journals Lower limb kinetic comparisons between the chasse step and one step footwork during stroke play in table tennis

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12481
Author(s):  
Yuqi He ◽  
Dong Sun ◽  
Xiaoyi Yang ◽  
Gusztáv Fekete ◽  
Julien S. Baker ◽  
...  
Keyword(s):  
Lower Limb ◽  
Peak Pressure ◽  
Table Tennis ◽  
Time Integral ◽  
Pressure Time ◽  
One Step ◽  
Force Time ◽  
The One ◽  
Plantar Force ◽  
Force Time Integral

Background Biomechanical footwork research during table tennis performance has been the subject of much interest players and exercise scientists. The purpose of this study was to investigate the lower limb kinetic characteristics of the chasse step and one step footwork during stroke play using traditional discrete analysis and one-dimensional statistical parameter mapping. Methods Twelve national level 1 table tennis players (Height: 172 ± 3.80 cm, Weight: 69 ± 6.22 kg, Age: 22 ± 1.66 years, Experience: 11 ± 1.71 year) from Ningbo University volunteered to participate in the study. The kinetic data of the dominant leg during the chasse step and one step backward phase (BP) and forward phase (FP) was recorded by instrumented insole systems and a force platform. Paired sample T tests were used to analyze maximum plantar force, peak pressure of each plantar region, the force time integral and the pressure time integral. For SPM analysis, the plantar force time series curves were marked as a 100% process. A paired-samples T-test in MATLAB was used to analyze differences in plantar force. Results One step produced a greater plantar force than the chasse step during 6.92–11.22% BP (P = 0.039). The chasse step produced a greater plantar force than one step during 53.47–99.01% BP (P < 0.001). During the FP, the chasse step showed a greater plantar force than the one step in 21.06–84.06% (P < 0.001). The one step produced a higher maximum plantar force in the BP (P = 0.032) and a lower maximum plantar force in the FP (P = 0) compared with the chasse step. The one step produced greater peak pressure in the medial rearfoot (P = 0) , lateral rearfoot (P = 0) and lateral forefoot (P = 0.042) regions than the chasse step during BP. In FP, the chasse step showed a greater peak pressure in the Toe (P = 0) than the one step. The one step had a lower force time integral (P = 0) and greater pressure time integral (P = 0) than the chasse step in BP, and the chasse step produced a greater force time integral (P = 0) and pressure time integral (P = 0.001) than the one step in the FP. Conclusion The findings indicate that athletes can enhance plantarflexion function resulting in greater weight transfer, facilitating a greater momentum during the 21.06–84.06% of FP. This is in addition to reducing the load on the dominant leg during landing by utilizing a buffering strategy. Further to this, consideration is needed to enhance the cushioning capacity of the sole heel and the stiffness of the toe area.

Plantar Pressure Measurements and Geometric Analysis of Patients With and Without Morton’s Neuroma

2018 ◽  
Vol 39 (7) ◽  
pp. 829-835 ◽  
Author(s):  
Reza Naraghi ◽  
Linda Slack-Smith ◽  
Alan Bryant
Keyword(s):  
Contact Time ◽  
Time Pressure ◽  
Peak Pressure ◽  
Control Subjects ◽  
Time Integral ◽  
Foot Progression Angle ◽  
Foot Length ◽  
Pressure Time ◽  
Arch Index ◽  
And Control

Background: The purpose of this research was to see if there were any differences in peak pressure, contact time, pressure-time integrals, and geometric variables such as forefoot width, foot length, coefficient of spreading, and arch index between subjects with Morton’s neuroma (MN) and control subjects. Methods: Dynamic peak plantar pressure, contact time, pressure-time integral, and geometric data were extracted using the EMED-X platform in 52 subjects with MN and 31 control subjects. Differences in peak pressure, contact time, pressure-time integral, and geometric data between participants with and those without MN were determined using independent-samples t tests. There were no significant differences in age, weight, height, and body mass index between patients with MN and control subjects. Results: There were no significant differences in the peak pressures of all masked areas and pressure-time integrals under metatarsal 2 to 4 heads between patients with MN and control subjects. In addition, no significant differences were observed between patients with MN and control subjects in geometric measurements of forefoot length, width, coefficient of spreading, foot progression angle, and arch index. Conclusion: No relationship was found in this study between peak pressure, contact time, and pressure-time integral under the metatarsal heads, forefoot width, foot length, coefficient of spreading, and foot progression angle in a symptomatic MN group compared with a control group. The need to perform osteotomies to treat MN not associated with other lesser metatarsal phalangeal joint pathologies is questionable. Level of Evidence: Level III, Case-Control Study

FOOT LOADING PATTERNS WITH DIFFERENT UNSTABLE SOLES STRUCTURE

2015 ◽  
Vol 15 (01) ◽  
pp. 1550014 ◽  
Author(s):  
QICHANG MEI ◽  
NENG FENG ◽  
XUEJUN REN ◽  
MAK LAKE ◽  
YAODONG GU
Keyword(s):  
Lower Limb ◽  
Peak Pressure ◽  
Technological Development ◽  
Healthy Male ◽  
Time Integral ◽  
Pressure Time ◽  
Loading Patterns ◽  
Foot Loading ◽  
Novel Concept ◽  
Male Subjects

Foot loading patterns can be changed by using different unstable sole structures, detailed quantification of which is of great significance for research and technological development in falling prevention and lower limb disorders rehabilitation. In this study, unstable soles constructions are adjusted through unstable elements in heel and medial, neutral and lateral forefoot and the foot loading patterns are comparatively studied. A total of 22 healthy male subjects participated in this test. Subjects are asked to walk over a 12 m walkway with control shoes and experimental shoes in self-adapted speed. Significant peak pressure, contact area and pressure-time integral differences in middle foot are found between control shoes and experimental shoes. In addition, peak pressure and pressure-time integral are found to increase significantly with unstable elements adding to center forefoot. The results showed that adjusting the unstable elements in coronal plane of forefoot could effectively alter the distribution of plantar pressure, this could potentially offer a mechanism for preventing falling of elderly and rehabilitation of lower extremity malfunctions. This study also demonstrates a novel concept that unstable element could be effectively adjusted in terms of position to meet different functional requirement.

Increased In-Shoe Lateral Plantar Pressures with Chronic Ankle Instability

2011 ◽  
Vol 32 (11) ◽  
pp. 1075-1080 ◽  
Author(s):  
Heather Schmidt ◽  
Lindsay D. Sauer ◽  
Sae Yong Lee ◽  
Susan Saliba ◽  
Jay Hertel
Keyword(s):  
Plantar Pressure ◽  
Peak Pressure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Maximum Force ◽  
Pressure System ◽  
Time To Peak ◽  
Time Integral ◽  
Pressure Time ◽  
Force Time

Background: Previous plantar pressure research found increased loads and slower loading response on the lateral aspect of the foot during gait with chronic ankle instability compared to healthy controls. The studies had subjects walking barefoot over a pressure mat and results have not been confirmed with an in-shoe plantar pressure system. Our purpose was to report in-shoe plantar pressure measures for chronic ankle instability subjects compared to healthy controls. Methods: Forty-nine subjects volunteered (25 healthy controls, 24 chronic ankle instability) for this case-control study. Subjects jogged continuously on a treadmill at 2.68 m/s (6.0 mph) while three trials of ten consecutive steps were recorded. Peak pressure, time-to-peak pressure, pressure-time integral, maximum force, time-to-maximum force, and force-time integral were assessed in nine regions of the foot with the Pedar-x in-shoe plantar pressure system (Novel, Munich, Germany). Results: Chronic ankle instability subjects demonstrated a slower loading response in the lateral rearfoot indicated by a longer time-to-peak pressure (16.5% ± 10.1, p = 0.001) and time-to-maximum force (16.8% ± 11.3, p = 0.001) compared to controls (6.5% ± 3.7 and 6.6% ± 5.5, respectively). In the lateral midfoot, ankle instability subjects demonstrated significantly greater maximum force (318.8 N ± 174.5, p = 0.008) and peak pressure (211.4 kPa ± 57.7, p = 0.008) compared to controls (191.6 N ± 74.5 and 161.3 kPa ± 54.7). Additionally, ankle instability subjects demonstrated significantly higher force-time integral (44.1 N/s ± 27.3, p = 0.005) and pressure-time integral (35.0 kPa/s ± 12.0, p = 0.005) compared to controls (23.3 N/s ± 10.9 and 24.5 kPa/s ± 9.5). In the lateral forefoot, ankle instability subjects demonstrated significantly greater maximum force (239.9N ± 81.2, p = 0.004), force-time integral (37.0 N/s ± 14.9, p = 0.003), and time-to-peak pressure (51.1% ± 10.9, p = 0.007) compared to controls (170.6 N ± 49.3, 24.3 N/s ± 7.2 and 43.8% ± 4.3). Conclusion: Using an in-shoe plantar pressure system, chronic ankle instability subjects had greater plantar pressures and forces in the lateral foot compared to controls during jogging. Clinical Relevance: These findings may have implications in the etiology and treatment of chronic ankle instability. Level of Evidence: III, Retrospective Case Control Study

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