The Effect of Terrain on Foot Pressures During Walking

2005 ◽  
Vol 26 (10) ◽  
pp. 859-869 ◽  
Author(s):  
Olfat Mohamed ◽  
Kay Cerny ◽  
Wendy Jones ◽  
Judy M. Burnfield
Keyword(s):  
Repeated Measures ◽  
Metatarsal Head ◽  
First Metatarsal ◽  
Plantar Pressures ◽  
Time Integral ◽  
Pressure Time ◽  
Alpha Level ◽  
Mean Pressure ◽  
Musculoskeletal Pathology ◽  
Post Hoc

Background: High plantar pressures are associated with the development of foot ulcers in people with diabetic neuropathy. The effect of terrain on plantar pressures during walking has not been fully explored. Methods: Twenty 23- to 40-year-old subjects with no known musculoskeletal pathology walked across three terrains: padded carpet (R), grass (G), and concrete (C) while wearing Novel Pedar (Novel Electronics Inc. GMBH, Munich, Germany) insoles with and without shoes. Pressures were collected at 50 Hz. The sole of the foot was divided into: heel (H), lateral midfoot (LM), medial midfoot (MM), big toe and first metatarsal head (BT), and lateral toes and metatarsal heads (LT). Repeated measures ANOVA identified differences in pressures, forces, and contact areas across terrains. Post hoc Bonferroni adjustments were used to accept an overall alpha level of 0.05. Results: Peak pressure (PP), maximal mean pressure (MMP) and pressure time integral (PTI) were significantly higher ( p < 0.01) when walking barefoot on concrete than on grass or carpet for all foot regions except MM and LM. The percent increase in the three pressure variables ranged from 21% to 43%. Grass and carpet PP, MMP, and PTI were similar for the BT and LT. Wearing shoes significantly increased contact area and decreased all pressure variables on all three terrains. Conclusion: Walking barefoot, especially on concrete was associated with higher plantar pressure variables. Wearing shoes eliminated terrain differences in pressure except under the lesser toes. Persons with insensate feet should avoid walking barefoot on hard surfaces to avoid excessive plantar pressures. Wearing shoes and covering hard floors with nonslip, padded rugs may decrease plantar pressures and the risk of ulceration.

Plantar Pressures During Level Walking Compared with Other Ambulatory Activities

1994 ◽  
Vol 15 (6) ◽  
pp. 324-328 ◽  
Author(s):  
Steve Lundeen ◽  
Kurt Lundquist ◽  
Mark W. Cornwall ◽  
Thomas G. McPoil
Keyword(s):  
Repeated Measures ◽  
Experimental Conditions ◽  
Plantar Pressures ◽  
Time Integral ◽  
Level Walking ◽  
Pressure Time ◽  
Normal Individuals ◽  
Sensor Platform ◽  
Ambulatory Activities ◽  
Post Hoc

This study was designed to determine the magnitude of plantar pressures during level walking in comparison to other activities. These activities included climbing up stairs, going down stairs, a simple pivot while walking, and a crossover pivot while walking in normal individuals. Twelve volunteers, six men and six women, mean age 28 years, served as subjects. Data were collected on the dominant foot with an EMED-SF pressure sensor platform as each subject walked barefoot and did each of the five activities. Maximum plantar pressure (MPP) and pressure-time integral (PTI) was found in the metatarsal and heel regions. The results of repeated-measures analysis of variance tests showed that the five experimental conditions were statistically different for both MPP and PTI in the metatarsal and heel regions. Post hoc analysis indicated that MPP and PTI were decreased during the going down stairs condition in the heel and increased during the crossover pivot while walking and pivot while walking conditions for the metatarsal region.

scholarly journals Sex differences in pedobarographic findings and relationship between radiograph and pedobarograph measurements in young healthy adults

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Kyoung Min Lee ◽  
Seung Yeol Lee ◽  
Moon Seok Park ◽  
Ki Hyuk Sung ◽  
Seungbum Koo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Peak Pressure ◽  
Metatarsal Head ◽  
Healthy Adults ◽  
Tissue Thickness ◽  
First Metatarsal ◽  
Time Integral ◽  
Soft Tissue Thickness ◽  
Metatarsal Angle ◽  
Pressure Time

Category: Basic Sciences/Biologics Introduction/Purpose: Although pedobarographic measurement is increasingly used for clinical and research purposes, relatively few published studies have investigated normative data. This study examined pedobarographic findings in young healthy adults with regard to sex-related differences and correlations among measurement indices. Methods: Twenty young healthy adults (mean age 22.4 years, SD 1.2 years; 10 males and 10 females) were included. Weightbearing anteroposterior and lateral foot radiographs were taken, and dynamic pedobarographic data during treadmill walking and maximum ankle dorsiflexion were obtained. AP talo-first metatarsal angle, naviculocuboid overlap, lateral talo-first metatarsal angle, and plantar soft tissue thickness were measured on foot radiographs. Pedobarographic data including peak pressure and pressure-time integral were measured on five plantar segments: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel. Results: Male and female subjects significantly differed in BMI (p<0.001), AP talo-first metatarsal angle (p=0.018), soft tissue thickness under the metatarsal head (p=0.04) and calcaneal tuberosity (p<0.001), maximum dorsiflexion during stance phase (p=0.041), peak pressure on the MFF (p=0.005) and LFF (p=0.004), and pressure-time integral on the MFF (p=0.018) and heel (p=0.001). Maximum dorsiflexion demonstrated significant negative correlations with pressure-time integral on the MFF (r=-0.595, p=0.007) and total pressure-time integral (r=-0.492, p=0.032). Pressure-time integral varus/valgus index was significantly correlated with pressure-time integral forefoot/heel index (r=0.472, p=0.036). Conclusion: Sex-related differences in pedobarographic examination were observed. Achilles stretching exercise was considered to reduce foot pressures, and subtalar joint was hypothesized to play an important role in pressure distribution.

Effectiveness and Duration of Plantar Pressure Off-loading by Two Designs of Felt Padding: A Preliminary Study

2019 ◽  
Vol 109 (6) ◽  
pp. 431-436
Author(s):  
María Pilar Nieto-Gil ◽  
Ana Belen Ortega-Avila ◽  
Manuel Pardo-Rios ◽  
Gabriel Gijon-Nogueron
Keyword(s):  
Plantar Pressure ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Load Pressure ◽  
First Metatarsophalangeal Joint ◽  
Time Points ◽  
First Metatarsal ◽  
Plantar Pressures ◽  
Mean Pressure ◽  
Pressure Changes

Background: The aim of this study was to observe the pressure changes in the felt padding used to off-load pressure from the first metatarsal head, the effects obtained by different designs, and the loss of effectiveness over time. Method: With a study population of 17 persons, two types of 5-mm semicompressed felt padding were tested: one was C-shaped, with an aperture cutout at the first metatarsophalangeal joint, and the other was U-shaped. Pressures on the sole of the foot were evaluated with a platform pressure measurement system at three time points: before fitting the felt padding, immediately afterward, and 3 days later. Results: In terms of decreased mean pressure on the first metatarsal, significant differences were obtained in all of the participants (P &lt; .001). For plantar pressures on the central metatarsals, the differences between all states and time points were significant for the C-shaped padding in both feet (P &lt; .001), but with the U-shaped padding the only significant differences were between no padding and padding and at day 3 (P = .01 and P = .02). Conclusions: In healthy individuals, the U-shaped design, with a padding thickness of 5 mm, achieved a more effective and longer-lasting reduction in plantar pressure than the C-shaped design.

The Influence of Running on Foot Posture and In-Shoe Plantar Pressures

2016 ◽  
Vol 106 (2) ◽  
pp. 109-115 ◽  
Author(s):  
María Bravo-Aguilar ◽  
Gabriel Gijón-Noguerón ◽  
Alejandro Luque-Suarez ◽  
Javier Abian-Vicen
Keyword(s):  
Heel Strike ◽  
Neutral Position ◽  
Training Time ◽  
Plantar Pressures ◽  
Time Integral ◽  
Pressure Time ◽  
Limb Injuries ◽  
Before And After ◽  
Foot Posture ◽  
The Mean

Background: Running can be considered a high-impact practice, and most people practicing continuous running experience lower-limb injuries. The aim of this study was to determine the influence of 45 min of running on foot posture and plantar pressures. Methods: The sample comprised 116 healthy adults (92 men and 24 women) with no foot-related injuries. The mean ± SD age of the participants was 28.31 ± 6.01 years; body mass index, 23.45 ± 1.96; and training time, 11.02 ± 4.22 h/wk. Outcome measures were collected before and after 45 min of running at an average speed of 12 km/h, and included the Foot Posture Index (FPI) and a baropodometric analysis. Results: The results show that foot posture can be modified after 45 min of running. The mean ± SD FPI changed from 6.15 ± 2.61 to 4.86 ± 2.65 (P &lt; .001). Significant decreases in mean plantar pressures in the external, internal, rearfoot, and forefoot edges were found after 45 min of running. Peak plantar pressures in the forefoot decreased after running. The pressure-time integral decreased during the heel strike phase in the internal edge of the foot. In addition, a decrease was found in the pressure-time integral during the heel-off phase in the internal and rearfoot edges. Conclusions: The findings suggest that after 45 min of running, a pronated foot tends to change into a more neutral position, and decreased plantar pressures were found after the run.

Effect of Orthotic Therapy on Claw Toe Loading

2004 ◽  
Vol 94 (3) ◽  
pp. 246-254 ◽  
Author(s):  
Penny J. Claisse ◽  
Jodi Binning ◽  
Julia Potter
Keyword(s):  
Pressure Measurement ◽  
Plantar Pressure ◽  
Metatarsal Head ◽  
Plantar Surface ◽  
Time Integral ◽  
Pressure Time ◽  
Second Metatarsal ◽  
Plantar Pressure Measurement ◽  
Access To Data ◽  
Toe Deformity

This study demonstrates the effect of orthotic therapy for toe deformity on toe and metatarsal head pressures using a new analysis method facilitated by an in-shoe pressure-measurement system’s ability to export detailed data. Plantar pressure–time integrals in 11 individuals (22 feet) with claw deformity of the lesser toes were measured with and without toe props. Differences in pressure–time integrals at every individual sensor unit were then calculated for the two conditions, and significance was tested using the paired t-test. Plantar surface charts with contours of equal significant pressure–time integral change showed significant reduction under 17 second toes (77%), 22 third toes (100%), 15 fourth toes (68%), 13 second metatarsal heads (59%), 16 third metatarsal heads (73%), and 16 fourth metatarsal heads (73%). All 22 feet showed increases under the prop in the area of the third toe sulcus. This innovative approach to plantar pressure analysis could improve access to data that show significant pressure–time integral changes and, therefore, could advance the clinical application of plantar pressure measurement. (J Am Podiatr Med Assoc 94(3): 246–254, 2004)

Effectiveness of the Fixtoe Device® in Plantar Pressure Reduction: A Preliminary Study.

2021 ◽  
Author(s):  
Maria Ruiz-Ramos ◽  
Ángel Manuel Orejana-García ◽  
Ignacio Vives-Merino ◽  
Carmen Bravo-Llatas ◽  
José Luis Lázaro-Martínez ◽  
...  
Keyword(s):  
Plantar Pressure ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Clinical Results ◽  
Cross Sectional ◽  
Time Integral ◽  
Pressure Time ◽  
Second Metatarsal ◽  
Maximal Pressure ◽  
Taping Technique

Abstract Background: Metatarsalgia is a common foot condition. The metatarsophalangeal stabilizing taping technique described by Yu et al. has shown good clinical results as a provisional treatment in propulsive metatarsalgia. 35 The Fixtoe Device®, a novel orthopedic device, intends to simulate stabilizing tape. However, to date, there is no evidence of its effectiveness.Methods: The aim of this study was to assess plantar pressure changes using the Fixtoe Device®, in comparison with the traditional method (stabilizing tape) in a young, healthy sample thorough a cross-sectional study. Maximal pressure (Kpa) and pressure-time integral (Kpa/s) in the second metatarsal head were measured in twenty-four healthy volunteers. Registers were taken in four different conditions: barefoot, traditional stabilizing tape, Fixtoe Device® without metatarsal pad, and Fixtoe Device® with metatarsal pad. Results: Mean second metatarsal head maximal pressure and mean pressure-time integral showed statistical difference among the four analyzed conditions (p < 0.0001 in both cases). The improvement in maximal pressure and pressure-time integral obtained in each intervention also showed significance (p < 0.0001 in both cases). Comparing the improvement of the Fixtoe Device® with and without metatarsal pad with that of tape condition showed a moderate to high and moderate effect size for both peak pressure and pressure-time integral reduction.Conclusions: The Fixtoe Device® reduces median maximal pressure and median pressure-time integral under the second metatarsal head in healthy young individuals. The Fixtoe Device® shows higher effectiveness than the traditional second metatarsophalangeal joint stabilizing taping technique. To our knowledge, this is the first investigation proving the effectiveness of the recently developed Fixtoe Device® in terms of plantar pressure modification, which leads the way to its use in clinics.

scholarly journals Effect of insole material on lower limb kinematics and plantar pressures during treadmill walking

2011 ◽  
Vol 36 (1) ◽  
pp. 53-62 ◽  
Author(s):  
Aoife Healy ◽  
Dave N Dunning ◽  
Nachiappan Chockalingam
Keyword(s):  
Contact Area ◽  
Repeated Measures ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The Other ◽  
Medium Density ◽  
Ethyl Vinyl ◽  
Plantar Pressures ◽  
Time Integral ◽  
Material Conditions

Background: Currently there is a paucity of research providing recommendations on the type of orthotic or material used in its construction for different patient requirements.Objectives: To gain a greater understanding of the characteristics of orthotic materials and how they affect gait so to enhance the clinical decision-making process.Study Design: Repeated measures.Methods: Plantar pressures and kinematics were evaluated for 10 participants while walking on a treadmill under various conditions which included, shoes only and shoes with four different flat insoles and custom devices created in each of two densities of two materials.Results: For the flat insoles, medium density ethyl vinyl acetate was found to produce greater peak pressures than at least one of the other material conditions and low and medium density polyurethane were most effective at increasing average contact area and at reducing pressure time integral. For the custom devices, while no significant differences were evident, when compared to the shoe only condition, medium density polyurethane increased average contact area by a greater percentage than the other materials.Conclusions: Results for medium density polyurethane suggest a possible difference in loading characteristics, indicating a potential material suitability for patients with a compromised ability to deal with pressure.Clinical relevanceFindings from the present study provide information for a clinician to draw an evidence-based orthotic prescription based on material properties.

Plantar Pressures During Shod Gait in Diabetic Neuropathic Patients with and without a History of Plantar Ulceration

2009 ◽  
Vol 99 (4) ◽  
pp. 285-294 ◽  
Author(s):  
Isabel C. N. Sacco ◽  
Tatiana Almeida Bacarin ◽  
Maíra Grizzo Canettieri ◽  
Ewald M. Hennig
Keyword(s):  
Diabetic Neuropathy ◽  
Plantar Pressure ◽  
Clinical History ◽  
Control Group ◽  
Diabetic Patients ◽  
Plantar Pressures ◽  
Time Integral ◽  
Pressure Time ◽  
Plantar Ulcers ◽  
History Of

Background: Diabetic neuropathy leads to progressive loss of sensation, lower-limb distal muscle atrophy, autonomic impairment, and gait alterations that overload feet. This overload has been associated with plantar ulcers even with consistent daily use of shoes. We sought to investigate and compare the influence of diabetic neuropathy and plantar ulcers in the clinical history of diabetic neuropathic patients on plantar sensitivity, symptoms, and plantar pressure distribution during gait while patients wore their everyday shoes. Methods: Patients were categorized into three groups: a control group (CG; n = 15), diabetic patients with a history of neuropathic ulceration (DUG; n = 8), and diabetic patients without a history of ulceration (DG; n = 10). Plantar pressure variables were measured by Pedar System shoe insoles in five plantar regions during gait while patients wore their own shoes. Results: No statistical difference between neuropathic patients with and without a history of plantar ulcers was found in relation to symptoms, tactile sensitivity, and duration of diabetes. Diabetic patients without ulceration presented the lowest pressure–time integral under the heel (72.1 ± 16.1 kPa × sec; P = .0456). Diabetic patients with a history of ulceration presented a higher pressure–time integral at the midfoot compared to patients in the control group (59.6 ± 23.6 kPa × sec × 45.8 ± 10.4 kPa × sec; P = .099), and at the lateral forefoot compared to diabetic patients without ulceration (70.9 ± 17.7 kPa sec × 113.2 ± 61.1 kPa × sec, P = .0193). Diabetic patients with ulceration also presented the lowest weight load under the hallux (0.06 ± 0.02%, P = .0042). Conclusions: Although presenting a larger midfoot area, diabetic neuropathic patients presented greater pressure–time integrals and relative loads over this region. Diabetic patients with ulceration presented an altered dynamic plantar pressure pattern characterized by overload even when wearing daily shoes. Overload associated with a clinical history of plantar ulcers indicates future appearance of plantar ulcers. (J Am Podiatr Med Assoc 99(4): 285–294, 2009)

Effects of Preconditioning Local Vibrations on Subsequent Plantar Skin Blood Flow Response to Walking

2020 ◽  
pp. 153473462090574 ◽  
Author(s):  
Xiaotong Zhu ◽  
Fu-Lien Wu ◽  
Ting Zhu ◽  
Fuyuan Liao ◽  
Yuanchun Ren ◽  
...  
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Repeated Measures ◽  
Recovery Time ◽  
Reactive Hyperemia ◽  
Weight Bearing ◽  
Metatarsal Head ◽  
Foot Ulcers ◽  
Sham Control ◽  
First Metatarsal

Weight-bearing exercise such as walking may increase risk of foot ulcers in people with diabetes mellitus (DM) because of plantar ischemia due to repetitive, high plantar pressure. Applications of local vibrations on plantar tissues as a preconditioning intervention before walking may reduce plantar tissue ischemia during walking. The objective of this study was to explore whether preconditioning local vibrations reduce reactive hyperemia after walking. A double-blind, repeated-measures, and crossover design was tested in 10 healthy participants without DM. The protocol included 10-minute baseline, 10-minute local vibrations (100 Hz or sham), 10-minute walking, and 10-minute recovery periods. The order of local vibrations was randomly assigned. Skin blood flow (SBF) was measured over the first metatarsal head during baseline and recovery periods. SBF responses were characterized as peak SBF, total SBF, and recovery time of reactive hyperemia. SBF was expressed as a ratio of recovery to baseline SBF to quantify the changes. Peak SBF in the vibration protocol (6.98 ± 0.87) was significantly lower than the sham control (9.26 ± 1.34, P < .01). Total SBF in the vibration protocol ([33.32 ± 7.98] × 103) was significantly lower than the sham control ([48.09 ± 8.9] × 103, P < .05). The recovery time in the vibration protocol (166.08 ± 32.71 seconds) was not significantly different from the sham control (223.53 ± 38.85 seconds, P = .1). Local vibrations at 100 Hz could reduce walking-induced hyperemic response on the first metatarsal head. Our finding indicates that preconditioning local vibrations could be a potential preventive intervention for people at risk for foot ulcers.

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