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

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

Author(s):  
Yao Meng ◽  
Li Yang ◽  
Xin Yan Jiang ◽  
Bíró István ◽  
Yao Dong Gu

The objective of this study was to investigate the effectiveness of different hardness of personalized custom insoles on plantar pressure redistribution in healthy young males during walking and running. Six males participated in the walking and running test (age: 24±1.6 years, weight: 67.9±3.6 kg, height: 175.5±4.7 cm). All subjects were instructed to walk and run along a 10m pathway wearing two different hardness insoles (i.e., hard custom insoles (CHI) and soft custom insole (CSI)) and control insole (CI) at their preferred speed. Peak pressure, mean pressure, maximum force, pressure-time integral were collected to analyze using SPSS. The plantar pressure of forefoot and medial midfoot were significantly increased and of lateral forefoot and lateral midfoot were decreased by both kinds of custom insoles in running tests. While the CHI significantly increased plantar pressure of the medial forefoot compared with the CSI and CI both in walking and running tests. The custom insoles showed significantly higher plantar pressure on medial midfoot. But CSI seems better than CHI because of redistributing the plantar pressure by increasing the plantar pressure of whole forefoot. Moreover, CSI showed significantly lower plantar pressure than CI and CHI at lateral midfoot during running test. The CHI causes significant high pressure at medial forefoot (MF), which may raise the risk of forefoot pain.


2018 ◽  
Vol 108 (5) ◽  
pp. 355-361 ◽  
Author(s):  
Helen Branthwaite ◽  
Gemma Grabtree ◽  
Nachiappan Chockalingam ◽  
Andrew Greenhalgh

Background: Weakness of the toe flexor muscles has been attributed to the development of toe pathologies, and it responds well in the clinic to toe grip exercises. However, it is unknown whether exercising the toe flexor muscles improves the ability to grip and alter function. The aim of this study was to assess the effect of toe flexor exercises on apical plantar pressure, as a measure of grip, while seated and during gait. Methods: Twenty-three individuals with no known toe pathologies were recruited. Static peak pressure, time spent at peak pressure, and pressure-time integral while seated, as well as dynamic forefoot maximal force, contact area, and percentage contact time, were recorded before and after exercise. Toe grip exercises with a therapy ball were completed daily for 6 weeks. Results: Static peak pressure significantly increased after exercise on the apex of the second and third digits, as did the pressure-time integral. Dynamic peak force and contact area did not alter after exercise around the metatarsals and toes, yet percentage contact time significantly increased for each metatarsal after completing daily toe grip exercises. Conclusions: Exercises to improve the grip ability of the toes increased the static peak pressure on the apex of the second and third digits as well as the percentage contact time of the metatarsals during gait. The ability to increase apical peak pressure and contact time after exercises could assist in improving forefoot stability and gait efficiency and in reducing toe pathology progression.


2008 ◽  
Vol 98 (4) ◽  
pp. 261-267 ◽  
Author(s):  
Erin E. Klein ◽  
Ryan T. Crews ◽  
Stephanie C. Wu ◽  
James S. Wrobel ◽  
David G. Armstrong

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 < .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 < .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)


PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8551 ◽  
Author(s):  
Lovro Štefan ◽  
Mario Kasović ◽  
Martin Zvonar

Background The main purpose of the study was to determine whether lower levels of physical activity were associated with higher plantar pressure generated under each foot. Methods In this cross-sectional study, we recruited 641 children aged 6–14 years (agemean ± SD = 9.7  ± 2.4 years; heightmean ± SD = 143.6  ± 15.3 cm, weightmean ± SD = 37.6  ± 13.4 kg; body-mass indexmean ± SD = 17.6  ± 3.2 kg/m2; 44.2% girls). We used EMED –XL pressure platform to measure force time integral, pressure-time integral, contact-time and contact area, peak plantar pressure and mean plantar pressure of the right and the left foot during the gait analysis. The level of physical activity was measured by using The Physical Activity Questionnaire for Older Children (PAQ–C). The associations were calculated by using generalized estimating equations with linear regression models. Results Lower levels of physical activity were associated with higher force- and pressure-time integrals, longer contact time and higher peak and mean plantar pressures in both feet. Conclusion Our study shows that the level of physical activity is strongly and inversely associated with plantar pressure in a sample of 6–14 year olds.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12481
Author(s):  
Yuqi He ◽  
Dong Sun ◽  
Xiaoyi Yang ◽  
Gusztáv Fekete ◽  
Julien S. Baker ◽  
...  

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.


2014 ◽  
Vol 104 (2) ◽  
pp. 125-133 ◽  
Author(s):  
Jeanna M. Fascione ◽  
Ryan T. Crews ◽  
James S. Wrobel

Background The use of foot measurements to classify morphology and interpret foot function remains one of the focal concepts of lower-extremity biomechanics. However, only 27% to 55% of midfoot variance in foot pressures has been determined in the most comprehensive models. We investigated whether dynamic walking footprint measurements are associated with inter-individual foot loading variability. Methods Thirty individuals (15 men and 15 women; mean ± SD age, 27.17 ± 2.21 years) walked at a self-selected speed over an electronic pedography platform using the midgait technique. Kinetic variables (contact time, peak pressure, pressure-time integral, and force-time integral) were collected for six masked regions. Footprints were digitized for area and linear boundaries using digital photo planimetry software. Six footprint measurements were determined: contact area, footprint index, arch index, truncated arch index, Chippaux-Smirak index, and Staheli index. Linear regression analysis with a Bonferroni adjustment was performed to determine the association between the footprint measurements and each of the kinetic variables. Results The findings demonstrate that a relationship exists between increased midfoot contact and increased kinetic values in respective locations. Many of these variables produced large effect sizes while describing 38% to 71% of the common variance of select plantar kinetic variables in the medial midfoot region. In addition, larger footprints were associated with larger kinetic values at the medial heel region and both masked forefoot regions. Conclusions Dynamic footprint measurements are associated with dynamic plantar loading kinetics, with emphasis on the midfoot region.


1999 ◽  
Vol 89 (10) ◽  
pp. 495-501 ◽  
Author(s):  
TG McPoil ◽  
MW Cornwall ◽  
L Dupuis ◽  
M Cornwell

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.


2010 ◽  
Vol 100 (1) ◽  
pp. 14-24 ◽  
Author(s):  
Shuping Xiong ◽  
Ravindra S. Goonetilleke ◽  
Channa P. Witana ◽  
Thilina W. Weerasinghe ◽  
Emily Yim Lee Au

Background: The medial longitudinal arch of the foot is important because it helps protect the foot from injury. Researchers have developed many measures to quantify the characteristics of the arch, and there is ongoing debate about the suitability of these different metrics. This article compares the various measures related to the foot arch, including a new metric, the midfoot dorsal angle, and then investigates the differences in the dimensional measures among various foot types. Methods: The right feet of 48 healthy individuals (24 men and 24 women) were measured, and various metrics, including the arch height index, the navicular height to arch length ratio, the arch index, the footprint index, the subjective ranking, the modified arch index, the malleolar valgus index, and the midfoot dorsal angle, were determined. Results: Correlation analyses showed that the arch index obtained from the inked footprint has a moderate to high correlation (Pearson correlation coefficients &gt;0.50) with all measured foot-type metrics except for the malleolar valgus index. There were no differences in participant age, stature, weight, body mass index, foot length, foot width, and midfoot height among high, normal, and low foot arches. However, the high-arched group had significantly shorter arch lengths but larger navicular heights and higher midfoot dorsal angles compared with the low-arched group. There were differences in force distributions and peak pressures as well. The rearfoot had more loading and greater peak pressure whereas the midfoot had less load in the high-arched group compared with the low-arched group. Conclusions: The midfoot dorsal angle may be an appropriate metric for characterizing the foot arch because it is quick and easy to measure, without the tedious procedures associated with area calculations and dimension measurements. (J Am Podiatr Med Assoc 100(1): 14–24, 2010)


2015 ◽  
Vol 15 (01) ◽  
pp. 1550014 ◽  
Author(s):  
QICHANG MEI ◽  
NENG FENG ◽  
XUEJUN REN ◽  
MAK LAKE ◽  
YAODONG GU

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.


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