A Comparison Study of Plantar Foot Pressure in a Standardized Shoe, Total Contact Cast, and Prefabricated Pneumatic Walking Brace

1997 ◽  
Vol 18 (1) ◽  
pp. 26-33 ◽  
Author(s):  
J.F. Baumhauer ◽  
R. Wervey ◽  
J. McWilliams ◽  
G.F. Harris ◽  
M.J. Shereff
Keyword(s):  
Peak Pressure ◽  
Foot Pressure ◽  
Total Contact Cast ◽  
Recommended Treatment ◽  
Time Integral ◽  
Custom Made ◽  
Plantar Ulcers ◽  
Total Contact Casting ◽  
Peak Pressures ◽  
Sensor Locations

Total contact casting is the current recommended treatment for Wagner Stage 1 and 2 neuropathic plantar ulcers. The rationale for this treatment includes the equalization of plantar foot pressures and generalized unweighting of the foot through a total contact fit at the calf. Total contact casting requires meticulous technique and multiple cast applications to avoid complications before ulcer healing. An alternative to total contact casting is the use of a prefabricated brace designed to maintain a total contact fit. This study compares plantar foot pressure metrics in a standardized shoe (SS), total contact cast (TCC), and prefabricated pneumatic walking brace (PPWB). Five plantar foot sensors (Interlink Electronics, Santa Barbara, CA) were placed at the first, third, and fifth metatarsal heads, fifth metatarsal base, and midplantar heel of 10 healthy male subjects. Each subject walked at a constant speed over a distance of 280 meters in a SS, PPWB, and TCC. A custom-made portable microprocessor-based system, with demonstrated accuracy and reliability, was used to acquire the data. No significant differences in peak pressure or contact duration were found between the initial and repeat SS trials ( P > 0.05). Peak pressures were reduced in the PPWB as compared to the SS for all sensor locations ( P < 0.05). Similarly, peak pressures were reduced in the TCC compared to the SS for all sensor locations ( P < 0.05) with the exception of the fifth metatarsal base ( P = 0.45). Our results are summarized as follows: (1) the methods used in the current study were found to be reliable through a test-retest analysis; (2) the PPWB decreased peak plantar foot pressures to an equal or greater degree than the TCC in all tested locations of the forefoot, midfoot, and hindfoot; (3) compared to a SS, contact durations were increased in both the TCC and PPWB for most sensor locations; and (4) the relationship of peak pressure over time, the pressure-time integral, is lower in the brace compared to the shoe at the majority of sensor locations. The values are not significantly different between the cast and shoe. These findings suggest an unweighting of the plantar foot and equalization of plantar foot pressures with both the PPWB and TCC. Based on these findings, the PPWB may be useful in the treatment of neuropathic plantar ulcerations of the foot.

Is TCC-EZ a Suitable Alternative to Gold Standard Total-Contact Casting?

2021 ◽  
Vol 111 (5) ◽  
Author(s):  
Umangi K. Bhatt ◽  
Hui Ying Foo ◽  
Mahalia P. McEvoy ◽  
Sarah J. Tomlinson ◽  
Cara Westphal ◽  
...  
Keyword(s):  
Gold Standard ◽  
Peak Pressure ◽  
Pressure Reduction ◽  
Reduced Pressure ◽  
Suitable Alternative ◽  
Total Contact Cast ◽  
Plantar Pressures ◽  
Signed Rank ◽  
Significant Difference ◽  
Peak Pressures

Background The total-contact cast (TCC) is the gold standard for off-loading diabetic foot ulcers (DFUs) given its nonremovable nature. However, this modality remains underused in clinical settings due to the time and experience required for appropriate application. The TCC-EZ is an alternative off-loading modality marketed as being nonremovable and having faster and easier application. This study aims to investigate the potential of the TCC-EZ to reduce foot plantar pressures. Methods Twelve healthy participants (six males, six females) were fitted with a removable cast walker, TCC, TCC-EZ, and TCC-EZ with accompanying brace removed. These off-loading modalities were tested against a control. Pedar-X technology measured peak plantar pressures in each condition. Statistical analysis of four regions of the foot (rearfoot, midfoot, forefoot, and hallux) was conducted with Friedman and Wilcoxon signed rank tests. Significance was set at P &lt; .05. Results All of the off-loading conditions significantly reduced pressure compared with the control, except the TCC-EZ without the brace in the hallux region. There was no statistically significant difference between TCC-EZ and TCC peak pressure in any foot region. The TCC-EZ without the brace obtained significantly higher peak pressures than with the brace. The removable cast walker produced similar peak pressure reduction in the midfoot and forefoot but significantly higher peak pressures in the rearfoot and hallux. Conclusions The TCC-EZ is a viable alternative to the TCC. However, removal of the TCC-EZ brace results in minimal plantar pressure reduction, which might limit clinical applications of the TCC-EZ.

Changes in Plantar Foot Pressure with In-Shoe Varus or Valgus Wedging

2004 ◽  
Vol 94 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Bart Van Gheluwe ◽  
Howard J. Dananberg
Keyword(s):  
Pressure Distribution ◽  
Loading Rate ◽  
Peak Pressure ◽  
Center Of Pressure ◽  
Scientific Evidence ◽  
Peak Load ◽  
Foot Orthoses ◽  
Foot Pressure ◽  
Custom Made

Varus and valgus wedging are commonly used by podiatric physicians in therapy with custom-made foot orthoses. This study aimed to provide scientific evidence of the effects on plantar foot pressure of applying in-shoe forefoot or rearfoot wedging. The plantar foot pressure distribution of 23 subjects walking on a treadmill was recorded using a pressure insole system for seven different wedging conditions, ranging from 3° valgus to 6° varus for the forefoot and from 4° valgus to 8° varus for the rearfoot. The results demonstrate that increasing varus wedging magnifies peak pressure and maximal loading rate at the medial forefoot and rearfoot, whereas increasing valgus wedging magnifies peak pressure and maximal loading rate at the lateral forefoot and rearfoot. As expected, the location of the center of pressure shifts medially with varus wedging and laterally with valgus wedging. However, these shifts are less significant than those in peak load and maximal loading rate. Timing variables such as interval from initial impact to peak load do not seem to be affected by forefoot or rearfoot wedging. Finally, rearfoot wedging does not significantly influence pressure variables of the forefoot; similarly, rearfoot pressure remains unaffected by forefoot wedging. (J Am Podiatr Med Assoc 94(1): 1-11, 2004)

Reliability of an In-Shoe Pressure Measurement System During Treadmill Walking

1996 ◽  
Vol 17 (4) ◽  
pp. 204-209 ◽  
Author(s):  
T. W. Kernozek ◽  
E. E. LaMott ◽  
M. J. Dancisak
Keyword(s):  
Measurement System ◽  
Pressure Measurement ◽  
Peak Pressure ◽  
Measurement Techniques ◽  
Peak Force ◽  
Foot Pressure ◽  
Time Integral ◽  
Pressure Time ◽  
Force Time ◽  
Pressure Measurement System

We examined the reliability of in-shoe foot pressure measurement using the Pedar in-shoe pressure measurement system for 25 participants walking at treadmill speeds of 0.89, 1.12, and 1.34 meters/sec. The measurement system uses EMED insoles, which consist of 99 capacitive sensors, sampled at 50 Hz. Data were collected for 20 seconds at two separate times while participants walked at each gait speed. Differences in some of the loading variables across speed relative to the total foot and across the different anatomical regions were detected. Different anatomical regions of the foot were loaded differently with variations in walking speed. The results indicated the need to control speed when evaluating loading parameters using in-shoe pressure measurement techniques. Coefficients of reliability were calculated. Variables such as peak force for the total foot required two steps to achieve a coefficient of reliability of 0.98. To achieve excellent reliability (>0.90) in the peak force, force time integral, peak pressure, and pressure time integral across the total foot and the seven regions, a maximum of eight steps was needed. In general, timing variables, such as the instant of peak force and the instant of peak pressure, tended to be the least reliable measures.

scholarly journals Effects of walking speed and slope on foot pressure in young healthy adults

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0030
Author(s):  
Kyoung Min Lee ◽  
Byung-Cho Min ◽  
Seungbum Koo
Keyword(s):  
Walking Speed ◽  
Peak Pressure ◽  
Healthy Adults ◽  
Basic Sciences ◽  
Foot Pressure ◽  
Time Integral ◽  
Pressure Time ◽  
Downhill Walking ◽  
Walking Speeds ◽  
Uphill Walking

Category: Basic Sciences/Biologics Introduction/Purpose: Although pedobarographic measurement is increasingly used for clinical and research purposes, relatively few published studies have investigated regarding effects of walking speed and slope. This study examined pedobarographic findings in young healthy adults with regard to different walking speeds and slopes. Methods: Twenty young healthy adults (mean age 22.4 years, SD 1.2 years; 10 males and 10 females) were recruited. Dynamic pedobarographic data were obtained during treadmill walking with different walking speeds (3.2 km/hr, 4.3 km/hr, and 5.4 km/hr) and slopes (-8°, -4°, 0°, 4°, and 8°). 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. Distribution of foot pressure between medial and lateral sides, and between anterior and posterior aspects were calculated as varus/valgus index and forefoot/heel index, respectively. Walking speed of 4.3 km/hr on 0° of slope was considered as standard walking condition. Results: Varus/valgus index of peak pressure showed significant increase on the slope of 8° and the walking speed of 4.3 km/hr (p=0.036) and 5.4 km/hr (p=0.007). Forefoot/heel index of peak pressure significantly decreased on downhill walking. Varus/valgus index of pressure-time integral showed significant increase when uphill and downhill slope was greater and walking speed was faster compared with standard with walking condition. Forefoot/heel index of pressure-time integral showed significant increase in downhill walking while significant decrease was observed during uphill walking. Conclusion: Changes of walking speed and slope caused those of foot pressure distribution. Therefore, combination of walking speed and speed might be associated with pressure related symptoms and disorders of the foot.

Reduction of Peak Pressure on the Forefoot with a Rigid Rocker-Bottom Postoperative Shoe

2001 ◽  
Vol 91 (10) ◽  
pp. 501-507 ◽  
Author(s):  
Eric Fuller ◽  
Stephen Schroeder ◽  
Jenifer Edwards
Keyword(s):  
Peak Pressure ◽  
Time Integral ◽  
Force Time ◽  
Injury Protection ◽  
Peak Pressures ◽  
Force Time Integral

An ideal postoperative shoe should be comfortable to wear and protect the foot during recovery from surgery or injury. Protection is assumed to be related to peak pressure and force-time integral under the foot. This study compared a commonly used postoperative shoe with a new postoperative shoe that incorporates a rigid sole with an 11° rocker bottom. The new postoperative shoe significantly reduced peak pressures on the forefoot by 20%. The amount of pressure and force-time integral reduction is compared with other values found in the literature for various shoe modifications. Indications for rocker-bottom shoes are also explored. (J Am Podiatr Med Assoc 91(10): 501-507, 2001)

Application of the method of dimensional analysis in laser-shock-wave processing of titanium alloys with shape memory

2021 ◽  
pp. 66-72
Author(s):  
Keyword(s):  
Shock Wave ◽  
Finite Element ◽  
Plastic Zone ◽  
Shape Memory ◽  
Dimensional Analysis ◽  
Peak Pressure ◽  
Laser Shock ◽  
Zone Depth ◽  
Peak Pressures ◽  
Laser Shock Wave

The processes of laser-shock-wave processing of NiTi alloys with shape memory effect are investigated by the methods of dimensional analysis and finite element modeling. The dependences of the depth of the plastic zone on the peak pressure in the shock wave and the duration of the laser pulse are obtained at different peak pressures. Keywords: shape memory alloys, laser-shock-wave processing, dimensional analysis, residual stresses, plastic zone depth. [email protected]

scholarly journals Foot pressure distributions during walking in African elephants ( Loxodonta africana )

2016 ◽  
Vol 3 (10) ◽  
pp. 160203 ◽  
Author(s):  
Olga Panagiotopoulou ◽  
Todd C. Pataky ◽  
Madeleine Day ◽  
Michael C. Hensman ◽  
Sean Hensman ◽  
...  
Keyword(s):  
Large Body ◽  
Loxodonta Africana ◽  
Centre Of Pressure ◽  
Mass Peak ◽  
Foot Care ◽  
African Elephants ◽  
Foot Pressure ◽  
Pressure Distributions ◽  
Foot Morphology ◽  
Peak Pressures

Elephants, the largest living land mammals, have evolved a specialized foot morphology to help reduce locomotor pressures while supporting their large body mass. Peak pressures that could cause tissue damage are mitigated passively by the anatomy of elephants' feet, yet this mechanism does not seem to work well for some captive animals. This study tests how foot pressures vary among African and Asian elephants from habitats where natural substrates predominate but where foot care protocols differ. Variations in pressure patterns might be related to differences in husbandry, including but not limited to trimming and the substrates that elephants typically stand and move on. Both species' samples exhibited the highest concentration of peak pressures on the lateral digits of their feet (which tend to develop more disease in elephants) and lower pressures around the heel. The trajectories of the foot's centre of pressure were also similar, confirming that when walking at similar speeds, both species load their feet laterally at impact and then shift their weight medially throughout the step until toe-off. Overall, we found evidence of variations in foot pressure patterns that might be attributable to husbandry and other causes, deserving further examination using broader, more comparable samples.

The effects of increasing heel height on forefoot peak pressure

1999 ◽  
Vol 89 (2) ◽  
pp. 75-80 ◽  
Author(s):  
MG Mandato ◽  
E Nester
Keyword(s):  
Measurement System ◽  
Pressure Measurement ◽  
Peak Pressure ◽  
First Metatarsal ◽  
Heel Height ◽  
Peak Pressures ◽  
Pressure Measurement System

The purpose of this study was to determine the effect of increasing heel height on peak forefoot pressure. Thirty-five women were examined while wearing sneakers and shoes with 2-inch and 3-inch heels. An in-shoe pressure-measurement system was used to document the magnitude and location of plantar peak pressures. Pressure under the forefoot was found to increase significantly with increasing heel height. As the heel height increased, the peak pressure shifted toward the first metatarsal and the hallux. The reproducibility of data obtained with the in-shoe pressure-measurement system was tested in five subjects; the data were found to be reproducible to within approximately 3% of measured pressures.

scholarly journals Analysis of Differences in the Degree of Biomechanical Adaptation according to Habituation to Different Heel Heights

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Yu-Jin Cha
Keyword(s):  
Peak Pressure ◽  
Plantar Flexion ◽  
Muscle Tension ◽  
Surface Emg ◽  
Foot Pressure ◽  
Maximum Voluntary Isometric Contraction ◽  
Heel Height ◽  
High Maximum ◽  
Eyes Open ◽  
Balance Ability

This study aims to comprehensively investigate whether there are any differences in the degree of biomechanical adaptation according to habituation to different heel heights. The biomechanical characteristics of 54 subjects in 3 groups habituated to three heel heights (low, medium-high, and high heels) were evaluated by the measurement of surface EMG, myotonometer (e.g., measurement of muscle tension), foot pressure, and lumbosacral angle, and comparative analysis was carried out to find out whether they showed differences in the comfort visual analog scale (comfort VAS). Wearers of high-heeled shoes (6 cm or more in heel height), in foot pressure comparison, showed significantly high peak pressure in the mask of the hallux, high maximum peak EMG in the gastrocnemius medius (GM), and a high percentage of maximum voluntary isometric contraction (%MVIC) in the plantar flexor. Wearers of low-heeled shoes (3 cm and below in heel height) showed the highest plantar peak pressure in the lateral forefoot and midfoot, the highest contact area in midfoot, the highest %MVIC in the plantar flexion and dorsiflexion of the tibialis anterior (TA), and the highest stiffness in the TA, and they showed the lowest static balance ability with eyes open (EO) among the three groups. It was found that there were significant differences between those habituated to high-heeled shoes and those not habituated to high-heeled shoes and that longtime wearing of high-heeled shoes brings about biomechanical adaptive changes in the human body.

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