Casting Methods and Plantar Pressure

2006 ◽  
Vol 96 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Nick A. Guldemond ◽  
Pieter Leffers ◽  
Antal P. Sanders ◽  
Hans Emmen ◽  
Nicolaas C. Schaper ◽  
...  
Keyword(s):  
Contact Area ◽  
Plantar Pressure ◽  
Neutral Position ◽  
Foot Orthoses ◽  
Contact Areas ◽  
Plantar Surface ◽  
Plantar Pressure Distribution ◽  
Plaster Casting ◽  
The Difference ◽  
Peak Pressures

Foot orthoses are widely used to treat various foot problems. A literature search revealed no publications on differences in plantar pressure distribution resulting from casting methods for foot orthoses. Four casting methods were used for construction of orthoses. Two foam box techniques were used: accommodative full weightbearing method (A) and functional semiweightbearing method (B). Also, two suspension plaster casting techniques were used: accommodative casting (C) and functional subtalar joint neutral position (Root) method (D). Their effects on contact area, plantar pressure, and walking convenience were evaluated. All orthoses increased the total contact area (mean, 17.4%) compared with shoes without orthoses. Differences in contact areas between orthoses for total plantar surface were statistically significant. Peak pressures for the total plantar surface were lower with orthoses than without orthoses (mean, 22.8%). Among orthoses, only the difference between orthoses A and B was statistically significant. Differences between orthoses for the forefoot were small and not statistically significant. The gait lines of the shoe without an insole and of the accommodative orthoses are more medially located than those of functional orthoses. Walking convenience in the shoe was better rated than that with orthoses. There were no differences in perception of walking convenience between orthoses A, B, and C. Orthosis D had the lowest convenience rating. The four casting methods resulted in differences between orthoses with respect to contact areas and walking convenience but only slight differences in peak pressures. (J Am Podiatr Med Assoc 96(1): 9–18, 2006)

The Effect of Tibiotalar Fixation on Foot Biomechanics

1997 ◽  
Vol 18 (12) ◽  
pp. 792-797 ◽  
Author(s):  
Jennifer S. Wayne ◽  
Keith W. Lawhorn ◽  
Kenneth E. Davis ◽  
Karanvir Prakash ◽  
Robert S. Adelaar
Keyword(s):  
Subtalar Joint ◽  
Sagittal Plane ◽  
Lower Limbs ◽  
Coronal Plane ◽  
Neutral Position ◽  
Talonavicular Joint ◽  
Tibiotalar Joint ◽  
Contact Areas ◽  
Joint Contact ◽  
Peak Pressures

Contact areas and peak pressures in the posterior facet of the subtalar and the talonavicular joints were measured in cadaver lower limbs for both the normal limb and after fixation of the tibiotalar joint. Six joints were fixed in neutral, in 5–7° of varus and of valgus. Ten degrees of equinus angulation was also studied. Each position of fixation was tested independently. Neutral was defined as fixation without coronal or sagittal plane angulation compared with prefixation alignment of the specimen. When compared with normal unfused condition, peak pressures increased, and contact areas decreased in the subtalar joint for specimens fixed in neutral, varus, and valgus. However, the change in peak pressure for neutral fusion compared with normal control was not statistically significant ( P > 0.07). Peak pressures for varus and valgus fixation were significantly different from normal ( P < 0.001). Contact areas for all positions of fixation were significantly different from normal ( P < 0.001). Coronal plane angulation, however, also resulted in significantly lower contact areas compared with neutral fixation ( P < 0.001). Contact areas and peak pressures in the talonavicular joint did not appear to be substantially affected by tibiotalar fixation with coronal plane angulation. Equinus fixation qualitatively increased contact areas and peak pressures in the talonavicular and posterior facet of the subtalar joint. Neutral alignment of the tibiotalar joint in the coronal and sagittal planes altered subtalar and talonavicular joint contact characteristics the least compared with normal controls. Therefore, ankle fusion in the neutral position would be expected to most closely preserve normal joint biomechanics and may limit the progression of degenerative arthrosis of the subtalar joint.

Plantar Pressure and Load in Cadaver Feet After a Weil or Chevron Osteotomy

2005 ◽  
Vol 26 (2) ◽  
pp. 158-165 ◽  
Author(s):  
John Snyder ◽  
John Owen ◽  
Jennifer Wayne ◽  
Robert Adelaar
Keyword(s):  
Contact Area ◽  
Plantar Pressure ◽  
Metatarsal Osteotomy ◽  
Plantar Surface ◽  
First Metatarsal ◽  
The Third ◽  
Load Transmission ◽  
Chevron Osteotomy ◽  
First Ray ◽  
Fresh Frozen

Background: Since metatarsal osteotomy was first used to treat metatarsalgia in the early twentieth century, many techniques have been described to accomplish the basic aim of reduction of load transmission through the operated metatarsal and reduction of localized high pressure on the plantar surface of the metatarsal. Our study examined two popular distal metatarsal neck osteotomies used for the relief of central metatarsalgia and the biomechanical changes that result from their use in a cadaver forefoot model. Methods: After applying 445N (100 lbs) of axially directed force, we measured plantar pressure using the TekScan HR Mat™ (TekScan, Inc., South Boston, MA) in twelve paired, thawed, fresh-frozen intact cadaver legs, then after either a Weil or chevron osteotomy of the second metatarsal and finally after the addition of the same osteotomy of the third metatarsal. Results: Load in the forefoot was not significantly affected by the Weil osteotomy. A significant increase in load was produced in the first metatarsal region, and significant decreases in load were produced beneath the operated metatarsal heads after the chevron osteotomy. Average pressure in the contact area of the forefoot showed similar trends; however, load and pressure changes occurred independently, owing to the changes in contact area produced by the osteotomies. No significant changes were observed in the nonoperated metatarsal regions. Conclusions: In this model, the chevron osteotomy more effectively reduced load and plantar pressure in the operated metatarsal regions; however, increases in load and pressure were observed in the first metatarsal region. The increase in pressure without a change in load in region 3 (third metatarsal) after a Weil osteotomy of the third metatarsal was attributed to the creation of a plantar prominence. This study did not show a reduction in load transmission as a result of the Weil osteotomy, which contradicts the proposed mechanism of clinical benefit. An intact first ray likely prevents transfer of load or pressure to adjacent lesser metatarsals with chevron osteotomy.

scholarly journals Alterations in the Plantar Pressure Patterns of Overweight and Obese Schoolchildren Due to Backpack Carriage

2013 ◽  
Vol 103 (4) ◽  
pp. 306-313 ◽  
Author(s):  
Massimiliano Pau ◽  
Bruno Leban ◽  
Marco Pau
Keyword(s):  
Contact Area ◽  
Plantar Pressure ◽  
Normal Weight ◽  
The Body ◽  
Long Term Effects ◽  
Contact Areas ◽  
Regular School ◽  
Plantar Pressures ◽  
School Day ◽  
Load Action

Background: Among other adverse consequences, childhood obesity is known to influence foot structure and functionality. Yet little information is available regarding how the physiologic foot-ground interaction is altered when a localized load is carried, as occurs in the case of schoolbags. We investigated plantar contact area and pressure modifications induced by backpack carriage under actual conditions. We hypothesized that a localized load acting on the body would further increase the already excessive plantar pressure that exists with overweight and obese status. Methods: Seventy overweight and obese schoolchildren aged 6 to 11 years underwent two 30-sec trials on a pressure platform during a regular school day, with and without a backpack. Total and subregion contact areas along with peak plantar pressures were obtained, and results were compared with those of an equal-numbered group of normal-weight schoolchildren. Results: Overweight and obese children generally had larger contact areas and higher peak plantar pressures compared with their normal-weight peers. In overweight and normal-weight participants, the backpack induced a similar generalized increase in contact area and pressures. However, the largest changes were observed in the forefoot, suggesting that load action tends to modify the physiologic pressure patterns. Conclusions: Backpack carriage raises the already elevated peak plantar pressures in overweight children during upright stance and modifies the physiologic pressure patterns. Further investigations are needed to clarify the features of such phenomenon when dynamic activities are performed and to verify the existence of fatigue and overexertion on the foot as well as other possible negative long-term effects. (J Am Podiatr Med Assoc 103(4): 306–313, 2013)

Comparison of plantar pressure distribution in CAD–CAM and prefabricated foot orthoses in patients with flexible flatfeet

The Foot ◽  
2017 ◽  
Vol 33 ◽  
pp. 76-80 ◽  
Author(s):  
Banafsheh Khodaei ◽  
Hassan Saeedi ◽  
Maryam jalali ◽  
Maede Farzadi ◽  
Ehsan Norouzi
Keyword(s):  
Pressure Distribution ◽  
Plantar Pressure ◽  
Foot Orthoses ◽  
Plantar Pressure Distribution ◽  
Cad Cam

scholarly journals Design and Preliminary Validation of Individual Customized Insole for Adults with Flexible Flatfeet Based on the Plantar Pressure Redistribution

Sensors ◽  
2021 ◽  
Vol 21 (5) ◽  
pp. 1780
Author(s):  
Yangzheng Jiang ◽  
Duojin Wang ◽  
Jiming Ying ◽  
Pengfei Chu ◽  
Yu Qian ◽  
...  
Keyword(s):  
Pressure Distribution ◽  
Contact Area ◽  
Plantar Pressure ◽  
Characteristic Analysis ◽  
Plantar Pressure Distribution ◽  
Preliminary Validation ◽  
Practical Evaluation ◽  
Characteristic Points ◽  
Stance Time ◽  
Orthotic Insoles

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.

scholarly journals An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Calvin T. F. Tse ◽  
Michael B. Ryan ◽  
Jason Dien ◽  
Alex Scott ◽  
Michael A. Hunt
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Pressure Distribution ◽  
Contact Area ◽  
Plantar Pressure ◽  
Load Distribution ◽  
Plantar Pressure Distribution ◽  
Arch Support ◽  
Knee Joint Load ◽  
Joint Load

Abstract Background Lateral wedge insoles (LWI), standalone or with medial arch support (supported-LWI), have been thoroughly investigated for their effects on modifying gait biomechanics for people with knee osteoarthritis. However, plantar pressure distribution between these insole types has not been investigated and could provide insight towards insole prescription with concomitant foot symptoms taken into consideration. Methods In a sample of healthy individuals (n = 40), in-shoe plantar pressure was measured during walking with LWI, with or without medial arch support (variable- and uniform-stiffness designs), and a flat control insole condition. Pressure data from the plantar surface of the foot were divided into seven regions: medial/lateral rearfoot, midfoot, medial/central/lateral forefoot, hallux. Plantar pressure outcomes assessed were the medial-lateral pressure index (MLPI) for the whole foot, and the peak pressure, pressure-time integral (PTI), and contact area in each plantar region. Comfort in each insole condition was rated as a change relative to the flat control insole condition. Repeated-measures analyses of variance were calculated to compare the plantar pressure outcomes between insole conditions. Results Regionally, medial rearfoot and forefoot pressure were reduced by all wedged insoles, with the variable-stiffness supported-wedge showing greater reductions than the standalone wedge. Lateral rearfoot and forefoot pressure were reduced by both supported-LWI, but unchanged by the standalone wedge. In the midfoot, the standalone wedge maintained pressure but reduced regional contact area, while both supported-LWI increased midfoot pressure and contact area. All LWI increased the MLPI, indicating a lateral shift in plantar pressure distribution throughout the weightbearing phase of gait. Comfort ratings were not significantly different between insole conditions. Conclusions Regional differences in plantar pressure may help determine an appropriate lateral wedge insole variation to avoid exacerbation of concomitant foot symptoms by minimizing pressure in symptomatic regions. Lateral shifts in plantar pressure distribution were observed in all laterally wedged conditions, including one supported-LWI that was previously shown to be biomechanically ineffective for modifying knee joint load distribution. Thus, shifts in foot centre of pressure may not be a primary mechanism by which LWI can modify knee joint load distribution for people with knee osteoarthritis.

The effects of calf muscles fatigue on dynamic plantar pressure distribution in normal foot posture and flexible flatfoot: A case-control study

2021 ◽  
pp. 1-9
Author(s):  
Muge Kirmizi ◽  
Yesim Salik Sengul ◽  
Salih Angin
Keyword(s):  
Pressure Distribution ◽  
Contact Area ◽  
Plantar Pressure ◽  
Maximum Force ◽  
Mixed Design ◽  
Plantar Pressure Distribution ◽  
Flexible Flatfoot ◽  
Before And After ◽  
Foot Posture ◽  
Calf Muscles

BACKGROUND: Flexible flatfoot is associated with altered plantar pressure distribution, but it is not clear how muscle fatigue affects plantar pressure characteristics in flexible flatfoot and normal foot. OBJECTIVE: To investigate the effects of calf muscles fatigue on plantar pressure variables in flexible flatfoot and normal foot. METHODS: Twenty-five people with flexible flatfoot and twenty-five people with normal foot were included. The unilateral heel-rise test was used to induce calf muscles fatigue. Plantar pressure variables were collected during preferred walking immediately before and after fatigue. The two-way mixed-design ANOVA was used to determine the main effect of fatigue and the interaction between foot posture and fatigue. RESULTS: Fatigue causes medialization of the contact area under the forefoot and the maximum force under the heel and forefoot (p< 0.05). When examining the differences in the effects of fatigue between groups, the contact area under the medial heel increased with fatigue in flexible flatfoot but decreased in normal foot; moreover, the contact area and maximum force under the midfoot and the maximum force under the third metatarsal decreased with fatigue in flexible flatfoot but increased in normal foot (p< 0.05). CONCLUSIONS: Calf muscles fatigue causes medialization of the maximum force and contact area. Especially the midfoot was affected differently by fatigue in flexible flatfoot and normal foot.

Influence of casting method on effectiveness of foot orthoses using plantar pressure distribution: a preliminary study

2011 ◽  
Vol 35 (4) ◽  
pp. 411-417 ◽  
Author(s):  
Tomaž Štajer ◽  
Helena Burger ◽  
Gaj Vidmar
Keyword(s):  
Plantar Pressure ◽  
Low Cost ◽  
Foot Orthoses ◽  
Casting Method ◽  
Double Blind ◽  
Plantar Pressure Distribution ◽  
Casting System ◽  
Wearing Off ◽  
Carry Over ◽  
Second Period

Background: Existing techniques of taking foot impressions for producing foot orthoses are static, while walking is a dynamic process. Objectives: The aim of the study was to evaluate a newly developed dynamic casting method for foot orthoses in comparison with static casts. Study Design: Double-blind, randomized two-period cross-over trial. Methods: Twelve healthy volunteers (six women, six men) were randomly assigned within gender to two groups. The first group wore orthoses made from static casts for two weeks and then orthoses made from dynamic casts for two weeks, and the second group vice versa. The orthoses were worn during work in sports shoes. The outcome measure was coefficient of variation (CV, defined as standard deviation/mean) over seven measurement spots on each foot. Results: Foot orthoses produced by a dynamic casting system redistributed plantar pressure (reduced CV) more effectively in the first period on both feet. In the second period, carry-over effect and/or treatment wearing off was observed. Conclusion: The dynamic casting procedure is simple, low-cost and appears promising, but further research is needed to introduce it into clinical practice.

The effect of prefabricated and proprioceptive foot orthoses on plantar pressure distribution in patients with flexible flatfoot during walking

2012 ◽  
Vol 37 (3) ◽  
pp. 227-232 ◽  
Author(s):  
Gholamreza Aminian ◽  
Zahra Safaeepour ◽  
Mahboobeh Farhoodi ◽  
Abbas Farjad Pezeshk ◽  
Hassan Saeedi ◽  
...  
Keyword(s):  
Pressure Distribution ◽  
Plantar Pressure ◽  
Sensory Stimulation ◽  
Maximum Force ◽  
Plantar Surface ◽  
Plantar Pressure Distribution ◽  
Gait Parameters ◽  
Flexible Flatfoot ◽  
Quasi Experimental ◽  
Foot Orthosis

Background:Previous studies have suggested that orthoses with different constructions could alter gait parameters in flexible flatfoot. However, there is less evidence about the effect of insoles with proprioceptive mechanism on plantar pressure distribution in flatfoot.Objectives:To assess the effect of orthoses with different mechanisms on plantar pressure distribution in subjects with flexible flatfoot.Study Design:Quasi-experimental.Methods:In total, 12 flatfoot subjects were recruited for this study. In-shoe plantar pressure in walking was measured by Pedar-X system under three conditions including wearing the shoe only, wearing the shoe with a proprioceptive insole, and wearing the shoe with a prefabricated foot insole.Results:Using the proprioceptive insoles, maximum force was significantly reduced in medial midfoot, and plantar pressure was significantly increased in the second and third rays (0.94 ± 0.77 N/kg, 102.04 ± 28.23 kPa) compared to the shoe only condition (1.12 ± 0.88 N/kg and 109.79 ± 29.75 kPa). For the prefabricated insole, maximum force was significantly higher in midfoot area compared to the other conditions ( p < 0.05).Conclusions:Construction of orthoses could have an effect on plantar pressure distribution in flatfeet. It might be considered that insoles with sensory stimulation alters sensory feedback of plantar surface of foot and may lead to change in plantar pressure in the flexible flatfoot.Clinical relevanceBased on the findings of this study, using orthoses with different mechanisms such as proprioceptive intervention might be a useful method in orthotic treatment. Assessing plantar pressure can also be an efficient quantitative outcome measure for clinicians in evidence-based foot orthosis prescription.

A portable plantar pressure system: Specifications, design, and preliminary results

2020 ◽  
Vol 28 (5) ◽  
pp. 553-560
Author(s):  
Michal Ostaszewski ◽  
Jolanta Pauk ◽  
Kacper Lesniewski
Keyword(s):  
Healthy Volunteer ◽  
Pressure Distribution ◽  
Plantar Pressure ◽  
Pressure Sensors ◽  
Pressure System ◽  
Distribution Measurement ◽  
Plantar Pressure Distribution ◽  
Portable System ◽  
Linearity Error ◽  
The Difference

BACKGROUND: In recent years, there has been an increasing interest in developing in-shoe foot plantar pressure systems. Although such devices are not novel, devising insole devices for gait analysis is still an important issue. OBJECTIVE: The goal of this study is to develop a new portable system for plantar pressure distribution measurement based on a three-axis accelerometer. METHODS: The portable system includes: PJRC Teensy 3.6 microcontroller with 32-bit ARM Cortex-M4 microprocessor with a clock speed of 180 MHz; HC-11 radio modules (transmitter and receiver); a battery; a fixing band; pressure sensors; MPU-9150 inertial navigation module; and FFC tape. The pressure insole is leather-based and consists of seven layers. It is divided into 16 areas and the outcome of the system is data concerning plantar pressure distribution under foot during gait. The system was tested on 22 healthy volunteer subjects, and the data was compared with a commercially available system: Medilogic. RESULT: The SNR value for the proposed sensor is 28.27 dB. For a range of pressure of 30–100 N, the sensitivity is 0.0066 V/N while the linearity error is 0.05. The difference in plantar pressure from both the portable plantar pressure system and Medilogic is not statistically significant. CONCLUSION: The proposed system could be recommended for research applications both inside and outside of a typical gait laboratory.

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