Effects of Different External Supports on Plantar Pressure-Time Integral and Contact Area in Flexible Flatfoot

2021 ◽  
Vol 111 (3) ◽  
Author(s):  
Banu Ünver ◽  
Nilgün Bek
Keyword(s):  
Contact Area ◽  
Plantar Pressure ◽  
Dynamic Pressure ◽  
Foot Orthoses ◽  
Time Integral ◽  
Pressure Time ◽  
Flexible Flatfoot ◽  
Custom Made ◽  
External Supports ◽  
The Right

Background Flexible flatfoot disturbs the load distribution of the foot. Various external supports are used to prevent abnormal plantar loading in flexible flatfoot. However, few studies have compared the effects of different external supports on plantar loading in flexible flatfoot. The objective of this study was to investigate the effects of elastic taping, nonelastic taping, and custom-made foot orthoses on plantar pressure-time integral and contact area in flexible flatfoot. Methods Twenty-seven participants with flexible flatfoot underwent dynamic pedobarographic analysis while barefoot and with elastic tape, nonelastic tape, and custom-made foot orthoses. Results Pressure-time integral percentage was higher with foot orthoses than in the barefoot and taping conditions in the midfoot (P < .001) and was lower with foot orthoses than in barefoot in the right forefoot (P < .05). Pressure-time integral values were lower with foot orthoses in the second, third, and fourth metatarsals and the lateral heel (P < .05). With foot orthoses, contact area values were higher in the toes; second, third, and fourth metatarsi; midfoot; and heel compared with the other conditions (P < .05). Pressure-time integral in the right lateral heel and contact area in the left fourth metatarsal increased with nonelastic taping versus barefoot (P < .05). Conclusions Foot orthoses are more effective in providing dynamic pressure redistribution in flexible flatfoot. Although nonelastic taping has some effects, taping methods may be insufficient in altering the measured pedobarographic values in this condition.

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 < .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)

scholarly journals Association between the levels of physical activity and plantar pressure in 6-14-year-old children

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8551 ◽  
Author(s):  
Lovro Štefan ◽  
Mario Kasović ◽  
Martin Zvonar
Keyword(s):  
Physical Activity ◽  
Plantar Pressure ◽  
Contact Time ◽  
Cross Sectional Study ◽  
Linear Regression Models ◽  
Older Children ◽  
Cross Sectional ◽  
Time Integral ◽  
Pressure Time ◽  
The Right

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.

The Effect of Toe Flexion Exercises on Grip

2018 ◽  
Vol 108 (5) ◽  
pp. 355-361 ◽  
Author(s):  
Helen Branthwaite ◽  
Gemma Grabtree ◽  
Nachiappan Chockalingam ◽  
Andrew Greenhalgh
Keyword(s):  
Contact Area ◽  
Plantar Pressure ◽  
Contact Time ◽  
Peak Pressure ◽  
Peak Force ◽  
Time Integral ◽  
Pressure Time ◽  
Flexor Muscles ◽  
Before And After ◽  
Force Contact

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.

Biomechanical Response to External Biofeedback During Functional Tasks in Individuals With Chronic Ankle Instability

2021 ◽  
Author(s):  
Danielle M. Torp ◽  
Abbey C. Thomas ◽  
Tricia Hubbard-Turner ◽  
Luke Donovan
Keyword(s):  
Real Time ◽  
Plantar Pressure ◽  
Ankle Instability ◽  
Static Balance ◽  
Eyes Closed ◽  
Visual Biofeedback ◽  
Time Integral ◽  
Pressure Time ◽  
Eyes Open ◽  
Functional Task

Context Altered biomechanics displayed by individuals with chronic ankle instability (CAI) is a possible cause of recurring injuries and posttraumatic osteoarthritis. Current interventions are unable to modify aberrant biomechanics, leading to research efforts to determine if real-time external biofeedback can result in changes. Objective To determine the real-time effects of visual and auditory biofeedback on functional-task biomechanics in individuals with CAI. Design Crossover study. Setting Laboratory. Patients or Other Participants Nineteen physically active adults with CAI (7 men, 12 women; age = 23.95 ± 5.52 years, height = 168.87 ± 6.94 cm, mass = 74.74 ± 15.41 kg). Intervention(s) Participants randomly performed single-limb static balance, step downs, lateral hops, and forward lunges during a baseline and 2 biofeedback conditions. Visual biofeedback was given through a crossline laser secured to the dorsum of the foot. Auditory biofeedback was given through a pressure sensor placed under the lateral foot and connected to a buzzer that elicited a noise when pressure exceeded the set threshold. Cues provided during the biofeedback conditions were used to promote proper biomechanics during each task. Main Outcome Measure(s) We measured the location of center-of-pressure (COP) data points during balance with eyes open and eyes closed for each condition. Plantar pressure in the lateral column of the foot during functional tasks was extracted. Secondary outcomes of interest were COP area and velocity, time to boundary during static balance, and additional plantar-pressure measures. Results Both biofeedback conditions reduced COP in the anterolateral quadrant while increasing COP in the posteromedial quadrant of the foot during eyes-open balance. Visual biofeedback increased lateral heel pressure and the lateral heel and midfoot pressure-time integral during hops. The auditory condition produced similar changes during the eyes-closed trials. Auditory biofeedback increased heel pressure during step downs and decreased the lateral forefoot pressure-time integral during lunges. Conclusions Real-time improvements in balance strategies were observed during both external biofeedback conditions. Visual and auditory biofeedback appeared to effectively moderate different functional-task biomechanics.

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)

Efficacy of Plantar Loading Parameters During Gait in Terms of Reliability, Variability, Effect of Gender and Relationship Between Contact Area and Plantar Pressure

2005 ◽  
Vol 26 (2) ◽  
pp. 171-179 ◽  
Author(s):  
Darlene F. Murphy ◽  
Bruce D. Beynnon ◽  
James D. Michelson ◽  
Pamela M. Vacek
Keyword(s):  
Gender Differences ◽  
Measurement System ◽  
Contact Area ◽  
Plantar Pressure ◽  
Collegiate Athletes ◽  
Single Subject ◽  
Radiographic Measurements ◽  
Multiple Trials ◽  
Highly Correlated ◽  
The Right

Background: The purpose of this study was to determine plantar pressure and contact areas of the foot inside the athletic shoe during activity. The objectives were to determine if plantar pressure and contact area measurements collected on multiple trials from the same subject were reliable, to determine the variability of measurements between subjects as compared to that found between steps within a single subject, to determine the relationship between contact area and plantar pressure, and to ascertain whether there were any systematic gender differences in these measurements. Methods: Sixteen healthy adults volunteered for participation in the first part of the study that was designed to determine reliability and variability of the testing methodology. A separate group of fifty healthy high school and collegiate athletes participating in soccer, field hockey, basketball, and lacrosse comprised the second part of the study that was designed to investigate gender differences in terms of normalized midfoot plantar pressure and contact area, and the interrelationship between the two measurements. Data were collected during the midstance phase of gait, using the Pedar inshoe measurement system (Novel GMBH, St. Paul, MN). Athletes wore their own athletic shoes and performed walking trials on a surface similar to that used in their sport. The foot was divided into four regions based on radiographic measurements. Results: The midfoot region demonstrated excellent reliability across multiple trials of the same subject in contact area and plantar pressure, and the variability between steps within a single subject was small when compared to that between subjects. Normalized midfoot contact area and plantar pressure values were highly correlated with r values of 0.862 on the left foot and. 912 on the right foot. No significant differences were found in normalized midfoot contact area or plantar pressure values between males and females. Conclusions: The Pedar in-shoe pressure measurement system can be used reliably to quantify contact area and plantar pressure beneath the midfoot region during the midstance phase of gait. This measurement technique can now be used in risk factor studies designed to identify individuals at risk for injury to the foot, ankle, and other lower extremity structures.

scholarly journals What Should Be the Determinant of Treatment for Juveniles with Flexible Flatfeet?

2020 ◽  
Author(s):  
JunNa Zhai ◽  
YuSheng Qiu ◽  
Lina Shao
Keyword(s):  
Exercise Therapy ◽  
Contact Area ◽  
Plantar Pressure ◽  
Living Standards ◽  
Repeated Measure ◽  
Control Group ◽  
Pressure Data ◽  
Flexible Flatfoot ◽  
Load Rate ◽  
Experimental Group

Abstract Background: It is still controversial that if juveniles with flexible flatfeet need to be treated. Some believed they did not need the treatment unless they felt pain after exercise. However, as living standards rise, the amount of exercise among teenagers is declining. The juveniles with flexible flatfeet don’t feel pain not because they don’t have symptoms, but because they rarely walk. This study recruited juveniles with flexible flatfoot to find out if there was other determinant of treatment. Methods: We recruited an experimental group with 20 severe flexible flatfeet and a control group with 20 severe flexible flatfeet. The contact area and load rate were measured separately. Then the subjects of experimental group were treated by exercise therapy for 8 weeks, and the plantar pressure data were measured again. The repeated measure was used to analyze the data. Results: The contact area and load rate of mid foot decreased significantly in experimental group after 8-week treatment. All the subjects of experimental group did not feel any uncomfortable during the treatment. While the two kinds of data in control group were not changed much between pre-after measurements. Conclusion: Exercise therapy could effectively improve the severe flexible flatfoot. If the juveniles with flexible flatfoot need the treatment should not depend on the symptoms only, but also on the severity. The juveniles with severe flexible flatfoot should be treated as soon as diagnosed.

scholarly journals The Difference of In-Shoe Plantar Pressure Between Level Walking and Stair Walking

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0026
Author(s):  
Min Gyu Kyung ◽  
Chungho Lee ◽  
Jae Hee Lee ◽  
Yoon Jae Cho ◽  
Cao Linying ◽  
...  
Keyword(s):  
High Pressure ◽  
Plantar Pressure ◽  
Pressure Load ◽  
Stair Ascent ◽  
Time Integral ◽  
Stair Descent ◽  
Level Walking ◽  
Pressure Time ◽  
Stair Walking ◽  
Peak Pressures

Category: Basic Sciences/Biologics Introduction/Purpose: Stair walking is one of common activities of daily living. It is more demanding than level walking and can aggravate discomfort of the foot, such as Morton’s neuroma, plantar fasciitis, Achilles tendinitis, pressure related-ulcer, and etc. Therefore, analysis of increased pressure in specific plantar area at stair walking can be used as a risk assessment of foot discomfort and basic data in the clinical field. The purpose of this study is to analyze plantar pressure distribution and pressure patterns during gait cycle at stair walking compared to level walking. Methods: Fourty healthy male adults were recruited. Radiologic measurements and gait analysis were performed to check participants’ normality, and 35 healthy males with 20-28 years old were included. They performed level walking (18 meters walkway), stair (26 steps stair, height:16.7 cm, depth:29.8 cm) ascending, and descending in same type of running shoes. Measurements of in-shoe plantar pressure including peak pressure, pressure-time integral (PTI) were done by Pedar-X system. Only measurements of right steps were used to exclude the effect of the dominant foot. The sole was masked in 7 segments (hallux, 2nd-5th toes, medial forefoot, central forefoot, lateral forefoot, midfoot, heel region) to analyze properly. Percentages were assigned in relation to the size for each mask segment. Statistical analysis was performed using repeated measure ANOVA, and Bonferroni post hoc test was done. Results: Mean peak pressures in all regions except for the midfoot were higher during level walking than stair walking. During stair descent, mean peak pressures in all the regions except for the midfoot were generally lower than other types of walking, but it was the highest in the midfoot region. Pressure time integral (PTI) in the medial and central forefoot was higher during stair descent than level walking. PTI in the central and lateral forefoot, and the midfoot was higher when stair ascending than level walking. Pressure time integral (PTI) in the heel region was the highest during level walking, followed by stair ascent, stair descent. Conclusion: The risk of aggravation of discomfort in the midfoot area increases when stair descending. The medial region of forefoot bear high pressure load during stair descent, and the lateral region of forefoot and the midfoot region bear high pressure load during stair ascent. This is the first study to show plantar pressure patterns during level and stair walking in the large healthy gender-controlled population. We recommend that patients with pressure related foot lesions in the forefoot or midfoot avoid stair walking.

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.

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