Changes in plantar pressures in children

NewsBot · Jul 19, 2013

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A cross-sectional study of age-related changes in plantar pressure distribution between 4 and 7 years: A comparison of regional and pixel-level analyses
Jill Phethean, Todd C. Patakyemail address, Christopher J. Nester, Andrew H. Findlow
Gait & Posture; Article in Press

Quantifying morphological and functional development in children's feet, and thereby establishing development norms is difficult. In addition to practical challenges of experimentation on children, measurement equipment like plantar pressure (PP) platforms are almost exclusively geared towards adult-sized feet. These PP quantification problems may be exacerbated by typical regional data analysis techniques, which further reduce spatial resolution. The goal of this study was to quantify PP distributions in developing children, and also to compare the results obtained from typical (regional) techniques with those obtained from a higher-resolution (pixel-level) technique. Ninety-eight children between four and seven years of age were assessed in a cross-sectional design. Maximum PP distributions were collected for each child, and these pressures were linearly regressed against age. Present results agree with previous investigations in that maximum pressures and maximum pressure changes occurred in the forefoot. However, results from the present pixel-level technique suggest that these changes are limited to the central metatarsals, and that regional methods can suggest significance where none exists in the actual raw (pixel-level) data, due to signal aliasing and, in particular, to conflation of regional boundaries. We postulate that increased central metatarsal pressures are reflective of the coupling between generalised joint laxity decreases and relatively increasingly inclined central metatarsal bones with age.
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•We examined age-related plantar pressure changes in young children.
•Regional pressures increased with age at the central metatarsals and medial midfoot.
•Pixel data disagreed with regional midfoot and heel data and were also more detailed.
•Pixel data showed that children's feet tend to become longer and narrower with age.
•Pixel-level analysis overcomes regional analysis’ inadequate spatial resolution.
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NewsBot · Feb 24, 2017

The Mechanism of Force Transference in Feet of Children Ages Two to Six
Mingyu Hu et al
Gait and Posture; Article in Press

Highlights
•An algorithm was designed to quantify the plantar force transferences of toddlers;.
•Intra-, inter- and across-level force transferences were calculated within ages;.
•Both transverse and longitudinal arches had developed at an early stage of toddlerhood;.
•Arches are an important attractor engaged in the windlass mechanism while walking
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The aim of this study was to design an algorithm to quantify the plantar force transference of children from ages 2 to 6. In total, 319 healthy children without abnormal gait patterns, foot deformities or injuries, able to walk independently, and with normal BMIs were recruited, and their plantar force distributions were measured. Their plantar areas were divided into ten parts: the hallux, toes #2-5, the first to fifth metatarsal heads (1st to 5th MTH), the mid-foot (MF), medial heel (MH) and lateral heel (LH), in which a relative force-time integral (FTIrel) (%) was calculated. Our results show that the FTIrel was significantly transferred along either the transverse or longitudinal arches. The middle of the forefoot and the toe areas were the two main loading regions in children aged 2-3, and posterior to anterior FTIrel shifting was typical. However, anterior to posterior and lateral to medial FTI transferences were found in children aged 5-6, and major loading was found in the heel area. Further, loading in the mid-foot varied with the child's development and was observed to tend to decrease over time. Overall, according to the algorithm designed in this study, these results demonstrated that the development of the arches, both in transverse and longitudinal directions, had already begun in early stages of toddlerhood. Meanwhile, the arches were an important attractor engaged in the windlass mechanism while walking, and they played a major role as bridges to promote posterior to anterior and medial to lateral force transference.
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NewsBot · Feb 5, 2019

Ensembling rules in automatic analysis of pressure on plantar surface in children with pes planovalgus
MarcinDerlatkaaMikhailIhnatouskibMarekJałbrzykowskiaVladimirLashkovskicŁukaszMinarowskid
Advances in Medical Sciences; Volume 64, Issue 1, March 2019, Pages 181-18

Purpose
This paper presents a method of ensembling rules obtained through induction of several basic types of decision trees.

Material and methods
The proposed method uses rules generated by means of well-known decision trees: CART, CHAID, exhaustive CHAID and C4.5. The method was tested on data describing pressure distribution under foot during gait in children with pes planovalgus (PV) and typical foot. Children with pes planovalgus underwent surgical intervention and were re-examined. Overall, 316 gait cycles have been used in analysis.

Results
The obtained results consist of a set of rules for all considered cases and show that the proposed method may be a useful tool of gait analysis on the basis of parameters that have a physical interpretation.

Conclusions
The presented method for mining rules useful in this respect may be successfully used by persons with a typically medical knowledge and could improve the understanding of the human gait phenomenon. There is obviously no reason why this method could not be used in the case of other data as well.
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NewsBot · May 1, 2019

Running and Walking Foot Loading in Children Aged 4-10 Years
Paula Ribeiro Mesquita et al
Journal of Applied Biomechanics Volume: 0 Issue: 0 Pages: 1-17

While previous reports have provided normative plantar pressure data for walking in children, evaluation during running is lacking. Our study aimed to compare foot loading patterns during running and walking in children aged 4-10 years. Furthermore, the relationship between running baropodometric parameters and anthropometric measures was investigated. Foot loading of 120 volunteers was evaluated during running and walking using an Emed AT-4 pressure platform. Analyses were performed for 5 anatomical regions (rearfoot, midfoot, forefoot, hallux and lesser toes). Higher peak pressure and maximum force values were seen under most foot regions during running in comparison to walking, while relative contact area tended to increase only in the midfoot. Data for running indicated that aging explained less than 23% of the variance of plantar loads and contact area. Running foot loads were more associated with height, body mass and foot length. Our data described plantar loads under the feet of children were greater during running. Aging was associated with little increase in running plantar loads and larger contact areas. Results may be useful as reference to characterize foot loading during running and in the development of orthoses in clinical applications or products such as sport shoes for children.
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NewsBot · Feb 5, 2021

Vulnerability of the foot's morphological structure to deformities caused by foot loading paradigm in school-aged children: a cross-sectional study
Beata Szczepanowska-Wolowiec, Paulina Sztandera, Ireneusz Kotela & Marek Zak
Scientific Reports volume 11, Article number: 2749 (2021)

The study aimed to assess the association between the key predictive foot structure variables and its loading paradigm in 625 school-aged children. Clinical appraisal relied primarily on having the plantar parts of their feet comprehensively assessed with Podoscan 2D Foot CAD, and a dynamometer platform, the research tools of choice widely acknowledged for their overall accuracy and reliability, with a view to determining the distribution of respective foot loads, as well as addressing both balance and gait issues. The Clarke's angle, Wejsflog index, length and width of the feet, regardless of gender, proved the key predictive variables for the foot-loading paradigm. Notably the Clarke's angle, construed the most sensitive variable in assessing flat-footedness, offered an extra added value in overall investigative effort. The actual design of the study protocol effectively complements a standard clinical assessment procedure, whereas by comprehensively addressing those variables, it is also believed to aid clinicians in gaining an extra, hands-on, diagnostic potential, so that any teenagers exposed to the highest risk of developing foot deformities could effectively be identified through pertinent screening tests, and consequently offered a task-oriented, therapeutic management, specifically aimed at preventing potential postural complaints in later life.
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NewsBot · Oct 17, 2021

Pedobarographic Statistical Parametric Mapping of plantar pressure data in new and confident walking infants: A preliminary analysis
Eleonora Montagnani et al
J Biomech. 2021 Sep 22

In infancy, plantar pressure data during walking has been investigated through regional approaches, whilst the use pedobarographic Statistical Parametric Mapping (pSPM) has not been reported. Analysis of pressure data using pSPM is higher in resolution and can enhance understanding of foot function development, providing novel insights into plantar pressure changes. This work aims to detail the implementation of the pSPM data processing framework on infants' pressure data, comparing plantar pressure patterns between new and confident walking steps. Twelve infants walked across an EMED- xl platform. Steps were extracted and imported into MATLAB for analysis. Maximum pressure pictures were transformed to point clouds and registered within and between participants with iterative closest point and coherent point drift algorithms, respectively. Root mean square error (RMSE) was calculated within both registrations as a quality measure. Pressure patterns were compared between new and confident walking using nonparametric-paired sample SPM1D t-test. RMSEs were under 1 mm for both registration algorithms. In the transition to confident walking, significantly increasing pressure was detected in the left central forefoot. Implementing pSPM to infants' pressure data was non-trivial, as several phases of data processing were required to ensure a robust approach. Our analysis highlighted the presence of significant changes in pressure in central left forefoot after 2.2 months of walking, which have not been reported before. This can be explained as previous regional approaches in infancy considered the forefoot as whole, preventing detection of changes in discrete anatomical regions.
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NewsBot · Nov 14, 2022

The Development of a Built-In Shoe Plantar Pressure Measurement System for Children
Sarah De Guzman et al
Sensors (Basel). 2022 Oct 30;22(21):8327

There is a rapid increase in plantar pressure from the infant to toddler stage, yet little is known about the reasons for this change. More information about plantar pressure distribution can help clinicians identify early-stage foot-related diseases that may occur during transitions from childhood to adulthood. This information also helps designers create shoes that adapt to different needs. This research describes the development of a low-cost, built-in shoe plantar pressure measurement system that determines foot pressure distribution in toddlers. The study aimed to improve and provide data on pressure distribution during foot growth. This was accomplished by implementing a plantar pressure capacitive measurement system within shoes. The capacitive sensors were laminated using a copper tape sheet on plastic backing with adhesive, elastomer layers, and a combination of conductive and non-conductive fabrics. Constructed sensors were characterized using compression tests with repeated loads. Results demonstrated that the sensors exhibited rate-independent hysteresis in the estimation of pressure. This enabled a calibration model to be developed. The system can mimic more expensive plantar pressure measurement systems at lower fidelity. This emerging technology could be utilized to aid clinicians, researchers, and footwear designers interested in how pressure distribution changes from infants to toddlers.
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