Foot mechanics during the first six years of independent walking

NewsBot · Jan 25, 2011

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Foot mechanics during the first six years of independent walking.
Samson W, Dohin B, Desroches G, Chaverot JL, Dumas R, Cheze L.
J Biomech. 2011 Jan 21. [Epub ahead of print]

Recognition of the changes during gait that occur normally as a part of growth is essential to prevent mislabeling those changes from adult gait as evidence of gait pathology. Currently, in the literature, the definition of a mature age for ankle joint dynamics is controversial (i.e., between 5 and 10 years). Moreover, the mature age of the metatarsophalangeal (MP) joint, which is essential for the functioning of the foot, has not been defined in the literature. Thus, the objective of the present study explored foot mechanics (ankle and MP joints) in young children to define a mature age of foot function. Forty-two healthy children between 1 and 6 years of age and eight adults were measured during gait. The ground reaction force (GRF), the MP and ankle joint angles, moments, powers, and 3D angles between the joint moment and the joint angular velocity vectors (3D angle α(M.ω)) were processed and compared between four age groups (2, 3.5, 5 and adults). Based on statistical analysis, the MP joint biomechanical parameters were similar between children (older than 2 years) and adults, hinting at a quick maturation of this joint mechanics. The ankle joint parameters and the GRFs (except for the frontal plane) showed an adult-like pattern in 5-year-old children. Some ankle joint parameters, such as the joint power and the 3D angle α(M.ω) still evolved significantly until 3.5 years. Based on these results, it would appear that foot maturation during gait is fully achieved at 5 years.
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Admin2 · Jan 25, 2011

Related thread:
Development of walking in preterm infants

Craig Payne · Jan 28, 2011

I finally got to read the full text. I attached below the graph for the first MPJ. Interesting to note that the first MPJ dorsiflexion is present in the youngest age group. First MPJ dorsiflexion = windlass working .... I always assumed that it did not start as this young age.

mike weber · Jan 28, 2011

Craig Payne said: ↑

I finally got to read the full text. I attached below the graph for the first MPJ. Interesting to note that the first MPJ dorsiflexion is present in the youngest age group. First MPJ dorsiflexion = windlass working .... I always assumed that it did not start as this young age.
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As we discussed on the windlass mechanism and children thread.

interesting findings.

Simon Spooner · Jan 28, 2011

See also: http://www.ejbjs.org/cgi/reprint/62/3/336

NewsBot · Sep 7, 2017

Biomechanics of the infant foot during the transition to independent walking: a narrative review
Carina Price et al
Gait & Posture; 6 September 2017

Highlights
•Detailing the structural and functional development of paediatric feet is valuable.
•Data quantifying motion and foot loading exists mainly from independent walking.
•Minimal research is published which includes baseline data prior to ambulation.
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Recognising structural and functional development of the paediatric foot is fundamental to ensuring a strong theoretical framework for health professionals and scientists. The transition of an infant from sitting to walking takes approximately 9 months and is when the structures and function of the foot must respond to the challenges of bearing load; becoming increasingly more essential for locomotion. Literature pertaining to the phase of development was searched. A narrative approach synthesised the information from papers written in English, with non-symptomatic infant participants up to the development stage of independent walking or two years of age. A range of literature was identified documenting morphological, physiological, neuromuscular and biomechanical aspects of the infant within this phase of development. The progression of variable gait to a regular pattern is documented within a range of studies focusing on neuromuscular control and ambulation development. However, methodological approaches may have compromised the external validity of such data. Additionally, limited consideration for the specific function and development of the foot is evident, despite its role as the primary site of weight bearing and interface with the floor. A lack of consideration of infants prior to ambulation (i.e. before cruising or walking) is also apparent which prevents a reference baseline being used effectively. This review also identifies future research priorities such that a comprehensive understanding of foot development from a non-weight bearing to a weight bearing structure during locomotor advancement can be gained
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NewsBot · Sep 24, 2017

Ontogenetic changes in foot strike pattern and calcaneal loading during walking in young children
Angel Zeininger et al
Gait and Posture; Article in Press

Highlights
•Calcaneal loading in children is modeled.
•Flat foot contact in young children is associated with high impact transients.
•Vertical forces decrease with age and the emergence of initial heel contact.
•The heel and calcaneus experience loading throughout early locomotor development.
•This illuminates structure-function relationships and potential for heel injury.
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The assumption that the morphology of the human calcaneus reflects high and cyclical impact forces at heel strike during adult human walking has never been experimentally tested. Since a walking step with a heel strike is an emergent behavior in children, an ontogenetic study provides a natural experiment to begin testing the relationship between the mechanics of heel strike and calcaneal anatomy. This study examined the ground reaction forces (GRFs) of stepping in children to determine the location of the center of pressure (COP) relative to the calcaneus and the orientation and magnitude of ground reaction forces during foot contact. Three-dimensional kinematic and kinetic data were analyzed for 18 children ranging in age from 11.5 to 43.1 months. Early steppers used a flat foot contact (FFC) and experienced relatively high vertical and resultant GRFs with COP often anterior to the calcaneus. More experienced walkers used an initial heel contact (IHC) in which GRFs were significantly lower but the center of pressure remained under the heel a greater proportion of time. Thus, during FFC the foot experienced higher loading, but the heel itself was relatively wider and the load was distributed more evenly. In IHC walkers load was concentrated on the anterior calcaneus and a narrower heel, suggesting a need for increased calcaneal robusticity during development to mitigate injury. These results provide new insight into foot loading outside of typical mature contact patterns, inform structure-function relationships during development, and illuminate potential causes of heel injury in young walkers.
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NewsBot · Oct 7, 2017

Foot placement characteristics and plantar pressure distribution patterns during stepping on ground in neonates
Francesca Sylos-Labini et al
Front. Physiol. | doi: 10.3389/fphys.2017.00784

Stepping on ground can be evoked in human neonates, though it is rather irregular and stereotyped heel-to-toe roll-over pattern is lacking. Such investigations can provide insights into the role of contact- or load-related proprioceptive feedback during early development of locomotion. However, the detailed characteristics of foot placements and their association with motor patterns are still incompletely documented. We elicited stepping in 33 neonates supported on a table. Unilateral limb kinematics, bilateral plantar pressure distribution and EMG activity from up to 11 ipsilateral leg muscles were recorded. Foot placement characteristics in neonates showed a wide variation. In about 25% of steps, the swinging foot stepped onto the contralateral foot due to generally small step width. In the remaining steps with separate foot placements, the stance phase could start with forefoot (28%), midfoot (47%) or heel (25%) touchdowns. Despite forefoot or heel initial contacts, the kinematic and loading patterns markedly differed relatively to toe-walking or adult-like two-peaked vertical force profile. Furthermore, while the general stepping parameters (cycle duration, step length, range of motion of proximal joints) were similar, the initial foot contact was consistently associated with specific center-of-pressure excursion, range of motion in the ankle joint, and the center-of-activity of extensor muscles (being shifted by about 5% of cycle towards the end of stance in the ‘heel’ relative to ‘forefoot’ condition). In sum, we found a variety of footfall patterns in conjunction with associated changes in motor patterns. These findings suggest the potential contribution of load-related proprioceptive feedback and/or the expression of variations in the locomotor program already during early manifestations of stepping on ground in human
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NewsBot · Jul 30, 2020

FOOTFALL PATTERN DURING RUNNING IN PRESCHOOL CHILDREN
ACCORDING TO AGE AND FOOTWEAR
Jan Plesek et al
38th International Society of Biomechanics in Sport Conference: July 20-24, 2020

The aim of this study was to compare the footfall pattern (FP) in different age groups of
preschool children while they ran in standard running shoes (SRS) and barefoot. Fortyeight children aged 3-6 years participated in the study and were split into 4 age groups
(n=12). All children performed a simple running game (based on the shuffle run) in SRS
and barefoot. The length of the runway was adjusted for each age group. Kinematic and
kinetic data were collected using 3-D motion capture system. We analyzed strike index (SI)
and sagittal plane ankle angle (AA) at initial contact (IC) from 6 successful running trials for
each child in each condition. We found differences between conditions in both SI (p=0.000,
η
2=0.448) and AA (p=0.000, η
2=0.259) respectively, but we did not find any differences
among age groups. Moreover, we found an interaction between age and conditions in AA
(p=0.019, η
2= 0.201). In preschool children, FP changed differently in certain age groups
according to the footwear condition.
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NewsBot · Feb 22, 2021

Biomechanical maturation of foot joints in typically developing boys: Novel insight in mechanics and energetics from a cross-sectional study
KevinDeschamps et al
Gait & Posture; Volume 85, March 2021, Pages 244-250

Highlights
•Ankle and Chopart joint moments increases with age.
•Ankle power generation matures around the age of eight.
•Regardless of age, the tarsometatarsal joint only generates power.
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Background
A growing body of quantitative evidence has been provided regarding age-related differences in plantar foot loading, multi-segment foot kinematics and muscle activity. Fundamental insight into the joint mechanics and energetics of the maturing foot has yet to be provided.

Research question/Hypothesis
It was hypothesized that so-called ‘biomechancial maturation’ joint kinetics would be observed in children underneath the age of eight and that older age-groups would not differ from each other in these parameters.

Methods
Fourty-three typically developing boys were recruited and allocated to three different age groups: 1) an early childhood group, 2) a middle childhood group, and 3) an early and late adolescence group. Multi-segment joint kinematics and kinetics of the Ankle-, Chopart-, Lisfranc- and Hallux joint were collected during barefoot walking. One-way Analysis of Covariance was conducted to examine differences among the outcome measures with group as a fixed factor and walking cadence as covariate.

Results
The youngest group differed significantly from the other two age groups with respect to their ankle and chopart joint peak plantarflexion moment (p < 0.05). Ankle and chopart joint peak power generation as well as the lisfranc peak plantarflexion moment was found to be significantly lower in the youngest age group compared to the oldest group (p < 0.05). At the lisfranc joint, the youngest age group demonstrated a significantly higher peak plantarflexion velocity compared to the two older age groups (p < 0.05).

Significance
This study provides novel insight into the biomechanical maturation of the developing foot which may guide clinical interventions in paediatric cohorts.
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NewsBot · Nov 9, 2021

Kinematic patterns during walking in children: Application of principal component analysis
ChiaraMalloggi et al
Human Movement Science; Volume 80, December 2021, 102892

The relative displacements of body segments during walking can be reduced to a small number of multi-joint kinematic patterns, pmk, through Principal Component Analysis (PCA). These patterns were extracted from two groups of children (n = 8, aged 6–9 years, 4 males, and n = 8, aged 10–13 years, 4 males) and 7 adults (21–29 years, 1 male), walking on a treadmill at various velocities, normalized to body stature (adimensional Froude number, Fr). The three-dimensional coordinates of body markers were captured by an optoelectronic system.

Five components (pm1 to pm5) explained 99.1% of the original dataset variance. The relationship between the variance explained (“size”) of each pmk and the Fr velocity varied across movement components and age groups. Only pm1 and pm2, which described kinematic patterns in the sagittal plane, showed significant differences (at p < 0.05) across pairs of age groups. The time course of the size of all the five components matched various mechanical events of the step cycle at the level of both body system and lower limb joints. Such movement components appeared clinically interpretable and lend themselves as potential markers of neural development of walking.
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NewsBot · Dec 19, 2021

Longitudinal study of foot pressures during real-world walking as infants develop from new to confident walkers
CarinaPrice et al
Gait & Posture; Volume 92, February 2022, Pages 351-358

Highlights
•Our protocol enabled us to characterise straight, medial and lateral turning steps.
•In confident walking more steps were taken including twice as many turning steps.
•In straight walking we found more significant change once confident than in turning.
•These findings are key to understanding biomechanical function of infants’ feet.
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Background
Onset of walking in infants leads to regular cyclic loading of the plantar foot surface for the first time. This is a critical period for evolving motor skills and foot structure and function. Plantar pressure literature typically studies gait only once walking is established and under conditions that artificially constrain the walking direction and bouts compared to how infants move in the real-world. We therefore do not know how the foot is loaded when self-directed walking is first achieved and whether it changes as walking is practiced.

Research question

How do pressures on the plantar foot in real-world walking change from new to confident walking?

Methods

Fifty-seven infants participated in a two-site longitudinal study. Bespoke child-friendly spaces incorporated large pressure platforms and video. Data was collected at two milestones: new (403 days) and confident (481 days) walking. Steps were defined as walking straight or turning medially/laterally. Pressure variables were calculated for eight-foot regions and compared between milestones.

Results

Confident walking resulted in more steps (median: 18 v 35) and almost twice as many turning steps. During straight-line steps, confident walking increased peak pressures in the medial heel (median: 99.3 v 106.7kPa, p < .05) and lateral forefoot (median: 53.9 v 65.3kPa, p < .001) and reduced medial toe pressure (median: 98.1 v 80.0kPa, p < .05). Relative medial midfoot contact area reduced (median: 12.4 v 11.2%, p < .05) as absolute foot contact increased. A faster transition across stance and a reduced relative contact time in the forefoot were recorded in confident walking.

Significance

Pressures change rapidly as walking is initiated with significant differences in foot loading evident within an average 77 days. Importantly, these changes differ in straight and turning walking. Continued reliance on assessment of straight-line walking during early stages of ambulation likely fails to characterise 26% of steps experienced by infant feet.
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NewsBot · Mar 29, 2022

Biomechanical Characteristics of the Typically Developing Toddler Gait: A Narrative Review
Wei Liu et al
Children (Basel). 2022 Mar 13;9(3):406

Independent ambulation is one of the most important motor skills in typically developing toddlers. Gait analysis is a key evaluation method in basic and clinical research. A narrative review on the literature of toddler gait development was conducted following inclusion criteria, explicitly including the factors of English article, age range, no external intervention during the experimental process of studies involved, the non-symptomatic toddler, and no pathological gait. Studies about toddlers' morphological, physiological, and biomechanical aspects at this developmental stage were identified. Remarkable gait characteristics and specific development rules of toddlers at different ages were reported. Changes in gait biomechanics are age and walking experience-dependent. Gait patterns are related to the maturation of the neuro and musculoskeletal systems. This review thus provides critical and theoretical information and the nature of toddler walking development for clinicians and other scientific researchers. Future studies may systematically recruit subjects with more explicit criteria with larger samples for longitudinal studies. A particular design could be conducted to analyze empirically before practical application. Additionally, the influence of external interventions on the development of toddler gait may need consideration for gait development in the toddler cohort.
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NewsBot · Apr 18, 2022

Age-related changes in three-dimensional foot motion during barefoot walking in children aged between 7 and 11 years old
RyanMahaffey et al
Gait & Posture; Volume 95, June 2022, Pages 38-43

Highlights
•Frontal and transverse plane motion of the midfoot during gait correlates with age.
•Transverse plan motion of the metatarsals during gait correlates with age.
•Development of foot segment kinematics continues until at least 11 years old.
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Background
The biomechanical complexity of children’s feet changes throughout childhood, yet kinematic development of the feet is poorly understood. Further work exploring the kinematic profile of children’s feet would be beneficial to help inform our understanding of the typical development of children’s feet.

Research Question
Do three-dimensional segmental kinematics of the feet during gait relate to age in a sample of children age 7–11 years?

Methods
This study was a secondary analysis of an existing database representing one hundred and twenty-one children age 7 – 11 years (90 male, 31 female; mean ± SD: age 9.57 ± , 1.17 years, height 1.37 ± 0.08 m, body mass 35.61 ± 9.33 kg). Fifteen, 9 mm retroreflective markers were attached to the right shank and foot of each participant in, line with the 3DFoot model. Multi-segmental joint kinematics were collected during barefoot walking. Sagittal, frontal, and transverse planar motion was described for the shank-calcaneus, calcaneus-midfoot, and midfoot-metatarsals segment of the right foot. Principal component analysis (PCA) was used to reduce the major modes of variation in the data to fully explore foot segment motion over the entire gait cycle. Correlations and multiple regression between PCA outputs with age, and potential confounding factors are presented.

Results
Significant positive correlations were found between age and greater calcaneus, dorsiflexion, midfoot inversion and adduction, and metatarsal dorsiflexion, plantarflexion and abduction. There were no significant confounding effects of height, body mass, walking speed or gender on the relationships between age and PCA outputs.

Significance
The findings from this study demonstrated a relationship between foot kinematics and age suggesting that the development of foot kinematics is ongoing until at least the age of 11 years. This work offers a comprehensive data set of inter-segmental kinematics which helps to advance understanding of the development of the pediatric foot.
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NewsBot · May 30, 2022

Measurement of the Developing Foot in Shod and Barefoot Paediatric Populations: A Narrative Review
Maisie Squibb et al
Children (Basel). 2022 May 19;9(5):750

The theory that footwear may change foot shape dates back 100 years. Since this period, research has revealed the anatomical and functional consequences that footwear can cause to the foot. Children's feet remain malleable as they undergo developmental changes until adolescence, which is why childhood is arguably a crucial period to understand how footwear can affect natural foot development. This review explored the development of the foot in children and adolescents and the methods used to measure the different foot structures; it comments on the key issues with some of these methods and gives direction for future research. Various internal and external factors can affect foot development; the main factors are age, gender, ethnicity, body mass index (BMI) and footwear habits. Research on how footwear can affect foot development has increased over the years and the final section of this review aimed to unpick the findings. Studies investigating the influence of footwear habits on foot length and width have established inconsistent findings. Many of the studies in the review did not control for internal and external factors that can affect foot development. There was also a limited number of studies that investigated hallux valgus angle and muscle strength differences in those with different footwear habits. Moreover, multiple studies in the final section of this review did not successfully examine the footwear habits of the participants and instead used observations or self-assessments, which is a major limitation. Future research should examine footwear behaviors and other confounding factors when investigating the development of the foot in children and adolescents. Moreover, researchers should critically evaluate the methods used to quantify the different structures of the foot to ensure valid and reliable parameters are being used.
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NewsBot · Jun 23, 2022

Lower limb inter-joint coordination patterns are associated with walking experience in toddlers according to limb and stance periods
Thiago Ribeiro TelesSantosaLiria AkieOkai-NóbregaacPriscila AlbuquerqueAraújoaRodrigo de SousaGomidebEduardo de MendonçaMesquitabGuilherme Augusto GomesDe VillabAna PaulaLagecThales RezendeSouzaaSergio TeixeiraFonsecaaMarcus FragaVieirabMarisa CottaMancinia
Infant Behavior and Development; Volume 68, August 2022, 101730

Walking experience is crucial for inter-joint coordination during gait acquisition. Toddlers show asymmetrical lower limb function during early locomotion for transferring body weight (regulatory limb) and steering the direction of walking (impulse limb). This study aimed to investigate the association between coordination patterns and walking experience, and between coordination variability and walking experience according to healthy toddlers’ lower limb function and stance periods. Typically developing toddlers (n = 22; 17.27 ± 3.13 months) were distributed into two groups: up to (LWE) and greater than (GWE) three months of walking experience. The lower limbs were classified as regulatory or impulse limb and analyzed during the onset (SO), mid (MS), and late (LS) stance intervals. Hip-ankle, knee-ankle, and hip-knee coupling angle (CA) and its variability (CAV) were assessed. A relationship was found between inter-joint coordination pattern and groups, which was distinct according to stance period and lower limb function: (a) hip-ankle CA: at SO for both limbs, MS for the regulatory limb, and LS for the impulse limb; (b) knee-ankle CA: at SO for both limbs and MS for the regulatory limb; (c) hip-knee CA: at SO for both limbs, at MS for the regulatory limb, and LS for the impulse limb. These findings were linked to differences observed in distal joints between groups, mainly at the ankle during stance onset. The CAV was negatively associated with walking experience only in the regulatory limb in the following variables: hip-ankle at MS, knee-ankle at SO, and hip-knee at LS. Findings showed different functional roles of the lower limbs in dealing with the demands of balance and propulsion during early walking
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NewsBot · Dec 12, 2022

Children’s foot parameters and basic anthropometry — do arch height and midfoot width change?
Carles Escalona-Marfil, Anna Prats-Puig, Xavier Ortas-Deunosajut, Raquel Font-Lladó, Xavier Ruiz-Tarrazo & Angela Margaret Evans
European Journal of Pediatrics (2022)

The aims of this study were as follows: (1) to assess how foot posture and morphology assessments change according to body mass index (BMI) status; (2) to determine which body composition parameter (BMI or waist circumference) correlates better with the foot posture index (FPI), arch height index (AHI), and midfoot width (MFW) in children. Foot morphometry (FPI, AHI, and MFW) and body composition (BMI and waist circumference (WC)) were assessed in a cross-sectional study of 575 children (mean age = 7.42 ± 1.67 years; 53.27% female). When comparing BMI groups, an increase of 8.3% in AHI and 13.6% in MFW (both p < 0.0001) was seen. In linear regression analyses, BMI and WC were positively associated with MFW explaining together 64.8% of its variance. Noteworthy, MFW is the most related to body composition parameters.

Conclusion: Foot morphology assessed by FPI, AHI, and MFW differs among BMI categories in children. Noteworthy, WC correlates better with foot measures than does the more commonly used BMI, and more importantly the MFW is the foot measure best explained by children’s body weight. Since foot morphometry is different among different BMI groups, children would benefit from shoes with different patterns (thinner and wider), as well as a good system to adjust midfoot height.
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NewsBot · Mar 11, 2023

Masking approaches to analyse plantar pressure data of new and confident walking infants
Eleonora Montagnani, Stewart C Morrison, Carina Price
Gait & Posture; 11 March 2023

Background
Due to its easy and straightforward use, regional analysis with the “standard” mask is the most common approach for quantifying plantar pressures in infancy. Such a mask, however, identifies foot regions based on typical foot proportions and pressure gradients. Alternatively, the use of a customised mask retaining infants’ feet proportions has not been explored.

Research question
Does a customised mask scaled on infants’ feet improve processing of pressure data collected during walking development compared with a standard mask?

Methods
Thirteen infants walked across an EMED xl platform. Steps were grouped applying eight foot-regions standard and customised masks. To evaluate masks’ performance, peak pressure (PP) and contact area (CA) were extracted from each region, and mask. Intra-individual coefficients of variation were then calculated for each variable, and compared between masks using a Mann-Whitney U test (p<0.05). Unsuccessful masks application was reported, expressed as percentage of data loss.

Results
For CA variation, significant differences were found in all the regions but the lateral toes in new (Z= -0.184, p=0.8540) and confident walking (Z= -1.562, p=0.118). For PP variation, a significant difference was found in confident walking within the lateral midfoot (Z=-2.598, p=0.009). With the standard mask, 22-27% of data was lost in new and confident walking respectively, compared to 1.6-0% with the customised. As a result, the customised mask characterised the more variable steps, demonstrating higher variation compared to the standard mask.

Significance
Identifying foot regions using a mask based on infants’ feet proportions yielded an improved performance compared to the standard mask. With the customised mask, we retained almost all the steps and characterised the variability of the data, thereby providing an appropriate approach for infants’ pressure data processing. Application of the customised mask could therefore be beneficial in future studies analysing highly variable data sets.
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NewsBot · Mar 14, 2023

Effect of Spatiotemporal Parameters on the Gait of Children Aged from 6 to 12 Years in Podiatric Tests: A Cross Sectional Study
Magdalena Martinez-Rico et al
Healthcare (Basel). 2023 Feb 27;11(5):708

The use of lower limb tests in the paediatric population is of great importance for diagnostic evaluations. The aim of this study is to understand the relationship between the tests performed on the feet and ankles, covering all of its planes, and the spatiotemporal parameters of children's gait.

Methods: It is a cross-sectional observational study. Children aged between 6 and 12 years participated. Measurements were carried out in 2022. An analysis of three tests used to assess the feet and ankles (FPI, the ankle lunge test, and the lunge test), as well as a kinematic analysis of gait using OptoGait as a measurement tool, was performed.

Results: The spatiotemporal parameters show how Jack's Test is significant in the propulsion phase in its % parameter, with a p-value of 0.05 and a mean difference of 0.67%. Additionally, in the lunge test, we studied the % of midstance in the left foot, with a mean difference between the positive test and the 10 cm test of 10.76 (p value of 0.04).

Conclusions: The diagnostic analysis of the functional limitation of the first toe (Jack's test) is correlated with the spaciotemporal parameter of propulsion, as well as the lunge test, which is also correlated with the midstance phase of gait.
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NewsBot · Oct 19, 2023

Spatiotemporal Evolution of Toddlers' Regional Foot Pressure Distribution and Center of Pressure At Antero-Posterior Axis During Learning of Standing
Elmira Pourreza et al
J Biomech Eng. 2023 Oct 18:1-13

We investigated quiet stance of newly standing infants every three months (trimesters) of their second year of life. Their anteroposterior Center-of-Pressure (CoPx) velocity and centroidal frequency (CFREQ: 2.36±0.10 to 1.50±0.11 Hz) decreased over time. Besides, mean pressures revealed a potential role-sharing of foot regions in learning and control aspects of standing, with hindfoot carrying the highest (23.89±6.47 kPa) pressure while forefoot the lowest (10.26±2.51 kPa). The highest CFREQ of pressure signal was at mid-foot. Through regional CoPx, forefoot has manifested the highest CFREQ (2.10±0.40 Hz) and 90% power frequency (90%PF), whereas hindfoot presented the lowest (CFREQ: 1.80±0.33 Hz). CFREQ and 90%PF of both pressure and regional CoPx significantly decreased at each region throughout all trimesters
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