Normative values for plantar pressures

NewsBot · Apr 23, 2014

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Plantar Static Pressure Distribution in Healthy Individuals
Percentiles for the Evaluation of Forefoot Loading
David Pomarino, Andrea Pomarino
Foot Ankle Spec April 21, 2014

In literature, one finds little scientific statements regarding plantar static pressure distribution in healthy individuals. Miscellaneous studies, however, characterize pathologies of feet and associate those with abnormal static or dynamic plantar load sharing. Our study reveals that healthy individuals show significant age-dependent differences in forefoot and rear foot load measured in standing position. The forefoot and rear foot load of 238 female and 193 male individuals aged between 2 and 69 years were measured. Using a pressure distribution measurement platform, the measurements were taken barefooted in standing position. Those measurements are presented as percentage of the overall load. The measurements within the age groups A1 (2-6 years), A2 (7-10 years), and A3 (11-69 years) showed significantly different forefoot loading means of the left foot (A1, 19.9%; A2, 28.2%; A3, 39.7%) and the right foot (A1, 22.6%; A2, 29.7%; A3, 39.6%). The forefoot loadings are graphically displayed as a function of the percentiles 5, 10, 25, 50, 75, 90, and 95. Forefoot loadings are referred to as “prominent” if the measured values lie off the interquartile range; if either below the percentile 10 or above 90 the loadings are referred to as “very prominent.” Our study contains significant data regarding the extent of the static load sharing of the forefoot and rear foot of healthy individuals; the data are suited for being standard values to evaluate plantar load sharing.
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Admin2 · Apr 23, 2014

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efuller · Apr 24, 2014

In literature, one finds little scientific statements regarding plantar static pressure distribution in healthy individuals.
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There was a paper by Nigg or Cavanagh that showed that sensor size affects pressure measurements. The paper took the same measurment with relatively small sensells and then grouped some of them together and go different pressure values. So, one reason that a range has not been reported in the literature is that the range will be dependent on the equipment used create that range. It makes sense. After all pressure = F/area. The force is not uniformly distributed so messing with the area of the sensor will affect the value of pressure that is found.

Eric

NewsBot · Aug 27, 2014

Test-retest reliability of an insole plantar pressure system to assess gait along linear and curved trajectories.
Godi M, Turcato AM, Schieppati M, Nardone A.
J Neuroeng Rehabil. 2014 Jun 5;11:95

BACKGROUND:
Previous studies have assessed reliability of insole technology for evaluating foot pressure distribution during linear walking. Since in natural motion straight walking is intermingled with turns, we determined the test-retest reliability of insole assessment for curved as well as linear trajectories, and estimated the minimum number of steps required to obtain excellent reliability for each output variable.
METHODS:
Sixteen young healthy participants were recruited. Each performed, two days apart, two sessions of three walking conditions: linear (LIN) and curved, clockwise (CW) and counter-clockwise (CCW). The Pedar-X system was used to collect pressure distribution. Foot print was analyzed both as a whole and as subdivided into eight regions: medial and lateral heel, medial and lateral arch, I metatarsal head, II-V metatarsal heads, hallux, lateral toes. Reliability was assessed by using intraclass correlation coefficient (ICC) for clinically relevant variables from analysis of 50 steps per trajectory: Peak Force (PF); Peak Pressure (PP); Contact Area (CA); Stance Duration (S).
RESULTS:
When considering whole-foot, all variables showed an ICC >0.80, therefore highly reliable. This was true for both LIN and curved trajectories. There was no difference in ICC of the four variables between left and right foot. When collapsing foot and trajectories, S had a lower ICC than PP and CA, and PP lower than CA. Mean percent error between the values of first and second session was <5%. When separately considering the eight foot regions, ICCs of PF, PP and CA for all regions and trajectories were generally >0.90, indicating excellent reliability. In curved trajectories, S showed smaller ICCs. Since the least ICC value for S was 0.60 in LIN trajectory, we estimated that to achieve an ICC ≥0.90 more than 200 steps should be collected.
CONCLUSIONS:
High reliability of insole dynamic variables (PF, PP, CA) is obtained with 50 steps using the Pedar-X system. On the contrary, high reliability of temporal variable (S) requires a larger step number. The negligible differences in ICC between LIN and curved trajectory allow use of this device for gait assessment along mixed trajectories in both clinical and research setting.
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NewsBot · Dec 23, 2014

A color-code based method for the interpretation of plantar pressure measurements in clinical gait analysis
Kevin Deschamps, Filip Staes, Dirk Desmet, Philip Roosen, Giovanni Arnoldo Matricali, Noel Keijsers, Frank Nobels, Jos Tits, Herman Bruyninckx
The Foot; Article in Press

Highlights
•We propose a z-score based analysis method for plantar pressure measurement.
•Increasing the visualization tools will guide decision making process.
•High dimensional character of plantar pressure measurements is reduced to a clinically accessible format.
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Comparing plantar pressure measurements (PPM) of a patient following an intervention or between a reference group and a patient-group is common practice in clinical gait analysis. However, this process is often time consuming and complex, and commercially available software often lacks powerful visualization and interpretation tools. In this paper, we propose a simple method for displaying pixel-level PPM deviations relative to a so-called reference PPM pattern. The novel method contains 3 distinct stages: 1) a normalization of pedobarographic fields (for foot length and width), 2) a pixel-level z-score based calculation and, 3) color coding of the normalized pedobarographic fields. The methodological steps associated to this novel method are precisely described and clinical output illustrated. We believe that the advantages of the novel method cover several domains.The strongest advantage of the novel method is that it provides a straightforward visual interpetation of PPM without decreasing the resolution perspective. A second advantage is that it may guide the selection of a local mapping technique (data reduction technique). Finally, it may be easily used as education tool during the therapist-patient interaction.
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NewsBot · Apr 2, 2019

Accuracy and repeatability of a semi-quantitative barefoot pressure measurement method for clinical use: The Derks Calculation Method.
Maetzler M, Bochdansky T, Abboud RJ
Foot (Edinb). 2019 Mar 27

BACKGROUND:
This study was designed to assess the accuracy and repeatability of the Derks Calculation Method in the normal foot during walking.

METHODS:
Measurements were taken from 25 healthy subjects (age 32.0 ± 12.4), 23 females and 2 males, on five separate occasions at seven days, three weeks, three months, and nine months apart by means of a mid-gait method. Values were calculated for internal rotation (IR) and external rotation of the heel (ER), heel valgus/varus (HV), heel length (HL), heel width (HW), width of the midfoot (WM) and the forefoot (WF), and the length of the foot (LF).

RESULTS:
For all five separate occasions and in 87.5% of the parameters investigated, the coefficient of repeatability (CR, expressed as a percentage of the mean) was less than 5%. One parameter showed a high CR - heel valgus/varus (HV) was extremely high (>800%). The maximum 95% Confidence Interval (CI) for the five different occasions was no higher than 0.2 cm for IR, ER and HV with a standard error (SE) of 0.01 and >0.01 respectively. The maximum 95% CI for WF was 0.4 cm (SE 0.1), and for HW, WM and LF the maximum 95% CI was 0.7 cm (SE 0.1 or 0.2). HL showed the highest 95% CI (0.9 cm) with an SE of 0.2.

CONCLUSION:
The Derks Calculation Method was found to be accurate and repeatable if HV was excluded, which renders this method a viable clinical tool in settings where sophisticated computerised systems are still unavailable.
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