Increased In-Shoe Lateral Plantar Pressures with Chronic Ankle Instability

2011 ◽  
Vol 32 (11) ◽  
pp. 1075-1080 ◽  
Author(s):  
Heather Schmidt ◽  
Lindsay D. Sauer ◽  
Sae Yong Lee ◽  
Susan Saliba ◽  
Jay Hertel
Keyword(s):  
Plantar Pressure ◽  
Peak Pressure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Maximum Force ◽  
Pressure System ◽  
Time To Peak ◽  
Time Integral ◽  
Pressure Time ◽  
Force Time

Background: Previous plantar pressure research found increased loads and slower loading response on the lateral aspect of the foot during gait with chronic ankle instability compared to healthy controls. The studies had subjects walking barefoot over a pressure mat and results have not been confirmed with an in-shoe plantar pressure system. Our purpose was to report in-shoe plantar pressure measures for chronic ankle instability subjects compared to healthy controls. Methods: Forty-nine subjects volunteered (25 healthy controls, 24 chronic ankle instability) for this case-control study. Subjects jogged continuously on a treadmill at 2.68 m/s (6.0 mph) while three trials of ten consecutive steps were recorded. Peak pressure, time-to-peak pressure, pressure-time integral, maximum force, time-to-maximum force, and force-time integral were assessed in nine regions of the foot with the Pedar-x in-shoe plantar pressure system (Novel, Munich, Germany). Results: Chronic ankle instability subjects demonstrated a slower loading response in the lateral rearfoot indicated by a longer time-to-peak pressure (16.5% ± 10.1, p = 0.001) and time-to-maximum force (16.8% ± 11.3, p = 0.001) compared to controls (6.5% ± 3.7 and 6.6% ± 5.5, respectively). In the lateral midfoot, ankle instability subjects demonstrated significantly greater maximum force (318.8 N ± 174.5, p = 0.008) and peak pressure (211.4 kPa ± 57.7, p = 0.008) compared to controls (191.6 N ± 74.5 and 161.3 kPa ± 54.7). Additionally, ankle instability subjects demonstrated significantly higher force-time integral (44.1 N/s ± 27.3, p = 0.005) and pressure-time integral (35.0 kPa/s ± 12.0, p = 0.005) compared to controls (23.3 N/s ± 10.9 and 24.5 kPa/s ± 9.5). In the lateral forefoot, ankle instability subjects demonstrated significantly greater maximum force (239.9N ± 81.2, p = 0.004), force-time integral (37.0 N/s ± 14.9, p = 0.003), and time-to-peak pressure (51.1% ± 10.9, p = 0.007) compared to controls (170.6 N ± 49.3, 24.3 N/s ± 7.2 and 43.8% ± 4.3). Conclusion: Using an in-shoe plantar pressure system, chronic ankle instability subjects had greater plantar pressures and forces in the lateral foot compared to controls during jogging. Clinical Relevance: These findings may have implications in the etiology and treatment of chronic ankle instability. Level of Evidence: III, Retrospective Case Control Study

Effects of Real-Time Video Feedback on Plantar Pressure Measures in Individuals With Chronic Ankle Instability During Walking

2019 ◽  
Vol 24 (6) ◽  
pp. 229-234
Author(s):  
Anna M. Ifarraguerri ◽  
Danielle M. Torp ◽  
Abbey C. Thomas ◽  
Luke Donovan
Keyword(s):  
Real Time ◽  
Plantar Pressure ◽  
Ankle Instability ◽  
Video Feedback ◽  
Chronic Ankle Instability ◽  
Treadmill Walking ◽  
Gait Retraining ◽  
Pressure System ◽  
Time Integral ◽  
Pressure Time

Individuals with chronic ankle instability (CAI) have been shown to have increased lateral plantar pressure during walking which is thought to contribute to symptoms associated with CAI. The objective of this study was to determine whether real-time video feedback can reduce lateral plantar pressure in individuals with CAI. Twenty-six participants with CAI completed 30 s of treadmill walking while plantar pressure was measured using an in-shoe plantar pressure system (baseline). Next, participants completed an additional 30 s of treadmill walking while receiving video feedback (VID FB). During the VID FB condition, participants had a significant decrease in medial forefoot peak pressure and medial midfoot pressure-time integral; however, both changes were associated with small effect sizes. Real-time video feedback did not reduce lateral plantar pressure in individuals with CAI; therefore, other gait retraining strategies should be considered when treating patients with CAI.

scholarly journals Biomechanical Response to External Biofeedback During Functional Tasks in Individuals with Chronic Ankle Instability

2020 ◽  
Author(s):  
Danielle M Torp ◽  
Abbey C Thomas ◽  
Tricia Hubbard-Turner ◽  
Luke Donovan
Keyword(s):  
Real Time ◽  
Plantar Pressure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Static Balance ◽  
Visual Biofeedback ◽  
Time Integral ◽  
Pressure Time ◽  
Eyes Open ◽  
Functional Task

Abstract Context: Altered biomechanics displayed by individuals with chronic ankle instability (CAI) is a potential cause for recurring injuries and posttraumatic osteoarthritis. Current interventions are unable to modify aberrant biomechanics leading research efforts to determine if real-time external biofeedback is capable of producing changes. Objective: Determine 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 (23.95±5.52 years; 168.87±6.94 cm; 74.74±15.41 kg, female=12) volunteered. Intervention: Participants randomly performed single-leg static balance, step-downs, lateral-hops, and forward-lunges during a baseline and two biofeedback conditions. Auditory biofeedback was given through a pressure sensor placed under the lateral foot connected to a buzzer eliciting a noise when pressure exceeded the set threshold. Visual biofeedback was given through a cross-line laser secured to the dorsum of the foot. Cues given during the biofeedback conditions were used to promote proper biomechanics during each respective task. Main Outcome Measure(s): Location of center of pressure (COP) data points during balance with eyes-open and closed during each condition. Plantar pressure during functional tasks were extracted in the lateral column of the foot. Secondary outcomes of interested 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, the auditory condition produced similar changes during eyes closed trials. Auditory biofeedback increased heel pressure during step-downs, while decreasing lateral forefoot pressure-time integral during lunges. Visual biofeedback increased lateral heel pressure and increased lateral heel and midfoot pressure-time integral during hops. Conclusions: Real-time improvements in balance strategies were observed during both external biofeedback conditions. Visual and auditory biofeedback appear to effectively moderate different functional task biomechanics.

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.

scholarly journals Lower limb kinetic comparisons between the chasse step and one step footwork during stroke play in table tennis

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12481
Author(s):  
Yuqi He ◽  
Dong Sun ◽  
Xiaoyi Yang ◽  
Gusztáv Fekete ◽  
Julien S. Baker ◽  
...  
Keyword(s):  
Lower Limb ◽  
Peak Pressure ◽  
Table Tennis ◽  
Time Integral ◽  
Pressure Time ◽  
One Step ◽  
Force Time ◽  
The One ◽  
Plantar Force ◽  
Force Time Integral

Background Biomechanical footwork research during table tennis performance has been the subject of much interest players and exercise scientists. The purpose of this study was to investigate the lower limb kinetic characteristics of the chasse step and one step footwork during stroke play using traditional discrete analysis and one-dimensional statistical parameter mapping. Methods Twelve national level 1 table tennis players (Height: 172 ± 3.80 cm, Weight: 69 ± 6.22 kg, Age: 22 ± 1.66 years, Experience: 11 ± 1.71 year) from Ningbo University volunteered to participate in the study. The kinetic data of the dominant leg during the chasse step and one step backward phase (BP) and forward phase (FP) was recorded by instrumented insole systems and a force platform. Paired sample T tests were used to analyze maximum plantar force, peak pressure of each plantar region, the force time integral and the pressure time integral. For SPM analysis, the plantar force time series curves were marked as a 100% process. A paired-samples T-test in MATLAB was used to analyze differences in plantar force. Results One step produced a greater plantar force than the chasse step during 6.92–11.22% BP (P = 0.039). The chasse step produced a greater plantar force than one step during 53.47–99.01% BP (P < 0.001). During the FP, the chasse step showed a greater plantar force than the one step in 21.06–84.06% (P < 0.001). The one step produced a higher maximum plantar force in the BP (P = 0.032) and a lower maximum plantar force in the FP (P = 0) compared with the chasse step. The one step produced greater peak pressure in the medial rearfoot (P = 0) , lateral rearfoot (P = 0) and lateral forefoot (P = 0.042) regions than the chasse step during BP. In FP, the chasse step showed a greater peak pressure in the Toe (P = 0) than the one step. The one step had a lower force time integral (P = 0) and greater pressure time integral (P = 0) than the chasse step in BP, and the chasse step produced a greater force time integral (P = 0) and pressure time integral (P = 0.001) than the one step in the FP. Conclusion The findings indicate that athletes can enhance plantarflexion function resulting in greater weight transfer, facilitating a greater momentum during the 21.06–84.06% of FP. This is in addition to reducing the load on the dominant leg during landing by utilizing a buffering strategy. Further to this, consideration is needed to enhance the cushioning capacity of the sole heel and the stiffness of the toe area.

Variability of plantar pressure data. A comparison of the two-step and midgait methods

1999 ◽  
Vol 89 (10) ◽  
pp. 495-501 ◽  
Author(s):  
TG McPoil ◽  
MW Cornwall ◽  
L Dupuis ◽  
M Cornwell
Keyword(s):  
Data Collection ◽  
Plantar Pressure ◽  
Peak Pressure ◽  
Pressure Data ◽  
Step Method ◽  
Plantar Surface ◽  
Time Integral ◽  
Risk Of Injury ◽  
Pressure Time ◽  
Reliable Representation

The number of trials required to obtain a reliable representation of the plantar pressure pattern is an important factor in the assessment of people with insensate feet or the use of plantar pressure data as a basis for fabrication of foot orthoses. Traditionally, the midgait method has been used for the collection of pressure data, but the large number of walking trials required by this method can increase the risk of injury to the plantar surface of the insensate foot. As a result, the two-step method of plantar pressure data collection has been advocated. The purpose of this investigation was to determine the degree of variability in regional plantar pressure measurements using the midgait and two-step methods of data collection. Plantar pressure data were collected from ten volunteers (five men and five women) between the ages of 20 and 35 years in 20 trials using both data-collection protocols. The results of the study indicate that three to five walking trials are needed to obtain reliable regional peak pressure and pressure-time integral values when the two-step data-collection protocol is used. Although either method can be used for pressure data collection, one method should be used consistently when repeated assessments are required.

Dynamic plantar pressure analysis. Comparing common insole materials

1992 ◽  
Vol 82 (10) ◽  
pp. 507-513 ◽  
Author(s):  
PB Sanfilippo ◽  
RM Stess ◽  
KM Moss
Keyword(s):  
Plantar Pressure ◽  
Human Subjects ◽  
Force Plate ◽  
Vertical Force ◽  
Time Integral ◽  
Pressure Time ◽  
Peak Plantar Pressure ◽  
Force Time ◽  
Dynamic Measures ◽  
Force Time Integral

A comparison of five commonly used insole materials (Spenco, PPT, Plastazote, Nickelplast, and Pelite) was made to evaluate their effectiveness in reducing plantar vertical pressures on human subjects during walking. With the use of the EMED-SF pedograph force plate system, dynamic measures of vertical force, force-time integral, peak plantar pressure, pressure-time integral, and area of foot-to-ground contact were compared with the force plate covered with each of the insole materials and without any interface material.

Reliability of an In-Shoe Pressure Measurement System During Treadmill Walking

1996 ◽  
Vol 17 (4) ◽  
pp. 204-209 ◽  
Author(s):  
T. W. Kernozek ◽  
E. E. LaMott ◽  
M. J. Dancisak
Keyword(s):  
Measurement System ◽  
Pressure Measurement ◽  
Peak Pressure ◽  
Measurement Techniques ◽  
Peak Force ◽  
Foot Pressure ◽  
Time Integral ◽  
Pressure Time ◽  
Force Time ◽  
Pressure Measurement System

We examined the reliability of in-shoe foot pressure measurement using the Pedar in-shoe pressure measurement system for 25 participants walking at treadmill speeds of 0.89, 1.12, and 1.34 meters/sec. The measurement system uses EMED insoles, which consist of 99 capacitive sensors, sampled at 50 Hz. Data were collected for 20 seconds at two separate times while participants walked at each gait speed. Differences in some of the loading variables across speed relative to the total foot and across the different anatomical regions were detected. Different anatomical regions of the foot were loaded differently with variations in walking speed. The results indicated the need to control speed when evaluating loading parameters using in-shoe pressure measurement techniques. Coefficients of reliability were calculated. Variables such as peak force for the total foot required two steps to achieve a coefficient of reliability of 0.98. To achieve excellent reliability (>0.90) in the peak force, force time integral, peak pressure, and pressure time integral across the total foot and the seven regions, a maximum of eight steps was needed. In general, timing variables, such as the instant of peak force and the instant of peak pressure, tended to be the least reliable measures.

The Effectiveness of Personalized Custom Insoles on Foot Loading Redistribution during Walking and Running

2020 ◽  
Vol 44 ◽  
pp. 1-8
Author(s):  
Yao Meng ◽  
Li Yang ◽  
Xin Yan Jiang ◽  
Bíró István ◽  
Yao Dong Gu
Keyword(s):  
Plantar Pressure ◽  
Peak Pressure ◽  
Young Males ◽  
Time Integral ◽  
Pressure Time ◽  
Mean Pressure ◽  
Pressure Maximum ◽  
Foot Loading ◽  
And Control ◽  
Better Than

The objective of this study was to investigate the effectiveness of different hardness of personalized custom insoles on plantar pressure redistribution in healthy young males during walking and running. Six males participated in the walking and running test (age: 24±1.6 years, weight: 67.9±3.6 kg, height: 175.5±4.7 cm). All subjects were instructed to walk and run along a 10m pathway wearing two different hardness insoles (i.e., hard custom insoles (CHI) and soft custom insole (CSI)) and control insole (CI) at their preferred speed. Peak pressure, mean pressure, maximum force, pressure-time integral were collected to analyze using SPSS. The plantar pressure of forefoot and medial midfoot were significantly increased and of lateral forefoot and lateral midfoot were decreased by both kinds of custom insoles in running tests. While the CHI significantly increased plantar pressure of the medial forefoot compared with the CSI and CI both in walking and running tests. The custom insoles showed significantly higher plantar pressure on medial midfoot. But CSI seems better than CHI because of redistributing the plantar pressure by increasing the plantar pressure of whole forefoot. Moreover, CSI showed significantly lower plantar pressure than CI and CHI at lateral midfoot during running test. The CHI causes significant high pressure at medial forefoot (MF), which may raise the risk of forefoot pain.

scholarly journals Effect of the Cavus and Planus Foot on Biomechanics Aspect of the Plantar Pressure in Adolescents With Idiopathic Scoliosis

2021 ◽  
Author(s):  
Carlos Eduardo Gonçalves Barsotti ◽  
Gustavo Alves Tostes ◽  
Rodrigo Mantelatto Andrande ◽  
Ariane Verttú Schmidt ◽  
Alexandre Penna Torini ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Contact Area ◽  
Plantar Pressure ◽  
Peak Pressure ◽  
Maximum Force ◽  
Level Of Evidence ◽  
Pressure System ◽  
Cross Sectional ◽  
The Mean

Abstract Purpose: To verify the effect of cavus and planus feet on plantar pressure during static posture in adolescents with idiopathic scoliosis (AIS). Methods: Cross-sectional study. Sixty adolescents with idiopathic scoliosis (AIS) were evaluated and divided into three groups: normal foot (n=20), cavus foot (n=20), and planus foot (n=20). The scoliosis was confirmed by a spine X-ray exam (Cobb angle). The plantar arch index (AI) was calculated from the ratio between the midfoot area and the total area of the foot. Distribution plantar pressure data was collected using a plantar pressure system. The contact area, maximum force, and peak pressure were acquired over areas: forefoot, midfoot, and lateral and medial rearfoot. Results: The Cobb angle of the AIS of the major curves averaged 33.7°±10.7°, the mean TK was 32.6°±6.7°, and the mean LL was 31.4°±8.3°. AIS with cavus feet showed a reduction in contact area and peak pressure on the midfoot and lateral rearfoot when compared to planus and normal feet, as well as maximum force on the midfoot and rearfoot (medial and lateral). Planus feet showed increased peak pressure and maximum force on the midfoot when compared to cavus and normal feet. Another observation was that planus feet also promoted an increase in peak pressure and maximum force on rearfoot in relation to cavus feet. Conclusions: Foot posture influences plantar pressure of patients with AIS. Cavus feet decrease the plantar load on the midfoot and rearfoot while planus feet increased plantar pressure in these regions. Level of evidence: III

THE EFFECTS OF CHANGES IN STEP WIDTH ON PLANTAR FOOT PRESSURE PATTERNS OF YOUNG FEMALE SUBJECTS DURING WALKING

2011 ◽  
Vol 11 (05) ◽  
pp. 1071-1083 ◽  
Author(s):  
SU-YA LEE ◽  
CHEN-YU CHOU ◽  
YI-YOU HOU ◽  
YU-LIN WANG ◽  
CHICH-HAUNG YANG ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Plantar Pressure ◽  
Reaction Force ◽  
Lateral Side ◽  
Step Width ◽  
Foot Pressure ◽  
Time Integral ◽  
Pressure Time ◽  
Force Time ◽  
Force Time Integral

The aim of this study was to investigate the foot plantar pressure distribution and the effect of different step width during walking. Methods: Nineteen female volunteers who aged 18~30 years old and with no history of lower extremity injury were considered. Subjects walked at a pre-determined set speed with varied step width (5 cm, 10 cm, and 20 cm) for three trials at each step width. This study used an in-sole plantar pressure measurement system to collect the peak pressure, maximum ground reaction force, pressure–time integral, and force–time integral data of eight different foot regions. Results: The data revealed that the peak plantar foot pressure on the medial arch increased with wider step width (p < 0.05). In contrast, maximum ground reaction force, peak plantar pressure, pressure–time integral, and force–time integral on the lateral arch and lateral side of the metatarsals decreased with wider step width (p < 0.05). Conclusion: The results of this study revealed that smaller step width during walking result in decreasing the pressure on the medial arch of the foot. It may have the relieving effect for clients with pes planus and it can be a reference for rehabilitation clinicians while treating the above-mentioned subjects.

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