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Objective Taking Chinese college students as the target group,this study detected the distribution of plantar pressure in different gait groups and analyzed the distribution characteristics of plantar pressure in in-toeing gait populations,to provide references for their orthopedic rehabilitation.Methods Ten subjects with typical in-toeing and normal and out-toeing gaits were selected to participate in the plantar pressure testing experiment.The maximum force,pressure,and contact time during natural standing and during one walking gait cycle were measured using a Zebris foot plantar pressure measurement system.Gait parameters,including step length,step width,step speed,step direction angle,gait center line,and force change curves,were collected,and a hazard analysis was conducted.Results During natural standing,the swaying interval area of the center of pressure was 939.0±252.4 mm2 for the in-toeing gait group and 1 120.2±101.6 mm2 for the out-toeing gait group,which was larger than that for the normal group(240.7±130.6 mm2).The in-toeing gait further weakens the human body's ability to maintain stability.The dynamic and static plantar pressures in the three gait groups exhibited different distribution characteristics.During static standing,the pressure center of the in-toeing gait group shifted to the hindfoot,which accounted for 70%of the plantar pressure and was higher than that of the normal group.During dynamic walking,the absolute value of peak pressure in the tripodal area of the foot in the in-toeing gait group was higher than that in the other two groups.Conclusions The in-toeing gait group had poor static maintenance ability,and to a certain extent,the distribution of plantar pressure in the foot tripodal area and plantar zone pressure were different compared with that of the normal gait.This led to poor stability,easy muscle fatigue,and ankle and knee joint injuries in the in-toeing gait group under equal-intensity exercise conditions.
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Objective:To explore the clinical efficacy of Kinesio taping combined with extracorporeal shock wave and the plantar pressure evaluation in the treatment of plantar fasciitis. Method:A total of 67 patients with unilateral plantar fasciitis were randomly divided into the control group(ESWT group)and the experimental group(KT combined group).The patients in the two groups were given the same health education and extracorporeal shock wave treatment(ESWT),and the experimental group was treated with Kinesio taping(KT).The pain and functional activity were evaluated by pain visual analogue scale and AOFAS ankle and hind-foot function scale;The insole plantar pressure measuring system was used to mea-sure the peak pressure values of each plantar regions.The clinical efficacy and plantar pressure of the affected side were compared before treatment,the 3rd week of treatment and 5th week of treatment. Result:There was no significant difference in various indcators of the measurements between the two groups before treatment(P＞0.05).The score of pain rating,functional activity scale score and plantar pressure of pa-tients in both groups were significantly improved at the 3rd week and the 5th week of treatment(P＜0.05),com-pared with those before treatment.At the 3rd week of treatment,there was no significant difference between the two groups in pain degree and functional activity scale score(P＞0.05),but there was statistical difference in plantar pressure analysis(P＜0.05).The peak force weight ratio of the medial heel in the KT combined group was significantly greater than that in the control group.At the 5th week of treatment,there were statisti-cally significant differences between the two groups in the score of pain rating,functional activity scale score and plantar pressure(P＜0.05).The KT combined treatment group was significantly better than the control group in the pain improvement and functional activity,and the weight bearing of the middle foot and hind foot was also significantly higher than the control group. Conclusion:Compared with the simple extracorporeal shock wave therapy,the combination of KT therapy can better relieve pain,improve the function of hind foot,correct abnormal foot weight bearing,and improve the gait of patients.
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Objective:To study the influence of electromyographic biofeedback therapy(EMGBFT)combined with mirror therapy(MT)on lower limb motor and balance function in stroke patients. Method:Sixty patients with hemiplegia after stroke were randomly divided into two groups:MT based EMG-BFT group and EMGBFT group,30 patients in each group.On the basis of conventional rehabilitation,the patients in the EMGBFT group received sham MT stimulation combined with EMGBFT,and the patients in the MT based EMGBFT group received MT combined with EMGBFT.Before and after treatment,the lower limb motor function of the patients was evaluated using Fugl-Meyer assessment scale-lower extremity(FMA-LE)and surface electromyography-integrated electromyography(iEMG)of knee flexion and ankle dorsiflex-ion,co-contraction ratio(CR).Plantar pressure-symmetry index(SI)of mean pressure and contact area of both feet,elliptical area of body center of gravity,anteroposterior(AP)and mediolateral(ML)displacement distance of body center of gravity under eye-opening and eye-closed states were calculated to evaluate pa-tients'weight-bearing and balance function. Result:After treatment,FMA-LE,CR and iEMG of biceps femoris and rectus femoris under knee flexion,tibialis anterior and medial gastrocnemius under ankle dorsiflexion were markedly ameliorated in the two groups(P＜0.01).After treatment,in the eye-opening state,the SI of mean pressure and contact area of both feet,elliptical area of body center of gravity,AP and ML displacement distances of body center of gravity were greatly enhanced in the two groups(P＜0.05,P＜0.01),in the eye-closed state,the SI of mean pressure and contact area of both feet,ML displacement distances of body center of gravity were observably ameliorat-ed in the two groups(P＜0.05,P＜0.01).Compared with the EMGBFT group,the FMA-LE,iEMG of biceps femoris and tibialis anterior muscles,elliptical area of body center of gravity,AP and ML displacement dis-tance of body center of gravity with eyes open,SI of contact area of both feet with eyes closed had more significant changes in the MT based EMGBFT group after treatment(P＜0.05,P＜0.01). Conclusion:Electromyographic biofeedback therapy combined with mirror therapy can improve lower limb motor and balance function in stroke patients,the underlying mechanism of which may be the activation of lower limb weak muscle motor units,the relief of lower limb spasm,and the improvement of standing static balance ability.
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ObjectiveTo investigate the effect of daily soft brace wearing on plantar dynamics during walking in patients with chronic ankle instability (CAI). MethodsA total of 52 patients with unilateral chronic ankle instability (CAI) in Beijing Rehabilitation Hospital from February, 2021 to January, 2023 were randomly divided into control group (n = 26) and experimental group (n = 26). Both groups underwent an eight-week exercise training program. The control group wore placebo brace during daily activities, while the experimental group wore soft ankle brace. Plantar dynamic parameters were measured using a pressure plate system during walking, including peak plantar pressure and plantar impulse before and after intervention. ResultsSix participants dropped out in the control group and five in the experimental group, resulting in a final inclusion of 41 participants. After intervention, there was no significant difference in peak plantar pressure and impulse on the affected side in the control group among different areas (P > 0.05). In the experimental group, the peak pressure and impulse in the heel medial, heel lateral and forefoot medial areas increased (|t| > 4.192, P < 0.001), while the peak pressure and impulse in the midfoot and lateral forefoot areas decreased (t > 2.984, P < 0.05); the peak pressure and impulse in the heel medial, heel lateral and forefoot medial areas were higher in the experimental group than in the control group (|t| > 2.126, P < 0.05), and the peak pressure and impulse were lower in the midfoot and forefoot lateral areas (t > 2.133, P < 0.05). ConclusionWearing a soft brace during daily activities may optimize the distribution of peak plantar pressure and plantar impulse on the affected side in patients with CAI, which may prevent recurrence of sprains.
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BACKGROUND:Kinesio taping is often used for the treatment of various sports injuries.The methods of foot and ankle sports taping are complex and diverse.Among them,Fascia taping is applicable to a wider range of people and can be used for different foot posture types,but it still lacks of practical verification,and its specific biomechanical role is not clear. OBJECTIVE:To observe the changes in plantar pressure characteristics of subjects with different foot positions during walking and jogging after Fascia taping. METHODS:Thirty-seven young healthy subjects were recruited from the Yantai campus of Binzhou Medical University to conduct the test.They were scored according to the foot posture index-six items version,and were divided into the supination foot group,the neutral foot group,and the pronation foot group.The static foot morphological indexes(including navicular drop,arch height index,arch height flexibility-longitudinal arch,and arch height flexibility-transverse arch)and the pressure-time integral of each foot zone during walking and jogging were collected and calculated respectively before and after Kinesio taping.The specific biomechanical mechanism of Fascia taping was analyzed. RESULTS AND CONCLUSION:(1)General data:There was no statistical difference among the three groups of subjects in general data,such as gender,height,and body mass index(P>0.05).Before taping,there was a significant difference in the foot morphological indexes and the areas of the outer front foot,midfoot,and hindfoot between different foot posture groups(P<0.01).(2)Static foot morphological indexes:After taping,there was no statistically significant difference between the groups in navicular drop,arch height flexibility-longitudinal arch,and arch height flexibility-transverse arch(P>0.05),while there was still a significant difference between the groups in the arch height index(P<0.05).In the supination foot group,the arch height index increased slightly,but there was no significant difference before and after taping(P>0.05).In the pronation foot group,the navicular drop and arch height flexibility-longitudinal arch was significantly reduced,and the arch height index was increased.There was a significant difference before and after taping(P<0.05).(3)The index of plantar pressure during walking:After taping,there was no significant difference between the three groups in the area of lateral forefoot and medial midfoot(P>0.05).In the pronation foot group,the lateral load of the forefoot increased after taping(P<0.05).In the supination position group,the load of the lateral forefoot and midfoot regions increased significantly(P<0.05),while the difference in the rear foot region was not significant(P>0.05).(4)The index of plantar pressure during jogging:After taping,there was no statistically significant difference between groups in the lateral forefoot(P>0.05).In the pronation foot group,the load of the medial forefoot increased significantly(P<0.05).In the supination position group,the load of the lateral forefoot,the middle foot and the rear foot region increased significantly(P<0.05).(5)The results showed that the Fascia taping was suitable for different foot postures.It could not only correct the static foot structure of subjects with different foot postures,but also regulate the abnormal plantar pressure distribution during the dynamic activities of walking and jogging,and the load of the midfoot,forefoot,and hindfoot in the supination and pronation posture tended to normal foot posture load level.
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BACKGROUND:Human plantar pressure can reflect the health status of the lower limbs and even the whole body,which is an important basis for gait analysis,and body mass index is an important influencing factor. OBJECTIVE:To investigate the effect of body mass index on plantar pressure. METHODS:Twenty young college students from Xuzhou Medical University,including 10 males and 10 females aged 19-21 years,were selected as test subjects and divided into three groups according to the body mass index value:overweight group(body mass index>25 kg/m2,n=3),lean group(body mass index<18 kg/m2,n=4),and normal group(body mass index 18-25 kg/m2,n=13).A natural walking gait test was carried out on the three groups of subjects with a Zebris pressure distribution measurement plate to obtain the complete gait cycle parameters.The time proportion of support time phase,peak pressure,time to peak force,peak force and impulse volume were analyzed and the correlation between each parameter and the body mass index was analyzed by Person analysis. RESULTS AND CONCLUSION:(1)Compared with the other two groups,the time proportion of support time phase of subjects in the overweight group was relatively small,while the time proportion in the foot heel contact period and forefoot extension period was relatively large.There was a positive correlation of the time proportion of the foot heel contact period and forefoot extension period with body mass index,while there was a negative correlation between the time proportion of the arch support period and body mass index.(2)The peak pressure of the left arch and palm of the foot of the subjects of the overweight group was higher than that of the normal group,and the peak pressure of the left and right palm of the foot of the lean group was lower than that of the normal group.The peak pressure was positively correlated with the body mass index during the foot heel contact period.There was a significant positive correlation between the peak pressure of the left foot and body mass index during the arch support period as well as the peak pressure of both feet and body mass index during the forefoot extension period.(3)Plantar peak force time in the order of the gait cycle in increasing order:heel<arch<metatarsal<toe.In the foot heel contact period,the time of peak force was negatively correlated with body mass index,but they were positively correlated with each other in the forefoot extension period.In the arch support period,the time of peak force of the left arch was significantly positively correlated with body mass index.(4)Plantar peak force was mainly expressed as medial heel>toe/middle 2-4 metatarsal>lateral heel>medial and lateral metatarsal>arch;medial heel peak force was the largest,and the arch peak force was the smallest.Except for the toe of the left foot,there was a significant positive correlation between peak force and body mass index.(5)The maximum ground impulse of the lean group and the overweight group was in the foot heel contact stage,the minimum ground impulse was in the forefoot extension period,and the minimum ground impulse of the arch was in the normal group.There was a significant positive correlation between ground impulse and body mass index at different periods.(6)The results show that young people should control their body mass index,wear appropriate shoes,protect their feet and ankles,and prevent the occurrence of flat feet.
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ObjectiveTo analyze the characteristics of plantar pressure of diabetic patients during gait cycle, and to design a offloading insole with variable stiffness. MethodsThe plantar pressure experiment was carried out and a database including 157 subjects was established. The differences of plantar pressure distribution were analyzed among diabetic patients with and without peripheral neuropathy, and healthy people. The insole pressure area was divided, and porous units were filled in different insole areas according to the pressure gradient. The fed-calf-insole finite element model of diabetic patients was constructed. The simulation analysis of different insole schemes was carried out under the conditions of push-off, footheel-strike and dynamic neutrality posture, and to explore the most reasonable insole stiffness design. ResultsCompared with the healthy group, the percentage of peak pressure and high pressure in the left and right heel areas of diabetic neuropathy patients showed a decreasing trend, in which the left peak pressure was significantly reduced by 11% (P = 0.026) and the percentage of high pressure was significantly reduced by 9.8% (P = 0.02). When the porous elements of 2.5 MPa and 1.9 MPa were used in the high pressure area of the insole metatarsal and high pressure area of the heel, the peak plantar pressure of footheel-strike, dynamic neutral and push-off was reduced by 42.4%, 27.4% and 26.4%, and the peak stress of the soft tissue was reduced by 49.8%, 43.6% and 25.1%, respectively. ConclusionThere is a higher risk of ulcer in the metatarsal region than in the heel region for diabetic patients. The variable stiffness insoles based on the optimization of plantar pressure and internal stress under multi-posture can effectively reduce the peak pressure of plantar and peak stress of soft tissue during walking, which provides a reference for the design of variable stiffness insoles.
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Objective To explore the difference of balance ability between patients with chronic nonspecific low back pain ( CNLBP) and healthy individuals, and the correlation between patients’ pain symptoms, lumbar flexibility, abdominal muscle endurance, overall function, quality of life and fear of avoidance with balance ability, so as to guide clinical rehabilitation evaluation. Methods A total of 34 patients with CNLBP were selected as the experimental group, and 34 healthy volunteers without history of low back pain were selected as control group. The plantar pressure measurement system was used to collect the ratio of forefoot to hindfoot pressure, pathlength ( L) of plantar center of pressure ( COP), displacement length in anteroposterior direction ( LAP ), displacement length in mediolateral direction (LML ), mean velocity (v), displacement velocity in anteroposterior direction (vAP ), displacement velocity in mediolateral direction (V-ML) and elliptical swing area (S). In addition,the experimental group was assessed by the visual analogue scale (VAS), the finger floor distance (FFD), the number of sit-ups in 1 minute, the Oswestry disability index (ODI), the 36-item short form survey (SF-36) and the fear avoidance beliefs questionnaire (FABQ), and correlated with plantar pressure parameters. Results All plantar pressure parameters were significantly different between the two groups ( P < 0. 05). The the ratio of forefoot to hindfoot pressure in experimental group was significantly lower than that in control group (P<0. 05), and the parameters L, LAP , LML , v, vAP , vML and S were significantly higher than those of control group (P<0. 05). With eyes open or closed, the VAS score of experimental group was positively correlated with L, LAP , LML(P<0. 05), and FFD and FABQ scores were positively correlated with L and LML , respectively (P< 0. 05). With eyes open, ODI was positively correlated with L, LAP and LML (P< 0. 05), and SF-36 score was negatively correlated with L and LML(P<0. 05). With eyes closed, the number of 1-min sit-ups was negatively correlated with LAP and S (P<0. 05), ODI was positively correlated with L and LML(P<0. 05), and the SF-36 score was negatively correlated with L (P<0. 05). Conclusions The static balance ability of patients with CNLBP is decreased, and it is correlated with pain symptoms, lumbar function, quality of life and psychological status. The result can provide references for the assessment of functional activities.
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Objective To analyze the plantar pressure distribution of knee osteoarthritis ( KOA) patients after medial opening wedge high tibial osteotomy ( MOWHTO), so as to provide biomechanical references for the surgical treatment and rehabilitation of patients. Methods A total of 31 patients with medial single compartmental KOA after unilateral MOWHTO treatment were selected as the experimental group, and 35 healthy subjects at same age were selected as the control group. The Pedomedic 40 pressure measuring system was used to test dynamic plantar pressure. By comparing the maximum pressure ( pmax ), force-time integral ( FTI) and contact area (CA) of different plantar zones between the experimental group (operative side and unoperated side) and the control group during walking, the changes of plantar pressure in patients with medial single compartmental KOA after MOWHTO were evaluated. Results Compared with the unoperated side and the control group, the CA and FTI of the 1st metatarsal head (MH1) were higher (P<0. 05), the CA of the 4th metatarsal head (MH4)was smaller (P<0. 001), the pmax and FTI of the 5th metatarsal head (MH5) were smaller (P<0. 05), the CA of the lateral middle foot (MF-L) was smaller (P<0. 001), and the CA of the medial rear foot (RF-M) was larger (P<0. 05). Compared with the control group, the pmax of MH1 and MH2 was smaller (P<0. 05), the CA and FTI of MH5 were larger (P<0. 05), the pmax of MF-L was larger (P<0. 001), and the FTI of lateral rear foot (RF-L) was larger (P<0. 05). Conclusions Compared with healthy people, patients with medial single compartmental KOA have abnormal plantar pressure residual after MOWHTO. In clinical practice, targeted intensive rehabilitation therapy is necessary to restore the normal plantar distributions of patients.
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Objective To compare the differences in kinematic parameters and plantar pressures for two types of knee varus with tibial and femoral origins in gait analysis, so as to provide biomechanical theoretical basis for different types of genu varus. Methods Twenty-six patients with unilateral knee osteoarthritis (KOA) varus genu were enrolled, with 13 from femoral and 13 from tibial sources. Using Noraxon MyoMotion three-dimensional (3D) motion capture system and Footscan plantar pressure test system, the gait of the subjects during natural walking was measured, the temporal and spatial parameters of the gait, the kinematics parameters of lower limb joints and plantar pressures were collected, to make comparative analysis between the two groups. Results The range of knee flexion and extension of tibial varus, the peak of hip abduction, the range of motion (ROM) of hip adduction and abduction and the peak of ankle pronation were larger than those of femoral lateral genu varus. The peak of knee flexion and hip adduction was smaller than that of femoral lateral genu varus. Compared with femoral varus, subjects with tibial varus had increased stress time and peak pressure on the plantar of the 4th and 5th metatarsals (P<0.05). In the 3rd metatarsal region, the impulse of healthy femoral limb was greater than that of healthy limb with tibial deformity. While in the medial calcaneal region, the impulse of healthy femoral limb was smaller (P<0.05). Conclusions There are some differences in kinematic parameters and plantar pressures between two different types of unilateral genu varus patients. The results of this study are helpful to understand the abnormal gait caused by genu varus, and provide reliable reference for postoperative rehabilitation and limb exercise for different types of genu varus.
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Objective An X-shaped cushioning insole with variable stiffness was designed to explore its effects on plantar pressure and internal stress of diabetic patients with toe amputation. Methods Based on CT images, the feet-calf finite element model of diabetic patients with toe amputation was established, and the insole was divided into different areas according to distribution characteristics of the planter pressure. The three-dimensional (3D) printed cushioning insole with an X-shaped sandwich structure was designed. The modulus of the sandwichstructure was changed by changing thickness of the sandwich structure panel. For simulation analysis, the divided area was filled with the X-shaped sandwich structure with different modulus. Results The peak plantar pressure of diabetic patients with toe amputation was in calcaneal region, and the combined insoles with 1. 2 mpanel thickness in toe area, 1. 4 mm panel thickness in metatarsal area, 2. 0 mm panel thickness in middle area and 1. 6 mm panel thickness in heel area had the best decompression effect. Compared with bare feet, the peak pressure in heel area of the insole, the peak pressure in phalangeal head area and the stress in plantar softissues were reduced by 40. 18% , 31. 7% , and 50. 44% , respectively. Conclusions The 3D printed insoles with variable stiffness can effectively reduce surface pressure and internal stress of the sole and reduce probability of the 2nd toe amputation
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Objective To analyze the influence of different backpack types and loads on kinematics and plantar pressure of college students during stair climbing, so as to provide references for choosing the appropriate backpack and carrying mode. Methods The Nokov infrared light point motion capture system and Podome plantar pressure system were used to analyze the differences in the range of motion ( ROM) of the trunk and lower limb joints, the kinematic parameters at the peak time, the peak pressure of each plantar partition, the contact time, the maximum pressure of the whole foot, the average pressure and the maximum contact area for 15 male college students during the support period of stair climbing. Results The 5% BW and 10% BW backpack loads reduced ROM of trunk rotation, increased ROM of ankle flexion/ extension and varus / valgus. The 10% BW backpack loads increased the peak pressure of the 1st and 3rd metatarsals bones and the maximum pressure of the whole foot ( P < 0. 05). Single-shoulder bag and handbag reduced ROM of trunk tilting and rotation, and increased ROM of ankle flexion and extension, hip flexion angle, peak pressure of foot arch and medial heel (P<0. 05). The double-shoulder bag loads increased peak pressure in the toe area (P<0. 05). Conclusions During walking on the stairs, the 5% BW and 10% BW backpack loads limited trunk rotation and increased ankle ROM. The 10% BW loads also increased the load in metatarsal area. The unilateral weight-bearing mode would make the trunk tilt to the unload side and rotate to the weight-bearing side. The pressure in toe area was higher when carrying double-shoulder bag, while single-shoulder bag and handbag mainly increased the pressure of arch foot and medial heel. It is suggested that college students choose symmetrical backpack scheme, and wisely allocate back weight to avoid the injury of foot area.
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Objective:To explore any changes with age in the center of plantar pressure among normal people after walking.Methods:Fifty healthy subjects were divided into a young group and an elderly group, each of 25. Gait descriptors were collected for each subject using a model AL-600 gait and balance training and evaluation apparatus. The gait descriptors were the center of pressure displacement (COPD), and the COPD in the medial-lateral (COPD-X) and anterior-posterior (COPD-Y) directions before and after 10 and 15 minutes of walking.Results:The average COPD, COPD-X and COPD-Y of the elderly group increased after both 10 and 15 minutes of walking, but among the young group increases were observed only after 15 minutes. The average COPD, COPD-X and COPD-Y of the elderly group were always significantly larger than the young group′s averages.Conclusions:Gait stability among the elderly decreases after as little as 10 minutes of walking, but among the young decreases are observed only after 15 minutes.
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Objective According to clinical demand of quantification evaluation on flat foot and high arch, an intelligent and rapid method to diagnose arch shape based on principal component analysis (PCA) of plantar pressure is proposed, and its clinic validity is tested. Methods Volunteers diagnozed as abnormal arch and healthy arch were included in this study, and a portable intelligent arch test system was designed and developed. By adopting thin-firm piezoresistive sensor array with 44 rows, 52 columns of sensing units, the system could collect plantar pressure distribution data from the subjects under static standing. Foot axis could be fitted automatically by using the self-programmed PCA, so that foot diagnosis was completed with diagnostic report. The plantar pressure results from the system were compared with those from the existing plantar pressure acquisition device, so as to verify precision of collected data. The accuracy of the diagnosis algorithm for flat foot, high arch and healthy foot was verified through comparison with clinical diagnosis. Results The result of the system had a good correlation with that of the existing plantar pressure acquisition device, the deviation of contact area acquired by the system was smaller than 3.2%, and the angle deviation of the fitted foot axis with clinically defined angel was less than 1°. The system was capable of making diagnosis on arch shape that was 92.6% consistent with the clinical diagnosis. Conclusions PCA is introduced to automatically fit foot axis to achieve the purpose of fast and accurate extraction of foot arch information. The method can be used to assist clinical diagnosis of flat foot and high arch foot, and contribute to quantative analysis on foot arch deformity and its pathogenesis study.
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Objective To explore dynamic characteristics of the gait for the elderly with different fall risks before and after obstacle crossing. Methods Twenty-seven elderly people in community were graded as fall risk by using the time up and go test and five-time sit to stand test. The plantar pressure parameters of the elderly before and after obstacle crossing were measured and analyzed by foot pressure measurement system. Results There was no significant difference in the characteristic value of bimodal curve of overall plantar pressure between the high and low fall risk groups before and after obstacle crossing(P>0.05). The center of pressure (COP) trajectory in X direction of high fall risk group after obstacle crossing was significantly greater than that of low fall risk group (P0.05). Conclusions The support time of the elderly with high fall risk is longer than that of the elderly with low fall risk during obstacle crossing, the peak pressure of plantar metatarsal region of the crossing leg increases, and the plantar COP curve shows asymmetry, with an increase in transverse range of the coronal plane. In clinical evaluation, plantar pressure characteristics of people with fall risks during obstacle crossing should be focused on.
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Objective To develop plantar force model of patellofemoral pain (PFP), so as to provide theoretical references for the assessment of PFP rehabilitation. Methods The case-control study was conducted, and a total of 126 patients with PFP and 126 healthy controls matched by gender and age were enrolled in the study. The participants were tested for plantar force and pressure during level walking, and twelve plantar regions were divided and recorded. Whether the participants suffered PFP was analyzed as dependent variable, meanwhile the peak force and peak pressure in 12 plantar regions of participants at selected speed during level walking were analyzed as independent variables. Conditional logistic regression (CLR) equations of peak force and peak pressure with PFP were established, respectively. The receiver-operating characteristic (ROC) curve of the corresponding equations was derived, and the area under ROC curve was calculated to analyzed the validity of different equations on PFP assessment. Results The CLC equation of peak force in 12 plantar regions of the participants with FFP was constructed, and only peak force of lateral heel was in the equation. The CLC equation of peak pressure in each plantar region included medial heel, midfoot, 1st and 2nd metatarsals. Meanwhile, the area under ROC curve of the pressure equation was larger than that of the force equation. Conclusions Peak force and pressure at different plantar regions can be used to assess PFP during level walking, and peak pressure is more effective for assessment.
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Objective To analyze the gait characteristics of hip disarticulation amputees, and analyze the reasons for their differences from normal gait, so as to assist clinical diagnosis and evaluation. Methods Through the portable human motion capture device and plantar pressure analysis system, the kinematics and plantar pressure information of 5 hip amputees were collected and compared with 15 healthy volunteers in control group. Gait differences between the amputees and normal subjects and between the affected leg side and the healthy leg side of the amputees were compared. Results The proportion of double-support period for hip amuptees was higher than that of normal gait. Step length, step time, loading response period, mid support period, pre-swing period, proportion of the swing period for the affected leg side and healthy leg side of hip amputees showed significant differences with those of control group. The relative symmetry index of the gait for hip amputees was 0.60±0.05. Compared with the affected leg side, the support period of the healthy leg side was extended, the step length was shortened, the ground reaction force was greater than that of the affected leg side, and the center of pressure trajectory shifted to the affected leg side. Conclusions The gait of hip amputees is significantly different from that of normal people. Hip amputees have weak walking ability, poor gait symmetry, and they lack of continuity in the body’s center of gravity. The results provide experimental basis and theoretical analysis for the design of mechanical structure and control system of novel hip prosthesis.
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Objective:To explore the features the gait of elderly persons with type 2 diabetes and peri-pheral neuropathy.Methods:Twenty patients no less than 60 years old with type 2 diabetes and peripheral neuropathy (DPN) formed a DPN group, while 20 counterparts with type 2 diabetes but without peripheral neuropathy composed the DM group, and another 20 healthy counterparts served as a control group. The three groups were tested using the Swedish Qualisys motion capture system and their walking speed, step length, step width, stride frequency and stride length, bipedal foot support phase time, single foot support phase time, peak plantar pressure, and regional-holding time were collected and compared.Results:The average walking speed, stride length and stepping frequency of the DPN group were all significantly lower than the other 2 groups′ averages. Their bipedal support phase was significantly longer, but their single foot support phase time was significantly shorter. And in the DPN group the average first and second peak plantar pressures and the second peak pressure time were significantly greater than the other groups′ averages.Conclusions:Elderly patients with type 2 diabetes and peripheral neuropathy have significant gait abnormalities, decreased walking stability, as well as increased plantar pressure and plantar compression time.
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Resumen: Introducción: El pie cavo es una patología musculoesquelética con un aumento del arco medial del pie. La etiología del pie cavo aún es incomprensible, está relacionada con afecciones neurológicas, enfermedad de Charcot-Marie-Tooth, ataxia de Friedreich y parálisis cerebral. El objetivo de esta investigación fue analizar la distribución de la presión plantar en atletas jóvenes con pie cavo. Material y métodos: Se reclutaron 83 atletas jóvenes de entre nueve y 20 años de edad, que presentaban patología de pie cavo. La masa y el promedio de altura fueron 56.9 ± 12.36 kg y 1.61 ± 0.10 m, respectivamente. La distribución de la presión plantar de los pies se registró durante condiciones estáticas. Se compararon las presiones del antepié y el retropié. Resultados: La distribución de la presión plantar se categorizó en tres grupos. En el primer grupo los participantes presentaron mayor presión en la parte anterior del pie; en el segundo grupo los atletas mostraron una presión similar en la región posterior y anterior de los pies y en el último los sujetos revelaron una mayor presión en el retropié. Para ser considerado en uno de los tres grupos, la diferencia de presión entre la parte posterior y anterior del pie se estableció en 16%. Conclusión: Muchos trastornos musculoesqueléticos en el cuerpo humano son de origen biomecánico y están relacionados con la anatomía del pie. El pie cavo es una patología con alta prevalencia en atletas y está relacionada con las fuerzas mecánicas sobre los pies en condiciones dinámicas.
Abstract: Introduction: The cavus foot is a musculoskeletal pathology with an increase of the medial arch of the concavity of the foot. The etiology of the cavus foot is still enigmatic, it is related with neurologic conditions, Charcot-Marie-Tooth disease, Friedreich's ataxia, and cerebral palsy. The aim of this research was to analyze the plantar pressure distribution of the feet on young athletes with cavus foot. Material and methods: Eighty-three young athletes between nine and 20 years old, that presented cavus feet pathology were recruited. The mass and height average were 56.9 ± 12.36 kg and 1.61 ± 0.10 m respectively. Plantar pressure distribution of the feet was recorded during static conditions. The hindfoot and forefoot pressure were compared in each foot. Results: The plantar pressure distribution were categorized in three groups. In the first group the participants presented higher pressure in the hindfoot than forefoot, in the second group, the athletes showed similar pressure in the posterior and anterior region of the feet and in the last one, the subjects revealed higher pressure in the forefoot. To be considered in one of the three groups, the difference of pressure between the posterior and anterior part of the foot was established at 16%. Conclusion: Many musculoskeletal disorders in the human body are biomechanical in origin and related with foot anatomy. The cavus foot is a pathology with high prevalence in athletes and it is related with the mechanical forces over the feet during dynamic conditions.
RÉSUMÉ
Objective To compare the differences in plantar kinetics between older male adults and young male adults during walking, and to explore the influences of aging on plantar kinetics. Methods The in-shoe plantar sensory measurement system was used to collect and compare left foot parameters of 13 older men and 14 young men during tandem walk, including contact time, beginning of contact in percentage of roll over process (%ROP), and end of contact in %ROP, peak pressure, instant of peak pressure in %ROP, maximum mean pressure, pressure-time integral, maximum force, instant of maximum force in %ROP, mean force and force-time integral. Results Beside media arch, the contact time on all regions of older men was longer, whereas, the beginning of contact in %ROP on lateral heel, lateral arch was greater, and the end of contact in %ROP on medial heel and 2nd-3rd metatarsal head was smaller compared with young men. The maximum force and mean force on the whole foot region, and the maximum mean pressure and maximum force on 2nd-3rd metatarsal head of older people were significantly lower; the pressure-time integral on the whole foot region, the 4th-5th metatarsal head, the 2nd -5th toes, and the force-time integral on the whole foot region, medial heel, lateral heel and 2nd -5th toes were significantly higher compared with young men. Conclusions During tandem walking, plantar fascia dysfunction might be one of the main reasons for the decline of postural control ability, and the contraction enhancement of flexor digitorum longus and flexor digitorum brevis could compensate for postural stability improvement in older men.