The impact of anthropometric measures on plantar pressure distribution in male handball players and non-athletes: A cross-sectional study.

BACKGROUND: Increasing body anthropometry brings substantial spinal stress, which influences the spinal curvatures; this in turn may affect the foot plantar pressure distribution. OBJECTIVES: This study investigated the impact of body anthropometry on static plantar pressure distribution and their relationship among handball players and non-athletes subjects. METHODS: Thirty handball players aged from 21 to 26 years, and thirty age-matched non-athletes subjects aged from 21 to 28 years participated in this study. The spinal lordosis and kyphosis angles, trunk length, pelvic tilting, and pelvic rotation were evaluated using Formetric 4-dimensions and the Pedoscan device was used to assess the plantar pressure distribution. RESULTS: The handball players were significantly taller, heavier, and have a long trunk length than non-athletes group (p < 0.05), and a significantly increased thoracic kyphosis, forefeet pressure distribution compared to non-athletes group (p < 0.05). The handball players had a significantly increased forefeet pressure distribution compared to the rearfeet pressure distribution (p < 0.05), a high positive correlation between body height, and both trunk length and kyphosis angle (r = 0.932, 0.665 respectively), and the body height showed a high positive correlation with the forefeet pressure distribution (r = 0.665). There was a high positive correlation between the handball players' thoracic kyphosis and forefeet pressure distribution (r = 0.751). CONCLUSION: Increasing the handball players' body height was related to increased thoracic kyphosis and forefeet pressure distribution compared to non-athletes subjects. Additionally, the kyphotic posture of handball players is associated with increasing the total forefeet pressure distribution compared to the total rearfeet pressure distribution.

Effect of short-term spinal orthosis and insoles application on cobb angle, plantar pressure and balance in individuals with adolescent idiopathic scoliosis.

BACKGROUND: Spinal orthosis applications are preferred for conservative treatment of adolescent idiopathic scoliosis, and holistic biomechanical approaches are recommended. METHODS: This was single-blind, prospective, randomized, controlled study. It included 42 patients (29 females/13 males) aged 10-18 years with adolescent idiopathic scoliosis, Cobb angle of 20°-45°, who were deemed suitable for spinal orthosis use. Patients were randomly divided into two groups: control, spinal orthosis group (n = 21), and insoles and spinal orthosis group (n = 21). All participants used spinal orthoses for 3 months. This study evaluated the functional capacities, quality of life, balance, and plantar pressures of the participants. The evaluations were repeated after 1 week, and 3 months following spinal orthosis application. FINDINGS: Statistically significant difference and positive effect were observed in Cobb angle (p = 0.008; p = 0.878, respectively), right total (p = 0.037; p = 0.193, respectively), left total (p = 0.037; p = 0.193, respectively), left rearfoot (p = 0.002; p = 0.708, respectively), and right forefoot plantar pressure (p = 0.001; p = 0.739, respectively) in participants in insoles and spinal orthosis group compared with those in the control group. Statistically significant differences and positive effects were observed in swing length (p = 0.001; p = 0.053, respectively) and functional capacity (p = 0.005; p = 0.220, respectively), which are parameters related to postural balance. No change was found in quality of life of either group (p > 0.05). INTERPRETATION: Insoles may have positive impact on functional capacity, balance, and plantar pressure during long-term follow-up in individuals with scoliosis. Therefore, the evaluation of foot plantar pressure in individuals with scoliosis is recommended, and personalized insoles may be a beneficial option.

Effectiveness of Photobiomodulation Therapy on Neuropathic Pain, Nerve Conduction and Plantar Pressure Distribution in Diabetic Peripheral Neuropathy - A Systematic Review.

BACKGROUND: Diabetic peripheral neuropathy is a severe complication of type 2 diabetes mellitus. The most common symptoms are neuropathic pain and altered sensorium due to damage to small nerve fibers. Altered plantar pressure distribution is also a major risk factor in diabetic peripheral neuropathy, leading to diabetic foot ulcers. OBJECTIVE: The objective of this systematic review was to analyze the various studies involving photobiomodulation therapy on neuropathic pain and plantar pressure distribution in diabetic peripheral neuropathy. METHODS: We conducted a systematic review (PubMed, Web of Science, CINAHL, and Cochrane) to summarise the evidence on photobiomodulation therapy for Diabetic Peripheral Neuropathy with type 2 diabetes mellitus. Randomized and non-randomized studies were included in the review. RESULTS: This systematic review included eight studies in which photobiomodulation therapy showed improvement in neuropathic pain and nerve conduction velocity. It also reduces plantar pressure distribution, which is a high risk for developing foot ulcers. CONCLUSION: We conclude that photobiomodulation therapy is an effective, non-invasive, and costefficient means to improve neuropathic pain and altered plantar pressure distribution in diabetic peripheral neuropathy.

Within-session and between-session effects of auditory biofeedback training on center of pressure location during gait in patients with chronic ankle instability.

OBJECTIVES: To establish preliminary gait training dosage parameters for patients with chronic ankle instability (CAI) by determining the within-session and between-session effects of auditory biofeedback training on center of pressure (COP) location during gait. DESIGN: Observational Longitudinal. SETTING: Laboratory. PARTICIPANTS: 19 participants with CAI, 8 participants who did not receive auditory biofeedback (NoFeedback group) and 11 participants who did receive auditory biofeedback (AuditoryFeedback group) over an 8-session 2-week intervention. MAIN OUTCOME MEASURES: COP location was measured at the start and at each 5-min interval during treadmill walking across all eight 30-min training sessions. RESULTS: The AuditoryFeedback group had significant within-session lateral-to-medial shifts in COP location during only session-1 at the 15-min (45% of stance; peak mean difference = 4.6 mm), 20-min (35% and 45%; 4.2 mm), and 30-min time intervals (35% and 45%; 4.1 mm). Furthermore, the AuditoryFeedback group had significant between-session lateral-to-medial shifts in COP location at session-5 (35-55% of stance; 4.2 mm), session-7 (35%-95%; 6.7 mm), and session-8 (35%-95%; 7.7 mm). The NoFeedback group had no significant changes in COP location within-sessions or between-sessions. CONCLUSIONS: Participants with CAI who received auditory biofeedback during gait needed an average of 15-min during session-1 to meaningfully shift their COP location medially and 4-sessions before retaining the adapted gait pattern.

[Tiaohe Yinyang acupotomy for knee osteoarthritis: a randomized controlled trial].

OBJECTIVE: To observe the clinical efficacy of Tiaohe Yinyang acupotomy (acupotomy for regulating and harmonizing yin and yang) for knee osteoarthritis (KOA). METHODS: A total of 88 patients with KOA were randomized into a acupotomy group and a sham-acupotomy group, 44 cases in each group. In the acupotomy group, acupotomy was applied at yin side (4-5 high stress points i.e. pes anserinus and terminal of popliteus) and yang side (1-2 high stress points i.e. stimulation point of infrapatellar ligament and suprapatellar bursa) of knee joint. In the sham-acupotomy group, sham-acupotomy was applied at the same points as the acupotomy group. The treatment was given once a week for 2 weeks in the two groups. Before and after treatment, the Western Ontario and McMaster Universities arthritis index (WOMAC) score, visual analogue scale (VAS) score, thickness of medial and lateral collateral ligaments of knee joint, motion range of knee joint and plantar pressure distribution were observed in the two groups. In the follow-up of 3 months after treatment, the WOMAC and VAS scores were recorded in the acupotomy group. RESULTS: After treatment, the sub item scores (pain, stiffness and function) and total scores of WOMAC and VAS scores were decreased in the both groups (P<0.05), pain score, function score and total score of WOMAC and VAS score in the acupotomy group were lower than those in the sham-acupotomy group (P<0.05). Before and after treatment, there were no statistical differences in thickness of medial and lateral collateral ligaments of knee joint and motion range of knee joint between the two groups (P>0.05). After treatment, the plantar medial pressure was increased while the plantar lateral pressure was decreased (P<0.05), and the plantar force line moved medially in the acupotomy group. In the follow-up, the sub item scores and total score of WOMAC and VAS score were lower than those before and after treatment in the acupotomy group (P<0.05). CONCLUSION: Tiaohe Yinyang acupotomy can improve the clinical symptoms of knee joint in patients with KOA by changing the local biological stress.

Insole-Based Systems for Health Monitoring: Current Solutions and Research Challenges.

Wearable health monitoring devices allow for measuring physiological parameters without restricting individuals' daily activities, providing information that is reflective of an individual's health and well-being. However, these systems need to be accurate, power-efficient, unobtrusive and simple to use to enable a reliable, convenient, automatic and ubiquitous means of long-term health monitoring. One such system can be embedded in an insole to obtain physiological data from the plantar aspect of the foot that can be analyzed to gain insight into an individual's health. This manuscript provides a comprehensive review of insole-based sensor systems that measure a variety of parameters useful for overall health monitoring, with a focus on insole-based PPD measurement systems developed in recent years. Existing solutions are reviewed, and several open issues are presented and discussed. The concept of a fully integrated insole-based health monitoring system and considerations for future work are described. By developing a system that is capable of measuring parameters such as PPD, gait characteristics, foot temperature and heart rate, a holistic understanding of an individual's health and well-being can be obtained without interrupting day-to-day activities. The proposed device can have a multitude of applications, such as for pathology detection, tracking medical conditions and analyzing gait characteristics.

[Therapeutic effect of acupoint catgut embedding on balance function and plantar pressure in hemiplegic patients].

OBJECTIVE: To investigate the therapeutic effect of acupoint catgut embedding on balance function and plantar pressure in hemiplegic patients. METHODS: A total of 98 hemiplegic patients were equally randomly assigned to routine treatment group and acupoint catgut embedding group. The patients in the routine treatment group were given routine medical treatment, routine acupuncture and rehabilitation training. And those in the catgut embedding group were given catgut embedment at Shenshu (BL23), Xinshu (BL15), Ganshu (BL18), Pishu (BL20), Guanyuan (CV4) and Qihai (CV6) in addition to the treatment in the routine treatment group. The course of treatment was 3 weeks for both groups. The plantar pressure as well as the Berg balance scale (BBS) score were measured before and after treatment. RESULTS: (1) After 3 weeks treatment, the percentage of static plantar pressure of the affected foot was significantly increased in the two groups compared with their own pre-treatment (P<0.05, P<0.01), and it was significantly higher in the catgut embedding group than in the routine treatment group after one week treatment (P<0.01). (2) After 3 weeks treatment, the peak pressures of the following parts in the catgut embedding group increased significantly in comparison to its own pre-treatment (P<0.05, P<0.01), which were 1) the first toe (affected foot), 2) the first metatarsal bone (affected foot), 3) the third metatarsal bone (affected foot), 4) the middle of foot (affected foot), 5) the medial heel (affected foot). After 3 weeks treatment, the peak pressures of the first metatarsal bone and the medial heel of the affected foot in the routine treatment group were significantly higher than those before treatment (P<0.05). After 1 week treatment, the peak pressure of the first toe of the affected foot in the embedding group was significantly higher than that in the routine treatment group (P<0.05). The peak pressures of the first metatarsal bone and the middle of the affected foot in the catgut embedding group were significantly higher than those in the routine treatment group after one and two weeks treatment (P<0.01, P<0.05). After 1, 2 and 3 weeks treatment, the peak pressure in the middle of the healthy foot in the embedding group was significantly lower than that in the routine treatment group (P<0.01). (3) After 3 weeks treatment, the BBS scores of the two groups were significantly higher than those before treatment (P<0.05), and the BBS score of the embedding group was significantly higher than that of the routine treatment group (P<0.05). CONCLUSION: Acupoint catgut embedding can effectively improve the plantar pressure and balance function of stroke patients with hemiplegia.

Correlation between baropodometric variables, disability, and intensity of low back pain in pregnant women in the third trimester.

BACKGROUND: Growth of uterus, enlargement of breasts and weight gain result from the development and growth of the fetus during pregnancy. The posture and the displacement of the center of gravity change. OBJECTIVE: Correlate baropodometric variables with low back pain in pregnant women in the third trimester of pregnancy. METHODS: This is a cross-sectional analytical study conducted in São Luís (MA, Brazil). For data collection, we used a form containing sociodemographic and clinical data, Oswestry Disability Questionnaire for disability evaluation of the lumbar spine, Numerical Rating Scale to measure pain intensity, and baropodometric evaluation. RESULTS: Twenty-five pregnant women took part in the study. There was a significant and positive correlation (r = 0.404, p = 0.045) between functional disability and hindfoot pressure and a significant and negative correlation (r = -0.404, p = 0.045) between functional disability and plantar pressure in the forefoot of the right foot. In addition, there was a positive and significant correlation between the intensity of pain and the contact area on the left (r = 0.504, p = 0.010) and right (r = 0.509, p = 0.009) foot. CONCLUSION: There is a relation between disability and plantar pressure and between pain intensity and area of contact of feet in pregnant women.

Baropodometric quantification and implications of muscle coactivation in the lower limbs caused by head movement: A prospective study.

BACKGROUND: In healthy young adults, muscle coactivation can sometimes be induced by remote voluntary contractions when the motor task is forceful, maximal, tiring, or cyclic and brief. OBJECTIVES: To show that a change in plantar pressure is an unequivocal response to backward movement of the head, and to contribute to a better understanding of physiotherapy methods that involve remote muscle activation. METHODS: Involuntary coactivation was quantified as a percentage of the anteroposterior plantar pressure distribution, using a baropodometric platform in a population of young adults. The baropodometric data were collected from a 1s recording after 30 s in the reference condition, and from 1s recordings during the first second and then during the 120th second in the test condition. The results were analyzed with Bayesian statistics (Markov chains and Monte Carlo integration techniques). RESULTS: 90 adults participated in the study (age range: 19-26; 38 males and 52 females). The forefoot plantar pressure increased in all cases, by a mean multiplicative factor (on a logit scale) of 1.12 (from 72.24% to 74.45%) when the head was aligned over the trunk. CONCLUSIONS: This 90-participant trial confirmed our initial hypothesis: a increase in forefoot plantar pressure is a systematic response to the motor task (head movement), and suggests greater recruitment of the plantar flexor muscles. A spinal reflex and/or a previously unknown form of motor overflow might be involved in this phenomenon. These results support the development of inductive physiotherapy techniques based on remote muscle activation in the treatment of musculoskeletal disorders. CLINICALSTRIAL. GOV IDENTIFIER: NCT02320097.

A biomechanical assessment of the acute hallux abduction manipulation intervention.

BACKGROUND: Naturally aligned toes, particularly hallux, have reported with gripping functions during locomotion, thus expanding the forefoot loading area. RESEARCH QUESTION: The purpose of this study was aimed to investigate the influence of hallux abduction manipulation on the foot plantar pressure distribution and inter-segment kinematic alterations. METHODS: Thirteen subjects participated in this toe manipulation study. A Footscan® pressure plate and Vicon motion capture system were utilized for the measurement of plantar pressure distribution and lower extremity and foot inter-segment kinematics during walking and running. Paired-sample t-test from statistical parametric mapping 1d was used to check the kinematic significance. RESULTS: Peak pressure in third metatarsal (M3) increased significantly during walking under manipulation. Contact area increased in second metatarsal (M2) with manipulation during running. Peak pressure and pressure-time integral illustrated significant increases in M3, and the maximum force and impulse in fourth metatarsal (M4) increased significantly. Arch height index increased while walking with toe manipulation. The foot progression angle in the frontal plane showed significant decrease in mid-swing phase during walking and significant increase in mid-stance phase during running. The hallux relative to forefoot angles presented higher axial rotation in the frontal plane. SIGNIFICANCE: Findings form this study showed centrally and laterally redistributed foot loadings and increased forefoot inter-segment flexibility with manipulation, which may be used as baseline to evaluate toe-manipulation interventions in foot disorders, specifically hallux valgus deformity.

Changes in gait and plantar foot loading upon using vibrotactile wearable biofeedback system in patients with stroke.

BACKGROUND: Patients with stroke walk with excessive foot inversion at the affected side, which may disturb their balance and gait. OBJECTIVES: This study aimed to investigate the effects of instant biofeedback of plantar force at the medial and lateral forefoot regions on gait and plantar foot loading in patients with stroke. METHODS: A total of eight patients with hemiplegic stroke, who had flexible rearfoot varus deformity at the affected side, participated in this study. A vibrotactile biofeedback system was developed and evaluated. It analyzed forces at the medial and lateral forefeet, and instantly provided vibration clues when the plantar force at medial forefoot was less than a threshold. Each subject's three-dimensional gait parameters and plantar-pressure distribution during walking were measured under two experimental conditions (sequence randomized): with and without the device turned on (Trial-registration number: ChiCTR-IPB-15006530 and HKCTR-1853). RESULTS: Providing biofeedback significantly reduced the foot inversion and increased the mid-stance foot-floor contact area and medial midfoot plantar pressure of the affected limb, bringing the values of these parameters closer to those of the unaffected side. The biofeedback also significantly reduced the unaffected side's excessive knee flexion and hip abduction. CONCLUSIONS: There were signs of improved foot loading characteristics and gait upon provision of instant vibrotactile biofeedback of plantar force. The positive results of this study further support the development of wearable biofeedback devices for improving gait of patients with stroke.

A review of the utilization of baropodometry in postural assessment.

Postural deviations have been linked to a series of different kinds of pain and dysfunction. Since the human foot is the basis of support and propulsion for gait, and baropodometric analysis assesses dysfunctions of the feet, it may be valuable in terms of postural assessment. Therefore, the aim of this literature review was to investigate which studies have used this baropodometric equipment and how the equipment was used, as well as to discuss the scientific problems and solutions associated with the study and clinical practice of baropodometry. Twenty-eight of the 48 articles found in the Pubmed and Lilacs databases were used. The baropodometer has the potential to provide excellent research in the postural field and related areas. However, baropodometry requires standardization and an improved calibration system. Further significant scientific papers, using properly calibrated equipment, are important in order to improve the quality of the technique and display evidence of its clinical and scientific value.