Use of Pressure-Measuring Insoles to Characterize Gait Parameters in Simulated Reduced-Gravity Conditions.

Prior researchers have observed the effect of simulated reduced-gravity exercise. However, the extent to which lower-body positive-pressure treadmill (LBPPT) walking alters kinematic gait characteristics is not well understood. The purpose of the study was to investigate the effect of LBPPT walking on selected gait parameters in simulated reduced-gravity conditions. Twenty-nine college-aged volunteers participated in this cross-sectional study. Participants wore pressure-measuring insoles (Medilogic GmBH, Schönefeld, Germany) and completed three 3.5-min walking trials on the LBPPT (AlterG, Inc., Fremont, CA, USA) at 100% (normal gravity) as well as reduced-gravity conditions of 40% and 20% body weight (BW). The resulting insole data were analyzed to calculate center of pressure (COP) variables: COP path length and width and stance time. The results showed that 100% BW condition was significantly different from both the 40% and 20% BW conditions, p < 0.05. There were no significant differences observed between the 40% and 20% BW conditions for COP path length and width. Conversely, stance time significantly differed between the 40% and 20% BW conditions. The findings of this study may prove beneficial for clinicians as they develop rehabilitation strategies to effectively unload the individual's body weight to perform safe exercises.

Enhancing the Accuracy of Vertical Ground Reaction Force Measurement During Walking Using Pressure-Measuring Insoles.

Pressure-measuring insoles can be an attractive tool for measuring ground reaction force (GRF) since they are portable and can record multiple consecutive steps. Several researchers have, however, observed that these insoles are less accurate than instrumented force platforms. To address this issue, the authors identified transfer functions that best described each insole size to enhance the measurements of the vertical component of GRF during walking. GRF data were collected from 29 participants (6/23 male/female, 24.3 ± 6.7 yrs, 70.4 ± 23.9 kg, 1.66 ± 0.11 m) using Medilogic® pressure-measuring insoles and Kistler® force platforms for three walking trials. Participants provided the institutionally approved written consent (IRB #724468). The data from both instruments were preprocessed. A subset of the data was used to train the system identification toolbox (matlab) to identify the coefficients of several candidate transfer functions for each insole size. The resulting transfer functions were compared using all available data for each insole to assess which one modified the insole data to be closer to that of the force platform. All tested transfer functions moved the vertical component of GRF closer to the corresponding force platform data. Each insole size had a specific transfer model that that yielded the best results. Using system identification techniques produced transfer functions that, when using insole data of the vertical component of GRF as input, produced output that is comparable to the corresponding measurement using an instrumented force platform.

A comparison of two techniques for center of pressure measurements.

INTRODUCTION: Force platforms and pressure-measuring insoles are the most common tools used for measuring center of pressure. Earlier studies to assess these instruments suffered from limited sample sizes or an inadequate range of participant foot sizes. The purpose of this study was to propose new methods to extract and calculate comparably accurate center of pressure for the Kistler® force platform and Medilogic® insoles. METHODS: Center of pressure data were collected from 65 participants wearing pressure-measuring insoles (six different sizes). Participants walked over consecutive force platforms for three trials while wearing pressure-measuring insoles within socks. Onset force thresholds and center of pressure segment length thresholds were used to determine accurate center of pressure path length and width. A single step for each foot and trial was extracted from both instruments. RESULTS: A strong correlation was observed between instruments in center of pressure length (4.12 ± 6.72% difference, r = 0.74). Center of pressure width varied and was weakly correlated (-7.04 ± 4.48% difference, r = 0.11). CONCLUSIONS: The results indicate that both instruments can measure center of pressure path length consistently and with comparable accuracy (differences < 10%). There were differences between instruments in measuring center of pressure path width, which were attributed to the limited number of sensors across the width of the insoles.

A viscoelastic ellipsoidal model of the mechanics of plantar tissues.

Several assessments of the mechanics of plantar tissues, using various material models in conjunction with representing plantar regions using simple geometry, have been proposed. In this study, the plantar tissues were divided into eight regions to account for the various tissue characteristics. The plantar tissue model described each region as an ellipsoid, with a viscoelastic material model. The model combined varying elliptical contact areas with nonlinear tissue stiffness and damping. The main instruments used in this research were pressure-measuring insoles, which were used to determine the ground reaction force, as well as contact areas. The measured contact areas were fitted as elliptical areas to describe the compression of the corresponding ellipsoids. The approach was tested using walking data collected from 26 individuals: four men, 22 women, 24.4 ±â€¯6.9 years old, 66.9 ±â€¯21.4 kg of mass, 1.66 ±â€¯0.12 m tall. The geometric and material variables of the proposed ellipsoidal model were optimized for each participant to match the ground reaction forces. Results suggest that the ellipsoid model is able to reproduce ground reaction force with reasonable accuracy. The largest errors were seen in heel and toe regions and were due to high-rate forces and small comparative areas, respectively. The model also showed that there are regional differences in the mechanical characteristics of plantar tissue, which confirms earlier research.

Electronic measurement of plantar contact area during walking using an adaptive thresholding method for Medilogic® pressure-measuring insoles.

BACKGROUND: Pressure-measuring insoles have the potential to measure plantar contact area (PA) during walking. However, they are not widely used for this purpose because of the need for a reliable process that can convert the insole output into PA. The purposes of this study were to: (1) develop an adaptive-threshold method for pressure-measuring insoles that can improve the accuracy of the PA measurements during walking, and (2) experimentally assess the accuracy and generalizability of this method. METHODS: A sample of 42 healthy, ambulatory, young adults (age=24.3±3.2years, mass=67.2±16.9kg, height=1.63±0.08m) completed 10 trials walking on an elevated walkway while wearing Medilogic® pressure-measuring insoles (sizes 35-45). A total of six insole sizes were considered. Insole data were converted to PA using three unique adaptive-thresholds that were based on percentages of the maximum sum of digital values (MSDV) during an analyzed step. Three values were considered: 0.1%, 0.2%, and 0.3% of the MSDV. Additionally, a fixed-threshold, which is typically used to estimate PA, was assessed. These two techniques, applied to the insole worn on the left foot, were compared with PA obtained from high-resolution reference footprints obtained from optical pedography of the right foot and processed using digital image processing algorithms. An assumption of PA symmetry between the left (insole) and right (barefoot) feet was made and comparisons were conducted over the entire stance phase of walking. The generalizability of the algorithm was assessed by comparing PA errors from insoles with respect to the optical pedography results based on insole size criteria. RESULTS: The adaptive-thresholds of 0.1%, 0.2%, and 0.3% of MSDV produced mean errors of 7.31±17.44%, -8.62±15.01%, and -20.45±14.18%, respectively. Using the 2-digital value fixed-threshold produced a mean error of 20.88±22.44%. The best performing adaptive-threshold varied among insole sizes. CONCLUSION: It was observed that the fixed-threshold technique produced large magnitudes of errors. The proposed adaptive-thresholds of 0.1% and 0.2% of the MSDV reduced PA error to ±10% during walking. The adaptive-threshold method consistently reduced PA error vs. the fixed-threshold for each insole size.

Concurrent Validity of an Automated Footprint Detection Algorithm to Measure Plantar Contact Area During Walking.

BACKGROUND: Monitoring footprints during walking can lead to better identification of foot structure and abnormalities. Current techniques for footprint measurements are either static or dynamic, with low resolution. This work presents an approach to monitor the plantar contact area when walking using high-speed videography. METHODS: Footprint images were collected by asking the participants to walk across a custom-built acrylic walkway with a high-resolution digital camera placed directly underneath the walkway. This study proposes an automated footprint identification algorithm (Automatic Identification Algorithm) to measure the footprint throughout the stance phase of walking. This algorithm used coloration of the plantar tissue that was in contact with the acrylic walkway to distinguish the plantar contact area from other regions of the foot that were not in contact. RESULTS: The intraclass correlation coefficient (ICC) demonstrated strong agreement between the proposed automated approach and the gold standard manual method (ICC = 0.939). Strong agreement between the two methods also was found for each phase of stance (ICC > 0.78). CONCLUSIONS: The proposed automated footprint detection technique identified the plantar contact area during walking with strong agreement with a manual gold standard method. This is the first study to demonstrate the concurrent validity of an automated identification algorithm to measure the plantar contact area during walking.

Assessing the validity of pressure-measuring insoles in quantifying gait variables.

INTRODUCTION: Pressure-measuring insoles can provide a portable alternative to existing gait analysis tools. However, there is disagreement among researchers on their accuracy and the appropriate calibration methods. The purposes of this study were to (1) determine the validity of pressure-measuring insoles for calculating stance time and support-phase impulse during walking using two calibration procedures, and (2) examine the effect of insole size on the results. METHODS: Data were collected from 39 participants (23.5 ± 3.24 yrs, 66.7 ± 17.5 kg, 1.64 ± 0.09 m), each wearing appropriately sized insoles as they walked over two consecutive force platforms. Two calibration methods were evaluated: (1) manufacturer's recommendation, and (2) a participant weight-based approach. Qualitative and quantitative evaluations were conducted. RESULTS: The results indicated that the insoles measured longer stance times than the force platform (differences are less than 10%). Both calibration methods resulted in inaccurate impulse values (differences are 30 and 50% for the two calibration methods, respectively). The results showed that when using the first calibration method, impulse values depended on insole size. The second calibration consistently underestimated the impulse. CONCLUSIONS: It was concluded that while the insoles provide acceptable qualitative representation of the gait, the two studied calibration methods may lead to a misleading quantitative assessment.