Correlation between selected gait variables and emotion using virtual reality

THU0530 Spatiotemporal Gait Parameters and Plantar Pressure Distribution during Barefoot Walking in People with Gout and Asymptomatic Hyperuricaemia: A Cross-Sectional Observational Study

Objective: People with diabetic peripheral neuropathy (DPN) are usually accompanied with increased plantar pressure. Such high plantar loading during daily activities may cause changes in the biomechanical properties of plantar soft tissue, whose viability is critical to the development of foot ulcers. This study aimed to investigate the relationship between plantar tissue hardness and plantar pressure in people with and without DPN, and preliminarily explore the influence of plantar loading patterns on the plantar pressure and tissue hardness.Methods: The study was conducted on 14 people with DPN and 14 diabetic people without DPN. The Shore durometer and MatScan System were used to measure the plantar tissue hardness and plantar pressure, respectively. The plantar loading level was evaluated by the duration of daily weight-bearing activity and was used to group diabetic participants with and without DPN into two subgroups (lower loading group and higher loading group).Results: The plantar tissue hardness was significantly correlated with static peak plantar pressure (PPP, p < 0.05) and dynamic pressure-time integral (PTI, p < 0.05) in the forefoot region in people with DPN. Results of variance analysis showed a significant interaction effect between peripheral neuropathy and plantar loading on tissue hardness (p < 0.05), but not plantar pressure. For people with DPN, significant differences in tissue hardness between the higher loading group and lower loading group were observed in the forefoot, midfoot and hindfoot regions. In the higher loading group, people with DPN had significantly greater tissue hardness than that in people without DPN in the toes, forefoot, midfoot and hindfoot regions (p < 0.05).Conclusions: There is a significant correlation between tissue hardness and PPP, and between tissue hardness and PTI in people with DPN. Plantar loading associated with daily activities plays a significant role on the plantar tissue hardness in people with DPN. The findings of this study contribute to further understand the relationship between increased plantar tissue hardness and high plantar pressure in people with diabetic peripheral neuropathy.

Link of Video Abstract: https://youtu.be/91dLGOg7wjc Background: Treatment that can be done to prevent ulceration in diabetic feet is reducing high pressure in the foot area. One strategy that is currently being developed is biofeedback on gait patterns. Scientific evidence regarding the use of biofeedback in cases of diabetic neuropathy is still sparse, but it is a promising rehabilitation strategy to improve biomechanical deficits in gait patterns and allow subjects to initiate new gait strategies using visual and/or auditory information. Methods: This study is a pre-experimental research design before and after the intervention of giving biofeedback on walking patterns to 20 subjects with diabetic neuropathy who met the inclusion criteria and did not have exclusion criteria, measured plantar pressure at the beginning of the examination, and immediately after giving biofeedback on gait patterns. Results: The initial value of peak plantar pressure in the total area was high (more than 200 kPa). The initial value of peak plantar pressure in the 4 areas analyzed (heel, midfoot, forefoot, and big toe) was found to be in the range of 100-200 kPa, while the initial value of peak plantar pressure in the toes area was found to be &lt;100 kPa. Immediately after administering biofeedback, the walking pattern showed a significant decrease in peak plantar pressure values in the total area, heel, and big toe compared to the initial value (p-value= 0.001, 0.012, 0.00). There was no significant decrease in peak plantar pressure values in the midfoot and toe areas. Conclusions: A significant reduction was achieved in the average plantar pressure in the heel, big toe, and overall area. This supports the recommendation to provide walking pattern biofeedback in diabetic neuropathy patients.

Influence of gait speed on plantar pressure in subjects with unilateral knee osteoarthritis

The major goal of investigating plantar pressure in patients with pain or those at risk for skin injury is to reduce pressure under prominent metatarsal heads, especially the first and second metatarsals. In research, the insole is used to reduce plantar pressure by increasing the contact area in the midfoot region, which, in turn, induces an uncomfortable feeling near the arch during walking. It is deduced that sock structure can redistribute plantar pressure distribution. Seven sock types with seven structures (plain, single cross tuck, mock rib inlay, cross miss, mock rib, double cross tuck, and double cross miss) for the sole area were produced. A plantar pressure measurement device was used to measure plantar static pressure in ten participants. The barefoot plantar pressure distribution was compared with the plantar pressure distribution with socks. In the seven sock samples, the mean plantar pressure of the cross miss and mock rib structures at high plantar pressure zones (toe and first through fourth metatarsal bone regions) were decreased, and, as a result, the pressure shifted to relatively low pressure zones (fifth metatarsal bone and midfoot regions). These results indicate that wearing socks with cross miss and mock rib structures will reduce mean plantar pressure values compared with the barefoot condition in high plantar pressure zones. In general, the results suggest that mean plantar pressure is redistributed from high to low plantar pressure zones.

We investigated whether a low-Dye application of Scotchcast Soft Cast significantly altered plantar pressure distribution during gait in patients with a navicular drop greater than 10 mm. An experimental, same-subject, repeated-measures design was used. Thirty-two subjects aged 18 to 35 years were screened with the navicular drop test and were included if a navicular drop greater than 10 mm was established. The Emed-AT-2 platform system was used to measure the plantar pressure distribution under the right foot of each subject using the midgait method of data collection. Each subject performed six barefoot walks and six walks with Soft Cast applied to the right foot. Average peak and mean plantar pressure measurements were recorded for ten discrete areas (masks). The heel and midfoot were each divided into two masks, and the forefoot and toe regions were divided into three masks each. Paired t tests were used to detect differences in peak and mean plantar pressures for each mask. Soft Cast significantly affected peak and mean plantar pressures in seven and nine of the ten masks, respectively. No significant change in peak or mean plantar pressure was found beneath the medial midfoot. Plantar pressure may represent dynamic foot and ankle joint motion. With further research, Soft Cast may provide an alternative to current management techniques in controlling foot pronation and reducing symptoms of lower-limb abnormalities.

Plantar pressure distributions in symptomatic clubfoot

Background: People with stroke often suffer abnormal foot posture including structural and movement deficiencies in the intrinsic foot segments on the affected side, which are associated with limitation in mobility. As part of a programme of research examining foot and ankle biomechanics after stroke, we investigated plantar pressure distribution under the affected foot of people with stroke and the relationship with functional mobility. Methods: Plantar pressure distribution was investigated while standing and walking on the affected side of twenty stroke and fifteen healthy sex and age-matched participants, using a Medilogic platform system at a frequency of 20 HZ. Functional mobility in real life was measured using the Walking Handicap Scale. Results: While standing, people with stroke bore greater pressure on the affected side through the lateral heel and lesser toes (p<0.01) and less at the medial (MP1) and central forefoot (MP23) areas (p<0.05) than healthy controls. During walking, more pressure was taken through the heel area, especially the medial heel and less through the medial and central forefoot of the affected foot of people with stroke compared to healthy controls. The logistic regression model revealed that stroke participants who took greater pressure on the medial heel while walking (odds ratio=1.11, p<0.05) had more limited functional mobility (i.e. were more likely to be household walkers) than those who did not. While standing, none of the standing plantar pressure variables significantly contributed to the model. Conclusion: The plantar pressure distribution differs significantly between the affected foot of people with stroke and healthy controls. Abnormal plantar pressure distribution while walking, but not while standing, is a significant contributor to limited functional mobility post stroke.

Can we predict outcome of surgical reconstruction of Charcot neuroarthropathy by dynamic plantar pressure assessment?—A proof of concept study

Diabetes-adapted insoles are essential in prevention and rehabilitation of foot ulcers in diabetic foot syndrome. However, their manufacture is labour-intensive and costly. Therefore, the study aims to present an alternative method that allows the individual adjustment of the stiffness of the insoles using the finite element (FE) method and subsequent 3D printing. In the study, 3D gait analysis followed by musculoskeletal modelling was used to determine the boundary conditions of a healthy subject for the FE model. While muscle forces are elaborately implemented in most studies, this FE model presented a more efficient way by using ankle moments and joint reaction forces. The deviation between the simulated plantar peak pressure and the experimentally determined using the Pedar system amounted to 234 kPa in the heel area and 30 kPa in the toe area. The stiffness of the individual insole was adjusted by applying soft insole plugs in areas where high plantar pressures occurred during walking. Three different Young’s moduli were analysed in these areas (0.5 MPa, 1.0 MPa, 1.5 MPa). The computer-based approach to adjust the stiffness of an individual insole revealed a plantar peak pressure reduction by 37% in the heel area and by 119% in the toe area with a Young’s modulus of 0.5 MPa. The presented method could be a valuable tool in the cost-efficient development and engineering of subject-specific 3D-printed insoles for patients with diabetic foot syndrome.

The purpose of this study was to investigate the effect that difference in forefoot of shoe flexibility during the quick lunge from a jump smashing on the lower limbs and the plantar pressure distribution. For this 10 elite badminton players with over 10 years experience and right handed participated. Two kinds of badminton shoes were selected and tested mechanical testing for the forefoot flexibility. Motion analysis, ground reaction forces and plantar pressure distribution were recorded. It was required to conduct lunge movement after jumping smashing as possible as high. Photo sensor was located in 3 meter away from standing position and its height was 40 cm. Subjects were conducted to return original position after touching the sensor as under clear movement as possible as fast. Forefoot stiffness had an effect on shoe peak bending degree and peak bending angular velocity in propulsion phase. Forefoot flexibility had an effect on ankle plantar flexion and knee flexion moment. It appears that joint power on lower limb and peak plantar pressure were not influenced by the flexibility of shoes.

Category: Basic Sciences/Biologics Introduction/ Purpose: Combat boots are special shoes designed for soldiers to wear during activities in rough terrains, such as long marches or military training. Combat boots cause high plantar pressure and increase the injury rate of the lower extremities. Therefore, this study aimed to compare the difference of in-shoe plantar pressure between Korean combat boots and running shoes. We hypothesized that the newest Korean combat boots would have comparable plantar pressure distribution to running shoes. Methods: We prospectively recruited 30 asymptomatic male participants, who are considered as candidates for military services, from the local area. Two types of shoes (newly developed Korean combat boots and running shoes) were examined. Data of pedobarographic measurements were collected using the pedar®-X in-shoe pressure measurement system. Peak pressure (PP), pressure time integral (PTI), contact area, and contact time were analyzed. Results: Both PP and PTI at the region of central and lateral forefoot (FF) were significantly higher in combat boots. The contact area of combat boots was significantly lower at the region of the hallux, 2-5 toes, medial FF, central FF, and midfoot. Contact time at the region of central FF and medial heel was significantly higher in combat boots. Conclusion: Understanding plantar pressure distribution of combat boots can be helpful in the development of combat boots and prevention of injury. Based on the results of our study, the next generation Korean combat boots should be developed to increase contact area and distribute impulse under the head of the metatarsal bone

Faster gait speed and better endurance have been cross-sectionally and jointly associated with a lower likelihood of dementia. However, gait speed associations plateau above 1m/s, suggesting gait speed may be less predictive at near normal speeds. This study examined prospective associations of gait speed, endurance, and moderating effects of endurance on gait speed associations with incident dementia among ARIC participants without dementia at Visit 6 (2016-2017) who completed assessments of endurance ( 2- Minute Walk (2MW), meters) and usual-pace 4-meter gait speed (m/s) (n = 2767, mean age 78+/- 4.3 years, 43% male, 18% Black). Dementia was adjudicated using neuropsychological tests, functional assessments, informant interviews, and medical/vital record surveillance over a median of 3.3 years follow-up. Cox regression models estimated the hazard ratio (HR, 95% CI) for dementia, incorporating gait speed, 2MW, gait speed-by-2MW interaction, demographic, and cardiovascular factors. In separate models, each standard deviation higher 2MW [HR = 0.62, (0.50,0.76)] and faster gait speed [HR = 0.63, (0.50,0.81)] were associated with lower incident dementia risk. However, when jointly adjusting for 2MW and gait speed, higher 2MW was associated with a 32% lower incident dementia risk [HR = 0.68,(0.51, 0.90)], but faster gait speed was not statistically associated with incident dementia [HR = 0.85, (0.62,1.16)]. Moderating effects were not supported (gait speed-x-2MW interaction, p = 0.14). Although both endurance and gait speed predict dementia, endurance may be more informative across the gait speed spectrum, whereas gait speed may be more feasible for clinical settings. Longer follow-up and more dementia events may better inform differential utilities of gait speed and endurance measures.

Dry immersion (DI) is a ground-based model of simulated weightlessness that reduces support and proprioceptive input. This model produces reversible sensorimotor deconditioning and allows simulation of the early acute readaptation phase after spaceflight. We aimed to determine changes in spatiotemporal gait parameters and shin muscle work resulting from 7 d of DI, and whether plantar pressure distribution shifts accompany these changes. A total of 28 healthy males (14 DI, 14 controls) completed overground walking tests twice pre-DI and 2-3 h post-DI at first standing. Spatiotemporal parameters and plantar pressure (10 zones) were recorded. Surface electromyography [tibialis anterior, gastrocnemius (caput laterale), soleus] was sampled at 2000 Hz; the root mean square of electromyography was computed over phase-relevant intervals. After DI, walking speed, step frequency, and step length decreased by 19.6%, 8.3%, and 12.3%, respectively. The stance phase increased (≈2% of gait cycle) due to longer double support. Plantar pressure showed posterior-lateral redistribution: reduced loading at the toes and medial forefoot, with increased loading at the heel; lateral forefoot changes showed trends in some subjects. Root mean square electromyography increased in all recorded muscles. The results obtained are consistent with previous findings after spaceflight and its ground-based models. At the same time, they extend existing knowledge by adding new data on changes in plantar pressure distribution. These alterations may represent both the consequence and the target of locomotor strategies that compensate for gait instability. These findings clarify locomotor risks after short spaceflights. Saveko A, Bekreneva M, Ponomarev I, Shigueva T, Rukavishnikov I, Tomilovskaya E. Reorganization of human gait and foot pressure patterns after 1-week dry immersion. Aerosp Med Hum Perform. 2026; 97(4):235-242.

Relationship between foot motion and plantar pressures in the diabetic foot