Pub on pp analysis

1. J Athl Train. 2011 May-Jun;46(3):257-62.
Differential ability of selected postural-control measures in the prediction of chronic ankle
instability status.
Knapp D, Lee SY, Chinn L, Saliba SA, Hertel J.
Source
University of Virginia, Charlottesville, VA 22903, USA.
Abstract
CONTEXT:
Chronic ankle instability (CAl) is a term used to identify a condition associated with recurrent ankle
sprains and persistent symptoms. Balance deficits, evaluated using center-of-pressure (COP) force-
plate measurements, have been shown to occur in people with CAl.
OBJECTIVE:
To determine the differential abilities of selected force-plate postural-control measures to assess CAl.
DESIGN:
Case-control study.
SETTING:
Laboratory.
PATIENTS OR OTHER PARTICIPANTS:
A total of 63 individuals with CAl (30 men, 33 women: age= 22.3± 3.7 years, height= 169.8 ±9.6 cm,
mass= 70.7± 14.3 kg) and 46 healthy controls (22 men, 24 women: age= 21.2± 4.1 years, height= 173.3±
9.2 cm, mass =69.2± 13.2 kg) volunteered.
INTERVENTION(S):
Participants performed 3 10-second trials of quiet, single-limb stance on a force plate under 2 conditions:
eyes open and eyes closed.
MAIN OUTCOME MEASURE(S):
Measures of COP area, COP velocity, COP SO, COP range of excursion, percentage of COP range
used, time-to-boundary absolute minimum, time-to-boundary mean of the minima, and time-to-boundary
SO of the minima were calculated. All measures with the exception of COP area were calculated in both
the mediolateral (ML) and anteroposterior directions. For each measure, a receiver operator
curveanalysis was created, and the corresponding area under the curve was tested. The optimal
diagnostic threshold value for each measure was determined, and the corresponding positive and
negative likelihood ratios were calculated.
RESULTS:
Three eyes-closed, single-limb force-plate measures (COP ML SO, ML percentage of COP range used,
and time-to-boundary absolute minimum) predicted CAl status. However, all 3 measures had positive
likelihood ratios associated with only small shifts in the probability of a patient with a positive test having
CAl and negative likelihood ratios associated with very small shifts in the probability of a patient with a
negative test not having CAl.
CONCLUSIONS:
No single force-plate measure was very effective in predicting if an individual had CAl or not.

2. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:3678-81. doi: 10.1109/IEMBS.2010.5627649.
Classification of elderly as fallers and non-fallers using Centre of Pressure velocity.
Hewson DJ, Singh NK, Snoussi H, Duchene J.
Source
University of Technology of Troyes (UTT), France. david.hewson@utt.fr
Abstract
Falls are a leading cause of death in the elderly. One of the most common methods of predicting falls is to
evaluate balance using force platemeasurement of the Centre of Pressure (COP) displacement. This
signal, known as a stabilogram, can be decomposed into movement in anteroposterior (AP) and
mediolateral (ML) directions. It has been suggested that studying the velocity of COP displacement could
lead to new insights into fall risk. The aim of this study was to attempt to classify elderly fallers and non-
fallers, as well as control subjects based on COP velocity measurements. Three groups of 10 subjects
(controls, elderly fallers, and elderly non-fallers) were compared. Discriminant function analysis was able
to correctly classify 90% of the subjects based only on COP velocity measurements. Further work is
needed to determine whether this parameter might be of use in longitudinal measurement of fall risk in
home-dwelling elderly.
PMID:
21097047
[PubMed - indexed for MEDLINE]
3 Gait Posture. 2010 Jan;31(1):9-12. doi: 10.1016/j.gaitpost.2009.08.003. Epub 2009 Oct 31.
The effect of gait velocity on calcaneal balance at heel strike; Implications for orthotic prescription
in injury prevention.
Shanthikumar S, Low Z, Falvey E, McCrory P, Franklyn-Miller A.
Source
Centre for Health, Exercise and Sports Medicine, University of Melbourne, Parkville, Victoria 3010,
Australia.
Abstract
Exercise related lower limb injuries (ERLLI), are common in the recreational and competitive sporting
population. Although ERLLI are thought to be multi-factorial in aetiology, one of the critical predisposing
factors is known to gait abnormality. There is little published evidence comparing walking and running gait
in the same subjects, and no evidence on the effect of gait velocity on calcaneal pronation, even though
this may have implications for orthotic prescription and injury prevention. In this study, the walking and
running gait of 50 physically active subjects was assessed using pressureplate analysis. The results show
that rearfoot pronation occurs on foot contact in both running and walking gait, and that there is
significantly more rearfoot pronation in walking gait (p<0.01). The difference in the magnitude of rearfoot
pronation affected foot orthoses prescription. A 63% fall in computerized correction suggested by RSscan
D3D software prescription was seen, based on running vs. walking gait. The findings of this study suggest

that in the athletic population orthoses prescription should be based on dynamic assessment of running
gait
4. Gait Posture. 2009 Jul;30(1):45-9. doi: 10.1016/j.gaitpost.2009.02.012. Epub 2009 Mar 28.
Rocker bottom soles alter the postural response to backward translation during stance.
Albright BC, Woodhull-Smith WM.
Source
Department of Physical Therapy, College of Allied Health Sciences, Health Sciences Building, East
Carolina University, Greenville, NC 27858, United States. albrightb@ecu.edu
Abstract
Shoes with rocker bottom soles are utilized by persons with diabetic peripheral neuropathy to reduce
plantar pressures during gait. This population also has a high risk for falls. This study analyzed the effects
of shoes with rocker bottom soles on the postural response during perturbed stance. Participants were 20
healthy subjects (16 women, 4 men) ages 22-25 years. Canvas shoes were modified by the addition of
crepe sole material to represent two forms of rocker bottom shoes and a control shoe. Subjects stood on
a dynamic force plate programmed to move backward at a velocity that produced an automatic postural
response without stepping. Force plate data were collected for five trials per shoe type. Sway variables
for center of pressure (COP) and center of mass (COM) included: mean sway amplitude, sway variance,
time to peak, anterior and posterior peak velocities, functional stability margin, and peak duration time.
Compared to control, both the experimental shoes had significantly larger COP and COM values for
mean sway amplitude, sway variance and peak duration. The functional stability margins were
significantly smaller for the experimental shoes while their anterior and posterior peak velocities were
slower and time to peaks were significantly longer. In young healthy adults, shoes with rocker bottom
soles had a destabilizing effect to perturbed stance, thereby increasing the potential for
imbalance. These results raise concerns that footwear with rocker bottom sole modifications to
accommodate an insensate foot may increase the risk of falls.
5. Br J Sports Med. 2009 Dec;43(13):1057-61. doi: 10.1136/bjsm.2008.055723. Epub 2009 Feb 18.
A prospective study on gait-related intrinsic risk factors for lower leg overuse injuries.
Ghani Zadeh Hesar N, Van Ginckel A, Cools A, Peersman W, Roosen P, De Clercq D, Witvrouw E.
Source
Faculty of Medicine, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De
Pintelaan 185, 3B3 9000 Ghent, Belgium. Narmin.Ghanizadehhesar@ugent.be
Abstract
OBJECTIVE:
To determine prospectively gait-related risk factors for lower leg overuse injury (LLOI).
DESIGN:
A prospective cohort study.
SETTING:
Male and female recruits from a start-to-run (STR) programme during a 10-week training period.
PARTICIPANTS:

131 healthy subjects (20 men and 111 women), without a history of any lower leg complaint, participated
in the study.
INTERVENTIONS:
Before the start of the 10-week STR programme, plantar force measurements during running were
performed. During STR, lower leg injuries were diagnosed and registered by a sports physician.
MAIN OUTCOME MEASURES:
Plantar force measurements during running were performed using a footscan pressure plate.
RESULTS:
During the STR, 27 subjects (five men and 22 women) developed a LLOI. Logistic
regression analysis revealed that subjects who developed a LLOI had a significantly more laterally
directed force distribution at first metatarsal contact and forefoot flat, a more laterally directed force
displacement in the forefoot contact phase, foot flat phase and at heel-off. These subjects also had a
delayed change of the centre of force (COF) at forefoot flat, a higher force and loading underneath the
lateral border of the foot, and a significantly higher directed force displacement of the COF at forefoot flat.
CONCLUSIONS:
These findings suggest that a less pronated heel strike and a more laterally directed roll-off can
be considered as risk factors for LLOI. Clinically, the results of this study can be considered important
in identifying individuals at risk of LLOI
6. J Am Podiatr Med Assoc. 2006 Jul-Aug;96(4):305-12.
Application of center-of-pressure data to indicate rearfoot inversion-eversion in shod running.
Dixon SJ.
Source
School of Sport and Health Sciences, St Luke's Campus, University of Exeter, England.
Abstract
Although pressure plates are used to help in the selection of appropriate footwear for runners, evidence
relating aspects of pressure data to movement is lacking. A study was conducted to investigate whether
center-of-pressure (COP) data obtained for shod running could be used to indicate the amount of rearfoot
eversion. It was hypothesized that subjects exhibiting high rearfoot eversion during the initial ground
contact phase of running would also show a large lateral-to-medial deviation in the
COP. Pressure plate and rearfoot movement data were collected for 33 subjects. The COP was
characterized using the lateral-to-medial deviation of the COP during the eversion phase of ground
contact. Correlation coefficients were determined for COP deviation versus rearfoot range of motion and
versus peak rearfoot eversion (P < .05). In addition, subjects were grouped as high, moderate, or low
pronators, and analysis of variance was used to test whether there were significant differences in COP
deviation for these three groups (P < .05). The COP deviation was found to have a low correlation with
rearfoot range of motion (R = 0.46; P < .05) and with peak rearfoot eversion (R = .54; P < .05). High
pronators had significantly higher COP deviation than the medium- and low-pronation groups (P <
.05). These findings support the use of COP deviation to detect high pronation. However, caution is
advised in using the COP to indicate absolute rearfoot eversion.

7. Gait Posture. 2005 Dec;22(4):372-6. Epub 2004 Dec 7.
Assessment of sub-division of plantar pressure measurement in children.
Stebbins JA, Harrington ME, Giacomozzi C, Thompson N, Zavatsky A, Theologis TN.
Source
University of Oxford, Oxford, UK. julie.stebbins@ndos.ox.ac.uk
Abstract
Methods for the measurement of plantar pressure are poorly defined particularly when describing sub-
sections of the plantar surface of the foot in the presence of deformity. The aim of this study was to
assess foot pressure measurement in healthy children, using an automatic technique of sub-area
definition that has the potential for objective evaluation of treatment of foot deformity. Twelve healthy
children were examined on three occasions. Plantar pressure data were collected and time synchronised
with force plate and stereophotogrammetric data. The footprint was divided into five sub-sections by using
the position of the markers on the foot at mid-stance projected onto the pressure footprint. Repeatability
for peak pressure and peak force was assessed. Automatic sub-area definition based on marker
placement was found to be reliable in healthy children. A comparison of results revealed that peak
vertical force was a more consistent measure than peak pressure for each of the five sub-areas.
This suggests that force may be a more appropriate measurement for outcome studies.
8. J Appl Biomech. 2000 Aug;16(3):234-47.
A comparative analysis of the center of gravity and center of pressure trajectory path lengths in
standing posture: an estimation of active stiffness.
Caron O, Gelat T, Rougier P, Blanchi JP.
Source
UFR Staps, Laboratoire ESP, Universite de Toulon et du Var, Lagarde Cedex, France.
Abstract
The center of foot pressure (CP) motions, representing the net neuromuscular control, was compared to
the center of gravity (CG) motions, representing the net performance. The comparison focused on the
trajectory path length parameter along the medio-lateral and antero-posterior axes because these two
variables depend on amplitude versus frequency relationship. This relationship was used to evaluate the
CG motions based on the CP motions. Seven subjects stood still on a force plate with eyes open and
eyes closed. The results showed that the ratio of (CP-CG)/CP trajectory path length was personal for
each subject. These results suggest different levels of passive (ligaments, elastic properties) and active
(reflex activity) stiffness. For some subjects, this ratio was significantly lower for the eyes open condition
than for the eyes closed condition, indicating a decrease of the active stiffness for the eyes open
condition. Therefore, a CG-CP comparative analysis appeared helpful in understanding the control
of balance and necessary to quantify the subjects' net performance

9. Gait Posture. 2013 Oct 28. pii: S0966-6362(13)00652-8. doi: 10.1016/j.gaitpost.2013.10.018. [Epub
ahead of print]
Comparison of plantar pressures and contact area between normal and cavus foot.
Fernández-Seguín LM, Diaz Mancha JA, Sánchez Rodríguez R, Escamilla Martínez E, Gómez Martín
B, Ramos Ortega J.
Source
Physiotherapy Department, University of Seville, Spain. Electronic address: lfdez@us.es.
Abstract
BACKGROUND:
In pes cavus, the medial longitudinal arch elevation reduces the contact surface area and consequently
increases the corresponding plantar pressure measurements. This poor distribution of loads may produce
associated pathology and pain in this or other areas of the body. Normal reference values need to be
established in order to determine which patterns are prone to pathology.
OBJECTIVES:
To compare the plantar pressures and weight-bearing surface in a population with pes cavus to a
population with neutral feet.
METHOD:
The sample comprised 68 adults, 34 with pes cavus and 34 with neutral feet. The Footscan USB Gait
Clinical System® was used as a platform to measure the total contact area and plantar pressure under the
forefoot, midfoot, hindfoot, each metatarsal head, and the overall metatarsal area. A statistical analysis of
the data was performed using Student's t-test for independent samples.
RESULTS:
The pes cavus subjects showed a significant reduction in their weight-bearing area [neutral feet: 165.04
(±20.68)cm2; pes cavus: 118.26 (±30.31)cm2; p<0.001] and significantly increased pressures under all
zones of the forefoot except the fifth metatarsal [metatarsal pressure: in neutral feet 503,797 (±9.32)kPa;
in pes cavus 656.12 (±22.39)kPa; p<0.001].
CONCLUSIONS:
Compared to neutral feet, pes cavus feet show a reduction in total contact surface and the load
under the first toe. A significant increase is present in the load under the metatarsal areas, but the
relative distribution of this load is similar in both groups
10. Res Dev Disabil. 2013 Nov;34(11):3720-6. doi: 10.1016/j.ridd.2013.07.040. Epub 2013 Sep 7.
Plantar pressure patterns in women affected by Ehlers-Danlos syndrome while standing and
walking.
Pau M, Galli M, Celletti C, Morico G, Leban B, Albertini G, Camerota F.
Source
Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy.
Electronic address: massimiliano.pau@dimcm.unica.it.
Abstract

This study aims to quantitatively characterize plantar pressure distribution in women affected by Ehlers-
Danlos syndrome of the hypermobile type (EDS-HT) to verify the existence of peculiar patterns possibly
related to postural anomalies or physical and functional lower limb impairments typical of this disease. A
sample of 26 women affected by EDS-HT (mean age 36.8, SD 12.0) was tested using
a pressure platform in two conditions, namely static standing and walking. Raw data were processed to
assess contact area and mean and peak pressure distribution in rearfoot, midfoot and forefoot. Collected
data were then compared with those obtained from an equally numbered control group of unaffected
women matched for age and anthropometric features. The results show that, in both tested conditions,
women with EDS-HT exhibited significantly smaller forefoot contact areasand higher peak and
mean pressure than the control group. No differences in the analyzed parameters were found between
right and left limb. The findings of the present study suggest that individuals with EDS-HT are
characterized by specific plantar pressure patterns that are likely to be caused by the morphologic and
functional foot modification associated with the syndrome. The use of electronic pedobarography may
provide physicians and rehabilitation therapists with information useful in monitoring the disease's
progression and the effectiveness of orthotic treatments.
11. Hum Mov Sci. 2013 Aug;32(4):785-93. doi: 10.1016/j.humov.2013.05.001. Epub 2013 Aug 16.
Increased forefoot loading is associated with an increased plantar flexion moment.
Melai T, Schaper NC, Ijzerman TH, de Lange TL, Willems PJ, Meijer K, Lieverse AG, Savelberg HH.
Source
Department of Health Innovation & Technology, Institute of Allied Health Professions, Fontys University of
Applied Sciences, Eindhoven, The Netherlands; Department of Human Movement Sciences, NUTRIM
School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, The
Netherlands.
Abstract
The aim of this study was to identify the cascade of effects leading from alterations in force generation
around the ankle joint to increased plantar pressures under the forefoot. Gait analysis including
plantar pressure measurement was performed at an individually preferred and a standardized, imposed
gait velocity in diabetic subjects with polyneuropathy (n=94), without polyneuropathy (n=39) and healthy
elderly (n=19). The plantar flexion moment at 40% of the stance phase was negatively correlated with the
displacement rate of center of pressure (r=-.749, p<.001 at the imposed, and r=-.693, p<.001 at the
preferred gait velocity). Displacement rate of center of pressure was strongly correlated with
forefoot loading (r=-.837, p<.001 at the imposed, and r=-.731, p<.001 at the preferred gait velocity).
People with a relatively high plantar flexion moment at 40% of the stance phase, have a faster
forward transfer of center of pressure and consequently higher loading of the forefoot. This
indicates that interventions aimed at increasing the control of the roll-off of the foot may contribute to a
better plantar pressure distribution.

12. J Med Eng Technol. 2013 Jul;37(5):342-7. doi: 10.3109/03091902.2013.810788.
The effect of foot arch on plantar pressure distribution during standing.
Periyasamy R, Anand S.
Source
Center for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.
periyasamy25@gmail.com
Abstract
The aim of this study was to explore how foot type affects plantar pressure distribution during standing. In
this study, 32 healthy subjects voluntarily participated and the subject feet were classified as: normal feet
(n = 23), flat feet (n = 14) and high arch feet (n = 27) according to arch index (AI) values obtained
from foot pressure intensity image analysis. Foot pressure intensity images were acquired by a
pedopowergraph system to obtain afoot pressure distribution parameter-power ratio (PR) during standing
in eight different regions of the foot. Contact area and mean PR were analysed in hind foot, mid-foot and
fore foot regions. One-way analysis of variance was used to determine statistical differences between
groups. The contact area and mean PR value beneath the mid-foot was significantly increased in the low
arch foot when compared to the normal arch foot and high arch foot (p < 0.001) in both feet. However,
subjects with low-arch feet had significantly higher body mass index (BMI) compared to subjects with
high-arch feet (p < 0.05) and subjects with normal arch feet (p < 0.05) in both feet. In addition, subjects
with low-arch feet had significant differences in arch index (AI) value as compared to subjects with high-
arch feet (p < 0.001) and subjects with normal arch feet (p < 0.05) in both feet. Mean mid-foot PR value
were positively (r = 0.54) correlated with increased arch index (AI) value. A significant (p < 0.05) change
was obtained in PR value beneath the mid-foot of low arch feet when compared with other groups in both
feet. The findings suggest that there is an increased mid-foot PR value in the low arch foot as compared
to the normal arch foot and high arch foot during standing. Therefore, individuals with low arch feet
could be at high risk for mid-foot collapse and Charcot foot problems, indicating that foot type should
be assessed when determining an individual's risk for foot injury.
13. Gait Posture. 2013 Sep;38(4):929-33. doi: 10.1016/j.gaitpost.2013.04.026. Epub 2013
Jun 5.
Effect of overground vs treadmill running on plantar pressure: influence of fatigue.
García-Pérez JA, Pérez-Soriano P, Llana S, Martínez-Nova A, Sánchez-Zuriaga D.
Source
GIBD (Grupo de Investigación en Biomecánica aplicada al Deporte), Universidad de
Valencia, Spain. Electronic address: joseant1992@hotmail.com.
Abstract
The differences produced when running on a treadmill vs overground may call into question
the use and validity of the treadmill as a piece of equipment commonly used in research,
training, and rehabilitation. The aim of the present study was to analyze under pre/post
fatigue conditions the effect of treadmill vs overground on plantar pressures.
Twenty-seven recreational runners (17 men and 10 women) ran on a treadmill and
overground at two speeds: S1=3.33 m/s and S2=4.00 m/s, before and after a fatigue

protocol consisting of a 30-min run at 85% of their individual maximal aerobic speed (MAS).
Contact time (CT in seconds), peak pressure (PP in kPa), and relative load (RL in %) were
analyzed under nine foot zones of the leftfoot using an in-shoe plantar pressure device. A
two-way repeated measures ANOVA showed that running on a treadmill increases CT
(7.70% S1 and 9.91% S2), modifies the pressure distribution and reduces PP (25.98% S1
and 31.76% S2), especially under the heel, medial metatarsals, and hallux, compared to
running overground. Moreover, on both surfaces, fatigue (S2) led to a reduced stride
frequency (2.78%) and reduced PP on the lateral heel and hallux (15.96% and 16.35%,
respectively), and (S1) increased relative load on the medial arch (9.53%). There was no
significant interaction between the two factors analyzed (surface and fatigue).
Therefore, the aforementioned surface effect, which occurs independently of the fatigue
state, should be taken into account when interpreting the results of studies that use the
treadmill in their experimental protocols, and when prescribing physical exercise on a
treadmill.
14. Phys Ther. 2013 Sep;93(9):1175-84. doi: 10.2522/ptj.20120103. Epub 2013 Apr 11.
Changes in dynamic plantar pressure during loaded gait.
Goffar SL, Reber RJ, Christiansen BC, Miller RB, Naylor JA, Rodriguez BM, Walker MJ, Teyhen DS.
Source
Rehabilitation Service, Landstuhl Regional Medical Center, Landstuhl, Germany.
stephen.goffar@amedd.army.mil
Abstract
BACKGROUND:
Lower extremity overuse injuries are detrimental to military readiness. Extremes of arch height and heavy
loads carried by military personnel are associated with increased risk for overuse injury. Little is known
regarding the impact of load carriage on plantar pressure distributions during gait.
OBJECTIVE:
The objective of this study was to determine how load carriage affects plantar pressure distributions
during gait in individuals with varying arch types.
DESIGN:
A cross-sectional, repeated-measures design was used for the study.
METHODS:
The study was performed at a research laboratory at Fort Sam Houston, Texas. Service members who
were healthy and weighing ≥70 kg were enrolled in the study. The participants (97 men, 18 women; mean
age=31.3 years, SD=5.6; mean weight=86.0 kg, SD=11.0) were categorized as having high-, normal-, or
low-arched feet on the basis of published cutoff values for the arch height index.
Plantar pressure measurements were obtained with the use of an in-shoe pressure measurement system
while participants wore combat boots and walked on a treadmill under 3 loaded conditions (uniform, 20-kg
load, and 40-kg load). Maximal force (MaxF) and force-time integral (FTI) were assessed with the use of a
9-sector mask to represent regions of the foot. A 3 × 3 repeated-measures analysis of variance was used
for analysis across the levels of load and arch type.
RESULTS:

A significant interaction existed between arch type and load for MaxF and FTI in the medial midfoot, with
greater force in low-arched feet. In the medial forefoot, MaxF and FTI were greatest in high-arched feet
across all load conditions. In the great toe region, low-arched and normally arched feet had greater MaxF
and FTI. The relative distribution of FTI increased proportionately in all regions of the foot regardless of
arch type for all load conditions.
LIMITATIONS:
The influence of fatigue, greater loads, and different walking speeds was not assessed.
CONCLUSIONS:
Regardless of arch type, increases in load did not alter the relative distribution of force over the
plantar foot during gait. Participants with high-arched feet had greater force in the medial forefoot
region, whereas those with normally arched or low-arched feet had greater force in the great toe region,
regardless of load. These differences in force distribution may demonstrate different strategies to
generate a rigid lever during toe-off.
15. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:7388-92. doi: 10.1109/IEMBS.2011.6091720.
Analysis of foot pressure distribution data for the evaluation of foot arch type.
Imaizumi K, Iwakami Y, Yamashita K.
Source
Tokyo Healthcare University, Tokyo, Japan. k-imaizumi@ thcu.ac.jp
Abstract
In order to develop an evaluation system for foot arch type in the elderly
using foot pressure distribution data, foot pressure distribution parameters were selected and the data
thereby derived were discussed. Results from the study show that the midfoot area and pressure ratios
were correlated tofoot arch type determined by visual analysis and were not correlated to arch height
parameters. It is assumed that foot pressure distribution parameters reflect a different
phenomenon from that of arch height parameters. The inconsistency between them is considered to
be a result of the effect of the forefoot arch on the arch height parameters.
16. Gait Posture. 2012 Mar;35(3):405-9. doi: 10.1016/j.gaitpost.2011.10.362. Epub 2011 Dec 5.
The effect of a long-distance run on plantar pressure distribution during running.
Willems TM, De Ridder R, Roosen P.
Source
Ghent University, Department of Rehabilitation Sciences and Physiotherapy, Ghent University Hospital,
De Pintelaan 185, 3B3, 9000 Ghent, Belgium.
Abstract
The purpose of this study was to assess plantar pressure alterations after long-distance running. Prior to
and after a 20 km run, force distributionunderneath the feet of 52 participants was registered using
Footscan(®) pressure plates while the participants ran shod at a constant self-selected pace. Peak force,
mean force and impulse were registered underneath different zones of the foot. In addition, temporal data
as total foot contact time, time of contact and end of contact were derived for these zones. Furthermore, a

medio-lateral pressure distribution ratio was calculated in different phases of the roll-off. After the run,
increases in the loading of the forefoot, midfoot and medial heel were noted and decreases in loading of
the lateral toes. In the forefoot push off phase a more lateral pressure distribution was observed. The
results of this study demonstrated plantar pressure deviations after long-distance running which
could give additional information related to several running injuries
17. PLoS One. 2011 Mar 18;6(3):e17749. doi: 10.1371/journal.pone.0017749.
Natural gaits of the non-pathological flat foot and high-arched foot.
Fan Y, Fan Y, Li Z, Lv C, Luo D.
Source
Center for Scientific Research, Guangzhou Institute of Physical Education, Guangzhou, People's
Republic of China. tfyf@gipe.edu.cn
Abstract
There has been a controversy as to whether or not the non-pathological flat foot and high-
arched foot have an effect on human walking activities. The 3D foot scanning system was employed to
obtain static footprints from subjects adopting a half-weight-bearing stance. Based upon their footprints,
the subjects were divided into two groups: the flat-footed and the high-arched. The
plantar pressure measurement system was used to measure and record the subjects' successive natural
gaits. Two indices were proposed: distribution of vertical ground reaction force (VGRF) of plantar and the
rate of change of footprint areas. Using these two indices to compare the natural gaits of the two subject
groups, we found that (1) in stance phase, there is a significant difference (p<0.01) in the
distributions of VGRF of plantar; (2) in a stride cycle, there is also a significant difference (p<0.01) in
the rate of change of footprint area. Our analysis suggests that when walking, the VGRF of the plantar
brings greater muscle tension to the flat-footed while a smaller rate of change of footprint area brings
greater stability to the high-arched.
*** This study is consistent with my observation that media pressure readings are higher
in PreClinical Clubfoot Deformity patients (low ILA), and the mP readings are lower in
Rothbarts Foot (Higher ILA)

18. J Bodyw Mov Ther. 2011 Apr;15(2):242-50. doi: 10.1016/j.jbmt.2010.10.007. Epub 2010 Dec 9.
Interrelationships between dental occlusion and plantar arch.
Cuccia AM.
Source
Orthodontic and Gnathology Section, Department of Stomatological Sciences G. Messina, University of
Palermo, Via del Vespro 129, Palermo, Italy. cucciaam@odonto.unipa.it
Abstract
OBJECTIVE:
The aim of this study was to evaluate the influence of different jaw relationships on the plantar arch during
gait.
METHODS:
168 subjects, participating in this study, were distributed into two groups: a control (32 males and 52
females, ranging from 18 to 36 years of age) and a Temporomandibular joint disorders group (28 males
and 56 females, ranging from 19 to 42 years of age). Five baropodometric variables were evaluated using
a baropodometric platform: the mean load pressure on the plantar surface, the total surface of feet,
forefoot vs rearfoot loading, forefoot vs rearfoot surface, and the percentage of body weight on each limb.
The tests were performed in three dental occlusion conditions: mandibular rest position (REST); voluntary
teeth clenching (VTC); and cotton rolls placed between the upper and the lower dental arches without
clenching (CR). The variables were analyzed through repeated measures ANOVA. The Mann-Whitney
test was used to compare the postural parameters of the two groups. The level of significance was
p < 0.05.
RESULTS:
As to the intra-group analysis of TMD group, all posturographic parameters in both lower limbs showed a
significant difference between REST vs CR (P < 0.001) and between VTC vs CR (p < 0.001), except for
the percentage of body weight on each limb. The control group showed a significant difference between
REST vs VTC, REST vs CR and VTC vs CR (p < 0.001) in the mean load pressure on the plantar arch,
forefoot surface, rearfoot surface and total surface of feet. The mean load pressure on the plantar arch in
VTC, and the forefoot and total surfaces of feet in CR (p < 0.05) were significantly higher in the TMD
group in both limbs. The results of this study indicate that there are differences in the plantar arch
between the TMD group and control group and that, in each group, the condition of voluntary tooth
clenching determines a load reduction and an increase in surface on both feet, while the inverse situation
occurs with cotton rolls. The results also suggest that a change in the load distributionbetween forefoot
and backfoot when cotton rolls were placed between the dental arches can be considered as a possible
indicator of a pathological condition of the stomatognathic system (SS) which could influence posture.
Therefore the use of posture monitoring systems during the treatment of stomatognathic system is
justified.
*** This study is consistent with the fact that malocclusions can change mP readings by
changing the contour of the ILA

19. Spine (Phila Pa 1976). 2011 Jun;36(13):E847-54. doi: 10.1097/BRS.0b013e3181ff5837.
Postural instability in early-stage idiopathic scoliosis in adolescent girls.
Haumont T, Gauchard GC, Lascombes P, Perrin PP.
Source
Balance Control & Motor Performance, Nancy-University, UFR STAPS, Villers-lès-Nancy, France.
Abstract
STUDY DESIGN:
Cross-sectional study.
OBJECTIVE:
To evaluate whether the amplitude of spine deformation in adolescent idiopathic scoliosis (AIS) is an
important factor for postural control at disease onset.
SUMMARY OF BACKGROUND DATA:
AIS is related to disorders of postural control with potential involvement of vestibular, proprioceptive, and
visual input. So far no assessment of postural control has been done in an AIS population at the onset of
spine deformation.
METHODS:
Sixty-five female patients with AIS (mean age: 11.4 ± 2.3 years) were clinically and radiologically
assessed at the time of diagnosis and evaluated in posturography, including static tests-with and without
sensory conflict-and dynamic tests. Two groups were formed according to the mean Cobb angle of the
primary curve.
RESULTS:
The mean Cobb angle was 14.8° ± 5.1°; 35 patients were included in group I with a Cobb angle of 5° to
14°, and 30 patients into group II with a Cobb angle of 15° to 25°. The latter group displayed higher body
sways in static tests, characterized by a larger area covered by center of footpressure in both eyes open
and eyes closed conditions, and by higher lateral oscillations in only the eyes closed condition. Group II
patients displayed poorer balance control, mainly in visual and somatosensory conflict conditions. Group
II patients used fewer anticipatory strategies to stabilize body oscillations than Group I patients, especially
in the more challenging sensory conflict and dynamic situations.
CONCLUSION:
Poorer postural performance, especially in sensory conflict situations, observed in patients with a Cobb
angle greater or equal to 15°, reflect less effective central information processing.
This study demonstrated that surface area increased with scoliosis
20. Foot Ankle Int. 2011 Jan;32(1):57-65. doi: 10.3113/FAI.2011.0057.
Plantar pressure with and without custom insoles in patients with common foot complaints.
Stolwijk NM, Louwerens JW, Nienhuis B, Duysens J, Keijsers NL.
Source

Sint Maartenskliniek, Research Development and Education, Hengstdal 3, 6522 JV Nijmegen, P.O. Box
9011 6500 GM, The Netherlands. n.stolwijk@maartenskliniek.nl
Abstract
BACKGROUND:
Although many patients with foot complaints receive customized insoles, the choice for an insole design
can vary largely among footexperts. To investigate the variety of insole designs used in daily practice, the
insole design and its effect on plantar pressure distribution were investigated in a large group of patients.
MATERIALS AND METHODS:
Mean, peak, and pressure-time-integral per sensor for 204 subjects with common foot complaints for
walking with and without insoles was measured with the footscan® insole system (RSscan International).
Each insole was scanned twice (precision3D), after which the insole height along the longitudinal and
transversal cross section was calculated. Subjects were assigned to subgroups based on complaint and
medial arch height. Data were analyzed for the total group and for the separate subgroups (forefoot or
heel pain group and flat, normal or high medial arch group).
RESULTS:
The mean pressure significantly decreased under the metatarsal heads II-V and the calcaneus and
significantly increased under the metatarsal bones and the lateral foot (p<0.0045) due to the insoles.
However, similar redistribution patterns were found for the different foot complaints and arch heights.
There was a slight difference in insole design between the subgroups; the heel cup was significantly
higher and the midfoot support lower for the heel pain group compared to the forefoot pain group. The
midfoot support was lowest in the flat arch group compared to the high and normal arch group (p<0.05).
CONCLUSION:
Although the insole shape was specific for the kind of foot complaint and arch height, the differences in
shape were very small and the plantar pressure redistribution was similar for all groups.
CLINICAL RELEVANCE:
This study indicates that it might be sufficient to create basic insoles for particular patient groups

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