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To evaluate test-retest reliability of trunk kinematics relative to the pelvis during gait in two groups (males and females) of patients with non-specific chronic low back pain (NCLBP) using three-dimensional motion capture system.
A convenience sample of 40 NCLBP participants (20 males and 20 females) was evaluated in two sessions. Participants were asked to walk with self-selected speed and kinematics of thorax and lumbar spine were captured using a 6-infrared-cameras motion-analyzer system. Peak amplitude of displacement and its measurement errors and minimal detectable change (MDC) were then calculated.
Intraclass correlation coefficients (ICCs) were relatively constant but small for certain variables (lower lumbar peak flexion in female: inter-session ICC=0.51 and intra-session ICC=0.68; peak extension in male: inter-session ICC=0.67 and intra-session ICC=0.66). The measurement error remained constant and standard error of measurement (SEM) difference was large between males (generally ≤4.8°) and females (generally ≤5.3°). Standard deviation (SD) was higher in females. In most segments, females exhibited higher MDCs except for lower lumbar sagittal movements.
Although ICCs were sufficiently reliable and constant in both genders during gait, there was difference in SEM due to difference in SD between genders caused by different gait disturbance in chronic low back pain. Due to the increasing tendency of measurement error in other areas of men and women, attention is needed when measuring lumbar motion using the method described in this study.
Citations
Method: Three dimensional gait analysis was performed in 19 unilateral below-knee amputees and 20 controls. Measured gait parameters were temporal parameters and kinematic and kinetic parameters at hip, knee and ankle joints. Gait parameters obtained from amputated limbs were compared with those of sound limbs and control group.
Results: There were no significant differences in temporal parameters among 3 limbs. In amputated limbs, degree of knee flexion and knee extension moment in stance phase were less than sound limbs and control group. In addition, timing of peak knee extension moment occurred later. Also, timing of ankle plantar flexion in loading response and preswing phase occured later, and degree of ankle plantar flexion in preswing phase were less in amputated limbs compared to other limbs. Peak plantar flexion moment in amputated limbs were less than sound limbs, but not than control group.
Conclusion: This study suggested that most significant gait abnormalities in unilateral below-knee amputees were observed at the knee and ankle joint in amputated limbs. (J Korean Acad Rehab Med 2003; 27: 958-963)
Method: Eighteen children with spastic diplegic cerebral palsy participated in this study. Gait patterns on sagittal plane were studied before and at average 3.5 years after SPR. Kinematic and temporospatial data were obtained by the VICON 370 system.
Results: The spasticity of hip adductor and ankle plantarflexor were improved significantly after SPR. The maximal angle of pelvic tilt, ankle dorsiflexion angle at initial contact, peak ankle dorsiflexion angle during stance phase, at toe-off and during swing phase, mid-range point of flexion-extension motion on ankle were significantly improved after SPR. The temporospatial data tended to improve after SPR at long-term follow up.
Conclusion: The SPR reduced spasticity and the gait patterns were improved in children with spastic diplegic cerebral palsy at long-term follow up. (J Korean Acad Rehab Med 2003; 27: 855-861)
Method: Nine patients participated with PWB harness on the treadmill, and nine patients with traditional exercise. In harness group, the gait training with 30% weight reduction was offered on treadmill, they were treated daily and gait training was done for 20 minutes. In no-harness group, traditional gait training was done by physical therapists. Variables were gait parameters assessed by VICON 370 Gait Analyzer, other function tested by Motricity Index and Functional Ambulatory Category.
Results: In linear parameter, the harness group had faster gait speed, longer stride length, and more decreased double support time compared to the no-harness group. In kinematic parameters, the maximal flexion of knee was significantly increased in harness group, but no significant differences was in hip and ankle motion. In kinetic parameters, hip flexion moment of normal side was increased in harness group at heel strike phase, knee flexion moment of normal side was decreased in harness group at heel strike phase.
Conclusion: The gait training with partial weight bearing harness was more effective in acute stroke patients than traditional therapy, and was influenced in gait pattern, functional ability.
Objectives: To evaluate changes of the gait pattern and the clinical improvement in patients with degenerative arthritis of the knee after total knee arthroplasty (TKA).
Method: Gait analysis was performed in 64 patients with degenerative arthritis of the knee at pre- and post-surgery 1 year, also Hospital for Special Surgery (HSS) knee score and Visual analogue scale (VAS) for clinical assessment were investigated.
Results: 1) In the HSS knee score and VAS, there were statistically significant improvement after surgery (p＜0.05). 2) In the postoperative gait analysis, all the linear parameters except single limb support period were significantly improved (p＜0.05). Single limb support period was improved, but statistically insignificant. All the kinematic and kinetic parameters also were significantly improved (p＜0.05).
Conclusion: This study suggests that gait analysis can be used for quantitative evaluation of the effects of total knee arthroplasty in patients with degenerative arthritis of the knee. (J Korean Acad Rehab Med 2002; 26: 581-586)
Objective: The aims of this study were to investigate the characteristics of stair climbing through the comparison between the stair climbing and level walking, and to present the standard values of stair climbing.
Method: Twenty healthy young adults were recruited. The kinematic and kinetic data of level walking and stair climbing on the specially designed stair were obtained through 3 dimensional motion analyzer (Vicon 370 system) with the force plate.
Results: The sagittal range of motion of all examined joints at stair climbing was significantly increased compared as at level walking (p＜0.05). The maximal flexion angle at swing phase of all examined joints were significantly increased at stair climbing compared than at level walking (p＜0.05). At loading response, the kinetic data showed the significant differences between stair climbing and level walking. The time when the maximal extensor moment of knee developed was significantly earlier than when that of hip developed (p＜0.05).
Conclusion: As a results, we found that stair climbing was different from level walking and had the unique pattern in the kinematic and kinetic aspect. The motion analysis of stair climbing may be useful to the further studies.
Objective: The aim of this study was to speculate the role of arm swing during gait through the comparison of energy consumption and kinematic data between the arm restriction and free arm swing
Method: 20 healthy male adults were recruited as subjects. The kinematic data including upper trunk and oxygen consumption were compared at three different walking speeds (2 km/hr, 4 km/hr, 6 km/hr) between with and without arm restriction.
Results: The oxygen consumption rate with arm restriction was significantly increased at fast speed walking (6 km/hr) comparing that without arm restriction. We found the significant difference of anterior-tilt angle, range of motion (ROM) in the coronal and transverse plane of upper trunk, anterior pelvic tilting angle, ROM of pelvis in coronal and transverse plane, maximal flexion angle of hip, ROM of hip in the coronal plane, and the external rotation angle at single support time in the transverse plane of hip between with and without arm restriction at fast walking speed (p＜0.05).
Conclusion: These results revealed that arm restriction while walking resulted in the minimal, significant changes of energy consumption, and kinematic data. Therefore, arm swing on gait was considered to have roles on energy conservation at fast walking, and on getting better limb advancement and stability.
Objective: To investigate a biomechanism of pelvic pain in pregnancy by use of motion analyzer.
Method: Ten pregnant women in the early third trimester and 10 healthy women as control were enrolled. A gait analysis by a Vicon 370 motion analyzer system was performed to investigate the dynamic lumbo-pelvic motion of pregnancy in biomechanical aspects.
Results: The mean maximal surface lordotic angle of pregnant women was 24.42⁑3.98 degrees, the mean minimal surface lordotic angle 20.64⁑4.27 degrees, and the mean maximal surface lordotic angle of controls was 21.61⁑2.43 degrees, the mean minimal surface lordotic angle 18.38⁑2.29 degrees (p＞0.05). The mean maximal anterior pelvic tilt of pregnant women was 21.11⁑5.91 degrees, and the mean maximal anterior pelvic tilt of controls was 15.28⁑4.94 degrees (p＜0.05).
Conclusion: The angle of lumbar lordosis was within normal ranges but the anterior pelvic tilt was increased significantly in pregnancy. This can place mechanical stress on lumbo-pelvic region. This dynamic sagittal imbalance of the spine may be a considerable cause for low back and pelvic pain in pregnancy as indicated by the results of this study.
Objective: The purpose of this study is to evaluate gait characteristics using kinematic analysis in children with hemiplegic spastic cerebral palsy.
Method: Fifty-seven non-operated spastic hemiplegic children who were able to walk independently without any walking aid were recruited as subjects. Three-dimensional kinematic gait analysis using a motion analyzer (Vicon 370 M. A. with 6 infrared cameras) were performed in all patients. Changes in joint angle of hip, knee and ankle in sagittal plane were evaluated to classify gait pattern and also the temporospatial values were measured to determine any differences between groups.
Results: Gait patterns were able to be classified into 6 groups. Group I had a minimal gait disturbance, a drop foot pattern. Group II showed hip and knee flexed, with normal ankle range. Group III showed hip, knee, and ankle flexed. Group IV showed genu recurvatum with tibia progression, Group V showed genu recurvatum with tibia arrest. Group VI showed stiff crouch gait. However, the temporospatial values between groups were not significantly different.
Conclusion: This classification system would be useful for converting the vast quantitative information of gait analysis into descriptive and clinically relevant patterns. Therefore, it would be helpful for the clinician to understand underlying pathology and plan appropriate treatment.
Congenital Achilles tendon contracture is an autosomal dominant disease which is relatively rare. The disease manifests itself as 'toe walking'. Since the clinical condition is relatively benign, it is easy to be overlooked by the clinicians. To the patients, it presents problems of ambulation and activities of daily living. We present a case of 23 year old man who has been walking on his toes. The patient had a difficulty in squatting and tieing shoes and performed poorly gym activities. The patient's father and brother also walked on toes, which made the patient become indifferent to his condition. Upon physical examination, plantarflexion contractures of both ankle joints were 10 degree and the knee were 5 degree. We could not find any abnormal findings in motor or sensory function tests of both lower limbs. Deep tendon reflexes on patella and ankle were within normal range. There were no abnormalities in ankle X-ray, electromyography, blood sample test including muscle enzymes. Gait analysis showed increased ankle plantarflexion moment during entire gait cycle, increased knee flexion during terminal stance, and decreased both knee flexion during initial swing.
Objective: The purpose of this study were to investigate the temporospatial, kinematic data and energy consumption in hemiplegic patients according to the types of ankle-foot orthosis (AFO), and to determine the most effective type of AFO for gait training.
Method: A prospective study was performed for 10 patients with hemiplegia who was able to walk independently at indoor level. The temporospatial, kinematic data and energy consumption were compared in each five different conditions: 1) barefoot, 2) donning AFO with posterior leaf spring (PLS), 3) donning PLS with the distal part of metatarsal head trimmed off (PLS-C), 4) donning hinged PLS (HPLS), 5) donning hinged PLS with the distal part of metatarsal head trimmed off (HPLS-C).
Results: With four types of PLS, maximal ankle plantar flexion was significantly decreased, however we didn't find any difference in kinematic data of the pelvis and hip as compared with barefoot and with PLS, HPLS, HPLS-C and maximal knee extension angle was significantly decreased compared with barefoot. With HPLS-C, cadence and walking speed significantly increased and double support time and oxygen cost significantly decreased as compared with barefoot.
Conclusion: This study showed increased walking speed, decreased energy cost and improved
Objective: The purpose of this study is to evaluate objectively and quantitatively gait improvement after total hip arthroplasty (THA) using a 3-dimensional computerized Vicon motion analyzer.
Method: A preoperative gait evaluation was performed within one month before surgery and two postoperative gait evaluations at 6 months intervals after surgery. Pre- and postoperative gait parameters of 176 patients with unilateral total hip arthroplasty were evaluated and data were compared with those of 56 healthy persons.
Results: 1) Single limb support of affected limb increased significantly at postoperative 6 and 12 months compared with preoperative data. 2) The improvements of hip flexion and abduction of affected limb were in almost normal range at postoperative 12 months. 3) Maximal hip flexor moment in terminal stance of affected limb reached to nearly normal level at postoperative 12 months.
Conclusion: A quantitative gait analyzer is a very useful tool to assess objectively the success of THA as substantiated by the results of this study with a significant improvement in all the parameters of gait., Unilateral total hip arthroplasty, Gait analysis, Kinematics of hip joint
Objective: The ability to get up from a chair is an important component in maintaining independence and a prerequisite for upright mobility for stroke patients. The purpose of this study was to compare the sit-to-stand movement in stroke patients with that in healthy adult.
Method: Twenty-three stroke patients and thirty-seven young healthy subjects were included in this study. Subjects sat on an adjustable chair with their feet on force plates and performed the standing up movement at a self-paced, comfortable speed. The study patients were tested barefoot. The changes in joint angle, maximal moment, power, and ground reaction force in lower limb were calculated using 3 dimensional motion analyzer throughout the sit-to-stand transfer.
Results: The mean time needed was significantly longer in stroke patients than in young healthy subjects. Pelvic tilting and hip flexion angle at initial and final angle were significantly greater in stroke patients than in young healthy subjects. Maximal momentum, power and change of ground reaction force in ankle joint were significantly lower in stroke patients than in young healthy subjects. Hip external rotation angle at standing point showed significant correlation with maximal hip external rotation and slow walking speed during the comfortable walking.
Conclusion: We concluded that the analysis of sit-to-stand movement in stroke patients may provide a useful guide for gait recovery and training.
Objective: To investigate the effects of dynamic (hinged) and solid ankle-foot orthoses (AFO) on the gait characteristics in spastic cerebral palsied children and to find out which AFO has a more beneficial effect on correcting the abnormal gait pattern in those children.
Method: The subjects were 40 children with spastic cerebral palsy (CP) who were able to walk independently without walking aids. Their ages were ranging from 2 to 12 years. Children were randomly prescribed to dynamic or to solid AFO. Twenty-four children got solid AFO and 16 children got hinged AFO. Gait characteristics were evaluated by computer based kinematic gait analysis while they were walking with AFO and on barefoot. Gait characteristics on barefoot and with hinged AFO and with solid AFO respectively were compared.
Results: Temporospatial parameters while walking on barefoot were not significantly different from those while walking with AFOs. While walking with hinged AFO, the maximal knee extension angle during stance phase was decreased in comparison with that on barefoot (p＜0.05). Ankle dorsiflexion angle on hinged AFO was increased throughout the gait cycle (p＜0.05). While walking with solid AFO, ankle dorsiflexion angle at initial contact, at 98% of gait cycle and at maximal ankle dorsiflexion angle in stance phase were increased in comparison with that on barefoot (p＜0.05). There was no significant difference of changes after wearing orthoses between hinged and solid AFO.
Conclusion: Both types of AFOs exerted a positive effect on ankle motion, not in knee or hip joints in the children with spastic cerebral palsy. The gait characteristics during walking with both AFOs were not significantly different, even if the hinged type might be more effective in preventing knee hyperextension in stance phase and in improving maximal ankle dorsiflexion during the swing phase.
Objective: To find out the characteristics of gait maturation process in Korean normal children.
Method: Three dimensional kinematic gait analysis using Vicon 370 system from Oxford Metrics Company was performed for 72 children (33 females) without known gait anomalies aging between one and six years old. The data were compared with those from 41 normal adults which were collected previously using the same method, and with those from study by Sutherland et. al.
Results:
1. The initial heel contact, initial flexion wave of the knee joint during the early stance phase and reciprocal arm swing were found before the age of 3.5.
2. Pelvic motion in transverse plane, hip joint motion in all the three planes, knee joint motion in coronal plane, and ankle joint motion in transverse plane remained greater than those of Caucasian children of Sutherland et. al.
3. Single stance period remained shorter than that of Caucasian children.
4. Internal rotation of hip joint and varus motion of the knee joint remained greater than those of Caucasian children.
Conclusion: The difference between Korean and Caucasian children were
1. Development of muscles' ability which stabilize the large leg joints during gait seems slower among Korean children than Caucasian children.
2. These differences are probably from the anthropometrical characteristics of Korean and Caucasian growing children. Also, the different definition of angle systems between the Korean and Caucasian data might case some erroneous effect on the interpretation of result.
Objective: To investigate the changes of gait patterns in subjects who use the ankle foot orthoses (AFOs) with a variable ankle joint stop.
Method: Six young subjects without a known physical disability were involved in this study. Double upright AFOs with three kinds of ankle joint stops (eg. AFOs with 85o posterior stop, 90o posterior stop, and 95o posterior stop) were used for the right foot and a rigid shoe was used for the left foot. Gait patterns of the subjects using the AFOs with a variable ankle joint stop were evaluated with the three dimensional gait analysis system.
Results: The gait patterns of the subjects with a 85o posterior stop AFO showed a shorter duration of single support phase than the subjects with a 90o posterior stop or 95o posterior stop. They showed the increased maximal knee flexion angles, decreased knee extension angles and decreased ankle range of motions by the kinematics. These linear changes in parameters and kinematics were statistically significant. In kinetics, the gait patterns of the subjects using a AFO with 85o posterior stop had the largest maximal knee flexion moment and the gait patterns of the subjects using a AFO with 95o posterior stop had the largest maximal knee extension moment. However these results were not statistically significant.
Conclusion: For the patients with uncontrolled ankle motion, the AFOs with 90o or 95o posterior stop would be more desirable than the AFOs with 85o posterior stop, for the clearance of foot and stability of knees but not for the correction of the knee hyperextension.
Objects: The purpose of this study is to estimate the values of foot pressure of the stance phase during a gait cycle in hemiplegic gait.
Method: Thirty patients who had a stroke and forty healthy adults were evaluated by the EMED-SF system to analyze the stance phase of hemiplegic gait. The stance phase was evaluated by 6 points according to the foot pressure and center of pressure proposed by Lee et al.2)
Results:
1) In hemiplegics, the stance time of involved limb decreased compared with that of the uninvolved limb and increased that of control groups (p＜0.05).
2) In hemiplegics, the midstance time increased but the loading response and terminal stance decreased compared with the uninvolved limb and controls (p＜0.05).
3) In hemiplegics, the midstance time decreased and the loading response and terminal phase increased according to the increased Brunnstrom stage (p＜0.05).
Conclusion: The results showed that an analysis of stance phase by the measurement of plantar pressure was a valuable parameter in the gait analysis of hemiplegic patients.
Objective: Excessive external rotation of the hemiplegic foot is a common problem of hemiplegic gait. There has been a few report on etiological investigation and corrective measurement of an excessive external rotation of hemiplegic foot. Thus we present a newly designed Torque heelⰒ to correct the external rotation of hemiplegic foot.
Method: Ten hemiparetic patients with an excessive external rotation of affected foot participated in this study. All of the participants were able to walk at least 10 meters with metal a ankle foot orthosis (AFO) using a single cane. Each of these patients was placed on four tries of walk: (1) on a bare foot; (2) with an AFO; (3) with an AFO and a quarter inch of lateral wedge; and (4) with an AFO and the Torque heelⰒ. Gait patterns were analysed by the Vicon 370, three dimensional motion analyser.
Results: The speed and stride length increased in all tries except for the bare foot walk. Those who walked with the assistive devices showed no difference in the speed and stride length. All the participants showed an increased in external rotation of pelvis and ankle. Those who walked with an AFO and Torque heelⰒ presented a decrease in the external rotation of foot and pelvis. The hip and ankle motions of the hemiplegic limbs were not affected with the AFO and Torque heelⰒ. A significant degree of correction in pelvic rotation with an AFO and Torque heelⰒ was noted.
Conclusions: This study indicates that an AFO with Torque heelⰒ is beneficial to the correction of external rotation of a hemiplegic foot. And the excessive external rotation of hemiplegic foot may be due possibly to the external rotation of pelvis.
Objective: The aim of this study is to present the basic reference data of age and sex specific gait parameters for Korean adults.
Method: The basic gait parameters were extracted from 70 healthy adults, 38 men and 32women, 21 to 69 years of age using VICON 340 Motion Analyzer.
Results: The temporal gait parameters and kinematic parameters of Korean adults were similar to other western reference data.
Conclusion: Significant sex differences exist in the maximal pelvic tilting, pelvic internal rotation and foot internal rotation and plantar flexion. There is a statistically significant age variability for the hip and knee flexion at stance phase.
Objective: To develop and evaluate a new orthotic device for the knee to improve the ambulation patterns in paraplegic patients.
Method: The new orthotic device combined a high torque servo motor with a bail-lock knee joint, and a its wireless controller adopting open-loop control system. The device was tried in a paraplegic volunteer for two months, simultaneously with the conventional long leg brace.
Results: The new device could keep the orthotic knee joint exended during the stance phase, and allow the sequential flexion and extension of the joint during the swing phase. The new orthotic device provided both longer step length(p＜0.05) and fewer cadence(p＜0.05) maintaining the same walking speed. Also, a circumduction during the swing phase reduced, and the posture of the trunk became straighter. The stride time and the double support period became longer(p＜0.05), and the magnitude of the shift of pelvic center increased(p＜0.05).
Conclusion: The new orthotic device for the knee was developed and evaluated in a paraplegic volunteers who had failed to use the functional electrical stimulation. The results were satisfactory with a probable lower energy efficiency with the new orthosis. Further study for verification of the results seems to be necessary.
The purpose of this study was to detect where the center of pressure in foot would be located at the end point of loading response and the terminal stance by the dynamic plantar pressure measurement.
Seventeen adults who had the usual feet without a pathologic gait were evaulated simultaneously by the motion analysis using VICON 370, and the plantar pressure measurement using EMED-SF. Two devices were set in the 60 Hz frame. The foot was divided into 3 different zones; hindfoot, midfoot, and forefoot.
The end point of loading response was located at the 1.92⁑1.46 frame distal to the hindfoot- midfoot borderline. The end point of terminal response was located at the 2.27⁑1.96 frame distal to the maximal pressure points of metatarsal head.
Authors could differentiate each period of stance phase; the initial contact, loading response, mid-stance, terminal stance, and preswing, using the analysis of center of pressure by the dynamic plantar pressure measurement.
There have been a many reports of observational analysis on hip disarticulation prosthetic ambulation, but not a scientific analysis by a computerized motion analyzer. We present to share with our professional colleague our invaluable experience gained from the study on the gait analysis of a left hip disarticulation prosthetic gait.
Using a Vicon 370 three dimensional gait analysis system, the gait analysis was performed in a left hip disarticulation patient fitted with a left Canadian type hip disarticulation prosthesis.
In linear parameters, the cadence showed 79 steps/min, the gait speed was 0.68 m/sec, and the double support phase was 25.27% of a total gait cycle. In kinematics, the maximal pelvic tilt angle showed 29.92o at pre-swing phase, and significantly increased as compared with normal person. Hip motion change remained flexed, and maximal knee flexion angle disclosed 22.07o at the terminal stage of initial swing phase. In kinetics, the hip extension moment on initial contact stage was 0.089 NM/kg, which was impaired being compared with normal person.
In conclusion, the increased pelvic tilt which implies that initiation of a prosthetic gait for hip disarticulation comes from a forward swing of the pelvis on the affected side, and an overall decrease of gait parameters accounts for the degree of disability of hip disarticulation amputee.
Previous studies proved that, the high-heeled shoes caused postural changes, a loss of foot function, and deformities of foot. However the lumbar lordosis in gait is rarely measured. The purposes of this study were to compare kinematics and kinetics between high-heeled and high-forefoot gait by skin markers, and to find the influence of heel height to lumbar vertebral alignment. We used the Vicon 370 three-dimension Gait Analysis System.
In the present study, the lower extremity biomechanics in high-heeled and high-forefoot shoes were examined in 20 Korean female subjects. Results showed that the double support phase increased in high-forefoot gait in linear parameters. In sagittal plane kinematics, the lumbar lordosis slightly increased in high-forefoot gait, but that did not increase in high-heeled gait. The knee flexion and ankle plantarflexion increased in high-heeled gait, but ankle pantar flexion reduced in high-forefoot gait. Clinically the change of ankle motion was not significantly influenced to the lumbar lordosis. However, high-heeled shoe users with low back pain are probably influenced by the overstress of paraspinal muscles and vertebral ligments. Further studies are required for more precise analysis of high-heeled and high-forefoot gaits.
Variations in the distribution and the magnitude of the forces in the foot may reflect painful conditions and abnormalities of structure or function. By tracking the path of the instantaneous COP(center of pressure) during stance phase, the balance and pattern of progression can be determined, but parameters on COP have not been standardized nor widely applied to clinical settings yet. To quantify the COP parameters and to evaluate the clinical applicability of COP, within subject experimental design was used. Twenty six subjects with age of sixties who had no history of foot problems were recruited. Foot contact and COP parameters were measured and compared between flat foot, low heel and high heel shod walking.
1) Gait cycle parameters, 2) foot contact parameters such as total contact area, contact length, contact width, and 3) COP parameters such as initial contact COP, mean COP, anteroposterior and mediolateral displacement of COP, slope of COP, velocity of COP during each functional rocker were measured with F-scan pressure sensitive insole system.
In normal flat foot walking, COP of initial contact and mean COP were anatomically correspond to the center of the heel and to the center of the sole respectively. COP displacements corresponded to 83% of foot contact length anteroposteriorly and 18% of forefoot contact width mediolaterally. Slope of COP was about 6 degrees inwardly directed. Velocities of the COP during each functional rocker action were even and about 22∼27 cm/sec around.
In high heel shod walking, COP of initial contact was displaced 1.73 cm anteriorly and mean COP was displaced 0.31 cm medially and 1.89 cm anteriorly. Anteroposterior displacement of COP was also reduced. Velocity of the COP during heel rocker was faster and velocity during ankle rocker was slower compared to flat foot walking, which suggests excessive heel rocker and reduced ankle rocker action in high heel shod walking.
In conclusion, COP parameters measured by pressure sensitive insole system may reflect the biomechanical alteration of the foot quantitatively and may be useful in assessing the biomechanical function of the foot.
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