To assess the plantar pressure distribution during the robotic-assisted walking, guided through normal symmetrical hip and knee physiological kinematic trajectories, with unassisted walking in post-stroke hemiplegic patients.
Fifteen hemiplegic stroke patients, who were able to walk a minimum of ten meters independently but with asymmetric gait patterns, were enrolled in this study. All the patients performed both the robotic-assisted walking (Lokomat) and the unassisted walking on the treadmill with the same body support in random order. The contact area, contact pressure, trajectory length of center of pressure (COP), temporal data on both limbs and asymmetric index of both limbs were obtained during both walking conditions, using the F-Scan in-shoe pressure measurement system.
The contact area of midfoot and total foot on the affected side were significantly increased in robotic-assisted walking as compared to unassisted walking (p<0.01). The contact pressure of midfoot and total foot on affected limbs were also significantly increased in robotic-assisted walking (p<0.05). The anteroposterior and mediolateral trajectory length of COP were not significantly different between the two walking conditions, but their trajectory variability of COP was significantly improved (p<0.05). The asymmetric index of area, stance time, and swing time during robotic-assisted walking were statistically improved as compared with unassisted walking (p<0.05).
The robotic-assisted walking may be helpful in improving the gait stability and symmetry, but not the physiologic ankle rocker function.
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Method: Thirty three normal subjects and fourteen diabetic patients were participated. Plantar peak pressures in shoes were measured by pedarⰒ during a comfortable gait wearing two types of diabetic shoes, respectively. A shoes and B shoes were used in this study. Plantar pressure was analyzed by pedar C-expert program at T0 (whole foot), M1 (heel), M2 (midfoot), M3 (1st, 2nd metatarsal area), M4 (3rd, 4th, 5th metatarsal area), M5 (great toe), M6 (2nd, 3rd toe area) and M7 (4th, 5th toe area) zones respectively.
Results: Plantar peak pressures of diabetic patients without neuropathic and ischemic symptom were not different from normal subjects. In normal subjects, plantar peak pressure of B shoes were lower than A shoes at both T0, M3 and M5 zones and left M6 and M7 zones. Plantar peak pressures of A shoes was lower than B shoes at both M2 zones. In diabetic patients plantar peak pressures of B shoes was lower than A shoes at right M4 and left M5 zones.
Conclusion: There was no sgnificant difference between plantar peak pressures of normal subjects and diabetic patients without neuproathic and ischemic symptom. B shoes were better than A shoes to reduce plantar peak pressure. (J Korean Acad Rehab Med 2003; 27: 433-437)
Objective: To assess the proper type of outsole for the diabetic shoes according to the hardness of outsole in diabetic patients.
Method: Seventeen diabetic patients and 33 normal control volunteers in the 5∼6th decade were participated in this study. Walking exercise in the treadmill was performed in all subjects wearing the custom-made shoes with the two layers of hard outsole and one layer of soft outsole, respectively. Peak plantar pressures were measured after exercise by Pedar system with pressure sensitive insoles inserted in each shoes and compared with two types of outsoles. The degree of oxygen saturation was measured in the fourth toe by Oxysensor and the plantar thermography were measured by infrared thermometer before and after exercise, and compared with the two types of outsoles in diabetic and control groups, respectively.
Results: There were not significant differences of peak plantar pressures in all measuring points according to the type of outsole in diabetic group. The degree of oxygen saturation in the fourth toe was not significantly changed between the two types of outsoles before and after exercise in diabetic group. The plantar temperatures were significantly increased after exercise in all groups, but there was not significant difference according to the type of outsole.
Conclusion: There was not significant difference between hard and soft outsole with the custom-made shoes for diabetic patient applied in this study. But more advanced studies about the outsole of diabetic shoe should be needed. (Korean Acad Rehab Med 2002; 26: 598-605)
Objective: To study the relationship between plantar pressure and diabetic foot ulcer and the assessment the usefulness of plantar pressure measurement in diabetic patients.
Method: The total 94 diabetic patients were enrolled in this study. The plantar pressure was measured by using EMED-SF. And the nerve conduction studies, physical examination, and history taking were done. Patients were divided into 3 subgroups, Group A: without neuropathy and past ulcer history (n=31), Group B: with neuropathy and without past ulcer history (n=44), Group C: with neuropathy and past ulcer history (n=19).
Results: 1) There were significant increase in the maximum peak pressure (MPP) and the pressure-time integral (PTI) values in the Group C as compared with the Group A and B (p＜0.05). 2) As compared among the groups for each areas, the MPP and the PTI significantly higher in group C for heel, medial fore-foot, and lateral fore-foot area than in another two groups (p＜0.05).
Conclusion: The high plantar pressure was significantly related with diabetic foot ulcer history. The plantar pressure measurement may be useful in diabetic patients as a predictive and management aids of diabetic foot ulcer.
Objective: The purpose of this study is to analyze the distribution of plantar pressure in six balletpositions and to compare those between the skilled and unskilled ballet dancers.
Methods: Thirty eight feet of healthy ballerina were evaluated by EMED-SF (Novel GMBH Inc. Ger.) system to analyze six positions of ballet. At each position, we estimated the static and dynamic positions. The forefoot was divided into 6 different zones on the basis of head of metatarsal bones. The degree of discipline was assessed by 3 expert ballerina.
Results: In each position, there were significant peak pressure distribution areas. In the skilled ballerina, there was less difference in peak pressure between the static and dynamic positions in comparision with the unskilled ballerina. In the skilled ballerina, more forces are distributed to M6 area in releve position and to M3 and M6 areas in turnout positions.
Conclusion: Six basic ballet positions could be analyzed by plantar pressure measurement. There were some differences in the distribution of planter pressure in some ballet positions between the skilled and unskilled ballet dancers.
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.
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