Plantar Pressure Distribution During Level Walking, and Stair Ascent and Descent in Asymptomatic Flexible Flatfoot

The first purpose was to identify the plantar pressure distributions (peak pressure, pressure integral time, and contact area) during level walking, and stair ascent and descent in asymptomatic flexible flatfoot (AFF). The second purpose was to investigate whether peak pressure data during level walking could be used to predict peak pressure during stair walking by identifying correlations between the peak pressures of level walking and stair walking. Twenty young adult subjects (8 males and 12 females, age $21.0{\pm}1.7$ years) with AFF were recruited. A distance greater than 10 mm in a navicular drop test was defined as flexible flatfoot. Each subject performed at least 10 steps during level walking, and stair ascent and descent. The plantar pressure distribution was measured in nine foot regions using a pressure measurement system. A two-way repeated analysis of variance was conducted to examine the differences in the three dependent variables with two within-subject factors (activity type and foot region). Linear regression analysis was conducted to predict peak pressure during stair walking using the peak pressure in the metatarsal regions during level walking. Significant interaction effects were observed between activity type and foot region for peak pressure (F=9.508, p<.001), pressure time integral (F=5.912, p=.003), and contact area (F=15.510, p<.001). The regression equations predicting peak pressure during stair walking accounted for variance in the range of 25.7% and 65.8%. The findings indicate that plantar pressures in AFF were influenced by both activity type and foot region. Furthermore the findings suggest that peak pressure data during level walking could be used to predict the peak pressure data during stair walking. These data collected for AFF can be useful for evaluating gait patterns and for predicting pressure data of flexible flatfoot subjects who have difficulty performing activities such as stair walking. Further studies should investigate plantar pressure distribution during various functional activities in symptomatic flexible flatfoot, and consider other predictors for regression analysis.