Purpose: The purpose of this study was to compare the pathway of COP and plantar foot pressure and to determine the correlation between plantar regions during the ascending and descending of a ramp. Methods: Fifteen healthy adults who had no musculoskeletal problems participated in our study. They were asked to walk on a level surface and on an ascending and descending ramp in their bare feet. Pathway of COP and plantar foot pressures were recorded using the Matscan system (Tekscan, Boston, USA). For pressure measurements, the plantar foot surface was divided into seven regions: two toe regions, three forefoot regions, a midfoot region, and a heel region. To determine whether there was a statistically significant difference between pathway of COP and plantar foot pressures during walking, we used repeated measuremes ANOVA. Results: In comparison to results for a level walking, pathway of COP while ascending a ramp had a tendency to be shifted medially in the forefoot and became longer till the big toe. Pathway of COP while descending a ramp also was shifted medially, but ended in the forefoot. Plantar foot pressure of the second and third metatarsal head and the fourth and fifth metatarsal heads was significantly decreased while descending the ramp. Conclusion: These results indicated that plantar foot pressure is changed while ascending and descending a ramp and demonstrated that ramp walking can affect the structure and function of the foot. Therefore, gait environment is associated with significant changes in foot characteristics, which contribute to altered plantar loading patterns during gait.
Purpose : Plantar surfaces, calcaneal area, and region of Achilles insertion, which are extremely related with weight-bearing area and shoes application, must be reconstructed with glabrous and strong fibrous skin. Numerous methods of reconstructing defects of these regions have been advocated, but the transfer of similar local tissue as a cutaneous flap with preservation of sensory potential would best serve the functional needs of the weight-bearing and non-weight-bearing surfaces of this region. Therefore it is recommended to use the limited skin of medial surface of foot that is similar to plantar region and non-weight-bearing area. In this paper we performed the medial plantar flap transfered as a fasciocutaneous island as one alterative for moderate-sized defects of the plantar forefoot, plantar heel, and area around the ankle in 25 cases and report the result, availability and problem of medial plantar flap. Materials and methods : We performed proximally based medial plantar flap in 22 cases and reverse flow island flap in 3 cases. Average age was $36.5(4{\sim}70)$ years and female was 3 cases. The causes of soft tissue defect were crushing injury on foot 4 cases, small bony exposure at lower leg 1 case, posterior heel defect with exposure of calcaneus 8 cases, severe sore at heel 2 cases, skin necrosis after trauma on posterior foot 4 cases, and defect on insertion area of Achilles tendon 6cases. Average follow up duration was 1.8(7 months-9.5 years) years. Results: Medial plantar flaps was successful in 22 patients. 18 patients preserved cutaneous branches of medial plantar nerve had sensation on transfered flap but diminished sensation or dysesthesia. At the follow up, we found there were no skin ulceration, recurrence of defect or skin breakdown in all 18 patients. But there was one case which occurred skin ulceration postoperatively among another 4 cases not contained medial plantar nerve. At the last follow up, all patients complained diminished sensation and paresthesia at medial plantar area distally to donor site, expecially with 4 patients having severe pain and discomfort during long-time walking. Conclusion : Medial plantar island flap based on medial plantar neurovascualr pedicle have low failure rate with strong fibrous skin and preserve sensibility of flap, so that it is useful method to reconstruct the skin and soft tissue defect of foot. But it should be emphasized that there are some complications such like pain and paresthesia by neuropraxia or injury of medial plantar nerve at more distal area than donor site. We may consider that medial plantar flap have limited flap size and small arc of rotation, and require skin graft closure of the donor defect and must chose this flap deliberately.
Journal of Korean Society of Occupational and Environmental Hygiene
/
v.19
no.1
/
pp.25-29
/
2009
The purpose of this study was to investigate the effect of two different lifting posture on the plantar foot pressure, force and COP(center of pressure) trajectory path during object lifting. Fourteen healthy adults who had no musculoskeletal disorders were instructed to lift with two postures(stoop and squat) and two object weights(empty box and 10 kg box). Plantar foot pressures, forces and COP trajectory path were recorded by the F-mat system(Tekscan, Boston, USA) during object lifting with barefoot. Plantar foot surface was defined as seven regions for pressure measurement; two toe regions, three forefoot regions, one midfoot region and one heel region. Paired t-test was used to compare the outcomes of peak pressure and maximum force with different two lifting postures and two object weights. Plantar peak pressure and maximum force under hallux was significantly greater in squat posture than stoop posture during the two different boxes lifting(p<.05). During the empty box lifting, maximum force under lessor toes was significantly less and plantar peak pressure under second metatarsal region was significantly greater in squat than stoop(p<.05). Maximum force under heel was significantly less in squat than stoop posture during 10kg box lifting(p<.05). Finally, COP trajectory path was significantly greater in squat than stoop(p<.05). These findings confirm that there are significantly change in the structure and function of the foot during the object lifting with different posture. Future studies should focus on the contribution of both structural and functional change to the development of common foot problems in adults.
Objectives : The object of this study is to report the effectiveness of Korean medicine treatment and to urge in-depth research on plantar fasciitis. Methods : Four patients, diagnosed as plantar fasciitis, were treated by Korean medicine interventions; acupuncture at K13, BL60, BL40, indirect moxibustion at local region, oral intake herbal medicine and Korean physical therapy on plantar fascia. Visual analog scale(VAS) was adpoted as a method of measuring the effect of treatment on plantar pain. Results : As a result, the plantar pain decreased and VAS score was declined at three cases. However, at one case, the symptom was not changed and VAS score was same. Conclusions : Korean rehabilitative complex therapy can be effectively used for plantar fasciitis. Further studies are needed to set up a rehabilitation protocol with Korean medicine interventions on this disease.
D. K. LEE, J. S. LEE, B. J. LEE, H. S. LEE, Y. J. KIM, S. B. PARK, J. P. JOO. Plantar foot pressure analysis during golf swing motion using plantar foot pressure measurement system. Korean Journal of Sport Biomechanics, Vol. 15, No. 1, pp. 75-89, 2005. In this study, weight carrying pattern analysis and comparison method of four foot region were suggested. We used three types of club(driver, iron7, pitching wedge). This analysis method can compare between top class golfer and beginner. And the comparison data can be used to correct the swing pose of trainee. If motion analysis system, which can measure the swing speed and instantaneous acceleration at the point of hitting a ball, is combined with this plantar foot force analysis method, new design development of golf shoes to increase comfort and ball flight distance will be available. 1. Address acting, forces concentrated in rare foot regions and lateral foot of right foot. Back swing top acting, relatively high force occurred in medial forefoot region of left foot and forefoot region of right foot. Impact acting, high force value observed in the lateral rarefoot region of left foot and medial forefoot region of right foot. Finish acting, force concentration observed on the lateral region and rarefoot region of left foot. 2. Forces were increased in address of right foot with clubs length increased. All clubs, back swing top acting, high force value observed in the lateral forefoot region of right foot. All clubs, in impact, high force value observed in the lateral rarefoot region of left foot and medial forefoot region of right foot. Finish acting, force concentration observed on the rarefoot region in driver and lateral foot region in iron on left foot. 3. Right foot forces distribution were increased in address, back swing top and left foot force distribution were increased in impact, finnish
The purposes of this study were 1) to determine the effects of low-dye taping on peak plantar pressure following treadmill walking exercise, 2) to determine whether the biomechanical effectiveness of low-dye taping in peak plantar pressure was still maintained following removal of the tape during treadmill walking, and 3) to determine the trend towards a medial-to-lateral shift in peak plantar pressure in the midfoot region before and after application of low-dye taping. Twenty subjects with flexible flatfoot were recruited using a navicular drop test. The peak plantar pressure data were recorded during five treadmill walking sessions: (1) un-taped, (2) baseline-taped, (3) after a 10-minute treadmill walking exercise, (4) after a 20-minute treadmill walking exercise, and (5) after removal of the taping. The foot was divided into six parts during the data analysis. One-way repeated measures analysis of variance was performed to investigate peak plantar pressure variations in the six foot parts in the five sessions. This study resulted in significantly increased medial forefoot peak plantar pressure compared to the un-taped condition (p=.017, post 10-minute treadmill walking exercise) and (p=.021, post 20-minute treadmill walking exercise). The peak plantar pressure in the lateral forefoot showed that there was a significant decrease after sessions of baseline-taped (p=.006) and 10-minute of treadmill walking exercise (p=.46) compared to the un-taped condition. The tape removal values were similar to the un-taped values in the five sessions. Thus, the findings of the current study may be helpful when researchers and clinicians estimate single taping effects or consider how frequently taping should be replaced for therapeutic purposes. Further studies are required to investigate the evidence in support of biomechanical effectiveness of low-dye taping in the midfoot region.
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.
This study compares the gait characteristics of elderly women during barefoot walking and walking with sneakers. We measured foot angles, max foot pressure, peak plantar pressure of each plantar region, velocity of Center of Pressure(COP), and axis shifting of COP with an RS-scan system. Elderly women's foot angles were narrower when walking with sneakers than when barefoot walking. We found that the subtalar joint angle (representing ankle joint flexibility) affected walking stability. Regarding the peak plantar pressure of each foot region, pressures were high in the medial regions and the pressures greatly varied depending on the region measured during barefoot walking. The COP moved significantly faster when walking with sneakers than barefoot walking and suggests that elderly women walked faster in sneakers. Axis shifting of the COP decreased during walking with sneakers and indicated that gait balance improved when walking with sneakers. The findings of the present study can be utilized as foundational data for elderly women's gait characteristics as well as data for the production of functional footwear. Future research that focuses on various types of shoes, age groups, and gender are recommended for the development of more functional footwear for stable gaits.
In-shoe measurement systems allow the clinician and researcher to examine the pressure parameters within the shoe. The purpose of this study was to investigate the test-retest reliability of plantar pressures using the Parotec system over speeds and plantar regions. Seventeen healthy subjects were recruited for the study. Sampling rate was 100 Hz, and data of six variables (pressure on medial heel, lateral heel, 1st metatarsal head, 5th metatarsal head, and great toe and total impulse) were collected in four different gait speed (1.0 m/sec, 1.5 m/sec, 2.0 m/sec, and comfortable walking speed) in each day. The result indicates fair to excellent reliability between the two day test. Intraclass correlation coefficients (ICCs) ranged from .693 to .979, and range of reliability was similar depending on the speed and plantar region. In most cases, data recorded by the Parotec systems provide good evidence for the reliability.
The purpose of this study was to investigate the effect of different ramp inclination on the maximum plantar foot pressure and pathway of the center of pressure. Fifteen healthy adults who had no musculoskeletal disorders were participated with this study and descended the ramp with different inclination(level, $-5^{\circ}$, $-10^{\circ}$, $-15^{\circ}$). Plantar foot pressures were recorded by the Matscan system(Tekscan, Boston, USA) during level and descending ramp with barefoot. Plantar foot surface was defined as seven regions for pressure measurement; two toe regions, three forefoot regions, one midfoot region, one heel region. Repeated ANOVA was used to compare each region data of foot according to different ramp inclination. As descending ramp inclination became increased, the pressure of hallux region was significantly increased at $-15^{\circ}$ inclination and the pressure of 2-3 metatasal head region were significantly decreased at $-5^{\circ}$, $-10^{\circ}$, $-15^{\circ}$ inclination. The pathway of COP had a tendency to be shifted inside in forefoot and prolonged to great toe as the descending ramp inclination increased. The results indicated that plantar foot pressure could be changed at hallux and forefoot regions with $-5^{\circ}$ ramp inclination and these findings demonstrated that ramp inclination could affect the structure and function of foot.
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