Preliminary investigation of foot pressure distribution variation in men and women adults while standing

doi:10.1016/j.foot.2011.03.001

The Foot

Volume 21, Issue 3, September 2011, Pages 142-148

https://doi.org/10.1016/j.foot.2011.03.001 Get rights and content

Abstract

Background

Women and men are anatomically and physiologically different in a number of ways. They differ in both shape and size. These differences could potentially mean foot pressure distribution variation in men and women. The purpose of this study was to analyze standing foot pressure image to obtain the foot pressure distribution parameter – power ratio variation between men and women using image processing in frequency domain.

Methods

We examined 28 healthy adult subjects (14 men and 14 women) aged between 20 and 45 years was recruited for our study. Foot pressure distribution patterns while standing are obtained by using a PedoPowerGraph plantar pressure measurement system for foot image formation, a digital camera for image capturing, a TV tuner PC-add on card, a WinDvr software for still capture and Matlab software with dedicated image processing algorithms have been developed. Various PedoPowerGraphic parameters such as percentage medial impulse (PMI), fore foot to hind foot pressure distribution ratio (F/H), big toe to fore foot pressure distribution ratio (B/F) and power ratio (PR) were evaluated.

Results

In men, contact area was significantly larger in all regions of the foot compared with women. There were significant differences in plantar pressure distribution but there was no significant difference in F/H and B/F ratio. Mean PR value was significantly greater in men than women under the hind foot and fore foot. PMI value was greater in women than men. As compared to men, women have maximum PR variations in the mid foot. Hence there is significant difference at level p < 0.05 in medial mid foot and mid foot PR of women as compared to men.

Conclusion

There was variation in plantar pressure distribution because the contact area of the men foot was larger than that of women foot. Hence knowledge of pressure distributions variation of both feet can provide suitable guidelines to biomedical engineers and doctor for designing orthotic devices for reliving the area of excessively high pressure.

Introduction

Plantar pressure analysis has been used in various studies to detect foot pathologies [1], [2], [3], [4]. These studies have identified the pressure characteristics during gait, contact area of the foot and the forces produced. The pressure distributions underneath the feet are affected by several conditions such as the anatomical structure of the foot, body weight, gender (men and women) and joint range of motion [5]. Plantar pressure has been examined mostly during adult walking [6]. Little information is available about the function of the foot in standing [6], [7]. Despite the range of devices available to measure peak pressure during barefoot walking, there have been few studies to explore foot characteristics and investigate potential differences in pressure distribution under foot sole between men and women. Women and men are anatomically and physiologically different in a number of ways. Anthropometric studies have found considerable differences between the foot bones of each gender which have helped in identifying gender in forensic science studies [8]. Murphy et al. [9] compared the mid foot contact area and plantar pressure in males and females and found no difference among genders in four regions of the foot. They only compared the mid foot region for plantar peak pressure and contact area in their study. But Putti et al. [10] compare in-shoe foot pressure parameters in males and females in 10 different regions of the foot for all the important pressure measurement characteristics and found that no significant between gender differences in peak pressure, contact time, pressure–time integral and instant of peak pressure in the foot. However they fully represent all areas of foot well and fail to show subtle differences in the different regions. Also they compared in-shoe foot pressure parameters in their study. No evaluation and study was done for PedoPowerGraphic parameters (power ratio, fore foot to hind foot pressure ratio and percentage medial impulse). The purpose of this study was to analyze the standing foot pressure image obtained by PedoPowerGraph in men and women to find out the foot pressure distribution variations using image processing in frequency domain.

Section snippets

Methods

The Subjects were recruited from the student community of our institute. All the subjects were given written informed consent before data recording.

Image analysis

The foot pressure image data are analyzed in the frequency domain analysis using the image processing to obtain power ratio.

Result

In the present study, we have investigated and analyzed 28 healthy adult subjects with bipedal standing. The characteristics of the participants were summarized in Table 1. For our result analysis we have divided the foot sole areas as shown in Fig. 7 and obtain the results of the mean PR value. The PedoPowerGraph system used in this study has been shown to have good repeatability as mentioned in Fig. 8. The data were assessed to see if any differences in various PedoPowerGraphic parameters

Discussion

In the present study, no calibration process is needed for selecting plastic sheet. Larger glass plate of length: 57 cm; breadth: 44 cm; thickness: 12 mm is used to get the both foot activities on the glass area. Plantar pressure distributions for both feet are studied and recorded simultaneously. Plantar pressure values are influenced by a lot of factors such as the anatomical structure of foot, joint movement separation and sex [5], [15]. However, the loading in the right and left foot were not

Limitations

The number of subjects in our preliminary study was relatively small, but was comparable to other studies of gait and foot pressure [5], [9].

Conclusion and future work

Pressure distribution measurement techniques are useful in analyzing the mechanical behavior of the human foot during static and dynamic loading situations in adult subjects. Hence a complete analysis of variation of pressure distribution pattern under both feet while standing is done. Also comparison of men and women pressure distribution pattern under the foot can be analyzed. The advantages over other methods are high resolution capacity, low-cost, simplicity of use. This preliminary study

Conflict of interest statement

We have no conflicts of interest either financial or personal with other people or organizations that could inappropriately influence our work.

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Identifying elderly individuals with locomotive syndrome is important to prevent disability in this population. Although screening tools for locomotive syndrome are available, these require time commitment and are limited by an individual's ability to complete questionnaires independently. To improve on this limitation, we developed a screening tool that uses information on the distribution of pressure on the plantar surface of the foot with an artificial intelligence (AI)-based decision system to identify patients with locomotor syndrome. Herein, we describe our AI-based system and evaluate its performance.
This was a cross-sectional study of 409 participants (mean age, 73.5 years). A foot scan pressure system was used to record the planter pressure distribution during gait. In the image processing step, we developed a convolutional neural network (CNN) to return the logit of the probability of locomotive syndrome based on foot pressure images. In the logistic regression step of the AI model, we estimated the predictor coefficients, including age, sex, height, weight, and the output of the CNN, based on foot pressure images.
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The AI system, which includes force distribution over the plantar surface of the foot during gait, is an effective tool to screen for locomotive syndrome.
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The aim of this research was to investigate the best methodology for disc hernia diagnosis using foot force measurements from the designed platform. Based on the subjective neurological examination that examines muscle weakness on the nerve endings of the skin area on feet and concludes about origins of nerve roots between spine discs, a platform for objective recordings of the aforementioned muscle weakness has been designed. The dataset included 33 patients with pre-diagnosed L4/L5 and L5/S1 disc hernia on the left or the right side, confirmed with the MRI scanning and neurological exam. We have implemented 5 different classifiers that were found to be the most suitable for smaller dataset and investigated the accuracy of classification depending on the normalization method, linearity/non-linearity of the algorithm, and dataset splitting variation (32–1, 31–2, 30–3, 29-4 patients for training and testing, respectively). The classifier is able to distinguish between four different diagnoses L4/L5 on the left side, L4/L5 on the right side, L5/S1 on the left side and L5/S1 on the right side, as well as to recognize healthy subjects (without disc herniation). The results show that non-linear algorithms achieved better accuracy in comparison to tested linear classifiers, suggesting the expected non-linear connection between the foot force values and the level of disc herniation. Two algorithms with highest accuracy turned out to be Decision Tree and Naïve Bayes, depending on the normalization method. The system is also able to record and recognize improvements in muscle weakness after surgical operation and physical therapy.
Plantar pressure distribution during standing in women with end-stage hip osteoarthritis
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Citation Excerpt :
Assessment of plantar pressure indicates how the plantar region contacts the ground as the first point in a leg-linked kinetic chain and how the plantar region receives force from the ground. Periyasamy et al. described that pressure distribution measurement techniques are useful for understanding the biomechanics of the human foot and for addressing various concerns regarding the association between plantar pressure distribution and lower-extremity posture [6,7]. However, very few studies have examined plantar pressure distribution in patients with hip OA, and to our knowledge, no study has compared plantar pressure distribution between patients with hip OA and healthy adults.
Patients with hip osteoarthritis (OA) experience abnormal movement patterns and reduced loading of the affected leg. The plantar contacts the ground and receives force from the ground. Plantar pressure distribution may differ in patients with hip OA compared to healthy adults and may influence physical functioning in these patients.
We investigated whether plantar pressure distribution during standing differed between patients with hip OA and healthy adults. We also analyzed the relationship between plantar pressure distribution and walking ability and the factors affecting plantar pressure distribution.
Maximum plantar pressure distribution during standing for 20 seconds was investigated in patients with hip OA (n = 62; OA group) and in healthy adults (n = 53; Control group). Statistical comparisons between these groups were made using Fisher’s exact test and residual analysis. In the OA group, leg length discrepancy, range of hip extension, leg loading, knee extensor strength, and 10 m walking time were assessed; multiple linear regression and logistic regression analyses were used to examine the relationships between these factors and maximum plantar pressure distribution.
Maximum plantar pressure distribution was different between the OA and control groups. In the OA group, maximum plantar pressure distribution was one of the significant predictors of 10 m walking time. Additionally, leg length discrepancy was a significant predictor of maximum plantar pressure distribution in this group.
During standing, the proportion of patients for whom the maximum plantar pressure region was the heel tended to be lower in the group with hip OA compared to the healthy adults. Plantar pressure distribution may have an importance for evaluating walking ability in patients with hip OA. Correcting leg length discrepancy and loading under the heel could adjust plantar pressure distribution in patients with hip OA.
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The aim of the study was to investigate gender and age effect on dynamic plantar pressure distribution in early adolescence.
A total of 524 adolescents (211 women and 313 men; mean age: 12.58 ± 1.11 years (range: 11–14 years)) participated in pedobarographic measurements during gait at self-selected speed. Data of peak pressure (PP), maximum force (MaxF-Newton), body weight corrected maximum force (BW_MaxF), contact area (CA-cm²) were analyzed for total foot and four plantar regions (hindfoot, midfoot, forefoot and toes).
Higher toes PP was found in the ages of 12–14 years in females compared to males (253.79 ± 104.93 vs 216.00 ± 81.12 for the age of 12, p = 0.011, 264.40 ± 65.02 vs 227.21 ± 83.4 for the age of 13, p = 0.044, 299.75 ± 140.60 vs 238.75 ± 103.32 for the age of 14, p = 0.005). Females' higher MaxF especially for toes (136.24 ± 48.54 vs 115.33 ± 46.03, p = 0.008) and smaller CA especially for forefoot (50.12 ± 5.79 vs 54.4893 ± 6.80, p = 0.001) were considerable in the late of early adolescence. Forefoot (305.66 ± 82.14 females p = 0.001, 281.35 ± 79.59 males p < 0.001) and total foot PP (374.08 ± 113.93 females, p = 0.035, 338.61 ± 85.85 males p = 0.009) at the age of 14 was significantly higher than in younger ages in both gender groups.
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Citation Excerpt :
These differences were shown to cause a variation in foot pressure distribution in men and women during standing.7 Men have higher foot contact areas and pressure distribution than women.7 Also, men showed a larger contact area in all regions when compared to women, however there was no differences in peak pressure between genders in any of the regions.21
In clinical practice and within the scope of research studies, foot pressure distribution as measured by plantar pressure analysis is widely used to diagnose foot pathologies. Although plantar pressure data have been recognized as an important element in the assessment of patients with various foot problems, an in-depth knowledge of the plantar pressure distribution of the foot is lacking in literatures.
This article presents a review of literature on plantar pressure distribution and factors that may affect plantar pressure among patients with foot pathologies and healthy population.
A literature search was conducted in Science Direct and PubMed databases for articles published from January 2000 to August 2012. Medical Subject Headings (MeSH) and other keywords for search were plantar pressure, age, body weight, gender, reliability, instrument and healthy subjects.
This paper reviews on the factors influencing plantar pressure distribution. Factors such as the gender, age, body weight, foot type and footwear proved to have a significant effect on plantar pressure distribution of the foot. The paper also reports on the plantar pressure distribution of the foot and the reliability of the measurement. Studies were excluded from this narrative review if they did not meet the above criteria.
This review has added sufficient knowledge on plantar pressure distribution of the foot in clinical practice. Data obtained from a plantar pressure distribution can be used by the physical therapist in the evaluation and management of patients with a wide variety of foot and lower extremity disorders.
Foot pressure distribution variation in pre-obese and non-obese adult
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Preliminary investigation of foot pressure distribution variation in men and women adults while standing

Abstract

Background

Methods

Results

Conclusion

Introduction

Section snippets

Methods

Image analysis

Result

Discussion

Limitations

Conclusion and future work

Conflict of interest statement

Gait Posture

Curr Orthop

Foot

J Foot Ankle Surg

J Biomech

Foot Ankle Surg

Gait Posture

Pressure distribution beneath the human foot

J Am Podiatr Med Assoc