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Diabetes mellitus is a medical disorder characterized by varying or persistent hyperglycemia (elevated blood sugar levels), especially after eating. People with diabetes have problems converting food to energy. The most common form of diabetes is type 2 diabetes. Foot disease is a common complication of diabetes that can have tragic consequences. Abnormal plantar pressures are considered to play a major role in the pathologies of neuropathic ulcers in the diabetic foot. The purpose of this study was to classify the plantar pressure distribution in normal and type 2 diabetes subjects with and without neuropathy. Foot scans were obtained using the F-Scan (Tekscan, USA) in-shoe pressure measurement system. Various pedobarographic parameters such as the total plantar force, total contact area, peak pressures, and percentage medial impulse (PMI) were evaluated. These parameters were subjected to analysis of variance (ANOVA) test with a >95% confidence interval, giving excellent p-values in all of the categories. When these extracted parameters were presented to the artificial neural network (ANN) for classification, the neural network classifier was seen to be correct in more than 90% of the test cases.

High heeled shoes may alter the regular loading pattern of the plantar pressure, especially increased in the forefoot area. Walking with narrow base of high heeled shoes may induce the brisk acceleration of the supported leg due to instability that increases the force on the plantar area. Particularly, this phenomenon may be amplified while slow running, but never been investigated. Materials and Methods: Plantar pressures were measured for different specific area of foot using the Pedar-X system. The effects on plantar pressure with different sized bases (1.2× 1.2 cm² and 2.2 × 3.5 cm²) of high-heeled shoe (7.8 cm in height) were examined while walking in thirteen healthy female subjects and during slow running in nine healthy female subjects. Results: The plantar pressures of the hallux and toe while wearing narrow base high heel were significantly (p < 0.05) greater than those when walking with wearing wide base one. For both narrow and wide base heels, significantly increased (p < 0.05) plantar pressure were found in the medial forefoot while slow running at 2.0 m/s as compared with walking at 1.0 m/s and 1.5 m/s. While slow running with wearing narrow base high heel indicated significantly (p < 0.05) increased plantar pressures in the medial, central and lateral forefoot and toes regions compared with those with wearing wide base one. Conclusion: The findings suggest that if individuals have to wear high heeled shoes, it would be better to select one with a wide based heel to avoid running in at any circumstance.

Young females with mild hallux valgus (HV) have been identified as having an increased risk of first ray deformation. Little is known, however, about the biomechanical changes that might contribute to this increased risk. The purpose of this study was to compare kinetics changes during walking for mild HV subjects with high-heel-height shoes. Twelve female subjects (six with mild HV and six controls) participated in this study with heel height varying from 0 cm (barefoot) to 4.5 cm. Compared to healthy controls, patients had significantly higher peak pressure on the big toe area during barefoot walking. When the heel height increased, loading was transferred to medial side of the forefoot, and the big toe area suffered more impact compared to barefoot in mild HV. This study also demonstrated that the center of pressure (COP) inclines to medial side alteration after high-heeled shoes wearing. These findings indicate that mild HV people should be discouraged from wearing high-heeled shoes.

Plantar pressure assessment is commonly used as a tool to assess the efficacy of insoles in reducing the risk of mechanical trauma to the plantar soft tissue during walking gait. The slow rebound (SR) Poron insole is intended to provide a custom fit to the foot and is believed to be superior in increasing the contact area and consequently reducing the contact pressure compared to a normal Poron (NP) insole. The aim of this study was to compare the effectiveness of SR or NP versus an ethylene vinyl acetate (EV) insole in increasing the contact area (CA), and in reducing the contact pressure (CP) at different regions of the foot during walking. Plantar pressure data was collected from nine healthy individuals during walking using commercially available in-shoe plantar pressure sensors. Although, the NP insole significantly increased the CA and decreased the CP on the entire foot compared to the EV, there was no significant change in CP or CA at any region of the foot in any of the tested insoles. CP showed a positive significant correlation with CA at heel, hallux and heel center in all three insoles. The expected significant negative correlation between regional CA and CP was not observed.

Foot loading patterns can be changed by using different unstable sole structures, detailed quantification of which is of great significance for research and technological development in falling prevention and lower limb disorders rehabilitation. In this study, unstable soles constructions are adjusted through unstable elements in heel and medial, neutral and lateral forefoot and the foot loading patterns are comparatively studied. A total of 22 healthy male subjects participated in this test. Subjects are asked to walk over a 12 m walkway with control shoes and experimental shoes in self-adapted speed. Significant peak pressure, contact area and pressure-time integral differences in middle foot are found between control shoes and experimental shoes. In addition, peak pressure and pressure-time integral are found to increase significantly with unstable elements adding to center forefoot. The results showed that adjusting the unstable elements in coronal plane of forefoot could effectively alter the distribution of plantar pressure, this could potentially offer a mechanism for preventing falling of elderly and rehabilitation of lower extremity malfunctions. This study also demonstrates a novel concept that unstable element could be effectively adjusted in terms of position to meet different functional requirement.

Diabetic ulcers can lead to infection and amputation. Using insole can help to reduce and prevent foot ulceration and amputation in a diabetic patient. The aim of this study was to analyze the effect of wearing an insole with different density on standing and walking plantar pressure distribution. Methods: A group of 10 diabetic patients participated in this one-grouped before-after trial. Plantar pressure distribution was measured during walking and standing. Repeated Measure was used to test differences. Results: Repeated measure test showed that use of insole decreased foot pressure while walking significantly ($P=0.023$). Pairwise comparison showed that wearing shoe insole with shore 30 decreased pressure compared to wearing shoe insole with shore 50 ($P=0.004$) and walking without insole respectively ($P=0.06$). Conclusion: The insole has more effect on plantar pressure during walking than standing, it also concluded that insole with shore 30 decreased pressure during walking more than that of the insole with shore 50. It could be said that patients who suffer from pain and discomfort on hind and forefoot may benefit insole with shore 30 to relieve from plantar pressure on the hindfoot and forefoot regions during standing and walking.

Gait is one of the most common and important factor of human movements in daily life. Pelvis is closely connected with the gait due to it allows maintain stable posture by supporting the spine and lower extremities against the gravity. Therefore, pelvic asymmetry, which is caused by biomechanical stress and muscle imbalance, has been associated with postural imbalance and abnormal walking pattern. The purpose of this study was to manufacture customized foot orthotics for improving gait balance and evaluate the effectiveness of customized foot orthotics during walking by measuring lower extremity muscle activity and plantar pressure distribution. All subjects with pelvic asymmetry were asked to walk on a treadmill under three conditions: walking without foot orthotics, walking with customized foot orthotics and walking with non-customized foot orthotics. Root mean square (RMS) value of the electromyography signals, force and peak pressure of the plantar pressure distribution was analyzed based on the gait cycle. The results showed that excessive tension of the muscles and high pressure of the foot that was induced by pelvic asymmetry were more reduced when walking with custom-made foot orthotics than walking without foot orthotics and walking with non-customized foot orthotics. This paper suggest that custom-made orthotics for patients with pelvic asymmetry could be helpful to relieve the excessive loading of the foot and maintain balanced gait pattern.

Due to the current focus of research on ankle rehabilitation robots on structural design, there is still limited research on ankle human–machine interaction technology. In order to enable rehabilitation robots to conduct personalized rehabilitation training based on patients’ ankle movement intentions, we propose a new ankle motion recognition method based on plantar pressure. First, we designed a plantar pressure collection system based on array sensors. Then, we collected nine types of ankle joint motion pressure data from five volunteers and conducted algorithm selection, data processing, and algorithm optimization. Finally, we proposed a small sample optimization algorithm based on support vector machine, with an average recognition rate of 93.16%. The recognition method proposed in this paper can be combined with ankle rehabilitation robots to achieve active rehabilitation functions, laying the foundation for the clinical application of active rehabilitation technology.

Background: Handball affects the spinal anterior–posterior curvatures and disturbs the foot plantar pressure which provides insights into alterations in an individual’s posture. However, little is known about how the mal-alignment affects the distribution of plantar pressure.

Objective: To investigate the relationship between the thoracic kyphosis angle, and plantar pressure distribution among handball players.

Methods: Sixty male handball players were distributed into two groups based on their thoracic kyphosis angles. Group A: 28 handball players with an angle greater than 44^∘ (kyphotic group), and group B: 32 handball players with an angle equal to or less than 44^∘ (normal group). The Formetric III 4D spine and DIERS Pedoscan devices were used to measure the trunk anthropometry and plantar pressure distribution. The Pearson correlation test was used to explore the relationship between the kyphosis angle and plantar pressure distribution.

Results: Group A was significantly taller, had longer trunk length, greater lumbar lordosis angles, and forefoot plantar pressure (FPP), and less rearfoot plantar pressure (RPP) than group B ($p<0.05$). They showed a highly significant positive correlation between the thoracic kyphosis angle and FPP, and a highly significant negative correlation with the RPP ($r=0.672$, $-0.650$, respectively). There was no correlation between the lumbar lordosis angle and FPP or RPP ($r=0.025$, $-0.045$, respectively).

Conclusion: Handball players with greater thoracic kyphosis angle have greater lumbar lordosis angle. Increasing the thoracic kyphosis angle is strongly associated with increased FPP and decreased RPP. While there is no relationship between the lumbar lordosis angle and FPP or RPP.