Between-day reliability of repeated plantar pressure distribution measurements in a normal population.

The objective of this study was to determine the reliability of repeated plantar pressure distribution measurements during normal gait across multiple testing sessions. Testing sessions were conducted on 5 separate days at approximately the same time of day. Nine subjects (five males, four females, age 26+/-8.4 years) who were free of any musculoskeletal injury were recruited. A capacitive pressure distribution platform (EMED AT, Novel GmbH, Munich, Germany), sampling at 50Hz was used to collect plantar pressure patterns during barefoot walking at a self-selected speed. Four parameters were investigated: peak pressure, maximum force, impulse, and contact time, and these were investigated in 10 areas of the foot after using the PRC mask method of subdividing the foot into ten anatomical areas of interest. Individual means of all the five repeated trials for each foot were calculated, and these values were used to calculate intraclass correlation coefficients (ICC) and coefficients of variation (CoV) for all parameters. The results of this investigation show a generally good level of reliability, the quality of which is dependent on the region of the foot and the parameter investigated. Areas with typically high loading characteristics, such as the central forefoot showed a higher level of reliability in the ICC's (>0.9) than less loaded areas such as the medial midfoot (<0.8). The conclusion of this study is that plantar pressure distribution measurements can be used in comparative evaluations since the measures of repeatability are satisfactory for the parameters and foot regions usually used in the investigation of clinical populations such as neuropathic diabetics.

[1]  S. Rajá,et al.  The modified McBride procedure: clinical, radiological, and pedobarographic evaluations. , 2006, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.

[2]  H. Jacob,et al.  Pressure and force distribution characteristics under the normal foot during the push-off phase in gait , 1999 .

[3]  H Ramon,et al.  Buttock and back pressure distribution tests on seats of mobile agricultural machinery. , 2001, Applied ergonomics.

[4]  P. Cavanagh,et al.  Ulceration, unsteadiness, and uncertainty: the biomechanical consequences of diabetes mellitus. , 1993, Journal of biomechanics.

[5]  Bruce D Beynnon,et al.  Efficacy of Plantar Loading Parameters During Gait in Terms of Reliability, Variability, Effect of Gender and Relationship Between Contact Area and Plantar Pressure , 2005, Foot & ankle international.

[6]  M. Cornwall,et al.  Effect of foot orthotics on the initiation of plantar surface loading , 1997 .

[7]  P. Cavanagh,et al.  Clinical plantar pressure measurement in diabetes: rationale and methodology , 1994 .

[8]  D. Rosenbaum,et al.  Plantar pressure distribution measurements. Technical background and clinical applications , 1997 .

[9]  P. Cavanagh,et al.  New developments in the biomechanics of the diabetic foot , 2000, Diabetes/metabolism research and reviews.

[10]  L. Klenerman,et al.  Plantar foot pressure distribution in patients with Hallux valgus treated by distal soft tissue procedure and proximal metatarsal osteotomy , 1998 .

[11]  A. de Lange,et al.  Elevated plantar pressures in neuropathic diabetic patients with claw/hammer toe deformity. , 2005, Journal of biomechanics.

[12]  A. Bryant,et al.  Plantar pressure distribution in normal, hallux valgus and hallux limitus feet , 1999 .

[13]  T J Wieman,et al.  Effect of metatarsal head resection for diabetic foot ulcers on the dynamic plantar pressure distribution. , 1994, American journal of surgery.

[14]  R J Abboud,et al.  The Pedar in-shoe system: repeatability and normal pressure values. , 2007, Gait & posture.

[15]  P. Finch Technology in biomedicine: the EMED pedar pressure measurement system , 1999 .

[16]  L Klenerman,et al.  Reliability of pressure measurements: the EM ED F system. , 1991, Clinical biomechanics.

[17]  G Atkinson,et al.  Statistical Methods For Assessing Measurement Error (Reliability) in Variables Relevant to Sports Medicine , 1998, Sports medicine.