Background: Despite its high prevalence, interventions in plantar fasciitis remain inconclusive. To improve the daily life of plantar fasciitis patients, it is necessary to identify appropriate interventions to improve pain and foot pressure and balance. Improving the interventions for plantar fasciitis is one of the main goals for rehabilitation. Objectives: To investigate the changes in pain and static-dynamic foot pressure and balance through the evaluation of 42 plantar fasciitis patient before and after the foot stretching and joint mobilization interventions. Design: Randomized controlled trial. Methods: The 42 subjects of the study were divided into a stretching group and a joint mobilization group with 21 subjects being assigned to each group. The results before and after the experiment were analyzed by applying stretching and joint movement interventions for a total of 6 weeks. Results: Before and after the intervention, there were significant improvements in the pain index and static-dynamic foot pressure and static balance in both stretching and joint mobilization groups. However, the between-group comparison indicated no significant differences. Conclusion: The stretching and the joint mobilization can improve the pain and static-dynamic foot pressure and static balance in plantar fasciitis patients.

The purpose of this study was to identify the effect of proprioceptive neuromuscular facilitation (PNF) stretching exercise and joint mobilization on ankle joint range of motion (ROM), plantar pressure, and balance in subjects with stroke. Thirty patients (n=30) were organized into three groups, each of which received different treatments: PNF stretching (n=10), joint mobilization (n=10), and joint mobilization and PNF stretching combined (n=10). Each group received three exercise sessions per week for four weeks. The ankle ROM was measured using a goniometer, and plantar pressure and balance ability were measured using BioResque static posturography. In comparison within each group, the joint mobilization group and the joint mobilization with PNF stretching group showed significant improvements in ankle ROM, plantar pressure, and balance ability (p<.05). In comparison between the groups, a statistically significant difference was found in SECS change between the PNF stretching group, joint mobilization group and the joint mobilization with PNF stretching group. This study found demonstrates that the joint mobilization and joint mobilization with the PNF stretching methods were effective in improving ankle ROM, plantar pressure, and balance ability in stroke patients.

본 연구의 목적은 평발을 가진 여성 노인의 계단 하강 보행 시 일반인솔 및 아치 지지형 인솔을 적용에 따른 족저압력 및 압력중심점 변인들의 차이를 조사하는데 목적이 있다. 족저압력 분석장비(Pedar-X, Novel, Germany)를 사용하여 14명의 평발 노인을 대상으로 3종류(일반인솔, A형 인솔, B형 인솔)의 인솔착용 후 최대족저압력, 평균족저압력, 접촉면적, 압력중심점의 이동거리, 변위 및 최대범위의 평균값을 산출하였으며, 일원변량분석(one-way ANOVA)를 이용하여 인솔 종류간 평균을 비교하였다. 족저압력 변인 중 최대족저압력은 중족부의 M3, 평균족저압력은 M2, M3, M4 영역에서, 접촉면적은 M2, M3, 그리고 M6 영역에서 통계적으로 유의한 차이를 보였으며, 압력중심점 변인 중 전후축과 좌우축에서 압력중심점의 이동거리에서 통계적으로 유의한 차이를 보였다. 족저압력 평가결과 아치 지지 기능을 가진 인솔을 삽입한 A와 B형 인솔에서 족궁지지 영역인 M3의 최대압력은 B형 인솔과 A형 인솔이 일반인솔과 비교했을 때 높게 나타났다. 좌우축, 전후축 압력중심점의 이동거리는 A형과 B형 인솔 모두 일반 인솔에 비해 짧게 나타났다.

The purpose of the study was to investigate the immediate effects of negative pressure soft tissue therapy on muscle tone, muscle stiffness and balance in patients with stroke. In total, 20 patients with stroke and assigned to the negative pressure soft tissue therapy group (NPST, n=10) or, placebo-negative pressure soft tissue therapy group(Placebo-NPST, n=10). Both groups underwent NPST or placebo-NPST once a day during the experimental period. MyotonPRO was used to assess the parameters for muscle tone and stiffness. Biorescue was used to assess the parameters for balance. Each group showed improvements in muscle tone, muscle stiffness, and balance ability (p<.05). Especially, Muscle tone, muscle stiffness, and anterior length in the limit of stability were the significant improvement on NPST group (p<.05). The results of the study suggest that the NPST is effective in improving muscle tone, muscle stiffness, and balance ability in patients with stroke.

본 연구의 목적은 충격흡수 및 통기기능 인솔을 적용한 개발 전투화의 족저압력 및 온도변화를 연구하는데 있다. 남성 피험자 11명(age: 21.8±2.2 yrs, height: 174.3±3.6 cm, weight: 71.6±8.6 kg, foot length: 261.0±1.0 mm)을 대상으로 총 3종류 전투화의 족저압력 및 온도 변화를 비교하였다: 전투화 A(보급형 일반 전투화), 전투화 B(통기구가 적용된 개발 전투화), 전투화 C(전투화 B에 통기기능 및 충 격흡수용 인솔 적용). 족저압력 측정을 위해 Pedar-X를 사용하였고, 전투화의 내부온도는 휴대용 써미스터의 온도센서를 사용하였다. 전투화의 종류별 족저압력 및 온도 변화결과를 비교하기 위해 일원변량분석 (one-way ANOVA)을 실시한 결과, 첫째, 족저압력 변인에서, 기능성 인솔을 적용한 전투화 C가 전투화 A보다 오른발/왼발 후족부의 최대족저압력에서 통계적으로 유의하게 낮았으며, 전투화 C가 전투화 B보다 왼발 후족부의 평균족저압력에서 통계적으로 유의하게 낮은 압력을 나타내었다. 둘째, 내부온도에서 보행 시작 후 40분경과 시점부터 개발 전투화인 B, C가 일반 전투화인 A보다 낮은 내부 온도를 보였다.

The purpose of this study was to identify the effect of chiropractic treatment on the alignment of the lower extremities and plantar pressure in subjects with pelvic misalignment. The study included 20 subjects with pelvic misalignment. They were divided into two groups: the chiropractic treatment group (n=10) and stretching group (n=10). They performed the intervention for 10 minutes, twice a week, for weeks, and pelvic displacement, functional leg length, and plantar pressure were measured In chiropractic group, both pelvic displacement and plantar pressure distribution were significantly decreased and leg length difference was significantly increased (p<.05). However, in the stretching group, only pelvic displacement was significantly reduced (p<.05), and leg length difference and plantar pressure distribution decreased slightly. There was no significant difference in all variables between the groups. This study suggests that chiropractic and stretching are effective in changing pelvic displacement, leg length difference, and plantar pressure distribution.

This study aimed to identify the effects of modified low-dye taping and foot intrinsic muscle strengthening exercise on foot pressure in people with flat feet. The subjects were 12 participants with flat feet in their 20s. They were randomly divided into two groups: taping and strengthening exercise. They performed the interventions twice a week for six weeks. The taping group was applied the modified low-dye taping. The exercise group was performed foot intrinsic muscle strengthening exercise for 30 minutes. The data were measured by Foot Pressure Measurement. There was no significant difference in plantar pressure between taping group and exercise group. There was also no significant difference in all variables before and after intervention in all groups. The present study suggests that taping and exercise can change the foot pressure in patients with flat-footed.

Background:Individuals with spinal cord injury (SCI) rely on their upper limbs for body-lifting activity (BLA). While studies have examined the electromyography (EMG) and kinematics of the shoulder joints during BLA, no studies have considered foot position during BLA.Objects:This study compared the effects of different foot positions during BLA on the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion in individuals with SCI.Methods:The study enrolled 13 mens with motor-complete paraplegic SCI, ASIA (American Spinal Injury Association) A or B. All subjects performed BLA with the feet positioned on the wheelchair footrest and on the floor independently. Surface EMG was used to collect data from the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii. The peak plantar pressure was measured using pedar-X and the knee flexion angle with Image J. Borg’s rating perceived exertion scale was used to measure the physical activity intensity level. The paired t-test was used to compare the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion between the two feet positions during BLA.Results:The activity of the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii and rating perceived exertion decreased significantly and the peak plantar pressure and knee flexion angle increased significantly when performing BLA with the feet positioned on the wheelchair footrest compared with on the floor (p<.05).Conclusion:These findings suggest that individuals with SCI may perform BLA with the feet positioned on the wheelchair footrest for weight-relief lifting to decrease the shoulder muscle activities and the rating perceived exertion and to increase the peak plantar pressure and the knee flexion angle.

Background: In previous studies regarding flexible pes planus, Foot orthosis, special shoes have been used as interventions for correcting malalignment and intrinsic muscles strengthening exercise have been regarded as interventions for foot function and supporting medial longitudinal arch during walking. However, some recent studies reported that strengthening extrinsic muscles as well as intrinsic muscles is more effective and active intervention for flexible pes planus. In particular, the tibialis posterior muscle of foot extrinsic muscles plays essential roles in maintaining the medial longitudinal arch during dynamic weight bearing and balance. In addition this muscle acts longer than other supination muscles during the stance phase in the gait cycle. Objects: This study aimed to investigate the effect of foot intrinsic muscle and tibialis posterior muscle strengthening exercise for plantar pressure and dynamic balance in adults with flexible pes planus. Methods: 16 young flexible pes planus adults (7 males, 9 females) were recruited and were randomized into two groups. The experimental group performed foot intrinsic muscle and tibialis posterior muscle strengthening training, the control group performed only foot intrinsic muscle strengthening training. All groups received strengthening training for 30 minutes five times a week for six weeks. Results: The experimental group had significantly lower plantar pressure of medial heel area than the control group in stand (p<.05). The experimental group had significantly higher dynamic balance ability than control group (p<.05). Conclusion: The results of this study provide evidence to suggest that foot intrinsic muscle and tibialis posterior muscle of extrinsic muscle strengthening exercises may improve plantar pressure distribution and dynamic balance ability in adults with flexible pes planus.

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±1.7 years) with AFF were recruited. A distance greater than 10 ㎜ 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.

The purpose of this study was to assess the peak plantar pressure distribution under foot areas according to the height of heel lifts in obese adults and non-obese adults during walking. Thirty-one participants volunteered for this experiment. The average body mass index (BMI) value of the fourteen subjects in the obese group was 26.5±1.4 ㎏/㎡ (from 25.1 to 29.3 ㎏/㎡), and of seventeen subjects in the non-obese group was 20.0±1.1 ㎏/㎡ (from 18.7 to 22.7 ㎏/㎡). The subject ambulated while walking in the sneakers, walking with 2 cm heel lifts, and walking with 4 cm heel lifts in the shoes. We measured the peak plantar pressure under the hallux, 1st, 2nd, 3~4th, and 5th metatarsal head (MTH), mi foot, and heel using F-scan system. The obese group had significantly higher peak plantar pressure under all foot areas than the non-obese group regardless of the height of heel lifts (p<.05). The peak plantar pressure under the 5th MTH and heel was significantly decreased, also the peak plantar pressure under hallux, 1st, and 2nd MTH was significantly increased according to the height of heel lifts in the obese group and non-obese group (p<.05), We proposed that individuals with heel lifts in shoes should be careful, as there is high plantar pressure under the forefoot.

The purpose of this study was to investigate how COP displacement of a hemiplegic foot in stance phase during gait is related to clinical balance measures and the recovery stage in hemiplegic stroke patients. Twenty-eight functionally ambulant hemiplegic patients who had suffered from strokes and thirty age-matched healthy subjects participated in this study. COP parameters were calculated. Clinical balance was measured using the Functional Reach Test (FRT) and Timed Up and Go Test (TUGT). The recovery stage, proprioception, and clonus of the ankles or lower extremities were also measured for physical impairment status. The COPx max-displacement in the medial-lateral side of the stroke patients was significantly longer than that of the normal group (p=.038). The COPy max-displacement in the anterior-posterior side of the stroke patients was significantly shorter than that of normal group (p<.001). Significant differences in the COPx and COPy displacement asymmetry index were found between the two groups (p<.01). The FRT was correlated with the COPx displacement (r=.552) and COPy displacement (r=.765). The TUGT was correlated with the COPy displacement (r=-.588) only. The recovery stage of the lower extremities was correlated with COPy displacement (r=.438). The results of the study indicate that the characteristic of COP displacement in hemiplegic feet in stance phase during gait is related to balance ability and recovery in stroke patients. COP parameters acquired by the mapping of foot pressure in stance phase during gait will provide additional useful clinical information. This information can be used by clinicians to assess objectively the pathologic gait with other diseases and to evaluate the therapeutic effects on gait in stroke patients.

Many factors affect foot and ankle biomechanics during walking, including gait speed and anthropometric characteristics. However, speed has not been taken into account in foot kinematics and kinetics during walking. This study examined the effect of walking speed on foot joint motion and peak plantar pressure during the walking phase. Eighty healthy subjects (40 men, 40 women) were recruited. Maximal dorsiflexion and excursion were measured at the first metatarsophalangeal joints during walking phase at three different cadences (80, 100, and 120 step/min) using a three dimensional motion analysis system (CMS70P). At the same time, peak plantar pressure was investigated using pressure distribution platforms (MatScan system) under the hallux heads of the first, second, and third metatarsal bones and heel. Maximal dorsiflexion and excursion and excursion at the ankle joint decreased significantly with increasing walking speed. Peak plantar pressure increased significantly under the heads of the first of the first, second, and third metatarsal bones, and heel with increasing walking speed: three was no change under the hallux. There were no significant changes in maximal dorsiflexion or excursion at the first metatarsophalangeal joint. The results show that walking speed should be considered when comparing gait parameters. The results also suggest that slow walking speeds may decrease forefoot peak plantar pressure in patients with peripheral neuropathy who have a high risk of skin breakdown under the forefoot.

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.