The Pedar® in-shoe system: Repeatability and normal pressure values

Putti, Amit; Arnold, Graham; Cochrane, Lindy; Abboud, Rami

doi:10.1016/j.gaitpost.2006.05.010

Cited by 225 publications

(213 citation statements)

References 8 publications

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“…Participants attended on a single occasion and all measurements were obtained by the principal examiner. Intrarater reliability for these outcome measures was acceptable and has been reported previously (26,27).…”

Section: Methodssupporting

confidence: 74%

“…The first and last steps of each trial were removed, leaving an average of 23 steps across the 5 trials for analysis. Five forefoot regions were identified using a relative mask based on prior work by Putti et al (27): hallux, lesser toes, first metatarsal, second metatarsal, and third to fifth metatarsal heads. Peak pressures (kPa) and pressure-time integrals (kPa ϫ seconds) were calculated.…”

Section: Significance and Innovationsmentioning

confidence: 99%

“…The Pedar-X insole system comprises 99 capacitive sensors; however, masking to identify forefoot regions is somewhat constrained by the number and positioning of these sensors. A standardized relative mask was used for all participants, consistent with previous studies using Pedar insoles (27). Forefoot morphology is clearly altered in individuals with HV and lateral deviation of the hallux may have resulted in activation of pressure sensors more laterally, therefore explaining reduced pressure under the hallux in individuals with more severe HV.…”

mentioning

confidence: 99%

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Functional Impairments Characterizing Mild, Moderate, and Severe Hallux Valgus

Hurn

Vicenzino

Smith

2014

Arthritis Care & Research

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Objective. Hallux valgus (HV) has been linked to functional disability and increased risk of falls, but mechanisms underpinning functional disability are unclear. This study investigated functional performance, muscle strength, and plantar pressures in adults with mild, moderate, and severe HV compared to controls, while considering the influence of foot pain. Methods. Sixty adults with HV (classified as mild, moderate, and severe on dorsalplantar radiographs) and 30 controls participated. Measures included hallux plantar flexion and abduction strength, walking performance, postural sway, and forefoot plantar pressures. Multivariate analysis of covariance and pairwise comparisons (P < 0.05 after Bonferroni adjustment) were used to investigate differences between groups, adjusting for age, sex, body mass index, and foot pain. Results. Hallux plantar flexion and abduction strength were significantly reduced in those with moderate (mean differences: plantar flexion ؊45.8 N, abduction ؊12.3 N; P < 0.001) and severe HV (plantar flexion ؊50.1 N; P < 0.001, abduction ؊11.2 N; P ‫؍‬ 0.01) compared to controls. A significant reduction in hallux peak pressure and pressure-time integral was evident in moderate (peak pressure ؊90.8 kPa; P < 0.001) and severe HV (peak pressure ؊106.2 kPa; P < 0.001) compared to controls. Those with severe HV also demonstrated increased mediolateral postural sway in single leg stance compared to controls (3.5 cm; P ‫؍‬ 0.01). Conclusion. Moderate to severe HV is associated with reduced hallux plantar pressures and strength measures, while relatively normal function compared to controls was found in those with mild deformity. Greater understanding of specific functional deficits associated with different stages of HV will help inform clinical management and future research.

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Section: Methodssupporting

confidence: 74%

Section: Significance and Innovationsmentioning

confidence: 99%

mentioning

confidence: 99%

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Functional Impairments Characterizing Mild, Moderate, and Severe Hallux Valgus

Hurn

Vicenzino

Smith

2014

Arthritis Care & Research

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“…The validity and repeatability of some in-shoe measurement devices have been investigated utilising both bench-top [1], [5] and in-situ methods [6] through protocols with varying methodologies. High repeatability with the Pedar in-shoe system has been demonstrated between days [6], [7] and the measurement of midfoot pressure and contact area variables also demonstrate high intra class correlations between trials [4].…”

Section: Introductionmentioning

confidence: 99%

“…High repeatability with the Pedar in-shoe system has been demonstrated between days [6], [7] and the measurement of midfoot pressure and contact area variables also demonstrate high intra class correlations between trials [4]. The loading characteristics of the Medilogic in-shoe system have not been considered in publications.…”

Section: Introductionmentioning

confidence: 99%

Validity and repeatability of three in-shoe pressure measurement systems

2016

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In-shoe pressure measurement devices are used in research and clinic to quantify plantar foot pressures. Various devices are available, differing in size, sensor number and type; therefore accuracy and repeatability. Three devices (Medilogic, Tekscan and Pedar) were examined in a 2 day x 3 trial design, quantifying insole response to regional and whole insole loading. The whole insole protocol applied an even pressure (50-600 kPa) to the insole surface for 0-30 seconds in the Novel TruBlue TM device. The regional protocol utilised cylinders with contact surfaces of 3.14 and 15.9cm 2 to apply pressures of 50 and 200 kPa. The validity (% difference and Root Mean Square Error: RMSE) and repeatability (Intra-Class Correlation Coefficient: ICC) of the applied pressures (whole insole) and contact area (regional) were outcome variables. Validity of the Pedar system was highest (RMSE 2.6 kPa; difference 3.9%), with the Medilogic (RMSE 27.0 kPa; difference 13.4%) and Tekscan (RMSE 27.0 kPa; difference 5.9%) systems displaying reduced validity. The average and peak pressures demonstrated high between-day repeatability for all three systems and each insole size (ICC≥0.859). The regional protocol contact area % difference ranged from -97 to +249%, but the ICC demonstrated medium to high between-day repeatability (ICC≥0.797). Due to the varying responses of the systems, the choice of an appropriate pressure measurement device must be based on the loading characteristics and the outcome variables sought. Medilogic and Tekscan were most effective between 200-300 kPa; Pedar performed well across all pressures. Contact area was less precise, but relatively repeatable for all systems.3

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Biomechanical Effects of Prefabricated Foot Orthoses and Rocker‐Sole Footwear in Individuals With First Metatarsophalangeal Joint Osteoarthritis

Menz

Auhl

Tan

et al. 2016

Arthritis Care & Research

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ObjectiveTo evaluate the effects of prefabricated foot orthoses and rocker‐sole footwear on spatiotemporal parameters, hip and knee kinematics, and plantar pressures in people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). Methods. A total of 102 people with first MTP joint OA were randomly allocated to receive prefabricated foot orthoses or rocker‐sole footwear. The immediate biomechanical effects of the interventions (compared to usual footwear) were examined using a wearable sensor motion analysis system and an in‐shoe plantar pressure measurement system.ResultsSpatiotemporal/kinematic and plantar pressure data were available from 88 and 87 participants, respectively. The orthoses had minimal effect on spatiotemporal or kinematic parameters, while the rocker‐sole footwear resulted in reduced cadence, percentage of the gait cycle spent in stance phase, and sagittal plane hip range of motion. The orthoses increased peak pressure under the midfoot and lesser toes. Both interventions significantly reduced peak pressure under the first MTP joint, and the rocker‐sole shoes also reduced peak pressure under the second through fifth MTP joints and heel. When the effects of the orthoses and rocker‐sole shoes were directly compared, there was no difference in peak pressure under the hallux, first MTP joint, or heel; however, the rocker‐sole shoes exhibited lower peak pressure under the lesser toes, second through fifth MTP joints, and midfoot.ConclusionPrefabricated foot orthoses and rocker‐sole footwear are effective at reducing peak pressure under the first MTP joint in people with first MTP joint OA, but achieve this through different mechanisms. Further research is required to determine whether these biomechanical changes result in improvements in symptoms.

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The Pedar® in-shoe system: Repeatability and normal pressure values

Cited by 225 publications

References 8 publications

Functional Impairments Characterizing Mild, Moderate, and Severe Hallux Valgus

Functional Impairments Characterizing Mild, Moderate, and Severe Hallux Valgus

Validity and repeatability of three in-shoe pressure measurement systems

Biomechanical Effects of Prefabricated Foot Orthoses and Rocker‐Sole Footwear in Individuals With First Metatarsophalangeal Joint Osteoarthritis

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