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Method: Twenty children with mild spastic diplegic cerebral palsy and fourteen normal children over 7 years old participated in this study. The foot was divided into 7 portions and then foot contact area, pressure of each foot portion and pathway of center of pressure (COP) were measured and analyzed by F-scan system (Tekscan Inc., USA)
Results: In children with cerebral palsy, first metatarsal area (MET1) showed the highest relative impulse followed by MET2/3, hindfoot and hallux. Relative impulse of hallux, MET1 and medial midfoot were significantly higher in cerebral palsied than in normal children, while that of hindfoot was significantly lower in cerebral palsied than in normal children. Anteroposterior ratio of COP and gait velocity were significantly lower in cerebral palsied than in normal children.
Conclusion: The characteristics of foot pressure distribution and the pathway of COP in children with mild spastic diplegic cerebral palsy were identified by quantitative analysis by F-scan system. Foot scan could be used for evaluating the foot pathology in children with cerebral palsy during gait. (J Korean Acad Rehab Med 2003; 27: 33-37)
Objective: To find out the characteristics of the foot pressure distribution and the path of center of pressure (COP) in the children with cerebral palsy, compared with normal control children.
Method: Twenty-four children with spastic cerebral palsy (CP) and 38 normal children were participated in this study. The parameters of foot contact, plantar pressure and COP were measured using F-scan system (Teksan Inc.) with pressure sensitive insoles inserted in the shoes.
Results: The total contact area, mid foot contact width and also the pressure of hallux and medial side of mid foot were significantly higher in the children with CP than in normal
controls. While the pressure of hind foot was significantly lower in the children with CP compared with normal controls. Anteroposterior distance and velocity of COP were significantly lowered in the cerebral palsied children. The paths of COP of both groups were directed inwardly without any significant differences between both groups.
Conclusion: We can identify the characteristics of the foot pressure distribution and the path of COP in the children with spastic CP using F-scan system. These quantitative data of foot scan may be useful for evaluating the foot pathology during the gait in the children with CP. (J Korean Acad Rehab Med 2002; 26: 127-132)
Objective: To find out the changes of the plantar pressure distribution of foot and the pathway of center of pressure (COP) in normal preschool children with age.
Method: Thirty-eight normal children aged 1 to 6 were participated in this study. We divided into three groups according to the age. Foot contact area, pressure of the foot and pathway of COP were measured using F-scan in-shoe measuring system (Tekscan Inc.) during the gait.
Results: The ratio of midfoot contact width to forefoot contact width was decreased with age (p＜0.05). And the relative pressure of the medial midfoot was decreased with age (p＜0.05). In the analysis of COP, the ratio of anteroposterior length of COP to total contact length was significantly increased (p＜0.05), and the ratio of mediolateral width of COP to forefoot contact width was tend to decrease.
Conclusion: We can identify the characteristics and changes of the foot pressure distribution and the pathway of COP in preschool children with normal foot using F-scan system. These quantitative data of foot scan are useful for evaluating the foot pathology in preschool children during the gait.
Objective: The aim of the present study was to understand biomechanical characteristics during the process of initiation of gait (IOG) from the standing position in hemiplegic patients.
Method: We recorded the ratio of the vertical forces of both limbs to body weight and the movement of net center of pressure (COP) on two force platforms during the process of initiation of gait (IOG) from standing in 10 normal control and 10 hemiplegic patients and processed these data using ELITE DMA acquisition program. All data were collected with uninvolved limb and involved limb and compared each other by independent samples t-test.
Results: 1) In 10 hemiplegic patients, nine patients began taking a step with an uninvolved limb in the first, followed by an involved limb. 2) The period of IOG of the swing limb was 0.80 sec when patients walked with an uninvolved side and those of the stance limb was 1.60 sec with involved side. When the control group walked, the period of IOG of the swing limb was 0.70 sec and those of stance limb was 1.50 sec. The period of IOG of the swing limb in uninvolved side and those of the stance limb in involved side showed significant longer than control group. 3) The latency of IOG of swing and stance limb was significantly more prolonged than control groups. 4) Anteroposterior (AP) and mediolateral (ML) distance of net COP from release to unloading with uninvolved limb showed significant longer than control groups. 5) The velocity of net COP displacement from start to release with involved limb was significantly slower than control groups.
Conclusion: This pattern of IOG could be used as one of the tools to evaluate postural control during gait training in the hemiplegic patients with gait disabilities, and it can be used as a basis for specific therapeutic intervention, and it allows evaluation of the effectiveness of treatment.
The purpose of this study was to detect where the center of pressure in foot would be located at the end point of loading response and the terminal stance by the dynamic plantar pressure measurement.
Seventeen adults who had the usual feet without a pathologic gait were evaulated simultaneously by the motion analysis using VICON 370, and the plantar pressure measurement using EMED-SF. Two devices were set in the 60 Hz frame. The foot was divided into 3 different zones; hindfoot, midfoot, and forefoot.
The end point of loading response was located at the 1.92⁑1.46 frame distal to the hindfoot- midfoot borderline. The end point of terminal response was located at the 2.27⁑1.96 frame distal to the maximal pressure points of metatarsal head.
Authors could differentiate each period of stance phase; the initial contact, loading response, mid-stance, terminal stance, and preswing, using the analysis of center of pressure by the dynamic plantar pressure measurement.
Variations in the distribution and the magnitude of the forces in the foot may reflect painful conditions and abnormalities of structure or function. By tracking the path of the instantaneous COP(center of pressure) during stance phase, the balance and pattern of progression can be determined, but parameters on COP have not been standardized nor widely applied to clinical settings yet. To quantify the COP parameters and to evaluate the clinical applicability of COP, within subject experimental design was used. Twenty six subjects with age of sixties who had no history of foot problems were recruited. Foot contact and COP parameters were measured and compared between flat foot, low heel and high heel shod walking.
1) Gait cycle parameters, 2) foot contact parameters such as total contact area, contact length, contact width, and 3) COP parameters such as initial contact COP, mean COP, anteroposterior and mediolateral displacement of COP, slope of COP, velocity of COP during each functional rocker were measured with F-scan pressure sensitive insole system.
In normal flat foot walking, COP of initial contact and mean COP were anatomically correspond to the center of the heel and to the center of the sole respectively. COP displacements corresponded to 83% of foot contact length anteroposteriorly and 18% of forefoot contact width mediolaterally. Slope of COP was about 6 degrees inwardly directed. Velocities of the COP during each functional rocker action were even and about 22∼27 cm/sec around.
In high heel shod walking, COP of initial contact was displaced 1.73 cm anteriorly and mean COP was displaced 0.31 cm medially and 1.89 cm anteriorly. Anteroposterior displacement of COP was also reduced. Velocity of the COP during heel rocker was faster and velocity during ankle rocker was slower compared to flat foot walking, which suggests excessive heel rocker and reduced ankle rocker action in high heel shod walking.
In conclusion, COP parameters measured by pressure sensitive insole system may reflect the biomechanical alteration of the foot quantitatively and may be useful in assessing the biomechanical function of the foot.
Hemiplegic gait is characterized by slow and poorly coordinated movements of the affected limb resulting from foot drop or equinus deformities. Ankle-foot orthoses(AFO) are frequently prescribed to improve the gait pattern of hemiplegics. Plastic AFO with different trimlines in controlling ankle motion can cause variable biomechanical effects.
In this study, we analysed the biomechanical effect of donning AFO on hemiplegic gait and assessed whether any differences resulted when the AFO was modified. Gait events, plantar pressure, foot contact and centers of pressure(COP) parameters were measured with F-scan pressure sensitive insole system in 21 hemiplegic stroke patients with Brunnstrom's lower extremity stage 3. And those parameters were compaired in each of four different conditions: 1) before donning AFO, 2) donning AFO without any modification, 3) donning AFO with the distal part of metatarsal head trimmed off, 4) donning AFO with third condition and weaning a cushioned heel shoes.
After donning AFO, total contact area and contact width were increased, and initial contact COP and mean COP were displaced medially. But contact length was not changed and initial contact COP and mean COP were not displaced anteroposteriorly. Anteroposterior displacement of COP, slope and velocity of COP were not also changed after donning AFO. Among various AFO adjustments, there were no significant changes of plantar pressure, foot contact and COP parameters.
The results suggest that 1) AFO provides mediolateral stability, but does not provide additional functional rocker actions during stance phase and 2) There were no definite different biomechanical actions among various adjustments of plastic AFO in hemiplegic gait of Brunnstrom's lower extremity stage 3.
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