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      Identification of Foot Pathologies Based on Plantar Pressure Asymmetry

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          Abstract

          Foot pathologies can negatively influence foot function, consequently impairing gait during daily activity, and severely impacting an individual’s quality of life. These pathologies are often painful and correspond with high or abnormal plantar pressure, which can result in asymmetry in the pressure distribution between the two feet. There is currently no general consensus on the presence of asymmetry in able-bodied gait, and plantar pressure analysis during gait is in dire need of a standardized method to quantify asymmetry. This paper investigates the use of plantar pressure asymmetry for pathological gait diagnosis. The results of this study involving plantar pressure analysis in fifty one participants (31 healthy and 20 with foot pathologies) support the presence of plantar pressure asymmetry in normal gait. A higher level of asymmetry was detected at the majority of the regions in the feet of the pathological population, including statistically significant differences in the plantar pressure asymmetry in two regions of the foot, metatarsophalangeal joint 3 (MPJ3) and the lateral heel. Quantification of plantar pressure asymmetry may prove to be useful for the identification and diagnosis of various foot pathologies.

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          Symmetry and limb dominance in able-bodied gait: a review.

          As one of the most universal of all human activities, gait in the able-bodied has received considerable attention, but many aspects still need to be clarified. Symmetry or asymmetry in the actions of the lower extremities during walking and the possible effect of laterality on gait are two prevalent and controversial issues. The purpose of this study was to review the work done over the last few decades in demonstrating: (a) whether or not the lower limbs behave symmetrically during able-bodied gait; and (b) how limb dominance affects the symmetrical or asymmetrical behavior of the lower extremities. The literature reviewed shows that gait symmetry has often been assumed, to simplify data collection and analysis. In contrast, asymmetrical behavior of the lower limbs during able-bodied ambulation was addressed in numerous investigations and was found to reflect natural functional differences between the lower extremities. These functional differences were probably related to the contribution of each limb in carrying out the tasks of propulsion and control during able-bodied walking. In current debates on gait symmetry in able-bodied subjects, laterality has been cited as an explanation for the existence of functional differences between the lower extremities, although a number of studies do not support the hypothesis of a relationship between gait symmetry and laterality. Further investigation is needed to demonstrate functional gait asymmetry and its relationship to laterality, taking into consideration the biomechanical aspects of gait.
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            Evaluation of gait symmetry after stroke: a comparison of current methods and recommendations for standardization.

            Symmetry is a gait characteristic that is increasingly measured and reported, particularly in the stroke patient population. However, there is no accepted standard for assessing symmetry making it difficult to compare across studies and establish criteria to guide clinical decision making. This study compares the most common expressions of spatiotemporal gait symmetry to describe post-stroke gait and makes recommendations regarding the most suitable measure for standardization. The following symmetry equations were compared: symmetry ratio, symmetry index, gait asymmetry and symmetry angle using step length, swing time, stance time, double support time and an intra-limb ratio of swing: stance time. Comparisons were made within a group of 161 community-dwelling, ambulatory individuals with stroke and 81 healthy adults as a reference group. Our analysis supports the recommendations of the symmetry ratio as the equation for standardization and step length, swing time and stance time as the gait parameters to be used in the equation. Future work should focus on establishing the intra-individual variability of these measures and linking them to mechanisms of gait dysfunction. Copyright 2009 Elsevier B.V. All rights reserved.
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              Foot Plantar Pressure Measurement System: A Review

              Foot plantar pressure is the pressure field that acts between the foot and the support surface during everyday locomotor activities. Information derived from such pressure measures is important in gait and posture research for diagnosing lower limb problems, footwear design, sport biomechanics, injury prevention and other applications. This paper reviews foot plantar sensors characteristics as reported in the literature in addition to foot plantar pressure measurement systems applied to a variety of research problems. Strengths and limitations of current systems are discussed and a wireless foot plantar pressure system is proposed suitable for measuring high pressure distributions under the foot with high accuracy and reliability. The novel system is based on highly linear pressure sensors with no hysteresis.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Sensors (Basel)
                Sensors (Basel)
                sensors
                Sensors (Basel, Switzerland)
                MDPI
                1424-8220
                18 August 2015
                August 2015
                : 15
                : 8
                : 20392-20408
                Affiliations
                [1 ]College of Engineering and Science, Victoria University, Melbourne VIC-3032, Australia; E-Mails: Linah.Wafai@ 123456live.vu.edu.au (L.W.); Aladin.Zayegh@ 123456vu.edu.au (A.Z.)
                [2 ]Boronia Podiatry, Melbourne VIC-3155, Australia; E-Mail: John.Woulfe@ 123456nwhcn.org.au
                [3 ]School of Engineering, University of South Australia, Mawson Lakes SA-5095, Australia; E-Mail: mahfuz.aziz@ 123456unisa.edu.au
                [4 ]Gait and Balance Research Group, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne VIC-3032, Australia
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: Rezaul.Begg@ 123456vu.edu.au ; Tel.: +61-3-9919-1116.
                Article
                sensors-15-20392
                10.3390/s150820392
                4570427
                26295239
                809d1d0b-c360-4c0d-95ae-1e4912e1cf01
                © 2015 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 13 March 2015
                : 11 August 2015
                Categories
                Article

                Biomedical engineering
                foot pathology,gait symmetry,plantar pressure
                Biomedical engineering
                foot pathology, gait symmetry, plantar pressure

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