Step-to-step reproducibility and asymmetry to study gait auto-optimization in healthy and cerebral palsied subjects

AbstractObjectiveThe purpose of our study was to compare plantar pressure asymmetry and step-to-step reproducibility in both able-bodied persons and two groups of hemiplegics. The relevance of the research was to determine the efficiency of asymmetry and reproducibility as indexes for diagnosis and rehabilitation processes.Material and methodThis study comprised 31 healthy young subjects and 20 young subjects suffering from cerebral palsy hemiplegia assigned to two groups of 10 subjects according to the severity of their musculoskeletal disorders. The peaks of plantar pressure and the time to peak pressure were recorded with an in-shoe measurement system. The intra-individual coefficient of variability was calculated to indicate the consistency of plantar pressure during walking and to define gait stability. The effect size was computed to quantify the asymmetry and measurements were conducted at eight footprint locations.ResultsResults indicated few differences in step-to-step reproducibility between the healthy group and the less spastic group while the most affected group showed a more asymmetrical and unstable gait.ConclusionFrom the concept of self-optimisation and depending on the neuromotor disorders the organism could make priorities based on pain, mobility, stability or energy expenditure to develop the best gait auto-optimisation

A real time plantar pressure feedback device for foot unloading

The design and development of a plantar pressure control device, adapted to correct plantar pressure distribution patterns, is described. This device is based on the artificial return of information in real time to instantaneously reveal to subject certain events, of which he was unaware and which are difficult to quantify, such as the pressure variation generated by foot-ground contact. An acoustic alarm and visual signals, adjusted to a specific pressure load, alert the user in the case of excessive plantar pressure. So, our feedback device is designed to substitute for loss of feeling in patients who have peripheral neuropathy secondary to diabetes mellitus. The ultimate aim of this project is to prevent the development of neuropathic foot ulceration by providing both visual and auditory extrinsic sensory feedback to compensate for the malfunctioning peripheral nerves and to transmit information to the patient about dangerous conditions on the plantar surface of the feet. A trial of the device in a healthy subject is presented to evaluate whether a new gait pattern can emerge thanks to feedback from plantar pressure measurements