Classification of forefoot plantar pressure distribution in persons with diabetes : a novel perspective for the mechanical management of diabetic foot?

Background: The aim of this study was to identify groups of subjects with similar patterns of forefoot loading and verify if specific groups of patients with diabetes could be isolated from non-diabetics. Methodology/Principal Findings: Ninety-seven patients with diabetes and 33 control participants between 45 and 70 years were prospectively recruited in two Belgian Diabetic Foot Clinics. Barefoot plantar pressure measurements were recorded and subsequently analysed using a semi-automatic total mapping technique. Kmeans cluster analysis was applied on relative regional impulses of six forefoot segments in order to pursue a classification for the control group separately, the diabetic group separately and both groups together. Cluster analysis led to identification of three distinct groups when considering only the control group. For the diabetic group, and the computation considering both groups together, four distinct groups were isolated. Compared to the cluster analysis of the control group an additional forefoot loading pattern was identified. This group comprised diabetic feet only. The relevance of the reported clusters was supported by ANOVA statistics indicating significant differences between different regions of interest and different clusters. Conclusion/s Significance: There seems to emerge a new era in diabetic foot medicine which embraces the classification of diabetic patients according to their biomechanical profile. Classification of the plantar pressure distribution has the potential to provide a means to determine mechanical interventions for the prevention and/or treatment of the diabetic foot

A color-code based method for the interpretation of plantar pressure measurements in clinical gait analysis

Comparing plantar pressure measurements (PPM) of a patient following an intervention or between a reference group and a patient-group is common practice in clinical gait analysis. However, this process is often time consuming and complex, and commercially available software often lacks powerful visualization and interpretation tools. In this paper, we propose a simple method for displaying pixel-level PPM deviations relative to a so-called reference PPM pattern. The novel method contains 3 distinct stages: (1) a normalization of pedobarographic fields (for foot length and width), (2) a pixel-level z-score based calculation and, (3) color coding of the normalized pedobarographic fields. The methodological steps associated to this novel method are precisely described and clinical output illustrated. We believe that the advantages of the novel method cover several domains. The strongest advantage of the novel method is that it provides a straightforward visual interpretation of PPM without decreasing the resolution perspective. A second advantage is that it may guide the selection of a local mapping technique (data reduction technique). Finally, it may be easily used as education tool during the therapist-patient interaction.publisher: Elsevier articletitle: A color-code based method for the interpretation of plantar pressure measurements in clinical gait analysis journaltitle: Gait & Posture articlelink: http://dx.doi.org/10.1016/j.gaitpost.2014.12.013 content_type: article copyright: Copyright © 2014 Elsevier B.V. All rights reserved.status: publishe

A novel method of quantifying gait deviations using plantar pressure patterns

BACKGROUND: Comparing the dynamic pedobarographic patterns of individuals is common practice in basic and applied research. However, this process is often time-consuming and complex, and commercially available software often lacks powerful visualization and interpretation tools. METHODS: We propose a simple method for displaying pixel-level pedobarographic deviations over time relative to a so-called reference pedobarographic pattern. This novel method contains four distinct automated preprocessing stages: 1) normalization of pedobarographic fields (for foot length and width), 2) temporal normalization, 3) a pixel-level z-score-based calculation, and 4) color coding of the normalized pedobarographic fields. Group and patient-level comparisons were illustrated using an experimental data set including diabetic and nondiabetic patients. RESULTS: The automated procedure was found to be robust and quantified distinct temporal deviations in pedobarographic fields. CONCLUSIONS: The advantages of the novel method cover several domains, including visualization, interpretation, and education.status: publishe

Classification of forefoot plantar pressure distribution in patients with diabetes: A biomechanical approach based on relative regional impulses and non-hierarchical clustering

This study aimed to identify groups of subjects with similar patterns of forefoot loading and verify if patients with diabetes (PwD) could be distinguished from non-diabetics. Kmeans cluster analysis on the relative regional impulses originating from 6 forefoot segments, led to the identification of three distinct groups when considering only non-diabetics and of four groups when taking into account diabetics only or both populations together. An ‘exclusive’ pattern of PwD only was identified. The relevance of the reported clusters was supported by differences observed between groups when considering other parametersstatus: publishe

Classification of forefoot plantar pressure distribution in persons with diabetes: A novel perspective for the mechanical management of diabetic foot?

The aim of this study was to identify groups of subjects with similar patterns of forefoot loading and verify if specific groups of patients with diabetes could be isolated from non-diabetics.status: publishe

ArcNEMO, a new spatially distributed nutrient emission model to quantify N and P losses from agriculture to surface waters

status: publishe