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Dynamic foot pressure measurements for assessing foot deformity in persons with spastic cerebral palsy
Eun Sook Park1, Hyun Woo Kim, Chang Il Park
1Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Insights
Computerized insole sensors reveal distinct foot pressure patterns in children with spastic cerebral palsy (CP) deformities. Corrective surgery significantly improves foot contact, pressure distribution, and center of pressure trajectories, aiding in evaluating treatment outcomes.
Area of Science:
- Biomechanics
- Pediatric Orthopedics
- Medical Technology
Background:
- Children with spastic cerebral palsy (CP) often present with complex foot deformities.
- Accurate assessment of foot pressure distribution is crucial for understanding biomechanical abnormalities and guiding treatment.
- Computerized insole sensor systems offer objective, quantitative data on foot function.
Purpose of the Study:
- To characterize foot pressure distribution in children with CP and various foot deformities.
- To evaluate the impact of corrective orthopedic surgery on foot pressure parameters post-intervention.
Main Methods:
- A before-after trial design was employed at a university hospital.
- Sixty-seven limbs from 44 children with spastic CP (equinus, equinovarus, equinovalgus) underwent assessment.
- The F-scan computerized insole system measured foot contact patterns, pressure-time integral (PTI), and center of pressure (COP) trajectories pre- and post-surgery.
Main Results:
- Pre-surgery, significant differences in medial midfoot relative impulse were observed between deformity groups.
- Abnormal weight-bearing patterns, indicated by high lateral relative impulse in equinovarus and medial in equinovalgus, were identified.
- Post-surgery, significant improvements were noted in foot contact area, hindfoot parameters, relative impulse distribution, and COP trajectory characteristics.
Conclusions:
- Dynamic foot pressure measurements using insole sensors effectively identify deformities and assess post-surgical improvements in the frontal plane.
- Parameters like Center of Pressure Index (COPI) and coronal index are valuable for evaluating varus and valgus deformities.
- Comprehensive analysis of foot contact patterns, PTI, and COP trajectories aids in evaluating surgical outcomes for pediatric foot deformities.
Objectives:
To identify characteristics of foot pressure distribution in different foot deformities using a computerized insole sensor system, and to identify changes in these parameters after corrective surgery in children with spastic cerebral palsy (CP).
Design:
Before-after trial.
Setting:
University hospital.
Participants:
Sixty-seven limbs of 44 children with spastic CP were assessed (35 equinus, 17 equinovarus, 15 equinovalgus).
Intervention:
Orthopedic surgery for foot deformities.
Main Outcome Measures:
Parameters of foot contact pattern, pressure-time integral (PTI), and center of pressure (COP) trajectories were assessed before and at a minimum of 6 months postsurgery, using the F-scan system.
Results:
Prior to surgery, the medial midfoot relative impulse, which is PTI normalized by a percentage of the entire foot, differed significantly between foot deformity groups. Relative impulse was high on the lateral column of the foot in the equinovarus group and on the medial column of the foot in the equinovalgus group. Center of pressure index (COPI) and coronal index reflecting the asymmetry of the medial and lateral columns of the foot differed significantly between the equinovalgus and equinovarus groups. After surgery, significant changes occurred in foot contact patterns, including total contact area, contact length, contact width of hindfoot, and the relative impulse of specific areas of the foot. In addition, there were significant changes in the parameters of COP, such as anteroposterior displacement, slope, and velocity.
Conclusions:
In dynamic foot pressure measurements using a computerized insole sensor system, the parameters reflecting medial or lateral changes in weight bearing, such as COPI and coronal index, appear to be useful for evaluating abnormalities and improvements after intervention in the frontal plane, such as varus and valgus. Additionally, assessment of parameters in foot contact patterns, PTIs, and COP path trajectories appears to be helpful in evaluating outcomes after corrective surgery.
