The development of an intraoperative plantar pressure assessment device

The goal of this study was to develop an accurate and reliable supine plantar pressure measurement apparatus that could potentially be used in the operating room to guide operative decision making. It was hypothesized that plantar pressures would be similar in supine and vertical posture trials.

A supine plantar pressure system was developed using the Pliance 32 sensor array (Novel, Munich, Germany). Accuracy was tested with a standardized manometer and the Trublu calibration system (Novel). Next, bilateral feet of 10 healthy, asymptomatic patients were tested in the apparatus by two separate investigators. Intraclass correlation coefficients (ICC) were calculated to determine intrarater and interrater reliability for parameters of average mean pressure (AMP), peak pressure (PP) and percentage of total force (PF). Finally, plantar pressures were tested in vertical posture and compared to supine parameters.

The sensor was both linear and accurate. The ICC values demonstrated that the sensor was reliable for AMP (0.66 to 0.93), PP (0.75 to 0.94), and PF (0.69 to 0.97). In general, AMP, PP, and PF values were significantly different at most anatomical regions for supine and vertical posture trials (p < 0.0001).

This intraoperative pressure measurement system provided an accurate, linear, and reliable method to measure plantar pressure parameters in the supine subject. These measures were similar in magnitude to vertical posture, but were statistically different.

This intraoperative plantar pressure system could guide operative reconstruction of foot deformities whose outcome depends on the distribution of pressures across the plantar foot.