Analysis of toe pressures under the foot while dynamic standing on one foot in healthy subjects

Dynamic balance is a crucial element in performing many activities of daily living. The one-leg stance test is a valuable test for balance impairment. The aim of the present study was to assess the relationships between body sway and toe pressure for dynamic balance test of one-leg standing on a perturbation platform. The subjects were 15 volunteers (six males and nine females, age = 21.1 +/- 1.8 years). The instrument used for evaluation of balance was the Balance System, whose software provides information on the subject's stance balance through calculation of two main variables: 1) body sway parameters (cm) and 2) peak pressure (percent of body weight/cm2) under the toes. The Balance System includes actuators which move the foot platform back and forth (+/- 40 mm perturbation at 0.25 Hz) at an average velocity of 20 mm/sec. The subjects were asked to balance on each leg for 20 seconds. The trials were repeated on the opposite foot after 5 minutes of rest. The dynamic postural control induced by low frequency perturbation in the anterior/posterior direction used the ankle strategy. Body sway was more significantly correlated with the peak anterior/posterior sway component than with lateral sway (p < 0.01). The peak pressure value of the great toe was significantly greater (p < 0.01) than the sum of the peak values of the other four toes for both sides. The study indicates the importance of the strength of the toes and somatosensory information from the sole and ankle during the dynamic one-foot standing balance as goals in rehabilitation for poor balance.