Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 24, 2023
Date Accepted: Feb 17, 2024
Characteristic changes of the stance-phase plantar pressure curve when walking uphill and downhill – implications for long-term monitoring of gait patterns via insoles for smart healthcare
ABSTRACT
Background:
Monitoring of gait patterns via insoles is popular to study behavior and activity in the daily life of people and throughout the rehabilitation process of patients. Live data analyses may improve personalized prevention and treatment regimen, as well as rehabilitation. The M-shaped plantar pressure curve during the stance phase is mainly defined by the loading and unloading slope, two maxima, one minimum, as well as the force during defined periods. When monitoring gait continuously, walking uphill or downhill could affect this curve in characteristic ways.
Objective:
For walking on a slope, typical changes in the stance phase curve measured by insoles were hypothesized.
Methods:
Forty healthy participants of both sexes were fitted with individually calibrated insoles with 16 pressure sensors each and a recording frequency of 100 Hz. Participants walked on a treadmill at 4 km/h for one minute in each of the following slopes: -20, -15, -10, -5, 0, 5, 10, 15 and 20 %. Raw data were exported for analyses. A custom-developed data platform was used for data processing and parameter calculation.
Results:
An ANOVA analysis with the gait parameters as dependent and slope as independent variables revealed significant changes for the following parameters of the stance phase curve: the mean force during loading and unloading, the two maxima and the minimum, as well as the loading and unloading slope (all P<.001).
Conclusions:
Results indicate that a simultaneous increase in loading slope, the first maximum and the mean loading force combined with a decrease in the mean unloading force, the second maximum, and the unloading slope indicates downhill walking. The opposite indicates uphill walking. The minimum has its peak at horizontal walking and values drop when walking uphill and downhill alike. It is therefore not a suitable parameter to distinguish between uphill and downhill walking. While patient-related factors, such as anthropometrics, injury or disease shape the stance phase curve on a longer-term scale, walking on slopes leads to temporary and characteristic short-term changes in the curve trajectory. Clinical Trial: The study is registered in the German Clinical Trials Register (DRKS-ID: DRKS00025108)
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