5/24/2011

New Concepts in Foot Function and Gait Analysis Assessments and Treatments

Foot Function and Gait Analysis?

Specific here, it is the examination, investigation and study of the function of the foot and gait during activities such as walking, running, jumping, standing and those other associated to sport events.

Presented By: Norman Murphy, PhD

Purpose of Presentation
Present biomechanical parameters obtained from pressure mapping. Illustrate the biomechanical parameters used i assessments and for treatment of d in t df t t t f foot function and gait. Present example applications. Follow-up with a hands-on practical demo session.

What are the Biomechanical Parameters For Assessment?

Pressure Profiles & Distribution Peak Pressure Values Force Curve & Load Patterns Center of Force (CoF) Location CoF Trajectory Timing Integral / Impulse Stability / Instability Measures Sway and Balance

What is Gait?
Gait refers to the manner and style of walking or running.

Oh la la Dont Worry Be Happy

Not all of the Biomechanical Parameters just listed are used when doing an assessment. Each event or activity and the nature of the y situation dictates the parameters to use in the assessment. So, how are the parameters obtained? As the subject stands, walks, runs, jumps, etc on the pressure mapping system, the forces are recorded.

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Specifically, Pressure Mapping Measures Compression Forces

What is Peak Pressure ?

It is the specific area (black box) where there is the highest amount of pressure.

Weight bearing foot In the diagram above, note that the body moves far more than the weight-bearing foot. The weight-bearing foot also serves as the pivot point at which the body advances. As the body moves over the weight-bearing foot, the ground reaction vertical forces applied to the plantar foot change with body position, and are being measured.

Display of the Biomechanical Parameters

After the events have been recorded the biomechanical parameters are calculated, and then presented in visual displays for subsequent analysis and interpretation. Three approaches in display are used: 1) Plantar pressure profiles 2) Graphs (curves) 3) Tables (numbers)

What are Force Curves ?

They are the graphic representation of the measured Forces over a period of time.
Graph for one step Without orthotic With orthotic

What are Pressure Profiles ?

They are color representations (distribution) of the calculated Pressures over a period of time. They are also referred to as maps.
Kg/cm2

The Force vs. Time (Load Pattern) Graph

Force

Time Force is represented by the vertical axis Time is represented by the horizontal axis

Pressure Column Dark Red = high Dark Blue = low Dark Blue = low

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Example of a Force vs. Time (Load Pattern) Graph

2 3 4

What is Center of Force (CoF) ?

It is the point where all Forces acting on the plantar foot may be considered to be concentrated. At heel strike During stance Where = CoF

1. Indicates a rapid initial loading. 2. A 50% drop in force or loading. 3. An increase to about 10% more than the 1st peak. 4. A rapid decline in force to 0. This curve is also a sample pattern of the vertical force (Gait) curve during the stance phase of walking.

Can Isolate Foot Segments to Analyze & Interpret Load Patterns

Then concentrate on the actual foot and its pivots: Foot (Red box) Heel (Green box) Forefoot (Magenta box) A Graph is generated with the respective Force vs. Time curves

What is CoF Trajectory ?

It is the path that of which the Center of Force (CoF) follows over time (such as in during the stance phase).
Without orthotic With orthotic Where = CoF = Trajectory

For Example, Assess on the Relationship Between the Force Curves and the Pivots

What is Timing ?
It is the amount of time the segments of the feet are in contact with the ground, and the speed with which they move during the stance phase.
At heel strike At mid-stance mid-

Foot (Gait) Heel Forefoot

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What is Integral ?
It is the relationship between the amount of Pressure (load) that is applied throughout a period of Time.
Without orthotic
0.73 kg/cm2*sec

Stability / Instability Measures Posture, Sway and Balance

For example, when standing up-right, optimal CoF location is located in a minimal area of displacement (sway), at intersection of the midline between the feet and at level of the mid-tarsal (mid-foot).
Gravity Line Alignment Ali t Line

With orthotic
0.50 kg/cm2*sec

CoF optimal plantar location

MidMid-Line

Pressure Profile

Mid tarsal

What is Impulse ?
It is the relationship between the amount of Force (load) that is applied throughout a period of Time.
With cushioning Without cushioning

Standing on Individual Foot

Example for the CoF ( ) Location
Left Right

7.22 kg*sec

10.68 kg*sec

Stability / Instability Measures Clarification on Posture, Sway and Balance

When applied to the human body, a distinction is often made between posture, sway and balance. The following defines these three concepts: Posture is the relative alignment and orientation of the segments of the body. Sway is the oscillating movement of the body. Balance is the harmony between the manner of swaying and maintaining posture, and preserving equilibrium when in motion. It is the sense of balance that allows to stand upright or move, without falling over.

What are the Stability / Instability Measures?

Area of Sway for the CoF - Ellipse Displacement of the CoF: Total Linear Distance A-P and M-L Variance (Variability in Displacement) Displacement Pattern Body Weight Distribution

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What is Ellipse ?
It is the elliptical region (area) in which the CoF traveled (moved) during the event.
Posture misalignment Treated

What is Body Weight Distribution ?

It is the percent (%) of body weight bearing by segments of the feet during the event.
Left vs. Right and Rearfoot vs. Forefoot Posture misalignment Treated

What is Displacement ?
It is the distance (excursion) traveled by the CoF during the event, and the variability in its displacement during the event.
Posture misalignment P t i li t Treated T t d

In Summary for Application

Biomechanical measures from pressure mapping are tangible & measurable parameters that can be used as: Desired performance and/or treatment outcomes to achieve. Indicators to assess pre-post treatment (performance) outcomes.

What is Displacement Pattern ?

It is the graphic display of the manner in which the CoF traveled during the event.
Left-Right CoF Movement Anterior-Posterior CoF Movement

Following are some examples where pressure mapping and its related biomechanical parameters are applied.

Posture misalignment Treated

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Example of Applications

Example of Applications

Example of Applications

Example of Applications

Example of Applications

Example of Applications

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Example of Applications

Example of Applications

Example of Applications

Example of Applications

Outcomes of the study

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In Conclusion
What is the magical recipe for successful biomechanical based performance assessments and treatments? Skill and Science The Skill resides in: Setting desired & expected biomechanical outcomes. outcomes Preparing the training program and/or treatment protocol such to meet the outcomes. Applying the training and treatment as such. The SCIENCE resides in: Measuring biomechanical (parameter) outcomes. Analyzing, interpreting and ensuring that the biomechanical outcomes are met or achieved.

THANK YOU!