After 1500 Plantar Pressure Measurments

Orthotic Biomechanical Solutions 2010

Since 1996, in-shoe plantar pressure measurement (PedarR) has been used as a research tool for assessment of foot function and the effectiveness of orthoses. As experience developed and migrated into routine clinical practice, assessments (average 3, range 1 – 11) with PedarR increased over seven-fold from 80 to 583 assessments per annum.

Of 288 diabetic patients examined 47% had already undergone amputation of the contra-lateral limb and the remaining natural foot was considered at risk. Orthoses provided were tested with PedarR until adequate off-loading was achieved ‑ 41% needed re-adjustment. Over 300 patients are wearing pressure re-distribution orthoses, which are replaced only when PedarR values deteriorate. PedarR measurements have ensured that pressure-relieving ankle foot orthoses also remain effective with up to 100% off-loading of the affected areas, thereby improving patient education and hopefully compliance.

PedarR measurements performed in conjunction with video vector analysis have given an extra depth to gait analysis. In Juvenile Idiopathic Arthritis this combination enabled differentiation of four distinct pathological gait patterns1. Orthotic prescription for a variety of neurological and musculo-skeletal disorders were also refined with this approach. Subtle impairments such as Functional Hallux Limitus were more objectively identified and managed with PedarR.

Fine-tuning of orthoses using scientific measurements may appear extravagant but is a challenge faced by any busy clinician wishing to adopt evidence-based practice. However, integration of measurements into normal clinical practice will increase accuracy of treatment, thereby improving outcomes for patients and satisfaction for clinicians.

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