Reliability of pediobarographs for paediatric foot deformity

Abstract

Purpose Dynamic pediobarograph measures foot-floor contact pressure during walking and provides a quantitative functional assessment. The goal of this study was to assess the reliability of pediobarograph measurements in normal children and in those with cerebral palsy (CP). Materials and methods During the first investigation, five non-disabled children and four with CP had three pediobarograph measurements taken of each foot, repeated five times. The pediobarographs were analysed by dividing the foot into five segments; the heel, the lateral midfoot, the medial midfoot, the lateral forefoot and the medial forefoot. A measure of valgus/varus foot posture was defined as the relative medial-lateral difference of combined mid-and forefoot impulse, named valgus/varus index. During the second investigation, 50 children (100 feet) with spastic diplegic CP were studied to calculate the standard error of measurements (SEM), to investigate the number of pediobarograph measurements necessary to obtain accurate results. The third investigation was an inter-and intraobserver study performed on one normal subject's repeated measurements. ResultsIn the first investigation, the group with CP had a significantly increased variability in the medial midfoot (P = 0.013). The variability of the valgus/varus index had a standard deviation of 13%, demonstrating that this measure is relatively stable. The SEM and 95% confidence interval from the second experiment showed that, even if the accuracy increased with the number of measurements, the greatest gain seemed to be contributed by increasing the number of measurements from 3 to 6. The inter-and intraobserver study showed good to mostly excellent agreement. Conclusion Pediobarograph measurements can be used to monitor and quantitatively assess the progressive changes of foot deformity over time. Pediobarograph is a reliable measurement that shows little variability between measurements at the same occasion and between measurements on different days. Three to six measurements seems practical and adequate to obtain. The technical aspect of measuring shows good repeatability and agreement between observers.

Short-Term Effect of Botulinum Toxin A Injection on Spastic Equinovarus Foot in Cerebral Palsy Patients: A Study Using the Foot Pressure Measurement System

“…The foot pressure measurement system (FPMS) is known to be useful in providing quantitative information on weight bearing pattern of the foot during the gait cycle [ 10 ]. Several studies have used the FPMS to investigate the therapeutic effect of patients with rheumatoid arthritis, diabetes mellitus, and several forefoot problems [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ].…”

Effects of walking speed and slope on pedobarographic findings in young healthy adults

“…The area of pedobarographic measurement was divided into five segments, medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel, wherein the forefoot, midfoot, and heel were equally divided (Fig 1). [19,20] The peak pressure and pressure-time integral were obtained for each segment.…”

Sex Differences in Pedobarographic Findings and Relationship between Radiographic and Pedobarographic Measurements in Young Healthy Adults

“… 23) Foot pressure measurement is increasingly used for clinical and research purposes in diabetic foot ulcer, footwear or orthosis, foot deformities, and sports activities. 1 3 4 14 16 18 24 25 26 27) It is necessary to establish normal data according to sex and ethnic groups in order to help clinicians and researchers set appropriate treatment goals and obtain appropriate control data.…”

“…The area of measurement was divided equally into anterior, middle, and posterior thirds, and the anterior and middle thirds were further equally divided into medial and lateral halves. 17 18) Therefore, five segments were defined: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel ( Fig. 2 ).…”

“…The peak pressure varus/valgus index was defined as [(MFF + MMF) − (LFF + LMF)] / (MFF + MMF + LFF + LMF). 17 18) The peak pressure forefoot/heel index was defined as (MFF − heel) / (MFF + heel). The pressure-time integral varus/valgus index was calculated using the same method as peak pressure, and the pressure-time integral forefoot/heel index was defined as (MFF + LFF − heel) / (MFF + LFF + heel).…”