Most activities of daily living and numerous modes of physical activity incorporate some form of ambulation, of which the foot and ankle constitute the first link in the kinetic chain. A change in foot or ankle structure may therefore have subsequent effects on the superincumbent joints of the human body such as the knee, hip and lower back. Plantar pressure and impulse measurements can therefore provide greater insight into the mechanics of the foot under load-bearing conditions with regards to the areas and regions of the foot that exhibit the largest pressure values and impulse figures. Hence, it is of importance to establish normative data so as to obtain a frame of reference to identify those individuals that fall outside these norms and may exhibit a larger probability of injury. Aim and Objectives: The primary aim was to identify and compare the plantar pressure distribution patterns and impulse values of students of a South African university of different gender and race groups. To realise this aim two specific objectives were set. The first was to determine whether height, weight, body mass index (BMI), gender, race, and the level of physical activity were related to the pressure and impulse values obtained, and the second was to generate reference tables from the normative data gathered. Method: The RS Footscan system was used to measure the pressure and impulse values of the foot. The characteristics that were analysed were height, weight, body mass index and the level of physical activity of the participant and their respective association with plantar pressure and impulse values obtained. This information was then used to establish normative data. A quasi-experimental study design utilising convenience sampling was implemented as the intention was to investigate as single instance in as natural a manner as possible. Convenience sampling was used with predefined inclusion and exclusion criteria. A total of 180 participants were utilised in this study and were subdivided as follows: Gender: Males (n = 90); Females (n = 90); Race: African black (n = 60); white (n = 60) and coloured (n = 60). Each race group therefore comprised of 30 males and 30 females respectively. The anthropometric profile of participants was as follows: Age (S.D.) = 22.21 (S.D. ± 2.93) years; Height (S.D.) = 169.69 (S.D. ± 8.91) cm; Weight (S.D.) = 66.97 (S.D. ± 12.01) kg; BMI (S.D.) = 23.16 (S.D. ± 3.15) kg/m2. Participants were asked to complete a questionnaire prior to testing that would identify all exclusion criteria consisting of: the presence of foot pain or deformity, acute lower extremity trauma, lower extremity surgery, exhibited problems of performance including eye, ear or cognitive impairment, diabetes mellitus or other neurological neuropathy, or the use of walking aids. Anthropometric measurements were then taken for those participants that qualified for the study. Participants were required to perform approximately five warm-up trials to familiarise themselves with the testing equipment before testing commenced. A total of ten successful trails were subsequently recorded for each participant, with three footprints being recorded per trial on the pressure platform, thereby comprising 30 footprints (15 left foot and 15 right foot) per participant that were analysed regarding pressure and impulse values. The two-step gait initiation protocol was implemented which was proven to be a valid and reliable means of assessing gait. Participants were instructed to walk at a comfortable walking speed between 1.19 – 1.60 m/s to ensure conformity between all participants as between-trial gait velocities were proven to be significantly variable. The foot was subdivided into ten anatomical areas focusing on the great toe, lesser toes, metatarsal 1, metatarsal 2, metatarsal 3, metatarsal 4, metatarsal 5, midfoot, medial heel and lateral heel. These ten areas were then grouped into one of three regions, namely the forefoot region (great toe, lesser toes, and all five metatarsal head areas), midfoot region (midfoot area), and rearfoot/heel region (medial and lateral heel areas). Once all relevant data was gathered, corrected and analysed it was used to establish normative data tables pertaining to the various gender and race groups. Results: Of the ten individual pressure and impulse areas, the second and third metatarsal heads demonstrated the highest mean peak pressure and impulse values. Once grouped into one of the three regions, the heel region was ascribed with the largest impulse and pressure values. It was established that statistically and practically significant racial pressure differences were apparent in the left and right forefoot and midfoot regions, with black and coloured individuals yielding the highest values, whereas white participants yielded the lowest. The same was true with regards to impulse figures in that both statistical and practical significant levels were established in the forefoot and midfoot regions. Black and coloured participants exhibited larger impulse values than the white participants. The level of physical activity was found to be associated with both pressure and impulse values over the various regions of the foot. Black individuals that were largely inactive as well as moderately active coloured participants yielded the highest pressure and impulse values, which were found to be statistically and practically significant over the forefoot regions. Conversely, white participants of all physical activity levels as well as coloured participants of both low and high physical activity levels exhibited the lowest pressure values over the forefoot region, which were also found to be statistically and practically significant. The anthropometric variables of height, weight and BMI were found to relate statistically to pressure and impulse values under the various regions of the foot, but none were found to be of any practical significance (r < .30). Conclusion: It was clearly established that both gender and race specific differences existed regarding plantar pressure and impulse values of the normal foot. Plantar pressure and impulse values were also associated with the level of physical activity of the individual, thereby indicating that the level of physical activity could be a contributing factor to altered pressure and impulse values. Anthropometric variables such as height, weight and BMI could not solely account for the variances observed in pressure and impulse. Further research is required to determine whether pressure or impulse values above or below those obtained predispose an individual to injury and to contrast between various activity or sporting codes and the effect of these on plantar pressure and impulse figures. Finally, from the collected data one was able to establish reference tables for the specific gender and race groups for both plantar pressure and impulse values. This enables one to classify individuals based on the pressure and impulse values generated.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nmmu/vital:10095 |
| Date | January 2012 |
| Creators | Kramer, Mark |
| Publisher | Nelson Mandela Metropolitan University, Faculty of Health Sciences |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis, Masters, MA |
| Format | xvi, 160 leaves, pdf |
| Rights | Nelson Mandela Metropolitan University |
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