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5/24/2011

NewNew ConceptsConcepts inin FootFoot FunctionFunction andand GaitGait AnalysisAnalysis AssessmentsAssessments andand
NewNew ConceptsConcepts inin FootFoot FunctionFunction andand
GaitGait AnalysisAnalysis AssessmentsAssessments andand
TreatmentsTreatments
Presented By:
Norman Murphy, PhD
Purpose of Presentation Present biomechanical parameters obtained from pressure mapping. Illustrate the biomechanical
Purpose of Presentation
Present biomechanical parameters
obtained from pressure mapping.
Illustrate the biomechanical parameters
used in assessments and for treatment of
foot function and gait.
Present example applications.
Follow-up with a hands-on practical demo
session.
WhatWhat isis Gait?Gait? Gait refers to the manner and style of walking or running.
WhatWhat isis Gait?Gait?
Gait refers to the
manner and style of
walking or running.
FootFoot FunctionFunction andand GaitGait Analysis?Analysis? Specific here, it is the examination, investigation and
FootFoot FunctionFunction andand GaitGait Analysis?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.
WhatWhat areare thethe BiomechanicalBiomechanical ParametersParameters ForFor Assessment?Assessment? Pressure Profiles
WhatWhat areare thethe BiomechanicalBiomechanical
ParametersParameters ForFor Assessment?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
Oh la la… Don’t Worry… Be Happy… Not all of the Biomechanical Parameters just listed
Oh la la…
Don’t 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
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.

5/24/2011

Specifically,Specifically, PressurePressure MappingMapping MeasuresMeasures CompressionCompression ForcesForces Weight
Specifically,Specifically, PressurePressure MappingMapping
MeasuresMeasures CompressionCompression ForcesForces
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.
DisplayDisplay ofof thethe BiomechanicalBiomechanical ParametersParameters After the events have been recorded the
DisplayDisplay ofof thethe BiomechanicalBiomechanical
ParametersParameters
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)
WhatWhat areare PressurePressure ProfilesProfiles ?? They are color representations (distribution) of the calculated
WhatWhat areare PressurePressure ProfilesProfiles ??
They are color representations
(distribution) of the calculated
Pressures over a period of time.
Th
ey are a so re erre
maps.
l
f
d t
o as
Kg/cm 2
Pressure Column
Dark Red = high
Dark Blue = low
Dark Blue = low
WhatWhat isis PeakPeak PressurePressure ?? It is the specific area (black box) where there is
WhatWhat isis PeakPeak PressurePressure ??
It is the specific area (black box) where
there is the highest amount of pressure.
WhatWhat areare ForceForce CurvesCurves ?? They are the graphic representation of the measured Forces over
WhatWhat areare ForceForce CurvesCurves ??
They are the graphic representation of the
measured Forces over a period of time.
Graph for one step
Without orthotic With orthotic
TheThe ForceForce vs.vs. TimeTime (Load(Load Pattern)Pattern) GraphGraph Force Time Force is represented by the
TheThe ForceForce vs.vs. TimeTime
(Load(Load Pattern)Pattern) GraphGraph
Force
Time
Force is represented by the vertical axis
Time is represented by the horizontal axis

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ExampleExample ofof aa ForceForce vs.vs. TimeTime (Load(Load Pattern)Pattern) GraphGraph 3 4 2 1 1. Indicates
ExampleExample ofof aa ForceForce vs.vs. TimeTime
(Load(Load Pattern)Pattern) GraphGraph
3
4
2
1
1. Indicates a rapid initial loading.
2. A 50% drop in force or loading.
3. An increase to about 10% more than the 1 st 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.
CanCan IsolateIsolate FootFoot SegmentsSegments toto AnalyzeAnalyze && InterpretInterpret LoadLoad
CanCan IsolateIsolate FootFoot SegmentsSegments toto
AnalyzeAnalyze && InterpretInterpret LoadLoad PatternsPatterns
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
ForFor Example,Example, AssessAssess onon thethe RelationshipRelationship BetweenBetween thethe ForceForce CurvesCurves
ForFor Example,Example, AssessAssess onon thethe RelationshipRelationship
BetweenBetween thethe ForceForce CurvesCurves andand thethe PivotsPivots
Foot (Gait)
Heel
Forefoot
What is Center of Force (CoF) ? It is the point where all Forces acting
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
What is CoF Trajectory ? It is the path that of which the Center of
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
Wh
ere
=
C
o
F
= Trajectory
WhatWhat isis TimingTiming ?? It is the amount of time the segments of the feet
WhatWhat isis TimingTiming ??
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.
AtAt hheeeell ssttrrikikee
AtAt mmidid--ssttanceance

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WhatWhat isis IntegralIntegral ?? It is the relationship between the amount of Pressure (load) that
WhatWhat isis IntegralIntegral ??
It is the relationship between the amount
of Pressure (load) that is applied
throughout a period of Time.
WithoutWithout orthoticorthotic
WithWith orthoticorthotic
0.73 kg/cm 2 *sec
0.50 kg/cm 2 *sec
WhatWhat isis ImpulseImpulse ?? It is the relationship between the amount of Force (load) that
WhatWhat isis ImpulseImpulse ??
It is the relationship between the amount
of Force (load) that is applied throughout
a period of Time.
WithWith cushioningcushioning
WithoutWithout cushioningcushioning
7.22 kg*sec
10.68 kg*sec
StabilityStability // InstInstabilityability MeasuresMeasures ClarificationClarification onon Posture,Posture, SwaySway
StabilityStability // InstInstabilityability MeasuresMeasures
ClarificationClarification onon Posture,Posture, SwaySway andand BalanceBalance
When applied to the human body, a distinction is often
made between “posture”, “sway” and “balance”. The
following defines these three concepts:
PosturePosture is the relative alignment and orientation of
the segments of the bod y.
SwaySway is the oscillating movement of the body.
BalanceBalance 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.
StabilityStability // InstInstabilityability MeasuresMeasures Posture, Sway and Balance For example, when standing
StabilityStability // InstInstabilityability MeasuresMeasures
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 mid-
line between the feet and at level of the mid-tarsal (mid-foot).
GravityGravity
LineLine
AligAlignmennmentt
LineLine
CoFCoF optimaloptimal
plantarplantar locationlocation
Pressure Profile
MidMid--LineLine
MidMid
tarsaltarsal
StandingStanding onon IndividualIndividual FootFoot ExampleExample forfor thethe CoFCoF (( )) LocationLocation Left
StandingStanding onon IndividualIndividual FootFoot
ExampleExample forfor thethe CoFCoF ((
)) LocationLocation
Left
Right
WhatWhat areare thethe StabilityStability // InstabilityInstability Measures?Measures? Area of Sway for the CoF -
WhatWhat areare thethe StabilityStability //
InstabilityInstability Measures?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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WhatWhat isis EllipseEllipse ?? It is the elliptical region (area) in which the CoF traveled
WhatWhat isis EllipseEllipse ??
It is the elliptical region (area) in which the CoF
traveled (moved) during the event.
Posture misalignment
Treated
WhatWhat isis DisplacementDisplacement ?? It is the distance (excursion) traveled by the CoF during the
WhatWhat isis DisplacementDisplacement ??
It is the distance (excursion) traveled by
the CoF during the event, and the variability
in its displacement during the event.
Posture misalignment
Treated
WhatWhat isis DisplacementDisplacement PatternPattern ?? It is the graphic display of the manner in which
WhatWhat isis DisplacementDisplacement PatternPattern ??
It is the graphic display of the manner in
which the CoF traveled during the event.
Left-Right CoF Movement
Anterior-Posterior CoF Movement
Posture misalignment
Treated
WhatWhat isis BodyBody WeightWeight DistributionDistribution ?? It is the percent (%) of body weight bearing
WhatWhat isis BodyBody WeightWeight DistributionDistribution ??
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
InIn SummarySummary forfor ApplicationApplication Biomechanical measures from pressure mapping are tangible &
InIn SummarySummary forfor ApplicationApplication
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.
Following are some examples where pressure mapping and its related biomechanical parameters are applied.
Following are some examples
where pressure mapping and its
related biomechanical parameters
are applied.

5/24/2011

ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications

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ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ExampleExample ofof ApplicationsApplications
ofof ApplicationsApplications ExampleExample ofof ApplicationsApplications OutcomesOutcomes ofof thethe studystudy 7
OutcomesOutcomes ofof thethe studystudy
OutcomesOutcomes ofof thethe studystudy

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InIn ConclusionConclusion What is the “magical recipe” for successful biomechanical based performance assessments
InIn ConclusionConclusion
What is the “magical recipe” for successful
biomechanical based performance assessments and
treatments?
SkillSkill and ScienceScience
The SkillSkill resides in:
• Setting desired & expected biomechanical
outcomes.
• Preparing the training program and/or treatment
protocol such to meet the outcomes.
• Applying the training and treatment as such.
The SCIENCESCIENCE resides in:
• Measuring biomechanical (parameter) outcomes.
• Analyzing, interpreting and ensuring that the
biomechanical outcomes are met or achieved.

THANKTHANK YOU!YOU!