A real-time plantar pressure feedback device for foot unloading

Objective: To develop and test a plantar pressure control device that provides both visual and auditory feedback and is suitable for correcting plantar pressure distribution patterns in persons susceptible to neuropathic foot ulceration. Design: Pilot test. Setting: Sports medicine laboratory in a university in France. Participant: One healthy man in his mid thirties. Interventions: Not applicable. Main Outcome Measures: A device was developed based on real-time feedback, incorporating an acoustic alarm and visual signals, adjusted to a specific pressure load. Plantar pressure measured during walking, at 6 sensor locations over 27 steps under 2 different conditions: (1) natural and (2) unloaded in response to device feedback. Results: The subject was able to modify his gait in response to the auditory and visual signals. He did not compensate for the decrease of peak pressure under the first metarsal by increasing the duration of the load shift under this area. Gait pattern modification centered on a mediolateral load shift. Conculsions: The auditory signal provided a warning system alerting the user to potentially harmful plantar pressures. The visual signal warned of the degree of pressure. People who have lost nociceptive perception, as in cases of diabetic neuropathy, may be able to change their walking pattern in response to the feedback provided by this device. The visual may have diagnostic value in determining plantar pressures in such patients. This pilot test indicates that further studies are warranted. (C) 2004 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.