Antonio’s Recommended Reading, Research, & Review for Human Performance - Issue #14 | May 2025

XSENSOR's Sports Performance Science Contributor, Antonio Robustelli, MSc, CSCS (Sports Performance Scientist & Technologist with OmniAthlete Performance Concept), offers his take on essential and recommended reading, research, and review for plantar pressure applications using gait analysis for athletes.

Be sure to tune in to get the abstracts, summaries, and key takeaways, or read the complete studies.

Research Title: An Overview of Plantar Pressure Distribution Measurements & Its Applications in Health & Medicine

Authors: Arzehgar A, Nia RG, Hoseinkhani M, Masoumi F, Sayyed-Hosseinian SH, Eslami S.

Journal: Gait & Posture

Publication Year: 2025

Abstract

Background: Measuring plantar pressure distribution is critical for understanding foot-ground interactions, providing valuable insights for diagnosing and managing various health conditions. Since its initial studies in 1984, this field has garnered increasing attention within healthcare and medicine due to its broad applications across clinical settings.

Research Question: How does measuring plantar pressure distribution affect healthcare outcomes across different age groups and health conditions

Methods: This review thoroughly explores the literature concerning plantar pressure distribution, focusing on studies conducted from 1984 onwards. It investigates the methodologies and clinical applications associated with plantar pressure measurement, tracing the evolution of research and practice in this field.

Results: The review identifies and classifies key methods used to measure plantar pressure distribution, emphasizing their application in clinical and research contexts. It highlights the considerable influence these measurements have on the diagnosis and management of various health conditions across all age groups and demonstrates the practical benefits of plantar pressure analysis in improving diagnostic accuracy and informing more tailored treatment plans.

Significance: Understanding plantar pressure distribution is crucial for advancing healthcare practices, particularly in diagnostic and therapeutic interventions. This review underscores the clinical importance of plantar pressure measurement, illustrating its value in improving patient outcomes and contributing to broader medical research. The findings aim to assist healthcare professionals, researchers, and clinicians in effectively leveraging plantar pressure data to optimize healthcare delivery and patient care.

Why the Study is Relevant

The study aims to review the use of foot pressure distribution data from sensors for medical and health-related purposes.

The review included 565 papers that met the inclusion criteria. The study population involved measuring plantar pressure distribution on living humans of different ages. Sixty-six articles are related to sporting activities and have been categorized based on the specific sports they investigated.

This review aims to elucidate key factors essential for understanding the current landscape of plantar pressure measurement and its various applications.

Furthermore, it sought to be comprehensive by covering different applications, age groups, and health conditions. However, the heterogeneity of available methods may have inadvertently led to the omission of specific studies.

Summary

In biomechanical assessment, plantar pressure mapping technology, whether dynamic or static, can provide valuable insights from anatomical, physiological, functional, and pathological perspectives. Combined with other sources of information, these multifactorial datasets can contribute to comprehensive diagnostic and monitoring systems, offering deep insights into an individual's health and performance status. The range of applications spans medical and sports-related domains and covers different age groups.

The authors of this review study tried to investigate and recognize the different analytical methods and applications of plantar pressure mapping measurements within the medical field.

Key Takeaways

• The integration of advanced electronic tools, coupled with advances in data processing and artificial intelligence, has significantly enhanced the effectiveness of plantar pressure measurements in healthcare practices.

• Plantar pressure data holds great promise for health monitoring.

• Plantar pressure mapping can play a pivotal role in clinical and non-clinical health applications, supporting advancements in personalized care and broader healthcare management systems.

Read the full study.

Research Title: Correlation Between Body Composition Variables, Plantar Pressure & Pain Level

Authors: Dikhtyarenko S, Forte P, Esteves D.

Journal: Acta of Bioengineering & Biomechanics

Publication Year: 2025

Abstract

From a current perspective, it is understood that body posture is influenced by individual asymmetries, cultural context, habitual body patterns, etiological factors, and psychosocial factors allocated to the individual. Clarifying the musculoskeletal cause that originated the postural alteration is considered the clinical challenge in the treatment of pain or discomfort. Recent studies have shown the influence of changes in body weight on the distribution of plantar pressure and foot pain, emphasizing the importance of understanding these relationships. Integrating body composition with plantar pressure analysis presents an opportunity to explore gender differences and their associations with plantar pressure distribution. There is currently a lack of research integrating body composition, plantar pressure distribution, and gender comparison to elucidate the complex interaction between these variables. Therefore, the main objective of this investigation is to evaluate body composition through BIA (bioimpedance) and the distribution of plantar pressure in the subjects' feet through pressure platform analysis with a specific focus on comparisons between the genders and the associations between these variables. The study employed an observational cross-sectional design. A total of 77 participants (n=77) aged between 18 and 91 years were assessed, the majority of whom were female (n=53, 68.83%), while 24 participants (n=24, 31.17%) were male. The average age of the participants was 60.717 years for males and 54.33 years for females. Baropodometry and bioimpedance tests were carried out. Significant differences with a medium effect were recorded only for the three indicators. At the same time, the rest of the values showed a large effect. Significant negative correlations were found between age and height (p<0.05) and positive correlations between age and other factors such as BMI, fat mass, lean mass, and various foot-related metrics. The results of this study showed that plantar pressure characteristics differ according to gender and are related to body composition and pain level.

Why the Study is Relevant

The study aims to assess body composition using BIA and plantar pressure distribution in subjects' feet through pressure plate analysis, with a specific focus on gender comparisons and the associations between these variables.

The study has an observational cross-sectional design and an acceptable sample size (n=77) involving both sexes.

However, the study is not experimental and does not look at any change in variables after an intervention.

Furthermore, neither protocols for body composition assessment nor plantar pressure mapping were correctly explained.

Summary

Assessing body composition and plantar pressure distribution is crucial to understanding the physiological and biomechanical aspects of human health.

The integration of body composition with plantar pressure analysis presents an opportunity to explore gender differences and their associations with plantar pressure distribution. This comprehensive approach can provide valuable insights into the interplay between body composition, foot biomechanics, and gender-specific differences.

The authors of this study tried to investigate the hypothesis that plantar pressure characteristics differ by gender and are related to body composition and pain level.

Key Takeaways

• It is important to consider gender-related differences in foot characteristics and body composition when assessing foot function and plantar pressure distribution.

• Positive correlations were noted between age and other factors such as BMI, fat mass, lean mass, and various foot-related metrics.

• BMI displayed associations with fat mass, lean mass, water percentage (H2O%), pain levels, and various foot-related measurements.

Read the full study.

Research Title: The Effect of Weight Distribution in the Foot on Balance & Plantar Pressure in Female Adolescent Athletes

Authors: Cerezci-Duygu S, Sarak-Kucukosmanoglu H, Aytar A.

Journal: Sports Health

Publication Year: 2024

Abstract

Background: It is widely reported that the weight distribution in each foot is approximately 60% in the rearfoot and 40% in the forefoot. Transferring some weight to the forefoot is recommended for balance training. However, whether the fore-rear foot weight-bearing ratio affects balance and plantar pressure parameters is still unclear.

Hypothesis: There is a relationship between the forefoot weight-bearing ratio and balance and plantar pressure in female adolescent athletes.

Methods: A total of 91 adolescent female athletes aged between 10 and 19 years were included in the study. Weightbearing ratios of the forefoot, balance, and plantar pressure were assessed using a plantar pressure platform (FootWork, AMCube IST). In the static and stabilometric evaluation, the weight-bearing ratio (%), mean and maximum plantar pressure (kPa), center of pressure (CoP) total, anteroposterior and mediolateral sway length (cm), CoP surface area (cm2), and length over the area (cm-1) were recorded. The dynamic evaluation recorded the kPa acting on each foot.

Results: Two groups with forefoot weight-bearing ratios <40% and ≥40% were compared. Maximum pressure values in static conditions, CoP anteroposterior, and total sway length were significantly different between these groups. In addition, as the amount of load transferred to the forefoot increased, CoP total and anteroposterior sway length increased postural stability.

Conclusion: Although postural control mechanisms are complex, plantar pressure and postural control parameters can be varied by optimizing rear-to-fore foot weight transfer.

Clinical Relevance: This study will contribute to the development of appropriate training and rehabilitation strategies to optimize athlete performance and reduce injury risk.

Why the Study is Relevant

The study aims to examine the effect of increased forefoot loading on balance and plantar pressure in adolescent athletes.

The study has a cross-sectional design and has a very good sample size (n=91) involving female adolescent athletes in different sports.

The measurement protocols do not satisfy the requirements for stabilometry analysis, as they do not mention the surrounding environment, which is a factor that may negatively affect the reliability and validity of measurements.

Furthermore, the research question does not consider the complexity of the interrelated mechanisms underlying postural control and stability.

Summary

In the postural system, the foot provides balance by being exposed to varying loads in static and dynamic conditions to ensure a safe posture. The foot offers a symmetrical load distribution to the lower extremities with sensory, vestibular, visual, and motor functions. It ensures that balance can be maintained according to changing conditions and prevents falls.

The authors of this study investigated the types of strategies that can be used to increase balance and postural stability in adolescents.

Key Takeaways

• It is possible to change plantar pressure and postural control parameters by optimizing the weight-bearing ratio of the fore-rear foot.

Read the full study.