Antonio’s Recommended Reading, Research, & Review for Human Performance - Issue #17
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: Relationship Between Plantar Pressure Distribution & Sagittal Spine Curvatures Among Handball Players: A Cross-Sectional Study
Authors: Abdel-Aziem A. A., Ameer M. A., Al Abbad A. M., Mahdi M. A.
Journal: Hong Kong Physiotherapy Journal
Publication Year: 2025
Abstract
Background: Handball affects the spinal anterior–posterior curvatures and disturbs the foot plantar pressure, which provides insights into alterations in an individual’s posture. However, little is known about how the malalignment affects the distribution of plantar pressure.
Objective: To investigate the relationship between the thoracic kyphosis angle and plantar pressure distribution among handball players.
Methods: Sixty male handball players were distributed into two groups based on their thoracic kyphosis angles. Group A: 28 handball players with an angle greater than 44∘ (kyphotic group), and Group B: 32 handball players with an angle equal to or less than 44∘ (normal group). The Formetric III 4D spine and DIERS Pedoscan devices were used to measure the trunk anthropometry and plantar pressure distribution. The Pearson correlation test was used to explore the relationship between the kyphosis angle and plantar pressure distribution.
Results: Group A was significantly taller, had longer trunk length, greater lumbar lordosis angles, and forefoot plantar pressure (FPP), and less rearfoot plantar pressure (RPP) than group B (p<0.05). They showed a highly significant positive correlation between the thoracic kyphosis angle and FPP, and a highly significant negative correlation with the RPP (r=0.672, −0.650, respectively). There was no correlation between the lumbar lordosis angle and FPP or RPP (r=0.025, −0.045, respectively).
Conclusion: Handball players with greater thoracic kyphosis angle have greater lumbar lordosis angle. Increasing the thoracic kyphosis angle is strongly associated with increased FPP and decreased RPP. There is no relationship between the lumbar lordosis angle and FPP or RPP.
Why the Study is Relevant
The study aims to investigate the relationship between the thoracic kyphosis angle and plantar pressure distribution among handball players. This study is highly relevant as it explores the biomechanical link between spinal sagittal curvatures and plantar pressure distribution in athletes, specifically handball players - a population exposed to asymmetric loading. The study has a cross‑sectional design and a very good sample size (n=60). The equipment used for measurements was described in detail, and statistical analyses included independent t‑tests for group comparisons and Pearson correlation tests to examine associations, ensuring robust evaluation of anthropometric and biomechanical variables. No information about each player's status during measurement was provided (e.g., on a training day, a rest day, etc.).
Summary
Adult spinal deformities are a prevalent medical condition with a significant and measurable impact on health-related quality of life. Kyphosis, or the thoracic spine's convex curvature, is regarded as “normal" when it falls between 20° and 40°.
Handball, a sport characterized by unilateral loading, affects the anterior–posterior curvatures of the spine. The taller the players, the greater the thoracic kyphosis and the lesser lumbar lordosis than the normal non-athletic subjects. Variations in plantar pressure distribution may affect athletes' performance, and body anthropometry significantly influences playing skills.
The authors of this study tried to investigate the relationship between the thoracic kyphosis angle and plantar pressure distribution among handball players.
Key Takeaways
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Players with greater thoracic kyphosis angles were taller, heavier, and had longer trunk lengths, alongside increased lumbar lordosis.
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Excessive thoracic kyphosis shifts the load anteriorly, affecting plantar pressure distribution.
Read the full study.
Research Title: Gait Analysis Technologies for Evaluating Biomechanical Deviations: Insights From a Pilot Study on Healthy Athletes & Foot Deformities
Authors: Avramesci E. T., Amzolini A. M., Bumbea A. M., Patru S., Traistaru M. R., Neagoe C. D., Ionescu G., Munteanu C., Matei D.
Journal: Balneo & PRM Research Journal
Publication Year: 2025
Abstract
Gait analysis is an essential tool for assessing musculoskeletal function and identifying biomechanical abnormalities. This study aimed to establish normative reference values for gait parameters in young, physically active individuals and to identify deviations associated with foot deformities.
Methods: A cross-sectional observational study was conducted on 102 healthy young adults engaged in performance sports. Gait parameters were recorded using the RSscan plantar pressure distribution platform. Outlier identification methods were applied to exclude 12 participants with significant deviations, resulting in a final sample of 90 subjects. Descriptive statistics and comparative analyses were used to evaluate maximum force, impulse, load rate, and contact area across ten anatomical foot regions.
Results: The final normative dataset established baseline values for plantar pressure distribution and biomechanical force dynamics. Among excluded participants, 33% exhibited pes planus (flatfoot), and one case presented pes cavus (high arch), both associated with altered pressure distributions and deviations in temporal gait parameters. Statistical comparisons confirmed significant variations in foot loading patterns and pressure maps (p<0.05).
Conclusions: This study provides a comprehensive reference for gait parameters in young, healthy adults and highlights the clinical relevance of individualized gait assessments. The findings underscore the utility of plantar pressure analysis for early detection of biomechanical abnormalities that could contribute to musculoskeletal dysfunction. These insights can aid in optimizing rehabilitation strategies, sports performance assessments, and orthopedic interventions.
Clinical Implications: The results emphasize the need for targeted interventions in individuals with foot deformities to prevent long-term functional impairments. Future research should explore the longitudinal implications of biomechanical deviations in active populations.
Why the Study is Relevant
The study aims to investigate plantar pressure distribution and force dynamics in a young, athletic population. It’s a pilot study, and it’s relevant because it establishes normative gait parameters in young athletes and highlights deviations linked to foot deformities. The design is a cross-sectional observational study, with a sample of 102 participants initially assessed and 90 for final analysis. However, there is no detailed description of the participants' fitness levels or the types of sport they practiced. Also, the measurement device lacks important information about the hardware (resolution, sampling frequency, sensor type) and software capabilities.
Statistical analyses included descriptive statistics, outlier identification, and comparative tests, ensuring reliable normative datasets for clinical and sports applications.
Summary
Walking is not only fundamental to human movement but also reflects an individual’s personality and physical state. While normal gait exhibits common patterns across individuals, subtle individual-specific variations are always present, making each person’s walking pattern unique. The study of gait alignment and 3D kinematics of the lower limb, as well as plantar pressure measurement, has revealed that improper movement execution is one of the most common and significant risk factors for dysfunction.
The authors of this study hypothesized that 1) healthy athletes will exhibit distinct plantar pressure distributions compared to previously reported general population data and 2) individuals with foot deformities will demonstrate significant deviations in force application, load symmetry, and pressure patterns.
Key Takeaways
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Plantar pressure analysis is a valuable tool for early detection of abnormalities, supporting rehabilitation, performance optimization, and orthopedic interventions.
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Plantar pressure analysis can detect subtle biomechanical deviations, even in the absence of observable gait alterations or clinical symptoms.
Read the full study.
Research Title: Bilateral Asymmetries of Plantar Pressure & Foot Balance During Walking, Running, & Turning Gait in Typically Developing Children
Authors: Liu W., Xu L., Wu H., Wang Y., Jiang H., Gao Z., Janosi E., Fekete G., Mei Q., Gu Y.
Journal: Bioengineering
Publication Year: 2025
Abstract
Biomechanical asymmetries between children's left and right feet can affect stability and coordination, especially during dynamic movements. This study aimed to examine plantar pressure distribution, foot balance, and center of pressure (COP) trajectories in children during walking, running, and turning activities to understand how different movements influence these asymmetries. Fifteen children participated in the study, using a FootScan plantar pressure plate to capture detailed pressure and balance data. The parameters, including time-varying forces, COP, and the Foot Balance Index (FBI), were analyzed using the one-dimensional Statistical Parametric Mapping (SPM1d) package. Results showed that asymmetries in COP and FBI became more pronounced, particularly during running and directional turns. Regional plantar pressure analysis also revealed greater load on specific foot areas during these dynamic movements, indicating increased reliance on one foot for stability and control. These findings suggest that early identification of asymmetrical loading patterns may be vital in promoting a balanced gait and preventing potential foot health issues in children. This study contributes to understanding pediatric foot biomechanics and provides insights for developing targeted interventions to support healthy physical development in children.
Why the Study is Relevant
The study aims to explore differences in loading and COP between the left and right feet during four maneuvers: walking, walking turn, running, and running turn. This study is relevant because it investigates the biomechanical impact of foot posture on gait and musculoskeletal health in children. The study used a cross-sectional design to establish normative values and detect deviations, and the equipment used and the testing protocols were described in detail. However, the sample size is small (n=15).
Summary
The foot is one of the most significant bodily elements and an essential component of locomotion. The muscles, ligaments, and tendons associated with the foot bones are essential for maintaining overall form and ensuring function under both static and dynamic conditions. Differences in foot structure are associated with differences in foot function during static postures or dynamic movements. The foot of children develops rapidly between the ages of 7 and 12, and it has been reported that male arch height increases between ages 6 and 13, and female arch height increases between ages 8 and 13. During walking and running, the arches of different morphologies and structures also alter plantar pressure and load. The authors of this study sought to examine differences in loading and COP between the left and right feet during completion of different walking and running tasks.
Key Takeaways
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Children may rely more heavily on either foot for stability and control, which becomes the dominant limb, as reflected in the center of pressure (COP), Foot Balance Index (FBI), and regional plantar pressure distributions.
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Plantar pressure analysis is a valuable tool for the early detection of abnormalities.