Search Results (60)

Falls are a major safety concern in physically demanding occupations such as roofing, where workers operate on inclined surfaces under unstable postures. While inertial measurement units (IMUs) are widely used in wearable fall detection systems, they often fail to capture early indicators of instability related to foot–ground interactions. This study evaluates the effectiveness of plantar pressure sensors, alone and combined with IMUs, for fall detection on sloped surfaces. We collected data in a controlled laboratory environment using a custom-built roof mockup with incline angles of 0°, 15°, and 30°. Participants performed roofing-relevant activities, including standing, walking, stooping, kneeling, and simulated fall events. Statistical features were extracted from synchronized IMU and plantar pressure data, and multiple machine learning models were trained and evaluated, including traditional classifiers and deep learning architectures, such as MLP and CNN. Our results show that integrating plantar pressure sensors significantly improves fall detection. A CNN using just three IMUs and two plantar pressure sensors achieved the highest F1 score of 0.88, outperforming the full 17-sensor IMU setup. These findings support the use of multimodal sensor fusion for developing efficient and accurate wearable systems for fall detection and physical health monitoring. Full article

Diabetic foot ulcers (DFUs) represent a critical global health issue, necessitating the development of advanced smart, flexible, and wearable sensors for continuous monitoring that are reimbursable within foot orthotics. This study presents the design and characterization of a pressure sensor implemented into a shoe insole to monitor diabetic wound pressures, emphasizing the need for a high sensitivity, durability under cyclic mechanical loading, and a rapid response time. This investigation focuses on the electrical and mechanical properties of carbon nanotube (CNT) composites utilizing Ecoflex and polydimethylsiloxane (PDMS). Morphological characterization was conducted using Transmission Electron Microscopy (TEM), Laser Confocal Microscopy, and Scanning Electron Microscopy (SEM). The electrical and mechanical properties of the CNT/Ecoflex- and the CNT/PDMS-based sensor composites were then investigated. CNT/Ecoflex was then further evaluated due to its lower variability performance between cycles at the same pressure, as well as its consistently higher capacitance values across all trials in comparison to CNT/PDMS. The CNT/Ecoflex composite sensor showed a high sensitivity (2.38 to 3.40 kPa⁻¹) over a pressure sensing range of 0 to 68.95 kPa. The sensor’s stability was further assessed under applied pressures simulating human weight. A custom insole prototype, incorporating 12 CNT/Ecoflex elastomeric matrix-based sensors (as an example) distributed across the metatarsal heads, midfoot, and heel regions, was developed and characterized. Capacitance measurements, ranging from 0.25 pF to 60 pF, were obtained across N = 3 feasibility trials, demonstrating the sensor’s response to varying pressure conditions linked to different body weights. These results highlight the potential of this flexible insole prototype for precise and real-time plantar surface monitoring, offering an approachable avenue for a challenging diabetic orthotics application. Full article

Background: Charcot-Marie-Tooth (CMT) disease is a hereditary motor and sensory neuropathy that affects foot morphology and gait patterns, potentially leading to abnormal plantar pressure distribution. This systematic review synthesizes the existing literature examining plantar pressure characteristics in CMT patients. Methods: A comprehensive search was conducted across PubMed, Scopus, and Web of Science databases. Risk of bias was assessed using the Newcastle–Ottawa Scale. Results: Six studies comprising 146 patients were included. Four studies employed dynamic baropodometry, and two used in-shoe pressure sensors to evaluate the main plantar pressure parameters. The findings were consistent across different populations and devices, with a characteristic plantar-pressure profile of marked midfoot off-loading with peripheral overload at the forefoot and rearfoot, often accompanied by a lateralized center-of-pressure path and a prolonged pressure–time exposure. These alterations reflect both structural deformities and impaired neuromuscular control. Interventional studies demonstrated a load redistribution of pressure after corrective surgery, though residual lateral overload often persists. Conclusions: Plantar pressure mapping seems to be a valuable tool to identify high-pressure zones of the foot in order to personalize orthotic treatment planning, to objectively monitor disease progression, and to evaluate therapeutic efficacy. Further longitudinal studies with standardized protocols are needed to confirm these results. Full article

Plantar pressure monitoring is decisive in injury prevention, especially in at-risk populations such as people with diabetic foot. In this context, innovative solutions such as pneumatic insoles can be essential in plantar pressure management. This study describes the development of a variable pressure system that promotes the monitoring, stabilization, and offloading of plantar pressure through a pneumatic insole. This research was also intended to evaluate its ability to redistribute plantar pressure, reduce peak pressure in both static and dynamic conditions, and validate its pressure measurements by comparing the results with those obtained from a pedar^® insole. Tests were carried out under both static and dynamic conditions, before and after the pressure stabilization process by air cells and the subsequent pressure offloading. During the validation process, methods were used to evaluate the agreement between measurements obtained by the two systems. The results of the static test showed that pressure stabilization reduced pressure on the heel by 32.43%, distributing it to the metatarsals and toes. After heel pressure offloading, the reduction reached 42.72%. In the dynamic test, despite natural dispersion of the measurements, a trend to reduce the peak pressure in the heel, metatarsals, and toes was observed. Agreement analysis recorded 96.32% in the static test and 94.02% in the dynamic test. The pneumatic insole proved effective in redistributing and reducing plantar pressure, with more evident effects in the static test. Its agreement with the pedar^® system reinforces its reliability as a tool for measuring and managing plantar pressure, representing a promising solution for preventing plantar lesions. Full article

Football players, particularly in youth leagues, face a high risk of lower limb injuries due to improper movement patterns. While programs like FIFA 11+ help reduce injuries, they lack real-time, personalized feedback for biomechanical correction. This concept protocol outlines the development of a DAid^® smart socks-based biofeedback system that integrates biomechanical monitoring with mixed reality (MR) feedback to enhance injury prevention. The DAid^® smart socks, equipped with pressure sensors and inertial measurement units (IMUs), track plantar pressure distribution and the center of pressure (COP). Real-time feedback is delivered via a Meta Quest 3 MR headset, enabling athletes to adjust movement patterns instantly. This protocol establishes a framework for evaluating the system’s feasibility and effectiveness in optimizing biomechanics and reducing injury risks. By combining wearable technology with MR-based feedback, this study advances injury prevention strategies, with potential applications in rehabilitation and performance training. Full article

Background/Objectives: Gait retraining is widely used in orthopedic rehabilitation to address abnormal movement patterns. However, retaining walking modifications can be challenging without guidance from physical therapists. Real-time auditory biofeedback can help patients learn and maintain gait alterations. This study piloted the feasibility of the musification of feedback to medialize the center of pressure (COP). Methods: To provide musical feedback, COP and plantar pressure were captured in real time at 100 Hz from a wireless 16-sensor pressure insole. Twenty healthy subjects (29 ± 5 years old, 75.9 ± 10.5 Kg, 1.73 ± 0.07 m) were recruited to walk using this system and were further analyzed via marker-based motion capture. A lowpass filter muffled a pre-selected music playlist when the real-time center of pressure exceeded a predetermined lateral threshold. The only instruction participants received was to adjust their walking to avoid the muffling of the music. Results: All participants significantly medialized their COP (−9.38% ± 4.37, range −2.3% to −19%), guided solely by musical feedback. Participants were still able to reproduce this new walking pattern when the musical feedback was removed. Importantly, no significant changes in cadence or walking speed were observed. The results from a survey showed that subjects enjoyed using the system and suggested that they would adopt such a system for rehabilitation. Conclusions: This study highlights the potential of musical feedback for orthopedic rehabilitation. In the future, a portable system will allow patients to train at home, while clinicians could track their progress remotely through cloud-enabled telemetric health data monitoring. Full article

Flexible pressure sensors are increasingly recognized for their potential use in wearable electronic devices, attributed to their sensitivity and broad pressure response range. Introducing surface microstructures can notably enhance sensitivity; however, the pressure response range remains constrained by the limited volume of the compressible structure. To overcome this limitation, this study implements an aligned airgap structure fabricated using 3D printing technology. This structure, designed with a precisely aligned triaxial airgap configuration, offers high deformability under pressure, substantially broadening the pressure response range and improving sensitivity. This study analyzes the key structural parameters—the number of axes and pore size—that influence the compressibility and stability of the dielectric material. The results indicate that the capacitive pressure sensor with an aligned airgap structure, manufactured via 3D printing, exhibits a wide operating pressure range (50 Pa to 500 kPa), rapid response time (100 ms), wide limit of detection (50 Pa), and approximately 21 times enhancement in sensitivity (~0.019 kPa⁻¹ within 100 kPa) compared with conventional bulk structures. Furthermore, foot pressure monitoring trials for wearable sensor applications demonstrated exceptional performance, indicating the sensor’s suitability as a wearable device for detecting plantar pressure. These findings advocate for the potential of 3D printing technology to supplant traditional sensor manufacturing processes. Full article

The prevention of diabetic foot ulcers remains a critical challenge. This study evaluates a smart compression sock designed to address this issue by integrating temperature, plantar pressure, and blood oxygen sensors and monitoring data recorded by these sensors. The smart sock, developed with input from a certified Pedorthist, was tested on 20 healthy adult participants aged 16 to 53. It includes four temperature sensors and pressure sensors at common ulcer sites (first and fifth metatarsal heads, calcaneus, and hallux), and a blood oxygen sensor on the hallux. The sensors are monitored, and their transduced data are collected and stored through an app installed on a personal cell phone. The mobile app interface is user-friendly, providing intuitive navigation and easy access to the sensors’ data. Using repeated measures ANOVA and post hoc tests, we analyzed the impact of various physical activities on physiological changes in the foot. The device effectively detected significant variations in blood oxygen, temperature, and pressure across six activities. Statistical analyses revealed significant differences based on activity type and sensor location. These results highlight the smart sock’s sensitivity and accuracy, suggesting its potential to prevent diabetic foot ulcers. Further clinical trials are needed to evaluate its efficacy in a larger, more diverse population. Full article

In recent years, flexible pressure sensors have garnered significant attention. However, the development of large-area, low-cost, and easily fabricated flexible pressure sensors remains challenging. We designed a flexible fiber optic pressure sensor for contact force detection based on the principle of backward Rayleigh scattering using a single-mode optical fiber as the sensing element and polymer PDMS as the encapsulation material. To enhance the sensor’s sensitivity and stability, we optimized its structural design, parameters, and fabrication process and measured the fiber strain using an optical frequency domain reflectometer (OFDR). The results showed that the sensor achieved a high sensitivity of 6.93247 με/kPa with a PDMS concentration ratio of 10:1, a curing time of 2 h, and a substrate thickness of 5 mm. The sensor demonstrated excellent linearity and repeatability in static performance tests and was successfully used to monitor the plantar pressure distribution in real time. This flexible fiber optic pressure sensor can be developed via a simple fabrication process, has a low cost, and has high sensitivity, highlighting its potential applications in smart wearables and medical diagnostics. Full article

One of the most significant complications of diabetes mellitus is diabetic sensory neuropathy. A reduction in pain perception increases the risk of diabetic patients developing foot ulcers and requiring amputation, which in turn results in impaired mobility and a diminished quality of life. Despite recent advances in our understanding of the aetiology of diabetic foot ulcers (DFUs), there remains a significant gap in the clinical prevention and management of these ulcers. Given that inflammation represents the initial stage in the formation of skin wounds, the utilisation of infrared thermography for the early detection of inflammatory tissue, the analysis of plantar pressures and the monitoring of controlled physical activity (PA) may facilitate the close observation of plantar skin alterations that are susceptible to the development of DFUs, thereby enabling the implementation of timely interventions such as personalised PA for these patients. It is recommended that an integrated approach be adopted which encompasses the utilisation of all emerging technologies in order to enhance outcomes in the prevention and management of DFUs. The aim of this study is to examine the existing literature on the relationship between temperature, pressure and physical activity in the diabetic foot. To this end, a systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format across the PubMed, Scopus and Web of Science databases, with no temporal restriction. A total of 14 studies were included in the review. The use of infrared thermography for the early detection of inflammatory tissue, plantar pressures and the monitoring of controlled PA can facilitate the close monitoring of changes that may pose a risk for the formation of UFDs and provide timely intervention, thereby personalising the PA of the diabetic patient. Full article

Sarcopenia is an age-related syndrome characterized by the loss of skeletal muscle mass and function. Community screening, commonly used in early diagnosis, usually lacks features such as real-time monitoring, low cost, and convenience. This study introduces a promising approach to sarcopenia screening by dynamic plantar pressure monitoring. We propose a wearable flexible-printed piezoelectric sensing array incorporating barium titanate thin films. Utilizing a flexible printer, we fabricate the array with enhanced compressive strength and measurement range. Signal conversion circuits convert charge signals of the sensors into voltage signals, which are transmitted to a mobile phone via Bluetooth after processing. Through cyclic loading, we obtain the average voltage sensitivity (4.844 mV/kPa) of the sensing array. During a 6 m walk, the dynamic plantar pressure features of 51 recruited participants are extracted, including peak pressures for both sarcopenic and control participants before and after weight calibration. Statistical analysis discerns feature significance between groups, and five machine learning models are employed to screen for sarcopenia with the collected features. The results show that the features of dynamic plantar pressure have great potential in early screening of sarcopenia, and the Support Vector Machine model after feature selection achieves a high accuracy of 93.65%. By combining wearable sensors with machine learning techniques, this study aims to provide more convenient and effective sarcopenia screening methods for the elderly. Full article

Introduction: Diabetic foot ulcers (DFU) are a devastating complication of diabetes. There are numerous challenges with preventing diabetic foot complications and barriers to achieving the care processes suggested in established foot care guidelines. Multi-faceted digital health solutions, which combine multimodal sensing, patient-facing biofeedback, and remote patient monitoring (RPM), show promise in improving our ability to understand, prevent, and manage DFUs. Methods: Patients with a history of diabetic plantar foot ulcers were enrolled in a prospective cohort study and equipped with custom sensory insoles to track plantar pressure, plantar temperature, step count, and adherence data. Sensory insole data enabled patient-facing biofeedback to cue active plantar offloading in response to sustained high plantar pressures, and RPM assessments in response to data trends of concern in plantar pressure, plantar temperature, or sensory insole adherence. Three non-consecutive case participants that ultimately presented with pre-ulcerative lesions (a callus and/or erythematous area on the plantar surface of the foot) during the study were selected for this case series. Results: Across three illustrative patients, continuous plantar pressure monitoring demonstrated promise for empowering both the patient and provider with information for data-driven management of pressure offloading treatments. Conclusion: Multi-faceted digital health solutions can naturally enable and reinforce the integrative foot care guidelines. Multi-modal sensing across multiple physiologic domains supports the monitoring of foot health at various stages along the DFU pathogenesis pathway. Furthermore, digital health solutions equipped with remote patient monitoring unlock new opportunities for personalizing treatments, providing periodic self-care reinforcement, and encouraging patient engagement—key tools for improving patient adherence to their diabetic foot care plan. Full article

We aimed to assess the success rate and facilitators of and the barriers to the implementation of in-shoe plantar pressure measurements in footwear practice for people with diabetes at high risk of foot ulceration. Eleven Dutch footwear practices were partly supported in purchasing a pressure measurement system. Over a 2.5-year period, trained shoe technicians evaluated 1030 people with diabetes (range: 13 to 156 across practices). The implementation success and associated facilitators and barriers were evaluated quantitatively using completed measurement forms and pressure measurement data obtained during four monitoring sessions and qualitatively through semi-structured interviews with technicians. Across the 11 practices, the primary target group (people with diabetes and a healed plantar foot ulcer) represented 25–90% of all the patients measured. The results showed that three practices were successful, five moderately successful, and three not successful. The facilitators included support by the company management board, collaboration with a prescribing physician, measurement sessions separate from the outpatient clinic, and a (dedicated) shoe technician experiencing a learning effect. The barriers included investment costs, usability aspects, and limited awareness among shoe technicians. In-shoe plantar pressure measurements can be implemented to a moderate to large degree in diabetic footwear practice. The barriers to and facilitators of implementation are organizational, logistical, financial, or technical, and the barriers are modifiable, supporting future implementation. Full article

Background: Total ankle arthroplasty (TAA) has grown in popularity and indications, with encouraging results over time. Today, preoperative and postoperative evaluations are mainly performed using clinical test and diagnostic imaging, but there is a deficiency in objectively evaluating the biomechanics of the foot and ankle, which serve as the functional markers for monitoring the effectiveness and outcomes of surgery. Inertial measurement units associated with plantar pressure measurements may provide an accurate and reliable method of evaluating function through the analysis of gait and ankle joint mobility. The aim of this study was to introduce an innovative technology, to assess its accuracy and feasibility compared to standard clinical assessment methods and to objectify kinematic outcomes in patients with end-stage ankle OA before and after TAA surgery. Methods: A consecutive series of eight patients with symptomatic end-stage osteoarthritis and treated with TAA was prospectively evaluated using clinical scores (AOFAS, MOxFQ, VAS, SF-36, 17-IFFI), physical tests (FPI, ALT), plantar pressure measurements with FLEX EPS/R2 Letsense^® baropodometric platform, gait analysis and wearable sensors-based ankle motion and kinematic outcomes using Wiva Science inertial sensors by Letsense^®. Data were collected preoperatively and 4 months after surgery. Results: All PROMs exhibited statistical significance in improvement from pre- to postoperative periods, except for one. Physical examinations showed no significant changes of the foot shape and alignment. Plantar pressure analyses revealed no significant changes in static and dynamic evaluations, but a more uniform distribution of plantar pressure was observed between the two periods. Inertial sensor parameters demonstrated no significant differences, except for a significant reduction in stride length and step length for the operated foot after surgery. Conclusions: Gait analysis using inertial sensors and plantar pressure measurements offer ease of handling, cost effectiveness, portability and swift data reading, making them highly appealing for widespread clinical use. Integrating these tools into the routine assessments of patients with TAA holds promise for advancing precision of treating this condition and our depth of its understanding, contributing to more comprehensive and insightful patient care. Full article

Plantar pressure plays a crucial role in the pathogenesis of foot ulcers among patients with diabetes and peripheral polyneuropathy. Pressure relief is a key requirement for both the prevention and treatment of plantar ulcers. Conventional medical practice to enable such an action is usually realized by means of dedicated insoles and special footwear. Another technique for foot pressure offloading (not in medical practice) can be achieved by sensing/estimating the current state (pressure) and, accordingly, enabling a pressure release mechanism once a defined threshold is reached. Though these mechanisms can make plantar pressure monitoring and release possible, overall, they make shoes bulkier, power-dependent, and expensive. In this work, we present a passive and self-offloading alternative to keep plantar pressure within a defined safe limit. Our approach is based on the use of a permanent magnet, taking advantage of its non-linear field reduction with distance. The proposed solution is free from electronics and is a low-cost alternative for smart shoe development. The overall size of the device is 13 mm in diameter and 30 mm in height. The device allows more than 20-times the tunability of the threshold pressure limit, which makes it possible to pre-set the limit as low as 38 kPa and as high as 778 kPa, leading to tunability within a wide range. Being a passive, reliable, and low-cost alternative, the proposed solution could be useful in smart shoe development to prevent foot ulcer development. The proposed device provides an alternative for offloading plantar pressure that is free from the power feeding requirement. The presented study provides preliminary results for the development of a complete offloading shoe that could be useful for the prevention/care of foot ulcers among diabetic patients. Full article