In-shoe plantar pressure measurements for patients with knee osteoarthritis: Reliability and effects of lateral heel wedges

Gait Posture. 2011 Jul;34(3):391-6. doi: 10.1016/j.gaitpost.2011.06.008. Epub 2011 Jul 7.


Although plantar pressure measurement systems are being used increasingly during gait analyses to investigate foot orthotics, there is limited information describing test-retest reliability of such measurements. Objectives of this study were to (1) examine the test-retest reliability of lateral heel pressure (LHP) and centre of pressure (COP) during walking with and without lateral heel wedges, and (2) evaluate the effects of 4° and 8° lateral heel wedges on the magnitude of LHP, the pathway of the COP and the peak external knee adduction moment (KAM) in subjects with and without knee osteoarthritis (OA). Twenty-six subjects, 12 patients with knee OA and 14 healthy subjects, were evaluated during three lateral heel wedge conditions (control, 4° and 8°) with standardized footwear. Three-dimensional analyses of gait with optical motion capture, floor-mounted force plate and in-shoe plantar pressure were completed on two occasions. Intraclass correlation coefficients (ICC(2, 1)) for LHP were excellent (0.79-0.83) while ICCs for COP in the medial-lateral and anterior-posterior directions were more variable (0.66-0.86). Reliability was slightly diminished when using heel wedges. Standard errors of measurement suggested considerable day-to-day variability in an individual's measures. Lateral heel wedges significantly (p<0.001) increased LHP, shifted COP anteriorly and laterally, and decreased the KAM. No significant differences were observed between subjects with and without OA. Although the day-to-day variability appears too large to confidently evaluate changes in individual patients, and decreases in reliability with increases in wedge size indicate caution, these results suggest in-shoe measurement of LHP and COP are appropriate for use in studies evaluating biomechanical effects of foot orthoses for knee OA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Case-Control Studies
  • Female
  • Foot / physiology*
  • Humans
  • Male
  • Middle Aged
  • Orthotic Devices*
  • Osteoarthritis, Knee / physiopathology*
  • Pressure*
  • Reproducibility of Results
  • Shoes
  • Walking / physiology