Reproducibility and agreement between different protocols of dynamic baropodometry during gait: a preliminary study

Rogerio, Fernando Raphael Pinto Guedes; Guedes, Dartagnan Pinto

doi:10.1590/1809-2950/17018227042020

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ORIGINAL RESEARCH • Fisioter. Pesqui. 27 (4) • Oct-Dec 2020 • https://doi.org/10.1590/1809-2950/17018227042020 copy

Reproducibility and agreement between different protocols of dynamic baropodometry during gait: a preliminary study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The identification of plantar pressure during gait is used by clinicians and researchers to verify burden on the plantar structure. In this study, different protocols have been employed for this purpose. The aim of this study was to verify the reproducibility and agreement of shortened gait protocols to identify dynamic plantar pressure in asymptomatic young people. Fifteen volunteers were submitted to the shortened one-step and three-step protocols and to the standard midgait protocol in three moments: initial, after one day and after seven days. For each of the eight foot masks, the measurements of peak plantar pressure and pressure-time integral were considered. Reproducibility was analyzed by one-way Anova test and intraclass correlation coefficient, while the agreement between the protocols was verified through paired t-test, Pearson’s moment-product correlation and Bland-Altman plot. The results showed that the three-step protocol presented higher reproducibility in both measurements of dynamic plantar pressure. Regarding the agreement between protocols, although the shortened ones showed a tendency to underestimate the standard midgait measurements, most foot masks showed no statistical differences between mean scores. Furthermore, through the Bland-Altman technique, there was substantial agreement capacity between the one-step, three-step and midgait protocols measurements. In conclusion, the shortened protocols should be selected according to the measurement of interest of plantar pressure and foot masks to be analyzed. The evidence of reproducibility and agreement was more favorable for the use of the three-step protocol.

Keywords |
Foot; Data Accuracy; Gait Analysis

Masks surfaces		Peak plantar pressure (KPa)		Pressure-time integral (KPa/s)
Masks surfaces		One-step	Three-step	One-step	Three-step
Hallux	M⁰	368.61±83.72	357.36±95.03	21.11±8.27	23.57±10.53
	M¹	316.31±93.74	328.11±99.77	20.60±9.35	22.78±11.16
	M⁷	325.01±122.28	340.35±92.59	20.24±13.09	22.67±9.78
	F Test	2.498 (ns)	0.817 (ns)	0.020 (ns)	0.098 (ns)
	CCI	0.78	0.79	0.96	0.85
Other toes	M⁰	289.75±122.32	288.86±134.31	11.55±9.27	11.92±7.37
	M¹	295.36±75.97	249.04±147.36	13.45±12.66	12.03±10.03
	M⁷	300.84±78.13	268.62±121.88	13.23±9.96	16.07±10.88
	F Test	0.065 (ns)	0.734 (ns)	0.483 (ns)	2.202 (ns)
	CCI	0.44	0.79	0.63	0.78
1^st metatarsal	M⁰	295.65±81.77	311.79±54.93	29.67±11.92	34.68±10.87
	M¹	268.36±54.85	279.48±48.65	30.43±13.81	38.95±14.03
	M⁷	272.48±60.92	288.61±51.06	27.94 ±13.40	40.25±12.45
	F Test	1.019 (ns)	2.048 (ns)	0.190 (ns)	2.993 (ns)
	CCI	0.54	0.80	0.50	0.88
2^nd and 3^rd metatarsal	M⁰	388.72±52.55	402.59±38.87	50.42±9.89	54.99±6.19
	M¹	398.33±52.20	394.33±35.37	52.72±9.38	56.89±4.44
	M⁷	396.20±47.88	405.13±54.83	52.42±9.08	57.62±6.09
	F Test	1.014 (ns)	0.757(ns)	1.619 (ns)	2.444 (ns)
	CCI	0.86	0.94	0.84	0.87
4^th and 5^th metatarsal	M⁰	371.93±86.34	373.51±63.47	30.35±13.04	35.58±10.74
	M¹	389.68±74.19	376.60±64.76	36.83±12.64	34.70 ±10.81
	M⁷	377.54±66.53	356.12±73.07	32.83±9.61	34.36±9.57
	F Test	0.593 (ns)	1.022 (ns)	2.600 (ns)	0.306 (ns)
	CCI	0.84	0.82	0.79	0.93
Midfoot	M⁰	70.57±51.95	61.15±39.44	4.82±3.85	3.73±2.42
	M¹	102.71±67.73	56.43±40.90	6.70±5.04	4.59±2.88
	M⁷	97.37±63.55	53.47±42.42	6.67±6.39	3.94±3.07
	F Test	1.442 (ns)	0.391 (ns)	0.485 (ns)	1.737 (ns)
	CCI	0.40	0.74	0.55	0.81
Internal calcaneus	M⁰	373.73±37.80	393.43±55.47	40.20±10.35	32.89±7.94
	M¹	377.83±47.73	404.18±37.65	40.56±10.22	33.84±8.41
	M⁷	390.38±41.52	403.13±46.41	40.26±10.21	33.72±9.75
	F Test	2.294 (ns)	0.606 (ns)	0.009 (ns)	0.125 (ns)
	CCI	0.82	0.87	0.93	0.90
External calcaneus	M⁰	375.32±44.43	402.49±63.29	32.46±9.45	28.15±7.31
	M¹	365.98±43.32	420.62±47.20	31.64±7.08	28.01±6.80
	M⁷	381.76±46.76	412.20±50.56	33.58±7.51	27.74±7.57
	F Test	1.153 (ns)	1.282 (ns)	0.383 (ns)	0.029 (ns)
	CCI	0.81	0.86	0.70	0.80

Masks surfaces	Protocol	M±SD	T-test	r	Bland-Altman Plot
Masks surfaces	Protocol	M±SD	T-test	r	Mean difference	Agreement limits (± 2 SD)
Hallux	Midgait	389.72±90.95	1.138 (ns)	0.58 (p=0.02)	−25.9	−198.4-146.6
	One-step	368.61±83.72	1.588 (ns)	0.59 (p=0.02)	−37.1	−214.6-140.4
	Three-step	357.36±95.03
Other toes	Midgait	281.05±97.93	0.328 (ns)	0.58 (p=0.02)	8.7	−192.4-209.8
	One-step	289.75±122.32	0.232 (ns)	0.46 (p=0.04)	19.8	−193.6-233.1
	Three-step	288.86±134.31
1^st metatarsal	Midgait	326.62±33.23	1.442 (ns)	0.41 (p=0.05)	−31.0	−194.0-132.1
	One-step	295.65±81.77	4.793 (p<0.01)	0.52 (p=0.05)	−50.6	−130.9-29.6
	Three-step	275.98±46.86
2^nd and 3^rd metatarsal	Midgait	408.11±56.65	1.684 (ns)	0.67 (p=0.01)	−19.4	−106.8-68.0
	One-step	388.72±52.55	0.603 (ns)	0.78 (p<0.01)	−5.5	−74.9-63.9
	Three-step	402.59±38.87
4^th and 5^th metatarsal	Midgait	351.20±34.42	0.856 (ns)	0.39 (p=0.05)	20.7	−163.1-204.5
	One-step	371.93±86.34	1.909 (ns)	0.72 (p=0.01)	22.3	−66.4-111.0
	Three-step	373.51±63.47
Midfoot	Midgait	67.21±37.57	0.253 (ns)	0.46 (p=0.04)	3.4	−97.6-104.3
	One-step	70.57±51.95	0.541 (ns)	0.44 (p=0.05)	−6.1	−91.0-78.9
	Three-step	61.15±39.44
Internal calcaneus	Midgait	411.53±37.27	3.411 (p=0.01)	0.34 (ns)	−37.8	−121.9-46.3
	One-step	373.73±37.80	1.957 (ns)	0.82 (p<0.01)	−18.1	−81.7-45.5
	Three-step	393.43±55.47
External calcaneus	Midgait	408.28±53.69	2.393 (p=0.03)	0.41 (ns)	−33.0	-137.5 - 71.6
	One-step	375.32±44.43	0.535 (ns)	0.75 (p=0.01)	−5.8	-87.8 - 76.2
	Three-step	402.49±63.29

Masks surfaces	Protocol	M±SD	T-test	r	Bland-Altman Plot
Masks surfaces	Protocol	M±SD	T-test	r	Mean difference	Agreement limits (± 2 SD)
Hallux	Midgait	24.15±7.30	0.734 (ns)	0.64 (p=0.01)	−2.0	−23.0-18.9
	One-step	21.11±8.27	0.181 (ns)	0.71 (p<0.01)	−0.6	−24.8-23.7
	Three-step	23.57±10.53
Other toes	Midgait	11.33±6.46	0.097 (ns)	0.67 (p=0.01)	0.2	−17.4-17.9
	One-step	11.55±9.27	0.378 (ns)	0.61 (p=0.01)	1.9	−23.1-27.0
	Three-step	11.92 ±7.37
1^st metatarsal	Midgait	38.94±11.53	2.456 (p=0.03)	0.22 (ns)	−9.3	−37.9-19.4
	One-step	34.68±10.87	1.887 (ns)	0.69 (p=0.01)	−4.3	−21.4-12.9
	Three-step	29.67±11.92
2^nd and 3^rd metatarsal	Midgait	53.81±8.46	1.575 (ns)	0.62 (p=0.02)	−3.4	−19.7-13.0
	One-step	50.42±9.89	1.003 (ns)	0.85 (p<0.01)	1.2	−7.8-10.1
	Three-step	54.99±6.19
4^th and 5^th metatarsal	Midgait	29.27±7.22	0.409 (ns)	0.62 (p=0.01)	1.1	−19.0-21.2
	One-step	30.35±13.04	2.615 (p=0.02)	0.36 (ns)	6.3	−12.0-24.6
	Three-step	35.58±10.74
Midfoot	Midgait	4.40±1.85	0.384 (ns)	0.43 (p=0.05)	0.4	−7.9-8.7
	One-step	4.82±3.85	1.847 (ns)	0.81 (p<0.01)	−0.7	−3.4-2.1
	Three-step	3.73±2.42
Internal calcaneus	Midgait	37.88±9.77	0.847 (ns)	0.44 (p=0.05)	2.3	−18.5-23.1
	One-step	40.20±10.35	2.089 (ns)	0.47 (p=0.04)	−5.0	−23.1-13.1
	Three-step	32.89±7.94
External calcaneus	Midgait	28.66±6.53	2.001 (ns)	0.63 (p=0.01)	3.8	−10.6-18.2
	One-step	32.46±9.45	0.366 (ns)	0.70 (p=0.01)	−0.5	−11.0-10.0
	Three-step	28.15±7.31

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[1] Correspondence address: Fernando Raphael Pinto Guedes Rogério - Rua Paranaguá, 1900, apto. 803, Londrina (PR), Brasil - CEP: 86015-030. E-mail: fernandopintoguedes@hotmail.com