van der Leeden Marike, Dekker Jos H M, Siemonsma Petra C, Lek-Westerhof Sandy S, Steultjens Martijn P M
Rehabilitation Department, Jan van Breemen Instituut, Centre for Rheumatology and Rehabilitation, 1056 AB Amsterdam, The Netherlands.
Foot Ankle Int. 2004 Oct;25(10):739-44. doi: 10.1177/107110070402501008.
Plantar pressure measurement may be a helpful evaluation tool in patients with foot complaints. Determination of dynamic pressure distribution under the foot may give information regarding gait, progress of disorders, and the effect of treatment. However, for these measurements to have clinical application, reproducibility, consistency, and accuracy must be ascertained. We compared the reproducibility of measurements among one-step, two-step, and three-step protocols for data collection in patients with arthritis. In addition, the number of measurements needed for a consistent average was determined for the protocol that was found to be the most reproducible.
Twenty patients with foot complaints secondary to arthritis participated in the study. Each patient was tested with a pressure platform system using two of the three testing protocols. Reproducibility of contact time and maximal peak pressure were assessed. Intraclass Correlation Coefficients (ICC) were calculated for measurement results among protocols. In stage two of the study, the number of measurements needed for a consistent average was determined by calculating the first three measurements, the first five measurements, and then all seven measurements for both feet. ICC of three, five, and seven measurements were compared. The two-step protocol (13 patients), which was found in stage one of the study to be the most reproducible, was used for this determination.
Reproducibility was found to be reasonable or good for all three measurement protocols. The mean values of contact time for the one-step protocol were found to be higher than the mean values of contact time for the two-step or three-step protocols in both feet. The differences between the one-step and three-step protocols were statistically significant for the left foot only. The mean peak pressure did not show statistically-significant differences among the three protocols. The one-step and three-step protocols were not used for stage two of the study. Using the two-step protocol, three measurements were found to be sufficient for obtaining a consistent average.
The results of our study indicated that the one-step, two-step, and three-step protocols of collecting plantar pressure measurements in patients with foot complaints secondary to chronic arthritis were all similar. However, the use of the two-step protocol is recommended over the one-step and three-step protocols; the one-step protocol produced a longer stance phase that did not resemble normal walking and when comparing the two-step and three-step protocols, the two-step protocol was less time consuming and less strenuous for patients with painful feet.
足底压力测量可能是评估足部疾病患者的一种有用工具。确定足底动态压力分布可为步态、疾病进展及治疗效果提供相关信息。然而，要使这些测量具有临床应用价值，必须确定其可重复性、一致性和准确性。我们比较了关节炎患者在一步法、两步法和三步法数据收集方案中的测量可重复性。此外，还针对被发现可重复性最高的方案，确定了获得一致平均值所需的测量次数。
20名继发于关节炎的足部疾病患者参与了本研究。每位患者使用三种测试方案中的两种，通过压力平台系统进行测试。评估接触时间和最大峰值压力的可重复性。计算各方案测量结果的组内相关系数（ICC）。在研究的第二阶段，通过计算双脚的前三次测量、前五次测量以及全部七次测量结果，确定获得一致平均值所需的测量次数。比较三次、五次和七次测量的ICC。研究第一阶段发现最具可重复性的两步法方案（13名患者）用于此项测定。
所有三种测量方案的可重复性均为合理或良好。一步法方案的双脚接触时间平均值高于两步法或三步法方案的接触时间平均值。仅左脚的一步法和三步法方案之间的差异具有统计学意义。三种方案的平均峰值压力未显示出统计学显著差异。一步法和三步法方案未用于研究的第二阶段。使用两步法方案时，发现三次测量足以获得一致的平均值。
我们的研究结果表明，慢性关节炎继发足部疾病患者中，一步法、两步法和三步法收集足底压力测量数据的方案都相似。然而，推荐使用两步法方案而非一步法和三步法方案；一步法方案产生的站立期较长，与正常行走不同，并且在比较两步法和三步法方案时，两步法方案对足部疼痛患者来说耗时更少、强度更低。
