Pressure thresholds of the human foot: measurement reliability and effects of stimulus characteristics.

Information related to reliable values of discomfort thresholds can help to improve the designs of various products. This study aimed to investigate the measurement reliabilities associated with pressure thresholds, while determining the effects of stimulus characteristics (stimulus area, indentation speed) of the human foot. An indentation apparatus was used with four sizes of indentation probes and three indentation speeds. In total, 13 locations on the right foot of 10 male and 10 female participants were tested to determine the pressure discomfort thresholds (PDT) and pressure pain thresholds (PPT). Results show that the tests had very good measurement reliability with intra-class correlations (ICC) greater than 0.8 for the PPT measurements and acceptable reliability (most ICC > 0.75, with a few between 0.5 and 0.75) for the PDT measurements, demonstrating that participants are capable of judging their pain and discomfort thresholds. Pressure sensitivity differs across locations of the foot, with the medial plantar arch of the foot being the most sensitive, followed by the dorsal surface of the foot. The heel area was the least sensitive. PPT and PDT are dependent on the stimulus characteristics of the area and the speed of indentation. A smaller area has a higher PPT and PDT, indicating significant effects of spatial summation. The increase of PDT and PPT at higher speeds may be partially explained by the increase in stiffness because foot tissue exhibits viscoelastic properties. The findings can have a significant impact on the design of footwear and other accessories for improved foot health and comfort. Statement of Relevance: This study investigated the threshold measurement reliability while determining the pressure sensitivity on the surface of the foot with varying stimulus characteristics. The findings may be very useful in the design of footwear and other accessories for improved comfort and reduced injuries.