Feedback system based on plantar pressure for monitoring toe-walking strides in children with cerebral palsy.

Abstract

The aim of this study was to develop a feedback system to assist gait rehabilitation of cerebral palsy (CP) toe walkers with dynamic equinus. Plantar pressure of the forefoot and the heel was collected by sensorized insoles embedded in custom-built shoes and transmitted to a smartphone via Bluetooth. Dynamic foot pressure index of each stride was calculated by purpose-designed software running in the smartphone to distinguish toe-walking strides from normal strides in real time. An auditory signal would be produced to alert the patient each time a toe-walking stride was detected. For CP toe walkers, the one-way analysis of variance indicated a significant difference (F1,14 = 19.492, P = 0.001) in dynamic foot pressure index between the affected side (31.4 ± 12.0) and the unaffected side (58.6 ± 2.5). In addition, the validation test showed that this system can distinguish toe-walking strides from normal strides of children with CP with an accuracy of 95.3%. This system was able to monitor the toe-walking strides of children with CP in real time and had the potential to enhance rehabilitation training efficiency and correct toe-walking gait in children with CP with dynamic equinus.