PTOtherJournal of neuroengineering and rehabilitation2025

A toolbox for the identification of foot-floor contact sequences to analyze atypical gait cycles in a real-life scenario: application on patients after proximal femur fracture and healthy elderly.

Marco Ghislieri, Nicolas Leo, Marco Caruso and 3 others

PMID 40660342

WHAT IT FOUND

Pressure insoles worn during daily walking showed people after proximal femur fracture had more unusual foot-floor contact patterns and more uneven flat-foot and swing timing than healthy older adults.

Key findings

01The normalized percentage of atypical gait cycles on the worst side was 8.8 ± 4.1%/min after proximal femur fracture and 0.8 ± 0.1%/min in healthy adults (p = 0.007).

02In standard gait cycles, flat-foot contact asymmetry was 6.9 ± 1.2%GC after proximal femur fracture versus 2.5 ± 0.4%GC in healthy adults, and swing asymmetry was 6.5 ± 1.6%GC versus 1.6 ± 0.3%GC.

03Participants after proximal femur fracture had fewer gait cycles (1059 ± 201 versus 2076 ± 246), spent less time walking (9.1 ± 1.7% versus 15.0 ± 1.9%), and had lower cadence (39.2 ± 2.0 versus 45.7 ± 1.2 cycles/min).

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The analysis was small and observational, with 14 fracture participants and 18 healthy controls after exclusions. It did not follow participants for falls or test whether the gait parameters predicted future falls. Almost all fracture participants had a fall history, while only 3 healthy adults did, so the groups differed in fall history as well as fracture status. The fracture side was not available in the dataset, so the authors used the worst side and interlimb asymmetry rather than affected-side-specific measures. The toolbox was tested with one pressure-insole configuration and not against machine-learning alternatives or across various insole types. Some recordings were shorter than the target 2.5 hours.

Declared interests

The funding declaration names the European Union. No other conflicts of interest are stated.

The easy way to misread this

Do not read these gait differences as proof that pressure-insole analysis prevents falls or improves fracture rehabilitation. The study described recorded walking patterns in a small observational dataset and did not test an intervention or follow patients for falls.

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The study

Participants
32 analysed participants: 14 with proximal femur fracture and 18 healthy adults. The original dataset had 19 proximal femur fracture patients and 20 healthy adults.
Certainty of evidence
Low

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Marco Ghislieri, Nicolas Leo, Marco Caruso, et al. A toolbox for the identification of foot-floor contact sequences to analyze atypical gait cycles in a real-life scenario: application on patients after proximal femur fracture and healthy elderly. Journal of neuroengineering and rehabilitation. 2025.

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