Under pressure: design and validation of a pressure-sensitive insole for ankle plantar flexion biofeedback during neuromuscular gait training.
Benjamin C Conner, Ying Fang, Zachary F Lerner
PMID 36482447WHAT IT FOUND
A pressure-sensitive insole increased calf muscle activity during treadmill walking in children with cerebral palsy, matching the effect of a more complex EMG system.
The pressure sensor is cheaper, faster to set up, and less prone to signal loss from sweat or hair.
Key findings
01Both the pressure-based and EMG-based systems significantly increased mean soleus muscle activity compared to baseline, with no significant difference between the two systems.
02Both systems significantly increased mean and peak medial gastrocnemius activity compared to baseline, with no significant difference between the systems.
03The EMG system increased ankle co-contraction (soleus and tibialis anterior working against each other), while the pressure system did not, suggesting the pressure sensor may drive more functional muscle recruitment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Very small sample size (n=8) limits generalizability. Validation was limited to treadmill walking; overground walking has not been tested. The study did not assess whether the biofeedback leads to lasting improvements in walking ability. Participants were aged 10–21 years with GMFCS levels I–III; results may not apply to younger children or those with higher GMFCS levels.
Declared interests
Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Science Foundation. The smartphone app was developed by Biomotum, Inc., but no commercial conflicts of interest were declared by the authors.
The easy way to misread this
Do not assume this system improves walking ability. This study only validated that the pressure insole can increase muscle activity during short bouts of treadmill walking, not that it leads to functional gait changes or long-term benefits.