Can the F-Scan in-shoe pressure system be combined with the GAITRite® temporal and spatial parameter-recording walkway as a cost-effective alternative in clinical gait analysis? A validation study.

Abstract

Background: Clinical gait analysis is widely used to aid the assessment and diagnosis of symptomatic pathologies. Foot function pressure systems such as F-scan and analysis of the spatial-temporal parameters of gait using GAITRite® can provide clinicians with a more comprehensive assessment. There are systems however, such as Strideway™ that can measure these parameters simultaneously but can be expensive. F-Scan in-shoe pressure data is normally collected whilst the person is walking on a hard floor surface. The effects of the softer Gaitrite® mat upon the F-Scan in-shoe sensor pressure data is unknown. This study therefore aimed to assess the agreement between F-Scan pressure measurements taken from a standard walkway (normal hard floor), and those from a GAITRite® walkway to establish whether these two pieces of equipment (in-shoe F-Scan and GAITRite®) can be used simultaneously, as a cost-effective alternative.

Method: Twenty-three participants first walked on a standard floor and then on a GAITRite® walkway wearing F-Scan pressure sensor insoles with same footwear. They repeated these walks three times on each surface. Mid gait protocols were utilised by analysing the contact pressure of the first and second metatarsophalangeal joint of the third, fifth and seventh step from each walk. For both joints, 95% Bland-Altman Limits of Agreement was used to determine a level of agreement between the two surfaces, using mean values from pressure data collected from participants who successfully completed all required walks. The intraclass correlation coefficient (ICC) and Lin's concordance correlation coefficient were calculated as indices of reliability.

Findings: ICC results for the hard surface and the GAITRrite® walkway at the first and second metatarsophalangeal joints were 0.806 and 0.991 respectively. Lin's concordance correlation coefficient for the first and second metatarsophalangeal joints were calculated to be 0.899 and 0.956 respectively. Both sets of statistics indicate very good reproducibility. Bland-Altman plots revealed good repeatability of data at both joints.

Conclusion: The level of agreement in F-Scan plantar pressures observed between walking on a normal hard floor and on a GAITRite® walkway was very high, suggesting that it is feasible to use F-Scan with GAITRite® together in a clinical setting, as an alternative to other less cost-effective standalone systems. Although it is assumed combining F-Scan with GAITRite® does not affect spatiotemporal analysis, this was not validated in this study.