Plantar pressure distribution in people with stroke and association with functional mobility

People with stroke often suffer abnormal foot posture including structural and movement deficiencies in the intrinsic foot segments on the affected side, which are associated with limitation in mobility. As part of a programme of research examining foot and ankle biomechanics after stroke, we investigated plantar pressure distribution under the affected foot of people with stroke and the relationship with functional mobility. Plantar pressure distribution was investigated while standing and walking on the affected side of twenty stroke and fifteen healthy sex and age-matched participants, using a Medilogic platform system at a frequency of 20 HZ. Functional mobility in real life was measured using the Walking Handicap Scale. While standing, people with stroke bore greater pressure on the affected side through the lateral heel and lesser toes (p<0.01) and less at the medial (MP1) and central forefoot (MP23) areas (p<0.05) than healthy controls. During walking, more pressure was taken through the heel area, especially the medial heel and less through the medial and central forefoot of the affected foot of people with stroke compared to healthy controls. The logistic regression model revealed that stroke participants who took greater pressure on the medial heel while walking (odds ratio=1.11, p<0.05) had more limited functional mobility (i.e. were more likely to be household walkers) than those who did not. While standing, none of the standing plantar pressure variables significantly contributed to the model. The plantar pressure distribution differs significantly between the affected foot of people with stroke and healthy controls.  Abnormal plantar pressure distribution while walking, but not while standing,   is a significant contributor to limited functional mobility post stroke.