Footsteps required for reliable and valid in-shoe plantar pressure assessment during gait per foot region in people with hallux valgus

Hiroki Okawara, Tomonori Sawada, Satoshi Hakukawa, Kohei Nishizawa, Masahiro Okuno, Masaya Nakamura, Takeshi Hashimoto, Takeo Nagura

Research output: Contribution to journalArticlepeer-review


Background: Plantar pressure assessment is commonly performed to identify pathognomonic gait characteristics and evaluate therapeutics against them in people with various foot disorders. Little is known about the reliability and validity of this assessment in people with hallux valgus (HV) per foot region. Research question: This study aimed to assess the reliability and validity of the in-shoe plantar pressure measurement method during gait in people with HV and the required number of footsteps, as an intra-subject sample size, to ensure a reliable and valid use of this method. Methods: With an inserted disposable insole plantar pressure sensor in shoes, 17 females with HV (HV angle > 15°) completed three gait trials over the ground at a comfortable speed. Peak plantar pressure data and its distribution in 15 stance phases on the foot clinically diagnosed with HV in each participant were extracted by dividing the foot into eight regions. The intraclass correlation coefficient per foot region and the number of footsteps required to produce a valid peak plantar pressure and distribution (intraclass correlation coefficient > 0.90) were used to measure reliability. Based on the limit of agreement analysis, the coefficient of variation between the averaged value from each incremental footstep (2–14 footsteps) and 15 reference footsteps was calculated. Results: The intraclass correlation coefficient of plantar pressure assessment with the in-shoe sensor was 0.606–0.847 in the eight foot regions in people with HV. Additionally, the number of steps required for a valid assessment ranged from two to nine. Hence, the application of averaged values from more than nine footsteps is recommended for this evaluation. Significance: This reference sample size is intended to be used in future studies and clinical settings to determine the efficacy of HV treatment.

Original languageEnglish
Pages (from-to)21-27
Number of pages7
JournalGait and Posture
Publication statusPublished - 2022 Sep


  • Gait
  • Hallux valgus
  • Plantar pressure
  • Reliability
  • Validity

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation


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