Bi-BEAT Pedograph User’s Manual

For dynamic foot pressure display and measurement

Diabetic patients usually suffer from lack of nerve sensation, especially in the feet. Therefore, their gait
on standing and during walking may deviate from that of a normal person and points of high pressure
develop under the feet. However, due to neuropathy they do not feel any pain which would have been
felt had the nerve functions were alright. Later, ulcers form at these high pressure points, leading to
gangrene and eventual amputation of the leg. A Pedograph revealing the variation of foot pressure at
various points under the sole easily delineates such high pressure regions at an early stage so that
special shoe insoles can be prepared to spread the pressure away from the hot spots. This way the
patient is saved from eventual amputation, from being crippled for the entire life. Again, pressure points
and pattern may differ while standing and during walking, usually it is the latter which put the soles on
greater burden, and a dynamic pressure measurement during walking has more importance from a
clinical point of view.

Description of the unit:

The main sensor unit (Fig.1) uses an optical method to create an
image of light intensities proportional to the pressure impressed at
individual points. This unit is to be fitted within a suitably raised
platform, to be at the same level as the top of the sensor unit. A
person walks, stepping within the sensor area (Fig.2), when
moving images representing the distribution of foot pressure under
the sole are created in the unit and delivered to a microcomputer.
These images are analysed in the computer by specially developed
software to produce colour contour images of the pressure
distribution under the walking foot. A composite image also
identifies the highest pressures occurring at each picture element
(pixel). From this image the user can select up to 6 locations, for Fig. 1: The main sensor
unit coded calibration scale is
each of which a graph shows the variation of pressure with time. A colour
used to indicate the range of pressures. The results can be printed
on paper using a colour printer.

The instrument is very user-friendly. After switching on, the user

has to activate the video image capture program first in the movie
mode. This is the software from the manufacturer of the digital
camera used in this device (Logitech® Webcam). When the video
capture is started through a mouse click, the subject should be
asked to walk on the sensor area (within the red marked region).
After the foot leaves the sensor, the video capture should be
stopped. This creates a video file with a ‘.wmv’ extension at the
directory set up by the user beforehand.

Then the user has to start the Pedograph software (Bi-

Fig. 2: Person walking with a
step in the sensor area
BEAT_Pedograph_2.3.jar or Bi-BEAT_Pedograph Data Analysis)
when a command window as shown in Fig.3 appears. Of course the
command buttons do not appear all at once. These appear as and
when necessary, in sequence, during the procedure. It has self
explanatory indications and directions. ‘Extract & Select Frames’ is
the first command which allows the operator to browse the

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directories and select the video file,
in ‘wmv’ format. It also allows the
operator to select the initial frame
number from which 3 seconds of
video will be processed. This is to
ensure that the range of frames
actually cover the period when the
foot actually touched the sensor area,
eliminating unnecessary blank
images. The next command, ‘Crop &
Color Frames’, allows the operator to
crop the video frames to select only
the desired area (of the foot) in the
image. The sensor area in the device
is intentionally kept much bigger
than a typical foot size since a
walking person may not be precise in
putting a step. This cropping
function helps eliminate unnecessary Fig. 3: User friendly command window
background from the image. The
‘color frames’ function replaces the raw images by coded artificial colours, consisting of 7 colours,
which correspond to different degrees of pressure-bands. The colours have been chosen keeping view
of the contemporary human psychology that would give a quick interpretation of the severity of the
pressure under the foot. The command, “Show Composite Image’, gives a composite of all frames
showing the highest pressures at each pixel position occurring at any time during the stepping process
(within the chosen 3 seconds). This helps the user in selecting areas for detailed analysis. By simply
clicking the mouse, up to 6 points may be selected around which the pressure variation with time would
be plotted in 6 separate graphs. On clicking each of these points a circle appears on the image that
indicates the area over which the pressure is averaged for the graph. The default diameter of this area is
20 pixels. If needed, the operator can increase or decrease this circular area for averaging by clicking
and dragging a scale bar appearing on
the right. ‘Show Colored Video’
command shows a movie of the colour
coded pressure distribution of the foot.
This allows the user to visualize the time
variation of pressure at different areas
under the foot. The speed of the movie
display may be slowed down if desired,
again by clicking and dragging the
mouse on a scale bar below.

Fig.4 shows a composite image (top)

Fig. 4: Snapshot of colour coded composite image (top)
and a frame of the movie image (bottom).
and an instantaneous snapshot of the
video image (bottom). Fig.5 shows a
composite image showing a calibration
colour chart and the 6 circular areas
selected for detailed analysis. The
graphs in Fig.6 show the time variations
of pressures for the corresponding
selected areas in Fig.5. The maximum
pressure occurring at each of these
points can be obtained from these
graphs.

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 Fig. 5: A composite image of the foot
pressure distribution together with colour
calibration chart for pressure. The small
circles represent areas chosen by the operator
for detailed analysis.
Fig. 6: Pressure vs time graph for the 6
selected areas as shown by the circles in
Fig.5. Each of the graphs shows the time
when the maximum pressure occurred
during walking.

Note: While walking on the sensor area for the measurements the patient should not touch any
person or a wall or a side rail (we do not encourage making a side rail). Because, then some of
the weight of the body will be diverted through this touch and the measurement will not be
right. In case the patient cannot stand properly, hold him or her before walking, but try to
release the patient for a few seconds when he or she is walking onto the sensor area.

This Pedograph unit was designed and developed by a team under the leadership
of Dr. K Siddique-e Rabbani, Professor, Department of Biomedical Physics &
Technology, University of Dhaka, Dhaka, Bangladesh.

Bi-BEAT
(Bangladesh Institute for Biomedical Engineering & Appropriate Technology)
40 Basement, Concord Emporium, 253-254 Elephant Rd, Dhaka-1205, Bangladesh
www.bibeat.com, email: bibeat.medical@gmail.com

For technical queries contact: Dr. K S Rabbani, +8801-817-022-834 (cell), email: ksrabbani@gmail.com

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