2011 8th International Multi-Conference on Systems, Signals & Devices
A POSTURAL STABILITY ANALYSIS
BY USING PLANTAR PRESSURE MEASUREMENTS
Samir Boukhenous and Mokhtar Attari
Laboratory of Instrumentation, Faculty of Electronics and Computers
USTHB, BP. 32, Bab-Ezzouar, Alger, Algeria, http://www.lins.usthb.dz
Email: sboukhenous@gmail.com, attari.mo@gmail.com
ABSTRACT
The foot and ankle contribute significantly to postural
control by providing a contact area to the support surface.
Persons with visual and neuromuscular disorders have
deficits in response to perturbations of balance and often
require assistive devices. This work investigated to
posture analysis by using plantar pressure measurements
coupled with an EMG analog signal processor. The
output signals from the plantar pressure and the EMG
analog processor are feeding to a high resolution data
acquisition system of National Instrument data
acquisition card with PCI interfacing to a PC.
Experimental tests have been carried out concerning the
postural stability conducted by subjects with eyes open
and closed. However, an analog circuit has been realized
for recording the EMG signal of Soleus muscle during
the experimentation tests.
Index Terms— Foot and ankle, postural stability,
plantar pressure, EMG, Soleus muscle, neuromuscular.
1. INTRODUCTION
The postural control system coordinates information from
the visual and neuromuscular systems to maintain a stable
standing posture. The integrity of these systems can be
damaged by diseases, accident or as well as aging [1]. In
some cases, the performance of the postural control is
affected in a way that results in an increased risk of
falling. Objective methods of diagnosis may be useful in
identifying persons at risk. Furthermore, the ability to
assess postural performance can help to monitor the
progression of diseases affecting the postural control
system and to evaluate effeteness of rehabilitation
treatments [2]. Stability can be defined as “the property
of a body that causes it when disturbed from a condition
of equilibrium or steady motion to develop forces or
moments that restore the original condition”. Nowadays,
various methods have been devised to quantify postural
stability. The most widely used method for both static
and dynamic posturography is based on measurement of
ground reaction forces and center of pressure as the
subject stands on a platform equipped with force
978-1-4577-0411-6/11/$26.00 ©2011 IEEE
transducers. However, foot-to-floor interaction is
commonly studied using force and pressure measurement
systems [3], [4]. Force platforms are widely used both in
posture and gait analysis. They reliably deliver all the
components of the resulting ground reaction and the free
moment; they also furnish the displacement of the
instantaneous center of pressure but they do not return
any information related to foot location on the platform
or the local distribution of loads under the foot. Several
empirical solutions have been proposed in the literature
to obtain this information essential for gait and posture
analysis [5]. Foot location is frequently determined using
a force platform in conjunction with an optoelectronic
system, which detects a variable number of markers
placed in correspondence to anatomical points [6].
Simpler solutions are also adopted, especially in
posturographic analysis, in which markers placed on the
subject’s feet match reference lines on the platform.
Sometimes foot placement is determined from footprints
left by the subject on the force platform [7]. The
evaluation of local contribution to the reaction force
resultant is more difficult, and, when mandatory, it is
sometimes obtained by superimposing smaller dedicated
force platforms. All the above requirements could be met
by a matrix of sensors capable of detecting the normal
stresses. A variety of different types of sensors have been
used, including resistive strain gauges, piezoelectric film,
infrared displacement sensors capacitive, sensors
detecting conductance and ultrasonic sensors.
The present paper illustrates a prototype of new
plantar pressure measurements for a postural stability
analysis. The instrument is based on the use of low cost
Hall device, magnet and a polymer elastic materiel.
Basically, the signal is acquired, amplified and feed to a
high resolution data acquisition card (DaqBoard 1005).
The 16 bits digital signal is analyzed and processed by a
compatible PC. A preliminary experimental test has been
carried out concerning the postural stability with one foot
conducted by subjects. The effect of visual input is
studied by performing the test with eyes open and fixed
visual surround and with eyes closed. However, an
analog circuit has been realized for recording the EMG
signal of Soleus muscle during the control of postural
stability.
 2. EXPERIMENTAL MATERIALS
2.1. Principle of plantar pressure measurements
The plantar pressure measurement is based of six tactile
sensors locations [8]. The considered sensor element is
constructed by placing a magnet which produces a
constant magnetic field nearby the selected Hall sensor
[9]. Fig.1 shows the realized sensors were located within
predetermined anatomic areas under the calcaneus
(CAL), medial (MMF) and lateral (LMF) midfoot, medial
(MMH) and lateral (LMH) metatarsal heads, and hallux
(HAL). These six discrete anatomic areas were identified
as useful in analyzing the paediatric foot during
ambulation [10]. These locations have also been shown
to present pressure gradients associated with
biomechanical variations and foot pathology in other
studies. Sensor sites within the defined plantar anatomic
areas were determined through a combination of clinical
examination. The objective was to determine the precise
coordinates of highest load centre within each anatomic
area. The outputs signals for each sensor element are
carried onto a low level instrumentation amplifier
(AD622) with low offset voltage, low noise and high
CMRR. After the conditioning, the signals are included
in the data acquisition card.
Figure 1. Plantar pressure measurements
and conditioning circuit
2.2. EMG Hardware realization
The EMG signal is acquired with three Ag/AgCl
commercial electrodes. The input signal is amplified with
an instrumentation amplifier (AD622) by a gain 1000
(Fig.2). Owing to the lack of isolating amplifier, patient
safety was increased with the use of isolated power
source with batteries bioinstrumentation powered. After
amplification, the signal feed a band pass filter which is
composed of a second order Butterworth high pass filter
with a cut-off frequency: 0.05Hz associated in cascade
with a fourth order Butterworth low pass filter with cut
off frequency: 500Hz to remove the DC artifact and
noise.
Figure 2. EMG conditioning circuit
3. EXPERIMENTATION TESTS
For dynamic experimentation test, two subjects are
participating for postural stability with one foot by using
the plantar pressure measurement and EMG conditioning
circuit. Fig.3 shows the principle of the experimentation
test. For acquisition signals by National Instrument card
(DaqBoard 1005), one channel is selected to the EMG
signal according to the Soleus muscle and six channels
are selected to six tactile sensors. Fig.4 and Fig.5 shows
the response corresponding to six tactile sensors
distributed on the insole surface during the experiment test
with eyes-open and eyes-closed. The ratio of eyes-closed
to eyes-open measure referred to as the Romberg quotient,
estimates the impairment of the perception and vestibular
systems by eliminating inputs from the visual system.
Figure 3. Plantar pressure and EMG electrodes
From the recorded signals, two parameters are
determined: peak pressure of plantar distribution and the
time-delay of eyes-closed. The peak pressure was defined
as the maximum vertical amplitude exerted during the
postural instability. Time-delay was defined as the instant
of eyes-closed to the instant of the postural instability
with one foot. Comparing the two recorders signals, the
highest values of pressure were noted at the Calcaneus
(CAL) region of the subject.2, Calcaneus (CAL) and
hallux (HAL) region of the subject.1. We notice, for the
subject.2, the time-delay with eyes-closed is highest than
the subject.1 result. This observation is in concordance
with the investigation of soleus muscle activity during the
phase of the control foot position. However, the ratio 4. CONCLUSION
time-delay of eyes-closed to eyes-open measure for the
subject.2 is highest than the ratio time-delay for the The plantar pressure measurements to be used for further
subject.1. This result shows the significant degree of clinical application and therapeutics treatment. The low
stability of the subject.2. cost of the system it use as a practical clinical monitoring
tool. The result obtained from this study was not
designed to investigate a specific clinical issue, but rather
PThim
as e -d
d ’a ppui
e lay
to demonstrate operation of the prototype plantar
Y
C elouse
x fe
d rm é ess
-e ye CAL pressure measurements and EMG analogue conditioning.
P h a se d’a p p u i Peak
LM F
O p e n -e ye s p h a se ’s
Y e u x o u ve rte s p re s s u re MMF In our laboratory, the system is now being used to
LM H
M TM investigate plantar distribution characteristics for foot and
Voltage (v)

HAL
ankle pathology and orthopaedic rehabilitation.
NPoh acse
o nd e nt opnh a
tac ap p ’s
se ui

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