Pressure distribution patterns under the metatarsal heads in healthy individuals

Objectives: Recognition of plantar pressure distribution pat¬terns of healthy individuals would be helpful in the manage¬ment of metatarsalgia. We investigated plantar pressure distri¬bution patterns under metatarsal heads in healthy individuals using the EMED-SF plantar pressure analysis system. Methods: Plantar pressure measurements were per¬formed in 106 healthy volunteers (45 females, 61 males; mean age 24 years; range 20 to 35 years) during walking on the EMED-SF platform. Footprints were divided into three areas based on the three functional columns of the tarsometatarsal joint, that is, the first metatarsal head, the second and third metatarsal heads, and the fourth and fifth metatarsal heads. The mean and peak pressures obtained in these areas were recorded. Results: Pressure distribution patterns did not differ sig¬nificantly between the two sexes and the right and left soles (p>0.05). The mean and peak pressures of the middle column during the mid-stance phase of the gait cycle were signifi¬cantly higher than those recorded for the medial and lateral columns (p=0.000). There were no significant differences between the medial and lateral columns in this respect. At the pre-swing phase, pressures were significantly greater in the medial column compared to the lateral column. Four dif¬ferent patterns were noted with respect to the distribution of pressures among the three columns. Body mass index (BMI) was below the limit for obesity (<30 kg/m2) in all the partici¬pants. Peak pressure values obtained from each column at the pre-swing phase were significantly correlated with BMI (p<0.05); however, no correlation existed between the plan¬tar pressures and BMI at the mid-stance phase (p>0.05). Conclusion: Our data show that there are four distinct pres¬sure distribution patterns, but the greatest plantar pressure occurs in the middle column of the foot in the majority of healthy individuals.