Temporomandibular disorders (TMDs) refer to a group of conditions that affect the temporomandibular joint, causing pain and dysfunction in the jaw joint and related muscles. The diagnosis of TMDs typically involves clinical assessment through operator-based physical examination, a self-reported questionnaire and imaging studies. To objectivize the measurement of TMD, this study aims at investigating the feasibility of using machine-learning algorithms fed with data gathered from low-cost and portable instruments to identify the presence of TMD in adult subjects. Through this aim, the experimental protocol involved fifty participants, equally distributed between TMD and healthy subjects, acting as a control group. The diagnosis of TMD was performed by a skilled operator through the typical clinical scale. Participants underwent a baropodometric analysis by using a pressure matrix and the evaluation of the cervical mobility through inertial sensors. Nine machine-learning algorithms belonging to support vector machine, k-nearest neighbours and decision tree algorithms were compared. The k-nearest neighbours algorithm based on cosine distance was found to be the best performing, achieving performances of 0.94, 0.94 and 0.08 for the accuracy, F1-score and G-index, respectively. These findings open the possibility of using such methodology to support the diagnosis of TMDs in clinical environments.

BACKGROUND: the area beneath the metatarsal heads is a common location of foot pain, which is often associated with high plantar pressures. The aim of this study was to determine the effect of the application of a Morton\'s extension on the pressure in the metatarsal bones of the foot using a pressure platform.
METHODS: twenty-five subjects without musculoskeletal pathology were selected for this study, and an experiment was conducted with them as the subjects, before and after application of a Morton\'s extension. The foot regions were divided into the forefoot (transversely subdivided into six areas corresponding to the first, second, third, fourth, and fifth metatarsal heads, and the hallux), midfoot, and rearfoot, and then the maximum and average pressures exerted at each region were measured before and after placing a Morton\'s extension.
RESULTS: we found a pressure reduction, with a p-value less than (p < 0.05), in the head of the second and third metatarsals in statics and dynamics.
CONCLUSIONS: we can conclude that the Morton\'s extension produces a variation in plantar pressures on the lesser metatarsals. The application of a Morton\'s extension may be beneficial for the management of forefoot pathology. This study will help clinicians consider various tools to treat forefoot disorders. NCT05879094 (ClinicalTrial.gov (accessed on 18 May 2023)).

In-shoe models are required to extend the clinical application of current multisegment kinetic models of the bare foot to study the effect of foot orthoses. Work to date has only addressed marker placement for reliable kinematic analyses. The purpose of this study is to address the difficulties of recording contact forces with available sensors. Ten participants walked 5 times wearing two different types of footwear by stepping on a pressure platform (ground contact forces) while wearing in-shoe pressure sensors (foot sole contact forces). Pressure data were segmented by considering contact cells\' anteroposterior location, and were used to compute 3D moments at foot joints. The mean values and 95% confidence intervals were plotted for each device per shoe condition. The peak values and times of forces and moments were computed per participant and trial under each condition, and were compared using mixed-effect tests. Test-retest reliability was analyzed by means of intraclass correlation coefficients. The curve profiles from both devices were similar, with higher joint moments for the instrumented insoles at the metatarsophalangeal joint (~26%), which were lower at the ankle (~8%) and midtarsal (~15%) joints, although the differences were nonsignificant. Not considering frictional forces resulted in ~20% lower peaks at the ankle moments compared to previous studies, which employed force plates. The device affected both shoe conditions in the same way, which suggests the interchangeability of measuring joint moments with one or the other device. This hypothesis was reinforced by the intraclass correlation coefficients, which were higher for the peak values, although only moderate-to-good. In short, both considered alternatives have drawbacks. Only the instrumented in-soles provided direct information about foot contact forces, but it was incomplete (evidenced by the difference in ankle moments between devices). However, recording ground reaction forces offers the advantage of enabling the consideration of contact friction forces (using force plates in series, or combining a pressure platform and a force plate to estimate friction forces and torque), which are less invasive than instrumented insoles (which may affect subjects\' gait).

The gait cycle can be divided into four functional rocker units. Although the widespread use of the OptoGait (OG) system and the Freemed (FM) platform, their accuracy has not been tested. An observational study was completed with eighteen healthy volunteers to determine the accuracy of OG and FM for overground walking gait analysis. The pairwise comparison between data obtained from OG, FM and high-speed video analysis revealed significant differences for most of the measurements (p < 0.05). ICCs revealed an excellent absolute agreement between measurements (ICCs > 0.94) for all measures for OG systems compared to video-analysis. When considering FM vs. video-analysis, ICCs showed good absolute agreement for rocker 1 (ICC = 0.86) and 3 (ICC = 0.82), excellent for rocker 2 (ICC = 0.93) and poor (ICC < 0.5) for rocker 4. Bland-Altman plots (95% limits of agreement) revealed heteroscedasticity of error for OG in all variables for foot rockers (r2 > 0.1) while no heteroscedasticity of error was found when using FM (r2 < 0.1). This study indicates that the OG system and the FM platform can provide consistent foot rockers values when walking at a constant velocity. The differences between the systems assessed and their agreement and consistency values advise against their interchangeable use.

OBJECTIVE: Determine the concordance between two methods of obtaining the plantar footprint (pedigraph and pressure platform).
METHODS: A descriptive, cross-sectional, observational study of prevalence was carried out in the social center of Cariño (Coruña), Spain (n = 65 participants). Older people without amputations or the presence of dysmetria were included. The variables studied were: sociodemographic (age, sex), anthropometric (body mass index) and footprint measurement variables. These measurements were made by obtaining the plantar footprint using two methods: pedigraph and pressure platform.
RESULTS: The mean age of the sample was 37.42 ± 15.05 years, with a predominance of the female gender (61.54%). Positive linear correlation between pedigraph and platform was observed in both feet in the Chippaux and Staheli indices (correlation coefficient > 0.3, p < 0.001 in each comparison). The reliability was good or moderate in relation with the Chippaux and Staheli index. Slightly lower coefficients were observed in the dimensions of the foot.
CONCLUSIONS: A positive linear correlation between pedigraph and platform was observed in both feet in the Chippaux and Staheli indices. Significant differences were observed between pedigraph and platform in relation to the width and length of the foot. It is probably due to the fact that the pressure platform provides more exhaustive, detailed and accurate information of the foot.

BACKGROUND: The effect of Leg-Length Discrepancy (LLD) on dynamic gait parameters has been extensively discussed. Podobarography is the study of foot-to-ground pressure distribution. It has been used to test plantar footprint deviations that could reveal pathology.
OBJECTIVE: The aim of this study is to determine the effects of simulated LLD on dynamic gait parameters measured with a pressure platform in healthy subjects.
METHODS: Thirty-seven healthy subjects participated in observational cross-sectional research. A procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Support time, mean pressure, and peak pressure measures were registered on three trials for each foot and LLD level per session. An analysis of variance (ANOVA) test for repeated measures was performed to check for differences between the different simulated LLD levels.
RESULTS: The stance time of the short leg had no significant changes. The stance time of the long leg increased by 3.51% (p < 0.001), mean pressure of the short leg increased by 1.23% (p = 0.005), and decreased by 5.89% in the long leg (p < 0.001). Peak pressure of the short leg decreased by 2.58% (p = 0.031) and the long leg decreased by 12.11% (p < 0.001).
CONCLUSIONS: This study demonstrates that increasing LLD causes an asymmetrical foot-loading pattern, with decreased mean and peak pressure on the longer limb, and consequently an overload on the short side. Furthermore, an increasing LLD causes increased stance time on the long leg.

Impaired sitting balance is common in persons with stroke, affecting postural control in different directions. However, studies seldomly investigate sitting balance in severely affected non-ambulatory persons with stroke and precise assessment including the diagonal directions are scarce.
Are measurements of maximal voluntary weight-shifts decreased in severely affected persons with stroke in comparison to healthy controls, and is there a relationship with clinical measurements of trunk control, sitting and standing balance?
14 Persons with stroke were recruited in the rehabilitation phase along with 32 healthy controls. A clinical pressure platform (RM Ingénierie, France) evaluated the weight-distribution during static sitting and measurements of maximal voluntary weight-shifts, by centre of pressure displacements in six directions. Clinical measurements included Trunk Control Test, Trunk Impairment Scale and Berg Balance Scale.
The persons with stroke had a mean (SD) age of 69 (17) years, including 5 females and 9 males and were on average 57 (40) days post stroke. No patient was able to walk without manual support and median (IQR) Berg Balance Scale score was 17 (6-33) out of 56 points. Measurements showed that the centre of pressure distance was significantly smaller in all directions in persons with stroke compared to healthy controls (p < 0.05). The clinical measurements demonstrated moderate to very high correlations with centre of pressure distance in the diagonal forward, diagonal backward and lateral directions (r = 0.54 - 0.89).
This study reveals that measurements of maximal voluntary weight-shifts are feasible and show clinically relevant deficits in severely affected non-ambulatory persons with stroke. Especially the lateral and diagonal directions can be of interest to investigate further as they are most strongly correlated with clinical measurements of balance. Reaching exercises in these directions could be considered a core element of rehabilitation for this group of patients.

Low back pain (LBP) is a common recurrent pathology among assembly chain workers. This population tends to spend most of the workday in a static standing posture and handling loads, with balance being essential for correct job performance. LBP is related to poorer postural control, so balance could be affected in this condition.
The purpose of the present study is to analyze the deterioration of static balance generated by work activity in a prolonged standing position. We assess sway with a pressure platform at three moments of the workday (before, during, and after work), comparing the different balance parameters in 22 manufacturing plant workers with (17) and without (5) LBP.
In the pre-work capture, an independent t-test showed no significant differences between the pain and non-pain groups\' static balance parameters. Between the pre- and mid-workday captures, a two-way ANOVA with repeated measures showed a significant decrease in the medial-lateral center of pressure displacement with open eyes in workers with LBP.
workers with low back pain do not show a greater deterioration in static balance than workers without pain during the workday.

BACKGROUND: Falls are a major health problem among older adults. The risk of falling can be increased by polypharmacy, vision impairment, high blood pressure, environmental home hazards, fear of falling, and changes in the function of musculoskeletal and sensory systems that are associated with aging. Moreover, individuals who experienced previous falls are at higher risk. Nevertheless, falls can be prevented by screening for known risk factors.
OBJECTIVE: The objective of our study was to develop a multifactorial, instrumented, screening tool for fall risk, according to the key risk factors for falls, among Portuguese community-dwelling adults aged 50 years or over and to prospectively validate a risk prediction model for the risk of falling.
METHODS: This prospective study, following a convenience sample method, will recruit community-dwelling adults aged 50 years or over, who stand and walk independently with or without walking aids in parish councils, physical therapy clinics, senior\'s universities, and other facilities in different regions of continental Portugal. The FallSensing screening tool is a technological solution for fall risk screening that includes software, a pressure platform, and 2 inertial sensors. The screening includes questions about demographic and anthropometric data, health and lifestyle behaviors, a detailed explanation about procedures to accomplish 6 functional tests (grip strength, Timed Up and Go, 30 seconds sit to stand, step test, 4-Stage Balance test \"modified,\" and 10-meter walking speed), 3 questionnaires concerning environmental home hazards, and an activity and participation profile related to mobility and self-efficacy for exercise.
RESULTS: The enrollment began in June 2016 and we anticipate study completion by the end of 2018.
CONCLUSIONS: The FallSensing screening tool is a multifactorial and evidence-based assessment which identifies factors that contribute to fall risk. Establishing a risk prediction model will allow preventive strategies to be implemented, potentially decreasing fall rate.
UNASSIGNED: RR1-10.2196/10304.

BACKGROUND: The usefulness of studying posture and its modifications due to locomotor deficiencies of multiple origins has been widely proven in humans. To assess its suitability in the canine species, static posturography and dynamic pedobarography were performed on lame dogs affected with unilateral elbow dysplasia and cranial cruciate ligament rupture by using a pressure platform. With this objective, statokinesiograms and stabilograms, the percentage of pressure distribution between limbs, paw area, mean pressure, and peak pressure, were obtained from lame and sound dogs. These data were compared with Peak Vertical Force values originated from a force platform in the same recording sessions.
RESULTS: Significant differences were found in the parameters mentioned above between sound and lame dogs and limbs.
CONCLUSIONS: Posturography and pedobarography are useful and reliable for the monitoring of fore and hindlimb lameness in dogs, providing a new set of parameters for lameness detection.