AN OBSERVATIONAL STUDY TO ASSESS THE ROLE OF FOREFOOT AND HINDFOOT WEIGHT DISTRIBUTION PATTERN USING SENSOR PLATE EVALUATION IN PATIENTS WITH UNSPECIFIED HEEL PAIN

Abstract

Background: Heel pain is commonly seen in physiotherapy and orthopaedic practice. In many patients,
routine examination does not reveal one clear cause. The way body weight is shared between the front and
back of the foot may place repeated stress on the heel. Sensor plate assessment provides an objective record
of this loading pattern and may help identify abnormal weight-bearing in patients with unspecified heel
pain.
Aim: To examine forefoot and hindfoot weight distribution using sensor plate assessment in patients with
unspecified heel pain.
Methodology: This observational study included 50 participants aged 20 to 70 years with unspecified heel
pain. Participants were selected according to the study criteria. Age, sex, body measurements, duration and
side of pain, and pain intensity on the Visual Analogue Scale were recorded. Sensor plate assessment
measured forefoot and hindfoot load, the difference between these regions, the hindfoot-to-forefoot ratio,
plantar pressure, posterior centre-of-pressure shift and the overall loading impression. Data were analysed
using descriptive and inferential statistics, with significance set at p < 0.05.
Results: The participants had a mean age of 39.28 ± 11.19 years; 28 were male and 22 were female. Mean
BMI was 27.28 ± 3.63 kg/m2 and mean VAS pain was 3.90 ± 1.13. Mean forefoot load was 39.67 ±
7.08%, compared with 60.33 ± 7.08% over the hindfoot. Hindfoot load was significantly greater than
forefoot load, with a mean difference of 20.66% (t = 10.32, p < 0.001), and was also above the neutral
reference value of 50% (p < 0.001). Higher hindfoot load was strongly related to greater heel pain (r =
0.746, p < 0.001). Posterior centre-of-pressure shift also showed a significant positive relationship with
pain intensity (r = 0.645, p < 0.001).
Conclusion: Participants with unspecified heel pain commonly placed more weight through the hindfoot.
Greater hindfoot loading and a more posterior centre of pressure were associated with higher pain levels.
Sensor plate assessment may therefore be useful for identifying altered plantar loading and for planning
more focused physiotherapy management.