Plantar pressure repeatability data analysis for healthy adult based on EMED system


  • Ali Hussein Sabry Universiti Putra Malaysia
  • Wan Zuha Wan Hasan Universiti Putra Malaysia
  • Mohd Nazim Mohtar Universiti Putra Malaysia
  • Raja Mohd Kamil Raja Ahmad Universiti Putra Malaysia



Plantar pressure system, EMED, Repeatability, Variance Coefficient


This paper presents the repeatability data analyses and discusses the selection of the appropriate type of plantar pressure measurements for the EMED system with regards to Pressure Level Values (PLV) over the touch insole area of healthy adults. In this research, a participant with age 28 years old has been chosen as a sample to  measure under foot pressure, it is conducted the test 20 times and took part in four types of plantar pressure clinical assessments, Dynamic (normal walking), Dynamic with load (normal walking, carrying 1.5 Kg), Static (Standing test), and Static with load (Standing, carrying 1.5 Kg). The analysis is implemented using a new approach of recognizing the measurements into 7 different levels of pressure that assigned with 7 colors by considering the image processing algorithm. Variance Coefficient (VC) check is adopted for the statistical analysis and the selection decision. The results highlighted that the overall pressure levels in dynamic with load category have a better variance as compared with three other categories of plantar pressure on this type of repeatability test. In conclusion, EMED system can be considered as an effective instrument to record plantar foot pressure measurements in such type of analysis.


Ahmed M. M. ALmassri, Chikamune Wada, W. Z. Wan Hasan and S. A. Ahmad, 2017 “Auto Grasping Algorithm of Robot Gripper Based on Pressure Sensor” Pertanika J. Sci. & Technol. 25 (S):113 122

Ahroni, J. H., E. J. Boyko, and R. Forsberg. 1998. “Reliability of F-Scan in-Shoe Measurements of Plantar Pressure.” Foot & Ankle International 19(10):668–73.

Anon. n.d. “Calibration EMED.”

Bircher, A., E. M. de Boer, T. Agner, J. E. Wahlberg, and J. Serup. 1994. “Guidelines for Measurement of Cutaneous Blood Flow by Laser Doppler Flowmetry. A Report from the Standardization Group of the European Society of Contact Dermatitis.” Contact Dermatitis 30:65–72.

Bland, J.Martin and Douglas G. Altman. 2010. “Statistical Methods for Assessing Agreement between Two Methods of Clinical Measurement.” International Journal of Nursing Studies 47(8):931–36.

Castro, Marcelo et al. 2011. “WalkinSense Validation: Preliminary Tests of Mobility Parameters.” ISBS - Conference Proceedings Archive 1(1):845–48.

Castro, Marcelo P. De et al. 2014. “Accuracy and Repeatability of the Gait Analysis by the Walkinsense System.” BioMed Research International 2014.

De Cock, A., T. Willems, E. Witvrouw, J. Vanrenterghem, and D. De Clercq. 2006. “A Functional Foot Type Classification with Cluster Analysis Based on Plantar Pressure Distribution during Jogging.” Gait and Posture 23(3):339–47.

Deutsch, Judith E., Megan Borbely, Jenny Filler, Karen Huhn, and Phyllis

Guarrera-Bowlby. 2008. “Plantar Pressure Assessment.” Physical Therapy 88(10):1196–1207.

Firth, Jill, Deborah Turner, Wendy Smith, Jim Woodburn, and Philip Helliwell. 2007. “The Validity and Reliability of PressureStat??? For Measuring Plantar Foot Pressures in Patients with Rheumatoid Arthritis.” Clinical Biomechanics 22(5):603–6.

Franco, Pedro S., Caio Borella P. da Silva, Emmanuel S. da Rocha, and Felipe P. Carpes. 2015. “Variability and Repeatability Analysis of Plantar Pressure during Gait in Older People.” Revista Brasileira de Reumatologia 55(5):427–33.

Ghazali, Aina Mardhiyah M. W. Z. W. Hasan, M. N. Hamidunb, Ahmed H. Sabry, S.A. Ahmed, C. Wada, 2015. “An Accurate Wireless Data Transmission and Low Power Consumption of Foot Plantar Pressure Measurements.” Procedia Computer Science 76(Iris):302–7.

Graf, P. M. 1993. “The EMED System of Foot Pressure Analysis.” Clinics in Podiatric Medicine and Surgery 10(3):445–54.

Gurney, J. K., P. W. M. Marshall, D. Rosenbaum, and U. G. Kersting. 2013. “Test-Retest Reliability of Dynamic Plantar Loading and Foot Geometry Measures in Diabetics with Peripheral Neuropathy.” Gait and Posture 37(1):135–37.

Gurney, Jason K., Uwe G. Kersting, and Dieter Rosenbaum. 2008. “Between-Day Reliability of Repeated Plantar Pressure Distribution Measurements in a Normal Population.” Gait & Posture 27(4):706–9.

Hafer, Jocelyn F. et al. 2013. “Reliability of Plantar Pressure Platforms.” Gait and Posture 38(3):544–48.

Healy, Aoife, Philip Burgess-Walker, Roozbeh Naemi, and Nachiappan Chockalingam. 2012. “Repeatability of WalkinSense(R) in Shoe Pressure Measurement System: A Preliminary Study.” Foot (Edinburgh, Scotland) 22(1):35–39.

Hsiao, Hongwei, Jinhua Guan, and Matthew Weatherly. 2002. “Accuracy and Precision of Two in-Shoe Pressure Measurement Systems.” Ergonomics 45(8):537–55.

Hurkmans, H. L. P., J. B. J. Bussmann, E. Benda, J. A. N. Verhaar, and H. J. Stam. 2006. “Accuracy and Repeatability of the Pedar Mobile System in Long-Term Vertical Force Measurements.” Gait and Posture 23(1):118–25.

Jonely, Holly, Jean Michel Brismée, Phillip S. Sizer, and C.Roger James. 2011. “Relationships between Clinical Measures of Static Foot Posture and Plantar Pressure during Static Standing and Walking.” Clinical Biomechanics 26(8):873–79.

Kernozek, T. W., E. E. Lamott, and M. J. Dancisak. 1996. “Reliability of an in-Shoe Pressure Measurement System during Treadmill Walking.” Foot and Ankle International 17(4):204–9.

Low, D. C. and S. J. Dixon. 2010. “Footscan Pressure Insoles: Accuracy and Reliability of Force and Pressure Measurements in Running.” Gait and Posture 32(4):664–66.

Maetzler, M., T. Bochdansky, and R. J. Abboud. 2010. “Normal Pressure Values and Repeatability of the Emed?? ST2 System.” Gait and Posture 32(3):391–94.

Martínez-Nova, Alfonso, José Carlos Cuevas-García, Javier Pascual-Huerta, and Raquel Sánchez-Rodríguez. 2007. “BioFoot® in-Shoe System: Normal Values and Assessment of the Reliability and

Repeatability.” Foot 17(4):190–96.

Murphy, Darlene F., Bruce D. Beynnon, James D. Michelson, and Pamela M. Vacek. 2005. “Efficacy of Plantar Loading Parameters During Gait in Terms of Reliability, Variability, Effect of Gender and Relationship Between Contact Area and Plantar Pressure.” Foot & Ankle International 26(2):171–79.

M.H. Chong, H.Jaafar, W.Z.W.Hasan, S.Shafie, M.N.Hamidun, M.M. Isa and A.F. Hawary, 2013 “An Experiment of Thick Film Force Sensor using MEMS Simulation Software”, Journal of Theoretical and Applied Information Technology (JATIT), 48 (1):902-910

O. Hussein, W.Z. Wan Hasan, A.Che Soh. H.Jafaar. 2011. An Accurate Setting for Remapping Process of Foot Plantar Pressure.

Putti, A. B., G. P. Arnold, L. A. Cochrane, and R. J. Abboud. 2008. “Normal Pressure Values and Repeatability of the Emed® ST4 System.” Gait and Posture 27(3):501–5.

Putti, A. B., G. P. Arnold, L. Cochrane, and R. J. Abboud. 2007. “The Pedar® in-Shoe System: Repeatability and Normal Pressure Values.” Gait and Posture 25(3):401–5.

Ramanathan, A. K., G. E. Fadel, A. S. Jain, and R. J. Abboud. 2008. “Press-Fit Ceramic Implant Arthroplasty of the Hallux Metatarsophalangeal Joint-Evaluation of Outcomes.” Foot 18(1):34–39.

Ramanathan, A. K., P. Kiran, G. P. Arnold, W. Wang, and R. J. Abboud. 2010. “Repeatability of the Pedar-X?? In-Shoe Pressure Measuring System.” Foot and Ankle Surgery 16(2):70–73.

Randolph, Audrey L., Mario Nelson, Sudha Akkapeddi, Aleksandr Levin, and Rodica Alexandrescu. 2000. “Reliability of Measurements of Pressures Applied on the Foot during Walking by a Computerized Insole Sensor System.” Archives of Physical Medicine and Rehabilitation 81(5):573–78.

Rosenbaum, D. and HP Becker. 1997. “Review Article Plantar Pressure Distribution Measurements . Technical Background and Clinical Applications.” Foot and Ankle Surgery (3):1–14.

Tong, Jasper W. K. and Pui W. Kong. 2013. “Reliability of Footprint Geometric and Plantar Loading Measurements in Children Using the Emed® M System.” Gait and Posture 38(2):281–86.

Vela, S. a, L. a Lavery, D. G. Armstrong, and a a Anaim. 1998. “The Effect of Increased Weight on Peak Pressures: Implications for Obesity and Diabetic Foot Pathology.” The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons 37(5):416-420-449.

Vidmar, Gaj and Primoz Novak. 2009. “Reliability of in-Shoe Plantar Pressure Measurements in Rheumatoid Arthritis Patients.” International Journal of Rehabilitation Research. Internationale Zeitschrift Für Rehabilitationsforschung. Revue Internationale de Recherches de Réadaptation 32(1):36–40.

Wiegers, Karl E. and Joy Beatty. 2013. Software Requirements 3rd Ed.

Woodburn, J. and P. S. Helliwell. 1996. “Observations on the F-Scan in-Shoe Pressure Measuring System.” Clinical Biomechanics 11(5):301–4.

W.Z.Wan Hasan, F. R. M. Rashidi, M. N. Hamidon and Y. Wahab 2015 "Investigation on developing of piezoresistive pressure sensor for foot plantar measurement system", IEEE Regional Symposium on Micro and Nanoelectronics 2015:1-4.