Evaluation of plantar pressure and stability parameters in a forefoot offloading footwear : a comparative study

Abstract

Forefoot offloading footwear is widely used in postoperative care, trauma management, and the prevention of diabetic foot ulceration, where redistribution of plantar load must be achieved without compromising gait stability. This study evaluated plantar pressure and centre of pressure characteristics of a new side-specific forefoot offloading footwear design in comparison with commonly used clinical and retail footwear. Twelve healthy adults completed treadmill walking trials at 4.0 km/h under five footwear conditions. Plantar pressure data were collected using an in-shoe pressure measurement system and analysed for peak pressure, average pressure, force–time impulse, centre of pressure velocity, and centre of pressure excursion index across seven anatomically defined plantar regions. Across all conditions, consistent left–right asymmetry in plantar loading was observed, although overall variability between footwear designs was modest. The experimental footwear demonstrated pressure and impulse distributions comparable to retail and universal offloading footwear, without increasing hallux loading. Centre of pressure measures were generally consistent between side variability, indicating controlled rollover and preserved gait stability. These findings suggest that side-specific sole geometry can support balanced forefoot load management without introducing instability in healthy walking and provide a foundation for future bilateral testing in clinical populations at risk.