Plantar shear stress distributions: comparing actual and predicted frictional forces at the foot-ground interface.

Plantar shear stresses are believed to play a major role in diabetic ulceration. Due to the lack of commercial devices that can measure plantar shear distribution, a number of mathematical models have been developed to predict plantar frictional forces. This study assessed the accuracy of these models using a custom-built platform capable of measuring plantar stresses simultaneously. A total of 48 (38 healthy and 10 diabetic) human subjects (75+/-20 kg, 41+/-20 years, 32 males, 16 females) were recruited in the study. Plantar force data were collected for 2s at 50 Hz. Two models (M1 and M2) reported in the literature by different groups were used to predict local shear stresses. Root mean squared errors (RMSE) were calculated to compare model data with the actual data, focusing on three parameters: location, magnitude and timing of peak shear components. RMSE values of estimated peak AP and ML shear locations were 3.1 and 2.2 cm for M1 and 3.1 and 2.1cm for M2, respectively. Magnitude RMS error values for M1 were found to be 86.6 kPa in AP shear and 38.5 kPa in ML shear, whereas these values were determined to be 97.8 and 63.5 kPa, respectively by M2. Time to peak shear RMSE values averaged 17.2% in terms of the gait duration. In conclusion, distribution of plantar shear should be measured rather than predicted, particularly if one is interested in the magnitudes of shear components.