Background: In-shoe pressure measurement systems are used in research and clinical practice to quantify areas and levels of pressure underfoot whilst shod. Their validity and reliability across different pressures, durations of load and contact areas determine their appropriateness to address different research questions or clinical assessments. XSENSOR is a relatively new pressure measurement device and warrants assessment. Research question: Does the XSENSOR in-shoe pressure measurement device have sufficient validity and reliability for clinical assessments in diabetes? Methods: Two XSENSOR insoles were examined across two days with two lab-based protocols to assess regional and whole insole loading. The whole insole protocol applied 50–600 kPa of pressure across the insole surface for 30 seconds and measured at 0, 2, 10 and 30 seconds. The regional protocol used two (3.14 and 15.9 cm² surface area) cylinders to apply pressures of 50, 110 and 200 kPa to each insole. Three trials of all conditions were averaged. The validity (% difference and Root Mean Square Error: RMSE) and repeatability (Bland Altman, Intra-Class Correlation Coefficient: ICC) of the target pressures (whole insole) and contact area (regional) were outcome variables. Results: Regional results demonstrated mean contact area errors of less than 1 cm² for both insoles and high repeatability (≥0.939). Whole insole measurement error was higher at higher pressures but resulted in average peak and mean pressures error < 10%. Reliability error was 3–10% for peak pressure, within the 15% defined as an analytical goal. Significance: Errors associated with the quantification of pressure are low enough that they are unlikely to influence the assessments of interventions or screening of the at-risk-foot considering clinically relevant thresholds. Contact area is accurate due to a high spatial resolution and the repeatability of the XSENSOR system likely makes it appropriate for clinical applications that require multiple assessments.

Background: An improved understanding of the structural and functional development of the paediatric foot is fundamental to a strong theoretical framework for health professionals and scientists. An infant's transition from sitting, through crawling and cruising, to walking is when the structures and function of the foot must adapt to bearing load. The adaptation of skin and other hard and soft tissue, and foot and gait biomechanics, during this time is poorly understood. This is because data characterising the foot tissue and loading pre‐walking onset does not exist. Of the existing kinematic and plantar pressure data, few studies have collected data which reflects the real‐life activities of infants with modern equipment.Methods: This is a longitudinal study and part of the Great Foundations Initiative, a collaborative project between the University of Brighton and the University of Salford, which is seeking to improve foot health in children. Two cohorts of 50 infants will be recruited at the two sites (University of Brighton, Eastbourne, UK and University of Salford, Salford, UK). Infants will be recruited when they first reach for their feet and attend four laboratory visits at milestones related to foot loading, with experienced independent walking being the final milestone. Data collection will include tissue characteristics (skin thickness, texture, elasticity, pH and tendon thickness and cross‐sectional area), plantar pressures and kinematics captured during real world locomotion tasks.Discussion: This study will provide a database characterising the development of the infant foot as it becomes a weight bearing structure. The data will allow effective comparison and quantification of changes in structure and function due to maturation and loading by measuring pre and post established walking. Additional variables which impact on the development of the foot (gender, ethnicity and body weight) will also be factored into our analysis. This will help us to advance understanding of the determinants of foot development in early childhood.

High heeled shoes remain popular; nevertheless it is not clear what influence manipulating characteristics of this footwear has on their functioning. It is accepted that shoe features other than heel height can affect plantar pressures. However, few investigations have compared such features, and none have compared the influence of modifying upper material stiffness, whilst systematically increasing heel height. A firm understanding of the interactions of footwear properties is essential to ensure that footwear designers can optimise design for the comfort and health of the wearer. This paper investigates a feature that is known to reduce comfort (heel height) and a feature that is easy to change without affecting aesthetics (material stiffness) to better understand the effects of their interaction on plantar pressure and comfort. Sixteen female participants with experience wearing high heels wore a range of shoes with five effective heel heights (35–75 mm) and two upper materials (with different stiffness). In-shoe plantar pressure was recorded and participants completed a comfort questionnaire. Increasing heel height increased plantar pressure under the metatarsal heads, while reducing pressure in the hallux and heel. Higher heel heights also lead to increased discomfort, particularly in the toes where discomfort increased 154.3% from the 35 to 75 mm heels. Upper stiffness did not affect plantar pressure. However, stiffer uppers significantly increased reported discomfort, most notably on top of the foot (108.6%), the back of the heel (87.7%), the overall width (99%) and the overall comfort (100.7%). Significant interaction effects between heel height and upper material existed for comfort questionnaire data. Manipulating heel height alters plantar pressure and comfort, and choice of upper material is paramount to achieving wearer comfort in heels.