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Assessment of Long-Term Badminton Experience on Foot Posture Index and Plantar Pressure Distribution

Assessment of Long-Term Badminton Experience on Foot Posture Index and Plantar Pressure Distribution Hindawi Applied Bionics and Biomechanics Volume 2019, Article ID 8082967, 7 pages https://doi.org/10.1155/2019/8082967 Research Article Assessment of Long-Term Badminton Experience on Foot Posture Index and Plantar Pressure Distribution 1 2 1,2 Ping Huang, Minjun Liang, and Feng Ren Faculty of Sports Science, Ningbo University, Ningbo, China Research Academy of Grand Health, Ningbo University, Ningbo, China Correspondence should be addressed to Feng Ren; renfengnb@yeah.net Received 21 June 2018; Revised 24 September 2018; Accepted 16 October 2018; Published 2 January 2019 Academic Editor: Craig P. McGowan Copyright © 2019 Ping Huang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This study was aimed to analyze the foot posture index and plantar pressure characteristics of fifteen badminton players and fifteen controls. The hypothesis was that people with the habit of playing badminton would be significantly different with nonplaying people in foot posture index, 3D foot surface data, and plantar pressure distribution. Nine regions of plantar pressure were measured by using the EMED force platform, and badminton players showed significantly higher peak pressure in the hallux (p =0 003), medial heel (p =0 016), and lateral heel (p =0 021) and force-time integral in the hallux (p =0 002), medial heel (p =0 026), and lateral heel (p =0 015). There is no asymmetrical plantar pressure distribution between the left foot and the right foot of players. The mean foot posture index values of male and female badminton players are 5.2 ± 1.95 and 5.7 ± 1.15, respectively, and comparatively, those values of male and female controls are 1.5 ± 1.73 and 1.7 ± 4.16, respectively. This study shows that significant differences in morphology between people with the habit of playing badminton and people without that habit could be taken as a factor for a future study in locomotion biomechanics characteristics and foot shape of badminton players and in a footwear design in order to reduce injury risks. is based on the biological adaptation degree of the body. 1. Introduction The continuous improvement of sport level is the basis of Badminton attracted extensive participation when it was physiological support [4]. Previous studies showed that dif- introduced to the Barcelona Summer Games in 1992 [1]. ferent foot shapes have different foot functions. Although With the prevalence of badminton, the International Bad- presenting the same anatomical features, human foot has var- ious shapes and biomechanical characteristics [5–7]. Players minton Federation reported that there were about 200 mil- lion people playing badminton around the world [2]. Due of different races and different sports levels have different to easy learning rules, low-cost equipment, and small playing plantar pressures, foot shapes, and foot functions [8]. Previ- court, badminton appeals participants of different ages, eco- ous studies have shown that by understanding the character- nomic conditions, and physical capabilities [3]. Long-time istics of foot pressure distribution, it is possible to effectively badminton sport will cause a series of biological adaption optimize technical movements, reduce foot injuries, and and modifications to the motor system. improve the design of special shoes [9]. A report indicated Long-time badminton sport has adaptive influence on that when professional badminton players finish competi- the foot. Biological adaptation is a feature of phenotypic char- tions, stress gathers in their Achilles tendon and anterior acteristics of organisms adapting to the selection requirement knee tendons, especially in the dominant lunge leg [10]. High of the environment. According to the features of sports, bio- plantar pressure serves as an implicit causation of sports inju- logical adaptive modifications can be short term or long term, ries to lower limbs [11]. As a result, recognizing the impact which indicates adaptive modifications on all body levels forces and features of plantar pressure distribution would require complicated efforts. High-level sports performance contribute to finding the preseasons of sports injuries. 2 Applied Bionics and Biomechanics five times, and the averaged value was used for analysis. After Different sports have different technical posture features, which may result in certain foot shape comparing to other data collection, peak pressure, contact area, and pressure foot shapes. The foot posture index (FPI), as an effective time integral were obtained from the plantar pressure measurement for the quantization of standing foot pos- measurement system. The footprint was divided into nine ture, is relatively simple and fast to determine foot posture anatomical segments (Figure 1): hallux (H), other toes [12, 13]. FPI values of special postures in different sports (OT), first metatarsal (M1), second and fourth metatarsals are different [14]. Previous studies showed that FPI values (M24), fifth metatarsal (M5), medial midfoot (MM), lateral of a runner, basketball player, and handball player are signif- midfoot (LM), medial heel (MH), and lateral heel (LH). icantly different, mainly caused by talar head position and talonavicular [15]. The FPI index of basketball players in dif- 2.3. Foot Posture Index. Foot posture index (FPI), as a clinical ferent positions is related to lower limb injuries. After run- tool, can quantify the angle a foot can be pronated and supi- nated to [13, 19]. This is a relatively easy, fast, and reliable ning for a long time, foot posture and plantar pressure overall decrease in peak and mean plantar pressure was method [20]. The FPI was assessed in standing using the original protocol with the six items [12]: (1) talar head pal- revealed. The FPI value will be different during sport with higher intensity [16]. In the field of badminton study, there pation, (2) curvature at the lateral malleoli, (3) inversion/ are few studies about FPI and foot shape. Sports injuries eversion of the calcaneus, (4) talonavicular bulging, (5) con- gruence of the medical longitudinal arch, and (6) abduction/ may be reduced when designers design shoes according to different foot shapes [17, 18]. adduction of the forefoot on the rearfoot (Figure 2). Each item was scored on a scale of −2, −1, 0, +1, and +2 (0 for However, badminton players are rarely taken as the study participant. This study recruited 15 badminton players and neutral, −2 for clear signs of supination, and +2 for clear 15 normal people as the control. In the meantime, data of signs of pronation), and all scores were summed. The final score ranged from −12 to +12; a larger positive value means kinetics and foot shape of the 30 participants are collected, aiming to find the characteristics of kinetics and foot shape. a more pronated foot. There are no significant differences in the FPI between the right foot and the left foot in asymp- The hypothesis is that badminton players will be significantly different from controls in plantar pressure-based foot mor- tomatic individuals [21]. The FPI values and the plantar phology and posture characteristics. pressures only used the right foot measurements to avoid breaching assumptions of statistical independence in bilat- eral limb studies [22]. The FPI was evaluated by an experi- 2. Methods enced professional who did not know the purposes of the study and the participant identity and only sees the foot 2.1. Participants. A total of 30 participants, including 15 and 10 cm of the shank [23]. badminton players and 15 controls, participated in the exper- The BMI (body mass index) means the body weight (kg) iment approved by the local ethics committee. The partici- divided by the squared body height (m ). The World Health pants signed a consent form and were told about the Organization (WHO) regards BMI values between 18.5 and requirements and procedures before the experiment. Bad- 23.9 as normal, values below 18.5 as underweight, and values minton players have several years of badminton exercising over 30 as obese. See Table 1. As all participants’ BMI were in or playing habits and play more than one hour every time. the normal range, the foot shape changes due to different Controls do not have badminton exercise habits. In the past body weights or load-bearing conditions and different stature half year, participants do not have any injuries in both upper can be negligible bearing their own body weight [24, 25]. and lower limbs. Their basic demographics are shown in Table 1. 2.4. Statistical Analyses. The normality of variables in this experiment was checked before statistical analysis. An inde- 2.2. Design and Procedures pendent sampled t-test was used for the peak pressure, con- tact area pressure time integral, and FPI data analysis. The 2.2.1. Plantar Pressure Measurements. An EMED pressure effect size was calculated according to Cohen’s d used for platform was used to record plantar pressure at 50 Hz (Novel, Germany). The platform was placed on the ground at the comparing the differences in the mean value of the two groups. The statistical power of the analysis was calculated center of an 8-meter walkway. The participants were trained to walk and run on the platform before the test, and then using NCSS-PASS 16.0 software (Table 2). We established new variables on the basis of the foot morphological values every participant was required to walk and run on the plat- measured and did not consider participants’ weight. We cre- form five times. Every participant started walking and run- ning approximately five steps before contacting the ated new variables of length, width, ball, waist girth, and short heel to compare the athlete foot with the normal foot platform and contacted the platform at the sixth steps, then continued to walk and run. All tests were supervised, using morphological characteristics. Shortly, the new variables were obtained using the formulae as follows: a timer to test the time during a certain distance and calculate the average speed of every subject in each trial, and then the (1) Ratio: length/width date will not be used if the average speed in the trial deviates over ±5% from the certain walking and running speeds. Par- (2) Ratio: ball/waist girth ticipants would be asked to do the task one more time. The plantar pressure of every participant was recorded more than (3) Ratio: short heel/length Applied Bionics and Biomechanics 3 Table 1: The basic demographics of habitual badminton players and normal people. Badminton players Normal players Male Female Male Female Age (years) 22 ± 2.8 21 ± 1.0 24 ± 1.2 23 ± 1.0 Weight (kg) 69.8 ± 6.5 51.7 ± 2.9 67 ± 6.1 61 ± 12.1 Height (m) 175 ± 4.5 162 ± 2.9 173 ± 4.1 163 ± 6.4 BMI (kg/m ) 21.66 ± 1.38 19.75 ± 0.39 21.99 ± 1.46 20.58 ± 1.29 Badminton experience (years) 5.5 ± 2.8 6 ±00 0 Note: mean ± standard deviation; BMI—body mass index. lateral midfoot, first metatarsal head, second and fourth metatarsal heads, fifth metatarsal head, hallux, and other toes Hallux Other toes of badminton players and normal people. Figure 2 displays the mean (SD) values of peak pressure in badminton players and in those without the habit. During walking tests, the significance values (p) of nine anatomical ∗ ∗ ∗ parts are 0.003 (H), 0.021 (OT), 0.047 (M1), 0.394 (M24), 0.217 (M5), 0.375 (MM), 0.887 (LM), 0.016 (MH), First and 0.021 (LH) with higher variance exhibited in H, OT, metatarsal 2-4th M1, MH, and LH. During running tests, the significance metatarsal 5th ∗ values (p) of nine anatomical parts are 0.136 (H), 0.014 metatarsal (OT), 0.104 (M1), 0.932 (M24), 0.132 (M5), 0.963 (MM), Medial ∗ ∗ ∗ 0.047 (LM), 0.006 (MH), and 0.036 (LH). Peak pressures midfoot in the forefoot and rearfoot of badminton players are signif- icantly larger than those of people without that habit. In Figure 3, the contact areas are depicted. When the partici- Lateral pants are walking, the significance values (p) from indepen- midfoot dent sampled t-tests are 0.034 (H), 0.392 (OT), 0.664 (M1), 0.976 (M24), 0.133 (M5), 0.502 (MM), 0.983 (LM), 0.318 (MH), and 0.138 (LH). Professional and amateur players show significant differences only in the hallux during the walking test, and the differences in other toes are not obvious. When the participants are running, the significance ∗ ∗ Lateral values (p) are 0.042 (H), 0.076 (OT), 0.000 (M1), 0.773 Medial heel (M24), 0.114 (M5), 0.940 (MM), 0.443 (LM), 0.114 (MH), heel and 0.074 (LH). Significant differences in the contact area between professional players and amateur players appear in the inside of the forefoot during the walking test. In Figure 4, the force-time integrals (impulse) are illustrated. Figure 1: The foot segments (nine in total) used by the EMED When the participants are walking, the significance value pressure platform. ∗ (p) are 0.002 (H), 0.095 (OT), 0.138 (M1), 0.178 (M24), ∗ ∗ 0.002 (M5), 0.562 (MM), 0.683 (LM), 0.026 (MH), and 0.015 (LH). The force-time integrals to H, M5, MH, and (4) Ratio: short heel/width LH of badminton players are significantly larger than those of controls. When the participants are running, the signifi- All statistical analyses were carried out by using SPSS 17.0 cance values (p) are 0.061 (H), 0.001 (OT), 0.085 (M1), (SPSS Inc., Chicago, IL, USA) with significance level settings 0.650 (M24), 0.279 (M5), 0.653 (MM), 0.518 (LM), 0.079 at p <0 05. (MH), and 0.299 (LH). 30 participants include 15 people with the habit of play- ing badminton and 15 people without the habit of playing 3. Results badminton. The mean FPI values of males and females with For the plantar pressure, the mean and standard deviation the habit of playing badminton are 5.2 ± 1.95 and 5.7 ± 1.15, (SD) values of foot loading distribution characteristics are respectively, and that of males and females without the habit of playing badminton are 1.5 ± 1.73 and 1.7 ± 4.16, respec- shown in Figure 2 (peak pressure), Figure 3 (contact area), and Figure 4 (force-time integral) for every anatomical part. tively. No mean differences in the FPI were shown between The acronyms MH, LH, MM, LM, M1, M24, M5, H, and the right foot and the left foot. The mean FPI of the study OT stand for the medial heel, lateral heel, medial midfoot, group are displayed in Table 3. 4 Applied Bionics and Biomechanics Peak pressure Peak pressure 900 900 800 800 ⁎ ⁎ 700 700 600 600 500 500 400 400 300 300 200 200 100 100 0 0 HOT M1 M5 MM LM MH LH H OT M1 M24 M5 MM LM MH LH M24 Anatomical parts Anatomical parts Players walk Players run Normal walk Normal run (a) (b) Figure 2: The peak pressure in nine anatomical parts with an illustration of existing significance (∗ indicates p <0 05). Table 2: G power for the foot pressure. Peak pressure Contact area Force-time integral Walk Run Walk Run Walk Run Effect size Power Effect size Power Effect size Power Effect size Power Effect size Power Effect size Power H 0.52 0.84 0.23 0.8 0.21 0.8 0.31 0.8 0.64 0.88 0.29 0.81 OT 0.4 0.82 0.42 0.81 0.19 0.8 0.28 0.81 0.28 0.8 0.61 0.85 M1 0.37 0.82 0.31 0.81 0.18 0.8 0.83 0.93 0.31 0.81 0.37 0.82 M24 0.18 0.8 0.07 0.8 0.01 0.8 0.08 0.8 0.21 0.8 0.07 0.8 M5 0.22 0.81 0.3 0.81 0.32 0.81 0.28 0.8 0.6 0.83 0.26 0.81 MM 0.12 0.8 0.02 0.8 0.2 0.8 0.08 0.8 0.07 0.8 0.1 0.8 LM 0.09 0.8 0.48 0.83 0.06 0.8 0.16 0.8 0.09 0.8 0.03 0.8 MH 0.44 0.81 0.53 0.8 0.26 0.8 0.13 0.8 0.42 0.82 0.34 0.8 LH 0.44 0.81 0.29 0.8 0.24 0.8 0.18 0.8 0.41 0.81 0.16 0.8 Contact area Contact area 30 30 25 25 20 20 15 ⁎ 15 10 10 5 5 0 0 H OT M1 M24 M5 MM LM MH LH H OT M1 M24 M5 MM LM MH LH Anatomical parts Anatomical parts Players walk Players run Normal walk Normal run (a) (b) Figure 3: The contact area in nine anatomical parts with an illustration of significance (∗ indicates p <0 05). 4. Discussion will be significantly different from people having the habit of playing badminton in plantar pressure and kinematics. The The purpose of this study was to identify that biological experimental results support this hypothesis. The character- istics of plantar pressure distribution and that of foot shape adaptation in people without the habit of playing badminton 2 Peak pressure (Kpa) Contact area (cm ) 2 Peak pressure (Kpa) Contact area (cm ) Applied Bionics and Biomechanics 5 Force time integral Force time integral 120 ⁎ 80 60 40 0 0 H OT M1 M24 M5 MM LM MH LH H OT M1 M24 M5 MM LM MH LH Anatomical parts Anatomical parts Players walk Players run Normal walk Normal run (a) (b) Figure 4: The force-time integral in nine anatomical parts with an illustration of significance (∗ indicates p <0 05). Table 3: Mean values for the foot posture index. extremities [30]. This research probed into plantar pressure distribution of different areas of both the right foot and the Habitual players Normal players left foot of badminton players and controls when they are Male Female Male Female walking and running. The analysis of plantar pressure of FPI 5.2 ± 1.95 5.7 ± 1.15 1.5 ± 1.73 1.7 ± 4.16 the right and left feet shows that there is no significant differ- L/W ratio 2.3 ± 0.26 2.2 ± 0.22 2.2 ± 0.32 2.1 ± 0.10 ence between them, which is in accordance with the analysis B/W G ratio 1.0 ± 0.09 1.0 ± 0.02 1.0 ± 0.02 1.0 ± 0.01 of muscle force around the ankle; that is, the difference in the S H/L ratio 1.3 ± 0.04 1.3 ± 0.06 1.3 ± 0.04 1.3 ± 0.04 bilateral antagonist muscle ratio is caused by the difference in S H/W ratio 2.9 ± 0.30 2.8 ± 0.26 2.7 ± 0.37 2.6 ± 0.13 force using the method instead of that in bilateral muscle force [31]. Note: values are presented as the mean ± standard deviation. L/W ratio, Results show the correlation between FPI and plantar length/width; B/W G ratio, ball/waist girth; S H/L ratio, short hell/length; S H/W ratio, short hell/width. pressure [32]. Many researches have estimated the pressure distribution of flatfeet, and some of them aimed at identify- ing the normal value [33]. Therefore, the FPI is a more intu- are significantly different between people with many years of itive and reliable index for selecting athletes. Results of our badminton playing habit and those without that habit when research show that the mean FPI values of males and they walk and run. These parameters should be considered females with the habit of playing badminton are 5.2 ± 1.95 in future sports intervention and sports equipment design. and 5.7 ± 1.15, respectively, and that of males and females Long-time sport can improve physical activity level, and without the habit of playing badminton are 1.5 ± 1.73 and supercompensation theory and adaptation theory have 1.7 ± 4.16, respectively. explained the changes of people’s sports ability when training Fatigue caused by sports will lead to changes in the plan- [26]. Reports said that research on the plantar pressure of tar pressure. Changes in foot posture after running were athletes may optimize technology, promote footwear design, studied and combined with the plantar pressure model, indi- cating that heel strike posture during running is related to and reduce the risk of foot injuries [27]. Therefore, the data of plantar pressure in walking and running are collected plantar pressure distribution. The investigation can help and analyzed. In terms of plantar pressure distribution, peak understand foot function, prevent sport-related injury, and pressures of H, OT, M1, MH, and LH of badminton players design effective foot type orthodontic appliance [34, 35]. This are significantly higher than controls in walking. These fea- method was rarely used in badminton research before. In the tures are related to the habit of landing on the balls of their future, changes in the foot posture index after playing bad- feet when people play badminton. The contact area and minton can be taken as a factor to study the biological adap- force-time integral of H show a marked difference, demon- tation of foot function of badminton players after long-term strating that the metatarsal head and lateral heel are areas badminton sports. with the highest pressure; thus, different areas of outsoles The foot shape index is used to evaluate foot function and need different materials for dispersing pressure [28]. footwear design. In general, length, width, and height are In actual badminton sports movement, the in-shoe peak regarded as the standards to test whether the footwear is fit plantar pressures in left- and right-forward lunges were to the foot [36, 37]. However, owing to that foot height is investigated [29]. Thus, differences in the plantar pressures not directly related to foot length, the method of grading among lunges of different directions may be latent risks for shoes by increasing height or scaling according to foot length badminton players to sustain injuries to their lower is undesirable [24, 25]. Common indexes of the footwear Force time integral (N S) Force time integral (N S) 6 Applied Bionics and Biomechanics [5] Y. D. Gu, J. S. Li, and Z. Y. Li, “Deformation of female foot design are foot length, heel width, forefoot width, and mid- binding in China,” Journal of Clinical Rheumatology, vol. 19, foot width. The research aimed at providing reference no. 7, p. 418, 2013. indexes for a badminton footwear design by setting specific [6] J. Ma, Y. Song, M. Rong, and Y. Gu, “Bound foot metatarsals ratios according to foot shape features. 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Assessment of Long-Term Badminton Experience on Foot Posture Index and Plantar Pressure Distribution

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Hindawi Applied Bionics and Biomechanics Volume 2019, Article ID 8082967, 7 pages https://doi.org/10.1155/2019/8082967 Research Article Assessment of Long-Term Badminton Experience on Foot Posture Index and Plantar Pressure Distribution 1 2 1,2 Ping Huang, Minjun Liang, and Feng Ren Faculty of Sports Science, Ningbo University, Ningbo, China Research Academy of Grand Health, Ningbo University, Ningbo, China Correspondence should be addressed to Feng Ren; renfengnb@yeah.net Received 21 June 2018; Revised 24 September 2018; Accepted 16 October 2018; Published 2 January 2019 Academic Editor: Craig P. McGowan Copyright © 2019 Ping Huang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This study was aimed to analyze the foot posture index and plantar pressure characteristics of fifteen badminton players and fifteen controls. The hypothesis was that people with the habit of playing badminton would be significantly different with nonplaying people in foot posture index, 3D foot surface data, and plantar pressure distribution. Nine regions of plantar pressure were measured by using the EMED force platform, and badminton players showed significantly higher peak pressure in the hallux (p =0 003), medial heel (p =0 016), and lateral heel (p =0 021) and force-time integral in the hallux (p =0 002), medial heel (p =0 026), and lateral heel (p =0 015). There is no asymmetrical plantar pressure distribution between the left foot and the right foot of players. The mean foot posture index values of male and female badminton players are 5.2 ± 1.95 and 5.7 ± 1.15, respectively, and comparatively, those values of male and female controls are 1.5 ± 1.73 and 1.7 ± 4.16, respectively. This study shows that significant differences in morphology between people with the habit of playing badminton and people without that habit could be taken as a factor for a future study in locomotion biomechanics characteristics and foot shape of badminton players and in a footwear design in order to reduce injury risks. is based on the biological adaptation degree of the body. 1. Introduction The continuous improvement of sport level is the basis of Badminton attracted extensive participation when it was physiological support [4]. Previous studies showed that dif- introduced to the Barcelona Summer Games in 1992 [1]. ferent foot shapes have different foot functions. Although With the prevalence of badminton, the International Bad- presenting the same anatomical features, human foot has var- ious shapes and biomechanical characteristics [5–7]. Players minton Federation reported that there were about 200 mil- lion people playing badminton around the world [2]. Due of different races and different sports levels have different to easy learning rules, low-cost equipment, and small playing plantar pressures, foot shapes, and foot functions [8]. Previ- court, badminton appeals participants of different ages, eco- ous studies have shown that by understanding the character- nomic conditions, and physical capabilities [3]. Long-time istics of foot pressure distribution, it is possible to effectively badminton sport will cause a series of biological adaption optimize technical movements, reduce foot injuries, and and modifications to the motor system. improve the design of special shoes [9]. A report indicated Long-time badminton sport has adaptive influence on that when professional badminton players finish competi- the foot. Biological adaptation is a feature of phenotypic char- tions, stress gathers in their Achilles tendon and anterior acteristics of organisms adapting to the selection requirement knee tendons, especially in the dominant lunge leg [10]. High of the environment. According to the features of sports, bio- plantar pressure serves as an implicit causation of sports inju- logical adaptive modifications can be short term or long term, ries to lower limbs [11]. As a result, recognizing the impact which indicates adaptive modifications on all body levels forces and features of plantar pressure distribution would require complicated efforts. High-level sports performance contribute to finding the preseasons of sports injuries. 2 Applied Bionics and Biomechanics five times, and the averaged value was used for analysis. After Different sports have different technical posture features, which may result in certain foot shape comparing to other data collection, peak pressure, contact area, and pressure foot shapes. The foot posture index (FPI), as an effective time integral were obtained from the plantar pressure measurement for the quantization of standing foot pos- measurement system. The footprint was divided into nine ture, is relatively simple and fast to determine foot posture anatomical segments (Figure 1): hallux (H), other toes [12, 13]. FPI values of special postures in different sports (OT), first metatarsal (M1), second and fourth metatarsals are different [14]. Previous studies showed that FPI values (M24), fifth metatarsal (M5), medial midfoot (MM), lateral of a runner, basketball player, and handball player are signif- midfoot (LM), medial heel (MH), and lateral heel (LH). icantly different, mainly caused by talar head position and talonavicular [15]. The FPI index of basketball players in dif- 2.3. Foot Posture Index. Foot posture index (FPI), as a clinical ferent positions is related to lower limb injuries. After run- tool, can quantify the angle a foot can be pronated and supi- nated to [13, 19]. This is a relatively easy, fast, and reliable ning for a long time, foot posture and plantar pressure overall decrease in peak and mean plantar pressure was method [20]. The FPI was assessed in standing using the original protocol with the six items [12]: (1) talar head pal- revealed. The FPI value will be different during sport with higher intensity [16]. In the field of badminton study, there pation, (2) curvature at the lateral malleoli, (3) inversion/ are few studies about FPI and foot shape. Sports injuries eversion of the calcaneus, (4) talonavicular bulging, (5) con- gruence of the medical longitudinal arch, and (6) abduction/ may be reduced when designers design shoes according to different foot shapes [17, 18]. adduction of the forefoot on the rearfoot (Figure 2). Each item was scored on a scale of −2, −1, 0, +1, and +2 (0 for However, badminton players are rarely taken as the study participant. This study recruited 15 badminton players and neutral, −2 for clear signs of supination, and +2 for clear 15 normal people as the control. In the meantime, data of signs of pronation), and all scores were summed. The final score ranged from −12 to +12; a larger positive value means kinetics and foot shape of the 30 participants are collected, aiming to find the characteristics of kinetics and foot shape. a more pronated foot. There are no significant differences in the FPI between the right foot and the left foot in asymp- The hypothesis is that badminton players will be significantly different from controls in plantar pressure-based foot mor- tomatic individuals [21]. The FPI values and the plantar phology and posture characteristics. pressures only used the right foot measurements to avoid breaching assumptions of statistical independence in bilat- eral limb studies [22]. The FPI was evaluated by an experi- 2. Methods enced professional who did not know the purposes of the study and the participant identity and only sees the foot 2.1. Participants. A total of 30 participants, including 15 and 10 cm of the shank [23]. badminton players and 15 controls, participated in the exper- The BMI (body mass index) means the body weight (kg) iment approved by the local ethics committee. The partici- divided by the squared body height (m ). The World Health pants signed a consent form and were told about the Organization (WHO) regards BMI values between 18.5 and requirements and procedures before the experiment. Bad- 23.9 as normal, values below 18.5 as underweight, and values minton players have several years of badminton exercising over 30 as obese. See Table 1. As all participants’ BMI were in or playing habits and play more than one hour every time. the normal range, the foot shape changes due to different Controls do not have badminton exercise habits. In the past body weights or load-bearing conditions and different stature half year, participants do not have any injuries in both upper can be negligible bearing their own body weight [24, 25]. and lower limbs. Their basic demographics are shown in Table 1. 2.4. Statistical Analyses. The normality of variables in this experiment was checked before statistical analysis. An inde- 2.2. Design and Procedures pendent sampled t-test was used for the peak pressure, con- tact area pressure time integral, and FPI data analysis. The 2.2.1. Plantar Pressure Measurements. An EMED pressure effect size was calculated according to Cohen’s d used for platform was used to record plantar pressure at 50 Hz (Novel, Germany). The platform was placed on the ground at the comparing the differences in the mean value of the two groups. The statistical power of the analysis was calculated center of an 8-meter walkway. The participants were trained to walk and run on the platform before the test, and then using NCSS-PASS 16.0 software (Table 2). We established new variables on the basis of the foot morphological values every participant was required to walk and run on the plat- measured and did not consider participants’ weight. We cre- form five times. Every participant started walking and run- ning approximately five steps before contacting the ated new variables of length, width, ball, waist girth, and short heel to compare the athlete foot with the normal foot platform and contacted the platform at the sixth steps, then continued to walk and run. All tests were supervised, using morphological characteristics. Shortly, the new variables were obtained using the formulae as follows: a timer to test the time during a certain distance and calculate the average speed of every subject in each trial, and then the (1) Ratio: length/width date will not be used if the average speed in the trial deviates over ±5% from the certain walking and running speeds. Par- (2) Ratio: ball/waist girth ticipants would be asked to do the task one more time. The plantar pressure of every participant was recorded more than (3) Ratio: short heel/length Applied Bionics and Biomechanics 3 Table 1: The basic demographics of habitual badminton players and normal people. Badminton players Normal players Male Female Male Female Age (years) 22 ± 2.8 21 ± 1.0 24 ± 1.2 23 ± 1.0 Weight (kg) 69.8 ± 6.5 51.7 ± 2.9 67 ± 6.1 61 ± 12.1 Height (m) 175 ± 4.5 162 ± 2.9 173 ± 4.1 163 ± 6.4 BMI (kg/m ) 21.66 ± 1.38 19.75 ± 0.39 21.99 ± 1.46 20.58 ± 1.29 Badminton experience (years) 5.5 ± 2.8 6 ±00 0 Note: mean ± standard deviation; BMI—body mass index. lateral midfoot, first metatarsal head, second and fourth metatarsal heads, fifth metatarsal head, hallux, and other toes Hallux Other toes of badminton players and normal people. Figure 2 displays the mean (SD) values of peak pressure in badminton players and in those without the habit. During walking tests, the significance values (p) of nine anatomical ∗ ∗ ∗ parts are 0.003 (H), 0.021 (OT), 0.047 (M1), 0.394 (M24), 0.217 (M5), 0.375 (MM), 0.887 (LM), 0.016 (MH), First and 0.021 (LH) with higher variance exhibited in H, OT, metatarsal 2-4th M1, MH, and LH. During running tests, the significance metatarsal 5th ∗ values (p) of nine anatomical parts are 0.136 (H), 0.014 metatarsal (OT), 0.104 (M1), 0.932 (M24), 0.132 (M5), 0.963 (MM), Medial ∗ ∗ ∗ 0.047 (LM), 0.006 (MH), and 0.036 (LH). Peak pressures midfoot in the forefoot and rearfoot of badminton players are signif- icantly larger than those of people without that habit. In Figure 3, the contact areas are depicted. When the partici- Lateral pants are walking, the significance values (p) from indepen- midfoot dent sampled t-tests are 0.034 (H), 0.392 (OT), 0.664 (M1), 0.976 (M24), 0.133 (M5), 0.502 (MM), 0.983 (LM), 0.318 (MH), and 0.138 (LH). Professional and amateur players show significant differences only in the hallux during the walking test, and the differences in other toes are not obvious. When the participants are running, the significance ∗ ∗ Lateral values (p) are 0.042 (H), 0.076 (OT), 0.000 (M1), 0.773 Medial heel (M24), 0.114 (M5), 0.940 (MM), 0.443 (LM), 0.114 (MH), heel and 0.074 (LH). Significant differences in the contact area between professional players and amateur players appear in the inside of the forefoot during the walking test. In Figure 4, the force-time integrals (impulse) are illustrated. Figure 1: The foot segments (nine in total) used by the EMED When the participants are walking, the significance value pressure platform. ∗ (p) are 0.002 (H), 0.095 (OT), 0.138 (M1), 0.178 (M24), ∗ ∗ 0.002 (M5), 0.562 (MM), 0.683 (LM), 0.026 (MH), and 0.015 (LH). The force-time integrals to H, M5, MH, and (4) Ratio: short heel/width LH of badminton players are significantly larger than those of controls. When the participants are running, the signifi- All statistical analyses were carried out by using SPSS 17.0 cance values (p) are 0.061 (H), 0.001 (OT), 0.085 (M1), (SPSS Inc., Chicago, IL, USA) with significance level settings 0.650 (M24), 0.279 (M5), 0.653 (MM), 0.518 (LM), 0.079 at p <0 05. (MH), and 0.299 (LH). 30 participants include 15 people with the habit of play- ing badminton and 15 people without the habit of playing 3. Results badminton. The mean FPI values of males and females with For the plantar pressure, the mean and standard deviation the habit of playing badminton are 5.2 ± 1.95 and 5.7 ± 1.15, (SD) values of foot loading distribution characteristics are respectively, and that of males and females without the habit of playing badminton are 1.5 ± 1.73 and 1.7 ± 4.16, respec- shown in Figure 2 (peak pressure), Figure 3 (contact area), and Figure 4 (force-time integral) for every anatomical part. tively. No mean differences in the FPI were shown between The acronyms MH, LH, MM, LM, M1, M24, M5, H, and the right foot and the left foot. The mean FPI of the study OT stand for the medial heel, lateral heel, medial midfoot, group are displayed in Table 3. 4 Applied Bionics and Biomechanics Peak pressure Peak pressure 900 900 800 800 ⁎ ⁎ 700 700 600 600 500 500 400 400 300 300 200 200 100 100 0 0 HOT M1 M5 MM LM MH LH H OT M1 M24 M5 MM LM MH LH M24 Anatomical parts Anatomical parts Players walk Players run Normal walk Normal run (a) (b) Figure 2: The peak pressure in nine anatomical parts with an illustration of existing significance (∗ indicates p <0 05). Table 2: G power for the foot pressure. Peak pressure Contact area Force-time integral Walk Run Walk Run Walk Run Effect size Power Effect size Power Effect size Power Effect size Power Effect size Power Effect size Power H 0.52 0.84 0.23 0.8 0.21 0.8 0.31 0.8 0.64 0.88 0.29 0.81 OT 0.4 0.82 0.42 0.81 0.19 0.8 0.28 0.81 0.28 0.8 0.61 0.85 M1 0.37 0.82 0.31 0.81 0.18 0.8 0.83 0.93 0.31 0.81 0.37 0.82 M24 0.18 0.8 0.07 0.8 0.01 0.8 0.08 0.8 0.21 0.8 0.07 0.8 M5 0.22 0.81 0.3 0.81 0.32 0.81 0.28 0.8 0.6 0.83 0.26 0.81 MM 0.12 0.8 0.02 0.8 0.2 0.8 0.08 0.8 0.07 0.8 0.1 0.8 LM 0.09 0.8 0.48 0.83 0.06 0.8 0.16 0.8 0.09 0.8 0.03 0.8 MH 0.44 0.81 0.53 0.8 0.26 0.8 0.13 0.8 0.42 0.82 0.34 0.8 LH 0.44 0.81 0.29 0.8 0.24 0.8 0.18 0.8 0.41 0.81 0.16 0.8 Contact area Contact area 30 30 25 25 20 20 15 ⁎ 15 10 10 5 5 0 0 H OT M1 M24 M5 MM LM MH LH H OT M1 M24 M5 MM LM MH LH Anatomical parts Anatomical parts Players walk Players run Normal walk Normal run (a) (b) Figure 3: The contact area in nine anatomical parts with an illustration of significance (∗ indicates p <0 05). 4. Discussion will be significantly different from people having the habit of playing badminton in plantar pressure and kinematics. The The purpose of this study was to identify that biological experimental results support this hypothesis. The character- istics of plantar pressure distribution and that of foot shape adaptation in people without the habit of playing badminton 2 Peak pressure (Kpa) Contact area (cm ) 2 Peak pressure (Kpa) Contact area (cm ) Applied Bionics and Biomechanics 5 Force time integral Force time integral 120 ⁎ 80 60 40 0 0 H OT M1 M24 M5 MM LM MH LH H OT M1 M24 M5 MM LM MH LH Anatomical parts Anatomical parts Players walk Players run Normal walk Normal run (a) (b) Figure 4: The force-time integral in nine anatomical parts with an illustration of significance (∗ indicates p <0 05). Table 3: Mean values for the foot posture index. extremities [30]. This research probed into plantar pressure distribution of different areas of both the right foot and the Habitual players Normal players left foot of badminton players and controls when they are Male Female Male Female walking and running. The analysis of plantar pressure of FPI 5.2 ± 1.95 5.7 ± 1.15 1.5 ± 1.73 1.7 ± 4.16 the right and left feet shows that there is no significant differ- L/W ratio 2.3 ± 0.26 2.2 ± 0.22 2.2 ± 0.32 2.1 ± 0.10 ence between them, which is in accordance with the analysis B/W G ratio 1.0 ± 0.09 1.0 ± 0.02 1.0 ± 0.02 1.0 ± 0.01 of muscle force around the ankle; that is, the difference in the S H/L ratio 1.3 ± 0.04 1.3 ± 0.06 1.3 ± 0.04 1.3 ± 0.04 bilateral antagonist muscle ratio is caused by the difference in S H/W ratio 2.9 ± 0.30 2.8 ± 0.26 2.7 ± 0.37 2.6 ± 0.13 force using the method instead of that in bilateral muscle force [31]. Note: values are presented as the mean ± standard deviation. L/W ratio, Results show the correlation between FPI and plantar length/width; B/W G ratio, ball/waist girth; S H/L ratio, short hell/length; S H/W ratio, short hell/width. pressure [32]. Many researches have estimated the pressure distribution of flatfeet, and some of them aimed at identify- ing the normal value [33]. Therefore, the FPI is a more intu- are significantly different between people with many years of itive and reliable index for selecting athletes. Results of our badminton playing habit and those without that habit when research show that the mean FPI values of males and they walk and run. These parameters should be considered females with the habit of playing badminton are 5.2 ± 1.95 in future sports intervention and sports equipment design. and 5.7 ± 1.15, respectively, and that of males and females Long-time sport can improve physical activity level, and without the habit of playing badminton are 1.5 ± 1.73 and supercompensation theory and adaptation theory have 1.7 ± 4.16, respectively. explained the changes of people’s sports ability when training Fatigue caused by sports will lead to changes in the plan- [26]. Reports said that research on the plantar pressure of tar pressure. Changes in foot posture after running were athletes may optimize technology, promote footwear design, studied and combined with the plantar pressure model, indi- cating that heel strike posture during running is related to and reduce the risk of foot injuries [27]. Therefore, the data of plantar pressure in walking and running are collected plantar pressure distribution. The investigation can help and analyzed. In terms of plantar pressure distribution, peak understand foot function, prevent sport-related injury, and pressures of H, OT, M1, MH, and LH of badminton players design effective foot type orthodontic appliance [34, 35]. This are significantly higher than controls in walking. These fea- method was rarely used in badminton research before. In the tures are related to the habit of landing on the balls of their future, changes in the foot posture index after playing bad- feet when people play badminton. The contact area and minton can be taken as a factor to study the biological adap- force-time integral of H show a marked difference, demon- tation of foot function of badminton players after long-term strating that the metatarsal head and lateral heel are areas badminton sports. with the highest pressure; thus, different areas of outsoles The foot shape index is used to evaluate foot function and need different materials for dispersing pressure [28]. footwear design. In general, length, width, and height are In actual badminton sports movement, the in-shoe peak regarded as the standards to test whether the footwear is fit plantar pressures in left- and right-forward lunges were to the foot [36, 37]. However, owing to that foot height is investigated [29]. Thus, differences in the plantar pressures not directly related to foot length, the method of grading among lunges of different directions may be latent risks for shoes by increasing height or scaling according to foot length badminton players to sustain injuries to their lower is undesirable [24, 25]. Common indexes of the footwear Force time integral (N S) Force time integral (N S) 6 Applied Bionics and Biomechanics [5] Y. D. Gu, J. S. Li, and Z. Y. Li, “Deformation of female foot design are foot length, heel width, forefoot width, and mid- binding in China,” Journal of Clinical Rheumatology, vol. 19, foot width. The research aimed at providing reference no. 7, p. 418, 2013. indexes for a badminton footwear design by setting specific [6] J. Ma, Y. Song, M. Rong, and Y. Gu, “Bound foot metatarsals ratios according to foot shape features. Results show that skeletal rays kinematics information through inverse model- there is no significant difference in foot shape between people ling,” International Journal of Biomedical Engineering and with many years of badminton playing habit and those with- Technology, vol. 13, no. 2, pp. 147–153, 2013. out that habit, but data of this research, combined with data [7] M. Razeghi and M. E. Batt, “Foot type classification: a critical of plantar pressure distribution and FPI, can be taken as ref- review of current methods,” Gait Posture, vol. 15, no. 3, erence indexes for footwear design. Further research can use pp. 282–291, 2002. the arch index as the reference index. Findings show that the [8] J. K. Gurney, U. G. Kersting, and D. 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