Assessing Concurrent Validity and Reliability of the S-Gait Insole: A Novel Tool for Measuring Weight Bearing
Yıl 2025,
Cilt: 12 Sayı: 3, 897 - 911, 31.12.2025
Muharrem Gökhan Beydağı
,
Zilan Bazancir Apaydın
,
Muhammed Çakır
,
Hande Guney Deniz
,
Nazli Busra Cıgercıoglu
,
Yaşar Gül Baltaci
Öz
Objectives: Accurate measurement of weight-bearing (WB) is critical in musculoskeletal and neurological rehabilitation, yet current systems are often costly and impractical for routine use. This study investigated the concurrent validity of the S-GAIT insole, a low-cost and portable tool, compared with the Digital Biometry Scanning System and Milletrix Software (DIASU, Italy).
Materials and Methods: A cross-sectional, within-subject comparative design was applied to compare S-GAIT and DIASU. Twenty-one healthy individuals (mean age 32.6 ± 7.3 years) participated. WB of both lower extremities was assessed during quiet standing using both devices in a single laboratory session. Data were collected under standardized static conditions, and outcomes were statistically analyzed.
Results: No significant differences were found between S-GAIT and DIASU in WB measures (p > 0.05). Strong Pearson correlations (r = 0.832–0.838, p < 0.001) and high intraclass correlation coefficients (ICC = 0.89–0.94, 95% CI: 0.73–0.95) were obtained. Bland–Altman analysis indicated low standard error of the mean for differences, confirming agreement between systems.
Conclusions: The S-GAIT insole provided valid WB measurements when compared with DIASU under static conditions. Its strong psychometric properties and low cost support its potential as an economical, accessible, and clinically useful tool for objective WB quantification. By enabling portable WB assessment and real-time feedback that can be integrated into home-based or remote rehabilitation, the S-GAIT may facilitate patient compliance, telemonitoring, and more individualized therapeutic decision-making in musculoskeletal and neurological care.
Kaynakça
-
Bohannon, R. W., Waters, G., & Cooper, J. (1989). Perception of unilateral lower extremity weightbearing during bilateral upright stance. Perceptual and Motor Skills, 69(3 Pt 1), 875-880. http://doi.org/10.1177/00315125890693-130
-
DiStasio, A., Jaggears, F., DePasquale, L., Frassica, F., & Turen, C. (1994). Protected early motion versus cast immobilization in postoperative management of ankle fractures. Contemporary Orthopaedics, 29(4), 273-277. https://europepmc.org/article/med/10150249
-
Gapeyeva, H., Haviko, T., Märtson, A., Aibast, H., Ereline, J., & Pääsuke, M. (2012). Postural control in total knee arthroplasty patients with patellofemoral pain syndrome before and six months after re-operation. Journal of Foot and Ankle Research, 5(Suppl 1), O33. http://doi.org/10.1186/1757-1146-5-S1-O33
-
Gray, F., Gray, C., & McClanahan, J. (1998). Assessing the accuracy of partial weight-bearing instruction. American Journal of Orthopedics (Belle Mead, NJ), 27(8), 558-560. https://europepmc.org/article/med/9732078
-
Gupta, S., Dabke, H. V., Holt, C. A., O’Callaghan, P., Hayes, N., & Dent, C. M. (2004). How accurate is partial weight bearing? Orthopaedic Proceedings, 86-B(Suppl III), 376. http://doi.org/10.1302/0301-620X.86BSUPP_III.0860376c
-
Hegde, N., & Sazonov, E. (2014). SmartStep: A fully integrated, low-power insole monitor. Electronics, 3(2), 381-397. http://doi.org/10.3390/electronics3020381
-
Hurkmans, H., Bussmann, J., Benda, E., Verhaar, J., & Stam, H. (2006). Accuracy and repeatability of the Pedar Mobile system in long-term vertical force measurements. Gait & Posture, 23(1), 118-125. http://doi.org/10.1016/j.gaitpost.2005.05.008
-
Hurkmans, H. L., Bussmann, J. B., Benda, E., Verhaar, J. A., & Stam, H. J. (2012). Effectiveness of audio feedback for partial weight-bearing in and outside the hospital: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 93(4), 565-570. http://doi.org/10.1016/j.apmr.2011.11.019
-
Hustedt, J. W., Blizzard, D. J., Baumgaertner, M. R., Leslie, M. P., & Grauer, J. N. (2012). Current advances in training orthopaedic patients to comply with partial weight-bearing instructions. The Yale Journal of Biology and Medicine, 85(1), 119-125. https://pmc.ncbi.nlm.nih.gov/articles/PMC3313526/
-
Josipović, P. (2020). Availability and clinical use of different in-shoe devices for partial weight bearing – a systematic review. Journal of Applied Health Sciences, 6(2), 261-270. http://doi.org/10.24141/1/6/2/8
-
Luo, Z.-P., Berglund, L. J., & An, K.-N. (1998). Validation of F-Scan pressure sensor system: A technical note. Journal of Rehabilitation Research and Development, 35(2), 186-191.
-
Meadows, T. H., Bronk, J. T., Chao, Y. S., & Kelly, P. J. (1990). Effect of weight-bearing on healing of cortical defects in the canine tibia. Journal of Bone and Joint Surgery. American Volume, 72(7), 1074-1080. http://doi.org/10.2106/00004623-199072070-00018
-
Meys, G., Kalmet, P. H., Sanduleanu, S., Van Horn, Y. Y., Maas, G. J., Poeze, M., & Seelen, H. A. (2019). A protocol for permissive weight-bearing during allied health therapy in surgically treated fractures of the pelvis and lower extremities. Journal of Rehabilitation Medicine, 51(4), 290-297. http://doi.org/10.2340/16501977-2532
-
Price, C., Parker, D., & Nester, C. (2016). Validity and repeatability of three in-shoe pressure measurement systems. Gait & Posture, 46, 69-74. http://doi.org/10.1016/j.gaitpost.2016.01.026
-
Putti, A., Arnold, G., Cochrane, L., & Abboud, R. (2007). The Pedar® in-shoe system: Repeatability and normal pressure values. Gait & Posture, 25(3), 401-405. http://doi.org/10.1016/j.gaitpost.2006.05.010
-
Quesada, P., Rash, G., & Jarboe, N. (1997). Assessment of pedar and F-Scan revisited. Clinical Biomechanics, 12(Suppl 1), S15. http://doi.org/10.1016/S0268-0033(97)88328-3
-
Reiff, A. L. (2016). Different in-shoe devices for partial weight bearing [Bachelor’s thesis, Faculty of Science and Engineering, University of Groningen, The Netherlands]. https://fse.studenttheses.ub.rug.nl/14470/
-
Stöggl, T., & Martiner, A. (2017). Validation of Moticon’s OpenGo sensor insoles during gait, jumps, balance and cross-country skiing specific imitation movements. Journal of Sports Sciences, 35(2), 196-206. http://doi.org/10.1080/02640414.2016.1161205
-
Sturnieks, D. L., Menant, J., Valenzuela, M., Delbaere, K., Sherrington, C., Herbert, R. D., et al. (2019). Effect of cognitive-only and cognitive-motor training on preventing falls in community-dwelling older people: Protocol for the smart±step randomised controlled trial. BMJ Open, 9(8), e029409. http://doi.org/10.1136/bmjopen-2019-029409
-
Tveit, M., & Kärrholm, J. (2001). Low effectiveness of prescribed partial weight bearing: Continuous recording of vertical loads using a new pressure-sensitive insole. Journal of Rehabilitation Medicine, 33(1), 42-46. http://doi.org/10.1080/165019701300006533
-
Van Lieshout, R., Stukstette, M. J., de Bie, R. A., Vanwanseele, B., & Pisters, M. F. (2016). Biofeedback in partial weight bearing: Validity of 3 different devices. Journal of Orthopaedic & Sports Physical Therapy, 46(11), 993-1001. http://doi.org/10.2519/jospt.2016.6625
-
Vasarhelyi, A., Baumert, T., Fritsch, C., Hopfenmüller, W., Gradl, G., & Mittlmeier, T. (2006). Partial weight bearing after surgery for fractures of the lower extremity – is it achievable? Gait & Posture, 23(1), 99-105. http://doi.org/10.1016/j.gaitpost.2004.12.005
-
Winquist, R. A., & Frankel, V. H. (1986). Complications of implant use. In C. H. Epps (Ed.), Complications in Orthopaedic Surgery (pp. 149-156). J. B. Lippincott.
-
Young, C. R. (1993). The F-SCAN system of foot pressure analysis. Clinics in Podiatric Medicine and Surgery, 10(3), 455-461. http://doi.org/10.1016/S0891-8422(23)00621-3
-
Yu, S., McDonald, T., Jesudason, C., Stiller, K., & Sullivan, T. (2014). Orthopedic inpatients’ ability to accurately reproduce partial weight-bearing orders. Orthopedics, 37(1), e10-e18. http://doi.org/10.3928/01477447-20131219-10
Assessing Concurrent Validity and Reliability of the S-Gait Insole: A Novel Tool for Measuring Weight Bearing
Yıl 2025,
Cilt: 12 Sayı: 3, 897 - 911, 31.12.2025
Muharrem Gökhan Beydağı
,
Zilan Bazancir Apaydın
,
Muhammed Çakır
,
Hande Guney Deniz
,
Nazli Busra Cıgercıoglu
,
Yaşar Gül Baltaci
Öz
Objectives: Accurate measurement of weight-bearing (WB) is critical in musculoskeletal and neurological rehabilitation, yet current systems are often costly and impractical for routine use. This study investigated the concurrent validity of the S-GAIT insole, a low-cost and portable tool, compared with the Digital Biometry Scanning System and Milletrix Software (DIASU, Italy).
Materials and Methods: A cross-sectional, within-subject comparative design was applied to compare S-GAIT and DIASU. Twenty-one healthy individuals (mean age 32.6 ± 7.3 years) participated. WB of both lower extremities was assessed during quiet standing using both devices in a single laboratory session. Data were collected under standardized static conditions, and outcomes were statistically analyzed.
Results: No significant differences were found between S-GAIT and DIASU in WB measures (p > 0.05). Strong Pearson correlations (r = 0.832–0.838, p < 0.001) and high intraclass correlation coefficients (ICC = 0.89–0.94, 95% CI: 0.73–0.95) were obtained. Bland–Altman analysis indicated low standard error of the mean for differences, confirming agreement between systems.
Conclusions: The S-GAIT insole provided valid WB measurements when compared with DIASU under static conditions. Its strong psychometric properties and low cost support its potential as an economical, accessible, and clinically useful tool for objective WB quantification. By enabling portable WB assessment and real-time feedback that can be integrated into home-based or remote rehabilitation, the S-GAIT may facilitate patient compliance, telemonitoring, and more individualized therapeutic decision-making in musculoskeletal and neurological care.
Etik Beyan
The study was conducted with the approval of the ethics committee of the Ankara Medipol University (Decision no: 16; date: February 14, 2023).
Destekleyen Kurum
This research was supported by The Scientific and Technological Research Council of Türkiye (TÜBİTAK) under the 1002–Short Term R&D Funding Program
Kaynakça
-
Bohannon, R. W., Waters, G., & Cooper, J. (1989). Perception of unilateral lower extremity weightbearing during bilateral upright stance. Perceptual and Motor Skills, 69(3 Pt 1), 875-880. http://doi.org/10.1177/00315125890693-130
-
DiStasio, A., Jaggears, F., DePasquale, L., Frassica, F., & Turen, C. (1994). Protected early motion versus cast immobilization in postoperative management of ankle fractures. Contemporary Orthopaedics, 29(4), 273-277. https://europepmc.org/article/med/10150249
-
Gapeyeva, H., Haviko, T., Märtson, A., Aibast, H., Ereline, J., & Pääsuke, M. (2012). Postural control in total knee arthroplasty patients with patellofemoral pain syndrome before and six months after re-operation. Journal of Foot and Ankle Research, 5(Suppl 1), O33. http://doi.org/10.1186/1757-1146-5-S1-O33
-
Gray, F., Gray, C., & McClanahan, J. (1998). Assessing the accuracy of partial weight-bearing instruction. American Journal of Orthopedics (Belle Mead, NJ), 27(8), 558-560. https://europepmc.org/article/med/9732078
-
Gupta, S., Dabke, H. V., Holt, C. A., O’Callaghan, P., Hayes, N., & Dent, C. M. (2004). How accurate is partial weight bearing? Orthopaedic Proceedings, 86-B(Suppl III), 376. http://doi.org/10.1302/0301-620X.86BSUPP_III.0860376c
-
Hegde, N., & Sazonov, E. (2014). SmartStep: A fully integrated, low-power insole monitor. Electronics, 3(2), 381-397. http://doi.org/10.3390/electronics3020381
-
Hurkmans, H., Bussmann, J., Benda, E., Verhaar, J., & Stam, H. (2006). Accuracy and repeatability of the Pedar Mobile system in long-term vertical force measurements. Gait & Posture, 23(1), 118-125. http://doi.org/10.1016/j.gaitpost.2005.05.008
-
Hurkmans, H. L., Bussmann, J. B., Benda, E., Verhaar, J. A., & Stam, H. J. (2012). Effectiveness of audio feedback for partial weight-bearing in and outside the hospital: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 93(4), 565-570. http://doi.org/10.1016/j.apmr.2011.11.019
-
Hustedt, J. W., Blizzard, D. J., Baumgaertner, M. R., Leslie, M. P., & Grauer, J. N. (2012). Current advances in training orthopaedic patients to comply with partial weight-bearing instructions. The Yale Journal of Biology and Medicine, 85(1), 119-125. https://pmc.ncbi.nlm.nih.gov/articles/PMC3313526/
-
Josipović, P. (2020). Availability and clinical use of different in-shoe devices for partial weight bearing – a systematic review. Journal of Applied Health Sciences, 6(2), 261-270. http://doi.org/10.24141/1/6/2/8
-
Luo, Z.-P., Berglund, L. J., & An, K.-N. (1998). Validation of F-Scan pressure sensor system: A technical note. Journal of Rehabilitation Research and Development, 35(2), 186-191.
-
Meadows, T. H., Bronk, J. T., Chao, Y. S., & Kelly, P. J. (1990). Effect of weight-bearing on healing of cortical defects in the canine tibia. Journal of Bone and Joint Surgery. American Volume, 72(7), 1074-1080. http://doi.org/10.2106/00004623-199072070-00018
-
Meys, G., Kalmet, P. H., Sanduleanu, S., Van Horn, Y. Y., Maas, G. J., Poeze, M., & Seelen, H. A. (2019). A protocol for permissive weight-bearing during allied health therapy in surgically treated fractures of the pelvis and lower extremities. Journal of Rehabilitation Medicine, 51(4), 290-297. http://doi.org/10.2340/16501977-2532
-
Price, C., Parker, D., & Nester, C. (2016). Validity and repeatability of three in-shoe pressure measurement systems. Gait & Posture, 46, 69-74. http://doi.org/10.1016/j.gaitpost.2016.01.026
-
Putti, A., Arnold, G., Cochrane, L., & Abboud, R. (2007). The Pedar® in-shoe system: Repeatability and normal pressure values. Gait & Posture, 25(3), 401-405. http://doi.org/10.1016/j.gaitpost.2006.05.010
-
Quesada, P., Rash, G., & Jarboe, N. (1997). Assessment of pedar and F-Scan revisited. Clinical Biomechanics, 12(Suppl 1), S15. http://doi.org/10.1016/S0268-0033(97)88328-3
-
Reiff, A. L. (2016). Different in-shoe devices for partial weight bearing [Bachelor’s thesis, Faculty of Science and Engineering, University of Groningen, The Netherlands]. https://fse.studenttheses.ub.rug.nl/14470/
-
Stöggl, T., & Martiner, A. (2017). Validation of Moticon’s OpenGo sensor insoles during gait, jumps, balance and cross-country skiing specific imitation movements. Journal of Sports Sciences, 35(2), 196-206. http://doi.org/10.1080/02640414.2016.1161205
-
Sturnieks, D. L., Menant, J., Valenzuela, M., Delbaere, K., Sherrington, C., Herbert, R. D., et al. (2019). Effect of cognitive-only and cognitive-motor training on preventing falls in community-dwelling older people: Protocol for the smart±step randomised controlled trial. BMJ Open, 9(8), e029409. http://doi.org/10.1136/bmjopen-2019-029409
-
Tveit, M., & Kärrholm, J. (2001). Low effectiveness of prescribed partial weight bearing: Continuous recording of vertical loads using a new pressure-sensitive insole. Journal of Rehabilitation Medicine, 33(1), 42-46. http://doi.org/10.1080/165019701300006533
-
Van Lieshout, R., Stukstette, M. J., de Bie, R. A., Vanwanseele, B., & Pisters, M. F. (2016). Biofeedback in partial weight bearing: Validity of 3 different devices. Journal of Orthopaedic & Sports Physical Therapy, 46(11), 993-1001. http://doi.org/10.2519/jospt.2016.6625
-
Vasarhelyi, A., Baumert, T., Fritsch, C., Hopfenmüller, W., Gradl, G., & Mittlmeier, T. (2006). Partial weight bearing after surgery for fractures of the lower extremity – is it achievable? Gait & Posture, 23(1), 99-105. http://doi.org/10.1016/j.gaitpost.2004.12.005
-
Winquist, R. A., & Frankel, V. H. (1986). Complications of implant use. In C. H. Epps (Ed.), Complications in Orthopaedic Surgery (pp. 149-156). J. B. Lippincott.
-
Young, C. R. (1993). The F-SCAN system of foot pressure analysis. Clinics in Podiatric Medicine and Surgery, 10(3), 455-461. http://doi.org/10.1016/S0891-8422(23)00621-3
-
Yu, S., McDonald, T., Jesudason, C., Stiller, K., & Sullivan, T. (2014). Orthopedic inpatients’ ability to accurately reproduce partial weight-bearing orders. Orthopedics, 37(1), e10-e18. http://doi.org/10.3928/01477447-20131219-10