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01-12-2012 | Methodology | Uitgave 1/2012 Open Access

Journal of Foot and Ankle Research 1/2012

A novel approach to mapping load transfer from the plantar surface of the foot to the walls of the total contact cast: a proof of concept study

Journal of Foot and Ankle Research > Uitgave 1/2012
Lindy Begg, Patrick McLaughlin, Leon Manning, Mauro Vicaretti, John Fletcher, Joshua Burns
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Electronic supplementary material

The online version of this article (doi:10.​1186/​1757-1146-5-32) contains supplementary material, which is available to authorized users.

Competing interests

JB receives funds from the NHMRC (National Health and Medical Research Council of Australia, Fellowship #1007569 and Centre of Research Excellence #1031893), NIH (National Institutes of Neurological Disorders and Stroke and Office of Rare Diseases, #U54NS065712), Australian Podiatry Education and Research Foundation, Podiatry Council of New South Wales, Charcot Marie Tooth Association, Muscular Dystrophy Association, CMT Association of Australia. PM is the Australian and New Zealand agent for novel gmbh.

Authors’ contributions

LB, PM, JB participated in the design of the study and secured funding, LB, PM, LM carried out data collection, PM, JB contributed to statistical analysis. All authors reviewed and approved the final manuscript.



Total contact casting is regarded as the gold standard treatment for plantar foot ulcers. Load transfer from the plantar surface of the foot to the walls of the total contact cast has previously been assessed indirectly. The aim of this proof of concept study was to determine the feasibility of a new method to directly measure the load between the cast wall and the lower leg interface using capacitance sensors.


Plantar load was measured with pedar® sensor insoles and cast wall load with pliance® sensor strips as participants (n=2) walked along a 9 m walkway at 0.4±0.04 m/sec. The relative force (%) on the cast wall was calculated by dividing the mean cast wall force (N) per step by the mean plantar force (N) per step in the shoe-cast condition.


The combined average measured load per step upon the walls of the TCC equated to 23-34% of the average plantar load on the opposite foot. The highest areas of load on the lower leg were located at the posterior margin of the lateral malleolus and at the anterior ankle/extensor retinaculum.


These direct measurements of cast wall load are similar to previous indirect assessment of load transfer (30-36%) to the cast walls. This new methodology may provide a more comprehensive understanding of the mechanism of load transfer from the plantar surface of the foot to the cast walls of the total contact cast.

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