E065 Scoping review for the application of centre of pressure for patient or intervention assessment in rheumatoid conditions
Authors: Goodwin Fraser S , Price Carina , Jones Richard 
Published: April 2023

Abstract

Background/Aims
Centre of pressure (COP) is the point on a surface through which a single resultant force appears to act. It has been quantified using various commercially available hardware and software such as force plates, in-shoe and platform pressure measurement systems and used to assess stability and function in gait research. Recently, advancements in technology mean systems are more affordable and portable and therefore may be realistically used within clinic to screen patients or assess intervention effectiveness. However, this would require the translation of research protocols and outcomes to clinical practice with consensus on the effective application of COP data to patient assessment in rheumatology. Our aim was to undertake a scoping review to explore the potential role of COP in patients with rheumatoid conditions. We aimed to determine relevant patient groups, COP technology, protocols, and outcome measures.

Methods
Three electronic databases were comprehensively searched in August 2022 relating to the key themes of the research question: “centre of pressure” and “arthritis”. Individual search terms were tailored to databases (i.e., MeSH terms and truncation) and combined with Boolean operators. Search results were exported to Microsoft Excel. Initial screening was undertaken to remove duplicates (242 excluded) and paper titles that were unrelated to the topic area (332 excluded). Abstracts of remaining articles (140) were then manually screened by two researchers according to criteria to assess their relevance to the aim. Inclusion criteria included lower-limb arthritis sufferers and quantitative studies with peer-reviewed full-text written in English, published since 1980. Exclusion criteria were the inclusion of post-intervention subjects (i.e., replacement arthroplasty) and literature reviews, editorials, preliminary/pilot studies. Full-text screening was then performed and any discrepancies between individual search results were resolved by a third researcher. Relevant information from the remaining studies was scoped and recorded according to the aim.

Results
108 papers were included, and preliminary analysis has identified that 90% included patients with osteo-arthritis and 37% rheumatoid. The focus of articles was the knee joint (69%) and primarily observational studies (61%). COP was used to assess interventions in 36% of papers, 21% were shoes/insoles and 4% activity programs. COP was quantified during walking (41%), standing (49%) and gait-initiation (2%) and primarily using force plates (68%). Pressure technology was used to measure COP in 16% of the research, with commercially available in-shoe (6%) and platform (7%) technology being clearly described in papers. Primary outcome measures quantified displacement (93%), velocity (41%) and variability (21%) qualities using a range of variables.

Conclusion
COP clearly has a role in research for quantifying stability in patients and changes to gait function in response to interventions. The increasing availability and accessibility of pressure technology facilitates the translation of these to assessment in clinic.
Disclosure
F.S. Goodwin: Grants/research support; NMAHPs Internship Versus Arthritis (Grant reference 22082). C. Price: None. R. Jones: None.