# Pedobarography: A Review on Methods and Practical Use in Foot Disorders
## 4 Discussion
### Pedoaborgraphic Measurements
Before the examination, the foot sole should be divided into regions by choosing one of the existing classifications based on the regional anatomic differences in the plantar pressure [40, 41]. In some studies, the examination is limited to a part of the foot sole, e.g., the forefoot [42, 43, 44], or the anatomic region, e.g., hindfoot [45], leaving out other parts. The division of the plantar surface is made individually for each patient since the foot length must be considered. A commonly used plantar surface division in children has been described by [PERSON] et al. [46]. This division considers five regions: the hindfoot, lateral midfoot, medial midfoot, lateral forefoot, and medial forefoot. For comparison, a division proposed by [PERSON] [47] considers 10 regions: the medial heel (MH), lateral heel (LH), medial midfoot (MM), and lateral midfoot (LM); the regions under the first metatarsal head (1 st MET), second metatarsal head (2 nd MET), 3 rd-5 th metatarsal heads (Lateral MET), hallux (H), second toe (2 nd Toe), and 3 rd-5 th toes (Lateral toes). Foot masking is performed according to the protocols supported by the automated masking software, e.g., Research Foot [48]. The auto masking algorithms precisely define foot regions in healthy feet. The precision is upheld in gait but reduced in foot deformities, for instance, halluxes [49]. The pedobarographic examination is performed in sequence. The static measurement comes first. The patient is instructed to stand barefoot in an upright position keeping the symmetry of the body and gazing straight ahead. The test starts with an introductory trial to familiarize the patient with the procedure and to calibrate the equipment. Then, the active measurement begins and is repeated until three reproducible results are obtained. In the static model, a single image of the plantar pressure distribution at a specific point in time during the patient's stance is recorded. The postural or dynamic examination follows. The postural model enables the evaluation of the dynamics of standing. It consists of a series of static tests that show the distribution of plantar surface pressures over time, which is presented as an average of all measurements [50]. In the dynamic model, patients are instructed to walk barefoot at the natural walking speed while taking steps of the same length. Concerning the test on a mat, it is best performed with a starting slide step designated at the usual patient's length. The patient walks a minimum of three steps before and after contacting the platform located in the middle of the walkway. It is essential to ensure that patients do not aim for the platform as they walk and are unaware of the measurement time. Three to five trials are performed and patients who report fatigue are permitted to rest for 2-5 min in-between. The test results are controlled for age, height,weight, and foot length [51; 52; 53]. In the case of the insole-based system, patients are fitted with proper insoles having embedded sensors. Tightly fitting insole pads must be used. During testing, the patient is instructed to walk approximately 15 m before returning to the starting point [27]. [PERSON] et al. [39] have opted for a long straight 60 m distance while performing a test using the Ingval System, disregarding the data of the first and last 5 m corresponding to acceleration and deceleration phases. A shorter walk distance has been proposed by [PERSON] et al. [48] during the in-shoe-based examination performed according to a seven-stride protocol. The first and last strides are discarded, with the remaining being averaged in each trial. In a study by [PERSON] et al. [54] using an F-scan in-shoe pressure measurement, patients were asked to walk 10 m along the walkway.