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Schallig W, Piening M, Quirijnen L, Witbreuk MM, Buizer AI, van der Krogt MM. Multi-segment foot kinematics during gait in children with spastic cerebral palsy. Gait Posture 2024; 110:144-149. [PMID: 38608379 DOI: 10.1016/j.gaitpost.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/10/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Foot deformities (e.g. planovalgus and cavovarus) are very common in children with spastic cerebral palsy (CP), with the midfoot often being involved. Dynamic foot function can be assessed with 3D gait analysis including a multi-segment foot model. Incorporating a midfoot segment in such a model, allows quantification of separate Chopart and Lisfranc joint kinematics. Yet, midfoot kinematics have not previously been reported in CP. RESEARCH QUESTIONS What is the difference in multi-segment kinematics including midfoot joints between common foot deformities in CP and typically-developing feet? METHODS 103 feet of 57 children with spastic CP and related conditions were retrospectively included and compared with 15 typically-developing children. All children underwent clinical gait analysis with the Amsterdam Foot Model marker set. Multi-segment foot kinematics were calculated for three strides per foot and averaged. A k-means cluster analysis was performed to identify foot deformity groups that were present within CP data. The deformity type represented by each cluster was based on the foot posture index. Kinematic output of the clusters was compared to typically-developing data for a static standing trial and for the range of motion and kinematic waveforms during walking, using regular and SPM independent t-tests respectively. RESULTS A neutral, planovalgus and varus cluster were identified. Neutral feet showed mostly similar kinematics as typically-developing data. Planovalgus feet showed increased ankle valgus and Chopart dorsiflexion, eversion and abduction. Varus feet showed increased ankle varus and Chopart inversion and adduction. SIGNIFICANCE This study is the first to describe Chopart and Lisfranc joint kinematics in different foot deformities of children with CP. It shows that adding a midfoot segment can provide additional clinical and kinematic information. It highlights joint angles that are more distinctive between deformities, which could be helpful to optimize the use of multi-segment foot kinematics in the clinical decision making process.
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Affiliation(s)
- Wouter Schallig
- Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, de Boelelaan 1117, Amsterdam the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Rehabilitation Medicine, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Marjolein Piening
- Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, de Boelelaan 1117, Amsterdam the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Loes Quirijnen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, de Boelelaan 1117, Amsterdam the Netherlands
| | - Melinda M Witbreuk
- Amsterdam UMC location University of Amsterdam, Orthopedic surgery, Meibergdreef 9, Amsterdam, the Netherlands
| | - Annemieke I Buizer
- Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, de Boelelaan 1117, Amsterdam the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Rehabilitation Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Emma Children's Hospital, Amsterdam UMC, Amsterdam, the Netherlands
| | - Marjolein M van der Krogt
- Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, de Boelelaan 1117, Amsterdam the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Rehabilitation Medicine, Meibergdreef 9, Amsterdam, the Netherlands
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2
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Origo D, Buffone F, Montini G, Belluto D, Tramontano M, Dal Farra F. Foot Posture Index Does Not Correlate with Dynamic Foot Assessment Performed via Baropodometric Examination: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:814. [PMID: 38667576 PMCID: PMC11050396 DOI: 10.3390/healthcare12080814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/29/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Clinicians employ foot morphology assessment to evaluate the functionality of the method and anticipate possible injuries. This study aims to correlate static foot posture and the dynamic barefoot evaluation in a sample of healthy adult participants. METHODS The foot posture was evaluated using the Foot Posture Index-6 (FPI-6) and the dynamics were evaluated through baropodometric examination. Two operators independently assessed the participants' foot posture through FPI-6, and then a dynamic evaluation was performed by asking them to walk 8 times across a platform. One hundred participants (mean age: 32.15 ± 7.49) were enrolled. RESULTS The inter-rater agreement between the two assessors was found to be excellent. The majority of the feet belonged to the 0 < FPI < 4 class (32%), followed by the 4 < FPI < 8 (31%) and the FPI > 8 ranges (19.5%). Our "area of contact" analysis showed a significant poor correlation between FPI and total foot, midfoot, and the second metatarsophalangeal joint (MTPJ) (-0.3 < r < 0). Regarding "force" parameters, the analysis showed a poor correlation between the midfoot, hallux, and the second toe (-0.2 < r < 2); finally the "pressure" analysis showed a poor correlation between FPI, the fourth MTPJ, and the second toe (-0.2 < rs < 0.3) and a moderate correlation between the hallux (r = 0.374) and the fifth MTPJ (r = 0.427). CONCLUSIONS This study emphasizes the constrained correlation between static foot posture observation and dynamic barefoot examination.
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Affiliation(s)
- Daniele Origo
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
| | - Francesca Buffone
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
- Division of Pediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy
- Principles and Practice of Clinical Research (PPCR), Harvard T.H. Chan School of Public Health–ECPE, Boston, MA 02115, USA
| | - Gabriele Montini
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
| | - Daniele Belluto
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
| | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, 40126 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Fulvio Dal Farra
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
- Department Information Engineering, University of Brescia, Via Branze 38, 25123 Brescia, Italy
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3
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Sharath HV, Rathi SG, Kolhe PD. The Effect of Foot Rehabilitation Protocol in Adults With Congenital Deformity of Foot: An Analytical Case Series. Cureus 2024; 16:e59102. [PMID: 38803723 PMCID: PMC11129531 DOI: 10.7759/cureus.59102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Congenital deformities of the foot significantly challenge the mobility and quality of life of affected individuals. While surgical interventions are common, rehabilitation protocols tailored to address the specific needs of adults with congenital foot deformities are less explored. This case series aims to evaluate the effectiveness of a specialized foot rehabilitation protocol in improving functional outcomes and quality of life in adults with congenital foot deformities. A series of cases involving adults diagnosed with congenital foot deformities were enrolled in a structured rehabilitation program. The protocol incorporated a combination of therapeutic exercises, manual therapy, gait training, and orthotic management tailored to individual needs. Outcome measures included functional assessments, gait analysis, pain levels, and patient-reported outcomes at baseline, midpoint, and endpoint of the rehabilitation program. Preliminary findings from the case series indicate significant improvements in various outcome measures following the foot rehabilitation protocol. Participants demonstrated enhanced gait parameters, reduced pain levels, increased range of motion, and improved functional capacity. Moreover, subjective assessments revealed enhanced satisfaction and perceived improvements in quality of life among participants. The findings suggest that a tailored foot rehabilitation protocol can be beneficial in improving functional outcomes and quality of life in adults with congenital foot deformities. This underscores the importance of integrating comprehensive rehabilitation strategies alongside surgical interventions to optimize long-term outcomes and enhance the overall well-being of individuals with congenital foot deformities. Further research with larger sample sizes and controlled study designs is warranted to validate these findings and establish evidence-based rehabilitation guidelines for this population.
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Affiliation(s)
- H V Sharath
- Department of Pediatric Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Wardha, IND
| | - Siddhi G Rathi
- Department of Pediatric Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Wardha, IND
| | - Pradhyum D Kolhe
- Department of Pediatric Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Wardha, IND
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Iwamoto Y, Kawakami W, Takeuchi R, Takeuchi Y, Ishii Y, Ishikawa M, Adachi N, Takahashi M. Effect of lateral wedge length on knee adduction moment reduction mechanics during gait. Prosthet Orthot Int 2024:00006479-990000000-00237. [PMID: 38557974 DOI: 10.1097/pxr.0000000000000349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 02/01/2024] [Indexed: 04/04/2024]
Abstract
Lateral wedge insole (LWI) wear is a well-known conservative treatment for patients with knee osteoarthritis and is expected to decrease knee joint loading. Although the effect of LWI length on knee adduction moment (KAM) has been investigated, the biomechanical mechanism has not been fully investigated. Twelve healthy young subjects walked in the laboratory with and without 2 different lengths of LWIs. Three-dimensional motion analysis was performed to calculate the first and second peaks and impulses of the KAM during the stance phase. In addition, the knee-ground reaction force lever arm (KLA) and center of pressure (COP), ankle eversion moment, and ankle eversion angle were calculated. The first peak of KAM was lower, COP was displaced outward, and KLA was shorter with both LWIs attached. On the other hand, the second peak of KAM was lower with longer LWIs, COP was displaced outward, and KLA was shorter. The KAM impulse was significantly smaller in the condition with longer LWI than in the other conditions with smaller ankle eversion motion; longer LWI induced COP to the lateral side through the stance phase and kept KLA short, thus reducing the KAM impulse.
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Affiliation(s)
- Yoshitaka Iwamoto
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Wataru Kawakami
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Rehabilitation, Kure Kyosai Hospital, Kure, Hiroshima, Japan
| | - Ryosuke Takeuchi
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasutaka Takeuchi
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yosuke Ishii
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masakazu Ishikawa
- Department of Artificial Joints and Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Takahashi
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Lee JH, Hwang J, Park H, Kang H, Song W, Choi DA, Seong CH, Jang WY. Muscle strength and foot pressure vary depending on the type of foot pain. Sci Rep 2024; 14:5857. [PMID: 38467691 PMCID: PMC10928145 DOI: 10.1038/s41598-024-56490-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/07/2024] [Indexed: 03/13/2024] Open
Abstract
This study compared muscle strength and foot pressure among patients with metatarsalgia, patients with plantar fasciitis, and healthy controls. A total of 31 patients with foot pain (14 metatarsalgia and 17 plantar fasciitis) and 29 healthy controls participated in the study. The strengths of the plantar flexor and hip muscles were measured using isokinetic and handheld dynamometers, respectively. Foot pressure parameters, including the pressure-time integral (PTI) and foot arch index (AI), were assessed using pedobarography. Compared with the healthy control group, plantar flexor strength was significantly reduced in the affected feet of the metatarsalgia and plantar fasciitis groups (F = 0.083, all p < 0.001); however, hip strength was significantly decreased only in the affected feet of the metatarsalgia group (F = 20.900, p < 0.001). Plantar flexor (p < 0.001) and hip (p = 0.004) strength were significantly lower in the metatarsalgia group than in the plantar fasciitis group. The PTI was lower in the forefeet of the affected feet in the metatarsalgia (p < 0.001) and plantar fasciitis (p = 0.004) groups. Foot AI (p < 0.001) was significantly reduced only in the metatarsalgia group. These results suggest the need to consider the evaluation of muscle strength and foot pressure in both feet for the diagnosis and treatment of foot pain.
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Affiliation(s)
- Jin Hyuck Lee
- Department of Sports Medical Center, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Institute of Nanobiomarker-Based Medicine, Korea University, Seoul, Korea
| | - Jangsun Hwang
- Institute of Nanobiomarker-Based Medicine, Korea University, Seoul, Korea
| | | | | | | | | | | | - Woo Young Jang
- Department of Sports Medical Center, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
- Department of Orthopedic Surgery, College of Medicine, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
- Institute of Nanobiomarker-Based Medicine, Korea University, Seoul, Korea.
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6
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Wang Y, Qi Y, Ma B, Wu H, Wang Y, Wei B, Wei X, Xu Y. Three-dimensional gait analysis of orthopaedic common foot and ankle joint diseases. Front Bioeng Biotechnol 2024; 12:1303035. [PMID: 38456008 PMCID: PMC10919227 DOI: 10.3389/fbioe.2024.1303035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/02/2024] [Indexed: 03/09/2024] Open
Abstract
Walking is an indispensable mode of transportation for human survival. Gait is a characteristic of walking. In the clinic, patients with different diseases exhibit different gait characteristics. Gait analysis describes the specific situation of human gait abnormalities by observing and studying the kinematics and dynamics of limbs and joints during human walking and depicting the corresponding geometric curves and values. In foot and ankle diseases, gait analysis can evaluate the degree and nature of gait abnormalities in patients and provide an important basis for the diagnosis of patients' diseases, the correction of abnormal gait and related treatment methods. This article reviews the relevant literature, expounds on the clinical consensus on gait, and summarizes the gait characteristics of patients with common ankle and foot diseases. Starting from the gait characteristics of individuals with different diseases, we hope to provide support and reference for the diagnosis, treatment and rehabilitation of clinically related diseases.
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Affiliation(s)
| | | | | | | | | | | | | | - Yongsheng Xu
- Orthopedic Center (Sports Medicine Center), Inner Mongolia People’s Hospital, Hohhot, China
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7
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Lithgow MJ, Buldt AK, Munteanu SE, Marshall M, Thomas MJ, Peat G, Roddy E, Menz HB. Plantar pressures in people with midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot. Gait Posture 2024; 108:243-249. [PMID: 38141537 DOI: 10.1016/j.gaitpost.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/06/2023] [Accepted: 12/08/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Midfoot osteoarthritis (OA) is a common condition, however its aetiology is not well understood. Understanding how plantar pressures differ between people with and without midfoot OA may provide insight into the aetiology and how best to manage this condition. RESEARCH QUESTION To compare plantar pressures between people with and without symptomatic radiographic midfoot OA. METHODS This was a cross-sectional study of adults aged ≥ 50 years registered with four UK general practices who reported foot pain in the past year. Symptomatic radiographic midfoot OA was defined as midfoot pain in the last four weeks, combined with radiographic OA in one or more midfoot joints. Cases were matched 1:1 for sex and age ( ± 5 years) to controls. Peak plantar pressure and maximum force in 10 regions of the foot were determined using a pressure platform (RSscan International, Olen, Belgium) and compared between the groups using independent samples t-tests and effect sizes (Cohen's d). RESULTS We included 61 midfoot OA cases (mean age 67.0, SD 8.1, 31 males, 30 females) and matched these to 61 controls (mean age 66.0, SD 7.9). Midfoot OA cases displayed greater force (d=0.79, medium effect size, p = <0.001) and pressure at the midfoot (d=0.70, medium effect size, p = <0.001), greater force at the fourth metatarsophalangeal (MTP) joint (d=0.28, small effect size, p = 0.13), and fifth MTP joint (d=0.37, small effect size, p = 0.10) and greater pressure at the fifth MTP joint (d=0.34, small effect size, p = 0.13). They also displayed lower force (d=0.40, small effect size, p = 0.02) and pressure at the hallux (d=0.50, medium effect size, p = <0.001) and lower force (d=0.54, medium effect size, p = <0.001) and pressure at the lesser toes (d=0.48, small effect size, p = <0.001) compared with controls. SIGNIFICANCE Midfoot OA appears to be associated with lowering of the medial longitudinal arch, greater lateral push off and less propulsion at toe off. Longitudinal studies are needed to establish causal relationships.
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Affiliation(s)
- Merridy J Lithgow
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia.
| | - Andrew K Buldt
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Michelle Marshall
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom
| | - Martin J Thomas
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom; Haywood Academic Rheumatology Centre, Midlands Partnership University NHS Foundation Trust, Haywood Hospital, Burslem, Staffordshire ST6 7AG, United Kingdom
| | - George Peat
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom; Centre for Applied Health and Social Care Research, Sheffield Hallam University, Sheffield S10 2BP, United Kingdom
| | - Edward Roddy
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom; Haywood Academic Rheumatology Centre, Midlands Partnership University NHS Foundation Trust, Haywood Hospital, Burslem, Staffordshire ST6 7AG, United Kingdom
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia; Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom
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8
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Schuster RW, Cresswell AG, Kelly LA. Human foot form and function: variable and versatile, yet sufficiently related to predict function from form. Proc Biol Sci 2024; 291:20232543. [PMID: 38196364 PMCID: PMC10777145 DOI: 10.1098/rspb.2023.2543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024] Open
Abstract
The human foot is a complex structure that plays an important role in our capacity for upright locomotion. Comparisons of our feet with those of our closest extinct and extant relatives have linked shape features (e.g. the longitudinal and transverse arches, heel size and toe length) to specific mechanical functions. However, foot shape varies widely across the human population, so it remains unclear if and how specific shape variants are related to locomotor mechanics. Here we constructed a statistical shape-function model (SFM) from 100 healthy participants to directly explore the relationship between the shape and function of our feet. We also examined if we could predict the joint motion and moments occurring within a person's foot during locomotion based purely on shape features. The SFM revealed that the longitudinal and transverse arches, relative foot proportions and toe shape along with their associated joint mechanics were most variable. However, each of these only accounted for small proportions of the overall variation in shape, deformation and joint mechanics, most likely owing to the high structural complexity of the foot. Nevertheless, a leave-one-out analysis showed that the SFM can accurately predict joint mechanics of a novel foot, based on its shape and deformation.
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Affiliation(s)
- Robert W. Schuster
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, 4067, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University, Gold Coast, Queensland, 4215, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, 4215, Australia
| | - Andrew G. Cresswell
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, 4067, Australia
| | - Luke A. Kelly
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, 4067, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University, Gold Coast, Queensland, 4215, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, 4215, Australia
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9
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Telfer S, Li EY. pressuRe: an R package for analyzing and visualizing biomechanical pressure distribution data. Sci Rep 2023; 13:16776. [PMID: 37798383 PMCID: PMC10556014 DOI: 10.1038/s41598-023-44041-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/03/2023] [Indexed: 10/07/2023] Open
Abstract
In many biomechanical analyses, the forces acting on a body during dynamic and static activities are often simplified as point loads. However, it is usually more accurate to characterize these forces as distributed loads, varying in magnitude and direction, over a given contact area. Evaluating these pressure distributions while they are applied to different parts of the body can provide effective insights for clinicians and researchers when studying health and disease conditions, for example when investigating the biomechanical factors that may lead to plantar ulceration in diabetic foot disease. At present, most processing and analysis for pressure data is performed using proprietary software, limiting reproducibility, transparency, and consistency across different studies. This paper describes an open-source software package, 'pressuRe', which is built in the freely available R statistical computing environment and is designed to process, analyze, and visualize pressure data collected on a range of different hardware systems in a standardized manner. We demonstrate the use of the package on pressure dataset from patients with diabetic foot disease, comparing pressure variables between those with longer and shorter durations of the disease. The results matched closely with those from commercially available software, and individuals with longer duration of diabetes were found to have higher forefoot pressures than those with shorter duration. By utilizing R's powerful and openly available tools for statistical analysis and user customization, this package may be a useful tool for researchers and clinicians studying plantar pressures and other pressure sensor array based biomechanical measurements. With regular updates intended, this package allows for continued improvement and we welcome feedback and future contributions to extend its scope. In this article, we detail the package's features and functionality.
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Affiliation(s)
- Scott Telfer
- Department of Orthopaedics and Sports Medicine, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
- Center for Limb Loss and MoBility, VA Puget Sound Healthcare System, Seattle, WA, USA.
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA.
| | - Ellen Y Li
- Center for Limb Loss and MoBility, VA Puget Sound Healthcare System, Seattle, WA, USA
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
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10
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Bassett KE, Charles SK, Bruening DA. The signed helical angle: A technique for characterizing midfoot motion during gait. J Biomech 2023; 159:111791. [PMID: 37734183 DOI: 10.1016/j.jbiomech.2023.111791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023]
Abstract
Quantifying motion in the midfoot during gait and other movements is important for a variety of applications, but challenging due to the complexity of the multiple small articulations involved. The most common motion capture based techniques are limited in their ability to characterize the non-planar nature of the midfoot joint axes. In this study we developed a novel Signed Helical Angle (SHA) to quantify midfoot angular displacement. Motion capture data from 40 healthy subjects walking at a controlled speed were used to calculate finite helical axes and angles from a two-segment foot model. Axes were classified as either pronation or supination based on their orientation, and given a sign, thus either adding to or subtracting from the angular displacement. Analysis focused on insights from axis orientation and comparisons to other techniques. Results showed that when transitions were excluded, pronation and supination axes were fairly well clustered in the transverse plane. The resulting SHA midfoot angle waveform was comparable to sagittal plane Euler and helical component waveforms, but with 39% (approximately 3°) greater range of motion in pronation and 25% (approximately 4°) greater in supination, due to the direct measurement of the motion path and the influence of the other planes. The proposed SHA method may provide an intuitive and useful method to analyze midfoot motion for a variety of applications, particularly when interventions cause subtle changes that may be diluted in planar analyses.
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Affiliation(s)
- Kirk E Bassett
- Brigham Young University, Mechanical Engineering Department, USA
| | - Steven K Charles
- Brigham Young University, Mechanical Engineering Department, USA
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11
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Feyzioğlu Ö, Öztürk Ö, Muğrabi S. Is Morton's neuroma in a pes planus or pes cavus foot lead to differences in pressure distribution and gait parameters? Heliyon 2023; 9:e19111. [PMID: 37636349 PMCID: PMC10448470 DOI: 10.1016/j.heliyon.2023.e19111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023] Open
Abstract
Morton's neuroma (MN) is a compressive neuropathy of the common digital plantar nerve causing forefoot pain. Foot posture and altered plantar pressure distribution have been identified as predispoing factors, however no studies have compared individuls with different foot postures with MN. Thus, we aimed to compare the effect of MN on spatiotemporal gait parameters and foot-pressure distribution in individuals with pes planus and pes cavus. Thirty-eight patients with unilateral MN were evaluated between June and August 2021. Nineteen patients with bilateral pes planus and 19 age and gender-matched patients with pes cavus who had no prior surgery were recruited. A Zebris FDM-THM-S treadmill system (Zebris Medical GmbH, Germany) was used to evaluate step length, stride length, step width, step time, stride time, cadence, velocity, foot-pressure distribution, force and whole stance phase, loading response, mid stance, pre-swing and swing phase percentages. There were no significant differences between the groups in spatiotemporal gait parameters (p > 0.05). Patients with pes planus displayed the following results for step length (49.36 ± 8.38), step width (9.05 ± 2.12), stance phase percentage (65.92 ± 2.11), swing phase percentage (34.08 ± 2.12), gait speed (2.96 ± 0.55), and cadence (100.57 ± 8.84). In contrast, patients with pes cavus displayed the following results for step length (49.06 ± 8.37), step width (8.10 ± 2.46), stance phase percentage (64.96 ± 1.61), swing phase percentage (34.79 ± 1.60), gait speed (2.95 ± 0.65), and cadence (99.73 ± 13.81). Foot-pressure distribution values showed no differences were detected in force, forefoot, and rearfoot pressure distribution, except for midfoot force (p < 0.05). The forefoot, midfoot, and rearfoot pressure values for the pronated group were 32.14 ± 10.90, 13.80 ± 3.03, and 22.78 ± 5.10, and for the supinated group were 33.50 ± 11.49, 14.23 ± 3.11 and 24.93 ± 6.52. MN does not significantly affect spatiotemporal gait parameters or foot-pressure distribution in patients with pes cavus or pes planus.
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Affiliation(s)
- Özlem Feyzioğlu
- Acibadem Mehmet Ali Aydinlar University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Özgül Öztürk
- Acibadem Mehmet Ali Aydinlar University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
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12
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Pau M, Porta M, Pau C, Tacconi P, Sanna A. Quantitative Characterization of Gait Patterns in Individuals with Spinocerebellar Ataxia 38. Bioengineering (Basel) 2023; 10:788. [PMID: 37508815 PMCID: PMC10376738 DOI: 10.3390/bioengineering10070788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Spinocerebellar ataxia 38 (SCA 38) is a rare autosomal neurological disease whose clinical features include, among others, severe gait disturbances that have not yet been fully characterized. In this study, we employed a computerized 3D gait analysis to obtain spatio-temporal parameters of gait and the kinematics in the sagittal plane in the hip, knee, and ankle joints of seven individuals with SCA 38, which were then compared with those of twenty unaffected individuals matched for age, sex, and anthropometric features. The results show that, in comparison with unaffected individuals, those with SCA 38 are characterized by a significantly reduced speed, stride length, and duration of the swing phase, as well as an increased step width and stance and double support phase durations. The point-by-point comparison of the angular trends at the hip, knee, and ankle joints revealed significant alterations during most part of the stance phase for hip joint and at pre-swing/swing phases for knee and ankle joints. For these latter joints, a significantly reduced dynamic range of motion was also found. Such findings provide some new insights into hip and knee kinematics for this specific form of ataxia and may be useful for monitoring the disease's progression and designing specific, tailored rehabilitative interventions.
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Affiliation(s)
- Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09124 Cagliari, Italy
| | - Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09124 Cagliari, Italy
| | - Chiara Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09124 Cagliari, Italy
| | - Paolo Tacconi
- Multiple Sclerosis Center, Binaghi Hospital, ASL Cagliari, 09126 Cagliari, Italy
| | - Angela Sanna
- U.O.C. Neurology, S.S. Trinità Hospital, ASL Cagliari, 09121 Cagliari, Italy
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13
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Tibialis posterior muscle stiffness assessment in flat foot subjects by ultrasound based Shear-Wave Elastography. Foot (Edinb) 2023; 54:101975. [PMID: 36806117 DOI: 10.1016/j.foot.2023.101975] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 10/21/2021] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Few methodologies are used to assess Tibialis Posterior muscle stiffness. Those present limitations leading to a lack of evidence. Muscle stiffness assessment can help in the injuries risk factors identification while coupling with Ultrasound based Shear-Wave Elastography for its management. However, a precise and reliable methodology needs to be utilized to increase stiffness accuracy among the entire Tibialis Posterior muscle. Therefore, this study aims to investigate the stiffness association between Tibialis posterior deep and superficial layer and between flat and neutral footed subjects. METHODS The sample consisted of 18 participants, where 9 subjects represent the flatfoot group and 9 the neutral foot group. Only the subjects who presented a Navicular Drop Test value of > 9 mm were included in the flatfooted group. All participants were submitted to the Tibialis posterior stiffness assessment with the help of Ultrasound base Shear-Wave Elastography in a lying supine position. Association between Tibialis Posterior deep and superficial layers were determined by Pearson's correlation analysis and group differences were assessed using the U-Mann Whitney test in the comparison between flat foot and neutral foot group (p < 0.05). RESULTS No significant correlations between Tibialis Posterior layers stiffness were found (p = 0.194), nor in the comparison between both neutral and flat foot groups (p = 0.424/p = 0.258). CONCLUSION Among participants, no associations between tibialis posterior layers stiffness were found. Also, we did not find any differences in the stiffness between flat and neutral foot groups. In this study, the stiffness did not differentiate flat-footed subjects from neutral subjects.
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14
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Schuster RW, Cresswell AG, Kelly LA. Foot shape is related to load-induced shape deformations, but neither are good predictors of plantar soft tissue stiffness. J R Soc Interface 2023; 20:20220758. [PMID: 36651181 PMCID: PMC9846431 DOI: 10.1098/rsif.2022.0758] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Modern human feet are considered unique among primates in their capacity to transmit propulsive forces and re-use elastic energy. Considered central to both these capabilities are their arched configuration and the plantar aponeurosis (PA). However, recent evidence has shown that their interactions are not as simple as proposed by the theoretical and mechanical models that established their significance. Using three-dimensional foot scans and statistical shape and deformation modelling, we show that the shape of the longitudinal and transverse arches varies widely among the healthy adult population, and that the former is subject to load-induced arch flattening, whereas the latter is not. However, longitudinal arch shape and flattening are only one of the various foot shape-deformation relationships. PA stiffness was also found to vary widely. Yet only a small amount of this variability (approx. 10-18%) was explained by variations in foot shape, deformation and their combination. These findings add to the mounting evidence showing that foot mechanics are complex and cannot be accurately represented by simple models. Especially the interactions between longitudinal arch and PA appear to be far less constrained than originally proposed, most likely due to the many degrees of freedom provided by the structural complexity of our feet.
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Affiliation(s)
- Robert W. Schuster
- School of Human Movement & Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Andrew G. Cresswell
- School of Human Movement & Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Luke A. Kelly
- School of Human Movement & Nutrition Sciences, The University of Queensland, Brisbane, Australia
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15
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Kirmizi M, Sengul YS, Yalcinkaya G, Angin S. Are Static Foot Posture Measures Related to Static and Dynamic Plantar Pressure Parameters? J Am Podiatr Med Assoc 2022; 112:20-129. [PMID: 36525325 DOI: 10.7547/20-129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND A few studies have investigated the relationship between foot posture measures and plantar pressure parameters, but no study has investigated the correlation of foot posture measures with all primary parameters consisting of contact area (CA), maximum force (MF), and peak pressure (PP). We aimed to determine the relationship of the Foot Posture Index-6 (FPI-6) and navicular drop (ND) with plantar pressure parameters during static standing and preferred walking. METHODS Seventy people were included. Navicular drop and the FPI-6 were used to assess foot posture. Plantar pressure parameters including CA, MF, and PP were recorded by a pressure-sensitive mat during barefoot standing and barefoot walking at preferred speed. All assessments were repeated three times and averaged. Pearson correlation coefficients below 0.300 were accepted as negligible and higher ones were interpreted. RESULTS Navicular drop was moderately correlated with dynamic CA under the midfoot and second metatarsal; also, the FPI-6 was moderately correlated with dynamic CA under the midfoot (0.500 < r < 0.700). The other interpreted correlations were poor (0.300 < r < 0.500). Both measures were correlated with dynamic CA under the second and third metatarsals; dynamic CA and MF under the midfoot; and static CA, MF, and PP under the first metatarsal and hallux (P < .01). Navicular drop was also correlated with dynamic MF under the first metatarsal and dynamic CA under the fourth metatarsal (P < .01). Furthermore, ND was correlated with static CA and PP under the second metatarsal and static PP under the fifth metatarsal (P < .01). The FPI-6 was also correlated with dynamic MF and PP under the hallux (P < .01). CONCLUSIONS The correlations between foot posture measures and plantar pressure variables are poor to moderate. The measures may be useful in the clinical assessment of medial forefoot problems related to prolonged standing and midfoot complaints related to high force during walking. Furthermore, the FPI-6 may provide valuable data regarding hallux complaints related to the high loads during walking.
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Affiliation(s)
- Muge Kirmizi
- *Izmir Katip Celebi University, Faculty of Health Sciences, İzmir, Turkey
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16
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Mei Q, Kim HK, Xiang L, Shim V, Wang A, Baker JS, Gu Y, Fernandez J. Toward improved understanding of foot shape, foot posture, and foot biomechanics during running: A narrative review. Front Physiol 2022; 13:1062598. [PMID: 36569759 PMCID: PMC9773215 DOI: 10.3389/fphys.2022.1062598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
The current narrative review has explored known associations between foot shape, foot posture, and foot conditions during running. The artificial intelligence was found to be a useful metric of foot posture but was less useful in developing and obese individuals. Care should be taken when using the foot posture index to associate pronation with injury risk, and the Achilles tendon and longitudinal arch angles are required to elucidate the risk. The statistical shape modeling (SSM) may derive learnt information from population-based inference and fill in missing data from personalized information. Bone shapes and tissue morphology have been associated with pathology, gender, age, and height and may develop rapid population-specific foot classifiers. Based on this review, future studies are suggested for 1) tracking the internal multi-segmental foot motion and mapping the biplanar 2D motion to 3D shape motion using the SSM; 2) implementing multivariate machine learning or convolutional neural network to address nonlinear correlations in foot mechanics with shape or posture; 3) standardizing wearable data for rapid prediction of instant mechanics, load accumulation, injury risks and adaptation in foot tissue and bones, and correlation with shapes; 4) analyzing dynamic shape and posture via marker-less and real-time techniques under real-life scenarios for precise evaluation of clinical foot conditions and performance-fit footwear development.
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Affiliation(s)
- Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Hyun Kyung Kim
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,Department of Engineering Science, The University of Auckland, Auckland, New Zealand
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17
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Jandova S, Mendricky R. Benefits of 3D Printed and Customized Anatomical Footwear Insoles for Plantar Pressure Distribution. 3D PRINTING AND ADDITIVE MANUFACTURING 2022; 9:547-556. [PMID: 36660748 PMCID: PMC9831565 DOI: 10.1089/3dp.2021.0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
During walking, the foot is in direct contact with the insole of the footwear, and it affects the biomechanics of the whole human body. The aim of this study was to compare the plantar pressure distribution while walking in the same footwear in three different situations: with an original footwear insole, with an ethylene-vinyl acetate customized insole, and with a 3D printed anatomical insole to find out the optimal insoles for people with a normal, flat, and high arched foot according to the plantar pressure relief. Fifty-one adults were grouped into three groups (normal foot, flat foot, and high arched foot geometry). The feet of the randomly selected subjects from each group were scanned, and the insoles were designed on the basis of the foot model. These models were then used for the 3D printing. The plantar pressure distribution was observed when walking in all three different insole types for each of the three subjects with the different foot types. The peak pressure values in the forefoot, midfoot, and rearfoot and contact area were compared. The results of the study show that customized insoles influence the plantar pressure distribution mainly in people with a flat foot or with a high arched foot deformity. This influence is dependent on the type of the customized insoles, mainly in people with a high arched foot. People with a flat foot deformity have a similar plantar pressure relief in the thermoplastic insoles as those in the 3D printed insoles, and both these customized insoles can be used as a supplementary therapeutic instrument. Our study showed that the biggest attention, with regards to customizing insoles, is required by people with a high arched foot deformity, and we recommend that these people use fully customized insoles which can be guaranteed with 3D printing techniques.
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Affiliation(s)
- Sona Jandova
- Department of Applied Mechanics, Faculty of Mechanical Engineering, Technical University of Liberec, Liberec, Czech Republic
- Department of Physical Education, Faculty of Education, Charles University, Prague, Czech Republic
| | - Radomir Mendricky
- Department of Manufacturing Systems and Automation, Faculty of Mechanical Engineering, Technical University of Liberec, Liberec, Czech Republic
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18
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Kirmizi M, Sengul YS, Angin S. The effects of calf muscles fatigue on dynamic plantar pressure distribution in normal foot posture and flexible flatfoot: A case-control study. J Back Musculoskelet Rehabil 2022; 35:649-657. [PMID: 34459384 DOI: 10.3233/bmr-210069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Flexible flatfoot is associated with altered plantar pressure distribution, but it is not clear how muscle fatigue affects plantar pressure characteristics in flexible flatfoot and normal foot. OBJECTIVE To investigate the effects of calf muscles fatigue on plantar pressure variables in flexible flatfoot and normal foot. METHODS Twenty-five people with flexible flatfoot and twenty-five people with normal foot were included. The unilateral heel-rise test was used to induce calf muscles fatigue. Plantar pressure variables were collected during preferred walking immediately before and after fatigue. The two-way mixed-design ANOVA was used to determine the main effect of fatigue and the interaction between foot posture and fatigue. RESULTS Fatigue caused medialization of the contact area under the forefoot and the maximum force under the heel and forefoot (p< 0.05). When examining the differences in the effects of fatigue between groups, the contact area under the medial heel increased with fatigue in flexible flatfoot but decreased in normal foot; moreover, the contact area and maximum force under the midfoot and the maximum force under the third metatarsal decreased with fatigue in flexible flatfoot but increased in normal foot (p< 0.05). CONCLUSIONS Calf muscles fatigue caused medialization of the maximum force and contact area. Especially the midfoot was affected differently by fatigue in flexible flatfoot and normal foot.
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Affiliation(s)
- Muge Kirmizi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Cigli, Izmir, Turkey.,Institute of Health Sciences, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Yesim Salik Sengul
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Salih Angin
- Faculty of Health Sciences, Cyprus International University, Nicosia, Cyprus
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19
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Jasiewicz B, Klimiec E, Guzdek P, Kołaszczyński G, Piekarski J, Zaraska K, Potaczek T. Investigation of Impact of Walking Speed on Forces Acting on a Foot-Ground Unit. SENSORS 2022; 22:s22083098. [PMID: 35459082 PMCID: PMC9028688 DOI: 10.3390/s22083098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 12/04/2022]
Abstract
Static and dynamic methods can be used to assess the way a foot is loaded. The research question is how the pressure on the feet would vary depending on walking/running speed. This study involved 20 healthy volunteers. Dynamic measurement of foot pressure was performed using the Ortopiezometr at normal, slow, and fast paces of walking. Obtained data underwent analysis in a “Steps” program. Based on the median, the power generated by the sensors during the entire stride period is the highest during a fast walk, whereas based on the average; a walk or slow walk prevails. During a fast walk, the difference between the mean and the median of the stride period is the smallest. Regardless of the pace of gait, the energy released per unit time does not depend on the paces of the volunteers’ gaits. Conclusions: Ortopiezometr is a feasible tool for the dynamic measurement of foot pressure. For investigations on walking motions, the plantar pressure analysis system, which uses the power generated on sensors installed in the insoles of shoes, is an alternative to force or energy measurements. Regardless of the pace of the walk, the amounts of pressure applied to the foot during step are similar among healthy volunteers.
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Affiliation(s)
- Barbara Jasiewicz
- Department of Orthopedics and Rehabilitation, Medical College, Jagiellonian University, Balzera 15, 34-500 Zakopane, Poland;
- Correspondence:
| | - Ewa Klimiec
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Piotr Guzdek
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Grzegorz Kołaszczyński
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Jacek Piekarski
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Krzysztof Zaraska
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, Kraków Division, Zablocie 39, 30-701 Krakow, Poland; (E.K.); (P.G.); (G.K.); (J.P.); (K.Z.)
| | - Tomasz Potaczek
- Department of Orthopedics and Rehabilitation, Medical College, Jagiellonian University, Balzera 15, 34-500 Zakopane, Poland;
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20
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Yoshimoto K, Noguchi M, Maruki H, Nasu Y, Ishibashi M, Okazaki K. How does the postoperative medial arch height influence the patient reported outcomes of stage Ⅱ acquired adult flatfoot deformity? J Orthop Sci 2022; 27:429-434. [PMID: 33509698 DOI: 10.1016/j.jos.2020.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/27/2020] [Accepted: 12/11/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study aimed to assess how the postoperative medial arch height influenced postoperative patient-reported clinical outcomes after surgery for stage Ⅱ acquired adult flatfoot deformity. METHODS A total of 30 feet of 30 patients (7 males, 23 females) who underwent surgery for stage Ⅱ acquired adult flatfoot deformity and could be followed up for at least 2 years were included. The average age at surgery was 60.0 (standard deviation, 13.0) years, and the average follow-up period was 40 (standard deviation, 15.4) months. Among them, 16 patients underwent lateral column lengthening and 14 patients did not. Patient-reported clinical outcomes were evaluated using the Self-Administered Foot Evaluation Questionnaire. Radiographic alignment was evaluated by the talonavicular coverage angle, lateral talo-1st metatarsal angle, medial cuneiform height, medial cuneiform to 5th metatarsal height, and calcaneal pitch. The correlation between postoperative Self-Administered Foot Evaluation Questionnaire and radiographic alignment was assessed with Pearson's correlation analysis. RESULTS Self-Administered Foot Evaluation Questionnaire and radiographic alignment significantly improved postoperatively in all patients (P < 0.0001). In patients with severe deformity who needed lateral column lengthening, lateral talo-1st metatarsal angle was negatively and medial cuneiform to 5th metatarsal height was positively correlated with physical functioning Self-Administered Foot Evaluation Questionnaire subscales (r = -0.56 and 0.55), and medial cuneiform height was positively correlated with physical functioning, social functioning and general health Self-Administered Foot Evaluation Questionnaire subscales (r = 0.70, 0.55 and 0.73, respectively). CONCLUSION Postoperative medial arch height could influence physical functioning, social functioning, and general health in patients with severe stage II adult-acquired flatfoot deformity.
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Affiliation(s)
- Kensei Yoshimoto
- Department of Orthopedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan; Orthopaedic Foot and Ankle Center, Shiseikai Daini Hospital, 5-19-1 Kamisoshigaya, Setagaya-ku, Tokyo, 157-8550, Japan
| | - Masahiko Noguchi
- Department of Orthopedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan; Orthopaedic Foot and Ankle Center, Shiseikai Daini Hospital, 5-19-1 Kamisoshigaya, Setagaya-ku, Tokyo, 157-8550, Japan; Kohno Clinical Medicine Research Institute, 3-3-7, Kitashinagawa, Shinagawa-ku, Tokyo, 140-0001, Japan.
| | - Hideyuki Maruki
- Orthopaedic Foot and Ankle Center, Shiseikai Daini Hospital, 5-19-1 Kamisoshigaya, Setagaya-ku, Tokyo, 157-8550, Japan
| | - Yuki Nasu
- Orthopaedic Foot and Ankle Center, Shiseikai Daini Hospital, 5-19-1 Kamisoshigaya, Setagaya-ku, Tokyo, 157-8550, Japan
| | - Mina Ishibashi
- Orthopaedic Foot and Ankle Center, Shiseikai Daini Hospital, 5-19-1 Kamisoshigaya, Setagaya-ku, Tokyo, 157-8550, Japan
| | - Ken Okazaki
- Department of Orthopedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan
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21
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Morgan O, Hillstrom H, Bitar R, Sturnick D, Koff MF, Ellis S, Deland J, Hillstrom R. Finite Element Modelling of Planus and Rectus Foot Types for the Study of First Metatarsophalangeal and First Metatarsocuneiform Joint Contact Mechanics. J Biomech Eng 2022; 144:1135615. [PMID: 35147162 DOI: 10.1115/1.4053791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Indexed: 11/08/2022]
Abstract
Evaluating the contact mechanics of human joints is an important element in understanding the pathomechanics of orthopaedic diseases. Although physical testing is essential in the evaluation process, reliable computational models can augment these experiments by non-invasive predictions of biomechanical or surgical variables. The objective of this study was to perform verification of a framework for developing a medial forefoot finite element. Verification was conducted by comparing computational predictions to experimental measurements of first metatarsophalangeal and first metatarsocuneiform joint contact mechanics. A custom-built force-controlled cadaveric test-rig was used to derive measurements of contact pressure, force, and area. A quasi-static finite element was developed and driven under the same boundary and loading conditions. Calibration of cartilage moduli and mesh sensitivity analyses were performed. Mean errors in contact pressures, forces, and areas were 24%, 4%, and 40% at the first metatarsophalangeal joint and 23%, 12%, and 19% at the first Metatarsocuneiform joint, respectively. Verification of a medial forefoot finite element model development framework was presented and found to be within 30% for contact pressure and contact force of both joints. This study presents a method to verify and simulate realistic physiological loading to investigate orthopaedic diseases of the medial forefoot.
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Affiliation(s)
- Oliver Morgan
- Faculty of Science and Engineering, Anglia Ruskin University, Chelmsford, Essex, UK
| | - Howard Hillstrom
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Rogerio Bitar
- Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA
| | - Daniel Sturnick
- Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA
| | - Matthew F Koff
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
| | - Scott Ellis
- Department of Orthopedics, Foot and Ankle Division, Hospital for Special Surgery, New York, NY, USA
| | - Jonathan Deland
- Department of Orthopedics, Foot and Ankle Division, Hospital for Special Surgery, New York, NY, USA
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22
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Morgan OJ, Hillstrom R, Turner R, Day J, Thaqi I, Caolo K, Ellis S, Deland JT, Hillstrom HJ. Is the Planus Foot Type Associated With First Ray Hypermobility? FOOT & ANKLE ORTHOPAEDICS 2022; 7:24730114221081545. [PMID: 35274071 PMCID: PMC8902198 DOI: 10.1177/24730114221081545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Many foot pathologies have been associated with foot type. However, the
association of first ray hypermobility remains enigmatic. The purpose of
this study was to investigate first ray hypermobility among participants
with planus and rectus foot types and its influence on static measures of
foot structure. Methods: Twenty asymptomatic participants with planus (n = 23 feet) and rectus (n = 17
feet) foot types were enrolled. Several parameters of static foot structure
(arch height index, arch height flexibility, first metatarsophalangeal joint
flexibility, and first ray mobility) were measured. Participants were
further stratified into groups with nonhypermobile (n = 26 feet) and
hypermobile (n = 14 feet) first rays. First ray mobility ≥8 mm
was used to define “first ray hypermobility”. Generalized estimating
equations, best-fit regression lines, and stepwise linear regression were
used to identify significant differences and predictors between the study
variables Results: Overall, 86% of subjects categorized with first ray hypermobility exhibited a
planus foot type. Arch height flexibility, weightbearing first ray mobility,
and first metatarsophalangeal joint flexibility showed no significant
between-group differences. However, weightbearing ray mobility and first
metatarsophalangeal joint laxity were associated with partial weightbearing
first ray mobility, accounting for 38% of the model variance. Conclusion: The planus foot type was found to be associated with first ray hypermobility.
Furthermore, weightbearing first ray mobility and first metatarsophalangeal
joint laxity were predictive of partial weightbearing first ray mobility,
demonstrating an interaction between the translation and rotational
mechanics of the first ray. Clinical Relevance: Association of first ray hypermobility with foot type and first
metatarsophalangeal joint flexibility may help understand the sequela to
symptomatic pathologies of the foot.
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Affiliation(s)
- Oliver J. Morgan
- Medical Engineering Research Group, Faculty of Science and Engineering, Anglia Ruskin University, Chelmsford, Essex, United Kingdom
| | - Rajshree Hillstrom
- Biomed Consulting, Inc, New York, NY, USA
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Robert Turner
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Jonathan Day
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Ibadet Thaqi
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Kristin Caolo
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Scott Ellis
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Jonathan T. Deland
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Howard J. Hillstrom
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
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Morgan OJ, Hillstrom R, Turner R, Day J, Thaqi I, Caolo K, Song J, Russell R, Ellis S, Deland JT, Hillstrom HJ. Comparative Reliability of a Novel Electromechanical Device and Handheld Ruler for Measuring First Ray Mobility. Foot Ankle Int 2021; 42:1613-1623. [PMID: 34112024 DOI: 10.1177/10711007211020345] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Quantifying first ray mobility is crucial to understand aberrant foot biomechanics. A novel device (MAP1st) that can perform measurements of first ray mobility in different weightbearing conditions, foot alignments, and normalization was tested. The reliability of these measurement techniques was assessed in comparison to a handheld ruler considered representative of the common clinical examination. METHODS The study included 25 participants (50 feet). Two independent raters performed baseline, test-retest, and remove-replace measurements of first ray mobility with MAP1st and the handheld device. The effects of non-, partial, and full weightbearing in subtalar joint neutral and the resting calcaneal stance position were assessed. Measurement normalization relative to foot size was also investigated. Intra- and interclass correlation coefficients (ICCs) were calculated for each device between the 2 raters. In addition, Bland-Altman plots were constructed to determine if fixed biases or substantial outliers were present. RESULTS Similar intrarater ICC values were found for both devices (≥0.85). However, interrater ICC values were substantially improved by MAP1st compared with the handheld device (0.58 vs 0.06). Bland-Altman plots demonstrated biases of 1.27 mm for the handheld ruler, and 2.88 to 0.05 mm and -1.16 to 0.00 for linear and normalized MAP1st measurements, respectively. Improved reliability was achieved with MAP1st for normalized assessments of first ray mobility while the foot was placed in partial- and full-weightbearing resting calcaneal stance positions. CONCLUSION MAP1st provided reliable assessments of partial- and full-weightbearing first ray mobility. It should help investigators to explore the potential relationships between first ray function and aberrant foot biomechanics in future research. LEVEL OF EVIDENCE Level II, prospective cohort study.
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Affiliation(s)
- Oliver J Morgan
- Medical Engineering Research Group, Faculty of Science and Engineering, Anglia Ruskin University, Chelmsford, Essex, UK
| | - Rajshree Hillstrom
- Leon Root, MD, Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA.,Biomed Consulting, Inc. New York, New York, USA
| | - Robert Turner
- Leon Root, MD, Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Jonathan Day
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Ibadet Thaqi
- Leon Root, MD, Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Kristin Caolo
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Jinsup Song
- School of Podiatric Medicine, Temple University, Philadelphia, PA, USA
| | | | - Scott Ellis
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Jonathan T Deland
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Howard J Hillstrom
- Leon Root, MD, Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
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24
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Hu CW, Dabnichki P, Baca A, Nguyen CT, Pang TY. Preventive strategy of flatfoot deformity using fully automated procedure. Med Eng Phys 2021; 95:15-24. [PMID: 34479688 DOI: 10.1016/j.medengphy.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/26/2021] [Accepted: 07/04/2021] [Indexed: 11/30/2022]
Abstract
A non-invasive, no radiation, out-of-hospital automated system is proposed to identify low arch integrated in the design and manufacturing of personalized orthoses using parametric modelling. The aim of the design process is to integrate assistive technology with assessment and prevent low arch progressing to a more serious case - flatfoot. In the automated procedure, we developed an assessment method including reliable thresholds of foot type classification and test protocol to reduce interferences due to preceding activities, an automation to translate scanned data into parametric design for orthotic customization, finite element model evaluating effectiveness of the personalized design, and a personalized comparative test to evaluate the long-term improvement of foot arch shape. Our low arch threshold established by subject-specific 3D models reduced the misclassification rate from 55%, as previously reported to 6.9%. Individuals who engaged in sedentary activity (i.e. sitting) had the greater change in arch height compared to active activity (i.e. standing and walking), which is more likely to affect the obtained measure. Therefore, a test protocol now states that participants are not allowed to sit over 100 min prior the measurement to reduce such interference. We have proposed and tested an automated algorithm to translate scanned data including seven foot's parameters into customised parametric design of the insert. The method decreases the required time of orthotic computer-aided design from over 3 h to less than 2 min. A finite element analysis procedure was additionally developed to assess the performance of geometries and material of designed orthotic based on the distribution of plantar pressure and internal stress. The personalized comparative assessment based on midfoot contact area was carried out periodically for follow-up and the orthotic could be re-designed if necessary. The proposed automated procedure develops a pre-screening system to distinguish low arch and provide preventatives before it becomes symptomatic. Furthermore, non-symptom flatfoot can be detected at early stages and referred to medics for further diagnosis or treatment.
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Affiliation(s)
- Che-Wei Hu
- School of Engineering, RMIT University, Australia; Department of Sport Science, University of Vienna, Austria.
| | | | - Arnold Baca
- Department of Sport Science, University of Vienna, Austria.
| | | | - Toh Yen Pang
- School of Engineering, RMIT University, Australia.
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25
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SHEN LONGBIN, OUYANG HUI, HUANG YIXUAN, PAN RUI, LU JIANLIANG, XIE ZUWEN, CHEN ZHUOMING. ESTABLISHING THE NORMAL GAIT OF CHINESE YOUTH BASED ON THE PLANTAR PRESSURE TEST: AN EXPERIMENTAL STUDY. J MECH MED BIOL 2021. [DOI: 10.1142/s021951942150038x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: This study will measure the geometric and pressure centerlines of the foot’s plantar region in healthy Chinese youth to construct a gait norm. Methods: In the present experiment, 203 healthy college students and postgraduates (90 males and 113 females) were recruited as subjects. Their average age was [Formula: see text] years old, average height was [Formula: see text][Formula: see text]cm, and average weight was [Formula: see text][Formula: see text]kg. A double-blind method was used in this experiment. The plantar pressure and gait parameters of time and space among subjects were tested using a gait and balance function-training evaluation system. Data were collected using five pressure-sensor plates, based on the distribution in the geometric and pressure centers of the foot’s plantar area, according to the calculation formula of biomechanics. Results: From 20 selected subjects, the experiment gathered a total of 197 data points from the plantar pressure during walking. The results defined the foot’s centerline of maximum pressure while walking and showed that the pressure and geometric centerlines tended to converge and overlap in normal youth, irrespective of gender. In addition, differences were found between the foot’s centerline of pressure and the geometric and pressure centerlines of the plantar. Conclusion: This study showed that the plantar’s pressure and geometric centerlines can be used as a reference to assess normal gait in Chinese youth.
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Affiliation(s)
- LONG-BIN SHEN
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, P. R. China
| | - HUI OUYANG
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, P. R. China
| | | | - RUI PAN
- Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, P. R. China
| | - JIAN-LIANG LU
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, P. R. China
| | - ZU-WEN XIE
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, P. R. China
| | - ZHUO-MING CHEN
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, P. R. China
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26
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Dickerson LC, Queen RM. Foot Posture and Plantar Loading With Ankle Bracing. J Athl Train 2021; 56:461-472. [PMID: 34000019 DOI: 10.4085/1062-6050-164-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Arch height is one important aspect of foot posture. An estimated 20% of the population has pes planus and 20% has pes cavus. These abnormal foot postures can alter lower extremity kinematics and plantar loading and contribute to injury risk. Ankle bracing is commonly used in sport to prevent these injuries, but no researchers have examined the effects of ankle bracing on plantar loading. OBJECTIVE To evaluate the effects of ankle braces on plantar loading during athletic tasks. DESIGN Cross-sectional study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 36 participants (11 men, 25 women; age = 23.1 ± 2.5 years, height = 1.72 ± 0.09 m, mass = 66.3 ± 14.7 kg) were recruited for this study. INTERVENTION(S) Participants completed walking, running, and cutting tasks in 3 bracing conditions: no brace, lace-up ankle-support brace, and semirigid brace. MAIN OUTCOME MEASURE(S) We analyzed the plantar-loading variables of contact area, maximum force, and force-time integral for 2 midfoot and 3 forefoot regions and assessed the displacement of the center of pressure. A 3 × 3 mixed-model repeated-measures analysis of variance was used to determine the effects of brace and foot type (α = .05). RESULTS Foot type affected force measures in the middle (P range = .003-.047) and the medial side of the foot (P range = .004-.04) in all tasks. Brace type affected contact area in the medial midfoot during walking (P = .005) and cutting (P = .01) tasks, maximum force in the medial and lateral midfoot during all tasks (P < .001), and force-time integral in the medial midfoot during all tasks (P < .001). Portions of the center-of-pressure displacement were affected by brace wear in both the medial-lateral and anterior-posterior directions (P range = .001-.049). CONCLUSIONS Ankle braces can be worn to redistribute plantar loading. Additional research should be done to evaluate their effectiveness in injury prevention.
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Affiliation(s)
- Laura C Dickerson
- Kevin P. Granata Biomechanics Lab, Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg
| | - Robin M Queen
- Kevin P. Granata Biomechanics Lab, Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg
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27
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Abstract
Background: Authors refer to different methods to assess subjects’ foot posture. All methods present several limitations depending on the examiner or the chosen test. This study aims to investigate the relationship between different tests and Footprints parameters to diagnose subjects with a flat and neutral foot. Methods: The sample consisted of 37 participants, where 16 were included in the flatfoot group and 21 in the neutral foot group. Only subjects who presented a Navicular Drop Test value of >9 mm were included in the flatfooted group. All participants were submitted to Resting Calcaneal Stance Position and plantar pressure platform assessment for Footprints analysis. Associations between all tests and Footprints parameters were determined by Pearson’s correlation analysis. Results: Regarding both groups, significant correlations between tests were moderate to nearly perfect to identified both conditions of foot posture. All correlations were statistically significant (p < 0.05). Conclusions: The diagnosis accuracy of foot posture condition can be compromised depending on the used test. The Navicular Drop Test and the Resting Calcaneal Stance Position were shown to mislead foot posture condition assessment, unlike Footprints parameters that can be important evaluation tools in a clinical environment.
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28
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Guenka LC, Carrasco AC, Pelegrinelli ARM, Silva MF, Dela Bela LF, Moura FA, Cardoso JR. Influence of the medial longitudinal arch of the foot in adult women in ankle isokinetic performance: a cross-sectional study. J Foot Ankle Res 2021; 14:43. [PMID: 34118961 PMCID: PMC8196527 DOI: 10.1186/s13047-021-00479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maintenance of the medial longitudinal arch (MLA) of the foot is fundamental during functional tasks and disorders can lead to clinical alterations. Studies have demonstrated that deficits in ankle isokinetic performance can predispose an individual to lower limb injuries. OBJECTIVES To evaluate the muscular performance of cavus, planus, and normal feet by means of torque/body mass and the isokinetic phases, to generate 3D surface map analysis, and to verify whether there is a relationship between MLA height and arch height flexibility with isokinetic performance. METHODS The sample consisted of 105 healthy adult women, divided into three groups: normal, cavus, and planus. Assessment in concentric mode at 30, 60, and 90 °/s in the dorsiflexion and plantarflexion of the ankle joint were analyzed during the three isokinetic phases (acceleration, sustained velocity, and deceleration). The variables total range of motion, peak of torque (PT), and angle of PT were extracted within the sustained velocity. RESULTS In dorsiflexion at 60 °/s, the phase where the velocicty is sustained (load range phase) was higher in the planus group (MeanDifference=10.9 %; ω2p = 0.06) when compared with the cavus group. Deficits in the peak torque/body mass in dorsiflexion at 60 °/s (cavus feet: MD=-3 N.m/kg; ω2p = 0.06; and planus feet: MD=-1.1 N.m/kg; ω2p = 0.06) were also observed as well as in the 3D surface maps, when compared with the normal group. The flexibility of MLA had a negative correlation of PT at 30 °/s in cavus group. The heigth of MLA had a postive correlation with the PT for the cavus and planus group ate 60 °/s. All other results did not show differences between the groups. CONCLUSIONS The planus groups showed a better capacity of attain and sustained the velocity in dorsiflexion in relation the cavus group. The cavus and planus group had deficts in torque in relation the normal. The correlations were weak between the measures of MLA and PT. Thereby, in general the differences between foot types showed small effect in isokinetic muscle performance measures of the plantar and dorsi flexores. TRIAL REGISTRATION Study design was approved by the IRB (#90238618.8.0000.5231).
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Affiliation(s)
- Leandro C Guenka
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil
| | - Aline C Carrasco
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil.,Universidade Estadual do Centro-Oeste, Guarapuava, PR, Brazil
| | | | - Mariana F Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil
| | - Laís F Dela Bela
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil.,Universidade Positivo, Curitiba, PR, Brazil
| | - Felipe A Moura
- Laboratory of Applied Biomechanics, Universidade Estadual de Londrina, PR, Londrina, Brazil
| | - Jefferson Rosa Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil.
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29
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Shin Y, Ahn SY, Bok SK. Relationships Between Relative Ankle Muscle Ratios, Severity of Symptoms, and Radiologic Parameters in Adolescent Patients With Symptomatic Flexible Flat Feet. Ann Rehabil Med 2021; 45:123-130. [PMID: 33849086 PMCID: PMC8137383 DOI: 10.5535/arm.20174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022] Open
Abstract
Objective To investigate differences in the relative sizes of the ankle-stabilizing muscles in individuals with versus without flexible flat feet and to determine predictors of symptom severity. Methods This cross-sectional study included 30 patients with symptomatic flexible flat feet and 24 normal controls. The following were evaluated: foot posture index, resting calcaneal stance position angle, radiographic findings (calcaneal pitch, Meary’s angle, talocalcaneal angle, talonavicular coverage angle [TNCA]), foot function index (FFI), and cross-sectional areas (CSA) of the tibialis anterior (TA), tibialis posterior (TP), and peroneus longus (PL) upon ultrasonographic examination. To address morphometric differences among participants, individual muscle measurements were normalized to proportions of total muscle CSA. Between-group differences were evaluated with independent t-tests. Correlations between muscle ratios, radiographic parameters, and FFI scores were investigated. Logistic regression analysis was performed to determine which parameters predicted severe symptoms. Results The relative size of the TP was significantly greater and those of the TA and PL were significantly smaller in patients with flat feet than in normal controls. Correlations were found among relative muscle CSA ratios, radiographic parameters, and FFI score. Linear regression analysis confirmed that the TNCA and the relative CSA of the PL were independent predictors of symptom severity. Conclusion This study found significant differences in the relative CSAs of the ankle muscles in patients with flexible flat feet versus individuals without flat feet; these differences were significantly correlated with anatomic abnormalities. Symptoms were more severe in patients with relatively greater forefoot abduction and relatively smaller PL.
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Affiliation(s)
- Youngju Shin
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - So Young Ahn
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Soo-Kyung Bok
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
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30
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Kondo M, Iwamoto Y, Kito N. Relationship between forward propulsion and foot motion during gait in healthy young adults. J Biomech 2021; 121:110431. [PMID: 33873109 DOI: 10.1016/j.jbiomech.2021.110431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 02/28/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022]
Abstract
The foot contributes to propulsion and postural stability function by changing its morphology during walking through the truss/windlass mechanisms. We quantified the truss mechanism regarding foot stiffness and the windlass mechanism regarding the movement coordination between the foot arch and metatarsophalangeal (MTP) joint. We aimed to clarify the relationship of these mechanisms with propulsive force and static foot alignment. Forty-eight healthy young adults participated and walked at a comfortable speed. The ground reaction force (GRF), ankle power, and sagittal plane motion of the foot arch and MTP joint were recorded using a three-dimensional motion analysis system. The vertical GRF and foot arch motion were used to quantify foot stiffness as the truss coefficient, and the foot arch and first MTP joint were used to quantify movement coordination as the windlass coefficient. The Foot Posture Index (FPI) and arch height index (AHI) were used to assess static foot alignment. A canonical correlation analysis was performed using the foot- and gait-related index group, and then a single-correlation analysis was performed. The canonical correlation analysis showed that a composite variable consisting of FPI, AHI, and the truss coefficient was related to the anterior GRF (A-GRF) and ankle power. The truss coefficient was positively correlated with A-GRF and ankle power, whereas the windlass coefficient was positively correlated with ankle power. Therefore, the truss and windlass coefficients can be used as indices to evaluate foot function, suggesting that maintaining foot stiffness and foot arch coordination with the first MTP joint is important for propulsion.
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Affiliation(s)
- Masatoshi Kondo
- Graduate School of Medical Welfare Science, Medical Engineering, Hiroshima International University, 555-36, Gakuendai, Kurose, Higashihiroshima-shi, Hiroshima 739-0295, Japan
| | - Yoshitaka Iwamoto
- Department of Rehabilitation, Hiroshima Hiramatsu Hospital, 11-27, Hijiyamahonnmachi, Minami-ku, Hiroshima-shi, Hiroshima 732-0816, Japan
| | - Nobuhiro Kito
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, 555-36, Gakuendai, Kurose, Higashihiroshima-shi, Hiroshima 739-0295, Japan.
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31
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Miyazaki T, Kawada M, Kiyama R, Yone K. Validity of two-dimensional analysis using a tablet computer for estimation of foot arch height during walking. J Phys Ther Sci 2021; 33:194-198. [PMID: 33814703 PMCID: PMC8012182 DOI: 10.1589/jpts.33.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/01/2020] [Indexed: 12/04/2022] Open
Abstract
[Purpose] To examine the validity of two-dimensional analysis using a tablet computer
for the estimation of arch height during walking by comparing it with a motion capture
system and static foot alignment screenings. [Participants and Methods] Fourteen healthy
males and 15 healthy females participated in this study. The arch height of the right foot
while walking was simultaneously measured using a tablet computer and motion capture
system. Dynamic foot alignment, including arch height, at the mid-stance and pre-swing
phases was calculated from the kinematic data measured using the tablet computer and
motion analysis system. Static foot alignment was also assessed by screening tests
including arch height index and foot posture index. [Results] Arch height measured using a
tablet computer showed a significant high correlation with that measured using the motion
capture system at the mid-stance and pre-swing phases. Arch height index showed a
significant moderate correlation with arch height measured using the motion capture system
at the mid-stance phase. Meanwhile, foot posture index showed no relationship with arch
height measured by the motion capture system. [Conclusion] These results demonstrate the
high validity of dynamic foot analysis using a tablet computer for the estimation of arch
height during walking. Such gait analysis can be effective for assessing dynamic foot
alignment in clinical practice.
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Affiliation(s)
- Takasuke Miyazaki
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan.,Department of Rehabilitation, Tarumizu Municipal Medical Center, Tarumizu Central Hospital, Japan
| | - Masayuki Kawada
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan
| | - Ryoji Kiyama
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan
| | - Kazunori Yone
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan
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32
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Lenz AL, Strobel MA, Anderson AM, Fial AV, MacWilliams BA, Krzak JJ, Kruger KM. Assignment of local coordinate systems and methods to calculate tibiotalar and subtalar kinematics: A systematic review. J Biomech 2021; 120:110344. [PMID: 33744722 DOI: 10.1016/j.jbiomech.2021.110344] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 12/14/2022]
Abstract
The introduction of biplane fluoroscopy has created the ability to evaluate in vivo motion, enabling six degree-of-freedom measurement of the tibiotalar and subtalar joints. Although the International Society of Biomechanics defines a standard method of assigning local coordinate systems for the ankle joint complex, standards for the tibiotalar and subtalar joints are lacking. The objective of this systematic review was to summarize and appraise the existing literature that (1) defined coordinate systems for the tibia, talus, and/or calcaneus or (2) assigned kinematic definitions for the tibiotalar and/or subtalar joints. A systematic literature search was developed with search results limited to English Language from 2006 through 2020. Articles were screened by two independent reviewers based on title and abstract. Methodological quality was evaluated using a modified assessment tool. Following screening, 52 articles were identified as having met inclusion criteria. Methodological assessment of these articles varied in quality from 61 to 97. Included articles adopted primary methods for defining coordinate systems that included: (1) anatomical coordinate system (ACS) based on individual bone landmarks and/or geometric shapes, (2) orthogonal principal axes, and (3) interactive closest point (ICP) registration. Common methods for calculating kinematics included: (1) joint coordinate system (JCS) to calculate rotation and translation, (2) Cardan/Euler sequences, and (3) inclination and deviation angles for helical angles. The methods each have strengths and weaknesses. This summarized knowledge should provide the basis for the foot and ankle biomechanics community to create an accepted standard for calculating and reporting tibiotalar and subtalar kinematics.
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Affiliation(s)
- Amy L Lenz
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, United States
| | - Marisa A Strobel
- Department of Biomedical Engineering, Marquette University, 1515 W Wisconsin Ave, Milwaukee, WI 53233, United States
| | - Abigail M Anderson
- Department of Biomedical Engineering, Marquette University, 1515 W Wisconsin Ave, Milwaukee, WI 53233, United States
| | - Alissa V Fial
- Research & Instruction Services, Marquette University, 1355 W. Wisconsin Ave, Milwaukee, WI 53201, United States
| | - Bruce A MacWilliams
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, United States; Motion Analysis Center, Shriners Hospitals for Children-Salt Lake City, 1275 Fairfax Rd., Salt Lake City, UT 84103, United States
| | - Joseph J Krzak
- Physical Therapy Program, Midwestern University, 555 31st St., Downers Grove, IL 60515, United States; Motion Analysis Center, Shriners Hospitals for Children-Chicago, 2211 N Oak Park Ave, Chicago, IL 60707, United States
| | - Karen M Kruger
- Department of Biomedical Engineering, Marquette University, 1515 W Wisconsin Ave, Milwaukee, WI 53233, United States; Motion Analysis Center, Shriners Hospitals for Children-Chicago, 2211 N Oak Park Ave, Chicago, IL 60707, United States.
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Takabayashi T, Edama M, Inai T, Kubo M. Differences in rearfoot, midfoot, and forefoot kinematics of normal foot and flatfoot during running. J Orthop Res 2021; 39:565-571. [PMID: 33038023 DOI: 10.1002/jor.24877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/23/2020] [Accepted: 10/06/2020] [Indexed: 02/04/2023]
Abstract
Flatfoot is a common foot deformity, which could contribute to running injuries such as medial tibial stress syndrome. Intrafoot kinematics of flatfoot during walking have often been documented using multisegment foot models. However, the intrafoot kinematics of flatfoot during running remains unclear, despite the possible relationship between flatfoot and running injuries. We aimed to clarify rearfoot, midfoot, and forefoot kinematics when running in participants with normal foot and flatfoot. Participants with the normal foot (n = 14) and flatfoot (n = 14) were asked to runover-ground at their preferred speed. Three-dimensional kinematics of the rearfoot, midfoot, and forefoot during running were calculated based on the Rizzoli foot model. A two-sample t-test of statistical parametric mapping was performed to determine differences between normal foot and flatfoot in time histories of intrafoot kinematics during running. No differences were found between groups in characteristics and spatiotemporal parameters. In the frontal rearfoot angle, a significantly increased eversion from 24% to 100% (p < .001) was observed in the flatfoot compared to the normal foot. At the midfoot angle, a significantly increased eversion from 0% to 4% (p < .049) and 21% to 100% (p < .001) was observed in the flatfoot compared to the normal foot. At the forefoot angle, a significantly increased inversion from 6% to 17% (p < .047) was observed in the flatfoot compared to the normal foot. These findings may be useful to explain why flatfoot could contribute to running injuries such as medial tibial stress syndrome.
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Affiliation(s)
- Tomoya Takabayashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan
| | - Mutsuaki Edama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan
| | - Takuma Inai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan
| | - Masayoshi Kubo
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, Japan
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Deleu PA, Naaim A, Chèze L, Dumas R, Devos Bevernage B, Goubau L, Besse JL, Leemrijse T. The effect of ankle and hindfoot malalignment on foot mechanics in patients suffering from post-traumatic ankle osteoarthritis. Clin Biomech (Bristol, Avon) 2021; 81:105239. [PMID: 33246795 DOI: 10.1016/j.clinbiomech.2020.105239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 09/21/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ankle and hindfoot malalignment is a common finding in patients suffering from post-traumatic ankle osteoarthritis. However, no studies have addressed the effect of concomitant foot deformities on intrinsic foot kinematics and kinetics. Therefore, the objective of this study was to investigate the effect of ankle and hindfoot malalignment on the kinematics and kinetics of multiple joints in the foot and ankle complex in patients suffering from post-traumatic ankle osteoarthritis. METHODS Twenty-nine subjects with post-traumatic ankle osteoarthritis participated in this study. Standardized weight-bearing radiographs were obtained preoperatively to categorize patients as having cavus, planus or neutral ankle and hindfoot alignment, based on 4 X-ray measurements. All patients underwent standard gait assessment. A 4-segment foot model was used to estimate intrinsic foot joint kinematics and kinetics during gait. Statistical parametric mapping was used to compare foot kinematics and kinetics between groups. FINDINGS There were 3 key findings regarding overall foot function in the 3 groups of post-traumatic ankle osteoarthritis: (i) altered frontal and transverse plane inter-segmental angles and moments of the Shank-Calcaneus and Calcaneus-Midfoot joints in the cavus compared to the planus group; (ii) in cavus OA group, Midfoot-Metatarsus joint abduction sought to compensate the varus inclination of the ankle joint; (iii) there were no significant differences in inter-segmental angles and moments between the planus and neutral OA groups. INTERPRETATION Future studies should integrate assessment of concomitant foot and ankle deformities in post-traumatic ankle osteoarthritis, to provide additional insight into associated mechanical deficits and compensation mechanisms during gait.
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Affiliation(s)
- P-A Deleu
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, F69622 Lyon, France; Foot & Ankle Institute, Brussels, Belgium.
| | - A Naaim
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, F69622 Lyon, France
| | - L Chèze
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, F69622 Lyon, France
| | - R Dumas
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, F69622 Lyon, France
| | | | - L Goubau
- Foot & Ankle Institute, Brussels, Belgium
| | - J-L Besse
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Service de Chirurgie Orthopédique et Traumatologique, France
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Morante Naranjo J, Sanchis Sales E. Relación entre la dorsiflexión de tobillo y la dorsiflexión de la primera articulación metatarsofalángica en las fases de apoyo total y despegue de la marcha: estudio transversal en sujetos sanos. REVISTA ESPAÑOLA DE PODOLOGÍA 2021. [DOI: 10.20986/revesppod.2021.1602/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Guner S, Alsancak S. Kinesiotaping Techniques to Alter Static Load in Patients With Foot Pronation. J Chiropr Med 2020; 19:175-180. [PMID: 33362440 DOI: 10.1016/j.jcm.2019.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 11/26/2022] Open
Abstract
Objective This study aimed to assess the effect of kinesio tape (KT) application on foot pronation using the laser postural alignment system. Methods Twenty participants (10 females and 10 males, mean age 19.7 ± 1.2 years) with foot pronation were included in the study. The laser line projected on the participant by the laser postural alignment system showed the joint load carrying line. The location of the joint load carrying line was assessed during barefoot static standing with one foot on the force plate before KT application, immediately after application, then 24 and 48 hours later. Displacement of the load-carrying line was measured using a ruler placed tangentially to the patella and ankle joint at the level of the joint line. Weight bearing on the barefoot was assessed before KT application, immediately after, then 24 and 48 hours later. Results Weight bearing was not significantly changed after KT application. The load-carrying line measured using KT did not notably move with KT versus without KT in the ankle joint. Immediately after KT application, significant lateral knee joint movement was measured, but this change was not importantly 24 and 48 hours later. Conclusion KT was not altered in changing weight bearing or moving the lower extremity load-carrying line in people with foot pronation. KT of the foot can amplify sensory input and improve perceived comfort; therefore, it can be used with an orthotic insole in footwear.
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Affiliation(s)
- Senem Guner
- Faculty of Health Science, Prosthetics-Orthotics Department, University of Ankara, Ankara, Turkey
| | - Serap Alsancak
- Faculty of Health Science, Prosthetics-Orthotics Department, University of Ankara, Ankara, Turkey
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Variable Lower Limb Alignment of Clinical Measures With Digital Photographs and the Footscan Pressure System. J Sport Rehabil 2020; 30:437-444. [PMID: 33075751 DOI: 10.1123/jsr.2018-0283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 06/04/2020] [Accepted: 07/20/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study examines the effect of the lower limb misalignment and its possible compensatory effect on plantar pressure in a normal population. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique and plantar pressure measuring device. DESIGN Cohort. SETTING Laboratory. PARTICIPANTS A total of 200 adult volunteers between 18 and 22 years of age who had no current symptoms of pain and foot or ankle pathology participated in the study. MAIN OUTCOME MEASURES The gold standard measure of lower limb alignment with weight-bearing status is the mechanical axis and their angles using Image J software. Structural and functional measurements of the same foot were taken using a plantar pressure measuring device. In this study, 5 alignment (thigh, knee, leg, ankle, and foot) characteristics were measured on the lower limb using the 2 techniques, and, additionally, the foot contact area, peak pressure, foot axis, rearfoot angle, and subtalar joint flexibility score were analyzed in 10 different regions of the foot. RESULTS This study has shown a reasonable correlation between digitalized measurements and plantar pressures values. Quadriceps angle affected midfoot impulse, foot axis angle, subtalar joint minimum angle, and rearfoot angle positively. Subtalar joint flexibility scores were analyzed in 10 different regions of the foot. There was a positive correlation between rearfoot angle and quadriceps angle (P = .009, r = .261). Results of both methods show that they endorse each other. CONCLUSIONS The posture of the standing feet may have influence on lower limb alignment. Currently, there are no studies carried out by using digital photogrammetry and foot scan. The authors claim that patient-friendly digital photogrammetry would have a positive contribution to the monitoring of patients, even including new ones in the treatment programs, reducing any possible loss in the personal and national economy.
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Tse CTF, Ryan MB, Hunt MA. Influence of foot posture on immediate biomechanical responses during walking to variable-stiffness supported lateral wedge insole designs. Gait Posture 2020; 81:21-26. [PMID: 32650239 DOI: 10.1016/j.gaitpost.2020.06.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Novel designs of lateral wedge insoles with arch support can alter walking biomechanics as a conservative treatment option for knee osteoarthritis. However, variations in foot posture may influence individual responses to insole intervention and these effects are not yet known. RESEARCH QUESTION How does foot posture influence biomechanical responses to novel designs of lateral wedge insoles with arch support? METHODS This exploratory biomechanical investigation categorized forty healthy volunteers (age 23-34) into pronated (n = 16), neutral (n = 15), and supinated (n = 9) foot posture groups based on the Foot Posture Index. Three-dimensional gait analysis was conducted during walking with six orthotic insole conditions: flat control, lateral wedge, uniform-stiffness arch support, variable-stiffness arch support, and lateral wedge + each arch support. Frontal plane knee and ankle/subtalar joint kinetic and kinematic outcomes were compared among insole conditions and foot posture groups using a repeated measures analysis of variance. RESULTS The lateral wedge alone and lateral wedge + variable-stiffness arch support were the only insole conditions effective at reducing the knee adduction moment. However, the lateral wedge + variable-stiffness arch support had a smaller increase in peak ankle/subtalar eversion moment than the lateral wedge alone. Supinated feet had smaller ankle/subtalar eversion excursion and moment impulse than neutral and pronated feet, across all insole conditions. SIGNIFICANCE Supinated feet have less mobile ankle/subtalar joints than neutral and pronated feet and, as a result, may be less likely to respond to biomechanical intervention from orthotic insoles. Supported lateral wedge insoles incorporating an arch support design that is variable-stiffness may be better than uniform-stiffness since reductions in the knee adduction moment can be achieved while minimizing increases in the ankle/subtalar eversion moment.
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Affiliation(s)
- Calvin T F Tse
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada; Motion Analysis and Biofeedback Laboratory, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada; Kintec Footlabs, 13645 King George Blvd., Surrey, BC V3T 2TB, Canada
| | - Michael B Ryan
- Kintec Footlabs, 13645 King George Blvd., Surrey, BC V3T 2TB, Canada; Biomedical Physiological and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Michael A Hunt
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada; Department of Physical Therapy, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3.
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Latey PJ, Eisenhuth J, McKay MJ, Hiller CE, Sureshkumar P, Nightingale EJ, Burns J. Feasibility of the Archercise biofeedback device to strengthen foot musculature. J Foot Ankle Res 2020; 13:43. [PMID: 32660591 PMCID: PMC7359285 DOI: 10.1186/s13047-020-00394-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
Background Foot muscle weakness can produce foot deformity, pain and disability. Toe flexor and foot arch exercises focused on intrinsic foot muscle strength and functional control may mitigate the progression of foot deformity and disability. Ensuring correct exercise technique is challenging due to the specificity of muscle activation required to complete some foot exercises. Biofeedback has been used to improve adherence, muscle activity and movement patterns. We investigated the feasibility of using a novel medical device, known as “Archercise”, to provide real-time biofeedback of correct arch movement via pressure change in an inflatable bladder, and foot location adherence via sensors embedded in a footplate during four-foot exercises. Methods Thirty adults (63% female, aged 23–68 years) performed four-foot exercises twice on the Archercise sensor footplate alone and then with biofeedback. One-way repeated measures ANOVA with pairwise comparisons were computed to assess the consistency of the exercise protocol between trial 1 and trial 2 (prior to biofeedback), and the effectiveness of the Archercise biofeedback device between trial 2 and trial 3 (with biofeedback). Outcome measures were: Arch movement exercises of arch elevation and lowering speed, controlled arch elevation, controlled arch lowering, endurance of arch elevation; Foot location adherence was determined by percentage of time the great toe, fifth toe and heel contacted footplate sensors during testing and were analysed with paired sample t-tests. Participant survey comments on the use of Archercise with biofeedback were reported thematically. Results Seventeen (89%) arch movement and foot location variables were collected consistently with Archercise during the foot exercises. Archercise with biofeedback improved foot location adherence for all exercises (p = 0.003–0.008), coefficient of determination for controlled arch elevation (p < 0.0001) and endurance area ratio (p = 0.001). Twenty-nine (97%) participants reported Archercise with biofeedback, helped correct exercise performance. Conclusions Archercise is a feasible biofeedback device to assist healthy participants without foot pathologies perform foot doming exercises. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR): 12616001559404. Registered 11 November 2016, http://www.ANZCTR.org.au/ACTRN12616001559404p.aspx
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Affiliation(s)
- Penelope J Latey
- The University of Sydney, School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, 2141, Australia.
| | - John Eisenhuth
- The University of Sydney, School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, 2141, Australia
| | - Marnee J McKay
- The University of Sydney, School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, 2141, Australia
| | - Claire E Hiller
- The University of Sydney, School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, 2141, Australia
| | - Premala Sureshkumar
- The University of Sydney, Concord Clinical School, Concord, New South Wales, 2139, Australia
| | - Elizabeth J Nightingale
- The University of Sydney, School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, 2141, Australia
| | - Joshua Burns
- The University of Sydney, School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, 2141, Australia.,Children's Hospital at Westmead, New South Wales, 2145, Australia
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Laštovička O, Klein T, Abrantes J, Janura M. Immediate effect of individual bars of insoles and their combination on gait parameters in asymptomatic healthy adults. Somatosens Mot Res 2020; 37:125-131. [PMID: 32314675 DOI: 10.1080/08990220.2020.1753686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
Objective: The way how individual bars of sensorimotor insoles influence the gait kinematics is not fully understood yet. Therefore, this study aimed to explore the effect of three sensorimotor orthotic conditions (the medial calcaneal and retrocapital lateral bars and their combination) on the gait parameters in healthy adults during the stance phase of gait cycle.Materials and methods: Twenty-six young adults performed 20 gait cycles in each condition using their self-selected cadence and provided standardised shoes with the base-sole and the three types of orthotics. A three-dimensional motion analysis system (8 cameras; 200 Hz) was used and a six-degrees of freedom model was applied. The cadence, the stride length, the first peaks of foot external rotation, eversion and dorsal flexion as well as the first peak of hip adduction were analysed.Results: Significant differences (p < 0.05) were found for all parameters between the orthotic conditions, except the cadence. Significant difference in the first peak of hip adduction (p = 0.008) was found between the dominant and non-dominant leg. There were no significant interactions between the factors of condition and leg dominance (p > 0.05).Conclusions: There seems to be overall tendencies in immediate changes in ankle joint kinematics caused by all three sensorimotor orthotic conditions and besides the mechanical principles, also 'proprioceptive mechanism' seems to play a role. However, maximum observed average angular change was 2° and some variability in reactions to each orthotic condition exists among the individuals. Therefore, clinical relevance of such changes remains unclear and careful analysis of expected outcomes should be the common part of every orthotic intervention.
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Affiliation(s)
- Ondřej Laštovička
- Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
| | - Tomáš Klein
- Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
| | - João Abrantes
- MovLab, CICANT, University Lusófona of Humanities and Technologies, Lisboa, Portugal
| | - Miroslav Janura
- Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
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Footprint Curvature in Spanish Women: Implications for Footwear Fit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061876. [PMID: 32183182 PMCID: PMC7142565 DOI: 10.3390/ijerph17061876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 01/09/2023]
Abstract
The incorrect adjustment of footwear produces alterations in the foot that affect quality of life. The usual measurements for shoe design are lengths, widths and girths, but these measures are insufficient. The foot presents an angle between the forefoot and the rearfoot in the transverse plane, which is associated with foot pronation, hallux valgus and metatarsus adductus. Here, we aimed at identifying the groups formed by the angulations between the forefoot and rearfoot using a sample of footprints from 102 Spanish women. The angle between the forefoot and rearfoot was measured according to the method described by Bunch. A cluster analysis was performed using the K-means algorithm. Footprints were grouped into three types: curved, semi-curved and straight, according to the degrees of angulation between the forefoot and rearfoot. There is great variability in the morphology of the foot. Based on our findings, to achieve a better footwear fit, we propose the manufacture of three types of lasts with different curvatures.
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Shi D, Zhang W, Ding X, Sun L. Parametric generation of three-dimensional gait for robot-assisted rehabilitation. Biol Open 2020; 9:bio047332. [PMID: 32001490 PMCID: PMC7063668 DOI: 10.1242/bio.047332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 01/21/2020] [Indexed: 12/22/2022] Open
Abstract
For robot-assisted rehabilitation and assessment of patients with motor dysfunction, the parametric generation of their normal gait as the input for the robot is essential to match with the features of the patient to a greater extent. In addition, the gait needs to be in three-dimensional space, which meets the physiological structure of the human better, rather than only on a sagittal plane. Thus, a method for the parametric generation of three-dimensional gait based on the influence of the motion parameters and structure parameters is presented. First, the three-dimensional gait kinematic of participants is collected, and trajectories of ankle joint angle and ankle center position are calculated. Second, for the trajectories, gait features are extracted including gait events indicating the physiological features of walking gait, in addition to extremes indicating the geometrical features of the trajectories. Third, regression models are derived after using leave-one-out cross-validation for model optimization. Finally, cubic splines are fitted between the predicted gait features to generate the trajectories for a full gait cycle. It is inferred that the generated curves match the measured curves well. The method presented herein gives an important reference for research into lower limb rehabilitation robots.
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Affiliation(s)
- Di Shi
- School of Mechanical Engineering and Automation, Beihang University, Beijing 100191, China
| | - Wuxiang Zhang
- School of Mechanical Engineering and Automation, Beihang University, Beijing 100191, China
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100191, China
| | - Xilun Ding
- School of Mechanical Engineering and Automation, Beihang University, Beijing 100191, China
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100191, China
| | - Lei Sun
- Beijing Institute Traumatology & Orthopedics, Beijing Jishuitan Hospital, Beijing 100035, China
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Effects of a foot strengthening program on foot muscle morphology and running mechanics: A proof-of-concept, single-blind randomized controlled trial. Phys Ther Sport 2020; 42:107-115. [DOI: 10.1016/j.ptsp.2020.01.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 12/17/2022]
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THE EFFECT of KINESIO TAPE® on STATIC FOOT POSTURE, PLANTAR PRESSURE, and REARFOOT MOTION in INDIVIDUALS with PRONATED FEET. Int J Sports Phys Ther 2019; 14:368-375. [PMID: 31681496 DOI: 10.26603/ijspt20190368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Kinesio Tape® (KT) is an elastic therapeutic tape that is applied to the skin for treatment of sport-related injuries. Its application has been purported to facilitate the neuromuscular system, thus altering skeletal muscle activity to increase joint range of motion and improve performance. Due to its proposed therapeutic effect, KT may benefit individuals with excess foot pronation in order to decrease pain and improve function. Unfortunately, current research regarding the ability of KT to alter foot biomechanics is limited. Purpose The purpose of this study was to determine if the application of KT to the ankle and lower leg would alter static foot posture, plantar pressure, and foot motion during walking in individuals with foot pronation. Study Design Prospective Cohort Study. Methods Thirty participants (10M/20F) were recruited for this study. Each participant had their dorsal arch height and midfoot width measured prior to the application of the KT. In addition, their dynamic rearfoot eversion and plantar pressure was recorded during walking using an electrogoniometer and plantar pressure system. After these measurements were collected, KT was applied to their right foot and lower leg in order to attempt to facilitate activity in the posterior tibialis muscle. After applying the tape, the above measurements were repeated. Results None of the variables measured were statistically significantly different between the pre-test and post-test. Conclusion Application of KT did not result in a change in static foot posture, plantar pressure, and frontal plane rearfoot motion during walking. As such, KT cannot be recommended as a treatment for reducing excessive foot pronation where such a goal would be beneficial. Level of Evidence Level 3.
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Behling AV, Nigg BM. Relationships between the foot posture Index and static as well as dynamic rear foot and arch variables. J Biomech 2019; 98:109448. [PMID: 31677779 DOI: 10.1016/j.jbiomech.2019.109448] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/13/2019] [Accepted: 10/20/2019] [Indexed: 10/25/2022]
Abstract
Clinicians, podiatrists and researchers have been quantifying foot posture and movement in various speed conditions and populations. Common variables to assess foot posture/movement are the Foot Posture Index (FPI-6), Achilles tendon angle (β), rear foot angle (γ) and longitudinal arch angle (LAA). These variables were frequently used in clinical and biomechanical settings. This study aimed to determine the relationship between the biomechanical variables (β, γ & LAA) in static and dynamic conditions and the clinically used FPI-6 and their redundancy. Forty participants performed bipedal standing, over ground walking and running trials. Manual assessment data (FPI-6), kinematic data and ground reaction forces were collected. Discrete biomechanical variables (β, γ & LAA) were calculated at various time points (e.g. heel strike). A Principal Component Analysis (PCA) was performed to quantify the contribution of each variable to the overall variance in the data set. Spearman correlations were used to assess the relationship between the sub-measures of the FPI-6 and the biomechanical variables. Two major components were found that explained 85.2% of the overall variance, consisting of LAA and β variables, respectively. Only LAA variables showed significant, but moderate correlations (r < -0.6) with the fifth sub-measurement of the FPI-6. The LAA and β describe independent movements, which dominate foot posture/movement in static and dynamic conditions. The FPI-6 sub-measurements did not closely reflect static nor dynamic behavior of the rear and mid foot. The FPI-6 and biomechanical variables may not be used interchangeably for screening or grouping individuals according to their foot posture/movement.
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Affiliation(s)
- Anja-Verena Behling
- Biomedical Engineering, Schulich School of Engineering, University of Calgary, Alberta, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Alberta, Canada.
| | - Benno Maurus Nigg
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Alberta, Canada
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Segmental foot and ankle kinematic differences between rectus, planus, and cavus foot types. J Biomech 2019; 94:180-186. [DOI: 10.1016/j.jbiomech.2019.07.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/22/2019] [Accepted: 07/27/2019] [Indexed: 11/19/2022]
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Jasiewicz B, Klimiec E, Młotek M, Guzdek P, Duda S, Adamczyk J, Potaczek T, Piekarski J, Kołaszczyński G. Quantitative Analysis of Foot Plantar Pressure During Walking. Med Sci Monit 2019; 25:4916-4922. [PMID: 31266932 PMCID: PMC6621646 DOI: 10.12659/msm.914915] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background There are many methods of dynamic analysis of foot loading, however, we still need a simple, easily applicable system for foot plantar pressure analysis. In this study we asked the question: “Can a new system for foot evaluation, the ITE System, provide a good quantitative dynamic foot pressure analysis? Can it be used in clinical practice?”. Material/Methods Twenty healthy volunteers, 8 females and 12 males, aged 20 to 25 years old took part in this study. Normal static foot loading was tested using a typical pedobarographic platform, followed by a dynamic analysis using the foot-pressure ITE System. A new algorithm for data analysis (from 8 sensors) was proposed. Results The sum of all maximal values from sensors was 11.71 N mean, with relatively low standard deviation (SD) of 1.81. Loading of sensor 1 (heel) was the highest – on average 29.84%. Sensor 2 (medial midfoot) received the lowest loading – normal range for this segment would be 0–4%. The manner of loading heel/toes, dynamics of changes in loading during gait was quite diverse; when analyzing courses of changes on sensors, 4 gait patterns were observed. Conclusions Use of the ITE System creates a new possibility for dynamic foot evaluation, drawing from pedobarography and methods of gait analysis. The proposed data analysis algorithm is simple and can be applied in all cases. Normally, 30% of the sum of all pressures during stance phase falls on the rearfoot; 39% falls on forefoot.
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Affiliation(s)
- Barbara Jasiewicz
- Department of Orthopedics and Rehabilitation, Jagiellonian University, Medical College, Cracow, Poland
| | - Ewa Klimiec
- Institute of Electron Technology Cracow Division, Cracow, Poland
| | - Magdalena Młotek
- Institute of Applied Mechanics, University of Technology, Cracow, Poland
| | - Piotr Guzdek
- Institute of Electron Technology Cracow Division, Cracow, Poland
| | - Sławomir Duda
- Department of Orthopedics and Rehabilitation, Jagiellonian University, Medical College, Cracow, Poland
| | - Jakub Adamczyk
- Department of Orthopedics and Rehabilitation, Jagiellonian University, Medical College, Cracow, Poland
| | - Tomasz Potaczek
- Department of Orthopedics and Rehabilitation, Jagiellonian University, Medical College, Cracow, Poland
| | - Jacek Piekarski
- Institute of Electron Technology Cracow Division, Cracow, Poland
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Flatfoot deformity affected the kinematics of the foot and ankle in proportion to the severity of deformity. Gait Posture 2019; 72:123-128. [PMID: 31195311 DOI: 10.1016/j.gaitpost.2019.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 05/03/2019] [Accepted: 06/04/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Flatfoot deformity is thought to affect gait kinematics, but the effect of flatfoot on segmental motion of the foot during gait remains unclear. Recently, multi-segmental foot models (MFMs) have been introduced for the in vivo analysis of dynamic foot kinematics. The objective of this study was to find the effect of flatfoot on segmental motion of the foot during gait in females by comparisons with age and gender controlled healthy adults. METHODS Thirty six symptomatic flatfeet patients (52-80 years old) and 42 symptom-free female participants without flatfoot (60-69 years old) were included in this study. According to the Meary angle (MA) on standing lateral radiograph, flatfoot patients are divided into severe (SFF, MA>20°) and moderate (MFF, 10°<MA<20°) flatfoot group. Segmental foot kinematics were evaluated using a 3D MFM of a 15-marker set (DuPont Foot Model). RESULTS The cadence, speed, stride length, and step width are significantly lower in flatfoot patients. ROM of sagittal and transverse plane of the hindfoot, transverse plane of the forefoot and sagittal plane of the hallux were lower in severe flatfoot group. In the SFF group, there was loss of hindfoot adduction motion during the terminal stance and pre-swing phase. In forefoot kinematics, the SFF group showed significantly supinated and abducted position throughout the gait cycle. In hindfoot kinematics, plantar flexion motion in the pre-swing phase was significantly lower in flatfoot patients in proportion to the severity of the deformity. CONCLUSIONS We showed that flatfoot deformity affected the kinematics of the foot and ankle in proportion to the severity of deformity. We cautiously suggest that there might be a threshold of flatfoot precluding normal foot kinematics because normal kinematic pattern of the foot might not collapse in moderate flatfoot with a Meary angle of less than 20 degrees.
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Arnold JB, Marshall M, Thomas MJ, Redmond AC, Menz HB, Roddy E. Midfoot osteoarthritis: potential phenotypes and their associations with demographic, symptomatic and clinical characteristics. Osteoarthritis Cartilage 2019; 27:659-666. [PMID: 30660723 DOI: 10.1016/j.joca.2018.12.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the demographic, symptomatic, clinical and structural foot characteristics associated with potential phenotypes of midfoot osteoarthritis (OA). DESIGN Cross-sectional study of 533 community-dwelling adults aged ≥50 years with foot pain in the past year. Health questionnaires and clinical assessments of symptoms, foot structure and function were undertaken. Potential midfoot OA phenotypes were defined by the pattern of radiographic joint involvement affecting either the medial midfoot (talonavicular, navicular-1st cuneiform, or cuneiform-1st metatarsal joint), central midfoot (2nd cuneiform-metatarsal joint), or both medial and central midfoot joints. Multivariable regression models with generalised estimating equations were used to investigate the associations between patterns of midfoot joint involvement and symptomatic, clinical and structural characteristics compared to those with no or minimal midfoot OA. RESULTS Of 879 eligible feet, 168 had medial midfoot OA, 103 central midfoot OA, 76 both medial and central midfoot OA and 532 no/minimal OA. Having both medial and central midfoot OA was associated with higher pain scores, dorsally-located midfoot pain (OR 2.54, 95%CI 1.45, 4.45), hallux valgus (OR 1.76, 95%CI 1.02, 3.05), flatter foot posture (β 0.44, 95%CI 0.12, 0.77), lower medial arch height (β 0.02, 95%CI 0.01, 0.03) and less subtalar inversion and 1st MTPJ dorsiflexion. Isolated medial midfoot OA and central midfoot OA had few distinguishing clinical characteristics. CONCLUSIONS Distinct phenotypes of midfoot OA appear challenging to identify, with substantial overlap in symptoms and clinical characteristics. Phenotypic differences in symptoms, foot posture and function were apparent in this study only when both the medial and central midfoot were involved.
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Affiliation(s)
- J B Arnold
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; National Institute for Health Research (NIHR), Leeds Biomedical Research Centre, Leeds, UK; Alliance for Research in Exericse, Nutrition & Activity (ARENA) and School of Health Sciences, University of South Australia, Adelaide, Australia.
| | - M Marshall
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - M J Thomas
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Staffordshire, UK
| | - A C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; National Institute for Health Research (NIHR), Leeds Biomedical Research Centre, Leeds, UK
| | - H B Menz
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
| | - E Roddy
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Staffordshire, UK
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Deforth M, Zwicky L, Horn T, Hintermann B. The effect of foot type on the Achilles tendon moment arm and biomechanics. Foot (Edinb) 2019; 38:91-94. [PMID: 30849670 DOI: 10.1016/j.foot.2018.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/30/2018] [Accepted: 10/08/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim was to calculate the Achilles tendon moment arm in different degrees of plantarflexion for pes planus, pes cavus and normal arched feet. METHODS 99 patients (99 radiographs; 40 males, 59 females; mean age 49 years, SD 15) with a healthy ankle joint and a preoperative weightbearing lateral radiograph of the foot were included. Three groups (pes planus, pes cavus and normal-arched feet) with equal sample sizes (n=33) were formed. On radiographs, the angle formed between a horizontal line and the line connecting the insertion of the Achilles tendon with the center of rotation of the ankle, was measured. The interrater reliabilities (ICC) of the angle alpha were compared on radiographs and on MRIs. Using the angle alpha, the Achilles tendon moment arm was calculated in different plantarflexion positions. RESULTS The ICC of alpha was higher on radiographs (0.84, [0.73-0.91]) than on MRIs (0.61, [0.27-0.81]). The average alpha was statistically significantly different (normal arched foot 31 degrees (°), pes planus 24°, pes cavus 36°, p=0.021), resulting in a significant shorter Achilles tendon moment arm for pes cavus than for pes planus (p<0.0001) and normal arched feet (p=0.006) in neutral position. CONCLUSION The data suggests that it is feasible to use radiographs to measure the Achilles tendon moment arm. The maximum Achilles tendon moment arm is reached at different angles of ankle flexion for pes cavus, pes planus and normal-arched feet. This has to be taken into consideration when planning surgeries.
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Affiliation(s)
- Manja Deforth
- Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Switzerland
| | - Lukas Zwicky
- Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Switzerland
| | - Tamara Horn
- Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Switzerland
| | - Beat Hintermann
- Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Switzerland.
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