Effects of toe length, foot arch length and toe joint axis on walking biomechanics

Human foot form and function: variable and versatile, yet sufficiently related to predict function from form

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.

Biomechanical Impacts of Toe Joint With Transfemoral Amputee Using a Powered Knee-Ankle Prosthesis

Transfemoral amputees are currently forced to utilize energetically passive prostheses that provide little to no propulsive work. Among the several joints and muscles required for healthy walking, the ones most vital for push-off assistance include the knee, ankle, and metatarsophalangeal (MTP) joints. There are only a handful of powered knee-ankle prostheses (also called powered transfemoral prostheses) in literature and few of them comprise a toe-joint. However, no one has researched the impact of toe-joint stiffness on walking with a power transfemoral prosthesis. This study is aimed at filling this gap in knowledge. We conducted a study with an amputee and a powered transfemoral prosthesis consisting of a spring loaded toe-joint. The prosthesis's toe-joint stiffness was varied between three values: 0.83 Nm/deg, 1.25 Nm/deg, and infinite (rigid). This study found that 0.83 Nm/deg stiffness reduced push-off assistance and resulted in compensatory movements that could lead to issues over time. While the joint angles and moments did not considerably vary across 1.25 Nm/deg and rigid stiffness, the latter led to greater power generation on the prosthesis side. However, the 1.25 Nm/deg joint stiffness resulted in the least power production from the intact side. We, thus, concluded that the use of a stiff toe-joint with a powered transfemoral prosthesis can reduce the cost of transport of the intact limb.

The influence of the windlass mechanism on kinematic and kinetic foot joint coupling

Background

Previous research shows kinematic and kinetic coupling between the metatarsophalangeal (MTP) and midtarsal joints during gait. Studying the effects of MTP position as well as foot structure on this coupling may help determine to what extent foot coupling during dynamic and active movement is due to the windlass mechanism. This study’s purpose was to investigate the kinematic and kinetic foot coupling during controlled passive, active, and dynamic movements.

Methods

After arch height and flexibility were measured, participants performed four conditions: Seated Passive MTP Extension, Seated Active MTP Extension, Standing Passive MTP Extension, and Standing Active MTP Extension. Next, participants performed three heel raise conditions that manipulated the starting position of the MTP joint: Neutral, Toe Extension, and Toe Flexion. A multisegment foot model was created in Visual 3D and used to calculate ankle, midtarsal, and MTP joint kinematics and kinetics.

Results

Kinematic coupling (ratio of midtarsal to MTP angular displacement) was approximately six times greater in Neutral heel raises compared to Seated Passive MTP Extension, suggesting that the windlass only plays a small kinematic role in dynamic tasks. As the starting position of the MTP joint became increasingly extended during heel raises, the amount of negative work at the MTP joint and positive work at the midtarsal joint increased proportionally, while distal-to-hindfoot work remained unchanged. Correlations suggest that there is not a strong relationship between static arch height/flexibility and kinematic foot coupling.

Conclusions

Our results show that there is kinematic and kinetic coupling within the distal foot, but this coupling is attributed only in small measure to the windlass mechanism. Additional sources of coupling include foot muscles and elastic energy storage and return within ligaments and tendons. Furthermore, our results suggest that the plantar aponeurosis does not function as a rigid cable but likely has extensibility that affects the effectiveness of the windlass mechanism. Arch structure did not affect foot coupling, suggesting that static arch height or arch flexibility alone may not be adequate predictors of dynamic foot function.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13047-022-00520-z.

Effects of Longitudinal Bending Stiffness of forefoot rocker profile shoes on ankle kinematics and kinetics

INTRODUCTION

Rocker profile shoes with a proximally placed apex are currently one of the most prescribed shoe modifications for treatment and prevention of lower leg deficits. Three geometrical rocker design parameters apex position (AP), apex angle (AA) and rocker radius (RR) influence both plantar pressure redistribution and kinetic and kinematic alterations of the lower leg. In addition, longitudinal bending stiffness (LBS) of the outsole influences these parameters as well. This study aims to investigate the effects of the LBS in combination with different forefoot radii of rocker shoes on kinematics and kinetics of the lower limb.

METHODS

10 participants walked in standard shoes and six experimental shoe conditions with high and low LBS and three different forefoot rocker radii with the same (proximal) AP and AA. Lower extremity kinematics and kinetics were collected while walking on an instrumented treadmill at preferred walking speed and analysed with a repeated measures ANOVA and Statistical Parametric Mapping (SPM) (α = .05; post hoc α = .05/6).

RESULTS

SPM analyses revealed no significant differences for LBS and interaction LBS*RR for most research variables in terminal stance (ankle angle, ankle moment, ankle power, foot-to-horizontal angle, shank-to-vertical angle, external ankle moment, ground reaction force angle). A significant LBS effect was found for anterior-posterior position of the centre of pressure during pre-swing and peak ankle dorsiflexion angle. No relevant significant differences were found in spatio-temporal parameters and total work at the ankle between low and high LBS.

CONCLUSION

This study showed that longitudinal bending stiffness does not affect the biomechanical working mechanism of rocker profile shoes as long as toe plantarflexion is restricted. Providing that the forefoot rocker radius supports at least a normal foot-to-horizontal angle at toe-off, there is no reason to increase sole stiffness to change ankle kinematics and kinetics.

Timing of gait events affects whole trajectory analyses: A statistical parametric mapping sensitivity analysis of lower limb biomechanics

Time continuous analyses, such as statistical parametric mapping (SPM), have been increasingly used in biomechanics research to determine differences between populations, interventions and methodologies. Currently, it is not known how sensitive time-continuous analyses are to timing variability that occur in gait data. We evaluated this sensitivity by examining the frequency of significant SPM outcomes between two walking speeds when lower limb kinematics and kinetics were segmented and aligned based on 40 repeatable gait events. These events, defined in the supplementary material, include a commonly used event like foot contact and other events that have been previously demonstrated to be repeatable. Repeatable gait events were determined from joint and segment kinematics, joint kinetics as well as ground reaction forces. We examined the frequency of statistical outcomes for a single subject with different numbers of strides analyzed and for a cohort of 10 subjects. Our findings demonstrate that gait interventions, such as changes in walking speed, can induce temporal shifts that affect time-continuous outcomes for both cohort- and subject-level analyses. As both timing and magnitude are important in gait data, researchers are encouraged to perform additional analyses to understand how both of these variables affect time-continuous analysis outcomes. Finally, we demonstrate that multiple SPM tests can be performed to determine if statistical outcomes are due to temporal shifting or differences in magnitude. It is important to understand how both timing and magnitude of biomechanical data influences time continuous analyses as these analyses inform injury prevention, device development and basic understanding of biomechanics.