Adding Stiffness to the Foot Modulates Soleus Force-Velocity Behaviour during Human Walking

The functional importance of human foot muscles for bipedal locomotion

Human feet have evolved uniquely among primates, losing an opposable first digit in favor of a pronounced arch to enhance our ability to walk and run with an upright posture. Recent work suggests that muscles within our feet are key to how the foot functions during bipedal walking and running. Here we show direct evidence for the significance of these foot muscles in supporting the mechanical performance of the human foot. Contrary to expectations, the intrinsic foot muscles contribute minimally to supporting the arch of the foot during walking and running. However, these muscles do influence our ability to produce forward propulsion from one stride into the next, highlighting their role in bipedal locomotion.

Human feet have evolved to facilitate bipedal locomotion, losing an opposable digit that grasped branches in favor of a longitudinal arch (LA) that stiffens the foot and aids bipedal gait. Passive elastic structures are credited with supporting the LA, but recent evidence suggests that plantar intrinsic muscles (PIMs) within the foot actively contribute to foot stiffness. To test the functional significance of the PIMs, we compared foot and lower limb mechanics with and without a tibial nerve block that prevented contraction of these muscles. Comparisons were made during controlled limb loading, walking, and running in healthy humans. An inability to activate the PIMs caused slightly greater compression of the LA when controlled loads were applied to the lower limb by a linear actuator. However, when greater loads were experienced during ground contact in walking and running, the stiffness of the LA was not altered by the block, indicating that the PIMs’ contribution to LA stiffness is minimal, probably because of their small size. With the PIMs blocked, the distal joints of the foot could not be stiffened sufficiently to provide normal push-off against the ground during late stance. This led to an increase in stride rate and compensatory power generated by the hip musculature, but no increase in the metabolic cost of transport. The results reveal that the PIMs have a minimal effect on the stiffness of the LA when absorbing high loads, but help stiffen the distal foot to aid push-off against the ground when walking or running bipedally.

Effect of toe joint stiffness and toe shape on walking biomechanics

During typical human walking, the metatarsophalangeal joints undergo extension/flexion, which we term toe joint articulation. This toe joint articulation impacts locomotor performance, as evidenced by prior studies on prostheses, footwear, sports and humanoid robots. However, a knowledge gap exists in our understanding of how individual toe properties (e.g. shape, joint stiffness) affect bipedal locomotion. To address this gap, we designed and built a pair of adjustable foot prostheses that enabled us to independently vary different toe properties, across a broad range of physiological and non-physiological values. We then characterized the effects of varying toe joint stiffness across a range of different ankle joint stiffness conditions, and the effects of varying toe shape on walking biomechanics. Ten able-bodied individuals walked on a treadmill with prostheses mounted bilaterally underneath simulator boots (which immobilized their biological ankles). We collected motion capture and ground reaction force data, then computed joint kinematics and kinetics, and center-of-mass (COM) power and work. To our surprise, we found that varying toe joint stiffness affected COM Push-off dynamics during walking as much as, or in some cases even more than, varying ankle joint stiffness. Increasing toe joint stiffness increased COM Push-off work by up to 48% (6 J), and prosthetic anklefoot Push-off work by up to 181% (12 J). In contrast, large changes in toe shape had little effect on gait. This study brings attention to the toes, an aspect of prosthetic and robotic foot design that is often overlooked or overshadowed by design of the ankle. Optimizing toe joint stiffness in assistive and robotic devices (e.g. prostheses, exoskeletons, robot feet) may provide a complementary means of enhancing Push-off or other aspects of locomotor performance, in conjunction with the more conventional approach of augmenting ankle dynamics. Future studies are needed to isolate the effects of additional toe properties (e.g. toe length).

The energetic behaviour of the human foot across a range of running speeds

The human foot contains passive elastic tissues that have spring-like qualities, storing and returning mechanical energy and other tissues that behave as dampers, dissipating energy. Additionally the intrinsic and extrinsic foot muscles have the capacity to act as dampers and motors, dissipating and generating mechanical energy. It remains unknown as to how the contribution of all passive and active tissues combine to produce the overall energetic function of the foot during running. Therefore, the aim of this study was to determine if the foot behaves globally as an active spring-damper during running. Fourteen participants ran on a force-instrumented treadmill at 2.2 ms-1, 3.3 ms-1 and 4.4 ms-1, while foot segment motion was collected simultaneously with kinetic measurements. A unified deformable segment model was applied to quantify the instantaneous power of the foot segment during ground contact and mechanical work was calculated by integrating the foot power data. At all running speeds, the foot absorbed energy from early stance through to mid-stance and subsequently returned/generated a proportion of this energy in late stance. The magnitude of negative work performed increased with running speed, while the magnitude of positive work remained relatively constant across all running speeds. The proportion of energy dissipated relative to that absorbed (foot dissipation-ratio) was always greater than zero and increased with running speed, suggesting that the foot behaves as a viscous spring-damper.

Interactions Between Transfemoral Amputees and a Powered Knee Prosthesis During Load Carriage

Machines and humans become mechanically coupled when lower limb amputees walk with powered prostheses, but these two control systems differ in adaptability. We know little about how they interact when faced with real-world physical demands (e.g. carrying loads). Here, we investigated how each system (i.e. amputee and powered prosthesis) responds to changes in the prosthesis mechanics and gravitational load. Five transfemoral amputees walked with and without load (i.e. weighted backpack) and a powered knee prosthesis with two pre-programmed controller settings (i.e. for load and no load). We recorded subjects' kinematics, kinetics, and perceived exertion. Compared to the no load setting, the load setting reduced subjects' perceived exertion and intact-limb stance time when they carried load. When subjects did not carry load, their perceived exertion and gait performance did not significantly change with controller settings. Our results suggest transfemoral amputees could benefit from load-adaptive powered knee controllers, and controller adjustments affect amputees more when they walk with (versus without) load. Further understanding of the interaction between powered prostheses, amputee users, and various environments may allow researchers to expand the utility of prostheses beyond simple environments (e.g. firm level ground without load) that represent only a subset of real-world environments.

Technical Aspects and Validation of a New Biofeedback System for Measuring Lower Limb Loading in the Dynamic Situation

Background: A variety of techniques for measuring lower limb loading exists, each with their own limitations. A new ambulatory biofeedback system was developed to overcome these limitations. In this study, we described the technical aspects and validated the accuracy of this system. Methods: A bench press was used to validate the system in the static situation. Ten healthy volunteers were measured by the new biofeedback system and a dual-belt instrumented treadmill to validate the system in the dynamic situation. Results: Bench press results showed that the sensor accurately measured peak loads up to 1000 N in the static situation. In the healthy volunteers, the load curves measured by the biofeedback system were similar to the treadmill. However, the peak loads and loading rates were lower in the biofeedback system in all participants at all speeds. Conclusions: Advanced sensor technologies used in the new biofeedback system resulted in highly accurate measurements in the static situation. The position of the sensor and the design of the biofeedback system should be optimized to improve results in the dynamic situation.

The Athletic Shoe in Football

BACKGROUND

Foot and ankle injuries are common in sports, particularly in cleated athletes. Traditionally, the athletic shoe has not been regarded as a piece of protective equipment but rather as a part of the uniform, with a primary focus on performance and subjective feedback measures of comfort. Changes in turf and shoe design have poorly understood implications on the health and safety of players.

EVIDENCE ACQUISITION

A literature search of the MEDLINE and PubMed databases was conducted. Keywords included athletic shoewear, cleated shoe, football shoes, and shoewear, and search parameters were between the years 2000 and 2016.

STUDY DESIGN

Clinical review.

LEVEL OF EVIDENCE

Level 5.

RESULTS

The athletic shoe is an important piece of protective sports equipment. There are several important structural considerations of shoe design, including biomechanical compliance, cleat and turf interaction, and shoe sizing/fit, that affect the way an athlete engages with the playing surface and carry important potential implications regarding player safety if not understood and addressed.

CONCLUSION

Athletic footwear should be considered an integral piece of protective equipment rather than simply an extension of the uniform apparel. More research is needed to define optimal shoe sizing, the effect that design has on mechanical load, and how cleat properties, including pattern and structure, interact with the variety of playing surfaces.