A comparison of metatarsophalangeal joint center locations on estimated joint moments during running

Role of midsole hollow structure in energy storage and return in running shoes

Understanding the relationship between footwear features and their potential influence on running performance can inform the ongoing innovation of running footwear, aimed at pushing the limits of humans. A notable shoe feature is hollow structures, where an empty space is created in the midsole. Presently, the potential biomechanical effect of the hollow structures on running performance remains unknown. We investigated the role of hollow structures through quantifying the magnitude and timing of foot and footwear work. Sixteen male rearfoot runners participated in an overground running study in three shoe conditions: (a) a shoe with a hollow structure in the forefoot midsole (FFHS), (b) the same shoe without any hollow structure (Filled-FFHS) and (c) a shoe with a hollow structure in the midfoot midsole (MFHS). Distal rearfoot power was used to quantify the net power generated by foot and footwear together. The magnitude and timing of distal rearfoot work and ankle joint work were compared across shoe conditions. The results indicated that MFHS can significantly (p = 0.024) delay distal rearfoot energy return (3.4 % of stance) when compared to Filled-FFHS. Additionally, FFHS had the greatest positive (0.425 J/kg) and negative (-0.383 J/kg) distal rearfoot work, and the smallest positive (0.503 J/kg) and negative (-0.477 J/kg) ankle joint work among the three conditions. This showed that the size and location of the midsole hollow structure can affect timing and magnitude of energy storage and return. The forefoot hollow shoe feature can effectively increase distal rearfoot work and reduce ankle joint work during running.

Examining the intrinsic foot muscles' capacity to modulate plantar flexor gearing and ankle joint contributions to propulsion in vertical jumping

BACKGROUND

During human locomotion, a sufficiently stiff foot allows the ankle plantar flexors to generate large propulsive powers. Increasing foot stiffness (e.g., via a carbon plate) increases the ankle's external moment arm in relation to the internal moment arm (i.e., increasing gear ratio), reduces plantar flexor muscles' shortening velocity, and enhances muscle force production. In contrast, when activation of the foot's intrinsic muscles is impaired, there is a reduction in foot and ankle work and metatarsophalangeal joint stiffness. We speculated that the reduced capacity to actively control metatarsophalangeal joint stiffness may impair the gearing function of the foot at the ankle.

METHODS

We used a tibial nerve block to examine the direct effects of the intrinsic foot muscles on ankle joint kinetics, in vivo medial gastrocnemius' musculotendinous dynamics, and ankle gear ratio on 14 participants during maximal vertical jumping.

RESULTS

Under the nerve block, the internal ankle plantar flexion moment decreased (p = 0.004) alongside a reduction in external moment arm length (p = 0.021) and ankle joint gear ratio (p = 0.049) when compared to the non-blocked condition. Although medial gastrocnemius muscle-tendon unit and fascicle velocity were not different between conditions, the Achilles tendon was shorter during propulsion in the nerve block condition (p < 0.001).

CONCLUSION

In addition to their known role of regulating the energetic function of the foot, our data indicate that the intrinsic foot muscles also act to optimize ankle joint torque production and leverage during the propulsion phase of vertical jumping.

Comparison of skin and shoe marker placement on metatarsophalangeal joint kinematics and kinetics during running

This study investigated the effects of marker placement (skin- vs shoe-mounted) on metatarsophalangeal joint (MTP) kinematics and kinetics during running. Fifteen trained men ran on a 15-m track at 10 and 13 km/h with three (low, standard and high stiffness) shoe longitudinal bending stiffnesses (LBS). Reflective markers were fixed on the shoe upper, and on the skin using holes cut in the shoe. Three-dimensional marker positions and ground reaction forces were recorded at 200 and 2000 Hz, respectively. Kinematic and kinetic parameters were analyzed using one-dimensional metrics (statistical parametric mapping). MTP joint was less dorsiflexed at midstance ([57% to 100%] of braking phase and [0% to 48%] of pushing phase), and the MTP joint plantarflexion moment was higher ([22% to 55%] of pushing phase) with the shoe markerset in comparison with the skin markerset. The effect of LBS on MTP angle was found to be significant for a larger percentage of each stride using the shoe markerset compared to the skin markerset. However, the effect of LBS on plantarflexion moment was significant with the shoe markerset only. The effect of running speed on MTP angle was significant for a larger percentage of each stride with the skin markerset. This study demonstrates that the placement of markers influences the measurement of MTP kinematics and kinetics and that these effects are mediated by other variables such as LBS or running speed. It is concluded that the shoe markerset does not fully reflect the movement of the MTP joint.

Metatarsophalangeal Joint Dynamic Stiffness During Toe Rocker Changes With Walking Speed

Dynamic joint stiffness (or simply "stiffness") is a customization criteria used to tune mechanical properties of orthotic and prosthetic devices. This study examines metatarsophalangeal (MTP) joint stiffness during the toe-rocker phase of barefoot walking and establishes baseline characteristics of MTP joint stiffness. Ten healthy individuals walked at 4 speeds (0.4, 0.6, 0.8, and 1.0 statures·s-1) over level ground. MTP sagittal plane joint angles and moments were calculated during the toe-rocker phase of stance. Least-squares linear regressions were conducted on the MTP moment versus angle curve to determine joint stiffness during early toe rocker and late toe rocker. Multilevel linear models were used to test for statistically significant differences between conditions. Early toe rocker stiffness was positive, while late toe rocker was negative. Both early toe rocker and late toe rocker stiffness increased in magnitude significantly with speed. This study establishes baseline characteristics of MTP joint stiffness in healthy walking, which previously had not been examined through a range of controlled walking speeds. This information can be used in the future as design criteria for orthotic and prosthetic ankle and ankle-foot devices that can imitate, support, and facilitate natural human foot motion during walking better than existing devices.

A Deep Learning Method for Foot Progression Angle Detection in Plantar Pressure Images

Foot progression angle (FPA) analysis is one of the core methods to detect gait pathologies as basic information to prevent foot injury from excessive in-toeing and out-toeing. Deep learning-based object detection can assist in measuring the FPA through plantar pressure images. This study aims to establish a precision model for determining the FPA. The precision detection of FPA can provide information with in-toeing, out-toeing, and rearfoot kinematics to evaluate the effect of physical therapy programs on knee pain and knee osteoarthritis. We analyzed a total of 1424 plantar images with three different You Only Look Once (YOLO) networks: YOLO v3, v4, and v5x, to obtain a suitable model for FPA detection. YOLOv4 showed higher performance of the profile-box, with average precision in the left foot of 100.00% and the right foot of 99.78%, respectively. Besides, in detecting the foot angle-box, the ground-truth has similar results with YOLOv4 (5.58 ± 0.10° vs. 5.86 ± 0.09°, p = 0.013). In contrast, there was a significant difference in FPA between ground-truth vs. YOLOv3 (5.58 ± 0.10° vs. 6.07 ± 0.06°, p < 0.001), and ground-truth vs. YOLOv5x (5.58 ± 0.10° vs. 6.75 ± 0.06°, p < 0.001). This result implies that deep learning with YOLOv4 can enhance the detection of FPA.

Lower Limb Kinematic Coordination during the Running Motion of Stroke Patient: A Single Case Study

The purpose of this study was to clarify the lower limb joint motor coordination of para-athletes during running motion from frequency characteristics and to propose this as a method for evaluating their performance. The subject used was a 43-year-old male para-athlete who had suffered a left cerebral infarction. Using a three-dimensional motion analysis system, the angles of the hip, knee, and ankle joints were measured during 1 min of running at a speed of 8 km/h on a treadmill. Nine inter- and intra-limb joint angle pairs were analyzed by coherence and phase analyses. The main characteristic of the stroke patient was that there were joint pairs with absent or increased coherence peaks in the high-frequency band above 4 Hz that were not found in healthy subjects. Interestingly, these features were also observed on the non-paralyzed side. Furthermore, a phase analysis showed different phase differences between the joint motions of the stroke patient and healthy subjects in some joint pairs. Thus, we concluded there was a widespread functional impairment of joint motion in the stroke patient that has not been revealed by conventional methods. The coherence analysis of joint motion may be useful for identifying joint motion problems in para-athletes.

Increasing Step Rate Affects Rearfoot Kinematics and Ground Reaction Forces during Running

Simple Summary

Excessive movements, or inadequate timing in movement patterns, during running may contribute to the development of some running-related injuries. Specifically, excessive movement at the rearfoot, influencing lower leg rotation, has been a focus on different running-related injuries. One method to change how the lower limbs move is to increase step rate, or cadence. There is little research available describing how the rearfoot is affected by changes in step rate; therefore, the primary purpose of this study was to evaluate the effects of increasing step rate on rearfoot motion during running. Reflective markers were placed on twenty runners’ lower legs and feet in order to capture leg and foot movements while running on a treadmill at the runners’ preferred speed and step rate. Step rate was increased by 5% and 10%, while runners were cued by a metronome. Three-dimensional rearfoot motion was calculated during the stance phase (foot in contact with the ground) of running. The main finding of this study was that increasing step rate decreased peak rearfoot and lower leg rotation. These findings may be useful for rehabilitation for some running-related injuries.

Abstract

Relatively high frontal and transverse plane motion in the lower limbs during running have been thought to play a role in the development of some running-related injuries (RRIs). Increasing step rate has been shown to significantly alter lower limb kinematics and kinetics during running. The purpose of this study was to evaluate the effects of increasing step rate on rearfoot kinematics, and to confirm how ground reaction forces (GRFs) are adjusted with increased step rate. Twenty runners ran on a force instrumented treadmill while marker position data were collected under three conditions. Participants ran at their preferred pace and step rate, then +5% and +10% of their preferred step rate while being cued by a metronome for three minutes each. Sagittal and frontal plane angles for the rearfoot segment, tibial rotation, and GRFs were calculated during the stance phase of running. Significant decreases were observed in sagittal and frontal plane rearfoot angles, tibial rotation, vertical GRF, and anteroposterior GRF with increased step rate compared with the preferred step rate. Increasing step rate significantly decreased peak sagittal and frontal plane rearfoot and tibial rotation angles. These findings may have implications for some RRIs and gait retraining.

Does running speed affect the response of joint level mechanics in non-rearfoot strike runners to footwear of varying longitudinal bending stiffness?

BACKGROUND

Modifying the longitudinal bending stiffness (LBS) of footwear has become a popular method to improve sport performance. It has been demonstrated to influence running economy by altering lower extremity joint level mechanics. Previous studies have only examined within-participant effects at one running speed.

RESEARCH QUESTION

Do joint level mechanics differ in response to varying footwear LBS at a range of running speeds?

METHODS

This study utilized a cross-sectional repeated measure study design using a convenience sample. Ten well trained non-rearfoot strike male distance runners ran at 3.89, 4.70, and 5.56 m/s (14, 17, 20 km/hr) in footwear of three different LBS levels. Mechanics and energetics of the metatarsophalangeal joint (MTPJ), ankle, knee, and hip joints during stance phase were assessed using an 8-camera optical motion capture system (f_s = 200 Hz), a force instrumented treadmill (f_s = 1000 Hz) and standard inverse dynamics theory.

RESULTS

Range of motion and negative work decreased and angular stiffness increased for the MTPJ with increasing LBS at all speeds (p < .001). Peak MTPJ moment did not change at any speed in response to increased LBS. Negative work at the ankle decreased in the stiff shoe at 17 km/hr (p = .036). Peak ankle plantar flexion velocity decreased with increasing LBS at all speeds (p < .05).

SIGNIFICANCE

While changes in MTPJ mechanics were consistent across speeds, decreased negative ankle work was only observed at 17 km/hr in the stiff shoe, suggesting that perhaps tuned footwear LBS may need to focus primarily on metabolically beneficial changes in ankle plantar flexor mechanical behavior to improve performance in distance runners. Tuning footwear stiffness may also be beneficial to clinical populations, as clinicians seek to optimize their patients' locomotion economy.

The Effects of Increased Midsole Bending Stiffness of Sport Shoes on Muscle-Tendon Unit Shortening and Shortening Velocity: a Randomised Crossover Trial in Recreational Male Runners

BACKGROUND

Individual compliances of the foot-shoe interface have been suggested to store and release elastic strain energy via ligamentous and tendinous structures or by increased midsole bending stiffness (MBS), compression stiffness, and resilience of running shoes. It is unknown, however, how these compliances interact with each other when the MBS of a running shoe is increased. The purpose of this study was to investigate how structures of the foot-shoe interface are influenced during running by changes to the MBS of sport shoes.

METHODS

A randomised crossover trial was performed, where 13 male, recreational runners ran on an instrumented treadmill at 3.5 m·s-1 while motion capture was used to estimate foot arch, plantar muscle-tendon unit (pMTU), and shank muscle-tendon unit (sMTU) behaviour in two conditions: (1) control shoe and (2) the same shoe with carbon fibre plates inserted to increase the MBS.

RESULTS

Running in a shoe with increased MBS resulted in less deformation of the arch (mean ± SD; stiff, 7.26 ± 1.78°; control, 8.84 ± 2.87°; p ≤ 0.05), reduced pMTU shortening (stiff, 4.39 ± 1.59 mm; control, 6.46 ± 1.42 mm; p ≤ 0.01), and lower shortening velocities of the pMTU (stiff, - 0.21 ± 0.03 m·s-1; control, - 0.30 ± 0.05 m·s-1; p ≤ 0.01) and sMTU (stiff, - 0.35 ± 0.08 m·s-1; control, - 0.45 ± 0.11 m·s-1; p ≤ 0.001) compared to a control condition. The positive and net work performed at the arch and pMTU, and the net work at the sMTU were significantly lower in the stiff compared to the control condition.

CONCLUSION

The findings of this study showed that if a compliance of the foot-shoe interface is altered during running (e.g. by increasing the MBS of a shoe), the mechanics of other structures change as well. This could potentially affect long-distance running performance.

Acute Effects of Wedge Orthoses and Sex on Iliotibial Band Strain During Overground Running in Nonfatiguing Conditions

BACKGROUND

Previous research has identified that iliotibial band (ITB) syndrome is more prevalent in females than in males. It has been theorized that high ITB strain rate is a primary etiological factor for developing ITB syndrome. Orthoses are commonly used to influence gait mechanics and may reduce ITB strain rate by influencing alterations in the kinematic chain.

OBJECTIVES

To identify how wedge orthoses and sex affect ITB strain and strain rate.

METHODS

Thirty asymptomatic participants (15 male, 15 female) ran with 7° lateral, 3° lateral, 0° (no wedge), 3° medial, and 7° medial wedges in this within-subject, repeated-measures study. Participants ran overground while data were collected with a motion-capture system and force platform. Iliotibial band strain and strain rate were estimated using a novel 6-degrees-of-freedom musculoskeletal model. A mixed-model multivariate analysis of covariance for between-subject comparison of sex and within-subject comparison of wedge was used.

RESULTS

There were no significant differences in ITB strain or strain rate between wedge conditions. Females had significantly higher ITB strain and strain rate compared to males.

CONCLUSION

Clinicians should be aware that medial wedges may not acutely alter ITB strain or strain rate. Females exhibited greater peak ITB strain and strain rate, potentially due to increased hip internal rotation compared to males. Further research is needed to investigate longitudinal effects of the wedges. J Orthop Sports Phys Ther 2019;49(10):743-750. Epub 31 Aug 2019. doi:10.2519/jospt.2019.8837.

Does increased midsole bending stiffness of sport shoes redistribute lower limb joint work during running?

OBJECTIVES

To investigate if lower limb joint work is redistributed when running in a shoe with increased midsole bending stiffness compared to a control shoe.

DESIGN

Within-subject with two conditions: (1) commercially available running shoe and (2) the same shoe with carbon fibre inserts to increase midsole bending stiffness.

METHODS

Thirteen male, recreational runners ran on an instrumented treadmill at 3.5m/s in each of the two shoe conditions while motion capture and force platform data were collected. Positive and negative metatarsophalangeal (MTP), ankle, knee, and hip joint work were calculated and statistically compared between conditions.

RESULTS

Running in the stiff condition (with carbon fibre inserts) resulted in significantly more positive work and less negative work at the MTP joint, and less positive work at the knee joint.

CONCLUSIONS

Increased midsole bending stiffness resulted in a redistribution of positive lower limb joint work from the knee to the MTP joint. A larger MTP joint plantarflexor moment due to increased vGRF at the instant of peak positive power and an earlier onset of MTP joint plantarflexion velocity were identified as the reasons for lower limb joint work redistribution.