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Paterson KL, Metcalf BR, Campbell PK, Bennell KL, Li P, De Silva AP, Hinman RS. Associations between static foot posture, dynamic in-shoe plantar foot forces and knee pain in people with medial knee osteoarthritis: A cross-sectional exploratory study. Osteoarthritis Cartilage 2024:S1063-4584(24)01263-9. [PMID: 38986834 DOI: 10.1016/j.joca.2024.04.023] [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] [Received: 10/24/2023] [Revised: 04/08/2024] [Accepted: 04/18/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE To investigate relationships between static foot posture, dynamic plantar foot forces and knee pain in people with medial knee osteoarthritis (OA). DESIGN Data from 164 participants with symptomatic, moderate to severe radiographic medial knee OA were analysed. Knee pain was self-reported using a numerical rating scale (NRS; scores 0-10; higher scores worse) and the Knee Injury and Osteoarthritis Outcome Score pain subscale (KOOS; scores 0-100; lower scores worse). Static foot posture was assessed using clinical tests (foot posture index, foot mobility magnitude, navicular drop). Dynamic plantar foot forces (lateral, medial, whole foot, medial-lateral ratio, arch index) were measured using an in-shoe plantar pressure system while walking. Relationships between foot posture and plantar forces (independent variables) and pain (dependent variables) were evaluated using linear regression models, unadjusted and adjusted for sex, walking speed, Kellgren & Lawrence grade, shoe category, and body mass (for dynamic plantar foot forces). RESULTS No measure of static foot posture was associated with any knee pain measure. Higher medial-lateral foot force ratio at midstance, and a higher arch index during overall stance, were weakly associated with higher knee pain on the NRS (regression coefficient = 0.69, 95% confidence interval (CI) 0.09 to 1.28) and KOOS (coefficient=3.03, 95% CI 0.71 to 5.35) pain scales, respectively. CONCLUSION Dynamic plantar foot forces, but not static foot posture, were associated with knee pain in people with medial knee OA. However, the amount of pain explained by increases in plantar foot force was small; thus, these associations are unlikely to be clinically meaningful.
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Affiliation(s)
- Kade L Paterson
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia.
| | - Ben R Metcalf
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Penny K Campbell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Peixuan Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Methods and Implementation Support for Clinical and Health Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Anurika P De Silva
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Methods and Implementation Support for Clinical and Health Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
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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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Blouin C, Genet F, Graff W, Bonnyaud C, Perrier A. Cross-cultural adaptation and reliability of the Foot Posture Index (FPI-6) - French version. Disabil Rehabil 2024; 46:1621-1629. [PMID: 37204129 DOI: 10.1080/09638288.2023.2203524] [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: 07/18/2022] [Accepted: 04/12/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE The 6-item Foot Posture Index (FPI-6) is a reliable tool for the evaluation of foot deformities. Our aim was to translate and cross-culturally validate the FPI-6 for use in French-speaking countries and to determine the intra-rater and inter-rater reliability of the French version. METHODS Cross-cultural adaptation was performed according to guidelines. Two clinicians assessed the FPI-6 in 52 asymptomatic individuals. We evaluated intra- and inter-rater reliability with the intraclass correlation coefficients (ICC), correlations (p-value < 0.05) and Bland-Altman plots. Standard error of measurement (SEM) and minimum detectable change (MDC95) were determined. RESULTS For the cross-cultural adaptation, we modified several items of the FPI-6 user guide and added footnotes to ensure correct interpretation. ICC of the total FPI-6 scores were 0.94 to 0.96 for the intra- and inter-rater reliability for dominant and non-dominant lower limb. Correlations were significant (p < 0.001); r 0.88 to 0.92. Total score SEM was 0.68 to 0.78 and MDC95 was 1.58 to 1.82. CONCLUSIONS Intra- and inter-rater reliability of this French version of the FPI-6 was excellent for the total score and good to excellent for each item. The French FPI-6 can be used in French-speaking countries. The identification of SEM and MDC scores is useful for clinical interpretation.
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Affiliation(s)
- Cédric Blouin
- Université Paris Saclay, UVSQ, ERPHAN, Versailles, France
- Service de chirurgie orthopédique, Hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
- ISPC Synergies, Paris, France
| | - François Genet
- ISPC Synergies, Paris, France
- Unité Péri Opératoire du Handicap, (UPOH- Perioperative Disability Unit), Département PARASPORT- SANTE, service de Médecine Physique et de Réadaptation, Hôpital Raymond-Poincaré, Groupe Hospitalo-Universitaire APHP-Université PARIS SACLAY, Garches, France
- END: ICAP, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); UFR Simone Veil - Santé, Montigny-le-Bretonneux, France
| | - Wilfrid Graff
- Service de chirurgie orthopédique, Hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
| | - Céline Bonnyaud
- Université Paris Saclay, UVSQ, ERPHAN, Versailles, France
- Laboratoire d'analyse du mouvement, Service des Explorations Fonctionnelles, Hôpital Raymond Poincaré, APHP, Garches, France
| | - Antoine Perrier
- Service de chirurgie orthopédique, Hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
- Laboratoire de Recherche Translationnelle et d'innovation en Médecine et Complexité TIMC, CNRS, Grenoble, France
- Service de diabétologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Wang Y, Chen Z, Wu Z, Li J, Li C, Yang J, Chen W, Ye Z, Shen X, Jiang T, Liu W, Xu X. Reliability of foot posture index (FPI-6) for evaluating foot posture in patients with knee osteoarthritis. Front Bioeng Biotechnol 2023; 11:1103644. [PMID: 36741758 PMCID: PMC9889869 DOI: 10.3389/fbioe.2023.1103644] [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: 11/20/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
Objective: To determine the reliability of FPI-6 in the assessment of foot posture in patients with knee osteoarthritis (KOA). Methods: Thirty volunteers with KOA (23 females, 7 males) were included in this study, assessed by two raters and at three different moments. Inter-rater and test-retest reliability were assessed with Cohen's Weighted Kappa (Kw) and Intraclass Correlation Coefficient (ICC). Bland-Altman plots and respective 95% limits of agreement (LOA) were used to assess both inter-rater and test-retest agreement and identify systematic bias. Moreover, the internal consistency of FPI-6 was assessed by Spearman's correlation coefficient. Results: FPI-6 total score showed a substantial inter-rater (Kw = .66) and test-retest reliability (Kw = .72). The six items of FPI-6 demonstrated inter-rater and test-retest reliability varying from fair to substantial (Kw = .33 to .76 and Kw = .40 to .78, respectively). Bland-Altman plots and respective 95% LOA indicated that there appeared no systematic bias and the acceptable agreement of FPI-6 total score for inter-rater and test-retest was excellent. There was a statistically significant positive correlation between each item and the total score of FPI-6, which indicated that FPI-6 had good internal consistency. Conclusion: In conclusion, the reliability of FPI-6 total score and the six items of FPI-6 were fair to substantial. The results can provide a reliable way for clinicians and researchers to implement the assessment of foot posture in patients with KOA.
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Affiliation(s)
- Yi Wang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zehua Chen
- The Orthopedics Hospital of Traditional Chinese Medicine Zhuzhou city, Zhuzhou, China
| | - Zugui Wu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiaman Yang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weijian Chen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinxin Shen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tao Jiang
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China,*Correspondence: Tao Jiang, ; Wengang Liu, ; Xuemeng Xu,
| | - Wengang Liu
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China,*Correspondence: Tao Jiang, ; Wengang Liu, ; Xuemeng Xu,
| | - Xuemeng Xu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China,Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China,*Correspondence: Tao Jiang, ; Wengang Liu, ; Xuemeng Xu,
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Falla D, Devecchi V, Jiménez-Grande D, Rügamer D, Liew BXW. Machine learning approaches applied in spinal pain research. J Electromyogr Kinesiol 2021; 61:102599. [PMID: 34624604 DOI: 10.1016/j.jelekin.2021.102599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/26/2021] [Accepted: 08/01/2021] [Indexed: 01/13/2023] Open
Abstract
The purpose of this narrative review is to provide a critical reflection of how analytical machine learning approaches could provide the platform to harness variability of patient presentation to enhance clinical prediction. The review includes a summary of current knowledge on the physiological adaptations present in people with spinal pain. We discuss how contemporary evidence highlights the importance of not relying on single features when characterizing patients given the variability of physiological adaptations present in people with spinal pain. The advantages and disadvantages of current analytical strategies in contemporary basic science and epidemiological research are reviewed and we consider how analytical machine learning approaches could provide the platform to harness the variability of patient presentations to enhance clinical prediction of pain persistence or recurrence. We propose that machine learning techniques can be leveraged to translate a potentially heterogeneous set of variables into clinically useful information with the potential to enhance patient management.
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Affiliation(s)
- Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
| | - Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - David Jiménez-Grande
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - David Rügamer
- Department of Statistics, Ludwig-Maximilians-Universität München, Germany
| | - Bernard X W Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, UK
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PERSIANE ANDRÉSETTI, NEGRÃO DAIANEMAGALHÃESGOMES, ALVES RAONEDALTROPARAGUASSU, FREITAS DIEGOGALACEDE, CAZARINI JÚNIOR CLÁUDIO, ALVES VERALÚCIADOSSANTOS. SUBTALAR JOINT IN NEUTRAL AND RELAXED POSITIONS FOR EVALUATION OF MEDIAL LONGITUDINAL ARCH. ACTA ORTOPEDICA BRASILEIRA 2021; 29:177-180. [PMID: 34566473 PMCID: PMC8443015 DOI: 10.1590/1413-785220212904240893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/24/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The medial longitudinal arch is the main structure of load bearing and shock absorption of the foot. The evaluation of medial longitudinal arch, such as the navicular height, the medial longitudinal arch angle and the Feiss line should be performed with the subtalar joint in the neutral and relaxed position. Our study analyzed the correlation between the measurements of the subtalar joint in neutral and relaxed positions during the evaluation tests of the medial longitudinal arch. METHODS This is a cross-sectional study, in which 51 healthy volunteers (102 feet; 36 women; 28 ± 5 years, 1.66 ± 0.10 m; 24.5 ± 4.5 kg/m2) had their navicular height, medial longitudinal arch angle and Feiss line measured in the neutral and relaxed positions. The correlation between the measures was evaluated using Pearson's test. RESULTS A strong correlation of the 102 feet Feiss line measurements between neutral and relaxed positions (r = 0.81) was observed, and a moderate correlation between the medial longitudinal arch angle (r = 0.78) and between navicular height in neutral and relaxed positions (r = 0.76). CONCLUSION The measurements of the longitudinal medial arch between the neutral and relaxed positions are strongly correlated. Therefore, it is not necessary to measure the medial longitudinal arch in both neutral and relaxed positions. Level of Evidence II, Diagnostic Studies - Investigating a diagnostic test.
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Matla J, Filar-Mierzwa K, Ścisłowska-Czarnecka A, Jankowicz-Szymańska A, Bac A. The Influence of the Physiotherapeutic Program on Selected Static and Dynamic Foot Indicators and the Balance of Elderly Women Depending on the Ground Stability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094660. [PMID: 33925676 PMCID: PMC8125779 DOI: 10.3390/ijerph18094660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/15/2021] [Accepted: 04/25/2021] [Indexed: 11/23/2022]
Abstract
Seniors are a constantly growing group of people in many societies. It is necessary to develop physiotherapeutic programs to improve their mobility. The aim of this study was to assess the impact of the physiotherapeutic program conducted unstable ground on selected indicators of motor functions of elderly women. Sixty women (60–80 years) participated in the research. Group A (N = 20) underwent a 12-week physiotherapeutic program on stable ground, group B (N = 20) followed an exercise program on unstable ground, and group C (N = 20) (control group) had no therapeutic intervention. The effects of the therapy were assessed by using a FreeMed platform (foot load analysis) and a Biosway balance system. The results were compared using ANOVA (the one-way analysis), the Kruskal–Wallis test and also the post hoc tests (Tukey’s test and the multiple comparison test). In group A, a statistically significant change was observed in the static test and balance assessment, in group B this was observed in the static and dynamic foot tests and balance assessment, in group C, no statistical significance was achieved. The authors’ physiotherapeutic program had a statistically significant effect on changes in the balance and selected indicators of the motor functions of the examined people. Comparing the results before and after the therapy more improvement changes were noted in women training on an unstable ground compared to women training on a stable ground.
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Affiliation(s)
- Joanna Matla
- Faculty of Motor Rehabilitation, The Bronislaw Czech University of Physical Education, Jana Pawła II 78, 31-571 Krakow, Poland; (J.M.); (K.F.-M.); (A.Ś.-C.)
| | - Katarzyna Filar-Mierzwa
- Faculty of Motor Rehabilitation, The Bronislaw Czech University of Physical Education, Jana Pawła II 78, 31-571 Krakow, Poland; (J.M.); (K.F.-M.); (A.Ś.-C.)
| | - Anna Ścisłowska-Czarnecka
- Faculty of Motor Rehabilitation, The Bronislaw Czech University of Physical Education, Jana Pawła II 78, 31-571 Krakow, Poland; (J.M.); (K.F.-M.); (A.Ś.-C.)
| | | | - Aneta Bac
- Faculty of Motor Rehabilitation, The Bronislaw Czech University of Physical Education, Jana Pawła II 78, 31-571 Krakow, Poland; (J.M.); (K.F.-M.); (A.Ś.-C.)
- Correspondence: ; Tel.: +48-12-683-15-40
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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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Fraser JJ, Hertel J. The quarter-ellipsoid foot: A clinically applicable 3-dimensional composite measure of foot deformation during weight bearing. Foot (Edinb) 2021; 46:101717. [PMID: 33509711 DOI: 10.1016/j.foot.2020.101717] [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] [Received: 02/28/2020] [Revised: 05/14/2020] [Accepted: 07/03/2020] [Indexed: 02/04/2023]
Abstract
STUDY DESIGN Descriptive Laboratory OBJECTIVES: To assess change in foot morphology across loading using innovative, clinically accessible 3-dimesional composite measurements of surface area (SA), volume (V), and SA:V ratio in recreationally-active young adults. METHODS The feet of 53 female [mean age:20.7 ± 3.8 years, BMI:23.9 ± 4.2 kg m-2, foot posture index (FPI):3.8 ± 3.7] and 31 male participants (mean age:20.8 ± 2.4 years, BMI:23.7 ± 2.5 kg m-2, FPI:3.8 ± 4.1) were evaluated. FPI was assessed and foot length, width, and dorsal arch height were measured in sitting and bipedal standing and used to calculate the SA and V of a quarter-ellipsoid. ΔSA characterized foot widening and lengthening and ΔV characterized arch deformation during loading. The SA:V represented changes in both foot size and shape. Linear regression was performed to assess the effects of component foot change measures during loading on the composite measurements. The composite measures were compared to the established measures of ΔArch Height Index (ΔAHI), Arch Flexibility, Foot Mobility Magnitude (FMM), and FPI. RESULTS Foot width and dorsal arch height change measures were significant predictors (p < 0.001) for the ΔV and SA:V composite measures, explaining 90-91% of the variance. Significant fair to good associations (p < .05) were found between the novel and established composite measures: ΔSA: Arch flexibility (r=-0.27); SA:V: ΔAHI (r=-0.57), Arch Flexibility (r=-0.75), FMM (r=-0.30), FPI (r = 0.42). CONCLUSION Quarter-ellipsoid measures calculated from morphologic measurements may have clinical utility in quantifying 3-dimensional foot changes during loading and may be useful when assessing need and response to clinical interventions.
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Affiliation(s)
- John J Fraser
- Department of Kinesiology, University of Virginia, 210 Emmet Street South, Charlottesville, VA 22904-4407, USA; Warfighter Performance Department, Naval Health Research Center, San Diego, CA.
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, 210 Emmet Street South, Charlottesville, VA 22904-4407, USA.
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Naderi A, Baloochi R, Rostami KD, Fourchet F, Degens H. Obesity and foot muscle strength are associated with high dynamic plantar pressure during running. Foot (Edinb) 2020; 44:101683. [PMID: 32801069 DOI: 10.1016/j.foot.2020.101683] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 02/08/2020] [Accepted: 03/22/2020] [Indexed: 02/04/2023]
Abstract
Obese people are often encouraged to lose body mass by exercise. The aim of the study was to determine the effect of body mass and ankle muscle strength on the dynamic foot-pressure distribution before and after running. Twenty-five normal weight (72.0±5.3kg), 25 overweight (80.8±5.6kg) and 25 obese (96.8±6.5kg) age- and height-matched male recreational runners joined the study. Before and after 30min running, dynamic foot-pressure distribution during running, and ankle plantarflexor, dorsiflexor, invertor and evertor muscle strength were measured using a foot-scan pressure-plate and isokinetic dynamometer, respectively. Body mass index and percentage fat mass correlated positively to almost all components of foot-pressure distribution; this explantion was extracted from 14% (for toe 1) to 52% (for dynamic arch index) of peak foot pressure and between 21% (for metatarsal 1) to 48% (for midfoot) of the impulse underneath different foot zones. Only plantarflexor muscle strength significantly predicted plantar pressure and impulse underneath the T1, T2-5, midfoot area and the dynamic arch index. After running, plantarflexor and invertor muscle strength predicted from 30% (for metatarsal 2) to 58% (for metatarsal 1) of peak foot-pressure and impulse underneath the different foot zones. Obesity is associated with excessive plantar loading that is aggravated after running by fatigue-related reductions in plantar flexor and invertor muscle strength. To prevent foot pain and injuries related to excessive foot pressures, at the start of the weight control process non-weight bearing rather than weight-bearing exercise is advisable.
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Affiliation(s)
- Aynollah Naderi
- Department of Health and Corrective Exercise, School of Physical Education and Sport Sciences, Shahrood University of Technology, Shahrood, Semnan, Iran.
| | - Ramin Baloochi
- Department of Health and Corrective Exercise, School of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Komeil Dashti Rostami
- Department of Biomechanics, Faculty of Physical Education and Sports Sciences, University of Mazandaran, Mazandaran, Babolsar, Iran
| | - François Fourchet
- Motion Analysis Lab, Physiotherapy Department, La Tour Hospital, Meyrin, Switzerland
| | - Hans Degens
- Department of Life Sciences, Manchester Metropolitan University, UK; Institute of Sport Science and Innovations, Lithuanian Sports University, Lithuania; University of Medicine and Pharmacy of Targu Mures, Romania
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Dodelin D, Tourny C, L'Hermette M. The biomechanical effects of pronated foot function on gait. An experimental study. Scand J Med Sci Sports 2020; 30:2167-2177. [PMID: 32735749 DOI: 10.1111/sms.13785] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 07/07/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023]
Abstract
The relationship between foot kinematics and the development of lower extremity musculoskeletal disorders (MSD) has been the focus of recent attention. However, most studies evaluated static foot type and not dynamic foot function. The purpose was to compare lower limb and foot kinematics, and plantar pressures during gait in physically active individuals with pronated and non-pronated foot function. Foot function in 154 adult participants was documented as pronated (n = 63) or neutral (n = 91) using 2 established methods: The Foot Posture Index and the Center of Pressure Excursion Index. Difference between the groups in triplanar motion of the lower limb during barefoot gait was evaluated using a 3D motion capture system incorporating the Oxford Foot Model. Dynamic parameters of plantar pressure were recorded using a pressure platform. Anterior-posterior pelvic tilt range of motion (ROM), peak knee internal rotation, forefoot dorsiflexion ROM, peak forefoot abduction, and rearfoot eversion were all increased in those with pronated foot function. Hallux contact time and time to peak force under the medial forefoot were increased with pronated foot function, and maximal force under the lateral forefoot was reduced. Pronated foot function affected the whole lower limb kinematic chain during gait. These kinematic alterations could increase the risk of developing MSD. Further studies should elucidate the relationship between pronated foot function and MSD, and, if confirmed, foot function should be evaluated in clinical practice for patients with lower limb and low back pain.
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Affiliation(s)
- Damien Dodelin
- CETAPS, EA 3832, EDSH, UFR STAPS, Université de Rouen-Normandie, Mont Saint Aignan Cedex, France
| | - Claire Tourny
- CETAPS, EA 3832, EDSH, UFR STAPS, Université de Rouen-Normandie, Mont Saint Aignan Cedex, France
| | - Maxime L'Hermette
- CETAPS, EA 3832, EDSH, UFR STAPS, Université de Rouen-Normandie, Mont Saint Aignan Cedex, France
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Liew BXW, Rugamer D, Abichandani D, De Nunzio AM. Classifying individuals with and without patellofemoral pain syndrome using ground force profiles - Development of a method using functional data boosting. Gait Posture 2020; 80:90-95. [PMID: 32497981 DOI: 10.1016/j.gaitpost.2020.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/06/2020] [Accepted: 05/21/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Predictors of recovery in patellofemoral pain syndrome (PFPS) currently used in prognostic models are scalar in nature, despite many physiological measures originally lying on the functional scale. Traditional modelling techniques cannot harness the potential predictive value of functional physiological variables. RESEARCH QUESTION What is the classification performance of PFPS status of a statistical model when using functional ground reaction force (GRF) time-series? METHODS Thirty-one individuals (control = 17, PFPS = 14) performed maximal countermovement jumps, on two force plates. The three-dimensional components of the GRF profiles were time-normalized between the start of the eccentric phase and take-off, and used as functional predictors. A statistical model was developed using functional data boosting (FDboost), for binary classification of PFPS statuses (control vs PFPS). The area under the Receiver Operating Characteristic curve (AUC) was used to quantify the model's ability to discriminate the two groups. RESULTS The three predictors of GRF waveform achieved an average out-of-bag AUC of 93.7 %. A 1 % increase in applied medial force reduced the log odds of being in the PFPS group by 0.68 at 87 % of jump cycle. In the AP direction, a 1 % reduction in applied posterior force increased the log odds of being classified as PFPS by 1.10 at 70 % jump cycle. For the vertical GRF, a 1 % increase in applied force reduced the log odds of being classified in the PFPS group by 0.12 at 44 % of the jump cycle. SIGNIFICANCE Using simple functional GRF variables collected during functionally relevant task, in conjunction with FDboost, produced clinically interpretable models that retain excellent classification performance in individuals with PFPS. FDboost may be an invaluable tool to be used in longitudinal cohort prognostic studies, especially when scalar and functional predictors are collected.
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Affiliation(s)
- Bernard X W Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, CO4 3SQ, United Kingdom; Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston B152TT, United Kingdom.
| | - David Rugamer
- Department of Statistics, Ludwig-Maximilians-Universität München, Germany; Chair of Statistics, School of Business and Economics, Humboldt University of Berlin, Germany
| | - Deepa Abichandani
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston B152TT, United Kingdom
| | - Alessandro Marco De Nunzio
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston B152TT, United Kingdom; LUNEX International University of Health, Exercise and Sports, 50, avenue du Parc des Sports, L-4671 Differdange, Luxembourg
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13
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Kudo S, Sakamoto K, Shirakawa T. Comparison of foot kinematics and the morphology of intrinsic musculature of the foot using a foot-type classification based on function. J Phys Ther Sci 2020; 32:238-242. [PMID: 32184540 PMCID: PMC7064354 DOI: 10.1589/jpts.32.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/14/2019] [Indexed: 12/11/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate a correlation between the
morphology of the intrinsic musculature of the foot and foot kinematics during gait using
a foot type classification based on the windlass function. [Participants and Methods] We
examined 67 feet of 35 healthy participants in this study. We collected three-dimensional
foot kinematic data during gait from the Oxford Foot Model and assessed the morphology of
the flexor digitorum brevis, abductor hallucis, adductor halluces (oblique head), and
abductor digiti minimi muscles using B-mode ultrasound. Using the Foot Posture Index
(six-item version), we divided static foot postures into two groups: normal arch and
flatfoot. Subsequently, we compared foot kinematics and the morphology of the intrinsic
musculature among the four groups using the analysis of variance with the Bonferroni test.
[Results] Foot kinematics of the flatfoot-adduction type during gait significantly
differed from that of the normal arch-abduction type. The abductor digiti minimi of the
flatfoot-adduction type was significantly thinner than that of the normal arch-abduction
type. [Conclusion] There may be some variations in flatfoot, and the flatfoot-abduction
type might not be a risk factor for overuse injuries.
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Affiliation(s)
- Shintarou Kudo
- Department of Physical Therapy, Morinomiya University of Medical Sciences: 1-26-16 Nanko-kita, Suminoe-ku, Osaka-shi, Osaka 559-8611, Japan.,Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Japan
| | - Kodai Sakamoto
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Japan
| | - Takeshi Shirakawa
- Department of Rehabilitation, AR-Ex Medical Group Toritudai Orthopedics Clinic, Japan
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14
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Behling AV, Manz S, von Tscharner V, Nigg BM. Pronation or foot movement - What is important. J Sci Med Sport 2019; 23:366-371. [PMID: 31776068 DOI: 10.1016/j.jsams.2019.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/17/2019] [Accepted: 11/04/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Despite difficulties to quantify foot pronation non-invasively and during dynamic tasks, pronation was frequently discussed with respect to injury risk and footwear development. Typically, surrogate measures were used to approximate the movement of pronation showing inconsistent results due to the high variability in the methodology and protocols. This study determines the relationships between all identified pronation variables and aims to reduce the data set to its dominant factors. DESIGN Cross-sectional. METHODS Forty barefoot participants (14 F, 26 M) performed four standing tasks (subneutral, bipedal, single-leg with 20° and single-leg with 30° knee flexion), over ground walking (1.5m/s) and running (3.5m/s) trials. Manual assessment data, motion capture data, ground reaction forces, and plantar pressure distributions were collected. Sixty-one commonly used pronation measures were compared using Spearman Correlations and a Principal Component Analysis (PCA). RESULTS Two groups of correlated variables were found, 4.2% of them correlated mainly with the longitudinal arch angle (LAA), the other 10.2% correlated with the Achilles tendon angle (β). The remaining 85.6% were not significantly correlated to each other. CONCLUSIONS The LAA is representative for the movement of the mid foot and β quantifies rear foot eversion relative to the shank. Since these dominant variables varied independently from each other, both cannot quantify pronation simultaneously. Therefore, it is important to consider and report both, LAA-pronation and β-pronation separately to represent prevalent foot movement properties. Separately assessing the two dominant underlying mechanisms of foot movement may lead to improved guidelines for clinical screening and footwear manufacturing.
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Affiliation(s)
- Anja-Verena Behling
- Biomedical Engineering, Schulich School of Engineering, University of Calgary, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada.
| | - Sabina Manz
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada
| | | | - Benno Maurus Nigg
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada
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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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16
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Zhang X, Pauel R, Deschamps K, Jonkers I, Vanwanseele B. Differences in foot muscle morphology and foot kinematics between symptomatic and asymptomatic pronated feet. Scand J Med Sci Sports 2019; 29:1766-1773. [DOI: 10.1111/sms.13512] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/23/2019] [Accepted: 06/26/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Xianyi Zhang
- Department of Movement Sciences, Human Movement Biomechanics Research Group KU Leuven Leuven Belgium
| | - Rinus Pauel
- Department of Movement Sciences, Human Movement Biomechanics Research Group KU Leuven Leuven Belgium
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group KU Leuven Leuven Belgium
- Laboratory for Clinical Motion Analysis University Hospital Pellenberg, KU Leuven Leuven Belgium
| | - Ilse Jonkers
- Department of Movement Sciences, Human Movement Biomechanics Research Group KU Leuven Leuven Belgium
| | - Benedicte Vanwanseele
- Department of Movement Sciences, Human Movement Biomechanics Research Group KU Leuven Leuven Belgium
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17
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Sanchis-Sales E, Rodríguez-Cervantes PJ, Sancho-Bru JL. Kinematics reduction applied to the comparison of highly-pronated, normal and highly-supinated feet during walking. Gait Posture 2019; 68:269-273. [PMID: 30551052 DOI: 10.1016/j.gaitpost.2018.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Kinematic analysis could help to study how variations in the static foot posture affect lower limb biomechanical function. The analysis of foot kinematics is complex because it involves managing the time-dependent joint angles in different joints and in all three planes of motion. But it could be simplified if joint angles are coordinated. METHODS The kinematics of the ankle, midtarsal and metatarsophalangeal joints were registered in 20 highly-pronated, 30 normal and 20 highly-supinated subjects (assessed by the Foot Posture Index - FPI) as they walked barefoot. Coordination for each sample was analysed through principal component analysis applied to the dorsiflexion, abduction and inversion angles measured. Finally, a systematic comparison among the samples was performed through a set of ANOVAs applied to the reduced variables corresponding to the factors found. RESULTS Three principal components (coordination patterns) accounted for about 70% of the variance of the joint angles, and were affected by the FPI. The main coordination in normal feet was the supination movement, while in highly-supinated and highly-pronated feet it was the flexion coordination of all foot joints, which could work against adaptation in cases of varying terrain. The original joint angles were reduced to three factors, and the ANOVAs applied to them showed that highly-pronated feet presented a delayed propulsion peak and smaller ranges of motion during propulsion regarding all factors, and that highly-supinated feet require more pronation time to fully support the foot during walking. SIGNIFICANCE The coordination patterns of normal feet might be considered the normal patterns used for an efficient gait, and may help in planning surgical procedures and designing foot prostheses or orthotics. Dimensional reduction makes it possible to perform more systematic kinematic analyses, which have revealed that highly-pronated feet are in poorer propulsive condition, and this in turn may make them more prone to injury.
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Affiliation(s)
- E Sanchis-Sales
- Facultad de Enfermería y Podología, Universidad de Valencia, C/Jaume Roig s/n, 46010, Valencia, Spain.
| | - P J Rodríguez-Cervantes
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I, Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain.
| | - J L Sancho-Bru
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I, Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain.
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Three-dimensional cameras and skeleton pose tracking for physical function assessment: A review of uses, validity, current developments and Kinect alternatives. Gait Posture 2019; 68:193-200. [PMID: 30500731 DOI: 10.1016/j.gaitpost.2018.11.029] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/16/2018] [Accepted: 11/21/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Three-dimensional camera systems that integrate depth assessment with traditional two-dimensional images, such as the Microsoft Kinect, Intel Realsense, StereoLabs Zed and Orbecc, hold great promise as physical function assessment tools. When combined with point cloud and skeleton pose tracking software they can be used to assess many different aspects of physical function and anatomy. These assessments have received great interest over the past decade, and will likely receive further study as the integration of depth sensing and augmented reality smartphone cameras occurs more in everyday life. RESEARCH QUESTION The aim of this review is to discuss how these devices work, what options are available, the best methods for performing assessments and how they can be used in the future. METHODS Firstly, a review of the Microsoft Kinect devices and associated artificial intelligence, automated skeleton tracking algorithms is provided. This includes a narrative critique of the validity and clinical utility of these devices for assessing different aspects of physical function including spatiotemporal, kinematic and inverse dynamics data derived from gait and balance trials, and anatomical assessments performed using the depth sensor information. Methods for improving the accuracy of data are examined, including multiple-camera systems and sensor fusion with inertial monitoring units, model fitting, and marker tracking. Secondly, alternative hardware, including other structured light and time of flight methods, stereoscopic cameras and augmented reality leveraging smartphone and tablet cameras to perform measurements in three-dimensional space are summarised. Software options related to depth sensing cameras are then discussed, focussing on recent advances such as OpenPose and web-based methods such as PoseNet. RESULTS AND SIGNIFICANCE The clinical and non-laboratory utility of these devices holds great promise for physical function assessment, and recent developments could strengthen their ability to provide important and impactful health-related data.
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Effect of knee unloading shoes on regional plantar forces in people with symptomatic knee osteoarthritis - an exploratory study. J Foot Ankle Res 2018; 11:34. [PMID: 29983749 PMCID: PMC6019230 DOI: 10.1186/s13047-018-0278-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/14/2018] [Indexed: 11/10/2022] Open
Abstract
Background Knee 'unloading' footwear can reduce the external knee adduction moment in people with knee osteoarthritis, yet effects of these shoes on regional plantar forces are unknown. We evaluated the effects of unloading shoes on in-shoe regional plantar forces, and whether measures of foot posture and/or mobility moderate these effects in people with symptomatic knee osteoarthritis. Methods In this exploratory study 21 participants underwent testing while wearing knee unloading shoes (ASICS GEL-Melbourne OA) and conventional shoes in random order. Peak total forces were compared across conditions for: lateral heel, medial heel, lateral forefoot, and medial forefoot. Arch index, centre of pressure position and medial-lateral heel peak force ratio were also evaluated. Foot posture, foot mobility magnitude and navicular drop were separately added to the mixed linear model to investigate if these modified the effect of footwear on outcomes. Results Unloading shoes significantly increased lateral heel and lateral forefoot force (12.9 and 20.2% respectively, all P < 0.001), with concurrent decreases in the medial heel (8.9%, P = 0.001) and medial forefoot (9.9%, P = 0.005). Unloading shoes significantly shifted the centre of pressure anteriorly (4.7%, P < 0.001) and laterally (5.6%, P = 0.034), but did not affect the arch index (8.7%, P = 0.093). Foot posture, foot mobility magnitude and navicular drop did not moderate the effect of footwear on outcomes. Conclusion Compared to conventional shoes, unloading shoes caused a lateral shift in foot pressure and force patterns. Although these effects were not moderated by foot posture, FMM or navicular drop, variability in the individual increases in lateral heel force suggests participant characteristics other than foot posture may play a role. Trial registration ACTRN12613000851763. Registered 02 August 2013.
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Bishop C, Hillier S, Thewlis D. The reliability of the Adelaide in-shoe foot model. Gait Posture 2017; 56:1-7. [PMID: 28463819 DOI: 10.1016/j.gaitpost.2017.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 04/11/2017] [Accepted: 04/13/2017] [Indexed: 02/02/2023]
Abstract
Understanding the biomechanics of the foot is essential for many areas of research and clinical practice such as orthotic interventions and footwear development. Despite the widespread attention paid to the biomechanics of the foot during gait, what largely remains unknown is how the foot moves inside the shoe. This study investigated the reliability of the Adelaide In-Shoe Foot Model, which was designed to quantify in-shoe foot kinematics and kinetics during walking. Intra-rater reliability was assessed in 30 participants over five walking trials whilst wearing shoes during two data collection sessions, separated by one week. Sufficient reliability for use was interpreted as a coefficient of multiple correlation and intra-class correlation coefficient of >0.61. Inter-rater reliability was investigated separately in a second sample of 10 adults by two researchers with experience in applying markers for the purpose of motion analysis. The results indicated good consistency in waveform estimation for most kinematic and kinetic data, as well as good inter-and intra-rater reliability. The exception is the peak medial ground reaction force, the minimum abduction angle and the peak abduction/adduction external hindfoot joint moments which resulted in less than acceptable repeatability. Based on our results, the Adelaide in-shoe foot model can be used with confidence for 24 commonly measured biomechanical variables during shod walking.
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Affiliation(s)
- Chris Bishop
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Australia.
| | - Susan Hillier
- International Centre for Allied Health Evidence (iCAHE), University of South Australia, Australia
| | - Dominic Thewlis
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Australia
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