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Gepubliceerd in: Journal of Foot and Ankle Research 1/2008

Open Access 01-09-2008 | Oral presentation

Foot joint pressures during dynamic gait simulation

Auteurs: W Brent Edwards, Erin D Ward, Timothy R Derrick

Gepubliceerd in: Journal of Foot and Ankle Research | bijlage 1/2008

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Introduction

Adult acquired flatfoot deformity is a progressive loss of normal function of the entire foot. A limited number of studies concerning joint pressures [1, 2] with adult acquired flatfoot exist. Custom orthotics [3, 4] are often used for conservative treatment of adult acquired flatfoot.

Methods

5 fresh cadaveric specimens were connected to a dynamic gait simulator. I-scan #6900 sensors® were calibrated and surgically inserted into the subtalar (ST), naviculocuneiform (NC) calcaneocuboid (CC), and talonavicular (TN) joints using a joint spreader. Each foot was walked multiple trials across a force platform for three conditions (normal, flatfoot, flatfoot-orthotic). The flatfoot condition was created by detaching the posterior tibial tendon from the simulator and surgically releasing the spring ligament complex and the plantar fascia. Joint pressure data were collected at 100 Hz. Peak pressures were averaged within subjects and effect sizes were calculated between conditions.

Results

Mean joint pressures ranged between 0.5 and 1.5 MPa (Figure 1).
According to Cohen [5], effect sizes of .20, .50 and .80 represent small, medium and large differences, respectively.
Medium and large effect sizes were observed for the ST, NC, and CC joint (Table 1). Compared to the normal condition: ST pressures were lower during the orthotic condition, NC pressures were lower during the flatfoot and orthotic conditions, and CC pressures were higher during the flatfoot condition. Compared to the flatfoot condition: ST, NC, and CC pressures were all lower during the orthotic condition.
Table 1
Measurements of effect size
 
ST
NC
CC
TN
Normal vs Flatfoot
-0.43
0.60*
-2.62**
-0.19
Normal vs Orthotic
3.40**
1.26**
-0.46
-0.03
Flatfoot vs Othotic
2.17**
0.75*
3.96**
0.11
* medium effect, ** large effect.

Conclusion

Adult acquired flatfoot deformity appears to increase pressure at the CC joint, and slightly decrease pressure at the NC joint. The use of orthotics may be an effective method to reduce joint pressures in both the normal foot and flatfoot. The TN joint does not appear to be substantially affected by flatfoot deformity or the use of orthotics.

Acknowledgements

Tekscan, Inc., South Boston, MA, USA. KLM Orthotics Laboratory, Valencia, CA, USA
Open AccessThis article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://​creativecommons.​org/​licenses/​by/​2.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Metagegevens
Titel
Foot joint pressures during dynamic gait simulation
Auteurs
W Brent Edwards
Erin D Ward
Timothy R Derrick
Publicatiedatum
01-09-2008
Uitgeverij
BioMed Central
Gepubliceerd in
Journal of Foot and Ankle Research / Uitgave bijlage 1/2008
Elektronisch ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-1-S1-O21

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