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The online version of this article (doi:10.1186/1757-1146-2-35) contains supplementary material, which is available to authorized users.
HBM and KBL are Editor-in-Chief and Deputy Editor-in-Chief, respectively, of Journal of Foot and Ankle Research. It is journal policy that editors are removed from the peer review and editorial decision-making processes for papers they have co-authored.
GSM, HBM and KBL conceived the idea and obtained funding for the study. GSM, HBM and KBL designed the study protocol. GSM recruited participants, conducted the laboratory testing and processed data. GSM, HBM and KBL drafted the manuscript. All authors have read and approved the final manuscript.
Some studies have found that flat-arched foot posture is related to altered lower limb muscle function compared to normal- or high-arched feet. However, the results from these studies were based on highly selected populations such as those with rheumatoid arthritis. Therefore, the objective of this study was to compare lower limb muscle function of normal and flat-arched feet in people without pain or disease.
Sixty adults aged 18 to 47 years were recruited to this study. Of these, 30 had normal-arched feet (15 male and 15 female) and 30 had flat-arched feet (15 male and 15 female). Foot posture was classified using two clinical measurements (the arch index and navicular height) and four skeletal alignment measurements from weightbearing foot x-rays. Intramuscular fine-wire electrodes were inserted into tibialis posterior and peroneus longus under ultrasound guidance, and surface EMG activity was recorded from tibialis anterior and medial gastrocnemius while participants walked barefoot at their self-selected comfortable walking speed. Time of peak amplitude, peak and root mean square (RMS) amplitude were assessed from stance phase EMG data. Independent samples t-tests were performed to assess for significant differences between the normal- and flat-arched foot posture groups.
During contact phase, the flat-arched group exhibited increased activity of tibialis anterior (peak amplitude; 65 versus 46% of maximum voluntary isometric contraction) and decreased activity of peroneus longus (peak amplitude; 24 versus 37% of maximum voluntary isometric contraction). During midstance/propulsion, the flat-arched group exhibited increased activity of tibialis posterior (peak amplitude; 86 versus 60% of maximum voluntary isometric contraction) and decreased activity of peroneus longus (RMS amplitude; 25 versus 39% of maximum voluntary isometric contraction). Effect sizes for these significant findings ranged from 0.48 to 1.3, representing moderate to large differences in muscle activity between normal-arched and flat-arched feet.
Differences in muscle activity in people with flat-arched feet may reflect neuromuscular compensation to reduce overload of the medial longitudinal arch. Further research is required to determine whether these differences in muscle function are associated with injury.
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- Foot posture influences the electromyographic activity of selected lower limb muscles during gait
George S Murley
Hylton B Menz
Karl B Landorf
- BioMed Central