Elsevier

Gait & Posture

Volume 32, Issue 4, October 2010, Pages 519-523
Gait & Posture

A comparison of foot kinematics in people with normal- and flat-arched feet using the Oxford Foot Model

https://doi.org/10.1016/j.gaitpost.2010.07.013Get rights and content

Abstract

Foot posture is thought to influence predisposition to overuse injuries of the lower limb. Although the mechanisms underlying this proposed relationship are unclear, it is thought that altered foot kinematics may play a role. Therefore, this study was designed to investigate differences in foot motion between people with normal- and flat-arched feet using the Oxford Foot Model (OFM). Foot posture in 19 participants was documented as normal-arched (n = 10) or flat-arched (n = 9) using a foot screening protocol incorporating measurements from weightbearing antero-posterior and lateral foot radiographs. Differences between the groups in triplanar motion of the tibia, rearfoot and forefoot during walking were evaluated using a three-dimensional motion analysis system incorporating a multi-segment foot model (OFM). Participants with flat-arched feet demonstrated greater peak forefoot plantar-flexion (−13.7° ± 5.6° vs −6.5° ± 3.7°; p = 0.004), forefoot abduction (−12.9° ± 6.9° vs −1.8° ± 6.3°; p = 0.002), and rearfoot internal rotation (10.6° ± 7.5° vs −0.2° ± 9.9°; p = 0.018) compared to those with normal-arched feet. Additionally, participants with flat-arched feet demonstrated decreased peak forefoot adduction (−7.0° ± 9.2° vs 5.6° ± 7.3°; p = 0.004) and a trend towards increased rearfoot eversion (−5.8° ± 4.4° vs −2.5° ± 2.6°; p = 0.06). These findings support the notion that flat-arched feet have altered motion associated with greater pronation during gait; factors that may increase the risk of overuse injury.

Section snippets

Background

Human foot posture is generally characterised by the alignment of the foot skeleton and varies considerably between individuals. Variation from normal foot posture has long been thought to influence function of the foot and lower limb during gait, thereby predisposing to injury [1]. While the link between altered foot posture and injury is still unclear, several studies have demonstrated that foot posture influences lower limb muscle electromyographic (EMG) activity [2] and joint kinematics [3]

Participants

Participants with normal- and flat-arched feet were recruited from a related electromyography study involving healthy adults [17]. All participants were without symptoms of macrovascular (e.g. angina, stroke, peripheral vascular disease) and/or neuromuscular disease, or any biomechanical abnormalities that affected their ability to walk. Each participant's foot posture had been classified based on a foot screening protocol that included radiographic measurements obtained from weight bearing

Results

There were no significant differences between the groups for age (p = 0.17), height (p = 0.87), body mass (p = 0.72) or BMI (p = 0.73) (see Table 1). Significant differences were found for all radiographic measurements between the groups (p < 0.01) as indicated in Table 1. Gait velocity was also comparable between the normal-arched (1.30 ± 0.18 m/s) and flat-arched (1.33 ± 0.14 m/s) groups (p = 0.77) with the flat-arched group showing a slightly longer stride length (p = 0.07) and reduced cadence (p = 0.07), as

Discussion

This is the first study to investigate differences in foot motion between normal- and flat-arched feet using a rigorous protocol to classify foot type based on radiographic measurements. Previous studies investigating the association between static foot posture and dynamic motion of the foot during walking have been inconclusive and provided limited information regarding the reliability and validity of the methods used to classify foot posture [9], [20], [21], [22], [23]. Currently, the gold

Conclusion

Differences in foot motion between adults with normal- and flat-arched feet classified radiographically were detected using the OFM. People with flat-arched feet demonstrated greater peak plantar-flexion and abduction of the forefoot and internal rotation of the rearfoot during late stance phase. Moreover, decreased peak forefoot adduction and a trend towards increased rearfoot eversion were also found for this group. These findings support the notion that flat-arched feet have altered motion

Acknowledgements

This study was funded by the Australian Podiatry Education and Research Foundation (APERF). The authors would like to thank Gabriele Paolini from Vicon Motion System Ltd. for his assistance and support of this project. H.B.M. is currently a National Health and Medical Research Council fellow (Clinical Career Development Award, ID: 433049).

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