The relationship of static foot structure to dynamic foot function

doi:10.1016/S0021-9290(96)00136-4

Journal of Biomechanics

Volume 30, Issue 3, March 1997, Pages 243-250

https://doi.org/10.1016/S0021-9290(96)00136-4 Get rights and content

Abstract

Many theories have been advanced concerning the relationship between structure and function in the human foot, yet few of these theories have been subjected to quantitative examination. In this study, foot structure was characterized by 27 measurements taken from standardized lateral and dorsi-plantar weight-bearing plain radiographs of 50 healthy adult subjects. regional plantar pressure distribution data collected from the same feet were chosen as the functional measures. A stepwise regression analysis was performed to (1) explore what portion of the variance in peak plantar pressure during walking can be explained by the radiographic measurements, and (2) identify structural characteristics of the foot which are significant predictors of peak plantar pressure under the heel and the first metatarsal head (MTH1).

Most of the radiographic measurements were highly reliable. However, only 31 and 38% of the variance in peak plantar pressure at the heel and MTH1, respectively, could be explained using multiple regression analyses with the radiographic measurements as independent variables. Among the structural predictors that were identified, soft tissue thickness (e.g. calcaneus or sesamoid heights), and arch-related measurements were the strongest predictors of plantar pressure under both the heel and the first metatarsal head. We conclude that, in normal subjects, only about 35% of the variance in dynamic plantar pressure can be explained by the measurements of foot structure derived from radiographs. This implies that the dynamics of gait are likely to exert the major influence on plantar pressure during walking.

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Forefoot pain is a common symptom for several foot problems. This study aimed to determine whether parameters of forefoot structure (hallux valgus angle (HVA), transverse arch height (TAH) and sesamoid rotation angle (SRA)) are associated with forefoot pain. 547 feet of adult women were divided into two groups: without pain (n = 472) and with pain (n = 75). HVA was measured with a goniometer, TAH and SRA were measured using a weight bearing plantar ultrasound imaging device.Associations between forefoot pain and parameters of forefoot structure were analyzed using the Mann-Whitney U test and univariate and multivariate logistic regression analyses. The intra-rater and inter-rater reliability of the ultrasound images were also tested. SRA was significantly greater in the group with pain compared to the group without pain (p = 0.031) but not HVA (p = 0.057) nor TAH (p = 0.117). The association between forefoot pain and SRA was significant (univariate: p = 0.015 and multivariate p = 0.015), but not between HVA nor TAH. The intra-rater and inter-rater reliability were almost perfect (SRA: ICC1,1 = 0.94, ICC2,1 = 0.91 and TAH: ICC1,1 = 0.88, ICC2,1 = 0.81). We conclude that a higher SRA is related to forefoot pain and should be taken into consideration for assessment of patients with forefoot pain.
Arch-related alteration in foot loading patterns affected by the increasing extent of body mass index in children: A follow-up study
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A high load on children 's feet can cause arch deformation and negatively affect their normal development. Studies have yet to document how the foot arch varied with different body mass index (BMI) increments and its influence on foot loading patterns.
Barefoot walking trails were conducted using a Footscan® plate system. A follow-up check was performed after twenty-four months. Participants were selected with an initial BMI between 14.5 kg/m² and 16.5 kg/m². Totally 75 participants were classified into groups 0–7 according to the BMI increment levels of 0–0.49 kg/m², 0.50–1.49 kg/m², 1.50–2.49 kg/m², 2.50–3.49 kg/m², 3.50–4.49 kg/m², 4.50–5.49 kg/m², 5.50–6.49 kg/m², 6.50–7.49 kg/m², respectively. Paired t-tests and effect sizes were used to compare the data.
The arch index significantly decreased when the BMI reached 20.8 kg/m². Significantly increased normalized maximum forces were found in the great toe and 1st MTPJ in groups 4–5. Meanwhile, the absence of significance showed under the 3rd-5th, midfoot, and rearfoot in those groups. The normalized maximum force increments under the 3rd-5th MTPJs, midfoot and rearfoot regions in groups 4–5 after the follow-up study were significantly decreased compared with the increments found in groups 0–3, followed by a sudden increase arising under those regions in group 6. It indicates a transition period that leads to alteration in gait pattern characteristics when BMI increases to 18.6–19.9 kg/m² (between group 3 and group 4). Group 6 displayed significantly increased peak pressure amplitudes under the great toe, 1st-3rd MTPJs, midfoot, and medial rearfoot compared to other groups.
There was a transition period when the BMI of normal-weighted children increased to a certain extent and failed to reach the obesity level, resulting in changes in foot arch structure and loading patterns.
Effect of Simulated Bone Resorption on the Biomechanical Performance of Intramedullary Devices for Foot and Ankle Arthrodesis
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Midfoot and subtalar arthrodesis surgeries are performed to correct foot deformities and relieve arthritic pain. These procedures often employ intramedullary (IM) devices. The aim of the present study was to evaluate the biomechanical performance of a sustained dynamic compression (SDC) IM device compared to mechanically static devices in withstanding the effects of simulated bone resorption. Mechanically static and SDC IM devices were implanted in simulated bone blocks (n = 5/device). Compressive loads were measured with a custom-made mechanism to simulate bone resorption. The construct bending stiffness was determined from a 4-point bend test. Resorption was simulated by cutting a 1 mm or 2 mm gap in the midpoint of each construct and repeating the loading (n = 6/device). Initial compressive loads after device insertion were greater in the SDC IM devices when compared to the static devices (p < .01). The SDC device was able to sustain compression from 2 mm to 5.5 mm of simulated resorption depending upon device length, while the static devices lost compression within 1 mm of simulated resorption regardless of implant length (p < .001). In the 4-point bend test, the SDC device maintained its bending stiffness during simulated resorption whereas the static device displayed a significant loss in bending stiffness after 1 mm of simulated resorption (p < .001). The SDC device exhibited a significantly higher bending stiffness than the static device (p < .001). The SDC IM device demonstrated superior biomechanical performance during simulated resorption compared to static devices (p < .001). In conclusion, the ability of SDC IM devices to maintain construct stability and sustain compression across the fusion site while adapting to bone resorption may lead to greater fusion rates and overall quicker times to fusion than static IM devices. Surgeons who perform midfoot and subtalar arthrodesis procedures should be aware of a device's ability to sustain compression, especially in cases where bone resorption and joint settling are prevalent postoperatively.
A three-dimensional finite element foot-ankle model and its personalisation methods analysis
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Foot and ankle injuries are common as a result of overuse or trauma as well as various pathologies. This study aims to establish a three-dimensional foot-ankle model and investigate its suitability personalisation for the analysis of foot-ankle biomechanical responses during dynamic gait loading. The model was first established based on medical images and validated in both static standing posture and dynamic gait loading concerning regional plantar pressures and the centre of pressure curve (COP). Then, two model personalisation methods using magnetic resonance imaging (MRI) and fast optical scan data, respectively, were investigated and compared through analysing the dynamic gait responses of the scaled models. In both methods, material personalisation of plantar tissues was also combined through supersonic shear wave elastography (SWE) measurements. With regard to plantar pressure distribution and internal soft tissue strain, both personalisation methods correlated well with the subject-specific experimental results. Thus, we believe that the present model, with a fast optical scan personalisation method of specific SWE measurement, is a reasonable arrangement for subject-specific plantar deformation behaviour analysis during dynamic gait loading.
Long-term follow-up of children with a surgically treated clubfoot: Assessing the multi-segment-foot motions, dynamic plantar pressures, and functional outcomes
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The purpose of this study was to compare surgically treated clubfoot with typically developing (TD) children using plantar pressure, multi-segment-foot kinematic analysis, and multiple functional outcomes in comprehensive and long-term study. Methods: 26 patients with 45 clubfeet and 23 TD children with 45 normal feet were evaluated. Most clubfoot patients had a complete subtalar release and a few patients had a posterior medial-lateral release at the mean age of 5 years and 6 months. The mean age at follow-up for clubfoot was 12 years and 5 months. Subjects underwent physical and radiographic examination, plantar pressure analysis, multi-segment-foot motion analysis, AAOS Foot & Ankle Questionnaire (AAOS-FAQ), the Pediatric Outcomes Data Collection Instrument (PODCI), and the Child Behavior Checklist (CBCL).
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This study supports evidence that surgically treated clubfoot continues to have residual deformity of forefoot, overcorrection of hindfoot, stiffness, and a decrease in physical functioning. This comprehensive study accurately portrays postsurgical clubfoot function with objective means through appropriate technologies. A plantar pressure redistributed and finite element analysis designed orthosis may be of importance in the improvement of the foot and ankle joint function for ambulatory children with a relapse of clubfoot deformity.
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The morphology and function of the human foot vary significantly across individuals, generally a result of the underlying musculoskeletal structures. While these are continuous, multi-dimensional spectrums, for clinical and anatomical ease of categorization, feet are generally grouped into three types: cavus (high arched), neutral, or planus (flatfoot). This chapter provides an overview of these foot types, reviewing their structural and functional differences, as well as the tools that are used to help define each type. An overview of the biomechanics of different foot types will be presented. Associations between foot type and clinical problems along with potential treatments will be covered. Future areas of research will also be discussed.

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The relationship of static foot structure to dynamic foot function

Abstract

J. biomed. Engng

The assessment of dynamic foot-to-ground contact forces and plantar pressure distribution: a review of the evolution of current techniques and clinical applications

Foot Ankle

Dynamic foot pressure and other studies as diagnostic and management aids in diabetic neuropathy

Diabetes Care

Quantifying magnification in pedal radiographs

J. Am. Podiat. Med. Assoc.

Radiographic abnormalities in the feet of patients with diabetic neuropathy

Diabetes Care

Plantar pressure measurements and the prevention of ulceration in the diabetic foot

J. Bone Jt Surg.

The effect of shortness of the first metatarsal bone on foot function

Res. Q.

Sonography of the sole of the foot: evidence for loss of foot pad thickness in diabetes and its relationship to ulceration of the foot

Invest. Radiol.

Biomechanical considerations of the diabetic foot

A clinician's view of foot pressure: a comparison of three different methods of measurement

Foot Ankle

Injuries to runners

Am. J. Sports Med.