Search

Background: Understanding midfoot joint kinetics is valuable for improved treatment of foot pathologies. Segmental foot kinetics cannot currently be obtained in a standard gait lab without the use of multiple force plates or a pedobarographic plate overlaid with a force plate due to the single ground reaction force (GRF) vector., Research Question: Can an algorithm be created to distribute the GRF into multiple segmental vectors that will allow for calculation of accurate midfoot and ankle moments?, Methods: 20 pediatric subjects (10 typically developing, 10 with foot pathology) underwent multi-segment foot gait analysis using the Milwaukee Foot Model. A novel force distribution algorithm (FDA) was developed to proportionally divide the GRF into segmental vectors based on the location of the center of pressure and these vectors were used to calculate midfoot and ankle moments with an inverse dynamic approach. FDA GRF segmental vectors and midfoot/ankle moments were compared to metrics obtained from a previously validated pedobarographic plate methodology using correlations, statistical parametric mapping, and effect size with 95 % confidence intervals., Results: All force distributions and midfoot/ankle moments waveforms were highly correlated with R> 0.99 for hindfoot and forefoot forces, R> 0.99 for sagittal and transverse plane moments, and R> 0.95 for coronal plane moments. No statistical differences were found during 2nd rocker where the FDA was applied., Significance: Midfoot and ankle moments can be accurately obtained with our algorithm using standard equipment utilized in clinical and research motion analysis labs without the requirement of additional trials, or targeted walking by patients., Competing Interests: Declaration of Competing Interest Authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: While wearing shoes is common in daily activities, most foot kinematic models report results on barefoot conditions. It is difficult to describe foot position inside shoes. This study used fluoroscopic images to determine talocrural and subtalar motion., Research Question: What are the differences in sagittal talocrual and subtalar kinematics between walking barefoot and while wearing athletic walking shoes?, Methods: Thirteen male subjects (mean age 22.9 ± 2.9 years, mean weight 77.2 ± 6.9 kg, mean height 178.2 ± 3.7 cm) screened for normal gait were tested. A fluoroscopy unit was used to collect images during stance. Sagittal motion of the talocrural and subtalar joints of the right foot were analyzed barefoot and in an athletic walking shoe., Results: Shod talocrural position at heel strike was 6.0° of dorsiflexion and shod peak talocrural plantarflexion was 4.2°. Barefoot talocrural plantarflexion at heel strike was 4.2° and barefoot peak talocrural plantarflexion was 10.9°. Shod subtalar position at heel strike was 2.6° of plantarflexion and peak subtalar dorsiflexion was 1.5°. The barefoot subtalar joint at heel strike was in 0.4° dorsiflexion and barefoot peak subtalar dorsiflexion was 3.5°. As the result of wearing shoes, average walking speed and stride length increased and average cadence decreased. Comparing barefoot to shod walking there was a statistical significance in talocrural dorsiflexion and at heel strike and peak talocrural dorsiflexion, subtalar plantarflexion at heel strike and peak subtalar dorsiflexion, walking speed, stride length, and cadence., Significance: This work demonstrates the ability to directly measure talocrural and subtalar kinematics of shod walking using fluoroscopy. Future work using this methodology can be used to increase understanding of hindfoot kinematics during a variety of non-barefoot activities., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Kinematic variability of the foot and ankle segments exists during ambulation among individuals with pes planovalgus (PPV) secondary to cerebral palsy (CP). Clinicians have previously recognized such variability through classification schemes to identify subgroups of individuals, but have been unable to identify kinematic foot types., Research Question: The purpose of this work was to identify kinematic foot types among children with PPV secondary to CP using 3-dimensional multi-segment foot and ankle kinematics during gait as inputs for principal component analysis (PCA) and K-means cluster analysis., Methods: In a single assessment session, multi-segment foot and ankle kinematics using the Milwaukee Foot Model (MFM) were collected in 31 children/adolescents with pes planovalgus (49 feet) and 16 typically developing (TD) children/adolescents (31 feet). PCA was used as a data reduction technique on 34 kinematic variables. K-means cluster analysis was performed on the identified principal components (PCs) and one-way analyses of variance (ANOVA) was done to determine the effect of subgroup membership on PC scores., Results: The PCA reduced the kinematic variables to seven PCs which accounted for 91% of the total variance. Six distinct kinematic foot types were identified by the cluster analysis. The foot types showed unique kinematic characteristics in both the hindfoot and forefoot., Significance: This study provides further evidence of kinematic variability in the foot and ankle during ambulation associated with pes planovalgus secondary to CP. The specific contributions of the hindfoot and forefoot would not have been detected using a single segment foot model. The identification of kinematic foot types with unique foot and ankle characteristics has the potential to improve treatment since patients within a foot type are likely to benefit from similar intervention(s)., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Pes planovalgus (flatfoot) is a common deformity among children with cerebral palsy. The Milwaukee Foot Model (MFM), a multi-segmental kinematic foot model, which uses radiography to align the underlying bony anatomy with reflective surface markers, was used to evaluate 20 pediatric participants (30feet) with planovalgus secondary to cerebral palsy prior to surgery. Three-dimensional kinematics of the tibia, hindfoot, forefoot, and hallux segments are reported and compared to an age-matched control set of typically-developing children. Most results were consistent with known characteristics of the deformity and showed decreased plantar flexion of the forefoot relative to hindfoot, increased forefoot abduction, and decreased ranges of motion during push-off in the planovalgus group. Interestingly, while forefoot characteristics were uniformly distributed in a common direction in the transverse plane, there was marked variability of forefoot and hindfoot coronal plane and hindfoot transverse plane positioning. The key finding of these data was the radiographic indexing of the MFM was able to show flat feet in cerebral palsy do not always demonstrate more hindfoot eversion than the typically-developing hindfoot. The coronal plane kinematics of the hindfoot show cases planovalgus feet with the hindfoot in inversion, eversion, and neutral. Along with other metrics, the MFM can be a valuable tool for monitoring kinematic deformity, facilitating clinical decision making, and providing a quantitative analysis of surgical effects on the planovalgus foot., (Copyright © 2017 Elsevier B.V. All rights reserved.)