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Kinematic coupling between the foot and lower limb during gait

By Michael Bernhard Pohl

Abstract

INTRODUCTION:\ud \ud Abnormal kinematic coupling between the foot and lower limb has been associated with chronic overuse injuries of the lower extremity during running. However, the normal coupling relationship between the two segments remains\ud unclear. The equivocal findings in the literature may be due to previous studies concentrating on determining coupling at discrete instances only, along with the\ud failure to include the midtarsal joint in coupling analyses. By including motion across the midtarsal joint and measures of continuous coupling, this research aimed to gain a more complete understanding of the relationship between foot and lower limb kinematics during gait.\ud \ud METHODS: \ud \ud Following the development of a multi-segment foot model, in-vitro and invivo studies were conducted to assess the validity and reliability of determining foot and lower limb segmental kinematics during gait. Three experiments were then undertaken to assess the rigidity of the kinematic coupling between the forefoot, rearfoot and shank by manipulating step width, running speed, foot strike pattern and mode of gait (run versus walk). Kinematic coupling was assessed by determining how well matched the angular displacements of two adjacent segments (e. g rearfoot\ud eversion/inversion with shank intemal/external rotation) were in both spatial and temporal terms using both discrete point and cross correlation analyses.\ud \ud RESULTS: \ud \ud Although the in-vitro study suggested care should be taken when interpreting data obtained from skin mounted markers the modelling and analysis approach used in-vivo was found to have good within- and between-day reliability. In all conditions it was evident that following touchdown, the shank internally rotated, the rearfoot everted and the forefoot dorsiflexed and abducted. This was followed by the reversal of the segmental angular displacements starting with that of the shank, followed by the rearfoot and then the forefoot. During running, coupling between rearfoot\ud eversion/inversion and shank internal/external rotation was consistently high (r > 0.92) regardless of step width, speed or foot strike pattern. In walking, however, this\ud coupling value was low (r = 0.49). Rearfoot eversion/inversion was also highly coupled with both forefoot dorsiflexion/plantarflexion and abduction/adduction in running and walking. However, there was little evidence of any coupling between rearfoot eversion/inversion and forefoot eversion/inversion.\ud \ud CONCLUSION: \ud \ud The consistently high kinematic coupling between the rearfoot and shank during running suggests a robust coupling mechanism that is able to withstand changes in the loading of the subtalar joint. However, lower coupling between these two segments in walking, implies that the relationship is not entirely rigid and some degree of elasticity exists at the subtalar joint. Strong coupling of forefoot sagittal and transverse plane motions with rearfoot frontal plane motion during running and\ud walking suggests the two segments are linked via the action of the midtarsal joint. From the timings of discrete kinematic events it appeared that shank external rotation\ud was driving rearfoot inversion and that this in turn was causing the forefoot to plantarflex and abduct. This implies that a kinetic chain exists with proximal\ud segments driving motion of the distal segments during propulsion.\ud \ud IMPLICATIONS: \ud \ud If the proximal segments drive the motion of the foot then injuries associated with excessive or prolonged pronation should not only be treated using orthoses, but also by using interventions to modify the kinematics of the joints\ud proximal to the ankle-joint-complex. Future work should determine the effects of muscle stiffness on subtalar joint kinematics since this may have important implications in terms of lower extremity injuries

Publisher: Institute of Membrane and Systems Biology (Leeds)
Year: 2006
OAI identifier: oai:etheses.whiterose.ac.uk:812

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Citations

  1. 1). Kinematic analysis of a multi-segment foot model for research and clinical applications: a repeatability analysis. doi
  2. (1987). A biomechanical analysis of the talocalcaneal joint - in vitro. doi
  3. (2001). A closed-loop cadaveric foot and ankle loading model. doi
  4. (1998). A comparison of three-dimensional lower extremity kinematics during running between excessive pronators and normals. doi
  5. (2002). A comparison of within- and between-day reliability of discrete 3D lower extremity variables in runners. doi
  6. (1998). A dynamic cadaver model of the stance phase of gait: performance characteristics and kinetic validation. doi
  7. (1999). A dynamical systems approach to lower extremity running injuries. doi
  8. (1997). A method to determine bone movement in the ankle joint complex in vitro. doi
  9. (2001). a). Lower extremity kinematic and kinetic differences in runners with high and low arches.
  10. (1999). An anatomically based protocol for the description of foot segment kinematics during gait. doi
  11. (1997). Anatomical factors associated with overuse sports injuries. Sports Medicine, doi
  12. (2004). Ankle and subtalar kinematics measured with intracortical pins during the stance phase of walking.
  13. (2001). Arch structure and injury patterns in runners. doi
  14. (1999). Asynchrony between subtalar and knee joint function during running. doi
  15. (1990). Athletic footwear and chronic overloading -a brief review. Sports Medicine, doi
  16. (1999). Basic Biomechanics, Third Edition.
  17. (2000). Biomechanical analysis of the stance phase during barefoot and shod running. doi
  18. (1990). Biomechanical aspects of distance running injuries. In
  19. (2005). Biomechanics and Motor Control of Human Movement, Third Edition. doi
  20. (1996). Biomechanics of iliotibial band friction syndrome in runners. doi
  21. (1995). Biomechanics of running. In doi
  22. (1985). Biomechanics of the foot in walking: a function approach. doi
  23. (1999). Coefficient of cross correlation and the time domain correspondence. doi
  24. (1995). Comparison of 2-dimensional and 3-dimensional rearfoot motion during walking. doi
  25. (2002). Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain.
  26. (2000). Comparison of surface mounted markers and attachment methods in estimating tibial rotations during walking: an in vivo study. Gait and Posture, doi
  27. (2000). Contributions of proximal and distal moments to axial rotation during walking and running. doi
  28. (2002). Does running on a cambered road predispose a runner to injury?
  29. (1994). Dynamic loading of the plantar aponeurosis in walking.
  30. (2002). Effect of foot orthoses on 3-dimensional kinematics of flatfoot: a cadaveric study. doi
  31. (2005). Effect of foot orthotics on rearfoot and tibia joint coupling patterns and variability. doi
  32. (2003). Effect of inverted orthoses on lower-extremity mechanics in runners. doi
  33. (2002). Effect of normalization and phase angle calculations on continuous relative phase. doi
  34. (1998). Effect of shoe insert construction on foot and leg movement. doi
  35. (1993). Effects of arch height of the foot on angular motion of the lower extremities in running. doi
  36. (2000). Effects of foot orthoses on skeletal motion during running. doi
  37. (2001). Effects of shoe sole construction on skeletal motion during running. doi
  38. Etiologic factors associated with anterior knee pain in distance runners. doi
  39. Etiological factors associated with patellofemoral pain in runners. doi
  40. (1988). Etiological factors associated with selected running injuries. doi
  41. (1994). Evaluation of time-series data sets using the Pearson product- moment correlation-coefficient. doi
  42. (2001). Experimental flatfoot model: the contribution of dynamic loading.
  43. (1995). Foot and ankle linkage system. In
  44. (1977). Foot and Ankle Linkage System. Los Angeles: Clinical Biomechanics Corporation.
  45. (2002). Foot type classification: a critical review of current methods. doi
  46. (1995). Freeze clamping musculotendinous junctions for in-vitro simulation of joint mechanics. doi
  47. (1996). Gait Analysis: An Introduction, Second Edition.
  48. (1992). Gait Analysis: Normal and Pathological Function. Thorofare: doi
  49. (1980). Ground reaction forces in distance running. doi
  50. (2005). High-speed non-invasive measurement of tibial rotation during the impact phase of running. doi
  51. (1981). Human Walking. doi
  52. (2004). Identification of individuals with patellofemoral pain whose symptoms improved after a combined program of foot orthosis use and modified activity: a preliminary investigation. Physical Therapy,
  53. (1987). Injuries in runners. doi
  54. (2003). Introduction to Human Anatomy and Physiology, 2nd Edition.
  55. (1995). ISB recommendations for standardization in the reporting of kinematic data. doi
  56. (1997). Joint Kinematics. In
  57. (1983). Kinematic analysis of the tarsal joints. Acta Orthopaedica Scandinavica Supplement,
  58. (2002). Kinematic behavior of the ankle following malleolar fracture repair in a high-fidelity cadaver model.
  59. (1999). Kinematics of Human Motion. Champaign: Human Kinetics.
  60. (1989). Kinematics of the ankle and foot: in vivo roentgen stereophotogrammetry. Acta Orthopaedica Scandinavica Supplement, doi
  61. (2002). Kinematics of the midtarsal joint during standing leg rotation. doi
  62. (1992). Kinesiology: Scientific Basis of Human Motion.
  63. (1997). Lower extremity alignment and risk of overuse injuries in runners. doi
  64. (2004). Lower extremity joint coupling during running: a current update. doi
  65. (2000). Lower extremity mechanics in runners with a converted forefoot strike pattern.
  66. (1989). Mechanisms of shock attenuation via the lower extremity during running. doi
  67. (2002). Motion of the calcaneus, navicular, and first metatarsal during the stance phase of walking. doi
  68. (1990). Muscle-Fiber Architecture in the Human Lower-Limb. doi
  69. (1983). Normative data of knee joint motion and ground reaction forces in adult level walking. doi
  70. (1999). On skin movement artefact-resonant frequencies of skin markers attached to the leg. Human Movement Science, doi
  71. (2004). Orthotic intervention in forefoot and rearfoot strike running patterns. doi
  72. (1964). Phasic activity of intrinsic muscles of the foot.
  73. (1995). Position and orientation in sPace of bones during movement: anatomical frame definition and determination. doi
  74. (1996). Position and orientation in space of bones during movement: experimental artefacts. doi
  75. (1997). Preferred placement of the feet during quiet stance: Development of a standardized foot placement for balance testing. doi
  76. (1996). Proficiency of foot care specialists to place the reafoot at subtalar neutral. doi
  77. (1998). Pronation in runners: implications for injuries. Sports Medicine, doi
  78. (1993). Quadriceps angle and rearfoot motion: relationships in walking.
  79. (1990). Rearfoot motion in distance running. In
  80. (1994). Relationship between foot placement and mediolateral ground reaction forces during running. doi
  81. (1999). Relationship between foot pronation and rotation of the tibia and femur during walking. doi
  82. (2003). Relative motions of the tibia, talus, and calcaneus during the stance phase of gait: a cadaver study. Gait and Posture, doi
  83. (1989). Repeatability of kinematic, kinetic, and electromyographic data in non-nal adult gait. doi
  84. (1997). Repeated measures of adult normal walking using a video tracking system. doi
  85. (1980). Rigid body motion calculated from spatial co-ordinates of markers. doi
  86. (2003). Risk factors for lower extremity injury: a review of the literature. doi
  87. (1992). Running injuries: a review of the epidemiological literature. Sports Medicine, doi
  88. (1996). Skeletal Anatomy, Third Edition.
  89. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. doi
  90. (2003). Subtalar and knee joint interaction during running at various stride lengths.
  91. (1998). Support of the talus: A biomechanical investigation of the contributions of 194 the talonavicular and talocalcaneal joints, and the superomedial calcaneonavicular ligament. doi
  92. (1998). The biomechanics of running. doi
  93. (1996). The Biomechanics of the Foot and Ankle, Second Edition.
  94. (1987). The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model. doi
  95. (1998). The effect of foot structure on the three-dimensional kinematic coupling behaviour of the leg and rear foot. Physical Therapy,
  96. (2001). The effect of posterior tibial tendon dysfunction on hindfoot kinematics.
  97. (1990). The effect of running velocity on rearfoot motion and mediolateral placement of the feet: Unpublished Master's Thesis. In
  98. (2004). The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. doi
  99. (1998). The influence of foot abduction on differences between two- dimensional and three-dimensional rearfoot motion. doi
  100. (1999). The influence of heel fit on rearfoot motion in running shoes.
  101. (1976). The Joints of the Ankle.
  102. (1953). The mechanics of the foot. 1. The Joints.
  103. (1954). The mechanics of the foot. 11. The plantar aponeurosis and the arch.
  104. (1992). The movement of the heel within a running shoe. doi
  105. (1997). The relationship between subtalar and knee joint function as a possible mechanism for running injuries. doi
  106. (1998). The relative skin movement of the foot: a 2-D roentgen photogrammetry study. doi
  107. (1988). The three-dimensional kinematics and flexibility characteristics of the human ankle and subtalar joints - part 1: kinematics. doi
  108. (1989). The torsion of the foot in running.
  109. (1960). The transverse tarsal joint and its control.
  110. (2002). Three-dimensional kinematics at the ankle joint complex in rheumatoid arthritis patients with painful valgus deformity of the rearfoot. doi
  111. (1996). Three-dimensional kinematics of the rearfoot during the stance phase of walking in normal young adult males. doi
  112. (1997). Three-dimensional, sixdegrees -of-freedom kinematics of the human hindfoot during the stance phase of level walking. doi
  113. (1999). Threedimensional kinematics of the forefoot, rearfoot, and leg without the function of tibialis posterior in comparison with normals during stance phase of walking. doi
  114. (1990). Threedimensional measurement of rearfoot motion during running. doi
  115. (2000). Tibiocalcaneal kinematics of barefoot versus shod running. doi
  116. (1992). Timing of lower-extremity joint actions during treadmill running. doi
  117. (1994). Transfer of movement between calcaneus and tibia in vitro. doi
  118. (1998). Two reconstructive techniques for flatfoot deformity comparing contact characteristics of the hindfoot joints. doi
  119. (2004). Validation of a multisegment foot and ankle kinematic model for pediatric gait. doi

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