Segmental foot and ankle kinematic differences between rectus,planus, and cavus foot types

The presence of multiple foot types has been used to explain the variability of foot structure observed among healthy adults. These foot types were determined by specific static morphologic features and included rectus (well aligned hindfoot/forefoot), planus (low arched), and cavus (high arched) foot types. Unique biomechanical characteristics of these foot types have been identified but reported differences in segmental foot kinematics among them has been inconsistent due to differences in neutral referencing and evaluation of only select discrete variables. This study used the radiographically-indexed Milwaukee Foot Model to evaluate differences in segmental foot kinematics among healthy adults with rectus, planus, and cavus feet based on the true bony alignment between segments. Based on the definitions of the individual foot types and due to conflicting results in previous literature, the primary study outcome was peak coronal hindfoot position during stance phase. Additionally, locally weighted regression smoothing with alpha-adjusted serial t-test analysis (LAAST) was used to compare these foot types across the entire gait cycle. Average peak hindfoot inversion was −1.6° ± 5.1°, 6.7° ± 3.5°, and 13.6° ± 4.6°, for the Planus, Rectus, and Cavus Groups, respectively. There were significant differences among all comparisons. Differences were observed between the Rectus and Planus Groups and Cavus and Planus Groups throughout the gait cycle. Additionally, the Planus Group had a premature peak velocity toward coronal varus and early transition toward valgus, likely due to a deficient windlass mechanism. This assessment of kinematic data across the gait cycle can help understand differences in dynamic foot function among foot types.     

Natural gaits of the non-pathological flat foot and high-arched foot

There has been a controversy as to whether or not the non-pathological flat foot and high-arched foot have an effect on human walking activities. The 3D foot scanning system was employed to obtain static footprints from subjects adopting a half-weight-bearing stance. Based upon their footprints, the subjects were divided into two groups: the flat-footed and the high-arched. The plantar pressure measurement system was used to measure and record the subjects' successive natural gaits. Two indices were proposed: distribution of vertical ground reaction force (VGRF) of plantar and the rate of change of footprint areas. Using these two indices to compare the natural gaits of the two subject groups, we found that (1) in stance phase, there is a significant difference (p<0.01) in the distributions of VGRF of plantar; (2) in a stride cycle, there is also a significant difference (p<0.01) in the rate of change of footprint area. Our analysis suggests that when walking, the VGRF of the plantar brings greater muscle tension to the flat-footed while a smaller rate of change of footprint area brings greater stability to the high-arched.     

Trunk kinematic,kinetic, and neuro-muscular response to foot center of pressure translation along the medio-lateral foot axis during gait

Footwear devices that shift foot center of pressure (COP), thereby impacting lower-limb biomechanics to produce clinical benefit, have been studied regarding degenerative diseases of knee and hip joints, exhibiting evidence of clinical success. Ability to purposefully affect trunk biomechanics has not been investigated for this type of footwear. Fifteen healthy young male subjects underwent gait and electromyography analysis using a biomechanical device that shifts COP via moveable convex elements attached to the shoe sole. Analyses were performed in three COP configurations for pairwise comparison: (1) neutral (control) (2) laterally deviated, and (3) medially deviated. Sagittal and frontal-plane pelvis and spine kinematics, external oblique activity, and frontal and transverse-plane lumbar moments were affected by medio-lateral COP shift. Transverse-plane trunk kinematics, activity of the lumbar longissimus, latissimus dorsi, rectus abdominus, and quadratus lumborum, and sagittal-plane lumbar moment, were not significantly impacted. Two linear mixed effects models assessed predictive impact of (I) COP location, and (II) trunk kinematics and neuromuscular activity, on the significant lumbar moment parameters. The COP was a significant predictor of all modeled frontal and transverse-plane lumbar moment parameters, while pelvic and spine rotation, and lumbar longissimus activity were significant predictors of one frontal-plane lumbar moment parameter. Model results suggest that, although trunk biomechanics and muscle activity were altered by COP shift, COP offset influences lumbar kinetics directly, or via lower-limb changes not assessed in this study, but not by means of alteration of trunk kinematics or muscle activity. Further study may reveal implications in treatment of low back pain.     

Estimation of sex from the dimensions of foot, footprints, and shoe

This study intends to determine if the sex of an individual can be identified by foot lengths, shoe lengths, and/or footprints. For this purpose, foot length, foot breadth, and foot heel breadth of 506 subjects, comprising 253 females and 253 males ranging from 17.56 to 82.92 years of age, were taken. In addition, the footprints (length, breadth, and heel breadth) and footwear (length and breadth) of the same subjects were measured. Finally, the shoe size of the subjects was recorded. Univariate and multivariate discriminant function models were developed for sex allocations. Statistical analyses indicated that univariate models correctly assign approximately 67-94% of individuals to their correct sex groups. Among univariate models the most reliable measurement was shoe length. The results of multivariate models were better than those of univariate ones, with an approximately 82-96% correct assignment. The best multivariate model was comprised of four variables: foot length, shoe length, shoe breadth and shoe size. It could be suggested that these discriminant functions can provide useful clues to establish personal identity whenever complete or partial feet, footprints, or footwear are recovered.     

Diabetic foot infections: fate of the contralateral foot

Following an initial report urging conservative management of severe diabetic foot infections, the authors have managed 45 patients with a minimum 3-year follow-up. By using standard principles for soft-tissue infection, 78 percent of the patients healed minor amputation sites and maintained biped ambulation following the initial foot involvement. Only 22 percent required a major amputation at the time of the initial foot involvement. The 45 patients were followed and 22 (or 49 percent) developed a severe infection involving the contralateral foot within 18 months. Although 15 of the 22 patients developing contralateral infection (or 33 percent of the total series) required some type of amputation on the contralateral foot, the conservative approach allowed 64 percent of the patients with severe infections in both feet to maintain biped ambulation. This included 40 percent of the patients who required amputation of some portion of both feet.     

The tempo of human childhood: a maternal foot on the accelerator,a paternal foot on the brake

Relative to the life history of other great apes, that of humans is characterized by early weaning and short interbirth intervals (IBIs). We propose that in modern humans, birth until adrenarche, or the rise in adrenal androgens, developmentally corresponds to the period from birth until weaning in great apes and ancestral hominins. According to this hypothesis, humans achieved short IBIs by subdividing ancestral infancy into a nurseling phase, during which offspring fed at the breast, and a weanling phase, during which offspring fed specially prepared foods. Imprinted genes influence the timing of human weaning and adrenarche, with paternally expressed genes promoting delays in childhood maturation and maternally expressed genes promoting accelerated maturation. These observations suggest that the tempo of human development has been shaped by consequences for the fitness of kin, with faster development increasing maternal fitness at a cost to child fitness. The effects of imprinted genes suggest that the duration of the juvenile period (adrenarche until puberty) has also been shaped by evolutionary conflicts within the family.     

A biomechanical model of the foot: the role of muscles,tendons, and ligaments

A biomechanical model of the foot is developed and analyzed to determine the distribution of support under the metatarsal heads, the tension in the plantar aponeurosis, and the bending moment at each of the joints of the foot. This model is an extension of our earlier work to include the role of muscles, tendons, and ligaments. Two cases are presented: in the first the center of gravity of the body is over the mid foot, and in the second, the center of gravity is anterior, over the metatarsals, and no support is provided by the heel. The model shows the extent to which the muscles reduce the force in the supporting ligaments at each of the joints and decrease the tension in the plantar aponeurosis, and that this effect is more pronounced when the center of gravity of the body is moved forward.     

Elastic properties of the hind foot of the Donkey, Equus asinus

The elastic properties of the hind feet of Donkeys, and of tendons removed from the feet, have been investigated by methods similar to those used in a previous study of the forefoot. The elastic strain energy stored in the foot, during a trotting step, is calculated to be approximately the optimum which would minimize the work required of the muscles in this gait.     

Analysis of the human and ape foot during bipedal standing with implications for the evolution of the foot

The ratio of the power arm (the distance from the heel to the talocrural joint) to the load arm (that from the talocrural joint to the distal head of the metatarsals), or RPL, differs markedly between the human and ape foot. The arches are relatively higher in the human foot in comparison with those in apes. This study evaluates the effect of these two differences on biomechanical effectiveness during bipedal standing, estimating the forces acting across the talocrural and tarsometatarsal joints, and attempts to identify which type of foot is optimal for bipedal standing. A simple model of the foot musculoskeletal system was built to represent the geometric and force relationships in the foot during bipedal standing, and measurements for a variety of human and ape feet applied. The results show that: (1) an RPL of around 40% (as is the case in the human foot) minimizes required muscle force at the talocrural joint; (2) the presence of an high arch in the human foot reduces forces in the plantar musculature and aponeurosis; and (3) the human foot has a lower total of force in joints and muscles than do the ape feet. These results indicate that the proportions of the human foot, and the height of the medial arch are indeed better optimized for bipedal standing than those of apes, further suggesting that their current state is to some extent the product of positive selection for enhanced bipedal standing during the evolution of the foot.     

Age-related changes of the bones of the leg, foot and ankle joint in pole-vaulters

The data on age changes occurring in the height of the articular cleft of the talocrural joint, in morphological components of the diaphysis of the crus and foot bones have been presented in pole-jumpers and in non-sportsmen at the age of 13-21 years. Roentgenological, roentgenogrammetric and x-ray densitometric methods have been used. At the age of 14-15 years the greatest changes in the talocrural joint, crus and foot bones are noted.