Purpose: The intervention of 12 week gait retraining with minimalist shoes was established to examine its effect on impact forces, joint mechanics, and vertical stiffness during running. Methods: Thirty male recreational runners were randomly assigned to the gait retraining + minimalist shoe (n = 15, GR) and minimalist shoe (n = 15, MIN) groups. The ground reaction force and marker trajectories were collected before and after intervention at a speed of 3.33 ± 5% m/s. Results: A total of 17 participants (9 in the GR group and 8 in the MIN group) completed the training. After training, (1) the loading rate of both groups decreased significantly, and the loading rate of the GR group was lower than that of the MIN group. (2) The foot strike angle of the GR group decreased significantly after training, and the plantarflexion angle and hip joint angular extension velocity increased in both groups. (3) The moment of ankle joint increased in the GR group, and the stiffness of lower limbs was significantly improved in both groups. Conclusion: The 12 week gait retraining with minimalist shoes converted rearfoot strikers into forefoot strikers with a rate of 78% (7/9). More importantly, such a combined program, compared to the training with only minimalist shoes, can avoid the peak impact force and decrease the loading rate more effectively, thus providing a potential means of reducing risk of running injury caused by impact forces. Moreover, the increased vertical stiffness of lower extremity after gait retraining may improve running economy and corresponding energy utilization. However, these observations also suggest that the sole use of minimalist footwear may have limited effects on reducing running-related impacts.
The biomechanics of the first metatarsophalangeal joint (MTPJ) is affected by different shoe conditions. In the biomechanical research field, traditional skin marker motion capture cannot easily acquire the in vivo joint kinematics of the first MTPJ in shoes. Thus, the present study aims to investigate the differences of the first MTPJ’s six-degree-of-freedom (6DOF) kinematics between shod and barefoot running by using a high-speed dual fluoroscopic imaging system (DFIS). In total, 15 healthy male runners were recruited. Computed tomography scans were taken from each participant’s right foot for the construction of 3D models and local coordinate systems. Radiographic images were acquired at 100 Hz while the participants ran at a speed of 3 m/s ± 5% in shod and barefoot conditions along an elevated runway, and 6DOF kinematics of the first MTPJ were calculated by 3D–2D registration. Paired sample t-tests were used to compare the kinematic characteristics of the first MTPJ 6DOF kinematics during the stance phase between shod and barefoot conditions. Compared with barefoot, wearing shoes showed significant changes (p < 0.05): 1) the first MTPJ moved less inferior at 50% but moved less superior at 90 and 100% of the stance phase; 2) the peak medial, posterior, and superior translation of the first MTPJ significantly decreased in the shod condition; 3) the extension angle of the first MTPJ was larger at 30–60% but smaller at 90 and 100% of the stance phase; 4) the maximum extension angle and flexion/extension range of motion of the first MTPJ were reduced; and 5) the minimum extension and adduction angle of the first MTPJ was increased in the shod condition. On the basis of the high-speed DFIS, the aforementioned results indicated that wearing shoes limited the first MTPJ flexion and extension movement and increased the adduction angle, suggesting that shoes may affect the propulsion of the first MTPJ and increase the risk of hallux valgus.
Foot and ankle joints are complicated anatomical structures that combine the tibiotalar and subtalar joints. They play an extremely important role in walking, running, jumping and other dynamic activities of the human body. The in vivo kinematic analysis of the foot and ankle helps deeply understand the movement characteristics of these structures, as well as identify abnormal joint movements and treat related diseases. However, the technical deficiencies of traditional medical imaging methods limit studies on in vivo foot and ankle biomechanics. During the last decade, the dual fluoroscopic imaging system (DFIS) has enabled the accurate and noninvasive measurements of the dynamic and static activities in the joints of the body. Thus, this method can be utilised to quantify the movement in the single bones of the foot and ankle and analyse different morphological joints and complex bone positions and movement patterns within these organs. Moreover, it has been widely used in the field of image diagnosis and clinical biomechanics evaluation. The integration of existing single DFIS studies has great methodological reference value for future research on the foot and ankle. Therefore, this review evaluated existing studies that applied DFIS to measure the in vivo kinematics of the foot and ankle during various activities in healthy and pathologic populations. The difference between DFIS and traditional biomechanical measurement methods was shown. The advantages and shortcomings of DFIS in practical application were further elucidated, and effective theoretical support and constructive research direction for future studies on the human foot and ankle were provided.
Accurately obtaining the in vivo motion of the medial longitudinal arch (MLA), first metatarsophalangeal joint (MTPJ), and plantar fascia (PF) is essential for analyzing the biomechanics of these structures in different running strike patterns. Most previous studies on the biomechanics of the MLA, first MTPJ, and PF have been based on traditional skin-marker–based motion capture, which cannot acquire the natural foot motion. Therefore, this study aimed to 1) describe the movement of the MLA, first MTPJ, and PF during running by using the high-speed dual fluoroscopic imaging system (DFIS) and 2) explore changes of the in vivo kinematics of the MLA and first MTPJ, and the length of the PF during the stance phase of running with different foot strike patterns. Fifteen healthy male runners all of whom ran with a regular rearfoot strike (RFS) pattern were required to run with forefoot strike (FFS) and RFS patterns. Computed tomography scans were taken from each participant’s right foot for the construction of 3D models (the calcaneus, first metatarsal, and first proximal phalanges) and local coordinate systems. A high-speed DFIS (100 Hz) and 3D force platform (2,000 Hz) were used to acquire X-ray images of the foot bones and ground reaction force data during the stance phase of running (3 m/s ± 5%) simultaneously. Then, 3D-2D registration was used to obtain the in vivo kinematic data of the MLA and first MTPJ and the length of the PF. When compared with RFS, in FFS, 1) the range of motion (ROM) of the medial/lateral (5.84 ± 5.61 mm vs. 0.75 ± 3.38 mm, p = 0.002), anterior/posterior (14.64 ± 4.33 mm vs. 11.18 ± 3.56 mm, p = 0.010), plantarflexion/dorsiflexion (7.13 ± 3.22° vs. 1.63 ± 3.29°, p < 0.001), and adduction/abduction (−3.89 ± 3.85° vs. −0.64 ± 4.39°, p = 0.034) motions of the MLA were increased significantly; 2) the ROM of the anterior/posterior (7.81 ± 2.84 mm vs. 6.24 ± 3.43 mm, p = 0.003), superior/inferior (2.11 ± 2.06 mm vs. −0.57 ± 1.65 mm, p = 0.001), and extension/flexion (−9.68 ± 9.16° vs. −5.72 ± 7.33°, p = 0.018) motions of the first MTPJ were increased significantly; 3) the maximum strain (0.093 ± 0.023 vs. 0.075 ± 0.020, p < 0.001) and the maximum power (4.36 ± 1.51 W/kg vs. 3.06 ± 1.39 W/kg, p < 0.001) of the PF were increased significantly. Running with FFS may increase deformation, energy storage, and release of the MLA and PF, as well as the push-off effect of the MTPJ. Meanwhile, the maximum extension angle of the first MTPJ and MLA deformation increased in FFS, which showed that the PF experienced more stretch and potentially indicated that FFS enhanced the PF mechanical responses.
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