A system for the analysis of foot and ankle kinematics during gait

Kidder, S.M.; Abuzzahab, F.S.; Harris, Gerald F.; Johnson, Jeffrey E.

doi:10.1109/86.486054

Cited by 263 publications

(225 citation statements)

References 21 publications

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“…41 Many multisegment foot models vary in their marker placement and definition of anatomic coordinate systems. 7,15,16,20,24 Because foot kinematics are affected by these choices, comparisons across studies are challenging. The variables used in this study from the multisegment foot model were chosen to reflect the function of the posterior tibialis muscle on foot movement.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Foot Kinematics Between Subjects With Posterior Tibialis Tendon Dysfunction and Healthy Controls

Tome

Nawoczenski²,

Flemister³

et al. 2006

J Orthop Sports Phys Ther

157

178

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Study Design: A 2 × 4 mixed-design ANOVA with a fixed factor of group (posterior tibialis tendon dysfunction [PTTD] and asymptomatic controls), and a repeated factor of phase of stance (loading response, midstance, terminal stance, and preswing). Objective: To compare 3-dimensional stance period kinematics (rearfoot eversion/inversion, medial longitudinal arch [MLA] angle, and forefoot abduction) of subjects with stage II PTTD to asymptomatic controls. Background: Abnormal foot postures in subjects with stage II PTTD are clinical indicators of disease progression, yet dynamic investigations of forefoot, midfoot, and rearfoot kinematic deviations in this population are lacking. Methods: Fourteen subjects with stage II PTTD were compared to 10 control subjects with normal arch index values. Subjects were matched for age, gender, and body mass index. A 5-segment, kinematic model of the leg and foot was tracked using an Optotrak Motion Analysis System. The dependent kinematic variables were rearfoot inversion/eversion, forefoot abduction/adduction, and the MLA angle. An ANOVA model was used to compare kinematic variables between groups across 4 phases of stance.Results: Subjects with PTTD demonstrated significantly greater rearfoot eversion (P = .042), MLA angle (P = .008) and forefoot abduction angles (PϽ.005) during specific phases of stance. Subjects with PTTD demonstrated significantly greater rearfoot eversion (PϽ.004) and MLA angles (PϽ.009) by 6.2°and 8.0°, respectively, during loading response when compared to controls. During preswing, the subjects with PTTD demonstrated a significantly greater MLA angle (PϽ.002) and a forefoot abduction angle (PϽ.001) which exceeded that of the controls by 10.0°. Conclusions: The abnormal kinematics observed at the rearfoot, midfoot, and forefoot across all phases of stance implicate a failure of compensatory muscle and secondary ligamentous support to control foot kinematics in subjects with stage II PTTD.

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Section: Discussionmentioning

confidence: 99%

Comparison of Foot Kinematics Between Subjects With Posterior Tibialis Tendon Dysfunction and Healthy Controls

Tome

Nawoczenski²,

Flemister³

et al. 2006

J Orthop Sports Phys Ther

157

178

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“…The Milwaukee foot model was used to measure segmental foot and ankle motion, which incorporates radiographic referencing [20]. Gait data and temporal spatial parameters were averaged over three trials for each participant.…”

Section: Gait Analysismentioning

confidence: 99%

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

Smith

Kuo

Graf

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Clubfoot can be treated nonoperatively, most commonly using a Ponseti approach, or surgically, most often with a comprehensive clubfoot release. Little is known about how these approaches compare with one another at longer term, or how patients treated with these approaches differ in terms of foot function, foot biomechanics, or quality-of-life from individuals who did not have clubfoot as a child. Questions/purposes We compared (1) focused physical and radiographic examinations, (2) gait analysis, and (3) quality-of-life measures at long-term followup between groups of adult patients with clubfoot treated either with the Ponseti method of nonsurgical management or a comprehensive surgical release through a Cincinnati incision, and compared these two groups with a control group without clubfoot. Methods This was a case control study of individuals treated for clubfoot at two separate institutions with different methods of treatment between 1983 to 1987. One hospital used only the Ponseti method and the other mainly used a comprehensive clubfoot release. There were 42 adults (24 treated surgically, 18 treated with Ponseti method) with isolated clubfoot along with 48 healthy control subjects who agreed to participate in a detailed analysis of physical function, foot biomechanics, and quality-of-life metrics. Results Both treatment groups had diminished strength and motion compared with the control subjects on physical examination measures; however, the Ponseti group had significantly greater ankle plantar flexion ROM (p \ 0.001), greater ankle plantar flexor (p = 0.031) and evertor (p = 0.012) strength, and a decreased incidence of osteoarthritis in the ankle and foot compared with the surgical group. During gait the surgical group had reduced peak ankle plantar flexion (p = 0.002), and reduced sagittal plane hindfoot (p = 0.009) and forefoot (p = 0.008) ROM during the preswing phase compared with the Ponseti group. The surgical group had the lowest overall ankle power generation during push off compared with the control subjects (p = 0.002). Outcome tools revealed elevated pain levels in the surgical group compared with the Ponseti group (p = 0.008) and lower scores for physical function and quality-of-life for both clubfoot groups compared with age-range matched control subjects (p = 0.01).

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“…3,[31][32][33][34] These techniques are complex and time consuming and in some applications expose the patient to ionizing radiation.…”

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confidence: 99%

A clinically applicable six‐segmented foot model

Mits

Segers

Woodburn

et al. 2011

Journal Orthopaedic Research

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We describe a multi-segmented foot model comprising lower leg, rearfoot, midfoot, lateral forefoot, medial forefoot, and hallux for routine use in a clinical setting. The Ghent Foot Model describes the kinematic patterns of functional units of the foot, especially the midfoot, to investigate patient populations where midfoot deformation or dysfunction is an important feature, for example, rheumatoid arthritis patients. Data were obtained from surface markers by a 6 camera motion capture system at 500 Hz. Ten healthy subjects walked barefoot along a 12 m walkway at self-selected speed. Joint angles (rearfoot to shank, midfoot to rearfoot, lateral and medial forefoot to midfoot, and hallux to medial forefoot) in the sagittal, frontal, and transverse plane are reported according to anatomically based reference frames. These angles were calculated and reported during the foot rollover phases in stance, detected by synchronized plantar pressure measurements. Repeated measurements of each subject revealed low intra-subject variability, varying between 0.78 and 2.38 for the minimum values, between 0.58 and 2.18 for the maximum values, and between 0.88 and 5.88 for the ROM. The described movement patterns were repeatable and consistent with biomechanical and clinical knowledge. As such, the Ghent Foot model permits intersegment, in vivo motion measurement of the foot, which is crucial for both clinical and research applications. Keywords: multi-segment foot model; foot and ankle kinematics; gait analysis; Ghent Foot Model Multi-segmented foot models can provide better insight into foot kinematics (and to a less extent segmental foot kinetics) during gait than single segments models. Clinically, they are used to describe and analyze functional characteristics associated with foot impairments. A number of multi-segmented foot models, using either bone pins or surface markers, have been proposed. They vary according to the number of segments and functional unit definition, in the methods of calculating intersegment angles, and in the definition of the neutral foot reference position. 1,2The need exists for a clinically relevant, user-friendly multi-segment foot model that would include the lower leg, hindfoot, midfoot, medial and lateral forefoot, and the hallux, with wide utility to investigate single joint/segment joint dysfunction through to complex foot deformities. Models with <5 segments often can not describe whole foot kinematics. [3][4][5][6][7] In contrast, those with nine segments 8 are not always easily applicable in clinical settings. To our knowledge and based upon a recent review, 2 no such model is currently available.There are two main reasons why a 6 segment model is clinically relevant. First, these segments are examined clinically by physical therapists and podiatrists. The medial arch, formed by the rearfoot (talus), the medial part of the midfoot, and the first ray, plays an important role in foot function during weight bearing activities. 9 Different arch configurations are an intrinsic ris...

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A system for the analysis of foot and ankle kinematics during gait

Cited by 263 publications

References 21 publications

Comparison of Foot Kinematics Between Subjects With Posterior Tibialis Tendon Dysfunction and Healthy Controls

Comparison of Foot Kinematics Between Subjects With Posterior Tibialis Tendon Dysfunction and Healthy Controls

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

A clinically applicable six‐segmented foot model

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