The effect of posterior tibialis tendon dysfunction on the plantar pressure characteristics and the kinematics of the arch and the hindfoot

Imhauser, Carl W.; Siegler, Sorin; Abidi, Nicholas A.; Frankel, David Z.

doi:10.1016/j.clinbiomech.2003.10.007

Cited by 103 publications

(90 citation statements)

References 22 publications

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“…Each foot was cycled an average of 17,600 cycles (range 14,000-20,000) at 2 Hz with a maximum force of 600 N. Extrinsic tendons continued to be loaded during cycling, except the posterior tibialis tendon, which was unloaded to simulate posterior tibial tendon insufficiency, which is commonly associated with adult acquired flatfoot. 2,9,14,18,20,28,29 After cyclic loading, the flatfoot was reloaded in the frame. Flatfoot 3D bone orientation and plantar pressure data were acquired in the unloaded, normal tendon loads, and Achilles tendon overpull conditions.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, many cadaveric models utilize substantial sectioning of ligaments and tendons to create the deformity. 6,14,15,[17][18][19] Sectioning simulates complete rupture, which does not typically occur in vivo. 20 Attenuation of ligaments and tendons followed by cyclic axial loading has been used to simulate progressive development of soft tissue laxity.…”

mentioning

confidence: 99%

“…12 Much research has been devoted to creating and testing cadaveric flatfoot models. 5,6,[13][14][15][16] However, we are unaware of any models that have examined the effects of Achilles tendon contracture. Furthermore, many cadaveric models utilize substantial sectioning of ligaments and tendons to create the deformity.…”

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confidence: 99%

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Cadaveric flatfoot model: Ligament attenuation and Achilles tendon overpull

Blackman

Blevins

Sangeorzan

et al. 2009

Journal Orthopaedic Research

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Flatfoot deformity is characterized by loss of the medial longitudinal arch, forefoot abduction, hindfoot eversion, and often Achilles tendon contracture. Our objectives were to validate a cadaveric flatfoot model that involves selective ligament attenuation and to determine if Achilles tendon overpull is associated with increased pes planus severity. We measured the three-dimensional (3D) orientation of the bones of interest in the unloaded, loaded, and Achilles tendon overpull conditions. A flatfoot model was created by attenuating ligaments involved in the pes planus deformity followed by cyclic axial loading, and bone orientations were acquired in the three conditions. Significant differences seen between normal feet and flat feet were consistent with those seen with the pes planus deformity. The first metatarsal dorsiflexed and abducted relative to the talus. The navicular abducted relative to the talus. The calcaneus everted relative to the tibia. The talus plantar flexed and adducted. Achilles overpull resulted in first metatarsal-to-talus dorsiflexion and navicular-to-talus abduction. Thus, selective ligament attenuation followed by cyclic axial loading can create a cadaveric flatfoot model consistent with the in vivo deformity. Longitudinal arch depression, hindfoot eversion, talonavicular joint abduction, forefoot abduction, and talar plantar flexion were seen. Simulated Achilles tendon contracture increased the severity of the deformity, particularly in arch depression and forefoot abduction.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Cadaveric flatfoot model: Ligament attenuation and Achilles tendon overpull

Blackman

Blevins

Sangeorzan

et al. 2009

Journal Orthopaedic Research

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“…Although the rearfoot has been primarily implicated in kinematic alterations found in subjects with PTTD, 17,18,30 there is evidence to suggest even greater influence on forefoot function with tendon attenuation. Using a multisegment foot model applied to a single case of a subject with PTTD and a longstanding lacerated tendon, Rattanaprasert et al 31 found that rearfoot eversion/inversion was surprisingly similar to a group of 10 healthy controls.…”

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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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“…Probably, the MLA support force from these muscles could be compensated by other MLA support structures, such as the extrinsic foot inversion muscles, which was also suggested by the significant decrease of the rear foot eversion angle after the fatigue-inducing exercise. Previously, Pohl et al13 ) reported no substantial changes in foot kinematics following the fatigue-inducing exercise of the tibialis posterior, although the tibialis posterior was regarded as a main MLA support structure14, 15 ) . They also concluded that a reduced force output of the tibialis posterior might be compensated for by other muscles.…”

Section: Discussionmentioning

confidence: 98%

Does the weakening of intrinsic foot muscles cause the decrease of medial longitudinal arch height?

et al. 2017

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[Purpose] There are no reliable evidences that the weakening of intrinsic foot muscles causes the decrease of the medial longitudinal arch (MLA) height. The purpose of this study was to confirm whether the fatigue of intrinsic foot muscles decrease the MLA height during standing and gait using 3D motion analysis system. [Subjects and Methods] Twenty healthy male subjects participated in this study. Foot kinematics was measured using an Oxford Foot Model before and after fatigue-inducing exercises of the abductor hallucis and flexor hallucis brevis muscles. [Results] Following fatigue-inducing exercise, in both standing and gait, the MLA height did not decrease but slightly increased. In addition, the reduction of a rear foot eversion angle was noted. [Conclusion] Fatigue of the abductor hallucis and flexor hallucis brevis muscles did not cause a change associated with collapsing of the MLA during both standing and gait. This suggested that the MLA support force from these muscles would be compensated by other MLA support structures, such as extrinsic foot muscles.

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The effect of posterior tibialis tendon dysfunction on the plantar pressure characteristics and the kinematics of the arch and the hindfoot

Cited by 103 publications

References 22 publications

Cadaveric flatfoot model: Ligament attenuation and Achilles tendon overpull

Cadaveric flatfoot model: Ligament attenuation and Achilles tendon overpull

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

Does the weakening of intrinsic foot muscles cause the decrease of medial longitudinal arch height?

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