The Relationship Between Foot and Pelvic Alignment While Standing

Abstract

A normal motion and segmental interrelationship has been determined as a significant factor in normal function. Yet, the relationship between distal segments and pelvic alignment needs further investigation. The aim of this study was to investigate the interrelationship between distal and proximal lower extremity segments while standing and during induced feet hyperpronation. Changes in alignment of the pelvis and lower extremities were measured at a gait laboratory using the VICON 612 computerized motion analysis system. Thirty-five healthy volunteer subjects were recruited. Four randomized repeated-measure standing modes were used: standing directly on the floor and then on three wedges angled at 10°, 15° and 20° to induce bilateral hyperpronation for 20 seconds. A significant (p<0.05) bi-variate relationship was found between the anterior pelvic tilt and thigh internal rotation, in all four standing positions (.41≤r≤.46, in all p<0.014). A combined effect of rotational alignment between segments and the cumulative effect of foot hyperpronation on pelvic tilt revealed that only the shank significantly affected pelvic alignment, acting as a mediator between a foot and a thigh with the thigh having a crude significant effect on the pelvis. When internal rotation of the shank occurs, calcaneal eversion couples with thigh internal rotation and anterior pelvic tilt. It can be concluded that in response to induced hyperpronation, the shank is a pivotal segment in postural adjustment.

The biomechanical effects of pronated foot function on gait. An experimental study

“…Previous studies of healthy subjects walking with wedges to artificially induce FP have revealed alterations in lower limb kinematics 4,[31][32][33][34][35][36] ; however, artificial FP may not represent the true effects and adaptations to FP. Peak knee internal rotation, for example, was increased during the whole stance phase in the FPg compared with the CTRg in agreement with previous studies 4,31-34 and our hypothesis.…”

Changes in lower extremity alignment in standing position using a foot plate

“…It is suggested that these changes occur due to a stable subtalar joint, which leads maintenance of bone stability, and also due to stability of the knee joints reinforced by the surrounding soft tissue [3]. A study by Khamis et al [13] had found the following results of the measurements with changes in alignment from In a previous study using a fixed wedge, the pelvis was tested for associated correlation with other LE structures. With use of the wedge and heel abducted, the hip abduction angle and pelvic anterior tilt increased [3,9].…”

Plantar Pressure During Gait in Pregnancy-Related Pelvic Girdle Pain and the Influence of Pelvic Belts

“…Khamis and Yizhar 20 did not find a correlation between the change in foot hyperpronation and pelvic response and therefore concluded on a weak relationship between foot and pelvic alignment. On the contrary, for Khamis et al, 19 an interaction exists between nearby segments as well as between distant segments such as the shank and pelvis. Thus, lower-limb and lower-back symptoms may require a comprehensive biomechanical evaluation of the foot and understanding of their interaction.…”

“…16,17 Studies have evaluated the relationship between foot position or movement and alignment of the lower limb. 19 Foot pronation is strongly coupled with internal rotation of the shank, both in walking and running. It has been suggested that abnormal movements and interaction between segmental alignments of the lower-limb increase risk of lower-limb injuries.…”