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Background: Interactions between hip and foot biomechanical factors may result in different magnitudes of foot pronation during walking., Objective: To investigate non-linear interactions between hip and foot biomechanical factors and their capability to predict foot pronation during walking and identify the profiles of biomechanical factors that predict greater and lower pronation., Methods: This is a cross-sectional study. Fifty-one women were classified into greater and lower foot pronation during walking. Biomechanical factors measured: (1) foot-ankle varus alignment, (2) hip passive stiffness, (3) isokinetic eccentric strength of hip external rotators, and (4) foot abduction angle. Classification and regression trees (CART) were used to investigate non-linear interactions that predict greater and lower foot pronation., Results: Four main profiles of biomechanical factors were identified as related to greater and lower foot pronation. Profiles for greater pronation were: (1) varus >25.83°; (2) interaction between varus ≤25.83° and hip stiffness ≤0.09 Nm/rad kg -1 ; (3) interaction between varus ≤25.83°, hip stiffness >0.09 Nm/rad kg -1 , and foot abduction >19.58° The profile for lower pronation involved an interaction among varus ≤25.83°, hip stiffness >0.09 Nm/rad kg -1 , and foot abduction ≤19.58° The model had 61% sensitivity and 96% specificity, with the total prediction of 78%. The area under the ROC curve was 0.79 (p = 0.001)., Conclusion: Foot-ankle varus, hip passive stiffness, and foot abduction predicted greater and lower foot pronation. Non-linear interactions between hip and foot factors influence the magnitude of foot pronation during walking. The observed profiles help identify which combinations of biomechanical factors should be assessed in individuals with increased or reduced pronation., Competing Interests: Conflicts of interest The authors declares no conflicts of interest., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Background: Gastrocnemius medialis (GM) and lateralis (GL) act at the ankle complex in the sagittal and frontal planes and there is evidence that their actions can be somewhat uncoupled from each other. Some independence of GM and GL from each other could be advantageous, e.g. to stabilise the ankle complex in unstable walking conditions. Given the compartmentalised structure of the Achilles tendon, the sub-tendons of GM and GL may exhibit different elongation during plantarflexion contractions, particularly with the foot in different frontal plane positions., Research Questions: METHODS: Sub-tendon elongation was determined from 18 participants during ramped isometric plantarflexion contractions to 70% of their maximum voluntary contraction (MVC) level with the foot in neutral, inversion and eversion. One-dimensional statistical parametric mapping was applied to determine elongation differences., Results: Elongation within a sub-tendon did not differ in the three foot positions. Elongation was similar between both sub-tendons at very low contraction levels, but GM sub-tendon elongation exceeded GL sub-tendon displacement significantly from 30% MVC. The elongation differences between the sub-tendons were not affected by foot position., Significance: Greater GM sub-tendon elongation is likely caused by the greater force production capability of GM but may also indicate that the sub-tendons of GM and GL have different mechanical properties, which is currently unknown. Elongation differences were contraction level dependent suggesting that contributions of GM and GL to plantarflexion torque may also be contraction level dependent., (Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.)

In the etiology of Achilles tendinopathy (AT), it is frequently suggested that excessive pronation causes a vascular constriction of the Achilles tendon, described as the "whipping phenomenon" (Clement et al., 1984). Although previous studies focused on the association between pronation and AT, it is striking that the underlying association between foot pronation and blood flow has not been studied yet. Therefore, the aim of this study was to investigate whether the amount of pronation during running influences the Achilles tendon blood flow. Twenty-five experienced runners, aged 34.5±10.2 years, participated in this study. 2D-lower limb kinematics during barefoot and shod running in both frontal and sagittal plane were assessed. Blood flow of the Achilles tendon was measured before and after barefoot and shod running, using the oxygen-to-see device. The results of this study showed a significant effect of eversion excursion on the increase in Achilles tendon blood flow after shod running. More specifically, the more the eversion excursion observed, the lower the increase in blood flow (P=.013). We therefore suggest, in individuals with increased inversion at touchdown and increased eversion around midstance during shod running, that antipronation measures could be useful in both preventing and managing Achilles tendinopathy., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

A hypertrophied peroneal process of the hallucal metatarsal, as seen in prosimians, has been linked to a powerful hallucal grasp via the contraction of the peroneus longus (PL) muscle causing adduction of the big toe. Electromyography (EMG) studies of lemurs and lorises, however, have concluded that PL is not substantially recruited during small branch locomotion when powerful hallucal grasping is needed most, and have suggested that there is no link between PL activity and peroneal process size. If this is correct, then we should also observe no change in PL activity when strong hallucal grasping is required in anthropoids because they have a relatively smaller peroneal process for PL to act on. This study addresses this hypothesis by evaluating EMG of crural and pedal muscles in capuchins (Sapajus apella) walking on substrates of different diameters. During locomotion on the narrow substrate (3.1 cm) that should elicit a strong hallucal grasp, we observed an intense increased recruitment of adductor hallucis, but only sustained, rather than markedly increased, PL activity. This indicates that PL is not involved in powerful hallucal grasping in capuchins, and confirms similar findings previously documented in prosimians. We continue to reject the hypothesis that a large peroneal process is an adaptation for powerful grasping and further argue that its morphology may not be related to PL's ability to adduct the hallux at all. In addition, the morphology of the peroneal process should not be used to assess hallucal grasping performance in fossils., (© 2015 Wiley Periodicals, Inc.)

This study examined differences in center of pressure (COP) trajectories between shod and barefoot running. Ten habitually shod runners ran continuous laps under both shod and barefoot conditions. The COP trajectory was calculated in the global coordinate system but then transformed to the anatomic coordinate system of the foot. The anterior-posterior and medio-lateral positions and excursions of the COP, as well as the most medial location and percent stand at which it occurred were examined. Additionally, external eversion moments and ground reaction forces were assessed. Compared to the shod condition, in the barefoot condition the COP was located more anteriorly early in stance and the COP was located significantly more medially at most time points across stance. There were no differences in external eversion moments during early stance or peak ground reaction forces between conditions. Future studies on mechanical or epidemiological differences between shod and barefoot running may find the COP trajectory an informative parameter to examine., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: Several studies have described the biomechanical effects of foot orthotics, as well as their effects at the level of muscular recruitment. Although the latter effect is unlikely to be limited to muscular intensity, the temporal pattern of activity of the muscles involved in walking with orthoses is still unclear., Methods: Twelve adults with everted static rearfoot posture higher than 5° of valgus participated in the study. For all participants, the kinematic data and the muscular temporal activity of the tibialis anterior, the soleus, the gastrocnemius medialis, the gastrocnemius lateralis and the peroneus longus were measured under two experimental conditions, walking with and without custom-made orthoses. Data were recorded and analyzed using a motion analysis and a surface EMG system., Findings: The results showed that, when walking with insoles, the activity of the tibialis anterior, the soleus, the gastrocnemius medialis, the gastrocnemius lateralis and the peroneus longus is shorter than walking without orthoses. Furthermore, when walking with orthoses, the activity of the soleus and the gastrocnemius medialis is delayed., Interpretation: Our study corroborates that the realignment of the calcaneus with the talus decreases the range of eversion and inversion of midfoot. Moreover, it reports noticeable modifications on the start time and the duration of the muscular activity of the tibialis anterior, soleus, gastrocnemii and peroneus longus while using foot orthoses., (© 2013. Published by Elsevier Ltd on behalf of American Society of Biomechanics. All rights reserved.)

Context: Inversion ankle sprains can lead to a chronic condition called functional ankle instability (FAI). Limited research has been reported regarding isokinetic measures for the plantar flexors and dorsiflexors of the ankle., Objective: To examine the isokinetic eccentric torque measures of the ankle musculature in participants with stable ankles and participants with functionally unstable ankles during inversion, eversion, plantar flexion, and dorsiflexion., Design: Case-control study., Setting: Athletic training research laboratory., Patients or Other Participants: Twenty participants with a history of "giving way" were included in the FAI group. Inclusion criteria for the FAI group included a history of at least 1 ankle sprain and repeated episodes of giving way. Twenty participants with no prior history of ankle injury were included in the control group., Intervention(s): Isokinetic eccentric torque was assessed in each participant., Main Outcome Measure(s): Isokinetic eccentric testing was conducted for inversion-eversion and plantar-flexion-dorsiflexion movements. Peak torque values were standardized to each participant's body weight. The average of the 3 trials for each direction was used for statistical analysis., Results: A significant side-by-group interaction was noted for eccentric plantar flexion torque (P < .01). Follow-up t tests revealed a significant difference between the FAI limb in the FAI group and the matched limb in the control group. Additionally, a significant difference was seen between the sides of the control group (P = .03). No significant interactions were identified for eccentric inversion, eversion, or dorsiflexion torques (P > .05)., Conclusions: A deficit in plantar flexion torque was identified in the functionally unstable ankles. No deficits were identified for inversion, eversion, or dorsiflexion torque. Therefore, eccentric plantar flexion strength may be an important contributing factor to functional ankle instability.

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Context: Lateral ankle sprains commonly occur in an athletic population and can lead to chronic ankle instability. Objective: To compare ankle strength measurements in athletes who have mechanical laxity and report functional instability after a history of unilateral ankle sprains. Design: Retrospective cohort. Setting: Athletic Training Research Lab. Participants: A total of 165 National Collegiate Athletic Association Division I athletes, 97 males and 68 females, with history of unilateral ankle sprains participated. Main Outcome Measures: Functional ankle instability was determined by Cumberland Ankle Instability Tool scores and mechanical ankle instability by the participant having both anterior and inversion/eversion laxity. Peak torque strength measures, concentric and eccentric, in 2 velocities were measured. Results: Of the 165 participants, 24 subjects had both anterior and inversion/eversion laxity and 74 self-reported functional ankle instability on their injured ankle. The mechanical ankle instability group presented with significantly lower plantar flexion concentric strength at 30°/s (139.7 [43.7] N-m) (P =.01) and eversion concentric strength at 120°/s (14.8 [5.3] N-m) (P= .03) than the contralateral, uninjured ankle (166.3 [56.8] N-m, 17.4 [6.2] N-m, respectively). Conclusion: College athletes who present with mechanical laxity on a previously injured ankle exhibit plantar flexion and eversion strength deficits between ankles. [ABSTRACT FROM AUTHOR]

Background: The socket reaction moment (SRM) has been reported to change because of alignment changes in transtibial prosthetic sockets. However, the influence of prosthetic foot alignment on SRM remains unclear.Research Question: Are SRMs predictable from alignment changes of prosthetic feet?Methods: Ten users of transtibial prostheses participated in this study. Under five alignment conditions (3 ° plantarflexion and dorsiflexion, 6 ° inversion and eversion, and baseline alignment), temporal-spatial parameters and sagittal and coronal SRMs were measured during walking. Cadence, walking speed, step time, single support time, and step length were compared. The maximum/minimum SRM, % stance (timing) of the maximum/minimum SRM, Zero-cross, and SRMs at 5 %, 20 %, and 75 % stance were extracted and compared. Repeated measures analysis of variance or Friedman tests, and linear regression analyses were conducted for statistical analyses (i.e., alignment conditions as independent variables and SRM parameters as dependent variables).Results: The SRMs at 5%, 20 %, and 75 % stance showed significant differences under coronal angular changes. The minimum SRM, % stance of the minimum/maximum SRM, and Zero-cross showed significant differences under sagittal alignment changes. In linear regression analysis, the minimum SRM, % stance of the minimum/maximum SRM, SRM at 20 % stance, and Zero-cross were significant dependent variables in the sagittal plane. The maximum/minimum SRM, SRM at 20 % and 75 % stance, and % stance of the minimum SRM were significant dependent variables in the coronal plane.Significance: The results indicated that the changes in prosthetic feet angles may predict the magnitude of SRM (maximum/minimum SRM, SRM at 20 % and 75 % stance) in the coronal plane, and the timing of SRM (Zero-cross, % stance of the maximum/minimum SRM) in the sagittal plane. These findings suggest that the SRM may be useful for evaluating foot alignment in transtibial prostheses. [ABSTRACT FROM AUTHOR]

Foot Pronation, also called as "eversion" is a normal and necessary component of the gait cycle. However, abnormal pronation occurs when foot pronates, when actually it shouldn't. It occurs during the half of the stance phase. The foot rolls inward when one lands their foot on surface while walking and running. The complementing structures of the ankle or foot complex permits both stability and mobility depending on conditions acting on it. This article presents on overview on current knowledge on pronated foot and focuses on biomechanics, etiology diagnosis and treatment strategies, conservative treatment. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effects of transversely sloped ballasted walking surface on gait and rearfoot motion (RFM) parameters. Motion analysis was performed with 20 healthy participants (15 male and 5 female) walking in six surface-slope conditions: two surfaces (solid and ballasted) by three slopes (0, 5, and 10 degrees). The gait parameters (walking velocity, step length, step rate, step width, stance time, and toe-out angle) showed significant surface effect (p = .004) and surface-slope interaction (p = .017). The RFM motion parameters (peak everted/inverted position, eversion/inversion velocity, and acceleration) revealed significant surface (p = .004) and slope (p = .024) effects. The ballasted conditions showed more cautious gait patterns with lower walk velocity, step length, and step rate and longer stance time. In the RFM parameters, the slope effect was more notable in the solid conditions due to the gait adaptations in the ballasted conditions. Ballast conditions showed reduced inversion and increased eversion and RFM range. The RFM data were comparable to other typical walking conditions but smaller than those from running. [ABSTRACT FROM AUTHOR]

Background: A recent study suggested that maximal running shoes may increase the impact force and loading rate of the vertical ground-reaction force during running. It is currently unknown whether runners will adapt to decrease the impact force and loading rate over time. Purpose: To compare the vertical ground-reaction force and ankle kinematics between maximal and traditional shoes before and after a 6-week acclimation period to the maximal shoe. Study Design: Controlled laboratory study. Methods: Participants ran in a traditional running shoe and a maximal running shoe during 2 testing sessions 6 weeks apart. During each session, 3-dimensional kinematics and kinetics were collected during overground running. Variables of interest included the loading rate, impact peak, and active peak of the vertical ground-reaction force, as well as eversion and dorsiflexion kinematics. Two-way repeated measures analyses of variance compared data within participants. Results: No significant differences were observed in any biomechanical variable between time points. The loading rate and impact peak were higher in the maximal shoe. Runners were still everted at toe-off and landed with less dorsiflexion, on average, in the maximal shoe. Conclusion: Greater loading rates and impact forces were previously found in maximal running shoes, which may indicate an increased risk of injury. The eversion mechanics observed in the maximal shoes may also increase the risk of injury. A 6-week transition to maximal shoes did not significantly change any of these measures. Clinical Relevance: Maximal running shoes are becoming very popular and may be considered a treatment option for some injuries. The biomechanical results of this study do not support the use of maximal running shoes. However, the effect of these shoes on pain and injury rates is unknown. [ABSTRACT FROM AUTHOR]

Abnormal-pronation, excessive-pronation, over-pronation, or hyper-pronation, are terms with a long historical use in both medical and research terminology pertaining to an abnormal movement of the foot. These terms are commonly used as a potential kinematic aetiology to explain the occurrence of multiple lower limb and foot pathologies. Yet despite this widespread use there is no clear definition to explain what the terms abnormal, excess, over, or hyper-pronation, mean. Without a strict definition the use of these terms as a patho-mechanical explanation of injuries, leaves a distinct lack of clarity and is meaningless in regards to being able to distinguish what movement may need clinical intervention. It is unlikely that hyper-pronation can be given a quantitative scale because individual anatomy and activity changes the necessary range of pronation within the foot. This paper attempts to give hyper-pronationa philosophically justifiable definition so that the term may be used in a more precise manner and avoid the confusion that presently exists clinically as well as in research literature. [ABSTRACT FROM AUTHOR]

Background: There are conflicting results with respect to the validity and reliability of lower extremity strength measurements using a hand-held dynamometer (HHD) in the healthy population. Previous studies exploring foot inversion and eversion strength using a HHD were carried out with predominantly clinically affected participants in different positions. The question arises whether HHD measurements of isometric foot inversion and eversion strength performed with participants in different positions are valid, reliable and comparable and can be used alternatively. Purpose: The aims of this study were to investigate: a) the intra- and inter-tester reliability of measurements of foot inversion and eversion strength in different participant positions using a belt-stabilized HHD; b) the comparability of results obtained in different positions; and c) the concurrent validity of the aforementioned measurements using an isokinetic dynamometer. Methods: Thirty adults (12 females and 18 males; mean age 22.5 ± 3.9 years) volunteered to participate in this study. Maximal isometric foot inversion and eversion torques (Nm) were measured with participants lying supine, sitting with knees extended and lying on their side using a belt-stabilized HHD. Measurements were performed independently by two physiotherapists over two days and were repeated using an isokinetic dynamometer. Validity and intra- and inter-tester reliability were determined using the intra-class correlation coefficient (ICC). A two-way ANOVA (p<0.05) and post-hoc tests with Bonferroni correction were used to compare data from different positions. Bland-Altman plots were used to demonstrate the range of error and difference between HHD and isokinetic measurements. Results: Intra-tester reliability for inversion and eversion torques was fair to excellent in all positions (ICC = 0.598-0.828). Excellent inter-tester reliability was found for eversion torques in all positions (ICC = 0.773-0.860). For inversion torques, inter-tester reliability was fair to excellent (ICC = 0.519-0.879). ICC values of 0.205 to 0.562 indicated a low to fair concurrent validity. A significant difference was observed between the torques of the supine and side-lying positions as well as sitting and side-lying positions (p<0.05). Bland-Altman plots showed that the mean of the differences for inversion and eversion torques deviates considerably from zero, indicating that measurements with the HHD in the three positions produce lower values compared to using the isokinetic dynamometer. Conclusions: Inversion and eversion strength measurements with subjects in different positions using HHD seem to be reliable, but consistently underestimated torque output when compared with measurements using isokinetic dynamometry. While the HHD outcomes measured in supine and sitting positions seem to be comparable, those measured in supine/sitting and side-lying positions differed. [ABSTRACT FROM AUTHOR]

The linearity of soft robotic sensors (SRS) was recently validated for movement angle assessment using a rigid body structure that accurately depicted critical movements of the foot–ankle complex. The purpose of this study was to continue the validation of SRS for joint angle movement capture on 10 participants (five male and five female) performing ankle movements in a non-weight bearing, high-seated, sitting position. The four basic ankle movements—plantar flexion (PF), dorsiflexion (DF), inversion (INV), and eversion (EVR)—were assessed individually in order to select good placement and orientation configurations (POCs) for four SRS positioned to capture each movement type. PF, INV, and EVR each had three POCs identified based on bony landmarks of the foot and ankle while the DF location was only tested for one POC. Each participant wore a specialized compression sock where the SRS could be consistently tested from all POCs for each participant. The movement data collected from each sensor was then compared against 3D motion capture data. R-squared and root-mean-squared error averages were used to assess relative and absolute measures of fit to motion capture output. Participant robustness, opposing movements, and gender were also used to identify good SRS POC placement for foot–ankle movement capture. [ABSTRACT FROM AUTHOR]