Pes planus, a pronated foot, is often attended by a calcaneal eversion and abducted forefoot, as well as flattening or lowering of the medial longitudinal arch (MLA). 1 During weight-bearing activities, the foot is stabilized by maintaining the MLA via passive support (bony structure and
Jung-Hoon Choi, Heon-Seock Cynn, Chung-Hwi Yi, Tae-Lim Yoon and Seung-Min Baik
Banu Unver, Emin Ulas Erdem and Eda Akbas
Pes planus is a prevalent chronic condition with a reported incidence of 2% to 23% in the adult population and characterized by the lower medial longitudinal arch (MLA) with calcaneal eversion. 1 – 3 The most common problem associated with pes planus is excessive pronation during weight
Stacy E. Stamm and Loren Z.F. Chiu
When the rear- and forefoot are constrained, calcaneal plantar flexion may occur, deforming the longitudinal arch. Previous research has reported calcaneal motion relative to the tibia or forefoot; these joint rotations may not accurately describe rotation of the calcaneus alone. This investigation: (1) characterized the calcaneus and leg segment and ankle joint rotations during stance in gait, and (2) described the range of calcaneal plantar flexion in different structural arch types. Men (n = 14) and women (n = 16) performed gait in a motion analysis laboratory. From heel strike to heel off, the leg rotated forward while the calcaneus plantar flexed. Before foot flat, calcaneal plantar flexion was greater than forward leg rotation, resulting in ankle plantar flexion. After foot flat, forward leg rotation was greater than calcaneal plantar flexion, resulting in ankle dorsiflexion. Structural arch type was classified using the longitudinal arch angle. The range of calcaneal plantar flexion from foot flat to heel off was small in low (−2° to −8°), moderate in high (−3° to −12°), and large in normal (−2° to −20°) structural arches. Calcaneal plantar flexion in gait during midstance may reflect functional arch characteristics, which vary depending on structural arch type.
Stephanie J. Facchini, Matthew C. Hoch, Deanna H. Smith and Johanna M. Hoch
The intrinsic foot muscle test (IFMT) is purported to identify intrinsic foot muscle (IFM) weakness during clinical examination. However, before this test can be used in clinical practice the clinometric properties must be determined. In addition, it is unclear if the IFMT provides information regarding the integrity of the foot arch beyond static foot posture assessments such as the navicular drop test (NDT).
To determine the reliability of the IFMT as well as its correlation with the NDT.
Patients or other Participants:
Two novice ATs served as the raters. The NDT was assessed by a third investigator during the first session. Twenty-five participants (16 females, 9 males; age: 22.4 ± 1.7 years; height: 170.8 ± 10.2 cm; mass: 73.5 ± 12.8 kg) completed two data collection sessions separated by one week.
During each session the IFMT was assessed bilaterally in a counterbalanced order by the raters. Each test was rated simultaneously by both raters during each trial and the raters were blinded to each other’s results during and between test sessions.
Main Outcome Measures:
The independent variable was time (session one and session two) and the dependent variables included rating on the IFMT and navicular drop height.
Intrarater agreement was poor to fair (κ = .03−.41) and interrater agreement was fair to moderate (κ = .25−.60). Post hoc Wilcoxon rank tests demonstrated a significant number of participants improved between sessions for both raters. A weak correlation was observed between the NDT and IFMT for both right (r = −.14 to .04, p < .49) and left (r = −.19 to .07, p < .37) feet.
The IFMT demonstrated poor to fair intrarater and fair to moderate interrater agreement, suggesting future research is needed to modify this method of measuring IFM function. The improvement between sessions indicates a potential familiarization period within the test. The weak correlation between the IFMT and NDT indicates these tests evaluate different aspects of foot function.
Douglas W. Powell, Benjamin Long, Clare E. Milner and Songning Zhang
The medial longitudinal arch plays a major role in determining lower extremity kinematics. Thus, it is necessary to understand the dynamics of the arch structure in response to load. The purpose of this study was to examine arch function in high- and low-arched feet during a vertical loading condition. Ten high- and ten low-arched females performed five trials in a sit-to-stand exercise. Ground reaction force (1200 Hz) and three-dimensional kinematics (240 Hz) were collected simultaneously. The high-and low-arched athletes had no differences in vertical deformation of the arch. High-arched participants were less everted than the low-arched athletes; furthermore, the high-arched athletes had smaller mid-forefoot eversion excursions. Differences between the high-arched and low-arched athletes occur through and motion at the mid-forefoot joint.
Fredrick Anthony Gardin, David Middlemas, Jennifer L. Williams, Steven Leigh and Rob R. Horn
Navicular drop is widely believed to be an indicator of elevated susceptibility to pronation-related injuries, which may be increased by fatigue in the muscles that dynamically support the medial longitudinal arch.
The purpose of this study was to evaluate navicular drop before and after fatigue of the ankle invertor muscles among individuals with different foot types.
20 male and 16 female recreationally active, college-age volunteers (20.03 ± 1.48 years of age).
Navicular drop was measured before and after inducing fatigue in the ankle invertor muscles. Participants’ foot types were classified as high-arch, neutral, or low-arch.
There was no interaction between foot type and trial, and no main effect for trial. A main effect for foot type was significant (p = .001). Intra-class correlation coefficients for prefatigue and postfatigue measurements indicated good internal consistency.
Our fndings failed to provide any evidence to support the existence of a relationship between ankle invertor muscle fatigue and static measurements of change in navicular height from a sitting to standing position.
Scott K. Lynn, Ricardo A. Padilla and Kavin K.W. Tsang
Proper functioning of the intrinsic foot musculature (IFM) is essential in maintaining the integrity of the medial longitudinal arch (MLA). Improper functioning of the IFM leads to excessive pronation of the foot, which has been linked to various pathologies. Therefore, training the IFM to avoid excessive pronation may help prevent some of these pathologies; however, it is not clear how to train these muscles optimally.
To investigate the effects of 2 different types of IFM training on the height of the MLA and static- and dynamic-balance task performance.
Randomized controlled trial, repeated-measures mixed-model design.
University biomechanics laboratory for testing and a home-based training program.
24 healthy, university-age volunteers (3 groups of 8) with no history of major lower limb pathology or balance impairment.
One experimental group performed 4 wk of the short-foot exercise (SFE) and the other performed 4 wk of the towel-curl exercise (TCE). Participants were asked to perform 100 repetitions of their exercise per day.
Main Outcome Measures:
Navicular height during weight bearing, the total range of movement of the center of pressure (COP) in the mediolateral (ML) direction for a static-balance test and a dynamic-balance test.
There were no differences in the navicular height or static-balance tests. For the dynamic-balance test, all groups decreased the ML COP movement on the dominant limb by a small amount (~5 mm); however, the SFE group was able to decrease COP movement much more than the TCE group in the nondominant limb.
The SFE appeared to train the IFM more effectively than the TCE; however, there were differing results between the dominant and nondominant legs. These imbalances need to be taken into consideration by clinicians.
Nicole J. Chimera and Mallorie Larson
chronic ankle instability. 15 In addition, individuals with supinated or pronated foot type(s) performed worse on static single-leg stance than those with neutral feet. 16 Furthermore, females with low-medial longitudinal arch, as classified by the arch height index (AHI), performed worse on static
Cameron Haun, Cathleen N. Brown, Kimberly Hannigan and Samuel T. Johnson
an active stabilizer to the arches of the foot. 7 An approach we have observed being utilized for overuse injuries associated with deformation of the arch is the short foot exercise (SFE). The goal of the SFE is to support the arches of the foot, specifically the medial longitudinal arch, by
Wataru Kawakami, Makoto Takahashi, Yoshitaka Iwamoto and Koichi Shinakoda
hallux valgus; in particular, the medial longitudinal arch collapse is often associated with the hallux valgus etiology. 2 – 4 However, it has been indicated that static foot characteristics are not necessarily reflected in the dynamic foot characteristics. 5 Therefore, an important step in the