Coupling Between Foot Pronation and Tibial Internal Rotation

NewsBot · Nov 12, 2014

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Evaluating the Coupling Between Foot Pronation and Tibial Internal Rotation Continuously Using Vector Coding.
Rodrigues P, Chang R, TenBroek T, van Emmerik R, Hamill J.
J Appl Biomech. 2014 Nov 11

Excessive pronation, because of its coupling with tibial internal rotation (TIR), has been implicated as a risk factor in the development of anterior knee pain (AKP). Traditionally this coupling has been expressed as a ratio between the eversion range of motion and the TIR range of motion (Ev/TIR) that occurs during stance. Currently, this technique has not been used to evaluate specific injuries or the effects of gender. Additionally, Ev/TIR is incapable of detecting coupling changes that occur throughout stance. Therefore, the purpose of this study was to compare the coupling between eversion and TIR in runners with (n = 19) and without AKP (n = 17) and across gender using the Ev/TIR ratio, and more continuously using vector coding. When using vector coding, significant coupling differences were noted in runners with AKP (34-38% stance), with runners with AKP showing relatively more TIR than eversion. Similarly significant differences were noted across gender (14-25 & 36-47% stance) with males transitioning from a loading to propulsive coordination pattern using a proximal to distal strategy, while female runners used a distal to proximal strategy. These differences were only detected when evaluating this coupling relationship using a continuous technique such as vector coding.
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Admin2 · Nov 12, 2014

Related Thread:
Does the tibia drive the foot or does the foot drive the tibia?

NewsBot · Mar 20, 2015

Foot posture and function have only minor effects on knee function during barefoot walking in healthy individuals
Andrew K. Buldt, Pazit Levinger, George S. Murley, Hylton B. Menz, Christopher J. Nester, Karl B. Landorf
Article in Press
Clinical Biomechanics; Article in Press

Highlights
•Recruited healthy participants with either normal, planus and cavus foot posture
•Compared knee rotations and adduction moment while walking at a comfortable pace
•Examined association between rear/midfoot joint rotations and knee adduction moment
•Found differences in knee joint angle at heel contact.
•Foot posture/ joint rotations do not substantially influence the knee
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Background
Foot posture has been postulated as a risk factor for overuse injuries of the knee, however the link between foot posture and knee joint function is unclear. The aims of this study were to: (i) compare knee adduction moment and knee joint rotations between normal, planus and cavus foot posture groups, and (ii) to determine the relationship between rearfoot and midfoot joint rotations and knee adduction moment magnitude.

Methods
Rotation of the knee, rearfoot and midfoot was evaluated in 97 healthy adults that were classified as normal (n = 37), cavus (n = 31) or planus (n = 32) for the Foot Posture Index, Arch Index and normalised navicular height. One way ANOVAs were used to compare tri-planar knee joint rotation, knee adduction moment peak variables and knee adduction angular impulse between foot posture groups. Pearson’s correlation coefficient was used to investigate the association between rearfoot and midfoot joint rotation during initial contact phase and the magnitude of 1st knee adduction moment peak.

Findings The planus group displayed significantly greater external rotation angle at heel contact compared to both normal and cavus groups. The planus groups also displayed greater extension at heel contact and sagittal plane flexion range of motion during propulsion and early swing compared to the cavus group. Otherwise, differences between groups were characterised by small effect sizes. There was no association between rearfoot or midfoot joint rotations and knee adduction moment.

Interpretation These findings suggest that in healthy individuals, foot posture and foot joint rotations do not substantially influence knee joint rotations and knee adduction moment while walking at a comfortable pace.
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NewsBot · Aug 9, 2017

Foot and Ankle Joint Biomechanical Adaptations to an Unpredictable Coronally-Uneven Surface.
Segal A et al
J Biomech Eng. 2017 Aug 8. doi: 10.1115/1.4037563.

Coronally-uneven terrain, a common yet challenging feature encountered in daily ambulation, exposes individuals to an increased risk of falling. The foot-ankle complex may adapt to improve balance on uneven terrains, a recovery strategy which may be more challenging in patients with foot-ankle pathologies. A multi-segment foot model was used to study the biomechanical adaptations of the foot and ankle joints during a step on a visually obscured, coronally-uneven surface. Kinematic, kinetic and in-shoe pressure data were collected as ten participants walked on an instrumented walkway with a surface randomly positioned ±15° or 0° in the coronal plane. Coronally-uneven surfaces altered hindfoot-tibia loading, with more conformation to the surface in early than late stance. Distinct loading changes occurred for the forefoot-hindfoot joint in early and late stance, despite smaller surface conformations. Hindfoot-tibia power at opposite heel contact was generated and increased on both uneven surfaces, whereas forefoot-hindfoot power was absorbed and remained consistent across surfaces. Push-off work increased for the hindfoot-tibia joint on the everted surface and for the forefoot-hindfoot joint on the inverted surface. Net work across joints was generated for both uneven surfaces, while absorbed on flat terrain. The partial decoupling and joint-specific biomechanical adaptations on uneven surfaces suggest that multi-articulating interventions such as prosthetic devices and arthroplasty may improve ambulation for mobility-impaired individuals on coronally-uneven terrain.
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NewsBot · Oct 24, 2018

Factors that determine kinematic coupling behavior of calcaneal pronation/supination and shank rotation during weight bearing: ananalysis based on foot bone alignment using radiographic images.
Edo M, Yamamoto S, Yonezawa T
J Phys Ther Sci. 2018 Oct;30(10):1215-1220

[Purpose] This study aimed to identify factors that determine the kinematic coupling behavior of calcaneal pronation/supination and shank rotation in a standing position. [Participants and Methods] Study participants included 15 healthy adults (30 legs). Kinematic coupling behavior was quantified as the linear regression coefficient (kinetic chain ratio [KCR]) of the angle of shank rotation against the angle of calcaneal pronation-to-supination measured using a 3-dimensional motion analysis system during pronation and supination of both feet while standing. The relationship between the KCR and the foot bone alignment was also analyzed using 35 parameters that were evaluated based on plain radiography. [Results] Greater the height of the medial longitudinal arch, and greater the backward tilt of the long axis of the talus and the backward tilt of the talar articular surface of the calcaneus, larger the KCR. This alignment differed between the genders. [Conclusion] This study suggested that the KCR increases as the subtalar joint axis approaches the long axis of the shank secondary to the lifting of the medial longitudinal arch of the foot and decreases as the subtalar joint axis approaches the long axis of the foot secondary to the lowering of the medial longitudinal arch of the foot.
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NewsBot · Jan 23, 2021

Foot joint coupling variability differences between habitual rearfoot and forefoot runners prior to and following an exhaustive run
Rhiannon M Seneli et al
J Electromyogr Kinesiol. 2021 Jan 8

As joint coupling variability has been associated with running-related lower extremity injury, the purpose of this study was to identify how variability within the foot may be different between forefoot (FFS) and rearfoot strike (RFS) runners. Identifying typical variability in uninjured runners may contribute to understanding of ideal coordination associated with running foot strike patterns. Fifteen FFS and 15 RFS runners performed a maximal-effort 5 km treadmill run. A 7-segment foot model identified 6 functional articulations (rearfoot, medial and lateral midfoot and forefoot, and 1st metatarsophalangeal) for analysis. Beginning and end of the run motion capture data were analyzed. Vector coding was used to calculate 6 joint couples. Standard deviations of the coupling angles were used to identify variability within subphases of stance (loading, mid-stance, terminal, and pre-swing). Mixed between-within subjects ANOVAs compared differences between the foot strikes, pre and post run. Increased variability was identified within medial foot coupling for FFS and within lateral foot coupling for RFS during loading and mid-stance. The exhaustive run increased variability during mid-stance for both groups. Interpretation. Joint coupling variability profiles for FFS and RFS runners suggest different foot regions have varying coordination needs which should be considered when comparing the strike patterns.
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