Subtalar joint motion during gait

NewsBot · May 3, 2019

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Evaluation of the subtalar joint during gait using 3-D motion analysis: Does the STJ achieve neutral position?
James M. Mahoney DPM et al
The Foot and Ankle Online Journal 12 (1): 4

Background: One theory of hindfoot biomechanics claims that the subtalar joint (STJ) reaches neutral position during midstance, while another maintains that the STJ stays in an everted position throughout. There is also evidence that STJ position during midstance changes with walking speed. The present study will compare four distinct STJ static positions to 3D kinematics of the STJ during self-selected and fast gait in over-ground level walking.
Methods: The right lower leg of 20 male participants was placed in three clinically used subtalar joint neutral static positions using biomechanical examination: SJNR (STJ neutral by calculation method), SJNP (STJ neutral by palpation method), NCSP (neutral calcaneal stance position), as well as in the resting bilateral standing posture RCSP (resting calcaneal stance position). An eight-camera 3D motion capture system was used to capture and analyze the kinematics of the ankle complex during self-selected and fast walking conditions, as well as, the four static postures.
Results: The 3D subtalar joint movement pattern did not coincide with any of the three subtalar joint neutral positions (SJNR, SJNP and NCSP) during the midstance phase of self-selected or fast walking. Specifically, the subtalar joint remained in a significantly more everted and abducted position with greater deviations from neutral under the fast-walking condition.
Conclusions: None of the clinically used STJ neutral positions agree with the 3D pattern of the STJ during self-selected and fast gait. These results have implications related to clinical practice and the use of the STJ neutral position for evaluation and treatment purposes.
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NewsBot · Nov 1, 2023

Ankle and subtalar joint axes of rotation and center of rotation during walking and running in healthy individuals measured using dynamic biplane radiography
Paige Paulus et al
J Biomech. 2023 Oct 11:160:111837

The goal of this study was to determine how foot type and activity level affect ankle and hindfoot motion. Dynamic biplane radiography and a validated volumetric registration process was used to measure ankle and hindfoot motion of 20 healthy adults during walking and running. The helical axes of motion (HAM) during stance were calculated at the tibiotalar and subtalar joints. The intersection of each HAM and the rotation plane of interest defined the tibiotalar and subtalar centers of rotation (COR). Correlations between foot type and hindfoot kinematics were calculated using Pearson's correlations. The effect of activity, phase of gait, and dominant vs. non-dominant limb on HAM and COR were evaluated using linear mixed effects models. Activity and phase of gait influenced the superior location of the tibiotalar (p < 0.041) and subtalar (p < 0.044) CORs. Activity and gait phase affected tibiotalar (p < 0.049) and subtalar (p < 0.044) HAM direction during gait. Both HAM orientation and COR location changed with activity and phase of gait. These ankle and hindfoot kinematics have implications for total ankle replacement design and musculoskeletal models that estimate force and moment generating capabilities of muscles.
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NewsBot · Apr 3, 2024

Influence of Talar and Calcaneal Morphology on Subtalar Kinematics During Walking
Tetsuya Yamamoto et al
Foot Ankle Int. 2024 Mar 15

Background: Cadaver biomechanical testing suggests that the morphology of articulating bones contributes to the stability of the joints and determines their kinematics; however, there are no studies examining the correlation between bone morphology and kinematics of the subtalar joint. The purpose of this study was to investigate the influence of talar and calcaneal morphology on subtalar kinematics during walking in healthy individuals.

Methods: Forty ankles (20 healthy subjects, 10 women/10 men) were included. Participants walked at a self-selected pace while synchronized biplane radiographs of the hindfoot were acquired at 100 images per second during stance. Motion of the talus and calcaneus was tracked using a validated volumetric model-based tracking process, and subtalar kinematics were calculated. Talar and calcaneal morphology were evaluated using statistical shape modeling. Pearson correlation coefficients were used to assess the relationship between subtalar kinematics and the morphology features of the talus and calcaneus.

Results: This study found that a shallower posterior facet of the talus was correlated with the subtalar joint being in more dorsiflexion, more inversion, and more internal rotation, and higher curvature in the posterior facet was correlated with more inversion and eversion range of motion during stance. In the calcaneus, a gentler slope of the middle facet was correlated with greater subtalar inversion.

Conclusion: The morphology of the posterior facet of the talus was found to a primary factor driving multiplanar subtalar joint kinematics during the stance phase of gait.

Clinical relevance: This new knowledge relating form and function in the hindfoot may assist in identifying individuals susceptible to subtalar instability and in improving implant design to achieve desired kinematics after surgery.
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