Midfoot passive stiffness affects foot and ankle kinematics and kinetics during the propulsive phase of walking.

The midfoot joint complex (MFJC) is related to the mechanics and efficiency of the walking propulsive phase and low midfoot passive stiffness may require compensatory foot and ankle joint moments to avoid excessive pronation and inefficient propulsion. This study aimed to investigate the kinematics and kinetics of the MFJC and ankle during the propulsive phase of walking in subjects with larger and smaller midfoot passive stiffness. MFJC passive stiffness of 20 healthy adult participants, and the kinematics and kinetics of the MFJC (forefoot-rearfoot) and ankle (rearfoot-shank) during the stance phase of walking were measured. The participants were divided equally into two groups according to the MFJC passive stiffness. Ranges of motion (ROM) and mean joint moments were computed for the late stance. Independent t-tests (α = 0.05) revealed that subjects with lower midfoot passive stiffness showed an increased MFJC sagittal ROM (flattened longitudinal arch) (p = 0.002), increased ankle frontal ROM (more everted positions) (p = 0.002), increased MFJC frontal ROM (more inverted positions) (p = 0.019), as well as a tendency for larger ankle sagittal ROM (p = 0.056). They also showed increased MFJC (p = 0.021) and ankle (p = 0.018) moments in the sagittal plane, increased MFJC moment in the frontal plane (p = 0.047) and a tendency for a predominant ankle moment in the frontal (p = 0.058). Foot and ankle joint moments are possible strategies to reduce pronation and improve propulsion, but not sufficient to prevent the altered kinematics related to low midfoot stiffness. Therefore, midfoot passive stiffness is critical for foot and ankle kinematics and kinetics during walking propulsive phase and is a potential target of interventions.

Comparison of the rigidity and forefoot - Rearfoot kinematics from three forefoot tracking marker clusters during walking and weight-bearing foot pronation-supination.

Due to the relative motion among the foot rays, the present study aimed to compare the rigidity as well as the forefoot - rearfoot kinematics obtained from three forefoot tracking marker clusters during walking and foot pronation-supination (PROSUP). Nineteen healthy adults performed six walking trials and ten cycles of foot PROSUP movements recorded by an optoelectronic system. Rearfoot's and forefoot's coordinate system were equal for all setups, only the forefoot's tracking markers locations varied among them, which were: (1st) a typical cluster, focusing on the proximal forefoot, (2nd) a second typical cluster, focusing on the distal forefoot and outer metatarsals, and (3rd) a new cluster proposition, focusing on the distal forefoot and central metatarsals. Cluster rigidity was the normalized intra-markers residual, and forefoot - rearfoot angles were the forefoot motion relative to the rearfoot at the peak of each plane of motion. Repeated-measures ANOVA with pairwise comparisons (α=0.05) revealed that the 3rd cluster had the smallest residual (p < 0.001) in comparison with the other clusters for both walking and PROSUP. Differences between forefoot - rearfoot angles were found in the sagittal plane for walking (p < 0.001), but not for PROSUP (p > 0.686). In the frontal and transverse planes, all clusters showed different forefoot - rearfoot angles (p < 0.001) for both walking and PROSUP. The 1st cluster showed smaller ROM in the three planes during walking, and the 3rd cluster was the only that showed forefoot - rearfoot inversion during maximum pronation. Therefore, the new forefoot tracking marker cluster proposition (3rd cluster) captured different forefoot - rearfoot kinematics and can be recommended when the objective is to maximize the cluster rigidity.