Bilateral Gait Asymmetry in Patients with Hallux Valgus using Normalized Cross-Correlation Function

Abstract

The characterization of changed gait patterns caused by hallux valgus (HV) has been proposed in several studies; however, most of these studies have primarily focused on univariate kinematic variables rather than on the coupled and coordinated movement of multiple body segments during walking. Human gait is a spatiotemporally complex and coordinated movement; hence, simple univariate measures cannot assess the coupled relationship between multiple joint motions. The purpose of this study was to examine how HV would change the gait dynamics of the lower extremity and whether the type of shoes worn by the subjects would affect gait behavior. In particular, the cross-correlation function (CCF) was used to determine the coupled characteristics between individual joint variables during gait. The CCF quantified the bilateral asymmetry of the lower extremities and the degree of coupling of multiple body segments. From the perspective of bilateral symmetry, the joint coupling relationship of the lower limbs had a significant deviation in the ankle and knee joint coupling (AK) instead of in the hip and knee joint coupling (HK). For low heels, the types of shoes worn by patients with HV are commonly found to have the lowest maximum CCF values for HK and AK $$(p < .05)$$ . The ankle joints in patients with HV had the main effect, particularly with higher heels. The results of this study show that the gait performance can be characterized using the CCF and may help clinicians in examining the bilateral gait asymmetry of patients with HV and other people with gait disturbances.