Abstract
BackgroundThe Root model of normal and abnormal foot function remains the basis for clinical foot orthotic practice globally. Our aim was to investigate the relationship between foot deformities and kinematic compensations that are the foundations of the model.MethodsA convenience sample of 140 were screened and 100 symptom free participants aged 18–45 years were invited to participate. The static biomechanical assessment described by the Root model was used to identify five foot deformities. A 6 segment foot model was used to measure foot kinematics during gait. Statistical tests compared foot kinematics between feet with and without foot deformities and correlated the degree of deformity with any compensatory motions.ResultsNone of the deformities proposed by the Root model were associated with distinct differences in foot kinematics during gait when compared to those without deformities or each other. Static and dynamic parameters were not correlated.ConclusionsTaken as part of a wider body of evidence, the results of this study have profound implications for clinical foot health practice. We believe that the assessment protocol advocated by the Root model is no longer a suitable basis for professional practice. We recommend that clinicians stop using sub-talar neutral position during clinical assessments and stop assessing the non-weight bearing range of ankle dorsiflexion, first ray position and forefoot alignments and movement as a means of defining the associated foot deformities. The results question the relevance of the Root assessments in the prescription of foot orthoses.
Highlights
The Root model of normal and abnormal foot function remains the basis for clinical foot orthotic practice globally
The first definitive protocol for clinical biomechanical assessment of the foot was developed by Root et al [1, 2] which is often referred to as the “Root model” of foot function
These include using static assessment of the foot to infer dynamic foot kinematics [15], defining structural deformities between foot segments and advocating their correction [4, 5], and using foot shape when the sub talar joint is in a ‘neutral positon’ as a basis for orthotic design[4, 11, 16]
Summary
The Root model of normal and abnormal foot function remains the basis for clinical foot orthotic practice globally. The core concepts continue to be prominent in popular texts [3,4,5,6], debates, conferences [7,8,9,10], practice [11,12,13,14,15,16,17], undergraduate podiatry syllabus across the United Kingdom [Nester, personal communication, December 2016] and are highly prevalent in grey literature and online resources These include using static assessment of the foot to infer dynamic foot kinematics [15], defining structural deformities between foot segments and advocating their correction [4, 5], and using foot shape when the sub talar joint is in a ‘neutral positon’ as a basis for orthotic design[4, 11, 16]. The degree of abnormal alignment or movement would correlate with the degree of compensation
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