Abstract
Background and Objectives: Acquiring knowledge about the magnitude and direction of induced joint forces during modifying gait strategies is critical for proper exercise prescription. The present study aimed to evaluate whether a heel-first strike pattern during gait can affect the biomechanical characteristics of ankle and knee joints among asymptomatic people. Materials and Methods: In this cross-sectional study performed in the biomechanics laboratory, 13 professional healthy male athletes walked on an instrumented walkway under two walking conditions. For the normal condition, subjects were instructed to walk as they normally would. For the heel-first strike condition, subjects were instructed to walk with heel-first strike pattern and increase heel contact duration as much as possible. Then, knee and ankle joint range of motions and moments, as well as vertical ground reaction force was measured by the Kistler force plate and Vicon motion analysis system. Results: Knee flexion angle at the initial contact and during stance phase was significantly lower when increasing the heel strike pattern. In addition, the mean values of the knee external rotation and adductor moments during heel strike condition were lower than those in normal walking. Further, the ankle dorsiflexion range of motion (ROM) during mid-stance increased significantly during heel-first strike pattern compared to the value in normal gait pattern. Conclusions: The modification of gait pattern including heel-first strike pattern can reduce the mechanical load applied to the knee, while improving the extensibility of gastro-soleus muscle complex.
Highlights
Excessive joint forces play a significant role in developing musculoskeletal system impairment and pain which are the major causes of disability and form a major part of the high costs of health care in the industrialized world [1,2]
No significant difference was observed between the mean values for ankle dorsiflexion during stance phase in two conditions (t = 0.22, df = 12, p = 0.82)
The mean ankle dorsiflexion during mid-stance was higher during walking with heel-first strike compared to normal walking (t = −2.37, df = 12, p = 0.04)
Summary
Excessive joint forces play a significant role in developing musculoskeletal system impairment and pain which are the major causes of disability and form a major part of the high costs of health care in the industrialized world [1,2]. The decreased ankle dorsiflexion may decrease anterior tibial translation at the ankle joint during stance phase of the gait cycle [7] and result in lowering the center of gravity during functional tasks such as walking [9]. This may compensate through mid-foot and subtalar joint pronation, knee joint flexion and valgus, which are related to chronic and acute injuries including ACL rupture, patella-femoral pain syndrome (PFPS), and knee osteoarthritis [10]. The ankle dorsiflexion range of motion (ROM) during mid-stance increased significantly during heel-first strike pattern compared to the value in normal gait pattern. Conclusions: The modification of gait pattern including heel-first strike pattern can reduce the mechanical load applied to the knee, while improving the extensibility of gastro-soleus muscle complex
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