In vivo kinematic changes of the medial longitudinal arch during barefoot and high-heeled shoes walking.

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The medial longitudinal arch (MLA) is crucial for maintaining balance and center of gravity stability during human walking. High-heeled shoes (HHS) will affect the kinematics of the MLA which further affects the overall function of the foot. However specific motion effects of HHS on MLA during walking remain unclear. Therefore, this study aimed to use dynamic biplane radiography (DBR) to explore the angle and six-degrees-of-freedom (6DOF) kinematic changes of MLA in barefoot and HHS conditions. Fourteen healthy women without HHS experience were recruited. All subjects are required to undergo foot and ankle MRI scans for 3D modeling. Then DBR captured 2D fluorescence images of MLA throughout the stance phase during barefoot and HHS walking. MLA angle and 6DOF kinematics of the first metatarsal relative to the calcaneus were calculated using 3D-2D alignment technique in MATLAB. The MLA kinematics in 6DOF and MLA angle were compared between barefoot and HHS. During the stance phase, compared to barefoot, the MLA's maximum lateral (9.8 ± 2.4 mm vs 7.9 ± 0.9 mm, p = 0.01), and anterior (10.0 ± 1.8 mm vs 8.1 ± 0.9 mm, p = 0.002) displacement; medial-lateral ROM(7.7 ± 2.1 mm vs 5.8 ± 1.7 mm, p = 0.004) were significantly smaller in the HHS condition. The MLA's maximum flexion (2.4 ± 1.5° vs 7.3 ± 1.9°, p < 0.001), supination (-1.7 ± 2.3° vs 0.6 ± 1.9°, p = 0.009) were significantly larger in the HHS condition. The adduction-abduction ROM (10.2 ± 2.0° vs 7.1 ± 2.0°, p < 0.001) of the MLA was significantly smaller in the HHS condition. No significant differences (p > 0.05) were observed in peak MLA angle change and ROM after wearing HHS. DBR quantifies the kinematics of the MLA during HHS walking. The results indicated that HHS decreased the MLA angle, limiting joint translation while enhancing supination and flexion angles. It may increase the risk of MLA damage during walking. These findings deepen our understanding of HHS's influence on MLA kinematics and clarify its impact on foot health.