Abstract
BackgroundThis study evaluated the 3D angle between the joint moment and the joint angular velocity vectors at the intrinsic foot joints, and investigated if these joints are predominantly driven or stabilized during gait.MethodsThe participants were 20 asymptomatic subjects. A four-segment kinetic foot model was used to calculate and estimate intrinsic foot joint moments, powers and angular velocities during gait. 3D angles between the joint moment and the joint angular velocity vectors were calculated for the intrinsic foot joints defined as follows: ankle joint motion described between the foot and the shank for the one-segment foot model (hereafter referred as Ankle), and between the calcaneus and the shank for the multi-segment foot model (hereafter referred as Shank-Calcaneus); joint motion described between calcaneus and midfoot segments (hereafter referred as Chopart joint); joint motion described between midfoot and metatarsus segments (hereafter referred as Lisfranc joint); joint motion described between first phalanx and first metatarsal (hereafter referred as First Metatarso-Phalangeal joint). When the vectors were approximately aligned, the moment was considered to result in propulsion (3D angle <60o) or resistance (3D angle >120o) at the joint. When the vectors are approximately orthogonal (3D angle close to 90°), the moment was considered to stabilize the joint.ResultsThe results showed that the four intrinsic joints of the foot are never fully propelling, resisting or being stabilized, but are instead subject to a combination of stabilization with propulsion or resistance during the majority of the stance phase of gait. However, the results also show that during pre-swing all four the joints are subject to moments that result purely in propulsion. At heel off, the propulsive configuration appears for the Lisfranc joint first at terminal stance, then for the other foot joints at pre-swing in the following order: Ankle, Chopart joint and First Metatarso-Phalangeal joint.ConclusionsIntrinsic foot joints adopt a stabilized-resistive configuration during the majority of the stance phase, with the exception of pre-swing during which all joints were found to adopt a propulsive configuration. The notion of stabilization, resistance and propulsion should be further investigated in subjects with foot and ankle disorders.
Highlights
This study evaluated the 3D angle between the joint moment and the joint angular velocity vectors at the intrinsic foot joints, and investigated if these joints are predominantly driven or stabilized during gait
While kinematic multisegment foot models can demonstrate the motion of the various intrinsic joints of the foot, establishing the kinetics of these joints represent a new series of challenges: definition of inter-segment joint centers, estimation of segmental shear forces and definition of segment inertial properties [11]
The 3D angle αMω and P/R % curves show that the four joints are never fully propelling, resisting or stabilized, but adopt a stabilized-resistive configuration during most of the stance phase, except at pre-swing with all joints in a propulsive configuration (Fig. 5)
Summary
This study evaluated the 3D angle between the joint moment and the joint angular velocity vectors at the intrinsic foot joints, and investigated if these joints are predominantly driven or stabilized during gait. While kinematic multisegment foot models can demonstrate the motion of the various intrinsic joints of the foot, establishing the kinetics of these joints represent a new series of challenges: definition of inter-segment joint centers, estimation of segmental shear forces and definition of segment inertial properties [11]. Despite these technical and methodological challenges, joint moments and powers have been able to provide new insights into the dynamic contribution of the Chopart and Lisfranc joints during gait, and new mechanisms of foot dysfunction in specific foot and ankle pathologies [11, 13, 14]. The Chopart joint has been described as the inter-segmental joint between the calcaneus and the midfoot segments whereas the Lisfranc joint was defined as the inter-segmental joint between the midfoot and the forefoot segments [4]
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