Arch Height Ratio Research Articles

Foot posture alteration and recovery following a full marathon run

Prolonged running results in lowering of the foot arch and a low arch is associated with subsequent chronic injuries. Foot posture alteration and recovery following a marathon run remain unknown. Therefore, the present study aimed to evaluate foot posture alteration following a full marathon run. The three-dimensional foot posture data of 11 collegiate runners were obtained using an optical foot scanner system before, and immediately, 1 day, 3 days, and 8 days after a full marathon. The navicular height and arch height ratio significantly decreased from before to immediately, 1 day, 3 days, and 8 days after the marathon (navicular height: before, 44.2 ± 5.0 mm; immediately after, 39.4 ± 5.5 mm; 1 day, 37.7 ± 6.2 mm; 3 days, 38.7 ± 5.5 mm; 8 days, 37.6 ± 5.7 mm; arch height ratio: before, 18.4 ± 1.9; immediately after, 16.5 ± 2.5; 1 day, 15.7 ± 2.5; 3 days, 16.2 ± 2.6; 8 days, 15.6 ± 2.2, P < 0.001, respectively). By contrast, the dorsal height significantly increased from before and immediately after to 1 day after the marathon, and then significantly decreased until 8 days after the marathon (P < 0.001). These results indicate that the recovery patterns of the dorsal and navicular heights following a marathon did not coincide; the dorsal height rose temporally at 1 day after and subsequently decreased, but the navicular height decreased throughout the 8-day period after the marathon. More than one week may be necessary for sufficient foot alignment recovery from marathon-induced changes.

Foot structure is significantly associated to subtalar joint kinetics and mechanical energetics

Introduction/aimFoot structure has been implicated as a risk factor of numerous overuse injuries, however, the mechanism linking foot structure and the development of soft-tissue overuse injuries are not well understood. The aim of this study was to identify factors that could predict foot function during walking. MethodsA total of eleven variables (including measures of foot structure, anthropometry and spatiotemporal gait characteristics) were investigated for their predictive ability on identifying kinematic, kinetic and energetic components of the foot. Three-dimensional motion capture and force data were collected at preferred walking speed on an instrumented treadmill. Mechanical measures were subsequently assessed using a custom multi-segment foot model in Opensim. Factors with significant univariate associations were entered into multiple linear regression models to identify a group of factors independently associated with the mechanical measures. ResultsAlthough no model could be created for any of the kinematic measures analysed, approximately 46% and 37% of the variance in the kinetic and energetic measures were associated with three or two factors respectively. Arch-height ratio, foot length and step width were associated with peak subtalar joint (STJ) moment, while greater STJ negative work was correlated to a low arch-height ratio and greater foot mobility. ConclusionThe models presented in this study suggest that the soft-tissue structures of a flat-arched, mobile foot are at a greater risk of injury as they have greater requirements to absorb energy and generate larger forces. However, as these associations are only moderate, other measures may also have an influence.

Association between Height of the Forefoot Transverse Arch and Kinetics or Kinematics of Ankle Joint during Gait

Objective: Most studies on arch biomechanics focus on the medial longitudinal arch (MLA) and its function; however, there are fewer studies on the forefoot transverse arch (FTA) biomechanics and its function is not well understood. This study aimed at investigating the function of FTA on foot kinetics and kinematics during gait. Methods: Nineteen healthy participants (10 men, 9 women) with a mean age of 25.8 years were recruited. Each measurement was performed with the participants’ dominant foot. For evaluating FTA, transverse arch index (TAI) was measured using ultrasonic diagnostic equipment, which represented the relative height of FTA. Measurements were performed in a two-stance condition: 90% of weight bearing (90% WB), and 10% of weight bearing (10% WB). For evaluating MLA, arch height ratio (AHR) were measured with a ruler. A three-dimensional motion analysis system was used to capture and analyze foot kinetics and kinematics. Participants were instructed to walk barefoot along a 7 m walkway at regular walking pace (110 steps/minute). To examine the function of FTA, spearman’s correlation coefficients were calculated for non-parametric variables (TAI at 10% WB with foot kinetics and kinematics), to examine the relationship between MLA and FTA, (TAI at 10% WB with AHR), to examine flexibility of FTA, (the difference between TAI in 90% and 10% WB with vertical ground reaction force (GRFV)in the terminal stance). Results: A significant positive correlation was observed between TAI and max GRFV in the terminal stance (r=0.50, P=0.03). There was no significant difference between TAI at 10% WB and AHR, A significant negative correlation was observed between the difference in TAI at 90% and 10% WB and, max GRFV in the terminal stance (r=-0.64, P=0.003). Conclusions: The present study showed that GRFV in the terminal stance was positively correlated with the height of FTA, and that flexibility of FTA has relative to GRFV in the terminal stance during gait. It is important to measure flexibility of FTA as well as height of FTA so as to predict the risk of forefoot injury.

The use of a static measure to predict foot posture at midstance during walking

Previous studies have successfully used the longitudinal arch angle (LAA) to assess foot posture, but the measurement consistency and ability of the LAA to predict dynamic foot posture during activity in a variety of foot types have not been evaluated. The purpose of this study was to determine the reliability of the LAA as well as if the clinical method of assessing the LAA could be used to predict the LAA at midstance during walking for supinated, normal, and pronated foot types. The Arch Height Ratio was used to select 35 participants with 12 supinated, 46 normal, and 12 pronated feet. A standard goniometer was used to measure the LAA (CLINIC_LAA) on both feet while standing. Both feet were then filmed using a high speed camera while walking on a treadmill. The LAA was determined by the angle formed by two lines drawn between the markers placed on the first metatatarsal and medial malleolus with the apex the navicular tuberosity. The LAA in midstance (WALK_LAA) was determined using the mean of five walking trials. The reliability of the CLINIC_LAA assessed on both feet by two raters over two days were excellent. There was no difference between the left and right foot for the CLINIC_LAA. The Pearson correlation between CLINIC_LAA and WALK_LAA for all 70 feet was r=0.96 (r2=0.92). The results indicate the LAA is highly predictive of foot posture at midstance in walking explaining over 90% of the variance for a wide range of foot types.

Pathogenesis of Fifth Metatarsal Stress Fractures in College Soccer Players

Category: Sports Introduction/Purpose: The pathogenesis of fifth metatarsal stress fractures remains uncertain. We hypothesized that physical characteristics and environmental factors, which have received limited attention in the literature thus far, might be involved in the development of such fractures. To test our hypothesis, we performed a medical checkup and a survey of the living environment of athletes in college soccer teams, and subsequently, we investigated the existence of fifth metatarsal stress fractures, and examined the differences between the injury group and the non-injury group. Methods: The survey and measurements were conducted in 273 male athletes from the same college soccer team between 2005 and 2013. A medical checkup, comprising assessment of stature, body weight, body mass index, arch height ratio, toe-grip strength, quadriceps angle, leg-heel angle, functional reach test, one-leg standing time with eyes closed, straight leg raise test, finger-floor distance, heel-to-buttock distance, ankle joint range of motion, and general joint laxity test, and a questionnaire survey were performed once a year. A survey was conducted at the time of injury that resulted in fifth metatarsal stress fractures. The study participants were separated into an injury group and a non-injury group, depending on whether they had a fifth metatarsal stress fracture. The measurement items and survey items were compared, and the association between the presence or absence of injury and the measurement items was analyzed. Results: Toe-grip strength was significantly weaker in the injury group, compared with the non-injury group, suggesting that a weak toe-grip is associated with fifth metatarsal stress fracture (p &lt; 0.05). In addition, injury on the non-dominant leg was more frequent in the fifth metatarsal stress fracture injury group (p &lt; 0.05). Between-group comparisons of the other items showed no statistically significant differences. Conclusion: The association between weak toe-grip strength and fifth metatarsal fracture suggests that a weak toe-grip may lead to an increase in the load applied onto the lateral side of the foot; this may cause mechanical stress on the bone. In addition, the effect of the non-dominant leg on the fifth metatarsal bone may need to be studied further.

Changes in Foot Shape after Long-Distance Running

Changes in foot shape during long-distance running may lead to alteration in shoe fit. However, little information is available on changes in foot shape following long-distance running. The purpose of this study was to assess changes in foot shape in experienced runners after a single long-distance run. Data from the right feet of 21 subjects were obtained using a foot scanner before and after running 35 km on an asphalt road. After the run, the dorsal height, navicular height, and arch height ratio were significantly decreased. Midfoot cross-sectional shape after the run was deformed laterally compared to before running. Lateral deformity of the lateral dorsum was seen in 76.2% of the feet. For the medial side, 47.6% of feet deformed medially and 38.1% of feet did not change. The findings of the present study suggest that foot shape is altered during a single long-distance run. These results suggest that footwear fit and comfort could be affected during long distance running because athletes tie their shoelaces based on their pre-running foot shape.

Pathogenesis of Fifth Metatarsal Fractures in College Soccer Players

Background:The pathogenesis of fifth metatarsal stress fractures remains uncertain.Hypothesis:Physical characteristics and environmental factors, which have received limited attention in the literature thus far, might be involved in the development of fifth metatarsal stress fractures.Study Design:Case-control study; Level of evidence, 3.Methods:To test the study hypothesis, a medical examination and survey of the living environment of collegiate soccer players was conducted and correlated with the existence of fifth metatarsal stress fractures. The survey and measurements were conducted in 273 male athletes from the same college soccer team between 2005 and 2013. A medical examination comprising assessment of stature, body weight, body mass index, foot–arch height ratio, toe-grip strength, quadriceps angle, leg-heel angle, functional reach test, single-leg standing time with eyes closed, straight-leg raise angle, finger-floor distance, heel-buttock distance, ankle joint range of motion, and a general joint laxity test were performed once a year, along with a questionnaire survey. The survey was also repeated when a fifth metatarsal stress fracture was diagnosed. The study participants were separated into a fifth metatarsal stress fracture injury group and a noninjury group. The measurement items and survey items were compared, and the association between the factors and the presence or absence of injuries was analyzed.Results:Toe-grip strength was significantly weaker in the injury group compared with the noninjury group, suggesting that weak toe-grip is associated with fifth metatarsal stress fracture (P < .05). In addition, fifth metatarsal stress fractures were more common in the nondominant leg (P < .05). Between-group comparisons of the other items showed no statistically significant differences.Conclusion:The association between weak toe-grip strength and fifth metatarsal fracture suggests that weak toe-grip may lead to an increase in the load applied onto the lateral side of the foot, resulting in stress fracture. The finding of stress fracture being more common in the nondominant leg needs further study.

Standard growth of the foot arch in childhood and adolescence--derived from the measurement results of 10,155 children.

The definition of flatfoot remains analytically vague. Toward the purpose of establishing the standard values of the foot length and arch height in childhood and adolescence, large-scale measurement and investigation of the foot arch were conducted using a three-dimensional foot-measuring device. Measurements of foot structure were performed on 5311 boys and 4844 girls, for a total of 20,310 ft. of 10,155 children aged from 6 to 18 years during the 2006-2008 year period. The foot length (FL) and the navicular height (NH) were measured, and the arch height ratio (AHR (%)=NH×100/FL) was calculated. The FL in boys showed an extension from the age of 6 to 14 and nearly reached a plateau at 14 years old. In girls, the extension was observed from the age of 6 to 13, and the FL came to a plateau at 13 years old. The NH in boys increased from the age of 6 to 13. In girls, the NH increased from the age of 8 to 13. The AHR, presented a normal distribution, and no differences were observed in the distribution for all ages in boys and girls. In boys, the AHR was almost flat until 11 years old, but elevated in the 11-13 year age period. In girls, the AHR was almost flat until 10 years old, but elevated in the 10-12 year age period. We are certain that the data demonstrating the normal growth of the foot contribute to the diagnosis and treatment of the failure of the foot to thrive.

Effect of Functional Fatigue on Vertical Ground-Reaction Force in Individuals With Flat Feet

Flat foot is one of the lower extremity deformities that might change kinetic variables of gait. Fatigue is one of the factors that can alter the vertical ground-reaction force (GRF). The effect of a fatiguing condition on vertical GRF has not been documented in individuals with flat feet. To examine the fatigue effect on vertical GRF in individuals with flat feet compared with a normal group during barefoot walking. Repeated-measure ANOVA for the effects of fatigue on individuals with flat feet and normal feet. Biomechanics laboratory. 17 subjects with flat feet and 17 normal subjects (recruited according to their arch-height ratio). Three vertical GRF measures (F1, the first peak force; F2, minimum force; and F3, the second peak force) were extracted before and after a functional fatigue protocol. No significant interaction between fatigue and group was observed for the 3 vertical GRF measures. For F2, fatigue and group effects were significant (P = .001 and P = .02, respectively). Furthermore, F2 was higher in the flat-feet group than in the normal group; F2 also increased after fatigue. For F3, only a significant fatigue effect was observed (P = .004). F3 decreased after fatigue in both groups. In the flat-feet group, a decrease in the variation of vertical GRF might be due to more flexible foot joints. After fatigue, muscles might lose their ability to control the foot joints and cause higher F2 in the flat-feet group.

The Comparison of Clinical Assessment Tools for the Foot Posture

It is important to assess foot posture when investigating the relationship between lower extremity dysfunctions and foot types. Although several measurements of static foot posture have been used, there is no consensus regarding clinical measurements for foot posture. The aim of this study is to explore the differences among navicular drift (NDt), foot posture index (FPI), arch index (AI), dorsal arch height ratio (DAHR), normal navicular height truncated (NNHt) and to discover the most effective measurement. After foot types were classified by navicular drop test (NDp), clinical measurements of NDt, FPI, AI, DAHR, and NNHt were performed on 64 subjects' feet. ANOVA analysis was used for the variance of the difference between the NDp and the five kinds of clinical measurements, and the level of significance was set at <TEX>${\alpha}$</TEX>=.05. The results showed that all five clinical measurements demonstrated significant differences with navicular drop. In post-hoc, FPI and NNHt showed significant differences in all foot types. The five clinical measurements are suitable the classification of foot types through the NDp. Therefore, it could be possible to assess correct and objective foot posture by using FPI and NNHt.

Effect of functional fatigue on vertical ground reaction force among individuals with flat feet

Context: Flat foot is one of the lower extremity deformities that might change kinetic variables of gait. Fatigue is one of the factors that can alter the vertical ground-reaction force (GRF). The effect of a fatiguing condition on vertical GRF has not been documented in individuals with flat feet. Objective: To examine the fatigue effect on vertical GRF in individuals with flat feet compared with a normal group during barefoot walking. Design: Repeated-measure ANOVA for the effects of fatigue on individuals with flat feet and normal feet. Setting: Biomechanics laboratory. Participants: 17 subjects with flat feet and 17 normal subjects (recruited according to their arch-height ratio). Main Outcome Measures: Three vertical GRF measures (F1, the first peak force; F2, minimum force; and F3, the second peak force) were extracted before and after a functional fatigue protocol. Results: No significant interaction between fatigue and group was observed for the 3 vertical GRF measures. For F2, fatigue and group effects were significant (P = .001 and P = .02, respectively). Furthermore, F2 was higher in the flat-feet group than in the normal group; F2 also increased after fatigue. For F3, only a significant fatigue effect was observed (P = .004). F3 decreased after fatigue in both groups. Conclusions: In the flat-feet group, a decrease in the variation of vertical GRF might be due to more flexible foot joints. After fatigue, muscles might lose their ability to control the foot joints and cause higher F2 in the flat-feet group.

Variations in Foot Posture and Mobility Between Individuals with Patellofemoral Pain and Those in a Control Group

We sought to determine whether foot posture and foot mobility were increased in individuals with patellofemoral pain syndrome compared with individuals in a control group. A nested case-control design was used with two controls matched to each patient by sex and age (±1 year). Participants included 43 individuals with a history of unilateral or bilateral patellofemoral pain syndrome and 86 participants in a control group. Data collected included height, weight, and five different measures of foot height and width in weightbearing and nonweightbearing that have been previously shown to have high levels of reliability. Individuals with patellofemoral pain syndrome were found to be four times more likely (odds ratio, 4.04; 95% confidence interval, 1.45-11.32) to have a larger-than-normal difference between nonweightbearing and weightbearing arch height compared with those in the control group. The mean values for difference in arch height and foot mobility magnitude were also statistically significant between the patient and control groups. Foot posture, as determined using the arch height ratio, was not significant between groups (odds ratio, 0.94; 95% confidence interval, 0.34-2.61). Although foot posture may not be different between individuals with patellofemoral pain syndrome and controls, foot mobility assessed using difference in arch height and foot mobility magnitude is different between the two groups.

Continual use of augmented low-Dye taping increases arch height in standing but does not influence neuromotor control of gait

This study investigated the effect of continual use of augmented low-Dye (ALD) taping on neuromotor control of the lower limb during gait, as well as foot posture and mobility. Twenty-eight females were randomly allocated to wear ALD tape continuously or a no-tape control for a mean 12 ± 2 days. Electromyographic activity from 12 lower limb muscles, three-dimensional motion at the ankle, knee, hip and pelvis (i.e., measures of neuromotor control) and foot posture and mobility was measured before and after the tape or control interventions. For the tape group, arch height ratio (=arch height/distance from heel to first metatarsophalangeal joint line) was greater by 0.006 (95% confidence interval: 0.0002–0.01, p = 0.04) following the intervention period, whereas no change was observed for the control group (−0.003 (−0.01–0.004), p = 0.36). The difference between groups (0.009 (0.0004–0.02), p = 0.04) equated to a 0.16 cm increase in arch height for the tape group following continual use of ALD tape. There was no change in neuromotor control of gait following continual use of ALD taping ( p > 0.05). Continual use of ALD tape for approximately 12 days produced a small change in foot posture, but no alteration in neuromotor control. Previous literature suggests that this increase in arch height is likely to be clinically relevant and may be one factor that contributes to the known efficiency of ALD tape in the treatment of lower extremity pain and injury.

A clinical prediction rule for identifying patients with patellofemoral pain who are likely to benefit from foot orthoses: a preliminary determination

ObjectiveTo develop a clinical prediction rule to identify patients with patellofemoral pain (PFP) who are more likely to benefit from foot orthoses.DesignPosthoc analysis of one treatment arm of a randomised...

Effect of using truncated versus total foot length to calculate the arch height ratio

Objective The purpose of this study was to determine the arch height ratio in a large cohort of subjects as well as to assess the reliability and validity of the foot measurements utilized in the study. Method Eight hundred and fifty subjects, 393 women and 457 men, consented to participate in the study. The dorsal arch height, total foot length, and the truncated foot length were used to calculate two variations of the arch height ratio. In addition to determining within- and between-rater measurement reliability, radiographs were used to establish validity. Results The truncated arch height ratio can be estimated using the total foot length, unless toe deformities are present in the individual being assessed. All foot measurements had high levels of intra- and inter-rater reliability and the validity of measuring the dorsal arch height while standing with equal weight on both feet was established. Conclusions This investigation provides normative values from a large cohort of healthy female and male subjects for two variations of the arch height ratio. The arch height ratio is a reliable and valid measurement that may prove useful to clinicians and researchers for the classification of foot posture.

Arch Height and First Metatarsal Joint Axis Orientation as Related Variables in Foot Structure and Function

This study investigated the association of arch height combined with first metatarsal joint axis vertical (V) orientation to the size of the 1-2 intermetatarsal angle (IMA) and first metatarsal adduction/abduction position simulating foot postures during gait, kinematics commonly affected by bunion. Nine cadaver specimens were mounted in a loading frame. Measures of arch height ratio and IMA were made. With the foot placed in positions seen during normal gait cycle an electromagnetic device measured displacement of the relative angle of rotations between the first metatarsal and navicular, and helical axis (HA) parameters. Canonical correlation analysis assessed the relationship among the variables. A negative relationship (r = -0.73) was found between arch height and first metatarsal HA V-orientation. When considered as combined variables, arch height and metatarsal HA V-orientation accounted for 69% of the variance of IMA and change in first metatarsal adduction/abduction position. Orientation of the first metatarsal joint axis was highly variable between specimens but correlated with arch height. The conjoined factors of arch height and first metatarsal HA V-orientation accounted for most of the variance of IMA and change in first metatarsal adduction/abduction position during the sequence of foot position during simulated gait. These findings suggest that orthotic arch support could reorient the metatarsal joint axis out-of-vertical and in effect, limit the first metatarsal from displacing into an adducted bunion deformity. These findings could help to explain the pathogenesis of bunions.

The Ability to Predict Dynamic Foot Posture from Static Measurements

A study was undertaken to investigate the ability to predict dynamic foot posture from static measurements. Arch height and arch height ratio measurements were obtained from videotape images of the medial aspect of the foot during standing, walking, and jogging in 5 male and 13 female asymptomatic subjects. Arch height and arch height ratio measurements taken in standing explained 66% to 83% of the variance associated with these measurements at midstance during walking and running. Arch height and arch height ratio demonstrated high reliability as static and dynamic measures. The results of this study support the use of arch height and arch height ratio measurements taken statically in the clinical assessment of the foot and may assist the clinician in estimating foot posture during dynamic activity in patients with lower-limb injuries.

Serial measurement of calcaneal pitch during midstance.

Although emerging evidence suggests a causal relationship between arch structure and musculoskeletal injury, few investigations have adequately assessed arch function during gait. In this study, digitized videofluoroscopy was used to evaluate the sagittal plane motion of the calcaneus during gait. Nine female subjects requiring diagnostic foot radiographs underwent videofluoroscopy. The calcaneal inclination angle, arch height ratio, and tarsal index were digitally analyzed for all radiographic images. Calcaneal pitch was correlated to both the arch height ratio and the tarsal index. Repeated measures analysis of variance helped to identify a significant reduction in the mean calcaneal pitch during the midstance and early propulsive periods of gait. These findings suggest that although calcaneal pitch may be used as an indicator of rearfoot position, biomechanical classification of foot types based on radiographs may result in erroneous conclusions concerning foot function.