Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

First Advisor

M. Samuel Cheng

Date of original Performance / Presentation

January 2023

Publication Date / Copyright Date

1-1-2023

Abstract

Introduction: The tissue stress model has been proposed to guide the examination and treatment of foot and ankle disorders. Foot posture may affect tissue loading and injury risk, yet little is known about foot posture and joint kinetics. This study aims to compare joint kinetics and quasi-stiffness between foot posture groups during gait and explore relationships with clinical tests. Methods: Midfoot and ankle joint kinetics and quasi-stiffness were examined in different foot posture groups during the stance phase of gait. Foot posture groups were based on normative data for the Foot Posture Index. Relationships between clinical tests of foot posture and mobility and peak kinetics and quasi-stiffness were also explored. Three-dimensional motion analysis was performed using the Oxford Foot Model. Kinetics were calculated via an inverse dynamics approach. All participants walked at 1.3 m/s ± 5%. Results: Midfoot joint kinetics were similar between groups, but midfoot quasi-stiffness during late midstance was significantly lower in the pes planus group compared to the pes cavus group. At the ankle joint, significant differences in frontal plane moments were observed between all groups. Clinical tests showed relationships with midfoot and ankle joint peak kinetics and quasi-stiffness. The strongest relationships were found between the peak ankle joint evertor moment and the Foot Posture Index logit score (r = -0.72) and navicular drop (r = -0.62). A multivariate linear model predicted the peak evertor moment at the ankle joint. Conclusion: Foot posture impacts frontal plane ankle joint moments, with pes planus and pes cavus groups showing distinct loading and timing patterns. Clinicians can use the Foot Posture Index and navicular drop to consider tissue loading in the frontal plane. Improving midfoot quasi-stiffness may benefit those with pes planus.

Disciplines

Physical Therapy

Keywords

Ankle; Foot posture; Gait; Kinetics; Midfoot; Quasi-stiffness

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