Faculty Collaboration Database

Foot and ankle kinematics in patients with posterior tibial tendon dysfunction. Gait Posture 2008 Feb;27(2):331-9

Date

06/23/2007

Pubmed ID

17583511

DOI

10.1016/j.gaitpost.2007.04.014

Scopus ID

2-s2.0-38049087969 (requires institutional sign-in at Scopus site)   110 Citations

Abstract

The purpose of this study is to provide a quantitative characterization of gait in patients with posterior tibial tendon dysfunction (PTTD), including temporal-spatial and kinematic parameters, and to compare these results to those of a Normal population. Our hypothesis was that segmental foot kinematics were significantly different in multiple segments across multiple planes. A 15 camera motion analysis system and weight-bearing radiographs were employed to evaluate 3D foot and ankle motion in a population of 34 patients with PTTD (30 females, 4 males) and 25 normal subjects (12 females, 13 males). The four-segment Milwaukee Foot Model (MFM) with radiographic indexing was used to analyze foot and ankle motion and provided kinematic data in the sagittal, coronal and transverse planes as well as temporal-spatial information. The temporal-spatial parameters revealed statistically significant deviations in all four metrics for the PTTD population. Stride length, cadence and walking speed were all significantly diminished, while stance duration was significantly prolonged (p<0.0125). Significant kinematic differences were noted between the groups (p<0.002), including: (1) diminished dorsiflexion and increased eversion of the hindfoot; (2) decreased plantarflexion of the forefoot, as well as abduction shift and loss of the varus thrust in the forefoot; and (3) decreased range of motion (ROM) with diminished dorsiflexion of the hallux. The study provides an impetus for improved orthotic and bracing designs to aid in the care of distal foot segments during the treatment of PTTD. It also provides the basis for future evaluation of surgical efficacy. The course of this investigation may ultimately lead to improved treatment planning methods, including orthotic and operative interventions.

Author List

Ness ME, Long J, Marks R, Harris G

Author

Gerald Harris PhD Director in the Orthopaedic Research Engineering Center (OREC) department at Marquette University

MESH terms used to index this publication - Major topics in bold

Adult
Ankle
Biomechanical Phenomena
Case-Control Studies
Female
Foot
Gait
Humans
Imaging, Three-Dimensional
Male
Middle Aged
Posterior Tibial Tendon Dysfunction
Range of Motion, Articular