Faculty Collaboration Database

Kinematic foot types in youth with pes planovalgus secondary to cerebral palsy. Gait Posture 2019 Feb;68:430-436

Date

12/31/2018

Pubmed ID

30594871

DOI

10.1016/j.gaitpost.2018.12.026

Scopus ID

2-s2.0-85059058005 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

BACKGROUND: Kinematic variability of the foot and ankle segments exists during ambulation among individuals with pes planovalgus (PPV) secondary to cerebral palsy (CP). Clinicians have previously recognized such variability through classification schemes to identify subgroups of individuals, but have been unable to identify kinematic foot types.

RESEARCH QUESTION: The purpose of this work was to identify kinematic foot types among children with PPV secondary to CP using 3-dimensional multi-segment foot and ankle kinematics during gait as inputs for principal component analysis (PCA) and K-means cluster analysis.

METHODS: In a single assessment session, multi-segment foot and ankle kinematics using the Milwaukee Foot Model (MFM) were collected in 31 children/adolescents with pes planovalgus (49 feet) and 16 typically developing (TD) children/adolescents (31 feet). PCA was used as a data reduction technique on 34 kinematic variables. K-means cluster analysis was performed on the identified principal components (PCs) and one-way analyses of variance (ANOVA) was done to determine the effect of subgroup membership on PC scores.

RESULTS: The PCA reduced the kinematic variables to seven PCs which accounted for 91% of the total variance. Six distinct kinematic foot types were identified by the cluster analysis. The foot types showed unique kinematic characteristics in both the hindfoot and forefoot.

SIGNIFICANCE: This study provides further evidence of kinematic variability in the foot and ankle during ambulation associated with pes planovalgus secondary to CP. The specific contributions of the hindfoot and forefoot would not have been detected using a single segment foot model. The identification of kinematic foot types with unique foot and ankle characteristics has the potential to improve treatment since patients within a foot type are likely to benefit from similar intervention(s).

Author List

Amene J, Krzak JJ, Kruger KM, Killen L, Graf A, Altiok H, Smith PA, Harris GF

Authors

Gerald Harris PhD Director in the Orthopaedic Research Engineering Center (OREC) department at Marquette University
Karen Kruger PhD Research Assistant Professor in the MU-MCW Department of Biomedical Engineering department at Marquette University

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

Adolescent
Ankle Joint
Biomechanical Phenomena
Cerebral Palsy
Child
Child, Preschool
Cluster Analysis
Female
Flatfoot
Foot
Gait
Humans
Imaging, Three-Dimensional
Male
Principal Component Analysis
Retrospective Studies