Kinematics of the lower leg and foot during gait in subjects with pathological plantar hyperkeratosis

Doctoral thesis English OPEN
Findlow, AH

This study seeks to consider the functional characteristics of a five segment\ud lower leg and foot model during gait, using the application of elementary kinematics to\ud measure, analyse and describe lower leg and foot motion and compare these parameters\ud between two subject groups with plantar pathological hyperkeratosis (PPH); PPH group\ud one having callus under metatarsal heads 2, 3 and 4, and PPH group two having callus\ud under metatarsal heads 1 and 5.\ud Root's elegant theory of foot function (Root et al. 1966; Root et al. 1977) has\ud become widely accepted in podiatry. This theory suggests the orientation of the subtalar\ud joint axis influences the amount of motion in all the cardinal body planes. Therefore, a\ud foot which has a joint axis which is highly inclined will exhibit more transverse plane\ud lower leg rotation than frontal plane calcaneal motion; will be a less mobile foot; and\ud tend to present with callus under metatarsal heads 1 and 5. Conversely, a foot with a\ud lower inclined subtalar joint axis will exhibit more frontal plane calcaneal motion than\ud transverse plane leg rotation; will be more mobile; and tend to have callus under the 2, 3\ud and 4 metatarsal heads.\ud A non-invasive in vivo kinematic method was developed to collect three\ud dimensional coordinates of markers attached to a novel five segment model of the lower\ud leg and foot in order to estimate the angular displacement and motion between the lower\ud leg and foot segments.\ud The results have shown that there are statistically significant differences in the\ud lower leg and foot kinematics between the PPH groups (p < 0.05) during various\ud periods within the stance phase. These differences suggest that the motions of the lower\ud leg and foot are similar to those proposed by the podiatric theory. However the findings\ud contradict Root's theory within the latter stages of midstance and propulsive periods of\ud gait.
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