RELATION BETWEEN PLANTAR PRESSURE AND NAVICULAR MOVEMENT IN HEALTHY ADULTS AND PATIENTS WITH KNEE AND FOOT PROBLEMS DURING GAIT

M. Müller¹, M. Mauch², J. Riesterer³, P. Eichelberger¹

¹Bern University of Applied Sciences, School of Health Professions, Physiotherapy, Bern, Switzerland, ²University Hospital Basel, Department of Orthopaedics and Traumatology, Basel, Switzerland, ³Praxisklinik Rennbahn AG, Muttenz, Switzerland

Background: The foot plays a crucial role for proper human locomotion - one hand it must act as compliant shock absorber, on the other hand it builds a stiff lever to enable efficient propulsion. Evidence indicates that foot function should be evaluated by dynamic assessments. Plantar pressure measurements during walking and running are the most widely used clinical method because it is simple to use. However, foot kinematics seem to be relevant as well and recent research focused on the measurement of navicular movement with a simple set of four skin-surface markers and three-dimensional motion capture to assess foot pronation. It is unclear how navicular movement is related to plantar pressure parameters and to what extent the two aspects must be both taken into account during foot function assessment.

Purpose: Determine the relation between plantar pressure parameters and navicular movement in healthy adults and patients with knee and foot problems during gait to inform about optimized foot function assessment.

Methods: In an exploratory cross-sectional study, 55 participants where assessed during walking and running on a treadmill ergometer with integrated pressure sensors. Navicular movement was assessed simultaneously by three-dimensional motion capture and a four-marker foot model, which measured cranio-caudal and medio-lateral navicular excursion (navicular drop and drift, respectively) during stance. Relation between plantar pressure parameters and foot kinematics was explored by multiple linear regression analysis.

Results: Significant peak pressure and maximum force changes in relation to medio-lateral navicular excursion were observed in hindfoot and midfoot. Medio-lateral navicular excursion increased with decreasing peak pressure (p = 0.007) and maximum force in midfoot (p = 0.001), as well as with increasing peak pressure (p < 0.001) and maximum force (p < 0.001) in hindfoot during running. Cranio-caudal navicular excursion couldn’t explain any variation in peak pressure and maximum force. There was no correlation between center of pressure shift and cranio-caudal und medio-lateral navicular excursion during running. During walking there were no relevant relation between kinematics and all kinetic variables.

Conclusions: It might be a relevant relation between medio-lateral navicular excursion and peak pressure and maximum force in midfoot and hindfoot during running. A close correlation between kinetic and kinematic data across the whole foot couldn’t be definitively confirmed in this study.

Implications: The finding about relatively weak relations between parameters of foot motion and variables of plantar pressure indicate that it could not be concluded from one to the other and that both aspects must be treated as independent aspects of foot function. This means for the practice that both aspects should be taken into account to evaluate foot function comprehensively.

Funding acknowledgements: None

Keywords:
Foot kinematics
Plantar pressure
Foot function

Topics:
Musculoskeletal: lower limb
Sport & sports injuries
Research methodology, knowledge translation & implementation science

Did this work require ethics approval? Yes

Institution: Local authority

Committee: Ethikkommission Nordwest- und Zentralschweiz

Ethics number: 2021-01282