Extrinsic foot muscle forces and joint contact forces in flexible flatfoot adult with foot orthosis: A parametric study of tibialis posterior muscle weakness

Yinghu Peng; Yan Wang; Duo Wai-Chi Wong; Tony Lin-Wei Chen; Guoxin Zhang; Qitao Tan; Ming Zhang

doi:10.1016/j.gaitpost.2021.05.009

Extrinsic foot muscle forces and joint contact forces in flexible flatfoot adult with foot orthosis: A parametric study of tibialis posterior muscle weakness

Gait Posture. 2021 Jul:88:54-59. doi: 10.1016/j.gaitpost.2021.05.009. Epub 2021 May 10.

Authors

Yinghu Peng¹, Yan Wang², Duo Wai-Chi Wong², Tony Lin-Wei Chen¹, Guoxin Zhang¹, Qitao Tan¹, Ming Zhang³

Affiliations

¹ Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region.
² Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.
³ Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China. Electronic address: ming.zhang@polyu.edu.hk.

PMID: 33991769
DOI: 10.1016/j.gaitpost.2021.05.009

Abstract

Background: The posterior tibialis tendon dysfunction (PTTD) is typically associated with progressive flatfoot deformity, which could be alleviated with foot orthosis. However, the evaluation of tibialis posterior (TP) weakness on lower limb mechanics of flatfoot adults with foot orthoses is scarce and requires further investigation.

Research question: This study aimed to examine the effects of TP weakness on lower limb mechanics in flatfoot adults with foot orthosis through gait analysis and musculoskeletal modelling.

Methods: Fifteen young adults with flatfoot were recruited from University to perform a gait experiment with and without foot orthoses. Data collected from the motion capture system were used to drive the musculoskeletal modelling for the estimation of the joint force and extrinsic muscle forces of the lower limb. A parametric analysis was conducted by adjusting the TP muscle strength from 40 % to 100 %. Two-way repeated measures ANOVA was used to compare the peak extrinsic foot muscle forces and joint forces among different levels of TP weakness and insole conditions.

Results: TP weakness significantly increased ankle joint force superoinferiorly (F = 125.9, p < 0.001) and decreased anteroposteriorly (F = 125.9, p < 0.001), in addition to a significant increase in the muscle forces of flexor hallucis longus (p < 0.001) and flexor digitorum longus (p < 0.001). Besides, the foot orthosis significantly reduced most peak muscle forces whilst significantly reduced the second peak knee force and peak ankle force compared to the control condition (F = 8.79-30.9, p < 0.05).

Significance: The increased extrinsic foot muscle forces (flexor hallucis longus and flexor digitorum longus) and ankle joint forces in the TP weakness condition indicated that TP weakness may induce compensatory muscle activation and attenuated joint load. The abnormal muscle and joint mechanics in flatfoot adults with TP weakness might be restored by the orthosis.

Keywords: Foot orthoses; Gait analysis; Joint contact force; Musculoskeletal dynamics simulation; Tibialis posterior muscle.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomechanical Phenomena
Flatfoot*
Foot
Foot Orthoses*
Humans
Muscle Weakness / etiology
Muscle, Skeletal
Young Adult