Extrinsic foot muscle forces and joint contact forces in flexible flatfoot adult with foot orthosis: A parametric study of tibialis posterior muscle weakness |
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| Affiliation: | 1. Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region;2. The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China;1. Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea;2. Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea;3. Department of Mathematics and Department of AI and Data Science, Ajou University, Gyeonggi, Republic of Korea;2. Centre for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, DK-9800 Hjoerring, Denmark;3. Department of Rheumatology, Hjørring Hospital, Bispensgade 37, DK-9800 Hjørrring, Denmark;4. King Christian 10th Hospital for Rheumatic Diseases, University of Southern Denmark, Toldbodgade 3, DK-6300 Gråsten, Denmark;5. Department of Materials and Production, Aalborg University, Fibigerstraede 16, DK-9220 Aalborg East, Denmark |
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| Abstract: | BackgroundThe 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 questionThis 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.MethodsFifteen 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.ResultsTP 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).SignificanceThe 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. |
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| Keywords: | Joint contact force Foot orthoses Tibialis posterior muscle Gait analysis Musculoskeletal dynamics simulation |
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