Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA.
Musculoskelet Sci Pract. 2020 Jun;47:102149. doi: 10.1016/j.msksp.2020.102149. Epub 2020 Mar 10.
The alignment of the foot-ankle complex may influence the kinematics and kinetics of the entire lower limb during walking.
This study investigated the effect of different magnitudes of varus alignment of the foot-ankle complex (small versus large) on the kinematics and kinetics of foot, ankle, knee, and hip in the frontal and transverse planes during walking.
Cross-sectional study.
Foot-ankle complex alignment in the frontal plane was measured as the angle between the metatarsal heads and the inferior edge of the examination table, measured with the volunteer in prone maintaining the ankle at 0° in the sagittal plane. The participants (n = 28) were divided into two groups according to their alignment angles. The first group had values equal to or inferior to the 45 percentile, and the second group had values equal to or above the 55 percentile. The lower limb kinematics and kinetics were evaluated with the participant walking at self-select speed in an instrumented treadmill.
The group of large varus alignment showed significantly higher (p < 0.03) forefoot inversion angle at initial contact, amplitude of rearfoot-shank eversion, and peak of inversion ankle moment. There were no differences (p > 0.05) between the groups for knee and hip amplitudes and moments in the frontal and transverse planes. The durations of rearfoot-shank eversion, knee abduction, knee medial rotation, hip adduction, and hip medial rotation were not different between groups (p > 0.05).
Large varus alignment of the foot-ankle complex may increase the magnitude of foot pronation and ankle inversion moment during walking.
足踝复合体的对线可能会影响整个下肢在行走时的运动学和动力学。
本研究旨在探讨不同程度的足踝复合体内翻对线（小角度与大角度）对步行时足、踝、膝和髋关节在额状面和横断面上运动学和动力学的影响。
横断面研究。
采用足踝复合体在额状面的对线角度，即跖骨头部与检查台下缘之间的夹角，在矢状面中立位保持踝关节中立位的情况下，让志愿者俯卧位测量。根据他们的对线角度，将参与者（n=28）分为两组。第一组的角度等于或小于第 45 百分位，第二组的角度等于或大于第 55 百分位。在仪器化跑步机上以自我选择的速度行走时，评估下肢运动学和动力学。
大角度内翻组在初始接触时的前足内翻角度、后足-小腿外展幅度和内翻踝关节力矩峰值显著较高（p<0.03）。在额状面和横断面上，两组的膝关节和髋关节幅度和力矩均无差异（p>0.05）。后足-小腿外展、膝关节外展、膝关节内旋、髋关节内收和髋关节内旋的持续时间在两组之间无差异（p>0.05）。
足踝复合体的大角度内翻可能会增加行走时足旋前和踝关节内翻力矩的幅度。
