Uhan Jerneja, Kothari Alpesh, Zavatsky Amy, Stebbins Julie
Department of NDORMS, University of Oxford, Oxford, UK.
Department of NDORMS, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Gait Posture. 2023 May;102:118-124. doi: 10.1016/j.gaitpost.2023.03.016. Epub 2023 Mar 27.
Static and dynamic assessment of the medial longitudinal arch (MLA) is an essential aspect for measuring foot function in both clinical and research fields. Despite this, most multi-segment foot models lack the ability to directly track the MLA. This study aimed to assess various methods of MLA assessment, through motion capture of surface markers on the foot during various activities.
Thirty general population participants (mean age 20 years) without morphological alterations to their feet underwent gait analysis. Eight measures, each representing a unique definition of the MLA angle using either real only, or both real and floor-projected markers, were created. Participants performed tasks including standing, sitting, heel lift, Jack's test and walking, and had their Arch Height Index (AHI) measured using callipers. Multiple-criteria decision analysis (MCDA) with 10 criteria was utilised for selecting the optimal measure for dynamic and static MLA assessment.
In static tasks, the standing MLA angle was significantly greater in all measures but one when compared to sitting, Jack's test and heel lift. The MLA angle in Jack's test was significantly greater than in heel lift in all measures. Across the compared dynamic tasks, significant differences were noted in all measures except one for foot strike in comparison to 50% gait cycle. All MLA measures held significant inverse correlations with MLA measured from static and dynamic tasks. Based on MCDA criteria, a measure comprising the first metatarsal head, fifth metatarsal base, navicular and heel markers was deemed the best for MLA assessment.
This study aligns with the current literature recommendations for the use of a navicular marker for characterising the MLA. It contrasts with previous recommendations and advocates against the use of projected markers in most situations.
内侧纵弓（MLA）的静态和动态评估是临床和研究领域测量足部功能的重要方面。尽管如此，大多数多节段足部模型缺乏直接追踪MLA的能力。本研究旨在通过在各种活动中对足部表面标志物进行运动捕捉，评估MLA评估的各种方法。
30名足部无形态改变的普通人群参与者（平均年龄20岁）接受了步态分析。创建了八项测量指标，每项指标使用仅真实的或真实与地面投影的标志物来代表MLA角度的独特定义。参与者进行了包括站立、坐立、足跟抬起、杰克测试和行走等任务，并使用卡尺测量了足弓高度指数（AHI）。采用具有10个标准的多标准决策分析（MCDA）来选择动态和静态MLA评估的最佳测量指标。
在静态任务中，与坐立、杰克测试和足跟抬起相比，除一项指标外，所有测量指标中的站立MLA角度均显著更大。在所有测量指标中，杰克测试中的MLA角度显著大于足跟抬起时的角度。在比较的动态任务中，与步态周期的50%相比，除一项指标外，所有测量指标在足跟着地时均存在显著差异。所有MLA测量指标与静态和动态任务中测量的MLA均呈显著负相关。根据MCDA标准，一种包含第一跖骨头、第五跖骨基部、舟骨和足跟标志物的测量指标被认为是MLA评估的最佳指标。
本研究与当前文献中使用舟骨标志物来表征MLA的建议一致。它与先前的建议形成对比，并主张在大多数情况下不使用投影标志物。
