Master of Science
Musculoskeletal Health Research
This study aims to develop a clinically useful multi-segment foot model that will enable the analysis of foot kinematics and kinetics in an optical motion capture laboratory setting. This study will also test the new multi-segment foot model on patients with knee osteoarthritis and varus knee alignment that is corrected by high tibial osteotomy (HTO). The multi-segment foot model divides the foot into four functional segments: the hindfoot, midfoot, forefoot and hallux. An X-Z-Y-Cardan angle rotation convention was used to determine intersegmental dorsi/plantar flexion, inversion/eversion, and internal/external rotation. Joint moments, joint powers and medio-longitudinal arch (MLA) height/length ratio were also measured. Ten healthy adults and four HTO patients were tested with an optical motion capture system as they walked barefoot in their self-selected speeds. Repeatability of joint motions was calculated using coefficients of multiple correlation. Outcome measures were compared with other multi-segment foot models found in the biomechanics literature to assess validity.
This novel multi-segment foot model showed strong test-retest and within-subject reliability (R>0.7) for most joint motions (24/27) in healthy adults. The model was sensitive enough to detect abnormal foot motions, including lower MLA, increased hallux abduction, in patient gait compared to the normal cohort. This novel model has been shown to be a clinically useful tool for research and assessment on clinical populations.
Summary for Lay Audience
The foot has been traditionally treated as a single, rigid segment in gait analysis. For this reason, the loads and motions of the segment that make up the foot have not been studied. The study aims to develop a multi-segment foot model that can measure the motion and biomechanical load within the foot in patients in a clinical setting. This model functionally divides the foot into four segments: the hindfoot, midfoot, forefoot and hallux. Relative motions between these segments and the load carried between these segments is measured. The novel model was tested on patients with knee osteoarthritis and a varus knee alignment. These patients were undergoing a corrective realignment surgery at the knee called a high tibial osteotomy (HTO). It is hypothesized that due to the varus knee alignment, these patients would experience abnormal foot/ankle motions as well. This novel multi-segment foot model showed strong reliability and validity in a cohort of ten healthy adults and was sensitive enough to detect abnormal foot/ankle motions in four HTO patients. This model has been shown to be a clinically useful tool in a gait analysis laboratory for use in research and for the assessment on clinical populations.
Zhu, Songlin, "To develop a clinically friendly multi-segment kinematic and kinetic foot model and test it on pre-/post-HTO patients with medial knee osteoarthritis and knee varus" (2022). Electronic Thesis and Dissertation Repository. 8634.
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