Measuring motion of the human foot presents a unique challenge due to the large number of closely packed bones with congruent articulating surfaces. Optical motion capture (OMC) and multi-segment models can be used to infer foot motion, but might be affected by soft tissue artifact (STA). Biplanar videoradiography (BVR) is a relatively new tool that allows direct, non-invasive measurement of bone motion using high-speed, dynamic x-ray images to track individual bones. It is unknown whether OMC and BVR can be used interchangeably to analyse multi-segment foot motion. Therefore, the aim of this study was to determine the agreement in kinematic measures of dynamic activities. Nine healthy participants performed three walking and three running trials while BVR was recorded with synchronous OMC. Bone position and orientation was determined through manual scientific-rotoscoping. The OMC and BVR kinematics were co-registered to the same coordinate system, and BVR tracking was used to create virtual markers for comparison to OMC during dynamic trials. Root mean square (RMS) differences in marker positions and joint angles as well as a linear fit method (LFM) was used to compare the outputs of both methods. When comparing BVR and OMC, sagittal plane angles were in good agreement (ankle: R 2 = 0.947, 0.939; Medial Longitudinal Arch (MLA) Angle: R 2 = 0.713, 0.703, walking and running, respectively). When examining the ankle, there was a moderate agreement between the systems in the frontal plane (R 2 = 0.322, 0.452, walking and running, respectively), with a weak to moderate correlation for the transverse plane (R 2 = 0.178, 0.326, walking and running, respectively). However, root mean squared error (RMSE) showed angular errors ranging from 1.06 to 8.31° across the planes (frontal: 3.57°, 3.67°, transverse: 4.28°, 4.70°, sagittal: 2.45°, 2.67°, walking and running, respectively). Root mean square (RMS) differences between OMC and BVR marker trajectories were task dependent with the largest differences in the shank (6.0 ± 2.01 mm) for running, and metatarsals (3.97 ± 0.81 mm) for walking. Based on the results, we suggest BVR and OMC provide comparable solutions to foot motion in the sagittal plane, however, interpretations of out-of-plane movement should be made carefully.

The arch of the human foot is unique among hominins as it is compliant at ground contact but sufficiently stiff to enable push-off. These behaviours are partly facilitated by the ligamentous plantar fascia whose role is central to two mechanisms. The ideal windlass mechanism assumes that the plantar fascia has a nearly constant length to directly couple toe dorsiflexion with a change in arch shape. However, the plantar fascia also stretches and then shortens throughout gait as the arch-spring stores and releases elastic energy. We aimed to understand how the extensible plantar fascia could behave as an ideal windlass when it has been shown to strain throughout gait, potentially compromising the one-to-one coupling between toe arc length and arch length. We measured foot bone motion and plantar fascia elongation using high-speed X-ray during running. We discovered that toe plantarflexion delays plantar fascia stretching at foot strike, which probably modifies the distribution of the load through other arch tissues. Through a pure windlass effect in propulsion, a quasi-isometric plantar fascia's shortening is delayed to later in stance. The plantar fascia then shortens concurrently to the windlass mechanism, likely enhancing arch recoil at push-off.

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