Changes in gait associated with acute stage II posterior tibial tendon dysfunction

Ringleb, Stacie I.; Kavros, Steven J.; Kotajarvi, Brian R.; Hansen, Diana; Kitaoka, Harold B.; Kaufman, Kenton R.

doi:10.1016/j.gaitpost.2006.06.008

Cited by 97 publications

(113 citation statements)

References 26 publications

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“…In the current study, individuals with AAFD exhibited lower single-limb heel height and lower fore- foot and rearfoot excursions compared to the older control group. In agreement with previous studies evaluating foot kinematics, 11,21,24,28,30 the finding of lower first metatarsal PF underscores the role of midfoot instability in impaired heelrise ability. The low ankle excursion was consistent with the premise that excessive rearfoot PF diminishes the ability of the ankle to contribute to a heel-rise height in persons with AAFD.…”

Section: Discussionsupporting

confidence: 91%

Adult-Acquired Flatfoot Deformity and Age-Related Differences in Foot and Ankle Kinematics During the Single-Limb Heel-Rise Test

Chimenti

Tome²,

Hillin³

et al. 2014

J Orthop Sports Phys Ther

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Section: Discussionsupporting

confidence: 91%

Adult-Acquired Flatfoot Deformity and Age-Related Differences in Foot and Ankle Kinematics During the Single-Limb Heel-Rise Test

Chimenti

Tome²,

Hillin³

et al. 2014

J Orthop Sports Phys Ther

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“…9,23,28,32 Moreover, those with PTTD demonstrated approximately 4° less inversion at heel strike compared to controls, and a significant positive association was found between rearfoot angle at heel strike and peak rearfoot eversion angle. These data suggest that the PTTD group exhibit altered rearfoot kinematics throughout the entire stance phase of gait.…”

Section: Discussionmentioning

confidence: 88%

Biomechanical and Clinical Factors Related to Stage I Posterior Tibial Tendon Dysfunction

Rabbito

Pohl²,

Humble³

et al. 2011

J Orthop Sports Phys Ther

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Posterior tibial tendon dysfunction (PTTD) is a progressive and debilitating condition that is estimated to affect nearly 5 million people in the United States. 7 In the early stages (stage I) of the condition, PTTD is a common running-related injury. 31While the aetiology of PTTD has not been established, it is considered multifactorial in nature and has generally been related to progressive alterations in arch structure, muscular strength, and gait biomechanics. T T BACKGROUND:PTTD is a progressive condition, so early recognition and treatment are essential to help delay or reverse the progression. However, no previous studies have investigated stage I PTTD, and no single study has measured static anatomical structure, muscle strength, and gait mechanics in this population. T T METHODS: Twelve individuals with stage I PTTDand 12 healthy, age-and gender-matched control subjects, who were engaged in running-related activities, participated in this study. Measurements of arch height index, maximum voluntary ankle invertor muscle strength, and 3-dimensional rearfoot and medial longitudinal arch kinematics during walking were obtained. T T RESULTS:The runners with PTTD demonstrated significantly lower seated arch height index (P = .02) and greater (P = .03) and prolonged (P = .05) peak rearfoot eversion angle during gait, compared to the healthy runners. No differences were found in standing arch height index values (P = .28), arch rigidity index (P = .06), ankle invertor strength (P = .49), or peak medial longitudinal arch values (P = .49) between groups. T T CONCLUSION:The increased foot pronation is hypothesized to place greater strain on the posterior tibialis muscle, which may partially explain the progressive nature of this condition.

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“…decreased and delayed activation of the tibialis posterior muscle, often resulting in prolonged pronation during the latter stance phases of walking gait, 21,30,32 and decreased functional strength (ie, singlelimb heel rise performance) of the ankle. 2 Prolonged pronation likely overloads the posterior tibialis tendon, resulting in localized degenerative changes, impaired muscle strength capacity, and pain.…”

Section: Women With Posterior Tibial Tendon Dysfunction Have Diminishmentioning

confidence: 99%

“…2 Prolonged pronation likely overloads the posterior tibialis tendon, resulting in localized degenerative changes, impaired muscle strength capacity, and pain. In the presence of flatfoot deformity, the result is typically increased hindfoot eversion, 16,17 increased transverse plane foot motion, 28,29,38 inefficient propulsion during locomotion, 32 and diminished plantar flexion moment. 28,32 The actions of the hip extensors and abductors are essential during walking.…”

Section: Women With Posterior Tibial Tendon Dysfunction Have Diminishmentioning

confidence: 99%

“…In the presence of flatfoot deformity, the result is typically increased hindfoot eversion, 16,17 increased transverse plane foot motion, 28,29,38 inefficient propulsion during locomotion, 32 and diminished plantar flexion moment. 28,32 The actions of the hip extensors and abductors are essential during walking. The hip extensors absorb energy created by ground reaction forces during the early stance phase of gait, 3,41 and this necessitates adequate strength, power, and control.…”

Section: Women With Posterior Tibial Tendon Dysfunction Have Diminishmentioning

confidence: 99%

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Women With Posterior Tibial Tendon Dysfunction Have Diminished Ankle and Hip Muscle Performance

Kulig¹,

Popovich²,

Noceti-Dewit³

et al. 2011

J Orthop Sports Phys Ther

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Persons with acquired flatfoot deformity demonstrate impaired walking performance, as indicated by slower walking speed and frequent reports of foot pain during activity and at rest. 25,29 There is no doubt that acquired flatfoot deformity is accompanied by some level of tibialis posterior tendon dysfunction. The tibialis posterior functions to create a rigid foot segment by stabilizing the midfoot 37 and assists in generating energy, by the plantar flexors in terminal stance, to produce successful propulsion. 41 Laboratory studies confirm that persons with acquired flatfoot deformity demonstrate T T STUDY DESIGN: Controlled laboratory study using a cross-sectional design. T T OBJECTIVES:To characterize ankle and hip muscle performance in women with posterior tibial tendon dysfunction (PTTD) and compare them to matched controls. We hypothesized that ankle plantar flexor strength, and hip extensor and abductor strength and endurance, would be diminished in women with PTTD and this impairment would be on the side of dysfunction. T T BACKGROUND:Individuals with PTTD demonstrate impaired walking abilities. Walking gait is strongly dependent on the performance of calf and hip musculature. T T METHODS:Thirty-four middle-aged women (17 with PTTD) participated. Ankle plantar flexor strength was assessed with the single-leg heel raise test. Hip muscle performance, including strength and endurance, were dynamometrically measured. Differences between groups and sides were assessed with a mixed-model analysis of variance. T T RESULTS:Females with PTTD performed significantly fewer single-leg heel raises and repeated sagittal and frontal plane non-weight-bearing leg lifts, and also had lower hip extensor and abductor torques than age-matched controls. There were no differences between sides for hip strength and endurance measures for either group, but differences between sides in ankle strength measures were noted in both groups. T T CONCLUSION:Women with PTTD demonstrated decreased ankle and hip muscle performance bilaterally.

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Changes in gait associated with acute stage II posterior tibial tendon dysfunction

Cited by 97 publications

References 26 publications

Adult-Acquired Flatfoot Deformity and Age-Related Differences in Foot and Ankle Kinematics During the Single-Limb Heel-Rise Test

Adult-Acquired Flatfoot Deformity and Age-Related Differences in Foot and Ankle Kinematics During the Single-Limb Heel-Rise Test

Biomechanical and Clinical Factors Related to Stage I Posterior Tibial Tendon Dysfunction

Women With Posterior Tibial Tendon Dysfunction Have Diminished Ankle and Hip Muscle Performance

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