Cluster analysis to identify foot motion patterns in children with flexible flatfeet using gait analysis—A statistical approach to detect decompensated pathology?

Böhm, Harald; Oestreich, Claudia; Rethwilm, Roman; Federolf, Peter; Döderlein, Leonhard; Fujak, Albert; Dussa, Chakravarthy U.

doi:10.1016/j.gaitpost.2019.04.028

Cited by 21 publications

(19 citation statements)

References 31 publications

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“…In this study a principal component analysis (PCA) was used to identify the most discriminative gait kinematics analog to the method used by Rozumalski et al, [ 23 ] and Böhm et al, [ 24 ]. The PCA method reduced the dimensionality while preserving most of the variation [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…Patients having similar pathologies can be grouped based on regularities in the data, using so-called unsupervised machine learning methods, such as the popular k-means clustering technique [ 21 , 22 ]. Cluster analysis has been used to identify functional groups in patients walking with crouch gait [ 23 ], patients with flexible flatfeet [ 24 ], swimming [ 25 ] and running [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

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Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis

Drongelen

Stetter

Böhm

et al. 2021

JCM

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Despite good clinical functional outcome, deficits in gait biomechanics exist 2 years after total hip replacement surgery. The aims of this research were (1) to group patients showing similar gait adaptations to hip osteoarthritis and (2) to investigate the effect of the surgical treatment on gait kinematics and external joint moments. In a secondary analysis, gait data of 51 patients with unilateral hip osteoarthritis were analyzed. A k-means cluster analysis was performed on scores derived via a principal component analysis of the gait kinematics. Preoperative and postoperative datasets were statistically tested between clusters and 46 healthy controls. The first three principal components incorporated hip flexion/extension, pelvic tilt, foot progression angle and thorax tilt. Two clusters were discriminated best by the peak hip extension during terminal stance. Both clusters deviated from healthy controls in spatio-temporal, kinematic and kinetic parameters. The cluster with less hip extension deviated significantly more. The clusters improved postoperatively but differences to healthy controls were still present one year after surgery. A poor preoperative gait pattern in patients with unilateral hip osteoarthritis is associated with worse gait kinematics after total hip replacement. Further research should focus on the identification of patients who can benefit from an adapted or individualized rehabilitation program.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis

Drongelen

Stetter

Böhm

et al. 2021

JCM

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“…Additionally, flatfoot has also been classified into two groups, compensated or decompensated, by dynamic gait analyses. 40 Thus, the results of this study may differ when flatfoot is further categorized based on severity and dynamics. Secondly, the present study includes the use of skinmounted makers to track the underlying skeletal structures.…”

Section: Resultsmentioning

confidence: 87%

“…Shin et al 39 found that lower limb kinematics of flatfoot during walking is affected by the severity of flatfoot deformity. Additionally, flatfoot has also been classified into two groups, compensated or decompensated, by dynamic gait analyses 40 . Thus, the results of this study may differ when flatfoot is further categorized based on severity and dynamics.…”

Section: Discussionmentioning

confidence: 98%

Differences in rearfoot, midfoot, and forefoot kinematics of normal foot and flatfoot during running

Takabayashi

Edama

Inai

et al. 2020

Journal Orthopaedic Research

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Flatfoot is a common foot deformity, which could contribute to running injuries such as medial tibial stress syndrome. Intrafoot kinematics of flatfoot during walking have often been documented using multisegment foot models. However, the intrafoot kinematics of flatfoot during running remains unclear, despite the possible relationship between flatfoot and running injuries. We aimed to clarify rearfoot, midfoot, and forefoot kinematics when running in participants with normal foot and flatfoot. Participants with the normal foot (n = 14) and flatfoot (n = 14) were asked to runover‐ground at their preferred speed. Three‐dimensional kinematics of the rearfoot, midfoot, and forefoot during running were calculated based on the Rizzoli foot model. A two‐sample t‐test of statistical parametric mapping was performed to determine differences between normal foot and flatfoot in time histories of intrafoot kinematics during running. No differences were found between groups in characteristics and spatiotemporal parameters. In the frontal rearfoot angle, a significantly increased eversion from 24% to 100% (p < .001) was observed in the flatfoot compared to the normal foot. At the midfoot angle, a significantly increased eversion from 0% to 4% (p < .049) and 21% to 100% (p < .001) was observed in the flatfoot compared to the normal foot. At the forefoot angle, a significantly increased inversion from 6% to 17% (p < .047) was observed in the flatfoot compared to the normal foot. These findings may be useful to explain why flatfoot could contribute to running injuries such as medial tibial stress syndrome.

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“…In 2019, Kerr et al [20] reported significant differences among asymptomatic and symptomatic FFFs in terms of hip flexion, knee flexion and varus, hindfoot inversion-eversion and forefoot abduction-adduction. Moreover, patients with symptomatic FFF have reduced walking speed, peak moments and powers at the ankle joint [21]. The improvement of sport performance is another important parameter identified by the SITOP survey; some authors documented the upgrading of sport activity levels within 3 months of surgery and without any notable restriction in physical activities [22,23].…”

Section: Discussionmentioning

confidence: 99%

Results of the Italian Pediatric Orthopedics Society juvenile flexible flatfoot survey: diagnosis and treatment options

Pavone

Vescio

Andreacchio

et al. 2021

Journal of Pediatric Orthopaedics B

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The objectives of this study were to collect and analyze current diagnosis and treatment options of symptomatic flexible flatfoot (FFF), as well as to identify treatment expectations, among the members of the Italian Pediatric Orthopedics Society (SITOP). Diagnosis and treatment preferences were recorded according to a web-based survey. The survey was divided into six main sections:(1) general clinical parameters; (2) foot aspects; (3) X-ray angles (or lines); (4) expectations; (5) standard clinical assessment; (6) treatment options. One hundred and ten out of 248 SITOP members answered to the questionnaire. Age (85.5%), pain at the level of the plantar arch or fascia (61.8%), fatigue (59.1%) were the clinical parameters of crucial importance. Heel valgus (85.4%), flexibility (61.8%) and forefoot supination (47.3%) were identified as the most important foot aspects. Ninety-two responders (83.6%) identified the 'improved ability to walk longer without symptoms or discomfort' as the principal treatment expectation. Pain evaluated through the visual analog scale (VAS) was considered crucial in 31.8% of cases. All respondents confirmed they also treat patients with FFF surgically; in particular, 97.3% of SITOP affiliates declare to perform arthroereisis followed by lateral column lengthening (29.1%) and medializing calcaneal osteotomy (9.1%). Although in this survey heterogeneous findings for diagnosis and treatment of patients with symptomatic FFF within SITOP members were found, a large preference for age, heel valgus, flexibility as clinical aspects and parameters, as well as nonoperative treatment and arthroereisis, was reported.

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Cluster analysis to identify foot motion patterns in children with flexible flatfeet using gait analysis—A statistical approach to detect decompensated pathology?

Cited by 21 publications

References 31 publications

Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis

Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis

Differences in rearfoot, midfoot, and forefoot kinematics of normal foot and flatfoot during running

Results of the Italian Pediatric Orthopedics Society juvenile flexible flatfoot survey: diagnosis and treatment options

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