Deep Posterior Compartment Strength and Foot Kinematics in Subjects With Stage II Posterior Tibial Tendon Dysfunction

Abstract

Background-Tibialis posterior muscle weakness has been documented in subjects with Stage II posterior tibial tendon dysfunction (PTTD) but the effect of weakness on foot structure remains unclear. The association between strength and flatfoot kinematics may guide treatment such as the use of strengthening programs targeting the tibialis posterior muscle.

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

“…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.…”

“…21 In terminal stance, persons with stage 2 AAFD demonstrate signs of midfoot instability, as indicated by reduced forefoot plantar flexion (PF) compared to that of healthy controls. 21,24,30 Due to similar loading of the foot during walking, 10 reduced forefoot PF also may impair the ability of individuals with AAFD to perform a single-limb heel rise.…”

“…Recognizing this issue, most studies that have evaluated footankle kinematics in AAFD have used age-matched controls. 11,16,24,30 Therefore, comparing younger and older controls will clarify whether restoring foot-ankle kinematics to that of a young adult is a reasonable clinical goal for older persons with AAFD.…”

An Image-Based Gait Simulation Study of Tarsal Kinematics in Women With Hallux Valgus

“…A 5-degree group difference in the measurement of hind foot eversion is considered an indicator of hindfoot deformity. 27 A flyer announcing a call for study participants (ages 18 -75 years) with "bunion deformity" was posted at the University of Minnesota medical clinics. As many as 30 people responded to the advertisement, but only the first 10 people having what the principal investigator (W.M.G.)…”

The associations of leg lean mass with foot pain, posture and function in the Framingham foot study

“…Studies of clinical populations suggest that poor lower extremity muscle function is associated with atypical foot posture and function. Patients with posterior tibial tendon dysfunction, a common acquired flatfoot deformity, have lower ankle and hip muscle strength compared to non-patients [14], and the degree of deformity is inversely related to leg muscle strength [15]. Imbalance of the muscles that control the foot, but originate in the lower leg has been implicated in the etiology of both idiopathic and disease-related pes cavus (high arches) [16][17][18].…”