Influence of the windlass mechanism on arch-spring mechanics during dynamic foot arch deformation

Welte, Lauren; Kelly, Luke A.; Lichtwark, Glen A.; Rainbow, Michael J.

doi:10.1098/rsif.2018.0270

Cited by 80 publications

(102 citation statements)

References 27 publications

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“…However, the small increases in MTP joint dorsiflexion angles caused by toe springs in this study did not affect measured arch stiffness. This result corresponds to the findings of Welte et al 14 , who used static loading to compress the arches of sitting participants at different toe dorsiflexion angles, and found that engaging the windlass mechanism did not increase arch stiffness. A possible explanation might be the flexibility of the plantar aponeurosis, which stretches as the arch is loaded 44 – 46 .…”

Section: Discussionsupporting

confidence: 90%

“…Recent research, however, challenges this traditional perspective of the windlass mechanism. In a static in vivo loading experiment, Welte et al 14 found that raising the longitudinal arch by dorsiflexing the toes actually decreases the longitudinal arch’s stiffness. In another static in vivo experiment, Farris et al 15 found that the windlass mechanism has little effect on longitudinal arch motion while the arch is experiencing the high loads associated with push-off.…”

Section: Introductionmentioning

confidence: 99%

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Effect of the upward curvature of toe springs on walking biomechanics in humans

Sichting

Holowka

Hansen

et al. 2020

Sci Rep

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Although most features of modern footwear have been intensively studied, there has been almost no research on the effects of toe springs. This nearly ubiquitous upward curvature of the sole at the front of the shoe elevates the toe box dorsally above the ground and thereby holds the toes in a constantly dorsiflexed position. While it is generally recognized that toe springs facilitate the forefoot’s ability to roll forward at the end of stance, toe springs may also have some effect on natural foot function. This study investigated the effects of toe springs on foot biomechanics in a controlled experiment in which participants walked in specially-designed sandals with varying curvature in the toe region to simulate toe springs ranging from 10 to 40 degrees of curvature. Using inverse dynamics techniques, we found that toe springs alter the joint moments and work at the toes such that greater degrees of toe spring curvature resulted in lower work requirements during walking. Our results help explain why toe springs have been a pervasive feature in shoes for centuries but also suggest that toe springs may contribute to weakening of the foot muscles and possibly to increased susceptibility to common pathological conditions such as plantar fasciitis.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Effect of the upward curvature of toe springs on walking biomechanics in humans

Sichting

Holowka

Hansen

et al. 2020

Sci Rep

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“…The similarity may arise from the fact that both models include the MTP joint, because hopping requires a considerable MTP joint range of motion, which is captured by the 3MFM and 5MFM. An additional, albeit slightly unrelated consideration, is that the presence of the MTP joint may also better capture intrinsic foot mechanics such as the windlass mechanism, which occurs with dorsiflexion of the MTP joint, increases plantar fascia tension, and transitions the arch from compliant to rigid and generates propulsion . Thus, the MTP joint in 3MFM and 5MFM may better capture the range of motion and perhaps other intrinsic muscle mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Number of Segments Within Musculoskeletal Foot Models Influences Ankle Kinematics and Strains of Ligaments and Muscles

Kim

Kipp

2019

Journal Orthopaedic Research

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Multi‐segment foot models (MFMs) are becoming a common tool in musculoskeletal research on the ankle‐foot complex. The purpose of this study was to compare ankle joint kinematics as well as ligament and muscle strains that result from MFM with a different number of segments during vertical hopping. Ten participants were recruited and performed double‐limb vertical hops. Marker positions and ground reaction forces were collected. Two‐segment (2MFM), three‐segment (3MFM), and five‐segment MFM (5MFM) were used to calculate ankle kinematics and the strains of the anterior talofibular and calcaneofibular ligaments and of the soleus and gastrocnemius muscles. Ranges of motion and peak strains were analyzed with Kruskal–Wallis and post hoc tests, whereas the time‐series of the ankle kinematics and ligament and muscle strains were analyzed with statistical parametric mapping. There were significant main effects for MFM in the talocrural joint range of motion and peak strains of ligaments and muscles. In addition, there were significant main effects for MFM in time‐series data of the talocrural joint angle as well as for ligament and muscle strains. In all cases, the post hoc analyses showed that the 2MFM consistently overestimated the range of motion and tissue strains compared to the 3MFM and 5MFM, while 3MFM and 5MFM did not differ from each other in the most variables. This study showed that the number of segments in MFM significantly affects the biomechanical estimates of joint kinematics and tissue strains during hopping. Clinical significance: MFM that combine all foot structures beyond the talus into one segment likely overestimate ankle joint biomechanics. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2231–2240, 2019

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“…For instance, if the patient is standing, the longitudinal medial arch may flatten, but it can also increase with extension of the metacarpophalangeal (MTP) joints. 22 In case of the ICFSG score, cavus deformity is evaluated with the foot dorsiflexed and depending on the appearance of the medial longitudinal arch it can be rated moderate or severe. This method is subjective and might have contributed to the increased rate of cavus deformities reported in this study, particularly if there is some degree of associated extension of the first MTP joint during ankle dorsiflexion.…”

Section: Discussionmentioning

confidence: 99%

<p>Posteromedial Release versus Ponseti Treatment of Congenital Idiopathic Clubfoot: A Long-Term Retrospective Follow-Up Study into Adolescence</p>

Corbu¹,

Cosma²,

Vasilescu³

et al. 2020

TCRM

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Purpose Although many short-term studies have shown the superiority of Ponseti treatment to surgical treatment, studies with long-term follow-up of patients into adolescence are lacking. The aim of this study was to compare the morphological, functional and radiological results of the two methods into and during adolescent age, when both soft tissue and bony procedures can be performed to correct residual deformities. Patients and Methods We retrospectively evaluated two groups of patients diagnosed with congenital idiopathic clubfoot and treated with either the Ponseti method (34 clubfeet) and surgery in the form of posteromedial release (31 clubfeet). All included clubfeet were clinically fully corrected after initial treatment and final plaster removal. Evaluation was performed with the International Clubfoot Study Group (ICFSG) score. Results The age at follow-up was 12.8±1.6 years in the Ponseti group and 13.5±1.7 years in the surgical group. Excellent or good results were obtained in 26 feet (76%) of the Ponseti group and in 14 feet (45%) in the surgical group. The Ponseti treatment was significantly superior to posteromedial release in terms of the final score (10.58±6.49 versus 17.26±8.83, p<0.001), functional score (p<0.001) and radiological score (p<0.001). Residual deformities were clinically present in both groups but were less frequent and less severe in Ponseti-treated patients. Flat-top talus was found to be present in both groups, but the Ponseti method was more protective than surgical treatment against this outcome (relative risk=0.494, p=0.002). The overall foot and ankle mobility was significantly better in the Ponseti group (p<0.001). Conclusion The Ponseti method was superior to surgery for treatment of clubfoot and achieved better long-term morphological, functional and radiological results. It preserves better mobility of the foot and ankle, and results in less frequent and less severe residual deformities than surgical treatment.

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Influence of the windlass mechanism on arch-spring mechanics during dynamic foot arch deformation

Cited by 80 publications

References 27 publications

Effect of the upward curvature of toe springs on walking biomechanics in humans

Effect of the upward curvature of toe springs on walking biomechanics in humans

Number of Segments Within Musculoskeletal Foot Models Influences Ankle Kinematics and Strains of Ligaments and Muscles

<p>Posteromedial Release versus Ponseti Treatment of Congenital Idiopathic Clubfoot: A Long-Term Retrospective Follow-Up Study into Adolescence</p>

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