The structure of the medial longitudinal arch (MLA) affects the foot's overall function and its ability to dissipate plantar pressure forces. Previous research on the MLA includes measuring the calcaneal–first metatarsal angle using a static sagittal plane radiograph, a dynamic height-to-length ratio using marker clusters with a multisegment foot model, and a contained angle using single point markers with a multisegment foot model. The objective of this study was to use biplane fluoroscopy to measure a contained MLA angle between foot types: pes planus (low arch), pes cavus (high arch), and normal arch. Fifteen participants completed the study, five from each foot type. Markerless fluoroscopic radiostereometric analysis (fRSA) was used with a three-dimensional model of the foot bones and manually matching those bones to a pair of two-dimensional radiographic images during midstance of gait. Statistically significant differences were found between barefoot arch angles of the normal and pes cavus foot types (p = 0.036), as well as between the pes cavus and pes planus foot types (p = 0.004). Dynamic walking also resulted in a statistically significant finding compared to the static standing trials (p = 0.014). These results support the classification of individuals following a physical assessment by a foot specialist for those with pes cavus and planus foot types. The differences between static and dynamic kinematic measurements were also supported using this novel method.

References

References
1.
Mootanah
,
R.
,
Song
,
J.
,
Lenhoff
,
M. W.
,
Hafer
,
J. F.
,
Backus
,
S. I.
,
Gagnon
,
D.
,
Deland
,
J. T.
, III
, and
Hillstrom
,
H. J.
,
2013
, “
Foot Type Biomechanics Part 2: are Structure and Anthropometrics Related to Function?
,”
Gait Posture
,
37
(
3
), pp.
452
456
.
2.
Franco
,
A. H.
,
1987
, “
Pes Cavus and Pes Planus—Analyses and Treatment
,”
Phys. Ther.
,
67
(
5
), pp.
688
694
.
3.
Tome
,
J.
,
Nawoczenski
,
D. A.
,
Flemister
,
A.
, and
Houck
,
J.
,
2006
, “
Comparison of Foot Kinematics Between Participants With Posterior Tibialis Tendon Dysfunction and Healthy Controls
,”
J. Orthop. Sports Phys. Ther.
,
36
(
9
), pp.
635
644
.
4.
Jenkyn
,
T.
, and
Nicol
,
A.
,
2007
, “
A Multi-Segment Kinematic Model of the Foot With a Novel Definition of Forefoot Motion for Use in Clinical Gait Analysis During Walking
,”
J. Biomech.
,
40
(
14
), pp.
3271
3278
.
5.
Leardini
,
A.
,
Chiari
,
L.
,
Della Croce
,
U.
, and
Cappozzo
,
A.
,
2005
, “
Human Movement Analysis Using Stereophotogrammetry Part 3. Soft Tissue Artifact Assessment and Compensation
,”
Gait Posture
,
21
(
2
), pp.
212
225
.
6.
Jenkyn
,
T. R.
,
Anas
,
K.
, and
Nichol
,
A.
,
2009
, “
Foot Segment Kinematics During Normal Walking Using a Multisegment Model of the Foot and Ankle Complex
,”
ASME J. Biomech. Eng.
,
131
(
3
), p.
034504
.
7.
Stebbins
,
J.
,
Harringon
,
M.
,
Thompson
,
N.
,
Zavatsky
,
T.
, and
Theologis
,
T.
,
2006
, “
Repeatability of a Model for Measuring Multi-Segment Foot Kinematics in Children
,”
Gait Posture
,
23
(
4
), pp.
401
410
.
8.
Wright
,
C. J.
,
Arnold
,
B. L.
,
Coffey
,
T. G.
, and
Pidcoe
,
P. E.
,
2011
, “
Repeatability of the Modified Oxford Foot Model During Gait in Healthy Adults
,”
Gait Posture
,
33
(
1
), pp.
108
112
.
9.
Bishop
,
C.
,
Paul
,
G.
, and
Thewlis
,
D.
,
2013
, “
The Reliability, Accuracy and Minimal Detectable Difference of a Multi-Segment Kinematic Model of the Foot-Shoe Complex
,”
Gait Posture
,
37
(
4
), pp.
552
557
.
10.
Seo
,
S. G.
,
Lee
,
D. Y.
,
Moon
,
H. J.
,
Kim
,
S. J.
,
Kim
,
J.
,
Lee
,
K. M.
,
Chung
,
C. Y.
, and
Choi
,
I. H.
,
2014
, “
Repeatability of a Multi-Segment Foot Model With a 15-Marker Set in Healthy Adults
,”
J. Foot Ankle Res.
,
7
(
1
), pp.
24
32
.
11.
Shultz
,
R.
,
Kedgley
,
A. E.
, and
Jenkyn
,
T. R.
,
2011
, “
Quantifying Skin Motion Artifact Error of the Hindfoot and Forefoot Marker Clusters With the Optical Tracking of a Multi-Segment Foot Model Using Single-Plan Fluoroscopy
,”
Gait Posture
,
34
(
1
), pp.
44
48
.
12.
Murley
,
G. S.
,
Menz
,
H. B.
, and
Landorf
,
K. B.
,
2009
, “
A Protocol for Classifying Normal- and Flat-Arched Foot Posture for Research Studies Using Clinical and Radiographic Measurements
,”
J. Foot Ankle Res.
,
2
(
1
), pp.
22
34
.
13.
Peltz
,
C. D.
,
Haladik
,
J. A.
,
Hoffman
,
S. E.
,
McDonald
,
M.
,
Ramo
,
N. L.
,
Divine
,
G.
,
Nurse
,
M.
, and
Bey
,
M. J.
,
2014
, “
Effects of Footwear on Three-Dimensional Tibiotalar and Subtalar Joint Motion During Running
,”
J. Biomech.
,
47
(
11
), pp.
2647
2653
.
14.
Hoffman
,
S. E.
,
Peltz
,
C. D.
,
Haladik
,
J. A.
,
Divine
,
G.
,
Nurse
,
M. A.
, and
Bey
,
M. J.
,
2015
, “
Dynamic In-Vivo Assessment of Navicular Drop While Running in Barefoot, Minimalist, and Motion Control Footwear Conditions
,”
Gait Posture
,
41
(
3
), pp.
825
829
.
15.
Deland
,
J. T.
,
2008
, “
Adult-Acquired Flatfoot Deformity
,”
J. Am. Acad. Orthop. Surg.
,
16
(
7
), pp.
399
406
.
16.
Kedgley
,
A. E.
, and
Jenkyn
,
T. R.
,
2009
, “
RSA Calibration Accuracy of a Fluoroscopy-Based System Using Nonorthogonal Images for Measure Functional Kinematics
,”
Med. Phys.
,
36
(
7
), pp.
3176
3180
.
17.
Chakraborty
,
D. P.
,
1987
, “
Image Intensifier Distortion Correction
,”
Med. Phys.
,
14
(
2
), pp.
249
252
.
18.
Kedgley
,
A. E.
,
Fox
,
A.-M. V.
, and
Jenkyn
,
T. R.
,
2012
, “
Image Intensifier Distortion Correction for Fluoroscopic RSA: The Need for Independent Accuracy Assessment
,”
J. Appl. Clin. Med. Phys.
,
13
(
1
), pp.
197
204
.
19.
Allen
,
A.-M.
,
2009
, “
Development and Validation of a Markerless Radiostereometric Analysis (RSA) System
,” Ph.D. thesis, Western University, London, ON, Canada.
20.
Geideman
,
W. M.
, and
Johnson
,
J. E.
,
2000
, “
Posterior Tibial Tendon Dysfunction
,”
J. Orthop. Sports Phys. Ther.
,
30
(
2
), pp.
68
77
.
21.
Saltzman
,
C. L.
,
Nawoczenski
,
D. A.
, and
Talbot
,
K. D.
,
1995
, “
Measurement of the Medial Longitudinal Arch
,”
Arch. Phys. Med. Rehabil.
,
76
(
1
), pp.
45
49
.
22.
Stolwijk
,
N. M.
,
Koenraadt
,
K. L. M.
,
Louwerens
,
J. W. K.
,
Grim
,
D.
,
Duysens
,
J.
, and
Keijsers
,
N. L. W.
,
2014
, “
Foot Lengthening and Shortening During Gait: A Parameter to Investigate Foot Function?
,”
Gait Posture
,
39
(
2
), pp.
773
777
.
23.
Muir
,
B. C.
,
Rietdyk
,
S.
, and
Haddad
,
J. M.
,
2014
, “
Gait Initiation: The First Four Steps in Adults Aged 20–25 years, 65–79 years, and 80–91 years
,”
Gait Posture
,
39
(
1
), pp.
490
494
.
24.
Martin
,
H.
,
Bahlke
,
U.
,
Zschorlich
,
V.
,
Schmitz
,
K.-P.
, and
Mittlmeier
,
T.
,
2012
, “
Investigation of First Ray Mobility During Gait by Kinematic Fluoroscopic Imaging—A Novel Method
,”
BMC Musculoskeletal Disord.
,
13
(
1
), pp.
14
21
.
25.
McHenry
,
B. D.
,
Exten
,
E. L.
,
Long
,
J.
,
Law
,
B.
,
Marks
,
R. M.
, and
Harris
,
G.
,
2015
, “
Sagittal Subtalar and Talocrural Joint Assessment With Weight-Bearing Fluoroscopy During Barefoot Ambulation
,”
Am. Orthop. Foot Ankle Soc.
,
36
(
4
), pp.
430
435
.
26.
McHenry
,
B. D.
,
Exten
,
E.
,
Long
,
J. T.
, and
Harris
,
G. F.
,
2015
, “
Sagittal Fluoroscopy for the Assessment of Hindfoot Kinematics
,”
ASME J. Biomech. Eng.
,
138
(3), p.
034502
.
27.
Campbell
,
K. J.
,
Wilson
,
K. J.
,
LaPrade
,
R. F.
, and
Clanton
,
T. O.
,
2014
, “
Normative Rearfoot Motion During Barefoot and Shod Walking Using Biplane Fluoroscopy
,”
Knee Surg., Sports Traumatol., Arthrosc.
,
24
(
1
), pp.
1402
1408
.
28.
Iaquinto
,
J. M.
,
Tsai
,
R.
,
Haynor
,
D. R.
,
Fassbind
,
M. J.
,
Sangeorzan
,
B. J.
, and
Ledoux
,
W. R.
,
2013
, “
Marker-Based Validation of a Biplane Fluoroscopy System for Quantifying Foot Kinematics
,”
Med. Eng. Phys.
,
36
, pp.
391
396
.
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