Arch-Support Induced Changes in Foot-Ankle Coordination in Young Males with Flatfoot during Unplanned Gait Termination

Objective: The efficacy of arch orthoses in posture adjustment and joint coordination improvement during steady-state gait is well documented; however, the biomechanical changes of gait sub-tasks caused by arch support (AS), especially during gait termination, are poorly understood. Hence, this study aimed to investigate how the acute arch-supporting intervention affects foot-ankle coordination and coordination variability (CV) in individuals with flatfoot during unplanned gait termination (UGT). Methods: Twenty-five male patients with flatfoot were selected as subjects participated in this AS manipulation study. A motion capture system was used for the collection of the metatarsophalangeal joint (MPJ) and ankle kinematics during UGT. MPJ-Ankle coordination and CV were quantified using an optimized vector coding technique during the three sub-phases of UGT. A paired-sample t-test from the one-dimensional statistical parametric mapping of one-dimensional was applied to examine the data significance. Results: Significant differences for the joint kinematics between non-arch-support (NAS) and AS were exhibited only in the MPJ transverse plane during the middle and later periods of UGT (p = 0.04-0.026). Frontal plane MPJ-ankle coordination under AS during stimulus delay significantly decreased from 177.16 +/- 27.41 degrees to 157.75 +/- 32.54 degrees compared with under NAS (p = 0.026); however, the coordination pattern had not changed. Moreover, no significant difference was found in the coupling angle variability between NAS and AS in three planes during sub-phases of UGT (all p > 0.5). Conclusions: The detailed intrinsic characteristic of AS induced acute changes in lower extremity segment coordination in patients with mild flatfoot has been recorded. This dataset on foot-ankle coordination characteristics during UGT is essential for explaining foot function and injury prediction concerning AS manipulation. Further studies are expected to reflect lower limb inter-joint coordination during gait termination through the long-term effects of AS orthoses.

Automated summary

This study investigated the acute effects of arch-supporting intervention on lower extremity segment coordination in patients with mild flatfoot during unplanned gait termination. Significant differences were found in joint kinematics and frontal plane MPJ-ankle coordination under arch support, while no significant difference was observed in coordination angle variability compared to non-arch-support conditions. Further research is needed to explore the long-term effects of arch orthoses on lower limb inter-joint coordination during gait termination.