Quantifying rearfoot-forefoot coordination in human walking

A method is proposed to facilitate the quantification and interpretation of inter-joint/-segment coordination. This technique is illustrated using rearfoot-forefoot kinematic data. We expand existing vector coding techniques and introduce a set of operational terms through which the coordinative patterns between the rearfoot segment and the forefoot segment are summarized: in-phase, anti-phase, rearfoot phase and forefoot phase. The literature on foot mechanics has characterized the stable foot at pushoff by a decreasing medial longitudinal arch angle in the sagittal plane, which is accompanied by forefoot pronation and concurrent rearfoot supination-in other words, anti-phase motion. Nine skin markers were placed on the rearfoot and forefoot segments according to a multi-segment foot model. Three healthy subjects performed standing calibration and walking trials (1.35 ms(-1)), while a three-dimensional motion capture system acquired their kinematics. Rearfoot-forefoot joint angles were derived and the arch angle was inferred from the sagittal plane. Coupling angles of rearfoot and forefoot segments were derived and categorized into one of the four coordination patterns. Arch kinematics were consistent with the literature; in stance, the arch angle reached peak dorsiflexion, and then decreased rapidly. However, anti-phase coordination was not the predominant pattern during mid- or late stance. These preliminary data suggest that the coordinative interactions between the rearfoot and the forefoot are more complicated than previously described. The technique offers a new perspective on coordination and may provide insight into deformations Of underlying tissues, such as the plantar fascia. (C) 2008 Elsevier Ltd. All rights reserved.