Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

The Influence of Pronated Foot Posture on Knee Isokinetic Strength, Static and Dynamic Postural Stability in Healthy Young Individuals

  • Chun, Woochan (Department of Physical Therapy, College of Health and Welfare, Woosong University) ;
  • Kim, Hee-su (Department of Physical Therapy, College of Health and Welfare, Woosong University) ;
  • Park, Sieun (Department of Physical Therapy, Taegu Science University) ;
  • Park, Jihea (Department of Physical Therapy, College of Health and Welfare, Woosong University) ;
  • Shim, Seunghee (Department of Physical Therapy, College of Health and Welfare, Woosong University) ;
  • Park, Sookyoung (Department of Physical Therapy, College of Health and Welfare, Woosong University)
  • Received : 2021.07.13
  • Accepted : 2021.07.22
  • Published : 2021.08.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The foot is a complex body structure that plays an important role in static and dynamic situations. Previous studies have reported that altered foot posture might affect knee joint strength and postural stability, however their relationship still remains unclear. Objects: The purpose of this study was to identify whether pronated foot posture has an influence on knee isokinetic strength and static and dynamic postural stability. Methods: Forty healthy young males aged 18 to 26 years were included. Foot posture was evaluated using the Foot Posture Index-6 (FPI-6), and the subjects were divided into two groups according to their FPI-6 scores: a neutral foot group (n = 20, FPI-6 score 0 to +5) and a pronated foot group (n = 20, FPI-6 score +6 or more). Biodex Systems 3 isokinetic dynamometer was used to evaluate knee isokinetic strength and hamstring to quadriceps ratio at three angular velocities: 60°/sec, 90°/sec, and 180°/sec. The static and dynamic postural stability in a single-leg stance under the eyes-open and eyes-closed conditions were measured with a Biodex Balance System. Results: There were no significant differences between the groups in knee isokinetic strength and static postural stability (p > 0.05), but there was a significant difference in the medial-lateral stability index (MLSI) for dynamic postural stability under the eyes-closed condition (p = 0.022). The FPI-6 scores correlated significantly only with the dynamic overall stability index (OSI) and the MLSI (OSI: R = 0.344, p = 0.030; MLSI: R = 0.409, p = 0.009) under the eyesclosed condition. Conclusion: Participants with pronated foot had poorer medial-lateral dynamic stability under an eyes-closed condition than those without, and FPI-6 scores were moderately positively correlated with dynamic OSI and dynamic MLSI under the eyes-closed condition. These results suggest that pronated foot posture could induce a change in postural stability, but not in knee isokinetic strength.

Keywords

References

  1. Angin S, Mickle KJ, Nester CJ. Contributions of foot muscles and plantar fascia morphology to foot posture. Gait Posture 2018;61:238-42. https://doi.org/10.1016/j.gaitpost.2018.01.022
  2. Dahle LK, Mueller MJ, Delitto A, Diamond JE. Visual assessment of foot type and relationship of foot type to lower extremity injury. J Orthop Sports Phys Ther 1991;14(2):70-4. https://doi.org/10.2519/jospt.1991.14.2.70
  3. Walker M, Fan HJ. Relationship between foot pressure pattern and foot type. Foot Ankle Int 1998;19(6):379-83. https://doi.org/10.1177/107110079801900607
  4. Stovitz SD, Coetzee JC. Hyperpronation and foot pain: steps toward pain-free feet. Phys Sportsmed 2004;32(8):19-26. https://doi.org/10.3810/psm.2004.08.503
  5. Kodithuwakku Arachchige SNK, Chander H, Knight A. Flatfeet: biomechanical implications, assessment and management. Foot (Edinb) 2019;38:81-5. https://doi.org/10.1016/j.foot.2019.02.004
  6. Koura GM, Elimy DA, Hamada HA, Fawaz HE, Elgendy MH, Saab IM. Impact of foot pronation on postural stability: an observational study. J Back Musculoskelet Rehabil 2017;30(6):1327-32. https://doi.org/10.3233/BMR-170886
  7. Snook AG. The relationship between excessive pronation as measured by navicular drop and isokinetic strength of the ankle musculature. Foot Ankle Int 2001;22(3):234-40. https://doi.org/10.1177/107110070102200311
  8. Tweed JL, Campbell JA, Avil SJ. Biomechanical risk factors in the development of medial tibial stress syndrome in distance runners. J Am Podiatr Med Assoc 2008;98(6):436-44. https://doi.org/10.7547/0980436
  9. Chuter VH, Janse de Jonge XA. Proximal and distal contributions to lower extremity injury: a review of the literature. Gait Posture 2012;36(1):7-15. https://doi.org/10.1016/j.gaitpost.2012.02.001
  10. Tong JW, Kong PW. Association between foot type and lower extremity injuries: systematic literature review with meta-analysis. J Orthop Sports Phys Ther 2013;43(10):700-14. https://doi.org/10.2519/jospt.2013.4225
  11. Neal BS, Griffiths IB, Dowling GJ, Murley GS, Munteanu SE, Franettovich Smith MM, et al. Foot posture as a risk factor for lower limb overuse injury: a systematic review and metaanalysis. J Foot Ankle Res 2014;7(1):55. https://doi.org/10.1186/s13047-014-0055-4
  12. Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech (Bristol, Avon) 2006;21(1):89-98. https://doi.org/10.1016/j.clinbiomech.2005.08.002
  13. Ashnagar Z, Hadian MR, Olyaei G, Talebian S, Rezasoltani A, Saeedi H, et al. Ultrasound evaluation of the quadriceps muscles in pronated foot posture. Foot (Edinb) 2019;38:86-90. https://doi.org/10.1016/j.foot.2019.01.003
  14. Viseux FJF. The sensory role of the sole of the foot: review and update on clinical perspectives. Neurophysiol Clin 2020;50(1):55-68. https://doi.org/10.1016/j.neucli.2019.12.003
  15. Cote KP, Brunet ME, Gansneder BM, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. J Athl Train 2005;40(1):41-6.
  16. Kim EK, Kim JS. The effects of short foot exercises and arch support insoles on improvement in the medial longitudinal arch and dynamic balance of flexible flatfoot patients. J Phys Ther Sci 2016;28(11):3136-9. https://doi.org/10.1589/jpts.28.3136
  17. Tsai LC, Yu B, Mercer VS, Gross MT. Comparison of different structural foot types for measures of standing postural control. J Orthop Sports Phys Ther 2006;36(12):942-53. https://doi.org/10.2519/jospt.2006.2336
  18. Al Abdulwahab SS, Kachanathu SJ. The effect of various degrees of foot posture on standing balance in a healthy adult population. Somatosens Mot Res 2015;32(3):172-6. https://doi.org/10.3109/08990220.2015.1029608
  19. Hyong IH, Kang JH. Comparison of dynamic balance ability in healthy university students according to foot shape. J Phys Ther Sci 2016;28(2):661-4. https://doi.org/10.1589/jpts.28.661
  20. McLester CN, Nickerson BS, Kliszczewicz BM, McLester JR. Reliability and agreement of various inbody body composition analyzers as compared to dual-energy X-ray absorptiometry in healthy men and women. J Clin Densitom 2020;23(3):443-50. https://doi.org/10.1016/j.jocd.2018.10.008
  21. Langley B, Cramp M, Morrison SC. Clinical measures of static foot posture do not agree. J Foot Ankle Res 2016;9:45. https://doi.org/10.1186/s13047-016-0180-3
  22. Cornwall MW, McPoil TG, Lebec M, Vicenzino B, Wilson J. Reliability of the modified Foot Posture Index. J Am Podiatr Med Assoc 2008;98(1):7-13. https://doi.org/10.7547/0980007
  23. McLaughlin P, Vaughan B, Shanahan J, Martin J, Linger G. Inexperienced examiners and the Foot Posture Index: a reliability study. Man Ther 2016;26:238-40. https://doi.org/10.1016/j.math.2016.06.009
  24. Oh KY, Kim SA, Lee SY, Lee YS. Comparison of manual balance and balance board tests in healthy adults. Ann Rehabil Med 2011;35(6):873-9. https://doi.org/10.5535/arm.2011.35.6.873
  25. Akhbari B, Salavati M, Mohammadi F, Safavi-Farokhi Z. Intraand inter-session reliability of static and dynamic postural control in participants with and without patellofemoral pain syndrome. Physiother Can 2015;67(3):248-53. https://doi.org/10.3138/ptc.2014-51
  26. Van Driessche S, Van Roie E, Vanwanseele B, Delecluse C. Test-retest reliability of knee extensor rate of velocity and power development in older adults using the isotonic mode on a Biodex System 3 dynamometer. PLoS One 2018;13(5):e0196838. https://doi.org/10.1371/journal.pone.0196838
  27. Mikkola I, Jokelainen JJ, Timonen MJ, Harkonen PK, Saastamoinen E, Laakso MA, et al. Physical activity and body composition changes during military service. Med Sci Sports Exerc 2009;41(9):1735-42. https://doi.org/10.1249/MSS.0b013e31819fcd3c
  28. Lee SA, Kim AR, Yoo KT, Lee HS. Evaluation of muscle activity and foot pressure during gait, and isokinetic strength and balance in persons with functional ankle instability. J Korean Soc Phys Med 2018;13(3):27-37.
  29. Redmond A. The foot posture index©: easy quantification of standing foot posture. Six item version FPI-6. User guide and manual. University of Leeds [Internet]. Leeds: 2005 Aug [cited 2021 May 2]. Available from: https://pdfcoffee.com/foot-posture-index-pdf-free.html.
  30. Karimi N, Ebrahimi I, Kahrizi S, Torkaman G. Evaluation of postural balance using the biodex balance system in subjects with and without low back pain. Pak J Med Sci 2008;24(3):372-7.
  31. Kim JA, Lim OB, Yi CH. Difference in static and dynamic stability between flexible flatfeet and neutral feet. Gait Posture 2015;41(2):546-50. https://doi.org/10.1016/j.gaitpost.2014.12.012
  32. Tiberio D. The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model. J Orthop Sports Phys Ther 1987;9(4):160-5. https://doi.org/10.2519/jospt.1987.9.4.160
  33. Gross KD, Felson DT, Niu J, Hunter DJ, Guermazi A, Roemer FW, et al. Association of flat feet with knee pain and cartilage damage in older adults. Arthritis Care Res (Hoboken) 2011;63(7):937-44. https://doi.org/10.1002/acr.20431
  34. Solomonow M. Ligaments: a source of work-related musculoskeletal disorders. J Electromyogr Kinesiol 2004;14(1):49-60. https://doi.org/10.1016/j.jelekin.2003.09.011
  35. Kim YH, Kim KI, Paik NJ, Kim KW, Jang HC, Lim JY. Muscle strength: a better index of low physical performance than muscle mass in older adults. Geriatr Gerontol Int 2016;16(5):577-85. https://doi.org/10.1111/ggi.12514
  36. Gribble PA, Hertel J. Effect of lower-extremity muscle fatigue on postural control. Arch Phys Med Rehabil 2004;85(4):589-92. https://doi.org/10.1016/j.apmr.2003.06.031
  37. Bizid R, Margnes E, Francois Y, Jully JL, Gonzalez G, Dupui P, et al. Effects of knee and ankle muscle fatigue on postural control in the unipedal stance. Eur J Appl Physiol 2009;106(3):375-80. https://doi.org/10.1007/s00421-009-1029-2
  38. Vahtrik D, Ereline J, Gapeyeva H, Paasuke M. Postural stability in relation to anthropometric and functional characteristics in women with knee osteoarthritis following total knee arthroplasty. Arch Orthop Trauma Surg 2014;134(5):685-92. https://doi.org/10.1007/s00402-014-1940-9
  39. Sims KJ, Richardson CA, Brauer SG. Investigation of hip abductor activation in subjects with clinical unilateral hip osteoarthritis. Ann Rheum Dis 2002;61(8):687-92. https://doi.org/10.1136/ard.61.8.687
  40. Schorderet C, Hilfiker R, Allet L. The role of the dominant leg while assessing balance performance. A systematic review and meta-analysis. Gait Posture 2021;84:66-78. https://doi.org/10.1016/j.gaitpost.2020.11.008
  41. Bigoni M, Turati M, Gandolla M, Augusti CA, Pedrocchi A, La Torre A, et al. Balance in young male soccer players: dominant versus non-dominant leg. Sport Sci Health 2017;13(2):253-258. https://doi.org/10.1007/s11332-016-0319-4
  42. Wikstrom EA, Tillman MD, Kline KJ, Borsa PA. Gender and limb differences in dynamic postural stability during landing. Clin J Sport Med 2006;16(4):311-5. https://doi.org/10.1097/00042752-200607000-00005