The effects of small and large varus alignment of the foot-ankle complex on lower limb kinematics and kinetics during walking: A cross-sectional study

• Published in: Musculoskeletal science & practice Vol. 47; p. 102149
• Main Authors: Araújo, Vanessa L., Santos, Thiago R.T., Khuu, Anne, Lewis, Cara L., Souza, Thales R., Holt, Kenneth G., Fonseca, Sergio T.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2020
• Subjects: Foot pronation; Varus alignment; Walking; Walking; Foot pronation; Varus alignment
• ISSN: 2468-7812; 2468-8630; 2468-7812
• DOI: 10.1016/j.msksp.2020.102149

The alignment of the foot-ankle complex may influence the kinematics and kinetics of the entire lower limb during walking.
This study investigated the effect of different magnitudes of varus alignment of the foot-ankle complex (small versus large) on the kinematics and kinetics of foot, ankle, knee, and hip in the frontal and transverse planes during walking.
Cross-sectional study.
Foot-ankle complex alignment in the frontal plane was measured as the angle between the metatarsal heads and the inferior edge of the examination table, measured with the volunteer in prone maintaining the ankle at 0° in the sagittal plane. The participants (n = 28) were divided into two groups according to their alignment angles. The first group had values equal to or inferior to the 45 percentile, and the second group had values equal to or above the 55 percentile. The lower limb kinematics and kinetics were evaluated with the participant walking at self-select speed in an instrumented treadmill.
The group of large varus alignment showed significantly higher (p < 0.03) forefoot inversion angle at initial contact, amplitude of rearfoot-shank eversion, and peak of inversion ankle moment. There were no differences (p > 0.05) between the groups for knee and hip amplitudes and moments in the frontal and transverse planes. The durations of rearfoot-shank eversion, knee abduction, knee medial rotation, hip adduction, and hip medial rotation were not different between groups (p > 0.05).
Large varus alignment of the foot-ankle complex may increase the magnitude of foot pronation and ankle inversion moment during walking.
•Large varus of the foot-ankle complex increased foot pronation during walking.•Large varus alignment increased forefoot inversion at initial contact.•Large-varus group had higher ankle inversion moment compared to small-varus group.•No differences between the groups were observed for the knee and hip joints.