Effects of toe-in/ out toe-in gait and lateral wedge orthoses on lower extremity joint kinetics; an exploration using musculoskeletal simulation and Bayesian contrasts

Abstract

Introduction

The aim of the current investigation was to examine the effects of both lateral orthoses and toe-in/ toe-out foot progression angles on lower extremity joint loading during walking using a musculoskeletal simulation approach.

Methods

The current investigation examined 15 healthy males, walking in 6 different conditions (neutral, lateral orthoses, toe-in, lateral toe-in, toe-out and lateral toe-out). Walking kinematics were collected using an eight-camera motion capture system, and kinetics via an embedded piezoelectric force plate. Lower extremity joint loading was explored using a musculoskeletal simulation approach.

Results

This investigation showed that peak patellofemoral joint stress was greater in the neutral (3.96 kPa/BW) and lateral orthoses (4.20 kPa/BW) conditions compared to toe-in (3.33 kPa/BW), lateral toe-in (3.43 kPa/BW), toe-out (3.35 kPa/BW) and lateral toe-out (3.53 kPa/BW) and ankle joint impulse larger in the toe-in (1.65BW·s) and toe-out (1.62BW·s) foot progression angle modalities compared to neutral (1.51BW·s) and lateral orthoses (1.53BW·s). Furthermore, it was also shown that medial tibiofemoral impulse was statistically greater in the toe-in (1.20BW·s) and lateral toe-in (1.15BW·s) conditions compared to neutral (1.07BW·s), lateral orthoses (1.07BW·s), toe-out (1.09BW·s) and lateral toe-out (1.05BW·s).

Conclusions

Therefore, the current investigation provides evidence that altering the foot progression angle may attenuate the risk from patellofemoral disorders whilst simultaneously enhancing the risk from degenerative ankle pathologies. Similarly, adopting a toe-in foot progression angle may also increase the risk from medial tibiofemoral degeneration.