Search Results (62)

Background/Objectives: Sciatica secondary to lumbar disc herniation is a common cause of chronic radicular pain and functional disability. Since the sciatic nerve is involved in the motor and sensory innervation of the foot, it is important to evaluate the potential distal biomechanical alterations it produces. Evidence regarding the effect of radicular pain on kinetic parameters remains limited and heterogeneous. The aim of this study was to describe gait characteristics in people with chronic unilateral radicular pain due to non-traumatic lumbar or lumbosacral disc herniation and to compare kinetic differences between the affected and unaffected limbs. Methods: A cross-sectional analytical observational study was conducted in 41 patients who met the inclusion criteria. Dynamic baropodometric assessment was performed using the Footscan^® system. The analysis focused on kinetic parameters, including surface area, pressure, and maximum force, as well as spatiotemporal variables comprising stance time, step time, step length, and plantar push-off mechanics. Demographic data, Foot Posture Index (FPI) scores, and muscle strength were also recorded. Results: According to patient reports, the left foot was the most severely affected. Significant differences in muscle strength were found between the affected and unaffected limbs. However, no significant differences were observed in any of the kinetic or spatiotemporal parameters evaluated. Conclusions: Patients with unilateral sciatica due to lumbar disc herniation showed reduced muscle strength in the affected limb with no significant differences in kinetic or spatiotemporal gait parameters, suggesting compensatory mechanisms. Full article

Background: Flatfoot deformity is associated with altered lower extremity biomechanics and functional impairment during gait. However, evidence describing spatio-temporal gait alterations remains heterogeneous and has not been consistently synthesized across studies. Methods: A systematic review was conducted in accordance with PRISMA guidelines. MEDLINE (via PubMed) and Scopus were searched through 24 March 2025 for studies evaluating gait characteristics in individuals with flatfoot or progressive collapsing foot deformity. Studies reporting spatio-temporal parameters in both flatfoot and healthy control cohorts were included in quantitative synthesis. Random-effects meta-analyses were performed to evaluate gait velocity, stance duration, stride length, and cadence. Results: Fifteen studies met inclusion criteria, of which five provided sufficient data for meta-analysis. Compared with healthy controls, individuals with flatfoot demonstrated longer stance duration and shorter stride length. No differences were observed in gait velocity or cadence. Substantial heterogeneity was present across all pooled outcomes (I² > 80%), reflecting variability in study populations, disease characteristics, and gait analysis methodologies. Conclusions: Flatfoot is associated with consistent spatio-temporal gait adaptations characterized by longer stance duration and reduced stride length. Despite heterogeneity among included studies, these findings suggest consistent spatio-temporal gait adaptations that may serve as clinically relevant markers of altered gait mechanics and functional impairment. Further studies with standardized protocols are needed to refine the role of gait analysis in the assessment and management of flatfoot. Full article

Background/Objectives: The modern prosthetic foot market is characterized by a pronounced polarization between affordable but low-function devices and high-performance yet costly composite prostheses. The aim of this study was to develop and comprehensively evaluate cost-effective, functional prosthetic feet manufactured by fused deposition modeling (FDM). Methods: An iterative design methodology was employed, combining finite element analysis to optimize the biomechanical response of the device, the incorporation of user-specific requirements and experimental validation. Two TPU 95A-based 3D-printed prosthetic foot designs were designed and developed, and their strength and functional characteristics were assessed numerically under the ISO 22675:2024 normative loading cycle. Bench-top mechanical tests were conducted on the fabricated prototypes. Functional performance was evaluated by a transtibial amputee using an inertial motion capture system to analyze gait kinematics. Results: The results demonstrated that both designs operate predominantly within the elastic range with an adequate safety margin. The pilot feasibility gait assessment indicated feasibility and plausibility within the tested protocol and participant for both prototypes. Conclusions: The developed TPU 95A-based FDM prosthetic feet demonstrated promising structural integrity and functional feasibility, supporting the potential of low-cost additive manufacturing as a viable approach for producing affordable prosthetic feet. Further studies with larger participant cohorts and extended testing are needed to confirm clinical applicability and long-term performance. Full article

Background: Ankle foot orthosis–footwear combination (AFO–FC) tuning involves structured adjustment of the AFO relative to footwear to optimise shank alignment and ground reaction force (GRF) positioning during stance. Although established biomechanical frameworks and clinical algorithms are available, variability in clinical implementation persists. Previous investigations have primarily relied on self-reported practice within single healthcare settings and have not, to our knowledge, systematically examined how orthotists articulate and apply tuning principles within structured clinical reasoning across diverse educational and practice environments. Objectives: This study aimed to determine the level of awareness and framework-based proficiency in AFO–FC tuning among practising orthotists in a geographically diverse convenience sample, to examine the extent to which AFO–FC tuning is integrated into routine clinical practice, and to explore associations between framework-based proficiency level and selected professional characteristics. Methods: A cross-sectional study was conducted using an online survey of practising orthotists (n = 245). Awareness of AFO–FC tuning and self-reported routine implementation were assessed. Framework-based proficiency was evaluated among respondents reporting awareness (n = 212) using structured content analysis of open-text responses within a predefined exploratory five-domain biomechanical framework, and classified as limited (0–1 domains), partial (2–3 domains), or full (4–5 domains). Associations between framework-based proficiency level and professional characteristics were examined using chi-square tests. Binary logistic regression was performed to assess the association between framework-based proficiency level and self-reported routine implementation. Results: Self-reported awareness of AFO–FC tuning was high (86.5%), whereas 53.5% reported routine implementation. Based on the framework scoring, 59.0% demonstrated limited framework-based proficiency, 31.6% partial framework-based proficiency, and 9.4% full framework-based proficiency. No statistically significant associations were observed in this sample between framework-based proficiency level and educational qualification, years of clinical experience, or annual AFO case volume (p > 0.05). Full framework-based proficiency was associated with higher odds of self-reported routine implementation (OR = 4.03, 95% CI 1.44–11.25, p = 0.008). Conclusions: Despite high self-reported awareness, framework-based proficiency in AFO–FC tuning was limited within this sample. Self-reported routine implementation was more frequently reported among respondents with higher framework-based proficiency, whereas no statistically significant associations were observed with educational level, clinical experience, or annual AFO case volume. These hypothesis-generating findings should be interpreted cautiously given the cross-sectional design and framework-based (non-validated) classification. Full article

Wearable systems based on inertial measurement units (IMUs) have attracted considerable interest in recent years in the field of gait analysis. However, most gait studies using such devices have been conducted in laboratory rather than clinical settings. This study evaluated a commercially available IMU-based insole system in two cohorts: a clinical group (59 ± 18, years) recruited from podiatry clinics and a non-clinical group (28 ± 7, years) recruited from a university with no reported complaints. Participants wore the IMU-based device and performed treadmill walking (clinical group) and overground walking (non-clinical group). Spatiotemporal parameters were compared between groups using statistical analyses included the Shapiro–Wilk test, Mann–Whitney test, and Welch’s t-tests for non-bilateral data, and a two-factor linear mixed-effects model estimated by restricted maximum likelihood (REML) for bilateral spatiotemporal parameters to evaluate group, foot-side, and interaction effects. Ten of the twenty-two spatiotemporal parameters showed significant group differences, with statistical significance observed in at least one foot for parameters measured bilaterally. The observed differences may reflect a combination of clinical characteristics, age-related effects, and walking environment influences. Findings are discussed in relation to potential biomechanical mechanisms, factors influencing results and the clinical utility of IMU systems. Future research should investigate specific foot conditions under standardized walking conditions with age-matched cohorts. Full article

Background: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder that involves various biomechanical factors, including the altered positioning of the patella, weakness of the lower extremity muscles, delayed activation of the vastus medialis muscle, and excessive pronation of the foot. Although the short- and long-term effects of external support among the recommended conservative treatment methods for PFPS have been examined, there remains a lack of consensus regarding their impacts. This study was conducted to investigate the immediate effects of braces and rigid taping applied to control pain on proprioception, functional status, and balance in patients with PFPS, and to compare these outcomes with normative values obtained from healthy individuals. Methods: The study included 18 patients with PFPS and 18 healthy individuals who met the inclusion criteria. Through randomization of the intervention sequence, patients were evaluated under conditions of rigid taping, support, or without any support. Their pain levels before and after the application were assessed using the Visual Analog Scale; their functional status was evaluated with the Kujala Patellofemoral Scoring, the 10-Step Up Test, and the Squat; their balance performance was measured using the Y-Balance Test and the Single Leg Stance Test; and their proprioception was assessed with the Joint Position Sense Test. Results: It has been determined that rigid taping and bracing have similar effects in the immediate management of pain, proprioception, functional status, and balance issues in patients with PFPS. The interventions were observed to bring patients’ static balance and proprioception parameters closer to the values seen in healthy individuals. Conclusions: Rigid taping and bracing are both effective interventions in the management of PFPS, offering benefits such as pain relief, prevention of proprioceptive deficits, mitigation of balance impairments, and enhancement of functional outcomes. The selection of the most appropriate modality should be based on the individual patient’s characteristics and tolerance levels. Full article

Objectives: To investigate the association between calcaneal bump height and hindfoot radiographic parameters on weight-bearing lateral radiographs in adult males with Progressive Collapsing Foot Deformity (PCFD), and to determine whether posterior calcaneal morphology differs between feet with and without PCFD-related flatfoot alignment. Materials: We retrospectively reviewed 583 men (1166 feet), aged 17–46 years, who underwent standing weight-bearing lateral foot radiographs between 1 January 2024 and 31 August 2025. Radiographic measurements included calcaneal pitch, Meary’s angle, navicular height, tibiocalcaneal angle, Böhler’s angle, Fowler–Philip angle, calcaneal bump height, and additional calcaneal morphological indices. A flatfoot alignment consistent with PCFD was defined as a calcaneal pitch < 18°. Receiver operating characteristic (ROC) analysis and multivariable logistic regression were performed to assess diagnostic performance and identify parameters independently associated with flatfoot alignment. Results: Flatfoot alignment was identified in 232 feet (19.9%) from 153 patients (26.2%). Compared with normally aligned feet, the flatfoot group demonstrated significantly lower navicular height, calcaneal bump height, and Böhler’s angle, along with higher tibiocalcaneal and Meary’s angles (all p < 0.001). ROC analysis showed navicular height to be the most accurate diagnostic parameter (AUC = 0.75), followed by the tibiocalcaneal angle (AUC = 0.69). Multivariable logistic regression revealed that navicular height ≤ 52.7 mm, tibiocalcaneal angle > 64.6°, Böhler’s angle ≤ 32.9°, Meary’s angle > 4.9°, calcaneal bump height ≤ 3.9 mm, and Fowler–Philip angle > 61.1° were independently associated with flatfoot alignment (Nagelkerke R² = 0.293, p < 0.001). Conclusions: Calcaneal bump height is reduced in PCFD and reflects posterior calcaneal remodelling associated with hindfoot malalignment and medial arch collapse. Although not a primary diagnostic parameter, calcaneal bump height provides complementary morphological information that may inform surgical planning and osteotomy strategy aimed at restoring physiologic hindfoot biomechanics and Achilles tendon loading in patients with PCFD. Full article

Reaction time (RT) is a key indicator of cognitive and motor processing speed, and its age-related decline has important implications for everyday activities such as driving. However, conventional Psychomotor Vigilance Tests (PVTs) assess hand responses and do not capture lower-limb reaction characteristics relevant to pedal operations. This study aimed to compare RT characteristics between younger and older adults using the foot-response version of the PVT (Foot PVT) and to examine factors associated with RT. Sleep-related variables, physical activity level (PAL), and height were analyzed, and RT distribution characteristics were evaluated. Twenty younger adults (24 ± 3 years, range: 22–29 years) and twenty-four older adults (73 ± 5 years, range: 66–84 years) performed a 10 min Foot PVT. Mean RT was significantly slower in older adults (818 ± 105 ms) than in younger adults (700 ± 73 ms) (p < 0.001), indicating an age-related delay of approximately 120 ms. Older adults showed lower skewness and kurtosis, suggesting more homogeneous and cautious responses. In younger adults, height was negatively correlated with RT (r = −0.593, p = 0.006), and multiple regression analysis identified height as a significant predictor (adjusted R² = 0.316). No significant predictors were found in older adults. In the combined sample, age and height jointly explained 37.2% of the variance in mean RT. These findings indicate that Foot PVT performance reflects both biomechanical characteristics and age-related declines in reaction speed, supporting its utility for assessing lower-limb reaction capabilities relevant to driving and aging. Full article

Soccer is the most widely practiced sport globally, but is also associated with a high incidence of lower limb injuries. Among multiple risk factors, soccer footwear represents a crucial biomechanical interface affecting traction, proprioception, and joint loading. This narrative review aims to explore how each component of modern soccer footwear impacts performance and injury risk, with a focus on evidence-based functional customization. A comprehensive narrative review of available literature was conducted across PubMed, Scopus, and Web of Science, integrating biomechanical, clinical, and materials science studies. We included studies concerning the structures composing soccer technical footwear. Conical studs were associated with reduced rotational stiffness and lower joint torque, while bladed studs enhanced linear traction but increased ACL strain risk. Upper materials, such as knitted fabrics and engineered mesh, improve proprioception and thermal regulation but show trade-offs in durability and protection. Soleplate stiffness influenced load distribution and performance: increased stiffness improves sprinting but compromises multidirectional agility. Fatigue and proprioception were modulated by insole and soleplate synergy. Soccer footwear should be seen as a clinical and performance tool requiring evidence-based customization. Advances in material technology, 4D foot scanning, and plantar pressure mapping enable functional matching between footwear and athlete characteristics. Translating these insights into player-specific footwear designs may reduce injury rates and enhance on-field performance. Full article

Background: Static coronal alignment is considered a key of lower limb biomechanics after total knee replacement (TKR); however, its relationship with dynamic foot loading patterns and gait characteristics remains unclear. The primary objective of this prospective study was to investigate whether there is a correlation between dynamic plantar pressures and spatiotemporal parameters of gait and the coronal alignment of the lower limb after unilateral TKR for primary knee osteoarthritis (KOA). Methods: Thirty-two consecutive patients scheduled for TKR were evaluated preoperatively and at six months postoperatively. Changes in plantar pressure distribution and spatiotemporal gait parameters were collected using a multiplatform plantar pressure analysis system (PPAS), while coronal alignment was assessed using the femorotibial angle (FTA). Relationships with preoperative, postoperative, and correction-related alignment measures were examined using non-parametric statistical methods. Results: Dynamic plantar pressures and spatiotemporal gait parameters were not found to be consistently associated with pre- or postoperative values of FTA, respectively. Furthermore, the degree of correction did not appear to influence baropodometric outcomes. Conclusions: Static coronal alignment, as defined by the FTA, was not found to be consistently associated with dynamic plantar pressure patterns or spatiotemporal gait parameters at six months following unilateral TKR in our study population. These findings highlight the potential limitations of using solely static radiographic markers to evaluate complex functional outcomes such as gait. Full article

Regular sports activity induces kinesiological adaptations and alters musculoskeletal configuration, influencing postural control and balance. These adaptations vary by sport type and may differentiate athletes from non-athletes. This study analysed the effect of regular physical activity, including high-performance sport participation, on postural stability and examined whether this influence is reflected in static sway parameters. The study included 88 men divided into an athlete group (S: n = 46) and a non-athlete control group (NS: n = 42). A comparative design was used to assess differences between groups. Postural diagnostics were carried out with the Feemed Maxi baropodometric platform, enabling precise evaluation of plantar pressure distribution and standing stability. Athletes demonstrated greater asymmetry in foot-loading distribution globally and within partial plantar segments. Mean asymmetry values were higher in athletes (total foot: +3.131; forefoot: −2.414; rearfoot: +2.413) than in non-athletes (total foot: −2.472; forefoot: +0.983; rearfoot: −1.317). The primary statistically significant finding was a greater anteroposterior centre-of-pressure displacement in athletes, indicating increased sagittal-plane postural load (p < 0.001), whereas mediolateral displacement remained minimal and non-significant (NS: −0.012; S: −0.011; p = 0.891). Overall normalised CoP position was slightly higher in non-athletes (10.245%) than in athletes (10.103%). Long-term sports loading influences plantar pressure distribution and postural mechanics through subtle, often subclinical adaptations shaped by training level, sport specialisation, and individual biomechanical characteristics. Full article

Background/Objectives: Accurate plantar pressure assessment is essential for injury prevention and rehabilitation monitoring in sports. Wearable sensor technologies, such as DAid^® Smart Socks, offer portable, real-time biomechanical feedback and enable data collection in field conditions. However, there is limited evidence on their level of agreement with a gold standard in measuring the foot plantar center of pressure (CoP) in football-specific tasks. This study aimed to determine the preliminary validity of DAid^® Smart Socks compared with a gold-standard force platform in measuring plantar center of pressure (CoP) during functional football FIFA 11+ Part 2 exercises. Methods: Ten male volunteer youth football players (mean age 12.2 ± 0.42 years; height 158.7 ± 7.72 cm; weight 46.46 ± 8.78 kg; shoe size EU 39.8 ± 2.68) from the Latvian Football Federation Youth League participated. Eight players had right-leg dominance, two had left-leg dominance; three reported past lower-limb injuries. Plantar pressure was measured simultaneously using DAid^® Smart Socks and a 1.5 m entry-level force platform with a calibration factor of 3.2. Center of pressure (CoP) data from the force platform were recorded using Footscan software version 9.10.4. Participants performed two selected FIFA 11+ Part 2 exercises—a single-leg squat (unilateral) and a squat with heel raise, performed bilaterally—under standardized conditions. Each exercise was performed twice, with sock removal and reapplication between trials. Agreement between the DAid^® Smart Socks and the force platform was examined using waveform synchronization, root mean square error (RMSE), Bland–Altman analysis, and Lin’s Concordance Correlation Coefficient (CCC) to quantify both relative waveform correspondence and absolute CoP measurement accuracy. Results: Across 160 paired recordings, the DAid^® Smart Socks showed moderate-to-high correlation with the force platform for relative CoP dynamics, with 79% of waveforms demonstrating CCC ≥ 0.60. Absolute agreement was limited, with only 16% of recordings reaching CCC ≥ 0.90, and RMSE values ranging from 2.1 to 18.9 mm (X) and 4.3–34.2 mm (Y). Conclusions: DAid^® Smart Socks showed moderate-to-high correspondence with the force platform in capturing the directional and temporal characteristics of plantar CoP during functional football tasks, with agreement varying across individuals. Full article

Background: This scoping review systematically maps and synthesises contemporary literature on the biomechanics of active below-knee prosthetic devices, focusing on gait kinematics, kinetics, energy expenditure, and muscle activation. It further evaluates design advancements, including powered ankle–foot prostheses and variable impedance systems, that seek to emulate physiological ankle function and enhance mobility outcomes for transtibial amputees. Methods: This review followed the PRISMA-ScR guidelines. A comprehensive literature search was conducted on ScienceDirect, PubMed and IEEE Xplore for studies published between 2013 and 2023. Search terms were structured according to the Population, Intervention, Comparator, and Outcome (PICO) framework. From 971 identified articles, 27 peer-reviewed studies were found to meet the inclusion criteria between January 2013 and December 2023. Data were extracted on biomechanical parameters, prosthetic design characteristics, and participant demographics to identify prevailing trends and research gaps. This scoping review was registered with Research Registry under the following registration number: reviewregistry 2055. Results: The reviewed studies demonstrate that active below-knee prosthetic systems substantially improve gait symmetry and ankle joint range of motion compared with passive devices. However, compensatory trunk and pelvic movements persist, indicating that full restoration of natural gait mechanics remains incomplete. Metabolic efficiency varied considerably across studies, influenced by device design, control strategies, and user adaptation. Notably, the literature exhibits a pronounced gender imbalance, with only 10.7% female participants, and a reliance on controlled laboratory conditions, limiting ecological validity. Conclusions: Active prosthetic technologies represent a significant advancement in lower-limb rehabilitation. Nevertheless, complete biomechanical normalisation has yet to be achieved. Future research should focus on long-term, real-world evaluations using larger, more diverse cohorts and adaptive technologies such as variable impedance actuators and multi-level control systems to reduce asymmetrical loading and optimise gait efficiency. Full article

Background: Accurate assessment of pediatric foot biomechanics is challenging due to growth-related variability and limited quantitative tools. The supination and pronation angles of the ankle are critical for understanding lower limb alignment and pathological gait patterns. Objectives: This study introduces a novel digital pedoscopic system designed to enhance the quantitative evaluation of foot alignment and to demonstrate its clinical utility through clustering analysis of pediatric ankle angles. Methods: Thirty-five pediatric patients (mean age = 6.17 ± 4.54 years) with neurological or developmental disorders were evaluated using a semi-automated digital pedoscopic system to obtain quantitative measurements of ankle alignment. Key anatomical landmarks, including the heel, calf, and knee centers, were manually identified from posterior images, and the system automatically calculated ankle pronation and supination angles. K-means clustering analysis was applied to classify participants based on their biomechanical profiles. Results: A total of thirty-five pediatric patients were assessed, and the revised abstract now explicitly reports this sample size to improve clarity. Data-driven k-means clustering of bilateral rearfoot angles identified three clearly defined alignment subgroups—neutral, pronated, and supinated—each exhibiting characteristic distribution patterns and degrees of inter-individual variability. These findings highlight the system’s ability to quantitatively distinguish biomechanical phenotypes within a heterogeneous pediatric population. Visualization through scatter, box, and violin plots demonstrated distinct cluster-specific distributions and inter-individual variability in rearfoot alignment, demonstrating the feasibility of objective biomechanical stratification in pediatric populations. Conclusions: The digital pedoscopic imaging system provides a reliable and reproducible approach for quantitative assessment of foot alignment in children. Clustering analysis enables stratification of biomechanical subtypes, supporting individualized rehabilitation strategies and longitudinal monitoring in pediatric clinical practice. Full article

Generalised joint hypermobility (GJH) describes an excessive range of joint movement and is associated with increased musculoskeletal injury risk, joint pain, and instability. This study compares lower limb biomechanical characteristics between children with and without GJH. Children aged 5–18 years with GJH (Beighton score ≥ 6/9 pre-puberty, ≥5/9 post-puberty) were age- and sex-matched with controls (Beighton score ≤ 2/9). Biomechanical measures included internal hip rotation, quadriceps (Q) angle, tibial torsion, ankle range of motion (ROM), and foot posture index (FPI). Wilcoxon rank sum test and chi-square were used to assess group differences. Fifty-two participants (median age 11 years, 69% females) included 27 children with GJH and 25 healthy children. Internal hip rotation, Q-angle, ankle ROM and FPI were significantly higher for children with GJH (p < 0.001) than healthy peers. While tibial torsion showed no difference in males, females had greater internal tibial torsion [median difference: right −4° (95%CI:−7,−2), p = 0.002; left −5° (95%CI:−7,−1), p = 0.010]. The largest differences were in ankle ROM [median difference: right 9° (95%CI:7,12); left 9° (95%CI:6,12)]. Children with GJH present different biomechanical measures than non-GJH peers. Further research into the clinical relevance of ROM at the hip, ankle and foot for children with GJH which are movement planes not assessed in Beighton score is warranted. Full article