Influence of forefoot deformities on the gait cycle

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Abstract

Modern treatment of foot deformities made it possible to increase the positivity of the outcomes of their surgical treatment. Surgical correction of anatomical distortions significantly improves the supporting and motor functions of the foot. To achieve this goal are widely used in various corrective interventions on the anterior section of the foot. The abundance of methods for these operations indicates that there are no optimal standards to date. The influence of bone and articular changes to locomotion and dynamics of movements of the lower extremities remains largely unexplored. Expanding the diagnosis of dynamic changes in the gait cycle as a result of deformity of the forefoot can help optimize the choice of correction method. This will give the potential to determine the indications for a particular method of restoring the correctness of anatomical relationships. Therefore, diagnostics of the transformation of the gait cycle with deformations of the forefoot is of undoubted interest. The purpose of the study is to evaluate the biomechanical features of movement of a person with anterior foot deformity, pain syndrome caused by deformity, and to explain the influence of the deformed foot shape on the change of individual phases of the gait cycle. To find out the changes in the walking function, we used a three-dimensional video analysis method. The main group was represented by 29 patients with anterior deformity of feet. The research was organized in 2018-2020. The average age was 51.3±16.5 years (from 20 to 80 years female patients were 29 (96.7%)). The control group consisted of 22 healthy women without foot deformities, with an average age of 45.4±15.5 years. The tool base of the research was the Vicon motion capture system (digital infrared cameras Vicon T40-10 PCs., video cameras Vicon bonita 720-2 PCs., dynamometer platform AMTI – 2 PCs., software Vicon Nexus, Vicon Polygon). The study used a full Body Plugin Gate (URM-FRM) skeletal model consisting of 39 reflective markers arranged in a certain order on the human body. The analysis of kinematic data revealed that all 29 studied patients had violations of biomechanics of movements in the joints of the lower extremities. There was an increase in the time of double support by 22.2% from 0.21±0.057 s for the control group to 0.27±0.064 s for the main group. Video analysis allowed us to combine the data obtained using computer graphical visualization of movements with the indicators of the support reaction force and the speed of movement of the lower extremities in patients with foot deformities, as well as to reveal the internal architecture of the gait cycle.