Skip to main content
Top
Published in: Journal of Foot and Ankle Research 1/2011

Open Access 01-12-2011 | Research

Relationships between the Foot Posture Index and foot kinematics during gait in individuals with and without patellofemoral pain syndrome

Authors: Christian J Barton, Pazit Levinger, Kay M Crossley, Kate E Webster, Hylton B Menz

Published in: Journal of Foot and Ankle Research | Issue 1/2011

Login to get access

Abstract

Background

Foot posture assessment is commonly undertaken in clinical practice for the evaluation of individuals with patellofemoral pain syndrome (PFPS), particularly when considering prescription of foot orthoses. However, the validity of static assessment to provide insight into dynamic function in individuals with PFPS is unclear. This study was designed to evaluate the extent to which a static foot posture measurement tool (the Foot Posture Index - FPI) can provide insight into kinematic variables associated with foot pronation during level walking in individuals with PFPS and asymptomatic controls.

Methods

Twenty-six individuals (5 males, 21 females) with PFPS aged 25.1 ± 4.6 years and 20 control participants (4 males, 16 females) aged 23.4 ± 2.3 years were recruited into the study. Each participant underwent clinical evaluation of the FPI and kinematic analysis of the rearfoot and forefoot during walking using a three-dimensional motion analysis system. The association of the FPI score with rearfoot eversion, forefoot dorsiflexion, and forefoot abduction kinematic variables (magnitude, timing of peak and range of motion) were evaluated using partial correlation coefficient statistics with gait velocity entered as a covariate.

Results

A more pronated foot type as measured by the FPI was associated with greater peak forefoot abduction (r = 0.502, p = 0.013) and earlier peak rearfoot eversion relative to the laboratory (r = -0.440, p = 0.031) in the PFPS group, and greater rearfoot eversion range of motion relative to the laboratory (r = 0.614, p = 0.009) in the control group.

Conclusion

In both individuals with and without PFPS, there was fair to moderate association between the FPI and some parameters of dynamic foot function. Inconsistent findings between the PFPS and control groups indicate that pathology may play a role in the relationship between static foot posture and dynamic function. The fair association between pronated foot posture as indicated by the FPI and earlier peak rearfoot eversion relative to the laboratory observed exclusively in those with PFPS is consistent with the biomechanical model of PFPS development. However, prospective studies are required to determine whether this relationship is causal.
Appendix
Available only for authorised users
Literature
1.
go back to reference Powers CM: The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003, 33: 639-646.CrossRefPubMed Powers CM: The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003, 33: 639-646.CrossRefPubMed
2.
go back to reference Tiberio D: The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model. J Orthop Sports Phys Ther. 1987, 9: 160-165.CrossRefPubMed Tiberio D: The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model. J Orthop Sports Phys Ther. 1987, 9: 160-165.CrossRefPubMed
3.
go back to reference Powers CM, Ward SR, Fredericson M, Guillet M, Shellock FG: Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella: a preliminary study. J Orthop Sports Phys Ther. 2003, 33: 677-685.CrossRefPubMed Powers CM, Ward SR, Fredericson M, Guillet M, Shellock FG: Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella: a preliminary study. J Orthop Sports Phys Ther. 2003, 33: 677-685.CrossRefPubMed
4.
go back to reference Lee TQ, Morris G, Csintalan RP: The influence of tibial and femoral rotation on patellofemoral contact area and pressure. J Orthop Sports Phys Ther. 2003, 33: 686-693.CrossRefPubMed Lee TQ, Morris G, Csintalan RP: The influence of tibial and femoral rotation on patellofemoral contact area and pressure. J Orthop Sports Phys Ther. 2003, 33: 686-693.CrossRefPubMed
5.
go back to reference Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A: A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. Am J Sports Med. 2009, 37: 2108-2116. 10.1177/0363546509337934.CrossRefPubMedPubMedCentral Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A: A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. Am J Sports Med. 2009, 37: 2108-2116. 10.1177/0363546509337934.CrossRefPubMedPubMedCentral
6.
go back to reference Barton CJ, Munteanu SE, Menz HB, Crossley KM: The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review. Sports Med. 40: 377-395. 10.2165/11530780-000000000-00000. Barton CJ, Munteanu SE, Menz HB, Crossley KM: The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review. Sports Med. 40: 377-395. 10.2165/11530780-000000000-00000.
7.
go back to reference Razeghi M, Batt ME: Foot type classification: a critical review of current methods. Gait Posture. 2002, 15: 282-291. 10.1016/S0966-6362(01)00151-5.CrossRefPubMed Razeghi M, Batt ME: Foot type classification: a critical review of current methods. Gait Posture. 2002, 15: 282-291. 10.1016/S0966-6362(01)00151-5.CrossRefPubMed
8.
go back to reference 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. 2006, 21: 89-98. 10.1016/j.clinbiomech.2005.08.002.CrossRef 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. 2006, 21: 89-98. 10.1016/j.clinbiomech.2005.08.002.CrossRef
9.
go back to reference Barton CJ, Bonanno D, Levinger P, Menz HB: Foot and ankle characteristics in patellofemoral pain syndrome: a case control and reliability study. J Orthop Sports Phys Ther. 2010, 40: 286-296.CrossRefPubMed Barton CJ, Bonanno D, Levinger P, Menz HB: Foot and ankle characteristics in patellofemoral pain syndrome: a case control and reliability study. J Orthop Sports Phys Ther. 2010, 40: 286-296.CrossRefPubMed
10.
go back to reference McPoil TG, Cornwall MW: Prediction of dynamic foot posture during running using the longitudinal arch angle. J Am Podiatr Med Assoc. 2007, 97: 102-107.CrossRefPubMed McPoil TG, Cornwall MW: Prediction of dynamic foot posture during running using the longitudinal arch angle. J Am Podiatr Med Assoc. 2007, 97: 102-107.CrossRefPubMed
11.
go back to reference McPoil TG, Cornwall MW: Use of the longitudinal arch angle to predict dynamic foot posture in walking. J Am Podiatr Med Assoc. 2005, 95: 114-120.CrossRefPubMed McPoil TG, Cornwall MW: Use of the longitudinal arch angle to predict dynamic foot posture in walking. J Am Podiatr Med Assoc. 2005, 95: 114-120.CrossRefPubMed
13.
go back to reference Franettovich MM, McPoil TG, Russell T, Skardoon G, Vicenzino B: The ability to predict dynamic foot posture from static measurements. J Am Podiatr Med Assoc. 2007, 97: 115-120.CrossRefPubMed Franettovich MM, McPoil TG, Russell T, Skardoon G, Vicenzino B: The ability to predict dynamic foot posture from static measurements. J Am Podiatr Med Assoc. 2007, 97: 115-120.CrossRefPubMed
14.
go back to reference Levinger P, Gilleard W: Relationship between static posture and rearfoot motion during walking in patellofemoral pain syndrome: effect of a reference posture for gait analysis. J Am Podiatr Med Assoc. 2006, 96: 323-329.CrossRefPubMed Levinger P, Gilleard W: Relationship between static posture and rearfoot motion during walking in patellofemoral pain syndrome: effect of a reference posture for gait analysis. J Am Podiatr Med Assoc. 2006, 96: 323-329.CrossRefPubMed
15.
go back to reference Callaghan MJ, Baltzopoulos V: Gait analysis in patients with anterior knee pain. Clin Biomech. 1994, 9: 79-84. 10.1016/0268-0033(94)90028-0.CrossRef Callaghan MJ, Baltzopoulos V: Gait analysis in patients with anterior knee pain. Clin Biomech. 1994, 9: 79-84. 10.1016/0268-0033(94)90028-0.CrossRef
16.
go back to reference Duffey MJ, Martin DF, Cannon DW, Craven T, Messier SP: Etiologic factors associated with anterior knee pain in distance runners. Med Sci Sports Exerc. 2000, 32: 1825-1832. 10.1097/00005768-200011000-00003.CrossRefPubMed Duffey MJ, Martin DF, Cannon DW, Craven T, Messier SP: Etiologic factors associated with anterior knee pain in distance runners. Med Sci Sports Exerc. 2000, 32: 1825-1832. 10.1097/00005768-200011000-00003.CrossRefPubMed
17.
go back to reference Levinger P, Gilleard W: Tibia and rearfoot motion and ground reaction forces in subjects with patellofemoral pain syndrome during walking. Gait Posture. 2007, 25: 2-8. 10.1016/j.gaitpost.2005.12.015.CrossRefPubMed Levinger P, Gilleard W: Tibia and rearfoot motion and ground reaction forces in subjects with patellofemoral pain syndrome during walking. Gait Posture. 2007, 25: 2-8. 10.1016/j.gaitpost.2005.12.015.CrossRefPubMed
18.
go back to reference Barton CJ, Levinger P, Webster KE, Menz HB: Walking kinematics in individuals with patellofemoral pain syndrome: a case control study. Gait Posture. 2011, 33: 286-291. 10.1016/j.gaitpost.2010.11.022.CrossRefPubMed Barton CJ, Levinger P, Webster KE, Menz HB: Walking kinematics in individuals with patellofemoral pain syndrome: a case control study. Gait Posture. 2011, 33: 286-291. 10.1016/j.gaitpost.2010.11.022.CrossRefPubMed
19.
go back to reference Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003, 35: 1381-1395. 10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMed Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003, 35: 1381-1395. 10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMed
20.
go back to reference Crossley K, Bennell K, Green S, Cowan S, McConnell J: Physical therapy for patellofemoral pain: a randomized, double-blinded, placebo-controlled trial. Am J Sports Med. 2002, 30: 857-865.PubMed Crossley K, Bennell K, Green S, Cowan S, McConnell J: Physical therapy for patellofemoral pain: a randomized, double-blinded, placebo-controlled trial. Am J Sports Med. 2002, 30: 857-865.PubMed
21.
go back to reference Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B: Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. BMJ. 2008, 337: a1735-10.1136/bmj.a1310.CrossRefPubMedPubMedCentral Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B: Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. BMJ. 2008, 337: a1735-10.1136/bmj.a1310.CrossRefPubMedPubMedCentral
22.
go back to reference Stebbins J, Harrington M, Thompson N, Zavatsky A, Theologis T: Repeatability of a model for measuring multi-segment foot kinematics in children. Gait Posture. 2006, 23: 401-410. 10.1016/j.gaitpost.2005.03.002.CrossRefPubMed Stebbins J, Harrington M, Thompson N, Zavatsky A, Theologis T: Repeatability of a model for measuring multi-segment foot kinematics in children. Gait Posture. 2006, 23: 401-410. 10.1016/j.gaitpost.2005.03.002.CrossRefPubMed
23.
go back to reference Keenan AM, Redmond AC, Horton M, Conaghan PG, Tennant A: The Foot Posture Index: Rasch analysis of a novel, foot-specific outcome measure. Arch Phys Med Rehabil. 2007, 88: 88-93. 10.1016/j.apmr.2006.10.005.CrossRefPubMed Keenan AM, Redmond AC, Horton M, Conaghan PG, Tennant A: The Foot Posture Index: Rasch analysis of a novel, foot-specific outcome measure. Arch Phys Med Rehabil. 2007, 88: 88-93. 10.1016/j.apmr.2006.10.005.CrossRefPubMed
24.
go back to reference Barton CJ, Levinger P, Menz HB, Webster KE: Kinematic gait characteristics associated with patellofemoral pain syndrome: a systematic review. Gait Posture. 2009, 30: 405-416. 10.1016/j.gaitpost.2009.07.109.CrossRefPubMed Barton CJ, Levinger P, Menz HB, Webster KE: Kinematic gait characteristics associated with patellofemoral pain syndrome: a systematic review. Gait Posture. 2009, 30: 405-416. 10.1016/j.gaitpost.2009.07.109.CrossRefPubMed
25.
go back to reference McCulloch MU, Brunt D, Vander Linden D: The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. J Orthop Sports Phys Ther. 1993, 17: 2-10.CrossRefPubMed McCulloch MU, Brunt D, Vander Linden D: The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. J Orthop Sports Phys Ther. 1993, 17: 2-10.CrossRefPubMed
26.
go back to reference Chiu MC, Wang MJ: The effect of gait speed and gender on perceived exertion, muscle activity, joint motion of lower extremity, ground reaction force and heart rate during normal walking. Gait Posture. 2007, 25: 385-392. 10.1016/j.gaitpost.2006.05.008.CrossRefPubMed Chiu MC, Wang MJ: The effect of gait speed and gender on perceived exertion, muscle activity, joint motion of lower extremity, ground reaction force and heart rate during normal walking. Gait Posture. 2007, 25: 385-392. 10.1016/j.gaitpost.2006.05.008.CrossRefPubMed
27.
go back to reference Riley PO, DellaCroce U, Kerrigan DC: Effect of age on lower extremity joint moment contributions to gait speed. Gait Posture. 2001, 14: 264-270. 10.1016/S0966-6362(01)00133-3.CrossRefPubMed Riley PO, DellaCroce U, Kerrigan DC: Effect of age on lower extremity joint moment contributions to gait speed. Gait Posture. 2001, 14: 264-270. 10.1016/S0966-6362(01)00133-3.CrossRefPubMed
28.
go back to reference Portney LG, Watkins MP: Foundations of clinical research - applications to practice. 2009, Conneticut: Appleton and Lange, 3 Portney LG, Watkins MP: Foundations of clinical research - applications to practice. 2009, Conneticut: Appleton and Lange, 3
29.
go back to reference Powers CM, Chen PY, Reischl SF, Perry J: Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain. Foot Ankle Int. 2002, 23: 634-640.CrossRefPubMed Powers CM, Chen PY, Reischl SF, Perry J: Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain. Foot Ankle Int. 2002, 23: 634-640.CrossRefPubMed
30.
go back to reference Myer GD, Ford KR, Foss KDB, Goodman A, Ceasar A, Rauth MJ, Divine JG, Hewitt TE: The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech. 2010, 25: 700-707. 10.1016/j.clinbiomech.2010.04.001.CrossRef Myer GD, Ford KR, Foss KDB, Goodman A, Ceasar A, Rauth MJ, Divine JG, Hewitt TE: The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech. 2010, 25: 700-707. 10.1016/j.clinbiomech.2010.04.001.CrossRef
31.
go back to reference Brechter HJ, Powers CM: Patellofemoral joint stress during walking in persons with and without patellofemoral pain. Med Sci Sports Exerc. 2002, 34: 1582-1593. 10.1097/00005768-200210000-00009.CrossRef Brechter HJ, Powers CM: Patellofemoral joint stress during walking in persons with and without patellofemoral pain. Med Sci Sports Exerc. 2002, 34: 1582-1593. 10.1097/00005768-200210000-00009.CrossRef
32.
go back to reference Brechter HJ, Powers CM: Patellofemoral joint stress during stair ascent and descent in persons with and without patellofemoral pain. Gait Posture. 2002, 16: 115-123. 10.1016/S0966-6362(02)00090-5.CrossRefPubMed Brechter HJ, Powers CM: Patellofemoral joint stress during stair ascent and descent in persons with and without patellofemoral pain. Gait Posture. 2002, 16: 115-123. 10.1016/S0966-6362(02)00090-5.CrossRefPubMed
33.
go back to reference Cowan SM, Bennell KL, Crossley KM, Hodges PW, McConnell J: Physical therapy alters recruitment of the vasti in patellofemoral pain syndrome. Med Sci Sports Exerc. 2002, 34: 1879-1885. 10.1097/00005768-200205001-00758.CrossRefPubMed Cowan SM, Bennell KL, Crossley KM, Hodges PW, McConnell J: Physical therapy alters recruitment of the vasti in patellofemoral pain syndrome. Med Sci Sports Exerc. 2002, 34: 1879-1885. 10.1097/00005768-200205001-00758.CrossRefPubMed
34.
go back to reference Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J: Simultaneous feedforward recruitment of the vasti in untrained postural tasks can be restored by physical therapy. J Orthop Res. 2003, 21: 553-558. 10.1016/S0736-0266(02)00191-2.CrossRefPubMed Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J: Simultaneous feedforward recruitment of the vasti in untrained postural tasks can be restored by physical therapy. J Orthop Res. 2003, 21: 553-558. 10.1016/S0736-0266(02)00191-2.CrossRefPubMed
35.
go back to reference Van Tiggelen D, Cowan S, Coorevits P, Duvigneaud N, Witvrouw E: Delayed vastus medialis obliquus to vastus lateralis onset timing contributed to the development of patellofemoral pain in previously healthy men. Am J Sports Med. 2009, 37: 1099-1105. 10.1177/0363546508331135.CrossRefPubMed Van Tiggelen D, Cowan S, Coorevits P, Duvigneaud N, Witvrouw E: Delayed vastus medialis obliquus to vastus lateralis onset timing contributed to the development of patellofemoral pain in previously healthy men. Am J Sports Med. 2009, 37: 1099-1105. 10.1177/0363546508331135.CrossRefPubMed
36.
go back to reference Carson MC, Harrington ME, Thompson N, O'Connor JJ, Theologis TN: Kinematic analysis of a multi-segment foot model for research and clinical applications: a repeatability analysis. J Biomech. 2001, 34: 1299-1307. 10.1016/S0021-9290(01)00101-4.CrossRefPubMed Carson MC, Harrington ME, Thompson N, O'Connor JJ, Theologis TN: Kinematic analysis of a multi-segment foot model for research and clinical applications: a repeatability analysis. J Biomech. 2001, 34: 1299-1307. 10.1016/S0021-9290(01)00101-4.CrossRefPubMed
Metadata
Title
Relationships between the Foot Posture Index and foot kinematics during gait in individuals with and without patellofemoral pain syndrome
Authors
Christian J Barton
Pazit Levinger
Kay M Crossley
Kate E Webster
Hylton B Menz
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2011
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-4-10

Other articles of this Issue 1/2011

Journal of Foot and Ankle Research 1/2011 Go to the issue