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Year 2021 / Volume 32 / Number 1

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Original Papers

Relationship between ankle dorsiflexion and dorsiflexion of the first metatarsophalangeal joint in the full stance and toe-off phases of gait: cross-sectional study in healthy subjects

Rev. Esp. Pod. 2021; 32(1): 36-41 / DOI: 10.20986/revesppod.2021.1602/2021

Joan Morante Naranjo, Enrique Sanchis Sales

ABSTRACT

Objectives: The ankle joint and first metatarsophalangeal joint have been widely discussed in the literature given their importance during the course of gait as a fundamental part of proximal to distal load shifting and their possible relationship when performing that function. The aim of this study is to test if there is a relationship between the degrees of dorsal flexion of both joints during the course of human gait.
Patients and methods: The study consisted of 29 adult subjects without the presence of lower limb pathology. Foot posture was classified using the foot posture index. Using the Lunge test and the Dananberg test, the degrees of dorsal flexion of the ankle and first metatarsophalangeal joint in static were established. The dynamic measurement was carried out by means of a 2D recording of the subjects gait cycle, which was subsequently analyzed using Kinovea® video analysis software.
Results: The degrees of dorsal flexion of the ankle and first metatarsophalangeal joint in dynamics did not show a significant linear relationship. Regarding foot posture, no significant linear relationship was found with the previous measurements.
Conclusion: The present study shows the absence of a relationship between the degrees of dorsal flexion of the ankle and first metatarsophalangeal joint in dynamics. It would be advisable to continue investigating the mechanical behavior of both joints in order to fully understand their function and reach definitive conclusions.

RESUMEN

Objetivos: La articulación del tobillo y la primera articulación metatarsofalángica han sido ampliamente tratadas en la literatura dada su importancia durante el transcurso de la marcha como parte fundamental del desplazamiento de cargas, de proximal a distal, y su posible relación la hora de realizar dicha función. El objetivo de este estudio es comprobar si existe una relación entre los grados de flexión dorsal de ambas articulaciones durante el trascurso de la marcha humana.
Pacientes y métodos: El estudio se compone de 29 sujetos adultos sin presencia de patología en el miembro inferior. La postura del pie se clasificó mediante el índice de postura del pie. Mediante el test de Lunge y el test de Dananberg se establecieron los grados de flexión dorsal de tobillo y primera articulación metatarsofalángica en estática. La medición dinámica se llevó a cabo mediante una grabación en 2D del ciclo de marcha de los sujetos; posteriormente se analizó mediante el software de análisis de vídeo Kinovea®.
Resultados: Los grados de flexión dorsal de tobillo y primera articulación metatarsofalángica en dinámica no mostraron una relación lineal significativa. Respecto a la postura del pie tampoco se encontró una relación lineal significativa con las mediciones anteriores.
Conclusión: El presente estudio muestra la ausencia de relación entre los grados de flexión dorsal de tobillo y la primera articulación metatarsofalángica en dinámica. Sería recomendable seguir investigando el comportamiento mecánico de ambas articulaciones con el fin de entender completamente el funcionamiento de estas y llegar a conclusiones definitivas.

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Bibliografía

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2. Perry, J. Burnfield J. Análisis de la marcha: función normal y patológica. Madrid: Editorial Base; 2015. p. 51-84.

3. Grimston SK, Nigg BM, Hanley DA, Engsberg JR. Differences in Ankle Joint Complex Range of Motion as a Function of Age. Foot Ankle Int. 1993;14(4):215-22.

DOI: 10.1177/107110079301400407

4. Winter DA. Kinematic and kinetic patterns in human gait: Variability and compensating effects. Hum Mov Sci. 1984;3(1-2):51-76.

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5. Jordan RP, Cooper M, Schuster RO. Ankle dorsiflexion at the heel-off phase of gait: a photokinegraphic study. J Am Podiatry Assoc. 1979;69(1):40-6.

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8. Pascual Huerta J. The effect of the gastrocnemius on the plantar fascia. Foot Ankle Clin. 2014;19(4):701-18.

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9. Nakale NT, Strydom A, Saragas NP, Ferrao PNF. Association Between Plantar Fasciitis and Isolated Gastrocnemius Tightness. Foot Ankle Int. 2018;39(3):271-7.

DOI: 10.1177/1071100717744175

10. García Vidal J-A, Piñero Palazón J-G, Baño Alcaraz A, Sánchez Martínez M-P, Medina Mirapeix F. Rev int cienc Podol. 2018;13(1):41-6. DOI: 10.5209/RICP.62343.

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12. Bennell K, Talbot R, Wajswelner H, Techovanich W, Kelly D. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998;44(3):175-80.

DOI: 10.1016/S0004-9514(14)60377-9

13. Powden CJ, Hoch JM, Hoch MC. Reliability and minimal detectable change of the weight-bearing lunge test: A systematic review. Man Ther. 2015;20(4):524-32.

DOI: 10.1016/j.math.2015.01.004

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16. Root ML, Orien WP, Weed JH, Vergés Salas C. Función normal y anormal del pie. Madrid: Editorial Base; 2012. p. 54-60.

17. Kelikian AS, Sarrafian SK. Sarrafian’s anatomy of the foot and ankle : descriptive, topographical, functional. Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011. p. 86-87.

18. Kirby KA. Biomecánica del pie y la extremidad inferior II : artículos de Precision Intricast, 1997-2002. Payson, AZ: Precision Intricast; 2002.

19. Shereff M. Pathophysiology, Anatomy, and Biomechanics of Hallux Valgus. Orthopedics. 1990;13(9):939-45.

DOI: 10.3928/0147-7447-19900901-06

20. Hopson MM, McPoil TG, Cornwall MW. Motion of the first metatarsophalangeal joint. Reliability and validity of four measurement techniques. J Am Podiatr Med Assoc. 1995;85(4):198-204.

DOI: 10.7547/87507315-85-4-198

21. Phillips RD, Law EA, Ward ED. Functional motion of the medial column joints of the foot during propulsion. J Am Podiatr Med Assoc. 1996;86(10):474-86.

DOI: 10.7547/87507315-86-10-474

22. Hetherington V, Johnson R, Albritton J. Necessary dorsiflexion of the first metatarsophalangeal joint during gait. J Foot Ankle Surg. 1990;29:218.

23. Halstead J, Redmond AC. Weight-bearing passive dorsiflexion of the hallux in standing is not related to hallux dorsiflexion during walking. J Orthop Sports Phys Ther. 2006;36(8):550-6.

DOI: 10.2519/jospt.2006.2136

24. Nawoczenski DA, Baumhauer JF, Umberger BR. Relationship between clinical measurements and motion of the first metatarsophalangeal joint during gait. J Bone Jt Surg - Ser A. 1999;81(3):370-6.

DOI: 10.2106/00004623-199903000-00009

25. Leal Serra V, Leal Serra V, Aquíleo Calcáneo Plantar S. Sistema aquíleo calcáneo plantar. Biomecánica. 2011;19(1):35-43.

26. Espinosa C. Sistema Aquileo-calcáneo-plantar. Rev Española Podol. 1998;6(9):283.

27. Arandes R, Viladot A. Biomecánica del calcaneo. Med Clin (Barc). 1953;21(1):25-34.

28. Carlson RE, Fleming LL, Hutton WC. The biomechanical relationship between the tendoachilles, plantar fascia and metatarsophalangeal joint dorsiflexion angle. Foot Ankle Int. 2000;21(1):18-25.

DOI: 10.1177/107110070002100104

29. Hicks J. The mechanics of the foot. Part II: The Plantar Aponeurosis and the Arc. J Anat. 1954;88(1):25-31.

30. Kirby KA. Biomecánica del pie y la extremidad inferior III : artículos de Precision Intricast, 2002-2008. Payson, AZ: Precision Intricast; 2009.

31. 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(1):89-98.

DOI: 10.1016/j.clinbiomech.2005.08.002

32. Williams M, Caserta AJ, Haines TP. The TiltMeter app is a novel and accurate measurement tool for the weight bearing lunge test. J Sci Med Sport. 2013;16:392-5.

DOI: 10.1016/j.jsams.2013.02.001

33. Dananberg HJ. Gait style as an etiology to chronic postural pain. Part I. Functional hallux limitus. J Am Podiatr Med Assoc. 1993;83(8):433-41.

DOI: 10.7547/87507315-83-8-433

34. Hall C, Nester CJ. Sagittal plane compensations for artificially induced limitation of the first metatarsophalangeal joint: A preliminary study. J Am Podiatr Med Assoc. 2004;94(3):269-74.

DOI: 10.7547/0940269

35. Allan JJ, McClelland JA, Munteanu SE, Buldt AK, Landorf KB, Roddy E, et al. First metatarsophalangeal joint range of motion is associated with lower limb kinematics in individuals with first metatarsophalangeal joint osteoarthritis. J Foot Ankle Res. 2020;13(1):33.

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37. Wanivenhaus A, Pretterklieber M. First Tarsometatarsal Joint: Anatomical Biomechanical Study. Foot Ankle Int. 1989;9(4):153-7.

DOI: 10.1177/107110078900900401

38. Phan CB, Shin G, Lee KM, Koo S. Skeletal kinematics of the midtarsal joint during walking: Midtarsal joint locking revisited. J Biomech. 2019;95:109287.

DOI: 10.1016/j.jbiomech.2019.07.031

39. Powell DW, Long B, Milner CE, Zhang S. Frontal plane multi-segment foot kinematics in high- and low-arched females during dynamic loading tasks. Hum Mov Sci. 2011;30(1):105-14.

DOI: 10.1016/j.humov.2010.08.015

40. Nawoczenski DA, Ludewig PM. The Effect of Forefoot and Arch Posting Orthotic Designs on First Metatarsophalangeal Joint Kinematics During Gait. J Orthop Sports Phys Ther. 2004;34(6):317-27.

DOI: 10.2519/jospt.2004.34.6.317

Voegeli AV. Anatomía funcional y biomecánica del tobillo y el pie. Rev Esp Reumatol. 2003;30(9):469-77.

2. Perry, J. Burnfield J. Análisis de la marcha: función normal y patológica. Madrid: Editorial Base; 2015. p. 51-84.

3. Grimston SK, Nigg BM, Hanley DA, Engsberg JR. Differences in Ankle Joint Complex Range of Motion as a Function of Age. Foot Ankle Int. 1993;14(4):215-22.

DOI: 10.1177/107110079301400407

4. Winter DA. Kinematic and kinetic patterns in human gait: Variability and compensating effects. Hum Mov Sci. 1984;3(1-2):51-76.

DOI: 10.1016/0167-9457(84)90005-8

5. Jordan RP, Cooper M, Schuster RO. Ankle dorsiflexion at the heel-off phase of gait: a photokinegraphic study. J Am Podiatry Assoc. 1979;69(1):40-6.

DOI: 10.7547/87507315-69-1-40

6. Baggett BD, Young G. Ankle joint dorsiflexion. Establishment of a normal range. J Am Podiatr Med Assoc. 1993;83(5):251-4.

DOI: 10.7547/87507315-83-5-251

7. Dananberg HJ. Sagittal plane biomechanics. J Am Podiatr Med Assoc. 2000;90(1):47-50.

DOI: 10.7547/87507315-90-1-47

8. Pascual Huerta J. The effect of the gastrocnemius on the plantar fascia. Foot Ankle Clin. 2014;19(4):701-18.

DOI: 10.1016/j.fcl.2014.08.011

9. Nakale NT, Strydom A, Saragas NP, Ferrao PNF. Association Between Plantar Fasciitis and Isolated Gastrocnemius Tightness. Foot Ankle Int. 2018;39(3):271-7.

DOI: 10.1177/1071100717744175

10. García Vidal J-A, Piñero Palazón J-G, Baño Alcaraz A, Sánchez Martínez M-P, Medina Mirapeix F. Rev int cienc Podol. 2018;13(1):41-6. DOI: 10.5209/RICP.62343.

DOI: 10.5209/RICP.62343

11. DiGiovanni CW, Langer P. The Role of Isolated Gastrocnemius and Combined Achilles Contractures in the Flatfoot. Foot Ankle Clin. 2007;12(2):363-79.

DOI: 10.1016/j.fcl.2007.03.005

12. Bennell K, Talbot R, Wajswelner H, Techovanich W, Kelly D. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998;44(3):175-80.

DOI: 10.1016/S0004-9514(14)60377-9

13. Powden CJ, Hoch JM, Hoch MC. Reliability and minimal detectable change of the weight-bearing lunge test: A systematic review. Man Ther. 2015;20(4):524-32.

DOI: 10.1016/j.math.2015.01.004

DOI: 10.1016/j.repod.2017.10.001

15. Chisholm MD, Birmingham TB, Brown J, MacDermid J, Chesworth BM. Reliability and Validity of a Weight-Bearing Measure of Ankle Dorsiflexion Range of Motion. Physiother Canada. 2012;64(4):347-55.

DOI: 10.3138/ptc.2011-41

16. Root ML, Orien WP, Weed JH, Vergés Salas C. Función normal y anormal del pie. Madrid: Editorial Base; 2012. p. 54-60.

17. Kelikian AS, Sarrafian SK. Sarrafian’s anatomy of the foot and ankle : descriptive, topographical, functional. Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011. p. 86-87.

18. Kirby KA. Biomecánica del pie y la extremidad inferior II : artículos de Precision Intricast, 1997-2002. Payson, AZ: Precision Intricast; 2002.

19. Shereff M. Pathophysiology, Anatomy, and Biomechanics of Hallux Valgus. Orthopedics. 1990;13(9):939-45.

DOI: 10.3928/0147-7447-19900901-06

20. Hopson MM, McPoil TG, Cornwall MW. Motion of the first metatarsophalangeal joint. Reliability and validity of four measurement techniques. J Am Podiatr Med Assoc. 1995;85(4):198-204.

DOI: 10.7547/87507315-85-4-198

21. Phillips RD, Law EA, Ward ED. Functional motion of the medial column joints of the foot during propulsion. J Am Podiatr Med Assoc. 1996;86(10):474-86.

DOI: 10.7547/87507315-86-10-474

22. Hetherington V, Johnson R, Albritton J. Necessary dorsiflexion of the first metatarsophalangeal joint during gait. J Foot Ankle Surg. 1990;29:218.

23. Halstead J, Redmond AC. Weight-bearing passive dorsiflexion of the hallux in standing is not related to hallux dorsiflexion during walking. J Orthop Sports Phys Ther. 2006;36(8):550-6.

DOI: 10.2519/jospt.2006.2136

24. Nawoczenski DA, Baumhauer JF, Umberger BR. Relationship between clinical measurements and motion of the first metatarsophalangeal joint during gait. J Bone Jt Surg - Ser A. 1999;81(3):370-6.

DOI: 10.2106/00004623-199903000-00009

25. Leal Serra V, Leal Serra V, Aquíleo Calcáneo Plantar S. Sistema aquíleo calcáneo plantar. Biomecánica. 2011;19(1):35-43.

26. Espinosa C. Sistema Aquileo-calcáneo-plantar. Rev Española Podol. 1998;6(9):283.

27. Arandes R, Viladot A. Biomecánica del calcaneo. Med Clin (Barc). 1953;21(1):25-34.

28. Carlson RE, Fleming LL, Hutton WC. The biomechanical relationship between the tendoachilles, plantar fascia and metatarsophalangeal joint dorsiflexion angle. Foot Ankle Int. 2000;21(1):18-25.

DOI: 10.1177/107110070002100104

29. Hicks J. The mechanics of the foot. Part II: The Plantar Aponeurosis and the Arc. J Anat. 1954;88(1):25-31.

30. Kirby KA. Biomecánica del pie y la extremidad inferior III : artículos de Precision Intricast, 2002-2008. Payson, AZ: Precision Intricast; 2009.

31. 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(1):89-98.

DOI: 10.1016/j.clinbiomech.2005.08.002

32. Williams M, Caserta AJ, Haines TP. The TiltMeter app is a novel and accurate measurement tool for the weight bearing lunge test. J Sci Med Sport. 2013;16:392-5.

DOI: 10.1016/j.jsams.2013.02.001

33. Dananberg HJ. Gait style as an etiology to chronic postural pain. Part I. Functional hallux limitus. J Am Podiatr Med Assoc. 1993;83(8):433-41.

DOI: 10.7547/87507315-83-8-433

34. Hall C, Nester CJ. Sagittal plane compensations for artificially induced limitation of the first metatarsophalangeal joint: A preliminary study. J Am Podiatr Med Assoc. 2004;94(3):269-74.

DOI: 10.7547/0940269

DOI: 10.1186/s13047-020-00404-0

DOI: 10.1177/107110079401500103

37. Wanivenhaus A, Pretterklieber M. First Tarsometatarsal Joint: Anatomical Biomechanical Study. Foot Ankle Int. 1989;9(4):153-7.

DOI: 10.1177/107110078900900401

38. Phan CB, Shin G, Lee KM, Koo S. Skeletal kinematics of the midtarsal joint during walking: Midtarsal joint locking revisited. J Biomech. 2019;95:109287.

DOI: 10.1016/j.jbiomech.2019.07.031

39. Powell DW, Long B, Milner CE, Zhang S. Frontal plane multi-segment foot kinematics in high- and low-arched females during dynamic loading tasks. Hum Mov Sci. 2011;30(1):105-14.

DOI: 10.1016/j.humov.2010.08.015

40. Nawoczenski DA, Ludewig PM. The Effect of Forefoot and Arch Posting Orthotic Designs on First Metatarsophalangeal Joint Kinematics During Gait. J Orthop Sports Phys Ther. 2004;34(6):317-27.

DOI: 10.2519/jospt.2004.34.6.317

41. Halstead J, Turner DE, Redmond AC. The relationship between hallux dorsiflexion and ankle joint complex frontal plane kinematics: A preliminary study. Clin Biomech. 2005;20(5):526-31.

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Morante Naranjo J, Sanchis Sales E. Relationship between ankle dorsiflexion and dorsiflexion of the first metatarsophalangeal joint in the full stance and toe-off phases of gait: cross-sectional study in healthy subjects. Rev Esp Pod 2021; 32(1): 36-41 / DOI: 1020986/revesppod20211602/2021

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