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research-article

Foot and Ankle Joint Biomechanical Adaptations to an Unpredictable Coronally-Uneven Surface

[+] Author and Article Information
Ava Segal

Center for Limb Loss and Mobility, Rehabilitation Research and Development, Department of Veterans Affairs, 1660 S. Columbian Way, MS-151, Seattle, WA 98108, USA
avasegal@gmail.com

Kyle Yeates

Center for Limb Loss and Mobility, Rehabilitation Research and Development, Department of Veterans Affairs, 1660 S. Columbian Way, MS-151, Seattle, WA 98108, USA; Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
kyle.yeates@gmail.com

Richard Neptune

Member, ASME, Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, USA
rneptune@mail.utexas.edu

Glenn K. Klute

Center for Limb Loss and Mobility, Rehabilitation Research and Development, Department of Veterans Affairs, 1660 S. Columbian Way, MS-151, Seattle, WA 98108, USA; Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
gklute@u.washington.edu

1Corresponding author.

ASME doi:10.1115/1.4037563 History: Received March 13, 2017; Revised August 01, 2017

Abstract

Coronally-uneven terrain, a common yet challenging feature encountered in daily ambulation, exposes individuals to an increased risk of falling. The foot-ankle complex may adapt to improve balance on uneven terrains, a recovery strategy which may be more challenging in patients with foot-ankle pathologies. A multi-segment foot model was used to study the biomechanical adaptations of the foot and ankle joints during a step on a visually obscured, coronally-uneven surface. Kinematic, kinetic and in-shoe pressure data were collected as ten participants walked on an instrumented walkway with a surface randomly positioned ±15° or 0° in the coronal plane. Coronally-uneven surfaces altered hindfoot-tibia loading, with more conformation to the surface in early than late stance. Distinct loading changes occurred for the forefoot-hindfoot joint in early and late stance, despite smaller surface conformations. Hindfoot-tibia power at opposite heel contact was generated and increased on both uneven surfaces, whereas forefoot-hindfoot power was absorbed and remained consistent across surfaces. Push-off work increased for the hindfoot-tibia joint on the everted surface and for the forefoot-hindfoot joint on the inverted surface. Net work across joints was generated for both uneven surfaces, while absorbed on flat terrain. The partial decoupling and joint-specific biomechanical adaptations on uneven surfaces suggest that multi-articulating interventions such as prosthetic devices and arthroplasty may improve ambulation for mobility-impaired individuals on coronally-uneven terrain.

Copyright (c) 2017 by ASME
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