OBJECTIVES:: Evaluate effects of a new off-the-shelf insert on frontal plane foot biomechanics and compare effectiveness of the new and an existing off-the-shelf insert and a motion-control shoe in neutralizing frontal plane foot biomechanics. Design: Descriptive. Setting: Biomechanics laboratory. Participants: Fifteen uninjured subjects with a flexible flatfoot secondary to forefoot varus. Assessment of risk factors: Three-dimensional kinematic and kinetic data were collected as subjects walked and jogged at their self-selected speed while wearing a motion-control running shoe, the shoe with a new off-the-shelf insert, and the shoe with an existing off-the-shelf insert. Main outcome measures: Frontal plane kinematics and rearfoot kinetics were evaluated during stance. Statistical analysis was performed using a repeated measures analysis of variance and Student-Newman-Keuls post hoc tests (α ≤ 0.05). Results: The new insert and motion-control shoe placed the forefoot in a less-everted position than the existing off-the-shelf insert during walking. There were no differences in forefoot kinematics during jogging, nor were there differences in rearfoot motion during walking or jogging. The rearfoot eversion moment was significantly lower with the new off-the-shelf insert compared with the motion-control shoe and the existing insert during walking and jogging. Conclusions: A new off-the-shelf device is available that promotes more neutral frontal plane biomechanics, thus providing a theoretical rationale for using this device for injury prevention and treatment. The comparative biomechanical effectiveness of a motion-control shoe and the orthotic inserts may assist health care professionals in selecting a device to correct the flatfoot structure.

No / The purpose of this article is determining if and how the kinematic relationship between adjacent body segments changes when an individual’s gait pattern is experimentally manipulated can yield insight into the robustness of the kinematic coupling across the associated joint(s). The aim of this study was to assess the effects on the kinematic coupling between the forefoot, rearfoot and shank during ground contact of running with alteration in foot strike pattern. Twelve subjects ran over-ground using three different foot strike patterns (heel strike, forefoot strike, toe running). Kinematic data were collected of the forefoot, rearfoot and shank, which were modelled as rigid segments. Coupling at the ankle-complex and midfoot joints was assessed using cross-correlation and vector coding techniques. In general good coupling was found between rearfoot frontal plane motion and transverse plane shank rotation regardless of foot strike pattern. Forefoot motion was also strongly coupled with rearfoot frontal plane motion. Subtle differences were noted in the amount of rearfoot eversion transferred into shank internal rotation in the first 10–15% of stance during heel strike running compared to forefoot and toe running, and this was accompanied by small alterations in forefoot kinematics. These findings indicate that during ground contact in running there is strong coupling between the rearfoot and shank via the action of the joints in the ankle-complex. In addition, there was good coupling of both sagittal and transverse plane forefoot with rearfoot frontal plane motion via the action of the midfoot joints.

No / Background - Although there is a wealth of research into the kinematic coupling between the foot and shank, it remains unclear whether the relationship is stable across speed and mode of gait. The aim of this study was to determine whether the coupling relationship between the forefoot, rearfoot and shank differed between walking and running, and across different running speeds. Methods Twelve subjects walked/ran barefoot over-ground at one walking and three running speeds. The shank, rearfoot and forefoot were modelled as rigid segments and three-dimensional joint kinematics were determined using a seven camera ProReflex system. Coupling between the forefoot, rearfoot and shank was assessed using cross-correlation and vector coding techniques. Findings Cross-correlation of rearfoot eversion/inversion with shank internal/external rotation was lower in walking (r=0.49) compared to running (r>0.95). This was also the case between rearfoot frontal plane and forefoot sagittal plane motion (walking, r=¿0.80; running, r=¿0.96). Rearfoot frontal plane and forefoot transverse plane cross-correlation was high in both running and walking (r>0.90), but there was little evidence of any coupling between rearfoot frontal plane and forefoot frontal plane motion in any condition. No differences in cross-correlations were found between the three running speeds. Interpretation Kinematic coupling between the forefoot, rearfoot and shank was weak during walking relative to running. In particular, the low cross-correlation between rearfoot eversion/inversion and shank internal/external rotation during walking implies the two motions are not rigidly linked, as has been assumed in previous injury models.

Introduktion: Fotisättningstyper (FST) vid löpning är associerat med prestation och löprelaterade skador. Tidigare studier har undersökt prevalensen av olika FST hos amerikanska och asiatiska löpare, men däremot inte hos svenska löpare. Syfte: Att undersöka och jämföra prevalensen av olika FST (RFS = hälisättning; MFS = mittfotisättning; FFS = framfotaisättning) hos svenska löpare mellan olika löptävlingar, distanser och med avseende på prestation. Metod: Fotisättningar spelades in i 100 bilder per sekund (fps), vid tre olika platser för både Stockholm maraton (1.2, 25, 42 km) och Göteborgs halv-maraton (7.5, 15, 20 km), baserat på 2071 personer per mätpunkt. FST bedömdes genom en frame-by-frame analys. Resultat: 12’426 observationer av fotisättningar analyserades. Den totala prevalensen av FST var 92.3% (n=11’465), 4.5% (n=559), och 3.2% (n=402), för RFS, MFS, respektive FFS, och skiljde sig mellan maraton och halv-maraton (p < .001, φc = 0.069), där det förekom högre andel RFS i det sistnämnda. FST var associerat med distans, där MFS och FFS var mer vanligt förekommande på kortare distanser jämfört med RFS (p < .001, df = 2; H = 71.524). Stratifierade analyser baserade på löptävling visade att associationen mellan FST och distans inom respektive lopp försvann för halv-maratontävlingen, men kvarstod för maratontävlingen. Slutligen så var FST associerat med prestation (p < .001, df = 2, H = 65.419) och denna kvarstod för både halv-maraton (p < .001) och maratontävlingen (p < .001) efter stratifierade analyser baserat på löptävling. Konklusion: Resultaten överenstämmer med tidigare studier på området av andra grupper löpare, och stödjer tidigare fynd att RFS är den vanligaste förekommande FST, och att FST är associerat med distans och prestation, vid hel- och halvmaraton. / Foot strike type (FST) is associated with performance and running-related injuries. Previous studies have examined the prevalence proportion of FST among predominantly American and Asian cohorts. However, no study has investigated this among a predominantly Swedish cohort. Aim: To examine and compare the prevalence proportions of FST between running races, distance and performance, among a predominantly Swedish cohort of runners. Method: FST was recorded in 100 frames per second (fps), at three different points of measure for both the Stockholm Marathon (1.2, 25, 42 km) and the Gothenburg Half-Marathon (7.5, 15, 20 km), based on 2071 individuals per point of measure. FST was assessed using frame-by-frame analysis. Results: 12’426 observations of FST were analyzed. The overall prevalence proportions of FST was 92.3% (n=11’465), 4.5% (n=559), and 3.2% (n=402), for RFS, MFS, and FFS respectively, and differed between the half-marathon and marathon (p < .001, φc = 0.069), with the latter having higher proportion of RFS. FST was associated with distance, with MFS and FFS being more common at shorter distances compared with RFS (p < .001, df = 2; H = 71.524). Stratifying the data by race type revealed that the association between FST and distance within the races disappeared within the half-marathon race, but remained for the marathon. Lastly, FST was associated with performance (p < .001), and this association remained for both the half-marathon (p < .001) and marathon (p < .001) after stratifying by race type. Conclusion: The results are consistent with previous studies on other populations, and add to the body of literature showing that RFS is the most common FST, and that FST is associated with distance and performance, for full- and half-marathon races.

No / Motion at the midfoot joints can contribute significantly to overall foot motion during gait. However, there is little information regarding the kinematic coupling relationship at the midfoot. The purpose of the present study was to determine whether the coupling relationship at the midfoot and subtalar joints was affected when step width was manipulated during running. Twelve subjects ran over-ground at self-selected speeds using three different step widths (normal, wide, cross-over). Coupling at the midfoot (forefoot relative to rearfoot) and subtalar (rearfoot relative to shank) joints was assessed using cross-correlation techniques. Rearfoot kinematics were significantly different from normal running in cross-over running (P < 0.05) but not in wide running. However, coupling between rearfoot eversion/inversion and shank rotation was consistently high (r > 0.917), regardless of step width. This was also the case for coupling between rearfoot frontal plane motion and forefoot sagittal plane (r < 0.852) and forefoot transverse plane (r > 0.946) motion. There was little evidence of coupling between rearfoot frontal plane motion and forefoot frontal plane motion in any of the conditions. Forefoot frontal plane motion appeared to have little effect on rearfoot frontal plane motion and thus, had no effect on motion at the subtalar joint. The strong coupling of forefoot sagittal and transverse plane motions with rearfoot frontal plane motion suggests that forefoot motion exerts an important influence on subtalar joint kinematics.

A fasciite plantar, terceira lesão mais comum em corredores, apresenta como principais fatores etiológicos o alinhamento do retropé, o arco longitudinal plantar e a carga mecânica dos pés. Os únicos dois estudos que investigaram estes fatores, durante a corrida, permanecem controversos e ainda não claros, principalmente, em relação ao efeito da dor. Outra questão importante é o suporte teórico da associação entre as medidas clinicas dos pés com a carga mecânica no calcâneo, porém sem evidência científica comprovada. A compreensão dos padrões dinâmicos da carga plantar e a sua associação com as medidas clínicas do pé poderão perpetuar uma maior efetividade de recursos terapêuticos como calçados e palmilhas direcionadas a essa população. Portanto, o objetivo geral desse estudo foi avaliar o padrão de carga plantar e impacto dos pés em contato com o solo durante a corrida de corredores com fasciite plantar aguda e crônica e sua associação com o arco longitudinal medial e ângulo do retropé. Foram estudados 75 corredores adultos de ambos os sexos entre 20 a 55 anos. Destes 45 apresentavam fasciite plantar (30 com dor - FPA e 15 sem dor - FPC) e 30 eram corredores controles - GC. Para responder a questões específicas foram realizados dois experimentos. O primeiro teve como objetivo analisar e comparar as taxas de impacto estimadas e as cargas em três regiões distintas dos pés de corredores com fasciite plantar na fase aguda e crônica e corredores controle. A pressão plantar foi avaliada por meio de palmilhas capacitivas (Pedar X System) durante uma corrida de 40m a uma velocidade de 12±5%km/h, utilizando um calçado esportivo padrão. A dor foi mensurada pela escala visual analógica. As taxas de impacto e a carga plantar em retropé, mediopé e antepé foram analisadas em série temporal. Os dados foram processados no Matlab e comparados por ANOVAs (p<0,05). Os principais resultados indicam que a força máxima e integral da força no retropé e as taxas de impacto (20-80%; 10-100%) apresentam-se maiores em corredores com fasciite plantar em relação aos corredores controle (p<0,01). Porém, corredores com fasciite plantar na fase aguda apresentaram menores taxas de impacto e cargas plantares no retropé em relação à fase crônica (p<0,01). O segundo experimento teve como objetivo investigar a relação entre o arco longitudinal medial, o alinhamento do retropé e a dinâmica da pressão plantar em corredores com fasciite plantar: aguda e crônica. O índice do arco plantar e o alinhamento do retropé foram calculados no AutoCAD por meio de imagem fotográfica digital. Para análise da pressão plantar foi utilizado os dados previamente coletados no experimento 1 pelo sistema de palmilhas capacitivas (Pedar X System) durante a corrida. Uma análise de regressão múltipla foi realizada (p<0,05). Os resultados indicam que o arco plantar elevado pode predizer a integral da força (R=0,35, R2=0,15) e a força máxima (R=0,59, R2=0,35) no antepé na fase aguda e crônica, respectivamente. O alinhamento valgo do retropé prediz a força máxima no retropé na fase aguda (R=0,42, R2=0,18) e crônica (R=0,67, R2=0,45), além de predizer o aumento das taxas de impacto do pé na fase crônica da fasciite plantar, 20-80% (R=0,44, R2=0,19) e 10-100% (R=0,63, R2=0,40). Conclui-se que corredores com fasciite plantar aguda e crônica apresentam maiores cargas plantares no retropé e aumento das taxas de impacto do pé no solo. No entanto, a condição fasciite plantar aguda mostrou-se com menores taxas e cargas plantares no retropé em relação à fase crônica, possivelmente, devido ao mecanismo de proteção a dor na região do calcâneo. Além disso, o arco plantar prediz as cargas plantares do antepé de corredores com fasciite plantar e o alinhamento em valgo do retropé demonstrou ser uma medida clínica de fundamental importância para avaliação de corredores com fasciite plantar, pois permitiu predizer tanto o aumento das cargas e taxas de impacto na região do calcâneo e com isso, prevenir os sintomas e a progressão da fasciite plantar / The plantar fasciitis, the third most common injury in runners, presents as the main etiological factors rearfoot alignment, the longitudinal arch and mechanical load on the feet. The only two studies have investigated these factors during running and the results remain controversial and still not clear, specifically regarding the pain symptoms. Another important question is the theoretical support of the association between clinical measurements of the feet with the mechanical load on the heel, but without proven scientific evidence. Understanding the dynamic patterns of plant load and its association with clinical measures of foot may perpetuate more effective therapeutic resources, such as footwear and insoles that target this population. Therefore, the general objective of this study was to evaluate the load pattern and impact of plantar foot in contact with the ground during running in runners with acute and chronic plantar fasciitis and its association with the medial longitudinal arch and rearfoot angle. We studied 75 adult runners of both sexes between 20 and 55 years. Of these 45 had plantar fasciitis (pain-APF 30 with and 15 without pain - CPF) and 30 controls were runners - CG. To answer specific questions two experiments were conducted. The first aimed to analyze and compare the estimated impact rates and the plantar loads in runners with both acute and chronic PF, compared to controls. Seventy-five runners with heel contact running patterns were evaluated and divided into three groups: Acute PF (n=30); chronic PF (n=15); and controls (n=30). Pain was assessed by the Visual Analogue Scale. The plantar pressures was measured by X Pedar system during 40-meter running sessions at speeds of 12±5% Km/h with standard sport footwear. The impact rates and the loads over the rearfoot, midfoot, and forefoot were analyzed based upon temporal series. The data were processed in Matlab and compared by ANOVAs (p <0.05). The main results indicate that the maximum force and integral force in the rearfoot and impact rates (20-80%, 10-100%) were higher in runners with plantar fasciitis when compared with control runners (p <0.01). However, runners with plantar fasciitis in the acute phase showed lower impact rates and loads plantar on rearfoot in relation to chronic phase (p <0.01). The second experiment aimed to investigate the relationship between the medial longitudinal arch, rearfoot alignment and dynamic plantar pressure in runners with plantar fasciitis: acute and chronic. The plantar arch index and rearfoot alignment were calculated in AutoCAD using digital photographic image. For analysis of plantar pressure was used previously collected data in experiment 1 by the system of capacitive insoles (Pedar X System) during the running. A multiple regression analysis was performed (p <0.05). The results indicate that high plantar arch can predict the increase: integral force (R = 0.35, R2 = 0.15) and maximum force (R = 0.59, R2 = 0.35) in the forefoot in acute and chronic phase, respectively. The alignment of the rearfoot valgus predict the maximum force on rearfoot in the acute phase (R = 0.42, R2 = 0.18) and chronic (R = 0.67, R2 = 0.45), and predict increased rates impact of the foot during the chronic plantar fasciitis, 20-80% (R = 0.44, R2 = 0.19) and 10-100% (R = 0.63, R2 = 0.40). We conclude that runners with plantar fasciitis acute and chronic have higher plantar loads on rearfoot and increased rates of impact of the foot on the ground. However, the condition plantar fasciitis acute proved loads with lower impact rates and plantar load on rearfoot in relation to chronic phase, possibly due to the protective mechanism pain in calcaneal region. Moreover, the plantar arch predicts loads plantar in forefoot of the runners with plantar fasciitis and alignment in valgus rearfoot proved to be a measure of fundamental importance for clinical evaluation of runners with plantar fasciitis because it can predict the increase of the plantar loads and impact rates of calcaneal region and thus prevents the symptoms and progression of plantar fasciitis.

Submitted by Aelson Maciera (aelsoncm@terra.com.br) on 2017-05-25T20:35:56Z No. of bitstreams: 1 DissBCL.pdf: 3021742 bytes, checksum: 521e476f6891dfc521177d5f7bd80228 (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-05-30T14:07:29Z (GMT) No. of bitstreams: 1 DissBCL.pdf: 3021742 bytes, checksum: 521e476f6891dfc521177d5f7bd80228 (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-05-30T14:07:41Z (GMT) No. of bitstreams: 1 DissBCL.pdf: 3021742 bytes, checksum: 521e476f6891dfc521177d5f7bd80228 (MD5) / Made available in DSpace on 2017-05-30T14:13:03Z (GMT). No. of bitstreams: 1 DissBCL.pdf: 3021742 bytes, checksum: 521e476f6891dfc521177d5f7bd80228 (MD5) Previous issue date: 2017-02-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Patellofemoral pain (PFP) is the most common running overuse injury. Excessive rearfoot eversion is commonly considered as a risk factor for patellofemoral pain and the relationship between the ankle-foot complex movement and the lower limb may be involved with this dysfunction. The purpose of this study was to evaluate the relationship between rearfoot eversion with tibia and femur kinematics in frontal and transverse planes during running in individuals with and without PFP. Methods: Fifty-four recreational runners were divided into 2 groups: healthy runners (CG, n = 27) and runners with patellofemoral pain (PFPG, n = 27). Kinematics during running were assessed using a three-dimensional motion analysis. Pearson's correlation coefficients (r) were calculated to establish the relationship of rearfoot eversion with tibial and femur movements (peak and range of motion). Findings: Greater peak rearfoot eversion was associated with greater peak tibial internal rotation and peak femur adduction in the PFPG. Additionally, greater peak rearfoot eversion was associated with greater femur adduction, femur external rotation and tibial adduction range of motion in the PFPG. Interpretation: Strongest associations between the greater rearfoot eversion and the greater peak hip adduction and hip adduction range of motion might be related to the etiology and/or persistence of patellofemoral pain, and indicate that treatment strategies aimed at controlling the movement of the rearfoot could help modify the symptoms. / A dor patelofemoral (DPF) é a lesão por sobrecarga mais comum da corrida. A eversão excessiva do retropé é comumente considerada como um fator de risco para a DPF e a relação entre o movimento do complexo do tornozelo-pé e do membro inferior pode estar envolvido com essa disfunção. O objetivo desse estudo foi avaliar a relação entre a eversão do retropé com a cinemática da tíbia e do fêmur nos planos frontal e transversal durante a corrida em individuos com e sem dor patelofemoral. Métodos: Cinquenta e quarto corredores recreacionais foram divididos em 2 grupos: corredores saudáveis (GC, n = 27) e corredores com dor patelofemoral (GDPF, n = 27). A cinemática durante a corrida foi avaliada por meio de um sistema de captura de movimento. Coeficiente de correlação de Pearson ( r ) foi calculado para estabelecer a relação da eversão do retropé com os movimentos da tíbia e do fêmur (pico e amplitude de movimento). Resultados: Um maior pico de eversão do retropé foi associado a um maior pico de rotação intera da tíbia e de adução do fêmur no GDPF. Além disso, um maior pico de eversão do retropé foi associado a uma maior amplitude de movimento de adução do fêmur, rotação externa do fêmur e adução da tíbia no GDPF. Interpretação: As associações mais fortes entre a maior eversão do retropé e o maior pico de adução do quadril e a amplitude de movimento de adução do quadril podem estar relacionadas à etiologia e/ou persistência da dor patelofemoral, e indicam que as estratégias de tratamento que visam controlar o movimento do retropé podem ajudar a modificar o sintomas.

A fasciite plantar, terceira lesão mais comum em corredores, apresenta como principais fatores etiológicos o alinhamento do retropé, o arco longitudinal plantar e a carga mecânica dos pés. Os únicos dois estudos que investigaram estes fatores, durante a corrida, permanecem controversos e ainda não claros, principalmente, em relação ao efeito da dor. Outra questão importante é o suporte teórico da associação entre as medidas clinicas dos pés com a carga mecânica no calcâneo, porém sem evidência científica comprovada. A compreensão dos padrões dinâmicos da carga plantar e a sua associação com as medidas clínicas do pé poderão perpetuar uma maior efetividade de recursos terapêuticos como calçados e palmilhas direcionadas a essa população. Portanto, o objetivo geral desse estudo foi avaliar o padrão de carga plantar e impacto dos pés em contato com o solo durante a corrida de corredores com fasciite plantar aguda e crônica e sua associação com o arco longitudinal medial e ângulo do retropé. Foram estudados 75 corredores adultos de ambos os sexos entre 20 a 55 anos. Destes 45 apresentavam fasciite plantar (30 com dor - FPA e 15 sem dor - FPC) e 30 eram corredores controles - GC. Para responder a questões específicas foram realizados dois experimentos. O primeiro teve como objetivo analisar e comparar as taxas de impacto estimadas e as cargas em três regiões distintas dos pés de corredores com fasciite plantar na fase aguda e crônica e corredores controle. A pressão plantar foi avaliada por meio de palmilhas capacitivas (Pedar X System) durante uma corrida de 40m a uma velocidade de 12±5%km/h, utilizando um calçado esportivo padrão. A dor foi mensurada pela escala visual analógica. As taxas de impacto e a carga plantar em retropé, mediopé e antepé foram analisadas em série temporal. Os dados foram processados no Matlab e comparados por ANOVAs (p<0,05). Os principais resultados indicam que a força máxima e integral da força no retropé e as taxas de impacto (20-80%; 10-100%) apresentam-se maiores em corredores com fasciite plantar em relação aos corredores controle (p<0,01). Porém, corredores com fasciite plantar na fase aguda apresentaram menores taxas de impacto e cargas plantares no retropé em relação à fase crônica (p<0,01). O segundo experimento teve como objetivo investigar a relação entre o arco longitudinal medial, o alinhamento do retropé e a dinâmica da pressão plantar em corredores com fasciite plantar: aguda e crônica. O índice do arco plantar e o alinhamento do retropé foram calculados no AutoCAD por meio de imagem fotográfica digital. Para análise da pressão plantar foi utilizado os dados previamente coletados no experimento 1 pelo sistema de palmilhas capacitivas (Pedar X System) durante a corrida. Uma análise de regressão múltipla foi realizada (p<0,05). Os resultados indicam que o arco plantar elevado pode predizer a integral da força (R=0,35, R2=0,15) e a força máxima (R=0,59, R2=0,35) no antepé na fase aguda e crônica, respectivamente. O alinhamento valgo do retropé prediz a força máxima no retropé na fase aguda (R=0,42, R2=0,18) e crônica (R=0,67, R2=0,45), além de predizer o aumento das taxas de impacto do pé na fase crônica da fasciite plantar, 20-80% (R=0,44, R2=0,19) e 10-100% (R=0,63, R2=0,40). Conclui-se que corredores com fasciite plantar aguda e crônica apresentam maiores cargas plantares no retropé e aumento das taxas de impacto do pé no solo. No entanto, a condição fasciite plantar aguda mostrou-se com menores taxas e cargas plantares no retropé em relação à fase crônica, possivelmente, devido ao mecanismo de proteção a dor na região do calcâneo. Além disso, o arco plantar prediz as cargas plantares do antepé de corredores com fasciite plantar e o alinhamento em valgo do retropé demonstrou ser uma medida clínica de fundamental importância para avaliação de corredores com fasciite plantar, pois permitiu predizer tanto o aumento das cargas e taxas de impacto na região do calcâneo e com isso, prevenir os sintomas e a progressão da fasciite plantar / The plantar fasciitis, the third most common injury in runners, presents as the main etiological factors rearfoot alignment, the longitudinal arch and mechanical load on the feet. The only two studies have investigated these factors during running and the results remain controversial and still not clear, specifically regarding the pain symptoms. Another important question is the theoretical support of the association between clinical measurements of the feet with the mechanical load on the heel, but without proven scientific evidence. Understanding the dynamic patterns of plant load and its association with clinical measures of foot may perpetuate more effective therapeutic resources, such as footwear and insoles that target this population. Therefore, the general objective of this study was to evaluate the load pattern and impact of plantar foot in contact with the ground during running in runners with acute and chronic plantar fasciitis and its association with the medial longitudinal arch and rearfoot angle. We studied 75 adult runners of both sexes between 20 and 55 years. Of these 45 had plantar fasciitis (pain-APF 30 with and 15 without pain - CPF) and 30 controls were runners - CG. To answer specific questions two experiments were conducted. The first aimed to analyze and compare the estimated impact rates and the plantar loads in runners with both acute and chronic PF, compared to controls. Seventy-five runners with heel contact running patterns were evaluated and divided into three groups: Acute PF (n=30); chronic PF (n=15); and controls (n=30). Pain was assessed by the Visual Analogue Scale. The plantar pressures was measured by X Pedar system during 40-meter running sessions at speeds of 12±5% Km/h with standard sport footwear. The impact rates and the loads over the rearfoot, midfoot, and forefoot were analyzed based upon temporal series. The data were processed in Matlab and compared by ANOVAs (p <0.05). The main results indicate that the maximum force and integral force in the rearfoot and impact rates (20-80%, 10-100%) were higher in runners with plantar fasciitis when compared with control runners (p <0.01). However, runners with plantar fasciitis in the acute phase showed lower impact rates and loads plantar on rearfoot in relation to chronic phase (p <0.01). The second experiment aimed to investigate the relationship between the medial longitudinal arch, rearfoot alignment and dynamic plantar pressure in runners with plantar fasciitis: acute and chronic. The plantar arch index and rearfoot alignment were calculated in AutoCAD using digital photographic image. For analysis of plantar pressure was used previously collected data in experiment 1 by the system of capacitive insoles (Pedar X System) during the running. A multiple regression analysis was performed (p <0.05). The results indicate that high plantar arch can predict the increase: integral force (R = 0.35, R2 = 0.15) and maximum force (R = 0.59, R2 = 0.35) in the forefoot in acute and chronic phase, respectively. The alignment of the rearfoot valgus predict the maximum force on rearfoot in the acute phase (R = 0.42, R2 = 0.18) and chronic (R = 0.67, R2 = 0.45), and predict increased rates impact of the foot during the chronic plantar fasciitis, 20-80% (R = 0.44, R2 = 0.19) and 10-100% (R = 0.63, R2 = 0.40). We conclude that runners with plantar fasciitis acute and chronic have higher plantar loads on rearfoot and increased rates of impact of the foot on the ground. However, the condition plantar fasciitis acute proved loads with lower impact rates and plantar load on rearfoot in relation to chronic phase, possibly due to the protective mechanism pain in calcaneal region. Moreover, the plantar arch predicts loads plantar in forefoot of the runners with plantar fasciitis and alignment in valgus rearfoot proved to be a measure of fundamental importance for clinical evaluation of runners with plantar fasciitis because it can predict the increase of the plantar loads and impact rates of calcaneal region and thus prevents the symptoms and progression of plantar fasciitis.

Objectives: The aim of the study was to evaluate how lower limbs injuries are related to footstrike pattern in 800 m women runners aged 16 - 22 in the Czech Republic and around the world. Methods: Due to the current epidemiological situation, the original field investigation of 48 runners was not possible to complete. Literature research on the topic and the series of ten case studies were performed instead. The research was performed in following databases: Medline, ScienceDirect, SPORTDiscus and Bibliographia medica Čechoslovaca. Results showed seven studies that met inclusion criteria. After that footstrike pattern was evaluated and compared with injury history in 10 women runners in 800 meters, who took part in the Czech Republic championship. Results: Two studies out of seven confirmed a higher incidence of injuries in RFS than in FFS, 4/7 did not show a significant difference, 1/7 did not evaluate the higher incidence in one or the other type of the footstrike. Three studies out of seven confirmed the relationship between RFS and knee injuries. Furthermore, two of them showed relationship between RFS and hip pain. 2/7 did not confirm any relationship between footstrike pattern and specific injury and 2/7 did not evaluated this relationship at all. Based on the series of ten case studies, it...

Einführung Der Pronation, als Bewegungsrichtung der Rückfußbewegung, ist in der biomechanischen Forschung in der Vergangenheit sehr viel Aufmerksamkeit geschenkt worden. In den unzähligen Veröffentlichungen zur Pronation wiederholen sich zwei Kernaussagen: Einerseits ist Pronation ein natürlicher Dämpfungsmechanismus, der andererseits bei übermäßiger Ausprägung zu Überlastungsschäden führen kann. Zu beiden Aussagen finden sich viele Untersuchungen, doch eindeutig belegt oder widerlegt sind beide nicht. Die vorliegende Arbeit möchte anhand von Untersuchungen zur Methodik der Bewegungsanalyse des Rückfußes dazu beitragen, den Diskrepanzen der verschiedenen Studienergebnisse auf den Grund zu gehen. Die Arbeit gliedert sich dazu in zwei Teile: Im ersten Teil werden diverse interne und externe Faktoren auf ihr pronationsbeeinflussendes Potential dargestellt. Für den zweiten Teil werden erstens das Elektrogoniometer, als gebräuchliches Messsystem der Rückfußbewegung, mit Hilfe der stereophotogrammetrischen Bewegungsanalyse (Goldstandard) validiert und zweitens innovative Messsysteme mit Schwerpunkt auf mobiler Bewegungsanalyse der Rückfußbewegung (Hall- und Drucksensoren, Gyrometer) entwickelt und ebenfalls validiert. Methodik Im Rahmen dieser Arbeit wurde eine Reihe von Einzelstudien durchgeführt, deren Methodik schwer zu verallgemeinern ist. Grundsätzlich kamen hauptsächlich Laborstudiendesigns zur Anwendung, in denen Gelenkwinkelamplituden, -ausmaße und -geschwindigkeiten der Rückfußbewegung analysiert wurden. In den Laborstudien der Einflussfaktoren wurde die Rückfußbewegung dabei entweder mit stereophotogrammetrischer Bewegungsanalyse oder mit dem Elektrogoniometer erfasst. Bei einer Ermüdungsstudie mit Feldtestdesign wurde die Rückfußbewegung mittels Gyrometer erfasst. Zur Validierung innovativer Messsysteme der Rückfußbewegung wurde entweder die stereophotogrammetrische Bewegungsanalyse oder das Elektrogoniometer verwendet. Ergebnisse Anhand der in der Arbeit vorgenommenen Analyse der pronationsbeeinflussenden Faktoren muss geschlussfolgert werden, dass Einflussfaktoren auf die Rückfußbewegung unzureichend verstanden sind. Die Einflussfaktoren lassen sich grundsätzlich jedoch in drei Gruppen einteilen: 1. kaum erforschte Faktoren (z.B. Alter, Geschlecht, Fußdimensionen, individueller Laufstil und generelle Bewegungsart), 2. kontrovers diskutierte Faktoren (z.B. Fußform, Gelenkkoppelung, genereller Schuheinfluss und Ermüdung) und 3. gesicherte Faktoren (z.B. USG-Achsenorientierung, varus / valgus-modifizierte Schuhgeometrie, Laufgeschwindigkeit). Für Laboruntersuchungen bieten, neben der stereophotogrammetrischen Bewegungsanalyse, zwei weitere Messsysteme, Elektrogoniometer und Gyrometer, vergleichbare Resultate bei der Bestimmung der Rückfußkinematik auf. Das Elektrogoniometer zeigte mittlere bis hohe, das Gyrometer nur mittlere Korrelationen bei den betrachteten Parametern. Hall- und Drucksensoren konnten zwar für eine gegebene Stichprobe rekursiv zur Bestimmung der Rückfußparameter verwendet werden, bei unbekannten Probanden oder alternativen Schuhmodellen lagen die Bestimmtheitsmaße jedoch nicht im akzeptablen Bereich. Dennoch sind für Messungen der Sohlendeformation mit Hilfe von Hallsensoren andere Anwendungsbereiche vorstellbar und auch realisierbar. Für Felduntersuchungen der Rückfußbewegung hat das Gyrometer das größte Potential. Es war im Rahmen dieser Arbeit bereits möglich, einzelne Parameter der Rückfußbewegung (Eversiongeschwindigkeit und -ausmaß) valide in mobilen Einsatzszenarien zu bestimmen. Schlussfolgerungen und Ausblick Die wichtigste Fragestellung für die biomechanische Forschung in Bezug auf die Rückfußbewegung ist die Klärung, ob ein Zusammenhang mit der Entstehung von Überlastungsschäden besteht. Aus den Erkenntnissen dieser Arbeit lassen sich fünf Kernzielstellungen skizzieren, die beachtet werden sollten, um dieser Frage nachzugehen: 1. Entwicklung von mobilen und direkten Messsystemen, zur Erfassung der Rückfußbewegung, nicht der des Schuhs, im natürlichen Bewegungsumfeld, 2. methodische und inhaltliche Diskussion und Standardisierung der Rückfußparameter, 3. Erweiterung der isolierten Betrachtung der Rückfußbewegung auf umliegende Segmente und Gelenke, 4. Kontrolle bzw. Einbeziehung von pronationsbeeinflussenden Faktoren in Untersuchungsdesigns und 5. Durchführung von großangelegten Längsschnittuntersuchungen. / Introduction In previous biomechanical research, a lot of effort has been put into the investigation of rearfoot pronation. In numerous publications, two main assumptions have been postulated: On the one hand, pronation is considered a natural damping mechanism; on the other hand, excessive pronation may lead to overuse injuries. Both assumptions have been intensively investigated; confirmed or negated is neither of the two assumptions so far. Within the frame of this thesis the author tries to contribute to the methodological analysis of rearfoot motion to solve current discrepancies regarding rearfoot motion. The thesis is devided in two parts: In the first part, the influences of various internal and external factors on rearfoot motion are investigated. In the second part, rearfoot motion measurement devices are being validated. Firstly, the elctrogoniometer, a common device used for rearfoot motion measurements, is being validated against the stereophotogrammetric motion analysis system (golden standard) and secondly, innovative devices with their main focus on mobile measurements are being developed and validated. Methods In the case of this thesis, numerous single studies were performed, whose methods vary in such a way, that it is difficult to generalize. Mainly laboratory settings have been used, in which joint angle excursions, ranges of motion and velocities were analysed. In laboratory settings, either a stereophotogrammetric motion analysis system or an electrogoniometer were used to determine rearfoot motion. A gyrometer was utilized in a field test investigating the influence of fatigue on rearfoot motion. Either a stereophotogrammetric motion analysis system or an electrogoniometer were chosen as the golden standard to validate the innovative measurement devices. Results The results of the studies within this thesis regarding pronation influencing factors lead to the conclusion, that factors influencing rearfoot motion are not well understood so far. However, it is possible to divide the investigated factors in three groups: 1. factors, that have received little research attention (e.g. age, gender, foot dimensions, individual running style, general type of movement), 2. factors, that are controversially discussed (e.g. foot shape, joint coupling, general shoe influence, fatigue), and 3. factors that have proven to influence rearfoot motion (e.g. orientation of subtalar joint axis, varus/valgus modified shoes geometry, running velocity). For laboratory investigations two innovative measurements devices, electrogoniometer and gyrometer, have shown similar results compared to the stereophotogrammetric motion analysis system. The correlations of the analyzed parameter were medium to high for the electrogoniometer and medium for the gyrometer. In a known subject sample, using the signals of hall resp. pressure sensors resulted in acceptable rearfoot motion values. However, applied on the data of unknown subjects or alternative shoe models, the calculated rearfoot motion values were way out of an acceptable range. Nevertheless, especially the measurement of midsole deformation by using hall sensors may be useful in further usage scenarios The gyrometer has the highest potential for rearfoot motion measurements within field testings. It was already possible to validly determine various rearfoot motion parameters (eversion velocity and excursion) in mobile testing scenarios. Conclusions and outlook The clarification of a possible correlation between various pronation parameters and the development of overuse injuries turns out to be the most important question for further biomechanical research concerning rearfoot motion. The findings of the thesis indicate five major objectives that should be considered in future research: 1. Development of mobile and direct measurement devices to determine rearfoot motion, not shoe motion, in a natural movement environment, 2. methodological and contentual discussion and standardization of rearfoot motion parameters, 3. extension of the isolated perspective of a single joint motion to adjoining segments and joints, 4. control or integration of rearfoot influencing factors in the testing design and 5. realization of comprehensive longitudinal studies.