• 1. 

    Hoy D, Brooks P & Blyth F et al.: The epidemiology of low back pain. Best Pract Res Clin Rheumatol 24 : 769, 2010.

  • 2. 

    Farahpour N, Jafarnezhadgero A & Allard P et al.: Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain. J Electromyogr Kinesiol 39: 35, 2018.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3. 

    Barrey C, Jund J & Noseda O et al.: Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases: a comparative study of about 85 cases. Eur Spine J 16 : 1459, 2007.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4. 

    Menz HB, Dufour AB & Riskowski JL et al.: Foot posture, foot function and low back pain: the Framingham Foot Study. Rheumatology (Oxford) 52: 2275, 2013.

  • 5. 

    Giles LG & Taylor JR: Low back pain associated with leg length inequality. Spine 6 : 510, 1981.

  • 6. 

    Fourchet F, Kelly L & Horobeanu C et al.: High-intensity running and plantar-flexor fatigability and plantar-pressure distribution in adolescent runners. J Athl Train 50 : 117, 2015.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7. 

    Betsch M, Schneppendahl J & Dor L et al.: Influence of foot positions on the spine and pelvis. Arthritis Care Res 63 : 1758, 2011.

  • 8. 

    Bird AR, Bendrups AP & Payne CB: The effect of foot wedging on electromyographic activity in the erector spinae and gluteus medius muscles during walking. Gait Posture 18 : 81, 2003.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9. 

    Ogon M, Aleksiev AR & Pope MH et al.: Does arch height affect impact loading at the lower back level in running? Foot Ankle Int 20 : 263, 1999.

  • 10. 

    Duval K, Lam T & Sanderson D: The mechanical relationship between the rearfoot, pelvis and low-back. Gait Posture 32 : 637, 2010.

  • 11. 

    Tateuchi H, Wada O & Ichihashi N: Effects of calcaneal eversion on three-dimensional kinematics of the hip, pelvis and thorax in unilateral weight bearing. Hum Mov Sci 30 : 566, 2011.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12. 

    Neal BS, Griffiths IB & Dowling GJ et al.: Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis. J Foot Ankle Res 7 : 55, 2014.

  • 13. 

    Banwell HA, Mackintosh S & Thewlis D: Foot orthoses for adults with flexible pes planus: a systematic review. J Foot Ankle Res 7 : 23, 2014.

  • 14. 

    Mosca VS: Flexible flatfoot in children and adolescents. J Child Orthop 4 : 107, 2010.

  • 15. 

    Kosashvili Y, Fridman T & Backstein D et al.: The correlation between pes planus and anterior knee or intermittent low back pain. Foot Ankle Int 29 : 910, 2008.

  • 16. 

    Bird AR & Payne CB: Foot function and low back pain. Foot 9 : 175, 1999.

  • 17. 

    Aquino A & Payne C: Function of the windlass mechanism in excessively pronated feet. JAPMA 91 : 245, 2001.

  • 18. 

    Panjabi MM: The stabilizing system of the spine: part 1. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 5 : 383, 1992.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. 

    Hodges PW: Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther 4 : 74, 1999.

  • 20. 

    Macintosh JE, Valencia F & Bogduk N et al.: The morphology of the human lumbar multifidus. Clin Biomech (Bristol, Avon) 1: 196, 1986.

  • 21. 

    Critchley D: Instructing pelvic floor contraction facilitates transversus abdominis thickness increase during low-abdominal hollowing. Physiother Res Int 7: 65, 2002.

  • 22. 

    Choi M-H, An S-D & Lee D-Y et al.: The comparison of various positions on lumbar multifidus activation. Indian J Sci Technol 9 : 1, 2016.

  • 23. 

    Cuellar WA, Blizzard L & Callisaya ML et al.: Test-retest reliability of measurements of abdominal and multifidus muscles using ultrasound imaging in adults aged 50-79 years. Musculoskelet Sci Pract 28: 79, 2017.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24. 

    Hides JA, Miokovic T & Belavý DL et al.: Ultrasound imaging assessment of abdominal muscle function during drawing-in of the abdominal wall: an intrarater reliability study. J Orthop Sports Phys Ther 37: 480, 2007.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25. 

    Barker KL, Shamley DR & Jackson D: Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability. Spine 29 : 515, 2004.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26. 

    Hides J, Gilmore C & Stanton W et al.: Multifidus size and symmetry among chronic low back pain and healthy asymptomatic subjects. Man Ther 13 : 43, 2008.

  • 27. 

    Hodges P, Holm AK & Hansson T et al.: Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury. Spine 31 : 2926, 2006.

  • 28. 

    O'Sullivan PB, Twomey L & Allison GT: Altered abdominal muscle recruitment in patients with chronic back pain following a specific exercise intervention. J Orthop Sports Phys Ther 27 : 114, 1998.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29. 

    Willson JD, Dougherty CP & Ireland ML et al.: Core stability and its relationship to lower extremity function and injury. J Am Acad Orthop Surg 13 : 316, 2005.

  • 30. 

    Freeman MD, Woodham MA & Woodham AW: The role of the lumbar multifidus in chronic low back pain: a review. PM R 2 : 142, 2010.

  • 31. 

    Sheikh Taha AM & Feldman DS: Painful flexible flatfoot. Foot Ankle Clin 20 : 693, 2015.

  • 32. 

    Sung PS: Kinematic analysis of ankle stiffness in subjects with and without flatfoot. Foot (Edinb) 26 : 58, 2016.

  • 33. 

    Brody DM: Techniques in the evaluation and treatment of the injured runner. Orthop Clin North Am 13 : 541, 1982.

  • 34. 

    Loudon JK, Jenkins W & Loudon KL: The relationship between static posture and ACL injury in female athletes. J Orthop Sports Phys Ther 24 : 91, 1996.

  • 35. 

    Morrison SC, Durward BR & Watt GF et al.: A literature review evaluating the role of the navicular in the clinical and scientific examination of the foot. Br J Podiatr 7 : 5, 2004.

    • Search Google Scholar
    • Export Citation
  • 36. 

    Evans AM, Copper AW & Scharfbillig RW et al.: Reliability of the Foot Posture İndex and traditional measures of foot position. JAPMA 93 : 203, 2003.

  • 37. 

    Redmond AC, Crane YZ & Menz HB. Normative values for the Foot Posture Index. J Foot Ankle Res 1 : 6, 2008.

  • 38. 

    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 (Bristol Avon) 21: 89, 2006.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39. 

    Niiler T, Church C & Lennon N et al.: Reliability and minimal detectable change in foot pressure measurements in typically developing children. Foot (Edinb) 29: 29, 2016.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40. 

    Zhu Q, Li J & Fang M et al.: Effect of Chinese massage (Tui Na) on isokinetic muscle strength in patients with knee osteoarthritis [in Chinese]. J Tradit Chin Med 36: 314, 2016.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41. 

    Lanza IR, Towse TF & Caldwell GE et al.: Effect of age on human muscle torque, velocity, and power in two muscle groups. J Appl Physiol 95 : 2361, 2003.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42. 

    Coombs R & Garbutt G: Developments in the use of the hamstring/quadriceps ratio for the assessment of muscle balance. J Sports Sci Med 1 : 56, 2002.

  • 43. 

    Tankevicius G, Lankaite D & Krisciunas A: Test-retest reliability of Biodex System 4 Pro for isometric ankle-eversion and -inversion measurement. J Sport Rehabil 22: 212, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44. 

    de Paula Lima PO, Camelo PRP, Ferreira VMLMet al: Evaluation of the isokinetic muscle function, postural control and plantar pressure distribution in capoeira players: a cross-sectional study. Muscles Ligaments Tendons J 7: 498, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45. 

    Madill SJ & McLean L: Quantifiction of abdominal and pelvic florr muscle synergies in response to voluntary pelvic floor muscle contractions. J Electromyogr Kinesiol 18: 955, 2008.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 46. 

    Goubert D, De Pauw R & Meeus M et al.: Lumbar muscle structure and function in chronic versus recurrent low back pain: a cross-sectional study. Spine J 17: 1285, 2017.

  • 47. 

    Vetter TR: Fundamentals of research data and variables: the devil is in the details. Anesth Analg 125: 1375, 2017.

  • 48. 

    Cohen J: “Differences Between Correlation Coefficients,” in Statistical Power Analysis for the Behavioural Sciences, 2nd Ed, p 109, Lawrence Erlbaum Associates, Mahwah, NJ, 1988.

    • Search Google Scholar
    • Export Citation
  • 49. 

    Cresswell AG, Grundstrom H & Thorstensson A: Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Acta Physiol Scand 144 : 409, 1992.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50. 

    Cresswell AG, Oddsson L & Thorstensson A: The influence of sudden perturbations on trunk muscle activity and intra-abdominal pressure while standing. Exp Brain Res 98 : 336, 1994.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51. 

    Dananberg HJ & Guiliano M: Chronic low-back pain and its response to custom-made foot orthoses. JAPMA 89: 109, 1999.

  • 52. 

    Ebenbichler GR, Oddsson LI & Kollmitzer J et al.: Sensory-motor control of the lower back: implications for rehabilitation. Med Sci Sports Exerc 33: 1889, 2001.

  • 53. 

    Thorstensson A, Carlson H & Zomlefer MR: Lumbar back muscle activity in relation to trunk movements during locomotion in man. Acta Physiol Scand 116: 13, 1982.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 54. 

    Saunders SW, Schache AG & Rath D: Changes in three dimensional lumbopelvic kinematics and trunk muscle activity with speed and mode of locomotion. Clin Biomech (Bristol Avon) 20: 784, 2005.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 55. 

    Chuter VH & Janse de Jonge XA: Proximal and distal contributions to lower extremity injury: a review of the literature. Gait Posture 36 : 7, 2012.

  • 56. 

    Barwick A, Smith J & Chuter V: The relationship between foot motion and lumbopelvic-hip function: a review of the literature. Foot (Edinb) 22 : 224, 2012.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 57. 

    Brantingham JW, Adams KJ & Cooley JR et al.: A single-blind pilot study to determine risk and association between navicular drop, calcaneal eversion and low back pain. J Manipulative Physiol Ther 30 : 380, 2007.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

Are Biomechanical Features of the Foot and Ankle Related to Lumbopelvic Motor Control?

Caner Kararti PT, MSc, Sevil Bilgin PT, PhD, Yeliz Dadali MD, Buket Büyükturan PT, PhD, Öznur Büyükturan PT, PhD, and Nilgün Bek PT, PhD
View More View Less
Restricted access

Background

Any pathomechanical change in the foot or ankle is expected to cause adverse biomechanical effects on the lumbopelvic region. However, no objective data can be found in the literature regarding the effects of musculus transversus abdominis (mTrA) and musculus lumbar multifidus (mLM), which are effective muscles in lumbopelvic motor control, or regarding the extent of their effects.

Methods

Sixty-four healthy young adults were assessed by a physiotherapist (C.K.) experienced in treating feet and a radiologist (Y.D.) specialized in muscular imaging. In the determination of biomechanical properties of the foot, the navicular drop test (NDT), Foot Posture Index (FPI), pedobarographic plantar pressure analysis, and isokinetic strength dynamometer measurements were used in determining the strength of the muscles around the ankle. Ultrasonographic imaging was used to determine mTrA and mLM thicknesses.

Results

Significant correlation was found between NDT results and mTrA and mLM thicknesses (P < .05) and between FPI results and mTrA thicknesses (P < .05). As the peak pressure of the foot medial line increased, mTrA and mLM thicknesses decreased (P < .05). Although dorsiflexion muscle strength was also effective, mTrA and mLM thicknesses were found to increase especially as plantarflexion muscle strength increased (P < .05).

Conclusions

These results show that the biomechanical and musculoskeletal properties of the foot-ankle are associated with lumbopelvic stability.

Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey.

Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.

Department of Radiology, Kırşehir Ahi Evran University, Education and Research Hospital, Kırşehir, Turkey.

Corresponding author: Caner Kararti, PT, MSc, Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, 40100, Turkey. (E-mail: fzt.caner.92@gmail.com)