Mendonça LDM, Macedo LG, Fonseca ST, et al: Comparison of the anatomical alignment of lower limbs between healthy individuals and those with patellar tendinosis. .Rev Bras Fisioterapia9::101. ,2005. .
Mendonça LDM, Macedo LG, Fonseca ST, et al: Comparison of the anatomical alignment of lower limbs between healthy individuals and those with patellar tendinosis. .Rev Bras Fisioterapia9::101. ,2005. .)| false
Fonseca ST, Ocarino JM, Silva PLP, et al: “Integration of Stresses and Their Relationship to the Kinetic Chain,” in Scientific Foundations and Principles of Practice in Musculoskeletal Rehabilitation, Vol 1, ed by DJ Magee, JE Zachazewsky, WS Quillem, p 476, Saunders Elsevier, St. Louis. ,2007. .
Preece SJ, Graham-Smith P, Nester CJ, et al: The influence of gluteus maximus on transverse plane tibial rotation. .Gait Posture27::616. ,2008. .
Manal K, McClay I, Stanhope S, et al: Comparison of surface mounted markers and attachment methods in estimating tibial rotations during walking: an in vivo study. .Gait Posture11::38. ,2000. .10664484)| false
Westblad P, Hashimoto T, Winson I, et al: Differences in ankle-joint complex motion during the stance phase of walking as measured by superficial and bone anchored markers. .Foot Ankle Int23::856. ,2002. .
Westblad P, Hashimoto T, Winson I, et al: Differences in ankle-joint complex motion during the stance phase of walking as measured by superficial and bone anchored markers. .Foot Ankle Int23::856. ,2002. .12356185)| false
Background: The influence of distal mechanical factors that change the interaction between the forefoot and the support surface on lower-limb kinematics is not well established. This study investigated the effects of the use of lateral wedges under the forefoot on the kinematics of the lower extremity during the stance phase of walking.
Methods: Sixteen healthy young adults participated in this repeated-measures study. They walked wearing flat sandals and laterally wedged sandals, which were medially inclined only in the forefoot. One wedged sandal had a forefoot lateral wedge of 5° and the other wedged sandal had a forefoot lateral wedge of 10°. Kinematic variables of the lower extremity, theoretically considered clinically relevant for injury development, were measured with a three-dimensional motion analysis system. The variables were evaluated for three subphases of stance: loading response, midstance, and late stance.
Results: The 5° laterally wedged sandal increased rearfoot eversion during midstance and the 10° laterally wedged sandal increased rearfoot eversion during mid- and late stances, in comparison to the use of flat sandals. The 10° laterally wedged sandal produced greater internal rotation of the shank relative to the pelvis and of the hip joint, during the midstance, also compared to the use of flat sandals.
Conclusions: Lateral wedges under the forefoot increase rearfoot eversion during mid-and late stances and may cause proximal kinematic changes throughout the lower-extremity kinetic chain. Distal mechanical factors should be clinically addressed when a patient presents late excessive rearfoot eversion during walking. (J Am Podiatr Med Assoc 99(6): 503–511, 2009)
Corresponding author: Thales R. Souza, MSc, Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Antonio Carlos 6627, Belo Horizonte, MG, 31270-010 Brazil. (E-mail: firstname.lastname@example.org)