Foot pronation affects pelvic motion during the loading response phase of gait

Joana Ferreira Hornestam, Paula Maria Machado Arantes, Thales Rezende Souza, Renan Alves Resende, Cecilia Ferreira Aquino, Sergio Teixeira Fonseca, Paula Lanna Pereira da Silva, Joana Ferreira Hornestam, Paula Maria Machado Arantes, Thales Rezende Souza, Renan Alves Resende, Cecilia Ferreira Aquino, Sergio Teixeira Fonseca, Paula Lanna Pereira da Silva

Abstract

Background: Increased foot pronation during walking has been associated with low back pain. This association may be due to the impact of increased pronation on pelvic motion.

Objective: To investigate the effects of increased bilateral foot pronation on pelvic kinematic in frontal and transverse planes during the loading response phase of gait.

Methods: Pelvic, hip, and foot angular positions of 20 participants were collected while they walked at fast speed wearing flat and medially inclined insoles inserted in the shoes. Pelvic motion in frontal and transverse planes was analyzed during the loading response phase. Foot eversion-inversion was analyzed during the complete stance phase to verify the insoles effectiveness in inducing increased pronation and to exclude excessive pronators.

Results: Inclined insoles were effective in inducing increased foot pronation. Pelvic and hip motion were altered in the increased pronation condition compared to the control condition. In the frontal plane, mean pelvic position was more inclined to the contralateral side (mean difference [MD]: 0.54°; 95%CI: 0.23, 0.86) and its range of motion (ROM) was reduced (MD: 0.50°; 95%CI: 0.20, 0.79). In the transverse plane, mean pelvic position was less rotated toward the contralateral leg (MD: 1.03°; 95%CI: 0.65, 1.60) without changes in ROM (MD: 0.04°; 95%CI: -0.17, 0.25). The hip was more internally rotated (MD: 1.37°; 95%CI: 0.76, 1.98) without changes in ROM (MD: 0.10°; 95%CI: -1.02, 1.23).

Conclusion: Increased bilateral foot pronation changes pelvic motion during walking and should be assessed, as a contributing factor to possible pelvic and lower back disorders.

Keywords: Biomechanics; Foot pronation; Gait; Kinematics; Pelvic motion; Physical therapy.

Copyright © 2021 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier España, S.L.U. All rights reserved.

Figures

Fig. 1
Fig. 1
a) Clusters of tracking markers mounted on the lower limb and pelvis; b) Rearfoot cluster placement and shoe adaptation; c) Technical markers indicated by red arrows.
Fig. 2
Fig. 2
Rearfoot eversion/inversion during stance phase of gait (mean curve defined over the 30 gait cycles of all participants).
Fig. 3
Fig. 3
Effects of increased pronation on pelvic motion in the frontal plane; a) Pelvic movement in frontal plane during stance phase of gait (mean curve defined over the 30 gait cycles of all participants). The gray highlighted area refers to the loading response of the reference leg; b) Average position of the pelvis in the frontal plane during the loading response phase of gait performed under the control (CC) and increased pronation (IPC) conditions. More negative values suggest greater magnitudes of contralateral drop; c) Mean pelvic range of motion in the frontal plane during the loading response phase of gait performed under control (CC) and increased pronation (IPC) conditions.
Fig. 4
Fig. 4
Effects of increased pronation on pelvic motion in the transverse plane; a) Pelvic movement in transverse plane during stance phase of gait (mean curve defined over the 30 gait cycles of all participants). The gray highlighted area refers to the loading response of the reference leg; b) Mean pelvic position in transverse plane during loading response phase of gait performed under control (CC) and increased pronation (IPC) conditions; c) Mean pelvic range of motion in the transverse plane during loading response phase of gait performed under control (CC) and increased pronation (IPC) conditions.

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