title: Comparison of foot kinematics between subjects with posterior tibialis tendon dysfunction and healthy controls.
abstract: METHODS
  A 2 x 4 mixed-design ANOVA with a fixed factor of group (posterior tibialis tendon dysfunction [PTTD] and asymptomatic controls), and a repeated factor of phase of stance (loading response, midstance, terminal stance, and preswing).
  
  
  OBJECTIVE
  To compare 3-dimensional stance period kinematics (rearfoot eversion/inversion, medial longitudinal arch [MLA] angle, and forefoot abduction) of subjects with stage II PTTD to asymptomatic controls.
  
  
  BACKGROUND
  Abnormal foot postures in subjects with stage II PTTD are clinical indicators of disease progression, yet dynamic investigations of forefoot, midfoot, and rearfoot kinematic deviations in this population are lacking.
  
  
  METHODS
  Fourteen subjects with stage II PTTD were compared to 10 control subjects with normal arch index values. Subjects were matched for age, gender, and body mass index. A 5-segment, kinematic model of the leg and foot was tracked using an Optotrak Motion Analysis System. The dependent kinematic variables were rearfoot inversion/eversion, forefoot abduction/adduction, and the MLA angle. An ANOVA model was used to compare kinematic variables between groups across 4 phases of stance.
  
  
  RESULTS
  Subjects with PTTD demonstrated significantly greater rearfoot eversion (P = .042), MLA angle (P = .008) and forefoot abduction angles (P < .005) during specific phases of stance. Subjects with PTTD demonstrated significantly greater rearfoot eversion (P<.004) and MLA angles (P < .009) by 6.2 degrees and 8.0 degrees, respectively, during loading response when compared to controls. During preswing, the subjects with PTTD demonstrated a significantly greater MLA angle (P < .002) and a forefoot abduction angle (P<.001) which exceeded that of the controls by 10.0 degrees.
  
  
  CONCLUSIONS
  The abnormal kinematics observed at the rearfoot, midfoot, and forefoot across all phases of stance implicate a failure of compensatory muscle and secondary ligamentous support to control foot kinematics in subjects with stage II PTTD.
authors.affiliation: Ithaca College-Rochester Campus, Department of Physical Therapy, Center for Foot and Ankle Research, Rochester, NY 14623, USA.
authors.forename: Josh
authors.initials: J
authors.lastname: Tome
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Nawoczenski
authors.forename: Adolph
authors.initials: A
authors.lastname: Flemister
authors.forename: Jeff
authors.initials: J
authors.lastname: Houck
mesh_terms: D001696:Biomechanical Phenomena; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005528:Foot / Q000503:physiopathology*; D005545:Forefoot, Human / Q000503:physiopathology; D006365:Heel / Q000503:physiopathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D037081:Posterior Tibial Tendon Dysfunction / Q000503:physiopathology*; D011187:Posture / Q000502:physiology; D012399:Rotation; D013977:Tibia / Q000503:physiopathology; D014034:Toes / Q000503:physiopathology; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology