title: Foot kinematics in patients with two patterns of pathological plantar hyperkeratosis.
abstract: BACKGROUND
  The Root paradigm of foot function continues to underpin the majority of clinical foot biomechanics practice and foot orthotic therapy. There are great number of assumptions in this popular paradigm, most of which have not been thoroughly tested. One component supposes that patterns of plantar pressure and associated hyperkeratosis lesions should be associated with distinct rearfoot, mid foot, first metatarsal and hallux kinematic patterns. Our aim was to investigate the extent to which this was true.
  
  
  METHODS
  Twenty-seven subjects with planter pathological hyperkeratosis were recruited into one of two groups. Group 1 displayed pathological plantar hyperkeratosis only under metatarsal heads 2, 3 and 4 (n = 14). Group 2 displayed pathological plantar hyperkeratosis only under the 1st and 5th metatarsal heads (n = 13). Foot kinematics were measured using reflective markers on the leg, heel, midfoot, first metatarsal and hallux.
  
  
  RESULTS
  The kinematic data failed to identify distinct differences between these two groups of subjects, however there were several subtle (generally <3°) differences in kinematic data between these groups. Group 1 displayed a less everted heel, a less abducted heel and a more plantarflexed heel compared to group 2, which is contrary to the Root paradigm.
  
  
  CONCLUSIONS
  There was some evidence of small differences between planter pathological hyperkeratosis groups. Nevertheless, there was too much similarity between the kinematic data displayed in each group to classify them as distinct foot types as the current clinical paradigm proposes.
authors.affiliation: 1Centre for Health, Sport and Rehabilitation Sciences Research, School of Health, Sport and Rehabilitation Sciences, University of Salford, Salford M6 6PU, England, UK.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Findlow
authors.affiliation: 1Centre for Health, Sport and Rehabilitation Sciences Research, School of Health, Sport and Rehabilitation Sciences, University of Salford, Salford M6 6PU, England, UK.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Nester
authors.affiliation: 1Centre for Health, Sport and Rehabilitation Sciences Research, School of Health, Sport and Rehabilitation Sciences, University of Salford, Salford M6 6PU, England, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Bowker