Sagittal Subtalar and Talocrural Joint Assessment Between Barefoot and Shod Walking: A Fluoroscopic Study

Background: While wearing shoes is common in most daily activities, most foot kinematic models report results on barefoot conditions. It is difficult to describe the position of the foot inside of a shoe. This study used fluoroscopic images to determine talar motion relative to tibia and calcaneal motion relative to talus. Research Question: What are the differences in sagittal talocrual and subtalar kinematics between walking barefoot and while wearing athletic walking shoes? Methods: Thirteen male subjects (mean age 22.9 +/- 2.9 years, mean weight 77.2 +/- 6.9 kg, mean height 178.2 +/- 3.7 cm) screened for normal gait were tested. A fluoroscopy unit was used to collect images at 120 Hz during stance. Sagittal motion of the talocrural and subtalar joints of the right foot were analyzed barefoot and in an athletic walking shoe. Results: Shod talocrural dorsiflexion at heel strike was -2.4 degrees and shod peak talocrural plantarflexion was 7.0 degrees (occurring at 16% stance). Barefoot talocrural plantarflexion at heel strike was 4.2 degrees and barefoot peak talocrural plantarflexion was 10.9 degrees (occurring at 11% stance). Shod subtalar plantarflexion at heel strike was 1.3 degrees and shod peak subtalar dorsiflexion was -1.9 degrees (occurring at 26% stance). Barefoot subtalar dorsiflexion at heel strike was -0.4 degrees and barefoot peak subtalar dorsiflexion was -3.5 degrees (occurring at 31% stance). As the result of wearing shoes, average walking speed increased by 0.04 m/s, average stride length increased by 0.10 m, and average cadence decreased by 4.74 steps/min. Significance: This work demonstrates the ability to directly measure talocrural and subtalar kinematics of shod walking using fluoroscopy. Future work using this methodology can be used to increase understanding of hindfoot kinematics during a variety of non-barefoot activities.