Serial measurement of calcaneal pitch during midstance

Although emerging evidence suggests a causal relationship between arch structure and musculoskeletal injury, few investigations have adequately assessed arch function during gait. In this study, digitized videofluoroscopy was used to evaluate the sagittal plane motion of the calcaneus during gait. Nine female subjects requiring diagnostic foot radiographs underwent videofluoroscopy. The calcaneal inclination angle, arch height ratio, and tarsal index were digitally analyzed for all radiographic images. Calcaneal pitch was correlated to both the arch height ratio and the tarsal index. Repeated measures analysis of variance helped to identify a significant reduction in the mean calcaneal pitch during the midstance and early propulsive periods of gait. These findings suggest that although calcaneal pitch may be used as an indicator of rearfoot position, biomechanical classification of foot types based on radiographs may result in erroneous conclusions concerning foot function.