Quantifying the Dynamic Stability of Gait Patterns in People with Hallux Valgus

Hallux valgus (HV), which is mainly caused by the wearing of narrow-width and high-heeled shoes, disrupts gait behavior because it deforms lower limb joints. There is limited information regarding the relationship between the foot disease HV and lower limb joints. Previous studies evaluating abnormal gait patterns caused by deformity used spatiotemporal parameters; however, they failed to characterize the overall gait dynamics. To address this issue, this study is aimed at characterizing the gait stability of patients with HV and examining the joints that are critically affected by HV. To assess complex gait dynamics, we quantified the potential changes in gait stability by using the maximum Lyapunov exponent (MLE). Angular displacements of the ankle, knee, and hip in the sagittal plane during walking were investigated to calculate the MLE for gait stability based on foot conditions (i.e., barefoot, flat shoes, and high heels). During walking, a large MLE (P < 0.05) was noted for the knee joints of subjects with HV, relative to the other lower limb joints. HV appears to have the most critical effect on the knee joints during walking. Ankle movement exhibited higher dynamic stability than the other joint movements of the lower limb (P < 0.05). The type of shoe used in the experiment showed no significant dependence with gait stability and joint movement (P > 0.05). Quantitative assessments of dynamic stability using the MLE may help clinicians assess the overall gait dynamics of HV patients and other people suffering from gait disturbances.