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Postural Control Differences between Patients with Posterior Tibial Tendon Dysfunction and Healthy People during

Junsig Wang1,2, L Daniel Latt3, Robert D Martin2

  • 1Department of Sports Medicine, Kyung Hee University, Yongin-si 17014, Gyeonggi-do, Korea.

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Summary

Patients with posterior tibial tendon dysfunction (PTTD) adopt cautious walking strategies, shifting their center of pressure (COP) medially. This study reveals altered dynamic postural control in PTTD, informing rehabilitation for improved gait.

Keywords:
PTTDcenter of pressuregaitpostural controltime-to-boundary

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Area of Science:

  • Biomechanics
  • Orthopedics
  • Rehabilitation Science

Background:

  • Posterior tibial tendon dysfunction (PTTD) can cause postural instability during walking due to arch collapse and foot malalignment.
  • Understanding dynamic postural control in PTTD is crucial for effective gait training and rehabilitation programs.

Purpose of the Study:

  • To assess dynamic postural control mechanisms in individuals with stage II PTTD compared to healthy controls during gait.

Main Methods:

  • Eleven patients with stage II PTTD and ten healthy controls walked on a 10m walkway.
  • Kinematic and center of pressure (COP) data were collected using Vicon cameras and AMTI force platforms.
  • Independent t-tests were used to compare PTTD and control groups (α < 0.05).

Main Results:

  • PTTD patients exhibited a higher double stance ratio (+23%) and anterior-posterior (AP) time to contact (TTC) (+16%).
  • PTTD patients showed reduced AP COP excursion (-19%), AP COP velocity (-30%), and medial-lateral (ML) COP velocity (-40%).
  • Mean ML COP trace values were decreased (-23%) in PTTD, indicating a medial shift during single-support phase.

Conclusions:

  • PTTD patients employ conservative postural strategies, potentially reducing the need for adjustments during gait.
  • A medially shifted COP pattern during single-support phase was observed in PTTD patients compared to controls.
  • Dynamic postural control findings can guide the development of gait training programs to improve function and efficiency in PTTD.