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

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.