Simple foot strike angle calculation from three-dimensional kinematics: A methodological comparison

A simple and accurate method of determining foot strike angle (FSA) during running can simplify data collections and validations of wearable sensors. The purpose of this study was to determine the validity of two simplified methods for estimating FSA and foot angle (throughout the ground contact) from three-dimensional kinematics. Markers were placed on the heel and head of the second metatarsal (HEEL-TOE) or on the lateral side of the head of the fifth metatarsal (HEEL-MET₅). When compared to the reference foot segment, the HEEL-TOE method performed similarly with a minimal mean difference (0.28° [0.19°,0.36°], p < 0.001), a high Pearson's r (r = 0.994; p < 0.001), and low bias (-0.20°±1.05°). Alternatively, the HEEL-MET₅ method underestimated FSA: mean difference = 4.28° [4.07°,4.91°] (p < 0.001), Pearson's r = 0.968 (p < 0.001), and bias = -4.58°±2.61°. Throughout the contact phase, significant SPM cluster regions were identified, indicating that the HEEL-MET₅ method underestimated the angle of the foot for all foot strike patterns in the first 23-34% of the stance (p < 0.025). This study supports the idea that the HEEL-TOE method can be used as a simplified method for determining FSA from 3D kinematics. Researchers should proceed with caution when employing the HEEL-MET₅ method, as it is likely underestimating FSA due to foot inversion in the early stance phase.