The impact of wide step width on lower limb coordination and its variability in individuals with flat feet

Flat foot is a common condition marked by the collapse of the medial longitudinal arch, leading to altered lower limb biomechanics and increased risk of musculoskeletal injuries. We aimed to investigate if wide step width changes the lower limb inter-joint coordination and its variability in flat feet individuals. Twenty flat-footed individuals participated in this cross-sectional study. Lower limb kinematics were assessed by 3-dimensional motion analysis during walking and running on a treadmill with preferred and wide step widths while receiving visual feedback. Inter-joint coordination was quantified using vector-coding for joint angles in the hip, knee, and ankle. Wide walking showed a shift towards proximal joint motion in sagittal ankle-knee coordination during loading response during LR (p=0.006), an In-phase motion in transverse ankle-hip coordination during push-off (p=0.004), and an In-phase pattern in frontal knee-hip coordination during mid-stance (p=0.027). Frontal ankle and transverse knee coordination during push-off changed to In-phase (p=0.003). Wide running significantly shifted frontal ankle-hip coordination towards proximal joint motion during mid-stance (p=0.05). Transverse ankle-hip coordination showed an in-phase pattern in wide conditions during push-off (p=0.044), during LR (p=0.022). Wide walking, significantly increased coordination variability of the sagittal ankle-knee during LR and decreased transverse ankle-hip during push-off. Wide walking significantly increased coordination variability in ankle-knee in sagittal plane during LR (p<0.001). Wide running significantly decreased the coordination variability in the ankle-knee sagittal during LR (p<0.001) and knee-hip sagittal during LR (p=0.007) and push-off (p=0.016). The results showed that wide step width can affect inter-joint coordination during walking/running in flat-footed individuals at certain points. These results should be considered when using a wide step width as a gait retraining method for managing flat-footed individuals.