The effect of a selected exercise protocol on trunk and lower limb muscle activity of older adults with both low back pain and pronated feet during walking

Alavi Mehr, Seyed Majid; Mousavi, Seyed Hamed; Jafarnezhadgero, AmirAli

doi:10.22059/sshr.2023.350097.1065

The effect of a selected exercise protocol on trunk and lower limb muscle activity of older adults with both low back pain and pronated feet during walking

Document Type : Research Paper

Authors

¹ Department of Sport Managements and Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

² University of Tehran, Faculty of Sport Sciences and Health, Department of Health and Sport Medicine, Tehran, Iran

10.22059/sshr.2023.350097.1065

Abstract

Background: Low back pain is a common musculoskeletal condition that can impact a person's ability to walk and move comfortably. Pronated foot posture has been suggested as a potential contributor to low back pain, and this study examines its impact on muscle activity during gait in individuals with low back pain.
Aim: This study aimed to investigate whether pronated foot alters the activity timing of trunk and lower limb muscles during gait in low back pain patients.
Materials and Methods: The sample of this study included 32 men with low back pain and pronated foot. Participants were divided into control (n=15, with foot pronated only) and experimental (n=17, with both low back pain and foot pronated) groups. The experimental group did resistance training with Thera-band for 12 weeks, 3 sessions per week. A wireless electromyography system with 9 pairs of bipolar surface electrodes was used to record the electromyography activity timing of back and lower limb muscles (sample rate: 2000 Hz). Two-way ANOVA was used for statistical analysis.
Results: Significant between-group differences were found at baseline onset of EMG activity timing for gastrocnemious medialis (P<0.001), gluteus medius (P<0.001) and erector spinae at 3rd lumbar vertebral level (P=0.001) muscles. Results indicated significant main effects of “Time” for erector spinae at 3rd lumbar vertebral level offset (P=0.023), significant main effects of “group” for tibialis anterior offset (P= 0.039) and for erector spinae at 3rd lumbar vertebral level offset (P= 0.010).
Conclusion: The selected training program changed the timing of erector spinae at 3rd lumbar vertebral level in older adults with both low back pain and pronated feet during walking.

Keywords

References

[1] Vader K, Donnelly C, French SD, Grady C, Hill JC, Tripp DA, et al. “Implementing a new physiotherapist-led primary care model for low back pain: a qualitative study of patient and primary care team perspectives”. BMC Primary Care. 2022; 23(1): 1-12. https://doi.org/10.1186/s12875-022-01817-5.

[2] Al Sad S, Start AR. “Primary care providers’ experiences treating low back pain”. Journal of Osteopathic Medicine. 2022; 122(5): 263-9. https://doi.org/10.1515/jom-2021-0229.

[3] Rahman MA. “To evaluate the different causes and preventive measures of low back pain: a retrospective study”. SAR J Med. 2021; 2(3): 22-31.

[4] Grabovac I, Dorner TE. “Association between low back pain and various everyday performances”. Wiener Klinische Wochenschrift. 2019; 131(21): 541-9. https://doi.org/10.1007/s00508-019-01542-7.

[5] Bazargan M, Loeza M, Ekwegh T, Adinkrah EK, Kibe LW, Cobb S, et al. “multi-dimensional impact of chronic low back pain among underserved African American and Latino older adults”. International Journal of Environmental Research and Public Health. 2021; 18(14): 7246. https://doi.org/10.3390/ijerph18147246.

[6] Majumder MSM, Hakim F, Bandhan IH, Razzaque MA, Zahid-Al-Quadir A, Ahmed S, et al. “Low back pain in the Bangladeshi adult population: a cross-sectional national survey”. BMJ Open. 2022; 12(9): e059192. https://doi.org/10.1136/bmjopen-2021-059192.

[7] Yang J, Ou Z, Mao Z, Wang Y, Zhong Y, Chen Z, et al. “Reliability and validity of Foot Posture Index (FPI-6) for evaluating foot posture in participants with low back pain”. Research Sququre. 2022. https://doi.org/10.21203/rs.3.rs-1466101/v1.

[8] Madadi-Shad M, Jafarnezhadgero AA, Sheikhalizade H, Dionisio VC. “Effect of a corrective exercise program on gait kinetics and muscle activities in older adults with both low back pain and pronated feet: A double-blind, randomized controlled trial”. Gait & Posture. 2020; 76: 339-45. https://doi.org/10.1016/j.gaitpost.2019.12.026.

[9] Jafarnezhadgero A, Musavi SH, Mehr SMA, Madadi-Shad M. “the long-term wearing of foot orthoses can change the frequency domain of ground reaction forces in children with flexible flat feet”. JPO: Journal of Prosthetics and Orthotics. 2022; 34(1): 22-32. https://doi.org/10.1097/jpo.0000000000000386.

[10] Yar UB. "A review: Biomechanical substitutions during pregnancy and application of orthoses". Journal of University Medical & Dental College. 2022; 13(3): 446-52. https://doi.org/10.37723/jumdc.v13i3.715.

[11] Gevers-Montoro C, Murray KJ, Santamaría B, Dominguez-Vera G, Álvarez-Galovich L, Vindigni D, et al. “Combined chiropractic and podiatric treatment for chronic low back pain concomitant with a unilateral pronated foot: protocol for a multicenter pilot randomized controlled trial”. Journal of Chiropractic Medicine. 2021; 20(4): 177-82. https://doi.org/10.1016/j.jcm.2021.12.012.

[12] Tirtashi FH, Eslami M, Taghipour M. “Effect of shoe insole on the dynamics of lower extremities in individuals with leg length discrepancy during walking”. Journal of Bodywork and Movement Therapies. 2022; 31: 51-6. https://doi.org/10.1016/j.jbmt.2022.03.006.

[13] Castro-Méndez A, Munuera PV, Albornoz-Cabello M. “The short-term effect of custom-made foot orthoses in subjects with excessive foot pronation and lower back pain: a randomized, double-blinded, clinical trial”. Prosthetics and Orthotics International. 2013; 37(5): 384-90. https://doi.org/10.1177/0309364612471370.

[14] Farahpour N, Jafarnezhad A, Damavandi M, Bakhtiari A, Allard P. “Gait ground reaction force characteristics of low back pain patients with pronated foot and able-bodied individuals with and without foot pronation”. Journal of Biomechanics. 2016; 49(9): 1705-10. https://doi.org/10.1016/j.jbiomech.2016.03.056.

[15] Farahpour N, Jafarnezhadgero A, Allard P, Majlesi M. “Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain”. Journal of Electromyography and Kinesiology. 2018; 39: 35-41. https://doi.org/10.1016/j.jelekin.2018.01.006.

[16] Nabavi N, Bandpei MAM, Mosallanezhad Z, Rahgozar M, Jaberzadeh S. “The effect of 2 different exercise programs on pain intensity and muscle dimensions in patients with chronic low back pain: a randomized controlled trial”. Journal of Manipulative and Physiological Therapeutics. 2018; 41(2): 102-10. https://doi.org/10.1016/j.jmpt.2017.03.011.

[17] Chasouraki A, Kourek C, Sianis A, Loritis K, Kostakou P, Tsougos E, et al. “Practical approaches to build and sustain a cardio-oncology clinic”. Journal of Cardiovascular Development and Disease. 2022; 9(5): 158. https://doi.org/10.3390/jcdd9050158.

[18] Motallebi L, Mohseni Bandpei MA, Rahmani N. “Effects of stabilization exercises on pain intensity, functional disability and cross sectional area of multifidus muscle in women with non-specific chronic low back pain”. Journal of Mazandaran University of Medical Sciences. 2013; 23(100): 11-19. https://doi.org/10.1016/j.ultrasmedbio.2013.02.270.

[19] van Tulder M, Malmivaara A, Esmail R, Koes B. “Exercise therapy for low back pain: a systematic review within the framework of the cochrane collaboration back review group”. Spine. 2000; 25(21): 2784-96. https://doi.org/10.1097/00007632-200011010-00011.

[20] Bogduk N. Clinical Anatomy of the Lumbar Spine and Sacrum: Elsevier Health Sciences; 2005.

[21] Singh SK, Khan N, Agarwal R. “Effect of rhythmic stabilization exercise v/s conventional physiotherapy on pain and disability with patients of chronic mechanical low back pain”. The Indian Journal of Physiotherapy & Occupational Therapy. 2019; 13(4): 4122. https://doi.org/10.5958/0973-5674.2019.00146.1.

[22] Kliziene I, Sipaviciene S, Klizas S, Imbrasiene D. “Effects of core stability exercises on multifidus muscles in healthy women and women with chronic low-back pain”. Journal of Back and Musculoskeletal Rehabilitation. 2015; 28(4): 841-7. https://doi.org/10.3233/bmr-150596.

[23] Nelson-Wong E, Callaghan JP. “Is muscle co-activation a predisposing factor for low back pain development during standing? A multifactorial approach for early identification of at-risk individuals”. Journal of Electromyography and Kinesiology. 2010; 20(2): 256-63. https://doi.org/10.1016/j.jelekin.2009.04.009.

[24] Sipaviciene S, Kliziene I. “Effect of different exercise programs on non-specific chronic low back pain and disability in people who perform sedentary work”. Clinical Biomechanics. 2020; 73: 17-27. https://doi.org/10.1016/j.clinbiomech.2019.12.028.

[25] Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: The foot posture index”. Clinical Biomechanics. 2006; 21(1): 89-98. https://doi.org/10.1016/j.clinbiomech.2005.08.002.

[26] Cote KP, Brunet ME, II BMG, Shultz SJ. “Effects of pronated and supinated foot postures on static and dynamic postural stability”. Journal of Athletic Training. 2005; 40(1): 41.

[27] Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The oswestry disability index, the Roland-Morris disability questionnaire, and the Quebec back pain disability scale: translation and validation studies of the Iranian versions”. Spine. 2006; 31(14): E454-E9. https://doi.org/10.1097/01.brs.0000222141.61424.f7.

[28] Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. “Development of recommendations for SEMG sensors and sensor placement procedures”. Journal of Electromyography and Kinesiology. 2000; 10(5): 361-74. https://doi.org/10.1016/s1050-6411(00)00027-4.

[29] Cheung J, Halbertsma JP, Veldhuizen AG, Sluiter WJ, Maurits NM, Cool JC, et al. “A preliminary study on electromyographic analysis of the paraspinal musculature in idiopathic scoliosis”. European Spine Journal. 2005; 14(2): 130-7. https://doi.org/10.1007/s00586-004-0780-7.

[30] de Sèze MP, Cazalets JR. “Anatomical optimization of skin electrode placement to record electromyographic activity of erector spinae muscles”. Surgical and Radiologic Anatomy. 2008; 30(2): 137-43. https://doi.org/10.1007/s00276-007-0289-y.

[31] Mirka GA, Marras WS. “Coactivation during trunk bending”. Spine. 1993; 18(11): 1396-409. https://doi.org/10.1097/00007632-199318110-00003.

[32] Andersen LL, Andersen CH, Mortensen OS, Poulsen OM, Bjørnlund IBT, Zebis MK. “Muscle activation and perceived loading during rehabilitation exercises: comparison of dumbbells and elastic resistance”. Physical Therapy. 2010; 90(4): 538-49. https://doi.org/10.2522/ptj.20090167.

[33] Patterson RM, Jansen CWS, Hogan HA, Nassif MD. “Technical report-material properties of thera-band tubing”. Physical Therapy. 2001; 81(8): 1437-45. https://doi.org/10.1093/ptj/81.8.1437.

[34] Franzke B, Halper B, Hofmann M, Oesen S, Pierson B, Cremer A, et al. “The effect of six months of elastic band resistance training, nutritional supplementation or cognitive training on chromosomal damage in institutionalized elderly”. Experimental Gerontology. 2015; 65: 16-22. https://doi.org/10.1016/j.exger.2015.03.001.

[35] Page P, Ellenbecker TS, Page P. Strength Band Training. Human Kinetics USA; 2005.

[36] Lagally KM, Robertson RJ. “Construct validity of the OMNI resistance exercise scale”. Journal of Strength and Conditioning Research. 2006; 20(2): 252. https://doi.org/10.1519/00124278-200605000-00003.

[37] Clarkson PM, Hubal MJ. “Exercise-induced muscle damage in humans”. American Journal of Physical Medicine & Rehabilitation. 2002; 81(11): S52-S69. https://doi.org/10.1097/00002060-200211001-00007.

[38] Kamonseki DH, Gonçalves GA, Liu CY, Júnior IL. “Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: a randomized controlled single-blind clinical trial”. Manual Therapy. 2016; 23: 76-82. https://doi.org/10.1016/j.math.2015.10.006.

[39] Kordi R, Dehghani S, Noormohammadpour P, Rostami M, Mansournia MA. “Effect of abdominal resistance exercise on abdominal subcutaneous fat of obese women: A randomized controlled trial using ultrasound imaging assessments”. Journal of Manipulative and Physiological Therapeutics. 2015; 38(3): 203-9. https://doi.org/10.1016/j.jmpt.2014.12.004.

[40] Haff GG, Triplett NT. Essentials of Strength Training and Conditioning. 4th edition: Human Kinetics; 2015.

[41] Hanada EY, Johnson M, Hubley-Kozey C. “A comparison of trunk muscle activation amplitudes during gait in older adults with and without chronic low back pain”. PM & R. 2011; 3(10): 920-8. https://doi.org/10.1016/j.pmrj.2011.06.002.

[42] Lamoth CJ, Daffertshofer A, Meijer OG, Beek PJ. “How do persons with chronic low back pain speed up and slow down?: Trunk–pelvis coordination and lumbar erector spinae activity during gait”. Gait & Posture. 2006; 23(2): 230-9. https://doi.org/10.1016/j.gaitpost.2005.02.006.

[43] Vogt L, Pfeifer K, Banzer W. “Neuromuscular control of walking with chronic low-back pain”. Manual Therapy. 2003; 8(1): 21-8. https://doi.org/10.1054/math.2002.0476.

[44] Hunt AE, Smith RM. “Mechanics and control of the flat versus normal foot during the stance phase of walking”. Clinical Biomechanics. 2004; 19(4): 391-7. https://doi.org/10.1016/j.clinbiomech.2003.12.010.

[45] Arab AM, Ghamkhar L, Emami M, Nourbakhsh MR. “Altered muscular activation during prone hip extension in women with and without low back pain”. Chiropractic & Manual Therapies. 2011; 19(1): 18. https://doi.org/10.1186/2045-709x-19-18.

[46] Ferguson SA, Marras WS, Burr DL, Davis KG, Gupta P. “Differences in motor recruitment and resulting kinematics between low back pain patients and asymptomatic participants during lifting exertions”. Clinical Biomechanics. 2004; 19(10): 992-9. https://doi.org/10.1016/j.clinbiomech.2004.08.007.

[47] van der Hulst M, Vollenbroek-Hutten MM, Rietman JS, Hermens HJ. “Lumbar and abdominal muscle activity during walking in subjects with chronic low back pain: support of the “guarding” hypothesis?”. Journal of Electromyography and Kinesiology. 2010; 20(1): 31-8. https://doi.org/10.1016/j.jelekin.2009.03.009.

[48] Begon M, Leardini A, Belvedere C, Farahpour N, Allard P. “Effects of frontal and sagittal thorax attitudes in gait on trunk and pelvis three-dimensional kinematics”. Medical Engineering & Physics. 2015; 37(10): 1032-6. https://doi.org/10.1016/j.medengphy.2015.08.001.

[49] Ntousis T, Mandalidis D, Chronopoulos E, Athanasopoulos S. “EMG activation of trunk and upper limb muscles following experimentally-induced overpronation and oversupination of the feet in quiet standing”. Gait & Posture. 2013; 37(2): 190-4. https://doi.org/10.1016/j.gaitpost.2012.06.028.

[50] Murley GS, Landorf KB, Menz HB, Bird AR. “Effect of foot posture, foot orthoses and footwear on lower limb muscle activity during walking and running: a systematic review”. Gait & Posture. 2009; 29(2): 172-87. https://doi.org/10.1016/j.gaitpost.2008.08.015.

[51] Hunt AE, Smith RM, Torode M. “Extrinsic muscle activity, foot motion and ankle joint moments during the stance phase of walking”. Foot & Ankle International. 2001; 22(1): 31-41. https://doi.org/10.1177/107110070102200105.

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The effect of a selected exercise protocol on trunk and lower limb muscle activity of older adults with both low back pain and pronated feet during walking

References

[2] Al Sad S, Start AR. “Primary care providers’ experiences treating low back pain”. Journal of Osteopathic Medicine. 2022; 122(5): 263-9. https://doi.org/10.1515/jom-2021-0229.

[3] Rahman MA. “To evaluate the different causes and preventive measures of low back pain: a retrospective study”. SAR J Med. 2021; 2(3): 22-31.

[4] Grabovac I, Dorner TE. “Association between low back pain and various everyday performances”. Wiener Klinische Wochenschrift. 2019; 131(21): 541-9. https://doi.org/10.1007/s00508-019-01542-7.

[6] Majumder MSM, Hakim F, Bandhan IH, Razzaque MA, Zahid-Al-Quadir A, Ahmed S, et al. “Low back pain in the Bangladeshi adult population: a cross-sectional national survey”. BMJ Open. 2022; 12(9): e059192. https://doi.org/10.1136/bmjopen-2021-059192.

[7] Yang J, Ou Z, Mao Z, Wang Y, Zhong Y, Chen Z, et al. “Reliability and validity of Foot Posture Index (FPI-6) for evaluating foot posture in participants with low back pain”. Research Sququre. 2022. https://doi.org/10.21203/rs.3.rs-1466101/v1.

[10] Yar UB. "A review: Biomechanical substitutions during pregnancy and application of orthoses". Journal of University Medical & Dental College. 2022; 13(3): 446-52. https://doi.org/10.37723/jumdc.v13i3.715.

[12] Tirtashi FH, Eslami M, Taghipour M. “Effect of shoe insole on the dynamics of lower extremities in individuals with leg length discrepancy during walking”. Journal of Bodywork and Movement Therapies. 2022; 31: 51-6. https://doi.org/10.1016/j.jbmt.2022.03.006.

[15] Farahpour N, Jafarnezhadgero A, Allard P, Majlesi M. “Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain”. Journal of Electromyography and Kinesiology. 2018; 39: 35-41. https://doi.org/10.1016/j.jelekin.2018.01.006.

[17] Chasouraki A, Kourek C, Sianis A, Loritis K, Kostakou P, Tsougos E, et al. “Practical approaches to build and sustain a cardio-oncology clinic”. Journal of Cardiovascular Development and Disease. 2022; 9(5): 158. https://doi.org/10.3390/jcdd9050158.

[19] van Tulder M, Malmivaara A, Esmail R, Koes B. “Exercise therapy for low back pain: a systematic review within the framework of the cochrane collaboration back review group”. Spine. 2000; 25(21): 2784-96. https://doi.org/10.1097/00007632-200011010-00011.

[20] Bogduk N. Clinical Anatomy of the Lumbar Spine and Sacrum: Elsevier Health Sciences; 2005.

[22] Kliziene I, Sipaviciene S, Klizas S, Imbrasiene D. “Effects of core stability exercises on multifidus muscles in healthy women and women with chronic low-back pain”. Journal of Back and Musculoskeletal Rehabilitation. 2015; 28(4): 841-7. https://doi.org/10.3233/bmr-150596.

[24] Sipaviciene S, Kliziene I. “Effect of different exercise programs on non-specific chronic low back pain and disability in people who perform sedentary work”. Clinical Biomechanics. 2020; 73: 17-27. https://doi.org/10.1016/j.clinbiomech.2019.12.028.

[25] Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: The foot posture index”. Clinical Biomechanics. 2006; 21(1): 89-98. https://doi.org/10.1016/j.clinbiomech.2005.08.002.

[26] Cote KP, Brunet ME, II BMG, Shultz SJ. “Effects of pronated and supinated foot postures on static and dynamic postural stability”. Journal of Athletic Training. 2005; 40(1): 41.

[28] Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. “Development of recommendations for SEMG sensors and sensor placement procedures”. Journal of Electromyography and Kinesiology. 2000; 10(5): 361-74. https://doi.org/10.1016/s1050-6411(00)00027-4.

[29] Cheung J, Halbertsma JP, Veldhuizen AG, Sluiter WJ, Maurits NM, Cool JC, et al. “A preliminary study on electromyographic analysis of the paraspinal musculature in idiopathic scoliosis”. European Spine Journal. 2005; 14(2): 130-7. https://doi.org/10.1007/s00586-004-0780-7.

[30] de Sèze MP, Cazalets JR. “Anatomical optimization of skin electrode placement to record electromyographic activity of erector spinae muscles”. Surgical and Radiologic Anatomy. 2008; 30(2): 137-43. https://doi.org/10.1007/s00276-007-0289-y.

[31] Mirka GA, Marras WS. “Coactivation during trunk bending”. Spine. 1993; 18(11): 1396-409. https://doi.org/10.1097/00007632-199318110-00003.

[32] Andersen LL, Andersen CH, Mortensen OS, Poulsen OM, Bjørnlund IBT, Zebis MK. “Muscle activation and perceived loading during rehabilitation exercises: comparison of dumbbells and elastic resistance”. Physical Therapy. 2010; 90(4): 538-49. https://doi.org/10.2522/ptj.20090167.

[33] Patterson RM, Jansen CWS, Hogan HA, Nassif MD. “Technical report-material properties of thera-band tubing”. Physical Therapy. 2001; 81(8): 1437-45. https://doi.org/10.1093/ptj/81.8.1437.

[35] Page P, Ellenbecker TS, Page P. Strength Band Training. Human Kinetics USA; 2005.

[36] Lagally KM, Robertson RJ. “Construct validity of the OMNI resistance exercise scale”. Journal of Strength and Conditioning Research. 2006; 20(2): 252. https://doi.org/10.1519/00124278-200605000-00003.

[37] Clarkson PM, Hubal MJ. “Exercise-induced muscle damage in humans”. American Journal of Physical Medicine & Rehabilitation. 2002; 81(11): S52-S69. https://doi.org/10.1097/00002060-200211001-00007.

[40] Haff GG, Triplett NT. Essentials of Strength Training and Conditioning. 4th edition: Human Kinetics; 2015.

[41] Hanada EY, Johnson M, Hubley-Kozey C. “A comparison of trunk muscle activation amplitudes during gait in older adults with and without chronic low back pain”. PM & R. 2011; 3(10): 920-8. https://doi.org/10.1016/j.pmrj.2011.06.002.

[42] Lamoth CJ, Daffertshofer A, Meijer OG, Beek PJ. “How do persons with chronic low back pain speed up and slow down?: Trunk–pelvis coordination and lumbar erector spinae activity during gait”. Gait & Posture. 2006; 23(2): 230-9. https://doi.org/10.1016/j.gaitpost.2005.02.006.

[43] Vogt L, Pfeifer K, Banzer W. “Neuromuscular control of walking with chronic low-back pain”. Manual Therapy. 2003; 8(1): 21-8. https://doi.org/10.1054/math.2002.0476.

[44] Hunt AE, Smith RM. “Mechanics and control of the flat versus normal foot during the stance phase of walking”. Clinical Biomechanics. 2004; 19(4): 391-7. https://doi.org/10.1016/j.clinbiomech.2003.12.010.

[45] Arab AM, Ghamkhar L, Emami M, Nourbakhsh MR. “Altered muscular activation during prone hip extension in women with and without low back pain”. Chiropractic & Manual Therapies. 2011; 19(1): 18. https://doi.org/10.1186/2045-709x-19-18.

[48] Begon M, Leardini A, Belvedere C, Farahpour N, Allard P. “Effects of frontal and sagittal thorax attitudes in gait on trunk and pelvis three-dimensional kinematics”. Medical Engineering & Physics. 2015; 37(10): 1032-6. https://doi.org/10.1016/j.medengphy.2015.08.001.

[49] Ntousis T, Mandalidis D, Chronopoulos E, Athanasopoulos S. “EMG activation of trunk and upper limb muscles following experimentally-induced overpronation and oversupination of the feet in quiet standing”. Gait & Posture. 2013; 37(2): 190-4. https://doi.org/10.1016/j.gaitpost.2012.06.028.

[50] Murley GS, Landorf KB, Menz HB, Bird AR. “Effect of foot posture, foot orthoses and footwear on lower limb muscle activity during walking and running: a systematic review”. Gait & Posture. 2009; 29(2): 172-87. https://doi.org/10.1016/j.gaitpost.2008.08.015.

[51] Hunt AE, Smith RM, Torode M. “Extrinsic muscle activity, foot motion and ankle joint moments during the stance phase of walking”. Foot & Ankle International. 2001; 22(1): 31-41. https://doi.org/10.1177/107110070102200105.

Volume 14, Issue 1January 2022Pages 129-140

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Volume 14, Issue 1
January 2022
Pages 129-140