An easily applicable method to analyse the ankle-foot power absorption and production during walking

Background: Power and work at the ankle joint during gait are usually computed considering the foot as a rigid body [1 -6] (Ankle Joint method, AJ). The foot is instead a deformable structure and can absorb and produce work by pronation/supination, foot arch deformation and other intrinsic movements. A different approach, named "the Distal Shank method (DS)" [7-12] considers all these aspects without increasing the complexity of the protocol, and thus it seems promising for clinical applications [12].Research questions: a) To characterize the differences in power and work computed using the two mentioned methods for a relatively large number of subjects walking at different velocities, barefoot and with different shoes; b) To assess the practical feasibility of the DS method for clinical applications.Materials and methods: Eighteen healthy subjects were evaluated while walking barefoot at slow, natural and fast velocity. Shod walking was analysed at natural velocity. Four subjects were also analysed while walking in high-heel shoes. The power at the ankle joint was computed with both the AJ and the DS methods. We then compared the obtained results.Results: The DS method showed a consistent negative peak of power absorption during the load acceptance phase, barely visible with the AJ method. The maximum power production calculated with the DS method was significantly lower. The work at the end of the stride cycle was lower with the DS method, and in most conditions even negative, thus indicating higher energy dissipation.Significance: We confirmed on a large cohort of healthy subjects and in different walking conditions that neglecting foot deformations during gait leads to underestimate power absorption and overestimate power production. The DS method does not require a complex gait analysis protocol, nor additional time for the analysis, and can provide information of clinical interest, related to foot mechanical alterations