Effects Of Athletic Shoes Collar Height On Foot And Ankle Biomechanics During Side-cutting Maneuvers Based On High Speed Fluoroscopic Image System

Objective:Foot and Ankle injury is one of the most common injuries and may affect the athlete’s sports career and even be disabling.This injury occurs frequently in the ankle joint and is more common when athletes perform side cutting movements.As a commonly used equipment to protect the foot and ankle,high-top athletic shoes can theoretically prevent people injury by limiting the range of motion of the foot and ankle.However,the real and accurate effects of high-top athletic shoes on the in vivo joint movement and ligament strain in the ankle joint and talocalcaneal joint during side cutting movement are debated.The debate lies in the fact that sports shoes cover the collection of foot and ankle movements,it is invasive to collect foot and ankle movements by implanting bone nails,punching holes in shoes may destroy the shoe’s structure,and the traditional three-dimensional motion capture system can only collect the movement of shoes relative to the lower leg by means of the reflective marker attached on the shoe upper.The aboved limitations make researchers unable to obtain the in vivo six degrees of freedom movement of the foot and ankle,so that the problem has been in the stage of speculation and inference.Solving this problem will help us to deeply explore the potential risk factors causing foot and ankle injury and explore the role of high-top athletic shoes in the protection of foot and ankle injury.Therefore,the objective of this study was to:(1)provide a theoretical basis for researchers to select appropriate foot and ankle movement test methods;(2)provide more knowledge of foot and ankle kinematic characteristics such as in vivo joint movement and ligament strain inside the ankle and talocalcaneal joints during side cutting movements and further explore the effect of shoe upper height on the risk of foot and ankle injury;(3)further investigate the effect of shoe upper height on foot and ankle injury by obtaining foot and ankle dynamics such as lateral collateral ligament tension and ankle and talocalcaneal joint reaction force.Methods:Sixteen recreational basketball players were participanted in this study,and ankle kinematic and kinetic data were simultaneously collected from subjects while barefoot,wearing low-top basketball shoes,and high-top basketball shoes to complete a 90 ° sidestep cutting movement using a traditional three-dimensional motion capture system,a three-dimensional force plate,and a dural fluoroscopic image system.Foot slice images were obtained from magnetic resonance imaging(MRI)and the bones of the tibia,talus,and calcaneus were modeled,combined with two-dimensional/three-dimensional(2D/3D)registration techniques to obtain the six degrees of freedom data of the ankle-and subtalar joints during sidestep cutting movements,and ligament models were established according to the ligament starting and ending point positions marked on the bones by MRI images,and ligament length and strain were calculated using a self-made script based on the result of 2D/3D registration,and then to investigate the strain characteristics of the lateral collateral ligament of the ankle joint during side cutting movements and to explore the differences among different shoe wearing conditions.The ligament force and joint reaction force were further calculated using the method of opensim model simulation,to explore the difference of aboved parameters among the three shoe wearing conditions.Two-way ANOVA with repeated measures was used to examine the effect of test method and shoe upper height on evaluating the relative tibial rotational motion of the calcaneus.One-way ANOVA with repeated measures was used to test the six degrees of freedom of the ankle-and subtalar joints,strain of the ankl lateral collateral ligament,ligament force,and joint reaction force of the ankle-and subtalar joints during the sidestep cutting movement,and Bonferroni’s method was used for post-hoc tests with the significance set at 0.05.Results:(1)The range of motion of plantar flextion/dorsiflexion and inversion and eversion in the motion of calcaneus relative to the tibia during the side cutting movement measured by Mocap were significantly greater than those measured by DFIS(P < 0.05),while the internal and external rotation range of motion was less than that measured by DFIS(P < 0.05).(2)Compared with the barefoot condition,the doriflexion angle,plantar flexion/dorsiflexion range of motion,and peak external rotation angle of the ankle joint were significantly decreased(P < 0.05);the maximum plantar flexion angle,range of motion of dorsiflection and plantar flexion,maximum inversion angle,inversion and eversion range of motion,maximum internal rotation,and internal and external rotation range of motion of the subtalar joint were significantly decreased(P < 0.05)when the subjects completed the sidestep cutting maneuvers on the shod condition.There were no statistically significant differences(P > 0.05)between high-and low top basketball shoes in the 6DOF movement of the talocrural and subtalar joints and ankle lateral collateral ligament strain during the sidestep cutting movement(P<0.05).(3)Compared with barefoot condtion,the peak calcaneofibular ligament force was significantly decreased when the subjects wore high-top and low-top basketball shoes during sidestep cutting movement(P < 0.05);the peak posterior talofibula ligament ligament force of the was significantly decreased when the subjects wore high-top basketball shoes during sidestep cutting movement(P< 0.05);Joint reaction forces in the medial and lateral directions of the ankle and talocalcaneal joints were significantly increased when subjects wore high-top shoes compared with the barefoot and low-top shoes condition(P < 0.05).Conclusions:(1)The traditional three-dimensional motion capture method overestimates range of motion of plantar flexion/dorsiflexion,varus/valgus,and underestimate the internal/external range of motion of the tibiotalar-and subtalar joints compared with DFIS.(2)Compared with barefoot conditon,the athletic shoes can provide more support and protection to the ankle joint for the healthy individules;compared with low-top basketball shoes,wearing high-top basketball shoes does not reduce ankle lateral collateral ligament strain and strain rate,which in turn does not reduce the risk of this ligament injury.(3)Compared with barefoot and low-top basketball shoes,the lateral shear forces of the ankle and talocalcaneal joints were significantly increased during side-cutting movements in high-top basketball shoes.Frequent side-cutting movements in basketball games may increase the articular cartilage injury in the ankle and talocalcaneal joints.