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Phys. Ther. Korea 2024; 31(1): 40-47
Published online April 20, 2024
https://doi.org/10.12674/ptk.2024.31.1.40
© Korean Research Society of Physical Therapy
Comparison of Foot Pressure Distribution During Single-leg Squat in Individuals With and Without Pronated Foot
Il-kyu Ahn1,2 
, PT, BPT, Gyeong-tae Gwak2 , PT, PhD, Ui-jae Hwang2 , PT, PhD, Hwa-ik Yoo2 , PT, PhD, Oh-yun Kwon2,3 , PT, PhD
1Department of Physical Therapy, The Graduate School, Yonsei University, 2Kinetic Ergocise Based on Movement Analysis Laboratory, 3Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea
Correspondence to: Oh-yun Kwon
E-mail: kwonoy@yonsei.ac.kr
https://orcid.org/0000-0002-9699-768X
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Single-leg squat (SLS)s are commonly used as assessment tool and closed kinetic exercises are useful for assessing performance of the lower extremities. Pronated feet are associated with foot pressure distribution (FPD) during daily activities.
Objects: To compare the FPD during SLSs between groups with pronated and normal feet.
Methods: This cross-sectional study included 30 participants (15 each in the pronated foot and control groups) are recruited in this study. The foot posture index was used to distinguish between the pronated foot and control groups. The Zebris FDM (Zebris Medical GmbH) stance analysis system was used to measure the FPD on the dominant side during a SLS, which was divided into three phases. A two-way mixed-model ANOVA was used to identify significant differences in FPD between and within the two groups.
Results: In the hallux, the results of the two-way mixed-model ANOVAs revealed a significant difference between the group and across different phases (p < 0.05). The hallux, and central forefoot were significantly different between the group (p < 0.05). Moreover, significant differences across different phases were observed in the hallux, medial forefoot, central forefoot, lateral forefoot, and rearfoot (p < 0.05). The post hoc t-tests were conducted for the hallux and forefoot central regions. In participants with pronated foot, the mean pressure was significantly greater in hallux and significantly lower, in the central forefoot during the descent and holding phases.
Conclusion: SLSs are widely used as screening tests and exercises. These findings suggest that individuals with pronated feet should be cautious to avoid excessive pressure on the hallux during the descent-to-hold phase of a SLS.
Keywords: Biomechanics, Flatfoot, Pressure
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Original Article
Phys. Ther. Korea 2024; 31(1): 40-47
Published online April 20, 2024 https://doi.org/10.12674/ptk.2024.31.1.40
Copyright © Korean Research Society of Physical Therapy.
Comparison of Foot Pressure Distribution During Single-leg Squat in Individuals With and Without Pronated Foot
Il-kyu Ahn1,2 , PT, BPT, Gyeong-tae Gwak2 , PT, PhD, Ui-jae Hwang2 , PT, PhD, Hwa-ik Yoo2 , PT, PhD, Oh-yun Kwon2,3 , PT, PhD
1Department of Physical Therapy, The Graduate School, Yonsei University, 2Kinetic Ergocise Based on Movement Analysis Laboratory, 3Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea
Correspondence to:Oh-yun Kwon
E-mail: kwonoy@yonsei.ac.kr
https://orcid.org/0000-0002-9699-768X
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Single-leg squat (SLS)s are commonly used as assessment tool and closed kinetic exercises are useful for assessing performance of the lower extremities. Pronated feet are associated with foot pressure distribution (FPD) during daily activities.
Objects: To compare the FPD during SLSs between groups with pronated and normal feet.
Methods: This cross-sectional study included 30 participants (15 each in the pronated foot and control groups) are recruited in this study. The foot posture index was used to distinguish between the pronated foot and control groups. The Zebris FDM (Zebris Medical GmbH) stance analysis system was used to measure the FPD on the dominant side during a SLS, which was divided into three phases. A two-way mixed-model ANOVA was used to identify significant differences in FPD between and within the two groups.
Results: In the hallux, the results of the two-way mixed-model ANOVAs revealed a significant difference between the group and across different phases (p < 0.05). The hallux, and central forefoot were significantly different between the group (p < 0.05). Moreover, significant differences across different phases were observed in the hallux, medial forefoot, central forefoot, lateral forefoot, and rearfoot (p < 0.05). The post hoc t-tests were conducted for the hallux and forefoot central regions. In participants with pronated foot, the mean pressure was significantly greater in hallux and significantly lower, in the central forefoot during the descent and holding phases.
Conclusion: SLSs are widely used as screening tests and exercises. These findings suggest that individuals with pronated feet should be cautious to avoid excessive pressure on the hallux during the descent-to-hold phase of a SLS.
Keywords: Biomechanics, Flatfoot, Pressure
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Table 1 . General characteristics of the study participants.
Variable Total (N = 30) Pronated foot group (n = 15) Normal foot group (n = 15) p - valueAge (y) 26.03 ± 3.07 26.40 ± 3.11 25.67 ± 3.37 0.930 Height (cm) 171.41 ± 7.43 169.87 ± 6.76 173.07 ± 7.51 0.497 Body mass (kg) 67.62 ± 10.11 68.13 ± 9.69 67.07 ± 9.20 0.483 Values are presented as mean ± standard deviation..
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Table 2 . Foot pressure distribution during single-leg squat in three different phases.
Foot pressure Pronated foot group Normal foot group p - valueDescent Hold Ascent Descent Hold Ascent Group Time Group x Time Hallux 19.69 ± 4.47 22.63 ± 5.61 16.27 ± 4.89 11.33 ± 4.93 13.70 ± 6.88 12.13 ± 6.23 0.001* < 0.001* 0.015* Forefoot medial 7.42 ± 1.56 8.77 ± 2.63 7.35 ± 2.48 7.78 ± 2.58 8.74 ± 2.45 8.80 ± 1.81 0.435 0.024* 0.187 Forefoot central 9.20 ± 2.91 9.59 ± 2.91 9.05 ± 3.09 12.51 ± 3.70 12.77 ± 2.30 11.03 ± 1.73 0.007* 0.073 0.312 Forefoot lateral 7.59 ± 1.60 7.50 ± 1.94 8.00 ± 2.23 8.30 ± 1.49 8.39 ± 2.05 7.95 ± 2.70 0.453 0.997 0.352 Medial/lateral ratio 1.03 ± 0.29 1.25 ± 0.44 1.01 ± 0.48 0.98 ± 0.33 1.14 ± 0.48 1.22 ± 0.42 0.923 0.054 0.096 Rearfoot 9.15 ± 2.56 7.48 ± 3.61 9.88 ± 3.63 10.17 ± 3.57 8.87 ± 3.66 11.45 ± 3.96 0.263 0.001* 0.903 Values are presented as mean ± standard deviation. *Statistical significance is set at the 0.05 level..