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Effect of Fatigue on Mechanical Values of Impulse and Center of Pressure in Obese Male Students with Pronated Feet During a Landing Maneuver
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Amir Ali Jafarnezhadgero *1    , Ehsan Fakhri Mirzanag2 , Farhad Rezazadeh3 |
1- Professor, Department of Sport Biomechanics, University of Mohaghegh Ardabili, Ardabil, Iran. , amiralijafarnezhad@gmail.com
2- Ph.D Candidate in Sport Biomechanics, Department of Sport Biomechanics, University of Mohaghegh Ardabili, Ardabil, Iran.
3- Assistant Professor, Department of Sport Injuries, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran. |
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Keywords: Pronation [MeSH], Foot [MeSH], Fatigue [MeSH], Obesity [MeSH], Kinetics [MeSH]
Article ID: Vol28-05 |
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Type of Study: Original Articles |
Subject:
Sport Biomechanics
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Abstract: (701 Views) |
Extended Abstract
Introduction
Obesity is highly associated with musculoskeletal disorders, such as low back pain, osteoarthritis, and lower extremity injuries, with the most critical issue being the functional impairment of the foot regions. Since the foot serves as the interface between the lower extremity and the ground surface, obesity can apply excessive loads, leading to stress and strain, which consequently predisposes the lower extremity to overload-induced injuries.
The pronated foot is characterized by a decrease in the medial longitudinal arch during weight-bearing in daily living activities. The prevalence of the pronated foot has been reported to range from 48-78% in the youth and approximately 2-23% in adults. Although the pronated foot is considered a significant contributing factor to injuries, such as muscle imbalances and stress and strain loads in the lower extremity, it appears that forefoot varus is compensated through excessive pronation of the subtalar joint. Several factors contribute to the development of excessive foot pronation, including weakness of the posterior leg muscles, ligamentous laxity, overweight, flat feet, genu valgum, calcaneal eversion, and other biomechanical disorders in the lower extremities. However, one of the primary factors in the progression of foot pronation is subtalar joint eversion. When the heel everts, load-bearing forces are transferred to the medial aspect of the foot. Overweight can lead to foot pronation, as the additional load causes subtalar eversion and the collapse of the medial longitudinal arch.
Body mass index (BMI) and increased ground reaction forces (GRF) across all three axes—vertical, anteroposterior, and mediolateral—are associated with the development of knee osteoarthritis. A study demonstrated that gait speed increased in the exercise + diet group compared to the diet-only group. Furthermore, the impulse was significantly lower in both the diet-only and the diet + exercise groups compared to the exercise-only group. The present study aimed to determine the effect of fatigue on the mechanical values of impulse and center of pressure (COP) in obese with pronated feet individuals during a landing maneuver.
Methods
This quasi-experimental study was conducted on 16 male students with healthy feet and normal BMIs (navicular drop: 4 to 10 mm), and 15 obese male students (BMI>30 kg/m²) with pronated feet (navicular drop>10 mm).
The participants’ dominant leg was determined using the ball-kicking test, and all of them were right-footed. An orthopedist evaluated the anthropometric characteristics of all participants before the initiation of the study; participants who exhibited no signs of musculoskeletal or neurological disorders were assigned to the healthy group.
The inclusion criteria consisted of male gender, pronated foot, and a BMI greater than 30 kg/m². The exclusion criteria included hypertension or any other known medical conditions, such as the use of anorectics or weight-loss surgery, the use of prescription medications (including dietary supplements), smoking, and musculoskeletal disorders other than pronated foot.
The navicular drop difference was utilized to diagnose pronated feet among the participants. Specifically, each participant was instructed to sit on a chair and keep their foot in a non-weight-bearing position, during which the distance from the navicular tuberosity to the ground was measured. Subsequently, the participant was asked to stand up and distribute their body weight equally on both feet. In this weight-bearing position, the height from the navicular tuberosity to the plantar surface was measured again. If the difference between these two positions was between 5 to 10 mm, the subject was classified as having a normal foot; however, if it exceeded 10 mm, the subject was considered to have a pronated foot. Additionally, the six-item Foot Posture Index (FPI-6) was employed as a complementary assessment criterion. Participants were asked to stand in the anatomical position with their arms hanging by their sides and to look forward with minimal muscle contraction. The six criteria for the FPI-6 included palpation of the talus bone, mediolateral curvature of the ankle joint, position of the calcaneus in the frontal plane, prominence in the region of the talonavicular joint, variation of the medial longitudinal arch during weight-bearing, and abduction and adduction of the forefoot relative to the rearfoot. Each criterion was scored on a scale ranging from -2 to +2. A scale score between 0 and 5 was considered a normal foot, while a score between 6 and +12 was classified as a pronated foot.
The fatigue protocol was conducted using a flat advanced treadmill (Horizon Fitness, Omega GT, USA). At the onset of the protocol, participants walked at an initial speed of 6 km/h, with the treadmill speed increasing by 1 km/h every 2 minutes. To determine the participants' peak fatigue, the 6-20 Borg Rating of Perceived Exertion (RPE) scale was utilized. Following the completion of the fatigue protocol, participants were instructed to repeat the landing maneuver from a height of 50 cm onto a force plate for three trials.
The Landing Maneuver Implementation Protocol: Prior to the commencement of the test, participants from both groups performed warm-up and stretching exercises for 10 minutes. The participants were instructed to execute the landing maneuver from a 62 cm high platform onto a force plate under two conditions (pre- and post-fatigue) for 3 trials while wearing their athletic shoes.
Ground Reaction Force (GRF): The GRF values were smoothed using a 20 Hz low-pass filter (fourth-order Butterworth filter). Accordingly, the moment of heel strike was defined by the first data point of the vertical GRF exceeding
20 Newton, and the moment of toe-off was determined by the last data point of the vertical GRF falling below 20 Newton. Measuring the GRF values along the three axes (vertical, anterior-posterior, and mediolateral), impulse, and COP values were among the most important kinetic variables associated with musculoskeletal injury patterns during a landing maneuver. The first peak vertical GRF (FzHC) was extracted from the vertical GRF data. The positive peak (FxHC) was calculated from the mediolateral curve occurring immediately after heel strike.
The normality of the data distribution was assessed using the Shapiro-Wilk test. Independent samples t-tests and Chi-square tests were employed for between-group comparisons, while paired t-tests were used for within-group comparisons of the results. The significance level for all tests was set at less than 0.05.
Results
There was a statistically significant difference in the anthropometric characteristics of weight, BMI, navicular drop, waist circumference, waist-to-thigh ratio, and waist-to-height ratio (P<0.001). Furthermore, the results demonstrated an increase in these parameters in the obese with pronated feet group compared to the healthy feet with normal BMIs group.
The mechanical impulse values along the anteroposterior axis in the healthy feet with normal BMIs group (34.69±17.9) were statistically lower than those in the obese with pronated feet group (9.41±2.07) (P<0.004).
There was a statistically significant difference in the mechanical impulse values along the mediolateral axis during a landing maneuver (P<0.036). Specifically, the impulse values along the mediolateral axis were significantly greater in the healthy feet with normal BMIs group (11.34±8.62) compared to the obese with pronated feet group (26.36±6.2).
No statistically significant differences were observed between the two groups during a landing maneuver in other mechanical components, such as the COP in the mediolateral direction and the COP in the anterior-posterior direction.
The results of the within-group analysis showed no statistically significant differences in the mechanical values of vertical impulse, anterior-posterior impulse, mediolateral impulse, mediolateral COP, and anterior-posterior COP in the healthy feet with normal BMIs group between the pre- and post-fatigue protocol during a landing maneuver.
The results of the within-group analysis revealed no statistically significant differences in the mechanical values of vertical impulse, anterior-posterior impulse, mediolateral impulse, mediolateral COP, and anterior-posterior COP in the obese with pronated feet group between the pre- and post-fatigue protocol during a landing maneuver.
Conclusion
Based on the results of this study, the effect of fatigue on the mechanical values of vertical impulse, anteroposterior impulse, mediolateral impulse, mediolateral COP, and anteroposterior COP was not statistically significant during a landing maneuver.
Ethical Statement
This study was approved by the Research Ethics Committees of University of Mohaghegh Ardabili (IR.UMA.REC.1403.062).
Funding
This article has been extracted from the doctoral dissertation of Ehsan Fakhri Mirzanag in Sports Biomechanics at University of Mohaghegh Ardabili, and it was funded (Grant No. 2456) by University of Mohaghegh Ardabili.
Authors' Contributions
Amir Ali Jafarnezhadgero (Ph.D): Project administration and design, Project execution, Interpretation of the results, Drafting of the initial manuscript and Approval of the final manuscript.
Ehsan Fakhri Mirzanag (M.Sc): Project administration and design, Project execution, Data collection, Data analysis, Interpretation of the results, Drafting of the initial manuscript and Approval of the final manuscript.
Farhad Rezazadeh (Ph.D): Project administration and design, Drafting of the initial manuscript and Approval of the final manuscript.
Conflicts of Interest
No conflicts of interest.
Acknowledgement
The authors would like to thank all the participants and experts at the Health and Wellness Center of University of Mohaghegh Ardabili who assisted us in conducting this study.
Key Message: The mechanical impulse components during a landing maneuver exhibited a statistically significant decrease in obese with pronated feet individuals compared to healthy feet with normal BMIs individuals. However, the fatigue protocol did not cause any alterations in the impulse values. |
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Jafarnezhadgero A A, Fakhri Mirzanag E, Rezazadeh F. Effect of Fatigue on Mechanical Values of Impulse and Center of Pressure in Obese Male Students with Pronated Feet During a Landing Maneuver. J Gorgan Univ Med Sci 2026; 28 (1) :38-47 URL: http://goums.ac.ir/journal/article-1-4585-en.html
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