Integrated Multi-Axial Posture Theory™



Biomechanics integration as a concept involves the consideration of the human body in its entire complexity wherein each individual articulation is a part of a well-connected chain with spheres of influence ranging between distal to proximal in relation to the problematic area.

The functional integration of the foot and ankle becomes an area of prime interest in this regard especially when examining the chain reaction it sets forth during the gait cycle.

Advancements in technology and instrumentation have contributed largely towards the better understanding and analysis of the foot and ankle motion. The dynamic link of the foot and ankle becomes more evident as we study the different phases of gait starting from heel strike to toe-off.

One of the three main joints in the foot, the talocrural joint or the ankle is supported by three bones namely the tibia, the fibula and the talus, which when combined together with the anterior and posterior muscles, allow for movement in the lower limbs.

These movements could either involve the top portion of the foot moving towards the leg (dorsiflexion) or away from it (plantar flexion). In addition to supporting the weight of the body in motion, the bones in the ankle and foot are responsible for propulsion and balance which are also essential to the whole process of walking.

The integrated multi-axial postural function, caused as a result of this union, leads to constant postural adjustments and readjustments the body undertakes on variable terrains and at variable speeds.

This is at the core of optimal foot biomechanics, necessitating the need to recognise the function of all the articulations in the foot and ankle rather than focusing on a single site of pathology or dysfunction or standard of care.

Another important aspect of foot functionality is its multi-axial capabilities which are required for adaptability to uneven terrain while walking. It is the ankle which permits movement of the foot in multiple planes; a fact which, along with the optimal arch of the foot, should remain central to the manufacturing of orthotics.

This approach is needed to primarily reflect the correct posture and alignment of the foot while providing for transient changes occurring in the lower limbs during motion.

Postural stability is crucial to boost optimal articulation alignment which, in turn, facilitates optimal arthrokinematics of the foot and ankle.

A high-calibre orthotic must enhance balance and posture of the body by performing a proprioception input function from the plantar surface of the foot proximally to to the central nervous system, throughout all types of daily activities.

Integrated Multi-Axial Posture Theory looks at establishing a foot posture which results in optimum neuromuscular efficiency, reducing the stress placed on the entire kinetic chain so that tasks can be performed with the least amount of energy.

For this purpose, it is necessary to ensure that all articulations work well within their natural ranges of motion (ROM) to produce the greatest productive force while maintaining full functionality in the foot.

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References:

  1. Keith Rome, Douglas Richie Jr., Anna Lucy Hatton (2010) Can Orthoses And Insoles Have An Impact On Postural Stability? PodiatryToday: October 2010, Vol. 23, Issue 10.

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