Validity of KineFeet for Assessing Medial Longitudinal Arch Deformation During Gait in Individuals with Flat and Non–Flat Feet
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Published:
Dec 24, 2025
Keywords:
KineFeet; medial longitudinal arch; gait analysis; flat feet; navicular drop test; depth camera.
Main Article Content
Abstract
Background: Accurate assessment of medial longitudinal arch (MLA) deformation during gait is essential for diagnosing and managing foot-related musculoskeletal disorders. KineFeet is a novel, depth-camera–based web application developed for real-time foot kinematic analysis. This study aimed to evaluate the validity of KineFeet in measuring MLA angles during the stance phase of walking.
Methods: A total of 89 healthy adults (74.2% female; mean age: 30.9 ± 2.5 years) were recruited and classified into flat-footed and non-flat-footed groups based on the navicular drop test. Each participant walked on a treadmill while MLA angles were recorded using KineFeet and manually measured using Kinovea software as a reference. Measurements were taken across seven subphases of the stance phase. Statistical agreement and correlation with static foot posture were analyzed.
Results: In non-flat-footed individuals, MLA angles obtained from KineFeet showed no significant differences compared to Kinovea across all stance subphases (p > 0.05), indicating good validity. However, in flat-footed participants, significant discrepancies were observed in the initial contact, loading response, and midstance phases (p < 0.05). Weak positive correlations were found between navicular drop test scores and dynamic MLA angles, particularly during initial contact, hallux extension, and initial swing (r = 0.23–0.29).
Conclusion: KineFeet demonstrated acceptable validity for assessing medial longitudinal arch (MLA) dynamics in individuals with normal foot posture and showed potential for clinical use in detecting flexible flatfoot deformities during walking. Further algorithm refinement is recommended to enhance its accuracy, particularly for early stance phases in individuals with flat feet.
Methods: A total of 89 healthy adults (74.2% female; mean age: 30.9 ± 2.5 years) were recruited and classified into flat-footed and non-flat-footed groups based on the navicular drop test. Each participant walked on a treadmill while MLA angles were recorded using KineFeet and manually measured using Kinovea software as a reference. Measurements were taken across seven subphases of the stance phase. Statistical agreement and correlation with static foot posture were analyzed.
Results: In non-flat-footed individuals, MLA angles obtained from KineFeet showed no significant differences compared to Kinovea across all stance subphases (p > 0.05), indicating good validity. However, in flat-footed participants, significant discrepancies were observed in the initial contact, loading response, and midstance phases (p < 0.05). Weak positive correlations were found between navicular drop test scores and dynamic MLA angles, particularly during initial contact, hallux extension, and initial swing (r = 0.23–0.29).
Conclusion: KineFeet demonstrated acceptable validity for assessing medial longitudinal arch (MLA) dynamics in individuals with normal foot posture and showed potential for clinical use in detecting flexible flatfoot deformities during walking. Further algorithm refinement is recommended to enhance its accuracy, particularly for early stance phases in individuals with flat feet.
Article Details
How to Cite
Anestherita, F., Tulaar, A. B. M., Rachmawati, M. R., Yunir, E., Saksono Harbuwono, D., Wedhani, R. A., Safri, A. Y., Rachmadi, M. F., Nadhif, M. H., M, A. N. H., Wahyuni, L. K., ., N., Nugraha, B., Fianita, F., Saputri, T. N., & Putri, S. N. (2025). Validity of KineFeet for Assessing Medial Longitudinal Arch Deformation During Gait in Individuals with Flat and Non–Flat Feet. Indonesian Journal of Physical Medicine and Rehabilitation, 14(2), 170 - 176. https://doi.org/10.36803/indojpmr.v14i2.492
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Original Article
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12. Zifchock R, Parker R, Wan W, Neary M, Song J, Hillstrom H. The relationship between foot arch flexibility and medial-lateral ground reaction force distribution. Gait Posture 2019;69:46. https://doi.org/10.1016/j.gaitpost.2019.01.012.
13. Kelly LA, Lichtwark GA, Cresswell AG. Active regulation of longitudinal arch compression and recoil during walking and running. J Royal Soc Interface 2014;12:20141076. https://doi.org/10.1098/rsif.2014.1076.
14. Nourbakhsh S, Sheikhhoseini R, Piri H, Soltani F, Ebrahimi E. Spatiotemporal and kinematic gait changes in flexible flatfoot: A systematic review and meta-analysis. J Orthop Surg Res 2025;20. https://doi.org/10.1186/s13018-025-05649-8.
2. Flores DV, Gómez CM, Hernando MF, Davis MA, Pathria MN, et al. Adult acquired flatfoot deformity: Anatomy, biomechanics, staging, and imaging findings. Radiographics 2019;39:1437. https://doi.org/10.1148/rg.2019190046.
3. Miyazaki T, Kawada M, Kiyama R, Yone K. Validity of two-dimensional analyses for the assessment of dynamic foot alignment during walking. Research Square 2020. https://doi.org/10.21203/rs.3.rs-27020/v1.
4. McPoil TG, Vicenzino B, Cornwall M, Collins NJ, Warren M. Reliability and normative values for the foot mobility magnitude: A composite measure of vertical and medial-lateral mobility of the midfoot. J Foot Ankle Res 2009;2. https://doi.org/10.1186/1757-1146-2-6.
5. Buldt AK, Murley GS, Levinger P, Menz HB, Nester C, Landorf KB. Are clinical measures of foot posture and mobility associated with foot kinematics when walking? J Foot Ankle Res 2015;8. https://doi.org/10.1186/s13047-015-0122-5.
6. Marouvo J, Sousa F, Fernandes O, Castro MA, Paszkiel S. Gait kinematics analysis of flatfoot adults. Appl Sci 2021;11:7077. https://doi.org/10.3390/app11157077.
7. Morrison KE, Kaminski TW. Foot characteristics in association with inversion ankle injury. PubMed 2007;42:135.
8. Anestherita F, Hasbiandra RA, Kusumaningsih W, Lakmudin A, Handoko H. Inter-observer reliability of Kinovea® software in dynamic foot posture analysis in healthy population. F1000Research 2024;13:1533. https://doi.org/10.12688/f1000research.157736.1.
9. Neville CG, Flemister AS, Houck J. Effect of walking speed on plantar loading and foot kinematics in subjects with stage II posterior tibial tendon dysfunction. n.d.
10. Stolwijk NM, Koenraadt KLM, Louwerens JWK, Grim DC, Duysens J, Keijsers N. Foot lengthening and shortening during gait: A parameter to investigate foot function? Gait Posture 2013;39:773. https://doi.org/10.1016/j.gaitpost.2013.10.014.
11. Buldt AK, Levinger P, Murley GS, Menz HB, Nester C, Landorf KB. Foot posture is associated with kinematics of the foot during gait: A comparison of normal, planus, and cavus feet. Gait Posture 2015;42:42. https://doi.org/10.1016/j.gaitpost.2015.03.004.
12. Zifchock R, Parker R, Wan W, Neary M, Song J, Hillstrom H. The relationship between foot arch flexibility and medial-lateral ground reaction force distribution. Gait Posture 2019;69:46. https://doi.org/10.1016/j.gaitpost.2019.01.012.
13. Kelly LA, Lichtwark GA, Cresswell AG. Active regulation of longitudinal arch compression and recoil during walking and running. J Royal Soc Interface 2014;12:20141076. https://doi.org/10.1098/rsif.2014.1076.
14. Nourbakhsh S, Sheikhhoseini R, Piri H, Soltani F, Ebrahimi E. Spatiotemporal and kinematic gait changes in flexible flatfoot: A systematic review and meta-analysis. J Orthop Surg Res 2025;20. https://doi.org/10.1186/s13018-025-05649-8.