Associations Between Limited Dorsiflexion Under Load and Compensatory Hip/Pelvic Gait Patterns in Healthy Adults

Abstract

Background/Objectives: Limited ankle dorsiflexion has been associated with compensatory movement patterns throughout the lower extremity kinematic chain. This study investigated relationships between weight-bearing dorsiflexion capacity and lower limb kinematics and plantar pressure patterns during gait.
Methods: Twenty-seven healthy adults (age: 22.8 ± 3.4 years) performed a weight-bearing lunge test (WBLT) and walked at a standardized pace across a pressure-sensing walkway while wearing inertial measurement units. Statistical Parametric Mapping assessed correlations between WBLT dorsiflexion and kinematic variables throughout the stance phase. Partial correlations controlled for walking velocity and were used to examine relationships with discrete plantar pressure measurements.
Results: Reduced dorsiflexion capacity during the WBLT showed bilateral moderate associations with less ankle dorsiflexion (LEFT: peak r = 0.53; RIGHT: peak r = 0.60) and knee flexion (LEFT: peak r = 0.56; RIGHT: peak r = 0.58) during terminal stance and push-off. Proximal compensations demonstrated limb-specific patterns. Hip abduction was strongly negatively correlated in the left leg only (peak r = −0.65), while pelvic tilt showed bilateral relationships with opposing temporal patterns (LEFT: peak r = −0.58 early stance; RIGHT: peak r = 0.62 terminal stance). Plantar pressure analysis revealed that reduced dorsiflexion was associated with decreased heel relative impulse bilaterally (r = 0.53–0.56) and altered temporal patterns of midfoot loading on the left leg (r = 0.56).
Conclusions: Limited dorsiflexion under load is associated with compensatory movement patterns extending from the ankle to the pelvis bilaterally. The evaluation of loaded ankle mobility should be considered an essential component of lower extremity movement assessment.