Evidence map›Paper›PMID 41865148›Full record

ArticleAnnals of biomedical engineering2026

Foot Progression Angle Modulates Knee Loading During Walking in Individuals with Flexible Flatfoot.

Linxiao Shen, Zhenghui Lu, Xin Li, Zifan Xia, Yufan Xu, Chengyuan Zhu, Yang Song, Xuanzhen Cen, Dong Sun, Gusztáv Fekete and 1 more

Abstract read
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In one paragraph

Article in Annals of biomedical engineering, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Linxiao ShenFaculty of Sports Science, Ningbo University, Ningbo, China.
Zhenghui LuFaculty of Engineering, University of Pannonia, Veszprém, Hungary.
Xin LiFaculty of Engineering, University of Pannonia, Veszprém, Hungary.
Zifan XiaFaculty of Sports Science, Ningbo University, Ningbo, China.
Yufan XuFaculty of Sports Science, Ningbo University, Ningbo, China.
Chengyuan ZhuFaculty of Sports Science, Ningbo University, Ningbo, China.
Yang SongFaculty of Sports Science, Ningbo University, Ningbo, China.
Xuanzhen CenFaculty of Sports Science, Ningbo University, Ningbo, China.
Dong SunFaculty of Sports Science, Ningbo University, Ningbo, China. sundong@nbu.edu.cn.ORCID http://orcid.org/0000-0002-7634-5668
Gusztáv FeketeFaculty of Engineering, University of Pannonia, Veszprém, Hungary.
Yaodong GuFaculty of Sports Science, Ningbo University, Ningbo, China. guyaodong@nbu.edu.cn.

Funding

Joint Fund of Zhejiang Provincial Natural Science Foundation of China LKLY26H170001National Key R&D Program of China 2024YFC3607305Ningbo Clinical Research Center for Orthopedics and Exercise Rehabilitation No.2024L004Ningbo key R&D Program 2022Z196Research Academy of Medicine Combining Sports, Ningbo No.2023001Scientific Research Fund of Zhejiang Provincial Education Department Y202559510Zhejiang Provincial Key Project of Education Science Planning 2025SB084Zhejiang Rehabilitation Medical Association Scientific Research Special Fund ZKKY2023001
6 · The paper itself

Abstract

purposeThis study evaluated tibiofemoral loading and medial meniscal stress distribution in individuals with flexible flatfoot (FFF) during walking under different foot progression angle (FPA) conditions.

methodsThis study analyzed the gait of 28 FFF patients (16 males, 12 females) under three FPA conditions (neutral, toe-in, toe-out). Kinematic (Vicon) and kinetic (Kistler) data were used to estimate tibiofemoral forces in OpenSim. Subsequently, joint angles and muscle forces at peak tibiofemoral forces were used to drive a finite element (FE) model of the knee, enabling the comparison of meniscal von Mises stress, maximum shear stress, and contact pressure across FPA conditions.

resultsTibiofemoral force increased during early stance (9-11%) in the toe-in condition with this increase reaching statistical significance in males (p = 0.008, mean partial

conclusionAdjusting FPA modulates intra-articular knee loading via the kinetic chain. For FFF patients, neutral FPA provides stable loading. The toe-in condition presents a complex mechanism: despite increasing tibiofemoral force (notably in males), it reduces peak stress by altering contact mechanics and stress distribution. Therefore, FFF gait interventions must be individualized based on factors like foot morphology, sex, and functional goals.

Indexed as

BiomechanicsFinite element analysisFlexible flatfootFoot progression angleKnee joint

Identifiers

PMID41865148

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.