Introduction The six-item Foot Posture Index (FPI-6) was previously developed as an assessment tool to measure the posture of the foot across multiple segments and planes. It was derived from a criterion-based observational assessment of six components of each foot during static standing. The association between abnormal foot posture and musculoskeletal injuries remains unclear and is in of need further exploration. Hypothesis/Purpose The purpose of this study was to assess the association between foot biomechanics and self-reported history of musculoskeletal pain or injury. Study Design Retrospective, cross-sectional study of collegiate football players at the U.S. Naval Academy. Materials and Methods For each athlete, data were recorded on height, weight, self-reported history of pain or injury, and foot posture, which was measured using a FPI-6 with each item measuring the degree of pronation/supination. The primary outcome was each athlete’s maximum deviation from neutral posture across the six-item index (FPImax). The prespecified primary analysis used generalized linear models to measure the association between FPImax and self-report history of pain or injury. Exploratory analyses measured the association using penalized regression (L1-norm) and a type of tree-based ensemble known as extreme gradient boosting (XGBoost). Results Data were collected on 101 athletes, 99 of whom had sufficient body mass index (BMI) data to be included for analysis. Among the 99 athletes, higher FPImax was associated with a prior history of musculoskeletal pain (odds ratio [OR] 1.15, 95% confidence interval [CI] 0.97 to 1.35), although the sample size was too small for the association to be significant with 95% CI (P = .107). FPImax was not associated with a history of knee injury/pain (OR 0.98, 95% CI 0.83 to 1.15, P = .792), nor with a history of ankle/foot injury or pain (OR 1.04, 95% CI 0.90 to 1.21, P = .599). From the L1-penalized model, the FPI components with the strongest linear associations were the L6, R2, R1-squared, and FPImax. From the XGBoost model, the most important variables were FPItotal, BMI, R1, and R2. Conclusions The U.S. Naval Academy football players whose foot postures deviated from neutral were more likely to have reported a previous history of musculoskeletal pain. However, this deviation from normal was not strongly associated with a specific history of pain or injury to the knee, ankle, or foot. Clinical Relevance The information ascertained from this study could be used to better inform clinicians about the value of the FPI in predicting or mitigating injuries for varsity football athletes.

中文翻译：

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美国海军学院足球运动员足部生物力学和损伤史的回顾性研究

简介 六项足部姿势指数 (FPI-6) 以前是作为评估工具开发的，用于测量跨多个部分和平面的足部姿势。它是从静态站立期间每只脚的六个组件的基于标准的观察评估得出的。足部姿势异常与肌肉骨骼损伤之间的关系仍不清楚，需要进一步探索。假设/目的 本研究的目的是评估足部生物力学与自我报告的肌肉骨骼疼痛或损伤病史之间的关联。研究设计 美国海军学院大学橄榄球运动员的回顾性横断面研究。材料和方法 对于每位运动员，记录有关身高、体重、自我报告的疼痛或受伤史以及足部姿势的数据，这是使用 FPI-6 测量的，每个项目测量旋前/旋后的程度。主要结果是每位运动员在六项指数 (FPImax) 中与中立姿势的最大偏差。预先指定的主要分析使用广义线性模型来测量 FPImax 与自我报告的疼痛或损伤史之间的关联。探索性分析使用惩罚回归 (L1-norm) 和一种称为极端梯度提升 (XGBoost) 的基于树的集成来测量关联。结果 收集了 101 名运动员的数据，其中 99 人有足够的体重指数 (BMI) 数据进行分析。在 99 名运动员中，较高的 FPImax 与既往肌肉骨骼疼痛史相关（优势比 [OR] 1.15，95% 置信区间 [CI] 0.97 至 1.35），虽然样本量太小，但相关性在 95% CI 下不显着（P = .107）。FPImax 与膝关节损伤/疼痛史无关（OR 0.98，95% CI 0.83 至 1.15，P = .792），也与踝/足损伤或疼痛史无关（OR 1.04，95% CI 0.90 至 1.21 , P = .599)。在 L1 惩罚模型中，具有最强线性关联的 FPI 分量是 L6、R2、R1 平方和 FPImax。在 XGBoost 模型中，最重要的变量是 FPItotal、BMI、R1 和 R2。结论 足部姿势偏离中立位的美国海军学院足球运动员更有可能报告先前的肌肉骨骼疼痛病史。然而，这种与正常值的偏差与膝、踝或足部疼痛或损伤的特定病史没有密切关系。