Assessment of Biomechanical Parameters and Their Correlation During Barefoot Walking and Arch-Building Gait in Plantar Fasciitis Using a Dynamic Gait Analysis System: A Cross-Sectional Study.

Background Plantar fasciitis (PF) is one of the most common causes of heel pain and is associated with significant functional limitation and reduced quality of life. Alterations in foot biomechanics and plantar pressure distribution are considered key contributors. Short foot exercises effectively strengthen intrinsic foot muscles, improve arch support, and dynamic stability. We can incorporate the arch-building gait as a short-foot exercise. This study aims to evaluate and compare biomechanical parameters and plantar forces at the forefoot, midfoot, and heel among individuals with unilateral and bilateral PF and healthy individuals, using a dynamic gait analysis system. Additionally, it analyses the correlations during barefoot walking and arch-building gait. Methods This cross-sectional study was conducted at the Department of Physical Medicine and Rehabilitation (PMR), All India Institute of Medical Sciences (AIIMS), Mangalagiri, India, over 15 months. A total of 141 participants were included: 47 with unilateral PF, 47 with bilateral PF, and 47 healthy individuals. Gait analysis was performed using the Diers Formetric 4D system (DIERS, Biomedical Solutions, Germany) to assess biomechanical gait parameters, as well as plantar force distribution at the forefoot, midfoot, and heel during barefoot walking and arch-building gait. Statistical analysis was carried out using ANOVA, the chi-square test, and Pearson's correlation coefficient, with p-values < 0.05 considered statistically significant. Results A total of 141 participants were included, with 47 in each of the following groups: unilateral (U/L), bilateral (B/L), and normal. No significant differences in biomechanical gait parameters were observed among the groups during barefoot walking. In contrast, during arch-building gait, significant differences were present in cadence and antero-posterior (A/P) centre of pressure. For barefoot walking, a significant difference in midfoot plantar force was found between the unilateral and bilateral PF groups, whereas no significant differences emerged during arch-building gait. Strong-to-moderate positive correlations were observed between barefoot walking and arch-building gait parameters across all groups. Conclusion Individuals with unilateral and bilateral PF show near-normal gait during barefoot walking. Arch-building gait reveals subtle biomechanical changes and improves plantar load distribution. These findings support that the arch-building gait activates the intrinsic foot muscles and can serve as both a sensitive assessment tool and a potential rehabilitation strategy.