Math/ Cornput. Vol.

II,
Modelling, pp.341-345,1988 OXY5-7177/Xx
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PrintedinGreat Britain Pcrgamon Pressplc

A MATHEMATICAL TAXONOMY TO EVALUATE THE BIOMECHANICAL QUALITY

OF THE HUMAN FOOT

Philip H. Demp

Department of Mathematics and Computer Science

Glassboro State College
Glassboro, New Jersey 08028

Abstract. The relationship between a functional disorder of the foot

and the geometric configuration of its anatomical structure has been a
subject of continuing interest among clinicians who are concerned with
the various biomechanical disabilities of the foot. A survey of the
literature shows that various geometric criteria and models have been
proposed to arrive at a diagnosis and select a" appropriate plan of
treatment. Although these models have been used in biomechanical
evaluation with varying degrees of success, their verbal descriptions
and measurements are considered as over-simplifications with respect to
both classification and discrimination. A more realistic model should
induce a classification of sufficient refinement to produce a
differential diagnosis among clinically significant variations in the
biostructure of the foot.

Based on a rationale of anatomical, physiological, and clinical

considerations, the one-quarter ellipsoid is selected as the model.
Mathematical methods are used to classify human feet into a continuum of
points representing the entire range of variations in foot shape. There
is located an optimal point (foot) from which every other point is
measured by means of a distance function. Each numerical deviation of a
particular foot reflects the biomechanical quality of that foot.

The concept of a biomechanically optimal foot which has ideal function

as opposed to normal function offers the practitioner a quantitative
rationale for the diagnosis and treatment of mechanical foot disorders.

INTRODUCTION lateral border of the foot; C is the distance

The biostructural form of the human foot
determines the range of its function. Although
function has a" effect upon structure, it still
must take place within the means provided by
the changed form of the biostructure. The
actual form or geometric configuration of the
foot should be one whose inherent properties
allow for the maximum efficiency of function.
Accordingly, this mea".s a biostructure in which
the gravitational stresses being transmitted
through the foot can be dissipated with minimal
energy expenditure. The importance of the
relation between anatomical structure and
efficient foot function has motivated many
clinicians in their search for a" optimal
biostructure resulting in a variety of models
obtained from different approaches.
from this same midpoint to the navicular
articulation. The components A, B, C can
roughly be called the one-half foot length,
foot breadth and foot height respectively.
They correspond to three rectangular coordinate
axes with the above midpoint as the origin.
All distances are measured from weightbearing
radiographs and the scale is one unit equals
0.125 in. In this way, the entire population
of human feet is represented as a three-
dimensional vector space such that each vector
is a point whose coordinates are (A,B,C).
Two feet F and F' having vectors (A, B, C,) and
A',B',C') respectively will be defined as
similar if one vector is a scalar multiple of
the other, i.e., both vectors have the same
direction.

The "ideal foot" is defined as a one-quarter
ellipsoid with specific parameters. The
reasons for this are developed in the
subsequent chapters. The clinician is offered
a" infinite foot typology with a" associated
clinical interpretation which does not depend
on the concept of "normal function" or "neutral
position". Considered as a generalization of
previous typologies, significant advancements
can be expected in the diagnosis and treatment
of mechanical foot disorders.
THE REPRESENTATION OF FEET AS PLANAR POINTS
Each human foot will be represented by the
three-dimensional vector (A, B, C,). The
components of this vector are defined as
follows: A is equal to one-half of the line
segment between the weightbearing points of the
head of the first metatarsal bone and the
calcaneal tuberosity; B is the distance from
the midpoint of the above line segment to the
From each set of similar feet, there is
selected a unique foot as a representative of
the set.
The actual selection of these unique vectors is
accomplished by using the Riemann Sphere
represented by the equation,
2 2
x + y2, u = u
From each set of vectors with the same
direction (set of similar feet) and, therefore,
corresponding to a set of points lying on the
same line in space is selected that point where
the line and sphere intersect. This point is
found by the simultaneous solution of the
symmetric equations for the line and the
equation for the sphere, i.e.

341
342 Proc. 6th Int. Conf. on Marhemaiical Model@
x/A = y/B - u/C
Tl:
The solution is:
2
i x2+ y + II2 - u
x- AC/(A'+ B2+ C');
y- BC/(A2+ B2+ C*);
u- C2/(A2+ B2+ C2.
This point (x. y. u) lies on the sphere and is
the uniquely selected vector, (AC/(A2+ B2+ C2),
BC/(A2+ B2+ C2), C2/(A2+ B2+ C2). The union of
all these differently directed vectors which
terminate on the sphere or, considered as
points, lie on the sphere is the constructed
subspace of non-similar feet.
Each set of similar feet is now in one-to-one
correspondence to a point (x, y, u) defined on
the Riemann Sphere. By usng the north pole of
the sphere as the center of projection, a
straight line is drawn from the point (0, 0, 1)
through the point (x, y9 u) on the sphere and
extended to the (x, y)-plane where it
intersects the plane at the point (xl, yl, 0).
There is now established a one-to-one
correspondence between all sets of similar feet
1 circular paths are segments of circles whose
and points (xl, y ) defined in the plane. The
projection from the point (x, y, u) to the
point (xl, y') is accomplished by the following
equations of transformation:
1
x - r/l-u
T2:
i yl- y/l-u
This kind of transformation is called a
stereographic projection and, in effect, has
reduced a three-dimensional representation of
feet into a two-dimensional representation. A
discussion of vectors can be found in (1); one
on stereographic projection can be found in
(2).
The population of non-similar feet corresponds
to the points making up the Image of the
stereographic projection. The following is a
flow diagram from Source to Image:
2 of the ellipsoid:
c
A2+B2+C2' A2+B2+C2
Foot---j Point in Sphere--$Point in plane
We now interpret the projected image in terms
of our knowledge of feet. A is greater than or
equal to B and B is greater than or equal to C,
i.e. At B 2 C 2 0. This implies that for any
point in the projected image, the x-coordinate,
AC/(A2+B2), is greater than or equal to the y-
coordinate, BC/(A2+B2). If A-B-C, then the
projected image point is (5,
' ').
2 If C=B, then
the x-coordinate, AC/(A2+B2) is less than or
equal to AB/(A'+B') and the y-coordinate,
BC/(A2+B2), is less than or equal to
B2/(A2+B2). If AB/(A2+B2) is written as
i/(1+($'), and B2/(A2+B2) is written
B2
B2 /(l+(z)
(;) ), then the point
2
--L
I!
lA
B
1+;1 A
2'
l+B
A
A
il
2 will be the end point of
j
the ray having slope equal to B/A. The set of
all such end points will lie on a curve with
the parametric equations:
2
x_--+- t
2’ y-l+t2.
1+t
121-z,
Since x2+y2-y or x2+(y-7) the curve is
a circle with center at the point (0, and
radius equal to ' The intersection of this
2'
circle with the line, y=x, forms a bounded
region which defines the projected image.
Each line (ray) passing through the origin and
lying in the bounded region is a set of points
corresponding to all nonsimilar feet with ratio
B/A equal to a constant and C varying from 0 to
B. There are also circular paths within the
bounded region such that B/A varies from 0 to 1
and C is a constant proportion d of 8. These
center is the point (0, 2 d) and whose radius
is id. Each point lies on the intersection of
a ray and a circular segment and, depending on
its location, the corresponding foot can be
described as varying from very broad to very
narrow and from very flatfooted to very high-
arched. Thus the projected image is a bounded
region whose points describe a typological
continuum of human feet.
MATHEMATICAL DEVELOPMENT OF BIOMECHANICALLY
OPTIMAL PARAMETERS BASED ON A MODEL OF THE FOOT
The present thesis will move from the
descriptive model to the mathematical model;
from the changes in contour to the mathematical
variations in shape. In this way, the
ellipsoid will become a family of ellipsoids
ranging from the degenerative ellipsoid to the
sphere. The mathematical model is an equation
The mathematical variations in shape are the
different sets of values assigned to the
parameters, A, B, C. These parameters are
considered equivalent to the A, B, and C of
Chapter II and are defined in the same way.
When A-B-C, the shape is a sphere; when A>B=C,
the shape is a prolate spheroid; when A=B>C,
the shape is an ablate spheroid. Given any
foot, one can determine the numerical values
for A, B, C and write down the particular
ellipsoid equation for that foot.
The ellipsoid itself is considered as the
transmitter of forces analogous to those forces
being transmitted by the foot. The surface of
the ellipsoid will control and guide these
forces according to the curvature or steepness
from point to point. This point by point rate
of surface change will be given precisely by
the gradient vector field. The equation for
the ellipsoid is,
 Proc. 6th Int. Conf. on Mathematical Modelling 343

interval length is close to zero; the

eccentricities, ek, are all concentrated at
zero or one; and the foot's biomechanical
quality is considered to be very poor.
The partial derivatives of z are,
Since efficiency in transmitting forces over a
2 surface is related to the gradient field, the
z _cx GZY. interval length will be defined as a measure of
x
A22 ’ =Y-B2/ the degree of concentration and indirectly as a
measure of efficiency in transmitting forces.
the gradient of z is, The efficiency will be considered maximum when
the degree of concentration is minimum, i.e.
grad z -
& &. the interval length is maximum.
A2z ’ B*z ’ The interval length L is equal to,
the magnitude of the gradient of z is,

by algebraic manipulation, the equation

I grad z I - k (k is a constant)
The derivative of L(x) is,
becomes the equation,

x2
k2A4
+-& =
k
1.
\ 1 \ /
k2A2+C2 k2B2+C2
Setting this equal to zero, gives,
This last equation is an ellipse and is
satisfied by those points whose gradient 1
magnitude is equal to k. If this set of points x(1+x2)2 - 2x3= 0
is called Sk, then or
1
sk - {(x,Y)/ (grad= 1- k} x[(l+x2)2 - 2x23 = 0

The eccentricity, ek, of the ellipse satisfied

Thus, 2x2 = (1+x2)2
by Sk is,
4x4 = 1+x2

1 4x4 - x2-1 = 0
k2A2+C2 2,
ek - .r x2 =
>

and k approaches zero,

x = 0.8
; This means that L(x) is a maximum when B/A -
0.8. In the projected image, the ray whose
slope is 0.8 or whose angle of inclination is
as k approaches infinity, 38.7 degrees contains all those points (feet)
such that the ratio B/A is 0.8 and the C value
varies from 0 to B. This set of non-similar
feet contains the biomechanically optimal foot
lim ek -
with B/A = 0.8 as a necessary condition.
k+m
For C -0orC = B, the foot is considered to
The sat of eccentricities k<- have very poor, biomechanical quality.
Therefore, C/B will have some value between 0
is bounded as follows,
and 1 for the optimal foot. This value is
determined in the following way:

1. The intersection of the ellipsoid with the

(x,z)-plane is the ellipse

The length of this bounded interval depends on
the ratio, B/A. When B/A is close to zero, the
foot has practically no breadth and is called 2. The inner arch rests on this ellipse.
degenerate; when B/A is close to one, the
plantar, weightbearing foot structure is
practically a circle and the foot itself is
approximately a spheroid. In either case, the
344 Proc. 6th Int. Conf. on Mathematical
3. The intersection of the ellipsoid with the
(y,z)-plane is the ellipse 5 + $ - 1.
4. The transverse arch rests on this ellipse.
5. The eccentricity of the Transverse Arch
1 is the set of simple chord distances between
Ellipse (TAE) is, [l - (C/B)2]2 . As C/B
goes from 0 to 1, the eccentricity of the
TAE goes from 1 to 0, i.e. the Transverse
Arch goes from flatness to circularity.
6. The eccentricity of the Inner Arch Ellipse
_
1 points, Z1-(~l,yl,~l) and Z2-(x2,y2,u2) and its
(IAE) is [l - (C/A)2]2. Using the optimal
ratio B/A - 0.8, multiply both sides by C/B
and obtain C/A = 0.8 C/B. Therefore, the
eccentricity of the IAE can now be written
L.
as (1 - (0.8 C/B)2]2. Now as CB goes from
0 to 1, the eccentricity of the IAE goes
from 1 to 0.6, i.e. the IAE goes from
flatness to a lesser degree of flatness.
7. The Transverse Arch Ellipse receives the
body weight and transmits it from the top
of the ellipse.
The angle midway between 0 degrees and 45
degrees is taken as the optimal angle,
i.e. a - 22.5 degrees.
8. Since the tan a - C/B and tan (22.5') -
0.4142, the optimal value for C/B is taken
as 0.414.
9. With C/B = 0.414, the IAE and the TAE will
have eccentricities of 0.9435 and 0.9102
respectively. Although both arch ellipses
have the property of more flatness than
circularity, the TAE has less flatness than
the IAE. This fits in with the stretch
reflex action, because the IAE can undergo
an effective stretch excursion while the
less flattened TAE controls overstretching
and aids the rebound effect. Theorem: C/B
- 0.414 and B/A = 0.8 are sufficient
conditions for biomechanical optimality of
the human foot. As previously stated in
Chapter III, the foot maps into the
projected image point as follows:
(A, 8, dB) --+ d
i of 0.8.
If d = 0.414 and B/A = 0.8,
where C = dB.
0.414 d (0.2,0.16)
l+(O.S)
The point (0.2, 0.16) represents the
biomechanically optimal foot in the
projected image.
A TAXONOMY BASED ON CHORDAL DISTANCE
Attention will now be directed toward this
chordal distance relation among the points in
the projected image. In the transformation,
T2, from the Riemann Sphere to the projected
image, there occurs a reduction of dimension-
ality in which a one-to-one correspondence of
points is maintained. However, the transfor-
mation does not preserve distance. The
distance between points on the Riemann Sphere
Modelling
is variably magnified in the projected image
under the transformation. This results in a
less than accurate distance relation among the
original set of non-similar feet represented by
points on the Riemann Sphere. In order to
correct this distortion, one must use a
distance function whose domain is the set of
points in the projected image and whose range
points on the Riemann Sphere. This particular
distance function is called the Chordal
1
11
Distance, CD. If zl-(xi, 2) and z2-(~2,q)
are any two points in the projected image, then
the Chordal Distance is the simple chord
distance between the corresponding pre-image
specific mathematical expression is:
lzl - z21
CD - . ,
The derivation of this distance function can be
found in E. Hille's book (2).
Each taxonomic unit or foot type is a set of
points (feet) whose Chordal Distances are equal
with respect to the optimal point. It is an
infinite taxonomy of feet in which differently
shaped feet can belong to the same foot type.
Because the optimal point represents the
biomechanically optimal foot, the Chordal
Distance can be used not only as a quantitative
basis for constructing a taxonomy but also as a
guide for evaluating the biomechanical status
of the foot.
STATISTICAL DISTRIBUTION OF CHORDAL DISTANCES
As yet, no actual observations have been made.
Therefore, a small sample of weightbearing
radiographs is selected from patients' files.
The sample consists of 17 left feet and 16
right feet which includes 13 pairs of feet.
Each foot is measured for A, B, C as previously
defined; these measurements are transformed
into a point in the projected image; its
Euclidean distance from the optimal point is
calculated; and its Chordal Distance from the
optimal point is calculated.
The B/A ratios for the left foot ranged from
0.75 to 0.917 with a mean of 0.826 and a
standard deviation of 0.0688. It is noted that
the B/A ratios cluster around the optimal ratio
The C/B ratios for the left foot range from
0.25 to 0.545 with a mean of 0.398 and a
standard deviation of 0.0838; for the right
foot they range from 0.292 to 0.55 with a mean
of 0.422 and a standard deviation of 0.079. It
is noted that the C/B ratios cluster around the
optimal ratio of 0.414.
Consideration is given to a weighting scheme
that gives a large value for the biomechanical
quality of a foot (point) near 0; a small value
for a foot (point) greater than 0.179.
Accordingly, a cumulative distribution function
is constructed from the P proportions of the
random variable Chordal Distance. Those feet
(points) whose Chordal Distance is greater than
0.179 should have small percentiles to reflect
poor quality; those feet (points) whose Chordal
Distance is close to 0 should have large
percentile values. In order to satisfy these
conditions, the cumulative percentages
 Proc. 6th Int. Conf: on Mathematical
corresponding to the 1-P proportions are taken
as the weighting percentages of the
biomechanically optimal foot.
The Chordal Distances, the P proportions, the
(1-P) proportions and the weighting percentages
for each foot given two cumulative distribution
functions.
CONCLUSION
It is hoped that the methodology described can
help the clinician formulate a rationale having
a much higher probability of success in the
diagnosis and treatment of biomechanical
disabilities of the foot.
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