Dynamic gait phase alterations and spatiotemporal stance characteristics in bilateral pes cavus: A case-control study

Background Dynamic baropodometric assessment is an established technique for evaluating functional foot biomechanics and gait alterations associated with cavus foot deformities. The primary objective of this study was to analyze spatiotemporal gait variables and stance phase progression in individuals with bilateral pes cavus compared to healthy control participants with normal foot posture. Methods A total of 82 participants were enrolled in this observational case-control study, comprising 41 individuals with bilateral pes cavus (case group) and 41 healthy individuals with normal bilateral foot posture (control group). Following the validated three-step protocol, participants walked barefoot across a calibrated baropodometric platform. Spatiotemporal parameters during the stance phase were recorded, including absolute duration (ms) and stance percentage (%) for the Initial Contact Phase (ICP), Flatfoot Phase (FFP), and Forefoot Contact Phase (FFCP), along with their corresponding transition frame indices. Group comparisons were performed using the Mann-Whitney U test. Results In the right foot, participants with pes cavus exhibited a significantly longer ICP duration (109.29 ± 63.10 ms vs. 79.71 ± 35.35 ms, p = 0.034) and higher ICP stance percentage (14.46 ± 8.27% vs. 10.20 ± 4.55%, p = 0.024), accompanied by a markedly reduced FFP duration (347.95 ± 127.31 ms vs. 417.20 ± 92.98 ms, p < 0.001) and lower FFP percentage (47.68 ± 14.05% vs. 56.02 ± 10.45%, p = 0.002). In the left foot, the case group demonstrated a reduced FFP duration (341.61 ± 115.79 ms vs. 405.73 ± 72.40 ms, p = 0.002) and a significantly higher FFCP percentage (37.05 ± 8.28% vs. 32.71 ± 7.85%, p = 0.020), alongside lower FFCP frame transition indices p = 0.002. Conclusions Individuals with bilateral pes cavus present significant alterations in dynamic stance phase progression, characterized by prolonged initial contact, restricted midfoot flatfoot support duration, and premature transition toward forefoot contact. These findings highlight altered dynamic gait mechanics in cavus feet and support the clinical utility of baropodometric gait analysis for functional assessment and orthotic planning.