Baseline skin information from the foot dorsum is used to control lower limb kinematics during level walking

The aim of the current study was to explore the role of dorsal foot skin on the joint kinematics of gait during level walking. Twelve volunteers experienced sensory perturbations with either reduced dorsal skin feedback using topical anesthetic, reduced visual feedback of the lower visual field, or a combination of both cutaneous and visual reductions (paired). The visual condition was introduced to impose a greater reliance on skin input (goggles occluded lower visual field input). Our results showed that a reduction in skin input, alone, resulted in significant angular position changes at both the ankle and knee joints through swing (increased flexion, p < 0.010), despite preservation of minimal toe clearance (MTC; p = 0.908). Conversely, a reduction in lower visual field input resulted in a greater minimal toe clearance affect (MTC; p < 0.001), a slight increase in dorsiflexion at the ankle (p = 0.046), yet no effect on angular position changes for the knee (p = 0.110). The locomotor changes observed following a reduction in cutaneous feedback from the foot dorsum suggest an important role of the skin over this region for the regulation of level ground walking. Interestingly, it appears that these healthy young adults were able to compensate for the reduced skin information while preserving locomotor efficiency via a maintained ground clearance (MTC). Our data also demonstrated an interaction between skin and visual inputs; vision appears to have a less dominant role compared to skin in controlling the joint positions through swing phase of gait. This work is the first to highlight the influence of reduced cutaneous input from the dorsum of the foot on locomotor strategies.