The Effect of Foot Arch Morphology and Plantar Pressure Distribution on Craniovertebral Angle and Acoustic Voice Parameters Across Different Postures
Journal of Voice, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.jvoice.2026.09.050
- Dergi Adı: Journal of Voice
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Periodicals Index Online, CINAHL, Communication Abstracts, EMBASE, International Bibliography of Theatre & Dance (IBTD), MEDLINE, Music Index, Music Periodicals Database, EBSCO Communication Source, Communication Source (EBSCO), Health Research Premium Collection (ProQuest), Music & Performing Arts Collection (ProQuest)
- Anahtar Kelimeler: Acoustic voice analysis, Craniovertebral angle, Foot arch morphology, Kinetic chain, Myofascial continuum
- Dokuz Eylül Üniversitesi Adresli: Evet
Özet
Objectives: Human voice is a holistic phenomenon shaped by whole-body biomechanics and the integrity of the kinetic chain. This study investigated the effects of foot arch morphology on the craniovertebral angle and acoustic voice parameters across four postural conditions, in the context of forefoot plantar pressure distribution. Methods: Seventeen female university students were classified into a neutral arch group (n = 7) and a pes planus group (n = 10) based on three-dimensional optical foot scanning. In each of four postural conditions defined as neutral, kyphotic, upright, and anterior sway, the craniovertebral angle was measured photogrammetrically, plantar pressure was recorded using a piezoresistive sensor platform, and acoustic parameters including fundamental frequency (F₀), jitter, shimmer, harmonics-to-noise ratio, first formant (F₁), second formant (F₂), and Cepstral Peak Prominence Smoothed were extracted using Praat software. Data were analyzed using the Mann-Whitney U test, Spearman rank-order correlation with Bonferroni correction, the Friedman test, and linear mixed-effects models. Results: The pes planus group showed numerically lower craniovertebral angle values across all postures, although between-group differences in this angle were not statistically significant, and lower F₀, F₁, F₂, and CPPS during text reading than the neutral arch group, with the most pronounced differences observed during anterior sway loading. Linear mixed-effects model analyses revealed that foot arch morphology had significant independent effects on F₀ (F(1, 62) = 12.734, P < 0.001), F₁ (F(1, 62) = 20.871, P < 0.001), F₂ (F(1, 62) = 25.665, P < 0.001), CPPS during text reading (F(1, 62) = 12.536, P < 0.001), and CPPS during sustained /a/ phonation (F(1, 62) = 6.019, P = 0.017), independent of posture type and forefoot pressure. Total forefoot pressure percentage showed a significant independent negative effect on CPPS during sustained /a/ phonation (F(1, 62) = 6.129, P = 0.016). Within-group Friedman tests showed that F₁ varied significantly across postures in both groups, whereas shimmer and CPPS during sustained /a/ phonation varied significantly only in the neutral arch group and F₂ varied significantly only in the pes planus group (χ2 = 13.920, P = 0.003). Conclusion: Foot arch morphology was associated with acoustic voice parameters independently of posture and forefoot plantar pressure, and with a consistent but non-significant trend toward lower craniovertebral angle values. These findings suggest that the integrity of the myofascial and proprioceptive chain extending from the sole to the larynx may warrant consideration as a parameter in the holistic evaluation of voice.