This review aims to summarise the applications of finite element modelling used in labour mechanics and explore their clinical relevance in optimising labour management and intervention strategies. A systematic literature search was performed in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines across the PubMed, IEEE Xplore, Web of Science and Elsevier ScienceDirect databases. Selected 13 studies were evaluated based on the methodological quality assessment of single-subject finite element analysis (MQSSFE). The review highlights the widespread use of whole-body foetal finite element models in childbirth simulations. Key factors in childbirth biomechanics include uterine contraction intensity, abdominal muscle forces, pelvic floor function, foetal head flexion, tissue properties, and descent trajectory. Finite element modelling offers key insights but faces challenges in accuracy, personalised anatomy, and clinical application. Advances in computational biomechanics, imaging validation, and patient-specific simulations will improve childbirth understanding, risk assessment and labour management.

Introduction: Foot progression angle affects gait and lowerlimb alignment. Altered angles may increase knee and ankle loading and produce tissue loading patterns previously linked to musculoskeletal injury. This study investigates how different foot progression angles modify knee and ankle biomechanics in young adults with flexible flatfoot. Methods: 28 participants (aged 18–35 years) with flexible flatfoot completed gait trials under three foot progression angle conditions. Kinematic and kinetic variables were analyzed using one-dimensional statistical parametric mapping. A 1D convolutional neural network was applied to classify progression angle patterns based on flexible flatfoot severity and gait biomechanics. Results: Decreasing foot progression angle reduced the ankle eversion/inversion range and knee abduction and external rotation (p < 0.05). Increasing foot progression angle lowered early stance ankle plantarflexion and increased knee abduction/external rotation (p < 0.05). Kinetically, a smaller foot progression angle reduced peak ankle plantarflexion moment and knee extension moment but increased the first peak of the knee adduction moment and rotational moment fluctuations (p < 0.05). A larger foot progression angle reduced rotational fluctuations and terminal stance knee extension moment (p < 0.05). The convolutional neural network model was most accurate for moderate flexible flatfoot cases, and ankle coronal and knee transverse biomechanics showed the strongest discriminative power. Conclusion: Modifying the foot progression angle can meaningfully alter knee and ankle loading in young adults with flexible flatfoot. Neutral or mild toe-in angles may help mitigate excessive eversion and rotational stress, suggesting a simple noninvasive adjustment that clinicians can incorporate during gait retraining or orthotic prescription. Because biomechanical responses vary across individuals, FPA modification may be the most effective when tailored to patient-specific gait characteristics. In addition, deep-learning-based gait classification shows promise for supporting personalized monitoring and guiding clinical decision-making during rehabilitation.

Purpose: This study evaluated tibiofemoral loading and medial meniscal stress distribution in individuals with flexible flatfoot (FFF) during walking under different foot progression angle (FPA) conditions. Methods: This study analyzed the gait of 28 FFF patients (16 males, 12 females) under three FPA conditions (neutral, toe-in, toe-out). Kinematic (Vicon) and kinetic (Kistler) data were used to estimate tibiofemoral forces in OpenSim. Subsequently, joint angles and muscle forces at peak tibiofemoral forces were used to drive a finite element (FE) model of the knee, enabling the comparison of meniscal von Mises stress, maximum shear stress, and contact pressure across FPA conditions. Results: Tibiofemoral force increased during early stance (9–11%) in the toe-in condition with this increase reaching statistical significance in males (p = 0.008, mean partial η2=0.70 within the SPM-identified cluster). FE analysis showed that peak stresses and contact pressure were primarily localized in the anterior region of the medial meniscus. A consistent directional response to FPA was observed with the lowest peak values occurring in the toe-in condition and the highest values in the toe-out condition. Conclusion: Adjusting FPA modulates intra-articular knee loading via the kinetic chain. For FFF patients, neutral FPA provides stable loading. The toe-in condition presents a complex mechanism: despite increasing tibiofemoral force (notably in males), it reduces peak stress by altering contact mechanics and stress distribution. Therefore, FFF gait interventions must be individualized based on factors like foot morphology, sex, and functional goals.