Search Results
Background:
Fatigue due to running has been shown to contribute to changes in plantar pressure distribution. However, little is known about changes in foot posture after running. We sought to compare the Foot Posture Index before and after moderate exercise and to relate any changes to plantar pressure patterns.
Methods:
A baropodometric evaluation was made, using the FootScan platform (RSscan International, Olen, Belgium), of 30 men who were regular runners and their foot posture was examined using the Foot Posture Index before and after a 60-min continuous run at a moderate pace (3.3 m/sec).
Results:
Foot posture showed a tendency toward pronation after the 60-min run, gaining 2 points in the Foot Posture Index. The total support and medial heel contact areas increased, as did pressures under the second metatarsal head and medial heel.
Conclusions:
Continuous running at a moderate speed (3.3 m/sec) induced changes in heel strike related to enhanced pronation posture, indicative of greater stress on that zone after physical activity. This observation may help us understand the functioning of the foot, prevent injuries, and design effective plantar orthoses in sport. (J Am Podiatr Med Assoc 103(2): 121–125, 2013)
Background: Tarsal tunnel syndrome (TTS) occurs when an individual suffers from tibial nerve compression at the tarsal tunnel. Symptoms of TTS may include pain, burning, or tingling on the bottom of the foot and into the toes. Tarsal tunnel syndrome can be divided into distal and proximal TTS. Furthermore, a high tarsal tunnel syndrome (HTTS) has also been described as a fascial entrapment proximal to the laciniate ligament at the level of the high ankle. Multiple risk factors, including obesity, have been said to be associated with TTS. This study aimed to determine the frequency of obesity in the form of body mass index (BMI) with HTTS.
Methods: A cross-sectional descriptive study using a nonprobability sampling method retrospectively surveyed the BMI of 73 patients whose clinical presentation suggested HTTS or TTS, and in which electrodiagnostic testing found HTTS. The age of the patients ranged from 25 to 90 years (mean, 56.4 years). Thirty-five patients were men and 38 patients were women.
Results: Based on BMI, nine patients with HTTS had normal weight (12.9%), 17 patients were overweight (23.3%), and the remaining 47 patients were obese (64.3%).
Conclusions: The frequency of obesity in the form of BMI was 64.3% in patients with HTTS, which is a significantly high correlation.
Background: Studies have shown that personal and economic reasons determine whether clinicians use diagnostic technology in their routine clinical biomechanical practice. This study aimed to identify the biomechanical management plan of local clinicians in relation to management of the diabetic high-risk foot and to investigate whether diagnostic technology is being used to determine the effectiveness of dispensed prescription orthoses in view of ulcer prevention.
Methods: A mixed-methodologic approach was adopted in this study. A retrospective quantitative study was also conducted to access records of patients attending the biomechanics clinic at a local health biomechanics clinic. Outcomes of interest included the number and percentage of patients attending the biomechanics clinic, source of referral to this clinic, age and gender of patients, clinical diagnosis, management plan, and referral pathway. Following a phenomenologic approach, four experienced clinicians working in the private, primary, and tertiary health sectors were interviewed. Thematic analysis was used to analyze and interpret data.
Results: Only low-risk patients living with diabetes mellitus were referred for a comprehensive biomechanical examination; the majority were referred by podiatrists. There was no record of diabetic high-risk patients being referred for a detailed biomechanical assessment within the health service. This study also confirmed that, because of the expenses and laborious work involved when using diagnostic technology to assess foot pressures, interviewed clinicians based their treatment plan and tested the efficiency of dispensed offloading devices on the basis of clinical experience and visual observation only.
Conclusions: Waiting for signs of ulceration can be too late for the high-risk foot. A change in clinical practice is recommended where the integration of diagnostic technology, together with standard care, in view of ulcer prevention is warranted.
The purposes of this study were to develop an instrument to assess the validity of randomized controlled trials and to report on the differences in the validity of randomized controlled trials between two podiatric medical journals and a mainstream medical journal. The study demonstrated that after adequate training, there can be agreement among reviewers evaluating the quality of published randomized controlled trials using an established instrument and guidelines. The results of the study indicate that randomized controlled trials published in podiatric medical journals are less credible than those published in a mainstream medical journal. (J Am Podiatr Med Assoc 93(5): 392-398, 2003)
The objective of the present study was to determine the amount of agreement among three clinicians in the clinical assessment of dorsal mobility of the foot’s first ray and the agreement between their assessments and that of a mechanical device designed to quantify first-ray mobility. Sixty feet from 30 individuals evaluated clinically by three health-care professionals were classified as having a hypomobile, normal, or hypermobile first ray. The amount of first-ray dorsal mobility of each participant’s foot was then measured using a device specifically constructed for that purpose. The results of this study show generally poor agreement among the three clinicians on whether a foot should be classified as having hypomobility, hypermobility, or normal mobility of the first ray. The amount of agreement with the quantitative device was poor for two of the clinicians and moderate for the third clinician. (J Am Podiatr Med Assoc 94(5): 470–476, 2004)
Background:
The influence of childhood obesity on shape and structure of the pediatric foot remains poorly understood. The purpose of this work was to determine associations between obesity and pediatric foot dimensions.
Methods:
A retrospective analysis of pediatric foot dimensions (foot length [FL] and foot width [FW]) in 3,713 children aged 3 to 18 years was undertaken. Logistic regression was used to determine relationships between FL, FW, and weight category.
Results:
Compared with obese peers, typical weight (FL, P < .05 [odds ratio (OR)] = .83; FW, P < .05 [OR = .56]) and underweight (FL, P < .05 [OR = .76]; FW, P < .05 [OR = .41]) boys had significantly shorter and narrower feet. Overweight (FL, P = .02 [OR = .88]; FW, P = .02 [OR = .72]), typical weight (FL, P < .05 [OR = .77]; FW, P < .05 [OR = .47]), and underweight (FL, P < .05 [OR = .70]; FW, P < .05 [OR = .33]) girls had significantly shorter and narrower feet.
Conclusions:
These findings suggest that obesity is an important determinant of pediatric foot dimensions. Given the current prevalence of obesity in children and young people, these findings may have population-wide implications for pediatric foot health.
Lower-Leg and Foot Contributions to Turnout in University-Level Female Ballet Dancers
A Preliminary Investigation
Background:
Turnout in ballet is produced through summation of the joint structure characteristics and ranges of motion at the hip, knee, ankle, and foot. Contributions of the hip joint to functional turnout in dancers have received extensive examination, whereas little is known about contributions from the knee, ankle, and foot. The aim of this study was to explore the nonhip components of turnout to dancers' functional turnout in first position by assessing passive external tibiofemoral rotation and active measures of foot pronation, ie, navicular drop and Foot Posture Index.
Methods:
Nineteen female university-level dance students aged 16 to 19 years participated in this descriptive correlational study. External tibiofemoral rotation, navicular drop, Foot Posture Index, and functional turnout were measured for the participants' right and left legs.
Results:
Regression analyses revealed a weak relationship between passive external tibiofemoral rotation and functional turnout. Correlation analysis revealed a moderate negative relationship between passive tibiofemoral external rotation and the Foot Posture Index in functional turnout.
Conclusions:
These findings suggest that the lower leg does contribute to dancers' overall position of functional turnout. However, current methods are not useful in predicting a dancer's lower-leg contribution and alignment in functional turnout in first position.
Background:
Orthotic insole is a popular physiotherapy for flatfoot. However, the effects and whether flexible flatfoot needs orthotic insole treatment are not clear, and how the plantar pressure changes while walking up and down stairs has not been studied. Therefore, this study observed the plantar pressures of different walking conditions to find the answers.
Methods:
Fifteen adults with flexible flatfoot and 15 adults with normal foot were examined while walking on a level surface and while walking up and down 10- and 20-cm stairs before treatment. The maximum force and the arch index were acquired with a force plate system. Participants with flexible flatfoot were instructed to wear the orthotic insoles for 3 months, and plantar pressures were measured again after treatment. The repeated measure was performed to analyze the data.
Results:
The maximum force and the arch index of flatfoot after treatment were significantly decreased under different walking conditions (P < .01). When walking down 10- and 20-cm stairs, the plantar data of normal foot and flatfoot were significantly increased (P < .05).
Conclusions:
Orthotic insoles could effectively improve the plantar pressure of flatfoot under different walking conditions. In addition, the arches of normal foot and flatfoot were obviously influenced when walking down stairs. It is, therefore, necessary to wear orthotic insoles for flexible flatfoot to prevent further deformation.
Background: The path of the center of pressure during walking varies among individuals by deviating to a greater or lesser extent toward the medial or lateral border of the foot. It is unclear whether this variance is systematic and is affected by foot posture. The aim of this study was to explore the relationship between foot morphology and center-of-pressure excursion during barefoot walking.
Methods: Pressure data were collected from 83 participants whose foot type had been classified as supinated, normal, or pronated according to the Foot Posture Index. Three center-of-pressure variables were analyzed: medial excursion area, lateral excursion area, and total excursion area.
Results: Across the spectrum of foot types, we found that the more supinated a participant’s foot posture, the larger the area of lateral center-of-pressure excursion, and, conversely, the more pronated the foot posture, the smaller the area of lateral center-of-pressure excursion. Furthermore, the supinated foot type had a relatively larger center-of-pressure total excursion area, and the pronated foot type had a relatively smaller center-of-pressure total excursion area.
Conclusions: These results indicate the importance of assessing foot posture when measuring center of pressure and may help explain regional differences in pain and injury location among foot types. (J Am Podiatr Med Assoc 98(2): 112–117, 2008)
Background: The use of cushioned or shock-absorbing insoles has been suggested as a mechanism to reduce the impact forces associated with running, thereby protecting against overuse injuries. The purpose of this study was to determine whether the use of cushioned insoles reduced impact forces during running in healthy subjects.
Methods: Sixteen recreational runners (9 females and 7 males) ran at a self-selected pace for five trials with and without the use of cushioned insoles. During each trial, ground reaction forces, tibial accelerations, lower-extremity kinematics, and subject-perceived comfort were recorded. All variables were tested with the level of statistical significance set at α = .05.
Results: The use of cushioned insoles resulted in significant reductions in mean vertical ground reaction force peak impact (6.8%) and ground reaction force loading rate (8.3%), as well as peak tibial acceleration (15.8%). Spectral analysis of the tibial acceleration data in the frequency range associated with impact accelerations (12–25 Hz) revealed no change in the predominant frequency or the power of the predominant frequency. The knee flexion angle at initial contact and perceived comfort were similar for the two conditions.
Conclusions: This study demonstrates the effectiveness of one type of cushioned insole in reducing peak impact force and tibial acceleration at initial foot-ground contact during running. The impact reduction observed was independent of knee kinematic adjustments or changes in perceived comfort. Further study is required to determine whether the reduction in loading that accompanied the use of the cushioned insoles can affect the incidence of running-related injuries. (J Am Podiatr Med Assoc 98(1): 36–41, 2008)