Literature examining the incidence of foot diseases in rock climbing is limited to traumatic injuries. We examined a large sample of climbers, assessed the chronic diseases of the foot, and correlated them with foot morphology, shoe type, and type of climbing practiced.
Between May 1 and September 30, 2009, 144 climbers (mean age, 31.7 years) were examined to analyze the effect of rock climbing on the various foot diseases found at the time of the evaluation.
Eighty-six percent of the climbers were affected by a pathologic condition. Nail disease was found in 65.3% of patients, followed by recurrent ankle sprains (27.8%), retrocalcaneal bursitis (19.4%), Achilles tendinitis (12.5%), metatarsalgia (12.5%), and plantar fasciitis (5.6%). Male sex, the use of high-type shoes, the high degree of climbing difficulty, and the competitive level were often related to the onset of foot diseases. Climbing shoes are usually smaller than common footwear. This “shoe-size reduction” averaged 2.3 sizes, forcing the foot into a supinated and cavus posture that favors lateral instability. The posterior edge of the shoe aperture produces increased pressure on the heel, with retrocalcaneal bursitis.
Overuse foot diseases related to rock climbing are particularly frequent and debilitating. Detailed knowledge of these diseases and their predisposing factors may help us implement effective preventive or therapeutic measures, including changes in the type of climbing, correction of body weight, degree of difficulty, footwear, orthoses, and measures that maximize the support of the foot to the ground. (J Am Podiatr Med Assoc 103(2): 113–120, 2013)
The aim of this study was to determine the quality of life in patients living with hallux abducto valgus deformity before and after a taping technique.
This study used a time series, quasi-experimental, same-subject design. Thirty-five patients with hallux abducto valgus were recruited in this study. Nonelastic zinc oxide tape was applied for 4 weeks. The Foot Health Status Questionnaire was used to assess the quality of life of participants before and after the intervention. The paired samples t test was used to test for statistical significance at the 95% confidence level.
In this study, a statistical reduction was seen in foot pain, foot function, and general foot health (P < .0001) after applying the nonelastic zinc oxide tape for 10 hours daily for 4 weeks. No statistically significant difference was found in the remaining domains of the Foot Health Status Questionnaire, although a difference in mean scores was observed.
Treatment with nonelastic zinc oxide tape led to improved management of hallux abducto valgus and better quality of life; it is a safe, easy-to-use method with minimal adverse effects. Future studies should evaluate this method using larger sample groups and longer treatment periods while comparing this method with alternative treatment approaches, such as exercise or orthotic devices.
Background: Subjective comfort of footwear is important for shoe and orthosis design. This study compared shoe preferences between walking and running, using subjective comfort as an outcome tool.
Methods: Forty-one participants walked and ran 20 times each along a runway in three types of footwear (cushioning, lightweight, and stability) and chose the model that they preferred most for walking and running separately based on subjective comfort.
Results: More participants preferred the cushioning model (walking, 34%; running, 41%) or the lightweight model (walking, 44%; running, 41%) over the stability model (walking, 22%; running, 17%). χ2 tests revealed no differences between walking and running, runners and nonrunners, and lighter and heavier individuals. Women were more likely (odds ratio = 4.09) to prefer the lightweight model, whereas men preferred the cushioning (odds ratio = 2.05) and stability (odds ratio = 3.19) models. Most participants (71%) chose the same model for both activities.
Conclusions: Shoe preference varies among individuals and is influenced by sex. Most people feel comfortable walking and running in the same shoe model. (J Am Podiatr Med Assoc 100(6): 456–462, 2010)
Neuropathologic changes may occur in the nervous system due to long-term substance use, leading to functional disability with altering of balance. We know little about substance-related mechanisms that can cause movement disorders. This study investigated the effects of plantar foot sensation and balance on physical performance as an effect of substance use in detoxified patients.
Twenty-three users of cannabis, volatile agents, or narcotic/stimulant agents alone or in combination for at least 1 year (mean age, 27.6 years) and 20 healthy volunteers (mean age, 24.6 years) were included. Participant evaluations were implemented immediately after the detoxification process with psychiatrist approval. Depression, state-trait anxiety, and fear of movement levels were evaluated with the Beck Depression Inventory, State-Trait Anxiety Inventory, and Tampa Scale for Kinesiophobia, respectively. Plantar foot sensations were evaluated with light touch, two-point discrimination, and vibration examinations. Balance was assessed with balance software and a balance board and force platform. Balance path, balance path distance, and center of pressure were recorded. Physical performance was evaluated with the Timed Up and Go (TUG) test in the final step.
There was a significant difference in two-point discrimination of patients versus controls (P < .05). Significant differences were also found in balance values, particularly in the sagittal direction (P < .05). TUG test results of patients compared with controls showed a negative influence on physical function (P < .05).
Detailed examination should be performed to understand movement disorders in substance users. Herein, substance users had impaired two-point discrimination and sagittal balance reciprocally. Thus, customized physiotherapy approaches to substance users should be considered to improve their movement disorders.
A study was conducted to determine whether a pedograph could be used as a field-based screening tool to predict pressures generated on the plantar surfaces of the feet of prepubertal children during single-limb weightbearing stance. Plantar pressures were collected in 51 primary school–aged children using a pressure distribution measurement system. Statistically significant negative correlations were found between footprint angle and both peak force (r = −0.453) and peak area (r = −0.539), and statistically significant positive correlations were found between the Chippaux-Smirak Index and both peak force (ρ= 0.285) and peak area (ρ = 0.559). Although statistically significant, the weak relationships precluded foot structure variables from being used to predict the plantar pressures of children during static weightbearing. It is therefore recommended that an alternative field-based tool that directly measures plantar pressures be used to screen children in the public school system to identify those at risk of excessive plantar pressures. (J Am Podiatr Med Assoc 94(5): 429–433, 2004)
The rate of aerobic dance injuries has been high for two decades. To determine the types of lower-extremity injuries to aerobic instructors, a questionnaire was sent to 18 fitness centers in the Sydney, Australia, metropolitan area requesting information on the number and types of injuries, frequency of activity levels, footwear worn, and treatments sought. The reported rate of injury was 77%. The leg was the most common site of injury, reported by 52.9% of respondents, followed by the foot and ankle (32.8%), and the knee (20%). These figures are comparable to previous studies. Further investigation is warranted into causes and preventive measures, and information on the kinetics and kinematics of the lower extremity may increase understanding of the incidence of lower-extremity injuries to aerobic instructors and participants. (J Am Podiatr Med Assoc 91(10): 528-532, 2001)
This study evaluated the magnitude and location of activity of diabetic patients at high risk for foot amputation. Twenty subjects aged 64.6 ± 1.8 years with diabetes, neuropathy, deformity, or a history of lower-extremity ulceration or partial foot amputation were dispensed a continuous activity monitor and a log book to record time periods spent in and out of their homes for 1 week. The results indicate that patients took more steps per hour outside their home, but took more steps per day inside their homes. Although 85% of the patients wore their physician-approved shoes most or all of the time while they were outside their homes, only 15% continued to wear them at home. Focusing on protection of the foot during in-home ambulation may be an important factor on which to focus future multidisciplinary efforts to reduce the incidence of ulceration and amputation. The ability to continuously monitor the magnitude, duration, and time of activity ultimately may assist clinicians in dosing activity just as they dose drugs. (J Am Podiatr Med Assoc 91(9): 451-455, 2001)
Our aim in this study was to compare the long-term outcomes of three different surgical procedures for the treatment of hallux rigidus (ie, cheilectomy, decompressive osteotomy, and arthrodesis) between active duty military and non–active duty patients.
A retrospective review of 80 patients (95 feet) undergoing surgical treatment for hallux rigidus was performed. Telephone survey was used to obtain postoperative outcome measures and subjective satisfaction. Additional data recorded and analyzed included age, sex, status of patient (active duty or non–active duty), grade of hallux rigidus, surgical procedure performed, date of surgery, time to return to full activity, ability to return to full duty, and follow-up time postoperatively.
The decompressive osteotomy group had the highest return-to-duty rate, satisfaction rate, and Maryland Foot Scores of all three surgical groups, although these differences were not statistically significant. Active duty and non–active duty patients did not have statistically significant differences in outcomes measures (ie, time to return to full activity, ability to return to full duty, satisfaction, or postoperative Maryland Foot Score) in any of the three surgical groups.
Decompressive osteotomy, cheilectomy, and first metatarsophalangeal joint arthrodesis are all reliable and effective procedures for treatment of hallux rigidus in both active duty military and non–active duty patients. Active duty military personal have a high rate of returning to their prior military activities after surgical treatment of hallux rigidus.
Background: Metatarsalgia is a common affliction in rheumatoid arthritis (RA), often requiring aggressive pharmacologic treatment that carries associated adverse effects. The aim of this study was to investigate whether simple insoles would have a beneficial effect on forefoot pain, disability, and functional limitation in participants with RA experiencing forefoot pain.
Method: A prospective, quasi-experimental, pretest-posttest trial was performed at a rheumatology outpatient clinic. Participants were supplied with a simple insole comprising a valgus pad and a plantar metatarsal pad and covered with a cushioning material. The Foot Function Index (FFI) was self-administered before and 3 months after insole use.
Results: Reductions in forefoot pain (from 56.78 to 42.97) and total (from 41.64 to 33.54) FFI scores were noted. Statistical significance for this reduction was achieved following the t test (P = .002 and P = .0085, respectively). However, although reductions in mean disability and activity limitation scores were recorded (from 50 to 44.85 and from 18 to 14.57, respectively), these did not reach significance (P = .151 and P = .092, respectively)
Conclusions: Simple insoles have been shown to be effective in reducing total and forefoot pain FFI scores in patients with RA experiencing metatarsalgia. This treatment offers advantages because these devices can be fabricated simply and cheaply, thus initiating the patient on an effective orthosis therapy immediately in the clinic without having to wait for prolonged periods until custom orthotic devices can be supplied.
Despite sufficient evidence to suggest that lower-limb–related factors may contribute to fall risk in older adults, lower-limb and footwear influences on fall risk have not been systematically summarized for readers and clinicians. The purpose of this study was to systematically review and synethesize the literature related to lower-limb, foot, and footwear factors that may increase the risk of falling among community-dwelling older adults.
We searched PubMed, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Library, and AgeLine. To describe the trajectory toward increasing risk of falls, we examined those articles that linked age-related changes in the lower limb or footwear to prospective falls or linked them to evidenced-based fall risk factors, such as gait and balance impairment.
This systematic review consisted of 81 articles that met the review criteria, and the results reflect a narrative review of the appraised literature for eight pathways of lower-limb–related influences on fall risk in older adults. Six of the eight pathways support a direct link to fall risk. Two other pathways link to the intermediate factors but lack studies that provide evidence of a direct link.
This review provides strong guidance to advance understanding and assist with managing the link between lower-limb factors and falls in older adults. Due to the lack of literature in specific areas, some recommendations were based on observational studies and should be applied with caution until further research can be completed.