Background: This cross-sectional study aimed to determine whether normal, flat, or high-arched feet corresponded to better performance of certain motor tests in children.
Methods: One hundred eighty-seven children (mean ± SD age, 11.15 ± 1.24 years) were recruited and divided into three groups: 96 with normal feet, 54 with high-arched feet, and 37 with low-arched feet. Nine motor trials were selected to assess motor performance: standing long jump, standing triple jump from each foot, standing vertical jump, shuttle run 10 × 5 m, standing-start 20-m sprint, static balance, dynamic balance on a beam of an inverted gym bench, and agility circuit.
Results: There were no significant differences in the trial results between groups, although in eight of the nine trials participants in the high-arched group tended to perform better. Boys performed better than girls in all of the trials except those of balance.
Conclusions: These results suggest that children with a certain foot type did not achieve better motor performance in the nine trials tested.
Background: Podiatric and osteopathic medical students at Des Moines University take the same basic science medical curriculum. The first course students complete is medical biochemistry. The final common course is the second-year medical pharmacology course. Attrition typically occurs between these academic offerings. We sought to compare admissions data, retention rates, and academic performance between these two groups of medical students for the classes of 2008 to 2011.
Methods: Average admission scores, performance scores for the biochemistry and medical pharmacology courses, and retention rates for the 2008 to 2011 classes were obtained from the registrar and enrollment offices. One-way analysis of variance was used to compare the scores of the two cohorts. Linear regression was used to identify changes across time.
Results: The DO students showed significantly better performance than the DPM students in matriculating overall and science grade point averages, total Medical College Admissions Test scores, retention rates, and the medical biochemistry course (P < .01). There was no difference in the performance of the student groups in the medical pharmacology course. The DPM student scores across the four classes increased for both academic courses, whereas the DO student scores remained at the same level for medical biochemistry, at a rate of 0.74% per year (R2 = 0.50), and pharmacology, at a rate of 0.90% per year (R2 = 0.49).
Conclusions: Admissions data and initial academic performance of osteopathic medical students were higher than those of podiatric medical students. Once attrition occurred in year 1, the difference in academic performance between these groups of students was no longer statistically significant, and students in both medical programs at that time in the curriculum are equally academically qualified. (J Am Podiatr Med Assoc 100(4): 276–280, 2010)
Background: This pilot study explores the influence of preadmission data on podiatric medical school performance, specifically, the role of undergraduate institutional selectivity. This type of study has never been described in the podiatric medical education literature. We conducted a longitudinal analysis of preadmission data on 459 students from the graduating classes of 2000 to 2009 at the College of Podiatric Medicine and Surgery at Des Moines University.
Methods: Multivariate linear regression was used to assess the relationship between performance during the first year of podiatric medical school and a set of independent variables that represent certain preadmission student characteristics. Student demographic characteristics, such as race/ethnicity and sex, were also included in the regression analysis as control variables.
Results: The regression analysis revealed that ethnic origin, undergraduate grade point average, Medical College Admission Test biological science and verbal reasoning scores, and institutional selectivity together had a significant effect on the dependent variable (F = 18.3; P < .001). The variance for the independent variable/constant variables was 32%. Almost twice as many students were dismissed or withdrew in poor academic standing who attended undergraduate institutions in the lowest selectivity category.
Conclusions: This analysis revealed that in the College of Podiatric Medicine and Surgery, some preadmission variables, such as institutional selectivity, undergraduate grade point average, ethnic origin, and Medical College Admission Test verbal reasoning and biological science scores, are statistically significant in predicting first-year podiatric medical school grade point average. The selectivity of a student’s undergraduate institution should be considered when screening potential podiatric medical school applicants. (J Am Podiatr Med Assoc 100(6): 479–486, 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.
Background: Direct assessment of health professional student performance of clinical skills can be accurately performed in the standardized performance assessment laboratory (SPAL), typically by health professional faculty. However, owing to time and economic considerations, nonmedical individuals have been specially trained to perform the same function (standardized patients [SPs]). This study compared the assessment scores of the history and physical examination components of a SPAL designed for second-year podiatric medical students at Des Moines University (DMU) by a podiatry medical faculty member and SPs.
Methods: A total of 101 students from the classes of 2015 and 2016 were evaluated in 2013 and 2014 by 11 to 13 SPs from the DMU SPAL program. The video recordings of these 101 students were then evaluated by one faculty member from the College of Podiatric Medicine and Surgery at DMU.
Results: The Pearson correlation coefficient for each class showed a strong linear relationship between SP and faculty assessment scores. The associations between SP and faculty assessment scores in the history, physical examination, and combined history and physical examination components for the 2016 class (0.706, 0.925, and 0.911, respectively) were found to be stronger than those for the 2015 class (0.697, 0.791, and 0.791, respectively).
Conclusions: This study indicated that there are strong associations between the assessment scores of trained SPs and faculty for the history, physical examination, and combined history and physical examination components of second-year SPAL activity for podiatric medical students.
A cross-sectional survey administered to first- and second-year podiatric medical students aimed to investigate the effect of coffee intake, energy drink consumption, and perceived stress on sleep quality in medical students during their preclinical studies.
Ninety-eight of 183 students contacted (53.6%) completed a questionnaire comprising standard instruments measuring sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness scale), and perceived stress (ten-item Perceived Stress Scale). Furthermore, we investigated coffee and energy drink consumption. Logistic regression was conducted to identify factors associated with poor sleep quality and the relation between sleep quality and academic performance (grade point average).
High prevalences of poor sleep quality, excessive daytime sleepiness, and perceived stress were reported. In addition, higher odds of developing poor sleep quality were associated with coffee and energy drink intake, perceived stress, and excessive daytime sleepiness. The total Pittsburgh Sleep Quality Index score was inversely correlated with grade point average.
First- and second-year podiatric medical students have poor sleep quality. Further research is needed to identify effective strategies to reduce stress and decrease coffee and energy drink intake to minimize their negative effect on sleep quality and academic performance in podiatric medical students.
Research on foot problems and frailty is sparse and could advance using wearable sensor–based measures of gait, balance, and physical activity (PA). This study examined the effect of foot problems on the likelihood of falls, frailty syndrome, motor performance, and PA in community-dwelling older adults.
Arizona Frailty Cohort Study participants (community-dwelling adults aged ≥65 years without baseline cognitive deficit, severe movement disorders, or recent stroke) underwent Fried frailty and foot assessment. Gait, balance (bipedal eyes open and eyes closed), and spontaneous PA over 48 hours were measured using validated wearable sensor technologies.
Of 117 participants, 41 (35%) were nonfrail, 56 (48%) prefrail, and 20 (17%) frail. Prevalence of foot problems (pain, peripheral neuropathy, or deformity) increased significantly as frailty category worsened (any problem: 63% in nonfrail, 80% in prefrail [odds ratio (OR) = 2.0], and 95% in frail [OR = 8.3]; P = .03 for trend) due to associations between foot problems and both weakness and exhaustion. Foot problems were associated with fear of falling but not with fall history or incident falls over 6 months. Foot pain and peripheral neuropathy were associated with lower gait speed and stride length; increased double support time; increased mediolateral sway of center of mass during walking, age adjusted; decreased eyes open sway of center of mass and ankle during quiet standing, age adjusted; and lower percentage walking, percentage standing, and total steps per day.
Foot problems were associated with frailty level and decreased motor performance and PA. Wearable technology is a practical way to screen for deterioration in gait, balance, and PA that may be associated with foot problems. Routine assessment and management of foot problems could promote earlier intervention to retain motor performance and manage fear of falling in older adults, which may ultimately improve healthy aging and reduce risk of frailty.
Achilles tendon injuries are among the three most frequent sports-related injuries of the foot and ankle. Proper function of the Achilles tendon is critical to performance in sports. A thorough knowledge of the anatomy and biomechanical function of this tendon is essential to the effective treatment of these injuries. Distinguishing among the various pathologies of the Achilles tendon is an important first step toward successful treatment and return of the athlete to sports activity. The term Achilles tendinitis is a nonspecific diagnosis that does not accurately describe an actual injury. This review is intended to provide the sports medicine physician with a means of classifying Achilles tendon injuries and, thus, arriving at an accurate diagnosis and treatment plan. (J Am Podiatr Med Assoc 97(1): 37–48, 2007)
We sought to investigate the effect of wearing shoes on joint range of motion, ground reaction force (GRF), and muscle activity (electromyography) in children with flat and normal feet during walking.
Nine children with flat feet and 12 children with normal feet aged 5 to 11 years were recruited. Each child was instructed to walk on a walkway in the barefoot and shod conditions. Joint range of motion, GRF, and electromyographic data within one gait cycle were collected simultaneously. Two-way analysis of variance was performed to evaluate the effects of foot type and shoe condition on the response measures.
Children with flat feet had greater joint motion and higher muscle activities in the lower extremity, as well as lower vertical GRF and longer duration of the first peak forces in vertical and mediolateral GRFs than children with normal feet while walking. Compared with the barefoot condition, shoe wearing in both groups of children showed an increase in ankle dorsiflexion at heel strike, a decrease in anteroposterior GRF and its duration, and an increase in leg muscle electromyographic activities. Pelvic tilt range of motion was affected by the interaction of foot type and shoe condition.
Gait performance in pelvic tilt, hip flexion, and ankle dorsiflexion were different between the two groups of children. Wearing shoes increased the muscle activities of the shin. This finding can provide important information for clinical assessment of and shoe design for children with flat feet.
Insoles are commonly used to assist in the prevention of diabetic neuropathic foot ulceration. Insole replacement is often triggered only when foot lesions deteriorate, an indicator that functional performance is comprised and patients are exposed to unnecessary ulcer risk. We investigated the durability of insoles used for ulcer prevention in neuropathic diabetic feet over 12 months.
Sixty neuropathic individuals with diabetes were provided with insoles and footwear. Insole durability over 12 months was evaluated using an in-shoe pressure measurement device and through repeated measurement of material depth at the first metatarsal head and the heel seat. Analysis of variance was performed to assess change across time (at issue, 6 months, and 12 months).
Analyses were conducted using all available data (n = 43) and compliant data (n = 18). No significant difference was found in the reduction of mean peak pressure tested across time (P < .05). For both sites, significant differences in insole depth were identified between issue and 6 months and between issue and 12 months but not between 6 and 12 months (P < .05). Most insole compression occurred during the initial 6 months.
Visual material compression does not seem to be a reliable indicator of insole usefulness. Frequency of insole replacement is best informed by a functional review of effect determined using an in-shoe pressure measurement system. These results suggest that insoles for diabetic neuropathic patients can be effective in maintaining peak pressure reduction for 12 months regardless of wear frequency.