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Athletic injuries of the foot and lower extremity are commonly treated with custom foot orthoses. These devices usually provide immediate relief of the athlete’s pain and dysfunction. Occasionally, however, they do not help, or even increase the patient’s discomfort. We discuss a method of using in-shoe pressure-measurement systems to analyze the athletic patient’s foot and lower-extremity function before and after treatment with custom foot orthoses, with a focus on sagittal plane biomechanics. Case histories are presented of athletes whose gait pathologies were identified and treated successfully using an in-shoe pressure-measurement system. (J Am Podiatr Med Assoc 97(1): 49–58, 2007)
Background:
Malalignment and dysfunction of the foot have been associated with an increased propensity for overuse and traumatic injury in athletes. Several multisegment foot models have been developed to investigate motions in the foot. However, it remains unknown whether the kinematics measured by different multisegment foot models are equivocal. The purpose of the present study is to examine the efficacy of two multisegment foot models in tracking aberrant foot function.
Methods:
Ten high-arched and ten low-arched female athletes walked and ran while ground reaction forces and three-dimensional kinematics were tracked using the Leardini and Oxford multisegment foot models. Ground reaction forces and joint angles were calculated with Visual 3D (C-Motion Inc, Germantown, MD). Repeated-measures analyses of variance were used to analyze peak eversion, time to peak eversion, and eversion excursions.
Results:
The Leardini model was more sensitive to differences in peak eversion angles than the Oxford model. However, the Oxford model detected differences in eversion excursion values that the Leardini model did not detect.
Conclusions:
Although both models found differences in frontal plane motion between high- and low-arched athletes, the Leardini multisegment foot model is suggested to be more appropriate as it directly tracks frontal plane midfoot motion during dynamic motion. (J Am Podiatr Med Assoc 103(2): 99–105, 2013)
Background:
Idiopathic toe-walking (ITW) in children has been associated with ankle equinus. Although equinus has been linked to foot deformity in adults, there has been limited investigation of the impact of equinus on structural foot change in children. We used the weightbearing lunge test and the six-item version of the Foot Posture Index (FPI-6) to evaluate the weightbearing foot and ankle measures of children with an ITW gait and to compare these with their age-matched peers.
Methods:
Sixty 4-to 6-year-old children were grouped into ITW (n = 30) and non–toe-walking (n = 30) cohorts using a validated ITW tool. Ankle range of motion was determined with weightbearing lunge tests. The FPI-6 was calculated during weightbearing stance.
Results:
There was a highly significant difference in the weightbearing lunge test measures between the ITW cohort and the non–toe-walking cohort. The FPI-6 comparison was not significant. The straight-leg lunge test had a statistically significant relationship with the FPI-6 in the ITW cohort.
Conclusion:
Children with an ITW gait demonstrated reduced flexibility at the ankle joint but similar weightbearing foot posture compared with non–toe-walking children, showing that for children 4 to 8 years old, an ITW gait affects the available ankle dorsiflexion but seems to have a limited effect on weightbearing foot posture as measured by the FPI-6. (J Am Podiatr Med Assoc 103(5): 374–379, 2013)
Background: Anterior cruciate ligament injuries are more prevalent in female athletes than in male athletes. Basketball is a high-risk sport for anterior cruciate ligament injury in female athletes. This study was conducted to observe the effect of a foot orthosis on the knee ligament injury rate in female basketball players at one US university.
Methods: One hundred fifty-five players on the women’s basketball team were observed for knee ligament injury from 1992 to 2005. Athletes in the 1992–1993 to 1995–1996 school years (July–June) did not receive a foot orthosis and served as the control group; the treatment group comprised the athletes during the 1996–1997 to 2004–2005 school years (July–June). Athletes in the treatment group received a foot orthosis before participating in basketball. Data analysis included knee ligament injury rates and a comparison of injury rates with an incidence density ratio.
Results: Athletes in the control group had three collateral ligament injuries and three anterior cruciate ligament injuries, for an injury rate of 0.50 for both the anterior cruciate ligament and collateral ligaments. Athletes in the treatment group had four collateral ligament injuries and one anterior cruciate ligament injury, for an injury rate of 0.29 for the collateral ligaments and 0.07 for the anterior cruciate ligament. Athletes in the control group were 1.72 times more likely to sustain a collateral ligament injury and 7.14 times more likely to sustain an anterior cruciate ligament injury than the treatment group.
Conclusions: Foot orthoses may contribute to a decreased knee ligament injury rate in female collegiate basketball players. (J Am Podiatr Med Assoc 98(3): 207–211, 2008)
Fungal foot infections are becoming an increasingly common public health problem as the population ages. New studies have shown that some of the traditional therapeutic antifungal agents have multiple actions that enable them to be more efficacious than previously thought, and more efficacious than other agents without multiple actions. In this review article, the pedal infections commonly referred to as tinea pedis, or athlete's foot, are described. The etiologic agents involved in the pathogenesis, the methodologies for proper diagnosis, and the therapeutic agents commercially available for treatment are reviewed.
Anterior Cruciate Ligament Injury in Female and Male Athletes
The Relationship Between Foot Structure and Injury
Background: It has been shown that anterior cruciate ligament (ACL) injuries are more prevalent in female athletes than in male athletes. Soccer and basketball are considered high-risk sports for ACL injury in female athletes. Several studies have reported a relationship between ACL injury and measures of foot structure. This study was conducted to investigate the relationship between foot structure and ACL injury rates in female and male soccer and basketball players.
Methods: One hundred five soccer and basketball players (53 women and 52 men) were recruited and divided into an ACL-normal group (n = 89) and an ACL-injured group (n = 16). Two measures of foot structure (subtalar joint neutral position and navicular drop test values) were recorded for each subject. An independent t test and a paired t test were used to analyze differences in ACL status, foot structure, and sex. A χ2 analysis determined whether the prevalence of ACL injury was independent of sport.
Results: No statistically significant differences were found in the foot structure measures between women and men. Female soccer and basketball players had an ACL injury rate seven times that of male players.
Conclusions: Values derived from subtalar joint neutral position measurement and the navicular drop test were not associated with ACL injury in collegiate female and male soccer and basketball players. (J Am Podiatr Med Assoc 97(5): 371–376, 2007)
Repeatable measures are essential for clinicians and researchers alike. Both need baseline measures that are reliable, as intervention effects cannot be accurately identified without consistent measures. The intrarater and interrater reliability of the new Foot Posture Index and current podiatric measures of foot position were assessed using a same-subject, repeated-measures study design across three age groups. The Foot Posture Index total score showed moderate reliability overall, demonstrating better reliability than most other current measures, although navicular height (normalized for foot length) was the single most reliable measure in adults. None of the tested measures exhibited adequate reliability in young children, and, with less-than-desirable reliability being demonstrated, most measures need to be interpreted accordingly when repeated measures are involved. (J Am Podiatr Med Assoc 93(3): 203-213, 2003)
Background:
We developed a prototype of a novel thermochromic liquid crystal (TLC)–coated fabric with an extended temperature range and enhanced sensitivity. By incorporating color and pattern recognition into the fabric, rapid determination of the underlying pedal temperature is facilitated. The purpose of this study was to evaluate the accuracy of the TLC fabric as a potential diagnostic aid for identifying complications in the high-risk foot.
Methods:
The hands of 100 individuals were used to compare the mean maximum temperatures indicated by the fabric versus standard thermal camera images. Findings were statistically analyzed using a paired t test, with significance defined as P < .05.
Results:
Except for the tip of the thumb and regions in the palm, there were no statistically significant differences between mean maximum temperatures measured with the thermal camera and those detected with the TLC fabric. Minor differences were relatively consistent in all nine regions of the hand and were not considered to be clinically significant.
Conclusions:
Using direct visual analysis, we demonstrated that a novel TLC fabric could accurately map temperatures in the palmar surface of the hand. The findings support the continued development of a temperature-sensitive sock that can be used in the home to monitor for temperature changes that may indicate the onset of complications in the high-risk foot.
