Search Results
Abstract
Objectives: To examine the effects of foot dominance and body mass on foot plantar pressures in older women of regular, overweight, and obese weights.
Methods: 96 female adults were divided into regular-weight group (68.30 ± 4.19 yr), overweight group (69.88 ± 3.76 yr), and obesity group (68.47 ± 3.67 yr) based on their body mass index scores. Footscan® plantar pressure test system was used to assess the dynamic plantar pressures, and parameters were collected from risk analysis, foot axis analysis, single foot timing analysis, and pressure analysis.
Results: (1) The local risks of lateral forefoot and midfoot, the minimum and maximum subtalar joint angles, the flexibility of subtalar joint, foot flat phase, as well as the average pressures on toes, metatarsals,, midfoot, and lateral heel, with the peak pressures on toe 2–5, metatarsal 2, metatarsal 5, midfoot, and lateral heel had significant within-subject differences. (2) The phases of initial contact and foot flat, the average pressures on toe 2–5, metatarsals, midfoot, and heels, with the peak pressures on metatarsal 1–4, midfoot, and heels exhibited significant between-subjects differences. (3) There was an interaction effect of foot dominance and body mass index on the flexibility of subtalar joint.
Conclusions: The non-dominant foot works better for stability, especially when touching on and off the ground. The dominant foot works better for propulsion but is more susceptible to pain, injury, and falls. For obese older women, the forefoot and midfoot are primarily responsible for maintaining stability, but the lateral midfoot and hindfoot are more prone to pain and discomfort.
Background: Studies of arch height index (AHI), arch rigidity index (ARI), and arch stiffness have primarily focused on healthy populations. Normative values of the aforementioned measurements in a pathologic sample may be useful in identifying relationships between arch structure and pathology.
Methods: AHI was obtained bilaterally at 10% and 90% weightbearing conditions using the AHI measurement system. ARI and arch stiffness were calculated using AHI measurements. Dependent t tests compared right and left, dominant and nondominant, and injured and noninjured limbs. Dominant feet were compared between sexes using independent t tests. Relationships between arch stiffness and subcategories were examined using the coefficient of determination (R2). One-way analyses of variance determined differences between arch structure and number of pathologies or body mass index (BMI).
Results: A total of 110 participants reported one (n = 55), two (n = 38), or three or more (n = 17) pathologies. Plantar fasciitis (n = 31) and hallux valgus (n = 28) were the most common. AHI, ARI, and arch stiffness did not differ between limbs or sexes for any comparisons. Between subgroups of BMI and number of pathologies, BMI influenced AHI (10% weightbearing) and arch stiffness (P < .05). Arch stiffness showed a weak relationship to AHI, where a higher AHI was associated with a stiffer arch (R2 = 0.06).
Conclusions: Normative arch structure values were established in a pathologic sample with a large incidence of plantar fasciitis and hallux valgus. Understanding relationships between arch structure and pathology is helpful for clinicians and researchers.
Background: Hyperkeratosis is a hypertrophic thickening of the skin. A callus (tyloma) is considered diffuse thickening, whereas a corn—also known as a clavus, heloma durum, or intractable plantar hyperkeratosis (IPK)—is a more focal, circumscribed hyperkeratotic lesion with a central conical core of keratin. Treatment (including surgical excision) of plantar keratoses is often sought because of pain and discomfort. The aim of this study was to collect and chart data regarding the surgical excision of plantar corns. The emerging themes were then mapped so that suggestions for areas of future research could be made.
Methods: A scoping review of the literature was performed using the six-stage methodologic framework (minus stage 6) proposed by Arksey and O’Malley incorporating the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews reporting guideline. A database search by means of the United Kingdom National Health Service Care Advanced Database Search yielded 1,056 articles, 12 of which appeared to be of potential relevance. After removing five duplicate articles, this total was reduced to seven, which were retrieved as full texts. Three were excluded. Thirteen further articles were found through Google Scholar and reference lists from the full texts retrieved to give 17 articles for review. One was discounted as not being in English/irrelevant; and one article did not relate to IPK excision, leaving 15 articles for data extraction.
Results: Iterative charting of the included articles yielded overlapping codes and two main themes. The first theme was closure: by primary intention (with or without a skin flap) or by secondary intention. The second theme was whether excision was performed in combination with IPK excision with other (bony) surgery.
Conclusions: There is modest evidence that excision of the lesion with either primary closure or healing by means of secondary intention can be useful for the management of IPKs. A further consideration is an emerging hypothesis that many of these IPKs are viral in origin, rather than mechanical, which implies that prospective studies are required with cross-reference to lesion excision by anatomical site and histopathologic confirmation of the diagnosis.
Objective: Computed tomography (CT) is superior to plain radiography for evaluating ankle syndesmosis, but anatomical variations can affect the measurements. This study aimed to assess the radiologic parameters of the incisura fibularis and the factors that could affect these parameters.
Materials and Methods: Lower-extremity CT angiography images were used to evaluate the morphology of the incisura fibularis, anterior and posterior tibiofibular distance, longitudinal and transverse length of the distal fibula, length and depth of the incisura fibularis notch, tibiofibular clear space, tibiofibular overlap, and fibular rotation. Each measured parameter was compared based on sex and body side. Also, the effect of age, height, weight, and body mass index (BMI) on parameters was evaluated.
Results: A total of 123 patients (83 men and 40 women) were included, and 246 ankles were measured. The CT measurements demonstrated excellent intraobserver and interobserver reliability. No statistically significant sex or side differences were found in tibiofibular overlap (TFO) and tibiofibular clear space, the most-used parameters in radiographs. Age, weight, and BMI were found to be correlated with TFO.
Conclusions: The present study provides CT measurements of the normal tibiofibular syndesmosis in the Turkish population. Also, the correlations of the parameters with age, height, weight, and BMI are presented. Therefore, TFO and tibiofibular clear space of the uninjured side can be used to plan the treatment of ankle injuries.
The Occurrence of Ipsilateral or Contralateral Foot Disorders and Hand Dominance
The Framingham Foot Study
Background:
To our knowledge, hand dominance and side of foot disorders has not been described in the literature. We sought to evaluate whether hand dominance was associated with ipsilateral foot disorders in community-dwelling older men and women.
Methods:
Data were from the Framingham Foot Study (N = 2,089, examined 2002–2008). Hand preference for writing was used to classify hand dominance. Foot disorders and side of disorders were based on validated foot examination findings. Generalized linear models with generalized estimating equations were used to estimate odds ratios and 95% confidence intervals, accounting for intraperson variability.
Results:
Left-handed people were less likely to have foot pain or any foot disorders ipsilateral but were more likely to have hallux valgus ipsilateral to the left hand. Among right-handed people, the following statistically significant increased odds of having an ipsilateral versus contralateral foot disorder were seen: 30% for Morton’s neuroma, 18% for hammer toes, 21% for lesser toe deformity, and a twofold increased odds of any foot disorder; there was a 17% decreased odds for Tailor’s bunion and an 11% decreased odds for pes cavus.
Conclusions:
For the 2,089 study participants, certain forefoot disorders were shown to be ipsilateral and others were contralateral to the dominant hand. Future studies should examine whether the same biological mechanism that explains ipsilateral hand and foot preference may explain ipsilateral hand dominance and forefoot disorders. (J Am Podiatr Med Assoc 103(1): 16–23, 2013)
Background: This study investigated the effects of two low-Dye and two high-Dye strapping techniques that are commonly used to treat pronatory sequelae.
Methods: Plantar pressure distribution in normal adults with a pronated foot type was assessed with a commercially available pressure platform system. Twenty study participants first walked across the platform barefoot and then with each of the four strapping conditions applied. The footprints were averaged and divided into seven areas for analysis.
Results: Paired t tests found significant differences between the barefoot and strapping conditions. Overall, there was a general lateralization of pressures indicating an antipronation effect from all strapping conditions. Low-Dye strap 2, used to limit the degree of calcaneal eversion, produced the most significant changes at the foot pressure areas analyzed.
Conclusions: The data reported in this study suggest that the four strapping techniques offer different levels of control, and this should be considered during the decision-making process and clinical management of pronatory conditions. It was the contention of this study that low-Dye strap 2 was the most effective strapping technique to control foot mechanics associated with a pronated foot type. (J Am Podiatr Med Assoc 99(5): 391–398, 2009)
