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Foot and Ankle Clinics Dec 2021Congenital vertical talus represents a congenital structural foot deformity characterized by the classical rocker bottom deformity. The main feature is dislocation of... (Review)
Review
Congenital vertical talus represents a congenital structural foot deformity characterized by the classical rocker bottom deformity. The main feature is dislocation of the talonavicular joint along with contractures of the dorsolateral tendons of the foot and tendo Achilles. In the past treatment consisted of 2- or single-stage more or less extensive soft tissue releases including reduction of the talonavicular joint following casting in the first phase. Nowadays all feet are treated by serial casting, closed or miniopen talonavicular joint reduction, and percutaneous achillotenotomy. Functional results of the miniinvasive method are superior to those of the former more extensive surgical releases.
Topics: Achilles Tendon; Casts, Surgical; Flatfoot; Foot Deformities, Congenital; Humans; Talus; Tenotomy
PubMed: 34752243
DOI: 10.1016/j.fcl.2021.08.002 -
Journal of Back and Musculoskeletal... 2023Studies on the effects of performing short foot exercises (SFEs) on the medial longitudinal arch (MLA) have been inconclusive. (Review)
Review
BACKGROUND
Studies on the effects of performing short foot exercises (SFEs) on the medial longitudinal arch (MLA) have been inconclusive.
OBJECTIVE
This study aimed to conduct a systematic review of the effects of SFEs.
METHODS
'SFE' and 'intrinsic foot muscle' were keywords used to search for randomized controlled trials. One researcher screened relevant articles based on their titles and abstracts, and two independent researchers closely read the texts, accepting nine studies for inclusion. Outcomes, intervention duration, frequency, and the number of interventions were investigated.
RESULTS
Of 299 potential studies identified, the titles and abstracts of 211 studies were reviewed, and 192 were excluded. The full texts of 21 studies were obtained and evaluated according to inclusion and exclusion criteria. Nine studies met the inclusion criteria. Six studies concerning the MLA were identified, with four reporting MLA improvement. There was no consensus concerning the number and frequency of SFEs performed, and the mechanism of MLA improvement was unclear. MLA improvement was observed in participants who undertook ⩾ 5 weeks of interventions.
CONCLUSIONS
The results suggest that performing SFEs for ⩾ 5 weeks is effective in improving the MLA. Randomized controlled trials with details concerning the number and frequency of treatments are required.
Topics: Humans; Exercise Therapy; Flatfoot; Exercise; Foot; Muscle, Skeletal
PubMed: 35871320
DOI: 10.3233/BMR-210374 -
International Journal of Environmental... Jul 2022Background: This study aimed to explore the risk factors for flatfoot in children and adolescents to provide a reference basis for studying foot growth and development... (Meta-Analysis)
Meta-Analysis Review
Background: This study aimed to explore the risk factors for flatfoot in children and adolescents to provide a reference basis for studying foot growth and development in children and adolescents. Methods: We examined the cross-sectional research literature regarding flatfoot in children and adolescents published in the past 20 years, from 2001 to 2021, in four electronic databases: PubMed, Web of Science, EBSCO, and Cochrane Library. Two researchers independently searched the literature according to the inclusion and exclusion criteria and evaluated the literature quality of the selected research; from this, a total of 20 articles were included in our review. After the relevant data were extracted, the data were reviewed using Manager 5.4 software (The Cochrane Collaboration, Copenhagen, Denmark), and the detection rate and risk factors for flatfoot in children were analyzed. Results: In total, 3602 children with flatfoot from 15 studies were included in the analysis. The meta-analysis results showed that being male (OR = 1.33, 95% CI: 1.09, 1.62, p = 0.005), being aged <9 years (age <6, OR = 3.11, 95% CI: 2.47, 3.90, p < 0.001; age 6−9 years, OR = 0.54, 95% CI: 0.41, 0.70, p < 0.001), joint relaxation (OR = 4.82, 95% CI: 1.19, 19.41, p = 0.03), wearing sports shoes (OR = 2.97, 95% CI: 1.46, 6.03, p = 0.003), being a child living in an urban environment (OR = 2.10, 95% CI: 1.66, 2.64, p < 0.001) and doing less exercise (OR = 0.25, 95% CI: 0.08, 0.80, p = 0.02) were risk factors for the detection of flatfoot. Conclusion: In summary, the detection rate of flatfoot in children in the past 20 years was found to be 25% through a meta-analysis. Among the children included, boys were more prone to flatfoot than girls, and the proportion of flatfoot decreased with age.
Topics: Adolescent; Child; Cross-Sectional Studies; Female; Flatfoot; Foot; Humans; Male; Risk Factors; Shoes
PubMed: 35886097
DOI: 10.3390/ijerph19148247 -
Journal of Sport Rehabilitation May 2020Pes planus is a prevalent chronic condition that causes foot pain, disability, and impaired plantar load distribution. Short-foot exercises are often recommended to...
CONTEXT
Pes planus is a prevalent chronic condition that causes foot pain, disability, and impaired plantar load distribution. Short-foot exercises are often recommended to strengthen intrinsic foot muscles and to prevent excessive decrease of medial longitudinal arch height.
OBJECTIVE
To investigate the effects of short-foot exercises on navicular drop, foot posture, pain, disability, and plantar pressures in pes planus.
DESIGN
Quasi-experimental study.
SETTING
Biomechanics laboratory.
PARTICIPANTS
A total of 41 participants with pes planus were assigned to the short-foot exercises group (n = 21) or the control group (n = 20).
INTERVENTION
Both groups were informed about pes planus, usual foot care, and appropriate footwear. Short-foot exercises group performed the exercises daily for 6 weeks.
MAIN OUTCOME MEASURES
Navicular drop, Foot Posture Index, foot pain, disability, and plantar pressures were assessed at the baseline and at the end of 6 weeks.
RESULTS
Navicular drop, Foot Posture Index, pain, and disability scores were significantly decreased; maximum plantar force of midfoot was significantly increased in short-foot exercises group over 6 weeks (P < .05). No significant differences were determined between the baseline and the sixth week outcomes in control group (P > .05).
CONCLUSIONS
Six-week short-foot exercises provided a reduction in navicular drop, foot pronation, foot pain, and disability and increment in plantar force of medial midfoot in pes planus.
Topics: Adolescent; Exercise Therapy; Female; Flatfoot; Foot; Humans; Male; Muscle Strength; Pain; Posture; Pressure; Pronation; Young Adult
PubMed: 30860412
DOI: 10.1123/jsr.2018-0363 -
Journal of Foot and Ankle Research 2018Flexible flat foot is a normal observation in typically developing children, however, some children with flat feet present with pain and impaired lower limb function.... (Review)
Review
BACKGROUND
Flexible flat foot is a normal observation in typically developing children, however, some children with flat feet present with pain and impaired lower limb function. The challenge for health professionals is to identify when foot posture is outside of expected findings and may warrant intervention. Diagnoses of flexible flat foot is often based on radiographic or clinical measures, yet the validity and reliability of these measures for a paediatric population is not clearly understood. The aim of this systematic review was to investigate how paediatric foot posture is defined and measured within the literature, and if the psychometric properties of these measures support any given diagnoses.
METHODS
Electronic databases (MEDLINE, CINAHL, EMBASE, Cochrane, AMED, SportDiscus, PsycINFO, and Web of Science) were systematically searched in January 2017 for empirical studies where participants had diagnosed flexible flat foot and were aged 18 years or younger. Outcomes of interest were the foot posture measures and definitions used. Further articles were sought where cited in relation to the psychometric properties of the measures used.
RESULTS
Of the 1101 unique records identified by the searches, 27 studies met the inclusion criteria involving 20 foot posture measures and 40 definitions of paediatric flexible flat foot. A further 18 citations were sought in relation to the psychometric properties of these measures. Three measures were deemed valid and reliable, the FPI-6 > + 6 for children aged three to 15 years, a Staheli arch index of > 1.07 for children aged three to six and ≥ 1.28 for children six to nine, and a Chippaux-Smirak index of > 62.7% in three to seven year olds, > 59% in six to nine year olds and ≥ 40% for children aged nine to 16 years. No further measures were found to be valid for the paediatric population.
CONCLUSION
No universally accepted criteria for diagnosing paediatric flat foot was found within existing literature, and psychometric data for foot posture measures and definitions used was limited. The outcomes of this review indicate that the FPI - 6, Staheli arch index or Chippaux-Smirak index should be the preferred method of paediatric foot posture measurement in future research.
Topics: Anthropometry; Child; Child Development; Flatfoot; Foot; Humans; Posture; Psychometrics; Reproducibility of Results; Research Design
PubMed: 29854006
DOI: 10.1186/s13047-018-0264-3 -
Gait & Posture Jan 2020No reliable evidence has confirmed whether plantar intrinsic foot muscle strengthening exercises improve static and dynamic foot kinematics in individuals with pes... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of plantar intrinsic foot muscle strengthening exercise on static and dynamic foot kinematics: A pilot randomized controlled single-blind trial in individuals with pes planus.
BACKGROUND
No reliable evidence has confirmed whether plantar intrinsic foot muscle strengthening exercises improve static and dynamic foot kinematics in individuals with pes planus.
RESEARCH QUESTION
Does the short-foot exercise affect static foot alignment and foot kinematics during gait in individuals with pes planus?
METHODS
This was a randomized controlled single-blind trial involving 20 participants with pes planus who were randomly allocated to a short-foot exercise group (exercise) or a control group (controls). Exercise patients performed a progressive short-foot exercise three times per week for 8 weeks; controls received no intervention. Before and after the 8-week intervention, foot kinematics during gait, including dynamic navicular drop-the difference between navicular height at heel strike and the minimum value-and the time at which navicular height reached its minimum value were assessed, using three-dimensional motion analysis. We assessed static foot alignment by foot posture index and navicular drop test, and the thickness of the intrinsic and extrinsic foot muscles using ultrasound. All measurements were performed by one investigator (KO) blinded to the participants' allocation.
RESULTS
After the 8-week intervention in the exercise group, foot posture index scores with regard to calcaneal inversion/eversion improved significantly (p < 0.05). Moreover, the time required for navicular height to reach the minimum value decreased significantly (p < 0.01).
SIGNIFICANCE
For individuals with pes planus, the short-foot exercise effectively corrected static foot alignment and temporal parameters of foot kinematics during gait. This temporal change, which shortens the time for navicular height to reach its minimum value, indicates an improved windlass mechanism. Therefore, short-foot exercise might effectively prevent or treat injuries related to the pes planus alignment.
Topics: Biomechanical Phenomena; Exercise Therapy; Female; Flatfoot; Gait; Humans; Male; Muscle Strength; Muscle, Skeletal; Pilot Projects; Posture; Single-Blind Method; Ultrasonography; Young Adult
PubMed: 31590069
DOI: 10.1016/j.gaitpost.2019.09.030 -
European Journal of Physical and... Jun 2023Flatfoot is a musculoskeletal problem associated with dysfunctional active and passive supporting structures of the normal foot curvature. Strengthening of the intrinsic... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Flatfoot is a musculoskeletal problem associated with dysfunctional active and passive supporting structures of the normal foot curvature. Strengthening of the intrinsic foot muscles or using shoe orthosis are recommend treatment approaches. However, investigating the effect of combining both approaches is still warranted.
AIM
To examine the effect of applying short foot exercises (SFE) combined with shoe insole versus shoe insole alone on foot pressure measures, pain, function and navicular drop in individuals with symptomatic flexible flatfoot.
DESIGN
Prospective, active control, parallel-group, assessor-blinded, randomized controlled trial and intention-to-treat analysis.
SETTING
Outpatient physical therapy clinic of a university teaching hospital.
POPULATION
Forty participants with symptomatic flexible flatfoot.
METHODS
A six-week treatment protocol of SFE (three sets of 10 repetitions a day) in addition to shoe insole (eight hours a day) (experimental group, N.=20) or shoe insole only (eight hours a day) (control group, N.=20). Clinic visits were made at baseline and every two weeks for monitoring and follow-up. The static and dynamic foot area, force and pressure measures, pain, lower extremity function, and navicular drop were assessed at baseline and postintervention.
RESULTS
Forty participants joined the study and 37 (92.5%) completed the six-week intervention period. Foot pressure, pain and function showed a significant interaction (P=0.02 - <0.001) and time (P<0.001) effects with a non-significant group effect in favor of the experimental group. Post-hoc analysis revealed that the experimental group had lesser pain (P=0.002) and better function (P=0.03) than the control group at six weeks. Navicular drop decreased equally in both groups.
CONCLUSIONS
Implementation of shoe insole and SFE for six weeks improved pain and function and altered foot pressure distribution greater than shoe insole alone in patients with symptomatic flatfoot.
CLINICAL REHABILITATION IMPACT
Wearing shoe insole is an easy, but passive, treatment approach for a flatfoot problem. This study provided evidence regarding the added benefit of SFE. It is recommended that rehabilitation practitioners implement a comprehensive treatment protocol including both shoe insole and SFE for at least six weeks to achieve better results for their flatfoot patients.
Topics: Humans; Flatfoot; Prospective Studies; Foot Orthoses; Foot; Pain
PubMed: 36988565
DOI: 10.23736/S1973-9087.23.07846-2 -
The Journal of the American Academy of... Oct 2015Congenital vertical talus is a rare foot deformity. If left untreated, it causes significant disability, including pain and functional limitations. Although the etiology... (Review)
Review
Congenital vertical talus is a rare foot deformity. If left untreated, it causes significant disability, including pain and functional limitations. Although the etiology of vertical talus is likely heterogeneous, recent evidence strongly supports a genetic cause linking it to genes expressed during early limb development. Traditional management for vertical talus involves extensive surgeries that are associated with significant short- and long-term complications. A minimally invasive approach that relies on serial manipulation and casting to achieve most of the correction has been shown to produce excellent short-term results with regard to clinical and radiographic correction in both isolated and nonisolated cases of vertical talus. Although long-term studies are needed, achieving correction without extensive surgery may lead to more flexible and functional feet, much as Ponseti method has done for clubfeet.
Topics: Casts, Surgical; Flatfoot; Foot Deformities, Congenital; Humans; Minimally Invasive Surgical Procedures; Orthopedic Procedures; Range of Motion, Articular
PubMed: 26337950
DOI: 10.5435/JAAOS-D-14-00034 -
Der Orthopade Nov 2020
Topics: Adult; Flatfoot; Foot Deformities, Acquired; Humans
PubMed: 33136192
DOI: 10.1007/s00132-020-03989-3 -
Seminars in Musculoskeletal Radiology Jun 2023Ankle and foot deformity is one of the most common musculoskeletal disorders in children and a leading cause of functional impairment and diminished quality of life when...
Ankle and foot deformity is one of the most common musculoskeletal disorders in children and a leading cause of functional impairment and diminished quality of life when not treated. A spectrum of conditions may produce foot and ankle deformities, with congenital disorders the most frequent cause, followed by acquired conditions. Congenital disorders include congenital talipes equinovarus or congenital clubfoot, metatarsus adductus, skewfoot, congenital vertical talus, and tarsal coalition.Some of these deformities are frequent and easily diagnosed based on clinical features, but clinical overlap between pathologies can be challenging. Thus imaging plays a paramount role in evaluating these patients. Radiographs are the first imaging modality of choice, but they may not be sufficient in infants due to the lack of ossification of the tarsal bones. Ultrasonography allows not only a detailed visualization of the cartilaginous structures but also permits a dynamic study of the foot and ankle. Computed tomography may be necessary in certain conditions such as tarsal coalitions.
Topics: Infant; Humans; Child; Ankle; Quality of Life; Clubfoot; Flatfoot; Ankle Joint; Foot Deformities, Congenital
PubMed: 37230135
DOI: 10.1055/s-0043-1766099