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Scientific Reports Nov 2020The aim of this study was to examine the effects of individually designed insole in pes planus treatment. Designed insoles was adjusted according to height, length and...
The aim of this study was to examine the effects of individually designed insole in pes planus treatment. Designed insoles was adjusted according to height, length and function of the sole of each participant with pes planus in order to improve the physical parameters of them. A total of 34 participants (17 males and 17 females) with pes planus participated in the study. Height, weight, percent body fat, 30-m sprint test, vertical jump, 12-min Cooper test and Visual Analog Scale (VAS) measurement were obtained before the study and after 1 year later. Wilcoxon signed rank test was conducted to examine whether there were any differences between the pre- and post-test measurements. It was determined that individually designed insoles reduced body weight and BMI, made positive improvements in 30-m speed, vertical jump and 12-min Cooper scores, and significant decrease in VAS scores. In conclusion, it is seen that individually designed insoles have beneficial role in normalizing forces acting on the foot and improve the physical performance parameters of individuals with pes planus. Future studies are needed to explore the long-term effects of individually designed insoles and prefabricated insoles.
Topics: Adolescent; Adult; Equipment Design; Female; Flatfoot; Humans; Male; Pressure; Running; Shoes; Young Adult
PubMed: 33184442
DOI: 10.1038/s41598-020-76767-y -
Scientific Reports Jul 2022Angle measurement methods for measuring pes planus may lose consistency by errors between observers. If the feature points for angle measurement can be provided in...
Angle measurement methods for measuring pes planus may lose consistency by errors between observers. If the feature points for angle measurement can be provided in advance with the algorithm developed through the deep learning method, it is thought that the error between the observers can be reduced. A total of 300 weightbearing lateral radiographs were used for the development of the deep learning-based algorithm, and a total of 95 radiographs were collected for the clinical validation test set. Meary angle (MA) and calcaneal pitch (CP) were selected as measurement methods and measured twice by three less-experienced physicians with the algorithm-based tool and twice without. The intra- and inter-observer agreements of MA and CP measures were assessed via intra-class correlation coefficient. In addition, verification of the improvement of measurement performance by the algorithm was performed. Interobserver agreements for MA and CP measurements with algorithm were more improved than without algorithm. As for agreement with reference standard, combining the results of all readers, both MA and CP with algorithm were greater than those without algorithm. The deep learning algorithm tool is expected to improve the reproducibility of radiographic measurements for pes planus, especially by improving inter-observer agreement.
Topics: Deep Learning; Flatfoot; Humans; Observer Variation; Radiography; Reproducibility of Results; Weight-Bearing
PubMed: 35902681
DOI: 10.1038/s41598-022-16995-6 -
Journal of Orthopaedic Surgery and... Jan 2023Accessory navicular is accompanied by the deformity of valgus flexible flatfoot. The surgical treatment includes reconstruction of insertion of posterior tibial tendon... (Review)
Review
PURPOSE
Accessory navicular is accompanied by the deformity of valgus flexible flatfoot. The surgical treatment includes reconstruction of insertion of posterior tibial tendon following resection of the accessory navicular. However, this treatment could not correct completely the deformity of valgus flexible flatfoot. This study aimed to evaluate the efficacy of subtalar arthroereisis combined with medial soft tissue reconstruction in treating 8-14-year-old flexible flatfoot patients with accessory navicular.
METHODS
Clinical data of 35 pediatric flatfoot patients (with 50 feet) with accessory navicular who underwent subtalar arthroereisis and medial soft tissue reconstruction between April 2013 and September 2018 were analyzed retrospectively. Anteroposterior, lateral, and hindfoot alignment radiological images were measured in the weight-bearing position, and visual analog scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, and satisfaction degree were evaluated. Also, surgical complications were recorded.
RESULTS
The average follow-up time of the patients was 30 ± 9.3 months. None of the patients presented wound complications, and no implant loosening was detected. The AOFAS and VAS scores improved significantly (P < 0.001). Radiological parameters, such as the talar first metatarsal angle and talonavicular coverage angle on anteroposterior foot view, Meary's angle and calcaneal pitch angle on the lateral view, and calcaneus valgus angle on hindfoot alignment view improved significantly (P < 0.001). Postoperative complications were observed in three patients.
CONCLUSION
Subtalar arthroereisis combined with medial soft tissue reconstruction significantly alleviated pain and improved the functions in pediatric and adolescent flexible flatfoot patients with accessory navicular; also, the radiological manifestations and functions improved.
Topics: Adolescent; Humans; Child; Flatfoot; Retrospective Studies; Treatment Outcome; Tarsal Bones
PubMed: 36658597
DOI: 10.1186/s13018-023-03542-w -
Frontiers in Bioengineering and... 2022Flatfoot is a common foot deformity that seriously affects the quality of life. The aim of this study is to develop an accurate and noninvasive method for the diagnosis...
Flatfoot is a common foot deformity that seriously affects the quality of life. The aim of this study is to develop an accurate and noninvasive method for the diagnosis of flatfoot based on B-mode ultrasound. In this study, 51 patients (the flatfoot group) and 43 healthy subjects (the control group) were included. The plantar fascia angle, a new measurement for use in the diagnosis of flatfoot is proposed, as determined using B-mode ultrasound. For comparison, the calcaneal pitch angle and medial cuneiform height were also measured using lateral X-radiography, based on traditional diagnostic methods. The intraclass correlation values of the plantar fascia angle, the calcaneal pitch angle, and the medial cuneiform height were all more than 0.95, and there is a moderate correlation (r = 0.51) between the medial cuneiform height and the calcaneal pitch angle, and an excellent correlation (r = 0.85) between the plantar fascia angle and the calcaneal pitch angle. The optimal cutoff value, sensitivity, and specificity for medial cuneiform height in flatfoot diagnosis were 12.8 mm, 93.0%, and 54.9%, respectively. The optimal cutoff value, sensitivity, and specificity for plantar fascia angle in flatfoot diagnosis were 9.8°, 97.7%, and 94.1%, respectively. The proposed plantar fascia angle has good sensitivity and specificity in diagnosing flatfoot, therefore supplying a new approach for the noninvasive diagnosis of flatfoot.
PubMed: 36147531
DOI: 10.3389/fbioe.2022.961462 -
International Journal of Environmental... Sep 2022The foot absorbs shocks with its arches, muscles, ligaments and joints, and bodyweight transmission and it pushes the body forward during all movement patterns. Pes...
The foot absorbs shocks with its arches, muscles, ligaments and joints, and bodyweight transmission and it pushes the body forward during all movement patterns. Pes planus is more important in sports activities that include balance and sports performance, such as walking, running, jumping, or transferring weight to a single lower limb. This study, conducted with this information in mind, aims to examine the effects of pes planus deformity on balance and vertical jump performance. Fifty athletes were included in the study. The presence of pes planus was evaluated according to the Feiss line. Balance measurements were performed with a Balance System SD Biodex. Vertical jump performance was recorded using an Omegawave jumping mat. The relationship between the pes planus grades of the participants and their balance and jump performances was analyzed using the Spearman correlation method. Vertical jump and Limit of stability (LOS) was significantly correlated with pes planus.
Topics: Athletes; Athletic Performance; Flatfoot; Foot; Humans; Walking
PubMed: 36141874
DOI: 10.3390/ijerph191811602 -
Journal of Medical Genetics Apr 2016Deletions of the HOXC gene cluster result in variable phenotypes in mice, but have been rarely described in humans.
BACKGROUND
Deletions of the HOXC gene cluster result in variable phenotypes in mice, but have been rarely described in humans.
OBJECTIVE
To report chromosome 12q13.13 microdeletions ranging from 13 to 175 kb and involving the 5' HOXC genes in four families, segregating congenital lower limb malformations, including clubfoot, vertical talus and hip dysplasia.
METHODS
Probands (N=253) with clubfoot or vertical talus were screened for point mutations and copy number variants using multiplexed direct genomic selection, a pooled BAC targeted capture approach. SNP genotyping included 1178 probands with clubfoot or vertical talus and 1775 controls.
RESULTS
The microdeletions share a minimal non-coding region overlap upstream of HOXC13, with variable phenotypes depending upon HOXC13, HOXC12 or the HOTAIR lncRNA inclusion. SNP analysis revealed HOXC11 p.Ser191Phe segregating with clubfoot in a small family and enrichment of HOXC12 p.Asn176Lys in patients with clubfoot or vertical talus (rs189468720, p=0.0057, OR=3.8). Defects in limb morphogenesis include shortened and overlapping toes, as well as peroneus muscle hypoplasia. Finally, HOXC and HOXD gene expression is reduced in fibroblasts from a patient with a 5' HOXC deletion, consistent with previous studies demonstrating that dosage of lncRNAs alters expression of HOXD genes in trans.
CONCLUSIONS
Because HOXD10 has been implicated in the aetiology of congenital vertical talus, variation in its expression may contribute to the lower limb phenotypes occurring with 5' HOXC microdeletions. Identification of 5' HOXC microdeletions highlights the importance of transcriptional regulators in the aetiology of severe lower limb malformations and will improve their diagnosis and management.
Topics: Animals; Chromosomes, Human, Pair 12; Clubfoot; Extremities; Female; Flatfoot; Gene Deletion; Genetic Association Studies; Genetic Predisposition to Disease; Genotype; Homeodomain Proteins; Humans; Male; Mice; Pedigree; Polymorphism, Single Nucleotide; RNA, Long Noncoding
PubMed: 26729820
DOI: 10.1136/jmedgenet-2015-103505 -
Journal of Athletic Training May 2021Arch height is one important aspect of foot posture. An estimated 20% of the population has pes planus and 20% has pes cavus. These abnormal foot postures can alter...
CONTEXT
Arch height is one important aspect of foot posture. An estimated 20% of the population has pes planus and 20% has pes cavus. These abnormal foot postures can alter lower extremity kinematics and plantar loading and contribute to injury risk. Ankle bracing is commonly used in sport to prevent these injuries, but no researchers have examined the effects of ankle bracing on plantar loading.
OBJECTIVE
To evaluate the effects of ankle braces on plantar loading during athletic tasks.
DESIGN
Cross-sectional study.
SETTING
Laboratory.
PATIENTS OR OTHER PARTICIPANTS
A total of 36 participants (11 men, 25 women; age = 23.1 ± 2.5 years, height = 1.72 ± 0.09 m, mass = 66.3 ± 14.7 kg) were recruited for this study.
INTERVENTION(S)
Participants completed walking, running, and cutting tasks in 3 bracing conditions: no brace, lace-up ankle-support brace, and semirigid brace.
MAIN OUTCOME MEASURE(S)
We analyzed the plantar-loading variables of contact area, maximum force, and force-time integral for 2 midfoot and 3 forefoot regions and assessed the displacement of the center of pressure. A 3 × 3 mixed-model repeated-measures analysis of variance was used to determine the effects of brace and foot type (α = .05).
RESULTS
Foot type affected force measures in the middle (P range = .003-.047) and the medial side of the foot (P range = .004-.04) in all tasks. Brace type affected contact area in the medial midfoot during walking (P = .005) and cutting (P = .01) tasks, maximum force in the medial and lateral midfoot during all tasks (P < .001), and force-time integral in the medial midfoot during all tasks (P < .001). Portions of the center-of-pressure displacement were affected by brace wear in both the medial-lateral and anterior-posterior directions (P range = .001-.049).
CONCLUSIONS
Ankle braces can be worn to redistribute plantar loading. Additional research should be done to evaluate their effectiveness in injury prevention.
Topics: Ankle; Ankle Injuries; Biomechanical Phenomena; Braces; Cross-Sectional Studies; Female; Flatfoot; Humans; Male; Plantar Plate; Running; Talipes Cavus; Walking; Weight-Bearing; Young Adult
PubMed: 34000019
DOI: 10.4085/1062-6050-164-20 -
The British Journal of Radiology Apr 2022To determine the additional benefit of MRI for children with flatfoot deformity assessed with weight-bearing radiographs in a specialist paediatric orthopaedic unit.
OBJECTIVE
To determine the additional benefit of MRI for children with flatfoot deformity assessed with weight-bearing radiographs in a specialist paediatric orthopaedic unit.
METHODS AND MATERIALS
Patient cohort was obtained by searching the Radiology Information System for children referred for investigation of flatfoot. All patients with flatfoot on weight-bearing radiographs who had undergone MRI were included. Radiographs were classified by a consultant musculoskeletal radiologist as showing no underlying abnormality, talo-calcaneal coalition, calcaneonavicular coalition, accessory navicular or other abnormality. MRI studies were classified similarly by a different consultant musculoskeletal radiologist blinded to the radiographic findings.
RESULTS
33 males and 24 females were included (mean age 12.5 years; range 3-18 years). 24 had bilateral abnormality, so 81 feet were assessed. Radiographs showed no specific abnormality ( = 51), talocalcaneal coalition ( = 6), calcaneonavicular coalition ( = 3), os naviculare ( = 12) or other abnormality ( = 9). MRI showed no specific abnormality ( = 40), talocalcaneal coalition ( = 10), calcaneonavicular coalition ( = 5), os naviculare ( = 12) or other abnormality ( = 14). Assuming MRI as the diagnostic gold-standard, additional relevant diagnostic information was identified in 19 (23.5%) cases, while in the 51 cases for which radiographs provided no specific diagnosis MRI confirmed no underlying abnormality in 31 (60.8%).
CONCLUSION
MRI is a valuable adjunct to weight-bearing radiography for investigating paediatric flatfoot deformity.
ADVANCES IN KNOWLEDGE
MRI is of value in the assessment of paediatric flatfoot, additional diagnostic information to radiography being identified in 23.5% cases, while in 60.8% of cases for which radiographs provided no specific diagnosis MRI confirmed no underlying abnormality.
Topics: Adolescent; Child; Child, Preschool; Female; Flatfoot; Humans; Magnetic Resonance Imaging; Male; Radiography; Retrospective Studies; Synostosis; Tarsal Bones
PubMed: 34919445
DOI: 10.1259/bjr.20210784 -
Annals of Rehabilitation Medicine Dec 2021
PubMed: 35000365
DOI: 10.5535/arm.21189 -
Journal of Orthopaedic Research :... Sep 2023Progressive collapsing foot deformity (PCFD) is characterized by a progressive subluxation of the peritalar bones and respective joints. Two-dimensional conventional...
Progressive collapsing foot deformity (PCFD) is characterized by a progressive subluxation of the peritalar bones and respective joints. Two-dimensional conventional radiographs are limited in their ability to visualize the peritalar bones and joints with adequate detail to describe the complex three-dimensional deformity. An improved understanding of the relationship between joint coverage and deformity would allow clinicians to use coverage analysis to distinguish among the stages of PCFD. The aim of this study was to analyze the joint coverage of the six articular relationships within the talocrural, subtalar, and Chopart joints using weightbearing computed tomography (WBCT) scans. Ten individuals with a flexible hindfoot and ten individuals with a rigid hindfoot presentation of PCFD were compared to twenty-seven asymptomatic control individuals. The three most relevant findings are: (I) the anterior-medial facet of the subtalar joint contains the greatest reduction in coverage for patients with a rigid deformity, (II) an increase in talonavicular overlap (TNO) moderately correlated with a decreased coverage in the: tibiotalar, anterior-medial subtalar, talonavicular joints, and (III) the calcaneocuboid joint lacks radiographic values to adequately quantify alignment and coverage. To conclude, there were significant differences in coverage area of various articulating regions throughout the hind- and midfoot when comparing PCFD patients to asymptomatic control individuals. Relevant radiographic measures correlating to articular coverage areas of clinical interest were identified, possibly helping to better quantify PCFD in clinical practice.
Topics: Humans; Flatfoot; Foot Deformities; Foot; Subtalar Joint; Tarsal Joints; Weight-Bearing
PubMed: 36891918
DOI: 10.1002/jor.25543