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Journal of Foot and Ankle Research 2018Posterior tibial tendon dysfunction (PTTD) is a painful, progressive tendinopathy that reportedly predominates in middle-age, overweight women. There is no evidence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Posterior tibial tendon dysfunction (PTTD) is a painful, progressive tendinopathy that reportedly predominates in middle-age, overweight women. There is no evidence based guidelines that clinicians can use to guide treatment planning, which leaves clinicians to make decisions on the basis of presenting clinical impairments and self-reported pain and disability. The purpose of this systematic review was to quantify clinical impairments, pain and disability in individuals with PTTD compared with controls.
METHODS
Five databases were searched for terms referring to the posterior tibial tendon and flatfoot up to and including 11 March 2018. The systematic review was registered with PROSPERO (CRD: 42016046951). Studies were eligible if they were published in the English language and contained data on clinical impairments, pain or disability compared between participants diagnosed with PTTD and pain-free individuals. Standardised mean differences (SMDs) were calculated where possible and meta-analysis was performed when homogeneity of outcomes allowed.
RESULTS
Ten eligible studies were identified and pooled in the meta-analyses. Strong effects were revealed for poor heel rise endurance (SMD -1.52, 95% CI -2.05 to - 0.99), less forefoot adduction-inversion strength (SMD -1.19, 95% CI -1.68 to - 0.71) and lower arch height (SMD -1.76, 95% CI -2.29 to - 1.23). Compared to controls, individuals with PTTD also had more self-reported stiffness (SMD 1.45, 95% CI 0.91 to 1.99), difficulties caused by foot problems (SMD 1.42, 95% CI 0.52 to 2.33) and social restrictions (SMD1.26, 95% CI 0.25 to 2.27).
CONCLUSION
There is evidence of impaired tibialis posterior capacity and lowered arch height in individuals with PTTD compared to controls. Further to addressing the expected impairments in local tendon function and foot posture, pain, stiffness, functional limitations and social participation restrictions should be considered when managing PTTD.
Topics: Activities of Daily Living; Adult; Disabled Persons; Female; Heel; Humans; Male; Middle Aged; Muscle Strength; Posterior Tibial Tendon Dysfunction; Postural Balance; Posture; Range of Motion, Articular; Self Report; Social Participation; Walking
PubMed: 30186369
DOI: 10.1186/s13047-018-0292-z -
Acta Orthopaedica Mar 2022Albeit pediatric flexible flat foot (FFF) is a common condition, only a minority of patients become symptomatic. Long-term outcomes of surgically treated pediatric...
BACKGROUND AND PURPOSE
Albeit pediatric flexible flat foot (FFF) is a common condition, only a minority of patients become symptomatic. Long-term outcomes of surgically treated pediatric patients with symptomatic FFF are largely unknown. In this systematic review, studies providing outcomes at a mean follow-up of at least 4 years after the procedure in these patients were analyzed.
MATERIAL AND METHODS
A PubMed search was undertaken involving original articles published up to July 2021 on outcome in children aged 6 to 14 with surgically treated FFF and mean (or minimum) follow-up of at least 4 years. Radiographic and clinical outcomes were analyzed.
RESULTS
Of initially 541 entries, 10 could be included in the systematic review (all level IV), involving 846 pediatric patients with 1,536 symptomatic FFF. Pooled mean radiological (n = 8) and clinical follow-up (n = 10) was 5.3 (range 0.5-15) and 7.0 (range 4.1-15) years, respectively. Surgical procedures included arthroereisis (n = 8), lateral column lengthening (n = 1), and Horseman procedure (n = 1). Overall relative frequency of implant-associated complications and wound-healing problems was 3.2% and 1.3%, as well as 2.8% and 1.6% following subtalar arthroereisis only. From preoperative to latest radiological assessment following subtalar arthroereisis (including 3 studies with radiological follow-up < 48 months), pooled median decrease in talonavicular coverage angle (TNCA; -9.2°), anteroposterior talocalcaneal angle (A-TCA; -6.5°), lateral talocalcaneal angle (L-TCA; -3.5°), talar declination angle (TDA; -14°), Moreau Costa Bertani angle (MCB; -13°), and talo-firstmetatarsal angle (L-T1MA; -10°) was observed, as was an increase in calcaneal pitch (4.5°).
INTERPRETATION
In symptomatic pediatric FFF patients, surgery is associated with a manageable complication profile, and results in satisfactory long-term clinical as well as radiological outcome. Yet scientific evidence is low, warranting larger scaled studies in the future.
Topics: Adolescent; Calcaneus; Child; Flatfoot; Forecasting; Humans; Radiography; Retrospective Studies
PubMed: 35347339
DOI: 10.2340/17453674.2022.2254 -
Archives of Orthopaedic and Trauma... May 2024Progressive collapsing foot deformity (PCFD), formally known as "adult-acquired flatfoot deformity" (AAFFD), is a complex foot deformity consisting of multiple...
INTRODUCTION
Progressive collapsing foot deformity (PCFD), formally known as "adult-acquired flatfoot deformity" (AAFFD), is a complex foot deformity consisting of multiple components. If surgery is required, joint-preserving procedures, such as a medial displacement calcaneal osteotomy (MDCO), are frequently performed. The aim of this systematic review is to provide a summary of the evidence on the impact of MDCO on foot biomechanics.
MATERIALS AND METHODS
A systematic literature search across two major sources (PubMed and Scopus) without time limitation was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria. Only original research studies reporting on biomechanical changes following a MDCO were included. Exclusion criteria consisted of review articles, case studies, and studies not written in English. 27 studies were included and the methodologic quality graded according to the QUACS scale and the modified Coleman score.
RESULTS
The 27 included studies consisted of 18 cadaveric, 7 studies based on biomechanical models, and 2 clinical studies. The impact of MDCO on the following five major parameters were assessed: plantar fascia (n = 6), medial longitudinal arch (n = 9), hind- and midfoot joint pressures (n = 10), Achilles tendon (n = 5), and gait pattern parameters (n = 3). The quality of the studies was moderate to good with a pooled mean QUACS score of 65% (range 46-92%) for in-vitro and a pooled mean Coleman score of 58 (range 56-65) points for clinical studies.
CONCLUSION
A thorough knowledge of how MDCO impacts foot function is key in properly understanding the postoperative effects of this commonly performed procedure. According to the evidence, MDCO impacts the function of the plantar fascia and Achilles tendon, the integrity of the medial longitudinal arch, hind- and midfoot joint pressures, and consequently specific gait pattern parameters.
Topics: Humans; Biomechanical Phenomena; Calcaneus; Flatfoot; Foot; Foot Deformities, Acquired; Gait; Osteotomy
PubMed: 38554203
DOI: 10.1007/s00402-024-05267-9 -
Sports Medicine (Auckland, N.Z.) May 2023The heights obtained during the countermovement jump and drop jump tests have been measured by numerous studies using different calculation methods and pieces of...
BACKGROUND
The heights obtained during the countermovement jump and drop jump tests have been measured by numerous studies using different calculation methods and pieces of equipment. However, the differences in calculation methods and equipment used have resulted in discrepancies in jump height being reported.
OBJECTIVES
The aim of this systematic review was to examine the available literature pertaining to the different calculation methods to estimate the jump height during the countermovement jump and drop jump.
METHODS
A systematic review of the literature was undertaken using the SPORTDiscus, MEDLINE, CINAHL, and PubMed electronic databases, with all articles required to meet specified criteria based on a quality scoring system.
RESULTS
Twenty-one articles met the inclusion criteria, relating various calculation methods and equipment employed when measuring jump height in either of these two tests. The flight time and jump-and-reach methods provide practitioners with jump height data in the shortest time, but their accuracy is affected by factors such as participant conditions or equipment sensitivity. The motion capture systems and the double integration method measure the jump height from the centre of mass height at the initial flat foot standing to the apex of jumping, where the centre of mass displacement generated by the ankle plantarflexion is known. The impulse-momentum and flight time methods could only measure the jump height from the centre of mass height at the instant of take-off to the apex of jumping, thus, providing statistically significantly lower jump height values compared with the former two methods. However, further research is warranted to investigate the reliability of each calculation method when using different equipment settings.
CONCLUSIONS
Our findings indicate that using the impulse-momentum method via a force platform is the most appropriate way for the jump height from the instant of take-off to the apex of jumping to be measured. Alternatively, the double integration method via a force platform is preferred to quantify the jump height from the initial flat foot standing to the apex of jumping.
Topics: Humans; Flatfoot; Reproducibility of Results; Lower Extremity; Exercise; Ankle Joint
PubMed: 36940054
DOI: 10.1007/s40279-023-01828-x -
International Wound Journal Oct 2022Calcaneal osteotomy is a commonly established method used to correct various foot malalignment surgery problems that produce varus and valgus hindfoot abnormality as...
Calcaneal osteotomy is a commonly established method used to correct various foot malalignment surgery problems that produce varus and valgus hindfoot abnormality as well as Haglund's deformity, cavovarus foot reconstruction, flatfoot deformity, plantar fasciitis, posterior tibial tendon insufficiency and planovalgus foot. After decades, several procedures in orthopaedic foot surgery have been suggested for reducing the risk of wound and neurovascular complications. The goal of this Prisma statement guidelines compliant systematic review was to establish the effectiveness and safety of calcaneal osteotomy in foot surgery. We have performed a novel systematic review of the current published literature in order to evaluate the scientific evidence now available on this association, assigning predefined exclusion and inclusion criteria. Eight investigations were selected which had 191 cases. The adult flatfoot, tibialis posterior reconstruction and cavovarus foot deformity were treated with different procedures of calcaneal osteotomy techniques. The adequate level of effectiveness of calcaneal osteotomy is associated with the kind and location of the incision, with or without screw application, in each specific foot condition. There is a limited number of scientific investigations of the effectiveness and safety of the different kinds of calcaneal osteotomy in foot surgery, and there is the need to enhance outcome knowledge on this foot surgery technique.
Topics: Adult; Humans; Calcaneus; Flatfoot; Foot; Foot Diseases; Osteotomy
PubMed: 35077021
DOI: 10.1111/iwj.13745 -
Revista Do Colegio Brasileiro de... Dec 2018Flexible flatfoot is a common condition in small children, which shows a strong tendency to spontaneously correct with their growth or to become moderate or mild in...
Flexible flatfoot is a common condition in small children, which shows a strong tendency to spontaneously correct with their growth or to become moderate or mild in adults, which will not cause future problems. However, in a small number of cases, this condition is more severe, does not improve spontaneously, which may cause mechanical impairment, deformity, and, eventually, pain. In such cases, surgical treatment should be considered. The aim of this systematic review was to evaluate the literature results on the treatment of the symptomatic flexible flatfoot in children or adolescents through a very frequent procedure: calcaneal lateral column lengthening osteotomy, A systematic electronic search in PubMed, Web of Science, Cochrane, CINAHL, SciELO, SCOPUS and LILACS databases was performed. We searched articles published between March 1975 and September 2016. After applying the eligibility criteria, the selected publications were evaluated in relation to their clinical and radiographic results and complications. We found 341 articles in the mentioned databases, but selected only eight studies, according to the inclusion and exclusion criteria. These studies included a total of 105 patients and 167 treated feet. Only three authors performed prospective studies, but without case-control or randomization. The majority of publications were descriptive studies or case series (level of evidence III or IV), with great methodological variations, but with a high satisfaction rate on the part of both patients and surgeons in relation to the results. However, more prospective and randomized studies are required, with adequate control groups and validated evaluation criteria.
Topics: Adolescent; Bone Lengthening; Calcaneus; Child; Flatfoot; Follow-Up Studies; Humans; Osteotomy; Postoperative Complications; Postoperative Period; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 30569951
DOI: 10.1590/0100-6991e-20181969 -
PloS One 2021To investigate effects of taping techniques on arch deformation in adults with pes planus. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate effects of taping techniques on arch deformation in adults with pes planus.
METHODS
The following databases were searched up to March 2020, including Web of Science, Pubmed, EBSCO, CNKI and Cochrane Library. Heterogeneity and publication bias were assessed by I2 index and funnel plots, respectively. In addition, Cochrane scale was used to evaluate the quality of research.
RESULTS
Navicular height for three antipronation taping techniques significantly increased immediately post tape compared with baseline (mean difference = 4.86 mm, 95% CI = 2.86-6.87 mm, Z = 4.75, p < 0.001). The highest increase was observed in Augmented low-Dye (ALD). Modified low-Dye (MLD) was second only to ALD (p<0.001). Navicular height after walking for 10 min was much higher than baseline (p<0.001), with MLD decreased smaller than ALD.
CONCLUSIONS
ALD was the most effective taping technique for controlling foot arch collapse immediately post tape compared with baseline, followed by MLD. By contrast, MLD could possibly performed better than ALD in maintaining immediate navicular height after walking for 10 min. Low-Dye could make resting calcaneal stance position closer to neutral position. Although positive effects of Navicular sling, low-Dye and Double X taping interventions were observed, they could not maintain this immediate navicular height effect after a period of higher intensity weight-bearing exercise.
Topics: Adult; Athletic Tape; Flatfoot; Humans; Resistance Training; Treatment Outcome
PubMed: 34214104
DOI: 10.1371/journal.pone.0253567