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Gait & Posture Mar 2013Differences in foot structure are thought to be associated with differences in foot function during movement. Many foot pathologies are of a biomechanical nature and...
BACKGROUND
Differences in foot structure are thought to be associated with differences in foot function during movement. Many foot pathologies are of a biomechanical nature and often associated with foot type. Fundamental to the understanding of foot pathomechanics is the question: do different foot types have distinctly different structure and function?
AIM
To determine if objective measures of foot structure and function differ between planus, rectus and cavus foot types in asymptomatic individuals.
METHODS
Sixty-one asymptomatic healthy adults between 18 and 77 years old, that had the same foot type bilaterally (44 planus feet, 54 rectus feet, and 24 cavus feet), were recruited. Structural and functional measurements were taken using custom equipment, an emed-x plantar pressure measuring device, a GaitMat II gait pattern measurement system, and a goniometer. Generalized Estimation Equation modeling was employed to determine if each dependent variable of foot structure and function was significantly different across foot type while accounting for potential dependencies between sides. Post hoc testing was performed to assess pair wise comparisons.
RESULTS
Several measures of foot structure (malleolar valgus index and arch height index) were significantly different between foot types. Gait pattern parameters were invariant across foot types. Peak pressure, maximum force, pressure-time-integral, force-time-integral and contact area were significantly different in several medial forefoot and arch locations between foot types. Planus feet exhibited significantly different center of pressure excursion indices compared to rectus and cavus feet.
CONCLUSIONS
Planus, rectus and cavus feet exhibited significantly different measures of foot structure and function.
Topics: Adolescent; Adult; Aged; Ankle Joint; Biomechanical Phenomena; Female; Foot; Foot Deformities; Gait; Humans; Male; Middle Aged; Pressure; Pronation; Supination; Weight-Bearing; Young Adult
PubMed: 23107625
DOI: 10.1016/j.gaitpost.2012.09.007 -
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 -
Journal of Physiotherapy Jan 2023In people with flexible flat foot, what is the effect of a comprehensive exercise program on navicular drop height and medial longitudinal arch angle compared with a... (Randomized Controlled Trial)
Randomized Controlled Trial
QUESTION
In people with flexible flat foot, what is the effect of a comprehensive exercise program on navicular drop height and medial longitudinal arch angle compared with a control regimen of brief active range of motion exercises?
DESIGN
Randomised controlled trial with concealed allocation, blinding of assessors and intention-to-treat analysis.
PARTICIPANTS
Fifty-two people with flexible flat foot.
INTERVENTION
The experimental group undertook 30-minute exercise sessions three times per week for 6 weeks. The exercises involved active dorsiflexion and plantarflexion, foot shortening exercises, gluteal muscle strengthening, and stretching. The control group performed active dorsiflexion and plantarflexion only for 6 weeks.
OUTCOME MEASURES
Navicular drop height and longitudinal arch angle.
RESULTS
Randomisation allocated 26 participants to each group. One participant from the experimental group and two from the control group did not complete the study. After 6 weeks, the participants in the experimental group improved their navicular drop height by 0.4 cm (95% CI 0.4 to 0.5) more than those in the control group. These participants also improved their longitudinal arch angle by 16 deg (95% CI 13 to 19) more than those in the control group.
CONCLUSION
In people with flexible flat foot, a comprehensive 6-week exercise program improved the navicular drop height and longitudinal arch angle more than active dorsiflexion and plantarflexion alone. This improved the cosmetic appearance of the foot and reduced progression towards more severe flat foot, which typically becomes symptomatic.
TRIAL REGISTRATION
CTRI/2021/07/034599.
Topics: Humans; Flatfoot; Foot; Exercise Therapy; Muscle, Skeletal
PubMed: 36526555
DOI: 10.1016/j.jphys.2022.11.011 -
Sports Health 2021Plantar fasciitis (PF) is a common condition in active individuals. The lack of agreement on PF etiology makes treatment challenging and highlights the importance of... (Meta-Analysis)
Meta-Analysis
CONTEXT
Plantar fasciitis (PF) is a common condition in active individuals. The lack of agreement on PF etiology makes treatment challenging and highlights the importance of understanding risk factors for preventive efforts.
OBJECTIVE
The purpose of this systematic review and meta-analysis was to determine what factors may put physically active individuals at risk of developing PF.
DATA SOURCES
CENTRAL, CINAHL, EMBASE, Gray Lit, LILACS, MEDLINE (PubMed), ProQuest, Scopus, SPORTDiscus, and Web of Science were searched through April 2018 and updated in April 2020.
STUDY SELECTION
Studies were included if they were original research investigating PF risk factors, compared physically active individuals with and without PF, were written in English, and were accessible as full-length, peer-reviewed articles.
STUDY DESIGN
Systematic review and meta-analysis.
LEVEL OF EVIDENCE
Level 3, because of inconsistent definitions and blinding used in the included observational studies.
DATA EXTRACTION
Data on sample characteristics, study design and duration, groups, PF diagnosis, and risk factors were extracted. The methodological quality of the studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology statement. When means and standard deviations of a particular risk factor were presented 2 or more times, that risk factor was included in the meta-analysis.
RESULTS
Sixteen studies were included in the systematic review and 11 risk factors in the meta-analysis. Increased plantarflexion range of motion (weighted mean difference [MD] = 7.04°; 95% CI, 5.88-8.19; < 0.001), body mass index (MD = 2.13 kg/m; 95% CI, 1.40-2.86; < 0.001; = 0.00%), and body mass (MD = 4.52 kg; 95% CI, 0.55-8.49; = 0.026) were risk factors for PF.
CONCLUSION
Interventions focused on addressing a greater degree of plantarflexion range of motion, body mass index, and body mass and their load on the force-absorbing plantar surface structures may be a good starting point in the prevention and treatment of active individuals with PF.
Topics: Ankle; Athletic Injuries; Body Mass Index; Calcaneus; Fasciitis, Plantar; Foot; Humans; Pronation; Range of Motion, Articular; Risk Factors
PubMed: 33530860
DOI: 10.1177/1941738120970976 -
Orthopaedics & Traumatology, Surgery &... Feb 2023Lesser-toe deformity is frequent and varied, with severe functional impact. In elderly subjects, it leads to loss of autonomy and increases the risk of falls. The aim of... (Review)
Review
Lesser-toe deformity is frequent and varied, with severe functional impact. In elderly subjects, it leads to loss of autonomy and increases the risk of falls. The aim of the present study was to provide an update on management, addressing 5 questions. What are the normal anatomy and pathophysiology? These acquired deformities mainly result from imbalance between the intrinsic and extrinsic muscles of the foot or from capsule-ligament stabilizer failure. How to analyze the deformity? It is important to identify the cause, site, reducibility and metatarsophalangeal joint stability. What are the main deformities and how should they be classified? Classifications used to be based on confusing terminology as the deformities were poorly defined. The French Foot Surgery Association (AFCP) therefore validated a classification with standardized, exhaustive and reproducible morphologic descriptions. What treatments are there? Treatment needs to take account of the cause. Footwear adaptation, physiotherapy and podologic measures are in first line, with surgery in second line. Surgery concerns soft tissues (tendon lengthening, tendon transfer, arthrolysis, plantar plate repair), bone (metatarsal and phalangeal osteotomy) and joints (replacement and fusion), with percutaneous and open approaches. What are the treatment strategies? Surgery is performed sequentially, from proximal to distal, if necessary. Options are set out in the decision-trees included in this article. LEVEL OF EVIDENCE: V, expert opinion.
Topics: Humans; Aged; Foot Deformities; Metatarsophalangeal Joint; Toes; Foot; Tendon Transfer
PubMed: 36942795
DOI: 10.1016/j.otsr.2022.103464 -
The New England Journal of Medicine Apr 2019
Topics: Animals; Child; Female; Foot; Foot Diseases; Humans; Tunga; Tungiasis
PubMed: 30943340
DOI: 10.1056/NEJMicm1810588 -
Ankle and foot power in gait analysis: Implications for science, technology and clinical assessment.Journal of Biomechanics Jun 2018In human gait analysis studies, the entire foot is typically modeled as a single rigid-body segment; however, this neglects power generated/absorbed within the foot.... (Review)
Review
In human gait analysis studies, the entire foot is typically modeled as a single rigid-body segment; however, this neglects power generated/absorbed within the foot. Here we show how treating the entire foot as a rigid body can lead to misunderstandings related to (biological and prosthetic) foot function, and distort our understanding of ankle and muscle-tendon dynamics. We overview various (unconventional) inverse dynamics methods for estimating foot power, partitioning ankle vs. foot contributions, and computing combined anklefoot power. We present two case study examples. The first exemplifies how modeling the foot as a single rigid-body segment causes us to overestimate (and overvalue) muscle-tendon power generated about the biological ankle (in this study by up to 77%), and to misestimate (and misinform on) foot contributions; corroborating findings from previous multi-segment foot modeling studies. The second case study involved an individual with transtibial amputation walking on 8 different prosthetic feet. The results exemplify how assuming a rigid foot can skew comparisons between biological and prosthetic limbs, and lead to incorrect conclusions when comparing different prostheses/interventions. Based on analytical derivations, empirical findings and prior literature we recommend against computing conventional ankle power (between shank-foot). Instead, we recommend using an alternative estimate of power generated about the ankle joint complex (between shank-calcaneus) in conjunction with an estimate of foot power (between calcaneus-ground); or using a combined anklefoot power calculation. We conclude that treating the entire foot as a rigid-body segment is often inappropriate and ill-advised. Including foot power in biomechanical gait analysis is necessary to enhance scientific conclusions, clinical evaluations and technology development.
Topics: Ankle Joint; Biomechanical Phenomena; Foot; Gait Analysis; Humans
PubMed: 29724536
DOI: 10.1016/j.jbiomech.2018.04.017 -
Gerontology 2015Foot pain is highly prevalent in older people and has a significant detrimental impact on mobility and quality of life. In recent years, there has been increased... (Review)
Review
Foot pain is highly prevalent in older people and has a significant detrimental impact on mobility and quality of life. In recent years, there has been increased interest in exploring the biomechanical factors that may contribute to the development of foot disorders and the associated impairment of mobility in this age group. Studies have shown that with advancing age, there is a general tendency for the foot to exhibit increased soft tissue stiffness, a decreased range of motion, decreased strength and a more pronated posture as well as to function in a more pronated position with reduced joint mobility and less efficient propulsion when walking. These changes may contribute to the development of foot pain, impair performance in functional weight-bearing activities and increase the risk of falls. However, plantar pressure analysis technology has considerable potential to assist in optimising the design of interventions to redistribute load away from high-pressure areas, thereby alleviating foot symptoms and improving mobility in older people.
Topics: Aging; Foot; Foot Joints; Humans; Posture; Range of Motion, Articular; Walking; Weight-Bearing
PubMed: 25402236
DOI: 10.1159/000368357 -
International Journal of Environmental... Feb 2020The purpose of this study was to investigate if measurements of foot morphology in sitting and standing positions can predict foot muscle strength. Twenty-six healthy...
The purpose of this study was to investigate if measurements of foot morphology in sitting and standing positions can predict foot muscle strength. Twenty-six healthy male adults were recruited, and their foot morphology and foot muscle strength were measured. Foot morphological variables, toe flexor strength, and metatarsophalangeal joint flexor strength were measured by using a digital caliper, Ailitech-AFG500 dynameter and metatarsophalangeal joint flexor strength tester, respectively. Partial correlation and multivariate stepwise regression were used to explore the relationships between foot morphology and toe/metatarsophalangeal joint strength. Results adjusted by age and body mass index were as follows: (1) truncated foot length in sitting and standing positions and foot width in standing position were positively correlated with the flexor strength of the first toe; (2) foot length, foot width, and truncated foot length in both positions were positively related to the flexor strength of the other toes; (3) arch height index in sitting position and differences in navicular height were negatively associated with the flexor strength of the other toes; (4) differences in foot width were negatively associated with metatarsophalangeal joint flexor strength; and (5) the multivariate stepwise regression model showed that truncated foot length in sitting position, navicular height in standing position, differences in navicular height, foot width in sitting position, and differences in foot width were significantly correlated with toe/metatarsophalangeal joint flexor strength. Simple measurements of foot morphological characteristics can effectively predict foot muscle strength. Preliminary findings provided practical implications for the improvement of the foot ability by making specific foot muscle training sessions in professional sports and by compensating the predicted muscle strength defects to prevent foot injury.
Topics: Adult; Foot; Humans; Male; Muscle Strength; Muscle, Skeletal; Standing Position; Toes
PubMed: 32079188
DOI: 10.3390/ijerph17041274 -
International Journal of Environmental... Mar 2021The aim of this study is to observe the morphological and postural changes to the foot that take place during pregnancy and the puerperium. In this descriptive,... (Observational Study)
Observational Study
The aim of this study is to observe the morphological and postural changes to the foot that take place during pregnancy and the puerperium. In this descriptive, observational, longitudinal study, we analysed 23 pregnant women, with particular attention to morphological and postural aspects of the foot, at three time points during and after pregnancy: in weeks 9-13 of gestation, weeks 32-35 of gestation and weeks 4-6 after delivery. The parameters considered were changes in foot length, the Foot Posture Index (FPI) and the Hernández Corvo Index, which were analysed using a pedigraph and taking into account the Body Mass Index (BMI). The same procedure was conducted in each review. The statistical analyses obtained for each foot did not differ significantly between the three measurement times. A pronator-type footprint was most frequently observed during the third trimester of pregnancy; it was predominantly neutral during the postpartum period. Statistically significant differences between the measurement times were obtained in the right foot for cavus vs. neutral foot type (between the first and third trimesters and also between the first trimester and the puerperium) (in both cases, < 0.0001). Foot length increases in the third trimester and returns to normal in the puerperium. According to FPI findings, the third trimester of pregnancy is characterised by pronation, while the posture returns to neutrality during the postpartum period. During pregnancy, the plantar arch flattens, and this persists during the puerperium. The incidence of cavus foot increases significantly in the third trimester and in the puerperium.
Topics: Female; Foot; Humans; Longitudinal Studies; Postpartum Period; Posture; Pregnancy; Pregnancy Trimester, Third
PubMed: 33801299
DOI: 10.3390/ijerph18052423