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Albarova-Corral I, Segovia-Burillo J, Malo-Urriés M, Ríos-Asín I, Asín J, Castillo-Mateo J, Gracia-Tabuenca Z, Morales-Hernández M. A New Quantitative Tool for the Ultrasonographic Assessment of Tendons: A Reliability and Validity Study on the Patellar Tendon. Diagnostics (Basel) 2024; 14:1067. [PMID: 38893594 PMCID: PMC11171978 DOI: 10.3390/diagnostics14111067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
Ultrasound is widely used for tendon assessment due to its safety, affordability, and portability, but its subjective nature poses challenges. This study aimed to develop a new quantitative analysis tool based on artificial intelligence to identify statistical patterns of healthy and pathological tendons. Furthermore, we aimed to validate this new tool by comparing it to experts' subjective assessments. A pilot database including healthy controls and patients with patellar tendinopathy was constructed, involving 14 participants with asymptomatic (n = 7) and symptomatic (n = 7) patellar tendons. Ultrasonographic images were assessed twice, utilizing both the new quantitative tool and the subjective scoring method applied by an expert across five regions of interest. The database contained 61 variables per image. The robustness of the clinical and quantitative assessments was tested via reliability analyses. Lastly, the prediction accuracy of the quantitative features was tested via cross-validated generalized linear mixed-effects logistic regressions. These analyses showed high reliability for quantitative variables related to "Bone" and "Quality", with ICCs above 0.75. The ICCs for "Edges" and "Thickness" varied but mostly exceeded 0.75. The results of this study show that certain quantitative variables are capable of predicting an expert's subjective assessment with generally high cross-validated AUC scores. A new quantitative tool for the ultrasonographic assessment of the tendon was designed. This system is shown to be a reliable and valid method for evaluating the patellar tendon structure.
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Affiliation(s)
- Isabel Albarova-Corral
- PhysiUZerapy Health Sciences Research Group, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - José Segovia-Burillo
- Fluid Mechanics, Instituto de Investigación en Ingeniería de Aragón (I3A), University of Zaragoza, 50018 Zaragoza, Spain
| | - Miguel Malo-Urriés
- PhysiUZerapy Health Sciences Research Group, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Izarbe Ríos-Asín
- PhysiUZerapy Health Sciences Research Group, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jesús Asín
- Modelos Estocásticos Research Group, Department of Statistical Methods, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jorge Castillo-Mateo
- Modelos Estocásticos Research Group, Department of Statistical Methods, University of Zaragoza, 50009 Zaragoza, Spain
| | - Zeus Gracia-Tabuenca
- Modelos Estocásticos Research Group, Department of Statistical Methods, University of Zaragoza, 50009 Zaragoza, Spain
| | - Mario Morales-Hernández
- Fluid Mechanics, Instituto de Investigación en Ingeniería de Aragón (I3A), University of Zaragoza, 50018 Zaragoza, Spain
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Matsumoto Y, Ogihara N. Direct visualization and measurement of the plantar aponeurosis behavior in foot arch deformation via the windlass mechanism. Clin Anat 2024. [PMID: 38642017 DOI: 10.1002/ca.24171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/28/2024] [Accepted: 04/11/2024] [Indexed: 04/22/2024]
Abstract
The plantar aponeurosis (PA) is an elastic longitudinal band that contributes to the generation of a propulsive force in the push-off phase during walking and running through the windlass mechanism. However, the dynamic behavior of the PA remains unclear owing to the lack of direct measurement of the strain it generates. Therefore, this study aimed to visualize and quantify the PA behavior during two distinct foot postures: (i) neutral posture and (ii) windlass posture with midtarsal joint plantarflexion and metatarsophalangeal joint dorsiflexion, using computed tomography scans. Six healthy adult males participated in the experiment, and three-dimensional reconstruction of the PA was conducted to calculate its path length, width, thickness, and cross-sectional area. This study successfully visualized and quantified the morphological changes in the PA induced by the windlass mechanism, providing a precise reference for biomechanical modeling. This study also highlighted the interindividual variability in the PA morphology and stretching patterns. Although the windlass posture was not identical to that observed in the push-off phase during walking, the observed PA behavior provides valuable insights into its mechanics and potential implications for foot disorders.
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Affiliation(s)
- Yuka Matsumoto
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
- Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
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Gao J, Xu L, Wan M. Incremental learning for an evolving stream of medical ultrasound images via counterfactual thinking. Comput Med Imaging Graph 2023; 109:102290. [PMID: 37647830 DOI: 10.1016/j.compmedimag.2023.102290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/27/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
Despite the fact that traditional deep learning (DL) approaches provide promising accuracy and efficiency in medical ultrasound image analysis, they cannot replace the physician in making a diagnosis since the DL model is only appropriate in static application scenarios. Currently, most DL-based models are incapable of learning new tasks in the dynamic clinical environments due to the catastrophic forgetting of old tasks. To address the above problem, we propose an incremental classifier that is sequentially trained on evolving tasks for medical ultrasound images by counterfactual thinking. Specifically, the proposed model consists of a feature extractor and a classifier that can add new classes at any time during training. Toward a more discriminative model in the continual learning setting, a contrastive strategy is designed to leverage fine-grained information by generating a series of counterfactual regions. For model optimization, we design a multi-task loss made up of a knowledge distillation loss, a cross-entropy loss, and a contrasting loss. This objective jointly enjoys the merits of less forgetting, better accuracy, and fine-grained information utilization. A newly collected dataset with 52 medical ultrasound classification tasks is used to demonstrate the effectiveness of our method. The proposed approach achieves 76.59%, 11.67%, and 7.93% in terms of the average incremental accuracy, forgetting rate, and feature retention, respectively.
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Affiliation(s)
- Junling Gao
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Lei Xu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China; Xi'an Hospital of Traditional Chinese Medicine, Xi'an 710021, PR China
| | - Mingxi Wan
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China.
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Aguilar-Nuñez D, Cervera-Garvi P, Aguilar-Garcia M, Cuevas-Cervera M, Gonzalez-Muñoz A, Navarro-Ledesma S. Ultrasound Strain Elastography Reliability in the Assessment of the Plantar Fascia and Its Relationship with the Plantar Thickness in Healthy Adults: An Intra and Interobserver Reliability Study in Novice Evaluators. Biomedicines 2023; 11:2040. [PMID: 37509678 PMCID: PMC10377694 DOI: 10.3390/biomedicines11072040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
PURPOSE This study was aimed at verifying both the intraobserver and interobserver reliability of measuring plantar fascia stiffness for a given image in healthy active adults. METHODOLOGY This study is reported following the Guidelines of Reporting Reliability and Agreement Studies. A total of 20 plantar fascia from healthy volunteers were analyzed. The thickness of the plantar fascia was measured vertically from the anterior edge of the inferior calcaneal border to the inferior border of the plantar fascia and the ultrasound elastography measurement was taken at the calcaneal insertion of the plantar fascia with the region of interest one centimeter away from the insertion. RESULTS The ultrasound strain elastography measurements: the right intraobserver 1 showed an ICC value of 0.9 and the left intraobserver 1 showed an ICC value of 0.78, while the right intraobserver 2 showed an ICC value of 0.91 and the left intraobserver 2 showed an ICC value of 0.83. Interobserver measurements showed excellent reliability with a right ICC value of 0.8 and a left ICC value of 0.9 for the plantar fascia thickness measurements. DISCUSSION The results of this study showed a strong correlation between left and right plantar fascia thickness. The intraobserver reliability was excellent for both plantar fascia ultrasound strain elastography and thickness measurements, with interobserver measurements showing excellent reliability.
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Affiliation(s)
- Daniel Aguilar-Nuñez
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain
- Clinica Ana Gonzalez, Avenida Hernan Nuñez de Toledo 6, 29018 Malaga, Spain
| | - Pablo Cervera-Garvi
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain
| | - Maria Aguilar-Garcia
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain
| | - Maria Cuevas-Cervera
- Clinica Ana Gonzalez, Avenida Hernan Nuñez de Toledo 6, 29018 Malaga, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain
| | - Ana Gonzalez-Muñoz
- Clinica Ana Gonzalez, Avenida Hernan Nuñez de Toledo 6, 29018 Malaga, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain
| | - Santiago Navarro-Ledesma
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain
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Nafees F, Fatima Z, Malik SS, Yousaf Q, Latif M, Farooq SMY. Ultrasound measurement of plantar fascia thickness: Is the current criterion for normality applicable to everyone? SONOGRAPHY 2022. [DOI: 10.1002/sono.12342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Fouad Nafees
- Radiology Research Section The University of Lahore Lahore Pakistan
| | - Zareen Fatima
- University Institute of Radiological Sciences and Medical Imaging Technology, Faculty of Allied Health Sciences The University of Lahore Lahore Pakistan
| | - Sajid Shaheen Malik
- University Institute of Radiological Sciences and Medical Imaging Technology, Faculty of Allied Health Sciences The University of Lahore Lahore Pakistan
| | - Qasim Yousaf
- Department of Radiology Government Kot Khawaja Saeed Teaching Hospital Lahore Pakistan
| | - Mahrukh Latif
- University Institute of Radiological Sciences and Medical Imaging Technology, Faculty of Allied Health Sciences The University of Lahore Lahore Pakistan
| | - Syed Muhammad Yousaf Farooq
- University Institute of Radiological Sciences and Medical Imaging Technology, Faculty of Allied Health Sciences The University of Lahore Lahore Pakistan
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Matsumoto Y, Ogihara N, Hanawa H, Kokubun T, Kanemura N. Novel Multi-Segment Foot Model Incorporating Plantar Aponeurosis for Detailed Kinematic and Kinetic Analyses of the Foot With Application to Gait Studies. Front Bioeng Biotechnol 2022; 10:894731. [PMID: 35814002 PMCID: PMC9265906 DOI: 10.3389/fbioe.2022.894731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Kinetic multi-segment foot models have been proposed to evaluate the forces and moments generated in the foot during walking based on inverse dynamics calculations. However, these models did not consider the plantar aponeurosis (PA) despite its potential importance in generation of the ground reaction forces and storage and release of mechanical energy. This study aimed to develop a novel multi-segment foot model incorporating the PA to better elucidate foot kinetics. The foot model comprised three segments: the phalanx, forefoot, and hindfoot. The PA was modeled using five linear springs connecting the origins and the insertions via intermediate points. To demonstrate the efficacy of the foot model, an inverse dynamic analysis of human gait was performed and how the inclusion of the PA model altered the estimated joint moments was examined. Ten healthy men walked along a walkway with two force plates placed in series close together. The attempts in which the participant placed his fore- and hindfoot on the front and rear force plates, respectively, were selected for inverse dynamic analysis. The stiffness and the natural length of each PA spring remain largely uncertain. Therefore, a sensitivity analysis was conducted to evaluate how the estimated joint moments were altered by the changes in the two parameters within a range reported by previous studies. The present model incorporating the PA predicted that 13%–45% of plantarflexion in the metatarsophalangeal (MTP) joint and 8%–29% of plantarflexion in the midtarsal joints were generated by the PA at the time of push-off during walking. The midtarsal joint generated positive work, whereas the MTP joint generated negative work in the late stance phase. The positive and negative work done by the two joints decreased, indicating that the PA contributed towards transfer of the energy absorbed at the MTP joint to generate positive work at the midtarsal joint during walking. Although validation is limited due to the difficulty associated with direct measurement of the PA force in vivo, the proposed novel foot model may serve as a useful tool to clarify the function and mechanical effects of the PA and the foot during dynamic movements.
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Affiliation(s)
- Yuka Matsumoto
- Graduate School of Saitama Prefectural University, Graduate Course of Health and Social Services, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
| | - Hiroki Hanawa
- Department of Health Science, University of Human Arts and Sciences, Saitama, Japan
| | - Takanori Kokubun
- Department of Health and Social Services, Saitama Prefectural University, Saitama, Japan
| | - Naohiko Kanemura
- Department of Health and Social Services, Saitama Prefectural University, Saitama, Japan
- *Correspondence: Naohiko Kanemura,
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Heinen EH, Lima KMME, Correia R, Diefenthaeler F, de Brito Fontana H. Reliability in ultrasound measurements of plantar aponeurosis thickness. Foot (Edinb) 2021; 46:101749. [PMID: 33285494 DOI: 10.1016/j.foot.2020.101749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/21/2020] [Accepted: 11/11/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE Given the increasing research interest in ultrasound plantar aponeurosis (PA) thickness measurements, this study aimed to analyze the inter and intra-rater reliability of independent sonograms and to identify the error related to the image analysis procedure. METHODS Twenty-one healthy men participated in this study. Imaging of PA consisted of two independent sonograms per subject. Two raters (R1 and R2) evaluated each sonogram twice using standardized steps. Precision of the image analysis procedure was analyzed using the Bland and Altman plot and Intraclass Correlation Coefficient (ICC). Agreement estimates and ICC were used to assess absolute and relative inter and intra-rater reliability. RESULTS Reliability of PA thickness was found to depend strongly on the number of images acquired per subject. Intra-rater agreement for single measurements were 0.696 (R1) and 0.495 (R2), whereas average measurements yielded values of 0.821 (R1) and 0.662 (R2), respectively. Precision within a sonogram varied from ICC values of 0.873 to 0.960 (intra-rater) and 0.670 to 0.822 (inter-rater). CONCLUSION Most part of the error in PA thickness measurements seems to be related to the sonogram acquisition process and not to the visual inspection of the image. To minimize error, average values of a minimum of two images per subject should be used. The moderate agreement between raters found in this study ratifies the need of all measurements being made by the same rater or group of raters. If a single rater evaluates all subjects, performing multiple measurements over one image does not seem to affect ICC as much as acquiring multiple images.
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Affiliation(s)
- Eduarda Heydt Heinen
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil.
| | - Kelly Mônica Marinho E Lima
- Health Sciences Department, School of Science, Technology and Health, Federal University of Santa Catarina, Araranguá, 88.906-072, Brazil.
| | - Raissa Correia
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil.
| | - Fernando Diefenthaeler
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil; Physical Eduaction Department, School of Sports, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil.
| | - Heiliane de Brito Fontana
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil; Morphological Sciences Department, School of Biological Sciences, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil.
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Kim K, Choi D, Im S. Understanding the effect of methane gas sensitivity using ultrasonic sensors and multi-matching layers inside a natural gas vehicle tank. ULTRASONICS 2019; 99:105970. [PMID: 31394480 DOI: 10.1016/j.ultras.2019.105970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 06/10/2023]
Abstract
This research paper is the experimental study to investigate the effect of ultrasound sensitivity in the pure methane gas space as the pressure and sensor distance increases. We offer the solution to overcome the low sensitivity characteristics of ultrasonic sensors in the methane gas space. This proposal shows the physical characteristics analyzed with self-induced vibration, beam pattern, amplitude, attenuation, and Gaussian distribution validation in CH4 gas space. An ultrasonic sensor is designed with PbTio3 material of an MS-50 PTZ. The signal processing analysis system (APAS) is composed of the mechanical and controlling sections including three mass flow controllers, an air cylinder, safety valves, three pressure regulators, a CVC, ultrasound sensors, and two gas tanks (air and CH4). The experiment is performed in a wide range of the initial conditions, i.e., supplying voltage of 25 V, current of 0.2 A, pulse rate of 7 Hz, measuring distance of 0.32 to 1.02 m, resonance frequency of 57.3 Hz, ambient temperature of 296 K, and pressure increases of 1, 2, 3 and 4 bar. The ultrasonic sensitivity of a sensor (T: EVA and R: EVA) significantly enhanced the acoustic impedance in a methane gas space as pressure increases. It is verified that the sensitivity effect of an ultrasonic sensor used with ethylene vinyl acetate (EVA) matching layer is higher in the methane gas space than a chemical wood (CW) matching layer. Consequently, the effect of gas sensitivity computed by a GDA including the width (W), area (A), and height (H) is enhanced by an EVA sensor in comparison to other Models.
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Affiliation(s)
- Kwonse Kim
- Mechanical Engineering Department, Mississippi State University, Starkville, MS 39762, USA
| | - Dooseuk Choi
- Mechanical & Automotive Engineering Division, Kongju National University, 1223-24, Cheonan-daero, Seobuk-gu, Cheonan-si, Chungnam 31080, Republic of Korea
| | - Seokyeon Im
- Automotive Engineering Department, Tongmyong University, 428, Sinseon-ro, Nam-gu, Busan 48520, Republic of Korea.
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Romero-Morales C, Martín-Llantino PJ, Calvo-Lobo C, López-López D, Sánchez-Gómez R, De-La-Cruz-Torres B, Rodríguez-Sanz D. Ultrasonography Features of the Plantar Fascia Complex in Patients with Chronic Non-Insertional Achilles Tendinopathy: A Case-Control Study. SENSORS 2019; 19:s19092052. [PMID: 31052554 PMCID: PMC6539056 DOI: 10.3390/s19092052] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/25/2019] [Accepted: 04/30/2019] [Indexed: 12/28/2022]
Abstract
Purpose: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). Methods: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (n = 71) and B group comprised by healthy subjects (n = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. Results: the CFP and PF at the calcaneus thickness showed statistically significant differences (P < 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (P > 0.05) were observed between groups. Conclusion: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI.
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Affiliation(s)
- Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.
| | | | - César Calvo-Lobo
- Faculty of Health Sciences, Institute of Biomedicine (IBIOMED), Universidad de León, 24401 Ponferrada, Spain.
| | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403 Ferrol, Spain.
| | - Rubén Sánchez-Gómez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | | | - David Rodríguez-Sanz
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain.
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Pękala PA, Kaythampillai L, Skinningsrud B, Loukas M, Walocha JA, Tomaszewski KA. Anatomical variations of the plantar fascia's origin with respect to age and sex-an MRI based study. Clin Anat 2019; 32:597-602. [PMID: 30701591 DOI: 10.1002/ca.23342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 12/20/2022]
Abstract
The plantar fascia (PF) plays a significant role in ankle movement and anatomical variations of this structure may significantly alter the biomechanical properties of the foot and lower extremity. The aim of this study was to evaluate the changes of the PF's origin point on the calcaneus (CB), and whether these changes are dependent on age and sex. Two independent observers evaluated two hundred and two foot and ankle MRIs and the following measurements was performed: (A) horizontal length of the AT insertion into the posterior aspect of the CB, (B) horizontal length of the CB and (C) horizontal distance from the most anterior point of the CB to the most posterior part of the PF. Statistical analysis was performed with the results obtained to evaluate both sex and age differences. Based on our results, we observed that: (1) changes of the PF's origin point on the CB is independent of age and sex and (2) the continuity between the PF and AT decreases during aging as a result from changes in the AT's insertion point into the CB. This study concludes that the PF's origin point does not change with respect to age or sex, but the continuity between the PF and AT decreases during aging. Knowledge regarding the biomechanical influences caused by changes in the relationship between the AT and PF may be important in terms of treatment and prophylaxis of both PF and AT pathologies. Clin. Anat. 32:597-602, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Przemysław A Pękala
- International Evidence-Based Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Lourdes Kaythampillai
- International Evidence-Based Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Bendik Skinningsrud
- International Evidence-Based Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies
| | - Jerzy A Walocha
- International Evidence-Based Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof A Tomaszewski
- International Evidence-Based Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
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