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de Castro Cruz A, Fonseca ST, Araújo VL, Cardoso TB, Milagres Brandão FC, de Melo Ocarino J, Resende RA, Souza TR. Reductions in rearfoot eversion posture due to proximal muscle strengthening are dependent on foot-ankle varus alignment. J Bodyw Mov Ther 2024; 39:79-86. [PMID: 38876705 DOI: 10.1016/j.jbmt.2024.02.001] [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: 07/08/2022] [Revised: 11/03/2023] [Accepted: 02/22/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Strengthening the hip and trunk muscles may decrease foot pronation in upright standing due to expected increases in hip passive torque and lower-limb external rotation. However, considering the increased pronation caused by a more varus foot-ankle alignment, subjects with more varus may experience smaller or no postural changes after strengthening. OBJECTIVE To investigate the effects of hip and trunk muscle strengthening on lower-limb posture during upright standing and hip passive torque of women with more and less varus alignment. METHODS This nonrandomized controlled experimental study included 50 young, able-bodied women. The intervention group (n = 25) performed hip and trunk muscle strengthening exercises, and the control group (n = 25) maintained their usual activities. Each group was split into two subgroups: those with more and less varus alignment. Hip, shank, and rearfoot-ankle posture and hip passive external rotation torque were evaluated. Mixed analyses of variance and preplanned contrasts were used to assess prepost changes and between-group differences (α = 0.05). RESULTS The less-varus subgroup of the intervention group had a reduced rearfoot eversion posture (P = 0.02). No significant changes were observed in the less-varus subgroup of the control group (P = 0.31). There were no significant differences in posture between the control and intervention groups when varus was not considered (P ≥ 0.06). The intervention group had increased hip passive torque (P = 0.001) compared to the control group, independent of varus alignment. CONCLUSION Despite the increases in hip passive torque, the rearfoot eversion posture was reduced only in women with a less-varus alignment. Having more foot-ankle varus may prevent eversion reductions.
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Affiliation(s)
- Aline de Castro Cruz
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Sérgio Teixeira Fonseca
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Vanessa Lara Araújo
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Thais Brasil Cardoso
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | | | - Juliana de Melo Ocarino
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Renan Alves Resende
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Thales Rezende Souza
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Payas A, Batin S. Is a keystone Bone Anomaly the Main Cause of Flatfoot (Pes Planus)? J Pediatr Orthop 2024:01241398-990000000-00599. [PMID: 38918893 DOI: 10.1097/bpo.0000000000002760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
BACKGROUND Flatfoot (pes planus) is a decrease or loss of longitudinal medial arch height. The cause of symptomatic flatfoot occurring in adolescents is still unclear. In this study, the relationship between adolescent pes planus and foot bone shape was investigated. For this purpose, the volume and superficial area data of the foot bones of adolescent individuals with flatfoot deformity and individuals without any foot deformity were compared. METHODS Between September 2022 and June 2023, 30 individuals with adolescent pes planus with a medial arch angle greater than 145 degrees and 30 individuals without any foot deformity were included in the study. Computed tomography (CT) images of the participants' feet were obtained with a General Electric brand IQ model 32 detector CT device with a section thickness of 0.625 mm in accordance with the bone protocol. Using the 3D Slicer program on CT images, foot bones were segmented and the volume and surface area ratios of each foot bone were determined. RESULTS Cuneiforme mediale and cuneiforme intermediale volume ratios in individuals with flatfoot deformity decreased by 14% and 24%, respectively, compared with the control group (P<0.05). Cuneiforme mediale and cuneiforme intermediale superficial area ratios were found to be 10% and 30% lower in the flatfoot group compared with the control group, respectively (P<0.05). There was no difference in the volume and superficial area ratios of other foot bones between the groups (P>0.05). CONCLUSIONS The study results suggest that symptomatic adolescent flatfoot deformity may be associated with developmental anomalies of the os cuneiforme mediale and os cuneiforme intermedium.
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Affiliation(s)
- Ahmet Payas
- Department of Anatomy, Faculty of Medicine, Amasya University, Amasya
| | - Sabri Batin
- Kayseri City Education and Training Hospital Orthopedics and Traumatology Department, Kayseri, Turkey
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Ogawa Y, Maemichi T, Yamaguchi R, Okunuki T, Kinoshita O, Nagamoto H, Kumai T. Differences in muscle activity of extrinsic and intrinsic foot muscles in toe grip and push-down movements of the great toe. Foot (Edinb) 2024; 60:102111. [PMID: 38924935 DOI: 10.1016/j.foot.2024.102111] [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: 04/19/2024] [Revised: 05/27/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
Toe flexor strength is generated primarily by the flexor hallucis longus (FHL) of the extrinsic foot muscles (EFMs) and the plantar intrinsic foot muscles (PIFMs) of the great toe. Toe flexion methods can be broadly classified into toe grip (TG) and toe push-down (TP). Additionally, TP's interphalangeal joint (IPJ) position may influence the FHL and PIFMs activity ratios. This study aimed to elucidate the differences in the muscle activity and muscle activity ratios of the FHL and AbdH during TG, TP with IPJ flexion (TPIF), and TP with IPJ extension (TPIE). Surface electromyography and a custom-made instrument were used to measure the FHL and AbdH muscle activity during TG, TPIF, and TPIE of the great toe in 28 healthy men. The muscle activity and AbdH/FHL muscle activity ratio in the three conditions were statistically compared. The FHL activity was significantly higher during TG and TPIF than during TPIE. The AbdH muscle activity was significantly higher during TPIF and TPIE than that during TG. The AbdH/FHL muscle activity ratio was significantly higher for TPIE, TPIF, and TG in that order. This study showed that the FHL and AbdH muscle activity differed depending on the TG and TP of the great toe, and that the AbdH/FHL muscle activity ratio was different in the IPJ position. These results suggest that selecting a toe flexion method according to the target muscle when measuring and training the great toe flexor strength is important.
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Affiliation(s)
- Yuki Ogawa
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan; Wako Rehabilitation Hospital, Saitama, Japan
| | | | - Ryusei Yamaguchi
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | | | - Hideaki Nagamoto
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan.
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Katakura M, Rezende MAG, Calder JDF, Kedgley AE. A comparison of abductor hallucis muscle activation and medial longitudinal arch angle during nine different foot exercises. Gait Posture 2024; 113:167-172. [PMID: 38905851 DOI: 10.1016/j.gaitpost.2024.06.008] [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: 03/23/2024] [Revised: 05/12/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Intrinsic foot muscles are known to support the medial longitudinal arch (MLA) and stabilize the foot, and they are activated with weight bearing and increased postural demand. Various types of intrinsic foot muscle training have been reported, but one of the most useful of these, the short foot exercise, is challenging to perform effectively and requires practice, making it difficult to implement in ordinary clinical settings. RESEARCH QUESTION What are the differences in abductor hallucis longus (ABH) muscle activity and MLA angle during intrinsic foot muscle exercises that employ weight bearing and balancing conditions when they are performed with minimal practice? METHODS Sixteen healthy volunteers performed nine different intrinsic foot muscle exercises, practiced once or twice. The exercises consisted of toe curl, short foot without pushing, short foot with pushing and toe spread exercises in sitting and standing positions, and single leg swing in a standing position. Each exercise was performed three times for five seconds. The activities of the ABH muscles were measured using surface electromyographic (EMG) sensors and the MLA angles during the exercises were captured using an optical motion tracking system. The integrals of the ABH EMG signals were calculated. RESULTS Differences in the integral and maximum of the ABH EMG signal were found between the exercises (p < 0.001). Post-hoc pair-wise analysis revealed that the EMG activity was larger during the swing exercise than in exercises other than toe spread, both in sitting and standing positions, and short foot exercise with pushing while standing. The minimum MLA angle during each exercise was smaller for the toe spread exercise in a sitting position than other exercises (p < 0.023). SIGNIFICANCE A single leg swing exercise may be effective for self-exercise of intrinsic foot muscles, particularly when intensive supervised physiotherapy is not possible.
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Affiliation(s)
- Mai Katakura
- Department of Bioengineering, White City Campus, Imperial College London, London W12 0BZ, United Kingdom; Fortius Clinic FIFA Centre of Excellence, 17 Fitzhardinge Street, London W1H 6EQ, United Kingdom
| | | | - James D F Calder
- Department of Bioengineering, White City Campus, Imperial College London, London W12 0BZ, United Kingdom; Fortius Clinic FIFA Centre of Excellence, 17 Fitzhardinge Street, London W1H 6EQ, United Kingdom
| | - Angela E Kedgley
- Department of Bioengineering, White City Campus, Imperial College London, London W12 0BZ, United Kingdom.
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Kirmizi M, Sengul YS, Akcali O, Angin S. Effects of foot exercises and customized arch support insoles on foot posture, plantar force distribution, and balance in people with flexible flatfoot: A randomized controlled trial. Gait Posture 2024; 113:106-114. [PMID: 38865799 DOI: 10.1016/j.gaitpost.2024.05.030] [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: 01/03/2024] [Revised: 04/19/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Exercises strengthening foot muscles and customized arch support insoles are recommended for improving foot posture in flexible flatfoot. However, it is not known what the effects of exercises and insoles on plantar force distribution obtained during walking at different speeds. Also, randomized controlled trials comparing the effects of exercises and insoles are limited. RESEARCH QUESTION What are the effects of foot exercises, customized arch support insoles, and exercises plus insoles on foot posture, plantar force distribution, and balance in people with flexible flatfoot? Do exercises, insoles, and exercises plus insoles affect outcome measures differently? METHODS Forty-five people with flexible flatfoot were randomly divided into three groups and 40 of those completed the study. The exercise group performed tibialis posterior strengthening and short foot exercises three days a week for six weeks. The insole group used their customized arch support insoles for six weeks. The exercise plus insole group received both interventions for six weeks. The assessments were performed three times: before the interventions and at the 6th and 12th weeks. Outcome measures were (1) foot posture, (2) plantar force distribution in the following conditions: static standing, barefoot walking at different speeds, and walking immediately after the heel-rise test, and (3) balance. RESULTS Foot posture improved in all groups, but insole was less effective than exercise and exercise plus insole (p<0.05). Plantar force variables obtained during standing and walking changed in all groups (p<0.05). The superiority of the interventions differed according to the plantar regions and walking speed conditions (p<0.05). Static balance improved in all groups, but limits of stability improved in the exercise plus insole and exercise groups (p<0.05). SIGNIFICANCE The superiority of the interventions differed according to the assessed parameter. The management of flexible flatfoot should be tailored based on the assessment results of each individual.
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Affiliation(s)
- Muge Kirmizi
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey; Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey.
| | - Yesim Salik Sengul
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Omer Akcali
- Faculty of Medicine, Department of Orthopaedics and Traumatology, Dokuz Eylul University, Izmir, Turkey
| | - Salih Angin
- Faculty of Health Sciences, Cyprus International University, Nicosia, Cyprus
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Kao SL, Hsiao ML, Wang JH, Chen CS, Chen SY, Shiau YJ, Yang CH. Effects of integrated intrinsic foot muscle exercise with foot core training device on balance and body composition among community-dwelling adults aged 60 and above. BMC Geriatr 2024; 24:403. [PMID: 38714957 PMCID: PMC11075247 DOI: 10.1186/s12877-024-04945-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/03/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Evidence on the effects of plantar intrinsic foot muscle exercise in older adults remains limited. This study aimed to evaluate the effect of an integrated intrinsic foot muscle exercise program with a novel three-dimensional printing foot core training device on balance and body composition in community-dwelling adults aged 60 and above. METHODS A total of 40 participants aged ≥ 60 years were enrolled in this quasi-experimental, single-group, pretest-posttest design; participants were categorized into two groups, those with balance impairment and those without balance impairment. The participants performed a 4-week integrated intrinsic foot muscle exercise program with a three-dimensional printing foot core training device. The short physical performance battery (SPPB) and timed up and go test were employed to evaluate mobility and balance. A foot pressure distribution analysis was conducted to assess static postural control. The appendicular skeletal muscle mass index and fat mass were measured by a segmental body composition monitor with bioelectrical impedance analysis. The Wilcoxon signed rank test was used to determine the difference before and after the exercise program. RESULTS Among the 40 enrolled participants (median age, 78.0 years; female, 80.0%; balance-impaired group, 27.5%), the 95% confidence ellipse area of the center of pressure under the eyes-closed condition was significantly decreased (median pretest: 217.3, interquartile range: 238.4; median posttest: 131.7, interquartile range: 199.5; P = 0.001) after the exercise. Female participants without balance impairment demonstrated a significant increase in appendicular skeletal muscle mass index and a decrease in fat mass. Participants in the balance-impaired group exhibited a significant increase in SPPB. CONCLUSIONS Integrated intrinsic foot muscle exercise with a three-dimensional printing foot core training device may improve balance and body composition in adults aged 60 and above. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05750888 (retrospectively registered 02/03/2023).
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Affiliation(s)
- Sheng-Lun Kao
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan
- Department of Family Medicine, College of Medicine, Tzu Chi University, No. 701, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan
| | - Mei-Lan Hsiao
- Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan
| | - Chen-Sheng Chen
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou District, Taipei, 112, Taiwan
| | - Shin-Yuan Chen
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan
- School of Medicine, Tzu Chi University, No. 701, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan
| | - Yung-Jeng Shiau
- Department of Physical Therapy, College of Medicine, Tzu Chi University, No. 701, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan
- Sports Medicine Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan
| | - Chich-Haung Yang
- Department of Physical Therapy, College of Medicine, Tzu Chi University, No. 701, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan.
- Sports Medicine Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 970, Taiwan.
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Adeeb N, Farooqui SI, Meher Hasan Z, Khan A, Rizvi J. Foot Muscle Exercise: A Novel Approach to Improve Motor Functions in Children with Down Syndrome Having Pes Planus - A Randomized Controlled Trial. Dev Neurorehabil 2024; 27:145-153. [PMID: 38889352 DOI: 10.1080/17518423.2024.2365798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE The study aimed to determine the efficacy of foot muscle exercises in children with DS having pes planus. METHODS Forty-seven subjects randomly assigned to foot muscle exercises (study group) or an arch support insole with one-leg balance exercises (control group), thrice weekly intervention for 12-weeks followed by a home program with residual effect assessed after 24-weeks from baseline. RESULTS The motor functions were significantly improved in both groups (p = 0.00). A positive residual effect was found in the study group for both parameters. Whilst in the control group it failed to give a positive residual effect for GMFM-88, while PBS yielded positive outcomes. The study group showed significantly better results than the control group in comparison. CONCLUSION The novel finding suggests that the foot muscle exercise has the potential to improve motor functions in children with Down syndrome and it can be used as an alternative therapeutic approach to the conventional method.
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Affiliation(s)
- Nazia Adeeb
- Department of Physical Therapy, A.C.E.L.P (Institute of Child Development), Karachi, Pakistan
| | | | - Zainab Meher Hasan
- Department of Physical Therapy, A.C.E.L.P (Institute of Child Development), Karachi, Pakistan
| | - Abid Khan
- College of Physical Therapy, Faculty of Allied Health Sciences, Ziauddin, University
| | - Jaza Rizvi
- College of Physical Therapy, Faculty of Allied Health Sciences, Ziauddin, University
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Kudo S, Hatanaka M, Kanazawa S, Hirakawa K, Hara S, Tsutsumi M. Effects of short foot exercises with ultrasound bio-feedback on motor learning and foot alignment: A double blinded randomized control trial. J Back Musculoskelet Rehabil 2024; 37:671-678. [PMID: 38160335 DOI: 10.3233/bmr-230163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Short foot exercises (SFE) take a long time to master and require a feedback tool to improve motor learning. OBJECTIVE This study aimed to investigate the effect of bio-feedback of talonavicular joint movements in learning SFE with ultrasound (US) imaging. METHODS This study included thirty-one healthy volunteers and was designed as a double-blind randomized control trial. Subjects were randomly assigned to one of two groups: the control group, which performed SFE under verbal instruction, and the US bio-feedback (USBF) group, which performed SFE with real-time bio-feedback of the talonavicular joint alignment. All subjects underwent two sessions of 5 minutes each, and SFE was performed as a self-exercise, between sessions, for one week. The difference in foot length and navicular height were assessed at baseline, after Session 1, before Session 2, and one week after Session 2. These differences were compared between the two groups using the Mann-Whitney U test. RESULTS In terms of navicular height change, the USBF group (7.5 ± 4.3 mm) was significantly higher than the control group (4.2 ± 3.3 mm) one week after session 2 (p= 0.04, effect size = 0.86). CONCLUSION SFE with USBF is an effective intervention for performing SFE.
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Affiliation(s)
- Shintarou Kudo
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Japan
- AR-Ex Medical Research Center, Tokyo, Japan
| | - Mizuki Hatanaka
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Seiya Kanazawa
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Keisuke Hirakawa
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Shigeyuki Hara
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
- Department of Rehabilitation, Kindai University Nara Hospital, Nara, Japan
| | - Masahiro Tsutsumi
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
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Hwang BH, Jeon IC. Comparison of abductor hallucis muscle activity in subjects with mild hallux valgus during three different foot exercises. J Back Musculoskelet Rehabil 2024; 37:47-54. [PMID: 37599517 DOI: 10.3233/bmr-220252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
BACKGROUND Normal alignment of the foot is important because the feet support the body's weight. The intrinsic muscles of the foot mainly maintain the alignment and movement of the foot, whereas the abductor hallucis (AbdH) aligns the first metatarsophalangeal joint and maintains the medial longitudinal arch. OBJECTIVE This study was conducted to investigate the muscle activity of the AbdH and hallux valgus (HV) angle during three different foot exercises. METHODS Participants included 15 subjects aged 20-24 years with mild HV. All subjects performed three different foot exercises in random order: short foot exercise (SF), toe spread out exercise (TSO), and TSO with a pressure bio-feedback unit (TSOP). The muscle activity of the AbdH and the HV angle were measured during each foot exercise using surface electromyography and X-ray and then compared using one-way repeated-measures analysis of variance, followed by Bonferroni adjustment. RESULTS AbdH muscle activity differed significantly among SF, TSO, and TSOP. AbdH muscle activity was greater in TSOP (89.60%) than in SF (19.99%) and TSO (60.96%) (p= 0.006). The HV angle was significantly smaller in TSOP (15.72∘) than in SF (18.85∘) and TSO (16.81∘) (p= 0.001). CONCLUSIONS TSOP can be recommended as an effective AbdH strengthening exercise in subjects with mild HV.
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Affiliation(s)
- Byeong-Hun Hwang
- Department of Physical Therapy, Graduate School, Hoseo University, Asan, Korea
- Department of Physical Therapy, College of Life and Health Sciences, Hoseo University, Asan, Korea
| | - In-Cheol Jeon
- Department of Physical Therapy, College of Life and Health Sciences, Hoseo University, Asan, Korea
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Suh JH, Yoon SY. Comparing the effects of University of California Biomechanics Laboratory and custom-made semi-rigid insole on pedobarographic parameters in pediatric flexible flat foot. Prosthet Orthot Int 2023; 47:614-620. [PMID: 37227812 DOI: 10.1097/pxr.0000000000000238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 02/22/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Pediatric flexible flat foot (PFFF) is often associated with pain along the medial longitudinal arch and potential disability. There are several conservative treatment options for PFFF, ranging from intrinsic muscle exercises to orthosis, including University of California Biomechanics Laboratory (UCBL) and custom-made semi-rigid insoles. OBJECTIVES To investigate and compare the effect of UCBL and custom-made semi-rigid insoles on pedobarographic and radiologic parameters in PFFF. STUDY DESIGN This study prepared a retrospective chart review of 143 children diagnosed with PFFF between the age of 4 and 12 years. METHODS Data of twenty-seven children with PFFF who were prescribed foot orthoses between the age of 4 and 12 years were retrospectively reviewed. Medical charts were retrospectively reviewed, and pedobarographic and radiological parameters assessed before and 1 year after application of orthoses were reviewed. RESULTS The difference in the calcaneal pitch angle and the center of pressure excursion index (CPEI) were significantly improved in the custom-made semi-rigid insole group compared to that in the UCBL group. The contact area ratio of the midfoot and toe and CPEI at 1 year after wearing the insole was significantly improved in the custom-made semi-rigid insole group compared to that in the UCBL group. Moreover, the calcaneal pitch angle and CPEI were significantly improved 1 year after application of the insole in the custom-made semi-rigid insole group. CONCLUSIONS This result showed that the custom-made semi-rigid insole is more effective in improving the deviation of the center pressure curve and calcaneal pitch angle than the UCBL. The custom-made semi-rigid insole may help relieve foot instability during gait and improve the medial longitudinal arch in children with PFFF.
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Affiliation(s)
- Jee Hyun Suh
- Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Seo Yeon Yoon
- Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, South Korea
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Abran G, Schwartz C, Delvaux F, Aguilaniu A, Bornheim S, Croisier JL. Foot and Ankle Muscle Isometric Strength in Nonrearfoot Compared With Rearfoot Endurance Runners. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231205305. [PMID: 37886623 PMCID: PMC10599118 DOI: 10.1177/24730114231205305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
Background Transitioning to a forefoot strike pattern can be used to manage running-related knee injuries. However, adopting a nonrearfoot strike induces a higher load on foot and ankle structures than rearfoot strike. Sufficient foot muscle strength is also necessary to prevent excessive longitudinal arch (LA) deformation when running with nonrearfoot strike. The aim of this study was to investigate the potential differences in foot-ankle muscle strength between RF and NRF runners. Methods A cross-sectional study including 40 RF and 40 NRF runners was conducted. The foot posture and the maximal voluntary isometric strength (MVIS) of 6 foot-ankle muscles were measured. The footstrike pattern was determined using a 2-D camera during a self-paced run on a treadmill. Results NRF had higher MVIS for ankle plantar flexor (+12.5%, P = .015), ankle dorsiflexor (+17.7%, P = .01), hallux flexor (+11%, P = .04), and lesser toe flexor (+20.8%, P = .0031). We found a small positive correlation between MVIS of ankle plantar flexor with MVIS of hallux flexor (r = 0.26; P = .01) and lesser toe flexor (r = 0.28; P = .01). Conclusion In this cross-sectional study, we found that NRF runners on average have a higher MVIS of hallux and lesser toe flexor compared with RF runners. NRF runners also have a higher MVIS of ankle plantar flexor and dorsiflexor than RF runners. We found only a small correlation between ankle plantar flexor and foot muscle strength. Level of Evidence Level III, case-control study.
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Affiliation(s)
- Guillaume Abran
- Department of Motricity sciences, University of Liege, Liege, Belgium
| | | | - François Delvaux
- Department of Motricity sciences, University of Liege, Liege, Belgium
| | - Aude Aguilaniu
- Department of Motricity sciences, University of Liege, Liege, Belgium
| | - Stephen Bornheim
- Department of Motricity sciences, University of Liege, Liege, Belgium
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Patil AR, Jawade S, Somaiya KJ, Boob MA. Efficacy of Faradic Foot Baths and Short Foot Exercises in Symptomatic Flatfoot: A Review. Cureus 2023; 15:e47803. [PMID: 38021688 PMCID: PMC10676730 DOI: 10.7759/cureus.47803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Flatfoot is a common condition among adults, according to orthopedic experts. Flatfoot is defined in this document as a foot condition that occurs after the completion of skeletal growth and is characterized by either partial or complete reduction of the medial longitudinal arch (MLA). The purpose of this study was to evaluate the effects of short foot exercise (SFE) and faradic foot baths on people who have flat feet. This review focused on comprehensive original primary articles written in English. Numerous studies have been conducted in order to determine the effects of both interventions. The search yielded a wide range of papers, including editorials, review articles, freely available full texts, and abstracts. The results showed that both SFE and faradic foot baths effectively improved flat feet.
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Affiliation(s)
- Anushri R Patil
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swapna Jawade
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kamya J Somaiya
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Manali A Boob
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Tahmasbi A, Shadmehr A, Attarbashi Moghadam B, Fereydounnia S. Does Kinesio taping of tibialis posterior or peroneus longus have an immediate effect on improving foot posture, dynamic balance, and biomechanical variables in young women with flexible flatfoot? Foot (Edinb) 2023; 56:102032. [PMID: 37019042 DOI: 10.1016/j.foot.2023.102032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Flexible flatfoot is common in young adults. One of its causes is the failure of dynamic stabilizers, which play an important role in the medial longitudinal arch support, and their appropriate function is necessary for the integrity of the lower extremity and the spine. OBJECTIVE The study aimed to determine Kinesio taping on which extrinsic foot muscle provides greater benefit regarding enhancement of foot posture, dynamic balance, and biomechanical parameters in functional tasks immediately. METHODS Thirty women were recruited for the study. They were randomly divided into groups (A = 15, B = 15). In group A, Kinesio taping was applied on the tibialis posterior (TP), and in group B, Kinesio taping was applied on the peroneus longus (PL) and remained for 30 min. Outcome measures were the navicular drop test (NDT), foot posture index (FPI), Y-balance test, and biomechanical parameters in functional tasks. Before/After within-group and between-group comparisons of outcome measures were performed. RESULTS NDT and FPI decreased in both groups (p < 0.05) with no significant difference between groups. In group A, maximum total force of the stance phase (MaxTFSP) during running increased, and some temporal parameters were changed. (p < 0.05). In group B, Y-balance test improved in all directions, and the width of the gait line during walking increased. There were no significant differences in the postural stability parameters in the within-group comparison, except for mean center of pressure displacement in group B (p = 0.04). CONCLUSION Kinesio taping of both muscles could improve foot posture. TP Kinesio taping can increase the MaxTFSP during running and alter some temporal parameters during walking and running tasks. PL Kinesio taping could lead to better dynamic stability and coordination during dynamic tasks. Each muscle can be considered a therapeutic target for a specific purpose.
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Affiliation(s)
- Alireza Tahmasbi
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Shadmehr
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Sara Fereydounnia
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Haelewijn N, Peters Dickie JL, Staes F, Vereecke E, Deschamps K. Current evidence regarding 2D ultrasonography monitoring of intrinsic foot muscle properties: A systematic review. Heliyon 2023; 9:e18252. [PMID: 37520980 PMCID: PMC10374929 DOI: 10.1016/j.heliyon.2023.e18252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background Ultrasonography can discriminate between intrinsic and extrinsic foot muscle properties and has therefore gained considerable popularity as an indirect strength evaluation. However, an overview on the use of ultrasound for assessing intrinsic foot musculature (IFM) is currently lacking. Research question What is the current evidence regarding (1) 2D ultrasonography protocols and its reliability? (2) Reference values for cross-sectional area and dorso-plantar thickness evaluation in asymptomatic and symptomatic persons? Methods The PRISMA guidelines were used to conduct this systematic review. Eight databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, SPORTDiscus and EuropePMC) were searched up to November 1, 2021. Studies reporting quantitative 2D ultrasound findings of the intrinsic foot muscles with no limitation to sex, BMI, ethnicity or physical activity were included. Studies were assessed for methodological quality using the Downs and Black checklist. Results Fifty-three studies were retained. Protocols showed an overall good to great reliability, suggesting limits of agreement between 8 and 30% of relative muscle size with minimal detectable changes varying from 0.10 to 0.29 cm2 for cross-sectional area and 0.03-0.23 cm for thickness. Reference values are proposed for both cross-sectional area and thickness measurements of the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis and quadratus plantae in asymptomatic persons. This could not be performed in the symptomatic studies due to a limited number of relevant studies addressing the symptomatic population, therefore a clinical overview is outlined. Clinically, IFM properties have been studied in ten distinct pathological conditions, predominantly pointing towards decreased muscle properties of the abductor hallucis. Significance We provide a clear and comprehensive overview of the literature regarding 2D ultrasonography of the IFM, making the available evidence more accessible to decision makers and researchers.
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Affiliation(s)
- Nicolas Haelewijn
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
| | - Jean-Louis Peters Dickie
- Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Filip Staes
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Tervuursevest 101, 3000 Leuven, Belgium
| | - Evie Vereecke
- Department of Development & Regeneration, Muscles & Movement Group, KU Leuven, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
- Haute Ecole Leonard De Vinci, Division of Podiatry, Avenue E. Mounier 84, 1200 Sint-Lambrechts-Woluwe, Belgium
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15
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Utsahachant N, Sakulsriprasert P, Sinsurin K, Jensen MP, Sungkue S. Effects of short foot exercise combined with lower extremity training on dynamic foot function in individuals with flexible flatfoot: A randomized controlled trial. Gait Posture 2023; 104:109-115. [PMID: 37379736 DOI: 10.1016/j.gaitpost.2023.06.013] [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: 01/13/2023] [Revised: 05/29/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Flexible flatfoot has demonstrated biomechanical linkages between distal and proximal lower extremities. However, supporting evidence is required to investigate the benefits of short foot exercise (SF) and short foot exercise in combination with lower extremity training (SFLE) on dynamic foot function. RESEARCH QUESTION This study aimed to determine the effects of a 6-week SF, 6-week SFLE, or control condition (no intervention) on dynamic foot function during gait in individuals with flexible flatfoot. METHODS Forty-five individuals with flexible flatfoot were randomly assigned into three conditions: (1) SF, (2) SFLE, and (3) control conditions. Participants in two intervention programs performed daily training via telerehabilitation and a home-based exercise program. Foot kinematics and center of pressure excursion index (CPEI) during the gait, intrinsic foot muscle test, and navicular drop test were assessed at baseline and after the 6-week intervention program. RESULTS Post-intervention participants in the SF and SFLE conditions showed a shorter time to the lowest medial longitudinal arch (MLA) and improved MLA motion during the stance phase compared with the baseline. In addition, participants in the SFLE conditions showed greater changes in CPEI than in the SF and control conditions. Improvements in intrinsic foot muscle and navicular drop tests were also observed in participants in both intervention programs post-intervention. SIGNIFICANCE A major finding of the study was the improvement in dynamic foot function during gait in individuals with flexible flatfoot after the six weeks of the SF and SFLE intervention programs. Both intervention programs appear to have the potential for inclusion in a corrective program for individuals with flexible flatfoot.
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Affiliation(s)
- Nalut Utsahachant
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | | | - Komsak Sinsurin
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Sumarttra Sungkue
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
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Wei Z, Liao J, Hu X, Li P, Wang L. Comparison of intrinsic foot muscle morphology and isometric strength among runners with different strike patterns. PLoS One 2023; 18:e0286645. [PMID: 37267296 DOI: 10.1371/journal.pone.0286645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023] Open
Abstract
This study aimed to compare the intrinsic foot muscle (IFM) morphology and isometric strength among runners with habitual rearfoot strike (RFS) and non-rearfoot strike (NRFS) patterns. A total of 70 recreational male runners were included in this study (32 RFS and 38 NRFS), an ultrasound device and hand-held dynamometry were used to measure IFM morphology and isometric strength. Results indicated that the RFS runners had significantly thicker tibialis anterior (P = 0.01, ES = 0.64, 95% CI [0.01-0.07]) in IFMs morphology and higher Toe2345 flexion strength in IFMs strength (P = 0.04, ES = 0.50, 95% CI [0.01-0.27]) than NRFS runners, the cross-sectional area of flexor digitorum brevis was positively correlated with T2345 flexion strength (r = 0.33, p = 0.04), T12345 (r = 0.37, p = 0.02) and Doming (r = 0.36, p = 0.03) for runners with NRFS. IFMs morphology and isometric strength were associated with foot strike pattern, preliminary findings provide new perspectives for NRFS runners through the simple measurement of IFMs morphological characteristics predicting IFMs strength, future studies could adopt IFMs training to compensate the muscle strength defects and prevent foot-related injuries.
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Affiliation(s)
- Zhen Wei
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
| | - Jingjing Liao
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
| | - Xiaomei Hu
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
| | - Pan Li
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
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17
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Markowicz M, Skrobot W, Łabuć A, Poszytek P, Orlikowska A, Perzanowska E, Krasowska K, Drewek K, Kaczor JJ. The Rehabilitation Program Improves Balance Control in Children with Excessive Body Weight and Flat Feet by Activating the Intrinsic Muscles of the Foot: A Preliminary Study. J Clin Med 2023; 12:jcm12103364. [PMID: 37240471 DOI: 10.3390/jcm12103364] [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: 02/22/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND determining the appropriate rehabilitation protocol is essential to influence the correction of flat feet, e.g., by activating the intrinsic muscles of the foot. Therefore, this study aimed to determine the impact of the exercises activating the intrinsic foot muscles for postural control in children with flat feet, with normal and excessive body weight. METHODS Fifty-four children aged 7 to 12 were enrolled in the research. Forty-five children were qualified for the final evaluation. Each child in the experimental group was demonstrated an appropriate technique for performing a short foot exercise without compensation by extrinsic muscle. The participants then performed a supervised short foot training session once a week and on other days of the week under the supervision of caregivers for 6 weeks. Flat feet were scored on the foot posture index scale. A postural test was evaluated with a Biodex balance system SD. Statistical significance in the foot posture index scale and postural test were evaluated using an analysis of variance (ANOVA) with Tukey's post-hoc test. RESULTS according to the six indices of the foot posture index scale, five indicators showed statistically significant improvement after rehabilitation. At the 8-12 platform mobility level, it was revealed that the excessive body weight group had significant improvements in the overall stability index and medio-lateral stability index, with eyes closed. CONCLUSION our results indicate that a 6-week rehabilitation program based on the activation of the intrinsic muscles of the foot resulted in an improvement in the foot position. This, in turn, affected balance control, especially in children with excess body weight in conditions of closed eyes.
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Affiliation(s)
- Maria Markowicz
- Department of Health and Life Sciences, Department of Clinical Physiotherapy, Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Wojciech Skrobot
- Department of Health and Life Sciences, Department of Clinical Physiotherapy, Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Agnieszka Łabuć
- Department of Health and Life Sciences, Department of Clinical Physiotherapy, Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Paulina Poszytek
- Department of Health and Life Sciences, Department of Clinical Physiotherapy, Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Agnieszka Orlikowska
- Department of Health and Life Sciences, Department of Clinical Physiotherapy, Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Ewelina Perzanowska
- Department of Health and Life Sciences, Department of Clinical Physiotherapy, Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Katarzyna Krasowska
- Department of Health and Life Sciences, Department of Clinical Physiotherapy, Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Konrad Drewek
- Cathedral and Clinic for Orthopaedics and Traumatology, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Jan J Kaczor
- Division of Bioenergetics and Physiology of Exercise, Medical University of Gdansk, 80-210 Gdansk, Poland
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18
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Newsham KR. Intrinsic Foot Muscle Exercises With and Without Electric Stimulation. J Sport Rehabil 2023:1-9. [PMID: 37142409 DOI: 10.1123/jsr.2022-0008] [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: 01/06/2022] [Revised: 01/19/2023] [Accepted: 02/24/2023] [Indexed: 05/06/2023]
Abstract
CONTEXT Exercising intrinsic foot muscles (IFMs) can improve dynamic balance and foot posture. The exercises are not intuitive and electrotherapy (neuromuscular electrical stimulation [NMES]) has been suggested to help individuals execute the exercises. The aim of this study was to evaluate the effects of training IFM program on dynamic balance and foot posture and compare traditional training methods (TRAIN) with traditional training plus NMES on the perceived workload of the exercises, balance, and foot posture. DESIGN Randomized controlled trial. METHODS Thirty-nine participants were randomized to control, TRAIN, or NMES. TRAIN and NMES performed IFM exercises daily for 4 weeks; NMES received electrotherapy during the first 2 weeks of training. The Y-Balance test and arch height index were measured in all participants at baseline. The training groups were measured again at 2 weeks; all participants were measured at 4 weeks and 8 weeks, after 4 weeks of no training. Perceived workload (National Aeronautics and Space Administration Task Load Index) of exercises was assessed throughout the first 2 weeks and at 4 weeks. RESULTS A 4-week IFM training program demonstrated increases in Y-Balance (P = .01) for TRAIN and in arch height index (seated P = .03; standing P = .02) for NMES, relative to baseline. NMES demonstrated improvement in Y-Balance (P = .02) and arch height index standing (P = .01) at 2 weeks. There were no significant differences between the training groups. Groups were similar in the number responding to exercises in excess of minimal detectable change on all clinical measures. Perceived workload of the exercises decreased during the first 2 weeks of training (P = .02), and more notably at 4 weeks (P < .001). The groups did not differ in how they perceived the workload. CONCLUSIONS A 4-week IFM training program improved dynamic balance and foot posture. Adding NMES in early phases of training provided early improvement in dynamic balance and foot posture, but did not affect perceived workload.
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Affiliation(s)
- Katherine R Newsham
- Department of Physical Therapy & Athletic Training, Saint Louis University, St Louis, MO,USA
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19
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Engkananuwat P, Kanlayanaphotporn R. Gluteus medius muscle strengthening exercise effects on medial longitudinal arch height in individuals with flexible flatfoot: a randomized controlled trial. J Exerc Rehabil 2023; 19:57-66. [PMID: 36910682 PMCID: PMC9993003 DOI: 10.12965/jer.2244572.286] [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: 12/16/2022] [Accepted: 01/14/2023] [Indexed: 02/25/2023] Open
Abstract
This study aimed to compare the effects of 8 weeks of foot plus hip exercise to foot exercise alone on medial longitudinal arch (MLA) parameters; navicular drop (ND), arch height index (AHI), plantar pressure, static balance, and dynamic balance were measured at baseline, 4 weeks, and 8 weeks. A total of 52 healthy participants with bilateral flatfoot were randomly assigned into foot exercise (n=26) and foot plus hip exercise (n=26) group. At 4 weeks, the foot plus hip exercise group showed significantly less ND (P=0.002), plantar pressure at the medial forefoot (P=0.002), and mediolateral displacement (P=0.001) while showing a greater AHI (P=0.019) than the foot exercise group. At 8 weeks, there was also significantly less plantar pressure at the medial hindfoot (P=0.017) and less anteroposterior displacement (P=0.002) in the foot plus hip exercise group than in the foot exercise group. No significant differences between groups were found in dynamic balance. The addition of gluteus medius muscle strengthening exercise to foot exercise was more effective in supporting the MLA than performing foot exercise alone.
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Affiliation(s)
- Phoomchai Engkananuwat
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Rotsalai Kanlayanaphotporn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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20
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Hara S, Kitano M, Kudo S. The effects of short foot exercises to treat flat foot deformity: A systematic review. J Back Musculoskelet Rehabil 2023; 36:21-33. [PMID: 35871320 DOI: 10.3233/bmr-210374] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
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.
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Affiliation(s)
- Shigeyuki Hara
- Department of Rehabilitation, Kindai University Nara Hospital, Nara, Japan
| | - Masashi Kitano
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan.,Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Shintarou Kudo
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan.,Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan.,AR-Ex Medical Research Center, Tokyo, Japan
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21
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Carranza García LE, López-García R, Lagunes-Carrasco JO, Hernández-Cortés PL, Enríquez-Reyna MC, Navarro-Orocio R. Pie plano y tratamientos conservadores en adultos físicamente activos. Una revisión sistemática. REVISTA IBEROAMERICANA DE CIENCIAS DE LA ACTIVIDAD FÍSICA Y EL DEPORTE 2022. [DOI: 10.24310/riccafd.2022.v11i3.15205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
El término pie plano es utilizado para describir cualquier anormalidad que causa el colapso del arco longitudinal medial del pie, cuando es sintomático condiciona el grado, tipo y calidad de actividad física que practique un adulto. Como objetivo nos planteamos revisar los tratamientos conservadores existentes para el pie plano en adultos jóvenes y de mediana edad. Siguiendo las directrices de la declaración PRISMA, se realizó una revisión sistemática de la literatura científica publicada sobre el pie plano y tratamientos conservadores. Los tratamientos conservadores para el pie plano son aplicados de manera aislada o en combinación, estos incluyen ejercicios de fortalecimiento, de estiramientos, uso de ortesis, aplicación de vendaje, modificación del calzado y estimulación eléctrica. Son requeridos estudios de tratamientos conservadores en adultos de mediana edad con pie plano sintomático que evalúen el efecto a corto y largo plazo de los actuales protocolos en poblaciones con diferente nivel de condición física.
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22
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Ishiyama H, Takabayashi T, Hiratsuka S, Ito W, Kikumoto T, Kubo M. Effect of Arch Height Flexibility in Individuals With Flatfoot on Abductor Hallucis Muscle Activity and Medial Longitudinal Arch Angle During Short Foot Exercises. J Foot Ankle Surg 2022; 62:168-172. [PMID: 35850890 DOI: 10.1053/j.jfas.2022.06.007] [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: 01/27/2022] [Revised: 06/14/2022] [Accepted: 06/20/2022] [Indexed: 02/03/2023]
Abstract
Flatfoot presents decreased medial longitudinal arch (MLA), and such foot deformity involves intrinsic foot muscles dysfunction. Flatfoot can be classified into flexible and stiff types according to arch height flexibility (AHF). Short foot exercise (SFE) is an intrinsic foot muscle strengthening exercise, which is reportedly effective against flatfoot. However, its effectiveness against flexible or stiff types in flatfoot is unclear. We examined the effect of AHF in individuals with flatfoot during abductor hallucis muscle (AbH) activity and medial longitudinal arch during SFE. Foot alignment was assessed using the arch height index during standing, and individuals with flatfoot (N = 16) were recruited. The AbH activity and MLA angle during SFE while maintaining single-leg standing were assessed. The relationship between AHF and AbH activity and between AHF and MLA angle ratio was analyzed using correlation coefficients. Additional correlations between AHF and AbH activity were observed with the outliers removed. There were no correlations between AHF and AbH muscle activity and between AHF and MLA angle ratio. However, with the 2 outliers removed, moderate correlations between AHF and AbH activity were significant (r = 0.64, p = .01). AbH activity during SFE increased in individuals with flatfoot for high AHF (flexible type). Thus, SFE may be more effective for individuals with flatfoot having a high AHF. These findings may be helpful when making decisions for surgery and rehabilitation.
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Affiliation(s)
- Haruki Ishiyama
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Tomoya Takabayashi
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan.
| | - Shiori Hiratsuka
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Wataru Ito
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Takanori Kikumoto
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
| | - Masayoshi Kubo
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198, Japan
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Huang C, Chen LY, Liao YH, Masodsai K, Lin YY. Effects of the Short-Foot Exercise on Foot Alignment and Muscle Hypertrophy in Flatfoot Individuals: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911994. [PMID: 36231295 PMCID: PMC9564534 DOI: 10.3390/ijerph191911994] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 05/05/2023]
Abstract
This study aimed to conduct a meta-analysis of randomized controlled trials to examine the effects of the short-foot exercise (SFE) compared to foot orthosis or other types of interventions. Eligibility criteria involved participants with flatfoot engaging in the SFE compared to other forms of intervention or control groups without specific intervention. Relevant studies published before the end of June 2022 were identified from databases. A meta-analysis was performed by calculating the mean differences (MD) and standard MD (SMD) using the random effects model. Six trials with 201 patients (out of 609 records) that met selection criteria were reviewed. Five of the six trials implemented distinct interventions in the control group such as shoe insoles and muscle strengthening exercises, while in the remaining trial, controls received no intervention. The SFE group significantly reduced the navicular drop test (NDT) values (MD: -0.23; 95% confidence interval: -0.45 to -0.02; p = 0.04) and the foot posture index (FPI-6) score (MD: -0.67; 95% confidence interval: -0.98 to -0.36; p < 0.0001) when compared to the control group. The muscle hypertrophy did not differ significantly between the groups. The SFE may contribute more benefits than other intervention as it affects flatfoot individuals' foot alignment. Hence, the SFE is recommended as a beneficial dynamic support when facing flatfoot problems.
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Affiliation(s)
- Ching Huang
- Department of Physical Therapy, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan
| | - Liang-Yu Chen
- Department of Physical Therapy, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan
| | - Yi-Hung Liao
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan
- Correspondence: (Y.-H.L.); (Y.-Y.L.); Tel.: +886-2-28227101 (ext. 7707) (Y.-H.L.); +886-2-28227101 (ext. 7712) (Y.-Y.L.)
| | - Kunanya Masodsai
- Faculty of Sports Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Yi-Yuan Lin
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan
- Correspondence: (Y.-H.L.); (Y.-Y.L.); Tel.: +886-2-28227101 (ext. 7707) (Y.-H.L.); +886-2-28227101 (ext. 7712) (Y.-Y.L.)
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Wei Z, Zeng Z, Liu M, Wang L. Effect of intrinsic foot muscles training on foot function and dynamic postural balance: A systematic review and meta-analysis. PLoS One 2022; 17:e0266525. [PMID: 35442981 PMCID: PMC9020712 DOI: 10.1371/journal.pone.0266525] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 03/22/2022] [Indexed: 12/13/2022] Open
Abstract
This systematic review aimed to analyse the effects of intrinsic foot muscle (IFM) training on foot function and dynamic postural balance. Keywords related to IFM training were used to search four databases (PubMed, CINAHL, SPORTDiscus and Web of Science databases.) for relevant studies published between January 2011 and February 2021. The methodological quality of the intervention studies was assessed independently by two reviewers by using the modified Downs and Black quality index. Publication bias was also assessed on the basis of funnel plots. This study was registered in PROSPERO (CRD42021232984). Sixteen studies met the inclusion criteria (10 with high quality and 6 with moderate quality). Numerous biomechanical variables were evaluated after IFM training intervention. These variables included IFM characteristics, medial longitudinal arch morphology and dynamic postural balance. This systematic review demonstrated that IFM training can exert positive biomechanical effects on the medial longitudinal arch, improve dynamic postural balance and act as an important training method for sports enthusiasts. Future studies should optimise standardised IFM training methods in accordance with the demands of different sports.
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Affiliation(s)
- Zhen Wei
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Ziwei Zeng
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Min Liu
- Shanghai Normal University Tianhua College, Shanghai, China
- * E-mail: (ML); (LW)
| | - Lin Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
- * E-mail: (ML); (LW)
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Okamura K, Hasegawa M, Ikeda T, Fukuda K, Egawa K, Kanai S. Classification of medial longitudinal arch kinematics during running and characteristics of foot muscle morphology in novice runners with pronated foot. Gait Posture 2022; 93:20-25. [PMID: 35051713 DOI: 10.1016/j.gaitpost.2022.01.006] [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: 09/13/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Novice runners with pronated feet are at an increased risk of running-related injuries. However, not all runners with pronated feet have increased foot pronation during running. Moreover, although foot muscle morphology is related to static foot alignment, the relationship between foot muscle morphology and foot kinematics during running remains unclear. We aimed to determine foot kinematic patterns during running among novice runners with pronated feet and the presence of a relationship between these foot kinematic patterns and foot muscle morphology. METHODS Twenty-one novice runners with pronated feet participated in this study, and data on 39 lower limbs were collected. Data on foot kinematics during running (rearfoot strike) were collected using a three-dimensional motion capture system in terms of navicular height (NH) at initial contact and dynamic navicular drop (DND). A hierarchical cluster analysis method was used to identify the optimal number of clusters based on these two foot-related kinematic variables. Following identification of the clusters, differences in cluster variables and cross-sectional areas of selected foot muscles assessed using ultrasonography in each cluster were examined. The muscles of interest included the abductor hallucis, flexor hallucis brevis and longus, flexor digitorum brevis and longus, and peroneus longus. RESULTS Three subgroups were identified based on foot kinematics during running: cluster 1, lowest NH at initial contact and larger DND; cluster 2, moderate NH at initial contact and smaller DND; and cluster 3, highest NH at initial contact and larger DND. Clusters 1 and 3 had a larger abductor hallucis compared with cluster 2, and cluster 3 had a larger flexor hallucis brevis compared with cluster 2. SIGNIFICANCE These subgroups may differ in terms of resistance to and type of running-related injury. Moreover, foot kinematics during running is possibly impacted by the morphology and function of medial intrinsic foot muscles.
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Affiliation(s)
- Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Masaki Hasegawa
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Tomohiro Ikeda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Kengo Fukuda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Kohei Egawa
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
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Kudo S, Sakamoto K. Influence of a novel elastic foot orthosis in foot motion during locomotion in adults with mild flatfoot. Gait Posture 2022; 93:59-63. [PMID: 35086050 DOI: 10.1016/j.gaitpost.2022.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/15/2022] [Accepted: 01/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Collapse of the foot arch is a one of the risk factors in medial tibial stress syndrome. Custom-made foot orthoses are used to reduce the collapse of foot arch, but the orthoses are designed for a specific shoe and cannot be used in other shoes. We developed an elastic foot orthosis that is highly fitted on the foot using thin films, is lightweight, and can be used with any shoe or without shoes. The purpose of this study was to investigate foot kinematics with our elastic foot orthosis during walking and running. METHODS We recruited 30 participants with asymptomatic flatfoot for this study. Foot kinematic data were recorded for treadmill walking, treadmill running, and over-ground walking. Foot kinematics were recorded in three conditions, barefoot (BF), with the elastic foot orthosis (EFO), and with sham foot orthosis (SFO), and foot strain was measured using a stretch strain sensor. The difference in foot strain from initial contact to maximum strain during gait was calculated as loading arch strain, which was reflected as forefoot eversion excursion. A one-way analysis of variance with Bonferroni test was performed to compare the loading arch strain among the three conditions. RESULTS In all tasks, loading arch strain with the EFO was significantly less than that in the BF and SFO conditions. Loading arch strain with the SFO was significantly more than that of BF in the treadmill gait condition. CONCLUSION Our results indicate that the EFO decreased foot strain during locomotion compared to without the EFO and is capable of supporting the foot arch during locomotion.
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Affiliation(s)
- Shintarou Kudo
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16 Nankokita Suminoe Ward, Osaka City, Osaka Prefecture 559-8611, Japan; Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, 1-26-16 Nankokita Suminoe Ward, Osaka City, Osaka Prefecture 559-8611, Japan; AR-Ex Medical Research Center, 1109-4 Iwamurata, Saku-shi, Nagano 385-0022, Japan.
| | - Kodai Sakamoto
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, 1-26-16 Nankokita Suminoe Ward, Osaka City, Osaka Prefecture 559-8611, Japan
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Abstract
BACKGROUND Paediatric flat feet are a common presentation in primary care; reported prevalence approximates 15%. A minority of flat feet can hurt and limit gait. There is no optimal strategy, nor consensus, for using foot orthoses (FOs) to treat paediatric flat feet. OBJECTIVES To assess the benefits and harms of foot orthoses for treating paediatric flat feet. SEARCH METHODS We searched CENTRAL, MEDLINE, and Embase to 01 September 2021, and two clinical trials registers on 07 August 2020. SELECTION CRITERIA We identified all randomised controlled trials (RCTs) of FOs as an intervention for paediatric flat feet. The outcomes included in this review were pain, function, quality of life, treatment success, and adverse events. Intended comparisons were: any FOs versus sham, any FOs versus shoes, customised FOs (CFOs) versus prefabricated FOs (PFOs). DATA COLLECTION AND ANALYSIS We followed standard methods recommended by Cochrane. MAIN RESULTS We included 16 trials with 1058 children, aged 11 months to 19 years, with flexible flat feet. Distinct flat foot presentations included asymptomatic, juvenile idiopathic arthritis (JIA), symptomatic and developmental co-ordination disorder (DCD). The trial interventions were FOs, footwear, foot and rehabilitative exercises, and neuromuscular electrical stimulation (NMES). Due to heterogeneity, we did not pool the data. Most trials had potential for selection, performance, detection, and selective reporting bias. No trial blinded participants. We present the results separately for asymptomatic (healthy children) and symptomatic (children with JIA) flat feet. The certainty of evidence was very low to low, downgraded for bias, imprecision, and indirectness. Three comparisons were evaluated across trials: CFO versus shoes; PFO versus shoes; CFO versus PFO. Asymptomatic flat feet 1. CFOs versus shoes (1 trial, 106 participants): low-quality evidence showed that CFOs result in little or no difference in the proportion without pain (10-point visual analogue scale (VAS)) at one year (risk ratio (RR) 0.85, 95% confidence interval (CI) 0.67 to 1.07); absolute decrease (11.8%, 95% CI 4.7% fewer to 15.8% more); or on withdrawals due to adverse events (RR 1.05, 95% CI 0.94 to 1.19); absolute effect (3.4% more, 95% CI 4.1% fewer to 13.1% more). 2. PFOs versus shoes (1 trial, 106 participants): low to very-low quality evidence showed that PFOs result in little or no difference in the proportion without pain (10-point VAS) at one year (RR 0.94, 95% CI 0.76 to 1.16); absolute effect (4.7% fewer, 95% CI 18.9% fewer to 12.6% more); or on withdrawals due to adverse events (RR 0.99, 95% CI 0.79 to 1.23). 3. CFOs versus PFOs (1 trial, 108 participants): low-quality evidence found no difference in the proportion without pain at one year (RR 0.93, 95% CI 0.73 to 1.18); absolute effect (7.4% fewer, 95% CI 22.2% fewer to 11.1% more); or on withdrawal due to adverse events (RR 1.00, 95% CI 0.90 to 1.12). Function and quality of life (QoL) were not assessed. Symptomatic (JIA) flat feet 1. CFOs versus shoes (1 trial, 28 participants, 3-month follow-up): very low-quality evidence showed little or no difference in pain (0 to 10 scale, 0 no pain) between groups (MD -1.5, 95% CI -2.78 to -0.22). Low-quality evidence showed improvements in function with CFOs (Foot Function Index - FFI disability, 0 to 100, 0 best function; MD -18.55, 95% CI -34.42 to -2.68), child-rated QoL (PedsQL, 0 to 100, 100 best quality; MD 12.1, 95% CI -1.6 to 25.8) and parent-rated QoL (PedsQL MD 9, 95% CI -4.1 to 22.1) and little or no difference between groups in treatment success (timed walking; MD -1.33 seconds, 95% CI -2.77 to 0.11), or withdrawals due to adverse events (RR 0.58, 95% CI 0.11 to 2.94); absolute difference (9.7% fewer, 20.5 % fewer to 44.8% more). 2. PFOs versus shoes (1 trial, 25 participants, 3-month follow-up): very low-quality evidence showed little or no difference in pain between groups (MD 0.02, 95% CI -1.94 to 1.98). Low-quality evidence showed no difference between groups in function (FFI-disability MD -4.17, 95% CI -24.4 to 16.06), child-rated QoL (PedsQL MD -3.84, 95% CI -19 to 11.33), or parent-rated QoL (PedsQL MD -0.64, 95% CI -13.22 to 11.94). 3. CFOs versus PFOs (2 trials, 87 participants): low-quality evidence showed little or no difference between groups in pain (0 to 10 scale, 0 no pain) at 3 months (MD -1.48, 95% CI -3.23 to 0.26), function (FFI-disability MD -7.28, 95% CI -15.47 to 0.92), child-rated QoL (PedsQL MD 8.6, 95% CI -3.9 to 21.2), or parent-rated QoL (PedsQL MD 2.9, 95% CI -11 to 16.8). AUTHORS' CONCLUSIONS Low to very low-certainty evidence shows that the effect of CFOs (high cost) or PFOs (low cost) versus shoes, and CFOs versus PFOs on pain, function and HRQoL is uncertain. This is pertinent for clinical practice, given the economic disparity between CFOs and PFOs. FOs may improve pain and function, versus shoes in children with JIA, with minimal delineation between costly CFOs and generic PFOs. This review updates that from 2010, confirming that in the absence of pain, the use of high-cost CFOs for healthy children with flexible flat feet has no supporting evidence, and draws very limited conclusions about FOs for treating paediatric flat feet. The availability of normative and prospective foot development data, dismisses most flat foot concerns, and negates continued attention to this topic. Attention should be re-directed to relevant paediatric foot conditions, which cause pain, limit function, or reduce quality of life. The agenda for researching asymptomatic flat feet in healthy children must be relegated to history, and replaced by a targeted research rationale, addressing children with indisputable foot pathology from discrete diagnoses, namely JIA, cerebral palsy, congenital talipes equino varus, trisomy 21 and Charcot Marie Tooth. Whether research resources should continue to be wasted on studying flat feet in healthy children that do not hurt, is questionable. Future updates of this review will address only relevant paediatric foot conditions.
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Affiliation(s)
- Angela M Evans
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Keith Rome
- Division of Rehabilitation & Occupation Studies, AUT University, Auckland 1020, New Zealand
| | - Matthew Carroll
- Department of Podiatry, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Fiona Hawke
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Ourimbah, Australia
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Willemse L, Wouters EJM, Bronts HM, Pisters MF, Vanwanseele B. The effect of interventions anticipated to improve plantar intrinsic foot muscle strength on fall-related dynamic function in adults: a systematic review. J Foot Ankle Res 2022; 15:3. [PMID: 35057831 PMCID: PMC8772142 DOI: 10.1186/s13047-021-00509-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/28/2021] [Indexed: 12/30/2022] Open
Abstract
Background The plantar intrinsic foot muscles (PIFMs) have a role in dynamic functions, such as balance and propulsion, which are vital to walking. These muscles atrophy in older adults and therefore this population, which is at high risk to falling, may benefit from strengthening these muscles in order to improve or retain their gait performance. Therefore, the aim was to provide insight in the evidence for the effect of interventions anticipated to improve PIFM strength on dynamic balance control and foot function during gait in adults. Methods A systematic literature search was performed in five electronic databases. The eligibility of peer-reviewed papers, published between January 1, 2010 and July 8, 2020, reporting controlled trials and pre-post interventional studies was assessed by two reviewers independently. Results from moderate- and high-quality studies were extracted for data synthesis by summarizing the standardized mean differences (SMD). The GRADE approach was used to assess the certainty of evidence. Results Screening of 9199 records resulted in the inclusion of 11 articles of which five were included for data synthesis. Included studies were mainly performed in younger populations. Low-certainty evidence revealed the beneficial effect of PIFM strengthening exercises on vertical ground reaction force (SMD: − 0.31-0.37). Very low-certainty evidence showed that PIFM strength training improved the performance on dynamic balance testing (SMD: 0.41–1.43). There was no evidence for the effect of PIFM strengthening exercises on medial longitudinal foot arch kinematics. Conclusions This review revealed at best low-certainty evidence that PIFM strengthening exercises improve foot function during gait and very low-certainty evidence for its favorable effect on dynamic balance control. There is a need for high-quality studies that aim to investigate the effect of functional PIFM strengthening exercises in large samples of older adults. The outcome measures should be related to both fall risk and the role of the PIFMs such as propulsive forces and balance during locomotion in addition to PIFM strength measures. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-021-00509-0.
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Abstract
BACKGROUND Paediatric flat feet are a common presentation in primary care; reported prevalence approximates 15%. A minority of flat feet can hurt and limit gait. There is no optimal strategy, nor consensus, for using foot orthoses (FOs) to treat paediatric flat feet. OBJECTIVES To assess the benefits and harms of foot orthoses for treating paediatric flat feet. SEARCH METHODS We searched CENTRAL, MEDLINE, and Embase to 01 September 2021, and two clinical trials registers on 07 August 2020. SELECTION CRITERIA We identified all randomised controlled trials (RCTs) of FOs as an intervention for paediatric flat feet. The outcomes included in this review were pain, function, quality of life, treatment success, and adverse events. Intended comparisons were: any FOs versus sham, any FOs versus shoes, customised FOs (CFOs) versus prefabricated FOs (PFOs). DATA COLLECTION AND ANALYSIS We followed standard methods recommended by Cochrane. MAIN RESULTS We included 16 trials with 1058 children, aged 11 months to 19 years, with flexible flat feet. Distinct flat foot presentations included asymptomatic, juvenile idiopathic arthritis (JIA), symptomatic and developmental co-ordination disorder (DCD). The trial interventions were FOs, footwear, foot and rehabilitative exercises, and neuromuscular electrical stimulation (NMES). Due to heterogeneity, we did not pool the data. Most trials had potential for selection, performance, detection, and selective reporting bias. No trial blinded participants. We present the results separately for asymptomatic (healthy children) and symptomatic (children with JIA) flat feet. The certainty of evidence was very low to low, downgraded for bias, imprecision, and indirectness. Three comparisons were evaluated across trials: CFO versus shoes; PFO versus shoes; CFO versus PFO. Asymptomatic flat feet 1. CFOs versus shoes (1 trial, 106 participants): low-quality evidence showed that CFOs result in little or no difference in the proportion without pain (10-point visual analogue scale (VAS)) at one year (risk ratio (RR) 0.85, 95% confidence interval (CI) 0.67 to 1.07); absolute decrease (11.8%, 95% CI 4.7% fewer to 15.8% more); or on withdrawals due to adverse events (RR 1.05, 95% CI 0.94 to 1.19); absolute effect (3.4% more, 95% CI 4.1% fewer to 13.1% more). 2. PFOs versus shoes (1 trial, 106 participants): low to very-low quality evidence showed that PFOs result in little or no difference in the proportion without pain (10-point VAS) at one year (RR 0.94, 95% CI 0.76 to 1.16); absolute effect (4.7% fewer, 95% CI 18.9% fewer to 12.6% more); or on withdrawals due to adverse events (RR 0.99, 95% CI 0.79 to 1.23). 3. CFOs versus PFOs (1 trial, 108 participants): low-quality evidence found no difference in the proportion without pain at one year (RR 0.93, 95% CI 0.73 to 1.18); absolute effect (7.4% fewer, 95% CI 22.2% fewer to 11.1% more); or on withdrawal due to adverse events (RR 1.00, 95% CI 0.90 to 1.12). Function and quality of life (QoL) were not assessed. Symptomatic (JIA) flat feet 1. CFOs versus shoes (1 trial, 28 participants, 3-month follow-up): very low-quality evidence showed little or no difference in pain (0 to 10 scale, 0 no pain) between groups (MD -1.5, 95% CI -2.78 to -0.22). Low-quality evidence showed improvements in function with CFOs (Foot Function Index - FFI disability, 0 to 100, 0 best function; MD -18.55, 95% CI -34.42 to -2.68), child-rated QoL (PedsQL, 0 to 100, 100 best quality; MD 12.1, 95% CI -1.6 to 25.8) and parent-rated QoL (PedsQL MD 9, 95% CI -4.1 to 22.1) and little or no difference between groups in treatment success (timed walking; MD -1.33 seconds, 95% CI -2.77 to 0.11), or withdrawals due to adverse events (RR 0.58, 95% CI 0.11 to 2.94); absolute difference (9.7% fewer, 20.5 % fewer to 44.8% more). 2. PFOs versus shoes (1 trial, 25 participants, 3-month follow-up): very low-quality evidence showed little or no difference in pain between groups (MD 0.02, 95% CI -1.94 to 1.98). Low-quality evidence showed no difference between groups in function (FFI-disability MD -4.17, 95% CI -24.4 to 16.06), child-rated QoL (PedsQL MD -3.84, 95% CI -19 to 11.33), or parent-rated QoL (PedsQL MD -0.64, 95% CI -13.22 to 11.94). 3. CFOs versus PFsO (2 trials, 87 participants): low-quality evidence showed little or no difference between groups in pain (0 to scale, 0 no pain) at 3 months (MD -1.48, 95% CI -3.23 to 0.26), function (FFI-disability MD -7.28, 95% CI -15.47 to 0.92), child-rated QoL (PedsQL MD 8.6, 95% CI -3.9 to 21.2), or parent-rated QoL (PedsQL MD 2.9, 95% CI -11 to 16.8). AUTHORS' CONCLUSIONS Low to very low-certainty evidence shows that the effect of CFOs (high cost) or PFOs (low cost) versus shoes, and CFOs versus PFOs on pain, function and HRQoL is uncertain. This is pertinent for clinical practice, given the economic disparity between CFOs and PFOs. FOs may improve pain and function, versus shoes in children with JIA, with minimal delineation between costly CFOs and generic PFOs. This review updates that from 2010, confirming that in the absence of pain, the use of high-cost CFOs for healthy children with flexible flat feet has no supporting evidence, and draws very limited conclusions about FOs for treating paediatric flat feet. The availability of normative and prospective foot development data, dismisses most flat foot concerns, and negates continued attention to this topic. Attention should be re-directed to relevant paediatric foot conditions, which cause pain, limit function, or reduce quality of life. The agenda for researching asymptomatic flat feet in healthy children must be relegated to history, and replaced by a targeted research rationale, addressing children with indisputable foot pathology from discrete diagnoses, namely JIA, cerebral palsy, congenital talipes equino varus, trisomy 21 and Charcot Marie Tooth. Whether research resources should continue to be wasted on studying flat feet in healthy children that do not hurt, is questionable. Future updates of this review will address only relevant paediatric foot conditions.
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Affiliation(s)
- Angela M Evans
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Keith Rome
- Division of Rehabilitation & Occupation Studies, AUT University, Auckland 1020, New Zealand
| | - Matthew Carroll
- Department of Podiatry, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Fiona Hawke
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Ourimbah, Australia
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Nakao H, Imaoka M, Hida M, Imai R, Tazaki F, Morifuji T, Hashimoto M, Nakamura M. Correlation of medial longitudinal arch morphology with body characteristics and locomotive function in community-dwelling older women: A cross-sectional study. J Orthop Surg (Hong Kong) 2021; 29:23094990211015504. [PMID: 34114530 DOI: 10.1177/23094990211015504] [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] [Indexed: 11/16/2022] Open
Abstract
PURPOSE This cross-sectional study aimed to investigate the effects of foot arch deformities on physical characteristics, muscular strength, and motor function in older women depending on the presence or absence of pain. METHODS Overall, 145 community-dwelling women aged 65 to 90 years were included in this study. We measured the foot arch height ratio (AHR, dorsal height/truncated foot length) and classified participants with AHR values above, below, or within 1.5 standard deviations into the high-arched group (HAG), Low-Arched Group (LAG), or normal-arched group (NAG), respectively. We also compared body characteristics (age, height, weight, body mass index (BMI), and skeletal mass index), muscle strength (handgrip strength and intrinsic foot strength (IFS)), and locomotive function (two-step value and gait speed) among the three groups. RESULTS Locomotive examination and muscle strength showed significant differences among the three groups only in the presence of pain; in the two-step test, HAG, NAG, and LAG values were 0.98 cm/cm, 1.19 cm/cm, and 1.18 cm/cm, respectively. The IFS measured 19.2 N, 24.2 N, 31.0 N, respectively, in the HAG, NAG, and LAG. CONCLUSION This study suggests that decreased IFS affects the mobility function of high-arched feet in older women. Although there was no significant difference in the evaluation of pain, HAG showed the highest average value, which is considered to contribute to the decreased two-step value. It has been suggested that a high-arched foot in the presence of pain is associated with IFS weakness and may affect the decline of mobility function in older women.
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Affiliation(s)
- Hidetoshi Nakao
- School of Rehabilitation, Osaka Kawasaki Rehabilitation University, Osaka, Japan
| | - Masakazu Imaoka
- School of Rehabilitation, Osaka Kawasaki Rehabilitation University, Osaka, Japan
| | - Mitsumasa Hida
- School of Rehabilitation, Osaka Kawasaki Rehabilitation University, Osaka, Japan
| | - Ryota Imai
- School of Rehabilitation, Osaka Kawasaki Rehabilitation University, Osaka, Japan
| | - Fumie Tazaki
- School of Rehabilitation, Osaka Kawasaki Rehabilitation University, Osaka, Japan
| | - Takeshi Morifuji
- Department of Physical Therapy, Faculty of Social Work Studies, Josai International University, Chiba, Japan
| | - Masashi Hashimoto
- Department of Rehabilitation, Faculty of Health Sciences, Nara Gakuen University, Nara City Nara, Japan
| | - Misa Nakamura
- School of Rehabilitation, Osaka Kawasaki Rehabilitation University, Osaka, Japan
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Pavone V, Testa G, Vescio A, Wirth T, Andreacchio A, Accadbled F, Canavese F. Diagnosis and treatment of flexible flatfoot: results of 2019 flexible flatfoot survey from the European Paediatric Orthopedic Society. J Pediatr Orthop B 2021; 30:450-457. [PMID: 33399292 DOI: 10.1097/bpb.0000000000000849] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The aim of the study was to evaluate flexible flatfoot (FFF) diagnostic and current therapeutic modalities, as well as treatment expectations, among members of the European Paediatric Orthopaedic Society (EPOS). A 59-questions survey on FFF diagnosis and treatment preferences was distributed to EPOS members. The survey consisted of six sections (1) general clinical parameters; (2) foot aspects; (3) X-ray angles (or lines); (4) expectations; (5) standard clinical assessment; and (6) management options. Descriptive statistics were performed. A total of 93 responses were analysed. In general, clinical parameters, age (91.4% of cases), laxity (81.7%), diffuse pain (84.9%), and pain at the ankle joint (81.7%) were rated as 'average' and 'crucial importance' by the vast majority of respondents. Meary's angle (47.3% of cases), talonavicular coverage (35.5%), and lateral talocalcaneal angle (35.5%) were assessed as main radiological tools in the FFF evaluation. Among respondents, 61.3% rated 'improved ability to walk longer without symptoms' as of 'crucial importance'. Eighty-two percent of the respondents felt less than 10% of patients with FFF are candidates for corrective surgery. Arthroereisis (29.3%) was the most common surgical procedure (16.4% for subtalar and 12.9% for extra-articular arthroereisis, respectively), followed by lateral column lengthening (17.9%) and medializing calcaneal osteotomy (12.3%). There is great variation among respondents in diagnostic and treatment preferences in the management of children with FFF. The results of the EPOS 2019 FFF survey clearly show that large-scale, multicentric, international studies are necessary to elucidate which diagnostic and treatment practices lead to the best outcomes.
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Affiliation(s)
- Vito Pavone
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - Gianluca Testa
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - Andrea Vescio
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - Thomas Wirth
- Orthopaedic Department, Olgahospital, Stuttgart, Germany
| | - Antonio Andreacchio
- Department of Pediatric Orthopedic Surgery, "V. Buzzi" Children Hospital, Milan, Italy
| | - Franck Accadbled
- Department of Orthopaedics, Children's Hospital, Toulouse University Hospital, Toulouse
| | - Federico Canavese
- Department of Pediatric Surgery, University Hospital Estaing, Clermont Ferrand, France
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Hoang NTT, Chen S, Chou LW. The Impact of Foot Orthoses and Exercises on Pain and Navicular Drop for Adult Flatfoot: A Network Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158063. [PMID: 34360354 PMCID: PMC8345534 DOI: 10.3390/ijerph18158063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/25/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022]
Abstract
Background: Adult flatfoot leads to injury and decreased quality of life. The most widely applied noninvasive approaches are wearing foot orthoses or exercising. Both interventions raise controversy about reducing pain and neutralizing foot posture. This study investigated the impact of foot orthoses and exercise on pain and navicular drop (present for foot posture). Methods: Four databases were used: MEDLINE, PubMed, Web of Science, and Cochrane, from the earliest records to November 2020. Randomized controlled studies focused on adult flatfoot that evaluated the effect of exercise and foot orthoses on pain and navicular drop were extracted. We used data analysis to estimate the relative effect of heterogeneity using I2 and publication bias using funnel plots. Results: Ten studies were identified through to November 2020. Active interventions (AIs) were exercise and exercise combined with foot orthoses; passive interventions (PIs) were foot orthoses and added stretching. Both AIs and PIs decreased pain significantly (SMD −0.94, 95% CI −1.35, −0.54 and SMD −1.4, 95% CI −1.87, −0.92). The AIs reduced pain level better than PIs. Controversially, no treatment was found to affect navicular drop. Conclusion: Both exercise and foot orthoses can reduce pain but not realign foot posture. Exercise alone or combined with foot orthoses showed a better effect on adult flatfoot than only wearing foot orthoses. Active intervention was shown to have better efficacy in reducing pain than passive intervention.
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Affiliation(s)
- Ngoc-Tuyet-Trinh Hoang
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan; (N.-T.-T.H.); (S.C.)
- Department Physiotherapy, Hong Bang International University, Ho Chi Minh City 700000, Vietnam
| | - Shuya Chen
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan; (N.-T.-T.H.); (S.C.)
| | - Li-Wei Chou
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan; (N.-T.-T.H.); (S.C.)
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 404332, Taiwan
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung 413505, Taiwan
- Correspondence:
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Okamura K, Egawa K, Ikeda T, Fukuda K, Kanai S. Relationship between foot muscle morphology and severity of pronated foot deformity and foot kinematics during gait: A preliminary study. Gait Posture 2021; 86:273-277. [PMID: 33831742 DOI: 10.1016/j.gaitpost.2021.03.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/12/2021] [Accepted: 03/25/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The morphology of foot muscles that support the medial longitudinal arch differs between normal and pronated feet. The degree to which the difference depends on the severity of the pronated foot deformity is unclear. In the clinical setting, however, to reduce the pronated deformity, muscle-strengthening exercises are performed. RESEARCH QUESTION Does a relationship exist between foot muscle morphology and severity of the pronated foot deformity and foot kinematics during gait? METHODS Using the six-item foot posture index (FPI-6), 26 study participants were assessed for their foot posture and divided into two groups of 13 participants each based on the FPI-6 score: pronated foot group (with a score of 6-9) and highly pronated foot group (with a score of 10-12). Select foot muscles were scanned with ultrasonography, and muscle thicknesses were measured. The following were the muscles of interest: abductor hallucis, flexor hallucis brevis and longus, flexor digitorum brevis and longus, and peroneus longus. Foot kinematic data during gait was collected using a three-dimensional motion capture system as a dynamic navicular drop. RESULTS No between-group differences were noted for muscle thickness and dynamic navicular drop. However, the abductor hallucis and flexor hallucis brevis thicknesses were correlated with the dynamic navicular drop, but not with the severity of the pronated foot deformity. SIGNIFICANCE In individuals with pronated foot deformity, more developed abductor hallucis and flexor hallucis brevis muscles may reduce the dynamic navicular drop that represents the degree of medial longitudinal arch deformation during the stance phase of gait.
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Affiliation(s)
- Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Kohei Egawa
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Tomohiro Ikeda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Kengo Fukuda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
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Morikawa M, Maeda N, Komiya M, Hirota A, Mizuta R, Kobayashi T, Kaneda K, Nishikawa Y, Urabe Y. Contribution of Plantar Fascia and Intrinsic Foot Muscles in a Single-Leg Drop Landing and Repetitive Rebound Jumps: An Ultrasound-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094511. [PMID: 33922807 PMCID: PMC8123000 DOI: 10.3390/ijerph18094511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/10/2021] [Accepted: 04/19/2021] [Indexed: 11/16/2022]
Abstract
The plantar fascia and intrinsic foot muscles (IFM) modulate foot stiffness. However, it is unclear whether the corresponding ultrasonography findings reflect it. This study aimed to examine the effect of the plantar fascia and IFM morphologies on force attenuation during landing and reactivity when jumping in healthy adults (n = 21; age, 21-27 years). Thickness, cross-sectional area (CSA), and hardness of the plantar fascia, abductor hallucis (AbH), and flexor hallucis brevis (FHB) muscles were measured using ultrasonography. Single-leg drop landing and repetitive rebound jumping tests assessed the ground reaction force (GRF) and reactive jump index (RJI), respectively. The CSA of FHB was negatively correlated with maximum vertical GRF (r = -0.472, p = 0.031) in the single-leg drop landing test. The CSA of AbH was negatively correlated with contact time (r = -0.478, p = 0.028), and the plantar fascia thickness was positively correlated with jump height (r = 0.615, p = 0.003) and RJI (r = 0.645, p = 0.002) in the repetitive bound jump test. In multivariate regression analysis, only the plantar fascia thickness was associated with RJI (β = 0.152, 95% confidence interval: 7.219-38.743, p = 0.007). The CSA of FHB may contribute to force attenuation during landing. The thickness of the plantar fascia and CSA of AbH may facilitate jumping high with minimal contact time.
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Affiliation(s)
- Masanori Morikawa
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Noriaki Maeda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Makoto Komiya
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Arisu Hirota
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Rami Mizuta
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China;
| | - Kazuki Kaneda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa 076-264-5111, Japan;
| | - Yukio Urabe
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
- Correspondence:
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Force Generation on the Hallux Is More Affected by the Ankle Joint Angle than the Lesser Toes: An In Vivo Human Study. BIOLOGY 2021; 10:biology10010048. [PMID: 33445422 PMCID: PMC7828001 DOI: 10.3390/biology10010048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 12/18/2022]
Abstract
Simple Summary This study clarified the difference in force generation characteristics on the hallux and lesser toes. The maximal generated torque on the hallux at the dorsiflexed position of the ankle was higher than that at the plantar-flexion position of the ankle. However, no significant difference existed between the maximal generated torque on the lesser toes at any ankle position. The present study suggested that the force generation characteristic on the hallux is more affected by the ankle joint angle than the lesser toes. Abstract The structure of the first toe is independent of that of the other toes, while the functional difference remains unclear. The purpose of this study was to investigate the difference in the force generation characteristics between the plantar-flexion of the first and second–fifth metatarsophalangeal joints (MTPJs) by comparing the maximal voluntary plantar-flexion torques (MVC torque) at different MTPJs and ankle positions. The MVC torques of the first and second–fifth MTPJs were measured at 0°, 15°, 30°, and 45° dorsiflexed positions of the MTPJs, and at 20° plantar-flexed, neutral, and 20° dorsiflexed positions of the ankle. Two-way repeated measures analyses of variance with Holm’s multiple comparison test (MTPJ position × ankle position) were performed. When the MTPJ was dorsiflexed at 0°, 15°, and 30°, the MVC torque of the first MTPJ when the ankle was dorsiflexed at 20° was higher than that when the ankle was plantar-flexed at 20°. However, the ankle position had no significant effect on the MVC torque of the second–fifth MTPJ. Thus, the MVC torque of the first MTPJ was more affected by the ankle position than the second–fifth MTPJs.
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Okamura K, Egawa K, Okii A, Oki S, Kanai S. Intrinsic foot muscle strengthening exercises with electromyographic biofeedback achieve increased toe flexor strength in older adults: A pilot randomized controlled trial. Clin Biomech (Bristol, Avon) 2020; 80:105187. [PMID: 33038685 DOI: 10.1016/j.clinbiomech.2020.105187] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 09/11/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Toe flexor strength is important for preventing older adults from falling. Although intrinsic foot muscles are the main determinants of toe flexor strength, exercises for strengthening these muscles are difficult for older adults. This study therefore aimed to determine whether the use of electromyographic biofeedback helps older adults to perform intrinsic foot muscle strengthening exercises. METHODS This randomized controlled trial had two parallel arms. Participants were randomly allocated to the control group or the electromyographic biofeedback group. Control participants performed two progressive intrinsic foot muscle strengthening exercises twice a week for 6 weeks. Participants in the other group performed these exercises assisted by electromyographic biofeedback. Primary outcome measures were changes in toe flexor strength and the timed up-and-go and functional reach tests (the latter two being balance tests). FINDINGS Altogether, 23 older adults were randomized to the control group (n = 12) or the electromyographic biofeedback group (n = 11). After the 6-week intervention, toe flexor strength on the dominant side increased in both groups (P < 0.017). However, toe flexor strength on the nondominant side increased only in the electromyographic biofeedback group (P < 0.017), with a large effect size of 1.5. There were no changes in the two balance tests. Three of the control group and two of the electromyographic biofeedback group were lost to follow- up. INTERPRETATION Our results indicate that, the use of electromyographic biofeedback can enhance the effect of intrinsic foot muscle strengthening exercises on the nondominant side in older adults. CLINICAL TRIAL REGISTRATION NUMBER UMIN000036521.
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Affiliation(s)
- Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara, Hiroshima 723-0053, Japan.
| | - Kohei Egawa
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara, Hiroshima 723-0053, Japan; Okii Clinic, 4-5-10 Motomachi, Iwakuni, Yamaguchi 740-0012, Japan
| | - Akira Okii
- Okii Clinic, 4-5-10 Motomachi, Iwakuni, Yamaguchi 740-0012, Japan
| | - Sadaaki Oki
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara, Hiroshima 723-0053, Japan.
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara, Hiroshima 723-0053, Japan.
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Pabón-Carrasco M, Castro-Méndez A, Vilar-Palomo S, Jiménez-Cebrián AM, García-Paya I, Palomo-Toucedo IC. Randomized Clinical Trial: The Effect of Exercise of the Intrinsic Muscle on Foot Pronation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4882. [PMID: 32645830 PMCID: PMC7369729 DOI: 10.3390/ijerph17134882] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/18/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022]
Abstract
Background: There is little scientific evidence regarding the effectiveness of strengthening exercises on the foot's intrinsic musculature in improving the lower limb on the statics and dynamics in healthy individuals. Method: To evaluate the effect on foot posture with regard to the reinforcement of the short foot exercise (SFE) compared to another without a recognized biomechanical action, which we called the "non-biomechanical function" (NBF) exercise. A randomized clinical trial was carried out with 85 asymptomatic participants with a bilateral Foot Posture Index (FPI) greater than 6 points. An experimental group (n = 42) did SFE training and a control group (n = 43) carried out NBF exercises. The foot posture was evaluated twice via the navicular drop (ND) test, and the FPI was assessed on the day of inclusion in the study (pre-intervention) and after four weeks of training (post-intervention). Results: Statistically significant values were not found in foot posture between the experimental and the control groups when comparing before and after the training. However, the foot posture was modified in both groups with respect to its initial state, and the ND value decreased. Conclusions: SFE could be considered a useful tool to deal with pathologies whose etiology includes excessive pronation of the foot.
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Affiliation(s)
| | | | | | - Ana María Jiménez-Cebrián
- Nursing and Podiatry Department, University of Malaga, 29071 Malaga, Spain; (A.M.J.-C.); (I.G.-P.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain
| | - Irene García-Paya
- Nursing and Podiatry Department, University of Malaga, 29071 Malaga, Spain; (A.M.J.-C.); (I.G.-P.)
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Posa G, Betak O, Nagy E. Balance in focus: a simple observational scale to monitor the effect of exercises on static balance in case of childhood flexible flat foot. J Phys Ther Sci 2020; 32:735-741. [PMID: 33281289 PMCID: PMC7708003 DOI: 10.1589/jpts.32.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/22/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Childhood flexible flat foot is the most common lower limb deformity.
Observational evaluation of the underlying elements of reactive balance during static
positions is an accepted tool besides the timed measures. We aim to assess the effects of
combined balance training on the foot function and to test the usefulness of our
observational static balance score. [Participants and Methods] A total of 19 healthy
primary school students with flexible flat foot deformity volunteered for the study. We
evaluated the foot’s dynamic properties and static postural stability before and after a
20-week combined balance training. On the basis of the observational findings, the time
vs. quality observational static balance score was developed. All data were subjected to
Wilcoxon’s test and Friedman’s ANOVA to compare the effects of the training on foot
trajectory and observational static balance score. [Results] Better strength and endurance
in the foot extensors and improved foot function were noted after the training. Using our
observational static balance score, the quality of the balance performance remarkably
changed. [Conclusion] The quality domain of our new scale seems to be a useful tool in
daily clinical practice and a more sensitive measure in eyes-closed situations.
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Affiliation(s)
- Gabriella Posa
- Juhász Gyula Faculty of Education Institute of Applied Health Sciences and Health Promotion, University of Szeged, Hungary
| | - Orsolya Betak
- Physiotherapy Programme, Faculty of Health and Social Sciences, University of Szeged, Hungary
| | - Edit Nagy
- Department of Physiotherapy, Faculty of Health and Social Sciences, University of Szeged: H-6726 Szeged, Temesvári krt. 31, Hungary
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