Foot Posture Index Reference Values among Young Adults in Saudi Arabia and Their Association with Anthropometric Determinants, Balance, Functional Mobility, and Hypermobility

How does pes planus affect jumping performance and balance ability?

BackgroundPes planus is characterized by the flattening of the medial longitudinal arch of the foot, which can alter the biomechanics of the lower extremities and affect overall athletic performance. This randomized double-blinded controlled study was designed to investigate the effects of pes planus on jumping and balance performance.MethodsOne hundred thirty-one participants were assigned to the pes planus group (n = 66) and the control group (n = 65). Foot posture index (FPI) was used to determine pes planus. The vertical jump was measured by the VertiMetric device; horizontal jump performance by using the single leg hop test. Y Balance Test (YBT) was used to evaluate dynamic balance. The Mann-Whitney U test has been used for comparison of the groups and the alpha level is set at 0.05.ResultsVertical jump results of the pes planus group have been found statistically lower compared to the control group (p < 0.05). However, there were no statistically significant differences in the horizontal jump and YBT measurements between groups (p > 0.05). A weak negative correlation was found between the vertical jump distance and FPI scores (p < 0.05). There was a significant weak positive relationship between the FPI scores and anterior parameter of YBT in both sides (p < 0.05) and there were no statistically significant correlations between the posteromedial and posterolateral parameters in both sides (p > 0.05).ConclusionPes planus is associated with the only anterior reach of YBT, and vertical jumping performance; therefore, it is recommended to include strengthening and correction exercises for pes planus to improve vertical jumping performance and reduce risk of injuries.

Analyzing Foot Posture Malalignments in Obese Individuals

Background and objective  Obesity often leads to foot deformities due to the increased pressure on the feet, the body's most distal parts. Obesity-induced foot malalignments can impact foot posture, making it essential to study these changes for better understanding and management. Hence, the study aimed to examine foot posture malalignments in obese individuals. Methods  In this cross-sectional study, 216 participants - 108 obese and 108 with normal BMI - were selected based on inclusion and exclusion criteria. The study was performed at Krishna College of Physiotherapy (KCPT), Karad. A well-elaborated assessment was done using Foot Posture Index-6, navicular drop test, degree of toe-out, Meary's angle (MA), and forefoot and rearfoot deviations. This study was statistically analyzed using SPSS Statistics software (IBM Corp., Armonk, NY), and results were obtained accordingly. Results  Among 216 participants, regarding the FPI-6 assessment, those in the age group of 43-50 years experienced a significant impact on foot (p=0.0003), particularly among the females (p=0.0002). As for the navicular drop test, the 43-50 age group was significantly affected (p=0.0032), with females again being most affected (p<0.0001). While assessing the toe-out angle, the 43-50 age group was significantly affected (p=0.0007) and females were substantially affected (p=0.0018). For MA, the age group of 35-42 and 43-50 years of obese BMI group were significantly affected, with males and females both affected significantly (p<0.0001). Abnormal rearfoot valgus and forefoot varus were combined and seen in the obese population and had a significant impact on the elderly and females (p<0.0001). Conclusions  Based on our findings, obese individuals are more susceptible to foot posture malalignments than the normal BMI group. The study also highlighted that the elderly and females are more prone to have altered foot posture, predominantly flat feet.

Static and dynamic balance in physically active females with pronated feet

BACKGROUND

Understanding and assessing static and dynamic balance and their relationship with the function of the medial longitudinal arch of the foot is crucial for people with pronated feet.

PURPOSE

This study aimed to assess the medial longitudinal arch height and postural balance in physically active females with pronated feet.

METHODS

A case-control study. The participants were divided into two groups based on their Foot Posture Index (FPI) scores: females with bilateral foot pronation (n = 33) and the control group with normal feet (n = 30). A Navicular Drop Test (NDT) and Knee-to-Wall Test (KTW) were used to assess foot and ankle function. Static balance was assessed using the Stork Balance Test (SBT) and Tandem Stance (TS). Dynamic balance was assessed using the Y-Balance Test (Y-BT). Physical activity was assessed using the total score of the short version of the International Physical Activity Questionnaire.

RESULTS

There was a lack of differences in static balance between pronated and normal feet groups in SBT and TS. The Y-BT anterior reaching depends on foot posture in favor of a pronated foot (p = .04). Correlation also showed a significant relationship between Y-BT components and NDT (r = 0.33, p = .01) and between KTW and NDT (r = 0.30, p = .02).

CONCLUSION

These results may suggest that foot pronation can be associated with dynamic balance in some directions. However, given that most comparisons did not show significant differences, the relationship between foot posture and functional assessment remains unclear.

Present but Ignored: Physical Condition and Health-Related Quality of Life in College-Aged Females with Generalized Joint Hypermobility

BACKGROUND

Generalized joint hypermobility (GJH) is prevalent among young adults, necessitating effective monitoring of musculoskeletal health, particularly among college-aged females. This study aimed to identify physical fitness and health-related quality of life (HR-QoL) characteristics associated with GJH.

METHODS

A total of 67 participants were assessed: 26 with GJH (mean age 20.06, SD 1.2 years), and 41 without (mean age 20.15, SD 2.2 years). Assessments included hypermobility, anthropometric data, foot posture, balance, flexibility, strength, and HR-QoL. We used the Mann-Whitney test for two independent samples, categorical variables were analyzed with Cramer's V test. The results indicated that participants with GJH exhibited inferior balance and back muscle static strength endurance but greater flexibility compared to those without GJH. Significant differences were observed in foot posture. However, handgrip strength, explosive strength, and abdominal muscle static strength endurance did not differ significantly between groups. No significant differences were observed in HR-QoL components between the two groups. In conclusion, there appears to be a link between GJH and increased flexibility, impaired balance, reduced back muscle static strength endurance, and altered posture of both feet.

Does medial calcaneal wedge improve static balance and load distribution in young adults with pronated foot?

BACKGROUND

Foot orthoses changing the momentum in the subtalar joint are often recommended, especially in activities loading the foot, to bring the pronated foot posture closer to neutral.

OBJECTIVES

To examine the immediate effect of medial heel wedge on static balance and load distribution in patients with increased pronation in the foot.

STUDY DESIGN

Experimental study design.

METHODS

Forty people with right dominant lower extremity participated in the study. For static balance assessment, we assessed ellipse surface, sway length, x-y mean, AP index, and Romberg ratio on 1 foot and measured load distribution as right-left foot and fore-hind foot with and without wedge.

RESULTS

There was a difference between the parameters of the ellipse surface and the Romberg ratio on the left side in the measurements performed with and without wedge for static balance on the left side ( P < 0.05) while there was no difference in the remaining values ( P > 0.05). In the load distribution, the change in the right anteroposterior foot was significant, increasing the load on the forefoot with the wedge ( P < 0.05) while we observed no difference in the left fore-hind foot load distribution and right-left foot load distribution ( P > 0.05).

CONCLUSION

Our study showed that for static balance, medial wedge can improve balance on the left side by decreasing sway, and for load distribution, the medial wedge changed the load distribution from back to front on the right side. These small differences in young healthy individuals are a preliminary indication that further studies are needed.

A Review of Anthropometric Measurements for Saudi Adults and Elderly, Directions for Future Work and Recommendations to Establish Saudi Guidelines in Line with the Saudi 2030 Vision

Body weight is a significant risk factor for the disease burden of noncommunicable diseases (NCDs). Anthropometric measurements are the first step in determining NCDs risk, and clinicians must have access to valid cutoffs. This study aims to review the literature of Saudi national guidelines and studies previously conducted in Saudi Arabia (SA) and to provide insights and recommendations to establish national guidelines in anthropometric measurements for Saudi adults/elderly in line with the Saudi 2030 Vision. In total, 163 studies were included, and 12 of them contributed to the development of specific anthropometric cutoffs. Cutoffs for metabolic syndrome, waist circumference, and body mass index were established in Saudi adults. However, limited studies were conducted in the elderly. This review warrants establishing standard cutoffs of Saudi adult anthropometrics to avoid over/underreporting of malnutrition and adiposity. This review will help policymakers and the Ministry of Health to establish national guidelines and standard cutoffs to be used in SA for anthropometric measurements that may assist in detecting malnutrition and NCDs.

Instrument-Assisted Soft Tissue Mobilization Technique versus Static Stretching in Patients with Pronated Dominant Foot: A Comparison in Effectiveness on Flexibility, Foot Posture, Foot Function Index, and Dynamic Balance

Background: Pronated foot is a deformity with various degrees of physical impact. Patients with a pronated foot experience issues such as foot pain, ankle pain, heel pain, shin splints, impaired balance, plantar fasciitis, etc. Objective: The study intended to compare the effectiveness of IASTM (instrument-assisted soft tissue mobilization) and static stretching on ankle flexibility, foot posture, foot function, and balance in patients with a flexible pronated foot. Methods: Seventy-two participants between the ages of 18–25 years with a flexible pronated foot were included and allocated into three groups: Control, stretching, and IASTM group using single-blinded randomization. Range of motion (ROM) measuring ankle flexibility, foot posture index (FPI), foot function index (FFI), and dynamic balance was measured at baseline and after 4 weeks of intervention. Soft tissue mobilization was applied on to the IASTM group, while the stretching group was directed in static stretching of the gastrocnemius-soleus complex, tibialis anterior, and Achilles tendon in addition to the foot exercises. The control group received only foot exercises for 4 weeks. Results: The result shows the significant improvement of the right dominant foot in ROM plantar flexion, (F = 3.94, p = 0.03), dorsiflexion (F = 3.15, p = 0.05), inversion (F = 8.54, p = 0.001) and eversion (F = 5.93, p = 0.005), FFI (control vs. IASTM, mean difference (MD) = 5.9, p < 0.001), FPI (right foot, control vs. IASTM MD = 0.88, p = 0.004), and in dynamic balance of the right-leg stance (anterior, pre vs. post = 88.55 ± 2.28 vs. 94.65 ± 2.28; anteromedial, pre vs. post = 80.65 ± 2.3 vs. 85.55 ± 2.93; posterior, pre vs. post = 83 ± 3.52 vs. 87 ± 2.99 and lateral, pre vs. post = 73.2 ± 5.02 vs. 78.05 ± 4.29) in the IASTM group. The FFI was increased remarkably in the stretching group as compared to the control group. Conclusions: Myofascial release technique, i.e., IASTM with foot exercises, significantly improves flexibility, foot posture, foot function, and dynamic balance as compared to stretching, making it a choice of treatment for patients with a flexible pronated foot.