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Mei Q, Kim HK, Xiang L, Shim V, Wang A, Baker JS, Gu Y, Fernandez J. Toward improved understanding of foot shape, foot posture, and foot biomechanics during running: A narrative review. Front Physiol 2022; 13:1062598. [PMID: 36569759 PMCID: PMC9773215 DOI: 10.3389/fphys.2022.1062598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
The current narrative review has explored known associations between foot shape, foot posture, and foot conditions during running. The artificial intelligence was found to be a useful metric of foot posture but was less useful in developing and obese individuals. Care should be taken when using the foot posture index to associate pronation with injury risk, and the Achilles tendon and longitudinal arch angles are required to elucidate the risk. The statistical shape modeling (SSM) may derive learnt information from population-based inference and fill in missing data from personalized information. Bone shapes and tissue morphology have been associated with pathology, gender, age, and height and may develop rapid population-specific foot classifiers. Based on this review, future studies are suggested for 1) tracking the internal multi-segmental foot motion and mapping the biplanar 2D motion to 3D shape motion using the SSM; 2) implementing multivariate machine learning or convolutional neural network to address nonlinear correlations in foot mechanics with shape or posture; 3) standardizing wearable data for rapid prediction of instant mechanics, load accumulation, injury risks and adaptation in foot tissue and bones, and correlation with shapes; 4) analyzing dynamic shape and posture via marker-less and real-time techniques under real-life scenarios for precise evaluation of clinical foot conditions and performance-fit footwear development.
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Affiliation(s)
- Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Hyun Kyung Kim
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,Department of Engineering Science, The University of Auckland, Auckland, New Zealand
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Blouin C, Genet F, Denormandie P, Graff W, Perrier A. Development of a preoperative questionnaire to improve satisfaction with hallux valgus repair: A Delphi study. PLoS One 2022; 17:e0276303. [PMID: 36279269 PMCID: PMC9591061 DOI: 10.1371/journal.pone.0276303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/05/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Satisfaction with hallux valgus repair is often poor, despite good surgical outcomes. Many tools have been developed to assess the outcome of the procedure; however none evaluate the association between the initial motive for repair and the reasons for post-surgical dissatisfaction. The aim of this study was to develop a new tool to analyse the subjective and objective expectations of individuals during a pre-operative consultation for hallux valgus repair in order to improve post-surgical satisfaction. METHODS We first collected the reasons for dissatisfaction with repair from the medical files of dissatisfied individuals. Then, a steering committee of 4 French experts in the management of hallux valgus designed a questionnaire based on the reasons for dissatisfaction. We then used the DELPHI method to validate the questionnaire: we submitted the questionnaire to a panel of 34 francophone experts in hallux valgus repair for rating in 4 rounds. RESULTS The medical files of 853 individuals were reviewed and a 52-item questionnaire relating to expectations from hallux valgus surgery was drafted. After the 4 rounds, a final 44 item questionnaire reached consensus. Thirteen items related to clinical and psychological profile, 5 to pain, 9 to physical activity, 4 to aesthetics and 13 to footwear. CONCLUSION This tool should facilitate gathering of individuals' expectations from hallux valgus repair to ensure realistic goals and reduce post-surgical dissatisfaction.
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Affiliation(s)
- Cédric Blouin
- UFR Simone Veil-Santé, UR2020 Erphan, Université Versailles Saint-Quentin-en-Yvelines (UVSQ), Montigny-le-Bretonneux, France
- Service de Chirurgie Orthopédique, Hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses–Croix-Saint-Simon, Paris, France
- ISPC Synergies, Paris, France
- * E-mail:
| | - François Genet
- ISPC Synergies, Paris, France
- Département PARASPORT-SANTE, Unité Péri Opératoire du Handicap, (UPOH-Perioperative Disability Unit), Service de Médecine Physique et de Réadaptation, Hôpital Raymond-Poincaré, Groupe Hospitalo-Universitaire APHP-Université PARIS SACLAY, Garches, France
- UFR Simone Veil-Santé, END: ICAP, Inserm U1179, Université Versailles Saint-Quentin-en-Yvelines (UVSQ), Montigny-le-Bretonneux, France
| | - Philippe Denormandie
- Service de Chirurgie Orthopédique, Hôpital Raymond Poincaré, APHP, Garches, France
- Groupe Mutuelle Nationale des Hospitaliers (MNH), Paris, France
| | - Wilfrid Graff
- Service de Chirurgie Orthopédique, Hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses–Croix-Saint-Simon, Paris, France
| | - Antoine Perrier
- Service de Chirurgie Orthopédique, Hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses–Croix-Saint-Simon, Paris, France
- Laboratoire de Recherche Translationnelle et D’Innovation en Médecine et Complexité TIMC, CNRS, Grenoble, France
- Service de Diabétologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Early Notice Pointer, an IoT-like Platform for Point-of-Care Feet and Body Balance Screening. MICROMACHINES 2022; 13:mi13050682. [PMID: 35630149 PMCID: PMC9144081 DOI: 10.3390/mi13050682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022]
Abstract
Improper foot biomechanics associated with uneven bodyweight distribution contribute to impaired balance and fall risks. There is a need to complete the panel of commercially available devices for the self-measurement of BMI, fat, muscle, bone, weight, and hydration with one that measures weight-shifting at home as a pre-specialist assessment system. This paper reports the development of the Early Notice Pointer (ENP), a user-friendly screening device based on weighing scale technology. The ENP is designed to be used at home to provide a graphic indication and customised and evidence-based foot and posture triage. The device electronically detects and maps the bodyweight and distinct load distributions on the main areas of the feet: forefoot and rearfoot. The developed platform also presents features that assess the user's balance, and the results are displayed as a simple numerical report and map. The technology supports data display on mobile phones and accommodates multiple measurements for monitoring. Therefore, the evaluation could be done at non-specialist and professional levels. The system has been tested to validate its accuracy, precision, and consistency. A parallel study to describe the frequency of arch types and metatarsal pressure in young adults (1034 healthy subjects) was conducted to explain the importance of self-monitoring at home for better prevention of foot arch- and posture-related conditions. The results showed the potential of the newly created platform as a screening device ready to be wirelessly connected with mobile phones and the internet for remote and personalised identification and monitoring of foot- and body balance-related conditions. The real-time interpretation of the reported physiological parameters opens new avenues toward IoT-like on-body monitoring of human physiological signals through easy-to-use devices on flexible substrates for specific versatility.
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Unique foot posture in Neanderthals reflects their body mass and high mechanical stress. J Hum Evol 2021; 161:103093. [PMID: 34749003 DOI: 10.1016/j.jhevol.2021.103093] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/02/2021] [Accepted: 10/03/2021] [Indexed: 11/20/2022]
Abstract
Neanderthal foot bone proportions and morphology are mostly indistinguishable from those of Homo sapiens, with the exception of several distinct Neanderthal features in the talus. The biomechanical implications of these distinct talar features remain contentious, fueling debate around the adaptive meaning of this distinctiveness. With the aim of clarifying this controversy, we test phylogenetic and behavioral factors as possible contributors, comparing tali of 10 Neanderthals and 81 H. sapiens (Upper Paleolithic and Holocene hunter-gatherers, agriculturalists, and postindustrial group) along with the Clark Howell talus (Omo, Ethiopia). Variation in external talar structures was assessed through geometric morphometric methods, while bone volume fraction and degree of anisotropy were quantified in a subsample (n = 45). Finally, covariation between point clouds of site-specific trabecular variables and surface landmark coordinates was assessed. Our results show that although Neanderthal talar external and internal morphologies were distinct from those of H. sapiens groups, shape did not significantly covary with either bone volume fraction or degree of anisotropy, suggesting limited covariation between external and internal talar structures. Neanderthal external talar morphology reflects ancestral retentions, along with various adaptations to high levels of mobility correlated to their presumably unshod hunter-gatherer lifestyle. This pairs with their high site-specific trabecular bone volume fraction and anisotropy, suggesting intense and consistently oriented locomotor loading, respectively. Relative to H.sapiens, Neanderthals exhibit differences in the talocrural joint that are potentially attributable to cultural and locomotor behavior dissimilarity, a talonavicular joint that mixes ancestral and functional traits, and a derived subtalar joint that suggests a predisposition for a pronated foot during stance phase. Overall, Neanderthal talar variation is attributable to mobility strategy and phylogenesis, while H. sapiens talar variation results from the same factors plus footwear. Our results suggest that greater Neanderthal body mass and/or higher mechanical stress uniquely led to their habitually pronated foot posture.
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Leardini A, Stebbins J, Hillstrom H, Caravaggi P, Deschamps K, Arndt A. ISB recommendations for skin-marker-based multi-segment foot kinematics. J Biomech 2021; 125:110581. [PMID: 34217032 DOI: 10.1016/j.jbiomech.2021.110581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 06/14/2021] [Accepted: 06/20/2021] [Indexed: 10/21/2022]
Abstract
The foot is anatomically and functionally complex, and thus an accurate description of intrinsic kinematics for clinical or sports applications requires multiple segments. This has led to the development of many multi-segment foot models for both kinematic and kinetic analyses. These models differ in the number of segments analyzed, bony landmarks identified, required marker set, defined anatomical axes and frames, the convention used to calculate joint rotations and the determination of neutral positions or other offsets from neutral. Many of these models lack validation. The terminology used is inconsistent and frequently confusing. Biomechanical and clinical studies using these models should use established references and describe how results are obtained and reported. The International Society of Biomechanics has previously published proposals for standards regarding kinematic and kinetic measurements in biomechanical research, and in this paper also addresses multi-segment foot kinematics modeling. The scope of this work is not to prescribe a particular set of standard definitions to be used in all applications, but rather to recommend a set of standards for collecting, calculating and reporting relevant data. The present paper includes recommendations for the overall modeling and grouping of the foot bones, for defining landmarks and other anatomical references, for addressing the many experimental issues in motion data collection, for analysing and reporting relevant results and finally for designing clinical and biomechanical studies in large populations by selecting the most suitable protocol for the specific application. These recommendations should also be applied when writing manuscripts and abstracts.
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Affiliation(s)
- Alberto Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Julie Stebbins
- Oxford Gait Laboratory, Oxford University Hospitals NHS Foundation Trust, UK
| | - Howard Hillstrom
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, NY, USA
| | - Paolo Caravaggi
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Kevin Deschamps
- Faculty of Movement & Rehabilitation Sciences, KULeuven, Bruges, Belgium
| | - Anton Arndt
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
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Mazoteras-Pardo V, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias M, Palomo-López P, López-López D, Calvo-Lobo C, Romero-Morales C, Casado-Hernández I. Degree of Impact of Tailor's Bunion on Quality of Life: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020736. [PMID: 33467061 PMCID: PMC7830808 DOI: 10.3390/ijerph18020736] [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: 11/29/2020] [Revised: 01/09/2021] [Accepted: 01/13/2021] [Indexed: 12/24/2022]
Abstract
Tailor’s bunion (TB) disease should be considered one of the foot injuries that causes disability in feet as well as general health. This case–control descriptive study investigated and contrasted the effects of different TB types in a sociodemographic population using the Foot Health Status Questionnaire (FHSQ). A sample of 100 subjects with a mean age of 51.70 ± 17.78 years was recruited and requested to reply to a foot health survey. Results were self-reported. Subjects were scored. Participants with TB type III (TB3) registered lower scores for foot pain, foot function, footwear, and foot health. Physical activity and social capacity had higher scores, and vigor and general health were lower. A Kruskal–Wallis test was used for systematic differences between the FHSQ and different TB types. In all analyses, statistical significance was considered a p-value <0.05 with a 95% confidence interval. Statistically significant differences were found between all domains of the FHSQ and TB, except for the social capacity domain and vigor. The FHSQ is an important measurement tool in TB subjects, showing that factors such as sex, age, and footwear used throughout an individual’s life are significantly associated with the development of TB3 and its influence on foot pain and foot health.
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Affiliation(s)
- Victoria Mazoteras-Pardo
- Grupo de Investigación ENDOCU, Departamento Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Fisioterapia y Enfermería de Toledo, Universidad de Castilla-La Mancha, 45071 Toledo, Spain;
| | - Ricardo Becerro-de-Bengoa-Vallejo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (R.B.-d.-B.-V.); (C.C.-L.); (I.C.-H.)
| | - Marta Losa-Iglesias
- Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
| | - Patricia Palomo-López
- Department of Nursing, University Center of Plasencia, Universidad de Extremadura, 10600 Plasencia, Spain
- Correspondence: ; Tel.: +34-927-25-70-00 (ext. 52181)
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403 Ferrol, Spain;
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (R.B.-d.-B.-V.); (C.C.-L.); (I.C.-H.)
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain;
| | - Israel Casado-Hernández
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (R.B.-d.-B.-V.); (C.C.-L.); (I.C.-H.)
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Clinical Assessment and Management of Foot and Ankle Osteoarthritis: A Review of Current Evidence and Focus on Pharmacological Treatment. Drugs Aging 2019; 36:203-211. [DOI: 10.1007/s40266-019-00639-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Effect of static foot posture on the dynamic stiffness of foot joints during walking. Gait Posture 2018; 62:241-246. [PMID: 29574363 DOI: 10.1016/j.gaitpost.2018.03.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/13/2018] [Accepted: 03/16/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The static foot posture has been related to the development of lower limb injuries. RESEARCH QUESTION This study aimed to investigate the dynamic stiffness of foot joints during gait in the sagittal plane to understand the role of the static foot posture in the development of injuries. METHODS Seventy healthy adult male subjects with different static postures, assessed by the Foot Posture Index (FPI) (30 normal, 20 highly pronated and 20 highly supinated), were recruited. Kinematic and kinetic data were recorded using an optical motion capture system and a pressure platform, and dynamic stiffness at the different stages of the stance was calculated from the slopes of the linear regression on the flexion moment-angle curves. The effect of foot type on dynamic stiffness and on ranges of motion and moments was analysed using ANOVAs and post-hoc tests, and linear correlation between dynamic stiffness and FPI was also tested. RESULTS Highly pronated feet showed a significantly smaller range of motion at the ankle and metatarsophalangeal joints and also a larger range of moments at the metatarsophalangeal joint than highly supinated feet. Dynamic stiffness during propulsion was significantly greater at all foot joints for highly pronated feet, with positive significant correlations with the squared FPI. Highly supinated feet showed greater dynamic stiffness than normal feet, although to a lesser extent. Highly pronated feet during normal gait experienced the greatest decrease in the dorsiflexor moments during propulsion, normal feet being the most balanced regarding work generated and absorbed. SIGNIFICANCE Extreme static foot postures show greater dynamic stiffness during propulsion and greater absorbed work, which increases the risk of developing injuries. The data presented may be used when designing orthotics or prostheses, and also when planning surgery that modifies joint stiffness.
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Formosa MP, Gatt A, Formosa C. Evaluating Quality of Life in Patients with Hallux Abducto Valgus Deformity After a Taping Technique. J Am Podiatr Med Assoc 2017; 107:287-291. [PMID: 28880597 DOI: 10.7547/15-110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The aim of this study was to determine the quality of life in patients living with hallux abducto valgus deformity before and after a taping technique. METHODS This study used a time series, quasi-experimental, same-subject design. Thirty-five patients with hallux abducto valgus were recruited in this study. Nonelastic zinc oxide tape was applied for 4 weeks. The Foot Health Status Questionnaire was used to assess the quality of life of participants before and after the intervention. The paired samples t test was used to test for statistical significance at the 95% confidence level. RESULTS In this study, a statistical reduction was seen in foot pain, foot function, and general foot health (P < .0001) after applying the nonelastic zinc oxide tape for 10 hours daily for 4 weeks. No statistically significant difference was found in the remaining domains of the Foot Health Status Questionnaire, although a difference in mean scores was observed. CONCLUSIONS Treatment with nonelastic zinc oxide tape led to improved management of hallux abducto valgus and better quality of life; it is a safe, easy-to-use method with minimal adverse effects. Future studies should evaluate this method using larger sample groups and longer treatment periods while comparing this method with alternative treatment approaches, such as exercise or orthotic devices.
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Affiliation(s)
| | - Alfred Gatt
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Cynthia Formosa
- Faculty of Health Sciences, University of Malta, Msida, Malta
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Paterson KL, Kasza J, Hunter DJ, Hinman RS, Menz HB, Peat G, Bennell KL. The relationship between foot and ankle symptoms and risk of developing knee osteoarthritis: data from the osteoarthritis initiative. Osteoarthritis Cartilage 2017; 25:639-646. [PMID: 27939621 PMCID: PMC5403611 DOI: 10.1016/j.joca.2016.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 10/20/2016] [Accepted: 12/01/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate whether foot and/or ankle symptoms increase the risk of developing (1) knee symptoms and (2) symptomatic radiographic knee osteoarthritis (OA). DESIGN 1020 Osteoarthritis Initiative (OAI) participants who were at-risk of knee OA, but were without knee symptoms or radiographic knee OA, were investigated. Participants indicated the presence and laterality of foot/ankle symptoms at baseline. The main outcome was development of knee symptoms (pain, aching or stiffness in and around the knee on most days of the month for at least 1 month in the past year). A secondary outcome was development of symptomatic radiographic knee OA (symptoms plus Kellgren and Lawrence [KL] grade ≥2), over the subsequent 4 years. Associations between foot/ankle symptoms and study outcomes were assessed by logistic regression models. RESULTS Foot/ankle symptoms in either or both feet significantly increased the odds of developing knee symptoms (adjusted odds ratio (OR) 1.55, 95% confidence interval (CI) 1.10 to 2.19), and developing symptomatic radiographic knee OA (adjusted OR 3.28, 95% CI 1.69 to 6.37). Based on laterality, contralateral foot/ankle symptoms were associated with developing both knee symptoms (adjusted OR 1.68, 95% CI 1.05 to 2.68) and symptomatic radiographic knee OA (adjusted OR 3.08, 95% CI 1.06 to 8.98), whilst bilateral foot/ankle symptoms were associated with developing symptomatic radiographic knee OA (adjusted OR 4.02, 95% CI 1.76 to 9.17). CONCLUSION In individuals at-risk of knee OA, the presence of contralateral foot/ankle symptoms in particular increases risk of developing both knee symptoms and symptomatic radiographic knee OA.
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Affiliation(s)
- K L Paterson
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia.
| | - J Kasza
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
| | - D J Hunter
- Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia; Rheumatology Department, Royal North Shore Hospital Australia, Sydney, Australia.
| | - R S Hinman
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia.
| | - H B Menz
- School of Allied Health, La Trobe University, Melbourne, Australia.
| | - G Peat
- Arthritis Research UK Primary Care Centre, Keele University, Keele, United Kingdom.
| | - K L Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia.
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Phillips A, McClinton S. Gait deviations associated with plantar heel pain: A systematic review. Clin Biomech (Bristol, Avon) 2017; 42:55-64. [PMID: 28095359 DOI: 10.1016/j.clinbiomech.2016.12.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 12/06/2016] [Accepted: 12/21/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Plantar heel pain is a common foot disorder associated with significant pain and gait-related disability. The aim of this systematic review was to identify gait deviations associated with plantar heel pain. METHODS A systematic review of articles with quantitative gait variables in individuals with plantar heel pain was conducted using the CINAHL, MEDLINE, Scopus, and Embase databases. Methodological quality was assessed using the modified Downs and Black criteria and used along with the number of studies per gait variable to determine level of evidence. FINDINGS Nineteen articles were included. There was strong evidence that stance phase duration is unchanged. There was moderate to strong evidence of decreased rearfoot center of pressure duration, impulse, and peak vertical ground reaction force at loading response. In compensation there was increased contact time of the midfoot and forefoot, increased midfoot and forefoot impulse, delayed time to the mid-stance vertical ground reaction force valley, and decreased peak force at terminal stance. The only quantitative measure of pronation/supination included limited evidence of increased medial forefoot and rearfoot inversion-eversion total mobility, and medial forefoot plantar flexion. INTERPRETATION Studies included in this review identified specific foot and ankle gait deviations in individuals with plantar heel pain compared to asymptomatic cases or limbs. The variables identified in this review may be used to assist in identifying movement-related gait dysfunction for treatment decisions or as outcome measures of recovery. Additional research is needed to increase confidence and clinical relevance of gait variables used to assess and treat individuals with PHP.
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Affiliation(s)
- Adam Phillips
- Des Moines University, 3200 Grand Avenue, Des Moines, IA 50312, USA.
| | - Shane McClinton
- Des Moines University, 3200 Grand Avenue, Des Moines, IA 50312, USA
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Naraghi R, Bremner A, Slack-Smith L, Bryant A. The relationship between foot posture index, ankle equinus, body mass index and intermetatarsal neuroma. J Foot Ankle Res 2016; 9:46. [PMID: 27980684 PMCID: PMC5131555 DOI: 10.1186/s13047-016-0179-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 11/25/2016] [Indexed: 11/25/2022] Open
Abstract
Background The main purpose of this study was to investigate the presence of an association between intermetatarsal neuroma and foot type, as measured by the Foot Posture Index. The study also examined whether there was a relationship between foot type and the interspace affected with intermetatarsal neuroma, and whether ankle equinus or body mass index had an effect. Methods In total, 100 participants were recruited from The University of Western Australia’s Podiatry Clinic, 68 of whom were diagnosed with inter-metatarsal neuroma from 2009 to 2015. There were 32 control participants recruited from 2014 to 2015. The age of subjects was recorded, as were weight and height, which were used to calculate body mass index. The foot posture index and ankle dorsiflexion were measured using standard technique. Independent t-tests and Kruskal-Wallis tests were used to compare differences in foot posture index, body mass index and ankle dorsiflexion between the inter-metatarsal neuroma and control groups. Multivariable logistic regression was also used to model relationships for outcome. Results The 68 intermetatarsal neuroma subjects had a mean age of 52 years (range 20 to 74 years) and comprised of 56 females and 12 males. The 32 control subjects had a mean age of 49 years (range 24 to 67 years) with 26 females and six males. There were no significant differences between the control and the intermetatarsal neuroma groups with respect to the mean foot posture index scores of the left and right foot (p = 0.21 and 0.87, respectively). Additionally no significant differences were detected between the affected intermetatarsal neuroma interspace and foot posture index (p = 0.27 and 0.47, respectively). There was no significant difference in mean body mass index between the intermetatarsal neuroma (26.9 ± 5.7) and control groups (26.5 ± 4.1) (p = 0.72). There was, however, a significant difference in mean ankle dorsiflexion between the intermetatarsal neuroma and control groups (p < 0.001 for both feet). Logistic regression models, adjusted for age, sex, foot posture index and body mass index estimated that the odds of having an intermetatarsal neuroma in the right foot increased by 61% (OR 1.61; 95% CI 1.32–1.96) with each one degree reduction of ankle dorsiflexion, and in the left foot by 43% (OR 1.43; 95% CI 1.22–1.69). Conclusion No relationships were found between foot posture index and body mass index with intermetatarsal neuroma, or between foot posture index and the interspaces affected. However, a strong association was demonstrated between the presence of intermetatarsal neuroma and a restriction of ankle dorsiflexion.
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Affiliation(s)
- Reza Naraghi
- School of Surgery, Podiatric Medicine Unit M422, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009 Australia
| | - Alexandra Bremner
- School of Population Health M431, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009 Australia
| | - Linda Slack-Smith
- School of Dentistry M512, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009 Australia
| | - Alan Bryant
- School of Surgery, Podiatric Medicine Unit M422, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009 Australia
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Souza TR, Araújo VL, Silva PL, Carvalhais VOC, Resende RA, Fonseca ST. External rotation elastic bands at the lower limb decrease rearfoot eversion during walking: a preliminary proof of concept. Braz J Phys Ther 2016; 20:571-579. [PMID: 27849289 PMCID: PMC5176205 DOI: 10.1590/bjpt-rbf.2014.0194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/22/2016] [Indexed: 12/05/2022] Open
Abstract
Background Reducing rearfoot eversion is a commonly desired effect in clinical practice to prevent or treat musculoskeletal dysfunction. Interventions that pull the lower limb into external rotation may reduce rearfoot eversion. Objective This study investigated whether the use of external rotation elastic bands, of different levels of stiffness, will decrease rearfoot eversion during walking. We hypothesized that the use of elastic bands would decrease rearfoot eversion and that the greater the band stiffness, the greater the eversion reduction. Method Seventeen healthy participants underwent three-dimensional kinematic analysis of the rearfoot and shank. The participants walked on a treadmill with and without high- and low-stiffness bands. Frontal-plane kinematics of the rearfoot-shank joint complex was obtained during the stance phase of walking. Repeated-measures ANOVAs were used to compare discrete variables that described rearfoot eversion-inversion: mean eversion-inversion; eversion peak; and eversion-inversion range of motion. Results The low-stiffness and high-stiffness bands significantly decreased eversion and increased mean eversion-inversion (p≤0.037) and eversion peak (p≤0.006) compared with the control condition. Both bands also decreased eversion-inversion range of motion (p≤0.047) compared with control by reducing eversion. The high-stiffness band condition was not significantly different from the low-stiffness band condition for any variables (p≥0.479). Conclusion The results indicated that the external rotation bands decreased rearfoot eversion during walking. This constitutes preliminary experimental evidence suggesting that increasing external rotation moments at the lower limb may reduce rearfoot eversion, which needs further testing.
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Affiliation(s)
- Thales R Souza
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Vanessa L Araújo
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Paula L Silva
- Department of Psychology, University of Cincinnati, Cincinnati, OH, United States of America
| | - Viviane O C Carvalhais
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Renan A Resende
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Sérgio T Fonseca
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Paterson KL, Hinman RS, Hunter DJ, Wrigley TV, Bennell KL. Impact of concurrent foot pain on health and functional status in people with knee osteoarthritis: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 2015; 67:989-95. [PMID: 25581254 DOI: 10.1002/acr.22537] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 11/16/2014] [Accepted: 12/16/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To document the prevalence of foot pain and foot pain laterality in people with knee osteoarthritis (OA) and to examine its impact on health and function. METHODS Participants from the Progression subcohort (n = 1,255, ages 45-79 years) of the Osteoarthritis Initiative with symptomatic tibiofemoral knee OA were included. Prevalence of foot pain, defined as pain in the foot/ankle, and foot pain laterality were determined. Health status was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index, the Short Form-12 Health Survey, and the Center for Epidemiological Studies Depression Scale. Function was assessed using the 20-meter walk test (WT) and a repeated chair stand test. Differences in health and functional measures were compared between groups with and without foot pain using multivariate analysis of covariance. RESULTS One-fourth (n = 317 [25%]) of people with knee OA experienced concurrent foot pain, with the majority (n = 174 [55%]) reporting pain in both feet. After adjusting for covariates, people with foot pain scored worse on all health measures and on the 20-meter WT, compared to those without (P < 0.05). Differences in health and function were found between the bilateral and ipsilateral foot pain groups compared to those without foot pain (P < 0.05), but no differences were found with the contralateral group. CONCLUSION Foot pain is common in people with knee OA, and bilateral and ipsilateral foot pain adversely affect health and function, suggesting laterality is important. Further research is needed to establish the mechanism and interaction of pathology at these sites and to evaluate foot pain treatment in this population.
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Affiliation(s)
- Kade L Paterson
- Centre for Health, Exercise and Sports Medicine, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - David J Hunter
- Royal North Shore Hospital, Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, and University of Sydney, Sydney, New South Wales, Australia
| | - Tim V Wrigley
- Centre for Health, Exercise and Sports Medicine, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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15
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Golightly YM, Dufour AB, Hannan MT, Hillstrom HJ, Katz PP, Jordan JM. Leg Muscle Mass and Foot Symptoms, Structure, and Function: The Johnston County Osteoarthritis Project. J Gerontol A Biol Sci Med Sci 2015; 71:385-90. [PMID: 26297655 DOI: 10.1093/gerona/glv136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 07/20/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Loss of muscle mass occurs with aging and in lower limbs it may be accelerated by foot problems. In this cross-sectional analysis, we evaluated the relationship of leg muscle mass to foot symptoms (presence or absence of pain, aching, or stiffness), structure while standing (high arch or low arch), and function while walking (pronated or supinated) in a community-based study of Caucasian and African American men and women who were 50-95 years old. METHODS In the Johnston County Osteoarthritis Project, leg muscle mass was measured with whole body dual-energy x-ray absorptiometry, and plantar foot pressure data, using predetermined values, were used to classify foot structure and function. Sex-specific crude and adjusted (age, body mass index, and race) linear regression models examined associations of leg muscle mass index (Leg muscle mass [kg]/Height [m](2)) with foot symptoms, structure, and function. RESULTS Complete data were available for 1,037 participants (mean age 68 years, mean body mass index 31 kg/m(2), 68% women, 29% African American). In women, pronated foot function was associated with lower leg muscle mass in crude (p = .02), but not adjusted (p = .22), models. A low arch was associated with a higher leg muscle mass in adjusted models for both men and women (p < .01). CONCLUSIONS Leg muscle mass was associated with foot structure in our biracial sample, whereas relations between leg muscle mass and foot function were attenuated by age, body mass index, and race. Future longitudinal analyses are needed to explain the temporal relationship between these conditions and how they relate to other aspects of impairment and physical function.
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Affiliation(s)
- Yvonne M Golightly
- Department of Epidemiology, Thurston Arthritis Research Center, and Injury Prevention Research Center, University of North Carolina, Chapel Hill.
| | - Alyssa B Dufour
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts. Department of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Marian T Hannan
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts. Department of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Howard J Hillstrom
- Department of Rehabilitation, Hospital for Special Surgery, New York, New York
| | - Patricia P Katz
- Department of Medicine, University of California, San Francisco
| | - Joanne M Jordan
- Department of Epidemiology, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, University of North Carolina, Chapel Hill
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Menz HB. Biomechanics of the Ageing Foot and Ankle: A Mini-Review. Gerontology 2014; 61:381-8. [DOI: 10.1159/000368357] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/15/2014] [Indexed: 11/19/2022] Open
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