1
|
Danckaers F, Stanković K, Huysmans T, Booth BG, Sijbers J. Foot shape assessment techniques for orthotic and footwear applications: a methodological literature review. Front Bioeng Biotechnol 2024; 12:1416499. [PMID: 39301175 PMCID: PMC11410610 DOI: 10.3389/fbioe.2024.1416499] [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: 04/12/2024] [Accepted: 08/26/2024] [Indexed: 09/22/2024] Open
Abstract
Introduction Foot shape assessment is important to characterise the complex shape of a foot, which is in turn essential for accurate design of foot orthoses and footwear, as well as quantification of foot deformities (e.g., hallux valgus). Numerous approaches have been described over the past few decades to evaluate foot shape for orthotic and footwear purposes, as well as for investigating how one's habits and personal characteristics influence the foot shape. This paper presents the developments reported in the literature for foot shape assessment. Method In particular, we focus on four main dimensions common to any foot assessment: (a) the choice of measurements to collect, (b) how objective these measurement procedures are, (c) how the foot measurements are analyzed, and (d) other common characteristics that can impact foot shape analysis. Results For each dimension, we summarize the most commonly used techniques and identify additional considerations that need to be made to achieve a reliable foot shape assessment. Discussion We present how different choices along these two dimensions impact the resulting foot assessment, and discuss possible improvements in the field of foot shape assessment.
Collapse
Affiliation(s)
- Femke Danckaers
- imec - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
| | - Kristina Stanković
- imec - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
| | - Toon Huysmans
- imec - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
- Section on Applied Ergonomics & Design, Department of Human-Centered Design, Delft University of Technology, Delft, Netherlands
| | - Brian G Booth
- imec - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
- imec - Image Processing and Interpretation Lab, TELIN Department, Ghent University, Ghent, Belgium
| | - Jan Sijbers
- imec - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
2
|
Noh WJ, Lee MS, Lee BD. Deep learning-based automated angle measurement for flatfoot diagnosis in weight-bearing lateral radiographs. Sci Rep 2024; 14:18411. [PMID: 39117787 PMCID: PMC11310201 DOI: 10.1038/s41598-024-69549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 08/06/2024] [Indexed: 08/10/2024] Open
Abstract
This study aimed to develop and evaluate a deep learning-based system for the automatic measurement of angles (specifically, Meary's angle and calcaneal pitch) in weight-bearing lateral radiographs of the foot for flatfoot diagnosis. We utilized 3960 lateral radiographs, either from the left or right foot, sourced from a pool of 4000 patients to construct and evaluate a deep learning-based model. These radiographs were captured between June and November 2021, and patients who had undergone total ankle replacement surgery or ankle arthrodesis surgery were excluded. Various methods, including correlation analysis, Bland-Altman plots, and paired T-tests, were employed to assess the concordance between the angles automatically measured using the system and those assessed by clinical experts. The evaluation dataset comprised 150 weight-bearing radiographs from 150 patients. In all test cases, the angles automatically computed using the deep learning-based system were in good agreement with the reference standards (Meary's angle: Pearson correlation coefficient (PCC) = 0.964, intraclass correlation coefficient (ICC) = 0.963, concordance correlation coefficient (CCC) = 0.963, p-value = 0.632, mean absolute error (MAE) = 1.59°; calcaneal pitch: PCC = 0.988, ICC = 0.987, CCC = 0.987, p-value = 0.055, MAE = 0.63°). The average time required for angle measurement using only the CPU to execute the deep learning-based system was 11 ± 1 s. The deep learning-based automatic angle measurement system, a tool for diagnosing flatfoot, demonstrated comparable accuracy and reliability with the results obtained by medical professionals for patients without internal fixation devices.
Collapse
Affiliation(s)
- Won-Jun Noh
- Department of Computer Science, Graduate School, Kyonggi University, Suwon-si, Gyeonggi-do, 16227, Republic of Korea
| | - Mu Sook Lee
- Department of Radiology, Keimyung University Dongsan Hospital, Daegu, 24601, Republic of Korea
| | - Byoung-Dai Lee
- Division of AI and Computer Engineering, Kyonggi University, Suwon-si, Gyeonggi-do, 16227, Republic of Korea.
| |
Collapse
|
3
|
Lee JH, Hwang J, Park H, Kang H, Song W, Choi DA, Seong CH, Jang WY. Muscle strength and foot pressure vary depending on the type of foot pain. Sci Rep 2024; 14:5857. [PMID: 38467691 PMCID: PMC10928145 DOI: 10.1038/s41598-024-56490-8] [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: 12/29/2023] [Accepted: 03/07/2024] [Indexed: 03/13/2024] Open
Abstract
This study compared muscle strength and foot pressure among patients with metatarsalgia, patients with plantar fasciitis, and healthy controls. A total of 31 patients with foot pain (14 metatarsalgia and 17 plantar fasciitis) and 29 healthy controls participated in the study. The strengths of the plantar flexor and hip muscles were measured using isokinetic and handheld dynamometers, respectively. Foot pressure parameters, including the pressure-time integral (PTI) and foot arch index (AI), were assessed using pedobarography. Compared with the healthy control group, plantar flexor strength was significantly reduced in the affected feet of the metatarsalgia and plantar fasciitis groups (F = 0.083, all p < 0.001); however, hip strength was significantly decreased only in the affected feet of the metatarsalgia group (F = 20.900, p < 0.001). Plantar flexor (p < 0.001) and hip (p = 0.004) strength were significantly lower in the metatarsalgia group than in the plantar fasciitis group. The PTI was lower in the forefeet of the affected feet in the metatarsalgia (p < 0.001) and plantar fasciitis (p = 0.004) groups. Foot AI (p < 0.001) was significantly reduced only in the metatarsalgia group. These results suggest the need to consider the evaluation of muscle strength and foot pressure in both feet for the diagnosis and treatment of foot pain.
Collapse
Affiliation(s)
- Jin Hyuck Lee
- Department of Sports Medical Center, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Institute of Nanobiomarker-Based Medicine, Korea University, Seoul, Korea
| | - Jangsun Hwang
- Institute of Nanobiomarker-Based Medicine, Korea University, Seoul, Korea
| | | | | | | | | | | | - Woo Young Jang
- Department of Sports Medical Center, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
- Department of Orthopedic Surgery, College of Medicine, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
- Institute of Nanobiomarker-Based Medicine, Korea University, Seoul, Korea.
| |
Collapse
|
4
|
Khan F, Chevidikunnan MF, Alsobhi MG, Ahmed IAI, Al-Lehidan NS, Rehan M, Alalawi HA, Abduljabbar AH. Diagnostic Accuracy of Various Radiological Measurements in the Evaluation and Differentiation of Flatfoot: A Cross-Sectional Study. Diagnostics (Basel) 2022; 12:diagnostics12102288. [PMID: 36291977 PMCID: PMC9600622 DOI: 10.3390/diagnostics12102288] [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: 09/01/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Arch angle is used to indicate flatfoot, but in some cases, it is not easily defined. The presence of flatfoot deformity remains difficult to diagnose due to a lack of reliable radiographic assessment tools. Although various assessment methods for flatfoot have been proposed, there is insufficient evidence to prove the diagnostic accuracy of the various tools. The main purpose of the study was to determine the best radiographic measures for flatfoot concerning the arch angle. Fifty-two feet radiographs from thirty-two healthy young females were obtained. Five angles and one index were measured using weight-bearing lateral radiographs; including arch angle, calcaneal pitch (CP), talar-first metatarsal angle (TFM), lateral talar angle (LTA), talar inclination angle (TIA) and navicular index (NI). Receiver-operating characteristics were generated to evaluate the flatfoot diagnostic accuracy for all radiographic indicators and Matthews correlation coefficient was calculated to determine the cutoff value for each measure. The strongest correlation was between arch angle and CP angle [r = −0.91, p ≤ 0.0001, 95% confidence interval (CI) (from −0.94 to −0.84)]. Also, significant correlations were found between arch angle and NI [r = 0.62, p ≤ 0.0001, 95% CI (0.42 to 0.76)], and TFM [r = 0.50, p ≤ 0.0001, 95% CI (from 0.266 to 0.68)]. Furthermore, CP (cutoff, 12.40) had the highest accuracy level with value of 100% sensitivity and specificity followed by NI, having 82% sensitivity and 89% specificity for the cutoff value of 9.90. In conclusion, CP angle is inversely correlated with arch angle and considered a significant indicator of flatfoot. Also, the NI is easy to define radiographically and could be used to differentiate flat from normal arched foot among young adults.
Collapse
Affiliation(s)
- Fayaz Khan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Correspondence:
| | - Mohamed Faisal Chevidikunnan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Mashael Ghazi Alsobhi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Israa Anees Ibrahim Ahmed
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Nada Saleh Al-Lehidan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Mohd Rehan
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Hashim Abdullah Alalawi
- Department of Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Ahmed H. Abduljabbar
- Department of Radiology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah 22252, Saudi Arabia
| |
Collapse
|
5
|
Safar Cherati A, Khalifeh Soltani S, Moghadam N, Hassanmirzaei B, Haratian Z, Khalifeh Soltani S, Rezaei M. Is there a relationship between lower-extremity injuries and foot postures in professional football players? A prospective cohort study. SCI MED FOOTBALL 2022; 6:49-59. [PMID: 35236229 DOI: 10.1080/24733938.2020.1870711] [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: 10/22/2022]
Abstract
BACKGROUND Lower extremity injuries are an ongoing concern for professional football players. This study aims to evaluate the relationship between foot posture and lower extremity injuries in professional football players. METHOD In this prospective cohort study, 420 male players of the Iran Premium football league were evaluated during the 2015-2016 season. The players were assessed for their foot types based on optical and static foot scans and foot posture index (FPI). The trained club physicians recorded all injuries during the season. RESULT The analyzed data of 244 players showed the highest rate of lower extremity injury in hamstrings, ankle, and groin, respectively. These injuries led to 46% of time loss. The probability of hamstrings injuries was higher among pronated players based on static, optic, FPI, and visual examination, 2.1, 1.8, 1.8, and 2.3, respectively. Medial Collateral Ligament (MCL) injuries were associated with subtalar joint abnormality defined by visual observation. An increased relative risk of leading-to-absence injuries among the flat foot group was significant based on optic scanning, FPI, and visual observation. CONCLUSION Abnormal foot postures in professional football players may increase the risk of hamstring and MCL injuries and time loss due to lower extremity injuries.
Collapse
Affiliation(s)
- Afsaneh Safar Cherati
- Department of Sport and Exercise Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Salman Khalifeh Soltani
- Department of Sport and Exercise Medicine, Iran University of Medical Sciences, Tehran, Iran.,Iran Football Medical Assessment and Rehabilitation Center - IFMARC, Tehran, Iran
| | - Navid Moghadam
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahar Hassanmirzaei
- Iran Football Medical Assessment and Rehabilitation Center - IFMARC, Tehran, Iran.,Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Haratian
- Iran Football Medical Assessment and Rehabilitation Center - IFMARC, Tehran, Iran
| | | | - Meisam Rezaei
- Department of Sport and Exercise Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Palomo-Toucedo IC, Reina-Bueno M, Munuera-Martínez PV, Domínguez Maldonado G, Castillo-López JM, Ramos-Ortega J, Vázquez-Bautista C. Dolor y postura del pie en pacientes con Lupus Eritematoso Sistémico. Un estudio descriptivo. REVISTA ESPAÑOLA DE PODOLOGÍA 2022. [DOI: 10.20986/revesppod.2022.1633/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
7
|
Abstract
Background: Authors refer to different methods to assess subjects’ foot posture. All methods present several limitations depending on the examiner or the chosen test. This study aims to investigate the relationship between different tests and Footprints parameters to diagnose subjects with a flat and neutral foot. Methods: The sample consisted of 37 participants, where 16 were included in the flatfoot group and 21 in the neutral foot group. Only subjects who presented a Navicular Drop Test value of >9 mm were included in the flatfooted group. All participants were submitted to Resting Calcaneal Stance Position and plantar pressure platform assessment for Footprints analysis. Associations between all tests and Footprints parameters were determined by Pearson’s correlation analysis. Results: Regarding both groups, significant correlations between tests were moderate to nearly perfect to identified both conditions of foot posture. All correlations were statistically significant (p < 0.05). Conclusions: The diagnosis accuracy of foot posture condition can be compromised depending on the used test. The Navicular Drop Test and the Resting Calcaneal Stance Position were shown to mislead foot posture condition assessment, unlike Footprints parameters that can be important evaluation tools in a clinical environment.
Collapse
|
8
|
Shah DK, Khatun S. Pes Planus Foot among the First and Second Year Medical Students of a Medical College: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2021; 59:327-330. [PMID: 34508531 PMCID: PMC8369593 DOI: 10.31729/jnma.6020] [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: 02/01/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Foot is a complex segmented structure formed by the articulation of 26 different bones which are held together by multiple ligaments, extrinsic tendons and the intrinsic muscles of the feet. The assessment of median longitudinal arch serves as an important reference in determining the degree of pes planus or pes cavus. This study aims to find the prevalence of pes planus among the undergraduate medical students of a medical college. Methods: A descriptive cross-sectional study was carried out in the first- and second-year undergraduate medical students of a teaching hospital after taking ethical approval from Institutional Review Committee. The study was conducted from 15th November 2019 to 14th November 2020. Eighty-seven participants were involved in study using the random sampling technique. Foot prints were collected from the participants in the A4 size paper after applying ink over plantar surface of the foot. Measurements were done using the Autodesk Autocad software. Statistical Package for the Social Sciences was used. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of the total subjects, 14 (8.04%) (5.14-10.94 at 95% Confidence Interval) presented with flat foot. Similarly, high arched foot was seen in 29 (16.67%) of subjects whereas normal arched foot was seen in 131 (75.29%) subjects. Conclusions: From the current study we conclude that the prevalence of pes planus was slightly higher than that compared with the similar studies.
Collapse
Affiliation(s)
- Diwakar Kumar Shah
- Department of Anatomy, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal
| | - Sanzida Khatun
- Department of Anatomy, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal
| |
Collapse
|
9
|
Clinical measures of foot posture and ankle joint dorsiflexion do not differ in adults with and without plantar heel pain. Sci Rep 2021; 11:6451. [PMID: 33742026 PMCID: PMC7979904 DOI: 10.1038/s41598-021-85520-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/19/2021] [Indexed: 01/31/2023] Open
Abstract
Foot posture and ankle joint dorsiflexion have long been proposed to be risk factors for plantar heel pain, however body mass may be a confounder when investigating these factors. The aim of this study was to determine if clinical measures of foot posture and ankle joint dorsiflexion differ in adults with and without plantar heel pain after accounting for body mass. This was a cross-sectional observational study that compared 50 participants with plantar heel pain to 25 control participants without plantar heel pain who were matched for age, sex and body mass index. Foot posture was assessed using the Foot Posture Index and the Arch Index. Ankle joint dorsiflexion was assessed with a weightbearing lunge test with the knee extended and with the knee flexed. No significant differences (P < 0.05) were found between the groups for foot posture, whether measured with the Foot Posture Index or the Arch Index. Similarly, no significant differences were found in the weightbearing lunge test whether measured with the knee extended or with the knee flexed. Clinical measures of foot posture and ankle joint dorsiflexion do not differ in adults with and without plantar heel pain when body mass is accounted for. Therefore, clinicians should not focus exclusively on foot posture and ankle dorsiflexion and ignore the contribution of overweight or obesity.
Collapse
|
10
|
Farahmand B, Pourhoseingholi E, Bagheri A. The comparison of medial longitudinal arch development in normal feet and flexible flatfeet in preschool children with an 18-month follow-up: a retrospective case-control study. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000000978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Lam WK, Cheung CC, Huang Z, Leung AK. Effects of shoe collar height and arch-support orthosis on joint stability and loading during landing. Res Sports Med 2021; 30:115-127. [PMID: 33579163 DOI: 10.1080/15438627.2021.1888102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examined the effects of shoe collar height and foot orthosis on ground reaction force (GRF), ankle and knee mechanics during landing. Sixteen male university basketball players performed drop landing when wearing different shoes with collar height (high vs. low) and foot orthoses (arch-support vs. flat). Biomechanical variables included vertical peak GRF and joint angles and moments in sagittal and coronal planes were analysed with two-way ANOVA with repeated measures (α = 0.05). Results indicated that high-collar shoes had significantly smaller peak ankle dorsiflexion (P < 0.001), smaller ankle sagittal total RoM (P < 0.001), higher forefoot peak GRF (P = 0.009) and peak knee valgus moment (P < 0.001) compared with low-collar shoes. Wearing arch-support orthoses induced higher forefoot peak GRF (P < 0.001) but smaller ankle inversion moment (P = 0.001) compared to flat-orthoses. Furthermore, significant interactions between collar-height and orthosis were found only for initial ankle plantarflexion (P = 0.023) and knee flexion (P = 0.035), but not in any kinetics variables. The findings suggest increased collar height and arch-support orthoses appear to reduce the risks of ankle sprains during landing, but might increase loading at adjacent joints.
Collapse
Affiliation(s)
- Wing-Kai Lam
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China.,Department of Kinesiology, Shenyang Sport University, Shenyang, China.,Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company, Beijing, China
| | - Chris C Cheung
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company, Beijing, China.,Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Zhiguan Huang
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China
| | - Aaron K Leung
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| |
Collapse
|
12
|
Alfageme-García P, Calderón-García JF, Martínez-Nova A, Hidalgo-Ruiz S, Martínez-Álvarez M, Rico-Martín S. Backpacks Effect on Foot Posture in Schoolchildren with a Neutral Foot Posture: A Three-Year Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197313. [PMID: 33036376 PMCID: PMC7579156 DOI: 10.3390/ijerph17197313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/25/2020] [Accepted: 10/03/2020] [Indexed: 12/27/2022]
Abstract
Background: There is a paucity of data on the relationship between backpack use and foot posture in children. The aim of this study was to assess the effects of a backpack on foot posture in children with neutral foot posture during three years of follow-up. Methods: A prospective longitudinal observational study was conducted in a sample of 627 children with neutral foot. For each participant included in the study, age, sex, weight, height, body mass index, type of schoolbag (backpack or non-backpack), foot shape, metatarsal formula and type of shoes were recorded. Foot posture was described by the mean of the foot posture index (FPI) and reassessed after three years in a follow-up study. Results: The average age of the children was 8.32 ± 1.32 years. A total of 458 used a backpack when going to school. Over the three-year follow-up period, 50 children who had neutral foot developed supinated foot (n = 18) or pronated foot (n = 32). Univariate and multivariate analysis showed that the children using a backpack were at a higher risk of developing pronated foot (adjusted Odds Ratio (aOR) = 2.05, 95% IC: 1.08–3.89, p = 0.028). Backpack use was not associated with the change from neutral foot to supinated foot. Conclusions: We found a positive association between using a backpack and the risk of developing pronated but not supinated foot. Clinical trials should be conducted to analyze the effect of backpack use on the foot among schoolchildren.
Collapse
Affiliation(s)
- Pilar Alfageme-García
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain
| | - Julián Fernando Calderón-García
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
- Correspondence:
| | - Alfonso Martínez-Nova
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain
| | - Sonia Hidalgo-Ruiz
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain
| | - Mariana Martínez-Álvarez
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Faculty of Medicine, University of Extremadura, 06006 Badajoz, Spain
| | - Sergio Rico-Martín
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
| |
Collapse
|
13
|
Beelen PE, Kingma I, Nolte PA, van Dieën JH. The effect of foot type, body length and mass on postural stability. Gait Posture 2020; 81:241-246. [PMID: 32818860 DOI: 10.1016/j.gaitpost.2020.07.148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 07/04/2020] [Accepted: 07/28/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Poor postural stability is associated with chronic ankle instability. Previous research showed an effect of foot type on postural stability. However, the specific effect of supinated feet remains unclear. RESEARCH QUESTION Our study aimed to assess the effect of foot type on postural stability, while taking potential confounding effects of body mass and body height into account. METHODS Forty-three healthy participants between 18 and 40 years old performed barefooted single leg stance tests with eyes open (EO) and closed (EC) on solid ground, and on a balance board (BB). Foot type was determined from pressure recordings during gait, using the arch index. Ground reaction forces were measured using a force plate. Outcome measures were Center of Pressure Velocity (COPV) divided by body height, and the Horizontal Ground Reaction Force (HGRF) divided by body mass. Generalized Estimating Equations models assessed the differences between supinated, normal and pronated feet during EO, EC and on a BB. RESULTS During EO an interaction between supinated feet and body mass showed an increase of COPV with 0.03 × 10-2 1/s per kilogram of mass relative to normal feet (p = .03). During EC this interaction was more pronounced with 0.22 × 10-2 1/s increase per kilogram mass (p < .01). The HGRF did not differ between foot types in any of the conditions. SIGNIFICANCE Supinated feet have a larger increase in COPV compared to normal feet with increasing mass when standing on solid ground during EO and EC. This indicates that people with supinated feet and a higher mass are less stable during single leg stance. LEVEL OF EVIDENCE Level 3, associative study.
Collapse
Affiliation(s)
- Paul Erik Beelen
- Spaarne Gasthuis Hospital, Spaarnepoort 1, 2134 TM, Hoofddorp, Noord-Holland, the Netherlands
| | - Idsart Kingma
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Peter A Nolte
- Spaarne Gasthuis Hospital, Spaarnepoort 1, 2134 TM, Hoofddorp, Noord-Holland, the Netherlands
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands
| |
Collapse
|
14
|
Chae J, Kang YJ, Noh Y. A Deep-Learning Approach for Foot-Type Classification Using Heterogeneous Pressure Data. SENSORS 2020; 20:s20164481. [PMID: 32796568 PMCID: PMC7472491 DOI: 10.3390/s20164481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/24/2020] [Accepted: 08/06/2020] [Indexed: 01/22/2023]
Abstract
The human foot is easily deformed owing to the innate form of the foot or an incorrect walking posture. Foot deformations not only pose a threat to foot health but also cause fatigue and pain when walking; therefore, accurate diagnoses of foot deformations are required. However, the measurement of foot deformities requires specialized personnel, and the objectivity of the diagnosis may be insufficient for professional medical personnel to assess foot deformations. Thus, it is necessary to develop an objective foot deformation classification model. In this study, a model for classifying foot types is developed using image and numerical foot pressure data. Such heterogeneous data are used to generate a fine-tuned visual geometry group-16 (VGG16) and K−nearest neighbor (k-NN) models, respectively, and a stacking ensemble model is finally generated to improve accuracy and robustness by combining the two models. Through k-fold cross-validation, the accuracy and robustness of the proposed method have been verified by the mean and standard deviation of the f1 scores (0.9255 and 0.0042), which has superior performance compared to single models generated using only numerical or image data. Thus, the proposed model provides the objectivity of diagnosis for foot deformation, and can be used for analysis and design of foot healthcare products.
Collapse
Affiliation(s)
- Jonghyeok Chae
- School of Mechanical Engineering, Pusan National University (PNU), Busan 46290, Korea;
| | - Young-Jin Kang
- Research Institute of Mechanical Technology, Pusan National University (PNU), Busan 46290, Korea;
| | - Yoojeong Noh
- School of Mechanical Engineering, Pusan National University (PNU), Busan 46290, Korea;
- Correspondence:
| |
Collapse
|
15
|
Nirenberg M, Ansert E, Campbell J, Curran M. Forensic implications of foot arch index comparison between dynamic bare footprints and shoe insole foot impressions. Sci Justice 2020; 60:375-380. [PMID: 32650939 DOI: 10.1016/j.scijus.2020.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 02/16/2020] [Accepted: 03/01/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Michael Nirenberg
- Clinical and Forensic Podiatrist, Friendly Foot Care, PC, Crown Point, IN, USA.
| | | | | | | |
Collapse
|
16
|
Locomotion Variations of Arch Index and Interlimb Symmetry in Shod and Barefoot Populations. Appl Bionics Biomech 2020; 2020:7610789. [PMID: 32565888 PMCID: PMC7281800 DOI: 10.1155/2020/7610789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/05/2020] [Accepted: 02/13/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to investigate the variations of arch index from static standing to dynamic walking and running; furthermore, the interlimb symmetry was checked in the two populations. A total of eighty male participants were recruited for this study, with forty habitually barefoot and forty habitually shod males, respectively. Arch index (AI) was calculated following the previously established “gold standard” measurement via contact areas recorded from EMED. Repeated measure analysis of variance (ANOVA) was employed to compare the difference between static and dynamic walking and running arch index. Paired-samples t-test and symmetry index (SI) were used to investigate the symmetry of the left foot arch index and right foot arch index. It was found that the dynamic arch index was significantly higher than the static arch index in barefoot and shod males, showing an increase from static weight-bearing standing to dynamic walking and running. However, interlimb (right-left) symmetry in the foot arch index was observed in the two populations. Dynamic changes of the arch index may provide implications that need to be considered while designing shoe lasts or insoles. Knowledge of the healthy arch index range reported from this study could also be used as a standard baseline to probe into foot and arch disorders.
Collapse
|
17
|
Gijon-Nogueron G, Marchena-Rodriguez A, Montes-Alguacil J, Evans AM. Evaluation of the paediatric foot using footprints and foot posture index: A cross-sectional study. J Paediatr Child Health 2020; 56:201-206. [PMID: 31267610 DOI: 10.1111/jpc.14558] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 03/19/2019] [Accepted: 06/06/2019] [Indexed: 12/14/2022]
Abstract
AIM Footprints have long been used as proxy measures of foot morphology, yet there is little consensus regarding footprints versus measures of foot posture, which address foot anatomy directly. Foot posture in children can be a confusing clinical presentation, with previous studies both supporting and refuting the relationship between childhood obesity and flat feet. The aim of this study was to determine the relationship between footprints and foot posture in children. METHODS A total of 316 school children (153 boys, 163 girls) from Spain, aged 6-9 years, were assessed for both footprint (Clarke's angle (CA)), by Tecniwork Pedrograph Plate, and foot posture (foot posture index (FPI)) measures, with participants barefoot, in a relaxed standing position, on a 50-cm elevated platform. RESULTS A negative correlation was found between FPI and footprints (CA) (rho = -0.505 left, P < 0.001) and by gender (rho = -0.457 for the left foot in girls, P < 0.001; rho = -0.548 for the left foot in boys, P < 0.001). The children with pes cavus according to the CA (73.3%) had normal feet according to FPI, and the children with severe pes planus according to the CA (78.98%) had pronated feet according to the FPI. A χ2 test showed these results to be statistically significant (P > 0.001). CONCLUSIONS An inverse relationship between CA and FPI was identified, that is, the greater the FPI, the smaller the CA, but not all pronated foot are planus feet and not all cavus feet are supinated feet. Footprints may overestimate and misguide paediatric foot posture concerns.
Collapse
Affiliation(s)
| | | | | | - Angela M Evans
- Discipline of Podiatry, College of Science, Health, and Engineering, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
18
|
Charles JA, Mignot C, Jelinek HF. Reliability of a New Method to Determine Foot Arch Height for Clinicians. J Am Podiatr Med Assoc 2019; 109:187-192. [PMID: 31268787 DOI: 10.7547/18-007] [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: 02/03/2023]
Abstract
BACKGROUND Arch height is an important indicator of risk of foot pathology. The current non-invasive gold standard based on footprint information requires extensive pre-processing. Methods used to obtain arch height that are accurate and easier to use are required in routine clinical practice. METHODS The proposed arch index diagonals (AId) method for determining the arch index (AI) reduces the complexity of the preprocessing steps. All footprints were first prepared as required by the Cavanagh and Rodgers method for determining the AI and then compared to the proposed diagonals method. Results were classified according to the Cavanagh and Rodgers cut-off values into three groups of low, normal and high AI. ANOVA and Tukey's post hoc tests were applied to identify significant differences between AI groups. Linear modeling was applied to determine the fit of the new AId method compared to the Cavanagh and Rodgers AI. RESULTS One hundred and ninety-six footprints were analyzed. The ANOVA indicated significant differences between the groups for AId (F1,194=94.49, p<0.0001) and the Tukey post hoc tests indicated significant differences between the pair-wise comparisons (p<0.001). Linear modeling indicated that the AId ratio classified more footprints in the high arch group compared to Cavanagh and Rodgers results (R2=32%, p< 0.01). Intra- and inter-rater correspondence was above 90% and confirmed that the AId results provided a better indication of arch height. CONCLUSIONS The proposed method simplifies current processing steps to derive the arch height.
Collapse
Affiliation(s)
- James A. Charles
- Institute of Koori Education and School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
| | - Clare Mignot
- Department of Bioinformatic Engineering, University of Poitiers, Poitiers, France
| | - Herbert F. Jelinek
- School of Community Health, Charles Sturt University, Albury, NSW, Australia
| |
Collapse
|
19
|
Arnold JB, Marshall M, Thomas MJ, Redmond AC, Menz HB, Roddy E. Midfoot osteoarthritis: potential phenotypes and their associations with demographic, symptomatic and clinical characteristics. Osteoarthritis Cartilage 2019; 27:659-666. [PMID: 30660723 DOI: 10.1016/j.joca.2018.12.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the demographic, symptomatic, clinical and structural foot characteristics associated with potential phenotypes of midfoot osteoarthritis (OA). DESIGN Cross-sectional study of 533 community-dwelling adults aged ≥50 years with foot pain in the past year. Health questionnaires and clinical assessments of symptoms, foot structure and function were undertaken. Potential midfoot OA phenotypes were defined by the pattern of radiographic joint involvement affecting either the medial midfoot (talonavicular, navicular-1st cuneiform, or cuneiform-1st metatarsal joint), central midfoot (2nd cuneiform-metatarsal joint), or both medial and central midfoot joints. Multivariable regression models with generalised estimating equations were used to investigate the associations between patterns of midfoot joint involvement and symptomatic, clinical and structural characteristics compared to those with no or minimal midfoot OA. RESULTS Of 879 eligible feet, 168 had medial midfoot OA, 103 central midfoot OA, 76 both medial and central midfoot OA and 532 no/minimal OA. Having both medial and central midfoot OA was associated with higher pain scores, dorsally-located midfoot pain (OR 2.54, 95%CI 1.45, 4.45), hallux valgus (OR 1.76, 95%CI 1.02, 3.05), flatter foot posture (β 0.44, 95%CI 0.12, 0.77), lower medial arch height (β 0.02, 95%CI 0.01, 0.03) and less subtalar inversion and 1st MTPJ dorsiflexion. Isolated medial midfoot OA and central midfoot OA had few distinguishing clinical characteristics. CONCLUSIONS Distinct phenotypes of midfoot OA appear challenging to identify, with substantial overlap in symptoms and clinical characteristics. Phenotypic differences in symptoms, foot posture and function were apparent in this study only when both the medial and central midfoot were involved.
Collapse
Affiliation(s)
- J B Arnold
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; National Institute for Health Research (NIHR), Leeds Biomedical Research Centre, Leeds, UK; Alliance for Research in Exericse, Nutrition & Activity (ARENA) and School of Health Sciences, University of South Australia, Adelaide, Australia.
| | - M Marshall
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - M J Thomas
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Staffordshire, UK
| | - A C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; National Institute for Health Research (NIHR), Leeds Biomedical Research Centre, Leeds, UK
| | - H B Menz
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
| | - E Roddy
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Staffordshire, UK
| |
Collapse
|
20
|
Correlates and predictors of paediatric leg pain: a case-control study. Rheumatol Int 2018; 38:1251-1258. [PMID: 29797060 DOI: 10.1007/s00296-018-4056-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/16/2018] [Indexed: 01/15/2023]
Abstract
Paediatric leg pains, long described as 'growing pains', frequently present to clinicians, are prevalent in early childhood, disrupt sleep, and distress affected children and parents. There are many cited associations, but no defined leg pain sub-types, nor revealed predictive factors. We explored the implicated factors (viz. foot arches, foot strength, joint mobility, vitamin D, iron) in children with leg pain versus a control group. Leg pain sub-groups-growing pains (GP), restless legs (RLS), both (mixed)-are defined for the first time. A case controlled study design, in a primary care setting, Mumbai, India. A total of 77 children with leg pains (n = 64) and controls (n = 13), aged 3-12 years, identified by paediatricians, completed data collection. Blood assays for iron and vitamin D, pain, Beighton score, foot arch, foot strength and anthropometrical data were collected. All outcome measures were validated, with standardised protocols. Leg pain (all groups) was predicted by increased joint mobility and increased ankle dorsiflexion strength (β = 0.56, P < 0.05). GP sub-group was predicted by increased ankle dorsiflexion strength (β = - 0.06, P < 0.05). Mixed (GP/RLS) and RLS sub-groups were predicted by increased ankle dorsiflexion strength (β = 0.66, P < 0.05) and pain questionnaire (β = 0.11, P < 0.05). Hypovitaminosis D was detected in 87% of the sample, and anaemia in 13%. Increased strength of ankle dorsiflexors and joint flexibility were each found predictive for leg pain. Increased body weight, waist girth, and BMI were all associated with leg pain.
Collapse
|
21
|
Bac A, Bogacz G, Ogrodzka-Ciechanowicz K, Kulis A, Szaporów T, Woźniacka R, Radlińska N. Characteristics of Selected Anthropometric Foot Indicators in Physically Active Students. J Am Podiatr Med Assoc 2018; 108:236-244. [PMID: 29932755 DOI: 10.7547/15-157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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 type of medial longitudinal arch (MLA) in students of Krakow universities, investigate the relationship between physical activity and the shaping of the feet, and examine the relationship between hallux valgus angle and the type of footwear chosen most often. METHODS The study group consisted of 120 students, of which 56 respondents were students of the University School of Physical Education in Krakow, whereas the remaining 64 respondents were students of the Pedagogical University of Krakow. To evaluate the MLA, a podoscope was used, which allowed us to determine the length and width of the foot, and calculation of the Clarke angle, heel angle γ, and the angle of hallux valgus. All students were also subjected to a measurement of body weight and height. RESULTS There was a statistically significant relationship between physical activity and the Clarke angle in the group of women studying at the University School of Physical Education. There was no correlation between the hallux valgus angle and the type of footwear chosen most often in the research groups. CONCLUSIONS The most frequently diagnosed type of longitudinal and transverse arch foot in the research group was normal MLA. There was no relationship between physical activity and transverse arch foot in any of the research groups.
Collapse
Affiliation(s)
- Aneta Bac
- Department of Occupational Therapy, Faculty of Motor Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Gabriela Bogacz
- Department of Occupational Therapy, Faculty of Motor Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Katarzyna Ogrodzka-Ciechanowicz
- Department of Clinical Rehabilitation, Faculty of Motor Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Aleksandra Kulis
- Department of Occupational Therapy, Faculty of Motor Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Tomasz Szaporów
- Department of Occupational Therapy, Faculty of Motor Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Renata Woźniacka
- Department of Physiotherapy, Faculty of Motor Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Natalia Radlińska
- Department of Occupational Therapy, Faculty of Motor Rehabilitation, University School of Physical Education, Krakow, Poland
| |
Collapse
|
22
|
Son Y, Kang HJ, Song YM, Hwang JH. Relationships Between Self-awareness and Clinical Diagnostic Findings of Abnormal Foot Arch Height in Koreans. Ann Rehabil Med 2018; 41:1013-1018. [PMID: 29354578 PMCID: PMC5773421 DOI: 10.5535/arm.2017.41.6.1013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 05/30/2017] [Indexed: 12/03/2022] Open
Abstract
Objective To see how people think about their own feet, and evaluate whether there are correlations among self-awareness of the participants and clinical examination findings. Methods Adult twins and their families who participated in the Healthy Twin study from May 2008 to April 2010 were recruited. Participants were asked whether they thought their feet were normal, flat, or cavus. The lateral talometatarsal angles were measured on foot X-rays to determine the foot arch height. Using the podoscopic footprints taken with the podobaroscope, the Staheli arch index was also measured. Kappa statistics were used to calculate degree of agreement among the three measurement methods. Results Self-awareness and radiographic findings were significantly different (Pearson chi-square test, p=0.000) and only slightly agreed (kappa measure of agreement=0.136, p=0.000). Self-awareness and podoscopy results revealed a significant difference (Pearson chi-square test, p=0.000), with only slight agreement (kappa measure of agreement=0.072, p=0.000). Conclusion There is significant disagreement between patients' perception of their feet and actual test results. Many people may have an incorrect assumption about their own foot conditions that may be reflected in improper management. Dissemination of accurate information about foot disorders by foot clinicians would be helpful.
Collapse
Affiliation(s)
- Youngsuk Son
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyo Jeong Kang
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Korea
| | - Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
23
|
Pita-Fernandez S, Gonzalez-Martin C, Alonso-Tajes F, Seoane-Pillado T, Pertega-Diaz S, Perez-Garcia S, Seijo-Bestilleiro R, Balboa-Barreiro V. Flat Foot in a Random Population and its Impact on Quality of Life and Functionality. J Clin Diagn Res 2017; 11:LC22-LC27. [PMID: 28571173 DOI: 10.7860/jcdr/2017/24362.9697] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/19/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Flat foot is a common deformity in adults. It is characterized by medial rotation and plantar flexion of the talus, eversion of the calcaneus, collapsed medial arch and abduction of the forefoot. AIM The aim of this study was to determine the prevalence of flat foot and its impact on quality of life, dependence, foot pain, disability and functional limitation among random population of 40-year-old and above. MATERIALS AND METHODS A cross-sectional study in a random population sample from Cambre (A Coruña-Spain) (n=835) was performed (α =0.05; Precision=±3.4%). The diagnosis of flat foot was stablished by the study of the footprint obtained with a pedograph. Anthropometric variables were studied, Charlson's Comorbidity Index, function and state of foot (Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ)), quality of life (SF-36), and dependence for activities of daily living (Barthel and Lawton index). A logistic and linear multiple regression analysis was performed. RESULTS The prevalence of flat foot was 26.62%. Patients with flat foot were significantly older (65.73±11.04 vs 61.03±11.45-year-old), showed a higher comorbidity index (0.92±1.49 vs 0.50±0.98), had a greater BMI (31.45±5.55 vs 28.40±4.17) and greater foot size (25.16±1.66 vs 24.82±1.65). The presence of flat foot diminishes the quality of life, as measured by the FHSQ, and foot function, measured by the FFI. The presence of flat foot does not alter the physical and mental dimension of the SF-36 or the degree of dependence. CONCLUSION Flat foot was associated with age, Charlson's Comorbidity Index, BMI and foot size. The SF-36, Barthel and Lawton questionnaires remained unaltered by the presence of flat foot. The FHSQ and FFI questionnaires did prove to be sensitive to the presence of flat foot in a significant manner.
Collapse
Affiliation(s)
- Salvador Pita-Fernandez
- Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - Cristina Gonzalez-Martin
- Clinical Epidemiology Research Group, Health Sciences Department, Facultad de Enfermería y Podología, Universidade da Coruña (UDC), Campus de Ferrol, Ferrol, Spain
| | - Francisco Alonso-Tajes
- Clinical Epidemiology Research Group, Health Sciences Department, Facultad de Enfermería y Podología, Universidade da Coruña (UDC), Campus de Ferrol, Ferrol, Spain
| | - Teresa Seoane-Pillado
- Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - Sonia Pertega-Diaz
- Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - Sergio Perez-Garcia
- Clinical Epidemiology Research Group, Health Sciences Department, Facultad de Enfermería y Podología, Universidade da Coruña (UDC), Campus de Ferrol, Ferrol, Spain
| | - Rocio Seijo-Bestilleiro
- Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - Vanesa Balboa-Barreiro
- Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| |
Collapse
|
24
|
Thomas MJ, Roddy E, Rathod T, Marshall M, Moore A, Menz HB, Peat G. Clinical diagnosis of symptomatic midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot. Osteoarthritis Cartilage 2015; 23:2094-2101. [PMID: 26093213 PMCID: PMC4672469 DOI: 10.1016/j.joca.2015.06.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 05/29/2015] [Accepted: 06/09/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To derive a multivariable diagnostic model for symptomatic midfoot osteoarthritis (OA). METHODS Information on potential risk factors and clinical manifestations of symptomatic midfoot OA was collected using a health survey and standardised clinical examination of a population-based sample of 274 adults aged ≥50 years with midfoot pain. Following univariable analysis, random intercept multi-level logistic regression modelling that accounted for clustered data was used to identify the presence of midfoot OA independently scored on plain radiographs (dorso-plantar and lateral views), and defined as a score of ≥2 for osteophytes or joint space narrowing in at least one of four joints (first and second cuneometatarsal, navicular-first cuneiform and talonavicular joints). Model performance was summarised using the calibration slope and area under the curve (AUC). Internal validation and sensitivity analyses explored model over-fitting and certain assumptions. RESULTS Compared to persons with midfoot pain only, symptomatic midfoot OA was associated with measures of static foot posture and range-of-motion at subtalar and ankle joints. Arch Index was the only retained clinical variable in a model containing age, gender and body mass index. The final model was poorly calibrated (calibration slope, 0.64, 95% CI: 0.39, 0.89) and discrimination was fair-to-poor (AUC, 0.64, 95% CI: 0.58, 0.70). Final model sensitivity and specificity were 29.9% (95% CI: 22.7, 38.0) and 87.5% (95% CI: 82.9, 91.3), respectively. Bootstrapping revealed the model to be over-optimistic and performance was not improved using continuous predictors. CONCLUSIONS Brief clinical assessments provided only marginal information for identifying the presence of radiographic midfoot OA among community-dwelling persons with midfoot pain.
Collapse
Affiliation(s)
- M J Thomas
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom.
| | - E Roddy
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom.
| | - T Rathod
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom.
| | - M Marshall
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom.
| | - A Moore
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, United Kingdom.
| | - H B Menz
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom; Lower Extremity and Gait Studies Program, School of Allied Health, La Trobe University, Bundoora, Victoria, 3086, Australia.
| | - G Peat
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom.
| |
Collapse
|
25
|
Fernando ME, Crowther RG, Cunningham M, Lazzarini PA, Sangla KS, Golledge J. Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol. BMC Endocr Disord 2015; 15:59. [PMID: 26499881 PMCID: PMC4619003 DOI: 10.1186/s12902-015-0057-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/15/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Foot ulceration is the main precursor to lower limb amputation in patients with type 2 diabetes worldwide. Biomechanical factors have been implicated in the development of foot ulceration; however the association of these factors to ulcer healing remains less clear. It may be hypothesised that abnormalities in temporal spatial parameters (stride to stride measurements), kinematics (joint movements), kinetics (forces on the lower limb) and plantar pressures (pressure placed on the foot during walking) contribute to foot ulcer healing. The primary aim of this study is to establish the biomechanical characteristics (temporal spatial parameters, kinematics, kinetics and plantar pressures) of patients with plantar neuropathic foot ulcers compared to controls without a history of foot ulcers. The secondary aim is to assess the same biomechanical characteristics in patients with foot ulcers and controls over-time to assess whether these characteristics remain the same or change throughout ulcer healing. METHODS/DESIGN The design is a case-control study nested in a six-month longitudinal study. Cases will be participants with active plantar neuropathic foot ulcers (DFU group). Controls will consist of patients with type 2 diabetes (DMC group) and healthy participants (HC group) with no history of foot ulceration. Standardised gait and plantar pressure protocols will be used to collect biomechanical data at baseline, three and six months. Descriptive variables and primary and secondary outcome variables will be compared between the three groups at baseline and follow-up. DISCUSSION It is anticipated that the findings from this longitudinal study will provide important information regarding the biomechanical characteristic of type 2 diabetes patients with neuropathic foot ulcers. We hypothesise that people with foot ulcers will demonstrate a significantly compromised gait pattern (reduced temporal spatial parameters, kinematics and kinetics) at base line and then throughout the follow-up period compared to controls. The study may provide evidence for the design of gait-retraining, neuro-muscular conditioning and other approaches to off-load the limbs of those with foot ulcers in order to reduce the mechanical loading on the foot during gait and promote ulcer healing.
Collapse
Affiliation(s)
- Malindu Eranga Fernando
- Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia.
- Movement analysis Laboratory, Discipline of Sports and Exercise Science, James Cook University, Townsville, Australia.
- Podiatry Service, Kirwan Community Health Campus, Townsville, QLD, Australia.
| | - Robert George Crowther
- Movement analysis Laboratory, Discipline of Sports and Exercise Science, James Cook University, Townsville, Australia.
- Sport and Exercise, School of Health and Wellbeing, University of Southern Queensland, Brisbane, Australia.
| | - Margaret Cunningham
- Department of Health Sciences, University of Stirling, Stirling, Scotland, UK.
| | - Peter Anthony Lazzarini
- Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia.
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
| | | | - Jonathan Golledge
- Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia.
- Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Australia.
| |
Collapse
|
26
|
Genc Y, Gultekin A, Duymus TM, Mutlu S, Mutlu H, Komur B. Pedobarography in the Assessment of Postoperative Calcaneal Fracture Pressure With Gait. J Foot Ankle Surg 2015; 55:99-105. [PMID: 26364236 DOI: 10.1053/j.jfas.2015.07.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Indexed: 02/03/2023]
Abstract
The purpose of the present study was to evaluate the benefits and importance of pedobarography in the diagnosis and treatment of plantar pressure changes in the postoperative follow-up of calcaneus fractures treated with open reduction and internal fixation. The 28 patients included 23 males (82%) and 5 females (18%). The clinical evaluation was performed using the American Orthopaedic Foot and Ankle Society hindfoot scoring system. The Böhler and Gissane angles were measured on the preoperative and postoperative radiographs. In the postoperative follow-up period (mean ± standard deviation 22.25 ± 10.8 months), all the patients underwent analysis with a dynamic pedobarogram. Because the arch index of the operated feet was 29.73% and that of the nonoperated feet was 28.94%, a similar slightly low arch was seen in both feet (p = .078). When the plantar surface maximum pressures were evaluated, a significant reduction was seen in the operated feet in the second, third, fourth, and fifth metatarsals and the medial hindfoot (p < .05). Displaced intra-articular calcaneus fractures resulted in a significant reduction in maximum pressure of the second, third, fourth, and fifth metatarsals and the medial hindfoot. Also, the hindfoot pressure was lateralized. Pedobarography is a simple and useful method for the diagnosis of plantar pressure changes occurring postoperatively.
Collapse
Affiliation(s)
- Yasin Genc
- Orthopaedic Surgeon, Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Alper Gultekin
- Orthopaedic Surgeon, Department of Orthopaedics, Kocaeli Derince Training and Research Hospital, Istanbul, Turkey
| | - Tahir Mutlu Duymus
- Orthopaedic Surgeon, Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Serhat Mutlu
- Orthopaedic Surgeon, Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
| | - Harun Mutlu
- Orthopaedic Surgeon, Department of Orthopaedics, Taksim Training and Research Hospital, Istanbul, Turkey
| | - Baran Komur
- Orthopaedic Surgeon, Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
27
|
Saghazadeh M, Tsunoda K, Soma Y, Okura T. Static Foot Posture and Mobility Associated With Postural Sway in Elderly Women Using a Three-dimensional Foot Scanner. J Am Podiatr Med Assoc 2015; 105:412-7. [PMID: 26429610 DOI: 10.7547/14-021] [Citation(s) in RCA: 4] [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 Maintaining balance is a complex phenomenon that is influenced by a range of sensorimotor factors. Foot posture and mobility may also influence balance and postural sway. Recently, three-dimensional foot scanners have been used to assess foot posture. This tool allows many individuals to be scanned quickly and easily and helps eliminate patients' radiation exposure. The objective of this study was to determine whether static foot posture and mobility are independently associated with postural sway in a large community sample of older women using objective measures of balance status and the recently launched technology of three-dimensional foot scanning. METHODS This cross-sectional study included 140 community-dwelling elderly women (mean ± SD age, 73.9 ± 5.1 years) recruited in Kasama City, Japan. The postural sway variables were total path length and area and were measured by force plate. We measured static foot posture, sitting and standing navicular height, and mobility using a three-dimensional foot scanner. Foot mobility was determined as the amount of vertical navicular excursion between the positions of the subtalar joint, from neutral in sitting position to relaxed bilateral standing. RESULTS After adjusting for potential cofounders, analysis of covariance revealed that sitting navicular height was associated with total path length (P = .038) and area (P = .031). Foot mobility was associated with total path length (P = .018). CONCLUSIONS These findings suggest that sitting navicular height and foot mobility are associated with postural sway in elderly women and might be an important factor in defining balance control in older adults.
Collapse
Affiliation(s)
- Mahshid Saghazadeh
- Department of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Kenji Tsunoda
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Yuki Soma
- Department of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tomohiro Okura
- Department of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| |
Collapse
|
28
|
Butterworth PA, Urquhart DM, Landorf KB, Wluka AE, Cicuttini FM, Menz HB. Foot posture, range of motion and plantar pressure characteristics in obese and non-obese individuals. Gait Posture 2015; 41:465-9. [PMID: 25482032 DOI: 10.1016/j.gaitpost.2014.11.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 11/17/2014] [Accepted: 11/18/2014] [Indexed: 02/02/2023]
Abstract
Obesity is a world-wide health problem and is strongly associated with musculoskeletal disorders of the lower limb. The aim of this study was to evaluate plantar loading patterns in obese and non-obese individuals, while accounting for the contribution of foot structure, range of motion and walking speed. Sixty-eight participants (mean±SD age, 52.6±8.0 years), including 47 females (69%), underwent assessments of body mass index, foot pain and foot structure. Plantar pressures were also obtained, using a floor-mounted resistive sensor mat system. Multiple regression analysis was used to determine which variables were most strongly associated with plantar loading patterns. Obese individuals exhibited flatter feet, reduced inversion-eversion range of motion, and higher peak plantar pressures when walking. After accounting for foot structure and walking speed, bodyweight was found to be significantly associated with elevated loading of the foot, particularly the forefoot and midfoot. These findings suggest that obesity increases the stresses applied to the foot directly, via increased bodyweight, and indirectly, via alterations to foot structure, which may partly explain the link between obesity and the development of foot pain. Clinicians dealing with foot problems should consider the effect of increased bodyweight on plantar loading in obese patients.
Collapse
Affiliation(s)
- Paul A Butterworth
- Department of Podiatry, La Trobe University, Bundoora, Victoria, Australia; Lower Extremity and Gait Studies Program, La Trobe University, Bundoora, Victoria, Australia; School of Health and Human Sciences, Southern Cross University, Bilinga, Queensland, Australia
| | - Donna M Urquhart
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Karl B Landorf
- Department of Podiatry, La Trobe University, Bundoora, Victoria, Australia; Lower Extremity and Gait Studies Program, La Trobe University, Bundoora, Victoria, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Hylton B Menz
- Lower Extremity and Gait Studies Program, La Trobe University, Bundoora, Victoria, Australia
| |
Collapse
|
29
|
Pita-Fernández S, González-Martín C, Seoane-Pillado T, López-Calviño B, Pértega-Díaz S, Gil-Guillén V. Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older. J Epidemiol 2014; 25:148-54. [PMID: 25382154 PMCID: PMC4310876 DOI: 10.2188/jea.je20140082] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Research is needed to determine the prevalence and variables associated with the diagnosis of flatfoot, and to evaluate the validity of three footprint analysis methods for diagnosing flatfoot, using clinical diagnosis as a benchmark. Methods We conducted a cross-sectional study of a population-based random sample ≥40 years old (n = 1002) in A Coruña, Spain. Anthropometric variables, Charlson’s comorbidity score, and podiatric examination (including measurement of Clarke’s angle, the Chippaux-Smirak index, and the Staheli index) were used for comparison with a clinical diagnosis method using a podoscope. Multivariate regression was performed. Informed patient consent and ethical review approval were obtained. Results Prevalence of flatfoot in the left and right footprint, measured using the podoscope, was 19.0% and 18.9%, respectively. Variables independently associated with flatfoot diagnosis were age (OR 1.07), female gender (OR 3.55) and BMI (OR 1.39). The area under the receiver operating characteristic curve (AUC) showed that Clarke’s angle is highly accurate in predicting flatfoot (AUC 0.94), followed by the Chippaux-Smirak (AUC 0.83) and Staheli (AUC 0.80) indices. Sensitivity values were 89.8% for Clarke’s angle, 94.2% for the Chippaux-Smirak index, and 81.8% for the Staheli index, with respective positive likelihood ratios or 9.7, 2.1, and 2.0. Conclusions Age, gender, and BMI were associated with a flatfoot diagnosis. The indices studied are suitable for diagnosing flatfoot in adults, especially Clarke’s angle, which is highly accurate for flatfoot diagnosis in this population.
Collapse
Affiliation(s)
- Salvador Pita-Fernández
- Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña
| | | | | | | | | | | |
Collapse
|
30
|
Cimolin V, Galli M, Celletti C, Pau M, Castori M, Morico G, Albertini G, Camerota F. Foot type analysis based on electronic pedobarography data in individuals with joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type during upright standing. J Am Podiatr Med Assoc 2014; 104:588-93. [PMID: 25514270 DOI: 10.7547/8750-7315-104.6.588] [Citation(s) in RCA: 4] [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 Joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type (JHS/EDS-HT) is a rheumatologic condition characterized by generalized joint hypermobility and musculoskeletal and nonmusculoskeletal findings related to congenital laxity of connective tissue. Because foot pain and other foot problems are reported to make daily life problematic to manage for individuals with JHS/EDS-HT, and thanks to the availability of modern technology, the aim of the present study was to quantitatively characterize foot type in individuals with JHS/EDS-HT during upright standing. METHODS Forty feet of 20 women with JHS/EDS-HT (mean ± SD age, 36.03 ± 14.01 years) were assessed clinically and with a pressure-sensitive mat during upright standing. RESULTS Forty-five percent of feet had a high arch (pes cavus), 27.5% had a normal arch, and 27.5% had a low arch (pes planus or flatfoot). CONCLUSIONS From a clinical perspective, the characterization of foot type in JHS/EDS-HT is important to identify, develop, and enhance the rehabilitative options. An understanding of the relationship between pes cavus and foot pain in these patients could, in fact, improve the clinical management of these patients.
Collapse
Affiliation(s)
- Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “San Raffaele Pisana,” Tosinvest Sanità, Roma, Italy
| | - Claudia Celletti
- Physical Medicine and Rehabilitation Division, Orthopaedic Department, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Marco Castori
- Physical Medicine and Rehabilitation Division, Orthopaedic Department, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Gianfranco Morico
- Physical Medicine and Rehabilitation Division, Orthopaedic Department, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Giorgio Albertini
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “San Raffaele Pisana,” Tosinvest Sanità, Roma, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation Division, Orthopaedic Department, Umberto I Hospital, Sapienza University, Rome, Italy
| |
Collapse
|
31
|
Butterworth PA, Landorf KB, Gilleard W, Urquhart DM, Menz HB. The association between body composition and foot structure and function: a systematic review. Obes Rev 2014; 15:348-57. [PMID: 24165357 DOI: 10.1111/obr.12130] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/12/2013] [Accepted: 09/20/2013] [Indexed: 11/26/2022]
Abstract
The aim of this systematic review was to investigate the relationship between body composition and foot structure and function. Six electronic databases (Ovid MEDLINE, Ovid EMBASE, Ovid AMED, CINAHL, Scopus and The Cochrane Library) and reference lists from relevant papers were searched on 2 September 2013. Sixteen papers that reported on the association between body composition and foot structure and function met our inclusion criteria and were reviewed. The evidence indicates that obesity is strongly associated with planus (low-arched) foot posture, pronated dynamic foot function and increased plantar pressures when walking. However, there is limited evidence to support an association between other body composition measures, such as fat mass, with foot structure or function.
Collapse
Affiliation(s)
- P A Butterworth
- Department of Podiatry, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia; Lower Extremity and Gait Studies Program, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia
| | | | | | | | | |
Collapse
|
32
|
The pictogram of the pes planus from the first century AD. INTERNATIONAL ORTHOPAEDICS 2013; 37:1871-3. [PMID: 23881065 DOI: 10.1007/s00264-013-2020-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 07/02/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE This study presents a pictogram engraved into the Marble Road of the ancient town of Ephesus, with a special emphasis on one part of it which represents a flat foot. Although the flat foot is a widespread and common disturbance in all time periods, we were motivated by a lack of its representation within iconographical, historical or other sources. METHOD Aiming to confirm the diagnosis objectively we applied the modern diagnostic methodology, arch index (AI). The result was 0.33, which is a mathematical proof that the Ephesus foot is definitely flat. CONCLUSION To the best of our knowledge, this picture from the first century AD is among the oldest representations of a flat foot in history.
Collapse
|
33
|
Periyasamy R, Anand S. The effect of foot arch on plantar pressure distribution during standing. J Med Eng Technol 2013; 37:342-7. [PMID: 23795697 DOI: 10.3109/03091902.2013.810788] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The aim of this study was to explore how foot type affects plantar pressure distribution during standing. In this study, 32 healthy subjects voluntarily participated and the subject feet were classified as: normal feet (n = 23), flat feet (n = 14) and high arch feet (n = 27) according to arch index (AI) values obtained from foot pressure intensity image analysis. Foot pressure intensity images were acquired by a pedopowergraph system to obtain a foot pressure distribution parameter-power ratio (PR) during standing in eight different regions of the foot. Contact area and mean PR were analysed in hind foot, mid-foot and fore foot regions. One-way analysis of variance was used to determine statistical differences between groups. The contact area and mean PR value beneath the mid-foot was significantly increased in the low arch foot when compared to the normal arch foot and high arch foot (p < 0.001) in both feet. However, subjects with low-arch feet had significantly higher body mass index (BMI) compared to subjects with high-arch feet (p < 0.05) and subjects with normal arch feet (p < 0.05) in both feet. In addition, subjects with low-arch feet had significant differences in arch index (AI) value as compared to subjects with high-arch feet (p < 0.001) and subjects with normal arch feet (p < 0.05) in both feet. Mean mid-foot PR value were positively (r = 0.54) correlated with increased arch index (AI) value. A significant (p < 0.05) change was obtained in PR value beneath the mid-foot of low arch feet when compared with other groups in both feet. The findings suggest that there is an increased mid-foot PR value in the low arch foot as compared to the normal arch foot and high arch foot during standing. Therefore, individuals with low arch feet could be at high risk for mid-foot collapse and Charcot foot problems, indicating that foot type should be assessed when determining an individual's risk for foot injury.
Collapse
Affiliation(s)
- R Periyasamy
- Center for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.
| | | |
Collapse
|