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Gómez-Carrión Á, Sánchez-Gómez R, Reguera-Medina JM, Martínez-Sebastián C, Márquez-Reina S, Coheña-Jiménez M, Moisan G. Effect of using a kinetic wedge during the hallux dorsiflexion resistance test in asymptomatic individuals. BMC Musculoskelet Disord 2024; 25:409. [PMID: 38783248 PMCID: PMC11118613 DOI: 10.1186/s12891-024-07520-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The hallux dorsiflexion resistance test is a frequently employed clinical maneuver for assessing the initiation of the windlass mechanism This maneuver involves dorsiflexion of the phalanx of the hallux, thereby evaluating plantarflexion of the first metatarsal, elevation of the medial longitudinal arch, and supination of the rearfoot. The windlass mechanism plays a crucial role in gait, and orthopedic devices, such as a kinetic wedge, which aims to facilitate its activation by increasing the hallux dorsiflexion. Although it is believed that facilitating the windlass mechanism with the kinetic wedge should be directly correlated with a decrease in hallux dorsiflexion resistance, its effects have yet to be characterized. Thus, this study aimed to determine the influence of a kinetic wedge on hallux dorsiflexion resistance in asymptomatic individuals. METHODS The sample comprised thirty participants (14 women and 16 men). A digital force gauge measured the force required to perform the hallux dorsiflexion resistance test during two conditions: barefoot and with a kinetic wedge. The Wilcoxon signed-rank test was used to compare the hallux dorsiflexion resistance between conditions. RESULTS A statistically significant reduction in force (10.54 ± 3.16N vs. 19.62 ± 5.18N, p < 0.001) was observed when using the kinetic wedge compared to the barefoot condition during the hallux dorsiflexion resistance test. CONCLUSION The use of a kinetic wedge reduces the required force for performing the passive hallux dorsiflexion resistance test in asymptomatic individuals. Future studies should determine to what extent the kinetic wedge can attenuate the required force to dorsiflex the hallux in individuals with musculoskeletal disorders such as plantar fasciopathy and functional hallux limitus.
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Affiliation(s)
- Álvaro Gómez-Carrión
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain.
| | - Rubén Sánchez-Gómez
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain
- IdISSC, Institute for Health Research. Hospital Clínico San Carlos, 28040, Madrid, Spain
| | | | - Carlos Martínez-Sebastián
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain
| | - Salvador Márquez-Reina
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, 41009, Seville, Spain
| | - Manuel Coheña-Jiménez
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, 41009, Seville, Spain
| | - Gabriel Moisan
- Department of Human Kinetics, Université du Québec À Trois-Rivières, Trois Rivières, Québec, Canada
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Jor A, Lau NWK, Daryabor A, Koh MWP, Lam WK, Hobara H, Kobayashi T. Effects of foot orthoses on running kinetics and kinematics: A systematic review and meta-analysis. Gait Posture 2024; 109:240-258. [PMID: 38367456 DOI: 10.1016/j.gaitpost.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/14/2024] [Accepted: 02/03/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Foot orthoses (FOs) are often prescribed by clinicians to treat foot and ankle conditions, prevent running injuries, and enhance performance. However, the lack of higher-order synthesis of clinical trials makes it challenging for clinicians to adopt an evidence-based approach to FOs' prescriptions. RESEARCH QUESTION Do FOs with different modifications alter lower extremity running kinematics and kinetics? METHODS A systematic search of seven databases was conducted from inception to February 2023. The analysis was restricted to healthy adults without foot musculoskeletal impairments and studies that compared the FOs effects with the controls. The methodological quality of the 35 studies that met the eligibility criteria was evaluated using the modified Downs and Black checklist. The random effects model estimated the standardized mean difference (SMD) with 95% confidence intervals and effect sizes. Sub-group analyses based on FOs type were performed to assess the potential effects of the intervention. RESULTS Our findings indicated that both custom and off-the-shelf arch-support FOs reduced peak plantar pressure at the medial heel (SMD=-0.35, and SMD=-1.03), lateral heel (SMD=-0.50, and SMD=-0.53), and medial forefoot (SMD=-0.20, and SMD=-0.27), but increased plantar pressure at the mid-foot (SMD=0.30, and SMD=0.56). Compared with the controls, significant increases (SMD=0.36) in perceived comfort were found with custom FOs. A reduction (SMD=-0.58) in initial ankle inversion was found when a raised heel cup was integrated with arch-support FOs. A medial post integrated with arch support exhibited a reduced ankle (SMD=-1.66) and tibial (SMD=-0.63) range of motion. Custom FOs, however, unfavorably affected the running economy (SMD=-0.25) and perceived exertion (SMD=0.20). SIGNIFICANCE Although FOs have been reported to have some positive biomechanical effects in healthy populations without musculoskeletal impairments or running-related issues, they need to be optimized and generalized to achieve better running performance and prevent injury.
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Affiliation(s)
- Abu Jor
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China; Department of Leather Engineering, Faculty of Mechanical Engineering, Khulna University of Engineering & Technology, Khulna, Bangladesh
| | - Noelle W K Lau
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Aliyeh Daryabor
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mark W P Koh
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong, China
| | - Hiroaki Hobara
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
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Moisan G, Griffiths I, Chicoine D. Flat feet: deformities or healthy anatomical variants? Br J Sports Med 2023; 57:1536-1537. [PMID: 37586781 DOI: 10.1136/bjsports-2023-107183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 08/18/2023]
Affiliation(s)
- Gabriel Moisan
- Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
| | - Ian Griffiths
- Sports and Exercise Medicine, Queen Mary University of London, London, UK
| | - Dominic Chicoine
- Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
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Janowski AJ, Post AA, Heredia-Rizo AM, Mosby H, Dao M, Law LF, Bayman EO, Wilken JM, Sluka KA, Chimenti RL. Patterns of movement-evoked pain during tendon loading and stretching tasks in Achilles tendinopathy: A secondary analysis of a randomized controlled trial. Clin Biomech (Bristol, Avon) 2023; 109:106073. [PMID: 37657267 PMCID: PMC10543613 DOI: 10.1016/j.clinbiomech.2023.106073] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND This study aimed to characterize movement-evoked pain during tendon loading and stretching tasks in individuals with Achilles tendinopathy, and to examine the association between movement-evoked pain with the Achilles tendinopathy type (insertional and midportion), biomechanical, and psychological variables. METHODS In this laboratory-based, cross-sectional study, 37 individuals with chronic Achilles tendinopathy participated. Movement-evoked pain intensity (Numeric Rating Scale: 0 to 10) and sagittal-plane ankle biomechanics were collected simultaneously during standing, fast walking, single-leg heel raises, and weight-bearing calf stretch. Description of symptoms, including location of Achilles tendon pain and duration of tendon morning stiffness, as well as pain-related psychological measures, including the Tampa Scale of Kinesiophobia were collected. Linear mixed effects models were built around two paradigms of movement-evoked pain (tendon loading and stretching tasks) with each model anchored with pain at rest. FINDINGS Movement-evoked pain intensity increased as task demand increased in both models. Lower peak dorsiflexion with walking (β = -0.187, 95% CI: -0.305, -0.069), higher fear of movement (β = 0.082, 95% CI: 0.018, 0.145), and longer duration of tendon morning stiffness (β = 0.183, 95% CI: 0.07, 0.296) were associated with greater pain across tendon loading tasks (R2 = 0.47). Lower peak dorsiflexion with walking (β = -0.27, 95% CI: -0.41, -0.14), higher dorsiflexion with the calf stretch (β = 0.095, 95% CI: 0.02, 0.16), and insertional Achilles tendinopathy (β = -0.93, 95% CI: -1.65, -0.21) were associated with higher pain across tendon stretching tasks (R2 = 0.53). INTERPRETATION In addition to exercise, the ideal management of Achilles tendinopathy may require adjunct treatments to address the multifactorial aspects of movement-evoked pain.
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Affiliation(s)
- Adam J Janowski
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA.
| | - Andrew A Post
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - Alberto M Heredia-Rizo
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy, and Podiatry, University of Seville, Spain; Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Spain
| | - Hadley Mosby
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - Megan Dao
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - Laura Frey Law
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - Emine O Bayman
- Department of Biostatistics and Department of Anesthesia, University of Iowa, Iowa City, IA, USA
| | - Jason M Wilken
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - Kathleen A Sluka
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - Ruth L Chimenti
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
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Xiang L, Gu Y, Wang A, Shim V, Gao Z, Fernandez J. Foot Pronation Prediction with Inertial Sensors during Running: A Preliminary Application of Data-Driven Approaches. J Hum Kinet 2023; 87:29-40. [PMID: 37559759 PMCID: PMC10407326 DOI: 10.5114/jhk/163059] [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: 11/07/2022] [Accepted: 03/01/2023] [Indexed: 08/11/2023] Open
Abstract
Abnormal foot postures may affect foot movement and joint loading during locomotion. Investigating foot posture alternation during running could contribute to injury prevention and foot mechanism study. This study aimed to develop feature-based and deep learning algorithms to predict foot pronation during prolonged running. Thirty-two recreational runners have been recruited for this study. Nine-axial inertial sensors were attached to the right dorsum of the foot and the vertical axis of the distal anteromedial tibia. This study employed feature-based machine learning algorithms, including support vector machine (SVM), extreme gradient boosting (XGBoost), random forest, and deep learning, i.e., one-dimensional convolutional neural networks (CNN1D), to predict foot pronation. A custom nested k-fold cross-validation was designed for hyper-parameter tuning and validating the model's performance. The XGBoot classifier achieved the best accuracy using acceleration and angular velocity data from the foot dorsum as input. Accuracy and the area under curve (AUC) were 74.7 ± 5.2% and 0.82 ± 0.07 for the subject-independent model and 98 ± 0.4% and 0.99 ± 0 for the record-wise method. The test accuracy of the CNN1D model with sensor data at the foot dorsum was 74 ± 3.8% for the subject-wise approach with an AUC of 0.8 ± 0.05. This study found that these algorithms, specifically for the CNN1D and XGBoost model with inertial sensor data collected from the foot dorsum, could be implemented into wearable devices, such as a smartwatch, for monitoring a runner's foot pronation during long-distance running. It has the potential for running shoe matching and reducing or preventing foot posture-induced injuries.
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Affiliation(s)
- Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Zixiang Gao
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Faculty of Engineering, University of Pannonia, Veszprém, Hungary
| | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Department of Engineering Science, Faculty of Engineering, The University of Auckland, Auckland, New Zealand
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Young JL, Sell TC, Boeth R, Foster K, Greenlee TA, Rhon DI. What is the Incidence of Subsequent Adjacent Joint Injury After Patellofemoral Pain? Clin Rehabil 2023:2692155231157177. [PMID: 36793225 DOI: 10.1177/02692155231157177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To investigate the incidence of subsequent lumbar spine, hip, and ankle-foot injuries after a diagnosis of patellofemoral pain. DESIGN Retrospective cohort study. SETTING Military Health System. PARTICIPANTS Individuals (n = 92,319) ages 17-60 diagnosed with patellofemoral pain between 2010-2011. INTERVENTIONS Therapeutic exercise. MAIN OUTCOME MEASURES Frequency of adjacent joint injuries in the 2-year period after initial patellofemoral pain injury, and hazard ratios (HR) with 95% confidence interval (CI) and Kaplan-Meier survival curves for risk of adjacent joint injury based on receiving therapeutic exercise for the initial injury. RESULTS After initial patellofemoral pain diagnosis, 42,983 (46.6%) individuals sought care for an adjacent joint injury. Of these, 19,587 (21.2%) were subsequently diagnosed with a lumbar injury, 2837 (3.1%) a hip injury, and 10,166 (11.0%) an ankle-foot injury. One in five (19.5%; n = 17,966) received therapeutic exercise which reduced the risk of having a subsequent lumbar (HR = 0.78, 95% CI 0.76-0.81), hip (HR = 0.93, 95% CI 0.87-0.98) or ankle-foot (HR = 0.86, 95% CI 0.83-0.90) injury. CONCLUSION The results suggest that a high number of individuals with patellofemoral pain will sustain an adjacent joint injury within 2 years although causal relationships cannot be determined. Receiving therapeutic exercise for the initial knee injury reduced the risk of sustaining an adjacent joint injury. This study helps provide normative data for subsequent injury rates in this population and guide development of future studies designed to understand causal factors.
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Affiliation(s)
- Jodi L Young
- 15638Physical Therapy Department, Bellin College, Green Bay, WI, USA.,104849The Geneva Foundation, Tacoma, WA, USA
| | - Timothy C Sell
- 2351Department of Orthopedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC, USA
| | - Riley Boeth
- 104849The Geneva Foundation, Tacoma, WA, USA
| | - Kaitlyn Foster
- 104849The Geneva Foundation, Tacoma, WA, USA.,Department of Rehabilitation Medicine, 3998Brooke Army Medical Center, San Antonio, TX, USA
| | - Tina A Greenlee
- 104849The Geneva Foundation, Tacoma, WA, USA.,Department of Rehabilitation Medicine, 3998Brooke Army Medical Center, San Antonio, TX, USA
| | - Daniel I Rhon
- 104849The Geneva Foundation, Tacoma, WA, USA.,Department of Rehabilitation Medicine, 3998Brooke Army Medical Center, San Antonio, TX, USA.,Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Malisoux L, Gette P, Backes A, Delattre N, Theisen D. Lower impact forces but greater burden for the musculoskeletal system in running shoes with greater cushioning stiffness. Eur J Sport Sci 2023; 23:210-220. [PMID: 35014593 DOI: 10.1080/17461391.2021.2023655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In a recent randomised trial investigating running shoe cushioning, injury risk was greater in recreational runners who trained in the shoe version with greater cushioning stiffness (Stiff) compared to those using the Soft version. However, vertical impact peak force (VIPF) was lower in the Stiff version. To investigate further the mechanisms involved in the protective effect of greater cushioning, the present study used an intra-subject design and analysed the differences in running kinematics and kinetics between the Stiff and Soft shoe versions on a subsample of 41 runners from the previous trial. Data were recorded in the two shoe conditions using an instrumented treadmill at 10 km.h-1. VIPF was confirmed to be lower in the Stiff version compared to the Soft version (1.39 ± 0.25 vs. 1.50 ± 0.25 BW, respectively; p = 0.009, d = 0.42), but not difference was observed in vertical loading rate (p = 0.255 and 0.897 for vertical average and instantaneous loading rate, respectively). Ankle eversion maximal velocity was not different (p = 0.099), but the Stiff version induced greater ankle negative work (-0.55 ± 0.09 vs. -0.52 ± 0.10 J.kg-1; p = 0.009, d = 0.32), maximal ankle negative power (-7.21 ± 1.90 vs. -6.96 ± 1.92 W.kg-1; p = 0.037, d = 0.13) and maximal hip extension moment (1.25 ± 0.32 vs.1.18 ± 0.30 N.m.kg-1; p = 0.009, d = 0.22). Our results suggest that the Stiff shoe version is related to increased mechanical burden for the musculoskeletal system, especially around the ankle joint.Trial registration: ClinicalTrials.gov identifier: NCT03115437.
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport & Health Research Group, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Paul Gette
- Human Motion, Orthopaedics, Sports Medicine and Digital Methods, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Anne Backes
- Physical Activity, Sport & Health Research Group, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Nicolas Delattre
- Movement Sciences Department, Decathlon Sports Lab, Villeneuve d'Ascq, France
| | - Daniel Theisen
- ALAN - Maladies Rares Luxembourg, Bascharage, Grand-Duchy of Luxembourg
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A Pilot Study of Plantar Mechanics Distributions and Fatigue Profiles after Running on a Treadmill: Using a Support Vector Machine Algorithm. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:7461729. [PMID: 36890878 PMCID: PMC9988392 DOI: 10.1155/2023/7461729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/06/2022] [Accepted: 10/12/2022] [Indexed: 02/25/2023]
Abstract
The treadmill is widely used in running fatigue experiments, and the variation of plantar mechanical parameters caused by fatigue and gender, as well as the prediction of fatigue curves by a machine learning algorithm, play an important role in providing different training programs. This experiment aimed to compare changes in peak pressure (PP), peak force (PF), plantar impulse (PI), and gender differences of novice runners after they were fatigued by running. A support vector machine (SVM) was used to predict the fatigue curve according to the changes in PP, PF, and PI before and after fatigue. 15 healthy males and 15 healthy females completed two runs at a speed of 3.3 m/s ± 5% on a footscan pressure plate before and after fatigue. After fatigue, PP, PF, and PI decreased at hallux (T1) and second-fifth toes (T2-5), while heel medial (HM) and heel lateral (HL) increased. In addition, PP and PI also increased at the first metatarsal (M1). PP, PF, and PI at T1 and T2-5 were significantly higher in females than in males, and metatarsal 3-5 (M3-5) were significantly lower in females than in males. The SVM classification algorithm results showed the accuracy was above average level using the T1 PP/HL PF (train accuracy: 65%; test accuracy: 75%), T1 PF/HL PF (train accuracy: 67.5%; test accuracy: 65%), and HL PF/T1 PI (train accuracy: 67.5%; test accuracy: 70%). These values could provide information about running and gender-related injuries, such as metatarsal stress fractures and hallux valgus. Application of the SVM to the identification of plantar mechanical features before and after fatigue. The features of the plantar zones after fatigue can be identified and the learned algorithm of plantar zone combinations with above-average accuracy (T1 PP/HL PF, T1 PF/HL PF, and HL PF/T1 PI) can be used to predict running fatigue and supervise training. It provided an important idea for the detection of fatigue after running.
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An exploration of the effects of prefabricated and customized insoles on lower limb kinetics and kinematics during walking, stepping up and down tasks: A time series analysis. Gait Posture 2022; 98:297-304. [PMID: 36257239 DOI: 10.1016/j.gaitpost.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 07/29/2022] [Accepted: 10/06/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Prefabricated and customized insoles are used in clinical practice to reduce foot pronation. Although data exist on the effects at key points within the stance phase, exploring the impact of different insoles using time series analysis may reveal more detail about their efficacy. RESEARCH QUESTION What are the effects revealed by a time series analysis of arch-supported prefabricated insoles (PREFABRICATED) versus arch-supported prefabricated insoles customized with a 6º medial wedge (CUSTOMIZED) on the lower limb biomechanics during walking, stepping up and down tasks in individuals with pronated feet? METHODS Nineteen individuals with excessive foot pronation performed walking, stepping up and down tasks using three insoles: CONTROL (flat insole), CUSTOMIZED, and PREFABRICATED. Angles and moments of ankle and knee coronal and hip transverse planes were compared between conditions using statistical parametric mapping (SPM). RESULTS For walking, CUSTOMIZED reduced ankle eversion moment compared to CONTROL during midstance and PREFABRICATED during propulsion. CUSTOMIZED decreased KAM during midstance and propulsion compared to PREFABRICATED. Compared to CONTROL, CUSTOMIZED and PREFABRICATED reduced hip internal rotation during propulsion and loading response, respectively. CUSTOMIZED decreased eversion movement during midstance and propulsion for the stepping up task. PREFABRICATED reduced eversion movement during midstance in comparison to CONTROL. For the stepping down task, CUSTOMIZED increased eversion movement during propulsion compared to PREFABRICATED. CUSTOMIZED reduced hip internal rotation angle for stepping up task during propulsion, decreased medial rotation movement during midstance compared to CONTROL, and reduced medial rotation during midstance compared to PREFABRICATED. CUSTOMIZED increased KAM for stepping up and down tasks during propulsion. SIGNIFICANCE These findings suggest that both CUSTOMIZED and PREFABRICATED reduce foot pronation. However, non-local effects, such as changes in KAM and hip internal rotation, were seen only in the CUSTOMIZED. Therefore, CUSTOMIZED may be preferable if the objective is to modify the knee and hip mechanics.
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Effects of Foot Orthoses on Pain and the Prevention of Lower Limb Injuries in Runners: Systematic Review and Meta-Analysis. J Sport Rehabil 2022; 31:1067-1074. [PMID: 35894921 DOI: 10.1123/jsr.2021-0302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 04/02/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT A variety of approaches have been proposed to prevent lower limb injuries in runners. However, the evidence for the effectiveness of interventions to reduce lower limb pain and injury after intensive running is very weak. OBJECTIVE The authors performed a systematic review to investigate the effects of foot orthoses on pain and the prevention of lower limb injuries in runners. EVIDENCE ACQUISITION The authors searched the MEDLINE/PubMed, Physiotherapy Evidence Database, Scielo, and Cochrane Central (from inception to February 2022) databases for randomized controlled trials that evaluated the effects of foot orthoses in runners. The authors then calculated mean differences and 95% confidence intervals from these trials. Heterogeneity was assessed using the I2 test. Furthermore, the authors compared the criteria between runners with foot orthoses and ones with no intervention (control group). EVIDENCE SYNTHESIS Twelve studies (5321 runners) met our review criteria. The control and the foot orthoses group sustained 721 (37%) and 238 (24%) injuries, respectively. Compared with the control group, the use of foot orthoses resulted in a significant reduction in lower limb injury risk (risk ratio = 0.6; 95% confidence interval, 0.5-0.7; P = .00001, I2 = 54%; 7 studies, N = 2983: moderate-quality evidence). Moreover, the foot orthoses group corresponded to a 40% reduction in the risk of developing lower limb injuries. CONCLUSIONS The use of foot orthoses may help reduce the incidence of lower limb injuries and pain in runners.
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Ho M, Nguyen J, Heales L, Stanton R, Kong PW, Kean C. The biomechanical effects of 3D printed and traditionally made foot orthoses in individuals with unilateral plantar fasciopathy and flat feet. Gait Posture 2022; 96:257-264. [PMID: 35709609 DOI: 10.1016/j.gaitpost.2022.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Foot orthoses (FOs) are used to manage foot pathologies such as plantar fasciopathy. 3D printed custom-made FOs are increasingly being manufactured. Although these 3D-printed FOs look like traditionally heat-moulded FOs, there are few studies comparing FOs made using these two different manufacturing processes. RESEARCH QUESTION How effective are 3D-printed FOs (3D-Print) compared to traditionally-made (Traditional) or no FOs (Control), in changing biomechanical parameters of flat-footed individuals with unilateral plantar fasciopathy? METHODS Thirteen participants with unilateral plantar fasciopathy walked with shoes under three conditions: Control, 3D-print, and Traditional. 2 × 3 repeated measures analysis of variance (ANOVAs) with Bonferroni post-hoc tests were used to compare discrete kinematic and kinetic variables between limbs and conditions. Waveform analyses were also conducted using statistical parametric mapping (SPM). RESULTS There was a significant condition main effect for arch height drop (p = 0.01; ηp2 =0.54). There was 0.87 mm (95% CI [-1.84, -0.20]) less arch height drop in 3D-print compared to Traditional. The SPM analyses revealed condition main effects on ankle moment (p < 0.001) and ankle power (p < 0.001). There were significant differences between control condition and both 3D-print and Traditional conditions. For ankle moment and power, there were no differences between 3D-print and Traditional conditions. SIGNIFICANCE 3D-printed FOs are more effective in reducing arch height drop, whist both FOs lowered ankle plantarflexion moment and power compared to no FOs. The results support the use of 3D-printed FOs as being equally effective as traditionally-made FOs in changing lower limb biomechanics for a population of flat-footed individuals with unilateral plantar fasciopathy.
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Affiliation(s)
- Malia Ho
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Julie Nguyen
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Luke Heales
- Department of Physiotherapy, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Robert Stanton
- Department of Exercise and Sports Science, School of Health, Medical and Applied Sciences, CQUniversity Australia, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Pui W Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore.
| | - Crystal Kean
- Department of Exercise and Sports Science, School of Health, Medical and Applied Sciences, CQUniversity Australia, Bruce Highway, North Rockhampton, QLD 4701, Australia.
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12
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Jafarnezhadgero AA, Fatollahi A, Granacher U. Eight Weeks of Exercising on Sand Has Positive Effects on Biomechanics of Walking and Muscle Activities in Individuals with Pronated Feet: A Randomized Double-Blinded Controlled Trial. Sports (Basel) 2022; 10:sports10050070. [PMID: 35622479 PMCID: PMC9146857 DOI: 10.3390/sports10050070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/23/2022] [Accepted: 04/28/2022] [Indexed: 12/04/2022] Open
Abstract
This study aimed to investigate the effects of eight weeks of barefoot running exercise on sand versus control on measures of walking kinetics and muscle activities in individuals with diagnosed pronated feet. Sixty physically active male adults with pronated feet were randomly allocated into an intervention or a waiting control group. The intervention group conducted an 8-weeks progressive barefoot running exercise program on sand (e.g., short sprints) with three weekly sessions. Pre and post intervention, participants walked at a constant speed of 1.3 m/s ± 5% on a 18 m walkway with a force plate embedded in the middle of the walkway. Results showed significant group-by-time interactions for peak impact vertical and lateral ground reaction forces. Training but not control resulted in significantly lower peak impact vertical and lateral ground reaction forces. Significant group-by-time interactions were observed for vastus lateralis activity during the loading phase. Training-induced increases were found for the vastus lateralis in the intervention but not in the control group. This study revealed that the applied exercise program is a suitable means to absorb ground reaction forces (e.g., lower impact vertical and lateral peaks) and increase activities of selected lower limb muscles (e.g., vastus lateralis) when walking on stable ground.
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Affiliation(s)
- Amir Ali Jafarnezhadgero
- Department of Sport Managements and Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil 56131-56491, Iran; (A.A.J.); (A.F.)
| | - Amir Fatollahi
- Department of Sport Managements and Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil 56131-56491, Iran; (A.A.J.); (A.F.)
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, 14469 Potsdam, Germany
- Correspondence: ; Tel.: +49-331-977-1543
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13
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Carrasco AC, Silva MF, Guenka LC, Silva CT, Moura FA, Cardoso JR. Non-radiographic validity and reliability measures for assessing foot types: A systematic review. Foot Ankle Surg 2021; 27:839-850. [PMID: 33431323 DOI: 10.1016/j.fas.2020.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 11/18/2020] [Accepted: 11/29/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Foot type classification is well recognized in clinical practice and orthopedic literature, a universally accepted classification or standardized measures to determine foot types are lacking. The objective of this study was to identify which non-radiographic assessment methods are considered valid and/or reliable for the classification of foot types. METHOD A systematic database search was performed. Only cross-sectional studies that performed reliability and/or validity analysis of non-radiographic methods were included. To evaluate the risk of bias, the Critical Appraisal Tool (CAT) was used to evaluate the measurement properties of objective clinical methods. RESULTS Twenty-six studies were included. The results of reliability and validity, in general, demonstrated high scores, but, inconsistencies were related to the variability of the measurements, heterogeneity of the methods used to determine reliability and validity, and lack of parameters for classifying foot types, which resulted in few elements to determine which method of foot type evaluation is valid and reliable. CONCLUSION Given the Intraclass Correlation Coefficient and CAT results and the presence of normative values, the static measurements of the "Arch Height Index", "Foot Posture Index", and "Staheli Arch Index" can be suggested to classify foot types.
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Affiliation(s)
- Aline C Carrasco
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil; Universidade Estadual do Centro-Oeste, Guarapuava, PR, Brazil
| | - Mariana F Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Leandro C Guenka
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Carla T Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Felipe A Moura
- Laboratory of Applied Biomechanics, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Jefferson R Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil.
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14
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Doğan A, Şengül İ, Aşkın A, Tosun A. Effect of static knee joint flexion on vastus medialis obliquus fiber angle in patellofemoral pain syndrome: An ultrasonographic study. PM R 2021; 14:802-810. [PMID: 34165244 DOI: 10.1002/pmrj.12655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/30/2021] [Accepted: 06/11/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION In patients with patellofemoral pain syndrome, the vastus medialis obliquus muscle fiber angle measured by ultrasound at knee extension was found to be different from that in healthy individuals. An important feature of patellofemoral pain syndrome is the increase in pain severity during activities that require knee flexion. OBJECTIVE To investigate whether there was an ultrasonographic change in the vastus medialis obliquus fiber angle by flexing the knee joint in patients with patellofemoral pain syndrome compared to healthy pain-free individuals. DESIGN A cross-sectional clinical study. SETTING An outpatient clinic of a tertiary care hospital. PARTICIPANTS Forty-seven patients with patellofemoral pain syndrome (median age of 40 years) and 43 healthy volunteers (median age of 39 years) were included in the study. INTERVENTIONS No intervention. MAIN OUTCOME MEASURES Vastus medialis obliquus fiber angle measured by ultrasonography at three different positions of knee joint including extension, 30° of flexion, and 45° of flexion. RESULTS There was no significant change in the vastus medialis obliquus fiber angle with knee flexion in both groups (p > .05 for each group). However, the median vastus medialis obliquus fiber angle values in the group with patellofemoral pain syndrome were significantly lower at all knee joint angles than those in the comparison group (p < .05 at all knee joint angles). CONCLUSIONS Although the vastus medialis obliquus fiber angle does not change with static knee flexion, the lower angle of the vastus medialis obliquus fiber in those with patellofemoral pain syndrome implicitly suggests that vastus medialis obliquus dysfunction may exist.
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Affiliation(s)
- Ali Doğan
- Department of Physical Medicine and Rehabilitation, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - İlker Şengül
- Department of Physical Medicine and Rehabilitation, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Ayhan Aşkın
- Department of Physical Medicine and Rehabilitation, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Aliye Tosun
- Department of Physical Medicine and Rehabilitation, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
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15
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Park DJ, Lee KS, Park SY. Effects of Two Foot-Ankle Interventions on Foot Structure, Function, and Balance Ability in Obese People with Pes Planus. Healthcare (Basel) 2021; 9:667. [PMID: 34205155 PMCID: PMC8229031 DOI: 10.3390/healthcare9060667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022] Open
Abstract
Obese people are prone to foot deformities such as flat feet. Foot management programs are important to prevent them. This study investigated the effects of two foot-ankle interventions on balance ability, foot arch, ankle strength, plantar fascia thickness, and foot functions in obese people with pes planus for four weeks. The experiment was designed as a randomized controlled trial. Twenty-four participants who met the inclusion criteria were selected, and they were randomly assigned to either a short foot group (SFG) or proprioceptive neuromuscular facilitation group (PNFG) according to foot-ankle intervention. Two interventions were commenced three times a week for 20 min over four weeks. The tests were conducted at two intervals: pre-intervention and at four weeks. The tests were conducted in the following order: the patient-specific functional scale test (PSFS), an ultrasound of the plantar fascia, the navicular drop test, balance test, and the four-way ankle strength test. Two groups showed significant differences in balance ability, foot arch, ankle strength, plantar fascia thickness, and foot functions between pre-test and post-test (p < 0.05). PNFG had significantly higher dorsiflexor and invertor strength than SFG (p < 0.05). SF and PNF interventions were effective to improve balance ability, foot arch, ankle strength, plantar fascia thickness, and foot functions in obese people with pes planus. Additionally, PNF intervention is more beneficial in increasing the dorsiflexor and invertor strength compared to SF intervention.
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Affiliation(s)
- Du-Jin Park
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan 46252, Korea;
| | - Kyung-Sun Lee
- Department of Industrial Health, College of Health Sciences, Catholic University of Pusan, Busan 46252, Korea;
| | - Se-Yeon Park
- Department of Physical Therapy, Uiduk University, Gyeongju 38004, Korea
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16
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Sakamoto K, Tsujioka C, Sasaki M, Miyashita T, Kitano M, Kudo S. Validity and reproducibility of foot motion analysis using a stretch strain sensor. Gait Posture 2021; 86:180-185. [PMID: 33756406 DOI: 10.1016/j.gaitpost.2021.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/15/2021] [Accepted: 03/03/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Multi-segment foot analysis is traditionally challenging to perform while subjects are wearing footwear or a foot orthosis and is difficult to apply in the clinical setting. A recently developed stretch strain sensor (STR), that is thin and highly flexible, may solve this limitation because it does not require observation using a camera and is highly portable. RESEARCH QUESTION This study aimed to examine the reproducibility and validity of foot motion analysis using the STR during walking and running by comparing it with a conventional motion capture system. METHODS Twenty-one healthy participants were examined in this study. The STR was placed on the participant's foot in one of two locations in separate experiments (spring ligament; SL and navicular drop; ND methods). Foot kinematic data during walking and running were simultaneously recorded using the STR and a three-dimensional motion capture system. Intra-class correlation (ICC) was used to assess test-retest reproducibility of the STR method. Cross-correlation coefficient evaluated the similarity of the pattern of the signals between the two systems. Pearson and Spearman correlation analysis was used to evaluate the relationships between the STR measurement and angular excursion of the forefoot or hindfoot. RESULTS The ICCs of the SL method were 0.95 and 0.96, and those of the ND method were 0.93 and 0.71 during walking and running, respectively. In the SL method, the pattern of the signals between the STR and forefoot frontal motion was strongly correlated. The STR measurement was significantly correlated with forefoot eversion excursion (walking: r=-0.67, running: r=-0.64, p < 0.01 each). In the ND method, the STR signal was not associated with forefoot and hindfoot kinematics. SIGNIFICANCE Our results showed that the STR has acceptable reproducibility and validity of foot motion analysis. This system may enable measurement of foot motion while subjects are wearing shoes and outside the laboratory.
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Affiliation(s)
- Kodai Sakamoto
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16 Nankokita Suminoe Ward Osaka City Osaka Prefecture, 559-8611, Japan
| | - Chie Tsujioka
- Department of Physical Therapy, Morinomiya University of Medical Sciences, 1-26-16 Nankokita Suminoe Ward Osaka City Osaka Prefecture, 559-8611, Japan
| | - Megumi Sasaki
- Department of Physical Therapy, Morinomiya University of Medical Sciences, 1-26-16 Nankokita Suminoe Ward Osaka City Osaka Prefecture, 559-8611, Japan
| | - Toshinori Miyashita
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16 Nankokita Suminoe Ward Osaka City Osaka Prefecture, 559-8611, Japan; Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, Osaka, 1-26-16 Nankokita Suminoe Ward Osaka City Osaka Prefecture, 559-8611, Japan
| | - Masashi Kitano
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16 Nankokita Suminoe Ward Osaka City Osaka Prefecture, 559-8611, Japan; Yamamuro Orthopedic Clinic Postal Address, 44-1 Yamamuro, Toyama-shi, Toyama, 939-8006, Japan.
| | - Shintarou Kudo
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16 Nankokita Suminoe Ward Osaka City Osaka Prefecture, 559-8611, Japan; Department of Physical Therapy, Morinomiya University of Medical Sciences, 1-26-16 Nankokita Suminoe Ward Osaka City Osaka Prefecture, 559-8611, Japan; Inclusive Medical Science Research Institute, Morinomiya University of Medical Science, Osaka, 1-26-16 Nankokita Suminoe Ward Osaka City Osaka Prefecture, 559-8611, Japan.
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17
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Hunt MA, Charlton JM, Felson DT, Liu A, Chapman GJ, Graffos A, Jones RK. Frontal plane knee alignment mediates the effect of frontal plane rearfoot motion on knee joint load distribution during walking in people with medial knee osteoarthritis. Osteoarthritis Cartilage 2021; 29:678-686. [PMID: 33582238 DOI: 10.1016/j.joca.2021.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/08/2021] [Accepted: 02/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the nature of differences in the relationship between frontal plane rearfoot kinematics and knee adduction moment (KAM) magnitudes. DESIGN Cross-sectional study resulting from a combination of overground walking biomechanics data obtained from participants with medial tibiofemoral osteoarthritis at two separate sites. Statistical models were created to examine the relationship between minimum frontal plane rearfoot angle (negative values = eversion) and different measures of the KAM, including examination of confounding, mediation, and effect modification from knee pain, radiographic disease severity, static rearfoot alignment, and frontal plane knee angle. RESULTS Bivariable relationships between minimum frontal plane rearfoot angle and the KAM showed consistent negative correlations (r = -0.411 to -0.447), indicating higher KAM magnitudes associated with the rearfoot in a more everted position during stance. However, the nature of this relationship appears to be mainly influenced by frontal plane knee kinematics. Specifically, frontal plane knee angle during gait was found to completely mediate the relationship between minimum frontal plane rearfoot angle and the KAM, and was also an effect modifier in this relationship. No other variable significantly altered the relationship. CONCLUSIONS While there does appear to be a moderate relationship between frontal plane rearfoot angle and the KAM, any differences in the magnitude of this relationship can likely be explained through an examination of frontal plane knee angle during walking. This finding suggests that interventions derived distal to the knee should account for the effect of frontal plane knee angle to have the desired effect on the KAM.
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Affiliation(s)
- M A Hunt
- Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia: Vancouver, BC, Canada.
| | - J M Charlton
- Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia: Vancouver, BC, Canada.
| | - D T Felson
- Department of Rheumatology, Boston University School of Medicine, Boston, MA, USA; NIHR Manchester Musculoskeletal Biomedical Research Centre, Manchester, UK; Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
| | - A Liu
- School of Health and Society, University of Salford: Manchester, UK.
| | - G J Chapman
- School of Sport and Health Sciences, University of Central Lancashire: Preston, UK.
| | - A Graffos
- Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia: Vancouver, BC, Canada.
| | - R K Jones
- School of Health and Society, University of Salford: Manchester, UK.
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18
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Miyazaki T, Kawada M, Kiyama R, Yone K. Validity of two-dimensional analysis using a tablet computer for estimation of foot arch height during walking. J Phys Ther Sci 2021; 33:194-198. [PMID: 33814703 PMCID: PMC8012182 DOI: 10.1589/jpts.33.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/01/2020] [Indexed: 12/04/2022] Open
Abstract
[Purpose] To examine the validity of two-dimensional analysis using a tablet computer
for the estimation of arch height during walking by comparing it with a motion capture
system and static foot alignment screenings. [Participants and Methods] Fourteen healthy
males and 15 healthy females participated in this study. The arch height of the right foot
while walking was simultaneously measured using a tablet computer and motion capture
system. Dynamic foot alignment, including arch height, at the mid-stance and pre-swing
phases was calculated from the kinematic data measured using the tablet computer and
motion analysis system. Static foot alignment was also assessed by screening tests
including arch height index and foot posture index. [Results] Arch height measured using a
tablet computer showed a significant high correlation with that measured using the motion
capture system at the mid-stance and pre-swing phases. Arch height index showed a
significant moderate correlation with arch height measured using the motion capture system
at the mid-stance phase. Meanwhile, foot posture index showed no relationship with arch
height measured by the motion capture system. [Conclusion] These results demonstrate the
high validity of dynamic foot analysis using a tablet computer for the estimation of arch
height during walking. Such gait analysis can be effective for assessing dynamic foot
alignment in clinical practice.
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Affiliation(s)
- Takasuke Miyazaki
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan.,Department of Rehabilitation, Tarumizu Municipal Medical Center, Tarumizu Central Hospital, Japan
| | - Masayuki Kawada
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan
| | - Ryoji Kiyama
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan
| | - Kazunori Yone
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan
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19
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Ugbolue UC, Yates EL, Rowland KE, Wearing SC, Gu Y, Lam WK, Baker JS, Sculthorpe NF, Dutheil F. A novel simplified biomechanical assessment of the heel pad during foot plantarflexion. Proc Inst Mech Eng H 2020; 235:197-207. [PMID: 33148117 DOI: 10.1177/0954411920971069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The heel pad (HP) which is located below the calcaneus comprises a composition of morphometrical and morphological arrangements of soft tissues that are influenced by factors such as gender, age and obesity. It is well known that HP pain and Achilles tendonitis consist of discomfort, pain and swelling symptoms that usually develop from excessive physical activities such as walking, jumping and running. The purpose of this study was to develop biomechanical techniques to evaluate the function and characteristics of the HP. Ten healthy participants (five males and five females) participated in this laboratory-based study, each performing a two-footed heel raise to mimic the toe-off phase during human locomotion. Twenty-six (3 mm) retroreflective markers were attached to the left and right heels (thirteen markers on each heel). Kinematic data was captured using three-dimensional motion analysis cameras synchronised with force plates. Descriptive and multivariate statistical tests were used in this study. In addition, a biomechanical technique that utilises only six markers from 26 markers to assess HP deformation and function has been developed and used in this study. Overall HP displacement was significantly higher in males on the most lateral part of the right heel (p < 0.05). No significant differences were evident when comparing the non-dominant and dominant heels during the baseline, unloading and loading phases (p > 0.05). Findings from this study suggested that biomechanical outputs expressed as derivatives from tracked HP marker movements can morphologically and morphometrically characterise HP soft tissue deformation changes. The outcome of this study highlights the importance of 3D motion analysis being used as a potential prospective intervention to quantify the function / characteristics of the heel pad soft tissues.
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Affiliation(s)
- Ukadike C Ugbolue
- Faculty of Sports Science, Ningbo University, China.,School of Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, South Lanarkshire, Scotland, UK.,Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Emma L Yates
- School of Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, South Lanarkshire, Scotland, UK
| | - Keir E Rowland
- School of Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, South Lanarkshire, Scotland, UK
| | - Scott C Wearing
- Faculty of Health, School - Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, China
| | - Wing-Kai Lam
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Co. Ltd, Beijing, China.,Department of Kinesiology, Shenyang Sports University, Shenyang, China
| | - Julien S Baker
- Faculty of Sports Science, Ningbo University, China.,School of Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, South Lanarkshire, Scotland, UK.,Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Nicholas F Sculthorpe
- School of Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, South Lanarkshire, Scotland, UK
| | - Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France.,Faculty of Health, School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia
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20
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Naderi A, Moen MH, Degens H. Is high soleus muscle activity during the stance phase of the running cycle a potential risk factor for the development of medial tibial stress syndrome? A prospective study. J Sports Sci 2020; 38:2350-2358. [PMID: 32615855 DOI: 10.1080/02640414.2020.1785186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To assess the impact of lower-leg muscle activity during the stance phase of running on the development of medial tibial stress syndrome (MTSS), in 123 healthy participants (18.2 ± 0.8 years), dynamic and static foot posture, and soleus and tibialis anterior muscle activity during the stance phase of running were measured before a 17-week track- and field-course. After the course, MTSS was identified in 20.5% of the participants. MTSS participants had a higher body mass (ES = 1.13), body mass index (BMI) (ES = 1.31), lower previous vigorous physical activity level (ES = 0.84) and VO2max (ES = 0.61), greater dynamic foot pronation (ES = 0.66), higher soleus peak EMG amplitude during the absorption (ES = 0.60) and propulsion phases (ES = 0.56) of running, and a history of MTSS (OR = 6.38) (p < 0.05). Stepwise logistic regression showed BMI, dynamic foot index, soleus peak EMG amplitude during propulsion, MTSS history and previous vigorous physical activity were predictors of MTSS. The model predicted 96.6% of the healthy participants and 56.5% of the MTSS participants and correctly classified 88.4% of overall cases. Coaches and sports-medicine professionals that screen for injury risk should consider adopting a comprehensive evaluation that includes these parameters.
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Affiliation(s)
- Aynollah Naderi
- School of Sport Science, Shahrood University of Technology , Shahrood, Iran
| | - Maarten H Moen
- Bergman Clinics , Naarden, The Netherlands.,The Sport Physician Group, OLVG West , Amsterdam, The Netherlands.,Department of Elite Sports, National Olympic Committee and National Sports Federation , Arnhem, The Netherlands
| | - Hans Degens
- Department of Life SciencesResearch Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University , Manchester, UK.,Institute of Sport Science & Innovations, Lithuanian Sports University , Kaunas, Lithuania.,University of Medicine & Pharmacy of Targu Mures , Targu Mures, Rumania
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21
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Gwynne CR. Alterations in Center of Pressure During Single-Limb Loading in Individuals with Patellofemoral Pain. J Am Podiatr Med Assoc 2020; 110:9910. [PMID: 30900909 DOI: 10.7547/18-070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Altered foot loading during weightbearing is suggested to play a role in the development of patellofemoral pain (PFP). This study aimed to determine foot-loading characteristics associated with PFP by assessing center of pressure (COP) during single-limb loading in individuals with PFP compared with noninjured controls. METHODS Thirty recreationally active patients with PFP and 30 noninjured control participants had barefoot plantar pressure assessed during single-limb squats (SLSs) from which COP parameters (COP velocity and COP index) were obtained. Groups were compared using independent t tests. RESULTS Individuals with PFP demonstrated a greater COP index (P = .042), indicating a more lateral foot-loading pattern, and exhibited increased overall COP velocity (P = .013) and anteroposterior COP velocity during SLSs compared with control participants (P = .033). CONCLUSIONS Greater lateral foot loading and increased COP velocity during SLSs demonstrated by individuals with PFP may indicate reduced dynamic balance in this patient group, which may be implicated in the development of PFP.
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22
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Flip-flops do not alter the neuromuscular function of the gastrocnemius muscle and tendon during walking in children. Gait Posture 2020; 77:83-88. [PMID: 32004950 DOI: 10.1016/j.gaitpost.2019.12.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 12/15/2019] [Accepted: 12/20/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION/AIM Flip-flops are a popular choice of footwear for children. However, their inherent design provides minimal support to the foot and ankle and has been suggested to increase the work performed by muscle and tendon structures, potentially predisposing them to injury. Therefore, the aim of this study was to compare the length change behaviour of the medial gastrocnemius (MG) muscle fascicles and muscle tendon unit (MTU) and their mechanical function at the ankle and subtalar joints in children during walking with and without flip-flop. METHODS Eight healthy children walked barefoot and with flip-flops whilst 3D gait analysis and simultaneous B-mode ultrasound images of the MG fascicles during level walking were collected. Joint kinematics, kinetics and MTU lengths were analysed using musculoskeletal modelling and fascicle lengths using a semi-automated tracking algorithm. RESULTS The muscles and tendons across the ankle absorbed greater amounts of power during barefoot walking compared to flip-flop walking. The muscle activations of the lateral gastrocnemius, soleus and tibialis anterior remained invariant across the conditions as did the activation, and fascicle length change behaviour of the medial gastrocnemius. In the barefoot condition, there was a trend of greater MTU lengthening, to potentially absorb greater amounts of power, although no differences in shortening was observed during late stance. CONCLUSION Walking with flip-flops does not increase the mechanical work performed by the MG muscle at the ankle and subtalar joints, suggesting that flip-flops do not increase the stresses and strains of the Achilles tendon and hence its predisposition to strain induced injury. Instead, our results suggest that flip-flops, act as a compliant surface and absorb energy during contact and hence the strain experienced by the Achilles tendon.
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Sisk D, Fredericson M. Update of Risk Factors, Diagnosis, and Management of Patellofemoral Pain. Curr Rev Musculoskelet Med 2019; 12:534-541. [PMID: 31773479 DOI: 10.1007/s12178-019-09593-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW Patellofemoral pain is the most common cause of anterior knee pain. The purpose of this review is to examine the latest research on risk factors, physical examination, and treatment of patellofemoral pain to improve accuracy of diagnosis and increase use of efficacious treatment modalities. RECENT FINDINGS The latest research suggests patellofemoral pain pathophysiology is a combination of biomechanical, behavioral, and psychological factors. Research into targeted exercise therapy and other conservative therapy modalities have shown efficacy especially when used in combination. New techniques such as blood flow restriction therapy, gait retraining, and acupuncture show promise but require further well-designed studies. Patellofemoral pain is most commonly attributed to altered stress to the patellofemoral joint from intrinsic knee factors, alterations in the kinetic chain, or errors in training. Diagnosis can be made with a thorough assessment of clinical history and risk factors, and a comprehensive physical examination. The ideal treatment is a combination of conservative treatment modalities ideally individualized to the risk factors identified in each patient. Ongoing research should continue to identify biomechanical risk factors and new treatments as well as look for more efficient ways to identify patients who are amenable to treatments.
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Affiliation(s)
- Daniel Sisk
- Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Stanford University, Stanford, CA, USA.
| | - Michael Fredericson
- Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Stanford University, Stanford, CA, USA
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Abstract
Patellofemoral pain (PFP) is a common musculoskeletal-related condition that is characterized by insidious onset of poorly defined pain, localized to the anterior retropatellar and/or peripatellar region of the knee. The onset of symptoms can be slow or acutely develop with a worsening of pain accompanying lower-limb loading activities (eg, squatting, prolonged sitting, ascending/descending stairs, jumping, or running). Symptoms can restrict participation in physical activity, sports, and work, as well as recur and persist for years. This clinical practice guideline will allow physical therapists and other rehabilitation specialists to stay up to date with evolving PFP knowledge and practices, and help them to make evidence-based treatment decisions. J Orthop Sports Phys Ther. 2019;49(9):CPG1-CPG95. doi:10.2519/jospt.2019.0302.
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Park J, Kim T. Acute effect of taping on plantar pressure characteristics in athletes with exercise-induced leg pain: a description and comparison of groups. PHYSICIAN SPORTSMED 2019; 47:212-219. [PMID: 30462925 DOI: 10.1080/00913847.2018.1547085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Foot pronation is considered as a potential risk factor of lower leg overuse injury. This study aimed to identify plantar pressure characteristics of elite athletes with exercise-induced leg pain in throwing athletic disciplines, and to verify the acute effect of taping for restricting foot pronation by analyzing the plantar pressure characteristics. METHODS This study was designed as a description and comparison of throwing athletic athletes. Participants were divided into exercise-induced leg pain (ELP group, n = 17) and control groups (CON group, n = 14). Plantar pressure variables (contact area, maximum force, and peak pressure) at eight-foot regions in athletes' supporting leg were recorded during standing on one leg and a natural walk before and after applying anti-pronation or sham taping techniques. RESULTS There are significant difference of contact area, maximal force, and peak pressure in some regions of their foot between the ELP and CON groups. But the anti-pronation taping decreased only the peak pressure in lateral midfoot of CON group during a natural walk (p = 0.002). CONCLUSION The anti-pronation taping technique may not be effective preventive strategy from the exercise-induced leg pain, such as shin splints.
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Affiliation(s)
- JaeMyoung Park
- a Research Institute of Physical Education and Sport Science , Korea National Sport University , Seoul , Republic of Korea
| | - Taegyu Kim
- b Department of Marine Sports , Pukyoung National University , Busan , Republic of Korea
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Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review. Sports Med 2019; 49:1095-1115. [DOI: 10.1007/s40279-019-01110-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ankle Joint and Rearfoot Biomechanics During Toe-In and Toe-Out Walking in People With Medial Compartment Knee Osteoarthritis. PM R 2019; 11:503-511. [PMID: 30195708 DOI: 10.1016/j.pmrj.2018.08.388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/25/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Toe-in and toe-out walking are 2 strategies that have been shown to be effective in reducing the knee adduction moment in people with knee osteoarthritis. However, despite a positive biomechanical impact on the knee, altering foot rotation may impart unintended forces or joint positions on the ankle that could impact joint health. The kinematic and kinetic changes at the ankle during toe-in or toe-out walking have yet to be examined. OBJECTIVE To examine ankle/rearfoot biomechanics during toe-in and toe-out walking in those with knee osteoarthritis. DESIGN Single-session repeated measures design to compare ankle biomechanics during walking with 4 different foot rotations. SETTING University motion analysis laboratory. PARTICIPANTS A convenience sample (N = 15) of males and females with a diagnosis of medial knee osteoarthritis confirmed by radiographs. METHODS Participants walked in 4 conditions guided by real-time biofeedback: (1) toe-in (+10°), (2) zero rotation (0°), (3) toe-out (-10°), and (4) toe-out (-20°). Ankle and rearfoot kinematics and kinetics were examined during barefoot over-ground walking. MAIN OUTCOME MEASURES Ankle joint angles, moments, moment impulses, and foot rotation. RESULTS Overall, toe-in compared to toe-out walking decreased (P = .03) peak rearfoot eversion (toe-in = -1.6°; 10° toe-out = -3.7°; 20° toe-out = -4.1°). Toe-in compared to toe-out walking also increased rearfoot inversion at initial contact (7.4° vs 3.1° at 10° toe-out and 1.9° at 20° toe-out; P < .001) and frontal plane rearfoot angle excursion (9.0° vs 6.8° at 10° toe-out and 6.0° at 20° toe-out; P < .006). Toe-in compared to all other conditions increased peak external ankle inversion moments (0.04 Nm/kg vs 0.02 Nm/kg at 0°, 0.02 Nm/kg at 10° toe-out, and 0.01 Nm/kg at 20° toe-out; P < .003). CONCLUSIONS Toe-in and toe-out walking require different ankle/rearfoot biomechanics, though no differences in discomfort were observed. Longer-term studies are required to properly assess these relationships in knee osteoarthritis populations. LEVEL OF EVIDENCE IV.
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Bonanno DR, Ledchumanasarma K, Landorf KB, Munteanu SE, Murley GS, Menz HB. Effects of a contoured foot orthosis and flat insole on plantar pressure and tibial acceleration while walking in defence boots. Sci Rep 2019; 9:1688. [PMID: 30737450 PMCID: PMC6368555 DOI: 10.1038/s41598-018-35830-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/12/2018] [Indexed: 12/21/2022] Open
Abstract
This study investigated the effects of a contoured, prefabricated foot orthosis and a flat insole on plantar pressure and tibial acceleration while walking in defence boots. Twenty-eight adults walked along an 8-metre walkway in a: (i) defence boot (control condition), (ii) defence boot with a flat insole, and (iii) defence boot with a contoured foot orthosis. Plantar pressure data were collected using the pedar-X in-shoe system and tibial accelerations were measured with an accelerometer. In relation to plantar pressure under the rearfoot, the contoured foot orthosis, compared to the defence boot, decreased peak pressure and maximum force, and increased contact area. Under the medial midfoot, the contoured foot orthosis and flat insole increased peak pressure, maximum force and contact area. Under the medial forefoot, the contoured foot orthosis and flat insole increased maximum force. Under the lateral forefoot, the contoured foot orthosis and flat insole increased contact area, with the flat insole also increasing maximum force. In relation to tibial acceleration, the contoured foot orthosis, compared to the defence boot, decreased tibial peak positive acceleration. These findings provide novel biomechanical evidence for the effects of contoured foot orthoses in defence boots.
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Affiliation(s)
- Daniel R Bonanno
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia. .,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.
| | - Ketharasarma Ledchumanasarma
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - George S Murley
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
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Taddei UT, Matias AB, Ribeiro FI, Inoue RS, Bus SA, Sacco IC. Effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: Feasibility study for a randomized controlled trial. Phys Ther Sport 2018; 34:216-226. [DOI: 10.1016/j.ptsp.2018.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/22/2018] [Accepted: 10/23/2018] [Indexed: 12/23/2022]
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Bolgla LA, Boling MC, Mace KL, DiStefano MJ, Fithian DC, Powers CM. National Athletic Trainers' Association Position Statement: Management of Individuals With Patellofemoral Pain. J Athl Train 2018; 53:820-836. [PMID: 30372640 DOI: 10.4085/1062-6050-231-15] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE: To present recommendations for athletic trainers and other health care providers regarding the identification of risk factors for and management of individuals with patellofemoral pain (PFP). BACKGROUND: Patellofemoral pain is one of the most common knee diagnoses; however, this condition continues to be one of the most challenging to manage. Recent evidence has suggested that certain risk factors may contribute to the development of PFP. Early identification of risk factors may allow clinicians to develop and implement programs aimed at reducing the incidence of this condition. To date, clinicians have used various treatment strategies that have not necessarily benefitted all patients. Suboptimal outcomes may reflect the need to integrate clinical practice with scientific evidence to facilitate clinical decision making. RECOMMENDATIONS: The recommendations are based on the best available evidence. They are intended to give athletic trainers and other health care professionals a framework for identifying risk factors for and managing patients with PFP.
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Affiliation(s)
- Lori A Bolgla
- Department of Physical Therapy, Augusta University, GA
| | - Michelle C Boling
- Department of Clinical and Applied Movement Sciences, University of North Florida, Jacksonville
| | | | | | | | - Christopher M Powers
- Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles
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Neal BS, Lack SD, Lankhorst NE, Raye A, Morrissey D, van Middelkoop M. Risk factors for patellofemoral pain: a systematic review and meta-analysis. Br J Sports Med 2018; 53:270-281. [PMID: 30242107 DOI: 10.1136/bjsports-2017-098890] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Patellofemoral pain (PFP) is a prevalent condition commencing at various points throughout life. We aimed to provide an evidence synthesis concerning predictive variables for PFP, to aid development of preventative interventions. METHODS We searched Medline, Web of Science and SCOPUS until February 2017 for prospective studies investigating at least one potential risk factor for future PFP. Two independent reviewers appraised methodological quality using the Newcastle-Ottawa Scale. We conducted meta-analysis where appropriate, with standardised mean differences (SMD) and risk ratios calculated for continuous and nominal scaled data. RESULTS This review included 18 studies involving 4818 participants, of whom 483 developed PFP (heterogeneous incidence 10%). Three distinct subgroups (military recruits, adolescents and recreational runners) were identified. Strong to moderate evidence indicated that age, height, weight, body mass index (BMI), body fat and Q angle were not risk factors for future PFP. Moderate evidence indicated that quadriceps weakness was a risk factor for future PFP in the military, especially when normalised by BMI (SMD -0.69, CI -1.02, -0.35). Moderate evidence indicated that hip weakness was not a risk factor for future PFP (multiple pooled SMDs, range -0.09 to -0.20), but in adolescents, moderate evidence indicated that increased hip abduction strength was a risk factor for future PFP (SMD 0.71, CI 0.39, 1.04). CONCLUSIONS This review identified multiple variables that did not predict future PFP, but quadriceps weakness in military recruits and higher hip strength in adolescents were risk factors for PFP. Identifying modifiable risk factors is an urgent priority to improve prevention and treatment outcomes.
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Affiliation(s)
- Bradley S Neal
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Pure Sports Medicine, London, UK
| | - Simon D Lack
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Pure Sports Medicine, London, UK
| | | | - Andrew Raye
- Sports and Exercise Medicine, Queen Mary University of London, London, UK
| | - Dylan Morrissey
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Physiotherapy Department, Barts Health NHS Trust, London, UK
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Is There a Biomechanical Link Between Patellofemoral Pain and Osteoarthritis? A Narrative Review. Sports Med 2018; 46:1797-1808. [PMID: 27142536 DOI: 10.1007/s40279-016-0545-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The patellofemoral (PF) joint is the knee compartment most commonly affected by osteoarthritis (OA). Even mild PF OA is associated with considerable pain and functional limitations. Despite its prevalence and impact, little is understood of the etiology or structural and functional features of PF OA. The clinical symptoms of PF OA, such as anterior knee pain during stair ambulation and squatting, share many similarities with PF pain in adolescents and young adults. PF joint OA is most commonly diagnosed in people aged >40 years, many of whom report a history of PF pain. As such, there is growing evidence that PF pain and PF OA form a continuum of disease. This review explores the possible relationship between the presence of PF pain and the development of PF OA. We review the evidence for altered neuromotor control and biomechanical factors that may be associated with altered PF loading in people with PF pain and PF OA. In doing so, we highlight similarities and differences that may evolve along the continuum. By improving our understanding of the neuromotor and biomechanical links between PF pain and PF OA, we may highlight potential targets for new rehabilitation strategies.
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Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2018. J Orthop Sports Phys Ther 2018; 48:A1-A38. [PMID: 29712543 DOI: 10.2519/jospt.2018.0302] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to midportion Achilles tendinopathy. J Orthop Sports Phys Ther 2018;48(5):A1-A38. doi:10.2519/jospt.2018.0302.
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Lack S, Neal B, De Oliveira Silva D, Barton C. How to manage patellofemoral pain - Understanding the multifactorial nature and treatment options. Phys Ther Sport 2018; 32:155-166. [PMID: 29793124 DOI: 10.1016/j.ptsp.2018.04.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/11/2018] [Accepted: 04/11/2018] [Indexed: 12/18/2022]
Abstract
Patellofemoral pain (PFP) is one of the most prevalent conditions within sports medicine, orthopaedic and general practice settings. Long-term treatment outcomes are poor, with estimates that more than 50% of people with the condition will report symptoms beyond 5 years following diagnosis. Additionally, emerging evidence indicates that PFP may be on a continuum with patellofemoral osteoarthritis. Consensus of world leading clinicians and academics highlights the potential benefit of delivering tailored interventions, specific to an individual's needs, to improve patient outcome. This clinical masterclass aims to develop the reader's understanding of PFP aetiology, inform clinical assessment and increase knowledge regarding individually tailored treatment approaches. It offers practical application guidance, and additional resources, that can positively impact clinical practice.
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Affiliation(s)
- Simon Lack
- Sports and Exercise Medicine, William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom; Pure Sports Medicine, London, United Kingdom.
| | - Bradley Neal
- Sports and Exercise Medicine, William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom; Pure Sports Medicine, London, United Kingdom
| | - Danilo De Oliveira Silva
- Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia; Laboratory of Biomechanics and Motor Control, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Christian Barton
- Sports and Exercise Medicine, William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom; Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
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Bonanno DR, Munteanu SE, Murley GS, Landorf KB, Menz HB. Risk factors for lower limb injuries during initial naval training: a prospective study. J ROY ARMY MED CORPS 2018; 164:347-351. [DOI: 10.1136/jramc-2018-000919] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/14/2018] [Accepted: 03/14/2018] [Indexed: 11/04/2022]
Abstract
IntroductionThis study aimed to identify risk factors associated with the development of common lower limb injuries during initial defence training in naval recruits who were enrolled in a randomised trial.MethodsThree-hundred and six naval recruits were randomly allocated flat insoles (n=153) or foot orthoses (n=153) while undertaking 11 weeks of initial training. Participant characteristics (including anthropometrics, general health, physical activity, fitness and foot characteristics) were collected at the baseline assessment and injuries were documented prospectively. Injury was defined as the combined incidence of participants with medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy and plantar fasciitis/plantar heel pain throughout the 11 weeks of training. A discriminant function analysis was used to explore the ability of baseline measures to predict injury.ResultsOverall, 67 (21.9%) participants developed an injury. Discriminant function analysis revealed that participants who sustained an injury were slightly younger (mean 21.4±SD 4.1 vs 22.5±5.0 years) and were less likely to be allocated to the foot orthosis group (40% vs 53%) compared with those who remained uninjured. The accuracy of these baseline variables to predict injury was moderate (78.1%).ConclusionsLower limb injury was not accurately predicted from health questionnaires, fitness results and clinical assessments in naval recruits undertaking initial defence training. However, although not reaching statistical significance, the use of foot orthoses may be protective against common lower limb injuries.Trial registration numberACTRN12615000024549; Post-results.
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Kim HK, Mirjalili SA, Fernandez J. Gait kinetics, kinematics, spatiotemporal and foot plantar pressure alteration in response to long-distance running: Systematic review. Hum Mov Sci 2018; 57:342-356. [DOI: 10.1016/j.humov.2017.09.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 09/07/2017] [Accepted: 09/17/2017] [Indexed: 11/25/2022]
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Are two-dimensional measured frontal plane angles related to three-dimensional measured kinematic profiles during running? Phys Ther Sport 2018. [DOI: 10.1016/j.ptsp.2017.02.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Maharaj JN, Cresswell AG, Lichtwark GA. Foot structure is significantly associated to subtalar joint kinetics and mechanical energetics. Gait Posture 2017; 58:159-165. [PMID: 28783556 DOI: 10.1016/j.gaitpost.2017.07.108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 07/14/2017] [Accepted: 07/20/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION/AIM Foot structure has been implicated as a risk factor of numerous overuse injuries, however, the mechanism linking foot structure and the development of soft-tissue overuse injuries are not well understood. The aim of this study was to identify factors that could predict foot function during walking. METHODS A total of eleven variables (including measures of foot structure, anthropometry and spatiotemporal gait characteristics) were investigated for their predictive ability on identifying kinematic, kinetic and energetic components of the foot. Three-dimensional motion capture and force data were collected at preferred walking speed on an instrumented treadmill. Mechanical measures were subsequently assessed using a custom multi-segment foot model in Opensim. Factors with significant univariate associations were entered into multiple linear regression models to identify a group of factors independently associated with the mechanical measures. RESULTS Although no model could be created for any of the kinematic measures analysed, approximately 46% and 37% of the variance in the kinetic and energetic measures were associated with three or two factors respectively. Arch-height ratio, foot length and step width were associated with peak subtalar joint (STJ) moment, while greater STJ negative work was correlated to a low arch-height ratio and greater foot mobility. CONCLUSION The models presented in this study suggest that the soft-tissue structures of a flat-arched, mobile foot are at a greater risk of injury as they have greater requirements to absorb energy and generate larger forces. However, as these associations are only moderate, other measures may also have an influence.
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Affiliation(s)
- Jayishni N Maharaj
- The University of Queensland, School of Human Movement and Nutrition Sciences, Centre for Sensorimotor Neuroscience, Brisbane, 4072, Queensland, Australia.
| | - Andrew G Cresswell
- The University of Queensland, School of Human Movement and Nutrition Sciences, Centre for Sensorimotor Neuroscience, Brisbane, 4072, Queensland, Australia
| | - Glen A Lichtwark
- The University of Queensland, School of Human Movement and Nutrition Sciences, Centre for Sensorimotor Neuroscience, Brisbane, 4072, Queensland, Australia
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Taylor JB, Nguyen AD, Griffin JR, Ford KR. Effects of turf and cleat footwear on plantar load distributions in adolescent American football players during resisted pushing. Sports Biomech 2017. [PMID: 28632050 DOI: 10.1080/14763141.2016.1271448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Metatarsal and midfoot injuries are common in American football. Footwear design may influence injury rates by altering plantar foot loading patterns in these regions. The purpose of this study was to determine the effect of cleat design on in-shoe plantar foot loading during a football-specific, resisted pushing task. Twenty competitive football players (age 14.7 ± 1.8 years, height 1.72 ± 0.10 m, and mass 71.8 ± 26.9 kg) completed three trials of pushing a weighted sled at maximal effort in a standard shoe (CLEAT) and artificial turf-specific shoe (TURF), with flexible in-shoe force measuring insoles. Repeated measures ANOVAs identified mean differences in maximum force and relative load under all regions of the foot. Results showed higher forces in the CLEAT under the medial (p < 0.001) and lateral (p = 0.004) midfoot, central (p = 0.007) and lateral (p < 0.001) forefoot, and lesser toes (p = 0.01), but lower forces in the hallux (p = 0.02) compared to the TURF shoe. Additionally, relative loading was higher in the CLEAT under the medial (p < 0.001) and lateral (p = 0.002) midfoot and lateral (p < 0.001) forefoot, but lower in the medial forefoot (p = 0.006) and hallux (p < 0.001) compared to the TURF shoe. The two shoes elicited distinct plantar loading profiles and may influence shoe selection decisions during injury prevention or rehabilitation practices.
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Affiliation(s)
- Jeffrey B Taylor
- a Department of Physical Therapy, Congdon School of Health Sciences , High Point , NC , USA
| | - Anh-Dung Nguyen
- b Department of Athletic Training, Congdon School of Health Sciences , High Point , NC , USA
| | | | - Kevin R Ford
- a Department of Physical Therapy, Congdon School of Health Sciences , High Point , NC , USA
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Effects of hip and trunk muscle strengthening on hip function and lower limb kinematics during step-down task. Clin Biomech (Bristol, Avon) 2017; 44:28-35. [PMID: 28315596 DOI: 10.1016/j.clinbiomech.2017.02.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 02/11/2017] [Accepted: 02/21/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Strengthening of the hip and trunk muscles has the potential to change lower limb kinematic patterns, such as excessive hip medial rotation and adduction during weight-bearing tasks. This study aimed to investigate the effect of hip and trunk muscles strengthening on hip muscle performance, hip passive properties, and lower limb kinematics during step-down task in women. METHODS Thirty-four young women who demonstrated dynamic knee valgus during step-down were divided into two groups. The experimental group underwent three weekly sessions of strengthening exercises for eight weeks, and the control group continued their usual activities. The following evaluations were carried out: (a) isokinetic maximum concentric and eccentric work of hip lateral rotators, (b) isokinetic hip passive torque of lateral rotation and resting transverse plane position, and (c) three-dimensional kinematics of the lower limb during step-down. FINDINGS The strengthening program increased concentric (P<0.001) and eccentric (P<0.001) work of hip lateral rotators, and changed hip resting position toward lateral rotation (P<0.001). The intervention did not significantly change hip passive torque (P=0.089, main effect). The program reduced hip (P=0.002), thigh (P=0.024) and shank (P=0.005) adduction during step-down task. Hip, thigh and knee kinematics in transverse plane and foot kinematics in frontal plane did not significantly modify after intervention (P≥0.069, main effect). INTERPRETATION Hip and trunk strengthening reduced lower limb adduction during step-down. The changes in hip maximum work and resting position may have contributed to the observed kinematic effects.
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Physical risk factors for developing non-specific neck pain in office workers: a systematic review and meta-analysis. Int Arch Occup Environ Health 2017; 90:373-410. [DOI: 10.1007/s00420-017-1205-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
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Bonanno DR, Landorf KB, Munteanu SE, Murley GS, Menz HB. Effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury: a systematic review and meta-analysis. Br J Sports Med 2016; 51:86-96. [PMID: 27919918 DOI: 10.1136/bjsports-2016-096671] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the evidence relating to the effectiveness of foot orthoses and shock-absorbing insoles for the prevention of musculoskeletal injury. DESIGN Systematic review and meta-analysis. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Clinical trials evaluating the effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury. DATA SOURCES Cochrane Library, CINAHL, EMBASE, MEDLINE and SPORTDiscus from their inception up to the first week of June 2016. RESULTS 11 trials that had evaluated foot orthoses and 7 trials that had evaluated shock-absorbing insoles were included. The median Physiotherapy Evidence Database (PEDro) score for trials that had evaluated foot orthoses and shock-absorbing insoles was 5 (range 3-8/10) and 3 (range 1-7/10), respectively. Meta-analysis found that foot orthoses were effective for preventing overall injuries (risk ratio (RR) 0.72, 95% CI 0.55 to 0.94) and stress fractures (RR 0.59, 95% CI 0.45 to 0.76), but not soft-tissue injuries (RR 0.79, 95% CI 0.55 to 1.14). In contrast, shock-absorbing insoles were not effective for preventing overall injuries (RR 0.92, 95% CI 0.73 to 1.16), stress fractures (RR 1.15, 95% CI 0.57 to 2.32) or soft-tissue injuries (RR 0.92, 95% CI 0.74 to 1.15). CONCLUSIONS Foot orthoses were found to be effective for preventing overall injuries and stress fractures but not soft-tissue injuries, while shock-absorbing insoles were not found to be effective for preventing any injury. However, further well-designed trials will assist the accuracy and precision of the estimates of risk reduction as the quality of the included trials varied greatly.
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Affiliation(s)
- Daniel R Bonanno
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,Department of Allied Health, Melbourne Health, Parkville, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - George S Murley
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 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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Johannsen F, Hansen P, Stallknecht S, Rathleff MS, Hangaard S, Nybing JD, Boesen M. Can positional MRI predict dynamic changes in the medial plantar arch? An exploratory pilot study. J Foot Ankle Res 2016; 9:35. [PMID: 27588043 DOI: 10.1186/s13047-016-0168-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Positional MRI (pMRI) allows for three-dimensional visual assessment of navicular position. In this exploratory pilot study pMRI was validated against a stretch sensor device, which measures movement of the medial plantar arch. We hypothesized that a combined pMRI measure incorporating both vertical and medial displacement of the navicular bone induced by loading would be correlated with corresponding stretch sensor measurements. METHODS 10 voluntary participants were included in the study. Both pMRI and subsequent stretch sensor measurements were performed in a) supine, b) standing and c) standing position with addition of 10 % body weight during static loading of the foot. Stretch sensor measurements were also performed during barefoot walking. RESULTS The total change in navicular position measured by pMRI was 10.3 mm (CI: 7.0 to 13.5 mm). No further displacement occurred when adding 10 % bodyweight (mean difference: 0.7 mm (CI: -0.7 to 2.0 mm), P = 0.29). The total navicular displacement correlated with stretch sensor measurement under static loading conditions (Spearman's rho = 0.66, P = 0.04) but not with measurements during walking (Spearman's rho = 0.58, P = 0.08). CONCLUSIONS Total navicular bone displacements determined by pMRI showed concurrent validity with stretch sensor measurements but only so under static loading conditions. Although assessment of total navicular displacement by combining concomitant vertical and medial navicular bone movements would appear advantageous compared to monoplanar measurement the combined measure did not seem to predict dynamic changes of the medial foot arch during walking, which are among several possible factors depending on different walking patterns.
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Affiliation(s)
- Finn Johannsen
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, Building 8, 1., Bispebjerg Bakke 23, Copenhagen, DK-2400, Denmark
| | - Philip Hansen
- Department of Radiology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Nordre Fasanvej 57, vej 4, opg. 5, Frederiksberg, DK-2000 Denmark
| | - Sandra Stallknecht
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, Building 8, 1., Bispebjerg Bakke 23, Copenhagen, DK-2400, Denmark
| | - Michael Skovdal Rathleff
- Research Unit for General Practice in Aalborg and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark ; Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
| | - Stine Hangaard
- Department of Radiology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Nordre Fasanvej 57, vej 4, opg. 5, Frederiksberg, DK-2000 Denmark
| | - Janus Damm Nybing
- Department of Radiology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Nordre Fasanvej 57, vej 4, opg. 5, Frederiksberg, DK-2000 Denmark
| | - Mikael Boesen
- Department of Radiology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Nordre Fasanvej 57, vej 4, opg. 5, Frederiksberg, DK-2000 Denmark ; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Copenhagen, Denmark
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Effects of running-induced fatigue on plantar pressure distribution in novice runners with different foot types. Gait Posture 2016; 48:52-56. [PMID: 27477708 DOI: 10.1016/j.gaitpost.2016.04.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 04/23/2016] [Accepted: 04/27/2016] [Indexed: 02/02/2023]
Abstract
This study aimed to assess the effects of running-induced fatigue on plantar pressure parameters in novice runners with low and high medial longitudinal arch. Plantar pressure data from 42 novice runners (21 with high, and 21 with low arch) were collected before and after running-induced fatigue protocol during running at 3.3m/s along the Footscan(®) platform. Peak plantar pressure, peak force and force-time integral (impulse) were measured in ten anatomical zones. Relative time for foot roll-over phases and medio-lateral force ratio were calculated before and after the fatigue protocol. After the fatigue protocol, increases in the peak pressure under the first-third metatarsal zones and reduction under the fourth-fifth metatarsal regions were observed in the low arch individuals. In the high arch group, increases in peak pressure under the fourth-fifth metatarsal zones after the running-induced fatigue was observed. It could be concluded that running-induced fatigue had different effects on plantar pressure distribution pattern among novice runners with low and high medial longitudinal foot arch. These findings could provide some information related to several running injuries among individuals with different foot types.
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BISHOP CHRISTOPHER, ARNOLD JOHNB, MAY THOMAS. Effects of Taping and Orthoses on Foot Biomechanics in Adults with Flat-Arched Feet. Med Sci Sports Exerc 2016; 48:689-96. [DOI: 10.1249/mss.0000000000000807] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Neal BS, Barton CJ, Gallie R, O'Halloran P, Morrissey D. Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: A systematic review and meta-analysis. Gait Posture 2016; 45:69-82. [PMID: 26979886 DOI: 10.1016/j.gaitpost.2015.11.018] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/14/2015] [Accepted: 11/28/2015] [Indexed: 02/02/2023]
Abstract
Patellofemoral pain (PFP) is the most prevalent running pathology and associated with multi-level biomechanical factors. This systematic review aims to guide treatment and prevention of PFP by synthesising prospective, observational and intervention studies that measure clinical and biomechanical outcomes in symptomatic running populations. Medline, Web of Science and CINAHL were searched from inception to April 2015 for prospective, case-control or intervention studies in running-related PFP cohorts. Study methodological quality was scored by two independent raters using the modified Downs and Black or PEDro scales, with meta-analysis performed where appropriate. 28 studies were included. Very limited evidence indicates that increased peak hip adduction is a risk factor for PFP in female runners, supported by moderate evidence of a relationship between PFP and increased peak hip adduction, internal rotation and contralateral pelvic drop, as well as reduced peak hip flexion. Limited evidence was also identified that altered peak force and time to peak at foot level is a risk factor for PFP development. Limited evidence from intervention studies indicates that both running retraining and proximal strengthening exercise lead to favourable outcomes in both pain and function, but only running retraining significantly reduces peak hip adduction, suggesting a possible kinematic mechanism. Put together, these findings highlight limited but coherent evidence of altered biomechanics which interventions can alter with resultant symptom change in females with PFP. There is a clear need for high quality prospective studies of intervention efficacy with measurement of explanatory mechanisms.
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Affiliation(s)
- Bradley S Neal
- Sports and Exercise Medicine, Queen Mary University of London, United Kingdom; Pure Sports Medicine, London, United Kingdom
| | - Christian J Barton
- Sports and Exercise Medicine, Queen Mary University of London, United Kingdom; Pure Sports Medicine, London, United Kingdom; Complete Sports Care, Melbourne, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Rosa Gallie
- Sports and Exercise Medicine, Queen Mary University of London, United Kingdom
| | - Patrick O'Halloran
- Sports and Exercise Medicine, Queen Mary University of London, United Kingdom
| | - Dylan Morrissey
- Sports and Exercise Medicine, Queen Mary University of London, United Kingdom; Physiotherapy Department, Barts Health NHS Trust, London, United Kingdom.
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Barton CJ, Bonanno DR, Carr J, Neal BS, Malliaras P, Franklyn-Miller A, Menz HB. Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion. Br J Sports Med 2016; 50:513-26. [DOI: 10.1136/bjsports-2015-095278] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2015] [Indexed: 12/20/2022]
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Bade MB, Chi TL, Farrell KC, Gresl AJ, Hammel LJ, Koster BN, Leatzow AB, Thomas EC, McPoil TG. THE USE OF A STATIC MEASURE TO PREDICT FOOT POSTURE AT MIDSUPPORT DURING RUNNING. Int J Sports Phys Ther 2016; 11:64-71. [PMID: 26900501 PMCID: PMC4739049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND The posture of the foot has been implicated as a factor in the development of running-related injuries. A static measure of foot posture, such as the longitudinal arch angle (LAA), that can be easily performed and is predictive of the posture of the foot at midsupport while running could provide valuable information to enhance the clinician's overall evaluation of the runner. PURPOSE The purpose of this study was to determine if the LAA, assessed in relaxed standing, could predict the posture of the foot at midsupport while running on a treadmill. STUDY DESIGN Cross-sectional Study. METHODS Forty experienced runners (mean age 26.6 years) voluntarily consented to participate. Inclusion criteria included running at least 18 miles per week, previous experience running on a treadmill, no history of lower extremity congenital or traumatic deformity, or acute injury three months prior to the start of the study. Each runner had markers placed on the medial malleolus, navicular tuberosity, and medial aspect 1(st) metatarsal head of both feet. A high speed camera (240 Hz) was used to film both feet of each runner in standing and while running on a treadmill at their preferred speed. The LAA in standing and at mid-support while running was determined by angle formed by two lines drawn between the three markers with the navicular tuberosity serving as the apex. The LAA in midsupport was determined using the mean of the middle five running trials. RESULTS The levels of intra-rater and inter-rater reliability for the dynamic LAA were excellent. The results of the t-tests indicated that mean values between the left and right foot were not significantly different for the standing or running LAA. The results of the t-tests between male and female runners were also not significantly different for standing or running LAA. The Pearson correlation between standing and running LAA for all 80 feet was r = 0.95 (r(2) = 0.90). CONCLUSIONS The standing LAA was found to be highly predictive of the running LAA at midsupport while running. Approximately 90% of the variance associated with foot posture at midsupport in running could be explained by the standing LAA. LEVEL OF EVIDENCE 4, Controlled laboratory study.
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Affiliation(s)
- Michael B. Bade
- School of Physical Therapy, Regis University, Denver, CO, USA
| | - Timothy L. Chi
- School of Physical Therapy, Regis University, Denver, CO, USA
| | | | - Amanda J. Gresl
- School of Physical Therapy, Regis University, Denver, CO, USA
| | - Laura J. Hammel
- School of Physical Therapy, Regis University, Denver, CO, USA
| | | | | | - Emily C. Thomas
- School of Physical Therapy, Regis University, Denver, CO, USA
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