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Tagawa N, Okamura K, Araki D, Sugahara A, Kanai S. Influence of the menstrual cycle on static and dynamic kinematics of the foot medial longitudinal arch. J Orthop Sci 2024; 29:609-614. [PMID: 36759230 DOI: 10.1016/j.jos.2023.01.009] [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: 09/30/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND In women, the laxity of the plantar fascia increases during the ovulation phase of the menstrual cycle. Although it is possible that this increased laxity results in a decreased height of the foot in the medial longitudinal arch and exacerbates symptoms of several overuse injuries of the lower extremity, the influence of the menstrual cycle on static and dynamic kinematics of the medial longitudinal arch is unclear. The purpose of this study was to confirm that the medial longitudinal arch height during static standing, gait, and landing decrease during the menstrual cycle ovulation phase. METHODS Participants in this study were 16 female college students with normal menstrual cycles and 16 male college students. Navicular height in the static standing position was measured using a three-dimensional foot scanner. Kinematics of the medial longitudinal arch during gait and landing were measured using a three-dimensional motion capture system to determine the navicular height at initial contact, minimal navicular height, and dynamic navicular drop. In all measurements, female participants were tested twice during the course of one complete menstrual cycle: once during the follicular phase and once during the ovulation phase. Male participants were tested twice with an interval of ≥1 week and <2 weeks. RESULTS In women, navicular height in the static standing position significantly decreased during the ovulation phase compared with follicular phase (mean difference [95% confidence interval] = 2.1 [0.9-3.4] mm; p = 0.002), whereas men showed no statistical difference between the first and second measurements. In both men and women, no statistical differences were identified for the dynamic medial longitudinal arch kinematics measured during gait and landing. CONCLUSIONS Navicular height in the static standing position slightly decreased during the ovulation phase.
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Affiliation(s)
- Nanoha Tagawa
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan; Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima-shi, Hiroshima, 734-8551, Japan
| | - Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Daisuke Araki
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan
| | - Ayaka Sugahara
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan; Department of Rehabilitation Technology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan
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Hansen P, Brinch S, Radev DI, Nybing JU, Toftgaard S, Johannsen FE. Reliability and correlation of weight-bearing cone beam CT and Foot Posture Index (FPI) for measurements of foot posture: a test-retest study. Skeletal Radiol 2023; 52:2387-2397. [PMID: 37130960 PMCID: PMC10582147 DOI: 10.1007/s00256-023-04352-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/17/2023] [Accepted: 04/19/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To assess test-retest reliability and correlation of weight-bearing (WB) and non-weight-bearing (NWB) cone beam CT (CBCT) foot measurements and Foot Posture Index (FPI) MATERIALS AND METHODS: Twenty healthy participants (age 43.11±11.36, 15 males, 5 females) were CBCT-scanned in February 2019 on two separate days on one foot in both WB and NWB positions. Three radiology observers measured the navicular bone position. Plantar (ΔNAVplantar) and medial navicular displacements (ΔNAVmedial) were calculated as a measure of foot posture changes under loading. FPI was assessed by two rheumatologists on the same two days. FPI is a clinical measurement of foot posture with 3 rearfoot and 3 midfoot/forefoot scores. Test-retest reproducibility was determined for all measurements. CBCT was correlated to FPI total and subscores. RESULTS Intra- and interobserver reliabilities for navicular position and FPI were excellent (intraclass correlation coefficient (ICC) .875-.997). In particular, intraobserver (ICC .0.967-1.000) and interobserver reliabilities (ICC .946-.997) were found for CBCT navicular height and medial position. Interobserver reliability of ΔNAVplantar was excellent (ICC .926 (.812; .971); MDC 2.22), whereas the ΔNAVmedial was fair-good (ICC .452 (.385; .783); MDC 2.42 mm). Using all observers' measurements, we could calculate mean ΔNAVplantar (4.25±2.08 mm) and ΔNAVmedial (1.55±0.83 mm). We demonstrated a small day-day difference in ΔNAVplantar (0.64 ±1.13mm; p<.05), but not for ΔNAVmedial (0.04 ±1.13mm; p=n.s.). Correlation of WBCT (WB navicular height - ΔNAVmedial) with total clinical FPI scores and FPI subscores, respectively, showed high correlation (ρ: -.706; ρ: -.721). CONCLUSION CBCT and FPI are reliable measurements of foot posture, with a high correlation between the two measurements.
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Affiliation(s)
- Philip Hansen
- Department of Radiology, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Signe Brinch
- Department of Radiology, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | | | - Janus Uhd Nybing
- Department of Radiology, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | | | - Finn Elkjær Johannsen
- Furesø-reumatologerne, Copenhagen, Farum Denmark
- Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
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Galloso-Lagos MJ, González-Elena ML, Pérez-Belloso AJ, Coheña-Jiménez M, Elena-Pérez M, Muriel-Sánchez JM, Castro-Méndez A. A Short-Term Evaluation of Foot Pronation Tendency in Healthy Recreational Runners. Life (Basel) 2023; 13:2202. [PMID: 38004342 PMCID: PMC10672250 DOI: 10.3390/life13112202] [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: 10/10/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Running is a highly physical activity, and it is related to injuries when there is an excessive pronation of the foot. This study evaluates, from a sample group of healthy recreational runners, if the foot tends to pronate after a period of running activity and when, with respect to a period of running compared to walking, evaluated during several phases: after 30, 45, and 60 min. This quasi-experimental study has been carried out on a total of 36 healthy recreational subjects. The subjects were evaluated during two different activities: running activity for a period of an hour with respect to normal walking activity. The main outcome measures were the foot posture index (FPI) and the navicular drop test (NDT), which were evaluated at p1 (the screening day), after 30 min of activity (p2), after 45 min of activity (p3), and finally after 60 min (p4) during running or walking activity. The analysis showed significant differences for the FPI and NDT variables in both groups and on both feet, comparing p1 and p4. These changes showed a significant relationship comparing p1 and p3 for the FPI variable, and for the NDT variable (p < 0.001) of the left foot and, with respect to the right foot, significance was shown to the FPI comparing the p1 and p2. A significant difference was found in the tendency to pronate the foot after a period of running compared to the same period of walking after 60 min of activity. Running produced an excessive pronation of the foot after 45 min of activity, evaluated with the FPI for both feet.
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Affiliation(s)
- María José Galloso-Lagos
- Podiatry Department, University of Seville, 41009 Seville, Spain; (M.J.G.-L.); (M.L.G.-E.); (A.J.P.-B.); (M.C.-J.)
| | - María Luisa González-Elena
- Podiatry Department, University of Seville, 41009 Seville, Spain; (M.J.G.-L.); (M.L.G.-E.); (A.J.P.-B.); (M.C.-J.)
| | - Ana Juana Pérez-Belloso
- Podiatry Department, University of Seville, 41009 Seville, Spain; (M.J.G.-L.); (M.L.G.-E.); (A.J.P.-B.); (M.C.-J.)
| | - Manuel Coheña-Jiménez
- Podiatry Department, University of Seville, 41009 Seville, Spain; (M.J.G.-L.); (M.L.G.-E.); (A.J.P.-B.); (M.C.-J.)
| | - Mar Elena-Pérez
- Departamento de Ingeniería Electrónica, Universidad de Sevilla, 41092 Sevilla, Spain;
| | | | - Aurora Castro-Méndez
- Podiatry Department, University of Seville, 41009 Seville, Spain; (M.J.G.-L.); (M.L.G.-E.); (A.J.P.-B.); (M.C.-J.)
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Mei Q, Kim HK, Xiang L, Shim V, Wang A, Baker JS, Gu Y, Fernandez J. Toward improved understanding of foot shape, foot posture, and foot biomechanics during running: A narrative review. Front Physiol 2022; 13:1062598. [PMID: 36569759 PMCID: PMC9773215 DOI: 10.3389/fphys.2022.1062598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
The current narrative review has explored known associations between foot shape, foot posture, and foot conditions during running. The artificial intelligence was found to be a useful metric of foot posture but was less useful in developing and obese individuals. Care should be taken when using the foot posture index to associate pronation with injury risk, and the Achilles tendon and longitudinal arch angles are required to elucidate the risk. The statistical shape modeling (SSM) may derive learnt information from population-based inference and fill in missing data from personalized information. Bone shapes and tissue morphology have been associated with pathology, gender, age, and height and may develop rapid population-specific foot classifiers. Based on this review, future studies are suggested for 1) tracking the internal multi-segmental foot motion and mapping the biplanar 2D motion to 3D shape motion using the SSM; 2) implementing multivariate machine learning or convolutional neural network to address nonlinear correlations in foot mechanics with shape or posture; 3) standardizing wearable data for rapid prediction of instant mechanics, load accumulation, injury risks and adaptation in foot tissue and bones, and correlation with shapes; 4) analyzing dynamic shape and posture via marker-less and real-time techniques under real-life scenarios for precise evaluation of clinical foot conditions and performance-fit footwear development.
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Affiliation(s)
- Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Hyun Kyung Kim
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,Department of Engineering Science, The University of Auckland, Auckland, New Zealand
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Okamura K, Hasegawa M, Ikeda T, Fukuda K, Egawa K, Kanai S. Classification of medial longitudinal arch kinematics during running and characteristics of foot muscle morphology in novice runners with pronated foot. Gait Posture 2022; 93:20-25. [PMID: 35051713 DOI: 10.1016/j.gaitpost.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Novice runners with pronated feet are at an increased risk of running-related injuries. However, not all runners with pronated feet have increased foot pronation during running. Moreover, although foot muscle morphology is related to static foot alignment, the relationship between foot muscle morphology and foot kinematics during running remains unclear. We aimed to determine foot kinematic patterns during running among novice runners with pronated feet and the presence of a relationship between these foot kinematic patterns and foot muscle morphology. METHODS Twenty-one novice runners with pronated feet participated in this study, and data on 39 lower limbs were collected. Data on foot kinematics during running (rearfoot strike) were collected using a three-dimensional motion capture system in terms of navicular height (NH) at initial contact and dynamic navicular drop (DND). A hierarchical cluster analysis method was used to identify the optimal number of clusters based on these two foot-related kinematic variables. Following identification of the clusters, differences in cluster variables and cross-sectional areas of selected foot muscles assessed using ultrasonography in each cluster were examined. The muscles of interest included the abductor hallucis, flexor hallucis brevis and longus, flexor digitorum brevis and longus, and peroneus longus. RESULTS Three subgroups were identified based on foot kinematics during running: cluster 1, lowest NH at initial contact and larger DND; cluster 2, moderate NH at initial contact and smaller DND; and cluster 3, highest NH at initial contact and larger DND. Clusters 1 and 3 had a larger abductor hallucis compared with cluster 2, and cluster 3 had a larger flexor hallucis brevis compared with cluster 2. SIGNIFICANCE These subgroups may differ in terms of resistance to and type of running-related injury. Moreover, foot kinematics during running is possibly impacted by the morphology and function of medial intrinsic foot muscles.
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Affiliation(s)
- Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Masaki Hasegawa
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Tomohiro Ikeda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Kengo Fukuda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Kohei Egawa
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
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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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Association between abductor hallucis abductory force and navicular drop index, a predictive correlational study. J Pediatr Orthop B 2021; 30:484-487. [PMID: 33315804 DOI: 10.1097/bpb.0000000000000840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The role of intrinsic muscles of the foot in the medial longitudinal arch mechanism was investigated in several recent studies. It is determined that the abductor hallucis muscle (AHM) has an important role in dynamic support of the arch. Objective of our preliminary study was to establish a relationship between the navicular drop index (NDI) and the AHM abduction force. A single group exploratory design was used. The participants were 127 athletes aged 8-16 years (m/f 74/53; 11.99 ± 2.11 years; 156.21 cm ± 15.51 cm; 47.61 kg ± 13.96 kg; 2-5 training h/week), examined at a regular sport medical checkup. Abductor hallucis force was measured by a digital Algometer FPX 25/220, which is a newly developed approach that should be properly assessed in further studies to establish standardization and qualification of the algometer for this specific use. Navicular drop test has been performed as originally developed by Brody. Data were analyzed using Student's t-test, Mann-Whitney U test, contingency coefficients and logistic regression. Average NDI was found to be significantly different comparing the group with positive abduction force and the group that cannot perform the active abduction. Logistic regression indicated that the variable representing impossible active abduction was significantly associated with NDI. Preliminary results showed that there was a strong relationship between the hallux active abduction force and NDI in young athletes: the higher abduction force correlates to lower NDI. To determine clinical relevance of our investigation, further study is planned in which hallux active abduction force and NDI would be compared and correlated pre- and postspecific strengthening program.
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Leardini A, Stebbins J, Hillstrom H, Caravaggi P, Deschamps K, Arndt A. ISB recommendations for skin-marker-based multi-segment foot kinematics. J Biomech 2021; 125:110581. [PMID: 34217032 DOI: 10.1016/j.jbiomech.2021.110581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 06/14/2021] [Accepted: 06/20/2021] [Indexed: 10/21/2022]
Abstract
The foot is anatomically and functionally complex, and thus an accurate description of intrinsic kinematics for clinical or sports applications requires multiple segments. This has led to the development of many multi-segment foot models for both kinematic and kinetic analyses. These models differ in the number of segments analyzed, bony landmarks identified, required marker set, defined anatomical axes and frames, the convention used to calculate joint rotations and the determination of neutral positions or other offsets from neutral. Many of these models lack validation. The terminology used is inconsistent and frequently confusing. Biomechanical and clinical studies using these models should use established references and describe how results are obtained and reported. The International Society of Biomechanics has previously published proposals for standards regarding kinematic and kinetic measurements in biomechanical research, and in this paper also addresses multi-segment foot kinematics modeling. The scope of this work is not to prescribe a particular set of standard definitions to be used in all applications, but rather to recommend a set of standards for collecting, calculating and reporting relevant data. The present paper includes recommendations for the overall modeling and grouping of the foot bones, for defining landmarks and other anatomical references, for addressing the many experimental issues in motion data collection, for analysing and reporting relevant results and finally for designing clinical and biomechanical studies in large populations by selecting the most suitable protocol for the specific application. These recommendations should also be applied when writing manuscripts and abstracts.
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Affiliation(s)
- Alberto Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Julie Stebbins
- Oxford Gait Laboratory, Oxford University Hospitals NHS Foundation Trust, UK
| | - Howard Hillstrom
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, NY, USA
| | - Paolo Caravaggi
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Kevin Deschamps
- Faculty of Movement & Rehabilitation Sciences, KULeuven, Bruges, Belgium
| | - Anton Arndt
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
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Okamura K, Egawa K, Ikeda T, Fukuda K, Kanai S. Relationship between foot muscle morphology and severity of pronated foot deformity and foot kinematics during gait: A preliminary study. Gait Posture 2021; 86:273-277. [PMID: 33831742 DOI: 10.1016/j.gaitpost.2021.03.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/12/2021] [Accepted: 03/25/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The morphology of foot muscles that support the medial longitudinal arch differs between normal and pronated feet. The degree to which the difference depends on the severity of the pronated foot deformity is unclear. In the clinical setting, however, to reduce the pronated deformity, muscle-strengthening exercises are performed. RESEARCH QUESTION Does a relationship exist between foot muscle morphology and severity of the pronated foot deformity and foot kinematics during gait? METHODS Using the six-item foot posture index (FPI-6), 26 study participants were assessed for their foot posture and divided into two groups of 13 participants each based on the FPI-6 score: pronated foot group (with a score of 6-9) and highly pronated foot group (with a score of 10-12). Select foot muscles were scanned with ultrasonography, and muscle thicknesses were measured. The following were the muscles of interest: abductor hallucis, flexor hallucis brevis and longus, flexor digitorum brevis and longus, and peroneus longus. Foot kinematic data during gait was collected using a three-dimensional motion capture system as a dynamic navicular drop. RESULTS No between-group differences were noted for muscle thickness and dynamic navicular drop. However, the abductor hallucis and flexor hallucis brevis thicknesses were correlated with the dynamic navicular drop, but not with the severity of the pronated foot deformity. SIGNIFICANCE In individuals with pronated foot deformity, more developed abductor hallucis and flexor hallucis brevis muscles may reduce the dynamic navicular drop that represents the degree of medial longitudinal arch deformation during the stance phase of gait.
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Affiliation(s)
- Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Kohei Egawa
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Tomohiro Ikeda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Kengo Fukuda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
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Sichting F, Ebrecht F. The rise of the longitudinal arch when sitting, standing, and walking: Contributions of the windlass mechanism. PLoS One 2021; 16:e0249965. [PMID: 33831112 PMCID: PMC8031382 DOI: 10.1371/journal.pone.0249965] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/27/2021] [Indexed: 12/23/2022] Open
Abstract
The original windlass mechanism describes a one-to-one coupling between metatarsal joint dorsiflexion and medial longitudinal arch rise. The description assumes a sufficiently stiff plantar aponeurosis and absence of foot muscle activity. However, recent research calls for a broader interpretation of the windlass mechanism that accounts for an extensible plantar aponeurosis and active foot muscles. In this study, we investigate the rise of the arch in response to toe dorsiflexion when sitting, standing, and walking to discuss the windlass mechanism’s contributions in static and dynamic load scenarios. 3D motion analysis allowed a kinematic investigation of the rise and drop of the arch relative to the extent of toe dorsiflexion. The results suggest that static windlass effects poorly predict the relationship between arch dynamics and metatarsophalangeal joint motion during dynamic load scenarios, such as walking. We were able to show that toe dorsiflexion resulted in an immediate rise of the longitudinal arch during sitting and standing. In contrast, a decrease in arch height was observed during walking, despite toe dorsiflexion at the beginning of the push-off phase. Further, the longitudinal arch rose almost linearly with toe dorsiflexion in the static loading scenarios, while the dynamic load scenario revealed an exponential rise of the arch. In addition to that, the rate of change in arch height relative to toe motion was significantly lower when sitting and standing compared to walking. Finally, and most surprisingly, arch rise was found to correlate with toe dorsiflexion only in the dynamic loading scenario. These results challenge the traditional perspective of the windlass mechanism as the dominating source of foot rigidity for push-off against the ground during bipedal walking. It seems plausible that other mechanisms besides the windlass act to raise the foot arch.
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Affiliation(s)
- Freddy Sichting
- Department of Human Locomotion, Chemnitz University of Technology, Chemnitz, Germany
- * E-mail:
| | - Florian Ebrecht
- Department of Human Locomotion, Chemnitz University of Technology, Chemnitz, Germany
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Prophylaxis of Pain and Fractures within Feet in the Course of Osteoporosis: The Issue of Diagnosing. Pain Res Manag 2020; 2020:1391026. [PMID: 33312316 PMCID: PMC7719525 DOI: 10.1155/2020/1391026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/10/2020] [Accepted: 11/10/2020] [Indexed: 11/17/2022]
Abstract
Background Considering the enormous risk of fractures in the course of osteoporosis in the area of the feet, an important aspect of prophylaxis is periodic and, in special cases, ongoing monitoring of defects and deformations as well as pressure distribution. The purpose of this article is to indicate the role of the examination of posture and pressure distribution during standing, postural balance, and gait, in the prevention of fatigue fractures in the course of osteoporosis, based on the literature review and examples of patients. Methods The manuscript consists of two parts; it has a review-analytical character. The first part reviews the literature. The data were obtained using the MEDLINE (PubMed), as well as Cochrane and Embase databases. The database review was carried out focusing mainly on English-language publications, while taking into account the topicality of scientific and research works in the area of osteoporosis. The problem of multiaspects in the area of bone density was pointed out. Considering the above, in the second part, the authors analyzed 11 exemplary patients with osteoporosis, referring to the assessment of foot and lower limb defects using traditional posturological methods and including pedobarography to diagnostic procedures that are used in the assessment of pressure distribution, standing and moving, and an attempt to balance. Results Analysis of the research and scientific literature proved the lack of unambiguous diagnostic procedures of the locomotor system recommended for the prevention of fatigue fractures in the course of osteoporosis. The main diagnostic recommendations are imaging tests (most often X-ray), which are recommended in the case of specific clinical symptoms. The analysis of exemplary patients with osteoporosis showed numerous disorders in the distribution of pressure in the plantar part of the feet, which are related, among other things, with their individual defects and lower limbs. Conclusions Detailed posture diagnostics and gait estimation, along with the analysis of pressure distribution within the feet are a very important aspect of the prevention of structural degradation and fatigue fractures within the feet. An important postulate for further research and scientific work is the elaboration of the procedures that will serve the preventive diagnostics of the locomotor system, aimed at early detection of threats of fatigue fractures.
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Di Stasio G, Montanelli M. A Narrative Review on the Tests Used in Biomechanical Functional Assessment of the Foot and Leg: Diagnostic Tests of Deformities and Compensations. J Am Podiatr Med Assoc 2020; 110:447062. [PMID: 33151303 DOI: 10.7547/19-040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND To date, scientific literature has not as yet come up with any review showing the diagnostic tests used for functional assessment of the foot and leg. METHODS A literature review was conducted of electronic databases (MEDLINE, PEDro, DOAJ, BioMed Central, PLOS, and Centre for Reviews and Dissemination at the University of York) up to December 8, 2018. The biomechanical tests, which have adequate supportive literature, were divided into qualitative tests that provide a dichotomy/trichotomy-type answer to clinical diagnostic questions; semiquantitative tests that provide numerical data to clinical diagnostic questions; and quantitative tests that record continuous numerical data (in analogue or digital form). RESULTS These tests produce a useful functional evaluation model of the foot and leg for different purposes: evaluation of lower limb deficits or abnormalities in healthy patients and in athletes (in sports or other physical activities); assessment of tissue stress syndromes caused by pathomechanics; evaluation of lower limb deficits or abnormalities in rheumatic disease and diabetic foot patients; and to determine the appropriate functional or semifunctional foot orthotic therapy and therapeutic path used in gait rehabilitation. CONCLUSIONS Many of these tests have adequate diagnostic reliability and reproducibility and therefore can be considered diagnostic. Few of these are validated, and some have initiated the validation process by determining their sensitivity and specificity. The widespread use of these tools in clinical practice (diagnosis of function) lacks scientific evidence and in-depth analysis of their limitations.
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The effect of marker size on three-dimensional motion analysis of the foot. Gait Posture 2020; 82:217-219. [PMID: 32950920 DOI: 10.1016/j.gaitpost.2020.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/22/2020] [Accepted: 09/03/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND In the field of three-dimensional motion analysis of the foot, there is little agreement on the preferred size of markers to record kinematic parameters. Although currently applied marker sizes show a considerable range, there has been no detailed investigation of the effect of marker size on the calculation of foot kinematics in the current literature. RESEARCH QUESTION The objective of this research was to determine whether marker size impacts essential parameters that describe foot biomechanics. METHODS Seventeen subjects participated in this randomized repeatability study. All participants had to walk on a treadmill twice to test two sets of markers (set A: small marker, 9.5 mm, 1 g; set B: large marker, 14 mm, 2 g). Three-dimensional motion capturing was used to record the trajectories of the markers. The spatial relation of the markers, as well as vertical motion of the navicular bone and the angle of the medial longitudinal arch were calculated based on the marker trajectories. In addition to motion capturing, skin rigidity was quantified by applying an oscillatory shear force to the skin. Analysis of variance, root-mean-square error calculations and linear fit methods were applied to evaluate effects of marker size on the calculation of foot kinematics and the impact of skin rigidity. RESULTS The estimated foot kinematics appeared to be unaffected by the size of the markers. Further, there was no evidence that skin rigidity influenced the error of the marker trajectories. Interestingly, the large markers fell off more frequently. SIGNIFICANCE The findings will be of interest to those who use marker-based three-dimensional motion capturing, especially to analyze foot biomechanics. Although the calculation of kinematic parameters appears to be unaffected by marker size, practical aspects, like accidental marker loss, favor the application of small markers.
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Okamura K, Fukuda K, Oki S, Ono T, Tanaka S, Kanai S. Effects of plantar intrinsic foot muscle strengthening exercise on static and dynamic foot kinematics: A pilot randomized controlled single-blind trial in individuals with pes planus. Gait Posture 2020; 75:40-45. [PMID: 31590069 DOI: 10.1016/j.gaitpost.2019.09.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/02/2019] [Accepted: 09/27/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND No reliable evidence has confirmed whether plantar intrinsic foot muscle strengthening exercises improve static and dynamic foot kinematics in individuals with pes planus. RESEARCH QUESTION Does the short-foot exercise affect static foot alignment and foot kinematics during gait in individuals with pes planus? METHODS This was a randomized controlled single-blind trial involving 20 participants with pes planus who were randomly allocated to a short-foot exercise group (exercise) or a control group (controls). Exercise patients performed a progressive short-foot exercise three times per week for 8 weeks; controls received no intervention. Before and after the 8-week intervention, foot kinematics during gait, including dynamic navicular drop-the difference between navicular height at heel strike and the minimum value-and the time at which navicular height reached its minimum value were assessed, using three-dimensional motion analysis. We assessed static foot alignment by foot posture index and navicular drop test, and the thickness of the intrinsic and extrinsic foot muscles using ultrasound. All measurements were performed by one investigator (KO) blinded to the participants' allocation. RESULTS After the 8-week intervention in the exercise group, foot posture index scores with regard to calcaneal inversion/eversion improved significantly (p < 0.05). Moreover, the time required for navicular height to reach the minimum value decreased significantly (p < 0.01). SIGNIFICANCE For individuals with pes planus, the short-foot exercise effectively corrected static foot alignment and temporal parameters of foot kinematics during gait. This temporal change, which shortens the time for navicular height to reach its minimum value, indicates an improved windlass mechanism. Therefore, short-foot exercise might effectively prevent or treat injuries related to the pes planus alignment.
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Affiliation(s)
- Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Kengo Fukuda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan; Department of Rehabilitation, Innoshima Ishikai Hospital, 1962 Innoshima nakanosyo-cho, Onomichi-shi, Hiroshima 722-2211, Japan.
| | - Sadaaki Oki
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Takeya Ono
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Satoshi Tanaka
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
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Lerch TD, Eichelberger P, Baur H, Schmaranzer F, Liechti EF, Schwab JM, Siebenrock KA, Tannast M. Prevalence and diagnostic accuracy of in-toeing and out-toeing of the foot for patients with abnormal femoral torsion and femoroacetabular impingement: implications for hip arthroscopy and femoral derotation osteotomy. Bone Joint J 2019; 101-B:1218-1229. [PMID: 31564157 DOI: 10.1302/0301-620x.101b10.bjj-2019-0248.r1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Abnormal femoral torsion (FT) is increasingly recognized as an additional cause for femoroacetabular impingement (FAI). It is unknown if in-toeing of the foot is a specific diagnostic sign for increased FT in patients with symptomatic FAI. The aims of this study were to determine: 1) the prevalence and diagnostic accuracy of in-toeing to detect increased FT; 2) if foot progression angle (FPA) and tibial torsion (TT) are different among patients with abnormal FT; and 3) if FPA correlates with FT. PATIENTS AND METHODS A retrospective, institutional review board (IRB)-approved, controlled study of 85 symptomatic patients (148 hips) with FAI or hip dysplasia was performed in the gait laboratory. All patients had a measurement of FT (pelvic CT scan), TT (CT scan), and FPA (optical motion capture system). We allocated all patients to three groups with decreased FT (< 10°, 37 hips), increased FT (> 25°, 61 hips), and normal FT (10° to 25°, 50 hips). Cluster analysis was performed. RESULTS We found a specificity of 99%, positive predictive value (PPV) of 93%, and sensitivity of 23% for in-toeing (FPA < 0°) to detect increased FT > 25°. Most of the hips with normal or decreased FT had no in-toeing (false-positive rate of 1%). Patients with increased FT had significantly (p < 0.001) more in-toeing than patients with decreased FT. The majority of the patients (77%) with increased FT walk with a normal foot position. The correlation between FPA and FT was significant (r = 0.404, p < 0.001). Five cluster groups were identified. CONCLUSION In-toeing has a high specificity and high PPV to detect increased FT, but increased FT can be missed because of the low sensitivity and high false-negative rate. These results can be used for diagnosis of abnormal FT in patients with FAI or hip dysplasia undergoing hip arthroscopy or femoral derotation osteotomy. However, most of the patients with increased FT walk with a normal foot position. This can lead to underestimation or misdiagnosis of abnormal FT. We recommend measuring FT with CT/MRI scans in all patients with FAI. Cite this article: Bone Joint J 2019;101-B:1218-1229.
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Affiliation(s)
- Till D Lerch
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Patric Eichelberger
- Bern University of Applied Sciences Health, Physiotherapy, Bern, Switzerland
| | - Heiner Baur
- Bern University of Applied Sciences Health, Physiotherapy, Bern, Switzerland
| | - Florian Schmaranzer
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Emanuel F Liechti
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Joe M Schwab
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Klaus A Siebenrock
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Moritz Tannast
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Orthopaedic Surgery and Traumatology, Fribourg Cantonal Hospital, University of Fribourg, Fribourg, Switzerland
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Alam F, Raza S, Moiz JA, Bhati P, Anwer S, Alghadir A. Effects of selective strengthening of tibialis posterior and stretching of iliopsoas on navicular drop, dynamic balance, and lower limb muscle activity in pronated feet: A randomized clinical trial. PHYSICIAN SPORTSMED 2019; 47:301-311. [PMID: 30517043 DOI: 10.1080/00913847.2018.1553466] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Flexibility and strength are compromised in pronated feet, which could in turn lead to alteration of the dynamic balance and muscle activity in the lower extremities. This study aimed to analyze the effects of selective tibialis posterior strengthening and iliopsoas stretching on navicular drop, dynamic balance, and lower limb muscle activity in young adults with pronated feet. Methods: Twenty-eight participants with pronated feet were randomly assigned to either the stretching and strengthening group (n = 14) or the conventional exercise group (n = 14). The stretching and strengthening group performed tibialis posterior strengthening exercises and iliopsoas stretching three times a week for 6 weeks in addition to the conventional towel curl exercises. The conventional exercise group performed towel curl exercises only. Navicular drop, dynamic balance, and lower limb muscle activity were assessed at baseline and post-intervention. A mixed model analysis of variance was performed to test the study hypothesis. Results: Significant group effects for the activity of tibialis anterior (p = 0.003) and abductor hallucis muscle (p = 0.010), as well as for the posterolateral (p = 0.036) and composite reach scores (p = 0.018), were detected. Significant group × time interactions were observed for naviculardrop (p < 0.001), all dynamic balance components (p < 0.001), and the activity of tibialis anterior (p < 0.001) and abductor hallucis (p < 0.001). Conclusions: This study demonstrated that inclusion of selective tibialis posterior strengthening and iliopsoas stretching in addition to the conventional towel curl exercise program could improve important clinical outcomes, such as navicular drop, muscle activity, and dynamic balance in flatfeet.
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Affiliation(s)
- Farhan Alam
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia , New Delhi , India
| | - Shahid Raza
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia , New Delhi , India
| | - Jamal Ali Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia , New Delhi , India
| | - Pooja Bhati
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia , New Delhi , India
| | - Shahnawaz Anwer
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University , Riyadh , Saudi Arabia
| | - Ahmad Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University , Riyadh , Saudi Arabia
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Carter SL, Bryant AR, Hopper LS. An analysis of the foot in turnout using a dance specific 3D multi-segment foot model. J Foot Ankle Res 2019; 12:10. [PMID: 30740146 PMCID: PMC6360724 DOI: 10.1186/s13047-019-0318-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 01/20/2019] [Indexed: 12/03/2022] Open
Abstract
Introduction Recent three-dimensional (3D) kinematic research has revealed foot abduction is the strongest predictor of standing functional and forced turnout postures. However, it is still unknown how the internal foot joints enable a large degree of foot abduction in turnout. The primary purpose of this study was to use a dance specific multi-segment foot model to determine the lower leg and foot contributions to turnout that female university-level ballets use to accentuate their turnout. Methods Eighteen female dance students (mean age, 18.8 ± 1.6 years) volunteered for this study. Retro-reflective markers were attached to the dancers’ dominant foot. Each dancer performed three repetitions of functional turnout, forced turnout and ten consecutive sautés in first position. Repeated measures ANOVA with Bonferroni adjustments for the multiple comparisons were used to determine the kinematic adjustments, hindfoot eversion, midfoot and forefoot abduction, navicular drop (i.e. lowering of the medial longitudinal arch) and first metatarsophalangeal joint abduction between natural double leg up-right posture and the first position conditions. Results Hindfoot eversion (4.6°, p < 0.001) and midfoot abduction (2.8°, p < 0.001) significantly increased in functional turnout compared to the natural double leg up-right posture. Thirteen dancers demonstrated increased first metatarsophalangeal joint (MTPJ) abduction in forced turnout, however no statistically significant increase was found. Navicular drop during sautés in first position significantly increased by 11 mm (p < 0.001) compared to the natural double leg up-right posture. Conclusion Our findings suggest dancers do pronate, via hindfoot eversion and midfoot abduction in both functional and forced turnout, however, no immediate association was found between forced turnout and first MTPJ abduction. Foot pronation does play a role in achieving turnout. Further prospective research on in situ measures of the lower limb in turnout and injury surveillance is required to improve our understanding of the normal and abnormal dance biomechanics. Electronic supplementary material The online version of this article (10.1186/s13047-019-0318-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah L Carter
- 1Podiatric Medicine and Surgery Division, School of Allied Health, The University of Western Australia, Perth, Australia.,2Western Australian Academy of Performing Arts, Edith Cowan University, Perth, Australia.,Podiatric Medicine and Surgery Division, M422, 35 Stirling Highway, Crawley, WA 6009 Australia
| | - Alan R Bryant
- 1Podiatric Medicine and Surgery Division, School of Allied Health, The University of Western Australia, Perth, Australia
| | - Luke S Hopper
- 2Western Australian Academy of Performing Arts, Edith Cowan University, Perth, Australia
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Eichelberger P, Pohl J, Jaspers T, Ferraro M, Krause F, Baur H. Cranio-caudal and medio-lateral navicular translation are representative surrogate measures of foot function in asymptomatic adults during walking. PLoS One 2018; 13:e0208175. [PMID: 30517158 PMCID: PMC6281217 DOI: 10.1371/journal.pone.0208175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 11/13/2018] [Indexed: 11/24/2022] Open
Abstract
Introduction The translation of the navicular bone is thought to be a representative surrogate measure to assess foot pronation and hence foot function; however, it is not known how it is related to multi-segment foot kinematics. Methods Cranio-caudal (NCC) and medio-lateral (NML) navicular translation and multi-segment foot kinematics from the Oxford Foot Model (OFM) were simultaneously assessed during the stance phase of walking in 20 healthy adults. Relationships to forefoot to hindfoot (FFtoHF), hindfoot to tibia (HFtoTBA) and global hindfoot (HFL) motion were explored by cross-correlations at zero phase shift. Results FFtoHF sagittal, transversal and frontal plane angles showed median cross correlations of -0.95, 0.82 and 0.53 with NCC and of 0.78, -0.81 and -0.90 with NML. HFtoTBA transversal and frontal plane angles had correlations of 0.15 and 0.74 with NCC and of -0.38 and -0.83 with NML. The HFL frontal plane angle showed correlations of 0.41 and -0.44 with NCC and NML, respectively. Discussion The strongest relationships were found between FFtoHF sagittal plane angles and NCC and between FFtoHF frontal plane angles and NML. However, cranio-caudal and medio-lateral navicular translation seem to be reasonable surrogates for the triplanar motion between the fore- and hindfoot. The medial longitudinal arch dropped and bulged medially, while the forefoot dorsiflexed, abducted and everted with respect to the hindfoot and vice-versa. The lower cross-correlation coefficients between the rear foot parameters and NCC/NML indicated no distinct relationships between rearfoot frontal plane and midfoot kinematics. The validity of rearfoot parameters, like Achilles tendon or Calcaneal angle, to assess midfoot function must be therefore questioned. The study could also not confirm a systematic relationship between midfoot kinematics and the internal/external rotation between the hindfoot and the tibia. The measurement of navicular translation is suggested as an alternative to more complex multi-segment foot models to assess foot function.
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Affiliation(s)
- Patric Eichelberger
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
- * E-mail:
| | - Johannes Pohl
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
| | - Theo Jaspers
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
| | - Matteo Ferraro
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
| | - Fabian Krause
- University Hospital Bern, Inselspital, Department of Orthopedic Surgery, Bern, Switzerland
| | - Heiner Baur
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
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Blasimann A, Eichelberger P, Lutz N, Radlinger L, Baur H. Intra- and interday reliability of the dynamic navicular rise, a new measure for dynamic foot function: A descriptive, cross-sectional laboratory study. Foot (Edinb) 2018; 37:48-53. [PMID: 30326410 DOI: 10.1016/j.foot.2018.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/02/2018] [Accepted: 08/17/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND The lack of reliable parameters to evaluate dynamic foot function, emphasizes the need for a deeper insight in foot biomechanics. The aims were to investigate the reliability of a new parameter (dynamic navicular rise dNR), and its relationship with the dynamic navicular drop (dND). METHODS Twenty healthy participants (mean age 30.2±8.1years) had to walk on even ground and downstairs. Data of ten trials per task on two measurement days were recorded. The dNR was defined as the difference in millimetres (mm) between the minimum navicular height (NH) during stance and the NH at toe off. To test intra- and interday reliability, Intraclass Correlation Coefficients (ICC2.1) and repeatability were calculated. To obtain the absolute repeatability (RP) in mm, the equation RP=1.96×SDdifferences was used. Furthermore, the relationship between the dNR and the dND was examined by calculating Pearson (r) or Spearman (rs) correlation coefficients. RESULTS Included participants showed a mean dNR of (12.2±3.7) mm for level walking and (14.8±3.4) mm for stair descent. The ICC2.1 for the dNR were 0.98 (intraday), 0.91 (interday) for level walking and 0.97 (intraday), 0.94 (interday) for stair descent. The interday repeatability was 3.2mm (level walking), 2.7mm (stair descent) respectively. For level walking, r was 0.31 (p=0.049), and rs=0.88 (p<0.001) for stair descent. CONCLUSIONS The dNR seems to be highly reliable (ICCs), however, repeatability is unacceptable. For level walking, the dNR might be an independent measure, but not for stair climbing.
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Affiliation(s)
- Angela Blasimann
- Bern University of Applied Sciences, Department of Health Professions, Murtenstrasse 10, CH-3008 Bern, Switzerland.
| | - Patric Eichelberger
- Bern University of Applied Sciences, Department of Health Professions, Murtenstrasse 10, CH-3008 Bern, Switzerland; Graduate School for Cellular and Biomedical Sciences, University of Bern, Switzerland
| | - Nicole Lutz
- Bern University of Applied Sciences, Department of Health Professions, Murtenstrasse 10, CH-3008 Bern, Switzerland
| | - Lorenz Radlinger
- Bern University of Applied Sciences, Department of Health Professions, Murtenstrasse 10, CH-3008 Bern, Switzerland
| | - Heiner Baur
- Bern University of Applied Sciences, Department of Health Professions, Murtenstrasse 10, CH-3008 Bern, Switzerland
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The influence of gait and speed on the dynamic navicular drop - A cross sectional study on healthy subjects. Foot (Edinb) 2018; 36:67-73. [PMID: 30368194 DOI: 10.1016/j.foot.2018.04.001] [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: 12/10/2017] [Revised: 03/03/2018] [Accepted: 04/18/2018] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Variations of gait speed influence kinematic variables that may have an effect on dynamic foot deformation. The influence of gait speed on the navicular drop has not yet been investigated. METHODS The navicular drop was evaluated in static and dynamic conditions using a 3D-motion capture system. The dynamic navicular drop was evaluated on a treadmill while walking and running at three different speeds. A repeated measures ANOVA and post-hoc tests were conducted to evaluate the differences in dynamic navicular drop, corresponding unloaded navicular height at foot strike and loaded navicular height during stance. RESULTS Higher walking speed led to a significant decrease in navicular height at foot strike and a subsequent decrease of dynamic navicular drop (p=0.006). Across increasing running speeds, minimum navicular height was significantly decreased which in consequence led to an increased dynamic navicular drop (p=0.015). For walking and running at the same speed, there was a large effect of gait style with an increase of dynamic navicular drop by 3.5mm (p<0.001) during running. DISCUSSION The change of gait from walking to running at the same speed had a large effect on dynamic navicular drop. The values of navicular height at foot strike and minimum navicular height during stance should be taken into account for the interpretation of dynamic navicular drop measures. Static and dynamic navicular drop measures differ substantially.
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