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Fong Yan A, Quinlan S, Cheung RTH. Minimalist school shoes improve intrinsic foot muscle size, strength, and arch integrity among primary school students. J Sports Sci 2024:1-7. [PMID: 39087807 DOI: 10.1080/02640414.2024.2386213] [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: 01/21/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
Minimalist walking shoes have been shown to improve foot muscle size and strength in active adults, but not in our previous study involving children, which could relate to the more structured footwear used in our study. Hence, this study examined the effects of true minimalists on intrinsic foot muscle size and strength, foot arch integrity, and physical function among primary school children. After a baseline assessment, 30 primary school students aged between 9 and 12 were given a pair of minimalist shoes (minimalist index = 92%) as their regular school shoes for two school terms, followed by a re-assessment. Seventeen of the 30 participants in the minimalist group completed the study. Compared to the control group, the minimalist group showed significantly increased cross-sectional area of abductor hallucis (p = 0.047, Cohen's d = 0.57) and flexor digitorum brevis (p = 0.037, Cohen's d = 0.80), increased strength of the hallux (p = 0.015, Cohen's d = 0.76) and lesser toes (p = 0.014, Cohen's d = 0.66), greater arch height (p = 0.020, Cohen's d = 0.52) and standing long jump distance (p = 0.001, Cohen's d = 9.79). The control group exhibited improved standing long jump performance only (p = 0.020, Cohen's d = 10.70). Minimalist shoes worn daily to school promote intrinsic foot muscle size and strength, and improve foot arch integrity among primary school students.
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Affiliation(s)
- Alycia Fong Yan
- Sydney Musculoskeletal Health, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Shayan Quinlan
- Sydney Musculoskeletal Health, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Roy T H Cheung
- School of Health Sciences, Western Sydney University, Campbelltown, Australia
- Translational Health Research Institute, Western Sydney University, Australia
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Sulowska-Daszyk I, Zając B, Mika A. The influence of foot muscles exercises and minimalist shoes on lactate threshold velocity in long-distance amateur runners: a randomized controlled trial. Sci Rep 2024; 14:16496. [PMID: 39019999 PMCID: PMC11254916 DOI: 10.1038/s41598-024-67525-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024] Open
Abstract
The exercises of plantar foot muscles may have beneficial effects on the performance of the lower extremity muscles. The aim of this study was to compare two methods of foot muscle strengthening: direct short foot muscle exercises and indirect activation through training in minimalist footwear in regard to influence on lactate threshold velocity in long-distance runners. 55 recreational runners aged 21-45 years took part in that study. They were randomly divided into 2 groups: Group 1 (n = 25) with short foot muscle exercises, and Group 2 (n = 30) with training in minimalist shoes. The progressive running test was performed to determine heart rate (HR) and running velocity corresponding to lactate threshold (VLT). Two-way ANOVA was used to determine the significance of the differences regarding the evaluated variables. After the 8-week training program, higher values of VLT were observed in both groups. This change was significant only in Group 1 (p < 0.05). In Group 2, the higher value was noted but the changes were non-significant. Strengthening of the short foot muscles may improve lactate threshold velocity which is connected with running performance. Considering the obtained results, it is worth contemplating the implementation of these methods in the training of long-distance runners.
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Affiliation(s)
- Iwona Sulowska-Daszyk
- Institute of Clinical Rehabilitation, University of Physical Education, Al. Jana Pawla II 78, 31-571, Krakow, Poland.
| | - Bartosz Zając
- Laboratory of Functional Diagnostics, Central Scientific and Research Laboratory, University of Physical Education, 31-571, Kraków, Poland
| | - Anna Mika
- Institute of Clinical Rehabilitation, University of Physical Education, Al. Jana Pawla II 78, 31-571, Krakow, Poland
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Malus J, Urbaczka J, Hamill J, Rygelova M, Monte A, Horka V, Uchytil J. Does an acute transition to different footwear conditions affect walking patterns in people with different experiences of minimalist footwear? Gait Posture 2024; 113:258-264. [PMID: 38968820 DOI: 10.1016/j.gaitpost.2024.07.003] [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: 10/03/2023] [Revised: 06/21/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Minimalistic footwear provides adequate toe space, tripod function, improving foot function, muscle activation and stability during walking similarly to barefoot walking. Due to the increasing popularity of this specific footwear, there is a lack of research focusing on general users of minimalistic footwear. RESEARCH QUESTION Does annual walking in minimalistic footwear affect gait biomechanics? METHODS Cross-sectional study involving twenty participants in a minimalistic footwear group with both experience (MFE) and no experience (NMFE). Participants walked in three different conditions (barefoot, minimalistic, and neutral footwear) in the laboratory at normal human walking speed. RESULTS A significant main effect of groups regardless of footwear conditions show significantly greater values during walking in minimalistic footwear and barefoot in the stride length (p=0.035, p=0.003, respectively), and stride width (p=0.047, p=0.028, respectively) in the NMFE group compared to MFE group. The significant differences in the main effects of footwear regardless of experience were found in stance time (p<0.001), steps per minute (p<0.001), stride length (<0.001), foot adduction in TO (p<0.001), foot eversion angle in IC and TO (p<0.001, p<0.001, respectively), foot progression angle (p<0.001), ankle dorsiflexion angle in IC and TO (p<0.001, p<0.001, respectively), in ankle eversion angle in IC and TO (p<0.001, p<0.001, respectively), knee flexion angle in IC and TO (p<0.001; p<0.001, respectively), and in knee flexion range of motion (p<0.001). SIGNIFICANCE Based on our findings, barefoot walking should be used primarily during daily activities if the environment is conducive. Only one year of experience with minimalistic footwear seems insufficient and an intervention should be incorporated to change the gait pattern when transitioning to full minimalistic footwear walking.
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Affiliation(s)
- Jan Malus
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
| | - Jan Urbaczka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
| | - Joseph Hamill
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic; Department of Kinesiology, University of Massachusetts, Amherst, USA.
| | - Marketa Rygelova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
| | - Andrea Monte
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Veronika Horka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
| | - Jaroslav Uchytil
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava 70200, Czech Republic.
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García-Arrabé M, Batuecas-Sánchez I, de Vidania S, Bravo-Aguilar M, Ruiz-Ruiz B, Romero-Morales C. Effects of technological running shoes versus barefoot running on the intrinsic foot muscles, ankle mobility, and dynamic control: a novel cross-sectional research. Braz J Phys Ther 2024; 28:101092. [PMID: 38964202 PMCID: PMC11269782 DOI: 10.1016/j.bjpt.2024.101092] [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: 07/17/2023] [Revised: 05/08/2024] [Accepted: 06/05/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Technological running shoes have become increasingly popular, leading to improvements in performance. However, their long-term effects on foot musculature and joint mobility have not been thoroughly studied. OBJECTIVE To compare the activation of the intrinsic foot muscles between runners wearing technological footwear and barefoot runners. Secondary objectives included assessing ankle dorsiflexion (DF) range of motion (ROM) and dynamic postural control in both groups. METHODS A cross-sectional study was conducted involving 22 technological footwear runners and 22 barefoot runners. Ultrasonography was used to measure the thickness of the plantar fascia (PF) and the quadratus plantae (QP), abductor digiti minimus (ADM), abductor hallucis (AH), and flexor hallucis longus (FHL) muscles. Ankle mobility and dynamic postural control were also recorded. RESULTS Ultrasonography measurements showed statistically significant differences for PF thickness (mean difference [MD]: -0.10 cm; 95% CI: -0.13, -0.05 cm), QP cross-sectional area (CSA) (MD: -0.45 cm2; 95% CI: -0.77, -0.12 cm2), ADM CSA (MD: -0.49 cm2; 95% CI: -0.70, -0.17 cm2), and FHL thickness (MD: 0.82 cm; 95% CI: 0.53, 1.09 cm), with all measurements being lower in the group wearing technological footwear compared to the barefoot runners. Ankle DF ROM was also significantly greater for the barefoot runners (MD: -5.1°; 95% CI: -8.6, -1.7°). CONCLUSIONS These findings suggest potential implications for the foot musculature and ankle mobility in runners using technological footwear.
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Affiliation(s)
- María García-Arrabé
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain.
| | - Iván Batuecas-Sánchez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Silvia de Vidania
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - María Bravo-Aguilar
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Beatriz Ruiz-Ruiz
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
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Blouin C, Perrier A, Denormandie P, Genêt F. Relationship between care pathway features and use or non-use of orthotic devices by individuals with Charcot-Marie-Tooth disease: a cross-sectional, exploratory study. Disabil Rehabil 2024; 46:2155-2165. [PMID: 37147931 DOI: 10.1080/09638288.2023.2208883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 04/22/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE Orthotic devices may be prescribed for the management of foot and ankle deformities caused by Charcot-Marie-Tooth disease (CMT). However, the actual use of these devices is variable. No studies have evaluated the impact of prescription, delivery and follow-up of orthotic devices on their use.We aimed to describe the relationship between the pathways followed by individuals with CMT and orthotic device use. MATERIALS AND METHODS Exploratory, cross-sectional, 35-item survey of orthotic device management. Individuals with CMT were recruited from CMT-France Association. RESULTS Of the 940 respondents, 795 were included, mean age of 52.9 (SD 16.9) years. Rate of orthotic device use was 49.2% (391/795). The most frequent reason for non-use was a poor fit. Non-use was related to the orthotic device type, the health professionals consulted, and the severity of the CMT-related impairments. Follow-up visits (38.7%), re-evaluation of orthotic devices (25.3%) and consultations with the Physical and Rehabilitation Medicine physician were infrequent (28.3%). CONCLUSIONS Orthotic devices are massively underused. Follow-up and re-evaluation are infrequent. Care pathways, prescription and delivery of orthotic devices must be optimized to meet the expectations of people with CMT. Device fitting, individual needs, and changes in the clinical state must be re-evaluated regularly by specialists to improve orthotic device use.
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Affiliation(s)
- Cédric Blouin
- Université Versailles Saint-Quentin-en-Yvelines (UVSQ); UFR Simone Veil - Santé, UR2020 Erphan, Montigny-le-Bretonneux, France
- Service de chirurgie orthopédique, hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
- ISPC-Synergies (Institut de Santé Parasport Connecté), Paris, France
| | - Antoine Perrier
- Service de chirurgie orthopédique, hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
- Laboratoire de recherche translationnelle et d'innovation en médecine et complexité TIMC, CNRS, Grenoble, France
- Service de diabétologie, Groupe hospitalier Pitié-Salpêtrière, Paris, France
| | - Philippe Denormandie
- Service de chirurgie orthopédique, Hôpital Raymond Poincaré, APHP, Garches, France
- Groupe Mutuelle nationale des hospitaliers (MNH), Paris, France
| | - François Genêt
- ISPC-Synergies (Institut de Santé Parasport Connecté), Paris, France
- Unité Péri Opératoire du Handicap, (UPOH- Perioperative Disability Unit), Département PARASPORT- SANTE, service de Médecine Physique et de Réadaptation, Hôpital Raymond-Poincaré, Groupe Hospitalo-Universitaire APHP-Université PARIS SACLAY, Garches, France
- Université Versailles Saint-Quentin-en-Yvelines (UVSQ); UFR Simone Veil - Santé, END: ICAP, Montigny-le-Bretonneux, France
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Reinstein M, Weisman A, Masharawi Y. Barefoot walking is beneficial for individuals with persistent plantar heel pain: A single-blind randomized controlled trial. Ann Phys Rehabil Med 2024; 67:101786. [PMID: 38118297 DOI: 10.1016/j.rehab.2023.101786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND A lack of data exist about the effectiveness of active treatments for persistent plantar heel pain (PPHP). OBJECTIVES To compare short-term functional and clinical effects of a 4-week barefoot or shod treadmill walking program for people with PPHP. METHODS A single-blinded clinical trial randomized 52 participants with PPHP into either a barefoot walking group (BWG), or a shod walking group (SWG). All participants received therapeutic ultrasound. Outcomes were measured at baseline (t0), following 4 weeks of treatment (t1), and at 1-month follow-up (t2). The SF-36 functional questionnaire score was the main outcome. Secondary outcomes were self-reported and clinically-assessed pain provocation levels, pressure pain thresholds and pain tolerance. Treadmill walking time and speed were measured at t0 and t1; people also recorded the time spent walking each day in a diary. RESULTS The BWG exhibited significant improvements in all SF-36 items (except "emotional well-being") (P < 0.05), whereas the SWG exhibited improvements only in "pain" and "health change" items (P = 0.0001; effect size 0.13-0.94). Greater improvements were observed in the BWG than the SWG for "physical function" (P = 0.019) and "role limitations due to physical health" items (P = 0.035). Both groups demonstrated significant improvements in pain, with greater improvements in the BWG (P = 0.0001; effect size 0.89). Only the BWG showed significant improvements in pain pressure thresholds (P < 0.05; effect size 0.70) and pain tolerance (P < 0.001; effect size 0.67). Both groups significantly increased their speed and time spent walking on the treadmill (BWG Δ=19.7 min and Δ=1.7 km/h; SWG Δ=16.7 min and Δ=1.1 km/h) and time outdoors (SWG ∆=38.2 min/week; BWG mean ∆=48.5 min/week) (P < 0.001). All clinical tests of pain were significantly less positive in the BWG at all time points (P < 0.05). CONCLUSIONS Both walking programs benefited people with PPHP by alleviating pain and improving function and quality of life. Greater improvements were observed in the BWG than the SWG overall.
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Affiliation(s)
- Miriam Reinstein
- Mevaseret Zion and Bruchim Outpatient Clinics, Jerusalem District, Meuhedet Health Services, Jerusalem, Israel; Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Israel
| | - Asaf Weisman
- Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Israel
| | - Youssef Masharawi
- Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Israel.
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Xiao S, Shen B, Zhang C, Xu Z, Li J, Fu W, Jin J. Effects of tDCS on Foot Biomechanics: A Narrative Review and Clinical Applications. Bioengineering (Basel) 2023; 10:1029. [PMID: 37760131 PMCID: PMC10525503 DOI: 10.3390/bioengineering10091029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/13/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
In recent years, neuro-biomechanical enhancement techniques, such as transcranial direct current stimulation (tDCS), have been widely used to improve human physical performance, including foot biomechanical characteristics. This review aims to summarize research on the effects of tDCS on foot biomechanics and its clinical applications, and further analyze the underlying ergogenic mechanisms of tDCS. This review was performed for relevant papers until July 2023 in the following databases: Web of Science, PubMed, and EBSCO. The findings demonstrated that tDCS can improve foot biomechanical characteristics in healthy adults, including proprioception, muscle strength, reaction time, and joint range of motion. Additionally, tDCS can be effectively applied in the field of foot sports medicine; in particular, it can be combined with functional training to effectively improve foot biomechanical performance in individuals with chronic ankle instability (CAI). The possible mechanism is that tDCS may excite specific task-related neurons and regulate multiple neurons within the system, ultimately affecting foot biomechanical characteristics. However, the efficacy of tDCS applied to rehabilitate common musculoskeletal injuries (e.g., CAI and plantar fasciitis) still needs to be confirmed using a larger sample size. Future research should use multimodal neuroimaging technology to explore the intrinsic ergogenic mechanism of tDCS.
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Affiliation(s)
- Songlin Xiao
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Bin Shen
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Chuyi Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Zhen Xu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Jingjing Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Weijie Fu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Jing Jin
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
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Haelewijn N, Peters Dickie JL, Staes F, Vereecke E, Deschamps K. Current evidence regarding 2D ultrasonography monitoring of intrinsic foot muscle properties: A systematic review. Heliyon 2023; 9:e18252. [PMID: 37520980 PMCID: PMC10374929 DOI: 10.1016/j.heliyon.2023.e18252] [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: 06/21/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background Ultrasonography can discriminate between intrinsic and extrinsic foot muscle properties and has therefore gained considerable popularity as an indirect strength evaluation. However, an overview on the use of ultrasound for assessing intrinsic foot musculature (IFM) is currently lacking. Research question What is the current evidence regarding (1) 2D ultrasonography protocols and its reliability? (2) Reference values for cross-sectional area and dorso-plantar thickness evaluation in asymptomatic and symptomatic persons? Methods The PRISMA guidelines were used to conduct this systematic review. Eight databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, SPORTDiscus and EuropePMC) were searched up to November 1, 2021. Studies reporting quantitative 2D ultrasound findings of the intrinsic foot muscles with no limitation to sex, BMI, ethnicity or physical activity were included. Studies were assessed for methodological quality using the Downs and Black checklist. Results Fifty-three studies were retained. Protocols showed an overall good to great reliability, suggesting limits of agreement between 8 and 30% of relative muscle size with minimal detectable changes varying from 0.10 to 0.29 cm2 for cross-sectional area and 0.03-0.23 cm for thickness. Reference values are proposed for both cross-sectional area and thickness measurements of the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis and quadratus plantae in asymptomatic persons. This could not be performed in the symptomatic studies due to a limited number of relevant studies addressing the symptomatic population, therefore a clinical overview is outlined. Clinically, IFM properties have been studied in ten distinct pathological conditions, predominantly pointing towards decreased muscle properties of the abductor hallucis. Significance We provide a clear and comprehensive overview of the literature regarding 2D ultrasonography of the IFM, making the available evidence more accessible to decision makers and researchers.
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Affiliation(s)
- Nicolas Haelewijn
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
| | - Jean-Louis Peters Dickie
- Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Filip Staes
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Tervuursevest 101, 3000 Leuven, Belgium
| | - Evie Vereecke
- Department of Development & Regeneration, Muscles & Movement Group, KU Leuven, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
- Haute Ecole Leonard De Vinci, Division of Podiatry, Avenue E. Mounier 84, 1200 Sint-Lambrechts-Woluwe, Belgium
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Malus J, Urbaczka J, Rygelova M, Casula V, Nieminen M, Monte A, Horka V, Uchytil J. Effect of Footwear Type on Biomechanical Risk Factors for Knee Osteoarthritis. Orthop J Sports Med 2023; 11:23259671231183416. [PMID: 37560612 PMCID: PMC10406632 DOI: 10.1177/23259671231183416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/31/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Regular walking in different types of footwear may increase the mediolateral shear force, knee adduction moment, or vertical ground-reaction forces that could increase the risk of early development of knee osteoarthritis (OA). PURPOSE To compare kinematic and kinetic parameters that could affect the development of knee OA in 3 footwear conditions. STUDY DESIGN Controlled laboratory study. METHODS A total of 40 asymptomatic participants performed walking trials in the laboratory at self-selected walking speeds under barefoot (BF), minimalistic (MF), and neutral (NF) footwear conditions. Knee joint parameters were described using discrete point values, and continuous curves were evaluated using statistical parametric mapping. A 3 × 1 repeated-measures analysis of variance was used to determine the main effect of footwear for both discrete and continuous data. To compare differences between footwear conditions, a post hoc paired t test was used. RESULTS Discrete point analyses showed a significantly greater knee power in NF compared with MF and BF in the weight absorption phase (P < .001 for both). Statistical parametric mapping analysis indicated a significantly greater knee angle in the sagittal plane at the end of the propulsive phase in BF compared with NF and MF (P = .043). Knee joint moment was significantly greater in the propulsive phase for the sagittal (P = .038) and frontal planes (P = .035) in BF compared with NF and MF and in the absorption phase in the sagittal plane (P = .034) in BF compared with MF and NF. A significant main effect of footwear was found for anteroposterior (propulsion, ↑MF, NF, ↓BF [P = .008]; absorption, ↑BF, MF, ↓NF [P = .001]), mediolateral (propulsion, ↑MF, NF, ↓BF [P = .005]; absorption, ↑NF, MF, ↓BF [P = .044]), and vertical (propulsion, ↑NF, BF, ↓MF [P = .001]; absorption, ↑MF, BF, ↓NF [P < .001]) ground-reaction forces. Knee power showed a significant main effect of footwear (absorption, ↑NF, MF, ↓BF [P = .015]; propulsion, ↑MF, NF, ↓BF [P = .039]). CONCLUSION Walking in MF without sufficient accommodation affected kinetic and kinematic parameters and could increase the risk of early development of knee OA.
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Affiliation(s)
- Jan Malus
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic
| | - Jan Urbaczka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic
| | - Marketa Rygelova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic
| | - Victor Casula
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Miika Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Andrea Monte
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Veronika Horka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic
| | - Jaroslav Uchytil
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic
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Linares-Martín JÁ, Rico-González M. Influence of Minimalist Footwear in Middle and Long Distance Runners' Physical Fitness, Biomechanics, and Injury Incidence: A Systematic Review. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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MacGabhann S, Kearney D, Perrem N, Francis P. Barefoot Running on Grass as a Potential Treatment for Plantar Fasciitis: A Prospective Case Series. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15466. [PMID: 36497540 PMCID: PMC9741467 DOI: 10.3390/ijerph192315466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Foot characteristics and running biomechanics in shod populations are associated with the aetiology of plantar fasciitis, the most common musculoskeletal disease of the foot. Previous Case reports have demonstrated improvements in the symptoms of plantar fasciitis after a period of barefoot running on grass. METHODS Recreational runners with symptomatic plantar fasciitis were prospectively enrolled into a 6-week grass based barefoot running programme. Duration of symptoms, previous management and current pain scores (NRS, VAS) were recorded at entry. Daily pain scores were recorded during the 6-week period and 12 weeks from entry to the programme. RESULTS In total, 20 of 28 patients (71.4%) enrolled were included in the analysis. Relative to the entry point, pain at 6-weeks was lower (2.5 ± 1.4 vs. 3.9 ± 1.4, p < 0.001) and pain at the 12-week point was lower (1.5 (1.8), p = 0.002). 19 out of 20 patients had improved at week-6 (mean ± SD % change in pain score, -38.8 ± 21.5%) and at week-12 (median (IQR) % change in pain score, -58.3 (34.8) %). CONCLUSION Barefoot running on grass improved pain associated with plantar fasciitis at the 6-week and 12-week follow up points. This type of barefoot running has the ability to improve symptoms whilst allowing patients to continue running, the intervention may also address some impairments of the foot associated with plantar fasciitis.
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Affiliation(s)
- Stephen MacGabhann
- EVOLVE Research Group, Department of Health and Sports Sciences, Southeast Technological University (SETU), R93 V960 Carlow, Ireland
- School of Medicine, College of Medicine, Nursing & Health Sciences, National University of Ireland, H91 TK33 Galway, Ireland
| | - Declan Kearney
- School of Medicine, College of Medicine, Nursing & Health Sciences, National University of Ireland, H91 TK33 Galway, Ireland
| | - Nic Perrem
- EVOLVE Research Group, Department of Health and Sports Sciences, Southeast Technological University (SETU), R93 V960 Carlow, Ireland
- NHS Devon, Exeter EX2 5DW, UK
| | - Peter Francis
- EVOLVE Research Group, Department of Health and Sports Sciences, Southeast Technological University (SETU), R93 V960 Carlow, Ireland
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Shen B, Zhang S, Cui K, Zhang X, Fu W. Effects of a 12-week gait retraining program combined with foot core exercise on morphology, muscle strength, and kinematics of the arch: A randomized controlled trial. Front Bioeng Biotechnol 2022; 10:1022910. [PMID: 36299287 PMCID: PMC9589891 DOI: 10.3389/fbioe.2022.1022910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022] Open
Abstract
Objective: This study aims to explore the effects of a 12-week gait retraining program combined with foot core exercise on arch morphology, arch muscles strength, and arch kinematics. Methods: A total of 26 male recreational runners with normal arch structure who used rear-foot running strike (RFS) were divided into the intervention group (INT group) and control group (CON group) (n = 13 in each group). The INT group performed a 12-week forefoot strike (FFS) training combined with foot core exercises. The CON group did not change the original exercise habit. Before and after the intervention, the arch morphology, as well as the strength of hallux flexion, lesser toe flexion, and the metatarsophalangeal joint (MPJ) flexors were measured in a static position, and changes in the arch kinematics during RFS and FFS running were explored. Results: After a 12-week intervention, 1) the normalized navicular height increased significantly in the INT group by 5.1% (p = 0.027, Cohen’s d = 0.55); 2) the hallux absolute flexion and relative flexion of the INT group increased significantly by 20.5% and 21.7%, respectively (p = 0.001, Cohen’s d = 0.59; p = 0.001, Cohen’s d = 0.73), the absolute and relative strength of the MPJ flexors of the INT group were significantly improved by 30.7% and 32.5%, respectively (p = 0.006, Cohen’s d = 0.94; p = 0.006, Cohen’s d = 0.96); 3) and during RFS, the maximum arch angle of the INT group declined significantly by 5.1% (p < 0.001, Cohen’s d = 1.49), the arch height at touchdown increased significantly in the INT group by 32.1% (p < 0.001, Cohen’s d = 1.98). Conclusion: The 12-week gait retraining program combined with foot core exercise improved the arch in both static and dynamic positions with a moderate to large effect size, demonstrating the superiority of this combined intervention over the standalone interventions. Thus, runners with weak arch muscles are encouraged to use this combined intervention as an approach to enhance the arch.
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Affiliation(s)
- Bin Shen
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Shen Zhang
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
- *Correspondence: Shen Zhang,
| | - Kedong Cui
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xini Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Weijie Fu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
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Xiao S, Wang B, Yu C, Shen B, Zhang X, Ye D, Deng L, Xu Y, Zhou J, Fu W. Effects of intervention combining transcranial direct current stimulation and foot core exercise on sensorimotor function in foot and static balance. J Neuroeng Rehabil 2022; 19:98. [PMID: 36104787 PMCID: PMC9476283 DOI: 10.1186/s12984-022-01077-5] [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: 11/09/2021] [Accepted: 09/01/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
This study aimed to examine the effects of combining transcranial direct current stimulation (tDCS) and foot core exercise (FCE) on the sensorimotor function of the foot (i.e., toe flexor strength and passive ankle kinesthesia) and static balance.
Methods
In this double-blinded and randomized study, 30 participants were randomly assigned into two groups: tDCS combined with FCE and sham combined with FCE (i.e., control group). The participants received 2 mA stimulation for 20 min concurrently with FCE over 4 weeks (i.e., three sessions per week). After the first two groups completed the intervention, a reference group (FCE-only group) was included to further explore the placebo effects of sham by comparing it with the control group. Foot muscle strength, passive ankle kinesthesia, and static balance were assessed at baseline and after the intervention.
Results
Compared with the control group and baseline, tDCS combined with FCE could increase toe flexor strength (p < 0.001) and decrease the passive kinesthesia threshold of ankle eversion (p = 0.002). No significant differences in static balance were observed between tDCS + FCE and control groups. The linear regression models showed an association towards significance between the percent changes in metatarsophalangeal joint flexor strength and the anteroposterior average sway velocity of the center of gravity in one-leg standing with eyes closed following tDCS + FCE (r2 = 0.286; p = 0.057). The exploratory analysis also showed that compared with FCE alone, the sham stimulation did not induce any placebo effects during FCE.
Conclusion
Participating in 4 weeks of intervention using tDCS in combination with FCE effectively enhances toe flexor strength and foot–ankle sensory function.
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Kusagawa Y, Kurihara T, Maeo S, Sugiyama T, Kanehisa H, Isaka T. Associations of muscle volume of individual human plantar intrinsic foot muscles with morphological profiles of the foot. J Anat 2022; 241:1336-1343. [PMID: 36001459 PMCID: PMC9644943 DOI: 10.1111/joa.13753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/21/2022] [Accepted: 08/11/2022] [Indexed: 01/17/2023] Open
Abstract
Human plantar intrinsic foot muscles consist of 10 muscles that originate and insert within the sole of the foot. It is known that the anatomical cross‐sectional area (ACSA) and muscle thickness of two plantar intrinsic foot muscles, the flexor hallucis brevis (FHB) and abductor hallucis (ABH), associate with morphological parameters of the foot, such as total and truncated foot length and navicular height. However, it is unclear how the size for each of the plantar intrinsic foot muscles associates with various morphological profiles of the foot. This study aimed to elucidate this subject. By using magnetic resonance imaging (MRI), serial images of the right foot were obtained in 13 young adult men without foot deformities. From the obtained MR images, ACSA for each of the individual plantar intrinsic foot muscles was analyzed along the foot length, and then its muscle volume (MV) was calculated. The analyzed muscles were the abductor digiti minimi (ABDM), ABH, adductor hallucis oblique head (ADDH‐OH), adductor hallucis transverse head (ADDH‐TH), flexor digitorum brevis (FDB), FHB, and quadratus plantae (QP). Furthermore, MV of the whole plantar intrinsic foot muscle (WHOLE) was defined as the total MVs of all the analyzed muscles. As morphological parameters, total foot length, truncated foot length, forefoot width, ball circumference, instep circumference, navicular height, great toe eversion angle, and little toe inversion angle were measured using a laser three‐dimensional foot scanner in standing and sitting conditions. In addition, navicular drop (ND) and normalized truncated navicular height (NTNH) were also calculated as medial longitudinal arch (MLA) height indices. The MV of WHOLE was significantly associated with the forefoot width, ball circumference, and instep circumference (r = 0.647–0.711, p = 0.006–0.013). Positive correlations were found between the forefoot width and MV of FHB, FDB, and QP (r = 0.564–0.653, p = 0.015–0.045), between the ball circumference and MV of QP (r = 0.559, p = 0.047), between the instep circumference and MV of FHB (r = 0.609, p = 0.027), and between the little toe inversion angle and MV of QP (r = 0.570, p = 0.042). The MVs of ABH, ABDM, and ADDH‐OH were not significantly correlated with any morphological parameters of the foot. Similarly, no significant correlations were found between MV of each muscle and either of the MLA height indices (ND and NTNH). Thus, the current results indicate that forefoot width and circumferential parameters (instep and ball circumference), not MLA height, associate with the size of the whole plantar intrinsic foot muscles, especially those specialized in toe flexion (FHB, FDB, and QP).
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Affiliation(s)
- Yuki Kusagawa
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Toshiyuki Kurihara
- Faculty of Science and Engineering, Kokushikan University, Setagaya, Japan
| | - Sumiaki Maeo
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Takashi Sugiyama
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Hiroaki Kanehisa
- National Institute of Fitness and Sports in Kanoya, Kanoya, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
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15
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Ribeiro AP, de Souza BL, João SMA. Effectiveness of mechanical treatment with customized insole and minimalist flexible footwear for women with calcaneal spur: randomized controlled trial. BMC Musculoskelet Disord 2022; 23:773. [PMID: 35964021 PMCID: PMC9375309 DOI: 10.1186/s12891-022-05729-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKROUND Calcaneal spurs are described as bony outgrowths arising on medial calcaneal, where inappropriate footwear can promote disease progression. OBJECTIVE Investigate the effectiveness of mechanical treatment with customized insole and minimalist flexible footwear during gait training program in women with calcaneal spur. METHODS Design: A single-blinded, randomized and controlled trial. SETTING Biomechanics laboratory. PARTICIPANTS Forty-three women, 29 with calcaneal spur and 14 control. INTERVENTION Gait training program with use of the minimalist flexible footwear (MFG n = 15, age: 48.9 ± 9.4, height: 1.61 ± 0.1, BMI: 32.1 ± 7.0) and customized insole on footwear (COIG n = 14, age: 50.3 ± 5.8, height: 1.62 ± 0.1, BMI: 32.2 ± 4.3) and control (CG n = 14, age: 47.8 ± 8.6, height: 1.63 ± 0.1, BMI: 27.5 ± 4.5), followed of the evaluations: baseline (T0) and after three (T3) and six (T6) months. Duration of the intervention was of the six months consecutive for at least 42 h per week (six hours a day, seven days a week). Outcome primary were calcaneus pain (visual analogue scale), Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ-Br) and 6-min walk test (6MWT). Secondary was plantar pressure distribution by a pressure platform system during gait and static index foot posture (FPI). STATISTICAL ANALYSIS analysis of variance for repeated measure and between groups were used to detect treatment-time interactions (α = 5%). Effect size with D Cohen's also was used between T0 and after six (T6) months of intervention. RESULTS The MFG and COIG were effective at reducing pain after six months (MFG: 2.5-4.5 CI, p = 0.001; COIG: 1.5-3.5 CI, p = 0.011). The FFI and FHSQ-Br showed improvements with MFG and COIG after T6 (MFG: 13.7-15.4 CI, p = 0.010; COIG: 11.3-15.0 CI, p = 0.001). The 6MWT increased with MFG (589.3-622.7 CI) and COIG (401.3-644.7 CI) and foot pronation was decreased after T3 and T6 MFG (FPI Right: 4.2-5.4 CI; Left: 3.6-5.4 CI) COIG (FPI Right: 3.4-6.8 CI; Left: 3.3-5.7 CI). The contact area reduced on forefoot and rearfoot with MFG and GOIG and midfoot and rearfoot with MFG. Maximum force was reduced on foot with MFG after T3 and T6. The peak pressure was reduced on the forefoot with MFG and COIG and on midfoot and rearfoot with MFG. CONCLUSIONS The mechanical treatment with customized insole and minimalist flexible footwear during gait training program during six months in women with calcaneal spur reduced the calcaneus pain, increased function and health feet and reduced plantar load on the rearfoot, midfoot and forefoot. However, the footwear alone was more effective than when combined customized insole, given the greater efficacy on clinical and biomechanical aspects. TRIAL REGISTRATION ClinicalTrials.gov NCT03040557 (date of first registration: 02/02/2017).
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Affiliation(s)
- Ana Paula Ribeiro
- Physical Therapy Department, Post-Graduate Department, School of Medicine, University of São Paulo, R: Cipotânea, 51, Campus Universitário, São Paulo/SP, Brazil. .,School of Medicine, Post-Graduate in Health Science Department, Biomechanics and Musculoskeletal Rehabilitation Laboratory, University Santo Amaro, São Paulo, Brazil.
| | - Brenda Luciano de Souza
- School of Medicine, Post-Graduate in Health Science Department, Biomechanics and Musculoskeletal Rehabilitation Laboratory, University Santo Amaro, São Paulo, Brazil
| | - Silvia Maria Amado João
- Physical Therapy Department, Post-Graduate Department, School of Medicine, University of São Paulo, R: Cipotânea, 51, Campus Universitário, São Paulo/SP, Brazil
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16
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Ogaya S, Okubo S, Utsumi T, Konno F, Kita S. Effects of flat-flexible shoes on lower limb joint kinetics and kinematics in gait. J Biomech 2022; 141:111216. [DOI: 10.1016/j.jbiomech.2022.111216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/27/2022]
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17
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Xiao S, Wang B, Zhang X, Zhou J, Fu W. Effects of 4 Weeks of High-Definition Transcranial Direct Stimulation and Foot Core Exercise on Foot Sensorimotor Function and Postural Control. Front Bioeng Biotechnol 2022; 10:894131. [PMID: 35721844 PMCID: PMC9198259 DOI: 10.3389/fbioe.2022.894131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to examine the effects of 4 weeks of high-definition transcranial direct current stimulation (HD-tDCS) and foot core exercise (FCE) on foot sensorimotor function (i.e., toe flexor strength and passive ankle kinesthesia) and postural control.Methods: In total, 36 participants were randomly assigned into three groups as follows: HD-tDCS, FCE, and the control group. A total of 12 training sessions were performed over 4 weeks (i.e., three sessions per week) in the laboratory. The HD-tDCS group received 20-min HD-tDCS with a current density of 2 mA, and the FCE group completed short foot exercise, towel curls, toe spread and squeeze, and balance board training. Participants in the control group just maintained the activities what they usually did and did not receive any interventions. Foot muscle strength, passive ankle kinesthesia, and postural control were assessed at baseline and post-intervention.Results: HD-tDCS induced a greater decrease in the percentage changes in the passive kinesthesia thresholds of ankle inversion (p < 0.001) and eversion (p = 0.013) than the control group. Compared with the control group, a significant increase in the percentage change in the metatarsophalangeal joint flexor strength was found in the HD-tDCS group (p = 0.008) and the FCE group (p = 0.027), and a significant increase in the percentage change in toe flexor strength was observed in the FCE group (p = 0.015). Moreover, FCE induced a greater reduction in the percent changes in the medial–lateral average center of gravity sway velocity in one-leg standing with eyes open (p = 0.033) and the anteroposterior average center of gravity sway velocity in one-leg standing with eyes closed (p < 0.001) than control.Conclusion: This study demonstrated that 4 weeks of HD-tDCS and FCE induced distinct benefits on foot sensorimotor function and the standing postural control performance in healthy young adults. HD-tDCS could improve the metatarsophalangeal joint flexor strength and the passive kinesthesia thresholds of ankle inversion and eversion. Meanwhile, FCE could also enhance foot muscle strength and enhance postural control performance in one-leg standing.
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Affiliation(s)
- Songlin Xiao
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Baofeng Wang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Xini Zhang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Junhong Zhou
- The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- *Correspondence: Junhong Zhou, ; Weijie Fu,
| | - Weijie Fu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
- *Correspondence: Junhong Zhou, ; Weijie Fu,
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18
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Squibb M, Sheerin K, Francis P. Measurement of the Developing Foot in Shod and Barefoot Paediatric Populations: A Narrative Review. CHILDREN 2022; 9:children9050750. [PMID: 35626927 PMCID: PMC9139892 DOI: 10.3390/children9050750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022]
Abstract
The theory that footwear may change foot shape dates back 100 years. Since this period, research has revealed the anatomical and functional consequences that footwear can cause to the foot. Children’s feet remain malleable as they undergo developmental changes until adolescence, which is why childhood is arguably a crucial period to understand how footwear can affect natural foot development. This review explored the development of the foot in children and adolescents and the methods used to measure the different foot structures; it comments on the key issues with some of these methods and gives direction for future research. Various internal and external factors can affect foot development; the main factors are age, gender, ethnicity, body mass index (BMI) and footwear habits. Research on how footwear can affect foot development has increased over the years and the final section of this review aimed to unpick the findings. Studies investigating the influence of footwear habits on foot length and width have established inconsistent findings. Many of the studies in the review did not control for internal and external factors that can affect foot development. There was also a limited number of studies that investigated hallux valgus angle and muscle strength differences in those with different footwear habits. Moreover, multiple studies in the final section of this review did not successfully examine the footwear habits of the participants and instead used observations or self-assessments, which is a major limitation. Future research should examine footwear behaviors and other confounding factors when investigating the development of the foot in children and adolescents. Moreover, researchers should critically evaluate the methods used to quantify the different structures of the foot to ensure valid and reliable parameters are being used.
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Affiliation(s)
- Maisie Squibb
- Department of Science and Health, South East Technological University, Kilkenny Road, Moanacurragh, R93 V960 Carlow, Ireland;
- Correspondence:
| | - Kelly Sheerin
- Sports Performance Research Institute New Zealand (SPRINZ), School of Sport and Recreation, Auckland University of Technology, 1010 Auckland, New Zealand;
| | - Peter Francis
- Department of Science and Health, South East Technological University, Kilkenny Road, Moanacurragh, R93 V960 Carlow, Ireland;
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19
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Huber G, Jaitner T, Schmidt M. Acute effects of minimalist shoes on biomechanical gait parameters in comparison to walking barefoot and in cushioned shoes: a randomised crossover study. FOOTWEAR SCIENCE 2022. [DOI: 10.1080/19424280.2022.2057593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Gina Huber
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
| | - Thomas Jaitner
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
| | - Marcus Schmidt
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
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20
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Swanson DC, Sponbeck JK, Swanson DA, Stevens CD, Allen SP, Mitchell UH, George JD, Johnson AW. Validity of ultrasound imaging for intrinsic foot muscle cross-sectional area measurements demonstrated by strong agreement with MRI. BMC Musculoskelet Disord 2022; 23:146. [PMID: 35164718 PMCID: PMC8842549 DOI: 10.1186/s12891-022-05090-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Intrinsic foot muscles maintain foot structural integrity and contribute to functional movement, posture and balance. Thus, assessing intrinsic foot muscle size and strength are important. Magnetic resonance imaging (MRI) has been shown to accurately image the individual muscles but is costly and time consuming. Ultrasound (US) imaging may provide an alternative that is less costly and more readily available. The purpose of this study was to investigate the validity and intratester reliability of US imaging in measuring intrinsic foot muscle size in comparison to MRI. METHODS US and MRI were employed to measure the intrinsic foot muscle size involving 35 participants (females = 13; males = 22). The scanned intrinsic foot muscles included the flexor hallucis brevis (FHB), abductor hallucis (ABDH), flexor digitorum brevis (FDB), quadratus plantae (QP) and abductor digiti minimi (ADM). Pearson product correlation (r), intraclass correlation coefficients (ICC), standard error of the measurement (SEm) and minimal detectable difference (MDD) were calculated. RESULTS High correlations were detected between the US and MRI cross-sectional area (CSA) measurements (r = .971 to 0.995). Test reliability was excellent for both MRI and US (ICC = 0.994 to 0.999). Limits of agreement between MRI and US measurements from ranged from 5.7 to 12.2% of muscle size. SEm values for US ranged from 0.026 to 0.044 cm2, while the SEm for MRI ranged from 0.018 to 0.023 cm2. MDD values for US ranged from 0.073 to 0.122 cm2, while MRI ranged from 0.045 to 0.064 cm2. CONCLUSIONS US appears to be a valid and reliable alternative to MRI when measuring intrinsic foot muscle CSA. While US is less costly and more readily available, the MRI results were shown to be slightly more precise.
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Affiliation(s)
- Dallin C Swanson
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Joshua K Sponbeck
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Derek A Swanson
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Conner D Stevens
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Steven P Allen
- Electrical and Computer Engineering, Ira A. Fulton College of Engineering, Brigham Young University, Provo, UT, USA
| | - Ulrike H Mitchell
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - James D George
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Aaron Wayne Johnson
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA.
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21
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Willemse L, Wouters EJM, Pisters MF, Vanwanseele B. Intra-assessor reliability and measurement error of ultrasound measures for foot muscle morphology in older adults using a tablet-based ultrasound machine. J Foot Ankle Res 2022; 15:6. [PMID: 35078499 PMCID: PMC8788121 DOI: 10.1186/s13047-022-00510-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/07/2022] [Indexed: 12/25/2022] Open
Abstract
Background To gain insight into the role of plantar intrinsic foot muscles in fall-related gait parameters in older adults, it is fundamental to assess foot muscles separately. Ultrasonography is considered a promising instrument to quantify the strength capacity of individual muscles by assessing their morphology. The main goal of this study was to investigate the intra-assessor reliability and measurement error for ultrasound measures for the morphology of selected foot muscles and the plantar fascia in older adults using a tablet-based device. The secondary aim was to compare the measurement error between older and younger adults and between two different ultrasound machines. Methods Ultrasound images of selected foot muscles and the plantar fascia were collected in younger and older adults by a single operator, intensively trained in scanning the foot muscles, on two occasions, 1–8 days apart, using a tablet-based and a mainframe system. The intra-assessor reliability and standard error of measurement for the cross-sectional area and/or thickness were assessed by analysis of variance. The error variance was statistically compared across age groups and machines. Results Eighteen physically active older adults (mean age 73.8 (SD: 4.9) years) and ten younger adults (mean age 21.9 (SD: 1.8) years) participated in the study. In older adults, the standard error of measurement ranged from 2.8 to 11.9%. The ICC ranged from 0.57 to 0.97, but was excellent in most cases. The error variance for six morphology measures was statistically smaller in younger adults, but was small in older adults as well. When different error variances were observed across machines, overall, the tablet-based device showed superior repeatability. Conclusions This intra-assessor reliability study showed that a tablet-based ultrasound machine can be reliably used to assess the morphology of selected foot muscles in older adults, with the exception of plantar fascia thickness. Although the measurement errors were sometimes smaller in younger adults, they seem adequate in older adults to detect group mean hypertrophy as a response to training. A tablet-based ultrasound device seems to be a reliable alternative to a mainframe system. This advocates its use when foot muscle morphology in older adults is of interest. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-022-00510-1.
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Willemse L, Wouters EJM, Bronts HM, Pisters MF, Vanwanseele B. The effect of interventions anticipated to improve plantar intrinsic foot muscle strength on fall-related dynamic function in adults: a systematic review. J Foot Ankle Res 2022; 15:3. [PMID: 35057831 PMCID: PMC8772142 DOI: 10.1186/s13047-021-00509-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/28/2021] [Indexed: 12/30/2022] Open
Abstract
Background The plantar intrinsic foot muscles (PIFMs) have a role in dynamic functions, such as balance and propulsion, which are vital to walking. These muscles atrophy in older adults and therefore this population, which is at high risk to falling, may benefit from strengthening these muscles in order to improve or retain their gait performance. Therefore, the aim was to provide insight in the evidence for the effect of interventions anticipated to improve PIFM strength on dynamic balance control and foot function during gait in adults. Methods A systematic literature search was performed in five electronic databases. The eligibility of peer-reviewed papers, published between January 1, 2010 and July 8, 2020, reporting controlled trials and pre-post interventional studies was assessed by two reviewers independently. Results from moderate- and high-quality studies were extracted for data synthesis by summarizing the standardized mean differences (SMD). The GRADE approach was used to assess the certainty of evidence. Results Screening of 9199 records resulted in the inclusion of 11 articles of which five were included for data synthesis. Included studies were mainly performed in younger populations. Low-certainty evidence revealed the beneficial effect of PIFM strengthening exercises on vertical ground reaction force (SMD: − 0.31-0.37). Very low-certainty evidence showed that PIFM strength training improved the performance on dynamic balance testing (SMD: 0.41–1.43). There was no evidence for the effect of PIFM strengthening exercises on medial longitudinal foot arch kinematics. Conclusions This review revealed at best low-certainty evidence that PIFM strengthening exercises improve foot function during gait and very low-certainty evidence for its favorable effect on dynamic balance control. There is a need for high-quality studies that aim to investigate the effect of functional PIFM strengthening exercises in large samples of older adults. The outcome measures should be related to both fall risk and the role of the PIFMs such as propulsive forces and balance during locomotion in addition to PIFM strength measures. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-021-00509-0.
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Willwacher S, Fischer KM, Rohr E, Trudeau MB, Hamill J, Brüggemann GP. Surface Stiffness and Footwear Affect the Loading Stimulus for Lower Extremity Muscles When Running. J Strength Cond Res 2022; 36:82-89. [PMID: 32028460 DOI: 10.1519/jsc.0000000000003410] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Willwacher, S, Fischer, KM, Rohr, E, Trudeau, MB, Hamill, J, and Brüggemann, G-P. Surface stiffness and footwear affect the loading stimulus for lower extremity muscles when running. J Strength Cond Res 36(1): 82-89, 2022-Running in minimal footwear or barefoot can improve foot muscle strength. Muscles spanning the foot and ankle joints have the potential to improve performance and to reduce overuse injury risk. Surface stiffness or footwear use could modify the intensity of training stimuli acting on lower extremity joints during running. The purpose of this study was to systematically investigate external ankle, knee, and hip joint moments during shod and barefoot running while considering the stiffness of the running surface. Two footwear conditions (barefoot and neutral running shoe) and 4 surface conditions (Tartan, Tartan + Ethylene Vinyl Acetate [EVA] foam, Tartan + artificial turf, Tartan + EVA foam + artificial turf) were tested at 3.5 m·s-1. Repeated measures analysis of variance revealed that barefoot running in general and running barefoot on harder surfaces increased and decreased ankle (between +5 and +26%) and knee (between 0 and -11%) joint moments, respectively. Averaged over all surfaces, running barefoot was characterized by a 6.8° more plantarflexed foot strike pattern compared with running shod. Foot strike patterns were more plantarflexed on harder surfaces; the effects, however, were less than 3°. Most surface effects were stronger in barefoot compared with shod running. Surface stiffness may be used to modulate the loading intensity of lower extremity muscles (in particular extrinsic and intrinsic foot muscles) during running. These results need to be considered when coaches advise barefoot running as a method to improve the strength of extrinsic and intrinsic foot muscles or when trying to reduce knee joint loading.
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Affiliation(s)
- Steffen Willwacher
- German Sport University Cologne, Institute of Biomechanics and Orthopedics, Köln, Germany
- Institute of Functional Diagnostics, Köln, Germany
| | - Katina M Fischer
- German Sport University Cologne, Institute of Biomechanics and Orthopedics, Köln, Germany
- Institute of Functional Diagnostics, Köln, Germany
| | - Eric Rohr
- Brooks Running Company, Seattle, Washington; and
| | | | - Joseph Hamill
- University of Massachusetts, Biomechanics Laboratory, Amherst, Massachusetts
| | - Gert-Peter Brüggemann
- German Sport University Cologne, Institute of Biomechanics and Orthopedics, Köln, Germany
- Institute of Functional Diagnostics, Köln, Germany
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Futrell EE, Roberts D, Toole E. The effects of intrinsic foot muscle strengthening on functional mobility in older adults: A systematic review. J Am Geriatr Soc 2021; 70:531-540. [PMID: 34716700 DOI: 10.1111/jgs.17541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/10/2021] [Accepted: 10/02/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Weakness and disuse of intrinsic foot muscles contributes to dysfunction in foot and toe alignment and sensory input, which may lead to instability and falls in older adults. The aim of this systematic review was to report the effects of intrinsic foot muscle strengthening (IFMS) interventions on functional mobility in adults aged ≥65 years. METHODS A systematic review was performed with searches from December 2019-February 2021 using MEDLINE, CINAHL, SPORTDiscus, Rehab and Sports Medicine Source, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials. Additional sources were sought using reference scanning. Eligible sources analyzed adults aged ≥65 years (n = 1674) who were ambulatory, used a functional mobility outcome measure, and contained foot and ankle interventions that included IFMS. Literature studies regarding neurological, vestibular, cognitive, amputation, or post-surgical conditions were excluded. Studies that did not specify intrinsic foot muscle involvement were excluded. Two authors extracted relevant studies and appraised them using the Physiotherapy Evidence Database (PEDro) scale. RESULTS A total of 1420 articles were screened for relevance, and 16 were extracted. Five additional sources were obtained through reference scanning. Nine articles were eligible for review. PEDro scores ranged from 3 to 7 (out of 10), indicating "fair" quality of evidence. Heterogeneity of methods and data did not allow for statistical comparison. Themes extracted from sources were types of intrinsic foot strengthening interventions and parameters; outcomes on falls, balance, functional mobility; and subjective reports regarding functional mobility. CONCLUSION Evidence reviewed was of fair quality. IFMS interventions contributed to improvements in strength, balance, mobility, and possibly reduced fall risk. There was little effect on gait. Subjective reports indicate a possible mechanism for improved mobility may be from increased proprioception and sensation.
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Affiliation(s)
| | - Dawn Roberts
- Springfield College, Springfield, Massachusetts, USA
| | - Eric Toole
- Springfield College, Springfield, Massachusetts, USA
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Davis IS, Hollander K, Lieberman DE, Ridge ST, Sacco ICN, Wearing SC. Stepping Back to Minimal Footwear: Applications Across the Lifespan. Exerc Sport Sci Rev 2021; 49:228-243. [PMID: 34091498 DOI: 10.1249/jes.0000000000000263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Minimal footwear has existed for tens of thousands of years and was originally designed to protect the sole of the foot. Over the past 50 yr, most footwear has become increasingly more cushioned and supportive. Here, we review evidence that minimal shoes are a better match to our feet, which may result in a lower risk of musculoskeletal injury.
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Affiliation(s)
- Irene S Davis
- Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
| | | | - Daniel E Lieberman
- Department of Human Evolutionary Biology, Harvard University, Cambridge MA
| | - Sarah T Ridge
- Department of Exercise Sciences, Brigham Young University, Salt Lake City, Utah
| | - Isabel C N Sacco
- Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
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Daily activity in minimal footwear increases foot strength. Sci Rep 2021; 11:18648. [PMID: 34545114 PMCID: PMC8452613 DOI: 10.1038/s41598-021-98070-0] [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: 07/29/2021] [Accepted: 08/30/2021] [Indexed: 11/24/2022] Open
Abstract
The human foot is uniquely adapted to bipedal locomotion and has a deformable arch of variable stiffness. Intrinsic foot muscles regulate arch deformation, making them important for foot function. In this study we explore the hypothesis that normal daily activity in minimal footwear, which provides little or no support, increases foot muscle strength. Western adults wore minimal footwear for a six-month period (the “intervention” group). Foot strength, i.e., maximum isometric plantarflexion strength at the metatarsophalangeal joints, and foot biometrics were measured before and after the intervention. An additional group was investigated to add further insight on the long-term effects of footwear, consisting of Western adults with an average 2.5 years of experience in minimal footwear (the “experienced” group). This study shows that foot strength increases by, on average, 57.4% (p < 0.001) after six months of daily activity in minimal footwear. The experienced group had similar foot strength as the post intervention group, suggesting that six months of regular minimal footwear use is sufficient to gain full strength, which may aid healthy balance and gait.
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Lai Z, Pang H, Hu X, Dong K, Wang L. Effects of intrinsic-foot-muscle exercise combined with the lower extremity resistance training on postural stability in older adults with fall risk: study protocol for a randomised controlled trial. Trials 2021; 22:587. [PMID: 34479617 PMCID: PMC8414859 DOI: 10.1186/s13063-021-05554-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Falls are one of the most common accidents in older adults, often leading to injury, disability and quality-of-life declines. Foot core function contributes to postural stability in most static postures and dynamic activities. As efficient foot core training, the intrinsic-foot-muscle exercise has been proposed to improve postural control. However, the effects of the exercise on postural stability in the elderly remain unclear. Therefore, this study attempts to investigate the effect of 12-week intrinsic-foot-muscle exercise on postural stability in older adults with fall risk. METHODS We will conduct a prospective, single-blind randomised controlled trail on 120 older adults with fall risk. Participants will be randomly assigned to an intrinsic-foot-muscle exercise combining the lower extremity resistance training group (IFM group), an extrinsic-foot-muscle exercise combining the lower extremity resistance training group (EFM group) and a control group. The control group will perform lower extremity resistance training. The IFM and EFM groups will be given additional short-foot exercise or towel-curl exercise training, respectively. After the intervention, participants will be followed up for another 12 weeks with no active intervention. The outcome measures will include the postural stability measurements, self-reported postural stability, number of falls, intrinsic-foot-muscle strength and foot arch function. Furthermore, adverse events will be recorded and analysed. If any participant withdraws from the trial, an intention-to-treat analysis will be performed. DISCUSSION The trial is designed to investigate the efficacy of a 12-week intrinsic foot muscle training combined with the lower extremity resistance training on postural stability outcomes in elderly people with fall risk. The trial will also examine the comprehensive outcomes of postural stability during static standing and dynamic movements. The function of intrinsic foot muscle to support the arch will also be evaluated. Important features of this trial mainly include intervention setting, outcome measure selection and study duration. The results of this study will determine the effectiveness and provide scientific evidence to establish comprehensive fall prevention intervention. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000033623. Registered on 7 June 2020. http://www.chictr.org.cn/showproj.aspx?proj=54741.
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Affiliation(s)
- Zhangqi Lai
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Hongbo Pang
- Tianjin Rehabilitation guidance Center for the Disabledg, Tianjin, China
| | - Xiaoyue Hu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Kun Dong
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.
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Bassett K, Bruening D, McLean D, Barker K, Ridge ST. Effect of footwear on arch rise and drop when walking: a preliminary analysis. FOOTWEAR SCIENCE 2021. [DOI: 10.1080/19424280.2021.1916616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Magalhães FA, Fonseca ST, Araújo VL, Trede RG, Oliveira LM, Castor CGME, Pinto RZ, Souza TR. Midfoot passive stiffness affects foot and ankle kinematics and kinetics during the propulsive phase of walking. J Biomech 2021; 119:110328. [PMID: 33611052 DOI: 10.1016/j.jbiomech.2021.110328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/11/2020] [Accepted: 02/07/2021] [Indexed: 11/18/2022]
Abstract
The midfoot joint complex (MFJC) is related to the mechanics and efficiency of the walking propulsive phase and low midfoot passive stiffness may require compensatory foot and ankle joint moments to avoid excessive pronation and inefficient propulsion. This study aimed to investigate the kinematics and kinetics of the MFJC and ankle during the propulsive phase of walking in subjects with larger and smaller midfoot passive stiffness. MFJC passive stiffness of 20 healthy adult participants, and the kinematics and kinetics of the MFJC (forefoot-rearfoot) and ankle (rearfoot-shank) during the stance phase of walking were measured. The participants were divided equally into two groups according to the MFJC passive stiffness. Ranges of motion (ROM) and mean joint moments were computed for the late stance. Independent t-tests (α = 0.05) revealed that subjects with lower midfoot passive stiffness showed an increased MFJC sagittal ROM (flattened longitudinal arch) (p = 0.002), increased ankle frontal ROM (more everted positions) (p = 0.002), increased MFJC frontal ROM (more inverted positions) (p = 0.019), as well as a tendency for larger ankle sagittal ROM (p = 0.056). They also showed increased MFJC (p = 0.021) and ankle (p = 0.018) moments in the sagittal plane, increased MFJC moment in the frontal plane (p = 0.047) and a tendency for a predominant ankle moment in the frontal (p = 0.058). Foot and ankle joint moments are possible strategies to reduce pronation and improve propulsion, but not sufficient to prevent the altered kinematics related to low midfoot stiffness. Therefore, midfoot passive stiffness is critical for foot and ankle kinematics and kinetics during walking propulsive phase and is a potential target of interventions.
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Affiliation(s)
- Fabrício Anicio Magalhães
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Sérgio Teixeira Fonseca
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Vanessa Lara Araújo
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Renato Guilherme Trede
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Department of Physical Therapy, Graduate Program in Rehabilitation and Functional Performance, Diamantina, Minas Gerais, Brazil
| | - Lílian Marques Oliveira
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Camila Gomes Miranda E Castor
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Rafael Zambelli Pinto
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil
| | - Thales Rezende Souza
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences; Belo Horizonte, Minas Gerais, Brazil.
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Johnson AW, Bruening DA, Violette VA, Perkins KV, Thompson CL, Ridge ST. Ultrasound Imaging Is Reliable for Tibialis Posterior Size Measurements. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:2305-2312. [PMID: 32412115 DOI: 10.1002/jum.15340] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/09/2020] [Accepted: 04/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The tibialis posterior (TP) is a vital muscle for controlling the medial longitudinal arch of the foot during weight-bearing activities. Dysfunction of this muscle is associated with a variety of pathologic conditions; thus, it is important to reliably assess its morphologic characteristics. Ultrasound (US) has been used to assess characteristics of TP tendons but not the muscle cross-sectional area (CSA). The purpose of this study was to establish a reliable US technique to measure the TP CSA and thickness. METHODS Twenty-three healthy volunteers participated. We evaluated the CSA and thickness at 4 measurement locations (anterior and posterior views at both 30% and 50% of the shank length). RESULTS The participants included 12 female and 11 male volunteers (mean age ± SD, 31.23 ± 14.93 years). Excellent reliability was seen for the CSA and thickness at all locations (intraclass correlation coefficients, 0.988-0.998). Limits of agreement (LoA) and standard errors of the measurement (SEMs) were slightly lower at the 30% locations (LoA at 30%, 4.6-9.2; LoA at 50%, 6.4-9.7; SEM at 30%, 0.03-0.05; SEM at 50%, 0.04-0.07). Strong correlations were seen between anterior and posterior measurements of the CSA (30%, r = 0.99; P < .0001; 50%, r = 0.94; P < .0001) and thickness (30%, r = 0.98; P < .0001; 50%, r = 0.95; P = .0001). CONCLUSIONS Based on these results, the TP can be measured accurately with US at any of the tested locations. Due to the ease of collection and the quality of the data, we recommend the anterior view at 30% of the shank length to measure the CSA. The ability to assess muscle size of the TP will aid in a variety of medical and research applications.
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Affiliation(s)
- A Wayne Johnson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Dustin A Bruening
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | | | - Keisha V Perkins
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | | | - Sarah T Ridge
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
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Troy KL, Davis IS, Tenforde AS. A Narrative Review of Metatarsal Bone Stress Injury in Athletic Populations: Etiology, Biomechanics, and Management. PM R 2020; 13:1281-1290. [PMID: 33155355 DOI: 10.1002/pmrj.12518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 01/13/2023]
Abstract
Metatarsal bone stress injuries (BSIs) are common in athletic populations. BSIs are overuse injuries that result from an accumulation of microdamage that exceeds bone remodeling. Risk for metatarsal BSI is multifactorial and includes factors related to anatomy, biology, and biomechanics. In this article, anatomic factors including foot type, metatarsal length, bone density, bone geometry, and intrinsic muscle strength, which each influence how the foot responds to load, are discussed. Biologic factors such as low energy availability and impaired bone metabolism influence the quality of the bone. Finally, the influence of biomechanical loads to bone such as peak forces, load rates, and loading cycles are reviewed. General management of metatarsal BSI is discussed, including acute care, rehabilitation, treatment of refractory metatarsal BSI, and evaluation of healing/return to sport. Finally, we identify future research priorities and emerging treatments for metatarsal BSI.
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Affiliation(s)
- Karen L Troy
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Irene S Davis
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA, USA.,Spaulding National Running Center, Spaulding Hospital, Cambridge, MA, USA
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA, USA.,Spaulding National Running Center, Spaulding Hospital, Cambridge, MA, USA
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Willems C, Curtis R, Pataky T, D’Août K. Plantar pressures in three types of indigenous footwear, commercial minimal shoes, and conventional Western shoes, compared to barefoot walking. FOOTWEAR SCIENCE 2020. [DOI: 10.1080/19424280.2020.1825535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Catherine Willems
- Department of Design, KASK & Conservatorium, the School of Arts of HoGent and HoWest, Ghent, Belgium
| | - Rory Curtis
- Department of Musculoskeletal and Ageing Science, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Todd Pataky
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - Kristiaan D’Août
- Department of Musculoskeletal and Ageing Science, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- Department of Biology, University of Antwerp, Antwerp, Belgium
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Effect of footwear on intramuscular EMG activity of plantar flexor muscles in walking. J Electromyogr Kinesiol 2020; 55:102474. [PMID: 32979677 DOI: 10.1016/j.jelekin.2020.102474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 11/21/2022] Open
Abstract
One of the purposes of footwear is to assist locomotion, but some footwear types seem to restrict natural foot motion, which may affect the contribution of ankle plantar flexor muscles to propulsion. This study examined the effects of different footwear conditions on the activity of ankle plantar flexors during walking. Ten healthy habitually shod individuals walked overground in shoes, barefoot and in flip-flops while fine-wire electromyography (EMG) activity was recorded from flexor hallucis longus (FHL), soleus (SOL), and medial and lateral gastrocnemius (MG and LG) muscles. EMG signals were peak-normalised and analysed in the stance phase using Statistical Parametric Mapping (SPM). We found highly individual EMG patterns. Although walking with shoes required higher muscle activity for propulsion than walking barefoot or with flip-flops in most participants, this did not result in statistically significant differences in EMG amplitude between footwear conditions in any muscle (p > 0.05). Time to peak activity showed the lowest coefficient of variation in shod walking (3.5, 7.0, 8.0 and 3.4 for FHL, SOL, MG and LG, respectively). Future studies should clarify the sources and consequences of individual EMG responses to different footwear.
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Effect of the upward curvature of toe springs on walking biomechanics in humans. Sci Rep 2020; 10:14643. [PMID: 32943665 PMCID: PMC7499201 DOI: 10.1038/s41598-020-71247-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/12/2020] [Indexed: 11/24/2022] Open
Abstract
Although most features of modern footwear have been intensively studied, there has been almost no research on the effects of toe springs. This nearly ubiquitous upward curvature of the sole at the front of the shoe elevates the toe box dorsally above the ground and thereby holds the toes in a constantly dorsiflexed position. While it is generally recognized that toe springs facilitate the forefoot’s ability to roll forward at the end of stance, toe springs may also have some effect on natural foot function. This study investigated the effects of toe springs on foot biomechanics in a controlled experiment in which participants walked in specially-designed sandals with varying curvature in the toe region to simulate toe springs ranging from 10 to 40 degrees of curvature. Using inverse dynamics techniques, we found that toe springs alter the joint moments and work at the toes such that greater degrees of toe spring curvature resulted in lower work requirements during walking. Our results help explain why toe springs have been a pervasive feature in shoes for centuries but also suggest that toe springs may contribute to weakening of the foot muscles and possibly to increased susceptibility to common pathological conditions such as plantar fasciitis.
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Johnson AW, Stoneman P, McClung MS, Van Wagoner N, Corey TE, Bruening DA, Hunter TD, Myrer JW, Ridge ST. Use of Cine Loops and Structural Landmarks in Ultrasound Image Processing Improves Reliability and Reduces Error in the Assessment of Foot and Leg Muscles. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1107-1116. [PMID: 31837060 DOI: 10.1002/jum.15192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Foot and leg muscle strength and size are crucial to proper function. It is important to assess these characteristics reliably. Our primary objective was to compare the measurement of still images to cine loops. The secondary purpose was to determine interoperator and intraoperator reliability between operators of different experience levels using video clips and internal and external landmarks. METHODS Twelve healthy volunteers participated in our study. Internal (navicular tuberosity) and external (lateral leg length at 30% and 50% from the knee joint line) landmarks were used. Two operators each captured and later measured still and cine loop images of selected foot and leg muscles. RESULTS The 12 participants included 8 male and 4 female volunteers (mean age ± SD, 23.5 ± 1.9 years). Good to excellent intraoperator and interoperator reliability was seen (intraclass correlation coefficient range of 0.946-0.998). The use of cine loops improved the intraclass correlation coefficients for both intraoperator and interoperator reliability (0.5%-4% increases). The use of cine loops decreased the intraoperator standard error of the measurement and limits of agreement of the novice operator (decreases of 45%-73% and 24%-51%, respectively), and these became comparable to those of experienced operators using still images. The interoperator standard errors of the measurement dropped by 42% to 53%, whereas the limits of agreement dropped by 27% to 40%. No substantial changes were noted in the tibialis anterior across reliability metrics. CONCLUSIONS Improved protocols that take advantage of using internal bony landmarks and cine loops during both the image-gathering and measurement processes improve the reliability of research examining muscle size changes in the lower leg or foot associated with muscle changes due to exercise, injury, disuse, or disease.
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Affiliation(s)
- A Wayne Johnson
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Paul Stoneman
- Department of Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah, USA
| | - Matthew S McClung
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | | | - Taryn E Corey
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Dustin A Bruening
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | | | - J William Myrer
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Sarah T Ridge
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
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Franettovich Smith MM, Collins NJ, Mellor R, Grimaldi A, Elliott J, Hoggarth M, Weber Ii KA, Vicenzino B. Foot exercise plus education versus wait and see for the treatment of plantar heel pain (FEET trial): a protocol for a feasibility study. J Foot Ankle Res 2020; 13:20. [PMID: 32384905 PMCID: PMC7206811 DOI: 10.1186/s13047-020-00384-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022] Open
Abstract
Background Plantar heel pain (PHP) is present in a wide range of individuals and creates significant burden to quality of life and participation in physical activity. The high recurrence rates and persistence of PHP suggests current management options may not address all potentially modifiable factors associated with the condition. Reports of intrinsic foot muscle (IFM) atrophy in individuals with PHP, together with biomechanical evidence of their important contribution to optimal foot function, suggests that an intervention focused on IFM training may be beneficial in managing PHP. We will test the feasibility of a prospective, assessor-blinded, parallel-group, randomised clinical trial that compares foot exercise plus education to brief advice in individuals with PHP. Methods Twenty participants with PHP will be randomly allocated to one of two groups for a 12-week intervention period: (i) foot exercise plus education, or (ii) brief advice. The foot exercise plus education group will attend eight sessions with a physiotherapist and receive detailed education on self-management strategies as well as a progressive exercise program for the IFMs. The brief advice group will attend one session with a physiotherapist and receive brief information about self-management strategies and reassurance. Outcome measures will be obtained at baseline and the primary end-point of 12 weeks. Primary outcomes will be the feasibility of conducting a full-scale randomised clinical trial (RCT), and the credibility and acceptability of the foot exercise plus education intervention. Secondary outcomes will explore treatment effects, which will consist of pain, physical function, physical activity level, pain self-efficacy, perceived treatment effect, magnetic resonance and ultrasound image measurement of IFM morphology, ultrasound imaging measurement of plantar fascia thickness, IFM motor performance, foot posture, foot mobility, ankle dorsiflexion range of motion, toe flexor and plantar flexor strength/endurance. Discussion To reduce the burden of PHP on individuals and society, there is a need to establish effective treatments that are feasible and accepted by patients and health professionals. This trial will be the first to evaluate the feasibility of conducting a full-scale RCT, as well as the credibility, acceptability, and treatment effects, of education and foot exercise for PHP. The findings of this study will inform the development of a full-scale RCT. Trial registration The trial protocol was prospectively registered with the Australia and New Zealand Clinical Trial Registry (ACTRN12619000987167) on 11th July 2019.
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Affiliation(s)
- Melinda M Franettovich Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Natalie J Collins
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, 3086, Australia
| | - Rebecca Mellor
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Alison Grimaldi
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.,PhysioTec Physiotherapy, Brisbane, Queensland, 4121, Australia
| | - James Elliott
- Faculty of Medicine and Health and The Kolling Research Institute, The University of Sydney, Sydney, New South Wales, 2006, Australia.,Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Mark Hoggarth
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Kenneth A Weber Ii
- Systems Neuroscience and Pain Lab, Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia
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Francis P, Schofield G. From barefoot hunter gathering to shod pavement pounding. Where to from here? A narrative review. BMJ Open Sport Exerc Med 2020; 6:e000577. [PMID: 32405429 PMCID: PMC7202747 DOI: 10.1136/bmjsem-2019-000577] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2020] [Indexed: 12/22/2022] Open
Abstract
Understanding the current prevalence and incidence of running injury from an evolutionary perspective has sparked great debate. Proponents of the evolutionary approach to understanding running injury suggest that humans ran using less injurious biomechanics prior to the invention of cushioned running shoes. Those who disagree with this view, point to the many runners, wearing cushioned running shoes, who do not get injured and suggest that the evolutionary approach is indulging in a 'natural fallacy'. This polarises the scientific debate into discrete categories such as 'shod' vs 'barefoot'. This review aims, first, to describe humans' innate impact moderating mechanisms which arise from our evolutionary legacy. Second, we discuss the impact of footwear on these mechanisms and the potential link to injury in some runners. Finally, we discuss the role of barefoot training in sports medicine and attempt to make some practical suggestions as to how it might be integrated in our modern urban environments.
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Affiliation(s)
- Peter Francis
- Department of Science and Health, Institute of Technology Carlow, Carlow, Ireland
| | - Grant Schofield
- Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
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Tenforde AS, Roberts WO, Krabak BJ, Davis IS, Fredericson M, Luke AC, Ackerman KE. Recommendations to Optimize Health in Youth Runners. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Cudejko T, Gardiner J, Akpan A, D'Août K. Minimal footwear improves stability and physical function in middle-aged and older people compared to conventional shoes. Clin Biomech (Bristol, Avon) 2020; 71:139-145. [PMID: 31739197 DOI: 10.1016/j.clinbiomech.2019.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/09/2019] [Accepted: 11/09/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Effects of minimal shoes on stability and physical function in older people are under-researched. No studies have systematically explored effects of a range of minimal footwear features on these factors in older people. METHODS A within-participant repeated-measures design was used. Participants were subjected to thirteen footwear conditions: (i) barefoot, (ii) a conventional shoe, (iii) a control minimal shoe, (iv-xiii) minimal shoes differing from the control minimal shoe by one design feature. The outcomes were: (i) postural stability expressed with movement of the center of pressure (CoP) during standing (ii) dynamic stability expressed with the CoP movement during walking, (iv) physical function assessed with the Timed Up and Go test (TUG), and (iv) perceptions of footwear assessed with the Monitor Orthopaedic Shoes questionnaire. Linear Mixed Models were applied for statistical analyses. FINDINGS Twenty-two people participated in the study. Compared to the conventional shoe, participants: (i) were more stable during standing and walking in the majority of minimal shoes, and (ii) completed the TUG test faster when wearing the minimal shoe with wider sole. Compared to the control minimal shoe, participants: (i) completed the TUG test faster when wearing the minimal shoe with wider sole; and (ii) perceived features such as a split toe and a higher ankle collar as less fashionable and wearable. INTERPRETATION Wearing minimal shoes might be more beneficial for stability and physical function in older adults than wearing conventional shoes. The results will be highly valuable for the design of minimal footwear for older adults.
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Affiliation(s)
- Tomasz Cudejko
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - James Gardiner
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - Asangaedem Akpan
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom; Department of Medicine for the Elderly, Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom.
| | - Kristiaan D'Août
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
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40
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Henderson AD, Johnson AW, Rasmussen LG, Peine WP, Symons SH, Scoresby KA, Ridge ST, Bruening DA. Early-Stage Diabetic Neuropathy Reduces Foot Strength and Intrinsic but Not Extrinsic Foot Muscle Size. J Diabetes Res 2020; 2020:9536362. [PMID: 32258170 PMCID: PMC7091556 DOI: 10.1155/2020/9536362] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/14/2020] [Accepted: 02/25/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Tracking progression of diabetic peripheral polyneuropathy (DPN) is usually focused on sensory nerves and subjective testing methods. Recent studies have suggested that distal muscle atrophy may precede sensation loss. Methods to objectively measure distal muscle size and strength are needed to help understand how neuropathy affects muscle function. PURPOSE To evaluate individual intrinsic and extrinsic foot muscle sizes and functional foot strength in participants with DPN. METHODS Thirty individuals participated in this cross-sectional study (15 DPN and 15 matched controls). Sizes of 10 separate muscles of the lower leg and foot were measured using ultrasound imaging. Functional foot strength was also quantified using custom great toe and lateral toe flexion tests along with a doming test. Muscle size and strength metrics were compared between groups using ANOVAs and paired t-tests (α = 0.05). Correlations between strength and relevant muscle sizes were also evaluated. RESULTS The sizes of all four intrinsic foot muscles were smaller in individuals with DPN (p ≤ 0.03), while only one (toe extensor) of the six extrinsic muscles was smaller (p ≤ 0.03), while only one (toe extensor) of the six extrinsic muscles was smaller (p ≤ 0.03), while only one (toe extensor) of the six extrinsic muscles was smaller (p ≤ 0.03), while only one (toe extensor) of the six extrinsic muscles was smaller (r ≤ 0.80) with several corresponding intrinsic muscle sizes. The doming strength test did not show any difference between groups and was moderately correlated with one muscle size (r ≤ 0.80) with several corresponding intrinsic muscle sizes. The doming strength test did not show any difference between groups and was moderately correlated with one muscle size (. CONCLUSION Diabetic peripheral polyneuropathy affects intrinsic muscles before extrinsics. Ultrasound imaging of individual muscles and functional toe flexion tests can be used clinically to monitor DPN progression and foot function. Participants need to be trained in the doming test before a relationship can be established between this test and DPN foot function. Future studies should include muscle quality measurements to better understand characteristics of affected muscles.
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Affiliation(s)
| | - A. Wayne Johnson
- Exercise Sciences Department, Brigham Young University, Provo, UT, USA
| | | | - Weston P. Peine
- Exercise Sciences Department, Brigham Young University, Provo, UT, USA
| | - Sydney H. Symons
- Exercise Sciences Department, Brigham Young University, Provo, UT, USA
| | - Kade A. Scoresby
- Exercise Sciences Department, Brigham Young University, Provo, UT, USA
| | - Sarah T. Ridge
- Exercise Sciences Department, Brigham Young University, Provo, UT, USA
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Tourillon R, Gojanovic B, Fourchet F. How to Evaluate and Improve Foot Strength in Athletes: An Update. Front Sports Act Living 2019; 1:46. [PMID: 33344969 PMCID: PMC7739583 DOI: 10.3389/fspor.2019.00046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/24/2019] [Indexed: 11/29/2022] Open
Abstract
The foot is a complex system with multiple degrees of freedom that play an essential role in running or sprinting. The intrinsic foot muscles (IFM) are the main local stabilizers of the foot and are part of the active and neural subsystems that constitute the foot core. These muscles lengthen eccentrically during the stance phase of running before shortening at the propulsion phase, as the arch recoils in parallel to the plantar fascia. They play a key role in supporting the medial longitudinal arch, providing flexibility, stability and shock absorption to the foot, whilst partially controlling pronation. Much of the foot rigidity in late stance has been attributed to the windlass mechanism – the dorsiflexion of the toes building tension up in the plantar aponeurosis and stiffening the foot. In addition, recent studies have shown that the IFM provide a necessary active contribution in late stance, in order to develop sufficient impedance in the metatarsal-phalangeal joints. This in turn facilitates the propulsive forces at push-off. These factors support the critical role of the foot in providing rigidity and an efficient lever at push-off. During running or sprinting, athletes need to generate and maintain the highest (linear) running velocity during a single effort in a sprinting lane. Acceleration and sprinting performance requires forces to be transmitted efficiently to the ground. It may be of particular interest to strengthen foot muscles to maintain and improve an optimal capacity to generate and absorb these forces. The current evidence supports multiple exercises to achieve higher strength in the foot, such as the “short foot exercise,” doming, toes curl, towing exercises or the more dynamic hopping exercises, or even barefoot running. Their real impact on foot muscle strength remains unclear and data related to its assessment remains scarce, despite a recognized need for this, especially before and after a strengthening intervention. It would be optimal to be able to assess it. In this article, we aim to provide the track and field community with an updated review on the current modalities available for foot strength assessment and training. We present recommendations for the incorporation of foot muscles training for performance and injury prevention in track and field.
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Affiliation(s)
- Romain Tourillon
- Faculty of Sport Sciences, University of Nantes, Nantes, France.,School of Physical Therapy and Rehabilitation, IFM3R, Saint-Sébastien sur Loire, France.,Motion Analysis Lab, Physiotherapy and Sports Medicine Department, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
| | - Boris Gojanovic
- Motion Analysis Lab, Physiotherapy and Sports Medicine Department, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
| | - François Fourchet
- Motion Analysis Lab, Physiotherapy and Sports Medicine Department, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
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Day EM, Hahn ME. Increased toe-flexor muscle strength does not alter metatarsophalangeal and ankle joint mechanics or running economy. J Sports Sci 2019; 37:2702-2710. [DOI: 10.1080/02640414.2019.1661562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Evan M. Day
- Bowerman Sports Science Clinic, Department of Human Physiology, 1240 University of Oregon, Eugene, OR, USA
| | - Michael E. Hahn
- Bowerman Sports Science Clinic, Department of Human Physiology, 1240 University of Oregon, Eugene, OR, USA
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43
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Outerleys J, Matias A, Johnson C, Davis IS. Barefoot, minimal, and shod walking in habituated runners. FOOTWEAR SCIENCE 2019. [DOI: 10.1080/19424280.2019.1606331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jereme Outerleys
- Spaulding National Running Center, Cambridge, MA, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | | | - Caleb Johnson
- Spaulding National Running Center, Cambridge, MA, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Irene S. Davis
- Spaulding National Running Center, Cambridge, MA, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
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