Comparing Validity and Diagnostic Accuracy of Clarke's Angle and Foot Posture Index-6 to Determine Flexible Flatfoot in Adolescents: A Cross-Sectional Investigation

The predictive value of T-cell chimerism for disease relapse after allogeneic hematopoietic stem cell transplantation

Introduction

Chimerism is closely correlated with disease relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, chimerism rate is dynamic changes, and the sensitivity of different chimerism requires further research.

Methods

To investigate the predictive value of distinct chimerism for relapse, we measured bone marrow (BM), peripheral blood (PB), and T-cell (isolated from BM) chimerism in 178 patients after allo-HSCT.

Results

Receiver operating characteristic (ROC) curve showed that T-cell chimerism was more suitable to predict relapse after allo-HSCT compared with PB and BM chimerism. The cutoff value of T-cell chimerism for predicting relapse was 99.45%. Leukemia and myelodysplastic syndrome (MDS) relapse patients' T-cell chimerism was a gradual decline from 2 months to 9 months after allo-HSCT. Higher risk of relapse and death within 1 year after allo-HSCT. The T-cell chimerism rates in remission and relapse patients were 99.43% and 94.28% at 3 months after allo-HSCT (P = 0.009), 99.31% and 95.27% at 6 months after allo-HSCT (P = 0.013), and 99.26% and 91.32% at 9 months after allo-HSCT (P = 0.024), respectively. There was a significant difference (P = 0.036) for T-cell chimerism between early relapse (relapse within 9 months after allo-HSCT) and late relapse (relapse after 9 months after allo-HSCT) at 2 months after allo-HSCT. Every 1% increase in T-cell chimerism, the hazard ratio for disease relapse was 0.967 (95% CI: 0.948-0.987, P<0.001).

Discussion

We recommend constant monitoring T-cell chimerism at 2, 3, 6, and 9 months after allo-HSCT to predict relapse.

Foot Posture Index Does Not Correlate with Dynamic Foot Assessment Performed via Baropodometric Examination: A Cross-Sectional Study

BACKGROUND

Clinicians employ foot morphology assessment to evaluate the functionality of the method and anticipate possible injuries. This study aims to correlate static foot posture and the dynamic barefoot evaluation in a sample of healthy adult participants.

METHODS

The foot posture was evaluated using the Foot Posture Index-6 (FPI-6) and the dynamics were evaluated through baropodometric examination. Two operators independently assessed the participants' foot posture through FPI-6, and then a dynamic evaluation was performed by asking them to walk 8 times across a platform. One hundred participants (mean age: 32.15 ± 7.49) were enrolled.

RESULTS

The inter-rater agreement between the two assessors was found to be excellent. The majority of the feet belonged to the 0 < FPI < 4 class (32%), followed by the 4 < FPI < 8 (31%) and the FPI > 8 ranges (19.5%). Our "area of contact" analysis showed a significant poor correlation between FPI and total foot, midfoot, and the second metatarsophalangeal joint (MTPJ) (-0.3 < r < 0). Regarding "force" parameters, the analysis showed a poor correlation between the midfoot, hallux, and the second toe (-0.2 < r < 2); finally the "pressure" analysis showed a poor correlation between FPI, the fourth MTPJ, and the second toe (-0.2 < rs < 0.3) and a moderate correlation between the hallux (r = 0.374) and the fifth MTPJ (r = 0.427).

CONCLUSIONS

This study emphasizes the constrained correlation between static foot posture observation and dynamic barefoot examination.

Effect of Foot Rehabilitation Exercises for Painful Flat Foot in a 20-Year-Old Female: A Case Study Analysis

Pes planus, commonly referred to as flatfoot, is a congenital foot deformity characterized by the descent of the medial longitudinal arch, resulting in reduced spring action and increased stress on the foot during ambulation. This condition, opposite to pes cavus, typically lacks symptomatic presentation despite its structural abnormality. This case report discusses a 20-year-old female presenting to the musculoskeletal department of physiotherapy with impaired gait attributed to developmental flatfeet and an underdeveloped heel on one foot since birth. Apart from these foot deformities, no other significant abnormalities were noted upon examination. Orthotic management and ongoing monitoring have been initiated to facilitate functional independence. The prognosis for the patient's gait impairment remains optimistic with continued rehabilitation efforts aimed at dispelling misconceptions and barriers surrounding the correction of flatfoot deformities. This report underscores the importance of comprehensive rehabilitation strategies in managing flatfoot conditions to optimize patient outcomes and quality of life.

The relationship of three-dimensional foot morphology to clinical assessments and postural stability in adolescent male footballers

BACKGROUND

Foot morphology is associated with altered loading of the ankle-foot complex in adolescent footballers, predisposing to pain and injury. However, usual singular plane clinical assessments do not accurately capture the 3D nature of foot morphology. A new approach is 3D laser scanning, with statistical shape model techniques creating individual-to-group comparison. However, no research exists on the adolescent, football-playing foot. Furthermore, a link between 3D foot morphology, and usual clinical and performance measures would be beneficial for practical implementation.

METHODS

Four hundred forty-seven 3D foot scans from 224 elite male footballers (U12-U19) in bilateral stance were collected and further processed with statistical shape model techniques. Weighted shape parameters for individual principal components (Modes) were extracted for each foot. Centre of pressure displacement expressed as total travelled way in millimetres was calculated for bilateral and unilateral postural stability measures. Clinical assessments (Clarke's Angle, Resting Calcaneal Stance Position) were calculated on the 3D foot scans. Differences in weighted shape parameters, postural stability measures, and clinical assessments between age groups were determined by ANOVA. Correlations determined the relationship of Modes and clinical assessments to postural stability measures. Linear regression established if clinical assessments predicted the mode describing foot arch variation.

RESULTS

Age groups significantly differed for Mode 1 (foot length), Mode 2 (foot arch), and Mode 5 (tibial rotation relative to the foot) (p < 0.05). Resting Calcaneal Stance Position (r = .663) and Clarke's Angle (r = -.445) were low-to-moderately correlated to Mode 2 (both p < 0.001), and linear regression found they were both significant predictors of Mode 2, though only moderately (R2 = .522). There were low correlations of foot morphology to the postural stability tests.

CONCLUSION

This is the first study to describe the 3D foot morphology of male football-playing adolescents, and discover the differences between age groups. This will improve understanding and assessment of foot morphology in male adolescents because 2D techniques, as discovered in this study, do not strongly correlate to, nor predict, the 3D foot arch. Foot morphology was only lowly correlated to postural stability, thus a multifaceted program would be required for improvements.

Translation, Cross-Cultural Adaptation, and Validation of the Foot Posture Index (FPI-6)-Italian Version

Since foot posture is one of the main predictors of lower limb musculoskeletal injuries, it is crucial to use appropriate tools to define the foot's posture. The Foot Posture Index is, therefore, a reliable method to measure foot posture and is widely known and used in clinics and research. This study aimed to translate the Foot Posture Index 6 (FPI6) into Italian and to assess its psychometric properties. Translation and cross-cultural adaptation were obtained using a popular guideline. Two examinators assessed 68 subjects, and data were collected to test intra/inter-rater reliability, internal consistency and cross-cultural validity. The Italian version of FPI6 showed excellent inter- and intra-rater reliability (ICC 0.96 and 0.97), and Cronbach's alpha coefficient was 0.9, thus showing excellent internal consistency. The FPI-6 version has proved to be reliable in terms of inter- and intra-rater reliability and can, therefore, be used in clinical practice and scientific research.

Dental Malocclusion in Mixed Dentition Children and Its Relation to Podal System and Gait Parameters

BACKGROUND

Dental malocclusion is an increasingly frequent stomatognathic disorder in children and adolescents nowadays. The purpose of this study was to confirm or deny the correlations between body posture and malocclusion.

METHODS

In the study, gait, distribution of foot pressure on the ground, and body balance were examined. The research group consisted of 76 patients aged 12-15 years. The research group was obtained from patients attending periodic dental check-ups at Healthcare Center Your Health EL who agreed to participate in the study. The patients were divided into two groups without malocclusion and with malocclusion, using Angle classification, which enabled determination of the anteroposterior relationship of the first molars. The pedobarographic mat was used to analyze the distribution of foot forces on the ground, the diagnostic system Wiva^® Science was used for gait analysis, and Kineod 3D was used for posture analysis. The Shapiro-Wilk test used for analysis showed inconsistency with normal distribution for all measurement parameters. The Mann-Whitney U test was used for the analysis, and the significance level was set at p ≤ 0.05.

RESULTS

Examination of the relationship between stabilometric and gait parameters showed that the position of the mandible in relation to maxilla has an important effect on gait rhythm, gait cycle duration, and right step duration time. Patients diagnosed with malocclusion showed high-speed walking rhythm in comparison to patients with Angle's class I (p = 0.010). The duration of the whole gait cycle (p = 0.007) and the duration of right step (p = 0.027) were prolonged in students without orthodontic disorders compared to the other.

CONCLUSIONS

The conducted study proved that there is correlation between the presence of a stomatognathic disorder and gait cycle parameters. There is a statistically noticeable correspondence between the position of the mandible in relation to maxilla and walking rhythm, gait cycle duration, and right step duration time. Namely, students who presented malocclusion had a high-speed walking rhythm and decreased duration of the gait cycle and of the right step. On the other hand, students without disorders (Angle's class I) showed low-speed rhythm and increased duration of the gait cycle and of the right step in comparison to Angle's classes II and III.

Selected hallmarks of hallux valgus in older women with symptomatic hallux valgus compared to middle-aged women with and without deformation of the forefoot

The aim of the study was to compare the shape of the feet, the mobility of the metatarsophalangeal and interphalangeal joints and the flexibility of the calf muscles in older women with hallux valgus versus middle-aged women with and without this deformation to identify the presence of features which correlate particularly strongly with hallux valgus, and on which prophylaxis and conservative treatment should focus. The study involved 201 women: 92 aged 60-84 years with hallux valgus of both toes, 78 aged 38-59 with hallux valgus of both toes, and 31 aged 38-57 years with correctly shaped feet. The intensity of pain in the foot, the valgus angle of the big toe and fifth toe, the longitudinal and transverse arches of the foot, the symmetry of foot load with body weight, toe joint mobility and muscle flexibility were analysed. Both groups of women with hallux valgus differed from women with normal feet in the height of the transverse arch, the extent of dorsal extension in the first metatarsophalangeal joint and plantar flexion in the first interphalangeal joint. Older women were additionally characterised by reduced plantar flexion in the metatarsophalangeal joint of the big toe, limited flexibility of the soleus and gastrocnemius muscles as well as less pain in the toe area than in the foot itself. The most characteristic changes which were observed in older women with hallux valgus are a limited range of motion in the MTP and IP joints of the big toe, a reduced transverse arch and increased restriction of calf muscle flexibility.