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Pearson ZC, Harris AB, Agarwal AR, Kreulen RT, Martin J, Ahiarakwe U, Golladay GJ, Thakkar SC. Higher revision rates in patients with preoperative contralateral pes planovalgus deformity following total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2023; 31:4920-4926. [PMID: 37596366 DOI: 10.1007/s00167-023-07520-x] [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: 04/14/2023] [Accepted: 07/23/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE The purpose of this study was to compare the incidence of revision in those with pes planovalgus deformity to those without using a large national database. Given the reciprocal changes in lower extremity alignment associated with planovalgus foot deformity, it has been suggested that patients with this deformity has worse outcomes following total knee arthroplasty (TKA). METHODS A retrospective cohort analysis of patients undergoing elective TKA was conducted using the PearlDiver database. Patients were stratified into three cohorts: those without pes planovalgus, patients with ipsilateral or bilateral pes planovalgus relative to the TKA, and patients with contralateral pes planovalgus. Patients with prior foot reconstructive surgery were excluded. The cohorts were each matched to those without pes planovalgus. Bivariate analysis was performed comparing 90-day medical complications and 2- and 4-year revisions following TKA. An adjusted number needed to be exposed for one additional person to be harmed (NNEH) was calculated using the adjusted odds ratio (OR) and unexposed event rate. RESULTS Following matched analysis, those with contralateral pes planovalgus had similar odds (OR 3.41; 95% CI 0.93-12.54; p = n.s.) for aseptic revision within 2 years but significantly higher odds (OR 3.35; 95% CI 1.08-10.41; p = 0.03) within 4 years when compared to those without a pes planovalgus deformity. Within 4 years, there was no significant difference in the incidence of aseptic revision (p = n.s.) in patients with ipsilateral/bilateral pes planovalgus. No patients in any cohort underwent septic revision within 4 years of TKA. CONCLUSION This study found that patients with contralateral pes planovalgus deformity had higher odds of aseptic revision within 4 years following primary TKA in a national database, suggesting that the change in gait kinematics associated with this deformity could possibly be associated with increased revision rates. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Zachary C Pearson
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA.
| | - Andrew B Harris
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Amil R Agarwal
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - R Timothy Kreulen
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Jalen Martin
- Department of Orthopaedic Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Uzoma Ahiarakwe
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Gregory J Golladay
- Department of Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Savyasachi C Thakkar
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
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Yasin MS, Al-Labadi GM, Alshrouf MA, AlRaie BA, Ibrahim RA, AlRaie LA. Pediatric and Adolescent Flatfoot: A Questionnaire Based Middle East and North Africa Study. Int J Gen Med 2023; 16:2055-2061. [PMID: 37275331 PMCID: PMC10237185 DOI: 10.2147/ijgm.s400720] [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: 12/08/2022] [Accepted: 03/07/2023] [Indexed: 06/07/2023] Open
Abstract
Background Flatfoot is commonly seen in the community and is a common cause of concern for parents because it could become symptomatic and lead to decreased quality of life. One of the most used management approaches is foot orthoses, although no clear evidence supports their use. We aimed to study flatfoot symptoms' prevalence, effect on activities of daily living, and the use and effectiveness of orthoses. Methodology This was a cross-sectional study that included five countries from the Middle East and North Africa region (Jordan, Palestine, Syria, Egypt, and Iraq). Data were collected using an online questionnaire directed toward parents of children aged 0 to 16 from September to December 2020. The demographic factors were expressed as frequencies (percentages) using standard descriptive statistical parameters, and Pearson's chi-square test was used to examine the relationship between study factors. Results 1256 participants were recruited using this online survey. The majority (29.6%) of children were diagnosed in the age group of 0 to 2. The abnormal appearance of the foot was the most common (78.7%) complaint. Overall, 54.2% of patients were prescribed orthoses, of which 36.8% noticed improvement in flatness and 37.6% reported relief of symptoms. Conclusion This study demonstrated that most participants have no or minimal symptoms and that there is a mismatch between participants' expectations and the actual effectiveness of orthoses. Taking into consideration that there is no clear evidence to support the corrective effect of orthoses, we recommend that physicians prescribing them adhere more to their proper indications and spend more time and effort counseling and addressing patients' and parents' concerns about this developmental stage.
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Affiliation(s)
- Mohamad S Yasin
- Department of Special Surgery, Division of Orthopedics, The University of Jordan, Amman, 11942, Jordan
| | - Ghayda’a M Al-Labadi
- Department of Special Surgery, Division of Orthopedics, The University of Jordan, Amman, 11942, Jordan
| | - Mohammad Ali Alshrouf
- Department of Special Surgery, Division of Orthopedics, The University of Jordan, Amman, 11942, Jordan
| | - Bayan A AlRaie
- Department of Special Surgery, Division of Orthopedics, The University of Jordan, Amman, 11942, Jordan
| | - Raneem A Ibrahim
- Department of Special Surgery, Division of Orthopedics, The University of Jordan, Amman, 11942, Jordan
| | - Lana A AlRaie
- Department of Special Surgery, Division of Orthopedics, The University of Jordan, Amman, 11942, Jordan
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Engkananuwat P, Kanlayanaphotporn R. Gluteus medius muscle strengthening exercise effects on medial longitudinal arch height in individuals with flexible flatfoot: a randomized controlled trial. J Exerc Rehabil 2023; 19:57-66. [PMID: 36910682 PMCID: PMC9993003 DOI: 10.12965/jer.2244572.286] [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: 12/16/2022] [Accepted: 01/14/2023] [Indexed: 02/25/2023] Open
Abstract
This study aimed to compare the effects of 8 weeks of foot plus hip exercise to foot exercise alone on medial longitudinal arch (MLA) parameters; navicular drop (ND), arch height index (AHI), plantar pressure, static balance, and dynamic balance were measured at baseline, 4 weeks, and 8 weeks. A total of 52 healthy participants with bilateral flatfoot were randomly assigned into foot exercise (n=26) and foot plus hip exercise (n=26) group. At 4 weeks, the foot plus hip exercise group showed significantly less ND (P=0.002), plantar pressure at the medial forefoot (P=0.002), and mediolateral displacement (P=0.001) while showing a greater AHI (P=0.019) than the foot exercise group. At 8 weeks, there was also significantly less plantar pressure at the medial hindfoot (P=0.017) and less anteroposterior displacement (P=0.002) in the foot plus hip exercise group than in the foot exercise group. No significant differences between groups were found in dynamic balance. The addition of gluteus medius muscle strengthening exercise to foot exercise was more effective in supporting the MLA than performing foot exercise alone.
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Affiliation(s)
- Phoomchai Engkananuwat
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Rotsalai Kanlayanaphotporn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Taş S, Aktaş A, Dikici TF, Çekok FK. Achilles Tendon, Patellar Tendon, and Femoral Cartilage Thickness in Control vs Asymptomatic Flatfoot Young Adults. Foot Ankle Int 2023; 44:81-88. [PMID: 36412188 DOI: 10.1177/10711007221136137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Changes in lower extremity alignment in individuals with flatfoot may be associated with differences in morphology of the tendons or cartilage in lower extremities. The purpose of the present study was to investigate the potential association of flatfoot with the morphology of the Achilles tendon, patellar tendon, and femoral cartilage. METHODS This study was conducted with 40 participants with flatfoot (28 females, 12 males) and 40 participants with a normal foot posture (28 females, 12 males). The thickness of the Achilles tendon (at points 2 and 3 cm proximal to the superior aspect of the calcaneus), patellar tendon (at the inferior pole of the patella and 1 cm proximal of the inferior pole of the patella), and femoral cartilage (at the intercondylar area, medial condyle, and lateral condyle) was measured by an ultrasonography device. RESULTS The Achilles tendon thickness at 2 cm (P = .009) and 3 cm (P = .010) proximal of the superior aspect of the calcaneus was on average 4% to 6% lower in individuals with flatfoot compared with controls. The cartilage thickness at the intercondylar area (P = .005) and medial condyle (P = .018) was on average 8% to 12% greater in individuals with flatfoot; however, the cartilage thickness at the lateral condyle and patellar tendon thickness was similar in both groups. CONCLUSION The results obtained suggest that foot posture is associated with the morphology of the Achilles tendon and femoral cartilage. LEVEL OF EVIDENCE Level III, diagnostic comparative study.
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Affiliation(s)
- Serkan Taş
- Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Toros University, Mersin, Turkey
| | - Arda Aktaş
- Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Toros University, Mersin, Turkey
| | - Tahir Fatih Dikici
- Vocational School of Health Services, Department of Physiotherapy, Alanya Keykubat University, Antalya, Turkey
| | - Fatma Kübra Çekok
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilition, Tarsus University, Mersin, Turkey
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Low-dye taping may enhance physical performance and muscle activation in basketball players with overpronated feet. PLoS One 2022; 17:e0275178. [PMID: 36219599 PMCID: PMC9553044 DOI: 10.1371/journal.pone.0275178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/12/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Low-dye taping (LTD) is widely used by athletes and medical practitioners but the research regarding its impacts on athletic performance is lacking. This study investigated the effects of using low-dye taping on plyometric performance and muscle activities in recreational basketball players with overpronated feet. METHODS Twelve collegiate males with at least three years basketball training experience and navicular drop (ND) value ≥10 mm performed the navicular drop, drop jump and countermovement jump tests. Surface electromyography of selected lower limb muscles were observed during bilateral free squat. All tests in non-taped (NT) and taped (TAP) conditions were counterbalanced using repeated crossover study design. Paired t-test with an alpha level of 0.05 and non-clinical magnitude-based decision (MBD) with standardized effects were used to analyze data. RESULTS Contact time and reactive strength index (RSI) in the TAP condition were significantly shorter (p = 0.041) and higher (p<0.01) than the NT condition respectively. No significant difference in CMJ performance between NT and TAP was observed. MBD demonstrated clear effects on both ND (standardized effect: -1.54±0.24), flight time (standardized effect: 0.24±0.30), contact time (standardized effect: -0.27±0.21), RSI (standardized effect: 0.69±0.35) and eccentric activities of inferior gluteus maximus (standardized effect: 0.23±0.35), gluteus medius (standardized effect: 0.26±0.29) and tibialis anterior (standardized effect: 0.22±0.06). CONCLUSIONS LDT is effective in correcting overpronated feet by increasing ND height. Meanwhile, it provides a small increase in RSI and gluteal muscle activity during the eccentric (down) phase of the bilateral squat, and without affecting CMJ performance. Conditioning coaches or therapists may use LDT to enhance gluteal activation for reducing injury occurrence and reactive strength performance in drop jump tasks.
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Khan F, Chevidikunnan MF, Alsobhi MG, Ahmed IAI, Al-Lehidan NS, Rehan M, Alalawi HA, Abduljabbar AH. Diagnostic Accuracy of Various Radiological Measurements in the Evaluation and Differentiation of Flatfoot: A Cross-Sectional Study. Diagnostics (Basel) 2022; 12:diagnostics12102288. [PMID: 36291977 PMCID: PMC9600622 DOI: 10.3390/diagnostics12102288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Arch angle is used to indicate flatfoot, but in some cases, it is not easily defined. The presence of flatfoot deformity remains difficult to diagnose due to a lack of reliable radiographic assessment tools. Although various assessment methods for flatfoot have been proposed, there is insufficient evidence to prove the diagnostic accuracy of the various tools. The main purpose of the study was to determine the best radiographic measures for flatfoot concerning the arch angle. Fifty-two feet radiographs from thirty-two healthy young females were obtained. Five angles and one index were measured using weight-bearing lateral radiographs; including arch angle, calcaneal pitch (CP), talar-first metatarsal angle (TFM), lateral talar angle (LTA), talar inclination angle (TIA) and navicular index (NI). Receiver-operating characteristics were generated to evaluate the flatfoot diagnostic accuracy for all radiographic indicators and Matthews correlation coefficient was calculated to determine the cutoff value for each measure. The strongest correlation was between arch angle and CP angle [r = −0.91, p ≤ 0.0001, 95% confidence interval (CI) (from −0.94 to −0.84)]. Also, significant correlations were found between arch angle and NI [r = 0.62, p ≤ 0.0001, 95% CI (0.42 to 0.76)], and TFM [r = 0.50, p ≤ 0.0001, 95% CI (from 0.266 to 0.68)]. Furthermore, CP (cutoff, 12.40) had the highest accuracy level with value of 100% sensitivity and specificity followed by NI, having 82% sensitivity and 89% specificity for the cutoff value of 9.90. In conclusion, CP angle is inversely correlated with arch angle and considered a significant indicator of flatfoot. Also, the NI is easy to define radiographically and could be used to differentiate flat from normal arched foot among young adults.
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Affiliation(s)
- Fayaz Khan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Correspondence:
| | - Mohamed Faisal Chevidikunnan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Mashael Ghazi Alsobhi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Israa Anees Ibrahim Ahmed
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Nada Saleh Al-Lehidan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Mohd Rehan
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Hashim Abdullah Alalawi
- Department of Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Ahmed H. Abduljabbar
- Department of Radiology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah 22252, Saudi Arabia
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Şahin FN, Ceylan L, Küçük H, Ceylan T, Arıkan G, Yiğit S, Sarşık DÇ, Güler Ö. Examining the Relationship between Pes Planus Degree, Balance and Jump Performances in Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11602. [PMID: 36141874 PMCID: PMC9517403 DOI: 10.3390/ijerph191811602] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
The foot absorbs shocks with its arches, muscles, ligaments and joints, and bodyweight transmission and it pushes the body forward during all movement patterns. Pes planus is more important in sports activities that include balance and sports performance, such as walking, running, jumping, or transferring weight to a single lower limb. This study, conducted with this information in mind, aims to examine the effects of pes planus deformity on balance and vertical jump performance. Fifty athletes were included in the study. The presence of pes planus was evaluated according to the Feiss line. Balance measurements were performed with a Balance System SD Biodex. Vertical jump performance was recorded using an Omegawave jumping mat. The relationship between the pes planus grades of the participants and their balance and jump performances was analyzed using the Spearman correlation method. Vertical jump and Limit of stability (LOS) was significantly correlated with pes planus.
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Affiliation(s)
- Fatma Neşe Şahin
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara 06830, Türkiye
| | - Levent Ceylan
- Department of Coaching Education, Faculty of Sports Sciences, Sivas Cumhuriyet University, Sivas 58140, Türkiye
| | - Hamza Küçük
- Yasar Doğu Faculty of Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Türkiye
| | - Tülay Ceylan
- Department of Physical Education and Sport, Institute of Health Science, Sivas Cumhuriyet University, Sivas 58140, Türkiye
| | - Gökhan Arıkan
- Mehmet Arabacı School of Physical Education and Sport, Harran University, Şanlıurfa 63000, Türkiye
| | - Sevcan Yiğit
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara 06830, Türkiye
| | - Derya Çetin Sarşık
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara 06830, Türkiye
| | - Özkan Güler
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara 06830, Türkiye
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Yamashita T, Yamashita K, Sato M, Kawasumi M, Ata S. Analysis of skeletal characteristics of flat feet using three-dimensional foot scanner and digital footprint. Biomed Eng Online 2022; 21:56. [PMID: 35945533 PMCID: PMC9361570 DOI: 10.1186/s12938-022-01021-7] [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: 03/16/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background Flat feet increase the risk of knee osteoarthritis and contribute to frailty, which may lead to worse life prognoses. The influence of the foot skeletal structure on flat feet is not yet entirely understood. Footprints are often used to evaluate feet. However, footprint-based measurements do not reflect the underlying structures of feet and are easily confounded by soft tissue. Three-dimensional evaluation of the foot shape can reveal the characteristics of flat feet. Therefore, foot shape evaluations have garnered increasing research interest. This study aimed to determine the correlation between the three-dimensional (3D) features of the foot and the measurement results of footprint and to predict the evaluation results of flat feet from the footprint based on the 3D features. Finally, the three-dimensional characteristics of flat feet, which cannot be revealed by footprint, were determined. Methods A total of 403 individuals (40–89 years) participated in this study. The proposed system was developed to identify seven skeletal features that were expected to be associated with flat feet. The loads on the soles of the feet were measured in a static standing position and with a digital footprint device. Specifically, two footprint indices were calculated: the Chippaux–Smirak index (CSI) and the Staheli index (SI). In the analysis, comparisons between male and female measurement variables were performed using the Student’s t test. The relationships between the 3D foot features and footprint index parameters were determined by employing the Pearson correlation coefficient. Multiple linear regression was utilized to identify 3D foot features that were strongly associated with the CSI and SI. Foot features identified as significant in the multivariate regression analysis were compared based on a one-way analysis of variance (ANOVA) with Tukey’s post hoc test. Results The CSI and SI were highly correlated with the instep height (IH) and navicular height (NH) of the 3D foot scanning system and were also derived from multiple regression analysis. In addition to the NH and IH, the indicators of the forefoot, transverse arch width, and transverse arch height were considered. In the flat foot group with CSI values above 62.7%, NH was 13.5% (p < 0.001) for males and 14.9% (p = 0.01) for females, and the axis of the bone distance was 5.3% (p = 0.05) for males and 4.9% (p = 0.10) for females. In particular, for CSI values above 62.7% and NH values below 13%, the axis of the bone distance was large and the foot skeleton was deformed. Conclusions Decreased navicular bone height could be evaluated with the 3D foot scanning system even when flat feet were not detected from the footprint. The results indicate that the use of quantitative indices for 3D foot measurements is important when evaluating the flattening of the foot. Trial registration number UMIN000037694. Name of the registry: University Hospital Medical Information Network Registry. Date of registration: August 15, 2019.
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Affiliation(s)
- Tomoko Yamashita
- Graduate School of Engineering, Osaka City University, 3-3-138 Sugimoto, Sumiyoshi, Osaka, 558-8585, Japan.
| | - Kazuhiko Yamashita
- Department of Clinical Engineering, Faculty of Human Care at Makuhari, Tohto University, Chiba, Japan
| | - Mitsuru Sato
- School of Nursing and Rehabilitation Sciences, Showa University, Kanagawa, Japan
| | - Masashi Kawasumi
- School of Science and Technology for Future Life, Tokyo Denki University, Tokyo, Japan
| | - Shingo Ata
- Graduate School of Engineering, Osaka City University, 3-3-138 Sugimoto, Sumiyoshi, Osaka, 558-8585, Japan
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Strength, Flexibility and Postural Control of the Trunk and Lower Body in Participants with and without Patellofemoral Pain. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Patellofemoral pain (PFP) is a frequent knee condition. The aim of this study was to investigate strength, flexibility and postural control in people with and without PFP. Fifty-five participants between 14 and 54 years of age (PFP = 18, control group = 37) were included. Strength and flexibility for all trunk, hip, knee and ankle muscle groups were measured along with postural control outcomes. Analyses were conducted based on the “affected” and “non-affected” leg within-group and between-groups. Between-groups analysis demonstrated a statistically lower strength of trunk muscles (range: 35.8–29.3%, p < 0.001), knee extensors (20.8%, p = 0.005) and knee flexors (17.4%, p = 0.020) in PFP participants. Within-group analysis proved an 8.7% (p = 0.018) greater hip internal rotation strength and ankle extension flexibility (p = 0.032) of the “affected side” in PFP participants. This was, to our knowledge, the first study to investigate the strength of all trunk muscle groups. The results indicate that participants with PFP exhibit impaired strength of trunk muscle groups, along with knee muscle deficits, which may present a rehabilitation target. Clinicians should consider implementing trunk strengthening exercises into PFP programs along with knee-targeting exercise programs.
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Effects of a 6-Minute Fast-Walking Protocol on Changes in Muscle Activity in Individuals with Flatfoot. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12042207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Flatfoot causes abnormal biomechanics in the lower extremity, resulting in discomfort and excessive burden on lower extremity muscles during functional tasks, and it potentially leads to associated syndromes in the lower extremity. The aim of this study was to investigate how a demanding, repetitive task affects the muscle strength, activities, and fatigue of the lower extremities during function tasks. Nineteen individuals with flexible flatfoot (10M9F, age: 24.74 ± 2.68 years) and fifteen non-flatfoot participants (6M9F, age: 24.47 ± 3.74) took part in this study. All participants performed maximal voluntary isometric contraction and functional tasks, including walking and single-leg standing tests before and immediately after a 6-min fast-walking protocol. A surface electromyography system was used to collect muscle activation data. Our results showed that, after 6 min of fast walking, peroneus longus activity increased only in the non-flatfoot group, and gastrocnemius activity increased in the flexible flatfoot group. In the flexible flatfoot group, greater recruitment in abductor halluces and greater fatigue in the tibialis anterior was observed. Individuals with flexible flatfoot showed altered muscle activation pattern after 6-min fast walking. These findings can provide an evidence-based explanation of associated syndromes in flatfoot populations and lead to potential intervention strategies in the future.
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Bac A, Kaczor S, Pasiut S, Ścisłowska-Czarnecka A, Jankowicz-Szymańska A, Filar-Mierzwa K. The influence of myofascial release on pain and selected indicators of flat foot in adults: a controlled randomized trial. Sci Rep 2022; 12:1414. [PMID: 35082352 PMCID: PMC8791964 DOI: 10.1038/s41598-022-05401-w] [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: 06/18/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
Flat foot pain is a common complaint that requires therapeutic intervention. Currently, myofascial release techniques are often used in the therapy of musculoskeletal disorders. A group of 60 people suffering from flat feet with associated pain. Patients were assigned to four groups (15 people each): MF-myofascial release, E-the exercise program, MFE-myofascial release and the exercise program, C-no intervention. The rehabilitation program lasted 4 weeks. The NRS scale was used to examine pain intensity and FreeMed ground reaction force platform was used to examine selected static and dynamic foot indicators. Statistically significant pain reduction was obtained in all research. A static test of foot load distribution produced statistically significant changes only for selected indicators. In the dynamic test, statistically significant changes were observed for selected indicators, only in the groups subjected to therapeutic intervention. Most such changes were observed in the MF group. In the dynamic test which assessed the support phase of the foot, statistically significant changes were observed only for selected subphases. Most such changes were observed in the MFE group. Both exercise and exercise combined with myofascial release techniques, and especially myofascial release techniques alone, significantly reduce pain in a flat foot. This study shows a limited influence of both exercises and myofascial release techniques on selected static and dynamic indicators of a flat foot.
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Affiliation(s)
- Aneta Bac
- Faculty of Motor Rehabilitation, The Bronisław Czech, University of Physical Education, al. Jana Pawła II 78, 31-571, Krakow, Poland.
| | - Sabina Kaczor
- Faculty of Motor Rehabilitation, The Bronisław Czech, University of Physical Education, al. Jana Pawła II 78, 31-571, Krakow, Poland
| | - Szymon Pasiut
- Faculty of Motor Rehabilitation, The Bronisław Czech, University of Physical Education, al. Jana Pawła II 78, 31-571, Krakow, Poland
| | - Anna Ścisłowska-Czarnecka
- Faculty of Motor Rehabilitation, The Bronisław Czech, University of Physical Education, al. Jana Pawła II 78, 31-571, Krakow, Poland
| | | | - Katarzyna Filar-Mierzwa
- Faculty of Motor Rehabilitation, The Bronisław Czech, University of Physical Education, al. Jana Pawła II 78, 31-571, Krakow, Poland
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12
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Cho DJ, Ahn SY, Bok SK. Effect of Foot Orthoses in Children With Symptomatic Flexible Flatfoot Based on Ultrasonography of the Ankle Invertor and Evertor Muscles. Ann Rehabil Med 2022; 45:459-470. [PMID: 35000371 PMCID: PMC8743848 DOI: 10.5535/arm.21137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To examine the changes in the cross-sectional area (CSA) ratio of the ankle invertors and evertors following rigid foot orthosis (RFO) application in children with symptomatic flexible flatfoot and to determine the correlation between the degree of change in CSA ratio and pain-severity after RFO application. Methods We included 24 children with symptomatic flexible flatfoot without comorbidities and measured the CSAs of tibialis anterior (TA), tibialis posterior (TP), and peroneus longus (PL) using ultrasonography, resting calcaneal stance position (RCSP) angle, calcaneal pitch (CP), Meary’s angle, talonavicular coverage angle, and talocalcaneal angle using radiography, and foot function index (FFI) at baseline and 12 months after RFO application. We analyzed 48 data by measuring both feet of 24 children. The CSA ratios, the ratio of CSA of each muscle to the sum of CSA of TA, TP, and PL, were also compared. Correlations between the degree of change in FFI, each muscle’s CSA ratio, RCSP angle, and radiographic measurements were investigated. Results Following RFO application, significant increase in the PL ratio and CP and significant decrease in the RCSP angle, FFI total, pain, and disability scores were observed. The degree of change in the total score, pain, and disability score of FFI were significantly correlated with the degree of change in the PL ratio and RCSP angle. Conclusion RFOs applied to children with symptomatic flexible flatfoot might reduce the compensatory activities of the ankle invertors, thereby increasing the PL ratio, and pain decreases as the PL ratio increases.
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Affiliation(s)
- Dong Joon Cho
- Department of Rehabilitation Medicine, College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - So Young Ahn
- Department of Rehabilitation Medicine, College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Soo-Kyung Bok
- Department of Rehabilitation Medicine, College of Medicine, Chungnam National University Hospital, Daejeon, Korea
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Alahmri F, Alsaadi S, Ahsan M, Alqhtani S. Determining the knee joint laxity between the pronated foot and normal arched foot in adult participants. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022092. [PMID: 35775763 PMCID: PMC9335415 DOI: 10.23750/abm.v93i3.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/11/2022] [Indexed: 11/11/2022]
Abstract
AIM OF THE STUDY Foot pronation is often associated with increased internal rotation of the lower limb, predisposing the knee joint to greater stress. However, the impact of the pronated foot on knee joint laxity has not been well understood. The study aims to find out the effect of the pronated foot on knee joint laxity. METHODS Forty adult participants were recruited for the study: 20 with asymptomatic pronated foot and 20 control subjects with the normal arched foot. Foot assessments were performed by navicular drop test and rearfoot angle measurements. Knee joint laxity was measured by a KT 1000 arthrometer of the dominant leg. An independent t-test was performed to detect the differences between both groups. RESULTS Both groups were similar in age, BMI and physical activity level. The findings showed no significant differences between the pronated foot and control group in the knee joint laxity (P = 0.645). CONCLUSIONS There were no significant differences in anterior knee displacement between the pronated foot and normal arch foot. The study showed that pronated foot might not be responsible for ACL injuries during the age of twenties and cofounding factors. Further research is needed to investigate older subjects with the pronated foot.
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Affiliation(s)
- Fayez Alahmri
- Department of Medical Rehabilitation, Ministry of Health, Riyadh, Saudi Arabia
| | - Saad Alsaadi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Ahsan
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sarah Alqhtani
- Department of Medical Rehabilitation, Ministry of Health, Riyadh, Saudi Arabia
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Yamashita T, Yamashita K, Sato M, Ata S. Differences in Foot Features Between Children and Older Adults Assessed using a Three-Dimensional Foot Scanning System: A Cross-Sectional Observational Study. ADVANCED BIOMEDICAL ENGINEERING 2022. [DOI: 10.14326/abe.11.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Kazuhiko Yamashita
- Department of Clinical Engineering, Faculty of Human Care at Makuhari, Tohto University
| | - Mitsuru Sato
- Department of Physical Therapy, Faculty of Rehabilitation, Gunma Paz University
| | - Shingo Ata
- Graduate School of Engineering, Osaka City University
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15
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Jafarnezhadgero A, Fatollahi A, Sheykholeslami A, Dionisio VC, Akrami M. Long-term training on sand changes lower limb muscle activities during running in runners with over-pronated feet. Biomed Eng Online 2021; 20:118. [PMID: 34838002 PMCID: PMC8627070 DOI: 10.1186/s12938-021-00955-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/10/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Running on sand could be a promising exercise intervention for the treatment of over-pronated feet. However, there is a lack of knowledge about the effects of running on sand on muscle activities. Therefore, this study aims to evaluate the long-term effects of running on sand on the activities of selected lower limb muscles in individuals with OPF compared with healthy controls. METHODS Sixty recreational adult male runners with over-pronated feet (foot posture index > 10) were divided into two equal groups (intervention and control). Participants ran barefoot at a pre-defined speed (⁓3.3 m/s) over level stable ground both before and after long-term training on the sand. Muscle activities were recorded using a surface bipolar electromyography system. RESULTS For the intervention group, we found a reduced foot posture index (p < 0.001; d = 2.00) and significant group-by-time interactions for gluteus medius activity during the mid-stance phase (p < 0.028; d = 0.59). Significantly higher gluteus medius activity (p = 0.028, d = 0.569) was found during the post-test. We also observed significant group-by-time interactions for medial gastrocnemius activity during the push-off phase (p < 0.041; d = 0.54). Significantly larger medial gastrocnemius activity (p = 0.041; d = 0.636) was found during the post-test compared to the pre-test. CONCLUSIONS Long-term running on sand resulted in reduced pronation, increased medial gastrocnemius activity, and improved frontal plane pelvic stability due to higher gluteus medius activity. TRIAL REGISTRATION IRCT20191211045704N1. Registered 25 February 2020. Retrospectively registered.
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Affiliation(s)
- AmirAli Jafarnezhadgero
- Department of Sports Management and Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Amir Fatollahi
- Department of Sports Management and Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Ali Sheykholeslami
- Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Valdeci Carlos Dionisio
- Physical Education and Physiotherapy Faculty, Federal University of Uberlândia, Uberlândia, Brazil
| | - Mohammad Akrami
- Department of Engineering, University of Exeter, Exeter, EX4 4QF, UK.
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Cheng KW, Peng Y, Chen TLW, Zhang G, Cheung JCW, Lam WK, Wong DWC, Zhang M. A Three-Dimensional Printed Foot Orthosis for Flexible Flatfoot: An Exploratory Biomechanical Study on Arch Support Reinforcement and Undercut. MATERIALS (BASEL, SWITZERLAND) 2021; 14:5297. [PMID: 34576526 PMCID: PMC8469370 DOI: 10.3390/ma14185297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/03/2021] [Accepted: 09/12/2021] [Indexed: 11/18/2022]
Abstract
The advancement of 3D printing and scanning technology enables the digitalization and customization of foot orthosis with better accuracy. However, customized insoles require rectification to direct control and/or correct foot deformity, particularly flatfoot. In this exploratory study, we aimed at two design rectification features (arch stiffness and arch height) using three sets of customized 3D-printed arch support insoles (R+U+, R+U-, and R-U+). The arch support stiffness could be with or without reinforcement (R+/-) and the arch height may or may not have an additional elevation, undercutting (U+/-), which were compared to the control (no insole). Ten collegiate participants (four males and six females) with flexible flatfoot were recruited for gait analysis on foot kinematics, vertical ground reaction force, and plantar pressure parameters. A randomized crossover trial was conducted on the four conditions and analyzed using the Friedman test with pairwise Wilcoxon signed-rank test. Compared to the control, there were significant increases in peak ankle dorsiflexion and peak pressure at the medial midfoot region, accompanied by a significant reduction in peak pressure at the hindfoot region for the insole conditions. In addition, the insoles tended to control hindfoot eversion and forefoot abduction though the effects were not significant. An insole with stronger support features (R+U+) did not necessarily produce more favorable outcomes, probably due to over-cutting or impingement. The outcome of this study provides additional data to assist the design rectification process. Future studies should consider a larger sample size with stratified flatfoot features and covariating ankle flexibility while incorporating more design features, particularly medial insole postings.
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Affiliation(s)
- Ka-Wing Cheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - Wing-Kai Lam
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou 510000, China;
- Department of Kinesiology, Shenyang Sport University, Shenyang 110102, China
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company, Beijing 101111, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
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Almutairi AF, BaniMustafa A, Bin Saidan T, Alhizam S, Salam M. The Prevalence and Factors Associated with Low Back Pain Among People with Flat Feet. Int J Gen Med 2021; 14:3677-3685. [PMID: 34321913 PMCID: PMC8312604 DOI: 10.2147/ijgm.s321653] [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: 05/24/2021] [Accepted: 06/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background A positive relationship between flat feet and low back pain (LBP) has not gained consensus in literature. The aim of this study was to determine the prevalence and factors associated with low back pain (acute and chronic) among individuals with flat feet. Methods In 2018, a cross-sectional study was conducted at a national festival in Saudi Arabia, and 1798 adult visitors were invited to participate in face-to-face interviews. Participants' characteristics were stratified by the type of foot and they were questioned on acute low back pain (ALBP) or chronic low back pain (CLBP). The odds ratio (OR) were presented as a measure of this association, followed by a multivariate analysis. Results The prevalence of LBP among participants with flat feet was 65.9%, among whom 51.6% suffered ALBP and 48.4% suffered from CLBP. Flat feet increased the chances of having ALBP by 3.28 times and CLBP by 4.5 times. After stratification, ALBP and CLBP were both significantly higher among all participants with flat feet in comparison with their counter groups. Multivariate analyses showed that females were more likely to complain of ALBP. Participants who did no physical activity were more likely to complain of ALBP. Female participants and older participants were more likely to complain of ALBP and CLBP. Conclusion Flat feet are associated with both ALBP and CLBP. Significant factors of low back pain also included sex, age, occupation, and physical activity.
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Affiliation(s)
- Adel F Almutairi
- Science and Technology Unit, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ala'a BaniMustafa
- Science and Technology Unit, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Tagreed Bin Saidan
- Science and Technology Unit, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Shoug Alhizam
- Science and Technology Unit, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mahmoud Salam
- Science and Technology Unit, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
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Shah DK, Khatun S. Pes Planus Foot among the First and Second Year Medical Students of a Medical College: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2021; 59:327-330. [PMID: 34508531 PMCID: PMC8369593 DOI: 10.31729/jnma.6020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Foot is a complex segmented structure formed by the articulation of 26 different bones which are held together by multiple ligaments, extrinsic tendons and the intrinsic muscles of the feet. The assessment of median longitudinal arch serves as an important reference in determining the degree of pes planus or pes cavus. This study aims to find the prevalence of pes planus among the undergraduate medical students of a medical college. Methods: A descriptive cross-sectional study was carried out in the first- and second-year undergraduate medical students of a teaching hospital after taking ethical approval from Institutional Review Committee. The study was conducted from 15th November 2019 to 14th November 2020. Eighty-seven participants were involved in study using the random sampling technique. Foot prints were collected from the participants in the A4 size paper after applying ink over plantar surface of the foot. Measurements were done using the Autodesk Autocad software. Statistical Package for the Social Sciences was used. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of the total subjects, 14 (8.04%) (5.14-10.94 at 95% Confidence Interval) presented with flat foot. Similarly, high arched foot was seen in 29 (16.67%) of subjects whereas normal arched foot was seen in 131 (75.29%) subjects. Conclusions: From the current study we conclude that the prevalence of pes planus was slightly higher than that compared with the similar studies.
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Affiliation(s)
- Diwakar Kumar Shah
- Department of Anatomy, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal
| | - Sanzida Khatun
- Department of Anatomy, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal
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Martinelli N, Bianchi A, Prandoni L, Maiorano E, Sansone V. Quality of Life in Young Adults after Flatfoot Surgery: A Case-Control Study. J Clin Med 2021; 10:451. [PMID: 33498965 PMCID: PMC7866205 DOI: 10.3390/jcm10030451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/21/2022] Open
Abstract
The true impact of surgery for flatfoot deformities on patient's quality of life and health status remains poorly defined. The aim of this study is to evaluate the quality of life and the return to daily tasks and sports or physical activities in young adults after surgical correction of flatfoot deformity. Patients treated for bilateral symptomatic flat foot deformity were retrospectively studied. The healthy control group comprised a matched reference population with no history of foot surgery or trauma that was voluntary recruited from the hospital community. All subjects were asked to fill out questionnaires centered on the assessment of the health-related quality of life (Short-form 36; SF-36) and physical activity (International Physical Activity Questionnaire; IPAQ). Most study group SF-36 subscales were lower when compared to the control group. Among the study group, post-operatively, 36.6% of patients managed to resume low levels of sports activity, 40% were sufficiently active and were able to perform moderate sports activity (an activity that requires moderate physical effort and which forces the patient to breathe with a frequency only moderately higher than normal), while 23.3% of them were active or very active and were able to perform intense physical activity. Most IPAQ scores were statistically different from the control group. The present study suggests that patients treated with medializing calcaneal osteotomy and navicular-cuneiform arthrodesis for symptomatic flafoot had lower levels of quality of life and physical activity when compared to healthy subjects. After surgery, patients showed a significant improvement in the clinical scores.
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Affiliation(s)
- Nicolò Martinelli
- IRCCS Galeazzi, Via R. Galeazzi 4, 20100 Milan, Italy; (A.B.); (L.P.); (E.M.); (V.S.)
| | - Alberto Bianchi
- IRCCS Galeazzi, Via R. Galeazzi 4, 20100 Milan, Italy; (A.B.); (L.P.); (E.M.); (V.S.)
| | - Lorenzo Prandoni
- IRCCS Galeazzi, Via R. Galeazzi 4, 20100 Milan, Italy; (A.B.); (L.P.); (E.M.); (V.S.)
| | - Emanuele Maiorano
- IRCCS Galeazzi, Via R. Galeazzi 4, 20100 Milan, Italy; (A.B.); (L.P.); (E.M.); (V.S.)
| | - Valerio Sansone
- IRCCS Galeazzi, Via R. Galeazzi 4, 20100 Milan, Italy; (A.B.); (L.P.); (E.M.); (V.S.)
- Department of Orthopedics, University of Milan, 20122 Milan, Italy
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Finite element analysis of subtalar joint arthroereisis on adult-acquired flexible flatfoot deformity using customised sinus tarsi implant. J Orthop Translat 2020; 27:139-145. [PMID: 33981572 PMCID: PMC8071640 DOI: 10.1016/j.jot.2020.02.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/05/2020] [Accepted: 02/10/2020] [Indexed: 11/21/2022] Open
Abstract
Background Subtalar arthroereisis may cause sinus tarsi pain complications. In this study, we aimed to introduce a customised implant that facilitated treatment effect and less impingement. The biomechanical outcome between the intact and implant conditions was compared using finite element analysis. Methods A female patient with flatfoot (age: 36 years, height: 156 cm, body mass: 51 kg) was recruited as the model patient. The customised implant was designed from the extracted geometry. Boundary and loading conditions were assumed from the data of a normal participant. Four gait instants, including the ground reaction force first peak (25% stance), valley (45%), initial push-off (60%) and second peak (75%) were analyzed. Results The navicular height was elevated by 4.2% at 25% stance, whereas the strain of the spring, plantar cuneonavicular and plantar cuboideonavicular ligaments were reduced. The talonavicular joint force decreased and the calcaneocuboid joint increased by half and 67%, respectively, representing a lateralised load pathway. There was a stress concentration at the sulcus tali reaching 15.29 MPa Conclusion Subtalar arthroereisis using a customised implant may produce some positive treatment effects in terms of navicular height elevation, ligament strain relief and lateralised joint loading pathway. Although the concentrated stress at the sulcus tali did not exceed the threshold of bone breakdown, we could not rule out the potential of vascular disturbance owing to the remarkable elevation of stress. Future study may enlarge the contact area of the bone–implant interface by considering customisation based on the dynamic change of the sinus tarsi during walking gait. The translational potential of this article Geometry mismatch of prefabricated implants could be the reason for complications. With the advancement of 3D printing, customising implant becomes possible and may improve treatment outcome. This study implemented a theoretical model approach to explore its potential under a simulation of walking.
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The Design and Application of Simplified Insole-Based Prototypes with Plantar Pressure Measurement for Fast Screening of Flat-Foot. SENSORS 2018; 18:s18113617. [PMID: 30366375 PMCID: PMC6263767 DOI: 10.3390/s18113617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/16/2018] [Accepted: 10/20/2018] [Indexed: 11/23/2022]
Abstract
This study aimed to find the correlation between conventional Arch Index (AI) measurements and our prototype of a simplified insole-based plantar pressure measurement system and to find out the effective plantar pressure sensor position. Twenty-one subjects participated in this study, which was divided into two groups: 10 subjects with flatfoot and 11 subjects with normal foot. Five force sensitive resistance sensors were used on this prototype using Arduino as the data acquisition device. Two types of trials, namely static and dynamic, were conducted to validate our system against the ink-type AI measurement as a golden standard. The results showed that in the static trial, there was a high linear correlation with the medial arch sensor configuration, while in the dynamic trial, there was a high linear correlation in the medial arch sensor configuration and sensor 5 configuration. This study showed that both static and dynamic tests using the self-developed device could effectively determine most of the flatfoot subjects and suggests that in the future, it can be applied in clinical applications because of its advantages when compared to the expensive-high tech graphic input board and conventional tools, like ink-type based measurements.
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Prasad SA, Rajasekhar SSSN. Morphometric analysis of talus and calcaneus. Surg Radiol Anat 2018; 41:9-24. [DOI: 10.1007/s00276-018-2101-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022]
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