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Purpose The spring ligament complex (SL) is the chief static stabilizer of the medial longitudinal foot arch. The occurrence of normal anatomical variants may influence radiological diagnostics and surgical treatment. The aim of this study was to evaluate anatomical variants of the part of SL located inferior to the talar head (i-SL), medioplantar oblique ligament (MPO) and inferoplantar longitudinal ligament (IPL). Methods We included 220 MRI examinations of the ankle performed on a 3.0 T engine. Only patients with a normal SL were included. Two musculoskeletal radiologists assessed the examinations and Cohen’s kappa was used to assess agreement. Differences between groups were assessed using the chi-squared test; p Results Most commonly, i-SL was composed of the two ligaments IPL and MPO n = 167 (75.9%); in this group, bifid ligaments occurred in 19.2%, most commonly in the MPO. A branch to the os cuboideum was seen in n = 17 (10.2%). Three ligaments were seen in n = 52 (23.6%). In this group, bifid ligaments occurred in 13.5%; most commonly, the IPL was bifid and a branch to the os cuboideum was noted in n = 6 (11.5%). In one case, n = 1 (0.04%), we identified MPO, IPL and two accessory ligaments. No significant relationship was noted between the number of ligaments, the presence of bifid ligaments and side or gender (p > 0.05). Conclusion. More than two aligaments were seen in 24.1% of examined cases, the most common variant was the presence of MPO, IPL and one accessory ligament.

Background: Weightbearing plain radiography or computed tomography (CT) is used for diagnosis or treatment selection in foot disorders. This study compared foot alignment between full weightbearing (50% body weight [BW] per foot) plain radiography and nonweightbearing (0% BW) or partial weightbearing (10% BW per foot) CT scans. Methods: Subjects had both full (50% BW per foot) weightbearing plain radiographs and either a nonweightbearing (0% BW) or a partial weightbearing (20% BW or 10% BW per foot) CT scan. Feet (n = 89) had been previously classified as pes cavus (n = 14/17 [subjects/feet]), neutrally aligned (NA; 20/30), asymptomatic pes planus (APP; 18/24), and symptomatic pes planus (SPP; 15/18). Lateral talometatarsal angle (LTMA) and calcaneal pitch angle were compared between weightbearing radiography and maximum-intensity projection images generated from CT. Results: Significant differences in LTMA were found between nonweightbearing CT scans and full (50% BW per foot) weightbearing plain radiographs: the mean difference was 6.6 degrees in NA, 9.2 degrees in APP, and 11.3 degrees in SPP ( P < .0001); no significant difference in LTMA was found for pes cavus. Although the interaction of foot type ( P = .084) approached statistical significance, pairwise differences between 10% weightbearing and 50% weightbearing images by foot type were significant but small. The 50% weightbearing condition resulted in calcaneal pitch angles the same or slightly lower or higher than those of the 10% weightbearing and nonweightbearing images. LTMA and calcaneal pitch angle measurements made on full (50% BW per foot) weightbearing plain radiographs and non- (0%) or partial (10% BW per foot) weightbearing angles from CT scans were strongly correlated. Conclusion: Different foot types have similar 2-dimensional sagittal plane morphologies with partial weightbearing (10% BW per foot) CT scans and, to a lesser degree, nonweightbearing (0%) neutral-position CT scans when compared to full weightbearing (50% BW per foot) plain radiographs. Level of Evidence: Level III, retrospective case control study.

Research on the plantar segment has not been widely carried out in Indonesia’s population, even though the plantar segment data will be essential in further research and therapy of plantar-related problems. Therefore, this research intends to describe the plantar profile: the foot arch and the plantar pressure difference between the right and left foot. This research applied a cross-sectional study. Subjects were recruited from the Faculty of Medicine students, Universitas Indonesia, class 2012, with inclusion criteria aged 17-21 years and normal gait. Meanwhile, the exclusion criteria consisted of having postural abnormalities, a history of neuromusculoskeletal disorders in the lower limbs, a history of fractures in the spine and legs, a history of surgery on the spine and legs, and refusing to participate in the study. Research subjects stood on a plantar scanner, conducted at the Anatomy Laboratory, the Faculty of Medicine, Universitas Indonesia. The Mann-Whitney test was then used to analyze the difference in plantar pressure between the right and left foot. The results revealed that a hundred research subjects had a proportion of a low foot arch of 4%, a normal foot arch of 89%, and a high foot arch of 7%. The median right plantar pressure was 273.5 KPa, while the median left plantar pressure was 253.5 KPa. The Mann-Whitney test showed a p-value of 0.954 for the pressure difference between right and left foot. There was no plantar pressure difference between the right and left foot.

Long-distance running results in lowering of the foot medial longitudinal arch, but it is unknown whether the left and right arches decrease equally. This study aimed to determine whether foot arch asymmetry increases upon completion of a full marathon and to identify factors capable of explaining the degree of asymmetry of navicular height and navicular height displacement. The three-dimensional foot posture data of 74 collegiate runners were obtained using an optical foot scanner system before (PRE) and immediately after (POST) a full marathon. The navicular height and arch height ratio (normalised navicular height by foot length) of both feet significantly decreased from PRE to POST full marathon completion (44.3 ± 6.3 mm versus 40.8 ± 6.5 mm, 17.8 ± 2.5 versus 16.6 ± 2.7, respectively

Foot arch structure contributes to walking in adults with obesity. However, little is known about the relationship between arch height and walking in these populations. The purpose of this study was to investigate if arch height affects gait characteristics among adults classified into three groups by body mass index (BMI). In this study, dynamic plantar pressure, spatiotemporal gait parameters, and lower-limb joint kinematics were collected from adults with normal weight (n=21), moderate obesity (n=18), and severe obesity (n=8) during walking at their preferred speed. Digital foot pressure data were used to compute a measure of arch height, the Chippaux-Smirak Index (CSI). Our results revealed that adults with higher BMI scores had lower arches than adults with lower BMI scores (p

Improper foot biomechanics associated with uneven bodyweight distribution contribute to impaired balance and fall risks. There is a need to complete the panel of commercially available devices for the self-measurement of BMI, fat, muscle, bone, weight, and hydration with one that measures weight-shifting at home as a pre-specialist assessment system. This paper reports the development of the Early Notice Pointer (ENP), a user-friendly screening device based on weighing scale technology. The ENP is designed to be used at home to provide a graphic indication and customised and evidence-based foot and posture triage. The device electronically detects and maps the bodyweight and distinct load distributions on the main areas of the feet: forefoot and rearfoot. The developed platform also presents features that assess the user’s balance, and the results are displayed as a simple numerical report and map. The technology supports data display on mobile phones and accommodates multiple measurements for monitoring. Therefore, the evaluation could be done at non-specialist and professional levels. The system has been tested to validate its accuracy, precision, and consistency. A parallel study to describe the frequency of arch types and metatarsal pressure in young adults (1034 healthy subjects) was conducted to explain the importance of self-monitoring at home for better prevention of foot arch- and posture-related conditions. The results showed the potential of the newly created platform as a screening device ready to be wirelessly connected with mobile phones and the internet for remote and personalised identification and monitoring of foot- and body balance-related conditions. The real-time interpretation of the reported physiological parameters opens new avenues toward IoT-like on-body monitoring of human physiological signals through easy-to-use devices on flexible substrates for specific versatility.

Observational studies have found that habitually barefoot populations tend to have stronger feet, lower incidence of flat foot, and decreased lower extremity injury rates compared to traditionally ...

Introduction: The foot forms the natural base of the human body bearing all its weight. Over the course of a person's life, the foot ensures the contact of the body with the terrain and creates the basic support during dynamic activities such as walking or running, especially on uneven terrain. (Véle, 2006) Objectives: The aim of the research was to verify the effects of targeted corrective exercises on healthy foot development in preschool children. Methods: The research was conducted from September 2018 to March 2019. The research sample consisted of 105 probands (59 preschool girls and 46 preschool boys), out of whom 7.62% had the physiological position of the arch on the right foot during baseline measurements. The average age of probands was 5 years. The measured parameters were the foot arch height without and with a load. Measurements were taken before and after rehabilitation intervention. Results: The statistical analysis of the results confirmed the positive effect of rehabilitation treatment in all monitored variables on statistically significant diference in terms of an elevation in the foot arch (p

The purpose of this study was to (1) investigate the agreement among clinical experts regarding the classification of the medial longitudinal arch in children and to (2) examine the relationship between the expert ratings and the static and dynamic foot arch measurements. Eleven foot experts were asked to identify foot arches of seventy-four children (mean ± SD age of 9.0 ± 1.81 years) using three categories (low, normal, and high arch). Additionally, dynamic footprint data of all children were captured with a pedobarographic platform. For static arch measurements, a specially constructed caliper was used to assess heel-to-toe length and dorsum height. Agreement among raters was determined using the kappa statistic. For comparisons between clinical rating and diagnostic systems, receiver operating characteristic (ROC) curves and ordinal logistic regression were calculated. The combined kappa score for all three arch types (0.422, 32.8%) shows borderline moderate agreement between raters. Area under the curves (AUC) values of the ROC curves ranging from 0.48 to 0.68 show poor relationship between quantitative and qualitative arch height measurements. The highest agreement was found for the dynamic arch index and foot experts’ ratings for low arched vs non-low arched feet (AUC = 0.68) and normal vs low arched feet (AUC = 0.67). The results of this study showed borderline moderate agreement among clinical experts in the clinical assessment of the medial longitudinal plantar arch in children. Also, only a poor relationship between the clinical foot arch assessments and the static and dynamic foot measurements was revealed. Further research is necessary to establish an accurate and consistent diagnostic system for the measurement of the medial longitudinal arch in children.

Introduction Understanding the contribution of the fibularis longus tendon to the support of the midfoot arches has potential therapeutic applications. This cadaveric study sought to quantify this support across both the transverse arch and medial longitudinal arch and to establish whether a correlation exists between this support and the angle at which the tendon enters the sole. Materials and methods Markers placed in 11 dissected cadaveric foot specimens defined the arch boundaries. Incremental weights up to 150 N were applied to the fibularis longus tendon to simulate progressive muscle contraction, and associated changes in the transverse and medial longitudinal arch boundaries were recorded. Results A force of 150 N reduced the transverse arch distance by 4.6 (1.7) mm (mean [SD]) and medial longitudinal arch distance by 6.8 (1.4) mm. The angle of the fibularis longus tendon on the sole correlated well with changes in the transverse arch distance (slope ± s.e. = 0.56 ± 0.13 mm/degree, Pearson r = .83, p = .002) but only weakly with the medial longitudinal arch (0.18 ± 0.18 mm/degree, r = .32, p = .33). Conclusions The results of this preliminary study raise the possibility that physical therapies targeting the fibularis longus tendon may be valuable in the management of midfoot arch collapse. The correlation observed with the transverse arch suggests the possibility that surgical modification of the angle of the fibularis longus tendon on the sole may benefit patients with transverse arch collapse.

Background Intramedullary fusion bolts (FB) were introduced to stabilize the medial column of the instable Charcot foot (ICF), but complications as bolt loosening or breakage are frequent. We compared the use of a standard FB and a high-profile threaded FB with a grit-blasted surface. We hypothesized that implant related complications occurred less often and osseous consolidation of fusion sites was more distinctive using the latter type of FB. Methods Consecutive patients suffering from an ICF were stabilized with a high-profile threaded and surface-modified FB (HTFB) (n = 20) or with a standard FB (n = 20) which was placed into the first ray. Additional bolts and dorsal low-profile plates were applied in every patient. In a retrospective assessment osseous consolidation of the fusion sites was analyzed at 3 month and quantified by CT scan. At 3 and 12 month longitudinal foot arch collapse and rate of bolt loosening were assessed. Results Compared to the control group, the HTFB group reached significant higher consolidation after 3 month. No dislocation and a single bolt breakage was observed in the HTFB group after the fourth month, while the control group included 3 patients with bolt dislocation at 3 ± 1 month and 5 patients with bolt breakage at 6 ± 1.8 month. Compared to preoperative values, the improvement of Meary’s angle after one-year was significant higher in the HTFB group (23.4° ± 14) than in controls (11.7° ± 13). Conclusions Modification of bolt design improves the stability of the medial column: A higher rate of osseous consolidation of the medial column leads to lower rate of bolt dislocation/breakage and finally to permanently erected longitudinal foot arch. Initially disappointing results following medial column stabilization with fusion bolts can be rejected by modifications of bolt design and its technical application.

Context: Plyometric training promotes a highly effective neuromuscular stimulus to improve running performance. Jumping rope (JR) involves mainly foot muscles and joints, due to the quick rebounds, and it might be considered a type of plyometric training for improving power and stiffness, some of the key factors for endurance-running performance. Purpose: To determine the effectiveness of JR during the warm-up routine of amateur endurance runners on jumping performance, reactivity, arch stiffness, and 3-km time-trial performance. Methods: Athletes were randomly assigned to an experimental (n = 51) or control (n = 45) group. Those from the control group were asked to maintain their training routines, while athletes from the experimental group had to modify their warm-up routines, including JR (2–4 sessions/wk, with a total time of 10–20 min/wk) for 10 weeks. Physical tests were performed before (pretest) and after (posttest) the intervention period and included jumping performance (countermovement-jump, squat-jump, and drop-jump tests), foot-arch stiffness, and 3-km time-trial performance. Reactive strength index (RSI) was calculated from a 30-cm drop jump. Results: The 2 × 2 analysis of variance showed significant pre–post differences in all dependent variables (P P ≥ .05). Pearson correlation analysis revealed a significant relationship between Δ3-km time trial and ΔRSI (r = −.481; P r = −.336; P R2 = .394; P Conclusions: Compared with a control warm-up routine prior to endurance-running training, 10 weeks (2–4 times/wk) of JR training, in place of 5 minutes of regular warm-up activities, was effective in improving 3-km time-trial performance, jumping ability, RSI, and arch stiffness in amateur endurance runners. Improvements in RSI and arch stiffness were associated with improvements in 3-km time-trial performance.

Pes planus (“flat feet”) is one of the most common orthopaedic conditions observed in adult health practice. The purpose of this study was to evaluate the foot arch quality and the occurrence of toes deformities among physiotherapy students (N = 106; 33 men and 73 women). The mean age of students was 22.28 years. The CQ-ST Podoscope was used as the main research tool. We evaluated the Clark’s angle and Weisflog index as foot parameters to assess the quality of the longitudinal foot arch and the transverse foot arch, respectively. We also evaluated the incidence of toes deformities of the big toe angle (ALFA) and little toe angle (BETA) according to Weisflog. Most students had a physiologically arched longitudinal foot arch. Despite the young age of subjects, we found an increased occurrence of the flat transverse foot arch and big toe deformities, especially among women.

Long‐distance running (LDR) can induce transient lowering of the foot arch, which may be associated with mechanical fatigue of the plantar fascia (PF). However, this has not been experimentally tested in vivo. The purpose of this study was to test our hypothesis that LDR induces transient and site‐specific changes in PF stiffness and morphology and that those changes are related to the lowering of the foot arch. Ten male recreational long‐distance runners and 10 untrained men were requested to run overground for 10 km. Before and after running, shear wave velocity (SWV: an index of soft tissue stiffness) and thickness of PF at three different sites from its proximal to distal end were measured using supersonic shear imaging and B‐mode ultrasonography. Foot dimensions including the navicular height were measured using a three‐dimensional foot scanner. SWV at the proximal site of PF and navicular height was significantly decreased in both groups after running, with a higher degree in untrained men (−21.9% and −14.1%, respectively) than in runners (−4.0% and −6.3%, respectively). The relative change (%Δ) in SWV was positively correlated with %Δnavicular height in both groups (r = .69 and r = .65, respectively). Multiple regression analysis revealed that %ΔSWV at the proximal site solely explained 72.7% of the total variance in %Δnavicular height. It is concluded that LDR induces transient and site‐specific decreases in PF stiffness. These results suggest that the majority of running‐induced lowering of the foot arch is attributable to the reduction of PF stiffness at the proximal site.

Author(s): Heronemus, Marc J; Rabe, Kaitlin; Tolstykh, Irina; Gross, K Douglas; Wise, Barton L; Nevitt, Michael C; Lewis, Cora E; Hillstrom, Howard J; Segal, Neil A; MOST Study Group | Abstract: BackgroundPostpartum women are at increased risk for lower limb musculoskeletal disorders. Foot arch collapse following pregnancy has been reported as a mechanism for this increased risk. However, dynamic changes during gait in postpartum women have not been reported. Therefore, we assessed the association between parity and dynamic foot pronation during gait.ObjectiveTo determine (1) if there is an association between parity and dynamic foot pronation (center of pressure excursion index, CPEI) during gait; and (2) the extent to which there is a dose-effect of parity on foot pronation.DesignThe Multicenter Osteoarthritis Study (MOST) Study is a longitudinal cohort study of adults with or at risk for knee osteoarthritis (OA).SettingTwo communities in the United States, Birmingham, Alabama and Iowa City, Iowa.InterventionsNot applicable PARTICIPANTS: A population-based sample of 1177 MOST participants who were female, had complete CPEI and parity data and completed the baseline, 30- and 60-month visits.Main outcome measuresOdds of a one quintile decrease in CPEI by parity group and mean CPEI by parity group.ResultsIn 1177 women, mean age was 67.7 years and mean body mass index (BMI) was 30.6 kg/m2 . As parity increased, there was significantly greater foot pronation, lower mean CPEI: 19.1 (18.2-20.1), 18.9 (18.4-19.4), 18 (17.5-18.6) to 17.5 (16.4-18.6) in the 0 to 4 and g5 children groups, respectively; (P = .002), which remained significant after adjusting for race and clinic site (P = .005). There was a positive linear trend (β = 1.08, 1.03-1.14) in odds ratios of a one quintile decrease in CPEI (greater pronation) with increasing parity level (P = .004), which remained significant after adjusting for race and clinic site (P = .01). After adjusting for age and BMI, these two associations were no longer statistically significant.ConclusionsThis study indicates a positive correlation between parity and greater dynamic pronation of the feet.

Objective To identify the relationship between the body mass index and body fat composition with foot arch among osteoarthritis patients. Methods A cross-sectional study involved 30 patients with Osteoarthritis. Results The test results show that there is a significant correlation between body mass index and body structure and arch composition in osteoarthritis people (p = 0.005, r = −0.497). This study also found that there is a significant correlation between body fat composition and foot arch (p Conclusion Body mass index and body fat composition each had a significant relationship with the shape of a person's arch. In patients with osteoarthritis with pes planus have a higher body mass index than respondents with pes cavus. Likewise, with fat composition, people with pes cavus had a lower fat composition compared with respondents with pes planus.

The work is devoted to consideration of biometric parameters of walking of students aged 17–19 years with decreased height of a foot arch according to the SIGMA XL system and signs of functional scoliosis. The following walking parameters are considered: duration of one step cycle, single support, average normalized speed and analysis of the integrated FAP walking quality index. Objective. To evaluate the dynamics and features of time parameters of walking before and after the application of the physical therapy program in the remote observation period. Methods. The parameters of walking due to the hypohypertonic muscles that are part of the various myofascial chains are analyzed. In total, the data of 120 students were analyzed, who were divided into 2 groups: main (MG) and control (CG) of 60 people in every group. Students of MG were engaged in the author’s program, which envisaged the use of the means of physical therapy provided by the method of I. D. Loveyko [7], in the modification of O.V. Peshkova et al [12]. In addition, there were classes in modified water sports (polo, basketball, volleyball, impromptu games, etc.) with a temperature of 25 o C and pool depth of 1.2 m. CG students were only engaged in the program of I.D. Loveyko (1982). The examination was performed at the beginning of the study and 12 and 24 months after the use of appropriate physical therapy programs. Results. According to the results of the statistical survey, some patterns were identified in students with flat foot signs and functional scoliosis (CG) revealed by plantographical method and in those whose posture unchanged (MG). Before treatment, students, regardless of the study group, had the same walking parameters, ie, they showed all signs of gait distortion due to flat foot. 2 years after the implementation of both programs walking parameters restored, although their normalization according to the program for CG did not reach the average statistical reference norm. After treatment under the author’s program, there was a significant improvement in gait parameters in the students of MG – the symmetry of walking has almost restored. Conclusions. The decrease in tone and muscle imbalance of the lower leg and back is an objective cause of the loss of quality walking that students showed before the introduction of the author’s program. That is, a long asymmetrical load of the muscles leads to the loss of optimal gait, a decrease in the foot capacity, which is expressed by the ­increase in the time of the foot support with the violation of the foot arch and increase of the step duration. The consequence of these changes is the development and gradual progression of scoliotic disease. The use of modified exercise types in water in the physical therapy program of students of MG helps to increase the frequency-amplitude characteristics of the muscles of individual myofascial kinematic chains, and to reduce the imbalance between them, which improves the indices characterizing the quality of walking.

This study aimed to evaluate the anti-pronation effects of Kinesio tape on flexible flatfoot during running. Nine volunteers participated in a crossover trail of two conditions: with Kinesio tape (KT) or without taping (NT). The running consisted of 9 stages of different inclines on a treadmill over 28 minutes. Navicular drop distance (NDD) was measured before and after the running. Electromyography, the relative plantar pressure, Rating of Perceived Exertion and Visual Analogue Scale were recorded at each stage. After the application of Kinesio tapes over the tibialis posterior and transverse arch, the NDD reduced significantly and the relative posterior pressure reduced during stage 8. Without taping, the NDD decreased slightly after exercise. Comparing between conditions, the tibialis anterior were more activated with Kinesio tape in stages 4 and 5. During the latter half of the running, the medial gastrocnemius and peroneus longus reduced their activity in the KT and NT conditions respectively. In conclusion, the Kinesio tapes intended to facilitate the tibialis posterior and reinforce the transverse arch can reduce NDD in individuals with flexible flatfoot immediately after application, and increase muscle activity of their tibialis anterior during the first 15 minutes of the running.

Background The demonstration of the relationship between midfoot passive mechanical resistance and foot pronation during gait may guide the development of assessment and intervention methods to modify foot motion during gait and to alter midfoot passive mechanical resistance. Research question Is foot pronation during the stance phase of gait related to the midfoot passive mechanical resistance to inversion? Methods The resistance torque and stiffness provided by midfoot soft tissues of 33 participants (21 females and 12 males) with average of 26.21 years were measured. In addition, the participants’ forefoot and rearfoot kinematic data during the stance phase of gait were collected with the Qualisys System (Oqus 7+). Correlation Coefficients were calculated to test the association between kinematic variables representing pronation (forefoot-rearfoot inversion, forefoot-rearfoot dorsiflexion and rearfoot-shank eversion) and maximum resistance torque and maximum stiffness of the midfoot with α = 0.05. Results Reduced maximum midfoot resistance torque was moderately associated with increased forefoot-rearfoot inversion peak (p = 0.029; r = 0.38), with forefoot-rearfoot dorsiflexion peak (p = 0.048; r = −0.35) and with rearfoot-shank eversion peak (p = 0.008; r = −0.45). Maximum midfoot stiffness was not associated to foot pronation. Significance The smaller the midfoot resistance torque, the greater the forefoot-rearfoot inversion and dorsiflexion peaks and the rearfoot-shank eversion peak during gait. The findings suggest the existence of a relationship between foot pronation and midfoot passive mechanical resistance. Thus, changes in midfoot passive mechanical resistance may affect foot pronation during gait.

Background:Arch height is an important indicator of risk of foot pathology. The current non-invasive gold standard based on footprint information requires extensive pre-processing. Methods used to obtain arch height that are accurate and easier to use are required in routine clinical practice.Methods:The proposed arch index diagonals (AId) method for determining the arch index (AI) reduces the complexity of the preprocessing steps. All footprints were first prepared as required by the Cavanagh and Rodgers method for determining the AI and then compared to the proposed diagonals method. Results were classified according to the Cavanagh and Rodgers cut-off values into three groups of low, normal and high AI. ANOVA and Tukey's post hoc tests were applied to identify significant differences between AI groups. Linear modeling was applied to determine the fit of the new AId method compared to the Cavanagh and Rodgers AI.Results:One hundred and ninety-six footprints were analyzed. The ANOVA indicated significant differences between the groups for AId (F1,194=94.49, pConclusions:The proposed method simplifies current processing steps to derive the arch height.

The muscle and tendon complex of the foot helps to support the foot arch and generates the muscle force of the foot. The present study investigated the force‐generating capacity of the toe flexor muscles and the dynamic function of the foot arch when standing upright, and the relationships between these indices. The maximum toe flexor force and foot arch height in the sitting and standing positions were studied in the left and right feet of 224 healthy young individuals. To measure the maximum isometric force of the toe flexor muscles, the subjects exerted maximum force on a toe grip dynamometer. Measurements were repeated three times with at least a 1‐min rest period between bouts, and the maximum value among the measurements for each foot was used for further analysis. The absolute value of the toe flexor strength was normalised by body mass. The foot arch height was measured the distance between the tuberosity of the navicular bone and the floor, and normalised by height. The relative foot arch height difference between the sitting and standing positions was evaluated as the foot arch dynamics. The maximum isometric toe flexor strength was 42% higher in the standing position than in the sitting position. There was no relationship between the relative toe flexor strength and the relative foot arch height in either the sitting or standing positions; however, the relative increase in toe flexor strength from sitting to standing (the force amplification factor) was related to the foot arch dynamics, and the flexible foot arch showed a greater increase in the toe flexor strength from sitting to standing compared with the strength in the stiff foot arch. The results of this study suggest that the force‐generating capacity of the toe flexor muscles is augmented by bodyweight bearing in upright standing. Additionally, the force amplification mechanism is mechanically regulated by the dynamic function of the foot arch in conjunction with the stretching of the muscle–tendon complex of the foot.

Normalized arch height (NAH), which can be calculated as the instep height (IH) divided by total foot length (TFL), has been used when comparing the foot arch height, instead of navicular height (NH) because of the difficulty to palpate navicular tuberosity when measuring NH. The aim of current study was to investigate to investigate association between foot length and arch height, change in NAH over age, and distribution of foot type according to age in children and adolescent from 8 to 19 years. Foot scanning data of 1,451 children and adolescents were obtained. Four NAH indices were calculated as follows, 1) NH/TFL, 2) NH/instep length (IL), 3) IH/TFL and 4) IH/IL. There were significant positive relationships between foot length and arch height. Natural growth was observed in NH/TFL and NH/IL until 16 years old and IH/TFL and IH/IL between 11-13 and 14-16 years age groups. The proportions of pes planus also decreased, whereas the proportion of rectus foot type increased over age. Clinicians should be caution when diagnosing and designing non-surgical program for children with pes planus until 16 years old.

The aim of the study was to examine the influence of training processes modeled after the School of Sport of Faculty of Pedagogy, on changes in the status of the foot arch, motor abilities and morphological characteristics of preschool and young school children. The study was of longitudinal character. The experimental training program was conducted from 1st September 2018 till 1st December 2018. The follow-up included 92 subjects in total, divided into two sub-samples: one comprised of experimental group subjects, 45, and the other, control group of 47 subjects. The analysis of the status of the foot arch was performed with a Digital Computer Podoscope. For the assessment of the motor abilities a battery of motor abilities was used, modeled after Bala, Stojanović, Stojanović, (2007). Measurement of morphological characteristics was performed with the application and adherence to the International Biological Program. Using the MANOVA and χ2 test, the results obtained after the final measurement show statistically significant changes in motor abilities, morphological characteristics, and the status of the arch of the foot in children.

The aim of this study was to determine the effects of corrective exercise programmes on the foot condition. The research was attended by 66 subjects (students of the Jovan Cvijić elementary school, Banja Luka) aged 11-12 years. Of the total number of subjects on initial testing, 44 subjects (72.7%) had flat foot deformity (first, second and third degree) and they participated in further research. The Footplate currex platform was used to assess the arch of the foot. The programme of flat foot corrective exercises lasted a total of 4 months. Exercises were performed twice a week for 20 minutes. The programme included a total of 13 exercises and each exercise was repeated 20 times. A Chi-squared test was applied to determine if there was a difference in the frequency of foot deformities between the initial and final measurements, as well as gender differences, i.e. whether the applied exercise programme affected the reduction of foot arch deformity (p Article visualizations

Journal of Information Science and Technology, 11, 1, 75-82

Background: The arch height index (AHI) is a commonly used method for measuring foot arch posture. However, there are little studies have investigated the natural growth and normative values of the foot arch using the AHI. The objective of this study was to establish normative and cut-off values for foot arch posture and to identify factors influencing foot arch posture across childhood and adolescence. Methods: In this cross-sectional study, a sample of 3532 healthy children and adolescents (1804 boys, 1728 girls; aged 6 to 19 years) was recruited for the navicular height (NH) and AHI measurements and anthropometry assessment (weight, height, BMI and foot length). Data were explored descriptively and graphically, comparisons between groups used t-tests or ANOVA model as appropriate and a multiple regressions was conducted. The 95% and 68% prediction intervals were used as cut-off values. Results : approximately 69% had a normal AHI range, 12% low arched foot, 3% severely low arched, 14% high arched and 1.8% severely high arched foot. The mean (SD) AHI was 15.16 (2.61). Very little gender bias was found for AHI values, being higher in males 15.32 (2.54) than in females 15.0 (2.68) ( p = .019). Regression showed approximately 3%, 0.3% and 2% of the AHI change was explained by age, BMI and foot length, respectively. The mean NH significantly increased from the age of 6 (2.62 cm) to 19 (4.20 cm). Conclusions: This study confirms that the ‘flexible flatfoot’ or low arched foot decreases with age. Simultaneously, increase of high arched foot type and shift in foot posture towards more normal foot type are also confirmed. BMI does not seem to be an important determinant of children foot arch posture. Keywords: Foot posture, Navicular height, Arch height index, Normative values, Medial longitudinal arch, Foot arch development, Children, Adolescents

The short-foot exercise (SFE) has been used as a training method for the intrinsic muscles of the foot. The effectiveness of SFE is mostly reported in short-term interventions, with only a few reports of its sustained effects. The purpose of this study was to verify the effect of SFE training for 31 high school runners. All subjects were measured 3 times for 8 months, and underwent ankle stabilization training during the study period. During the first 3 months of the study period, one randomly selected group of subjects underwent SFE, and another group did not, the non-SFE group. Measurement items were pain, navicular drop (ND), modified star excursion balance test (mSEBT), ankle dorsiflexion angle and toe gripping force. A one-way analysis of variance with post-hoc Tukey’s test was performed to evaluate differences between groups with multiple comparison analysis for each measurement. The number of physical problems in the SFE group was lower at the time of the second measurement (M2) but increased at the third measurement (M3). In the SFE group, the ND value was significantly decreased at the time of the M2 but was significantly increased at the M3. Toe gripping force showed a significantly larger value in the SFE group at the M3. It was suggested that the SFE was effective for ND and decreasing some pains. There are no studies referring to the sustainability of the effects of the SFE, so these results can be a reference for future investigation of this exercise.

Objective To determine the prevalence of chronic ankle instability (CAI) and to investigate its relationship to the foot arch in collegiate female athletes by each sports event. Design Cross-sectional study. Setting University setting. Participants 138 collegiate female athletes. Main outcome measures All subjects were asked about previous ankle sprains, and the arch height index (AHI) was calculated. Athletes with a previous sprain history were evaluated based on the criteria by the International Ankle Consortium (IAC), the severity of ankle instability (CAIT), and foot and ankle function (FAAM). The prevalence of CAI and the relationship between the AHI and ankle instability were analyzed by each sports event. Results Of 106 athletes with a previous ankle sprain, 10 (9.4%) met the IAC criteria below the cut-off value of the CAIT, and only 1 athlete (0.9%) was below the FAAM cut-off value. The AHI was not significantly different in athletes with CAI. The AHI was significantly lower in swimmers than in track and field (sprint) athletes. Conclusion Most female athletes with CAI were aware of the severity of ankle instability, but they did not feel dysfunction of the ankle during sports. Additionally, the AHI may depend on the characteristics of sports events.

This study examined the relationships between the foot bone morphologies and sprint performance in sprinters. Foot images in 56 male sprinters obtained using magnetic resonance imaging. The relative lengths of the forefoot bones of the big and second toes, which were calculated as total lengths of the forefoot bones for each toe normalized to the foot length, correlated significantly with personal best 100-m sprint time (r = − 0.293 and − 0.459, both Ps r = − 0.378 and − 0.496, both Ps r = − 0.690, P r = 0.420, P = 0.001), and the foot arch height index correlated significantly with sprint performance (r = − 0.517, P

The purpose of this study were to identify the effect of medial longitudinal arch (MLA) height on static and dynamic balance among female athletes. The participants of this study were the active female athletes from Universiti Teknologi MARA (UiTM), Samarahan Branch. The participants were divided into three groups according to their foot arch which include low (n = 30), normal (n = 30) and high (n = 30) arch height. The foot arch or structure was measured by using the wet test (WT). The stork stand test (SST) was used to assess participant static balance (SB), while the balance beam speed test (BBST) was used to assess participant dynamic balance (DB). Significant level was set at p < .05. The result showed that there was a significant difference between groups on SB (p = .041) and DB (p = .0001) test. There was also a significant difference (p = .014) between SB and DB for high arch group. There was no significant difference between SB and DB on low arch (p = .153) and normal arch (p = 1.00). Thus, the MLA height have effect on static and dynamic balance.

PubMedID: 30010098 BACKGROUND AND OBJECTIVE: The study determined the effects of females wearing high-heeled shoes on the lowerextremity musculoskeletal system and somatometry.METHODS: The study was carried out with 136 females between 18 and 45 years old. The first group consisted of 66 femaleswearing 5 cm or higher high-heeled shoes, at least 5 hours a day, three days a week, and at least one year. The second groupconsisted of 70 females wearing shoes with heel height less than 5 cm for at least one year.RESULTS: Differences in length parameters may result from the narrow and pointed toe of the high-heeled shoe. These shoesdistribute the pressure on the caput ossis metatarsi I and compress the foot in this area. Differences in anthropometric measurements show that females wearing high-heeled shoes have more slender and smaller foot structure.CONCLUSION: These findings show that regular wearing of high-heeled shoes causes changes via the increased foot archstructure. These alterations result from regional, racial, gender, heel height, shoe type (shape), and shoe habits. © 2018-IOS Press and the authors. All rights reserved. Firat University Scientific Research Projects Management Unit: TF 2014 DT-1110 We would like to thank the Scientific Research Projects Unit of Cukurova University for financial support (grant number: TF 2014 DT-1110).

Background Assessment of the foot arch is an important element of posture examination. In clinical practice, different methods are used. Reliability and repeatability of the techniques raises many doubts. Objective Development and verification of our own, automated diagnostic algorithm for evaluation of the longitudinal arch of the foot with the use of the Zebris FDM-S dynamometric platform. Methods This paper presents selected footprints assessment methods and Zebris dynamometric platform to assess the longitudinal arch of the foot. Results The results were compared to standard plantography examination. The outcomes show high correlation of the investigated parameters methods used. The ambiguity of classification criteria of foot arch was observed. Conclusions 1/Examination confirmed strong linear correlation between the Arch Index results obtained during examinations on a stabilometric platform and plantography examination. 2/The proposed algorithm for AI evaluation using the Zebris FDM-S dynamometric platform enables simultaneous analysis of stabilometric and pedobarometric variables as well classifying the type of disorder arch longitudinal arch of the foot. 3/Qualitative analysis of the arch, based on plantography results and the Arch Index, shows inconsistency in results obtained with different methods. 4/The obtained results show further necessity to conduct more studies to develop methods of standardization of foot arch assessment.

Background While altered foot arch characteristics (high or low) are frequently assumed to influence lower limb biomechanics and are suspected to be a contributing factor for injuries, the association between arch characteristics and lower limb running biomechanics in children is unclear. Research question Therefore, the aim of this study was to investigate the relationship between a dynamically measured arch index and running biomechanics in healthy children. Methods One hundred and one children aged 10–14 years were included in this study and underwent a biomechanical investigation. Plantar distribution (Novel, Emed) was used to determine the dynamic arch index and 3D motion capture (Vicon) to measure running biomechanics. Linear mixed models were established to determine the association between dynamic arch index and foot strike patterns, running kinematics, kinetics and temporal-spatial outcomes. Results No association was found between dynamic arch index and rate of rearfoot strikes (p = 0.072). Of all secondary outcomes, only the foot progression angle was associated with the dynamic arch index (p = 0.032) with greater external rotation in lower arched children. Significance Overall, we found only few associations between arch characteristics and running biomechanics in children. However, altered foot arch characteristics are of clinical interest. Future studies should focus on detailed foot biomechanics and include clinically diagnosed high and low arched children.

The foot is an essential part of the human body, and a key factor enabling mobility. The proper functioning of the foot depends on its morphological structure and on the proper shape of its arches – transversal and longitudinal. Having in mind that flat feet develop as a succession of different stages, it is important to systematically monitor the development of feet at various phases of a child’s growth. Therefore, this study aims to evaluate longitudinal foot arch curvature in children aged 7 and 8. The study involved 122 children (77 girls and 45 boys) aged 7 and 8 – students of a primary school in Bezrzecze near the city of Szczecin. Body height and weight, and the length and width of the feet were measured. A podoscope was used to determine the curvature of the longitudinal foot arch, which was then expressed on a scale compatible with the Szriter-Gudanow “KY” foot arch curvature index. This non-invasive method enables preventive measures to be taken at critical stages of a child's life. The results for the tested groups of children revealed statistically significant relationships for body height and weight, and the length of the feet between the 7 and 8 year olds. Furthermore, it was observed that the vast majority of the tested children has normal curvature of the longitudinal arch of both the right and left foot.

The present work focuses on the first stage of the development of a mathematical mode for objective assessment of foot arch geometrical characteristics using 3D scanning approach. The model is a first step in the development of multi-parametric assessment that aims to bridge the existing mismatch between professional visual based assessment and objective measurement and objective indices. One of the perceived reasons for this is that the objective indices are applied to plane projections, i.e. 3D characteristics are inferred from partial 2D information. Hence a modified index using 3D scan data was developed and assessed. Based on this single index and statistical analysis, population result matched closely reported values by professional assessors. The overlap, i.e. type 1 and type 2 errors, were reduced but still require further refinement. The next step in the artificial intelligence type multi-criteria decision making is to utilize the Gaussian curve at a global shape level using ellipsoids for shape characterization. The work on this is still in progress as key characteristics for image reconstruction need to be finalized as well as the degree of complexity of the shape approximation.

Foot arch determines the shape of the foot, whether it is normal, flat or high. Excessive body weight is known to be the main factor in altering the foot arches. The foot arches of adult women were determined based on five different footprint parameters (Clarke index, Chippaux-Smirak index, Staheli index, Arch index and the Harris-imprint index) and the relationship between Body Mass Index (BMI) and foot arches were studied. A total of 309 adult women from the age of 20 to 60 years were recruited in this study. The shape of participants’ feet were obtained and their left and right foot arches were determined using five different footprint parameters. Body weight and height were measured and BMI was calculated. Paired t-test and one-way ANOVA were applied to perform the statistical analysis. Our analysis showed that two third of the participants have different foot arches between the left and right feet. The Harris-imprint index exhibited the most significant (p=0.004) differences between the left (mean=0.168) and right (mean=1.011) foot arches. Most of the overweight (53%) and obese (15%) participants have normal arches; however the prevalence of flat and high arches is still higher in overweight (flat arch= 51%; high arch= 52% ) and obese (flat arch= 18%; high arch= 12%) compared to other BMI categories. Harris-imprint index was successfully studied as a suitable parameter in determining the left and right foot arches.

Introduction. Platypodia, taking the lead in the structure of children’s pathologies of the locomotor system, makes from 30 to 60 % of all the diseases of this type. It is considered that different somatic dysfunctions can cause platypodia, and thus the use of methods of osteopathic diagnostics and correction can provide high effectiveness in treatment of platypodia in children.Objectives. To justify the use of osteopathic diagnostics and correction in combined therapy of platypodia in children.Methods. 30 patients aged from 10 to 11 presenting platypodia were examined. They were divided in two groups of 15 participants. Children from the trial group received osteopathic correction together with the traditional treatment. The results of the treatment were evaluated in accordance with the dynamics of the complaints. The state of the feet was evaluated according to the results of plantography. Moreover, the patient’s osteopathic status was evaluated.Results. The treatment dynamics in children from the control group showed that the number of complaints decreased in a statistically significant manner, the Chizhin index showed the rendering of the foot arch to the norm, somatic dysfunctions disappeared. It was noted that children from the control group presented less complaints, the Chizhin index decreased, but the foot was flat and the number of somatic dysfunctions didn’t change.Conclusion. The results of the research proved the effectiveness of osteopathic correction in treatment of flatfoot in children, which permits to recommend to include osteopathic treatment in combined therapy of the flatfoot in children’s polyclinics working practice.

Objectives: Bones of the foot form longitudinal and transverse arches which absorb and distribute downward forces from the body during standing and moving on different surfaces. The medial longitudinal arch is the longest, highest and most important in static position and moving. Studies classify the medial longitudinal arch as high, normal, and flat. This study was designed to determine the factors that affect the development of the medial longitudinal foot arch. Methods: Cross-sectional study design was employed, 424 subjects were selected using quota sampling method. The footprint areas were measured using a planimeter. Descriptive statistics and multiple logistic regressions were used for data analysis and p value

Objectives: The aim of this study was to assess the arch height index of pregnant women and its correlation with foot pain, anterior knee pain, and lower back pain. Subjects and Methods: Two hundred and fifteen consenting pregnant women participated in this cross-sectional study. The arch height index was assessed from their foot prints, while pain intensity was rated on a numerical rating scale. Data were summarized with descriptive statistics and the Pearson correlation was used to determine correlations between the variables at p < 0.05. Results: Of the 215 pregnant women, 123 (57.2%) and 127 (59.9%) had low arch heights on the right and left feet, respectively, and the mean arch height indices were 0.27 ± 0.71 for the right foot and 0.28 ± 0.07 for the left foot. The prevalence of foot, knee, and lower back pain was 65 (30.2%), 43 (20.0%), and 93 (43.3%), respectively. The Pearson correlation analysis did not reveal any significant relationship (p > 0.05) between foot pain and each of the right (r = -0.010, p = 0.886) and left (r = 0.004, p = 0.955) arch indices as well as between knee pain and each of the right (r = 0.042, p = 0.536) and left (r = 0.045, p = 0.515) arch indices. A similar trend was observed for the lower back, which also did not show any significant relationship to each of the right (r = 0.026, p = 0.703) and left (r = 0.097, p = 0.157) arch indices. Conclusion: The study participants had a high prevalence of low foot arches, indicating pes planus. Lower back pain was more common than foot and knee pain. The foot arch heights did not show any relationships between the intensities of foot, anterior knee, and lower back pain.

Foot arch problems such as flat foot, high and rigid arch foot are quite common. Such issues cause the decrease of impact absorbance, drops of walk endurance and sense of balance and deformation like Hallux Valgus. Measurements of the detailed movement and deformity of the foot are difficult because of its quickness in gait process. The standard diagnosis had been made at stand-still posture or naked eye observance by a podiatrist.We have developed a computer vision-based bone marker tracking system for Point of Care, that works with common smart-phone or action-cam. With this system, the podiatrist could quantitatively judge problems of bone or joint movement and deformity during gait. The effects of the prescribed insoles are also quantitatively validated with this system. Flatfoot subject showed 10 percent increased the arch angle. High and rigid arch subject shown improvement on reactive control of the arch.

Arch height index (AHI) and arch height flexibility (AHF) are useful methods for evaluating foot structure. Although foot structure may be linked to intrinsic factors such as gender and load conditions, information on AHI and AHF in consideration of these factors is lacking. This study aimed to examine the effect of gender and load conditions on AHI and AHF. One hundred Japanese youths (50 males, 50 females) were recruited in this study. Arch height and truncated foot length were measured with an AHI measurement system. AHI was calculated for each load condition using truncated foot length and arch height. AHF was defined as the change in arch height from 10% to 50% of weightbearing load, and from 10% to 90% of weightbearing load. To satisfy the assumption of independence, only measurements from the right foot were analyzed. A gender × load condition interaction was found in AHI. AHI in all load conditions showed significant differences between the genders (p.001), and AHI of female participants was significantly less than that of male participants (p.001). In contrast, no significant gender × load condition interaction was noted in AHF, and only the main effect of the load condition was found (p.001). In AHI use, the effects of gender and load conditions must be considered, and AHF may be used considering only changes in load conditions. The results of this study provide useful information regarding which normative values of AHI and AHF should be used.

This paper presents the investigation on the types of foot arch affecting plantar pressure distribution during running. In this study, 20 participants of different arch types volunteered. The participants were required to run on the treadmill at three different speed with the FSR sensors placed under the sole of the shoes. Two sensors used, one at forefoot and one at rear foot. Only left foot was examined through this study. The data were analysed to compare the foot pressure of individuals during running and to analyze the effect of speed on the voltage measured with different arch types. The rear foot showed higher pressure value compared to the fore foot.