Search

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.

Flat foot is a condition which pedal arch is absent. This condition is count physiological if found in infants and children at a certain age due to incomplete development of bone structure and surrounding tissue. Flat foot is a common condition in pediatrics, which affects about 20% to 30% of the world's population. The prevalence of flat foot will decrease concomitantly with age. At two years old, 94% of children experience flat foot and only 4% at ten years old experience this condition. Most children will show complete and normal development of the sole foot at 12 years old. Pedal arch is one of the important parts that affect the anatomical structure of the lower limb and foot biomechanical. This study aims to compare the anatomical structure of the pedal arch in patients with flat foot and normal foot from Arch Height Index (AHI), Plantar Arch Index, Calcaneal Pitch Angle (CP), Talo-Horizontal Angle (TH), and Meary’s talus-first metatarsal (T-1MT). This study is an analytical study with a cross sectional approach using a sample of 30 elementary school students in Denpasar. The data obtained were analyzed using descriptive analysis and comparative test. In this study, we found significant differences in the plantar arch index and calcaneal pitch angle between students with normal foot and flat foot. We also found no significant differences in AHI, T-1MT and TH between students with normal foot and flat foot.

Assessment of the total weight-bearing response of the navicular and talus bones is essential for evaluating the load absorption function. Although the weight-bearing response of the hindfoot valgus is likely related to the total weight-bearing response of the navicular and talus bones, this relationship is not well-understood. We evaluated the relationship between the total weight-bearing response of the navicular and talus bones and the weight-bearing response of the hindfoot valgus in the normal foot arch. Twenty-three males with normal foot arches were analyzed. We scanned the right foot of each participant under both non-loading and full weight-bearing conditions, using positional magnetic resonance imaging (pMRI). We measured the vertical and medial positions of the navicular and talus bones. The total positional changes of the navicular and talus bones (ΔTPCN and ΔTPCT, respectively) were calculated from the vertical and medial displacement values, using the Pythagorean theorem. To evaluate the weight-bearing response of the hindfoot valgus, the hindfoot alignment view (HAV) was measured. The difference in HAV (ΔHAV) between non-loading and full weight-bearing conditions was considered the weight-bearing response of the hindfoot valgus. Correlations between ΔTPCN, ΔTPCT, and ΔHAV were assessed using the Pearson correlation coefficient, and ΔTPCN and ΔTPCT were found to be moderately correlated with ΔHAV. Our study indicated that the total weight-bearing response of the navicular and talus bones correlated with the weight-bearing response of the hindfoot valgus in healthy adult males with normal foot arch.

Introduction: The ankle and foot are responsible for the support base of the whole body and variations in the foot posture influences the function of lower limbs. Objective: To observe whether there is a relationship between the isokinetic peak torque of ankle muscles with different types of foot. Method: The sample consisted of 32 volunteers, divided intentionally into 3 groups (normal, flat and cavus) according to the classification of the type of foot. They were evaluated in an isokinetic dynamometer Biodex 4 Medical Systems, for analysis of ankle muscles peak torque in flexion and dorsal plantar, inversion and eversion in concentric contraction at 30 and 60°/s speeds. Results: There was positive moderate correlation between cavus group and the inversion peak torque in the dominant lower limb and negative moderate correlation on the not dominant lower limb. The flat foot group presented correlation with peak torque in the plantar flexion movement at a speed of 30°/s in non-dominant leg, which was negative moderate correlation. The normal foot group was correlated with peak torque of dorsiflexion movement in the dominant lower limb on 60 °/s speed and the non-dominant leg on 30°/s, been negative moderate correlations. Conclusion: The foot types were correlated with the ankle muscles, showing that alterations on the position of the feet, the ankle muscle strength changes depending on it.

Purpose: The purpose of this study was to compare the morphology of the intrinsic foot muscle between typical foot and flat foot with the use ultrasound. Methods: Thirty-seven healthy participants were recruited in this study. Foot types were classified using the Foot posture index 6-item version. A total of 43 flat feet and 31 typical feet were examined. Using B-mode ultrasound imaging, the morphology of the abductor hallucis, oblique head of adductor hallucis, abductor digiti minimi, and flexor digitorum brevis muscles were measured. Morphology of all muscles measured was normalized by body height. The independent Student’s t-test was used to examine the differences in the thickness and the cross-sectional area (CSA) of the intrinsic foot muscle among the two groups. Results: The thickness of abductor hallucis was significantly larger in flat foot group. The thickness and CSA of abductor digiti minimi and the thickness of oblique head of adductor hallucis were significantly smaller in flat foot group. Conclusions: Our results showed hypertrophied adductor hallucis, atrophied abductor digiti minimi, and atrophied oblique head of the adductor hallucis in individuals with flat feet, suggesting a possible tendency to hypertrophy in muscles that are located in a medial position and a possible tendency to atrophy in muscles that are located in a lateral position in flat feet.

Introduction: Alteration of foot posture may influence the knee loading, particularly in medial compartment. The purpose of this study was to find the relation of foot postures with clinical finding in medial knee osteoarthritis (KOA).Methods: Subjects with medial KOA who met inclusion criteria were recruited consecutively, in Nursing home on August to October 2018. The foot posture has determined by Foot Posture Index (FPI). The severity of KOA has measured by Kelgreen-Lawrence (KL) grading system, and pain level using numeric rating score (NRS).Results: There were 37 subjects consisted of male and female with normal foot subsequently 17(8.5%) and 3(15%), male and female with abnormal food subsequently 3(15%) and 1(16%). There were 12 (32.43%) of pronated foot, 5 (13.51%) of supinated foot, and 20 (54.06%) of normal foot subjects. The subjects with abnormal foot posture have severe medial KOA (p

Background : Flatfoot is a musculoskeletal disorder of the foot where the medial longitudinal arch becomes flatter, resulting in a more foot surface touching the ground compared to the normal foot. One of the risk factors for flatfoot is the rather early footwear usage with a considerably long period of usage with the enclosed footwear type. This may cause weakening of supporting tissues of the foot. This study aimed to describe the use of footwear in children with flatfoot. Methods : This study used a descriptive categorical method, conducted from March to June 2017 among students from five elementary schools in Sukajadi sub-district, Bandung. Primary data were obtained by using questionnaires and descriptively presented. Results : Prevalence of flatfoot among included students (n73) of the elementary school with age range of 6–10 years was 54.8%. All students had their first years of wearing footwear in the age range 0-5 years. The majority (52.5%) of footwear usage duration in flatfoot disorder was ≥8 hours/day, and the footwear type of flatfoot disorder was dominated (65%) by sandals/slippers. Conclusions : There is a high number of flatfoot in elementary school, and this needs special attention, especially on how to use the footwear.

Morphological changes of the abductor hallucis muscle (AbH) in flexible flatfoot (FF) individuals influence regulations of the medial longitudinal arch (MLA). Prolonged and repeated stretching of AbH in flexible flatfoot may cause changes in muscle reflex properties and further influence postural performance. However, AbH muscle reflex under different postural conditions have never been examined. The purpose of this study was to investigate differences in AbH H-reflex and postural performance between individuals with normal foot (NF) alignment and FF under prone, double-leg stance (DLS), and single-leg stance (SLS) conditions.Cross-sectional study.University laboratory.Individuals with FF (n = 12) and NF (n = 12).AbH H-reflex, AbH EMG and center of pressure (CoP) displacement.Under all postural conditions, AbH H-reflex was significantly lower in the FF group (P .05). Under the SLS condition, AbH EMG was significantly higher in the FF group (P .05), and CoP displacement for the medial-lateral and anterior-posterior directions were significantly higher in the FF group (P .05).With increased postural demand, FF individuals maintained their postural stability by recruiting greater AbH activities than through automatic stretch reflex, but FF individuals still showed inferior posture stability.

Introduction: This study aimed to explore foot pronation deformity on the postural control of the body and the onset time of the electrical activity of ankle muscles during landing. Materials and Methods: In this cross-sectional study, 27 people with a pronated foot deformity and 27 normal people participated. The force plate was used to measure the postural control of the body. Surface electromyography signals were recorded in landing tests with electromyography, which synchronized with a force plate. To compare the performance of the two groups, we used multivariate analysis of variance. Results: The results indicated a statistically significant difference in the medial-lateral direction of differences between center of pressure and center of mass (COP-COM) between foot pronation (pronated) and normal group during landing (P

Background: Low Back Pain (LBP) is the commonest form of musculoskeletal disorder among physical therapists. Repetitive tasks, high force manual techniques bending/twisting postures, patient transfer assisting with mat activities, lifting heavy equipment, prolonged constrained posture and foot abnormalties identified as risk factors of low back pain which is common in the field of physical therapy.Aim of the Study: The purpose of this study was to identify prevalence of work related LBP among physical therapists with different foot postures working in governmental hospitals in fayoum-Egypt.Subjects and Methods: 147 physical therapists who are working in the governmental hospitals in Fayoum-Egypt, the LBP will be measured by Nordic Questionnaires (NQ) and foot postures measured by Foot Posture Index (FPI).Results: 112 of the 147P. Ts (76.19%) have completed the questionnaire. WRLBP (n=68), non WRLBP (n=25), no LBP (n=19). The lifetime prevalence of WRLBP was 60.71%, the twelve-month prevalence of WRLBP was 52.67%, the point prevalence of WRLBP was 47.32%, concerning BMI and WRLBP 74.28% of subjects with BMI of 20-24.9kg/m2 and 54.54% of subjects with BMI of 25-29.9kg/m2, the WRLBP was present in 54.83% of female subjects and in 68% of male subjects, the WRLBP was present in 56% of subjects with normal foot posture, 55% of subjects with pronated foot posture, 91% of subjects with highly pronated foot posture, 100% of subjects with supinated foot posture and 67% of subjects with highly supinated foot posture.Conclusion: There was no statistically significant associ-ation between LBP and foot postures, however there was a statistically significant association between WRLBP and BMI. There was a high prevalence of WRLBP among physical therapists who working in governmental hospitals in Fayoum-Egypt.

The main goal of this study was to investigate the size of all portions of the quadriceps muscles in individuals with pronated foot posture compared to normal foot posture using ultrasound imaging.Twenty nine females with pronated foot posture and 29 age-, body weight-, body height-matched females with normal foot posture were recruited from university communities. The muscle thicknesses of the rectus femoris (RF), vastus medialis (VM), vastus medialis oblique (VMO), vastus lateralis (VL) and vastus intermedius (VI) were measured using ultrasound imaging.The thicknesses of the RF and VMO were significantly smaller in individuals with pronated foot posture compared to normal foot posture (p0.05). No significant differences were observed in the VM, VL, and VI muscle thicknesses in both groups.Based on the results of the present study, it seems that besides the foot and lower leg muscles, an integrated assessment of proximal knee muscles, especially quadriceps, is required in individuals with pronated foot posture.

Diabetic foot problems are widespread globally, resulting in substantial medical, economic, and social challenges for patients and their families. Among diabetic complications, foot ulceration is the most frequent outcome and is more probable to be of neuropathic origin. To date, a plethora of studies has focused on diabetic foot and ulcer prevention. However, limited studies have investigated the biomechanics of diabetic foot post ulceration. In this work, extensive biomechanical modelling of diabetic foot ulcers was attempted. A full-scale foot model was developed using measurements from a human subject, and ulcers of differing sizes and depths were modelled at different plantar sites numerically. Also, the foot model was computationally modified to study the effect of flat foot conditions on the same diabetic ulcers. Standing condition was simulated, and the induced stresses were investigated at the plantar region. The maximum stresses were observed to be similar for all ulcer sizes and depths at the lateral midfoot region of the normal foot. However, the maximum stresses were reported in the lateral heel region for the flat foot, which varied significantly with size and depth. Such results present important information on the foot condition post ulceration and may help identify possibilities of further ulceration in the diabetic foot. These novel findings are anticipated to be indispensable for the development of suitable interventions (e.g., custom orthotics) for diabetic foot ulcer management.

The foot is a common source of parental concern and consultation with a primary care physician. The majority of foot conditions are benign and do not need specific treatment and only rarely is there a serious cause. A thorough understanding of normal foot development and physiological variations is essential to assess a paediatric foot and identify rare pathological conditions.

In this case report, we present the case of a 20-year-old male patient who suffered from pain in walking clinically, and in whom an extremely rare type of brachymetatarsia was diagnosed. Although distorted body image is the main reason for consulting a specialist, the patient presented because he was unable to find a proper shoe. The patient had no familial history of brachydactyly, trauma, or a genetic disorder. In this extremely rare case, the decision was made to perform shortening of the normal foot ray with a double osteotomy to the metatarsal and proximal phalanx. At the end of the follow-up period, the patient was walking pain-free and had no limitation in shoe choice.

Flatfoot is a common foot deformity, which could contribute to running injuries such as medial tibial stress syndrome. Intrafoot kinematics of flatfoot during walking have often been documented using multisegment foot models. However, the intrafoot kinematics of flatfoot during running remains unclear, despite the possible relationship between flatfoot and running injuries. We aimed to clarify rearfoot, midfoot, and forefoot kinematics when running in participants with normal foot and flatfoot. Participants with the normal foot (n = 14) and flatfoot (n = 14) were asked to runover-ground at their preferred speed. Three-dimensional kinematics of the rearfoot, midfoot, and forefoot during running were calculated based on the Rizzoli foot model. A two-sample t-test of statistical parametric mapping was performed to determine differences between normal foot and flatfoot in time histories of intrafoot kinematics during running. No differences were found between groups in characteristics and spatiotemporal parameters. In the frontal rearfoot angle, a significantly increased eversion from 24% to 100% (p < .001) was observed in the flatfoot compared to the normal foot. At the midfoot angle, a significantly increased eversion from 0% to 4% (p < .049) and 21% to 100% (p < .001) was observed in the flatfoot compared to the normal foot. At the forefoot angle, a significantly increased inversion from 6% to 17% (p < .047) was observed in the flatfoot compared to the normal foot. These findings may be useful to explain why flatfoot could contribute to running injuries such as medial tibial stress syndrome.

The foot arch index is an important index to evaluate the health of human feet and the biomechanics line, aiming at addressing the shortcomings of the low efficiency and slow speed of manual foot arch index measurement, in this work, an automatic foot arch index measurement method based on a flexible membrane pressure sensor was proposed. The distribution of plantar pressure data was obtained from the flexible membrane pressure sensor and converted into a digital image. The 8-neighborhood correlation pixel method was proposed to remove the interference of isolated noise points. In order to remove the toes&rsquo, data without affecting the foot sole data, the row element association algorithm was proposed. The front and back endpoints of the foot were automatically located to obtain the foot length, and the foot arch index was also automatically obtained based on the foot arch pressure area. Whether it was a high arch foot, flat foot or normal foot, the method proposed in this paper could accurately and quickly distinguish them. The prototype was developed, and its feasibility and validity were verified by a series of tests.

It is hypothesized that the subtalar hyperpronation may provoke the development of a biomechanical chain of events in lower extremity alignment. Several studies have shown that pelvic alignment may alter in the presence of immediate foot hyperpronation induced by external forces. It is unknown whether these alterations are presented in chronic foot hyperpronation or not. It is also unknown if these potential postural changes could affect iliopsoas muscle size. Therefore, it appears necessary to carry out thorough research in this study. Twenty nine females with pronated foot posture and twenty seven females with normal foot posture participated in this study. The iliopsoas muscle was measured using ultrasound imaging (USI). Pelvic angle (PA) was measured using reflective markers and digital photography. Intrarater reliability of USI for the iliopsoas muscle thickness was also measured. The results indicated that the iliopsoas muscle thickness and the PA were not different in individuals with pronated foot compared to the normal foot group. However, a good intrarater reliability of USI was found for measuring the iliopsoas muscle thickness.

Objective this study aims to develop a comprehensive 3D FE model of the foot to investigate the effect of soft tissue stiffness on the plantar pressure distributions and the internal load transfer between bony structures. Methods the stress shielding occurring on the plantar surface of a flatfoot was investigated and compared with the mechanical behavior of a healthy foot, trough baropodometric analyses and the FE models. Results the flatfoot evidences a more intensive stress-shielding map with significant values of pressure acting on the medial plantar fascia. Conclusion Clinically and radiographically, symptomatic adult flatfoot is a complex abnormality involving all three dimensions and multiple joints within the foot.

BACKGROUND Knowledge of children's foot shape is essential for podiatric healthcare and footwear design. Differences in foot shapes relative to sex and age were demonstrated among white children; however, no study has examined the foot characteristics of Asian children according to sex and age. This study aimed to analyze the age- and sex-associated differences in foot measurements in Chinese children. MATERIAL AND METHODS We recruited 1240 boys and 1303 girls from China as participants for the present study. Foot dimensions were recorded by a video filming system, and 12 foot-shape measurements were acquired. One-way ANOVA was used to calculated the changes in measurements with age for boys and girls. Scores were analyzed as raw and normalized to foot length using the independent-samples t test. RESULTS Most measurements increased significantly at 7-8 and 8-9 years for girls and 8-9 and 10-11 years for boys. Arch height, instep length, and heel width showed greatest increases for both sexes ages 7-12 years (P

A medial plantar flap is superior as a sensory flap with regard to tissue wear, prevention of ulcer recurrence, and other such factors. However, a wound at a plantar weight-bearing site is likely to lead to abnormal hyperkeratosis that can cause pain and fissures. In addition, the development of a scar contracture in infant patients can cause failure of normal foot development. To overcome these issues, we developed a method in which an island flap from a non-weight-bearing site is used as a step-ladder advancement plantar flap for moderate-sized tissue loss at a plantar weight-bearing site, followed by primary closure of the flap donor site with suturing to prevent scar contracture and abnormal hyperkeratosis. This technique showed good functional and cosmetic outcomes, as the step-ladder-like suture lines were unlikely to cause scar contracture and abnormal hyperkeratosis owing to the staggered scar, leading to pain prevention.

[Purpose] This study observed the plantar pressure between flexible flatfoot and normal foot on different walking conditions to find out if flexible flatfoot needs the treatment and how the plantar pressure change while walking upstairs and downstairs. [Subjects and Methods] Fifteen adults with mild flexible flatfoot, fifteen adults with severe flexible flatfoot and fifteen adults with normal foot were examined while walking on a level surface, walking up and down 10 cm and 20 cm stairs. The max force and the arch index were acquired using the RSscan system. The repeated measures ANOVA was performed to analyze the data. [Results] Compared with normal foot, both max force and arch index of severe flatfoot were significantly increased on different walking conditions. When walking down 10 cm and 20 cm stairs, the plantar data of both normal foot and flatfoot were significantly increased. [Conclusion] The plantar pressure of severe flexible flatfoot were significantly larger than that of normal foot on different walking conditions. In addition, the arches of both normal foot and flatfoot were obviously deformed when walking downstairs. It is therefore necessary to be treated for severe flexible flatfoot to prevent further deformation.

The article presents the methodology and the results of the studies conducted in order to develop a rational classification technique of the elderly foot typologies, based on parameters derived from the plantar footprint. The plantar footprints were taken from 67 women, aged between 52-84 years old with RSscan pressure plate and the associated system, Footscan 7 Gait, 2nd Generation, 0,5 Gait Scientific System. To classify the foot typology, Chippaux-Simark Index and Hallux-Valgus Angle have been used. According to the obtained results, the subjects were divided into five categories, subjects with Normal Foot, High Arched Foot, Flat Foot, Hallux-Valgus Foot and Hallux Varus Foot. The authors have developed a method of determining the middle area of a plantar footprint for a more accurate measurement, being able to register it in the same way, for all subjects. Using statistical analysis, differences between age groups have been found, demonstrating the necessity of modelling and designing customized shoe lasts, footwear and prophylactic components according to the age of the subject. A good fit of the shoe on the elderly foot involves modifying the shoe last, but this can only be achieved under certain standards. Having biomechanical data of the foot and a clear classification of it, the customization of the product is simplified, reducing the number of tests and increasing the footwear technological process efficiency.

This article discusses rearfoot fusions for foot and ankle surgeons. It establishes normal foot and ankle function primarily in the stance phase of gait. The foot is greatly affected by external and internal forces, which contribute to normal function or the need for compensatory mechanisms. As a result of compensation, many symptoms develop, often leading to debilitating disorders such as degenerative joint disease. The interaction of the ankle, subtalar, and midtarsal joints are outlined. Congenital deformities, trauma and abnormal compensation are reviewed along with corresponding sequelae. Surgery is often indicated to reduce symptoms, improve position, and help stabilize the foot.

Introduction: This study had two objectives. First, to determine the prevalence of the various foot types based on height of the medial longitudinal arch. Second, to examine if a change in body positions has an associate effect on the anthropometric parameters of the foot types. Material and methods: A total number of 98 men between the ages of 18–25 were studied. The prevalence of normal foot, high-arched foot and flatfoot, was determined using an electronic plantogragh. The foot parameters were measured at sitting position, bipedal position (standing on two legs) and unipedal position (standing on one-leg). The data obtained was analyzed using excel. Results: The present work shows a significant change in foot width, Shtriter index, and the total square area of the foot across the various foot types with respect to change in body positions. Conclusion: In conclusion, the impact of body weight on foot varies at different body positions. The load-bearing capacity of the foot changed with respect to the weight of the body and this resulted a significant changes in the anthropometric parameters of high-arched and normal arched foot unlike flatfoot which recorded slight changes in it's anthropometric parameters. Keywords: Foot, Body weight, Body position, Foot parameters, Plantar pressure, Load-bearing

Objectives To determine the prevalence of foot problems and its related associations in different regions across India among people with Intellectual Disabilities (ID) stratified by age and gender. Method A survey was done among a randomly chosen sample of 1517 Indian inhabitants (8–50 years of age) residing in different regions of the country under the drive named Healthy Athlete (HA) Fit Feet Screening Program of Special Olympics Bharat. Chi-Square test is used to draw an inference of prevalence of different foot conditions among the population from different age groups and from different genders. Results The percentage of Healthy Athletes with the normal foot in Bhiwadi, Warangal, Ajmer, Bhopal, Guwahati, and Jodhpur was 48.14%, 53.92%, 55.82%, 27.31%, 54.47%, and 76.34%. The percentage of athletes with foot problems from these areas was 53.08%, 46.07%, 44.1%, 72.69%, 45.53%, and 26.35%. Moreover, on analyzing the athletes with foot problems on the basis of the age group, it was found that the middle age group athletes from Bhopal had the highest incidence of more frequent foot problems. Furthermore, on comparing the prevalence of foot problem on basis of gender it was found that female athletes have more prevalence than men. Conclusion The numerical results indicate the middle age group subjects have statistically significant higher tendencies towards the foot problems in contrast to the lower and the higher age group subjects Also, the prevalence of the foot problems and their related associations in women are higher compared to men.

Background We recently reported age and gender differences in foot shape and size in Chinese school children aged between 7–12 years. This study aimed to analyze age and gender differences in foot shape and size in Chinese adolescents aged between 13–18 years. Material/Methods The study included 1,252 adolescent boys and 1274 adolescent girls from seven regions in China. Twelve measurements of foot shape were recorded using a video filming system. One-way analysis of variance (ANOVA) compared the changes in the measurements with age. An independent t-test was used to analyze gender-associated differences in foot size and shape. Results In adolescent boys, foot length and width increased significantly at 13–14 years and heel width, arch height, and fifth metatarsal head height increased until 18 years (P0.8). Adolescent boys showed a significant increase in ball width and girth, and instep length and height compared with adolescent girls, who had a longer medial foot length and higher fifth metatarsal head height compared with adolescent boys (P0.5). Conclusions Age and gender associated differences were found in foot measurements in Chinese adolescents, aged between 13–18 years. These differences should be considered by shoe manufacturers and when making clinical decisions about normal foot development.

The approach to the diabetic foot consists of four simple steps: assessment, classification, staging and intervention. A simple assessment of the diabetic foot is described so that it is possible to classify and stage the foot, looking for eight clinical features, namely skin breakdown, infection, necrosis, ischaemia, neuropathy, deformity, callus and oedema. The diabetic foot can be classified into two groups: (1) the neuropathic foot with palpable pulses and (2) the ischaemic foot without pulses and a varying degree of neuropathy. The neuropathic foot may be further divided into two clinical scenarios: (1) foot with neuropathic ulceration (2) Charcot foot, which may be secondarily complicated by ulceration. The ischaemic foot may be divided into three clinical scenarios: (1) neuroischaemic foot characterised by both ischaemia and neuropathy and complicated by ulcer, (2) critically ischaemic foot, (3) acutely ischaemic foot. Each of these five main clinical scenarios (two neuropathic and three ischaemic) are characterised by having specific stages in their natural history. These stages have been described in a Simple Staging System. The stages are (1) Normal foot, (2) High risk foot, (3) Ulcerated foot, (4) Threatened foot, (5) Necrotic foot, (6) Unsalvageable foot. Intervention should achieve: wound control, microbiological control, vascular control, mechanical control, metabolic control and educational control.

Flatfoot is a risk factor for patellofemoral pain syndrome (PFPS), and excessive rearfoot eversion occurring in flatfoot has been associated with the development and progression of PFPS; however, the mechanism remains unclear. This study aimed to investigate transverse shank and frontal rearfoot coordination patterns and variability when running with normal foot and flatfoot. Participants with normal foot (n = 13) and flatfoot (n = 13) were asked to run at their preferred speed. The coupling angle between the shank and rearfoot, representing intersegmental coordination, was calculated using the modified vector coding technique and categorized into four coordination patterns. Standard deviation of the coupling angle was computed as a measure of coordination variability during the stance phase. No differences in the characteristics and spatiotemporal parameters between groups were found, and all participants had rearfoot strike pattern. During midstance, the flatfoot group showed a significantly greater proportion of anti-phase with proximal (shank) dominancy than the normal foot group (p = 0.04, effect size = 0.88 [large]). Furthermore, flatfoot group showed a significantly greater in variability than the normal foot group (p = 0.03, effect size = 0.91 [large]). This study’s results may help explain why flatfoot is likely to result in PFPS. However, the occurrence mechanism of running injuries like PFPS is multi- factorial. Since these results alone are not sufficient to explain the cause-effect relationship between flatfoot and injuries like PFPS, a prospective study including other factors such as patellofemoral joint stress would also be needed.

Purpose: Some deformities that increase the risk of injury including cavus foot are not correctable yet and can only be limited by prevention and taking care of external causes. The current study aimed at determining if foot type (cavus or normal) resulted in loading differences during badminton fundamental movements, considering the prevalence of cavovarus foot deformity and the important role of the foot in sports - especially the sports that suddenly impose forces with different speeds on foot. Methods: Twenty healthy subjects (10 cases with normal feet and 10 with high arch feet) completed 5 trials in each condition, while in-shoe pressure data were collected at 100 Hz. Peak pressure and mean pressure were analyzed among the subjects in 5 major anatomical regions of the foot using the independent t test in SPSS version 20. Foot type was determined by foot posture index (FPI) (α

The limb deformity-based principles originate from a standard set of lower extremity radiographic angles and reference points. Objective radiographic measures are the building blocks for surgical planning. Critical preoperative planning and intraoperative and postoperative evaluation of radiographs are essential for proper deformity planning and correction of all foot and ankle cases. A total of 33 angles and reference points were measured on 24 healthy feet. The radiographic measurements were performed on standard weightbearing anteroposterior, lateral, and axial views of the right foot. A total of 4 measurements were made from the axial view, 12 from the lateral view, and 17 from the anteroposterior view. All angles were measured by both senior authors twice, independent of each other. The radiographic angles and measurements presented in the present study demonstrate a comprehensive and useful set of standard angles, measures, and reference points that can be used in clinical and perioperative evaluation of the foot and ankle. The standard radiographic measures presented in the present study provide the foundation for understanding the osseous foot and ankle position in a normal population.

BACKGROUND Accessory navicular (AN) is a common anatomic variant that is known to cause medial foot pain. Surgery may be required for excision if conservative measures fail. Often, the medial border of the navicular is excised in addition to the AN during surgery. The purpose of this radiographic study is to determine if the presence of an AN is associated with a wider or more prominent navicular in pediatric patients compared with normal controls. METHODS This study included pediatric patients who received an initial plain anteroposterior foot radiograph between January 1, 2004 and December 31, 2012 and were between the ages of 10 and 20 years. Feet with an AN were compared with those without, while controlling for age. Male and female patients were analyzed independently. Feet with fractures, deformities, or previous surgeries were excluded. Radiographic measurements included the navicular width and the protrusion of the navicular bone medially. RESULTS A total of 592 feet were included. An AN was identified in 73 feet. Male patients were analyzed separately from females. Cases with 1 AN bone had similar-sized native navicular bones in the contralateral normal foot compared with controls with 2 normal feet (P>0.05). The presence of an AN was associated with a larger navicular width (male: P=0.02, female: P=0.02) and a larger medial protrusion percent (male: P

Changes in anatomical structure of the foot reduce the foot ability for normal performance. This study aimed to compare selected muscles of trunk and lower extremities during walking in individuals with different foot types. Forty-five female students were categorized into three groups depending on their foot structures namely, pronated, supinated and normal feet. Foot types defined by foot posture index and X-ray under the specialist physician. Electromyography activities were recorded from muscles of tibialis anterior, peroneus longus, medial gastrocnemius, biceps femoris, gluteus medius, external oblique and erector spinae in three groups while walking in determined path with self-selected gait speed. Each effort simultaneous with electromyography registration was recorded with camera. One-way ANOVA test was used to compare the groups at significance level of 0.05. The activity of muscle of tibialis anterior and medial gastrocnemius was greater in pronated foot group than that in supinated and normal groups during heel contact phase of gait (p = 0.001). Supinated foot group exhibited a greater peroneus longus activation than the other groups (p = 0.001). No significant differences were observed for remaining four muscles (p > 0.05). During midstance phase, peroneus longus, supinated foot group exhibited a greater activity compared to other groups while pronated foot group exhibited a greater muscle activity for gluteus medius than others (p = 0.001). There was a significant difference between normal and pronated foot groups for external oblique (p = 0.001). Regarding the findings of this study, the muscular performance changes in pronated and supinated foot groups are more noticeable than that in normal foot type.

Plantar soft tissue stiffening in diabetes leads to a risk of developing ulcers. There are relatively few studies providing methods for quantifying the mechanical properties of skin and fat in the plantar tissue of diabetic patients. Previous studies used linear or non-linear single layer deformable models or linear multi-layer models. This study aimed to investigate the mechanical properties of plantar soft tissue using multi-layer, non-linear models to estimate more accurate mechanical properties in the plantar tissues of diabetic patients. Ten healthy young (HY) subjects, ten healthy old (HO) subjects, and ten old diabetic patients (DB) volunteered for the study. Indentation tests were performed at two sites in the heel. The subjects underwent computed tomography (CT) to measure the respective thicknesses of the skin and fat at the indentation sites. Subject-specific finite element models were created to estimate the parameters of the first-order Ogden forms of the skin and fat. The initial shear modulus for the fat layer μ F in DB, HO, and HY were 4.68 MPa (±0.87), 2.71 MPa (±1.25), and 2.27 MPa (±0.87), respectively. The initial shear modulus for the skin layer ( μ S ) in DB, HO, and HY were 5.86 MPa (±2.51), 7.05 MPa (±1.94), and 14.58 MPa (±1.98), respectively. The DB had stiffer fat tissue than the normal subjects in the same age group but had the same soft skin. These aspects can cause different mechanical stress conditions in a diabetic foot than in a normal foot under the same mechanical loading, making the diabetic foot vulnerable to the initiation of mechanical breakdowns such as ulcers.

In this study, it was aimed to produce a low cost customized orthopedic insole and perform its pressure analyzes. In this analysis, it was used thin film pressure sensor and Arduino programming platform equipped with ATmega328 microcontroller. For the sensor layout, 5 zones were determined in the sole and the proportional values with the pressure were recorded and these values were used for the insole design. For the pressure analysis, 17 volunteers aged 19 to 34 years, with flatfoot and normal foot participated for the experiments. A center line was determined to provide a balanced distribution of the pressure in the sole and a mathematical model was created for this distribution. Through this model, the data obtained from the experiments was normalized and the appropriate height values were calculated for the insole zones. In addition to this study, the reduction degree of pressure applied to the sole of a 9 mm high foam material placed on the heel of the foot was measured.

This work shows the development of a foot plant deformation classification system using image processing and fuzzy logic in LabVIEW programing environment. The system works in three stages: image acquisition, image processing, and classification of the deformation. For image acquisition, webcams were placed under a transparent acrylic surface, to get the foot plant. The image processing starts binarizing by threshold the acquired photography, taking as threshold criteria the intensity in the foot plant. The classification begins with the measurement of the distance of the foot wide and the foot arch. Then, the relation of this measurements is calculated and introduced to a fuzzy SISO system, identifying five categories: flat foot, normal foot, supinated foot, high supinated foot and extreme supinated foot; eliminating the uncertainty of other classification systems based on intervals. This classification system allows the development of an expert diagnosis system.

Background: Motor tasks involving the lower legs activate a closed kinetic chain, with the foot being the terminal part of that chain. It is known that when a part of this chain is disturbed, it will affect other parts of the chain, including the effect on the motor performance of lower extremities.Aims: To see the difference of physical performance on athlete age 14 – 17 years with flatfoot and normal foot on strength, balance and agility factors.Methods: Male athletes age 14 – 17 years enrolled in Sport Senior High School at Sidoarjo who underwent athletes screening at Sport Clinic of dr. Soetomo General Hospital and fulfill the inclusion criteria. The subject were 29 boys, the normal foot were 22 boys and the flatfoot were 7 boys. Subjects were examined for Clarke’s angle and Chippaux-Smirak index to diagnose flatfoot and did Single-leg Hop for Distance, One Leg Test, Star Excursion Balance Test, and Hexagon Hop Test.Result: The statistical analysis showed no difference of lower extremities’ physical performance in strength using Single-leg Hop for Distance (p>0.05), balance using One Leg Test and Star Excursion Balance Test (p>0.05), and agility using Hexagon Hop Test (p>0.05) on male athletes age 14-17 years with normal foot and flatfoot.Conclusion: There are no difference of lower extremities’ physical performance in strength, balance and agility on male athlete age 14-17 years with normal foot and flatfoot.

Feet are a part of the human body that allows daily movement and functioning. Feet are considered intimate, and ethical aspects related to them are rarely investigated. This chapter describes ethical issues from the perspective of the individual in the context of foot health care. The foot-related ethical issues are approached from the perspectives of individuality and availability of services. This chapter will also highlight the meanings and values how individuals experience their own foot health. Some long-term health problems, such as rheumatoid arthritis or diabetes mellitus, cause foot disorders that change normal foot structure. Therefore individual’s body image and aesthetic perspective are discussed.

Background:The metatarsal parabola or formula is an important principle in assessing normal foot structure and pathology. To understand what effect the positions of the distal ends of the metatarsals have on foot function, the relative length of each metatarsal must be considered. The purpose of this study was to investigate what the normal metatarsal formula is and compare these findings with previous research.Methods:Measurements of metatarsal lengths were taken from 20 feet of five male and five female cadavers. The mean lengths were used to identify each donor's metatarsal formula.Results:On average, the most common formula presented was in the order of metatarsals II>III>IV>V>I.Conclusions:These findings differ from historic measurements and raise questions regarding which metatarsal formula is considered normal. Further investigation is needed to standardize a more reliable method of measuring metatarsal lengths for evaluating foot biomechanics and planning forefoot surgeries.

Foot plantar classification is crucial to prevent dangers to patient's health that originated from an abnormal type of foot. When patients comprehend their type of foot, they will be able to form personal insole to prevent a hazard. On the contrary, some patients who ignore their risk will possibly have the problem. We design the system to classify type of foot by measuring foot pressure and foot curvature. For the software, we use webcams to capture the foot images that will be further processed by Raspberry Pi with OpenCV and color coding which correspond to foot pressure. For the hardware system, we use the component which is inexpensive and easily available. The hardware structure is composed of steel as a base where the transparent acrylic plate and glossy white paper is placed on. The black polypropylene sheet covering on the uppermost is used to block light from outside. Aligned on the side of the transparent acrylic plate LED strip is used for light source for the system. Underneath the steel base there are four webcams which is used to record feet images (two webcams for each foot). The images are sent to Raspberry Pi for image processing and displaying. The system is able to classify three types of the foot for patients including normal foot, high arch foot, and flat foot.

© Springer International Publishing AG 2018. The skin is the major organ of integumentary system of human body and helps to maintain the body temperature, excretes the waste through sweating, protects deepest structures of the human body, and prevent from various problems such as water loss, infection. However, excessive sweating leads to infection in human body especially in the foot such as dermatophyte infection. This study aimed to investigate the foot skin temperature and humidity after wearing socks with shoes. It is a pre-post experimental design study. Ten subjects were selected for this study by convenience sampling methods. In this experiments, humidity and temperature, infrared images were recorded at baseline and post experiment. For this experiment, Infrared camera, HC 520 IN/OUT Temperature/ humidity, and the thermometer were used as outcome measurement and the total duration of pre and post-session consists of 3 h. The results revealed that the foot skin temperature was slightly increased in the left foot: 97.02 (mn), 2.51 (SD). Thus, there was no difference observed in temperature changes. However, humidity level increased in socks with shoes experiment in the post-experiment results. At the same time, we observed in the infrared thermal image analysis that there were physiological changes and post-test temperature changes on the skin of foot. In conclusion, this study revealed that socks with shoes are altered the humidity and foot skin temperature.

This study analyzes the characteristics by age and type for middle aged and elderly women foot shapes aged40-69 years. ANOVA, factor, and cluster analyzed middle aged and elderly women's foot shapes. The results of the studyare as follows. First, higher age groups tended to have smaller foot lengths, ball/instep circumferences, circumferences,and ball heights with larger heel height values and higher degrees of gathering of toe 1 and toe 5 toward the feet referenceaxis. Second, foot lengths were 220 mm-240 mm and the ball circumference’s size symbol in high frequency sections weredistributed from E to EEEE in the 40s and 60s groups and from D to EEEE in the 50s group. Third, eight factors wereextracted through the factor analyses of middle aged and elderly women's foot measurement items. Fourth, a cluster anal-yses classified the subjects into four types. Type 1 is a normal foot type with medium foot length and small ball cir-cumference and type 2 is a long and flat foot type with a type with large foot length and ball circumference values as wellas small ball height values. Type 3 is a thick foot type with a medium foot length, large ball circumference, large ball heightand type 4 is a toe deformation foot type with medium foot length, small ball circumference, and a high degree of toe gath-ering toward the center.Key words : middle aged and elderly women, foot shape, foot measurement, 3D scan, shoes size

Introduction Musculoskeletal disorders of the locomotive apparatus are common in young people with Down syndrome (DS), especially in the feet. Early diagnosis by examination of podiatric footprints can help prevent orthopaedic symptoms. Our objective was to analyse, measure and classify footprints on the basis of podiatric indices (gold standard) in young people with DS. Method Cross-sectional study; 86 footprints were analysed from 2 groups; there were 21 healthy subjects, 11 men 20.45 (2.16) years and 10 females 20.00 (1.70) years; and 22 subjects with DS, 11 men 23.82 (3.12) years and 11 females 24.82 (6.81) years. Footprints were recorded in standing position using an optical pedoscope and a digital camera system. We calculated the Hernandez-Corvo index, Chippaux-Smirak index, Clarke's angle and Stahelli index. We then compared the results of both samples and analysed the concordance between types of feet and right and left feet by Chi-square test. Results Footprints in individuals with DS showed flatfoot and/or pronated foot of 38.6% according to Hernandez-Corvo index; 50%, to Chippaux-Smirak; 70.4%, to Stahelli; and 59.1%, to Clarke's angle. In healthy subjects the rates of cavus foot were 57.1%, according to Hernandez-Corvo index; 59.5%, to Chippaux-Smirak index; and 81%, to Stahelli index; while 57.1% showed a normal foot based on Clarke's angle. Differences between the 2 groups were statistically significant ( P Conclusions Young people with DS had a higher percentage of pronation and a lower percentage of cavus foot than the control group.

Background The goal of therapy for calcaneal fractures is elimination of pain and restoration of normal foot shape and walking ability. The occurrence of wound complications is a serious concern in treating calcaneal fractures.

PURPOSE:According to advanced research, the effect of foot type on balance is 3 type. There are squared foot, morton’s foot and Egyptian foot. Above all, Morton’s foot accounts for 22% of people. The purpose of this study is to find the effect of Morton's Foot on Balance Ability. METHODS:Twenty healthy woman participate in this study(Mean age:23.93; Mean height: 163.35; Mean weight: 56.20) . They doesn’t have musculoskeletal or neurogical disorder. Ten of participants have morton’s foot group, and another ten person are normal foot group. Measurment of balance was used by Balance trainer(BT4) and balance pad(AIREX). Data analyzed in 3 way ANOVA.RESULTS:In foot type and support type of variables, Morton’s foot was significant differences in C90 area and

The intent of this study was to determine if the use of a single or combination of static foot posture measurements can be used to predict rearfoot, midfoot, and forefoot plantar surface area in individuals with pronated or normal foot types.Twelve foot measurements were collected on 52 individuals (mean age 25.8 years) with the change in midfoot width used to place subjects in a pronated or normal foot mobility group. Dynamic plantar contact area was collected during walking with a pressure sensor platform. The 12 measures were entered into a stepwise regression analysis to determine the optimal set of measures associated with regional plantar surface area.A two variable model was found to describe the relationship between the foot measurements and forefoot plantar contact area (r(2)=0.79, p0.0001). A four variable model was found to describe the relationship between the foot measurements and midfoot plantar contact area (r(2)=0.85, p0.0001) in those individuals with a 1.26cm or greater change in midfoot width.The results indicate that clinicians can use a combination of simple, reliable and time efficient foot measures to explain 79% and 85% of the plantar surface area in the forefoot and midfoot, respectively.

Several multi-segment foot models (MFMs) have been introduced for in vivo analyses of dynamic foot kinematics. However, the normal gait patterns of healthy children and adolescents remain uncharacterized. We sought to determine normal foot kinematics according to age in clinically normal female children and adolescents using a Foot 3D model.Fifty-eight girls (age 7-17 years) with normal function and without radiographic abnormalities were tested. Three representative strides from five separate trials were analyzed. Kinematic data of foot segment motion were tracked and evaluated using an MFM with a 15-marker set (Foot 3D model). As controls, 50 symptom-free female adults (20-35 years old) were analyzed.In the hindfoot kinematic analysis, plantar flexion motion in the pre-swing phase was significantly greater in girls aged 11 years or older than in girls aged11 years, thereby resulting in a larger sagittal range of motion. Coronal plane hindfoot motion exhibited pronation, whereas transverse plane hindfoot motion exhibited increased internal rotation in girls aged11 years. Hallux valgus angles increased significantly in girls aged 11 years or older. The foot progression angle showed mildly increased internal rotation in the loading response phase and the swing phase in girls aged11 years old.The patterns of inter-segment foot motion in girls aged 11 years or older showed low-arch kinematic characteristics, whereas those in girls aged 11 years or older were more similar to the patterns in young adult women.

Background The Footscan® platform system is one of the most commonly used clinical tools for the measurement of the foot pressure. The present study was designed to assess the repeatability of the system and identify the range of loading parameters observed in the normal foot. Methods Measurements were collected from 32 healthy participants, 15 females and 17 males, twice at an interval of 1 week. Peak pressure (PP), contact time (CT), contact area (CA), pressure-time integral (PTI), and maximum force (MaF) were recorded; these parameters were investigated in 10 areas of the foot: medial heel, lateral heel, midfoot, first to fifth metatarsals, hallux, and toes 2–5. The intra-session repeatability was evaluated by calculating the intraclass correlation coefficients (ICCs) and coefficients of variation (CVs) across the three repeated trials within the same session. The inter-session repeatability was assessed using the average of the three trials in each session to determine the ICCs and CVs. Results The ICCs showed moderate to good repeatability for every variable of interest, and the CVs were all

The management of neuromuscular foot deformities in children and adolescents must be individualized because of differences in etiology and pathomechanics. If conservative treatment fails or reaches a plateau early soft tissue procedures are recommended. Treatment should focus not only at correction of the deformity but also at reestablishment of muscular balance. Early postoperative mobilisation is usually possible provided adequate orthotic control is maintained. Regular clinical follow-ups help to minimize postoperative problems. The general aim should be an optimization of functions and only rarely to achieve a normal foot. The basic principles of management can be described as correction of deformity, stabilization of unstable joints and balance of muscle power.

The relapse rate after Ponseti method of correction has reduced in recent years which is attributable to the better appreciation of the need to achieve the correct degree of abduction. Ponseti recommended clinical ‘overcorrection’ of the foot to 700 of abduction. However, no scientific basis for this figure was found in literature. As the indications of Ponseti method extend to older children, we conducted a study to find out the amount of foot abduction to be achieved before applying a foot abduction brace in various age groups. The normal 197 feet of children up to eight years of age were considered for study. The measurements included foot–bimalleolar angle in neutral and maximum possible abduction, thigh foot angle and leg foot angle. The foot bimalleolar angle in neutral had a mean of 82.6 degrees and in maximum abduction a mean of 99.0 degrees. The mean leg foot angle was 66.4 degrees and the mean thigh foot angle was 60.5 degrees. It was found that these variables do not change with age. From the study we concluded that achieved abduction should be about 60–70 degrees before applying foot abduction brace in all children till age eight years with clubfeet treated with Ponseti technique, keeping the leg foot angle or the thigh foot angle as a guideline. This is against the common perception of keeping the abduction at 70 degrees for infants and reducing the abduction to 30 to 40 degrees for older children. Both the leg foot angle and thigh foot angles are reliable indicators of correction.