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Fossil hominin footprints provide a direct source of evidence of locomotor behavior and allow inference of other biological data such as anthropometrics. Many recent comparative analyses of hominin footprints have used 3D analytical methods to assess their morphological affinities, comparing tracks from different locations and/or time periods. However, environmental conditions can sometimes preclude 3D digital capture, as was the case at Happisburgh (England) in 2013. Consequently, we use here a 2D geometric morphometric approach to investigate the evolutionary context of the Happisburgh tracks. The comparative sample of hominin tracks comes from eight localities that span a broad temporal range from the Pliocene to Late Holocene. The results show disparity in the shapes of tracks ascribed to hominins from the Pliocene (presumably Australopithecus afarensis), Pleistocene (presumably Homo erectus and Homo antecessor), and Holocene (Homo sapiens). Three distinct morphological differences are apparent between time samples: changes in adduction of the hallux, changes in the shape and position of the medial longitudinal arch impression, and apparent changes in foot proportions. Linear dimensions classified the potential H. antecessor tracks from Happisburgh as being most similar to the presumed H. erectus prints from Ileret. We demonstrate using 2D geometric morphometric methods and linear dimensions that the Happisburgh tracks are morphologically similar to other presumed Homo tracks and differ from the Laetoli footprints. The probable functional implications of these results fit well with previous comparative analyses of hominin tracks at other sites., Competing Interests: Conflict of interest The authors declare that there are no conflicts of interest in the study., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The distal insertions of the tendons crossing the ankle as well as the tendons originating in the foot are less well known by radiologists. We review the anatomy and ultrasound appearance of these insertions using our own cadaveric sectioning and dissection. The ultrasound images were correlated with anatomical slices. Occasionally magnetic resonance images were also used for better understanding. Understanding the normal appearance of these tendon insertions is important for diagnosing pathology in this region., (Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.)

Background: Foot ailments are common among schoolchildren, some of which may be attributed to wearing ill-fitting footwear. As schoolchildren often participate in athletic activity, they are doubly vulnerable to foot ailments, and are particularly vulnerable to conditions such as hallux valgus, Achilles tendonitis, athlete's foot, corns and calluses. Thus, there is an acute need for the design and manufacture of ergonomic footwear for this target group. While research on appropriate footwear for children has been carried out in relation to child populations in other societies, research on the circumstances of Sri Lankan schoolchildren is lacking. Neither the requisite design know-how nor the information for design is available to footwear manufacturers., Objectives: This review of the literature is aimed at confirming the need for ergonomic footwear from the point of view of the effects of wearing ill-fitting shoes and at identifying the requirements in terms of design information, especially for schoolchildren of the age group five to ten years, to empower footwear manufacturers., Methods: PubMed, Google scholar and Science Direct were used for the literature search., Results: 208 publications were read in full, 94 of which are referenced in this review., Conclusion: The review shows morphological measurements, behavior and activity patterns of schoolchildren and environmental conditions they are exposed to should be determined to formulate design information.

Objective: This study has assessed age-related changes of foot morphology for developing appropriate footwear with particular reference to the elderly., Methods: Anatomical parameters such as foot length, circumference and height and ankle length, circumference and height were assessed in a sample of males (n=577) and females (n=528) divided into three age groups. The groups included young-adult, aged between 20 and 25 years; adult, aged between 35 and 55 years; and old, aged between 65 and 70 years individuals., Results: In terms of gender differences, in young-adult individuals the sex-related morphological differences observed, are just related to a significantly lower length of foot in females. In adult subjects morphological parameters investigated were significantly lower in females even after normalization for foot length. In old individuals, no differences of the parameters were found after normalization for foot length. Comparative analysis of morphometric data between young-adult and adult individuals revealed that the instep length was smaller in adults. The opposite was observed for the great toe and medial foot arch height. Length of ankle was higher in adult than in young-adult individuals, whereas ankle circumference and height were smaller. In old vs adult individuals foot circumference showed the most relevant age-related differences., Conclusions: Feet anatomy presents specific characteristics in different ages of life. The ideal footwear should take into account these characteristics. This is true primarily for the elderly for minimizing the risk of falls or of other problems related to inappropriate footwear., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Approximately 90% of patients with arthritis exhibit forefoot deformities, including deformities within the metatarsophalangeal and proximal interphalangeal joints. Current pharmacological treatment with Disease Modifying Antirheumatic Drugs (DMARDs) consists of two groups: synthetic drugs (sDMARDs) and biological drugs (bDMARDs). The objective of our study was to investigate foot anthropometry changes in RA patients based on the administered treatment over a five-year period Method: A longitudinal analysis was conducted with RA patients who were grouped based on their pharmacological treatment. The pharmacological treatment groups were categorized into (I) methotrexate (MTX), (II) MTX plus biological treatments (including all variables), (III) biological treatment alone, and (IV) a miscellaneous group comprising patients with diverse treatments, including patients for whom various drugs had failed or who had not achieved remission with pharmacological treatment. For the anthropometric measurements, a foot measurement platform validated by McPoil et al. was used. Post hoc analyses with Bonferroni correction were performed to identify pairwise differences between the treatment groups while controlling for Type I errors due to multiple comparisons. Results: In the period from 2018 to 2023, significant changes were observed in several foot measurements. For instance, the MTX group showed a statistically significant increase in left heel width (p = 0.026). The MTX group experienced a slight increase in left foot length, while the Biologics and MTX + Bio groups exhibited more substantial increases in both maximum medial arch height and midfoot width. Conclusions: Different RA treatments can have a significant impact on foot structure over a five-year period, showing notable changes in heel width and overall foot morphology. Combined treatments with MTX and biologics potentially offer better management of RA. [ABSTRACT FROM AUTHOR]

At the inner rear portion of the foot is a tunnel through which a nerve, blood vessel, and several tendons pass. As long as the foot and ankle function in a balanced manner, this tunnel and its neurovascular bundle create no problems. If, however, the ankle and foot become imbalanced in a particular and measurable way, the fibrous band that covers the tunnel becomes stretched and interferes with both normal nerve function and circulation. This area is known as the tarsal tunnel. A narrowing of the tunnel follows foot pronation, an extremely common human problem, which is an inward rolling of the ankle and foot. Unfortunately, when the problem first develops it usually does not cause symptoms. If symptoms such as pain or numbness developed immediately, the individual would recognise a problem and seek treatment. Manual muscle testing of the muscles that move the foot permits the earliest diagnosis of this oncoming problem to occur and saves many patients from enormous troubles. The muscular analysis offered by chiropractic manual muscle testing are the very muscles that help support the bones during activity to avoid narrowing of the tarsal tunnel. [ABSTRACT FROM AUTHOR]

Introduction: The anatomy of the forefoot is complex, and the sonographic assessment to image the plantar digital nerves and exclude, diagnose or discriminate between a Morton's neuroma and intermetatarsal bursitis can be challenging. Topic description and discussion: A good appreciation of the sonographic anatomy, technique, normal and abnormal appearances is required to undertake a sonographic assessment of the forefoot and its interspaces, particularly the plantar digital nerves. This is unpacked in this paper with associated pictorial aids. Muscles, tendons, and ligaments of the interspaces and the nearby metatarsophalangeal joints and their associated soft-tissue structures are helpful sonographic landmarks to guide imaging and assessment of the common and proper plantar digital nerves and the intermetatarsal bursa. These need to be appreciated from both dorsal and plantar sonographic approaches, in both short- and long-axis imaging planes. Conclusion: Improved understanding of the anatomy and sonographic appearances of the interspace structures can enhance the sonographic assessment of the forefoot and improve diagnosis of a Morton's neuroma and/or intermetatarsal bursitis when present to guide patient management. [ABSTRACT FROM AUTHOR]

Background: As the anatomical variations of the foot, enlarged peroneal tubercle (EPT) and accessory anterolateral talar facet (AALTF) have attracted the attention of foot surgeons in recent years. However, EPT and AALTF have not been examined for a relationship with calcaneus spur (CS) as a common osteophyte. Methods: The subjects were 369 individuals who died in northeastern Thailand and were preserved as skeletal specimens. The authors examined for the presence of left and right EPT, AALTF, and calcaneus spur (CS). We divided the EPT (+) group with EPT and the EPT (-) group without it and also divided the AALTF (+) group with AALTF and the AALTF (-) group without it. The age at death and the presence of CS were compared statistically between the EPT (+) and EPT (-) groups and between the AATLF (+) and AALTF (-) groups. Results: Out of the total 369 cases, EPT was found in 117 cases (31.7%), AALTF was positive in 91 cases (24.7%), and CS was found in 194 cases (52.3%). In comparison between EPT (+) and EPT (-) groups, CS was significantly higher (p < 0.0001) in the EPT (+) group, but there was no significant difference in age at death. In comparison between AALTF (+) and AALTF (-) groups, there was no significant difference in age at death or CS. Conclusion: This study showed a strong relationship between EPT and CS, and the prevalence of EPT and AALTF by age in Thailand was first reported. We believe it helps to know the pathogenesis and biomechanism of EPT and AALTF. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Purpose: "Hallux valgus" is a common disease encountered in clinical practice and is accompanied by foot deformities. Conservative treatment is commonly used in the early stages of hallux valgus. On the other hand, surgical treatment often becomes necessary as the deformity progresses. Surgical treatments involve various osteotomy methods or joint fusion procedures combined with soft tissue release, and outcomes from these surgical treatments are generally favorable. This study compared two soft tissue release techniques in the hallux region. Materials and Methods: This study conducted a retrospective cohort study on 48 participants who underwent surgical treatment for hallux valgus at a single institution from March 1, 2018, to March 31, 2023. A scarf osteotomy was performed in all cases, and the "Modified Mcbride procedure" or "Trans-articular approach" was done for soft tissue release. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and the degree of subluxation of the lateral sesamoid were measured through simple foot radiographs taken before surgery and one year after surgery. Results: In the Modified Mcbride procedure group, HVA, IMA, and the sesamoid position grade decreased from 34.94º to 9.98º, 15.64º to 5.44º, and 2.47 to 0.44, respectively. In the trans-articular approach group, HVA, IMA, and the sesamoid position grade decreased from 33.42º to 7.34º, 15.06º to 6.03º, and 2.17 to 0.58, respectively. There was no significant difference in these changes between the preoperative and one-year postoperative measurements for both techniques (p-value>0.05). Conclusion: A radiological assessment of soft tissue release through the Modified Mcbride procedure and trans-articular approach in hallux valgus did not show significant differences. Therefore, both surgical techniques can be considered in the distal soft tissue release for a hallux valgus correction. [ABSTRACT FROM AUTHOR]

AIM: To design and develop a low-cost device to measure foot parameters in children with disability. METHOD: Designing of the device was done using Solidworks software, after finalization of design, Phase 2 which involved the development of footmeter, materials used were, a rectangular wooden frame, an aluminum slider, goniometers, metal sheet with markings of 1 cm over an entire sheet in vertical as well as horizontal direction forming small grids. RESULT: An early version of "Footmeter" device was developed by assembling all the parts together. The Footmeter evaluates: foot length, width of forefoot, midfoot and hindfoot, height of Medial Longitudinal Arch(MLA) , abduction of 1 st MetaTarso Phalangeal (MTP) and deviation for metatarsus adductus. CONCLUSION: The groundbreaking Footmeter device is meticulously designed for measuring foot parameters in children with disabilities. It offers an unparalleled blend of precision, efficiency, and simplicity. With its objective outcomes, minimal training requirements, decreased manual errors, and a streamlined assessment process, "Footmeter" device stands as the ultimate all-in-one tool for the meticulous measurement of foot parameters in children with disabilities. [ABSTRACT FROM AUTHOR]

Objective: This study examines the effect of the lower limb misalignment and its possible compensatory effect on plantar pressure in a normal population. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique and plantar pressure measuring device. Design: Cohort. Setting: Laboratory. Participants: A total of 200 adult volunteers between 18 and 22 years of age who had no current symptoms of pain and foot or ankle pathology participated in the study. Main Outcome Measures: The gold standard measure of lower limb alignment with weight-bearing status is the mechanical axis and their angles using Image J software. Structural and functional measurements of the same foot were taken using a plantar pressure measuring device. In this study, 5 alignment (thigh, knee, leg, ankle, and foot) characteristics were measured on the lower limb using the 2 techniques, and, additionally, the foot contact area, peak pressure, foot axis, rearfoot angle, and subtalar joint flexibility score were analyzed in 10 different regions of the foot. Results: This study has shown a reasonable correlation between digitalized measurements and plantar pressures values. Quadriceps angle affected midfoot impulse, foot axis angle, subtalar joint minimum angle, and rearfoot angle positively. Subtalar joint flexibility scores were analyzed in 10 different regions of the foot. There was a positive correlation between rearfoot angle and quadriceps angle (P= .009, r= .261). Results of both methods show that they endorse each other. Conclusions: The posture of the standing feet may have influence on lower limb alignment. Currently, there are no studies carried out by using digital photogrammetry and foot scan. The authors claim that patient-friendly digital photogrammetry would have a positive contribution to the monitoring of patients, even including new ones in the treatment programs, reducing any possible loss in the personal and national economy. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the effects of specialized Kyokushin karate exercises on the activity of leg muscles and the height of the medial longitudinal arch in adolescent girls with foot pronation. Methods: This study recruited twenty-four adolescent girls with foot pronation who voluntarily agreed to participate and were randomly assigned to either a training group (n=12) or control group (n=12). The training program consisted of eight weeks of specialized Kyokushin karate exercises. The fibularis longus, tibialis anterior, and lateral gastrocnemius muscles activity was measured during single-leg landing using surface electromyography. The medial longitudinal arch height was measured using the navicular drop test. All statistical analyses, including independent and paired t-tests, were conducted using SPSS software, version 26 at a significance level of 0.05. Results: The results showed that following eight weeks of specialized Kyokushin karate exercises, there was a significant increase in the activity levels of the tibialis anterior (P=0.005) and lateral gastrocnemius (P=0.04) muscles in the training group compared to the control group. However, there was no significant change in the activity of the fibularis longus muscle in the training group compared to the control group (P>0.05). Within the training group, there was a significant increase in the activity of all three measured muscles (fibularis longus, P=0.009; tibialis anterior, P=0.008; and lateral gastrocnemius, P=0.008) from post-test to pre-test (P<0.05). Additionally, the study found that the amount of navicular drop in the training group was significantly reduced compared to the control group (P=0.04) after eight weeks of training Conclusion: This study demonstrated that eight weeks of specialized Kyokushin karate exercises resulted in a significant increase in the activity levels of the tibialis anterior and lateral gastrocnemius muscles in adolescent girls with foot pronation. These exercises also improved the height of the medial longitudinal arch, indicating a potential solution for correcting flat feet. Therefore, we recommend Kyokushin karate exercises to improve muscle activity and arch height in adolescent girls with foot pronation. [ABSTRACT FROM AUTHOR]

Background: Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. Methods: This retrospective study included 39 adolescent athletes who were divided into the rearfoot eversion and control groups according to a leg heel angle of 7°. A total of 78 legs were analyzed (45 and 33 legs in the rearfoot eversion [women, 53.3%] and control groups [women, 48.5%], respectively). Gait was assessed using an in-shoe plantar pressure measuring system and a wearable inertial sensor. Results: The foot plantar pressure distribution in the hallux was higher in the rearfoot eversion group than that in the control group (p = 0.034). Spatiotemporal parameters showed that the foot pitch angle at heel strike was significantly larger in the rearfoot eversion group than that in the control group (24.5° vs. 21.7°; p = 0.015). Total sagittal range of motion of the ankle during the stance phase of gait was significantly larger in the rearfoot eversion group than that in the control group (102.5 ± 7.1° vs. 95.6 ± 15.8°; p = 0.020). Logistic regression analysis revealed that plantar pressure at the hallux and medial heel and foot pitch angle at heel strike were significantly associated with rearfoot eversion. Conclusions: Our findings suggest that rearfoot eversion affects the gait patterns of adolescent athletes. Notably, leg heel angle assessment, which is a simple and quick procedure, should be considered as an alternative screening tool for estimating plantar pressure and spatiotemporal gait parameters to prevent sports-related and overuse injuries in adolescent athletes. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Kineanthropometry & Human Performance is the property of Brazilian Journal of Kineanthropometry & Human Performance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the routine dissections study for medical postgraduates, a rare anatomical variation between the right leg and the ankle was observed on the Asian male cadaver. The peronaeus tertius muscle in this cadaver's right leg divided into two tendons: the first tendon was attached to the base of the fifth metatarsal bone, and the second tendon was inserted into the base of the fourth metatarsal bone. The purpose of this paper is to provide detailed anatomical case reports, and to discuss the possible causes and mechanisms of the variation by reviewing relevant literature, so as to provide some reference for future anatomical and clinical related disease research. [ABSTRACT FROM AUTHOR]

When the rear- and forefoot are constrained, calcaneal plantar flexion may occur, deforming the longitudinal arch. Previous research has reported calcaneal motion relative to the tibia or forefoot; these joint rotations may not accurately describe rotation of the calcaneus alone. This investigation: (1) characterized the calcaneus and leg segment and ankle joint rotations during stance in gait, and (2) described the range of calcaneal plantar flexion in different structural arch types. Men (n = 14) and women (n = 16) performed gait in a motion analysis laboratory. From heel strike to heel off, the leg rotated forward while the calcaneus plantar flexed. Before foot flat, calcaneal plantar flexion was greater than forward leg rotation, resulting in ankle plantar flexion. After foot flat, forward leg rotation was greater than calcaneal plantar flexion, resulting in ankle dorsiflexion. Structural arch type was classified using the longitudinal arch angle. The range of calcaneal plantar flexion from foot flat to heel off was small in low (-2° to -8°), moderate in high (-3° to -12°), and large in normal (-2° to -20°) structural arches. Calcaneal plantar flexion in gait during midstance may reflect functional arch characteristics, which vary depending on structural arch type. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There is evidence to suggest that navicular drop measures are associated with specific lower-extremity gait biomechanical parameters. The aim of this study was to examine the relationship between navicular drop and a) rearfoot eversion excursion, b) tibial internal rotation excursion, c) peak ankle inversion moment, and d) peak knee adduction moment during the stance phase of running. Sixteen able-bodied men having an average age of 28.1 (SD = 5.30) years, weight of 81.5 (SD = 10.40) kg, height of 179.1 (SD = 5.42) cm volunteered and ran barefoot at 170 steps/minute over a force plate. Navicular drop measures were negatively correlated with tibial internal rotation excursion (r = -0.53, P = .01) but not with rearfoot eversion excursion (r - -0.19; P = .23). Significant positive correlations were found between navicular drop and peak knee adduction moment (r = .62, P < .01) and peak ankle inversion moment (r = .60, P < .01). These findings suggest that a low navicular drop measure could be associated with increasing tibial rotation excursion while high navicular drop measure could be associated with increased peak ankle and knee joint moments. These findings indicate that measures of navicular drop explained between 28% and 38% of the variability for measures of tibial internal rotation excursion, peak knee adduction moment and peak ankle inversion moments. [ABSTRACT FROM AUTHOR]

Background: The Foot Posture Index (FPI) is a quick, easy, and reliable clinical assessment for measuring foot posture variation in different environments. The aim of the study was to translate the FPI into Brazilian Portuguese and assess its inter and intra-observer reliability. Methods: The cross-cultural adaptation of the 6-item version of the FPI (FPI-6) was accomplished using standard guidelines. Forty-two volunteers participated in the reliability process, assessed by two examiners and at three different occasions, evaluated using the intraclass correlation coefficient (ICC). The agreement between reliability assessments was investigated by the standard error of measurement (SEM) and the minimal detectable change (MDC90). Results: The Brazilian version of the FPI-6 showed excellent inter and intraobserver reliability for the dominant (ICC = 0.91 and 0.90) and nondominant lower limb (ICC = 0.94 and 0.92). The agreement was considered excellent for SEM with values representing less than 5% in relation to the total FPI-6 score. The MDC90 showed that changes in the score greater than 1.82 (for interobserver) and 1.90 (for intraobserver) can be considered as clinical changes in foot posture. Conclusion: The Brazilian version of the FPI-6 has proved reliable in terms of inter and intraobserver reliability and can therefore be used both in clinical practice and in scientific research. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the interexaminer and intraexaminer reliability of classification with the Viladot method of plantar impression obtained by means of a footprinting mat. Footprints were taken from 40 participants using a footprinting mat. The images were subjected to analysis by 3 independent examiners. To investigate intraexaminer reliability, the analysis was repeated by 1 of the examiners 1 week later. Excellent intraexaminer reliability was found (κ = 1.0; 95% confidence interval [CI], 0.77-1.0; P <.00). For interexaminer reliability, in the right foot high concordance was found for typical feet (κ p = 0.76; 95% CI, 0.58-0.93; P <.00) and excellent concordance for cavus feet and flat feet (respectively: κ p = 0.86; 95% CI, 0.68-1.0; P <.00; and κ p = 0.81; 95% CI, = 0.63-0.99; P <.00). In the left foot high concordance was observed between the 3 evaluators for typical feet and cavus feet (respectively: κ p = 0.75; 95% CI, 0.57-0.93; P <.00; and κ p = 0.69; 95% CI, 0.51-0.87; P <.00) and excellent concordance for flat feet (κ p = 1.0; 95% CI, 0.82-1.0; P <.00). The Viladot method is reliable for analyses involving 1 or more examiners, presenting excellent intraexaminer reliability and high to excellent interexaminer reliability. The Viladot method is a reliable (replicable and consistent) instrument, that is, its repeated application to the same subject produces similar results. [ABSTRACT FROM AUTHOR]

Foot torsion angles have previously been studied for different athletic movements. Sport shoes often contain a torsion element even though the location of the rotation axis of the foot is unknown. Therefore, the purpose of this study was to quantify the torsion axis location and determine if the location is influenced by the movement or the subject. The torsion axis location was calculated using a modified finite helical axis approach, which allowed the calculation of the rotation axis between the forefoot and the rearfoot without the influence of forefoot flexion. The torsion axis location during the lateral jab was 9.72 mm below and 26.96 mm lateral to a marker located at the posterior, central heel, whereas the shuffle cut resulted in an axis location of 9.59 mm below and 26.19 mm lateral to the reference marker. There was no significant difference for the average axis location between movements. There was, however, a significant difference for the location between subjects, indicating a subject specificity of the torsion axis. The results of the current study are the first to quantify the torsion axis location of the human foot during athletic movements. [ABSTRACT FROM AUTHOR]

Despite the high incidence of foot and ankle injuries and their biomechanical importance to more proximal joints, the foot and ankle are some of the most daunting and underemphasized musculoskeletal structures in medical training. This study used musculoskeletal ultrasound to identify a knowledge gap in physical medicine and rehabilitation residents in foot and ankle surface anatomy palpation and to determine whether senior residents had higher examination performance compared with more junior residents. Physical medicine and rehabilitation residents at different levels of training were tested cross-sectionally, and palpation accuracy was compared by class year. There was a trend of improvement across class years, with significant class differences in accuracy for the talonavicular joint, calcaneocuboidal joint, and posterior tibialis and peroneal tendons (P < 0.05). Despite this trend, the accuracy was not consistently higher among the senior residents considering the training they received. For all 30 residents assessed, accuracy within 1 cm was highest for the tibiotalar joint (93.3%), peroneal tendons (83.3%), posterior tibialis tendon (63.3%), and talonavicular joint (50%). It was lower for the calcaneocuboidal joint (26.7%) and the second (13.3%) and fourth for the tarsometatarsal joints (20%). Anatomical knowledge and palpation skills of the foot and ankle, particularly at the midfoot and forefoot, may be an area of improvement for physical medicine and rehabilitation resident training. [ABSTRACT FROM AUTHOR]

Background: Poor postural stability is associated with chronic ankle instability. Previous research showed an effect of foot type on postural stability. However, the specific effect of supinated feet remains unclear.Research Question: Our study aimed to assess the effect of foot type on postural stability, while taking potential confounding effects of body mass and body height into account.Methods: Forty-three healthy participants between 18 and 40 years old performed barefooted single leg stance tests with eyes open (EO) and closed (EC) on solid ground, and on a balance board (BB). Foot type was determined from pressure recordings during gait, using the arch index. Ground reaction forces were measured using a force plate. Outcome measures were Center of Pressure Velocity (COPV) divided by body height, and the Horizontal Ground Reaction Force (HGRF) divided by body mass. Generalized Estimating Equations models assessed the differences between supinated, normal and pronated feet during EO, EC and on a BB.Results: During EO an interaction between supinated feet and body mass showed an increase of COPV with 0.03 × 10-2 1/s per kilogram of mass relative to normal feet (p = .03). During EC this interaction was more pronounced with 0.22 × 10-2 1/s increase per kilogram mass (p < .01). The HGRF did not differ between foot types in any of the conditions.Significance: Supinated feet have a larger increase in COPV compared to normal feet with increasing mass when standing on solid ground during EO and EC. This indicates that people with supinated feet and a higher mass are less stable during single leg stance.Level Of Evidence: Level 3, associative study. [ABSTRACT FROM AUTHOR]

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Cutaneous nerves have vascular branches (VBs) that reach the arteries and are thought to be involved in arterial constriction. We aimed to examine the anatomical and histological relationship between the VBs of a cutaneous nerve in the foot and the acupuncture point LR3 (Taichong), which is a depression between the base of the first and second metatarsal bones on the dorsum of the foot and is a source point of the foot. We examined 40 cadaver feet to assess the distribution areas of the VBs of the medial branch of the deep peroneal nerve (MBDPN). MBDPNs were distally followed to identify the point where the VBs reached the arteries. The distance between the point and LR3 was measured. Sympathetic fibers in the VBs were histologically observed using tyrosine hydroxylase (TH) immunostaining. The VBs of the MBDPNs reaching the dorsal pedis arteries were observed in all specimens (100%). The mean distance between LR3 and the point where the VBs of the MBDPN reached the arteries was 3.2 ± 2.6 mm. Among the VBs, 70% were distributed proximal to LR3. Moreover, TH-positive fibers were present in the VBs. These findings revealed that a part of the MBDPN distributed the dorsal pedis artery and contained sympathetic fibers. We also found that the distribution area of the VBs was close to LR3. Our study provides anatomical evidence that LR3 is a specific area and its stimulation would be useful for treating peripheral circulatory failure. [ABSTRACT FROM AUTHOR]

Foot surgery is common. Orthopaedic nurses charged with evaluating and treating patients who have undergone foot surgery are required to evaluate the vascular status of the patient's foot (or feet). As a result, these nurses are often the first to identify vascular issues. This article provides orthopaedic nurses with the background to understand how the patient's history, the procedure(s) performed, and a thorough assessment of the foot's circulation will allow them to promptly identify circulatory problems and potentially save a patient from having a serious complication. [ABSTRACT FROM AUTHOR]

Introduction: Limb preservation procedures have become a much more common alternative to amputation after critical limb trauma, but high levels of disability result after both lower-limb amputation and lower-limb preservation. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom passive-dynamic ankle-foot orthosis developed for use in military service members with critical lower-limb injuries. A proposed mechanism for pain reduction seen with the IDEO is decreased loading or pressure experienced during weight bearing. However, until this study, no actual plantar pressure data had confirmed this unloading during walking gait, and this proposed mechanism has not been examined. The aim of this study was to evaluate the effect of an IDEO on peak plantar pressure in the total foot as well as in each of the eight areas of the foot in a sample with foot and/or ankle injury. Methods: For this within-subjects study, 74 potential participants who had been prescribed a unilateral IDEO were identified from a retrospective review of a clinical registry of patients. Patients were then excluded if they had bilateral lower-limb injury, spine or pelvis injury, or central neurological disorder, yielding 42 subjects (40 males). Patients were aged 29.7 ± 8.1 years. For each patient, data collection was performed before initiating training in use of the IDEO. Pressure-sensitive insoles were used to collect plantar pressure data in both shod and IDEO conditions at self-selected walking speeds. These trials were performed in a flat, linear hallway without turns or obstacles. The foot was divided into eight regions for analysis: medial and lateral sections of the hindfoot, midfoot, and forefoot, and greater and lesser toes. Results: Peak pressures were significantly decreased in the affected foot with use of the IDEO with up to 64% decreases seen at the forefoot and toes. Increases in peak pressure of up to 24% were seen in some regions of the unaffected foot as well as the total foot. Discussion: These findings help provide insight into the mechanism behind the improvement in function and decrease in pain that has been seen with use of the IDEO. The slight increases in plantar pressure seen in the unaffected foot with use of the IDEO may be due to higher gait velocity in the IDEO condition than in the shod condition (1.26 ± 0.14 m/s IDEO vs. 1.19 ± 0.17 m/s shod). Gait velocity was collected using instrumented gait analysis performed immediately before plantar pressure data collection. Alternately, overloading of the sound limb may be occurring due to unfamiliarity with the IDEO. Conclusions: Despite a growing body of evidence for functional improvements with use of the IDEO, this is the first study to confirm that this brace can decrease peak plantar pressure, particularly in the forefoot and toes of the affected foot, during walking. This outcome provides insight to clinicians seeking a device to improve painful gait, particularly for conditions of the foot or ankle that produce pain in weight bearing. In addition, although the IDEO was designed to enable performance of high-level activities in a population with critical limb injury, this study provides support for using the IDEO for walking by those with a diverse collection of injuries. [ABSTRACT FROM AUTHOR]

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Background: The purpose of this study was to evaluate the reliability and reproducibility of three commonly used radiographic measures for plantar surface angles.Methods: The calcaneal angle (CA), calcaneal pitch angle (CPA), and length-height index (LHI) was measured by three independent examiners on two occasions on lateral foot radiographs. Intra- and inter-rater correlations were calculated using a general linear estimate model and post-hoc tests for repeated measures. Bland-Altman's plots with limits of agreement were used for observer differences in scores.Results: The intra-class correlations for the CA ranged from 0.91 to 0.94, for the CPA from 0.93 to 0.98, and for the LHI from 0.96 to 0.97. The inter-class correlations were 0.80 for CA, 0.83 for CPA and 0.93 for LHI.Conclusions: The results of this study strongly suggest that the length-height index was the most consistent and reliable measure for arch height.Level Of Evidence: Diagnostic Level II, validity. [ABSTRACT FROM AUTHOR]

Introduction: Midfoot mobility plays an important role in the orthotic treatment of foot pathomechanical disorders, such as flexible pes planus and abnormal foot pronation. The sagittal plane mobility of the medial arch of only the unshod foot with a foot orthosis has been evaluated for improving therapeutic outcomes. Because foot orthoses are in-shoe devices, it is necessary to evaluate the sagittal plane mobility of the medial arch of the shod foot with a foot orthosis to optimize in-shoe orthotic effectiveness. Materials and Methods: This technical note describes a procedure using digital photography to evaluate the sagittal plane mobility of the medial arch of the shod foot with a foot orthosis. The procedure involves digitally photographing two weight-bearing states of the shoe in which the foot orthosis supports the foot: 1) 10% of body weight achieved by sitting, and 2) 50% of body weight achieved by standing. The two digital images of the shoe are then geometrically analyzed to calculate the displacement of the medial height of the dorsal surface of the shoe in response to the change in the two weight-bearing states. Conclusions: Clinicians and researchers can use the method described in this note to evaluate the sagittal plane mobility of the medial arch of the shod foot with a foot orthosis. The method is clinically useful for optimizing the in-shoe effectiveness of foot orthoses to treat foot pathomechanical disorders. [ABSTRACT FROM AUTHOR]

Individuals with lateral ankle sprain and chronic ankle instability have impaired postural control and altered motor strategies during walking. However, little is known regarding foot mechanics during gait. The purpose of this study was to compare three-dimensional multisegmented ankle-foot kinematics during stance phase following gait-initiation in acute lateral ankle sprain (Ankle-sprain), chronic ankle instability (Chronic-instability), Coper, and Control groups. 80 recreationally-active individuals (Control: n = 22, Coper: n = 21, Ankle-sprain: n = 17, Chronic-instability: n = 20) participated. Three-dimensional kinematics of the hallux, medial forefoot, lateral forefoot, medial midfoot, lateral midfoot, and rearfoot on shank were collected during the stance phase following gait initiation using an electromagnetic motion capture system. The average joint excursions of 10 steps were normalized to 101 points and analyzed using Statistical Parametric Mapping ANOVA and post hoc t -tests comparing Coper, Ankle-sprain, or Chronic-instability versus Control groups. Secondary analysis was performed comparing Chronic-instability versus Coper groups. The Ankle-sprain group had up to 4.1° more rearfoot inversion during midstance (mean difference: 3.1°) from 42 to 49% of stance phase compared to healthy controls. The Chronic-instability group had up to 5.3° more rearfoot inversion (mean difference: 3.6°) from 34% to 91% of stance phase compared to controls. There were no further statistical differences found between Chronic-instability and Copers, other planes, or segments of the ankle-foot complex. Ankle-sprain and Chronic-instability groups demonstrated more rearfoot inversion compared to controls with no differences in midfoot or forefoot mechanics. Clinicians and researchers should include interventions that control inversion and increase eversion following lateral ankle sprain. • Individuals with recent ankle sprains had 4.1° more rearfoot inversion during midstance. • The chronic ankle instability group had 5.3° more rearfoot inversion in the latter half of stance. • There were no significant differences in midfoot or forefoot kinematics between groups. [ABSTRACT FROM AUTHOR]

Background: Foot orthoses have proven to be effective for conservative management of various pathologies. Pathologies of the lower limb can be caused by abnormal biomechanics such as irregular foot structure and alignment, leading to inadequate support.Objectives: To compare biomechanical effects of different foot orthoses on the medial longitudinal arch during dynamic gait using skeletal kinematics.Study Design: This study follows a prospective, cross-sectional study design.Methods: The medial longitudinal arch angle was measured for 12 participants among three groups: pes planus, pes cavus and normal arch. Five conditions were compared: three orthotic devices (hard custom foot orthosis, soft custom foot orthosis and off-the-shelf Barefoot Science©), barefoot and shod. An innovative method, markerless fluoroscopic radiostereometric analysis, was used to measure the medial longitudinal arch angle.Results: Mean medial longitudinal arch angles for both custom foot orthosis conditions were significantly different from the barefoot and shod conditions ( p < 0.05). There was no significant difference between the off-the-shelf device and the barefoot or shod conditions ( p > 0.05). In addition, the differences between hard and soft custom foot orthoses were not statistically significant. All foot types showed a medial longitudinal arch angle decrease with both the hard and soft custom foot orthoses.Conclusion: These results suggest that custom foot orthoses can reduce motion of the medial longitudinal arch for a range of foot types during dynamic gait.Level Of Evidence: Therapeutic study, Level 2.Clinical Relevance: Custom foot orthoses support and alter the position of the foot during weightbearing. The goal is to eliminate compensation of the foot for a structural deformity or malalignment and redistribute abnormal plantar pressures. By optimizing the position of the foot, the medial longitudinal arch (MLA) will also change and quantifying this change is of interest to clinicians. [ABSTRACT FROM AUTHOR]

Objectives: This study compared foot arch height, plantar fascia thickness, a range of motion assessments of the ankle joint, strength of the ankle joint, plantar pressure, and balance between obese and normal weight young adults. Methods: Fifty-two participants were required for the present study design to achieve 80% power, 0.8 effect size (η2), and an alpha level of 0.05. The participants were categorized to normal weight or obese groups based on BMI (≤ 24 kg/m2 and ≥ 25 kg/m², respectively). The foot and ankle disability index and Sport survey were completed by the participants before the measurements. Foot arch height was measured using the navicular drop test, and plantar fascia thickness was measured using ultrasound. Plantar pressure and balance tests were also conducted, followed by ankle joint range of motion and strength tests. Results: Foot arch height and plantar fascia thickness was significantly higher in the obese group compared with the normal weight group (p < 0.01). There were significant differences in eversion of ankle strength, plantar pressure in the big toe and heel and anterior-posterior balance between normal and obese weight groups (p < 0.05). Conclusion: Obese young adults had more abnormalities in the medial longitudinal arch, plantar fascia, and plantar pressure as well as weakened ankle eversion strength and balance problems compared with the normal weight group. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: The study determined the effects of females wearing high-heeled shoes on the lower extremity 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 females wearing 5 cm or higher high-heeled shoes, at least 5 hours a day, three days a week, and at least one year. The second group consisted 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 shoes distribute 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 arch structure. These alterations result from regional, racial, gender, heel height, shoe type (shape), and shoe habits. [ABSTRACT FROM AUTHOR]

Abstract Objective The purpose of this study was to evaluate the correlation among the navicular drop test, the arch angle, the Staheli index and the Chippaux-Smirak index. The reliability and the correlation among the footprint parameters were also estimated. Methods A cross-sectional study (n = 86; 59.3% women; 27.8 years, standard deviation: 4.8 years) was carried out. The navicular drop test was evaluated and footprint parameters using a plantar pressure platform were recorded in the dominant foot. Pearson correlation coefficients, intraclass correlation coefficient, standard error of measurement, and minimum detectable change were calculated. Results Both intrarater and interrater reliability were excellent for all the parameters evaluated (intraclass correlation coefficients > 0.880). Statistically significant correlations existed between the navicular drop test and footprints parameters (arch angle = 0,643; Staheli index = 0.633; Chippaux-Smirak index = 0.614). The footprint parameters had excellent correlation with each other (0.838-0.881). The navicular drop test and the footprint parameters studied were reproducible and thus had excellent reliability. Conclusion The correlations obtained between the navicular drop test and the footprint parameters evaluated were good. The navicular drop test appears to be a reproducible, valid, and simple test for evaluating medial longitudinal arch height, having fewer disadvantages than using footprint parameters. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the normal location of the peroneus longus tendon (PL) in the cuboid groove in various ankle-foot positions by ultrasonography in asymptomatic volunteers.Materials and Methods: Ultrasonographic assessment of the PL in the cuboid groove was performed in 20 feet of ten healthy volunteers. Each PL was examined in five ankle-foot positions (i.e., neutral, dorsiflexion, plantar-flexion, supination, and pronation). The PL location was qualitatively categorized as "inside" when the PL was entirely within the cuboid groove, as "overlying" when some part of the PL was perched on the cuboid tuberosity, and as "outside" when the PL was entirely on the cuboid tuberosity. For quantitative evaluation of the PL location, the distance between the PL and the cuboid groove was measured. The width of the cuboid groove was measured in the neutral position.Results: The PL location did not significantly change with changes in the ankle-foot position. Qualitatively, an "overlying" PL was the most common type, regardless of the ankle-foot position. "Inside" PLs were found in only 35, 20, 30, 25, and 35% of feet in neutral, dorsiflexion, plantar-flexion, supination, and pronation positions, respectively. The quantitative PL location was also not significantly different among all ankle-foot positions and it was significantly negatively correlated with the cuboid groove width.Conclusions: In healthy volunteers, 65% or more of the PLs were partially or completely located outside of the cuboid groove, regardless of the ankle-foot position. The PL location relative to the cuboid groove was related to the cuboid groove width. [ABSTRACT FROM AUTHOR]

Objective: Barefoot impressions collected from crime scenes can be used in forensic analysis. The reliability of the measurement method employed during comparison of these foot impressions is paramount to prevent incorrect conclusions being made. A number of methods of obtaining measurements from barefoot impressions have been described in the research literature; however there has been no comprehensive review of their reliability. Therefore, the aim of this systematic review was to determine the reliability of measurements used to describe footprint morphology obtained from static and dynamic barefoot impressions.Methods: Four electronic databases were searched from inception to 23 November 2017. Eligible studies were required to report either the test-retest, intra or inter-rater reliability of measurements taken from barefoot impressions for the purposes of identification or classification of foot morphology. Methodological quality was assessed using the COSMIN checklist.Results: Eleven studies were identified that reported the reliability of 10 measurements (Reel method, arch index, Chippaux-Smirak index, footprint angle, Staheli index, contact area, Martirosov's K index, toe score and metatarsal ridge-to-toe measurement). High intra-rater reliability has been established for the Reel method (ICC=0.98-0.99), arch index (ICC=0.96-0.99), Chippaux-Smirak index (ICC=0.98-0.99), footprint angle (ICC=0.97-0.98), Staheli index (ICC=0.98-0.99) and footprint index (ICC=0.96-0.97). High inter-rater reliability has been established for the Reel method (ICC=0.99) and footprint angle (ICC=0.99). Overall methodological quality was rated as 'Poor' to 'Fair'.Conclusion: The measurement developed by Reel et al. has both its intra- and inter-rater reliability established to be high. However, the findings of this review were unable to inform a recommendation of one specific technique based on reliability data due to a small body of research at this time. Furthermore, there is a lack of data on the reliability of footprint measurement and comparison techniques in real-world scenarios. Overall, the findings regarding reliability of the techniques covered in this systematic review are to be interpreted with caution due to the methodological quality of reliability testing conducted within the included studies. [ABSTRACT FROM AUTHOR]

Minimally invasive surgery (MIS) and percutaneous (PC) surgery recently spread as a new technique in operative forefoot correction, and by extension in hindfoot and midfoot. Numerous procedures were described, and a race for MIS and PC has started. However, performing surgery with small incisions should not be an end in itself. Biomechanical and anatomical concerns must be taken into account and shall not be sacrificed for cosmetic reasons. For the most common hindfoot and midfoot pathologies, we discuss what we consider the surgical necessities and then describe the MIS and/or PC procedure we choose, according to these fundamentals. [ABSTRACT FROM AUTHOR]

Objective: To investigate the reliability of normalised truncated navicular height (NTNH) as a clinical measure of static foot posture in children. Methods: A cross-sectional study of a random sample of 300 school-aged children 6-12 years with mean ± SD of (9.44 ± 1.76) years. Two raters independently recoded the NTNH for each participant. Intrarater and interrater reliability of NTNH was assessed using intraclass correlation coefficient (ICC). Results: NTNH demonstrated excellent intrarater reliability (ICC = 0.98-0.99) and interrater reliability (ICC = 0.98). Conclusion: NTNH is a simple, quick and reliable clinical measure for static foot posture in the paediatric population. [ABSTRACT FROM AUTHOR]

Accessory ossicles are normal variants that are frequently seen but often overlooked or misdiagnosed. Commonly seen at the foot and ankle, they may be mistaken for fracture fragments or loose bodies, or not be recognised as a cause of the patient's symptoms. This pictorial essay aimed to review commonly encountered accessory ossicles of the foot and ankle by highlighting anatomic landmarks and associated pathologic processes through the use of both basic and advanced imaging modalities, in an effort to increase awareness of these clinical entities. [ABSTRACT FROM AUTHOR]

Purpose: There is still controversy regarding normal and abnormal values of the medial clear space (MCS) of the ankle. The aim of this study was to assess how much different degrees of plantar flexion, with and without stress, influenced the MCS.Methods: We submitted 30 volunteers to 6 different anteroposterior ankle radiographs in the following positions: neutral, neutral with external rotation stress, physiologic plantar flexion (FPF), physiologic plantar flexion with external rotation stress, maximum plantar flexion (MPF), and maximum plantar flexion with external rotation stress. The MCS oblique (MCSo) and perpendicular (MCSp) were measured in all images by an experienced foot and ankle surgeon.Results: The data showed that the position of the foot does influence the value of MCSp and MCSo ( P < .05), except for 3 comparisons. MCSo did not change between FPF with stress and MPF with stress. MCSp did not change in 2 situations: between FPF and neutral with stress and between MPF and FPF with stress.Conclusions: This study is unique in showing that different ways of positioning the foot and performing stress radiographs results in different MCS values and that these values differ depending on the anatomical site where they are measured.Levels Of Evidence: Diagnostic, Level IV. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: The foot and ankle offset (FAO) was developed as a 3D biometric tool to measure hindfoot alignment on weightbearing CT (WBCT) scans. It corresponds to the offset between the hindfoot-to-forefoot midline and the talus and is reported as a percentage of foot-length. (1) Recently, with increased availability of WBCT in both research and clinical practice, the FAO has been widely used for hindfoot alignment assessment. (2) However, after extensive review of WBCT scans the authors of this study have noticed that FAO has a high false negative rate. This study aimed to demonstrate why FAO is inadequate in assessing 3D hindfoot alignment using both case examples and mathematical algorithms. Methods: This was a retrospective study including a cohort of 31 cases with various clinical diagnoses selected from a data base of WBCT in 260 patients. The deformities included valgus or varus ankle deformities, hindfoot deformities combined with sagittal plane deformities of the foot and ankle, rocker bottom foot deformity, ankle equinus, metatarsus primus elevatus, and first metatarsal plantarflexion. All of the latter deformities caused one or more parts of the triangular base for FAO evaluation (the 1st metatarsal, the 5th metatarsal and the calcaneus) to remain off the floor. The medical charts and WBCT scans of each patient were reviewed to evaluate the deformities in more detail. The FAO was measured by two fellowship trained foot and ankle surgeons separately. The clinical and radiographic diagnoses were compared with the FAO value to determine the accuracy and utility of the latter measurement. Limitations of FAO as a semi 3D tool using the tripod theory in assessing the hindfoot alignment were also demonstrated mathematically. Results: For each of these 31 cases examined, the hindfoot alignment information reflected by the FAO value was vastly different from the clinical and imaging study findings. (Table 1). Using the reference value for FAO (Normal 2.3% ± 2.9%, Varus −11.6%± 6.9%, and Valgus 11.4% ± 5.7%), 24 out of 31 cases in the cohort had a normal FAO value, however, among them there were 7 with a valgus ankle or distal tibia plus a normal or cavovarus hindfoot, 2 varus ankles with a normal hindfoot, 1 varus ankle with a valgus hindfoot, 3 cavovarus feet, 1 clubfoot, 1 equinus ankle with cavovarus foot, 2 equinus ankle with severe valgus hindfoot, 4 severe valgus hindfoot and 1 varus hindfoot with sagittal plane deformities, 2 Muller Weiss Disease; 5 out of 31 cases had a varus FAO value, but they all had a valgus ankle with either a varus hindfoot or sagittal plane deformities; 2 out of 31 cases had a valgus FAO value, however both cases had a valgus ankle with a varus hindfoot. Thorough algorithm and geometric evidence were provided. Conclusion: FAO has a very limited capacity to reflect hindfoot deformities, understandable when analyzing how the FAO is designed and measured mathematically. It is not a 3D tool. It does not include the level of the ankle nor the tibia, therefore it is not appropriate nor capable to be used as a hindfoot alignment evaluation tool. The tripod and talus projection theories cannot reflect sagittal plane deformities or coronal plane rotation, and false results are inevitably generated. [ABSTRACT FROM AUTHOR]

Introduction/aim: Foot structure has been implicated as a risk factor of numerous overuse injuries, however, the mechanism linking foot structure and the development of soft-tissue overuse injuries are not well understood. The aim of this study was to identify factors that could predict foot function during walking.Methods: A total of eleven variables (including measures of foot structure, anthropometry and spatiotemporal gait characteristics) were investigated for their predictive ability on identifying kinematic, kinetic and energetic components of the foot. Three-dimensional motion capture and force data were collected at preferred walking speed on an instrumented treadmill. Mechanical measures were subsequently assessed using a custom multi-segment foot model in Opensim. Factors with significant univariate associations were entered into multiple linear regression models to identify a group of factors independently associated with the mechanical measures.Results: Although no model could be created for any of the kinematic measures analysed, approximately 46% and 37% of the variance in the kinetic and energetic measures were associated with three or two factors respectively. Arch-height ratio, foot length and step width were associated with peak subtalar joint (STJ) moment, while greater STJ negative work was correlated to a low arch-height ratio and greater foot mobility.Conclusion: The models presented in this study suggest that the soft-tissue structures of a flat-arched, mobile foot are at a greater risk of injury as they have greater requirements to absorb energy and generate larger forces. However, as these associations are only moderate, other measures may also have an influence. [ABSTRACT FROM AUTHOR]

Maintaining balance is vitally important in everyday life. Investigating the effects of individual foot muscle morphology on balance may provide insights into neuromuscular balance control mechanisms. This study aimed to examine the correlation between the morphology of foot muscles and balance performance during single-leg standing. Twenty-eight recreational runners were recruited in this study. An ultrasound device was used to measure the thickness and cross-sectional area of three intrinsic foot muscles (abductor hallucis, flexor digitorum brevis and quadratus plantae) and peroneus muscles. Participants were required to perform 30s of single-leg standing for three trials on a force plate, which was used to record the center of pressure (COP). The standard deviation of the amplitude and ellipse area of the COP were calculated. In addition, stabilogram diffusion analysis (SDA) was performed on COP data. Pearson correlation coefficients were computed to examine the correlation between foot muscle morphology and traditional COP parameters as well as with SDA parameters. Our results showed that larger abductor hallucis correlated to smaller COP sway, while larger peroneus muscles correlated to larger COP sway during single-leg standing. Larger abductor hallucis also benefited open-loop dynamic stability, as well as supported a more efficient transfer from open-loop to closed loop control mechanisms. These results suggest that the morphology of foot muscles plays an important role in balance performance, and that strengthening the intrinsic foot muscles may be an effective way to improve balance. [ABSTRACT FROM AUTHOR]

Purpose: High-arched (HA) athletes exhibit greater lower extremity stiffness during functional tasks than low-arched (LA) athletes. The contributions of skeletal and muscular structures to stiffness may underlie the distinct injury patterns observed in these athletes. The purpose of this study was to compare skeletal and muscular contributions to leg stiffness in HA and LA athletes during running and landing tasks. Methods: Ten HA and 10 LA female athletes performed five overground running trials at a self-selected pace and five step off bilateral landing trials from a height of 30 cm. Three-dimensional kinematics and kinetics were collected using a motion capture system and a force platform. Leg stiffness and its skeletal and muscular contributions were calculated. Independent t-tests were used to compare variable means between arch type groups and Cohen's d were computed to assess effect sizes of mean differences. Results: In running, HA athletes had greater leg stiffness (P = 0.010, d = 1.03) and skeletal stiffness (P = 0.016, d = 0.81), although there are no differences in muscular stiffness (P = 0.134). During landing, HA had greater leg stiffness (P = 0.015, d = 1.06) and skeletal stiffness (P < 0.001, d = 1.84), whereas LA athletes had greater muscular stiffness (P = 0.025, d = 0.96). Conclusions: These findings demonstrate that HA athletes place a greater reliance on skeletal structures for load attenuation during running and landing, whereas LA athletes rely more greatly on muscle contributions during landing only. These findings may provide insight into the distinct injury patterns observed in HA and LA athletes. [ABSTRACT FROM AUTHOR]

Objective: To assess whether fetal foot length at autopsy could reliably indicate gestation duration at stillbirth and the effects of maceration on this method.Methods: The present cross-sectional secondary analysis was part of the Safe Passage Study; all Safe Passage Study participants who experienced a stillbirth at Tygerberg Academic Hospital, Cape Town, South Africa, between August 1, 2007, and January 31, 2015, were eligible to participate. After providing written informed consent for autopsy, the duration of gestation calculated using early ultrasonography and fetal foot length were compared.Results: There were 69 fetal autopsies included in the present study; placental histology was available for 65. Generally, the gestation length calculated from the first ultrasonography scan correlated well with that calculated from the fetal foot length (Spearman correlation=0.85). However, significant differences were found in the gestation lengths calculated when the fetus was macerated (P<0.001), or when umbilical cord pathology (P<0.001) or maternal vascular malperfusion (P<0.001) was the cause of fetal death.Conclusion: Foot length at stillbirth was a good indicator of gestation length; however, it was a weaker indicator if fetal maceration had occurred. [ABSTRACT FROM AUTHOR]