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ABSTRACT Calcaneal fractures are complex injuries and have historically had a poor prognosis that results in substantial disability. However, no studies have been performed that analyze both the radiographic and plantar pressure changes after treatment of intraarticular calcaneus fracture. Patients with an intrarticular calcaneus fracture treated at our institution during the study period were identified from computerized hospital records. A total of 36 patients (34 males) completed physical examination and radiographic and dynamic pedobarographic assessments. The follow-up period was from 13 to 82 months (median 38 months). The mean pain score at rest was 3.7 and during activity was 4.0 on a 10-cm visual analogue scale. The mean range of motion of the subtalar joint was restricted. The mean American Orthopaedic Foot and Ankle Society function scale score was 68.1; the mean Short Form-36 physical score was 41.8; and the mental score was 44.9. Pedabarographic results showed that the mean maximum force in the midfoot, forefoot, and toes (p =.001; p =.04; p =.002) and peak pressure in the midfoot, forefoot (p =.001; p =.007), and contact area of the midfoot and toes (p =.038; p =.004) were significantly increased in the injured foot. Radiologic findings showed hindfoot varus, forefoot adductus, and an increase in the medial arch. Even after appropriate anatomic realignment with open reduction and internal fixation of calcaneus fractures, residual differences in plantar pressures and radiographic measures are noted compared to uninjured foot. [ABSTRACT FROM AUTHOR]

Plantar pressure distribution during walking in patients with painful Ledderhose disease is unknown. Do patients with painful Ledderhose disease have an altered plantar pressure distribution during walking compared to individuals without foot pathologies? It was hypothesized that plantar pressure is shifted away from the painful nodules. Pedobarography data of 41 patients with painful Ledderhose disease (cases, mean age: 54.2 ± 10.4 years) was collected and compared to pedobarography data from 41 individuals without foot pathologies (controls, mean age: 21.7 ± 2.0 years). Peak Pressure (PP), Maximum Mean Pressure (MMP) and Force-Time Integral (FTI) were calculated for eight regions (heel, medial midfoot, lateral midfoot, medial forefoot, central forefoot, lateral forefoot, hallux and other toes) under the soles of the feet. Differences between cases and controls were calculated and analysed by means of linear (mixed models) regression. Proportional differences in PP, MMP and FTI showed increased values for the cases compared to the controls, especially in the heel, hallux and other toes regions, and decreased values in the medial- and lateral midfoot regions. In naïve regression analysis, being a patient was a predictor for increased- and decreased values for PP, MMP and FTI for several regions. When dependencies in the data were taken into account with linear mixed-model regression analysis, the increased- and decreased values for the patients were most prevalent for FTI at the heel, medial midfoot, hallux and other toes regions. In patients with painful Ledderhose disease, during walking, a shift of pressure was found towards the proximal and distal foot regions, while offloading the midfoot regions. • Ledderhose disease results in altered plantar pressure distribution. • Offloading of affected midfoot regions during walking. • Increase of load on heel and hallux regions during walking. [ABSTRACT FROM AUTHOR]

Purpose: Pes planovalgus is one of the most common foot deformities among pediatric orthopedic diseases and is divided into idiopathic and neuromuscular planovalgus according to its etiology. This study evaluated the radiologic and pedobarographic outcomes of the treatment for pes planovalgus in children treated with lateral column lengthening, compared the outcomes according to the etiology, and investigated the correlation between the radiologic and pedobarographic findings. Materials and Methods: Sixty-three patients (97 feet), who underwent lateral column lengthening, were divided into groups of 30 patients (47 feet) with neuromuscular disease and 33 patients (50 feet) with idiopathic etiology. The preoperative, immediately postoperative, 1 year, and 3 year follow-up radiographic measurements on the plain radiograph antero-posterior (AP) and lateral view were compared. In pedobarography, the foot pressures were subdivided into 4 areas to measure the contact time, contact area, peak pressure, and maximum force. The pre- and postoperative pedobarographic measurements were compared and the correlations between the radiographic and pedobarographic measurements were evaluated. Results: The radiographic index at the 1st postoperative year and 3rd postoperative follow-up did not show significant differences according to the etiology. In pedobarography, idiopathic planovalgus showed a significant increase in the maximum force in the hindfoot and forefoot. The correlation between the radiologic findings and pedobarographic findings was statistically significant between the tibiocalcaneal angle in the lateral view and the maximum force, and the contact area of hindfoot on pedobarography, between tibiocalcaneal angle in the lateral view and the contact area of the toes in idiopathic planovalgus. In neuromuscular planovalgus, the peak pressure in the hindfoot had a strong negative correlation with talonavicular coverage angle in the AP view and talo-1st metatarsal angle, and the talohorizontal angle in the lateral view. Conclusion: Lateral column lengthening is an effective surgical procedure for flatfoot patients. On the other hand, the radiographic examination has limitations for accurate assessments of the postoperative results and prognosis. Qualitative and quantitative evaluations are available by pedobarography and it is a useful instrument for an evaluation of planovalgus when used in conjunction with radiography. [ABSTRACT FROM AUTHOR]

Background: Pedobarography produces large sets of plantar pressure samples that are routinely subsampled (e.g. using regions of interest) or aggregated (e.g. center of pressure trajectories, peak pressure images) in order to simplify statistical analysis and provide intuitive clinical measures.Research Question: We hypothesize that these data reductions discard gait information that can be used to differentiate between groups or conditions.Methods: To test the hypothesis of null information loss, we created an implementation of statistical parametric mapping (SPM) for dynamic plantar pressure datasets (i.e. plantar pressure videos). Our SPM software framework brings all plantar pressure videos into anatomical and temporal correspondence, then performs statistical tests at each sampling location in space and time. Novelly, we introduce non-linear temporal registration into the framework in order to normalize for timing differences within the stance phase. We refer to our software framework as STAPP: spatiotemporal analysis of plantar pressure measurements. Using STAPP, we tested our hypothesis on plantar pressure videos from 33 healthy subjects walking at different speeds.Results: As walking speed increased, STAPP was able to identify significant decreases in plantar pressure at mid-stance from the heel through the lateral forefoot. The extent of these plantar pressure decreases has not previously been observed using existing plantar pressure analysis techniques.Significance: We therefore conclude that the subsampling of plantar pressure videos - a task which led to the discarding of gait information in our study - can be avoided using STAPP. [ABSTRACT FROM AUTHOR]

Background: Minimally invasive surgery has a shorter surgical time, and in this study we focus on minimally invasive distal metatarsal metaphyseal osteotomy (DMMO). The operation seems to be less complex but requires a high learning curve. We report on our first patients to underline the need for extensive training and great awareness for the risks in the early learning stages.Methods: We evaluated 27 patients (mean age = 60.9 years) with a mean follow-up time of 7.2 months. Indication was metatarsalgia, intractable plantar keratosis, and the (sub-)luxation of the metatarsophalangeal joint. Clinical results were evaluated with the 12-item Short Form (SF-12), Foot Function Index (FFI), Foot and Ankle Ability Measure (FAAM), and the American Orthopaedic Foot and Ankle Score (AOFAS). Radiographs and pedobarographic analysis were obtained.Results: Scores ranged closely to standard value (AOFAS 88.07 points; FFI 93%; FAAM 36.4 points; SF-12 31.27 points). Pedobarography showed significant differences in several forefoot areas. We encountered nonunion/malunion and necrosis of the metatarsal head.Conclusions: The aim of this study was to demonstrate the need for intensive training before practicing DMMO. Results show that minimally invasive DMMO requires a high learning curve. Correct handling of the burr is associated with a lot of training. Wrong handling can lead to nonunion/malunion or necrosis.Levels Of Evidence: Therapeutic, Level IV: Case series. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the current study was to describe long-term gait changes after talus fractures, identify patterns associated with poor outcome and discuss possible treatment options based on dynamic gait analysis.Methods: Twenty-seven patients were followed-up clinically and via gait analysis after talus fracture osteosynthesis. Continuous dynamic pedobarography with a gait analysis insole was performed on a standardized parcours consisting of different gait tasks and matched to the outcome.Results: Mean follow-up was 78.3 months (range 21-150), mean AOFAS and Olerud-Molander scores 66 (range 20-100) and 54 (range 15-100). Significant correlations between fracture classification and osteoarthritis (Hawkins: rs = 0.67 / Marti-Weber: rs = 0.5) as well as several gait differences between injured and healthy foot with correlations to outcome were seen: decreased step load-integral/maximum-load; associations between centre-of-pressure displacement and outcome as well as between temporospatial measures and outcome. Overall, pressure-distribution was lateralized in patients with subtalar joint injury (Δ: 0.5765 N/cm2, p = 0.0475).Conclusions: Talus fractures lead to chronic gait changes and restricted function. Dynamic pedobarography can identify patterns associated with poor results. The observed gait patterns suggest that changes can be addressed by physical therapy and customized orthoses to improve overall outcome. The presented insole and measurement protocol are immediately feasible as a diagnostic and rehabilitation aid. [ABSTRACT FROM AUTHOR]

The athletic function of the foot is also extremely important in soccer and constantly exposed to the full impact of weight bearing, because it plays a vital role as a contact point with the ground, absorbing abnormal forces, and main area of the body to kick the ball. The purpose of this study was to compare female soccer players and sedentary individuals in terms of plantar pressure distribution while walking and bilateral standing with barefoot. Eleven female soccer players (21.44±2.12 years, 162.25±5.77 cm, 53.12±6.01 kg, BMI=20.23±1.52 kg/m2, Experience=5.98±0.78 years) and 14 sedentary individuals (23.38±5.79 years, 164.92±5.88 cm, 56.31±6.56 kg, BMI=20.67±1.78 kg/m2) participated in this study. Participants performed self-paced walking and 30 seconds bilateral standing on a 1.5-meter walking platform with barefoot. Each footprint was divided into 12 areas as total foot, hindfoot, midfoot, forefoot, 1st metatarsal, 2nd metatarsal, 3rd metatarsal, 4th metatarsal and 5th metatarsal, big toe, second toes and toes 3-4-5. Maximum force [MF (N)], peak pressure [PP (kPa)], contact area [CA(cm2)], mean pressure [MP (kPa)] and maximum force normalized to body weight [MFNBW (N)] plantar pressure values were analyzed with Mann-Whitney-U test. Results indicated that sedentary group showed significantly higher CA in the forefoot, 3rd and 4th metatarsals; MF in 4th and 5th metatarsals; MP in 5th metatarsal, p<0.05. On the other hand, soccer players demonstrated significantly higher MP in the forefoot, 2nd and 3rd metatarsals and PP in 2nd and 3rd metatarsals, p<0.05. This study indicates that soccer players and physically inactive sedentary individuals demonstrate different plantar pressure patterns during gait and bilateral stance. Coaches and athletic trainers should consider these different patterns while planning intervention protocols. [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature 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.)

Objectives: This study aims to investigate the effects of knee and foot alignments on the risk of falling. Patients and methods: Between April 2016 and December 2016, a total of 74 individuals (24 males, 50 females; mean age 32.2±4.9 years; range 18 to 65 years) were included in the study. The knee Q angle and Chippaux-Smirak Index (CSI), Arch Index, and foot progression angle (FPA) evaluated by pedobarography were used for the assessment of the lower extremity alignment. The fall risk was evaluated by the Fall Index, Fourier 56 Index (F56), and Stability Index. Results: The fall index was found to be correlated with the Q angle, CSI, the Arch index, and FPA (p<0.05). Q angle, Arch Index, and FPA which were explained 40% of the variance of the fall index. The Q angle was correlated with F56 and the stability index at the most position (p<0.05). The CSI was correlated with the F56 and the stability index at two and three positions, respectively (p<0.05); however, the Arch Index and FPA were not correlated with the F56 and Stability Index at any of the eight positions (p>0.05). According to the categorical regression analysis, the Q angle was the most effective on the F56 and Stability Index. Conclusion: Our study results suggest that lower extremity malalignment increases the risk of falling. We believe that the risk of falling can be decreased by the reduction of these malalingments and, thus, mortality and morbidity associated with the fall can be reduced as well. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to establish the reference values of spatiotemporal parameters, joint angles, ground reaction forces and plantar pressure distribution collected simultaneously on the same measurement path during normal gait in a homogenous group of young, healthy women. Methods: The studied group consisted of 28 healthy women aged 21 years on average. The motion capture system BTS Smart-D, 2 AMTI force platforms and Footscan pedobarographic platform were used in this research. The 14-metre measurement path and the 6-metre distance that examined women had to walk through before entering the measurement area ensured that a natural gait pattern was recorded. Statistical analysis was performed to evaluate differences between right and left lower extremities. Results: The applied method enabled collecting several parameters regarding normal female gait biomechanics such as: spatiotemporal parameters, angle-time characteristics as well as range of motion of pelvis, hip, knee and ankle joints in gait cycle, force-time characteristics and peaks of ground reaction force components in stance phase, peak pressure and time of loading of defined foot regions in stance phase. Conclusions: The results may be used by clinicians, physiotherapists or researchers as a reference in diagnosing gait disorders or evaluating patient's walking pattern. In recent literature there are some disparities in gait parameters reference values even regarding similar research groups. These differences may arise from distinct method, slower or faster gait, other laboratory environment etc. This should be considered and more than one source of normative values should be checked when searching for reference data. [ABSTRACT FROM AUTHOR]

Copyright of Polish Journal of Wound Management / Leczenie Ran is the property of Evereth Publishing Ltd. 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.)

Objective: The purpose of this study was to establish normative reference values for spatiotemporal and plantar pressure parameters, and to investigate the influence of demographic, anthropometric and physical characteristics.Methods: In 1000 healthy males and females aged 3-101 years, spatiotemporal and plantar pressure data were collected barefoot with the Zeno™ walkway and Emed® platform. Correlograms were developed to visualise the relationships between widely reported spatiotemporal and pressure variables with demographic (age, gender), anthropometric (height, mass, waist circumference) and physical characteristics (ankle strength, ankle range of motion, vibration perception) in children aged 3-9 years, adolescents aged 10-19 years, adults aged 20-59 years and older adults aged over 60 years.Results: A comprehensive catalogue of 31 spatiotemporal and pressure variables were generated from 1000 healthy individuals. The key findings were that gait velocity was stable during adolescence and adulthood, while children and older adults walked at a comparable slower speed. Peak pressures increased during childhood to older adulthood. Children demonstrated highest peak pressures beneath the rearfoot whilst adolescents, adults and older adults demonstrated highest pressures at the forefoot. Main factors influencing spatiotemporal and pressure parameters were: increased age, height, body mass and waist circumference, as well as ankle dorsiflexion and plantarflexion strength.Conclusion: This study has established whole of life normative reference values of widely used spatiotemporal and plantar pressure parameters, and revealed changes to be expected across the lifespan. [ABSTRACT FROM AUTHOR]

Pedobarography and the centre of pressure (COP) progression is useful to understand foot function. Pedobarography is often unavailable in gait laboratories or completed asynchronously to kinematic and kinetic data collection. This paper presents a model that allows calculation of COP progression synchronously using force plate data. The model is an adjunct to Plug-In-Gait and was applied to 49 typically developing children to create reference COP data. COP progressions were noted to spend 8% of stance behind the ankle joint centre, traverse lateral of the longitudinal axis of the foot through the midfoot for 76% of stance and finishing past the second metatarsal head on the medial side for 16% of stance. It is hoped the model will bridge the information gap for gait laboratories lacking pedobarography during foot assessments and will open up the possibility of retrospective research into COP progression based indices on kinematic data. [ABSTRACT FROM AUTHOR]

Purpose: Rehabilitation after lower-extremity fractures is based on the physicians' recommendation for non-, partial-, or full weight-bearing. Clinical studies rely on this assumption, but continuous compliance or objective loading rates are unknown. The purpose of this study was to determine the compliance to weight-bearing recommendations by introducing a novel, pedobarography system continuously registering postoperative ground forces into ankle, tibial shaft and proximal femur fracture aftercare and test its feasibility for this purpose.Methods: In this prospective, observational study, a continuously measuring pedobarography insole was placed in the patients shoe during the immediate post-operative aftercare after ankle, tibial shaft and intertrochanteric femur fractures. Weight-bearing was ordered as per the institutional standard and controlled by physical therapy. The insole was retrieved after a maximum of six weeks (28 days [range 5-42 days]). Non-compliance was defined as a failure to maintain, or reach the ordered weight-bearing within 30%.Results: Overall 30 patients were included in the study. Fourteen (47%) of the patients were compliant to the weight-bearing recommendations. Within two weeks after surgery patients deviated from the recommendation by over 50%. Sex, age and weight did not influence the performance (p > 0.05). Ankle fracture patients (partial weight-bearing) showed a significantly increased deviation from the recommendation (p = 0.01).Conclusions: Our study results show that, despite physical therapy training, weight-bearing compliance to recommended limits was low. Adherence to the partial weight-bearing task was further decreased over time. Uncontrolled weight-bearing recommendations should thus be viewed with caution and carefully considered as fiction. The presented insole is feasible to determine weight bearing continuously, could immediately help define real-time patient behaviour and establish realistic, individual weight-bearing recommendations. [ABSTRACT FROM AUTHOR]

Background/aim: Hormonal and structural changes that occur during pregnancy cause alterations in body biomechanics. These alterations reach their peak in the last trimester. Adaptive changes that appear in the foot result in pain in the foot and ankle. Pedobarography is a noninvasive measurement method that can be used to understand the origin of such pain. Materials and methods: One hundred and thirty-one pregnant women who did not have a foot or ankle problem prior to pregnancy volunteered to take part in the study. Pain was quantified by a visual analog scale (VAS). A cut-off value of 2.95 was taken to divide the subjects into two groups: Group 1 (n = 70) with VAS scores of <2.95 and Group 2 (n = 61) with VAS scores of ≥2.95. Plantar pressure measurements were taken by Tekscan HR Mat using midgait protocol. Results: Forces experienced by the total right foot area, right forefoot, and the midfoot for both feet were significantly higher in Group 2 (P < 0.05). Contact area was significantly larger in Group 2 (P < 0.05). Conclusion: Results indicate that presence and severity of foot pain during pregnancy are related to the force distribution along the foot, especially at midfoot and the contact area. [ABSTRACT FROM AUTHOR]

Background: Generalized joint laxity is often associated with gait deviations. The aim of this study was to investigate the static and dynamic loading pattern of the foot with increasing joint mobility and to discuss the potential impact of this condition on the plantar loading patterns. Methods: Seventy female participants between ages of 18 and 30 were included in this cross-sectional survey. The Beighton-Horan Joint Mobility Index scores were assessed and participants divided into 3 categories: no hypermobility (NH) group, scores 0 to 2; moderate hypermobility (MH) group, scores 3 to 4; distinct hypermobility (DH) group, scores 5 to 9. Pedobarographic analysis was performed both in static and walking conditions. Dynamic foot loading examined in 10 anatomic zones. Contact areas of forefoot, midfoot, and rearfoot were recorded. Results: In the dynamic pedobarographic analysis, individuals with distinct joint hypermobility displayed higher peak pressure and maximum force values under the hallux, compared with other groups (P < .05). The maximum force value of the second metatarsal was higher in the DH group than in the MH group (P < .05). Conclusion: Our study results suggest that plantar loading pattern differs with increasing degrees of the hypermobility score. Clinical Relevance: Differences in plantar loading parameters in people with severe joint mobility scores may be useful in interpreting the foot pathologies of these individuals. [ABSTRACT FROM AUTHOR]

Background: The peripheral complications of diabetes mellitus remain a significant risk to lower-limb morbidity. In New Zealand, risk of diabetes, comorbidity and lower-limb amputation are highly-differential between demographic groups, particularly ethnicity. There is growing and convincing evidence that the use of pedobarography - or plantar pressure measurement - can usefully inform diabetic foot care, particularly with respect to the prevention of re-ulceration among high-risk patients. Methods: For the current feasibility study, we embedded pedobarographic measurements into three unique diabetic foot clinic settings in the New Zealand context, and collected pedobarographic data from n = 38 patients with diabetes using a platform-based (Novel Emed) and/or in-shoe-based system (Novel Pedar). Our aim was to assess the feasibility of incorporating pedobarographic testing into the clinical care of diabetic feet in New Zealand. Results and Conclusions: We observed a high response rate and positive self-reported experience from participants. As part of our engagement with participants, we observed a high degree of lower-limb morbidity, including current ulceration and chronic foot deformities. The median time for pedobarographic testing (including study introduction and consenting) was 25 min. Despite working with a high-risk population, there were no adverse events in this study. In terms of application of pedobarography as a clinical tool in the New Zealand context, the current feasibility study leads us to believe that there are two avenues that deserve further investigation: a) the use of pedobarography to inform the design and effectiveness of offloading devices among high-risk diabetic patients; and b) the use of pedobarography as a means to increase offloading footwear and/or orthoses compliance among high-risk diabetic patients. Both of these objectives deserve further examination in New Zealand via clinical trial. [ABSTRACT FROM AUTHOR]

Copyright of Polish Journal of Wound Management / Leczenie Ran is the property of Evereth Publishing Ltd. 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.)

Copyright of Advances in Rehabilitation is the property of Termedia Publishing House 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.)

Background/aim: Anterior cruciate ligament (ACL) deficiency results in several kinematic changes in the lower extremities. The aim of this study is to define the plantar pressure parameters in ACL-deficient patients and to show the effect of ACL reconstruction on dynamic plantar pressure. Materials and methods: Forty patients with unilateral ACL rupture and 40 healthy controls were included in this study. Dynamic plantar pressures of both groups were recorded by the EMED SF-2 system during level walking. Thirteen of the patients who had ACL reconstructions with hamstring autografts (HS group) were reevaluated at an average of 14.5 months following the ACL reconstructions. Results: ACL-deficient patients had significantly lower hindfoot (P = 0.007) but higher midfoot pressure values (P = 0.03) on their ipsilateral foot compared to control group subjects. Ipsilateral hindfoot pressures were also found to be significantly lower than those of the contralateral foot (P = 0.001). Hindfoot pressure values of the HS group were increased in postoperative measurements (P = 0.01). Conclusion: ACL-deficient patients have altered plantar pressure distributions and ACL reconstructions restore these changes to normal. Pedobarography might be used as a practical method for dynamic functional assessment of ACL-deficient patients. [ABSTRACT FROM AUTHOR]

Background Arthroplasty of the first metatarsophalangeal joint is an alternative treatment option for end-stage hallux rigidus to the current gold standard of arthrodesis. The aim of this study was to investigate the mid-term functional outcome of an anatomically shaped prosthesis for the first metatarsophalangeal joint using pedobarography. Methods Ten patients (12 affected feet; age at surgery: 62.1 (SD: 7.2) years) were investigated preoperatively and 52 (SD: 3) months postoperatively using pedobarography (EMED, novel GmbH, Munich, Germany). Two patients were excluded at follow-up because their prosthesis was converted to an arthrodesis. Peak force and plantar pressure under the five metatarsal heads and the hallux were analyzed and correlated with the clinical outcome (pain, American Orthopaedic Foot and Ankle Society forefoot score and radiographic maximum first metatarsophalangeal dorsiflexion). Differences between pre- and postoperative data were analyzed using paired t -tests (alpha = 0.05). Findings Postoperatively, forefoot peak forces under the fourth (+ 40.9%; P = 0.018) and fifth metatarsal (+ 54.9%; P = 0.037) and plantar pressures under the fifth metatarsal (+ 38.7%; P = 0.027) increased significantly, while peak plantar pressures and forces under the hindfoot, medial forefoot and hallux did not change. While maximum passive dorsiflexion was not significantly greater at the 4-year follow-up compared to preoperatively, overall greater passive dorsiflexion was associated with higher first metatarsal peak pressure. Interpretation Despite of patients reporting less pain, the functional results indicate an altered and potentially non-physiological postoperative gait pattern with a lateralization of the load during walking, especially in patients with limited passive dorsiflexion. [ABSTRACT FROM AUTHOR]

Most pedobarographic studies of microsurgical foot reconstruction have been retrospective. In the present study, we report the results from a prospective pedobarographic study of a patient after microsurgical reconstruction of her foot with a latissimus dorsi flap and a cutaneous paddle, with a 42-month follow-up period. We describe the foot reconstruction plan and the pedobarographic measurements and analyzed its functional outcome. The goal of the present study was to demonstrate that pedobarography could have a role in the treatment of foot reconstruction from a quantitative perspective. The pedobarographic measurements were recorded after the initial coverage surgery and 2 subsequent foot remodeling procedures. A total of 4 pedobarographic measurements and 2 gait analyses were recorded and compared for both the noninvolved foot and the injured foot. Furthermore, the progress of the reconstructed foot was critically evaluated using this method. Both static and dynamic patterns were compared at subsequent follow-up visits after the foot reconstruction. The values and progression of the foot shape, peak foot pressure (kPa), average foot pressure (kPa), total contact surface (cm²), loading time (%), and step time (ms) were recorded. Initially, the pressure distribution of the reconstructed foot showed higher peak values at nonanatomic locations, revealing a greater ulceration risk. Over time, we found an improvement in the shape and values of these factors in the involved foot. To homogenize the pressure distribution and correct the imbalance between the 2 feet, patient-specific insoles were designed and fabricated. In our patient, pedobarography provided an objective, repeatable, and recordable method for the evaluation of the reconstructed foot. Pedobarography can therefore provide valuable insights into the prevention of pressure ulcers and optimization of rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Pedobarography offers dynamic information about the foot, but the interpretation of its large data is challenging. In a prior study it was shown that attention can be restricted to pedobarographic midfoot load data. We aim to verify this observation in ankle osteoarthritic and contralateral feet. Methods: We assessed both feet of 120 patients with end-stage ankle osteoarthritis (OA) and 35 healthy volunteers with AOFAS-score and dynamic pedobarography in barefoot condition. We introduce a new parameter, the Relative Midfoot Index (RMI), representing the depth of the midfoot weighted by the maximal force (MF) in the hindfoot and forefoot. Main outcome measures were the RMI, MF and contact times in the hindfoot, midfoot and forefoot. Ankle OA, contralateral and healthy feet were compared with ANOVA. Results: The RMI was significantly smaller in OA feet (0.65 ± 0.19) and contralateral feet (0.69 ± 0.15) than in healthy feet (0.84 ± 0.08, p < 0.0001). There was no significant difference between OA and contralateral feet. The RMI showed a correlation of 0.48 with the AOFAS score. Contralateral and OA feet were significantly different from healthy feet (p < 0.001) in all parameters except the hindfoot MF. An RMI <0.8 showed a positive predictive value of 80% and sensitivity of 78% for being unhealthy. Conclusion: The RMI assists the interpretation of pedobarographic parameters and provides a user-friendly indicator for unhealthy foot conditions with a cut-off value of 0.8. The contralateral feet of ankle OA patients differed significantly from healthy feet and are therefore not suitable as control group. Level of Evidence: 3 case control study. [ABSTRACT FROM AUTHOR]

Copyright of Sport-Orthopadie - Sport-Traumatologie is the property of Elsevier B.V. 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.)

Background In pedobarography, clinically meaningful comparison of measurements within or between subjects is limited by data variability and measurement error. This study aims to determine the components of the minimal detectable change (MDC) in impulse across all foot regions and the reliability of these measures. Methods A convenience sample of foot pressures from 108 visits by normal, healthy subjects aged 2–17 years was studied. Each subject had three pedobarograph measurements taken per foot, with six subjects returning for a second visit for assessment of day-to-day variability. Using a five-region mask, segmental impulses were determined, and from these we obtained the coronal plane pressure index (CPPI). Inter-rater, intra-rater, and day-to-day data were analyzed using intraclass correlation coefficients (ICC) to quantify reliability. Variability of the data was analyzed to quantify the MDC. Results Inter- and intra-rater reliability was high for all measurements while variability was low, indicating small direct measurement error. Generally, the largest contributing factor to the MDC was day-to-day variability. Step-to-step variability was more dependent on foot segment than age although minor age-related changes were noted. Finally, the high relative variability in the CPPI and the medial mid foot impulse resulted in very high MDCs for these measures. [ABSTRACT FROM AUTHOR]

Making assessments regarding postural control and balance is very important for injury prevention in soccer. However, there has been no study that has associated postural control variables with branch-specific technical properties in a game. The aim of the present study was to determine the relationships between variables designating postural control levels and technical performance variables in different (1:1, 2:2 and 3:3) small-sided games (SSGs). Sixteen trained male amateur soccer players volunteered to take part in the study (age 17.2 ± 1.02 years, body height 176.25 ± 0.07 m, body mass 67.67 ± 13.27 kg). Following familiarization sessions, postural control was evaluated using one-leg and both-leg quiet-stance positions by measuring postural sway with a Tekscan HR Mat™ in anterior–posterior and medial–lateral directions. Later, 1:1, 2:2 and 3:3 SSGs were performed at two-day intervals and the technical variables specified for each game were analyzed. A Spearman's rank-order correlation analysis demonstrated the relationship between postural control and soccer-specific technical variables in 1:1 (r-values ranging from 0.582 to 0.776), 2:2 (rvalues ranging from 0.511 to 0.740) and 3:3 (r-values ranging from 0.502 to 0.834) SSGs. In addition, a Wilcoxon signed rank test revealed differences between SSGs in terms of several variables. The results of the study showed that higher postural control levels are among the important variables that affect success in the performance of technical skills under rival pressure and suddenly changing conditions. Therefore, it is recommended that in addition to its use for injury prevention purposes, balance training should be conducted to improve branch-specific technical skills and to increase the levels of their successful performance in a game. [ABSTRACT FROM AUTHOR]

Aims: This study was aimed to study the arthrodesis of the first metatarsophalangeal joint using an oblique interfragmentary lag screw and dorsal plate as an effective option for the treatment of hallux rigidus. Few researchers have studied the outcome of this surgical method over a long follow-up period.Patients and Methods: We performed a retrospective review of 60 patients status post arthrodesis of the first metatarsophalangeal joint. The mean age was 68.5 years and average follow-up lasted for 47.3 months. Patients' satisfaction and functional outcomes were evaluated with the American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale, the foot and ankle questionnaire, the Functional Foot Index, and dynamic pedobarography.Results: Fusion rate of 93.3 % was recorded; 6.7 % of the cases ended up with a painless pseudarthrosis and required no additional surgery. Pedobarographic measurements demonstrated first ray weight bearing function restoration. More physiological foot plantar pressure patterns were observed. Concerning the postoperative outcomes, 71.7 % of the patients were very satisfied and 18.3 % were satisfied. The American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale increased post-operatively from 40.9 to 79.3.Conclusion: The arthrodesis of the metatarsophalangeal joint using transarticular screw and dorsal nonlocked plate is an effective method for the treatment of severe hallux rigidus with fair patient satisfaction rate and functional outcome. [ABSTRACT FROM AUTHOR]

Objectives To investigate foot loadings in different leg press settings with respect to a possible graduation of weight bearing (WB). Design Case series. Settings Assessing plantar force values by means of dynamic pedobarography taken place in orthopaedic departments' rehab center. Participants 15 healthy students (9 men and 6 women, age 23 ± 2, weight 75 ± 6 kg) were recruited as participants from the medical faculty. Main Outcome Measures Peak force values from normal gait (referred to as 100%) and single and double leg presses (SLP, DLP) with resistances of 10 kg, 20 kg and 40 kg, obtained with pedobarographic insoles. Results Performing DLP produced foot loadings (N) of 37 ± 15 with 10 kg, 91 ± 29 with 20 kg and 203 ± 27 with 40 kg, equal to 5%, 12% and 26% of full WB. SLP result in force values of 195 ± 32 with 10 kg, 308 ± 34 with 20 kg and 516 ± 45 with 40 kg, corresponding to 25%, 40% and 67% baseline. Conclusions Leg press exercises can be performed in accordance with a given limitation of foot loading. Above mentioned conditions allow a graduation from 5% to 67% of full WB. [ABSTRACT FROM AUTHOR]

Misalignment of the talar neck after surgical repair can redistribute the load among the posterior, middle, and anterior facets of the subtalar joints, which can change the joint biomechanics, cause arthritis, and impair function. However, we found no studies analyzing the plantar pressures after treatment of talus neck fracture. We determined the dynamic plantar pedobarographic and radiographic characteristics and ankle range of motion, function, and pain among patients after surgical repair of talar neck fractures. A total of 19 patients completed the assessments. The median follow-up period was 29 (range 12 to 113) months. At the last visit, the mean pain score was 3.3 on a 10-cm visual analog scale. The mean American Orthopaedic Foot and Ankle Society function scale score was fair (73.5), and the mean range of motion was restricted in 4 planes. The mean maximum force was lower in the hindfoot ( p = .002) and midfoot ( p = .03) of the injured foot than in the noninjured foot. The mean peak pressure was lower in the hindfoot ( p = .05) but higher in the forefoot ( p = .03). Radiographic measurements revealed differences between the feet in the talo–first metatarsal angle ( p = .002), Meary’s angle ( p = .001), and the medial cuneiform–fifth metatarsal angle ( p = .002). Radiographic and pedobarographic analysis showed an elevated arch in the injured foot. Thus, talar injury and immobilization can affect the stance and the gait cycle in these patients. Pain, range of motion, function, and the weight transfer pattern should be evaluated carefully during the follow-up period to provide the best postoperative results. [ABSTRACT FROM AUTHOR]