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Background: Pes planus, commonly known as flat foot is a deformity of the foot, characterized by loss of the medial longitudinal arch of the foot. There are several diagnostic methods available, such -as radiographs and digital footprint scanning techniques, that involve the usage of ink, dyes, and expensive instrumentation which may be harmful and not readily available at all time. The arch height may prove to be a user-friendly, portable, and affordable means of grading the foot. However, no tools were found during the search for review of literature. Hence, a need for a tool to measure the arch height and further give standard range of the arch height for flat feet and non-flat feet was identified. Objective: To design a tool and further provide values to differentiate flatfoot and non-flatfoot using arch height as a measurement tool. Relevance: The instrument was designed to quantify arch height and values to differentiate flatfoot and non-flatfoot are provided by comparison with Chippaux Smirak Index (CSI). Method: The study evaluated the medial longitudinal arches of 30 individuals (60 feet) using static footprints and arch height measurement with tool. The footprints were classified into flatfoot and non-flatfoot using CSI. Data was subjected to appropriate statistical analysis. Results: The range of medial longitudinal arch height between 15-21 mm in sitting position and 13-19 mm in standing position identified with non-flat foot, while the range of medial longitudinal arch height between 10-14 mm in sitting position and 8-12 mm in standing position identified with flat foot when compared with CSI. These findings suggest that the tool can be used effectively to measure the medial longitudinal arch height and differentiate between individuals with flat foot and non-flat foot. Conclusion: The study concludes that the tool is effective in measuring the medial longitudinal arch height and can be used to differentiate between individuals with flat foot and non-flat foot. Designers of the tool would like to name the tool as ArchCheck Tool. [ABSTRACT FROM AUTHOR]

Background: The treatment results of the Ponseti method for arthrogrypotic clubfoot have been described in only a few case series. Further evaluations are necessary. Methods: Children from two German paediatric orthopaedic hospitals with arthrogryposis-associated clubfoot treated with the Ponseti method between 2004 and 2011 and who were at least five years of age at their last follow-up were retrospectively evaluated. The endpoints were the clinical foot position, necessary surgeries during the follow-up period and radiological constellations. A comprehensive literature review was conducted after a systematic literature search. Results: Seventeen patients (47% with amyoplasia [AP] and 53% with distal arthrogryposis [DA]) met the inclusion criteria. Thirty-one feet were evaluated. The period between the treatment start and the last follow-up examination covered 8.9 ± 2.5 years. After the last cast removal within the initial Ponseti cast series, 74% of the clinical results were good to excellent. However, the clinical outcomes in the patients with AP were significantly worse. Overall, in 23 feet (74%), at least one major surgery at the age of 2.9 ± 2.2 years was necessary during the clinical course. Major surgeries were much more frequent on the feet of the patients with AP than with DA. Lateral X-rays showed normal age-appropriate radiological angles in 4% of the feet, hindfoot equinus in 19%, under-corrected hindfoot in 44%, under-corrected clubfoot in 26% and rocker bottom deformity in 7%. The radiological residual deformities in AP were much more severe than in DA (p = 0.042). Most of the studies reviewed (11 case series, 144 patients) reported high initial clinical correction rates, followed by high recurrence rates and the need for further surgeries. Conclusion: About a quarter of the arthrogrypotic patients benefited from the Ponseti therapy without further major surgery. However, the clinically observed high initial correction rate after Ponseti therapy of arthrogrypotic clubfoot was not accompanied by a correction of the bony foot position in the X-rays. The feet of the patients with DA had better outcomes than those of the patients with AP. Therefore, in outcome studies, a clear distinction between patients with AP and those with DA is necessary. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the frequency of biphalangeal toes in the Turkish population. Materials and Methods: Radiographs of 1096 cases (n=1286 feet) between September 2020 and August 2022 were analyzed. Our study had 386 left foot radiographs, 439 right foot radiographs, and 189 bilateral radiographs. Foot radiographs were assessed for biphalangealism of the second to the fifth toe. Data regarding sex, age, side, the number of phalanges of the fifth, fourth, third, and second toe, and the reason for performing radiographs were assessed. Groups were compared using Fisher’s exact test and the Chi-square test. Results: The prevalence of biphalangealism in the fifth toe was found to be 35.70%, in the fourth toe 1.70%, in the third toe 0.50% and in the second toe 0.20%. The difference in the frequency of biphalangeal and triphalangeal toes regarding sex and the right/left foot was statistically insignificant (p=0.245, p=0.815 respectively). The asymmetrical distribution of the fifth biphalangeal toe was seen in 6.90%, and the asymmetrical distribution of the fourth biphalangeal toe was 0.50% in the 189 bilateral feet radiographs. Conclusions: With this study, we found and demonstrated that the incidence of biphalangeal fifth toe is 35.70% and that this anatomical variant in the Turkish population is similar to other Turkish studies. The biphalangeal fifth toe must be kept in mind during the assessment of a case with foot pathologies and foot radiographs. Additionally, biphalangealism is not observed in the 4th and 3rd fingers on the same foot without the 5th finger being biphalangeal.

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]

Objective: The aim of the study is to evaluate the effect of minimally invasive ultrasound-guided fascial release and a foot orthoses with first metatarsal head cutout on the biomechanics of the medial longitudinal arch of the foot in cadaveric specimens. Design: A cross-sectional study was designed (20 body donors). Anthropometric measurements of the foot, foot posture index, and the windlass test and force were measured in different conditions: unloaded, loaded position, with foot orthoses, after a 25% plantar fascia release and after a 50% release. Results: For the anthropometric measurements of the foot, differences were found in foot length (P = 0.009), arch height (P < 0.001), and midfoot width (P = 0.019) when comparing the unloaded versus foot orthoses condition. When foot orthoses were compared with 25% plantar fascial release, differences were found in foot length (P = 0.014) and arch height (P < 0.001). In the comparison with 50% plantar fascial release, differences were found in the arch height (P < 0.001). A significant interaction between foot orthoses condition and grades was found in the arch height during the windlass test (P = 0.021). Conclusions: The results indicate that the presence of foot orthoses leads to a significant increase in arch height compared with other conditions. Furthermore, when plantar fascia release is performed, the arch does not exhibit any signs of collapse. [ABSTRACT FROM AUTHOR]

Introduction: Plantar orthoses are widely used in the prevention and treatment of foot and lower-limb disorders. Plantar orthoses can generally be classified as prefabricated devices; however, many prefabricated devices can be customized. Customized orthotic insoles are usually prescribed with the goal of improving foot function. However, evidence that customized orthoses modify foot function in a predictable and dose-responsive manner is limited, and there is currently no consensus on how orthoses should be prescribed. Consequently, a high variability in orthotic prescriptions by physicians is observed. The aim of this study is to propose an orthotic insole prescription form (INSPECTOR) that is clear, easy, and replicable by all professionals involved. Methods: All known clinical assessments and tests with high sensitivity and specificity indices, positive and negative predictive value, positive likelihood ratio, and negative likelihood ratio were included in the form. Result: The result of this study is a form that guides the clinician step by step toward an appropriate and correct foot prescription. Conclusions: INSPECTOR has several potential advantages; it is a step-by-step guide for the physician, starting with basic tasks such as anamnesis, functional prognosis, and prescription of the foot orthosis, and ending with the choice of the target area for the foot orthosis and the material to be used. The module lists scientifically validated and internationally recognized tests, making it understandable by professionals in all countries. Finally, it can reduce the differences between prescribed and finished orthopedic insoles, thus avoiding wasting money or material on reconstruction or construction [ABSTRACT FROM AUTHOR]

The study aims to compare static and dynamic postural stability, navicular drop, dorsiflexion range of motion, and jumping performance of individuals with neutral, prone, and hyperprone foot postures. Forty-eight participants between the ages of 18 and 40, were categorized into neutral (n=16), prone (n=16), and hyperprone (n=16) according to foot posture index (FPI). Static and dynamic postural control evaluations (with the Biodex Balance System SD), navicular drop test (NDT) weight-bearing lunge test, countermovement jump test without arm swing, and drop vertical jump tests have been completed. In the results, the average age of participants in the NG, PG, and HPG are 22.31 ± 2.75, 23.87± 3.72, and 22.37 ± 1.28 years and BMI are 22.6 ± 3, 23.4 ± 3.8, and 21.4 ± 2.24 (kg/m²), respectively. The demographic data of the participants showed a homogeneous distribution. There were no significant differences in none of the outcomes except the NDT. Navicular drop amount is positively correlated by the subtalar joint pronation. An increase in subtalar joint pronation does not have a significant effect on static and dynamic stability, jump performance, or dorsiflexion range of motion in healthy individuals. [ABSTRACT FROM AUTHOR]

Background: Dimensions of foot provide valuable information in determining the sex and stature of the individual based on various statistical formulae and equations. There were many physical anthropometric studies show the gender difference. Objectives: 1. To determine the correlation of various measurements of the feet with gender. 2. To derive logistic regression equations for gender determination from foot dimensions among Telanganite adults. Material and Methods: The present study was conducted in Prathima Institute of Medical Sciences, Karimnagar, Telangana State, India, amongst 436 students from Telangana state, aged between 18-22 years. After obtaining Institutional Ethics Committee clearance and informed consent from the participants, foot length, foot breadth and Bi-malleolar breadth were recorded and foot index was also calculated. The data was then subjected for statistical analysis using SPSS version 21. Results: The mean values of Foot length, Foot breadth, and Bi-malleolar breadth were found to be significantly higher in males than females. The average foot index in males and females were 43.465 and 41.595 respectively. Prediction of gender with logistic regression equations using multiple parameters was found to be better than that with individual parameters. Conclusion: The higher values of foot dimensions in males as compared to females proves thesexual dimorphism of foot dimensions. [ABSTRACT FROM AUTHOR]

Background: The spring ligament fibrocartilaginous complex (SLFC), which is essential for stabilizing the medial longitudinal arch, features a little-explored fibrocartilaginous facet within its superomedial aspect, articulating with the talar head. This research aimed to provide a detailed anatomical description of this facet, designated as the spring ligament articular facet (SLAF). Methods: Nine normally aligned cadaveric lower limbs were dissected, approaching the SLFC from a superior direction. Following talus disarticulation, high-resolution images of the ligament complex were captured and analyzed. ImageJ software was used to determine the areas and dimensions of the superomedial calcaneonavicular (SMCN) spring and SLAF. Results: The fibrocartilage facet exhibited a trapezoid shape in all specimens. The mean area for SMCN spring was 280.39 mm², and for SLAF, it was 200 mm². The proximal-to-distal length for SLAF averaged 11.78 mm at its longest and 5.34 mm at its shortest. Attachment of the SLAF to the calcaneum and the navicular showed robust fibrous structures, with average measurements of 3.75 and 1.75 mm at the medial and lateral calcaneal margins, and 2.75 and 2.98 mm at the medial and lateral navicular margins, respectively. Conclusion: This study clearly delineated the individual structural components of the SLFC articulating with the talar head and detailed its dimensions, emphasizing the need for more specific anatomical terminology that respects the intricate anatomy of the SLFC. Level of Evidence: Level III, descriptive study. [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]

Minimalist walking shoes have been shown to improve foot muscle size and strength in active adults, but not in our previous study involving children, which could relate to the more structured footwear used in our study. Hence, this study examined the effects of true minimalists on intrinsic foot muscle size and strength, foot arch integrity, and physical function among primary school children. After a baseline assessment, 30 primary school students aged between 9 and 12 were given a pair of minimalist shoes (minimalist index = 92%) as their regular school shoes for two school terms, followed by a re-assessment. Seventeen of the 30 participants in the minimalist group completed the study. Compared to the control group, the minimalist group showed significantly increased cross-sectional area of abductor hallucis (p = 0.047, Cohen's d = 0.57) and flexor digitorum brevis (p = 0.037, Cohen's d = 0.80), increased strength of the hallux (p = 0.015, Cohen's d = 0.76) and lesser toes (p = 0.014, Cohen's d = 0.66), greater arch height (p = 0.020, Cohen's d = 0.52) and standing long jump distance (p = 0.001, Cohen's d = 9.79). The control group exhibited improved standing long jump performance only (p = 0.020, Cohen's d = 10.70). Minimalist shoes worn daily to school promote intrinsic foot muscle size and strength, and improve foot arch integrity among primary school students. [ABSTRACT FROM AUTHOR]

Ankle arthrodesis was performed on a 55-year-old male patient with an active lifestyle who developed severe arthritis in the left ankle. Over the follow-up period, high tibial valgization osteotomy was conducted for painful medial knee joint arthritis with genu varum deformity to correct overall lower limb alignment from varus to valgus with respect to the fused ankle. This study was conducted to investigate how hindfoot alignment would change when the overall alignment of the lower limb shifted from varus to valgus with the ipsilateral ankle in a fused state. Conclusively, while no intrinsic changes in the hindfoot alignment were observed following the alteration of lower limb alignment, the hindfoot naturally adjusted to valgus deviation in response to limb valgus realignment. Moreover, symptoms changed in line with this adjustment. Given the absence of similar case studies or reports, a review of relevant literature is included to contribute to knowledge of this subject. [ABSTRACT FROM AUTHOR]

The study of the phenomena occurring in the plantar region is remarkably intriguing, especially when performing a normal gait cycle where the foot is under loading conditions. The effects presented in the foot while walking provide relevant indicators regarding clinical means for enhancing regular performance or rehabilitation therapies. Nevertheless, more than traditional methods are needed to biomechanically evaluate foot structural conditions, leading to an incomplete database for determining the patient's needs so that advanced methodologies provide detailed medical assessment. Therefore, it is necessary to employ technological engineering tools to optimize biomechanical plantar pressure evaluations to reach suitable personalized treatments. This research initially evaluated numerically the pressure points in the foot sole region in each one of the five stance phases in a normal gait cycle. Medical imaging techniques were utilized to construct an anatomically accurate biomodel of the soft tissues of the right foot. The Finite Element Method was employed to predict peak plantar pressure in barefoot conditions for all stance phases; results from this case study presented a close alignment with gait experimental testing implemented to analyze the feasibility and validation of all mechanical considerations for the numerical analyses. Hence, having a solid foundation in the biomechanical behavior from the first case study close estimates, a 3D-printable patient-specific insole was designed and numerically analyzed to observe the mechanical response in the plantar critical zones utilizing a personalized orthotic device. Results from the second case study notably demonstrated a crucial decrement in excessive pressure values. Employing morphological customization orthopedics modeling combined with 3D-printable materials is revolutionizing assistive device design and fabrication techniques. The fundamental contribution of this research relies on deepening the knowledge of foot biomechanics from an interdisciplinary approach by numerically analyzing pressure distribution in critical regions for all five stances phases; thus, based on the methods employed, the results obtained contribute to the advances of patient-specific foot orthopedics. [ABSTRACT FROM AUTHOR]

Background: Physiological changes in the foot may be influenced by external factors such as shoe types or demographic parameters, leading to podiatric conditions in adulthood. The aim of this study was to assess the changes in morphological measurements of the feet of boys and girls during childhood and adolescence. Methods: A total of 1678 Ecuadorian children aged 8 to 17 years participated in the study. The length, width, and height of the foot were analyzed using a 3D scanner to obtain the arch height ratio for the diagnosis of pediatric flat foot. Results: Statistical differences were observed for lengths, widths, and perimeters of the foot in boys aged 5 to 15–16 years and girls aged 5 to 12–13 years. Differences in the height of the navicular bone were found in all age groups, with changes from 2.8 to 4.1% in boys and from 1.3 to 1.5% in girls. The greatest differences between boys and girls of the same age were found at 14 years old onwards. The highest prevalence of flat foot was found in 8-year-old girls (64.9%) and in 12-year-old boys (82.5%). Conclusions: The feet of Ecuadorian children develop progressively during childhood and adolescence. Boys presented with longer and wider feet than girls of the same age. The highest prevalence of flat foot was found in 12-year-old boys and 8-year-old girls. [ABSTRACT FROM AUTHOR]

Context: To investigate the effects of midfoot joint mobilization and a 1-week home exercise program, compared with a sham intervention, and home exercise program on pain, patient-reported outcomes, ankle-foot joint mobility, and neuromotor function in young adults with chronic ankle instability. Design: Crossover clinical trial. Methods: Twenty participants with chronic ankle instability were instructed in a stretching, strengthening, and balance home exercise program and were randomized a priori to receive either midfoot joint mobilizations (forefoot supination, cuboid glide, and plantar first tarsometatarsal) or a sham laying of hands on the initial visit. Changes in foot morphology, joint mobility, strength, dynamic balance, and patient-reported outcomes assessing pain, physical, and psychological function were assessed pre to post treatment and 1 week following post treatment. Participants crossed over to receive the alternate treatment and were assessed pre to post treatment and 1 week following. Linear modeling was used to assess changes in outcomes. Results: Participants demonstrated significantly greater perceived improvement immediately following midfoot mobilization in the single assessment numeric evaluation (sham: 5.0% [10.2%]; mobilization: 43.9% [26.2%]; β: 6.8; P < .001; adj R²: .17; Hedge g: 2.09), and global rating of change (sham: -0.1 [1.1]; mobilization: 1.1 [3.0]; β: 1.8; P = .01; adj R²: .12; Hedge g: 0.54), and greater improved 1-week outcomes in rearfoot inversion mobility (sham: 4.4° [8.4°]; mobilization: -1.6° [6.1°]; β: -6.37; P = .01; adj R²: .19; Hedge g: 0.81), plantar flexion mobility (sham: 2.7° [6.4°]; mobilization: -1.7° [4.3°]; β: -4.36; P = .02; adj R²: .07; Hedge g: 0.80), and posteromedial dynamic balance (sham: 2.4% [5.9%]; mobilization: 6.0% [5.4%]; β: 3.88; P = .04; adj R²: .10; Hedge g: 0.59) compared to the sham intervention. Conclusion: Greater perceived improvement and physical signs were observed following midfoot joint mobilization. [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]

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BACKGROUND: Occupational foot-transmitted vibration (FTV) exposure is common in industries like mining, construction, and agriculture, often leading to acute and chronic injuries. Vibration assessments require technical expertise and equipment which can be costly for employers to perform. Alternatively, researchers have observed that self-reported discomfort can be used as an effective indicator of injury risk. OBJECTIVE: This study aimed to investigate the effect of standing FTV exposure on self-reported ratings of discomfort, and whether these subjective ratings differed by body area and exposure frequency. METHODS: Participants (n = 30) were randomly exposed to standing FTV at six frequencies (25, 30, 35, 40, 45, and 50 Hz) for 20–45 seconds. Following each exposure, participants rated discomfort on a scale of 0–9 in four body areas: head and neck (HN), upper body (UB), lower body (LB), and total body. RESULTS: Results indicated that participants experienced the most discomfort in the LB at higher frequencies (p < 0.001), consistent with the resonance of foot structures. The HN discomfort tended to decrease as the exposure frequency increased, although not statistically significant (p > 0.0167). The UB discomfort remained relatively low across all frequencies. CONCLUSIONS: The study suggests a potential connection between resonant frequencies and discomfort, potentially indicating injury risk. Although self-reported discomfort is insufficient for directly assessing injury risk from FTV, it provides a simple method for monitoring potential musculoskeletal risks related to vibration exposure at resonant frequencies. While professional vibration assessment remains necessary, self-reported discomfort may act as an early indicated of vibration-induced injuries, aiding in implementing mitigation strategies. [ABSTRACT FROM AUTHOR]

The 6-item Foot Posture Index (FPI-6) is a reliable tool for the evaluation of foot deformities. Our aim was to translate and cross-culturally validate the FPI-6 for use in French-speaking countries and to determine the intra-rater and inter-rater reliability of the French version. Cross-cultural adaptation was performed according to guidelines. Two clinicians assessed the FPI-6 in 52 asymptomatic individuals. We evaluated intra- and inter-rater reliability with the intraclass correlation coefficients (ICC), correlations (p-value < 0.05) and Bland-Altman plots. Standard error of measurement (SEM) and minimum detectable change (MDC95) were determined. For the cross-cultural adaptation, we modified several items of the FPI-6 user guide and added footnotes to ensure correct interpretation. ICC of the total FPI-6 scores were 0.94 to 0.96 for the intra- and inter-rater reliability for dominant and non-dominant lower limb. Correlations were significant (p < 0.001); r 0.88 to 0.92. Total score SEM was 0.68 to 0.78 and MDC95 was 1.58 to 1.82. Intra- and inter-rater reliability of this French version of the FPI-6 was excellent for the total score and good to excellent for each item. The French FPI-6 can be used in French-speaking countries. The identification of SEM and MDC scores is useful for clinical interpretation. The French version of the 6-item Foot Posture Index (FPI-6) can be used in clinical practice in French-speaking countries Intra- and inter-rater reliability of total FPI score are excellent We provide minimal detectable change value for clinical interpretation (1.58 to 1.82) [ABSTRACT FROM AUTHOR]

Introduction: The intact foot and ankle comprise a complex set of joints that allow rotation in multiple planes of motion. Some of these motions are coupled, meaning rotation in one plane induces motion in another. One such coupling is between the sagittal and transverse planes. For every step, plantarand dorsi-flexion motion is coupled with external and internal rotation of the shank relative to the foot, respectively. There is no prosthetic foot available for prescription that mimics this natural coupling. The purpose of this study was to determine if a sagittal:transverse ankle angle coupling ratio exists that minimizes the peak transverse plane moment during prosthetic limb stance. Methods: A novel, torsionally active prosthesis (TAP) was used to couple sagittal and transverse plane motions using a 60-watt motor. An embedded controller generated transverse plane rotation trajectories proportional to sagittal plane ankle angles corresponding to sagittal:transverse coupling ratios of 1:0 (rigid coupling analogous to the standard-of-care), 6:1, 4:1, 3:1, and 2:1. Individuals with unilateral transtibial amputation were block randomized to walk in a straight line and in both directions around a 2 m circle at their self-selected speed with the TAP set at randomized coupling ratios. The primary outcome was the peak transverse plane moment, normalized to body mass, during prosthetic limb stance. Secondary outcomes included gait biomechanic metrics and a measure of satisfaction. Results: Eleven individuals with unilateral transtibial amputations participated in the study. The 6:1 coupling ratio resulted in reduced peak transverse plane moments in pairwise comparisons with 3:1 and 2:1 coupling ratios while walking in a straight line and with the prosthesis on the outside of the circle (p < .05). Coupling ratio had no effect on gait biomechanic metrics or satisfaction. Discussion: The general pattern of results suggests a quadratic relationship between the peak transverse plane moment and coupling ratio with a minimum at the 6:1 coupling ratio. The coupling ratio did not appear to adversely affect propulsion or body support. Subjects indicated they found all coupling ratios to be comfortable. While a mechatronic prosthesis like the TAP may have limited commercial potential, our future work includes testing a robust, passive prosthetic foot with a fixed coupling ratio. [ABSTRACT FROM AUTHOR]

Background. Clinicians employ foot morphology assessment to evaluate the functionality of the method and anticipate possible injuries. This study aims to correlate static foot posture and the dynamic barefoot evaluation in a sample of healthy adult participants. Methods. The foot posture was evaluated using the Foot Posture Index-6 (FPI-6) and the dynamics were evaluated through baropodometric examination. Two operators independently assessed the participants' foot posture through FPI-6, and then a dynamic evaluation was performed by asking them to walk 8 times across a platform. One hundred participants (mean age: 32.15 ± 7.49) were enrolled. Results. The inter-rater agreement between the two assessors was found to be excellent. The majority of the feet belonged to the 0 < FPI < 4 class (32%), followed by the 4 < FPI < 8 (31%) and the FPI > 8 ranges (19.5%). Our "area of contact" analysis showed a significant poor correlation between FPI and total foot, midfoot, and the second metatarsophalangeal joint (MTPJ) (−0.3 < r < 0). Regarding "force" parameters, the analysis showed a poor correlation between the midfoot, hallux, and the second toe (−0.2 < r < 2); finally the "pressure" analysis showed a poor correlation between FPI, the fourth MTPJ, and the second toe (−0.2 < rs < 0.3) and a moderate correlation between the hallux (r = 0.374) and the fifth MTPJ (r = 0.427). Conclusions. This study emphasizes the constrained correlation between static foot posture observation and dynamic barefoot examination. [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]

This study aimed to investigate the effects of neuromuscular electrical stimulation (NMES) with gastrocnemius (GCM) strength exercise on foot morphology in patients with stroke. Herein, 31 patients with chronic stroke meeting the study criteria were enrolled and divided into two groups; 16 patients were randomized to the gastrocnemius neuromuscular electrical stimulation (GCMNMES) group, and 15 patients to the conventional neuromuscular electrical stimulation (CNMES) group. The GCMNMES group conducted GCM-strengthening exercise with NMES. CNMES group conducted NMES at paretic tibialis anterior muscle with ankle dorsiflexion movement. These patients underwent therapeutic interventions lasting 30 min/session, five times a week for 4 weeks. To analyze changes in foot morphology, 3D foot scanning was used, while a foot-pressure measurement device was used to evaluate foot pressure and weight-bearing area. In an intra-group comparison of 3D-foot-scanning results, the experimental group showed significant changes in longitudinal arch angle (p < 0.05), medial longitudinal arch angle (MLAA) (p < 0.01), transverse arch angle (TAA) (p < 0.01), rearfoot angle (RA) (p < 0.05), foot length (FL) (p < 0.05), foot width (FW) (p < 0.05), and arch height index (AHI) (p < 0.01) of the paretic side and in TAA (p < 0.05) and AHI (p < 0.05) of the non-paretic side. The CNMES group showed significant changes in TAA (p < 0.05) and FW (p < 0.05) of the paretic side and TAA (p < 0.05) and AHI (p < 0.05) of the non-paretic side. An inter-group comparison showed significant differences in MLAA (p < 0.05) and RA (p < 0.05) of the paretic side. In an intra-group comparison of foot pressure assessment, the experimental group showed significant differences in footprint area (FPA) (p < 0.05) of the paretic side and FPA symmetry (p < 0.05). The CNMES group showed a significant difference in only FPA symmetry (p < 0.05). An inter-group comparison showed no significant difference between the two groups (p < 0.05). Thus, NMES with GCM-strengthening exercises yielded positive effects on foot morphology in patients with stroke. [ABSTRACT FROM AUTHOR]

Background: The biomechanics of the hindfoot in ankle osteoarthritis (OA) are not yet fully understood. Here, we aimed to identify hindfoot motion in a gait analysis using a multi-segment foot model (MFM) according to ankle OA stage and the presence of subtalar compensation defined by hindfoot alignment. Methods: We retrospectively reviewed the medical records, plain radiographs, and gait MFM data of 54 ankles admitted to our hospital for the treatment of advanced ankle OA. Spatiotemporal gait parameters and three-dimensional motions of the hindfoot segment were analyzed according to sex, age, body mass index, Takakura classification, and the presence of subtalar compensation. Twenty ankles were categorized as compensated group, and 34 ankles as decompensated group. Results: No spatiotemporal gait parameters differed significantly according to the presence of subtalar compensation or ankle OA stage. Only normalized step width differed significantly (P = 0.028). Average hindfoot motion (decompensation vs. compensation) did not differ significantly between the sagittal and transverse planes. Graphing of the coronal movement of the hindfoot revealed collapsed curves in both groups that differed significantly. Compared with Takakura stages 3a, 3b, and 4, cases of more advanced stage 3b had a smaller sagittal range of motion than those of stage 3a (P = 0.028). Coronal movement of the hindfoot in cases of Takakura stage 3a/3b/4 showed a relatively flat pattern. Conclusions: The spatiotemporal parameters were not affected by the hindfoot alignment resulting from subtalar compensation. The sagittal range of hindfoot motion decreased in patients with advanced ankle OA. Once disrupted, the coronal movement of the subtalar joint in ankle OA did not change regardless of ankle OA stage or hindfoot compensation state. [ABSTRACT FROM AUTHOR]

A large proportion of netball players suffer foot-related problems and pain and are dissatisfied with current netball-specific footwear. To improve the fit and functionality of netball-specific shoes, we must understand the shape of these players' feet and determine whether any sex differences exist. Five hundred and two representative-level netball players (n = 251 male; n = 251 female) had their feet three-dimensionally scanned. We then used a validated MATLAB code to automatically extract 10 measurements to characterise each participant's foot shape. Differences between men and women for the absolute values and those normalised to foot length and stature were identified using independent samples t-tests with a Bonferroni adjusted alpha level. The size and shape of male netball players' feet differed significantly from their female counterparts. Males had significantly larger absolute and normalised foot measurements than females, notably at the ball of the foot, heel and instep (p < 0.001). Netball shoe manufacturers should develop unique lasts for each sex and foot size and should offer a more extensive range of shoe lengths and widths to netball players. Such considerations will help optimise shoe fit and comfort and, in turn, reduce foot-related problems and pain associated with ill-fitting footwear. [ABSTRACT FROM AUTHOR]

BACKGROUND: Foot arch dynamics play an important role in dynamic postural control. Association between foot arch dynamics and postural control among adolescent athletes remains poorly explored. OBJECTIVE: To examine the relationship between foot arch dynamics, intrinsic foot muscle (IFM) morphology, and toe flexor strength and dynamic postural stability after jump landing and repetitive rebound jump performance in competitive adolescent athletes. METHODS: Based on foot arch dynamics, evaluated from relative change in the foot arch height in sitting and standing positions, 50 adolescent athletes were classified as stiff, normal, or flexible. IFM morphology was evaluated by ultrasonography. Dynamic postural stability index (DPSI) was measured as participants jumped and landed with the right leg onto a force plate, whereas repetitive rebound jumping performance was assessed using the jump height and reactive jump index. RESULTS: The stiff group had a significantly worse DPSI and vertical stability index than the normal group (p = 0.26, p = 0.44, respectively), and worse anteroposterior stability index (APSI) values than the flexible group (p = 0.005). Multivariate regression models of the relationship between the APSI and foot arch dynamics showed adequate power (probability of error = 0.912). CONCLUSIONS: Increased foot arch stiffness negatively affects dynamic balance during jump-landing, which may deteriorate their performance. [ABSTRACT FROM AUTHOR]

Fit of fire boots is a crucial factor in the safety and performance of firefighters on the hostile fireground. Firefighters have reported that ill-fitting fire boots restrict their lower body movement and sometimes cause very dangerous situations by falling off behind the wearer. By using computed tomography, this study demonstrates the potential to quantify and visualize the fit of fire boots, which previously relied on subjective feedback from the wearers. The high-resolution three-dimensional (3D) models of two fire boot products allowed a detailed observation and measurement of the internal space of the boots. Also, the boot's internal dimension was compared to the foot measurement of local firefighters, showing the significant differences between the two boots. Lastly, simulation wrapping the 3D scanned foot with the boot revealed large void spaces around the toe box and ankle, as well as the narrower ball width of the boot than the foot. [ABSTRACT FROM AUTHOR]

We aimed to investigate whether foot function and physical performance differ between women with and without bilateral painful hallux valgus (HV). Forty-four women with bilateral painful HV and forty-three controls were included. The Foot Function Index, American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Joints Scale, and Manchester-Oxford Foot Questionnaire were used. The time while walking 10 m-walkway at maximum speed and ascending and descending ten stairs as fast as possible also single-limb stance time were measured. All self-reported and performance-based measures showed that women with HV had poorer foot function and physical performance than controls (p < 0.05). Women with mild HV had better self-reported foot function than those with moderate HV or severe HV (p < 0.05), but physical performance did not differ (p > 0.05). Women with bilateral painful HV exhibited poorer self-reported foot function and performance-based physical function than those without HV. Level III [ABSTRACT FROM AUTHOR]

Background and objectives: In anterior cruciate ligament reconstruction, the strength of the graft was found to be unsatisfactory usually the anterior half of the peroneus longus tendon was taken for supplementation, but the effect on foot and ankle function and gait in the donor area is unclear. This study aims to explore the changes in the ankle and gait after using the harvested anterior half of the peroneus longus tendon as a reconstruction graft for the anterior cruciate ligament. Methods: A total of 20 patients, 6 males and 14 females, aged 18 to 44 years, with unilateral anterior cruciate ligament injuries, underwent reconstruction using the harvested anterior half of the peroneus longus tendon as a graft between June 2021 and December 2021. The part on which the anterior half of the peroneus longus tendon was harvested was considered the experimental group, while the contralateral foot was the control group. At the 6-month follow-up, the Lysholm knee score, AOFAS ankle score, and gait-related data (foot length, arch index, arch volume, arch volume index, and gait cycle parameters: percentage of time in each gait phase, step frequency, step length, foot strike angle, and push-off angle) were assessed using a 3D foot scanner and wearable sensors for both groups. Results: All 20 patients completed the six-month follow-up. There were no statistically significant differences between the experimental and control groups regarding knee scores, ankle scores, foot length, arch index, arch volume, arch volume index, step frequency, and step length (P > 0.05). However, there were statistically significant differences between the experimental and control groups in terms of the gait cycle parameters, including the percentage of time in the stance, mid-stance, and push-off phases, as well as foot strike angle and push-off angle (P < 0.05). Conclusion: Through our study of the surgical experimental group we have shown that harvesting the anterior half of the peroneus longus tendon does not affect foot morphology and gait parameters; however, it does impact the gait cycle. [ABSTRACT FROM AUTHOR]

Background: Medial longitudinal arch of foot plays a crucial role on maintaining ankle during weight bearing activities. In previous studies arch index derived from foot print shows a negative correlation with the navicular height. There are no other studies have correlated mathematically derived foot print values with standing arch height measurements with an acceptable equation. This study correlates arch index and foot posture index to identify foot arches. Methods: subjects with high arch have taken for the study. The study type is observational study was done on sample size n=60, foot arch index and foot posture index was evaluated with the samples. Findings: a r- value of 0.333, there is a Negative correlation between Arch index and Foot posture index in low arched foot. There is no significant correlation, and the a r- value of 0.173, there is a low positive correlation between arch index and foot posture index in high arched foot. Interpretation: Among high arched foot and low arched foot, Foot Posture Index and Arch Index is correlated, according to Pearson's correlation, only high arched foot shows low positive correlation between Foot Posture Index and Arch Index. Flatfoot shows negative correlation. [ABSTRACT FROM AUTHOR]

The foot core system is essential for upright stability. However, aging‐induced changes in the foot core function remain poorly understood. The present study aimed to examine age‐related differences in postural stability from the perspective of foot core capacity and neuromuscular control during quiet standing. Thirty‐six older and 25 young adults completed foot core capacity tests including toe flexion strength, muscle ultrasonography, and plantar cutaneous sensitivity. The center of pressure (COP) and electromyography (EMG) of abductor hallucis (ABH), peroneus longus (PL), tibialis anterior (TA) and medial gastrocnemius (GM) were simultaneously recorded during double‐leg and single‐leg standing (SLS). EMG data were used to calculate muscle synergy and intermuscular coherence across three frequency bands. Compared to young adults, older adults exhibited thinner hallucis flexors, weaker toe strength, and lower plantar cutaneous sensitivity. The ABH thickness and plantar cutaneous sensitivity were negatively associated with the COP mean peak velocity in older adults, but not in young adults. Besides, older adults had higher cocontraction of muscles spanning the arch (ABH‐PL) and ankle (TA‐GM), and had lower beta‐ and gamma‐band coherence of the ABH‐PL and TA‐PL during SLS. Foot core capacities became compromised with advancing age, and the balance control of older adults was susceptible to foot core than young adults in balance tasks. To compensate for the weakened foot core, older adults may adopt arch and ankle stiffening strategies via increasing muscle cocontraction. Furthermore, coherence analysis indicated that aging may increase the demand for cortical brain resources during SLS. [ABSTRACT FROM AUTHOR]

Purpose: The present study aimed to evaluate the accuracy of anthropometric foot measurements in predicting the diameter of the intramedullary screw for fifth metatarsal fracture fixation. Secondary aim was to identify whether the fifth metatarsal intramedullary canal diameter is correlated to the fifth metatarsal length and the foot dimensions. Methods: In 29 cadaveric feet, the maximum length of the plantar surface of the foot (PL) and the perimeter of the foot at the level of the fifth metatarsal base (PBFM) were measured using a measuring tape. Subsequently, the fifth metatarsal was excised. Using Computed Tomography scan, the metatarsal length (FML), and the horizontal (HDI) and vertical diameter (VDI) at the isthmus level were measured. The HDI values were grouped in 5 mm increments to correspond to the recommended screw diameter (RSD) for intramedullary fixation. A univariate linear regression analysis considered RSD and HDI as the dependent variables and FML, PL, PBFM as the independent variables. A multivariate regression analysis was performed to examine the predictive value of the two anthropometric measurements. A p-value < 0.05 was considered statistically significant. Results: All six univariate analyses revealed that the dependent variable was significantly correlated with the independent variable. However, the multivariate regression models showed that the anthropometric measurements were not significantly correlated with the RSD and HDI. Conclusion: The current study found an association between the fifth metatarsal intramedullary canal diameter and the fifth metatarsal length and foot anthropometric dimensions. However, the anthropometric measurements of the foot presented a low predictive value for the decision of an intramedullary screw diameter in the treatment of fractures of the base of the fifth metatarsal. [ABSTRACT FROM AUTHOR]

BACKGROUND: Normal alignment of the foot is important because the feet support the body's weight. The intrinsic muscles of the foot mainly maintain the alignment and movement of the foot, whereas the abductor hallucis (AbdH) aligns the first metatarsophalangeal joint and maintains the medial longitudinal arch. OBJECTIVE: This study was conducted to investigate the muscle activity of the AbdH and hallux valgus (HV) angle during three different foot exercises. METHODS: Participants included 15 subjects aged 20–24 years with mild HV. All subjects performed three different foot exercises in random order: short foot exercise (SF), toe spread out exercise (TSO), and TSO with a pressure bio-feedback unit (TSOP). The muscle activity of the AbdH and the HV angle were measured during each foot exercise using surface electromyography and X-ray and then compared using one-way repeated-measures analysis of variance, followed by Bonferroni adjustment. RESULTS: AbdH muscle activity differed significantly among SF, TSO, and TSOP. AbdH muscle activity was greater in TSOP (89.60%) than in SF (19.99%) and TSO (60.96%) (p = 0.006). The HV angle was significantly smaller in TSOP (15.72 ∘) than in SF (18.85 ∘) and TSO (16.81 ∘) (p = 0.001). CONCLUSIONS: TSOP can be recommended as an effective AbdH strengthening exercise in subjects with mild HV. [ABSTRACT FROM AUTHOR]

Aim: Accessory and sesamoid bones are hidden anatomical structures that fulfil a wide variety of functions in the human body. Therefore, studying the nature, formation and dimensions of these structures is of great importance for the medical literature. In our study, we aimed to measure the presence and area (size) of these ossicles. Material and Method: Our study was performed retrospectively on the images of individuals who applied to Ordu University and whose radiological images were obtained. The presence of accessory and sesamoid ossicles (present/absent) and their sizes (measured using the PACS system) were evaluated on radiographs and Computed Tomography (CT) images. The results of the ossicles were divided into gender, age, and bilateral groups. Statistical analyzes were performed with the SPSS program. Results: The most common and largest accessory ossicles in the foot were os peroneum (18.2%), os naviculare accessoria (17.4%), os trigonum (12.1%) and os intermetatarsarum (7.8%). Sesamoid ossicles at the level of the first metatarsophalangeal (mtp) joint of the foot and the first metacarpopgalangeal (mcp) joint of the hand were found to be 100% common. The second most common sesamoid bone in the hand and foot was at the fifth mtp (22.22%) and mcp (68.53%) joints. In the hand, the most common accessory ossicles were os triangulare (6.08%), os radiale externum (2.60%) and os centrale (1.73%). Accessory ossicles (fabella: 19%, cyamella: 17.5%) were found in 25.5% of the knee. Conclusion: Accessory and sesamoid ossicles are most commonly found in the hand, foot, and knee. The presence and size of these ossicles can be both beneficial and harmful. Sesamoids provide mechanical benefit, whereas accessory ossicles can be mistaken for fractures and may lead to unnecessary medical conditions. Knowing the dimensions of these ossicles allows them to be clinically differentiated from avulsion fractures. [ABSTRACT FROM AUTHOR]

Background: Currently, more than 150 surgical techniques have been described for the treatment of hallux valgus. The abundance of techniques indicates that there is no technique that has been designated as a gold standard. In recent years, a particular interest in the use of minimally invasive techniques has grown. The aim of this study was to prospectively compare clinical, radiologic, and postoperative outcomes between the MICA technique and open chevron technique over a 1-year follow-up period. Methods: Between January 2016 and August 2020, data were prospectively collected from consecutive patients preoperatively and at 6 weeks, 3 months, and 12 months following minimally invasive chevron and Akin (MICA) or open chevron osteotomies. Radiographic outcomes were measured using weightbearing radiographs preoperatively and at 3 and 12 months postoperatively. Clinical outcomes were measured using the American Orthopaedic Foot & Ankle Society (AOFAS), Manchester-Oxford Foot Questionnaire (MOXFQ), VAS (visual analog scale), Foot Function Index (FFI), Foot and Ankle Outcome Score (FAOS), and Euro-QoL-5D (EQ5D) questionnaires. Results: Of the 68 patients, 42 patients (62%) underwent a MICA surgery and 26 patients (38%) underwent open chevron osteotomy. Both groups showed significant improvement in HVA, IMA, and DMAA at the 1-year follow-up. Our findings show that both clinical and radiologic outcomes of the MICA technique are comparable to the conventional open technique. No significant differences were found in clinical outcomes (VAS, AOFAS, MOXFQ, FFI, and FAOS), complication rate, and operative times. Conclusion: These results show that MICA is a safe alternative for chevron osteotomy. The clinical and radiologic outcomes of these 2 techniques by 12 months are comparable. [ABSTRACT FROM AUTHOR]

This study investigates whether there is a significant difference in oxygen saturation (SpO2) values obtained from the dorsal and plantar surfaces of the first metatarsophalangeal joint (MTPJ) in different Fitzpatrick skin types (FSTs). The moorVMS-OXY™ tissue oxygenation system is validated for use on FSTs 1 and 2, but melanin pigmentation can interfere with its reliability. This pilot study suggests that anatomical variations in the foot greatly affect SpO2 values compared to skin type; a step towards understanding if future prevention of plantar and dorsal ulcers can be made via measurement of SpO2 values from pigmented areas. However, as this is a pilot study, larger-scale research needs to be conducted. [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]

Objective: In this systematic review, we aim to evaluate the effectiveness of foot reflexology in reducing labor pain intensity. Material-Method: The study was done in the second half of 2019. PubMed (MEDLINE), CINAHL (EBSCO), Scopus, Science Citation Index, Science Direct, ULAKBIM (Turkish National Databases) databases were searched using terms and keywords including 'labor pain' 'vaginal delivery' 'normal delivery' 'pregnancy and delivery' 'reflexology' 'foot massage' 'pain and reflexology' in three languages. 3292 articles (English, Turkish and Persian languages) reached by using keywords and scanning electronic databases (between 2009 and 2019). Nine descriptive cross-sectional studies were evaluated that involving provide only quantitative results and descriptive designs quantitative elements of mixed (qualitative and quantitative) method studies. Results: Out of the 3292 articles found in the databases, only 9 met the inclusion criteria and were included in the study. Studies have shown that foot reflexology during labor reduces the severity of labor pain. Conclusion: Performing foot reflexology can be an effective and low-cost method of pain relief, reducing both pain and the duration of labor. It is recommended that further studies with sufficient statistical power be conducted in this field. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of manipulating foot longitudinal arch motion with different-stiffness foot orthoses on running economy (RE) in runners with flat-arched feet and if changes in arch deformation and recoil were associated with changes in RE. Methods: Twenty-three recreational distance runners performed 5-minute submaximal treadmill runs at 12 km·h−1, in the following 3 conditions in a randomized order: (1) footwear only, (2) flexible orthoses (reduced arch thickness), and (3) standard orthoses. The RE (submaximal steady-state oxygen consumption [VO2submax]) and sagittal arch range of motion were compared among conditions using a repeated-measures analysis of variance and effect sizes (Cohen d). Pearson correlation coefficients were used to determine the association between the change in the sagittal arch range of motion and VO2submax. Results: Compared with standard orthoses, the mean VO2submax was significantly lower in both the flexible orthoses (−0.8 mL·kg−1·min−1, P <.001, d = 0.35) and footwear-only conditions (−1.2 mL·kg−1·min−1, P <.001, d = 0.49). The change in VO2submax between the flexible orthoses and footwear-only conditions was significantly positively correlated with the change in sagittal arch range of motion (r =.591, P =.005). Conclusion: Conventional foot orthoses were associated with poorer RE compared with flexible orthoses and footwear alone. Changes in arch deformation were positively correlated to changes in oxygen consumption, indicating that foot orthoses that limit arch deformation and recoil degrade RE. Foot orthoses that facilitate energy storage and release in the foot longitudinal arch may be advisable for athletes prescribed these devices for clinical purposes to maintain optimal running performance. [ABSTRACT FROM AUTHOR]

Background: Imaging diagnosis plays a fundamental role in the evaluation and management of injuries suffered in sports activities. Objective: To analyze the differences in the thickness of the Achilles tendon, patellar tendon, plantar fascia, and posterior tibial tendon in the following levels of physical activity: persons who run regularly, persons otherwise physically active, and persons with a sedentary lifestyle. Design: Cross-sectional and observational. Participants: The 91 volunteers recruited from students at the university and the Triathlon Club from December 2016 to June 2019. The data were obtained (age, body mass index, and visual analog scale for quality of life together with the ultrasound measurements). Results: Tendon and ligament thickness was greater in the runners group than in the sedentary and active groups with the exception of the posterior tibial tendon. The thickness of the Achilles tendon was greater in the runners than in the other groups for both limbs (P =.007 and P =.005). This was also the case for the cross-sectional area (P <.01) and the plantar fascia at the heel insertion in both limbs (P =.034 and P =.026) and for patellar tendon thickness for the longitudinal measurement (P <.01). At the transversal level, however, the differences were only significant in the right limb (P =.040). Conclusion: The thickness of the Achilles tendon, plantar fascia, and patellar tendon is greater in runners than in persons who are otherwise active or who are sedentary. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the effect of variations in bony and soft tissue foot widths on clinical and functional outcomes after hallux valgus correction with the Lapidus procedure. Methods: Forty-three feet in 35 patients with a mean follow-up of 18.5 months undergoing the LP were reviewed. Clinical and functional data were assessed with the VAS for pain, AOFAS Scale, LEFS and SF-12 health survey, which is divided into physical and mental health composite scales (PCS-12 and MCS-12). Radiographic analysis of forefoot width was based on bony and soft tissue limits. Intermetatarsal-angle and HV-angle were also assessed. Results: Bony width changed significantly from 95.5 mm to 84.2 mm (11.8%) and soft tissue width from 107.12 mm to 100.84 mm (5.86%) (p < 0.001). IMA and HVA improved significantly. Significant clinical and functional improvements were observed, except in MCS-12. In simple linear regression, correlation was found between variations of bony width with Δ-AOFAS and Δ-PCS-12, meaning that as the forefoot narrows, their values increase (p = 0.02 and p = 0.005, respectively). It was also related to Δ-IMA, meaning that the forefoot narrows as these parameters improve (p < 0.001 and p < 0.001). Soft tissue width was related to Δ-PCS-12 and Δ-AIM. In multiple linear regression, the strongest correlation was between bony width variation and Δ-IMA (p = 0.029, r2 = 0.22). Conclusion: Forefoot narrowing was correlated with improved clinical and functional outcomes, as measured by AOFAS and PCS-12. In addition, correction of the radiographic parameters, mainly IMA, reflected on a significant decrease in the forefoot width. [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]

Background: Competitive adolescent athletes should be aware of the early signs of chronic ankle instability (CAI) and the connection between the condition and performance. Purpose: To investigate whether CAI is related to foot alignment and morphology as well as dynamic postural stability after a jump landing among adolescent competitive athletes with and without a history of a lateral ankle sprain and CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Between July 2020 and August 2021, adolescent competitive athletes (N = 85; n = 49 boys; n = 36 girls) were classified into 3 groups using Cumberland Ankle Instability Tool (CAIT) scores: healthy athletes (n = 55), coper athletes (n = 19), and athletes with CAI (n = 11). Results of foot alignment assessments involving the leg-heel angle (LHA) and navicular height, intrinsic foot muscle morphology, dynamic postural stability index (DPSI), and other parameters were compared among the 3 groups. The relationship between the CAIT score and the LHA and dynamic postural stability and instability were examined using multiple linear regression. Results: Compared with the healthy group, the CAI group had a significantly greater LHA (8.73°± 3.22° vs 6.09°± 3.26°; P <.05), higher DPSI (0.336 ± 0.046 vs 0.298 ± 0.035), and higher vertical stability index (0.303 ± 0.048 vs 0.264 ± 0.037; P <.05 for all). Multiple regression analysis showed that the LHA (β = −0.228; P =.033) and DPSI (β = −0.240; P =.025) were significantly associated with the CAIT score. Conclusion: Valgus rearfoot alignment and poorer dynamic postural control were associated with CAI among adolescent athletes. [ABSTRACT FROM AUTHOR]

Human foot is a biological masterpiece, which is strong enough to support the body weight and flexible enough to adjust to various surfaces. Foot postural deviation can alter the alignment of the entire body. The collapse of the medial longitudinal arch of the foot causes one of the most prevalent deformities i.e. flat foot. Diabetic patients are more prone to have flat foot due to degeneration of posterior tibial tendon over the course of their disease. The aim of this study was to determine the occurrence of adult acquired flat foot and assess the disability of flat foot among diabetic population in Rawalpindi and Islamabad, Pakistan. In this cross-sectional descriptive study, 384 diabetic patients aged 35-60 year were enrolled after obtaining informed consent. Non-probability convenience sampling technique was employed. The data was gathered by performing navicular drop test to determine the presence of flat foot, assessment of posterior tibial tendon dysfunction through single heel rise test and by using foot function index questionnaire to assess pain, disability and activity limitation. Based on results of the study, posterior tibial tendon dysfunction was observed to cause the appearance of low navicular height leading to flat foot in 58.33% of the population. Moreover, there is a moderate tendency of occurrence of flat foot among diabetic population in the absence of other risk factors such as hypertension, obesity, steroids use and previous foot trauma etc. With regard to the functionality measured by foot function index, it was implied that the functional status of the patient was reduced because of the pain, disability and activity restriction in the presence of flat foot. [ABSTRACT FROM AUTHOR]

Category: Hindfoot; Midfoot/Forefoot Introduction/Purpose: In clinical practice and research, there are several scenarios when a hindfoot alignment view weightbearing XR is not obtained whether as a result of a lack of resources, technology, in retrospective studies when a hindfoot view was not obtained, as well as in many practices where a hindfoot view XR is not considered a routine examination for foot and ankle disorders. A lateral weightbearing radiograph however is almost routinely obtained, and the goal of this study was to correlate the hindfoot alignment angle with measurements on lateral weightbearing images. Methods: Four volunteers (8 feet) with flexible feet and ankles and no symptoms, nor significant trauma & surgical history in their lower limbs were recruited for this study. A portable fluoroscopy machine (Smart C, Turner Imaging, Salt Lake City, USA) was used for imaging. The participant was asked to stand on different custom wooden wedges with the angle changed every 5 degrees from 30 degrees of varus to 30 degrees of valgus and a weightbearing lateral image was taken for each position. The hindfoot alignment was measured using a skin marker which had been drawn prior to initiation of the imaging, and the angular changes of the hindfoot was measured with the placement of each wedge placed. All standardized measurements of the midfoot and hindfoot were obtained on the lateral images. Results: With the hindfoot positional changes between 30o of varus to 30o of valgus, there was a gradual measurable change in the subtalar joint, with corresponding changes in the midfoot and hindfoot. There was a significant linear correlation between the hindfoot alignment angle and all radiographic parameters on lateral images. When the hindfoot alignment angle increased by 1 degree in the valgus direction, there was 0.49o decrease in the pitch angle, 0.58o of decrease in the middle vs posterior facet angle, 0.06o of decrease in the proximal cuneiform/cuboid height, 0.40o of decrease in the proximal cuneiform/5th Metatarsal height, 0.40o of increase in the fifth metatarsal/cuboid height, 0.009o of increase in the sinus tarsi/lateral process height, and 0.015o increase in Cuboid/Anterior Process Height. (Figure 1) Conclusion: The lateral weightbearing XR can be used to predict the status of the hindfoot alignment, and this study has proven that this can be none not only qualitatively but also quantitatively. This novel research can provide our colleagues with linear regression equations to correlate the lateral imaging metrics with the hindfoot alignment angle. Further study with a larger sample size and participants with different types of hindfoot deformities is needed to help develop an algorithm that would help both clinical practice and research. [ABSTRACT FROM AUTHOR]