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Purpose: The popularity of fencing and intense sports competition has burdened adolescents with excessive training, harming their immature bodies. Traditional training methods fail to provide timely movement corrections and personalized plans, leading to ineffective exercises. This paper aims to use artificial intelligence technology to reduce ineffective exercises and alleviate the training burden. Methods: We propose an action recognition algorithm based on the characteristics of adolescent athletes. This algorithm uses multimodal input data to comprehensively extract action information. Each modality is processed by the same network structure, utilizing attention mechanisms and adaptive graph structures. A multibranch feature fusion method is used to determine the final action category. Results: We gathered the fencing footwork data set 2.0. Our model achieved 93.3% accuracy, with the highest precision at 95.8% and the highest F1-Score at 94.5% across all categories. It effectively recognized actions of adolescents with different heights and speeds, outperforming traditional methods. Conclusion: Our artificial intelligence-based training solution improves training efficiency and reduces the training burden on adolescents. [ABSTRACT FROM AUTHOR]

Purpose: To study whether, during typical-level running, non-rear-foot strikers (non-RFS) or rear-foot strikers (RFS) presented a similar or different extent of neuromuscular fatigue after a prolonged graded run. Methods: Sixteen experienced male trail runners (8 non-RFS and 8 RFS) performed a 2.5-hour treadmill graded running exercise. Before and after exercise, neuromuscular tests were performed to assess neuromuscular fatigue of the plantar flexors. Biomechanical gait parameters were acquired with an instrumented treadmill, and electromyographic activity of the lower-limb muscles was collected as an index of muscle activation. Results: There were no significant time × foot strike interactions for neuromuscular (all P ≥.742), muscle activation (all P ≥.157), or biomechanical (all P ≥.096) variables. Conclusions: A dominant level running foot-strike pattern did not directly affect the extent of neuromuscular fatigue during a prolonged graded run. This suggests that no ideal running foot-strike pattern exists to minimize neuromuscular fatigue during prolonged-duration races wherein cumulative uphill and downhill segments are high, such as in trail running. [ABSTRACT FROM AUTHOR]

Vertical loading rate (VLR) and pelvic floor muscle activity (PFA) increase with running velocity, which may indicate a relationship between VLR and PFA. Foot strike pattern has been shown to influence VLR while running, but little is known about its influence on PFA. Twenty healthy women ran on a treadmill for 2 conditions: with a rearfoot strike and with a forefoot strike. PFA was measured with electromyography. Running kinematics associated with VLR were collected using inertial measurement units and tibial accelerometers. Change scores between conditions were calculated for average PFA and running kinematics: peak vertical tibial acceleration, vertical excursion of the center of mass (VO), and cadence. Paired t tests assessed differences between running conditions for all variables. Pearson correlations assessed the relationships between changes in PFA and running kinematics. PFA was significantly higher during the forefoot compared with the rearfoot strike condition. Change in vertical tibial acceleration was positively correlated with change in PFA during the right stance. Change in cadence was negatively correlated, and change in vertical excursion of the center of mass was positively correlated with change in PFA during left stance. The average PFA increased during the forefoot strike pattern condition. Changes in PFA were correlated with changes in running kinematics associated with VLR. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the test–retest reliability and usefulness of the foot–ankle rebound-jump test (FARJT) for measuring foot–ankle reactive strength metrics in athletes. Methods: Thirty-six highly trained, healthy athletes (5 female; 21.5 [3.9] y; 1.80 [0.10] m; 72.7 [10.4] kg) performed 8 repeated bilateral vertical foot–ankle rebound jumps on 2 testing days. Testing days were 1 week apart, and these sessions were preceded by a familiarization session. Reactive strength metrics were calculated by dividing jump height (in meters) by contact time (in seconds) for the reactive strength index (RSI) and flight time (in seconds) by contact time (in seconds) for the reactive strength ratio (RSR). The mean of 4 jumps (excluding the first and last 2 jumps) on each testing session were considered for RSI and RSR reliability and usefulness analysis. Results: We found a high reliability of the FARJT for RSI (intraclass correlation coefficient [ICC] >.90 and coefficient of variation [CV] = 12%) and RSR (ICC ≥.90 and CV = 8%). Regarding their usefulness, both RSI and RSR were rated as "marginal" in detecting the smallest worthwhile change (typical error > smallest worthwhile change) and "good" in detecting a moderate change in performance. Conclusions: The results showed that a FARJT is a highly reliable test for measuring foot–ankle reactive strength in athletes and useful for quantifying changes, for example, following a training block. However, its usefulness as an accurate daily or weekly monitoring tool in practice is questionable. [ABSTRACT FROM AUTHOR]

This study estimated the contribution of the midfoot joint complex (MJC) kinematics to the pelvis anterior–posterior positions during the stance phase of walking and investigated whether the MJC is functionally coordinated with the lower limb joints to maintain similar pelvic positions across steps. Hip, knee, ankle, and MJC sagittal angles were measured in 11 nondisabled participants during walking. The joints' contributions to pelvic positions were computed through equations derived from a link-segment model. Functional coordination across steps was identified when the MJC contribution to pelvic position varied and the summed contributions of other joints varied in the opposite direction (strong negative covariations [r ≤ −.7] in stance phase instants). We observed that the MJC plantarflexion (arch raising) during the midstance and late stance leads the pelvis backward, avoiding excessive forward displacement. The MJC was the second joint that contributed most to the pelvis positions (around 18% of all joints' contributions), after the ankle joint. The MJC and ankle were the joints that were most frequently coordinated with the other joints (≅70% of the stance phase duration). The findings suggest that the MJC is part of the kinematic chain that determines pelvis positions during walking and is functionally coordinated with the lower limb joints. [ABSTRACT FROM AUTHOR]

Two long-distance runners developed medial tibial stress syndrome (MTSS; male age = 26.3 years, female age = 47.5 years) after baseline assessment of plantar-flexor muscle structure and function and spatiotemporal running variables. B-mode ultrasound and lean leg girth characterized plantar-flexor muscle structure. Handheld dynamometry and a single-leg heel raise–to-failure protocol characterized plantar-flexor muscle function. Finally, spatiotemporal running variables were determined during a treadmill protocol. The 2 runners who developed MTSS demonstrated less plantar-flexor strength and endurance capacity than published comparative control data and marked variability in muscle structure. Reduced plantar-flexor strength and endurance capacity were thought to contribute to an impaired ability to resist tibial-bending moments during midstance due to earlier muscle fatigue. Earlier muscle fatigue could, in turn, contribute to increased tibial-bending moments and MTSS development. Therefore, assessing plantar-flexor muscle strength and endurance might help to identify athletes at risk of developing MTSS. [ABSTRACT FROM AUTHOR]

A common occupational task for the military is carrying heavy loads for long periods of time. The US Army has set a time standard of 3 hours to complete a 19.31-km march with a 15.9-kg ruck sack for combat arms training and specialty schools. The purpose of this study was to identify characteristics associated with 19.31-km foot march completion rates in Reserve Officers' Training Corps (ROTC) Cadets. Demographics, anthropometrics/body composition, Army Combat Fitness Test (ACFT) scores, and vertical countermovement jump (CMJ) data were collected on 65 ROTC cadets who conducted a 19.31-km foot march. Independent t tests and Mann-Whitney U tests compared variables between those who did and did not finish the foot march in less than 3 hours. Logistic regressions were used to calculate the odds of completing the foot march using military experience, fat-free mass, ACFT, and CMJ outcomes. Cadets who met the 3 hours standard had lower body fat percent, greater fat-free mass, higher ACFT scores, and higher CMJs than those who did not. In addition, for every one point increase in ACFT score and 1-kg increase in fat-free mass, a cadet's chances of finishing the foot march increased by 6.1 and 24%, respectively. When analyzing ACFT events separately, 2-mile run was the only significant variable, and for every 1 point increase in 2-mile run score, a cadet's chances of finishing the foot march increased by 9%. Thus, aspiring and current soldiers should train to improve aerobic fitness and build muscle mass in preparation for load carriage requirements. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the use of custom-made insoles adapted to flip-flops on pain intensity, foot function, and functional walking ability in individuals with persistent plantar heel pain in the short and medium term. Design: Randomised controlled trial. Setting: Flip-flop sandals in patients with persistent plantar heel pain. Main measures: Participants (n = 80) were assessed at baseline, six and 12 weeks after the intervention, and 4 weeks post-intervention. Results: For the primary outcomes, after 6 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference = −0.4 (95% confidence intervals = −1.5 to 0.8). Similarly, after 12 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference = −0.7 (95% confidence intervals = −1.9 to 0.6). Finally, at 4 weeks after the end of the intervention, there was no between-group difference in morning pain or pain on walking, mean difference = 0.01 (95% confidence intervals = −1.4 to 1.4). All differences and confidence intervals were smaller than the minimum clinically important difference for pain (2 points). There were no differences between the groups for the secondary outcomes. In addition, the mean differences were smaller than the minimum clinically important differences for pain intensity, foot function and functional walking ability. Conclusion: Custom-made insoles fitted to flip-flops did not differ from flip-flops with sham insoles in improving pain intensity, foot function and functional walking ability in people with persistent heel pain. Trial registration: ClinicalTrials.gov (Identifier: NCT04784598). Data of registration: 2023-01-20 [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to identify the most responsive foot position for detection of isolated unstable syndesmotic injury. Methods: Fourteen paired human cadaveric lower legs were positioned in a pressure-controlled radiolucent frame and loaded under 700 N. Computed tomography scans were performed in neutral position, 15° internal / external rotation, and 20° dorsal / plantar flexion of the foot before and after cutting all syndesmotic ligaments. For each position, generated 3D models of the intact and injured distal tibiofibular joints were matched and analyzed by calculating three parameters: diastasis, anteroposterior displacement, and shortening of the fibula. Results: Transection of syndesmotic ligaments resulted in significant posterior translation of the fibula (4.34°, SD 1.63°, p < 0.01) compared to uninjured state for external rotation, significant anterior translation (-2.08°, SD 1.65°, p < 0.01) for internal rotation, and significant posterior translation (1.32°, SD 1.16°, p = 0.01) for dorsiflexion. Furthermore, the syndesmotic injury led to significantly increased clear space (0.46 mm, SD 0.46 mm, p = 0.03) in external rotation of the foot. Conclusion: External rotation of the foot under loading seems to be the most responsive position for detection of isolated syndesmotic instability. Under external rotational stress, anteroposterior instability and increased clear space resulting from a complete isolated unstable syndesmotic lesion were most evident. [ABSTRACT FROM AUTHOR]

Background: Plantar fasciitis (PF) is a common cause of chronic foot pain that leads to functional limitations in individuals. There has been recent research on plantar fasciitis, but no studies have compared the effects of the active release technique and post-isometric relaxation in patients to determine which manual therapy technique improves foot pain and function. Objective: This study aimed to compare the effectiveness of the active release technique and post-isometric relaxation on proximal foot pain and functional status and to assess muscular tightness among patients with traffic police wards and plantar fasciitis. Methods: A quasi-experimental study (pre-test, post-test) was conducted in the Physiotherapy Department of Police Hospital, Gujranwala, Pakistan, between October 2022 and April 2023. We included 30 consecutively aged 25- to 60-year-old symptomatic police wardens diagnosed with planter fasciitis, who complained of pain on walking and standing for more than 3 months and met the inclusion criteria. They were equally assorted into two groups (n = 15 in each group) using convenient sampling. Group A received an active release exercise technique, group B received a post-isometric relaxation technique, and the participants in both groups received a similar baseline treatment protocol that consisted of calf stretching and stretching of the plantar fascia (5 repetitions and holding for 15 s). In the outcome measures, we included the Foot Function Index to assess the function of the foot and the Visual Analog Scale to examine the pain intensity measured during rest. The participants in both groups performed the selective protocol 3 days per week for 3 weeks, and we calculated the results at baseline and on the third day of the third week. We analyzed the data using SPSS software version 24 (IBM Corp., Armonk, NY). We compared within-group differences in the VAS score and FFI using paired t tests and analyzed between-group differences in the VAS score and FFI before and after performing the ART and PIR using independent t tests. Results: The 8-week intervention therapy revealed a demographic age mean and standard deviation of 36.60 ± 6.11 for group A and 35.60 ± 4.85 for group B. Within-group analysis demonstrated a significant decrease in VAS (pain) score following ART intervention (1.80 ± 0.862, p < 0.01) compared to PIR (6.07 ± 0.884). Between-group analysis indicated a significant reduction in FFI (disability) scores for group A (30.33 ± 3.200, p < 0.03) compared to group B (56.93 ± 4.773). Moreover, ART intervention exhibited significant improvement in VAS scores (p < 0.05), with 95% CI [1.49, 2.11]. The mean difference in FFI scores was substantially greater in the ART group (86.00 to 30.33) compared to the PIR group (p > 0.05), suggesting non-significant differences. Conclusion: The active release exercise intervention is more effective than post-isometric relaxation in improving pain and foot function disability in patients with plantar fasciitis. The present study aimed to help physical therapists choose the most efficient manual therapy exercise intervention to improve functional limitations. [ABSTRACT FROM AUTHOR]

This study investigated the kinematic (KmS) and kinetic (KnS) strategies integrating the trunk and lower limbs to achieve maximal kicking performance. Although strategies consisting of individual joint movements or moments are known, strategies combining joint movements or moments of the trunk and lower limbs have been less studied. Fifty adult amateur soccer players were assessed. Peak joint angles and moments of the trunk, the hip of the supporting limb, the hip and knee of the kicking limb, and the velocities of the foot and ball were recorded. Canonical Correlation Analysis evaluated relationships between sets of variables. A combination of greater hip extension and knee flexion of the kicking limb, as a KmS, correlated with better kick performance (Rc = 0.60, p = 0.004). Furthermore, a combination of larger moments of trunk flexion and rotation, internal rotation of the supporting hip, hip flexion, and knee extension of the kicking limb, as a KnS, were associated with better performance (Rc = 0.74, p < 0.001). The explained variance was 43% for the KmS and 59% for the KnS. In amateur players, the KmS for better kick performance involved greater hip and knee movement of the kicking limb, while the KnS involved greater moments at the trunk and both lower limbs. [ABSTRACT FROM AUTHOR]

Background: Although double calcaneal osteotomy (medial displacement calcaneal osteotomy with lateral column lengthening) is widely regarded as an effective treatment option for flexible flatfoot, limited studies have extensively analyzed the degree of deformity correction in three dimensions following double calcaneal osteotomy. This study was performed to evaluate the radiographic and clinical effectiveness of double calcaneal osteotomy to correct flexible flatfoot deformities. Methods: Thirty-one patients who had 44 symptomatic flexible flatfeet and underwent double calcaneal osteotomy were examined retrospectively with a mean follow-up of 50 months. Visual analog scale, foot and ankle activity measure, and other clinical data were obtained from medical records. Various radiographic variables for assessing flatfoot and osteoarthritic change in tarsal joints were analyzed from weightbearing radiographs. Results: Clinical scores and radiographic variables were significantly improved postoperatively. The mean values of medial sliding and lateral lengthening were 7.6 and 8.7 mm, respectively. No osteoarthritic changes were observed. Conclusions: Double calcaneal osteotomy could be used to correct flatfoot deformities effectively and sustainably and provide symptomatic relief and patient satisfaction. Level of evidence: Level 4, retrospective case series. [ABSTRACT FROM AUTHOR]

Background: Running is a widely practiced sport worldwide associated with a host of benefits on cardiovascular, metabolic, musculoskeletal, and mental health, but often leads to musculoskeletal overuse injuries. The prescription of a foot orthosis (FO) is common to manage musculoskeletal impairments during physical activity or functional tasks. Although FOs are frequently prescribed by clinicians for symptomatic populations of runners, the existing literature supporting the prescription of FOs in runners has predominantly focused on either uninjured individuals or a mix of uninjured and symptomatic populations. Thus, the effects of FOs on the treatment and/or prevention of overuse running injuries need to be investigated to guide future research and assist clinicians in their decision-making process. Main body: This scoping review aimed to evaluate the immediate and long-term effects of FOs on lower limb biomechanics, neuromuscular parameters, and pain and disability in symptomatic runners, and to identify factors that may influence the effects of FOs. Five databases (CINAHL, SPORTDiscus, MEDLINE, Embase, and Web of Science) were searched, resulting in 2536 studies. A total of 30 studies, published between 1992 and 2023 (730 symptomatic runners), were included following the removal of duplicates and the screening process. Wearing FOs while running is related to an immediate and a long-term decrease in pain and symptoms of overuse running injuries. Also, wearing FOs while running decreases eversion at the foot/ankle complex, leads to a more lateral plantar pressure at the heel and forefoot, and may change running motor control strategies. Finally, the effectiveness of FOs is influenced by its added features. Conclusions: This study provides recommendations for future research such as the need for standardized methods in describing FOs, considering participant characteristics such as foot morphology, and comparing different types of FOs. Also, this scoping review provides valuable insights for guiding the prescription and design of FOs, and suggests that integrating FOs into a comprehensive treatment plan may yield better results than standalone first-line treatments. Nonetheless, this scoping review highlights the need for future research to explore the optimal integration of FOs into injury-specific treatment plans. Key Points: Foot orthoses may redistribute loads onto non-injured structures, thereby resulting in an immediate decrease in pain and potentially contributing to the treatment of injuries. A rearfoot medial wedge decreases rearfoot and/or calcaneal eversion motion and moments in injured runners. A foot orthosis integrated into a comprehensive treatment plan may yield better results compared to standalone first-line treatments. The use of sham/flat insoles as a control/blinding condition is crucial in evaluating the effect of a foot orthosis. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine whether the width of the base of support (BOS) has an influence on early postural adjustments (EPA) and armed upper limb and COM kinematics during lunging. Eight elite female fencers participated in the study. The displacement of the centre of foot pressure (COP) and kinematics of centre of mass (COM) were recorded using force platforms. The kinematics of the wrist of the armed upper limb were obtained using a 3D accelerometer. The results show that EPA were characterised by a very small COP displacement (about 0.6 to 1.2 cm). The COP amplitude showed a tendency to decrease with an increase in BOS width under reaction time conditions. In contrast, a greater BOS width was associated with a significant increase in COM acceleration at foot-off and peak COM acceleration during lunging also under reaction time instructions. The kinematics of the wrist were not influenced by BOS. The results show that in elite fencers, the upper limb movement is dissociated from the whole body movement. We suppose that a small COP amplitude is a postural skill which is integrated into the lunging skill and might influence the acceleration of COM. [ABSTRACT FROM AUTHOR]

Context: Exercising intrinsic foot muscles (IFMs) can improve dynamic balance and foot posture. The exercises are not intuitive and electrotherapy (neuromuscular electrical stimulation [NMES]) has been suggested to help individuals execute the exercises. The aim of this study was to evaluate the effects of training IFM program on dynamic balance and foot posture and compare traditional training methods (TRAIN) with traditional training plus NMES on the perceived workload of the exercises, balance, and foot posture. Design: Randomized controlled trial. Methods: Thirty-nine participants were randomized to control, TRAIN, or NMES. TRAIN and NMES performed IFM exercises daily for 4 weeks; NMES received electrotherapy during the first 2 weeks of training. The Y-Balance test and arch height index were measured in all participants at baseline. The training groups were measured again at 2 weeks; all participants were measured at 4 weeks and 8 weeks, after 4 weeks of no training. Perceived workload (National Aeronautics and Space Administration Task Load Index) of exercises was assessed throughout the first 2 weeks and at 4 weeks. Results: A 4-week IFM training program demonstrated increases in Y-Balance (P =.01) for TRAIN and in arch height index (seated P =.03; standing P =.02) for NMES, relative to baseline. NMES demonstrated improvement in Y-Balance (P =.02) and arch height index standing (P =.01) at 2 weeks. There were no significant differences between the training groups. Groups were similar in the number responding to exercises in excess of minimal detectable change on all clinical measures. Perceived workload of the exercises decreased during the first 2 weeks of training (P =.02), and more notably at 4 weeks (P <.001). The groups did not differ in how they perceived the workload. Conclusions: A 4-week IFM training program improved dynamic balance and foot posture. Adding NMES in early phases of training provided early improvement in dynamic balance and foot posture, but did not affect perceived workload. [ABSTRACT FROM AUTHOR]

Background: This systematic review and meta-analysis aimed to investigate the differences in hallux valgus angle (HVA), intermetatarsal angle (IMA), American Orthopedic Foot and Ankle Society (AOFAS) scores, and complication rates between chevron osteotomy and scarf osteotomy for correcting hallux valgus. Methods: Two investigators independently searched for randomized controlled trials (RCTs) published from 2007 to 2018 on PubMed, Web of Science, and Cochrane Library databases. Next, chevron and scarf osteotomies were compared for their postoperative outcomes using HVA, IMA, and AOFAS scores and their complication rates. Meta-analysis was performed using Review Manager (version 5.3). Results: Six RCTs—comprising 507 feet, of which 261 and 246 underwent chevron and scarf osteotomies, respectively—were included. The meta-analysis revealed that chevron osteotomy led to significantly smaller postoperative HVAs than scarf osteotomy (weighted mean difference [WMD] = -1.94, 95% CI = − 2.65 to − 1.29, P <.00001). However, the differences in postoperative IMA (WMD = − 0.44, 95% CI = − 1.10 to 0.22, P =.19), postoperative AOFAS scores (WMD = 0.75; 95% CI = − 5.32 to 6.82; P =.81), and complication rates (risk ratio = 1.22, 95% CI = 0.65–2.27, P =.53) between feet that underwent chevron and scarf osteotomies were nonsignificant. Conclusions: Compared with scarf osteotomy, chevron osteotomy had significantly more favorable postoperative outcomes in terms of HVA correction, but not in terms of IMA, AOFAS scores, or complication rates. Level of evidence: Level I, systemic review and meta-analysis. [ABSTRACT FROM AUTHOR]

Context: The concept of anatomical fascial trains and myofascial release are heavily researched topics independently. However, few studies have determined if myofascial release of remote areas can cause lengthening throughout more distal aspects of these fascial trains. Clinical Question: In healthy individuals, what is the effect of myofascial release on the plantar aspect of the foot in improving flexibility and hamstring length as determined by a sit-and-reach test? Clinical Bottom Line: The usage of myofascial release on the plantar aspect of the foot via a firm object has been shown to improve sit-and-reach distance. Each article included for analysis utilized similar methods of instructing self-myofascial release with regard to time as well as type of object used for the intervention. Though this was consistent between studies, the authors should have implemented secondary outcome measures. Despite the limitations to each of the studies analyzed, there is a Strength of Recommendation Taxonomy (SORT) Level B evidence to support the implementation self-myofascial release to the plantar fascia. This intervention should be considered a concurrent option for individuals with range of motion deficits or fascial restrictions in the upper thigh. [ABSTRACT FROM AUTHOR]

The effects of an eight-week off-season strength training program upon lower-body strength, power, eccentric capacity, front foot contact (FFC) kinetics, and ball release speed (BRS) in pace bowlers were investigated. Ten elite-academy pace bowlers completed the intervention, and pre- and post-testing. Pre- and post-testing included: double (DLDL) and single leg (SLDL) drop landings; isometric mid-thigh pull (IMTP); countermovement jump; and pace bowling performance (two-over bowling spell measuring BRS and FFC kinetics). Changes from pre- to post-testing were assessed with paired sample t tests (p≤ 0.01), effects sizes and statistical parametrical mapping. Post-testing revealed a significant decrease in peak normalised vertical force during DLDL and SLDL with large effects and a significant, moderate effect increase in IMTP. There was no significant changes in BRS. Concomitantly, neither discrete scalar (p= 0.15-0.58) nor vector field analysis kinetics during FFC indicated significant changes. No significant alterations in FFC kinetics may explain the lack of improvement in BRS (pre = 31.55 ± 1.44 m/s; post = 31.79 ± 1.33 m/s). This study indicated an eight-week strength training program can improve strength and eccentric capacity in pace bowlers, and these changes when developed in the absence of skills training neither improved nor decreased pace bowling performance. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare responsiveness characteristics for the Foot Function Index revised short form (FFI-RS), RAND-12 Health Status Inventory (RAND-12), and Numeric Rating Scale (NRS), in patients with plantar fasciopathy receiving non-surgical treatment. Materials and methods: This study was conducted on a sub-group of patients from an ongoing randomised controlled trial. One-hundred fifteen patients were included. The patient-reported outcome measures (PROMs) were applied at baseline and after 6 months. Responsiveness was calculated using standardised response mean and area under the receiver operating characteristic (ROC) curve. ROC curves were used to compute the minimal important change (MIC) for the outcome measures. Results: The region specific FFI-RS had best responsiveness and the NRS at rest had lowest responsiveness. Conclusion: FFI-RS were marginally more responsive than the other PROMs. Responsiveness and MIC estimates should be regarded as indicative rather than fixed estimates. IMPLICATIONS FOR REHABILITATION: The region-specific Foot Function Index Revised Short Form could, based on responsiveness perspectives, be recommended as an outcome measurement for patients with plantar fasciopathy. Responsiveness and minimal important change estimates are indicative and should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Results obtained from the design process of a hardware-software instrument for a system for monitoring the bioelectrical activity of the foot muscles of patients with locomotor dysfunction of the lower limbs are presented. This measuring system uses non-invasive biosignal acquisition methods employing myographic sensors. The information obtained allows the patient's condition to be assessed in order to set goals and select means for subsequent rehabilitation. [ABSTRACT FROM AUTHOR]

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]

Training the plantar intrinsic foot muscles (PIFMs) has the potential to benefit patients with lower extremity musculoskeletal conditions as well as the aged population. Isolated foot exercises, often standard in clinical practice, are difficult to perform, whereas functional exercises are much easier to accomplish. However, it is unclear whether functional exercises are comparable to isolated foot exercises in activating the PIFMs. This study aims to compare the activation of PIFMs between functional exercises versus isolated foot exercises. Using surface electromyography (EMG), muscle activation of three PIFMs was measured in four functional exercises (i.e. normal/unstable toe stance, toe walking, and hopping) versus a muscle-specific isolated foot exercise in 29 younger adults, resulting in 12 comparisons. Functional exercises showed larger mean EMG amplitudes than the isolated foot exercises in 25% of the 12 comparisons, while there was no difference in the remaining 75%. Functional exercises provoked comparable or even more activation of the PIFMs than isolated foot exercises. Given that functional exercises are easier to perform, this finding indicates the need to further investigate the effectiveness of functional exercises in physical therapy to improve muscle function and functional task performance in populations that suffer from PIFM weakness or dysfunction. [ABSTRACT FROM AUTHOR]

Step‐up variations are frequently used in sports performance to develop coordinated and powerful movements that transfer to running. This study aimed to quantify the kinetic characteristics of the first foot contact of four different step‐up variations. Ten professional rugby league players participated in this study and performed the Barbell One Box Step‐Up with Catch (BB1), Barbell Two Box Step‐Up (BB2), Vest Two Box Run (VEST) and Step‐Up Jump (JUMP) as part of routine in‐season strength training sessions during one season. Peak force, total impulse and maximal rate of force development (RFD) were measured from first foot contact on the step‐up box. Significantly greater peak force and RFD were observed in JUMP than any other variation (standardized mean difference; SMD: 3.9–5.5; p < 0.001). Total impulse was equal between JUMP and BB1, and significantly greater in JUMP than BB2 and VEST (SMD: 1.3–2.3; p < 0.001), and in BB1 than BB2 and VEST (SMD: 1.8–2.8; p < 0.001). Significantly larger peak force and RFD were observed in BB2 and VEST than BB1 (SMD: 0.6–0.7) and in total impulse in BB2 than VEST (SMD: 1.6) (p < 0.05). The results of this study highlight that step‐up exercise variations maximize different kinetic characteristics, which may transfer differently to athlete running performance. Highlights: The Step‐Up Jump variation was shown to produce the largest relative peak force, largest rate of force development (RFD) and equal largest total impulse and therefore may have the greatest transferability to maximal speed running through the maximization of the stance phase.The Barbell Two Box Step‐Up (BB2) and Vest Two Box Run (VEST), produced significantly greater peak relative force and RFD than the Barbell One Box Step‐Up with Catch (BB1) and therefore may have better transferability to acceleration ability.Coaches can use the findings of this study to assist their selection of step‐up variations that are best suited to develop running ability and should consider the testing results and individual requirements of each athlete. [ABSTRACT FROM AUTHOR]

Aim: Hallux valgus is a common foot deformity that causes significant pain and functional impairment. This study aimed to compare the effectiveness of prolotherapy and dry needling in treating mild to moderate hallux valgus pain. Material and Methods: Patients with hallux valgus deformity experiencing refractory pain after orthotic and analgesic treatment, and treated with prolotherapy (52 patients, 68 feet) or dry needling (49 patients, 57 feet) methods were included in the study. Each group received three treatment sessions at 3-week intervals. Clinical assessments were performed using the visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) scores at baseline, in the third month, and twelfth month. Results: Both groups showed significant improvement in VAS and AOFAS scores after treatment (p<0.001). In the prolotherapy group, the VAS score decreased from 6 (range, 4-8) in the pre-treatment period to 2 (range, 1-5) both in the third and twelfth months (p<0.001). In the dry needling group, the VAS score decreased from 6 (range, 4-7) in the pre-treatment period to 4 (range, 2-7) both in the third and twelfth months (p<0.001). While the AOFAS scores improved to 75 (range, 63-85) in the third month and 76 (range, 60-80) in the twelfth month in the prolotherapy group (p<0.001), improved to 56 (range, 44-75) in the third month and 50 (range, 36-75) in the twelfth month in the dry needling group (p<0.001). Conclusion: Both prolotherapy and dry needling effectively treat hallux valgus pain and improve foot function, with prolotherapy showing superior effectiveness. [ABSTRACT FROM AUTHOR]

There is disagreement regarding the efficacy of 'safe' lifting recommendations for reducing low back disorder risk. These recommendations commonly focus on minimising lumbar spine flexion, which limits the range of allowable starting lift positions for that person. This study evaluated whether starting postural adaptations could allow a person to reach down further without rounding their lumbar spine before beginning a lift. Reach displacement was measured as participants performed a series of maximal reach tasks under different combinations of stance width, foot orientation and trunk inclination, with their lumbar spine motion restricted. There were no interactions between any of the three postural adaptations or any effect of stance width or trunk inclination. Seventy-nine percent of participants achieved their greatest reach displacement with their feet externally rotated, which contributed to a 4 cm greater reach displacement compared to a neutral foot orientation (p < 0.001). Practitioner summary: This study examined whether aspects of initial posture could influence the ability to adhere to 'safe' lifting recommendations across a range of lift heights. As a component of lifting (re)training interventions, practitioners should consider starting lift posture adaptations (e.g. manipulating foot external rotation) to improve capacity to adhere to recommendations. [ABSTRACT FROM AUTHOR]

Background. Nowadays the use of measurement instruments that evaluate the patient's condition is very common in the orthopedic field. We know that the most distal district of the lower limb, the osteoarticular complex of the ankle, is one of the most evaluated with rating scales; in fact, there are at least 76 different scoring systems for evaluating ankle problems. Furthermore, there is no measurement tool considered to be the absolute Gold Standard for evaluating problems affecting the ankle joint. Objectives. The main aim of this study was to translate, culturally adapt, and validate in Italian language the Self-Reported Foot and Ankle Score (SEFAS). Methods. The English version of the SEFAS has been translated according to international guidelines. The measurement properties (construct validity and reliability) have been tested according to COSMIN checklists. Cronbach's α was calculated to assess the internal consistency and the Intraclass Correlation Coefficient (ICC) was calculated to estimate the reliability. The Kaiser-Meier-Olkin (KMO), The Short-Form 36 (SF-36) and the EuroQol Health Questionnaire 5 Dimensions 5 Levels (EQ-5D-5L) were used to assess the construct validity and to verify sampling adequacy. A factorial analysis was used to confirm the mono-factorial nature of the scale. Results. All the items were similar in meaning to the originals. Cronbach's α was 0,880 and the ICC was 0.869. The Pearson's Correlation Coefficient showed significant correlations (p < 0.01) between SEFAS and SF-36 and EQ-5D-5L items. Conclusions. Based on the results obtained, we suggest the use of SEFAS in daily clinical practice, also promoting its continuation in the field of scientific research. [ABSTRACT FROM AUTHOR]

"Super-shoes" are designed to improve endurance running performance by reducing the metabolic demands of running. Although the research on "super-shoes" is still developing and has mostly been studied in male runners, it is not clear how possible mediating factors, such as foot strike pattern, influence the metabolic cost and joint mechanics in competitive female runners. Purpose: The objective of this study is to assess the influence of "super-shoes" on metabolic cost and joint mechanics in competitive female runners and to understand how foot strike patter may influence the footwear effects. Methods: Eighteen competitive female runners ran four 5-min bouts on a force instrumented treadmill at 12.9 km⋅h-1 in 1) Nike Vaporfly Next% 2™(SUPER) and 2) Nike Pegasus 38™(CON) in a randomized and mirrored order. Results: Metabolic power was improved by 4.2% (P < 0.001; d = 0.43) and metatarsophalangeal (MTP) negative work (P < 0.001; d = 1.22), ankle negative work (P = 0.001; d = 0.67), and ankle positive work (P < 0.001; d = 0.97) were all smaller when running in SUPER compared with CON. There was no correlation between foot strike pattern and the between-shoe (CON to SUPER) percentage change for metabolic power (r = 0.093, P = 0.715). Conclusions: Metabolic power improved by 4.2% in "super-shoes" (but only by ~3.2% if controlling for shoe mass differences) in this cohort of competitive female runners, which is a smaller improvement than previously observed in men. The reduced mechanical demand at the MTP and ankle in "super-shoes" are consistent with previous literature and may explain or contribute to the metabolic improvements observed in "super-shoes"; however, foot strike pattern was not a moderating factor for the metabolic improvements of "super-shoes." Future studies should directly compare the metabolic response among different types of "super-shoes" between men and women. [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]

Baseball coaches often focus on the landing position of a pitcher's front foot as a key aspect of mechanics. Furthermore, controversy persists regarding positioning the rear foot on the first base or third base end of the rubber. The purpose of this study was to determine the effect of rear and front foot placement on pitching biomechanics. Our hypotheses were that there would be significant kinematic and kinetic differences associated with foot placement. This was a retrospective review including 144 healthy right-handed adult baseball pitchers divided into groups based on their rear and front foot placements: first base open (1B-Open), first base closed (1B-Closed), third base open (3B-Open), and third base closed (3B-Closed). Two-way ANOVAs detected no statistically significant main effects for kinetic variables but several for kinematic variables. Open pitchers had less shoulder abduction at the time of ball release and greater maximum shoulder internal rotation velocity in comparison with closed pitchers. They also had less forearm pronation at the time of ball release and greater maximum elbow extension velocity. Additional statistically significant results were found; however, low effect sizes may lessen the clinical significance of many of the results. [ABSTRACT FROM AUTHOR]

BACKGROUND: The intrinsic foot muscles play an important role in medial longitudinal arch support, as well as several extrinsic foot muscles. While various strength training methods specific to intrinsic foot muscles have been conducted, these exercises are associated with certain concerns regarding their effectiveness and difficulty. We developed a new exercise for the intrinsic muscles (MTP flexion exercise). OBJECTIVE: The aim was to compare the shear modulus of the toe flexors as the muscle contraction activity during MTP flexion and short-foot exercises using ultrasound shear wave elastography. METHODS: Eleven healthy participants were included in this study. The shear modulus of the toe flexor muscles was measured during MTP flexion and short-foot exercises using ultrasound shear wave elastography. The muscle shear modulus was statistically compared between the resting phase, and during the two exercises. RESULTS: The shear modulus during MTP flexion exercise was significantly greater than in the resting phase in the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, and flexor digitorum longus. The flexor digitorum longus showed greater shear modulus during MTP flexion exercise than during short-foot exercise. CONCLUSION: MTP flexion exercise showed equivalent or greater contraction activity in certain intrinsic and extrinsic foot muscles when compared with short-foot exercise. This exercise is considered one of the training options for strengthening the intrinsic muscles of the foot. [ABSTRACT FROM AUTHOR]

BACKGROUND: The association between changes occurring in the spine and lower body parts is not well understood in adolescent idiopathic scoliosis (AIS). OBJECTIVES: The first aim of the study was to investigate the association of scoliosis with lower extremity (LE) alignments, foot characteristics, and muscle strengths in adolescents. Secondly, comparisons of the data among AIS with single and double curves and control groups were determined. METHODS: Thirty-one participants were recruited and classified into 3 groups; AIS with a single curve (n = 7), AIS with double curves (n = 14), and controls (n = 10). Association of the presence of scoliosis with LE alignments (Q and TC angles), LE muscle strengths (hip, knee, and ankle), and foot characteristics (arch indexes) were examined using the point biserial correlation, and the data among three groups were compared using the ANOVA. RESULTS: Scoliosis was associated with Q angle, arch indexes, and all LE muscle strengths except for hip extensors and ankle plantar flexors strengths. Comparisons among the three groups showed significant increases in LE alignments and foot characteristics in AIS. Almost all LE muscle strengths decreased in AIS, especially for the single curve group. CONCLUSIONS: Apart from spinal deformity, the AIS has changed in LE alignments, muscle strengths, and foot characteristics. Therapists should consider these associations and alterations for designing proper management. [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]

Nonpharmacological methods are used in the management of pain and kinesiophobia following total knee arthroplasty. The aim of this double-blind randomized controlled trial was to examine the effect of foot reflexology on pain and kinesiophobia in patients following total knee arthroplasty. A total of 40 patients (20 in the control group and 20 in the intervention group) were randomly assigned to either of two groups for the study. The intervention group was exposed to foot reflexology. Postoperative Visual Analog Scale scores decreased faster in the intervention group compared to the control group (F = 80.417; p < .001; η² = 0.685). The Western Ontario and McMaster Universities Osteoarthritis Index scores decreased in the intervention group over time, while they increased in the control group (p < .05). While a gradual increase was observed in the Tampa Scale for Kinesiophobia scores in the control group, there was a decrease in the intervention group (F = 84.860; p < .001; η² = 0.696). The amount of analgesics used was lower in the intervention group (p < .05). Foot reflexology can be applied as an effective and safe method to manage pain and kinesiophobia in total knee arthroplasty patients. [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: Clinicians and researchers are beginning to pay attention to the importance of the intrinsic foot muscles (IFMs). Among IFMs, the abductor hallucis (AbH) is associated with foot disorders. However, so far no method for assessing the strength of the AbH has been established. In addition, previous studies have shown increased IFM activity in the plantarflexed position of the ankle. Therefore, this study tests the hypothesis that a correlation will be found between the cross-sectional area (CSA) of the AbH and the flexion torque and that the first metatarsophalangeal (MTP) joint would be stronger in the plantarflexed (PF) position of the ankle joint than in the neutral (N) position. Methods: Eight male and 8 female patients (16 lower limbs) were included in this study to measure the CSA of IFM and the extrinsic foot muscles of the lower leg. Furthermore, the flexion torque of the first MTP joint was measured using a handheld dynamometer at the N and PF positions of the ankle joint. Correlation analysis was performed to examine the relationship between the CSA of each muscle and the flexion torque of the first MTP joint in the N and PF positions. Results: In the N position, a correlation was found between the flexion torque of the first MTP joint and the CSA of the AbH (r = 0.818), flexor hallucis brevis (r = 0.730), and flexor hallucis longus (r = 0.726). In the PF position, a correlation was found between the flexion torque of the first MTP joint and the CSA of the AbH (r = 0.863) and flexor hallucis brevis (r = 0.680). (P <.05) Conclusion: Overall, this study suggested that by measuring flexion torque of the first MTP joint in the PF position, AbH strength can be estimated without using any expensive equipment. Level of Evidence: Level V, mechanism-baced reasoning. [ABSTRACT FROM AUTHOR]

Background: There has been increasing interest in the use of percutaneous or minimally invasive osteotomy techniques for bunionette correction. The aim of this systematic review was to investigate the clinical and radiographic outcomes following percutaneous or minimally invasive surgery for bunionette deformity correction. Methods: A systematic review following PRISMA guidelines was undertaken. All clinical studies published in MEDLINE, Embase, PubMed, and the Cochrane Library Database from inception until December 2023 reporting on the use of percutaneous or minimally invasive osteotomy techniques for bunionette deformity correction were included. The primary outcome was radiographic deformity correction. A meta-analysis of clinical and radiographic outcomes was performed to assess the mean difference following surgery. Risk of bias was assessed using the ROBINS-I tool. Results: A total of 942 potential studies were identified, of which 18 were included encompassing 714 feet in 580 patients. There were no comparative studies identified. The majority of studies (n = 14/18) used an unfixed distal osteotomy technique. All studies showed a statistically significant improvement in clinical outcomes (American Orthopaedic Foot & Ankle Society ankle-hindfoot score and visual analog scale for pain) and radiologic outcomes (fourth-fifth intermetatarsal angle and fifth metatarsophalangeal angle). Complication rates ranged from 0% to 21.4%. The nonunion rate was 0% to 5.6%. Overall risk of bias was low to moderate. The most common complication was development of a hypertrophic callus that tended to resorb over time without needing further surgical intervention. Conclusion: The results of this systematic review must be considered in light of the methodologic limitations of the studies analyzed—including additional procedures performed at the same time as the bunionette correction, lack of comparative studies, and heterogeneity of the case series included. Despite these limitations, our review suggests that percutaneous techniques for bunionette deformity correction are generally clinically safe and associated with improvement in radiographic alignment and patient-reported outcome measures. [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]

The purpose of this study was to investigate the effects of foot positioning and lean mass on jumping and landing mechanics in collegiate dancers. Thirteen dancers performed 3 unilateral and bilateral vertical jumps with feet in neutral and turnout positions. Dual-energy x-ray absorptiometry scans, jump height, vertical stiffness, and joint stiffness were assessed for relationships between foot positions. Jump heights were greater in right compared with left limb (P =.029) and neutral compared with turnout (P =.020) during unilateral jumping. In unilateral landing, knee stiffness was greater in turnout compared with neutral (P =.004) during the loading phase. Jump height (P <.001) was significantly increased, and vertical stiffness (P =.003) was significantly decreased during bilateral jumping in neutral compared with turnout. Significantly increased hip stiffness during the attenuation phase was observed in neutral compared with turnout (P =.006). Left-limb lean mass was significantly less than the right limb (P <.05). Adjustments for bilateral jumping were focused on hip stiffness, whereas there was a slight shift to knee strategy for unilateral jump. [ABSTRACT FROM AUTHOR]

Altering running cadence is commonly done to reduce the risk of running-related injury/reinjury. This study examined how altering running cadence affects joint kinetic patterns and stride-to-stride kinetic variability in uninjured female runners. Twenty-four uninjured female recreational runners ran on an instrumented treadmill with their typical running cadence and with a running cadence that was 7.5% higher and 7.5% lower than typical. Ground reaction force and kinematic data were recorded during each condition, and principal component analysis was used to capture the primary sources of variability from the sagittal plane hip, knee, and ankle moment time series. Runners exhibited a reduction in the magnitude of their knee extension moments when they increased their cadence and an increase in their knee extension moments when they lowered their cadence compared with when they ran with their typical cadence. They also exhibited greater stride-to-stride variability in the magnitude of their hip flexion moments and knee extension moments when they deviated from their typical running cadence (ie, running with either a higher or lower cadence). These differences suggest that runners could alter their cadence throughout a run in an attempt to limit overly repetitive localized tissue stresses. [ABSTRACT FROM AUTHOR]

Dual-task walking and cell phone usage, which is associated with high cognitive load and reduced situational awareness, can increase risk of a collision, a fall event, or death. The objective of this study was to quantify the effect of dual-task cell phone talking, texting, and reading while walking on spatiotemporal gait parameters; minimum foot clearance; and dynamic stability of the lower limb joints, trunk, and head. Nineteen healthy male participants walked on an instrumented treadmill at their self-selected speed as well as walking while simultaneously (1) reading on a cell phone, (2) texting, and (3) talking on a cell phone. Gait analyses were performed using an optical motion analysis system, and dynamic stability was calculated using the Maximum Lyapunov Exponent. Dual-task cell phone usage had a significant destabilizing influence on the lower limb joints during walking. Cell phone talking while walking significantly increased step width and length and decreased minimum foot clearance height (P <.05). The findings suggest that dual-task walking and cell phone conversation may present a greater risk of a fall event than texting or reading. This may be due to the requirements for more rapid information processing and cognitive demand at the expense of motor control of joint stability. [ABSTRACT FROM AUTHOR]

Multiple obstacle avoidance induces a higher potential of falls among older adults. This study attempted to add other important measurements by investigating the pressure-related gait parameters when stepping over multiple obstacles on a portable pressure-sensing walkway. Twenty-six young and 26 older participants were recruited in this study. A portable pressure-sensing Zeno walkway and cyclogram intersection point analysis method was introduced to collect both spatial–temporal and pressure-related gait parameters. Older adults significantly reduced foot integrated pressure of the leading leg when stepping over the second obstacle compared with young adults (p =.0078). A significantly larger cyclogram intersection point shift in medial–lateral direction was found in older adults than in young adults (p =.024) when stepping over the second obstacle, especially in the lateral direction. The results of this study showed that a pressure-sensing walking combined with cyclogram intersection point method could detect foot pressure distribution differences caused by aging. [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]

Experimental motion capture studies have commonly considered the foot as a single rigid body even though the foot contains 26 bones and 30 joints. Various methods have been applied to study rigid body deviations of the foot. This study compared 3 methods: distal foot power (DFP), foot power imbalance (FPI), and a 2-segment foot model to study foot power and work in the takeoff phase of standing vertical jumps. Six physically active participants each performed 6 standing vertical jumps from a starting position spanning 2 adjacent force platforms to allow ground reaction forces acting on the foot to be divided at the metatarsophalangeal (MTP) joints. Shortly after movement initiation, DFP showed a power absorption phase followed by a power generation phase. FPI followed a similar pattern with smaller power absorption and a larger power generation compared to DFP. MTP joints primarily generated power in the 2-segment model. The net foot work was –4.0 (1.0) J using DFP, 1.8 (1.1) J using FPI, and 5.1 (0.5) J with MTP. The results suggest that MTP joints are only 1 source of foot power and that differences between DFP and FPI should be further explored in jumping and other movements. [ABSTRACT FROM AUTHOR]

The step characteristics of the starting motion of international-level skeleton athletes were investigated in official races as well as the relationship between the start and finish times. The starting motion of 26 male athletes was recorded with four video cameras in Intercontinental and Europe Cups, 2018 and their starting motion was analysed by a three-dimensional direct linear transformation method. The start time showed significant correlation with the finish time (ρ = 0.87, p < 0.001), as well as the sled speed at the 4 m (ρ = −0.43, p = 0.029) and 9 m (ρ = −0.79, p < 0.001) marks. The athletes were divided into two types according to the sled position and the foot for the 1st step: ipsilateral type and contralateral type. The sled speed of the ipsilateral type athletes in the 1st step was higher than that of the contralateral-type athletes. Step length from the 2nd to 5th and 7th steps showed a significant negative correlation with the start time (ρ = −0.70 to −0.46, p = 0.001 to 0.032). The international-level skeleton athletes gained a shorter start time due to a large running speed by acquiring the large SL. [ABSTRACT FROM AUTHOR]

Purpose: The Achilles tendon consists of three subtendons with the ability to slide relative to each other. As optimal intratendinous sliding is thought to reduce the overall stress in the tendon, alterations in sliding behavior could potentially play a role in the development of Achilles tendinopathy. The aims of this study were to investigate the difference in intratendinous sliding within the Achilles tendon during isometric contractions between asymptomatic controls and patients with Achilles tendinopathy and the effect of changing the horizontal foot position on intratendinous sliding in both groups. Methods: Twenty‐nine participants (13 Achilles tendinopathy and 16 controls) performed isometric plantarflexion contractions at 60% of their maximal voluntary contraction (MVC), in toes‐neutral, and at 30% MVC in toes‐neutral, toes‐in, and toes‐out positions during which ultrasound images were recorded. Intratendinous sliding was estimated as the superficial‐to‐middle and middle‐to‐deep relative displacement. Results: Patients with Achilles tendinopathy present lower intratendinous sliding than asymptomatic controls. Regarding the horizontal foot position in both groups, the toes‐out foot position resulted in increased sliding compared with both toes‐neutral and toes‐out foot position. Conclusion: We provided evidence that patients with Achilles tendinopathy show lower intratendinous sliding than asymptomatic controls. Since intratendinous sliding is a physiological feature of the Achilles tendon, the external foot position holds promise to increase sliding in patients with Achilles tendinopathy and promote healthy tendon behavior. Future research should investigate if implementing this external foot position in rehabilitation programs stimulates sliding within the Achilles tendon and improves clinical outcome. [ABSTRACT FROM AUTHOR]

Footwear has the potential to reduce soft‐tissue vibrations (STV) but responses are highly subject‐specific. Recent evidence shows that compressive garments minimizing STV have a beneficial effect on neuromuscular (NM) fatigue. The aim was to determine whether an individualized midsole hardness can minimize STV and NM fatigue during a half marathon. Twenty experienced runners were recruited for three visits: a familiarization session including the identification of midsole minimizing and maximizing STV amplitude (MIN and MAX, respectively), and two half marathon sessions at 95% of speed at the second ventilatory threshold. STV of the gastrocnemius medialis (GM) muscle, running kinetics, foot strike pattern, rating perceived exhaustion (RPE), and midsole liking were recorded every 3 km. NM fatigue was assessed on plantar flexors (PF) before (PRE) and after (POST) the half marathon. At POST, PF central and peripheral alterations and changes in contact time, step frequency, STV median frequency, and impact force frequency as well as foot strike pattern were found in both MIN and MAX. No significant differences in damping, STV main frequency, flight time, duty factor, and loading rate were observed between conditions whatever the time period. During the half marathon, STV amplitude of GM significantly increased over time for the MAX condition (+13.3%) only. Differences between MIN and MAX were identified for RPE and midsole liking. It could be hypothesized that, while significant, the effect of midsole hardness on STV is too low to substantially affect NM fatigue. [ABSTRACT FROM AUTHOR]

The article focuses on enhancing awareness and care of feet through somatic movement practices, highlighting their importance as the foundation of body movement and overall health. Topics include the benefits of somatic practices like Nia and Feldenkrais for strengthening and connecting with the feet, addressing common foot problems, and advocating for integrating foot health into fitness training to improve balance and well-being.