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Objective: To compare the efficacy of extracorporeal shock waves versus corticosteroids injections on pain, thickness of plantar fascia and foot function in patients with plantar fasciitis. Secondarily, to assess the efficacy of radial and focused extracorporeal shock waves and the most appropriated intensity (high, medium or low). Data sources: PubMed, SCOPUS, CINAHL and PEDro, until April 2024, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Review methods: Randomized controlled trials comparing the efficacy of extracorporeal shock waves versus corticosteroids injections on pain intensity and sensitivity, thickness of plantar fascia and foot function in patients with plantar fasciitis. Methodological quality and risk of bias were assessed using PEDro Scale and Cochrane Risk of Bias Tool. Pooled effect was calculated using the standardized mean difference (SMD) and its 95% confidence interval (95%CI). Results: Sixteen studies involving 1121 patients, showing a mean of 6 points in PEDro scale, were included. At three months, extracorporeal shock waves were better than corticosteroids injections in reducing pain (SMD −0.6; 95%CI −1.1 to −0.11) and thickness of the plantar fascia (SMD −0.4; 95%CI −0.8 to −0.01) and increasing foot function (SMD 0.27; 95%CI 0.12–0.44). At six months, extracorporeal shock waves are more effective in reducing pain (SMD −0.81; 95%CI −1.6 to −0.06) and increasing foot function (SMD 0.67; 95%CI 0.45–0.89). Local pain and slight erythema were the most frequent adverse events. Conclusions: Extracorporeal shock waves are a safe therapy, presenting more efficacy than corticosteroids injections in improving pain, thickness of plantar fascia and foot function at mid-term. [ABSTRACT FROM AUTHOR]

Introduction: Plantar fasciitis is the most common cause of heel and foot pain, leading individuals to use compensatory techniques to alleviate their pain, resulting in an antalgic gait. These compensations alter the feeling of joint position and muscle activation, making it challenging to maintain an upright posture within the base of support. According to Mulligan's concept, rigid tape allows painful or restricted movements with quick pain relief and increased range of motion while correcting positional faults and reducing tensile tension on the fascia, thereby decreasing inflammation and microscopic tears. Currently, there is a scarcity of data studying the effect of Mulligan’s calcaneal taping on dynamic balance. Aim: To evaluate the effect of Mulligan’s calcaneal taping on dynamic balance and functional performance in subjects with plantar fasciitis. Materials and Methods: The study was a prospective cohort study conducted at D.Y. Patil Hospital and Research Centre, Navi Mumbai, Maharashtra, India. It began in March 2023 and concluded in March 2024, spanning one year. Thirty-six subjects were randomly divided into group A (n=18) and group B (n=18). Subjects experiencing pain for more than six weeks, aged between 18-60 years, with a positive Windlass test, plantar medial heel pain, and abnormal foot posture index (between +6 to +9) were included in the study. The experimental group received Mulligan’s calcaneal taping along with conventional physiotherapy exercises, while the control group received only conventional physiotherapy exercises. Pre-post assessments were conducted using the star excursion balance test for dynamic balance assessment and the Foot Function Index (FFI) for functional performance. Results: Statistically significant differences were found among the medial (p-value=0.0212), posteromedial (p-value=0.0199), and posterior (p-value=0.0091) directions of the star excursion balance test. Both groups did not show statistically significant differences in the FFI score. However, with effect size, there was good clinical significance for the FFI score and all directions of the star excursion balance test except the posterolateral direction. Conclusion: Mulligan calcaneal taping has been shown to be more effective in improving dynamic balance in subjects with plantar fasciitis.

Objective：To explore the characteristics of arch function in patients with flexible flat foot by comparing the differences of static and dynamic arch function between normal and flexible flat foot patients, provide theoretical reference for the functional distinction of different types of foot arch. Method：Thirty adult male subjects were recruited. Normal and flat feet were distinguished by foot printing method, and flexible flat feet were screened by heel raising test and passive toe raising test. Sixteen normal feet and fourteen patients with flexible flat feet were screened. Static arch stiffness was calculated by the difference of arch height between natural standing and sitting at different loading positions, and the relative arch height at the beginning of the middle support period, change value of relative arch height, change rate of relative arch height and proportion of middle foot impulse during walking were evaluated by 3D motion capture and plantar pressure. The correlation between static arch stiffness and dynamic arch function was analyzed by partial correlation(controlling step speed). Result：The static arch stiffness of flexible flat feet was lower than that of normal feet (P<0.05). The results of dynamic arch function test showed that the relative height and change rate of arch height in the middle of walking support decreased gradually in both normal and flexible flat feet, the change value and change rate of arch height in flexible flat feet at the beginning of the middle of walking support period were lower than those in normal feet (P<0.05). The proportion of impulse of flexible flat feet in walking support was higher than that of normal feet (P<0.05). Partial correlation analysis showed that the relative height, relative height change value and relative height change rate at the beginning of middle support were positively correlated with static arch stiffness (r=0.580—0.679, P<0.05), the proportion of middle foot impulse was negatively correlated with static arch stiffness(r=﹣0.478, P<0.05). Conclusion：During walking, the arch of the foot continued to decline in the middle of support, and the rate of decline gradually decreased. The adaptability of static and dynamic arches to loading in patients with flexible flat feet was lower than that of normal feet. It is the key of ankle rehabilitation to improve the weight bearing adaptability of arch in patients with flexible flat foot. Arch stiffness is correlated with dynamic arch function, which is an important reference value for the functional division of different types of foot arch. [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]

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The prevalence of impaired foot function and floating toes of 91 baseball players with disabled throwing shoulder or elbow were retrospectively investigated. Foot function was evaluated by foot "rock paper scissors" and floating toes were confirmed if none of the toes made contact with the mat in standing posture. The prevalence of impaired foot function and floating toes and the relationship between between them were determined. Abnormal foot function was observed in 83 players (91%); of those, 73 players (88%) also had floating toes, and the prevalence was statistically significant compared to those without it (12%) (P < 0.001). Floating toes were observed in 74 players (81%); of those, 73 players (99%) had impaired foot function, and the prevalence was also statistically significant compared to those without them (59%) (P < 0.001). Baseball players with disabled throwing shoulder or elbow have high rates of impaired foot function and floating toes. [ABSTRACT FROM AUTHOR]

Friction blisters are formed by abrasion from frictional forces on the upper layer of the epidermis and can make physical activity an uncomfortable experience. To our knowledge, no previous studies have considered how these injuries affect the functionality of the foot. For this reason, the main aim of this study was to evaluate foot function in hikers, with or without blisters. This case-control study examined 298 hikers who walked the Camino de Santiago long-distance trail (in northern Spain); 207 had one or more blistering foot lesions and 91 had no blisters. Sociodemographic and clinical variables were collected, and the number of blisters and their locations on the foot were recorded. All participants self-completed the Foot Function Index (FFI) questionnaire, in their native language. Pain and disability were significantly greater among the hikers with blisters (pain p=<0.001; disability p = 0.015). However, there were no significant differences in the limitation of physical activity between those with blisters (case group) and the control group (p = 0.144). Neither was there any correlation between the number of blisters and pain, disability or limitation of activity. However, the location of the lesion did influence foot functionality. Blisters on the metatarsal heads were more limiting and caused greater pain (right foot p = 0.009; left foot p = 0.017), greater disability (right foot p = 0.005; left foot p = 0.005), greater limitation of activity (on right foot p = 0.012) and more loss of foot functionality (right foot p = 0.002; left foot p = 0.007). The hikers with blisters experienced reduced foot functionality in terms of pain and disability. The number of blisters was not related to foot functionality. Blisters located on the metatarsal heads caused the greatest increase in pain, disability and limitation of activity. • Hikers with blisters experience reduced foot functionality in terms of pain and disability. • Blisters located on the metatarsal heads cause further increase in pain, disability and limitation of activity. • The number of blisters was not related to the functionality of the foot. [ABSTRACT FROM AUTHOR]

Introduction: Plantar Fasciitis (PF) is the most frequent musculoskeletal condition that primarily affects the foot, causing tenderness and disturbed foot function. Need of the Study: The planned clinical trial will proceed with the aim of ensuring that the intervention is accessible to the general public, irrespective of the outcomes. This study will help in exploring the effect of HILT, KT and plantar-fascia stretching and to add this method as adjunct to conventional physiotherapy approach in plantar fasciitis sufferers. Aim: To evaluate the effect of combination of {High-Intensity Light Amplification by Stimulated Emission of Radiation (LASER) Therapy HILT)} with Kinesio-taping (KT), and plantar-fascia stretching in improving pain pressure threshold and foot function in individuals suffering from PF. Materials and Methods: A single-blinded randomised clinical trial design will be employed to enroll both male and female participants aged >18 years, with plantar heel pain lasting more than 4 weeks and will be randomly divided into two groups. The experimental group will receive HILT along with KT using the low-dye taping technique, while the comparator group will receive HILT along with plantar-fascia stretching. A power analysis will be conducted to determine the appropriate sample size based on the findings of a pilot study. Outcome measures will include pressure algometry to assess pressure pain threshold and the foot function index to evaluate disability. The study outcomes could either indicate a meaningful difference between the groups or not. This will confirm the practical relevance of the intervention for individuals suffering from plantar fasciitis. [ABSTRACT FROM AUTHOR]

Context: Pes planus is a prevalent chronic condition that causes foot pain, disability, and impaired plantar load distribution. Short-foot exercises are often recommended to strengthen intrinsic foot muscles and to prevent excessive decrease of medial longitudinal arch height. Objective: To investigate the effects of short-foot exercises on navicular drop, foot posture, pain, disability, and plantar pressures in pes planus. Design: Quasi-experimental study. Setting: Biomechanics laboratory. Participants: A total of 41 participants with pes planus were assigned to the short-foot exercises group (n = 21) or the control group (n = 20). Intervention: Both groups were informed about pes planus, usual foot care, and appropriate footwear. Short-foot exercises group performed the exercises daily for 6 weeks. Main Outcome Measures: Navicular drop, Foot Posture Index, foot pain, disability, and plantar pressures were assessed at the baseline and at the end of 6 weeks. Results: Navicular drop, Foot Posture Index, pain, and disability scores were significantly decreased; maximum plantar force of midfoot was significantly increased in short-foot exercises group over 6 weeks (P <.05). No significant differences were determined between the baseline and the sixth week outcomes in control group (P >.05). Conclusions: Six-week short-foot exercises provided a reduction in navicular drop, foot pronation, foot pain, and disability and increment in plantar force of medial midfoot in pes planus. [ABSTRACT FROM AUTHOR]

Purpose: The most popular surgical approach to manage Lisfranc fracture-dislocations is the double-incision approach, which frequently causes a variety of complications, such as skin necrosis, rotational malreduction of the first tarsometatarsal joint (TMTJ) and lateral column dorsoplantar malreduction of the TMTJ. We introduce a three-incision approach to treat Lisfranc fracture-dislocations with only minor postoperative complications and good foot function. Methods: We prospectively selected 30 previously healthy patients, ranging from 18 to 60 years of age, but only 23 patients completed the follow-up and thus were finally included, with an average age of 38.1 ± 12.9 years. All patients have sustained Lisfranc fracture-dislocations involving all three-column; 13.0% (3/23) were Myerson classification type A (medial), 47.8% (11/23) were type A (lateral), and 39.1% (9/23) were type C2. All patients were treated via a three-incision approach: a long incision made along the lateral border of the second ray was used as a working incision to visualize and reduce the first three TMTJs, as well as to apply internal fixation instrumentation; a 2 cm medial incision was made at the medial side of the first TMTJ as an inspecting incision, ensuring good reduction of the first TMTJ in medial and plantar view; another 1 cm inspecting incision was made at the dorsal side of the fourth/fifth TMTJ to prevent sagittal subluxation of the lateral column. Mean ± SD was used for quantitative data such as operation time, follow-up time and foot function scores. Postoperative complications were documented, and foot function was evaluated using the American orthopaedic foot & ankle society score, foot function index and Maryland foot score at follow-up. The foot function of the injured foot and contralateral foot of the same patient was at the end of follow-up, and independent sample t-test was used for statistical analysis. Results: The median operation time was 117.9 ± 14.6 min (range 93 - 142 min). All complications occurred within three months after the operation, and included delayed wound healing (17.4%), superficial infection (8.7%), complex regional pain syndrome (4.3%) and neuroma (4.3%). There was no case of postoperative skin necrosis or malreduction. At the end of follow-up of 14.1 ± 1.2 months (range 12–16 months), the median American orthopaedic foot & ankle society score of the operated foot was 89.7 ± 5.7, the median foot function index was 21.7 ± 9.9, and the median Maryland foot score was 88.7 ± 4.8. There were no significant differences between the operated and contralateral sides, in terms of foot function, at the end of followup (p > 0.05). Conclusion: The three-incision approach can provide adequate visualization of all TMTJs to ensure anatomical reduction and offer sufficient working space to apply internal fixation instrumentation, which is effective in treating three-column Lisfranc fracture-dislocations with minor soft tissue complications and satisfactory functional recovery.

BACKGROUND: Plantar fasciitis (PF) is a common condition amongst athletes as well as in non-sporting population. It is characterised by a sharp pain under the calcaneus during walking. The impact of pain due to PF on gait and static balance is examined in this observational study. OBJECTIVE: To compare gait and balance between individuals with PF and age-matched controls without PF. METHOD: A cross-sectional observational study was executed in an Outpatient Rehabilitation Centre. Twenty-nine participants were included, 14 with PF, and 15 age-matched healthy asymptomatic individuals. Main outcome measures were foot pain, foot function index (FFI), static balance measured with modified Romberg test, static balance measured on the TYMO ® system, and gait with the G-Walk System. RESULTS: Foot pain and FFI were adversely related to balance and gait parameters in subjects with PF. Static balance with eyes open and eyes closed on firm and soft surface measured on the TYMO ® balance platform as well as gait parameters measured with the G-Walk system, were significantly lower in subjects with PF compared to age-matched healthy controls. CONCLUSION: PF negatively affects parameters of static balance measured with TYMO ® system and gait parameters measured with the G-Walk System. However, the Romberg balance test did not detect differences between subjects with PF and age-matched healthy controls. [ABSTRACT FROM AUTHOR]

Abstract Introduction Foot involvement is a significant concern in psoriatic arthritis (PsA) as it can lead to severe levels of foot pain and disability and reduced mobility and quality of life. Previous studies have shown moderate efficacy for custom-made foot orthoses (CFO) in reducing foot pain and disability in people with rheumatoid arthritis. However, evidence on the efficacy of CFO in people with PsA is lacking. Objectives To explore the effects of CFO on foot function, foot and lower limb pain, gait function, and free-living walking activities (FWA) in people with PsA. Methods A pre-experimental study including twenty participants with PsA (mean age: 54.10 ± 9.06 years and disease duration: 11.53 ± 10.22 years) was carried out. All the participants received and wore CFO for 7 weeks. Foot and lower limb pain and foot function were measured before and after the intervention using the numerical rating scale (NRS) and the foot function index (FFI). Gait function was assessed by recording spatiotemporal parameters (STPs) during a 10-m walk test using an instrumented gait analysis system (Mobility Lab). Free-living walking activities (step count, free-living cadence, time spent in different ambulatory physical activities (APA)) were recorded over 7 days using an accelerometer-instrumented sock. Results The FFI reported scores demonstrated severe baseline levels of foot pain (54.46 ± 14.58 %) and disability (46.65 ± 16.14%). Statistically and clinically significant improvements in foot pain and foot function and large effect sizes (Cohen’s effect size > 1, p < 0.005) were observed after the intervention period. A strong correlation (r = −0.64, p < 0.01) between the CFO wearing time and foot function was demonstrated. However, no significant changes were found for gait STP or free-living walking activities after 7 weeks of CFO use. Conclusion Results support the clinical and biomechanical plausibility of using CFO in people with PsA to reduce pain and improve foot function. Large-scale and controlled studies are needed to confirm these findings. Moreover, a multidisciplinary approach including the prescription of exercise therapy and physiotherapy combined with CFO could be required to improve STP and promote APA in people with PsA. Trial registration ClinicalTrials.gov , NCT05075343 . Retrospectively registered on September 29, 2021

BACKGROUND: Walking is the most basic movement mode of the human, exploring the stress characteristics of the foot and the difference between the feet during walking is of great value to deeply understand the law of human walking. OBJECTIVE: To explore the foot function and walking law of human body in each stage of gait support through the processing and analysis of foot balance curve. METHODS: 116 subjects with normal foot type were selected by foot type and walked at their own optimal speed to record their plantar pressure data. A foot balance curve was drawn with average value and 1 times standard deviation. The curve rules and eigenvalues of dominant and non-dominant lateral feet were analyzed. RESULTS AND CONCLUSION: (1) During the walking support period, the force characteristics of the foot on the horizontal side constantly changed. From initial contact phase to forefoot contact phase, the foot stabilized its posture through the force migration. (2) In foot flat phase, the plantar force shifted to the outside. In forefoot push off phase, the plantar force shifted from outside to inside and the human body balanced through bipedal support. (3) There was no significant difference in the relative duration of initial contact phase, forefoot contact phase, foot flat phase, and forefoot push off phase between the dominant foot and the non-dominant foot (P > 0.05). (4) The characteristic similarity of the bilateral foot balance curve was highly consistent and the foot balance curve of the dominant side was lower than that of the non-dominant side (P < 0.05). (5) It is concluded that the changes of foot posture and foot function during human walking are reflected by the foot balance curve. The function of human feet is the same at all stages of the gait cycle, and the force acting on the dominant side is more lateral than that of the non-dominant side, and the pedal and extension function is more fully performed on the horizontal axis. The foot balance curve has an important reference value for the study of human walking law and the evaluation of foot function. [ABSTRACT FROM AUTHOR]

Purpose: The most popular surgical approach to manage Lisfranc fracture-dislocations is the double-incision approach, which frequently causes a variety of complications, such as skin necrosis, rotational malreduction of the first tarsometatarsal joint (TMTJ) and lateral column dorsoplantar malreduction of the TMTJ. We introduce a three-incision approach to treat Lisfranc fracture-dislocations with only minor postoperative complications and good foot function.Methods: We prospectively selected 30 previously healthy patients, ranging from 18 to 60 years of age, but only 23 patients completed the follow-up and thus were finally included, with an average age of 38.1 ± 12.9 years. All patients have sustained Lisfranc fracture-dislocations involving all three-column; 13.0% (3/23) were Myerson classification type A (medial), 47.8% (11/23) were type A (lateral), and 39.1% (9/23) were type C2. All patients were treated via a three-incision approach: a long incision made along the lateral border of the second ray was used as a working incision to visualize and reduce the first three TMTJs, as well as to apply internal fixation instrumentation; a 2 cm medial incision was made at the medial side of the first TMTJ as an inspecting incision, ensuring good reduction of the first TMTJ in medial and plantar view; another 1 cm inspecting incision was made at the dorsal side of the fourth/fifth TMTJ to prevent sagittal subluxation of the lateral column. Mean ± SD was used for quantitative data such as operation time, follow-up time and foot function scores. Postoperative complications were documented, and foot function was evaluated using the American orthopaedic foot & ankle society score, foot function index and Maryland foot score at follow-up. The foot function of the injured foot and contralateral foot of the same patient was at the end of follow-up, and independent sample t-test was used for statistical analysis.Results: The median operation time was 117.9 ± 14.6 min (range 93 - 142 min). All complications occurred within three months after the operation, and included delayed wound healing (17.4%), superficial infection (8.7%), complex regional pain syndrome (4.3%) and neuroma (4.3%). There was no case of postoperative skin necrosis or malreduction. At the end of follow-up of 14.1 ± 1.2 months (range 12-16 months), the median American orthopaedic foot & ankle society score of the operated foot was 89.7 ± 5.7, the median foot function index was 21.7 ± 9.9, and the median Maryland foot score was 88.7 ± 4.8. There were no significant differences between the operated and contralateral sides, in terms of foot function, at the end of followup (p > 0.05).Conclusion: The three-incision approach can provide adequate visualization of all TMTJs to ensure anatomical reduction and offer sufficient working space to apply internal fixation instrumentation, which is effective in treating three-column Lisfranc fracture-dislocations with minor soft tissue complications and satisfactory functional recovery. [ABSTRACT FROM AUTHOR]

Background: Arthrogryposis multiplex congenita (AMC) is one of the causes of rigid and resistant clubfoot. Talectomy is considered as a primary or salvage procedure for recurrent equinovarus deformity in these patients. We conducted this study to assess patients with AMC who underwent talectomy for the correction of foot and ankle deformities in terms of health-related quality of life and disability. Methods: Patients under 10 years of age with a primary diagnosis of AMC who underwent talectomy and attended follow-up for at least 5 years were included in this study. We also formed an age- and gender-matched control group consisting of 20 individuals without any foot-ankle problem in order to compare the measurements between the AMC and healthy groups. Oxford Ankle Foot Questionnaire (OxAFQ) was administered as a health-related quality of life instrument to objectively measure the disability of the pediatric patients. Results: Twenty patients (10 girls, 10 boys) who underwent a total of 35 talectomy operations with an average follow-up of 7.2 years and a control group of 20 similarly aged unaffected children were included in the study. The mean OxAFQ scores were significantly lower in the AMC group than in the controls for all domains (physical, emotional, and school and play), especially for the one concerning satisfaction with footwear The presence of plantigrade foot and absence of forefoot supination were significantly associated with the physical and footwear domains of the OxAFQ scores. The presence of hindfoot varus, midfoot adductus, dorsal bunion, and having less than 10 degrees of dorsiflexion had no effect on the OxAFQ scores. Conclusion: In this study, we found that the major driving factors for satisfaction after talectomy for AMC were plantigrade foot and absence of forefoot supination. The mean OxAFQ scores were universally lower in the AMC group than controls. Finding comfortable footwear is a major concern for the AMC patients. Level of Evidence: Level III, retrospective cohort study. [ABSTRACT FROM AUTHOR]

Background: The biomechanical complexity of children's feet changes throughout childhood, yet kinematic development of the feet is poorly understood. Further work exploring the kinematic profile of children's feet would be beneficial to help inform our understanding of the typical development of children's feet.Research Question: Do three-dimensional segmental kinematics of the feet during gait relate to age in a sample of children age 7-11 years?Methods: This study was a secondary analysis of an existing database representing one hundred and twenty-one children age 7 - 11 years (90 male, 31 female; mean ± SD: age 9.57 ± , 1.17 years, height 1.37 ± 0.08 m, body mass 35.61 ± 9.33 kg). Fifteen, 9 mm retroreflective markers were attached to the right shank and foot of each participant in, line with the 3DFoot model. Multi-segmental joint kinematics were collected during barefoot walking. Sagittal, frontal, and transverse planar motion was described for the shank-calcaneus, calcaneus-midfoot, and midfoot-metatarsals segment of the right foot. Principal component analysis (PCA) was used to reduce the major modes of variation in the data to fully explore foot segment motion over the entire gait cycle. Correlations and multiple regression between PCA outputs with age, and potential confounding factors are presented.Results: Significant positive correlations were found between age and greater calcaneus, dorsiflexion, midfoot inversion and adduction, and metatarsal dorsiflexion, plantarflexion and abduction. There were no significant confounding effects of height, body mass, walking speed or gender on the relationships between age and PCA outputs.Significance: The findings from this study demonstrated a relationship between foot kinematics and age suggesting that the development of foot kinematics is ongoing until at least the age of 11 years. This work offers a comprehensive data set of inter-segmental kinematics which helps to advance understanding of the development of the pediatric foot. [ABSTRACT FROM AUTHOR]

Background. Foot problems may have a substantial negative impact on rheumatoid arthritis (RA) patients' mobility. They affect walking and the functional capacity to perform daily tasks. Methods. This study included 61 patients with RA and foot pain or swelling. The study group comprised 37 patients (aged 54.3 ± 9.5 years) with foot lesions, as demonstrated in an ultrasound, and the control group comprised 24 patients (aged 57.3 ± 11.5 years) without foot lesions. The patients' health statuses were evaluated with the Foot Function Index-Revised Short Form (FFI-RS), the Polish version of the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the Disease Activity Score 28 (DAS 28). Results. The FFI-RS showed significant differences between the study and control groups in total results, as well as in the pain and stiffness subscales. Subsequent analyses showed numerous significant correlations. The FFI-RS total results correlated with the HAQ's standing up, walking, and total results. The FFI-RS pain results correlated with the social issues and HAQ's total results. The FFI-RS difficulty results correlated with the disease's duration. In the study group, there were significant correlations of the FFI-RS stiffness, difficulty, and social issues results with the HAQ's standing up, walking, and total results, and also of the FFI-RS activity limitation results with the HAQ's standing up results. In the control group, there were correlations of the FFI-RS stiffness, difficulty, and activity limitation results with the HAQ's walking and total results. Finally, in the study group, we also found correlations of the FFI-RS total, pain, stiffness, difficulty, and social issues results with the Visual Analog Scale (VAS) results, as well as of the FFI-RS total results with the DAS 28 results. Conclusions. The FFI-RS is an effective tool for assessing RA patients' functional status and can be used to evaluate treatment effects. The FFI-RS detected RA-related changes in the foot joint function in patients without foot lesions, as assessed by ultrasound. [ABSTRACT FROM AUTHOR]

The efficacy and safety of extracorporeal shock wave therapy (ESWT) on chronic plantar fasciitis (PF) in patients with axial spondyloarthritis (axSpA) remain unclear. To investigate the efficacy and tolerability of ESWT in patients with PF in axSpA. In this double-blind, randomized controlled trial, 22 axSpA patients with PF who had heel pain above 5 according to visual analog scale (VAS) over 3 months were randomly divided into 2 groups: ESWT and sham-ESWT. Both groups received a total of three treatments at 1-week intervals. All patients were assessed by the VAS, heel pressure algometry, Foot Function Index (FFI), and plantar fascia ultrasonography (thickness and morphology) at baseline, 1 week after each session, 4th and 8th week after the last therapy. The mean ± SD ages of the ESWT and sham-ESWT groups were 43.8 ± 8.2 and 48.5 ± 7.6 years, respectively. Significant time effects between the time points were observed in both groups in terms of VAS, pressure algometry, and FFI. There was a statistically significant decrease in pain, an increase in perceived pressure algometry values, and an improvement in activity restriction in the ESWT group compared to the sham-ESWT group. There was not a change in the plantar fascia thickness before and after the intervention in both groups. No side effects were observed during the treatment and follow-up. ESWT appears to be a safe and well-tolerated physical therapy modality for improving chronic refractory heel pain due to PF in patients with axSPA. This trial was registered to The Australian New Zealand clinical trial with the registration number ACTRN12618001954213. The enrollment began in 15/12/2018 and data collection stopped in 29/05/2020. [ABSTRACT FROM AUTHOR]

Background: Foot involvement is a major manifestation of psoriatic arthritis (PsA) and can lead to severe levels of foot pain and disability and impaired functional mobility and quality of life. Gait spatiotemporal parameters (STPs) and gait variability, used as a clinical index of gait stability, have been associated with several adverse health outcomes, including risk of falling, functional decline, and mortality in a wide range of populations. Previous studies showed some alterations in STPs in people with PsA. However, gait variability and the relationships between STPs, gait variability and self-reported foot pain and disability have never been studied in these populations. Body-worn inertial measurement units (IMUs) are gaining interest in measuring gait parameters in clinical settings. Objectives: To assess STPs and gait variability in people with PsA using IMUs, to explore their relationship with self-reported foot pain and function and to investigate the feasibility of using IMUs to discriminate patient groups based on gait speed-critical values. Methods: Twenty-one participants with PsA (age: 53.9 ± 8.9 yrs.; median disease duration: 6 yrs) and 21 age- and sex-matched healthy participants (age 54.23 ± 9.3 yrs) were recruited. All the participants performed three 10-m walk test trials at their comfortable speed. STPs and gait variability were recorded and calculated using six body-worn IMUs and Mobility Lab software (APDM®). Foot pain and disability were assessed in participants with PsA using the foot function index (FFI). Results: Cadence, gait speed, stride length, and swing phase were significantly lower, while double support was significantly higher, in the PsA group (p < 0.006). Strong correlations between STPs and the FFI total score were demonstrated (|r| > 0.57, p < 0.006). Gait variability was significantly increased in the PsA group, but it was not correlated with foot pain or function (p < 0.006). Using the IMUs, three subgroups of participants with PsA with clinically meaningful differences in self-reported foot pain and disability were discriminated. Conclusion: STPs were significantly altered in participants with PsA, which could be associated with self-reported foot pain and disability. Future studies are required to confirm the increased gait variability highlighted in this study and its potential underlying causes. Using IMUs has been useful to objectively assess foot function in people with PsA. Trial registration: ClinicalTrials.gov, NCT05075343, Retrospectively registered on 29 September 2021. [ABSTRACT FROM AUTHOR]

To explore the effect of acellular dermal matrix therapy on neuropathy and foot function in patients with diabetic foot syndrome and lower extremity arteriosclerosis occlusion. The 80 patients with diabetic foot syndrome and arteriosclerosis occlusion of the lower extremities who were admitted to our hospital from May 2017 to May 2020 were divided into two groups, observation group and control group. Patients in the control group were given conventional intervention combined with intracavitary treatment of lower extremity arteries, while the observation group was given acellular dermal matrix treatment on the basis of the control group. The differences of TCSs score, nerve conduction velocity, foot function, treatment effect, wound infection rate, treatment cost and complication rate between the two groups before and after treatment were analyzed. After treatment, TCSS score and foot function score of observation group were lower than control group, and nerve conduction velocity was faster than control group, the difference was statistically significant (P<0.05). The total effective rate, the incidence of wound infection and the incidence of complications in the observation group were 100.00%, 2.50% and 2.50%, respectively, while those in the control group were 80.00%, 17.50% and 55.00%, respectively. The hospitalization cost in the control group was higher than that in the observation group, with statistical significance (P<0.05). Acellular dermal matrix therapy has a definite relieving effect on neuropathy in patients with diabetic foot syndrome combined with lower extremity arteriosclerosis occlusion, especially on the function of the foot, and it is worthy of widespread clinical use. [ABSTRACT FROM AUTHOR]

Abstract Background Foot involvement is a major manifestation of psoriatic arthritis (PsA) and can lead to severe levels of foot pain and disability and impaired functional mobility and quality of life. Gait spatiotemporal parameters (STPs) and gait variability, used as a clinical index of gait stability, have been associated with several adverse health outcomes, including risk of falling, functional decline, and mortality in a wide range of populations. Previous studies showed some alterations in STPs in people with PsA. However, gait variability and the relationships between STPs, gait variability and self‐reported foot pain and disability have never been studied in these populations. Body‐worn inertial measurement units (IMUs) are gaining interest in measuring gait parameters in clinical settings. Objectives To assess STPs and gait variability in people with PsA using IMUs, to explore their relationship with self‐reported foot pain and function and to investigate the feasibility of using IMUs to discriminate patient groups based on gait speed‐critical values. Methods Twenty‐one participants with PsA (age: 53.9 ± 8.9 yrs.; median disease duration: 6 yrs) and 21 age‐ and sex‐matched healthy participants (age 54.23 ± 9.3 yrs) were recruited. All the participants performed three 10‐m walk test trials at their comfortable speed. STPs and gait variability were recorded and calculated using six body‐worn IMUs and Mobility Lab software (APDM®). Foot pain and disability were assessed in participants with PsA using the foot function index (FFI). Results Cadence, gait speed, stride length, and swing phase were significantly lower, while double support was significantly higher, in the PsA group (p 0.57, p

The interaction among joints of the midtarsal complex and subtalar joint is important for locomotor function; however, its complexity poses substantial challenges in quantifying the joints' motions. We determine the mobility of these joints across locomotion tasks and investigate the influence of individual talus morphology on their motion. Using highly accurate biplanar videoradiography, three-dimensional bone kinematics were captured during walking, running and hopping. We calculated the axis of rotation of the midtarsal complex and subtalar joint for the landing and push-off phases. A comparison was made between these rotation axes and the morphological subtalar axis. Measurement included total rotation about and the orientation of the rotation axes in the direction of the subtalar joint and its deviation via spatial angles for both phases. The rotation axes of all three bones relative to the talus closely align with the morphological subtalar axis. This suggests that the midtarsal and subtalar joints' motions might be described by one commonly oriented axis. Despite having such an axis, the location of the axes and ranges of motion differed among the bones. Our results provide a novel perspective of healthy foot function across different sagittal plane-dominant locomotion tasks underscoring the importance of quantifying midtarsal complex and subtalar motion while accounting for an individual's talus morphology.

BACKGROUND: The abnormal foot structure affects the cushioning, power and energy storage of the foot. Studies have shown that the biomechanical evaluation methods of foot structure and foot function have certain reference value for distinguishing asymptomatic abnormal foot types. OBJECTIVE: To explore the biomechanical indexes of the foot structure and function and to classify them. METHODS: A search of CNKI, Baidu Scholar, Baichain Scholar, PudMed, SpringeLink, and Nature was performed using the search terms of “foot structure, foot function,” “plantar pressure, pressure center trajectory,” “foot arch, transverse arch,” “gait,” in Chinese as well as “foot function,” “center of pressure,” “flatfoot,” “arch index” in English for relevant documents published from January 1993 to May 2020. We explored the testing methods for foot structure and the biomechanical evaluation methods for foot function from static and dynamic aspects in combination with the mechanical characteristics of the foot. RESULTS AND CONCLUSION: For the static evaluation of foot function, the turnover index and stiffness of the ankle joint are used to evaluate the structure and function of the ankle joint; the angle between the heelpiece and the crus and the medial longitudinal arch angle are used to evaluate the heel structure and function; the arch height index and arch height adaptability are used to evaluate the function of the foot arch; toe adaptability is used to evaluate the function of the thumb under external torque; the static function of the foot is systematically evaluated in combination with the scoring system of the foot posture index. In terms of dynamic kinematics, the dynamic foot function is evaluated based on arch index, pressure center trajectory and foot turnover index. [ABSTRACT FROM AUTHOR]

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Background. Foot problems may have a substantial negative impact on rheumatoid arthritis (RA) patients’ mobility. They affect walking and the functional capacity to perform daily tasks. Methods. This study included 61 patients with RA and foot pain or swelling. The study group comprised 37 patients (aged 54.3 ± 9.5 years) with foot lesions, as demonstrated in an ultrasound, and the control group comprised 24 patients (aged 57.3 ± 11.5 years) without foot lesions. The patients’ health statuses were evaluated with the Foot Function Index-Revised Short Form (FFI-RS), the Polish version of the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the Disease Activity Score 28 (DAS 28). Results. The FFI-RS showed significant differences between the study and control groups in total results, as well as in the pain and stiffness subscales. Subsequent analyses showed numerous significant correlations. The FFI-RS total results correlated with the HAQ’s standing up, walking, and total results. The FFI-RS pain results correlated with the social issues and HAQ’s total results. The FFI-RS difficulty results correlated with the disease’s duration. In the study group, there were significant correlations of the FFI-RS stiffness, difficulty, and social issues results with the HAQ’s standing up, walking, and total results, and also of the FFI-RS activity limitation results with the HAQ’s standing up results. In the control group, there were correlations of the FFI-RS stiffness, difficulty, and activity limitation results with the HAQ’s walking and total results. Finally, in the study group, we also found correlations of the FFI-RS total, pain, stiffness, difficulty, and social issues results with the Visual Analog Scale (VAS) results, as well as of the FFI-RS total results with the DAS 28 results. Conclusions. The FFI-RS is an effective tool for assessing RA patients’ functional status and can be used to evaluate treatment effects. The FFI-RS detected RA-related changes in the foot joint function in patients without foot lesions, as assessed by ultrasound.

Introduction: This study aimed to investigate the foot function, range of motion, plantar pressure, and plantar contact area in the distance runners with normal, pronated, highly-pronated, supinated, and highly-supinated foot posture groups during static standing. Materials and Methods: In this comparative cross-sectional study, a total of 75 distance runners were divided into 5 groups using the foot posture index. The foot function and knee and foot range of motion were assessed using the Foot And Ankle Ability Measure questionnaire (FAAM) and the goniometer, respectively. The mean of the plantar pressure percentage and the mean of the contact area on the forefoot and rearfoot were investigated during static standing. One-way ANOVA was used to compare the outcomes between the groups. Results: Among the groups, the normal foot group showed the highest scores in the activities of daily living subscale and sport subscale. Compared with the other groups, the highly-pronated foot group had a significantly greater range of motion in the ankle plantar flexion (P<0.002), and the normal foot group showed more range of motion in the first metatarsophalangeal extension (P<0.0001). In all groups, the mean plantar pressure percentage on the rearfoot was greater than the mean plantar pressure percentage on the forefoot. Of the groups, the highly-supinated foot group showed the highest plantar pressure percentage on the rearfoot (P<0.0001). However, the highly-pronated foot group showed the highest plantar pressure percentage and the largest contact area on the forefoot (P<0.0001) and the rearfoot (P>0.0001), respectively. Conclusion: Based on the results of this study, the foot posture is an important option that could affect function and range of motion of foot and ankle and distribution of the plantar pressure and plantar contact area. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the foot function, range of motion, plantar pressure, and plantar contact area in the distance runners with normal, pronated, highly-pronated, supinated, and highly-supinated foot posture groups during static standing. Materials and Methods: In this comparative cross-sectional study, a total of 75 distance runners were divided into 5 groups using the foot posture index. The foot function and knee and foot range of motion were assessed using the Foot And Ankle Ability Measure questionnaire (FAAM) and the goniometer, respectively. The mean of the plantar pressure percentage and the mean of the contact area on the forefoot and rearfoot were investigated during static standing. One-way ANOVA was used to compare the outcomes between the groups. Results: Among the groups, the normal foot group showed the highest scores in the activities of daily living subscale and sport subscale. Compared with the other groups, the highly-pronated foot group had a significantly greater range of motion in the ankle plantar flexion (P0.0001), respectively. Conclusion: Based on the results of this study, the foot posture is an important option that could affect function and range of motion of foot and ankle and distribution of the plantar pressure and plantar contact area.

Objectives: To assess foot function in Systemic Sclerosis (SSc) and its association with sociodemographic and clinical factors. To evaluate mobility, foot alterations, foot pain, and foot care in these patients., Methods: Consecutive SSc patients underwent structured interviews and physical examinations. Disability was assessed using Health Assessment Questionnaire (HAQ) and Scleroderma Health Assessment Questionnaire. (SHAQ). Foot function was measured using Foot Function Index (FFI), foot pain using a numeric pain scale (NPS), and mobility using Timed-UP-Go test (TUG)., Results: 101 patients were included. Forefoot pain was observed in 50.5%, hindfoot pain in 31.7%, foot ulcers in 6.9%, foot plantar callosities in 38.6%, foot arthritis in 2.97%, hallux valgus in 9.9%, claw toes in 5%, and valgus ankle in 3% of patients. The mean FFI was 3.54 (±2.6), NPS was 6.08 (±3.58), and TUG test was 10.52 (±6.5) seconds. Higher FFI scores, increased NPS, and prolonged TUG were associated with Raynaud's phenomenon severity, SHAQ, and HAQ. 36.6% of patients reported never having their feet examined, and only 32.7% had their feet examined within the past year., Conclusion: Foot dysfunction and pain are common in SSc. Higher FFI scores, increased pain, and prolonged TUG duration were linked to disability (HAQ and SHAQ). These analyses should be considered exploratory and require confirmation in external cohorts. Routine foot examinations were lacking in clinical practice. Improved attention for evaluating and caring for the feet in SSc patients is needed., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: In preaxial polydactyly of the foot, the choice for excision of the lateral or medial hallux is not straightforward, in particular with proximal phalangeal (type IV) and metatarsal (type VI) duplication, because of anatomical characteristics. We evaluated whether medial or lateral hallux excision gives better outcomes in these duplication types, to help clinical decision making. Methods: Children with type IV or type VI duplication (n=14, age: 4.4-17.2 years), who were operatively treated by excision of the lateral or medial hallux, were assessed for foot function using plantar pressure measurements and clinical examination. Foot aesthetics were scored by the child, an expert, and 10 laypersons, and additional patient-reported outcome questionnaires were obtained. Outcomes were compared between lateral and medial excision, per duplication type. Results: In type IV duplication (n=11), lateral excision showed a better distribution of peak pressure between the hallux and first metatarsal with significantly lower median first metatarsal peak pressure (P =.008). Lateral excision showed more medial hallux deviation (P =.017). Foot aesthetics were not different between excision sides. In type VI duplication (n=12), lateral excision showed a 59% higher hallux peak pressure, larger medial hallux deviation (P =.004), and more reoperations. Foot aesthetics were scored significantly better after lateral excision by experts and laypersons. Conclusions: Foot function by virtue of plantar pressure was better after lateral hallux excision in type IV and after medial hallux excision in type VI duplication. Surgeons and laypersons perceived the foot as more normal after lateral excision in type VI, whereas children reported no differences. These outcomes can be used in clinical decision making. Level of Evidence: Level III, therapeutic, comparative study. [ABSTRACT FROM AUTHOR]

BACKGROUND: In recent years, arthroscopy has been widely used in the treatment of calcaneal fractures, but it is often used to treat Sanders type I and II fractures, or as an auxiliary means of complex calcaneal fracture reduction and intraarticular injury exploration and cleaning. OBJECTIVE: To explore the effect of total arthroscopy-assisted reduction and internal fixation with cannulated screws for treatment of Sanders II and III calcaneal fractures. METHODS: From December 2016 to November 2018, 42 patients (42 feet) of Sanders II and III calcaneal fractures treated in Foshan Hospital of Traditional Chinese Medicine as the research subjects were divided into two groups according to the surgical plan. Patients in the total arthroscopy group (n=21) received total arthroscopy-assisted reduction and internal fixation with cannulated screws. Patients in the tarsal sinus approach group (n=21) received internal fixation of calcaneus anatomical plate through tarsal sinus approach. At 12 months after surgery, adverse reactions were recorded. X-ray films were reexamined. Böhler angle and Gissane angle were examined, and Maryland score and AOFAS ankle/hindfoot score were evaluated. This study was approved by the Ethics Committee of Foshan Hospital of Traditional Chinese Medicine. RESULTS AND CONCLUSION: (1) Preoperative preparation time and average hospital stay were longer in the tarsal sinus approach group than in the total arthroscopy group (P < 0.05). There was no injury of posterior tibial vessels, tibial nerve or sural nerve, and no infection of soft tissue in the incision in the total arthroscopy group. In the tarsal sinus approach group, there were three feet with superficial skin infection, one foot with gastrocnemial nerve injury, and no deep incision infection or necrosis. (2) At 12 months after operation, Böhler and Gissane angles in both groups were better than before surgery (P < 0.05), but there was no significant difference between the two groups (P > 0.05). (3) Perimeter of the ankle was significantly reduced after surgery than before surgery in both groups (P < 0.05), and motion range of ankle flexion and extension was significantly increased after surgery than before surgery in both groups (P < 0.05). The perimeter of the ankle was smaller in the total arthroscopy group than in the tarsal sinus approach group at 1 month after surgery (P < 0.05). Motion range of ankle flexion and extension was not significantly different at postoperative 1 year in both groups (P > 0.05). (4) At postoperative 12 months, Maryland scores and AOFAS ankle/hindfoot scores were not significantly different between the two groups (P > 0.05). (5) Compared with internal fixation of calcaneus anatomical plate through tarsal sinus approach, total arthroscopy-assisted reduction and internal fixation with cannulated screws for the treatment of Sanders II and III calcaneal fractures can promote the recovery of the patient’s foot function and reduce postoperative complications [ABSTRACT FROM AUTHOR]

The relationship between foot kinematics and the development of lower extremity musculoskeletal disorders (MSD) has been the focus of recent attention. However, most studies evaluated static foot type and not dynamic foot function. The purpose was to compare lower limb and foot kinematics, and plantar pressures during gait in physically active individuals with pronated and non‐pronated foot function. Foot function in 154 adult participants was documented as pronated (n = 63) or neutral (n = 91) using 2 established methods: The Foot Posture Index and the Center of Pressure Excursion Index. Difference between the groups in triplanar motion of the lower limb during barefoot gait was evaluated using a 3D motion capture system incorporating the Oxford Foot Model. Dynamic parameters of plantar pressure were recorded using a pressure platform. Anterior‐posterior pelvic tilt range of motion (ROM), peak knee internal rotation, forefoot dorsiflexion ROM, peak forefoot abduction, and rearfoot eversion were all increased in those with pronated foot function. Hallux contact time and time to peak force under the medial forefoot were increased with pronated foot function, and maximal force under the lateral forefoot was reduced. Pronated foot function affected the whole lower limb kinematic chain during gait. These kinematic alterations could increase the risk of developing MSD. Further studies should elucidate the relationship between pronated foot function and MSD, and, if confirmed, foot function should be evaluated in clinical practice for patients with lower limb and low back pain. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is to see the impact on foot morphology that affect changes in thefoot type or loading response (pronation / supination) of the foot and ankle with prolonged standing. Among those who work standing , patterned differ by proportion of time standing and years or months. This study aims to measure the change in foot posture or type by accessing and giving score using FPI-6 tool i.e Foot Posture Index whether the foot is pronated or supinated and related injuries that have chances to occur further in prolonged standing workers or individual and to find out the change in foot posture or type and see related changes in foot characterstics that leads injuries related to foot and ankle by using FPI-6 score. Methodology: Total 70 males and females between 21-45 years voluntarily participated and performed FPI-6 observational analysis. The FPI-6 is performed by positioned in relaxed standing with each foot. The examiner ensured the participant is comfortable, facing ahead and evenly balanced before commencing and then positioned themselves in kneeling behind the foot being scored. Result: Correlation of right and left foot with timing hours that indicated that changes in morphology of one foot will lead to the other foot later on. Correlation of right and left foot with timing hours is (lt.foot 0.97>0.0.96 lt.foot). Conclusion: The result of the study suggest that a significant change in the foot structure of the people who are standing for prolonged hours with years or months. This study emphasize the importance of not to stand for prolonged hours continuously for a long period of time and hence reduce anatomical changes in the foot or reduced musculoskeletal related injuries. For standing prolonged hours. it changes the anatomical view or structure of the foot that leads to foot pronation and supination and increase the risk of musculoskeletal disorders of the foot.The study shows that foot structure goes in pronationthose who stand for prolonged hours with minimum one to two years experience. These people have high chances of foot deformity and flat foot posmre or reduced medial arch height that strains the muscles of ankle and cause pain which change the foot type by changing their foot position and increases the load on foot. [ABSTRACT FROM AUTHOR]

The Course of Study for Elementary School, which was revised and announced in March 2017, requires that children learn reasonable and comfortable movements while manipulating their bodies skillfully in the act of running. In recent years, it has been reported that foot-gripping strength is important for sprinting ability, and a number of studies have reported that foot-gripping strength and sprint running ability are related. Therefore, in the present study, we measured the foot-gripping strength and sprint running ability of elementary school students (1st to 6th years), making adjustments for factors related to growth (i.e., height, weight, age, grip strength). The results revealed that foot-gripping strength was significantly correlated with sprint running ability (r = -0.130, p <0.05) even when factors related to development were adjusted with partial correlation analysis. These results suggest that foot-gripping strength affects sprint running ability in children, although not to a great extent. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of customized insole in patients with Morton's neuroma. Design: Double-blind randomized controlled trial with intent-to-treat analysis. Setting: Outpatients, University Hospital. Subjects: A total of 72 patients with Morton's neuroma met the inclusion criteria and were randomly allocated to either the study group (n = 36) or the control group (n = 36). Interventions: The study group was assigned to use a customized insole with metatarsal and arch support made of ethyl vinyl acetate and the control group received a flat insole of the same material, color, and density. Main measures: The primary outcome measure was walking pain intensity measured by the visual analogue scale. The secondary outcomes were as follows: pain at rest, palpation, and paresthesia (visual analogue scale); functional disability (6-minute walk test, Foot Function Index, and Foot Health Status Questionnaire); quality of life (Health Survey Short Form-36 (SF-36)); and foot pressure (AM Cube FootWalk Pro program). Results: In the comparison between the groups over time, a statistically significant difference, with improvement in favor of the experimental group, was found for pain during walking (P = 0.048); in the general health domains (P < 0.001) and physical activity (P = 0.025) of the Foot Health Status Questionnaire; in the general Foot Function Index score (P = 0.012); and in the functional capacity domain of the SF-36 questionnaire (P = 0.046). For the other parameters, no difference was found between groups. Conclusion: The study demonstrated that customized insole with metatarsal and arch support relieved walking pain and improved patient-reported measures of function in patients with Morton's neuroma. [ABSTRACT FROM AUTHOR]

Purpose Paediatric foot surgery is often performed to restore anatomical shape or range of movement (ROM). The purpose of this study was to determine how foot morphology and ROM are associated with foot function in children aged five to 16 years of age. Methods Participants included 89 patients with foot disorders and 58 healthy controls. In addition to measuring children's foot alignment and ankle ROM, children and parents completed the Oxford Ankle and Foot Questionnaire (OxAFQ). Results Mean age was 10.3 years for patients and 10.6 years for controls; 53 of 89 patients had clubfoot. All foot measurements and scores on the OxAFQ significantly differed (p < 0.001) between patients and controls. Patients and their parents significantly differed on the physical (p = 0.03) and emotional (p = 0.02) domains of the OxAFQ, with parents' ratings being lower than their children. Moderate correlations (r = 0.54 to 0.059; p < 0.001) were found between physical domain (reported by parents on the OxAFQ) and dorsi-flexion-knee flexed, and foot- arc-of-movement. Moderate correlations were found between physical domain (reported by children on OxAFQ) and foot-arc-of-movement (r = 0.56; p < 0.001). Patients in the surgical group showed moderate correlations (r = 0.57;, p < 0.001) between physical domain (reported by children on OxAFQ) and plantar flexion, and foot arc-of-movement. The control group and the patients in non-surgical subgroup showed no significant correlations. Conclusion Plantar flexion, arc of ankle ROM and hindfoot alignment impact foot function in children with foot deformities. Parents report significantly lower scores on the OxAFQ when judging foot functioning. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) can cause significant forefoot disorders. If forefoot deformity and pain are severe, surgical treatment can be considered. The aim of this study was to analyze the long-term outcomes of surgical forefoot correction per Tillmann, which involves resection of the metatarsal heads through a transverse plantar approach for the lesser toes and a dorsomedial approach to the great toe. Methods: This retrospective study used patient-based questionnaires to analyze the revision rate, pain, use of orthoses, walking ability, forefoot function, and patient satisfaction of patients with RA who had undergone a complete forefoot correction of metatarsophalangeal (MTP) I to V. The study only included participants with RA before the era of biological agents and who were at least 20 years postoperatively. A total of 60 patients who had undergone 100 complete forefoot operations according to Tillmann 24.6 ± 3.5 years ago were included in this study. Results: The data collected showed that 35 reoperations were performed on 26 of the patients. Deformity relapses were often documented for the hallux valgus. More than 60% of the patients were able to wear conventional shoes. The distances the participants were able to walk were significantly increased by wearing shoes when compared with walking barefoot (P <.01). Conclusion: While forefoot function remained difficult to assess, the majority of patients were able to use conventional shoes. This long-term follow-up study of patient-reported questionnaires completed more than 20 years after the Tillmann procedure showed that more than 80% of the patients remained satisfied with the outcome. Level of Evidence: Level IV, retrospective cohort study. [ABSTRACT FROM AUTHOR]

Objective: This systematic review and meta-analysis updated the effects of photobiomodulation therapy (PBMT) on pain, the Foot Function Index (FFI), and the effects on fascial thickness in adults with acute or chronic plantar fasciitis (PF). Methods: A systematic literature search was conducted in the PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases. Two researchers independently screened titles and abstracts of the retrieved studies for eligibility. A random-effects model was used for this meta-analysis. Subgroup meta-analyses were conducted to evaluate the influence of PBMT in pain and foot function under investigation and the study design on the overall weighted mean effect size. Results: From a total of 3865 studies, 7 randomized controlled trials were selected after final review and 4 were selected for meta-analysis. There was a significant difference between PBMT and control for Visual Analog Scale (Chi2 = 29.30; p < 0.00001) with an I2 value of 90% in favor of PBMT versus the control. The overall effect of PBMT was statistically significant (p < 0.02) with PBMT favoring for thickness of the plantar fascia reduction. FFI between PBMT and control group [Chi2 −83.46, df = 1 (p < 0.00001)]; I2 = 99% in favor of the PBMT. Conclusions: This meta-analysis presents evidence that PBMT is an effective treatment modality to reduce pain and improvement of foot function in patients with chronic PF, however, a broad discrepancy was found in the PBMT dosimetry. The ideal treatment parameters for PF need to be elucidated. [ABSTRACT FROM AUTHOR]

Abstract Identifying environmental risk factors for musculoskeletal disorders is challenging due to the number of potential confounders. Twins are of particular interest for researchers interested in studying these types of problems due to their inherent control for the influence of genetic factors. In twin studies, this population can allow environmental risk factors to be more easily identified, and this type of study design may allow the role of biomechanics in injury and disease to be further explored. At present, it is unclear if foot function displays more similarity between certain types of twins. In this study, we hypothesized that the plantar pressures of monozygotic (identical) twins would be more similar between pairs than dizygotic (non-identical) twins. We measured static and dynamic plantar pressures from five pairs of each twin type. Statistical parametric modeling was used to compare pressure distributions at the sensor level. For >80% of stance phase, the pixel level analysis indicated that monozygotic twins had less variation in plantar pressure between pairs. The average z-statistic across the entire trial was 0.88 for the monozygotic group and 1.13 for the dizygotic group. In this study we provide evidence of greater similarity of plantar pressures in monozygotic twin pairs compared to dizygotic twins. This finding supports the use of co-twin studies investigating potentially modifiable environmental and biomechanical risk factors for musculoskeletal conditions that affect the foot and ankle. [ABSTRACT FROM AUTHOR]

Background: The purpose of this article was to introduce calcaneal lengthening for partial traumatic loss of the calcaneus. Effectiveness with the use of the technique was also assessed.Methods: From January 2013 to May 2016, calcaneal lengthening was performed in 15 patients who sustained a partial traumatic loss of the tuberosity portion of calcaneus. There were 13 men and 2 women with an average age of 36 years (range, 19-53 years). Combined Achilles tendon rupture was noted in 7 patients, and the tendon was reinserted to the calcaneus before calcaneal lengthening. Calcaneal lengthening was performed using an Ilizarov frame. Clinical outcome was assessed based on the American Orthopedic Foot and Ankle score.Results: The mean loss of calcaneus was 27% (range, 19%-35%). Calcaneal lengthening (mean total time is157 days; range, 111-226 days) included three periods, i.e., latency (mean 7 days; range, 7-9 days), distraction (mean 43 days; range, 32-57 days), and consolidation (mean 108 days; range, 84-162 days). The mean amount of lengthening was 28% (range, 19%-38%). The mean follow-up duration was 25 months (range, 24-27 months). Based on the American Orthopaedic Foot and Ankle, there were 8 excellent, 6 good, and 1 fair result.Conclusions: For the treatment of partial traumatic loss of the calcaneus, calcaneal lengthening using an Ilizarov frame is a preferable technique to restore the length of calcaneus and foot function. [ABSTRACT FROM AUTHOR]

Highlights What is already known • Adult acquired flatfoot is a frequent problem. These patients have an increased risk for pathologies concerning the tibia, the back and posture. • Often used assessments include static and dynamic measures but they do not necessarily reflect foot motion under dynamic conditions. • The lack of reliable parameters in the evaluation of dynamic foot function under load needs a deeper insight in biomechanics of the foot. What this study adds • A new measure, the dynamic Navicular Rise (dNR), is proposed to describe dynamic foot function during stance. • During level walking, the new measure might be seen as new and independent. During stair descent, however, this is not the case. • The results are an example of the limitation and difficulties in interpreting ICCs. Abstract Background The lack of reliable parameters to evaluate dynamic foot function, emphasizes the need for a deeper insight in foot biomechanics. The aims were to investigate the reliability of a new parameter (dynamic navicular rise dNR), and its relationship with the dynamic navicular drop (dND). Methods Twenty healthy participants (mean age 30.2 ± 8.1 years) had to walk on even ground and downstairs. Data of ten trials per task on two measurement days were recorded. The dNR was defined as the difference in millimetres (mm) between the minimum navicular height (NH) during stance and the NH at toe off. To test intra- and interday reliability, Intraclass Correlation Coefficients (ICC 2.1) and repeatability were calculated. To obtain the absolute repeatability (RP) in mm, the equation RP = 1.96 × SD differences was used. Furthermore, the relationship between the dNR and the dND was examined by calculating Pearson (r) or Spearman (r s) correlation coefficients. Results Included participants showed a mean dNR of (12.2 ± 3.7) mm for level walking and (14.8 ± 3.4) mm for stair descent. The ICC 2.1 for the dNR were 0.98 (intraday), 0.91 (interday) for level walking and 0.97 (intraday), 0.94 (interday) for stair descent. The interday repeatability was 3.2 mm (level walking), 2.7 mm (stair descent) respectively. For level walking, r was 0.31 (p = 0.049), and r s = 0.88 (p < 0.001) for stair descent. Conclusions The dNR seems to be highly reliable (ICCs), however, repeatability is unacceptable. For level walking, the dNR might be an independent measure, but not for stair climbing. [ABSTRACT FROM AUTHOR]

Background and objectives: Obese people have many foot-related disorders and plantar fasciitis (PF) is the most common disorder among them. However, research on the role of therapeutic exercises in PF is lacking and there is no evidence to suggest its benefits. As such, a further insight into therapeutic exercises is needed within this group. This case study investigated the effect of three-dimensional (3D) ankle exercises using a combined isotonic (CI) technique on function and balance in an obese subject with PF. Material and methods: The subject in this study was a 28-year-old obese woman who was diagnosed with PF by an orthopedic surgeon. A 3D ankle exercise program was commenced three times a week for 15 min over 4 weeks. The evaluations were conducted at five intervals: pre-test, and at 1, 2, 3 and 4 weeks from the initiation of the intervention. The tests were conducted in the following order: the patient-specific functional scale test (PSFS), an ultrasound of the plantar fascia, the heel pressure and balance test, the pressure pain threshold (PPT), and the 4-way ankle strength test. Results: The mean score of the PSFS test reduced by 70.55% after 4 weeks of the intervention. The thickness of the plantar fascia and heel pressure measured during single-leg standing decreased by 6.67% and 10.37%, respectively, after 4 weeks of the intervention. The anteroposterior and medial-lateral balance ability showed improvements of 8.29% and 8.61%, respectively, after 4 weeks of the intervention. The PPT improved by 38.01% after 4 weeks of the intervention. In the 4-way ankle strength test, dorsiflexion, plantar flexion, inversion, and eversion increased by 14.46%, 9.63%, 4.3% and 13.25%, respectively, after 4 weeks of the intervention. Conclusion: 3D ankle exercises utilizing the CI technique were shown to be effective in improving foot function, pressure pain, and muscle strength in dorsiflexion and inversion in an obese patient with PF.

Objective: Postoperative pain is a frequent problem after orthopedic procedures like hallux valgus surgery. The aim of this study was to evaluate whether ankle block improves early and mid-term functional outcomes and postoperative pain management after hallux valgus surgery in patients receiving general anesthesia.Subjects and Methods: This randomized controlled trial investigated 60 patients who underwent hallux valgus surgery under general anesthesia. Patients were prospectively randomized into 2 groups: general anesthesia only (group A) and ankle block added to general anesthesia (group B). Age, body-mass index, tourniquet time, duration of surgery, first analgesic need time, perioperative analgesic regimen, visual analog scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and length of hospital stay were recorded. Independent variables were analyzed by t test. Nonparametric data were analyzed by the Mann-Whitney U test.Results: Patient age, demographics, and body mass indices were similar between the 2 groups. The average length of hospital stay was significantly longer in group A (p < 0.01). Group B had a longer time to first analgesic need than group A (p < 0.01). Patients in group B required less analgesic during the postoperative period. Preoperative VAS and AOFAS scores were not statistically dif ferent between the 2 groups. The postoperative day 1 VAS score was significantly lower in group B than in group A. Follow-up visits at 3, 6, and 12 months showed significantly lower VAS and higher AOFAS scores in group B than group A.Conclusion: Ankle block added to general anesthesia may improve early and mid-term postoperative functional outcomes and postoperative pain management in patients who undergo hallux valgus surgery. [ABSTRACT FROM AUTHOR]

This study was to investigate the acute effects of wearing shoes on lower limb kinetics, kinematics and muscle activation during a drop jump. Eighteen healthy men performed a drop jump under barefoot and shod conditions. Vertical ground reaction force (GRF) was measured on a force plate during the contact phase of a drop jump, and GRF valuables were calculated for each condition. The angles of the knee and ankle joints, and the foot strike angle (the angle between the plantar surface of the foot and the ground during ground contact) as well as the electromyography of 7 muscles were measured. The shod condition showed a significant larger first peak GRF, longer time to first peak GRF from the initial ground contact and lower initial loading rate than the barefoot condition. The shod condition showed a significant larger ankle joint angle at initial ground contact, smaller knee joint angle between the second peak GRF and take-off as well as smaller foot strike angle at both initial ground contact and take-off than the barefoot condition. There were significant correlations between relative differences in ankle joint at the initial ground contact and relative differences in the initial loading rate. The muscle activity of all muscles during foot ground contact did not differ between two conditions; however, in the shod condition, muscle activation of 150 ms before foot ground contact was significantly higher in the rectus femoris, whereas it was lower in the biceps femoris and tibialis anterior muscles than the barefoot condition. These results indicate that wearing shoes alternates the GRF variables at initial ground contact, joint kinematics at the ground contact and muscle activation before foot ground contact during a drop jump, suggesting that the effects of wearing shoes on drop jump training differ from being barefoot. [ABSTRACT FROM AUTHOR]

Background Lack of response to plantar heel pain (PHP) treatment may be related to unmanaged low back pain (LBP) and low back dysfunction, but a relationship between LBP and PHP has not been established. The purpose of this investigation was to compare the prevalence of LBP among individuals with and without PHP and to assess the association between low back disability and foot/ankle function. Methods A cross-sectional study compared the prevalence and likelihood of LBP in individuals with (n = 27) and without (n = 27) PHP matched to age, sex, BMI, foot posture, and foot mobility. In individuals with PHP, correlations were examined between foot/ankle function using the foot and ankle ability measure (FAAM), low back disability using the Oswestry low back disability questionnaire (OSW), duration of PHP symptoms, body mass index (BMI), and age. Results A greater percentage of individuals with PHP had LBP (74% versus 37% of controls, odds ratio = 5.2, P = 0.009) and higher levels of low back disability (17% higher OSW score than controls, P < 0.001). In individuals with PHP, FAAM scores were correlated with OSW scores ( ρ = −0.463, P = 0.015), but not with duration of PHP symptoms, BMI, or age ( P > 0.150). Conclusions Individuals with PHP had a greater prevalence of LBP and higher low back disability that was correlated to reduced foot and ankle function. Treatment to address both local and proximal impairments, including impairments related to LBP, may be warranted to improve the management of PHP. [ABSTRACT FROM AUTHOR]