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Sohrabi M, Torkaman G, Bahrami F. Comparing Knee Kinetics and Kinematics in Healthy Individuals and Those With Knee Osteoarthritis, With and Without Flat Feet. J Appl Biomech 2024; 40:232-240. [PMID: 38608717 DOI: 10.1123/jab.2023-0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/15/2024] [Accepted: 02/27/2024] [Indexed: 04/14/2024]
Abstract
Individuals with knee osteoarthritis (KOA) and flat feet are more likely to experience increased pain and cartilage damage. This study aimed to investigate the knee kinetics, kinematics, pain, and physical function in individuals with moderate symptomatic KOA, in comparison to asymptomatic control participants. Thirty volunteers with moderate KOA (with flat feet n = 15, with normal feet n = 15) and 30 asymptomatic people (with flat feet n = 15, with normal feet n = 15) were evaluated. The knee adduction angular impulse, knee flexion moment, knee flexion angular impulse, and knee flexion angle were measured during level walking. The pain was assessed in patients with KOA. The study found that individuals with KOA had a significant increase in the knee adduction angular impulse compared with the asymptomatic people (P < .05). The KOA with flat feet group had significantly lower knee flexion moment, knee flexion angular impulse, and knee flexion angle values than the KOA with normal feet group (P < .05). Furthermore, the KOA with flat feet group had a higher pain score than the KOA with normal feet group. Individuals with osteoarthritis and flat feet had lower knee flexion moments which may indicate reduced knee force exerted through compensatory mechanisms. Despite this reduction, they reported significantly higher levels of pain compared with those without flat feet, a finding that warrants further investigation in future studies.
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Affiliation(s)
- Maryam Sohrabi
- Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Giti Torkaman
- Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fariba Bahrami
- Human Motor Control and Computational Neuroscience Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
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Yokota S, Ishizu H, Miyazaki T, Takahashi D, Iwasaki N, Shimizu T. Osteoporosis, Osteoarthritis, and Subchondral Insufficiency Fracture: Recent Insights. Biomedicines 2024; 12:843. [PMID: 38672197 PMCID: PMC11048726 DOI: 10.3390/biomedicines12040843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/31/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
The increased incidence of osteoarthritis (OA), particularly knee and hip OA, and osteoporosis (OP), owing to population aging, have escalated the medical expense burden. Osteoarthritis is more prevalent in older women, and the involvement of subchondral bone fragility spotlights its association with OP. Notably, subchondral insufficiency fracture (SIF) may represent a more pronounced condition of OA pathophysiology. This review summarizes the relationship between OA and OP, incorporating recent insights into SIF. Progressive SIF leads to joint collapse and secondary OA and is associated with OP. Furthermore, the thinning and fragility of subchondral bone in early-stage OA suggest that SIF may be a subtype of OA (osteoporosis-related OA, OPOA) characterized by significant subchondral bone damage. The high bone mineral density observed in OA may be overestimated due to osteophytes and sclerosis and can potentially contribute to OPOA. The incidence of OPOA is expected to increase along with population aging. Therefore, prioritizing OP screening, early interventions for patients with early-stage OA, and fracture prevention measures such as rehabilitation, fracture liaison services, nutritional management, and medication guidance are essential.
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Affiliation(s)
| | | | | | | | | | - Tomohiro Shimizu
- Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (S.Y.); (H.I.); (T.M.); (D.T.); (N.I.)
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Wang Y, Chen Z, Wu Z, Li J, Li C, Yang J, Chen W, Ye Z, Shen X, Jiang T, Liu W, Xu X. Reliability of foot posture index (FPI-6) for evaluating foot posture in patients with knee osteoarthritis. Front Bioeng Biotechnol 2023; 11:1103644. [PMID: 36741758 PMCID: PMC9889869 DOI: 10.3389/fbioe.2023.1103644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
Objective: To determine the reliability of FPI-6 in the assessment of foot posture in patients with knee osteoarthritis (KOA). Methods: Thirty volunteers with KOA (23 females, 7 males) were included in this study, assessed by two raters and at three different moments. Inter-rater and test-retest reliability were assessed with Cohen's Weighted Kappa (Kw) and Intraclass Correlation Coefficient (ICC). Bland-Altman plots and respective 95% limits of agreement (LOA) were used to assess both inter-rater and test-retest agreement and identify systematic bias. Moreover, the internal consistency of FPI-6 was assessed by Spearman's correlation coefficient. Results: FPI-6 total score showed a substantial inter-rater (Kw = .66) and test-retest reliability (Kw = .72). The six items of FPI-6 demonstrated inter-rater and test-retest reliability varying from fair to substantial (Kw = .33 to .76 and Kw = .40 to .78, respectively). Bland-Altman plots and respective 95% LOA indicated that there appeared no systematic bias and the acceptable agreement of FPI-6 total score for inter-rater and test-retest was excellent. There was a statistically significant positive correlation between each item and the total score of FPI-6, which indicated that FPI-6 had good internal consistency. Conclusion: In conclusion, the reliability of FPI-6 total score and the six items of FPI-6 were fair to substantial. The results can provide a reliable way for clinicians and researchers to implement the assessment of foot posture in patients with KOA.
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Affiliation(s)
- Yi Wang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zehua Chen
- The Orthopedics Hospital of Traditional Chinese Medicine Zhuzhou city, Zhuzhou, China
| | - Zugui Wu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiaman Yang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weijian Chen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinxin Shen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tao Jiang
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China,*Correspondence: Tao Jiang, ; Wengang Liu, ; Xuemeng Xu,
| | - Wengang Liu
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China,*Correspondence: Tao Jiang, ; Wengang Liu, ; Xuemeng Xu,
| | - Xuemeng Xu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China,Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China,*Correspondence: Tao Jiang, ; Wengang Liu, ; Xuemeng Xu,
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Mei Q, Kim HK, Xiang L, Shim V, Wang A, Baker JS, Gu Y, Fernandez J. Toward improved understanding of foot shape, foot posture, and foot biomechanics during running: A narrative review. Front Physiol 2022; 13:1062598. [PMID: 36569759 PMCID: PMC9773215 DOI: 10.3389/fphys.2022.1062598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
The current narrative review has explored known associations between foot shape, foot posture, and foot conditions during running. The artificial intelligence was found to be a useful metric of foot posture but was less useful in developing and obese individuals. Care should be taken when using the foot posture index to associate pronation with injury risk, and the Achilles tendon and longitudinal arch angles are required to elucidate the risk. The statistical shape modeling (SSM) may derive learnt information from population-based inference and fill in missing data from personalized information. Bone shapes and tissue morphology have been associated with pathology, gender, age, and height and may develop rapid population-specific foot classifiers. Based on this review, future studies are suggested for 1) tracking the internal multi-segmental foot motion and mapping the biplanar 2D motion to 3D shape motion using the SSM; 2) implementing multivariate machine learning or convolutional neural network to address nonlinear correlations in foot mechanics with shape or posture; 3) standardizing wearable data for rapid prediction of instant mechanics, load accumulation, injury risks and adaptation in foot tissue and bones, and correlation with shapes; 4) analyzing dynamic shape and posture via marker-less and real-time techniques under real-life scenarios for precise evaluation of clinical foot conditions and performance-fit footwear development.
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Affiliation(s)
- Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Hyun Kyung Kim
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,Department of Engineering Science, The University of Auckland, Auckland, New Zealand
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Akaltun MS, Koçyiğit BF. Assessment of foot posture and related factors in patients with knee osteoarthritis. Arch Rheumatol 2021; 36:267-273. [PMID: 34527932 PMCID: PMC8418765 DOI: 10.46497/archrheumatol.2021.8354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/12/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives The aim of this study was to compare foot posture between patient and control groups, and to identify factors associated with foot posture abnormality in knee osteoarthritis (OA). Patients and methods This case-control study included a total of 115 patients (26 males, 89 females; mean age: 54.4±9.3 years; range, 29 to 73 years) with OA and 77 healthy controls (20 males, 57 females; mean age: 52.1±8.1 years; range, 32 to 69 years) between May 2019 and July 2019. The participants were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS), and the Beighton criteria. Radiological assessments were performed using the Kellgren-Lawrence grading, condylar plateau angle, and medial tibiofemoral joint width. The Foot Posture Index-6 (FPI-6) was used for foot posture analysis and three groups were formed as supinated, neutral, and pronated postures. Results Foot posture was significantly different between the patient and control groups (p<0.05). Of the patients with knee OA, significant differences were found in the VAS, WOMAC-pain, WOMAC-physical function, and WOMAC-total (p<0.05) among the foot postures. No significant difference was found among the foot posture groups in terms of the radiological parameters and WOMAC-stiffness (p>0.05). Hypermobility and WOMAC-total scores were significantly associated with foot posture abnormality (p<0.05). Conclusion Joint hypermobility and foot posture are the factors which may influence the clinical characteristics of knee OA. Foot posture and joint hypermobility should be taken into consideration during the examination and management of patients with knee OA.
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Affiliation(s)
- Mazlum Serdar Akaltun
- Department of Physical Medicine and Rehabilitation, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey
| | - Burhan Fatih Koçyiğit
- Department of Physical Medicine and Rehabilitation, Kahramanmaraş Sütçü Imam University, Faculty of Medicine, Kahramanmaraş, Turkey
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Hunt MA, Charlton JM, Felson DT, Liu A, Chapman GJ, Graffos A, Jones RK. Frontal plane knee alignment mediates the effect of frontal plane rearfoot motion on knee joint load distribution during walking in people with medial knee osteoarthritis. Osteoarthritis Cartilage 2021; 29:678-686. [PMID: 33582238 DOI: 10.1016/j.joca.2021.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/08/2021] [Accepted: 02/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the nature of differences in the relationship between frontal plane rearfoot kinematics and knee adduction moment (KAM) magnitudes. DESIGN Cross-sectional study resulting from a combination of overground walking biomechanics data obtained from participants with medial tibiofemoral osteoarthritis at two separate sites. Statistical models were created to examine the relationship between minimum frontal plane rearfoot angle (negative values = eversion) and different measures of the KAM, including examination of confounding, mediation, and effect modification from knee pain, radiographic disease severity, static rearfoot alignment, and frontal plane knee angle. RESULTS Bivariable relationships between minimum frontal plane rearfoot angle and the KAM showed consistent negative correlations (r = -0.411 to -0.447), indicating higher KAM magnitudes associated with the rearfoot in a more everted position during stance. However, the nature of this relationship appears to be mainly influenced by frontal plane knee kinematics. Specifically, frontal plane knee angle during gait was found to completely mediate the relationship between minimum frontal plane rearfoot angle and the KAM, and was also an effect modifier in this relationship. No other variable significantly altered the relationship. CONCLUSIONS While there does appear to be a moderate relationship between frontal plane rearfoot angle and the KAM, any differences in the magnitude of this relationship can likely be explained through an examination of frontal plane knee angle during walking. This finding suggests that interventions derived distal to the knee should account for the effect of frontal plane knee angle to have the desired effect on the KAM.
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Affiliation(s)
- M A Hunt
- Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia: Vancouver, BC, Canada.
| | - J M Charlton
- Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia: Vancouver, BC, Canada.
| | - D T Felson
- Department of Rheumatology, Boston University School of Medicine, Boston, MA, USA; NIHR Manchester Musculoskeletal Biomedical Research Centre, Manchester, UK; Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
| | - A Liu
- School of Health and Society, University of Salford: Manchester, UK.
| | - G J Chapman
- School of Sport and Health Sciences, University of Central Lancashire: Preston, UK.
| | - A Graffos
- Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia: Vancouver, BC, Canada.
| | - R K Jones
- School of Health and Society, University of Salford: Manchester, UK.
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Carroll LA, Kivlan BR, Martin RL, Phelps AL, Carcia CR. The Single Leg Squat Test: A "Top-Down" or "Bottom-Up" Functional Performance Test? Int J Sports Phys Ther 2021; 16:360-370. [PMID: 33842032 PMCID: PMC8016417 DOI: 10.26603/001c.21317] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/10/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Medial knee deviation (MKD) during the single leg squat test (SLST) is a common clinical finding that is often attributed to impairments of proximal muscular structures. Investigations into the relationship between MKD and the foot and ankle complex have provided conflicting results, which may impact clinicians' interpretation of the SLST. PURPOSE The purpose of this study was to compare ankle dorsiflexion range of motion (ROM) and foot posture in subjects that perform the SLST with MKD (fail) versus without MKD (pass). HYPOTHESIS There will be a difference in ankle dorsiflexion ROM and/or foot posture between healthy individuals that pass and fail the SLST for MKD. STUDY DESIGN Cross-sectional study. METHODS Sixty-five healthy, active volunteers (sex = 50 female, 15 male; age = 25.2 +/- 5.6 years; height = 1.7 +/- .1 m; weight = 68.5 +/- 13.5 kg) who demonstrated static balance and hip abductor strength sufficient for performance of the SLST participated in the study. Subjects were divided into pass and fail groups based on visual observation of MKD during the SLST. Foot Posture Index (FPI-6) scores and measures of non-weight bearing and weight bearing active ankle dorsiflexion (ROM) were compared. RESULTS There were 33 individuals in the pass group and 32 in the fail group. The groups were similar on age (p = .899), sex (p = .341), BMI (p = .818), and Tegner Activity Scale score (p = .456). There were no statistically significant differences between the groups on the FPI-6 (pass group mean = 2.5 +/- 3.9; fail group mean = 2.3 +/- 3.5; p = .599), or any of the measures of dorsiflexion range of motion (non-weight bearing dorsiflexion with knee extended: pass group = 6.9o +/- 3.7o, fail group = 7.8o +/- 3.0o; non-weight bearing dorsiflexion with knee flexed: pass group = 13.5o +/- 5.6o, fail group = 13.9o +/- 5.3o; weight bearing dorsiflexion: pass group = 42.7o +/- 6.0o, 42.7o +/- 8.3o, p = .611). CONCLUSIONS Failure on the SLST is not related to differences in clinical measures of active dorsiflexion ROM or foot posture in young, healthy individuals. These findings suggest that clinicians may continue using the SLST to assess neuromuscular performance of the trunk, hip, and knee without ankle dorsiflexion ROM or foot posture contributing to results. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
| | | | - RobRoy L Martin
- Department of Physical Therapy, Duquesne University; UPMC Center for Sports Medicine
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Foot characteristics and mechanics in individuals with knee osteoarthritis: systematic review and meta-analysis. J Foot Ankle Res 2021; 14:24. [PMID: 33771204 PMCID: PMC8004391 DOI: 10.1186/s13047-021-00462-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Foot characteristics and mechanics are hypothesized to affect aetiology of several lower extremity musculoskeletal conditions, including knee osteoarthritis (KOA). The purpose of this systematic review was to identify the foot characteristics and mechanics of individuals with KOA. Methods Five databases were searched to identify relevant studies on foot characteristics and mechanics in people with KOA. Meta-analyses were performed where common measures were found across included studies. Included studies were evaluated for data reporting quality using the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) checklist. Results Thirty-nine studies were included in this systematic review. Two studies reported participants with KOA had statistically significantly (P < 0.05) more pronated foot postures than those without. Meta-analyses for foot progression angle (FPA) and peak rearfoot eversion angle found no difference between those with and without KOA (FPA mean difference:-1.50 [95% confidence interval − 4.20-1.21]; peak rearfoot eversion mean difference: 0.71 [1.55–2.97]). Conclusion A more pronated foot posture was noticed in those with KOA. However, it was not possible to establish a relationship between other foot characteristics or mechanics in people with KOA due to heterogeneity between the included study and limited number of studies with similar measurements. There is need for identifying common measurement techniques and reporting metrics when studying the foot in those with KOA.
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Miyazaki T, Kawada M, Kiyama R, Yone K. Validity of two-dimensional analysis using a tablet computer for estimation of foot arch height during walking. J Phys Ther Sci 2021; 33:194-198. [PMID: 33814703 PMCID: PMC8012182 DOI: 10.1589/jpts.33.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/01/2020] [Indexed: 12/04/2022] Open
Abstract
[Purpose] To examine the validity of two-dimensional analysis using a tablet computer
for the estimation of arch height during walking by comparing it with a motion capture
system and static foot alignment screenings. [Participants and Methods] Fourteen healthy
males and 15 healthy females participated in this study. The arch height of the right foot
while walking was simultaneously measured using a tablet computer and motion capture
system. Dynamic foot alignment, including arch height, at the mid-stance and pre-swing
phases was calculated from the kinematic data measured using the tablet computer and
motion analysis system. Static foot alignment was also assessed by screening tests
including arch height index and foot posture index. [Results] Arch height measured using a
tablet computer showed a significant high correlation with that measured using the motion
capture system at the mid-stance and pre-swing phases. Arch height index showed a
significant moderate correlation with arch height measured using the motion capture system
at the mid-stance phase. Meanwhile, foot posture index showed no relationship with arch
height measured by the motion capture system. [Conclusion] These results demonstrate the
high validity of dynamic foot analysis using a tablet computer for the estimation of arch
height during walking. Such gait analysis can be effective for assessing dynamic foot
alignment in clinical practice.
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Affiliation(s)
- Takasuke Miyazaki
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan.,Department of Rehabilitation, Tarumizu Municipal Medical Center, Tarumizu Central Hospital, Japan
| | - Masayuki Kawada
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan
| | - Ryoji Kiyama
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan
| | - Kazunori Yone
- Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8506, Japan
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Zuil-Escobar JC, Martínez-Cepa CB, Martín-Urrialde JA, Gómez-Conesa A. Medial Longitudinal Arch: Accuracy, Reliability, and Correlation Between Navicular Drop Test and Footprint Parameters. J Manipulative Physiol Ther 2018; 41:672-679. [PMID: 30573198 DOI: 10.1016/j.jmpt.2018.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/03/2018] [Accepted: 04/05/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the correlation among the navicular drop test, the arch angle, the Staheli index and the Chippaux-Smirak index. The reliability and the correlation among the footprint parameters were also estimated. METHODS A cross-sectional study (n = 86; 59.3% women; 27.8 years, standard deviation: 4.8 years) was carried out. The navicular drop test was evaluated and footprint parameters using a plantar pressure platform were recorded in the dominant foot. Pearson correlation coefficients, intraclass correlation coefficient, standard error of measurement, and minimum detectable change were calculated. RESULTS Both intrarater and interrater reliability were excellent for all the parameters evaluated (intraclass correlation coefficients > 0.880). Statistically significant correlations existed between the navicular drop test and footprints parameters (arch angle = 0,643; Staheli index = 0.633; Chippaux-Smirak index = 0.614). The footprint parameters had excellent correlation with each other (0.838-0.881). The navicular drop test and the footprint parameters studied were reproducible and thus had excellent reliability. CONCLUSION The correlations obtained between the navicular drop test and the footprint parameters evaluated were good. The navicular drop test appears to be a reproducible, valid, and simple test for evaluating medial longitudinal arch height, having fewer disadvantages than using footprint parameters.
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Al-Bayati Z, Coskun Benlidayi I, Gokcen N. Posture of the foot: Don't keep it out of sight, out of mind in knee osteoarthritis. Gait Posture 2018; 66:130-134. [PMID: 30176381 DOI: 10.1016/j.gaitpost.2018.08.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/30/2018] [Accepted: 08/27/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND There are many contributors of knee osteoarthritis including the postural abnormalities of the adjacent joints. The relationship between foot posture and the clinical-radiological parameters of knee osteoarthritis is poorly understood. RESEARCH QUESTION Is foot posture related to the clinical and radiological parameters in patients with knee osteoarthritis? METHODS Patients diagnosed with primary clinical and radiographic medial tibiofemoral knee osteoarthritis were included in the study. Anteroposterior knee radiographs were staged by using the Kellgren-Lawrence grading system. Computer-based measurements of the medial joint space width (mJSW), condylar angle, anatomical axis angle, tibial plateau angle and condylar plateau angle were performed on digital anteroposterior knee radiographs. The Western Ontario and Mc Master University Osteoarthritis Index (WOMAC) questionnaire was used to assess pain and the functional status of the patients. Foot posture was assessed by the Foot Posture Index (FPI) system and feet were categorized into three (pronated, neutral and supinated). RESULTS The study included 150 patients (150 knees and feet at one side) with a mean age of 61.2 ± 10.1 years. In terms of foot posture groups; percentages for supination, neutral and pronation were 22.66%, 68.66% and 8.66%, respectively. In the group with supinated FPI; WOMAC total score, pain and function subscale scores were higher (p < 0.001), mJSW was narrowed (p = 0.038) and the condylar plateau angle was increased (p = 0.009). In the FPI pronation group; anatomic axis angle values were found to change in the varus direction (p = 0.012). SIGNIFICANCE The potential postural dysfunction of the foot should be taken into consideration during the assessment and/or management of a patient with knee osteoarthritis.
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Affiliation(s)
- Zainb Al-Bayati
- Cukurova University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Adana, Turkey
| | - Ilke Coskun Benlidayi
- Cukurova University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Adana, Turkey.
| | - Neslihan Gokcen
- Cukurova University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Adana, Turkey
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Ohi H, Iijima H, Fukutani N, Aoyama T, Kaneda E, Ohi K, Ito H, Matsuda S, Kaoru A. Varus thrust visualized during gait was associated with inverted foot in patients with knee osteoarthritis: An exploratory study. Gait Posture 2018; 61:269-275. [PMID: 29413796 DOI: 10.1016/j.gaitpost.2018.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/14/2017] [Accepted: 01/21/2018] [Indexed: 02/02/2023]
Abstract
The foot is speculated to play a role in knee joint kinematics. This exploratory cross-sectional study examined the association between static foot posture and the presence of varus thrust visualized during gait in patients with medial knee osteoarthritis (OA). Patients (n = 88 patients and 134 knees; age, 61-91 years; 68.2% female) with Kellgren/Lawrence (K/L) grade ≥1 in the medial compartment were included in this study and underwent gait observation for varus thrust. These patients' three-dimensional static foot posture while standing was evaluated and their tibiofemoral joint K/L grades and anatomical axis angles were also assessed as covariates. Knees with varus thrust (22 knees, 16.4%) on average had a 4° more inverted calcaneus relative to the floor than those without varus thrust (P < 0.001). A logistic regression analysis showed that an increased calcaneus inversion angle was significantly associated with higher odds of the presence of varus thrust with adjustments for age, sex, body mass index, K/L grade, and anatomical axis angle. The other predictors, such as navicular height, navicular height/foot length, and rearfoot angle relative to the lower leg, were not significantly associated with varus thrust. These results suggest that patients with varus thrust had a different static rearfoot posture as compared with those without varus thrust, a finding that may indicate an important role of static rearfoot posture in the pathogenesis of varus thrust. Furthermore, investigating the potential influence of foot posture on the efficacy of biomechanical interventions, such as lateral wedge insole use, on varus thrust would be of particular interest in the further studies.
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Affiliation(s)
- Hiroshi Ohi
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan; Ohi Manufacturing Co., Ltd., Kyoto, Japan.
| | - Hirotaka Iijima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Japan Society for the Promotion of Science, Tokyo, Japan; Department of System Design Engineering, Keio University, Yokohama, Japan.
| | - Naoto Fukutani
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | | | - Kazuko Ohi
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan; Ohi Manufacturing Co., Ltd., Kyoto, Japan.
| | - Hiromu Ito
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Shuichi Matsuda
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Abe Kaoru
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan.
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13
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Iijima H, Ohi H, Isho T, Aoyama T, Fukutani N, Kaneda E, Ohi K, Abe K, Kuroki H, Matsuda S. Association of bilateral flat feet with knee pain and disability in patients with knee osteoarthritis: A cross-sectional study. J Orthop Res 2017; 35:2490-2498. [PMID: 28370219 DOI: 10.1002/jor.23565] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 03/24/2017] [Indexed: 02/04/2023]
Abstract
This cross-sectional study examined the relationship of flat feet with knee pain, disability, and physical performance in patients with knee osteoarthritis (OA). Orthopedic clinic participants (n = 95; age 61-91 years; 68.4% women) with Kellgren-Lawrence (K/L) grade ≥1 in the medial compartment underwent evaluation of navicular height and foot length for flat feet. Knee pain intensity, disability, and physical performance were evaluated using the Japanese Knee Osteoarthritis Measure, 10-m walk, timed up and go, and five-repetition chair stand tests. Of the 95 enrolled patients, 24 (25.3%) had bilateral flat feet, and significantly higher knee pain compared to patients with no flat feet (11.3 ± 8.23 points vs. 6.58 ± 6.37 points; p = 0.043). A ordinal logistic regression analysis showed that bilateral flat feet were significantly associated with increased knee pain (proportional odds ratio: 5.48, 95% confidence interval: 1.96, 15.3; p = 0.001) compared with no flat feet, adjusted for age, sex, body mass index, and tibiofemoral joint K/L grade, which is consistent across various different cutoffs of the definition of flat feet. Physical performance was similar between patients with and without bilateral flat feet. The presence of unilateral flat feet was not significantly associated with any outcome measures. These findings indicate that bilateral, but not unilateral, flat feet are associated with worse knee pain. A prospective study investigating a causal relationship between bilateral flat feet posture and knee pain as well as disability would be of particular interest to verify the potential adverse effect of altered foot posture. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2490-2498, 2017.
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Affiliation(s)
- Hirotaka Iijima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of System Design Engineering, Keio University, Yokohama, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hiroshi Ohi
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan.,Ohi Manufacturing Co., Ltd., Kyoto, Japan
| | - Takuya Isho
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Rehabilitation Center, Fujioka General Hospital, Gunma, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoto Fukutani
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Kazuko Ohi
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan.,Ohi Manufacturing Co., Ltd., Kyoto, Japan
| | - Kaoru Abe
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan
| | - Hiroshi Kuroki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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14
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The association between toe grip strength and osteoarthritis of the knee in Japanese women: A multicenter cross-sectional study. PLoS One 2017; 12:e0186454. [PMID: 29040330 PMCID: PMC5645141 DOI: 10.1371/journal.pone.0186454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 10/02/2017] [Indexed: 11/24/2022] Open
Abstract
We evaluated the relationship between altered foot function and knee osteoarthritis through a specific comparison of toe grip strength in older women with and without knee osteoarthritis. Participants were 120 women with knee osteoarthritis (OA group) and 108 healthy community-dwelling women with no history of knee pain and lower limb surgery (control group). The following factors and outcome variables were included in our analysis: measured toe grip strength, isometric knee extension strength, the timed Up-and-Go, and the WOMAC scale. Between-group differences were compared using unpaired t-tests for descriptive characteristics and outcome measures. Pearson’s correlation coefficients between toe grip strength and age, body mass index, and other outcome measures were calculated. Multiple logistic regression analysis was used to evaluate the independence of toe grip strength and knee osteoarthritis. Compared to the control group, participants in the OA group were older, heavier, and had a higher body mass index. Toe grip strength and isometric knee extension strength were lower and the timed Up-and-Go longer for the OA group than the control group. Toe grip strength was correlated with age negatively and isometric knee extension strength positively in the OA group and to age and the timed Up-and-Go negatively, and isometric knee extension strength positively in the control group. Multiple logistic regression analysis revealed that body mass index, isometric knee extensor strength, and toe grip strength were independently associated with knee osteoarthritis. Our findings indicate a probable association between altered forefoot function and the incidence or progression of knee osteoarthritis. Increasing toe grip strength might provide a practical intervention for patients with knee osteoarthritis.
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15
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Sawada T, Tanimoto K, Tokuda K, Iwamoto Y, Ogata Y, Anan M, Takahashi M, Kito N, Shinkoda K. Rear foot kinematics when wearing lateral wedge insoles and foot alignment influence the effect of knee adduction moment for medial knee osteoarthritis. Gait Posture 2017. [PMID: 28649018 DOI: 10.1016/j.gaitpost.2017.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Lateral wedge insoles (LWIs) are prescribed for patients with medial knee osteoarthritis to reduce the external knee adduction moment (KAM). However, the biomechanical effects of LWIs are limited in some patients. The purpose of this study was to investigate whether the biomechanical effects of LWIs depend on individual foot alignment and to examine the relationship between change in KAM and changes in foot and ankle biomechanics when wearing LWIs. Twenty-one patients participated in this study. They were categorized into normal or abnormal foot groups based on the foot posture index (FPI). All patients were requested to perform a normal gait under barefoot and LWI conditions. A three-dimensional motion analysis system was used to record 1st and 2nd KAM, knee adduction angular impulse (KAAI), center of pressure displacement, and knee-ground reaction force lever arm. Furthermore, the foot and ankle frontal plane kinematic parameters were evaluated. The 1st KAM was significantly reduced under the LWI condition compared to that under the barefoot condition in the normal foot group. In contrast, there was no significant difference in 1st KAM between both conditions in the abnormal foot group. Decreased rear foot eversion strongly correlated with reduction in the 1st KAM in the normal foot group. These findings suggested that it is helpful to assess individual foot alignment to ensure adequate insole treatment for patients with medial knee osteoarthritis and that decreased rear foot eversion during the early stance phase is significantly involved in the reduction of 1st KAM when wearing LWIs with normal feet.
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Affiliation(s)
- Tomonori Sawada
- Graduate School of Biomedical & Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553, Japan
| | - Kenji Tanimoto
- Graduate School of Biomedical & Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553, Japan
| | - Kazuki Tokuda
- Graduate School of Biomedical & Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553, Japan
| | - Yoshitaka Iwamoto
- Graduate School of Biomedical & Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553, Japan
| | - Yuta Ogata
- Division of Rehabilitation, Kurume University Medical Center, 115-1, Kokubumachi, Kurume, 839-0863, Japan
| | - Masaya Anan
- Physical Therapy Course, Faculty of Welfare and Health Science, Oita University, 700, Dannoharu, Oita, 870-1192, Japan
| | - Makoto Takahashi
- Department of Biomechanics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553, Japan; Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical & Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553, Japan
| | - Nobuhiro Kito
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, 555-36, Kurose-Gakuendai, Higashi-Hiroshima, 739-2695, Japan
| | - Koichi Shinkoda
- Department of Biomechanics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553, Japan; Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical & Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553, Japan.
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16
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Seki H, Nagura T, Suda Y, Ogihara N, Ito K, Matsumoto M, Nakamura M. Effect of tibial coronal inclination on hindfoot kinematics: A biomechanical simulation study. Proc Inst Mech Eng H 2017; 231:952-958. [PMID: 28752791 DOI: 10.1177/0954411917721941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tibial coronal inclination is often recognized in everyday life, but the compensatory kinematic changes to maintain plantigrade of the hindfoot in response to tibial coronal inclination remain unclear. Lower legs and foot specimens obtained from seven human cadavers were loaded vertically with traction of Achilles' tendon in different tibial inclinations: 0° (neutral), 5°, and 10° medial inclination, and 5° and 10° lateral inclination. The orientations of the tibia, talus, and calcaneus were recorded under vertical load by a three-dimensional digitizing stylus. The angular changes of the talocrural and subtalar joints in the tibial inclinations from neutral were analyzed. The heights of the origins of the talus and calcaneus were also recorded. As the tibia was medially inclined from neutral, the talocrural joint was significantly more dorsiflexed. The subtalar joint was significantly more inverted, plantarflexed, and internally rotated. However, such significant changes in the joint angles were not observed when the tibia was laterally inclined. The height of the talus decreased as the tibia was medially inclined, but it was vice versa when laterally inclined. The compensatory motions of the hindfoot to tibial medial inclination involved coupled movement of both the talocrural and subtalar joints; such motions flatten the medial foot by decreasing the height of the talus. However, such compensatory capacities of the hindfoot to tibial lateral inclinations were limited. Tibial medial inclination under axial loading affects the kinematics of the hindfoot, and this is an important factor to consider in the treatment of flatfoot as well as foot orthotic/footwear intervention.
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Affiliation(s)
- Hiroyuki Seki
- 1 Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Takeo Nagura
- 1 Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan.,2 Department of Clinical Biomechanics, Keio University, Tokyo, Japan
| | - Yasunori Suda
- 3 Department of Orthopedic Surgery, Shioya Hospital, International University of Health and Welfare, Yaita, Japan
| | - Naomichi Ogihara
- 4 Department of Mechanical Engineering, Keio University, Yokohama, Japan
| | - Kohta Ito
- 4 Department of Mechanical Engineering, Keio University, Yokohama, Japan
| | - Morio Matsumoto
- 1 Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Masaya Nakamura
- 1 Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
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17
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Ohi H, Iijima H, Aoyama T, Kaneda E, Ohi K, Abe K. Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis. BMC Musculoskelet Disord 2017; 18:246. [PMID: 28592232 PMCID: PMC5463360 DOI: 10.1186/s12891-017-1588-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 05/17/2017] [Indexed: 11/22/2022] Open
Abstract
Background To examine the association of radiographic frontal plane knee alignment with three-dimensional foot posture in patients with medial knee osteoarthritis (OA). Methods Participants in orthopedic clinics with Kellgren/Lawrence (K/L) grade ≥1 (88 patients and 88 knees; age, 61–91 years; 65.9% female) were enrolled. An anteroposterior radiographic view was used to assess the anatomical axis angle (AAA) after subtracting a sex-specific correction factor. The three-dimensional foot posture was also evaluated. Results Multiple regression analyses showed that increased corrected AAA (i.e., valgus direction) was independently associated with a decrease in the hallux valgus angle (regression coefficient: −0.40 per degree, 95% confidence interval [CI]: −0.72, −0.09; P = 0.013) and increase in the pronation angle of the calcaneus relative to floor (regression coefficient: 0.33 per degree, 95% CI: 0.10, 0.56; P = 0.005) adjusted for age, sex, and body mass index. The relationship between the corrected AAA and hallux valgus angle strengthened (regression coefficient: −0.60 per degree, 95% CI: −1.08, −0.13; P = 0.014) in varus-aligned knees examined separately (63 knees). The other foot postures (navicular height, navicular height/foot length, and rearfoot angle) were not significantly associated with corrected AAA. Conclusions Radiographic frontal plane knee alignment was associated with hallux valgus angle and calcaneus angle relative to the floor in patients with medial knee OA, particularly in varus-aligned knees. These results indicate a connection between altered frontal knee alignment and foot posture, which may be helpful in understanding the pathogenesis of altered foot posture observed in patients with knee OA.
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Affiliation(s)
- Hiroshi Ohi
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan.,Ohi Manufacturing Co., Ltd., Kyoto, Japan
| | - Hirotaka Iijima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan. .,Department of System Design Engineering, Keio University, Yokohama, Japan. .,Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Kazuko Ohi
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan.,Ohi Manufacturing Co., Ltd., Kyoto, Japan
| | - Kaoru Abe
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan
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18
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Hunt MA, Takacs J, Krowchuk NM, Hatfield GL, Hinman RS, Chang R. Lateral wedges with and without custom arch support for people with medial knee osteoarthritis and pronated feet: an exploratory randomized crossover study. J Foot Ankle Res 2017; 10:20. [PMID: 28473871 PMCID: PMC5414382 DOI: 10.1186/s13047-017-0201-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pronated foot posture is associated with many clinical and biomechanical outcomes unique to medial compartment knee osteoarthritis (OA). Though shoe-worn insole treatment, including lateral wedges, is commonly studied in this patient population, their effects on the specific subgroup of people with medial knee OA and concomitant pronated feet are unknown. The purpose of this study was to evaluate whether lateral wedge insoles with custom arch support are more beneficial than lateral wedge insoles alone for knee and foot symptoms in people with medial tibiofemoral knee osteoarthritis (OA) and pronated feet. METHODS Twenty-six people with pronated feet and symptomatic medial knee OA participated in a randomized crossover study comparing five degree lateral wedge foot insoles with and without custom foot arch support. Each intervention was worn for two months, separated by a two-month washout period of no insoles wear. Main outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical function subscales, the revised short-form Foot Function Index (FFI-R) pain and stiffness subscales, and the timed stair climb test. Regression modeling was conducted to examine treatment, period, and interaction effects. RESULTS Twenty-two participants completed the study, and no carryover or interaction effects were observed for any outcome. Significant treatment effects were observed for the timed stair climb, with greater improvements seen with the lateral wedges with arch support. Within-condition significant improvements were observed for WOMAC pain and physical function, as well as FFI-R pain and stiffness with lateral wedges with arch support use. More adverse effects were reported with the lateral wedges alone, while more people preferred the lateral wedges with arch support overall. CONCLUSIONS Addition of custom arch support to a standard lateral wedge insole may improve foot and knee symptoms in people with knee OA and concomitant pronated feet. These preliminary findings suggest further research evaluating the role of shoe-worn insoles for treatment of this specific sub-group of people with knee OA is warranted. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT02234895.
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Affiliation(s)
- Michael A Hunt
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Judit Takacs
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Natasha M Krowchuk
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Gillian L Hatfield
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Rana S Hinman
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC Australia
| | - Ryan Chang
- Human Performance Engineering Laboratory, Reebok International, Canton, MA USA
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19
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Evaluation of foot static disturbances in patients with rheumatic diseases. Reumatologia 2017; 55:73-78. [PMID: 28539678 PMCID: PMC5442297 DOI: 10.5114/reum.2017.67601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 03/14/2017] [Indexed: 01/10/2023] Open
Abstract
Objectives Rheumatic diseases such as osteoarthritis and rheumatoid arthritis constitute the most frequent pathological states leading to the development of foot deformities, which reduce quality of life and cause disability. The aim of the present study was to compare the results of plantoconturographic examinations, obtained by means of a computer podoscope, in osteoarthritis and rheumatoid arthritis patients. Special attention was paid to the differences in the values of each parameter determining the level of foot function. Material and methods The study was performed in 94 female patients divided into two groups according to the type of disease. There were 54 patients with rheumatoid arthritis and 40 with osteoarthritis. The control group consisted of 34 healthy women. The plantographic assessment of static foot structure was carried out by means of a device for computer-aided foot examination. Results A fallen transverse arch of the right foot was statistically much more frequent in the rheumatoid arthritis patients than in osteoarthritis patients or the control group (p < 0.005 and p < 0.05, respectively). Significant differences in the values of the Wejsflog index were observed in the case of left foot between rheumatoid arthritis patients and the control group (p < 0.05). Similarly, there were statistically significant differences in the values of the hallux valgus angle (α) for the right foot between rheumatoid arthritis and osteoarthritis patients or control group (in both cases p < 0.05). Conclusions Rheumatic diseases predispose patients to disturbances of static foot function. The obtained results highlight the importance of diagnosing foot static disturbances in the prevention of destructive changes affecting the functioning of osteoarthritis and rheumatoid arthritis patients.
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20
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Iwamoto K, Mizukami M, Asakawa Y, Endo Y, Takata Y, Yoshikawa K, Yoshio M. Effects of friction massage of the popliteal fossa on blood flow velocity of the popliteal vein. J Phys Ther Sci 2017; 29:511-514. [PMID: 28356643 PMCID: PMC5361022 DOI: 10.1589/jpts.29.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 12/07/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Friction massage (friction) of the popliteal fossa is provided for the purpose
of relieving pain related to circulatory disorders by improving venous flow in the lower
legs. The purpose of this study is to verify the effects of enhancing the venous flow
based on measuring the blood flow velocity of the popliteal vein before and after
providing friction to the patients. [Subjects and Methods] Fifteen healthy male university
students participated in the study. The Doppler ultrasonography (DU) was used to measure
the blood flow velocity of the popliteal vein, in order to verify the effects of enhancing
the venous flow by comparing the measured values before and after a friction massage.
[Results] The result of comparing the blood flow velocity before and after providing
friction showed that there was a significant increase after friction. [Conclusion] This
study proved that friction to the popliteal fossa is effectively enhances venous flow by
increasing the blood flow velocity in the popliteal vein.
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Affiliation(s)
- Koji Iwamoto
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | - Masafumi Mizukami
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | - Yasutsugu Asakawa
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | - Yusuke Endo
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | - Yuichi Takata
- Department of Physical Therapy, Faculty of Human Science, Hokkaido Bunkyo University, Japan
| | - Kenichi Yoshikawa
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Japan
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21
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Elbaz A, Magram-Flohr I, Segal G, Mor A, Debi R, Kalichman L. Association Between Knee Osteoarthritis and Functional Changes in Ankle Joint and Achilles Tendon. J Foot Ankle Surg 2017; 56:238-241. [PMID: 28110795 DOI: 10.1053/j.jfas.2016.11.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Indexed: 02/03/2023]
Abstract
Increasing evidence has shown that biomechanical forces often drive the progression of knee osteoarthritis (OA). Attention should be given to the changes in adjacent joints and their relation to knee OA. The purpose of the present study was to examine the changes in Achilles tendon thickness of individuals with knee OA and to evaluate the correlation between Achilles tendon thickness and knee OA severity in a case-control prospective observational study. A total of 93 participants with no previous ankle injuries were recruited. Of the 93 participants, 63 had knee OA of the medial compartment and 30 served as controls. The subjects underwent a clinical examination that included measurements of weight, height, Achilles tendon thickness, and 1-leg heel rise. The subjects also underwent a computerized gait test and completed the Hebrew version of the Western Ontario and McMaster Osteoarthritis Index and 36-item short-form (SF-36) health survey. Significant difference was found in Achilles tendon thickness between the subjects with knee OA and the healthy controls (17.1 ± 3.4 versus 15.1 ± 3.1; p = .009). Significant differences were also found between the 2 groups in the 1-leg heel rise test, Western Ontario and McMaster Osteoarthritis Index scores, SF-36 scores, and all gait measures. Significant correlations were found between the Achilles tendon thickness and the following measures: weight (r = 0.46), body mass index (r = 0.55), Kellgren and Lawrence OA severity grade (r = 0.25), 1-leg heel rises (r = -0.50), and SF-36 score (r = -0.25). Subjects with knee OA presented with a thicker Achilles tendon compared with the healthy controls. Furthermore, a significant correlation between Achilles tendon thickness and knee OA severity was found. A comprehensive assessment of the Achilles tendon and ankle joint should be a part of the knee OA evaluation process.
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Affiliation(s)
- Avi Elbaz
- Orthopedist, AposTherapy Research Group, Herzliya, Israel
| | - Irina Magram-Flohr
- Physiotherapist, AposTherapy Research Group, Herzliya, Israel; Physiotherapist, Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences at Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ganit Segal
- Clinical Researcher, AposTherapy Research Group, Herzliya, Israel
| | - Amit Mor
- Medical Doctor, AposTherapy Research Group, Herzliya, Israel.
| | - Ronen Debi
- Orthopaedic Surgeon, Department of Orthopedic Surgery, Barzilay Medical Center, Ashkelon, Israel
| | - Leonid Kalichman
- Physiotherapist, Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences at Ben-Gurion University of the Negev, Beer-Sheva, Israel
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22
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Iwamoto K, Mizukami M, Asakawa Y, Yoshio M, Ogaki R, Takemura M. Effects of friction massage of the popliteal fossa on dynamic changes in muscle oxygenation and ankle flexibility. J Phys Ther Sci 2016; 28:2713-2716. [PMID: 27821920 PMCID: PMC5088111 DOI: 10.1589/jpts.28.2713] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/09/2016] [Indexed: 12/03/2022] Open
Abstract
[Purpose] This study aimed to examine whether or not friction massage of the popliteal
fossa would be effective for achieving dynamic changes in muscle oxygenation and ankle
flexibility. [Subjects and Methods] Twelve healthy male university students participated.
Before and after friction massage, dynamic changes in muscle oxygenation and ankle
flexibility were measured by near-infrared spectroscopy to evaluate its efficacy.
[Results] Oxygenated hemoglobin was significantly higher after as compared to before
massage. The range of ankle dorsiflexion tended to increase after massage. [Conclusion]
These results suggest that friction massage of the popliteal fossa stimulates venous
return in the lower leg.
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Affiliation(s)
- Koji Iwamoto
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | - Masafumi Mizukami
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | - Yasutsugu Asakawa
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | | | - Ryo Ogaki
- Sports Research and Development Core, Conditioning Department, University of Tsukuba, Japan
| | - Masahiro Takemura
- Graduate School of Comprehensive Human Science, University of Tsukuba, Japan
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Gursu S, Sofu H, Verdonk P, Sahin V. Effects of total knee arthroplasty on ankle alignment in patients with varus gonarthrosis: Do we sacrifice ankle to the knee? Knee Surg Sports Traumatol Arthrosc 2016; 24:2470-5. [PMID: 26590564 DOI: 10.1007/s00167-015-3883-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 11/12/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE Total knee arthroplasty is one of the most commonly preferred surgical methods in the treatment of patients with varus gonarthrosis. In this study, we aimed to evaluate the radiological changes observed in the ankles after total knee arthroplasty. METHODS Between May 2012 and June 2013, 80 knees of 78 patients with varus deformity over 10° underwent total knee arthroplasty. For each patient, full-leg standing radiographs were obtained pre- and post-operatively. Mechanical and anatomical axes (HKA and AA), lateral distal femoral angle, medial proximal tibial angle, lateral distal tibial angle (LDTA), ankle joint line orientation angle (AJOA), tibial plafond talus angle (PTA) and talar shift were measured for each patient both pre- and post-operatively. RESULTS Pre-operatively, the mean HKA was 16.6° and the mean AA was 10.41°, both in favour of varus alignment. Post-operatively, the mean HKA decreased to 3.6° and the mean AA to -2.1. The mean LDTA was 87.3°. Before the operation, the mean AJOA was -7.6°, opening to the medial aspect of the ankle, and it was 0.04° after the operation and opening to the lateral aspect (p < 0.05). CONCLUSION Our study reveals the changes occurring in the ankle after acute correction of long-standing varus deformity of the knee using total knee arthroplasty. In cases undergoing knee arthroplasty, effect of the acute change in the alignment of the knee on the ankle should be taken into consideration and the amount of correction should be calculated carefully in order not to damage the alignment of the ankle. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Sarper Gursu
- Baltalimanı Bone and Joint Diseases Education and Research Hospital, Rumelihisari caddesi No: 62, Sariyer, 34470, Istanbul, Turkey.
| | - Hakan Sofu
- Erzincan University Faculty of Medicine, Erzincan, Turkey
| | - Peter Verdonk
- Antwerp Orthopedic Center, Monica Hospitals, Antwerp, Belgium
| | - Vedat Sahin
- Erzincan University Faculty of Medicine, Erzincan, Turkey
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McPoil TG, Ford J, Fundaun J, Gallegos C, Kinney A, McMillan P, Murphy J, Sky E, Torba D, Bade M. The use of a static measure to predict foot posture at midstance during walking. Foot (Edinb) 2016; 28:47-53. [PMID: 27736722 DOI: 10.1016/j.foot.2016.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 09/18/2016] [Indexed: 02/04/2023]
Abstract
Previous studies have successfully used the longitudinal arch angle (LAA) to assess foot posture, but the measurement consistency and ability of the LAA to predict dynamic foot posture during activity in a variety of foot types have not been evaluated. The purpose of this study was to determine the reliability of the LAA as well as if the clinical method of assessing the LAA could be used to predict the LAA at midstance during walking for supinated, normal, and pronated foot types. The Arch Height Ratio was used to select 35 participants with 12 supinated, 46 normal, and 12 pronated feet. A standard goniometer was used to measure the LAA (CLINIC_LAA) on both feet while standing. Both feet were then filmed using a high speed camera while walking on a treadmill. The LAA was determined by the angle formed by two lines drawn between the markers placed on the first metatatarsal and medial malleolus with the apex the navicular tuberosity. The LAA in midstance (WALK_LAA) was determined using the mean of five walking trials. The reliability of the CLINIC_LAA assessed on both feet by two raters over two days were excellent. There was no difference between the left and right foot for the CLINIC_LAA. The Pearson correlation between CLINIC_LAA and WALK_LAA for all 70 feet was r=0.96 (r2=0.92). The results indicate the LAA is highly predictive of foot posture at midstance in walking explaining over 90% of the variance for a wide range of foot types.
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Affiliation(s)
- Thomas G McPoil
- School of Physical Therapy, Regis University, Denver, CO, United States.
| | - Jessica Ford
- School of Physical Therapy, Regis University, Denver, CO, United States
| | - Joel Fundaun
- School of Physical Therapy, Regis University, Denver, CO, United States
| | - Chelsea Gallegos
- School of Physical Therapy, Regis University, Denver, CO, United States
| | - Andrew Kinney
- School of Physical Therapy, Regis University, Denver, CO, United States
| | - Peter McMillan
- School of Physical Therapy, Regis University, Denver, CO, United States
| | - Jessica Murphy
- School of Physical Therapy, Regis University, Denver, CO, United States
| | - Elliot Sky
- School of Physical Therapy, Regis University, Denver, CO, United States
| | - Derrick Torba
- School of Physical Therapy, Regis University, Denver, CO, United States
| | - Michael Bade
- Physical Therapy Program, School of Medicine, University of Colorado, Denver, CO, United States
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25
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The Effect of Lateral Wedge and Medial Arch Support on Displacement of Ground Reaction Force in Patients with Knee Osteoarthritis. JOURNAL OF REHABILITATION 2016. [DOI: 10.20286/jrehab-170172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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26
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Paterson KL, Hinman RS, Hunter DJ, Wrigley TV, Bennell KL. Impact of concurrent foot pain on health and functional status in people with knee osteoarthritis: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 2015; 67:989-95. [PMID: 25581254 DOI: 10.1002/acr.22537] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 11/16/2014] [Accepted: 12/16/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To document the prevalence of foot pain and foot pain laterality in people with knee osteoarthritis (OA) and to examine its impact on health and function. METHODS Participants from the Progression subcohort (n = 1,255, ages 45-79 years) of the Osteoarthritis Initiative with symptomatic tibiofemoral knee OA were included. Prevalence of foot pain, defined as pain in the foot/ankle, and foot pain laterality were determined. Health status was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index, the Short Form-12 Health Survey, and the Center for Epidemiological Studies Depression Scale. Function was assessed using the 20-meter walk test (WT) and a repeated chair stand test. Differences in health and functional measures were compared between groups with and without foot pain using multivariate analysis of covariance. RESULTS One-fourth (n = 317 [25%]) of people with knee OA experienced concurrent foot pain, with the majority (n = 174 [55%]) reporting pain in both feet. After adjusting for covariates, people with foot pain scored worse on all health measures and on the 20-meter WT, compared to those without (P < 0.05). Differences in health and function were found between the bilateral and ipsilateral foot pain groups compared to those without foot pain (P < 0.05), but no differences were found with the contralateral group. CONCLUSION Foot pain is common in people with knee OA, and bilateral and ipsilateral foot pain adversely affect health and function, suggesting laterality is important. Further research is needed to establish the mechanism and interaction of pathology at these sites and to evaluate foot pain treatment in this population.
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Affiliation(s)
- Kade L Paterson
- Centre for Health, Exercise and Sports Medicine, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - David J Hunter
- Royal North Shore Hospital, Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, and University of Sydney, Sydney, New South Wales, Australia
| | - Tim V Wrigley
- Centre for Health, Exercise and Sports Medicine, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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27
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Zuil-Escobar JC, Martínez-Cepa CB, Martín-Urrialde JA, Gómez-Conesa A. Prevalence of Myofascial Trigger Points and Diagnostic Criteria of Different Muscles in Function of the Medial Longitudinal Arch. Arch Phys Med Rehabil 2015; 96:1123-30. [DOI: 10.1016/j.apmr.2015.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 02/15/2015] [Accepted: 02/16/2015] [Indexed: 12/17/2022]
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F E A, N K, H A, F L, A N, C N, T H. A positive association between foot posture index and medial compartment knee osteoarthritis in moroccan people. Open Rheumatol J 2014; 8:96-9. [PMID: 25553141 PMCID: PMC4279032 DOI: 10.2174/1874312901408010096] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 10/14/2014] [Accepted: 10/30/2014] [Indexed: 11/22/2022] Open
Abstract
Objectives : To compare foot posture in people with and without medial compartment knee osteoarthritis (OA), and to assess association between its abnormalities and medial compartment knee OA. Methods : We compared the foot posture of patients with clinically and radiographically-confirmed medial compartment knee OA and asymptomatic healthy controls using the foot posture index (FPI), navicular height, and the medial arch. Results : We included 100 patients and 80 asymptomatic controls. The mean age of patients was 59 ± 7 (44-76) years and 48 ± 9 (28-60) years in the control (p=0.06). Patients group have more pronated foot for FPI (1.50 ± 2.68 vs 0.72 ± 2.63; p=0.05), more flat foot (42% vs 22%; p=0.03), and less pes cavus than the control group (58% vs 77%; p=0.004). However, there was no significant difference between the groups in the navicular height (3.90 ± 0.85 cm vs 4.00 ± 0.76 cm; p=0.41). In multivariate statistical analysis, after adjusting for age and body mass index, pronated foot in FPI (OR=1.22, 95%IC= [1.06-1.40], p=0.005), and pes cavus (OR=0.32, 95%IC= [0.11-0.93], p=0.03) had a significant correlation with the knee osteoarthritis. Conclusion : Pronated foot posture and flat foot are significantly associated with medial compartment knee osteoarthritis.
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Affiliation(s)
- Abourazzak F E
- Rheumatology Department, Hassan II University Hospital, Fez, Morocco
| | - Kadi N
- Rheumatology Department, Hassan II University Hospital, Fez, Morocco
| | - Azzouzi H
- Rheumatology Department, Hassan II University Hospital, Fez, Morocco
| | - Lazrak F
- Rheumatology Department, Hassan II University Hospital, Fez, Morocco
| | - Najdi A
- Laboratory of Epidemiology and Public Health, Faculty of Medicine and Pharmacy, Fez, Morocco
| | - Nejjari C
- Laboratory of Epidemiology and Public Health, Faculty of Medicine and Pharmacy, Fez, Morocco
| | - Harzy T
- Rheumatology Department, Hassan II University Hospital, Fez, Morocco
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Tipnis RA, Anloague PA, Laubach LL, Barrios JA. The dose-response relationship between lateral foot wedging and the reduction of knee adduction moment. Clin Biomech (Bristol, Avon) 2014; 29:984-9. [PMID: 25246374 DOI: 10.1016/j.clinbiomech.2014.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/19/2014] [Accepted: 08/29/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lateral foot wedges represent a biomechanical intervention aimed at reducing medial knee loads. However, the effects of varying wedge amounts on biomechanical variables and orthotic comfort have not been systematically studied. Further, arch height may influence the comfort of laterally wedged devices. Therefore, the primary purpose of this study was to examine the effect of incrementally increasing lateral wedge amounts on knee adduction moment parameters and subjective comfort. The secondary purpose was to relate arch height measures to the comfort of the devices. METHODS Twenty-five healthy subjects underwent three-dimensional instrumented gait analysis testing using seven inclinations of lateral wedging (0°, 2°, 4°, 6°, 8°, 10°, 12°). Subjects reported comfort level for each orthotic condition. Arch heights were measured in standing and sitting, and rigidity index and stiffness were calculated. FINDINGS The knee adduction moment decreased with wedge amounts up to 6°, but more aggressive amounts did not yield additional reductions. Comfort ratings did not change from baseline until wedge amounts exceeded 8°. In addition, arch height measures, arch rigidity index and stiffness did not relate to the comfort of the orthotic device regardless of the wedge amount. INTERPRETATION Knee adduction moment decreased with mild wedge amounts while maintaining comfort. Wedge amounts greater than 6° yielded little additional mechanical benefit and amounts greater than 8° compromised comfort. It appears that 4°-6° of lateral wedging are optimal in regard to desirable biomechanical change and comfort level in healthy individuals.
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Affiliation(s)
- Rima A Tipnis
- Department of Health and Sport Science, University of Dayton, 300 College Park Center, Dayton, OH 45469, USA.
| | - Philip A Anloague
- Department of Physical Therapy, University of Dayton, 300 College Park Center, Dayton, OH 45469, USA.
| | - Lloyd L Laubach
- Department of Health and Sport Science, University of Dayton, 300 College Park Center, Dayton, OH 45469, USA.
| | - Joaquin A Barrios
- Department of Physical Therapy, University of Dayton, 300 College Park Center, Dayton, OH 45469, USA.
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30
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Silva RS, Ferreira ALG, Veronese LM, Serrão FV. Forefoot varus predicts subtalar hyperpronation in young people. J Am Podiatr Med Assoc 2014; 104:594-600. [PMID: 25514271 DOI: 10.7547/8750-7315-104.6.594] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Subtalar joint hyperpronation is a foot misalignment that has been associated with several musculoskeletal injuries. Forefoot varus is thought to result in subtalar hyperpronation during weightbearing circumstances. However, few studies have aimed to verify whether there is a significant relationship between forefoot alignment and subtalar hyperpronation. Moreover, no study has attempted to verify whether forefoot varus can predict subtalar hyperpronation in young individuals. Therefore, the purpose of this study was to verify whether forefoot varus can predict subtalar hyperpronation, measured using the rearfoot eversion angle test, the navicular drop test, and the Foot Posture Index (FPI), in young people. METHODS Fifty-four healthy adolescents volunteered for this study (28 boys and 26 girls). A single examiner evaluated the forefoot angle, rearfoot angle, navicular drop, and FPI of each participant. Statistical analysis included the Pearson correlation test and a linear regression analysis to establish the relationship between the variables. RESULTS These results showed a high positive correlation between forefoot varus and rearfoot angle (r = 0.86; P < .001), navicular drop (r = 0.76; P < .001), and FPI (r = 0.82; P < .001). Moreover, the forefoot varus variable was able to predict 74% of the variability in the rearfoot angle, 58% in the navicular drop, and 67% in the FPI (P < .001). CONCLUSIONS These findings support previous assumptions that individuals with forefoot varus present subtalar hyperpronation. Clinicians should not overlook forefoot alignment when prescribing foot orthoses for treating patients with foot misalignments.
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Affiliation(s)
- Rodrigo Scattone Silva
- Laboratory of Assessment and Intervention in Orthopaedics and Traumatology, Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Ana Luisa G. Ferreira
- Laboratory of Assessment and Intervention in Orthopaedics and Traumatology, Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Lívia M. Veronese
- Laboratory of Assessment and Intervention in Orthopaedics and Traumatology, Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Fábio V. Serrão
- Laboratory of Assessment and Intervention in Orthopaedics and Traumatology, Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
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Røsland T, Gregersen LS, Eskehave TN, Kersting UG, Arendt-Nielsen L. Pain sensitization and degenerative changes are associated with aberrant plantar loading in patients with painful knee osteoarthritis. Scand J Rheumatol 2014; 44:61-9. [PMID: 25296895 DOI: 10.3109/03009742.2014.923038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES This study focused on the biomechanical implications of knee osteoarthritis (OA) and the association with pain. The plantar loading force distribution of the foot was determined and correlated to degenerative knee changes, function, pain intensity, and pain sensitization. METHOD Knee OA patients (n = 34) with moderate and mild knee pain were characterized and compared to matched controls (n = 16). The Plantar Foot Posture Index (FPI) and mean maximum plantar forces were determined by pressure-sensitive insoles. Pain intensity and function were assessed by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Brief Pain Inventory (BPI). Local knee pain sensitization was assessed by pressure pain thresholds (PPTs) from eight knee locations. Spreading sensitization was assessed by PPTs from two extra-segmental test sites. Temporal summation to repeated pressure stimulation (knee and extra-segmental stimulation) and conditioning pain modulation (CPM) were assessed, representing central pain mechanisms. RESULTS The maximum force (MF) applied by the medial forefoot correlated to knee PPTs (r = 0.524, p < 0.001), CPM potency (r = 0.532, p < 0.001), and BPI (r = -0.325, p < 0.05) and WOMAC scores (pain r = -0.425, p < 0.01; stiffness r = -0.386, p < 0.01; function r = -0.378, p < 0.05). The MF applied by the medial hindfoot correlated negatively to scores on the FPI (r = -0.394, p < 0.01) and the Kellgren-Lawrence (K-L) grading scale (r = -0.330, p < 0.05). The MF applied by the medial forefoot correlated to extra-segmental PPTs (r = 0.554, p < 0.001) and the potency of CPM (r = 0.561, p < 0.0001). The MF applied by the lateral hindfoot correlated negatively to the PPT assessed extra-segmentally (r = -0.367, p < 0.05) and positively to CPM potency (r = 0.322, p < 0.05). CONCLUSIONS This study shows that mean maximum plantar foot force distribution in patients with painful knee OA is associated with specific pain mechanisms, function, radiological findings, and pain intensity.
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Affiliation(s)
- T Røsland
- Centre for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University , Denmark
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McPoil TG, Cornwall MW, Taylor O, Pomeroy M, Mufti J, Kuhlman H, Ehlers D, Carrell D. The consistency of individual-selected versus rater-determined angle and base of gait. J Am Podiatr Med Assoc 2014; 104:247-52. [PMID: 24901583 DOI: 10.7547/0003-0538-104.3.247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Several studies have reported the necessity of using a standardized foot placement to improve reliability when performing standing foot posture measurements. The intent of this study was to determine whether individuals can reliably place their feet in the same standing position after marching in place or whether the standing position must be determined by a rater observing the angle and base of gait during walking to ensure the consistency of foot placement. METHODS Twenty individuals (12 women and 8 men; mean age, 24.8 years) consented to participate. All of the participants were asked to march in place for 10 sec and then to stop in their preferred angle and base foot placement. Participants then walked over an 8-m walkway so that one of two raters could observe the participant's angle and base while walking. An angle and base of gait tracing was then made for each participant's foot placement. RESULTS The two raters and all of the participants demonstrated high levels of reliability for foot placement between the two sessions. The results indicate that asking the participant to march in place provides a more consistent angle and base foot placement between two sessions compared with having a rater determine the angle and base of gait foot placement after observing the participant while walking. CONCLUSIONS Based on these findings, we recommend using marching in place to position a patient in his or her angle and base foot placement when the measurement or visual assessment of foot posture must be performed for more than one clinical visit.
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Affiliation(s)
- Thomas G. McPoil
- School of Physical Therapy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO
| | - Mark W. Cornwall
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ
| | - Olivia Taylor
- School of Physical Therapy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO
| | - Mary Pomeroy
- School of Physical Therapy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO
| | - Judy Mufti
- School of Physical Therapy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO
| | - Holly Kuhlman
- School of Physical Therapy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO
| | - Derrik Ehlers
- School of Physical Therapy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO
| | - Drew Carrell
- School of Physical Therapy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO
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Castro-Méndez A, Munuera PV, Albornoz-Cabello M. The short-term effect of custom-made foot orthoses in subjects with excessive foot pronation and lower back pain: a randomized, double-blinded, clinical trial. Prosthet Orthot Int 2013; 37:384-90. [PMID: 23327838 DOI: 10.1177/0309364612471370] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN randomized, double-blinded, clinical trial. BACKGROUND Low back pain is one of the commonest disorders affecting the back. The literature reflects how over time excessive pronation of the foot has become to be recognized as linked to chronic low back pain, and how the problem can evolve for the better with the use of compensating foot orthoses. OBJECTIVES The main objective of this study is to answer the question of whether the use of a certain type of custom-made foot orthosis alleviates low back pain. MATERIAL AND METHODS In a sample of 51 participants with excessive subtalar pronation and chronic low back pain (43 women and 8 men), the effect of custom-made foot orthoses in low back pain was studied. The study design was a randomized, double-blinded, clinical trial with two groups: experimental, treated with the custom-made foot orthoses, and control, treated with a placebo. Low back pain was evaluated by a visual analog scale for pain and Oswestry's Disability Index Questionnaire for lower back pain at two moments--on the day of inclusion in the study and after 4 weeks of treatment. RESULTS The evolution of the low back pain showed significant differences in the experimental group, showing a significant reduction of pain and disability (p < 0.001, visual analog scale; p < 0.001, Oswestry's Index). CONCLUSIONS In the sample studied, the use of custom-made foot orthoses to control foot pronation had a short-term effect in reduction of perceived low back pain.
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Levinger P, Menz HB, Morrow AD, Bartlett JR, Feller JA, Bergman NR. Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis. J Foot Ankle Res 2013; 6:33. [PMID: 23927830 PMCID: PMC3750767 DOI: 10.1186/1757-1146-6-33] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 06/25/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dynamic joint loading, particularly the external knee adduction moment (KAM), is an important surrogate measure for the medio-lateral distribution of force across the knee joint in people with knee osteoarthritis (OA). Foot motion may alter the load on the medial tibiofemoral joint and hence affect the KAM. Therefore, this study aimed to investigate the relationship between tibia, rearfoot and forefoot motion in the frontal and transverse planes and the KAM in people with medial compartment knee OA. METHOD Motion of the knee, tibia, rearfoot and forefoot and knee moments were evaluated in 32 patients with clinically and radiographically-confirmed OA, predominantly in the medial compartment. Pearson's correlation coefficient was used to investigate the association between peak values of tibia, rearfoot and forefoot motion in the frontal and transverse planes and 1st peak KAM, 2nd peak KAM, and the knee adduction angular impulse (KAAI). RESULTS Lateral tilt of the tibia was significantly associated with increased 1st peak KAM (r = 0.60, p < 0.001), 2nd peak KAM (r = 0.67, p = 0.001) and KAAI (r = 0.82, p = 0.001). Increased peak rearfoot eversion was significantly correlated with decreased 2nd peak KAM (r = 0.59, p < 0.001) and KAAI (r = 0.50, p = 0.004). Decreased rearfoot internal rotation was significantly associated with increased 2nd peak KAM (r = -0.44, p = 0.01) and KAAI (r = -0.38, p = 0.02), while decreased rearfoot internal rotation relative to the tibia was significantly associated with increased 2nd peak KAM (r = 0.43, p = 0.01). Significant negative correlations were found between peak forefoot eversion relative to the rearfoot and 2nd peak KAM (r = -0.53, p = 0.002) and KAAI (r = -0.51, p = 0.003) and between peak forefoot inversion and 2nd peak KAM (r = -0.54, p = 0.001) and KAAI (r = -0.48, p = 0.005). CONCLUSION Increased rearfoot eversion, rearfoot internal rotation and forefoot inversion are associated with reduced knee adduction moments during the stance phase of gait, suggesting that medial knee joint loading is reduced in people with OA who walk with greater foot pronation. These findings have implications for the design of load-modifying interventions in people with knee OA.
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Affiliation(s)
- Pazit Levinger
- Institute of Sport, Exercise and Active Living, College of Sport and Exercise Science, Victoria University, Melbourne Vic 8001, Australia.
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Levinger P, Menz HB, Morrow AD, Feller JA, Bartlett JR, Bergman NR. Foot kinematics in people with medial compartment knee osteoarthritis. Rheumatology (Oxford) 2012; 51:2191-2198. [DOI: 10.1093/rheumatology/kes222] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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36
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Levinger P, Menz HB, Morrow AD, Bartlett JR, Feller JA, Fotoohabadi MR, Bergman NR. Dynamic foot function changes following total knee replacement surgery. Knee 2012; 19:880-5. [PMID: 22672961 DOI: 10.1016/j.knee.2012.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 03/26/2012] [Accepted: 05/13/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with knee osteoarthritis (OA) have flatter/more pronated feet than those without OA, but it is unclear whether altered foot posture and function are a cause or consequence of knee OA. The purpose of this study was to examine whether changes in foot posture and function occur after realignment of the knee following total knee replacement (TKR). MATERIALS AND METHODS Nineteen patients with predominantly medial compartment knee OA were tested prior to and 12 months after TKR. The Foot Posture Index (FPI) and Arch Index (AI) were measured as well as motion of the tibia, rearfoot and forefoot using a 3D motion analysis system incorporating a multisegment foot model. RESULTS There were no significant changes in FPI or AI following TKR, however gait analysis revealed significant increases in tibial external rotation (-18.7 ± 7.0° vs -22.5 ± 8.7°, p=0.002), tibial transverse plane range of motion (-9.1 ± 4.6° vs -11.4 ± 6.1°, p=0.0028) and rearfoot range of motion in the frontal plane (8.6 ± 2.6° vs 10.4 ± 2.7°, p=0.002), and a decrease in rearfoot transverse plane range of motion (8.7 ± 5.3° vs 5.9 ± 4.1°, p=0.038) following the procedure. CONCLUSIONS TKR produces no change in static foot posture, but results in significant changes in rearfoot kinematics during gait. These findings suggest that rearfoot motion compensates for changes in the alignment of the knee, highlighting the ability of the foot to accommodate for proximal skeletal malalignment.
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Affiliation(s)
- Pazit Levinger
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne VIC 8001, Australia.
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Kim SH, Kim SY, Kim HB. The Correlation Between Foot and Knee Posture Characteristics in Knee Osteoarthritis People. ACTA ACUST UNITED AC 2012. [DOI: 10.13066/kspm.2012.7.4.433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Radzimski AO, Mündermann A, Sole G. Effect of footwear on the external knee adduction moment - A systematic review. Knee 2012; 19:163-75. [PMID: 21733696 DOI: 10.1016/j.knee.2011.05.013] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 05/25/2011] [Accepted: 05/30/2011] [Indexed: 02/02/2023]
Abstract
CONTEXT Footwear modifications have been investigated as conservative interventions to decrease peak external knee adduction moment (EKAM) and pain associated with knee osteoarthritis (OA). OBJECTIVE To evaluate the literature on the effect of different footwear and orthotics on the peak EKAM during walking and/or running. METHODS A systematic search of databases resulted in 348 articles of which 33 studies were included. RESULTS Seventeen studies included healthy individuals and 19 studies included subjects with medial knee OA. Quality assessment (modified Downs and Black quality index) showed an (average±SD) of 73.1±10.1%. The most commonly used orthotic was the lateral wedge, with three studies on the medial wedge. Lateral wedging was associated with decreased peak EKAM in healthy participants and participants with medial knee OA while there is evidence for increased peak EKAM with the use of medial wedges. Modern footwear (subjects' own shoe, "stability" and "mobility" shoes, clogs) were likely to increase the EKAM compared to barefoot walking in individuals with medial knee OA. Walking in innovative shoes ("variable stiffness") decreased the EKAM compared to control shoes. Similarly, shoes with higher heels, sneakers and dress shoes increased EKAM in healthy individuals compared to barefoot walking. CONCLUSIONS Further development may be needed toward optimal footwear for patients with medial knee OA with the aim of obtaining similar knee moments to barefoot walking.
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Affiliation(s)
- Andy Oliver Radzimski
- Center for Physiotherapy Research, University of Otago, P.O. Box 56, Dunedin, New Zealand
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Riskowski J, Dufour AB, Hannan MT. Arthritis, foot pain and shoe wear: current musculoskeletal research on feet. Curr Opin Rheumatol 2011; 23:148-55. [PMID: 21150623 DOI: 10.1097/bor.0b013e3283422cf5] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Both arthritis and foot pain are major public health problems. Approximately 24% of adults have foot ailments, and the prevalence increases with age. Foot pain, particularly related to shoes, footwear and rheumatic disorders, may be an important modifiable factor. Surprisingly, this topic has received little attention in the rheumatology community. RECENT FINDINGS Despite the major focus of structure and alignment in arthritis, remarkably little work has focused on the foot and nonsurgical foot interventions that might affect lower extremity joint alignment, structure and pain in rheumatic diseases. Emerging research suggests that there may be a significant role for foot orthotics and footwear in the treatment of rheumatoid arthritis and osteoarthritis of the hip, knee and foot. This review highlights the current understanding on the topic of foot orthotics and footwear in adults with rheumatic diseases. SUMMARY Biomechanical evidence indicates that foot orthotics and specialized footwear may change muscle activation and gait patterns to reduce joint loading. Emerging evidence suggests that orthotics, specific shoe types and footwear interventions may provide an effective nonsurgical intervention in rheumatic diseases. Yet good data are sparse, and it is premature to recommend guidelines. As there are a limited number of studies that underpin the foot's role in arthritis cause and progression, clinical trials and prospective studies are of utmost importance to unravel the links between foot pain, foot conditions and interventions that lessen the impact of rheumatic diseases.
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Affiliation(s)
- Jody Riskowski
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131-1097, USA
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Abstract
STUDY DESIGN Controlled laboratory study. OBJECTIVE To explore potential associations between foot posture index (FPI-6) composite scores and dynamic plantar pressure measurements, and to describe each of the 6 subscales and the FPI-6 composite scores across our sample. BACKGROUND The FPI-6 is a static foot posture assessment comprised of 6 observations. Extreme scores have been associated with increased injury risk. However, knowledge describing the relationship between FPI-6 scores and plantar pressure distributions during gait is limited. METHODS Participants (n = 1000; 566 males, 434 females) were predominantly active adults (mean ± SD age, 30.6 ± 8.0 years; body mass index, 26.2 ± 3.7 kg/m²), who ran 3.1 ± 1.4 d/wk. Static and dynamic foot characteristics were compared using the FPI-6 and a capacitance-based pressure platform. Correlation and hierarchical stepwise regression analyses were performed to determine the most parsimonious set of dynamic pressure data associated with FPI-6 scores. RESULTS The mean ± SD FPI-6 score was 3.4 ± 2.9 (range, -6.0 to 11.0). Only 31 participants received a score of -2 (supinated foot) on any FPI-6 subscale. Classification of a pronated foot was 2.4 times more likely than a supinated foot. A 5-variable model (R = 0.57, R2 = 0.32) was developed to describe the association between dynamic plantar pressures and FPI-6 scores. CONCLUSION The multivariate model associated with FPI-6 scores comprised clinically plausible variables which inform the association between static and dynamic foot postures. Different cutoff values may be required when using the FPI-6 to screen for individuals with supinated feet, given the limited number of high-arched participants identified by FPI-6 classifications.
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Cornwall MW, McPoil TG. Relationship between static foot posture and foot mobility. J Foot Ankle Res 2011; 4:4. [PMID: 21244705 PMCID: PMC3033808 DOI: 10.1186/1757-1146-4-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 01/18/2011] [Indexed: 11/24/2022] Open
Abstract
Background It is not uncommon for a person's foot posture and/or mobility to be assessed during a clinical examination. The exact relationship, however, between static posture and mobility is not known. Objective The purpose of this study was to determine the degree of association between static foot posture and mobility. Method The static foot posture and foot mobility of 203 healthy individuals was assessed and then analyzed to determine if low arched or "pronated" feet are more mobile than high arched or "supinated" feet. Results The study demonstrated that those individuals with a lower standing dorsal arch height and/or a wider standing midfoot width had greater mobility in their foot. In addition, those individuals with higher Foot Posture Index (FPI) values demonstrated greater mobility and those with lower FPI values demonstrated less mobility. Finally, the amount of foot mobility that an individual has can be predicted reasonably well using either a 3 or 4 variable linear regression model. Conclusions Because of the relationship between static foot posture and mobility, it is recommended that both be assessed as part of a comprehensive evaluation of a individual with foot problems.
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Affiliation(s)
- Mark W Cornwall
- The Laboratory for Foot and Ankle Research, Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Thomas G McPoil
- School of Physical Therapy, Regis University, Denver, CO 80221, USA
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Levinger P, Menz HB, Fotoohabadi MR, Feller JA, Bartlett JR, Bergman NR. Foot posture in people with medial compartment knee osteoarthritis. J Foot Ankle Res 2010; 3:29. [PMID: 21162748 PMCID: PMC3020154 DOI: 10.1186/1757-1146-3-29] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 12/16/2010] [Indexed: 12/28/2022] Open
Abstract
Background Foot posture has long been considered to contribute to the development of lower limb musculoskeletal conditions as it may alter the mechanical alignment and dynamic function of the lower limb. This study compared foot posture in people with and without medial compartment knee osteoarthritis (OA) using a range of clinical foot measures. The reliability of the foot measures was also assessed. Methods The foot posture of 32 patients with clinically and radiographically-confirmed OA predominantly in the medial compartment of the knee and 28 asymptomatic age-matched healthy controls was investigated using the foot posture index (FPI), vertical navicular height and drop, and the arch index. Independent t tests and effect size (Cohen's d) were used to investigate the differences between the groups in the foot posture measurements. Results Significant differences were found between the control and the knee OA groups in relation to the FPI (1.35 ± 1.43 vs. 2.46 ± 2.18, p = 0.02; d = 0.61, medium effect size), navicular drop (0.02 ± 0.01 vs. 0.03 ± 0.01, p = 0.01; d = 1.02, large effect size) and the arch index (0.22 ± 0.04 vs. 0.26 ± 0.04, p = 0.04; d = 1.02, large effect size). No significant difference was found for vertical navicular height (0.24 ± 0.03 vs. 0.23 ± 0.03, p = 0.54; d = 0.04, negligible effect size). Conclusion People with medial compartment knee OA exhibit a more pronated foot type compared to controls. It is therefore recommended that the assessment of patients with knee OA in clinical practice should include simple foot measures, and that the potential influence of foot structure and function on the efficacy of foot orthoses in the management of medial compartment knee OA be further investigated.
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Affiliation(s)
- Pazit Levinger
- Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria 3086, Australia.
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Varus and valgus deformities in knee osteoarthritis among different ethnic groups (Indian, Portuguese and Canadians) within an urban Canadian rheumatology practice. INDIAN JOURNAL OF RHEUMATOLOGY 2010. [DOI: 10.1016/s0973-3698(11)60006-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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