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Blouin C, Genet F, Graff W, Bonnyaud C, Perrier A. Cross-cultural adaptation and reliability of the Foot Posture Index (FPI-6) - French version. Disabil Rehabil 2024; 46:1621-1629. [PMID: 37204129 DOI: 10.1080/09638288.2023.2203524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/12/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE The 6-item Foot Posture Index (FPI-6) is a reliable tool for the evaluation of foot deformities. Our aim was to translate and cross-culturally validate the FPI-6 for use in French-speaking countries and to determine the intra-rater and inter-rater reliability of the French version. METHODS Cross-cultural adaptation was performed according to guidelines. Two clinicians assessed the FPI-6 in 52 asymptomatic individuals. We evaluated intra- and inter-rater reliability with the intraclass correlation coefficients (ICC), correlations (p-value < 0.05) and Bland-Altman plots. Standard error of measurement (SEM) and minimum detectable change (MDC95) were determined. RESULTS For the cross-cultural adaptation, we modified several items of the FPI-6 user guide and added footnotes to ensure correct interpretation. ICC of the total FPI-6 scores were 0.94 to 0.96 for the intra- and inter-rater reliability for dominant and non-dominant lower limb. Correlations were significant (p < 0.001); r 0.88 to 0.92. Total score SEM was 0.68 to 0.78 and MDC95 was 1.58 to 1.82. CONCLUSIONS Intra- and inter-rater reliability of this French version of the FPI-6 was excellent for the total score and good to excellent for each item. The French FPI-6 can be used in French-speaking countries. The identification of SEM and MDC scores is useful for clinical interpretation.
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Affiliation(s)
- Cédric Blouin
- Université Paris Saclay, UVSQ, ERPHAN, Versailles, France
- Service de chirurgie orthopédique, Hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
- ISPC Synergies, Paris, France
| | - François Genet
- ISPC Synergies, Paris, France
- Unité Péri Opératoire du Handicap, (UPOH- Perioperative Disability Unit), Département PARASPORT- SANTE, service de Médecine Physique et de Réadaptation, Hôpital Raymond-Poincaré, Groupe Hospitalo-Universitaire APHP-Université PARIS SACLAY, Garches, France
- END: ICAP, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); UFR Simone Veil - Santé, Montigny-le-Bretonneux, France
| | - Wilfrid Graff
- Service de chirurgie orthopédique, Hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
| | - Céline Bonnyaud
- Université Paris Saclay, UVSQ, ERPHAN, Versailles, France
- Laboratoire d'analyse du mouvement, Service des Explorations Fonctionnelles, Hôpital Raymond Poincaré, APHP, Garches, France
| | - Antoine Perrier
- Service de chirurgie orthopédique, Hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
- Laboratoire de Recherche Translationnelle et d'innovation en Médecine et Complexité TIMC, CNRS, Grenoble, France
- Service de diabétologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Domaradzki J, Koźlenia D, Popowczak M, Šimonek J, Paška Ľ, Horička P. Prognostic Power of Foot Mobility in Identifying the Risk of Musculoskeletal Injuries: A Cross-Sectional Study of Male Volleyball Players at Different Competitive Levels. J Clin Med 2024; 13:1189. [PMID: 38592051 PMCID: PMC10932415 DOI: 10.3390/jcm13051189] [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: 01/09/2024] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: The arch structure and mobility of the foot are considered injury risk factors in volleyball. However, there are limited studies presenting differences in injury prevalence and the risk of lower limb injuries in relation to the competitive level in male volleyball. Therefore, the main aim of the current study was to evaluate foot mobility (through navicular drop test) as an injury risk factor in volleyball players from different competitive levels. (2) Methods: The reliability and usefulness of navicular drop testing were initially assessed in test-retest procedures (based on a sample of eight participants and 16 feet measurements), with primary analyses conducted using foot measurements of the twelve top-level volleyball players (24 feet) and eighteen academic-level volleyball players (36 feet). The modified navicular drop test was conducted, and the feet were classified based on arch height, and injury prevalence was retrospectively assessed with a previously validated questionnaire. Chi-squared tests, receiver operating curves, and logistic regression were used as statistical methods. The navicular drop test was verified as a reliable tool by intraclass correlation coefficient (ICC) (3.1) analysis. (3) Results: There were no significant differences in injury prevalence between academic- and top-level volleyball players, though there was a significant relationship between pronated foot and injury risk independent of competitive level. Generally, for both groups, thresholds above 10 mm of the navicular drop were predictors of lower limb injuries. The risk of injury if the foot was pronated ranged from 70% (academic level) to over 90% (top-level players). However, no statistically significant effect of competitive level on the chance of injury was observed. (4) Conclusions: Our study found a high prevalence of foot injuries independently of competitive level. There was a relationship between pronation of the foot and the risk of injury. However, the risk of lower limb injury was higher in pronated top-level players. Also, a navicular drop greater than 10 mm was an excellent predictor of injuries at both competitive levels.
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Affiliation(s)
- Jarosław Domaradzki
- Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, I.J. Paderewskiego 35, 51-612 Wroclaw, Poland
| | - Dawid Koźlenia
- Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, I.J. Paderewskiego 35, 51-612 Wroclaw, Poland
| | - Marek Popowczak
- Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, I.J. Paderewskiego 35, 51-612 Wroclaw, Poland
| | - Jaromir Šimonek
- Department of Physical Education and Sport, Constantine the Philosopher University in Nitra, Tr. A. Hlinku 1, 94901 Nitra, Slovakia; (J.Š.); (Ľ.P.); (P.H.)
| | - Ľubomír Paška
- Department of Physical Education and Sport, Constantine the Philosopher University in Nitra, Tr. A. Hlinku 1, 94901 Nitra, Slovakia; (J.Š.); (Ľ.P.); (P.H.)
| | - Pavol Horička
- Department of Physical Education and Sport, Constantine the Philosopher University in Nitra, Tr. A. Hlinku 1, 94901 Nitra, Slovakia; (J.Š.); (Ľ.P.); (P.H.)
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Castellini JLA, Grande Ratti MF, Chan DM. Age, Gender, Body Mass Index, and Foot Loading During Gait. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231198524. [PMID: 37767006 PMCID: PMC10521294 DOI: 10.1177/24730114231198524] [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] [Indexed: 09/29/2023] Open
Abstract
Background The aim was to analyze changes in normal functional parameters of gait analysis by aging, sex, and body mass index (BMI). Methods A cross-sectional study with a consecutive sample of asymptomatic subjects was performed between 2014 and 2020. Primary outcomes were time and force parameters (contact time and center of force [CoF] time), in the heel, midfoot, and metatarsal areas, measured using an in-office force platform. Results A total of 156 subjects (312 feet) were included, including 67% of women with a mean age of 47 years. The mean of total contact time was similar in males and females (P = .695) and across BMI (P = .413). Contact time did not show differences by region (P = .648 heel, P = .286 midfoot, and P = .690 metatarsal). CoF time in the heel and metatarsal areas did not change between males and females (P = .288 and P = .879, respectively); meanwhile, it was different in midfoot (P = .002). Maximum force showed a reduction between sexes in the heel (P = .039) but did not in the midfoot and metatarsal areas. By age, differences were detected in the heel and metatarsal areas in females (P = .002 and P = .001) and the metatarsal area in males (P = .001). According to the age groups, total contact time increased in females (P = .001) but not in males (P = .018), and no differences were detected between foot areas. In females, CoF time did not change either foot areas or age groups. In males, CoF time values increased in the midfoot area in the older group (P = .001). Conclusion Time variables did not change by foot region, independent of age, sex, and BMI. Heel maximum force decreased in females, probably linked to adaptive phenomena by aging. The midfoot remains stable, and acts as an undamaged "bridge." These parameters could be interpreted as normal in asymptomatic subjects. Level of Evidence Level III, diagnostic and prognostic.
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Affiliation(s)
| | - María Florencia Grande Ratti
- Internal Medicine Research Unit, Department of Internal Medicine, Hospital Italiano de Buenos Aires, Argentina
- CONICET (National Council for Scientific and Technical Research), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Débora Mirta Chan
- UTN (National Technological University), Buenos Aires Regional Faculty, Buenos Aires, Argentina
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Bitenc-Jasiejko A, Walińska A, Konior K, Gonta K, Skomro P, Kijak K, Kowacka M, Lietz-Kijak D. Characteristics of Pressure on the Apophysis in the Course of Paediatric Heel Pain-Preliminary Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5403. [PMID: 37048018 PMCID: PMC10094411 DOI: 10.3390/ijerph20075403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
Increased pressure on the heel apophysis is often implicated as a cause of paediatric heel pain. However, there are few reports on the causes of the increased pressure and its origin. Therefore, the aim of this study was to analyse the distribution of pressure on the feet in children with heel pain. The study included 33 paediatric patients with non-traumatic heel pain, i.e., 24 boys (73%) and 9 girls (27%), aged on average 11.2 years (±3 years). Pedobarographic diagnostics proved a decrease in the pressure on the heels in relation to the ground and the transfer of the projection of the centre of gravity to the forefoot. While standing, the average contribution of the pressure on the heel was 0.52, SD = 0.14 in children with normal and reduced weight. In overweight children, the average pressure on the heel was higher (0.60, SD = 0.08), but the small number of children with this characteristic (n = 4) did not allow conclusions to be drawn in this area. Heel underload was also demonstrated during gait. However, the assessment of this aspect requires additional observational analyses in the field of propulsion and gait phases. The reduced pressure on the heel promotes apophysis traction, causing intracanal compression. Studies have shown that the causes of apophysis traction may be postural defects (in particular, forward inclination of body posture) and overpronation of the foot, or defects in the metatarsal area.
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Affiliation(s)
- Aleksandra Bitenc-Jasiejko
- Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Anna Walińska
- PODOLOGIA.pl, FIKOU Physiotherapy, 44-100 Gliwice, Poland
| | - Krzysztof Konior
- Doctoral Study Department of Propaedeutic, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Kinga Gonta
- Orthogenic Rehabilitation and Podology Center, 45-573 Wroclaw, Poland
| | - Piotr Skomro
- Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Konrad Kijak
- Student Scientific Society at the Department and Clinic of Internal Diseases, Angiology and Physical Medicine, Medical University of Silesia, 40-055 Katowice, Poland
| | | | - Danuta Lietz-Kijak
- Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland
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Sato T, Fukui T, Kawata S, Nagahori K, Miyaso H, Li Z, Omotehara T, Itoh M. The interrelationship between three-dimensional foot mobility and bodyweight bearing. J Phys Ther Sci 2023; 35:199-203. [PMID: 36866006 PMCID: PMC9974320 DOI: 10.1589/jpts.35.199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/01/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] To clarify the three-dimensional nature of foot mobility and its interrelationships within the foot due to bodyweight bearing. [Participants and Methods] Data regarding left foot mobility due to body weight bearing were collected from 31 healthy adults. Foot shape differences while sitting and standing, and their interrelationship were examined. The same examiner reapplied the landmark stickers when misaligned during measurement position changes. [Results] The foot length, heel width, forefoot width, hallux valgus angle, and calcaneus eversion angle were significantly larger in the standing than in sitting position. The digitus minimus varus angle was significantly smaller in the standing than in sitting position. The medial and lateral malleoli, navicular, and dorsum of the foot were displaced medially and inferiorly; the other indices, except for the midfoot, were displaced anteriorly. The interrelationships within the foot showed a positive correlation between the calcaneus eversion angle and the medial displacement of the medial and lateral malleoli, navicular, and dorsum of the foot points. There was a negative correlation between the calcaneus eversion angle and inferior displacement of the medial malleolus, navicular, and dorsum of the foot. [Conclusion] The intra-foot coordination relationship in response to bodyweight bearing was clarified.
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Affiliation(s)
- Toshihiko Sato
- Department of Anatomy, School of Medicine, Tokyo Medical
University: 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan, Department of Physical Therapy, Faculty of Health Science
Technology, Bunkyo Gakuin University, Japan,Corresponding author. Toshihiko Sato (E-mail: )
| | - Tsutomu Fukui
- Department of Physical Therapy, Faculty of Health Science
Technology, Bunkyo Gakuin University, Japan, Health Care Science, Graduate School, Bunkyo Gakuin
University, Japan
| | - Shinichi Kawata
- Department of Anatomy, School of Medicine, Tokyo Medical
University: 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Kenta Nagahori
- Department of Anatomy, School of Medicine, Tokyo Medical
University: 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Hidenobu Miyaso
- Department of Anatomy, School of Medicine, Tokyo Medical
University: 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Zhonglian Li
- Department of Anatomy, School of Medicine, Tokyo Medical
University: 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Takuya Omotehara
- Department of Anatomy, School of Medicine, Tokyo Medical
University: 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Masahiro Itoh
- Department of Anatomy, School of Medicine, Tokyo Medical
University: 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
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Foot Morphology and Running Gait Pattern between the Left and Right Limbs in Recreational Runners. PHYSICAL ACTIVITY AND HEALTH 2023. [DOI: 10.5334/paah.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Castellini J. Parámetros biomecánicos de la función del pie medidos en el consultorio del especialista en Ortopedia y Traumatología. REVISTA DE LA ASOCIACIÓN ARGENTINA DE ORTOPEDIA Y TRAUMATOLOGÍA 2022. [DOI: 10.15417/issn.1852-7434.2022.87.6.1557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introducción: Los estudios dinámicos de la función del pie habitualmente se realizan en laboratorios de marcha de gran complejidad. El objetivo de este estudio fue analizar parámetros funcionales utilizando una plataforma de fuerza en una serie de pacientes asintomáticos evaluados en consultorios externos.
Materiales y Métodos: Estudio de corte transversal que incluyó una serie consecutiva de pacientes asintomáticos voluntarios a quienes se les realizó una medición con una plataforma de fuerza (TekScan MatScan®, Boston, MA, EE.UU.) entre 2014 y 2020, en la Ciudad Autónoma de Buenos Aires, Argentina.
Resultados: Se incluyeron 316 registros de 158 pacientes con mediciones bilaterales. La mayoría eran mujeres (66,5%) y el promedio de la edad era de 47 años (DE 16.1). Se evaluaron 14 variables, correspondientes a parámetros de fuerza, trayectoria y tiempo de contacto de la fuerza. El tiempo de contacto total fue de 0,79 segundos (DE 0,09), el CoF time según la región del pie fue del 20% en el talón, 26% en el mediopié y 46% en el antepié. El CPEI (center of pressure excursion index) fue del 16,55% (DE 7,14).
Conclusiones: Se comunican los parámetros funcionales del pie en pacientes asintomáticos. Se midieronel tiempo de contacto del pie en el suelo, la fuerza (en talón, mediopié y antepié) y la trayectoria de la fuerza con una plataforma de fuerza. No se utilizaron radiaciones ionizantes. Estos hallazgos podrían ser utilizados como valores de referencia para detectar marchas patológicas.
Nivel de Evidencia: II
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Zhao C, Chen J, Deng Y, Huang W, Ma S, Su S, Zhao Z, Tang J, Wang J, Huang W, Tang L, Hu N. Arch volume:a new method for medial longitudinal arch measurement. Foot Ankle Surg 2022; 28:962-967. [PMID: 35105517 DOI: 10.1016/j.fas.2022.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/21/2021] [Accepted: 01/19/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND As a flexible and elastic structure, the dynamic morphometry of medial longitudinal arch remains to be an unresolved Issue for clinic. Here we introduce a new measurement named arch volume to describe the morphological changes of the medial longitudinal arch during weight-bearing and compare with present method for measuring MLA. METHODS 64 healthy participants were enrolled. And the dynamic arch morphology was measured under four weight bearing status with navicular height, arch area and arch volume, respectively. RESULTS With the increase of weight loading, the flattening or slightly deformation of medial longitudinal arch was observed by all method (p<0.05). However, as a 3D indicator, arch volume not only showed higher sensitivity than other method, but also provide visualization of MLA during loading changing. CONCLUSIONS Compared with navicular height and arch area, arch volume has a significant advantage in describing arch morphological changes under different weight bearing status.
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Affiliation(s)
- Chen Zhao
- The First Affiliated Hospital of Chongqing Medical University, China.
| | - Jing Chen
- The First Affiliated Hospital of Chongqing Medical University, China; Shanqi (Chongqing) Smart Medical Technology Co., Ltd., China.
| | - Yi Deng
- Chongqing Orthopaedic Hospital of traditional Chinese Medicine, China.
| | - Wenping Huang
- Chongqing Orthopaedic Hospital of traditional Chinese Medicine, China.
| | - Shanzhi Ma
- Chongqing Orthopaedic Hospital of traditional Chinese Medicine, China.
| | - Songchuan Su
- Chongqing Orthopaedic Hospital of traditional Chinese Medicine, China.
| | - Zhi Zhao
- Chongqing Orthopaedic Hospital of traditional Chinese Medicine, China.
| | - Jing Tang
- Shanqi (Chongqing) Smart Medical Technology Co., Ltd., China.
| | - Jiawei Wang
- The First Affiliated Hospital of Chongqing Medical University, China.
| | - Wei Huang
- The First Affiliated Hospital of Chongqing Medical University, China.
| | - Li Tang
- The First Affiliated Hospital of Chongqing Medical University, China; Shanqi (Chongqing) Smart Medical Technology Co., Ltd., China.
| | - Ning Hu
- The First Affiliated Hospital of Chongqing Medical University, China.
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Patellofemoral Pain Syndrome in Young Female Athletes: A Case-Control Study. Adv Orthop 2022; 2022:1907975. [PMID: 35465126 PMCID: PMC9033388 DOI: 10.1155/2022/1907975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background Patellofemoral pain syndrome (PFPS) is the most common cause of anterior knee pain in children and adolescents, and it is characterized by highly limiting, recurrent, frontal pain. Objectives The purpose of the study is to assess the incidence and onset of PFPS in the young female athletes and to compare it to healthy individuals. Methods Between 2017 and 2019, 51 subjects were reviewed and divided in three groups: rhythmic gymnastics athletes (RG; 21 individuals, mean age: 13.8 ± 3.6 years), basketball athletes (BG; 17 individuals, mean age: 14.2 ± 3.1 years), and control group (CG; 13 individuals, mean age: 14.5 ± 4.3 years). All patients underwent physical examination including patellar glide, tilt, grind and apprehension tests, tiptoe and jack tests, Coleman block, and navicular drop tests. The clinical and functional outcomes of the subjects were assessed using the Kujala patellofemoral score (KPS). Results In RG patients were recorded 66.7% of normal footprint (NF), 9.5% of cavus feet (FCF), and 23.8% of flatfeet (FFF); 14.8% patellar positive tests, KS = 98.6 ± 13.7. BG patients had 70.6% of NF, 11.8% FCF, and 17.6% of FFF; 23.5% patellar positive tests, KS = 98.3 ± 12.4. CG patients had 61.5% of NF, 7.7% of FCF and 30.8% of FFF; 15.4% patellar positive tests, KPS = 98,9 ± 15.3. No statistically significance was found between the three cohorts of patients. Conclusions PFPS is a common pathology; muscular imbalance and overuse could exacerbate pain and discomfort in young female athletes. Our findings show high type and level of sport activity are not related to increase frequency of clinical symptoms related to PFPS.
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10
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Safar Cherati A, Khalifeh Soltani S, Moghadam N, Hassanmirzaei B, Haratian Z, Khalifeh Soltani S, Rezaei M. Is there a relationship between lower-extremity injuries and foot postures in professional football players? A prospective cohort study. SCI MED FOOTBALL 2022; 6:49-59. [PMID: 35236229 DOI: 10.1080/24733938.2020.1870711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Lower extremity injuries are an ongoing concern for professional football players. This study aims to evaluate the relationship between foot posture and lower extremity injuries in professional football players. METHOD In this prospective cohort study, 420 male players of the Iran Premium football league were evaluated during the 2015-2016 season. The players were assessed for their foot types based on optical and static foot scans and foot posture index (FPI). The trained club physicians recorded all injuries during the season. RESULT The analyzed data of 244 players showed the highest rate of lower extremity injury in hamstrings, ankle, and groin, respectively. These injuries led to 46% of time loss. The probability of hamstrings injuries was higher among pronated players based on static, optic, FPI, and visual examination, 2.1, 1.8, 1.8, and 2.3, respectively. Medial Collateral Ligament (MCL) injuries were associated with subtalar joint abnormality defined by visual observation. An increased relative risk of leading-to-absence injuries among the flat foot group was significant based on optic scanning, FPI, and visual observation. CONCLUSION Abnormal foot postures in professional football players may increase the risk of hamstring and MCL injuries and time loss due to lower extremity injuries.
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Affiliation(s)
- Afsaneh Safar Cherati
- Department of Sport and Exercise Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Salman Khalifeh Soltani
- Department of Sport and Exercise Medicine, Iran University of Medical Sciences, Tehran, Iran.,Iran Football Medical Assessment and Rehabilitation Center - IFMARC, Tehran, Iran
| | - Navid Moghadam
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahar Hassanmirzaei
- Iran Football Medical Assessment and Rehabilitation Center - IFMARC, Tehran, Iran.,Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Haratian
- Iran Football Medical Assessment and Rehabilitation Center - IFMARC, Tehran, Iran
| | | | - Meisam Rezaei
- Department of Sport and Exercise Medicine, Iran University of Medical Sciences, Tehran, Iran
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11
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Kirmizi M, Cakiroglu MA, Sengul YS, Elvan A, Simsek IE, Angin S. Investigation of the Relationships Among Clinical Measures of Foot Posture in Individuals with and Without Pronated Foot. J Am Podiatr Med Assoc 2021; 111. [PMID: 35294150 DOI: 10.7547/19-122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Many indirect clinical techniques have been developed to assess foot posture; however, there is relatively little research investigating the relationships among these techniques. We investigated the relationships among the most commonly used clinical measures of foot posture-Foot Posture Index-6 (FPI-6), navicular drop (NDP), navicular drift (NDT), and static and dynamic arch indices (SAI and DAI)-in individuals with normal foot posture and those with pronated foot. METHODS Sixty-three individuals with FPI-6 scores of 0 to 12 were included. A digital caliper was used to measure NDP and NDT; SAI and DAI were measured by electronic pedobarography. Assessments were applied on the dominant foot. Pearson correlation coefficients were calculated to determine the relationships among measures. Participants were classified into two groups, pronated foot (n = 33) and normal foot posture (n = 30), based on FPI-6 scores, providing a multisegmental and multiplanar assessment. The independent-samples t test was used to compare groups regarding NDP, NDT, SAI, and DAI. RESULTS We found a high correlation between NDP and FPI-6 (r = 0.754) and between NDP and NDT (r = 0.778) (all P < .001). A moderate correlation was found between NDT and FPI-6 (r = 0.599) and between DAI and SAI (r = 0.519) (all P < .001). A negligible correlation was found between NDP and DAI (r = 0.268; P = .033). Furthermore, NDP, NDT, and DAI values were higher in individuals with pronated foot compared with those with normal posture (P < .001 for NDP and NDT; P = .022 for DAI), whereas SAI values were not (P = .837). CONCLUSIONS These results suggest that there are moderate-to-strong relationships among FPI-6, NDP, and NDT and between SAI and DAI. The NDP, NDT, and DAI are suitable for the classification of foot posture based on FPI-6 scores. This study can guide clinicians and researchers to associate the foot posture measures with each other.
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12
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Walker H, Scharfbillig R, Jones S. Does the Nonweightbearing Foot Position Replicate the Neutral Calcaneal Stance Position in an Adult Population? J Am Podiatr Med Assoc 2021; 111. [PMID: 34861689 DOI: 10.7547/19-133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The neutral calcaneal stance position (NCSP), despite its known issues, is currently used as an "ideal" measure compared with the resting stance position in clinical podiatric medicine. The nonweightbearing (NWB) foot position, as used in the foot mobility magnitude (FMM), can provide an alternative comparative position, which is partially validated, if a significant correlation between the NCSP and the NWB position exists. This study aimed to establish the correlation between the component measures of the FMM in the NCSP and the NWB foot position of the FMM. METHODS Eighty participants were recruited. Measures of dorsal arch height (DAH) and midfoot width (MFW) were obtained at the 50% total foot length mark in the NCSP and the NWB position by two examiners using the apparatus described by McPoil et al. RESULTS Reliability analysis with intraclass correlation coefficients (ICCs) indicated intrarater results of 0.90 to 0.99 for DAH and 0.96 to 0.99 for MFW and interrater results of 0.90 for DAH and 0.96 for MFW in the NWB position. Using a Pearson product moment correlation coefficient analysis, there was a significant correlation between the NCSP and the NWB position for DAH (r = 0.82) and MFW (r = 0.86). CONCLUSIONS A significant correlation between the NCSP and the NWB position was evident when the measures of DAH and MFW were conducted. Therefore, clinically, the NWB position can potentially replace the NCSP as the ideal position for clinical treatment.
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Effects of taping techniques on arch deformation in adults with pes planus: A meta-analysis. PLoS One 2021; 16:e0253567. [PMID: 34214104 PMCID: PMC8253385 DOI: 10.1371/journal.pone.0253567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 06/08/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate effects of taping techniques on arch deformation in adults with pes planus. Methods The following databases were searched up to March 2020, including Web of Science, Pubmed, EBSCO, CNKI and Cochrane Library. Heterogeneity and publication bias were assessed by I2 index and funnel plots, respectively. In addition, Cochrane scale was used to evaluate the quality of research. Results Navicular height for three antipronation taping techniques significantly increased immediately post tape compared with baseline (mean difference = 4.86 mm, 95% CI = 2.86–6.87 mm, Z = 4.75, p < 0.001). The highest increase was observed in Augmented low-Dye (ALD). Modified low-Dye (MLD) was second only to ALD (p<0.001). Navicular height after walking for 10 min was much higher than baseline (p<0.001), with MLD decreased smaller than ALD. Conclusions ALD was the most effective taping technique for controlling foot arch collapse immediately post tape compared with baseline, followed by MLD. By contrast, MLD could possibly performed better than ALD in maintaining immediate navicular height after walking for 10 min. Low-Dye could make resting calcaneal stance position closer to neutral position. Although positive effects of Navicular sling, low-Dye and Double X taping interventions were observed, they could not maintain this immediate navicular height effect after a period of higher intensity weight-bearing exercise.
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Maruyama M, Yozu A, Okamoto Y, Shiraki H. Relationship between total weight-bearing response of the navicular and talus bones and weight-bearing response of hindfoot valgus in normal foot arch. THE JOURNAL OF PHYSICAL FITNESS AND SPORTS MEDICINE 2021. [DOI: 10.7600/jpfsm.10.75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Masafumi Maruyama
- Graduate School of Comprehensive Human Science, University of Tsukuba
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences
| | - Arito Yozu
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences
| | - Yoshikazu Okamoto
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University of Tsukuba
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15
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Kirmizi M, Cakiroglu MA, Elvan A, Simsek IE, Angin S. Reliability of Different Clinical Techniques for Assessing Foot Posture. J Manipulative Physiol Ther 2020; 43:901-908. [PMID: 32829944 DOI: 10.1016/j.jmpt.2020.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 02/06/2020] [Accepted: 02/14/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim was to determine the interrater and intrarater reliability of navicular drop (NDP), navicular drift (NDT), and the Foot Posture Index-6 (FPI-6), and test-retest reliability of the static arch index (SAI) and dynamic arch index (DAI). METHODS Sixty healthy individuals were assessed for intrarater and test-retest reliability. From 60 participants, 30 individuals were assessed for interrater reliability. A digital caliper was used to measure NDP and NDT. Electronic pedography was used to calculate SAI and DAI. The FPI-6 was also performed. All assessments were performed on the dominant foot. The NDP, NDT, SAI, and DAI were repeated 3 times. The NDP and NDT were analyzed separately using both first measurement and the average, but the SAI and DAI were analyzed using only the average. The NDP, NDT, and FPI-6 were conducted by 2 raters to determine interrater reliability and were repeated by a single rater after 5 days from initial assessment to determine intrarater reliability. The SAI and DAI were also repeated after 5 days to determine test-retest reliability. RESULTS Intrarater intraclass correlation coefficients (ICCs) were 0.934 and 0.970 for NDP, 0.724 and 0.850 for NDT, and 0.945 for FPI. Interrater ICCs were 0.712 and 0.811 for NDP, 0.592 and 0.797 for NDT, and 0.575 for FPI. Test-retest ICCs of the SAI and DAI were 0.850 and 0.876, respectively. CONCLUSION Navicular drop is relatively more reliable than other traditional techniques. Also, the FPI-6 has excellent intrarater reliability, but only moderate interrater reliability. The results can provide clinicians and researchers with a reliable way to implement foot posture assessment.
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Affiliation(s)
- Muge Kirmizi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, TurkeyInstitute of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
| | | | - Ata Elvan
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Ibrahim Engin Simsek
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Salih Angin
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
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Agoada D, Kramer PA. Radiographic measurements of the talus and calcaneus in the adult pes planus foot type. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 171:613-627. [PMID: 31930491 DOI: 10.1002/ajpa.23994] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 12/02/2019] [Accepted: 12/13/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE A distinctive feature of the modern human foot is the presence of a medial longitudinal arch when weight-bearing. Although the talus and calcaneus play a major role in the structure and function of the human foot, the association between the morphology of these bones and longitudinal arch height has not been fully investigated. A better understanding of this relationship may assist in the interpretation of pedal remains of fossil hominins, where features of the foot and ankle morphology have been described as providing evidence for the presence of a longitudinal arch. METHODS For this study, weight-bearing radiographs of 103 patients from an urban US Level 1 trauma center, taken as part of a clinical examination for medical evaluation, were selected. These radiographs were classified as to foot type by arch height as defined using the calcaneal inclination angle. From this group, 68 radiographs were suitable for linear and angular measurements of the talus and 74 of the calcaneus. The relationships between these measurements and arch height were explored using least squared linear regression analysis. RESULTS The results demonstrate that angular measurements of the calcaneus (particularly those that reflect the relationship of the talar articular facets to each other and the tilt of the calcaneocuboid joint to the longitudinal axis of the calcaneus) are predictive of arch height (r2 = .29-.44 p ≤ .001). All angular measurements of the talus and all examined linear measurements of both the talus and calcaneus were not predictive of arch height. DISCUSSION These results suggest that certain angular measurements of the calcaneus are associated with arch height in the modern human foot. While this information is useful in the interpretation of hominin pedal remains, the relationship of the morphology of these bones, as well as other bones of the foot, to arch height is complex, requiring further investigation.
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Affiliation(s)
- David Agoada
- Department of Anthropology, University of Washington, Seattle, Washington
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17
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Behling AV, Manz S, von Tscharner V, Nigg BM. Pronation or foot movement - What is important. J Sci Med Sport 2019; 23:366-371. [PMID: 31776068 DOI: 10.1016/j.jsams.2019.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/17/2019] [Accepted: 11/04/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Despite difficulties to quantify foot pronation non-invasively and during dynamic tasks, pronation was frequently discussed with respect to injury risk and footwear development. Typically, surrogate measures were used to approximate the movement of pronation showing inconsistent results due to the high variability in the methodology and protocols. This study determines the relationships between all identified pronation variables and aims to reduce the data set to its dominant factors. DESIGN Cross-sectional. METHODS Forty barefoot participants (14 F, 26 M) performed four standing tasks (subneutral, bipedal, single-leg with 20° and single-leg with 30° knee flexion), over ground walking (1.5m/s) and running (3.5m/s) trials. Manual assessment data, motion capture data, ground reaction forces, and plantar pressure distributions were collected. Sixty-one commonly used pronation measures were compared using Spearman Correlations and a Principal Component Analysis (PCA). RESULTS Two groups of correlated variables were found, 4.2% of them correlated mainly with the longitudinal arch angle (LAA), the other 10.2% correlated with the Achilles tendon angle (β). The remaining 85.6% were not significantly correlated to each other. CONCLUSIONS The LAA is representative for the movement of the mid foot and β quantifies rear foot eversion relative to the shank. Since these dominant variables varied independently from each other, both cannot quantify pronation simultaneously. Therefore, it is important to consider and report both, LAA-pronation and β-pronation separately to represent prevalent foot movement properties. Separately assessing the two dominant underlying mechanisms of foot movement may lead to improved guidelines for clinical screening and footwear manufacturing.
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Affiliation(s)
- Anja-Verena Behling
- Biomedical Engineering, Schulich School of Engineering, University of Calgary, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada.
| | - Sabina Manz
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada
| | | | - Benno Maurus Nigg
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada
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Kim DY, Miyakawa S, Fukuda T, Takemura M. Sex Differences in Iliotibial Band Strain under Different Knee Alignments. PM R 2019; 12:479-485. [PMID: 31583829 DOI: 10.1002/pmrj.12255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 09/16/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Increased strain of the iliotibial band (ITB) is a plausible contributing factor for the development of iliotibial band syndrome (ITBS). Although several studies have found relationships between the strain of the ITB and kinematic factors during running, the associations of the ITB strain with knee alignment and sex, which are considered intrinsic factors, are not well understood. OBJECTIVE To clarify the sex differences in the ITB strain between genu varum and normal knee alignments in different postures. DESIGN Observational cross-sectional study. SETTING Laboratory research within a university. PARTICIPANTS Forty-four healthy recreational athletes (21 men and 23 women) volunteered for this study and were divided into four groups by sex and knee alignment: men with genu varum alignment, men with normal knee alignment, women with genu varum alignment, and women with normal knee alignment. METHODS An ultrasound real-time elastography (RTE) unit was used for distal ITB strain measurements in weight bearing and for different non-weight-bearing: neutral, knee flexion, hip adduction, and hip adduction with knee flexion. Gender information and the intercondylar distance data were collected to divide the participants into two groups. MAIN OUTCOME MEASUREMENTS Main Outcome was the ITB strain (strain ratio) measured by the RTE. RESULTS There were no significant differences in neutral and hip adduction postures among the four groups. However, during weight-bearing, the women's genu varum group (6.91 ± 1.69; Mean ± SD) exhibited greater strain than both the men's normal group (3.50 ± 1.04, P = .005) and the women's normal group (4.42 ± 1.42, P = .048). In addition, there were significant positive correlations between the intercondylar distance and the ITB strain during weight-bearing (r = 0.315, P = .037). CONCLUSIONS The women's genu varum group exhibited a higher ITB strain during weight-bearing, which may be related to the high incidence of ITBS in women athletes. Furthermore, the changes in alignment and muscle activities during weight-bearing could influence the strain of the ITB. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Da Yoon Kim
- Doctoral Programs in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Shumpei Miyakawa
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Takashi Fukuda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Masahiro Takemura
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
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Hagen M, Seidel S, Sanchez Bergmann D, Muehlbauer T. Associations between Subtalar Muscle Strength and Balance Performance in Healthy Young and Old Adults. Gerontology 2019; 66:15-23. [PMID: 31266038 DOI: 10.1159/000500972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/15/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Associations between lower limb muscle strength and balance performance in adults have previously been reported. However, the function of the foot muscles for postural control has not been understood, yet. OBJECTIVE The purpose of the present study was to investigate associations between pronator and supinator muscle strength, subtalar range of motion (ROM) and postural stability while standing under various conditions in young versus old adults. METHODS Using a custom-built apparatus equipped with a force transducer and an electrogoniometer, maximum voluntary isometric subtalar pronator and supinator strength as well as ROM tests were administered to 30 young (mean age: 25.1 years) and 30 old (mean age: 65.2 years) volunteers. Total active subtalar ROM, peak pronator and peak supinator torques were measured. While standing on a force plate, limits of stability (LOS) were determined during anterior-posterior (AP) and medio-lateral (ML) leaning tasks. Furthermore, sway distance and velocity during single-legged standing were measured. Correlation and regression analyses were conducted. RESULTS In both age groups, subtalar pronator muscle strength was related to AP-LOS (young: r = 0.36; old: r = 0.49). In young adults, subtalar supinator muscle strength was associated with ML-LOS (r = 0.41). The regression analyses revealed that summed subtalar muscle strength predicts 13 and 20% of the variance of AP-LOS in young and old adults, respectively. Summed subtalar muscle strength was found to predict 18% of the variance in ML-LOS in young but not in old adults. There were no correlations and no predictors found concerning subtalar muscle strength and postural sway during single-legged standing for both age groups. CONCLUSIONS Longitudinal studies have to proof whether pronator muscle strength training might positively affect balance performance during AP leaning, specifically in old adults.
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Affiliation(s)
- Marco Hagen
- Division of Movement and Training Sciences/Biomechanics of Sport, Institute of Sport and Movement Sciences, University of Duisburg-Essen, Essen, Germany,
| | - Sebastian Seidel
- Division of Movement and Training Sciences/Biomechanics of Sport, Institute of Sport and Movement Sciences, University of Duisburg-Essen, Essen, Germany
| | - Daniel Sanchez Bergmann
- Division of Movement and Training Sciences/Biomechanics of Sport, Institute of Sport and Movement Sciences, University of Duisburg-Essen, Essen, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, Institute of Sport and Movement Sciences, University of Duisburg-Essen, Essen, Germany
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Aboelnasr EA, El-Talawy HA, Abdelazim FH, Hegazy FA. Sensitivity and specificity of normalized truncated navicular height in assessment of static foot posture in children aged 6-12 years. Hong Kong Physiother J 2019; 39:15-23. [PMID: 31156314 PMCID: PMC6467833 DOI: 10.1142/s1013702519500021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 11/04/2017] [Indexed: 11/30/2022] Open
Abstract
Background: Normalized truncated navicular height (NTNH) is a non-invasive, easy to perform, and simple clinical measure of static foot posture. However, its sensitivity and specificity in evaluation of the static foot posture in children have not been investigated yet. Objective: To investigate the intra-rater reliability, sensitivity, and specificity of NTNH in evaluation of the static foot posture in children using radiographic measure as a gold standard measure. Methods: A cross-sectional study of a random sample of 300 school children aged 6–12 years old. Intra-rater reliability, minimal detectable change, sensitivity, and specificity of NTNH were investigated. NTNH as a clinical measure of static foot posture was calculated and compared to the radiographic measure and displayed on the receiver operating characteristic (ROC) curve. Results: NTNH demonstrated an intra-rater reliability of ICC=0.98. The sensitivity and specificity of NTNH were 88.1% and 99.5%, respectively. The optimal cutoff point for the diagnosis of flat foot using NTNH in children aged 6–12 years is NTNH ≤0.19. Conclusion: NTNH is a sensitive and specific measure of static foot posture in the children aged 6–12 years. It is recommended to be used as a screening measure of static foot posture in children as it is easy, simple to perform, and a non-invasive clinical measure.
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Affiliation(s)
| | | | | | - Fatma A Hegazy
- Physiotherapy Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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21
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Shinohara H, Hori E, Obata F, Kobayashi M, Urabe Y. The validity of medial longitudinal arch measurements using ultrasound compared to that of caliper measurements. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03735-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Eichelberger P, Pohl J, Jaspers T, Ferraro M, Krause F, Baur H. Cranio-caudal and medio-lateral navicular translation are representative surrogate measures of foot function in asymptomatic adults during walking. PLoS One 2018; 13:e0208175. [PMID: 30517158 PMCID: PMC6281217 DOI: 10.1371/journal.pone.0208175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 11/13/2018] [Indexed: 11/24/2022] Open
Abstract
Introduction The translation of the navicular bone is thought to be a representative surrogate measure to assess foot pronation and hence foot function; however, it is not known how it is related to multi-segment foot kinematics. Methods Cranio-caudal (NCC) and medio-lateral (NML) navicular translation and multi-segment foot kinematics from the Oxford Foot Model (OFM) were simultaneously assessed during the stance phase of walking in 20 healthy adults. Relationships to forefoot to hindfoot (FFtoHF), hindfoot to tibia (HFtoTBA) and global hindfoot (HFL) motion were explored by cross-correlations at zero phase shift. Results FFtoHF sagittal, transversal and frontal plane angles showed median cross correlations of -0.95, 0.82 and 0.53 with NCC and of 0.78, -0.81 and -0.90 with NML. HFtoTBA transversal and frontal plane angles had correlations of 0.15 and 0.74 with NCC and of -0.38 and -0.83 with NML. The HFL frontal plane angle showed correlations of 0.41 and -0.44 with NCC and NML, respectively. Discussion The strongest relationships were found between FFtoHF sagittal plane angles and NCC and between FFtoHF frontal plane angles and NML. However, cranio-caudal and medio-lateral navicular translation seem to be reasonable surrogates for the triplanar motion between the fore- and hindfoot. The medial longitudinal arch dropped and bulged medially, while the forefoot dorsiflexed, abducted and everted with respect to the hindfoot and vice-versa. The lower cross-correlation coefficients between the rear foot parameters and NCC/NML indicated no distinct relationships between rearfoot frontal plane and midfoot kinematics. The validity of rearfoot parameters, like Achilles tendon or Calcaneal angle, to assess midfoot function must be therefore questioned. The study could also not confirm a systematic relationship between midfoot kinematics and the internal/external rotation between the hindfoot and the tibia. The measurement of navicular translation is suggested as an alternative to more complex multi-segment foot models to assess foot function.
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Affiliation(s)
- Patric Eichelberger
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
- * E-mail:
| | - Johannes Pohl
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
| | - Theo Jaspers
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
| | - Matteo Ferraro
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
| | - Fabian Krause
- University Hospital Bern, Inselspital, Department of Orthopedic Surgery, Bern, Switzerland
| | - Heiner Baur
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland
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Validation of normalized truncated navicular height as a clinical assessment measure of static foot posture to determine flatfoot in children and adolescents: A cross sectional study. Foot (Edinb) 2018; 37:85-90. [PMID: 30326417 DOI: 10.1016/j.foot.2018.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 04/11/2018] [Accepted: 05/17/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Reliability of clinical measures of static foot posture has been widely debated. However, validity of these measures has not been fully established especially in a pediatric population. The purpose of the study was to investigate reliability and validity of normalized truncated navicular height (NTNH) in assessment of static foot posture to determine flatfoot in children and adolescents using radiographic measures as a criterion gold standard measure. METHODS A sample of 612 participants aged 6-18 years (12.3±3.3) were enrolled in the study. Clinical assessment of static foot posture using NTNH was compared to the gold standard radiographic measures. Reliability, validity and diagnostic accuracy were investigated. The optimal cutoff point for flatfoot using NTNH was calculated. RESULTS NTNH demonstrated sensitivity of 98.4%, high positive predictive (PV +) value of 89.2%. The positive likelihood ratio was 19 and the negative likelihood ratio was 0.02. The area under the receiver operating curve (AUC) was 0.96 indicating high validity and diagnostic accuracy of NTNH. The optimal cutoff point for diagnosing flatfoot was NTNH≤0.195. CONCLUSION NTNH is a valid and diagnostically accurate clinical measure of static foot posture in children and adolescents.
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Eichelberger P, Blasimann A, Lutz N, Krause F, Baur H. A minimal markerset for three-dimensional foot function assessment: measuring navicular drop and drift under dynamic conditions. J Foot Ankle Res 2018; 11:15. [PMID: 29713385 PMCID: PMC5907216 DOI: 10.1186/s13047-018-0257-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 03/29/2018] [Indexed: 11/22/2022] Open
Abstract
Background The validity of predicting foot pronation occurring mainly at the midfoot by surrogate measures from the rearfoot, like eversion excursion, is limited. The dynamic navicular mobility in terms of vertical navicular drop (dNDrop) and medial navicular drift (dNDrift) may be regarded as meaningful clinical indicators to represent overall foot function. This study aimed to develop a minimal approach to measure the two parameters and to examine their intra- and interday reliability during walking. Methods The minimal markerset uses markers at the lateral and medial caput of the 1st and 5th metatarsals, respectively, at the dorsal calcaneus and at the tuberosity of the navicular bone. Dynamic navicular drop and drift were assessed with three-dimensional motion capture in 21 healthy individuals using a single-examiner test-retest study design. Results Intra- and interday repeatability were 1.1 mm (ICC21 0.97) and 2.3 mm (ICC21 0.87) for dynamic navicular drop and 1.5 mm (ICC21 0.96) and 5.3 mm (ICC21 0.46) for dynamic navicular drift. The contribution of instrumental errors was estimated to 0.25 mm for dynamic navicular drop and 0.86 mm for dynamic navicular drift. Conclusions Interday reliability was generally worse than intraday reliability primary due to day-to-day variations in movement patterns and the contribution of instrumental errors was below 23% for dynamic navicular drop but reached 57% for dynamic navicular drift. The minimal markerset allows to simply transfer the known concepts of navicular drop and drift from quasi-static clinical test conditions to functional tasks, which is recommended to more closely relate assessments to the functional behavior of the foot. Electronic supplementary material The online version of this article (10.1186/s13047-018-0257-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patric Eichelberger
- 1Bern University of Applied Sciences, Department of Health Professions, Discipline of Physiotherapy, Murtenstrasse 10, Bern, 3008 Switzerland.,2Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Angela Blasimann
- 1Bern University of Applied Sciences, Department of Health Professions, Discipline of Physiotherapy, Murtenstrasse 10, Bern, 3008 Switzerland
| | - Nicole Lutz
- 1Bern University of Applied Sciences, Department of Health Professions, Discipline of Physiotherapy, Murtenstrasse 10, Bern, 3008 Switzerland
| | - Fabian Krause
- 3University Hospital Bern, Inselspital, Department of Orthopaedic Surgery, Bern, Switzerland
| | - Heiner Baur
- 1Bern University of Applied Sciences, Department of Health Professions, Discipline of Physiotherapy, Murtenstrasse 10, Bern, 3008 Switzerland
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Association between hyper-pronated foot and the degree of severity of disability in patients with non-specific low back pain. J Bodyw Mov Ther 2017; 22:757-760. [PMID: 30100309 DOI: 10.1016/j.jbmt.2017.11.012] [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] [Received: 06/08/2017] [Revised: 10/23/2017] [Accepted: 11/07/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND It has been established that Hyper-pronation of the foot may lead to postural changes in the lower limbs, with a resultant pelvic ante-version, and a subsequent risk of development of low back pain. However, the association between the presence of a hyper-pronated foot and the severity of disability in low back pain is currently not known. OBJECTIVES The purpose of this study was to examine whether the presence of a hyper-pronated foot has any impact on the degree of severity of disability (functional status) in patients with non-specific low back pain. METHODS An observational study was conducted in an outpatient setting, where patients diagnosed as having non-specific low back pain were included. The degree of severity of disability was measured using the Modified Oswestry Low Back Pain Disability Questionnaire, and the foot hyper-pronation was assessed with the execution of the Navicular Drop test. Descriptive statistics and Linear regression analyses were conducted. RESULTS Of the 71 patients included, 14 demonstrated having a unilateral hyper-pronation of the foot. The mean scores for the functional status and hyper-pronation of the foot were 37.15 (SD = 10.40) and 6.06 (SD = 3.42) respectively. An association was not found between the severity of disability and the presence of foot hyper-pronation (B = .87, p = .78). CONCLUSIONS Hyper-pronation of the foot could lead to the development of non-specific low back pain, but the degree of severity of the disability is not influenced by the presence of a hyper-pronated foot. The alterations in lower limb mechanics leading to back pain are a complex issue, and thus needs further research.
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Kim T, Park JC. Short-term effects of sports taping on navicular height, navicular drop and peak plantar pressure in healthy elite athletes: A within-subject comparison. Medicine (Baltimore) 2017; 96:e8714. [PMID: 29145309 PMCID: PMC5704854 DOI: 10.1097/md.0000000000008714] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Medial tibial stress syndrome (MTSS) is one of the most common exercise-induced leg pain. The navicular drop (ND) was identified as a risk factor for MTSS. This study aimed to evaluate the short-term effects of sports taping applied to the supporting lower leg during sitting, standing, walking, and jogging to restrict the ND in healthy elite athletes.Twenty-four healthy elite athletes without a history of exercise-induced pain or injuries in the lower limbs participated in this study (median age: 21.00 years; 1st--3rd quartiles; 19.25-22.00). The 4 taping conditions were used: rigid taping (RT), kinesiology taping (KT), placebo taping (PT), and non-taping (NT). The order of taping techniques was randomly assigned. Normalized navicular height (NH), ND, and normalized ND evaluated using 3-dimensional motion analysis, and normalized peak plantar pressure (PP) were compared in 4 taping conditions during sitting, standing, walking, and jogging.During sitting, the normalized NH of RT is higher than that of NT, KT, and PT (χ = 17.30, P = .001), while during jogging, the normalized NH of RT is higher than that of NT and PT (χ = 10.55, P = .014). The normalized peak PP of NT is higher than that of PT (χ = 8.871, P = .031) in the lateral midfoot region.This study showed the RT technique maintained NH during sitting and jogging, and the RT technique could be an effective preventive and treatment strategy for MTSS.
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Affiliation(s)
- Taegyu Kim
- Department of Marine Sports, Pukyong National University, Busan
| | - Jong-Chul Park
- Department of Sport Science, Korea Institute of Sport Science, Seoul, Republic of Korea
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Walker H, Scharfbillig R, Jones S. Correlation of a non-weight bearing foot position to the neutral calcaneal stance position in an adult population. FOOTWEAR SCIENCE 2017. [DOI: 10.1080/19424280.2017.1314336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- H.A. Walker
- Queensland Health, Nuriyn Wellness Centre, Roma, Australia
| | | | - S. Jones
- University of South Australia, Adelaide, Australia
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Walker HA, Scharfbillig R, Jones S. Available and proposed foot measures in terms of reliability, validity and applicability on an adult population: a systematic review. FOOTWEAR SCIENCE 2017. [DOI: 10.1080/19424280.2017.1314337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Sara Jones
- University of South Australia, Adelaide, Australia
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Aenumulapalli A, Kulkarni MM, Gandotra AR. Prevalence of Flexible Flat Foot in Adults: A Cross-sectional Study. J Clin Diagn Res 2017; 11:AC17-AC20. [PMID: 28764143 DOI: 10.7860/jcdr/2017/26566.10059] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 04/06/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Flat foot (pes planus) is a commonly observed disorder in clinical practice. The height of Medial Longitudinal Arch (MLA) determines the degree of pes planus. Majority of the previous studies on prevalence of flexible flat foot were done among children. AIM The present study was undertaken to determine the prevalence of flexible flat foot among 18-21-year-old Indian adults using Navicular Drop Test (NDT) which is regarded as reliable and valid method to characterise MLA. MATERIALS AND METHODS The present study was a cross-sectional study in which Brody's Navicular Drop Test was performed in five hundred healthy subjects (250 males and 250 females) aged 18-21-year-old. Navicular Drop (ND) of ≥ 10 mm was regarded as flexible flat foot. Statistical analysis was done using SPSS version 23.0. RESULTS The prevalence of flexible flat foot was 13.6% (for males-12.8%; for females-14.4%). The median with Inter Quartile Range (IQR) for ND among males was 6 mm (4-8) and 6 mm (4-9) for right and left foot respectively. The median with IQR for ND among females was 6mm (4-10) and 7mm (3-8) for right & left respectively. The correlation of Right Side Navicular Drop (RND) with height and weight was significant, but insignificant correlation was found between RND and BMI. The correlation of Left Side Navicular Drop (LND) with height, weight and BMI of individuals was statistically not significant. The difference between the ND of males and female group was statistically not significant. CONCLUSION The present study quantified the prevalence of flexible flat foot and gender wise normative values of ND among 18-21-year-old Indian adults. The information obtained by this study will be useful in the field of orthopaedics.
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Affiliation(s)
- Ashok Aenumulapalli
- Assistant Professor, Department of Anatomy, SBKS Medical Institute and Research Centre, Vadodara, Gujarat, India
| | - Manoj Mohan Kulkarni
- Associate Professor, Department of Anatomy, SBKS Medical Institute and Research Centre, Vadodara, Gujarat, India
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Taspinar O, Kabayel DD, Ozdemir F, Tuna H, Keskin Y, Mercimek OB, Süt N, Yavuz S, Tuna F. Comparing the efficacy of exercise, internal and external shoe modification in pes planus: A clinical and pedobarographic study. J Back Musculoskelet Rehabil 2017; 30:255-263. [PMID: 27858680 DOI: 10.3233/bmr-150399] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Pes planus is a condition that can cause pain along the innerfoot due to the absence or abnormal depression of the longitudinal arch. There are few studies available that compare therapy modalities used in these patients. In our study, those treated with conservative therapies - internal and external shoe modifications and pes planus exercises - were compared clinically and pedobarographyically. 60 pes planus patients were included in the study. In the first group; internal modification was performed by placing a medial longitudinal arch support inside the shoe. In the second group, external shoe modification was performed using the Thomas heel. In the third group of patients however, only an exercise program was executed. The patients' foot pain levels, functional asssessment, satisfaction and quality of life were recorded. Pedobarography was used in measuring both static and dynamic plantar pressure. Assessments were carried out at baseline and at the end of the first and third months respectively where intra- and inter- group comparisons were performed. Each group was composed of 20 subjects. While improvement in terms of foot pain, foot function index and quality of life was observed in all the study groups (p< 0.05), the most improvement was observed in the group of patients treated with internal modification (p< 0.016). This was followed by the external modification and the exercise groups respectively. No difference was observed between the internal and external modification groups in terms of patient satisfaction. Cross-sectionally; clinical assessments, pedobarographic analysis were correlated. The changes observed after static and dynamic pedobarographic studies were not significantly different between the study groups. At the end of the study it was observed that internal modification yielded the most significant clinical improvement. In the literature, there are limited publications comparing the conservative treatments with each other. In this study we aimed to compare the conservative treatments for flatfoot.
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Affiliation(s)
- Ozgur Taspinar
- Physical Medicine and Rehabilitation Department, Bezm-i Alem Vakif University School of Medicine, Istanbul, Turkey
| | - Derya Demirbag Kabayel
- Physical Medicine and Rehabilitation Department, Trakya University School of Medicine, Edirne, Turkey
| | - Ferda Ozdemir
- Physical Medicine and Rehabilitation Department, Medipol University School of Medicine, Istanbul, Turkey
| | - Hakan Tuna
- Physical Medicine and Rehabilitation Department, Trakya University School of Medicine, Edirne, Turkey
| | - Yasar Keskin
- Physical Medicine and Rehabilitation Department, Bezm-i Alem Vakif University School of Medicine, Istanbul, Turkey
| | - Oznur Berke Mercimek
- Physical Medicine and Rehabilitation Department, Rize State Hospital, Rize, Turkey
| | - Necdet Süt
- Biostatistics Department, Trakya University School of Medicine, Edirne, Turkey
| | - Selcuk Yavuz
- Physical Medicine and Rehabilitation Department, Trakya University School of Medicine, Edirne, Turkey
| | - Filiz Tuna
- Physical Medicine and Rehabilitation Department, Trakya University School of Medicine, Edirne, Turkey
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Kondo T, Muneta T, Fukui T. Evaluation of the relationship between the static measurement of transverse arch flexibility of the forefoot and gait parameters in healthy subjects. J Phys Ther Sci 2017; 29:413-418. [PMID: 28356622 PMCID: PMC5361001 DOI: 10.1589/jpts.29.413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/24/2016] [Indexed: 01/31/2023] Open
Abstract
[Purpose] To investigate the relationship between the static measurement of the
transverse arch of the forefoot, using a 3-dimensional (3D) foot scanner, and kinetics and
kinematics of gait parameters in the sagittal plane. [Subjects and Methods] Twenty healthy
subjects participated in this study. The transverse arch of the forefoot was measured
under three conditions as follows: condition 1, sitting; condition 2, standing; and
condition 3, foot forward and lower leg tilting anteriorly to the maximum position with
heel contact. Gait parameters were recorded using a 3D motion analysis system and force
plate. Correlation coefficients between TAF for each comparison of conditions and gait
parameters were calculated using the Spearman correlation analysis. [Results] Rates of the
transverse arch of the forefoot width and height between condition 2 and condition 3 were
significantly correlated with the anterior and posterior component of ground reaction
forces, the hip joint extension angle, and the ankle plantar flexion moment. [Conclusion]
Our study’s findings indicated that increased stiffness of the transverse arch of the
forefoot was related to the increase in ankle plantar moment, and decreased stiffness of
the transverse arch of the forefoot was related to the increase in hip joint extension
angle during gait.
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Affiliation(s)
- Takashi Kondo
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan; Sports Management Center, Graduate School, Bunkyo Gakuin University, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Tsutomu Fukui
- Sports Management Center, Graduate School, Bunkyo Gakuin University, Japan
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Hill M, Naemi R, Branthwaite H, Chockalingam N. The relationship between arch height and foot length: Implications for size grading. APPLIED ERGONOMICS 2017; 59:243-250. [PMID: 27890134 DOI: 10.1016/j.apergo.2016.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 07/03/2016] [Accepted: 08/24/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Medial longitudinal Arch Height is synonymous with classifying foot type and conversely foot function. Detailed knowledge of foot anthropometry is essential in the development of ergonomically sound footwear. Current Footwear design incorporates a direct proportionate scaling of instep dimensions with those of foot length. The objective of this paper is to investigate if a direct proportional relationship exists between human arch height parameters and foot length in subjects with normal foot posture. METHOD A healthy convenience sample of 62 volunteers was recruited to participate in this observational study. All subjects were screened for normal foot health and posture. Each subject's foot dimensions were scanned and measured using a 3D Foot Scanner. From this foot length and arch height parameters were obtained. Normalised ratios of arch height with respect to foot length were also calculated. The arch height parameters and the normalised arch ratios were used interchangeably as the dependent variables with the foot length parameters used as the independent variable for Simple Linear Regression and Correlation. RESULTS Analysis of foot length measures demonstrated poor correlation with all arch height parameters. CONCLUSION No significant relationships between arch height and foot length were found. The predictive value of the relationship was found to be poor. This holds significant implications for the current method of proportionate scaling of footwear in terms of fit and function to the midfoot region for a normative population.
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Affiliation(s)
- Matthew Hill
- CSHER, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, United Kingdom.
| | - Roozbeh Naemi
- CSHER, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, United Kingdom
| | - Helen Branthwaite
- CSHER, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, United Kingdom
| | - Nachiappan Chockalingam
- CSHER, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, United Kingdom
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Johannsen F, Hansen P, Stallknecht S, Rathleff MS, Hangaard S, Nybing JD, Boesen M. Can positional MRI predict dynamic changes in the medial plantar arch? An exploratory pilot study. J Foot Ankle Res 2016; 9:35. [PMID: 27588043 DOI: 10.1186/s13047-016-0168-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Positional MRI (pMRI) allows for three-dimensional visual assessment of navicular position. In this exploratory pilot study pMRI was validated against a stretch sensor device, which measures movement of the medial plantar arch. We hypothesized that a combined pMRI measure incorporating both vertical and medial displacement of the navicular bone induced by loading would be correlated with corresponding stretch sensor measurements. METHODS 10 voluntary participants were included in the study. Both pMRI and subsequent stretch sensor measurements were performed in a) supine, b) standing and c) standing position with addition of 10 % body weight during static loading of the foot. Stretch sensor measurements were also performed during barefoot walking. RESULTS The total change in navicular position measured by pMRI was 10.3 mm (CI: 7.0 to 13.5 mm). No further displacement occurred when adding 10 % bodyweight (mean difference: 0.7 mm (CI: -0.7 to 2.0 mm), P = 0.29). The total navicular displacement correlated with stretch sensor measurement under static loading conditions (Spearman's rho = 0.66, P = 0.04) but not with measurements during walking (Spearman's rho = 0.58, P = 0.08). CONCLUSIONS Total navicular bone displacements determined by pMRI showed concurrent validity with stretch sensor measurements but only so under static loading conditions. Although assessment of total navicular displacement by combining concomitant vertical and medial navicular bone movements would appear advantageous compared to monoplanar measurement the combined measure did not seem to predict dynamic changes of the medial foot arch during walking, which are among several possible factors depending on different walking patterns.
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Affiliation(s)
- Finn Johannsen
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, Building 8, 1., Bispebjerg Bakke 23, Copenhagen, DK-2400, Denmark
| | - Philip Hansen
- Department of Radiology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Nordre Fasanvej 57, vej 4, opg. 5, Frederiksberg, DK-2000 Denmark
| | - Sandra Stallknecht
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, Building 8, 1., Bispebjerg Bakke 23, Copenhagen, DK-2400, Denmark
| | - Michael Skovdal Rathleff
- Research Unit for General Practice in Aalborg and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark ; Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
| | - Stine Hangaard
- Department of Radiology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Nordre Fasanvej 57, vej 4, opg. 5, Frederiksberg, DK-2000 Denmark
| | - Janus Damm Nybing
- Department of Radiology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Nordre Fasanvej 57, vej 4, opg. 5, Frederiksberg, DK-2000 Denmark
| | - Mikael Boesen
- Department of Radiology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Nordre Fasanvej 57, vej 4, opg. 5, Frederiksberg, DK-2000 Denmark ; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital Bispebjerg & Frederiksberg, Copenhagen, Denmark
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Hagen M, Asholt J, Lemke M, Lahner M. The angle-torque-relationship of the subtalar pronators and supinators in male athletes: A comparative study of soccer and handball players. Technol Health Care 2016; 24:391-9. [DOI: 10.3233/thc-161138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marco Hagen
- Biomechanics Laboratory, Department of Sport and Movement Sciences, University of Duisburg-Essen, Essen, Germany
| | - Johannes Asholt
- Biomechanics Laboratory, Department of Sport and Movement Sciences, University of Duisburg-Essen, Essen, Germany
| | - Martin Lemke
- Biomechanics Laboratory, Department of Sport and Movement Sciences, University of Duisburg-Essen, Essen, Germany
| | - Matthias Lahner
- Department of Orthopaedic Surgery, Ruhr-University Bochum, Bochum, Germany
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Molines-Barroso RJ, Lázaro-Martínez JL, Aragón-Sánchez FJ, Álvaro-Afonso FJ, García-Morales E, García-Álvarez Y. Forefoot ulcer risk is associated with foot type in patients with diabetes and neuropathy. Diabetes Res Clin Pract 2016; 114:93-8. [PMID: 26810268 DOI: 10.1016/j.diabres.2016.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 11/11/2015] [Accepted: 01/07/2016] [Indexed: 12/15/2022]
Abstract
AIMS To stratify the ulceration risk according to the foot morphology in people with diabetes and a history of forefoot neuropathic ulceration. METHODS A cross-sectional study was performed on 139 neuropathic individuals with diabetes and previous forefoot ulcers between January 2012 and February 2014. Foot position of the participants was evaluated by using the foot-posture index. A multivariate analysis adjusted for confounding variables was performed with the ulceration risk factors that were found in the univariate analysis. RESULTS Two hundred and fifty-eight feet were analysed, 104 (40.3%) feet had a history of ulceration on the forefoot and 154 (59.7%) feet had no previous ulceration. Two positive tests of neuropathy (p<0.001; CI[1.961-6.249] OR 3.500), presence of deformities (p=0.043; CI[1.020-3.599] OR 1.916) and foot type (p=0.039) showed an association with ulceration risk in multivariate analyses. Pronated feet showed a higher risk of ulceration than supinated feet (p=0.011; CI[1.253-5.708] OR 2.675), while significant differences between neutral and supinated feet were not found (p=0.221; CI[0.719-2.753] OR 1.476). CONCLUSIONS A pronated foot has a higher risk of ulceration on the forefoot in neuropathic people with deformities and diabetes mellitus. Foot type should be evaluated in people at risk of ulceration.
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Affiliation(s)
- R J Molines-Barroso
- Unidad de Pie Diabético, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - J L Lázaro-Martínez
- Unidad de Pie Diabético, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - F J Aragón-Sánchez
- Unidad de Pie Diabético, Hospital La Paloma, Las Palmas de Gran Canaria, Spain
| | - F J Álvaro-Afonso
- Unidad de Pie Diabético, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - E García-Morales
- Unidad de Pie Diabético, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Y García-Álvarez
- Unidad de Pie Diabético, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Coşkun G, Talu B, Bek N, Bayramlar KY. Effects of hallux valgus deformity on rear foot position, pain, function, and quality of life of women. J Phys Ther Sci 2016; 28:781-7. [PMID: 27134358 PMCID: PMC4842439 DOI: 10.1589/jpts.28.781] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 11/25/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the relationship between hallux valgus (HV) deformity and the
position of rearfoot joints, and its effects on the quality of life, pain, and related
functional status of women with bilateral hallux valgus (HV). [Subjects and Methods] The
subjects were 27 right-dominant women. Demographic data, HV angle, weight-bearing and
non-weight-bearing subtalar pronation (SP), and navicular height were recorded. Visual
Analog Pain Scale, Foot Function Index (FFI), and the American Orthopaedic Foot and Ankle
Society (AOFAS) first metatarsophalangeal- interphalangeal (MTP-IP) and AOFAS Mid foot
(MF) Scales, and SF-36 were also used. [Results] HV angle, weight-bearing SP, and pain
intensity of the left foot were higher. HV angle of left foot was correlated with all
sub-scales of FFI, the pain parameter of AOFAS MTP-IP, and pain and total scores of
AOFAS-MF Scale. HV angle of the left foot correlated with physical role, pain, and social
function sub-domains of SF-36. Right HV angles were correlated with right foot pain and
non-weight-bearing SP. [Conclusion] Increasing HV angle and pathomechanical changes in the
rear foot are correlated, resulting in increasing pain and thus decreasing functional
status as well as decreasing quality of life. Although all the participants were
right-dominant, their left foot problems were more prominent.
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Affiliation(s)
- Gürsoy Coşkun
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Turkey
| | - Burcu Talu
- Department of Physiotherapy and Rehabilitation, Inonu University, Turkey
| | - Nilgün Bek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Turkey
| | - Kezban Yigiter Bayramlar
- Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, School of Health Sciences, Turkey
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Navicular bone position determined by positional MRI: a reproducibility study. Skeletal Radiol 2016; 45:205-11. [PMID: 26510441 DOI: 10.1007/s00256-015-2272-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/19/2015] [Accepted: 10/14/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine intraobserver, interobserver and between-day reproducibility of positional MRI for evaluation of navicular bone height (NVH) and medial navicular position (MNP). MATERIALS AND METHODS Positional MRI (pMRI) of the foot was performed on ten healthy participants (0.25 T G-scanner). Scanning was performed in supine and standing position, respectively. Two radiologists evaluated the images in a blinded manner. Reliability and agreement were assessed by calculation of intraclass correlation coefficient (ICC) and 95 % limits of agreement as a percentage of the mean (LOA%). RESULTS Intraobserver and interobserver reliability was "substantial" in both supine and standing position (ICC 0.86-0.98) and showed good agreement (LOA% 4.9-14.7 %). Between-day reliability of navicular height and medial navicular position in standing position remained substantial (ICC 0.85-0.92) with adequate agreement (LOA% 8.3-19.8 %). In supine position between-day reliability was "moderate" for NVH (ICC 0.72) and "slight" for MNP (ICC 0.39). Agreement remained adequate between-days for MNP in supine position (LOA% 17.7 %), but it was less than adequate for NVH in supine position (LOA% 24.2 %). CONCLUSION Navicular height and medial navicular position can be measured by pMRI in a very reproducible manner within and between observers. Increased measurement variation is observed between-days in supine position, which may be due to small positional differences or other unknown biomechanical factors.
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Hagen M, Sanchez-Bergmann D, Seidel S, Lahner M. Angle-torque relationship of the subtalar pronators and supinators in younger and elderly males and females. J Foot Ankle Res 2015; 8:64. [PMID: 26609327 PMCID: PMC4659193 DOI: 10.1186/s13047-015-0125-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 11/19/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The angle-dependent torque capacity of the subtalar pronators and supinators is important to maintain dynamic ankle stabilisation. Based on the peak torques during maximum voluntary isometric pronation and supination across the subtalar range of motion, the strength curves of younger and elderly males and females were investigated. METHODS Maximum voluntary isometric subtalar pronator and supinator strength tests were administered to 30 younger and 30 elderly volunteers (each 15 male and 15 female subjects). Total active subtalar range of motion and peak pronator and supinator torques were measured in five anatomical subtalar joint angles using a custom-built apparatus with two force transducers. Furthermore, relative torques (normalised to the individual peak torque) and pronator-to-supinator strength-ratios were also calculated. RESULTS Pronator-to-supinator strength ratio, and peak pronator and supinator torques are affected by age and by joint angle x age interactions. All supinator strength curves show a steadily descending characteristic from the pronated to the supinated positions. The pronator strength curve had an inverted U-shaped characteristic, except for younger women of whom 47 % exert highest peak values in the end-range pronation angle. Both relative pronator and supinator strength are dependent on sex (P < 0.05). Relative pronator strength is also affected by joint angle x sex (P < 0.0001) and joint angle x sex x age (P < 0.05) interactions. Beside age effects on all range of motion parameters, pronation range of motion is influenced by a sex x age interaction (P < 0.05). CONCLUSIONS Age- and sex-related differences in both subtalar strength profile and range of motion have to be considered when testing strength across subtalar range of motion. Younger females have higher pronator strength capacity in the most pronated joint angle, which may be due in part to their greater subtalar joint range of motion compared to the other groups. In the most supinated position both pronator and supinator strength capacity is reduced in younger females compared to younger males.
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Affiliation(s)
- Marco Hagen
- Biomechanics Laboratory, Department of Sport and Movement Sciences, University of Duisburg-Essen, Gladbecker Str. 182, 45141 Essen, Germany
| | - Daniel Sanchez-Bergmann
- Biomechanics Laboratory, Department of Sport and Movement Sciences, University of Duisburg-Essen, Gladbecker Str. 182, 45141 Essen, Germany
| | - Sebastian Seidel
- Biomechanics Laboratory, Department of Sport and Movement Sciences, University of Duisburg-Essen, Gladbecker Str. 182, 45141 Essen, Germany
| | - Matthias Lahner
- Department of Orthopaedic Surgery, Ruhr-University Bochum, St. Josef-Hospital, Gudrunstr. 56, 44791 Bochum, Germany
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Buldt AK, Murley GS, Levinger P, Menz HB, Nester CJ, Landorf KB. Are clinical measures of foot posture and mobility associated with foot kinematics when walking? J Foot Ankle Res 2015; 8:63. [PMID: 26604987 PMCID: PMC4657281 DOI: 10.1186/s13047-015-0122-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 11/12/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is uncertainty as to which foot posture measures are the most valid in terms of predicting kinematics of the foot. The aim of this study was to investigate the associations of clinical measures of static foot posture and mobility with foot kinematics during barefoot walking. METHOD Foot posture and mobility were measured in 97 healthy adults (46 males, 51 females; mean age 24.4 ± 6.2 years). Foot posture was assessed using the 6-item Foot Posture Index (FPI), Arch Index (AI), Normalised Navicular Height (NNHt) and Normalised Dorsal Arch Height (DAH). Foot mobility was evaluated using the Foot Mobility Magnitude (FMM) measure. Following this, a five-segment foot model was used to measure tri-planar motion of the rearfoot, midfoot, medial forefoot, lateral forefoot and hallux. Peak and range of motion variables during load acceptance and midstance/propulsion phases of gait were extracted for all relative segment to segment motion calculations. Hierarchical regression analyses were conducted, adjusting for potential confounding variables. RESULTS The degree of variance in peak and range of motion kinematic variables that was independently explained by foot posture measures was as follows: FPI 5 to 22 %, NNHt 6 to 20 %, AI 7 to 13 %, DAH 6 to 8 %, and FMM 8 %. The FPI was retained as a significant predictor across the most number of kinematic variables. However, the amount of variance explained by the FPI for individual kinematic variables did not exceed other measures. Overall, static foot posture measures were more strongly associated with kinematic variables than foot mobility measures and explained more variation in peak variables compared to range of motion variables. CONCLUSIONS Foot posture measures can explain only a small amount of variation in foot kinematics. Static foot posture measures, and in particular the FPI, were more strongly associated with foot kinematics compared with foot mobility measures. These findings suggest that foot kinematics cannot be accurately inferred from clinical observations of foot posture alone.
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Affiliation(s)
- Andrew K. Buldt
- />Discipline of Podiatry, School of Allied Health, La Trobe University, Bundoora, Melbourne, VIC 3086 Australia
- />Lower Extremity and Gait Studies Program, School of Allied Health, La Trobe University, Bundoora, Melbourne, VIC 3086 Australia
| | - George S. Murley
- />Discipline of Podiatry, School of Allied Health, La Trobe University, Bundoora, Melbourne, VIC 3086 Australia
- />Lower Extremity and Gait Studies Program, School of Allied Health, La Trobe University, Bundoora, Melbourne, VIC 3086 Australia
| | - Pazit Levinger
- />Institute of Sport, Exercise & Active Living, Victoria University, Footscray, Melbourne, VIC 8001 Australia
| | - Hylton B. Menz
- />Lower Extremity and Gait Studies Program, School of Allied Health, La Trobe University, Bundoora, Melbourne, VIC 3086 Australia
| | | | - Karl B. Landorf
- />Discipline of Podiatry, School of Allied Health, La Trobe University, Bundoora, Melbourne, VIC 3086 Australia
- />Lower Extremity and Gait Studies Program, School of Allied Health, La Trobe University, Bundoora, Melbourne, VIC 3086 Australia
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Predicting Dynamic Foot Function From Static Foot Posture: Comparison Between Visual Assessment, Motion Analysis, and a Commercially Available Depth Camera. J Orthop Sports Phys Ther 2015; 45:789-98. [PMID: 26304638 DOI: 10.2519/jospt.2015.5616] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
UNLABELLED STUDY DESIGN :Controlled laboratory study. OBJECTIVE To evaluate the ability of 3 methods to assess static foot posture to predict rearfoot and midfoot kinematics during gait. BACKGROUND Static foot posture is commonly used clinically to infer dynamic function. Limitations of static clinical assessments may be overcome through advances in technologies, including commercially available depth cameras. METHODS The Foot Posture Index (FPI) of 31 males (average age, 22.5 years) was assessed using visual observation, a 3-D motion-analysis system, and a depth camera. Pearson correlations were used to evaluate relationships between FPI items and rearfoot and midfoot kinematics during walking. The ability of the static variables to predict dynamic function was assessed using multiple linear regression. RESULTS Most FPI items (85%) were not correlated with foot kinematics, regardless of assessment method. There were 6 fair to moderate correlations between visual FPI items and total rearfoot (r = -0.36 to -0.39, P<.05) and midfoot (r = 0.37 to 0.61, P<.05) motion, 2 fair correlations between 3-D motion-analysis FPI items and total midfoot (r = -0.43, P = .02) and peak rearfoot (r = -0.40, P = .03) motion, and 2 fair correlations between the depth-camera FPI items and average rearfoot (r = -0.38 to 0.44, P<.05) motion. Visual assessment of the FPI provided the best prediction model, explaining 37% of the variance in total midfoot inversion/eversion. CONCLUSION Static measures of foot posture are weakly correlated with rearfoot or midfoot kinematics, and have limited dynamic prediction ability. Our findings suggest that the FPI may not be an accurate representation of rearfoot or midfoot movement during walking, regardless of the measurement technique employed.
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Saghazadeh M, Tsunoda K, Soma Y, Okura T. Static Foot Posture and Mobility Associated With Postural Sway in Elderly Women Using a Three-dimensional Foot Scanner. J Am Podiatr Med Assoc 2015; 105:412-7. [PMID: 26429610 DOI: 10.7547/14-021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Maintaining balance is a complex phenomenon that is influenced by a range of sensorimotor factors. Foot posture and mobility may also influence balance and postural sway. Recently, three-dimensional foot scanners have been used to assess foot posture. This tool allows many individuals to be scanned quickly and easily and helps eliminate patients' radiation exposure. The objective of this study was to determine whether static foot posture and mobility are independently associated with postural sway in a large community sample of older women using objective measures of balance status and the recently launched technology of three-dimensional foot scanning. METHODS This cross-sectional study included 140 community-dwelling elderly women (mean ± SD age, 73.9 ± 5.1 years) recruited in Kasama City, Japan. The postural sway variables were total path length and area and were measured by force plate. We measured static foot posture, sitting and standing navicular height, and mobility using a three-dimensional foot scanner. Foot mobility was determined as the amount of vertical navicular excursion between the positions of the subtalar joint, from neutral in sitting position to relaxed bilateral standing. RESULTS After adjusting for potential cofounders, analysis of covariance revealed that sitting navicular height was associated with total path length (P = .038) and area (P = .031). Foot mobility was associated with total path length (P = .018). CONCLUSIONS These findings suggest that sitting navicular height and foot mobility are associated with postural sway in elderly women and might be an important factor in defining balance control in older adults.
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Affiliation(s)
- Mahshid Saghazadeh
- Department of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Kenji Tsunoda
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Yuki Soma
- Department of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tomohiro Okura
- Department of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
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Newell T, Simon J, Docherty CL. Arch-Taping Techniques for Altering Navicular Height and Plantar Pressures During Activity. J Athl Train 2015; 50:825-32. [PMID: 26098272 DOI: 10.4085/1062-6050-50.5.05] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Arch tapings have been used to support the arch by increasing navicular height. Few researchers have studied navicular height and plantar pressures after physical activity. OBJECTIVE To determine if taping techniques effectively support the arch during exercise. DESIGN Crossover study. SETTING Athletic training research laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-five individuals (13 men, 12 women; age = 20.0 ± 1.0 years, height = 172.3 ± 6.6 cm, mass = 70.1 ± 10.2 kg) with a navicular drop of more than 8 mm (12.9 ± 3.3 mm) volunteered. INTERVENTION(S) All individuals participated in 3 days of testing, with 1 day for each tape condition: no tape, low dye, and navicular sling. On each testing day, navicular height and plantar pressures were measured at 5 intervals: baseline; posttape; and after 5, 10, and 15 minutes of running. The order of tape condition was counterbalanced. MAIN OUTCOME MEASURE(S) The dependent variables were navicular height in millimeters and plantar pressures in kilopascals. Plantar pressures were divided into 5 regions: medial forefoot, lateral forefoot, lateral midfoot, lateral rearfoot, and medial rearfoot. Separate repeated-measures analyses of variance were conducted for each dependent variable. RESULTS Navicular height was higher immediately after application of the navicular-sling condition (P = .004) but was reduced after 5 minutes of treadmill running (P = .12). We observed no differences from baseline to posttape for navicular height for the low-dye (P = .30) and no-tape conditions (P = .25). Both the low-dye and navicular-sling conditions increased plantar pressures in the lateral midfoot region compared with the no-tape condition. The low-dye condition created decreased pressure in the medial and lateral forefoot regions compared with the no-tape condition. All changes were identified immediately after application and were maintained during running. No changes were noted in plantar pressures for the no-tape condition (P > .05). CONCLUSIONS Both taping techniques effectively changed plantar pressures in the lateral midfoot, and these changes were sustained throughout the 15 minutes of exercise.
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Affiliation(s)
- Tim Newell
- Thomas More College, Crestview Hills, KY
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Barton CJ, Kappel SL, Ahrendt P, Simonsen O, Rathleff MS. Dynamic navicular motion measured using a stretch sensor is different between walking and running, and between over-ground and treadmill conditions. J Foot Ankle Res 2015; 8:5. [PMID: 25741384 PMCID: PMC4349491 DOI: 10.1186/s13047-015-0063-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 02/06/2015] [Indexed: 11/10/2022] Open
Abstract
Background Non-invasive evaluation of in-shoe foot motion has traditionally been difficult. Recently a novel ‘stretch-sensor’ was proposed as an easy and reliable method to measure dynamic foot (navicular) motion. Further validation of this method is needed to determine how different gait analysis protocols affect dynamic navicular motion. Methods Potential differences in magnitude and peak velocity of navicular motion using the ‘stretch sensor’ between (i) barefoot and shod conditions; (ii) overground and treadmill gait; and/or (iii) running and walking were evaluated in 26 healthy participants. Comparisons were made using paired t-tests. Results Magnitude and velocity of navicular motion was not different between barefoot and shod walking on the treadmill. Compared to walking, velocity of navicular motion during running was 59% and 210% higher over-ground (p < 0.0001) and on a treadmill (p < 0.0001) respectively, and magnitude of navicular motion was 23% higher during over-ground running compared to over-ground walking (p = 0.02). Compared to over-ground, magnitude of navicular motion on a treadmill was 21% and 16% greater during walking (p = 0.0004) and running (p = 0003) respectively. Additionally, maximal velocity of navicular motion during treadmill walking was 48% less than walking over-ground (p < 0.0001). Conclusion The presence of footwear has minimal impact on navicular motion during walking. Differences in navicular motion between walking and running, and treadmill and over-ground gait highlight the importance of task specificity during gait analysis. Task specificity should be considered during design of future research trials and in clinical practice when measuring navicular motion.
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Affiliation(s)
- Christian J Barton
- Complete Sports Care, Melbourne, Australia ; Lower Extremity Gait Studies Program, Faculty of Health Sciences, La Trobe University, Bundoora, Australia ; Pure Sports Medicine, London, Australia ; Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK
| | - Simon L Kappel
- Department of Engineering, Aarhus University, Aarhus, Denmark
| | - Peter Ahrendt
- Department of Engineering, Aarhus University, Aarhus, Denmark
| | - Ole Simonsen
- Orthopaedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Michael S Rathleff
- Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark ; Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Boyer ER, Ward ED, Derrick TR. Medial longitudinal arch mechanics before and after a 45-minute run. J Am Podiatr Med Assoc 2014; 104:349-56. [PMID: 25076077 DOI: 10.7547/0003-0538-104.4.349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Medial longitudinal arch integrity after prolonged running has yet to be well documented. We sought to quantify changes in medial longitudinal arch kinematics before and after a 45-min run in healthy recreational runners. METHODS Thirty runners performed barefoot seated, standing, and running trials before and after a 45-min shod treadmill run. Navicular displacement, arch lengthening, and the arch height index were used to quantify arch deformation, and the arch rigidity index was used to quantify arch stiffness. RESULTS There were no statistically significant differences in mean (95% confidence interval) values for navicular displacement (5.6 mm [4.7-6.4 mm]), arch lengthening (3.2 mm [2.6-3.9 mm]), change in arch height index (0.015 [0.012-0.018]), or arch rigidity index (0.95 [0.94-0.96]) after the 45-min run (all multivariate analyses of variance P ≥ .065). CONCLUSIONS Because there were no statistically significant changes in arch deformation or rigidity, the structures of a healthy, intact medial longitudinal arch are capable of either adapting to cyclical loading or withstanding a 45-min run without compromise.
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van der Worp MP, de Wijer A, Staal JB, Nijhuis- van der Sanden MWG. Reproducibility of and sex differences in common orthopaedic ankle and foot tests in runners. BMC Musculoskelet Disord 2014; 15:171. [PMID: 24886037 PMCID: PMC4040482 DOI: 10.1186/1471-2474-15-171] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 04/30/2014] [Indexed: 11/29/2022] Open
Abstract
Background For future etiologic cohort studies in runners it is important to identify whether (hyper)pronation of the foot, decreased ankle joint dorsiflexion (AJD) and the degree of the extension of the first Metatarsophalangeal joint (MTP1) are risk factors for running injuries and to determine possible sex differences. These parameters are frequently determined with the navicular drop test (NDT) Stance and Single Limb-Stance, the Ankle Joint Dorsiflexion-test, and the extension MTP1-test in a healthy population. The aim of this clinimetric study was to determine the reproducibility of these three orthopaedic tests in runners, using minimal equipment in order to make them applicable in large cohort studies. Furthermore, we aimed to determine possible sex differences of these tests. Methods The three orthopaedic tests were administered by two sports physiotherapists in a group of 42 (22 male and 20 female) recreational runners. The intra-class correlation (ICC) for interrater and intrarater reliability and the standard error of measurement (SEM) were calculated. Bland and Altman plots were used to determine the 95% limits of agreements (LOAs). Furthermore, the difference between female and male runners was determined. Results The ICC’s of the NDT were in the range of 0.37 to 0.45, with a SEM in the range of 2.5 to 5 mm. The AJD-test had an ICC of 0.88 and 0.86 (SEM 2.4° and 8.7°), with a 95% LOA of -6.0° to 6.3° and -5.3° to 7.9°, and the MTP1-test had an ICC of 0.42 and 0.62 (SEM 34.4° and 9.9°), with a 95% LOA of -30.9° to 20.7° and -20° to 17.8° for the interrater and intrarater reproducibility, respectively. Females had a significantly (p < 0.05) lower navicular drop score and higher range of motion in extension of the MTP1, but no sex differences were found for ankle dorsiflexion (p ≥ 0.05). Conclusion The reproducibility for the AJD test in runners is good, whereas that of the NDT and extension MTP1 was moderate or low. We found a difference in NDT and MTP1 mobility between female and male runners, however this needs to be established in a larger study with more reliable test procedures.
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Affiliation(s)
- Maarten P van der Worp
- Department of Physical Therapy, Academic Institute, University of Applied Sciences Utrecht, Utrecht, the Netherlands.
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Van Alsenoy KK, De Schepper J, Santos D, Vereecke EE, D'Août K. The subtalar joint axis palpation technique-part 1: validating a clinical mechanical model. J Am Podiatr Med Assoc 2014; 104:238-46. [PMID: 24901582 DOI: 10.7547/0003-0538-104.3.238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Locating the position of the subtalar joint axis can be a predictive clinical variable in biomechanical analysis and a valuable tool in the design of functional foot orthoses. Before testing Kirby's palpation technique to locate the subtalar joint axis in cadavers, it was important to develop and test the experimental methods in a mechanical model in which the exact location of the hinge joint can be controlled. METHODS Four testers determined the hinge joint location and moved it through its range of motion, capturing the movement of the joint axis using a kinematic model. The joint axis location was determined and validated by comparing the actual hinge joint location on the mechanical model with the location determined by the palpation technique described by Kirby in 1987 and the location determined by the helical joint axis method using three-dimensional kinematic data. RESULTS The overall angles result in mean slopes and intersections of 87° and 92 mm, 86° and 97 mm, 85° and 92 mm, and 88° and 91 mm for testers 1, 2, 3, and 4, respectively. Testers 1 and 3 were able to determine the location to 1° and 1 mm accuracy, tester 2 to 0° and 4 mm, and tester 4 to 2° and 2 mm compared with the kinematic data. CONCLUSIONS The technique of determining the points of no rotation as described by Kirby could be validated by using a three-dimensional kinematic model to determine the helical axis.
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Affiliation(s)
| | - Joris De Schepper
- Department of Podiatry, Artevelde University College, Ghent, Belgium
- Department of Rehabilitation Sciences and Physical Therapy, Ghent University, Ghent, Belgium
| | - Derek Santos
- Queen Margaret University, Edinburgh, School of Health Sciences, Musselburgh, Scotland
| | - Evie E. Vereecke
- Department of Development and Regeneration, Katholieke Universiteit of Leuven, Kulak, Kortrijk, Belgium
| | - Kristiaan D'Août
- Department of Biology, Antwerp University, Wilrijk, Belgium. Dr. D'Aout is now with the Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, England
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Christensen BH, Andersen KS, Pedersen KS, Bengtsen BS, Simonsen O, Kappel SL, Rathleff MS. Reliability and concurrent validity of a novel method allowing for in-shoe measurement of navicular drop. J Foot Ankle Res 2014; 7:12. [PMID: 24520975 PMCID: PMC3924915 DOI: 10.1186/1757-1146-7-12] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 02/10/2014] [Indexed: 11/18/2022] Open
Abstract
Background Increased navicular drop is associated with increased risk of lower extremity overuse injuries and foot orthoses are often prescribed to reduce navicular drop. For laboratory studies, transparent shoes may be used to monitor the effect of orthoses but no clinically feasible methods exist. We have developed a stretch-sensor that allows for in-shoe measurement of navicular drop but the reliability and validity is unknown. The purpose of this study was to investigate: 1) the reliability of the stretch-sensor for measuring navicular drop, and 2) the concurrent validity of the stretch-sensor compared to the static navicular drop test. Methods Intra- and inter-rater reliability was tested on 27 participants walking on a treadmill on two separate days. The stretch-sensor was positioned 20 mm posterior to the tip of the medial malleolus and 20 mm posterior to the navicular tuberosity. The participants walked six minutes on the treadmill before navicular drop was measured. Reliability was quantified by the Intraclass Correlation Coefficient (ICC 2.1) and agreement was quantified by Limits of Agreement (LOA). To assess concurrent validity, static navicular drop was measured with the stretch-sensor and compared with static navicular drop measured with a ruler on 27 new participants. Linear regression was used to measure concurrent validity. Results The reliability of the stretch-sensor was acceptable for barefoot measurement (intra- and inter-rater ICC: 0.76-0.84) but lower for in-shoe measurement (ICC: 0.65). There was a significant association between static navicular drop measured with the stretch-sensor compared with a ruler (r = 0.745, p < 0.001). Conclusion This study suggests that the stretch-sensor has acceptable reliability for dynamic barefoot measurement of navicular drop. Furthermore, the stretch-sensor shows concurrent validity compared with the static navicular drop test as performed by Brody. This new simple method may hold promise for both clinical assessment and research but more work is needed before the method can be recommended.
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Affiliation(s)
| | | | | | | | | | | | - Michael S Rathleff
- Orthopaedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark.
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Mulligan EP, Cook PG. Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic function. ACTA ACUST UNITED AC 2013; 18:425-30. [DOI: 10.1016/j.math.2013.02.007] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 02/25/2013] [Accepted: 02/28/2013] [Indexed: 12/26/2022]
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Association between foot type and lower extremity injuries: systematic literature review with meta-analysis. J Orthop Sports Phys Ther 2013; 43:700-14. [PMID: 23756327 DOI: 10.2519/jospt.2013.4225] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Systematic literature review with meta-analysis. OBJECTIVES To investigate the association between nonneutral foot types (high arch and flatfoot) and lower extremity and low back injuries, and to identify the most appropriate methods to use for foot classification. METHODS A search of 5 electronic databases (PubMed, Embase, CINAHL, SPORTDiscus, and ProQuest Dissertations and Theses), Google Scholar, and the reference lists of included studies was conducted to identify relevant articles. The review included comparative cross-sectional, case-control, and prospective studies that reported qualitative/quantitative associations between foot types and lower extremity and back injuries. Quality of the selected studies was evaluated, and data synthesis for the level of association between foot types and injuries was conducted. A random-effects model was used to pool odds ratio (OR) and standardized mean difference (SMD) results for meta-analysis. RESULTS Twenty-nine studies were included for meta-analysis. A significant association between nonneutral foot types and lower extremity injuries was determined (OR = 1.23; 95% confidence interval [CI]: 1.11, 1.37; P<.001). Foot posture index (OR = 2.58; 95% CI: 1.33, 5.02; P<.01) and visual/physical examination (OR = 1.17; 95% CI: 1.06, 1.28; P<.01) were 2 assessment methods using distinct foot-type categories that showed a significant association with lower extremity injuries. For foot-assessment methods using a continuous scale, measurements of lateral calcaneal pitch angle (SMD, 1.92; 95% CI: 1.44, 2.39; P<.00001), lateral talocalcaneal angle (SMD, 1.36; 95% CI: 0.93, 1.80; P<.00001), and navicular height (SMD, 0.34; 95% CI: 0.16, 0.52; P<.001) showed significant effect sizes in identifying high-arch foot, whereas the navicular drop test (SMD, 0.45; 95% CI: 0.03, 0.87; P<.05) and relaxed calcaneal stance position (SMD, 0.49; 95% CI: 0.01, 0.97; P<.05) displayed significant effect sizes in identifying flatfoot. Subgroup analyses revealed no significant associations for children with flatfoot, cross-sectional studies, or prospective studies on high arch. CONCLUSIONS High-arch and flatfoot foot types are associated with lower extremity injuries, but the strength of this relationship is low. Although the foot posture index and visual/physical examination showed significance, they are qualitative measures. Radiographic and navicular height measurements can delineate high-arch foot effectively, with only anthropometric measures accurately classifying flatfoot. LEVEL OF EVIDENCE Prognosis, level 2a.
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Nielsen RO, Buist I, Parner ET, Nohr EA, Sørensen H, Lind M, Rasmussen S. Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study. Br J Sports Med 2013; 48:440-7. [DOI: 10.1136/bjsports-2013-092202] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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