1
|
Kamal Z, Hekman EEG, Verkerke GJ. A combined musculoskeletal and finite element model of a foot to predict plantar pressure distribution. Biomed Phys Eng Express 2024; 10:035024. [PMID: 38277697 DOI: 10.1088/2057-1976/ad233d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/26/2024] [Indexed: 01/28/2024]
Abstract
In this study, a combined subject-specific numerical and experimental investigation was conducted to explore the plantar pressure of an individual. The research utilized finite element (FE) and musculoskeletal modelling based on computed tomography (CT) images of an ankle-foot complex and three-dimensional gait measurements. Muscle forces were estimated using an individualized multi-body musculoskeletal model in five gait phases. The results of the FE model and gait measurements for the same subject revealed the highest stress concentration of 0.48 MPa in the forefoot, which aligns with previously-reported clinical observations. Additionally, the study found that the encapsulated soft tissue FE model with hyper-elastic properties exhibited higher stresses compared to the model with linear-elastic properties, with maximum ratios of 1.16 and 1.88 MPa in the contact pressure and von-Mises stress, respectively. Furthermore, the numerical simulation demonstrated that the use of an individualized insole caused a reduction of 8.3% in the maximum contact plantar pressure and 14.7% in the maximum von-Mises stress in the encapsulated soft tissue. Overall, the developed model in this investigation holds potential for facilitating further studies on foot pathologies and the improvement of rehabilitation techniques in clinical settings.
Collapse
Affiliation(s)
- Zeinab Kamal
- Department of Biomechanical Engineering, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Edsko E G Hekman
- Department of Biomechanical Engineering, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Gijsbertus J Verkerke
- Department of Biomechanical Engineering, University of Twente, Enschede, 7500 AE, The Netherlands
| |
Collapse
|
2
|
Setliff JC, Paulus PF, Yamamoto T, Yang S, Hogan MV, Anderst WJ. Ankle and hindfoot motion of healthy adults during running revealed by dynamic biplane radiography: Side-to-side symmetry, sex-specific differences, and comparison with walking. Med Eng Phys 2024; 126:104151. [PMID: 38621840 DOI: 10.1016/j.medengphy.2024.104151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 03/05/2024] [Accepted: 03/11/2024] [Indexed: 04/17/2024]
Abstract
This study aimed to characterize ankle and hindfoot kinematics of healthy men and women during overground running using biplane radiography, and to compare these data to those previously obtained in the same cohort during overground walking. Participants ran across an elevated platform at a self-selected pace while synchronized biplane radiographs of their ankle and hindfoot were acquired. Motion of the tibia, talus, and calcaneus was tracked using a validated volumetric model-based tracking process. Tibiotalar and subtalar 6DOF kinematics were obtained. Absolute side-to-side differences in ROM and kinematics waveforms were calculated. Side-to-side and sex-specific differences were evaluated at 10 % increments of stance phase with mixed model analysis. Pearson correlation coefficients were used to assess the relationship between stance-phase running and walking kinematics. 20 participants comprised the study cohort (10 men, mean age 30.8 ± 6.3 years, mean BMI 24.1 ± 3.1). Average absolute side-to-side differences in running kinematics waveforms were 5.6°/2.0 mm or less at the tibiotalar joint and 5.2°/3.2 mm or less at the subtalar joint. No differences in running kinematics waveforms between sides or between men and women were detected. Correlations were stronger at the tibiotalar joint (42/66 [64 %] of correlations were p < 0.05), than at the tibiotalar joint (38/66 [58 %] of correlations were p < 0.05). These results provide a normative reference for evaluating native ankle and hindfoot kinematics which may be informative in surgical or rehabilitation contexts. Sex-specific differences in ankle kinematics during overground running are likely not clinically or etiologically significant. Associations seen between walking and running kinematics suggest one could be used to predict the other.
Collapse
Affiliation(s)
- Joshua C Setliff
- University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.
| | - Paige F Paulus
- Biodynamics Lab, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tetsuya Yamamoto
- Biodynamics Lab, University of Pittsburgh, Pittsburgh, PA, USA; Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shumeng Yang
- Biodynamics Lab, University of Pittsburgh, Pittsburgh, PA, USA
| | - MaCalus V Hogan
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA; University of Pittsburgh, Foot and Ankle Injury Research [F.A.I.R] Group, USA
| | - William J Anderst
- Biodynamics Lab, University of Pittsburgh, Pittsburgh, PA, USA; Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
3
|
Wearing SC, Jones B, Horstmann T, Robertson A. A Method-Comparison Study Highlighting the Disparity between Osseous- and Skin-Based Measures of Foot Mobility. Med Sci Sports Exerc 2024; 56:737-744. [PMID: 37908026 DOI: 10.1249/mss.0000000000003336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
PURPOSE This study examined the validity of standard clinical measures of arch height mobility, midfoot width mobility (MWM), and foot mobility magnitude (FMM) relative to skin-based and osseous measures derived from radiographs. METHODS Skin-based clinical indices of foot mobility were calculated from standard, caliper-based measures of foot length, midfoot width, and dorsal arch height of the left limb of 20 healthy participants (8-71 yr) during non-weight-bearing and weight-bearing. Skin-based radiographic and osseous indices were derived from concurrent anteroposterior and lateral radiographs. Agreement between skin-based clinical and skin-based radiographic measures of foot mobility with those of osseous measures was investigated using the Bland and Altman approach. RESULTS Foot mobility indices derived from clinical measures were significantly higher (20%-50%) than skin-based radiographic measures ( P < 0.01), which were, in turn, significantly higher (200%-250%) than osseous measures ( P < 0.01). Clinical measures demonstrated significant levels of proportional bias compared with radiographic measures of foot mobility ( P < 0.01). The contribution of osseous movement to skin-based clinical measures of mobility was highly variable between individuals, ranging between 19% and 81% for arch height mobility, between 4% and 87% for MWM, and between 14% and 75% for FMM. The limits of tolerance for clinical measures of foot mobility ranged from ±3.2 mm for MWM to ±6.6 mm for measures of FMM. The limits of tolerance for skin-based clinical and skin-based radiographic measures were generally larger than osseous movement with weight-bearing. CONCLUSIONS Skin-based measures of foot mobility, whether clinical or radiographic methods, are not interchangeable and are poor indicators of osseous mobility. Although further research regarding the utility of osseous measures is warranted, these findings strongly caution against the use of skin-based clinical measures of foot mobility in clinical and research settings.
Collapse
Affiliation(s)
- Scott C Wearing
- Conservative and Rehabilitative Orthopaedics, Department of Sports and Health Sciences, Technical University of Munich, Munich, GERMANY
| | - Brendan Jones
- Brisbane Private Imaging and Royal Brisbane and Women's Hospital Radiology Department, Brisbane, AUSTRALIA
| | - Thomas Horstmann
- Conservative and Rehabilitative Orthopaedics, Department of Sports and Health Sciences, Technical University of Munich, Munich, GERMANY
| | - Aaron Robertson
- Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, AUSTRALIA
| |
Collapse
|
4
|
Hulshof CM, Schallig W, van den Noort JC, Streekstra GJ, Kleipool RP, Gg Dobbe J, Maas M, Harlaar J, van der Krogt MM. Skin marker-based versus bone morphology-based coordinate systems of the hindfoot and forefoot. J Biomech 2024; 166:112001. [PMID: 38527409 DOI: 10.1016/j.jbiomech.2024.112001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/31/2024] [Accepted: 02/14/2024] [Indexed: 03/27/2024]
Abstract
Segment coordinate systems (CSs) of marker-based multi-segment foot models are used to measure foot kinematics, however their relationship to the underlying bony anatomy is barely studied. The aim of this study was to compare marker-based CSs (MCSs) with bone morphology-based CSs (BCSs) for the hindfoot and forefoot. Markers were placed on the right foot of fifteen healthy adults according to the Oxford, Rizzoli and Amsterdam Foot Model (OFM, RFM and AFM, respectively). A CT scan was made while the foot was loaded in a simulated weight-bearing device. BCSs were based on axes of inertia. The orientation difference between BCSs and MCSs was quantified in helical and 3D Euler angles. To determine whether the marker models were able to capture inter-subject variability in bone poses, linear regressions were performed. Compared to the hindfoot BCS, all MCSs were more toward plantar flexion and internal rotation, and RFM was also oriented toward more inversion. Compared to the forefoot BCS, OFM and RFM were oriented more toward dorsal and plantar flexion, respectively, and internal rotation, while AFM was not statistically different in the sagittal and transverse plane. In the frontal plane, OFM was more toward eversion and RFM and AFM more toward inversion compared to BCS. Inter-subject bone pose variability was captured with RFM and AFM in most planes of the hindfoot and forefoot, while this variability was not captured by OFM. When interpreting multi-segment foot model data it is important to realize that MCSs and BCSs do not always align.
Collapse
Affiliation(s)
- Chantal M Hulshof
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118 1081 HZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.
| | - Wouter Schallig
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118 1081 HZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.
| | - Josien C van den Noort
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Geert J Streekstra
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands
| | - Roeland P Kleipool
- Department of Medical Biology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands
| | - Johannes Gg Dobbe
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118 1081 HZ, Amsterdam, the Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2 2628 CD, Delft, the Netherlands; Department of Orthopedics & Sports Medicine, Erasmus MC, Doctor Molewaterplein 40 3015 GD, Rotterdam, the Netherlands
| | - Marjolein M van der Krogt
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118 1081 HZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| |
Collapse
|
5
|
Jo J, Park H. Fit of fire boots: exploring internal morphology using computed tomography. Int J Occup Saf Ergon 2024; 30:90-99. [PMID: 37596795 DOI: 10.1080/10803548.2023.2247765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
Fit of fire boots is a crucial factor in the safety and performance of firefighters on the hostile fireground. Firefighters have reported that ill-fitting fire boots restrict their lower body movement and sometimes cause very dangerous situations by falling off behind the wearer. By using computed tomography, this study demonstrates the potential to quantify and visualize the fit of fire boots, which previously relied on subjective feedback from the wearers. The high-resolution three-dimensional (3D) models of two fire boot products allowed a detailed observation and measurement of the internal space of the boots. Also, the boot's internal dimension was compared to the foot measurement of local firefighters, showing the significant differences between the two boots. Lastly, simulation wrapping the 3D scanned foot with the boot revealed large void spaces around the toe box and ankle, as well as the narrower ball width of the boot than the foot.
Collapse
Affiliation(s)
- Jeyeon Jo
- Department of Human Centered Design, Cornell University, USA
- Department of Textiles, Merchandising and Interiors, University of Georgia, USA
| | - Huiju Park
- Department of Human Centered Design, Cornell University, USA
| |
Collapse
|
6
|
Pirri C, Stecco C, Güvener O, Mezian K, Ricci V, Jačisko J, Fojtik P, Kara M, Chang KV, Dughbaj M, Özçakar L. EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for Ankle/Foot. Am J Phys Med Rehabil 2024; 103:e29-e34. [PMID: 37903600 DOI: 10.1097/phm.0000000000002349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
ABSTRACT In this dynamic scanning protocol, ultrasound examination of the ankle is described using various maneuvers to assess different conditions. Real-time patient examination and scanning videos are used for better simulation of daily clinical practice. The protocol is prepared by several/international experts in the field of musculoskeletal ultrasound and within the umbrella of European Musculoskeletal Ultrasound Study Group in Physical and Rehabilitation Medicine/Ultrasound Study Group of the International Society of Physical and Rehabilitation Medicine.
Collapse
Affiliation(s)
- Carmelo Pirri
- From the Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy (CP, CS); Department of Physical and Rehabilitation Medicine, Mersin University Medical School, Mersin, Turkey (OG); Department of Rehabilitation Medicine, Charles University, First Faculty of Medicine, Prague, Czech Republic (KM); Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy (VR); Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic (JJ); Institute of Anatomy, Charles University, First Faculty of Medicine, Prague, Czech Republic, Department of Orthopedics, The Central Military Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic (PF); Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, L Ö); Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taiwan (K.-VC); National Taiwan University College of Medicine, Taipei, Taiwan (K.-VC); Physical Medicine and Rehabilitation Hospital, Ministry of Health, Kuwait (MD)
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Lithgow MJ, Buldt AK, Munteanu SE, Marshall M, Thomas MJ, Peat G, Roddy E, Menz HB. Structural Foot Characteristics in People With Midfoot Osteoarthritis: Cross-Sectional Findings From the Clinical Assessment Study of the Foot. Arthritis Care Res (Hoboken) 2024; 76:225-230. [PMID: 37563733 DOI: 10.1002/acr.25217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 07/26/2023] [Accepted: 08/08/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE This study compared radiographic measures of foot structure between people with and without symptomatic radiographic midfoot osteoarthritis (OA). METHODS This was a cross-sectional study of adults aged 50 years and older registered with four UK general practices who reported foot pain in the past year. Bilateral weightbearing dorsoplantar and lateral radiographs were obtained. Symptomatic radiographic midfoot OA was defined as midfoot pain in the last 4 weeks, combined with radiographic OA in one or more midfoot joints (first cuneometatarsal, second cuneometatarsal, navicular-first cuneiform, and talonavicular). Midfoot OA cases were matched 1:1 for sex and age to controls with a 5-year age tolerance. Eleven radiographic measures were extracted and compared between the groups using independent sample t-tests and effect sizes (Cohen's d). RESULTS We identified 63 midfoot OA cases (mean ± SD age was 66.8 ± 8.0 years, with 32 male and 31 female participants) and matched these to 63 controls (mean ± SD age was 65.9 ± 7.8 years). There were no differences in metatarsal lengths between the groups. However, those with midfoot OA had a higher calcaneal-first metatarsal angle (d = 0.43, small effect size, P = 0.018) and lower calcaneal inclination angle (d = 0.46, small effect size, P = 0.011) compared with controls. CONCLUSIONS People with midfoot OA have a flatter foot posture compared with controls. Although caution is required when inferring causation from cross-sectional data, these findings are consistent with a pathomechanical pathway linking foot structure to the development of midfoot OA. Prospective studies are required to determine the temporal relationships between foot structure, function, and the development of this common and disabling condition.
Collapse
Affiliation(s)
- Merridy J Lithgow
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Andrew K Buldt
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Shannon E Munteanu
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Michelle Marshall
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Martin J Thomas
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire, UK
- Haywood Academic Rheumatology Centre, Midlands Partnership University National Health Service Foundation Trust, Haywood Hospital, Burslem, Staffordshire, UK
| | - George Peat
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire, UK
- Centre for Applied Health and Social Care (CARe), Sheffield Hallam University, Sheffield, UK
| | - Edward Roddy
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire, UK
- Haywood Academic Rheumatology Centre, Midlands Partnership University National Health Service Foundation Trust, Haywood Hospital, Burslem, Staffordshire, UK
| | - Hylton B Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire, UK
| |
Collapse
|
8
|
Chen J, Zhang P, Hou L, Bao H, Li J, Zhao J. Injury of flexor halluics longus tendon in amateur marathon runners results in abnormal plantar pressure distribution: observational study. BMC Musculoskelet Disord 2024; 25:77. [PMID: 38245696 PMCID: PMC10799441 DOI: 10.1186/s12891-024-07169-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE To analyze the changes of plantar pressure in amateur marathon runners with flexor halluics longus (FHL) tendon injury using the Medtrack-Gait plantar pressure measurement system, and to explore whether the plantar pressure data can be used as an index for the diagnosis of injury. METHODS A total of 39 healthy amateur marathon runners without any ankle joint symptoms were recruited. Dynamic and static plantar pressure data were measured using the pressure plate of Medtrack-Gait. According to MRI imaging findings, whether the FHL tendon was injured or not was judged, and the dynamic and static data were divided into the injury group and control group. The data with statistically significant differences between the two groups were used to make the receiver operating characteristic (ROC) curve. RESULT The maximum contact area (PA) of the first metatarsal(M1) region, the maximum load-bearing peak value (PW) and the time pressure integral (PMPTI) of the second metatarsal(M2) region in the injury group were lower than those in the control group, respectively (P < 0.05). The maximum contact area (PA) of the fifth metatarsal(M5) region was higher than that in the control group (P < 0.05). The area under curve (AUC) value of the ROC curve of the PA of M1 region, the PW and PMPTI of M2 region were statistically (P < 0.05). CONCLUSION FHL tendon injury resulted in decreased PA in M1, decreased PW and PMPTI in M2, and increased PA in the M5 region, suggesting that FHL tendon injury resulted in a force shift from the medial to the lateral side of the foot. The PA of M1, PW and PMPTI of M2 have certain diagnostic value for early FHL injury in amateur marathon runners.
Collapse
Affiliation(s)
- Jianan Chen
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ping Zhang
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Liting Hou
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hailun Bao
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Junfei Li
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jian Zhao
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
- Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
| |
Collapse
|
9
|
Tonna R, Chatzistergos PE, Wyatt O, Chockalingam N. Reliability and Validity of Shore Hardness in Plantar Soft Tissue Biomechanics. Sensors (Basel) 2024; 24:539. [PMID: 38257632 PMCID: PMC10818800 DOI: 10.3390/s24020539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
Shore hardness (SH) is a cost-effective and easy-to-use method to assess soft tissue biomechanics. Its use for the plantar soft tissue could enhance the clinical management of conditions such as diabetic foot complications, but its validity and reliability remain unclear. Twenty healthy adults were recruited for this study. Validity and reliability were assessed across six different plantar sites. The validity was assessed against shear wave (SW) elastography (the gold standard). SH was measured by two examiners to assess inter-rater reliability. Testing was repeated following a test/retest study design to assess intra-rater reliability. SH was significantly correlated with SW speed measured in the skin or in the microchamber layer of the first metatarsal head (MetHead), third MetHead and rearfoot. Intraclass correlation coefficients and Bland-Altman plots of limits of agreement indicated satisfactory levels of reliability for these sites. No significant correlation between SH and SW elastography was found for the hallux, 5th MetHead or midfoot. Reliability for these sites was also compromised. SH is a valid and reliable measurement for plantar soft tissue biomechanics in the first MetHead, the third MetHead and the rearfoot. Our results do not support the use of SH for the hallux, 5th MetHead or midfoot.
Collapse
Affiliation(s)
- Redent Tonna
- Department of Engineering, School of Digital, Technologies and Arts, Staffordshire University, Stoke-on-Trent ST4 2DE, UK;
| | - Panagiotis E. Chatzistergos
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DE, UK; (O.W.); (N.C.)
| | - Otis Wyatt
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DE, UK; (O.W.); (N.C.)
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DE, UK; (O.W.); (N.C.)
| |
Collapse
|
10
|
Khan MJ, Apetuje MD, Cheng E, Christie L, Kim HR, Stark C, Malay DS. The Reliability of Common Radiographic Measurements Used to Describe Foot Deformities. J Foot Ankle Surg 2024; 63:64-73. [PMID: 37690498 DOI: 10.1053/j.jfas.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/15/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
Radiographic measurements are frequently used to classify deformity and determine treatment options. Correlation coefficients can be used to determine inter- and intrarater reliability. Reliability is a required feature of any measurement if the measurement is to provide valid information. We calculated correlation coefficients for standard radiographic measurements used to categorize foot deformities: this was done for 52 sets of radiographs assessed by 5 raters. We aimed for generalizability, and kept rater instructions to match what was originally published for each measurement of interest with schematic illustration. Overall, our results mostly showed a lack of inter-rater reliability (correlation coefficients <0.4), and strong intrarater reliability (correlation coefficients >0.6), for 12 forefoot and 12 rearfoot radiographic measurements that are commonly used. The results of this investigation bring into question the routine use of radiographic measurements to categorize deformity, select treatments, and measure surgical outcomes, between surgeons, because the validity of these measurements appears to be threatened by weak inter-rater reliability. In order for these measurements to be considered useful, it may be necessary for surgeons to more rigorously define and practice making standard radiographic measurements.
Collapse
Affiliation(s)
- Mohammad Junayed Khan
- Neighborhood Health Center (FQHC), Buffalo, NY; Penn Presbyterian Medical Center, Philadelphia, PA.
| | | | | | | | - Hye R Kim
- Penn Presbyterian Medical Center, Philadelphia, PA
| | | | - D Scot Malay
- Penn Presbyterian Medical Center, Philadelphia, PA
| |
Collapse
|
11
|
Wu G, Yang Y, Liu L. The effect of non-contrast enhanced MRA on patients with renal insufficiency and foot pain. Medicine (Baltimore) 2023; 102:e36372. [PMID: 38065876 PMCID: PMC10713136 DOI: 10.1097/md.0000000000036372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
To investigate the feasibility of non-contrast magnetic resonance angiography of arteries and veins (NATIVE) sampling perfection with application optimized contrasts by using different flip angle evolution (SPACE) and quiescent interval single shot (QISS) in assessing foot arteries of patients with renal insufficiency and foot pain. Fifty-three patients (mean age = 44.2 ± 11.4 years, male: female = 27:26) underwent QISS and NATIVE-SPACE. The source images were reconstructed to maximum intensity projection and volume render. The image quality of QISS and NATIVE-SPACE was rated (0-3, poor to excellent), and was compared using Wilcoxon test. True or false positive was determined by comparing the findings of QISS and NATIVE-SPACE. The relative signal intensity of artery was obtained for each case, and was compared between QISS and NATIVE-SPACE using Mann Whitney test. The acquisition time of NATIVE-SPACE was significantly longer than that of QISS (178.4 ± 35.7 seconds vs 45.4 ± 8.9 seconds, P < .001). QISS had significantly lower image quality score versus NATIVE-SPACE (1.4 ± 0.5 vs 2.4 ± 0.6, P = .02). Fifteen percentage (8/53) NATIVE-SPACE cases had poor image quality due to the similarity of peak flow and minimum flow. The relative signal intensity was significantly lower in QISS versus NATIVE-SPACE (9.7 ± 1.3 vs 68.2 ± 12.4, P < .001). NATIVE-SPACE is valuable in evaluating foot arteries of patients with renal insufficiency. QISS can serve as an alternative test to NATIVE-SPACE.
Collapse
Affiliation(s)
- Gang Wu
- Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yongli Yang
- Internal Medicine of Nephropathy, Hubei No.3 People’s Hospital of Jianghan University, Wuhan, Hubei, China
| | - Liangjin Liu
- Department of Radiology, Hubei No.3 People’s Hospital of Jianghan University, Wuhan, Hubei, China
| |
Collapse
|
12
|
Papineni VRK, Ballal M, Iyengar KP, Botchu R. Hydroxyapatite deposition disease (HADD) of the spring ligament: an unusual cause of medial foot pain. J Ultrasound 2023; 26:923-928. [PMID: 36995486 PMCID: PMC10632214 DOI: 10.1007/s40477-023-00781-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/23/2023] [Indexed: 03/31/2023] Open
Abstract
Foot pain is one of the most common presenting complaints in orthopaedic clinical practice and can be attributed to a multitude of pathologies in the various osseous structures, ligaments, and tendons of the foot. The spring ligament complex (SLC) between the calcaneum and navicular supports the talus and plays a major role in the static stability of the medial longitudinal arch of the foot. Although calcific ligamentous enthesopathy around the ankle has been described in the literature, we report the first case of its kind affecting the SLC in a 51-year-old male with medial foot pain and no history of trauma. We highlight the role of radiological interventions in the diagnosis and effective management using ultrasound (US)-guided barbotage.
Collapse
Affiliation(s)
- Vijay R K Papineni
- Department of Radiology, Sheikh Shakhbout Medical City (Mayo Clinic), Abu Dhabi, United Arab Emirates
| | - Moez Ballal
- Department of Orthopedics, Sheikh Shakhbout Medical City (Mayo Clinic), Abu Dhabi, United Arab Emirates
| | - Karthikeyan P Iyengar
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
- Department of Orthopaedics, Southport and Ormskirk Hospital, Southport, UK
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK.
| |
Collapse
|
13
|
Hansen P, Brinch S, Radev DI, Nybing JU, Toftgaard S, Johannsen FE. Reliability and correlation of weight-bearing cone beam CT and Foot Posture Index (FPI) for measurements of foot posture: a test-retest study. Skeletal Radiol 2023; 52:2387-2397. [PMID: 37130960 PMCID: PMC10582147 DOI: 10.1007/s00256-023-04352-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/17/2023] [Accepted: 04/19/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To assess test-retest reliability and correlation of weight-bearing (WB) and non-weight-bearing (NWB) cone beam CT (CBCT) foot measurements and Foot Posture Index (FPI) MATERIALS AND METHODS: Twenty healthy participants (age 43.11±11.36, 15 males, 5 females) were CBCT-scanned in February 2019 on two separate days on one foot in both WB and NWB positions. Three radiology observers measured the navicular bone position. Plantar (ΔNAVplantar) and medial navicular displacements (ΔNAVmedial) were calculated as a measure of foot posture changes under loading. FPI was assessed by two rheumatologists on the same two days. FPI is a clinical measurement of foot posture with 3 rearfoot and 3 midfoot/forefoot scores. Test-retest reproducibility was determined for all measurements. CBCT was correlated to FPI total and subscores. RESULTS Intra- and interobserver reliabilities for navicular position and FPI were excellent (intraclass correlation coefficient (ICC) .875-.997). In particular, intraobserver (ICC .0.967-1.000) and interobserver reliabilities (ICC .946-.997) were found for CBCT navicular height and medial position. Interobserver reliability of ΔNAVplantar was excellent (ICC .926 (.812; .971); MDC 2.22), whereas the ΔNAVmedial was fair-good (ICC .452 (.385; .783); MDC 2.42 mm). Using all observers' measurements, we could calculate mean ΔNAVplantar (4.25±2.08 mm) and ΔNAVmedial (1.55±0.83 mm). We demonstrated a small day-day difference in ΔNAVplantar (0.64 ±1.13mm; p<.05), but not for ΔNAVmedial (0.04 ±1.13mm; p=n.s.). Correlation of WBCT (WB navicular height - ΔNAVmedial) with total clinical FPI scores and FPI subscores, respectively, showed high correlation (ρ: -.706; ρ: -.721). CONCLUSION CBCT and FPI are reliable measurements of foot posture, with a high correlation between the two measurements.
Collapse
Affiliation(s)
- Philip Hansen
- Department of Radiology, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Signe Brinch
- Department of Radiology, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | | | - Janus Uhd Nybing
- Department of Radiology, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | | | - Finn Elkjær Johannsen
- Furesø-reumatologerne, Copenhagen, Farum Denmark
- Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| |
Collapse
|
14
|
Hirota K, Watanabe K, Negishi K, Miyamoto H, Taniguchi T, Teramoto A. Evaluation of the activities of the intrinsic and extrinsic muscles of the foot during toe flexion with or without interphalangeal joint flexion using ultrasound shear wave elastography. Foot (Edinb) 2023; 57:101945. [PMID: 37898055 DOI: 10.1016/j.foot.2022.101945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/17/2022] [Accepted: 10/04/2022] [Indexed: 10/30/2023]
Abstract
The intrinsic muscles of the foot are important to maintain the arch of the foot and to participate in sports activities. Using ultrasound shear wave elastography, we investigated the effect of different toe flexion methods on the activity of the intrinsic and extrinsic muscles of the foot. The study included 15 healthy adults who performed toe flexion under 2 conditions: with interphalangeal (IP) joint flexion and without IP joint flexion. The applied load during flexion was 500 g. Muscle stiffness was measured in the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, flexor hallucis longus, and flexor digitorum longus muscles using ultrasound shear wave elastography. Muscle stiffness was statistically compared with IP flexion and without IP flexion (P < 0.05). The stiffness of the abductor hallucis (P < 0.0005), flexor hallucis brevis (P = 0.022), and flexor digitorum brevis muscles (P < 0.0005) was significantly greater without IP flexion than with IP flexion. In contrast, the muscle stiffness of the flexor hallucis longus (P = 0.001) and the flexor digitorum longus (P = 0.004) was significantly greater during with IP flexion than without IP flexion. This study shows that the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis muscles are more active during toe flexion without IP flexion. These results suggest that the toe flexion method is important for more effective training of the intrinsic muscles of the foot.
Collapse
Affiliation(s)
- Kento Hirota
- Graduate School of Health Science, Sapporo Medical University, Sapporo, Japan.
| | - Kota Watanabe
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Keisuke Negishi
- Graduate School of Health Science, Sapporo Medical University, Sapporo, Japan
| | - Hiroki Miyamoto
- Department of Physical Therapy, Sendai Seiyo Gakuin College, Sendai, Japan
| | - Tatsuya Taniguchi
- Department of Rehabilitation, Sapporo Tokushukai Hospital, Sapporo, Japan
| | - Atsushi Teramoto
- Department of Orthopaedic Surgery, School of Medicine, Sapporo Medical University, Sapporo, Japan
| |
Collapse
|
15
|
Huang C, Cheng Y, Zheng W, Bing RW, Zhang H, Komornicki I, Harris LM, Arany PR, Chakraborty S, Zhou Q, Xu W, Xia J. Dual-Scan Photoacoustic Tomography for the Imaging of Vascular Structure on Foot. IEEE Trans Ultrason Ferroelectr Freq Control 2023; 70:1703-1713. [PMID: 37276111 PMCID: PMC10809222 DOI: 10.1109/tuffc.2023.3283139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Chronic leg ulcers are affecting approximately 6.5 million Americans, and they are associated with significant mortality, reduced quality of life, and high treatment costs. Since many chronic ulcers have underlying vascular insufficiency, accurate assessment of tissue perfusion is critical to treatment planning and monitoring. This study introduces a dual-scan photoacoustic (PA) tomography (PAT) system that can simultaneously image the dorsal and plantar sides of the foot to reduce imaging time. To account for the unique shape of the foot, the system employs height-adjustable and articulating baseball stages that can scan along the foot's contour. In vivo results from healthy volunteers demonstrate the system's ability to acquire clear images of foot vasculature, and results from patients indicate that the system can image patients with various ulcer conditions. We also investigated various PA features and examined their correlation with the foot condition. Our preliminary results indicate that vessel sharpness, occupancy, intensity, and density could all be used to assess tissue perfusion. This research demonstrated the potential of PAT for routine clinical tissue perfusion assessment.
Collapse
|
16
|
Omar IM, Weaver JS, Altbach MI, Herynk BA, McCurdy WE, Kadakia AR, Taljanovic MS. Imaging of osteoarthritis from the ankle through the midfoot. Skeletal Radiol 2023; 52:2239-2257. [PMID: 36737484 PMCID: PMC10400729 DOI: 10.1007/s00256-023-04287-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 02/05/2023]
Abstract
Ankle, hindfoot, and midfoot osteoarthritis (OA) is most commonly posttraumatic and tends to become symptomatic in younger patients. It often results from instability due to insufficiency of supportive soft tissue structures, such as ligaments and tendons. Diagnostic imaging can be helpful to detect and characterize the distribution of OA, and to assess the integrity of these supportive structures, which helps determine prognosis and guide treatment. However, the imaging findings associated with OA and instability may be subtle and unrecognized until the process is advanced, which may ultimately limit therapeutic options to salvage procedures. It is important to understand the abilities and limitations of various imaging modalities used to assess ankle, hindfoot, and midfoot OA, and to be familiar with the imaging findings of OA and instability patterns.
Collapse
Affiliation(s)
- Imran M Omar
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 800, Chicago, IL, 60611, USA.
| | - Jennifer S Weaver
- Department of Radiology, Medical Center North, Vanderbilt University Medical Center, 1161 21St Ave. South, Nashville, TN, 37232, USA
| | - Maria I Altbach
- Department of Medical Imaging, University of Arizona College of Medicine Tucson, 1501 North Campbell, P.O. Box 245067, Tucson, AZ, 85724, USA
| | - Bradley A Herynk
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 800, Chicago, IL, 60611, USA
| | - Wendy E McCurdy
- Department of Medical Imaging, University of Arizona College of Medicine Tucson, 1501 North Campbell, P.O. Box 245067, Tucson, AZ, 85724, USA
| | - Anish R Kadakia
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 1350, Chicago, IL, 60611, USA
| | - Mihra S Taljanovic
- Department of Medical Imaging, University of Arizona College of Medicine Tucson, 1501 North Campbell, P.O. Box 245067, Tucson, AZ, 85724, USA
- Department of Orthopaedic Surgery, University of Arizona College of Medicine Tucson, 1501 North Campbell, P.O. Box 245067, Tucson, AZ, 85724, USA
- Department of Radiology, University of New Mexico School of Medicine, 2211 Lomas Boulevard NE, Albuquerque, NM, 87106, USA
| |
Collapse
|
17
|
Smolinski MP, Amadio J, Prisk V, Conti SF, Miller MC. A Comparison of Imaging Outcomes From 2 Weightbearing CT Modalities. Foot Ankle Int 2023; 44:1174-1180. [PMID: 37772818 DOI: 10.1177/10711007231198230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND The use of weightbearing images to diagnose foot and ankle injuries continues to offer hope for improved insight into pathologies, but weightbearing CT imaging has been limited by availability. The ability to apply force to the lower limb in a horizontal bore CT system may offer an adaptation to currently available imaging systems that provides access to weightbearing images without the acquisition of additional expensive imaging space or equipment. METHODS In order to determine whether a horizontal CT system could produce the same results as a standing CT, 3 images of one foot from 10 subjects was obtained and standard measures were calculated. Each subject underwent a standing CT scan, a scan in a horizontal bore CT machine while the subject pressed against a pedal with spring resistance and a finally a scan with the foot placed on the pedal but without any pressure. RESULTS No statistically significant difference between the standing and pedal-based CTs resulted. Navicular height and Meary angle (axial) were statistically different from nonweightbearing for both standing and horizontal systems. The horizontal results were statistically different from nonweightbearing in IM angle, talocalcaneal angle, and talonavicular coverage. No differences from nonweightbearing were found for either system in talar tilt, talocrural angle, or the lateral Meary angle. CONCLUSION The results in this initial study of normal control subjects suggest that a pedal-based loading mechanism may adapt a horizontal-bore CT system for the acquisition of weightbearing images. CLINICAL RELEVANCE The ability to acquire a weightbearing CT from a horizontal bore CT machine can make these images more available.
Collapse
Affiliation(s)
| | | | - Victor Prisk
- Prisk Orthopaedics and Wellness, Pittsburgh, PA, USA
| | | | - Mark Carl Miller
- University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, USA
| |
Collapse
|
18
|
Das RS, Sagar TN. Bilateral Symmetric Absence of Lumbricals of the Foot: A Rare Case Report. J Am Podiatr Med Assoc 2023; 113:22-188. [PMID: 38170613 DOI: 10.7547/22-188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Variations of the lumbricals of the foot are not common, unlike the lumbricals of the hand. Few cases of unilateral absence of lumbricals of the foot have been reported. There have been far fewer cases of bilateral asymmetric absence of the lumbricals of the foot reported. The study reports the findings observed during the routine dissection for undergraduate medical students in the Department of Anatomy. We observed that the third lumbrical in both the feet was absent in an elderly male cadaver. The other features of both feet were usual. Externally, there was no apparent deformity, operation mark, or evidence of injury in any of the feet. Considering the functional role of the lumbricals in particular and other small intrinsic muscles in general, on the mechanics of foot movement, it is of much significance to have the knowledge of the possible variations and their clinical implications, which should be studied using different diagnostic tools such as imaging techniques, dynamometry, and other modalities.
Collapse
Affiliation(s)
- Rajat Subhra Das
- *All India Institute of Medical Sciences Raebareli, Uttar Pradesh, India
| | | |
Collapse
|
19
|
Cao Z, Zeng Z, Xie J, Zhai H, Yin Y, Ma Y, Tian Y. Diabetic Plantar Foot Segmentation in Active Thermography Using a Two-Stage Adaptive Gamma Transform and a Deep Neural Network. Sensors (Basel) 2023; 23:8511. [PMID: 37896605 PMCID: PMC10610917 DOI: 10.3390/s23208511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023]
Abstract
Pathological conditions in diabetic feet cause surface temperature variations, which can be captured quantitatively using infrared thermography. Thermal images captured during recovery of diabetic feet after active cooling may reveal richer information than those from passive thermography, but diseased foot regions may exhibit very small temperature differences compared with the surrounding area, complicating plantar foot segmentation in such cold-stressed active thermography. In this study, we investigate new plantar foot segmentation methods for thermal images obtained via cold-stressed active thermography without the complementary information from color or depth channels. To better deal with the temporal variations in thermal image contrast when planar feet are recovering from cold immersion, we propose an image pre-processing method using a two-stage adaptive gamma transform to alleviate the impact of such contrast variations. To improve upon existing deep neural networks for segmenting planar feet from cold-stressed infrared thermograms, a new deep neural network, the Plantar Foot Segmentation Network (PFSNet), is proposed to better extract foot contours. It combines the fundamental U-shaped network structure, a multi-scale feature extraction module, and a convolutional block attention module with a feature fusion network. The PFSNet, in combination with the two-stage adaptive gamma transform, outperforms multiple existing deep neural networks in plantar foot segmentation for single-channel infrared images from cold-stressed infrared thermography, achieving an accuracy of 97.3% and 95.4% as measured by Intersection over Union (IOU) and Dice Similarity Coefficient (DSC) respectively.
Collapse
Affiliation(s)
- Zhenjie Cao
- College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen 518000, China; (Z.C.); (Y.M.)
- College of Computer and Information Science, Chongqing Normal University, Chongqing 401331, China; (J.X.); (H.Z.)
| | - Zhi Zeng
- College of Computer and Information Science, Chongqing Normal University, Chongqing 401331, China; (J.X.); (H.Z.)
- Shunde Hospital, Southern Medical University, Foshan 528000, China
| | - Jinfang Xie
- College of Computer and Information Science, Chongqing Normal University, Chongqing 401331, China; (J.X.); (H.Z.)
| | - Hao Zhai
- College of Computer and Information Science, Chongqing Normal University, Chongqing 401331, China; (J.X.); (H.Z.)
| | - Ying Yin
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China;
| | - Yue Ma
- College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen 518000, China; (Z.C.); (Y.M.)
| | - Yibin Tian
- College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen 518000, China; (Z.C.); (Y.M.)
| |
Collapse
|
20
|
Alsaidi FA, Moria KM. Flatfeet Severity-Level Detection Based on Alignment Measuring. Sensors (Basel) 2023; 23:8219. [PMID: 37837049 PMCID: PMC10574869 DOI: 10.3390/s23198219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/17/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023]
Abstract
Flat foot is a postural deformity in which the plantar part of the foot is either completely or partially contacted with the ground. In recent clinical practices, X-ray radiographs have been introduced to detect flat feet because they are more affordable to many clinics than using specialized devices. This research aims to develop an automated model that detects flat foot cases and their severity levels from lateral foot X-ray images by measuring three different foot angles: the Arch Angle, Meary's Angle, and the Calcaneal Inclination Angle. Since these angles are formed by connecting a set of points on the image, Template Matching is used to allocate a set of potential points for each angle, and then a classifier is used to select the points with the highest predicted likelihood to be the correct point. Inspired by literature, this research constructed and compared two models: a Convolutional Neural Network-based model and a Random Forest-based model. These models were trained on 8000 images and tested on 240 unseen cases. As a result, the highest overall accuracy rate was 93.13% achieved by the Random Forest model, with mean values for all foot types (normal foot, mild flat foot, and moderate flat foot) being: 93.38 precision, 92.56 recall, 96.46 specificity, 95.42 accuracy, and 92.90 F-Score. The main conclusions that were deduced from this research are: (1) Using transfer learning (VGG-16) as a feature-extractor-only, in addition to image augmentation, has greatly increased the overall accuracy rate. (2) Relying on three different foot angles shows more accurate estimations than measuring a single foot angle.
Collapse
Affiliation(s)
- Fatmah A. Alsaidi
- Department of Computer Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Kawthar M. Moria
- Department of Electrical and Computer Engineering, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| |
Collapse
|
21
|
Zhang X, Teng Z, Geng X, Ma X, Chen WM. A fluoroscopic imaging-guided computational analyses to inform internal tissue loads within fat pad of the diabetic foot during gait. J Biomech 2023; 157:111744. [PMID: 37535986 DOI: 10.1016/j.jbiomech.2023.111744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
To accurately predict internal tissue loads for early diagnostics of diabetic foot ulcerations, a novel data-driven computational analysis was conducted. A dedicated dual fluoroscopic system was combined with a pressure mat to simultaneously characterize foot motions and soft tissue's material properties during gait. Finite element (FE) models of the heel pad of a diabetic patient were constructed with 3D trajectories of the calcaneus applied as boundary conditions to simulate gait events. The tensile and compressive stresses occurring in the plantar tissue were computed. Predictions of the layered tissue FE model with anatomically-accurate heel pad structures (i.e., fat and skin) were compared with those of the traditional lumped tissue (i.e., homogeneous) models. The influence of different material properties (patient-specific versus generic) on internal tissue stresses was also investigated. The results showed the peak tensile stresses in the layered tissue model were predominantly found in the skin and distributed towards the circumferential regions of the heel, while peak compressive stresses in the fat tissue-bone interface were up to 51.4% lower than those seen in the lumped models. Performing FE analyses at four different phases of walking revealed that ignorance of layered tissue structures resulted in an unphysiological increase of peak-to-peak value of stress fluctuation in the fat and skin tissue components. Thus, to produce more clinical-relevant predictions, foot FE models are suggested to include layered tissue structures of the plantar tissue for an improved estimation of internal stresses in the diabetic foot in gait.
Collapse
Affiliation(s)
- Xingyu Zhang
- Institute of Biomedical Engineering and Technology, Academy for Engineering and Technology, Fudan University, 220 Handan Road, Shanghai, China
| | - Zhaolin Teng
- Department of Orthopaedics, Huashan Hospital affiliated to Fudan University, 12 Middle Wulumuqi Road, Shanghai, China
| | - Xiang Geng
- Department of Orthopaedics, Huashan Hospital affiliated to Fudan University, 12 Middle Wulumuqi Road, Shanghai, China
| | - Xin Ma
- Department of Orthopaedics, Huashan Hospital affiliated to Fudan University, 12 Middle Wulumuqi Road, Shanghai, China
| | - Wen-Ming Chen
- Institute of Biomedical Engineering and Technology, Academy for Engineering and Technology, Fudan University, 220 Handan Road, Shanghai, China.
| |
Collapse
|
22
|
Patton D, Ghosh A, Farkas A, Sotardi S, Francavilla M, Venkatakrishna S, Bose S, Ouyang M, Huang H, Davidson R, Sze R, Nguyen J. Automating Angle Measurements on Foot Radiographs in Young Children: Feasibility and Performance of a Convolutional Neural Network Model. J Digit Imaging 2023; 36:1419-1430. [PMID: 37099224 PMCID: PMC10406755 DOI: 10.1007/s10278-023-00824-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/27/2023] Open
Abstract
Measurement of angles on foot radiographs is an important step in the evaluation of malalignment. The objective is to develop a CNN model to measure angles on radiographs, using radiologists' measurements as the reference standard. This IRB-approved retrospective study included 450 radiographs from 216 patients (< 3 years of age). Angles were automatically measured by means of image segmentation followed by angle calculation, according to Simon's approach for measuring pediatric foot angles. A multiclass U-Net model with a ResNet-34 backbone was used for segmentation. Two pediatric radiologists independently measured anteroposterior and lateral talocalcaneal and talo-1st metatarsal angles using the test dataset and recorded the time used for each study. Intraclass correlation coefficients (ICC) were used to compare angle and paired Wilcoxon signed-rank test to compare time between radiologists and the CNN model. There was high spatial overlap between manual and CNN-based automatic segmentations with dice coefficients ranging between 0.81 (lateral 1st metatarsal) and 0.94 (lateral calcaneus). Agreement was higher for angles on the lateral view when compared to the AP view, between radiologists (ICC: 0.93-0.95, 0.85-0.92, respectively) and between radiologists' mean and CNN calculated (ICC: 0.71-0.73, 0.41-0.52, respectively). Automated angle calculation was significantly faster when compared to radiologists' manual measurements (3 ± 2 vs 114 ± 24 s, respectively; P < 0.001). A CNN model can selectively segment immature ossification centers and automatically calculate angles with a high spatial overlap and moderate to substantial agreement when compared to manual methods, and 39 times faster.
Collapse
Affiliation(s)
- Daniella Patton
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Adarsh Ghosh
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amy Farkas
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Susan Sotardi
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Francavilla
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shyam Venkatakrishna
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Saurav Bose
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Minhui Ouyang
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hao Huang
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Richard Davidson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Divison of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Raymond Sze
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jie Nguyen
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
23
|
Park YH, Kim HJ, Kim W, Choi JW. Reliability of Ultrasound Measurement of Plantar Fascia Thickness: A Systematic Review. J Am Podiatr Med Assoc 2023; 113:21-024. [PMID: 37715979 DOI: 10.7547/21-024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
BACKGROUND Because ultrasound measurement of plantar fascia thickness is widely used in the diagnosis and evaluation of plantar fasciitis, it is important to understand and minimize the errors that occur with this measurement. The aim of this systematic review was to identify and synthesize studies reporting on intrarater and interrater reliability of ultrasound measurement of plantar fascia thickness. METHODS After comprehensive searches in the MEDLINE, Embase, and Cochrane Library databases, 11 studies involving 238 healthy participants and 68 patients with pathologic foot disorders were included. RESULTS Seven of 11 studies revealed a low risk of bias. Most of the studies reported good to excellent intrarater and interrater reliability for ultrasound measurement of plantar fascia thickness (intrarater intraclass correlation coefficient [ICC], 0.77-0.98; interrater ICC, 0.76-0.98). In addition, two studies on intrarater reliability and one study on interrater reliability showed moderate reliability (ICCs, 0.65, 0.67, and 0.59, respectively). Overall, the standard error of measurement was less than 5% and did not exceed 7%. CONCLUSIONS The findings of this review suggest that ultrasound measurement of plantar fascia thickness is reliable in terms of both relative and absolute reliability. Reliability can be optimized by using the average of multiple measurements and an experienced operator.
Collapse
Affiliation(s)
| | - Hak Jun Kim
- *Korea University Guro Hospital, Seoul, Republic of Korea
| | - Woon Kim
- *Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jung Woo Choi
- *Korea University Guro Hospital, Seoul, Republic of Korea
| |
Collapse
|
24
|
Mazzotti A, Arceri A, Martini B, Bonelli S, Zielli S, Artioli E, Brognara L, Faldini C. Hallux Valgus Plantar Pressure Distribution Before and After Surgery. J Am Podiatr Med Assoc 2023; 113:22-177. [PMID: 37463192 DOI: 10.7547/22-177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Hallux valgus is a common foot deformity that may cause pain and functional limitation, and often requires surgical correction. Clinical and radiographic parameters are typically used to assess postoperative outcomes. Plantar pressure distribution systems represent an innovative additional tool to evaluate hallux functional outcome after surgery. A systematic review of the current literature was performed to assess evaluation systems used for plantar pressure analysis and differences before and after hallux valgus surgery, and a possible relationship between different surgical techniques and clinical and radiographic results. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for this review. Initial search results yielded 40 studies. Two additional studies were found through cross-reference. Twenty-five studies were screened. A total of 10 articles were included in the review process. Two main plantar pressure analysis systems were identified. Hallux function restoration based on plantar pressure measurement did not always occur. No relevant relationships between plantar pressure distribution data and different surgical techniques were established. All patients achieved satisfactory clinical and radiographic outcomes, regardless of surgical techniques used; however, no clear relationships were observed between clinical and radiographic results and the change in foot plantar pressure patterns. The current literature on this topic showed several methodologic limitations. Therefore, it is not possible to provide sufficiently supported evidence-based data regarding plantar pressure distribution rebalance after surgery using current plantar pressure analysis systems. Further investigations are needed to fill these gaps in evidence.
Collapse
Affiliation(s)
- Antonio Mazzotti
- *IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- †Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Beatrice Martini
- †Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | | | | | - Lorenzo Brognara
- †Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Cesare Faldini
- *IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- †Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|
25
|
Lintz F, Ricard C, Mehdi N, Laborde J, Bernasconi A, Richardi G, Sans N. Hindfoot alignment assessment by the foot-ankle offset: a diagnostic study. Arch Orthop Trauma Surg 2023; 143:2373-2382. [PMID: 35445859 DOI: 10.1007/s00402-022-04440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/01/2022] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Foot-ankle offset (FAO) is a three-dimensional (3D) biometric measurement of hindfoot alignment (HA) measured on images from weight-bearing computed tomography (WBCT). Our aim was to investigate its distribution in a large cohort of patients, hypothesizing that threshold FAO values in valgus or varus could be identified as markers for increased risk of associated pathologies. MATERIALS AND METHODS Prospective, monocentric, level II study including 125 subjects (250 feet) undergoing bilateral WBCT [58.4% female; mean age, 54 years (18-84)]. Patients were clinically assessed and pathologies were classified according to anatomic location (valgus- or varus associated). HA was measured using FAO on 3D datasets and tibio-calcaneal angles (TCA) on two-dimensional Saltzman-El-Khoury views. Threshold FAO values and area under the receiver operating characteristics curve (AUC) were calculated for predicting increased risk of medial or lateral pathologies. RESULTS Mean FAO was 1.65% ± 4.72 and mean TCA was 4.15° ± 7.67. Clinically, 167 feet were normal, 33 varus and 50 valgus with FAO values of 1.71% ± 3.16, - 4.96% ± 5.30 and 5.79% ± 3.77, respectively. Mean FAO was 0.99% ± 3.26 for non-pathological feet, - 2.53% ± 5.05 for lateral and 6.81% ± 2.70 for medial pathologies. Threshold FAO values of - 1.64% (51.4% sensitivity, 85.1% specificity, AUC = 0.72) and 2.71% (95% sensitivity, 82.8% specificity, AUC = 0.93) best predicted the risk of lateral and medial pathology, respectively. CONCLUSION Patients with FAO between - 1.64% and 2.71% had the least risk of degenerative foot and ankle pathology. This interval could be considered a target for patients undergoing realignment procedures. CLINICAL RELEVANCE A "safe zone" for Foot Ankle Offset was described between - 1.64% and 2.71%, for which the risk of foot and ankle pathologies is lower. LEVEL OF EVIDENCE II-Diagnostic study.
Collapse
Affiliation(s)
- François Lintz
- Department of Foot and Ankle Surgery, Ramsay Healthcare, Clinique de L'Union, Saint-Jean, France.
| | - Claire Ricard
- Department of Radiology, Pierre-Paul Riquet Hospital, University Hospital, Toulouse, France
| | - Nazim Mehdi
- Department of Foot and Ankle Surgery, Ramsay Healthcare, Clinique de L'Union, Saint-Jean, France
| | - Julien Laborde
- Department of Foot and Ankle Surgery, Ramsay Healthcare, Clinique de L'Union, Saint-Jean, France
| | - Alessio Bernasconi
- Department of Public Health, Orthopaedic and Traumatology Unit, University of Napoli "Federico II", Napoli, Italy
| | - Gérard Richardi
- Department of Foot and Ankle Surgery, Ramsay Healthcare, Clinique de L'Union, Saint-Jean, France
| | - Nicolas Sans
- Department of Radiology, Pierre-Paul Riquet Hospital, University Hospital, Toulouse, France
| |
Collapse
|
26
|
Wu J, Wishart BD. Ultrasound-Guided Posterior Tibial Nerve Block for Focal Neuropathic Pain of the Plantar Foot. Am J Phys Med Rehabil 2023; 102:e40. [PMID: 36075877 DOI: 10.1097/phm.0000000000002094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Jennifer Wu
- From the Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts (JW, BDW); and Massachusetts General Hospital for Children, Boston, Massachusetts (BDW)
| | | |
Collapse
|
27
|
Arima S, Maeda N, Tsutsumi S, Ishihara H, Ikuta Y, Ushio K, Fujishita H, Kobayashi T, Komiya M, Morikawa M, Adachi N, Urabe Y. Association of the intrinsic foot muscles and plantar fascia with repetitive rebound jumping and jump landing in adolescent athletes: An ultrasound-based study. Gait Posture 2023; 99:146-151. [PMID: 36436441 DOI: 10.1016/j.gaitpost.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/17/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The characteristics of foot structure in adolescents and adults are different, affecting sports performance and leading to the progression of foot and lower extremity disorders. RESEARCH QUESTION This study aimed to investigate the relationship between the intrinsic foot muscles (IFM) and plantar fascia morphology and the repetitive rebound jumping and jump landing ability in adolescent athletes. METHODS A total of 60 adolescent athletes (35 boys and 25 girls) participated in this study. B-mode ultrasonography was used to obtain images of the IFM and plantar fascia morphology [thickness and cross-sectional area (CSA) of the abductor hallucis (AbH), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and thickness of the plantar fascia]. The repetitive rebound jump performance was evaluated using the Optojump™ system. Participants were instructed to jump five times continuously with one leg, jumping as high as possible with minimal ground contact time. The jump landing was assessed by measuring the dynamic posture stability index (DPSI) using forward one-legged jump landings. RESULTS The thickness and CSA of the AbH and FDB were positively correlated with the jump height and reactive jump index. The DPSI score was significantly correlated with the thickness of the AbH, but not with other IFMs or plantar fascia. In the multiple regression analysis, only the thickness of the FDB was associated with the jump height and reactive jump index, indicating that FDB thickness might facilitate adolescent athletes to jump higher with minimal contact time in repetitive rebounding movements. SIGNIFICANCE The IFM (especially FDB) should be focused on when examining sports performance in adolescent athletes.
Collapse
Affiliation(s)
- Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Shogo Tsutsumi
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Honoka Ishihara
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Yasunari Ikuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kai Ushio
- Sports Medical Center, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Hironori Fujishita
- Sports Medical Center, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Masanori Morikawa
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan.
| |
Collapse
|
28
|
Zhao L, Zhang R. The "Hand as Foot" teaching method in left ventriculography. Asian J Surg 2023; 46:647-648. [PMID: 35879219 DOI: 10.1016/j.asjsur.2022.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Lifang Zhao
- Department of Anesthesiology, Binzhou Medical University Hospital, China
| | - Ruyi Zhang
- Department of Anesthesiology, Binzhou Medical University Hospital, China.
| |
Collapse
|
29
|
Rafiq RB, Hoque KM, Kabir MA, Ahmed S, Laird C. OptiFit: Computer-Vision-Based Smartphone Application to Measure the Foot from Images and 3D Scans. Sensors (Basel) 2022; 22:9554. [PMID: 36502254 PMCID: PMC9739363 DOI: 10.3390/s22239554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
The foot is a vital organ, as it stabilizes the impact forces between the human skeletal system and the ground. Hence, precise foot dimensions are essential not only for custom footwear design, but also for the clinical treatment of foot health. Most existing research on measuring foot dimensions depends on a heavy setup environment, which is costly and ineffective for daily use. In addition, there are several smartphone applications online, but they are not suitable for measuring the exact foot shape for custom footwear, both in clinical practice and public use. In this study, we designed and implemented computer-vision-based smartphone application OptiFit that provides the functionality to automatically measure the four essential dimensions (length, width, arch height, and instep girth) of a human foot from images and 3D scans. We present an instep girth measurement algorithm, and we used a pixel per metric algorithm for measurement; these algorithms were accordingly integrated with the application. Afterwards, we evaluated our application using 19 medical-grade silicon foot models (12 males and 7 females) from different age groups. Our experimental evaluation shows that OptiFit could measure the length, width, arch height, and instep girth with an accuracy of 95.23%, 96.54%, 89.14%, and 99.52%, respectively. A two-tailed paired t-test was conducted, and only the instep girth dimension showed a significant discrepancy between the manual measurement (MM) and the application-based measurement (AM). We developed a linear regression model to adjust the error. Further, we performed comparative analysis demonstrating that there were no significant errors between MM and AM, and the application offers satisfactory performance as a foot-measuring application. Unlike other applications, the iOS application we developed, OptiFit, fulfils the requirements to automatically measure the exact foot dimensions for individually fitted footwear. Therefore, the application can facilitate proper foot measurement and enhance awareness to prevent foot-related problems caused by inappropriate footwear.
Collapse
Affiliation(s)
- Riyad Bin Rafiq
- Department of Computer Science and Engineering, University of North Texas, Denton, TX 76203-5017, USA
| | - Kazi Miftahul Hoque
- Department of Computer Science and Engineering, Chittagong University of Engineering and Technology, Chottogram 4349, Bangladesh
| | - Muhammad Ashad Kabir
- School of Computing, Mathematics and Engineering, Charles Sturt University, Bathurst, NSW 2795, Australia
| | - Sayed Ahmed
- School of Health and Human Sciences, Southern Cross University, East Lismore, NSW 2480, Australia
- Foot Balance Technology Pty. Ltd., Westmead, NSW 2145, Australia
- EYM (Ease Your Motion) Pty. Ltd., Westmead, NSW 2145, Australia
| | - Craig Laird
- EYM (Ease Your Motion) Pty. Ltd., Westmead, NSW 2145, Australia
- Walk Easy Pedorthics Pty. Ltd., Tamworth, NSW 2340, Australia
| |
Collapse
|
30
|
Brandenburg LS, Siegel M, Neubauer J, Merz J, Bode G, Kühle J. Measuring standing hindfoot alignment: reliability of different approaches in conventional x-ray and cone-beam CT. Arch Orthop Trauma Surg 2022; 142:3035-3043. [PMID: 33885961 PMCID: PMC9522738 DOI: 10.1007/s00402-021-03904-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/09/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Currently there is no consensus how hindfoot alignment (HA) should be assessed in CBCT scans. The aim of this study is to investigate how the reliability is affected by the anatomical structures chosen for the measurement. MATERIALS AND METHODS Datasets consisting of a Saltzman View (SV) and a CBCT of the same foot were acquired prospectively and independently assessed by five raters regarding HA. In SVs the HA was estimated as follows: transversal shift between tibial shaft axis and heel contact point (1); angle between tibial shaft axis and a tangent at the medial (2) or lateral (3) calcaneal wall. In CBCT the HA was estimated as follows: transversal shift between the centre of the talus and the heel contact point (4); angle between a perpendicular line and a tangent at the medial (5) or lateral (6) calcaneal wall; angle between the distal tibial surface and a tangent at the medial calcaneal wall (7). Intraclass correlation coefficients (ICC) were calculated to assess inter-rater reliability. A linear regression was performed to compare the different measurement regarding their correlation. RESULTS 32 patients were included in the study. The ICCs for the measurements 1-7 were as follows: (1) 0.924 [95% CI 0.876-0.959] (2) 0.533 [95% CI 0.377-0.692], (3) 0.553 [95% CI 0.399-0.708], (4) 0.930 [95% CI 0.866-0.962], (5) 0.00 [95% CI - 0.111 to 0.096], (6) 0.00 [95% CI - 0.103 to 0.111], (7) 0.152 [95% CI 0.027-0.330]. A linear regression between measurement 1 and 4 showed a correlation of 0.272 (p = 0.036). CONCLUSIONS It could be shown that reliability of measuring HA depends on the investigated anatomical structure. Placing a tangent along the calcaneus (2, 3, 5, 6, 7) was shown to be unreliable, whereas determining the weight-bearing heel point (1, 4) appeared to be a reliable approach. The correlation of the measurement workflows is significant (p = 0.036), but too weak (0.272) to be used clinically.
Collapse
Affiliation(s)
- Leonard Simon Brandenburg
- Department of Oral and Maxillofacial Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| | - Markus Siegel
- Department of Orthopedics and Trauma Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| | - Jakob Neubauer
- Department of Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| | - Johanna Merz
- Department of Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| | - Gerrit Bode
- Department of Orthopedics and Trauma Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
- Sporthopaedicum Straubing, Bahnhofsplatz 27, 94315 Straubing, Germany
| | - Jan Kühle
- Department of Orthopedics and Trauma Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| |
Collapse
|
31
|
Zhang Z, Wang Z. The “Hand as Foot” teaching method in MRI image of the brainstem. Asian J Surg 2022; 46:1900-1901. [PMID: 36372708 DOI: 10.1016/j.asjsur.2022.10.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Zhilong Zhang
- Graduate School, Inner Mongolia Medical University, Huhehot North Street, Inner Mongolia, 010050, China
| | - Zhong Wang
- Department of Neurosurgery, Inner Mongolia Autonomous Region People's Hospital, Hohhot, 010010, China.
| |
Collapse
|
32
|
Abstract
To study the changes of plantar fascia in patients with knee osteoarthritis. Collect knee arthritis surgery patients and according to the length of the course is divided into long-course and short-course group, collection of healthy volunteers as control group at the same time, basic information such as age, height, weight, and body mass index (BMI) were recorded; the application of Philips and Siemens ultrasonic diagnostic instrument, a foot plantar fascia in patients with knee osteoarthritis in ultrasonic scanning, measuring the thickness of the heel of plantar fascia, observe its sonographic manifestation; age, BMI, and plantar fascia thickness were compared between groups. The plantar fascia thickness of the normal control group was 0.30 ± 0.06 cm on the left side and 0.30 ± 0.05 cm on the right side. The plantar fascia thickness of the long-course group was 0.44 ± 0.10 cm on the left side and 0.42 ± 0.10 cm on the right side. The plantar fascia thickness of the group with short course of disease was 0.37 ± 0.06 cm on the left side and 0.34 ± 0.7 cm on the right side. Multivariable analysis of variance was used to compare the thickness of plantar fascia in the long-course group, the short-course group, and the control group, P < .05; there were statistical differences among the 3 groups. Multivariate analysis of variance was used to compare the general data of the long-course group, the short-course group, and the control group. Age: the long-course group was compared with the short-course group and the control group, P < .05; short-course group compared with control group, P > .05. BMI: compared with long-course group and short-course group, P < .05; long course of disease group compared with short course of disease group, P > .05. BMI was statistically different between the case group and the control group. Plantar fascia was thickened in patients with knee osteoarthritis, and the thickening of plantar fascia was related to BMI. The thickening of plantar fascia was uneven, and the degree of thickening was related to the course of disease. At the same time, the sonogram of plantar fascia was less echogenic than that of normal controls.
Collapse
Affiliation(s)
- Zongjie Liu
- Department of Ultrasound Medicine, The Thrid Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Xin Sui
- Department of Ultrasound Medicine, The Thrid Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
- *Correspondence: Sui Xin, Department of Ultrasound Medicine, The Third Hospital of Hebei Medical University, No. 139, Ziqiang Road, Shijiazhuang 050051, Hebei Province, China (e-mail: )
| | - Ran Hui
- Department of Ultrasound Medicine, The Thrid Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Ying Zhao
- Department of Ultrasound Medicine, The Thrid Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Hua Li
- Department of Ultrasound Medicine, The Thrid Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Xiaodan Huang
- Department of Orthopectics, The Thrid Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
| |
Collapse
|
33
|
Bougrine A, Harba R, Canals R, Ledee R, Jabloun M, Villeneuve A. Segmentation of Plantar Foot Thermal Images Using Prior Information. Sensors (Basel) 2022; 22:3835. [PMID: 35632244 PMCID: PMC9146771 DOI: 10.3390/s22103835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
Diabetic foot (DF) complications are associated with temperature variations. The occurrence of DF ulceration could be reduced by using a contactless thermal camera. The aim of our study is to provide a decision support tool for the prevention of DF ulcers. Thus, the segmentation of the plantar foot in thermal images is a challenging step for a non-constraining acquisition protocol. This paper presents a new segmentation method for plantar foot thermal images. This method is designed to include five pieces of prior information regarding the aforementioned images. First, a new energy term is added to the snake of Kass et al. in order to force its curvature to match that of the prior shape, which has a known form. Second, we defined the initial contour as the downsized prior-shape contour, which is placed inside the plantar foot surface in a vertical orientation. This choice makes the snake avoid strong false boundaries present outside the plantar region when evolving. As a result, the snake produces a smooth contour that rapidly converges to the true boundaries of the foot. The proposed method is compared to two classical prior-shape snake methods, that of Ahmed et al. and that of Chen et al. A database of 50 plantar foot thermal images was processed. The results show that the proposed method outperforms the previous two methods with a root-mean-square error of 5.12 pixels and a dice similarity coefficient of 94%. The segmentation of the plantar foot regions in the thermal images helped us to assess the point-to-point temperature differences between the two feet in order to detect hyperthermia regions. The presence of such regions is the pre-sign of ulcers in the diabetic foot. Furthermore, our method was applied to hyperthermia detection to illustrate the promising potential of thermography in the case of the diabetic foot. Associated with a friendly acquisition protocol, the proposed segmentation method is the first step for a future mobile smartphone-based plantar foot thermal analysis for diabetic foot patients.
Collapse
Affiliation(s)
- Asma Bougrine
- Multidisciplinary Research Laboratory in Systems Engineering, Mechanics and Energy (PRISME), University of Orleans, 12 rue de Blois, 45067 Orleans, France; (R.H.); (R.C.); (R.L.); (M.J.)
| | - Rachid Harba
- Multidisciplinary Research Laboratory in Systems Engineering, Mechanics and Energy (PRISME), University of Orleans, 12 rue de Blois, 45067 Orleans, France; (R.H.); (R.C.); (R.L.); (M.J.)
| | - Raphael Canals
- Multidisciplinary Research Laboratory in Systems Engineering, Mechanics and Energy (PRISME), University of Orleans, 12 rue de Blois, 45067 Orleans, France; (R.H.); (R.C.); (R.L.); (M.J.)
| | - Roger Ledee
- Multidisciplinary Research Laboratory in Systems Engineering, Mechanics and Energy (PRISME), University of Orleans, 12 rue de Blois, 45067 Orleans, France; (R.H.); (R.C.); (R.L.); (M.J.)
| | - Meryem Jabloun
- Multidisciplinary Research Laboratory in Systems Engineering, Mechanics and Energy (PRISME), University of Orleans, 12 rue de Blois, 45067 Orleans, France; (R.H.); (R.C.); (R.L.); (M.J.)
| | - Alain Villeneuve
- The Diabetic Foot Service, Regional Hospital of Orleans, 45100 Orleans, France;
| |
Collapse
|
34
|
Parkhurst DB, Saffarian MR, Andary MT, Fajardo RS, Knake JJ. Accessory Flexor Digitorum Longus Presenting as Tarsal Tunnel Syndrome: A Case Series. Clin J Sport Med 2022; 32:e316-e318. [PMID: 35316824 DOI: 10.1097/jsm.0000000000001025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 02/15/2022] [Indexed: 02/02/2023]
Abstract
ABSTRACT Tarsal tunnel syndrome (TTS) typically occurs from extrinsic or intrinsic sources of compression on the tibial nerve. We present 3 cases of patients, all of whom have a prolonged time to diagnosis after evaluation with multiple specialties, with foot pain ultimately secondary to an accessory flexor digitorum longus muscle causing TTS. The literature describing the association between TTS and accessory musculature has been limited to single case reports and frequently demonstrate abnormal electrodiagnostic testing. In our series, 2 cases had normal electrodiagnostic findings despite magnetic resonance imaging (MRI) that later revealed TTS and improvement with eventual resection. A normal electromyogram should not preclude the diagnosis of TTS and MRI of the ankle; it should be considered a useful diagnostic tool when examining atypical foot pain.
Collapse
|
35
|
Mehlhorn AT, Illgner U, Lemperle S, Huber V, Hoerterer H, Gottschalk O, Legrand MA, Krenn V, Walther M. [Does inflammatory activity of Charcot foot affect successful corrective arthrodesis?]. Orthopade 2022; 51:499-506. [PMID: 35476118 DOI: 10.1007/s00132-022-04251-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neuro-osteoarthropathy of the foot (CN) is divided into an active and inactive stage, with impact on the further treatment. The histopathological Charcot score (HCS) can be used, to grade the inflammatory activity in tissue samples. RESEARCH QUESTION This study aims to clarify whether successful bony healing after arthrodesis is related to inflammatory activity of the disease. MATERIAL AND METHOD N = 80 patients underwent corrective arthrodesis of the midfoot (group 1) or hindfoot/ankle (group 2). A distinction was made between patients with/without diabetes mellitus and with/without pain perception. Intraoperative samples were taken to determine HCS. The osseous healing of the arthrodesis was determined by computed tomography 12 weeks postoperatively. RESULTS There was an indirect correlation between bony consolidation and HCS. In group 2, there was a significantly worse bony healing in patients without pain sensation. There seems to be a tendency for HCS to be increased in patients without diabetes/no pain sensation. DISCUSSION The present study confirms the assumption that corrective arthrodesis should be performed in the inactive stage of CN only. High activity levels obviously impede bony healing. HCS represents a relevant prognostic tool for surgical treatment.
Collapse
Affiliation(s)
- Alexander T Mehlhorn
- Zentrum für Fuß- und Sprunggelenkschirurgie, Schönklinik München-Harlaching, München, Deutschland.
- Klinik für Orthopädie und Unfallchirurgie, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
- Sektion für Diabetische und Neuropathische Fußerkrankungen, Zentrum für Fuß- und Sprunggelenkschirurgie, Schönklinik München-Harlaching, Harlachinger Straße 51, 81547, München, Deutschland.
| | - Ulrich Illgner
- Orthopädische Privatpraxis Seintsch Illgner, Koblenz, Deutschland
| | - Stefan Lemperle
- Zentrum für Fuß- und Sprunggelenkschirurgie, Schönklinik München-Harlaching, München, Deutschland
| | - Verena Huber
- Zentrum für Fuß- und Sprunggelenkschirurgie, Schönklinik München-Harlaching, München, Deutschland
| | - Hubert Hoerterer
- Zentrum für Fuß- und Sprunggelenkschirurgie, Schönklinik München-Harlaching, München, Deutschland
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum der LMU München, München, Deutschland
| | - Oliver Gottschalk
- Zentrum für Fuß- und Sprunggelenkschirurgie, Schönklinik München-Harlaching, München, Deutschland
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum der LMU München, München, Deutschland
| | - Maria Anna Legrand
- Zentrum für Anästhesiologie und Intensivmedizin, Schönklinik München-Harlaching, München, Deutschland
| | - Veit Krenn
- MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik GmbH, Trier, Deutschland
| | - Markus Walther
- Zentrum für Fuß- und Sprunggelenkschirurgie, Schönklinik München-Harlaching, München, Deutschland
| |
Collapse
|
36
|
Ardhianto P, Subiakto RBR, Lin CY, Jan YK, Liau BY, Tsai JY, Akbari VBH, Lung CW. A Deep Learning Method for Foot Progression Angle Detection in Plantar Pressure Images. Sensors (Basel) 2022; 22:s22072786. [PMID: 35408399 PMCID: PMC9003219 DOI: 10.3390/s22072786] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 02/01/2023]
Abstract
Foot progression angle (FPA) analysis is one of the core methods to detect gait pathologies as basic information to prevent foot injury from excessive in-toeing and out-toeing. Deep learning-based object detection can assist in measuring the FPA through plantar pressure images. This study aims to establish a precision model for determining the FPA. The precision detection of FPA can provide information with in-toeing, out-toeing, and rearfoot kinematics to evaluate the effect of physical therapy programs on knee pain and knee osteoarthritis. We analyzed a total of 1424 plantar images with three different You Only Look Once (YOLO) networks: YOLO v3, v4, and v5x, to obtain a suitable model for FPA detection. YOLOv4 showed higher performance of the profile-box, with average precision in the left foot of 100.00% and the right foot of 99.78%, respectively. Besides, in detecting the foot angle-box, the ground-truth has similar results with YOLOv4 (5.58 ± 0.10° vs. 5.86 ± 0.09°, p = 0.013). In contrast, there was a significant difference in FPA between ground-truth vs. YOLOv3 (5.58 ± 0.10° vs. 6.07 ± 0.06°, p < 0.001), and ground-truth vs. YOLOv5x (5.58 ± 0.10° vs. 6.75 ± 0.06°, p < 0.001). This result implies that deep learning with YOLOv4 can enhance the detection of FPA.
Collapse
Affiliation(s)
- Peter Ardhianto
- Department of Visual Communication Design, Soegijapranata Catholic University, Semarang 50234, Indonesia;
- Department of Digital Media Design, Asia University, Taichung 413305, Taiwan;
| | | | - Chih-Yang Lin
- Department of Electrical Engineering, Yuan Ze University, Chung-Li 32003, Taiwan;
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA;
- Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
- Computational Science and Engineering, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Ben-Yi Liau
- Department of Biomedical Engineering, Hungkuang University, Taichung 433304, Taiwan;
| | - Jen-Yung Tsai
- Department of Digital Media Design, Asia University, Taichung 413305, Taiwan;
| | | | - Chi-Wen Lung
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA;
- Department of Creative Product Design, Asia University, Taichung 413305, Taiwan;
- Correspondence: or
| |
Collapse
|
37
|
Wang J, Tang L, Tang J, Chen J, Gong X, Qin L, Huang J, Deng Y, Liu X, Huang W, Li M, Hu N. The typically developing pediatric foot - The data of the 1744 children in China. Foot Ankle Surg 2022; 28:347-353. [PMID: 33903004 DOI: 10.1016/j.fas.2021.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/22/2021] [Accepted: 04/09/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The medial longitudinal arch (MLA) improves with age in childhood. However, it still causes parents to worry that children have flat feet. Due to the lack of a standard to quantitatively assess the arch development in kids at certain age, the pediatricians judge the flat feet by experience, causing many cases to be overtreated. The aim of this study was to plot the distribution of MLA parameters in children. METHODS Children without lower limb deformity and lower limb pain were recruited from 12 primary schools and kindergartens in Chongqing province-level city. Foot length (FL) and navicular height (NH) was measured manually, arch index (AI) and arch volume (AV) were measured with the Foot Plantar Scanner. Each parameter was measured in both weight-bearing and non-weight-bearing positions. Significant differences were also compared between the measurements of consecutive years. RESULTS This study was the first to use a three-dimensional laser surface scanner to measure the MLA parameters of children aged 3-12 years in China. 1744 children (871 girls, 873 boys) participated in this study. FL, NH, AI and AV varied significantly with age in both the weight-bearing and non-weight-bearing positions. These parameters have significant differences between the weighted and non-weighted positions (p < 0.05). CONCLUSIONS The age distribution characteristics of these parameters indicated that the MLA improves with age. The establishment of a developmental scale for the children's MLA is necessary.
Collapse
Affiliation(s)
- Jiawei Wang
- Department of Orthopedic Surgery, Chongqing Medical University First Affiliated Hospital, China.
| | - Li Tang
- Department of Orthopedic Surgery, Chongqing Orthopaedic Hospital of Traditional Chinese Medicine, China; Shanqi (Chongqing) Smart Medical Technology Co., Ltd., China.
| | - Jing Tang
- Shanqi (Chongqing) Smart Medical Technology Co., Ltd., China.
| | - Jing Chen
- Shanqi (Chongqing) Smart Medical Technology Co., Ltd., China.
| | - Xuan Gong
- Department of Outpatient, Chongqing General Hospital, China.
| | - Leilei Qin
- Department of Orthopedic Surgery, Chongqing Medical University First Affiliated Hospital, China.
| | - Jiaxing Huang
- Department of Orthopedic Surgery, Chongqing Medical University First Affiliated Hospital, China.
| | - Yi Deng
- Department of Orthopedic Surgery, Chongqing Orthopaedic Hospital of Traditional Chinese Medicine, China.
| | - Xing Liu
- Department of Orthopedic Surgery, Chongqing Medical University Children's Hospital, China.
| | - Wei Huang
- Department of Orthopedic Surgery, Chongqing Medical University First Affiliated Hospital, China.
| | - Ming Li
- Department of Orthopedic Surgery, Chongqing Medical University Children's Hospital, China.
| | - Ning Hu
- Department of Orthopedic Surgery, Chongqing Medical University First Affiliated Hospital, China.
| |
Collapse
|
38
|
Naemi R, Romero Gutierrez SE, Allan D, Flores G, Ormaechea J, Gutierrez E, Casado-Pena J, Anyosa-Zavaleta S, Juarez M, Casado F, Castaneda Aphan B. Diabetes Status is Associated With Plantar Soft Tissue Stiffness Measured Using Ultrasound Reverberant Shear Wave Elastography Approach. J Diabetes Sci Technol 2022; 16:478-490. [PMID: 33095039 PMCID: PMC8861805 DOI: 10.1177/1932296820965259] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate the association between the mechanical properties of plantar soft tissue and diabetes status. METHOD 51 (M/F: 21/30) participants with prediabetes onset (fasting blood sugar [FBS] level > 100 mg/dL), age >18 years, and no lower limb amputation were recruited after ethical approval was granted from Pontificia Universidad Catolica del Peru ethical review board. Ultrasound reverberant shear wave elastography was used to assess the soft tissue stiffness at the 1st metatarsal head (MTH), 3rd MTH, and the heel at both feet. RESULTS Spearman's rank-order correlation (rho) test indicated a significant (P < .05) positive correlations between FBS level and the plantar soft tissue shear wave speed at the 1st MTH: rho = 0.402 (@400 Hz), rho = 0.373 (@450 Hz), rho = 0.474 (@500 Hz), rho= 0.395 (@550 Hz), and rho = 0.326 (@600 Hz) in the left foot and rho = 0.364 (@450 Hz) in the right foot. Mann-Whitney U test indicated a significantly (P < .05) higher shear wave speed in the plantar soft tissue with the following effect sizes (r) at the 1st MTH of the left foot at all tested frequencies: r = 0.297 (@450 Hz), r = 0.345 (@500 Hz), r = 0.322 (@550 Hz), and r = 0.275 (@600 Hz), and at the 1st MTH of right foot r = 0.286 (@400 Hz) in diabetes as compared with the age and body mass index matched prediabetes group. CONCLUSION An association between fasting blood sugar level and the stiffness of the plantar soft tissue with higher values of shear wave speed in diabetes versus prediabetes group was observed. This indicated that the proposed approach can improve the assessment of the severity of diabetic foot complications with potential implications in patient stratification.
Collapse
Affiliation(s)
- Roozbeh Naemi
- Centre for Biomechanics and
Rehabilitation Technologies, School of Life Sciences and Education, Staffordshire
University, Staffordshire, UK
- Roozbeh Naemi, BSc, MSc, PhD, School of Life
Sciences and Education, Staffordshire University, Science Centre, Leek Road,
Stoke on Trent, Staffordshire, ST4 2DF, UK.
| | | | - David Allan
- Centre for Biomechanics and
Rehabilitation Technologies, School of Life Sciences and Education, Staffordshire
University, Staffordshire, UK
| | - Gilmer Flores
- Department of Engineering, Medical
Imaging Laboratory, Pontificia Universidad Catolica del Peru, Lima, Peru
| | - Juvenal Ormaechea
- Department of Engineering, Medical
Imaging Laboratory, Pontificia Universidad Catolica del Peru, Lima, Peru
- Department of Electrical and Computer
Engineering, University of Rochester, New York, USA
| | - Evelyn Gutierrez
- Department of Engineering, Medical
Imaging Laboratory, Pontificia Universidad Catolica del Peru, Lima, Peru
| | | | - Sharon Anyosa-Zavaleta
- Translational Unit, Institute of Omics
and Applied Biotechnology, Pontificia Universidad Catolica del Peru, Lima,
Peru
| | - Mauricio Juarez
- Department of Engineering, Medical
Imaging Laboratory, Pontificia Universidad Catolica del Peru, Lima, Peru
| | - Fanny Casado
- Department of Engineering, Medical
Imaging Laboratory, Pontificia Universidad Catolica del Peru, Lima, Peru
| | - Benjamin Castaneda Aphan
- Department of Engineering, Medical
Imaging Laboratory, Pontificia Universidad Catolica del Peru, Lima, Peru
| |
Collapse
|
39
|
Hirakawa K, Tsutsumi M, Kudo S. Investigation of the relationship between the thickness of the plantar calcaneonavicular ligament and plantar fascia in patients with plantar fasciitis. Foot (Edinb) 2022; 50:101890. [PMID: 34990973 DOI: 10.1016/j.foot.2021.101890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although patients with plantar fasciitis show spring ligament laxity, the thickness of the spring ligament in patients with plantar fasciitis remains unclear. This study aimed to elucidate the morphological characteristics of the spring ligament in patients with plantar fasciitis based on an ultrasound imaging system (US). METHODS Thirty feet of 30 patients (painful group) diagnosed with plantar fasciitis at our hospital and thirty feet of 30 healthy volunteers (healthy group) without plantar pain were investigated. The thicknesses of both the spring ligament and plantar fascia were assessed via a US statistical comparison of the spring ligament and plantar fascia thickness between the painful and healthy groups. This was performed using Welch's t-test, and the significance level was set at p < 0.01. In addition, Pearson's correlation coefficient was calculated to assess the correlation between the spring ligament and plantar fascia thickness in the two groups, and the significance level was set at p < 0.01. RESULTS The spring ligament thickness in the painful group was significantly lower than that in the healthy group (p < 0.001). The thickness of the plantar fascia in the painful group was significantly greater than that in the healthy group (p = 0.03). In addition, the correlation between the spring ligament and plantar fascia thickness was moderately negative (r = -0.42, p = 0.001). The thicker the plantar fascia in the subjects, the thinner was the spring ligament. CONCLUSIONS The thickness of the spring ligament in patients with plantar fasciitis decreased. The thinning of the spring ligament was negatively correlated with the thickening of the plantar fascia as per the US evaluation. Based on the spring ligament thinning determined via US evaluation, interventions such as insoles from an early stage could prevent the onset of plantar fasciitis.
Collapse
Affiliation(s)
- Keisuke Hirakawa
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, 1-26-16 Nankouminami Suminoeku, Osaka-city, Osaka, Japan; Amano Orthopadaedic Clinic, 4-1-5 Komagawa Higashisumiyoshi, Osaka-city, Osaka, Japan
| | - Masahiro Tsutsumi
- Inclusive Medical Science Research Institute, 1-26-16 Nankouminami Suminoeku, Osaka-city, Osaka, Japan
| | - Shintarou Kudo
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, 1-26-16 Nankouminami Suminoeku, Osaka-city, Osaka, Japan; AR-Ex Medical Research Center, 4-13-1 Todoroki Setagaya, Tokyo, Japan; Inclusive Medical Science Research Institute, 1-26-16 Nankouminami Suminoeku, Osaka-city, Osaka, Japan.
| |
Collapse
|
40
|
Sun H, Li L, Duan Y. "Hand as Foot" teaching method in the dermatoscope images. Asian J Surg 2022; 45:771-772. [PMID: 34991962 DOI: 10.1016/j.asjsur.2021.11.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hongyong Sun
- Department of Dermatology, People's Hospital of Inner Mongolia Autonomous Region, China.
| | - Linye Li
- Department of Dermatology, People's Hospital of Inner Mongolia Autonomous Region, China
| | - Yan Duan
- Department of Dermatology, People's Hospital of Inner Mongolia Autonomous Region, China
| |
Collapse
|
41
|
Lauder J, Harris J, Layton B, Heire P, Sorani A, DeSancha M, Davison AK, Sammut-Powell C, Lindner C. A fully automatic system to assess foot collapse on lateral weight-bearing foot radiographs: A pilot study. Comput Methods Programs Biomed 2022; 213:106507. [PMID: 34794087 PMCID: PMC8674729 DOI: 10.1016/j.cmpb.2021.106507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Foot collapse is primarily diagnosed and monitored using lateral weight-bearing foot x-ray images. There are several well-validated measurements which aid assessment. However, these are subject to inter- and intra-user variability. OBJECTIVE To develop and validate a software system for the fully automatic assessment of radiographic changes associated with foot collapse; automatically generating measurements for calcaneal tilt, cuboid height and Meary's angle. METHODS This retrospective study was approved by the Health Research Authority (IRAS 244852). The system was developed using lateral weight-bearing foot x-ray images, and evaluated against manual measurements from five clinical experts. The system has two main components: (i) a Random Forest-based point-finder to outline the bones of interest; and (ii) a geometry-calculator to generate the measurements based on the point positions from the point-finder. The performance of the point-finder was assessed using the point-to-point error (i.e. the mean absolute distance between each found point and the equivalent ground truth point, averaged over all points per image). For assessing the performance of the geometry-calculator, linear mixed models were fitted to estimate clinical inter-observer agreement and to compare the performance of the software system to that of the clinical experts. RESULTS A total of 200 images were collected from 79 subjects (mean age: 56.4 years ±12.9 SD, 30/49 females/males). There was good agreement among all clinical experts with intraclass correlation estimates between 0.78 and 0.86. The point-finder achieved a median point-to-point error of 2.2 mm. There was no significant difference between the clinical and automatically generated measurements using the point-finder points, suggesting that the fully automatically obtained measurements are in agreement with the manually obtained measurements. CONCLUSIONS The proposed system can be used to support and automate radiographic image assessment for diagnosing and managing foot collapse, saving clinician time, and improving patient outcomes.
Collapse
Affiliation(s)
- J Lauder
- Salford Royal NHS Foundation Trust, United Kingdom; East Lancashire Hospitals NHS Trust, Royal Blackburn Teaching Hospital, United Kingdom
| | - J Harris
- Salford Royal NHS Foundation Trust, United Kingdom
| | - B Layton
- Salford Royal NHS Foundation Trust, United Kingdom; East Lancashire Hospitals NHS Trust, Royal Blackburn Teaching Hospital, United Kingdom
| | - P Heire
- Salford Royal NHS Foundation Trust, United Kingdom
| | - A Sorani
- Salford Royal NHS Foundation Trust, United Kingdom
| | - M DeSancha
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, United Kingdom
| | - A K Davison
- Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, United Kingdom
| | - C Sammut-Powell
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, United Kingdom
| | - C Lindner
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, United Kingdom.
| |
Collapse
|
42
|
Romero SE, Naemi R, Flores G, Allan D, Ormachea J, Gutierrez E, Casado FL, Castaneda B. Plantar Soft Tissue Characterization Using Reverberant Shear Wave Elastography: A Proof-of-Concept Study. Ultrasound Med Biol 2022; 48:35-46. [PMID: 34702642 DOI: 10.1016/j.ultrasmedbio.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
Plantar soft tissue stiffness provides relevant information on biomechanical characteristics of the foot. Therefore, appropriate monitoring of foot elasticity could be useful for diagnosis, treatment or health care of people with complex pathologies such as a diabetic foot. In this work, the reliability of reverberant shear wave elastography (RSWE) applied to plantar soft tissue was investigated. Shear wave speed (SWS) measurements were estimated at the plantar soft tissue at the first metatarsal head, the third metatarsal head and the heel from both feet in five healthy volunteers. Experiments were repeated for a test-retest analysis with and without the use of gel pad using a mechanical excitation frequency range between 400 and 600 Hz. Statistical analysis was performed to evaluate the reliability of the SWS estimations. In addition, the results were compared against those obtained with a commercially available shear wave-based elastography technique, supersonic imaging (SSI). The results indicate a low coefficient of variation for test-retest experiments with gel pad (median: 5.59%) and without gel pad (median: 5.83%). Additionally, the values of the SWS measurements increase at higher frequencies (median values: 2.11 m/s at 400 Hz, 2.16 m/s at 450 Hz, 2.24 m/s at 500 Hz, 2.21 m/s at 550 Hz and 2.31 m/s at 600 Hz), consistent with previous reports at lower frequencies. The SWSs at the plantar soft tissue at the first metatarsal head, third metatarsal head and heel were found be significantly (p<0.05) different, with median values of 2.42, 2.16 and 2.03 m/s, respectively which indicates the ability of the method to differentiate between shear wave speeds at different anatomical locations. The results indicated better elastographic signal-to-noise ratios with RSWE compared to SSI because of the artifacts presented in the SWS generation. These preliminary results indicate that the RSWE approach can be used to estimate the plantar soft tissue elasticity, which may have great potential to better evaluate changes in biomechanical characteristics of the foot.
Collapse
Affiliation(s)
- Stefano E Romero
- Laboratorio de Imagenes Medicas, Pontificia Universidad Catolica del Peru, San Miguel, Lima, Peru.
| | - Roozbeh Naemi
- Centre for Biomechanics and Rehabilitation Technologies, School of Health Science and Wellbeing, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Gilmer Flores
- Laboratorio de Imagenes Medicas, Pontificia Universidad Catolica del Peru, San Miguel, Lima, Peru
| | - David Allan
- Centre for Biomechanics and Rehabilitation Technologies, School of Health Science and Wellbeing, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Juvenal Ormachea
- Laboratorio de Imagenes Medicas, Pontificia Universidad Catolica del Peru, San Miguel, Lima, Peru; Department of Electrical and Computer Engineering, University of Rochester, Rochester, New York, USA
| | - Evelyn Gutierrez
- Laboratorio de Imagenes Medicas, Pontificia Universidad Catolica del Peru, San Miguel, Lima, Peru
| | - Fanny L Casado
- Instituto de Ciencias Omicas y Biotecnologia Aplicada, Pontificia Universidad Catolica del Peru, San Miguel, Lima, Peru
| | - Benjamin Castaneda
- Laboratorio de Imagenes Medicas, Pontificia Universidad Catolica del Peru, San Miguel, Lima, Peru
| |
Collapse
|
43
|
Morrison T, Jones S, Causby RS, Thoirs K. Reliability of ultrasound in evaluating the plantar skin and fat pad of the foot in the setting of diabetes. PLoS One 2021; 16:e0257790. [PMID: 34555088 PMCID: PMC8459958 DOI: 10.1371/journal.pone.0257790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/13/2021] [Indexed: 11/18/2022] Open
Abstract
Ultrasound can be used to assess injury and structural changes to the soft-tissue structure of the foot. It may be useful to assess the feet of people with diabetes who are at increased risk of plantar soft-tissue pathological changes. The aim of this study was to determine if ultrasound measurements of plantar soft-tissue thickness and assessments of tissue acoustic characteristics are reliable in people with and without diabetes mellitus. A repeated measures design was used to determine intra-observer reliability for ultrasound measurements of plantar skin and fat pad thickness and intra- and inter-observer reliability of plantar skin and fat pad tissue characterisation assessments made at foot sites which are at risk of tissue injury in people with diabetes. Thickness measurements and tissue characterisation assessments were obtained at the heel and forefoot in both the unloaded and compressed states and included discrete layers of the plantar tissues: skin, microchamber, horizontal fibrous band, macrochamber and total soft-tissue depth. At each site, relative intra-observer reliability was achieved for the measurement of at least one plantar tissue layer. The total soft-tissue thickness measured in the unloaded state (ICC 0.925-0.976) demonstrated intra-observer reliability and is the most sensitive for detecting small change on repeated measures. Intra-observer agreement was demonstrated for tissue characteristic assessments of the skin at the heel (k = 0.70), fat pad at the lateral sesamoid region (k = 0.70) and both skin and fat pad at the second (k = 0.80, k = 0.70 respectively) and third metatarsal heads (k = 0.90, k = 0.79 respectively). However, acceptable inter-observer agreement was not demonstrated for any tissue characteristic assessment, therefore the use of multiple observers should be avoided when making these assessments.
Collapse
Affiliation(s)
- Troy Morrison
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- * E-mail:
| | - Sara Jones
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - Ryan Scott Causby
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kerry Thoirs
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| |
Collapse
|
44
|
Mahdiyar Z, Saeedi H, Vasaghi-Gharamaleki B, Abdollah V. Immediate effect of prefabricated and UCBL foot orthoses on alignment of midfoot and forefoot in young people with symptomatic flexible flatfoot: A radiographic evaluation. Prosthet Orthot Int 2021; 45:336-342. [PMID: 33840750 DOI: 10.1097/pxr.0000000000000010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 11/07/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Radiographic imaging has been considered the gold standard in evaluating the skeletal alignment of the foot in static weightbearing. The effects of foot orthoses on the alignment of foot bones have been mostly evaluated using lateral view x-rays. The posterior-anterior view has not been investigated extensively. OBJECTIVES To investigate the effects of 2 foot orthoses: University of California Biomechanics Laboratory Orthosis (UCBL) and a prefabricated orthosis (P-FFO) on the alignment of foot bones on anterior-posterior x-rays in young people with symptomatic flexible flatfoot (SFF). STUDY DESIGN This is a randomized, crossover study. METHODS Fifteen participants (mean [SD], 23.67 ± 2 years) with SFF were randomly imaged in 3 different conditions: shoes only, shoes + P-FFO, and shoes + UCBL. The talonavicular coverage, the first and the second talometatarsal angles, the intermetatarsal angle, and the cuboid abduction angle (CAA) were measured on weightbearing, anterior-posterior x-ray images for each condition. RESULTS Both orthotic designs demonstrated a significant reduction in the talonavicular coverage, the first and the second talometatarsal angles, and the CAA compared with the shoe-only condition (P < .001). The talonavicular coverage angle reduced by ∼11% using P-FFO compared with UCBL (P < .005). No significant differences were observed for other angles between the 2 orthotic conditions. CONCLUSIONS Both orthotic conditions improved the talonavicular coverage, first and the second talometatarsal angle, and CAA in young people with SFF. The walls of the UCBL orthosis did not result in further correction of the talonavicular coverage angle compared with the prefabricated FFO design.
Collapse
Affiliation(s)
- Zahra Mahdiyar
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Saeedi
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behnoosh Vasaghi-Gharamaleki
- Department of Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Abdollah
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
45
|
Southard EJ, Sands AK, Boyajian DA, Sieczka E, Bryk E, Vigorita VJ. Macrodystrophia Lipomatosa of the Foot: A Case Report of MRI and Histologic Findings Including Pacinian Corpuscle Abnormalities. JBJS Case Connect 2021; 11:01709767-202106000-00122. [PMID: 34129539 DOI: 10.2106/jbjs.cc.20.00785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CASE A 37-year-old man presented with pain and macrodactyly of a toe. Imaging and histology demonstrated findings consistent with macrodystrophia lipomatosa (MDL). We compared our findings with control tissue obtained from an identical site of a fresh-frozen cadaveric foot from the same anatomical site. Pacinian corpuscles (PCs) in the MDL tissue were increased in number, size, and shape compared with the control tissue and demonstrated edematous interstitial lamellae and vacuolar degenerative change. We also document the magnetic resonance imaging findings of the PCs. CONCLUSION Peculiar abnormalities of PCs in MDL underline nerve damage and may be a contributing factor in the pain associated with this unusual condition.
Collapse
Affiliation(s)
- Edward J Southard
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - Andrew K Sands
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - David A Boyajian
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - Elizabeth Sieczka
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - Eli Bryk
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - Vincent J Vigorita
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| |
Collapse
|
46
|
Vasella M, Guidi M, Waldner M, Calcagni M, Giovanoli P, Frueh FS. Fluorescence angiography-assisted debridement of critically perfused glabrous skin in degloving foot injuries: Two case reports. Medicine (Baltimore) 2021; 100:e26235. [PMID: 34087908 PMCID: PMC8183782 DOI: 10.1097/md.0000000000026235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/19/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Degloving foot injuries are challenging to treat and associated with life-long sequelae for patients. An appropriate debridement of ischemic soft tissues with maximal preservation of glabrous skin is key during the reconstruction of these injuries. Indocyanine green (ICG) fluorescence angiography is an established technique for the intraoperative evaluation of tissue perfusion. PATIENT CONCERNS Two patients sustained complex foot injuries in traffic accidents, including multiple fracture dislocations and extensive degloving of the plantar skin. DIAGNOSIS Clinical inspection revealed significant degloving of the glabrous skin in both patients. INTERVENTIONS After fracture fixation, ICG fluorescence angiography-assisted debridement with immediate latissimus dorsi free flap reconstruction was performed. OUTCOMES In both cases, this technique allowed a precise debridement with maximal preservation of the glabrous skin. The healing of the remaining glabrous skin was uneventful and the 6-month follow-up was characterized by stable soft tissues and satisfying ambulation. LESSONS ICG fluorescence angiography is a safe, user-friendly, and quick procedure with minimal risks, expanding the armamentarium of the reconstructive surgeon. It is highly useful for the debridement of extensive plantar degloving injuries and may also help to minimize the number of procedures and the risk of infection.
Collapse
|
47
|
Arceu M, Crespo P, Jeraldo C, Wortsman X. 18- and 70-MHz Ultrasonography of Actinomycetoma of the Foot Correlated with Clinical and Histologic Findings. J Am Podiatr Med Assoc 2021; 111:442369. [PMID: 32780099 DOI: 10.7547/20-026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We present the ultrasonographic morphology of an actinomycetoma of the foot at 18 and 70 MHz (high-frequency and ultrahigh-frequency ultrasound, respectively), and describe an ultrasonographic sign that may help to discriminate between eumycetoma and actinomycetoma called the "bright hyperechoic halo." To date, this is the first report on the morphology of mycetoma at 70 MHz with a clinical, ultrasonographic, and histologic correlation of the images, which provides ultrasound images that are very similar to the lower magnification of histology.
Collapse
|
48
|
Morikawa M, Maeda N, Komiya M, Hirota A, Mizuta R, Kobayashi T, Kaneda K, Nishikawa Y, Urabe Y. Contribution of Plantar Fascia and Intrinsic Foot Muscles in a Single-Leg Drop Landing and Repetitive Rebound Jumps: An Ultrasound-Based Study. Int J Environ Res Public Health 2021; 18:ijerph18094511. [PMID: 33922807 PMCID: PMC8123000 DOI: 10.3390/ijerph18094511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/10/2021] [Accepted: 04/19/2021] [Indexed: 11/16/2022]
Abstract
The plantar fascia and intrinsic foot muscles (IFM) modulate foot stiffness. However, it is unclear whether the corresponding ultrasonography findings reflect it. This study aimed to examine the effect of the plantar fascia and IFM morphologies on force attenuation during landing and reactivity when jumping in healthy adults (n = 21; age, 21-27 years). Thickness, cross-sectional area (CSA), and hardness of the plantar fascia, abductor hallucis (AbH), and flexor hallucis brevis (FHB) muscles were measured using ultrasonography. Single-leg drop landing and repetitive rebound jumping tests assessed the ground reaction force (GRF) and reactive jump index (RJI), respectively. The CSA of FHB was negatively correlated with maximum vertical GRF (r = -0.472, p = 0.031) in the single-leg drop landing test. The CSA of AbH was negatively correlated with contact time (r = -0.478, p = 0.028), and the plantar fascia thickness was positively correlated with jump height (r = 0.615, p = 0.003) and RJI (r = 0.645, p = 0.002) in the repetitive bound jump test. In multivariate regression analysis, only the plantar fascia thickness was associated with RJI (β = 0.152, 95% confidence interval: 7.219-38.743, p = 0.007). The CSA of FHB may contribute to force attenuation during landing. The thickness of the plantar fascia and CSA of AbH may facilitate jumping high with minimal contact time.
Collapse
Affiliation(s)
- Masanori Morikawa
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Noriaki Maeda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Makoto Komiya
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Arisu Hirota
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Rami Mizuta
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China;
| | - Kazuki Kaneda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa 076-264-5111, Japan;
| | - Yukio Urabe
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
- Correspondence:
| |
Collapse
|
49
|
Espinosa-Moyano I, Reina-Bueno M, Palomo-Toucedo IC, González-López JR, Castillo-López JM, Domínguez-Maldonado G. Study of the Distortion of the Indirect Angular Measurements of the Calcaneus Due to Perspective: In Vitro Testing. Sensors (Basel) 2021; 21:2585. [PMID: 33917016 PMCID: PMC8067713 DOI: 10.3390/s21082585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/04/2021] [Accepted: 04/06/2021] [Indexed: 11/19/2022]
Abstract
The study of the foot is relevant in kinematic analyses of gait. Images captured through a lens can be subjected to various aberrations or distortions that affect the measurements. An in vitro study was performed with a rearfoot simulator to compare the apparent degrees (photographed) with the real ones (placed in the simulator) in the plane of the rearfoot's orientation, according to variations in the capture angle in other planes of space (the sagittal plane and transverse plane-the latter determined by the foot progression angle). The following regression formula was calculated to correct the distortion of the image: real frontal plane = 0.045 + (1.014 × apparent frontal plane) - (0.018 × sagittal plane × foot progression angle). Considering the results of this study, and already knowing its angle in the transverse and sagittal planes, it is possible to determine the angle of a simulated calcaneus with respect to the ground in the frontal plane, in spite of distortions caused by perspective and the lack of perpendicularity, by applying the above regression formula. The results show that the angular measurements of a body segment made on frames can produce erroneous data due to the variation in the perspective from which the image is taken. This distortion must be considered when determining the real values of the measurements.
Collapse
Affiliation(s)
- Isidoro Espinosa-Moyano
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avice-na s/n, 41009 Seville, Spain; (I.E.-M.); (I.C.P.-T.); (J.M.C.-L.); (G.D.-M.)
| | - María Reina-Bueno
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avice-na s/n, 41009 Seville, Spain; (I.E.-M.); (I.C.P.-T.); (J.M.C.-L.); (G.D.-M.)
| | - Inmaculada C. Palomo-Toucedo
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avice-na s/n, 41009 Seville, Spain; (I.E.-M.); (I.C.P.-T.); (J.M.C.-L.); (G.D.-M.)
| | - José Rafael González-López
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avenzoar nº6, 41009 Seville, Spain;
| | - José Manuel Castillo-López
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avice-na s/n, 41009 Seville, Spain; (I.E.-M.); (I.C.P.-T.); (J.M.C.-L.); (G.D.-M.)
| | - Gabriel Domínguez-Maldonado
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avice-na s/n, 41009 Seville, Spain; (I.E.-M.); (I.C.P.-T.); (J.M.C.-L.); (G.D.-M.)
| |
Collapse
|
50
|
Schallig W, Streekstra GJ, Hulshof CM, Kleipool RP, Dobbe JGG, Maas M, Harlaar J, van der Krogt MM, van den Noort JC. The influence of soft tissue artifacts on multi-segment foot kinematics. J Biomech 2021; 120:110359. [PMID: 33730563 DOI: 10.1016/j.jbiomech.2021.110359] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 01/11/2021] [Accepted: 02/22/2021] [Indexed: 11/19/2022]
Abstract
Movement of skin markers with respect to their underlying bone (i.e. soft tissue artifacts (STAs)) might corrupt the accuracy of marker-based movement analyses. This study aims to quantify STAs in 3D for foot markers and their effect on multi-segment foot kinematics as calculated by the Oxford and Rizzoli Foot Models (OFM, RFM). Fifteen subjects with asymptomatic feet were seated on a custom-made loading device on a computed tomography (CT) table, with a combined OFM and RFM marker set on their right foot. One unloaded reference CT-scan with neutral foot position was performed, followed by 9 loaded CT-scans at different foot positions. The 3D-displacement (i.e. STA) of each marker in the underlying bone coordinate system between the reference scan and other scans was calculated. Subsequently, segment orientations and joint angles were calculated from the marker positions according to OFM and RFM definitions with and without STAs. The differences in degrees were defined as the errors caused by the marker displacements. Markers on the lateral malleolus and proximally on the posterior aspect of the calcaneus showed the largest STAs. The hindfoot-shank joint angle was most affected by STAs in the most extreme foot position (40° plantar flexion) in the sagittal plane for RFM (mean: 6.7°, max: 11.8°) and the transverse plane for OFM (mean: 3.9°, max: 6.8°). This study showed that STAs introduce clinically relevant errors in multi-segment foot kinematics. Moreover, it identified marker locations that are most affected by STAs, suggesting that their use within multi-segment foot models should be reconsidered.
Collapse
Affiliation(s)
- Wouter Schallig
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Geert J Streekstra
- Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Biomedical Engineering and Physics, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Chantal M Hulshof
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Roeland P Kleipool
- Amsterdam UMC, University of Amsterdam, Medical Biology, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Johannes G G Dobbe
- Amsterdam UMC, University of Amsterdam, Biomedical Engineering and Physics, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Mario Maas
- Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jaap Harlaar
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - Marjolein M van der Krogt
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Josien C van den Noort
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| |
Collapse
|