Comparison of the effectiveness of kinesio taping and a valgus splint in hallux valgus treatment

Hallux Valgus and Preferred Shoe Types among Young Healthy Saudi Arabian Females

To the Editor, The foot is involved in 80% to 90% of rheumatoid arthritis (RA) patients and the forefoot is affected the most [1]. Disruption of the ligaments, capsule, and other periarticular structures resulting from synovitis frequently leads to foot deformities. Common forefoot deformities in RA are hallux valgus, dislocation of the metatarsophalangeal (MTP) joints of the lesser toes, and claw toe [1,2]. The typical MTP joint deformity of the lesser toes in RA is dorsal dislocation of the proximal phalanges on the metatarsal heads and subsequent plantar displacement of the metatarsal heads with resultant plantar callosities. Recently, we experienced an unusual MTP joint deformity in a recurring rheumatoid foot in which the metatarsal heads were displaced dorsally and led to the dorsal protrusion of the MTP joints and subsequent dorsal callosities. A 76-year-old woman with a 25-year history of seropositive RA presented with painful deformities of both feet. Nine years earlier, she had undergone arthrodesis of the first MTP joints and resection arthroplasty of the MTP joints of all of the lesser toes of both feet. Four years later, bilateral knee replacement surgery was performed. The physical examination of the left foot revealed hyperextension of the first interphalangeal joint and claw toe deformities of the lesser toes (Fig. 1A). Of note, the MTP joints of the third to fifth toes protruded dorsally with dorsal callosities, which is an unusual MTP joint deformity in a rheumatoid foot. The plain X-ray of the left foot showed subluxation of the second to fifth MTP joints and erosions and diffuse joint space narrowing involving nearly all of the foot joints (Fig. 1B). Three-dimensional computed tomography showed dorsal subluxation of the metatarsal heads on the proximal phalanges of all the lesser toes (Fig. 1C), which seemed to have caused the dorsal protrusion of the MTP joints. Hyperextension of the first interphalangeal joint and claw toe deformities of the lesser toes were also apparent. To correct the foot deformities, fusion of the first interphalangeal joint and resection arthroplasty of the second to fifth MTP joints were performed. Figure 1 (A) Gross appearance of the lef t foot shows hyperextension of the first toe, claw toe deformities of the lesser toes, and dorsal protrusion of the third to fifth metatarsophalangeal (MTP) joints with dorsal callosities. (B) Plain radiograph of the left ... Rheumatoid forefoot deformities begin with hallux valgus, which makes the first toe incapable of weight bearing and leads to greater loads through the lesser toes [1,2]. This results in the dorsal subluxation of the proximal phalanges of the lesser toes and flexion deformity at the proximal interphalangeal joint, which is called claw toe when accompanied by a flexion deformity at the distal interphalangeal joint. As the dorsally dislocated phalanges push the corresponding metatarsal heads so that they are plantar flexed, plantar displacement of the metatarsal heads develops with resultant plantar callosities. Our case is unique in that the metatarsal heads were displaced dorsally and led to dorsal protrusion of the MTP joints with subsequent dorsal callosities, which is a very unusual form of MTP joint deformity in rheumatoid foot. The MTP joint deformity of the lesser toes is usually corrected with resection arthroplasty or shortening of the metatarsal heads in combination with arthrodesis of the first MTP joint [1,2,3,4]. Recurrence of the MTP joint deformity is common and causes metatarsalsia and plantar callosities again [1,3]. In our case, the MTP joint deformities recurred with dorsal displacement of the metatarsal heads, which differed from the original deformity. It appears that the distal metatarsal heads remaining after the initial surgery were too sharp, with their apices located dorsally (Fig. 1C), which might have caused the proximal phalanges to displace downwardly along the cut surface of the metatarsal heads, pushing the metatarsal heads dorsally because the MTP joints are usually mobile after a resection arthroplasty. Overcorrection or malposition of the reduced MTP joints, and flexor-extensor tendon imbalance after the initial operation are other explanations for this unusual MTP joint deformity. The hyperextension of the first interphalangeal joint was also unusual. Our case shows that when deformities recur in a previously operated foot in RA, they can differ from the original deformity.

Background and Objectives: Hallux valgus, one of the most common foot disorders, contributes to the formation of pain, changes foot proportions and hinders everyday functioning. In this study we wanted to verify if kinesiology taping improves hallux valgus and affects the position as well as reducing pain. Materials and Methods: Forty feet with hallux valgus were examined and the parameters were measured at three stages: before the kinesiology taping was applied, just after its application and after a month of use. Measurements were taken with a 3D scanner and a baropodometric platform. Results: When taping was applied, the hallux valgus angle decreased statistically significantly compared with pre-taping (p < 0.01). The use of taping for a month significantly reduced this angle compared with pre-taping (p < 0.05). Parameters such as foot length, the surface of the hindfoot and forefoot and hindfoot pressure on the ground changed. A change in the hallux position due to the taping produced significant changes in the perception of pain (p < 0.001). Conclusion: Kinesiology taping acts on the hallux valgus and foot position mechanically. This makes kinesiology taping an effective method of conservative treatment for patients who are not qualified for surgery.

Hallux valgus (HV) has an impact on quality of life since it alters the mechanics of the foot and causes pain. Kinesiotape (KT) has been demonstrated to be challengeable, cost-effective tool for restoring muscle function and strength, improving range of motion, reducing discomfort, and increasing lymphatic drainage. The aim of this study was to investigate the influence of 8 weeks KT on the degree HV angle (HVA) and subsequently on pain intensity. In this double-blinded randomized controlled trial, 30 subjects with HV deformity (mean age 29.07±6.3 years) were randomly allocated to study group (A) and control group (B). Group A received KT for HV, which was replaced every 5 days for 8 weeks, along with a home regular exercise program for HV, while Group B received placebo KT replaced every 5 days and the same exercise program for HV. HVA was measured using x-ray, pain intensity was measured using visual analogue scale (VAS). Outcomes were measured before and after 8 weeks of intervention. HVA showed a significant reduction in group A (p = 0.001) for both feet in comparison to group B (p = 0.11 for right foot, p = 0.09 for left foot, while pain showed significant improvement in both groups for both feet (p = 0.001). The results revealed that KT in mobile HV is effective on improving the metatarsophalangeal joint angle, decreasing pain, and hence may has positive functional impact on subjects with HV.

The results of hallux valgus correction were reviewed for 34 male patients (41 feet). The severity of the preoperative deformity determined the operative technique of correction. A distal soft tissue procedure with proximal first metatarsal osteotomy was performed in 30 patients (35 feet) with an average correction of the hallux valgus angle of 22 degrees. A chevron procedure was performed in five cases and a McBride procedure in one other case, all with less severe deformities. Complications included one deep wound infection, one broken screw at the metatarsal osteotomy site, and three cases of hallux varus. No patients underwent reoperation. Undercorrection was noted in 10 of 35 cases (29%) where a distal soft tissue procedure with proximal first metatarsal osteotomy was performed. A nonsubluxated (congruent) metatarsophalangeal (MTP) joint associated with a hallux valgus deformity was present in 15 of 41 (37%) of all cases and 10 of 35 (29%) of cases that underwent a distal soft tissue procedure with proximal metatarsal osteotomy (DSTR with PMO). A subluxated (noncongruent) MTP joint associated with hallux valgus was present in 26 of 41 (63%) of all cases and 25 of 35 (71%) of cases undergoing a DSTR with PMO. There was a highly significant difference in the average distal metatarsal articular angle (DMAA) as measured in the nonsubluxated (congruent) MTP joints (20.7 degrees) and the subluxated (noncongruent) MTP joints with hallux valgus (10 degrees) (P = 0.0001). The average distal metatarsal articular angle for all cases undergoing DSTR with PMO was 13 degrees. When the postoperative hallux valgus angle was compared with DMAA, the average residual hallux valgus angle was 10.1 degrees. With a subluxated (noncongruent) first MTP joint with hallux valgus (a low DMAA), the percent of hallux valgus correction (hallux valgus correction [in degrees]/preoperative hallux valgus deformity [in degrees]) was 77%. In patients with a nonsubluxated (congruent) first MTP joint with hallux valgus (a high DMAA), the percent correction was 46%, an almost twofold difference in percent correction. There was a close correlation between the preoperative DMAA and the postoperative hallux valgus angle in both the subluxated and congruent subgroups (P = 0.0003). With an intra-articular repair (a DSTP with PMO), the magnitude of correction of a hallux valgus deformity is limited at the MTP joint by the distal metatarsal articular angle.

Hallux valgus is a common foot deformity that leads to functional disability with serious sequelae. Minimally invasive surgery is often used to treat hallux valgus in order to reduce wound complications and improve recovery time. The objective of this study was to compare a Simple, Effective, Rapid, Inexpensive (SERI) technique with a simple Chevron technique in patients with minimum of 1-year follow-up. Between the years 2014-2015, we performed a prospective study comparing the SERI minimally invasive technique to treat symptomatic hallux valgus with a standard chevron osteotomy technique. All procedures were performed by a single fellowship trained foot and ankle surgeon. Twenty-one patients were randomized to the SERI cohort and 15 to the standard Chevron technique. The mean preoperative intermetatarsal angle (IMA) of the SERI group was 14.8 ± 1.9 (11.9-22.9). The mean preoperative IMA of the Chevron control group was 13.3 ± 2.3 (10.4-18.2) (p = 0.038). The mean IMA two weeks after the surgery was 6.0 ± 2.3 (2.4-12) in the SERI group, and 6.1 ± 3 (2.6-13.1) in the control group. At the two-week and 1-year follow-up, there was no significant difference found in the IMA between the two groups (p = 0.871). The mean hallux valgus angle reduction was 11.85 ± 4.88 (3-20.8) and 11.09 ± 6.51 (- 1.1 to 22.5) in the SERI and Chevron groups, respectively (p = 0.69). Neither groups reported symptomatic transfer metatarsalgia throughout the follow-up period. The SERI group had increased metatarsophalangeal joint (MTPJ) motion (p < 0.001); however, all other parameters with similar. The SERI technique provided comparable outcomes at up to 1-year follow-up when compared with a standard Chevron osteotomy for moderate hallux valgus. This study demonstrated good reproducible results using the SERI technique for moderate hallux valgus. Level II Prospective Study. Approved by local IRB at MMC.

BackgroundThis study aimed to assess the effect of corrective exercises and exercises supplemented by kinesiology taping or an orthosis on pain and foot alignment in women with hallux valgus (HV).MethodsEighty-two women with HV were randomly divided into groups: E (n = 24) who exercised for 12 weeks; EKT (n = 18) who exercised and used kinesiology taping on HV; EMC (n = 15) who performed exercise and used an orthosis to correct their big toe position; and CHV (25 women with HV without therapy). Additional control group C: (n = 31) women with normal hallux. The Wejsflog index, Clarke’s angle, alpha and beta angles, and pain intensity in the big toe area were assessed at the beginning and after therapy.ResultsThe Wejsflog index was significantly lower in women with HV and increased significantly after therapy in the E and EKT groups. Clarke’s angle did not differ between women with and without HV, and Clarke’s angle did not change after therapy. The HV angle decreased significantly in groups E and EKT but was still significantly greater than that in group C. The fifth toe varus angle did not differ between women with and without HV and decreased significantly in the right foot after therapy in group E. Pain in the HV area decreased significantly in all groups undergoing therapy.ConclusionWomen with HV have a greater forefoot width, but their longitudinal arch and fifth toe position do not differ. Exercises significantly reduce pain and improve hallux alignment. Combining exercises with kinesiology taping or an orthosis does not increase the therapeutic effect. Although the observed effects of conservative therapy are promising, it should be remembered that long-term effects have not been studied.Trial registrationThe Australian New Zealand Clinical Trials Registry (ACTRN12621000902897).

Hallux valgus, one of the most common foot disorders, contributes to the formation of pain and changes foot biomechanics. To assess the impact of Kinesiology Taping (KT) on foot loading during gait in patients with hallux valgus. Forty feet with hallux valgus were examined. Patients wore the KT for a month and the parameters of the foot during gait on a baropodometric platform were measured three times: before taping, immediately after application of taping and after one month's use. The taping had a statistically significant effect on dynamic foot measurements. The maximum and mean foot load (p< 0.001), foot surface (p< 0.001), ratio of forefoot to hindfoot load (p< 0.01) and the proportions of the lateral and medial foot loading (p< 0.05) all changed. During gait cycle, taping significantly increased the load and surface at the first metatarsal head (p< 0.001) while there was a decrease around the second to fifth (p< 0.001) metatarsal heads. Using KT to correct a hallux valgus is a procedure that has an impact on the dynamic parameters of the foot during gait. The use of this method could become an alternative to surgical treatment for those patients, who have any contraindication for surgery.

Background: Hallux valgus (HV) is a deformity that affects the quality of life and function in a negative manner causing disturbed balance and walking and even alters the foot kinematics. Conservative treatments are the choice for mild to moderate HV, but the question about the best method has not been responded yet. In the current study, it is aimed to assess and compare the efficacy of kinesiotaping (KT) versus phonophoresis (PH) for the treatment of painful HV. Materials and Methods: This randomized clinical trial has been conducted on a total number of 37 toes (37 toes of a total number of 24 patients) randomly divided into two subgroups of either KT or PH with 1% hydrocortisone among which the total numbers of 31 toes from 20 patients fulfilled the study protocol. The variables including pain (using VAS score), function (using Manchester-Oxford Foot questionnaire)(MOXFD), hallux valgus angle (HVA), and intermetatarsal angle (IMA) were assessed and compared between two groups before and after two months following the interventions. Results: The pain score decreased significantly within the time in both groups (P-value&lt;0.001), while the comparison of KT with PH revealed insignificant difference (P-value=0.08). MOXFD assessments showed significantly improved status within two months for both interventions (P-value&lt;0.001) with no remarkable difference between the groups (P-value=0.55). The IMA and HVA altered following both of the techniques. KT was superior to PH for the correction of HVA, but not for IMA (P-value&gt;0.05). Conclusion: We found both of the KT and PH techniques could successfully rehabilitate the patients’ pain and improve function, however the KT was slightly better than PH due to HVA reduction. [GMJ.2021;10:e1888]

Hallux valgus is the most common deformity of the forefoot. It has a multifactorial aetiology, with hindfoot valgus considered one of its causes. The aim of this study was to evaluate hindfoot position and loading pattern after a treatment of Kinesiology Taping (KT) for the mechanical correction of hallux valgus. The study involved 25 feet with hallux valgus deformity and hindfoot valgus. The hallux valgus angle (HVA) and hindfoot angle were assessed with a 3D scanner. Hindfoot loading pattern was examined with a baropodometric platform while standing and during gait. Measurements were taken on the following three occasions: before and immediately after KT placement as well as after a month of taping. The KT treatment had a significant influence on the hindfoot angle (p&lt;0.001) and HVA (p&lt;0.001) measured while standing and on lateral heel loading in dynamic conditions during gait (p&lt;0.01). 1. KT decreased HVA and improved hindfoot position while standing in the pilot study participants. 2. KT exerted a corrective influence on the foot loading pattern in patients with hallux valgus and hindfoot pronation. 3. The foot position correction and normalisation of foot loading achieved in the pilot study provide a basis for further research on KT effectiveness in patients with hallux valgus and hindfoot pronation.

Syndesmosis Practitioner Satisfied With One Technique for All His Hallux Valgus Deformity Corrections for 25 Years

There have been few prospective studies that have documented the outcome of surgical treatment of hallux valgus deformities. The purpose of this investigation was to evaluate the effect of operative treatment of hallux valgus with use of a proximal crescentic osteotomy and distal soft-tissue repair on the first metatarsophalangeal joint. All adult patients in whom moderate or severe subluxated hallux valgus deformities had been treated with surgical repair between September 1999 and May 2002 were initially enrolled in the study. Those who had a hallux valgus deformity treated with a proximal crescentic osteotomy and distal soft-tissue reconstruction (and optional Akin phalangeal osteotomy) were then invited to return for a follow-up evaluation at a minimum of two years after surgery. Outcomes were assessed by a comparison of preoperative and postoperative pain and American Orthopaedic Foot and Ankle Society scores; objective measurements included ankle range of motion, Harris mat imprints, mobility of the first ray (assessed with use of a validated calibrated device), and radiographic angular measurements. Of the 108 patients (127 feet), five patients (five feet) were unavailable for follow-up, leaving 103 patients (122 feet) with a diagnosis of moderate or severe primary hallux valgus who returned for the final evaluation. The mean duration of follow-up after the surgical repair was twenty-seven months. The mean pain score improved from 6.5 points preoperatively to 1.1 points following surgery. The mean American Orthopaedic Foot and Ankle Society score improved from 57 points preoperatively to 91 points postoperatively. One hundred and fourteen feet (93%) were rated as having good or excellent results following surgery. Twenty-three feet demonstrated increased mobility of the first ray prior to surgery, and only two feet did so following the bunion surgery. The mean hallux valgus angle diminished from 30 degrees preoperatively to 10 degrees postoperatively, and the mean first-second intermetatarsal angle decreased from 14.5 degrees preoperatively to 5.4 degrees postoperatively. Plantar gapping at the first metatarsocuneiform joint was observed in the preoperative weight-bearing lateral radiographs of twenty-eight (23%) of 122 feet, and it had resolved in one-third (nine) of them after hallux valgus correction. Complications included recurrence in six feet. First ray mobility was not associated with plantar gapping. There was a correlation between preoperative mobility of the first ray and the preoperative hallux valgus (r = 0.178) and the first-second intermetatarsal angles (r = 0.181). No correlation was detected between restricted ankle dorsiflexion and the magnitude of the preoperative hallux valgus deformity, the postoperative hallux valgus deformity, or the magnitude of hallux valgus correction. A proximal crescentic osteotomy of the first metatarsal combined with distal soft-tissue realignment should be considered in the surgical management of moderate and severe subluxated hallux valgus deformities. First ray mobility was routinely reduced to a normal level without the need for an arthrodesis of the metatarsocuneiform joint. Plantar gapping is not a reliable radiographic indication of hypermobility of the first ray in the sagittal plane.

ObjectivesTo explore the impact of hallux valgus (HV) on lower limb neuromuscular control strategies during the sit-to-stand (STS) movement, and to evaluate the effects of Kinesio taping (KT) intervention on these control strategies in HV patients.MethodsWe included 14 young healthy controls (HY), 13 patients in the HV group (HV), and 11 patients in the HV group (HVI) who underwent a Kinesio taping (KT) intervention during sit-to-stand (STS) motions. We extracted muscle and kinematic synergies from EMG and motion capture data using non-negative matrix factorization (NNMF). In addition, we calculated the center of pressure (COP) and ground reaction forces (GRF) to assess balance performance.ResultsThere were no significant differences in the numbers of muscle and kinematic synergies between groups. In the HV group, knee flexors and ankle plantar flexors were abnormally activated, and muscle synergy D was differentiated. Muscle synergy D was not differentiated in the HVI group.ConclusionAbnormal activation of knee flexors and plantar flexors led to the differentiation of module D in HV patients, which can be used as an indicator of the progress of HV rehabilitation. KT intervention improved motor control mechanisms in HV patients.

BackgroundHallux valgus is a common condition where the subluxation of the first metatarsophalangeal joint and lateral deviation of the hallux at the interphalangeal joint creates difficulty with footwear fit. Footwear and foot orthoses are commonly prescribed nonsurgical treatments for hallux valgus. Research questionDo extra-width footwear and foot orthoses influence peak pressure at the medial aspect of the metatarsophalangeal and interphalangeal joints in women with hallux valgus? MethodsCommunity-dwelling women with symptomatic hallux valgus underwent gait testing when wearing their own shoes and when wearing extra-width footwear fitted with three-quarter length, arch-contouring prefabricated foot orthoses. Peak pressure (kPa) on the medial aspect of the metatarsophalangeal and medial interphalangeal joints and on the plantar surface of the foot (hallux, lesser toes, metatarsophalangeal joint 1, metatarsophalangeal joints 2–5, midfoot and heel) were measured using the novel pedar®-X system with the pedar® pad and pedar® insole, respectively (Novel, GmbH, Munich, Germany). Paired samples t-tests were used to calculate the differences between the two conditions, and the magnitude of observed differences was calculated using Cohen’s d. ResultsWe tested 28 participants (aged 44–80 years, mean 60.7, standard deviation 10.7). Compared to their own footwear, wearing the intervention footwear and orthoses was associated with a statistically significant decrease in pressure on the medial aspect of the metatarsophalangeal joint (58.3 ± 32.8 versus 42.6 ± 32.8, p=0.026, d=0.49), increased pressure under the midfoot (70.7 ± 25.7 versus 78.7 ± 23.6, p=0.029, d=0.33) and decreased pressure underneath the heel (137.3 ± 39.0 versus 121.3 ± 34.8, p=0.019, d=0.45). SignificanceThe intervention footwear and orthoses significantly decreased peak pressure on the medial aspect of the first metatarsophalangeal joint but had no significant effect on the interphalangeal joint. Further studies are required to determine whether these changes are associated with improvements in symptoms associated with hallux valgus.

Finite element analysis of Scarf osteotomy for precise treatment of hallux valgus.