Arch Deformity Research Articles

Flat Foot based on Clarke's Angle Method and Overweight among Medical Students of Universitas Airlangga

Highlights: Being overweight can be one of the causes of flat foot. A person with flat feet may experience pain in the medial malleolus area and discomfort when tiptoeing. Abstract Introduction: A flat foot is an arch deformity, and being overweight is one of the risk factors. It can cause problems such as fatigue, pain in the ankle and back, foot pain (especially during long walks or sports), and disturbances in balance and walking patterns. This study aimed to examine the relationship between flat feet (measured using Clarke's angle) and overweight students at the Faculty of Medicine, Universitas Airlangga. Methods: This study used an observational analytic design with a cross-sectional method, gathering primary data directly from the research sample. The data were analyzed using the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26. Results: Of the 56 samples meeting inclusion criteria, most cases of flat foot occurred in males. A total of 36 research subjects were overweight or obese, evenly split between females and males. Among the 112 samples, 19 had flat feet, and 93 did not. Chi-square test analysis indicated a highly significant p-value (0.001, p < 0.05), suggesting a significant relationship between flat feet and overweight. Conclusion: There was a significant relationship between flat feet (measured using Clarke's angle) and overweight. The majority of subjects in this study were overweight based on body mass index (BMI), and most had a non-flat foot arch type. All cases of flat foot were found in subjects with overweight BMI.

Acute effects of athletic taping on arch deformity and plantar pressure in young female adults with flexible flatfoot

ObjectiveThis work aimed to explore the acute effects of athletic taping techniques on foot arch deformity and plantar pressure in young female adults with flexible flatfoot (FFT). MethodsTwenty young female adults with FFT were recruited in the current study. Each participant was randomly divided into two taping groups, namely, augmented low-dye (ALD) and modified low-dye (MLD). The foot arch deformity and plantar pressure were measured at baseline, after taping and after 20 min of walking. The foot arch deformity was determined based on navicular drop distance (NDD) and resting calcaneal stance position (RCSP). ResultsCompared with baseline, the NDD values were significantly lower after taping. After 20 min of walking, ALD taping resulted in a lower NDD value than MLD (p < 0.001). ALD maintained a higher RCSP than baseline after 20 min of walking (p = 0.004). Furthermore, compared with baseline, medial midfoot force–time integration (p = 0.013) and contact area (p = 0.022) increased after taping with MLD, and peak pressure in the medial midfoot increased after walking for 20 min with MLD (p = 0.026). Peak pressure in the second to fifth toes significantly decreased after 20 min of walking with ALD compared with that after taping immediately (p = 0.002). ConclusionsALD and MLD taping could improve FFT arch deformity and plantar pressure distribution, prospectively changing peak pressure of the second to fifth toe area and medial midfoot after 20 min of walking, integrated contact area and force–time integration medial midfoot during walking in young female adults. Furthermore, ALD taping could improve FFT deformity more than using MLD after 20 min of walking. Thus, when treating FFT in young female adults, ALD taping should be considered adaptively to guide arch support production and correct midfoot pronation.

Five-Segment Mandibular Osteotomy: A Novel Approach to the Correction of Complex Post-Traumatic Mandibular Deformities.

Post-traumatic mandibular malocclusion is a complex condition that poses a significant challenge to reconstructive surgeons. The malocclusion that ensues from bilateral condylar and parasymphseal fractures presents a particular challenge as it leads to bilateral posterior shortening and lingual tilting of dental arch leading to a combination of open anterior bite, crossbite, overbite, underbite, and/or facial asymmetry. The complexity of such malocclusion requires intricate freedom of movement of the mandibular arch that can be achieved by performing a 5-segment mandibular osteotomy. This is a case series of 9 adult patients with significant post-traumatic mandibular malocclusion who were treated with 5-segment mandibular osteotomy technique. This article details the demographics, surgical technique and outcomes in this cohort of patients. All 9 patients in this series had condylar fracture as part of the index mandibular trauma. They have a common post-traumatic deformity of the mandibular arch due to shortening of the vertical mandibular height in the fracture site and variable degrees of lingual tilting leading to crossbite. The 5-segment mandibular osteotomy provided an adequate correction of dental and facial deformities in all 9 patients. One patient had a relapse of the dental malocclusion that required postoperative rescue orthodontics. Furthermore, one patient had a significant postoperative hemorrhage that required a facial artery ligation. Post-traumatic mandibular malocclusion is a complex deformity that poses a great challenge to practicing surgeons. Five-segment mandibular osteotomy is a technique that provides ample degrees of movement of mandibular segments that is necessary to correct such deformity.

Consequences of Thumb Sucking Habit among School Going Children: A Cross Sectional Study

Background: Thumb-sucking, a non-nutritive sucking behavior, is a natural reflex seen in infants but can persist into childhood if not addressed leading to various dental and orofacial issues, including malocclusion, dental arch deformities, speech difficulties, and facial asymmetry. The aim of the study was to explore the consequences of thumb-sucking habits among the school going children. Methods: This cross-sectional study involved among purposively selected 124 school going children, aged between 5-8 years with their parents attended in the outpatient department of University Dental College at Moghbazar, Dhaka, Bangladesh. The data were obtained through a pretested structured questionnaire and checklist through face-to-face interview from parents regarding background characteristics, consequences of thumbs sucking and oral examination of children respectively. Then, data were analyzed using statistical package for social sciences (SPSS) software version 27 for descriptive analysis (frequency, percentage) and inferential statistics (chi-square test or fisher’s exact test) at 5% level of significance (P&lt;0.05). Results: The study revealed that 77.4% of children aged 5-6 years and about 41.9% of parents reported that their child had thumb sucking habit. The thumb sucking habit was found to be statistically significant with start of age thumb sucking( p= &lt;0.001), duration of thumb sucking ( p= &lt;0.001), pronunciation of word clearly( p= &lt;0.001), proclination of maxillary anterior teeth (P=0.002), asymmetry of face (P=0.002) and seek for dental advice or treatment(p=0.002). Majority of children (21.8%) start thumb sucking at the age 6-7 years. Only 8.1% of the children didn’t pronounce words clearly whereas only 5.6% had proclined maxillary anterior teeth, facial asymmetry and sought dental advice or treatment. Conclusion: This study found a significant association of thumb-sucking habit among children with notable consequences. It highlights the importance of early intervention and parental education and awareness regarding this habit's potential consequences on children's oral health and overall development. Update Dent. Coll. j: 2023; 13(2): 19-22

A Case History of Gross and Radiological Observations of Agnathia: Otocephaly in a Mehraban Ewe-lamb

Agnathia is one of the first pharyngeal arch deformities referred to as mandibular abnormality. This case report aimed to describe an unusual form of agnathia-otocephaly in a Mehraban ewe-lamb accompanied by other malformations. The scrutiny of the lamb’s face indicated a chain of abnormalities in the head region. Lack of mandible, lips, rima oris, oral cavity, tongue, and teeth were recognized. Eyes and ear lobes were normal, but the base of the pinnae met each other ventral to the atlantooccipital joint and formed a single external acoustic meatus there. The nostrils were normally formed, but the philtrum was not formed due to the lack of lips, especially the upper lip. The hyoid apparatus was normally developed. The laryngopharynx had no connection with the nasopharynx and dead end. Also, the nasal cavities ended blindly because of rinopharyngeal aplasia and no choanal foramen. So, the abnormal pharyngeal region caused a non-functional respiratory system followed by death.

Comparison of different surgical treatments for stage II progressive collapsing foot deformity: a finite element analysis

BackgroundThis study analyzed the advantages and disadvantages of different procedures for stage IIA progressive collapsing foot deformity (PCFD) through three-dimensional finite element models.MethodsA previous validated stage IIA PCFD FEA model was established consisting of 16 bones, 56 ligaments, 5 muscles and soft tissues. The ligament properties of the spring, deltoid, short plantar and long plantar ligaments, and plantar fascia were attenuated according to a previous publication. Medial column fusion (MCF), medializing calcaneal osteotomy (MCO), lateral column lengthening (LCL), and subtalar joint arthroereisis (SJA) operations were simulated in this model. The indexes of plantar stress distribution, maximum von Mises of the medial and lateral columns, strain of the medial ligaments and plantar fascia that supported the medial longitudinal arch, arch height, talo-first metatarsal angle, calcaneus pitch angle, and talonavicular coverage angle were all compared before and after simulated single-foot weight loading.ResultsThe maximum plantar stress of PCFD decreased with MCO and SJA but increased with MCF and LCL. MCF and LCL failed to significantly reduce the stress on the medial column fragments, thereby increasing their stress. Both MCO and SJA relieved medial plantar stress. MCF had no significant effect on stress relief of the medial ligament. MCO, LCL, and SJA were all shown to reduce the pressure on the medial plantar ligament, with LCL having the most obvious effect. All four procedures corrected the arch deformity; however, MCF was not as effective as the other methods. SJA is the best method for restoring arch height and correcting arch deformities. For stage IIA PCFD, isolated MCF failed to reduce pressure on the medial column; however, isolated MCO significantly reduced the pressure on the medial plantar and ligamentous soft tissues while restoring the foot’s arch and correcting the hindfoot valgus.ConclusionSJA with type II sinus tarsi implant effectively transferred pressure from the medial plantar tract to the lateral side and restored the arch. Isolated LCL was not found suitable for stage IIA PCFD.

Correction of tibial multiplanar deformities using single Taylor external fixator combined with biplanar osteotomy

To investigate the effectiveness of single Taylor external fixator combined with biplanar osteotomy on correction of tibial multiplanar deformities. Between October 2016 and December 2021, 11 patients with tibial multiplanar deformities (20 sides) were treated with single Taylor external fixator and biplanar osteotomy. Of them, 4 were male and 7 were female; the average age ranged from 13 to 33 years (mean, 21.9 years). Diagnosis included rickets severe genu varum deformity (7 cases, 14 sides), rickets severe genu valgum deformity (2 cases, 4 sides), multiple osteochondromatosis calf deformity (1 case, 1 side), neurofibromatosis medial lower leg anterior arch deformity with short of leg (1 case, 1 side). After fibular osteotomy and tibial multiplanar osteotomy, a Taylor external fixator was installed. After operation, the deformities were corrected successively and fixed completely. The osteotomy healed, then the external fixator was removed. Before operation and at 12 months after operation, the full-length X-ray films were taken. The leg-length discrepancy, medial proximal tibial angle (MPTA), lateral distal tibial angle (LDTA), posterior proximal tibial angle (PPTA), anterior distal tibial angle (ADTA), and tibial rotation angle were measured. The degree of lower limb deformity was scored with reference to a customized tibial mechanical axis scoring table. Osteotomy was successfully completed without neurovascular injury and other complications. The external fixator was adjusted for 28-46 days, with an average of 37 days, and the external fixator was worn for 136-292 days, with an average of 169 days. Mild needle infection during the fixation period occurred in 3 sides, refracture at the distal tibial osteotomy in 1 side after removing the external fixator, and nonunion of the distal fibular osteotomy in 1 side. All patients were followed up 369-397 days (mean, 375 days). At 12 months after operation, the lower limb discrepancy decreased, but there was no significant difference ( P>0.05). MPTA, LDTA, PPTA, ADTA, and tibial rotation angle improved, and the differences in LDTA, ADTA, and tibial rotation angle were significant ( P<0.05). The score of lower limb deformity was significantly higher than that before operation ( P<0.05), and the results were excellent in 9 sides, good in 8 sides, fair in 3 sides, with the excellent and good rate of 85%. Single Taylor external fixator combined with biplanar osteotomy is effective in the correction of tibial multiplanar deformities.

Elastic properties of aorta with respect to its dilatation vs aneurysm according to ECG-synchronized CT-angiography

Purpose: to compare the indicators of elasticity of the thoracic aorta, determined by ECG-Gated-CT angiography, in patients with ascending aortic aneurysm and dilatation.Materials and methods. The study included 20 patients with dilatation of the ascending aorta (40 mm ≤ maximum aortic diameter (Dmax) &lt; 50 mm) (group 1a), 30 patients with non-syndromic aneurysms of the ascending aorta (n = 30, Dmax ≥ 50 mm) (group 1b), as well as 19 patients with normal aortic sizes (Dmax &lt; 40 mm) as controls (group 2). All patients underwent multispiral computed tomography angiography of the aorta in ECG-Gated mode (ECG-Gated -CT). Maximum systolic and diastolic aortic diameters (Dmax) were measured at different levels of the thoracic aorta, followed by calculation of the difference between them and calculation of the circular deformation (CS), compliance, stiffness (Stiff), wall distensibility, longitudinal deformation (LS).Results. Moderate negative correlation between the age of the patients and CS at all levels of the thoracic aorta (rmaximum = –0.33, rminimum = –0.41) was revealed. Groups 1a and 1b did not differ significantly in all parameters. Group 1a differed from the control group (p &lt; 0.05) in Stiff at the level of the aortic annulus (AA) (0.07 [–0.14; 0.15] vs –0.04 [–0.1; 0.06]), as well as CS at the level of AA and sinuses of Valsalva (SV ) (0.49 [–2.94; 3.36] vs –1.18 [–4.51; 3.87]), and group 1b – in CS at the level of SV (3.73 [0.24; 6.56] vs 0.13 [–1.42; 3.04]) and proximal part of the descending aorta (distal to the left subclavian artery) (5.48 [1.27; 8.40] vs 1.97 [–0.32; 6.08]), also in LS (5.96 [–8.98; 9.25] vs –2.58 [–7.75; 1.89]) at the level of the aortic arch.Conclusion. According to ECG-Gated-CT angiography, the indicators of elasticity of the thoracic aorta in patients with ascending aortic aneurysm and dilatation did not differ. Compared with the control group, patients with aneurysm of the ascending aorta showed an increased pulse deformity of the non-dilated aortic arch.

Is there an association between plantar fasciitis and knee osteoarthritis?

Knee osteoarthritis (OA) and plantar fasciitis share similar risk factors including ageing, occupation, obesity, and inappropriate shoe wear. However, the association between knee OA and heel pain caused by plantar fasciitis has received limited attention to date. We aimed to assess the prevalence of plantar fasciitis using ultrasound in patients with knee OA and to identify factors associated with plantar fasciitis in these patients. We conducted a cross-sectional study including patients with Knee OA, fulfiling the European League Against Rheumatism criteria. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the Lequesne indexes were used to evaluate pain and function of the knees. The Manchester Foot Pain and Disability Index (MFPDI) was used to estimate foot pain and disability. Each patient underwent a physical examination, plain radiographs of the knees and the heels, and an ultrasound examination of both heels to find signs of plantar fasciitis. Statistical analysis was performed using SPSS. We included 40 knee OA patients, with a mean age of 59.85±9.65years [32-74] and a male-to-female ratio of 0.17. The mean WOMAC was 34.03±19.9 [4-75]. The mean Lequesne for knees was 9.62±4.57 [3-16.5]. Among our patients, 52% (n=21) experienced heel pain. The heel pain was severe in 19% (n=4). The mean MFPDI was 4.67±4.16 [0-8]. Limited ankle dorsiflexion and plantar flexion were noted in 47% of patients (n=17) each. High and low arch deformities were seen in 23% (n=9) and 40% (n=16) of patients. Ultrasound revealed a thickened plantar fascia in 62% (n=25). An abnormal hypoechoic plantar fascia was noted in 47% (n=19), with the loss of normal fibrillar architecture in 12 cases (30%). No Doppler signal was exhibited. Patients with plantar fasciitis had significantly limited dorsiflexion (n=2 (13%) versus n=15 (60%), p=0.004) and plantar flexion (n=3 (20%) versus n=14 (56%), p=0.026). The range of supination was also less important in the plantar fasciitis group (17.73±4.1 vs. 12.8±6.46, p=0.027). The low arch was statistically more present in patients with plantar fasciitis (G1: 36% [n=9] vs. G0: 0% [n=0], p=0.015). However, the high arch deformity was statistically more present in patients without plantar fasciitis (G1: 28% [n=7] vs. G0: 60% [n=9], p=0.046). Multivariate analysis showed that the risk factor for plantar fasciitis in knee OA patients was limited dorsiflexion (OR=3.889, 95% CI [0.017-0.987], p=0.049). In conclusion, our work showed that plantar fasciitis is frequent in knee OA patients, with reduced ankle dorsiflexion being the main risk factor for plantar fasciitis in these patients.

Foot Problems and Their Associations with Toe Grip Strength and Walking Speed in Community-Dwelling Older Individuals Using Day Services: A Cross-Sectional Study

Foot disorders in older individuals compromise balance and contribute to postural and gait instabilities, causing a decrease in the activities of daily living and quality of life. In this cross-sectional study, we analyzed the foot-related data of 160 frail older participants who attended day service centers in A prefecture in Japan to determine the prevalence of foot problems and their associations with toe grip strength and walking speed in frail older people. Multiple regression analysis was used to identify foot-related variables that correlated with toe grip strength and walking speed. The prevalence rates of skin dryness (Support level 88.2%, Care level 85.2% for men; Support level 84.9%, Care level 93% for women) and suspected and existing fungal infections in nails (Support level 94.1%, Care level 92.6% for men; Support level 98.1%, Care level 95.2% for women) were high in both sexes regardless of the level of care required. Furthermore, in both sexes, the prevalence rates of toe and arch deformities were significantly increased in the people who required care. Regression analysis revealed that some right-sided foot-related problems were significantly associated with right toe grip strength and walking speed. The decrease in toe grip strength was significantly associated with walking speed. Our study provides evidence that some specific conditions were associated with toe grip force and walking speed. This finding can contribute to future strategies to protect foot health in community-dwelling older individuals.

Three-dimensional Analysis of the Temporal Bone Morphology in Patients with Craniofacial Microsomia.

To characterise the morphology of temporal bone in patients with craniofacial microsomia (CFM). A retrospective study. A craniofacial centre. Ninety-four patients with unilateral craniofacial microsomia. Mimics 21.0 (Materialise Inc., Belgium) was used to locate temporal bone landmarks on preoperative computed tomography data. The spatial Cartesian coordinate system was established in 3-matic 13.0 (Materialise Inc., Belgium). The coordinates of each landmark and the distances and angles between the landmarks were calculated. A classification system was used to quantify the severity of the zygomatic arch deformity. The bilateral differences in coordinates, linear and angular measurements, and the severity of temporal bone deformity (TTL δ, Psag δ, Paxiδ, and Tsag δ) among the groups were compared using the paired t-test and Kruskal-Wallis test, respectively. Compared to those of the unaffected side, the landmarks of the inner ear and petrous part on the affected side showed a decrease in the Z-coordinate or an increase in the X-coordinate. A superolateral rotation tendency of the temporal bone on the affected side was found. There were no significant differences in the linear and angular measurements between the groups. The degree of zygomatic arch deformation was lower in the mild group; however, no significant difference was found between the moderate and severe groups. In patients with CFM, asymmetry of the temporal bone and its inner organs (vestibulocochlear organ, facial nerve, and vessels) exists in multiple dimensions; its severity is not completely consistent with the degree of mandibular involvement.

Ultrasonographic manifestation and genetic analysis of a fetus with Stickler syndrome

To carry out genetic analysis for a family with a fetus manifesting micrognathia and a previous history for fetal micromandibular deformity. Systematic ultrasound examination was carried out for the fetus, and the prenatal and postnatal phenotype of the first fetus were retrospectively analyzed. The fetus and his parents were subjected to whole exome sequencing (WES) to identify potential pathogenic variants. Candidate variants were verified by Sanger sequencing. Fetal ultrasound has indicated micrognathia. The first fetus was found to have micrognathia by prenatal ultrasonography and have featured macrosomia and dyspnea due to with tongue retraction, high palatal arch and small mandibular deformity. WES revealed that the fetus has a harbored a c.3G>C (p.Met1?) variant of the COL2A1 gene, which was inherited from the father who had myopia and retinal detachment. Stickler syndrome is mainly characterized prenatally by micrognathia, in addition with a variety of postnatal anomalies. The c.3G>C (p.Met1?) variant probably underlay the Stickler syndrome in this pedigree.

Effect of Longitudinal and Transverse Foot Arch on the Position of the Hallux and Fifth Toe in Preschool Children in the Light of Regression Analysis.

The aim of the study was to analyze the development of foot structure and the impact of longitudinal and transverse arching of the foot on the position of the hallux and fifth toe in preschool children. The study was carried out among 200 children aged 6 (100 G, 100 B). The research tool was the podoscope CQ-ST. The collected research results were analyzed with the use of the Mann–Whitney U test, Pearson Chi-square test and regression analysis. A statistically significant influence of the heel angle on the value of the varus angle of the fifth toe of the right (girls: p = 0.032; boys: p = 0.001) and left foot (girls: p = 0.004; boys: p = 0.005) was found. Boys’ feet are longer and wider than girls’ feet; moreover, they have a lower longitudinal arch. The frequency of longitudinal and transverse arch deformities of the feet, as well as valgus of the hallux and varus of the fifth toe do not depend on gender. In both sexes, decreasing the transverse arch of the foot has an influence on the severity of varus of the fifth toe. Changes in the height of the longitudinal foot arch does not affect the position of the hallux and fifth toe.

Mathematical Modeling and Nail Placement Accuracy Analysis of NF-1 Neurofibromatosis Scoliosis.

We have analyzed the arch root morphology, nail placement accuracy, degree of arch deformity, and three-dimensional Cobb angle in patients with NF scoliosis by CT 3D reconstruction. Likewise, we have thoroughly examined arch root morphology, nail placement accuracy, degree of arch deformity, and three-dimensional Cobb angle in patients with idiopathic scoliosis by CT 3D reconstruction. The results of the two groups were statistically analyzed and compared to assess the efficacy and other morphological differences between these groups. For this purpose, 276 patients with scoliosis, including 221 with idiopathic scoliosis and 16 with neurofibromatosis scoliosis, were treated in the hospital, which is from May 2008 to December 2016. The 16 patients with idiopathic scoliosis were matched with patients with neurofibromatosis, and the postoperative CT data were reconstructed in three dimensions, and the measurements included arch morphology, arch transverse diameter, arch-rib joint transverse diameter, three-dimensional coronal Cobb angle, and correction rate. The data of the two groups were statistically analyzed to compare the arch morphology, nail placement accuracy, and treatment effect between patients with NF and patients with AIS. Statistical analysis was performed to compare the differences between NF and AIS patients in terms of morphology, nail placement accuracy, and treatment outcome. The results showed that there were more severely deformed pedicles in NF patients than in idiopathic scoliosis, and the difference between them was statistically significant. Of the 142 screws placed in the NF group, 88 screws were in a good position, and the remaining 54 screws were misplaced.

Evaluation of Muscle Activity, Muscle Fatigue and Balance in Male High School Taekwondo Athlete with Deformity of Medial Longitudinal Arch

Evaluation of Muscle Activity, Muscle Fatigue and Balance in Male High School Taekwondo Athlete with Deformity of Medial Longitudinal Arch

The Optimal Energy Density of Photobiomodulation Therapy in Decreasing Orthodontic-Related Pain: A Systematic Review and Network Meta-Analysis.

Objective: The aim of this network meta-analysis (NMA) was to explore the optimal energy density (ED) for relief of orthodontic-related pain by photobiomodulation therapy. Background: Orthodontic treatment corrects the deformity of teeth, dental arch, jaw, and face using various orthodontic devices under the action of biomechanics. Materials and methods: A computerized literature search was conducted within the MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and CBM databases to identify randomized controlled trials (RCTs) that used photobiomodulation therapy to relieve pain during orthodontic treatment. Particular inclusion and exclusion criteria were connected to recognize relevant articles. The information was extricated autonomously by two reviewers, and a quality assessment was carried out by utilizing the Cochrane Collaboration "risk of bias" tool. The RevMan 5.4 software and STATA 15.0 were utilized for data analysis. Also, the NMA was performed with mvmeta commands in Stata (StataCorp, TX). Results: Of the 1024 recognized articles, 21 RCTs were at long last included. Within the risk-of-bias assessments, 2 studies displayed a high risk, 17 an unclear risk, and 2 a low risk. The global and local inconsistency of the NMA in 1 and 2 days was not significant; however, the NMA in 3 days showed a significant inconsistency. Laser with lower ED (0-10 J/cm2) appeared to be the most noteworthy possibility to become the optimal intervention, and it also had the highest mean rank in the rankogram and the biggest value of surface under the cumulative ranking in all three NMA structures. Conclusions: On account of the limited evidence of included trials, laser with lower ED (0-10 J/cm2) appeared to be more valid than the remaining treatment modalities (laser with higher ED, placebo, and control) for pain reduction in 1, 2, and 3 days after orthodontic procedures were applied. In the future, more high-quality research with consistency in research design is needed for further evaluation.

Correlation of medial longitudinal arch morphology with body characteristics and locomotive function in community-dwelling older women: A cross-sectional study.

This cross-sectional study aimed to investigate the effects of foot arch deformities on physical characteristics, muscular strength, and motor function in older women depending on the presence or absence of pain. Overall, 145 community-dwelling women aged 65 to 90 years were included in this study. We measured the foot arch height ratio (AHR, dorsal height/truncated foot length) and classified participants with AHR values above, below, or within 1.5 standard deviations into the high-arched group (HAG), Low-Arched Group (LAG), or normal-arched group (NAG), respectively. We also compared body characteristics (age, height, weight, body mass index (BMI), and skeletal mass index), muscle strength (handgrip strength and intrinsic foot strength (IFS)), and locomotive function (two-step value and gait speed) among the three groups. Locomotive examination and muscle strength showed significant differences among the three groups only in the presence of pain; in the two-step test, HAG, NAG, and LAG values were 0.98 cm/cm, 1.19 cm/cm, and 1.18 cm/cm, respectively. The IFS measured 19.2 N, 24.2 N, 31.0 N, respectively, in the HAG, NAG, and LAG. This study suggests that decreased IFS affects the mobility function of high-arched feet in older women. Although there was no significant difference in the evaluation of pain, HAG showed the highest average value, which is considered to contribute to the decreased two-step value. It has been suggested that a high-arched foot in the presence of pain is associated with IFS weakness and may affect the decline of mobility function in older women.

EFFECTS OF THE APPLICATION PROGRAMME OF CORRECTIVE EXERCISES ON FOOT CONDITION

The aim of this study was to determine the effects of corrective exercise programmes on the foot condition. The research was attended by 66 subjects (students of the Jovan Cvijić elementary school, Banja Luka) aged 11-12 years. Of the total number of subjects on initial testing, 44 subjects (72.7%) had flat foot deformity (first, second and third degree) and they participated in further research. The Footplate currex platform was used to assess the arch of the foot. The programme of flat foot corrective exercises lasted a total of 4 months. Exercises were performed twice a week for 20 minutes. The programme included a total of 13 exercises and each exercise was repeated 20 times. A Chi-squared test was applied to determine if there was a difference in the frequency of foot deformities between the initial and final measurements, as well as gender differences, i.e. whether the applied exercise programme affected the reduction of foot arch deformity (p &lt;0.05). The obtained results showed a statistically significant difference between the initial and final measurement (p= 0.008). At the initial measurement, most subjects had the first degree of flat foot deformity (33 subjects or 75%), the second degree (9 subjects or 20.50%), and the third degree (2 subjects or 4.50%). Corrective exercises had positive effects in subjects with the established first-degree flat foot deformity. After the programme of corrective exercises, the deformity of the first degree disappeared in 10 subjects (22.7%). In subjects with established foot deformities of the second and third degree, no statistically significant difference was observed after the programme of corrective exercises. By analysing the statistically obtained data of flat foot deformities between male and female subjects, we concluded that there is a higher number of deformities in boys, although the result has no statistical significance. Based on the data, we can conclude that exercises are the most effective method for flat foot correction. If there is a higher degree of foot deformity, it is necessary to perform corrective exercises for a longer period of time and with a stronger intensity (several times a week).&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0774/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Presurgical intervention of bilateral cleft lip and palate using nasoalveolar molding with a microfiber head cap

Nasoalveolar molding (NAM) was introduced by Grayson et al. in 1993. NAM helps with reshaping of the maxillary arch deformity and nose before surgical lip repair. NAM involves lengthy and extensive use of taping and skin barriers to the infant's cheeks, which usually causes skin irritation and discomfort. This is a case report describing NAM, for an infant with bilateral cleft lip and palate and severely malpositioned premaxilla. In this case, a special head cap with straps was used to secure the NAM appliance instead of the conventional taping. After NAM, there was a significant improvement in the cleft deformity. The parents were very satisfied about the result and felt much more comfortable using the head cap with the special straps compared to the conventional taping because it reduced cheek irritation and was much easier to use.

Community-Dwelling Older Individuals Using Day Services: Prevalence and Associations between Walking, Toe-Grip Strength, and Foot Problems

Background: Foot disorder in older individuals contributes to balance, posture and gait instability, leading to a decrease in activity of daily living and quality of life. However, the existing foot problems of older individuals in the community are not extensively studied in Japan. Method: This cross-sectional study analyzed the foot-related data of 176 frail, old-aged participants who attended day service centers in Japan. Foot conditions were assessed and measured from various aspects, as was weight distribution to the floor. Multiple regression analysis was used to find foot item variables that correlated with toe-grip strength and walking speed. Findings: Prevalence of skin dryness and suspected and existing nail fungal infection was high in both sexes regardless of care level. Prevalence rate of toe deformity and arch deformity was significantly higher in men and women requiring long-term care, respectively. Regression analysis revealed that some right-side foot-related problems were significantly associated with right toe-grip strength and walking speed. Toe-grip strength and walking speed had statistically significant association. The participants’ weight distribution to the floor was greater on the right side than on the left. Interpretation: Our study supported that individuals requiring more long-term care tend to have more foot problems. Some specific conditions were associated with toe-grip force and walking speed. This finding contributes to future strategies to protect foot health for community-dwelling older individuals, particularly the frail population. Funding Statement: The questionnaire development and data collection and analysis were funded by Grants-in-Aid for Scientific Research (No. 19K11111). Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: The Ethics Committee of the Human Environments University (2019N-002) and Nagoya University (2019-0150) approved this study. This study was conducted in accordance with the Helsinki Declaration. Information related to the purpose of the study, privacy, the right to discontinue, and future publication has been included in the cover letter. Consent for study participation was implied by the submission of a completed questionnaire.