Development Of Foot Research Articles

A scoping review of foot and ankle telemedicine guidelines.

The COVID-19 pandemic accelerated the adoption of telemedicine in general. Its use has been widely adopted in the healthcare sector, but relatively little research has been conducted on the use of telemedicine for podiatry. This review aimed to explore and compare existing guidelines on telemedicine related to foot and ankle pathologies within a primary care setting. The preferred reporting guidelines for the extension of scoping reviews were used in this review, and a set of inclusion and exclusion criteria were developed and implemented. This study made use of both databases and gray literature searches. Between 2012 and 2022, these databases were searched using various subject headings and free-text terms for the keywords "telemedicine" "foot health" and "guidelines" with appropriate Boolean operators. The search yielded 356 articles, which were reduced to 283 after removing duplicates. Six more records were discovered through a Google and Google Scholar search and one through an article reference search. Six articles and three institutional practice guidelines were selected for synthesis after screening. The findings were classified according to the level of evidence and research quality, the function of telemedicine and the communication used, the research outcomes sought, and the type of recommendations and guidelines made available. This review highlights the lack of podiatric telemedicine guidelines for foot and ankle pathologies. Although foot and ankle guidelines for orthopedic and musculoskeletal virtual consultations have been mentioned, they do not cover the full range of potential case scenarios that fall within the remit of podiatric consultations in a primary care setting. This review suggests the development of foot and ankle telemedicine guidelines with recommendations on how they can better provide accessible care to their patients, making foot and ankle care management not only a hand-on-one but also reachable virtually, where applicable.

Development of Foot and Mouth Disease Vaccine Formulation in Egypt by Using Silver Nanoparticles as Immunogenic and Adjuvant

Development of Foot and Mouth Disease Vaccine Formulation in Egypt by Using Silver Nanoparticles as Immunogenic and Adjuvant

Relation Analysis of Range of Motion and Motor Ability in Adult with Cerebral Palsy

Studies so far have not clarified the relationship with ROM by directly measuring the motor ability in adult with cerebral palsy, even though ROM is closely related to motor ability. Therefore, the purpose of this study is to reveal the relationship between AROM and motor ability based on the close relationship between ROM and motor ability of cerebral palsy.BR The subjects of this study were 101 adults with cerebral palsy (63 men and 38 women, 36.4±8.9 years old in average age, 162.8±9.6 cm in average height, 59.6±11.2 kg in weight, and 22.5±3.7 kg･m-2 in BMI) using three cerebral palsy welfare centers in Korea.BR The ROM measurement was performed by measuring the AROM (Active Range of Motion), and the items were 25 parts of 7 regions of the whole body. In addition, the motor ability measurements were a total of 10 items of motor ability (grip strength, shoulder strength, sit-up, left-back, and softball throwing) which mainly uses the upper extremities, and 5 items of motor ability (50 m running, side steps, single leg stance, standing long jump and 10 m shuttle run test).BR As a result of analyzing the correlation between AROM and motor ability, significant correlation with all exercise abilities was recognized in the ablation and under burst of foot joints in AROM (p.05). In particular, in the relationship between the bowing of the foot joint and standing long jump, the highest value of all correlation coefficients was shown (p.01). On the other hand, extra-shoulder joint rotation was not recognized to be correlated with all motor skills. In addition, there was less motor ability that showed a significant correlation with neck joint flexion and elongation, intra-shoulder joint rotation, and wrist joint extension. Most of the AROMs of the upper extremity were recognized to have a significant correlation with grip strength, shoulder muscle strength, and trunk forward flexion (p.05). In addition, most of the AROMs in the lower extremities were significantly correlated with sit-ups, convulsions, softball throwing, 50m running, side steps, single leg stance, long jump, and shuttle run test (p.05).BR Taken together, the development of foot and hip AROM among lower limb joints is considered the most important to obtain high motor skills in ambulatory cerebral palsy.

Age-related changes in three-dimensional foot motion during barefoot walking in children aged between 7 and 11 years old

BackgroundThe biomechanical complexity of children’s feet changes throughout childhood, yet kinematic development of the feet is poorly understood. Further work exploring the kinematic profile of children’s feet would be beneficial to help inform our understanding of the typical development of children’s feet. Research QuestionDo three-dimensional segmental kinematics of the feet during gait relate to age in a sample of children age 7–11 years? MethodsThis study was a secondary analysis of an existing database representing one hundred and twenty-one children age 7 – 11 years (90 male, 31 female; mean ± SD: age 9.57 ± , 1.17 years, height 1.37 ± 0.08 m, body mass 35.61 ± 9.33 kg). Fifteen, 9 mm retroreflective markers were attached to the right shank and foot of each participant in, line with the 3DFoot model. Multi-segmental joint kinematics were collected during barefoot walking. Sagittal, frontal, and transverse planar motion was described for the shank-calcaneus, calcaneus-midfoot, and midfoot-metatarsals segment of the right foot. Principal component analysis (PCA) was used to reduce the major modes of variation in the data to fully explore foot segment motion over the entire gait cycle. Correlations and multiple regression between PCA outputs with age, and potential confounding factors are presented. ResultsSignificant positive correlations were found between age and greater calcaneus, dorsiflexion, midfoot inversion and adduction, and metatarsal dorsiflexion, plantarflexion and abduction. There were no significant confounding effects of height, body mass, walking speed or gender on the relationships between age and PCA outputs. SignificanceThe findings from this study demonstrated a relationship between foot kinematics and age suggesting that the development of foot kinematics is ongoing until at least the age of 11 years. This work offers a comprehensive data set of inter-segmental kinematics which helps to advance understanding of the development of the pediatric foot.

Design and Development of Foot Operated Areca-Nut Leaf Plate Manufacturing Machine

Abstract: This paper describes the techniques for design and development of areca-nut leaf plate making machine which uses manual power (foot operated) as the main power source. The primary purpose of this research is the utilization of generally wasted areca-nut leaf sheath for the production of bio-degradable areca-nut leaf plates by the development of machine, which can be operated easily at home. This machine mainly uses mild steel for the development of the parts such as lower and upper die, frame, pedal, connecting links and shafts. The force applied at the pedal is transferred to moving upper die, which then presses the areca-nut leaf sheath placed above the fixed lower die, resulting areca-nut leaf sheath plates within 15 seconds of pressing. Keywords: Areca-nut leaf, Bio degradable, Foot operated

Foot Print Analysis and Prevalence of Flat Foot among Children of Rural India – A Study Protocol

Introduction: Foot shape and its proportions changes gradually during normal growth of human beings, but the mechanical stresses during bipedal locomotion are a key factor for development of foot. To sustain static position and to arrange for stable base while performing various functional activities, Foot plays major role in it. Deformities in lower extremities of children’s are being very common. As this conditions are physiological, that’s why most of the time this conditions do not require treatment. In an average 90% of patient who are visiting to clinic for foot problem are flat foot. Primary manifestation of flat foot is decreasing in longitudinal arch, which shows that while standing or walking, there is transmission of whole body weight towards the medial side of foot sole. This is the main reason for which flat foot is considered as problem of static alignment of foot and ankle structure.
 Objective: To analyze footprint of children and to determine prevalence of flat foot, their anthropometric measurement, Prevalence of structural pathologies of foot and correction of foot prints and radiological evaluation of 8 – 13 years age group of children.
 Methodology: All the visiting patients of orthopedic department of AVBRH of age group 8 – 13 year, with sample size. Examination will be done along with radiological examination, radiological assessment and different anthropometric will include Plain X-ray of both feet.
 Results: We expect that, anthropometric measurements of rural children may differ from other literatures.

The Effects of Altering the Center of Pressure in Standing Subjects Exposed to Foot-Transmitted Vibration on an Optimized Lumped-Parameter Model of the Foot

Many workers are exposed to foot-transmitted vibration, which can lead to the development of vibration-induced white foot: a debilitating condition with neurological, vascular and osteoarticular symptoms. To design effective prevention mechanisms (i.e., boots and insoles) for isolating workers from vibration exposure, continued model development of the foot’s biodynamic response in different positions is necessary. This study uses a previously developed model of the foot–ankle system (FAS) to investigates how altering the center of pressure (COP) location can change the biodynamic response of the FAS to standing vibration exposure. Formerly published experimental responses for apparent mass and transmissibility at five anatomical locations in three COP positions were used to optimize the model. Differences occurred with the Kelvin–Voigt elements used to represent the soft tissues of the foot sole: at the heel, the distal head of the metatarsals and distal phalanges. The stiffness increased wherever the COP was concentrated (i.e., forward over the toes or backward over the heel). The variability of the model parameters was always greatest when the COP was concentrated in the heel. This suggests future FAS models need to more clearly address how the soft tissue of the plantar fat pad is modelled.

Development of Foot and Mouth Disease Vaccine Formulation in Egypt by Using Silver Nanoparticles as Immunogenic and Adjuvant Corresponding author: Name: Rania Dweek, Tel: 01009377501 E-mail : raniadweek@yahoo.com

ABSTRACTObjective: To evaluate the effect of silver nanoparticles (AgNPs) with FMD inactivated oil adjuvant vaccine on immunological response of cattle.Study Design: Randomized clinical trial. Procedures: Silver nanoparticles (AgNPs) were prepared then added to locally produced inactivated trivalent FMD vaccine used in Egypt. Twenty cattle were classified into 4 groups (5 in each group).The first group was vaccinated by FMD trivalent inactivated oil adjuvant vaccine plus AgNPs (3ml subcutaneously), the second group was vaccinated by FMD trivalent inactivated oil adjuvant vaccine (3ml subcutaneously). The third group was vaccinated by FMD trivalent inactivated vaccine plus AgNPs as adjuvant (2ml subcutaneous). The fourth group was injected by AgNPs only (1 ml subcutaneous). Sera samples were collected from all animals groups for measuring humeral immunity by using serum neutralization test (SNT) and cell mediated immunity by using bovine Interleukin 6 (IL-6) at first ,second, third and fourth week for (IL-6 and SNT) and at 2 months and 4 months for SNT.Results: The size of AgNPs by TEM (Transmission Electron Microscope) is ranged from 5.8 to 28.51 nm. Antibody titer by SNT revealed that first group was the highest group reach to protective value at 2 weeks (1.538 log10) and reach to peak at 2 months (2.77 log10). Bovine IL-6 was revealed that animals vaccinated by AgNPs appear more quickly than that vaccinated by FMD inactivated oil adjuvant vaccine. Conclusion: The beneficial effect of AgNPs to potentiate both cellular and humeral immunity against FMD.

Tibial torsion correlates with talar morphology

BackgroundThere is limited literature on axial rotation of the ankle or variations in anatomy of the talus. We aim to evaluate the rotational profile of the distal tibia and its relationship to talus morphology, radiographic foot-type, and tibiotalar tilt in arthritic ankles. MethodsPreoperative imaging was reviewed in 173 consecutive patients with ankle arthritis. CT measurements were used to calculate tibial torsion and the talar neck-body angle (TNBA). Tibiotalar tilt and foot-type were measured on weightbearing plain radiographs. ResultsMeasurements indicated mean external tibial torsion of 29.2±9.1˚ and TNBA of 35.2±7.5˚ medial. Tibiotalar tilt ranged from 48˚ varus to 23.5˚ valgus. A moderate association between increasing external tibial torsion and decreasing TNBA was found (ρ=−0.576, p<.0001). Weak relationships were found between external tibial torsion and varus tibiotalar tilt (ρ=−0.239, p=.014) and plantarflexion of the talo-first metatarsal angle (ρ=−0.218, p<.025). ConclusionWe observed a statistically significant correlation between tibial torsion and morphology of the talus, tibiotalar tilt, and first ray plantarflexion. This previously unreported association may provide information regarding the development of foot and ankle deformity and pathology. Level of evidenceLevel III.

Risk Factors Associated With Foot and Ankle Insufficiency Fractures in Postmenopausal Sedentary Women.

Insufficiency fractures occur in bones with low elastic resistance. In contrast to stress fractures, which affect normal bones and have been extensively studied, insufficiency fractures of the foot and ankle have been the subject of little research. The objective of this study was to identify risk factors associated with the development of foot and ankle insufficiency fractures. The study included 55 postmenopausal sedentary women with foot and ankle insufficiency fractures and 51 women in the control group. The data collected were the fracture site, body mass index, use of corticosteroids, T scores of the femur and lumbar spine measured by bone densitometry, and serum 25-OH vitamin D level. The calcaneal pitch (CP), talar-first metatarsal, and metatarsus adductus (MA) angles were measured on radiographs. In 49 patients (89%), fractures occurred in the metatarsals. All metatarsals were affected, and the most common fracture site was the base of the fifth metatarsal, with 21 cases (33%). Twenty patients (36%) in the study group reported chronic use of corticosteroids and had lower bone mineral density levels than controls (P < .05). The factors associated with fracture development (P < .05) were the CP and MA angles and low lumbar bone mineral density. Insufficiency fractures in this population were associated with low bone mineral density and unfavorable biomechanical characteristics such as pes cavus and metatarsus adductus. Level IIIB, case-control study.

Tibial Torsion May Predict Morphology of the Talus

Category:Ankle Arthritis; Ankle; HindfootIntroduction/Purpose:The role of implant positioning in total ankle arthroplasty (TAA) has garnered increasing attention, particularly in defining coronal and sagittal plane alignment. With the ongoing developments in patient specific instrumentation, advanced imaging is becoming a more common tool in preoperative planning. Despite this, there is limited information available on axial rotation of the ankle or variations in anatomy of the talus and foot. We aim to evaluate the rotational profile of the distal tibia and its relationship to morphology of the talus, as well as assess tibiotalar tilt, in a cohort of end-stage arthritic ankles.Methods:Computed tomography (CT) scans and plain radiographs were reviewed in 59 patients with end-stage ankle arthritis. Patients with previous tibial or ankle trauma were excluded. Scans were obtained prior to total ankle arthroplasty surgery as part of standard preoperative planning protocol. Demographic data was recorded. Measurements were obtained at the posterior condyles of the tibial plateau and transmalleolar axis to calculate tibial torsion, as well as along the talar neck and body to evaluate talar angle. Tibiotalar tilt angle was measured on weightbearing mortise view radiographs. Linear regression was performed to evaluate statistical associations between tibial torsion and other measured parameters.Results:The mean tibial torsion was 29.5±9.2 degrees external (range 13.6-50.8 degrees), no internal torsion was found. Mean talar neck-body angle was 38.2±8.8 degrees medial (range 24.1-59.5 degrees). Tibiotalar angle ranged from 26.5 degrees varus to 23.5 degree valgus. There was a statistically significant relationship between increasing tibial torsion and decreasing talar neck-body angle (r=-0.49, p<0.001), demonstrating more angulation of the talar neck corresponding to the least tibial torsion as seen in Figure 1. No relationship was found between tibial rotation and tibiotalar angle when assessing varus/valgus tilt on a spectrum (p=.89) or when evaluating absolute angulation from neutral (p=.43). Our cohort had a mean age of 63.1±8.2 years, and 54% were male.Conclusion:Our cohort displayed wide variation in axial anatomy of the ankle. Our analysis identifies a statistically significant correlation between tibial torsion and morphology of the talus. This is a previously unreported association that could help understand development of foot and ankle deformity and pathology. While there was no clear correlation to degree of tibiotalar angulation, these axial deformities surely play a role in altered foot and ankle mechanics and the development of end-stage ankle arthrosis. In patients undergoing ankle arthroplasty, these are important parameters for the surgeon to consider in conjunction with other aspects of the hindfoot deformity.

Impacts of previous crops on inoculum of Fusarium culmorum in soil, and development of foot and root rot of durum wheat in Tunisia

Fusarium foot and root rot (FFRR) of cereals, caused by Fusarium culmorum and other Fusarium spp., is one of the most important soil- and residue-borne diseases in Tunisia. Management of the disease relies primarily on cultural practices such as crop rotation. Impacts of previous crops on the population of F. culmorum in the soil, and the incidence and severity of FFRR in durum wheat, were evaluated under Tunisian farming systems. A field trial showed that break crops of faba bean and fenugreek reduced the amount of F. culmorum DNA in soil, by 58% (faba bean) and 65% (fenugreek), and decreased numbers of F. culmorum propagules per g of soil by 83% (faba bean) and 85% (fenugreek). Farm demonstration trials also showed that faba bean and vetch used as previous crops reduced F. culmorum inoculum in the soil. Non-cereal crops also reduced the incidence of F. culmorum present in durum wheat roots and stem bases. The greatest grain yields and thousand kernel weights were recorded when faba bean and vetch were used as previous crops, but were less where durum wheat was previously grown. There were strong correlations between inoculum level of F. culmorum in the soil and incidence of FFRR in the following year. Results obtained in the field trial were supported by those collected from three demonstration farm trials during two cropping seasons. This study demonstrated for the first time in Tunisia and the Mediterranean region that break crops are effective for reducing F. culmorum inoculum in the soil and decreasing the pathogen in wheat roots and stem bases. Inoculum levels in soil can predict the expression of the disease in the following year in Tunisian farming conditions. These results are likely to be useful for developing and implementing guidelines for the management of FFRR of durum wheat.

TL 18206 - Foot and ankle insufficiency fractures among postmenopausal sedentary women

Introduction: Insufficiency fractures occur in bones with decreased elastic strength. In contrast to fatigue or stress fractures, which affect normal bones and have been extensively studied in the literature, foot and ankle insufficiency fractures have been poorly researched to date. The objective of this study was to identify behavioral, biomechanical and metabolic factors associated with the development of foot and ankle insufficiency fractures. Methods: In total, 53 sedentary postmenopausal female patients who had foot and ankle insufficiency fractures and who were treated at the São Paulo State Civil Servant Hospital (Hospital do Servidor Público do Estado de São Paulo) were included in the treatment group, and 53 individuals were included in the control group. Data were collected on fracture site, body mass index (BMI), corticoid use, femoral and lumbar T-score measured by bone densitometry, and serum 25-hydroxyvitamin D level. The calcaneal angle, the angle between the first metatarsal and the talus and the metatarsus adductus angle were measured in radiographs. Results: The fractures affected the metatarsal bones in 47 patients. Other fracture sites included the lateral malleolus, lateral cuneiform bone, cuboid bone, tibia and calcaneus. All metatarsal bones were affected, most frequently the 5th. The most common fracture was a 5th metatarsal base fracture in zone II. There was no significant difference in mean BMI, serum 25-hydroxyvitamin D levels, alcohol consumption or smoking between the groups. The development of fractures was significantly associated with corticoid use (p&lt;0.0001), low femur (p=0.028) and lumbar spine (p=0.002) bone mineral density and metatarsus adductus angle (p=0.02). When analyzed separately, 4th and 5th metatarsal fractures were associated with smaller angles between the talus and the first metatarsal (p=0.01). Conclusion: Foot and ankle insufficiency fractures among sedentary postmenopausal women are associated with corticoid use, low bone mineral density and biomechanical characteristics, such as pes cavus and metatarsus adductus. The presence of such fractures may be the first sign of bone fragility and should be used as criteria for initiating adequate treatment to prevent other fractures.

A parametric study of effect of experimental tibialis posterior muscle pain on joint loading and muscle forces—Implications for patients with rheumatoid arthritis?

BackgroundFoot pain and deformities are commonly encountered in patients with rheumatoid arthritis (RA). Likewise, Posterior tibial tendon dysfunction (PTTD) is commonly involved in development of foot and ankle abnormalities and has been reported with a prevalence in two-thirds of the RA patients. Research questionRedundancy in the physiological function between different muscles provides the central nervous system multiple options to perform the same movement but which muscles compensate for the impairment of the tibialis posterior (TP) muscle? And how does these changes affect ankle joint loading? MethodsExperimental and computational disciplines were applied to investigate changes in muscle forces as result of induced pain in the right TP muscle. Twelve healthy subjects were enrolled in the study. Experimental pain was induced in the TP by a single ultrasound graphically guided injection of 1 mL hypertonic saline (5.0% Sodium Chloride). The participants' gait was assessed by skin marker-based motion capture and force plates. Musculoskeletal models were used to investigate compensation mechanisms systematically in the lower under extremity when TP muscle was recruited less as a consequence of the induced pain. ResultsExperimental TP muscle pain and simulated reduced strength caused altered muscle recruitment and made the flexor digitorum longus and flexor hallucis longus muscles compensated for the impairment of the TP muscle. Further, the resultant ankle joint force was increased as the strength of the TP muscle was reduced. SignificanceThe compensation mechanism observed in the present study indicate that alterations in muscle recruitment and muscle force distribution as a result of the underlying disease inflammation itself may contribute to development of chronic foot pain and deformities in patients with RA. Further studies are required to understand the role of PTTD in occurrence of those late adverse musculoskeletal manifestations aiming at search for early preventive strategies.

Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study

ObjectivesImaging studies in patients with cutaneous psoriasis have demonstrated asymptomatic bone and tendon changes, commonly of the foot and ankle. We sought to determine if patients with cutaneous psoriasis have...

Development of the infant foot as a load bearing structure: study protocol for a longitudinal evaluation (the Small Steps study)

BackgroundAn improved understanding of the structural and functional development of the paediatric foot is fundamental to a strong theoretical framework for health professionals and scientists. An infant’s transition from sitting, through crawling and cruising, to walking is when the structures and function of the foot must adapt to bearing load. The adaptation of skin and other hard and soft tissue, and foot and gait biomechanics, during this time is poorly understood. This is because data characterising the foot tissue and loading pre-walking onset does not exist. Of the existing kinematic and plantar pressure data, few studies have collected data which reflects the real-life activities of infants with modern equipment.MethodsThis is a longitudinal study and part of the Great Foundations Initiative, a collaborative project between the University of Brighton and the University of Salford, which is seeking to improve foot health in children. Two cohorts of 50 infants will be recruited at the two sites (University of Brighton, Eastbourne, UK and University of Salford, Salford, UK). Infants will be recruited when they first reach for their feet and attend four laboratory visits at milestones related to foot loading, with experienced independent walking being the final milestone. Data collection will include tissue characteristics (skin thickness, texture, elasticity, pH and tendon thickness and cross-sectional area), plantar pressures and kinematics captured during real world locomotion tasks.DiscussionThis study will provide a database characterising the development of the infant foot as it becomes a weight bearing structure. The data will allow effective comparison and quantification of changes in structure and function due to maturation and loading by measuring pre and post established walking. Additional variables which impact on the development of the foot (gender, ethnicity and body weight) will also be factored into our analysis. This will help us to advance understanding of the determinants of foot development in early childhood.

Evaluation of the Curvature of the Longitudinal Foot Arch in Children aged 7 and 8 – A Pilot Study

The foot is an essential part of the human body, and a key factor enabling mobility. The proper functioning of the foot depends on its morphological structure and on the proper shape of its arches – transversal and longitudinal. Having in mind that flat feet develop as a succession of different stages, it is important to systematically monitor the development of feet at various phases of a child’s growth. Therefore, this study aims to evaluate longitudinal foot arch curvature in children aged 7 and 8. The study involved 122 children (77 girls and 45 boys) aged 7 and 8 – students of a primary school in Bezrzecze near the city of Szczecin. Body height and weight, and the length and width of the feet were measured. A podoscope was used to determine the curvature of the longitudinal foot arch, which was then expressed on a scale compatible with the Szriter-Gudanow “KY” foot arch curvature index. This non-invasive method enables preventive measures to be taken at critical stages of a child's life. The results for the tested groups of children revealed statistically significant relationships for body height and weight, and the length of the feet between the 7 and 8 year olds. Furthermore, it was observed that the vast majority of the tested children has normal curvature of the longitudinal arch of both the right and left foot.

Growing-up (habitually) barefoot influences the development of foot and arch morphology in children and adolescents

The development of the human foot is crucial for motor learning in children and adolescents as it ensures the basic requirements for bipedal locomotion and stable standing. Although there is an ongoing debate of the advantages and disadvantages of early and permanent footwear use, the influence of regular barefootness on foot characteristics in different stages of child development has not been extensively evaluated. A multicenter epidemiological study was conducted to compare the foot morphology between habitually barefoot children and adolescents (N = 810) to age-, sex- and ethnicity-matched counterparts that are used to wearing shoes. While controlling for confounders, we found that habitual footwear use has significant effects on foot-related outcomes in all age groups, such as a reduction in foot arch and hallux angles. The results indicate an impact of habitual footwear use on the development of the feet of children and adolescents. Therefore, growing up barefoot or shod may play an important role for childhood foot development, implying long-term consequences for motor learning and health later in life.

Status of Research and Development of Foot and Mouth Disease Diagnosis (Review)

Status of Research and Development of Foot and Mouth Disease Diagnosis (Review)

Housing and Demographic Risk Factors Impacting Foot and Musculoskeletal Health in African Elephants [Loxodonta africana] and Asian Elephants [Elephas maximus] in North American Zoos.

For more than three decades, foot and musculoskeletal conditions have been documented among both Asian [Elephas maximus] and African [Loxodonta africana] elephants in zoos. Although environmental factors have been hypothesized to play a contributing role in the development of foot and musculoskeletal pathology, there is a paucity of evidence-based research assessing risk. We investigated the associations between foot and musculoskeletal health conditions with demographic characteristics, space, flooring, exercise, enrichment, and body condition for elephants housed in North American zoos during 2012. Clinical examinations and medical records were used to assess health indicators and provide scores to quantitate conditions. Using multivariable regression models, associations were found between foot health and age [P value = 0.076; Odds Ratio = 1.018], time spent on hard substrates [P value = 0.022; Odds Ratio = 1.014], space experienced during the night [P value = 0.041; Odds Ratio = 1.008], and percent of time spent in indoor/outdoor exhibits during the day [P value < 0.001; Odds Ratio = 1.003]. Similarly, the main risk factors for musculoskeletal disorders included time on hard substrate [P value = 0.002; Odds Ratio = 1.050] and space experienced in indoor/outdoor exhibits [P value = 0.039; Odds Ratio = 1.037]. These results suggest that facility and management changes that decrease time spent on hard substrates will improve elephant welfare through better foot and musculoskeletal health.