Foot Arch Research Articles

Monitoring and evaluation of flat-feet in children of pre-school age and younger school age

Background. The issue of flat-feet in children of pre-school and younger school age has been a frequently discussed issue in recent times. This issue has been addressed in particular with regard to the deteriorating physical fitness and general health of children. The lack of sensory stimuli from the foot causes incorrect development of the arch of the foot, which later becomes apparent in other parts of the support-movement system. Objective. The aim of the study was to monitor the current condition of flat-feet in children. Method. In our study we observed the occurrence of flat-feet in children of pre-school (n:37; age ø: 5,22) and younger school age (n:52; age ø: 7,45). The study enrolled children of pre-school and younger school age between five and nine years of age. We used the examination device Podoscope to examine the condition of the arch of the foot. We used the subjective method Chipaux - Šmířák (CSI) to evaluate the fingerprints. For each child, both feet were always compared. The results were evaluated with descriptive statistics. Results. We found that 70.79% of all children have a normally shaped longitudinal arch on both feet. In the preschool year, the percentage of normal arch on both feet indicates 64.86% of all children. In primary school children, the figure is 73.08%. Among preschool and school age children, there was also a high foot, which was found on both feet in 8 out of 89 children. Flat-foot was found on both feet in 6.74% of the participants. 8.11% of kindergarten children had a flat-foot on both feet. In 5.77% of primary school pupils, a bipedal flat-foot was found. Conclusion. The arch of the foot shapes with age. However, it cannot be said that it always shapes into a physiologically correct shape in every circumstance. In kindergarten children, flat-foot predominates because children attending this facility have not yet had time to fully form the arch. It is necessary to consider which year the children attend. In younger school age pupils, i.e. first to fourth grades, all three types of arch of the foot are present.

Analysis of the influence of side wall opening on the arch structure of metro station using the PBA method

In order to meet the traffic and commercial needs, it is sometimes necessary to open the side wall of the metro station, while the current research on the mechanical properties and safety of the arch caused by the opening of the side wall of the station by pile-beam-arch (PBA) method is rarely involved. In this paper, based on the Tianhe East Station project of Guangzhou Metro Line 11 located in soft-hard uneven stratum using PBA method, the settlement law and mechanical characteristics of the arch under different side wall opening conditions is analyzed, and the influence of opening construction and opening span on the safety of arch is also further studied. The results show that the settlement caused by the opening of the side wall is mainly concentrated in the upper part of the opening area, and gradually expands around the opening area with the increase of opening span, and the maximum settlement occurs in the middle part of the arch. Opening leads to the differential settlement at both ends of the arch. With the increase in opening span, the settlement growth trend of the right side of the arch is greater than that of the left side. The opening of the side wall leads to the increase of the safety factor of the arch body and the decrease of the safety factor of the right arch foot, while the change of the safety factor of the left arch foot is not obvious, and the safety factor meets the specification requirements.

Relationship Between Obesity and Medial Longitudinal Arch Bowing.

There have been reports about the association between obesity and the medial longitudinal arch (MLA) of foot. The purpose of this study is to investigate the change of various parameters related to the MLA according to obesity classification severity by the World Health Organization using weightbearing computed tomography (WBCT). WBCT data of the noninvolved side of patients presenting with unilateral foot and ankle problems or healthy candidates from September 2014 to October 2022 were extracted from a single referral hospital. Forty-four cases in each of 5 obesity classes were selected sequentially. Two orthopaedic surgeons measured foot and ankle offset, forefoot arch angle (FAA), hindfoot moment arm, percentage of uncoverage of the middle facet of the subtalar joint, talonavicular angle (TNA), navicular-medial cuneiform angle, medial cuneiform-first metatarsal angle, talus-first metatarsal angle (TMT1A), first tarsometatarsal subluxation (TMT1S), talonavicular coverage angle, navicular floor distance (NFD), and NFD per height. Positive values indicate plantar collapse. Intra- and interobserver reliabilities were assessed using intraclass correlation coefficients. One-way analysis of variance tests were performed for parametric data with equal variances, and Welch's test for unequal variances. Kruskal-Wallis test was performed for nonparametric data. Post hoc analysis was performed for statistically significant parameters. Correlation analysis between body mass index (BMI) and 12 parameters were performed using Pearson test. Intraobserver and interobserver reliability were excellent, except for TMT1S. The TNA and TMT1A showed a statistically significant difference. FAA (r = -0.2), TNA (r = 0.182), TMT1A (r = 0.296), and NFD (r = -0.173) showed a statistically significant correlation with BMI. In nonsymptomatic feet, we found that the talonavicular joint, as measured by the TNA, to be influenced by obesity classification. Obesity and increased BMI was associated with a negative influence on the MLA. Level III, retrospective cohort study.

Two-Stage Caving Characteristics of Complex Irregular Goaf: A Case Study in China

Different from the goaf formed by normal mining, the goaf formed by the continuous caving of the lower illegal goafs is extremely irregular and unstable, which leads to the difference in the goaf caving characteristics. Taking the complex irregular goaf of the Shirengou Iron Mine in China as the research object, the 3D laser scanning technology is used to detect the goaf shape and analyze the cause of the formation. Then, the caving characteristics of the goaf are analyzed by the methods of the numerical simulation, the monitoring of the crash of the caving rock, and the monitoring of the deformation of the arch foot. The simulation results show that the transverse expansion of the irregular goaf boundary is mainly along the perpendicular to the direction of the ore body strike when the goaf caves upward in the initial stage. Additionally, the monitoring results show that the caving characteristics can be divided into two stages: the paroxysmal caving stage and the periodicity caving stage. The paroxysmal caving characteristics are intense and irregular, while the periodicity caving characteristics have obvious periodicity, which is mainly reflected in the periodic alternation between the mass caving and the temporary stability. The interval period of the goaf mass caving is about 15–30 days and is changed by the progress of filling treatment. The conclusions in this work reveal the particularity of the caving characteristics in the complex irregular goaf and contribute to the improvement of the caving characteristics and the prediction of mass caving.

Effect of Custom Design Insole Applications with 3D Modelling on Baropodometric Parameters in Individuals with Pes Planus

It was aimed to investigate the effect of custom made insoles on baropodometric analysis parameters in individuals with pes planus, using objective measurement and production methods. 100 individuals with pes planus, aged between 4-18 years in the study. Individuals who met the inclusion criteria and the medial longitudinal arch index were included in the study. Valgus angles of individuals, plantar measurements of the feet before the use of insoles and after 6 months of the use of insoles were evaluated with the Sensor Medica®️ device. When the measurement results of the ankle valgus angles of the individuals before and after the insoles were examined, it was observed that there was a statistical decrease in the mean results in both feet (p<0,05). When the plantar pressure results were examined, the load on the medial side of the right foot was reduced significantly (p=0,012). Although there was a decrease in medial longitudinal arch of the right foot, it was not significant. There were no change in the lateral side of the right foot and the medial side of the right rearfoot. The load on the medial left rearfoot and the left medial longitudinal arch were reduced significantly (p=0,004, p=0.021). In study in individuals with pes planus, it was concluded that the foot should be well evaluated before and after technological based applications. Whether the insoles used provide benefits in foot development should be followed up with controls and their suitability should be checked, and changes in their physical capacities should be observed.

Research on the Stability and Support Effect of Earth Section of Hydraulic Tunnel Based on FLAC 3D

The stress of the surrounding rock of hydraulic tunnel can produce a stress load on the lining body, which may cause the crack failure of the lining. The distribution and deformation characteristics play a key role in ensuring the long-term stability of tunnels. Therefore, an analysis of the distribution characteristic is of great significance. This paper takes the branch tunnel in the Yellow River Diversion Project of central Shanxi as an entity for modeling, and uses the finite difference program FLAC3D for analysis and calculation. The research results show that before the support is strengthened, the compressive stress of feet-lock bolts has exceeded the compressive strength of the bolts, with obvious stress concentration at the arch feet; the deformation mainly occurs on the vault and the bottom plate; after strengthening the support, the deformation of the steel arch prop, the axial force of the steel arch prop, and the maximum tensile stress of the anchor rods are all reduced. The stable support effect can meet the requirements of construction and later operation.

BIOMECHANICAL SUBSTANTIATION OF THE ALGORITHM FOR CHOOSING THE OPTION OF DISTAL CORRECTIVE OSTEOTOMY OF THE II–IV METATARSAL BONES IN THE TREATMENT OF METATARSALGIA

Deformations of the front part of the foot with valgus deformity of the first toe lead to a redistribution of the body weight load during walking between the heads of the metatarsal bones. At the same time, the load on the head of II and III, and sometimes IV metatarsal bones increases significantly. Objective. To substantiate the choice of the most correct distal metatarsal osteotomy for the treatment of patients with metatarsalgia. Materials and methods. Three variants of distal metatarsal osteotomy were simulated: Weil, Helal, and distal wedge-shaped metatarsal osteotomy. Result. Weil osteotomy allows you to raise the support point of the metatarsal head above the support surface from 2 to 7 mm, depending on the amount of displacement of the head in the proximal direction and the angle of inclination of the metatarsal bone relative to the plane of the support surface, which effectively reduces the load on the metatarsal head during walking, but under conditions of magnitude the angle of inclination of the axis of the metatarsal bone is more than 20°. Helal osteotomy with the subsequent displacement of the separated part proximally, ensures the lifting of the head above the conventional plane of support from 1 to 4 mm, contributes to the effective unloading of the head while standing and while walking. They are used only for severe metatarsalgia. The range of correction of the standing height of the support surface of the metatarsal head for performing a distal wedgeshaped osteotomy is determined to be from 0.6 to 2.9 mm. Its advantage is the independence of the amount of correction from the presence or absence of a decrease in the longitudinal arch of the foot. Conclusions. Weil osteotomy has the worst corrective possibilities of raising the head of the metatarsal bone, but is very easy to perform, so its use is advisable in the absence of reduction of the longitudinal arch of the foot. A wedge-shaped distal osteotomy has a range of correction of the metatarsal headelevation up to 3 mm, but it depends on its diameter, so it is used in the case of a head diameter of at least 10 mm. Helal osteotomy provides the widest range of elevation of the metatarsal head, which does not depend on the presence of any degree of flat feet, but has some technical limitations.

Simulation of Test Arch Based on Concrete Damage Plasticity Model and Damage Evolution Analysis

In light of the limited research on latent damages during the construction of large-span suspension arches, this study introduced a method to simulate structural damage utilizing random porosity. Initially, based on data from real-world engineering projects, the most susceptible areas within the arch structure were pinpointed. Subsequently, multiple test arch simulation models were constructed. Employing Python, commands for random porosity were implemented within ABAQUS and distinct mesh modules were devised to depict structures under varying degrees of damage. The current investigation delved into the structural responses of these susceptible areas under different damage rates, shedding light on damage progression patterns. Notably, our findings demonstrated that concealed damages on the top plate of the arch foot profoundly influenced structural integrity, whereas damages at the arch hance were comparatively minimal and predominantly manifest at the arch base. The pronounced localized damage at both the arch base and hance initiated and intensified at sectional corners, necessitating enhanced anti-crack measures in these regions. Moreover, depending on the stresses of the arch structure, diverse reinforcement strategies could be employed, optimizing the balance between load-bearing efficiency and cost considerations.

Comparing Symptomatic and Asymptomatic Flatfeet Using Known Markers of Progressive Collapsing Foot Deformity (PCFD): A Case Control Study

Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: Flattening of the longitudinal arch of the foot (Flatfoot) can represent a normal spectrum of foot morphology and alignment. The issue comes when the foot is collapsing progressively, what is now termed Progressive Collapsing Foot Deformity (PCFD). Literature on asymptomatic flatfoot is scarce since asymptomatic patients do not seek medical attention. Alignment differences between asymptomatic flatfoot and PCFD have not been established and might represent a key-step in understanding predictors of PCFD. The objective of this prospective study was to compare established PCFD measures in a cohort of asymptomatic flatfoot, PCFD patients and healthy controls. We hypothesized that asymptomatic flatfeet alignment would differ from both symptomatic PCFD patients and healthy controls. Methods: In this prospective comparative study, patients with asymptomatic flatfeet were recruited to undergo a weight-bearing CT (WBCT) scan. This cohort (22 feet, 10 males, 12 females) was compared to two other prospective cohorts (22 symptomatic PCFD and 22 healthy controls). Along with demographic data, PCFD measurements performed include Foot and Ankle Offset (FAO), Forefoot Arch Angle (FAA), Middle Facet Uncoverage, and the Transverse Arch Plantar (TAP) angle. Normality of variables was assessed using the Shapiro-Wilk test. Chi-squared or analysis of variance (ANOVA) test was performed to compare each parameter between the three groups. A post-hoc Bonferroni test was then performed to assess significance between each group pairing. P-values of >0.05 were considered significant. Results: All three groups were comparable on BMI (p=0.10), Age (p=0.75) and Gender (p=0.78). All measurements taken differed significantly between the symptomatic PCFD and healthy controls (Table 1). FAO was significantly different between controls vs asymptomatic (p < 0.001) and asymptomatic vs symptomatic (p < 0.001). FAA was also significantly different between asymptomatic and both symptomatic (p=0.001) and control groups (p=0.001). Middle facet uncoverage differed between the asymptomatic and control group (p=0.001) but the asymptomatic and symptomatic group were similar (p=0.106). While the TAP angle was significantly different between asymptotic and symptomatic groups (p=0.013), the asymptomatic and control groups failed to reach significance (p=0.061) (Table 1). On average, deformity measurements for asymptomatic flatfeet were in between the values for healthy controls and symptomatic PCFD (Figures 1-3). Conclusion: To our knowledge this is the first prospective study to compare healthy controls, asymptomatic flatfoot and symptomatic PCFD patients. We observed that asymptomatic flatfoot patients usually had measurements of PCFD that would fall in between normal alignment asymptomatic controls and symptomatic PCFD patients. Further, the asymptomatic group differed significantly from both other groups on every measure but two. Our data supports the idea that asymptomatic flatfoot should be considered a risk factor for Progressive Collapsing Foot Deformity. Our data can hopefully shine light in finding predictive markers for the development of PCFD.

The Importance of Rebalancing Foot Biomechanics by Computerized Podoscopic Assessment - Study in Charcot Marie Tooth Syndroms

Abstract Charcot–Marie–Tooth disease (CMT) is one of the hereditary motor and sensory neuropathies, a group of varied inherited disorders of the peripheral nervous system characterized by progressive loss of muscle tissue and touch sensation across various parts of the body. Currently incurable, this disease is the most commonly inherited neurological disorder, and affects about one in 2,500 people. A CMT diagnosis involves clinical evaluation of muscle function and atrophy, testing of sensory responses, and electromyography and nerve conduction studies. Often, the most important goal for patients with CMT is to maintain movement, muscle strength, and flexibility. Therefore, an interprofessional team approach with occupational therapy, physical therapy, orthotics, podiatrist, and orthopedic surgeon is recommended. Physical therapy should be involved in designing an exercise program that fits a person’s personal strengths and flexibility, but also in a god evaluation podoscopic assessment. Due to the lack of good sensory reception in the feet, CMT patients need to see a physical therapist in order to stabilize their feet or correct progressive problems by rebalancing the biomechanics of the foot. The procedure involves a computerized assessment, the realization of the plant footprint in the foam and the creation of plantatory therapeutics on the mold. These plantar orthoses help control foot drop and ankle instability and often provide a better sense of balance for patient. Appropriate footwear is also very important for CMT case, but often with difficulty finding well-fitting shoes because of their high arched feet and hammer toes. The patient will use these plantatory proponents in the right shoes in order to: increase of planting support surface, reduction of varus, slowing down the retraction tendency of plant aponeurosis

Three-Dimensional Analysis of Windlass Mechanism Using Loading Computed Tomography in Patients With Hallux Rigidus and Healthy Volunteers

Category: Midfoot/Forefoot; Basic Sciences/Biologics Introduction/Purpose: The windlass mechanism (WM) increases the height of the medial longitudinal arch (MLA) of the foot by tensing the plantar aponeurosis during dorsiflexion of the metatarsophalangeal (MTP) joint. We speculated that this mechanism may be deeply involved in the pathogenesis of forefoot diseases such as hallux rigidus (HR). These conditions are three- dimensional (3D) deformities including rotational deformity, but the role of the WM has been evaluated only two-dimensionally by measuring the height of the navicular on lateral plain radiographs. The purpose of this study was to analyze in detail the WM of normal and HR feet in 3D. Methods: Participants were 14 patients with HR (17 feet) and 13 volunteers (21 feet). The volunteers had no history of foot disease or trauma, whereas the patients with HR had Coughlin and Shurnas classification I or II. Computed tomography (CT) of the foot with a load equivalent to the participant’s body weight was performed. Imaging was performed with the 1st MTP joint in the neutral position and dorsiflexed 30 degrees. 3D models were created using the software Mimics Research 17.0. Next, we used the iterative closest point (ICP) algorithm, which allows 3D objects to be superimposed without specifying anatomical feature points. Then, we performed 3D measurements of the (1) rotation of each bone in the MLA with respect to the tibia, (2) rotation of the distal bone in each joint of the MLA, and (3) changes in the height of the geometric center of the navicular. Results: At the calcaneus, navicular and medial cuneiform, the HR group showed less inversion, adduction than healthy group. (P < 0.05) At the talonavicular joint, the navicular was 3.7° inversion, 2.9° adduction in the healthy group and 2.4°inversion, 1.3° adduction in the HR group. At the talocalcaneal joint, the calcaneus was 1.7° inversion, 1.5° adduction in the healthy group and 0.9°inversion, 0.6° adduction in the HR group. In the talonavicular and talocalcaneal joint, the HR group showed less inversion and adduction than control. (P < 0.05) With dorsiflexion of the hallux, the height of the navicular increased by 2.1 mm in the healthy group and 1.3 mm in the HR group. There was a significant difference (P < 0.05) between the two groups. Conclusion: In both groups, the calcaneus, navicular, and medial cuneiform bones moved not only in the sagittal plane but also in the frontal plane. But the movement of the talonavicular and talocalcaneal joints and the change in height of the navicular were significantly reduced compared with the healthy group. In other words, in the HR group, the motion of the midfoot and hindfoot was limited, suggesting that there may be a close relationship between WM dysfunction and midfoot and hindfoot motion. This study indicates that the dysfunction of the WM may have been a clue to the cause of HR.

Research on Mechanical Characteristics and Load-bearing Behavior of Nodes of Steel Fiber Concrete Arch Bridges

Steel fiber reinforced concrete (SFRC) is a new type of composite material formed by dispersing discontinuous short steel fibers in a uniform and random direction throughout the concrete, which has excellent properties of tensile, shear and high toughness, can effectively improve the load-bearing capacity of arch bridges. In this paper, the mechanics of SFRP in the nodal structure of an arch bridge is initially explored by means of indoor model tests and numerical simulation studies. The results show that the maximum principal tensile stress occurs at the intersection of arch rib, arch foot and tie beam, and the maximum principal compressive stress occurs at the connection between arch rib and arch seat, which should be considered in the design. In this paper, we hope to understand the characteristics of the force and bearing capacity of this type of structure to provide a reference for similar projects.

A Bio-Inspired Arched Foot with Individual Toe Joints and Plantar Fascia.

This paper presents the design and testing of an arched foot with several biomimetic features, including five individual MTP (toe) joints, four individual midfoot joints, and plantar fascia. The creation of a triple-arched foot represents a step further in bio-inspired design compared to other published designs. The arched structure creates flexibility that is similar to human feet with a vertical deflection of up to 12 mm. The individual toe joints enable abduction-adduction in the forefoot and therefore a natural pronation motion. Adult female bone data was obtained and converted into a CAD model to accurately identify the location of bones, joints, and arches. An analytical model is presented that gives the relationship between the vertical stiffness and horizontal stiffness of the longitudinal arches and therefore allows the optimization of stiffness elements. Experimental tests have demonstrated a vertical arch stiffness of 76 N/mm which is similar to adult human feet. The range of movement of the foot is similar to human feet with the following values: dorsi-plantarflexion (28°/37°), inversion-eversion (30°/15°), and abduction-adduction (30°/39°). Tests have also demonstrated a three-point contact with the ground that is similar to human feet.

Impact of pronated foot on energetic behavior and efficiency during walking

BackgroundThe longitudinal arch of the foot acts like a spring during stance and contributes to walking efficiency. Pronated foot characterized by a collapsed medial longitudinal arch may have the impaired spring-like function and poor walking efficiency. However, the differences in the energetic behavior during walking between individuals with pronated foot and neutral foot have not been considered. Research questionHow does the energetic behavior within the foot and proximal lower limb joints in pronated foot affect walking efficiency? MethodsTwenty-one healthy young adults were classified into neutral foot and pronated foot based on the Foot Posture Index score. All subjects walked across the floor and attempted to have the rearfoot and forefoot segments contact separate force plates to analyze the forces acting on isolated regions within the foot. Kinematic and kinetic data were recorded by a three-dimensional motion capture system. The hip, knee, ankle, and mid-tarsal joint power was quantified using a 6-degree-of-freedom joint power method. To qualify total power within all structures of the foot and forefoot, we used a unified deformable segment analysis. Additionally, we calculated the center of mass power to quantify the total power of the whole body ResultsThere is no difference in the mid-tarsal joint work between the pronated foot and neutral foot. On the other hand, pronated foot exhibited greater net negative work at structures distal to the forefoot during walking. Additionally, pronated foot exhibited less net positive work at the ankle and center of mass during walking compared to neutral foot. SignificanceIndividuals with pronated foot generate the mid-tarsal joint work by increasing the work absorbed at structures distal to the forefoot, which results in reduced energy efficiency during walking. That energy inefficiency may reduce positive work at the ankle and affect the walking efficiency in individuals with pronated foot.

An Analysis of Foot Morphology Using a Self-Designed Foot Scanner in Preparing Custom-Made Footwear: An Anatomical Approach

Foot morphology and morphometry knowledge is vital in several domains. 60% of the population has foot pain due to ill-fitting footwear. There is no standard device or parameters to evaluate the arches of the foot, and most of the research to assess the arches of the foot. Aim of the study: The study aimed to develop a hodoscope (foot scanner) device to evaluate the arches of the foot. The study's objective was to prepare custom–made footwear based on foot morphology. The study included 849 (405 males and 444 females) participants aged between 25 and 45. Podoscope was used to evaluate the arches of the foot. Based on the evaluation, 62 participants were provided with custom-made footwear based on the morphometry of the foot. The statistical analyses were performed using SPSS software. Wilcoxon Signed Ranks Test was used to analyze the pain scale based on positive ranks, with a statistically significant p-value (< 0.001). Results: 44.19% of men and 47.97% of women had a normal arch foot. 33.08% of men and 28.82% of women had a flat arch, and 22.71% of men and 23.19% of women had a high arch foot. The present study identified foot problems (forefoot, midfoot and hindfoot) using a self-designed podoscope and attempted to design custom–made footwear based on foot morphometry. The quality of the footwear was acceptable and cost-effective. Custom-made footwear based on foot morphology will benefit individuals with foot problems. KEYWORDS: Foot Morphology, Self-Designed Foot Scanner, Custom-Made Footwear, Podoscope.

A foot structure study of new arch flexibility grading system based on three-dimensional arch volume

PurposeDifferent arch structures may cause different foot function injuries. In the past, the arch structure and flexibility of the foot were often defined by the height of the arch, and there was no three-dimensional (3D) structure classification method. In order to form a more complete 3D description, we propose a new classification system of arch volume flexibility (AVF), and then use this new classification system to investigate the relationship between the AVF and arch index (AI), and the arch height flexibility (AHF) and AI, respectively. MethodsIt is proposed to recruit 180 young male adults for the test. We obtained arch volume and AI through 3D scanning and obtained the navicular height through manual measurement. Based on these data, we calculated the AHF and the AVF. Using the quintile method, these arches are divided into very stiff, stiff, neutral, flexible, and very flexible. According to AI value, all arches were divided into cavus, rectus, and planus. The distribution of AVF was compared using χ2 goodness of fit test. The spearman correlation test was used to compare the AHF and AVF. A p < 0.05 indicates that the difference is statistically significant. ResultsAll participants' plantar data was obtained through 3D scanning, but only 159 of them were complete, so only 318 feet had valid data. The left AHF is (21.23 ± 12.91) mm/kN, and the right AHF is (21.71 ± 12.69) mm/kN. The AVF of the left foot arch is (207.35 ± 118.28) mm3/kg, while the right one is (203.00 ± 117.92) mm3/kg, and the total AVF of the arch was (205.17 ± 117.94) mm3/kg. There was no statistical difference in the AVF between the left and right feet for the same participant (n = 159, p = 0.654). In cavus, the percentage of arch with AVF is 21.4% (very stiff), 21.4% (stiff), 14.3% (neutral), 7.1% (flexible), and 35.7% (very flexible). In rectus, the percentage of arch with AVF is 23.9% (very stiff), 19.6% (stiff), 14.7% (neutral), 24.5% (flexible), and 17.2% (very flexible). In planus, the percentage of arch with AVF is 14.9% (very stiff), 20.6% (stiff), 27.0% (neutral), 16.3% (flexible), and 21.3% (very flexible). Moreover, the correlation between AHF and AVF is not significant (p = 0.060). ConclusionIn cavus, rectus, and planus, different AVF accounts different percentage, but the difference is not statistically significant. AVF is evenly distributed in the arches of the feet at different heights. We further found the relationship between AHF and AVF is not significant. As a 3D index, AVF may be able to describe the flexibility of the arch more comprehensively than AHF.

Foot length – A reliable predictor of posterior tibial tendon thickness: A cadaveric study

BackgroundTibialis posterior tendon, deltoid ligament and spring ligament are the three most important structures on the medial aspect of the foot. They contribute to the stability of the foot and ankle and also to the maintenance of the arches of the foot. These structures get affected and dimensions get disrupted in various traumatic and degenerative conditions. Normal range of dimensions of these structures has not been studied in an Indian population. Our objective is to define the normal thicknesses of these structures using a cadaveric model. We also hypothesize that longer the foot, higher stresses on these structures and hence thicker they will be. We aim to assess this hypothesis as well. MethodsDissection of the medial aspect of the foot was done on twenty cadaveric below knee specimens. Tibialis posterior tendon was identified and its thickness was measured. Deltoid and plantar calcaneonavicular ligaments were identified. Their lengths and thicknesses were measured. Length of the feet was also measured prior to dissection. Statistical analysis was done using the data obtained. ResultsMean tibialis posterior thickness was 7.0165 ± 0.387 mm. Mean deltoid thickness was 5.124 ± 0.28 mm. Its mean length was 21.328 ± 2.22 mm. Mean plantarcalcaneonavicular ligament thickness was 2.491 ± 1.120 mm. Thicknesses of the tibialis posterior tendon and plantarcalcaneonavicular ligament correlated significantly with the length of the foot. ConclusionThe thicknesses of the tibialis posterior tendon and plantar calcaneonavicular ligament are shown to be a function of and significantly proportional to the length of the foot. This helps the surgeon to estimate the thicknesses which the structures had prior to the pathology, in order to recreate the non-pathological anatomy after a tendon transfer or a reconstruction procedure. The normal thicknesses of tibialis posterior, deltoid and plantar calcaneonavicular ligaments are described for an Indian setting and deviations can be used to assess various pathologies of the foot and ankle affecting these structures.

Effect of Various Conventional Treatments on Plantar Fasciitis: A Brief Review

Plantar fasciitis is a painful ailment caused by inflammation of the plantar fascia characterised by heel pain. Plantar fasciitis is a degenerative syndrome of the plantar fascia caused by recurrent trauma to the calcaneus. The plantar fascia is a thick, multilayered fibrous connective tissue on the sole of the foot that aids in the creation of the longitudinal arch of the foot. It dynamically stabilises the medial longitudinal arch, restores the arch and helps in reconfiguration of the foot for efficient toe-off. Also, it provides static support to the longitudinal arch as well as dynamic shock absorption. The characteristic PF discomfort is localised around the medial tubercle of the calcaneus and arises after the first few steps in the morning or after a lengthy period of non-weight bearing activities. Standing or walking causes pain and tenderness on the sole of the foot, particularly under the heel. Keywords: plantar fasciitis, heel pain, Muscle stretching exercises, gluteal muscle strengthening

Effectiveness of neuromuscular taping on balance, proprioception, pain, and nerve conduction parameters in patients with diabetic peripheral neuropathy: a two-group pretest-posttest randomized sham-controlled trial study protocol.

The management of diabetic peripheral neuropathy (DPN) comprises a multidimensional approach. Along with pharmacological treatment, physiotherapy has gained applaudable popularity in improving the symptoms of DPN. Neuromuscular taping (NMT) is effective in improving motor, sensory, and balance impairments in many neuromuscular and musculoskeletal conditions but no research has conducted to evaluate the effect of NMT on balance, proprioception, pain, and nerve conduction parameters in patients with DPN. To evaluate the effectiveness of NMT on balance, proprioception, pain, and nerve conduction parameters in patients with DPN. 50 DPN patients aged 40-60 years, scored ≥ 2/13 on physical appearance and ≥ 1/10 on physical examination of Michigan Neuropathy Screening Instrument (MNSI), > 12 on Leeds Assessment of Neuropathic Symptom and Sign (LANSS) scale and < 45 on Berg Balance Scale (BBS) will be included. The experimental group (EG) will receive NMT at the tibialis anterior, tibialis posterior, and peroneus longus muscle and transverse arch of the foot and TENS at the tibial and peroneal nerves (80Hz, 50 Amp, 0.2 ms square pulses, 2 to 3 times sensory threshold) and the control group (CG) will receive sham taping at the ankle joint and TENS with the same parameters as EG. Outcome measures will be taken at baseline, at 4 weeks, and at 8 weeks of intervention, respectively. The results obtained upon completion of this study may provide a cost-effective non-invasive treatment option to improve the outcomes that will be measured in the present study in patients with DPN. The online version contains supplementary material available at 10.1007/s40200-023-01275-5.

Mixed Comparison of Intervention with Assistive Devices for Plantar Pressure Distribution and Anatomical Characteristics in Adults with Pes Cavus: Systemic Review with Network Meta-Analysis

Background: Pes cavus is a multiplanar foot deformity with an abnormal plantar pressure distribution and an overhigh medial longitudinal arch (MLA). Its causes are complex. In the past, people have usually focused on clinical surgery for pes cavus. However, this is not necessarily the best choice for some patients with non-ongoing or mild symptoms. In the 21st century, studies have just begun to focus on assistive devices intervention for pes cavus, which has been proven to be an effective non-surgical treatment. However, the effectiveness of assistive devices for patients with arched feet of any etiology has not been evaluated and evidence-based guidelines for clinical treatment options are lacking. Methods: A systematic review and network meta-analysis were performed, employing a comprehensive search across the databases of Web of Science, PubMed, as well as Scopus. The selected studies adhered to specific eligibility criteria, which included: (1) involving patients with pes cavus; (2) interventions with assistive devices; and (3) outcome measures of plantar pressure distribution and anatomical characteristics (MLA). Meanwhile, the standard mean difference was selected as the effect size. Results: A total of three studies were selected, and the authors achieved an agreement on the risk of bias with a kappa value equal to 0.74. According to the results of network meta-analysis, customized foot orthotics compared to other devices (lace-up ankle-support brace, semirigid brace) demonstrated the highest likelihood of being the most effective in optimizing plantar-pressure distribution among pes cavus patients. On the other hand, wearing hard custom foot orthotics compared to other devices (soft custom foot orthotics, off-the-shelf orthotics) showed the greatest potential in improving the medial longitudinal arch (MLA) of pes cavus patients. Discussion: Although becoming better than wearing regular footwear, wearing lace-up ankle-support braces or semirigid braces might not be optimal choices for treatments of pes cavus with the potential mechanism that the internal force created by the fixation of the proximal joint might be much less than the ground reaction force loaded on the distal segments that touch the ground. It could be concluded that foot orthotics show great potential in treating pes cavus under non-surgical conditions. This systematic review could provide valuable evidence for future research and clinical practice. Other: The PROSPERO Registration Number is CRD42022349687.