Longitudinal Arch Research Articles

Pneumatic Plantar Stimulation Device Replicating Manual Therapy Improves Lateral Stability in Standing Posture

Strokes are a widespread condition characterized by motor paralysis and sensory impairment, and they significantly hinder daily activities. Hence, rehabilitation aimed at improving motor function is crucial for post-stroke patients. Manual therapy, which involves the manual stimulation of the limbs to provide sensory input and enhance motor function, is commonly employed for rehabilitation. However, the limited duration of inpatient rehabilitation highlights the need for devices that can provide similar rehabilitation interventions at home. Here we elucidate the skills employed by physical therapists during intervention through interviews and measurements of the force applied to the plantar surface of the foot. Subsequently, we develop a device capable of replicating these intervention skills. The investigation of physical-therapist skills revealed the importance of stimulating the muscles involved in forming the longitudinal and transverse arches and the flexor muscles of the toes during manual therapy. The required force for stimulation was also noted. Using our device, which utilized pneumatic actuation to replicate therapist skills, intervention on the plantar surface of the feet of healthy adults demonstrated improved stability in their standing posture, particularly in the lateral direction. These devices can enhance the sensory-motor connection from the plantar surface, thereby improving motor abilities, such as preventing falls.

Comparison of anthropometric measurements related to the medial longitudinal arch of feet between non-dancers and Bharatnatyam dancers- an observational study

BackgroundBharatnatyam is an Indian classical dance form that involves rhythmic barefoot tapping at varying speeds. The intense impact forces generated during this dance can result in biochemical alterations in the feet, potentially causing injuries to ligaments, tendons, and fascia. This can lead to changes in the structure of the foot over time. Therefore, this study was conducted to compare anthropometric measurements related to the medial longitudinal arch of the foot in non-dancer, mid-stage, and last stage Bharatnatyam dancers. MethodsThe study was conducted on 192 participants. They were divided into three groups: 1) Non dancers 2) Mid-stage Bharatnatyam dancers, and 3) Last-stage Bharatnatyam dancers. Each group consisted of 64 participants each. Various measurements were taken on both the right and left foot using a wooden platform, foot image, and footprint. Later the results were analyzed statistically. ResultsOn comparing the parameters in non-dancers and mid-stage Bharatnatyam dancers it was found that all the parameters were found to be significant except right and left arch index. On comparing the parameters of mid-stage and last-stage Bharatnatyam dancers, it was found that none of the parameters showed significant value. On comparing the non-dancers and last-stage Bharatnatyam dancers, it was found that except right and left arch index all the parameters were found to be significant. ConclusionFrom the results of the present study, it can be concluded that there were significant changes in the arches of the foot between the non-dancers and mid-stage and last-stage Bharatnatyam dancers.

Mesenchymal chondrosarcoma of the foot salvaged by sensate chimeric anterolateral thigh free flap

Mesenchymal chondrosarcoma is a rare, aggressive sarcoma of bone or soft tissue with a high risk of hematogenous spread, leading to significant morbidity and mortality. Surgical resection is the standard treatment for localized cases. Addressing the limited data, we present a case of localized mesenchymal chondrosarcoma in the foot, where upfront surgery risked sacrificing the medial longitudinal arch crucial for weight-bearing. The patient received neoadjuvant chemotherapy and underwent limb salvage surgery using a sensate chimeric anterolateral thigh flap to preserve functionality.

Adaptive Changes in Longitudinal Arch During Long-distance Running.

This study investigates the biomechanical adaptations of the longitudinal arch (LA) in long-distance runners, focusing on changes in stiffness, angle, and moment during a 60-minute run. Twenty runners participated in this experiment, and were asked to run at a speed of 2.7 m·s-1 for 60 minutes. The kinematic and kinetic data collected at five-minute intervals during running were calculated, including the stiffness of LA in the loading phase (k load ) and the stiffness of LA in the unloading phase (k unload ), the maximum LA moment (M max ), the range of LA angle change (∆θ range ), and the maximum LA angle change (∆θ max ). Foot morphology was also scanned before and after running. Variations of kinematic and kinetic data were analyzed throughout the running activity, as well as variations of foot morphology pre- and post-run. Results showed that there was a significant decrease in k load (p<0.001), coupled with increases in ∆θ range (p=0.002) and ∆θ max (p<0.001), during the first 15 minutes of running, which was followed by a period of mechanical stability. No differences were found in k unload and M max throughout the running process and the foot morphology remained unchanged after running. These results highlight a critical adaptation phase that may be pivotal for improving running economy and performance.

Influence of the transverse tarsal arch on radiological components of progressive collapsing foot deformity.

The importance of the transverse tarsal arch (TTA) has recently been extensively reevaluated and has even been considered to play a greater role in foot stability than the medial longitudinal arch (MLA). However, the relevance of this observation in the context of common clinical foot disorders, such as progressive collapsing foot deformity (PCFD), has not yet been fully clarified. In this biomechanical study, we examined ten pairs of human cadaveric feet by serial weight-bearing cone-beam computed tomography under controlled loading using a custom-designed testing machine. The MLA and TTA were transected separately, alternating the order in two study groups. A semiautomated three-dimensional evaluation of their influence on three components of PCFD, namely collapse of the longitudinal arch (sagittal Meary's angle), hindfoot alignment (sagittal talocalcaneal angle), and forefoot abduction (axial Meary's angle), was performed. Both arches had a relevant effect on collapse of the longitudinal arch, however the effect of transecting the MLA was stronger compared to the TTA (sagittal Meary's angle, 7.4° (95%CI 3.8° to 11.0°) vs. 3.2° (95%CI 0.5° to 5.9°); p = 0.021). Both arches had an equally pronounced effect on forefoot abduction (axial Meary's angle, 4.6° (95%CI 2.0° to 7.1°) vs. 3.0° (95%CI 0.6° to 5.3°); p = 0.239). Neither arch showed a consistent effect on hindfoot alignment. In conclusion, weakness of the TTA has a decisive influence on radiological components of PCFD, but not greater than that of the MLA. Our findings contribute to a deeper understanding and further development of treatment concepts for flatfoot disorders.

Step width modification to change rearfoot eversion and medial longitudinal arch angle during walking and running in individuals with pronated feet

BackgroundIndividuals with pronated feet often experience altered foot biomechanics, leading to increased risk of lower limb injuries. Step width modification has been proposed as a potential intervention to improve foot alignment during gait. Research questionDoes modifying step width influence rearfoot eversion and medial longitudinal arch angle (MLAA) in individuals with pronated feet during walking and running? MethodsTwenty individuals with pronated feet underwent analysis during walking and running on treadmill, maintaining increased or decreased step width using real-time visual feedback. Three-dimensional motion analysis measured rearfoot eversion and MLAA during the stance phase of gait. ResultsWide step width significantly reduced peak rearfoot eversion during waking (mean difference — with normal step width — (MD) = 3.6°, p < 0.001) and running (MD = 4.4°, p < 0.001), time to peak rearfoot eversion during walking (MD = 16.6 p < 0.001) and running (MD = 13.8°, p = 0.014), rearfoot eversion at touch down (TD) during walking (MD = 1.3°, p = 0.004), rearfoot eversion excursion during running (MD = 4.3°, p < 0.001), and peak MLAA during walking (MD = 2.9°, p = 0.006) and MLAA excursion during running (MD = 4.8°, p = 0.004).By contrast, during running, narrow condition significantly increased peak rearfoot eversion (MD = 3.4°, p < 0.001). During walking, time to peak rearfoot eversion (MD = 16.1, p < 0.001), rearfoot eversion at TD (MD = 1.4°, p = 0.008), rearfoot eversion excursion (MD = 5.9°, p < 0.001), and peak MLAA (MD = 3.4°, p < 0.001) were significantly increased. SignificanceThis study highlights the potential of step width modification as a simple yet effective intervention to improve foot biomechanics in pronated feet individuals during walking and running. Further research could lead to the development of personalized strategies for pronated feet individuals.

Assessment of correctness of foot shape and correlations with anthropometric indicators and the centre of body gravity in preschool children

Introduction and objective: Preschool and early school age plays an important role in shaping the foot and posture in children. The aims of the study were to assess the correctness of foot shape in preschool children and to determine possible correlations with age, gender, waist-to-height ratio (WHtR) and body mass index (BMI), and the centre of body gravity. Materials and methods: A study of feet and anthropometric parameters was carried out in children aged 4–6 years. Foot examination was performed using a podoscope and a strain gauge platform, while body weight was assessed using a Tanita device. Body weight, height, Clarke’s angle, centre of gravity, and WHtR were analysed. Results: There were no statistically significant differences in the value of the Clarke’s angle between the left and right feet in both girls and boys, regardless of the age group. The BMI did not correlate statistically with the results of the Clarke’s angle measurements, both for all the subjects and taking into account their age. The BMI value was statistically significantly correlated with the centre of body gravity due to the correct WHtR. Conclusions: The study confirmed that the longitudinal arch of the foot shows no clear sexual dimorphism. The BMI and Clarke’s angle were not dependent on each other in the study group. The study showed no changes in the centre of body gravity in relation to the children’s body shape.

High Medial Longitudinal Arch of the Foot and Latent Trigger Points in Lower Limb Muscles.

Background: The objective was to evaluate the prevalence of latent trigger points (LTrPs) in lower limb muscles in participants with a high medial longitudinal arch (MLA) of the foot compared to controls. Methods: Participants with a navicular drop test of 4-9 mm were included in the control group; the high MLA group included navicular drop test values of ≤4 mm. The presence of LTrPs was assessed by palpation techniques. The muscles evaluated were medial gastrocnemius (LTrP1), lateral gastrocnemius (LTrP2), soleus (LTrP1), peroneus longus, peroneus brevis, tibialis anterior, extensor digitorum longus, flexor digitorum longus, rectus femoris, vastus medialis (LTrP1 and LTrP2), and the vastus lateralis of the quadriceps (LTrP1 and LTrP2). Results: Thirty-seven participants with high MLA and thirty-seven controls were included in the study. Twenty-nine (78.4%) participants in the high MLA group had at least 1 LTrP, compared to twenty-three (62.2%) in the control group. No statistical difference (p < 0.05) was found in the total number of LTrPs between groups (4.46 ± 3.78 vs. 3.24 ± 3.85). There were more participants (p < 0.05) with LTrPs in the tibialis anterior, extensor digitorum longus, and vastus lateralis (LTrP1 and LTrP2) in the high MLA group than in the control group. Conclusion: Although no differences were found in the number of total LTrPs between groups, the prevalence was statistically significantly higher in the tibialis anterior, extensor digitorum longus, and vastus lateralis of the participants with high MLA of the foot.

Effect of orthopedic insoles on lower limb motion kinematics and kinetics in adults with flat foot: a systematic review.

Flatfoot is characterized by the collapse of the medial longitudinal arch, eversion of the rearfoot and abduction of the loaded forefoot. Orthopedic insoles are the frequently recommended treatment to support the arch of the foot, adjust the structure of the foot, reduce pain, improve stability and new techniques have been applied to the design of orthopedic insoles in recent years. However, the effectiveness of orthopedic insoles in different motions is still debated from the perspective of biomechanics. Therefore, this study aimed to explore the impact of orthopedic insoles on the kinematics and kinetics of lower limb motion, and to verify effectiveness and propose possible future research directions. We conducted a literature search across three databases employing Boolean operations and filtered results based on eligibility criteria. A total of 671 relevant literature were searched in this review, and 19 literature meeting the requirements were finally included. The results showed that: 1) orthopedic insoles were effective when patients walk, run and jump from the perspective of biomechanics; 2) orthopedic insoles had different result on the change of ankle sagittal angle, moment and peak pressure in the metatarsal region; 3) Whether the effect of insoles, which uses new techniques such as different 3D printed technologies and adds various accessories, can be further improved remains to be further studied; 4) Follow-up studies can pay more attention to the differences between diverse populations, increase the breadth of running and jumping and other movements research and long-term intervention.

Effect of forefoot transverse arch stiffness on foot biomechanical response--based on finite element method.

The plantar vault, comprising the transverse and longitudinal arches of the human foot, is essential for impact absorption, elastic energy storage, and propulsion. Recent research underscores the importance of the transverse arch, contributing over 40% to midfoot stiffness. This study aimed to quantify biomechanical responses in the ankle-foot complex by varying the stiffness of the deep metatarsal transverse ligament (DTML). Using CT image reconstruction, we constructed a complex three-dimensional finite element model of the foot and ankle joint complex, accounting for geometric complexity and nonlinear characteristics. The focus of our study was to evaluate the effect of different forefoot transverse arch stiffness, that is, different Young's modulus values of DTML (from 135MPa to 405MPa), on different biomechanical aspects of the foot and ankle complex. Notably, we analyzed their effects on plantar pressure distribution, metatarsal stress patterns, navicular subsidence, and plantar fascial strain. Increasing the stiffness of the DTML has significant effects on foot biomechanics. Specifically, higher DTML stiffness leads to elevate von Mises stress in the 1st, 2nd, and 3rd metatarsals, while concurrently reducing plantar pressure by 14.2% when the Young's modulus is doubled. This stiffening also impedes navicular bone subsidence and foot lengthening. Notably, a 100% increase in the Young's modulus of DTML results in a 54.1% decrease in scaphoid subsidence and a 2.5% decrease in foot lengthening, which collectively contribute to a 33.1% enhancement in foot longitudinal stiffness. Additionally, doubling the Young's modulus of DTML can reduce the strain stretch of the plantar fascia by 38.5%. Preserving DTML integrity sustains the transverse arch, enhancing foot longitudinal stiffness and elastic responsiveness. These findings have implications for treating arch dysfunction and provide insights for shoe developers seeking to enhance propulsion.

Comparison by ultrasound shear wave elastography of toe flexor muscle contraction during MTP flexion exercise and short-foot exercise.

The intrinsic foot muscles play an important role in medial longitudinal arch support, as well as several extrinsic foot muscles. While various strength training methods specific to intrinsic foot muscles have been conducted, these exercises are associated with certain concerns regarding their effectiveness and difficulty. We developed a new exercise for the intrinsic muscles (MTP flexion exercise). The aim was to compare the shear modulus of the toe flexors as the muscle contraction activity during MTP flexion and short-foot exercises using ultrasound shear wave elastography. Eleven healthy participants were included in this study. The shear modulus of the toe flexor muscles was measured during MTP flexion and short-foot exercises using ultrasound shear wave elastography. The muscle shear modulus was statistically compared between the resting phase, and during the two exercises. The shear modulus during MTP flexion exercise was significantly greater than in the resting phase in the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, and flexor digitorum longus. The flexor digitorum longus showed greater shear modulus during MTP flexion exercise than during short-foot exercise. MTP flexion exercise showed equivalent or greater contraction activity in certain intrinsic and extrinsic foot muscles when compared with short-foot exercise. This exercise is considered one of the training options for strengthening the intrinsic muscles of the foot.

Effectiveness of jumping rope combined with short foot exercise on the medial longitudinal arch in a patient with flat foot: A case report

A flat foot is a deformity that leads to the collapse of the medial longitudinal arch. Flat foot may be congenital or acquired, which can be treated with various exercises; short foot exercise is where the head of the first metatarsal is pulled towards the heel without flexion of the toes; jumping rope helps in eccentric and concentric muscle action of the foot. The study aims to determine the effectiveness of jumping rope and short foot exercises on the medial longitudinal arch of a 24-year-old female patient with a flat foot. The pre-treatment assessment was done using a navicular drop test, and treatment was given for 20 minutes daily for six weeks; following the intervention, jumping rope and short foot exercises effectively improved the medial longitudinal arch.

Surgical management of severe planovalgus foot deformity in children with generalised joint hypermobility

BackgroundThis study aimed to evaluate the outcomes of calcaneal lengthening osteotomy (CLO) and double arthrodesis of the talonavicular and calcaneocuboid joints (DA) for correcting planovalgus foot deformity exclusively in patients with generalised joint hypermobility. MethodsWe retrospectively reviewed 29 feet in 17 consecutive patients who underwent either CLO or DA. The mean age at surgery was 11.3 ± 2.3 years, and the mean follow-up duration was 7.7 ± 3.2 years. Preoperative and final follow-up radiographs and dynamic foot-pressure measurements were analysed. ResultsBoth operations significantly improved the radiographic parameters, except for the lateral talocalcaneal angle in the CLO group. Pedobarographic study demonstrated an elevation of the medial longitudinal arch and an improved foot-pressure distribution after both surgeries. The plantar pressure in the lateral forefoot significantly increased only in the DA group, while the pressures exerted on the medial forefoot and hindfoot and the arch index improved only in the CLO group. ConclusionsBoth CLO and DA effectively improve the foot alignments of the deformity in patients with generalised joint hypermobility. However, differences were observed in the changes in the lateral talocalcaneal angle and plantar pressure distribution between the two procedures. Level of evidenceTherapeutic Level III.

Anatomical Description of the Spring Ligament Articular Facet.

The spring ligament fibrocartilaginous complex (SLFC), which is essential for stabilizing the medial longitudinal arch, features a little-explored fibrocartilaginous facet within its superomedial aspect, articulating with the talar head. This research aimed to provide a detailed anatomical description of this facet, designated as the spring ligament articular facet (SLAF). Nine normally aligned cadaveric lower limbs were dissected, approaching the SLFC from a superior direction. Following talus disarticulation, high-resolution images of the ligament complex were captured and analyzed. ImageJ software was used to determine the areas and dimensions of the superomedial calcaneonavicular (SMCN) spring and SLAF. The fibrocartilage facet exhibited a trapezoid shape in all specimens. The mean area for SMCN spring was 280.39 mm², and for SLAF, it was 200 mm². The proximal-to-distal length for SLAF averaged 11.78 mm at its longest and 5.34 mm at its shortest. Attachment of the SLAF to the calcaneum and the navicular showed robust fibrous structures, with average measurements of 3.75 and 1.75 mm at the medial and lateral calcaneal margins, and 2.75 and 2.98 mm at the medial and lateral navicular margins, respectively. This study clearly delineated the individual structural components of the SLFC articulating with the talar head and detailed its dimensions, emphasizing the need for more specific anatomical terminology that respects the intricate anatomy of the SLFC. Level III, descriptive study.

Is a keystone Bone Anomaly the Main Cause of Flatfoot (Pes Planus)?

Flatfoot (pes planus) is a decrease or loss of longitudinal medial arch height. The cause of symptomatic flatfoot occurring in adolescents is still unclear. In this study, the relationship between adolescent pes planus and foot bone shape was investigated. For this purpose, the volume and superficial area data of the foot bones of adolescent individuals with flatfoot deformity and individuals without any foot deformity were compared. Between September 2022 and June 2023, 30 individuals with adolescent pes planus with a medial arch angle greater than 145 degrees and 30 individuals without any foot deformity were included in the study. Computed tomography (CT) images of the participants' feet were obtained with a General Electric brand IQ model 32 detector CT device with a section thickness of 0.625mm in accordance with the bone protocol. Using the 3D Slicer program on CT images, foot bones were segmented and the volume and surface area ratios of each foot bone were determined. Cuneiforme mediale and cuneiforme intermediale volume ratios in individuals with flatfoot deformity decreased by 14% and 24%, respectively, compared with the control group ( P <0.05). Cuneiforme mediale and cuneiforme intermediale superficial area ratios were found to be 10% and 30% lower in the flatfoot group compared with the control group, respectively ( P <0.05). There was no difference in the volume and superficial area ratios of other foot bones between the groups ( P >0.05). The study results suggest that symptomatic adolescent flatfoot deformity may be associated with developmental anomalies of the os cuneiforme mediale and os cuneiforme intermedium.

Determining the changes in morphology and loading status following medial displacement calcaneal osteotomy for flatfoot using patient-specific finite element models

Medial displacement calcaneal osteotomy (MDCO) is the standard procedure for flatfoot. We investigated the effect of MDCO on the foot using a finite element analysis. Foot models were created from computed tomography data of 8 patients with flat feet. MDCO was performed on each model with bone translation distance of 4, 8, and 12 mm. The morphological changes, plantar pressures, and stress percentage on the talocrural and subtalar joints were evaluated before and after surgery. Morphological evaluation showed improvement in the medial longitudinal arch. The stress percentage of plantar pressure in the medial area decreased, and the stress percentage of plantar pressure in the mid- and lateral forefoot area increased. At the talocrural joint, the medial and middle stress percentage increased, while the lateral and posterior stress percentage decreased. In the subtalar joint, the stress percentage in the middle subtalar joint increased and that in the posterior subtalar joint decreased. Within the posterior subtalar joint, the anterior and medial stress percentage increased, while the posterior and lateral stress percentage decreased. Preoperative simulation using the finite element analysis may be useful in understanding postoperative morphological changes and loading conditions to perform patient-specific surgery.

A dynamic foot model for predictive simulations of human gait reveals causal relations between foot structure and whole-body mechanics.

The unique structure of the human foot is seen as a crucial adaptation for bipedalism. The foot's arched shape enables stiffening the foot to withstand high loads when pushing off, without compromising foot flexibility. Experimental studies demonstrated that manipulating foot stiffness has considerable effects on gait. In clinical practice, altered foot structure is associated with pathological gait. Yet, experimentally manipulating individual foot properties (e.g. arch height or tendon and ligament stiffness) is hard and therefore our understanding of how foot structure influences gait mechanics is still limited. Predictive simulations are a powerful tool to explore causal relationships between musculoskeletal properties and whole-body gait. However, musculoskeletal models used in three-dimensional predictive simulations assume a rigid foot arch, limiting their use for studying how foot structure influences three-dimensional gait mechanics. Here, we developed a four-segment foot model with a longitudinal arch for use in predictive simulations. We identified three properties of the ankle-foot complex that are important to capture ankle and knee kinematics, soleus activation, and ankle power of healthy adults: (1) compliant Achilles tendon, (2) stiff heel pad, (3) the ability to stiffen the foot. The latter requires sufficient arch height and contributions of plantar fascia, and intrinsic and extrinsic foot muscles. A reduced ability to stiffen the foot results in walking patterns with reduced push-off power. Simulations based on our model also captured the effects of walking with anaesthetised intrinsic foot muscles or an insole limiting arch compression. The ability to reproduce these different experiments indicates that our foot model captures the main mechanical properties of the foot. The presented four-segment foot model is a potentially powerful tool to study the relationship between foot properties and gait mechanics and energetics in health and disease.

Variable gearing at the ankle during walking in adults and young children: implications for foot development and evolution

Introduction: The human foot has evolved over the past seven million years from a relatively mobile, grasping appendage to a highly derived structure with a heel pad and longitudinal arch that can absorb shock at heel strike and weight-bearing yet also function as a powerful lever at toe-off. It has been proposed that the modern human foot evolved to allow our species to use “variable gearing” during walking and running. In this model, the gears of the human foot are defined relative to the ankle center of rotation as R, the distance from the ground reaction resultant vector, and r, the distance from the calf muscle vector. The gear ratio defines the torque generated to propel the body or stretch the triceps surae muscles. We test the hypothesis that variable gearing is associated with modern human pedal anatomy and a heel-to-toe rollover that allows a shift from “low gear” to “high gear” during stance.Methods: Using force plate and video analysis, we examined variable gearing in adults and children engaging in adult heel strike (AHS = 35), flat foot contact (FFC = 39), or initial heel contact (IHC = 26).Results and Discussion: Our hypothesis was partly supported. Although variable gearing was observed in IHC steps and was greater than in FFC steps, it was not as developed as in AHS steps. This may be related to anatomical and motor control differences between juvenile and adult feet, suggesting that adult anatomy, including a high arch, and neural control are critical for full use of variable gearing and that this feature would have evolved in later hominins around two million years ago with the appearance of a fully modern foot.

A comparison of abductor hallucis muscle activation and medial longitudinal arch angle during nine different foot exercises

BackgroundIntrinsic foot muscles are known to support the medial longitudinal arch (MLA) and stabilize the foot, and they are activated with weight bearing and increased postural demand. Various types of intrinsic foot muscle training have been reported, but one of the most useful of these, the short foot exercise, is challenging to perform effectively and requires practice, making it difficult to implement in ordinary clinical settings. Research questionWhat are the differences in abductor hallucis longus (ABH) muscle activity and MLA angle during intrinsic foot muscle exercises that employ weight bearing and balancing conditions when they are performed with minimal practice? MethodsSixteen healthy volunteers performed nine different intrinsic foot muscle exercises, practiced once or twice. The exercises consisted of toe curl, short foot without pushing, short foot with pushing and toe spread exercises in sitting and standing positions, and single leg swing in a standing position. Each exercise was performed three times for five seconds. The activities of the ABH muscles were measured using surface electromyographic (EMG) sensors and the MLA angles during the exercises were captured using an optical motion tracking system. The integrals of the ABH EMG signals were calculated. ResultsDifferences in the integral and maximum of the ABH EMG signal were found between the exercises (p < 0.001). Post-hoc pair-wise analysis revealed that the EMG activity was larger during the swing exercise than in exercises other than toe spread, both in sitting and standing positions, and short foot exercise with pushing while standing. The minimum MLA angle during each exercise was smaller for the toe spread exercise in a sitting position than other exercises (p < 0.023). SignificanceA single leg swing exercise may be effective for self-exercise of intrinsic foot muscles, particularly when intensive supervised physiotherapy is not possible.

ASSESSMENT OF FOOT DEFORMITY IN PRE-SCHOOL CHILDREN IN "ALADIN" KINDERGARTEN TUZLA

Abstract The preschool years are characterized by additional physical development changes, enhanced motor abilities, and strengthened movement apparatus in the kid. The feet undergo morpho-functional changes at that period, particularly between the ages of 3 and 6, which result in the development of their longitudinal and transverse arches. The aim of this study was to evaluate the actual causes of foot deformity and its degree of severity in preschool-aged children, as well as the distinction in deformity representation between the sexes. The "Institution for preschool education" kindergarten "Aladin" in Tuzla is the focus of this study, which involves 74 children of both sexes, ages 3-6, were measured in 2023. Foot deformities are equally present in girls and boys. Deformities in boys are particularly pronounced: pedes recti 21 (56.8%), pedes planovalgi 6 (16.2%), while in girls: pedes recti 20 (54.1%), pedes excavati 8 (21.6%). With the Chi-square test, we determined the statistical significance of the presence of foot deformities between the sexes. By looking at the size of the chi-square (Pearson Chi-Square) 5.964a and Asymp. Sig. (2-sided) .544 tells us that there is no statistically significant difference in the representation of foot deformities between the sexes and that these deformities are equally represented. Because foot deviations can lead to problems kindergarten kids' foot arches need to be continuously monitored. This allows for timely intervention and the adoption of suitable treatment procedures to avoid the development of deformities. Keywords: children, preschool strature, foot, deformity, gender.