Mean Foot Research Articles

The role of diurnal variation in development of musculoskeletal pain during prolonged standing

BackgroundResearch suggests mechanical changes occur to the body over the course of the day including shrinking of the intervertebral disc height which can increase rotational stiffness and rigidity of the spinal column. Further, pain sensitivity has been observed to fluctuate throughout the day, suggesting variations in pain sensitivity. Previous work has identified biomechanical and neuromuscular features related to the development of musculoskeletal pain during prolonged standing; however, many protocols have not controlled for time of day. Research questionDoes the time of day (i.e., diurnal variation) have an effect on the common neuromuscular and biomechanical variables characterizing the development of standing musculoskeletal pain in a two-hour prolonged standing protocol? MethodsA convenience sample of 20 healthy young adults (10 female and 10 male) completed two 2-hour prolonged standing bouts (8:00 a.m. and 8:00 p.m.) on separate days. Visual analogue scales were used to measure pain perception of the low back, legs, and feet throughout each protocol. Neuromuscular control was measured using surface EMG on muscles of the trunk and lower extremities. Postural sway was captured using measures of joint range of motion, and the analysis of center of pressure trajectory data using a force plate. ResultsDiurnal variation was observed to influence the development of musculoskeletal pain. Specifically, pain perception was found to be increased in the evenings as more participants were classified as pain developers in the PM sessions, and mean leg and foot pain perceptions were higher in the evening. Reduced postural sway patterns, and elevated co-contraction indices were found to be associated with the development of pain. SignificanceThese results suggest that future research assessing standing-pain protocols should control for time of day. Additionally, further research is warranted to explore the mechanistic causes of the development of standing pain.

Effects of Mecobalamin on the Functional Outcomes of Complex Regional Pain Syndrome Type 1 of the Foot and Ankle.

Because of the unclear pathophysiology and the lack of consensus on the gold standard treatment of complex regional pain syndrome (CRPS), management requires a multidisciplinary approach, with the use of various treatment modalities. Nonetheless, no studies have ever been conducted to uncover the potential of mecobalamin as a treatment for CRPS type 1. Hence, the aim of this clinical trial was to evaluate the effects of mecobalamin on the functional outcomes of patients with CRPS type 1 of the foot and ankle, the total amount of pregabalin ingested, and the duration of pregabalin use in each patient. Forty-seven patients diagnosed with acute CRPS type 1 of the foot and ankle were recruited. Patients were randomly allocated into a control group (23 patients) and a mecobalamin group (24 patients), both receiving similar pain control medications and rehabilitation programs. Three divided doses of mecobalamin 1.5 mg/d were provided to the mecobalamin group for the first 3 months, whereas a placebo was administered to the control group. Data were collected from the pretreatment period, and from 1, 3, 6, and 12 months following the treatment. Both groups had similar demographics. The mean Foot and Ankle Ability Measure (FAAM) activities of daily living (ADL) and FAAM-sport scores in the mecobalamin group at 3 months were 74.5 ± 17.9 and 56.3 ± 22.9, whereas the mean FAAM-ADL and FAAM-sport scores in the placebo group at 3 months were 62.2.5 ± 15.2 and 43.4 ± 14.9, respectively (P < .05). The 36-Item Short Form Health Survey (SF-36) mental health subscale after 3 months were 83.3 ± 9.5 points and 75.8 ± 12.6 points in the mecobalamin and placebo group, respectively (P < .05). However, at other time points of assessment (1, 6, and 12 months), the improvement in symptoms was not distinguishable between the 2 groups. Both the amount and duration of total pregabalin required to achieve similar improvements in pain scores were significantly lower in the mecobalamin group than the control group. This small study revealed an improvement of the functional outcomes in patients with CRPS type 1 of the foot and ankle who received mecobalamin instead of a placebo at 3 months that was not sustained at 6 and 12 months. We identified an average 39% total reduction in the amount of total pregabalin used in the mecobalamin group in the first 12 months.

Campanacci Grade 2 or 3 Giant Cell Tumor of the Phalanges: En Bloc Resection and Matched Nonvascularized Toe Phalangeal Transfer

The goal of the study was to assess the result of en bloc resection and matched nonvascularized toe phalangeal transfer in Campanacci grade 2 or 3 giant cell tumors of the phalanges. Seven patients with Campanacci grade 2 and 3 phalangeal giant cell tumors were treated by en bloc resection and matched nonvascularized toe phalangeal transfer between June 2004 and May 2021. The patients were followed up by X-rays, Patient-Rated Hand and Wrist scores, Foot Function Index, Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, and total active motion measurements. The minimum follow-up was 18 months (range: 18-230 months; mean: 110 ± 81). There were three males and four females, with age ranging from 13 to 48 years (mean: 24.14 ± 11.74). The right:left hand ratio was 3:4. The thumb was involved in one patient, the index finger in two, the middle finger in one, and the ring finger in three patients. The mean total active motion was 201.70 (range: 190°-240°). The mean patient-rated hand and wrist score was 15.2 (range: 10-35). The mean quick disabilities of the arm, shoulder and hand questionnaire score was 1.3 (range: 0-9). The mean foot function index on follow-up was 2.86 (range: 2-3). There was no tumor recurrence. One patient had a pathological fracture with resultant shortening of the finger on follow-up. In our series en bloc resection and matched nonvascularized toe phalangeal transfer resulted in a functional tumor-free digit with a low complication rate and no recurrences. Therapeutic V.

Impact of Peripheral Angioplasty on Wound Oxygenation and Healing in Patients with Chronic Limb-Threatening Ischemia Measured by Near-Infrared Spectroscopy.

Managing chronic limb-threatening ischemia (CLTI) is challenging due to difficulties in assessing tissue oxygen saturation in ulcers. Near-infrared spectroscopy (NIRS) is a non-invasive method for measuring tissue oxygen saturation (StO2). This study evaluated the effects of endovascular treatment (EVT) on StO2 and wound healing in CLTI patients, comparing NIRS to standard ankle-brachial index (ABI) measurements. Using the Duesseldorf PTA Registry, 43 CLTI patients were analyzed: 27 underwent EVT, and 16 received conservative treatment. ABI assessed macrocirculation, while NIRS measured wound, wound area, and mean foot StO2 at baseline, post-EVT, and four-month follow-up. Wound severity was classified by wound area and wound, ischemia, and foot infection (WIfI) score. Wound StO2 increased significantly (median (interquartile range (IQR)), 38 (49.3) to 60 (34.5)%, p = 0.004), as did wound area StO2 (median (IQR), 70.9 (21.6) to 72.8 (18.3)%, p < 0.001), with no significant changes in the control group by four-month follow-up. Wound area decreased significantly after EVT (mean ± SD, 343.1 ± 267.8 to 178.1 ± 268.5 mm2, p = 0.01) but not in the control group. Changes in wound StO2, wound area StO2, and WIfI score correlated with wound area reduction, unlike ABI. This small exploratory study shows that NIRS-measured StO2 improvements after EVT correlate with reduced wound area and WIfI scores, highlighting NIRS as a potential enhancement for CLTI wound management in addition to ABI.

Anthropometric Measurements of Foot in Undergraduate Medical Students of a Medical College: A Descriptive Cross-sectional Study.

Anthropometry is one of the important parameters for differentiation of sex which varies significantly based on hereditary, geographical, racial, sexual, and other factors. This study was done to provide baseline foot anthropometric data for Nepali medical students to improve the accuracy of stature estimations and enhance forensic and clinical applications. The aim of the study was to calculate anthropometric measurements of foot in undergraduate medical students of a medical college. A descriptive cross-sectional study was conducted on medical students studying at a tertiary care hospital during the period of November 6, 2022 to February 28, 2023 after obtaining ethical clearance from the Institutional Review Committee (Reference number: 06/2022). A total population sampling method was used. The present study was conducted to determine the mean foot index from the right and left foot, mean measurements of the left and right foot, and sex-related dimensions of the foot in Nepalese medical students. Data were collected and analyzed using SPSS. Out of 115 participants, the mean foot index for male and female were 38.34±2.13 and 39.33±2.22 respectively. The mean length of the right foot for males and females were 24.12±0.98 cm and 22.10±1.25 cm respectively. The mean length of the left foot for males and females was 24.20±1.06 cm and 22.07±1.24 cm respectively. This study provides mean values of different measurements of the right and left foot of both sexes of the age group of 18-24 years in the students of a medical college.

Coalition Excision and Corrective Osteotomies versus Coalition Excision and Arthroereisis in the Management of Pes Planovalgus with Talocalcaneal Coalition in Adolescents: A Randomized Controlled Trial

Abstract Level of evidence: ΙΙ Background Talocalcaneal coalition is the most common cause of rigid flat foot in adolescents. It presents with recurrent ankle sprains, ankle pain, and foot deformity. Management is still controversial. Multiple options were utilized during the last 40 years, including arthroerisis; however, the role of arthroerisis in the management of rigid pes planovalgus remains questionable. Patients and Methods Thirty feet in 28 patients with rigid flat foot due to talocalcaneal coalition who presented to our institution between September 2018 and November 2020 were prospectively analyzed. Randomization was performed by random allocation using a computer- based system into two groups: group A for arthroereisis and coalition excision and group B for osteotomies and coalition excision. Functional and radiological outcomes and complications were recorded and analyzed using Statistical Package for Social Sciences software. Results Thirty feet in 28 patients were included in the final analysis (group A, 15 feet; group B, 15 feet). The mean age and follow-up duration of the participants were 14.5 years and 24 months, respectively. The mean AOFAS and foot and ankle ability measurement scores were 78.8±4.04 and 76.73±4.66 and 80±5 and 79±3 for groups A and B, respectively. The complication rate was higher in group A; however, this difference did not reach statistical significance. No difference was found regarding functional outcomes. Conclusion We believe that the combination of talocalcaneal coalition resection with either corrective osteotomies or arthroerisis resulted in a significant improvement of functional and radiological outcomes with no difference between both in the management of rigid pes planovalgus.

THE ROLE OF ROTATION IN TOTAL ANKLE ARTHROPLASTY

BackgroundThe importance of total ankle replacement (TAR) implant orientation in the axial plane is poorly understood with major variation in surgical technique of implants on the market. Our aims were to better understand the axial rotational profile of patients undergoing TAR.MethodsIn 157 standardised CT Scans of end-stage ankle arthritis patients planning to undergo primary TAR surgery, we measured the relationship between the knee posterior condylar axis, the tibial tuberosity, the transmalleolar axis(TMA) and the tibiotalar angle. The foot position was measured in relation to the TMA with the foot plantigrade. The variation between medial gutter line and the line bisecting both gutters was assessed.ResultsThe mean external tibial torsion was 34.5±10.3°(11.8–62°). When plantigrade the mean foot position relative to the TMA was 21±10.6°(0.7–38.4°) internally rotated. As external tibial torsion increased, the foot position became more internally rotated relative to the TMA(pearson correlation 0.6;p&lt; 0.0001). As the tibiotalar angle became more valgus, the foot became more externally rotated relative to the TMA(pearson correlation −0.4;p&lt; 0.01). The mean difference between the medial gutter line and a line bisecting both gutters was 4.9±2.8°(1.7°-9.4°). More than 51% of patients had a difference greater than 5°. The mean angle between the medial gutter line and a line perpendicular to the TMA was 7.5°±2.6°(2.8°-13.7°).ConclusionThere is a large variation in rotational profile of patients undergoing TAR, particularly between the medial gutter line and the transmalleolar axis. Surgeon designers and implant manufacturers need to develop consistent methods to guide surgeons towards judging appropriate axial rotation of their implanton an individual basis. We recommend careful clinical assessment and CT scanspre-operatively to enable the correct rotation to be determined.

Surgical treatment for recurrent patellar dislocation with severe torsional deformities:Double-level derotational osteotomy may not have a clear advantage over single-level derotational osteotomy in improving clinical and radiological outcomes.

The purpose of this study was toinvestigate whether double-level (femur + tibia) derotational osteotomy is superior to single-level femoral derotational osteotomy for recurrent patellar dislocation with severe femoral and tibial rotational deformities (femoral anteversion >30° and external tibial torsion >30°). Between January 2015 and June 2020, a total of 115 knees with recurrent patellar dislocation treated with combined medial patellofemoral ligament reconstruction (MPFL-R) and derotational osteotomies were evaluated after a minimum follow-up of 2 years. Among these cases, 15 knees that underwent double-level derotational osteotomy were included in the double-level group, which was propensity-matched in a 1:2 ratio to a single-level group of patients who underwent single-level femoral derotational osteotomy (30 knees). The clinical and radiological outcomes were evaluated and compared between the groups. Furthermore, the foot progression angle was measured preoperatively and 2 years after surgery. The patient-specific variables did not differ significantly between the double-and the single-level groups after propensity score matching. The postoperative mean foot progression angle was significantly lower in the double-level groupthan in the single-level group (9° ± 8° vs. 15° ± 11°; p = 0.014); however, there were no statistically significant differences between the groups in terms of any other clinical and radiological assessments. For patients with severe femoral and tibial torsional deformities (femoral anteversion >30° and external tibial torsion >30°), the double-level derotational osteotomy is superior to single-level osteotomy in maintaining normal foot progression angle, but it does not show an advantage in terms of patient-reported outcomes, radiological resultsand redislocation rate at minimum 2 years of follow-up. Furthermore, concomitant excessive external tibial torsion (>30°) did not have an adverse effect on clinical outcomes in patients who underwent derotational distal femoral osteotomy with MPFL-R due to excessive femoral anteversion. Level III.

Foot complaints pre-operative to primary total hip or knee arthroplasty

Purpose of the Study: Aim of the study was to determine the prevalence of foot and ankle complaints and radiographic abnormalities, and their association in patients planned for total joint surgery. Methods: A cross-sectional cohort study of 183 patients, planned for total hip or knee arthroplasty (THA, TKA). Assessments included recording of polyneuropathy, previous trauma, foot deformities, and ankle range of motion (ROM); self-reported foot and ankle complaints; and radiographic severity of the foot and ankle joints OA. Results: In patients planned for THA and TKA, the proportions of patients with risk factors or using bespoke footwear ranged from 21-41%, whereas the proportions with clavus, hammertoes, and/or hallux valgus or rigidus varied between 1-17%. Although the mean foot function scores were good (median FAOS &gt;93 and FFI-5pt 0), up to 24% of patients had a low score on one or more of the subscale scores. Prevalence of patients with signs of radiographic OA in foot and ankle were lower in THA than TKA patients, respectively. For the TKA group, we found an association between radiological scores and both self-reported measures of foot and ankle complaints. Conclusion: About a quarter of patients undergoing THA and TKA report some foot complaints, whereas 32-45% have signs of radiographic OA of foot and/or ankle. Since foot and ankle complaints have shown to have a negative effect on outcome of THA and TKA surgery, pre-operative optimisation concerning the foot complaints should be considered to support a more favourable outcome.

Preliminary Results of Calcaneal Lengthening Osteotomy Combined With Extra-articular Subtalar Arthrodesis for Severe Pes Planovalgus Deformity in Children With Cerebral Palsy: A New Surgical Technique.

Pes planovalgus is the most common foot deformity seen in patients with cerebral palsy (CP). There are several different treatment modalities to treat this condition. Single or double calcaneal osteotomies, extra-articular arthrodesis, calcaneo-cuboido-cuneiform osteotomy, intraarticular arthrodesis, and arthroereisis are some of these modalities. Currently, there is insufficient information to determine the most effective treatment approach for pes planovalgus in children with CP. The aim of this study is to show the short to mid-term results of the new technique which combines calcaneus lengthening osteotomy, extra-articular subtalar arthrodesis, and soft tissue reconstruction that aims to decrease recurrence and complication rates of pes planovalgus surgery for patients with ambulatory CP. Patients with CP who were treated with calcaneal lengthening surgery and extra-articular subtalar arthrodesis between 2018 and 2021 were investigated retrospectively. All patients were ambulatory and Gross Motor Function Classification System I-II-III. Functional levels of the patients were assessed with the American Orthopaedic Foot and Ankle Society, Ankle-Hindfoot Score, and the Foot and Ankle Ability Score (Foot and Ankle Ability Measure) in preoperative and postoperative periods. On anteroposterior x-rays, talus-first metatarsal, talocalcaneal, talonavicular coverage angle and on lateral x-rays talus-first metatarsal, talocalcaneal, calcaneal inclination angle and talar tilt angle were evaluated. The mean follow-up was 46 (range: 36 to 60) months. The mean American Orthopaedic Foot and Ankle Society increased from 41 (20 to 79) to 74 (38 to 93; P < 0.001). The mean Foot and Ankle Ability Measure increased significantly from 35 (7 to 73) to 54 (29 to 96; P <0.001). Clinical results were "satisfactory" for 32 feet, while they were "unsatisfactory" for 2 feet. Significant deformity correction was observed in all radiologic parameters. Our technique is found to be efficient for patients with Gross Motor Function Classification System I-II-III CP with pes planovalgus deformity. In short to mid-term follow-up, the technique achieved successful clinical and radiologic results with low complication rates. Superiority of this technique compared with the traditional ones can only be shown with randomized prospective studies. Level III-retrospective cohort study.

Participation in Sports or Recreational Activities After Osteochondral Allograft Transplantation of the Talus

Background: Fresh osteochondral allograft (OCA) transplantation is a viable treatment option for osteochondral defects of the talus. However, sufficient data are not available on patients’ participation in sports or recreational activities after the procedure. Purpose: To assess whether patients undergoing OCA transplantation of the talus participated in sports or recreational activities postoperatively. Study Design: Case series; level of evidence, 4. Methods: A total of 36 ankles in 34 patients underwent OCA transplantation of the talus. At a mean follow-up of 9.2 years, information on participation in sports or recreational activities pre- and postoperatively was obtained, as well as postoperative pain, function, and satisfaction. Results: The mean age at the time of surgery was 36.1 years (range, 20.5-57.7 years), and 50% of patients were men. The mean graft size was 3.6 cm2 (range, 1-7.2 cm2) or 41.1% of the talar dome. Before the injury, 63.9% of patients (23/36 ankles) reported being highly competitive athletes or well trained and frequently sporting; 36.1% of patients (13/36 ankles) reported sometimes sporting or were nonsporting. Also, 66.7% of patients (24/36 ankles) were able to participate in sports or recreational activities after OCA transplantation and 50% (18/36 ankles) were still participating in sports or recreational activities at the latest follow-up. In a subset of well-trained or highly competitive athletes, 73.9% (17/23 ankles) were able to return to sports or recreational activities at any point after OCA transplantation, and 65.2% (15/23 ankles) were still participating at the latest follow-up. Further surgery occurred in 16.7% of patients (6/36 ankles). Graft survivorship was 94.3% at 5 years and 85.3% at 10 years. There was a significant improvement in the mean Olerud-Molander Ankle Scores, and the mean Foot and Ankle Ability Measure scores were high postoperatively. Moreover, 79.4% of patients (27/34 ankles) were either satisfied or extremely satisfied with the allograft surgery. Conclusion: Fresh OCA transplantation is a reasonable surgical option for osteochondral defects of the talus for young, active patients who have failed previous operative management or have massive defects.

Normative Running Kinematics in Healthy Adolescent Runners: A 2-Dimensional Video Analysis.

The literature on the running kinematics of youth distance runners is limited. We sought to describe 2-dimensional (2D) video analysis of running kinematics in healthy adolescent distance runners, which has not been previously described. We conducted an observational study of healthy, competitive runners between the ages of 14 and 18 years, prospectively recruited through local running clubs and our hospital's outreach between August 2019 and July 2023. Participants ran on a treadmill at a self-selected speed with markers attached to the thorax, pelvis, and lower extremities. A high-definition video camera recorded the runners in the sagittal and frontal planes. Kinematic measurements were completed using Dartfish software and reported as means and standard deviations. Of the 53 participants (51% boys, mean age: 16.0 ± 1.4 years) included in the 2D running analysis, 91% ran with a rearfoot strike pattern, with a mean foot inclination angle of 10.2° ± 6.2°. Knee flexion angle at initial contact was 13.2° ± 3.8°, tibia inclination angle was 8.5° ± 3.2°, and peak knee flexion was 44.5° ± 3.6°. Cadence was 168.7° ± 8.6°. Contralateral pelvic drop was 6.0° ± 2.2° and peak rearfoot eversion was 11.8° ± 3.6°. This study is the first to describe running kinematics as captured by 2D video in healthy adolescent runners and to identify kinematic variables that may differ from those of adult runners. Further research is required to determine if adult recommendations are applicable to adolescent populations.

Foot Care Prioritization Among Health Care Providers Treating Diabetic Patients in Saudi Arabia: A Survey-Based Study.

Diabetic foot disease (DFD) is a significant complication associated with diabetes, characterized by the potential for progressive amputation of specific foot segments or the entire lower limb in the absence of timely identification of infection and intervention. The aim of our research is to evaluate the degree of importance given to foot care by healthcare professionals who are responsible for treating individuals with diabetes in Riyadh, Saudi Arabia. This cross-sectional study utilized an online survey previously validated in Australia. The mean foot care prioritization score was used to identify the dummy variable for binary logistic regression analysis, which was used to identify predictors of foot care prioritization. A total of 222 participants were involved in this study. Assessing for the risk of developing foot complications, visually inspecting feet for wounds, and providing or recommending footwear to prevent foot complications were the most commonly reported practices, accounting for 80.60% (n = 178), 76.10% (n = 169), and 75.20% (n = 167), respectively. The most commonly referred patients to a specialist tertiary multi-disciplinary foot care team were patients with ulcers in patients with absent foot pulses, ulcers with ascending cellulitis, and diabetic ulceration, accounting for 73.50% (n = 163), 71.60% (n = 159), and 66.70% (n = 148), respectively. The mean foot care prioritization score for the study participants was 54.1 (standard deviation: 11.7) out of 78 (69.4%), which demonstrates a moderately high level of foot care prioritization. Binary logistic regression analysis identified that healthcare professionals who are aged 35-44 years, those who have 5-10 years of experience, those who work at private hospitals, those who have a higher number of practice clinics per week, and those who have to manage a higher number of patients with diabetes in each clinic were more likely to prioritize foot care in their practices (p < 0.05). Our study found that healthcare professionals in Saudi Arabia place a moderate degree of emphasis on foot care. Healthcare professionals falling within the age range of 35-44 years, possessing 5-10 years of experience, employed at private hospitals, overseeing a greater number of practice clinics weekly, and managing a greater number of patients with diabetes per clinic exhibited a greater propensity to prioritize foot care within their respective practices. Policymakers should consider the integration of continuous glucose monitoring technologies, the establishment of standardized foot screening protocols, and the implementation of targeted educational programs for healthcare professionals.

317 Characterizing Foot and Leg Scores for Montana Registered Angus Cattle

Abstract The objectives of this study were to increase the amount of phenotypic data available for enhancing the foot and claw EPDs of Montana sires and evaluate factors that could impact foot angle and claw set scores. Specifically, this study evaluated the interaction of sex and age on claw set and foot angle scores of front or hind legs. Researchers used the American Angus Association (AAA) Foot Scoring Guidelines to subjectively analyze claw set and foot angle on a series of Montana Angus herds, scoring a total of 4,723 cattle: 1,475 yearling bulls, 992 yearling heifers, 1,044 two- and three-year-old cows, and 1,212 cows that were four years of age and older. The AAA Foot Scoring Guidelines require breeders to score the combined “worst foot” for both the claw set and foot angle traits on a hard, flat surface. Yearling bulls had a 0.12 and 0.20 greater mean foot angle and claw set score compared with yearling heifers (P &amp;lt; 0.01). The proportion of scores that differed from 5 (ideal foot score) were greater (P &amp;lt; 0.01) for front feet as compared with hind feet, with 61.5 and 74.5% of the scores not equal to 5 being front feet issues for yearling heifers and bulls, respectively. Foot angle scores increased linearly (P &amp;lt; 0.01) with advancing cow age, ranging from 5.15 to 5.80 for heifers versus cows 4 years and older, respectively. Likewise, claw set scores increased quadratically (P &amp;lt; 0.01) as a function of cow age. The location of the “worst foot” also changed quadratically with age (P &amp;lt; 0.01) with the majority of problem feet in two- and three-year old cows and cows 4 years and older being hind feet issues (70.5 and 77.1%, respectively). The proportion of foot angle and claw set scores not equal to 5 also increased quadratically with age (P &amp;lt; 0.01) with heifers having the lowest proportion of scores not equal to 5 (15.8 and 31.7%, respectively) compared with 4 year and older cows (66.0 and 68.0%, respectively). In analysis of progeny of sire lines, the range between the progeny of the sire line with the greatest foot angle score and that of the least was 0.60 for foot angle. Likewise, for claw set, a similar range 0.57 was observed. Sire lines did have an effect on progeny claw set (P &amp;lt; 0.05) and foot angle scores (P &amp;lt; 0.05), as well as variation of progeny foot scores. In summary, progress is being made by utilizing the AAA foot scoring guidelines, as well as foot angle and claw set EPDs. Additional improvements may be possible with continued model refinement and improvements with scoring guidelines specific to age and sex effects.

Postnatal foot length in the estimation of gestational age in relation to intrauterine growth pattern among Nigerian neonates.

To determine the relationship between postnatal foot lengths and estimated gestational age (EGA) in relation to intrauterine growth patterns determined at birth among Nigerian neonates. Hospital-based, cross-sectional. Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. 260 neonates with EGA 30- 42 weeks within 48 hours of life. Postnatal foot lengths (FL) were measured with Vernier digital calliper in millimetres. The intra-uterine growth pattern was determined using the Lubchenco chart. Pearson correlation and regression analysis tests were performed. Postnatal foot length in relation to Intra-Uterine Growth Pattern. The mean postnatal FL had a strong positive correlation with the EGA from 30 through 42 weeks (r = 0.855, p < 0.001). The overall mean foot length for preterm neonates was 65.44 (6.92) mm, while that of term neonates was 77.92 (4.24) mm. The linear regression equation was generated as: EGA = 9.43 + (0.37 × FL), p < 0.001. The EGA as measured by FL had the highest positive correlation with Small for Gestational Age (SGA) intra-uterine-growth pattern, followed by Appropriate for Gestational Age (AGA) and least by Large for Gestational Age (LGA) respectively (r = 0.936> 0.861 > 0.666). The postnatal foot length correlated well with estimated gestational age, and the correlation was best among SGA infants. None declared.

Characterizing Foot and Leg Scores for Montana's Registered Angus Cattle.

The objective of this study was to characterize foot angle and claw set scores of Montana's (USA) registered Angus cattle using a total of 4723 cattle scored: 1475 yearling bulls, 992 yearling heifers, 1044 2- and 3-year-old cows, and 1212 cows ≥ 4 years old. Yearling bulls had a 0.12 and 0.20 greater mean foot angle and claw set score, respectively, compared to yearling heifers (p < 0.01). Foot angle and claw set scores increased (p < 0.01) with advancing cow age. The combined worst foot changed quadratically with age (p < 0.01) with the majority of problem feet in cows aged 2 to 3 years and older being hind feet issues. The proportion of foot angle and claw set scores not equal to 5 increased quadratically with age (p < 0.01), with heifers having the lowest proportion of scores not equal to 5 (15.8 and 31.7%, respectively) compared to cows aged 4 years and older. Sire lines had an effect on progeny claw set (p < 0.05) and foot angle scores (p < 0.05), as well as variation of progeny foot scores. These data could potentially be used to refine expected progeny difference models.

The Relationship Between Leg Length And Stride Length In Students Of The Medical Faculty Of General Achmad Yani University

The foot is one part of the body that functions in the locomotion process, one of which is walking. Walking is a form of movement in which the centre of gravity of the body moves alternately on the right and left sides of the foot when touching the floor. Walking can be influenced by anatomical and physiological factors. The process of walking can be observed so that it can assess abnormalities in walking in a person that can interfere with activities. This study aims to determine the relationship between foot length and stride length. This study used a cross-sectional design with 60 adult subjects. The parameters measured were leg length, which is the distance drawn from the calcanea tuberosity to the tip of the longest finger, and stride length, which is the distance between the foot that makes initial contact with the other foot during the walking process. The subjects were selected by consecutive sampling. The data were analysed with Pearson correlation. The measurement results of the mean foot length in this study were 26 cm, and the mean stride length was 79.02 cm. The results of this study showed a strong and significant correlation between foot length and stride length. These results indicate that the longer the foot, the more it will help propel the foot when toeing off, so that the stride is longer.

Foot Temperature by Infrared Thermography in Patients with Peripheral Artery Disease before and after Structured Home-Based Exercise: A Gender-Based Observational Study.

Decreased arterial perfusion is a typical condition of patients with peripheral artery disease (PAD), with the microvascular picture particularly present among women. This observational study aimed to detect foot perfusion changes by infrared thermography (IRT) after a home-based exercise program in both sexes. A total of 76 PAD patients with claudication (72 ± 4 years; 52 males) were enrolled in a structured in-home exercise program composed of two daily 8 min interval walking sessions (1:1 walk:rest ratio) with progressively increasing speed. Outcome measures collected at baseline (T0) and at each hospital visit after 5 weeks, 12 weeks and 20 weeks included foot temperature measured by IRT (anterior tibial, posterior tibial, dorsalis pedis and arcuate artery regions), ankle brachial index and the 6 min walking test. After 20 weeks, foot temperature in both limbs showed a significant increasing trend, with a mean variation of 1.3 °C for the more impaired limb and 0.9 °C for the contralateral limb (t = 8.88, p < 0.001 and t = 5.36; p < 0.001, respectively), with significant changes occurring after 5 weeks of training. The sex-oriented analysis did not highlight any significant difference, with an improvement of mean foot temperature of 1.5 ± 0.6 °C in females versus 1.2 ± 0.5 °C in males (p = 0.42). Ankle brachial index and performance also significantly improved over time (p < 0.001) without gender differences. In patients with PAD, a structured low-intensity exercise program significantly improved foot temperature and exercise capacity without any sex-related difference.

Regional plantar forces and surface geometry variations of a chronic ankle instability population described by statistical shape modelling

BackgroundUnderstanding detailed foot morphology as well as regional plantar forces could provide insight into foot function and provide recommendation for footwear design for chronic ankle instability (CAI) people. Research QuestionThis study presented 3-dimensional statistical shape models of feet from three different populations including CAI, copers and healthy individuals, with regional plantar forces also acquired. MethodsSixty-six males (22 participants per group) were included in this study to capture 3-dimensional foot shapes under a standing condition and regional plantar forces during a cutting maneuver. Principal component analysis was performed to generate a mean foot shape of each group as well as modes of variations. A generalized procrustes analysis was used to achieve rapid registration of mean shapes. Besides, regional plantar forces and contact duration among these three populations were compared. ResultsFor 3-dimensional foot shapes, although no significant differences of the average distance between each mode and mean shape were found among three populations, there were subtle variations in mean shapes. The CAI population presented a more bulging of the lateral malleolus; copers were characterized by the flexion of the lesser toes, a more bulging of the medial foot in the sagittal plane; and healthy individuals showed a greater heel width and a more bulging of the heel in the sagittal plane. In terms of plantar forces, healthy individuals had significantly greater summated plantar forces and greater plantar forces in the lateral heel area during the early contact phase compared to copers and CAI participants. SignificanceOverall, this study suggested that repetitive ankle sprains may lead to the bulging of the lateral malleolus. Further, CAI and copers seem to stabilize the ankle joint by medially shifting the center of pressure compared to healthy individuals under the static and less challenging dynamic conditions.

Surgical treatment of ankle instability in children with os subfibulare.

Ankle instability in children due to soft tissue injury usually resolves after non-operative treatment. However, some children and adolescents with chronic instability require surgical treatment. A rarer cause of developing ankle instability is injury to the ligament complex in the presence of os subfibulare, an accessory bone inferior to the lateral malleolus. The aim of this study was to assess the results of operative management of chronic ankle instability in children with os subfibulare. 16 children with os subfibulare and chronic ankle instability who failed non-operative treatment were enrolled prospectively into the study. One child was lost to follow-up and excluded from analysis. The mean age at the time of the surgery was 14years and 2months (range 9.5-17years). The mean follow-up time was 43.2months (range 28-48months). Surgical treatment in all cases involved removal of os subfibulare and a modified Broström-Gould lateral complex reconstruction with anchors. Ankle status was assessed before and after surgery with The 100mm Visual Analogue Scale and Foot and Ankle Outcome Score questionnaire. The mean Foot and Ankle Outcome Score improved from 66.8 to 92.3 (p < 0.001). Pain level improved from 67.1 preoperatively to 12.7 (p < 0.001). All children reported improvement in their ankle stability. There was one case of scar hypersensitivity that improved during observation and one superficial wound infection that resolved with oral antibiotics. One child reported intermittent pain without symptoms of instability following another injury. Ankle joint sprain with associated injury to os subfibulare complex can lead to chronic instability in children. If conservative management fails, then surgical treatment with modified Broström-Gould technique and excision of accessory bone is a safe and reliable method.