Measurements Of Foot Research Articles

The association between measures of static foot posture and foot mobility and foot kinematics during barefoot walking

Background Variations in foot posture are associated with common lower limb injuries. However, there is uncertainty as to which measure of foot posture is the most valid in terms of predicting 3-dimensional kinematics of the foot. The aim of this study was to investigate the association between measures of static foot posture or foot mobility and kinematic variables of the foot during barefoot walking.

A case‐control pilot study of x‐ray measurements between the affected and unaffected foot in patients with unilateral hallux limitus

Background Controversy exists regarding the structural and functional causes of hallux limitus including metatarsus primus elevatus, long first metatarsal, first ray hypermobility, shape of the first metatarsal head and the presence of hallux interphalangeus. Papers have reported on the radiographic evaluation of these measurements in feet affected by hallux limitus, however no study to date has made direct comparisons between the affected and unaffected foot in a group of patients with unilateral hallux limitus. This case-control pilot study aimed to establish if any such differences existed.

Three-Dimensional Foot Scanning System with a Rotational Laser-Based Measuring Head

Three-dimensional (3D) measurements of the feet is crucial for the correct design and selection of shoes. Badly-fitting shoes are one of the major causes of pain, foot related diseases and injuries of the feet. This article presents a new system for 3D foot-shape measurements which is based on the laser-multiple-line-triangulation principle. The main part of a system is the measuring head comprising a three laser lines projection unit and two cameras, which rotate around the centre of the platform that the customer stands on, and measures both feet simultaneously. The developed software analyzes the different foot dimensions and suggests the most suitable model and size of a shoe from a database to the customer. Three experiments have been presented to demonstrate the measuring precision of the system: the in-vitro measurement of plastic feet, in-vivo within an hour and in-vivo within one week. The results show that the standard deviation for all feet dimensions is better than 0.6mm in in-vitro case.

Hallux Angles: A new medical software for smartphone for data archiving and angular measurements of foot operated for hallux valgus. Study and discussion on the software reliability

The purpose of this scientific research was to: 1) Verify the reliability of “Hallux Angles” ( https://itunes.apple.com/gb/app/hallux-angles/id398338105?mt=8 ) in terms of archiving of sensitive data about the photos of the deformities of patients, and in terms of the correction index measured on radiographs before and after surgery; 2) Compare the indexes of angular deformities of patients measured with three methods: a) With an iPhone software, “Hallux Angles”; b) With a standard goniometer; c) With a PC software (Agfa CR) commonly used in radiology; 3) test the stability of the application over the time. Four observers filed 95 patients affected by hallux valgus, operated on in different clinics and hospitals from September 2012 to January 2013, with the application “Hallux Angles” adding personal data for each patient, such as the birthday, gender, and radiographic photos taken in the upright position and angle values measured (distal metatarsal articular angle (DMAA), hallux valgus angle (HVA), and intermetatarsal angle (IMA)) before and after surgery. The photos relative to the post-surgical procedure were taken at 40 days. With the data that emerged from the postoperative angle measurements, we obtained the corrective index. Measurements obtained with the software were then compared with those emerged using a standard goniometer and then verified thanks to a reliable PC software (Agfa CR), supervised by a radiologist, giving us the opportunity to test the reliability of the measurements collected. The variability of the obtained results from the two different methods was similar and superposable among the four observers. In particular, the deviation between the two methodologies (manual measurement with goniometer and measurement with the application) was 1.50 ± 1.2 for HVA, 1.2 ± 0.90 for DMAA, and 1.4 ± 1.1 for IMA. The final verification of the data through the measurement with radiology equipment by a radiologist produced a correlation coefficient according to the Bland-Altman method and was very satisfactory, and it was close to the statistical measurement of 95%, thus confirming an index correlation very reliable and with very small deviations.

Psychometric Properties of the Foot and Ankle Outcome Score in a Community‐Based Study of Adults With and Without Osteoarthritis

Foot and ankle problems are common in adults, and large observational studies are needed to advance our understanding of the etiology and impact of these conditions. Valid and reliable measures of foot and ankle symptoms and physical function are necessary for this research. This study examined psychometric properties of the Foot and Ankle Outcome Score (FAOS) subscales (pain, other symptoms, activities of daily living [ADL], sport and recreational function [sport/recreation], and foot- and ankle-related quality of life [QOL]) in a large, community-based sample of African American and white men and women ages ≥50 years. Johnston County Osteoarthritis Project participants (n = 1,670) completed the 42-item FAOS (mean age 69 years, 68% women, 31% African American, mean body mass index [BMI] 31.5 kg/m(2) ). Internal consistency, test-retest reliability, convergent validity, and structural validity of each subscale were examined for the sample and for subgroups according to race, sex, age, BMI, presence of knee or hip osteoarthritis, and presence of knee, hip, or low back symptoms. For the sample and each subgroup, Cronbach's alpha coefficients ranged from 0.95-0.97 (pain), 0.97-0.98 (ADL), 0.94-0.96 (sport/recreation), 0.89-0.92 (QOL), and 0.72-0.82 (symptoms). Correlation coefficients ranged from 0.24-0.52 for pain and symptoms subscales with foot and ankle symptoms and from 0.30-0.55 for ADL and sport/recreation subscales with the Western Ontario and McMaster Universities Osteoarthritis Index function subscale. Intraclass correlation coefficients for test-retest reliability ranged from 0.63-0.81. Items loaded on a single factor for each subscale except symptoms (2 factors). The FAOS exhibited sufficient reliability and validity in this large cohort study.

Does Foot Placement Affect the Reliability of Static Foot Posture Measurements?

Previous studies have reported conflicting results on whether different foot placements in standing can affect static measurements of foot posture. We sought to determine whether three measurements of static foot posture could be consistently measured in three different foot placements while standing. Twenty individuals, 12 women and eight men, with a mean age of 24.8 years consented to participate. Two raters assessed the dorsal arch height, midfoot width, and heel width of each foot while the participant stood in the following three foot placements: a standardized placement, a participant-determined placement after marching in place, and a rater-determined foot placement based on observation of the participant's angle of gait and base of support while walking. All three measurements of static foot posture were shown to have high levels of intrarater and interrater reliability. Significant differences in the measurements of dorsal arch height, midfoot width, and heel width were found among all three of the foot placements. There were no differences between the two raters for any of the three measurements of foot posture. Based on these findings, we recommend that clinicians perform measurements of static foot posture using the same standing foot placement between sessions to ensure a high level of measurement consistency.

Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis.

BackgroundStatic measures of foot posture are regularly used as part of a clinical examination to determine the need for foot level interventions. This is based on the premise that pronated and supinated foot postures may be risk factors for or associated with lower limb injury. This systematic review and meta-analysis investigates foot posture (measured statically) as a potential risk factor for lower limb overuse injuries.MethodsA systematic search was performed using Medline, CINAHL, Embase, SportDiscus in April 2014, to identify prospective cohort studies that investigated foot posture and function as a risk factor for lower limb overuse injury. Eligible studies were classified based on the method of foot assessment: (i) static foot posture assessment; and/or (ii) dynamic foot function assessment. This review presents studies evaluating static foot posture. The methodological quality of included studies was evaluated by two independent reviewers, using an adapted version of the Epidemiological Appraisal Instrument (EAI). Where possible, effects were expressed as standardised mean differences (SMD) for continuous scaled data, and risk ratios (RR) for nominal scaled data. Meta-analysis was performed where injuries and outcomes were considered homogenous.ResultsTwenty-one studies were included (total n = 6,228; EAI 0.8 to 1.7 out of 2.0). There was strong evidence that a pronated foot posture was a risk factor for medial tibial stress syndrome (MTSS) development and very limited evidence that a pronated foot posture was a risk factor for patellofemoral pain development, although associated effect sizes were small (0.28 to 0.33). No relationship was identified between a pronated foot posture and any other evaluated pathology (i.e. foot/ankle injury, bone stress reactions and non-specific lower limb overuse injury).ConclusionThis systematic review identified strong and very limited evidence of small effect that a pronated foot posture is a risk factor for MTSS and patellofemoral pain respectively. Evaluation of static foot posture should be included in a multifactorial assessment for both MTSS and patellofemoral pain, although only as a part of the potential injury risk profile. Whilst the included measures are clinically applicable, further studies are required to determine their relationship with dynamic foot function.Electronic supplementary materialThe online version of this article (doi:10.1186/s13047-014-0055-4) contains supplementary material, which is available to authorized users.

A Longitudinal Analysis of the Effect of Mass Drug Administration on Acute Inflammatory Episodes and Disease Progression in Lymphedema Patients in Léogane, Haiti

We conducted a longitudinal analysis of 117 lymphedema patients in a filariasis-endemic area of Haiti during 1995-2008. No difference in lymphedema progression between those who received or did not receive mass drug administration (MDA) was found on measures of foot (P = 0.24), ankle (P = 0.87), or leg (P = 0.46) circumference; leg volume displacement (P = 0.09), lymphedema stage (P = 0.93), or frequency of adenolymphangitis (ADL) episodes (P = 0.57). Rates of ADL per year were greater after initiation of MDA among both groups (P < 0.01). Nevertheless, patients who received MDA reported improvement in four areas of lymphedema-related quality of life (P ≤ 0.01). Decreases in foot and ankle circumference and ADL episodes were observed during the 1995-1998 lymphedema management study (P ≤ 0.01). This study represents the first longitudinal, quantitative, leg-specific analysis examining the clinical effect of diethylcarbamazine on lymphedema progression and ADL episodes.

Characteristics of balance control in older persons who fall with injury – A prospective study

ObjectiveOlder adults who have recently fallen demonstrate increased postural sway compared with non-fallers. However, the differences in postural control between older adults who were seriously injured (SI) as a result of a fall, compared with those who fell but were not injured (NSI) and non-fallers (NFs), has not been investigated. The objective of the present study was to investigate the underlying postural control mechanisms related to injuries resulting from a fall. MethodsBoth traditional postural sway measures of foot center-of-pressure (CoP) displacements and fractal measures, the Stabilogram-Diffusion Analysis (SDA), were used to characterize the postural control. One hundred older adults aged 65–91years were tested during narrow base upright stance in eyes closed condition; falls were monitored over a 1-year period. ResultsForty-nine older adults fell during the 1-year follow-up, 13 were seriously injured as a result of a fall (SI), 36 were not injured (NSI), and 49 were non-fallers (NFs); two passed away. The SDA showed significantly higher short-term diffusion coefficients and critical displacements in SI in the anterior–posterior direction compared with both NSI and NF. However, in the medio-lateral direction there were no statistically significant differences between groups. For the traditional measures of sway, the average anterior–posterior CoP range was also larger in SI individuals. ConclusionsThis work suggests that older fallers with a deterioration of anterior–posterior postural control may be at higher risk of serious injury following fall events.

A multi-class bi-level thresholding method for accurate anthropometric measurements of scanned plantar images

Traditionally, the anthropometric measurements of foot or insole were taken manually by an anthropometrist for clinical and sporty purposes. Digital foot scanners have been developed in recent years to yield anthropometrists digital image of plantar with pressure distribution and anthropometric information. In this paper, an automated thresholding method based on Shanbag entropy and the weighted gray level spatial correlation histogram is presented for analysis of scanned foot images. The presented method compared with traditional two-dimensional histogram and other single-class-based methods automatically accurately detects the foot edges and areas. Also, by background removal, it attains a perfect foot image while in which white pixels of the resulting thresholded image correspond to the points of the scanner which detects pressure and on the contrary the black pixels correspond to background. We are taking into accounts the image’s local properties along with its global properties in a fuzzy domain by employing weighted gray level spatial correlation histogram (W-GLSC). First, a three-dimensional histogram based on the statistics of the gray levels’ probability and similarity with neighboring pixels (GLSC histogram) is weighted by the membership values assigned by Jawahar clustering method for foreground–background discrimination. Then, the Shanbag entropy is used to maximize the information transfer from the original image to the resulting thresholded image. Resulting binary images are undergone anthropometric measurements by considering the scale factor of pixel size to metric scale. The proposed method is finally applied to plantar images obtained through scanning feet of randomly selected subjects by a foot scanner system as our experimental setup described in the paper.

Reconstruction of Stature by Percutaneous Measurement of Foot - An Anthropometric Study

Reconstruction of Stature by Percutaneous Measurement of Foot - An Anthropometric Study

The kinematic effects of common peroneal functional electrical stimulation (FES) in chronic stroke (CVA) and multiple sclerosis (MS) using a 3-D model of the shoe

Measurements of foot inversion/eversion during gait are of particular interest in people using common peroneal Functional Electrical Stimulation (FES). In addition to addressing excessive equinus in swing, FES systems are commonly prescribed to improve stability at initial contact and/or forefoot clearance in swing, in the presence of excess inversion. To date, the direct effects of FES on foot movement in 3-D have not been published, as available 3-D clinical foot models such as the Oxford Foot Model (Stebbins et al. 2006) require additional markers to be applied to the foot in an accurate manner, preventing their use when footwear is donned.

Problems With “Validation of a Measurement Device for Instrumented Quantification of Anterior Translation and Rotational Assessment of the Knee”

Problems With “Validation of a Measurement Device for Instrumented Quantification of Anterior Translation and Rotational Assessment of the Knee”

Author's Reply

We thank Dr. Alam and his associates for their critical attention and comments. The Cronbach α was not used to verify the accuracy of the measured values but was used to validate the reproducibility. We are familiar with the studies they cite in their letter, and the problem of inaccuracy of the measurement of the rotation angle using a boot with the ankle in neutral position is known (the problem with the Rottometer). It is well known that fixation and measurement of the soft tissue of the lower leg do not make sense. Thus, as described in our article, in this experimental setup, dorsiflexion of the ankle was used to fix the trapezoid talus in the malleolar fork to minimize this error. The foot was not fixed on the soft tissue. The heads of metatarsals 1 and 5 and the calcaneus served as a counter-bearing. The measurements were calculated only in side-to-side comparison. This means that any angle inaccuracies are neutralized in the calculation. It would be an honor for us to invite Dr. Alam and his group to check out the measurement technique in our clinic. We hope to have served with this explanation. Problems With “Validation of a Measurement Device for Instrumented Quantification of Anterior Translation and Rotational Assessment of the Knee”ArthroscopyVol. 28Issue 2PreviewWe read with interest the recent article by Mayr et al.1 However, there are two related problems we would like to discuss. The first is regarding the accuracy of the “Laxitester.” The authors used the t test for independent and dependent samples to analyze the differences between the readings from healthy and pathologic knees. In addition, reliability was analyzed by use of intratester and intertester correlation according to the Cronbach α.1 However, neither of these methods assesses the accuracy of the measuring device; that is, how closely do the readings from the Laxitester reflect the translations and rotations occurring at the knee? What is reported is a comparison between measurements of foot and ankle rotations between subjects with normal and abnormal knees, as well as correlation of these foot and ankle rotations between testers. Full-Text PDF

The foot posture index, ankle lunge test, Beighton scale and the lower limb assessment score in healthy children: a reliability study

BackgroundOutcome measures are important when evaluating treatments and physiological progress in paediatric populations. Reliable, relevant measures of foot posture are important for such assessments to be accurate over time. The aim of the study was to assess the intra- and inter-rater reliability of common outcome measures for paediatric foot conditions.MethodsA repeated measures, same-subject design assessed the intra- and inter-rater reliability of measures of foot posture, joint hypermobility and ankle range: the Foot Posture Index (FPI-6), the ankle lunge test, the Beighton scale and the lower limb assessment scale (LLAS), used by two examiners in 30 healthy children (aged 7 to 15 years). The Oxford Ankle Foot Questionnaire (OxAFQ-C) was completed by participants and a parent, to assess the extent of foot and ankle problems.ResultsThe OxAFQ-C demonstrated a mean (SD) score of 6 (6) in adults and 7(5) for children, showing good agreement between parents and children, and which indicates mid-range (transient) disability. Intra-rater reliability was good for the FPI-6 (ICC = 0.93 - 0.94), ankle lunge test (ICC = 0.85-0.95), Beighton scale (ICC = 0.96-0.98) and LLAS (ICC = 0.90-0.98). Inter-rater reliability was largely good for each of the: FPI-6 (ICC = 0.79), ankle lunge test (ICC = 0.83), Beighton scale (ICC = 0.73) and LLAS (ICC = 0.78).ConclusionThe four measures investigated demonstrated adequate intra-rater and inter-rater reliability in this paediatric sample, which further justifies their use in clinical practice.

Visual categorisation of the Arch Index: a simplified measure of foot posture in older people

Visual categorisation of the Arch Index: a simplified measure of foot posture in older people

Visual categorisation of the arch index: a simplified measure of foot posture in older people

BackgroundFoot posture is considered to be an important component of musculoskeletal assessment in clinical practice and research. However, many measurement approaches are not suitable for routine use as they are time-consuming or require specialised equipment and/or clinical expertise. The objective of this study was therefore to develop and evaluate a simple visual tool for foot posture assessment based on the Arch Index (AI) that could be used in clinical and research settings.MethodsFully weightbearing footprints from 602 people aged 62 to 96 years were obtained using a carbon paper imprint material, and cut-off AI scores dividing participants into three categories (high, normal and low) were determined using the central limit theorem (i.e. normal = +/− 1 standard deviation from the mean). A visual tool was then created using representative examples for the boundaries of each category. Two examiners were then asked to use the tool to independently grade the footprints of 60 participants (20 for each of the three categories, randomly presented), and then repeat the process two weeks later. Inter- and intra-tester reliability was determined using Spearman’s rho, percentage agreement and weighted kappa statistics. The validity of the examiner’s assessments was evaluated by comparing their categorisations to the actual AI score using Spearman’s rho and analysis of variance (ANOVA), and to the actual AI category using percentage agreement, Spearman’s rho and weighted kappa.ResultsInter- and intra-tester reliability of the examiners was almost perfect (percentage agreement = 93 to 97%; Spearman’s rho = 0.91 to 0.95, and weighted kappas = 0.85 to 0.93). Examiner’s scores were strongly correlated with actual AI values (Spearman’s rho = 0.91 to 0.94 and significant differences between all categories with ANOVA; p < 0.001) and AI categories (percentage agreement = 95 to 98%; Spearman’s rho = 0.89 to 0.94, and weighted kappas = 0.87 to 0.94). There was a slight tendency for examiners to categorise participants as having higher arches than their AI scores indicated.ConclusionsFoot posture can be quickly and reliably categorised as high, normal or low in older people using a simplified visual categorisation tool based on the AI.

Magnetic Resonance Imaging of the Rheumatic Foot According to the RAMRIS System Is Reliable

In rheumatology, magnetic resonance imaging (MRI) is predominantly applied in the assessment and outcome measurement of rheumatoid arthritis (RA) in hands and wrists, leading to the development of the RAMRIS (RA-MRI-Scoring) system. It was initiated by the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). The RAMRIS system has not been applied widely in the measurement of feet. We investigated the interreader and intrareader agreement of the RAMRIS scoring system in the assessment of feet in RA. Twenty-nine patients with RA who had radiological damage and/or arthritis underwent MRI. Two experienced readers independently read both complete sets. One reader read 6 random sets after the initial session, in order to assess the intrareader agreement. For evaluation of the intrareader and interreader reliability, quadratic-weighted κ scores were calculated per joint and lesion. For the forefeet, interreader scores were excellent, ranging from 0.77 (bone edema) to 0.95 (bone erosion). Hindfoot interreader agreement scores were highest for erosion (0.90) and synovitis global score (0.88), but edema and synovial thickness agreement were also acceptable (0.83 and 0.86). Intrareader scores were on the whole slightly lower, but excellent. Reliability (interreader and intrareader agreement) in the assessment of the rheumatoid foot according to the RAMRIS method is excellent.

Estimation of stature from the foot and its segments in a sub‐adult female population of North India

BackgroundEstablishing personal identity is one of the main concerns in forensic investigations. Estimation of stature forms a basic domain of the investigation process in unknown and co-mingled human remains in forensic anthropology case work. The objective of the present study was to set up standards for estimation of stature from the foot and its segments in a sub-adult female population.MethodsThe sample for the study constituted 149 young females from the Northern part of India. The participants were aged between 13 and 18 years. Besides stature, seven anthropometric measurements that included length of the foot from each toe (T1, T2, T3, T4, and T5 respectively), foot breadth at ball (BBAL) and foot breadth at heel (BHEL) were measured on both feet in each participant using standard methods and techniques.ResultsThe results indicated that statistically significant differences (p < 0.05) between left and right feet occur in both the foot breadth measurements (BBAL and BHEL). Foot length measurements (T1 to T5 lengths) did not show any statistically significant bilateral asymmetry. The correlation between stature and all the foot measurements was found to be positive and statistically significant (p-value < 0.001). Linear regression models and multiple regression models were derived for estimation of stature from the measurements of the foot. The present study indicates that anthropometric measurements of foot and its segments are valuable in the estimation of stature. Foot length measurements estimate stature with greater accuracy when compared to foot breadth measurements.ConclusionsThe present study concluded that foot measurements have a strong relationship with stature in the sub-adult female population of North India. Hence, the stature of an individual can be successfully estimated from the foot and its segments using different regression models derived in the study. The regression models derived in the study may be applied successfully for the estimation of stature in sub-adult females, whenever foot remains are brought for forensic examination. Stepwise multiple regression models tend to estimate stature more accurately than linear regression models in female sub-adults.

Efficacy of a multifaceted podiatry intervention to improve balance and prevent falls in older people: a randomised trial

There was a significant reduction in falls rate in the intervention group compared to the control group (incidence rate ratio=0.64, 95% CI 0.45 to 0.91, p=0.01) but no significant differences between the groups in the proportion of fallers/ multiple fallers. There were also significant improvements in secondary outcome measures of the SF-12 physical subscale, the MFPDI function subscale, and several measures of foot and ankle strength and ROM, balance and functional ability in the intervention group compared to the control group. Conclusions In older people with foot pain and an elevated risk of falling, a multifaceted podiatry intervention reduces the rate of falls by 36% and improves several aspects of foot and ankle strength, ROM, balance and functional ability suggesting that podiatry has av aluable role to play in preventing falls in older people.