Medial Longitudinal Arch Height Research Articles

Prevalence of Flatfoot in School-Going Children, Lahore

Background: Flatfoot is characterized by a reduced medial longitudinal arch height and can be flexible or fixed, congenital, or acquired. It can influence physical activity and mood in children, and its prevalence varies widely among different populations. Objective: To determine the prevalence of flatfoot among school-going children aged 7-15 years in Lahore, Pakistan, and to assess its distribution across different age groups and genders. Methods: A cross-sectional study was conducted over six months at Dar-e-Arqam School, Westwood campus, Lahore. The sample size of 106 was calculated using the formula { n = Z^2 P(1-P) / d^2 } with a 16% expected prevalence, 7% precision, and Z value of 1.96. Non-probability sampling was used. Inclusion criteria were children aged 7-15 years of both genders, excluding those with fractures, congenital deformities, or a history of ankle sprain. Footprints were obtained using ink-impregnated pads, and the Chippaux-Smirak index (CSI) was used to diagnose and grade flatfoot. Data were analyzed using SPSS version 25, with descriptive statistics presented as frequencies and percentages. Results: The prevalence of flatfoot among the children was 40.6%, with 4 cases of unilateral flatfoot (3.8%) and 39 cases of bilateral flatfoot (36.7%). Normal arches were found in 62 children (58.5%), and 1 child (0.9%) had a high arch. Among those with flatfoot, 17 had grade 1 flatfoot (16.0%), 12 had grade 2 flatfoot (11.3%), and 14 had grade 3 flatfoot (13.2%). The highest prevalence of flatfoot was observed in the 7-9 years age group (23 cases), while the 13-15 years group had the highest number of normal arches (29 cases). There was no significant difference in the prevalence of flatfoot between genders. Conclusion: Flatfoot is relatively common among children in Lahore, with a prevalence of 40.6%. The condition's prevalence decreases with age, and no significant gender differences were observed. Further research should include a larger sample size, random sampling, and assessment of symptomatic aspects to enhance understanding.

Enhancing Athletes' Foot Stability: A Comparative Analysis of Gluteus Maximus and Gluteus Medius Muscle Strengthening Effects on Navicular Drop, Balance, and Foot Posture Index in Over-Pronated Foot

This study aimed to determine the effectiveness of gluteus maximus versus gluteus medius muscle strengthening exercises on the navicular drop (ND), balance, and foot posture index (FPI 6) among athletes with over-pronated feet. A pre-post experimental study design with a total of 54 athletes with bilateral over-pronated feet were randomly assigned into group A (n=18), group B (n=18), and group C (n=18). Medial longitudinal arch height (MLA) was assessed with the Navicular Drop Test, the static and dynamic balance was determined with the stork stance test (SST) and modified Star Excursion Balance Test, and Foot Posture was assessed with Foot Posture Index 6. Multivariate Repeated measures ANOVA was used to analyze the effects of gluteus maximus versus gluteus medius muscle strengthening and short foot exercises. At four weeks, the gluteus medius along with short foot exercises (group B) showed significantly less ND and FPI 6 while showing more excellent SST and modified SEBT than the gluteus maximus muscle strengthening along with short foot exercises (group A) and control group (group C). These results suggest that adding gluteus medius muscle strengthening exercises to short foot exercises (SFE) was more effective in supporting the medial longitudinal arch and improving balance than performing SFE alone.

Analysis of windlass mechanism according to one walking cycle.

[Purpose] This study aimed to calculate the windlass mechanism in one walking cycle (WC) using the medial longitudinal arch (MLA) height and compare its mechanism with joint moments, angles, and center of gravity movement. [Participants and Methods] The study analyzed the gait of 20 healthy adults (14 males, six females) using a three-dimensional motion analyzer to calculate several parameters. [Results] In the terminal stance, the MLA height reached 20.6 ± 6.0 mm (minimum value) at 49% WC. Simultaneously, the ankle dorsiflexion angle, ankle internal plantarflexion moment, and forward shift of the center of gravity reached the maximum values. At 62% WC, the MLA height was 26.8 ± 4.8 mm and reached maximum during the stance phase, indicating a windlass mechanism. Additionally, the MLA height was 61.7 ± 22.7 mm at 69% WC, indicating an MLA spiking phenomenon. [Conclusion] The MLA height was lowest at 49% WC due to reverse windlass mechanism. Although the windlass mechanism was activated at 62% WC, it was functionally equivalent to the swing phase. Push-off was impossible during the swing phase. At 69% WC, the swing phase showed a second windlass mechanism.

Effect of Weight Bearing on Medial Longitudinal Arch of Foot in Healthy Adults

Background: The medial longitudinal arch (MLA) of the foot plays a pivotal role in biomechanical stability and mobility. Understanding its behavior under different loading conditions is crucial for both clinical and sports-related applications. Previous studies have offered insights into the arch's adaptability, yet the impact of gender on this dynamic has remained underexplored. Objective: This study aimed to investigate the differences in medial longitudinal arch height between genders in non-weight bearing (NWB) and full weight bearing (FWB) positions, to ascertain if gender influences arch behavior under various loading conditions. Methods: Conducted at the Biomechanics and Kinesiology Laboratory of Shifa Tameer e Millat University, this cross-sectional study enrolled volunteers aged 18 to 40 years with normal foot arches. Exclusion criteria included history of foot pain, foot anomalies, pregnancy, or menstruation at the time of data collection. Navicular height was measured using Kinovea software (Version 0.9.5), with participants in both NWB and FWB positions. The study received approval from the Institutional Review Board and Ethics Committee of Shifa International Hospital (IRB # 0213-23). Statistical analysis was performed using independent and paired sample t-tests. Results: The study involved equal numbers of male and female participants, with no significant gender-based differences observed in navicular height in NWB (Males: Left Foot 5.17 ± 0.865, Right Foot 5.19 ± 0.675; Females: Left Foot 5.24 ± 0.89, Right Foot 5.39 ± 0.867) and FWB positions (Males: Left Foot 4.73 ± 0.834, Right Foot 4.88 ± 0.846; Females: Left Foot 4.83 ± 0.898, Right Foot 4.80 ± 0.837). Significant reductions in navicular height from NWB to FWB were noted across both genders (p < 0.01). Conclusion: The medial longitudinal arch height significantly changes under weight bearing, displaying a similar pattern of adaptability across genders. This indicates that gender does not significantly influence the biomechanical behavior of the MLA under the tested conditions.

Design and development of a low-cost device to measure foot parameters in children with disability: A “footmeter”

AIM: To design and develop a low-cost device to measure foot parameters in children with disability. METHOD: Designing of the device was done using Solidworks software, after finalization of design, Phase 2 which involved the development of footmeter, materials used were, a rectangular wooden frame, an aluminum slider, goniometers, metal sheet with markings of 1 cm over an entire sheet in vertical as well as horizontal direction forming small grids. RESULT: An early version of “Footmeter” device was developed by assembling all the parts together. The Footmeter evaluates: foot length, width of forefoot, midfoot and hindfoot, height of Medial Longitudinal Arch(MLA) , abduction of 1st MetaTarso Phalangeal (MTP) and deviation for metatarsus adductus. CONCLUSION: The groundbreaking Footmeter device is meticulously designed for measuring foot parameters in children with disabilities. It offers an unparalleled blend of precision, efficiency, and simplicity. With its objective outcomes, minimal training requirements, decreased manual errors, and a streamlined assessment process, “Footmeter” device stands as the ultimate all-in-one tool for the meticulous measurement of foot parameters in children with disabilities.

Morphological and mechanical characteristics of the intrinsic and extrinsic foot muscles under loading in individuals with flat feet

BackgroundThe intrinsic and extrinsic foot softtissue structures that apply force and support the medial longitudinal arch (MLA) have been implicated in the development of flat feet. However, the relationship between the changes in MLA height under increasing load and the morphological and mechanical properties of individual intrinsic and extrinsic foot soft tissue structures is not fully understood. Research questionTo examine the morphological and mechanical characteristics of the foot soft tissue structures in flat feet when subjected to loading. MethodsThis study consisted of two studies focusing on the extrinsic foot muscles (10 normal feet/11 flat feet) and intrinsic foot muscles (14 normal feet/13 flat feet). Images of the extrinsic and intrinsic foot muscles and plantar fascia (PF) under 10%, 50%, and 90% body weight conditions were obtained using ultrasound-based shear-wave elastography. ResultsThe cross-sectional area (CSA) of the peroneus brevis was larger in the flat-foot group than in the normal-foot group under all loading conditions. The CSAs of the intrinsic foot muscles (abductor hallucis, flexor digitorum brevis, and quadratus plantae) and thickness of the PF in the flat-foot group decreased significantly with increasing load. As for mechanical characteristics, the stiffness of the flexor digitorum longus and abductor hallucis was higher in the flat-foot group than in the normal group under high loading conditions. In addition, flat feet with greater flexibility tended to exhibit a greater decrease in PF thickness and smaller increase in stiffness. SignificanceExcessive stretching of the intrinsic foot muscles and PF occurs in flat feet, and excessive contraction of the flexor digitorum longus may counteract the excessive lowering of the foot arch. Therefore, it is necessary to promote the contraction of the intrinsic foot musculature in feet with greater flexibility of the MLA during loading.

Correlation Of Medial Longitudinal Arch Height With Postural Stability, Sensory Integration, Balance And Fall Risk Among Healthy Young Adults.

A cross-sectional analytical study was conducted on 165 healthy young adults. With pes rectus and pes planus to correlate the medial longitudinal arch height with postural stability, sensory integration of balance and fall risk. Persons with pes cavus, congenital foot anomalies other than pes planus, leg length discrepancies, recent history of trauma, lower limb amputations, history of serious foot injury, ligamentous laxity, or an active inflammatory disorder were excluded. Outcome measurements included normalised truncated navicular height (NTNH), Chippaux Smirak index (CSI), athletic single leg stability (ASLS) index, fall risk (FR) index, postural stability (PS), clinical test of sensory integration of balance (CTSIB), and balance error scoring system (BESS). Spearman correlation and Mann Whitney U test were used for data analysis. CSI and NTNH were noted to have no significant correlation (p<0.05) with PS, FR, CTSIB, ASLS and BESS among healthy young adults. Males were observed to have poorer balance and fall risk as compared to females.

Conservative Treatment with Arch Support Inflatable Ankle-Foot Orthosis Does Not Correct Progressive Collapsing Foot Deformity: A Prospective Comparative and Controlled Study

Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: Progressive Collapsing Foot Deformity (PCFD) can present with independent deformities, characterized by five classes: hindfoot valgus (Class A), midfoot abduction (Class B), forefoot varus (Class C), Peritalar Subluxation (PTS) (Class D) and ankle valgus (Class E). Conservative treatment includes the use of corrective insoles and orthotics. Arch support inflatable Ankle-Foot orthoses (IAFO) can help control symptoms in PCFD patients. However, the ability of IAFOs to correct deformities in PCFD is unknown. The aim of this prospective comparative and controlled study was to assess the ability of arch support IAFOs to correct 3D overall PCFD alignment as well as the five different PCFD classes independently. We hypothesized that IAFOs would correct PCFD 3D overall alignment as well as the five independent classes of deformity. Methods: After IRB approval, we enrolled 24 symptomatic PCFD and 24 controls matched on age, sex, and BMI. Flexible PCFD patients and controls were scanned using Weight-Bearing CT (WBCT) with and without an arch support IAFO. The Foot and Ankle Offset (FAO) was used to assess the 3D foot overall alignment. We measured the Hindfoot moment arm (HMA, Class A), the Talonavicular coverage angle (TNCA, Class B), the Meary’s angle and medial cuneiform-to-floor distance (C1-floor) for the Class C and the middle facet uncoverage (MFunco, Class D). No Class E patients were included. Measurements were performed by two fellowship-trained surgeons. A power-analysis hypothesizing that IAFOs would be two times less efficient than the PCFD surgery in correcting the FAO, the requisite number of subjects was 24 per group. Data normality was assessed by Shapiro-Wilk test. Comparisons used normality based paired T-tests or paired-Wilcoxon tests. P-values &lt; 0.05 were considered significant. Results: PCFD measurements performed in controls were all significantly less pronounced than unbraced PCFD patients, confirming the presence of collapse (ps &lt; 0.0001). Comparing PCFD without and with IAFO, the FAO did not show significant improvement (respectively 6.6+/-3.7% vs 5.5+/-4.2%, p=0.101). The HMA (8.8+/-5.8 vs 8.1+/-5.8, p=0.66), the TNCA (24.2+/-10.6 vs 21.9+/-9.7, p=0.44) and the MFunco (37+/-12% vs 31+/-18%, p=0.17) also did not portray significant improvements when applying the IAFOs. The Meary’s angle (17.6+/-7.2 vs 10.8+/-7.3, p=0.002) and C1-floor (17.2+/-3.3mm vs 24.1+/-5.3mm, p&lt; 0.001) were the only to improve significantly with use of IAFOs. When comparing braced PCFD and controls, the only measurement that improved to normal values, similar to controls, in braced PCFD was the C1-floor (24.1+/-5.3mm in PCFD with IAFO vs 25.7+/- 5.4mm in controls, p=0.31). Conclusion: In this prospective comparative and controlled study, we found that arch support IAFOs was not able to correct overall 3D deformity and most of the specific classes in PCFD. The orthosis did not improve hindfoot valgus (Class A), midfoot abduction (Class B) or peritalar subluxation (Class D) in PCFD. The only deformity pattern to improve with the use of IAFOs was the medial longitudinal arch height (Class C). These improvements were expected by the presence of the inflatable bladder of the IAFO on the plantar aspect of the foot, pushing the longitunal arch up but not correcting the entire PCFD.

The Effectiveness of Video-Based Game Exercise Therapy Applications in Pes Planus Rehabilitation: Protocol for a Randomized Controlled Trial.

Pes planus is one of the most common foot deformities. Although there are many studies on the effectiveness of various exercise methods in pes planus rehabilitation, the number of studies on video-based game exercise therapy applications is very limited. This study aims to evaluate the effectiveness of 2 video-based game exercise therapies and structured exercise practices in pes planus rehabilitation. This study is a 3-arm, parallel-group, single-blinded randomized controlled trial. The study will include 69 patients with flexible pes planus aged between 18 and 25 years who attend the orthopedics and traumatology clinic and meet the inclusion criteria. The primary outcomes are measures of navicular drop and pedobarographic analysis before and after the intervention, and the secondary outcomes include balance, femoral anteversion, and lower extremity muscle strength. Participants will be evaluated with a navicular drop test for medial longitudinal arch height, a pedobarographic analysis system for plantar pressure analysis, a Craig test for femoral anteversion, the Becure Balance System for balance measurement, and a myometer device for lower extremity muscle strength measurement. Participants will be randomly assigned to a structured exercise group, an exergame group, or a serious game group according to their order of arrival. The structured exercise group will use a short foot exercise, a towel-picking exercise, and various walking and balance exercises. Patients in the serious play group will play the lower extremity games in the Becure Balance System. Patients in the exergame group will play balance games on the Nintendo Wii game console. All participants will participate in 18 exercise sessions (3 days a week for 6 weeks). After the treatment, the initial measurements will be repeated. The study started in January 2023. It is expected to be completed in June 2024. This study will be the first randomized controlled study to evaluate the effectiveness of 2 different video-based game exercise therapy applications in pes planus rehabilitation. Through this study, the use of video-based game exercise therapy in pes planus rehabilitation, together with the developing technology, will be a guide. In addition, a new exercise protocol, including serious game exercises, will be added to the literature. In the future, it is expected that our study on the development of different game systems, especially for the ankle, will provide pioneering feedback. ClinicalTrials.gov NCT05679219; https://clinicaltrials.gov/study/NCT05679219. DERR1-10.2196/51772.

Ultrasound and Clinical Alterations in the Foot of Children with Obesity and Diabetes.

Alterations in plantar soft tissues are often reported in adults with diabetes, whereas data on children are conflicting. Also, the extent of foot damage caused by excess body fat in children has not been fully characterized yet. This study aimed to address the relationship between body mass and structural changes of the foot in children and adolescents with and without diabetes. In a case-control study, 43 participants (age 13 ± 2.6 years) were recruited, 29 (67%) with type 1 diabetes (T1D) and 14 (33%) controls. Anthropometric parameters [body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR)], foot posture index-6 (FPI-6) for static foot posture, and navicular drop test (NDT) for medial longitudinal arch height (MLA) were measured in all participants. The thickness of the midfoot plantar fascia (MPF) and medial midfoot fat pad (MMFP) were quantified using ultrasound. No differences in clinical and ultrasonographical parameters were observed between the study groups. MMFP thickness was correlated with MPF thickness (p = 0.027). MMFP and MPF thicknesses were positively associated with BMI (p < 0.001 and p = 0.013, respectively), WC (p < 0.001 and p = 0.013), and WHtR (p < 0.001 and p = 0.026). The NDT measured on the right and left foot correlated with WHtR (p = 0.038 and p = 0.009, respectively), but not with WC and BMI. Children with T1D show structural alterations of plantar soft tissues which seem related to body mass increase rather than diabetes pathology. Ultrasound is a valuable tool to assess early structural changes of the foot in young people with an elevated BMI.

The Effect of Eight Weeks of Kyokushin Karate Training on leg Muscle Activity and Medial Longitudinal arch Height of Adolescent Girls With Foot Pronation

Purpose: The purpose of this study was to investigate the effects of specialized Kyokushin karate exercises on the activity of leg muscles and the height of the medial longitudinal arch in adolescent girls with foot pronation. Methods: This study recruited twenty-four adolescent girls with foot pronation who voluntarily agreed to participate and were randomly assigned to either a training group (n=12) or control group (n=12). The training program consisted of eight weeks of specialized Kyokushin karate exercises. The fibularis longus, tibialis anterior, and lateral gastrocnemius muscles activity was measured during single-leg landing using surface electromyography. The medial longitudinal arch height was measured using the navicular drop test. All statistical analyses, including independent and paired t-tests, were conducted using SPSS software, version 26 at a significance level of 0.05. Results: The results showed that following eight weeks of specialized Kyokushin karate exercises, there was a significant increase in the activity levels of the tibialis anterior (P=0.005) and lateral gastrocnemius (P=0.04) muscles in the training group compared to the control group. However, there was no significant change in the activity of the fibularis longus muscle in the training group compared to the control group (P&gt;0.05). Within the training group, there was a significant increase in the activity of all three measured muscles (fibularis longus, P=0.009; tibialis anterior, P=0.008; and lateral gastrocnemius, P=0.008) from post-test to pre-test (P&lt;0.05). Additionally, the study found that the amount of navicular drop in the training group was significantly reduced compared to the control group (P=0.04) after eight weeks of training Conclusion: This study demonstrated that eight weeks of specialized Kyokushin karate exercises resulted in a significant increase in the activity levels of the tibialis anterior and lateral gastrocnemius muscles in adolescent girls with foot pronation. These exercises also improved the height of the medial longitudinal arch, indicating a potential solution for correcting flat feet. Therefore, we recommend Kyokushin karate exercises to improve muscle activity and arch height in adolescent girls with foot pronation.

Gluteus medius muscle strengthening exercise effects on medial longitudinal arch height in individuals with flexible flatfoot: a randomized controlled trial.

This study aimed to compare the effects of 8 weeks of foot plus hip exercise to foot exercise alone on medial longitudinal arch (MLA) parameters; navicular drop (ND), arch height index (AHI), plantar pressure, static balance, and dynamic balance were measured at baseline, 4 weeks, and 8 weeks. A total of 52 healthy participants with bilateral flatfoot were randomly assigned into foot exercise (n=26) and foot plus hip exercise (n=26) group. At 4 weeks, the foot plus hip exercise group showed significantly less ND (P=0.002), plantar pressure at the medial forefoot (P=0.002), and mediolateral displacement (P=0.001) while showing a greater AHI (P=0.019) than the foot exercise group. At 8 weeks, there was also significantly less plantar pressure at the medial hindfoot (P=0.017) and less anteroposterior displacement (P=0.002) in the foot plus hip exercise group than in the foot exercise group. No significant differences between groups were found in dynamic balance. The addition of gluteus medius muscle strengthening exercise to foot exercise was more effective in supporting the MLA than performing foot exercise alone.

Influence of the menstrual cycle on static and dynamic kinematics of the foot medial longitudinal arch

BackgroundIn women, the laxity of the plantar fascia increases during the ovulation phase of the menstrual cycle. Although it is possible that this increased laxity results in a decreased height of the foot in the medial longitudinal arch and exacerbates symptoms of several overuse injuries of the lower extremity, the influence of the menstrual cycle on static and dynamic kinematics of the medial longitudinal arch is unclear. The purpose of this study was to confirm that the medial longitudinal arch height during static standing, gait, and landing decrease during the menstrual cycle ovulation phase. MethodsParticipants in this study were 16 female college students with normal menstrual cycles and 16 male college students. Navicular height in the static standing position was measured using a three-dimensional foot scanner. Kinematics of the medial longitudinal arch during gait and landing were measured using a three-dimensional motion capture system to determine the navicular height at initial contact, minimal navicular height, and dynamic navicular drop. In all measurements, female participants were tested twice during the course of one complete menstrual cycle: once during the follicular phase and once during the ovulation phase. Male participants were tested twice with an interval of ≥1 week and <2 weeks. ResultsIn women, navicular height in the static standing position significantly decreased during the ovulation phase compared with follicular phase (mean difference [95% confidence interval] = 2.1 [0.9–3.4] mm; p = 0.002), whereas men showed no statistical difference between the first and second measurements. In both men and women, no statistical differences were identified for the dynamic medial longitudinal arch kinematics measured during gait and landing. ConclusionsNavicular height in the static standing position slightly decreased during the ovulation phase.

The effects of Dynamic® taping on vertical jumps in adolescent volleyball players with low medial longitudinal arch

Taping has long been used by health professionals to provide mechanical support for the musculoskeletal system. However, there is insufficient evidence to demonstrate the effect of Dynamic® taping. The aim of this study was to investigate the effect of Dynamic® taping on vertical jump and medial longitudinal arch height in adolescent volleyball players with navicular drop. Material and Methods: 23 female athletes participated in the study (mean age of 15.22 ± 1.54 years). The medial longitudinal arch height was evaluated with the navicular drop test. Vertical jumping was measured with the VERT® device (Mayfonk Athletic, USA). On the first day, athletes were evaluated without a tape, and the next day re-evaluated with the taping on. All athletes jumped on eight different surfaces. Results: The distance of navicular drop in both feet decreased to a statistically significant extent (P &lt; .05) following Dynamic® taping. Comparing the vertical jump heights on eight different floor surfaces, it was found that there was no statistically significant difference for all cases (P &gt; .05). Conclusions: Dynamic® tape application can be used as an easy-to-apply practical treatment agent to support the MLA in asymptomatic athletes with an increasing navicular drop.

Foot Muscle Strength, Muscle Shortness, Balance, and Shoe Preferences in Different Foot Postures

Objective: The aim of this study was to investigate the foot muscle strength, muscle shortness, tibialis posterior endurance, balance, and the shoe preference differences between the neutral and pronated foot posture.&#x0D; Methods: Forty-nine participants consisting of 23 women and 26 men, and age of between 18 and 45 years were participated in the study. Foot posture, medial longitudinal arch height, height, gastrocnemius and hamstring muscle shortness, foot and ankle muscle strength, tibialis &#x0D; posterior muscle endurance, static balance, and shoe preferences of the participants were evaluated. Subjects were recruited into two groups according to their foot posture evaluated with Foot Posture Index: as those with neutral and pronated foot posture.&#x0D; Results: Navicular drop, gastrocnemius, and hamstring muscle shortness were significantly higher in participants with pronated foot posture compared to those with neutral foot (p0.05).&#x0D; Conclusion: Flexibility of gastrocnemius and hamstring muscles were reduced, but foot muscle strength, tibialis posterior muscle endurance, and balance remained unaffected in young individuals with excessive foot pronation. Moreover, shoe preferences may not affect the foot posture in young people. Although all age-related biomechanical effects of foot pronation are not well known yet, muscle shortness seems to arise earlier than muscle weakness and reduced balance in pronated foot posture

Does ankle arthrodesis induce satisfactory changes in the medial longitudinal arch height of the foot for severe varus ankle arthritis?

We designed this study to determine how changes in coronal ankle alignment affect sagittal alignment of the foot. Specifically, we focused on the changes in medial longitudinal arch height, which could be reflected by the medial cuneiform height (MCH), Meary's angle, and calcaneal pitch angle (CPA). We retrospectively analyzed the radiographic findings of 37 patients who underwent open ankle arthrodesis without inframalleolar correction (such as first metatarsal dorsal closing wedge osteotomy, calcaneal osteotomies, tendon transfers, or tarsal joint arthrodesis) of severe varus ankle arthritis. The inclusion criterion was a pre-operative tibial axis to talar dome angle of 80 degrees or less. The enrolled patients were divided into two groups according to the post-operative decrease in MCH (≥ 2mm or < 2mm). A post-operative MCH decrease of ≥ 2mm was observed in 43.2% (16 patients). Although the degree of coronal ankle varus correction was similar, the decrease in the Meary's angle was significantly greater in the group with a post-operative MCH decrease of ≥ 2mm than in those with < 2mm (- 4.1 degrees vs. - 1.3 degrees, P = 0.01). The changes in CPA were not significantly different (P = 0.172). Correction of ankle varus deformity via ankle arthrodesis could lead to a decrease in the medial longitudinal arch height in less than half of the enrolled patients. In these patients, a cavus component of the foot might be an important factor in determining a successful sagittal foot alignment change, while the CPA was maintained post-operatively.

THE EFFECT OF MEDIAL LONGITUDINAL ARCH SUPPORTING DYNAMIC® TAPE APPLICATION ON PLANTAR PRESSURE DISTRIBUTION IN ADOLESCENT VOLLEYBALL PLAYERS

Low medial longitudinal arch (MLA), which is accepted as one of the predisposing factors leading to overuse injuries, changes the plantar pressure distribution by disrupting the load distribution. While there are studies investigating the effects of Kinesio® and rigid taping methods on plantar pressure distribution in the literature, there are no studies found investigating the effect of Dynamic® taping (DT) on foot load distribution. The purpose of this study was to examine the effect of arch-supportive DT on plantar pressure distribution in adolescent volleyball players with low MLA. Twenty-five female volleyball players with a navicular drop of 8 mm and above and a mean age of 15.44 ± 1.68 years participated in this study. The distance of navicular drop was evaluated by navicular drop test, and the plantar pressure distribution was evaluated by the pedobarographic analysis method. After the first measurements were taken, Dynamic® tape was applied. The athletes were then reassessed using the same procedure. After taping, the navicular drop was significantly reduced for both feet (p&lt;0.05). There was no significant difference between the peak pressure values before and after taping (p&gt;0.05). Total forefoot and hindfoot surface contact areas decreased significantly (p &lt;0.05). Our study results showed that DT did not affect the peak plantar pressure, but could be effective in decreasing the surface contact area and increasing the MLA height. Dynamic® tape can be used as a practical, easy-to-apply treatment agent that supports the arch in asymptomatic athletes.

Effect of Short-Foot Exercise Performed on Different Surfaces on Medial Longitudinal Arch Height and Static Balance in Healthy Adults

Effect of Short-Foot Exercise Performed on Different Surfaces on Medial Longitudinal Arch Height and Static Balance in Healthy Adults

Associations of muscle volume of individual human plantar intrinsic foot muscles with morphological profiles of the foot.

Human plantar intrinsic foot muscles consist of 10 muscles that originate and insert within the sole of the foot. It is known that the anatomical cross-sectional area (ACSA) and muscle thickness of two plantar intrinsic foot muscles, the flexor hallucis brevis (FHB) and abductor hallucis (ABH), associate with morphological parameters of the foot, such as total and truncated foot length and navicular height. However, it is unclear how the size for each of the plantar intrinsic foot muscles associates with various morphological profiles of the foot. This study aimed to elucidate this subject. By using magnetic resonance imaging (MRI), serial images of the right foot were obtained in 13 young adult men without foot deformities. From the obtained MR images, ACSA for each of the individual plantar intrinsic foot muscles was analyzed along the foot length, and then its muscle volume (MV) was calculated. The analyzed muscles were the abductor digiti minimi (ABDM), ABH, adductor hallucis oblique head (ADDH-OH), adductor hallucis transverse head (ADDH-TH), flexor digitorum brevis (FDB), FHB, and quadratus plantae (QP). Furthermore, MV of the whole plantar intrinsic foot muscle (WHOLE) was defined as the total MVs of all the analyzed muscles. As morphological parameters, total foot length, truncated foot length, forefoot width, ball circumference, instep circumference, navicular height, great toe eversion angle, and little toe inversion angle were measured using a laser three-dimensional foot scanner in standing and sitting conditions. In addition, navicular drop (ND) and normalized truncated navicular height (NTNH) were also calculated as medial longitudinal arch (MLA) height indices. The MV of WHOLE was significantly associated with the forefoot width, ball circumference, and instep circumference (r=0.647-0.711, p=0.006-0.013). Positive correlations were found between the forefoot width and MV of FHB, FDB, and QP (r=0.564-0.653, p=0.015-0.045), between the ball circumference and MV of QP (r=0.559, p=0.047), between the instep circumference and MV of FHB (r=0.609, p=0.027), and between the little toe inversion angle and MV of QP (r=0.570, p=0.042). The MVs of ABH, ABDM, and ADDH-OH were not significantly correlated with any morphological parameters of the foot. Similarly, no significant correlations were found between MV of each muscle and either of the MLA height indices (ND and NTNH). Thus, the current results indicate that forefoot width and circumferential parameters (instep and ball circumference), not MLA height, associate with the size of the whole plantar intrinsic foot muscles, especially those specialized in toe flexion (FHB, FDB, and QP).

Differences in Foot Characteristics Between Bharatanatyam Dancers and Age-Matched Non-Dancers.

The ankle-foot complex is the third most common site of pain in Indian dancers. In Bharatanatyam dance, rhythmic stamping performed barefoot at varying speeds may influence the height of the medial longitudinal arch, causing structural alteration of the ankle-foot complex. As little information is available on the ankle-foot complex of Bharatanatyam dancers, the present study was conducted to test the hypothesis that foot characteristics of Bharatanatyam dancers differ from those of non-dancers. Female professional Bharatanatyam dancers (n=21), aged 18-30 years, with a minimum of 8 years of performance experience after completing formal dance training, and 21 control non-dancers participated in this study. Physical foot examination included navicular drop test and Feiss line. Foot geometry and pedobarography were recorded as participants walked barefoot at self-selected walking pace over a pressure-platform. An average of five gait cycles was computed to analyse maximum peak pressure (MPP), pressure time integral, contact time, and foot geometry of the midfoot, forefoot, great toe, and second to fifth toes. Analysis of covariance was performed for intergroup comparison of all variables with gait speed as a covariate. During walking, dancers presented a higher medial-longitudinal-arch, wider midfoot, and wider forefoot (cm) (p<0.001), indicating an over-pronated foot due to lower medial longitudinal arch height. Total plantar peak pressure (kPa) was 37% higher among dancers, whereas MPP was 24% higher on midfoot and 13% higher on forefoot, indicating greater plantar loading during walking. Greater plantar loading and an over-pronated foot during the most commonly performed weight-bearing activity of daily living (e.g., walking) explain the common prevalence of ankle and foot pain among dancers. These findings will inform clinicians and Bharatanatyam dancers on dancer's foot function and guide strategies for prevention and management of foot pain.