Posture Index Research Articles

Evidence for Intrinsic Foot Muscle Training in Improving Foot Function: A Systematic Review and Meta-Analysis.

To critically assess the literature focused on strength training of the intrinsic foot muscles (IFMs) and resulting improvements in foot function. A search of electronic databases (PubMed, CINAHL, Scopus, and SPORTDiscus) was completed between January 2000 and March 2022. Randomized control trials with an outcome of interest and at least 2 weeks of IFM exercise intervention were included. Outcomes of interest were broadly divided into 5 categories of foot posture (navicular drop and Foot Posture Index), namely: balance, strength, patient-reported outcomes, sensory function, and motor performance. The PEDro scale was used to assess the methodologic quality of the included studies with 2 independent reviewers rating each study. Studies with a PEDro score greater than 4/10 were included. Data extracted by 2 independent reviewers were design, participant characteristics, inclusion and exclusion criteria, type of intervention, outcomes, and primary results. We performed a random-effects meta-analysis to analyze the difference between intervention and control groups for each outcome when at least 2 studies were available. Standardized mean differences (SMDs) describe effect sizes with 95% CIs (SMD ranges). When the CI crossed zero, the effect was not significant. Thirteen studies were included, and IFM exercise interventions were associated with decreasing navicular drop (SMD range = 0.37, 1.83) and Foot Posture Index (SMD range = 1.03, 1.69) and improving balance (SMD range = 0.18, 1.86), strength (SMD range = 0.06, 1.52), and patient-reported outcomes for disability (SMD range = 0.12, 1.00), with pooled effect sizes favoring the IFM intervention over the control. The IFM exercises were not superior (SMD range = -0.15, 0.66) for reducing pain. We could not perform a meta-analysis for sensory function and motor performance, as only 1 study was available for each outcome; however, these results supported the use of IFM strength training. Strength training of the IFMs was helpful for patients in improving foot and ankle outcomes.

Cavus Foot in Soccer Players: Increased Prevalence in Experienced Players and Risk Factor for Injury.

Foot type, especially cavus foot, is associated with foot and ankle soccer injuries, such as ankle sprains, ankle instability, and foot and ankle lateral injuries. The aim of this study was to identify risk factors for foot and ankle injuries among soccer players. Male and female soccer players, from beginners to semiprofessionals, aged between 10 and 40 years were enrolled in this cross-sectional study. Players filled in questionnaires about their training and injury history. Clinical measurements included foot length, Foot Posture Index-6, and arch height flexibility. Each variable was dichotomized: age (<18 years versus ≥18 years), level of play (AA and below versus AAA and above), foot type (cavus or not), and injury. Injury occurrence was analyzed using χ2 tests between each group of variables, and significance was set at P < .05. A total of 277 players, including 81 females, volunteered; 147 were younger than 18 years and 180 were AA level or below. Cavus foot prevalence was 30%. In the cavus foot group, 51.8% of players had reached at least an AAA level compared with 27.8% in the normal-arched group (P < .001 [χ2]). Injuries were associated with a cavus foot type (P < .01 [χ2]) and with sex, age, or highest level played (P < .001 [χ2]). This study identified a high prevalence of cavus foot among soccer players of all ages, with an increased prevalence among higher-level players. The injury risk factors were female sex, older age, playing at a higher level, and cavus feet.

Association between Foot Posture and Agility in Amateur Soccer Players

Background: Agility is the ability to accelerate, decelerate and sprint with change in direction. The risk factors for injuries in soccer players are imbalance, decreased agility, and improper foot posture. Understanding the relationship between foot posture and agility can facilitate agility training and rehabilitation to improve their performance in the sport. Objective: To determine an association between foot posture and agility in amateur soccer players. Methodology: The cross sectional study recruited 78 age and gender-matched amateur soccer players. They were then allocated into pronated, supinated and neutral foot postures based on the foot posture index scores. Later the modified Illinois change of direction test (MICODT) was administered to all the players to test agility. With standing as the starting position of the test the players were made to run from the starting point to the finish point without any stop in between. The time to complete the test was noted. Results: Out of 78 subjects, 26 subjects had supinated feet 26 had pronated feet and 26 had normal feet. An association was found between foot posture and agility with a significance of p0.001. Logistic regression analysis revealed that players with supinated a feet demonstrated 3.53 times greater influence on agility than players with normal feet (p0.05). Players with pronated feet showed 0.54 times greater influence on agility than players with normal feet. Conclusion: A significant association between foot posture and agility was detected in amateur soccer players. Supinated feet influenced agility to a greater degree when compared to pronated and normal foot postures in amateur soccer players.

Comparison of foot kinematics and ground reaction force characteristics during walking in individuals with highly and mildly pronated feet

BackgroundIndividuals with highly pronated feet (PF) are more prone to lower extremity injuries than those with mildly PF. However, whether foot kinematics and ground reaction force (GRF) characteristics differ according to the severity of PF deformity is unclear. Research questionAre there differences in foot kinematics and GRF characteristics during walking between individuals with mildly PF and those with highly PF? MethodsTen individuals with mildly PF and 10 with highly PF (six-item foot posture index scores: 6–9 and 10–12 points, respectively) participated in this study. A three-dimensional motion analysis system measured participants’ foot kinematics and GRF characteristics during gait trials. ResultsParticipants with highly PF exhibited significantly lower medial longitudinal arch heights than those with mildly PF from 0 % to 90 % of the stance phase (p < 0.05). No significant differences were observed in any of the angles between the foot segments. Additionally, participants with highly PF exhibited significantly larger posterior GRF than those with mildly PF from 2 % to 7 % of the stance phase (p < 0.05). Participants with highly PF also exhibited significantly larger anterior GRF than those with mildly PF, from 62 % to 82 % of the stance phase (p < 0.05). SignificanceThe results of this study suggest that the more severe the PF deformity, the more inefficient the foot ground force transmission, and the stronger the load applied to the foot. These results may be related to the higher incidence of lower extremity injuries in individuals with highly PF than in those with mildly PF.

Correlation of Foot Posture, Dynamic Balance and Gait Speed in Community-dwelling Older Individuals

Introduction: Foot posture is crucial in maintaining stability and balance during movement. It encompasses the position and alignment of the feet and ankles, significantly impacting overall body stability and reducing the risk of falls. Dynamic balance refers to maintaining balance while in motion, encompassing walking, running, and jumping. Aim: To find a correlation between foot posture, dynamic balance and gait speed in community-dwelling older individuals. Materials and Methods: The correlational study included 100 community-dwelling older individuals who met the specified inclusion and exclusion criteria. The Foot Posture Index was utilised as the outcome measure for foot posture, the Modified Four-Square Step Test (MFSST) for dynamic balance, and the Gait Speed Test for gait speed assessment. Results: The results revealed a weak positive correlation between gait speed and foot posture, with a statistically significant weak positive correlation observed in individuals with normal foot posture. In contrast, a statistically significant moderate positive correlation was found between gait speed, dynamic balance, and pronated foot posture (r= 0.63, P &lt; 0.05). Furthermore, a weak negative correlation was observed between gait speed and supinated foot posture, with a statistically significant moderate negative correlation between dynamic balance and supinated foot posture. Conclusion: Pronated foot posture demonstrated a stronger association with gait speed and dynamic balance than supinated and normal foot posture. These findings suggest that older adults with pronated foot posture experience greater effects on gait speed and dynamic balance. Keywords: Foot posture, Gait, Balance, Elderly

Relationship of Chronic Ankle Instability With Foot Alignment and Dynamic Postural Stability in Adolescent Competitive Athletes.

Competitive adolescent athletes should be aware of the early signs of chronic ankle instability (CAI) and the connection between the condition and performance. To investigate whether CAI is related to foot alignment and morphology as well as dynamic postural stability after a jump landing among adolescent competitive athletes with and without a history of a lateral ankle sprain and CAI. Cross-sectional study; Level of evidence, 3. Between July 2020 and August 2021, adolescent competitive athletes (N = 85; n = 49 boys; n = 36 girls) were classified into 3 groups using Cumberland Ankle Instability Tool (CAIT) scores: healthy athletes (n = 55), coper athletes (n = 19), and athletes with CAI (n = 11). Results of foot alignment assessments involving the leg-heel angle (LHA) and navicular height, intrinsic foot muscle morphology, dynamic postural stability index (DPSI), and other parameters were compared among the 3 groups. The relationship between the CAIT score and the LHA and dynamic postural stability and instability were examined using multiple linear regression. Compared with the healthy group, the CAI group had a significantly greater LHA (8.73°± 3.22° vs 6.09°± 3.26°; P < .05), higher DPSI (0.336 ± 0.046 vs 0.298 ± 0.035), and higher vertical stability index (0.303 ± 0.048 vs 0.264 ± 0.037; P < .05 for all). Multiple regression analysis showed that the LHA (β = -0.228; P = .033) and DPSI (β = -0.240; P = .025) were significantly associated with the CAIT score . Valgus rearfoot alignment and poorer dynamic postural control were associated with CAI among adolescent athletes.

Comparison of foot measures on dynamic and static balance in children engaged in different sports disciplines

It is known that sports contribute to the development of children's anthropometric, biomechanical, postural and proprioceptive characteristics. By participating in a sport discipline in childhood, it is possible to gain sports-specific features. Comparing sports that require different motoric features and neuromuscular competencies raises the question of how these different requirements might also affect biomechanical and balance skills. The aim of this study is to compare the foot posture, foot function and dynamic-static balance in children who engaged sports in different sport disciplines. The study included totally 66 child athletes with the mean age of 13.19±2.11 from the box, basketball and swimming disciplines. 54.55% of the participating athletes were female and 45.45% were male. Demographic and sport-specific characteristics of the participants were questioned with an 11-question case form. The Foot Posture Index (FPI) and the Foot Function Index (FFI) were administered. Static balance assessment was performed with the Flamingo Balance Test and dynamic balance assessment was performed with the Y Balance Test. The data obtained for each sport branch were compared between groups. There was no statistically significant difference in terms of demographic characteristics among groups. A statistically significant difference was found between boxing, basketball, and swimming branches in terms of FPI score, right and left static balance results, and foot posture class parameters (p

Foot Pain and Disability in Women with Rheumatoid Arthritis, Ehlers-Danlos Syndrome and Systemic Lupus Erythematosus: Relationship with Quality of Life.

The aim of this work was to investigate the relationship foot pain and foot disability have with HRQoL in groups of women with RA, SLE and EDS, in comparison with a control group. A cross-sectional study was carried out with females with one of these conditions and a control group. The SF-12 questionnaire was used to collect data about quality of life. The type of foot was classified according to the footprint and the foot posture index. A total of 156 patients and 47 controls participated in the study (N = 203). Neither pain nor foot posture were different between groups. The physical and mental components of SF-12 were worse in rheumatoid arthritis and Ehlers-Danlos syndrome patients, and the physical component was worse in systemic lupus erythematosus patients, compared to controls. A significant difference was also observed in the mental component between systemic lupus erythematosus and Ehlers-Danlos syndrome patients, the latter having the lowest values among the groups. We can conclude that women with rheumatoid arthritis, Ehlers-Danlos syndrome, systemic lupus erythematosus and foot pain perceive a worse quality of life. There are no significant changes in foot posture. Pain and health-related quality of life are independent of foot posture.

Vibration perception among children and adolescents with Charcot-Marie-tooth disease and implications for foot posture

BackgroundAlterations in vibration perception among children and adolescents with Charcot-Marie-Tooth disease might explain observed changes in foot posture. Therefore, this cross-sectional study compared the vibration perception of the lower limbs in youths with and without Charcot-Marie-Tooth disease and verified the cut-off value of the distal vibration perception for the Charcot-Marie-Tooth group. In addition, associations between dynamic plantar pressure, vibration perception and isometric muscle strength were investigated. MethodsParticipants aged 9–18 (Charcot-Marie-Tooth group n = 32; Typical group n = 32) had vibration perception measured by a 128-Hz graduated tuning fork. The static and dynamic foot posture were evaluated by the Foot Posture Index and pressure distribution measuring system, respectively. For the Charcot-Marie-Tooth group, a hand-held dynamometer evaluated the isometric muscle strength of the lower limbs. FindingsChildren with Charcot-Marie-Tooth disease presented impaired vibration perception at the distal phalanx of the hallux and head of the first metatarsal compared to their typically developing peers, while adolescents with Charcot-Marie-Tooth disease showed impairment in all the tested regions compared to their typically developing peers. The cut-off value for vibration perception for participants with Charcot-Marie-Tooth disease was 5.7, considering the original grade of the tuning-fork 128 Hz. Among the associations established for the Charcot-Marie-Tooth group, a greater vibration perception at the distal phalanx of the hallux was associated with a longer rearfoot contact time (β = 31.02, p = 0.04). InterpretationThese new findings may guide the clinical evaluation and rehabilitation treatment for children and adolescents with Charcot-Marie-Tooth disease.

Effect of anti-gravity treadmill (Alter G) training on gait characteristics and postural stability in adult with healed burns: A single blinded randomized controlled trial

BackgroundBurns constitute one of the foremost contributors to premature mortality and morbidity, and the recovery process from burn injuries is characterized by its intricate and protracted nature. ObjectiveThe principal aim of this study was to assess the influence of an anti-gravity treadmill (Alter G) training program on both gait characteristics and postural stability indices (PSI) in adult individuals who have recovered from burns. DesignThis study followed a single-blind, randomized, controlled design. MethodsA total of 45 adults, aged 18–35 years, with healed lower extremity burns that were circumferential and encompassed 35–50% of their total body surface area (TBSA) were randomly allocated to either the anti-gravity treadmill (Alter G) Training group (n = 22) or the traditional physical therapy program (TPTP) group (n=23). The TPTP group received conventional physical therapy, while the anti-gravity treadmill (Alter G) training group engaged in anti-gravity treadmill exercises alongside the traditional physical therapy program. The primary outcome measures, evaluated at both baseline and the conclusion of the 12-week intervention, included gait characteristics assessed using the GAITRite system and PSI measured by the Biodex Balance System (BBS). ResultsThe anti-gravity treadmill (Alter G) training group exhibited significantly greater enhancements than the TPTP group in terms of mean values and percentage changes in gait characteristics and PSI. Specifically, the percentage changes for the Alter G group were as follows: stride length (20.57%), step time (22.58%), step length (20.47%), velocity (15.67%), cadence (23.28%), and double support time (29.03%). In contrast, the TPTP group’s percentage changes were: 6.73%, 8.19%, 7.65%, 7.75%, 8.89%, and 9.37%, respectively. Concerning PSI, the Alter G group exhibited percentage changes of 55.17% for the medio-lateral stability index (MLI), 48.21% for antero-posterior stability index (API), and 48.48% for the overall stability index (OSI). The TPTP group’s corresponding percentage changes were 20%, 14.03%, and 16.41%. ConclusionsThe amalgamation of anti-gravity treadmill training with the traditional physical therapy program yields greater efficacy than TPTP in isolation. Consequently, the findings underscore the efficiency of anti-gravity treadmill (Alter G) Training as a valuable tool for rehabilitating patients with burn injuries.

Impact of pronated foot on energetic behavior and efficiency during walking

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

Foot Posture after MS and Functional Consequences

Background: Clinical convention suggests that foot posture and movements are adversely affected by MS and cause walking difficulties but there is little objective data to support or refute these beliefs. This study explores static foot posture in people with MS and their relationship to walking disability and limitations Materials and Methods: This is a cross-sectional study that was conducted in the multiple scoliosis specialist department of Kashani Hospital in Isfahan on 44 patients with MS with mobility limitations. The indices for determining Foot Posture Index (FPI), demographic characteristics, Expanded Disability Status Scale (EDSS), and walking scale (msws-12) were investigated. Results: About one-third of participants had abnormal foot posture, which wasn’t associated with walking limitations. Most (80%) had a symmetrical foot posture with similar frequencies of supination (9%) and pronation (11/5%) abnormalities. There was no relationship between foot posture and walking limitation and expanding disability. Conclusions: A minority of people with MS had abnormal or asymmetrical foot posture and equal numbers suffered pronation and supination abnormalities; these findings challenge the beliefs that underpin the clinical management of MS-related foot problems.

Postural control measured before and after simulated ankle inversion landings among individuals with chronic ankle instability, copers, and controls

BackgroundPostural control measured during single-leg stance and single-leg hop stabilization has been used to estimate sensorimotor function in CAI individuals and copers. To date, studies have not used postural control tasks as a way of measuring responses to sudden changes in sensory information after simulated ankle inversion landings. Research questionA cross-sectional study was performed to identify any differences in static and dynamic postural control before and after simulated ankle inversion landings among individuals with chronic ankle instability (CAI), copers, and healthy controls. MethodsNineteen CAI individuals, 19 copers, and 19 controls participated in this study. Participants performed 3 static and dynamic balance tasks before and after simulated ankle inversion landings onto a 25° tilted platform from a height of 30 cm. The main outcome measures were the center of pressure (COP) velocity and range from the single-leg stance, as well as the dynamic postural stability index from the single-leg hop stabilization. The Wilcoxon signed-rank test was used to compare posttest and pretest differences in static and dynamic postural control between groups. ResultsIn the static postural control measures, the CAI group had a higher difference in COP velocity and COP range in the frontal plane (p < 0.05 and p < 0.05, respectively) than the coper group. In the dynamic postural control measures, the CAI group demonstrated a higher difference in the vertical stability index (p < 0.05) than the healthy control group. SignificanceCAI individuals have persistent worse postural control after somatosensory modulation due to their inability to adapt to sudden somatosensory modulation. Relative to CAI individuals, copers may have different abilities not only the integration of somatosensory input about ankle inversion modulation, but also the adaptation of the entire motor control system, preventing recurrent ankle sprains after an initial LAS. Therefore, somatosensory modulation may be the indicator of understanding CAI and coper.

Investigation of mid-term functional skills and psychological factors in female patients undergoing total knee arthroplasty

Background/Aim: Previous studies have yielded conflicting clinical, psychological, and functional outcomes in patients undergoing total knee arthroplasty (TKA). This study aimed to more precisely evaluate the clinical outcomes, mid-term general physical and psychological health status, functional abilities, and improvements in patients’ quality-of-life undergoing TKA. Methods: This cross-sectional study included 25 female patients older than 55 years who underwent unilateral TKA due to osteoarthritis (OA). The Five Repetition Sit-to-Stand Test (5STS), Stair-Climbing Test (SCT), 6-Minute Walking Test (6MWT), Berg Balance Scale (BBS), Tampa Scale for Kinesiophobia (TSK), and Short Form Health Survey (SF-12) scores of the patients were evaluated using means. Meanwhile, the Lower Limb Length (LLL), Navicular Drop Test (NDT), Proprioception Assessment, Foot Posture Index (FPI-6), Foot Function Index (FFI), Lower Extremity Functional Scale (LEFS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS) were evaluated by comparing the operated (OP) sides that underwent TKA with the non-operated (NONOP) sides diagnosed with OA. Results: The study found that LLL (P=0.001), abduction/adduction forefoot on rearfoot (ABD) (P=0.017), and T.FPI-6 (P=0.014) in the FPI-6 parameters, as well as KOOS (P&lt;0.001), OKS (P&lt;0.001), LEFS (P&lt;0.001), and FFI (P&lt;0.001) results, were significantly in favor of the OP limb. Besides some parameters in FPI-6, no significant difference was found between the OP and NONOP extremities in terms of prone and supine proprioception values (P&gt;0.05). Conclusion: Overall, it was found that TKA plays a crucial role in recovery and regaining functional skills. Including preoperative evaluations with a control group and patients of both sexes in future studies and examining the relationships between the conducted tests and scales may contribute to better evaluating the results.

The Relationship between Features of Foot Posture, Thickness of Intrinsic Foot Muscles and Dynamic Postural Stability

PURPOSE: This study aimed to determine the correlations between foot posture features, intrinsic foot muscles (IFMs) thickness, and dynamic postural stability.METHODS: Forty-one male participants were divided into two groups according to quantified foot postures using the Foot Posture Index (FPI-6) scores: the neutral foot group (FPI-6 score: 0 to +5) and the pronated foot group (FPI-6 score: &gt;+6). The IFMs thickness was measured using ultrasound images of the flexor digitorum brevis (FDB), flexor hallucis brevis (FHB), and abductor hallucis muscles. To investigate the association between IFMs thickness and dynamic postural stability, the Biodex Balance System (BBS) was used in a single-leg stance position with both the eyes open and closed.RESULTS: In the BBS tests, the pronated foot group demonstrated significant results in the eyes-closed condition (&lt;i&gt;p&lt;/i&gt;&lt;.05). In particular, the differences between the eyes open and closed conditions in postural stability indices were significantly greater in the pronated foot group than in the neutral foot group (&lt;i&gt;p&lt;/i&gt;&lt;.05). No significant differences in IFMs thickness between the two groups were observed; however, some subdomains of the FPI-6 demonstrated significant positive correlations with postural stability indices and significant negative correlations with IFMs thickness (&lt;i&gt;p&lt;/i&gt;&lt;.05). The talonavicular joint was associated with FDB thickness (R=-0.311). Moreover, the forefoot was correlated with FHB thickness (R=-0.327).CONCLUSIONS: The aforementioned results suggest that dynamic postural stability and IFMs thickness are affected by the foot type. Although no significant differences in IFMs thickness were observed, dynamic postural stability and IFMs thickness reduced as the foot displayed features of pronation. This indicates that postural control ability and IFMs are vulnerable to changes in foot posture.

A feasibility study of applying two-dimensional photogrammetry for screening and monitoring of patients with adolescent idiopathic scoliosis in clinical practice

Standing posteroanterior radiographs have been the golden standard to quantify the severity of scoliosis deformity. However, it exposes ionizing radiation to scoliosis patients, and cannot be used for routine screening and monitoring. This study aimed to develop a protocol of measuring postural indexes by using the noninvasive and radiation-free two-dimensional (2D) photogrammetry method and identify its clinical value in scoliosis screening and monitoring. The five postural indexes were measured from the posterior view of 110 participants. One-way ANOVA with post hoc Tukey HSD/Games–Howell analysis was used to compare the differences between the participants in the scoliosis group and the non-scoliosis group. Pearson coefficients of correlation were analyzed to identify the relationships between Cobb angles and each of the five quantitative postural indexes. Based on 2D photogrammetry, the postural indexes of C7 deviation (p = 0.02), shoulder alignment (p < 0.001), scapula alignment (p < 0.001), waist angle discrepancy (p < 0.001), and PSIS alignment (p < 0.001) could significantly differentiate scoliosis and non-scoliosis patients during screening. The waist angle discrepancy (r = 0.4, p = 0.01; r = 0.8, p = 0.03; r = 0.7, p = 0.01) and shoulder alignment (r = 0.6, p = 0.03) had moderate to strong positive correlations with the Cobb angles, which supported their clinical values in monitoring scoliotic curvature changes of adolescent idiopathic scoliosis (AIS) patients.

Prevalence of foot posture deformities using foot posture index in various intensive care unit nurses

Background: This study aims to determine the prevalence of foot posture deformities among various intensive care unit nurses using the Foot Posture Index. Nurses working in ICUs often face long hours of standing and walking, which can contribute to the development of foot-related problems. Understanding the extent of these deformities can contribute to the development of preventive measures, such as ergonomic interventions and targeted exercises, to mitigate the risk of foot-related issues. Methods: A study was conducted among 159 nurses from various Intensive Care Units. The Foot Posture Index, a validated tool for assessing foot posture was used to assess foot deviations in nurses. Results: In total159 participants were evaluated, with 6 (4%) being males and 153 (96%) being females. The mean age of the participants was (Mean=40.67) and standard deviation (SD=9.6). Prevalence percentage of foot posture deviations were found to be bilateral as demonstrated by Foot Posture Index. Out of 159 participants 43% participants had pronated foot, 14% participants had highly pronated foot, 16% participants had supinated foot, 7% had normal highly supinated foot posture and 20% participants had normal foot. Conclusions: To conclude the present study, pronated foot posture was the most common foot deviation. Moreover, when BMI was compared with the pronated foot deviation, there was a positive association between pronated foot and the nurses who were overweight.

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.

Transcranial direct current stimulation over dorsolateral prefrontal cortex improves postural stability in non-specific chronic low back pain patients with high fear of pain: A randomized sham-controlled trial.

Deficits in postural stability in response to environmental challenges are seen in chronic low back pain (CLBP) patients with high fear of pain (HFP). Hence, it is essential to follow effective approaches to treat postural stability deficits and improve the health status of these patients. The current study aimed to compare the effects of cathodal and anodal transcranial direct current stimulation (c-tDCS and a-tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on postural stability in non-specific CLBP patients with HFP. In this randomized clinical trial study, 75 patients were randomly assigned to left DLPFC a-tDCS, left DLPFC c-tDCS and sham stimulation groups (n= 25 in each group). All groups received a single-session 2mA tDCS for 20 min, but the stimulation was slowly turned off after 30 s in the sham group. Before, immediately, 24 h and 1 week after the interventions, postural stability indices were assessed using a Biodex Balance System. A significant reduction in most indices was shown in both a-tDCS and c-tDCS groups after interventions (immediately, 24 h and 1 week follow-up) during static and dynamic postural tasks compared with the sham tDCS group (p< .01). In addition, some tests showed a significant difference between a-tDCS and c-tDCS (p< .05). The findings indicated positive effects of both a-tDCS and c-tDCS on the left DLPFC, with more efficacy of a-tDCS on postural stability in LBP patients with HFP.

Effect of Body Mass Index on Foot Posture Types and Core Stability Among University Students

Background: Core Stability is the capacity to regulate the position and motion of the trunk over the pelvis foroptimal force production, transmission, and motion control to the terminal segment during integrated sportsactivities. Obesity is linked to a number of debilitating musculoskeletal diseases in adults. The Foot PostureIndex can be used to assess deviations in foot posture alignment, such as pronation and supination. Variousstudies were conducted to determine the impact of Body Mass Index on core stability and foot posture alignmentin non-athletic males aged between 22 and 27 years. As a result, the current study is determining the impact ofBody Mass Index on core stability and foot posture types in male and female participants of the age group (18 to25 years).Materials and Methods: In this Observational study A total 100 samples were taken based on the inclusion andexclusion criteria which were categorized into two groups. Group A -50 male subjects, Group B - 50 femalesubjects.Foot Posture Index-6 was used to assess foot. Normal foot, Pronated and supinated foot type during static footposture was obtained by Foot Posture index. Core Stability was checked by prone plank test.Conclusion: According to this study, both Men and Women are more likely to acquire pronated feet when theirweight increases. In females, the likelihood of having a flat foot and a pronated foot type increases as the weightincreases, especially those who are belonging to overweight and obese category of Body Mass Index