Weight-bearing Function Research Articles

Accuracy of lachman and anterior drawer tests for anterior cruciate ligament injuries.

The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament (ACL) ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer tests in ACL injury in compare with arthroscopy. In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspected to have ACL rapture were entered the study. Statistical analysis was performed by the usage of SPSS 16. Multiple comparison procedures were performed for comparing data between clinical examination and arthroscopic findings and their relation with age and sex. Mean age of patients was 28.3±7.58 years (range from 16 to 68 years). From 428 patients, 41.2% (175 patients) were between 26 and 35, 38.8% (165 ones) between 15 and 25 and 20% (85 patients) out of 36 years. 414 patients were male (97.2%) and 12 were female (2.8%). Sensitivity of anterior drawer test was 94.4% and sensitivity of Lachman test was 93.5%. The diagnosis of the ACL injury and the decision to reconstruct ACL could be reliably made with regards to the anterior drawer and Lachman tests result. The tests did not have privilege to each other. The test accuracy increased considerably under anesthesia especially in women.

기능적인 하지길이 차이에 따른 족저압 변화가 족부체열에 미치는 영향

Purpose : The purpose of the research was to analyze foot pressure, foot temperature, and correlation between foot pressure and foot temperature to grasp impact on foot pressure and body temperature distribution chart depending on functional difference of leg length. Method : After measuring leg length, put 15 students whose functional difference of leg length was over 10mm to difference group and 15 students whose functional difference of leg length was under 5mm to normal group and categorize soles of foot into 6 sections of hallux head, 1st metatarsal head, 2-4 metatarsal head, 5 metatarsal head, lateral heel, and then measure by foot pressure analyzer to analyze characteristic of pressure distribution and classify into front of the lower leg, back of the lower leg, soles of foot and measure by body temperature analyzer to analyze by checking body temperature. Result : Weight difference depending on foot pressure and body temperature was bigger when functional difference of leg length was bigger, and it could be confirmed that foot pressure and body temperature of short leg side were higher than those of short leg side. Thus, if difference exists in leg length, weight load on short leg side increases which results in higher foot pressure and body temperature, therefore enabling an assumption that mechanical problem will occur in short leg. Conclusion : When functional leg length inequality, weight bearing and pressure was getting high as a result, temperature was getting high in short leg.

A free vascularized tibia-fibular composite graft for the traumatic femoral bony defect of a 6-year-old boy with 10-year follow up: a case report

IntroductionFree vascularized fibular grafts have been widely used for the reconstruction of long bone defects. However, the use of a vascularized tibial graft is precluded by its weight-bearing function and unacceptable donor site morbidity.Case presentationWe present a rare case of using a vascularized tibia-fibular composite graft taken from a 6-year-old Chinese boy’s ipsilateral lower leg to reconstruct a large bony defect of his traumatic femur. Hypertrophy of the tibial graft, good remodeling of the femoral shaft, and atrophy of the unloaded fibular graft were noted at the 10-year follow up. He was able to participate in outdoor activities such as basketball while wearing his prosthesis.ConclusionsThe 10-year follow up demonstrates the feasibility of this salvage procedure for a floating knee injury with neurovascular compromise.

Two‐staged hindfoot reconstruction with vascularized fibula graft for calcaneal osteomyelitis caused by methicillin‐resistant Staphylococcus aureus: A case report

Hindfoot reconstruction after calcaneal osteomyelitis is a challenging procedure designed to restore the weight bearing function of the heel and to allow a functional reconstruction of the Achilles tendon. Some patients require subtalar arthrodesis after primary calcaneal osteosyntesis or hindfoot reconstruction due to the considerable pain associated with weight-bearing caused by the irregular surface of the subtalar joint. To date, no reports have shown a case of hindfoot reconstruction with subtalar arthrodesis using a pedicled vascularized fibula graft. We report a case of a 24-year-old woman who presented with calcaneal methicillin-resistant Staphylococcus aureus osteomyelitis after open comminuted fracture due to a fall. Radical debridement of bone and soft tissue was repeated six times in combination with negative pressure wound therapy, followed by hindfoot reconstruction with pedicled vascularized fibula and subtalar arthrodesis. Good functional restoration had been achieved by the final follow-up 18 months after surgery.

Metatarsal Lengthening by Callotasis in Adults with First Brachymetatarsia

Brachymetatarsia is a rare clinical entity that presents a challenging problem for surgeons. One-stage lengthening with an autologous bone graft has been preferred for metatarsals that require a limited lengthening. With a gradual lengthening of metatarsals, callus distraction (callotasis) can achieve a greater length gain and a concomitant lengthening of the soft tissue. This article presents results of callotasis for adults with first brachymetatarsia. The outcomes of nine cases of first brachymetatarsia in five adult patients who underwent metatarsal lengthening by callotasis between March 1999 and February 2005 were retrospectively reviewed and analyzed. The average length gain was 16.4 mm and the average lengthening percentage was 43.7%. In addition, the average healing index was calculated as 3.8 months/cm, which was higher than that reported previously in the fourth brachymetatarsia. It was concluded that the period of bony consolidation following callotasis is longer in the first brachymetatarsia than in the fourth brachymetatarsia. Presumably, this might be because of the anatomically larger osteotomized cut surface and its weight-bearing function.

Unraveling the Influences of Soft‐Tissue Flipper Development on Skeletal Variation Using an Extinct Taxon

Adaptation to an aquatic habitat results in dramatic changes in tetrapod limb morphology as limbs take on the roles of propulsion and steering and lose their weight-bearing function. Changes include enclosure of the limb in a soft-tissue flipper and proportional lengthening of the distal limb, often accomplished through the addition of skeletal elements (hyperphalangy). The flipper structure itself and changes to the developmental architecture permitting hyperphalangy are hypothesized to increase observed limb variation, based on a cetacean model. These hypotheses are examined in the ichthyosaurs Stenopterygius and Mixosaurus. Hyperphalangy combined with high levels of variation in phalangeal counts were observed in both genera. The amount of variation was not proportional to the number of phalanges in a digit, but was related to functional digit length. In addition, qualitative variants were catalogued in both genera. Polyphalangy, phalangeal fusion, and additional ossifications in the zeugopodial row were not observed in Mixosaurus, but were common in Stenopterygius, even though both genera exhibited a similar degree of hyperphalangy. These results suggest that while the flipper structure and processes resulting in hyperphalangy may increase observed variation in phalangeal counts, these factors are unlikely to be causing high levels of qualitative variation in ichthyosaurs. Patterns of variation in ichthyosaur limbs, and thus variability, are unique to species but can change over evolutionary time.

Placement of bone screws in a standing horse for treatment of a fracture of the greater tubercle of the humerus

SummaryA mature Thoroughbred gelding that was used as a high level jumper presented for evaluation of a nonweightbearing forelimb lameness following a fall. Radiographs revealed a complete, noncomminuted, minimally displaced sagittal fracture of the greater tubercle. Supporting limb laminitis was a major concern in the short term based on the severe lameness at presentation. Open reduction with internal fixation was chosen over stall rest in an attempt to more rapidly return the weightbearing function to the limb. The procedure was performed standing and 3 bone screws were placed standing in an attempt to avoid implant or catastrophic bone failure that can accompany recovery from general anaesthesia. The day following surgery the lameness was significantly improved as the horse was able to bear some weight on the heel. The gelding was discharged 5 days following surgery and was fully weightbearing at the walk. Six months following surgery the horse was free of lameness and resumed training. This report describes our experience and rationale in placing bone screws in a standing horse for treatment of a greater tubercle fracture.

Transarticular fusion for treatment of cystic lesion arising from an odontoid fracture

Odontoid fractures are the most common upper cervical spine fracture. There are two mechanisms in which odontoid fractures occur, most commonly hyperflexion of the neck resulting in displacement of the dens anteriorly and hyperextension resulting in posterior dens displacement. Type 2 fractures are the most common and are associated with significant non-union rates after treatment. One possible consequence of an odontoid fracture is a synovial cyst, resulting in spinal cord compression, presenting as myelopathy or radiculopathy. Synovial cysts as a result of spinal fracture, usually of the facet joint, are most common in the lumbar region, followed by the thoracic and then cervical region; cervical cysts are rare. Fracture and subsequent cyst formation is thought to be related to hyper-motion or trauma of the spine. This is reinforced by the appearance of spinal synovial cysts most commonly at the level of L4/5; this being the region with the biggest weight-bearing function. The most common site of cervical cyst formation is at the level of C7/T1; this is a transitional joint subjected to unique stress and mechanical forces not present at higher levels. Treatment of a cervical synovial cyst at the level of the odontoid is challenging with little information available in the literature. The majority of cases appear to implement posterior surgical resection of the cyst, with fusion of adjacent cervical vertebrae to stabilise the fracture, resulting in restricted range of movement. We describe a case concerning a 39-year-old female who presented with uncertain cause of odontoid fracture, resulting in a cystic lesion compressing the upper cervical spinal cord. Minimal invasive surgery of C1/C2 transarticular fusion was successfully performed resulting in significant improvement of neurological symptoms in this patient. At 1-year follow-up, the cyst had resolved without surgical removal and this was confirmed by radiological measures.

In Vivo Analysis of the Isolated Posterior Cruciate Ligament–Deficient Knee During Functional Activities

Background: Most patients with isolated posterior cruciate ligament (PCL) injuries have minimal symptoms, and nonoperative treatment is recommended. However, over time, these patients can develop significant degenerative changes in their knees. Historically, PCL laxity is graded by nonweightbearing anteroposterior measuring techniques that do not reproduce the true, dynamic weightbearing conditions in the injured knee. The purpose of this study was to determine the patholaxity in patients with isolated PCL deficiency during functional weightbearing activities (running, walking, and stair ascent). Hypothesis: Patients with unilateral, isolated PCL deficiency will demonstrate dynamic anteroposterior and rotational instability in their affected knees during functional activities of level running and stair ascent compared with their unaffected, contralateral knees. Study Design: Controlled laboratory study. Methods: Nine asymptomatic patients with isolated grade II PCL injury underwent Dynamic Stereo X-Ray (DSX) of both knees during level running and stair ascent. Three-dimensional reconstructions of the patients’ bilateral distal femurs and proximal tibias were created from high-resolution computed tomography (CT) scans. Three-dimensional joint kinematics were determined using a model-based tracking approach to align the radiographic images with CT-derived bone models. The resulting tibiofemoral rotations and translations for the PCL-deficient and PCL-intact knees were then compared. Results: During level running, the tibia of the PCL-deficient knee was approximately 2 mm posteriorly subluxated and had an anterior velocity relative to the femur approximately 40 mm/s greater than the contralateral, uninjured knee; however, this was only during the swing phase. No significant differences were found during the stance phase of running. During stair ascent, the tibia of the PCL-deficient knee was approximately 4 mm posteriorly subluxated compared with the intact limb during the terminal swing phase and early stance phase. Between foot strike and the time of peak ground-reaction force (GRF), the tibia of the PCL-deficient knee translated anteriorly relative to the femur with velocities 3 to 4 times greater than in the intact limb. Level walking was also evaluated in 3 patients, but no differences were seen, and it was not tested in the remaining 6 patients. Conclusion: Changes in knee kinematics due to isolated PCL injuries were highly activity dependent. During running, small differences were identified only during the swing phase when the knee was unloaded. However, during stair ascent, significant differences extended from the late swing into early stance phase. During the swing phase of stair ascent, the tibia in the PCL-deficient joint subluxated posteriorly. Then, as load was transferred to the ascending limb, the tibia reduced anteriorly with high velocity relative to the femur. The resulting shear motion may expose the loaded joint to abnormal and potentially damaging forces. Clinical Relevance: During functional activities, patients with isolated PCL injuries experience significant knee instability that cannot be identified by standard nonweightbearing static laxity measurements. The finding that different activities create different degrees of instability may have important implications for rehabilitation and activity limitations for PCL-deficient individuals.

STUDY of ROLE of IST & IIND METATARSAL in HALLUX VALGUS DEFORMITY

A B S TR A C T The foot is a specialized structure. It possesses a record of man’s prehistory which in completeness and legibility surpasses that of any other structure of the body. Indeed, the foot is a specialized structure adapted to the pattern of bipedal locomotion and to the additional stresses imposed upon the hind limb. During the transition of the foot from an arboreal ape’s foot to the terrestrial change has predominantly affected the 1st metatarsal with medial cuneiform (1stray)and the 2nd metatarsal with intermediate cuneiform (2ndray) In most primates the distal end of the 1st metatarsal is not tied by ligaments to the 2nd thus allowing the hallux marked freedom of movements (opposability). In the human foot, the plantar ligaments of the 1st metatarsophalangeal joint are connected to the 2nd by deep transverse metatarsal ligaments. These are four bands and connect plantar ligaments of adjoining metatarsophalangeal joints to one another.1 Thus, the most important change which distinguishes man even from other primates is that, the opposability of the hallux in the apes has given way to the stability of the hallux in the apes has given way to the stability of the hallux and the 1st ray in the human foot. The 1st and the 2nd rays play a crucial role in foot function of weight bearing, body support and locomotion. Their deformities and affections, therefore, are disabling. Forefoot deformities constitute 90 % of all foot deformities1and those affecting the 1st ray are the commonest. Among these hallux valgus is the most disabling .Hence, it is important to understand the normal relationship between some of the parameters that constitute the most important part of the forefoot i.e. the 1st and the 2nd rays. Some of the parameters were studied earlier by based on anatomical observation and some statistical correlation2 of the 1st ray and its effect on the second ray. However, while examining the various abnormalities of the 1st ray, it was observed that not all the measurements were quantified or statistically correlated with each other. The two rays were linked to each other some a study of parameters and of their statistical correlations with each other. It would be possible to corroborate the previous opinions as to the anatomical causes of hallus valgus. Thus, the aim of this study is to –1 Establish and compare the values for bony configurations of the first and the second rays in the Indian feet 2 Show statistical correlation between parameters which will suggest the anatomical factors predisposing to hallux valgus. Research Paper

Influence of gastrocnemius‐soleus muscle force on sub‐MTH load distribution

Background The gastrocnemius-soleus (G-S) muscle complex, the most dominant extrinsic plantar flexor, plays an important role in the normal weight-bearing function of the foot. The stability and stance-phase placement of the foot can be adversely affected when muscular loads/support are abnormal (e.g. equinus contracture) [1]. This study aims to formulate a three-dimensional musculoskeletal finite element (FE) model of the foot to quantify

Variation in fibular robusticity reflects variation in mobility patterns

During hominin plantigrade locomotion, the weight-bearing function of the fibula has been considered negligible. Nevertheless, studies conducted on human samples have demonstrated that, even if less than that of the tibia, the load-bearing function of the fibula still represents a considerable portion of the entire load borne by the leg. The present study assesses whether variation in habitual lower limb loading influences fibular morphology in a predictable manner. To achieve this, both fibular and tibial morphology were compared amongst modern human athletes (field hockey players and cross-country runners) and matched sedentary controls. Peripheral quantitative computed tomography was used to capture two-dimensional, cross-sectional bone images. Geometric properties were measured at the midshaft for each bone. Results show a trend of increased fibular rigidity from control to runners through to field hockey players. Moreover, relative fibular robusticity (fibula/tibia) is significantly greater in hockey players compared with runners. These results are likely the consequence of habitual loading patterns performed by these athletes. Specifically, the repeated directional changes associated with field hockey increase the mediolateral loading on the lower leg in a manner that would not necessarily be expected during cross-country running. The present study validates the use of the fibula in association with the tibia as a mean to provide a more complete picture of leg bone functional adaptations. Therefore, the fibula can be added to the list of bones generally used (tibia and femur) to assess the correspondence between mobility patterns and skeletal morphology for past human populations.

Effects of barefoot trimming on hoof morphology

To monitor changes in hoof morphology in response to barefoot trimming. Seven horses were trimmed every 6 weeks according to barefoot trimming principles, which involved levelling the hoof to live sole, lowering the heels, bevelling the toe and rounding the peripheral wall, while leaving the sole, frog and bars intact. A 4-month period was allowed to lower the heels sufficiently to achieve a hoof shape representative of the barefoot trim. This was regarded as the starting point for morphological adaptations in response to maintenance of the trim. Hoof morphology was measured from lateral, dorsal and solar view photographs and lateromedial radiographs taken at 0, 4 and 16 months. Changes from 0 to 4 months represented differences between a natural hoof shape and the trim, while changes from 4 to 16 months represented adaptive effects during hoof growth. Establishment of the barefoot trim involved significant shortening of the toe, heel and medial and lateral walls, with increases in angulation at the toe, medial and lateral walls, but not at the heel. Maintenance of the trim resulted in a palmar/plantar migration of the heels, with increases in support length, heel angle and solar angle of the distal phalanx (P3). Bevelling the toe and engaging the frog and bars in the weight-bearing function of the foot resulted in elevation of the heel angle and solar angle of P3. These changes may be beneficial in treating under-run heels and negative solar plane angulation of P3.

Functional outcome after prosthetic rehabilitation of children with acquired and congenital lower limb loss

The purpose of this study was to compare the functional status of children with acquired and congenital lower limb loss after 3 weeks and 6 months of prosthetic rehabilitation. Forty-one children aged between 8 and 17 years participated in the study. The children underwent prosthetic fitting, prosthetic training and rehabilitation after physiotherapy evaluations. Gait patterns and weight bearing values were assessed, and the Amputee Mobility Predictor (AMP) Questionnaire was applied. The congenital group had better gait patterns, weight bearing values and AMP scores in the initial assessment and after 3 weeks. The statistical analyses of the same parameters after 6 months showed that there were no significant differences between the two groups (P>0.05). It was determined that all congenital patients and only 16 of 20 acquired patients were wearing their prostheses for more than 8 h a day. When the outcomes of the first assessments were compared, the congenital group showed a better functional level, gait pattern and weight bearing value. At the end of 6 months, an improvement was observed in the functional level, gait pattern and weight bearing value in both the groups. The functional state, gait pattern and weight bearing value of children with limb loss can be improved if they actively use their prosthesis.

Electromyographic preactivation pattern of the gluteus medius during weight-bearing functional tasks in women with and without anterior knee pain

Proximal factors have been proposed to influence the biomechanics of the patellofemoral joint. A delayed or diminished gluteus medius (GM) activation, before the foot contact on the ground during functional activities could lead to excessive femur adduction and internal rotation and be associated with anterior knee pain (AKP). There are few studies on this topic and the results were inconclusive, therefore, it is necessary to investigate the GM preactivation pattern during functional activities. To compare the GM electromyographic (EMG) preactivation pattern during walking, descending stairs and in single leg jump task in women with and without AKP. Nine women clinically diagnosed with AKP and ten control subjects with no history of knee injury participated in this study. We evaluated GM EMG linear envelope before the foot contact on the ground during walking and GM onset time and EMG linear envelope during descending stairs as well as in a single leg vertical jump. Mann-Whitney U tests were used to determine the between-group differences in GM EMG preactivation pattern. No between-group differences were observed in GM linear envelope during walking (P=0.41), GM onset time and linear envelope during descending stairs (P=0.17 and P=0.15) and single leg jump (P=0.81 and P=0.33). Women with AKP did not demonstrated altered GM preactivation pattern during functional weight bearing activities. Our results did not support the hypothesis that poor GM preactivation pattern could be associated with AKP.

The effects of dynamic ankle-foot orthoses on functional ambulation activities, weight bearing and spatio-temporal characteristics of hemiparetic gait

Purpose. To investigate the effects of dynamic ankle-foot orthoses (DAFOs) on functional ambulation activities, weight bearing and spatio-temporal characteristics of hemiparetic gait and to inquire whether wearing a DAFO for 3 months has a carryover effect.Method. Fourteen chronic hemiparetic patients who could walk independently with or without a cane were the subjects of the study. Patients were assessed initially with tennis shoes and were given custom fabricated DAFOs which they wore for three months and were retested under two conditions: with tennis shoes only and with DAFOs worn in these shoes. All patients were assessed for weight bearing percentage of the affected side, cadence, step length of the involved and uninvolved sides, step width, functional reach, timed up and go, timed down stairs, timed up stairs, physiologic cost index and velocity.Results. Comparison of initial and third month assessments with shoes only condition showed that there was no significant improvement for the measured parameters. When comparison was made at the third month while patients were wearing tennis shoes only and when they were wearing DAFO's in their shoes there was a significant difference in favour of the condition where patients were wearing DAFOs.Conclusion. The benefits of using DAFOs in chronic hemiparetic patients are lost when the patients are not wearing their orthoses.

Effect of Selective-task vs Set-task Program on Balance and Weight Bearing of Stroke Patient

[Purpose] This study investigated the change in functional balance and weight bearing of stroke patients in a set-task balance training program and a selective-task balance training program. [Method] the participants were randomly allocated to either the set-task program or the selective-task program. We evaluated balance capacity using the Berg Balance Scale (BBS). Postural weight bearing was measured using a Tetrax Intractive Balance System, and the lower extremity function was evaluated using the Fugel-Meyer Assessment of Sensorimotor Impairment (FMLE). Both programs were performed three days a week for 30 min, 8 for weeks. The participants were assessed again at the end of the 8 weeks of training, and again after 3 months. [Results] The selective-task group showed significant improvments in BBS and plantar foot pressure after training. FMLS showed no significant difference in the set-task group after training; however, the selective-task group showed a significant improvement. At the 3-month follow-up BBS and Plantar foot pressure had maintained the significant improvement in both groups, but FMLS only showed a significant improvement in the selective-task group. [Conclusion] Based on this study, a selective-task program for stroke patients in which the patients choose tasks is more effective at improving balance, symmetric weight bearing by the lower extremities, and lower extremity function than a set-task program.

Walking Cane Use in Prison: A Medical and Cultural Analysis

This study examined the diagnosis, race, age, and conviction offenses of those using walking canes at California Medical Facility through a random review of 40 charts and 40 conviction folders. Motivating factors were concern about the potential for misuse of canes as weapons and a desire to further understand the clinical challenges faced by patients. Findings suggest that walking canes are most often prescribed for neurological or musculoskeletal problems, sometimes are prescribed with no apparent indication, and are more readily prescribed to violent offenders. Beyond their weight-bearing medical function, it is possible that canes bear cultural significance in prison culture, perhaps symbolizing pugnacious independence. The anthropological literature on aggression, interpersonal violence, and weapon use is explored to help understand the racial variation in use of fighting accoutrements in prison settings.

Total Ankle Replacement in the Varus Ankle

Treatment of ankle varus with total ankle replacement (TAR) lacks consensus regarding the limits of deformity that can be managed successfully without recurrence. With newer anatomic prosthetic designs and a comprehensive surgical approach, treatment of frontal plane deformities with implant arthroplasty has gained acceptance. The purpose of this retrospective study was to determine the outcome and compare correction of large frontal plane varus deformities with TAR using 2 different replacement systems. Also, a stepwise surgical approach for consistent correction was determined. TAR was performed on 26 patients with varus ankle deformity and a mean age of 63.85 ± 9.33 (range 48–86) years. Duration of follow-up was 16.69 ± 7.26 (range 7–37) months. The difference between the immediate postoperative frontal plane radiographic alignments was compared with the preoperative deformity, and reevaluated after at least 1 year of weight-bearing function. The preoperative mortise view varus deformity was 16.8° ± 6.79° (range 6°–28°), whereas at final follow-up the degree of varus was 0° ± 2.64° ( P < .0001) on the anteroposterior view and 0.5° ± 2.7° ( P < .0001) on the mortise view. All but one patient was corrected to within 4° of frontal plane neutral. Overall, correction was maintained throughout the study period. In conclusion, surgical treatment of the varus ankle arthrosis with TAR can be successful.

Effects of backpack carriage on foot–ground relationship in children during upright stance

Although the scientific community widely recognizes that backpack carriage in primary school children represents a critical issue, its consequences in terms of postural alterations and possible onset of musculoskeletal pathologies are still not fully understood. In particular, little information is available on the way load carriage modifies the foot–ground relationship in terms of plantar pressure distribution. This issue is of particular relevance, because the presence of a load alters the physiological weightbearing functions and, when mechanical overloading is repeated in time, it can act as a co-factor in promoting foot discomfort or pain. On the basis of these considerations, this study analyzed plantar pressure maps of 359 children attending primary schools (6–10 years old) under static upright posture conditions, to assess the magnitude and features of effects originated by load carriage on the foot–ground relationship. The collected data showed that backpack introduces significant increases in overall contact area (up to 10%) and in the plantar pressure peaks in midfoot and forefoot regions (20–30%). A significant shift in the average position of the center of pressure towards the forefoot was also observed, as an indicator of the body's attempt to restore the initial balance conditions threatened by the load. These results suggest that heavy loads, in the case of significant exposure times, may increase the risk of foot discomfort and act as a co-factor in the onset of foot structure alterations or pathologies.