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Objective Through the evaluation of subjective comfort and plantar pressure during walking, with the integration of subjective perception and biomechanical indexes, to explore the effect of personalized insole on foot perception and ankle function of normal foot. Methods Sixteen male subjects with normal foot types were recruited, and the visual analog scale (VAS) was used to evaluate the differences of subjective comfort index under the intervention of minimalist shoes and personalized insoles, and changes of time and plantar pressures at each stage of barefoot walking and walking with minimalist shoes and personalized insoles were analyzed by single factor repeated measurement variance. Multiple linear regression was used to screen the main indexes which affected the overall comfort of shoes during walking with minimalist shoes and personalized insoles. Results For measurement of plantar pressures, the gait support buffer stage of walking with shoes was higher than that of barefoot walking or walking with minimalist shoes(P<0.05), and the dynamic arch index (AI) of walking with personalized insole was higher than that of walking with minimalist shoes and barefoot walking(P<0.05). The dynamic AI during walking with minimalist shoes was higher than that of barefoot walking(P<0.05), and the proportion of foot impulse during walking with personalized insoles was higher than that during barefoot walking(P<0.05). When wearing shoes, the average slope for center of pressure (COP) trajectory was lower than that of barefoot walking, and the slope of COP trajectory of walking with personalized insoles was lower than that of walking with minimalist shoes(P<0.05). For evaluation of subjective comfort, the overall comfort, heel cushioning, front foot cushioning, arch support, forefoot wrapping and foot control of walking with personalized insoles were higher than those of walking with minimalist shoes(P<0.05). The results of linear regression showed that arch support and the proportion of middle foot impulse had significant influences on the overall comfort of walking with shoes(P<0.05). Conclusions Personalized insoles can improve the overall comfort of normal foot mainly through the influence of foot arch. After personalized insole is added, the cushioning ability and foot control ability of walking are improved, and force deviation of the foot on coronal axis is reduced. Feet-insoles-shoes jointly affect the perception of human feet, and insoles should be selected in many aspects, such as foot types, shoe conditions and insole materials.
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| INTRODUÇÃO: A fascite plantar (FP) é uma causa comum de dor no calcanhar e deformidade da articulação do tornozelo. Mais de 11% -15% da população com sintomas nos pés precisa de cuidados de longo prazo. Foi comprovado que várias intervenções de fisioterapia com terapia convencional, que inclui terapia manual, ajudam nessa condição. OBJETIVO: Avaliar o efeito do fortalecimento do abdutor do quadril e da terapia manual (MT) em paciente com fascite plantar (FP). MÉTODOS: O desenho do estudo será um ensaio de controle randomizado de dois grupos, pré-teste e pós-teste. Um total de 30 participantes do sexo masculino e feminino com idade acima de 18-60 anos com dores provocadas pelos primeiros passos da manhã, dor na região plantar do calcanhar, serão alocados aleatoriamente em dois grupos - o Grupo A receberá terapia manual (TM) com fisioterapia convencional enquanto o Grupo B receberá fortalecimento dos abdutores do quadril com fisioterapia convencional. Ambos os grupos receberão 16 sessões de tratamento por 4 dias em cada semana durante 4 semanas. "Foot Function Index", "Podia scan", "Teste de queda do navicular" serão usados como medida de desfecho e serão avaliados na 1ª semana e na 4ª semana de tratamento em ambos os grupos. CONCLUSÃO: Os pacientes que recebem a intervenção de fortalecimento do abdutor do quadril podem ter resultados positivos quando comparados à intervenção de MT entre pacientes com FP. Este será o primeiro estudo a comparar o efeito do fortalecimento dos abdutores do quadril e da terapia manual. REGISTRO DE ENSAIO: Registro de Ensaios Clínicos - Índia. (CTRI / 2020/04/024541)
BACKGROUND: Plantar fasciitis (PF) is a common cause of heel pain and deformity of the ankle joint. More than 11%- 15% of the population with foot symptoms need long-term care. Various physical therapy intervention with conventional therapy, including manual therapy, has been proven to help this condition. OBJECTIVE: To evaluate the effect of Hip abductor strengthening and Manual therapy (MT) in a patient with Plantar Fasciitis (PF). METHODS: The design of the study will be A Two Group PretestPosttest randomized control trial. A total of 30 male and female participants aging above 18-60 years experiencing pain provoked by taking the first few steps in the morning, pain in the plantar heel region, will be allocated randomly into two groups- Group A will receive Manual therapy (MT) with conventional physiotherapy while Group B will receive hip abductors strengthening with conventional physiotherapy. Both groups will receive 16 sessions of treatment for 4 days each week for 4 weeks. "Foot function index," "Podiascan," "Navicular drop test" will be used as outcome measures and will be evaluated at the first week and fourth week of treatment in both the groups. CONCLUSION: The patients who receive Hip Abductor Strengthening intervention may have positive results compared to the MT intervention among patients with PF. This will be the first study to compare the effect of hip abductors strengthening and manual therapy. TRIAL REGISTRATION: Clinical Trial Registry- India. (CTRI/2020/04/024541)
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Fasciitis, Plantar , Musculoskeletal Manipulations , MethodsABSTRACT
Objective To evaluate the difference of foot-ankle function for subjects with different foot types from both dynamic and static aspects by means of sports biomechanics, so as to provide theoretical support and references for the study of foot-ankle movement. Methods According to the arch index, 65 subjects were divided into three groups: flat foot, low arch foot and normal foot. One-way ANOVA was used to analyze the difference of static and dynamic foot-ankle function indexes among the three groups. Results In terms of static foot-ankle function, the malleolar valgus flexibility (MVF) of normal foot and ankle was significantly higher than that of low arch foot and flat foot (P<0.05), while in terms of arch height flexibility (AHF), the effect of weight bearing on normal foot was smaller than that of flat foot (P<0.05), but there was no significant difference in transverse arch flexibility (TAF) among the three groups. In terms of dynamic foot-ankle function, the force offset amplitude and time of normal foot at buffer stage were higher than those of the other two groups (P<0.05), and at transition stage, the transition time of normal foot was significantly lower than that of low arch foot and flat foot (P<0.05). At pedal-extension stage, the pedal-extension time and speed of normal foot were significantly higher than those of flat foot (P<0.05). Conclusions The posture maintenance ability and longitudinal arch shape maintenance ability of low arch foot and flat foot are worse than those of normal foot with the load increasing, and the arch rigidity and plantar elasticity of low arch foot and flat foot are worse than those of normal foot, and normal foot shows better load-bearing cushioning ability, elastic-to-rigid transition ability and pedal extension efficiency during walking. A systematic and comprehensive evaluation system is of great significance to the prediction of foot-ankle injury risk and the evaluation of sports ability.
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Foot core system comprises active subsystem, passive subsystem and neural subsystem, which complement each other and provide different function for foot. Insufficient foot function (weak muscle strength, hypoesthesia of foot) is an important cause of foot injury, and aging, obesity and abnormal foot type are also possible factors of foot injury. At present, special foot strength enhancement methods, minimalist shoes training, and even the means of muscle/brain stimulation, can strengthen the intrinsic muscle strength of foot, improve the stability of the foot, increase the plantar sensory inputs, thereby enhance the core system, raise the foot function performance, and prevent sports injury.
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BACKGROUND: Calcaneal fracture is the most common patella fracture. Traditionally, surgical treatment via an enlarged lateral approach is the gold standard method for the treatment of calcaneal fractures. However, this method can lead to joint stiffness and peroneal tendon adhesion to different extents, resulting in postoperative foot pain. OBJECTIVE: To investigate the effect of preserving the integrity of peroneal tendon sheath on hindfoot movement during open reduction and internal fixation of calcaneus fractures. METHODS: A total of 160 patients with displaced intra-articular calcaneus fractures who were admitted to the Department of Foot and Ankle Surgery, Affiliated Hospital of Binzhou Medical University from July 2016 to September 2017 were randomly divided into a control group and an experimental group. The classical lateral “L” incision was used in both groups. In the control group, the calcaneus was exposed by traditional dynamic retraction of the fibular tendon, while the experimental group was treated by static retraction with the preservation of fibular tendon sheath. The trial protocol was approved by the Ethics Committee of the Affiliated Hospital of Binzhou Medical University on February 18, 2016 with the approval No. 2016-G026-01. RESULTS AND CONCLUSION: There were 156 patients with complete follow-up data, 78 in the control group and 78 in the experimental group. The visual analogue scale scores on the first day, Bohler angle and Gissane angle at the 3rd month, and ankle dorsiflexion and plantar flexion angle at the 6th month of internal fixation were similar in the two groups. Hind foot valgus and varus angles at the 6th month of internal fixation and the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale scores at the 1st year of internal fixation in the experimental group were better than those in the control group. Meanwhile, the excellent and good rate of Maryland hindfoot scoring system in the experimental group was higher than that in the control group at the last follow-up. There were four cases of incision complications in the control group (one case of infection and three cases of necrosis) and two cases of necrosis in the experimental group. These findings indicate that calcaneus fracture surgery with preserving the integrity of peroneal tendon sheath can significantly improve the mobility of the hindfoot, and improve the patient’s satisfaction, and meanwhile do not increase the incidence of incision complications.
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Objective: To observe the short-term effectiveness of Endobutton plate in the reconstruction of Lisfranc ligament in tarsometatarsal joint injury. Methods: Between March 2015 and July 2018, 18 patients with tarsometatarsal joint injuries were treated with Lisfranc ligament reconstruction by Endobutton plate. There were 12 males and 6 females with an average age of 32.5 years (range, 16-55 years). The causes of injury were traffic accident in 8 cases, falling from height in 3 cases, crushing by a heavy objective in 4 cases, and spraining in 3 cases. There were 10 cases of Myerson type A, 4 of type B1, 2 of type B2, 1 of type C1, and 1 of type C2. The interval between injury and operation ranged from 3 to 9 days (mean, 4.9 days). X-ray examination was performed regularly after operation to measure the distance between the first and the second metatarsal joints, and the visual analogue scale (VAS) score was used to evaluate the pain relief. At last follow-up, the reduction of tarsometatarsal joint was evaluated by measuring and comparing the height of the affected and healthy arches. The foot function was evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: The average follow-up time was 15.8 months (range, 10-28 months). All incisions healed by first intention. X-ray reexamination showed that there was no screw loosening or plate fracture. There were significant differences in the distance between the first and the second metatarsal joints and VAS score at 3 months after operation, before removal of the internal fixator, and at last follow-up when compared with preoperative values ( P0.05). At last follow-up, there was no significant difference in the arch height between affected foot [(5.3±0.2) mm] and healthy foot [(5.4± 0.3) mm] ( t=1.798, P=0.810). The AOFAS score of foot function was 89.5±7.3 with excellent in 12 cases, good in 4 cases, and fair in 2 cases. The excellent and good rate was 88.9%. Conclusion: The reconstruction of Lisfranc ligament with Endobutton plate can stabilize the tarsometatarsal joint and achieve satisfactory foot function at early stage.
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PURPOSE: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. MATERIALS AND METHODS: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. RESULTS: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paper-based group (paper vs tablet, 3.7±3.8 vs 2.3±1.3 minutes). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. CONCLUSION: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study.
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Humans , Academies and Institutes , Ankle , Clinical Study , Foot , Methods , Prospective Studies , VolunteersABSTRACT
Aim: The aim was to evaluate self-assessed foot health status and working efficiency of healthcare workers when using composite insoles to treat foot problems. Introduction: Foot pain and fatigue are two of the most common problems facing healthcare workers owing to many hours of walking and standing per day. Many choices of conservative treatment are available such as the use of insoles and orthotic support. Commercially prefabricated insoles are one of the most widely used treatments for foot pain and fatigue as they are easily accessible at reasonable prices. However, there is limited evidence supporting the effectiveness of these treatments. Methodology: Test subjects included 49 volunteers from Tung Song Hospital screened by an orthopedist and physical therapist to meet predetermined criteria. Data collected included demographic data, validated foot function score of a Foot Health Status Questionnaire (FHSQ), and a synthetic working efficiency score generated using the Thai Questionnaire of Working Efficiency for Healthcare workers. A self-evaluation form was designed to record the efficacy of using Smile feet™ insoles before and after one month of treatment. Statistical analysis was performed using the Wilcoxon signed rank test. Results: Responses to the Foot Heath Status Questionnaire showed a statistically significant change in several foot health metrics (p-value < 0.01) after using the composite insoles for 1 month: Improvement greater than the minimal important difference was achieved by 75.5% in foot pain, 44.9% in foot function, 89.8% in foot wear, and a 57.1% in general foot health. Respondents to the Thai Working Efficiency questionnaire reported improvement in sections of working, reducing muscle soreness and fatigue in 30 of the 49 volunteers (61.2%). Among those that experienced improvement, [self-reported] work productivity increased by 73%. Conclusion: Healthcare workers reported improvements after using a commercially available composite insole in all criteria on a self assessment questionnaire, including muscle soreness, working efficiency, work productivity, fatigue, foot pain, foot function, foot wear, and general foot health. Level of Evidence: Level IV, therapeutic case series.