The influence of subtalar axis orientation on the foot posture of older adults in a closed kinetic chain / A influência da orientação do eixo subtalar na postura do pé de idosos em cadeia cinética fechada

Objectives: This study compared the influence of subtalar axis position on foot behavior in a closed kinetic chain in older and younger adults. Methods: The sample included 50 older adults and a control group of 50 younger adults. The variables were initially analyzed for both feet together, and were later analyzed separately, comparing each foot (right and left) between groups. Range of motion was assessed by validated goniometric procedures: the position of subtalar axis was evaluated by the palpation technique, while the Foot Posture Index was used to assess behavior in a closed kinetic chain. Student's t-test / Mann-Whitney test compared the main variables according to sample distribution, while Student's t-test / Wilcoxon test was used for paired samples. A standardized Haberman residuals test was also used to determine the connection between the position of subtalar joint axis and the Foot Posture Index. Results: Data from the right and left feet were similar for all variables. The older group had reduced mobility in the ankle and first metatarsophalangeal joint (5.42º [SD (Standard Deviation), 4.49] and 76.12º [SD, 19.24], respectively) with statistically significant values, (p <0.001), as measured by the Mann-Whitney test for the ankle joint and the t-Sutdent test for the first metatarsophalangeal joint, while the younger group had normal values (11.46º [SD, 6.49] and 97.17º [SD, 13.65], respectively)(p < 0.001). The difference in subtalar axis position was not significant (p = 0.788), with more internal deviations in both groups. There was a significant difference in Foot Posture Index (p = 0.006, by applying the chi-square test), with the normal position more prevalent in the older group and the prone position more prevalent in the younger group. Conclusions: Regarding internal deviations in the subtalar joint axis, the older group had a higher frequency of feet in the normal position, while the younger group had a higher frequency of feet in the prone position which, in this case, agrees with the rotational balance theory. For the normal axis position, a higher frequency of normal position was found in both groups. Regarding external deviations of the subtalar joint axis, neither group followed the pattern expected in rotational balance theory. The most consistent connection in the older group was between external axis position and supine foot position, whereas in the younger group it was between normal axis position and normal foot position.

Objetivos: Este estudo comparou a influência da posição do eixo subtalar no comportamento do pé em cadeia cinética fechada em idosos e adultos jovens. Metodologia: O grupo amostral incluiu 50 idosos e o grupo controle, 50 adultos jovens. As variáveis foram estudadas inicialmente para ambos os pés e comparadas entre os grupos, sendo posteriormente analisadas separadamente, comparando-se cada pé (direito e esquerdo) entre os grupos. A amplitude de movimento articular foi avaliada por procedimentos goniométricos validados; a posição do eixo subtalar foi avaliada pela técnica de palpação; o Foot Posture Index foi utilizado para avaliar o comportamento do pé em uma cadeia cinética fechada. O teste t de Student/teste de Mann-Whitney comparou as principais variáveis de acordo com a distribuição amostral, enquanto o teste t de Student/teste de Wilcoxon foi utilizado para amostras emparelhadas. O teste de resíduais ajustados de Haberman padronizado foi usado para a relação entre a posição do eixo da subtalar e o Foot Posture Index. Resultados: Os dados dos pés direito e esquerdo foram semelhantes para todas as variáveis. O grupo mais velho apresentou mobilidade reduzida no tornozelo e na primeira articulação metatarsofalângica (5,42 [desvio padrão ­ DP, 4,49] e 76,12 [DP, 19,24] graus, respectivamente), enquanto o grupo mais jovem apresentou valores normais (11,46 [DP, 6,49] e 97,17 [DP, 13,65], respetivamente) com valores estatisticamente significativos, (p <0,001), aferidos pelo teste de Mann-Whitney para a articulação do tornozelo e pelo teste t-Sutdent para a primeira articulação metatarsofalângica. A diferença na posição do eixo subtalar não foi significativa (p = 0,788, pela aplicação do teste de Qui-quadrado), com mais desvios internos em ambos os grupos. O Foot Posture Index diferiu significativamente entre os grupos (p = 0,006 pela aplicação do teste de Qui-quadrado), sendo a postura normal mais prevalente no grupo mais velho e a postura pronada mais prevalente no grupo mais jovem. Conclusões: Em relação aos desvios internos do eixo da articulação subtalar, o grupo mais velho apresentou maior frequência de pés na postura normal, enquanto o mais jovem apresentou maior frequência de pés pronados, o que, neste caso, corrobora a teoria do equilíbrio rotacional. Na posição normal do eixo, foi encontrada maior frequência de pés com postura normal em ambos os grupos. Em relação aos desvios externos do eixo da articulação subtalar, nenhum dos grupos seguiu o padrão esperado na teoria do equilíbrio rotacional. A relação mais consistente no grupo mais velho foi entre a posição do eixo externo e a posutra supinada do pé, enquanto no grupo mais jovem se deu entre a posição normal do eixo e a postura normal do pé

Proportion of Genu Valgum and Genu Varum in Students Aged 19-25 Years

Background:Knee joint mal alignments are divided into genu valgum and genu varum. The presence of these mal-alignments leads to complications like tibio-femoral osteoarthritis, compensatory changes in ankle/foot, etc.Taking a community of physiotherapy students, the proportion ofgenu varum, genu valgumand its association with body mass index (BMI) and foot posture index (FPI) was investigated. The aim of the study was to evaluate the proportion of genu valgum and genu varum in subjects aged 19 -25 years.Materials and Methods: The data was collected from D.Y. Patil University, Navi Mumbai. A consent form and a validated proforma was used. Age, BMI, FPI, IKD (Inter-knee distance), IMD (Inter-malleolar distance) and Q-angle was recorded, and the data was statistically analysed.Results: 45 out of 100 females had genu valgum which was found to be associated with higher BMI and pronated feet. 9 out of 100 females had genu varum which was found to be associated with lower BMI. Chi-square test was done to find out these associations.Conclusion: Awareness of the proportion of angular mal-alignment in knee would increase the recognition of this problem among the individuals and doctors for better execution of strategies that can help avoid these mal-alignments.

Effect of pronated foot posture on proprioception and postural stability based on foot posture index / 中国组织工程研究

BACKGROUND: Studies outside China have shown that there is a certain relationship between foot posture and posture stability. OBJECTIVE: Based on foot posture index scale system, to compare the effect of pronated foot posture on postural stability and proprioception. METHODS: Thirty healthy youths aged from 20 to 30 years old were enrolled, and divided into two groups according to the right foot posture index: pronated group (foot posture index > 5) and neutral group (0 ≤ foot posture index 0.05). (2) When tested with single-leg (right side) static stance, sway area and length of pressure center were larger in pronated group than that in neutral group (P 0.05). (3) When tested with two-leg static stance, sway length of pressure center was larger in pronated group than that in neutral group (P 0.05). (4) Results confirmed that foot posture exerts a significant effect on postural stability. Pronated foot can reduce postural stability, which will increase sports injury and the risk of fall in the elder.

Reliability and Validity of Foot Position Index for Foot Posture Assessment / 中国康复理论与实践

Objective:To explore the reliability and validity of Foot Posture Index (FPI) scoring system in evaluating foot posture in China. Methods:From September to October, 2019, two testers (tester 1, tester 2) evaluated the foot posture of 15 adult volunteers (30 legs) aged 20 to 40 years after mastering the FPI-6 scoring system. They were tested first by two testers on the same day, and after two weeks, they were retested by tester 1. The intra-group correlation coefficient (ICC) was calculated to evaluate the test-retest reliability and the inter-tester reliability, and the MedCalc was used to perform the Bland-Altman plot. The correlation between the scores of items and scale was analyzed with Spearman analysis, and the items were analyzed with factor analysis. Results:The ICC of the test-retest and inter-tester reliability of each item and total score of FPI were higher than 0.75. The mean difference in FPI scores between the testers was -0.133 and the limits of agreement was (-1.82, 1.55). All items scores were correlated with the total score (P < 0.05); three factors were extracted with the cumulative contribution more than 80%. Conclusion:The FPI-6 scoring system is reliable and valid, to evaluate foot posture for Chinese.

Clinical Significance of Autonomic Neuropathy in Liver Cirrhosis / 대한간학회지

BACKGROUND/AIMS: Autonomic neuropathy is not rare in patients with liver cirrhosis but little is known about the mechanisms and clinical characteristics of it. We evaluated the relationship between the severity of liver disease and that of autonomic neuropathy. METHODS: Sixty patients with liver cirrhosis (age 53+/-8.4, mean+/-SD) were studied. Liver function and prothrombin time were tested and an ultrasonography or CT scan was performed. Liver function reservoir was classified according to Child-Pugh score for all patients. Heart rate variations in response to deep breathing, to Valsalva maneuver, and to orthostatism were also measured and were expressed by E/I index, Valsalva index, and Posture index, respectively. The prevalence was estimated and divided into early involvement and definite involvement using each index. The correlation between the severity of the liver disease and that of autonomic neuropathy was also studied. RESULTS: Evidence of autonomic neuropathy was found in 68.3% (41); early involvement 46.7% (28), and definite involvement 21.7% (13), respectively. The prevalence of autonomic neuropathy was similar in alcohol induced, and virus induced, liver disease (84.6% vs 63.8%). Child-Pugh score showed inverse correlation with E/I index (r=-0.38, p<0.01) and Valsalva index (r=-0.34, p<0.05). On multiple logistic regression analysis, cardiovascular autonomic neuropathy was related to the serum albumin level (odds ratio 0.063, 95% CI). CONCLUSION: In liver cirrhosis the prevalence and the severity of cardiovascular autonomic dysfunction are related to the severity of hepatic dysfunction (Child-Pugh score). It is possible that this complication may be of prognostic significance in patients with liver cirrhosis.