Effects of computer use on upper limb musculoskeletal disorders and function in academicians.

Objectives. This study aimed to investigate the effects of academician's demographic characteristics and computer usage habits on upper limb musculoskeletal disorders (MSDs) and function. Methods. A cross-sectional observational study was conducted with 100 academicians. Data were collected using questionnaires, which included the patient-rated wrist evaluation questionnaire - Turkish version (PRWE-T), the Cornell musculoskeletal discomfort questionnaire - Turkish version (CMDQ-T), the upper extremity functional index - Turkish version (UEFI-T), demographic characteristics and average daily computer usage time. Results. A low-level significant correlation was found between the age of the individuals and the CMDQ-T forearm (p = 0.044; r = 0.202) and CMDQ-T wrist (p = 0.001; r = 0.337) scores. Women had higher CMDQ-T neck scores and lower UEFI-T scores than men (p < 0.05). Academicians who used computers for 6 h a day or more had higher PRWE-T and CMDQ-T neck, shoulder, upper arm and forearm scores, and had a lower UEFI-T score (p < 0.05). Conclusion. Neck, shoulder, upper arm and forearm symptoms were higher and upper extremity function was impaired in academicians who used computers for 6 h a day or more. Besides, gender and age were associated with upper limb MSDs and function, but occupation duration did not affect those outcomes in academicians.

Comparison of two different orthoses used in the treatment of lateral epicondylitis.

BACKGROUND: Lateral epicondylitis (LE) is one of the most common causes of lateral elbow pain, and orthoses are often used in its conservative treatment. However, the number of studies examining the effectiveness of the orthoses used and their differences compared to each other is limited. OBJECTIVE: To determine the effects of 2 orthoses types, wrist orthosis (WO) and counterforce brace (CB), commonly used in the treatment of lateral epicondylitis on muscle activation, grip strength, hand function, and satisfaction level in healthy individuals. STUDY DESIGN: Quasi-experimental study. METHODS: Thirty-seven healthy individuals were recruited. Muscle activation was evaluated by surface electromyography, and maximum grip strength was evaluated with a handheld dynamometer. Hand function and satisfaction level were evaluated with Jebsen Taylor Hand Function Test and Orthotics and Prosthetics Users Survey, respectively. All evaluations were conducted for each individual in 3 conditions (no orthosis, WO, and CB). RESULTS: Extensor carpi radialis (ECR) muscle activation was greater when using CB compared with that when without orthosis (p = 0.036). There was no significant difference in extensor digitorum communis (EDC) muscle activation and maximum grip strength among the conditions (p > 0.05). Hand function was worse when using the WO compared with the other conditions (p < 0.001). In terms of orthosis satisfaction, individuals were found to be significantly more satisfied with the use of CB (p = 0.001). CONCLUSIONS: In our study highlight the use of CB in terms of EDC muscle activity, grip strength, hand function, and satisfaction, while the use of WO is prominent in terms of keeping extensor carpi radialis muscle activity low, which has been shown to be important for LE. To obtain definitive results on the effectiveness of different orthoses in the treatment of LE, more research is needed to compare the muscular activation in the extensor carpi radialis brevis (ECRB) and EDC muscles with objective methods.

Cross-cultural adaptation, reliability, and validity of the Turkish version of the Cumberland Ankle Instability Tool.

OBJECTIVES: The objective of the study was to cross-culturally adapt and assess the validity and reliability of the Turkish version of the CAIT (CAIT-TR). METHODS: The CAIT was translated and adapted into Turkish according to accepted cross-cultural adaptation guidelines of self-reported measures. A total of 130 individuals, including healthy participants (n = 40) and with chronic ankle instability (CAI) (n = 90), were recruited in this study. The internal consistency and test-retest reliability of the CAIT-TR were assessed using Cronbach's alpha and intraclass correlation coefficients (ICC), respectively. To assess convergent validity, hypotheses were tested regarding expected correlations between CAIT-TR, Foot and Ankle Outcome Score (FAOS) subscales, and the Visual Analogue Scale (VAS). Discriminative validity was evaluated with the hypothesis that the CAIT-TR can distinguish between subjects with and without CAI and also calculated a cut-off score for CAI. The dimensional structure of the CAIT-TR was investigated with confirmatory factor analysis. Additionally, minimal detectable change (MDC), floor/ceiling effects, and measurement error values were determined. RESULTS: The CAIT-TR demonstrated high Internal consistency (Cronbach's alpha = 0.854) and test-retest reliability (ICC = 0.919). Regarding convergent validity, the CAIT-TR exhibited a moderate-strong correlation with both the FAOS and VAS. The confirmatory factor analysis supported the unidimensional structure of the questionnaire. The identified cut-off value for the CAIT-TR was 25, and the MDC for individual-level CAIT-TR scores was determined to be 1.87. No floor or ceiling effects were observed. CONCLUSION: The CAIT-TR is a valid and reliable questionnaire for the assessment of ankle instability within the Turkish population.

Intensive physiotherapy versus home-based exercise and custom-made orthotic insoles in patients with plantar fasciitis: Pilot study.

BACKGROUND: This prospective pilot study assessed the feasibility of comparing intensive physiotherapy group (IPG), home-based exercise (HBEG) group, and insole group (IG) to find the most effective treatment program for plantar fasciitis. METHODS: Thirty-nine individuals with plantar fasciitis were selected to participate in this pilot study. The patients were randomly divided into 3 groups, as IPG (manual interventions, exercise, insoles), HBEG (exercise, insoles), and IG (insoles). The feasibility details including percentage of the enrollment and adherence to the groups were recorded. Pain was measured with a visual analog scale, and dorsiflexion range of motion (DROM), foot function, and health-related quality of life were evaluated at the baseline and week 6. One-way ANOVA analysis and Kruskal Wallis test were used to determine the differences of the percentage change of the parameters. RESULTS: Pain and functional evaluation results showed improvements clinically in all of groups and quality of life results were similar for all groups. There was no difference between the groups after 6 weeks of treatment (P > 0.05). CONCLUSIONS: The 3 treatment programs were found clinically applicable with high patient adherence. According to the data all intervention types were found moderately effective for pain and function. Insoles could be an option applied alone or with other treatments, and manual techniques gave better results in patients with limited ankle dorsiflexion. Although the results should be interpreted with caution because of the small sample size, these results were found promising and feasible to conduct a future RCT. CLINICAL TRIAL REGISTRATION NUMBER: RCT 06144834.

Plantar sensation, plantar pressure, and postural stability alterations and effects of visual status in older adults.

PURPOSE: Ageing leads to plantar sensation and pressure alterations and poor postural control. The aim of this study was to compare the plantar sensation and static plantar pressure distribution between young and older adults. A secondary aim was to investigate the effect of ageing and visual status on postural stability. MATERIALS AND METHODS: Forty older subjects and 43 young adult individuals participated in the study. Plantar light touch sensation was evaluated using Semmes-Weinstein monofilaments. Static plantar pressure and postural stability were assessed with the WinTrack® Pedobarography device. RESULTS: Plantar sensation thresholds of the older individuals were higher compared to the young in all plantar regions (p < 0.001). The plantar contact area was greater in older individuals (p < 0.001). Maximum plantar pressure of midfoot was higher and maximum plantar pressure of the rearfoot and whole foot was less in older individuals during quiet stance (p < 0.05). The main effects of group and visual condition were significant for mean latero-lateral and antero-posterior sway speed with large effect sizes (p < 0.05). CONCLUSIONS: The sensation of all plantar regions reduced, the rearfoot plantar pressure decreased, and the midfoot plantar pressure increased in older individuals compared to young. Postural stability was reduced in the older individuals, and their postural control was more affected by the eliminated visual information compared to the young. Increased plantar contact area and midfoot plantar pressure may be related to decreased MLA height in older individuals. Older individuals may need visual information more to maintain postural control because of reduced plantar sensation.

Effects of Different External Supports on Plantar Pressure-Time Integral and Contact Area in Flexible Flatfoot.

BACKGROUND: Flexible flatfoot disturbs the load distribution of the foot. Various external supports are used to prevent abnormal plantar loading in flexible flatfoot. However, few studies have compared the effects of different external supports on plantar loading in flexible flatfoot. The objective of this study was to investigate the effects of elastic taping, nonelastic taping, and custom-made foot orthoses on plantar pressure-time integral and contact area in flexible flatfoot. METHODS: Twenty-seven participants with flexible flatfoot underwent dynamic pedobarographic analysis while barefoot and with elastic tape, nonelastic tape, and custom-made foot orthoses. RESULTS: Pressure-time integral percentage was higher with foot orthoses than in the barefoot and taping conditions in the midfoot (P < .001) and was lower with foot orthoses than in barefoot in the right forefoot (P < .05). Pressure-time integral values were lower with foot orthoses in the second, third, and fourth metatarsals and the lateral heel (P < .05). With foot orthoses, contact area values were higher in the toes; second, third, and fourth metatarsi; midfoot; and heel compared with the other conditions (P < .05). Pressure-time integral in the right lateral heel and contact area in the left fourth metatarsal increased with nonelastic taping versus barefoot (P < .05). CONCLUSIONS: Foot orthoses are more effective in providing dynamic pressure redistribution in flexible flatfoot. Although nonelastic taping has some effects, taping methods may be insufficient in altering the measured pedobarographic values in this condition.

Short foot exercises have additional effects on knee pain, foot biomechanics, and lower extremity muscle strength in patients with patellofemoral pain.

BACKGROUND: Patellofemoral pain (PFP) is a common knee problem. The foot posture in a relaxed stance is reported as a distal factor of PFP. However, the effects of short foot exercise (SFE) on the knee and functional factors have not yet been investigated in patients with PFP. OBJECTIVE: This study aimed to investigate the additional effects of SFE on knee pain, foot biomechanics, and lower extremity muscle strength in patients with PFP following a standard exercise program. METHODS: Thirty patients with a 'weak and pronated' foot subgroup of PFP were randomized into a control group (ConG, n= 15) and a short foot exercise group (SFEG, n= 15) with concealed allocation and blinded to the group assignment. The program of ConG consisted of hip and knee strengthening and stretching exercises. SFEG program consisted of additional SFE. Both groups performed the supervised training protocol two times per week for 6 weeks. Assessment measures were pain visual analog scale (pVAS), Kujala Patellofemoral Score (KPS), navicular drop test (NDT), rearfoot angle (RA), foot posture index (FPI), and strength tests of the lower extremity muscles. RESULTS: Both groups displayed decreases in pVAS scores, but it was only significant in favor of SFEG. NDT, RA, and FPI scores decreased in SFEG whereas they increased in ConG. There was a significant group-by-time interaction effect in hip extensor strength and between-group difference was found to be significantly in favor of SFEG. CONCLUSIONS: An intervention program consisting of additional SFE had positive effects on knee pain, navicular position, and rearfoot posture. An increase in the strength of the hip extensors may also be associated with improved stabilization by SFE.

Evaluation of work-related musculoskeletal problems in pediatric surgeons.

PURPOSE: Pediatric surgeons are exposed to intense work-related activities, depending on their profession, including residency training. This study aims to investigate the musculoskeletal symptoms and analyze the relationship between musculoskeletal symptoms and the demographics, physical activity levels, and body mass index (BMI) of pediatric surgeons. METHODS: A total of 82 pediatric surgeons (female, 20; male, 62) were included in this study. The musculoskeletal symptoms were determined using the Cornell Musculoskeletal Discomfort Questionnaire. The levels of physical activity were determined using the International Physical Activity Questionnaire. RESULTS: The mean age of the participants was 48.97 ± 8.894 years, the mean BMI was 26.72 ± 4.12 kg/m2, and the mean working time after acquiring their specialty was 18.65 ± 9.83 years. The average surgery counts per week were 15.22 ± 12.17. Pediatric surgeons mostly complained from lower back pain, upper back pain, neck pain, and right and left shoulder pain. Surgeons with higher BMI had higher pain scores and received more treatment sessions. CONCLUSIONS: Pediatric surgeons' complaints are related to their total numbers of surgery. Higher BMI and lower physical activity seem to be the major contributing factors for developing musculoskeletal symptoms. The study results indicated that surgeons should keep their BMI levels to the optimum and increase their physical activity levels.

The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: A single-blind, randomized-controlled trial.

OBJECTIVES: The purpose of this study was to compare the efficacy of two different types of exercise methods in patients with adolescent idiopathic scoliosis. METHODS: In total, 28 subjects with adolescent idiopathic scoliosis with a mild curve magnitude (10°-26°) were randomly divided into two groups: the Schroth group (n = 14) and the core group (n = 14). The patients in the Schroth group were treated with supervised Schroth exercises, and the patients in the core group were treated with supervised core stabilization exercises; both groups performed the exercises for three days per week for a total of 10 weeks, and both were given additional traditional exercises to perform. Assessment included Cobb angle (Radiography), trunk rotation (Adam's test), cosmetic trunk deformity (Walter Reed Visual Assessment Scale), spinal mobility (Spinal Mouse), peripheral muscle strength (Biodex System 4-Pro), and quality of life (Scoliosis Research Society-22 questionnaire). RESULTS: It was found that patients in the Schroth group showed greater improvement in Cobb angles, thoracic trunk rotation angle, cosmetic trunk deformity, spinal mobility, and quality of life than those in the core group (p<0.05), except for in lumbar trunk rotation angle. Peripheral muscle strength improvement was greater in the core group than in the Schroth group (p<0.05). CONCLUSION: Schroth exercises are more effective than core stabilization exercises in the correction of scoliosis and related problems in mild adolescent idiopathic scoliosis, and core stabilization exercises are more effective than Schroth exercises in the improvement of peripheral muscle strength. TRIAL REGISTRATION: NCT04421157.

Are Biomechanical Features of the Foot and Ankle Related to Lumbopelvic Motor Control?

BACKGROUND: Any pathomechanical change in the foot or ankle is expected to cause adverse biomechanical effects on the lumbopelvic region. However, no objective data can be found in the literature regarding the effects of musculus transversus abdominis (mTrA) and musculus lumbar multifidus (mLM), which are effective muscles in lumbopelvic motor control, or regarding the extent of their effects. METHODS: Sixty-four healthy young adults were assessed by a physiotherapist (C.K.) experienced in treating feet and a radiologist (Y.D.) specialized in muscular imaging. In the determination of biomechanical properties of the foot, the navicular drop test (NDT), Foot Posture Index (FPI), pedobarographic plantar pressure analysis, and isokinetic strength dynamometer measurements were used in determining the strength of the muscles around the ankle. Ultrasonographic imaging was used to determine mTrA and mLM thicknesses. RESULTS: Significant correlation was found between NDT results and mTrA and mLM thicknesses (P < .05) and between FPI results and mTrA thicknesses (P < .05). As the peak pressure of the foot medial line increased, mTrA and mLM thicknesses decreased (P < .05). Although dorsiflexion muscle strength was also effective, mTrA and mLM thicknesses were found to increase especially as plantarflexion muscle strength increased (P < .05). CONCLUSIONS: These results show that the biomechanical and musculoskeletal properties of the foot-ankle are associated with lumbopelvic stability.

Reliability and validity of Turkish version of the Scoliosis Japanese Questionnaire- 27 in patients with adolescent idiopathic scoliosis.

BACKGROUND: The aim of this study was to evaluate the reliability and validity of an adapted Turkish version of the Scoliosis Japanese Questionnaire- 27 (SJ- 27). METHODS: Translation and retranslation of the English version of the SJ- 27 was conducted, and all steps of the cross-cultural adaptation process were performed. The Turkish version of the SJ- 27, the Scoliosis Research Society-22 (SRS- 22) questionnaire and the Short Form-36 (SF- 36) were performed to 139 patients with AIS. Reliability was assessed using the test-retest method (Pearson's correlation coefficient); internal consistency was analyzed using Cronbach's alpha. Validity was assessed by correlating the SJ- 27 with the SRS- 22 questionnaire and SF- 36. RESULTS: The mean Cobb angles were 23.2 ± 8.3° and 19 ± 5.9° for thoracic and lumbar regions, respectively. The SJ- 27 showed excellent test/retest reliability with an Intraclass correlation coefficient of 0.99. Internal consistency of the SJ- 27 was found to be very good (Cronbach's alpha = 0.991). The SJ- 27 demonstrated very good construct validity with the SRS- 22 total score (r = 0.61). The similar domains of the SJ- 27 and SF- 36 questionnaire was correlated also in the study. CONCLUSIONS: The Turkish version of the SJ- 27 to measure health related quality of life in adolescent idiopathic scoliosis was found to have very good validity, excellent reliability, and high internal consistency.

Comparison of the lower extremity function of patients with foot problems according to the level of kinesiophobia.

PURPOSE: The presence of kinesiophobia was identified in patients with foot problems. There was no finding of foot functionality according to the level of kinesiophobia in lower extremity problems. The aim of this study was to compare the lower extremity functional status in foot problems with a low or high level of kinesiophobia. MATERIALS AND METHODS: Evaluated herein were 37 patients with foot problems (plantar fasciitis, hallux valgus, flat foot). Physical and demographic characteristics were recorded. Patients were divided into two groups based on if they had a high or low level of kinesiophobia using the Tampa kinesiophobia scale. Ankle plantar flexor and knee flexor muscles tightness were recorded. The foot posture was evaluated using the Foot Posture Index. Foot-related pain was measured using the Visual Analog Scale Foot & Ankle. The Foot Function Index and the American Orthopaedics Foot and Ankle Foundation Ankle-Hindfoot Scale and Hallux Metatarsophalangeal-Interphalangeal Scale were used to assess the foot function. The general functional status of the lower extremities was evaluated using the Lower Extremity Functional Scale. RESULTS: Foot function was better in patients with a low level of kinesiophobia (p < 0.05). Pain was higher in patients with high level of kinesiophobia than in patients with a low level of kinesiophobia (p < 0.05). There was no difference between the groups in terms of foot posture index and muscle tightness (p > 0.05). The general lower extremity function was more negatively affected in patients with a high level of kinesiophobia (p < 0.05). CONCLUSIONS: Patients with a high level of kinesiophobia presented with more functional problems in the foot and whole lower extremity; hence, function-based rehabilitation and pain coping strategies should be a crucial part of the rehabilitation program at the earliest opportunity.

Validity and reliability of the Turkish version of the Self-reported Foot and Ankle Score in patients with foot or ankle pain.

OBJECTIVE: The aim of this study was to translate the Self-Reported Foot and Ankle Score (SEFAS) into Turkish and to determine the validity and reliability of the translated version in patients with foot or ankle pain. METHODS: A total of 98 patients (65 females, 33 males, mean age=39 years, age range 18-65 years) who presented with foot or ankle pain for at least one week were included in the study. SEFAS was translated into Turkish (SEFAS-T) and then back-translated into English by two bilingual translators to ensure the accuracy of translation. To determine the validity of the translated version, SEFAS-T, The Foot and Ankle Outcome Score (FAOS), and the Short Form 36 (SF-36) were administered at the first assessment on the same day. SEFAS-T was repeated five days later (Spearman's rho). Intra-class correlation coefficients (ICCs) were used for assessment of the test re-test reliability, while the Cronbach's alpha coefficient was used to assess the internal consistency of the questionnaire Results: SEFAS-T showed good test-retest reliability (ICC: 0.887). Item 4 showed poor item-total correlation and inter-item correlations. When item 4 was excluded, the Cronbach's alpha value was found as 0.906. SEFAS-T total scores showed correlation with all the FAOS sub-scores (p<0.001) and all the SF-36 components (p≤0.001) except mental health (rho: 0.149, p: 0.143). The highest correlation was found between SEFAS-T Total Score and the Sports and Recreations subscale of FAOS (rho: 0.796, p<0.001). CONCLUSION: SEFAS-T seems to be valid and reliable as a measure for foot or ankle pain in Turkish patients. LEVEL OF EVIDENCE: Level II, Diagnostic study.

Does Plantar Pressure Distribution Influence the Lumbar Multifidus Muscle Thickness in Asymptomatic Individuals? A Preliminary Study.

BACKGROUND: Atrophy can occur in the lumbar multifidus (LM) muscle quickly as a result of various musculoskeletal problems. Knowing factors influencing muscle thickness of the LM will provide important clues about lumbopelvic stability. OBJECTIVES: Although there are several studies in the literature investigating the adverse effects of foot-ankle postural disorders on the lumbopelvic region, to our knowledge there has been no investigation of plantar pressure distribution (PPD) as a factor influencing muscle thickness of the LM. The aim of this study was to determine whether PPD could affect LM muscle thickness. METHODS: This observational study consisted of 25 asymptomatic individuals. Ultrasonographic imaging was used to determine the thickness of the LM. All participants were subjected to PPD analysis using the Digital Biometry Scanning System and Milletrix software in 9 different plantar pressure zones. The Pearson product-moment correlation coefficients were used to examine the correlations between the LM muscle thickness and other variables. Stepwise multiple linear regression analysis was used to determine the variables with the greatest influence on LM muscle thickness. RESULTS: Peak pressures of medial and lateral zones of the heel were the significant and independent factors influencing static LM thickness, with 39.5% of the variance; moreover, the peak pressures of heel medial and fourth metatarsal bone were the significant and independent factors influencing dynamic LM thickness, with 38.7% of the variance. CONCLUSIONS: Plantar pressure distribution could be an important factor influencing LM thickness, although further research is required. Examining foot-ankle biomechanics may provide information about the stability of the LM.

Effects of morphological and mechanical properties of plantar fascia and heel pad on balance performance in asymptomatic females.

INTRODUCTION: Personal differences in morphological and mechanical properties of plantar fascia and heel fat pad may be an important parameter regarding an individual's balance performance. The purpose of this study was to investigate the effect of thickness and stiffness of heel fat pad and plantar fascia on balance performance in asymptomatic sedentary females. MATERIALS AND METHODS: This study was carried out on 37 asymptomatic sedentary females between the ages of 19 and 35 years. Balance assessments during single-leg standing were carried out using Biodex Balance Systems (Biodex Medical Systems, Shirley, NY, USA). In this study, the individuals' balance performance was assessed using the center of balance (COB) parameters, which were the standard deviation of the COB amplitude in the anterior-posterior (AP_SD) and medial-lateral (ML_SD) directions. Stiffness and thickness measurements of heel fat pad and plantar fascia were performed using an ACUSON S3000 Ultrasound System and a 9L4 probe (4-9MHz) (Siemens Medical Solution, Mountain View, CA, USA). RESULTS: AP_SD during single-leg standing tests had a moderate correlation with heel pad thickness (r=0.46, p=0.004) and heel pad stiffness (r=0.41, p=0.011), and a fair correlation with plantar fascia thickness (r=0.34, p=0.038) and plantar fascia stiffness (r=0.38, p=0.021). ML_SD during single-leg standing tests had a moderate correlation with heel pad thickness (r=0.41, p=0.013) and heel pad stiffness (r=0.53, p=0.001), and a fair correlation with plantar fascia thickness (r=0.40, p=0.015). CONCLUSION: It was found that higher plantar fascia and heel fat pad stiffness and thickness are related to higher postural sway in anterior-posterior and medial-lateral directions based on the single-leg balance tests. These results suggest that the morphological and mechanical properties of plantar fascia and heel fat pad play an important role in balance performance.

Validity and Reliability of Visual Analog Scale Foot and Ankle: The Turkish Version.

The present study tested the reliability and validity of the Turkish version of the visual analog scale foot and ankle (VAS-FA) among healthy subjects and patients with foot problems. A total of 128 participants, 65 healthy subjects and 63 patients with foot problems, were evaluated. The VAS-FA was translated into Turkish and administered to the 128 subjects on 2 separate occasions with a 5-day interval. The test-retest reliability and internal consistency were assessed with the intraclass correlation coefficient and Cronbach's α. The validity was assessed using the correlations with Turkish versions of the Foot Function Index, the Foot and Ankle Outcome Score, and the Short-Form 36-item Health Survey. A statistically significant difference was found between the healthy group and the patient group in the overall score and subscale scores of the VAS-FA (p < .001). The internal consistency of the VAS-FA was very good, and the test-retest reliability was excellent. Adequate to good correlations were found between the overall VAS-FA score and the Foot Function Index, Foot and Ankle Outcome Score, and Short-Form 36-item Health Survey scores in the healthy and patient groups both. The Turkish version of the VAS-FA is sensitive enough to distinguish foot and ankle-specific pathologic conditions from asymptomatic conditions. The Turkish version of the VAS-FA is a reliable and valid method and can be used for foot-related problems.

Effects of Body Mass Index on Mechanical Properties of the Plantar Fascia and Heel Pad in Asymptomatic Participants.

BACKGROUND: Musculoskeletal foot disorders have a high incidence among overweight and obese individuals. One of the important factors causing this high incidence may be plantar fascia and heel pad (HP)-related mechanical changes occurring in these individuals. The aim of the present study was to investigate the plantar fascia and HP stiffness and thickness parameters in overweight and obese individuals and compare these values with those of normal-weight individuals. METHODS: This study was carried out in 87 (52 female, 35 male) healthy sedentary individuals between the ages of 19 and 58 years (34 ± 11 years). Participants were subsequently categorized according to body mass index (BMI) as normal weight (18.5 kg/m2 < BMI < 25 kg/m2) or overweight and obese (BMI ≥25 kg/m2). Plantar fascia and HP thickness and stiffness were measured with an ultrasonography device using a linear ultrasonography probe. RESULTS: Overweight and obese individuals had higher HP thickness ( P < .001), plantar fascia thickness ( P = .001), heel pad microchamber layer (MIC) stiffness ( P < .001), and heel pad macrochamber layer (MAC) stiffness ( P < .001), whereas they had lower plantar fascia stiffness ( P < .001) compared with the individuals with normal weight. BMI had a moderate correlation with HP thickness ( P < .001, r = 0.500), plantar fascia thickness ( P = .001, r = 0.536), MIC stiffness ( P < .001, r = 0.496), and MAC stiffness ( P < .001, r = 0.425). A negative and moderate correlation was found between BMI and plantar fascia stiffness ( P < .001, r = -0.439). CONCLUSION: Increased BMI causes a decrease in the stiffness of plantar fascia and an increase in the thickness of the plantar fascia as well as the thickness and stiffness of HP. Increased body mass could cause changes in the mechanical properties of HP and plantar fascia. LEVEL OF EVIDENCE: Level 3, comparative study.

Effects of Corrective Taping on Balance and Gait in Patients With Hallux Valgus.

BACKGROUND: Taping is an effective temporary therapy for improving hallux valgus (HV) in adults. Although HV has been demonstrated to impair postural balance, there is a lack of information about how corrective taping affects balance and gait patterns in adults with HV deformity. METHODS: Eighteen middle-aged female patients (average age, 53.5 years) with HV were included. Corrective tape was applied to correct HV angulation. A series of balance and gait stability tests were performed before applying tape and 1 hour after the tape was applied with a Balance Master computerized posturography device. The study involved the following tests: modified clinical test of sensory interaction and balance (mCTSIB), unilateral stance (US), limit of stability (LoS), step up/over (SUO), and walk across (WA) tests. RESULTS: No significant difference was found between the no-tape and taped condition in the static balance mCTSIB and US tests ( P > .05). The taping intervention resulted in significant improvement in the dynamic balance measures for the LoS test's backward reaction time and left maximum excursion ( P < .05), a significantly higher impact index bilaterally in the SUO assessment ( P < .05), and an increase in step width mean and variability in the WA test ( P < .05). CONCLUSIONS: Taping for correcting HV angulation had negative acute effects on dynamic balance in the SUO and WA tests and positive effects in the LoS test. CLINICAL RELEVANCE: Corrective taping, although a form of conservative treatment for hallux valgus, has been insufficiently studied in terms of effects on balance. Our results show that taping, as an acute effect, may impair balance in middle-aged adults when walking or ascending and descending stairs.

Effects of different seating equipment on postural control and upper extremity function in children with cerebral palsy.

BACKGROUND: Adaptive seating supports for cerebral palsy are recommended to develop and maintain optimum posture, and functional use of upper extremities. OBJECTIVES: To compare the effectiveness of different seating adaptations regarding postural alignment and related functions and to investigate the effects of these seating adaptations on different motor levels. STUDY DESIGN: Prospective study. METHODS: A total of 20 children with spastic cerebral palsy (Gross Motor Function Classification System 3-5) were included. Postural control and function (Seated Postural Control Measure, Sitting Assessment Scale) were measured in three different systems: standard chair, adjustable seating system and custom-made orthosis. RESULTS: In results of all participants ungrouped, there was a significant difference in most parameters of both measurement tools in favor of custom-made orthosis and adjustable seating system when compared to standard chair ( p < 0.0017). There was a difference among interventions in most of the Seated Postural Control Measure results in Level 4 when subjects were grouped according to Gross Motor Function Classification System levels. A difference was observed between standard chair and adjustable seating system in foot control, arm control, and total Sitting Assessment Scale scores; and between standard chair and custom-made orthosis in trunk control, arm control, and total Sitting Assessment Scale score in Level 4. There was no difference in adjustable seating system and custom-made orthosis in Sitting Assessment Scale in this group of children ( p < 0.017). CONCLUSION: Although custom-made orthosis fabrication is time consuming, it is still recommended since it is custom made, easy to use, and low-cost. On the other hand, the adjustable seating system can be modified according to a patient's height and weight. Clinical relevance It was found that Gross Motor Function Classification System Level 4 children benefitted most from the seating support systems. It was presented that standard chair is sufficient in providing postural alignment. Both custom-made orthosis and adjustable seating system have pros and cons and the best solution for each will be dependent on a number of factors.

Development of Multidimensional Nil Hallux Valgus Scale: a reliability and validity study.

OBJECTIVE: The aim of this study was to develop a disease-specific multidimensional hallux valgus (HV) scale, as well as to establish the validity and reliability thereof. METHODS: The 14-item Multidimensional Nil Hallux Valgus Scale was developed. The scale has a score range of 0-60, with higher score indicating increased HV symptoms, complaints, and functional disorder. Among the patients referred to our clinic with HV diagnosis based on anterior-posterior non-weight-bearing radiography of the affected foot, 129 feet of 66 patients (63 bilateral, 3 unilateral) were included in the study. In clinical evaluations of these HV patients, American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal Interphalangeal Joints Scale (AOFAS-MTF-IF), Manchester Scale, and Short Form 36 Health Survey (SF-36) were used to test the validity and reliability of the new scale. RESULTS: From factor analyses, it was observed that the items clustered in 5 factors, which explained 73.2% of the variance. Floor and ceiling effects were observed to be within normal limits (floor effect: 3.1%; ceiling effect: 0.8%). The Cronbach's alpha level related with the overall internal consistency of the scale was estimated as 83.3%, and the Cronbach's alpha for the subheadings of the scale varied between 33.9% and 74.2%. High correlation was observed regarding test-retest reliability of the scale. CONCLUSION: This newly developed scale allows for the holistic evaluation of HV including the condition-specific parameters and is a valid and reliable scale that can be conveniently used by health care professionals.