Is There Any Association Between Foot Posture and Lower Limb-Related Injuries in Professional Male Basketball Players? A Cross-Sectional Study.

BACKGROUND: Several studies have shown that foot posture is related to the incidence of ankle sprains in athletes and in nonathletic populations, but this association has not previously been considered in basketball players. This study investigates the relationship between foot posture and lower limb injuries in elite basketball players. DESIGN AND METHOD: Two hundred twenty participants were recruited as a convenience sample. The players had a mean age of 22.51 ± 3.88 years and a body mass index of 23.98 ± 1.80. The players' medical records were accessed from the preceding 10 years, and injuries were recorded according to their location (knee, foot, and/or ankle). In addition, the Foot Posture Index (FPI) was scored for each player, and their playing positions were noted. RESULTS: An average FPI score of 2.66 was obtained across all players, with guards presenting a significantly lower average FPI of -0.48 (P < 0.001) compared with the rest of playing positions, indicating a more supinated foot. However, center players presented an average FPI of 5.15 (P < 0.001), indicating a more pronated foot. The most common injuries observed were lateral ankle sprain (n = 214) and patellar tendinopathy (n = 126). Patellar tendinopathy was more common in supinated feet (30.08%) compared with 20.7% and 19.8% in pronated and neutral feet, respectively. CONCLUSIONS: The most common lower limb injuries observed in basketball players were lateral ankle sprain and patellar tendinopathy. Patellar tendinopathy was more commonly associated with the supinated feet. Guard players tended to have a more supinated foot, whereas centers presented a more pronated foot.

Anthropometric and Psychomotor Development Factors Linked to Foot Valgus in Children Aged 6 to 9 Years.

BACKGROUND: Planovalgus foot prevalence estimates vary widely (0.6%-77.9%). Among the many factors that may influence planovalgus foot development, much attention has been given to body mass index, especially that of children's feet; factors related to psychomotor development have been less studied. We sought to determine the presence of planovalgus foot in children and its association with anthropometric parameters and psychomotor development. METHODS: A case-control study was conducted in Málaga, Spain, 2012-2013, of 104 schoolchildren (mean ± SD age, 7.55 ± 0.89 years; 45.2% were boys). Age, sex, body mass index, presence of valgus (valgus index, by pedigraphy), and personal history related to psychomotor development of the lower limbs (presence/absence of crawling, age at onset of crawling, age at onset of walking, use of mobility aids) were evaluated. RESULTS: Of the children with obesity, 53.7% had valgus deformity in the left hindfoot (odds ratio [OR], 6.94; 95% confidence interval [CI], 2.72-17.70; P < .0001). In the right foot, the corresponding values were 54.5% (OR, 9.08; 95% CI, 3.38-24.36; P < .0001). Multivariate logistic regression showed an increased risk of left planovalgus foot in boys, in children with overweight or obesity, and in those who began walking later. For the right foot, the same risk factors applied except age at onset of walking. CONCLUSIONS: These results corroborate data from previous studies, which report an association between overweight and obesity and the onset of planovalgus foot in children. In addition, we identify a new risk factor: age at onset of walking.

Influence of Shoe Characteristics on the Development of Valgus Foot in Children.

For thousands of years, shoes have been worn to protect the feet from injury, and the proper choice and use of footwear are directly relevant to foot health, especially that of children. The aim of this study was to evaluate the association between shoe-related factors (type and frequency of use) and the prevalence of valgus foot in children. This analytical cross-sectional observational study was carried out on a population of children in the first, second or third year of primary education, to analyzing the frequency and type of shoes worn, and to determining the presence or not of valgus foot. The sample consisted of 132 children (of 642 potential subjects), with an average age of 7.53 years (Standard Deviation (SD) 0.80), which was composed of 61 boys (46.2%) and 71 girls (53.8%). The overall prevalence of valgus foot was 45.5% (n = 60). The use of boots 2⁻5 days a week was significantly associated, in both sexes, with a lower prevalence of valgus in the left foot (30.5%, p = 0.009). The use of boots could be associated with a lower presence of valgus, depending on the frequency of wear.

Cross-cultural adaptation and validation of Spanish version of The Foot and Ankle Ability Measures (FAAM-Sp).

BACKGROUND: The Foot and Ankle Ability Measure (FAAM) is a Patient Reported Outcome (PRO) commonly used to determine the effectiveness of therapeutic interventions for patients with foot and ankle pathologies and associated impairments of body function and structure, activity limitations, and participation restrictions. The aim of this study was to cross-culturally adapt the FAAM into Spanish. METHODS: Cross-cultural adaptation was performed according to the international guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Cronbach's alpha, test re-test reliability, and item-total and inter-item correlations were analyzed. Confirmatory factor analysis (CFA) was carried out to test construct validity. Pearson correlations were calculated to assess the convergent validity between FAAM and EuroQol-5. RESULTS: Spanish data set comprised 194 patients, with a mean age of 38.45 (16.04) and 130 (67.1%) were female, seeing a podiatrist with a wide variety of foot and ankle related disorders. CFA was carried out to test structure matrix (which has three factors). The test-retest reliability was high with global ICC of 0.95 (95% CI: 0.93 to 0.98). A 15 items version of the FAAM-Sp Activities of Daily Living (ADL) obtained the best fit: relative chi-square (x2/df) of 2.46, GFI 0.90 CFI 0.95, NFI 0.93, and RMSEA 0.08 (90% CI 0.04 to 0.09). For exploratory factor analysis for the FAAM-Sp Sport, a one factor solution was obtained, which explained 76.70% of total variance. CFA corroborated this model with an excellent goodness of fit:: relative chi-square (x2/df) of 0.80, GFI 0.99 CFI 1.00, NFI 0.99, and RMSEA 0.00 (90% CI 0.00 to 0.75). CONCLUSIONS: This study validated a new 15-item FAAM-Sp ADL and FAAM-Sp Sport subscales, which can be used as a self-reported outcome measure in clinical practice and research for patients resident in Spain whose main language is Spanish.

Structural Changes in the Lower Extremities in Boys Aged 7 to 12 Years Who Engage in Moderate Physical ActivityAn Observational Longitudinal Study.

BACKGROUND: Physical activity in children may provide health benefits. We sought to consider the practice of soccer as a possible major factor in the development of the lower limb. The study is based on 3-year data for a group of children who practice this sport. METHODS: For 3 years we monitored 53 children who practiced soccer 3 times a week and had engaged in 2 years of continuous sports activity. Their mean ± SD age was 8.49 ± 2.01 years in the first year. Each year, Foot Posture Index, valgus index, subtalar joint axis, and Q angle for the knee were analyzed. RESULTS: The mean ± SD Foot Posture Index scores ranged from 5.38 ± 1.79 in the right foot and 4.49 ± 1.67 in the left foot in the first year to 4.64 ± 2.51 and 4.34 ± 2.26, respectively, in the third year. The valgus index for the same period ranged from 14.05° ± 1.51° (right) and 13.88° ± 1.46° (left) to 13.09° ± 1.28° and 13.07° ± 1.07°, respectively. In the knee, the Q angle ranged from 12.83° ± 1.98° (right) and 12.74° ± 1.68° (left) to 13.17° ± 1.45° and 13.26° ± 1.46°, respectively. In the subtalar joint, the changes were 37.73% right and 30.19% left between the first and third years toward a neutral subtalar joint axis. CONCLUSIONS: These results show that although playing soccer might cause structural changes in the lower limb, these alterations should not be considered harmful because they may be influenced by age as well.

Short-term effect of scalpel debridement of plantar callosities versus treatment with salicylic acid patches: The EMEDESCA randomized controlled trial.

This study compares scalpel debridement versus salicylic acid patches in the treatment of plantar callosities. A randomized clinical trial (ACTRN12614000591651) was performed with 62 patients, divided into two intervention groups. Group A received treatment with salicylic acid patches (Callívoro Marthand® ) and group B underwent scalpel debridement of plantar callosities. Pain was measured on a visual analog scale, and foot pain and disability were evaluated using the Manchester Foot Pain Disability Index (MFPDI) questionnaire (Spanish version). Significant differences were observed in pain measured immediately after treatment (P < 0.001) and at 15 days and 6 weeks after treatment. For some components, the MFPDI questionnaire revealed significantly better outcomes by scalpel debridement at 15 days after treatment. The scalpel debridement of plantar callosities relieves pain more effectively than salicylic acid patches, and patients achieve greater functionality in the initial weeks after debridement.

Establishing normative foot posture index values for the paediatric population: a cross-sectional study.

BACKGROUND: The Foot Posture Index (FPI) is an observational tool designed to measure the position of the foot. Its reliability is well established, and it provides normative reference values for the general population. However, this is not so for the paediatric population. The aim of this study is to determine FPI reference values in childhood, taking into account age and gender. METHODS: This cross-sectional study included 1,762 school children (863 boys and 899 girls) aged 6-11 years, from Málaga, Granada and Plasencia (Spain). In every case, FPI measurements were obtained for both feet by two experienced podiatrists. A descriptive analysis was then conducted and the percentiles of the variables determined, with a significance level of P < 0.05. RESULTS: The consolidated FPI results for the sample population produced mean values of 3.74 (SD 2.93) points for the right foot and 3.83 (SD 2.92) for the left. The 50th percentile was 4 points for both genders and for both feet, except for the right foot among the girls, which was slightly lower, at 3 points. The 85th percentile, which is considered to represent the boundary between the normal and the pronated foot among children, was 6 points, uniformly among the subjects. CONCLUSIONS: As a normative FPI value for the paediatric population, we recommend the 50th percentile, i.e. 4 points, for children, of both genders, aged 6 years. This value progressively falls with age, to 3 FPI points for children aged 11 years. The 85th percentile for the pronated foot and the 4th percentile for the supinated foot can be considered the pathological boundary.

Effect by custom-made foot orthoses with added support under the first metatarso-phalangeal joint in hallux limitus patients: Improving on first metatarso-phalangeal joint extension.

BACKGROUND: Hallux limitus is one of the most common disorders affecting foot biomechanics. Custom-made foot orthoses can improve the function of the first metatarso-phalangeal joint. OBJECTIVES: The objective underlying this study was to test whether custom-made foot orthoses increased the range of mobility of metatarso-phalangeal joint in patients with hallux limitus. STUDY DESIGN: Randomized, double-blinded, and clinical trial. METHODS: The study consisted of 20 participants (40 feet) diagnosed with hallux limitus. A control group and an experimental group both wore the same custom-made foot orthoses and, in the experimental group, a support element under the first metatarso-phalangeal joint was added to the orthoses. Two measurements were made with both groups: the relaxed position of the first metatarso-phalangeal joint and the maximum extension of the hallux. These measurements were made before first placing the foot orthoses and 6 months after application of the treatment. RESULTS: In the experimental group, the results showed an improvement of 4.5° in the relaxed position and 22.2° in the maximum extension being statistically significant (p < 0.001) for both measurements. CONCLUSION: Custom-made foot orthoses with added support under the first metatarso-phalangeal joint were proved to be an effective treatment to restore functionality of this joint in hallux limitus patients. CLINICAL RELEVANCE: Limitation of hallux movement in the joints propulsive phase of gait negatively affects the biomechanics of the lower extremity, causing changes in the rest of the joins. The use of foot orthoses designed in this study restores range of motion of the first metatarso-phalangeal joint.

Assessment of Foot Self-Care in Patients With Diabetes: Retrospective Assessment (2008-2014).

INTRODUCTION: The purpose of this article is to assess the current status of the relationship between foot self-care and self-examination and the development of complications of diabetes mellitus. METHODOLOGY: A systematic review of articles. We extracted assessments of health habits with regard to educational and training interventions intended for diabetic foot health care. We included clinical trials, meta-analysis, and Cochrane Reviews from 2008 to December 2014. RESULTS: We included 34 articles in this review. The initial number of articles selected was 35, including 12 from PubMed, 12 from Webs of Knowledge, and 4 Cochrane reviews that were considered valid as they complied with the requirements set: they related to interventions reducing foot complications caused by diabetes. CONCLUSION: Strategies aimed at behavioral changes are effective for the metabolic control of the disease and for the reduction of amputations. However, given the current methodology deficit existing in most studies with regard to sample selection and length of the study, it is necessary to validate a reliable tool or measurement to indicate the status of healthy behavior development and to sustain such measures over time. LEVELS OF EVIDENCE: Therapeutic, Level III: Systematic review of level I-III studies.

Normal values of the Foot Posture Index in a young adult Spanish population: a cross-sectional study.

BACKGROUND: Although the appearance of foot or lower-limb pathologies is etiologically multifactorial, foot postures in pronation or supination have been related to certain diseases such as patellofemoral syndrome and plantar fasciitis. The objective of the present study was to determine the normal values of foot posture in a healthy young adult Spanish sample, and to identify individuals at risk of developing some foot pathology. METHODS: The Foot Posture Index (FPI) was determined in a sample of 635 (304 men, 331 women) healthy young adults (ages 18-30 years). The FPI raw score was transformed into a logit score, and a new classification was obtained with the mean ± 2 SD to identify the 5% of the sample with potentially pathologic feet. RESULTS: The normal range of the FPI was -1 to +6, and FPI values from +10 to +12 and -6 to -12 could be classified as indicating potentially pathologic feet. The women's logit FPI (0.50 ± 1.4, raw FPI +3) was higher than the men's (0.25 ± 1.6, raw FPI +2), with the difference being significant (P = 0.038). No statistically significant differences were found between body mass index groups (P = 0.141). CONCLUSIONS: The normal FPI range goes from just one point of supination to a certain degree of pronation (+6). The identification of 35 individuals with potentially pathologic feet may help in the implementation of a preventive plan to avoid the appearance of foot disorders.

Changes in the parameters of gait after a mechanical debridement of a plantar callosities.

INTRODUCTION: Plantar callosities are a common cause of pain in the forefoot and also a cause of alterations in plantar pressure. Mechanical debridement with a scalpel can relieve pain and increase functional capacity. OBJECTIVE: The aim of the study was to analyse if debridement of plantar callosities and corns modify walking. METHODS: Thirty four patients with plantar foot pain due to callosities and corns, and up to 5 in the visual analogical scale (VAS) of pain, (20 women, age 29 ± 11.57 years) were analysed by taking into account the changes of their gait. The outcome measurement was the VAS scale and the Win-track system, cycle of the gait(milliseconds), angle(degrees), cadence(number/minutes) and step(centimetres) were measured, 24 h before and after the debridement with a scalpel. RESULTS: There were significant differences in foot pain (mean 67.7, p < 0.001) but there were no significant differences in measures of gait variables before the debridement of the callosities, and 24 h after the procedure, being all those above 0.05. CONCLUSIONS: Our study shows that the debridement with scalpel does not change the variables of the gait 24 h after the procedure.

Development, validation and psychometric analysis of the diabetic foot self-care questionnaire of the University of Malaga, Spain (DFSQ-UMA).

This paper assessed the reliability and construct validity of a tool to evaluate the foot self-care of diabetic patients. The education of diabetic patients about their foot care is a major issue to avoid complications like amputations and ulcers. Specific tools aimed to assess patient's knowledge in this area are needed. The study had two phases: in Phase 1, item-generation was carried out through a literature review, expert review by a Delphi technique and cognitive interviews with diabetic patients for testing readability and comprehension. In Phase 2, diabetic patients participated in a cross-sectional study for a psychometric evaluation (reliability and construct validity) was carried out on a sample of type I and II diabetic patients. The study was conducted at the University of Malaga (Spain), podiatric clinics and a Diabetic Foot Unit between October 2012 and March 2013. After psychometric-test analyses on a sample of 209 diabetic patients, the questionnaire resulted in 16 questions. Cronbach's alpha was 0.89 after removing 4 items because of their low reliability. Inter-item correlations gave a mean value of 0.34 (range: 0.06-0.74). The rotated solution showed a 3-factor structure (self-care, foot care, and footwear and socks) that jointly accounted for 60.88% of the variance observed. The correlation between the questionnaire scores and HbA1c was significant and inverse, (r = -0.15; p < 0.01). The findings show that the questionnaire is a valid and reliable tool for evaluating foot self-care behavior in diabetic patients.

The effects of custom-made foot orthosis using the Central Stabilizer Element on foot pain.

BACKGROUND: Foot orthoses have been applied for the management of lower limb disorders, mainly for those who develop foot pain. The Central Stabilizer Element (CSE) is a new element that contains the midfoot laterally when a plantar insole is manufactured. OBJECTIVES: To determine the effect on foot pain of adding the Central Stabilizer Element during the manufacturing process of foot orthosis, and to describe the proportions of Central Stabilizer Element in terms of width and length of this element. STUDY DESIGN: A clinical study. METHODS: A sample comprising 130 patients (57 males and 73 females) with foot pain was recruited for this study, with the patients having supinated, neutral, pronated and overpronated feet. All the patients received a custom-made foot orthosis with the Central Stabilizer Element. The Central Stabilizer Element was made of resins of polyvinyl chloride, and is a device insert in foot orthosis that contains the midfoot laterally to control pronation and supination movements. Perceived patient's foot pain was collected using a Visual Analog Scale at baseline, 15, 60 and 90 days after treatment. RESULTS: A statistically significant decrease was found after foot orthosis application at all times in all foot types. There was a statistically significant correlation between all the ratio proportions according to foot posture (Foot Posture Index scores), except for heel length proportion. CONCLUSIONS: The Central Stabilizer Element, applied at midfoot level of a custom-made foot orthoses through a directly mould technique, can reduce foot pain, when a previous foot posture status is considered. CLINICAL RELEVANCE: The Central Stabilizer Element can be of interest for those professionals who are involved in the manufacturing process of foot orthosis, throughout the control of an excesive pronated or a supinated foot condition that is provoking foot pain.

Anthropometric foot changes during pregnancy: a pilot study.

BACKGROUND: Women's feet change during pregnancy owing to hormonal and anatomical changes, thus having a strong influence on the decrease in their quality of life during pregnancy. This preliminary study aimed to value the anthropometric and positional changes that affect their feet. METHODS: Ten pregnant women were measured during their gestational period to analyze the anthropometric changes in their feet from the 12th week of pregnancy. We examined the changes that occured in foot length, forefoot width, arch of the foot height, and the fixed position of the foot by using the Foot Posture Index, and we analyzed three intervals corresponding to pregnancy weeks 12, 24, and 34. RESULTS: The most significant finding, with a reliability rate of 95%, is the decrease in internal arch height, which descends 0.65 mm (0.0394 inches) on average at the final stage of the pregnancy period. This change happened in 18 of the feet analyzed, tending toward pronation according to the measure provided by the Foot Posture Index, with a change of 3.78 points on this scale. CONCLUSIONS: The foot of the pregnant woman tends to flatten during gestational weeks 12 to 34, taking a more pronated posture, and the anthropometric changes in late pregnancy result in increases in foot length and forefoot width, changes that seem to be moderate.

Foot orthoses custom-made by vacuum forming on the non-load-bearing foot: preliminary results in male children with calcaneal apophysitis (Sever's disease).

BACKGROUND AND AIM: To our knowledge, the technique of molding orthoses to the non-load-bearing foot is still not widely investigated. The aim of this work is, therefore, first, to describe an off-loading custom-made technique and, second, to explain how it can be specifically adapted to treat Sever's disease. TECHNIQUES: A technique of directly molding orthoses to the non-load-bearing foot by vacuum forming an insole to the foot fabricated with a combination of polyvinyl chloride and polyester resins, 30 Shore A hardness and 148 kg/m(3) density polyethylene-ethylene-vinyl-alcohol, and a cushioning heel cup of 22 Shore A polyurethane, using a directly molding orthoses technique to the non-load-bearing foot by vacuum. DISCUSSION: Results show that this new technique could be a good alternative to traditional insoles in the management of Sever's disease pain.

Influencia de los soportes plantares en jugadores de hockey hierba en su resistencia aeróbica / No disponible

Existen numerosos estudios referentes a hockey hierba y condición aeróbica, pero no que relacione o haga referencia la utilización de soportes plantares en la práctica deportiva por parte de los jugadores y la mejora de su condición física (resistencia aeróbica, Test de Cooper). El propósito de este estudio es verificar que la utilización de soportes plantares mejora su condición física (resistencia aeróbica), puesto que al actuar sobre la distancia podemos aumentar el volumen de oxígeno. Material y métodos: jugadores de Hockey Hierba sometido a estudio han sido 20 (n=20). Participan: Equipo de Hockey de Benalmádena (Málaga) (grupo experimental). Componentes: 12. Y Equipo Málaga91 UMA (grupo control). Componentes: 8. Edad comprende el rango de los 15-28 años, aproximadamente. Sexo masculino. La mayoría tenían experiencia en este tipo de estudio. Resultados: los más significativos destacar que el grupo experimental mejoría de Vo2 de 3,8 (dt =2,5) frente a una mejoría de 1.o (dt=1,7) en el grupo control. Siendo las diferencias estadísticamente significativas (t (19) = 2,748, p= 0,013). Estas dos variables (“Grupo experimental y Pie griego”) explican el 40% de la variabilidad del cambio producido en el consumo de la diferencia de Vo2. Conclusiones: dado el número reducido de la muestra, en un estudio posterior sería conveniente realizar de nuevo las mediciones ampliando dicha muestra(AU)

Several studies exist on field hockey and aerobic condition, but none of them associates or references the use of custom-made foot orthoses for the sport and its improvement on physical condition (aerobic resistance, Cooper’s test) The aim of this study is to verify that the use of custom-made foot orthoses improves the physical condition (aerobic resistance) because by dealing with the distance, the volume of oxygen increases. Material and methods: Twenty field hockey players (n= 20). Teams: 20 members of Benalmadena Hockey Team (Experimental group) 8 members of Malaga 91 UMA Team (Control group). Age range: 15-28 years old approximately. Genre: Masculine. Most of the people had experience in this kind of study. Results: Improvement in the Experimental group was V02 of 3, 8 (dt=2, 5) against 1, 0 (dt=1, 7) in the Control group. Differences were statistically significant (t (19) =2,748 p=0,013). These two variables (Experimental group and Greek Foot) explain 40% of the variability of the change produced in the intake with a difference of V02. Conclusions: Because of the reduced size of the sample, it should be appropriate to extend the sample in future studies(AU)