Effectiveness of Custom-Made Foot Orthoses vs. Heel-Lifts in Children with Calcaneal Apophysitis (Sever's Disease): A CONSORT-Compliant Randomized Trial.

The aim of the present research was to determine the effectiveness of relieving calcaneal apophysitis pain using "off-the-shelf" heel-lifts and custom-made orthotics. Two intervention modalities were evaluated and compared in a 12-week follow-up trial. Inclusion criteria included 9- to 12-year-old children diagnosed with calcaneal apophysitis. Children were randomly stratified into treatment A (custom-made polypropylene foot orthoses) and treatment B ("off-the-shelf" heel-lifts) groups. Treatment effectiveness was measured by algometry and the visual analogical scale (VAS). A total of 208 patients were included. The treatment A group showed an increase in threshold algometry of 53.4% (95% CI 47.1% to 59.7%) and a decrease in VAS of -68.6% (95% CI -74.5% to -62.7%) compared with the treatment B group (p < 0.001). Calcaneal apophysitis pain perception was improved in both groups, but children who used custom-made foot orthoses showed a greater improvement.

Locally linear embedding and plantar pressure-time graph selection in heel pain classification: An observational, case-control study.

Plantar heel pain mainly manifests during the gait cycle when the whole foot is in contact with the floor, which corresponds to the second rocker of the gait. This moment can be studied through the analysis of pressure-time graphs obtained using plantar pressure plate systems. However, these graphs are complex, and a dimensionality reduction method, such as locally linear embedding (LLE), greatly assists in their comprehension. This observational, case-control pilot study included 45 subjects divided into case (n = 21) and control (n = 24) groups, depending on the presence/absence of plantar heel pain. The second rocker pressure-time graphs of the 45 subjects were obtained using the Footwork Pro® plantar pressure plate system. These graphs were analyzed and defined as the dynamic simultaneity surfaces (DSSs). This complex structure was composed of four dimensions: the dynamic simultaneity time (DST), slope upward grade (α), slope downward grade (ß), and height (h), and were reduced into one dimension and classified into pathological and non-pathological subjects using the LLE method. All 45 DSSs were successfully reduced and classified to distinguish between the case (plantar heel pain) and control (non-plantar heel pain) subjects. This study is the first to use the LLE method for gait analysis. This method serves as a novel and promising tool for the study and classification of pathological and non-pathological gait cycles. This method opens the door for future research and analysis, with significant potential to assess diagnosis, treatment follow-up, and injury prevention in physical medicine consultations.

Reliability and Repeatability of the Footwork Plantar Pressure Plate System.

BACKGROUND: Plantar pressure plate instruments are commonly used in clinical practice and biomechanical analysis and are useful to establish a relationship between gait disorders and foot pressure. The aim of this study was to verify the reliability and repeatability of the Footwork pressure plate system for static and dynamic conditions. METHODS: Forty healthy adults, without apparent gait pathology, were recruited. For the static condition, participants were asked to stand static on the Footwork pressure plate for 5 sec in natural position (arms on either side of the body, feet shoulder-width apart in a comfortable angle, and looking ahead). For the dynamic condition, subjects were told to step five times with each foot on the plate following the three-step protocol. Both conditions were performed in two testing sessions spaced by 1 week. RESULTS: Intrasession and intersession reliability for both conditions showed substantial to almost perfect intraclass correlation coefficient (ICC) values, and low coefficient of variation, low standard error measure, and low percentage error. Intrasession ICCs were 0.724 to 0.993 for static condition evaluation and 0.639 to 0.986 for dynamic condition evaluation. Intersession reliability ICCs ranged from 0.850 to 0.987 for the static condition and from 0.781 to 0.996 for the dynamic condition. Coefficient of variation values were below 8% in both cases and percentage error calculated from standard error measure were less than 10%. CONCLUSIONS: The present work demonstrates that the Footwork plantar pressure plate system is a reliable instrument for collecting plantar pressures in static and dynamic conditions. Reliability data were higher for the static trials, probably because of the individual physiologic fluctuations, which are larger during dynamic gait. Reliability for intersession and average intrasession trials were higher than single-test reliability. The results from the present work can be used as a starting point for future research and to establish a basis for sample sizes for investigations that would use the Footwork platform.

Association between the Foot Posture Index and running related injuries: A case-control study.

BACKGROUND: Novice runners are at significantly greater risk of running-related injuries than experienced recreational runners. To develop prevention strategies for this population, it is important to identify predisposing factors that contribute to the incidence of these injuries. This study aims to assess the relationship between running-related injuries, foot posture and other factors in novice runners. METHODS: Case-control study in 600 novice runners, classified as cases or controls based on incidence of running-related injuries. Participants' foot posture was measured using the Foot Posture Index, and we performed a descriptive analysis of the explanatory variables, comparing cases and controls. To assess the association between the injury and the presence of exposure and other explanatory variables, we performed a simple logistic regression for each variable and then fit a multivariable regression model. FINDINGS: Our regression model showed that high supination was associated with 76.8 times higher odds of injury than a neutral Foot Posture Index score (P < 0.001). High pronation was associated with 20-fold higher odds of injury than neutral foot posture (P < 0.001). Other variables such as running surface, number of shoes used, and body mass index were also associated with injury. The model showed an acceptable predictive capacity, with an area under the ROC curve of 0.7753. INTERPRETATION: If the association between Foot Posture Index and running-related injury is confirmed in large prospective studies, running programs for beginners should consider foot posture in efforts to prevent running-related injuries.

Fiabilidad de la cinemática angular de rodilla y tobillo de la carrera en el plano sagital medido con Younext Direct Motion Capture(R) / Reliability of the angular kinematic of knee and ankle during the running in the sagittal plane measured with Younext Direct Motion Capture(R)

En los últimos cuarenta años la popularidad de salir a correr o hacer running se ha incrementado notablemente. Su popularidad y el gran número de lesiones hace que el running sea la actividad física más estudiada por el área de la biomecánica. En la práctica clínica, se utilizan principalmente software de análisis de movimiento 2D para analizar la cinemática. Younext Direct Motion Capture(R) (Podoactiva S.L., Huesca) es un software que analiza los parámetros cinemáticos durante la carrera en el plano sagital. El objetivo general de este estudio fue determinar la fiabilidad y repetibilidad de la cinemática angular de la rodilla y del tobillo de la carrera en el plano sagital en población sana utilizando Younext Direct Motion Capture(R). Estudio piloto observacional de concordancia. 8 sujetos (5 varones y 3 mujeres) fueron filmados mientras corrían en una cinta de correr, obteniendo tres grabaciones del ciclo de la carrera de cada participante en la primera sesión. Se realizó una segunda sesión de grabaciones a los 7 días del primer registro para volver a grabar siguiendo el mismo protocolo. Se calculó el coeficiente de correlación intraclase (ICC) para determinar la fiabilidad intra-sesión e inter-sesión del software a la hora de medir la cinemática de la rodilla y del tobillo. Se obtuvo una fiabilidad intra-sesión e inter-sesión casi perfectas (ICC> 0,81) tanto para tobillo como para rodilla. Este estudio demostró que el software Younext Direct Motion Capture(R) es fiable para analizar la cinemática angular de la rodilla y del tobillo de la carrera en población adulta sana

The popularity of running has increased remarkably the past forty years. Its popularity and the large number of injuries make running the most studied physical activity in the area of biomechanics. In clinical practice, joint kinematics during running are primarily quantified by two-dimensional motion-analysis software. Younext Direct Motion Capture(R) (Podoactiva S.L., Huesca) is a software that analyzes the kinematic parameters during the running in the sagittal plane. The main goal of this study was to determine the reliability and repeatability of the angular kinematics of the knee and ankle in the sagittal plane in a healthy population using Younext Direct Motion Capture (R). Observational pilot study of concordance. 8 subjects (5 men and 3 women) were filmed while running on a treadmill, obtaining three recordings of the running cycle of each participant in the first session. A second session of recordings was made 7 days after the first recording to re-record following the same protocol. The intraclass correlation coefficient (ICC) was calculated to determine the intra-session reliability and inter-session reliability of the software when measuring the kinematics of the knee and the ankle. Very good intra-session and inter-session reliability (ICC> 0.81) were obtained for both ankle and knee measurements. This study showed that Younext Direct Motion Capture(R) software is reliable for analyzing the angular kinematics of the knee and ankle during running in a healthy adult population

Aluminum foot insoles reduce plantar forefoot pressure and increase foot comfort for motorcyclists.

BACKGROUND:: Foot pain and paresthesia are common in cycling, due to plantar pressure and repetitive loading. OBJECTIVES:: The aim was to investigate the effect of foot insoles on plantar pressure of the foot in motorcycling, as well as self-reported comfort. STUDY DESIGN:: A randomized crossover clinical trial. METHODS:: A flexible foot pressure mat (GP MobilData WiFi® Gebiomized®) with different sizes was utilized. RESULTS:: Maximum pressure values occurred predominantly in the hallux with 4.90 ± 1.19 N/cm2, followed by second and third metatarsal areas with 4.57 ± 0.73 N/cm2, followed by the first metatarsal area with 4.30 ± 0.96 N/cm2, and followed by the fourth and fifth metatarsal areas with 3.22 ± 0.89 N/cm2 when using the control foot insole and using aluminum foot insole, which reduces maximum pressure to 1.55 ± 0.34, 1.56 ± 0.75, 1.09 ± 0.43, and 1.07 ± 0.59 N/cm2, respectively ( p < 0.001), with an effect size of 3.828, 4.067, 4.315, and 2.847, respectively. CONCLUSION:: The use of an aluminum foot insole significantly reduced maximum pressure during motorcycling. CLINICAL RELEVANCE: In this study, an aluminum insole in a motorcycling boot was shown to decrease maximum pressure on the foot. Comfort was significantly higher than that from ethylene vinyl acetate or commercial boot inserts. This increased comfort and decreased pressure should result in increased safety and control for motorcyclists.

Relación de Lunge y Jack Test en la apófisis calcánea (Talalgia de Sever) en futbolistas jóvenes / Relationship of Lunge and Jack test in calcaneal apophysitis (sever´s disease) in young soccer players

La talalgia de Sever o apofisitis calcánea ocurre generalmente antes o durante el pico de crecimiento acelerado en niños y niñas. En ocasiones se presenta al practicar un nuevo deporte que implique desplazamientos y saltos como el fútbol. Fue descrita por el Doctor J. W. Sever, a causa de la detección de un dolor con sensibilidad localizada en la cara posterior del hueso calcáneo en jóvenes. El objetivo de este estudio es relacionar la incidencia de la talalgia de Sever con la restricción en los valores del Lunge test y con la incapacidad para activar el mecanismo de Windlass medido a través del test de Jack. Se realizaron los dos test a una muestra de 60 futbolistas jóvenes divididos en dos grupos (Sever = 30 jóvenes, de 10,84±0,79 años y 16,87±0,85 de IMC; No Sever = 30 jóvenes, de 10,87±0,80 y 17,58±1,41 de IMC). Los resultados muestran un test de Jack del pie derecho positivo en el 26,7% de los niños con Sever frente al 10,0% de los niños sin Sever (p=0,181). Mientras que, para el pie izquierdo, el 33,3% de los niños con Sever tiene el test de Jack positivo frente al 13,3% de los niños sin Sever (p=0,125). Por otro lado, el Lunge test para el pie derecho muestra una diferencia significativa (p< 0,01) entre los niños con Sever (32,2±3,6) y los niños sin Sever (40,5±4,1). Lo mismo ocurre para el pie izquierdo, niños con Sever (32,1±3,6) y sin Sever (39,2±4,4) con una diferencia significativa (p< 0,01). La restricción de la flexión dorsal (FD) de tobillo medida por medio del test de Lunge ha demostrado tener una relación significativa con la incidencia de la Talalgia de Sever. Mientras que el test de Jack no muestra una relación significativa (AU)

Sever´s Disease or calcaneal apophysitis occur before or during the early growth in children. Experienced after a new practice of psychical activity that involve running or jumping as soccer. It was described by Dr. J. W. Sever, due to detection of pain with localized sensitivity in the posterior area of the calcaneus bone in young people. The aim of the study is relate the Sever´s Disease incidence and restricted values of Lunge test. In the same way, the inability to activate the windlass mechanism measured through the Jack test related with Sever´s Disease incidence. We performed both test to 60 young soccer players divided in two groups (Sever = 30 young players, 10,84±0,79 years old and 16,87±0,85 IMC values; No Sever = 30 young players, 10,87±0,80 years old and y 17,58±1,41 IMC values). The results shows that a 26,7% of Sever´s Disease patient had a positive Jack test in right foot versus 10,0% of non Sever´s Disease patient (p=0,181). While for left foot, a 33,3% of Sever´s Disease patient had a positive Jack test versus 13,3% of non Sever´s Disease patient (p=0,125). On the other hand, Lunge test for right foot show a significant difference (p< 0,01) between Sever´s Disease patient (32,2±3,6) and non Sever´s Disease patient (40,5±4,1). At the same way, in left foot between Sever´s Disease patient (32,1±3,6) and non Sever´s Disease patient (39,2±4,4) with a significant difference (p< 0,01). The ankle dorsiflexion restriction measured by Lunge test is related with an incidence of Sever´s Disease. While, Jack test do not show a significant relationship (AU)

Reliability of the OptoGait portable photoelectric cell system for the quantification of spatial-temporal parameters of gait in young adults.

Determining progress in gait requires a reliable method. However, achieving standard assessment results in the clinical setting can be challenging. Searching for a reliable tool, we tested OptoGait, a tool that has floor-level, high-density photoelectric cells that can be used to determine patterns of spatial-temporal gait on the basis of 19 variables: step length, stride length, distance, total contact time, step time, walking speed, acceleration, progressive step time, cadence, gait cycle, stance phase, swing phase, heel contact phase, flatfoot phase, takeoff phase, single limb support, double limb support, load response phase, and pre-swing phase. The gait of 126 study participants (41 males, 85 females; 27.37±1.77 years) was assessed twice for each participant during 10 episodes of walking on a 10m walkway each 2 weeks apart. Intra-session and inter-session results were compared using data for each foot alone as well as both feet together. All variables resulted in a high consistency except for acceleration. The intra-session data showed substantial agreement; the intra-class correlation coefficient (ICC) ranged from 0.72-0.78 in the heel contact phase, 0.72-0.76 in the load response phase, and 0.76-0.85 in the pre-swing phase and a low SEM. The inter-session data for each foot alone and both feet together showed substantial agreement (0.77-0.79 in the load response phase) and slight agreement for acceleration (0.06-0.22) with a low SEM. Based on these results, we conclude that the OptoGait system can be used with confidence to evaluate spatial-temporal gait except for acceleration and progressive step time assessment.