Evaluating the Medial Longitudinal Arch of the Foot: Correlations, Reliability, and Accuracy in People With a Low Arch.

BACKGROUND: The medial longitudinal arch of the foot is a variable structure, and a decrease in its height could affect several functions and increase the risk of injuries in the lower limbs. There are many different techniques for evaluating it. OBJECTIVE: The objective of this study was to evaluate the correlations of the Navicular Drop Test, several footprint parameters, and the Foot Posture Index-6 in people with a low medial longitudinal arch. Intrarater reliability and interrater reliability were also estimated. DESIGN: This was a repeated-measures, observational descriptive study. METHODS: Seventy-one participants (53.5% women; mean age = 24.13 years; SD = 3.41) were included. All of the parameters were collected from the dominant foot. The correlation coefficients were calculated. The reliability was also calculated using the intraclass correlation coefficient, 95% CI, and kappa coefficient. RESULTS: Statistically significant correlations were obtained between the Navicular Drop Test and the footprint parameters, with r absolute values ranging from 0.722 to 0.788. The Navicular Drop Test and the Foot Posture Index-6 showed an excellent correlation (Spearman correlation coefficient = 0.8), and good correlations (Spearman correlation coefficient = |0.663-0.703|) were obtained between the footprint parameters and the Foot Posture Index-6. Excellent intrarater reliability and interrater reliability were obtained for all of the parameters. LIMITATIONS: Radiographic parameters, the gold standard for evaluating the medial longitudinal arch height, were not used. In addition, the results of this research cannot be generalized to people with normal and high medial longitudinal arches. CONCLUSIONS: In participants with a low medial longitudinal arch, the Navicular Drop Test showed significant correlations with footprint parameters; correlations were good for the arch angle and Chippaux-Smirnak Index, and excellent for the Staheli Index. The Foot Posture Index-6 showed an excellent correlation with the Navicular Drop Test and a good correlation with the footprint parameters evaluated. All of the parameters showed high reliability.

Prevalence of myofascial trigger points and diagnostic criteria of different muscles in function of the medial longitudinal arch.

OBJECTIVES: To evaluate the reliability of the used diagnostic criteria of latent trigger points (LTrPs) and pressure pain thresholds and to evaluate the prevalence of LTrPs in several muscles of the lower limb in subjects with a lower medial longitudinal arch (MLA) compared with controls. DESIGN: Cross-sectional study. SETTING: University campus. PARTICIPANTS: Subjects with a lower limb MLA (n=82) and controls (n=82) (N=164). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The navicular drop test was used to classify subjects with a lower MLA (≥10mm) and controls (5-9mm). The Simons et al recommended specific diagnostic criteria and pressure pain thresholds were used to evaluate the prevalence of LTrPs in several muscles of the lower limb, which was compared between the 2 groups. The reliability was evaluated using Cohen's kappa and intraclass correlation coefficient. The unpaired Student t test and chi-square test were used to evaluate the difference in the LTrP prevalence between the 2 groups. RESULTS: The intrarater reliability of the navicular drop test and the diagnosis of LTrPs was excellent, with the taut band and tender spot being the most reliable diagnostic criteria. In the lower MLA group, 60 subjects (73%) presented at least 1 LTrP whereas 57 controls (70%) presented at least 1 LTrP. The lower MLA group showed more LTrPs (4.46±4.10) than did controls (3.32±3.24) (P<.05). There were significantly (P<.05) more subjects with LTrPs in the flexor digitorum longus, tibialis anterior, and vastus medialis in the lower MLA group than in the control group. CONCLUSIONS: LTrPs are common in the lower limb muscles in both controls and subjects with a lower MLA. A lower MLA is associated with a higher prevalence of LTrPs, which are significant in the flexor digitorum longus, tibialis anterior, and vastus medialis.

Fisioterapia en la pubalgia: Revisión bibliográfica en publicaciones de idioma inglés en los últimos diez años / Physical therapy in groin pain: A bibliographical Review of the latest ten years

La pubalgia es una patología que aparece en deportistas, sobre todo, aquellos que en su práctica requieren de la realización de gestos repetidos, como carrera, cambios de dirección y ritmo y golpeo de balón. Así, es una patología frecuente en el fútbol, esquí y jockey. A pesar de su frecuencia, no existe unanimidad ni en sus causas ni en su tratamiento de fisioterapia. El objetivo del presente trabajo es valorar la efectividad de las distintas técnicas de fisioterapia empleadas en el tratamiento esta patología. Para ello, se ha realizado una revisión bibliográfica de los últimos diez años, en las bases de datos Medline, Cinalh, Sport Discuss y Science Direct; los criterios de inclusión utilizados son que se tratara deensayos clínicos o estudios de casos en idioma inglés. En cuanto a las palabras clave empleadas en la búsqueda, se han utilizado los términos “groin pain”, “osteitis”, “adductor-related”, “physical therapy”, “strentgh” y “stretcht &”.Se han obtenido sólo cuatro artículos que cumplan los criterios de inclusión. Se trata de un ensayo clínico y tres estudios de casos. Todos los artículos encontrados utilizan como sujetos de estudio a deportistas. Dentro de las técnicas empleadas, la más efectiva y presente en todos los estudios es la utilización de programas de entrenamiento muscular, orientados, sobre todo, a la musculatura estabilizadora del complejo lumbo-pélvico y aductores. Cabe señalar que, aunque clásicamente se considera que los estiramientos, sobre todo de aductores, son eficaces en el tratamiento de esta patología, los datos encontrados en esta revisión no demuestran que su efecto sea superioral de otras técnicas. Sin embargo, se hace necesario realizer más ensayos clínicos que permitan comparar la efectividad de las diversas técnicas de fisioterapia (AU)

Groin pain is a pathology which appears in sports, mainly in those whom in his practice require the accomplishment of repeated gestures such as running, changes of direction and rhythm, and ball hitting are included. For this reason, is a common pathology in football, ski and jockey. In spite of its frecuency, there seems to be nor consensus in its origin and physical treatment. The aim of this work is to evaluate the effectivity of several physical therapy treatments’ techniques in this pathology. For that reason, a bibliographical review of the last ten years has been made in Medline, Cinalh, Sport Discuss and Science Direct databases using clinical trials or cases study in English as inclusion criteria. The key words used in this search were “groin pain”, “osteitis”, “adductor-related”, “physical therapy”, “strength” and “stretcht &”. Only four articles met the inclusion criteria (a clinical trial and three cases study).All these articles used sportsmen as subjects of study. Among all the techniques, the use of muscular training stands out as the most effective found in all the studies, being guided to the stabilizing musculature of the lumbopelvic complex and adductors especially. It is interesting to point out, that in spite of the classic opinion about the stretchings, especially of the adductors muscles, which are effective in the treatment of this pathology, the information found in this review does not demonstrate that its effects are superior to those of other techniques. Nevertheless, it becomes necessary to develop more clinical trials to be able to compare the validity of the different physical therapy modalities (AU)