Wearing high-heeled shoes on a side slope makes standing balance unstable.

INTRODUCTION: Many women wearing high-heeled footwear are at high risk of falls. Past studies have examined the balance on level ground or balance during walking. We measured the standing balance on the ground and side slopes for 18 healthy women. METHOD: Body sway was evaluated based on the center of pressure (COP) while participants stood on level ground on a side slope. The total locus length as well as rectangular and outer peripheral areas were then measured using a Zebris system. Measurements were compared under bare feet, normal shoe, and high-heeled shoe conditions. RESULTS: On level ground, there were no significant differences among the three conditions. On the side slope, the total locus length (TLL), rectangular area (RA) and outer peripheral areas (OPA) were significantly greater for the high-heeled shoes than for the bare feet and normal shoes. Standing on the side slope caused larger body sway than on the level ground, along with a higher risk of falling. DISCUSSION: In TLL, OPA, and RA, the COP moved outside substantially when participants stood on a slope in high heels than in shoes. High heels were highly unstable for standing on a slope since the ankle joint of one leg is in plantar flexion, the foot is pronated, and the other side is plantarflexed at the ankle with pronation of the foot. CONCLUSION: High-heeled shoes significantly alter a person's balance when standing on a side slope, suggesting a high risk of falling.

The Changes in the 18F FDG Metabolism in the Muscles by the Use of Cuboid Support Insoles.

Healthy men aged 55,39, 23.45 years were administered 18F-fluorodeoxyglucose (18F-FDG) after fasting for over 5 h; then, a 30-min self-paced walking (6-min walk and 2-min rest + 6-min walk and 2-min rest + 6-min walk and 2-min rest + 6-min walk) session was performed. While walking, the same athletic shoes were used, same with walking supports, flat insoles, and cuboid support insoles (BMZ Inc., Tokyo, Japan). The walking test was performed with eye open. The examination was performed over 30 days apart. 18F-FDG accumulation within the gastrocnemius muscle was higher, the walking speed was improved. These results suggest that the use of cuboid support insoles may improve the cadence of the lower leg muscles.

Stabilization of postural sway on a sideward slope using cuboid support insoles.

[Purpose] The purpose of this study was to elucidate whether insoles alter postural sway on a sideward slope rather than on level ground. [Participants and Methods] This study involved 20 flat-footed individuals and 20 normal-footed individuals. The postural sway was determined based on the total length of the locus and the body sway area, which were measured using the Zebris system. The participants were divided into three groups: the BMZ insoles, Superfeet insoles, and no insole groups. These insoles were worn by the participants with their normal shoes worn daily. [Results] The total length of the locus of the BMZ group was significantly lower than those of the Superfeet and no-insole groups. The body sway area did not significantly differ based on the insole condition. [Conclusion] BMZ insoles improve postural sway in both normal-footed and flat-footed individuals on a sideward slope.

Data on the physical function of children with cerebral malaria.

We collected data from children with motor dysfunction living in Malawi from October 2, 2017 to November 15, 2017, using questionnaires and physical examinations. These data included diagnosis, birth history, medical history, and history of malaria based on interviews and patients' personal medical records. The patients' families provided consent to participate in this research. After applying the exclusion criteria, the remaining 33 patients (27%) were diagnosed with cerebral malaria (CM). We report the patients' type of paralysis, muscle tone, age of malaria infection, and Gross Motor Functional Classification Score. This dataset reports basic data on the physical function of an underreported pediatric population with CM. Future comparative studies with other children with CM are needed to improve rehabilitation interventions.

Comparison of flatfeet and normal feet using data of the gait cycle, contact area, and foot pressure.

Although the foot is involved in load-bearing and shock absorption, foot pressure (FP), ground contact area (CA), and gait cycle (GC) in flatfeet (FF) have not been examined in detail. We aimed to analyze the influence of FF on FP, CA, and GC. We included 20 and 21 women with FF and normal feet (NF), respectively. A Footscan plantar pressure plate (RsScan International, Belgium) was used to analyze FP, CA, and GC. FP was applied to the unit area of 10 compartments. GC analysis was performed using phase-time measurements by dividing the GC into four phases. In the analysis, FP and CA were compared between the FF and NF groups. A comparison of GC was similarly performed between the two groups. The data provided in this article will be useful when designing studies on the effect of foot shape on FP, CA, and GC during gait.

Relationship between Perceived Leg Length Discrepancy at One Month and Preoperative Hip Abductor Muscle Elasticity in Patients after Total Hip Arthroplasty.

OBJECTIVE: Preoperative factors related to perceived leg length discrepancy (PLLD) after total hip arthroplasty (THA) are not well studied. This study aimed to examine the preoperative factors, including hip abductor modulus, related to PLLD one month after THA. METHODS: The study included 73 patients diagnosed with osteoarthritis secondary to developmental dysplasia of the hip and a posterior approach to surgery. Multiple logistic regression analysis was performed using the presence or absence of PLLD as the dependent variable and preoperative hip abductor's modulus of elasticity, pain, hip abduction range of motion, hip abductor muscle strength and pelvic obliquity as the independent variable. Additionally, receiver operating characteristic curves were used for the extracted variables for calculating the cutoffs, sensitivity, specificity and area under the curve (AUC) to determine the presence or absence of PLLD. The significance level was set at p<0.05. RESULTS: The hip abductor modulus (odds ratio=1.13; 95% confidence interval=1.06-1.21; p<0.001) was selected as a preoperative factor. The cutoff value to determine the presence or absence of a PLLD was 16.32 kPa. The sensitivity and specificity were 81.8% and 72.5%, respectively, and the AUC was 0.8137. CONCLUSION: The hip abductor muscle elastic modulus affected PLLD one month after THA. If the preoperative hip abductor elastic modulus is higher than the cutoff value, it may affect the appearance of PLLD at one month postoperatively.

Can an insole for obese individuals maintain the arch of the foot against repeated hyper loading?

BACKGROUND: Insoles are often applied as preventive therapy of flatfoot deformity, but the therapeutic effects on obese individuals are still controversial. We aimed to investigate the effect of insole use on time-dependent changes in the foot arch during a repeated-loading simulation designed to represent 20,000 contiguous steps in individuals with a BMI value in the range of 30-40 kg/m2. METHODS: Eighteen cadaveric feet were randomly divided into the following three groups: normal, obese, and insole. Ten thousand cyclic loadings of 500 N (normal group) or 1000 N (obese and insole groups) were applied to the feet. We measured time-dependent change in arch height and calculated the bony arch index (BAI), arch flexibility, and energy absorption. RESULTS: The normal group maintained more than 0.21 BAI, which is the diagnostic criterion for a normal arch, throughout the 10,000 cycles; however, BAI was less than 0.21 at 1000 cycles in the obese group (mean, 0.203; 95% confidence interval [CI] 0.196-0.209) and at 6000 cycles in the insole group (mean, 0.200; 95% CI, 0.191-0.209). Although there was a significant time-dependent decrease in flexibility and energy absorption in both the obese and insole groups (P < 0.001), the difference between 1 and 10,000 cycles were significantly smaller in the insole group than in the obese group (P = 0.024). CONCLUSIONS: Use of insoles for obese individuals may help to slow time-dependent foot structural changes. However, the effect was not enough to maintain the foot structure against repeated hyper loadings.

Intensive physiotherapy with subsequent community-based rehabilitation: two cases of cerebral malaria in rural areas of Malawi.

[Purpose] This study aimed to elucidate the effect of intensive physiotherapy and community-based rehabilitation on motor function for patients with cerebral malaria in the rural areas of Malawi. [Participants and Methods] The participants were 10- and 9-year-old children with cerebral malaria. At ages 8 and 6 years, they contracted malaria, and their motor function decreased to Gross Motor Function Classification System level III. They underwent intensive physiotherapy for 2 weeks administered by their mothers and volunteers, who were taught rehabilitation exercises. The improvements in the participants' motor functions were assessed after completion of therapy and 2 months later. [Results] In case 1, no improvement was observed in the 88-item Gross Motor Function Measure (GMFM-88) score after intensive physiotherapy. However, after 2 months of intensive physiotherapy, the total score improved by 6% from 61% to 67%, and the scores for the target areas improved from 12% to 20%. In case 2, the total GMFM-88 score improved from 66% to 68% during physiotherapy and further improved from 68% to 78% after 2 months. The score for the target areas improved from 25% to 26% and further improved from 26% to 49% after 2 months. [Conclusion] The participants in this study achieved improvements in GMFM-88 score after receiving intensive rehabilitation by community members. The effect was more pronounced after 2 months than immediately after intensive physiotherapy.

Effects of friction massage of the popliteal fossa on blood flow velocity of the popliteal vein.

[Purpose] Friction massage (friction) of the popliteal fossa is provided for the purpose of relieving pain related to circulatory disorders by improving venous flow in the lower legs. The purpose of this study is to verify the effects of enhancing the venous flow based on measuring the blood flow velocity of the popliteal vein before and after providing friction to the patients. [Subjects and Methods] Fifteen healthy male university students participated in the study. The Doppler ultrasonography (DU) was used to measure the blood flow velocity of the popliteal vein, in order to verify the effects of enhancing the venous flow by comparing the measured values before and after a friction massage. [Results] The result of comparing the blood flow velocity before and after providing friction showed that there was a significant increase after friction. [Conclusion] This study proved that friction to the popliteal fossa is effectively enhances venous flow by increasing the blood flow velocity in the popliteal vein.

Reliability and validity of standing balance assessment index using a hand-held dynamometer in stroke patients.

[Purpose] This study aimed to determine the reliability and validity of our standing balance assessment index using a hand-held dynamometer (the hand-held dynamometer assessment index) in stroke patients. [Subjects and Methods] The participants were 60 stroke patients with impaired standing balance. Intrarater and interrater reliabilities were evaluated employing the intraclass correlation coefficient. Criterion-related validity was evaluated by Spearman's rank correlation coefficient between the HHD assessment index and the functional balance scale. [Results] The intraclass correlation coefficient values obtained ranged from 0.91 to 0.98, and the correlation coefficient with the FBS was 0.83. [Conclusion] Our findings confirmed the reliability and validity of the hand-held dynamometer assessment index in stroke patients.

Standing balance on the ground -the influence of flatfeet and insoles.

[Purpose] The aim of this study was to determine whether insoles change standing balance on the ground in normal and flat-footed subjects. [Subjects] Twenty subjects with flatfeet and 20 subjects with normal feet were included in this study. [Methods] Body sway was evaluated based on the center of pressure while subjects stood on the ground. Body sway was measured during upright standing with the feet 10 cm apart for 30 seconds. The total locus length and the area of body sway were then measured using a zebris system. Measurements were made under three sets of conditions: using BMZ insoles, which supported the cuboid; using Superfeet insoles, which supported the medial longitudinal arch; and with no insoles. [Results] The 3 insole conditions were compared. On level ground, the total locus length for the Superfeet insole was significantly less than those for the BMZ insole and no insole. [Conclusion] On level ground, Superfeet feet insoles were effective in stabilizing standing balance in both flat-footed and normal-footed subjects.