Is there a relationship between lower-extremity injuries and foot postures in professional football players? A prospective cohort study.

BACKGROUND: Lower extremity injuries are an ongoing concern for professional football players. This study aims to evaluate the relationship between foot posture and lower extremity injuries in professional football players. METHOD: In this prospective cohort study, 420 male players of the Iran Premium football league were evaluated during the 2015-2016 season. The players were assessed for their foot types based on optical and static foot scans and foot posture index (FPI). The trained club physicians recorded all injuries during the season. RESULT: The analyzed data of 244 players showed the highest rate of lower extremity injury in hamstrings, ankle, and groin, respectively. These injuries led to 46% of time loss. The probability of hamstrings injuries was higher among pronated players based on static, optic, FPI, and visual examination, 2.1, 1.8, 1.8, and 2.3, respectively. Medial Collateral Ligament (MCL) injuries were associated with subtalar joint abnormality defined by visual observation. An increased relative risk of leading-to-absence injuries among the flat foot group was significant based on optic scanning, FPI, and visual observation. CONCLUSION: Abnormal foot postures in professional football players may increase the risk of hamstring and MCL injuries and time loss due to lower extremity injuries.

Foot scan assessment of metatarsus adductus: A useful adjunct to Bleck's classification.

To determine the severity of metatarsus adductus (MA) comparing with Bleck's classification as a commonly acceptable method for assessing MA, static foot scan has been used. In this cross-sectional descriptive research study, 100 subjects were equally divided into four groups according to Bleck's classification. The feet were scanned and MA severity (MAS) index was measured on the obtained foot scan images. The MAS index was the ratio of the transverse deviation of the forefoot from the lateral border heel line to the width of the ball of the foot. The mean of the MAS index in normal, mild, moderate, and severe MA was 0.02±0.02, 0.1±0.01, 0.159±0.03, and 0.216±0.025, respectively. The difference of MAS index between each group was significant (p<0.001). The mean of MAS index in 4 groups was consistent with Bleck's classification, with a significant increase from normal to severe MA (p<0.05). Since the results of this method are consistent with Bleck's classification and this novel foot scan assessment appears to be more objective than Bleck's classification, the authors recommend this method to be used in examination of patients with MA. However, further studies should be conducted to define interobserver and intraobserver reliability. LEVEL OF EVIDENCE: III.

In shoe pressure measurements during different motor tasks while wearing safety shoes: The effect of custom made insoles vs. prefabricated and off-the-shelf.

Health and safety regulations in many countries require workers at risk to wear safety shoes in a factory environment. These shoes are often heavy, rigid, and uncomfortable. Wearing safety shoes daily leads to foot problems, discomfort and fatigue, resulting also in the loss of numerous working days. Currently, knowledge of the biomechanical effects of insoles in safety shoes, during working activities, is very limited. Seventeen workers from a metalworking factory were selected and clinically examined for any foot conditions. Workers feet were 3D scanned, with regards to their plantar view, and the images used to design 34 custom-insoles, based on foot and safety shoe models. Three insoles were blind-tested by each worker: custom (CUS); prefabricated with the safety-shoe (PSS), and off-the-shelf (OTS). Foot-to-insole pressure distribution was measured in seven motor tasks replicating typical working activities: single and double-leg standing; weight lifting; stair ascending and descending; normal and fast walking. Wearing CUS within safety shoes resulted in a greater uniform pressure distribution across plantar regions for most of the working activities. Peak pressure at the forefoot during normal walking was the lowest in the custom insole (CUS 275.9±55.3kPa; OTS 332.7±75.5kPa; PSS 304.5±54.2kPa). Normal and fast walking were found to be the most demanding activities in terms of peak pressure. Wearing safety shoes results in high pedobarographic parameters in several foot regions. The use of custom insoles designed on the foot morphology helps decrease peak pressure and pressure-time integral compared to prefabricated featureless insoles.

Short-term effect of botulinum toxin a injection on spastic equinovarus foot in cerebral palsy patients: a study using the foot pressure measurement system.

OBJECTIVE: To evaluate the therapeutic effect of botulinum toxin A (BTX-A) injection on spastic gastrocnemius (GCM) and tibialis posterior muscles (TPo) by using the foot pressure measurement system (FPMS). METHODS: Eighteen ambulatory CP patients were recruited in this study. BTX-A was injected into the GCM at a dose of 6-12 units/kg and TPo at a dose of 4-9 units/kg according to the severity of equinus and varus deformity. Foot contact pattern, pressure time integral (PTI), coronal index using the FPMS and Modified Ashworth Scale (MAS), and visual inspection of gait pattern were used for evaluation of the therapeutic effect of BTX-A injection. Clinical and FPMS data were statistically analyzed according to the muscle group. RESULTS: A significant decrease in the MAS score of the GCM and TPo was observed, and spastic equinovarus pattern during gait showed improvement after injection. The GCM+TPo injection group showed a significant decrease in forefoot, lateral forefoot pad, and lateral column PTI, and a significant increase in hindfoot PTI and coronal index. In the GCM only injection group, forefoot PTI and lateral column PTI were significantly decreased and hindfoot PTI was significantly increased. The TPo only injection group showed a significant decrease in lateral column PTI and a significant increase in the coronal index. Change in PTI in the hindfoot showed a significant correlation with the change in MAS score of the GCM. Change in PTI of the lateral column and coronal index showed a significant correlation with the change in MAS score of the TPo. CONCLUSION: The FPMS demonstrated the quantitative therapeutic effect of BTX-A on abnormal pressure distribution in equinovarus foot in detail. The FPMS can be a useful additional tool for evaluation of the effect of BTX-A injection.

Short-Term Effect of Botulinum Toxin A Injection on Spastic Equinovarus Foot in Cerebral Palsy Patients: A Study Using the Foot Pressure Measurement System

OBJECTIVE: To evaluate the therapeutic effect of botulinum toxin A (BTX-A) injection on spastic gastrocnemius (GCM) and tibialis posterior muscles (TPo) by using the foot pressure measurement system (FPMS). METHODS: Eighteen ambulatory CP patients were recruited in this study. BTX-A was injected into the GCM at a dose of 6-12 units/kg and TPo at a dose of 4-9 units/kg according to the severity of equinus and varus deformity. Foot contact pattern, pressure time integral (PTI), coronal index using the FPMS and Modified Ashworth Scale (MAS), and visual inspection of gait pattern were used for evaluation of the therapeutic effect of BTX-A injection. Clinical and FPMS data were statistically analyzed according to the muscle group. RESULTS: A significant decrease in the MAS score of the GCM and TPo was observed, and spastic equinovarus pattern during gait showed improvement after injection. The GCM+TPo injection group showed a significant decrease in forefoot, lateral forefoot pad, and lateral column PTI, and a significant increase in hindfoot PTI and coronal index. In the GCM only injection group, forefoot PTI and lateral column PTI were significantly decreased and hindfoot PTI was significantly increased. The TPo only injection group showed a significant decrease in lateral column PTI and a significant increase in the coronal index. Change in PTI in the hindfoot showed a significant correlation with the change in MAS score of the GCM. Change in PTI of the lateral column and coronal index showed a significant correlation with the change in MAS score of the TPo. CONCLUSION: The FPMS demonstrated the quantitative therapeutic effect of BTX-A on abnormal pressure distribution in equinovarus foot in detail. The FPMS can be a useful additional tool for evaluation of the effect of BTX-A injection.

Dynamic Foot Pressure Measurement in Parkinson's Disease with Foot Scan System

BACKGROUND: Foot Scan System (RS scan international cooperation) measuring the plantar pressure distribution is simple and inexpensive tool for gait analysis. The analysis of plantar pressure distribution of the feet during gait maybe helps the assessment of motor symptoms or gait stability of Idiopathic Parkinson's disease (IPD). METHODS: We compared the parameters of foot scan system between 34 normal controls and 23 IPD patients before and after levodopa administration. Data of plantar force distribution and time of stance phase were collected using pressure-sensitive insoles as parts of the Foot Scan System. RESULTS:There were significant difference between normal controls and IPD patients in fore foot peak pressure/rear foot peak pressure ratio, time percentage of heel strike phase, mid stance phase, propulsion phase in stance phase. But in these parameters there were no significant difference between IPD patients before dopamine with after dopamine medication. CONCLUSIONS: Using the Foot Scan System (RS scan international cooperation) measuring the plantar pressure distribution, we showed that F/R ratio and time percentage of propulsion phase are reduced significantly in patients with IPD, which enables us to understand the features of gait in IPD patients more easily.

Biomechanical effect of mid-upper fibular fracture on ankle joint / 中国矫形外科杂志

[Objective]To investigate the biomechanical effect of mid-upper fibular fracture on ankle joint.[Method]From January 2005 to June 2006,20 cases of mid-upper fibular fracture were collected.Normal anterior film of bilateral ankle joint was photographed,ankle mortise width and distal fibula upper shift were measured to observe the effect on stability of ankle joint.Foot-scan pressure analyzer was used to detect the central track of footplate pressue,subtalar joint angle,in order to compare the difference between normal ankle and the sick.[Result]Dislocated mid-upper fibular fracture could lead to ankle mortise widening,lateral malleolus up shift ( averaged,1.260?0.339mm,1.045?0.276mm).the central track of footplate pressure offset and the fracture sides subtalar joint angle were larger than those in normal feet(P

The Relationship between Body Mass Index and Foot Parameters

OBJECTIVE: To evaluate the relationship between body mass index (BMI) and foot parameters. METHOD: We examined 1, 107 feet of 872 volunteers (male: 325, female: 547) with 3D foot scanner (Nexcan , K & I, Korea). The relations of BMI and foot parameters were analyzed by partial correlation analysis with adjusted height. We classified subjects into 4 groups by BMI; low-weight (25 kg/m2) group. The relations of these groups and foot parameters were analyzed by univariate ANOVA with fixed height. RESULTS: Instep point length, ball width and girth, waist, instep height and girth, and vamp height showed a positive relation to BMI (p0.05). CONCLUSION: This study showed that BMI was positively related to height, width, girth of foot. But, BMI had no significant relation to length of foot, and medial longitudinal arch.

A Method of Analyzing Footprint Using the Harris Mat for Diabetic Foot Lesion

Deformity due to the diabetic foot causes repetitive and excessive pressure to the certain areas of a foot, which may result in ulcers and pains. Therefore, it is necessary to measure the pressure of the sole for the prevention and management of the diabetic foot lesions. The computerized foot scan system is one of the direct methods to measure the excessive pressure from the deformity of a foot. However, it is not usually affordable in a developing country due to its high cost, space occupancy, and lack of trained personnel. Manual counting using Harris mat is another rather affordable method, however it has problem of the time consumption for a quantitative measure and poor in reproducibility. The purposes of this study were to obtain the objective and quantitative data from Harris mat footprints of diabetic patients by using Paint Shop Pro and to apply the same method to the patients with other foot lesions. Fifty three cases(twenty four males and, twenty nine females) who were referred due to the diabetic foot lesions were evaluated. The average age was 56.62+/-8.03 years and the duration of diabetes mellitus was 104.93+/-79.53 months. By the Paint Shop Pro , the highest pressure was recorded at the first toe(thirteen cases), followed by the calcaneal area (also thirteen cases) and the first metatarsal head area (seven cases) in order of the right foot. Of the left foot, the highest pressure was recorded at the first toe (fourteen cases), followed by the calcaneal area(twelve cases) and the third metatarsal head area(nine cases). By the manual analysis, the highest pressure was recorded at the calcaneal area (thirteen cases), followed by the first toe(ten cases) and the fifth metatarsal head area (six cases) in order of the right foot. Of the left foot, the highest pressure site was the first toe(fourteen cases), followed by the calcaneal area(fifteen cases) and the third matatarsal head area(seven cases) in order of pressure level. Based on these results, we have concluded that the Paint Shop Pro analysis method is an easy and inexpensive foot pressure measurement system which is clinically applicable. However further researches for the test-retest reliability and a comparison with the computerized foot scan system would be required for the standardization of this method.