Fifth metatarsal strain distribution during cutting motions in soccer.

The objective of this study was to determine the fifth metatarsal strain generation mechanism during cutting motions performed while playing soccer using a finite element foot model. Five collegiate soccer players performed the side-step cutting and the cross-step cutting motions to measure the three-dimensional foot kinematics, ground reaction force, and plantar pressure distribution. In addition, a finite-element model of a foot consisting of bony structures, ligaments, and skin was constructed from computed tomography images. Simulations were conducted to perform the cutting motions, using the measured foot motion and distributed load on the plantar surface as boundary conditions for the model. During the side-step cutting, the maximum principal strain on the fifth metatarsal was correlated to forefoot adduction angle during stepping out. For cross-step cutting, the maximum principal strain was correlated with plantar pressure at the distal end of the fifth metatarsal. Therefore, to prevent a fracture, it is necessary to take measures to reduce the lateral bending deformation of the forefoot while stepping out during side-step cutting and to reduce the plantar pressure on the distal end of the fifth metatarsal during cross-step cutting.

Association of medial arch support of foot orthoses with knee valgus angle at initial contact during cutting maneuvers in female athletes: a controlled laboratory study.

BACKGROUND: The effect of medial arch support foot orthoses on kinematics and kinetics of the knee joint has remained unknown. METHODS: Sixteen female collegiate-level athletes volunteered to participate. Participants were asked to perform a 30° sidestep cut using orthoses of 3 different medial arch heights, comprising of the following: (1) "low," a full flat foot orthosis without arch support, (2) "mid," a commercially available foot orthosis with general height arch support, and (3) "high," a foot orthosis with double the commercially available height for arch support to observe the effect on the knee when overcorrected. Kinematics and kinetics of the knee joint were collected by a markerless motion capture system with 2 force plates and compared between orthosis types using linear regression analysis, assuming a correlation between the measurements of the same cases in the error term. RESULTS: The knee valgus angle at initial contact was 2.3 ± 5.2 degrees for "low" medial arch support height, 2.1 ± 5.8 degrees for "mid," and 0.4 ± 6.6 degrees for "high". Increased arch support height significantly decreased the knee valgus angle at initial contact (p = 0.002). Other kinematic and kinetic measurements did not differ between groups. CONCLUSIONS: The valgus angle of the knee at initial contact was decreased by the height of the medial arch support provided by foot orthosis during cutting manoeuvres. Increasing the arch support height may decrease knee valgus angle at initial contact. Medial arch support of foot orthosis may be effective in risk reduction of ACL injury. Clinical trial registration numbers and date of registration: UMIN000046071, 15/11/2021.

Validity of a simple footprint assessment board for diagnosing the severity of flatfoot: a prospective cohort study.

BACKGROUND: A simple, non-quantitative, and cost-effective diagnostic tool would enable the diagnosis of flatfoot without need for specialized training. A simple footprint assessment board that investigates which toe the cord passes through from the centre point of the heel to the most lateral point of the medial contour of the footprint has been developed to assess flatfoot. The purpose of this study was to verify the validity of a simple footprint assessment board for flatfoot. METHODS: Thirty-five consecutive patients with foot pain, foot injury, or any associated symptoms who underwent computed tomography (CT) were analysed prospectively. At the time of the CT scan, a footprint analysis using a simple footprint assessment board was performed. The navicular index, tibiocalcaneal angle, and calcaneal inclination angle were evaluated by CT to assess flat feet. These three criteria were compared to those evaluated with the simple footprint assessment board by regression analysis. In addition, the same analysis was conducted separately for young, middle-aged, and older patients in order to investigate each age group. RESULTS: The navicular index and tibiocalcaneal angle generally decreased as the score of the simple footprint assessment board increased. Calcaneal inclination angle generally increased as the score of the simple footprint assessment board increased. As the scores of the simple footprint assessment board decreased by approaching the great toe, the navicular index and tibiocalcaneal angle were higher and calcaneal inclination angle was lower, which is indicative of a higher likelihood of flatfoot. The scores derived from the simple footprint assessment board was correlated with these three criteria measured by CT, not only when the result of simple footprint assessment board was set as a non-continuous variable but also when the result was set as a continuous variable. The results of the age-stratified survey were similar for all groups. CONCLUSIONS: The findings of this study suggest that a simple footprint assessment board can be potentially useful to detect flatfoot. TRIAL REGISTRATION: Retrospectively registered.

Comparison of the Position-Matching and Position-Reproducing Tasks to Detect Deficits in Knee Position Sense After Reconstruction of the Anterior Cruciate Ligament.

CONTEXT: Deficits in knee position sense following reconstruction of the anterior cruciate ligament (ACL) can delay an athlete's return to sport participation and increase the risk of reinjury. Deficits in position sense postreconstruction have been evaluated using either a position-reproducing or position-matching task. OBJECTIVE: The aim of our study was to combine both to determine which assessment would be more effective to identify deficits in knee position sense. DESIGN: Longitudinal laboratory-based study. PARTICIPANTS: Eleven athletes (6 men and 5 women; mean age, 20.5 [1.2] y), who had undergone ACL reconstruction with an ipsilateral hamstring autograft, and 12 age-matched controls. INTERVENTIONS: Position sense was evaluated at 6 and 12 months postreconstruction and once for the control group. In addition, peak isokinetic knee extension and flexion strength, at 60°/s and 180°/s, was assessed for the ACL reconstruction group to evaluate possible influences of muscle strength on knee joint position sense. MAIN OUTCOME MEASURES: The variables include the angular differences between the reference limb and indicator limb, and peak torque values of isokinetic knee extension and flexion. RESULTS: Significant matching differences were identified at 6 months postsurgery on the position-matching task, but not at 12 months postsurgery. No significant between-group and within-subject differences were identified on the position-reproducing task. No significant matching errors were identified for the control group. There was no correlation between errors in position sense and maximum isokinetic strength. CONCLUSION: The position-matching task is more sensitive than the position-reproducing task to identify deficits in knee position sense over the first year following ACL reconstruction surgery.

Association between in vivo knee kinematics during gait and the severity of knee osteoarthritis.

BACKGROUND: Osteoarthritis patients may exhibit different kinematics according to the disease stage. However, changes in the frontal and horizontal planes in each stage remain unclear. The purpose of this study was to investigate changes in the knee kinematic gait variables of osteoarthritis patients, including the frontal and horizontal planes, with respect to the severity of the disease. METHODS: Forty-five patients with knee osteoarthritis and 13 healthy young subjects were recruited for the experiment. All subjects were examined while walking on a 10-m walkway at a self-selected speed. In each trial, we calculated the angular displacements of flexion/extension, abduction/adduction, and external/internal tibial rotation. We also measured muscle strength, range of motion (ROM), and alignment. We compared the differences in osteoarthritis severity and knee kinematic variables between osteoarthritis patients and normal subjects. RESULTS: The flexion angle at the time of foot contact was significantly less in patients with severe and moderate osteoarthritis than in normal subjects (both p<0.01). The abduction angle at the 50% stance phase was significantly less in patients with severe osteoarthritis than in normal subjects (p<0.05). The excursion of axial tibial rotation was significantly less in patients with early osteoarthritis than in normal subjects (p<0.05). CONCLUSION: Osteoarthritis patients had different knee kinematics during gait, depending on the progress of osteoarthritis. Early-stage patients exhibit decreased axial tibial rotation excursion, while severe-stage patient exhibit increased knee adduction.

Reliability of measuring humeral retroversion using ultrasound imaging in a healthy nonthrowing population.

CONTEXT: Studies have reported the difference in humeral retroversion (HR) between the dominant and nondominant side in throwing athletes. However, there are few data concerning HR for the rest of the population. In addition, the relationship between HR and external (ER) and internal rotation (IR) at 90 degrees shoulder abduction has not been thoroughly investigated. OBJECTIVES: To investigate the reliability of ultrasound methodology to measure HR. In addition, using ultrasonography, the authors compare HR between the dominant and nondominant sides in healthy adult men and determine the relationship between HR and ER and IR at 90 degrees of shoulder abduction. DESIGN: Descriptive study. SETTING: Laboratory. PARTICIPANTS: Thirty-seven healthy male subjects (age 21.9 +/- 2.4 y, height 172.9 +/- 5.3 cm, weight 66.0 +/- 7.2 kg) with no history of shoulder or elbow injury, recruited from a convenience sample, volunteered for the study. MAIN OUTCOME MEASURES: Subjects were bilaterally examined for HR, ER, and IR. HR was measured by ultrasonography. RESULTS: The intrarater reliability of the ultrasound methodology was .91-.98, and the interrater reliability was .97. The HR angle on the dominant side (mean +/- SD: 68.5 degrees +/- 10.0 degrees) was significantly greater than that of the nondominant side (58.0 degrees +/- 8.4 degrees; P < .001). ER on the dominant side was significantly greater than on the nondominant side (P < .001), whereas IR on the dominant side was significantly smaller than on the nondominant side (P < .001). Total arc of motion for the dominant side was not significantly different from that of the nondominant side (P = .335). CONCLUSION: In the current study, ultrasound methodology to measure HR showed high interrater reliability, as well as high intrarater reliability. In addition, this study indicates that healthy Japanese adult men have side-to-side differences in HR.