Obesity and Foot Posture

NewsBot · Sep 4, 2023

Effect of Body Mass Index on Foot Posture Types and Core Stability Among University Students.
Indian Journal of Physiotherapy & Occupational Therapy . Jul-Sep2023, Vol. 17 Issue 3, p9-15. 7p.
Kaur, Anmoldeep; Kaur, Chitvanjeet

Background: Core Stability is the capacity to regulate the position and motion of the trunk over the pelvis for optimal force production, transmission, and motion control to the terminal segment during integrated sports activities. Obesity is linked to a number of debilitating musculoskeletal diseases in adults. The Foot Posture Index can be used to assess deviations in foot posture alignment, such as pronation and supination. Various studies were conducted to determine the impact of Body Mass Index on core stability and foot posture alignment in non-athletic males aged between 22 and 27 years. As a result, the current study is determining the impact of Body Mass Index on core stability and foot posture types in male and female participants of the age group (18 to 25 years). Materials and Methods: In this Observational study A total 100 samples were taken based on the inclusion and exclusion criteria which were categorized into two groups. Group A -50 male subjects, Group B - 50 female subjects. Foot Posture Index-6 was used to assess foot. Normal foot, Pronated and supinated foot type during static foot posture was obtained by Foot Posture index. Core Stability was checked by prone plank test. Conclusion: According to this study, both Men and Women are more likely to acquire pronated feet when their weight increases. In females, the likelihood of having a flat foot and a pronated foot type increases as the weight increases, especially those who are belonging to overweight and obese category of Body Mass Index.
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NewsBot · Oct 3, 2023

Age, Gender, Body Mass Index, and Foot Loading During Gait
Jorge Luis Alberto Castellini et al
Foot Ankle Orthop. 2023 Sep 25;8(3):24730114231198524.

Background: The aim was to analyze changes in normal functional parameters of gait analysis by aging, sex, and body mass index (BMI).

Methods: A cross-sectional study with a consecutive sample of asymptomatic subjects was performed between 2014 and 2020. Primary outcomes were time and force parameters (contact time and center of force [CoF] time), in the heel, midfoot, and metatarsal areas, measured using an in-office force platform.

Results: A total of 156 subjects (312 feet) were included, including 67% of women with a mean age of 47 years. The mean of total contact time was similar in males and females (P = .695) and across BMI (P = .413). Contact time did not show differences by region (P = .648 heel, P = .286 midfoot, and P = .690 metatarsal). CoF time in the heel and metatarsal areas did not change between males and females (P = .288 and P = .879, respectively); meanwhile, it was different in midfoot (P = .002). Maximum force showed a reduction between sexes in the heel (P = .039) but did not in the midfoot and metatarsal areas. By age, differences were detected in the heel and metatarsal areas in females (P = .002 and P = .001) and the metatarsal area in males (P = .001). According to the age groups, total contact time increased in females (P = .001) but not in males (P = .018), and no differences were detected between foot areas. In females, CoF time did not change either foot areas or age groups. In males, CoF time values increased in the midfoot area in the older group (P = .001).

Conclusion: Time variables did not change by foot region, independent of age, sex, and BMI. Heel maximum force decreased in females, probably linked to adaptive phenomena by aging. The midfoot remains stable, and acts as an undamaged "bridge." These parameters could be interpreted as normal in asymptomatic subjects.
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NewsBot · Oct 31, 2023

Relationship Between Obesity and Medial Longitudinal Arch Bowing
Ki Chun Kim et al
Foot Ankle Int. 2023 Oct 30

Background: There has been reports about the association between obesity and the medial longitudinal arch (MLA) of foot. The purpose of this study is to investigate the change of various parameters related to the MLA according to obesity classification severity by the World Health Organization using weightbearing computed tomography (WBCT).

Methods: WBCT data of the noninvolved side of patients presenting with unilateral foot and ankle problems or healthy candidates from September 2014 to October 2022 were extracted from a single referral hospital. Forty-four cases in each of 5 obesity classes were selected sequentially. Two orthopaedic surgeons measured foot and ankle offset, forefoot arch angle (FAA), hindfoot moment arm, percentage of uncoverage of the middle facet of the subtalar joint, talonavicular angle (TNA), navicular-medial cuneiform angle, medial cuneiform-first metatarsal angle, talus-first metatarsal angle (TMT1A), first tarsometatarsal subluxation (TMT1S), talonavicular coverage angle, navicular floor distance (NFD), and NFD per height. Positive values indicate plantar collapse. Intra- and interobserver reliabilities were assessed using intraclass correlation coefﬁcients. One-way analysis of variance tests were performed for parametric data with equal variances, and Welch's test for unequal variances. Kruskal-Wallis test was performed for nonparametric data. Post hoc analysis was performed for statistically significant parameters. Correlation analysis between body mass index (BMI) and 12 parameters were performed using Pearson test.

Results: Intraobserver and interobserver reliability were excellent, except for TMT1S. The TNA and TMT1A showed a statistically significant difference. FAA (r = -0.2), TNA (r = 0.182), TMT1A (r = 0.296), and NFD (r = -0.173) showed a statistically significant correlation with BMI.

Conclusion: In nonsymptomatic feet, we found that the talonavicular joint, as measured by the TNA, to be influenced by obesity classification. Obesity and increased BMI was associated with a negative influence on the MLA.
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NewsBot · Dec 17, 2023

The The Association Of Obesity With The Incident Of Flat Foot In Adults: A Cross-Sectional Study Of Academic Community In Jambi City
Susan Tarawifa et al
JAMBI MEDICAL JOURNAL Jurnal Kedokteran dan Kesehatan /

Background: Flat feet is a foot deformity that refers to the loss of the mid-length of the foot. This can cause pain, stiffness, discomfort, and irritation in the ankles and feet. This study attempts to determine the relationship between obesity and the issue of flat feet in the academic community of the Faculty of Medicine and Health Sciences (FKIK) Universitas Jambi (UNJA) Medical Study Program.

Method: This observational analytic research used a cross-sectional design with samples of 102 academics from the FKIK UNJA Medical Study Program. The primary data consisted of body weight, height, BMI, and soles of the feet. Bivariate analysis using the Chi-square test.

Result: The incidence of flat feet is 20.6%, and 45,7% of flat feet are obese. There is an association between obesity and the incidence of flat foot in the academic community of the FKIK UNJA Medical Study Program.

Conclusion: There is a significant relationship between body mass index and the incidence of flat feet in the academic community of the FKIK Jambi University Medical Study Program.
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NewsBot · Jan 15, 2024

PLANOVALGUS DEFORMITIES AROSS VARYING BODY MASS INDEXES: TWO-DIMENSIONAL ANALYSIS FROM WBCT
Megan Carter and Amy Lenz
Source

Introduction

Progressive collapsing foot deformity (PCFD) is a complex foot and ankle condition characterized by peritalar subluxation [1]. Individuals with PCFD have unique and intricate morphologies with complex articular relationships, often causing pain, malalignment, and loss of function [2][3]. This foot deformity is more prevalent among high BMI patients, as their increased weight places higher stress on the medial longitudinal arch, causing it to flatten [4]. However, there is a scarcity of research investigating how BMI impacts the morphology of foot bones in PCFD patients. Typically, conditions of the foot and ankle, such as PCFD, are evaluated using x-rays and 2D measurements [5]. In this study, we aimed to observe several common 2D clinical measures of PCFD among groups of varying BMIs to check for statistical significance. We hypothesized that BMI would influence foot morphology and therefore, clinical measures would vary with BMI.

Methods

In this study, seventy-four patients (age: 44.4 ±18.4 years; 28 females, 98 feet) presenting with PCFD underwent WBCT scans (Planmed Verity; 0.4 x 0.4 x 0.4 mm voxels) with IRB approval. Using two-dimensional digitally reconstructed radiographs from DISIOR 2.1, comparisons were made across relevant clinical values determined from literature. Those chosen values were Talonavicular Coverage (TNC), Meary’s Angle (MA, sagittal), Calcaneal Inclination Angle (CIA), and Hindfoot Moment Arm (HMA). The data was then tested for normality using MATLAB. Parametric values (MA and CIA) were analyzed using a one-way ANOVA while non-parametric values (HMA and RNC) were analyzed using a Kruskal-Wallis test.

Results

The only statistically different clinical measure was HMA between BMI groups 2 and 3 (Group 2 = 25-29.99 BMI, Group 3 = 30-34.99 BMI). Comparisons of all other values among the varying BMI groups yielded no statistically significant p-values.

Discussion

The results from the 2D radiographs demonstrated a lack of significance among common 2D clinical measures, suggesting that BMI may not be a major factor in the morphology of PCFD. This information is important in understanding the etiology and treatment of PCFD. However, to further investigate these findings, the results from the 2D analyses should be compared with 3D measurements of the bones and joints. The bones of the foot have complex and unique orientations that are difficult to assess with conventional 2D radiographs.

Superimposition of these bones is often misrepresented in the conversion of 3D surfaces (bones) to 2D images (radiographs), leading to inaccurate measurements [6]. However, the development of weightbearing computed tomography (WBCT) has allowed accurate 3D visualization, comprehensive analyses, and a new grading system to report degenerative progression throughout the ankle joints [7]. This technology is a vital tool in the future of this study. Future work will include segmenting the WBCT scans of these PCFD patients and performing 3D evaluations of their bones. This data can then be compared to the 2D results, offering further insight into the role of BMI in PCFD. This study highlights the complexity of the foot and ankle complex as well as the need to consider complicated morphological variations of bones and joints when considering surgical intervention in PCFD.

Significance

These findings help surgeons to better understand the underlining mechanism of PCFD, while also suggesting that the selection of surgical procedures and treatments for PCFD may not need to be adapted for BMI. This information contributes to the growing database of information regarding PCFD, offering valuable insight that could be used to improve the diagnosis and treatment of pathological feet.
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NewsBot · Jul 29, 2024

Obesity & Arch Development in Children

NewsBot · Jul 30, 2024

Body Mass and Foot-dominance Disparities in the Foot Plantar Pressure Parameters of Older Women
Min Liu et al
J Am Podiatr Med Assoc. 2024 Jul 24:1-35

Objectives: To examine the effects of foot dominance and body mass on foot plantar pressures in older women of regular, overweight, and obese weights.

Methods: 96 female adults were divided into regular-weight group (68.30 ± 4.19 yr), overweight group (69.88 ± 3.76 yr), and obesity group (68.47 ± 3.67 yr) based on their body mass index scores. Footscan® plantar pressure test system was used to assess the dynamic plantar pressures, and parameters were collected from risk analysis, foot axis analysis, single foot timing analysis, and pressure analysis.

Results: (1) The local risks of lateral forefoot and midfoot, the minimum and maximum subtalar joint angles, the flexibility of subtalar joint, foot flat phase, as well as the average pressures on toes, metatarsals,, midfoot, and lateral heel, with the peak pressures on toe 2-5, metatarsal 2, metatarsal 5, midfoot, and lateral heel had significant within-subject differences. (2) The phases of initial contact and foot flat, the average pressures on toe 2-5, metatarsals, midfoot, and heels, with the peak pressures on metatarsal 1-4, midfoot, and heels exhibited significant between-subjects differences. (3) There was an interaction effect of foot dominance and body mass index on the flexibility of subtalar joint.

Conclusions: The non-dominant foot works better for stability, especially when touching on and off the ground. The dominant foot works better for propulsion but is more susceptible to pain, injury, and falls. For obese older women, the forefoot and midfoot are primarily responsible for maintaining stability, but the lateral midfoot and hindfoot are more prone to pain and discomfort.
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NewsBot · Aug 16, 2024

A cross-sectional study of medial longitudinal arch development in children with different BMI
Jing Chen et al
Front Pediatr. 2024 Jul 26:12:1343162.

Introduction: The influence of excess weight on the development of children's feet remains a subject of debate. To further elucidate whether this relation occurs, this study compared arch morphology and flexibility in three groups of children: underweight, normal, and overweight.

Methods: In total, 1,532 children (807 boys, 725 girls; age range 7-11 years) participated in the study. The researchers measured the participants' height and weight, calculated their body mass index, and categorized their weight status as underweight, normal weight, or overweight. A three-dimensional foot model was taken using a three-dimensional plantar scanner under non-weight-bearing and weight-bearing conditions to obtain arch morphometric indices (arch index and arch volume) and arch flexibility index (arch volume index).

Results: Analysis of the data showed that the arch index was higher in overweight children compared to underweight and normal weight children (p < 0.05), but the differences in arch volume and arch volume index in overweight children compared to underweight and normal weight children were not statistically significant (p > 0.05). All children were divided into flatfoot, normal, and pes cavus groups according to arch index, and the arch volume index was statistically significant (p < 0.01).

Conclusions: Overweight was not absolutely associated with arch structure and arch flexibility in children from a three-dimensional perspective. Arch development is a long-term process, and it is not clear whether being overweight has an effect on soft tissue or bone formation. Future studies will focus on the effects of long-term overweight on foot structure and arch flexibility in children.
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NewsBot · Aug 16, 2024

Is a Plantarflexed First Ray the Primary Deformity In Children With Cavovarus Feet Secondary to Charcot-Marie-Tooth Disease? A Pedobarographic Analysis
Stuart Ferguson, Patrick Do, Jing Feng, Jeremy Bauer
J Pediatr Orthop. 2024 Aug 12

Background: Charcot-Marie-Tooth disease (CMT) is a common cause of cavovarus foot deformity in children. This deformity is often quoted as being forefoot driven, with a primary deformity of first ray plantarflexion driving the hindfoot into varus by virtue of the tripod effect of the foot, which was hypothesized by Coleman and is commonly assessed clinically using his eponymous block test. The primary goal of this study was to objectively investigate this hypothesis using dynamic pedobarography.

Methods: A review of the gait lab archives at a large tertiary referral center was carried out to identify children with CMT who had foot photos and dynamic pedobarographic data. Two orthopaedic surgeons then determined the weight-bearing hindfoot alignment of these children using clinical photography. The order of contact during gait of the first metatarsal relative to the fifth metatarsal was then obtained from the dynamic pedobarographic data.

Results: One hundred eighteen feet from 60 children with CMT met the study inclusion criteria. Sixty-eight varus feet were compared with 50 nonvarus feet. First ray contact occurred before fifth ray contact in only 39.7% of the varus feet compared with 34.0% of the nonvarus feet, which did not meet statistical significance (P=0.526).

Conclusions: In this cohort, dynamic pedobarography did not consistently demonstrate the first metatarsal contact occurring before the fifth metatarsal contact in children with varus feet secondary to CMT. While nearly 40% of the feet did make initial contact on the first ray, 60% of the feet landed in varus before the first ray made contact, leading us to believe that the foot is prepositioned in varus. This may be in part due to the progressive muscle imbalance and secondary deformity that has occurred. Surgical management of these children should take this.
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NewsBot · Sep 10, 2024

Flat feet occurrence among young school-age children and its association with body mass index values
Sona Jandova
Homo. 2024 Sep 2.

A sedentary lifestyle, characterised by a lack of physical activity, negatively influences Body Mass Index (BMI). BMI may be related to the prevalence of flat feet. This study aims to observe the occurrence of flat feet in young children and determine its association with BMI. Additionally, it aims to analyse foot loading in the forefoot, midfoot and rearfoot. Dynamographic records of children (N = 142; age = 10.3 ± 0.21 years) were collected during walking, and foot-type evaluations were conducted using a force plate. A normal foot type was observed in 44% of children (BMI 16.0 ± 2.3 kg/m2). Flat feet were observed in 54% of children (BMI 18.4 ± 4.3 kg/m2). A high foot arch was observed in only 2% of children (BMI 16.0 ± 1.3 kg/m2). Children with flat feet had higher BMI values than those with normal feet. The contact time and maximal vertical force in the forefoot and rearfoot were similar in children with normal and flat feet. Significantly higher pressure values were observed in the midfoot zone of children with flat feet. Regression analysis results showed that in children with flat feet, there is a decrease in forefoot loading and an increase in midfoot loading with increasing BMI. This trend was not observed in children with normal feet. We recommend incorporating exercise interventions at this age to prevent pain and promote willingness to engage in physical activity. Higher BMI values indicate an increased risk for the prevalence of flat feet.
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Obesity and Foot Posture

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Question re research conclusions on obesity and foot posture

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Obesity and Foot Posture

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Question re research conclusions on obesity and foot posture

Influence of Obesity on Outcomes of Hallux Valgus Corrective Surgery

Obesity and plantar sensitivity

Prevalance of heel spurs in diabetes and obesity

Obesity surgery and diabetes

Who's to blame for obesity? Policymakers, the food industry, or individuals?

Obesity and Achilles tendon strain

Share This Page

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