Structure, Flexibility and Function Variables that Discriminate Asymptomatic Foot Types

NewsBot · Dec 20, 2016

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An Investigation of Structure, Flexibility and Function Variables that Discriminate Asymptomatic Foot Types.
Shultz SP, Song J, Kraszewski AP, Hafer JF, Rao S, Backus S, Mootanah R, Hillstrom HJ.
J Appl Biomech. 2016 Dec 19:1-25.

It has been suggested that foot type consider not only foot structure (high, normal, low arch), but also function (over-pronation, normal, over-supination) and flexibility (reduced, normal, excessive). Therefore, this study used canonical regression analyses to assess which variables of foot structure, function, and flexibility can accurately discriminate between clinical foot type classifications. The feet of 61 asymptomatic, healthy adults (18-77 years) were classified as cavus (N=24), rectus (N=54), or planus (N=44) using standard clinical measures. Custom jigs assessed foot structure and flexibility. Foot function was assessed using an emed-x plantar pressure measuring device. Canonical regression analyses were applied separately to extract essential structure, flexibility, and function variables. A third canonical regression analysis was performed on the extracted variables to identify a combined model. The initial combined model included 30 extracted variables; however five terminal variables (malleolar valgus index, arch height index while sitting, first metatarsophalangeal joint laxity while standing, pressure-time integral and maximum contact area of medial arch) were able to correctly predict 80.7% of foot types. These remaining variables focused on specific foot characteristics (hindfoot alignment, arch height, midfoot mechanics, Windlass mechanism) that could be essential to discriminating foot type.
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NewsBot · Dec 19, 2021

Clinico-radiological factors predicting the failure risk of conservative management in moderate to severe pediatric idiopathic flexible flatfoot
Kang, Michael Seungcheola, Bae, Kunhyungb, Kim, Ho Yeona; Park, Soo-Sunga
Journal of Pediatric Orthopaedics B: December 3, 2021 - Volume - Issue -

Objectives
This study aimed to investigate the clinico-radiological factors of related future surgical treatment in patients with pediatric flexible flatfoot (FFF) who first visited the orthopedic clinic before the age of 10 years.

Methods
Sixty-five patients diagnosed with moderate/severe idiopathic FFF deformity between the ages of 2–10 years were included. We developed prognostic models for the risk of the surgery during the follow-up period.

Results
Twenty (30.8%) patients required surgical treatment, and all of them underwent calcaneal lengthening osteotomy. Among them, 7 (10.8%) patients required concomitant Achilles-lengthening surgery. Unilateral involvement, older age, smaller calcaneal pitch angle, and higher talo-first metatarsal malalignment were considered high-risk factors for pediatric FFF surgery. Prognostic models identified three prognostic risk groups based on those factors, and survival curves revealed significant differences among the groups.

Conclusions
Our prognostic models help predict the failure risk of conservative management of pediatric idiopathic FFF.
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NewsBot · Jul 30, 2022

Risk Factors of Flatfoot in Children: A Systematic Review and Meta-Analysis
Liya Xu et al
Int J Environ Res Public Health. 2022 Jul 6;19(14):8247

Background: This study aimed to explore the risk factors for flatfoot in children and adolescents to provide a reference basis for studying foot growth and development in children and adolescents.

Methods: We examined the cross-sectional research literature regarding flatfoot in children and adolescents published in the past 20 years, from 2001 to 2021, in four electronic databases: PubMed, Web of Science, EBSCO, and Cochrane Library. Two researchers independently searched the literature according to the inclusion and exclusion criteria and evaluated the literature quality of the selected research; from this, a total of 20 articles were included in our review. After the relevant data were extracted, the data were reviewed using Manager 5.4 software (The Cochrane Collaboration, Copenhagen, Denmark), and the detection rate and risk factors for flatfoot in children were analyzed.

Results: In total, 3602 children with flatfoot from 15 studies were included in the analysis. The meta-analysis results showed that being male (OR = 1.33, 95% CI: 1.09, 1.62, p = 0.005), being aged <9 years (age <6, OR = 3.11, 95% CI: 2.47, 3.90, p < 0.001; age 6-9 years, OR = 0.54, 95% CI: 0.41, 0.70, p < 0.001), joint relaxation (OR = 4.82, 95% CI: 1.19, 19.41, p = 0.03), wearing sports shoes (OR = 2.97, 95% CI: 1.46, 6.03, p = 0.003), being a child living in an urban environment (OR = 2.10, 95% CI: 1.66, 2.64, p < 0.001) and doing less exercise (OR = 0.25, 95% CI: 0.08, 0.80, p = 0.02) were risk factors for the detection of flatfoot.

Conclusion: In summary, the detection rate of flatfoot in children in the past 20 years was found to be 25% through a meta-analysis. Among the children included, boys were more prone to flatfoot than girls, and the proportion of flatfoot decreased with age.
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NewsBot · Feb 3, 2023

Clinical, radiographic and gait parameters associated with medial arch pain in the flexible pediatric flatfoot
Harald Böhm, PhD % Chakravarty Ugandhar Dussa, MD
January 30, 2023

Pain in the flexible flatfoot is a common complaint, if present it is important to find its exact location and causes Therefore, the study aimed to find differences between children with and without medial arch pain and relate them to the reduction of pain following surgical treatment. Children with idiopathic flexible flatfeet were retrospectively included in the study. All children underwent a clinical, radiographic, and gait examination. The feet were subdivided into 2 groups: asymptomatic and those with medial arch pain. Factors associated with medial arch pain were identified via t-test. Significant radiological and gait parameters were correlated to the change in medial arch pain score following surgery. Included were 322 feet belonging to 177 children, with the mean age of 11.8 (SD=2.2) years. The pain was perceived in 52% of the feet, of these, 74% in the medial arch. In the group with pain, 31 feet received a gait analysis following surgery. The radiological parameters, talus-1 and -2 metatarsal angles and the gait parameter, calcaneal lateral shift during walking showed a significant difference (p≤0.004) between the no pain and pain groups and were associated (R2 ≥0.14, p≤0.04) with the reduction in pain following surgery. The increased talus-1 and -2 metatarsal angles and the calcaneal lateral shift may cause increased tension on the soft-tissues along the medial side of the foot and may produce pain. Therapies aiming at improving the medial arch pain should be directed to normalize the talus-1 or -2 metatarsal angles and the calcaneal lateral shift.
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NewsBot · Feb 27, 2023

Foot morphology and its relationship to arch height index in asymptomatic adults versus adults presenting with foot pain (nontraumatic).
Agrawal AC, Siddiqui AU, Sakale HS, John MR.
Natl J Clin Anat 2023;12:15-9

Background: The uniqueness of the human foot, in performing various functions, is intricately associated with different morphological parameters, and arch height index (AHI) is an important parameter for the same. The measurement of AHI has putative clinical implications in correcting the underlying causative factors, which contribute to foot pain. This study was an attempt to investigate these parameters as a correlation among asymptomatic versus patients complaining of foot pain (due to nontraumatic causes). Methodology: One hundred asymptomatic and 50 symptomatic adults were engaged in the study after taking prior consent. Various measurements (such as foot length, truncated foot length, foot breadth, arch height – [AH], and AHI) were taken in a standing position. In this study values of foot length, truncated foot length, foot breadth, AH and AHI were compared amongst the two groups . Comparison was done with earlier studies. Results: The difference in AH and AHI (P < 0.05) among the asymptomatic versus the foot pain patients, was significant. There was a considerable difference in body weight and Body Mass Index (BMI) affecting AH and AHI. AHI in the case of the symptomatic foot pain adults was 0.18 in both feet, with a standard deviation (SD) of 0.07. Conclusion: The AHI has been considered an essential parameter in defining and identifying the potential structural factors that predispose an individual to injuries of the foot. Our results indicate that the mean AHI in the case of foot pain adults (nontraumatic) was 0.18 in both feet, with an SD of 0.07. This is lower as compared to other studies. This can be attributed to the fact that earlier studies have been done on asymptomatic patients only. The present study was done to correlate between normal asymptomatic versus foot pain patients. There was a significant difference in the AH and AHI between our two study groups.
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