Multiple linear regression approach for the analysis of the relationships between joints mobility and regional pressure-based parameters in the normal-arched foot.

Science.gov (United States)

Caravaggi, Paolo; Leardini, Alberto; Giacomozzi, Claudia

2016-10-03

Plantar load can be considered as a measure of the foot ability to transmit forces at the foot/ground, or foot/footwear interface during ambulatory activities via the lower limb kinematic chain. While morphological and functional measures have been shown to be correlated with plantar load, no exhaustive data are currently available on the possible relationships between range of motion of foot joints and plantar load regional parameters. Joints' kinematics from a validated multi-segmental foot model were recorded together with plantar pressure parameters in 21 normal-arched healthy subjects during three barefoot walking trials. Plantar pressure maps were divided into six anatomically-based regions of interest associated to corresponding foot segments. A stepwise multiple regression analysis was performed to determine the relationships between pressure-based parameters, joints range of motion and normalized walking speed (speed/subject height). Sagittal- and frontal-plane joint motion were those most correlated to plantar load. Foot joints' range of motion and normalized walking speed explained between 6% and 43% of the model variance (adjusted R 2 ) for pressure-based parameters. In general, those joints' presenting lower mobility during stance were associated to lower vertical force at forefoot and to larger mean and peak pressure at hindfoot and forefoot. Normalized walking speed was always positively correlated to mean and peak pressure at hindfoot and forefoot. While a large variance in plantar pressure data is still not accounted for by the present models, this study provides statistical corroboration of the close relationship between joint mobility and plantar pressure during stance in the normal healthy foot. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of Acute Alterations in Foot Strike Patterns during Running on Sagittal Plane Lower Limb Kinematics and Kinetics.

Science.gov (United States)

Valenzuela, Kevin A; Lynn, Scott K; Mikelson, Lisa R; Noffal, Guillermo J; Judelson, Daniel A

2015-03-01

The purpose of this study was to determine the effect of foot strike patterns and converted foot strike patterns on lower limb kinematics and kinetics at the hip, knee, and ankle during a shod condition. Subjects were videotaped with a high speed camera while running a 5km at self-selected pace on a treadmill to determine natural foot strike pattern on day one. Preferred forefoot group (PFFG, n = 10) and preferred rear foot group (PRFG, n = 11) subjects were identified through slow motion video playback (n = 21, age = 22.8±2.2 years, mass = 73.1±14.5 kg, height 1.75 ± 0.10 m). On day two, subjects performed five overground run trials in both their natural and unnatural strike patterns while motion and force data were collected. Data were collected over two days so that foot strike videos could be analyzed for group placement purposes. Several 2 (Foot Strike Pattern -forefoot strike [FFS], rearfoot strike [RFS]) x 2 (Group - PFFG, PRFG) mixed model ANOVAs (p strike patterns during shod running can create alterations in certain lower limb kinematic and kinetic measures that are not dependent on the preferred foot strike pattern of the individual. This research also challenges the contention that the impact transient spike in the vertical ground reaction force curve is only present during a rear foot strike type of running gait. Key pointsFootstrike pattern changes should be individually considered and implemented based on individual histories/abilitiesForefoot strike patterns increase external dorsiflexion momentsRearfoot strike patterns increase external knee flexion momentsRecreational shod runners are able to mimic habitual mechanics of different foot strike patterns.

Effects of individual and group exercise programs on pain, balance, mobility and perceived benefits in rheumatoid arthritis with pain and foot deformities.

Science.gov (United States)

do Carmo, Carolina Mendes; Almeida da Rocha, Bruna; Tanaka, Clarice

2017-11-01

[Purpose] To verify the effects of individual and group exercise programs on pain, balance, mobility and perceived benefits of rheumatoid arthritis patients (RA) with pain and foot deformities. [Subjects and Methods] Thirty patients with RA pain and foot deformity were allocated into two groups: G1: individual exercise program and G2: group exercise program. The variables analyzed were Numerical Rating Scale (NRS) for pain, Berg Balance Scale (BBS) for balance, Timed Up & Go Test (TUG) and Functional Reach (FR) for mobility, and Foot Health Status Questionnaire (FHSQ-Br) for perceived benefits. Both exercise programs consisted of functional rehabilitation exercises and self-care guidance aimed at reducing pain and improving balance and mobility. Intragroup comparisons of variables between A1 (pre-intervention) and A2 (post-intervention) were performed. [Results] Patients in both groups were similar in A1 (pre-intervention) in all the variables analyzed. Comparison between A1 and A2 for each variable showed improvement for G1 in the NRS, BBS, FR, TUG and in four out of ten domains of FHSQ-Br. G2 showed improvement in the NRS, BBS and eight out of ten domains of FHSQ-Br. [Conclusion] Both individual and group programs revealed benefits for patients with RA, however, group exercise programs showed better perception of benefits.

SIM2PeD– Intelligent monitoring system for prevention of diabetic foot

African Journals Online (AJOL)

Tuoyo Aghomotsegin

2016-10-12

Oct 12, 2016 ... integrated with a mobile device to capture individuals' data, entitled Mobile ... Key words: Intelligent module, diabetes, application, diabetic foot. ..... treatment of 575 diabetic foot ulcers at home, Ph.D. thesis, University.

Obese older adults suffer foot pain and foot-related functional limitation.

Science.gov (United States)

Mickle, Karen J; Steele, Julie R

2015-10-01

There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI=25-30) and not overweight (BMI foot pain and scored significantly lower on the SF-36. Obesity was also associated with foot-related functional limitation whereby ankle dorsiflexion strength, hallux and lesser toe strength, stride/step length and walking speed were significantly reduced in obese participants compared to their leaner counterparts. Therefore, disabling foot pain and altered foot structure and foot function are consequences of obesity for older adults, and impact upon their quality of life. Interventions designed to reduce excess fat mass may relieve loading of the foot structures and, in turn, improve foot pain and quality of life for older obese individuals. Copyright © 2015 Elsevier B.V. All rights reserved.

Measuring of foot plantar pressure—possible applications in quantitative analysis of human body mobility

International Nuclear Information System (INIS)

Klimiec, E; Piekarski, J; Zaraska, K; Guzdek, P; Kołaszczyński, G; Jasiewicz, B

2017-01-01

The paper presents an evaluation of human mobility by gait analysis, carried out in natural conditions (outside of the laboratory). Foot plantar pressure is measured using a shoe insole with 8 sensors placed in different anatomical zones of the foot, and placed inside a sports shoe. Polarized polyvinylidene fluoride (PVDF) foil is used as a sensor material. A wireless transmission system is used to transmit voltage values to the computer. Miniaturization was the priority during the design of the system. Due to the linear relationship between force and transducer voltage, energy and power released during walking in arbitrary units can be calculated as an integral of the square of the transducer voltage over time. Gait measurements were carried out over several days on healthy persons during normal walking and slow walking. The performed measurements allowed for the determination of walking speed (number of steps per second), gait rhythm and manner of walking (applying force to inside versus outside part of the sole). It was found that switching from normal to slow walk increases gait energy by 25% while the pressure distribution across the anatomical regions of the foot remains unchanged. The results will be used to develop a programme for the evaluation of patients with orthopedic diseases or even with cardiac failures, for an estimation of the results of health recovery and training efficiency in many sports activities. (paper)

Effects of individual and group exercise programs on pain, balance, mobility and perceived benefits in rheumatoid arthritis with pain and foot deformities

OpenAIRE

do Carmo, Carolina Mendes; Almeida da Rocha, Bruna; Tanaka, Clarice

2017-01-01

[Purpose] To verify the effects of individual and group exercise programs on pain, balance, mobility and perceived benefits of rheumatoid arthritis patients (RA) with pain and foot deformities. [Subjects and Methods] Thirty patients with RA pain and foot deformity were allocated into two groups: G1: individual exercise program and G2: group exercise program. The variables analyzed were Numerical Rating Scale (NRS) for pain, Berg Balance Scale (BBS) for balance, Timed Up & Go Test (TUG) and Fu...

Effects of weight-bearing exercise on a mini-trampoline on foot mobility, plantar pressure and sensation of diabetic neuropathic feet; a preliminary study.

Science.gov (United States)

Kanchanasamut, Wararom; Pensri, Praneet

2017-01-01

Objective : Foot and ankle exercise has been advocated as a preventative approach in reducing the risk of foot ulceration. However, knowledge about the appropriate types and intensity of exercise program for diabetic foot ulcer prevention is still limited. The current study aimed to examine the effects of an eight-week mini-trampoline exercise on improving foot mobility, plantar pressure and sensation of diabetic neuropathic feet. Methods : Twenty-one people with diabetic peripheral neuropathy who had impaired sensation perception were divided into two groups. The exercise group received a foot-care education program plus an eight-week home exercise program using the mini-trampoline ( n  = 11); whereas a control group received a foot-care education only ( n  = 10). Measurements were undertaken at the beginning, at the completion of the eight-week program and at a 20-week follow-up. Results : Both groups were similar prior to the study. Subjects in the exercise group significantly increased the range of the first metatarsophalangeal joint in flexion (left: p  = 0.040, right: p  = 0.012) and extension (left: p  = 0.013) of both feet more than controlled subjects. There was a trend for peak plantar pressure at the medial forefoot to decrease in the exercise group ( p  = 0.016), but not in the control group. At week 20, the number of subjects in the exercise group who improved their vibration perception in their feet notably increased when compared to the control group (left: p  = 0.043; right: p  = 0.004). Conclusions : This is a preliminary study to document the improvements in foot mobility, plantar pressure and sensation following weight-bearing exercise on a flexible surface in people with diabetic neuropathic feet. Mini-trampoline exercise may be used as an adjunct to other interventions to reduce risk of foot ulceration. A larger sample size is needed to verify these findings. This trial is registered with COA No. 097.2/55.

Relationship between limited joint mobility of the hand and diabetic foot risk in patients with type 2 diabetes.

Science.gov (United States)

Mineoka, Yusuke; Ishii, Michiyo; Tsuji, Akiko; Komatsu, Yoriko; Katayama, Yuko; Yamauchi, Mitsuko; Yamashita, Aki; Hashimoto, Yoshitaka; Nakamura, Naoto; Katsumi, Yasukazu; Isono, Motohide; Fukui, Michiaki

2017-06-01

Foot ulceration is a serious problem for patients with type 2 diabetes (T2D), and the early detection of risks for this condition is important to prevent complications. The present cross-sectional study in T2D patients determined the relationship between limited joint mobility (LJM) of the hand and diabetic foot risk classified using the criteria of the International Working Group on the Diabetic Foot (IWGDF). Relationships between LJM of the hand and foot risk according to IWGDF category, HbA1c, age, body mass index, blood pressure, estimated glomerular filtration (eGFR), and diabetic complications (including diabetic peripheral neuropathy [DPN] and peripheral arterial disease [PAD]) were evaluated in 528 consecutive T2D patients. Poor glycemic control was defined as HbA1c ≥ 7%. Patients with LJM of the hand were older and had a longer duration of diabetes, a higher prevalence of diabetic complications, including DPN and PAD, and a higher IWDGF category (all P foot risk assessed with IWDGF category was correlated with age (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01-1.06; P = 0.001), poor glycemic control (OR 1.66; 95% CI 1.00-2.77; P = 0.04), eGFR (OR 0.98; 95% CI 0.97-0.99; P = 0.02), and the presence of LJM of the hand (OR 3.86; 95% CI 2.21-6.86; P foot risk. Diagnosis of diabetic hand is simple and non-invasive, and is thus a useful method for assessing the risk of diabetic foot in T2D patients. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Shoes alter the spring-like function of the human foot during running

Science.gov (United States)

Kelly, Luke A.; Lichtwark, Glen A.; Farris, Dominic J.; Cresswell, Andrew

2016-01-01

The capacity to store and return energy in legs and feet that behave like springs is crucial to human running economy. Recent comparisons of shod and barefoot running have led to suggestions that modern running shoes may actually impede leg and foot-spring function by reducing the contributions from the leg and foot musculature. Here we examined the effect of running shoes on foot longitudinal arch (LA) motion and activation of the intrinsic foot muscles. Participants ran on a force-instrumented treadmill with and without running shoes. We recorded foot kinematics and muscle activation of the intrinsic foot muscles using intramuscular electromyography. In contrast to previous assertions, we observed an increase in both the peak (flexor digitorum brevis +60%) and total stance muscle activation (flexor digitorum brevis +70% and abductor hallucis +53%) of the intrinsic foot muscles when running with shoes. Increased intrinsic muscle activation corresponded with a reduction in LA compression (−25%). We confirm that running shoes do indeed influence the mechanical function of the foot. However, our findings suggest that these mechanical adjustments are likely to have occurred as a result of increased neuromuscular output, rather than impaired control as previously speculated. We propose a theoretical model for foot–shoe interaction to explain these novel findings. PMID:27307512

Diabetic Foot and Exercise Therapy: Step by Step The Role of Rigid Posture and Biomechanics Treatment

Science.gov (United States)

Francia, Piergiorgio; Gulisano, Massimo; Anichini, Roberto; Seghieri, Giuseppe

2014-01-01

Lower extremity ulcers represent a serious and costly complication of diabetes mellitus. Many factors contribute to the development of diabetic foot. Peripheral neuropathy and peripheral vascular disease are the main causes of foot ulceration and contribute in turn to the growth of additional risk factors such as limited joint mobility, muscular alterations and foot deformities. Moreover, a deficit of balance, posture and biomechanics can be present, in particular in patients at high risk for ulceration. The result of this process may be the development of a vicious cycle which leads to abnormal distribution of the foot's plantar pressures in static and dynamic postural conditions. This review shows that some of these risk factors significantly improve after a few weeks of exercise therapy (ET) intervention. Accordingly it has been suggested that ET can be an important weapon in the prevention of foot ulcer. The aim of ET can relate to one or more alterations typically found in diabetic patients, although greater attention should be paid to the evaluation and possible correction of body balance, rigid posture and biomechanics. Some of the most important limitations of ET are difficult access to therapy, patient compliance and the transitoriness of the results if the training stops. Many proposals have been made to overcome such limitations. In particular, it is important that specialized centers offer the opportunity to participate in ET and during the treatment the team should work to change the patient’s lifestyle by improving the execution of appropriate daily physical activity. PMID:24807636

Role of neuropathy and high foot pressures in diabetic foot ulceration.

Science.gov (United States)

Frykberg, R G; Lavery, L A; Pham, H; Harvey, C; Harkless, L; Veves, A

1998-10-01

High plantar foot pressures in association with peripheral neuropathy have been ascertained to be important risk factors for ulceration in the diabetic foot. Most studies investigating these parameters have been limited by their size and the homogeneity of study subjects. The objective of this study was therefore to ascertain the risk of ulceration associated with high foot pressures and peripheral neuropathy in a large and diverse diabetic population. We studied a cross-sectional group of 251 diabetic patients of Caucasian (group C) (n=121), black (group B) (n=36), and Hispanic (group H) (n=94) racial origins with an overall age of 58.5+/-12.5 years (range 20-83). There was an equal distribution of men and women across the entire study population. All patients underwent a complete medical history and lower extremity evaluation for neuropathy and foot pressures. Neuropathic parameters were dichotomized (0/1) into two high-risk variables: patients with a vibration perception threshold (VPT) > or =25 V were categorized as HiVPT (n=132) and those with Semmes-Weinstein monofilament tests > or =5.07 were classified as HiSWF (n=190). The mean dynamic foot pressures of three footsteps were measured using the F-scan mat system with patients walking without shoes. Maximum plantar pressures were dichotomized into a high-pressure variable (Pmax6) indicating those subjects with pressures > or =6 kg/cm2 (n=96). A total of 99 patients had a current or prior history of ulceration at baseline. Joint mobility was significantly greater in the Hispanic cohort compared with the other groups at the first metatarsal-phalangeal joint (C 67+/-23 degrees, B 69+/-23 degrees, H 82+/-23 degrees, P=0.000), while the subtalar joint mobility was reduced in the Caucasian group (C 21+/-8 degrees, B 26+/-7 degrees, H 27+/-11 degrees, P=0.000). Maximum plantar foot pressures were significantly higher in the Caucasian group (C 6.7+/-2.9 kg/cm2, B 5.7+/-2.8 kg/cm2, H 4.4+/-1.9 kg/cm2, P=0

Changes in Foot Shape after Long-Distance Running

OpenAIRE

Fukano, Mako; Iso, Shigeo

2015-01-01

Changes in foot shape during long-distance running may lead to alteration in shoe fit. However, little information is available on changes in foot shape following long-distance running. The purpose of this study was to assess changes in foot shape in experienced runners after a single long-distance run. Data from the right feet of 21 subjects were obtained using a foot scanner before and after running 35 km on an asphalt road. After the run, the dorsal height, navicular height, and arch heigh...

Characterizing multisegment foot kinematics during gait in diabetic foot patients

Directory of Open Access Journals (Sweden)

Denti Paolo

2009-10-01

Full Text Available Abstract Background The prevalence of diabetes mellitus has reached epidemic proportions, this condition may result in multiple and chronic invalidating long term complications. Among these, the diabetic foot, is determined by the simultaneous presence of both peripheral neuropathy and vasculopathy that alter the biomechanics of the foot with the formation of callosity and ulcerations. To diagnose and treat the diabetic foot is crucial to understand the foot complex kinematics. Most of gait analysis protocols represent the entire foot as a rigid body connected to the shank. Nevertheless the existing multisegment models cannot completely decipher the impairments associated with the diabetic foot. Methods A four segment foot and ankle model for assessing the kinematics of the diabetic foot was developed. Ten normal subjects and 10 diabetics gait patterns were collected and major sources of variability were tested. Repeatability analysis was performed both on a normal and on a diabetic subject. Direct skin marker placement was chosen in correspondence of 13 anatomical landmarks and an optoelectronic system was used to collect the data. Results Joint rotation normative bands (mean plus/minus one standard deviation were generated using the data of the control group. Three representative strides per subject were selected. The repeatability analysis on normal and pathological subjects results have been compared with literature and found comparable. Normal and pathological gait have been compared and showed major statistically significant differences in the forefoot and midfoot dorsi-plantarflexion. Conclusion Even though various biomechanical models have been developed so far to study the properties and behaviour of the foot, the present study focuses on developing a methodology for the functional assessment of the foot-ankle complex and for the definition of a functional model of the diabetic neuropathic foot. It is, of course, important to evaluate

A comparison of foot kinematics in people with normal- and flat-arched feet using the Oxford Foot Model.

Science.gov (United States)

Levinger, Pazit; Murley, George S; Barton, Christian J; Cotchett, Matthew P; McSweeney, Simone R; Menz, Hylton B

2010-10-01

Foot posture is thought to influence predisposition to overuse injuries of the lower limb. Although the mechanisms underlying this proposed relationship are unclear, it is thought that altered foot kinematics may play a role. Therefore, this study was designed to investigate differences in foot motion between people with normal- and flat-arched feet using the Oxford Foot Model (OFM). Foot posture in 19 participants was documented as normal-arched (n=10) or flat-arched (n=9) using a foot screening protocol incorporating measurements from weightbearing antero-posterior and lateral foot radiographs. Differences between the groups in triplanar motion of the tibia, rearfoot and forefoot during walking were evaluated using a three-dimensional motion analysis system incorporating a multi-segment foot model (OFM). Participants with flat-arched feet demonstrated greater peak forefoot plantar-flexion (-13.7° ± 5.6° vs -6.5° ± 3.7°; p=0.004), forefoot abduction (-12.9° ± 6.9° vs -1.8° ± 6.3°; p=0.002), and rearfoot internal rotation (10.6° ± 7.5° vs -0.2°± 9.9°; p=0.018) compared to those with normal-arched feet. Additionally, participants with flat-arched feet demonstrated decreased peak forefoot adduction (-7.0° ± 9.2° vs 5.6° ± 7.3°; p=0.004) and a trend towards increased rearfoot eversion (-5.8° ± 4.4° vs -2.5° ± 2.6°; p=0.06). These findings support the notion that flat-arched feet have altered motion associated with greater pronation during gait; factors that may increase the risk of overuse injury. Copyright © 2010 Elsevier B.V. All rights reserved.

Patellofemoral joint stress during running with alterations in foot strike pattern.

Science.gov (United States)

Vannatta, Charles Nathan; Kernozek, Thomas W

2015-05-01

This study aimed to quantify differences in patellofemoral joint stress that may occur when healthy runners alter their foot strike pattern from their habitual rearfoot strike to a forefoot strike to gain insight on the potential etiology and treatment methods of patellofemoral pain. Sixteen healthy female runners completed 20 running trials in a controlled laboratory setting under rearfoot strike and forefoot strike conditions. Kinetic and kinematic data were used to drive a static optimization technique to estimate individual muscle forces to input into a model of the patellofemoral joint to estimate joint stress during running. Peak patellofemoral joint stress and the stress-time integral over stance phase decreased by 27% and 12%, respectively, in the forefoot strike condition (P forefoot strike condition (P forefoot strike (P forefoot strike condition (P strike pattern to a forefoot strike results in consistent reductions in patellofemoral joint stress independent of changes in step length. Thus, implementation of forefoot strike training programs may be warranted in the treatment of runners with patellofemoral pain. However, it is suggested that the transition to a forefoot strike pattern should be completed in a graduated manner.

Plantar loading changes with alterations in foot strike patterns during a single session in habitual rear foot strike female runners.

Science.gov (United States)

Kernozek, Thomas W; Vannatta, Charles N; Gheidi, Naghmeh; Kraus, Sydnie; Aminaka, Naoko

2016-03-01

Characterize plantar loading parameters when habitually rear foot strike (RFS) runners change their pattern to a non-rear foot strike (NRFS). Experimental. University biomechanics laboratory. Twenty three healthy female runners (Age: 22.17 ± 1.64 yrs; Height: 168.91 ± 5.46 cm; Mass: 64.29 ± 7.11 kg). Plantar loading was measured using an in-sole pressure sensor while running down a 20-m runway restricted to a range of 3.52-3.89 m/s under two conditions, using the runner's typical RFS, and an adapted NRFS pattern. Repeated measures multivariate analysis of variance was performed to detect differences in loading between these two conditions. Force and pressure variables were greater in the forefoot and phalanx in NRFS and greater in the heel and mid foot in RFS pattern, but the total force imposed upon the whole foot and contact time remained similar between conditions. Total peak pressure was higher and contact area was lower during NRFS running. The primary finding of this investigation is that there are distinctly different plantar loads when changing from a RFS to NRFS during running. So, during a transition from RFS to a NRFS pattern; a period of acclimation should be considered to allow for adaptations to these novel loads incurred on plantar regions of the foot. Copyright © 2015 Elsevier Ltd. All rights reserved.

Analysis of foot structural damage in rheumatoid arthritis: clinical evaluation by validated measures and serological correlations

Directory of Open Access Journals (Sweden)

E. Bartoloni Bocci

2011-06-01

Full Text Available Objective: To examine foot involvement in rheumatoid arthritis (RA and to characterize structural alterations in patients with anti-cyclic citrullinated peptide (CCP antibody-positive and -negative disease. Methods: Seventy-eight patients with RA with foot pain were consecutively enrolled. The Manchester Hallux Valgus (MHV rating scale was used to evaluate the hallux valgus deformity degree. The Foot Posture Index (FPI6, a novel, foot-specific outcome measure, was adopted in order to quantify variation in the position of the foot. The findings were correlated with disease duration and presence or absence of anti-CCP antibodies. Results: About 84.6% patients had different degrees of hallux valgus and 65.4% subjects had a pronated foot. These two foot alterations were prevalently found in patients with long-standing disease and circulating anti-CCP antibodies. On the contrary, RA patients without anti-CCP and early disease essentially displayed a supinated foot without relevant hallux valgus deformity. Conclusion: Our findings allowed to identify different anatomic foot alterations in RA patients according to disease duration and negative prognostic factors such as anti-CCP antibodies. Our findings support the role of an accurate analysis of foot structural damage and may suggest the usefulness of a correct plantar orthosis prescription also in early phases of the disease.

A feasibility study of UMTS mobile phones for supporting nurses doing home visits to patients with diabetic foot ulcers

DEFF Research Database (Denmark)

Larsen, Simon Bo; Clemensen, Jane; Ejskjær, Niels

2006-01-01

We tested the feasibility of Universal Mobile Telephone System (UMTS) mobile phones for video consultations in the home. Five patients with diabetic foot ulcers were included in the study. Each of them was offered three video consultations instead of visits to the hospital outpatient clinic....... The consultations took from 5 to 18 min. In all 15 consultations, the hospital experts were able to assess the ulcer in cooperation with the visiting nurse and to decide on the treatment. However, technical problems sometimes made it difficult for them. Connectivity problems occurred in seven of the 15...... consultations. Also, the audio signal was rather unstable at times. In all situations except one, however, the clinicians were able to reach a decision that the expert felt confident about, and after all consultations the atmosphere and participants' attitudes were very positive....

The prevalence of diabetic foot disease in the Waikato region.

Science.gov (United States)

O'Shea, C; McClintock, J; Lawrenson, R

2017-07-01

The aim of this study was to establish the prevalence of diabetic foot disease by utilising the retinal eye screening register in the Waikato region of New Zealand. Understanding both the prevalence and the degree of foot disease across the general diabetes population will help to determine what podiatry services are required for people with diabetes. 2192 people aged 15years and over, who attended the Waikato Regional Diabetes Service mobile retinal photo screening service for the six-month period between May and November 2014, consented to a foot screen including testing for sensation and pedal pulses. A digital image was taken of the dorsal and plantar aspect of each foot for review by a registered Podiatrist. Thirteen percent of the study sample was identified as having a high-risk foot including active foot complications. 65% were categorised as low risk and a further 22% at moderate risk of diabetic foot disease. Factors identified as significant included age, type of diabetes, duration of diabetes, and smoking. These factors placed people at greater risk of diabetic foot disease. A significant number of people with diabetes are at risk of diabetic foot disease. This study has highlighted the need for targeted podiatry services to address diabetic foot disease. Copyright © 2017 Elsevier B.V. All rights reserved.

Maternal mobile phone exposure alters intrinsic electrophysiological properties of CA1 pyramidal neurons in rat offspring.

Science.gov (United States)

Razavinasab, Moazamehosadat; Moazzami, Kasra; Shabani, Mohammad

2016-06-01

Some studies have shown that exposure to electromagnetic field (EMF) may result in structural damage to neurons. In this study, we have elucidated the alteration in the hippocampal function of offspring Wistar rats (n = 8 rats in each group) that were chronically exposed to mobile phones during their gestational period by applying behavioral, histological, and electrophysiological tests. Rats in the EMF group were exposed to 900 MHz pulsed-EMF irradiation for 6 h/day. Whole cell recordings in hippocampal pyramidal cells in the mobile phone groups did show a decrease in neuronal excitability. Mobile phone exposure was mostly associated with a decrease in the number of action potentials fired in spontaneous activity and in response to current injection in both male and female groups. There was an increase in the amplitude of the afterhyperpolarization (AHP) in mobile phone rats compared with the control. The results of the passive avoidance and Morris water maze assessment of learning and memory performance showed that phone exposure significantly altered learning acquisition and memory retention in male and female rats compared with the control rats. Light microscopy study of brain sections of the control and mobile phone-exposed rats showed normal morphology.Our results suggest that exposure to mobile phones adversely affects the cognitive performance of both female and male offspring rats using behavioral and electrophysiological techniques. © The Author(s) 2014.

Foot Function, Foot Pain, and Falls in Older Adults: The Framingham Foot Study.

Science.gov (United States)

Awale, Arunima; Hagedorn, Thomas J; Dufour, Alyssa B; Menz, Hylton B; Casey, Virginia A; Hannan, Marian T

2017-01-01

Although foot pain has been linked to fall risk, contributions of pain severity, foot posture, or foot function are unclear. These factors were examined in a cohort of older adults. The purpose of this study was to examine the associations of foot pain, severity of foot pain, and measures of foot posture and dynamic foot function with reported falls in a large, well-described cohort of older adults from the Framingham Foot Study. Foot pain, posture, and function were collected from Framingham Foot Study participants who were queried about falls over the past year (0, 1, and ≥2 falls). Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of falls with foot pain, pain severity, foot posture, and foot function adjusting for covariates. The mean age of the 1,375 participants was 69 years; 57% were female, and 21% reported foot pain (40% mild pain, 47% moderate pain, and 13% severe pain). One-third reported falls in the past year (1 fall: n = 263, ≥2 falls: n = 152). Foot pain was associated with a 62% increased odds of recurrent falls. Those with moderate and severe foot pain showed increased odds of ≥2 falls (OR 1.78, CI 1.06-2.99, and OR 3.25, CI 1.65-7.48, respectively) compared to those with no foot pain. Foot function was not associated with falls. Compared to normal foot posture, those with planus foot posture had 78% higher odds of ≥2 falls. Higher odds of recurrent falls were observed in individuals with foot pain, especially severe foot pain, as well as in individuals with planus foot posture, indicating that both foot pain and foot posture may play a role in increasing the risk of falls among older adults. © 2017 S. Karger AG, Basel.

Effect of Acute Alterations in Foot Strike Patterns during Running on Sagittal Plane Lower Limb Kinematics and Kinetics

Directory of Open Access Journals (Sweden)

Kevin A. Valenzuela, Scott K. Lynn, Lisa R. Mikelson, Guillermo J. Noffal, Daniel A. Judelson

2015-03-01

Full Text Available subjects were identified through slow motion video playback (n = 21, age = 22.8±2.2 years, mass = 73.1±14.5 kg, height 1.75 ± 0.10 m. On day two, subjects performed five overground run trials in both their natural and unnatural strike patterns while motion and force data were collected. Data were collected over two days so that foot strike videos could be analyzed for group placement purposes. Several 2 (Foot Strike Pattern –forefoot strike [FFS], rearfoot strike [RFS] x 2 (Group – PFFG, PRFG mixed model ANOVAs (p < 0.05 were run on speed, active peak vertical ground reaction force (VGRF, peak early stance and mid stance sagittal ankle moments, sagittal plane hip and knee moments, ankle dorsiflexion ROM, and sagittal plane hip and knee ROM. There were no significant interactions or between group differences for any of the measured variables. Within subject effects demonstrated that the RFS condition had significantly lower (VGRF (RFS = 2.58 ± .21 BW, FFS = 2.71 ± 0.23 BW, dorsiflexion moment (RFS = -2.6 1± 0.61 Nm·kg-1, FFS = -3.09 ± 0.32 Nm·kg-1, and dorsiflexion range of motion (RFS = 17.63 ± 3.76°, FFS = 22.10 ± 5.08°. There was also a significantly higher peak plantarflexion moment (RFS = 0.23 ± 0.11 Nm·kg-1, FFS = 0.01 ± 0.01 Nm·kg-1, peak knee moment (RFS = 2.61 ± 0.54 Nm·kg-1, FFS = 2.39 ± 0.61 Nm·kg-1, knee ROM (RFS = 31.72 ± 2.79°, FFS = 29.58 ± 2.97°, and hip ROM (RFS = 42.72 ± 4.03°, FFS = 41.38 ± 3.32° as compared with the FFS condition. This research suggests that acute changes in foot strike patterns during shod running can create alterations in certain lower limb kinematic and kinetic measures that are not dependent on the preferred foot strike pattern of the individual. This research also challenges the contention that the impact transient spike in the vertical ground reaction force curve is only present during a rear foot strike type of running gait.

Change of cortical foot activation following 70 days of head down bed rest.

Science.gov (United States)

Yuan, Peng; Koppelmans, Vincent; Reuter-Lorenz, Patricia; De Dios, Yiri; Gadd, Nichole; Riascos, Roy; Kofman, Igor; Bloomberg, Jacob; Mulavara, Ajitkumar; Seidler, Rachael D

2018-02-28

Head-down tilt bed rest (HDBR) has been used as a spaceflight analog to study some of the effects of microgravity on human physiology, cognition, and sensorimotor functions. Previous studies have reported declines in balance control and functional mobility after spaceflight and HDBR. Here we investigated how the brain activation for foot movement changed with HDBR. Eighteen healthy men participated in the current HDBR study. They were in a 6{degree sign} head-down tilt position continuously for 70 days. Functional MRI scans were acquired to estimate brain activation for foot movement pre-, during- and post-HDBR. Another eleven healthy males who did not undergo HDBR participated as control subjects and were scanned at four time points. In the HDBR subjects, the cerebellum, fusiform gyrus, hippocampus, and middle occipital gyrus exhibited HDBR-related increases in activation for foot tapping, whereas no HDBR-associated activation decreases were found. For the control subjects, activation for foot tapping decreased across sessions in a couple of cerebellar regions, while no activation increase with session was found. Furthermore, we observed that less HDBR-related declines in functional mobility and balance control were associated with greater pre-to-post HDBR increases in brain activation for foot movement in several cerebral and cerebellar regions. Our results suggest that more neural control is needed for foot movement as a result of HDBR.

Standardizing foot-type classification using arch index values.

Science.gov (United States)

Wong, Christopher Kevin; Weil, Rich; de Boer, Emily

2012-01-01

The lack of a reliable classification standard for foot type makes drawing conclusions from existing research and clinical decisions difficult, since different foot types may move and respond to treatment differently. The purpose of this study was to determine interrater agreement for foot-type classification based on photo-box-derived arch index values. For this correlational study with two raters, a sample of 11 healthy volunteers with normal to obese body mass indices was recruited from both a community weight-loss programme and a programme in physical therapy. Arch index was calculated using AutoCAD software from footprint photographs obtained via mirrored photo-box. Classification as high-arched, normal, or low-arched foot type was based on arch index values. Reliability of the arch index was determined with intra-class correlations; agreement on foot-type classification was determined using quadratic weighted kappa (κw). Average arch index was 0.215 for one tester and 0.219 for the second tester, with an overall range of 0.017 to 0.370. Both testers classified 6 feet as low-arched, 9 feet as normal, and 7 feet as high-arched. Interrater reliability for the arch index was ICC=0.90; interrater agreement for foot-type classification was κw=0.923. Classification of foot type based on arch index values derived from plantar footprint photographs obtained via mirrored photo-box showed excellent reliability in people with varying BMI. Foot-type classification may help clinicians and researchers subdivide sample populations to better differentiate mobility, gait, or treatment effects among foot types.

Standardizing Foot-Type Classification Using Arch Index Values

Science.gov (United States)

Weil, Rich; de Boer, Emily

2012-01-01

ABSTRACT Purpose: The lack of a reliable classification standard for foot type makes drawing conclusions from existing research and clinical decisions difficult, since different foot types may move and respond to treatment differently. The purpose of this study was to determine interrater agreement for foot-type classification based on photo-box-derived arch index values. Method: For this correlational study with two raters, a sample of 11 healthy volunteers with normal to obese body mass indices was recruited from both a community weight-loss programme and a programme in physical therapy. Arch index was calculated using AutoCAD software from footprint photographs obtained via mirrored photo-box. Classification as high-arched, normal, or low-arched foot type was based on arch index values. Reliability of the arch index was determined with intra-class correlations; agreement on foot-type classification was determined using quadratic weighted kappa (κw). Results: Average arch index was 0.215 for one tester and 0.219 for the second tester, with an overall range of 0.017 to 0.370. Both testers classified 6 feet as low-arched, 9 feet as normal, and 7 feet as high-arched. Interrater reliability for the arch index was ICC=0.90; interrater agreement for foot-type classification was κw=0.923. Conclusions: Classification of foot type based on arch index values derived from plantar footprint photographs obtained via mirrored photo-box showed excellent reliability in people with varying BMI. Foot-type classification may help clinicians and researchers subdivide sample populations to better differentiate mobility, gait, or treatment effects among foot types. PMID:23729964

Hemopathologic consequences of protracted gamma irradiation: alterations in granulocyte reserves and granulocyte mobilization

International Nuclear Information System (INIS)

Seed, T.M.; Cullen, S.M.; Kaspar, L.V.; Tolle, D.V.; Fritz, T.E.

1980-01-01

Aplastic anemia and myelogenous leukemia are prominent pathologic effects in beagles exposed to continuous, daily, low-dose gamma irradiation. In the present work, granulocyte reserves and related mobilization functions have been sequentially assessed by the endotoxin stress assay during the preclinical and clinical phases of these hemopoietic disorders. Characteristic patterns of granulocyte reserve mobilization are described that reflect given stages of pathologic progression. For radiation-induced leukemia, a five-stage pattern has been proposed. In contrast, a simple pattern of progressive, time-dependent contraction of granulocyte reserves and mobilization capacity was noted in the development of terminal aplastic anemia. Early preclinical phases of radiation-induced leukemia appear to involve an extensive depletion of the granulocyte reserves (phase I) during the first approx. 200 days of exposure followed by a partial renewal of the reserves and associated mobilization functions between approx. 200 and 400 days (phase II). Sustained, subnormal granulocyte mobilizations (phase III) following endotoxin stress typify the responses of dogs during the intermediate phase, whereas late preclinical, preleukemic stages (phase IV) are characterized by a further expansion of the reserves and in the mobilization capacities, particularly of the less mature granulocytes. Such late alterations in the pattern of granulocyte mobilization, together with other noted cellular aberrancies in the peripheral blood and marrow, appear to indicate leukemia (phase V) onset

Validation of hand and foot anatomical feature measurements from smartphone images

Science.gov (United States)

Amini, Mohammad; Vasefi, Fartash; MacKinnon, Nicholas

2018-02-01

A smartphone mobile medical application, previously presented as a tool for individuals with hand arthritis to assess and monitor the progress of their disease, has been modified and expanded to include extraction of anatomical features from the hand (joint/finger width, and angulation) and foot (length, width, big toe angle, and arch height index) from smartphone camera images. Image processing algorithms and automated measurements were validated by performing tests on digital hand models, rigid plastic hand models, and real human hands and feet to determine accuracy and reproducibility compared to conventional measurement tools such as calipers, rulers, and goniometers. The mobile application was able to provide finger joint width measurements with accuracy better than 0.34 (+/-0.25) millimeters. Joint angulation measurement accuracy was better than 0.50 (+/-0.45) degrees. The automatically calculated foot length accuracy was 1.20 (+/-1.27) millimeters and the foot width accuracy was 1.93 (+/-1.92) millimeters. Hallux valgus angle (used in assessing bunions) accuracy was 1.30 (+/-1.29) degrees. Arch height index (AHI) measurements had an accuracy of 0.02 (+/-0.01). Combined with in-app documentation of symptoms, treatment, and lifestyle factors, the anatomical feature measurements can be used by both healthcare professionals and manufacturers. Applications include: diagnosing hand osteoarthritis; providing custom finger splint measurements; providing compression glove measurements for burn and lymphedema patients; determining foot dimensions for custom shoe sizing, insoles, orthotics, or foot splints; and assessing arch height index and bunion treatment effectiveness.

Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic flatfeet using the Oxford Foot Model.

Science.gov (United States)

Hösl, Matthias; Böhm, Harald; Multerer, Christel; Döderlein, Leonhard

2014-01-01

Treatment of asymptomatic flexible flatfeet is a subject of great controversy. The purpose of this study was to examine foot function during walking in symptomatic (SFF) and asymptomatic (ASFF) flexible flatfeet. Thirty-five paediatric and juvenile patients with idiopathic flexible flatfeet were recruited from an orthopaedic outpatient department (14 SFF and 21 ASFF). Eleven age-matched participants with typically developing feet served as controls (TDF). To study foot function, 3D multi-segment foot kinematics and ankle joint kinetics were captured during barefoot gait analysis. Overall, alterations in foot kinematics in flatfeet were pronounced but differences between SFF and ASFF were not observed. Largest discriminatory effects between flatfeet and TDF were noticed in reduced hindfoot dorsiflexion as well as in increased forefoot supination and abduction. Upon clinical examination, restrictions in passive dorsiflexion in ASFF and SFF were significant. During gait, the hindfoot in flatfeet (both ASFF and SFF) was more everted, but less flexible. In sagittal plane, limited hindfoot dorsiflexion of ASFF and SFF was compensated for by increased forefoot mobility and a hypermobile hallux. Concerning ankle kinetics, SFF lacked positive joint energy for propulsion while ASFF needed to absorb more negative ankle joint energy during loading response. This may risk fatigue and overuse syndrome of anterior shank muscles in ASFF. Hence, despite a lack of symptoms flatfoot deformity in ASFF affected function. Yet, contrary to what was expected, SFF did not show greater deviations in 3D foot kinematics than ASFF. Symptoms may rather depend on tissue wear and subjective pain thresholds. Copyright © 2013. Published by Elsevier B.V.

Modelling foot height and foot shape-related dimensions.

Science.gov (United States)

Xiong, Shuping; Goonetilleke, Ravindra S; Witana, Channa P; Lee Au, Emily Yim

2008-08-01

The application of foot anthropometry to design good-fitting footwear has been difficult due to the lack of generalised models. This study seeks to model foot dimensions so that the characteristic shapes of feet, especially in the midfoot region, can be understood. Fifty Hong Kong Chinese adults (26 males and 24 females) participated in this study. Their foot lengths, foot widths, ball girths and foot heights were measured and then evaluated using mathematical models. The results showed that there were no significant allometry (p > 0.05) effects of foot length on ball girth and foot width. Foot height showed no direct relationship with foot length. However, a normalisation with respect to foot length and foot height resulted in a significant relationship for both males and females with R(2) greater than 0.97. Due to the lack of a direct relationship between foot height and foot length, the current practice of grading shoes with a constant increase in height or proportionate scaling in response to foot length is less than ideal. The results when validated with other populations can be a significant way forward in the design of footwear that has an improved fit in the height dimension.

Design and test of a hybrid foot force sensing and GPS system for richer user mobility activity recognition.

Science.gov (United States)

Zhang, Zelun; Poslad, Stefan

2013-11-01

Wearable and accompanied sensors and devices are increasingly being used for user activity recognition. However, typical GPS-based and accelerometer-based (ACC) methods face three main challenges: a low recognition accuracy; a coarse recognition capability, i.e., they cannot recognise both human posture (during travelling) and transportation mode simultaneously, and a relatively high computational complexity. Here, a new GPS and Foot-Force (GPS + FF) sensor method is proposed to overcome these challenges that leverages a set of wearable FF sensors in combination with GPS, e.g., in a mobile phone. User mobility activities that can be recognised include both daily user postures and common transportation modes: sitting, standing, walking, cycling, bus passenger, car passenger (including private cars and taxis) and car driver. The novelty of this work is that our approach provides a more comprehensive recognition capability in terms of reliably recognising both human posture and transportation mode simultaneously during travel. In addition, by comparing the new GPS + FF method with both an ACC method (62% accuracy) and a GPS + ACC based method (70% accuracy) as baseline methods, it obtains a higher accuracy (95%) with less computational complexity, when tested on a dataset obtained from ten individuals.

The effects of common footwear on stance-phase mechanical properties of the prosthetic foot-shoe system.

Science.gov (United States)

Major, Matthew J; Scham, Joel; Orendurff, Michael

2018-04-01

Prosthetic feet are prescribed based on their mechanical function and user functional level. Subtle changes to the stiffness and hysteresis of heel, midfoot, and forefoot regions can influence the dynamics and economy of gait in prosthesis users. However, the user's choice of shoes may alter the prosthetic foot-shoe system mechanical characteristics, compromising carefully prescribed and rigorously engineered performance of feet. Observe the effects of footwear on the mechanical properties of the prosthetic foot-shoe system including commonly prescribed prosthetic feet. Repeated-measures, Mechanical characterization. The stiffness and energy return was measured using a hydraulic-driven materials test machine across combinations of five prosthetic feet and four common shoes as well as a barefoot condition. Heel energy return decreased by an average 4%-9% across feet in all shoes compared to barefoot, with a cushioned trainer displaying the greatest effect. Foot designs that may improve perceived stability by providing low heel stiffness and rapid foot-flat were compromised by the addition of shoes. Shoes altered prosthesis mechanical characteristics in the sagittal and frontal planes, suggesting that shoe type should be controlled or reported in research comparing prostheses. Understanding of how different shoes could alter certain gait-related characteristics of prostheses may aid decisions on footwear made by clinicians and prosthesis users. Clinical relevance Shoes can alter function of the prosthetic foot-shoe system in unexpected and sometimes undesirable ways, often causing similar behavior across setups despite differences in foot design, and prescribing clinicians should carefully consider these effects on prosthesis performance.

Multisegmental Foot and Ankle Motion Analysis After Hallux Valgus Surgery

Science.gov (United States)

Canseco, Karl; Long, Jason; Smedberg, Thomas; Tarima, Sergey; Marks, Richard M.; Harris, Gerald F.

2015-01-01

Background Gait changes in patients with hallux valgus, including altered kinematic and temporal-spatial parameters, have been documented in the literature. Although operative treatment can yield favorable clinical and radiographic results, restoration of normal gait in this population remains unclear. Segmental kinematic changes within the foot and ankle during ambulation after operative correction of hallux valgus have not been reported. The aim of this study was to analyze changes in multisegmental foot and ankle kinematics in patients who underwent operative correction of hallux valgus. Methods A 15-camera Vicon Motion Analysis System was used to evaluate 24 feet in 19 patients with hallux valgus preoperatively and postoperatively. The Milwaukee Foot Model was used to characterize segmental kinematics and temporal-spatial parameters (TSPs). Preoperative and postoperative kinematics and TSPs were compared using paired nonparametric methods; comparisons with normative data were performed using unpaired nonparametric methods. Outcomes were evaluated using the SF-36 assessment tool. Results Preoperatively, patients with hallux valgus showed significantly altered temporal-spatial and kinematic parameters. Postoperatively, kinematic analysis demonstrated restoration of hallux position to normal. Hallux valgus angles and intermetatarsal angles were significantly improved, and outcomes showed a significant increase in performance of physical activities. Temporal-spatial parameters and kinematics in the more proximal segments were not significantly changed postoperatively. Conclusion Postoperative results demonstrated significant improvement in foot geometry and hallux kinematics in the coronal and transverse planes. However, the analysis did not identify restoration of proximal kinematics. Clinical Relevance Further investigation is necessary to explore possible causes/clinical relevance and appropriate treatment interventions for the persistently altered kinematics

Sweat function in the diabetic foot

Directory of Open Access Journals (Sweden)

Markendeya Nirmala

2004-01-01

Full Text Available Background: Autonomic dysfunction, an early manifestation of diabetic neuropathy, presents with altered sweating patterns, leading to dryness and fissuring. We conducted a study to assess the sweat function in the diabetic foot and to determine the interrelation between the duration of diabetes, sensation, fissuring, and sweating. Methods: The sweat function was assessed in 30 diabetic patients, 28 of whom had fissuring of the feet, using Ninhydrin impregnated discs. Results: There was a significant association between fissuring and sensation, but not between the duration of diabetes and fissuring and between loss of sweating and fissuring. In 18 patients (60% there was impairment or absence of sweating in the presence of normal sensation. Conclusion: Although fissuring increases with long-standing diabetes and sweating is reduced in diabetic patients with fissures on the foot, the correlation between these entities was not statistically significant. Since 60% patients had altered sweating in the presence of normal sensations, the sweat test can be used as an early indicator of diabetic neuropathy.

Hyperbaric oxygen in the treatment of a diabetic foot ulcer.

LENUS (Irish Health Repository)

Davenport, Colin

2011-02-01

Although simultaneous pancreas and kidney transplant improves most complications of type 1 diabetes, suppression of the immune system increases the risk for infection. The authors report the case of a patient who, despite receiving a simultaneous pancreas and kidney transplant, subsequently developed neuro-ischemic ulcers of his right foot requiring repeated amputations. He then developed an infected ulcer of his remaining right big toe, with significant implications for his mobility. This ulcer proved resistant to multiple courses of antibiotics and care in a specialist foot clinic but resolved completely following a course of hyperbaric oxygen therapy. The role of hyperbaric oxygen in diabetic foot ulcers is not yet fully established but should be considered in resistant cases with vascular insufficiency and a significant infective component.

Hyperbaric oxygen in the treatment of a diabetic foot ulcer.

LENUS (Irish Health Repository)

Davenport, Colin

2012-02-01

Although simultaneous pancreas and kidney transplant improves most complications of type 1 diabetes, suppression of the immune system increases the risk for infection. The authors report the case of a patient who, despite receiving a simultaneous pancreas and kidney transplant, subsequently developed neuro-ischemic ulcers of his right foot requiring repeated amputations. He then developed an infected ulcer of his remaining right big toe, with significant implications for his mobility. This ulcer proved resistant to multiple courses of antibiotics and care in a specialist foot clinic but resolved completely following a course of hyperbaric oxygen therapy. The role of hyperbaric oxygen in diabetic foot ulcers is not yet fully established but should be considered in resistant cases with vascular insufficiency and a significant infective component.

Effects of mobile phone use on specific intensive care unit devices.

Science.gov (United States)

Hans, Nidhi; Kapadia, Farhad N

2008-10-01

To observe the effects of mobile phone use in the vicinity of medical devices used in a critical care setting. Electromagnetic interference (EMI) was tested by using two types of mobile phones - GSM and CDMA. Mobile phones were placed at a distance of one foot from three medical devices - syringe pump, mechanical ventilator, and the bedside monitor - in switch off, standby, and talking modes of the phone. Medical devices were observed for any interference caused by the electromagnetic radiations (EMR) from the mobile phones. Out of the three medical devices that were tested, EMI occurred while using the mobile phone in the vicinity of the syringe pump, in the 'talk mode.' The mean variation observed in the calculated and delivered volume of the syringe pump was 2.66 ml. Mechanical ventilator did not show any specific adverse effects with mobile phone use in the one-foot vicinity. No other adverse effects or unexplained malfunctions or shutdown of the syringe pump, mechanical ventilator, or the bedside monitor was noted during the study period of 36 hours. EMI from mobile phones have an adverse effect on the medical devices used in critical care setup. They should be used at least one foot away from the diameter of the syringe pump.

A study of dynamic foot pressure measurement in diabetic patients

Directory of Open Access Journals (Sweden)

Milka D Madhale

2017-01-01

Full Text Available Introduction: Diabetic foot ulcer is a major source of morbidity and a leading cause of hospitalization. It is estimated that approximately 20% of hospital admissions among patients with diabetes mellitus are due to diabetic foot ulcer. It can lead to infection, gangrene, amputation, and even death if appropriate care is not provided. Overall, the lower limb amputation in diabetic patients is 15 times higher than in non-diabetics. In the majority of cases, the cause for the foot ulcer is the altered architecture of the foot due to neuropathy resulting in abnormal pressure points on the soles. Purpose: The aim of this study is to develop low cost, lightweight foot pressure scanner and check its reliability and validity which can help to prevent foot ulceration. Design/Methodology/Approach: In the present study, a low cost, lightweight foot pressure scanner is developed, and dynamic plantar pressures in a group of 110 Indian patients with diabetes with or without neuropathy and foot ulcers are measured. Practical Implications: If these pressure points can be detected, ulcers can be prevented by providing offloading footwear. Originality/Value: Differences are found in dynamic foot pressures in different study groups, namely, diabetic patients, patients with diabetic peripheral neuropathy, patients with foot ulcers, and nondiabetics. The differences are significant (P < 0.01, which showed the validity of the tool. Reliability and consistency of the tool was checked by test–retest method. Paper Type: Original Research work. Conclusion: Based on the results of the present study, it is concluded that the scanner is successfully developed and it can measure foot pressures. It is a novel device to proactively monitor foot health in diabetics in an effort to prevent and reduce diabetic foot complications.

The foot as a barrier in patients with early rheumatoid arthritis - an interview study among Swedish women and men.

Science.gov (United States)

Björk, Mathilda; Thyberg, Ingrid; Valtersson, Eva; Östlund, Gunnel; Stenström, Birgitta; Sverker, Annette

2017-12-01

Foot impairments are related to reduced mobility and participation restrictions in daily activities in patients with established rheumatoid arthritis (RA). The new biological medications are effective and reduce disease activity, but not disability to the same extent. Foot impairments are assumed to be related to participation restrictions also in patients with early RA, diagnosed after the introduction of biological medications. The knowledge of foot impairments needs to be more explored after the introduction of biological disease-modifying drugs (bDMARDs). The aim of this study was to explore the patients' perspective of foot impairments related to early RA. The sample included 59 patients (20-63 years) who were interviewed about participation dilemmas in daily life using the Critical Incident Technique. The interviews were audio-recorded and transcribed. Data related to foot impairments were extracted and analyzed thematically. A research partner validated the analysis. The study was approved by the Regional Ethics Committee. Patients with early RA described a variety of participation restrictions related to foot impairments: 1) foot hindrances in domestic life, 2) foot impairments influencing work, 3) leisure activities restricted by one's feet 4) struggling to be mobile 5) foot impairments as an early sign of rheumatic disease. There is a need to focus on foot impairments related to early RA, and for health care professionals to understand these signs. A suggestion for future research is to conduct a longitudinal follow-up of foot impairment related to medication, disease activity and disability in patients diagnosed after the introduction of bDMARDs. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Gait COP trajectory of left side hip-dislocation and scoliotic patient using ankle-foot orthoses

Science.gov (United States)

Chong, Albert K.; Alrikabi, Redha; Milburn, Peter

2017-07-01

Plantar pressure-sensing mats and insole plantar sensor pads are ideal low-cost alternatives to force plates for capturing plantar COP excursion during gait. The acquired COP traces, in the form of pedobarographic images are favored by many clinicians and allied health professionals for evaluation of foot loading and balance in relation to foot biomechanics, foot injury, foot deformation, and foot ulceration. Researchers have recommended the use of COP trace for the biomechanical study of the deformed foot and lower-limb to improve orthosis design and testing. A correctly designed orthoses improves mobility and reduces pain in the foot, lower limb and lower spine region during gait. The research was carried out to evaluate the performance of two types of orthosis, namely: a custom-molded orthosis and an over-the-counter molded orthosis to determine the quality of gait of an adult scoliotic patient. COP trace patterns were compared with those of a healthy adult and showed the design of the custom-molded orthosis resulted in an improved quality of movements and provided enhanced stability for the deformed left foot during gait.

Alterations to Bone Mineral Composition as an Early Indication of Osteomyelitis in the Diabetic Foot

OpenAIRE

Esmonde-White, Karen A.; Esmonde-White, Francis W.L.; Holmes, Crystal M.; Morris, Michael D.; Roessler, Blake J.

2013-01-01

OBJECTIVE Osteomyelitis in the diabetic foot is a major risk factor for amputation, but there is a limited understanding of early-stage infection, impeding limb-preserving diagnoses. We hypothesized that bone composition measurements provide insight into the early pathophysiology of diabetic osteomyelitis. RESEARCH DESIGN AND METHODS Compositional analysis by Raman spectroscopy was performed on bone specimens from patients with a clinical diagnosis of osteomyelitis in the foot requiring surgi...

Movement coordination patterns between the foot joints during walking

Directory of Open Access Journals (Sweden)

John B. Arnold

2017-10-01

Full Text Available Abstract Background In 3D gait analysis, kinematics of the foot joints are usually reported via isolated time histories of joint rotations and no information is provided on the relationship between rotations at different joints. The aim of this study was to identify movement coordination patterns in the foot during walking by expanding an existing vector coding technique according to an established multi-segment foot and ankle model. A graphical representation is also described to summarise the coordination patterns of joint rotations across multiple patients. Methods Three-dimensional multi-segment foot kinematics were recorded in 13 adults during walking. A modified vector coding technique was used to identify coordination patterns between foot joints involving calcaneus, midfoot, metatarsus and hallux segments. According to the type and direction of joints rotations, these were classified as in-phase (same direction, anti-phase (opposite directions, proximal or distal joint dominant. Results In early stance, 51 to 75% of walking trials showed proximal-phase coordination between foot joints comprising the calcaneus, midfoot and metatarsus. In-phase coordination was more prominent in late stance, reflecting synergy in the simultaneous inversion occurring at multiple foot joints. Conversely, a distal-phase coordination pattern was identified for sagittal plane motion of the ankle relative to the midtarsal joint, highlighting the critical role of arch shortening to locomotor function in push-off. Conclusions This study has identified coordination patterns between movement of the calcaneus, midfoot, metatarsus and hallux by expanding an existing vector cording technique for assessing and classifying coordination patterns of foot joints rotations during walking. This approach provides a different perspective in the analysis of multi-segment foot kinematics, and may be used for the objective quantification of the alterations in foot joint

A Wearable Foot-mounted / Instrument-mounted Effect Controller

DEFF Research Database (Denmark)

Konovalovs, Kristians; Zovnercuka, Jelizaveta; Adjorlu, Ali

2017-01-01

. The classic foot activated effect pedals that are used to alter the sound of the instrument are stationary, forcing the performer to return to the same location in order to interact with the pedals. This paper presents a new design that enables the performer to interact with the effect pedals anywhere...

Correlates between kinematics and baropodometric measurements for an integrated in-vivo assessment of the segmental foot function in gait.

Science.gov (United States)

Giacomozzi, Claudia; Leardini, Alberto; Caravaggi, Paolo

2014-08-22

Baropodometry and multi-segmental foot kinematics are frequently employed to obtain insight into the mechanics of the foot-ground interaction in both basic research and clinical settings. However, nothing hitherto has been reported on the full integration of kinematics with baropodometric parameters, and only a few studies have addressed the association between intersegmental kinematics and plantar loading within specific foot regions. The aim of this study was to understanding the relationships between foot joint mobility and plantar loading by focusing on the correlation between these two measures. An integrated pressure-force-kinematics system was used to measure plantar pressure and rotations between foot segments during the stance phase of walking in 10 healthy subjects. An anatomically-based mask was applied to each footprint to obtain six regions according to the position of the markers; hence each kinematic segment was paired with a corresponding area of the plantar surface. Relationships between segmental motion and relevant baropodometric data were explored by means of correlation analysis. Negative, weak-to-moderate correlations (R(2)plantar pressure in almost all regions. The study helps improve our understanding of the relationship between joint mobility and plantar loading in the healthy foot and represents a critical preliminary analysis before addressing possible clinical applications. Copyright © 2014 Elsevier Ltd. All rights reserved.

Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial.

Science.gov (United States)

Pham, H; Armstrong, D G; Harvey, C; Harkless, L B; Giurini, J M; Veves, A

2000-05-01

Diabetic foot ulceration is a preventable long-term complication of diabetes. A multicenter prospective follow-up study was conducted to determine which risk factors in foot screening have a high association with the development of foot ulceration. A total of 248 patients from 3 large diabetic foot centers were enrolled in a prospective study. Neuropathy symptom score, neuropathy disability score (NDS), vibration perception threshold (VPT), Semmes-Weinstein monofilaments (SWFs), joint mobility, peak plantar foot pressures, and vascular status were evaluated in all patients at the beginning of the study. Patients were followed-up every 6 months for a mean period of 30 months (range 6-40), and all new foot ulcers were recorded. The sensitivity, specificity, and positive predictive value of each risk factor were evaluated. Foot ulcers developed in 95 feet (19%) or 73 patients (29%) during the study. Patients who developed foot ulcers were more frequently men, had diabetes for a longer duration, had nonpalpable pedal pulses, had reduced joint mobility, had a high NDS, had a high VPT, and had an inability to feel a 5.07 SWE NDS alone had the best sensitivity, whereas the combination of the NDS and the inability to feel a 5.07 SWF reached a sensitivity of 99%. On the other hand, the best specificity for a single factor was offered by foot pressures, and the best combination was that of NDS and foot pressures. Univariate logistical regression analysis yielded a statistically significant odds ratio (OR) for sex, race, duration of diabetes, palpable pulses, history of foot ulceration, high NDSs, high VPTs, high SWFs, and high foot pressures. In addition, 94 (99%) of the 95 ulcerated feet had a high NDS and/or SWF which resulted in the highest OR of 26.2 (95% CI 3.6-190). Furthermore, in multivariate logistical regression analysis, the only significant factors were high NDSs, VPTs, SWFs, and foot pressures. Clinical examination and a 5.07 SWF test are the two most sensitive

Gait kinematics of subjects with ankle instability using a multisegmented foot model.

Science.gov (United States)

De Ridder, Roel; Willems, Tine; Vanrenterghem, Jos; Robinson, Mark; Pataky, Todd; Roosen, Philip

2013-11-01

Many patients who sustain an acute lateral ankle sprain develop chronic ankle instability (CAI). Altered ankle kinematics have been reported to play a role in the underlying mechanisms of CAI. In previous studies, however, the foot was modeled as one rigid segment, ignoring the complexity of the ankle and foot anatomy and kinematics. The purpose of this study was to evaluate stance phase kinematics of subjects with CAI, copers, and controls during walking and running using both a rigid and a multisegmented foot model. Foot and ankle kinematics of 77 subjects (29 subjects with self-reported CAI, 24 copers, and 24 controls) were measured during barefoot walking and running using a rigid foot model and a six-segment Ghent Foot Model. Data were collected on a 20-m-long instrumented runway embedded with a force plate and a six-camera optoelectronic system. Groups were compared using statistical parametric mapping. Both the CAI and the coper group showed similar differences during midstance and late stance compared with the control group (P foot segment showed a more everted position during walking compared with the control group. Based on the Ghent Foot Model, the rear foot also showed a more everted position during running. The medial forefoot showed a more inverted position for both running and walking compared with the control group. Our study revealed significant midstance and late stance differences in rigid foot, rear foot, and medial forefoot kinematics The multisegmented foot model demonstrated intricate behavior of the foot that is not detectable with rigid foot modeling. Further research using these models is necessary to expand knowledge of foot kinematics in subjects with CAI.

Treatment of congenital club foot with Ponseti method

Directory of Open Access Journals (Sweden)

Agrawal R

2005-01-01

Full Text Available Introduction: Idiopathic congenital talipes equinovarus (Club Foot is a complex deformity that is difficult to correct. The goal of treatment is to reduce or eliminate its four components so that the patient has a functional, pain free, plantigrade foot, with good mobility and without calluses, and does not need to wear modified shoes. Material and Methods: We have treated 41 patients with 60 idiopathic clubfoot deformity using Ponseti method of management. The severity of foot deformity was assessed according to the grading system of Dimeglio et al. Results: The mean number of casts that were applied to obtain correction was six (range four to nine casts. Tenotomy was done in 58 feet. Fifty eight feet had good results.Two patients developed recurrence of the deformity due to non-compliance of the use of orthrotics. Conclusion: The Ponseti method is a safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery. Non compliance with orthotics has been widely reported to be the main factor causing failure of the technique.

Foot morphometric phenomena.

Science.gov (United States)

Agić, Ante

2007-06-01

Knowledge of the foot morphometry is important for proper foot structure and function. Foot structure as a vital part of human body is important for many reasons. The foot anthropometric and morphology phenomena are analyzed together with hidden biomechanical descriptors in order to fully characterize foot functionality. For Croatian student population the scatter data of the individual foot variables were interpolated by multivariate statistics. Foot morphometric descriptors are influenced by many factors, such as life style, climate, and things of great importance in human society. Dominant descriptors related to fit and comfort are determined by the use 3D foot shape and advanced foot biomechanics. Some practical recommendations and conclusions for medical, sportswear and footwear practice are highlighted.

Foot morphology of Turkish football players according to foot ...

African Journals Online (AJOL)

Football is the most popular sport in the world. Foot morphology and foot preference are important factors in football player's performance. The aim of this cross-sectional study was to evaluate the foot morphology of elite football players with different foot preferences. 407 male football players participated in this study. 328 of ...

Differences in foot kinematics between young and older adults during walking.

Science.gov (United States)

Arnold, John B; Mackintosh, Shylie; Jones, Sara; Thewlis, Dominic

2014-02-01

Our understanding of age-related changes to foot function during walking has mainly been based on plantar pressure measurements, with little information on differences in foot kinematics between young and older adults. The purpose of this study was to investigate the differences in foot kinematics between young and older adults during walking using a multi-segment foot model. Joint kinematics of the foot and ankle for 20 young (mean age 23.2 years, standard deviation (SD) 3.0) and 20 older adults (mean age 73.2 years, SD 5.1) were quantified during walking with a 12 camera Vicon motion analysis system using a five segment kinematic model. Differences in kinematics were compared between older adults and young adults (preferred and slow walking speeds) using Student's t-tests or if indicated, Mann-Whitney U tests. Effect sizes (Cohen's d) for the differences were also computed. The older adults had a less plantarflexed calcaneus at toe-off (-9.6° vs. -16.1°, d = 1.0, p = range of motion (ROM) of the midfoot (11.9° vs. 14.8°, d = 1.3, p = young adults. Walking speed did not influence these differences, as they remained present when groups walked at comparable speeds. The findings of this study indicate that independent of walking speed, older adults exhibit significant differences in foot kinematics compared to younger adults, characterised by less propulsion and reduced mobility of multiple foot segments. Copyright © 2013 Elsevier B.V. All rights reserved.

Adding Stiffness to the Foot Modulates Soleus Force-Velocity Behaviour during Human Walking

Science.gov (United States)

Takahashi, Kota Z.; Gross, Michael T.; van Werkhoven, Herman; Piazza, Stephen J.; Sawicki, Gregory S.

2016-07-01

Previous studies of human locomotion indicate that foot and ankle structures can interact in complex ways. The structure of the foot defines the input and output lever arms that influences the force-generating capacity of the ankle plantar flexors during push-off. At the same time, deformation of the foot may dissipate some of the mechanical energy generated by the plantar flexors during push-off. We investigated this foot-ankle interplay during walking by adding stiffness to the foot through shoes and insoles, and characterized the resulting changes in in vivo soleus muscle-tendon mechanics using ultrasonography. Added stiffness decreased energy dissipation at the foot (p < 0.001) and increased the gear ratio (i.e., ratio of ground reaction force and plantar flexor muscle lever arms) (p < 0.001). Added foot stiffness also altered soleus muscle behaviour, leading to greater peak force (p < 0.001) and reduced fascicle shortening speed (p < 0.001). Despite this shift in force-velocity behaviour, the whole-body metabolic cost during walking increased with added foot stiffness (p < 0.001). This increased metabolic cost is likely due to the added force demand on the plantar flexors, as walking on a more rigid foot/shoe surface compromises the plantar flexors’ mechanical advantage.

Foot health and quality of life among university students: cross-sectional study

Directory of Open Access Journals (Sweden)

David Rodríguez-Sanz

2018-03-01

Full Text Available ABSTRACT BACKGROUND: Foot problems are believed to reduce quality of life and are increasingly present. Even among young adults of university age, untreated foot problems can lead to postural and mobility problems. Accordingly, our aim here was to determine the relationship between foot health and quality of life and general health among male and female university students. DESIGN AND SETTING: Observational cross-sectional quantitative study conducted at the Podiatric Medicine and Surgery Clinic of the University of Coruña, Ferrol, Spain. METHODS: A sample of 112 participants of median age 22 years came to a health center, where self-reported data were registered, including professional activity, and scores obtained through the Foot Health Status Questionnaire (FHSQ were compared. RESULTS: In Section One of the FHSQ, the university students recorded lower scores of 66.66 in the footwear domain and 60 in the general foot health domain and higher scores of 84.37 in the foot pain domain and 93.75 in the foot function domain. In Section Two, they obtained lower scores of 60 in the overall health domain and 62.50 in the vigor domain and higher scores of 100 in the physical activity and 87.50 in the social capacity domain. Differences between males and females were evaluated using the Wilcoxon rank-sum test, which showing statistical significance (P < 0.05 regarding the dimensions of footwear and general foot health. CONCLUSIONS: These university students’ quality of life relating to foot health was poor. This appears to be associated with the university period, regardless of gender.

Effect of Foot Massage on Physiologic Indicators in Critically Ill Patients Admitted in the I.C.U

Directory of Open Access Journals (Sweden)

H Alavi- Majd

2006-10-01

conc.10 minutes before massage and values at 30 minutes after foot massage were more than the values10 minutes before and 10 minutes after foot massage (p<0.001, Decrease in temperature on third and fourth days of ICU admission 10 minutes and 30 minutes after foot massage as compared to 10 minutes before massage was significant, but alterations were little and clinically, we can say that body temperature did not alter and approximately remind constant. Data analysis also showed that alterations in values of physiologic indicators during the three days of manipulation were the same and there was no difference between the alterations on different days (p<0.001. Conclusion: In general, parasympathetic activity after foot massages results in alteration of body physiologic responses. Decrease in heart rate, mean arterial pressure and respiratory rate along with increase in arterial oxygen concentration showed that patients were less anxious and more relaxed.

[Anlysis of foot biomechanics characteristic in 303 patients with type 2 diabetes mellitus].

Science.gov (United States)

Li, Wen-Xia; Cao, Ying; Zou, Meng-Chen; Huang, Ying; Hu, Ping; Luo, Xiang-Rong; Jiang, Ya; Xue, Yao-Ming; Gao, Fang

2016-10-20

To investigate foot biomechanics characteristic of patients with type 2 diabetes mellitus. This study was conducted among 303 patients with type 2 diabetes. The whole foot was divided into 10 regions, namely the first toe (T1); the second to fifth toes (T2-5); the first, second, third, fourth, and fifth metatarsals (M1, M2, M3, M4, and M5, respectively); midfoot (MF), and the heel medial (HM). Foot arch index, foot angle and maximum peak pressure (MPP) of the 10 regions were measured using a Footscan gait system. The maximum peak pressure of 10 regions decreased in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the left foot, and in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the right foot. The MPP in M1 region was higher in the right than in the left foot (Ppatients. Foot flat phase was extended and forefoot push-off phase shortened in stance phase in the patients. Compared with the right foot, the left foot showed a significantly increased foot arch index and increased low and high arch rates with a decreased normal arch rate. Total plantar pressure was higher in of the left high arch foot than in normal arch foot. The foot angle was significantly larger on the right than on the left. The bilateral total plantar pressures were significantly greater in male patients (Ppatients have obvious alterations in foot biomechanics with abnormalities of the plantar pressure, and the percentage of high-risk foot increases in overweight and obese patients, suggesting the need of body weight control in these patients when administering offloading treatment for prevention of diabetic foot ulcer.

The VSPA Foot: A Quasi-Passive Ankle-Foot Prosthesis With Continuously Variable Stiffness.

Science.gov (United States)

Shepherd, Max K; Rouse, Elliott J

2017-12-01

Most commercially available prosthetic feet do not exhibit a biomimetic torque-angle relationship, and are unable to modulate their mechanics to assist with other mobility tasks, such as stairs and ramps. In this paper, we present a quasi-passive ankle-foot prosthesis with a customizable torque-angle curve and an ability to quickly modulate ankle stiffness between tasks. The customizable torque-angle curve is obtained with a cam-based transmission and a fiberglass leaf spring. To achieve variable stiffness, the leaf spring's support conditions can be actively modulated by a small motor, shifting the torque-angle curve to be more or less stiff. We introduce the design, characterize the available torque-angle curves, and present kinematics from a transtibial amputee subject performing level-ground walking, stair ascent/descent, and ramp ascent/descent. The subject exhibited a more normative range of motion on stairs and ramps at lower stiffness levels, and preferred different stiffness levels for each task. Paired with an appropriate intent recognition system, our novel ankle prosthesis could improve gait biomechanics during walking and many other mobility tasks.

Foot Health

Science.gov (United States)

... straight across and not too short Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling ... foot checks are an important part of your health care. If you have foot problems, be sure ...

Weight transfer analysis in adults with hemiplegia using ankle foot orthosis.

Science.gov (United States)

Nolan, Karen J; Yarossi, Mathew

2011-03-01

Identifying and understanding the changes in transfer of momentum that are directly affected by orthotic intervention are significant factors related to the improvement of mobility in individuals with hemiplegia. The purpose of this investigation was to use a novel analysis technique to objectively measure weight transfer during double support (DS) in healthy individuals and individuals with hemiplegia secondary to stroke with and without an ankle foot orthosis. Prospective, Repeated measures, case-controlled trial. Participants included 25 adults with stroke-related hemiplegia >6 months using a prescribed ankle foot orthosis and 12 age-matched healthy controls. Main outcome measures included the weight transfer point timing (WTP, %DS), maximum total force timing (MTF, %DS), timing difference between WTP and MTF (MTF-WTP, %DS) and the linearity of loading (LOL, R(2)) during the DS phase of the gait cycle. The WTP and LOL were significantly different between conditions with and without the ankle foot orthosis for the affected and unaffected limb in post-stroke individuals, p ≤ 0.01. The MTF and difference in timing between MTF-WTP were significantly different during affected limb loading with and without the ankle foot orthosis in the stroke group, p ≤ 0.0001 and p = 0.03, respectively. MTF, MTF-WTP and LOL were significantly different between individuals with stroke (during affected limb loading) and healthy controls (during right limb loading). This research established a systematic method for analysing weight transfer during walking to evaluate the effect of an ankle foot orthosis on loading during double support in hemiplegic gait. This novel method can be used to elucidate biomechanical mechanisms behind orthosis-mediated changes in gait patterns and quantify functional mobility outcomes in rehabilitation. This novel approach to orthotic assessment will provide the clinician with needed objective evidence to select the most effective orthotic

Optimization of prosthetic foot stiffness to reduce metabolic cost and intact knee loading during below-knee amputee walking: a theoretical study.

Science.gov (United States)

Fey, Nicholas P; Klute, Glenn K; Neptune, Richard R

2012-11-01

Unilateral below-knee amputees develop abnormal gait characteristics that include bilateral asymmetries and an elevated metabolic cost relative to non-amputees. In addition, long-term prosthesis use has been linked to an increased prevalence of joint pain and osteoarthritis in the intact leg knee. To improve amputee mobility, prosthetic feet that utilize elastic energy storage and return (ESAR) have been designed, which perform important biomechanical functions such as providing body support and forward propulsion. However, the prescription of appropriate design characteristics (e.g., stiffness) is not well-defined since its influence on foot function and important in vivo biomechanical quantities such as metabolic cost and joint loading remain unclear. The design of feet that improve these quantities could provide considerable advancements in amputee care. Therefore, the purpose of this study was to couple design optimization with dynamic simulations of amputee walking to identify the optimal foot stiffness that minimizes metabolic cost and intact knee joint loading. A musculoskeletal model and distributed stiffness ESAR prosthetic foot model were developed to generate muscle-actuated forward dynamics simulations of amputee walking. Dynamic optimization was used to solve for the optimal muscle excitation patterns and foot stiffness profile that produced simulations that tracked experimental amputee walking data while minimizing metabolic cost and intact leg internal knee contact forces. Muscle and foot function were evaluated by calculating their contributions to the important walking subtasks of body support, forward propulsion and leg swing. The analyses showed that altering a nominal prosthetic foot stiffness distribution by stiffening the toe and mid-foot while making the ankle and heel less stiff improved ESAR foot performance by offloading the intact knee during early to mid-stance of the intact leg and reducing metabolic cost. The optimal design also

MEMS technology sensors as a more advantageous technique for measuring foot plantar pressure and balance in humans

OpenAIRE

Sanz Morère, C. (Clara); Surażyński, Ł. (Łukasz); Rodrigo Pérez-Tabernero, A. (Ana); Vihriälä, E. (Erkki); Myllylä, T. (Teemu)

2016-01-01

Abstract Locomotor activities are part and parcel of daily human life. During walking or running, feet are subjected to high plantar pressure, leading sometimes to limb problems, pain, or foot ulceration. A current objective in foot plantar pressure measurements is developing sensors that are small in size, lightweight, and energy efficient, while enabling high mobility, particularly for wearable applications. Moreover, improvements in spatial resolution, accuracy, and sensitivity are of i...

Stress Fractures of the Foot.

Science.gov (United States)

Hossain, Munier; Clutton, Juliet; Ridgewell, Mark; Lyons, Kathleen; Perera, Anthony

2015-10-01

Stress fractures of the foot and ankle may be more common among athletes than previously reported. A low threshold for investigation is warranted and further imaging may be appropriate if initial radiographs remain inconclusive. Most of these fractures can be treated conservatively with a period of non-weight-bearing mobilization followed by gradual return to activity. Early surgery augmented by bone graft may allow athletes to return to sports earlier. Risk of delayed union, nonunion, and recurrent fracture is high. Many of the patients may also have risk factors for injury that should be modified for a successful outcome. Copyright © 2015 Elsevier Inc. All rights reserved.

A 640 foot per second impact test of a two foot diameter model nuclear reactor containment system without fracture

Science.gov (United States)

Puthoff, R. L.

1971-01-01

An impact test was conducted on an 1142 pound 2 foot diameter sphere model. The purpose of this test was to determine the feasibility of containing the fission products of a mobile reactor in an impact. The model simulated the reactor core, energy absorbing gamma shielding, neutron shielding and the containment vessel. It was impacted against an 18,000 pound reinforced concrete block. The model was significantly deformed and the concrete block demolished. No leaks were detected nor cracks observed in the model after impact.

M.E.366-J embodiment design project: Portable foot restraint

Science.gov (United States)

Heaton, Randall; Meyer, Eikar; Schmidt, Davey; Enders, Kevin

1994-01-01

During space shuttle operations, astronauts require support to carry out tasks in the weightless environment. In the past, portable foot restraints (PFR) with orientations adjustable in pitch, roll, and yaw provided this support for payload bay operations. These foot restraints, however, were designed for specific tasks with a load limit of 111.2 Newtons. Since the original design, new applications for foot restraints have been identified. New designs for the foot restraints have been created to boost the operational work load to 444.8 Newtons and decrease setup times. What remains to be designed is an interface between the restraint system and the extravehicular mobility unit (EMU) boots. NASA provided a proposed locking device involving a spring-loaded mechanism. This locking mechanism must withstand loads of 1334.4 Newtons in any direction and weigh less than 222.4 Newtons. This paper develops an embodiment design for the interface between the PFR and the EMU boots. This involves design of the locking mechanism and a removable cleat that allows the boot to interface with this mechanism. The design team used the Paul Beitz engineering methodology to present the systematic development, structural analysis, and production considerations of the embodiment design. This methodology provides a basis for understanding the justification behind the decisions made in the design.

Functional β2-adrenoceptors in rat left atria: effect of foot-shock stress.

Science.gov (United States)

Moura, André Luiz de; Hyslop, Stephen; Grassi-Kassisse, Dora M; Spadari, Regina C

2017-09-01

Altered sensitivity to the chronotropic effect of catecholamines and a reduction in the β 1 /β 2 -adrenoceptor ratio have previously been reported in right atria of stressed rats, human failing heart, and aging. In this report, we investigated whether left atrial inotropism was affected by foot-shock stress. Male rats were submitted to 3 foot-shock sessions and the left atrial inotropic response, adenylyl cyclase activity, and β-adrenoceptor expression were investigated. Left atria of stressed rats were supersensitive to isoprenaline when compared with control rats and this effect was abolished by ICI118,551, a selective β 2 -receptor antagonist. Schild plot slopes for the antagonism between CGP20712A (a selective β 1 -receptor antagonist) and isoprenaline differed from unity in atria of stressed but not control rats. Atrial sensitivity to norepinephrine, as well as basal and forskolin- or isoprenaline-stimulated adenylyl cyclase activities were not altered by stress. The effect of isoprenaline on adenylyl cyclase stimulation was partially blocked by ICI118,551 in atrial membranes of stressed rats. These findings indicate that foot-shock stress equally affects inotropism and chronotropism and that β 2 -adrenoceptor upregulation contributes to the enhanced inotropic response to isoprenaline.

Meta-analysis on the efficacy of foot-and-mouth disease emergency vaccination

DEFF Research Database (Denmark)

Hisham Beshara Halasa, Tariq; Boklund, Anette; Cox, Sarah

2011-01-01

the results. Peer-reviewed, symposium, and unpublished studies were considered in the analysis. Clinical protection and virological protection against foot and mouth disease were used as parameters to assess the efficacy of emergency vaccination. The clinical protection was estimated based on the appearance...... publication bias tests. In total, 31 studies were included in the analyses, of which 26 were peer-reviewed studies, 1 was a symposium study and 4 were unpublished studies. Cattle, swine and sheep were well protected against clinical disease and foot and mouth disease infection following the use of emergency...... vaccine. Fortunately, no significant bias that would alter the conclusions was encountered in the analysis. Meta-analysis can be a useful tool to summarize literature results from a systematic review of the efficacy of foot and mouth disease emergency vaccination....

MR imaging features of foot involvement in patients with psoriasis

Energy Technology Data Exchange (ETDEWEB)

Erdem, C. Zuhal [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey)], E-mail: sunarerdem@yahoo.com; Tekin, Nilgun Solak [Department of Dermatology, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey); Sarikaya, Selda [Department of Physical Therapy and Rehabilitation, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey); Erdem, L. Oktay; Gulec, Sezen [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey)

2008-09-15

Objective: To determine alterations of the soft tissues, tendons, cartilage, joint spaces, and bones of the foot using magnetic resonance (MR) imaging in patients with psoriasis. Materials and methods: Clinical and MR examination of the foot was performed in 26 consecutive patients (52 ft) with psoriasis. As a control group, 10 healthy volunteers (20 ft) were also studied. Joint effusion/synovitis, retrocalcaneal bursitis, retroachilles bursitis, Achilles tendonitis, soft-tissue edema, para-articular enthesophytes, bone marrow edema, sinus tarsi syndrome, enthesopathy at the Achilles attachment and at the plantar fascia attachment, plantar fasciitis, tenosynovitis, subchondral cysts, and bone erosions, joint space narrowing, subchondral signal changes, osteolysis, luxation, and sub-luxation were examined. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in none of the patients while frequency of involvement was 92% (24/26) by MR imaging. The most common MR imaging findings were Achilles tendonitis (acute and peritendinitis) (57%), retrocalcaneal bursitis (50%), joint effusion/synovitis (46%), soft-tissue edema (46%), and para-articular enthesophytes (38%). The most commonly involved anatomical region was the hindfoot (73%). Conclusion: Our data showed that the incidence of foot involvement was very high in asymptomatic patients with psoriasis on MR imaging. Further MR studies are needed to confirm these data. We conclude that MR imaging may be of importance especially in early diagnosis and treatment of inflammatory changes in the foot.

MR imaging features of foot involvement in patients with psoriasis

International Nuclear Information System (INIS)

Erdem, C. Zuhal; Tekin, Nilgun Solak; Sarikaya, Selda; Erdem, L. Oktay; Gulec, Sezen

2008-01-01

Objective: To determine alterations of the soft tissues, tendons, cartilage, joint spaces, and bones of the foot using magnetic resonance (MR) imaging in patients with psoriasis. Materials and methods: Clinical and MR examination of the foot was performed in 26 consecutive patients (52 ft) with psoriasis. As a control group, 10 healthy volunteers (20 ft) were also studied. Joint effusion/synovitis, retrocalcaneal bursitis, retroachilles bursitis, Achilles tendonitis, soft-tissue edema, para-articular enthesophytes, bone marrow edema, sinus tarsi syndrome, enthesopathy at the Achilles attachment and at the plantar fascia attachment, plantar fasciitis, tenosynovitis, subchondral cysts, and bone erosions, joint space narrowing, subchondral signal changes, osteolysis, luxation, and sub-luxation were examined. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in none of the patients while frequency of involvement was 92% (24/26) by MR imaging. The most common MR imaging findings were Achilles tendonitis (acute and peritendinitis) (57%), retrocalcaneal bursitis (50%), joint effusion/synovitis (46%), soft-tissue edema (46%), and para-articular enthesophytes (38%). The most commonly involved anatomical region was the hindfoot (73%). Conclusion: Our data showed that the incidence of foot involvement was very high in asymptomatic patients with psoriasis on MR imaging. Further MR studies are needed to confirm these data. We conclude that MR imaging may be of importance especially in early diagnosis and treatment of inflammatory changes in the foot

Effects of ankle-foot orthoses on mediolateral foot-placement ability during post-stroke gait.

Science.gov (United States)

Zissimopoulos, Angelika; Fatone, Stefania; Gard, Steven

2015-10-01

Accurate and precise mediolateral foot placement is important for balance during gait, but is impaired post stroke. Mediolateral foot placement may be improved with ankle-foot orthosis use. The purpose of this study was to determine whether an ankle-foot orthosis improves mediolateral foot-placement ability during post-stroke ambulation. Crossover trial with randomized order of conditions tested. The accuracy and precision of mediolateral foot placement was quantified while subjects targeted four different randomized step widths. Subjects were tested with and without their regular non-rigid ankle-foot orthosis in two separate visits (order randomized). While ankle-foot orthosis use corrected foot and ankle alignment (i.e. significantly decreased mid-swing plantar flexion, p = 0.000), effects of ankle-foot orthosis use on hip hiking (p = 0.545), circumduction (p = 0.179), coronal plane hip range of motion (p = 0.06), and mediolateral foot-placement ability (p = 0.537) were not significant. While ankle-foot orthosis-mediated equinovarus correction of the affected foot and ankle was not associated with improved biomechanics of walking (i.e. proximal ipsilateral hip kinematics or mediolateral foot-placement ability), it may affect other aspects of balance that were not tested in this study (e.g. proprioception, cerebellar, vestibular, and cognitive mechanisms). Studies that investigate the effect of ankle-foot orthosis on gait can help advance stroke rehabilitation by documenting the specific gait benefits of ankle-foot orthosis use. In this study, we investigated the effect of ankle-foot orthosis use on mediolateral foot-placement ability, an aspect of gait important for maintaining balance. © The International Society for Prosthetics and Orthotics 2014.

Relationship between the mobility of medial longitudinal arch and postural control

Directory of Open Access Journals (Sweden)

Tansu Birinci

2017-05-01

Conclusion: Our results suggest that decrease of arch mobility on the dominant foot is associated with posterior sway by causing knee or hip strategy and preventing ankle strategy even in small perturbations. The rate of deviation from the equilibrium point and the degree of total swaying increase when arch mobility decreases.

Foot roll-over evaluation based on 3D dynamic foot scan.

Science.gov (United States)

Samson, William; Van Hamme, Angèle; Sanchez, Stéphane; Chèze, Laurence; Van Sint Jan, Serge; Feipel, Véronique

2014-01-01

Foot roll-over is commonly analyzed to evaluate gait pathologies. The current study utilized a dynamic foot scanner (DFS) to analyze foot roll-over. The right feet of ten healthy subjects were assessed during gait trials with a DFS system integrated into a walkway. A foot sole picture was computed by vertically projecting points from the 3D foot shape which were lower than a threshold height of 15 mm. A 'height' value of these projected points was determined; corresponding to the initial vertical coordinates prior to projection. Similar to pedobarographic analysis, the foot sole picture was segmented into anatomical regions of interest (ROIs) to process mean height (average of height data by ROI) and projected surface (area of the projected foot sole by ROI). Results showed that these variables evolved differently to plantar pressure data previously reported in the literature, mainly due to the specificity of each physical quantity (millimeters vs Pascals). Compared to plantar pressure data arising from surface contact by the foot, the current method takes into account the whole plantar aspect of the foot, including the parts that do not make contact with the support surface. The current approach using height data could contribute to a better understanding of specific aspects of foot motion during walking, such as plantar arch height and the windlass mechanism. Results of this study show the underlying method is reliable. Further investigation is required to validate the DFS measurements within a clinical context, prior to implementation into clinical practice. Copyright © 2013 Elsevier B.V. All rights reserved.

Contributions of foot muscles and plantar fascia morphology to foot posture.

Science.gov (United States)

Angin, Salih; Mickle, Karen J; Nester, Christopher J

2018-03-01

The plantar foot muscles and plantar fascia differ between different foot postures. However, how each individual plantar structure contribute to foot posture has not been explored. The purpose of this study was to investigate the associations between static foot posture and morphology of plantar foot muscles and plantar fascia and thus the contributions of these structures to static foot posture. A total of 111 participants were recruited, 43 were classified as having pes planus and 68 as having normal foot posture using Foot Posture Index assessment tool. Images from the flexor digitorum longus (FDL), flexor hallucis longus (FHL), peroneus longus and brevis (PER), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB) and abductor hallucis (AbH) muscles, and the calcaneal (PF1), middle (PF2) and metatarsal (PF3) regions of the plantar fascia were obtained using a Venue 40 ultrasound system with a 5-13 MHz transducer. In order of decreasing contribution, PF3 > FHB > FHL > PER > FDB were all associated with FPI and able to explain 69% of the change in FPI scores. PF3 was the highest contributor explaining 52% of increases in FPI score. Decreased thickness was associated with increased FPI score. Smaller cross sectional area (CSA) in FHB and PER muscles explained 20% and 8% of increase in FPI score. Larger CSA of FDB and FHL muscles explained 4% and 14% increase in FPI score respectively. The medial plantar structures and the plantar fascia appear to be the major contributors to static foot posture. Elucidating the individual contribution of multiple muscles of the foot could provide insight about their role in the foot posture. Copyright © 2018. Published by Elsevier B.V.

[Changes of renal blood flow during organ-associated foot reflexology measured by color Doppler sonography].

Science.gov (United States)

Sudmeier, I; Bodner, G; Egger, I; Mur, E; Ulmer, H; Herold, M

1999-06-01

Using colour Doppler sonography blood flow changes of the right kidney during foot reflexology were determined in a placebo-controlled, double-blind, randomised study. 32 healthy young adults (17 women, 15 men) were randomly assigned to the verum or placebo group. The verum group received foot reflexology at zones corresponding to the right kidney, the placebo group was treated on other foot zones. Before, during and after foot reflexology the blood flow of three vessels of the right kidney was measured using colour Doppler sonography. Systolic peak velocity and end diastolic peak velocity were measured in cm/s, and the resistive index, a parameter of the vascular resistance, was calculated. The resistive index in the verum group showed a highly significant decrease (p foot reflexology. There was no difference between men and women and no difference between smokers and non-smokers. Verum and placebo group significantly differed concerning alterations of the resistive index both between the measuring points before versus during foot reflexology (p = 0.002) and those during versus after foot reflexology (p = 0.031). The significant decrease of the resistive index during foot reflexology in the verum group indicates a decrease of flow resistance in renal vessels and an increase of renal blood flow. These findings support the hypothesis that organ-associated foot reflexology is effective in changing renal blood flow during therapy.

[Foot growth and foot types in children and adolescents: a narrative review].

Science.gov (United States)

Xu, Miaomiao; Wang, Lin

2017-08-01

Foot shape and size are important for footwear design and production. Information about important foot characteristics helps not only to improve shoe comfort but to maintain the proper physiological development of the feet. What's more, plenty of studies have suggested that the shape of the shoe must closely resemble the shape of the foot to create a properly fitted shoe. This means that the differences between various populations should be considered and that footwear should be designed according to the measurements of users. Childhood and adolescent are important periods of human growth. During these periods, foot shape changes with human growth and can be influenced by extrinsic factors. Therefore, the foot shape characteristics of children and adolescents should be investigated. The results from these investigations can contribute to developing appropriate shoe for children and adolescents, improving perceived comfort of children shoes and preventing pedopathy among children and adolescents. This review aims to discuss measuring methods of foot shape, types of foot shape, and factors influencing foot shape. The results of the review can provide recommendations for investigating growth development of foot shape and useful information for consumers and shoe manufacturers.

Foot Drop: Looking Beyond Common Peroneal Nerve Palsy – A Neurophysiology Centre Experience

LENUS (Irish Health Repository)

Yap, SM

2016-04-01

Foot drop is a complex symptom with a considerable range in aetiology, severity and prognosis. We aim to characterise the aetiologies of foot drop and assess the diagnostic contribution of neurophysiologic testing (NCS\\/EMG). Retrospective review of consecutive referrals of foot drop to the Neurophysiology Department in Cork University Hospital was performed over a two year period (January 2012 to December 2013). Of a total of 59 referrals, common peroneal nerve (CPN) palsy comprised only slightly more than half of cases; 3(5%) have central origin; 3(5%) have motor neuron disease. Six (10%) have diabetes; 7(12%) have cancer; 5(8%) were bilateral. NCS\\/EMG altered initial working diagnosis in 14 out of 52 (27%) cases whereby initial diagnosis was provided. However one-third of all cases revealed additional coexistent pathology in an anatomic location remote to that of the primary diagnosis. Foot drop with central and proximal localisations are important and under recognised. NCS\\/EMG is valuable and also reveals additional pathology which warrants investigation

The relationship between foot posture and lower limb kinematics during walking: A systematic review.

Science.gov (United States)

Buldt, Andrew K; Murley, George S; Butterworth, Paul; Levinger, Pazit; Menz, Hylton B; Landorf, Karl B

2013-07-01

Variations in foot posture, such as pes planus (low-arched foot) or pes cavus (high-arched foot), are thought to be an intrinsic risk factor for injury due to altered motion of the lower extremity. Hence, the aim of this systematic review was to investigate the relationship between foot posture and lower limb kinematics during walking. A systematic database search of MEDLINE, CINAHL, SPORTDiscus, Embase and Inspec was undertaken in March 2012. Two independent reviewers applied predetermined inclusion criteria to selected articles for review and selected articles were assessed for quality. Articles were then grouped into two broad categories: (i) those comparing mean kinematic parameters between different foot postures, and (ii) those examining associations between foot posture and kinematics using correlation analysis. A final selection of 12 articles was reviewed. Meta-analysis was not conducted due to heterogeneity between studies. Selected articles primarily focused on comparing planus and normal foot postures. Five articles compared kinematic parameters between different foot postures - there was some evidence for increased motion in planus feet, but this was limited by small effect sizes. Seven articles investigated associations between foot posture and kinematics - there was evidence that increasing planus foot posture was positively associated with increased frontal plane motion of the rearfoot. The body of literature provides some evidence of a relationship between pes planus and increased lower limb motion during gait, however this was not conclusive due to heterogeneity between studies and small effect sizes. Copyright © 2013 Elsevier B.V. All rights reserved.

Repeatability of the Oxford Foot Model in children with foot deformity

NARCIS (Netherlands)

McCahill, Jennifer; Stebbins, Julie; Koning, Bart; Harlaar, Jaap; Theologis, Tim

Introduction The Oxford Foot Model (OFM) is a multi-segment, kinematic model developed to assess foot motion. It has previously been assessed for repeatability in healthy populations. To determine the OFM's reliability for detecting foot deformity, it is important to know repeatability in

Forefoot deformity, pain, and mobility in rheumatoid and nonarthritic subjects.

Science.gov (United States)

O'Connell, P G; Lohmann Siegel, K; Kepple, T M; Stanhope, S J; Gerber, L H

1998-09-01

To evaluate how painful metatarsal arthritis affects foot and ankle mechanics and mobility. We studied 16 symptomatic forefeet in 10 patients with rheumatoid arthritis (RA) and compared them with 14 asymptomatic forefeet in 7 nonarthritic subjects. RA limbs with significant disease at other locations were excluded. We measured pain and deformity of the foot using a visual analog scale and a modified articular index. A video based 3 dimensional gait analysis system and force platform were used to collect data on subjects walking barefoot at a self-selected pace according to an established protocol. Mobility level was quantified using the Sickness Impact Profile (SIP) ambulation subscale. We observed considerable pain and deformity of the forefeet of RA subjects. During gait, motion and force measures revealed that RA subjects significantly (p SIP scores revealed that these changes in gait resulted in moderate disability in RA subjects (p=0.05). Impairments of the forefoot due to RA include pain and deformity, which produce characteristic stance phase abnormalities in foot function, a slow walking speed, and moderate disability.

Validation of Patient-Reported Outcomes Measurement Information System Computerized Adaptive Tests Against the Foot and Ankle Outcome Score for 6 Common Foot and Ankle Pathologies.

Science.gov (United States)

Koltsov, Jayme C B; Greenfield, Stephen T; Soukup, Dylan; Do, Huong T; Ellis, Scott J

2017-08-01

The field of foot and ankle surgery lacks a widely accepted gold-standard patient-reported outcome instrument. With the changing infrastructure of the medical profession, more efficient patient-reported outcome tools are needed to reduce respondent burden and increase participation while providing consistent and reliable measurement across multiple pathologies and disciplines. The primary purpose of the present study was to validate 3 Patient-Reported Outcomes Measurement Information System computer adaptive tests (CATs) most relevant to the foot and ankle discipline against the Foot and Ankle Outcome Score (FAOS) and the Short Form 12 general health status survey in patients with 6 common foot and ankle pathologies. Patients (n = 240) indicated for operative treatment for 1 of 6 common foot and ankle pathologies completed the CATs, FAOS, and Short Form 12 at their preoperative surgical visits, 1 week subsequently (before surgery), and at 6 months postoperatively. The psychometric properties of the instruments were assessed and compared. The Patient-Reported Outcomes Measurement Information System CATs each took less than 1 minute to complete, whereas the FAOS took 6.5 minutes, and the Short Form 12 took 3 minutes. CAT scores were more normally distributed and had fewer floor and ceiling effects than those on the FAOS, which reached as high as 24%. The CATs were more precise than the FAOS and had similar responsiveness and test-retest reliability. The physical function and mobility CATs correlated strongly with the activities subscale of the FAOS, and the pain interference CAT correlated strongly with the pain subscale of the FAOS. The CATs and FAOS were responsive to changes with operative treatment for 6 common foot and ankle pathologies. The CATs performed as well as or better than the FAOS in all aspects of psychometric validity. The Patient-Reported Outcomes Measurement Information System CATs show tremendous potential for improving the study of patient

Is the foot elevation the optimal position for wound healing of a diabetic foot?

Science.gov (United States)

Park, D J; Han, S K; Kim, W K

2010-03-01

In managing diabetic foot ulcers, foot elevation has generally been recommended to reduce oedema and prevent other sequential problems. However, foot elevation may decrease tissue oxygenation of the foot more than the dependent position since the dependent position is known to increase blood flow within the arterial system. In addition, diabetic foot ulcers, which have peripheral vascular insufficiency, generally have less oedema than other wounds. Therefore, we argue that foot elevation may not be helpful for healing of vascularly compromised diabetic foot ulcers since adequate tissue oxygenation is an essential factor in diabetic wound healing. The purpose of this study was to evaluate the influence of foot height on tissue oxygenation and to determine the optimal foot position to accelerate wound healing of diabetic foot ulcers. This study included 122 cases (73 males and 47 females; two males had bilateral disease) of diabetic foot ulcer patients aged 40-93 years. Trans-cutaneous partial oxygen tension (TcpO(2)) values of diabetic feet were measured before and after foot elevation (n=21). Elevation was achieved by placing a foot over four cushions. We also measured foot TcpO(2) values before and after lowering the feet (n=122). Feet were lowered to the patient's tibial height, approximately 30-35 cm, beside a bed handrail. Due to the large number of lowering measurements, we divided them into five sub-groups according to initial TcpO(2.) Tissue oxygenation values were compared. Foot-elevation-lowered TcpO(2) values before and after elevation were 32.5+/-22.2 and 23.8+/-23.1 mmHg (pFoot-lowering-augmented TcpO(2) values before and after lowering were 44.6+/-23.8 and 58.0+/-25.9 mmHg (pfoot lowering, rather than elevation, significantly augments TcpO(2) and may stimulate healing of diabetic foot ulcers. (c) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Flat Foot in a Random Population and its Impact on Quality of Life and Functionality.

Science.gov (United States)

Pita-Fernandez, Salvador; Gonzalez-Martin, Cristina; Alonso-Tajes, Francisco; Seoane-Pillado, Teresa; Pertega-Diaz, Sonia; Perez-Garcia, Sergio; Seijo-Bestilleiro, Rocio; Balboa-Barreiro, Vanesa

2017-04-01

Flat foot is a common deformity in adults. It is characterized by medial rotation and plantar flexion of the talus, eversion of the calcaneus, collapsed medial arch and abduction of the forefoot. The aim of this study was to determine the prevalence of flat foot and its impact on quality of life, dependence, foot pain, disability and functional limitation among random population of 40-year-old and above. A cross-sectional study in a random population sample from Cambre (A Coruña-Spain) (n=835) was performed (α =0.05; Precision=±3.4%). The diagnosis of flat foot was stablished by the study of the footprint obtained with a pedograph. Anthropometric variables were studied, Charlson's Comorbidity Index, function and state of foot (Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ)), quality of life (SF-36), and dependence for activities of daily living (Barthel and Lawton index). A logistic and linear multiple regression analysis was performed. The prevalence of flat foot was 26.62%. Patients with flat foot were significantly older (65.73±11.04 vs 61.03±11.45-year-old), showed a higher comorbidity index (0.92±1.49 vs 0.50±0.98), had a greater BMI (31.45±5.55 vs 28.40±4.17) and greater foot size (25.16±1.66 vs 24.82±1.65). The presence of flat foot diminishes the quality of life, as measured by the FHSQ, and foot function, measured by the FFI. The presence of flat foot does not alter the physical and mental dimension of the SF-36 or the degree of dependence. Flat foot was associated with age, Charlson's Comorbidity Index, BMI and foot size. The SF-36, Barthel and Lawton questionnaires remained unaltered by the presence of flat foot. The FHSQ and FFI questionnaires did prove to be sensitive to the presence of flat foot in a significant manner.

Altered intracellular localization and mobility of SBDS protein upon mutation in Shwachman-Diamond syndrome.

Directory of Open Access Journals (Sweden)

Claudia Orelio

Full Text Available Shwachman-Diamond Syndrome (SDS is a rare inherited disease caused by mutations in the SBDS gene. Hematopoietic defects, exocrine pancreas dysfunction and short stature are the most prominent clinical features. To gain understanding of the molecular properties of the ubiquitously expressed SBDS protein, we examined its intracellular localization and mobility by live cell imaging techniques. We observed that SBDS full-length protein was localized in both the nucleus and cytoplasm, whereas patient-related truncated SBDS protein isoforms localize predominantly to the nucleus. Also the nucleo-cytoplasmic trafficking of these patient-related SBDS proteins was disturbed. Further studies with a series of SBDS mutant proteins revealed that three distinct motifs determine the intracellular mobility of SBDS protein. A sumoylation motif in the C-terminal domain, that is lacking in patient SBDS proteins, was found to play a pivotal role in intracellular motility. Our structure-function analyses provide new insight into localization and motility of the SBDS protein, and show that patient-related mutant proteins are altered in their molecular properties, which may contribute to the clinical features observed in SDS patients.

A survey of foot problems in community-dwelling older Greek Australians

Directory of Open Access Journals (Sweden)

Menz Hylton B

2011-10-01

Full Text Available Abstract Background Foot problems are common in older people and are associated with impaired mobility and quality of life. However, the characteristics of foot problems in older Australians for whom English is a second language have not been evaluated. Methods One hundred and four community-dwelling people aged 64 to 90 years with disabling foot pain (according to the case definition of the Manchester Foot Pain and Disability Index, or MFPDI were recruited from four Greek elderly citizens clubs in Melbourne, Australia. All participants completed a Greek language questionnaire consisting of general medical history, the Medical Outcomes Study Short-Form 36 (SF-36 questionnaire, the MFPDI, and specific questions relating to foot problems and podiatry service utilisation. In addition, all participants underwent a brief clinical foot assessment. Results The MFPDI score ranged from 1 to 30 (median 14, out of a total possible score of 34. Women had significantly higher total MFPDI scores and MFPDI subscale scores. The MFPDI total score and subscale scores were significantly associated with most of the SF-36 subscale scores. The most commonly reported foot problem was difficulty finding comfortable shoes (38%, and the most commonly observed foot problem was the presence of hyperkeratotic lesions (29%. Only 13% of participants were currently receiving podiatry treatment, and 40% stated that they required more help looking after their feet. Those who reported difficulty finding comfortable shoes were more likely to be female, and those who required more help looking after their feet were more likely to be living alone and have osteoarthritis in their knees or back. Conclusions Foot problems appear to be common in older Greek Australians, have a greater impact on women, and are associated with reduced health-related quality of life. These findings are broadly similar to previous studies in English-speaking older people in Australia. However, only a small

Ewing sarcoma of the foot. Radiological findings

International Nuclear Information System (INIS)

Albisinni, U.; Capanna, R.; Nigrisoli, M.

1987-01-01

Ewing's Sarcoma (ES) is the most frequent malignant bone tumor of the foot. The radiological picture is characterized, in 14 patients, by a pure osteolytic lesion (9 cases) or by a mixed one (5 cases); the interruption of the cortical bone and swelling of the soft tissues were always present; the periostal reaction was occasional. The radiological aspects cannot be considered typical of the ES and it is suggested that biopsies should always be performed in the presence of structural alteration of the bone

Foot Health Education for People with Rheumatoid Arthritis: '…. A Game of Chance…' - A Survey of Patients' Experiences.

Science.gov (United States)

Graham, Andrea S; Williams, Anita E

2016-03-01

Up to 90% of people with rheumatoid arthritis (RA) experience foot problems leading to reduced function, mobility, quality of life and social participation, and impacts on body image, but these can be improved with general foot care, orthoses, footwear and patient education. Foot health patient education is lacking, so the aim of the present study was to identify the foot health educational needs of people with RA in relation to its content, timing, mode of delivery and the perceived barriers to its provision. People with RA completed an online survey and provided free-text comments for thematic analysis. A total of 249 people completed the free-text section of the survey. Five main themes emerged: 'Forgotten feet'; 'Too little, too late'; 'Lacks and gaps'; 'I am my feet' and 'Game of chance'. Foot pathology in people with RA has a bio-psychosocial impact on their lives. Foot health and related information appears to be considered rarely within the medical consultation. Access to foot health information and services is limited owing to a lack of patient and/or health professional awareness, with a detrimental impact on the prognosis of their foot health. The importance of foot health in people with RA should be reinforced for patients and health professionals alike. Opportunities to discuss foot health within the medical consultation should be provided regularly. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

The healthy donor profile of immunoregulatory soluble mediators is altered by stem cell mobilization and apheresis.

Science.gov (United States)

Melve, Guro Kristin; Ersvaer, Elisabeth; Paulsen Rye, Kristin; Bushra Ahmed, Aymen; Kristoffersen, Einar K; Hervig, Tor; Reikvam, Håkon; Hatfield, Kimberley Joanne; Bruserud, Øystein

2018-05-01

Peripheral blood stem cells from healthy donors mobilized by granulocyte colony-stimulating factor (G-CSF) and thereafter harvested by leukapheresis are commonly used for allogeneic stem cell transplantation. Plasma levels of 38 soluble mediators (cytokines, soluble adhesion molecules, proteases, protease inhibitors) were analyzed in samples derived from healthy stem cell donors before G-CSF treatment and after 4 days, both immediately before and after leukapheresis. Donors could be classified into two main subsets based on their plasma mediator profile before G-CSF treatment. Seventeen of 36 detectable mediators were significantly altered by G-CSF; generally an increase in mediator levels was seen, including pro-inflammatory cytokines, soluble adhesion molecules and proteases. Several leukocyte- and platelet-released mediators were increased during apheresis. Both plasma and graft mediator profiles were thus altered and showed correlations to graft concentrations of leukocytes and platelets; these concentrations were influenced by the apheresis device used. Finally, the mediator profile of the allotransplant recipients was altered by graft infusion, and based on their day +1 post-transplantation plasma profile our recipients could be divided into two major subsets that differed in overall survival. G-CSF alters the short-term plasma mediator profile of healthy stem cell donors. These effects together with the leukocyte and platelet levels in the graft determine the mediator profile of the stem cell grafts. Graft infusion also alters the systemic mediator profile of the recipients, but further studies are required to clarify whether such graft-induced alterations have a prognostic impact. Copyright © 2018. Published by Elsevier Inc.

Charcot Foot

Science.gov (United States)

... damage (neuropathy). The bones are weakened enough to fracture, and with continued walking, the foot eventually changes ... difference. Advanced therapies for foot wounds are saving limbs, restoring ... in the feet come from the lower back. Pressure or chemical change in the nerve ...

Integrated inertial sensors and mobile computing for real-time cycling performance guidance via pedaling profile classification.

Science.gov (United States)

Xu, James Y; Nan, Xiaomeng; Ebken, Victor; Wang, Yan; Pottie, Greg J; Kaiser, William J

2015-03-01

Today, the bicycle is utilized as a daily commute tool, a physical rehabilitation asset, and sporting equipment, prompting studies into the biomechanics of cycling. Of the number of important parameters that affect cycling efficiency, the foot angle profile is one of the most important as it correlates directly with the effective force applied to the bike. However, there has been no compact and portable solution for measuring the foot angle and for providing the cyclist with real-time feedback due to a number of difficulties of the current tracking and sensing technologies and the myriad types of bikes available. This paper presents a novel sensing and mobile computing system for classifying the foot angle profiles during cycling and for providing real-time guidance to the user to achieve the correct profile. Continuous foot angle tracking is firstly converted into a discrete problem requiring only recognition of acceleration profiles of the foot using a single shoe mounted tri-axial accelerometer during each pedaling cycle. A classification method is then applied to identify the pedaling profile. Finally, a mobile solution is presented to provide real-time signal processing and guidance.

High dietary levels of biotin and zinc to improve health of foot pads in broilers exposed experimentally to litter with critical moisture content.

Science.gov (United States)

Abd El-Wahab, A; Radko, D; Kamphues, J

2013-07-01

Foot pad dermatitis (FPD) is a widespread problem in poultry production and constitutes a welfare issue. The objective of this study was to test potentially prophylactic effects of higher biotin and Zn levels in the diet of broilers exposed to critical litter moisture content (35% water) on the development of FPD. Two trials were performed in each 4 groups of 1-wk-old male broilers (Ross 708) during 33 d. The pens of all groups (25 birds in each) were littered with wood shavings of critical moisture content. Two groups were fed high levels of Zn as zinc-oxide (150 mg/kg of diet), with normal levels of biotin (300 µg/kg of diet) or high biotin (2,000 µg/kg of diet). The other 2 groups were fed Zn as zinc-methionine (150 mg/kg of diet), with normal levels of biotin (300 µg/kg of diet) or high biotin (2,000 µg/kg of diet). External assessment of foot pads and measurements the moisture contents of excreta and litter were performed weekly. The signs of foot pad lesions were recorded on a 7-point scale (0 = normal skin; 7 = more than half of the foot pad is necrotic). High biotin supplementation resulted in a reduction of 30 and 18% of cases of foot pad lesions in trials 1 and 2, respectively. The combination of Zn-methionine and high biotin supplementation led to a decreased severity of FPD in a range of about 50 and 30% in trials 1 and 2, respectively. In broilers fed the diet containing zinc-oxide and normal biotin levels about 28 and 24% of the birds had the scores of 6 and 7 (= high foot pad alterations), whereas in birds fed Zn-methionine and high biotin no high alterations (score = 7) in the foot pad (0%) occurred in either trial. The presented results suggest that it is advisable to combine the maximum levels of Zn (especially of Zn-methionine) and high levels of biotin when clinically relevant alterations in the foot pad occur.

Natural gaits of the non-pathological flat foot and high-arched foot

OpenAIRE

Fan, Yifang; Fan, Yubo; Li, Zhiyu; Lv, Changsheng; Luo, Donglin

2010-01-01

There has been a controversy as to whether or not the non-pathological flat foot and high-arched foot have an effect on human walking activities. The 3D foot scanning system was employed to obtain static footprints from subjects adopting a half-weight-bearing stance. Based upon their footprints, the subjects were divided into two groups: the flat-footed and the high-arched. The plantar pressure measurement system was used to measure and record the subjects' successive natural gaits. Two indic...

The best way to reduce reulcerations: if you understand biomechanics of the diabetic foot, you can do it.

Science.gov (United States)

Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; Alvaro-Afonso, Francisco Javier; García-Morales, Esther; García-Álvarez, Yolanda; Molines-Barroso, Raúl Juan

2014-12-01

Foot ulcer recurrence is still an unresolved issue. Although several therapies have been described for preventing foot ulcers, the rates of reulcerations are very high. Footwear and insoles have been recommended as effective therapies that prevent the development of new ulcers; however, the majority of studies have analyzed their effects in terms of reducing peak plantar pressure rather than ulcer relapse. Knowledge of biomechanical considerations is low, in general, in the team approach to diabetic foot because heterogeneous professionals having competence in recurrence prevention are involved. Assessment of biomechanical alterations define a foot type position; examining foot structure and recording plantar pressure could help in appropriate insole and footwear prescription and design. Patient education and compliance should be taken into consideration for better therapy success. When patients suffer from rigid deformities or have undergone an amputation, surgical offloading should be considered as an alternative. © The Author(s) 2014.

Foot placement modulation diminishes for perturbations near foot contact

NARCIS (Netherlands)

Vlutters, Mark; Van Asseldonk, Edwin H.F.; van der Kooij, Herman

2018-01-01

Whenever a perturbation occurs during walking we have to maintain our balance using the recovery strategies that are available to us. Foot placement adjustment is often considered an important recovery strategy. However, because this strategy takes time it is likely a poor option if the foot is

The effectiveness of non-surgical interventions in the treatment of Charcot foot.

Science.gov (United States)

Smith, Caroline; Kumar, Saravana; Causby, Ryan

2007-12-01

trials evaluating bisphosphonates reported greater reduction in foot temperature and disease activity for intervention subjects compared with controls. Another outcome of this review indicated additional beneficial effects of bisphosphonates in reducing pain and discomfort. The trial evaluating palliative radiotherapy found no difference between groups on any outcome. A significant reduction in the amount of deformity and reduced healing time to consolidation was found after treatment in the group receiving magnetic therapy treatment. Discussion  There is a lack of clinical trials evaluating the effectiveness of non-operative interventions for the management of Charcot foot (immobilisation, removable cast walkers, advice/dispensing of footwear and prescribing of orthotics). Bisphosphonates may be useful adjuncts to standard management of Charcot foot by improved healing demonstrated by a reduction in disease activity indicated by skin temperature and bone destruction. Magnetic therapy may reduce deformity, joint destruction and improve mobility. Conclusion  There is a lack of evidence supporting the use of pharmacological or non-surgical interventions with reducing lesions, ulceration, rate of surgical intervention, hospital admissions and improving the quality of life of subjects with Charcot foot. Bisphosphonates may improve the healing of Charcot foot by reducing skin temperature and disease activity of Charcot foot, when applied in addition to standard interventions to control the position and shape of the foot.

Foot problems in a group of patients with rheumatoid arthritis: an unmet need for foot care.

Science.gov (United States)

Borman, Pinar; Ayhan, Figen; Tuncay, Figen; Sahin, Mehtap

2012-01-01

The aim of this study was to evaluate the foot involvement in a group of RA patients in regard to symptoms, type and frequency of deformities, location, radiological changes, and foot care. A randomized selected 100 rheumatoid arthritis (RA) patients were recruited to the study. Data about foot symptoms, duration and location of foot pain, pain intensity, access to services related to foot, treatment, orthoses and assistive devices, and usefulness of therapies were determined by the questionnaire. Radiological changes were assessed according to modified Larsen scoring system. The scores of disease activity scale of 28 joints and Health Assessment Questionnaire indicating the functional status of RA patients were collected from patient files. A total of 100 RA patients (90 female, 10 male) with a mean age of 52.5 ±10.9 years were enrolled to the study. Eighty-nine of the 100 patients had experienced foot complaints/symptoms in the past or currently. Foot pain and foot symptoms were reported as the first site of involvement in 14 patients. Thirty-six patients had ankle pain and the most common sites of the foot symptoms were ankle (36%) and forefoot (30%) followed by hindfoot (17%) and midfoot (7%) currently. Forty-nine of the patients described that they had difficulty in performing their foot care. Insoles and orthopedic shoes were prescribed in 39 patients, but only 14 of them continued to use them. The main reasons for not wearing them were; 17 not helpful (43%), 5 made foot pain worse (12.8%), and 3 did not fit (7.6%). Foot symptoms were reported to be decreased in 24 % of the subjects after the medical treatment and 6 patients indicated that they had underwent foot surgery. Current foot pain was significantly associated with higher body mass index and longer disease duration, and duration of morning stiffness. The radiological scores did not correlate with duration of foot symptoms and current foot pain (p>0.05) but the total number of foot deformities was

Development and validation of a computational model to study the effect of foot constraint on ankle injury due to external rotation.

Science.gov (United States)

Wei, Feng; Hunley, Stanley C; Powell, John W; Haut, Roger C

2011-02-01

Recent studies, using two different manners of foot constraint, potted and taped, document altered failure characteristics in the human cadaver ankle under controlled external rotation of the foot. The posterior talofibular ligament (PTaFL) was commonly injured when the foot was constrained in potting material, while the frequency of deltoid ligament injury was higher for the taped foot. In this study an existing multibody computational modeling approach was validated to include the influence of foot constraint, determine the kinematics of the joint under external foot rotation, and consequently obtain strains in various ligaments. It was hypothesized that the location of ankle injury due to excessive levels of external foot rotation is a function of foot constraint. The results from this model simulation supported this hypothesis and helped to explain the mechanisms of injury in the cadaver experiments. An excessive external foot rotation might generate a PTaFL injury for a rigid foot constraint, and an anterior deltoid ligament injury for a pliant foot constraint. The computational models may be further developed and modified to simulate the human response for different shoe designs, as well as on various athletic shoe-surface interfaces, so as to provide a computational basis for optimizing athletic performance with minimal injury risk.

The validity and accuracy in foot-to-foot bioelectrical impedance ...

African Journals Online (AJOL)

The validity and accuracy in foot-to-foot bioelectrical impedance analysis measuring models referenced by dual-energy X-ray absorptiometry in body composition in standing position. KC Hsieh, HK Lu, CH Chen, TR Jang, YY Chen, MF Kao ...

Mortality associated with acute Charcot foot and neuropathic foot ulceration

NARCIS (Netherlands)

van Baal, Juliette; Hubbard, Richard; Game, Fran; Jeffcoate, William

2010-01-01

To compare the mortality of patients with an acute Charcot foot with a matched population with uninfected neuropathic foot ulcers (NFUs). Data were extracted from a specialist departmental database, supplemented by hospital records. The findings were compared with the results of earlier populations

Repeatability of the Oxford Foot Model in children with foot deformity.

Science.gov (United States)

McCahill, Jennifer; Stebbins, Julie; Koning, Bart; Harlaar, Jaap; Theologis, Tim

2018-03-01

The Oxford Foot Model (OFM) is a multi-segment, kinematic model developed to assess foot motion. It has previously been assessed for repeatability in healthy populations. To determine the OFM's reliability for detecting foot deformity, it is important to know repeatability in pathological conditions. The aim of the study was to assess the repeatability of the OFM in children with foot deformity. Intra-tester repeatability was assessed for 45 children (15 typically developing, 15 hemiplegic, 15 clubfoot). Inter-tester repeatability was assessed in the clubfoot population. The mean absolute differences between testers (clubfoot) and sessions (clubfoot and hemiplegic) were calculated for each of 15 clinically relevant, kinematic variables and compared to typically developing children. Children with clubfoot showed a mean difference between visits of 2.9° and a mean difference between raters of 3.6° Mean absolute differences were within one degree for the intra and inter-rater reliability in 12/15 variables. Hindfoot rotation, forefoot/tibia abduction and forefoot supination were the most variable between testers. Overall the clubfoot data were less variable than the typically developing population. Children with hemiplegia demonstrated slightly higher differences between sessions (mean 4.1°), with the most reliable data in the sagittal plane, and largest differences in the transverse plane. The OFM was designed to measure different types of foot deformity. The results of this study show that it provides repeatable results in children with foot deformity. To be distinguished from measurement artifact, changes in foot kinematics as a result of intervention or natural progression over time must be greater than the repeatability reported here. Copyright © 2018 Elsevier B.V. All rights reserved.

Gender differences of foot characteristics in older Japanese adults using a 3D foot scanner.

Science.gov (United States)

Saghazadeh, Mahshid; Kitano, Naruki; Okura, Tomohiro

2015-01-01

Knowledge of gender differences in foot shape assists shoe manufactures with designing appropriate shoes for men and women. Although gender differences in foot shapes are relatively known among young men and women, less is known about how the older men and women's feet differ in shape. A recent development in foot shape assessment is the use of 3D foot scanners. To our knowledge this technology has yet to be used to examine gender differences in foot shape of Japanese older adults. This cross-sectional study included 151 older men (74.5 ± 5.6 years) and 140 older women (73.9 ± 5.1 years) recruited in Kasama City, Japan. Foot variables were measured in sitting and standing positions using Dream GP Incorporated's 3D foot scanner, Footstep PRO (Osaka, Japan). Scores were analyzed as both raw and normalized to truncated foot length using independent samples t-test and analysis of covariance, respectively. In men, the measurement values for navicular height, first and fifth toe and instep heights, ball and heel width, ball girth, arch height index (just standing), arch rigidity index and instep girth were significantly greater than the women's, whereas the first toe angle, in both sitting and standing positions was significantly smaller. However, after normalizing, the differences in ball width, heel width, height of first and fifth toes in both sitting and standing and ball girth in sitting position were nonsignificant. According to Cohen's d, among all the foot variables, the following had large effect sizes in both sitting and standing positions: truncated foot length, instep, navicular height, foot length, ball girth, ball width, heel width and instep girth. This study provides evidence of anthropometric foot variations between older men and women. These differences need to be considered when manufacturing shoes for older adults.

Diabetic foot syndrome: Immune-inflammatory features as possible cardiovascular markers in diabetes

Science.gov (United States)

Tuttolomondo, Antonino; Maida, Carlo; Pinto, Antonio

2015-01-01

Diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality. Diabetic foot syndrome (DFS), as defined by the World Health Organization, is an “ulceration of the foot (distally from the ankle and including the ankle) associated with neuropathy and different grades of ischemia and infection”. Pathogenic events able to cause diabetic foot ulcers are multifactorial. Among the commonest causes of this pathogenic pathway it’s possible to consider peripheral neuropathy, foot deformity, abnormal foot pressures, abnormal joint mobility, trauma, peripheral artery disease. Several studies reported how diabetic patients show a higher mortality rate compared to patients without diabetes and in particular these studies under filled how cardiovascular mortality and morbidity is 2-4 times higher among patients affected by type 2 diabetes mellitus. This higher degree of cardiovascular morbidity has been explained as due to the observed higher prevalence of major cardiovascular risk factor, of asymptomatic findings of cardiovascular diseases, and of prevalence and incidence of cardiovascular and cerebrovascular events in diabetic patients with foot complications. In diabetes a fundamental pathogenic pathway of most of vascular complications has been reported as linked to a complex interplay of inflammatory, metabolic and procoagulant variables. These pathogenetic aspects have a direct interplay with an insulin resistance, subsequent obesity, diabetes, hypertension, prothrombotic state and blood lipid disorder. Involvement of inflammatory markers such as IL-6 plasma levels and resistin in diabetic subjects as reported by Tuttolomondo et al confirmed the pathogenetic issue of the a “adipo-vascular” axis that may contribute to cardiovascular risk in patients with type 2 diabetes. This “adipo-vascular axis” in patients with type 2 diabetes has been reported as characterized

Inter-segment foot motion in girls using a three-dimensional multi-segment foot model.

Science.gov (United States)

Jang, Woo Young; Lee, Dong Yeon; Jung, Hae Woon; Lee, Doo Jae; Yoo, Won Joon; Choi, In Ho

2018-05-06

Several multi-segment foot models (MFMs) have been introduced for in vivo analyses of dynamic foot kinematics. However, the normal gait patterns of healthy children and adolescents remain uncharacterized. We sought to determine normal foot kinematics according to age in clinically normal female children and adolescents using a Foot 3D model. Fifty-eight girls (age 7-17 years) with normal function and without radiographic abnormalities were tested. Three representative strides from five separate trials were analyzed. Kinematic data of foot segment motion were tracked and evaluated using an MFM with a 15-marker set (Foot 3D model). As controls, 50 symptom-free female adults (20-35 years old) were analyzed. In the hindfoot kinematic analysis, plantar flexion motion in the pre-swing phase was significantly greater in girls aged 11 years or older than in girls aged foot progression angle showed mildly increased internal rotation in the loading response phase and the swing phase in girls aged foot motion in girls aged 11 years or older showed low-arch kinematic characteristics, whereas those in girls aged 11 years or older were more similar to the patterns in young adult women. Copyright © 2018 Elsevier B.V. All rights reserved.

Foot anthropometry and morphology phenomena.

Science.gov (United States)

Agić, Ante; Nikolić, Vasilije; Mijović, Budimir

2006-12-01

Foot structure description is important for many reasons. The foot anthropometric morphology phenomena are analyzed together with hidden biomechanical functionality in order to fully characterize foot structure and function. For younger Croatian population the scatter data of the individual foot variables were interpolated by multivariate statistics. Foot structure descriptors are influenced by many factors, as a style of life, race, climate, and things of the great importance in human society. Dominant descriptors are determined by principal component analysis. Some practical recommendation and conclusion for medical, sportswear and footwear practice are highlighted.

A methodological framework for detecting ulcers' risk in diabetic foot subjects by combining gait analysis, a new musculoskeletal foot model and a foot finite element model.

Science.gov (United States)

Scarton, Alessandra; Guiotto, Annamaria; Malaquias, Tiago; Spolaor, Fabiola; Sinigaglia, Giacomo; Cobelli, Claudio; Jonkers, Ilse; Sawacha, Zimi

2018-02-01

Diabetic foot is one of the most debilitating complications of diabetes and may lead to plantar ulcers. In the last decade, gait analysis, musculoskeletal modelling (MSM) and finite element modelling (FEM) have shown their ability to contribute to diabetic foot prevention and suggested that the origin of the plantar ulcers is in deeper tissue layers rather than on the plantar surface. Hence the aim of the current work is to develop a methodology that improves FEM-derived foot internal stresses prediction, for diabetic foot prevention applications. A 3D foot FEM was combined with MSM derived force to predict the sites of excessive internal stresses on the foot. In vivo gait analysis data, and an MRI scan of a foot from a healthy subject were acquired and used to develop a six degrees of freedom (6 DOF) foot MSM and a 3D subject-specific foot FEM. Ankle kinematics were applied as boundary conditions to the FEM together with: 1. only Ground Reaction Forces (GRFs); 2. OpenSim derived extrinsic muscles forces estimated with a standard OpenSim MSM; 3. extrinsic muscle forces derived through the (6 DOF) foot MSM; 4. intrinsic and extrinsic muscles forces derived through the 6 DOF foot MSM. For model validation purposes, simulated peak pressures were extracted and compared with those measured experimentally. The importance of foot muscles in controlling plantar pressure distribution and internal stresses is confirmed by the improved accuracy in the estimation of the peak pressures obtained with the inclusion of intrinsic and extrinsic muscle forces. Copyright © 2017 Elsevier B.V. All rights reserved.

Analysis of foot kinematics wearing high heels using the Oxford foot model.

Science.gov (United States)

Wang, Meizi; Gu, Yaodong; Baker, Julien Steven

2018-04-29

Wearing high heels is thought to lead to various foot disorders and injuries such as metatarsal pain, Achilles tendon tension, plantar fasciitis and Haglund malformation. However, there is little available information explaining the specific mechanisms and reasons why wearing high heels causes foot deformity. Therefore, the purpose of this study was to investigate the foot kinematics of high heel wearers and compare any differences with barefoot individuals using the Oxford Foot Model (OFM). Fifteen healthy women aged 20-25 years were measured while walking barefoot and when wearing high heels. The peak value of angular motion for the hallux with respect to the forefoot, the forefoot with respect to the hind foot, and the hind foot with respect to the tibia were all analyzed. Compared to the barefoot, participants wearing high heels demonstrated larger hallux dorsiflexion (22.55∘± 1.62∘ VS 26.6∘± 2.33∘ for the barefoot; P= 0.001), and less hallux plantarflexion during the initial stance phase (-4.86∘± 2.32∘ VS -8.68∘± 1.13∘; Pfoot demonstrated a larger dorsiflexion in the horizontal plane (16.59∘± 1.69∘ VS 12.08∘± 0.9∘; Pfoot extension rotation (-5.49∘± 0.69∘ VS -10.73∘± 0.42∘; P= 0.001). These findings complement existing kinematic evidence that wearing high heels can lead to foot deformities and injuries.

Reliability and normative values of the foot line test: a technique to assess foot posture

DEFF Research Database (Denmark)

Brushøj, C; Larsen, Klaus; Nielsen, MB

2007-01-01

STUDY DESIGN: Test-retest reliability. OBJECTIVE: To examine the reliability and report normative values of a novel test, the foot line test (FLT), to describe foot morphology. BACKGROUND: Numerous foot examinations are performed each day, but most existing examination techniques have considerable...... limitations regarding reliability and validity. METHODS: One hundred thirty subjects with mean foot size 44 (41-50 European size) participated. Two examiners, blinded to each other's measurements, measured the right foot of the subjects twice and the left foot once. The position of the most medial aspect...... of the navicular in the mediolateral direction was projected vertically onto a piece of paper placed under the subject's foot, and compared to the position of the forefoot and hindfoot to obtain the FLT value. RESULTS: FLT values ranged from -8 to 14 mm, with a mean (+/-SD) of 3.7 +/- 3.4 mm. The intratester...

Relationship between sagittal plane kinematics, foot morphology and vertical forces applied to three regions of the foot

OpenAIRE

Hannah, I.; Sawacha, Z.; Guiotto, A.; Mazza, C.

2016-01-01

Kinetic analysis of human motion with a multi-segment musculoskeletal foot model requires the distribution of loading applied to the modeled foot segments to be determined. This work thus examines the existence of any correlation between intersegmental foot kinematics, foot morphology, and the distribution of vertical loading in a multi-segment foot model. Gait analysis trials were performed by 20 healthy subjects at a self-selected speed with intersegmental foot joint angles and the distribu...

Beyond the Bottom of the Foot: Topographic Organization of the Foot Dorsum in Walking.

Science.gov (United States)

Klarner, Taryn; Pearcey, Gregory E P; Sun, Yao; Barss, Trevor S; Kaupp, Chelsea; Munro, Bridget; Frank, Nick; Zehr, E Paul

2017-12-01

Sensory feedback from the foot dorsum during walking has only been studied globally by whole nerve stimulation. Stimulating the main nerve innervating the dorsal surface produces a functional stumble corrective response that is phase-dependently modulated. We speculated that effects evoked by activation of discrete skin regions on the foot dorsum would be topographically organized, as with the foot sole. Nonnoxious electrical stimulation was delivered to five discrete locations on the dorsal surface of the foot during treadmill walking. Muscle activity from muscles acting at the ankle, knee, hip, and shoulder were recorded along with ankle, knee, and hip kinematics and kinetic information from forces under the foot. All data were sorted on the basis of stimulus occurrence in 12 step cycle phases, before being averaged together within a phase for subsequent analysis. Results reveal dynamic changes in reflex amplitudes and kinematics that are site specific and phase dependent. Most responses from discrete sites on the foot dorsum were seen in the swing phase suggesting function to conform foot trajectory to maintain stability of the moving limb. In general, responses from lateral stimulation differed from medial stimulation, and effects were largest from stimulation at the distal end of the foot at the metatarsals; that is, in anatomical locations where actual impact with an object in the environment is most likely during swing. Responses to stimulation extend to include muscles at the hip and shoulder. We reveal that afferent feedback from specific cutaneous locations on the foot dorsum influences stance and swing phase corrective responses. This emphasizes the critical importance of feedback from the entire foot surface in locomotor control and has application for rehabilitation after neurological injury and in footwear development.

Foot Problems in a Group of Patients with Rheumatoid Arthritis: An Unmet Need for Foot Care

OpenAIRE

Borman, Pinar; Ayhan, Figen; Tuncay, Figen; Sahin, Mehtap

2012-01-01

Objectives: The aim of this study was to evaluate the foot involvement in a group of RA patients in regard to symptoms, type and frequency of deformities, location, radiological changes, and foot care. Patients and Methods: A randomized selected 100 rheumatoid arthritis (RA) patients were recruited to the study. Data about foot symptoms, duration and location of foot pain, pain intensity, access to services related to foot, treatment, orthoses and assistive devices, and usefulness of therapie...

Management of high-energy foot and ankle injuries in the geriatric population.

Science.gov (United States)

Herscovici, Dolfi; Scaduto, Julia M

2012-03-01

By the year 2035 almost 20% of the US population of 389 million people will be 65 years and older. What this group has, compared with aged populations in the past, is better health, more mobility, and more active lifestyles. From January 1989 through December 2010, a total of 494 elderly patients with 536 foot and ankle injuries were identified. Within this group, 237 (48%) patients with 294 injuries were sustained as a result of a high-energy mechanism. These mechanisms consisted of 170 motor vehicle accidents, 30 as a result of high (not ground level) energy falls, 2 from industrial accidents, and 35 classified as other, which included sports, blunt trauma, bicycle, airplane or boating accidents, crush injuries, and injuries resulting from a lawn mower. The injuries produced were 17 metatarsal fractures, 9 Lisfranc injuries, 10 midfoot (navicular, cuneiform, or cuboid) fractures, 23 talus fractures, 63 calcaneal fractures, 73 unimalleolar, bimalleolar, or trimalleolar ankle fractures, 45 pilon fractures, and 3 pure dislocations of the foot or ankle. Overall, 243 (83%) of these injuries underwent surgical fixation and data have shown that when surgery is used to manage high-energy injuries of the foot and ankle in the elderly individuals, the complications and outcomes are similar to those seen in younger patients. Therefore, the decision for surgical intervention for high-energy injuries of the foot and ankle should be based primarily on the injury pattern and not solely on the age of the patient.

Natural gaits of the non-pathological flat foot and high-arched foot.

Science.gov (United States)

Fan, Yifang; Fan, Yubo; Li, Zhiyu; Lv, Changsheng; Luo, Donglin

2011-03-18

There has been a controversy as to whether or not the non-pathological flat foot and high-arched foot have an effect on human walking activities. The 3D foot scanning system was employed to obtain static footprints from subjects adopting a half-weight-bearing stance. Based upon their footprints, the subjects were divided into two groups: the flat-footed and the high-arched. The plantar pressure measurement system was used to measure and record the subjects' successive natural gaits. Two indices were proposed: distribution of vertical ground reaction force (VGRF) of plantar and the rate of change of footprint areas. Using these two indices to compare the natural gaits of the two subject groups, we found that (1) in stance phase, there is a significant difference (pplantar; (2) in a stride cycle, there is also a significant difference (pfootprint area. Our analysis suggests that when walking, the VGRF of the plantar brings greater muscle tension to the flat-footed while a smaller rate of change of footprint area brings greater stability to the high-arched.

From the diabetic foot ulcer and beyond: how do foot infections spread in patients with diabetes?

Science.gov (United States)

Aragón-Sánchez, Javier; Lázaro-Martínez, Jose Luis; Pulido-Duque, Juan; Maynar, Manuel

2012-01-01

A diabetic foot infection is usually the result of a pre-existing foot ulceration and is the leading cause of lower extremity amputation in patients with diabetes. It is widely accepted that diabetic foot infections may be challenging to treat for several reasons. The devastating effects of hyperglycemia on host defense, ischemia, multi-drug resistant bacteria and spreading of infection through the foot may complicate the course of diabetic foot infections. Understanding the ways in which infections spread through the diabetic foot is a pivotal factor in order to decide the best approach for the patient's treatment. The ways in which infections spread can be explained by the anatomical division of the foot into compartments, the tendons included in the compartments, the initial location of the point of entry of the infection and the type of infection that the patient has. The aim of this paper is to further comment on the existed and proposed anatomical principles of the spread of infection through the foot in patients with diabetes. PMID:23050067

Walking Training with Foot Drop Stimulator Controlled by a Tilt Sensor to Improve Walking Outcomes: A Randomized Controlled Pilot Study in Patients with Stroke in Subacute Phase

Directory of Open Access Journals (Sweden)

G. Morone

2012-01-01

Full Text Available Foot drop is a quite common problem in nervous system disorders. Neuromuscular electrical stimulation (NMES has showed to be an alternative approach to correct foot drop improving walking ability in patients with stroke. In this study, twenty patients with stroke in subacute phase were enrolled and randomly divided in two groups: one group performing the NMES (i.e. Walkaide Group, WG and the Control Group (CG performing conventional neuromotor rehabilitation. Both groups underwent the same amount of treatment time. Significant improvements of walking speed were recorded for WG (% than for CG (%, as well as in terms of locomotion (Functional Ambulation Classification score: . In terms of mobility and force, ameliorations were recorded, even if not significant (Rivermead Mobility Index: ; Manual Muscle Test: . Similar changes between groups were observed for independence in activities of daily living, neurological assessments, and spasticity reduction. These results highlight the potential efficacy for patients affected by a droop foot of a walking training performed with a neurostimulator in subacute phase.

The Glasgow-Maastricht foot model, evaluation of a 26 segment kinematic model of the foot.

Science.gov (United States)

Oosterwaal, Michiel; Carbes, Sylvain; Telfer, Scott; Woodburn, James; Tørholm, Søren; Al-Munajjed, Amir A; van Rhijn, Lodewijk; Meijer, Kenneth

2016-01-01

Accurately measuring of intrinsic foot kinematics using skin mounted markers is difficult, limited in part by the physical dimensions of the foot. Existing kinematic foot models solve this problem by combining multiple bones into idealized rigid segments. This study presents a novel foot model that allows the motion of the 26 bones to be individually estimated via a combination of partial joint constraints and coupling the motion of separate joints using kinematic rhythms. Segmented CT data from one healthy subject was used to create a template Glasgow-Maastricht foot model (GM-model). Following this, the template was scaled to produce subject-specific models for five additional healthy participants using a surface scan of the foot and ankle. Forty-three skin mounted markers, mainly positioned around the foot and ankle, were used to capture the stance phase of the right foot of the six healthy participants during walking. The GM-model was then applied to calculate the intrinsic foot kinematics. Distinct motion patterns where found for all joints. The variability in outcome depended on the location of the joint, with reasonable results for sagittal plane motions and poor results for transverse plane motions. The results of the GM-model were comparable with existing literature, including bone pin studies, with respect to the range of motion, motion pattern and timing of the motion in the studied joints. This novel model is the most complete kinematic model to date. Further evaluation of the model is warranted.

Priorities in offloading the diabetic foot

NARCIS (Netherlands)

Bus, Sicco A.

2012-01-01

Biomechanical factors play an important role in diabetic foot disease. Reducing high foot pressures (i.e. offloading) is one of the main goals in healing and preventing foot ulceration. Evidence-based guidelines show the strong association between the efficacy to offload the foot and clinical

Footwear Matters: Influence of Footwear and Foot Strike on Load Rates during Running.

Science.gov (United States)

Rice, Hannah M; Jamison, Steve T; Davis, Irene S

2016-12-01

Running with a forefoot strike (FFS) pattern has been suggested to reduce the risk of overuse running injuries, due to a reduced vertical load rate compared with rearfoot strike (RFS) running. However, resultant load rate has been reported to be similar between foot strikes when running in traditional shoes, leading to questions regarding the value of running with a FFS. The influence of minimal footwear on the resultant load rate has not been considered. This study aimed to compare component and resultant instantaneous loading rate (ILR) between runners with different foot strike patterns in their habitual footwear conditions. Twenty-nine injury-free participants (22 men, seven women) ran at 3.13 m·s along a 30-m runway, with their habitual foot strike and footwear condition. Ground reaction force data were collected. Peak ILR values were compared between three conditions; those who habitually run with an RFS in standard shoes, with an FFS in standard shoes, and with an FFS in minimal shoes. Peak resultant, vertical, lateral, and medial ILR were lower (P strike. When running with an FFS, peak posterior ILR were lower (P strike. Therefore, it appears that footwear alters the load rates during running, even with similar foot strike patterns.

The Glasgow-Maastricht foot model, evaluation of a 26 segment kinematic model of the foot

OpenAIRE

Oosterwaal, Michiel; Carbes, Sylvain; Telfer, Scott; Woodburn, James; T?rholm, S?ren; Al-Munajjed, Amir A.; van Rhijn, Lodewijk; Meijer, Kenneth

2016-01-01

Background Accurately measuring of intrinsic foot kinematics using skin mounted markers is difficult, limited in part by the physical dimensions of the foot. Existing kinematic foot models solve this problem by combining multiple bones into idealized rigid segments. This study presents a novel foot model that allows the motion of the 26 bones to be individually estimated via a combination of partial joint constraints and coupling the motion of separate joints using kinematic rhythms. Methods ...

Education for diabetic foot

Directory of Open Access Journals (Sweden)

Fabio Batista

2009-03-01

Full Text Available Objective: The purpose of this investigation was to stratify the risk in a consecutive group of diabetic patients presenting, for the first time, in a diabetic foot clinic. Additional aims were to investigate the preventive measures in the local health system and to evaluate the level of patient’s awareness about diabetic foot-associated morbidity. Methods: Fifty consecutive adult diabetic patients referred to a Diabetic Foot Clinic of a Municipal Public Hospital comprised the sample for this observational study. The enrollment visit was considered as the first health-system intervention for potential foot morbidity. The average time elapsed since a diagnosis of diabetes among patients was five years. Rresults: At the time of presentation, 94% of sample was not using appropriate footwear. Pedal pulses (dorsalis pedis and/or posterior tibial arteries were palpable in 76% of patients. Thirty subjects (60% had signs of peripheral neuropathy. Twenty-one subjects (42% had clinical deformity. There was a positive correlation between a history of foot ulcer, the presence of peripheral neuropathy, and the presence of foot deformity (p < 0.004 in each correlation. Cconclusions: Informing and educating the patients and those interested in this subject and these problems is essential for favorable outcomes in this scenario.

Foot Health Facts for Athletes

Science.gov (United States)

... common foot problems affecting athletes: Prevent Foot & Ankle Running Injuries (downloadable PDF) Back-to-School Soccer Season Surgeons ... and Ankle Soccer is hard on the feet! Injuries to the foot and ankle can occur from running and side-to-side cutting, sliding or tackling ...

Biogas container - mobile plant concept for the decentralized power generation; Biogascontainer. Mobiles Anlagenkonzept zur dezentralen Energiegewinnung

Energy Technology Data Exchange (ETDEWEB)

Warncke, Jessica; Orth, Maik [Innovations- und Bildungszentrum Hohen Luckow e.V., Hohen Luckow (Germany); Schlegel, Mathias [Rostock Univ. (Germany); Steinhagen, Katrin [ROSOMA GmbH, Rostock-Marienehe (Germany)

2011-07-01

In the framework of a cooperation project of the Federal Ministry of Economics and Technology was developed a small biogas system, that is concepted in the order of a 40-foot standard container, that is modular structured, works energy-independent and optional can be used mobile. First rank the system was designed for biogas production in developing and emerging countries. Now there are inter alia also concrete inquiries of german partners. (orig.)

Sesamoid Injuries in the Foot

Science.gov (United States)

... on the ball of the foot when walking, running and jumping. Sesamoid injuries can involve the bones, tendons and/or surrounding ... on the ball of the foot, such as running, basketball, football, golf, tennis and ballet. ... of Sesamoid Injuries in the Foot There are three types of ...

Combined diabetic foot infections treatment, complicated by foot phlegmon

Directory of Open Access Journals (Sweden)

Yavruyan O.A.

2017-01-01

Full Text Available the article shows the analysis of treatment results of 163 patients with diabetic foot infections, complicated by foot phlegmon. Patients were divided into 2 groups. The control group received traditional treatment and had an autopsy deep plantar space done and then, during the second phase, cytokine-rich autoplatelet concentrate had been applied. The research results confirmed a significant decrease in the duration of treatment and hospitalization of patients in the hospital.

Relationship between foot sensibility and postural control in the young and elderly. http://dx.doi.org/10.5007/1980-0037.2013v15n1p215

Directory of Open Access Journals (Sweden)

Letícia Suemi Ueda

2013-03-01

Full Text Available Impairments in the foot sensitivity in the elderly cause changes in locomotion and postural control that may increase fall risk. Understanding the use of foot afference in the elderly may help preventing loss of mobility and fall. However, there are few studies addressing the relation between the sensitivity of different foot regions and postural control. To investigating this lack in literature, the objective of our study was to assess the relationship between foot sensibility and postural control in young and elderly. Forty-two subjects volunteered to this study; they were assigned to a group according to their age (young or elderly. The participants were assessed regarding anthropometry, foot sensibility (using monofilaments and postural control (using a force plate. The indexes of foot sensibility and postural control were correlated and compared between the groups. Elderly had worst foot sensibility and postural control than young. Center of pressure are and amplitude in antero-posterior direction were correlated with the general foot sensibility, but not with a specific point of the foot in the elderly. For young, the sensitivity in the forefoot region was related to improved postural control.

Experience with a mobile and fixed base supercompactor

International Nuclear Information System (INIS)

Jessop, D.T.

1989-01-01

Dry active waste (DAW) produced at nuclear power plants, colleges and universities and the commercial industry accounts for the largest fraction of the radioactive waste volume generated and shipped for burial. Since burial of this waste is charged on a dollar per cubic foot basis, the application of volume reduction techniques to DAW merits attention to reduce a generators disposal and operating costs. Dramatically increased burial costs have now created a need for more advanced volume reduction techniques. In 1974 the cost of disposing of low-level radioactive waste was $1.10 per cubic foot. Since that time disposal charges have climbed to $27-38 per cubic foot depending on the disposal site. One way of slowing these rising costs is supercompacting waste to achieve the highest density and thus lowest burial volume. This becomes even more important if the generator is an out-of-compact generator and must pay an additional $20.00 per cubic foot surcharge. This will become $40 per cubic foot in 1990. This paper reports on a mobile supercompactor designed to reduce the volume of 52- or 55-gallon drums filled with dry active waste by as much as 9-percent. This supercompactor generates 2,200 tons of force, or approximately 10,000 pounds per square inch over the surface of the drum

Magnitude and Spatial Distribution of Impact Intensity Under the Foot Relates to Initial Foot Contact Pattern.

Science.gov (United States)

Breine, Bastiaan; Malcolm, Philippe; Segers, Veerle; Gerlo, Joeri; Derie, Rud; Pataky, Todd; Frederick, Edward C; De Clercq, Dirk

2017-12-01

In running, foot contact patterns (rear-, mid-, or forefoot contact) influence impact intensity and initial ankle and foot kinematics. The aim of the study was to compare impact intensity and its spatial distribution under the foot between different foot contact patterns. Forty-nine subjects ran at 3.2 m·s -1 over a level runway while ground reaction forces (GRF) and shoe-surface pressures were recorded and foot contact pattern was determined. A 4-zone footmask (forefoot, midfoot, medial and lateral rearfoot) assessed the spatial distribution of the vertical GRF under the foot. We calculated peak vertical instantaneous loading rate of the GRF (VILR) per foot zone as the impact intensity measure. Midfoot contact patterns were shown to have the lowest, and atypical rearfoot contact patterns the highest impact intensities, respectively. The greatest local impact intensity was mainly situated under the rear- and midfoot for the typical rearfoot contact patterns, under the midfoot for the atypical rearfoot contact patterns, and under the mid- and forefoot for the midfoot contact patterns. These findings indicate that different foot contact patterns could benefit from cushioning in different shoe zones.

Low-level stored waste inspection using mobile robots

International Nuclear Information System (INIS)

Byrd, J.S.; Pettus, R.O.

1996-01-01

A mobile robot inspection system, ARIES (Autonomous Robotic Inspection Experimental System), has been developed for the U.S. Department of Energy to replace human inspectors in the routine, regulated inspection of radioactive waste stored in drums. The robot will roam the three-foot aisles of drums, stacked four high, making decisions about the surface condition of the drums and maintaining a database of information about each drum. A distributed system of onboard and offboard computers will provide versatile, friendly control of the inspection process. This mobile robot system, based on a commercial mobile platform, will improve the quality of inspection, generate required reports, and relieve human operators from low-level radioactive exposure. This paper describes and discusses primarily the computer and control processes for the system

Natural gaits of the non-pathological flat foot and high-arched foot.

Directory of Open Access Journals (Sweden)

Yifang Fan

Full Text Available There has been a controversy as to whether or not the non-pathological flat foot and high-arched foot have an effect on human walking activities. The 3D foot scanning system was employed to obtain static footprints from subjects adopting a half-weight-bearing stance. Based upon their footprints, the subjects were divided into two groups: the flat-footed and the high-arched. The plantar pressure measurement system was used to measure and record the subjects' successive natural gaits. Two indices were proposed: distribution of vertical ground reaction force (VGRF of plantar and the rate of change of footprint areas. Using these two indices to compare the natural gaits of the two subject groups, we found that (1 in stance phase, there is a significant difference (p<0.01 in the distributions of VGRF of plantar; (2 in a stride cycle, there is also a significant difference (p<0.01 in the rate of change of footprint area. Our analysis suggests that when walking, the VGRF of the plantar brings greater muscle tension to the flat-footed while a smaller rate of change of footprint area brings greater stability to the high-arched.

Electromagnetic Energy Radiated from Mobile Phone Alters ...

African Journals Online (AJOL)

could be some risk of carcinogenicity. ... The position of mobile at the ... who attended the consultant clinic in the teaching hospital ... with the impulse conduction velocity like antimalarials, ... Each patient was allowed to lie on the supine position and ... The following ECG variables (which are calculated ..... Boston, MA:.

Foot Kinetics and Kinematics Profile in Type 2 Diabetes Mellitus with Peripheral Neuropathy: A Hospital Based Study from South India.

Science.gov (United States)

Hazari, Animesh; Maiya, Arun G; N, Shivashankara K

2018-02-01

A kinetic change in thefoot like altered plantar pressure is the most common etiological risk factor for causing foot ulcers among people with diabetes mellitus. Kinematic alterations in joint angle and spatiotemporal parameters of the gait have also been frequently observed in participants with diabetes peripheral neuropathy. Diabetes peripheral neuropathy is the most common long-term standing complication of type 2 diabetes mellitus. It leads to various micro and macrovascular related complication of the foot. There is a gap in theliteraturefor biomechanical evaluation and assessment in type 2 diabetes mellitus with peripheral neuropathy in Indian population. The aim of the study was to assess and determine the biomechanical changes including kinetics and kinematics of foot among diabetic peripheral neuropathy. The cross-sectional study was conducted at Diabetic Foot Clinic, Kasturba Hospital, Manipal University, Manipal, Karnataka, India. A total of 120 participants with type 2 diabetes mellitus and peripheral neuropathywere recruited under the purposive sampling method. Participants with any active ulceration or amputation were excluded from the study. The mean age, height, weight, body mass index, duration of diabetes was 57±14 year, 164±11cm, 61±18kg, 24± 3, 12±7 year respectively. There were significant changes in overall biomechanical profile along with clinical manifestations of diabetes peripheral neuropathy.The regression analysis showed statistical significance for dynamic maximum plantar pressure at forefoot with age, weight, height, duration of diabetes, body mass index, knee & ankle joint angle at toe-off phase of gait cycle,pinprick sensation and ankle reflex (R=.71,R =.55, F (12, 108)=521.9 kPa, p=.002) Conclusions: From the present study, we conclude that people with type 2 diabetes mellitus and peripheral neuropathy have significant changes in their foot kinetics and kinematicsparameters. Therefore, they could be at higher risk of foot

Omni directional mobile robot capable of variable foot printing based on hub type drive module

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyo Joong; Cho, Chang Nho; Kim, Hwi Su; Song, Jae Bok [Korea Univ., Seoul (Korea, Republic of)

2012-03-15

In recent years, an increased amount of research has been carried out on mobile robots to improve the performance of service robots. Mobile robots maximize the mobility of service robots, thus allowing them to work in different areas. However, conventional service robots have their center of mass placed high above the ground, which may cause them to fall when moving at high speed. Furthermore, hub type actuators, which are often used for mobile robots, are large and expensive. In this study, we propose a mobile robot with a hub type actuator unit and a variable footprint mechanism. The proposed variable footprint mechanism greatly improves the stability and mobility of the robot, allowing it to move freely in a narrow space and carry out various tasks. The performance of the proposed robot is verified experimentally.

A new method to normalize plantar pressure measurements for foot size and foot progression angle.

NARCIS (Netherlands)

Keijsers, N.L.; Stolwijk, N.M.; Nienhuis, B.; Duysens, J.E.J.

2009-01-01

Plantar pressure measurement provides important information about the structure and function of the foot and is a helpful tool to evaluate patients with foot complaints. In general, average and maximum plantar pressure of 6-11 areas under the foot are used to compare groups of subjects. However,

Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities

Science.gov (United States)

Amin, Noha; Doupis, John

2016-01-01

The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high risk foot are essential for the prevention of foot ulceration and amputation. Proper assessment of the diabetic foot ulceration and appropriate management ensure better prognosis. Management is based on revascularization procedures, wound debridement, treatment of infection and ulcer offloading. Management and type of dressing applied are tailored according to the type of wound and the foot condition. The scope of this review paper is to describe the diabetic foot syndrome starting from the evaluation of the foot at risk for ulceration, up to the new treatment modalities. PMID:27076876

24 CFR 3285.312 - Footings.

Science.gov (United States)

2010-04-01

... reinforcing steel in cast-in-place concrete footings. (2) Pressure-treated wood. (i) Pressure-treated wood footings must consist of a minimum of two layers of nominal 2-inch thick pressure-treated wood, a single... values listed have been reduced by the dead load of the concrete footing. 4. Concrete block piers must...

Foot muscles strengthener

Directory of Open Access Journals (Sweden)

Boris T. Glavač

2012-04-01

Full Text Available Previous experience in the correction of flat feet consisted of the use of insoles for shoes and exercises with toys, balls, rollers, inclined planes, etc. A device for strengthening foot muscles is designed for the correction of flat feet in children and, as its name suggests, for strengthening foot muscles in adults. The device is made of wood and metal, with a mechanism and technical solutions, enabling the implementation of specific exercises to activate muscles responsible for the formation of the foot arch. It is suitable for home use with controlled load quantities since it has calibrated springs. The device is patented with the Intellectual Property Office, Republic of Serbia, as a petty patent.

What Is a Foot and Ankle Surgeon?

Science.gov (United States)

... A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle surgeons are the surgical ... every age. What education has a foot and ankle surgeon received? After completing undergraduate education, the foot ...

Sex-related differences in foot shape.

Science.gov (United States)

Krauss, I; Grau, S; Mauch, M; Maiwald, C; Horstmann, T

2008-11-01

The purpose of the study was to investigate sex-related differences in foot morphology. In total, 847 subjects were scanned using a 3-D-footscanner. Three different analysis methods were used: (1) comparisons were made for absolute foot measures within 250-270 mm foot length (FL); (2) and for averaged measures (% FL) across all sizes; (3) the feet were then classified using a cluster analysis. Within 250-270 mm FL, male feet were wider and higher (mean differences (MD) 1.3-5.9 mm). No relevant sex-related differences could be found in the comparison of averaged measures (MD 0.3-0.6% FL). Foot types were categorised into voluminous, flat-pointed and slender. Shorter feet were more often voluminous, longer feet were more likely to be narrow and flat. However, the definition of 'short' and 'long' was sex-related; thus, allometry of foot measures was different. For shoe design, measures should be derived for each size and sex separately. Different foot types should be considered to account for the variety in foot shape. Improper footwear can cause foot pain and deformity. Therefore, knowledge of sex-related differences in foot measures is important to assist proper shoe fit in both men and women. The present study supplements the field of knowledge within this context with recommendations for the manufacturing of shoes.

The impact of rheumatoid foot on disability in Colombian patients with rheumatoid arthritis

Science.gov (United States)

Rojas-Villarraga, Adriana; Bayona, Javier; Zuluaga, Natalia; Mejia, Santiago; Hincapie, Maria-Eugenia; Anaya, Juan-Manuel

2009-01-01

Background Alterations in the feet of patients with rheumatoid arthritis (RA) are a cause of disability in this population. The purpose of this research was to evaluate the impact that foot impairment has on the patients' global quality of life (QOL) based on validated scales and its relationship to disease activity. Methods This was a cross-sectional study in which 95 patients with RA were enrolled. A complete physical examination, including a full foot assessment, was done. The Spanish versions of the Health Assessment Questionnaire (HAQ) Disability Index and of the Disease Activity Score (DAS 28) were administered. A logistic regression model was used to analyze data and obtain adjusted odds ratios (AORs). Results Foot deformities were observed in 78 (82%) of the patients; hallux valgus (65%), medial longitudinal arch flattening (42%), claw toe (lesser toes) (39%), dorsiflexion restriction (tibiotalar) (34%), cock-up toe (lesser toes) (25%), and transverse arch flattening (25%) were the most frequent. In the logistic regression analysis (adjusted for age, gender and duration of disease), forefoot movement pain, subtalar movement pain, tibiotalar movement pain and plantarflexion restriction (tibiotalar) were strongly associated with disease activity and disability. The positive squeeze test was significantly associated with disability risk (AOR = 6,3; 95% CI, 1.28–30.96; P = 0,02); hallux valgus, and dorsiflexion restriction (tibiotalar) were associated with disease activity. Conclusion Foot abnormalities are associated with active joint disease and disability in RA. Foot examinations provide complementary information related to the disability as an indirect measurement of quality of life and activity of disease in daily practice. PMID:19527518

Assessment of signs of foot infection in diabetes patients using photographic foot imaging and infrared thermography

NARCIS (Netherlands)

Hazenberg, Constantijn E. V. B.; van Netten, Jaap J.; van Baal, Sjef G.; Bus, Sicco A.

2014-01-01

Patients with diabetic foot disease require frequent screening to prevent complications and may be helped through telemedical home monitoring. Within this context, the goal was to determine the validity and reliability of assessing diabetic foot infection using photographic foot imaging and infrared

The association of foot arch posture and prior history of shoulder or elbow surgery in elite-level baseball pitchers.

Science.gov (United States)

Feigenbaum, Luis A; Roach, Kathryn E; Kaplan, Lee D; Lesniak, Bryson; Cunningham, Sean

2013-11-01

Case-control. The specific aim of this study was to examine the association between abnormal foot arch postures and a history of shoulder or elbow surgery in baseball pitchers. Pitching a baseball generates forces throughout the musculoskeletal structures of the upper and lower limbs. Structures such as the longitudinal arch of the foot are adaptable to stresses over time. Repeated pitching-related stresses may contribute to acquiring abnormal foot arch postures. Inversely, congenitally abnormal foot arch posture may lead to altered stresses of the upper limb during pitching. A convenience sample of 77 pitchers was recruited from a Division I university team and a professional baseball franchise. Subjects who had a history of shoulder or elbow surgery to the pitching arm were classified as cases. Subjects who met the criteria for classification of pes planus or pes cavus based on longitudinal arch angle were classified as having abnormal foot arch posture. Odds ratios were calculated to examine the association between abnormal foot arch posture and pitching-arm injury requiring surgery. Twenty-three subjects were classified as cases. The odds of being a case were 3.4 (95% confidence interval: 1.2, 9.6; P = .02) times greater for subjects with abnormal foot arch posture and 2.9 (95% confidence interval: 1.0, 8.1; P = .04) times greater for subjects with abnormal foot posture on the lunge leg. Abnormal foot arch posture and a surgical history in the pitching shoulder or elbow may be associated. Because the foot and its arches are adaptable and change over time, the pathomechanics of this association should be further explored.

Flip-flop footwear with a moulded foot-bed for the treatment of foot pain: a randomised controlled trial.

Science.gov (United States)

Chuter, Vivienne Helaine; Searle, Angela; Spink, Martin J

2016-11-11

Foot pain is a common problem affecting up to 1 in 5 adults and is known to adversely affect activities of daily living and health related quality of life. Orthopaedic footwear interventions are used as a conservative treatment for foot pain, although adherence is known to be low, in part due to the perception of poor comfort and unattractiveness of the footwear. The objective of this trial was to assess the efficacy of flip-flop style footwear (Foot Bio-Tec©) with a moulded foot-bed in reducing foot pain compared to participant's usual footwear. Two-arm parallel randomised controlled trial using computer generated random allocation schedule at an Australian university podiatry clinic. 108 volunteers with disabling foot pain were enrolled after responding to an advertisement and eligibility screening. Participants were randomly allocated to receive footwear education and moulded flip-flop footwear to wear as much as they were comfortable with for the next 12 weeks (n = 54) or footwear education and instructions to wear their normal footwear for the next 12 weeks (n = 54). Primary outcome was the pain domain of the Foot Health Status Questionnaire (FHSQ). Secondary outcomes were the foot function and general foot health domains of the FHSQ, a visual analogue scale (VAS) for foot pain and perceived comfort of the intervention footwear. Compared to the control group, the moulded flip-flop group showed a significant improvement in the primary outcome measure of the FHSQ pain domain (adjusted mean difference 8.36 points, 95 % CI 5.58 to 13.27, p footwear and six (footwear group = 4) were lost to follow up. Our results demonstrate that flip-flop footwear with a moulded foot-bed can have a significant effect on foot pain, function and foot health and might be a valuable adjunct therapy for people with foot pain. ACTRN12614000933651 . Retrospectively registered: 01/09/2014.

Imaging of Charcot foot

International Nuclear Information System (INIS)

Erlemann, Rainer; Schmitz, Annette

2014-01-01

The onset of a Charcot foot ist a feared complication of a long lasting diabetes mellitus. A peripheral neuropathy and continuous weight bearing of the foot subsequent to repeated traumas depict the conditions. There exist three types of a Charcot foot, an atrophic, a hypertophic and a mixed type. In early stages a differentiation from osteoarthritis is difficult. Subluxation or luxation within the Lisfranc's joint is typical. The joints of the foot could rapidly and extensively be destroyed or may present the morphology of a 'superosteoarthritis'. Often, soft tissue infections or osteomyelitis evolve from ulcers of the skin as entry points. Diagnosis of osteomyelitis necessitate MR imaging as plain radiography offers only low sensitivity for detection of an osteomyelitis. The existence of periosteal reactions is not a proof for osteomyelitis. Bone marrow edema and soft tissue edema also appear in a non infected Charcot foot. The range of soft tissue infections goes from cellulitis over phlegmon to abscesses. The ghost sign is the most suitable diagnostic criterion for osteomyelitis. In addition, the penumbra sign or the existence of a sinus tract between a skin ulcer and the affected bone may be helpful. (orig.)

Starting off on the right foot: strong right-footers respond faster with the right foot to positive words and with the left foot to negative words.

Science.gov (United States)

de la Vega, Irmgard; Graebe, Julia; Härtner, Leonie; Dudschig, Carolin; Kaup, Barbara

2015-01-01

Recent studies have provided evidence for an association between valence and left/right modulated by handedness, which is predicted by the body-specificity hypothesis (Casasanto, 2009) and also reflected in response times. We investigated whether such a response facilitation can also be observed with foot responses. Right-footed participants classified positive and negative words according to their valence by pressing a key with their left or right foot. A significant interaction between valence and foot only emerged in the by-items analysis. However, when dividing participants into two groups depending on the strength of their footedness, an interaction between valence and left/right was observed for strong right-footers, who responded faster with the right foot to positive words, and with the left foot to negative words. No interaction emerged for weak right-footers. The results strongly support the assumption that fluency lies at the core of the association between valence and left/right.

A three-dimensional model to assess the effect of ankle joint axis misalignments in ankle-foot orthoses.

Science.gov (United States)

Fatone, Stefania; Johnson, William Brett; Tucker, Kerice

2016-04-01

Misalignment of an articulated ankle-foot orthosis joint axis with the anatomic joint axis may lead to discomfort, alterations in gait, and tissue damage. Theoretical, two-dimensional models describe the consequences of misalignments, but cannot capture the three-dimensional behavior of ankle-foot orthosis use. The purpose of this project was to develop a model to describe the effects of ankle-foot orthosis ankle joint misalignment in three dimensions. Computational simulation. Three-dimensional scans of a leg and ankle-foot orthosis were incorporated into a link segment model where the ankle-foot orthosis joint axis could be misaligned with the anatomic ankle joint axis. The leg/ankle-foot orthosis interface was modeled as a network of nodes connected by springs to estimate interface pressure. Motion between the leg and ankle-foot orthosis was calculated as the ankle joint moved through a gait cycle. While the three-dimensional model corroborated predictions of the previously published two-dimensional model that misalignments in the anterior -posterior direction would result in greater relative motion compared to misalignments in the proximal -distal direction, it provided greater insight showing that misalignments have asymmetrical effects. The three-dimensional model has been incorporated into a freely available computer program to assist others in understanding the consequences of joint misalignments. Models and simulations can be used to gain insight into functioning of systems of interest. We have developed a three-dimensional model to assess the effect of ankle joint axis misalignments in ankle-foot orthoses. The model has been incorporated into a freely available computer program to assist understanding of trainees and others interested in orthotics. © The International Society for Prosthetics and Orthotics 2014.

Diabetic Foot - Multiple Languages

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... Are Here: Home → Multiple Languages → All Health Topics → Diabetic Foot URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Diabetic Foot - Multiple Languages To use the sharing features on ...

Plantar pressure and foot pain in the last trimester of pregnancy.

Science.gov (United States)

Karadag-Saygi, Evrim; Unlu-Ozkan, Feyza; Basgul, Alin

2010-02-01

Back and foot pain are common complaints during pregnancy. Progression of symptoms is seen especially in the third trimester as the center of gravity (COP) is altered due to weight gain. The aim of the study was to evaluate plantar pressure changes and postural balance differences of pregnant women. Thirty-five last trimester pregnant women with complaints of foot pain were included. The control group consisted of 35 non-pregnant women who were age and body mass index (BMI) matched volunteers. All selected cases were overweight. Foot pain in pregnancy was measured by Visual analogue scale (VAS). Percentages of pressure on forefoot and hindfoot were measured using static pedobarography and peak pressures at forefoot, midfoot and hindfoot were measured using dynamic pedobarography. As a measurement of balance, COP sway length and width were also analyzed. Compared to overweight individuals, pregnant patients had higher forefoot pressure on the right side with standing and walking. Also, significant increases in contact times under the forefoot and longer floor contact times were found. VAS scores were correlated with forefoot contact times during walking. Although the sway length from COP was higher than controls, no significant correlation was found in sway length and weight gain. These data suggest that forefoot pressures increase in the last trimester of pregnancy during standing and walking. There is prominent increased postural sway in anterior-posterior direction in this period. We believe that based on the observed pressure changes, foot pain in pregnancy due to changes in body mass and distribution may be relieved by exercise and shoewear modifications.

The Diabetic Foot as a Proxy for Cardiovascular Events and Mortality Review.

Science.gov (United States)

Dietrich, Isa; Braga, Gustavo Arruda; de Melo, Fernanda Gomes; da Costa Silva Silva, Ana Carolina Calmon

2017-10-02

This article reviewed very recent papers (2016) discussing or bringing clinical evidences of the possible common pathways leading to diabetic foot syndrome (DFS) and increased mortality rates. Diabetic patients with diabetic foot syndrome have a mortality rate greater than twofold when compared with non-ulcerated diabetics. In addition, the 5-year mortality rate following amputation is estimated at 39-68%, a life expectancy comparable to aggressive types of cancer or advanced congestive heart failure. The majority of patients with diabetic foot ulcer also present insulin resistance, central obesity, dyslipidemia, and hypertension that characterize the metabolic syndrome that, in turn, is associated with an elevated risk of major cardiovascular events. Sensory neuropathy is the primary cause of more the 60% of diabetic foot ulcer. Diabetic peripheral neuropathy is a microvascular complication of diabetes mellitus and in type 2 diabetes, not only hyperglycemia but also other metabolic alterations and persistent inflammatory status due to adiposity play a major role in axon injury. Elevated triglycerides have been showed to be an independent risk factor for lower extremity amputation in diabetic patients. Also, toxic adiposity, oxidative stress, mitochondrial dysfunction, activation of the polyol pathway, accumulation of advanced glycation end products (AGEs), and elevation of inflammatory markers are also implicated in diabetic vascular disease and neuropathy. The hypotheses that the association between DFS and increased rates of mortality reflects the progression of micro- and macrovascular complications are reinforced by the additional association of DFU to renal failure and retinopathy.

Health education programmes to improve foot self-care practices and foot problems among older people with diabetes: a systematic review.

Science.gov (United States)

Ahmad Sharoni, Siti Khuzaimah; Minhat, Halimatus Sakdiah; Mohd Zulkefli, Nor Afiah; Baharom, Anisah

2016-09-01

To assess the effectiveness of health education programmes to improve foot self-care practices and foot problems among older people with diabetes. The complications of diabetes among older people are a major health concern. Foot problems such as neuropathy, ulcer and ultimately amputation are a great burden on older people with diabetes. Diabetes foot education programmes can influence the behaviour of older people in practising foot self-care and controlling the foot problems. However, the educational approaches used by the educators are different. Therefore, it is important to assess the education programmes from various evidence-based practices. Six databases, EBSCOhost medical collections (MEDLINE, CINAHL, Psychology and Behavioral Sciences Collection), SAGE, Wiley Online Library, ScienceDirect, SpringerLink and Web of Science, were used to search for articles published from January 2000 to March 2015. The search was based on the inclusion criteria and keywords including 'foot', 'care' and 'diabetes'. Fourteen studies were assessed and reviewed in the final stage. Health education programmes varied according to their design, setting, approach, outcome measured and results. Foot assessment, verbal and written instructions and discussion were proved to improve the foot self-care and foot problems. Subsequent follow-ups and evaluations had a significant effect. An improvement was observed in foot self-care scores and foot problems (such as neuropathy, foot disability, lesion, ulcer, tinea pedis and callus grade) after implementation of the health education programme. The findings of this study support the claim that a health education programme increases the foot self-care scores and reduces the foot problems. However, there were certain methodological concerns in the reviewed articles, indicating the need for further evaluation. In future, researchers and practitioners must implement a vigorous education programme focusing on diabetes foot self-care among the

Diabetes: Good Diabetes Management and Regular Foot Care Help Prevent Severe Foot Sores

Science.gov (United States)

Amputation and diabetes: How to protect your feet Good diabetes management and regular foot care help prevent severe foot sores that ... and may require amputation. By Mayo Clinic Staff Diabetes complications can include nerve damage and poor blood ...

Foot Conditions among Homeless Persons: A Systematic Review

Science.gov (United States)

To, Matthew J.; Brothers, Thomas D.; Van Zoost, Colin

2016-01-01

Introduction Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. Methods A literature search was conducted on MEDLINE (1966–2016), EMBASE (1947–2016), and CINAHL (1982–2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Results Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Discussion Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and

Foot Conditions among Homeless Persons: A Systematic Review.

Science.gov (United States)

To, Matthew J; Brothers, Thomas D; Van Zoost, Colin

2016-01-01

Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. A literature search was conducted on MEDLINE (1966-2016), EMBASE (1947-2016), and CINAHL (1982-2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and addressing social factors that lead to increased risk

U-TH-REE mobility and diffusion in granitic environments during alteration of accessory minerals and U-ores

International Nuclear Information System (INIS)

Cathelineau, M.; Vergneaud, M.

1989-01-01

U, Th and REE concentrations and distributions have been studied in granitic rocks, using a multidisciplinary approach involving micromapping of cracks in oriented samples, together with mineralogical and geochemical studies of the different U-Th-REE bearing phases. The behavior of U, Th and Nd, considered as chemical analogue elements of the radiotoxic nuclides, was investigated either in the vicinity of microsites (accessory mineral enviornment) or along plurimetric sections around U-ore bodies. The different granite minerals, especially the accessory minerals (uraninite, monazite, thorite, apatite, xeonotime), as well as U-ores, present different initial concentrations of U, Th and REE. Limitations to the analogy between these U-Th-REE concentrations and the radwastes is discussed as a function of their mineralogical features, chemical compostion, size and solubilities. These primary concentrations present different behavior when subjected to hydrothermal alteration, such as propylitization, phyllite type alteration, or clay alteration. Results show that in reduced media, in the temperature range 80-2000 0 C, the rate of mobilization of U, Th, REE is relatively moderate. However, fluids enriched in flourides, phosphates or carbonates may significantly solubilize and transport U and REE under specific conditions. In addition, the degree of opening of the microcracks and faults, as well as the oxidation-reduction processes, are critical parameters for the efficiency of the granitic geological barrier

In-hospital costs of diabetic foot disease treated by a multidisciplinary foot team

NARCIS (Netherlands)

Rinkel, Willem D.; Luiten, Jacky; van Dongen, Jelle; Kuppens, Bram; Van Neck, Johan W.; Polinder, Suzanne; Castro Cabezas, Manuel; Coert, J. Henk

2017-01-01

Background The diabetic foot imposes significant burden on healthcare systems. Obtaining knowledge on the extent of the costs of diabetic foot ulcers (DFUs) is of value to health care researchers investigating cost-effectiveness of interventions that prevent these costly complications. Objectives To

Sural artery perforator flap with posterior tibial neurovascular decompression for recurrent foot ulcer in leprosy patients

Directory of Open Access Journals (Sweden)

Ismail, Hossam El-din Ali

2017-01-01

Full Text Available Introduction: The sensory loss and alteration of the shape of the foot make the foot liable to trauma and pressure, and subsequently cause more callus formation, blisters, and ulcers. Foot ulcers usually are liable to secondary infection as cellulitis or osteomyelitis, and may result in amputations. Foot ulcers are a major problem and a major cause of handicaps in leprosy patients. The current study is to present our clinical experience and evaluate the use of sural flap with posterior tibial neurovascular decompression (PTND in recurrent foot ulcers in leprosy patients.Patient and methods: A total number of 9 patients were suffering from chronic sequelae of leprosy as recurrent foot ulcers. All the patients were reconstructed with the reverse sural artery fasciocutaneous flap with posterior tibial neurovascular decompression from September 2012 to August 2015. Six patients were male and three were female with a mean age of 39.8 years (range, 30–50 years. All the soft tissue defects were in the weight-bearing area of the inside of the foot. The flap sizes ranged from 15/4 to 18/6 cm. Mean follow-up period was 21.2 months (range, 35–2 months.Results: All the flaps healed uneventfully. There was no major complication as total flap necrosis. Only minor complications occurred which were treated without surgical intervention except in two patients who developed superficial necrosis of the skin paddle. Surgical debridement was done one week later. The flap was completely viable after surgery, and the contour of the foot was restored. We found that an improvement of sensation occurred in those patients in whom the anesthesia started one year ago or less and no sensory recovery in patient in whom the anesthesia had lasted for more than two years.Conclusion: The reverse sural artery flap with posterior tibial neurovascular decompression provides a reliable method for recurrent foot soft tissue reconstruction in leprosy patients with encouraging

Assessment of foot perfusion in patients with a diabetic foot ulcer.

Science.gov (United States)

Forsythe, Rachael O; Hinchliffe, Robert J

2016-01-01

Assessment of foot perfusion is a vital step in the management of patients with diabetic foot ulceration, in order to understand the risk of amputation and likelihood of wound healing. Underlying peripheral artery disease is a common finding in patients with foot ulceration and is associated with poor outcomes. Assessment of foot perfusion should therefore focus on identifying the presence of peripheral artery disease and to subsequently estimate the effect this may have on wound healing. Assessment of perfusion can be difficult because of the often complex, diffuse and distal nature of peripheral artery disease in patients with diabetes, as well as poor collateralisation and heavy vascular calcification. Conventional methods of assessing tissue perfusion in the peripheral circulation may be unreliable in patients with diabetes, and it may therefore be difficult to determine the extent to which poor perfusion contributes to foot ulceration. Anatomical data obtained on cross-sectional imaging is important but must be combined with measurements of tissue perfusion (such as transcutaneous oxygen tension) in order to understand the global and regional perfusion deficit present in a patient with diabetic foot ulceration. Ankle-brachial pressure index is routinely used to screen for peripheral artery disease, but its use in patients with diabetes is limited in the presence of neuropathy and medial arterial calcification. Toe pressure index may be more useful because of the relative sparing of pedal arteries from medial calcification but may not always be possible in patients with ulceration. Fluorescence angiography is a non-invasive technique that can provide rapid quantitative information about regional tissue perfusion; capillaroscopy, iontophoresis and hyperspectral imaging may also be useful in assessing physiological perfusion but are not widely available. There may be a future role for specialized perfusion imaging of these patients, including magnetic resonance

Altered Gray Matter Volume and White Matter Integrity in College Students with Mobile Phone Dependence.

Science.gov (United States)

Wang, Yongming; Zou, Zhiling; Song, Hongwen; Xu, Xiaodan; Wang, Huijun; d'Oleire Uquillas, Federico; Huang, Xiting

2016-01-01

Mobile phone dependence (MPD) is a behavioral addiction that has become an increasing public mental health issue. While previous research has explored some of the factors that may predict MPD, the underlying neural mechanisms of MPD have not been investigated yet. The current study aimed to explore the microstructural variations associated with MPD as measured with functional Magnetic Resonance Imaging (fMRI). Gray matter volume (GMV) and white matter (WM) integrity [four indices: fractional anisotropy (FA); mean diffusivity (MD); axial diffusivity (AD); and radial diffusivity (RD)] were calculated via voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis, respectively. Sixty-eight college students (42 female) were enrolled and separated into two groups [MPD group, N = 34; control group (CG), N = 34] based on Mobile Phone Addiction Index (MPAI) scale score. Trait impulsivity was also measured using the Barratt Impulsiveness Scale (BIS-11). In light of underlying trait impulsivity, results revealed decreased GMV in the MPD group relative to controls in regions such as the right superior frontal gyrus (sFG), right inferior frontal gyrus (iFG), and bilateral thalamus (Thal). In the MPD group, GMV in the above mentioned regions was negatively correlated with scores on the MPAI. Results also showed significantly less FA and AD measures of WM integrity in the MPD group relative to controls in bilateral hippocampal cingulum bundle fibers (CgH). Additionally, in the MPD group, FA of the CgH was also negatively correlated with scores on the MPAI. These findings provide the first morphological evidence of altered brain structure with mobile phone overuse, and may help to better understand the neural mechanisms of MPD in relation to other behavioral and substance addiction disorders.

Altered Gray Matter Volume and White Matter Integrity in College Students with Mobile Phone Dependence

Science.gov (United States)

Wang, Yongming; Zou, Zhiling; Song, Hongwen; Xu, Xiaodan; Wang, Huijun; d’Oleire Uquillas, Federico; Huang, Xiting

2016-01-01

Mobile phone dependence (MPD) is a behavioral addiction that has become an increasing public mental health issue. While previous research has explored some of the factors that may predict MPD, the underlying neural mechanisms of MPD have not been investigated yet. The current study aimed to explore the microstructural variations associated with MPD as measured with functional Magnetic Resonance Imaging (fMRI). Gray matter volume (GMV) and white matter (WM) integrity [four indices: fractional anisotropy (FA); mean diffusivity (MD); axial diffusivity (AD); and radial diffusivity (RD)] were calculated via voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis, respectively. Sixty-eight college students (42 female) were enrolled and separated into two groups [MPD group, N = 34; control group (CG), N = 34] based on Mobile Phone Addiction Index (MPAI) scale score. Trait impulsivity was also measured using the Barratt Impulsiveness Scale (BIS-11). In light of underlying trait impulsivity, results revealed decreased GMV in the MPD group relative to controls in regions such as the right superior frontal gyrus (sFG), right inferior frontal gyrus (iFG), and bilateral thalamus (Thal). In the MPD group, GMV in the above mentioned regions was negatively correlated with scores on the MPAI. Results also showed significantly less FA and AD measures of WM integrity in the MPD group relative to controls in bilateral hippocampal cingulum bundle fibers (CgH). Additionally, in the MPD group, FA of the CgH was also negatively correlated with scores on the MPAI. These findings provide the first morphological evidence of altered brain structure with mobile phone overuse, and may help to better understand the neural mechanisms of MPD in relation to other behavioral and substance addiction disorders. PMID:27199831

The diabetic foot

OpenAIRE

Nabuurs-Franssen, M.H.

2005-01-01

The diabetic foot presents a complex interplay of neuropathic, macrovascular, and microvascular disease on an abnormal metabolic background, complicated by an increased susceptibility to mechanical, thermal, and chemical injury and decreased healing ability. The abnormalities of diabetes, once present, are not curable. But most severe foot abnormalities in the diabetic are due to neglect of injury and are mostly preventable. The physician must ensure that the diabetic patient learns the princ...

MR imaging features of foot involvement in ankylosing spondylitis

Energy Technology Data Exchange (ETDEWEB)

Erdem, C. Zuhal E-mail: sunarerdem@yahoo.com; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

2005-01-01

Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

MR imaging features of foot involvement in ankylosing spondylitis

International Nuclear Information System (INIS)

Erdem, C. Zuhal; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

2005-01-01

Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

THE INFLUENCE OF A FOOT ORTHOTIC ON LOWER EXTREMITY TRANSVERSE PLANE KINEMATICS IN COLLEGIATE FEMALE ATHLETES WITH PES PLANUS

Directory of Open Access Journals (Sweden)

Christopher R. Carcia

2006-12-01

Full Text Available Non-contact anterior cruciate ligament (ACL injuries in female athletes remain prevalent. Athletes with excessive foot pronation have been identified to be at greater risk for non-contact ACL injury. Excessive foot pronation has been linked to increased medial tibial rotation. Increased medial tibial rotation heightens ACL strain and has been observed at or near the time of ACL injury. Foot orthotics have been shown to decrease medial tibial rotation during walking and running tasks. The effect of a foot orthotic on activities that simulate a non-contact ACL injury mechanism (i.e. landing however is unknown. Therefore, the objective of this study was to determine whether a foot orthotic was capable of altering transverse plane lower extremity kinematics in female athletes during landing. Twenty uninjured collegiate female athletes participating in the sports of basketball, soccer or volleyball with pes planus volunteered. Utilizing a repeated measures counterbalanced design, subjects completed two landing tasks with and without a foot orthotic using standardized footwear. The prefabricated orthotic had a rigid shell and a 6 extrinsic rear-foot varus post. Dependent measures included initial contact angle, peak angle, excursion and time to peak angle for both the tibia and femur. Statistical analysis suggested that the selected foot orthosis had little influence over lower extremity transverse plane kinematics. Several factors including: the limitation of a static measure to predict dynamic movement, inter-subject variability and the physical characteristics of the orthotic device likely account for the results. Future research should examine the influence of different types of foot orthotics not only on lower extremity kinematics but also tibiofemoral kinetics

MEMS Technology Sensors as a More Advantageous Technique for Measuring Foot Plantar Pressure and Balance in Humans

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Clara Sanz Morère

2016-01-01

Full Text Available Locomotor activities are part and parcel of daily human life. During walking or running, feet are subjected to high plantar pressure, leading sometimes to limb problems, pain, or foot ulceration. A current objective in foot plantar pressure measurements is developing sensors that are small in size, lightweight, and energy efficient, while enabling high mobility, particularly for wearable applications. Moreover, improvements in spatial resolution, accuracy, and sensitivity are of interest. Sensors with improved sensing techniques can be applied to a variety of research problems: diagnosing limb problems, footwear design, or injury prevention. This paper reviews commercially available sensors used in foot plantar pressure measurements and proposes the utilization of pressure sensors based on the MEMS (microelectromechanical systems technique. Pressure sensors based on this technique have the capacity to measure pressure with high accuracy and linearity up to high pressure levels. Moreover, being small in size, they are highly suitable for this type of measurement. We present two MEMS sensor models and study their suitability for the intended purpose by performing several experiments. Preliminary results indicate that the sensors are indeed suitable for measuring foot plantar pressure. Importantly, by measuring pressure continuously, they can also be utilized for body balance measurements.

Foot-and-mouth disease

DEFF Research Database (Denmark)

Belsham, Graham; Charleston, Bryan; Jackson, Terry

2009-01-01

Foot-and-mouth disease is an economically important, highly contagious, disease of cloven-hoofed animals characterized by the appearance of vesicles (blisters) on the feet and in and around the mouth. The causative agent, foot-and-mouth disease virus, was the first mammalian virus to be discovered...

49 CFR 214.115 - Foot protection.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Foot protection. 214.115 Section 214.115... protection. (a) The railroad or railroad contractor shall require railroad bridge workers to wear foot protection equipment when potential foot injury may result from impact, falling or flying objects, electrical...

The impact of rheumatoid foot on disability in Colombian patients with rheumatoid arthritis

Directory of Open Access Journals (Sweden)

Rojas-Villarraga Adriana

2009-06-01

Full Text Available Abstract Background Alterations in the feet of patients with rheumatoid arthritis (RA are a cause of disability in this population. The purpose of this research was to evaluate the impact that foot impairment has on the patients' global quality of life (QOL based on validated scales and its relationship to disease activity. Methods This was a cross-sectional study in which 95 patients with RA were enrolled. A complete physical examination, including a full foot assessment, was done. The Spanish versions of the Health Assessment Questionnaire (HAQ Disability Index and of the Disease Activity Score (DAS 28 were administered. A logistic regression model was used to analyze data and obtain adjusted odds ratios (AORs. Results Foot deformities were observed in 78 (82% of the patients; hallux valgus (65%, medial longitudinal arch flattening (42%, claw toe (lesser toes (39%, dorsiflexion restriction (tibiotalar (34%, cock-up toe (lesser toes (25%, and transverse arch flattening (25% were the most frequent. In the logistic regression analysis (adjusted for age, gender and duration of disease, forefoot movement pain, subtalar movement pain, tibiotalar movement pain and plantarflexion restriction (tibiotalar were strongly associated with disease activity and disability. The positive squeeze test was significantly associated with disability risk (AOR = 6,3; 95% CI, 1.28–30.96; P = 0,02; hallux valgus, and dorsiflexion restriction (tibiotalar were associated with disease activity. Conclusion Foot abnormalities are associated with active joint disease and disability in RA. Foot examinations provide complementary information related to the disability as an indirect measurement of quality of life and activity of disease in daily practice.

Geckos significantly alter foot orientation to facilitate adhesion during downhill locomotion.

Science.gov (United States)

Birn-Jeffery, Aleksandra V; Higham, Timothy E

2014-10-01

Geckos employ their adhesive system when moving up an incline, but the directionality of the system may limit function on downhill surfaces. Here, we use a generalist gecko to test whether limb modulation occurs on downhill slopes to allow geckos to take advantage of their adhesive system. We examined three-dimensional limb kinematics for geckos moving up and down a 45° slope. Remarkably, the hind limbs were rotated posteriorly on declines, resulting in digit III of the pes facing a more posterior direction (opposite to the direction of travel). No significant changes in limb orientation were found in any other condition. This pes rotation leads to a dramatic shift in foot function that facilitates the use of the adhesive system as a brake/stabilizer during downhill locomotion and, although this rotation is not unique to geckos, it is significant for the deployment of adhesion. Adhesion is not just advantageous for uphill locomotion but can be employed to help deal with the effects of gravity during downhill locomotion, highlighting the incredible multi-functionality of this key innovation. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Metabolic profile of foot and mouth disease stressed sheep in semi arid region

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Sita R Gupta

2011-05-01

Full Text Available The present study was designed to evaluate serum biochemical parameters in twenty local bred sheep infected with Foot-and-Mouth disease virus (FMDV serotype O. Ten healthy sheep were used as controls. Peripheral blood was collected from both diseased and control group and serum was separated which was further used to estimate the concentration of glucose, total protein, albumin, urea, calcium, phosphorus, cholesterol and activity of AST, ALT and ALP. It was found that there was a significant increase in glucose, AST and phosphorus in FMD affected sheep (p<0.01. Total protein, albumin, calcium, cholesterol and urea level were significantly lower (p<0.05 in FMD group compared to those in the control group. The biochemical alteration indicates the development of pancreatic dysfunction in Foot and Mouth disease affected sheep with FMDV serotype O.

Diagnosis and Management of Common Foot Fractures.

Science.gov (United States)

Bica, David; Sprouse, Ryan A; Armen, Joseph

2016-02-01

Foot fractures are among the most common foot injuries evaluated by primary care physicians. They most often involve the metatarsals and toes. Patients typically present with varying signs and symptoms, the most common being pain and trouble with ambulation. Diagnosis requires radiographic evaluation, although emerging evidence demonstrates that ultrasonography may be just as accurate. Management is determined by the location of the fracture and its effect on balance and weight bearing. Metatarsal shaft fractures are initially treated with a posterior splint and avoidance of weight-bearing activities; subsequent treatment consists of a short leg walking cast or boot for four to six weeks. Proximal fifth metatarsal fractures have different treatments depending on the location of the fracture. A fifth metatarsal tuberosity avulsion fracture can be treated acutely with a compressive dressing, then the patient can be transitioned to a short leg walking boot for two weeks, with progressive mobility as tolerated after initial immobilization. A Jones fracture has a higher risk of nonunion and requires at least six to eight weeks in a short leg non-weight-bearing cast; healing time can be as long as 10 to 12 weeks. Great toe fractures are treated with a short leg walking boot or cast with toe plate for two to three weeks, then a rigid-sole shoe for an additional three to four weeks. Lesser toe fractures can be treated with buddy taping and a rigid-sole shoe for four to six weeks.

Epidermal growth factor treatment of A431 cells alters the binding capacity and electrophoretic mobility of the cytoskeletally associated epidermal growth factor receptor

International Nuclear Information System (INIS)

Roy, L.M.; Gittinger, C.K.; Landreth, G.E.

1991-01-01

Epidermal growth factor receptor interacts with structural elements of A431 cells and remains associated with the cytoskeleton following extraction with nonionic detergents. Extraction of cells with 0.15% Triton X-100 resulted in detection of only approximately 40% of the EGF binding sites on the cytoskeleton. If the cells were exposed to EGF prior to extraction, approximately twofold higher levels of low-affinity EGF binding sites were detected. The difference in number of EGF binding sites was not a consequence of differences in numbers of EGF receptors associated with the cytoskeleton; equal amounts of 35S-labeled receptor were immunoprecipitated from the cytoskeletons of both control and EGF-treated cells. The effect of EGF pretreatment on binding activity was coincident with a change in the mobility of the receptor from a doublet of Mr approximately 160-180 kDa to a single sharp band at 180 kDa. The alteration in receptor mobility was not a simple consequence of receptor phosphorylation in that the alteration was not reversed by alkaline phosphatase treatment, nor was the shift produced by treatment of the cells with phorbol ester. The two EGF receptor species demonstrated differential susceptibility to V8 proteinase digestion. The EGF-induced 180 kDa species was preferentially digested by the proteinase relative to the 160 kDa species, indicating that EGF binding results in a conformational change in the receptor. The EGF-mediated preservation of binding activity and altered conformation may be related to receptor oligomerization

Investigation of first ray mobility during gait by kinematic fluoroscopic imaging-a novel method

Directory of Open Access Journals (Sweden)

Martin Heiner

2012-02-01

Full Text Available Abstract Background It is often suggested that sagittal instability at the first tarso-metatarsal joint level is a primary factor for hallux valgus and that sagittal instability increases with the progression of the deformity. The assessment of the degree of vertical instability is usually made by clinical evaluation while any measurements mostly refer to a static assessment of medial ray mobility (i.e. the plantar/dorsal flexion in the sagittal plane. Testing methods currently available cannot attribute the degree of mobility to the corresponding anatomical joints making up the medial column of the foot. The aim of this study was to develop a technique which allows for a quantification of the in-vivo sagittal mobility of the joints of the medial foot column during the roll-over process under full weight bearing. Methods Mobility of first ray bones was investigated by dynamic distortion-free fluoroscopy (25 frames/s of 14 healthy volunteers and 8 patients with manifested clinical instability of the first ray. A CAD-based evaluation method allowed the determination of mobility and relative displacements and rotations of the first ray bones within the sagittal plane during the stance phase of gait. Results Total flexion of the first ray was found to be 13.63 (SD 6.14 mm with the healthy volunteers and 13.06 (SD 8.01 mm with the patients (resolution: 0.245 mm/pixel. The dorsiflexion angle was 5.27 (SD 2.34 degrees in the healthy volunteers and increased to 5.56 (SD 3.37 degrees in the patients. Maximum rotations were found at the naviculo-cuneiform joints and least at the first tarso-metatarsal joint level in both groups. Conclusions Dynamic fluoroscopic assessment has been shown to be a valuable tool for characterisation of the kinematics of the joints of the medial foot column during gait. A significant difference in first ray flexion and angular rotation between the patients and healthy volunteers however could not be found.

Ultrasound evaluation of foot muscles and plantar fascia in pes planus.

Science.gov (United States)

Angin, Salih; Crofts, Gillian; Mickle, Karen J; Nester, Christopher J

2014-01-01

Multiple intrinsic and extrinsic soft tissue structures that apply forces and support the medial longitudinal arch have been implicated in pes planus. These structures have common functions but their interaction in pes planus is not fully understood. The aim of this study was to compare the cross-sectional area (CSA) and thickness of the intrinsic and extrinsic foot muscles and plantar fascia thickness between normal and pes planus feet. Forty-nine adults with a normal foot posture and 49 individuals with pes planus feet were recruited from a university population. Images of the flexor digitorum longus (FDL), flexor hallucis longus (FHL), peroneus longus and brevis (PER), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB) and abductor hallucis (AbH) muscles and the plantar fascia were obtained using a Venue 40 ultrasound system with a 5-13 MHz transducer. The CSA and thickness of AbH, FHB and PER muscles were significantly smaller (AbH -12.8% and -6.8%, FHB -8.9% and -7.6%, PER -14.7% and -10%), whilst FDL (28.3% and 15.2%) and FHL (24% and 9.8%) were significantly larger in the pes planus group. The middle (-10.6%) and anterior (-21.7%) portions of the plantar fascia were thinner in pes planus group. Greater CSA and thickness of the extrinsic muscles might reflect compensatory activity to support the MLA if the intrinsic foot muscle function has been compromised by altered foot structure. A thinner plantar fascia suggests reduced load bearing, and regional variations in structure and function in feet with pes planus. Copyright © 2014 Elsevier B.V. All rights reserved.

Foot preferences during resting in wildfowl and waders.

Science.gov (United States)

Randler, Christoph

2007-03-01

Footedness in birds has been reported, e.g., in parrots and chickens, but the direction of footedness remained unclear. Is a bird left-footed because it uses its left foot for holding and handling food, or is it right-footed because it uses the right foot for stabilisation and balancing while perching? In 2004 and 2006 I examined footedness in wildfowl and waders while the birds were performing a single task: roosting on the ground on one foot. Avocet (Recurvirostra avosetta), northern shoveller (Anas clypeata), oystercatcher (Haematopus ostralegus), and Eurasian curlew (Numenius arquata) were right-footed. Another 21 species did not show any significant foot preferences. This study provides some evidence that asymmetries in preferential foot use in birds may be triggered by a preference during postural control.

Nineteen-Foot Diameter Explosively Driven Blast Simulator; TOPICAL

International Nuclear Information System (INIS)

VIGIL, MANUEL G.

2001-01-01

This report describes the 19-foot diameter blast tunnel at Sandia National Laboratories. The blast tunnel configuration consists of a 6 foot diameter by 200 foot long shock tube, a 6 foot diameter to 19 foot diameter conical expansion section that is 40 feet long, and a 19 foot diameter test section that is 65 feet long. Therefore, the total blast tunnel length is 305 feet. The development of this 19-foot diameter blast tunnel is presented. The small scale research test results using 4 inch by 8 inch diameter and 2 foot by 6 foot diameter shock tube facilities are included. Analytically predicted parameters are compared to experimentally measured blast tunnel parameters in this report. The blast tunnel parameters include distance, time, static, overpressure, stagnation pressure, dynamic pressure, reflected pressure, shock Mach number, flow Mach number, shock velocity, flow velocity, impulse, flow duration, etc. Shadowgraphs of the shock wave are included for the three different size blast tunnels

Relationship between running speed and initial foot contact patterns.

Science.gov (United States)

Breine, Bastiaan; Malcolm, Philippe; Frederick, Edward C; De Clercq, Dirk

2014-08-01

This study assessed initial foot contact patterns (IFCP) in a large group of distance runners and the effect of speed on the IFCP. We determined the strike index to classify the runners in IFCP groups, at four speeds (3.2, 4.1, 5.1, and 6.2 m·s), by measuring center of pressure (COP) with a 2-m plantar pressure plate. Such a system allows a direct localization of the COP on the plantar footprint and has a low threshold value (2.7 N·cm), resulting in more accurate COP data at low ground reaction forces than when obtained from force plate. The IFCP distribution evolves from mostly initial rearfoot contact (IRFC) (82%) at 3.2 m·s to more anterior foot contacts with an approximately equal distribution of IRFC (46%) and initial midfoot or forefoot contact (54%) at 6.2 m·s. Approximately 44% of the IRFC runners showed atypical COP patterns with a fast anterior displacement of the COP along the lateral shoe margin. Apart from the different COP patterns, these atypical IRFC were also characterized by a significantly higher instantaneous vertical loading rate than the typical IRFC patterns. The IFCP distribution changes were due to intraindividual alterations in IFCP at higher speeds. That is, 45% of the runners made one or even two "transitions" toward a more anterior IFCP (and 3% shows some other type of transition between initial foot contact styles as speed increases). However, 52% of the runners remained with the same IFCP.

Introduction of hind foot coronal alignment view

International Nuclear Information System (INIS)

Moon, Il Bong; Jeon, Ju Seob; Yoon, Kang Cheol; Choi, Nam Kil; Kim, Seung Kook

2006-01-01

Accurate clinical evaluation of the alignment of the calcaneus relative to the tibia in the coronal plane is essential in the evaluation and treatment of hind foot pathologic condition. Previously described standard anteroposterior, lateral, and oblique radiographic methods of the foot or ankle do not demonstrate alignment of the tibia relation to the calcaneus in the coronal plane. The purpose of this study was to introduce hind foot coronal alignment view. Both feet were imaged simultaneously on an elevated, radiolucent foot stand equipment. Both feet stood on a radiolucent platform with equal weight on both feet. Both feet are located foot axis longitudinal perpendicular to the platform. Silhouette tracing around both feet are made, and line is then drawn to bisect the silhouette of the second toe and the outline of the heel. The x-ray beam is angled down approximately 15 .deg. to 20 .deg. This image described tibial axis and medial, lateral tuberosity of calcaneus. Calcaneus do not rotated. The view is showed by talotibial joint space. Although computed tomographic and magnetic resonance imaging techniques are capable of demonstrating coronal hind foot alignment, they lack usefulness in most clinical situations because the foot is imaged in a non-weight bearing position. But hind foot coronal alignment view is obtained for evaluating position changing of inversion, eversion of the hind foot and varus, valgus deformity of calcaneus

The Relationship with Balance, Foot Posture, and Foot Size in School of Physical Education and Sports Students

Science.gov (United States)

Irez, Gonul Babayigit

2014-01-01

The aim of this study is to investigate the relationship of foot posture and foot size with balance. A hundred and thirteen healthy volunteers were recruited from undergraduate students (Male = 74, Female = 37, age range 18-22). The Foot Posture Index (FPI-6), anthropometric measurements, dynamic balance and static balance measurements were done…

Context-awareness and Mobile HCI

DEFF Research Database (Denmark)

Qin, Xiangang; Tan, Chee Wee; Clemmensen, Torkil

2017-01-01

-awareness has been employed broadly in developing applications and services on mobile platform, has had a huge impact on mobile user experience, and has altered the interaction between humans and computers by giving the latter a more active role to play. The significance of context-awareness in the usage......Context-awareness endows mobile devices and services with the capability of interacting with users in an efficient, intelligent, natural and smart fashion. Consequently, context-awareness makes a significant difference to mobile HCI. However, the challenges brought by context-awareness to users...... of mobile devices are rarely examined in depth. In this paper, previous conceptions of context and their contribution to context-awareness in mobile HCI is scrutinized and a preliminary context-computer interaction (CCI) model is advanced to illustrate the interaction characterized by mobile context...

The foot and ankle

International Nuclear Information System (INIS)

Berquist, T.H.

1985-01-01

Imaging of the foot and ankle can be difficult because of the complex anatomy. Familiarity with the bony and ligamentous anatomy is essential for proper evaluation of radiographic findings. Therefore, pertinent anatomy is discussed as it applies to specific injuries. Special views, tomography, arthrography, and other techniques may be indicated for complete evaluation of foot and ankle trauma

An ergonomic modular foot platform for isometric force/torque measurements in poststroke functional assessment: A pilot study

OpenAIRE

Stefano Mazzoleni, PhD; Jo Van Vaerenbergh, PhD; Emma Stokes, PhD; Gábor Fazekas, MD, PhD; Paolo Dario, PhD; Eugenio Guglielmelli, PhD

2012-01-01

The main goal of this article is to present the design, technical development, and preliminary validation of an innovative mechatronic device for force/torque measurements taken from the human foot using pilot data. The device, formed by a mobile platform equipped with two six-axis force/torque sensors, was used to perform accurate quantitative measurements during isometric exercises, aimed at performing functional assessment tests in poststroke patients undergoing a rehabilitation treatment....

A pneumatic power harvesting ankle-foot orthosis to prevent foot-drop

Directory of Open Access Journals (Sweden)

Chin Robin

2009-06-01

Full Text Available Abstract Background A self-contained, self-controlled, pneumatic power harvesting ankle-foot orthosis (PhAFO to manage foot-drop was developed and tested. Foot-drop is due to a disruption of the motor control pathway and may occur in numerous pathologies such as stroke, spinal cord injury, multiple sclerosis, and cerebral palsy. The objectives for the prototype PhAFO are to provide toe clearance during swing, permit free ankle motion during stance, and harvest the needed power with an underfoot bellow pump pressurized during the stance phase of walking. Methods The PhAFO was constructed from a two-part (tibia and foot carbon composite structure with an articulating ankle joint. Ankle motion control was accomplished through a cam-follower locking mechanism actuated via a pneumatic circuit connected to the bellow pump and embedded in the foam sole. Biomechanical performance of the prototype orthosis was assessed during multiple trials of treadmill walking of an able-bodied control subject (n = 1. Motion capture and pressure measurements were used to investigate the effect of the PhAFO on lower limb joint behavior and the capacity of the bellow pump to repeatedly generate the required pneumatic pressure for toe clearance. Results Toe clearance during swing was successfully achieved during all trials; average clearance 44 ± 5 mm. Free ankle motion was observed during stance and plantarflexion was blocked during swing. In addition, the bellow component repeatedly generated an average of 169 kPa per step of pressure during ten minutes of walking. Conclusion This study demonstrated that fluid power could be harvested with a pneumatic circuit built into an AFO, and used to operate an actuated cam-lock mechanism that controls ankle-foot motion at specific periods of the gait cycle.

Investigations on GSK-3β/NF-kB signaling in stress and stress adaptive behavior in electric foot shock subjected mice.

Science.gov (United States)

Bali, Anjana; Jaggi, Amteshwar Singh

2016-04-01

The present study was designed to explore the role of GSK-3β and NF-kB signaling in electric foot shock-induced stress and stress adaptation. Mice were subjected to foot shocks of 0.5mA intensity and 1s duration of 1h to produce acute stress. Animals were exposed to the same stressor for 5 days to induce stress adaptation. The behavioral alterations were assessed using the actophotometer, hole board, open field and social interaction tests. The serum corticosterone levels were assessed as a marker of the HPA axis. The levels of total GSK-3β, p-GSK-3β-S9 and p-NF-kB were determined in the hippocampus, frontal cortex and amygdala. Acute electric foot shock stress produced behavioral and biochemical changes; decreased the levels of p-GSK-3β-S9, produced no change in total GSK-3β levels and increased p-NF-kB levels in the brain. However, repeated exposure of foot shock stress restored the behavioral and biochemical changes along with normalization of p-GSK-3β-S9 and p-NF-kB levels. Administration of AR-A01, a selective GSK-3β inhibitor, or diethyldithiocarbamic acid (DDTC), a selective NF-kB inhibitor, diminished acute stress-induced behavioral and biochemical changes. Furthermore, AR-A014418 normalized acute stress-induced alterations in p-GSK-3β-S9 and p-NF-kB levels, however, DDTC selectively restored NF-kB levels without any change in p-GSK-3β-S9 levels. It probably suggests that NF-kB is a downstream mediator of the GSK-3 signaling cascade. It may conclude that acute stress associated decrease in p-GSK-3β-S9 and increase in p-NF-kB levels in the brain contribute in the development of behavioral and biochemical alterations and normalization of GSK-3β/NF-kB signaling may contribute in stress adaptive behavior in response to repeated electric foot shock-subjected mice. Copyright © 2016 Elsevier B.V. All rights reserved.

Secondary changes in the skeleton of the foot in Lupus vulgaris

Energy Technology Data Exchange (ETDEWEB)

Triebel, H J; Oesterreich, F U

1986-04-01

The case of a seventy-year old lady is presented who, fortyfive years ago, had dermal tuberculosis of the left lower limb and foot. After removal of the infected skin areas with an electric cauter the patient developed massive skin indurations, besides the typical scarification. Actual X-rays showed a decrease in seize of metatarsal bones and digits without lytic or porotic signs. Furthermore, dorsal luxation of the digits was visible. These alterations were interpreted as secondary bone remodelling resulting from long-term traction due to the extensive scarring.

Secondary changes in the skeleton of the foot in Lupus vulgaris

International Nuclear Information System (INIS)

Triebel, H.J.; Oesterreich, F.U.

1986-01-01

The case of a seventy-year old lady is presented who, fortyfive years ago, had dermal tuberculosis of the left lower limb and foot. After removal of the infected skin areas with an electric cauter the patient developed massive skin indurations, besides the typical scarification. Actual X-rays showed a decrease in seize of metatarsal bones and digits without lytic or porotic signs. Furthermore, dorsal luxation of the digits was visible. These alterations were interpreted as secondary bone remodelling resulting from long-term traction due to the extensive scarring. (orig.) [de

Reliability and Clinical Significance of Mobility and Balance Assessments in Multiple Sclerosis

Science.gov (United States)

Learmonth, Yvonne C.; Paul, Lorna; McFadyen, Angus K.; Mattison, Paul; Miller, Linda

2012-01-01

The aim of the study was to establish the test-retest reliability, clinical significance and precision of four mobility and balance measures--the Timed 25-Foot Walk, Six-minute Walk, Timed Up and Go and the Berg Balance Scale--in individuals moderately affected by multiple sclerosis. Twenty four participants with multiple sclerosis (Extended…

A review of the biomechanics of the diabetic foot

NARCIS (Netherlands)

van Schie, C. H. M.

2005-01-01

In general, diabetic foot ulcers result from abnormal mechanical loading of the foot, such as repetitive moderate pressure applied to the plantar aspect of the foot while walking. Diabetic peripheral neuropathy causes changes in foot structure, affecting foot function and subsequently leading to

Avoiding foot complications in diabetes

African Journals Online (AJOL)

preceded by a foot ulcer.1,2 Every 30 seconds a lower limb or part of a lower limb is ... of foot ulcers are peripheral neuropathy, deformity, peripheral vascular disease and ... Repetitive stresses cause hyperkeratosis, followed by subcutaneous ...

Foot, leg, and ankle swelling

Science.gov (United States)

Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot in the leg Is older Has ...

The association between foot-care self efficacy beliefs and actual foot-care behaviour in people with peripheral neuropathy: a cross-sectional study

Directory of Open Access Journals (Sweden)

Swerissen Hal

2009-02-01

Full Text Available Abstract Background People with diabetes and peripheral neuropathy often do not implement the foot-care behavioural strategies that are suggested by many health professionals. The concept of self-efficacy has been shown to be an effective predictor of behaviour in many areas of health. This study investigated the relationships between foot-care self-efficacy beliefs, self-reported foot-care behaviour and history of diabetes-related foot pathology in people with diabetes and loss of protective sensation in their feet. Methods Ninety-six participants were included in this cross-sectional study undertaken in a regional city of Australia. All participants had diabetes and clinically diagnosed loss of protective sensation in their feet. The participants completed a self-report pen-paper questionnaire regarding foot-care self efficacy beliefs (the "Foot Care Confidence Scale" and two aspects of actual foot-care behaviour-preventative behaviour and potentially damaging behaviour. Pearson correlation coefficients were then calculated to determine the association between foot-care self-efficacy beliefs and actual reported foot-care behaviour. Multiple analysis of variance was undertaken to compare mean self-efficacy and behaviour subscale scores for those with a history of foot pathology, and those that did not. Results A small positive correlation (r = 0.2, p = 0.05 was found between self-efficacy beliefs and preventative behaviour. There was no association between self-efficacy beliefs and potentially damaging behaviour. There was no difference in self-efficacy beliefs in people that had a history of foot pathology compared to those that did not. Conclusion There is little association between foot-care self-efficacy beliefs and actual foot-care behaviour. The usefulness of measuring foot-care self-efficacy beliefs to assess actual self foot-care behaviour using currently available instruments is limited in people with diabetes and loss of protective

Protocol for the Foot in Juvenile Idiopathic Arthritis trial (FiJIA: a randomised controlled trial of an integrated foot care programme for foot problems in JIA

Directory of Open Access Journals (Sweden)

Hendry Gordon J

2009-06-01

Full Text Available Abstract Background Foot and ankle problems are a common but relatively neglected manifestation of juvenile idiopathic arthritis. Studies of medical and non-medical interventions have shown that clinical outcome measures can be improved. However existing data has been drawn from small non-randomised clinical studies of single interventions that appear to under-represent the adult population suffering from juvenile idiopathic arthritis. To date, no evidence of combined therapies or integrated care for juvenile idiopathic arthritis patients with foot and ankle problems exists. Methods/design An exploratory phase II non-pharmacological randomised controlled trial where patients including young children, adolescents and adults with juvenile idiopathic arthritis and associated foot/ankle problems will be randomised to receive integrated podiatric care via a new foot care programme, or to receive standard podiatry care. Sixty patients (30 in each arm including children, adolescents and adults diagnosed with juvenile idiopathic arthritis who satisfy the inclusion and exclusion criteria will be recruited from 2 outpatient centres of paediatric and adult rheumatology respectively. Participants will be randomised by process of minimisation using the Minim software package. The primary outcome measure is the foot related impairment measured by the Juvenile Arthritis Disability Index questionnaire's impairment domain at 6 and 12 months, with secondary outcomes including disease activity score, foot deformity score, active/limited foot joint counts, spatio-temporal and plantar-pressure gait parameters, health related quality of life and semi-quantitative ultrasonography score for inflammatory foot lesions. The new foot care programme will comprise rapid assessment and investigation, targeted treatment, with detailed outcome assessment and follow-up at minimum intervals of 3 months. Data will be collected at baseline, 6 months and 12 months from baseline

Pathophysiology diabetic foot ulcer

Science.gov (United States)

Syafril, S.

2018-03-01

Diabetes Mellitus (DM) is known to have many complications. Diabetes and its complications are rapidly becoming the world’s most significant cause of morbidity and mortality, and one of the most distressing is Diabetic Foot Ulcer (DFU). Chronic wound complications are a growing concern worldwide, and the effect is a warning to public health and the economy. The etiology of a DFU is multifaceted, and several components cause added together create a sufficient impact on ulceration: neuropathy, vasculopathy, immunopathy, mechanical stress, and neuroarthropathy. There are many classifications of the diabetic foot. About 50% of patients with foot ulcers due to DM present clinical signs of infection. It is essential to manage multifactorial etiology of DFU to get a good outcome.

The clinical assessment study of the foot (CASF: study protocol for a prospective observational study of foot pain and foot osteoarthritis in the general population

Directory of Open Access Journals (Sweden)

Menz Hylton B

2011-09-01

Full Text Available Abstract Background Symptomatic osteoarthritis (OA affects approximately 10% of adults aged over 60 years. The foot joint complex is commonly affected by OA, yet there is relatively little research into OA of the foot, compared with other frequently affected sites such as the knee and hand. Existing epidemiological studies of foot OA have focussed predominantly on the first metatarsophalangeal joint at the expense of other joints. This three-year prospective population-based observational cohort study will describe the prevalence of symptomatic radiographic foot OA, relate its occurrence to symptoms, examination findings and life-style-factors, describe the natural history of foot OA, and examine how it presents to, and is diagnosed and managed in primary care. Methods All adults aged 50 years and over registered with four general practices in North Staffordshire, UK, will be invited to participate in a postal Health Survey questionnaire. Respondents to the questionnaire who indicate that they have experienced foot pain in the preceding twelve months will be invited to attend a research clinic for a detailed clinical assessment. This assessment will consist of: clinical interview; physical examination; digital photography of both feet and ankles; plain x-rays of both feet, ankles and hands; ultrasound examination of the plantar fascia; anthropometric measurement; and a further self-complete questionnaire. Follow-up will be undertaken in consenting participants by postal questionnaire at 18 months (clinic attenders only and three years (clinic attenders and survey participants, and also by review of medical records. Discussion This three-year prospective epidemiological study will combine survey data, comprehensive clinical, x-ray and ultrasound assessment, and review of primary care records to identify radiographic phenotypes of foot OA in a population of community-dwelling older adults, and describe their impact on symptoms, function and

Diabetic foot ulcers. Pathophysiology, assessment, and therapy.

OpenAIRE

Bowering, C. K.

2001-01-01

OBJECTIVE: To review underlying causes of diabetic foot ulceration, provide a practical assessment of patients at risk, and outline an evidence-based approach to therapy for diabetic patients with foot ulcers. QUALITY OF EVIDENCE: A MEDLINE search was conducted for the period from 1979 to 1999 for articles relating to diabetic foot ulcers. Most studies found were case series or small controlled trials. MAIN MESSAGE: Foot ulcers in diabetic patients are common and frequently lead to lower limb...

Taiwanese adult foot shape classification using 3D scanning data.

Science.gov (United States)

Lee, Yu-Chi; Wang, Mao-Jiun

2015-01-01

This study classifies the foot shapes of Taiwanese using 3D foot scanning data from 2000 males and 1000 females. Nine foot dimensions relative to foot length and absolute measures in the common foot length categories were applied to compare the gender differences. Using foot breadth in % foot length (% FL), ball of foot length in % FL and arch height in % FL as feature parameters, three foot shape types for males and females can be classified. Significant gender differences were found in seven of the nine foot dimensions. Females had greater ball of foot length than males (0.2% FL). When comparing feet of the same foot length, males had greater breadth, girth and height dimensions than females, except for toe height. In addition, ethnic differences in foot shape were also observed. The findings can provide very useful information for building gender-specific shoe lasts and designing footwear insoles. 3D foot scanning data of 2000 males and 1000 females were classified into three different footshapes for males and females, respectively. Gender and ethnic differences on foot shape were also compared. The finding scan provide very useful information for gender-specific shoe last design and footwear production.

Mobile X-ray radiographic systems

International Nuclear Information System (INIS)

Buchmann, F.

1990-01-01

Mobile X-ray radiography equipment consists of the X-ray source with the generator and the switching and control devices, mounted on a mobile unit for transport to the patient to be examined. These mobile systems, just as the stationary equipment, have been profiting from the technological progress made in the area of X-ray generation, and the considerable improvements thus achieved have altered not only the value of these systems, but also their applicability which frequently comes near that of stationary equipment. (orig./GDG) [de

Changes in multi-segment foot biomechanics with a heat-mouldable semi-custom foot orthotic device

Directory of Open Access Journals (Sweden)

Ferber Reed

2011-06-01

Full Text Available Abstract Background Semi-custom foot orthoses (SCO are thought to be a cost-effective alternative to custom-made devices. However, previous biomechanical research involving either custom or SCO has only focused on rearfoot biomechanics. The purpose of this study was therefore to determine changes in multi-segment foot biomechanics during shod walking with and without an SCO. We chose to investigate an SCO device that incorporates a heat-moulding process, to further understand if the moulding process would significantly alter rearfoot, midfoot, or shank kinematics as compared to a no-orthotic condition. We hypothesized the SCO, whether moulded or non-moulded, would reduce peak rearfoot eversion, tibial internal rotation, arch deformation, and plantar fascia strain as compared to the no-orthoses condition. Methods Twenty participants had retroreflective markers placed on the right limb to represent forefoot, midfoot, rearfoot and shank segments. 3D kinematics were recorded using an 8-camera motion capture system while participants walked on a treadmill. Results Plantar fascia strain was reduced by 34% when participants walked in either the moulded or non-moulded SCO condition compared to no-orthoses. However, there were no significant differences in peak rearfoot eversion, tibial internal rotation, or medial longitudinal arch angles between any conditions. Conclusions A semi-custom moulded orthotic does not control rearfoot, shank, or arch deformation but does, however, reduce plantar fascia strain compared to walking without an orthoses. Heat-moulding the orthotic device does not have a measurable effect on any biomechanical variables compared to the non-moulded condition. These data may, in part, help explain the clinical efficacy of orthotic devices.

Foot strike pattern in preschool children during running: sex and shod-unshod differences.

Science.gov (United States)

Latorre-Román, Pedro Á; Párraga-Montilla, Juan A; Guardia-Monteagudo, Ignacio; García-Pinillos, Felipe

2018-04-01

This study aims to determine the foot strike patterns (FSPs) and neutral support (no inversion [INV]/eversion [EVE] and no foot rotation) in preschool children, as well as to determine the influence of shod/unshod conditions and sex. A total of 1356 children aged 3-6 years (673 boys and 683 girls) participated in this study. A sagittal and frontal-plane video (240 Hz) was recorded using a high-speed camcorder to record the following variables: rearfoot strike (RFS), midfoot strike (MFS), forefoot strike (FFS), inversion/ eversion (INV/EVE) and foot rotation on initial contact. There were no between-sex significant differences in both shod and unshod conditions in RFS. In the unshod condition, there was a significant reduction (p < 0.001) of RFS prevalence in both boys (shod condition = 44.2% vs. 34.7% unshod condition) and girls (shod condition = 48.5% vs. 36.1% unshod condition). As for neutral support, there were no between-sex differences in both shod and unshod conditions or in the shod-unshod comparison. In preschool children, no between-sex differences were found in relation to prevalence of RFS and neutral support (no INV/EVE). Shod running alters FSP of running barefoot, producing a significant increase of RFS prevalence.

Implementation of foot thermometry plus mHealth to prevent diabetic foot ulcers: study protocol for a randomized controlled trial.

Science.gov (United States)

Lazo-Porras, Maria; Bernabe-Ortiz, Antonio; Sacksteder, Katherine A; Gilman, Robert H; Malaga, German; Armstrong, David G; Miranda, J Jaime

2016-04-19

Diabetic foot neuropathy (DFN) is one of the most important complications of diabetes mellitus; its early diagnosis and intervention can prevent foot ulcers and the need for amputation. Thermometry, measuring the temperature of the feet, is a promising emerging modality for diabetic foot ulcer prevention. However, patient compliance with at-home monitoring is concerning. Delivering messages to remind patients to perform thermometry and foot care might be helpful to guarantee regular foot monitoring. This trial was designed to compare the incidence of diabetic foot ulcers (DFUs) between participants who receive thermometry alone and those who receive thermometry as well as mHealth (SMS and voice messaging) over a year-long study period. This is an evaluator-blinded, randomized, 12-month trial. Individuals with a diagnosis of type 2 diabetes mellitus, aged between 18-80 years, having a present dorsalis pedis pulse in both feet, are in risk group 2 or 3 using the diabetic foot risk classification system (as specified by the International Working Group on the Diabetic Foot), have an operating cell phone or a caregiver with an operating cell phone, and have the ability to provide informed consent will be eligible to participate in the study. Recruitment will be performed in diabetes outpatient clinics at two Ministry of Health tertiary hospitals in Lima, Peru. participants in both groups will receive education about foot care at the beginning of the study and they will be provided with a thermometry device (TempStat™). TempStat™ is a tool that captures a thermal image of the feet, which, depending on the temperature of the feet, shows different colors. In this study, if a participant notes a single yellow image or variance between one foot and the contralateral foot, they will be prompted to notify a nurse to evaluate their activity within the previous 2 weeks and make appropriate recommendations. In addition to thermometry, participants in the intervention arm

[Foot reflexology massage: a clinical study].

Science.gov (United States)

Kesselring, A

1999-02-01

The aim of the study was to investigate the possible usefulness of foot reflexology on the recovery after a surgical intervention. 130 patients participated in the study. They underwent abdominal surgery under full anesthesia for different, but exclusively gynecological reasons. Foot reflexology investigated in this study was applied only for a few days for each patient. The following parameters were recorded: the subjective, self-assessed, general condition, pain intensity, movement of the bowels, micturition and sleep, beginning on the day before operation until day 10. Two other treatments served as controls, a simple massage of the foot or a personal conversation. The simple massage turned out to be a relaxing, positive experience, whereas foot reflexology had various effects, some of them were even negative. The conclusion was that foot reflexology is not recommended for acute, abdominal postsurgical situations in gynecology because it can occasionally trigger abdominal pain. This project is one of the few studies planned, conducted and performed by the nursing staff.

ARIES: A mobile robot inspector

International Nuclear Information System (INIS)

Byrd, J.S.

1995-01-01

ARIES (Autonomous Robotic Inspection Experimental System) is a mobile robot inspection system being developed for the Department of Energy (DOE) to survey and inspect drums containing mixed and low-level radioactive waste stored in warehouses at DOE facilities. The drums are typically stacked four high and arranged in rows with three-foot aisle widths. The robot will navigate through the aisles and perform an autonomous inspection operation, typically performed by a human operator. It will make real-time decisions about the condition of the drums, maintain a database of pertinent information about each drum, and generate reports

Effects on foot external rotation of the modified ankle-foot orthosis on post-stroke hemiparetic gait.

Science.gov (United States)

Kim, Ha Jeong; Chun, Min Ho; Kim, Hong Min; Kim, Bo Ryun

2013-08-01

To evaluate the effects of heel-opened ankle foot orthosis (HOAFO) on hemiparetic gait after stroke, especially on external foot rotation, and to compare the effects of HOAFO with conventional plastic-AFO (pAFO) and barefoot during gait. This cross-over observational study involved 15 hemiparetic patients with external rotation of the affected foot. All subjects were able to walk independently, regardless of their usual use of a single cane, and had a less than fair-grade in ankle dorsiflexion power. Each patient was asked to walk in three conditions with randomized sequences: 1) barefoot, 2) with a pAFO, and 3) with an HOAFO. Their gait patterns were analyzed using a motion analysis system. Fifteen patients consisted of nine males and six females. On gait analysis, hip and foot external rotation were significantly greater in pAFO (-3.35° and -23.68°) than in barefoot and HOAFO conditions (pexternal rotation compared with pAFO; although there was no significant difference between HOAFO and barefoot walking. Walking speed and percentage of single limb support were significantly greater for HOAFO than in barefoot walking. HOAFO was superior to pAFO in reducing hip and foot external rotation during the stance phase in patients with post-stroke hemiparesis. HOAFO may, therefore, be useful in patients with excessive external rotation of the foot during conventional pAFO.

Trends in lumber processing in the western United States. Part I: board foot Scribner volume per cubic foot of timber

Science.gov (United States)

Charles E. Keegan; Todd A. Morgan; Keith A. Blatner; Jean M. Daniels

2010-01-01

This article describes trends in board foot Scribner volume per cubic foot of timber for logs processed by sawmills in the western United States. Board foot to cubic foot (BF/CF) ratios for the period from 2000 through 2006 ranged from 3.70 in Montana to 5.71 in the Four Corners Region (Arizona, Colorado, New Mexico, and Utah). Sawmills in the Four Corners Region,...

Narrative review: Diabetic foot and infrared thermography

Science.gov (United States)

Hernandez-Contreras, D.; Peregrina-Barreto, H.; Rangel-Magdaleno, J.; Gonzalez-Bernal, J.

2016-09-01

Diabetic foot is one of the major complications experienced by diabetic patients. An early identification and appropriate treatment of diabetic foot problems can prevent devastating consequences such as limb amputation. Several studies have demonstrated that temperature variations in the plantar region can be related to diabetic foot problems. Infrared thermography has been successfully used to detect complication related to diabetic foot, mainly because it is presented as a rapid, non-contact and non-invasive technique to visualize the temperature distribution of the feet. In this review, an overview of studies that relate foot temperature with diabetic foot problems through infrared thermography is presented. Through this research, it can be appreciated the potential of infrared thermography and the benefits that this technique present in this application. This paper also presents the different methods for thermogram analysis and the advantages and disadvantages of each one, being the asymmetric analysis the method most used so far.

Mechanical performance of artificial pneumatic muscles to power an ankle-foot orthosis.

Science.gov (United States)

Gordon, Keith E; Sawicki, Gregory S; Ferris, Daniel P

2006-01-01

We developed a powered ankle-foot orthosis that uses artificial pneumatic muscles to produce active plantar flexor torque. The purpose of this study was to quantify the mechanical performance of the orthosis during human walking. Three subjects walked at a range of speeds wearing ankle-foot orthoses with either one or two artificial muscles working in parallel. The orthosis produced similar total peak plantar flexor torque and network across speeds independent of the number of muscles used. The orthosis generated approximately 57% of the peak ankle plantar flexor torque during stance and performed approximately 70% of the positive plantar flexor work done during normal walking. Artificial muscle bandwidth and force-length properties were the two primary factors limiting torque production. The lack of peak force and work differences between single and double muscle conditions can be explained by force-length properties. Subjects altered their ankle kinematics between conditions resulting in changes in artificial muscle length. In the double muscle condition greater plantar flexion yielded shorter artificial muscles lengths and decreased muscle forces. This finding emphasizes the importance of human testing in the design and development of robotic exoskeleton devices for assisting human movement. The results of this study outline the mechanical performance limitations of an ankle-foot orthosis powered by artificial pneumatic muscles. This orthosis could be valuable for gait rehabilitation and for studies investigating neuromechanical control of human walking.

Foot burns: epidemiology and management.

Science.gov (United States)

Hemington-Gorse, S; Pellard, S; Wilson-Jones, N; Potokar, T

2007-12-01

This is a retrospective study of the epidemiology and management of isolated foot burns presenting to the Welsh Centre for Burns from January 1998 to December 2002. A total of 289 were treated of which 233 were included in this study. Approximately 40% were in the paediatric age group and the gender distribution varied dramatically for adults and children. In the adult group the male:female ratio was 3.5:1, however in the paediatric group the male:female ratio was more equal (1.6:1). Scald burns (65%) formed the largest group in children and scald (35%) and chemical burns (32%) in adults. Foot burns have a complication rate of 18% and prolonged hospital stay. Complications include hypertrophic scarring, graft loss/delayed healing and wound infection. Although isolated foot burns represent a small body surface area, over half require treatment as in patients to allow for initial aggressive conservative management of elevation and regular wound cleansing to avoid complications. This study suggests a protocol for the initial acute management of foot burns. This protocol states immediate referral of all foot burns to a burn centre, admission of these burns for 24-48 h for elevation, regular wound cleansing with change of dressings and prophylactic antibiotics.

A prospective study of risk factors for foot ulceration: The West of Ireland Diabetes Foot Study.

LENUS (Irish Health Repository)

Hurley, L

2013-09-25

BackgroundThis is the first study to examine risk factors for diabetic foot ulceration in Irish general practice.AimTo determine the prevalence of established risk factors for foot ulceration in a community-based cohort, and to explore the potential for estimated glomerular filtration rate (eGFR) to act as a novel risk factor.DesignA prospective observational study.MethodsPatients with diabetes attending 12 (of 17) invited general practices were invited for foot screening. Validated clinical tests were carried out at baseline to assess for vascular and sensory impairment and foot deformity. Ulcer incidence was ascertained by patient self-report and medical record. Patients were re-assessed 18 months later. ResultsOf 828 invitees, 563 (68%) attended screening. On examination 23-25% had sensory dysfunction and 18-39% had evidence of vascular impairment. Using the Scottish Intercollegiate Guidelines Network risk stratification system we found the proportion at moderate and high risk of future ulceration to be 25% and 11% respectively. At follow-up 16\\/383 patients (4.2%) developed a new foot ulcer (annual incidence rate of 2.6%). We observed an increasing probability of abnormal vascular and sensory test results (pedal pulse palpation, doppler waveform assessment, 10g monofilament, vibration perception and neuropathy disability score) with declining eGFR levels. We were unable to show an independent association between new ulceration and reduced eGFR [Odds ratio 1.01; p=0.64].ConclusionsOur data show the extent of foot complications in a representative sample of diabetes patients in Ireland. Use of eGFR did not improve identification of patients at risk of foot ulceration.

Welcome to Journal of Foot and Ankle Research: a new open access journal for foot health professionals

Directory of Open Access Journals (Sweden)

Borthwick Alan M

2008-07-01

Full Text Available Abstract Journal of Foot and Ankle Research (JFAR is a new, open access, peer-reviewed online journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. JFAR will cover a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submission from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. All manuscripts will undergo open peer review, and all accepted manuscripts will be freely available on-line using the open access platform of BioMed Central.

Foot and ankle problems in Thai monks.

Science.gov (United States)

Vaseenon, Tanawat; Wattanarojanaporn, Thongaek; Intharasompan, Piyapong; Theeraamphon, Nipon; Auephanviriyakul, Sansanee; Phisitkul, Phinit

2015-01-01

Foot and ankle problems in Thai monks have not been explored. This is an unshod population, and its members have a unique lifestyle living among others in our modern era. Beginning at their ordainment, they follow strict rules about barefoot walking, the amount of daily walking, and their sitting position, practices that theoretically can increase their risk of developing foot and ankle problems. To evaluate the prevalence ofcommon foot and ankle problems in Thai monks. A cross-sectional survey was conducted in combination with foot and ankle examinations of monks living in northern Thailand Foot morphology was examined using a Harris mat footprint. Results of the interviews and the foot and ankle examinations were evaluated. Two hundred and nine monks from 28 temples were included in this study. Common foot and ankle problems found included callosity (70.8%), toe deformities (18.2%), plantar fasciitis (13.4%), metatarsalgia (3.8%), and numbness (2.9%). Callosity and toe deformities were associated with prolonged barefoot walking over extended periods since ordainment (p < 0.05). The callosity was found on the forefoot (47.3%), lateral malleolus (40.7%), and heel (12%). Arch types were considered normal in 66.4% of cases, high in 21.6%, and low in 12%. No association was found between arch type and foot and ankle problems. Callosity and toe deformity were the most common foot and ankle problems found in Thai monks, especially those with prolonged period of barefoot walking and long-term duration ofordainment. The unique pattern of walking and sitting of Thai monks may have contributed to the development of those feet and ankle problems.

Foot and ankle problems in Muay Thai kickboxers.

Science.gov (United States)

Vaseenon, Tanawat; Intharasompan, Piyapong; Wattanarojanapom, Thongaek; Theeraamphon, Nipon; Auephanviriyakul, Sansanee; Phisitkul, Phinit

2015-01-01

Muay Thai kickboxing is a common sport that uses the foot and ankle in fighting. Muay Thai kickboxing trainees usually receive training in Thailand Foot and ankle problems in this group ofpeople who usually train barefoot remain unexplored To evaluate the prevalence of common foot and ankle problems in Muay Thai kick boxers. The present study is a cross-sectional survey of Muay Thai kick boxers practicing in northern Thailand. Interviews were conducted and foot and ankle examinations were evaluated Foot morphology was examined using a Harris mat footprint. One hundred and twenty-three Muay Thai kickbox ersinnine training gyms were included in this study. Common foot and ankle problems found in the Muay Thai kick boxers were callosity (59%), gastrocnemius contracture (57%), toe deformities (49.3%), wounds (10%) and heel pain (9%). Callosity was most commonly found on the forefoot (77.5%), on the plantar first metatarsal (55.3%) and on the big toe (33.3%). An association was found between a tight heel cord and a history of foot injury with prolonged periods of weekly training. Toe deformities such as hallux rigidus (37.6%) were also associated with prolonged periods of training (p = 0.001). No correlation was found between type of foot arch and foot and ankle problems. Plantar forefoot callosities and wounds as well as toe deformities including tight heel cords are some of the foot and ankle problems commonly found in Muay Thai kick boxers. They are associated with prolonged periods of barefoot training. The unique pattern of training and of the kicks in Muay Thai might be a path mechanism, leading to the development of foot and ankle problems.

[Effects of foot reflexology on essential hypertension patients].

Science.gov (United States)

Park, Hyoung-Sook; Cho, Gyoo-Yeong

2004-08-01

This study was to evaluate the effects of foot reflexology on blood pressure, serum lipids level and life satisfaction in essential hypertension patients. The research design used was a nonequivalent control group pretest-posttest design. Foot Reflexology was used as the experimental treatment from June 23rd, 2003 until August 31st, 2003. Thirty-four subjects were assigned to an experimental group(18) and control group(16). Foot Reflexology was administered twice a week for 6 weeks and self foot Reflexology was administered twice a week for 4 weeks on the experimental group. There was a significant decrease in systolic blood pressure but no significant decrease in diastolic pressure in the experimental group compared to the control group. The total cholesterol level in the experimental group compared to the control group was not significantly decreased after foot reflexology. However, the triglyceride level in the experimental group compared to the control group was significantly decreased after foot reflexology. On the other hand, high density lipoprotein and low density lipoprotein levels in the experimental group compared to the control group was not significantly decreased after foot reflexology. Life satisfaction in the experimental group compared to the control group was significantly improved after foot reflexology. The results proved that foot reflexology was an effective nursing intervention to decrease systolic pressure, and triglyceride but not for the blood cholesterol and to improve life satisfaction. Therefore, blood cholesterol should be further evaluated in a larger group of subjects and for a longer period. Further research is regarded as necessary to evaluate and to compare effects of self-foot reflexology and foot reflexology.

COMPARISON OF GAIT USING A MULTIFLEX FOOT VERSUS A QUANTUM FOOT IN KNEE DISARTICULATION AMPUTEES

NARCIS (Netherlands)

BOONSTRA, AM; FIDLER, [No Value; SPITS, GMA; HOF, AL; Tuil, P.

The subjective responses and gait patterns of unilateral knee disarticulation amputees wearing prostheses fitted first with the Multiflex foot and then with the Quantum foot were studied. Nine amputees were included in the trial. A questionnaire asked the amputees about their preference for one of

Effects of kinesiotaping on foot posture in participants with pronated foot: a quasi-randomised, double-blind study.

Science.gov (United States)

Luque-Suarez, Alejandro; Gijon-Nogueron, Gabriel; Baron-Lopez, Francisco Javier; Labajos-Manzanares, Maria Teresa; Hush, Julia; Hancock, Mark Jonathan

2014-03-01

To investigate whether kinesiotaping improves excessive foot pronation compared with sham kinesiotaping. Quasi-randomised, double-blind study. One primary care centre. One hundred and thirty participants were screened for inclusion. Sixty-eight participants with pronated feet [Foot Posture Index (FPI)≥ 6] were enrolled, and the follow-up rate was 100%. Participants were allocated into one of two groups: an experimental kinesiotaping group (KT1) and a sham taping group (KT2). Measures were collected by a blinded assessor at baseline, and 1 minute, 10 minutes, 60 minutes and 24 hours after taping. The primary outcome was total FPI score, and the secondary outcome was rear-foot FPI score. There were no significant differences in total FPI score between kinesiotaping and sham taping at any time point. Similarly, there were no significant differences in rear-foot FPI score, apart from at 60-minute follow-up when the difference between groups was significant (P=0.04) but the effect size was very small (0.85 points on the rear-foot FPI score between -6 and +6). Kinesiotaping does not correct foot pronation compared with sham kinesiotaping in people with pronated feet. Copyright © 2013 Chartered Society of Physiotherapy. All rights reserved.

Novel In-Shoe Exoskeleton for Offloading of Forefoot Pressure for Individuals With Diabetic Foot Pathology.

Science.gov (United States)

Roser, Mark C; Canavan, Paul K; Najafi, Bijan; Cooper Watchman, Marcy; Vaishnav, Kairavi; Armstrong, David G

2017-09-01

Infected diabetic foot ulcers are the leading cause of lower limb amputation. This study evaluated the ability of in-shoe exoskeletons to redirect forces outside of body and through an exoskeleton as an effective means of offloading plantar pressure, the major contributing factor of ulceration. We compared pressure in the forefoot and hind-foot of participants (n = 5) shod with novel exoskeleton footwear. Plantar pressure readings were taken during a 6-m walk at participant's self-selected speed, and five strides were averaged. Results were taken with Achilles exotendon springs disengaged as a baseline, followed by measurements taken with the springs engaged. When springs were engaged, all participants demonstrated a decrease in forefoot pressure, averaging a 22% reduction ( P exoskeleton solution. Results suggest that when the novel exoskeletons were deployed in footwear and exotendon springs engaged, force was successfully transferred from the lower leg through the exoskeleton-enabled shoe to ground, reducing load on the forefoot. The results need to be confirmed in a larger sample. Another study is warranted to examine the effectiveness of this offloading to prevent diabetic foot ulcer, while minimizing gait alteration in daily physical activities.

Comparison of plantar pressure on normal -footed vs. high arch-footed badminton players in two-way lunge

Directory of Open Access Journals (Sweden)

parvane bazipoor

2017-03-01

Full Text Available Background: Compared to the individuals with a normal arch structure, those with high or low arch can be at an increased risk of overuse injuries. The risk of overuse injury among athletes is high due, in part, to the repeated loading of the lower extremities. The current study aimed to determine if foot type (high-arched or normal results in differences in plantar pressure during two badminton-specific movements (right-reverse lunge and right-lateral lunge. Methods: Twenty badminton players (10 with normal feet and 10 with higharched feet completed five trials in both right-reverse and right-lateral lunge, while in-shoe pressure data were collected at 100 Hz. The peak pressure and mean pressure were analyzed among the subjects for five major anatomical regions of the foot, using the independent t test in SPSS version 20. The foot type was determined by the foot posture index (FPI (α<0.05. Results: Results showed that the plantar pressure characteristics of normal and high-arched feet were different; such that in high-arched feet, as compared to normal subjects, there were significantly fewer pressure strikes in the medial (P=0.010 and lateral (P=0.002 mid-foot in right-reverse lunge and this was significantly higher in forefoot (P=0.003 and toes (P=0.010. However, the peak (P=0.157 and mean (P=0.104 pressure in the heel was higher but not significant. In the right- lateral lunge, we found statistically lower peak pressure stroke for the lateral mid-foot (P=0.010 and forefoot (P=0.011; however, the mean pressure was lower in the lateral (P=0.010 and medial (P=0.040 mid-foot and forefoot (P=0.120, although it was not significant in the forefoot. Conclusion: Results showed that the medial longitudinal arch of the foot might cause pressure differences in the feet among the players with normal and higharched feet. As the results demonstrated, in high-arched feet, there are some regions where plantar pressure is higher and some where it is lower

Hand, Foot, and Mouth Disease

Centers for Disease Control (CDC) Podcasts

Hand, foot, and mouth disease is a contagious illness that mainly affects children under five. In this podcast, Dr. Eileen Schneider talks about the symptoms of hand, foot, and mouth disease, how it spreads, and ways to help protect yourself and your children from getting infected with the virus.

What is the diabetic foot?

African Journals Online (AJOL)

increase in the complications related to diabetes as a result of this increasing ... A number of contributory factors work together to cause foot ... neuropathy, peripheral vascular disease, foot deformities, external ... it is usually a combination of problems rather than a single risk ... This results in increased oxidative stress.

Vitamin D deficiency is associated with inflammatory cytokine concentrations in patients with diabetic foot infection.

Science.gov (United States)

Tiwari, Shalbha; Pratyush, Daliparthy Devi; Gupta, Sanjeev Kumar; Singh, Surya Kumar

2014-12-28

Vitamin D has been recognised as a potent immunomodulator and its deficiency is common in different population groups including patients with diabetic foot infection. Diabetic foot infection reflects the altered immune status of the host. As cytokine regulation plays a significant role in infection and wound-healing processes, the present study aimed to evaluate the association between vitamin D status and inflammatory cytokine profiles in patients with diabetic foot infection. The serum concentrations of vitamin D (25-hydroxyvitamin D), IL-1β, IL-6, TNF-α and interferon-γ (IFN-γ) were measured in 112 diabetic foot infection cases and 109 diabetic controls. Severe vitamin D deficiency (25-hydroxyvitamin D concentration diabetes, HbA1C (glycosylated Hb) concentration and BMI were similar, cases had significantly higher concentrations of IL-6 (P≤ 0.001), IL-1β (P≤ 0.02) and TNF-α (P≤ 0.006) than controls. A significant negative correlation was also observed between 25-hydroxyvitamin D concentration and circulating concentrations of IL-1β (r -0.323; P≤ 0.001) as well as IL-6 (r -0.154; P≤ 0.04), but not between 25-hydroxyvitamin D and TNF-α and IFN-γ concentrations. Furthermore, a significant difference in IL-1β (P≤ 0.007) and IL-6 (P≤ 0.02) concentrations was observed in patients with severe 25-hydroxyvitamin D deficiency compared with patients with 25-hydroxyvitamin D concentration ≥ 25 nmol/l, and this difference was remarkable for TNF-α. In conclusion, severe vitamin D deficiency is associated with elevated inflammatory cytokine concentrations in diabetic patients, particularly in those with foot infection. A 25-hydroxyvitamin D concentration value diabetes mellitus.

Diabetic Foot Complications Despite Successful Pancreas Transplantation.

Science.gov (United States)

Seo, Dong-Kyo; Lee, Ho Seong; Park, Jungu; Ryu, Chang Hyun; Han, Duck Jong; Seo, Sang Gyo

2017-06-01

It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes. The mean age was 40.7 (range, 15-76) years. Diabetes type, transplantation type, body mass index, and diabetes duration before transplantation were confirmed. After pancreas transplantation, the occurrence and duration of foot and ankle complications were assessed. Twenty-two patients (10.1%) had diabetic foot complications. Fifteen patients (6.9%) had diabetic foot ulcer and 7 patients (3.2%) had Charcot arthropathy. Three patients had both diabetic foot ulcer and Charcot arthropathy. Three insufficiency fractures (1.4%) were included. Mean time of complications after transplantation was 18.5 (range, 2-77) months. Creatinine level 1 year after surgery was higher in the complication group rather than the noncomplication group ( P = .02). Complications of the foot and ankle still occurred following pancreas transplantation in patients with diabetes. Level III, comparative study.

Exploring the Relationship Between Mobile Facebook and Social Capital: What Is the “Mobile Difference” for Parents of Young Children?

OpenAIRE

Andrew R. Schrock

2016-01-01

Mobile media have generally been found to reinforce close ties. Many have predicted this will bring about an onerous social insularity or “network privatism.” However, mobile media now enable frequent communication and multimedia activities with larger, more diffuse social networks. Might we be at a tipping point where certain groups benefit from weak tie connections on mobile social media? To answer this question, this study considers how mobile media altered social capital outcomes on Faceb...

A review of the foot function index and the foot function index – revised

Science.gov (United States)

2013-01-01

Background The Foot Function Index (FFI) is a self-report, foot-specific instrument measuring pain and disability and has been widely used to measure foot health for over twenty years. A revised FFI (FFI-R) was developed in response to criticism of the FFI. The purpose of this review was to assess the uses of FFI and FFI-R as were reported in medical and surgical literature and address the suggestions found in the literature to improve the metrics of FFI-R. Methods A systematic literature search of PubMed/Medline and Embase databases from October 1991 through December 2010 comprised the main sources of literature. To enrich the bibliography, the search was extended to BioMedLib and Scopus search engines and manual search methods. Search terms included FFI, FFI scores, FFI-R. Requirements included abstracts/full length articles, English-language publications, and articles containing the term "foot complaints/problems." Articles selected were scrutinized; EBM abstracted data from literature and collected into tables designed for this review. EBM analyzed tables, KJC, JM, RMS reviewed and confirmed table contents. KJC and JM reanalyzed the original database of FFI-R to improve metrics. Results Seventy-eight articles qualified for this review, abstracts were compiled into 12 tables. FFI and FFI-R were used in studies of foot and ankle disorders in 4700 people worldwide. FFI Full scale or the Subscales and FFI-R were used as outcome measures in various studies; new instruments were developed based on FFI subscales. FFI Full scale was adapted/translated into other cultures. FFI and FFI-R psychometric properties are reported in this review. Reanalysis of FFI-R subscales' confirmed unidimensionality, and the FFI-R questionnaires' response categories were edited into four responses for ease of use. Conclusion This review was limited to articles published in English in the past twenty years. FFI is used extensively worldwide; this instrument pioneered a quantifiable measure

Bearing capacity of Skirt circular footing on sand

Directory of Open Access Journals (Sweden)

Amr Z. EL Wakil

2013-09-01

Full Text Available Skirts are used to improve the bearing capacity of shallow footings on sandy soil by constraining the soil beneath and containing the plastic flow of soil. They are used as an alternative to deep foundations in soils with low strength at the surface. As there has been available little work studying the performance of skirted foundation, we are performing eighteen laboratory experiments on circular steel footings of different diameters and different skirt lengths. The aim of these experiments is to shed some lights on the effects of skirts on the bearing capacity of shallow footings. The effects of skirt length and the relative density of sand on the ultimate load attained were investigated. From the accomplished laboratory tests, it was found that skirts improve appreciably the sustainability of shallow footings to applied load as they increase the ultimate load of shallow footings by some up to 6.25 times for the current study conditions and variables. The performance of skirted footing depends upon the relative density of sand and on the skirt length to footing diameter ratio. Skirts are more beneficial in case of footings on loose sand than in case of medium and dense sand.

Mutagenicity in Salmonella of a Simulated Urban-Smog Atmosphere Generated Using a Mobile Reaction Chamber

Science.gov (United States)

The EPA Mobile Reaction Chamber (MRC) is a 24-foot trailer containing a 14.3-m3 Teflon lined photochemical chamber used to generate simulated urban atmospheres. Photochemistry in the MRC is catalyzed by 120 fluorescent bulbs evenly mixed with black light bulbs and UV bulbs (300 &...

Clinical workflow for personalized foot pressure ulcer prevention.

Science.gov (United States)

Bucki, M; Luboz, V; Perrier, A; Champion, E; Diot, B; Vuillerme, N; Payan, Y

2016-09-01

Foot pressure ulcers are a common complication of diabetes because of patient's lack of sensitivity due to neuropathy. Deep pressure ulcers appear internally when pressures applied on the foot create high internal strains nearby bony structures. Monitoring tissue strains in persons with diabetes is therefore important for an efficient prevention. We propose to use personalized biomechanical foot models to assess strains within the foot and to determine the risk of ulcer formation. Our workflow generates a foot model adapted to a patient's morphology by deforming an atlas model to conform it to the contours of segmented medical images of the patient's foot. Our biomechanical model is composed of rigid bodies for the bones, joined by ligaments and muscles, and a finite element mesh representing the soft tissues. Using our registration algorithm to conform three datasets, three new patient models were created. After applying a pressure load below these foot models, the Von Mises equivalent strains and "cluster volumes" (i.e. volumes of contiguous elements with strains above a given threshold) were measured within eight functionally meaningful foot regions. The results show the variability of both location and strain values among the three considered patients. This study also confirms that the anatomy of the foot has an influence on the risk of pressure ulcer. Copyright © 2016. Published by Elsevier Ltd.

Association between plantar fascia vascularity and morphology and foot dysfunction in individuals with chronic plantar fasciitis.

Science.gov (United States)

Chen, Hongying; Ho, Hok-Ming; Ying, Michael; Fu, Siu Ngor

2013-10-01

Single-cohort laboratory-based study. To identify whether plantar fascia vascularity and thickness are associated with foot pain and dysfunction in individuals with chronic plantar fasciitis. Background Altered plantar fascia vascularity and thickening of the fascia have been identified in individuals with chronic plantar fasciitis. Thirty-eight patients with chronic unilateral plantar fasciitis and 21 controls participated in this study. Proximal plantar fascia vascularization and thickness were assessed using ultrasound imaging, and pain and foot dysfunction were quantified with a visual analog scale and the Chinese version of the Foot Function Index, respectively. Paired t tests were used to assess the side-to-side differences in fascia thickness and vascularity index (VI) in the control and patient groups, and an unpaired t test was used to make comparisons with the patient group. Multiple regression analysis was performed to identify whether the VI and fascia thickness were associated with pain and foot dysfunction. There were significantly higher VI (mean ± SD, 2.4% ± 1.4%) and fascia thickness (5.0 ± 1.3 mm) values in the affected feet when compared with the unaffected feet in the patient group (VI, 1.4% ± 0.5%; fascia thickness, 3.3 ± 0.7 mm) and with the dominant side of the controls (VI, 1.6% ± 0.4%; fascia thickness, 2.9 ± 0.6 mm). After accounting for age, gender, body mass index, and duration of symptoms, the VI explained 13% and 33% of the variance in pain scores measured with a visual analog scale and the pain subscale of the Foot Function Index, respectively; the VI and fascia thickness explained 42% of the variance in the Foot Function Index. Individuals with unilateral chronic plantar fasciitis demonstrated significantly greater vascularity and thickened fascia on the affected side compared to the unaffected side and also to healthy controls. Fascia vascularity was associated independently with self-perceived pain, and both fascia

Inter-assessor reliability of practice based biomechanical assessment of the foot and ankle

Directory of Open Access Journals (Sweden)

Jarvis Hannah L

2012-06-01

Full Text Available Abstract Background There is no consensus on which protocols should be used to assess foot and lower limb biomechanics in clinical practice. The reliability of many assessments has been questioned by previous research. The aim of this investigation was to (i identify (through consensus what biomechanical examinations are used in clinical practice and (ii evaluate the inter-assessor reliability of some of these examinations. Methods Part1: Using a modified Delphi technique 12 podiatrists derived consensus on the biomechanical examinations used in clinical practice. Part 2: Eleven podiatrists assessed 6 participants using a subset of the assessment protocol derived in Part 1. Examinations were compared between assessors. Results Clinicians choose to estimate rather than quantitatively measure foot position and motion. Poor inter-assessor reliability was recorded for all examinations. Intra-class correlation coefficient values (ICC for relaxed calcaneal stance position were less than 0.23 and were less than 0.14 for neutral calcaneal stance position. For the examination of ankle joint dorsiflexion, ICC values suggest moderate reliability (less than 0.61. The results of a random effects ANOVA highlight that participant (up to 5.7°, assessor (up to 5.8° and random (up to 5.7° error all contribute to the total error (up to 9.5° for relaxed calcaneal stance position, up to 10.7° for the examination of ankle joint dorsiflexion. Kappa Fleiss values for categorisation of first ray position and mobility were less than 0.05 and for limb length assessment less than 0.02, indicating slight agreement. Conclusion Static biomechanical assessment of the foot, leg and lower limb is an important protocol in clinical practice, but the key examinations used to make inferences about dynamic foot function and to determine orthotic prescription are unreliable.

Holographic interferometry for early diagnosisof children flat foot

Directory of Open Access Journals (Sweden)

Oleg Petrovich Bolshakov

2015-03-01

Full Text Available The article presents the first experience ofthe use of holographic interferometr y for earlydiagnosis of the flat foot in 4-5 years old children.13 patients were examined. The results of the clinicalexamination, plantography, and of the graphicalreconstruction of the form of the foot arch basedon the interferogramms of the prints on Pedilen areanalyzed. We revealed typical differences betweenthe form of the foot arches in children with flat foot and children with normal status. The use of the proposed method for early detection of congenital pes valgus and of the signs of “flexible flat” foot is being suggested.

Repeatability of the Oxford Foot Model for Kinematic Gait Analysis of the Foot and Ankle

NARCIS (Netherlands)

van Hoeve, S.; Vos, J.; Weijers, P.; Verbruggen, J.; Willems, P.; Poeze, M.; Meijer, K.

2015-01-01

INTRODUCTION: Kinematic gait analysis via the multi-segmental Oxford foot model (OFM) may be a valuable addition to the biomechanical examination of the foot and ankle. The aim of this study is to assess the repeatability of the OFM in healthy subjects. METHODS: Nine healthy subjects, without a

Challenging the foundations of the clinical model of foot function: further evidence that the root model assessments fail to appropriately classify foot function.

Science.gov (United States)

Jarvis, Hannah L; Nester, Christopher J; Bowden, Peter D; Jones, Richard K

2017-01-01

The Root model of normal and abnormal foot function remains the basis for clinical foot orthotic practice globally. Our aim was to investigate the relationship between foot deformities and kinematic compensations that are the foundations of the model. A convenience sample of 140 were screened and 100 symptom free participants aged 18-45 years were invited to participate. The static biomechanical assessment described by the Root model was used to identify five foot deformities. A 6 segment foot model was used to measure foot kinematics during gait. Statistical tests compared foot kinematics between feet with and without foot deformities and correlated the degree of deformity with any compensatory motions. None of the deformities proposed by the Root model were associated with distinct differences in foot kinematics during gait when compared to those without deformities or each other. Static and dynamic parameters were not correlated. Taken as part of a wider body of evidence, the results of this study have profound implications for clinical foot health practice. We believe that the assessment protocol advocated by the Root model is no longer a suitable basis for professional practice. We recommend that clinicians stop using sub-talar neutral position during clinical assessments and stop assessing the non-weight bearing range of ankle dorsiflexion, first ray position and forefoot alignments and movement as a means of defining the associated foot deformities. The results question the relevance of the Root assessments in the prescription of foot orthoses.

Genomic change, retrotransposon mobilization and extensive cytosine methylation alteration in Brassica napus introgressions from two intertribal hybridizations.

Science.gov (United States)

Zhang, Xueli; Ge, Xianhong; Shao, Yujiao; Sun, Genlou; Li, Zaiyun

2013-01-01

Hybridization and introgression represent important means for the transfer and/or de novo origination of traits and play an important role in facilitating speciation and plant breeding. Two sets of introgression lines in Brassica napus L. were previously established by its intertribal hybridizations with two wild species and long-term selection. In this study, the methods of amplified fragment length polymorphisms (AFLP), sequence-specific amplification polymorphism (SSAP) and methylation-sensitive amplified polymorphism (MSAP) were used to determine their genomic change, retrotransposon mobilization and cytosine methylation alteration in these lines. The genomic change revealed by the loss or gain of AFLP bands occurred for ∼10% of the total bands amplified in the two sets of introgressions, while no bands specific for wild species were detected. The new and absent SSAP bands appeared for 9 out of 11 retrotransposons analyzed, with low frequency of new bands and their total percentage of about 5% in both sets. MSAP analysis indicated that methylation changes were common in these lines (33.4-39.8%) and the hypermethylation was more frequent than hypomethylation. Our results suggested that certain extents of genetic and epigenetic alterations were induced by hybridization and alien DNA introgression. The cryptic mechanism of these changes and potential application of these lines in breeding were also discussed.

CLINICOMICROBIOLOGICAL STUDY OF DIABETIC FOOT ULCERS

Directory of Open Access Journals (Sweden)

Nirmal Kumar Palaniappan

2017-11-01

Full Text Available BACKGROUND Type 2 diabetes mellitus is a chronic disease caused by a combination of lifestyle and genetic factors affecting all organs in the body. Foot ulcers are one of the common and serious long-term complications of diabetes leads to recurrent and chronic infections, which results in limb loss when treatment is delayed. The aim of this study is to find out the clinical outcome and microbiological profile in patients admitted with diabetic foot ulcers. MATERIALS AND METHODS The study conducted between November 2008 to November 2009 over 50 patients with history of foot ulceration and diabetes. 50 patients were admitted with diabetic foot ulcer over a period of one year between November 2008-2009. They were studied after getting written consent. A predesigned pro forma was used to get the parameters comprising age, gender, duration, type of diabetes mellitus, presence of neuropathy, nephropathy (serum creatinine, urine albumin, retinopathy (screening funduscopy by ophthalmologist. RESULTS Among 50 patients admitted and treated for diabetic foot ulcers with mean stay of 18 days, 29 (58% had complete healing on conservative management, 18 (36% underwent minor amputation (toes, 3 (6% had major amputation (below knee/above knee. No mortality among the study groups encountered. Gram-negative aerobes E. coli (36%, Pseudomonas (52%, Klebsiella (28%, Proteus vulgaris (20% and Acinetobacter (16% were most frequently isolated followed by gram-positive aerobes MRSA (14%, Enterococcus (6%, Strep pyogenes (4% and no anaerobic growth. CONCLUSION Diabetic foot infections are frequently polymicrobial and predominantly gram-negative aerobic bacteria at presentation. Multidrug resistance pseudomonas aeruginosa and MRSA in diabetic foot ulcer is at its emergence and life threatening. Initial aggressive multimodal approach with surgical intervention, culture specific and sensitive targeted combined broad-spectrum antibiotics decreases the morbidity and mortality

A Powered Lower Limb Orthosis for Providing Legged Mobility in Paraplegic Individuals.

Science.gov (United States)

Quintero, Hugo A; Farris, Ryan J; Hartigan, Clare; Clesson, Ismari; Goldfarb, Michael

2011-01-01

This paper presents preliminary results on the development of a powered lower limb orthosis intended to provide legged mobility (with the use of a stability aid, such as forearm crutches) to paraplegic individuals. The orthosis contains electric motors at both hip and both knee joints, which in conjunction with ankle-foot orthoses, provides appropriate joint kinematics for legged locomotion. The paper describes the orthosis and the nature of the controller that enables the SCI patient to command the device, and presents data from preliminary trials that indicate the efficacy of the orthosis and controller in providing legged mobility.

Increased plantar foot pressure in persons affected by leprosy

NARCIS (Netherlands)

Slim, Frederik J.; van Schie, Carine H.; Keukenkamp, Renske; Faber, William R.; Nollet, Frans

2012-01-01

Although foot pressure has been reported to be increased in people affected by leprosy, studies on foot pressure and its determinants are limited. Therefore, the aim was to assess barefoot plantar foot pressure and to identify clinical determinants of increased plantar foot pressure in leprosy

A Prosthetic Foot Emulator to Optimize Prescription of Prosthetic Feet in Veterans and Service Members with Leg Amputations

Science.gov (United States)

2017-09-01

mobility, prosthetic foot preference and walking ability after two weeks of use in the home and community setting. No exclusions based on sex , race...2012 Page 17 of 33 Data collection Photos and video recording With the participant’s explicit consent, we may take video and photos during portions of...this study, for documentation and use in research publications. All videos and photos will exclue the participant’s face and identifying marks will

Increased Brain Activation for Foot Movement During 70-Day 6 Deg Head-Down Bed Rest (HDBR): Evidence from Functional Magnetic Resonance Imaging (fMRI)

Science.gov (United States)

Yuan, P.; Koppelmans, V.; Cassady, K.; Cooke, K.; De Dios, Y. E.; Stepanyan, V.; Szecsy, D.; Gadd, N.; Wood, S. J.; Reuter-Lorenz, P. A.;

Find an Orthopaedic Foot and Ankle MD/DO

Science.gov (United States)

... All Site Content AOFAS / FootCareMD / Find a Surgeon Find a Foot & Ankle Orthopaedic Surgeon Page Content Who ... your prescribed treatment (surgical and/or non-surgical) ​ Find a Surgeon ​ Click here to find a foot ...

Effect of forward/backward standing posture on foot shape

NARCIS (Netherlands)

Daanen, H.A.M.; Tan, T.K.; Punte, P.A.J.

2000-01-01

Foot length and breadth are generally used to determine the correct shoe size. An important question is whether foot length and foot breadth are dependent upon body posture. Therefore, the effect of leaning forward/backward on foot length and breadth is investigated in this study. Seven subjects

Clinical management of acute diabetic Charcot foot in Denmark

DEFF Research Database (Denmark)

Jansen, Rasmus Bo; Svendsen, Ole Lander; Kirketerp-Møller, Klaus

2016-01-01

INTRODUCTION: Charcot foot is a severe complication to diabetes mellitus and treatment involves several different clinical specialities. Our objective was to describe the current awareness, knowledge and treatment practices of Charcot foot among doctors who handle diabetic foot disorders. METHODS......: This study is based on a questionnaire survey sent out to healthcare professionals, primarily doctors, working with diabetic foot ulcers and Charcot feet in the public sector of the Danish healthcare system. RESULTS: The survey obtained a 52% response rate. A temperature difference of > 2 °C between the two...... and treatment practices of acute diabetic Charcot foot at diabetes foot clinics in Denmark. The responders seem to follow the international recommendations and guidelines on management of the acute diabetic Charcot foot, despite a lack of Danish guidelines. FUNDING: none. TRIAL REGISTRATION: not relevant....

Changes in gluteal muscle forces with alteration of footstrike pattern during running.

Science.gov (United States)

Vannatta, Charles Nathan; Kernozek, Thomas W; Gheidi, Naghmeh

2017-10-01

Gait retraining is a common form of treatment for running related injuries. Proximal factors at the hip have been postulated as having a role in the development of running related injuries. How altering footstrike affects hip muscles forces and kinematics has not been described. Thus, we aimed to quantify differences in hip muscle forces and hip kinematics that may occur when healthy runners are instructed to alter their foot strike pattern from their habitual rear-foot strike to a forefoot strike. This may gain insight on the potential etiology and treatment methods of running related lower extremity injury. Twenty-five healthy female runners completed a minimum of 10 running trials in a controlled laboratory setting under rear-foot strike and instructed forefoot strike conditions. Kinetic and kinematic data were used in an inverse dynamic based static optimization to estimate individual muscle forces during running. Within subject differences were investigated using a repeated measures multi-variate analysis of variance. Peak gluteus medius and minimus and hamstring forces were reduced while peak gluteus maximus force was increased when running with an instructed forefoot strike pattern. Peak hip adduction, hip internal rotation, and heel-COM distance were also reduced. Therefore, instructing habitual rearfoot strike runners to run with a forefoot strike pattern resulted in changes in peak gluteal and hamstring muscle forces and hip kinematics. These changes may be beneficial to the development and treatment of running related lower extremity injury. Copyright © 2017 Elsevier B.V. All rights reserved.

Site-specific differences in the association between plantar tactile perception and mobility function in older adults

Directory of Open Access Journals (Sweden)

Yenisel eCruz-Almeida

2014-04-01

Full Text Available Introduction Impaired somatosensation is common in older adults and contributes to age-related loss of mobility function. However, little is known about whether somatosensation at different sites on the plantar surface of the foot are differentially related to mobility function. Such a finding may have important implications for clinical care of older adults and other at-risk populations, such as for optimizing interventions (e.g., footwear for augmenting somatosensory feedback and for improving the efficiency of clinical assessment. Materials and Methods Tactile perception was evaluated with a 10g monofilament at four sites on the plantar surface of each foot: great toe (GT, first metatarsal head (MT1, heel (H and fifth metatarsal head (MT5. Mobility function was assessed with the Berg Balance Scale and walking speed. Results Sixty-one older adults participated. Tactile perception was significantly positively associated with Berg Balance Score (adjusted R2 = 0.30 - 0.75; p = 0.03 - Discussion The present findings indicate that tactile perception at MT1 is more closely linked to mobility function than is tactile perception at GT, MT5 or H. These findings warrant further research to examine whether interventions (e.g., textured insoles and assessments that preferentially or exclusively focus on the site of MT1 may be more effective for optimizing clinical care.

Isolation of a substance activating foot formation in hydra

DEFF Research Database (Denmark)

Grimmelikhuijzen, C J; Schaller, H C

1977-01-01

-forming potential of the tissue (2) It does not accelerate head regeneration, nor do the head factors of hydra discovered by Schaller (1973) and Berking (1977) accelerate foot regeneration. We propose that the foot-activating substance is a morphogen responsible for foot formation in hydra. The foot activator can...

Management of diabetic foot infections

International Nuclear Information System (INIS)

Jamil, M.; Amin, Z.; Chaudhary, T. H.; Shaheen, J.; Alvi, Z. R.

2001-01-01

Objective: To determine the infecting agent in diabetic food infection with the susceptibility pattern, and to evaluate the effect of wound infection, was culopathy, neuropathy and control of diabetes mellitus on the outcome of the patients. Design: A descriptive and observational study. Place and duration of study: Patients with diabetic foot, admitted in surgical unit 1, B.V. Hospital Bahawalpur, from April 1999 to April 2000, were included in this study. Subject and methods: A total of 60 known diabetic patients were studied, out of these 47 were males and 13 females. They were assessed for angiopathy, neuropathy and extend of foot involvement. Necessary investigations, including x-ray foot, ECG, serum urea and creatinine, pus culture and sensitivity were carried out. Diabetes was controlled on insulin of the basis of serum sugar and urine sugar chart and treated accordingly. Results: The most common age of foot involvement was between 40-70 years. Right side was involved more often than the left (67%: 37%). Most of the infections were due to staphylococcus (50%), pseudomonas (25%) and streptococci (8%). Antibiotic was started based on sensitivity report. Fluoro quinolone plus clindamycin was used in 50%, fluoro quinolone plus metronidazole in 20% and amoxicillin/clavulanate in 23%. Most of the patients (61.7%) were in grade iii or iv of Meggit wagner classification of diabetic foot. Three patients (5%) were treated by below knee amputations while 1.7% patient by above knee amputation. In twenty-four (40%) patients some form of to amputation/ray amputation had to be done,while 32(53.3%) patients had complete healing of would without any amputation. Mortality was 3.33% all the 4 patients (6.7%) who presented late, having uncontrolled diabetes, with angiopathy (absent foot pulses), neuropathy, infection of the foot (grade iii or above) resulted in major amputation sooner or latter. The 32 patients (53.3%) having controlled diabetes mellitus with no angiopathy or

Cosmetic Foot Surgery: Fashion's Pandora's Box

Science.gov (United States)

... Fashion’s Pandora’s Box? A A A | Print | Share Cosmetic Foot Surgery: Fashion’s Pandora’s Box? Foot and ankle ... extreme and imprudent as it may sound, the cosmetic surgery craze is not just for faces anymore— ...

Growth factors for treating diabetic foot ulcers

DEFF Research Database (Denmark)

Martí-Carvajal, Arturo J; Gluud, Christian; Nicola, Susana

2015-01-01

following treatment for diabetic foot ulcers (RR 0.64, 95% CI 0.14 to 2.94; P value 0.56, low quality of evidence)Although 11 trials reported time to complete healing of the foot ulcers in people with diabetes , meta-analysis was not possible for this outcome due to the unique comparisons within each trial...... (minimum of one toe), complete healing of the foot ulcer, and time to complete healing of the diabetic foot ulcer as the primary outcomes. DATA COLLECTION AND ANALYSIS: Independently, we selected randomised clinical trials, assessed risk of bias, and extracted data in duplicate. We estimated risk ratios......BACKGROUND: Foot ulcers are a major complication of diabetes mellitus, often leading to amputation. Growth factors derived from blood platelets, endothelium, or macrophages could potentially be an important treatment for these wounds but they may also confer risks. OBJECTIVES: To assess...

Repeatability of a 3D multi-segment foot model protocol in presence of foot deformities.

Science.gov (United States)

Deschamps, Kevin; Staes, Filip; Bruyninckx, Herman; Busschots, Ellen; Matricali, Giovanni A; Spaepen, Pieter; Meyer, Christophe; Desloovere, Kaat

2012-07-01

Repeatability studies on 3D multi-segment foot models (3DMFMs) have mainly considered healthy participants which contrasts with the widespread application of these models to evaluate foot pathologies. The current study aimed at establishing the repeatability of the 3DMFM described by Leardini et al. in presence of foot deformities. Foot kinematics of eight adult participants were analyzed using a repeated-measures design including two therapists with different levels of experience. The inter-trial variability was higher compared to the kinematics of healthy subjects. Consideration of relative angles resulted in the lowest inter-session variability. The absolute 3D rotations between the Sha-Cal and Cal-Met seem to have the lowest variability in both therapists. A general trend towards higher σ(sess)/σ(trial) ratios was observed when the midfoot was involved. The current study indicates that not only relative 3D rotations and planar angles can be measured consistently in patients, also a number of absolute parameters can be consistently measured serving as basis for the decision making process. Copyright © 2012 Elsevier B.V. All rights reserved.

Reliability and prevalence of physical performance examination assessing mobility and balance in older persons in the US: data from the Third National Health and Nutrition Examination Survey.

Science.gov (United States)

Ostchega, Y; Harris, T B; Hirsch, R; Parsons, V L; Kington, R; Katzoff, M

2000-09-01

This report provides reliability and prevalence estimates by sex, age, and race/ethnicity of an observed physical performance examination (PPE) assessing mobility and balance. The Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994. A cross-sectional nationally representative survey. All persons aged 60 and older (n = 5,403) who performed the PPE either in the mobile examination center (MEC) or in the home during NHANES III (conducted 1988-1994). The PPE included timed chair stand, full tandem stand, and timed 8-foot walk. Timed chair stand and 8-foot timed walk were reliable measurements (Intraclass Correlations > 0.5). Women were significantly slower (P physically limited than men.

The Influence of Foot-Strike Technique on the Neuromechanical Function of the Foot.

Science.gov (United States)

Kelly, Luke A; Farris, Dominic J; Lichtwark, Glen A; Cresswell, Andrew G

2018-01-01

The aim of this study was to investigate the influence of foot-strike technique on longitudinal arch mechanics and intrinsic foot muscle function during running. Thirteen healthy participants ran barefoot on a force-instrumented treadmill at 2.8 ms with a forefoot (FFS) and rearfoot (RFS; habitual) running technique, whereas kinetic, kinematic, and electromyographic data from the intrinsic foot muscles were collected simultaneously. The longitudinal arch was modeled as a single "midfoot" joint representing motion of the rearfoot (calcaneus) relative to the forefoot (metatarsals). An inverse dynamic analysis was performed to estimate joint moments generated about the midfoot, as well as mechanical work and power. The midfoot was more plantar flexed (higher arch) at foot contact when running with a forefoot running technique (RFS 0.2 ± 1.8 vs FFS 6.9 ± 3.0°, effect size (ES) = 2.7); however, there was no difference in peak midfoot dorsiflexion in stance (RFS -11.6 ± 3.0 vs FFS -11.4 ± 3.4°, ES = 0.63). When running with a forefoot technique, participants generated greater moments about the midfoot (27% increase, ES = 1.1) and performed more negative work (240% increase, ES = 2.2) and positive work (42% increase, ES = 1.1) about the midfoot. Average stance-phase muscle activation was greater for flexor digitorum brevis (20% increase, ES = 0.56) and abductor hallucis (17% increase, ES = 0.63) when running with a forefoot technique. Forefoot running increases loading about the longitudinal arch and also increases the mechanical work performed by the intrinsic foot muscles. These findings have substantial implications in terms of injury prevention and management for runners who transition from a rearfoot to a forefoot running technique.

Athlete's Foot: Clinical Update.

Science.gov (United States)

Ramsey, M L

1989-10-01

In brief: Athletes are particularly prone to athlete's foot because they are generally more exposed than others to conditions that encourage fungal growth, eg, communal showers and locker rooms. Diagnosis of athlete's foot rests on clinical suspicion and laboratory testing. Treatment may consist of topical antifungal agents and, for more resistant cases, oral griseofulvin. Preventive measures include keeping the feet dry, wearing nonocclusive leather shoes or sandals and absorbent cotton socks, and applying talcum or antifungal powder at least twice daily.

Foot deformation during walking: differences between static and dynamic 3D foot morphology in developing feet.

Science.gov (United States)

Barisch-Fritz, Bettina; Schmeltzpfenning, Timo; Plank, Clemens; Grau, Stefan

2014-01-01

The complex functions of feet require a specific composition, which is progressively achieved by developmental processes. This development should take place without being affected by footwear. The aim of this study is to evaluate differences between static and dynamic foot morphology in developing feet. Feet of 2554 participants (6-16 years) were recorded using a new scanner system (DynaScan4D). Each foot was recorded in static half and full weight-bearing and during walking. Several foot measures corresponding to those used in last construction were calculated. The differences were identified by one-way ANOVA and paired Student's t-test. Static and dynamic values of each foot measure must be considered to improve the fit of footwear. In particular, footwear must account for the increase of forefoot width and the decrease of midfoot girth. Furthermore, the toe box should have a more rounded shape. The findings are important for the construction of footwear for developing feet.

Infrared thermal imaging for automated detection of diabetic foot complications.

Science.gov (United States)

van Netten, Jaap J; van Baal, Jeff G; Liu, Chanjuan; van der Heijden, Ferdi; Bus, Sicco A

2013-09-01

Although thermal imaging can be a valuable technology in the prevention and management of diabetic foot disease, it is not yet widely used in clinical practice. Technological advancement in infrared imaging increases its application range. The aim was to explore the first steps in the applicability of high-resolution infrared thermal imaging for noninvasive automated detection of signs of diabetic foot disease. The plantar foot surfaces of 15 diabetes patients were imaged with an infrared camera (resolution, 1.2 mm/pixel): 5 patients had no visible signs of foot complications, 5 patients had local complications (e.g., abundant callus or neuropathic ulcer), and 5 patients had diffuse complications (e.g., Charcot foot, infected ulcer, or critical ischemia). Foot temperature was calculated as mean temperature across pixels for the whole foot and for specified regions of interest (ROIs). No differences in mean temperature >1.5 °C between the ipsilateral and the contralateral foot were found in patients without complications. In patients with local complications, mean temperatures of the ipsilateral and the contralateral foot were similar, but temperature at the ROI was >2 °C higher compared with the corresponding region in the contralateral foot and to the mean of the whole ipsilateral foot. In patients with diffuse complications, mean temperature differences of >3 °C between ipsilateral and contralateral foot were found. With an algorithm based on parameters that can be captured and analyzed with a high-resolution infrared camera and a computer, it is possible to detect signs of diabetic foot disease and to discriminate between no, local, or diffuse diabetic foot complications. As such, an intelligent telemedicine monitoring system for noninvasive automated detection of signs of diabetic foot disease is one step closer. Future studies are essential to confirm and extend these promising early findings. © 2013 Diabetes Technology Society.

Climate, Weather and Daily Mobility : Transport Mode Choices and Travel Experiences in the Randstad Holland

NARCIS (Netherlands)

Böcker, L.

2014-01-01

Intuitively, weather plays an important role in everyday mobility. How often do we not expose ourselves to cold, heat, sun, rain, snow or wind when we are travelling on foot or by bicycle; waiting at a bus stop; walking towards a parked car; or driving under slippery road conditions. Recently,

Efficient foot motor control by Neymar’s brain

Directory of Open Access Journals (Sweden)

Eiichi eNaito

2014-08-01

Full Text Available How very long-term (over many years motor skill training shapes internal motor representation remains poorly understood. We provide valuable evidence that the football brain of Neymar da Silva Santos Júnior (the Brasilian footballer recruits very limited neural resources in the motor-cortical foot regions during foot movements. We scanned his brain activity with a 3-tesla functional magnetic resonance imaging (fMRI while he rotated his right ankle at 1Hz. We also scanned brain activity when three other age-controlled professional footballers, two top-athlete swimmers and one amateur footballer performed the identical task. A comparison was made between Neymar’s brain activity with that obtained from the others. We found activations in the left medial-wall foot motor regions during the foot movements consistently across all participants. However, the size and intensity of medial-wall activity was smaller in the four professional footballers than in the three other participants, despite no difference in amount of foot movement. Surprisingly, the reduced recruitment of medial-wall foot motor regions became apparent in Neymar. His medial-wall activity was smallest among all participants with absolutely no difference in amount of foot movement. Neymar may efficiently control given foot movements probably by largely conserving motor-cortical neural resources. We discuss this possibility in terms of over-years motor skill training effect, use-dependent plasticity, and efficient motor control.

Congenital and acquired foot disorders and their roentgenographic examination

International Nuclear Information System (INIS)

Weber, M.

1986-01-01

In addition to general radiologic aspects there are special orthopedic considerations have in interpretation of X-rays of the foot. This is especially important for the diagnosis of orthopedic foot diseases. In clubfoot X-rays are useful for therapeutic planning and control. Even in the first months of life radiographs can show important disturbances of growth of the foot and displacement of the bones of the tarsus. In other congenital foot deformities X-rays are important for diagnostic reasons: they prove luxations or skeletal deformities. The most important acquired foot disease is the pronating foot. X-rays do not only show the amount of joint damage and structural changes of bones but also allow to draw conclusions to be drawn about the causes of static and dynamic changes of the foot skeleton. Functional diagnostic radiological investigation is of decisive importance for evaluation of infantile pronating foot. X-rays allow the differentiation to be made between physiological and pathologic changes. Subtle radiographic investigation is essential while planning operative treatment in childhood, as in adults. (orig.) [de

Foot Problems

Science.gov (United States)

... early. Start OverDiagnosisThe cause may be FEMORAL ANTEVERSION, TIBIAL TORSION or METATARSUS ADDUCTUS, commonly called intoeing. Self CareSee your doctor. Start OverDiagnosisYou may have a STRESS FRACTURE of the bones in your foot. The pain ...

Role of procalcitonin in infected diabetic foot ulcer.

Science.gov (United States)

Park, Jung Ho; Suh, Dong Hun; Kim, Hak Jun; Lee, Yong In; Kwak, Il Hoon; Choi, Gi Won

2017-06-01

Procalcitonin (PCT) has been recently accepted as a marker for diagnosing infection. The aim of the present study was to determine whether PCT levels are associated with infection severity of diabetic foot ulcers and whether PCT levels would be helpful to differentiate infected diabetic foot ulcer (IDFU) from IDFU associated with other infectious diseases (IDFU+O). We prospectively included 123 diabetic patients hospitalized for IDFU. Infection severity of diabetic foot ulcers was graded according to the Infectious Diseases Society of America-International Working Group on the Diabetic Foot clinical classification of diabetic foot infection. Chest radiograph, urinalysis, urine microscopy, urine culture, and blood cultures (if fever was present) were performed for all patients to diagnose other infectious diseases. Laboratory parameters were measured from blood venous samples. PCT (Spearman's ρ=0.338, Pdiabetic foot ulcers. However, only PCT levels could differentiate patients with associated infectious diseases from patients with no concomitant infection (area under the receiver-operator characteristic curve 0.869, Pdiabetic foot ulcers and PCT levels>0.59ng/mL in patients with IDFU may be associated with other systemic bacterial infection. Copyright © 2017 Elsevier B.V. All rights reserved.

Foot-strike pattern and performance in a marathon.

Science.gov (United States)

Kasmer, Mark E; Liu, Xue-Cheng; Roberts, Kyle G; Valadao, Jason M

2013-05-01

To determine prevalence of heel strike in a midsize city marathon, if there is an association between foot-strike classification and race performance, and if there is an association between foot-strike classification and gender. Foot-strike classification (forefoot, midfoot, heel, or split strike), gender, and rank (position in race) were recorded at the 8.1-km mark for 2112 runners at the 2011 Milwaukee Lakefront Marathon. 1991 runners were classified by foot-strike pattern, revealing a heel-strike prevalence of 93.67% (n = 1865). A significant difference between foot-strike classification and performance was found using a Kruskal-Wallis test (P strike. No significant difference between foot-strike classification and gender was found using a Fisher exact test. In addition, subgroup analysis of the 126 non-heel strikers found no significant difference between shoe wear and performance using a Kruskal-Wallis test. The high prevalence of heel striking observed in this study reflects the foot-strike pattern of most mid-distance to long-distance runners and, more important, may predict their injury profile based on the biomechanics of a heel-strike running pattern. This knowledge can help clinicians appropriately diagnose, manage, and train modifications of injured runners.

Minimally important change was estimated for the Manchester-Oxford Foot Questionnaire after foot/ankle surgery.

Science.gov (United States)

Dawson, Jill; Boller, Irene; Doll, Helen; Lavis, Grahame; Sharp, Robert; Cooke, Paul; Jenkinson, Crispin

2014-06-01

To ascertain the smallest amounts of change for the three Manchester-Oxford Foot Questionnaire (MOXFQ) domains that are likely to be clinically meaningful and beyond measurement error for conditions affecting the foot/ankle. Estimates were compared with those from the Short-Form 36 (SF-36). A prospective observational study of 671 consecutive patients undergoing foot or ankle surgery at an orthopedic hospital. Before and 9 months after surgery, patients completed the MOXFQ and SF-36; transition items (anchor) asked about perceived changes in foot/ankle pain or problems since the surgery. Four hundred ninety-one patients completed pre- and postoperative questionnaires. Anchor-based minimal clinically important change (MCIC) values were ~13 points for each of the MOXFQ Walking/standing (W/S), Pain, and Social Interaction (S-I) domains [and greater than the standard error of measurement (SEM)]. MCIC values for all SF-36 domains fell within the SEM. Between-group MCIDs for the MOXFQ were W/S, 16.2; Pain, 9.9; S-I, 9.3. Distribution-based minimal detectable change (MDC90) values for the MOXFQ were ~11, ~12, and ~16 score points for the W/S, Pain, and S-I scales, respectively. This article provides information for aiding the interpretability of MOXFQ outcomes data and for planning future studies. The SF-36 is not recommended as a primary outcome for foot/ankle surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

Subcellular distribution of swine vesicular disease virus proteins and alterations induced in infected cells: A comparative study with foot-and-mouth disease virus and vesicular stomatitis virus

International Nuclear Information System (INIS)

Martin-Acebes, Miguel A.; Gonzalez-Magaldi, Monica; Rosas, Maria F.; Borrego, Belen; Brocchi, Emiliana; Armas-Portela, Rosario; Sobrino, Francisco

2008-01-01

The intracellular distribution of swine vesicular disease virus (SVDV) proteins and the induced reorganization of endomembranes in IBRS-2 cells were analyzed. Fluorescence to new SVDV capsids appeared first upon infection, concentrated in perinuclear circular structures and colocalized to dsRNA. As in foot-and-mouth disease virus (FMDV)-infected cells, a vesicular pattern was predominantly found in later stages of SVDV capsid morphogenesis that colocalized with those of non-structural proteins 2C, 2BC and 3A. These results suggest that assembly of capsid proteins is associated to the replication complex. Confocal microscopy showed a decreased fluorescence to ER markers (calreticulin and protein disulfide isomerase), and disorganization of cis-Golgi gp74 and trans-Golgi caveolin-1 markers in SVDV- and FMDV-, but not in vesicular stomatitis virus (VSV)-infected cells. Electron microscopy of SVDV-infected cells at an early stage of infection revealed fragmented ER cisternae with expanded lumen and accumulation of large Golgi vesicles, suggesting alterations of vesicle traffic through Golgi compartments. At this early stage, FMDV induced different patterns of ER fragmentation and Golgi alterations. At later stages of SVDV cytopathology, cells showed a completely vacuolated cytoplasm containing vesicles of different sizes. Cell treatment with brefeldin A, which disrupts the Golgi complex, reduced SVDV (∼ 5 log) and VSV (∼ 4 log) titers, but did not affect FMDV growth. Thus, three viruses, which share target tissues and clinical signs in natural hosts, induce different intracellular effects in cultured cells

Genetics of club foot in Maori and Pacific people

Science.gov (United States)

Chapman, C.; Stott, N; Port, R. V.; Nicol, R.

2000-01-01

The role of major gene and multifactorial inheritance in the aetiology of club foot in the New Zealand Polynesian population was studied using 287 New Zealand Maori and Pacific club foot families. The club foot family data were analysed by complex segregation analysis under the mixed model using the computer program POINTER. This analysis shows that the best genetic model for club foot in this population is a single dominant gene with a penetrance of 33% and a predicted gene frequency of 0.9%. These data provide a scientific foundation for molecular studies in the Maori and Polynesian population to identify putative club foot genes.


Keywords: club foot; New Zealand Maori; complex segregation analysis PMID:10978359

Mycetoma foot

Directory of Open Access Journals (Sweden)

Somnath Gooptu

2013-01-01

Full Text Available Mycetoma is an uncommon chronic granulomatous infective disease of the skin, dermis and subcutaneous tissues predominantly seen in tropical countries. A patient presented to our hospital with the swelling of the left foot with a healed sinus and a painful nodule. He gave a history of sinuses in the left foot from which there was discharge of yellow granules. Culture of the ultrasound guided fine needle aspiration cytology of the nodule revealed growths of Nocardia species. The patient was treated with a multi-drug therapy along with debridement of the painful nodule. He experienced symptomatic relief and a regression of the swelling within the three months of follow-up so far. Due to the relatively slow progression of the disease, patients are diagnosed at a late stage. Hence, emphasis should be placed on health education and the importance of wearing footwear.

Welcome to Journal of Foot and Ankle Research: a new open access journal for foot health professionals

OpenAIRE

Borthwick Alan M; Potter Mike J; Menz Hylton B; Landorf Karl B

2008-01-01

Abstract Journal of Foot and Ankle Research (JFAR) is a new, open access, peer-reviewed online journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. JFAR will cover a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biome...

Thyrotoxicosis Presenting as Unilateral Drop Foot.

Science.gov (United States)

Hara, Kenju; Miyata, Hajime; Motegi, Takahide; Shibano, Ken; Ishiguro, Hideaki

2017-01-01

Neuromuscular disorders associated with hyperthyroidism have several variations in their clinical phenotype, such as ophthalmopathy, periodic paralysis, and thyrotoxic myopathy. We herein report an unusual case of thyrotoxic myopathy presenting as unilateral drop foot. Histopathological examinations of the left tibialis anterior muscle showed marked variation in the fiber size, mild inflammatory cell infiltration, and necrotic and regenerated muscle fibers with predominantly type 1 fiber atrophy. Medical treatment with propylthiouracil resulted in complete improvement of the left drop foot. This case expands the phenotype of thyrotoxicosis and suggests that thyrotoxicosis be considered as a possible cause of unilateral drop foot.

Treatment options for diabetic foot osteomyelitis.

Science.gov (United States)

Senneville, Eric; Robineau, Olivier

2017-06-01

Diabetic foot osteomyelitis therapeutical options are based on antibiotic therapy and surgical resection of the infected bone(s). Surgical and medical approaches of patients suffering from a diabetic foot osteomyelitis do not oppose but are complementary and need to be discussed as a tailored manner. Areas covered: The aim of the present article is to discuss data issued from the most recent guidelines of the Infectious Diseases Society of America and the International Working Group on the Diabetic Foot on the management of the diabetic foot infection and from a search in the current literature using the terms diabetic foot osteomyelitis and treatment/therapy/therapeutical in both PubMed and Medline, restricted to the last five years. Expert opinion: Surgical removal of the entire infected bone(s) has been considered in the past as the standard treatment but medical approach of these patients has now proven efficacy in selected situations. The current emergence of bacteria, especially among Gram negative rods, resistant to almost all the available antibiotics gradually augments the complexity of the management of these patients and is likely to decrease the place of the medical approach and to worsen the outcome of these infections in the next future.

Prevalence, impact and care of foot problems in people with rheumatoid arthritis: results from a United Kingdom based cross-sectional survey

Directory of Open Access Journals (Sweden)

Oonagh Wilson

2017-10-01

Full Text Available Abstract Background Foot symptoms in rheumatoid arthritis (RA derive from a combination of inflammation, altered foot mechanics, deformity and secondary skin lesions. Guidelines recommend regular review of patients’ feet, but the extent to which the general population of RA patients report foot symptoms and access foot care has not been established. The aims of this study were to determine the prevalence, impact and care of foot problems in all patients with RA in one geographical area and identify factors associated with accessing foot care. Methods Cross-sectional survey of a random sample of patients with RA, who resided within a single community-based National Health Service (NHS podiatry service. The questionnaire collected demographic data (age, gender, local deprivation score, clinical data (disease duration, arthritis medications, disability (Health Assessment Questionnaire (HAQ, current foot problems, foot care accessed (podiatry, orthotics and/or orthopaedics and care received, measures of impact (Foot Impact Scale and ability to work. Results Of 1003 total eligible patients in the target population, 739 were posted survey packs. Of these 413 (56% replied. Responders and non-responders had similar age (63.5 yr. vs.61.5 yr, gender (74.1%F vs. 75.2%F, and highest deprivation category (13.3% vs.15.9%. Of the responders 92.1% reported current foot problems: articular 73.8%, cutaneous lesions 65.4%, structural 57.6%, extra-articular 42.6%. Responders’ median (IQR disease duration 10 (5–20 years, HAQ 1.5 (0.75–2.0, FISIF 10 (6–14 and FISAP 16 (7–23 and 37.8% reported impacts on work. While 69.5% had accessed foot care there were differences in the route of access (by gender and whether independent or NHS provision and were older (64.9 yr. vs 60.4 yr. p = 0.001, had longer disease duration (12 yr. vs 7 yr. p < 0.001 and had a greater proportion of females (72.2% vs 61.7% p = 0.04 than those who had not accessed

Intra-rater repeatability of the Oxford foot model in healthy children in different stages of the foot roll over process during gait

DEFF Research Database (Denmark)

Curtis, D J; Bencke, J; Stebbins, J A

2009-01-01

BACKGROUND: The repeatability of the Oxford foot model has been reported, but possible variations in the repeatability during the foot roll over process have not been examined. The aim of this study was to determine the relative and absolute repeatability of the model for each stage of the foot...... roll over process during gait and to compare foot kinematic data from this study with that from another centre as a preliminary examination of the model's inter-centre repeatability and validity. METHOD: Eight healthy children were tested twice at the gait laboratory. Foot kinematics from this study...... were plotted against those from an earlier repeatability study and repeatability statistics calculated for the three rockers of stance phase and swing phase. RESULTS: Foot kinematics from this study and an earlier repeatability study produced similar kinematic patterns and joint angle ranges...

Genomic change, retrotransposon mobilization and extensive cytosine methylation alteration in Brassica napus introgressions from two intertribal hybridizations.

Directory of Open Access Journals (Sweden)

Xueli Zhang

Full Text Available Hybridization and introgression represent important means for the transfer and/or de novo origination of traits and play an important role in facilitating speciation and plant breeding. Two sets of introgression lines in Brassica napus L. were previously established by its intertribal hybridizations with two wild species and long-term selection. In this study, the methods of amplified fragment length polymorphisms (AFLP, sequence-specific amplification polymorphism (SSAP and methylation-sensitive amplified polymorphism (MSAP were used to determine their genomic change, retrotransposon mobilization and cytosine methylation alteration in these lines. The genomic change revealed by the loss or gain of AFLP bands occurred for ∼10% of the total bands amplified in the two sets of introgressions, while no bands specific for wild species were detected. The new and absent SSAP bands appeared for 9 out of 11 retrotransposons analyzed, with low frequency of new bands and their total percentage of about 5% in both sets. MSAP analysis indicated that methylation changes were common in these lines (33.4-39.8% and the hypermethylation was more frequent than hypomethylation. Our results suggested that certain extents of genetic and epigenetic alterations were induced by hybridization and alien DNA introgression. The cryptic mechanism of these changes and potential application of these lines in breeding were also discussed.

The reliability and validity of a three-camera foot image system for obtaining foot anthropometrics.

Science.gov (United States)

O'Meara, Damien; Vanwanseele, Benedicte; Hunt, Adrienne; Smith, Richard

2010-08-01

The purpose was to develop a foot image capture and measurement system with web cameras (the 3-FIS) to provide reliable and valid foot anthropometric measures with efficiency comparable to that of the conventional method of using a handheld anthropometer. Eleven foot measures were obtained from 10 subjects using both methods. Reliability of each method was determined over 3 consecutive days using the intraclass correlation coefficient and root mean square error (RMSE). Reliability was excellent for both the 3-FIS and the handheld anthropometer for the same 10 variables, and good for the fifth metatarsophalangeal joint height. The RMSE values over 3 days ranged from 0.9 to 2.2 mm for the handheld anthropometer, and from 0.8 to 3.6 mm for the 3-FIS. The RMSE values between the 3-FIS and the handheld anthropometer were between 2.3 and 7.4 mm. The 3-FIS required less time to collect and obtain the final variables than the handheld anthropometer. The 3-FIS provided accurate and reproducible results for each of the foot variables and in less time than the conventional approach of a handheld anthropometer.

Preventing Diabetic Foot Complications : Strategic Recommendations

African Journals Online (AJOL)

The diabetic foot is the commonest cause of non-traumatic lower extremity amputation in the developed and developing nations. Several risk factors predispose the diabetic patient to foot ulceration and peripheral neuropathy, with peripheral vascular disease are the commonest risk factors. Clinical examination for these risk ...

Gross Motor Skills in Children With Idiopathic Clubfoot and the Association Between Gross Motor Skills, Foot Involvement, Gait, and Foot Motion.

Science.gov (United States)

Lööf, Elin; Andriesse, Hanneke; André, Marie; Böhm, Stephanie; Iversen, Maura D; Broström, Eva W

2017-02-24

Little is known regarding gross motor skills (GMS) in children with idiopathic clubfoot (IC). This study describes GMS, specifically foot involvement and asymmetries, and analyses the association between GMS, gait, and foot status in children with IC. Gross motor tasks and gait were analyzed in children with IC and typically developed (TD) children. GMS were assessed using videotapes and the Clubfoot Assessment Protocol (CAP). The Gait Deviation Index (GDI) and GDI-Kinetic were calculated from gait analyses. Children were divided into bilateral, unilateral clubfoot, or TD groups. To analyze asymmetries, feet within each group were further classified into superior or inferior foot, depending on their CAP scores. Correlations identified associations between CAP and GDI, GDI-Kinetic, passive foot motion, and Dimeglio Classification Scores at birth in the clubfeet. In total, 75 children (mean age, 5 years) were enrolled (bilateral n=22, unilateral clubfoot n=25, TD=28). Children with clubfeet demonstrated significantly lower GMS, gait, and foot motion compared with TD children. One leg standing and hopping deviated in 84% and 91%, respectively, in at least one foot in children with clubfoot. Gross motor asymmetries were evident in both children with bilateral and unilateral involvement. In children with unilateral clubfoot, contralateral feet showed few deviations in GMS compared with TD; however, differences existed in gait and foot motion. The association between GMS and gait, foot motion, and initial foot status varied between poor and moderate. Gross motor deficits and asymmetries are present in children with both bilateral and unilateral IC. Development of GMS of the contralateral foot mirrors that of TD children, but modifies to the clubfoot in gait and foot motion. The weak association with gait, foot motion, and initial clubfoot severity indicates that gross motor measurements represent a different outcome entity in clubfoot treatment. We therefore, recommend

Foot pain

Science.gov (United States)

... that you were born with or develops later Injury Shoes that fit poorly or do not have much cushioning Too much walking or other sports activity Trauma The following can cause foot pain: Arthritis and gout . Common in the big toe, which becomes red, swollen, ...

A survey of foot problems in juvenile idiopathic arthritis.

Science.gov (United States)

Hendry, G; Gardner-Medwin, J; Watt, G F; Woodburn, J

2008-12-01

Evidence suggests that foot problems are common in juvenile idiopathic arthritis (JIA), with prevalence estimates over 90%. The aim of this survey was to describe foot-related impairment and disability associated with JIA and foot-care provision in patients managed under modern treatment paradigms, including disease-modifying anti-rheumatic drugs (DMARDs) and biologic therapies. The Juvenile Arthritis Foot Disability Index (JAFI), Child Health Assessment Questionnaire (CHAQ), and pain visual analogue scale (VAS) were recorded in 30 consecutive established JIA patients attending routine outpatient clinics. Foot deformity score, active/limited joint counts, walking speed, double-support time (s) (DS) and step length symmetry index % (SI) were also measured. Foot-care provision in the preceding 12 months was determined from medical records. Sixty-three per cent of children reported some foot impairment, with a median (range) JAFI subscale score of 1 (0-3); 53% reported foot-related activity limitation, with a JAFI subscale score of 1 (0-4); and 60% reported participation restriction, with a JAFI subscale score of 1 (0-3). Other reported variables were CHAQ 0.38 (0-2), VAS pain 22 (0-79), foot deformity 6 (0-20), active joints 0 (0-7), limited joints 0 (0-31), walking speed 1.09 m/s (0.84-1.38 m/s), DS 0.22 s (0.08-0.26 s) and SI +/-4.0% (+/-0.2-+/-31.0%). A total of 23/30 medical records were reviewed and 15/23 children had received DMARDS, 8/23 biologic agents and 20/23 multiple intra-articular corticosteroid injections. Ten children received specialist podiatry care comprising footwear advice, orthotic therapy and silicone digital splints together with intrinsic muscle strengthening exercises. Despite frequent use of DMARD/biologic therapy and specialist podiatry-led foot care, foot-related impairment and disability persists in some children with JIA.

Effect of foot placements during sit to stand transition on timed up and go test in stroke subjects: A cross sectional study.

Science.gov (United States)

Joshua, Abraham M; Karnad, Shreekanth D; Nayak, Akshatha; Suresh, B V; Mithra, Prasanna; Unnikrishnan, B

2017-01-01

Timed up and go (TUG) test is been used as a screening tool for the assessment of risk of falling in individuals following stroke. Though TUG test is a quick test, it has fair sensitivity compared to other tests. This study was carried out to obtain and compare test scores for different types of foot placements during sit to stand transition in stroke subjects. A Cross-sectional study with purposive sampling included 28 post stroke subjects who were able to walk 6 meter with or without assistance. Timed Up and Go test was carried out with four different types of foot placements and scores were recorded. The data were compared using Kruskal-Wallis One way analysis of variance and Wilcoxon signed ranks test. There were comparable differences between asymmetric 1 test strategy which involved affected extremity to be placed behind the unaffected and other test strategies (Z = -4.457,-3.848,-4.458; p = 0.000). The initial foot placements during sit to stand transition influenced the time taken to complete the test which was significantly higher in asymmetric 1 strategy, Incorporation of the initial foot placement mainly asymmetric 1 strategy into conventional TUG test would help in identifying accurately the subject's functional mobility and postural stability.

Experiences of mobility for people living with rheumatoid arthritis who are receiving biologic drug therapy: implications for podiatry services.

Science.gov (United States)

Sanders, Lucy; Donovan-Hall, Margaret; Borthwick, Alan; Bowen, Catherine J

2017-01-01

Despite significant advancements in new treatment modalities for rheumatoid arthritis with biological therapies, foot complications remain a disabling and common feature of the disease . In this study the aim was to explore and describe the personal experiences of people with rheumatoid arthritis in receipt of biologic treatments in a bid to understand the impact of this form of medication on their mobility. An interpretative phenomenological analysis (IPA) was undertaken to explore in depth the individual experience of rheumatoid disease through personal accounts of the patient journey spanning both 'before' and 'after' the instigation of biologic therapy. A purposive sampling strategy was adopted and in-depth semi structured interviews used to facilitate rich, detailed interview data exploring the lived experiences of individuals undertaking biological therapy and the changes to mobility experienced as a result. Thematic analysis was employed with an IPA framework to identify key meanings, and report patterns within the data. Five people with rheumatoid arthritis participated in the study. The mean disease duration was 20.2 years (range: 6 -32) and all were being treated with biologic therapies. Four key themes emerged from the data: 1) Life before biologic treatment, depicted in accounts as a negative experience characterised by painful and disabling symptoms and feelings of hopelessness. 2) Life with biologic treatment, often experienced as a life changing transition, restoring function and mobility and offering renewed hope. 3) Sense of self, in which the impact of rheumatoid disease and the subsequent changes arising from biologic therapy reveal a profound impact on feelings of personal identity both pre and post biologic therapy; an effect of footwear on self-image emerges as a dominant sub theme; 4) Unmet footcare needs were evident in the patient narrative, where the unrelenting if diminished impact of foot pain on mobility was viewed in the context of

Poststroke Muscle Architectural Parameters of the Tibialis Anterior and the Potential Implications for Rehabilitation of Foot Drop

Directory of Open Access Journals (Sweden)

John W. Ramsay

2014-01-01

Full Text Available Poststroke dorsiflexor weakness and paretic limb foot drop increase the risk of stumbling and falling and decrease overall functional mobility. It is of interest whether dorsiflexor muscle weakness is primarily neurological in origin or whether morphological differences also contribute to the impairment. Ten poststroke hemiparetic individuals were imaged bilaterally using noninvasive medical imaging techniques. Magnetic resonance imaging was used to identify changes in tibialis anterior muscle volume and muscle belly length. Ultrasonography was used to measure fascicle length and pennation angle in a neutral position. We found no clinically meaningful bilateral differences in any architectural parameter across all subjects, which indicates that these subjects have the muscular capacity to dorsiflex their foot. Therefore, poststroke dorsiflexor weakness is primarily neural in origin and likely due to muscle activation failure or increased spasticity of the plantar flexors. The current finding suggests that electrical stimulation methods or additional neuromuscular retraining may be more beneficial than targeting muscle strength (i.e., increasing muscle mass.

Iambic Feet in Paumari and the Theory of Foot Structure

Directory of Open Access Journals (Sweden)

Daniel L. Everett

2003-01-01

Full Text Available This paper analyzes stress and moraic constituencies in Paumari, an endangered language of the Arawan family of the Brazilian Amazon. It argues that Paumari feet are quantity-insensitive iambs, built from right-to-left within the prosodic word. Both of these latter claims are theoretically important because they violate some proposed universals of foot structure. The paper also discusses more general implications of the Paumari data for theories of foot size and shape, proposing two constraints on foot size, Foot Maximality and Foot Minimality, to replace the less fine-tuned constraint Foot Binarity.

Hand, Foot, and Mouth Disease

Centers for Disease Control (CDC) Podcasts

2013-08-08

Hand, foot, and mouth disease is a contagious illness that mainly affects children under five. In this podcast, Dr. Eileen Schneider talks about the symptoms of hand, foot, and mouth disease, how it spreads, and ways to help protect yourself and your children from getting infected with the virus.  Created: 8/8/2013 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 8/8/2013.

Clinical and functional correlates of foot pain in diabetic patients.

NARCIS (Netherlands)

Rijken, P.M.; Dekker, J.; Rauwerda, J.A.; Dekker, E.; Lankhorst, G.J.; Bakker, K.; Dooren, J.

1998-01-01

Purpose: patients with diabetes mellitus frequently suffer from foot pain. This pain seems to be a neglected area in studies on the diabetic foot. The purpose of this study was to identify clinical variables associated with foot pain in diabetic patients. In addition, the relationships between foot

The Effect of Foot Exercises on Wound Healing in Type 2 Diabetic Patients With a Foot Ulcer.

Science.gov (United States)

Eraydin, Şahizer; Avşar, Gülçin

2017-12-19

The purpose of this study was to investigate the effect of foot exercises on wound healing in type 2 diabetic patients with a diabetic foot ulcer. Prospective, randomized controlled study. Sixty-five patients from an outpatient clinic with grade 1 or 2 ulcers (Wagner classification) who met study criteria agreed to participate; 60 patients completed the study and were included in the final analysis. Subjects were followed up between February 2014 and June 2015. Subjects were recruited by the researchers in the clinics where they received treatment. Subjects were randomly allocated to either the control or intervention group. Data were collected using investigator-developed forms: patient information form and the diabetic foot exercises log. Patients in the intervention group received standard wound care and performed daily foot exercises for 12 weeks; the control group received standard wound care but no exercises. The ulcers of the patients in both the intervention and control groups were examined and measured at the 4th, 8th, and 12th weeks. The groups were compared in terms of the ulcer size and depth. To analyze and compare the data, frequency distribution, mean (standard deviation), variance analysis, and the independent samples t test and the χ test were used. The mean ulcer areas were 12.63 (14.43), 6.91 (5.44), 4.30 (3.70), and 3.29 (3.80) cm (P diabetic foot ulcer sizes in the study intervention group in the 4th and 12th weeks compared to beginning baseline (P ≤ .05). However, only the 12th week was different from the beginning in the control group (P = .000). The mean depths of the ulcers were 0.56 (0.85), 0.42 (0.68), 0.36 (0.50), and 0.28 (0.38) cm in the study intervention group (P foot exercises should be included in the treatment plan when managing patients with diabetic foot ulcers.

Foot length is a functional parameter for assessment of height.

Science.gov (United States)

Krishan, Kewal; Kanchan, Tanuj

2013-03-01

Stature estimation is considered as an important parameter in the examination of unknown human remains and during the analysis of evidence in crime scene investigations. During mass disasters isolated foot can be found enclosed in the shoes while footprints may be recovered at the crime scenes. Foot length and footprint length can provide valuable estimates of stature. The present communication makes a few pertinent observations on a recently published article in 'The Foot' entitled 'Foot length-a functional parameter for assessment of height, The Foot 2012, 22(1):31-34' and presents an insight into the literature available on the subject which is likely to be of value to future researchers in the field of Forensic Podiatry. The foot length and the footprint length of individuals differ from each other and hence, the research observations made in a study on foot prints cannot be applied to foot dimensions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effect of ski mountaineering track on foot sole loading pattern.

Science.gov (United States)

Haselbacher, Matthias; Mader, Katharina; Werner, Maximiliane; Nogler, Michael

2014-09-01

Ski mountaineering is becoming a popular sport. The ascending techniques (tracks) can be divided into 3 different groups: flat field, direct ascent, and traversing. This study examines the relationship between different mechanical loads on the foot and the 4 different mountaineering ascending techniques. All subjects used the same pair of ski boots and the same skis while performing the 4 different ascending techniques. An in-shoe dynamic pressure measuring system was used to measure the mechanical load on the foot soles of each ski mountaineer. The foot sole was divided into 6 anatomic sections to measure the different loads in each section. Thirteen men with an average age of 29 years were enrolled in the study. The results showed small, not significant differences in the mechanical foot load in the flat field or in the direct ascent. The average mechanical foot load was highest on the valley side foot while traversing (179 kPa to 117 kPa). The higher load forces were in the medial ball of the foot and the longitudinal aspect of the foot side closer to the hill. The higher impact placed on the valley side foot and the concentration of force placed on the medial ball of the valley side foot suggested the influence of the track on the load pattern of the foot sole. This higher impact may result in upward forces that affect the force distribution in the ankle and knee joints. Copyright © 2014. Published by Elsevier Inc.

Association of the gene expression variation of tumor necrosis factor-α and expressions changes of dopamine receptor genes in progression of diabetic severe foot ulcers

Directory of Open Access Journals (Sweden)

Hajar Vaseghi

2017-11-01

Full Text Available Objective(s:Regulation of pro-inflammatory factors such as TNF-, which are secreted by the immune cells through induction of their several receptors including dopamine receptors (especially DRD2 and DRD3 is one of the noticeable problems in diabetic severe foot ulcer healing. This study was conducted to evaluate the alteration of TNF- in plasma as well as DRD2 and DRD3 changes in PBMCs of diabetics with severe foot ulcers. Materials and Methods: Peripheral blood samples were collected from 31 subjects with ulcers, 29 without ulcers, and 25 healthy individuals. Total mRNA was extracted from PBMCs for the study of DRD2, DRD3, and TNF- gene expression variations. Expression patterns of these genes were evaluated by real-time PCR. Consequently, concentration of TNF- was investigated in plasma. Results: Significant decrease in gene expression and plasma concentration of TNF- in PBMCs was observed in both patient groups at P Conclusion: We concluded that DRD2 and DRD3 expression alteration and presence of new DRD3 transcripts can be effective in reduction of TNF-α expression as a pro-inflammatory factor. Performing complementary studies, may explain that variations in DRD2 and DRD3 are prognostic and effective markers attributed to the development of diabetes severe foot ulcers.

Painful Lytic Lesions of the Foot : A Case Report

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R Vaishya

2015-03-01

Full Text Available The presence of lytic lesions in the bones of foot raises a number of diagnostic possibilities ranging from infection, inflammatory pathology to neoplastic conditions. Although the radiological picture is not pathognomonic of any pathology, clinical history and histopathological examination can help to clinch the diagnosis. We present a case of multiple lytic lesions of the foot and discuss possible differential diagnoses. The patient was diagnosed as a case of madura foot and the lesions responded to surgical debridement and anti-fungal treatment with a good functional outcome. Madura foot is an uncommon, chronic granulomatous fungal or bacterial infection with a predilection in people who walk barefoot. Although known for a specific geographical distribution, madura foot should be kept as a possible diagnosis in patients presenting with lytic lesions of the foot due to population emigration across the world.

Diabetes: foot ulcers and amputations.

Science.gov (United States)

Hunt, Dereck L

2011-08-26

Diabetic foot ulceration is full-thickness penetration of the dermis of the foot in a person with diabetes. Severity is classified using the Wagner system, which grades it from 1 to 5. The annual incidence of ulcers among people with diabetes is 2.5% to 10.7% in resource-rich countries, and the annual incidence of amputation for any reason is 0.25% to 1.8%. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent foot ulcers and amputations in people with diabetes? What are the effects of treatments in people with diabetes with foot ulceration? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 50 systematic reviews and RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review, we present information relating to the effectiveness and safety of the following interventions: debridement, human cultured dermis, human skin equivalent, patient education, pressure off-loading with felted foam or pressure-relief half-shoe, pressure off-loading with total-contact or non-removable casts, screening and referral to foot-care clinics, systemic hyperbaric oxygen for non-infected ulcers, systemic hyperbaric oxygen in infected ulcers, therapeutic footwear, topical growth factors, and wound dressings.

Reliability, validity and responsiveness of the Spanish Manchester-Oxford Foot Questionnaire (MOXFQ) in patients with foot or ankle surgery.

Science.gov (United States)

Garcés, Juan B Gerstner; Winson, Ian; Goldhahn, Sabine; Castro, Michael D; Swords, Michael P; Grujic, Leslie; Rammelt, Stefan; Sands, Andrew K

2016-03-01

The Manchester-Oxford Foot Questionnaire (MOXFQ) has been validated in Spanish for use in patients undergoing foot and ankle surgery. 120 patients completed the MOXFQ and the SF-36 before surgery and 6 and 12 months postoperative. Surgeons completed the American Orthopaedic Foot and Ankle Society (AOFAS) Clinical Rating System. Psychometric properties were assessed for all three MOXFQ dimensions, and for the MOXFQ Index. The Spanish MOXFQ demonstrated consistency with Cronbach's alpha values between 0.65 and 0.90, and reliability ([ICCs] >0.95). It shows a moderate to strong correlation between the Walking/standing dimension and the related domains of the SF-36 (|r|>0.6), the AOFAS Ankle-Hindfoot Scale (|r|>0.47) and Hallux-MTP-IP Scale (|r|>0.64). Responsiveness was excellent, (effect sizes >2.1). The respective minimal detectable change (MDC90) was 14.18 for the MOXFQ Index. The Spanish version of the MOXFQ showed good psychometric properties in patients with foot and ankle disorders. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Preventative foot care in people with diabetes: Quality patient ...

African Journals Online (AJOL)

Keywords: preventative foot care; diabetes; risk stratification: self care. Introduction ... diabetes is considered to be a key indicator of the quality of foot ... loss of protective sensation, the importance of foot monitoring on a daily basis, the proper ...

CT guided diagnostic foot injections

International Nuclear Information System (INIS)

Saifuddin, A.; Abdus-Samee, M.; Mann, C.; Singh, D.; Angel, J.C.

2005-01-01

AIM: To describe a CT technique for guiding diagnostic and therapeutic injections in the hind- and mid-foot. MATERIALS AND METHODS: Over a period of 50 months, 28 individuals were referred for diagnostic and therapeutic hind- and mid-foot injections before possible arthrodesis. A CT technique was developed that allowed entry into the various joints using a vertical approach. Numbers of joints injected were as follows: posterior subtalar, 21; talonavicular, 4; calcaneonavicular, calcaneocuboid, navicular-cuneiform and 5th metatarsocuboid joints, 1 each. RESULTS: All injections but one were technically successful. Significant relief of symptoms was noted by 16 participants, whereas for 9 there was no improvement and for 3 a partial response was achieved. CONCLUSION: CT is a simple and safe alternative to fluoroscopy for guiding diagnostic and therapeutic foot injections, and may be the technique of choice in cases of disordered anatomy

The effect of prosthetic foot push-off on mechanical loading associated with knee osteoarthritis in lower extremity amputees.

Science.gov (United States)

Morgenroth, David C; Segal, Ava D; Zelik, Karl E; Czerniecki, Joseph M; Klute, Glenn K; Adamczyk, Peter G; Orendurff, Michael S; Hahn, Michael E; Collins, Steven H; Kuo, Art D

2011-10-01

Lower extremity amputation not only limits mobility, but also increases the risk of knee osteoarthritis of the intact limb. Dynamic walking models of non-amputees suggest that pushing-off from the trailing limb can reduce collision forces on the leading limb. These collision forces may determine the peak knee external adduction moment (EAM), which has been linked to the development of knee OA in the general population. We therefore hypothesized that greater prosthetic push-off would lead to reduced loading and knee EAM of the intact limb in unilateral transtibial amputees. Seven unilateral transtibial amputees were studied during gait under three prosthetic foot conditions that were intended to vary push-off. Prosthetic foot-ankle push-off work, intact limb knee EAM and ground reaction impulses for both limbs during step-to-step transition were measured. Overall, trailing limb prosthetic push-off work was negatively correlated with leading intact limb 1st peak knee EAM (slope=-.72±.22; p=.011). Prosthetic push-off work and 1st peak intact knee EAM varied significantly with foot type. The prosthetic foot condition with the least push-off demonstrated the largest knee EAM, which was reduced by 26% with the prosthetic foot producing the most push-off. Trailing prosthetic limb push-off impulse was negatively correlated with leading intact limb loading impulse (slope=-.34±.14; p=.001), which may help explain how prosthetic limb push-off can affect intact limb loading. Prosthetic feet that perform more prosthetic push-off appear to be associated with a reduction in 1st peak intact knee EAM, and their use could potentially reduce the risk and burden of knee osteoarthritis in this population. Published by Elsevier B.V.

Activation of protein kinase C alters the intracellular distribution and mobility of cardiac Na+ channels.

Science.gov (United States)

Hallaq, Haifa; Wang, Dao W; Kunic, Jennifer D; George, Alfred L; Wells, K Sam; Murray, Katherine T

2012-02-01

Na(+) current derived from expression of the cardiac isoform SCN5A is reduced by receptor-mediated or direct activation of protein kinase C (PKC). Previous work has suggested a possible role for loss of Na(+) channels at the plasma membrane in this effect, but the results are controversial. In this study, we tested the hypothesis that PKC activation acutely modulates the intracellular distribution of SCN5A channels and that this effect can be visualized in living cells. In human embryonic kidney cells that stably expressed SCN5A with green fluorescent protein (GFP) fused to the channel COOH-terminus (SCN5A-GFP), Na(+) currents were suppressed by an exposure to PKC activation. Using confocal microscopy, colocalization of SCN5A-GFP channels with the plasma membrane under control and stimulated conditions was quantified. A separate population of SCN5A channels containing an extracellular epitope was immunolabeled to permit temporally stable labeling of the plasma membrane. Our results demonstrated that Na(+) channels were preferentially trafficked away from the plasma membrane by PKC activation, with a major contribution by Ca(2+)-sensitive or conventional PKC isoforms, whereas stimulation of protein kinase A (PKA) had the opposite effect. Removal of the conserved PKC site Ser(1503) or exposure to the NADPH oxidase inhibitor apocynin eliminated the PKC-mediated effect to alter channel trafficking, indicating that both channel phosphorylation and ROS were required. Experiments using fluorescence recovery after photobleaching demonstrated that both PKC and PKA also modified channel mobility in a manner consistent with the dynamics of channel distribution. These results demonstrate that the activation of protein kinases can acutely regulate the intracellular distribution and molecular mobility of cardiac Na(+) channels in living cells.

Altered gray matter volume and white matter integrity in college students with mobile phone dependence

Directory of Open Access Journals (Sweden)

Yongming eWang

2016-05-01

Full Text Available Mobile phone dependence (MPD is a behavioral addiction that has become an increasing public mental health issue. While previous research has explored some of the factors that may predict MPD, the underlying neural mechanisms of MPD have not been investigated yet. The current study aimed to explore the microstructural variations associated with MPD as measured with functional Magnetic Resonance Imaging (fMRI. Gray matter volume (GMV and white matter (WM integrity (four indexes: fractional anisotropy, FA; mean diffusivity, MD; axial diffusivity, AD; and radial diffusivity, RD were calculated via voxel-based morphometry (VBM and tract-based spatial statistics (TBSS analysis, respectively. Sixty-eight college students (42 female were enrolled and separated into two groups (MPD group, N=34; control group, N=34 based on Mobile Phone Addiction Index (MPAI scale score. Trait impulsivity was also measured using the Barrett Impulsivity Scale (BIS-11. In light of underlying trait impulsivity, results revealed decreased GMV in the MPD group relative to controls in regions such as the right superior frontal gyrus (sFG, right inferior frontal gyrus (iFG, and bilateral thalamus (Thal. In the MPD group, GMV in the above mentioned regions was negatively correlated with scores on the MPAI. Results also showed significantly less FA and AD measures of white matter integrity in the MPD group relative to controls in bilateral hippocampal cingulum bundle fibers (CgH. Additionally, in the MPD group, FA of the CgH was also negatively correlated with scores on the MPAI. These findings provide the first morphological evidence of altered brain structure with phone-overuse, and may help to better understand the neural mechanisms of MPD in relation with other behavioral and substance addiction disorders.

Age determination enhanced by embryonic foot bud and foot plate measurements in relation to Carnegie stages, and the influence of maternal cigarette smoking

DEFF Research Database (Denmark)

Lutterodt, M C; Rosendahl, M; Yding Andersen, C

2009-01-01

habits, and delivered a urine sample for cotinine analysis. Embryonic age was evaluated by vaginal ultrasound measurements and by post-termination foot length and compared with the Carnegie stages. RESULTS: Foot bud and foot plate were defined and measured as foot length in embryos aged 35-47 days p.......c. (range 0.8-2.1 mm). In embryos and fetuses aged 41-69 days p.c., heel-toe length was measured (range 2.5-7.5 mm). We found a significant linear correlation between foot length and age. Morphology of the feet was compared visually with the Carnegie collection, and we found that the mean ages of the two...

The forgotten foot - an assessment of foot and ankle radiograph pathology in final year medical students.

LENUS (Irish Health Repository)

Groarke, P J

2014-04-27

It has been shown that doctors in Emergency Departments (EDs) have inconsistent knowledge of musculoskeletal anatomy. This is most likely due to a deficiency in focused musculoskeletal modules at undergraduate level in medical school. The aims of this study were to evaluate the knowledge of final year medical students on foot anatomy and common foot and ankle pathology as seen on radiographs.

Footwear interventions for foot pain, function, impairment and disability for people with foot and ankle arthritis: A literature review.

Science.gov (United States)

Frecklington, Mike; Dalbeth, Nicola; McNair, Peter; Gow, Peter; Williams, Anita; Carroll, Matthew; Rome, Keith

2017-11-03

To conduct a literature review on the effectiveness of footwear on foot pain, function, impairment and disability for people with foot and ankle arthritis. A search of the electronic databases Scopus, Medline, CINAHL, SportDiscus and the Cochrane Library was undertaken in September 2017. The key inclusion criteria were studies reporting on findings of footwear interventions for people with arthritis with foot pain, function, impairment and/or disability. The Quality Index Tool was used to assess the methodological quality of studies included in the qualitative synthesis. The methodological variation of the included studies was assessed to determine the suitability of meta-analysis and the grading of recommendations, assessment, development and evaluation (GRADE) system. Between and within group effect sizes were calculated using Cohen's d. 1440 studies were identified for screening with 11 studies included in the review. Mean (range) quality scores were 67% (39-96%). The majority of studies investigated rheumatoid arthritis (n = 7), but also included gout (n = 2), and 1st metatarsophalangeal joint osteoarthritis (n = 2). Meta-analysis and GRADE assessment were not deemed appropriated based on methodological variation. Footwear interventions included off-the-shelf footwear, therapeutic footwear and therapeutic footwear with foot orthoses. Key footwear characteristics included cushioning and a wide toe box for rheumatoid arthritis; cushioning, midsole stability and a rocker-sole for gout; and a rocker-sole for 1st metatarsophalangeal joint osteoarthritis. Between group effect sizes for outcomes ranged from 0.01 to 1.26. Footwear interventions were associated with reductions in foot pain, impairment and disability for people with rheumatoid arthritis. Between group differences were more likely to be observed in studies with shorter follow-up periods in people with rheumatoid arthritis (12 weeks). Footwear interventions improved foot pain, function and disability in

Evaluation of a mobile phone-based, advanced symptom management system (ASyMS) in the management of chemotherapy-related toxicity.

Science.gov (United States)

Kearney, N; McCann, L; Norrie, J; Taylor, L; Gray, P; McGee-Lennon, M; Sage, M; Miller, M; Maguire, R

2009-04-01

To evaluate the impact of a mobile phone-based, remote monitoring, advanced symptom management system (ASyMS) on the incidence, severity and distress of six chemotherapy-related symptoms (nausea, vomiting, fatigue, mucositis, hand-foot syndrome and diarrhoea) in patients with lung, breast or colorectal cancer. A two group (intervention and control) by five time points (baseline, pre-cycle 2, pre-cycle 3, pre-cycle 4 and pre-cycle 5) randomised controlled trial. Seven clinical sites in the UK; five specialist cancer centres and two local district hospitals. One hundred and twelve people with breast, lung or colorectal cancer receiving outpatient chemotherapy. A mobile phone-based, remote monitoring, advanced symptom management system (ASyMS). Chemotherapy-related morbidity of six common chemotherapy-related symptoms (nausea, vomiting, fatigue, mucositis, hand-foot syndrome and diarrhoea). There were significantly higher reports of fatigue in the control group compared to the intervention group (odds ratio = 2.29, 95%CI = 1.04 to 5.05, P = 0.040) and reports of hand-foot syndrome were on average lower in the control group (odds ratio control/intervention = 0.39, 95%CI = 0.17 to 0.92, P = 0.031). The study demonstrates that ASyMS can support the management of symptoms in patients with lung, breast and colorectal cancer receiving chemotherapy.

Knee joint kinetics in response to multiple three-dimensional printed, customised foot orthoses for the treatment of medial compartment knee osteoarthritis.

Science.gov (United States)

Allan, Richard; Woodburn, James; Telfer, Scott; Abbott, Mandy; Steultjens, Martijn Pm

2017-06-01

The knee adduction moment is consistently used as a surrogate measure of medial compartment loading. Foot orthoses are designed to reduce knee adduction moment via lateral wedging. The 'dose' of wedging required to optimally unload the affected compartment is unknown and variable between individuals. This study explores a personalised approach via three-dimensional printed foot orthotics to assess the biomechanical response when two design variables are altered: orthotic length and lateral wedging. Foot orthoses were created for 10 individuals with symptomatic medial knee osteoarthritis and 10 controls. Computer-aided design software was used to design four full and four three-quarter-length foot orthoses per participant each with lateral posting of 0° 'neutral', 5° rearfoot, 10° rearfoot and 5° forefoot/10° rearfoot. Three-dimensional printers were used to manufacture all foot orthoses. Three-dimensional gait analyses were performed and selected knee kinetics were analysed: first peak knee adduction moment, second peak knee adduction moment, first knee flexion moment and knee adduction moment impulse. Full-length foot orthoses provided greater reductions in first peak knee adduction moment (p = 0.038), second peak knee adduction moment (p = 0.018) and knee adduction moment impulse (p = 0.022) compared to three-quarter-length foot orthoses. Dose effect of lateral wedging was found for first peak knee adduction moment (p knee adduction moment (p knee adduction moment impulse (p knee adduction moment (p = 0.028) and knee adduction moment impulse (p = 0.036). Significant interaction effects were found between orthotic length and wedging condition for second peak knee adduction moment (p = 0.002). No significant changes in first knee flexion moment were found. Individual heterogeneous responses to foot orthosis conditions were observed for first peak knee adduction moment, second peak knee adduction moment and knee adduction moment impulse. Biomechanical response

Care of Patients with Diabetic Foot Disease in Oman

Science.gov (United States)

Al-Busaidi, Ibrahim S.; Abdulhadi, Nadia N.; Coppell, Kirsten J.

2016-01-01

Diabetes mellitus is a major public health challenge and causes substantial morbidity and mortality worldwide. Diabetic foot disease is one of the most debilitating and costly complications of diabetes. While simple preventative foot care measures can reduce the risk of lower limb ulcerations and subsequent amputations by up to 85%, they are not always implemented. In Oman, foot care for patients with diabetes is mainly provided in primary and secondary care settings. Among all lower limb amputations performed in public hospitals in Oman between 2002–2013, 47.3% were performed on patients with diabetes. The quality of foot care among patients with diabetes in Oman has not been evaluated and unidentified gaps in care may exist. This article highlights challenges in the provision of adequate foot care to Omani patients with diabetes. It concludes with suggested strategies for an integrated national diabetic foot care programme in Oman. PMID:27606104

Metallic Foreign Body in the Foot

Directory of Open Access Journals (Sweden)

Firat Ozan

2016-04-01

Full Text Available Aim: A foreign body injury of the foot is a frequently encountered problem. These foreign bodies can lead to various complications in the affected tissues, and their removal can be difficult and time consuming. Therefore, the removal of a foreign body requires good preoperative preparations. The surgical treatment results of patients with a foreign body, identified as a sewing needle, that had penetrated their foot were evaluated. Material and Method: Thirty-four patients (11 males, 23 females; mean age, 30.2 ± 18.6 years who were surgically treated between 2011 and 2013 were included. Data concerning the affected limb, placement of the needle, imaging techniques, season when the injury occurred, time between medical intervention and injury, anaesthesia type, fluoroscopy of use during surgery and surgical complications were analyzed. Results: A sewing needle had penetrated the right foot of 20 (58.8% patients and the left foot of 14 (41.1% patients. Broken needles were found in the toes of 14 (41.1% patients, in the middle of the foot of 12 (35.2% patients and in the heel area of 8 (23.5% patients. The injuries occurred in summer in 13 (38.2% patients, in winter in seven (20.6% patients, in spring in one (2.9% patient and in autumn in 13 (38.2% patients. Needle penetration had occurred in 28 (82.3% patients at home and 6 (17.6% patients outside of the home environment. The average follow-up time was 8.9 ± 2.8 months. Discussion: Removal of foreign bodies from the foot requires good preoperative preparations. Foreign bodies can lead to various complications in the affected tissues. It is important to perform detailed physical and radiological examinations to obtain good treatment results in these patients.

Ultrasound Findings of the Painful Ankle and Foot

Directory of Open Access Journals (Sweden)

Suheil Artul

2014-01-01

Full Text Available Objectives: To document the prevalence and spectrum of musculoskeletal ultrasound (MSKUS findings at different parts of the foot. Materials and Methods: All MSKUS studies conducted on the foot during a 2-year period (2012-2013 at the Department of Radiology were reviewed. Demographic parameters including age, gender, and MSKUS findings were documented. Results: Three hundred and sixty-four studies had been conducted in the 2-year period. Ninety-three MSKUS evaluations were done for the ankle, 30 studies for the heel, and 241 for the rest of the foot. The most common MSKUS finding at the ankle was tenosynovitis, mostly in female patients; at the heel it was Achilles tendonitis, also mostly in female patients; and for the rest of the foot it was fluid collection and presence of foreign body, mainly in male patients. The number of different MSKUS abnormalities that were reported was 9 at the ankle, 9 at the heel, and 21 on the rest of the foot. Conclusions: MSKUS has the potential for revealing a huge spectrum of abnormalities. The most common finding was collection/hematoma and foreign bodies at the foot, tenosynovitis at the ankle, and Achilles tendinitis at the heel.

29 CFR 1918.104 - Foot protection.

Science.gov (United States)

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Foot protection. 1918.104 Section 1918.104 Labor... following consensus standards: (i) ASTM F-2412-2005, “Standard Test Methods for Foot Protection,” and ASTM F... footwear that is constructed in accordance with one of the above consensus standards will be deemed to be...

Factors associated with combined hand and foot eczema

DEFF Research Database (Denmark)

Agner, T; Aalto-Korte, K; Andersen, K E

2017-01-01

BACKGROUND: As for hand eczema, the aetiology of foot eczema is multifactorial and not very well understood. The aim of the present study was to identify factors associated with foot eczema in a cohort of hand eczema patients being classified into different subgroups. METHODS: Associations between...... foot and hand eczema were studied in a cross-sectional design in a cohort of hand eczema patients. Consecutive patients were recruited from nine different European Centres during the period October 2011-September 2012. Data on demographic factors, presence of foot eczema, hand eczema duration...... and severity, and whether the hand eczema was work-related or not were available, as well as patch-test results. RESULTS: Of a total of 427 hand eczema patients identified, information on foot eczema was available in 419 patients who were included in the present study. A total of 125 patients (29.8%) had...

Foot posture in basketball players with history of the shin splint

Directory of Open Access Journals (Sweden)

Saeed Forghany

2013-07-01

Full Text Available Introduction: Shin splint is one of the common injuries in most athletes. Although the relationship between abnormal foot posture and shin splint has been reported previously but, the relation between foot posture and shin splint has not been well documented. The aim of this study was to explore the relationship between foot postures in basketball players and the history of shin splint. Materials and Methods: Thirty Iranian male basketball players who had experience of shin splint during last three months were participated in this study. Foot Posture Index (FPI-6 was used as the measure of foot posture. Talar head palpation, curvature at the lateral malleoli, inversion/eversion of the calcaneus, prominence in the region of the talonavicular joint, congruence of the medial longitudinal arch, abduction /adduction of the forefoot on the rear foot were 6 items which were assessed with FPI in the standing position. Foot posture was defined as ‘normal’, ‘supinated’ or ‘pronated. Data were collected and analyzed by SPSS, version16. Results: Most participants showed abnormal foot posture (%80. Fifty-three percent of subjects had pronated foot (%53 and 10% did hyper-pronation. The foot postures of 17% of participants were in supination. The results of this study did not show a significant difference in foot posture between right and left foot (P > 0.05. Conclusion: abnormal foot posture were common (%80 in basketball players with the history of shin splints. These findings could support this idea that the footwear and orthotic prescription both can prevent and treat basketball players with history of shin splints. Keywords: Foot posture, Shin splints, Basketball

Does 'hacking' surface type affect equine forelimb foot placement, movement symmetry or hoof impact deceleration during ridden walk and trot exercise?

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Barstow, A; Bailey, J; Campbell, J; Harris, C; Weller, R; Pfau, T

2018-04-17

Both pleasure and competition horses regularly exercise on surfaces such as tarmac, gravel and turf during 'hacking'. Despite this, there is limited evidence relating to the effect of these surfaces upon foot-surface interaction. To investigate forelimb foot placement, hoof vibration and movement symmetry in pleasure horses on three commonly encountered hacking surfaces. Quantitative gait study in a convenience sample. Six horses regularly partaking in hacking exercise were ridden in walk and trot on all surfaces. Horses were equipped with one hoof-mounted, accelerometer and four body-mounted inertial measurement units (IMUs) to measure foot impact and movement symmetry. High-speed (400 FPS) video footage of foot-placement was acquired (dorsal, palmar, lateral views). Foot-impact and movement symmetry were analysed with a mixed effects model and Bowker symmetry tests for foot-placement analysis. Vibration power and frequency parameters increase as perceived surface firmness increases from grass, to gravel, to tarmac (P≤0.001). Vibration power parameters were consistently greater at trot compared with walk (P≤0.001), but the same was not true for vibration frequency (P≥0.2). Greatest movement asymmetry was recorded during grass surface trotting. No significant difference in foot-placement was detected between the three surfaces. This was a field study using three commonly encountered hacking surfaces. Surface properties change easily with water content and temperature fluctuations so care must be taken when considering other similar surfaces, especially at different times of the year. Six leisure horses were used so the results may not be representative of horses of all types. Vibration parameters generally increase as perceived surface firmness increases. Increasing speed alters vibration power but not frequency. Further investigations are required to determine the role that this may play in the development of musculoskeletal disease in horses. © 2018 EVJ

A clinically applicable six-segmented foot model.

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De Mits, Sophie; Segers, Veerle; Woodburn, Jim; Elewaut, Dirk; De Clercq, Dirk; Roosen, Philip

2012-04-01

We describe a multi-segmented foot model comprising lower leg, rearfoot, midfoot, lateral forefoot, medial forefoot, and hallux for routine use in a clinical setting. The Ghent Foot Model describes the kinematic patterns of functional units of the foot, especially the midfoot, to investigate patient populations where midfoot deformation or dysfunction is an important feature, for example, rheumatoid arthritis patients. Data were obtained from surface markers by a 6 camera motion capture system at 500 Hz. Ten healthy subjects walked barefoot along a 12 m walkway at self-selected speed. Joint angles (rearfoot to shank, midfoot to rearfoot, lateral and medial forefoot to midfoot, and hallux to medial forefoot) in the sagittal, frontal, and transverse plane are reported according to anatomically based reference frames. These angles were calculated and reported during the foot rollover phases in stance, detected by synchronized plantar pressure measurements. Repeated measurements of each subject revealed low intra-subject variability, varying between 0.7° and 2.3° for the minimum values, between 0.5° and 2.1° for the maximum values, and between 0.8° and 5.8° for the ROM. The described movement patterns were repeatable and consistent with biomechanical and clinical knowledge. As such, the Ghent Foot model permits intersegment, in vivo motion measurement of the foot, which is crucial for both clinical and research applications. Copyright © 2011 Orthopaedic Research Society.

Foot preferences in wild-living ring-necked parakeets (Psittacula krameri, Psittacidae).

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Randler, Christoph; Braun, Michael; Lintker, Stephanie

2011-03-01

Evidence for foot preferences has been reported in parrots and the majority of parrot species uses the left foot to hold and process food objects. Here we assessed the footedness of ring-necked parakeets (Psittacula krameri) in a wild-living non-native population in Heidelberg, Baden-Wurttemberg, Germany. Observations were made when parrots fed on catalpa trees Catalpa sp., with 20- to 50-cm-long fruits. Parakeets tend to bite off catalpa fruits with their beak, using one foot holding the fruit. Further, we established an experimental set-up (feeding location) and prepared pieces of apple in an adequate size to force parrots to handle the food with one foot. From 184 individuals feeding on the catalpa trees, 102 were recorded using the left foot and 82 the right foot. At the feeding location, 24 individuals were left-footed and 11 were right-footed. These observations suggest a foot preference in the ring-necked parakeet both on the population level and on the individual level.

Comparing the Effect of Foot Reflexology Massage, Foot Bath and Their Combination on Quality of Sleep in Patients with Acute Coronary Syndrome.

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Rahmani, Ali; Naseri, Mahdi; Salaree, Mohammad Mahdi; Nehrir, Batool

2016-12-01

Introduction: Many patients in coronary care unit (CCU) suffer from decreased sleep quality caused by environmental and mental factors. This study compared the efficacy of foot reflexology massage, foot bath, and a combination of them on the quality of sleep of patients with acute coronary syndrome (ACS). Methods: This quasi-experimental study was implemented on ACS patients in Iran. Random sampling was used to divide the patients into four groups of 35 subjects. The groups were foot reflexology massage, foot bath, a combination of the two and the control group. Sleep quality was measured using the Veran Snyder-Halpern questionnaire. Data were analyzed by SPSS version 13. Results: The mean age of the four groups was 61.22 (11.67) years. The mean sleep disturbance in intervention groups (foot reflexology massage and foot bath groups) during the second and third nights was significantly less than before intervention. The results also showed a greater reduction in sleep disturbance in the combined group than in the other groups when compared to the control group. Conclusion: It can be concluded that the intervention of foot bath and massage are effective in reducing sleep disorders and there was a synergistic effect when used in combination. This complementary care method can be recommended to be implemented by CCU nurses.

Footwear used by older people and a history of hyperkeratotic lesions on the foot

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Palomo-López, Patricia; Becerro-de-Bengoa-Vallejo, Ricardo; Losa-Iglesias, Marta Elena; Rodríguez-Sanz, David; Calvo-Lobo, César; López-López, Daniel

2017-01-01

Abstract Inadequate footwear, painful and hyperkeratotic lesions (HL) are an extremely common problems amongst older people. Such problems increase the risk of falls, hamper mobility, reduction of quality of life, dignity, and ability to remain independent. The etiology of painful and feet conditions is poorly understood. To discover footwear preferences of older people, pain tolerance may favor presence of HL for the use of inadequate footwear in old age. A sample of 100 participants with a mean age of 74.90 ± 7.01 years attended an outpatient clinic where self-reported demographic data, frequency with which they checked their feet were recorded and measurements were taken of foot sensitivity. Additionally, all participants’ shoes were allocated into optimal, adequate, and dangerous categories based on design, structural and safety features, and materials. Only 12% of the sample population checked their feet every day, 37% revealed symptoms of neuropathy, 14% used optimal shoes, and 61% presented HL. In a bivariate analysis, no significant differences were observed. HL are associated with inadequate footwear, loss of sensitivity, and low frequency of foot health checks. PMID:28403112

Geothermal alteration of clay minerals and shales: diagenesis

Energy Technology Data Exchange (ETDEWEB)

Weaver, C.E.

1979-07-01

The objective of this report is to perform a critical review of the data on the mineral and chemical alterations that occur during diagenesis and low-grade metamorphism of shale and other clay-rich rocks - conditions similar to those expected from emplacement of heat-producing radioactive waste in a geologic repository. The conclusions drawn in this document are that the following type of alterations could occur: smectite alteration, ion mobilization, illitic shales, kaolinite reactions, chlorite reactions, organic reactions, paleotemperatures, low temperature shales, high temperature shales, and phase equilibrium changes.

Geothermal alteration of clay minerals and shales: diagenesis

International Nuclear Information System (INIS)

Weaver, C.E.

1979-07-01

The objective of this report is to perform a critical review of the data on the mineral and chemical alterations that occur during diagenesis and low-grade metamorphism of shale and other clay-rich rocks - conditions similar to those expected from emplacement of heat-producing radioactive waste in a geologic repository. The conclusions drawn in this document are that the following type of alterations could occur: smectite alteration, ion mobilization, illitic shales, kaolinite reactions, chlorite reactions, organic reactions, paleotemperatures, low temperature shales, high temperature shales, and phase equilibrium changes

Epigenetic control of mobile DNA as an interface between experience and genome change

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James A. Shapiro

2014-04-01

Full Text Available Mobile DNA in the genome is subject to RNA-targeted epigenetic control. This control regulates the activity of transposons, retrotransposons and genomic proviruses. Many different life history experiences alter the activities of mobile DNA and the expression of genetic loci regulated by nearby insertions. The same experiences induce alterations in epigenetic formatting and lead to trans-generational modifications of genome expression and stability. These observations lead to the hypothesis that epigenetic formatting directed by non-coding RNA provides a molecular interface between life history events and genome alteration.

Etiology, pathophysiology and classifications of the diabetic Charcot foot

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Papanas, Nikolaos; Maltezos, Efstratios

2013-01-01

In people with diabetes mellitus, the Charcot foot is a specific manifestation of peripheral neuropathy that may involve autonomic neuropathy with high blood flow to the foot, leading to increased bone resorption. It may also involve peripheral somatic polyneuropathy with loss of protective sensation and high risk of unrecognized acute or chronic minor trauma. In both cases, there is excess local inflammatory response to foot injury, resulting in local osteoporosis. In the Charcot foot, the acute and chronic phases have been described. The former is characterized by local erythema, edema, and marked temperature elevation, while pain is not a prominent symptom. In the latter, signs of inflammation gradually recede and deformities may develop, increasing the risk of foot ulceration. The most common anatomical classification describes five patterns, according to the localization of bone and joint pathology. This review article aims to provide a brief overview of the diabetic Charcot foot in terms of etiology, pathophysiology, and classification. PMID:23705058

The Guyana Diabetes and Foot Care Project: Improved Diabetic Foot Evaluation Reduces Amputation Rates by Two-Thirds in a Lower Middle Income Country

Science.gov (United States)

Sibbald, R. Gary; Martin, Carlos

2015-01-01

Background. Type 2 diabetes is the fourth leading cause of death in Guyana, South America. A complex, interprofessional, quality improvement intervention to improve foot and diabetes care was rolled out in two phases. Methods & Findings. Phase 1: Establishment of an Interprofessional Diabetic Foot Center (DFC) of Excellence to improve foot care and reduce diabetes-related amputations at the national referral hospital. Phase 2: Regionalization to cover 90% of the Guyanese population and expansion to include improved management of diabetes and hypertension. Fourteen key opinion leaders were educated and 340 health care professionals from 97 facilities trained. Eight centers for the evaluation and treatment of foot ulcers were established and 7567 people with diabetes evaluated. 3452 participants had foot screening and 48% were deemed high risk; 10% of these had undocumented foot ulcers. There was a 68% reduction in rate of major amputations (P diabetes with women (F/M = 2.09) and increased risk of major amputation in men [odds ratio 2.16 (95% CI 1.83, 2.56)] were documented. Conclusions. This intervention improved foot care with reduction in major amputations sustained over 5 years. PMID:26089901

Modeling and stress analyses of a normal foot-ankle and a prosthetic foot-ankle complex.

Science.gov (United States)

Ozen, Mustafa; Sayman, Onur; Havitcioglu, Hasan

2013-01-01

Total ankle replacement (TAR) is a relatively new concept and is becoming more popular for treatment of ankle arthritis and fractures. Because of the high costs and difficulties of experimental studies, the developments of TAR prostheses are progressing very slowly. For this reason, the medical imaging techniques such as CT, and MR have become more and more useful. The finite element method (FEM) is a widely used technique to estimate the mechanical behaviors of materials and structures in engineering applications. FEM has also been increasingly applied to biomechanical analyses of human bones, tissues and organs, thanks to the development of both the computing capabilities and the medical imaging techniques. 3-D finite element models of the human foot and ankle from reconstruction of MR and CT images have been investigated by some authors. In this study, data of geometries (used in modeling) of a normal and a prosthetic foot and ankle were obtained from a 3D reconstruction of CT images. The segmentation software, MIMICS was used to generate the 3D images of the bony structures, soft tissues and components of prosthesis of normal and prosthetic ankle-foot complex. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones, soft tissues and components of prosthesis were independently developed to form foot and ankle complex. SOLIDWORKS program was used to form the boundary surfaces of all model components and then the solid models were obtained from these boundary surfaces. Finite element analyses software, ABAQUS was used to perform the numerical stress analyses of these models for balanced standing position. Plantar pressure and von Mises stress distributions of the normal and prosthetic ankles were compared with each other. There was a peak pressure increase at the 4th metatarsal, first metatarsal and talus bones and a decrease at the intermediate cuneiform and calcaneus bones, in

Neuropathic diabetic foot ulcers – evidence-to-practice

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Ndip A

2012-02-01

Full Text Available Agbor Ndip1–3, Leonard Ebah3,4, Aloysius Mbako51Department of Diabetes and Medicine, Manchester Royal Infirmary, Central Manchester Foundation Trust, UK; 2Department of Medicine, Royal Bolton Hospital, Bolton, UK; 3Cardiovascular Research Group, School of Biomedicine, University of Manchester, UK; 4Department of Renal Medicine, Manchester Royal Infirmary, Central Manchester Foundation Trust, UK; 5Department of Orthopaedic Surgery, Wrexham Maelor Hospital, Wales, UKAbstract: Foot ulcers and their attendant complications are disquietingly high in people with diabetes, a majority of whom have underlying neuropathy. This review examines the evidence base underpinning the prevention and management of neuropathic diabetic foot ulcers in order to inform best clinical practice. Since it may be impractical to ask patients not to weight-bear at all, relief of pressure through the use of offloading casting devices remains the mainstay for management of neuropathic ulcers, whilst provision of appropriate footwear is essential in ulcer prevention. Simple non-surgical debridement and application of hydrogels are both effective in preparing the wound bed for healthy granulation and therefore enhancing healing. Initial empirical antibiotic therapy for infected ulcers should cover the most common bacterial flora. There is limited evidence supporting the use of adjunctive therapies such as hyperbaric oxygen and cytokines or growth factors. In selected cases, recombinant human platelet-derived growth factor has been shown to enhance healing; however, its widespread use cannot be advised due to the availability of more cost-effective approaches. While patient education may be beneficial, the evidence base remains thin and conflicting. In conclusion, best management of foot ulcers is achieved by what is taken out of the foot (pressure, callus, infection, and slough rather than what is put on the foot (adjuvant treatment.Keywords: diabetic foot ulcers, neuropathic

Epidemiology and outcome in patients of diabetic foot

International Nuclear Information System (INIS)

Ashraf, M.N.; Rehman, K.U.; Malik, K.I.; Iqbal, G.S.

2011-01-01

Background: The aim of study was detailed analysis of the presentation of diabetic foot ulcers, characteristics and predictors of outcome (incidence of amputation in neuropathic, ischemic, neuro ischemic) in patients presenting with diabetic foot at our hospital. Methods: This prospective analytic study was conducted from January 2009-August 2010 at POF Hospital Wah Cantt. Diabetic patients who presented with foot ulcers were enrolled in this study. Demographics of patients along with ulcer size, type, site and Grade according to Wagner Classification were recorded. Wounds were managed with daily dressings, nursing care and de-sloughing of necrotic tissue along with appropriate antibiotic cover. Patients were followed over period until wound healed completely or a lower limb amputation performed, the outcome noted and patient was deemed to have completed study. Results: One hundred and fifteen patients with mean age 55.46 +- 8.23 years, both male and female were included in this study. Out of 115 patients 111 patients had Type-II diabetes while only 4 presented with Type-I. Mean Duration of diabetes was 14.61 +- 2.17 years. With respect to underlying causes 18.3% foot ulcers were ischemic, 22.6% were neuropathic and 59% were neuro-ischemic. Median ulcer size was 74% of ulcer classified as Wagner grade-II and III while 24% were of Grade-V. Lower limb amputation were performed in 25% of patients whereas limb salvage achieved in 75% of patients with wounds healed (median healing time 5 (3-10 weeks). Conclusion: Preservation of the limb function without endangering the patient must be a goal of treating diabetic foot. Once foot amputation is successful, rehabilitation with orthotic or prosthetic devices may allow years of a functional extremity along with preventive measures like cessation of smoking, daily foot hygiene and foot inspection. (author)

Executive function processes predict mobility outcomes in older adults.

Science.gov (United States)

Gothe, Neha P; Fanning, Jason; Awick, Elizabeth; Chung, David; Wójcicki, Thomas R; Olson, Erin A; Mullen, Sean P; Voss, Michelle; Erickson, Kirk I; Kramer, Arthur F; McAuley, Edward

2014-02-01

To examine the relationship between performance on executive function measures and subsequent mobility outcomes in community-dwelling older adults. Randomized controlled clinical trial. Champaign-Urbana, Illinois. Community-dwelling older adults (N = 179; mean age 66.4). A 12-month exercise trial with two arms: an aerobic exercise group and a stretching and strengthening group. Established cognitive tests of executive function (flanker task, task switching, and a dual-task paradigm) and the Wisconsin card sort test. Mobility was assessed using the timed 8-foot up and go test and times to climb up and down a flight of stairs. Participants completed the cognitive tests at baseline and the mobility measures at baseline and after 12 months of the intervention. Multiple regression analyses were conducted to determine whether baseline executive function predicted postintervention functional performance after controlling for age, sex, education, cardiorespiratory fitness, and baseline mobility levels. Selective baseline executive function measurements, particularly performance on the flanker task (β = 0.15-0.17) and the Wisconsin card sort test (β = 0.11-0.16) consistently predicted mobility outcomes at 12 months. The estimates were in the expected direction, such that better baseline performance on the executive function measures predicted better performance on the timed mobility tests independent of intervention. Executive functions of inhibitory control, mental set shifting, and attentional flexibility were predictive of functional mobility. Given the literature associating mobility limitations with disability, morbidity, and mortality, these results are important for understanding the antecedents to poor mobility function that well-designed interventions to improve cognitive performance can attenuate. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Foot ulcers in the diabetic patient, prevention and treatment

Science.gov (United States)

Wu, Stephanie C; Driver, Vickie R; Wrobel, James S; Armstrong, David G

2007-01-01

Lower extremity complications in persons with diabetes have become an increasingly significant public health concern in both the developed and developing world. These complications, beginning with neuropathy and subsequent diabetic foot wounds frequently lead to infection and lower extremity amputation even in the absence of critical limb ischemia. In order to diminish the detrimental consequences associated with diabetic foot ulcers, a com-mon-sense-based treatment approach must be implemented. Many of the etiological factors contributing to the formation of diabetic foot ulceration may be identified using simple, inexpensive equipment in a clinical setting. Prevention of diabetic foot ulcers can be accomplished in a primary care setting with a brief history and screening for loss of protective sensation via the Semmes-Weinstein monofilament. Specialist clinics may quantify neuropathy, plantar foot pressure, and assess vascular status with Doppler ultrasound and ankle-brachial blood pressure indices. These measurements, in conjunction with other findings from the history and physical examination, may enable clinicians to stratify patients based on risk and help determine the type of intervention. Other effective clinical interventions may include patient education, optimizing glycemic control, smoking cessation, and diligent foot care. Recent technological advanced combined with better understanding of the wound healing process have resulted in a myriad of advanced wound healing modalities in the treatment of diabetic foot ulcers. However, it is imperative to remember the fundamental basics in the healing of diabetic foot ulcers: adequate perfusion, debridement, infection control, and pressure mitigation. Early recognition of the etiological factors along with prompt management of diabetic foot ulcers is essential for successful outcome. PMID:17583176

Foot Morphological Difference between Habitually Shod and Unshod Runners.

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Yang Shu

Full Text Available Foot morphology and function has received increasing attention from both biomechanics researchers and footwear manufacturers. In this study, 168 habitually unshod runners (90 males whose age, weight & height were 23±2.4 years, 66±7.1 kg & 1.68±0.13 m and 78 females whose age, weight & height were 22±1.8 years, 55±4.7 kg & 1.6±0.11 m (Indians and 196 shod runners (130 males whose age, weight & height were 24±2.6 years, 66±8.2 kg & 1.72±0.18 m and 66 females whose age, weight & height were 23±1.5 years, 54±5.6 kg & 1.62±0.15 m (Chinese participated in a foot scanning test using the easy-foot-scan (a three-dimensional foot scanning system to obtain 3D foot surface data and 2D footprint imaging. Foot length, foot width, hallux angle and minimal distance from hallux to second toe were calculated to analyze foot morphological differences. This study found that significant differences exist between groups (shod Chinese and unshod Indians for foot length (female p = 0.001, width (female p = 0.001, hallux angle (male and female p = 0.001 and the minimal distance (male and female p = 0.001 from hallux to second toe. This study suggests that significant differences in morphology between different ethnicities could be considered for future investigation of locomotion biomechanics characteristics between ethnicities and inform last shape and design so as to reduce injury risks and poor performance from mal-fit shoes.

Visualisation to enhance biomechanical tuning of ankle-foot orthoses (AFOs in stroke: study protocol for a randomised controlled trial

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Carse Bruce

2011-12-01

Full Text Available Abstract Background There are a number of gaps in the evidence base for the use of ankle-foot orthoses for stroke patients. Three dimensional motion analysis offers an ideal method for objectively obtaining biomechanical gait data from stroke patients, however there are a number of major barriers to its use in routine clinical practice. One significant problem is the way in which the biomechanical data generated by these systems is presented. Through the careful design of bespoke biomechanical visualisation software it may be possible to present such data in novel ways to improve clinical decision making, track progress and increase patient understanding in the context of ankle-foot orthosis tuning. Methods A single-blind randomised controlled trial will be used to compare the use of biomechanical visualisation software in ankle-foot orthosis tuning against standard care (tuning using observation alone. Participants (n = 70 will have experienced a recent hemiplegia (1-12 months and will be identified by their care team as being suitable candidates for a rigid ankle-foot orthosis. The primary outcome measure will be walking velocity. Secondary outcome measures include; lower limb joint kinematics (thigh and shank global orientations & kinetics (knee and hip flexion/extension moments, ground reaction force FZ2 peak magnitude, step length, symmetry ratio based on step length, Modified Ashworth Scale, Modified Rivermead Mobility Index and EuroQol (EQ-5D. Additional qualitative measures will also be taken from participants (patients and clinicians at the beginning and end of their participation in the study. The main aim of the study is to determine whether or not the visualisation of biomechanical data can be used to improve the outcomes of tuning ankle-foot orthoses for stroke patients. Discussion In addition to answering the primary research question the broad range of measures that will be taken during this study are likely to contribute to a

Driving reaction times in patients with foot and ankle pathology before and after image-guided injection: pain relief without improved function.

Science.gov (United States)

Talusan, Paul G; Miller, Christopher P; Save, Ameya V; Reach, John S

2015-04-01

Foot and ankle pathology is common in the driving population. Local anesthetic steroid injections are frequent ambulatory treatments. Brake reaction time (BRT) has validated importance in motor vehicle safety. There are no prior studies examining the effect of foot and ankle pathology and injection treatment on the safe operation of motor vehicles. We studied BRT in patients with foot and ankle musculoskeletal disease before and after image-guided injection treatment. A total of 37 participants were enrolled. Image-guided injections of local anesthetic and steroid were placed into the pathological anatomical location of the right or left foot and ankles. A driving reaction timer was used to measure BRTs before and after injection. Patients suffering right "driving" and left "nondriving" pathology as well as a healthy control group were studied. All patients reported >90% pain relief postinjection. All injections were confirmed to be accurate by imaging. Post hoc Bonferonni analysis demonstrated significant difference between the healthy group and the right-sided injection group (P = .008). Mean BRT for healthy controls was 0.57 ± 0.11 s. Patients suffering right foot and ankle disease displayed surprisingly high BRTs (0.80 ± 0.23 s preinjection and 0.78 ± 0.16 s postinjection, P > .99). Left nondriving foot and ankle pathology presented a driving hazard as well (BRT of 0.75 ± 0.12 s preinjection and 0.77 ± 0.12 s postinjection, P > .99). Injections relieved pain but did not significantly alter BRT (P > .99 for all). Patients suffering chronic foot and ankle pathology involving either the driving or nondriving side have impaired BRTs. This preexisting driving impairment has not previously been reported and exceeds recommended cutoff safety values in the United States. Despite symptom improvement, there was no statistically significant change in BRT following image-guided injection in either foot and ankle. Therapeutic, Level II: Prospective Comparative Study. �

Progress in detailed modelling of low foot and high foot implosion experiments on the National Ignition Facility

Science.gov (United States)

Clark, D. S.; Weber, C. R.; Eder, D. C.; Haan, S. W.; Hammel, B. A.; Hinkel, D. E.; Jones, O. S.; Kritcher, A. L.; Marinak, M. M.; Milovich, J. L.; Patel, P. K.; Robey, H. F.; Salmonson, J. D.; Sepke, S. M.

2016-05-01

Several dozen high convergence inertial confinement fusion ignition experiments have now been completed on the National Ignition Facility (NIF). These include both “low foot” experiments from the National Ignition Campaign (NIC) and more recent “high foot” experiments. At the time of the NIC, there were large discrepancies between simulated implosion performance and experimental data. In particular, simulations over predicted neutron yields by up to an order of magnitude, and some experiments showed clear evidence of mixing of ablator material deep into the hot spot that could not be explained at the time. While the agreement between data and simulation improved for high foot implosion experiments, discrepancies nevertheless remain. This paper describes the state of detailed modelling of both low foot and high foot implosions using 1-D, 2-D, and 3-D radiation hydrodynamics simulations with HYDRA. The simulations include a range of effects, in particular, the impact of the plastic membrane used to support the capsule in the hohlraum, as well as low-mode radiation asymmetries tuned to match radiography measurements. The same simulation methodology is applied to low foot NIC implosion experiments and high foot implosions, and shows a qualitatively similar level of agreement for both types of implosions. While comparison with the experimental data remains imperfect, a reasonable level of agreement is emerging and shows a growing understanding of the high-convergence implosions being performed on NIF.

Progress in detailed modelling of low foot and high foot implosion experiments on the National Ignition Facility

International Nuclear Information System (INIS)

Clark, D S; Weber, C R; Eder, D C; Haan, S W; Hammel, B A; Hinkel, D E; Jones, O S; Kritcher, A L; Marinak, M M; Milovich, J L; Patel, P K; Robey, H F; Salmonson, J D; Sepke, S M

2016-01-01

Several dozen high convergence inertial confinement fusion ignition experiments have now been completed on the National Ignition Facility (NIF). These include both “low foot” experiments from the National Ignition Campaign (NIC) and more recent “high foot” experiments. At the time of the NIC, there were large discrepancies between simulated implosion performance and experimental data. In particular, simulations over predicted neutron yields by up to an order of magnitude, and some experiments showed clear evidence of mixing of ablator material deep into the hot spot that could not be explained at the time. While the agreement between data and simulation improved for high foot implosion experiments, discrepancies nevertheless remain. This paper describes the state of detailed modelling of both low foot and high foot implosions using 1-D, 2-D, and 3-D radiation hydrodynamics simulations with HYDRA. The simulations include a range of effects, in particular, the impact of the plastic membrane used to support the capsule in the hohlraum, as well as low-mode radiation asymmetries tuned to match radiography measurements. The same simulation methodology is applied to low foot NIC implosion experiments and high foot implosions, and shows a qualitatively similar level of agreement for both types of implosions. While comparison with the experimental data remains imperfect, a reasonable level of agreement is emerging and shows a growing understanding of the high-convergence implosions being performed on NIF. (paper)

Preventative foot care in people with diabetes: Quality patient ...

African Journals Online (AJOL)

Foot ulceration and amputation cause extensive burden on individuals and health care systems. One of the reasons for the poor outcome of foot complications in developing countries is the lack of patient education. Due to the multi-factorial pathology of diabetic foot ulceration, the person with diabetes should receive health ...

Contemporary Evaluation and Management of the Diabetic Foot

Science.gov (United States)

Sumpio, Bauer E.

2012-01-01

Foot problems in patients with diabetes remain a major public health issue and are the commonest reason for hospitalization of patients with diabetes with prevalence as high as 25%. Ulcers are breaks in the dermal barrier with subsequent erosion of underlying subcutaneous tissue that may extend to muscle and bone, and superimposed infection is a frequent and costly complication. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischemia, and abnormal foot structure and biomechanics. Early recognition of the etiology of these foot lesions is essential for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection, and revascularization of ischemic limbs are the mainstays of therapy. Even when properly managed, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents, and negative pressure wound therapy. While these, increasingly expensive, therapies have shown promising results in clinical trials, the results have yet to be translated into widespread clinical practice leaving a huge scope for further research in this field. PMID:24278695

Behaviors Predicting Foot Lesions in Patients with Non-Insulin-Dependent Diabetes Mellitus

OpenAIRE

Suico, Jeffrey G; Marriott, Deanna J; Vinicor, Frank; Litzelman, Debra K

1998-01-01

Associations between specific foot-care behaviors and foot lesions in patients with non-insulin-dependent diabetes mellitus were prospectively investigated. Data from a randomized controlled trial for preventing diabetic foot lesions were analyzed as a prospective cohort using logistic regression. Independent variables included foot-care behaviors, patient self-foot examination, going barefoot, availability of foot-care assistance, and visits to health-care providers. The dependent variable w...

Diagnostic value of newborn foot length to predict gestational age

Directory of Open Access Journals (Sweden)

Mutia Farah Fawziah

2017-08-01

Full Text Available Background  Identification of gestational age, especially within 48 hours of birth, is crucial for newborns, as the earlier preterm status is detected, the earlier the child can receive optimal management. Newborn foot length is an anthropometric measurement which is easy to perform, inexpensive, and potentially efficient for predicting gestational age. Objective  To analyze the diagnostic value of newborn foot length in predicting gestational age. Methods  This diagnostic study was performed between October 2016 and February 2017 in the High Care Unit of Neonates at Dr. Moewardi General Hospital, Surakarta. A total of 152 newborns were consecutively selected and underwent right foot length measurements before 96 hours of age. The correlation between newborn foot length to classify as full term and gestational age was analyzed with Spearman’s correlation test because of non-normal data distribution. The cut-off point of newborn foot length was calculated by receiver operating characteristic (ROC curve and diagnostic values of newborn foot length were analyzed by 2 x 2 table with SPSS 21.0 software. Results There were no significant differences between male and female newborns in terms of gestational age, birth weight, choronological age, and newborn foot length (P>0.05. Newborn foot length and gestational age had a significant correlation (r=0.53; P=0.000. The optimal cut-off newborn foot length to predict full term status was 7.1 cm. Newborn foot length below 7.1 cm had sensitivity 75%, specificity 98%, positive predictive value 94.3%, negative predictive value 90.6%, positive likelihood ratio 40.5, negative likelihood ratio 0.25, and post-test probability 94.29%, to predict preterm status in newborns. Conclusion  Newborn foot length can be used to predict gestational age, especially for the purpose of differentiating between preterm and full term newborns.

Congenital hypertrophy of multiple intrinsic muscles of the foot.

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Shiraishi, Tomohiro; Park, Susam; Niu, Atushi; Hasegawa, Hiromi

2014-12-01

Congenital hypertrophy of a single intrinsic muscle of the foot is rare, and as far as we know, only six cases have been reported. We describe a case of congenital anomaly that showed hypertrophy of multiple intrinsic muscles of the foot; the affected muscles were all the intrinsic muscles of the foot except the extensor digitorum brevis or extensor hallucis. Other tissues such as adipose tissue, nervous tissue, or osseous tissue showed no abnormalities. To reduce the volume of the foot we removed parts of the enlarged muscles.

Are we telling the diabetic patients adequately about foot care

International Nuclear Information System (INIS)

Ali, R.; Din, M.J.U.; Jadoon, R.J.; Farooq, U.; Alam, M.A.; Qureshi, A.; Shah, S.U.

2016-01-01

Background: Diabetes mellitus affects more than 285 million people worldwide. The prevalence is expected to rise to 439 million by the year 2030. Diabetic foot ulcers precede 84 percentage of non-traumatic amputations in diabetics. One lower limb is lost every 30 seconds around the world because of diabetic foot ulceration. Apart from being lengthy, the treatment of diabetic foot is also very expensive. There is very limited emphasis on foot care in diabetic patients. Even in developed countries patients feel that they do not have adequate knowledge about foot care. This study was conducted to find out how much information is imparted by doctors to diabetic patients about foot care. Methods: This cross-sectional study was conducted in admitted patients of the Department of Medicine, DHQ Hospital, Abbottabad from May 2014 to June 2015. 139 diabetic patients more than 25 years of age were included by non-probability consecutive sampling. Results: The mean age was 57.17 ( percentage 11.1) years. 35.3 percentage of patients were male and 64.7 percentage were female. The mean duration of diabetes in patients was 8.3 (±6) years. Only 36.7 percentage of patients said that their doctor told them about foot care. Less than 40 percentage of patients knew that they should daily inspect their feet, wash them with gentle warm water, and dry them afterwards. Only 25.2 percentage of the participants knew how to manage corns or calluses on feet. 66.5 percentage of patients knew that they should not walk bare foot. Overall, 63 percentage of our patients had less than 50 percentage knowledge of the 11 points regarding foot care that the investigators asked them. Conclusion: Diabetic foot problems are the one of the costliest, most disabling and disheartening complication of diabetes mellitus. Doctors are not properly telling diabetic patients about foot care. There is a deficiency of knowledge among the diabetic patients regarding foot care. (author)

Serological, hematological, Biochemical and Oxidative Markers During Foot and Mouth Disease Serotype ‘O’ Infection, Egypt

Directory of Open Access Journals (Sweden)

Nasr A.M. NASR EL-DEEN

2017-11-01

Full Text Available Foot and mouth disease (FMD is an extremely grave communicable disease of livestock. It affects all wild and domestic animals with cloven hoof. It is caused by Aphtho virus (Apthous fever or (FMDV foot and mouth disease virus which is originated from family Picornaviridae. 30 adult female water buffaloes, 3-5 years old infected with FMD serotypes, O. These animals were located at Sharkia governorate, Egypt during the period beetwen December 2014 to March 2015. Hematological findings showed no significant change in erythrogram and reduction in total leukocytes in the early stage of FMDV infection. Moreover development of macrocytic normochromic anemia and increase in total leukocytes and lymphocytic counts was reported in the late stage of infection. A significant decrease in cholesterol , progesterone , total proteins, albumin , globulins, calcium and sodium levels in infected groups, while a significant increase in serum activities of ALT ,AST, glucose, total, direct ,indirect bilirubine, phosphorous potassium, NO. MDA, CK-MB, LDH and CTNI. Without alterations in creatinine level.

Chinese cross-cultural adaptation and validation of the Foot Function Index as tool to measure patients with foot and ankle functional limitations.

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González-Sánchez, Manuel; Ruiz-Muñoz, Maria; Li, Guang Zhi; Cuesta-Vargas, Antonio I

2017-05-11

To perform a cross-cultural adaptation and validation of the Foot Function Index (FFI) questionnaire to develop the Chinese version. Three hundred and six patients with foot and ankle neuromusculoskeletal diseases participated in this observational study. Construct validity, internal consistency and criterion validity were calculated for the FFI Chinese version after the translation and transcultural adaptation process. Internal consistency ranged from 0.996 to 0.998. Test-retest analysis ranged from 0.985 to 0.994; minimal detectable change 90: 2.270; standard error of measurement: 0.973. Load distribution of the three factors had an eigenvalue greater than 1. Chi-square value was 9738.14 (p Foot Function Index (Taiwan Version), Short-Form 12 (Version 2) and EuroQol-5D were used for criterion validity. Factors 1 and 2 showed significant correlation with 15/16 and 14/16 scales and subscales, respectively. Foot Function Index Chinese version psychometric characteristics were good to excellent. Chinese researchers and clinicians may use this tool for foot and ankle assessment and monitoring. Implications for rehabilitation A cross-cultural adaptation of the FFI has been done from original version to Chinese. Consistent results and satisfactory psychometric properties of the Foot Function Index Chinese version have been reported. For Chinese speaking researcher and clinician FFI-Ch could be used as a tool to assess patients with foot disease.

Comparing the Effect of Foot Reflexology Massage, Foot Bath and Their Combination on Quality of Sleep in Patients with Acute Coronary Syndrome

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Ali Rahmani

2016-12-01

Full Text Available Introduction: Many patients in coronary care unit (CCU suffer from decreased sleep quality caused by environmental and mental factors. This study compared the efficacy of foot reflexology massage, foot bath, and a combination of them on the quality of sleep of patients with acute coronary syndrome (ACS. Methods: This quasi-experimental study was implemented on ACS patients in Iran. Random sampling was used to divide the patients into four groups of 35 subjects. The groups were foot reflexology massage, foot bath, a combination of the two and the control group. Sleep quality was measured using the Veran Snyder-Halpern questionnaire. Data were analyzed by SPSS version 13. Results: The mean age of the four groups was 61.22 (11.67 years. The mean sleep disturbance in intervention groups (foot reflexology massage and foot bath groups during the second and third nights was significantly less than before intervention. The results also showed a greater reduction in sleep disturbance in the combined group than in the other groups when compared to the control group. Conclusion: It can be concluded that the intervention of foot bath and massage are effective in reducing sleep disorders and there was a synergistic effect when used in combination. This complementary care method can be recommended to be implemented by CCU nurses.

Sustainable development in city districts: BaLaLuZ project - Mobility

International Nuclear Information System (INIS)

Muehll, D. von der

2004-01-01

This final report for the Swiss Federal Office of Energy (SFOE) is one of a series of reports concerning municipal development in various cities in Switzerland. The four city districts involved include Basel (Gundeldinger Feld), Lausanne (Bellevaux), Lucerne (Basel-/Bernstrasse) and Zurich (Werdwies). This paper takes a look at mobility aspects and addresses the following questions with reference to city districts: sustainable mobility, what can and cannot be realised at this scale, what effects are to be expected, how can sustainability be measured and which obstacles are to be expected. Topics covered include public transport, foot and bicycle traffic, parking, noise, pollution and the reduction of physical danger. Management and information are also discussed as are promotion activities and ways of increasing awareness

The Diabetic Foot Attack: "'Tis Too Late to Retreat!"

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Vas, Prashanth R J; Edmonds, Michael; Kavarthapu, Venu; Rashid, Hisham; Ahluwalia, Raju; Pankhurst, Christian; Papanas, Nikolaos

2018-03-01

The "diabetic foot attack" is one of the most devastating presentations of diabetic foot disease, typically presenting as an acutely inflamed foot with rapidly progressive skin and tissue necrosis, at times associated with significant systemic symptoms. Without intervention, it may escalate over hours to limb-threatening proportions and poses a high amputation risk. There are only best practice approaches but no international protocols to guide management. Immediate recognition of a typical infected diabetic foot attack, predominated by severe infection, with prompt surgical intervention to debride all infected tissue alongside broad-spectrum antibiotic therapy is vital to ensure both limb and patient survival. Postoperative access to multidisciplinary and advanced wound care therapies is also necessary. More subtle forms exist: these include the ischemic diabetic foot attack and, possibly, in a contemporary categorization, acute Charcot neuroarthropathy. To emphasize the importance of timely action especially in the infected and ischemic diabetic foot attack, we revisit the concept of "time is tissue" and draw parallels with advances in acute myocardial infarction and stroke care. At the moment, international protocols to guide management of severe diabetic foot presentations do not specifically use the term. However, we believe that it may help increase awareness of the urgent actions required in some situations.

Foot orgasm syndrome: a case report in a woman.

Science.gov (United States)

Waldinger, Marcel D; de Lint, Govert J; van Gils, Ad P G; Masir, Farhad; Lakke, Egbert; van Coevorden, Ruben S; Schweitzer, Dave H

2013-08-01

Spontaneous orgasm triggered from inside the foot has so far not been reported in medical literature. The study aims to report orgasmic feelings in the left foot of a woman. A woman presented with complaints of undesired orgasmic sensations originating in her left foot. In-depth interview, physical examination, sensory testing, magnetic resonance imaging (MRI-scan), electromyography (EMG), transcutaneous electrical nerve stimulation (TENS), and blockade of the left S1 dorsal root ganglion were performed. The main outcomes are description of this clinical syndrome, results of TENS application, and S1 dorsal root ganglion blockade. Subtle attenuation of sensory amplitudes of the left suralis, and the left medial and lateral plantar nerve tracts was found at EMG. MRI-scan disclosed no foot abnormalities. TENS at the left metatarso-phalangeal joint-III of the left foot elicited an instant orgasmic sensation that radiated from plantar toward the vagina. TENS applied to the left side of the vagina elicited an orgasm that radiated to the left foot. Diagnostic blockade of the left S1 dorsal root ganglion with 0.8 mL bupivacaine 0.25 mg attenuated the frequency and intensity of orgasmic sensation in the left foot with 50% and 80%, respectively. Additional therapeutic blockade of the same ganglion with 0.8 mL bupivacaine 0.50 mg combined with pulsed radiofrequency treatment resulted in a complete disappearance of the foot-induced orgasmic sensations. Foot orgasm syndrome (FOS) is descibed in a woman. Blockade of the left S1 dorsal root ganglion alleviated FOS. It is hypothesized that FOS, occurring 1.5 years after an intensive care emergency, was caused by partial nerve regeneration (axonotmesis), after which afferent (C-fiber) information from a small reinnervated skin area of the left foot and afferent somatic and autonomous (visceral) information from the vagina on at least S1 spinal level is misinterpreted by the brain as being solely information originating from

A musculoskeletal foot model for clinical gait analysis.

Science.gov (United States)

Saraswat, Prabhav; Andersen, Michael S; Macwilliams, Bruce A

2010-06-18

Several full body musculoskeletal models have been developed for research applications and these models may potentially be developed into useful clinical tools to assess gait pathologies. Existing full-body musculoskeletal models treat the foot as a single segment and ignore the motions of the intrinsic joints of the foot. This assumption limits the use of such models in clinical cases with significant foot deformities. Therefore, a three-segment musculoskeletal model of the foot was developed to match the segmentation of a recently developed multi-segment kinematic foot model. All the muscles and ligaments of the foot spanning the modeled joints were included. Muscle pathways were adjusted with an optimization routine to minimize the difference between the muscle flexion-extension moment arms from the model and moment arms reported in literature. The model was driven by walking data from five normal pediatric subjects (aged 10.6+/-1.57 years) and muscle forces and activation levels required to produce joint motions were calculated using an inverse dynamic analysis approach. Due to the close proximity of markers on the foot, small marker placement error during motion data collection may lead to significant differences in musculoskeletal model outcomes. Therefore, an optimization routine was developed to enforce joint constraints, optimally scale each segment length and adjust marker positions. To evaluate the model outcomes, the muscle activation patterns during walking were compared with electromyography (EMG) activation patterns reported in the literature. Model-generated muscle activation patterns were observed to be similar to the EMG activation patterns. Published by Elsevier Ltd.

Self-efficacy of foot care behaviour of elderly patients with diabetes

Directory of Open Access Journals (Sweden)

Maizatul Nadwa Mohd Razi

2017-08-01

Full Text Available Introduction: Elderly patients with diabetes are at a high risk of contracting diabetic foot problems. Self-efficacy is essential to help improve foot care behaviour. Aim: To identify levels of self-efficacy and foot care behaviour and their relationship with demographic characteristics in elderly patients with diabetes Methods: A cross-sectional study was conducted in two general hospitals in Malaysia from May to June 2015. Diabetes patients aged 60 years with specific inclusion criteria were invited to participate in this study. The respondents were interviewed using a set of validated questionnaires. Data were analysed with descriptive and inferential statistics (multiple linear regression using Statistical Package for the Social Sciences version 20.0. Results: Levels of foot self-efficacy (mean+31.39; standard deviation=7.76 and foot care behaviour (mean=25.37; SD=5.88 were high. There was a positive significant relationship between foot selfefficacy (β = 0.41, p < 0.001 and gender (β = 0.30, p < 0.001 with foot care behaviour. Conclusion: Self-efficacy can be incorporated in diabetes education to improve foot care behaviour. High-risk patients should be taught proper foot inspection and protection as well as the merits of skin care to prevent the occurrence of diabetic foot problems.

Age determination enhanced by embryonic foot bud and foot plate measurements in relation to Carnegie stages, and the influence of maternal cigarette smoking.

Science.gov (United States)

Lutterodt, M C; Rosendahl, M; Yding Andersen, C; Skouby, S O; Byskov, A G

2009-08-01

Reliable age determination of first-trimester human embryos and fetuses is an important parameter for clinical use and basic science. Age determination by ultrasound or morphometric parameters of embryos 4-6 weeks post conception (p.c.) have been questioned, and more accurate methods are required. Data on whether and how maternal smoking and alcohol consumption influence embryonic and fetal foot growth is also lacking. Embryonic tissue from 102 first-trimester legal abortions (aged 35-69 days p.c.) were collected. All women answered a questionnaire concerning smoking and drinking habits, and delivered a urine sample for cotinine analysis. Embryonic age was evaluated by vaginal ultrasound measurements and by post-termination foot length and compared with the Carnegie stages. Foot bud and foot plate were defined and measured as foot length in embryos aged 35-47 days p.c. (range 0.8-2.1 mm). In embryos and fetuses aged 41-69 days p.c., heel-toe length was measured (range 2.5-7.5 mm). We found a significant linear correlation between foot length and age. Morphology of the feet was compared visually with the Carnegie collection, and we found that the mean ages of the two collections correlated well. Foot length was independent of gender, Environmental Tobacco Smoke, maternal smoking and alcohol consumption. Foot length correlated linearly to embryonic and foetal age, and was unaffected by gender, ETS, maternal smoking and alcohol consumption.

Accounting for Ecohydrologic Separation Alters Interpreted Catchment Hydrology

Science.gov (United States)

Cain, M. R.; Ward, A. S.; Hrachowitz, M.

2017-12-01

Recent studies have demonstrated that in in some catchments, compartmentalized pools of water supply either plant transpiration (poorly mobile water) or streamflow and groundwater (highly mobile water), a phenomenon referred to as ecohydrologic separation. Although the literature has acknowledged that omission of ecohydrologic separation in hydrological models may influence estimates of residence times of water and solutes, no study has investigated how and when this compartmentalization might alter interpretations of fluxes and storages within a catchment. In this study, we develop two hydrochemical lumped rainfall-runoff models, one which incorporates ecohydrologic separation and one which does not for a watershed at the H.J. Andrews Experimental Forest (Oregon, USA), the study site where ecohydrologic separation was first observed. The models are calibrated against stream discharge, as well as stream chloride concentration. The objectives of this study are (1) to compare calibrated parameters and identifiability across models, (2) to determine how and when compartmentalization of water in the vadose zone might alter interpretations of fluxes and stores within the catchment, and (3) to identify how and when these changes alter residence times. Preliminary results suggest that compartmentalization of the vadose zone alters interpretations of fluxes and storages in the catchment and improves our ability to simulate solute transport.

Ascending infection of foot tendons in diabetic patients.

Science.gov (United States)

Mismar, Ayman; Yousef, Mohammad; Badran, Darwish; Younes, Nidal

2013-12-01

Bone and soft tissue infection in the foot of diabetic patients is a well-described issue in the literature. A sound anatomical knowledge of the foot anatomy and compartments is mandatory to understand the mechanisms of infection spread. We describe four cases of diabetic foot infection complicated by long ascending infection. All did not respond initially to antibiotic treatment and the usual surgical debridement and were cured only after excision of the infected tendons. We highlight a rare but serious complication of the diabetic foot disease not commonly seen by the surgical community. We hope that this report raises the awareness of this condition so that a prompt diagnosis is made and appropriate treatment started, thereby reducing the risk of major lower limb amputations.

Custom-Made Foot Orthoses Decrease Medial Foot Loading During Drop Jump in Individuals With Patellofemoral Pain

DEFF Research Database (Denmark)

Rathleff, Michael S; Richter, Camilla; Brushøj, Christoffer

2016-01-01

OBJECTIVE: To investigate the effect of foot orthoses on medial-to-lateral plantar forces during drop jump and single leg squat, and second, to explore the self-reported change in symptoms after 12 weeks of wearing the orthoses in individuals with patellofemoral pain (PFP). DESIGN: Cohort study...... with 12 weeks of follow-up. SETTING: Hospital setting. PARTICIPANTS: 23 adults with PFP. INTERVENTIONS: Custom-made foot orthoses. MAIN OUTCOME MEASURES: Foot loading (plantar pressure) was collected from the most painful side during drop jump and single leg squat using pressure sensitive Pedar insoles....... Primary outcome was the medial-to-lateral peak force under the forefoot during drop jump. The PFP syndrome severity score was used to measure self-reported improvement from baseline to follow-up. RESULTS: Orthoses were associated with a significant 2.9%-point (95% confidence intervals: 0.7-5.1) reduction...

Influence of antibacterial therapy on bone scan indices at foot inflammation in diabetes mellitus accompanied by diabetic foot syndrome

International Nuclear Information System (INIS)

Slavnov, V.M.; Bolgars'ka, S.V.; Taran, E.V.; Markov, V.V.

2004-01-01

The influence of antibacterial therapy on bone scan indices at foot inflammation in patients with diabetes mellitus (DM) accompanied by diabetic foot syndrome was studied. Bone scan was performed using scintillation tomographic gamma-camera hours after intravenous injection of 99m Tc-methylene diphosphonate

Angiography in the region of the foot

Energy Technology Data Exchange (ETDEWEB)

Zeitler, E.

1984-06-01

It is reported on technique, incidence and findings of angiography of the foot which provided magnifying angiography and non-ionic contrast media are used, is especially qualified for the differentiation of diabetic and non-diabetic angiopathies as well as for the identification of peripherical embolizations and digital arterial occlusions at thrombocytosis or polycythemia. The arteries of the foot represent the peripherical outflow at peripherical reconstructive performances at the lower leg and have to be studied prior to such reconstructive surgical interventions. The different localization of arterial obliterations and changes of the walls in diabetics of stage I-IV according to Fontaine shows the particularly large number of vascular-pathological findings in arteries of the lower leg and foot in diabetics with arterial occlusive diseases of stage III and IV. Therefore, the unfavourable prognoses of arterial occlusive diseases in diabetics have also to be made for peripherical arterial obliterations of the foot and lower leg.

Angiography in the region of the foot

International Nuclear Information System (INIS)

Zeitler, E.

1984-01-01

It is reported on technique, incidence and findings of angiography of the foot which provided magnifying angiography and non-ionic contrast media are used, is especially qualified for the differentiation of diabetic and non-diabetic angiopathies as well as for the identification of peripherical embolizations and digital arterial occlusions at thrombocytosis or polycythemia. The arteries of the foot represent the peripherical outflow at peripherical reconstructive performances at the lower leg and have to be studied prior to such reconstructive surgical interventions. The different localization of arterial obliterations and changes of the walls in diabetics of stage I-IV according to Fontaine shows the particularly large number of vascular-pathological findings in arteries of the lower leg and foot in diabetics with arterial occlusive diseases of stage III and IV. Therefore, the unfavourable prognoses of arterial occlusive diseases in diabetics have also to be made for peripherical arterial obliterations of the foot and lower leg. (orig.) [de

Imaging diagnostics of the foot; Bildgebende Diagnostik des Fusses

Energy Technology Data Exchange (ETDEWEB)

Szeimies, Ulrike; Staebler, Axel [Radiologie in Muenchen-Harlaching, Muenchen (Germany); Walther, Markus (eds.) [Schoen-Klinik Muenchen-Harlaching, Muenchen (Germany). Zentrum fuer Fuss- und Sprunggelenkchirurgie

2012-11-01

The book on imaging diagnostics of the foot contains the following chapters: (1) Imaging techniques. (2) Clinical diagnostics. (3) Ankle joint and hind foot. (4) Metatarsus. (5) Forefoot. (6) Pathology of plantar soft tissue. (7) Nervous system diseases. (8) Diseases without specific anatomic localization. (9) System diseases including the foot. (10) Tumor like lesions. (11) Normative variants.

A new approach to children's footwear based on foot type classification.

Science.gov (United States)

Mauch, M; Grau, S; Krauss, I; Maiwald, C; Horstmann, T

2009-08-01

Current shoe designs do not allow for the comprehensive 3-D foot shape, which means they are unable to reproduce the wide variability in foot morphology. Therefore, the purpose of this study was to capture these variations of children's feet by classifying them into groups (types) and thereby provide a basis for their implementation in the design of children's shoes. The feet of 2867 German children were measured using a 3-D foot scanner. Cluster analysis was then applied to classify the feet into three different foot types. The characteristics of these foot types differ regarding their volume and forefoot shape both within and between shoe sizes. This new approach is in clear contrast to previous systems, since it captures the variability of foot morphology in a more comprehensive way by using a foot typing system and therefore paves the way for the unimpaired development of children's feet. Previous shoe systems do not allow for the wide variations in foot morphology. A new approach was developed regarding different morphological foot types based on 3-D measurements relevant in shoe construction. This can be directly applied to create specific designs for children's shoes.

MRI abnormalities of foot and ankle in asymptomatic, physically active individuals

International Nuclear Information System (INIS)

Lohman, M.; Kivisaari, A.; Kivisaari, L.; Kallio, P.

2001-01-01

Objective. To assess MRI changes in the ankle and foot after physical exercise.Design and patients. Nineteen non-professional marathon runners and 19 age- and sex-matched controls volunteered for the study. All had ankle and foot MR images (1.5 T) taken in three perpendicular planes (STIR, T2F and T1FS sequences) within 3 h of running a full-length marathon (42.125 km). Three radiologists independently analysed the groups on a masked basis using a predefined form.Results. Severe bone marrow oedema was seen in one and slight bone marrow oedema in three marathon runners. Slight bone marrow oedema was found in three control subjects. Signal alteration within the soleus muscle, consistent with a grade 1 strain, was found in one marathon runner. Small punctate hyperintensities within the Achilles tendon were seen in 26% of the marathon runners and in 63% of controls (P=0.016). An increased amount of fluid in the retrocalcaneal bursa was found in one control and in none of the marathon runners. Small amounts of fluid in the retrocalcaneal bursa were seen in 68% of marathon runners and in 53% of controls. Grade 1 or 2 peritendinous joint fluid was found around 22% of tendons, among both marathon runners and controls, most often involving the tendon sheath of the flexor hallucis longus muscle. An increased amount of joint fluid was noted in 34% of the joints of the marathon runners, and in 18% of the controls.Conclusion. MRI shows several abnormalities in the ankle and foot both after marathon races and in asymptomatic physically active individuals without any preceding extraordinary strain. Recreational sports may lead to a number of positive MRI findings without correlation with clinical findings. (orig.)

Benign and malignant tumors of the foot and ankle

Energy Technology Data Exchange (ETDEWEB)

Singer, Adam D.; Datir, Abhijit; Langley, Travis [Emory University Hospital, Department of Radiology, Section of Musculoskeletal Imaging, Atlanta, GA (United States); Tresley, Jonathan [University of Wisconsin, Department of Radiology, Madison, WI (United States); Clifford, Paul D.; Jose, Jean; Subhawong, Ty K. [University of Miami, Department of Radiology, Miami, FL (United States)

2016-03-15

Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed. (orig.)

The Study of Influence of Different Methods of Local Treatment on Wound Healing in Patients with Diabetic Foot Ulcers.

Science.gov (United States)

Zaitseva, E L; Tokmakova, A Y; Shestakova, M V; Galstyan, G R; Doronina, L P

To evaluate the influence of different methods of local treatment on tissue repair in patients with diabetic foot ulcers. We evaluated such clinical characteristics as wound size and local perfusion after using negative pressure wound therapy (NPWT), local collagen, and standard care in patients with diabetic foot ulcers. We observed 63 patients with neuropathic and neuroischemic forms of diabetic foot (without critical ischemia) after surgical debridement. After that 21 patients received NPWT, 21 local collagen treatment and 21 ― standard care. After using NPWT wound area and depth decreased in 19,8% and 42,8% (p<0.05), in group of collagen dressings in 26,4 and 30,4% (p<0.05). In control group those parameters were 17,0 и 16.6% respectively (p<0.05). There was found the significant increase of local perfusion according to oxygen monitoring in group of NPWT (p<0.05). The received data showed that the intensity of lower limb tissue repair processes increases more significant after using NPWT and collagen dressings in comparison to standard care which is found according to wound size and tissue perfusion alterations.

Metabolic Foot- and Fingerprinting of Lactobacillus paracasei

DEFF Research Database (Denmark)

Jäpelt, Kristina Bak

of lactobacilli has suggested bile response mechanisms such as efflux of bile acids/salts, bile salt hydrolysis, modified sugar metabolism, change in a number of transport systems, and cell membrane or cell wall composition modification. A number of these effects are expected to cause alterations...... in the metabolome, and an increased understanding of bile response mechanisms could be obtained by analysis of the response by tools within metabolomics. Therefore, the aim of this PhD thesis was to develop a platform for metabolic foot- and fingerprinting of L. paracasei subsp. paracasei strain (L. casei CRL-431...... picture of changes in the metabolome. It was shown that the L. paracasei cell membrane was significantly damaged by quenching in buffered methanol. In contrast minimal damage of the cell membrane and better recovery of intracellular metabolites were observed with glycerol saline quenching. Furthermore...

Possibilities and acceptance of mobile information technologies for the elderly - first results of an empirical study.

Science.gov (United States)

Szarvas, Ildikó; Nitsch, Manuela; Lambacher, Oliver; Howe, Jürgen; Reichwaldt, Nina; von Bargen, Tobias; Haux, Reinhold

2013-01-01

This paper summarizes the results of a questionnaire-study conducted for the project "Safe and mobile through accompanying assistance systems" (SIMBA) founded by the German Federal Ministry of Education and Research. The study analyzes the mobility requirements and obstacles of the 55 yearold and older seniors in three age-groups (N=210) to develop suitable health-enabling technologies. It focuses on the mobility of the elderly on foot, by public transport, by bicycle and by taxi. The usage and the acceptance of existing mobile devices are determined, to select a suitable terminal for assistance systems. The results show, that although public transport is a very important way of travelling for seniors, its role decreases with higher age. Above the age of 65 years only a small fraction of seniors uses new communication technologies. This implies that smartphones as mobility aids are only suitable for the youngest group of seniors and for future, perhaps more technology-friendly generations.

Foot deformities, function in the lower extremities, and plantar pressure in patients with diabetes at high risk to develop foot ulcers

OpenAIRE

Tang, Ulla Hellstrand; Z?gner, Roland; Lisovskaja, Vera; Karlsson, Jon; Hagberg, Kerstin; Tranberg, Roy

2015-01-01

Objective: Foot deformities, neuropathy, and dysfunction in the lower extremities are known risk factors that increase plantar peak pressure (PP) and, as a result, the risk of developing foot ulcers in patients with diabetes. However, knowledge about the prevalence of these factors is still limited. The aim of the present study was to describe the prevalence of risk factors observed in patients with diabetes without foot ulcers and to explore possible connections between the risk factors and ...

Comorbidities associated with Egyptian diabetic foot disease subtypes

Directory of Open Access Journals (Sweden)

Mary N. Rizk

2013-01-01

Conclusion Special attention should be paid toward the identification of patients who are at risk of foot ulceration to help prevent foot problems. Comorbid conditions must also be identified early and managed aggressively.

Mobile phone generated vibrations used to detect diabetic peripheral neuropathy.

Science.gov (United States)

May, Jonathan David; Morris, Matthew William John

2017-12-01

In the current United Kingdom population the incidence of diabetic peripheral neuropathy is increasing. The presence of diabetic neuropathy affects decision making and treatment options. This study seeks to evaluate if the vibrations generated from a mobile phone can be used to screen patients for diabetic peripheral neuropathy. This study comprised of 61 patients; a control group of 21 patients; a lower limb injury group of 19 patients; a diabetic peripheral neuropathy group of 21 patients. The control and injury group were recruited randomly from fracture clinics. The diabetic peripheral neuropathy group were randomly recruited from the diabetic foot clinic. The 61 patients were examined using a 10g Semmes-Weinstein monofilament, a 128Hz tuning fork and a vibrating mobile phone. The points tested were, index finger, patella, lateral malleoli, medial malleoli, heel, first and fifth metatarsal heads. The most accurate location of all the clinical tests was the head of the 1st metatarsal at 0.86. The overall accuracy of the tuning fork was 0.77, the ten gram monofilament 0.79 and the mobile phone accuracy was 0.88. The control group felt 420 of 441 tests (95%). The injury group felt 349 of 399 tests (87%). The neuropathic group felt 216 of 441 tests (48%). There is a significant difference in the number of tests felt between the control and both the injury and neuropathic groups. pperipheral neuropathy. The most accurate location to test for diabetic peripheral neuropathy is the head of the 1st metatarsal. Screening for diabetic peripheral neuropathy in the index finger and patella were inaccurate. An injury to the lower limb affects the patient's vibration sensation, we would therefore recommend screening the contralateral limb to the injury. This study represents level II evidence of a new diagnostic investigation. Copyright © 2016 European Foot and Ankle Society. All rights reserved.

The Dutch version of the Oxford Ankle and Foot Questionnaire for Children: Useful for evaluation of pediatric foot problems in groups.

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Burger, Elise; Selles, Ruud; van Nieuwkasteele, Shelly; Bessems, Gert; Pollet, Virginie; Hovius, Steven; van Nieuwenhoven, Christianne

2017-11-04

The purpose of this study is to develop a Dutch version of the Oxford Ankle and Foot Questionnaire for Children (OxAFQ-c) to allow evaluation of pediatric foot care. The OxAFQ-c was translated into Dutch, according to the ISPOR-guidelines. Children with different foot and ankle complaints completed the OxAFQ-c at baseline, after two weeks, and after 4-6 months. Measurement properties were assessed in terms of reliability, responsiveness, and construct validity. Test-retest reliability showed moderate intraclass correlation coefficients. Bland-Altman plots showed wide limits of agreement. After 4-6 months, the group that experienced improvement also showed improved questionnaire outcomes, indicating responsiveness. Moderate correlation between the OxAFQ-c and the Kidscreen and foot-specific VAS-scores were observed, indicating moderate construct validity. The Dutch OxAFQ-c showed moderate to good measurement properties. However, because we observed limited sensitivity to changes and wide limits of agreement in individual patients, we think the questionnaire should only be used in groups. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Diabetic foot syndrome as an interdisciplinary problem

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Emilia Rymkiewicz

2017-08-01

Full Text Available Diabetes is a metabolic disease of the growing maturity. Diabetic foot syndrome is a chronic complications of diabetes. In neuropathic sensory disorders, ischemia of the lower limbs, and improper alignment metabolic control may occur in minor injuries around the foot, giving rise to a difficult healing ulcers. Even minor wounds rapidly infection by pathogenic bacteria, which significantly hinders their treatment. Health and life-saving solution in situations of persistent symptoms of infection is amputation of the lower limb. Doing so, however, does not solve the problem of diabetic and should be the final proceedings after having exhausted all possible treatments for diabetic foot syndrome.

Development and validation of a questionnaire designed to measure foot-health status.

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Bennett, P J; Patterson, C; Wearing, S; Baglioni, T

1998-09-01

The aim of this study was to apply the principles of content, criterion, and construct validation to a new questionnaire specifically designed to measure foot-health status. One hundred eleven subjects completed two different questionnaires designed to measure foot health (the new Foot Health Status Questionnaire and the previously validated Foot Function Index) and underwent a clinical examination in order to provide data for a second-order confirmatory factor analysis. Presented herein is a psychometrically evaluated questionnaire that contains 13 items covering foot pain, foot function, footwear, and general foot health. The tool demonstrates a high degree of content, criterion, and construct validity and test-retest reliability.

The lives of Mary Foote: painter and Jungian.

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Trousdell, Richard

2016-11-01

Mary Foote (1872-1968) was a successful early twentieth century American artist who suddenly closed her New York studio in 1926 to go to Zurich to study with Jung. There she joined his 'Interpretation of Visions' seminars (1930-1934), which she recorded and edited. This work won Jung's praise and his friendship, but all too often Foote was seen merely as a secretary or background figure. Deirdre Bair's biography of Jung suggested that Foote's life and work deserved fuller study, if only to rebalance our view of Jung's early women followers. This paper takes up that work to ask how Foote's early life and career led to her important work in preserving and describing Jung's earliest attempts to apply his theories to clinical practice. © 2016, The Society of Analytical Psychology.

Validity and reliability of Thai version of the Foot and Ankle Outcome Score in patients with arthritis of the foot and ankle.

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Angthong, Chayanin

2016-12-01

Although the Foot and Ankle Outcome Score (FAOS) is commonly used in several languages for a variety of foot disorders, it has not been validated specifically for foot and ankle arthritic conditions. The aims of the present study were to translate the original English FAOS into Thai and to evaluate the validity and reliability of the Thai version of the FAOS for the foot and ankle arthritic conditions. The original FAOS was translated into Thai using forward-backward translation. The Thai FAOS and validated Thai Short Form-36 (SF-36 ® ) questionnaires were distributed to 44 Thai patients suffering from arthritis of the foot and ankle to complete. For validation, Thai FAOS scores were correlated with SF-36 scores. Test-retest reliability and internal consistency were also analyzed in this study. The Thai FAOS score demonstrated sufficient correlation with SF-36 total score in Pain (Pearson's correlation coefficient (r)=0.45, p=0.002), Symptoms (r=0.45, p=0.002), Activities of Daily Living (ADL) (r=0.47, p=0.001), and Quality of Life (QOL) (r=0.38, p=0.011) subscales. The Sports and Recreational Activities (Sports & Rec) subscale did not correlate significantly with the SF-36 ® (r=0.20, p=0.20). Cronbach's alpha, a measure of internal consistency, for the five subscales was as follows: Pain, 0.94 (pvalidity for the evaluation of foot and ankle arthritis. Although reliability was satisfactory for the major subscale ADL, it was not sufficient for the minor subscales. Our findings suggest that it can be used as a disease-specific instrument to evaluate foot and ankle arthritis and can complement other reliable outcome surveys. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Metronome rate and walking foot contact time in young adults.

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Dickstein, Ruth; Plax, Michael

2012-02-01

It is assumed that when people walk guided by an audible constant rate, they match foot contact to the external pace. The purpose of this preliminary study was to test that assumption by examining the temporal relationship between audible signals generated by a metronome and foot contact time during gait. Ten healthy young women were tested in walking repetitions guided by metronome rates of 60, 110, and 150 beats/min. Metronome beats and foot contact times were collected in real time. The findings indicated that foot contact was not fully synchronized with the auditory signals; the shortest time interval between the metronome beat and foot contact time was at the prescribed rate of 60 beats/min., while the longest interval was at the rate of 150 beats/min. The correlation between left and right foot contact times was highest with the slowest rate and lowest with the fastest rate.

Sex determination from hand and foot dimensions in a North Indian population.

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Krishan, Kewal; Kanchan, Tanuj; Sharma, Abhilasha

2011-03-01

Hands and feet are often recovered from the site of natural as well as man-made disasters because of bomb blasts, train accidents, plane crashes, or mass homicides. This study is intended to establish standards for determination of sex from the dimensions of hands and feet in a North Indian population. The data for this study comprise 123 men and 123 women aged between 17 and 20 years from the "Rajput" population of Himachal Pradesh in North India. Four anthropometric measurements viz. hand length, hand breadth, foot length, and foot breadth have been taken on both sides of each subject following international anthropometric standards. The hand index (hand breadth/hand length × 100) and the foot index (foot breadth/foot length × 100) were calculated. Sectioning points and regression models are derived for the hand and foot dimensions and the derived indices. The hand and foot dimensions show a higher accuracy in sex determination by sectioning point analysis when compared to hand and foot index. Of the hand and the foot dimensions, hand breadth and foot breadth showed better accuracy in sex determination. Hand index and foot index remain poor sex discriminators in the study. © 2011 American Academy of Forensic Sciences.

Restoration of ankle movements with the ActiGait implantable drop foot stimulator: a safe and reliable treatment option for permanent central leg palsy.

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Martin, Klaus Daniel; Polanski, Witold Henryk; Schulz, Anne-Kathrin; Jöbges, Michael; Hoff, Hansjoerg; Schackert, Gabriele; Pinzer, Thomas; Sobottka, Stephan B

2016-01-01

OBJECT The ActiGait drop foot stimulator is a promising technique for restoration of lost ankle function by an implantable hybrid stimulation system. It allows ankle dorsiflexion by active peroneal nerve stimulation during the swing phase of gait. In this paper the authors report the outcome of the first prospective study on a large number of patients with stroke-related drop foot. METHODS Twenty-seven patients who experienced a stroke and with persisting spastic leg paresis received an implantable ActiGait drop foot stimulator for restoration of ankle movement after successful surface test stimulation. After 3 to 5 weeks, the stimulator was activated, and gait speed, gait endurance, and activation time of the system were evaluated and compared with preoperative gait tests. In addition, patient satisfaction was assessed using a questionnaire. RESULTS Postoperative gait speed significantly improved from 33.9 seconds per 20 meters to 17.9 seconds per 20 meters (p < 0.0001), gait endurance from 196 meters in 6 minutes to 401 meters in 6 minutes (p < 0.0001), and activation time from 20.5 seconds to 10.6 seconds on average (p < 0.0001). In 2 patients with nerve injury, surgical repositioning of the electrode cuff became necessary. One patient showed a delayed wound healing, and in another patient the system had to be removed because of a wound infection. Marked improvement in mobility, social participation, and quality of life was confirmed by 89% to 96% of patients. CONCLUSIONS The ActiGait implantable drop foot stimulator improves gait speed, endurance, and quality of life in patients with stroke-related drop foot. Regarding gait speed, the ActiGait system appears to be advantageous compared with foot orthosis or surface stimulation devices. Randomized trials with more patients and longer observation periods are needed to prove the long-term benefit of this device.

Diabetic foot workshop: Improving technical and educational skills for nurses.

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Aalaa, Maryam; Sanjari, Mahnaz; Shahbazi, Samimeh; Shayeganmehr, Zahra; Abooeirad, Maryam; Amini, Mohammad Reza; Adibi, Hossien; Mehrdad, Neda

2017-01-01

Diabetes mellitus as one of the most common metabolic disorders has some complications, one of the main ones is diabetic foot (DF). Appropriate care and education prevents 85% of diabetic foot amputations. An ideal management to prevent and treat diabetic foot necessitates a close collaboration between the health team members and the diabetic patient. Therefore, improving nurses' knowledge about DF care and advancement in the quality of care provided by the nurses could significantly improve diabetic foot prevention and management. Therefore, the aim of DF workshop was to improve technical and educational skills of the nurses to prevent and manage diabetic foot. Considering the vital role of the nurses in providing DF care, EMRI decided to conduct Diabetic foot workshop for them. The following five steps were designed for the 14 coordinating sessions in the workshop: Goals definition, deciding about attendees, location selection, creating agenda, and developing a follow-up plan. "Diabetic Foot Workshop for Nurses" provides appropriate training to DF nurses at the national level; and combining theory and practice in this workshop not only increases nurses' knowledge, but also improves their skills in the field of the diabetic foot. Providing education and care to patients by DF nurse specialists instead of general nurses could be an important output of this workshop, which may lead to DF prevention and amputation decrease in the long term.

Non invasive blood flow assessment in diabetic foot ulcer using laser speckle contrast imaging technique

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Jayanthy, A. K.; Sujatha, N.; Reddy, M. Ramasubba; Narayanamoorthy, V. B.

2014-03-01

Measuring microcirculatory tissue blood perfusion is of interest for both clinicians and researchers in a wide range of applications and can provide essential information of the progress of treatment of certain diseases which causes either an increased or decreased blood flow. Diabetic ulcer associated with alterations in tissue blood flow is the most common cause of non-traumatic lower extremity amputations. A technique which can detect the onset of ulcer and provide essential information on the progress of the treatment of ulcer would be of great help to the clinicians. A noninvasive, noncontact and whole field laser speckle contrast imaging (LSCI) technique has been described in this paper which is used to assess the changes in blood flow in diabetic ulcer affected areas of the foot. The blood flow assessment at the wound site can provide critical information on the efficiency and progress of the treatment given to the diabetic ulcer subjects. The technique may also potentially fulfill a significant need in diabetic foot ulcer screening and management.

DESIGN OPTIMIZATION OF A FOOT VALVE BY USING ANSYS®

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Serdar KARAOĞLU

2008-02-01

Full Text Available In this study, main components of a foot valve, being produced by casting, were optimized for minimum weight. The study was focused on the minimization of casting costs by reducing the volumes of two main parts of the foot valve. ANSYS® finite elements package was used in the study. In the optimization stage, parametrical dimensions were determined according to manufacturer's design criteria and related standards. Final design of the foot valve was completed by using the calculated values of optimum dimensions of the main components. Design optimization procedure gave about 8.5% of weight reductions in the main foot valve components.

Foot strike patterns and collision forces in habitually barefoot versus shod runners.

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Lieberman, Daniel E; Venkadesan, Madhusudhan; Werbel, William A; Daoud, Adam I; D'Andrea, Susan; Davis, Irene S; Mang'eni, Robert Ojiambo; Pitsiladis, Yannis

2010-01-28

Humans have engaged in endurance running for millions of years, but the modern running shoe was not invented until the 1970s. For most of human evolutionary history, runners were either barefoot or wore minimal footwear such as sandals or moccasins with smaller heels and little cushioning relative to modern running shoes. We wondered how runners coped with the impact caused by the foot colliding with the ground before the invention of the modern shoe. Here we show that habitually barefoot endurance runners often land on the fore-foot (fore-foot strike) before bringing down the heel, but they sometimes land with a flat foot (mid-foot strike) or, less often, on the heel (rear-foot strike). In contrast, habitually shod runners mostly rear-foot strike, facilitated by the elevated and cushioned heel of the modern running shoe. Kinematic and kinetic analyses show that even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers. This difference results primarily from a more plantarflexed foot at landing and more ankle compliance during impact, decreasing the effective mass of the body that collides with the ground. Fore-foot- and mid-foot-strike gaits were probably more common when humans ran barefoot or in minimal shoes, and may protect the feet and lower limbs from some of the impact-related injuries now experienced by a high percentage of runners.

Self-reported activity in tortured refugees with long-term sequelae including pain and the impact of foot pain from falanga - a cross-sectional study

DEFF Research Database (Denmark)

Prip, Karen; Persson, Ann L; Sjölund, Bengt H

2011-01-01

, among them pain and mobility problems. All had been subjected to various forms of physical and psychological torture and 71 victims had also suffered falanga. Main outcome measures used were: the Disability Rating Index (DRI; 12 items) to assess self-reported capacity to carry out daily activities......; for falanga victims, a specific foot assessment of sensory function in the feet. Results. All patients perceived clear activity limitations according to the DRI. The falanga victims' feet were categorised according to the type of foot pain: stimulus-independent pain; stimulus-evoked pain; no pain. The two...... of victims who had chronic pain for at least 5 years after torture, all perceived activity limitations, but pain from falanga had a greater overall impact on disability assessed in terms of daily activities....

NUMERICAL MODELLING OF CHICKEN-FOOT FOUNDATION

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Vipman Tandjiria

1999-01-01

Full Text Available This paper presents an analysis of the chicken-foot foundation using the finite element method. The foundation is considered as a reinforced concrete slab resting on a number of reinforced concrete pipes filled with and surrounded by in-situ soil. The soil and the pipes were modelled by isoparametric solid elements while the slab was modelled by isoparametric thick-plate elements. The study was intended to illustrate the basic mechanism of the chicken-foot foundation. Three cases have been considered for the parametric studies. The parameters investigated are thickness of slab, length of pipes and spacing between pipes. It is shown that such a foundation improves the behaviour of the raft foundation. It is also found that all the parameters used in the parametric studies influence the behaviour of the chicken-foot foundation.

Nonplantigrade Foot Posture: A Constraint on Dinosaur Body Size

OpenAIRE

Kubo, Tai; Kubo, Mugino O.

2016-01-01

Dinosaurs had functionally digitigrade or sub-unguligrade foot postures. With their immediate ancestors, dinosaurs were the only terrestrial nonplantigrades during the Mesozoic. Extant terrestrial mammals have different optimal body sizes according to their foot posture (plantigrade, digitigrade, and unguligrade), yet the relationship of nonplantigrade foot posture with dinosaur body size has never been investigated, even though the body size of dinosaurs has been studied intensively. Accordi...

The Alteration of Emotion Regulation Precedes the Deficits in Interval Timing in the BACHD Rat Model for Huntington Disease

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Daniel Garces

2018-05-01

Full Text Available Huntington disease (HD is an autosomal dominantly inherited, progressive neurodegenerative disorder which is accompanied by executive dysfunctions and emotional alteration. The aim of the present study was to assess the impact of emotion/stress on on-going highly demanding cognitive tasks, i.e., temporal processing, as a function of age in BACHD rats (a “full length” model of HD. Middle-aged (4–6 months and old (10–12 months rats were first trained on a 2 vs. 8-s temporal discrimination task, and then exposed to a series of bisection tests under normal and stressful (10 mild unpredictable foot-shocks conditions. The animals were then trained on a peak interval task, in which reinforced fixed-interval (FI 30-s trials were randomly intermixed with non-reinforced probe trials. After training, the effect of stress upon time perception was again assessed. Sensitivity to foot-shocks was also assessed independently. The results show effects of both age and genotype, with largely greater effects in old BACHD animals. The older BACHD animals had impaired learning in both tasks, but reached equivalent levels of performance as WT animals at the end of training in the temporal discrimination task, while remaining impaired in the peak interval task. Whereas sensitivity to foot-shock did not differ between BACHD and WT rats, delivery of foot-shocks during the test sessions had a disruptive impact on temporal behavior in WT animals, an effect which increased with age. In contrast, BACHD rats, independent of age, did not show any significant disruption under stress. In conclusion, BACHD rats showed a disruption in temporal learning in late symptomatic animals. Age-related modification in stress-induced impairment of temporal control of behavior was also observed, an effect which was greatly reduced in BACHD animals, thus confirming previous results suggesting reduced emotional reactivity in HD animals. The results suggest a staggered onset in cognitive

A Powered Lower Limb Orthosis for Providing Legged Mobility in Paraplegic Individuals

OpenAIRE

Quintero, Hugo A.; Farris, Ryan J.; Hartigan, Clare; Clesson, Ismari; Goldfarb, Michael

2011-01-01

This paper presents preliminary results on the development of a powered lower limb orthosis intended to provide legged mobility (with the use of a stability aid, such as forearm crutches) to paraplegic individuals. The orthosis contains electric motors at both hip and both knee joints, which in conjunction with ankle-foot orthoses, provides appropriate joint kinematics for legged locomotion. The paper describes the orthosis and the nature of the controller that enables the SCI patient to comm...

Nociception at the diabetic foot, an uncharted territory

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Chantelau, Ernst A

2015-01-01

The diabetic foot is characterised by painless foot ulceration and/or arthropathy; it is a typical complication of painless diabetic neuropathy. Neuropathy depletes the foot skin of intraepidermal nerve fibre endings of the afferent A-delta and C-fibres, which are mostly nociceptors and excitable by noxious stimuli only. However, some of them are cold or warm receptors whose functions in diabetic neuropathy have frequently been reported. Hence, it is well established by quantitative sensory testing that thermal detection thresholds at the foot skin increase during the course of painless diabetic neuropathy. Pain perception (nociception), by contrast, has rarely been studied. Recent pilot studies of pinprick pain at plantar digital skinfolds showed that the perception threshold was always above the upper limit of measurement of 512 mN (equivalent to 51.2 g) at the diabetic foot. However, deep pressure pain perception threshold at musculus abductor hallucis was beyond 1400 kPa (equivalent to 14 kg; limit of measurement) only in every fifth case. These discrepancies of pain perception between forefoot and hindfoot, and between skin and muscle, demand further study. Measuring nociception at the feet in diabetes opens promising clinical perspectives. A critical nociception threshold may be quantified (probably corresponding to a critical number of intraepidermal nerve fibre endings), beyond which the individual risk of a diabetic foot rises appreciably. Staging of diabetic neuropathy according to nociception thresholds at the feet is highly desirable as guidance to an individualised injury prevention strategy. PMID:25897350

Leonardo da Vinci's foot: historical evidence of concept.

Science.gov (United States)

Jastifer, James R; Toledo-Pereyra, Luis H

2012-10-01

Leonardo da Vinci (1452-1519), world-renowned Italian renaissance master, is known for his contributions to, and broad interests in science and art. The objective of this work is to demonstrate the extent of his science by applying the use of his concepts to current models of foot and ankle mechanics. The art and science of Leonardo Da Vinci were extensively analyzed by reviewing his original drawings and hand written notebooks as well as their English translation. Current medical journals including the topics of foot, ankle, and biomechanics were reviewed for modern evidence and application of his concepts. The library of Michigan State University and the electronic library of the Royal Library at Windsor Castle were extensively utilized. From the depths of Santa Maria Nuova Hospital in Florence and Santo Spirito Hospital in Rome, through his commentary and anatomical drawings of around 30 cadaver dissections he performed, Leonardo da Vinci expressed his concept of foot and ankle anatomy and mechanics. He laid forth concepts, which vary little from current theories including those of proportion, statics and joint stability, sesamoid biomechanics, and structural support of the foot. Leonardo da Vinci, by combining an interest in anatomy and a gift of genius and artistic ability laid a foundation of foot and ankle anatomy and mechanics that have been applied in modern clinical sciences. Leonardo in this way made important contributions to the practice of foot and ankle orthopedics.

Imaging of Charcot foot; Bildgebung des Charcot-Fusses

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Erlemann, Rainer; Schmitz, Annette [Helios Klinikum Duisburg, Helios St. Johannes Klinik, Duisburg (Germany). Inst. fuer Radiologie

2014-03-15

The onset of a Charcot foot ist a feared complication of a long lasting diabetes mellitus. A peripheral neuropathy and continuous weight bearing of the foot subsequent to repeated traumas depict the conditions. There exist three types of a Charcot foot, an atrophic, a hypertophic and a mixed type. In early stages a differentiation from osteoarthritis is difficult. Subluxation or luxation within the Lisfranc's joint is typical. The joints of the foot could rapidly and extensively be destroyed or may present the morphology of a 'superosteoarthritis'. Often, soft tissue infections or osteomyelitis evolve from ulcers of the skin as entry points. Diagnosis of osteomyelitis necessitate MR imaging as plain radiography offers only low sensitivity for detection of an osteomyelitis. The existence of periosteal reactions is not a proof for osteomyelitis. Bone marrow edema and soft tissue edema also appear in a non infected Charcot foot. The range of soft tissue infections goes from cellulitis over phlegmon to abscesses. The ghost sign is the most suitable diagnostic criterion for osteomyelitis. In addition, the penumbra sign or the existence of a sinus tract between a skin ulcer and the affected bone may be helpful. (orig.)

Foot Structure in Boys with Down Syndrome

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Ewa Puszczałowska-Lizis

2017-01-01

Full Text Available Introduction and Aim. Down syndrome (DS is associated with numerous developmental abnormalities, some of which cause dysfunctions of the posture and the locomotor system. The analysis of selected features of the foot structure in boys with DS versus their peers without developmental disorders is done. Materials and Methods. The podoscopic examination was performed on 30 boys with DS aged 14-15 years. A control group consisted of 30 age- and gender-matched peers without DS. Results. The feet of boys with DS are flatter compared to their healthy peers. The hallux valgus angle is not the most important feature differentiating the shape of the foot in the boys with DS and their healthy peers. In terms of the V toe setting, healthy boys had poorer results. Conclusions. Specialized therapeutic treatment in individuals with DS should involve exercises to increase the muscle strength around the foot joints, enhancing the stabilization in the joints and proprioception. Introducing orthotics and proper footwear is also important. It is also necessary to monitor the state of the foot in order to modify undertaken therapies.

Improving diabetic foot care in a nurse-managed safety-net clinic.

Science.gov (United States)

Peterson, Joann M; Virden, Mary D

2013-05-01

This article is a description of the development and implementation of a Comprehensive Diabetic Foot Care Program and assessment tool in an academically affiliated nurse-managed, multidisciplinary, safety-net clinic. The assessment tool parallels parameters identified in the Task Force Foot Care Interest Group of the American Diabetes Association's report published in 2008, "Comprehensive Foot Examination and Risk Assessment." Review of literature, Silver City Health Center's (SCHC) 2009 Annual Report, retrospective chart review. Since the full implementation of SCHC's Comprehensive Diabetic Foot Care Program, there have been no hospitalizations of clinic patients for foot-related complications. The development of the Comprehensive Diabetic Foot Assessment tool and the implementation of the Comprehensive Diabetic Foot Care Program have resulted in positive outcomes for the patients in a nurse-managed safety-net clinic. This article demonstrates that quality healthcare services can successfully be developed and implemented in a safety-net clinic setting. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

An epidemiologic study of flat foot in Iran

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Alamy B

1997-07-01

Full Text Available Among 880 studied feet of 7-14 years old children 6.9% suffered mild and severe flat foot. 53.8% of the affected children were symptomatic. As 40.1% of the general population experiences symptoms, in a small proportion of affected persons, symptoms are due to flat foot. The prevalence of symptoms rises with increasing severity of the disorder. In this article, reviewing general aspects of flat food, prevalence and other epidemiological aspects of flat foot for the first time in Iran have been presented

Influence of patellofemoral pain syndrome on plantar pressure in the foot rollover process during gait

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Sandra Aliberti

2011-01-01

Full Text Available BACKGROUND: Patellofemoral Pain Syndrome is one of the most common knee disorders among physically active young women. Despite its high incidence, the multifactorial etiology of this disorder is not fully understood. OBJECTIVES: To investigate the influence of Patellofemoral Pain Syndrome on plantar pressure distribution during the foot rollover process (i.e., the initial heel contact, midstance and propulsion phases of the gait. MATERIALS AND METHODS: Fifty-seven young adults, including 22 subjects with Patellofemoral Pain Syndrome (30 ± 7 years, 165 ± 9 cm, 63 ± 12 kg and 35 control subjects (29 ± 7 years, 164 ± 8 cm, 60 ± 11 kg, volunteered for the study. The contact area and peak pressure were evaluated using the Pedar-X system (Novel, Germany synchronized with ankle sagittal kinematics. RESULTS: Subjects with Patellofemoral Pain Syndrome showed a larger contact area over the medial (p = 0.004 and central (p = 0.002 rearfoot at the initial contact phase and a lower peak pressure over the medial forefoot (p = 0.033 during propulsion when compared with control subjects. CONCLUSIONS: Patellofemoral Pain Syndrome is related to a foot rollover pattern that is medially directed at the rearfoot during initial heel contact and laterally directed at the forefoot during propulsion. These detected alterations in the foot rollover process during gait may be used to develop clinical interventions using insoles, taping and therapeutic exercise to rehabilitate this dysfunction.

Evaluation of foot static disturbances in patients with rheumatic diseases

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Anna Kuryliszyn-Moskal

2017-04-01

Full Text Available Objectives : Rheumatic diseases such as osteoarthritis and rheumatoid arthritis constitute the most frequent pathological states leading to the development of foot deformities, which reduce quality of life and cause disability. The aim of the present study was to compare the results of plantoconturographic examinations, obtained by means of a computer podoscope, in osteoarthritis and rheumatoid arthritis patients. Special attention was paid to the differences in the values of each parameter determining the level of foot function. Material and methods : The study was performed in 94 female patients divided into two groups according to the type of disease. There were 54 patients with rheumatoid arthritis and 40 with osteoarthritis. The control group consisted of 34 healthy women. The plantographic assessment of static foot structure was carried out by means of a device for computer-aided foot examination. Results : A fallen transverse arch of the right foot was statistically much more frequent in the rheumatoid arthritis patients than in osteoarthritis patients or the control group (p < 0.005 and p < 0.05, respectively. Significant differences in the values of the Wejsflog index were observed in the case of left foot between rheumatoid arthritis patients and the control group (p < 0.05. Similarly, there were statistically significant differences in the values of the hallux valgus angle ( for the right foot between rheumatoid arthritis and osteoarthritis patients or control group (in both cases p < 0.05. Conclusions : Rheumatic diseases predispose patients to disturbances of static foot function. The obtained results highlight the importance of diagnosing foot static disturbances in the prevention of destructive changes affecting the functioning of osteoarthritis and rheumatoid arthritis patients.

Foot Placement Modification for a Biped Humanoid Robot with Narrow Feet

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Kenji Hashimoto

2014-01-01

Full Text Available This paper describes a walking stabilization control for a biped humanoid robot with narrow feet. Most humanoid robots have larger feet than human beings to maintain their stability during walking. If robot’s feet are as narrow as humans, it is difficult to realize a stable walk by using conventional stabilization controls. The proposed control modifies a foot placement according to the robot's attitude angle. If a robot tends to fall down, a foot angle is modified about the roll axis so that a swing foot contacts the ground horizontally. And a foot-landing point is also changed laterally to inhibit the robot from falling to the outside. To reduce a foot-landing impact, a virtual compliance control is applied to the vertical axis and the roll and pitch axes of the foot. Verification of the proposed method is conducted through experiments with a biped humanoid robot WABIAN-2R. WABIAN-2R realized a knee-bended walking with 30 mm breadth feet. Moreover, WABIAN-2R mounted on a human-like foot mechanism mimicking a human's foot arch structure realized a stable walking with the knee-stretched, heel-contact, and toe-off motion.

Development of a foot impact scale for rheumatoid arthritis.

Science.gov (United States)

Helliwell, Philip; Reay, Naomi; Gilworth, Gill; Redmond, Anthony; Slade, Anita; Tennant, Alan; Woodburn, James

2005-06-15

To develop a new foot impact scale to assess foot status in rheumatoid arthritis (RA) using established qualitative methodology and the latest item response techniques (Rasch analysis). Foot problems in RA were explored by conducting qualitative interviews that were then used to generate items for a new foot impact scale. Further validation was undertaken following postal surveys and Rasch analysis. Analysis of the first postal survey (n = 192 responses) produced a 63-item binary response, 4-subscale instrument. The 4 subscales covered the domains impairment, activities, participation, and footwear. Following test-retest postal surveys and additional analysis, the instrument was reduced to a 2 subscale, 51-item questionnaire covering the domains of impairments/shoes and activities/participation. Initial results of these subscales indicate good psychometric properties, external validity, and test-retest reliability. A foot impact scale to assess the impact of RA and to measure the effect of interventions has been developed. The 2 scales comprising the instrument demonstrate good psychometric properties.

Attitude and knowledge about foot health: a spanish view

Directory of Open Access Journals (Sweden)

Daniel López-López

Full Text Available ABSTRACT Objective: to explore attitudes towards patients' self-reported data about foot health-related beliefs from a behavioural and attitudinal perspective. Methods: a sample of 282 participants of a mean age of 39.46 ± 16.026 came to a health centre where self-reported demographic, clinical characteristics and beliefs relating to foot health data were registered, informants' completed all the stages of the research process. Results: the results of the analysis revealed an 8-factor factorial structure based on (1 podiatric behaviours, (2 the intention to carry out protective behaviour, (3 attitudinal beliefs, (4 normative beliefs, (5 needs, (6 apathy, (7 self-care, and (8 the general perception of foot health. They all explained 62.78% of the variance, and were considered as independent variables in a regression analysis to determine which provided the best explanations for the importance attributed to foot health. Conclusions: the participants in the study revealed a positive attitude in relation to foot health care and responsible behaviour.

Foot Type Biomechanics Part 2: are structure and anthropometrics related to function?

Science.gov (United States)

Mootanah, Rajshree; Song, Jinsup; Lenhoff, Mark W; Hafer, Jocelyn F; Backus, Sherry I; Gagnon, David; Deland, Jonathan T; Hillstrom, Howard J

2013-03-01

Many foot pathologies are associated with specific foot types. If foot structure and function are related, measurement of either could assist with differential diagnosis of pedal pathologies. Biomechanical measures of foot structure and function are related in asymptomatic healthy individuals. Sixty-one healthy subjects' left feet were stratified into cavus (n=12), rectus (n=27) and planus (n=22) foot types. Foot structure was assessed by malleolar valgus index, arch height index, and arch height flexibility. Anthropometrics (height and weight), age, and walking speed were measured. Foot function was assessed by center of pressure excursion index, peak plantar pressure, maximum force, and gait pattern parameters. Foot structure and anthropometric variables were entered into stepwise linear regression models to identify predictors of function. Measures of foot structure and anthropometrics explained 10-37% of the model variance (adjusted R(2)) for gait pattern parameters. When walking speed was included, the adjusted R(2) increased to 45-77% but foot structure was no longer a factor. Foot structure and anthropometrics predicted 7-47% of the model variance for plantar pressure and 16-64% for maximum force parameters. All multivariate models were significant (pFoot structure and function are related in asymptomatic healthy individuals. The structural parameters employed are basic measurements that do not require ionizing radiation and could be used in a clinical setting. Further research is needed to identify additional predictive parameters (plantar soft tissue characteristics, skeletal alignment, and neuromuscular control) and to include individuals with pathology. Copyright © 2012. Published by Elsevier B.V.

The Charcot Foot in Diabetes

Science.gov (United States)

Frykberg, Robert G.; Armstrong, David G.; Boulton, Andrew J.M.; Edmonds, Michael; Van, Georges Ha; Hartemann, Agnes; Game, Frances; Jeffcoate, William; Jirkovska, Alexandra; Jude, Edward; Morbach, Stephan; Morrison, William B.; Pinzur, Michael; Pitocco, Dario; Sanders, Lee; Wukich, Dane K.; Uccioli, Luigi

2011-01-01

The diabetic Charcot foot syndrome is a serious and potentially limb-threatening lower-extremity complication of diabetes. First described in 1883, this enigmatic condition continues to challenge even the most experienced practitioners. Now considered an inflammatory syndrome, the diabetic Charcot foot is characterized by varying degrees of bone and joint disorganization secondary to underlying neuropathy, trauma, and perturbations of bone metabolism. An international task force of experts was convened by the American Diabetes Association and the American Podiatric Medical Association in January 2011 to summarize available evidence on the pathophysiology, natural history, presentations, and treatment recommendations for this entity. PMID:21868781

Diabetic gangrene of the foot

International Nuclear Information System (INIS)

Tanaka, Junji; Hoshi, Makoto; Shinozaki, Tatsuyo; Kimura, Masakata; Ichinohe, Hitomoto.

1983-01-01

A case of severe diabetic gangrene was reported. Angiography showed no evidence of ischemic changes in the foot, except for mild atherosclerosis in the femoral and popliteal arteries. Tc-99m labelled macroagglugated albumine (MAA) was injected transcatheterally into the abdominal aorta to see the blood perfusion of the lower extremities, which showed increased blood flow of the foot as well as the presence of micro arteriovenous shuntings shown by the appearance of both lungs. Damages of the microcirculation are thought to have much influences on the formation of diabetic gangrene. Histopathological findings supported above. (author)

Aqueous Alteration of Endeavour Crater Rim Apron Rocks

Science.gov (United States)

Ming, D. W.; Mittlefehldt, D. W.; Gellert, R.; Clark, B. C.; Morris, R. V.; Yen, A. S.; Arvidson, R. E.; Crumpler, L. S.; Farrand, W. H.; Grant, J. A., III; Jolliff, B. L.; Parker, T. J.; Peretyazhko, T.

2014-12-01

Mars Exploration Rover Opportunity is exploring Noachian age rocks of the rim of 22 km diameter Endeavour crater. Overlying the pre-impact lithologies and rim breccias is a thin apron of fine-grained sediments, the Grasberg fm, forming annuli on the lower slopes of rim segments. Hesperian Burns fm sandstones overly the Grasberg fm. Grasberg rocks have major element compositions that are distinct from Burns fm sandstones, especially when comparing interior compositions exposed by the Rock Abrasion Tool. Grasberg rocks are also different from Endeavour rim breccias, but have general compositional similarities to them. Grasberg sediments are plausibly fine-grained materials derived from the impact breccias. Veins of CaSO4 transect Grasberg fm rocks demonstrating post-formation aqueous alteration. Minor/trace elements show variations consistent with mobilization by aqueous fluids. Grasberg fm rocks have low Mn and high Fe/Mn ratios compared to the other lithologies. Manganese likely was mobilized and removed from the Grasberg host rock by redox reactions. We posit that Fe2+ from acidic solutions associated with formation of the Burns sulfate-rich sandstones acted as an electron donor to reduce more oxidized Mn to Mn2+. The Fe contents of Grasberg rocks are slightly higher than in other rocks suggesting precipitation of Fe phases in Grasberg materials. Pancam spectra show that Grasberg rocks have a higher fraction of ferric oxide minerals than other Endeavour rim rocks. Solutions transported Mn2+ into the Endeavour rim materials and oxidized and/or precipitated it in them. Grasberg has higher contents of the mobile elements K, Zn, Cl, and Br compared to the rim materials. Similar enrichments of mobile elements were measured by the Spirit APXS on West Spur and around Home Plate in Gusev crater. Enhancements in these elements are attributed to interactions of hydrothermal acidic fluids with the host rocks. Interactions of fluids with the Grasberg fm postdate the genesis

VACUUM ASSISTED CLOSURE IN DIABETIC FOOT MANAGEMENT

OpenAIRE

Moganakannan; `Prema; Arun Sundara Rajan

2014-01-01

Comparision of vacuum assisted closure vs conventional dressing in management of diabetic foot patients. 30 patients were taken in that 15 underwent vacuum therapy and remaining 15 underwent conventional dressing.They were analysed by the development of granulation tissue and wound healing.The study showed Vac therapy is the best modality for management of diabetic foot patients.

Treatment for Common Running/Walking Foot Injuries

Science.gov (United States)

McDaniel, Larry W.; Haar, Calin; Ihlers, Matt; Jackson, Allen; Gaudet, Laura

2009-01-01

Whether you are a weekend warrior or a serious athlete, most runners fear the possibility of being injured. For those who are physically active or stand on their feet all day, healthy feet are important Highly conditioned runners spend many hours performing foot maintenance to prevent unnecessary injuries. Some of the common foot injuries are:…

Analysis of risk factors for neuropathic foot ulceration in diabetes mellitus.

Science.gov (United States)

Bennett, P J; Stocks, A E; Whittam, D J

1996-03-01

Diabetes mellitus affects about one in 25 Australians. Neuropathic foot ulceration is a frequent complication in persons with diabetes. This study evaluates the importance of different risk factors for the development of this condition. The role of nonenzymatic glycosylation and pressure beneath the sole of the foot in the pathogenesis of neuropathic foot ulcers was investigated. Twenty-seven subjects with diabetes with a recent history of neuropathic foot ulceration were matched by age and sex with a group of 50 control subjects without neuropathy or history of foot ulceration. The degree of nonenzymatic glycosylation was assessed by analyzing the average level of glycosylated hemoglobin in the 3 years prior to the development of the foot ulcer and a goniometer assessment of peripheral joint (hand and ankle) flexibility. Dynamic pressure of the plantar aspect of the foot was recorded using a Musgrave Footprint System pedobarograph during a normal gait cycle. There was no significant difference in age, sex, body mass index, and duration or type of diabetes between the ulcer and control groups. The pressure of the plantar aspect of the foot was significantly elevated (p < 0.01). Ankle joint flexibility was reduced (p < 0.01) in cases with neuropathic foot ulceration compared with the control group. There was a trend toward elevation of glycosylated hemoglobin (HbA1c fraction) or HbA1c in the ulcer group (p = 0.06). The results suggested that nonenzymatic glycosylation occurs at a more significant level in patients with diabetes with a history of neuropathic foot ulceration.

Quality and Toxicity Assessments of Foot and Mouth Disease Virus ...

African Journals Online (AJOL)

The quality and toxicity assessment of foot and mouth disease virus vaccine was carried out in inoculated guinea pigs. ... could be used for the control and prevention of foot and mouth disease in Nigerian livestock. Keyword: Foot and Mouth Disease ... 2 blended with Incomplete. Seepic Adjuvant (ISA) montanide 206, which.

The prevalence of foot ulceration in patients with rheumatoid arthritis.

Science.gov (United States)

Firth, Jill; Hale, Claire; Helliwell, Philip; Hill, Jackie; Nelson, E Andrea

2008-02-15

To establish the prevalence of foot ulceration in patients with rheumatoid arthritis (RA) in secondary care. A postal survey of all patients with RA (n = 1,130) under the care of rheumatologists in Bradford, West Yorkshire, UK was performed. The prevalence data were validated through clinical examination, case-note review, and contact with health professionals. The false-negative rate was investigated in a subsample of patients (n = 70) who denied any history of ulceration. The postal survey achieved a 78% response rate. Following validation, the point prevalence of foot ulceration was 3.39% and the overall prevalence was 9.73%. The false-positive rate was initially high at 21.21%, but use of diagrammatic questionnaire data to exclude leg ulceration reduced the rate to 10.76%. The false-negative rate was 11.76%. The most common sites for ulceration were the dorsal aspect of hammer toes, the metatarsal heads, and the metatarsophalangeal joint in patients with hallux abducto valgus, with 33% of patients reporting multiple sites of ulceration. Patients with open-foot and healed-foot ulceration had significantly longer RA disease duration, reported significantly greater use of special footwear, and had a higher prevalence of foot surgery than ulcer-free patients. Foot ulceration affects a significant proportion of patients with RA. Further work is needed to establish risk factors for foot ulceration in RA and to target foot health provision more effectively.

The epigenetic alterations of endogenous retroelements in aging.

Science.gov (United States)

Cardelli, Maurizio

2018-02-16

Endogenous retroelements, transposons that mobilize through RNA intermediates, include some of the most abundant repetitive sequences of the human genome, such as Alu and LINE-1 sequences, and human endogenous retroviruses. Recent discoveries demonstrate that these mobile genetic elements not only act as intragenomic parasites, but also exert regulatory roles in living cells. The risk of genomic instability represented by endogenous retroelements is normally counteracted by a series of epigenetic control mechanisms which include, among the most important, CpG DNA methylation. Indeed, most of the genomic CpG sites subjected to DNA methylation in the nuclear DNA are carried by these repetitive elements. As other parts of the genome, endogenous retroelements and other transposable elements are subjected to deep epigenetic alterations during aging, repeatedly observed in the context of organismal and cellular senescence, in human and other species. This review summarizes the current status of knowledge about the epigenetic alterations occurring in this large, non-genic portion of the genome in aging and age-related conditions, with a focus on the causes and the possible functional consequences of these alterations. Copyright © 2018 Elsevier B.V. All rights reserved.

Perioperative nursing for patients with diabetic foot receiving endovascular interventional therapy

International Nuclear Information System (INIS)

Yang Yang; Wang Feng; Li Ke; Li Cheng; Ji Donghua

2010-01-01

Objective: To study the effect of perioperative nursing on the living quality of patients with diabetic foot who are treated with endovascular interventional therapy. Methods: Specific perioperative nursing care plan was accordingly designed for 43 patients with diabetic foot. Endovascular balloon angioplasty and stent implantation were formed in these patients to treat their diabetic foot. The clinical results were observed. Results: Perioperative nursing effectively improved patient's limb blood supply, enhanced the healing of diabetic foot ulceration and increased the possibility of limb preservation. Conclusion: Endovascular therapy combined with corresponding perioperative nursing care can benefit more patients with diabetic foot. (authors)

Discospondylitis caused by Staphylococcus aureus in an African black-footed penguin (Spheniscus demersus).

Science.gov (United States)

Field, Cara L; Beaufrère, Hugues; Wakamatsu, Nobuko; Rademacher, Nathalie; MacLean, Robert

2012-12-01

A 22-year-old female African black-footed penguin (Spheniscus demersus), housed indoors with other African and rockhopper penguins, was presented acutely with lethargy, ataxia, and hind limb weakness after a molt. The penguin would assume a hunched position and, when resting, sat on its hocks or lay on its keel. Physical and neurologic examination revealed hind limb paraparesis, proprioceptive deficits, and tiptoe walking. Results of a complete blood cell count and biochemical analysis revealed mild heterophilic leukocytosis, anemia, mild hypoalbuminemia, hypokalemia, and hyperuricemia. Results of whole-body radiographs and coelioscopy were unremarkable. Two computed tomographies of the spine at a 3-month interval revealed a lesion at the mobile thoracic vertebra proximal to the synsacrum with associated spinal cord compression. The penguin was treated with itraconazole, doxycycline, and meloxicam, and it initially improved with return to near normal gait and behavior. However, 5 months after the onset of clinical signs, the penguin was euthanatized after a relapse with worsening of the neurologic signs. Postmortem and histopathologic examination revealed focal granulomatous discospondylitis at the penultimate mobile thoracic vertebra, with intralesional bacteria from which Staphylococcus aureus was cultured.

The Assessment of Social Support and Self-Care Requisites for Preventing Diabetic Foot Ulcer in Diabetic Foot Patients

Directory of Open Access Journals (Sweden)

Mohammad Taher

2016-03-01

Full Text Available Background and Objectives: Diabetic foot as one of the most common complications of diabetes is involved in more than %25 of diabetic patients’ lives, and if not treated properly can lead to amputation up to %20. The lack of self-care is the underlying cause of mortality, morbidity and chronic complications of diabetes. Identification and rectifying of diabetic foot care needs of patients can additionally reduce readmission; also, %85 of diabetic foot problems can be prevented. Materials and Methods: In this descriptive study, 130patients with diabetic foot from Shahid Modarres hospital were selected using census method. Data in forms of demographic questionnaire, self-care requisites assessment tool for preventing diabetic foot ulcer, and Social Support Behavior Scale were completed by patients and then were collected. Data were analyzed by SPSS version 16. Results: In this study, a significant relationship was found between self-care and social support (P<0.05. This means that people with better social support reported better self-care than those with weaker social support. A significant relationship in level of education and monthly income with self-care was seen, as well as in level of education, monthly income and marital status with social support (P<0.001. Conclusions: The results showed that social support can be considered as an effective factor in individual self-care behaviors, and with regard to this factor in educational, treatment and care programs of patients, can improve their self-care, in addition to decreasing economic costs, and improve their qualities of lives as well.

Exploring the Relationship Between Mobile Facebook and Social Capital: What Is the “Mobile Difference” for Parents of Young Children?

Directory of Open Access Journals (Sweden)

Andrew R. Schrock

2016-08-01

Full Text Available Mobile media have generally been found to reinforce close ties. Many have predicted this will bring about an onerous social insularity or “network privatism.” However, mobile media now enable frequent communication and multimedia activities with larger, more diffuse social networks. Might we be at a tipping point where certain groups benefit from weak tie connections on mobile social media? To answer this question, this study considers how mobile media altered social capital outcomes on Facebook among parents with young children, a group that are heavy users of mobile media and requiring social support. An online survey ( N  = 262 conducted with parents with young children reveals a generally positive picture. Results show differences between desktop and mobile use of Facebook. Toward a contextual understanding of the impact of visual media, multimedia activities with social ties accrued bridging over bonding capital. Social capital was in turn correlated with mobile Facebook activities beneficial for parents’ well-being. Far from negative predictions, this study provides evidence of how mobile social media broaden our social spheres.

Isotopic and trace element variability in altered and unaltered tuffs at Yucca Mountain, Nevada

Science.gov (United States)

Peterman, Z.E.; Spengler, R.W.; Singer, F.R.; Dickerson, R.P.

1993-01-01

Reference stratigraphic sections near Yucca Mountain, Nevada were established and sampled in outcrop areas where the volcanic rocks have been minimally altered. Isotopic and trace element analyses obtained for these reference sections are baseline data for assessing the degree and extent of element mobility attendant with past zonal alteration of the rock mass. In agreement with earlier studies, zeolitization is shown to have occurred under wholesale open-system conditions. Calcium was increased by two three times the baseline values and strontium up to twenty times. In contrast, barium displays less variability, and the high-field strength elements zirconium and titanium were the least mobile during zeolitization. The data reported here establish the usefulness of reference sections of assessing past elements mobility. The information gained will be helpful in predicting possible future element mobility induced by thermally activated fluids in the near field of a potential repository.

Mechanics of the foot Part 2: A coupled solid-fluid model to investigate blood transport in the pathologic foot.

Science.gov (United States)

Mithraratne, K; Ho, H; Hunter, P J; Fernandez, J W

2012-10-01

A coupled computational model of the foot consisting of a three-dimensional soft tissue continuum and a one-dimensional (1D) transient blood flow network is presented in this article. The primary aim of the model is to investigate the blood flow in major arteries of the pathologic foot where the soft tissue stiffening occurs. It has been reported in the literature that there could be up to about five-fold increase in the mechanical stiffness of the plantar soft tissues in pathologic (e.g. diabetic) feet compared with healthy ones. The increased stiffness results in higher tissue hydrostatic pressure within the plantar area of the foot when loaded. The hydrostatic pressure acts on the external surface of blood vessels and tend to reduce the flow cross-section area and hence the blood supply. The soft tissue continuum model of the foot was modelled as a tricubic Hermite finite element mesh representing all the muscles, skin and fat of the foot and treated as incompressible with transversely isotropic properties. The details of the mechanical model of soft tissue are presented in the companion paper, Part 1. The deformed state of the soft tissue continuum because of the applied ground reaction force at three foot positions (heel-strike, midstance and toe-off) was obtained by solving the Cauchy equations based on the theory of finite elasticity using the Galerkin finite element method. The geometry of the main arterial network in the foot was represented using a 1D Hermite cubic finite element mesh. The flow model consists of 1D Navier-Stokes equations and a nonlinear constitutive equation to describe vessel radius-transmural pressure relation. The latter was defined as the difference between the fluid and soft tissue hydrostatic pressure. Transient flow governing equations were numerically solved using the two-step Lax-Wendroff finite difference method. The geometry of both the soft tissue continuum and arterial network is anatomically-based and was developed using

Footwear used by older people and a history of hyperkeratotic lesions on the foot: A prospective observational study.

Science.gov (United States)

Palomo-López, Patricia; Becerro-de-Bengoa-Vallejo, Ricardo; Losa-Iglesias, Marta Elena; Rodríguez-Sanz, David; Calvo-Lobo, César; López-López, Daniel

2017-04-01

Inadequate footwear, painful and hyperkeratotic lesions (HL) are an extremely common problems amongst older people. Such problems increase the risk of falls, hamper mobility, reduction of quality of life, dignity, and ability to remain independent. The etiology of painful and feet conditions is poorly understood.To discover footwear preferences of older people, pain tolerance may favor presence of HL for the use of inadequate footwear in old age.A sample of 100 participants with a mean age of 74.90 ± 7.01 years attended an outpatient clinic where self-reported demographic data, frequency with which they checked their feet were recorded and measurements were taken of foot sensitivity. Additionally, all participants' shoes were allocated into optimal, adequate, and dangerous categories based on design, structural and safety features, and materials.Only 12% of the sample population checked their feet every day, 37% revealed symptoms of neuropathy, 14% used optimal shoes, and 61% presented HL. In a bivariate analysis, no significant differences were observed.HL are associated with inadequate footwear, loss of sensitivity, and low frequency of foot health checks.

The influence of the program of prophylaxis of flat foot on the biomechanics characteristics of foot of children of pre-school age

Directory of Open Access Journals (Sweden)

Bychuk I.O.

2011-02-01

Full Text Available In the article is defined linear and angular biomechanics descriptions of children's foot of senior preschool age. It is analysed the dynamics and increase of the explored indexes during realization of the program of prophylaxis of flat foot in the teaching process. In experiment took part teachers and instructors of physical culture; control and experimental group consist of 20 children at the age of 5-6 years old. Efficiency of the offered program of prophylaxis of flat foot is proved.

Finite element modeling of a 3D coupled foot-boot model.

Science.gov (United States)

Qiu, Tian-Xia; Teo, Ee-Chon; Yan, Ya-Bo; Lei, Wei

2011-12-01

Increasingly, musculoskeletal models of the human body are used as powerful tools to study biological structures. The lower limb, and in particular the foot, is of interest because it is the primary physical interaction between the body and the environment during locomotion. The goal of this paper is to adopt the finite element (FE) modeling and analysis approaches to create a state-of-the-art 3D coupled foot-boot model for future studies on biomechanical investigation of stress injury mechanism, foot wear design and parachute landing fall simulation. In the modeling process, the foot-ankle model with lower leg was developed based on Computed Tomography (CT) images using ScanIP, Surfacer and ANSYS. Then, the boot was represented by assembling the FE models of upper, insole, midsole and outsole built based on the FE model of the foot-ankle, and finally the coupled foot-boot model was generated by putting together the models of the lower limb and boot. In this study, the FE model of foot and ankle was validated during balance standing. There was a good agreement in the overall patterns of predicted and measured plantar pressure distribution published in literature. The coupled foot-boot model will be fully validated in the subsequent works under both static and dynamic loading conditions for further studies on injuries investigation in military and sports, foot wear design and characteristics of parachute landing impact in military. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

Combined treatments of heat, irradiation, and pH effects on infectivity of foot-and-mouth disease virus in bovine tissues

International Nuclear Information System (INIS)

Lasta, J.; Blackwell, J.H.; Sadir, A.; Gallinger, M.; Marcoveccio, F.; Zamorano, M.; Ludden, B.; Rodriguez, R.

1992-01-01

Various traditional methods for processing meat products were examined for their virucidal effects on the A, O, and C serotypes of foot-and-mouth disease virus. Aging, curing, heating at 78 degrees C for 20 min or irradiation (1.5 Mrad, 2.4 Mrad) that did not alter the sensory characteristics of the product were used singly or in combination. The only processing treatment that was virucidal was the combination of heat and gamma irradiation

Foot ulcers in the diabetic patient, prevention and treatment

Directory of Open Access Journals (Sweden)

Stephanie C Wu

2007-03-01

Full Text Available Stephanie C Wu1, Vickie R Driver1, James S Wrobel2, David G Armstrong21Center for Lower Extremity Ambulatory Research,William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, and National Center of Limb Salvage, Advocate Lutheran General Hospital, Chicago, IL, USA; 2Center for Lower Extremity Ambulatory Research, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine, Chicago, IL, USAAbstract: Lower extremity complications in persons with diabetes have become an increasingly significant public health concern in both the developed and developing world. These complications, beginning with neuropathy and subsequent diabetic foot wounds frequently lead to infection and lower extremity amputation even in the absence of critical limb ischemia. In order to diminish the detrimental consequences associated with diabetic foot ulcers, a common-sense-based treatment approach must be implemented. Many of the etiological factors contributing to the formation of diabetic foot ulceration may be identified using simple, inexpensive equipment in a clinical setting. Prevention of diabetic foot ulcers can be accomplished in a primary care setting with a brief history and screening for loss of protective sensation via the Semmes-Weinstein monofilament. Specialist clinics may quantify neuropathy, plantar foot pressure, and assess vascular status with Doppler ultrasound and ankle-brachial blood pressure indices. These measurements, in conjunction with other findings from the history and physical examination, may enable clinicians to stratify patients based on risk and help determine the type of intervention. Other effective clinical interventions may include patient education, optimizing glycemic control, smoking cessation, and diligent foot care. Recent technological advanced combined with better understanding of the wound healing process have resulted in a myriad of advanced

Diabetic Foot Risk Factors in Patients with Diabetes at the

Directory of Open Access Journals (Sweden)

R. Hosseini

2008-10-01

Full Text Available Background and Objectives Diabetic foot problems are one of the major causes of mortality and disability in diabetic patients. It is considered one of the costliest conditions for health care systems. This study is designed to identify diabetic foot risk factors in patients with diabetes mellitus at Kamkar Hospital diabetes clinic in Qom, Iran during 2006.MethodsThis study was performed on 140 diabetes mellitus patients at the Kamkar Hospital diabetic clinic. International working Group on the Diabetic Foot (IWGDF guidelines were used for physical exam of diabetic foot in these patients. The physical exam consisted of inspection of foot appearance for deformity, skin keratosis and ulcer, and neurological and arterial pulse exam of the lower extremities of these patients. Patients in this study were divided into four risk groups based on the IWGDF guidelines. ANOVA method was used for analysis and comparison of the results with P<0.05 considered as significant. ResultsMean age of the participants in this study was 52.4±11.2 years old from which 67.1% were female, 37.1% of patients were illiterate, and 10% were active smokers. Mean duration of diabetes in these patients was 8.9 years. Mean body mass index (BMI was 29.4± 4.4 and HbA1C was 9.3 ± 1.9. Percentages of the patients with retinopathy and nephropathy were 33.6% and 17.7% respectively. 95% of the patients did not know the correct way of nail clipping, 95.5% were wearing uncomfortable shoes, and 14.3% of patients had history of foot ulcer. None of the them had any education about foot care. Physical examination with monofilament, ankle reflex and vibration perception were defected in 28.6%, 52.5%, and 32.1% of patients respectively. 37.7% of patients had a decreased lower extremity pulse that was not felt by touch. Based on the IWGDF classifications, 70% of the patients were in the higher-risk group for diabetic foot ulcer. In the high risk group, age, duration of diabetes, illiteracy was

Assessment of Lumped-Parameter Models for Rigid Footings

DEFF Research Database (Denmark)

Andersen, Lars

2010-01-01

and vertical translations as well as torsion and rocking, and the necessity of coupling between horizontal sliding and rocking is discussed. Most of the analyses are carried out for hexagonal footings; but in order to generalise the conclusions to a broader variety of footings, comparisons are made...

Risk factors for developing diabetic foot

Directory of Open Access Journals (Sweden)

Julia Estela Willrich Boell

2014-06-01

Full Text Available The goal of the present study is to identify the risk factors for developing diabetic foot. A cross-sectional study, with a convenience sample, developed with 70 individuals with diabetes mellitus (DM, registered in three basic health units in the municipality of Florianópolis/SC, Brazil, in the period from November 2010 to May 2011. Biometric data was collected regarding their sociodemographic, health and illness conditions. An assessment of the feet was also carried out. The average participant age was 66.17 years and time with diagnosed disease was under ten years (61.42%. The following risk factors were identified: advanced age; time of DM diagnosis; few years of schooling; overweight/obesity; inadequate diet; physical inactivity; inadequate metabolic control; lack of proper and specific foot care; and arterial hypertension. We conclude that the majority of the population presented one or more risk factors that favor the appearance of foot-related complications. doi: 10.5216/ree.v16i2.20460.

Off-label prescriptions in diabetic foot

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Luís Jesuíno de Oliveira Andrade

2014-09-01

Full Text Available Prescription of a drug outside of the indications for which it was originally approved by regulators is internationally known as "off-label" prescription. We describe off-label treatments for the diabetic foot reported in international scientific literature. This is a qualitative and descriptive bibliographical review based on the results of a search of the Medline international database. The criteria for review were publication between January 1985 and November 2013, and the MeSH (Medical Subject Heading keywords "off-label use" OR "off-label" OR "off-label prescribing" plus "diabetic foot" were input on the search form. Nine studies were selected that contained information about off-label treatments for the diabetic foot. We conclude that the practice of off-label prescribing has potential benefits. In some situations an off-label prescription is the only treatment available for patients, either because a more targeted drug does not exist, or because other methods of treatment are ineffective or unavailable due to patient intolerance.

Managing the diabetic foot in resource-poor settings: challenges and solutions

Directory of Open Access Journals (Sweden)

Abbas ZG

2017-10-01

Full Text Available Zulfiqarali G Abbas1,2 1Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 2Department of Internal Medicine, Abbas Medical Centre, Dar es Salaam, Tanzania Abstract: Diabetes mellitus is one of the most common noncommunicable diseases globally. In Africa, rates of diabetes are increasing, so there is a parallel increase of foot complications. Peripheral neuropathy is the main risk factor for foot ulceration in people with diabetes in developing nations, but peripheral arterial disease is also increasing in number owing to the change in lifestyle and increasing urbanization. Ulceration arising from peripheral neuropathy, peripheral arterial disease, and trauma are highly susceptible to secondary infection and gangrene, and are hence associated with increased morbidity and mortality. Government funding is very limited in many developing countries, and diabetes and its complications impose a heavy burden on health services. In particular, the outcomes of foot complications are often poor, and this is the result of various factors including lack of awareness of the need for foot care among patients, relatives, and health care providers; relatively few professionals with an interest in the diabetic foot and with the training to provide specialist treatment; nonexistent podiatry services; long distances for patients to travel to the clinic; delays among patients in seeking medical care, or the late referral of patients for specialist opinion; and lack of the awareness of the importance of a team approach to care, and the lack of training programs for health care professionals. Many of these can, however, potentially be tackled without exorbitant spending of financial resources. Cost-effective educational efforts should be targeted at both health care workers and patients. These include implementation of sustainable training programs for health care professionals with a special interest in foot

Bone tumors of the pediatric foot: imaging appearances

Energy Technology Data Exchange (ETDEWEB)

Caro-Dominguez, Pablo; Navarro, Oscar M. [University of Toronto, Department of Medical Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

2017-05-15

Tumors of the foot are rare in children. This review illustrates radiographic, CT and MR imaging findings of foot bone tumors in children based on all cases presented in a tertiary pediatric hospital during the 15-year period of 1999-2014. This search revealed 155 tumors of the foot, 72 of the bones and 83 of the soft tissues. Osteochondroma, bone cyst and fibrous dysplasia were the most frequent benign bone lesions. Ewing sarcoma was the most common malignant osseous tumor. Some tumors showed higher prevalence in certain age ranges and others showed predilection for specific bones. Radiographs are useful for diagnosis in the majority of cases but CT and MR imaging provide additional valuable information in select cases for diagnosis and determining extent of the lesions. Radiologists should be aware of some typical imaging findings in bone tumors of the foot in order to establish diagnosis and facilitate patient management. (orig.)

Cold immersion recovery responses in the diabetic foot with neuropathy.

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Bharara, Manish; Viswanathan, Vijay; Cobb, Jonathan E

2008-10-01

The aim of this article was to investigate the effectiveness of testing cold immersion recovery responses in the diabetic foot with neuropathy using a contact thermography system based on thermochromic liquid crystals. A total of 81 subjects with no history of diabetic foot ulceration were assigned to neuropathy, non neuropathy and healthy groups. Each group received prior verbal and written description of the test objectives and subsequently underwent a comprehensive foot care examination. The room temperature and humidity were consistently maintained at 24 degrees C and less than 50%, respectively, with air conditioning. The right foot for each subject was located on the measurement platform after cold immersion in water at 18-20 degrees C. Whole-field thermal images of the plantar foot were recorded for 10 minutes. Patients with diabetes with neuropathy show the highest 'delta temperature', that is difference between the temperature after 10-minute recovery period and baseline temperature measured independently at all the three sites tested, that is first metatarsal head (MTH), second MTH and heel. This clinical study showed for the first time the evidence of poor recovery times for the diabetic foot with neuropathy when assessing the foot under load. A temperature deficit (because of poor recovery to baseline temperature) suggests degeneration of thermoreceptors, leading to diminished hypothalamus-mediated activity in the diabetic neuropathic group.

Anaplerosis in Complex Treatment of Patients with Diabetic Foot Syndrome

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B.G. Bezrodny

2015-05-01

Full Text Available The article describes the improvement of anaplerosis in patients with diabetic foot syndrome using skin flaps on vascular pedicle of the perforating vessels. The study involved patients with type 2 diabetes mellitus complicated with diabetic foot syndrome of neuroischemic form and chronic wounds of the lower extremities that do not heal for more than 21 days from the date of occurrence. The wounds were cleaned with ultrasonic cavitation. There was applied bandage with sorption antibacterial remedy base on nanodispersed silicon dioxide. There was applied a drainage vacuum bandage on a wound on the third day (VAC therapy. The flap is forming fitting to the size and configuration of a wound on a foot. Fourteen patients (93 % in the basic group were found to have survived flaps. Long-term follow up in 6 months demonstrated full maintenance of supporting function and good survived skin graft, absence of foot ulcers. In a control group 7 patients had recurrent foot ulcer. Improved techniques of autodermoplasty in patients with diabetic foot syndrome include glycemia control, preparation of a wound using vacuum apparatus bandage. Usage of split-skin graft combined with vacuum apparatus bandage allows close acute and chronic wounds effectively, maintain supporting function of an extremity, decrease in-hospital staying, and improve quality of patient’s life. Adequate foot wound closure prevents high-level amputation of low extremities in diabetic patients.

The reliability of the Adelaide in-shoe foot model.

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Bishop, Chris; Hillier, Susan; Thewlis, Dominic

2017-07-01

Understanding the biomechanics of the foot is essential for many areas of research and clinical practice such as orthotic interventions and footwear development. Despite the widespread attention paid to the biomechanics of the foot during gait, what largely remains unknown is how the foot moves inside the shoe. This study investigated the reliability of the Adelaide In-Shoe Foot Model, which was designed to quantify in-shoe foot kinematics and kinetics during walking. Intra-rater reliability was assessed in 30 participants over five walking trials whilst wearing shoes during two data collection sessions, separated by one week. Sufficient reliability for use was interpreted as a coefficient of multiple correlation and intra-class correlation coefficient of >0.61. Inter-rater reliability was investigated separately in a second sample of 10 adults by two researchers with experience in applying markers for the purpose of motion analysis. The results indicated good consistency in waveform estimation for most kinematic and kinetic data, as well as good inter-and intra-rater reliability. The exception is the peak medial ground reaction force, the minimum abduction angle and the peak abduction/adduction external hindfoot joint moments which resulted in less than acceptable repeatability. Based on our results, the Adelaide in-shoe foot model can be used with confidence for 24 commonly measured biomechanical variables during shod walking. Copyright © 2017 Elsevier B.V. All rights reserved.

The effect of age and speed on foot and ankle kinematics assessed using a 4-segment foot model.

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van Hoeve, Sander; Leenstra, Bernard; Willems, Paul; Poeze, Martijn; Meijer, Kenneth

2017-09-01

The effects of age and speed on foot and ankle kinematics in gait studies using foot models are not fully understood, whereas this can have significant influence. We analyzed these variables with the 4-segment Oxford foot model. Twenty-one healthy subjects (aged 20-65 years) were recruited for gait analysis. The effect of speed on foot and ankle kinematics was assessed by comparing results during slow walking and fast walking. To assess the effect of age, a group of 13 healthy young adults (aged 20-24 years) were compared with a group of 8 older adults (aged 53-65 years). Also, the interaction between age and speed was analyzed. Regarding speed, there was a significant difference between forefoot/hindfoot motion in the sagittal plane (flexion/extension) during both loading- and push-off phase (P = .004, P < .001). Between hindfoot/tibia, there was a significant difference for all parameters except for motion in the sagittal plane (flexion/extension) during push-off phase (P = .5). Age did not significantly influence kinematics. There was no interaction between age and speed. Our analysis found that speed significantly influenced the kinematic outcome parameters. This was more pronounced in the ankle joint. In contrast, no significant differences were found between younger and older healthy subjects.

The effect of age and speed on foot and ankle kinematics assessed using a 4-segment foot model

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van Hoeve, Sander; Leenstra, Bernard; Willems, Paul; Poeze, Martijn; Meijer, Kenneth

2017-01-01

Abstract Background: The effects of age and speed on foot and ankle kinematics in gait studies using foot models are not fully understood, whereas this can have significant influence. We analyzed these variables with the 4-segment Oxford foot model. Methods: Twenty-one healthy subjects (aged 20–65 years) were recruited for gait analysis. The effect of speed on foot and ankle kinematics was assessed by comparing results during slow walking and fast walking. To assess the effect of age, a group of 13 healthy young adults (aged 20–24 years) were compared with a group of 8 older adults (aged 53–65 years). Also, the interaction between age and speed was analyzed. Results: Regarding speed, there was a significant difference between forefoot/hindfoot motion in the sagittal plane (flexion/extension) during both loading- and push-off phase (P = .004, P push-off phase (P = .5). Age did not significantly influence kinematics. There was no interaction between age and speed. Conclusion: Our analysis found that speed significantly influenced the kinematic outcome parameters. This was more pronounced in the ankle joint. In contrast, no significant differences were found between younger and older healthy subjects. PMID:28858109

Ankle and foot tuberculosis: A diagnostic dilemma

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Biswaranjan Nayak

2014-01-01

Full Text Available Aim and Objective: To know the biological behavior of ankle and foot tuberculosis (AFTB and to know the reasons for delay in diagnosis and treatment of AFTB in our population. Materials and Methods: Patients with non-healing ulcers/sinuses/swellings in the ankle and foot region are the subjects of present study. Detailed clinical history, physical examination and relevant investigations were done in all cases. Pus/wound discharge for acid fast bacillus (AFB study and biopsy from wound margin/sinus tract was taken in all the cases. Results: During the period from July 2007-June 2012, 20 cases of AFTB were treated. Out of them five cases were difficult to diagnose and a mean period of 6 month to 5year was elapsed before final diagnosis was established. Out of these five cases - three cases were diabetic with ulcers and sinuses in the heel and ankle region. One case was wrongly diagnosed as angiodysplasia with A-V malformation of foot and diagnosis was delayed for 5 year. In one case of rheumatoid arthritis with abscess in ankle joint, the diagnosis was delayed for 1year. Conclusion: AFTB is very rare condition. AFTB is suspected in cases with long standing pain/swelling/discharging sinus in the foot and thorough investigations is must to differentiate from other foot diseases. Diagnosis is delayed due to lack of clinical suspicion and non-confirmatory biopsy reports. Early diagnosis and ATT for 9-18 months is must in all cases of AFTB to prevent joint involvement and other complications.

Olfactory aversive conditioning alters olfactory bulb mitral/tufted cell glomerular odor responses

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Max L Fletcher

2012-03-01

Full Text Available The anatomical organization of receptor neuron input into the olfactory bulb (OB allows odor information to be transformed into an odorant-specific spatial map of mitral/tufted cell glomerular activity at the upper level of the olfactory bulb. In other sensory systems, neuronal representations of stimuli can be reorganized or enhanced following learning. While the mammalian OB has been shown to undergo experience-dependent plasticity at the glomerular level, it is still unclear if similar representational change occurs within mitral/tufted cell glomerular odor representations following learning. To address this, odorant-evoked glomerular activity patterns were imaged in mice expressing a GFP-based calcium indicator (GCaMP2 in OB mitral/tufted cells. Glomerular odor responses were imaged before and after olfactory associative conditioning to aversive foot shock. Following conditioning, we found no overall reorganization of the glomerular representation. Training, however, did significantly alter the amplitudes of individual glomeruli within the representation in mice in which the odor was presented together with foot shock. Further, the specific pairing of foot shock with odor presentations lead to increased responses primarily in initially weakly activated glomeruli. Overall, these results suggest that associative conditioning can enhance the initial representation of odors within the olfactory bulb by enhancing responses to the learned odor in some glomeruli.

Australian Diabetes Foot Network: management of diabetes-related foot ulceration - a clinical update.

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Bergin, Shan M; Gurr, Joel M; Allard, Bernard P; Holland, Emma L; Horsley, Mark W; Kamp, Maarten C; Lazzarini, Peter A; Nube, Vanessa L; Sinha, Ashim K; Warnock, Jason T; Alford, Jan B; Wraight, Paul R

2012-08-20

Appropriate assessment and management of diabetes-related foot ulcers (DRFUs) is essential to reduce amputation risk. Management requires debridement, wound dressing, pressure off-loading, good glycaemic control and potentially antibiotic therapy and vascular intervention. As a minimum, all DRFUs should be managed by a doctor and a podiatrist and/or wound care nurse. Health professionals unable to provide appropriate care for people with DRFUs should promptly refer individuals to professionals with the requisite knowledge and skills. Indicators for immediate referral to an emergency department or multidisciplinary foot care team (MFCT) include gangrene, limb-threatening ischaemia, deep ulcers (bone, joint or tendon in the wound base), ascending cellulitis, systemic symptoms of infection and abscesses. Referral to an MFCT should occur if there is lack of wound progress after 4 weeks of appropriate treatment.

Foot mobility and plantar fascia elasticity in patients with plantar fasciitis.

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Sahin, Namık; Oztürk, Alpaslan; Atıcı, Teoman

2010-01-01

In this study, we investigated the radiologic changes of feet in sagittal plane under weightbearing either with or without plantar fasciitis. The study includes 64 feet of the 42 subjects with heel pain (Group 1: 32 women, 10 men, mean age 48 years, range 33-57 years) and 80 feet of the 40 patients (Group 2: 30 women, 10 men, mean age 47.2 years, range 35-56 years) without heel pain. Calcaneal inclination angle (CIA), calcaneal-first metatarsal angle (CMA), and plantar fascia length (PFL) were measured in the lateral radiographs of the weightbearing and non-weightbearing foot. The values of Group 1 and Group 2 were compared. The mean CIA was 26° (range 18-35°), CMA was 121° (range 115-133°), and PFL was 131 mm (range 110-158 mm) in non-weightbearing position for Group 1. The mean CIA was 27° (range 17-38°), CMA was 122° (range 110-135°), and PFL was 136 mm (range 120-155 mm) in non-weightbearing position for Group 2. The mean CIA was 13.6° (range 5-25°), CMA was 138° (range 130-153°), and PFU was 143.8 mm (range 118-158 mm) in weightbearing position for Group 1. The mean CIA was 9.9° (range 4-25°), CMA was 145° (range 130-155°), and PFU was 151.4 mm (range 137-167 mm) in weightbearing position for Group 2. The difference between CIA, CMA, and PFL values were -13°, 17°, and 12 mm under condition of weightbearing and nonweightbearing position values for Group 1; and -17°, 23°, and 15 mm for Group 2. The differences were significant between weightbearing and non-weightbearing position values (pplantar fascia elasticity, which may lead to posterior heel pain syndrome.

Patients With Diabetic Foot Disease Fear Major Lower-Extremity Amputation More Than Death.

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Wukich, Dane K; Raspovic, Katherine M; Suder, Natalie C

2018-02-01

The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations. The control group (N = 254) was comprised of patients with diabetes who presented with common non-diabetes-related foot pathology. A total of 461 patients were enrolled in this study and included 254 patients without diabetic foot complications and 207 patients with diabetic foot problems. When comparing patients with and without diabetic disease, no significant differences were observed with regard to their fear of blindness, DFI, or ESRD requiring dialysis. Patients with diabetic foot disease (61 of 207, 31.9%) were 136% more likely (odds ratio [OR] = 2.36; 95% CI = 1.51-3.70; P = .002] to rank major LEA as their greatest fear when compared with diabetic patients without foot disease (42 of 254, 16.5%) and were 49% less likely (OR = 0.51; 95% CI = 0.34-0.79; P = .002) to rank death as their greatest fear compared with patients without diabetic foot disease. Patients with diabetic foot pathology fear major LEA more than death, foot infection, or ESRD. Variables that were associated with ranking LEA as the greatest fear were the presence of a diabetic-related foot complication, duration of DM ≥10 years, insulin use, and the presence of peripheral neuropathy. Level II: Prospective, Case controlled study.