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Sample records for chronic plantar heel

  1. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis

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    Barrett Joanna T

    2009-11-01

    Full Text Available Abstract Background Chronic plantar heel pain (CPHP is a generalised term used to describe a range of undifferentiated conditions affecting the plantar heel. Plantar fasciitis is reported as the most common cause and the terms are frequently used interchangeably in the literature. Diagnostic imaging has been used by many researchers and practitioners to investigate the involvement of specific anatomical structures in CPHP. These observations help to explain the underlying pathology of the disorder, and are of benefit in forming an accurate diagnosis and targeted treatment plan. The purpose of this systematic review was to investigate the diagnostic imaging features associated with CPHP, and evaluate study findings by meta-analysis where appropriate. Methods Bibliographic databases including Medline, Embase, CINAHL, SportDiscus and The Cochrane Library were searched electronically on March 25, 2009. Eligible articles were required to report imaging findings in participants with CPHP unrelated to inflammatory arthritis, and to compare these findings with a control group. Methodological quality was evaluated by use of the Quality Index as described by Downs and Black. Meta-analysis of study data was conducted where appropriate. Results Plantar fascia thickness as measured by ultrasonography was the most widely reported imaging feature. Meta-analysis revealed that the plantar fascia of CPHP participants was 2.16 mm thicker than control participants (95% CI = 1.60 to 2.71 mm, P P = 0.01. CPHP participants were also more likely to show radiographic evidence of subcalcaneal spur than control participants (OR = 8.52, 95% CI = 4.08 to 17.77, P Conclusion This systematic review has identified 23 studies investigating the diagnostic imaging appearance of the plantar fascia and inferior calcaneum in people with CPHP. Analysis of these studies found that people with CPHP are likely to have a thickened plantar fascia with associated fluid collection, and that

  2. Dry needling in patients with chronic heel pain due to plantar fasciitis: A single-blinded randomized clinical trial

    Science.gov (United States)

    Eftekharsadat, Bina; Babaei-Ghazani, Arash; Zeinolabedinzadeh, Vahideh

    2016-01-01

    Background: This study examined the effects of dry needling on chronic heel pain due to plantar fasciitis. Methods: During this single-blinded clinical trial, 20 eligible patients were randomized into two groups: A case group treated with dry needling and a control group. Patients’ plantar pain severity, (using modified visual analog scale [VAS] scoring system), range of motion of ankle joint in dorsiflexion [ROMDF] and plantar extension[ROMPE] and foot function index (using standard questionnaires of SEM5 and MDC7) were assessed at baseline, four weeks after intervention and four weeks after withdrawing treatment. Independent sample t-test, Mann-Whitney U test, paired t-test, Wilcoxon signed rank tests, and chi square test were used for data analysis. Results: The mean VAS scores in the case group was significantly lower than the control group after four weeks of intervention (pdry needling, by improving the severity of heel pain, can be used as a good alternative option before proceeding to more invasive therapies of plantar fasciitis. PMID:27683642

  3. Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study

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    Young Mark A

    2007-05-01

    Full Text Available Abstract Background Chronic plantar heel pain (CPHP is one of the most common musculoskeletal disorders of the foot, yet its aetiology is poorly understood. The purpose of this study was to examine the association between CPHP and a number of commonly hypothesised causative factors. Methods Eighty participants with CPHP (33 males, 47 females, mean age 52.3 years, S.D. 11.7 were matched by age (± 2 years and sex to 80 control participants (33 males, 47 females, mean age 51.9 years, S.D. 11.8. The two groups were then compared on body mass index (BMI, foot posture as measured by the Foot Posture Index (FPI, ankle dorsiflexion range of motion (ROM as measured by the Dorsiflexion Lunge Test, occupational lower limb stress using the Occupational Rating Scale and calf endurance using the Standing Heel Rise Test. Results Univariate analysis demonstrated that the CPHP group had significantly greater BMI (29.8 ± 5.4 kg/m2 vs. 27.5 ± 4.9 kg/m2; P P P 2 (OR 2.9, 95% CI 1.4 – 6.1, P P Conclusion Obesity and pronated foot posture are associated with CPHP and may be risk factors for the development of the condition. Decreased ankle dorsiflexion, calf endurance and occupational lower limb stress may not play a role in CPHP.

  4. Getting to the heel of the problem: plantar fascia lesions

    International Nuclear Information System (INIS)

    Heel pain is a frequent disabling symptom. Clinical diagnosis is often difficult with a large range of possible diagnoses. Lesions of the plantar fascia form an important group. We present a review describing the common lesions of the plantar fascia, including plantar fasciitis, plantar fascia rupture, plantar fibromatosis, and plantar xanthoma, and illustrate them with appropriate magnetic resonance imaging (MRI) and ultrasound imaging. We also address foreign-body reactions, enthesopathy, and diabetic fascial disease.

  5. Getting to the heel of the problem: plantar fascia lesions

    Energy Technology Data Exchange (ETDEWEB)

    Jeswani, T. [Department of Radiology, Worthing and Southlands Hospitals, West Sussex (United Kingdom); Morlese, J. [Department of Radiology, Royal Free Hospital, Pond street, London, NW3 2QG (United Kingdom); McNally, E.G. [Department of Radiology, Nuffield Orthopaedic Centre, Oxford (United Kingdom)], E-mail: eugene.mcnally@gmail.com

    2009-09-15

    Heel pain is a frequent disabling symptom. Clinical diagnosis is often difficult with a large range of possible diagnoses. Lesions of the plantar fascia form an important group. We present a review describing the common lesions of the plantar fascia, including plantar fasciitis, plantar fascia rupture, plantar fibromatosis, and plantar xanthoma, and illustrate them with appropriate magnetic resonance imaging (MRI) and ultrasound imaging. We also address foreign-body reactions, enthesopathy, and diabetic fascial disease.

  6. Plantar Pressure Variation during Jogging with Different Heel Height

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    Y. D. Gu

    2013-01-01

    Full Text Available This paper presents the key testing and analysis results of an investigation on the effect of heel height on the plantar pressure over different foot areas in jogging. It is important in improving the understanding of jogging with high heels and damage/injury prevention. It can also potentially guide the development of suitable/adaptive exercise schemes in between daily activities with high heels. In this work, plantar pressure data were collected from 10 habituated healthy female subjects (aged 21–25 years at their natural jogging speed with three different conditions: flat heeled shoes (0.8 cm, low heeled shoes (4.0 cm, and high heeled shoes (6.6 cm. Data analysis showed significantly differences in plantar pressure distribution associated with the heel heights with increased pressure in the first metatarsal region and decreased pressure in the lateral metatarsal and midfoot sections. However, there is no significant alteration of plantar pressure in the central area of the forefoot with jogging gait.

  7. Customized heel pads and soft orthotics to treat heel pain and plantar fasciitis.

    Science.gov (United States)

    Seligman, Deborah A; Dawson, Deirdre R

    2003-10-01

    We describe the design of a new cost-effective, comfortable orthotic designed to treat heel pain associated with plantar fasciitis. The heel pad is fabricated from a 4 degrees Sorbothane medial wedge with a customized insertion of low-density Plastazote. The orthotic is medium-density Plastazote reinforced with cork in the medial longitudinal arch. One pair of orthotics takes less than 1 hour to make. Pilot data were collected retrospectively to evaluate the efficacy of the orthotic for reducing pain. Ten clients at a hand and foot orthotic clinic with a mean age of 71+/-9.1 years and with unilateral or bilateral heel pain associated with plantar fasciitis were provided with customized heel pads and soft, molded orthotics at their initial visit. Pain levels were recorded with verbal and Likert-type scales. After 5 weeks of heel pad and orthotic use, all patients showed a reduction in pain, with the overall reduction being highly significant (Pheel pads and soft molded orthotics are an effective first-line treatment for the heel pain and loss of function associated with plantar fasciitis. PMID:14586928

  8. Comparison Of Medial Arch-Supporting Insoles And Heel Pads In The Treatment Of Plantar Fasciitis

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    Malkoc Melih

    2015-03-01

    Full Text Available Plantar fasciitis is a disorder caused by inflammation of the insertion point of the plantar fascia over the medial tubercle of the calcaneus. Foot orthotics are used to treat plantar fasciitis. Heel pads medialise the centre of force, whereas medial arch supporting insoles lateralise the force. We assessed the clinical results of the treatment of plantar fasciitis with silicone heel pads and medial arch-supported silicone insoles.

  9. Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review

    OpenAIRE

    Cotchett Matthew P; Landorf Karl B; Munteanu Shannon E

    2010-01-01

    Abstract Background Plantar heel pain (plantar fasciitis) is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs) however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. Methods We searched specific electronic data...

  10. An optimized design of in-shoe heel lifts reduces plantar pressure of healthy males.

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    Zhang, Xianyi; Li, Bo; Liang, Kaiyun; Wan, Qiufeng; Vanwanseele, Benedicte

    2016-06-01

    Conventional heel lift with a flat surface increases the risk of foot problems related to higher plantar pressure and decreased stability. In this study, an optimized design of in-shoe heel lifts developed to maintain the midfoot function was tested to investigate if the plantar pressure distribution was improved. The design was based on three dimensional foot plantar contour which was captured by an Infoot 3D scanning system while the heel was elevated by a heel wedge. To facilitate midfoot function, an arch support was designed to support the lateral longitudinal arch, while allowing functional movement of the medial longitudinal arch. Twenty healthy male subjects were asked to walk along an 8m walkway while wearing high-cut footwear with and without the optimized heel lift. Peak pressure, contact area and force-time integral were measured using the Pedar insole system. Range and velocity of medial-lateral center of pressure during forefoot contact phase and foot flat phase were collected using a Footscan pressure plate. Compared to the shoe only condition, peak pressure under the rearfoot decreased with the optimized heel lift, while no increase of peak pressure was observed under the forefoot and midfoot regions, indicating improved plantar pressure distribution. The findings of this study suggest that this optimized heel lift has better biomechanical performance than a conventional flat heel lift. Results from this study may have implications for insole and shoe last design, especially for people who need additional heel height without sacrificing midfoot function.

  11. Regional plantar foot pressure distributions on high-heeled shoes-shank curve effects

    Institute of Scientific and Technical Information of China (English)

    Yan Cong; Winson Lee; Ming Zhang

    2011-01-01

    Forefoot pain is common in high-heeled shoe wearers due to the high pressure caused by the center of body mass moving forward and the increased arch height with heel elevation.Sufficient arch support could reduce the high pressure over forefoot.However,too much arch support could lead to abnormal foot alignment and pain over midfoot.Little information is reported on the relationship among plantar arch height,shank curve design and plantar pressure.This study aimed at quantifying the plantar arch height changes at different heel heights and investigating the effect of shank curve on plantar pressure distribution.The plantar arch height increased to (7.6+1.3)mm at heel height of 75 mm.The Chinese standard suggests the depth of last should be 8.5 mm for heel height of 75 mm.When a shank curve with higher depth of last (11 mm) was used,the peak pressure over forefoot further decreased in midstance phase,which might ease the forefoot problems,while the peak pressure over midfoot increased but not exceeded the discomfort pressure thresholds.To achieve a more ideal pressure distribution in high-heeled shoes,a higher than expected depth of last would be suggested that would not cause discomfort over midfoot.

  12. The effect of different depths of medial heel skive on plantar pressures

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    Bonanno Daniel R

    2012-08-01

    Full Text Available Abstract Background Foot orthoses are often used to treat lower limb injuries associated with excessive pronation. There are many orthotic modifications available for this purpose, with one being the medial heel skive. However, empirical evidence for the mechanical effects of the medial heel skive modification is limited. This study aimed to evaluate the effect that different depths of medial heel skive have on plantar pressures. Methods Thirty healthy adults (mean age 24 years, range 18–46 with a flat-arched or pronated foot posture and no current foot pain or deformity participated in this study. Using the in-shoe pedar-X® system, plantar pressure data were collected for the rearfoot, midfoot and forefoot while participants walked along an 8 metre walkway wearing a standardised shoe. Experimental conditions included a customised foot orthosis with the following 4 orthotic modifications: (i no medial heel skive, (ii a 2 mm medial heel skive, (iii a 4 mm medial heel skive and (iv a 6 mm medial heel skive. Results Compared to the foot orthosis with no medial heel skive, statistically significant increases in peak pressure were observed at the medial rearfoot – there was a 15% increase (p = 0.001 with the 4 mm skive and a 29% increase (p  Conclusions This study found that a medial heel skive of 4 mm or 6 mm increases peak pressure under the medial rearfoot in asymptomatic adults with a flat-arched or pronated foot posture. Plantar pressures at the midfoot and forefoot were not altered by a medial heel skive of 2, 4 or 6 mm. These findings provide some evidence for the effects of the medial heel skive orthotic modification.

  13. Heel Pain

    Science.gov (United States)

    ... improperly fitted or excessively worn shoes, or obesity. Plantar Fasciitis: Both heel pain and heel spurs are frequently associated with plantar fasciitis, an inflammation of the band of fibrous connective ...

  14. Effectiveness of trigger point dry needling for plantar heel pain: study protocol for a randomised controlled trial

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    Landorf Karl B

    2011-01-01

    Full Text Available Abstract Background Plantar heel pain (plantar fasciitis is a common and disabling condition, which has a detrimental impact on health-related quality of life. Despite the high prevalence of plantar heel pain, the optimal treatment for this disorder remains unclear. Consequently, an alternative therapy such as dry needling is increasingly being used as an adjunctive treatment by health practitioners. Only two trials have investigated the effectiveness of dry needling for plantar heel pain, however both trials were of a low methodological quality. This manuscript describes the design of a randomised controlled trial to evaluate the effectiveness of dry needling for plantar heel pain. Methods Eighty community-dwelling men and woman aged over 18 years with plantar heel pain (who satisfy the inclusion and exclusion criteria will be recruited. Eligible participants with plantar heel pain will be randomised to receive either one of two interventions, (i real dry needling or (ii sham dry needling. The protocol (including needling details and treatment regimen was formulated by general consensus (using the Delphi research method using 30 experts worldwide that commonly use dry needling for plantar heel pain. Primary outcome measures will be the pain subscale of the Foot Health Status Questionnaire and "first step" pain as measured on a visual analogue scale. The secondary outcome measures will be health related quality of life (assessed using the Short Form-36 questionnaire - Version Two and depression, anxiety and stress (assessed using the Depression, Anxiety and Stress Scale - short version. Primary outcome measures will be performed at baseline, 2, 4, 6 and 12 weeks and secondary outcome measures will be performed at baseline, 6 and 12 weeks. Data will be analysed using the intention to treat principle. Conclusion This study is the first randomised controlled trial to evaluate the effectiveness of dry needling for plantar heel pain. The trial will

  15. The effectiveness of manual stretching in the treatment of plantar heel pain: a systematic review

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    Parish Ben

    2011-06-01

    Full Text Available Abstract Background Plantar heel pain is a commonly occurring foot complaint. Stretching is frequently utilised as a treatment, yet a systematic review focusing only on its effectiveness has not been published. This review aimed to assess the effectiveness of stretching on pain and function in people with plantar heel pain. Methods Medline, EMBASE, CINAHL, AMED, and The Cochrane Library were searched from inception to July 2010. Studies fulfilling the inclusion criteria were independently assessed, and their quality evaluated using the modified PEDro scale. Results Six studies including 365 symptomatic participants were included. Two compared stretching with a control, one study compared stretching to an alternative intervention, one study compared stretching to both alternative and control interventions, and two compared different stretching techniques and durations. Quality rating on the modified Pedro scale varied from two to eight out of a maximum of ten points. The methodologies and interventions varied significantly between studies, making meta-analysis inappropriate. Most participants improved over the course of the studies, but when stretching was compared to alternative or control interventions, the changes only reached statistical significance in one study that used a combination of calf muscle stretches and plantar fascia stretches in their stretching programme. Another study comparing different stretching techniques, showed a statistically significant reduction in some aspects of pain in favour of plantar fascia stretching over calf stretches in the short term. Conclusions There were too few studies to assess whether stretching is effective compared to control or other interventions, for either pain or function. However, there is some evidence that plantar fascia stretching may be more effective than Achilles tendon stretching alone in the short-term. Appropriately powered randomised controlled trials, utilizing validated outcome

  16. Application of electrophoresis of chlorine in the treatment of plantar fasciitis (prominent heel.

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    Filatova E.V.

    2014-12-01

    Full Text Available Aim: to determine the effectiveness of electrophoresis of chlorine in the treatment of patients with plantar fasciitis. Material and methods. Survey and treatment of 40 patients in out-patient treatment at a private medical clinic OOO «ЛЭЙТОНС» ("LEYTONS, LLC" of 45-65 years with "heel spur" (4 men and 36 women. Age of the disease varied from 6 months to several years. All patients' diagnosis was confirmed radiographically. Before and after the treatment there were tests: Visual analogue scale (VAS (scale from 0 to 100 points and dynamic test WAM, defines psychological component of pathology. Results: patients were divided into 3 groups according to type of therapy. In 1-St group was held on the heels of hydrocortisone phonophoresis, in the 2nd group of shock wave therapy; in 3rd group held electrophoresis 5% solution of calcium chloride on the heel with the cathode. In the 1st group pain after the treatment group stopped at 80% of the patients; in the group 2, with 83%; in the group 377% of the patients. Conclusion. Our study showed that the chlorine electrophoresis in patients with plantar fasciitis can be a choice in complex rehabilitation. Identification of adverse effects of therapy confirms the need for an integrated approach to treating patients with this pathology.

  17. Plantar Fasciitis

    Science.gov (United States)

    ... version Plantar Fasciitis Overview What is the plantar fascia? The plantar fascia is a band of tissue, much like a ... form the ball of your foot. The plantar fascia works like a rubber band between the heel ...

  18. Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Cotchett Matthew P

    2010-09-01

    Full Text Available Abstract Background Plantar heel pain (plantar fasciitis is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. Methods We searched specific electronic databases (MEDLINE, EMBASE, AMED, CINAHL, SPORTDiscus and AMI in April 2010 to identify randomised and non-randomised trials. We included trials where participants diagnosed with plantar heel pain were treated with dry needling and/or injections (local anaesthetics, steroids, Botulinum toxin A and saline alone or in combination with acupuncture. Outcome measures that focussed on pain and function were extracted from the data. Trials were assessed for quality using the Quality Index tool. Results Three quasi-experimental trials matched the inclusion criteria: two trials found a reduction in pain for the use of trigger point dry needling when combined with acupuncture and the third found a reduction in pain using 1% lidocaine injections when combined with physical therapy. However, the methodological quality of the three trials was poor, with Quality Index scores ranging form 7 to 12 out of a possible score of 27. A meta-analysis was not conducted because substantial heterogeneity was present between trials. Conclusions There is limited evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. However, the poor quality and heterogeneous nature of the included studies precludes definitive conclusions being made. Importantly, this review highlights the need for future trials to use rigorous randomised controlled methodology with measures such as blinding to reduce bias. We also recommend that such trials adhere to the

  19. 跖腱膜炎致跟痛症临床分析%Plantar fasciitis heel pain caused by Plantar aponeurositis

    Institute of Scientific and Technical Information of China (English)

    刘占奇

    2010-01-01

    Objective To investigate the etiology of heel pain.Methods 60 patients with pain plantar fascia in patients treated with needle knife.Results The plantar fascia to release results were satisfactory.Conclusion The incidence of pain with plantar fasciitis has close contact.%目的 探讨跟痛症的发病原因.方法 对60例跟痛症患者采用针刀松解跖腱膜治疗.结果 采取跖腱膜松解效果满意.结论 跟痛症的发病与跖腱膜炎有密切的联系.

  20. Plantar fasciitis

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    Mohammad Ali Tahririan

    2012-01-01

    Full Text Available Heel pain, mostly caused by plantar fasciitis (PF, is a common complaint of many patients who requiring professional orthopedic care and are mostly suffering from chronic pain beneath their heels. The present article reviews studies done by preeminent practitioners related to the anatomy of plantar fasciitis and their histo-pathological features, factors associated with PF, clinical features, imaging studies, differential diagnoses, and diverse treatment modalities for treatment of PF, with special emphasis on non-surgical treatment. Anti-inflammatory agents, plantar stretching, and orthosis proved to have highest priority; corticosteroid injection, night splints and extracorporeal shock wave therapy were of next priority, in patients with PF. In patients resistant to the mentioned treatments surgical intervention should be considered.

  1. Plantar fasciitis

    OpenAIRE

    Mohammad Ali Tahririan; Mehdi Motififard; Mohammad Naghi Tahmasebi; Babak Siavashi

    2012-01-01

    INTRODUCTION In this article we look at the aetiology of plantar fasciitis, the other common differentials for heel pain and the evidence available to support each of the major management options. We also review the literature and discuss the condition. METHODS A literature search was performed using PubMed and MEDLINE®. The following keywords were used, singly or in combination: ‘plantar fasciitis’, ‘plantar heel pain’, ‘heel spur’. To maximise the search, backward chaining of reference list...

  2. Endoscopic Plantar Fasciotomy: A Minimally Traumatic Procedure for Chronic Plantar Fasciitis

    OpenAIRE

    Hake, Daniel H.

    2000-01-01

    Endoscopic plantar fasciotomy (EPF) is a minimally invasive and minimally traumatic surgical treatment for the common problem of chronic plantar fasciitis. This procedure is indicated only for the release of the proximal medial aspect of the fascia in cases that do not respond to aggressive conservative, nonsurgical treatment. In the literature, an overall 87% success rate has been reported in 1228 procedures, in addition to an 83% success rate reported by Burke at the Northwest Podiatric Fou...

  3. The instep plantar fasciotomy for chronic plantar fasciitis. A retrospective review.

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    Fishco, W D; Goecker, R M; Schwartz, R I

    2000-02-01

    A retrospective study was conducted on the use of the instep plantar fasciotomy for the treatment of recalcitrant plantar fasciitis. A total of 83 patients (94 feet) were analyzed. The average postoperative follow-up time was 20.9 months. Surgery was deemed successful 93.6% of the time, and in 95.7% of cases, the patient would recommend the procedure to someone with the same condition. The main complications were scarring (9.6%), medial arch or heel pain (7.5%), cramping in the arch (6.4%), lateral column pain (5.3%), aching or pain across the dorsal midfoot (5.3%), and burning or tingling of the ball of the foot (5.3%). PMID:10697969

  4. Chronic Plantar Fasciitis: Effect of Platelet-Rich Plasma, Corticosteroid, and Placebo.

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    Mahindra, Pankaj; Yamin, Mohammad; Selhi, Harpal S; Singla, Sonia; Soni, Ashwani

    2016-01-01

    Plantar fasciitis is a common cause of heel pain. It is a disabling disease in its chronic form. It is a degenerative tissue condition of the plantar fascia rather than an inflammation. Various treatment options are available, including nonsteroidal anti-inflammatory drugs, corticosteroid injections, orthosis, and physiotherapy. This study compared the effects of local platelet-rich plasma, corticosteroid, and placebo injections in the treatment of chronic plantar fasciitis. In this double-blind study, patients were divided randomly into 3 groups. Local injections of platelet-rich plasma, corticosteroid, or normal saline were given. Patients were assessed with the visual analog scale for pain and with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot score before injection, at 3 weeks, and at 3-month follow-up. Mean visual analog scale score in the platelet-rich plasma and corticosteroid groups decreased from 7.44 and 7.72 preinjection to 2.52 and 3.64 at final follow-up, respectively. Mean AOFAS score in the platelet-rich plasma and corticosteroid groups improved from 51.56 and 55.72 preinjection to 88.24 and 81.32 at final follow-up, respectively. There was a significant improvement in visual analog scale score and AOFAS score in the platelet-rich plasma and corticosteroid groups at 3 weeks and at 3-month follow-up. There was no significant improvement in visual analog scale score or AOFAS score in the placebo group at any stage of the study. The authors concluded that local injection of platelet-rich plasma or corticosteroid is an effective treatment option for chronic plantar fasciitis. Platelet-rich plasma injection is as effective as or more effective than corticosteroid injection in treating chronic plantar fasciitis. PMID:26913766

  5. Orthosis-Shaped Sandals Are as Efficacious as In-Shoe Orthoses and Better than Flat Sandals for Plantar Heel Pain: A Randomized Control Trial.

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    Bill Vicenzino

    Full Text Available To investigate efficacy of a contoured sandal being marketed for plantar heel pain with comparison to a flat flip-flop and contoured in-shoe insert/orthosis.150 volunteers aged 50 (SD: 12 years with plantar heel pain (>4 weeks were enrolled after responding to advertisements and eligibility determined by telephone and at first visit. Participants were randomly allocated to receive commercially available contoured sandals (n = 49, flat flip-flops (n = 50 or over the counter, pre-fabricated full-length foot orthotics (n = 51. Primary outcomes were a 15-point Global Rating of Change scale (GROC: 1 = a very great deal worse, 15 = a very great deal better, 13 to 15 representing an improvement and the 20-item Lower Extremity Function Scale (LEFS on which participants rate 20 common weight bearing activities and activities of daily living on a 5-point scale (0 = extreme difficulty, 4 = no difficulty. Secondary outcomes were worst level of heel pain in the preceding week, and the foot and ankle ability measure. Outcomes were collected blind to allocation. Analyses were done on an intention to treat basis with 12 weeks being the primary outcome time of interest.The contoured sandal was 68% more likely to report improvement in terms of GROC compared to flat flip-flop. On the LEFS the contoured sandal was 61% more likely than flat flip-flop to report improvement. The secondary outcomes in the main reflected the primary outcomes, and there were no differences between contoured sandal and shoe insert.Physicians can have confidence in supporting a patient's decision to wear contoured sandals or in-shoe orthoses as one of the first and simple strategies to manage their heel pain.The Australian New Zealand Clinical Trials Registry ACTRN12612000463875.

  6. Intervention with Formulated Collagen Gel for Chronic Heel Pressure Ulcers in Older Adults with Diabetes.

    Science.gov (United States)

    Agosti, Jennifer K; Chandler, Lois A

    2015-11-01

    Chronic pressure ulcers (PrUs), ulcers that fail to progress through the expected phases of wound healing in a timely fashion, are not only a concern for the patients afflicted with them, but are also a significant burden for the long-term-care facilities in which patients reside. The heel is the second most common location for PrUs. Morbidity and mortality rates for heel PrUs, particularly in the diabetic population, are alarming. Therefore, a consistently effective, cost-conscious, and user-friendly topical treatment for heel ulcers would be welcomed by patients and clinicians. This article describes a marked and rapid improvement in wound granulation in 3 older adult patients following weekly treatment for 8 weeks of chronic (≥1-year duration) heel ulcers with an easy-to-use, cost-effective, topical, formulated collagen gel. PMID:26479694

  7. Randomized multicenter follow-up trial on the effect of radiotherapy for plantar fasciitis (painful heels spur) depending on dose and fractionation – a study protocol

    International Nuclear Information System (INIS)

    An actual clinical trial showed the effect of low dose radiotherapy in painful heel spur (plantar fasciitis) with single doses of 1.0 Gy and total doses of 6.0 Gy applied twice weekly. Furthermore, a lot of animal experimental and in vitro data reveals the effect of lower single doses of 0.5 Gy which may be superior in order to ease pain and reduce inflammation in patients with painful heel spur. Our goal is therefore to transfer this experimentally found effect into a randomized multicenter trial. This was a controlled, prospective, two-arm phase III-multicenter trial. The standard arm consisted of single fractions of 1.0 Gy applied two times a week, for a total dose of 6.0 Gy (total therapy time: 3 weeks). The experimental arm consisted of single fractions of 0.5 Gy applied 3 times a week, for a total dose of 6.0 Gy (total therapy time: 4 weeks). Following a statistical power calculation, there were 120 patients for each investigation arm. The main inclusion criteria were: age > = 40 years, clinical and radiologically diagnosed painful heel spur (plantar fasciitis), and current symptoms for at least 6 months. The main exclusion criteria were: former local trauma, surgery or radiotherapy of the heel; pregnant or breastfeeding women; and a pre-existing severe psychiatric or psychosomatic disorder. After approving a written informed consent the patients are randomized by a statistician into one of the trial arms. After radiotherapy, the patients are seen after six weeks, after twelve weeks and then every twelve weeks up to 48 weeks. Additionally, they receive a questionnaire every six weeks after the follow-up examinations up to 48 weeks. The effect is measured using the visual analogue scale of pain (VAS), the calcaneodynia score according to Rowe and the SF-12 score. The primary endpoint is the pain relief three months after therapy. Patients of both therapy arms with an insufficient result are offered a second radiotherapy series applying the standard dose

  8. Bursitis of the heel

    Science.gov (United States)

    ... gov/pubmed/15555841 . Kadakia AR. Heel pain and plantar fasciitis. In: Miller MD, Thompson SR eds. DeLee and ... M. Editorial team. Related MedlinePlus Health Topics Bursitis Heel Injuries and Disorders Browse the Encyclopedia A.D.A.M., Inc. ...

  9. How I Manage Heel Spur Syndrome.

    Science.gov (United States)

    Seder, Joseph I.

    1987-01-01

    This article discusses plantar fascitis and heel spurs, the two contributing causes of heel spur syndrome. Treatment methods, which include rest, anti-inflammatory medication, shoe padding, and, as a last resort, surgery are described. (Author/MT)

  10. Management of plantar fasciitis in the outpatient setting.

    Science.gov (United States)

    Lim, Ang Tee; How, Choon How; Tan, Benedict

    2016-04-01

    Plantar fasciitis is a very common cause of inferior heel pain that can be triggered and aggravated by prolonged standing, walking, running and obesity, among other factors. Treatments are largely noninvasive and efficacious. Supportive treatments, including the plantar fascia-specific stretch, calf stretching, appropriate orthotics and night dorsiflexion splinting, can alleviate plantar fascia pain. While local injections of corticosteroids can help with pain relief, the effects are short-lived and must be weighed against the risk of fat pad atrophy and plantar fascia rupture. Ultrasonography-guided focal extracorporeal shock wave therapy is useful for patients with chronic plantar fasciitis and referrals for this treatment can be made in recalcitrant cases. Activity modification to decrease cyclical repetitive loading of the plantar fascia should be advised during the treatment phase regardless of the chosen treatment modality. PMID:27075037

  11. Primary Care Management of Plantar Fasciitis.

    Science.gov (United States)

    Melvin, Thomas J; Tankersley, Zach J; Qazi, Zain N; Jasko, John J; Odono, Russell; Shuler, Franklin D

    2015-01-01

    Plantar fasciitis (PF) is present in 10% of the population and is the most common cause of plantar heel pain. PF is painful, can alter daily activities and presents as a sharp pain localized to the plantar foot and medial heel. The underlying etiology involves microtrauma to the plantar fascia, specifically at its insertion point on the calcaneus. Successful management of plantar fasciitis is typically achieved with the conservative therapy approaches discussed. PMID:26665894

  12. Randomized multicenter trial on the effect of radiotherapy for plantar Fasciitis (painful heel spur) using very low doses – a study protocol

    International Nuclear Information System (INIS)

    A lot of retrospective data concerning the effect of radiotherapy on the painful heel spur (plantar fasciitis) is available in the literature. Nevertheless, a randomized proof of this effect is still missing. Thus, the GCGBD (German cooperative group on radiotherapy for benign diseases) of the DEGRO (German Society for Radiation Oncology) decided to start a randomized multicenter trial in order to find out if the effect of a conventional total dose is superior compared to that of a very low dose. In a prospective, controlled and randomized phase III trial two radiotherapy schedules are to be compared: standard arm: total dose 6.0 Gy in single fractions of 1.0 Gy applied twice a week experimental arm: total dose 0.6 Gy in single fractions of 0.1 Gy applied twice a week (acting as a placebo) Patients aged over 40 years who have been diagnosed clinically and radiologically to be suffering from a painful heel spur for at least six months can be included. Former trauma, surgery or radiotherapy to the heel are not allowed nor are patients with a severe psychiatric disease or women during pregnancy and breastfeeding. According to the statistical power calculation 100 patients have to be enrolled into each arm. After having obtaining a written informed consent a patient is randomized by the statistician to one of the arms mentioned above. After radiotherapy, the patients are seen first every six weeks, then regularly up to 48 months after therapy, they additionally receive a questionnaire every six weeks after the follow-up examinations. The effect is measured using several target variables (scores): Calcaneodynia-score according to Rowe et al., SF-12 score, and visual analogue scale of pain. The most important endpoint is the pain relief three months after therapy. Patients with an inadequate result are offered a second radiotherapy series applying the standard dose (equally in both arms). This trial protocol has been approved by the expert panel of the DEGRO as well as

  13. Randomized multicenter trial on the effect of radiotherapy for plantar Fasciitis (painful heel spur using very low doses – a study protocol

    Directory of Open Access Journals (Sweden)

    Micke Oliver

    2008-09-01

    Full Text Available Abstract Background A lot of retrospective data concerning the effect of radiotherapy on the painful heel spur (plantar fasciitis is available in the literature. Nevertheless, a randomized proof of this effect is still missing. Thus, the GCGBD (German cooperative group on radiotherapy for benign diseases of the DEGRO (German Society for Radiation Oncology decided to start a randomized multicenter trial in order to find out if the effect of a conventional total dose is superior compared to that of a very low dose. Methods/Design In a prospective, controlled and randomized phase III trial two radiotherapy schedules are to be compared: standard arm: total dose 6.0 Gy in single fractions of 1.0 Gy applied twice a week experimental arm: total dose 0.6 Gy in single fractions of 0.1 Gy applied twice a week (acting as a placebo Patients aged over 40 years who have been diagnosed clinically and radiologically to be suffering from a painful heel spur for at least six months can be included. Former trauma, surgery or radiotherapy to the heel are not allowed nor are patients with a severe psychiatric disease or women during pregnancy and breastfeeding. According to the statistical power calculation 100 patients have to be enrolled into each arm. After having obtaining a written informed consent a patient is randomized by the statistician to one of the arms mentioned above. After radiotherapy, the patients are seen first every six weeks, then regularly up to 48 months after therapy, they additionally receive a questionnaire every six weeks after the follow-up examinations. The effect is measured using several target variables (scores: Calcaneodynia-score according to Rowe et al., SF-12 score, and visual analogue scale of pain. The most important endpoint is the pain relief three months after therapy. Patients with an inadequate result are offered a second radiotherapy series applying the standard dose (equally in both arms. This trial protocol has been

  14. Postura do pé e classificação do arco plantar de adolescentes usuárias e não usuárias de calçados de salto alto Foot posture and classification of the plantar arch among adolescent wearers and non-wearers of high-heeled shoes

    Directory of Open Access Journals (Sweden)

    Patrícia A. O. Pezzan

    2009-10-01

    Full Text Available OBJETIVOS: Correlacionar a postura dos pés com o arco plantar de adolescentes usuárias e não usuárias de calçados de salto alto. MÉTODOS: Foram selecionadas 36 adolescentes, 16 no grupo de não usuárias e 20 no grupo de usuárias, com idade entre 13 e 20 anos. A postura do pé foi analisada por fotos nas condições descalça e com calçado de salto alto tipo Anabella, previamente padronizado, após terem permanecido com ele por uma hora. Sua análise foi realizada pelo software SAPO. A impressão plantar foi realizada descalça e, a partir dela, calculado o Índice de Chipaux - Smirak para classificação do arco plantar. Para análise estatística, utilizou-se o teste t pareado para verificar igualdade entre lados direito e esquerdo. Foi realizado o teste de aderência Shapiro Wilk e, então, a análise inferencial por meio dos testes não paramétricos de Wilcoxon, o teste de Mann-Whitney e a correlação de Spearman. O nível de significância adotado foi de 0,05. RESULTADOS: Não foi encontrada correlação entre o tipo de arco plantar e a postura do pé das adolescentes estudadas. Porém, o ângulo do retropé se mostrou significativamente diferente, apresentando varo de retropé após a colocação do calçado em ambos os grupos, e o arco plantar do grupo de usuárias apresentou valores menores quanto ao Índice Chipaux - Smirak. CONCLUSÕES: Não existe correlação entre a postura do pé e o tipo de arco plantar, embora essas variáveis tenham sofrido influência do calçado de salto alto. Artigo registrado na Australian New Zealand Clinical Trials Registry (ANZCTR sob o número ACTRN12608000300370.OBJECTIVES: To investigate the relationship between foot posture and plantar arch among adolescent wearers and non-wearers of high-heeled shoes. METHODS: Thirty-six female adolescents aged 13 to 20 years were selected and grouped as 16 high-heel non-wearers and 20 high-heel wearers. Foot posture was analyzed using photos, firstly

  15. Heel pain

    Science.gov (United States)

    Pain - heel ... Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel ... on the heel Conditions that may cause heel pain include: When the tendon that connects the back ...

  16. Endoscopic Debridement for Treatment of Chronic Plantar Fasciitis: An Innovative Technique and Prospective Study of 46 Consecutive Patients.

    Science.gov (United States)

    Cottom, James M; Maker, Jared M; Richardson, Phillip; Baker, Joseph S

    2016-01-01

    Plantar fasciitis is one the most common pathologies treated by foot and ankle surgeons. When nonoperative therapy fails, surgical intervention might be warranted. Various surgical procedures are available for the treatment of recalcitrant plantar fasciitis. The most common surgical management typically consists of open versus endoscopic plantar fascia release. Comorbidities associated with the release of the plantar fascia have been documented, including lateral column overload and metatarsalgia. We present an innovative technique for this painful condition that is minimally invasive, allows visualization of the plantar fascia, and maintains the integrity of the fascia. Our hypothesis was that the use of endoscopic debridement of the plantar fascia with or without heel spur resection would provide a minimally invasive technique with acceptable patient outcomes. PMID:27066869

  17. Pathologic and post-operative conditions of the plantar fascia: review of MR imaging appearances

    Energy Technology Data Exchange (ETDEWEB)

    Yu, J.S. [Ohio State Univ., Columbus (United States). Dept. of Radiology

    2000-09-01

    Magnetic resonance (MR) imaging has emerged as an important noninvasive diagnostic imaging technique for assessment of foot pathology. This modality, owing to its multiplanar imaging capability and inherent superiority in contrast, has been shown to be more accurate and sensitive for detection of plantar fascia pathology than any other imaging method. One of the most important and recognizable causes of heel pain is plantar fasciitis. With the exception of plantar fasciitis, there has been little emphasis on imaging other conditions that affect this important structure. The objective of this review is to demonstrate, from a perspective of MR imaging, the many different pathologic conditions that affect the plantar fascia. Included in this review will be a discussion of normal anatomy as well as entities such as acute plantar fasciitis, chronic plantar fasciitis, traumatic rupture, normal post-surgical changes, pathologic post-fasciotomy conditions, infection, and fibromatosis. (orig.)

  18. Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study

    Science.gov (United States)

    Ribeiro, Ana P.; Sacco, Isabel C. N.; Dinato, Roberto C.; João, Silvia M. A.

    2016-01-01

    BACKGROUND: The risk factors for the development of plantar fasciitis (PF) have been associated with the medial longitudinal arch (MLA), rearfoot alignment and calcaneal overload. However, the relationships between the biomechanical variables have yet to be determined. OBJECTIVE: The goal of this study was to investigate the relationships between the MLA, rearfoot alignment, and dynamic plantar loads in runners with unilateral PF in acute and chronic phases. METHOD: Cross-sectional study which thirty-five runners with unilateral PF were evaluated: 20 in the acute phase (with pain) and 15 with previous chronic PF (without pain). The MLA index and rearfoot alignment were calculated using digital images. The contact area, maximum force, peak pressure, and force-time integral over three plantar areas were acquired with Pedar X insoles while running at 12 km/h, and the loading rates were calculated from the vertical forces. RESULTS: The multiple regression analyses indicated that both the force-time integral (R 2=0.15 for acute phase PF; R 2=0.17 for chronic PF) and maximum force (R 2=0.35 for chronic PF) over the forefoot were predicted by an elevated MLA index. The rearfoot valgus alignment predicted the maximum force over the rearfoot in both PF groups: acute (R 2=0.18) and chronic (R 2=0.45). The rearfoot valgus alignment also predicted higher loading rates in the PF groups: acute (R 2=0.19) and chronic (R 2=0.40). CONCLUSION: The MLA index and the rearfoot alignment were good predictors of plantar loads over the forefoot and rearfoot areas in runners with PF. However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot. PMID:26786073

  19. Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ana P. Ribeiro

    2016-02-01

    Full Text Available BACKGROUND: The risk factors for the development of plantar fasciitis (PF have been associated with the medial longitudinal arch (MLA, rearfoot alignment and calcaneal overload. However, the relationships between the biomechanical variables have yet to be determined. OBJECTIVE: The goal of this study was to investigate the relationships between the MLA, rearfoot alignment, and dynamic plantar loads in runners with unilateral PF in acute and chronic phases. METHOD: Cross-sectional study which thirty-five runners with unilateral PF were evaluated: 20 in the acute phase (with pain and 15 with previous chronic PF (without pain. The MLA index and rearfoot alignment were calculated using digital images. The contact area, maximum force, peak pressure, and force-time integral over three plantar areas were acquired with Pedar X insoles while running at 12 km/h, and the loading rates were calculated from the vertical forces. RESULTS: The multiple regression analyses indicated that both the force-time integral (R2=0.15 for acute phase PF; R2=0.17 for chronic PF and maximum force (R2=0.35 for chronic PF over the forefoot were predicted by an elevated MLA index. The rearfoot valgus alignment predicted the maximum force over the rearfoot in both PF groups: acute (R2=0.18 and chronic (R2=0.45. The rearfoot valgus alignment also predicted higher loading rates in the PF groups: acute (R2=0.19 and chronic (R2=0.40. CONCLUSION: The MLA index and the rearfoot alignment were good predictors of plantar loads over the forefoot and rearfoot areas in runners with PF. However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot.

  20. Sonographic evaluation of plantar fasciitis

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sook Ja; Choi, Yun Sun; Tien, Kuang Lung; Jung, Hye Jeon; Lee, Kyoung Tae; Yoon, Yong Kyu [Eulji College of Medicine Eulji Hospital, Seoul (Korea, Republic of)

    1999-03-01

    To evaluate the sonographic findings of plantar fasciitis. Both feet of 30 patients(mean age, 44years) in whom plantar fasciitis had been clinically diagnosed, and those of healthy volunteers(mean age, 34years) were evaluated with ultrasound(US) using a 7.0MHz linear array transducer. Heel pain was unilateral in 26 patients and bilateral in four. Sagittal sonograms were obtained in the prone position, and the thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. We also evaluated hypoechoic fascia, perifascial fluid collection, fiber rupture, calcaneal spur and calcifications. Plantar fascia thickness was significantly greater in the heels of patients with plantar fasciitis(3.2-8mm; mean, 5.1{+-}1.12) than in their asymptomatic heels(1.3-5mm; mean, 3.5{+-}0.78)(p<0.0001), in which it was similar to that of heels of patients in the control group(1.8-5mm; mean, 3.0{+-}0.71)(p<0.0001). The proximal plantar fascia was hypoechoic in 31 symptomatic heels(91.2%), in four asymptomatic heels(15.4%), and in none of the patients in the control group. Calcaneal spurs were identified in sixteen symptomatic heels(47.1%), and in two which were asymptomatic(7.7%). Perifascial fluid collection was identified in only two symptomatic heels(5.9%). In plantar fasciitis, sonography demonstrates that the fascia is thicker as well as hypoechic. For the clinical diagnosis of planter fasciitis, US can therefore be used as an adjunct to clinical diagnosis.

  1. Heel pain: A systematic review

    Institute of Scientific and Technical Information of China (English)

    Edward Kwame Agyekum; Kaiyu Ma

    2015-01-01

    Heel pain is a very common foot disease.Varieties of names such as plantar fasciitis,jogger's heel,tennis heal,policeman's heel are used to describe it.Mechanical factors are the most common etiology of heel pain.Common causes of hell pain includes:Plantar Fasciitis,Heel Spur,Sever's Disease,Heel bump,Achilles Tendinopathy,Heel neuritis,Heel bursitis.The diagnosis is mostly based on clinical examination.Normally,the location of the pain and the absence of associated symptoms indicating a systemic disease strongly suggest the diagnosis.Several therapies exist including rest,physical therapy,stretching,and change in footwear,arch supports,orthotics,night splints,anti-inflammatory agents,and surgery.Almost all patients respond to conservative nonsurgical therapy.Surgery is the last treatment option if all other treatments had failed.Rest,ice,massage,the use of correct exercise and complying with a doctor's advice all play important part in helping to recover from this hell pain condition,but getting good quality,suitable shoes with the appropriate amount of support for the whole foot is the most important.

  2. Heel pain: A systematic review.

    Science.gov (United States)

    Agyekum, Edward Kwame; Ma, Kaiyu

    2015-01-01

    Heel pain is a very common foot disease. Varieties of names such as plantar fasciitis, jogger's heel, tennis heal, policeman's heel are used to describe it. Mechanical factors are the most common etiology of heel pain. Common causes of hell pain includes: Plantar Fasciitis, Heel Spur, Sever's Disease, Heel bump, Achilles Tendinopathy, Heel neuritis, Heel bursitis. The diagnosis is mostly based on clinical examination. Normally, the location of the pain and the absence of associated symptoms indicating a systemic disease strongly suggest the diagnosis. Several therapies exist including rest, physical therapy, stretching, and change in footwear, arch supports, orthotics, night splints, anti-inflammatory agents, and surgery. Almost all patients respond to conservative nonsurgical therapy. Surgery is the last treatment option if all other treatments had failed. Rest, ice, massage, the use of correct exercise and complying with a doctor's advice all play important part in helping to recover from this hell pain condition, but getting good quality, suitable shoes with the appropriate amount of support for the whole foot is the most important. PMID:26643244

  3. Painful Heel: MR Imaging Findings

    Directory of Open Access Journals (Sweden)

    Babak Sanei

    2010-05-01

    Full Text Available Heel pain is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft-tissue disorders. "nThese disorders are classified on the basis of anatomic origin and predominant location of heel pain to foster a better understanding of this complaint. The disorders include plantar fascial lesions (fasciitis, rupture, fibromatosis, xanthoma, tendinous (tendonitis, tenosynovitis, osseous lesions (fractures, bone bruises, osteomyelitis, tumors, bursal lesions (retrocalcaneal bursitis, retroachilleal bursitis, tarsal tunnel syndrome, and heel plantar fat pad abnormalities. With its superior soft-tissue contrast resolution and multiplanar capability, magnetic resonance (MR imaging can help determine the cause of heel pain and help assess the extent and severity of the disease in ambiguous or clinically equivocal cases. Careful analysis of MR imaging findings and correlation of these findings with patient history and findings at physical examination can suggest a specific diagnosis in most cases. The majority of patients with heel pain can be successfully treated conservatively, but in cases requiring surgery (eg, plantar fascia rupture in competitive athletes, deeply infiltrating plantar fibromatosis, masses causing tarsal tunnel syndrome, MR imaging is especially useful in planning surgical treatment by showing the exact location and extent of the lesion

  4. Autologous platelet-rich plasma compared with whole blood for the treatment of chronic plantar fasciitis; a comparative clinical trial

    Directory of Open Access Journals (Sweden)

    Babak Vahdatpour

    2016-01-01

    Conclusions: Significant improvement in pain and function, as well as decrease in plantar fascia thickness, was observed by intralesional injection of the PRP and WB in patients with chronic PF. The study results indicate similar effectiveness between PRP and WB for the treatment of chronic PF in short-term.

  5. Heel Pain in Recreational Runners.

    Science.gov (United States)

    Bazzoli, Allan S.; Pollina, Frank S.

    1989-01-01

    Provides physicians with the signs, symptoms, and management of heel/sole pain in recreational runners (usually due to plantar fasciitis, Achilles tendinitis, and calcaneal stress fractures). Remedies involve palliative treatment of symptoms, correction of underlying biomechanical problems, and flexibility exercises. (SM)

  6. Island medial plantar artery perforator flap for reconstruction of plantar defects.

    Science.gov (United States)

    Koshima, Isao; Narushima, Mitsunaga; Mihara, Mokoto; Nakai, Ikuo; Akazawa, Satoshi; Fukuda, Norio; Watanabe, Yorikatsu; Nakagawa, Masahiro

    2007-11-01

    Three cases in which island medial plantar artery perforator flaps were successfully transferred for coverage of the plantar defects are described. This perforator flap is different from the medial plantar flap based on the medial plantar artery. The flap has no fascial component and is nourished only with the perforator of the medial plantar vessel. Therefore, transection of the medial plantar artery is usually unnecessary. This flap can cover defects on the forefoot and heel without transaction of the medial plantar system. The advantages of this flap are no need for deep or long dissection for the medial plantar vessel, no exposure of the plantar sensory nerve, a short time for flap elevation, minimal donor-site morbidity, relatively large flap survival, and no damage of both the posterior tibial and medial plantar neurovascular systems. PMID:17992152

  7. Imaging study of the painful heel syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Williams, P.L.; Smibert, J.G.; Cox, R.; Mitchell, R.; Klenerman, L.

    1987-06-01

    A total of 45 patients with the painful heel syndrome without evidence of an associated inflammatory arthritis, seven of whom had pain in both heels, were studied using technetium-99 isotope bone scans and lateral and 45 degrees medial oblique radiographs of both feet. Of the 52 painful heels 31 (59.6%) showed increased uptake of tracer at the calcaneum. Patients with scans showing increased uptake tended to have more severe heel pain and responded more frequently to a local hydrocortisone injection. On plain x-ray, 39 of 52 painful heels (75%) and 24 of the 38 opposite nonpainful heels (63%) showed plantar spurs, compared with five of 63 (7.9%) heels in 59 age- and sex-matched controls. No evidence of stress fractures was seen.

  8. Heel pain--operative results.

    Science.gov (United States)

    Baxter, D E; Thigpen, C M

    1984-01-01

    In 6 years through 1982, the authors performed 34 operative cases in 26 patients with recalcitrant heel pain. The operative procedure involves an isolated neurolysis of the mixed nerve supplying the abductor digiti quinti muscle as it passes beneath the abductor hallucis muscle and beneath the medial ridge of the calcaneus. The deep fascia of the abductor hallucis muscle is released routinely, and an impinging heel spur or tight plantar fascia is partially removed or released if it is causing entrapment of the nerve. The biomechanical pathogenesis of heel pain in relation to pes planus and pes cavus predisposing to an entrapment neuropathy is described, and the anatomy of the heel in relation to the nerve distribution is clarified and well illustrated. Of the 34 operated heels, 32 had good results and two had poor results. Heel pain can cause total disability in the working population and may jeopardize one's employment or professional athletic career. The authors believe operative treatment has a place in the care of recalcitrant heel pain and that an entrapment neuropathy is an etiological factor in heel pain.

  9. Treatment of chronic plantar fasciitis with extra corporeal shock wave therapy: ultrasonographic morphological aspect and functional evaluation

    Directory of Open Access Journals (Sweden)

    Roberto Androson

    2013-12-01

    Full Text Available Objective: This paper has the purpose to analyze prospectively the treatment results in patients with chronic plantar fasciitis resistant to conservative treatment who underwent extracorporeal shock wave therapy (ESWT. Methods: We evaluated 30 patients (36 feet; 16 (53.3% patients were male and 14 (47.7% female with mean age of 48.7 y.o., varying from 33 to 78 y.o.; 16 (53.3% present the problem on the left side, 14 (46.7% on the right ones and 6 (20% bilateral; the symptomatology varied from 6 to 60 months, with the average of 13.58 months. These patients were submitted to a weekly ESWT session for 4 consecutive weeks. We measured the plantar fascia thickness millimeters with ultrasound and we applied American Orthopaedic Foot and Ankle Society (AOFAS scale for ankle and hindfoot, and Roles & Maudsley scales in pre ESWT, after one, three and six months after and decrease in the plantar fascia thickness by the ultrasound (p = 0.011 along the different moments studied. Results: We observed improvement of the evaluated criteria (p < 0.001 and plantar fascia thickness by ultrasound (p = 0.011 at different time points studied. Conclusion: The ESWT can be considered an important tool in the primary or adjuvant treatment of the chronic plantar fasciitis when associated with conventional therapies. This methodology is safe, non-invasive and provides precocious rehabilitation and return to regular activities considering the results of the statistical analysis. This resource provides decrease in the thickness of the plantar fascia.

  10. Spectrum of Ultrasound Pathologies of Achilles Tendon, Plantar Aponeurosis and Flexor Digiti Brevis Tendon Heel Entheses in Patients with Clinically Suspected Enthesitis

    International Nuclear Information System (INIS)

    Enthesitis is considered a characteristic presentation of the second most common group of rheumatoid disorders, i.e. spondyloarthropathies (SpAs), particularly peripheral spondyloarthropathies. At the initial stages, enthesitis may be the only symptom of SpA, particularly in patients lacking the HLA-B27 receptor. In light of diagnostic difficulties with detecting enthesitis in clinical examinations and laboratory investigations, many studies point out the high specificity of imaging studies, and particularly ultrasonography. A total of 20% Achilles tendon entheses, 45% plantar aponeurosis entheses and 89.5% of flexor digiti brevis tendon entheses were unremarkable. In the remaining cases, the presentation of pathological lesions was not specific to enthesitis and might more likely correspond to degeneration or microinjuries of the entheses, beside the most obvious cases of achillobursitis or Kager’s fat pad inflammation. The studies demonstrated that ultrasound scans rarely confirm the clinical diagnosis of enthesitis

  11. Extracorporeal shock wave therapy for treatment of plantar fasciitis

    International Nuclear Information System (INIS)

    Objective: To explore the effect of extracorporeal shock wave therapy in patients with chronic plantar faciitis. Methods: The prospective study was conducted at Department of Orhopaedic, Regional Hospital, Limerick, Ireland from January to December 2004 and comprised 70 heels in 62 patients with chronic plantar fasciitis in whom conventional conservative treatment consisting of non-steroidal anti-inflammatory drugs, heel cup, orthoses and/or shoe modifications, local steroid injections had failed, and they were treated with low energy extracorporeal shock wave therapy. Patients were reviewed at 6, 12 and 24 weeks post treatment. Results: At follow-up there was significant decrease in pain on the visual analogue scale (p<0.027), with significant improvement in pain score (p<0.009) and in functional score (p<0.001). The comfortable walking distance had increased significantly and there were no reported side effects. Conclusion: Extracorporeal shock wave therapy is a new modality providing good pain relief and a satisfactory clinical outcome in patients with chronic plantar fasciitis. (author)

  12. Current therapeutic approaches for plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Martinelli N

    2014-03-01

    Full Text Available Nicolò Martinelli, Carlo Bonifacini, Giovanni RomeoDepartment of Ankle and Foot Surgery, IRCCS Galeazzi Orthopaedic Institute, Milan, ItalyAbstract: Almost 1 million Americans are affected by plantar fasciitis (PF, which is the commonest cause of chronic heel pain. This condition is often managed conservatively, and many rehabilitation protocols, some with the aid of orthoses, have been adopted, with good-to-excellent clinical results. Although most cases of chronic PF can be successfully managed with a conservative approach, alternative treatments, including high-energy shock wave therapy and corticosteroid injections, are commonly accepted as second-line treatment when traditional conservative therapy fails. However, surgery is still an important mode of treatment. Recently, new minimally invasive surgical techniques that offer numerous advantages (faster recovery time, early weight-bearing, lower postoperative pain over standard surgical approaches have been proposed, with good results and low complication rates. The purpose of this review is to report new conservative and surgical techniques for the treatment of PF. A literature search for articles about plantar fasciitis was conducted on the PubMed database in order to identify publications addressing the treatments of PF. The literature suggests that, initially, traditional conservative treatments consisting of rest, oral nonsteroidal anti-inflammatory drugs, foot orthotics, and stretching exercises can be tried for several weeks. In patients with chronic recalcitrant PF, extracorporeal shock wave therapy or corticosteroid injection can be considered. Surgery (minimally invasive techniques should be considered only after failure of the conservative treatments.Keywords: heel pain, surgery, plantar fasciosis

  13. Endoscopic Debridement for Treatment of Chronic Plantar Fasciitis: An Innovative Surgical Technique.

    Science.gov (United States)

    Cottom, James M; Maker, Jared M

    2016-01-01

    Plantar fasciitis is one the most common pathologies seen by foot and ankle surgeons. When nonoperative therapy fails, surgical intervention is warranted. Various surgical procedures are available for the treatment of recalcitrant plantar fasciitis. The most common surgical management typically consists of open versus endoscopic plantar fascia release. The documented comorbidities associated with the release of the plantar fascia include lateral column overload and metatarsalgia. We present a new technique for this painful condition that is minimally invasive, allows visualization of the plantar fascia, and maintains the integrity of this fascia. Our hypothesis was that the use of endoscopic debridement of the plantar fascia would provide a minimally invasive technique with acceptable patient outcomes. PMID:26952313

  14. Plantar fasciitis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007021.htm Plantar fasciitis To use the sharing features on this page, ... tissue becomes swollen or inflamed, it is called plantar fasciitis. Causes Plantar fasciitis occurs when the thick band ...

  15. Orthotics Compared to Conventional Therapy and Other Non-Surgical Treatments for Plantar Fasciitis

    Science.gov (United States)

    Lewis, Rebecca D.; Wright, Paul; McCarthy, Laine H.

    2016-01-01

    Clinical Question In adults with acute plantar fasciitis whose symptoms have not been relieved with the conventional regimen of NSAIDS, stretching and lifestyle modification, do the addition of orthotics (prefabricated or custom fitted) reduce pain and improve function compared with other non-surgical treatments (manipulative chiropractic, physical therapy and/or heel steroid injections)? Answer Yes. Studies have shown that orthotics, both prefabricated and custom fitted, reduce pain and improve function in adults with acute plantar fasciitis with few risks or side effects. Used alone or in addition to conventional therapy (NSAIDs, stretching, lifestyle modification), orthotics are effective and well tolerated by patients for short-term pain relief and improved function. Prefabricated orthotics are less costly and provide similar relief to more expensive custom orthotics. Level of Evidence of the Answer A Search Terms Plantar fasciitis, heel pain, treatment, orthotics, Limits Adult, human, English, Review, Randomized-Control Trials, Systematic Reviews, adults age 18 or more, publication dates 2004 to present. Date Search was Conducted January 16, 2014; updated January 20, 2015 Inclusion Criteria Recent published systematic reviews, randomized controlled, meta-analyses; adults with confirmed acute or recent diagnosis of plantar fasciitis. Exclusion Criteria Studies older than 10 years, children, adolescents less than 18 years of age, chronic or recalcitrant plantar fasciitis. PMID:26855444

  16. Ultra-som contínuo no tratamento da fasciíte plantar crônica Continuous ultrasound for chronic plantar fasciitis treatment

    Directory of Open Access Journals (Sweden)

    Renata Graciele Zanon

    2006-01-01

    absolute values for pain intensity (at first, eighth, and last session showed similarity between groups. The improvement percentage for 15 sessions did not present differences between both groups. That percentage was also calculated for two periods (before and after the eighth session. It was noted that the improvement percentage on all 15 sessions for group 2 (46.5% was inferior to the percentage of the first eighth sessions for group 1 (54.6%. Thus, the high-power continuous ultrasound did not add value for function and pain; additionally, only specific stretching exercises were efficient in reducing more than 50% of the pain in chronic plantar fasciitis.

  17. Sonographic evaluation of plantar fasciitis and relation to body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Ozdemir, Huseyin [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey)]. E-mail: ozdemir@firat.edu.tr; Yilmaz, Erhan [Department Orthopedic Firat University, Faculty of Medicine, Elazig (Turkey); Murat, Ayse [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey); Karakurt, Lokman [Department Orthopedic Firat University, Faculty of Medicine, Elazig (Turkey); Poyraz, A. Kursad [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey); Ogur, Erkin [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey)

    2005-06-01

    Purpose: We have investigated the role of sonography in the diagnosis of plantar fasciitis. Materials and methods: This study evaluates 39 patients with plantar fasciitis and control group of 22 healthy volunteers. The plantar fascia thickness was measured 5 mm distal to the insertion of the calcaneus of plantar aponeurosis. Qualitative parameters such as decreased echogenity, biconvexity, perifascial fluid and calcification of plantar fascia were also noted. Results: Mean plantar fascia thickness was measured 2.9 mm in patients with unilateral heel pain, 2.2 mm for contralateral normal heel and 2.5 mm for control group. There was a statistically significant difference between heel with plantar fasciitis, contralateral normal heel and control groups (p = 0.009 and 0.0001, respectively). Mean body mass index was 28 kg/m{sup 2} in patients with heel pain and 25 kg/m{sup 2} in control group. Body mass index measurements were significantly different between plantar fasciitis and control groups. We found reduced plantar fascia echogenity in 16 cases (41%), calcaneal spur in 20 cases (51%), biconvex appearance in two cases (5.1%) and perifascial fluid in one case (2.5%). Conclusion: We conclude that in patients with plantar fasciitis, ultrasound may detect relatively small differences in plantar fascia thickness even in clinically unequivocal plantar fasciitis.

  18. Chronic plantar fasciitis is mediated by local hemodynamics: Implications for emerging therapies

    OpenAIRE

    Miller, Larry E; Latt, Daniel L.

    2015-01-01

    Plantar fasciitis (PF) is a common, disabling condition affecting millions of patients each year. With early diagnosis and timely application of traditional nonsurgical treatments, symptoms generally resolve over time. However, despite adequate treatment, 20% of patients will experience persistent symptoms. In these patients, minimally invasive therapies that augment local hemodynamics to initiate a regenerative tissue-healing cascade have the greatest potential to resolve long-standing sympt...

  19. Mechanical Information of Plantar Fascia during Normal Gait

    Science.gov (United States)

    Gu, Yaodong; Li, Zhiyong

    The plantar fascia is an important foot tissue in stabilizing the longitudinal arch of human foot. Direct measurement to monitor the mechanical situation of plantar fascia at human locomotion is difficult. The purpose of this study was to construct a three-dimensional finite element model of the foot to calculate the internal stress/strain value of plantar fascia during different stage of gait. The simulated stress distribution of plantar fascia was the lowest at heel-strike, which concentrated on the medial side of calcaneal tubercle. The peak stress of plantar fascia was appeared at push-off, and the value is more than 5 times of the heel-strike position. Current FE model was able to explore the plantar fascia tension trend at the main sub-phases of foot. More detailed fascia model and intrinsic muscle forces could be developed in the further study.

  20. Finite element modelling of radial shock wave therapy for chronic plantar fasciitis.

    Science.gov (United States)

    Alkhamaali, Zaied K; Crocombe, Andrew D; Solan, Matthew C; Cirovic, Srdjan

    2016-01-01

    Therapeutic use of high-amplitude pressure waves, or shock wave therapy (SWT), is emerging as a popular method for treating musculoskeletal disorders. However, the mechanism(s) through which this technique promotes healing are unclear. Finite element models of a shock wave source and the foot were constructed to gain a better understanding of the mechanical stimuli that SWT produces in the context of plantar fasciitis treatment. The model of the shock wave source was based on the geometry of an actual radial shock wave device, in which pressure waves are generated through the collision of two metallic objects: a projectile and an applicator. The foot model was based on the geometry reconstructed from magnetic resonance images of a volunteer and it comprised bones, cartilage, soft tissue, plantar fascia, and Achilles tendon. Dynamic simulations were conducted of a single and of two successive shock wave pulses administered to the foot. The collision between the projectile and the applicator resulted in a stress wave in the applicator. This wave was transmitted into the soft tissue in the form of compression-rarefaction pressure waves with an amplitude of the order of several MPa. The negative pressure at the plantar fascia reached values of over 1.5 MPa, which could be sufficient to generate cavitation in the tissue. The results also show that multiple shock wave pulses may have a cumulative effect in terms of strain energy accumulation in the foot. PMID:26465270

  1. IMMEDIATE EFFECT OF THREE SOFT TISSUE MANIPULATION TECHNIQUES ON PAIN RESPONSE AND FLEXIBILITY IN CHRONIC PLANTAR FASCIITIS: A RANDOMIZED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    Renu B.Pattanshetty

    2015-02-01

    Full Text Available Background and Objectives: Plantar fasciitis is a common foot disorder in which patients have pain and tenderness at the sole of the foot. Rest, exercises, orthotics, taping, cryotherapy, therapeutic ultrasound, electrical stimulation, whirlpool bath, and iontophoresis have been widely used to relieve plantar pain. Long term use of manual therapy techniques like myofascial release technique, positional release therapy and passive stretching have been used in the past to reduce pain and improve ankle range of motion. The present study aimed to evaluate and compare the immediate effectiveness of myofascial release technique, positional release therapy and passive stretching on pain response and ankle flexibility in chronic plantar fasciitis. Material and methodology: A total of 60 participants with chronic plantar fasciitis were randomly allocated to Group A (myofascial release group and Group B (positional release group and Group C (passive stretching. Therapeutic ultrasound with intensity of 1W/cm2 and frequency of 1MHz for 5 min was given for a single session to all the patients and then given the manual techniques. Visual analogue scale, range of motion of the ankle were outcome measures that were assessed pre- and immediately post-interventional. Results: The study demonstrated statistical significant reduction in pain, in all three groups (p<0.0001. Ankle range of motion showed significant improvement in Group A (MFR. Group C (passive stretching demonstrated significant improvement (p=0.001 as compared to Group B (PRT. Conclusion: All three manual techniques with therapeutic ultrasound were effective in immediate relief of pain and improving ankle range of motion in subjects with chronic plantar fasciitis.

  2. Chronic plantar fasciitis is mediated by local hemodynamics: Implications for emerging therapies

    Directory of Open Access Journals (Sweden)

    Larry E Miller

    2015-01-01

    Full Text Available Plantar fasciitis (PF is a common, disabling condition affecting millions of patients each year. With early diagnosis and timely application of traditional nonsurgical treatments, symptoms generally resolve over time. However, despite adequate treatment, 20% of patients will experience persistent symptoms. In these patients, minimally invasive therapies that augment local hemodynamics to initiate a regenerative tissue-healing cascade have the greatest potential to resolve long-standing symptoms. We performed a narrative review based on a best evidence evaluation of manuscripts published in Medline-indexed journals to determine the mechanisms involved in soft tissue injury and healing. This evaluation also highlights emerging minimally invasive therapies that exploit these mechanisms in recalcitrant PF.

  3. Long-term results of radiotherapy in patients with chronic palmo-plantar eczema or psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Sumila, M.; Notter, M.; Bodis, S.; Gruber, G. [State Hospital, Aarau (Switzerland). Inst. of Radiation Oncology; Itin, P. [State Hospital, Aarau (Switzerland). Dept. of Dermatology

    2008-04-15

    Background and Purpose: Radiotherapy (RT) is well accepted for therapy-refractory palmo-plantar eczema or psoriasis, despite of lacking evidence regarding beneficial long term effects. Furthermore, the optimal irradiation dose is unknown. We evaluated the outcome of RT with two different RT single/total dose (SD/TD) treatment policies. Patients and Methods: 28 consecutive patients with therapy-refractory eczema (n = 22) or psoriasis (n = 6) of palms and/or soles were irradiated twice a week either with a D{sub max} SD of 1 Gy (6/98-5/03; median TD: 12 Gy) or 0.5 Gy (6/03-7/04; median TD: 5 Gy). Median age was 52 years (27-71), median follow-up 20 months (4-76). Totally 88 regions were treated, 49 with 1 Gy, 39 with 0.5 Gy SD. Eight different symptoms were scored from 0 (absent) -3 (severe), giving a possible sum score of 0-24. Patients' rating of RT result was also documented (worse/stable/better/complete remission). Results: The sum score was 15 (6-23) before RT, 2 (0-16) at the end of RT, and 1 (0-21) at last follow-up, respectively. The improvement was highly significant in both treatment regimens. Better or complete remission by the patients were reported in 44 and 39 (= 83 out of 88) localisations, that was often stable during the follow-up. 5 (6%) regions in 3 (11%) patients didn't benefit from RT. Conclusion: RT reveals excellent results in palmo-plantar eczema or psoriasis. We recommend a SD of 0.5 Gy twice a week up to a TD of 4-5 Gy. (orig.)

  4. MRI of the plantar structures of the foot after falanga torture

    International Nuclear Information System (INIS)

    Falanga is an ancient form of punishment or torture but is still commonly reported by our refugees. The late result of caning the heel and ball of the foot is a chronic painful condition with few clinical signs. The aim of the present study was to assess, by MRI, possible morphologic characteristics of the heel and ball of the foot, related to falanga and pain in correlation to clinical findings. Magnetic resonance imaging of the foot was obtained in 12 victims exposed to falanga torture and 9 healthy volunteers. Sagittal T1-weighted spin-echo images (TR 616-840 ms, TE 20 ms), T2-weighted spin-echo images (TR 1900 ms, TE 90 ms), and short tau inversion recovery (STIR) images (TR 1200 ms, TE 15 ms, TI 100 ms) were performed. The central portion of the plantar aponeurosis was generally significantly thicker in victims exposed to falanga torture as compared with that of controls (P < 0.05). In all except one of the victims, MRI demonstrated two layers of the thickened plantar aponeurosis: a deeper portion with normal homogeneous low signal intensity (SI) appearance, and a superficial layer with characteristic areas of mixed SI on both T1- and T2-weighted images. There were no signs of chronic muscular compartment syndromes, and the thickness of the plantar pad did not differ between the two groups. Magnetic resonance imaging may demonstrate morphologic characteristics of the plantar aponeurosis which may confirm falanga torture. Further imaging with more specific sequences is warranted to demonstrate the supposed injuries in the compartmental fat tissue chambers and the vascularity of the ball pad of the foot. (orig.)

  5. MRI of the plantar structures of the foot after falanga torture

    Energy Technology Data Exchange (ETDEWEB)

    Savnik, A. [Frederiksberg Hospital (Denmark). Dept. of Radiology; Frederiksberg Hospital (Denmark). Dept. of Rheumatology; Amris, K.; Prip, K. [Rehabilitation Center for Torture Victims RCT, Copenhagen (Denmark); Roegind, H.; Danneskiold-Samsoee, B.; Bliddal, H. [Frederiksberg Hospital (Denmark). Dept. of Rheumatology; Bojsen-Moeller, F. [Univ. of Copenhagen (Denmark). Panum Inst.; Bartels, E.M. [The Danish National Library of Science and Medicine, Copenhagen University Library 2, Noerre Alle 49, DK-2200 Copenhagen (Denmark); Boesen, J. [Frederiksberg Hospital (Denmark). Dept. of Radiology; Egund, N. [Department of Radiology R, Aarhus University Hospital, DK-8000 Aarhus C (Denmark)

    2000-10-01

    Falanga is an ancient form of punishment or torture but is still commonly reported by our refugees. The late result of caning the heel and ball of the foot is a chronic painful condition with few clinical signs. The aim of the present study was to assess, by MRI, possible morphologic characteristics of the heel and ball of the foot, related to falanga and pain in correlation to clinical findings. Magnetic resonance imaging of the foot was obtained in 12 victims exposed to falanga torture and 9 healthy volunteers. Sagittal T1-weighted spin-echo images (TR 616-840 ms, TE 20 ms), T2-weighted spin-echo images (TR 1900 ms, TE 90 ms), and short tau inversion recovery (STIR) images (TR 1200 ms, TE 15 ms, TI 100 ms) were performed. The central portion of the plantar aponeurosis was generally significantly thicker in victims exposed to falanga torture as compared with that of controls (P < 0.05). In all except one of the victims, MRI demonstrated two layers of the thickened plantar aponeurosis: a deeper portion with normal homogeneous low signal intensity (SI) appearance, and a superficial layer with characteristic areas of mixed SI on both T1- and T2-weighted images. There were no signs of chronic muscular compartment syndromes, and the thickness of the plantar pad did not differ between the two groups. Magnetic resonance imaging may demonstrate morphologic characteristics of the plantar aponeurosis which may confirm falanga torture. Further imaging with more specific sequences is warranted to demonstrate the supposed injuries in the compartmental fat tissue chambers and the vascularity of the ball pad of the foot. (orig.)

  6. Association of Achilles tendinopathy and plantar spurs.

    Science.gov (United States)

    Vulcano, Ettore; Mani, Sriniwasan B; Mani, Sriniwasan; Do, Huong; Bohne, Walter H; Ellis, Scott J

    2014-10-01

    Plantar spurs and Achilles tendinopathy are common causes of heel pain. In the authors' practice, it was anecdotally noted that patients with Achilles tendinopathy often presented with plantar spurs. Nonetheless, there is a shortage of studies investigating whether Achilles tendinopathy and plantar spurs exist concomitantly. A better understanding of the association between the 2 pathologies might help physicians recognize and treat both conditions, educate patients about Achilles tendinopathy and plantar spurs, and ultimately investigate possible underlying causes of both pathologies that could be addressed together. The authors examined the prevalence of plantar spurs in patients diagnosed with Achilles tendinopathy as well as demographic differences within the unilateral and bilateral Achilles tendinopathy populations. A total of 785 patient records were retrospectively reviewed. Mean patient age was 56.2±15.5 years (46.9% men and 53.1% women). Seventy-two (9.2%) patients were affected bilaterally by Achilles tendinopathy. Lateral radiographs were reviewed by an orthopedic surgeon to identify the presence of plantar spurs. A total of 329 (41.9%) patients with Achilles tendinopathy were found to have a concomitant plantar spur. Patients with unilateral Achilles tendinopathy and a plantar spur were more likely to be women (58.7% vs 49.8%, P=.020) and older (62.7 vs 51.7 years, P<.001). In the bilateral Achilles tendinopathy group, there were 46 (63.9%) patients with at least one foot presenting with a plantar spur. The study's findings suggest a significant association between Achilles tendinopathy and plantar spurs. Older women with Achilles tendinopathy are at greater risk of being affected by plantar spurs. PMID:25275977

  7. MRI of plantar fasciitis

    Energy Technology Data Exchange (ETDEWEB)

    Roger, B.; Grenier, P. [Service de Radiologie Polyvalente Diagnostique et Interventionelle, Hopital de la Pitie, 83, boulevard de l`Hopital, F-75651 Paris Cedex 13 (France)

    1997-12-01

    At present, MRI is the only imaging method that can precisely visualize lesions of the superficial plantar aponeurosis, whether they be musculoaponeurositides, enthesopathies or tears, and whether they be acute or chronic, with or without complications. By its direct visualization of the lesion, MRI enables an accurate assessment of the injury to be made and thereby better orients the therapeutic strategy. (orig.) With 11 figs., 15 refs.

  8. Long distance running and acute effects on plantar foot sensitivity and plantar foot loading.

    Science.gov (United States)

    Alfuth, Martin; Rosenbaum, Dieter

    2011-09-26

    The plantar surface of the foot senses local pressures during stance and locomotion. These foot loading characteristics may be affected by long distance running. Little is known about the physiological effects of sports-related loading on plantar sensitivity and their relationship with plantar foot loading. The purpose of this study was to investigate the acute effects of long distance running on plantar sensitivity to touch and their relationship with foot loading characteristics. It was hypothesized that plantar sensation would decrease after long distance running and may be related to foot loading characteristics. In 15 middle-aged runners, sensory detection thresholds to light touch and plantar pressures were measured before and after a 10 km run. After the run, no significant changes in sensory perception thresholds were observed so that correlations between foot sensitivity and foot loading could not be calculated. A significant decrease of force-time integrals and maximum forces was demonstrated in the whole foot (-6.2%, p=0.003; -3.9%, p=0.001) and the heel (-10.5%, p=0.003; -8.5%, p=0.002). Furthermore, maximum force was significantly reduced in the lateral midfoot (-6.4%, p=0.002). In conclusion, a sub-maximal 10 km running exercise appears to have no significant acute effects on plantar sensitivity, plantar pressure distribution and peak forces. PMID:21871535

  9. Ultrasound guided injection of dexamethasone versus placebo for treatment of plantar fasciitis: protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Gilheany Mark F

    2010-07-01

    Full Text Available Abstract Background Plantar fasciitis is the most commonly reported cause of chronic pain beneath the heel. Management of this condition commonly involves the use of corticosteroid injection in cases where less invasive treatments have failed. However, despite widespread use, only two randomised trials have tested the effect of this treatment in comparison to placebo. These trials currently offer the best available evidence by which to guide clinical practice, though both were limited by methodological issues such as insufficient statistical power. Therefore, the aim of this randomised trial is to compare the effect of ultrasound-guided corticosteroid injection versus placebo for treatment of plantar fasciitis. Methods The trial will be conducted at the La Trobe University Podiatry Clinic and will recruit 80 community-dwelling participants. Diagnostic ultrasound will be used to diagnose plantar fasciitis and participants will be required to meet a range of selection criteria. Participants will be randomly allocated to one of two treatment arms: (i ultrasound-guided injection of the plantar fascia with 1 mL of 4 mg/mL dexamethasone sodium phosphate (experimental group, or (ii ultrasound-guided injection of the plantar fascia with 1 mL normal saline (control group. Blinding will be applied to participants and the investigator performing procedures, measuring outcomes and analysing data. Primary outcomes will be pain measured by the Foot Health Status Questionnaire and plantar fascia thickness measured by ultrasound at 4, 8 and 12 weeks. All data analyses will be conducted on an intention-to-treat basis. Conclusion This will be a randomised trial investigating the effect of dexamethasone injection on pre-specified treatment outcomes in people with plantar fasciitis. Within the parameters of this protocol, the trial findings will be used to make evidence-based recommendations regarding the use of corticosteroid injection for treatment of this

  10. Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up

    International Nuclear Information System (INIS)

    Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.

  11. Fascitis plantar

    OpenAIRE

    López Pérez, Diego

    2014-01-01

    La fascitis plantar (FP) es una de las causas más frecuentes de dolor en el pie, afectando al talón. Es un síndrome degenerativo de la fascia plantar que se produce como resultado de traumas repetidos en el origen de ésta, en el calcáneo, y es la causa más común de dolor en el talón en las personas adultas. Suele presentarse en atletas y corredores, aunque también aparece en la población general, afectando aproximadamente a un 10% en ambos casos. La función que desempeña la fascia es doble...

  12. Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up

    Energy Technology Data Exchange (ETDEWEB)

    Niewald, Marcus, E-mail: marcus.niewald@uks.eu [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany); Seegenschmiedt, M. Heinrich [Radiotherapy Center, Hamburg (Germany); Micke, Oliver [Franziskus Hospital, Bielefeld (Germany); Graeber, Stefan [Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar (Germany); Muecke, Ralf [Lippe Hospital, Lemgo (Germany); Schaefer, Vera; Scheid, Christine; Fleckenstein, Jochen; Licht, Norbert; Ruebe, Christian [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany)

    2012-11-15

    Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.

  13. Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging*

    Science.gov (United States)

    Rodrigues, Rogéria Nobre; Lopes, Alexia Abuhid; Torres, Jardélio Mendes; Mundim, Marina Franco; Silva, Lênio Lúcio Gavio; Silva, Breno Rabelo de Carvalho e

    2015-01-01

    Objective To assess the prevalence of isolated findings of abnormalities leading to entrapment of the lateral plantar nerve and respective branches in patients complaining of chronic heel pain, whose magnetic resonance imaging exams have showed complete selective fatty atrophy of the abductor digiti quinti muscle. Materials and Methods Retrospective, analytical, and cross-sectional study. The authors selected magnetic resonance imaging of hindfoot of 90 patients with grade IV abductor digiti quinti muscle atrophy according to Goutallier and Bernageau classification. Patients presenting with minor degrees of fatty muscle degeneration (below grade IV) and those who had been operated on for nerve decompression were excluded. Results A female prevalence (78.8%) was observed, and a strong correlation was found between fatty muscle atrophy and plantar fasciitis in 21.2%, and ankle varices, in 16.8% of the patients. Conclusion Fatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle. PMID:26811554

  14. Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Rogéria Nobre Rodrigues

    2015-12-01

    Full Text Available Abstract Objective: To assess the prevalence of isolated findings of abnormalities leading to entrapment of the lateral plantar nerve and respective branches in patients complaining of chronic heel pain, whose magnetic resonance imaging exams have showed complete selective fatty atrophy of the abductor digiti quinti muscle. Materials and Methods: Retrospective, analytical, and cross-sectional study. The authors selected magnetic resonance imaging of hindfoot of 90 patients with grade IV abductor digiti quinti muscle atrophy according to Goutallier and Bernageau classification. Patients presenting with minor degrees of fatty muscle degeneration (below grade IV and those who had been operated on for nerve decompression were excluded. Results: A female prevalence (78.8% was observed, and a strong correlation was found between fatty muscle atrophy and plantar fasciitis in 21.2%, and ankle varices, in 16.8% of the patients. Conclusion: Fatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle.

  15. How We Manage Plantar Fasciitis (With Memory Jogger).

    Science.gov (United States)

    Tanner, Suzanne M.; Harvey, Jack S.

    1988-01-01

    Common among runners and athletes who participate in jumping sports, plantar fasciitis is an overuse injury that is potentially incapacitating, causes heel and arch pain, and usually occurs after sudden increases in running mileage, frequency, or speed. Therapy is described. (Author/CB)

  16. Randomized multicenter follow-up trial on the effect of radiotherapy on painful heel spur (plantar fasciitis) comparing two fractionation schedules with uniform total dose: first results after three months’ follow-up

    International Nuclear Information System (INIS)

    Our first trial on radiotherapy for painful heel spur published in 2012 comparing the analgesic effect of a standard dose (6 × 1.0Gy within three weeks) to that of a very low one (6 × 0.1Gy within three weeks) resulted in a highly significant superiority of the standard dose arm. In the meantime, experimental data have shown that lower single doses in the range of 0.5 – 0.7Gy might be even more effective than the current standard dose of 1.0 Gy. Therefore, we conducted a second trial comparing the analgesic effect of standard single doses of 1.0Gy to that of low single doses of 0.5Gy using uniform total doses of 6Gy. One hundred twenty-seven patients were randomized to receive radiation therapy either with a total dose of 6.0Gy applied in 6 fractions of 1.0Gy twice weekly (standard dose) or with the same total dose applied in 12 fractions of 0.5Gy three times weekly (experimental dose). In all patients lateral opposing 6MV photon beams were used. The results were measured using Visual analogue scale (VAS), Calcaneodynia score (CS) and SF-12 health survey. The first phase of this trial ended after a three months’ follow-up; it will be continued up to 48 weeks. Nine patients had to be excluded after randomization either due to the withdrawal of informed consent to radiotherapy by the patients or radiotherapy with an incorrect dosage. The groups were comparable concerning biographical and disease data. The mean calcaneodynia score (CS) was higher in the experimental group (p = 0.002). After three months’ follow-up, we saw a very favorable pain relief in both arms (decline of VAS score: standard arm 42 points, experimental arm 44 points (n.s.), but we did not notice any statistically significant difference between the arms neither concerning the pain parameters nor the quality of life parameters. No relevant acute side effects were recorded. Favorable laboratory results could not be translated into an enhanced pain relief in our patients. This trial was

  17. Effectiveness of Plantar Fascia-Specific Stretching Exercises in Plantar Fasciitis

    Directory of Open Access Journals (Sweden)

    Devrim Özer

    2015-12-01

    Full Text Available Aim: Plantar fasciitis (PF is a painful and disabling disease that affects the quality of life and daily activities of patients and it is the most common cause of heel pain in adults. In primary treatment, conservative treatment is suggested and different conservative options are described in the literature. In our study, we evaluated the efficacy of plantar fascia-specific stretching exercises in the treatment of PF. Methods: Twenty-nine feet - 21 patients with the mean age of 49.3 years were included in the study. The mean length of follow-up was 19.8 months and the mean length of exercise period was 4.94 months. Non-weight bearing plantar fascia-specific stretching exercise was done twice daily, for 10 times at each session. In addition to exercises, silicone heel pad and nonsteroidal anti-inflammatory drugs (NSAID were added. Visual analog scale (VAS was used for pain evaluation. Results: Full recovery detected in 15 feet in 10 patients (52% and a decrease in pain was seen in 10 feet in 8 patients (34%. There was no response in 4 feet in 3 patients (14%. There was statistically significant difference between pre-treatment and post-treatment visual analog scale scores (p=0.0001. Conclusion: Plantar fascia-specific stretching exercise is an effective treatment option in PF.

  18. Percutaneous Ultrasound-Guided TOPAZ Radiofrequency Coblation: A Novel Coaxial Technique for the Treatment of Recalcitrant Plantar Fasciitis-Our Experience.

    Science.gov (United States)

    Shah, Amit; Best, Alistair J; Rennie, Winston J

    2016-06-01

    Various therapeutic options are available for treatment of recalcitrant plantar fasciitis. Studies using TOPAZ coblation (ArthroCare, Sunnyvale, CA) have had good early results. The current coblation technique involves a surgical incision or breach of the highly specialized plantar fat pad, which can be associated with risks. We describe a novel technique of ultrasound-guided percutaneous coblation with a lateral heel approach. Advantages include precise targeting of the plantar fascia by direct dynamic visualization of the coblation tip, a true percutaneous approach with a needle skin puncture (plantar fat pad by using a lateral heel approach. PMID:27162283

  19. Percutaneous Ultrasound-Guided TOPAZ Radiofrequency Coblation: A Novel Coaxial Technique for the Treatment of Recalcitrant Plantar Fasciitis-Our Experience.

    Science.gov (United States)

    Shah, Amit; Best, Alistair J; Rennie, Winston J

    2016-06-01

    Various therapeutic options are available for treatment of recalcitrant plantar fasciitis. Studies using TOPAZ coblation (ArthroCare, Sunnyvale, CA) have had good early results. The current coblation technique involves a surgical incision or breach of the highly specialized plantar fat pad, which can be associated with risks. We describe a novel technique of ultrasound-guided percutaneous coblation with a lateral heel approach. Advantages include precise targeting of the plantar fascia by direct dynamic visualization of the coblation tip, a true percutaneous approach with a needle skin puncture (<5 mm), and preservation of the plantar fat pad by using a lateral heel approach.

  20. Heel pain and phonophoresis.

    Science.gov (United States)

    Deshpande, Milind M; Patil, C B

    2010-06-01

    A review of 25 cases of heel pain treated conservatively with phonophoresis, using the anti-inflammatory gel containing a combination of flufenamic acid, salicylic acid and mucopolysaccharide polysulphate is being reported here. The purpose of the study was to assess the effectiveness of a noninvasive procedure called phonophoresis in treating hell pain. It involved usage of ultrasound waves to deliver anti-inflammatory drugs to the painful site. The heel pain subsided in all the cases and did not recur for a period of one year till last reviewed indicating the definite role of phonophoresis in heel pain. PMID:21121387

  1. Plantar fasciitis: corticosteroid injection versus chiropractic therapy

    Directory of Open Access Journals (Sweden)

    Siddharth Raveendran

    2014-04-01

    Full Text Available The diagnosis of plantar fasciitis is usually clinical and rarely needs to be investigated further. The patient complains of pain in the medial side of the heel, most noticeable with initial steps after a period of inactivity and usually lessens with increasing level of activity during the day, but will tend to worsen toward the end of the day. Symptoms may become worse following prolonged weight bearing, and often precipitated by increase in weight bearing activities. Paresthesia is uncommon. It is usually unilateral, but up to 30% of cases have a bilateral presentation. In our study patients who received chiropractic therapy were treated by rest, heat, ice pack, non-steroidal anti-inflammatory drugs (NSAIDS, heel pads, magnetic insole, night splints, walking cast, taping, ultrasound, plantar and Achilles stretching for a period of 6 weeks scheduled accordingly. Patients receiving corticosteroid injection were administered 80mg methyl prednisolone locally at the heel. Each patient received 3 doses of methyl prednisolone injections on 1st day, 2nd week, and 4th week. The results with corticosteroid injection were better when analyzed with numeric rating scale over a period of 6 weeks. [Int J Res Med Sci 2014; 2(2.000: 639-642

  2. Clinical application of musculoskeletal ultrasound imaging in chronic plantar fascitiis%肌肉骨骼超声在评估慢性足底筋膜炎中的临床应用

    Institute of Scientific and Technical Information of China (English)

    李建新; 邓建林; 张志杰; 朱毅; 方建辉

    2012-01-01

    目的:观察肌肉骨骼超声在评估慢性足底筋膜炎中的临床应用.方法:应用肌肉骨骼超声对21例单侧足底筋膜炎患者进行足底筋膜厚度的评估,由一位有经验的超声医生分别对患侧和健侧的足底筋膜厚度进行测量,测量2次,时间间隔为2~3d.结果:应用肌肉骨骼超声测量健侧和患侧足底筋膜厚度重复性测量信度分别为0.92和0.87,对比健侧与患侧足底筋膜厚度,患侧明显高于健侧(P<0.05).结论:肌肉骨骼超声可有效可靠地评估足底筋膜厚度,对于诊断慢性足底筋膜炎及评估治疗效果有着重要的意义.%Objective:To determine the clinical application of musculoskeletal ultrasound imaging in patients with unilateral chronic plantar fascitiis. Methods:A experienced ultrasound doctor scanned 21 patients with unilateral plantar fasciitis twice with 2 - 3 days between test and retest. Results:Intrarater reliability of measurement of plantar fascia thickness using musculoskeletal ultrasound imaging for both sides were 0. 92 and 0. 87. The fascia thickness in injuried sides were obviouly thicker than uninjuried sides(P<0. 05). Conclusion:The results revealed that musculoskeletal ultrasound imaging is a reliable method to evaluate the thickness of plantar fascia and diagnose chronic plantar fascitiis.

  3. ROLE OF CALCIUM, CALCITRIOL AND INTRALESION CORTICOSTEROID FOR HEEL PAIN MANAGEMENT IN WOMEN

    Directory of Open Access Journals (Sweden)

    Sheela

    2014-09-01

    Full Text Available Plantar heel pain is a commonly encountered Orthopaedic problem in women that can cause significant discomfort and difficulty in bearing weight. Proximal plantar fasciitis is twice as common in women as in men (2. An infracalcaneal spur frequently is associated with the symptomatology of plantar fasciitiss. METHODS AND MATERIAL: It’s a retrograded study of 72 female patients came in orthopaedics OPD with complain of planter heel pain. Age more than 30 years. Out of 72 patients, 59 were peri menopausal age group (> 40 years and 13 were younger age group (30-40 years. 43 patients had radiological evidence of calcaneal spur. 29 patients have bilateral heel pain. We treated all these patients by life style modification, use of heel pads, stretching exercise of foot and ankle, analgesics (as and when required calcium and calcitriol supplementation for 3 months. In 25 cases the diagnosis were made planter fasciitis and one foot is involved more with point tenderness persisted after 2 weeks of above mention treatment, we gave intra- lesion methyl prednisolone injection along with above mention treatment. DISCUSSION: We found 45.83% of patient s responded to this treatment within one month, 70.83% responded within 3 months and 65.27% showed improvement even after 6 months. CONCLUSION: Treatment of plantar heel pain should proceed in a stepwise fashion and, according to the patient’s response, as follows. First, modify or suppress the alleged risk factors, give an NSAID, prescribe a stretching program for the Achilles tendon, and recommend orthotics such as heel pads .Calcium and calcitriol supplementation specially in peri menopausal women with bilateral heal pain. If these fail, give one or two local injections of a methylprednisolone.

  4. Effect of Field Size and Length of Plantar Spur on Treatment Outcome in Radiation Therapy of Plantar Fasciitis: The Bigger the Better?

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, Robert Michael, E-mail: hermann@strahlentherapie-westerstede.com [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Meyer, Andreas [Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Gemeinschaftspraxis für Strahlentherapie Hildesheim/Goslar (Germany); Becker, Alexandra [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Schneider, Michael [Orthopaedic Centre for Musculoskeletal Research, University of Würzburg (Germany); Reible, Michael; Carl, Ulrich Martin [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Christiansen, Hans [Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover (Germany); Nitsche, Mirko [Zentrum für Strahlentherapie und Radioonkologie, Bremen/Westerstede (Germany); Klinik für Strahlentherapie, Karl-Lennert-Krebscentrum, Universität Kiel (Germany)

    2013-12-01

    Purpose: Radiation therapy is well established in the treatment of painful plantar fasciitis or heel spur. A retrospective analysis was conducted to investigate the effect of field definition on treatment outcome and to determine the impact of factors potentially involved. Methods and Materials: A review of treatment data of 250 patients (285 heels) with a mean follow-up time of 11 months showed that complete symptom remission occurred in 38%, partial remission in 32%, and no change in 19% (11% were lost to follow-up). Variables such as radiologic evidence of plantar spurs, their length, radiation dose, field size, age, sex, and onset of pain before administration of radiation therapy were investigated in univariate and multivariate regression analyses. Results: Treatment response depended upon age >53 years, length of heel spur ≤6.5 mm (or no radiologic evidence of a heel spur), and onset of pain <12 months before radiation therapy. Patients with these clinical prerequisites stood a 93% chance of clinical response. Without these prerequisites, only 49% showed any impact. No influence of field size on treatment outcome became evident. Conclusion: Patients with short plantar heel spurs benefit from radiation therapy equally well as patients without any radiologic evidence. Moreover, smaller field sizes have the same positive effect as commonly used large field definitions covering the entire calcaneal bone. This leads to a recommendation of a considerable reduction of field size in future clinical practice.

  5. Effect of Field Size and Length of Plantar Spur on Treatment Outcome in Radiation Therapy of Plantar Fasciitis: The Bigger the Better?

    International Nuclear Information System (INIS)

    Purpose: Radiation therapy is well established in the treatment of painful plantar fasciitis or heel spur. A retrospective analysis was conducted to investigate the effect of field definition on treatment outcome and to determine the impact of factors potentially involved. Methods and Materials: A review of treatment data of 250 patients (285 heels) with a mean follow-up time of 11 months showed that complete symptom remission occurred in 38%, partial remission in 32%, and no change in 19% (11% were lost to follow-up). Variables such as radiologic evidence of plantar spurs, their length, radiation dose, field size, age, sex, and onset of pain before administration of radiation therapy were investigated in univariate and multivariate regression analyses. Results: Treatment response depended upon age >53 years, length of heel spur ≤6.5 mm (or no radiologic evidence of a heel spur), and onset of pain <12 months before radiation therapy. Patients with these clinical prerequisites stood a 93% chance of clinical response. Without these prerequisites, only 49% showed any impact. No influence of field size on treatment outcome became evident. Conclusion: Patients with short plantar heel spurs benefit from radiation therapy equally well as patients without any radiologic evidence. Moreover, smaller field sizes have the same positive effect as commonly used large field definitions covering the entire calcaneal bone. This leads to a recommendation of a considerable reduction of field size in future clinical practice

  6. MRI of the plantar structures of the foot after falanga torture.

    Science.gov (United States)

    Savnik, A; Amris, K; Røgind, H; Prip, K; Danneskiold-Samsøe, B; Bojsen-Møller, F; Bartels, E M; Bliddal, H; Boesen, J; Egund, N

    2000-01-01

    Falanga is an ancient form of punishment or torture but is still commonly reported by our refugees. The late result of caning the heel and ball of the foot is a chronic painful condition with few clinical signs. The aim of the present study was to assess, by MRI, possible morphologic characteristics of the heel and ball of the foot, related to falanga and pain in correlation to clinical findings. Magnetic resonance imaging of the foot was obtained in 12 victims exposed to falanga torture and 9 healthy volunteers. Sagittal T1-weighted spin-echo images (TR 616-840 ms, TE 20 ms), T2-weighted spin-echo images (TR 1900 ms, TE 90 ms), and short tau inversion recovery (STIR) images (TR 1200 ms, TE 15 ms, TI 100 ms) were performed. The central portion of the plantar aponeurosis was generally significantly thicker in victims exposed to falanga torture as compared with that of controls (P ball pad of the foot. PMID:11044943

  7. Plantar calcaneal spurs in older people: longitudinal traction or vertical compression?

    Directory of Open Access Journals (Sweden)

    Landorf Karl B

    2008-08-01

    Full Text Available Abstract Background Plantar calcaneal spurs are common, however their pathophysiology is poorly understood. This study aimed to evaluate the prevalence and correlates of plantar calcaneal spurs in a large sample of older people. Methods Weightbearing lateral foot radiographs of 216 people (140 women and 76 men aged 62 to 94 years (mean age 75.9, SD 6.6 were examined for plantar calcaneal and Achilles tendon spurs. Associations between the presence of spurs and sex, body mass index, radiographic measures of foot posture, self-reported co-morbidities and current or previous heel pain were then explored. Results Of the 216 participants, 119 (55% had at least one plantar calcaneal spur and 103 (48% had at least one Achilles tendon spur. Those with plantar calcaneal spurs were more likely to have Achilles tendon spurs (odds ratio [OR] = 2.0, 95% confidence interval [CI] 1.2 to 3.5. Prevalence of spurs did not differ according to sex. Participants with plantar calcaneal spurs were more likely to be obese (OR = 7.9, 95% CI 3.6 to 17.0, report osteoarthritis (OR = 2.6, 95% CI 1.6 to 4.8 and have current or previous heel pain (OR = 4.6, 95% CI 2.3 to 9.4. No relationship was found between the presence of calcaneal spurs and radiographic measures of foot posture. Conclusion Calcaneal spurs are common in older men and women and are related to obesity, osteoarthritis and current or previous heel pain, but are unrelated to radiographic measurements of foot posture. These findings support the theory that plantar calcaneal spurs may be an adaptive response to vertical compression of the heel rather than longitudinal traction at the calcaneal enthesis.

  8. Imaging of plantar fascia and Achilles injuries undertaken at the London 2012 Olympics

    OpenAIRE

    Elias, David A.; Carne, Andrew; Bethapudi, Sarath; Engebretsen, Lars; Budgett, Richard; O'Conor, Philip

    2013-01-01

    Plantar fascia and distal Achilles injuries are common in elite athletes. Acute athletic injuries of the plantar fascia include acute plantar fasciopathy and partial or complete tears. Underlying most acute injuries is a background of underlying chronic plantar fasciopathy. Injuries may affect the central or less commonly lateral portions of the fascia and acute tears are generally proximal. Athletic Achilles injuries may occur at the mid tendon or the distal insertion, and there may be an un...

  9. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality

    Directory of Open Access Journals (Sweden)

    Deepak Thapa

    2014-01-01

    Full Text Available Plantar fasciitis (PF is the most common cause of chronic heel pain which may be bilateral in 20 to 30% of patients. It is a very painful and disabling condition which can affect the quality of life. The management includes both pharmacological and operative procedures with no single proven effective treatment modality. In the present case series, we managed three patients with PF (one with bilateral PF. Following a diagnostic medial calcaneal nerve (MCN block at its origin, we observed reduction in verbal numerical rating scale (VNRS in all the three patients. Two patients has relapse of PF pain which was managed with MCN block followed with pulsed radio frequency (PRF. All the patients were pain-free at the time of reporting. This case series highlights the possible role of combination of diagnostic MCN block near its origin followed with PRF as a new modality in management of patients with PF.

  10. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality.

    Science.gov (United States)

    Thapa, Deepak; Ahuja, Vanita

    2014-03-01

    Plantar fasciitis (PF) is the most common cause of chronic heel pain which may be bilateral in 20 to 30% of patients. It is a very painful and disabling condition which can affect the quality of life. The management includes both pharmacological and operative procedures with no single proven effective treatment modality. In the present case series, we managed three patients with PF (one with bilateral PF). Following a diagnostic medial calcaneal nerve (MCN) block at its origin, we observed reduction in verbal numerical rating scale (VNRS) in all the three patients. Two patients has relapse of PF pain which was managed with MCN block followed with pulsed radio frequency (PRF). All the patients were pain-free at the time of reporting. This case series highlights the possible role of combination of diagnostic MCN block near its origin followed with PRF as a new modality in management of patients with PF.

  11. Effects of Shoe Heel Height on Loading and Muscle Activity for Trans-Tibial Amputees During Standing

    Institute of Scientific and Technical Information of China (English)

    JIA Xiaohong; WANG Rencheng; Winson Lee

    2009-01-01

    This study accesses the effects of shoe heel heights on loading, muscle activity, and plantar foot pressure of trans-tibial amputees during standing. Five male subjects with unilateral trans-tibial amputation volunteered to participate in this study. Three pairs of shoes with zero, 20 mm, and 40 mm heel heights were used. The loading line of the prosthetic side, the plantar foot pressure, and the surface electromyography (EMG) of 10 muscles were simultaneously recorded. With increasing shoe heel heights during standing, the loading line of the prosthetic side shifted from the anterior to the posterior side of the knee center, the peak pressure was increased in the medial forefoot region, and the peak pressure was reduced in the heel region. The EMG of the medial and lateral gastrocnemius of the sound leg almost doubled and that of the rectus fomris, vastus lateralis, and vastus medialis of the prosthetic side increased to different extents with in-creasing heel heights from zero to 40 mm. These results show a high correlation with human physical be-havior. Changing of the heel heights for trans-tibial amputees during standing actually had similar effects to altering the prosthetic sagittal alignment. The results suggest that an alignment change is necessary to ac-commodate heel height changes and that prosthesis users should be cautious when choosing shoes.

  12. Orthotic Heel Wedges Do Not Alter Hindfoot Kinematics and Achilles Tendon Force During Level and Inclined Walking in Healthy Individuals.

    Science.gov (United States)

    Weinert-Aplin, Robert A; Bull, Anthony M J; McGregor, Alison H

    2016-04-01

    Conservative treatments such as in-shoe orthotic heel wedges to treat musculoskeletal injuries are not new. However, weak evidence supporting their use in the management of Achilles tendonitis suggests the mechanism by which these heel wedges works remains poorly understood. It was the aim of this study to test the underlying hypothesis that heel wedges can reduce Achilles tendon load. A musculoskeletal modeling approach was used to quantify changes in lower limb mechanics when walking due to the introduction of 12-mm orthotic heel wedges. Nineteen healthy volunteers walked on an inclinable walkway while optical motion, force plate, and plantar pressure data were recorded. Walking with heel wedges increased ankle dorsiflexion moments and reduced plantar flexion moments; this resulted in increased peak ankle dorsiflexor muscle forces during early stance and reduced tibialis posterior and toe flexor muscle forces during late stance. Heel wedges did not reduce overall Achilles tendon force during any walking condition, but did redistribute load from the medial to lateral triceps surae during inclined walking. These results add to the body of clinical evidence confirming that heel wedges do not reduce Achilles tendon load and our findings provide an explanation as to why this may be the case. PMID:26502456

  13. Orthotic Heel Wedges Do Not Alter Hindfoot Kinematics and Achilles Tendon Force During Level and Inclined Walking in Healthy Individuals.

    Science.gov (United States)

    Weinert-Aplin, Robert A; Bull, Anthony M J; McGregor, Alison H

    2016-04-01

    Conservative treatments such as in-shoe orthotic heel wedges to treat musculoskeletal injuries are not new. However, weak evidence supporting their use in the management of Achilles tendonitis suggests the mechanism by which these heel wedges works remains poorly understood. It was the aim of this study to test the underlying hypothesis that heel wedges can reduce Achilles tendon load. A musculoskeletal modeling approach was used to quantify changes in lower limb mechanics when walking due to the introduction of 12-mm orthotic heel wedges. Nineteen healthy volunteers walked on an inclinable walkway while optical motion, force plate, and plantar pressure data were recorded. Walking with heel wedges increased ankle dorsiflexion moments and reduced plantar flexion moments; this resulted in increased peak ankle dorsiflexor muscle forces during early stance and reduced tibialis posterior and toe flexor muscle forces during late stance. Heel wedges did not reduce overall Achilles tendon force during any walking condition, but did redistribute load from the medial to lateral triceps surae during inclined walking. These results add to the body of clinical evidence confirming that heel wedges do not reduce Achilles tendon load and our findings provide an explanation as to why this may be the case.

  14. Diagnosis of heel pad injuries

    DEFF Research Database (Denmark)

    Matteoli, Sara

    load-displacement curves from in vivo heel pads. To ensure applicability also for pathological feet, the device uses force levels lower than those needed to reproduce the physiological conditions of walking. One hundred twenty seven healthy volunteers were enrolled for compression tests and ultrasound...... were conducted in two additional studies. In vivo experimental tests were used to validate a numerical 3D subject-specific heel pad model subjected to an external compression, and to further investigate the visco-elastic nature of the heel pad. Ultrasound distance measurements were compared with...... corresponding distance measurements with MRI and true values in order to assess its reliability in heel pad thickness measurements. The latter study confirmed the need to investigate the real speed of sound for the heel pad tissues, in order to obtain realistic measurements when dealing with human heel pad....

  15. A novel treatment for refractory plantar fasciitis.

    Science.gov (United States)

    Patel, Mihir M

    2015-03-01

    Chronic plantar fasciitis is a major health care problem worldwide and affects nearly 10% of the US population. Although most cases resolve with conservative care, the numerous treatments for refractory plantar fasciitis attest to the lack of consensus regarding these cases. The emerging goals for this condition are a minimally invasive percutaneous intervention that is safe, effective, and well-tolerated and has minimal morbidity and a low complication rate. We conducted a prospective study in which patients were allowed either to continue with noninvasive treatment or to undergo focal aspiration and partial fasciotomy with an ultrasonic probe. This is the first report of a plantar fascia partial release guided by ultrasonic energy delivered by a percutaneously inserted probe under local anesthesia. The procedure appears to be a safe, effective, well-tolerated treatment for a condition that is refractory to other options. PMID:25750942

  16. Re-irradiation for painful heel spur syndrome. Retrospective analysis of 101 heels

    International Nuclear Information System (INIS)

    Painful heel spur syndrome is a common disease with a lifetime prevalence of approximately 10 %. One of the most effective treatment options is radiotherapy. Many authors recommend a second or third series of radiation for recurrent pain and partial or no response to the initial treatment. As the results of re-irradiation have not been systematically analyzed the aim of this study was to document the results of repeated radiation treatment and to identify patients who could benefit from this treatment. The analysis was performed on patients from 2 German radiotherapy institutions and included 101 re-irradiated heels. Pain was documented with the numeric rating scale (NRS) and carried out before and directly after each radiation therapy as well as for the follow-up period of 24 months. The median age of the patients was 56 years with 30.1 % male and 69.9 % female patients. Pain was caused by plantar fasciitis in 72.3 %, Haglund's exostosis in 15.8 % and Achilles tendinitis in 11.9 %. Repeated radiation was indicated because the initial radiotherapy resulted in no response in 35.6 % of patients, partial response in 39.6 % and recurrent pain in 24.8 %. A significant response to re-irradiation could be found. For the whole sample the median NRS pain score was 6 before re-irradiation, 2 after 6 weeks and 0 after 12 and 24 months. Of the patients 73.6 % were free of pain 24 months after re-irradiation. All subgroups, notably those with no response, partial response and recurrent pain had a significant reduction of pain. Re-irradiation of painful heel spur syndrome is an effective and safe treatment. All subgroups showed a good response to re-irradiation for at least 24 months. (orig.)

  17. Plantar fascia (image)

    Science.gov (United States)

    The plantar fascia is a very thick band of tissue that covers the bones on the bottom of the foot. It ... band of tissue causes a high arch. This fascia can become inflamed and painful in some people, ...

  18. Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy.

    Science.gov (United States)

    Gerdesmeyer, Ludger; Mittermayr, Rainer; Fuerst, Martin; Al Muderis, Munjed; Thiele, Richard; Saxena, Amol; Gollwitzer, Hans

    2015-12-01

    Chronic Achilles tendinopathy has been described as the most common overuse injury in sports medicine. Several treatment modalities such as activity modification, heel lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading are known as standard treatment mostly without proven evidence. After failed conservative therapy, invasive treatment may be considered. Extracorporeal shock wave therapy (ESWT) has been successfully used in soft-tissue pathologies like lateral epicondylitis, plantar fasciitis, tendinopathy of the shoulder and also in bone and skin disorders. Conclusive evidence recommending ESWT as a treatment for Achilles tendinopathy is still lacking. In plantar fasciitis as well as in calcific shoulder tendinopathy shock wave therapy is recently the best evaluated treatment option. This article analysis the evidence based literature of ESWT in chronic Achilles tendinopathy. Recently published data have shown the efficacy of focused and radial extracorporeal shock wave therapy. PMID:26327530

  19. Platelet-Rich-Plasma injection seems to be effective in treatment of plantar fasciitis: a case series.

    Science.gov (United States)

    van Egmond, Jeroen C; Breugem, Stefan J M; Driessen, Marcel; Bruijn, Daniel J

    2015-06-01

    Plantar fasciitis is the most common cause of heel pain. Diverse non-operative treatment options are available. The purpose of this study was to determine if a single platelet-rich-plasma injection at the origin of the plantar fascia in patients with plantar fasciitis gives a functional improvement. Patients with plantar fasciitis and failed conservative treatment were included in this retrospective study. Included patients were sent four questionnaires after platelet-rich-plasma injection. Primary outcome is functional improvement, determined by foot function index in which lower scores correlates with a better foot function. A total of 61 feet in 58 patients were included. The median foot function index before treatment was 69.4 and after treatment 31.8, which is a significant decrease. In 80.3% of the patients the foot function index decreased. Therefore platelet-rich-plasma injection seems to be effective in treatment of patients with plantar fasciitis when conservative treatment failed. PMID:26280973

  20. Talalgia: plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Ricardo Cardenuto Ferreira

    2014-06-01

    Full Text Available Plantar fasciitis is a very common painful syndrome, but its exact etiology still remains obscure. The diagnosis is essentially clinical, based on history-taking and physical examination. Complementary laboratory tests and imaging examinations may be useful for differential diagnoses. The treatment is essentially conservative, with a high success rate (around 90%. The essence of the conservative treatment is the home-based program of exercises to stretch the plantar fascia. Indications for surgical treatment are only made when the symptoms persist without significant improvement, after at least six months of conservative treatment supervised directly by the doctor.

  1. Plantar Hyperhidrosis: An Overview.

    Science.gov (United States)

    Vlahovic, Tracey C

    2016-07-01

    Plantar hyperhidrosis, excessive sweating on the soles of feet, can have a significant impact on patients' quality of life and emotional well-being. Hyperhidrosis is divided into primary and secondary categories, depending on the cause of the sweating, with plantar hyperhidrosis typically being primary and idiopathic. There is an overall increased risk of cutaneous infection in the presence of hyperhidrosis, including fungal, bacterial, and viral infections. This article discusses a range of treatment options including topical aluminum chloride, iontophoresis, injectable botulinum toxin A, glycopyrrolate, oxybutynin, laser, and endoscopic lumbar sympathectomy. Lifestyle changes regarding hygiene, shoe gear, insoles, and socks are also discussed. PMID:27215162

  2. Anatomical features of plantar aponeurosis: cadaveric study using ultrasonography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Abnormalities of the plantar aponeurosis are commonly encountered in patients with subcalcaneal heel pain. Understanding normal anatomy is required to accurately diagnose some disorders of the foot. The purpose of our study was to describe the normal anatomy of the plantar aponeurosis, using ultrasonography and MRI with close anatomic correlation in cadavers. After MRI and ultrasonography of 10 cadaveric foot specimens, the thickness of the central and lateral portions of the plantar aponeurosis displayed by imaging studies was measured by three radiologists. One specimen was sectioned in the transverse plane, one in the coronal plane, one in the sagittal plane, and two in a sagittal oblique plane. Normal anatomy was identified and similar measurements of the plantar aponeurosis were also made. An average value was determined and a statistical analysis was accomplished. The calcaneal insertions of the plantar aponeurosis were better visualized than its distal portions with both MRI and ultrasonography. The measurements of the plantar aponeurosis made by three different radiologists were different, but without statistical significance. The average measurements for the central and lateral portions of the plantar aponeurosis with both imaging methods were different from each other because of differences in the morphology of these structures. The values obtained with ultrasonography and MRI, were also different from each other for both the central and lateral portions of the plantar aponeurosis, but with no statistical significance. We have described the detailed anatomy of the plantar aponeurosis with emphasis on the more distal structures that can be visualized with MRI. There was no statistically significant difference between the accuracy of ultrasonography and MRI regarding the measurements of the thickness of the central and lateral portions of the plantar aponeurosis. Knowledge of the normal anatomy of these structures enables the radiologist to identify early

  3. Anatomical features of plantar aponeurosis: cadaveric study using ultrasonography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Moraes do Carmo, Clarissa Canella; Fonseca de Almeida Melao, Lina Isabel; Valle de Lemos Weber, Marcio Freitas; Trudell, Debra; Resnick, Donald [UCSD, Department of Radiology, San Diego, CA (United States); VA Healthcare System San Diego, La Jolla, CA (United States)

    2008-10-15

    Abnormalities of the plantar aponeurosis are commonly encountered in patients with subcalcaneal heel pain. Understanding normal anatomy is required to accurately diagnose some disorders of the foot. The purpose of our study was to describe the normal anatomy of the plantar aponeurosis, using ultrasonography and MRI with close anatomic correlation in cadavers. After MRI and ultrasonography of 10 cadaveric foot specimens, the thickness of the central and lateral portions of the plantar aponeurosis displayed by imaging studies was measured by three radiologists. One specimen was sectioned in the transverse plane, one in the coronal plane, one in the sagittal plane, and two in a sagittal oblique plane. Normal anatomy was identified and similar measurements of the plantar aponeurosis were also made. An average value was determined and a statistical analysis was accomplished. The calcaneal insertions of the plantar aponeurosis were better visualized than its distal portions with both MRI and ultrasonography. The measurements of the plantar aponeurosis made by three different radiologists were different, but without statistical significance. The average measurements for the central and lateral portions of the plantar aponeurosis with both imaging methods were different from each other because of differences in the morphology of these structures. The values obtained with ultrasonography and MRI, were also different from each other for both the central and lateral portions of the plantar aponeurosis, but with no statistical significance. We have described the detailed anatomy of the plantar aponeurosis with emphasis on the more distal structures that can be visualized with MRI. There was no statistically significant difference between the accuracy of ultrasonography and MRI regarding the measurements of the thickness of the central and lateral portions of the plantar aponeurosis. Knowledge of the normal anatomy of these structures enables the radiologist to identify early

  4. Extracorporeal shock wave in the treatment of chronic plantar fasciitis%体外冲击波治疗慢性足底筋膜炎

    Institute of Scientific and Technical Information of China (English)

    郑萍; 闫汝蕴

    2008-01-01

    学术背景:已经证实应用体外冲击波治疗慢性足底筋膜炎的疗效是确定的,关于其作用机制有不同的解释,尚未完全明确.目的:介绍体外冲击波治疗慢性足底筋膜炎的作用机制及临床应用方面的研究进展.检索策略:由第一、二作者应用计算机检索PUBMED、HighWire、Springer数据库公开的截止到2007-08的相关文献,检索词为"chronic plantar fasciitis extracorporeal shock wave application",限定语言种类为"English".纳入标准:内容与体外冲击波治疗慢性足底筋膜炎的作用机制和临床应用有关.排除标准:较陈旧和重复研究.文献评价:共收集到65篇相关文献,25篇文献符合标准,其中4篇是综述和述评类文献,其余均为关于作用机制、临床应用的研究的文章.资料综合:①作用机制:有人认为高能量冲击波选择性地破坏了无髓鞘的感觉神经纤维;而低能量冲击波则可使如降钙素基因相关肽等肽类物质的释放,在局部产生神经源性炎症反应,进而抑制了感觉神经末梢的传导.并可引起大脑局部血流的改变,调整疼痛记忆,使对局部疼痛刺激反应的减少,从而起到了长期镇痛作用.②临床应用:有许多关于近期、远期疗效、不同能量等级的疗效以及使用局麻药物、跖筋膜的厚度、治疗位置的选择等对疗效的影响的报告.结论:应用体外冲击波治疗慢性足底筋膜炎有确定的疗效的,不同的临床应用方法可影响临床疗效.

  5. Effect of radial extracorporeal shock wave therapy on chronic plantar fasciitis%放散状体外冲击波疗法治疗慢性足底筋膜炎的疗效

    Institute of Scientific and Technical Information of China (English)

    范志英; 董启榕; 汪益; 秦建忠; 李柳炳

    2015-01-01

    Objective To investigate the clinical effect of radial extracorporeal shock wave therapy(ESWT) on chronic plantar fasciitis .Methods A total of 42 patients with chronic plantar fasciitis was equally randomized into two groups of A (treated with radial ESWT ) and B(injected with corticosteroid) .The clinical efficacy was evaluated by VAS scoring ,and adverse effect was observed . Results VAS scores in the 1st week and 3rd month after treatment in both groups were lower than those before treatment(P0 .05) .The effectiveness rate in group A was higher than that in group B (85.71% vs .57.14% )(P<0 .05) . There was no serious adverse effect in both groups .Conclusion Application of radial ESWT in the treatment of chronic plantar fasciitis can achieve satisfactory outcomes with the advantages of simple operation ,without need of anesthesia ,non‐invasion and durable clinical efficacy .%目的:研究放散状体外冲击波治疗慢性足底筋膜炎的临床效果。方法42例慢性足底筋膜炎患者随机均分为放散状体外冲击波组(A组)和局封组(B组),采用视觉模拟评分法(VAS )评估两组临床疗效,并观察不良反应的发生情况。结果两组治疗后 VAS评分均较治疗前下降(P<0.05),且A组治疗后VAS评分低于B组(P<0.05)。与治疗后1周相比,A组治疗后3个月时的VAS评分降低(P<0.05),而B组VAS 评分无明显变化(P>0.05)。A组临床有效率高于B组(85.71% vs .57.14%)(P<0.05)。两组均未发生严重不良反应。结论放散状体外冲击波疗法治疗慢性足底筋膜炎疗效显著,具有操作简单、无需麻醉、非侵入性和疗效持久可靠等优势。

  6. Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review.

    Science.gov (United States)

    Mohseni-Bandpei, Mohammad Ali; Nakhaee, Masoomeh; Mousavi, Mohammad Ebrahim; Shakourirad, Ali; Safari, Mohammad Reza; Vahab Kashani, Reza

    2014-08-01

    Plantar fasciitis (PFS) is one of the most common causes of heel pain, estimated to affect 10% of the general population during their lifetime. Ultrasound (US) imaging technique is increasingly being used to assess plantar fascia (PF) thickness, monitor the effect of different interventions and guide therapeutic interventions in patients with PFS. The purpose of the present study was to systematically review previously published studies concerning the application of US in the assessment of PF in patients with PFS. A literature search was performed for the period 2000-2012 using the Science Direct, Scopus, PubMed, CINAHL, Medline, Embase and Springer databases. The key words used were: ultrasound, sonography, imaging techniques, ultrasonography, interventional ultrasonography, plantar fascia and plantar fasciitis. The literature search yielded 34 relevant studies. Sixteen studies evaluated the effect of different interventions on PF thickness in patients with PFS using US; 12 studies compared PF thickness between patients with and without PFS using US; 6 studies investigated the application of US as a guide for therapeutic intervention in patients with PFS. There were variations among studies in terms of methodology used. The results indicated that US can be considered a reliable imaging technique for assessing PF thickness, monitoring the effect of different interventions and guiding therapeutic interventions in patients with PFS.

  7. High Heels Increase Women's Attractiveness.

    Science.gov (United States)

    Guéguen, Nicolas

    2015-11-01

    Research has found that the appearance of women's apparel helps increase their attractiveness as rated by men and that men care more about physical features in potential opposite-sex mates. However, the effect of sartorial appearance has received little interest from scientists. In a series of studies, the length of women's shoe heels was examined. A woman confederate wearing black shoes with 0, 5, or 9 cm heels asked men for help in various circumstances. In Study 1, she asked men to respond to a short survey on gender equality. In Study 2, the confederate asked men and women to participate in a survey on local food habit consumption. In Study 3, men and women in the street were observed while walking in back of the female confederate who dropped a glove apparently unaware of her loss. It was found that men's helping behavior increased as soon as heel length increased. However, heel length had no effect on women's helping behavior. It was also found that men spontaneously approached women more quickly when they wore high-heeled shoes (Study 4). Change in gait, foot-size judgment, and misattribution of sexiness and sexual intent were used as possible explanations. PMID:25408499

  8. Effect of antipronation foot orthosis geometry on compression of heel and arch soft tissues

    Directory of Open Access Journals (Sweden)

    Declan Sweeney, BSc (Hon

    2016-09-01

    Full Text Available This study aimed to understand how systematic changes in arch height and two designs of heel wedging affect soft tissues under the foot. Soft tissue thickness under the heel and navicular was measured using ultrasound. Heel pad thickness was measured while subjects were standing on a flat surface and also while they were standing on an orthosis with 4 and 8 degree extrinsic wedges and 4 and 8 mm intrinsic wedges (n = 27. Arch soft tissue thickness was measured when subjects were standing and when standing on an orthosis with –6 mm, standard, and +6 mm increments in arch height (n = 25. Extrinsic and intrinsic heel wedges significantly increased soft tissue thickness under the heel compared with no orthosis. The 4 and 8 degree extrinsic wedges increased tissue thickness by 28.3% and 27.6%, respectively, while the 4 and 8 mm intrinsic wedges increased thickness by 23.0% and 14.6%, respectively. Orthotic arch height significantly affected arch soft tissue thickness. Compared with the no orthosis condition, the –6 mm, standard, and +6 mm arch heights decreased arch tissue thickness by 9.1%, 10.2%, and 11.8%, respectively. This study demonstrates that change in orthotic geometry creates different plantar soft tissue responses that we expect to affect transmission of force to underlying foot bones.

  9. Predictors of barefoot plantar pressure during walking in patients with diabetes, peripheral neuropathy and a history of ulceration.

    Directory of Open Access Journals (Sweden)

    Ruth Barn

    Full Text Available Elevated dynamic plantar foot pressures significantly increase the risk of foot ulceration in diabetes mellitus. The aim was to determine which factors predict plantar pressures in a population of diabetic patients who are at high-risk of foot ulceration.Patients with diabetes, peripheral neuropathy and a history of ulceration were eligible for inclusion in this cross sectional study. Demographic data, foot structure and function, and disease-related factors were recorded and used as potential predictor variables in the analyses. Barefoot peak pressures during walking were calculated for the heel, midfoot, forefoot, lesser toes, and hallux regions. Potential predictors were investigated using multivariate linear regression analyses. 167 participants with mean age of 63 years contributed 329 feet to the analyses.The regression models were able to predict between 6% (heel and 41% (midfoot of the variation in peak plantar pressures. The largest contributing factor in the heel model was glycosylated haemoglobin concentration, in the midfoot Charcot deformity, in the forefoot prominent metatarsal heads, in the lesser toes hammer toe deformity and in the hallux previous ulceration. Variables with local effects (e.g. foot deformity were stronger predictors of plantar pressure than global features (e.g. body mass, age, gender, or diabetes duration.The presence of local deformity was the largest contributing factor to barefoot dynamic plantar pressure in high-risk diabetic patients and should therefore be adequately managed to reduce plantar pressure and ulcer risk. However, a significant amount of variance is unexplained by the models, which advocates the quantitative measurement of plantar pressures in the clinical risk assessment of the patient.

  10. Percutaneous Ultrasonic Fasciotomy for Refractory Plantar Fasciopathy After Failure of a Partial Endoscopic Release Procedure.

    Science.gov (United States)

    Pourcho, Adam M; Hall, Mederic M

    2015-11-01

    Plantar fasciopathy is a painful, degenerative condition of the plantar fascia that affects 2 million people annually and has an estimated 10% lifetime prevalence. When both nonoperative and operative management fails, patients have limited therapeutic options. We present a case of an active 47-year-old male runner who was successfully treated with songraphically guided percutaneous ultrasonic fasciotomy after undergoing a prolonged course of nonoperative management and an endoscopic plantar fascia release procedure. Percutaneous ultrasonic fasciotomy may be considered in patients with chronic, refractory plantar fasciopathy, including those for whom a prior operative release procedure has failed. PMID:25857590

  11. Making heel pricks less painful.

    OpenAIRE

    Harpin, V A; N. Rutter

    1983-01-01

    A mechanical lancet, the Autolet, was compared with a manual heel prick in 36 newborn infants undergoing routine blood sampling for the Guthrie test and hypothyroid screening. Each method was equally effective in obtaining satisfactory blood samples but the Autolet was considerably less painful.

  12. Ultrasound- versus palpation-guided injection of corticosteroid for plantar fasciitis: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Zonghuan Li

    Full Text Available BACKGROUND: It is controversial whether ultrasound-guided injection of corticosteroid is superior to palpation-guided injection for plantar fasciitis. This meta-analysis was performed to compare the effectiveness of ultrasound-guided and palpation-guided injection of corticosteroid for the treatment of plantar fasciitis. METHODS: Databases (MEDLINE, Cochrane library and EMBASE and reference lists were searched from their establishment to August 30, 2013 for randomized controlled trials (RCTs comparing ultrasound-guided with palpation-guided injection for plantar fasciitis. The Cochrane risk of bias (ROB tool was used to assess the methodological quality. Outcome measurements were visual analogue scale (VAS, tenderness threshold (TT, heel tenderness index (HTI, response rate, plantar fascia thickness (PFT, hypoechogenicity and heel pad thickness (HPT. The statistical analysis was performed with software RevMan 5.2 and Stata 12.0. When I2<50%, the fixed-effects model was adopted. Otherwise the randomized-effects model was adopted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE system was used to assess the quality of evidence. RESULTS: Five RCTs with 149 patients were identified and analyzed. Compared with palpation-guided injection, ultrasound-guided injection was superior with regard to VAS, TT, response rate, PFT and hypoechogenicity. However, there was no statistical significance between the two groups for HPT and HTI. CONCLUSION: Ultrasound-guided injection of corticosteroid tends to be more effective than palpation-guided injection. However, it needs to be confirmed by further research.

  13. Plantar vein thrombosis: a rare cause of plantar foot pain

    Energy Technology Data Exchange (ETDEWEB)

    Siegal, Daniel S.; Wu, Jim S.; Brennan, Darren D.; Hochman, Mary G. [Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA (United States); Challies, Tracy [Beth Israel Deaconess Medical Center, Department of Pathology, Boston, MA (United States)

    2008-03-15

    Plantar vein thrombosis is a rare condition, with only a handful of cases reported in the literature. The cause is unknown; however, the disease has been attributed to prior surgery, trauma, and paraneoplastic conditions. We present a case of a 32-year-old female runner with plantar vein thrombosis diagnosed on contrast-enhanced MRI and confirmed on ultrasound. The symptoms resolved with conservative treatment and evaluation revealed the presence of a prothrombin gene mutation and use of oral contraceptive pills. To our knowledge, this is the first case of plantar vein thrombosis diagnosed initially by MRI. Moreover, this case suggests that plantar vein thrombosis should be considered in patients with hypercoagulable states and plantar foot pain. (orig.)

  14. Plantar fasciitis – to jab or to support? A systematic review of the current best evidence

    Directory of Open Access Journals (Sweden)

    Uden H

    2011-05-01

    , corticosteroid injections may have side effects (especially pain as a result of the injection, which may limit its acceptability.Keywords: plantar fasciitis, heel pain, orthotics, orthoses, cortisone injection, corticosteroid injection

  15. Clinical effectiveness of extracorporeal shock wave treatment combined with electric acupuncture for chronic plantar fasciitis%体外冲击波联合电针治疗慢性足底筋膜炎

    Institute of Scientific and Technical Information of China (English)

    王俊华; 徐远红; 王刚; 李海峰; 朱小虎; 谢谨

    2012-01-01

    Objectives To observe the clinical effect of extracorporeal shock wave treatment (ESWT) combined with electric acupuncture for chronic plantar fasciitis. Methods: 60 patients with chronic plantar fasciitis were randomly divided into electric acupuncture group, ESWT group and combined group, with 20 cases in each group. Visual analog scale (VAS) was used to evaluate the pain degree before,2 weeks,4 weeks and 3 months after treatment, and VAS weighted value was used to evaluate the clinical effect 3 months after treatment in all 3 groups. Results. VAS scores were dramatically declined after treatment at all phases in 3 groups, and those in combined group were declined more significantly than in electric acupuncture group and ESWT group (P<0. 05). Improvement in ESWT group was more significant than in electric acupuncture group at 3rd month after treatment (F<0.05). VAS scores were gradually decreased in combined group and ESWT group, but increased at 3rd month after treatment in electric acupuncture group. The curative rate in combined group was obviously higher than in electric acupuncture group and ESWT group, and that in ESWT group was higher than in electric acupuncture group (P<0. 05). Conclusion: ESWT and electric acupuncture are both effective in treating chronic plantar fasciitis, and combined use of them shows more satisfactory short-term as well as long-term effects.%目的:观察体外冲击波联合电针治疗慢性足底筋膜炎的临床疗效.方法:60例慢性足底筋膜炎患者随机分为电针组、冲击波组(ESWT组)及联合治疗组(联合组)各20例.电针组只接受电针治疗,ESWT组只接受ESWT治疗,联合组同时接受电针和ESWT联合治疗,3组患者在治疗前、治疗后2周、4周及3个月行VAS疼痛评分,治疗3个月后采用VAS加权值评定临床疗效.结果:3组患者VAS评分在治疗后各时间点均较治疗前明显下降,且联合组更低于电针组及ESWT组(P<0.05);ESWT组在治疗后3

  16. Using an optimization approach to design an insole for lowering plantar fascia stress--a finite element study.

    Science.gov (United States)

    Hsu, Yu-Chun; Gung, Yih-Wen; Shih, Shih-Liang; Feng, Chi-Kuang; Wei, Shun-Hwa; Yu, Chung-Huang; Chen, Chen-Sheng

    2008-08-01

    Plantar heel pain is a commonly encountered orthopedic problem and is most often caused by plantar fasciitis. In recent years, different shapes of insole have been used to treat plantar fasciitis. However, little research has been focused on the junction stress between the plantar fascia and the calcaneus when wearing different shapes of insole. Therefore, this study aimed to employ a finite element (FE) method to investigate the relationship between different shapes of insole and the junction stress, and accordingly design an optimal insole to lower fascia stress.A detailed 3D foot FE model was created using ANSYS 9.0 software. The FE model calculation was compared to the Pedar device measurements to validate the FE model. After the FE model validation, this study conducted parametric analysis of six different insoles and used optimization analysis to determine the optimal insole which minimized the junction stress between plantar fascia and calcaneus. This FE analysis found that the plantar fascia stress and peak pressure when using the optimal insole were lower by 14% and 38.9%, respectively, than those when using the flat insole. In addition, the stress variation in plantar fascia was associated with the different shapes of insole.

  17. Plantar pressures in the tennis serve.

    Science.gov (United States)

    Girard, Olivier; Eicher, Frank; Micallef, Jean-Paul; Millet, Grégoire

    2010-06-01

    In-shoe loading patterns were examined in each foot (back and front) separately during two types of tennis serve [first (or flat) and second (or twist) serve] and two service stance styles [foot-up (back foot is moved forward next to front foot for push-off) and foot-back (feet remain at the same relative level)]. Ten competitive tennis players completed five trials for each type of serve and service stance style in random order. Plantar pressure distribution was recorded using Pedar insoles divided into nine areas for analysis. Mean and peak pressures (+15.2%, P forces (+20.2%, P forces were higher (+17.2%, P < 0.05) under the lesser toes. Relative load was higher on the lateral forefoot (+20.4%, P < 0.05) but lower (-32.5%, P < 0.05) on the medial heel of the front foot with foot-up compared with foot-back stance. Using a foot-up stance, loading of the back foot was higher (+31.8%, P < 0.01) under the lateral mid-foot but lower (-29.9%, P < 0.01) under the medial forefoot. The type of serve and the stance style adopted have a significant effect on foot loading. Such findings might help improve mechanical efficiency of the serve. PMID:20496222

  18. [Cover flaps for loss of substance on the heel. Apropos of 8 cases].

    Science.gov (United States)

    Mulfinger, C; Bardot, J; Legre, R; Aubert, J P; Magalon, G; Bureau, H

    1993-10-01

    The anatomical and function characteristics of the heel region explain the large number of methods used and the differences of opinion particularly in relation to the repair of weightbearing zones. Our study is based on 28 patients in whom we performed: ten regional flaps, six cross-leg flaps, sixteen microsurgical flaps. The temporal fascia free flap provides good results on the posterior surface with minimal sequelae at the donor site. The medial plantar flap appears to be the most suitable flap for weight-bearing zones. Cross-lep flaps allow satisfactory repair of the weightbearing zone, but the scarred appearance of the donor site is inaesthetic and immobilisation is uncomfortable. The problem of large defects is still not resolved and no really satisfactory method is available among the various distant, skin, myocutaneous, pure muscle or cross-leg flaps. The solution may reside in a combination of two flaps allowing better adaptation to the morphology of the heel. The importance of heel sensation, particularly in the weight-bearing zone, led to the concept of the use of sensitive or resensitised flaps. After a review of the literature and our results, we did not find any correlation between the sensitivity obtained and the success of the reconstruction. It therefore seems useless to perform microscopic nerve sutures in order to resensitise distant heel flaps. The patient's cooperation is essential in every case to compensate for the decreased sensitivity by means of increased visual surveillance and the wearing of suitable shoes.

  19. Acupuncture Treatment for Plantar Fasciitis: A Randomized Controlled Trial with Six Months Follow-Up

    Directory of Open Access Journals (Sweden)

    Shi Ping Zhang

    2011-01-01

    Full Text Available Plantar fasciitis is a common cause of heel pain. It has been suggested that some acupoints have a specific effect on heel pain. The aim of this study was to determine the efficacy and specificity of acupuncture treatment for plantar fasciitis. Subjects were randomly assigned to the treatment group (n = 28 or control group (n = 25. The treatment group received needling at the acupoint PC 7, which is purported to have a specific effect for heel pain. The control group received needling at the acupoint Hegu (LI 4, which has analgesic properties. Treatment was administered five times a week for 2 weeks, with an identical method of manual needling applied to the two acupoints. The primary outcome measure was morning pain on a 100-point visual analog scale (VAS at one month post-treatment. Secondary outcome measures included a VAS for activity pain, overall pain rating as well as pressure pain threshold using algometry. Significant differences in reduction in pain scores, favoring the treatment group, were seen at one month for morning pain (22.6 ± 4.0 versus 12.0 ± 3.0, mean ± SEM, overall pain (20.3 ± 3.7 versus 9.5 ± 3.6 and pressure pain threshold (145.5 ± 32.9 versus −15.5 ± 39.4. No serious adverse event was observed in either group. The results indicate that acupuncture can provide pain relief to patient with plantar fasciitis, and that PC 7 is a relatively specific acupoint for heel pain.

  20. Variant position of the medial plantar nerve

    OpenAIRE

    Astik RB; Dave UH; Gajendra KS

    2011-01-01

    Knowledge of variation of position of the medial plantar nerve is important for the forefoot surgeon for plantar reconstruction, local injection therapy and an excision of interdigital neuroma. During routine dissection of 50-year-old female cadaver, we found the medial plantar nerve and vessels variably located between plantar aponeurosis and the muscles of the first layer of the sole of the right foot. Due to this variant position, the medial plantar nerve and vessels lose their protection ...

  1. Effects of hallux limitus on plantar foot pressure and foot kinematics during walking.

    Science.gov (United States)

    Van Gheluwe, Bart; Dananberg, Howard J; Hagman, Friso; Vanstaen, Kerstin

    2006-01-01

    The effects of hallux limitus on plantar foot pressure and foot kinematics have received limited attention in the literature. Therefore, a study was conducted to assess the effects of limited first metatarsophalangeal joint mobility on plantar foot pressure. It was equally important to identify detection criteria based on plantar pressures and metatarsophalangeal joint kinematics, enabling differentiation between subjects affected by hallux limitus and people with normal hallux function. To further our understanding of the relation between midtarsal collapse and hallux limitus, kinematic variables relating to midtarsal pronation were also included in the study. Two populations of 19 subjects each, one with hallux limitus and the other free of functional abnormalities, were asked to walk at their preferred speed while plantar foot pressures were recorded along with three-dimensional foot kinematics. The presence of hallux limitus, structural or functional, caused peak plantar pressure under the hallux to build up significantly more and at a faster rate than under the first metatarsal head. Additional discriminators for hallux limitus were peak dorsiflexion of the first metatarsophalangeal joint, time to this peak value, peak pressure ratios of the first metatarsal head and the more lateral metatarsal heads, and time to maximal pressure under the fourth and fifth metatarsal heads. Finally, in approximately 20% of the subjects, with and without hallux limitus, midtarsal pronation occurred after heel lift, validating the claim that retrograde midtarsal pronation does occur. PMID:16988174

  2. Re-irradiation for painful heel spur syndrome. Retrospective analysis of 101 heels

    Energy Technology Data Exchange (ETDEWEB)

    Hautmann, M.G.; Koelbl, O. [University of Regensburg, Department of Radiotherapy, Regensburg (Germany); Neumaier, U. [MVZ Neumaier and Kollegen, Private Clinic for Radiotherapy, Regensburg (Germany)

    2014-03-15

    Painful heel spur syndrome is a common disease with a lifetime prevalence of approximately 10 %. One of the most effective treatment options is radiotherapy. Many authors recommend a second or third series of radiation for recurrent pain and partial or no response to the initial treatment. As the results of re-irradiation have not been systematically analyzed the aim of this study was to document the results of repeated radiation treatment and to identify patients who could benefit from this treatment. The analysis was performed on patients from 2 German radiotherapy institutions and included 101 re-irradiated heels. Pain was documented with the numeric rating scale (NRS) and carried out before and directly after each radiation therapy as well as for the follow-up period of 24 months. The median age of the patients was 56 years with 30.1 % male and 69.9 % female patients. Pain was caused by plantar fasciitis in 72.3 %, Haglund's exostosis in 15.8 % and Achilles tendinitis in 11.9 %. Repeated radiation was indicated because the initial radiotherapy resulted in no response in 35.6 % of patients, partial response in 39.6 % and recurrent pain in 24.8 %. A significant response to re-irradiation could be found. For the whole sample the median NRS pain score was 6 before re-irradiation, 2 after 6 weeks and 0 after 12 and 24 months. Of the patients 73.6 % were free of pain 24 months after re-irradiation. All subgroups, notably those with no response, partial response and recurrent pain had a significant reduction of pain. Re-irradiation of painful heel spur syndrome is an effective and safe treatment. All subgroups showed a good response to re-irradiation for at least 24 months. (orig.) [German] Der schmerzhafte Fersensporn ist eine der haeufigsten Erkrankungen unter den Fusssyndromen. Die Lebenszeitpraevalenz liegt bei etwa 10 %. Eine der wirkungsvollsten Therapieoptionen stellt die Strahlentherapie dar. Dabei beschreiben viele Autoren die Durchfuehrung einer

  3. Changes in plantar load distribution and gait pattern following foot drop correction in leprosy affected patients.

    Science.gov (United States)

    Karmakar, Mrinmoy; Joshua, Jerry; Mahato, Nidhu

    2015-09-01

    This study was done to compare the changes in plantar load (weight distribution) and gait patterns before and after tibialis posterior transfer surgery in people affected by leprosy. Changes in gait patterns were observed and proportionate changes in plantar load were quantified using data captured by a baropodometer. All the eight patients who underwent tibialis posterior transfer surgery in 2013 in our hospital were included in the study. In addition to the regular pre-operative and post-operative assessments, the patients also underwent baropodometric evaluation. There was a significant change in plantar load at the heel, lateral border and forefoot. Using the foot pressure scan, it was noted that the progression of the centre of mass (displayed graphically as 'the gait line') was also affected by the altered pattern of weight distribution. This study reiterates the importance of tibialis posterior transfer because: it restores the normal gait pattern of 1, 2, 3 (where 1 is heel strike, 2 is mid foot contact and 3 is forefoot contact) and provides a more uniform distribution of planter load. PMID:26665356

  4. Success and Recurrence Rate after Radial Extracorporeal Shock Wave Therapy for Plantar Fasciopathy: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Nikos Malliaropoulos

    2016-01-01

    Full Text Available Background and Aims. The exploration of an individualised protocol of radial extracorporeal shock wave therapy (rESWT for plantar fasciopathy, assessing success rates and the recurrence rate over a 1-year period after treatment, is not yet identified in literature. Methods and Results. Between 2006 and 2013, 68 patients (78 heels were assessed for plantar fasciopathy. An individualised rESWT treatment protocol was applied and retrospectively analysed. Heels were analysed for mean number of shock wave impulses, mean pressure, and mean frequency applied. Significant mean pain reductions were assessed through Visual Analogue Scale (VAS after 1-month, 3-month, and 1-year follow-up. Success rates were estimated as the percentage of patients having more than 60% VAS pain decrease at each follow-up. 1-year recurrence rate was estimated. The mean VAS score before treatment at 6.9 reduced to 3.6, 1 month after the last session, and to 2.2 and 0.9, after 3 months and 1 year, respectively. Success rates were estimated at 19% (1 month, 70% (3 months, and 98% (1 year. The 1-year recurrence rate was 8%. Moderate positive Spearman’s rho correlation (r=0.462, p<0.001 was found between pretreatment pain duration and the total number of rESWT sessions applied. Conclusions. Individualised rESWT protocol constitutes a suitable treatment for patients undergoing rESWT for plantar fasciitis.

  5. Success and Recurrence Rate after Radial Extracorporeal Shock Wave Therapy for Plantar Fasciopathy: A Retrospective Study.

    Science.gov (United States)

    Malliaropoulos, Nikos; Crate, Georgina; Meke, Maria; Korakakis, Vasileios; Nauck, Tanja; Lohrer, Heinz; Padhiar, Nat

    2016-01-01

    Background and Aims. The exploration of an individualised protocol of radial extracorporeal shock wave therapy (rESWT) for plantar fasciopathy, assessing success rates and the recurrence rate over a 1-year period after treatment, is not yet identified in literature. Methods and Results. Between 2006 and 2013, 68 patients (78 heels) were assessed for plantar fasciopathy. An individualised rESWT treatment protocol was applied and retrospectively analysed. Heels were analysed for mean number of shock wave impulses, mean pressure, and mean frequency applied. Significant mean pain reductions were assessed through Visual Analogue Scale (VAS) after 1-month, 3-month, and 1-year follow-up. Success rates were estimated as the percentage of patients having more than 60% VAS pain decrease at each follow-up. 1-year recurrence rate was estimated. The mean VAS score before treatment at 6.9 reduced to 3.6, 1 month after the last session, and to 2.2 and 0.9, after 3 months and 1 year, respectively. Success rates were estimated at 19% (1 month), 70% (3 months), and 98% (1 year). The 1-year recurrence rate was 8%. Moderate positive Spearman's rho correlation (r = 0.462, p plantar fasciitis. PMID:27478843

  6. The Achilles heel of adults and children

    NARCIS (Netherlands)

    J.I. Wiegerinck

    2014-01-01

    This thesis focuses on the imaging and treatment of the Achilles heel of adults and children. The figurative and literal Achilles heel consists of a number of pathologies: ankle impingement, Achilles tendinopathy, retrocalcaneal bursitis and calcaneal apophysitis. Research as well as diagnosis and t

  7. Effect of custom-made and prefabricated insoles on plantar loading parameters during running with and without fatigue.

    Science.gov (United States)

    Lucas-Cuevas, Angel Gabriel; Pérez-Soriano, Pedro; Llana-Belloch, Salvador; Macián-Romero, Cecili; Sánchez-Zuriaga, Daniel

    2014-01-01

    Controversy exists whether custom-made insoles are more effective in reducing plantar loading compared to prefabricated insoles. Forty recreational athletes ran using custom-made, prefabricated, and the original insoles of their running shoes, at rest and after a fatigue run. Contact time, stride rate, and plantar loading parameters were measured. Neither the insole conditions nor the fatigue state modified contact time and stride rate. Addressing prevention of running injuries, post-fatigue loading values are of great interest. Custom-made insoles reduced the post-fatigue loading under the hallux (92 vs. 130 kPa, P insoles provoked reductions in post-fatigue loading under the toes (120 vs. 175 kPa, P insoles, custom-made insoles reduced by 31% and 54% plantar loading under the medial and lateral heel compared to the prefabricated insoles. Finally, fatigue state did not influence plantar loading regardless the insole condition. In long-distance races, even a slight reduction in plantar loading at each foot strike may suppose a significant decrease in the overall stress experienced by the foot, and therefore the use of insoles may be an important protective mechanism for plantar overloading.

  8. Can We Measure the Heel Bump? Radiographic Evaluation of Haglund's Deformity.

    Science.gov (United States)

    Bulstra, Gythe H; van Rheenen, Thijs A; Scholtes, Vanessa A B

    2015-01-01

    Haglund's deformity is a symptomatic posterosuperior deformity of the heel. The lateral radiograph of the ankle will show a prominent, large, posterosuperior part of the calcaneus, which can be measured using the Fowler and Philips angle (FPA, the angle between the posterior and plantar surface of the calcaneus) and the calcaneal pitch angle (CPA, the angle between the sole of the foot and the plantar part of the calcaneus). Although these angles are commonly used, these radiographic angle measurements have never shown a relationship with Haglund's deformity. In 78 patients (51% male) with symptomatic Haglund's deformity and a control group of 100 patients (41% male) with no heel complaints, we measured the FPA and CPA on weightbearing lateral radiographs of the foot. Using an unpaired t tests, no significant difference was found between the 2 groups in the FPA (p = .40). We measured a significant difference in the CPA between the Haglund group and the control group (p = .014). Subgroup analysis showed that this difference was mainly found in females (p position results in extra traction on the Achilles tendon and can eventually cause tendinitis and bursitis. Radiographic measurement should be used as an auxiliary tool. If the calcaneus tends to change position, it would be interesting to understand this process, which could eventually lead to improvement in the treatment of Haglund's deformity.

  9. Miniscalpel-Needle versus Steroid Injection for Plantar Fasciitis: A Randomized Controlled Trial with a 12-Month Follow-Up

    Directory of Open Access Journals (Sweden)

    Shuming Li

    2014-01-01

    Full Text Available Plantar fasciitis is the most common cause of heel pain in adults. A novel alternative medical instrument, the miniscalpel-needle (MSN, which is based on an acupuncture needle, has been recently developed in China. The objective of this study was to evaluate the effectiveness of the MSN release treatment versus that of traditional steroid injection for plantar fasciitis. Patients with plantar fasciitis were randomly assigned to 2 groups and followed up for 12 months, with 29 receiving MSN treatment and 25 receiving steroid injection treatment. The results showed that visual analog scale scores for morning pain, active pain, and overall heel pain all were decreased significantly in the MSN group from 1 to 12 months after treatment. In contrast, treatment with steroid injection showed a significant effect only at the 1-month follow-up but not at 6 or 12 months after treatment. Moreover, the MSN group achieved more rapid and sustained improvements than the steroid group throughout the duration of this study. No severe side effects were observed with MSN treatment. Our data suggest that the MSN release treatment is safe and has a significant benefit for plantar fasciitis compared to steroid injection.

  10. The Achilles’ heel of positivism

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    D.F.M. Strauss

    2003-08-01

    Full Text Available The 20th century encompasses philosophical trends as wide apart as (neo- positivism and postmodernism. The assumed objectivity and neutrality of the former and the radical relativity claimed by the latter both have difficulties in accounting for the nature of universality. Since sense experience is directed towards concrete entities and events, the universal scope of law-statements remains problematic – particularly exemplified in the universal scope of modal terms (what will be designated as modal universality. Not even postmodernism can side-step this fundamental ontic dimension of reality. Insofar as the positivistic ideal of an objective and neutral science still dominates the thought-world of many practising (natural and social scientists, a critique of the Achilles’ heel of positivism may render a service to the ideal of Christian scholarship, since it is argued that such a critique highlights the inevitability of a distinct theoretical view of reality which ultimately emanates from a person’s deepest convictions. The contributions of Popper and Stegmüller are contextualized in the argumentation. Popper realized that rationality needs a more-than-rational foundation and Stegmüller acknowledges that one cannot justify something without a prior trust. The inability of sense experience to account for the functional properties of natural things and their accompanying concepts indeed reveals the Achilles’ heel of positivism. This view is explained with reference to the uniqueness of function concepts employed in the historical development of the concept of matter. In the final part of the article Popper’s idea of falsification is assessed by taking into account the criticism raised by Stegmüller. In the course of the argumentation the relevance for the South African context is mentioned with reference to the idea of neutrality as it is advanced in the current debate about the teaching of religion at school.

  11. 跖板修补联合Weil截骨治疗慢性跖趾关节不稳%Plantar plate repair with Weil osteotomy for chronic instability of the lesser metatarsophalangeal joint

    Institute of Scientific and Technical Information of China (English)

    薛剑锋; 梅国华; 施忠民; 柴益民; 张长青

    2014-01-01

    Objective To evaluate the clinical outcome of plantar plate repair with Weil osteotomy for chronic instability of the lesser metatarsophalangeal joint.Methods From February 2012 to January 2013,19 patient with chronic instability of the lesser metatarsophalangeal joint were treated in our department.They were 18 females and one male with an average age o f 57 years (from 51 to 65 years).By the Coughlin's classification,3 cases were grade 1,5 cases grade 2,9 cases grade 3 and 2 cases grade 4.Except for one case involving both the second and the third metatarsophalangeal joints,all lesions were located at the second metatarsophalangeal joint.Weil osteotomy was used to shorten and elevate the affected metatarsal head.Injury to the plantar plate was detected before directly repaired in 17 cases and with transfer of the flexor digitorum longus in 2 cases.American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores were used to assess the clinical outcome.Results The 2 patients who underwent tendon transfer were excluded from the final analysis.The mean follow-up period was 18 months (from 12 to 24 months).The symptoms were alleviated in all the patients.The dislocated metatarsophalangeal joints were reduced,and postoperative Lachman tests were negative.Radiological exams showed corrected alignment of the lesser metatarsophalangeal joint.At the last follow-up,the AOFAS score (83.4 ± 8.7) and VAS score (1.3 ± 0.9) were significantly improved compared to the preoperative ones (40.7 ± 6.9 and 6.8 ± 1.2,respectively) (P < 0.05).Conclusions For chronic instability of the lesser matatarsophalangeal joint,anatomical plantar plate repair with Weil osteotomy can restore the alignment of the metatarsophalangeal joint,diminish the pain and improve the functional recovery.Its short term clinical outcome is promising.%目的 评价跖板修补联合Weil截骨治疗慢性跖趾关节不稳的临床疗效.方法 回顾性分析2012年2月至2013年1

  12. Minimally invasive treatment of the KobyGard system for plantar fasciitis:a retrospective study

    Institute of Scientific and Technical Information of China (English)

    XU Hai-lin; XU Lei; ZHANG Dian-ying; FU Zhong-guo; WANG Tian-bing; ZHANG Pei-xun; JIANG Bao-guo

    2012-01-01

    Background Calcodynia is a persistent condition that podiatric surgeons frequently see among their patients,and plantar fasciitis is the main reason for pain.When systematic conservative treatments fail to alleviate these conditions,it requires surgical intervention,mainly plantar fascia release surgery,which used to be an open heel release surgery.This study aimed to investigate whether minimally invasive treatment of the KobyGard system is more safe and effective for plantar fasciitis.Methods From May 2009 to May 2012,a total of nine patients,three males and six females with plantar fasciitis,were treated in the Peking University People's Hospital with minimally invasive instruments,the KobyGard system,for the release of plantar fascia.Three patients,experiencing bilateral calcaneodynia,underwent bilateral surgery.One patient had bilateral calcaneodynia with enthesiopathy of Achilles tendon,and underwent Achilles tendon surgery.Preoperative and postoperative Visual Analogue Scale(VAS),American Orthopaedic Foot and Ankle Society(AOFAS)ankle and hindfoot scores,Roles and Maudsley scores and SF-36 questionnaires were evaluated.Results The nine patients were successfully followed up.The average postoperative follow-up time was 13.2 months and it varied from 2.0 months to 21.0 months.Pre-and postoperative average scores of VAS was 9.3 and 1.9(P<0.001),respectively.Pre-and postoperative average scores of AOFAS hind foot was 36.0 and 82.0(P<0.001),respectively.There was also a statistically significant amelioration in SF-36 scores and the Roles and Maudlesy scores.Eight patients were satisfied with the surgery outcome.Conclusion Minimally invasive surgery treatment of the KobyGard system for plantar fasciitis has the advantages of shorter operation time,ease of operation,and similar satisfaction rates with open surgery,but with smaller surgical incision.

  13. Heel-rise test in the assessment of individuals with peripheral arterial occlusive disease

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    Monteiro DP

    2013-01-01

    Full Text Available Débora Pantuso Monteiro,1 Raquel Rodrigues Britto,2 Ana Clara Ribeiro Lages,3 Marluce Lopes Basílio,3 Monize Cristine de Oliveira Pires,3 Maria Luiza Vieira Carvalho,1 Ricardo Jayme Procópio,4 Danielle Aparecida Gomes Pereira21Rehabilitation Sciences of the Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil; 2Physiotherapy Department of the School of Physical Education, Physiotherapy and Occupational Therapy of the Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil; 3Private Practice, Belo Horizonte-MG, Brazil; 4Hospital das Clínicas of the Universidade Federal de Minas Gerais, Belo Horizonte-MG, BrazilIntroduction: The Heel-Rise Test (HRT is a clinical instrument relevant to vascular rehabilitation that has been proposed to assess the function of the triceps surae muscle. To use HRT in the assessment of individuals with peripheral arterial occlusive disease (PAOD, its ability to detect differences in the functional performance of patients with PAOD must be verified.Aim: To verify whether the test is sensitive in differentiating between individuals with PAOD with distinct functional capacities.Materials and methods: A transversal study in which individuals with PAOD were assessed using the HRT, the Walking Impairment Questionnaire (WIQ, and the Shuttle Walk Test. The following variables were analyzed: number of plantar flexions performed in the HRT (time in seconds and velocity (plantar flexions per second when performing plantar flexions up to the point of volunteer fatigue, maximum distance walked in the Shuttle Walk Test, and scores obtained in each WIQ domain.Results: Twenty-five individuals (14 male were included in the study, with a mean age of 63.36 ± 9.83 years. The variables number of plantar flexions and time to perform the HRT were sensitive enough to differentiate between distinct functional capacities in individuals with PAOD (P = 0.003 and P = 0.009, respectively. However, this result was not found

  14. The use of running shoes to reduce plantar pressures in patients who have diabetes.

    Science.gov (United States)

    Perry, J E; Ulbrecht, J S; Derr, J A; Cavanagh, P R

    1995-12-01

    We compared the plantar pressures generated by walking in leather-soled Oxford-style shoes and by walking in inexpensive running shoes with those generated by walking in thin socks on a hard surface for thirty-nine individuals (thirteen who had diabetes and neuropathy, and thirteen who had diabetes without neuropathy, and thirteen who had neither diabetes nor neuropathy [controls]). Except for two anatomical regions, the plantar pressure associated with the Oxford-style shoes were not different from those associated with walking without shoes. In comparison, the inexpensive running shoes relieved plantar pressure in the forefoot and heel by a mean (and standard deviation) of 31 +/- 9.1 per cent, with the most relief occurring in the feet that had the highest pressures when they were unshod. There were significant reductions in pressure in all regions of the foot except for the midfoot (p leather-soled Oxford-style shoes because of the risk of ulceration due to elevated plantar pressures. Inexpensive running shoes should be viewed as the very minimally acceptable choice for footwear for these individuals if the feet are free of deformity. PMID:8550649

  15. Variant position of the medial plantar nerve

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    Astik RB

    2011-01-01

    Full Text Available Knowledge of variation of position of the medial plantar nerve is important for the forefoot surgeon for plantar reconstruction, local injection therapy and an excision of interdigital neuroma. During routine dissection of 50-year-old female cadaver, we found the medial plantar nerve and vessels variably located between plantar aponeurosis and the muscles of the first layer of the sole of the right foot. Due to this variant position, the medial plantar nerve and vessels lose their protection from the muscles of the first layer of the sole of the foot and became vulnerable for compression.

  16. Plantar Fasciitis: Prescribing Effective Treatments.

    Science.gov (United States)

    Shea, Michael; Fields, Karl B.

    2002-01-01

    Plantar fasciitis is an extremely common, painful injury seen among people in running and jumping sports. While prognosis for recovery with conservative care is excellent, prolonged duration of symptoms affects sports participation. Studies on treatment options show mixed results, so finding effective treatments can be challenging. A logical…

  17. Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers – A two-year, randomized trial

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    Ulla Hellstrand Tang

    2014-12-01

    Conclusions: Custom-made insoles used in combination with stable walking shoes gave lower pressures at the heel region. The variation makes it difficult to detect a systematic difference in plantar pressure for the 6 ROI, if such a difference indeed exists. The levels of satisfaction and usage for all the insoles tested were high. The insoles maintained their pressure redistribution properties over long periods, and few adjustments were needed.

  18. Effeciency of extracorporeal shock wave therapy in patients with plantar fasciitis and the relationship with subcalcaneal spur length

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    Serpil Tuna

    2014-06-01

    Full Text Available Objective: ESWT is widely used in the treatment of plantar fascitis. In this study, we aimed to investigate the effect of ESWT on heel pain and symptoms in the short and medium term. We also compared the subcalcaneal spur length and the heel pain severity and examined the effect of the subcalcaneal spur length on the efficiency of ESWT therapy. Methods: The efficiency of ESWT applied to 59 heel of 48 patients compared retrospectively . We used Visual Analog Scale (VAS and Wolgin scale to evaluate the treatment outcomes. We measure the subcalcaneal spurs length of the patients with foot x-ray . Correlation between the VAS scores and the length of subcalcaneal spur were also evaluated. Results: Improvement in VAS in the first week and 3 months after ESWT treatment was statistically significant. There was no correlation between subcalcaneal spur length and the severity of pain. The number of patients in the'' medium, bad'' group decreased while the number of patients in the '' good'' group incresed according to WDS after ESWT treatment. Conclusion: As a result of this study we concluded that ESWT is effective in the treatment of plantar fasciitis in the short and medium term.

  19. COMPARATIVE STUDY OF EFFICACY OF LOCAL STEROID INJECTION AND EXTRACORPOREAL SHOCKWAVE THERAPY IN THE TREATMENT OF PLANTAR FASCITIS

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    Rajan

    2014-04-01

    Full Text Available INTRODUCTION: Plantar fasciitis is a common condition causing misery to lot of patients. The etiology and treatment of plantar fasciitis are poorly understood. The results from such treatments vary considerably, and there is no consensus of opinion on the best method. MATERIAL AND METHODS: We conducted a controlled trial in our institute to compare the results of local steroid injections & the use of Extra-corporeal shock wave therapy (ESWT for managing plantar fasciitis. 200 patients with 240 painful heels were evaluated. All patients with moderate to severe heel pain who had already taken ten days of unsatisfactory treatment with oral NSAIDS were divided in two main groups. Group A of 100 patients received 1000 impulses of shock waves in three sessions at weekly interval. In Group B of 100 patients up to three local injections of 40 mg methyl prednisone mixed with 1 ml. of 2% lignocaine were given at biweekly interval. Pain assessment was done using VAS scale and the results were evaluated at six weeks, three months and six months after the completion of the therapy. CONCLUSIONS: There was a significant difference between two groups of patients being treated. The group B patients had significantly greater improvement in pain scale and early return to daily activities

  20. Ultrasound-guided injection for plantar fasciitis: A brief review

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    A S Nair

    2016-01-01

    Full Text Available Plantar fasciitis (PF is a distressing condition experienced by many patients. Although self-limiting, it tends to become a chronic ailment if the precipitating factors are not addressed. One of the modality of treating PF is intra-lesional corticosteroid injection. This was done using palpation technique earlier but nowadays many specialists use ultrasound (US imaging as a guide to give injection accurately instead of inadvertently damaging the plantar fascia or injecting into surrounding soft tissue, both of which can have serious implications. We did a literature search in Medline, Scopus, and Embase databases to find out articles describing US-guided corticosteroid injection for treating PF and whether guided injection was effective than injection given by palpation.

  1. The effectiveness of corticosteroid injection in the treatment of plantar fasciitis.

    Science.gov (United States)

    Ang, Teck Wee Andrew

    2015-08-01

    Plantar fasciitis is a common cause of heel pain in adults. Although it is usually a self-limiting condition, the pain may become prolonged and severe enough to cause significant distress and disruption to the patient's daily activities and work. PubMed and Cochrane Central Register of Controlled Trials databases were searched for randomised controlled trials (RCTs) and a total of ten RCTs were selected for evaluation. These RCTs involved the use of either palpation- or ultrasonography-guided corticosteroid injections in patients diagnosed with plantar fasciitis. All placebo-controlled RCTs showed a significant reduction in pain with the use of corticosteroid injections. Some studies also showed that corticosteroid injections yielded better results than other treatment modalities. However, it is evident from these studies that the effects of corticosteroid injections are usually short-term, lasting 4-12 weeks in duration. Complications such as plantar fascia rupture are uncommon, but physicians need to weigh the treatment benefits against such risks. PMID:26311907

  2. Foot kinematics in patients with two patterns of pathological plantar hyperkeratosis

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    Bowker Peter

    2011-02-01

    Full Text Available Abstract Background The Root paradigm of foot function continues to underpin the majority of clinical foot biomechanics practice and foot orthotic therapy. There are great number of assumptions in this popular paradigm, most of which have not been thoroughly tested. One component supposes that patterns of plantar pressure and associated hyperkeratosis lesions should be associated with distinct rearfoot, mid foot, first metatarsal and hallux kinematic patterns. Our aim was to investigate the extent to which this was true. Methods Twenty-seven subjects with planter pathological hyperkeratosis were recruited into one of two groups. Group 1 displayed pathological plantar hyperkeratosis only under metatarsal heads 2, 3 and 4 (n = 14. Group 2 displayed pathological plantar hyperkeratosis only under the 1st and 5th metatarsal heads (n = 13. Foot kinematics were measured using reflective markers on the leg, heel, midfoot, first metatarsal and hallux. Results The kinematic data failed to identify distinct differences between these two groups of subjects, however there were several subtle (generally Conclusions There was some evidence of small differences between planter pathological hyperkeratosis groups. Nevertheless, there was too much similarity between the kinematic data displayed in each group to classify them as distinct foot types as the current clinical paradigm proposes.

  3. Movement Behavior of High-Heeled Walking

    DEFF Research Database (Denmark)

    Alkjær, Tine; Raffalt, Peter Christian; Petersen, Nicolas Caesar;

    2012-01-01

    The human locomotor system is flexible and enables humans to move without falling even under less than optimal conditions. Walking with high-heeled shoes constitutes an unstable condition and here we ask how the nervous system controls the ankle joint in this situation? We investigated the movement...

  4. The impact of increasing body mass on peak and mean plantar pressure in asymptomatic adult subjects during walking

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    Sara Jones

    2010-11-01

    Full Text Available Introduction: The implication of high peak plantar pressure on foot pathology in individuals both with and without diabetes has been recognized. The aim of this study was to investigate and clarify the relationship between increasing body mass and peak and mean plantar pressure in an asymptomatic adult population during walking. Methods: Thirty adults without any relevant medical history, structural foot deformities or foot posture assessed as highly pronated or supinated, and within a normal body mass index range were included in the study. An experimental, same subjects, repeated measures design was used. Peak and mean plantar pressure were evaluated with the F-Scan in-shoe plantar pressure measurement system under four different loading conditions (0, 5, 10, and 15 kg simulated with a weighted vest. Pressure data were gathered from three stances utilizing the mid-gait protocol. Results: There were statistically significant increases in peak pressure between the 10 and 15 kg load conditions compared to the control (0 kg within the heel and second to fifth metatarsal regions. The first metatarsal and hallux regions only displayed statistically significant increases in peak pressure between 15 kg and the control (0 kg. The midfoot and lesser digits regions did not display any statistically significant differences in peak pressure between any load conditions compared to the control (0 kg. The second to fifth metatarsal region displayed statistically significant increases in mean pressure in the 5, 10 and 15 kg groups compared to the control (0 kg. A statistically significant increase in peak pressure between the 15 kg and control (0 kg group was evident in all other regions. Conclusion: The relationship between increasing body mass and peak and mean plantar pressure was dependent upon the plantar region. This study provides more detail outlining the response of peak and mean pressure to different loading conditions than previously reported in the

  5. 增高鞋垫对足底压力分布及后跟平衡的影响%The Effect of Heighten Insole on Pressure Distribution and Heel Balance

    Institute of Scientific and Technical Information of China (English)

    张先熠; 李悦; 李罗浩; 李波

    2013-01-01

    通过测量穿增高鞋垫前后足底压力参数,探究增高鞋垫对足底压力分布与后跟部位平衡的影响.用Footscan压力板与Novel鞋垫系统测量15名大学生穿板鞋及穿垫有增高鞋垫的板鞋行走时的压力参数,比较二者在足底7个分区的接触时间、峰值压强与冲量,以及后跟内外侧压力差值.结果显示:穿增高鞋垫后,足底各区域接触时间均延长,大部分区域峰值压强降低,部分冲量由前尖转移向后跟,后跟部位内外翻加剧,从而平衡稳定性能降低.%This study aimed to investigate the effect of heighten insole on plantar pressure distribution and heel balance by analyzing plantar pressure measurements with and without heighten insole. Footscan Force Plate and Novel Pedar - X system were used to measure plantar pressure for 15 undergraduates wearing board shoe with and without heighten insole. The measurements of two conditions were compared. Analysis parameters of seven regions included contact time, peak pressure, impulsing on and the force difference between medial heel and lateral heel. The results showed that when wearing heighten insole; the contact time was increased on all regions and peak pressure was decreased on most regions; some pressure was transferred from the toes to heel region; the balance and stability were decreased with heel supination increased.

  6. Low-dose Radiotherapy for painful heel spur. Retrospective study of 117 patients

    Energy Technology Data Exchange (ETDEWEB)

    Muecke, R.; Heyder, R. [Weiden Hospital, Weiden (Germany). Dept. of Radiotherapy; Schoenekaes, K.; Micke, O.; Berning, D. [University Hospital Muenster (Germany). Dept. of Radiotherapy; Seegenschmiedt, M.H. [Alfried Krupp Hospital, Essen (Germany). Dept. of Radiation Oncology, Radiotherapy and Nuclear Radiation

    2003-11-01

    Purpose: Retrospective analysis of 117 patients treated between 1996 and 2000 with low-dose radiotherapy (RT) for painful heel spurs. Patients and Methods: 71 women and 46 men were irradiated on 136 painful heel spurs in one (n = 104) or two radiation series (n = 13). The painful spurs were located either at the plantar (n = 94), dorsal (n = 5) or bilateral heel (n = 18). 82 patients had prior treatments, in 35 patients RT was the primary treatment. Low-dose RT was performed twice a week with one 6-MV photon field. Ten fractions of 0.5 Gy were applied to a total dose of 5 Gy. Evaluation was done on completion and during follow-up using the four-scale von Pannewitz score. Results: On completion of RT, 27 patients were free of pain, 40 were much improved, 31 reported slight improvement, and 19 experienced no change. After a mean follow-up of 20 months, 75 out of 100 patients were free of pain, twelve had marked and three some improvement. Ten patients reported no change of symptoms. Mean duration of pain before RT was 6 months. RT applied {<=} 6 months after the onset of clinical symptoms resulted in improvement in 94%. By contrast, an interval of > 6 months until the initiation of RT resulted in only 73% of patients with clinical improvement. Conclusion: Low-dose RT reveals a benefit in > 80% of the patients. RT should start during the first 6 months of symptoms. Prospective clinical studies with validated symptom scores should be conducted to assess optimal dose and fractionation scheme of RT. (orig.)

  7. Acroangiodermatite (pseudossarcoma de Kaposi: uma condição raramente reconhecida. Um caso na planta do pé associado a insuficiência venosa crônica Acroangiodermatitis (pseudo-Kaposi sarcoma: a rarely-recognized condition. A case on the plantar aspect of the foot associated with chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Maria Inês Fernandes Pimentel

    2011-08-01

    Full Text Available A acroangiodermatite ou pseudossarcoma de Kaposi é entidade angioproliferativa incomum relacionada a insuficiência venosa crônica, fístulas arteriovenosas, membros paralisados, cotos de amputação, síndromes vasculares e condições trombóticas. Apresenta-se, em geral, como máculas, pápulas ou placas purpúricas no dorso dos pés (especialmente hálux e maléolos. Relatamos um caso de acroangiodermatite afetando a região plantar, por dois anos sem diagnóstico, para o qual a coloração histológica por hematoxilina-eosina e a marcação imuno-histoquímica com CD34 foram decisivas. A paciente tinha insuficiência venosa crônica e a lesão respondeu bem ao uso de bandagens elásticas e repouso com a perna elevadaAcroangiodermatitis, often known as pseudo-Kaposi sarcoma, is an uncommon angioproliferative entity related to chronic venous insufficiency, arteriovenous fistulae, paralysed limbs, amputation stumps, vascular syndromes and conditions associated with thrombosis. It presents most frequently as purple macules, papules or plaques in the dorsal aspects of the feet, especially the toes, and the malleoli. We report a case of acroangiodermatitis in the plantar aspect of the foot, misdiagnosed for two years, in which haematoxylin-eosin hystopathological stain and immunolabeling with CD34 histochemistry examination were decisive for diagnosis. Patient had chronic venous insufficiency. The lesion responded well to the treatment with a combination of leg elevation and compression

  8. Tyrosinemia without liver or renal damage with plantar and palmar keratosis and keratitis (hypertyrosinemia type II).

    Science.gov (United States)

    Pelet, B; Antener, I; Faggioni, R; Spahr, A; Gautier, E

    1979-05-01

    A boy of 3 2/12 years of age with Richner-Hanhart syndrome (plantar and palmar keratosis and chronic keratitis) was found to have hypertyrosinemia and to excrete the hydroxyacids derived from tyrosine. A diet poor in phenylalanine and tyrosine cured the skin and corneal lesions. Clinical and biochemical observations are reported.

  9. Quantifying dynamic changes in plantar pressure gradient in diabetics with peripheral neuropathy

    Directory of Open Access Journals (Sweden)

    Chi-Wen Lung

    2016-07-01

    Full Text Available Diabetic foot ulcers remain one of the most serious complications of diabetes. Peak plantar pressure (PPP and peak pressure gradient (PPG during walking have been shown to be associated with the development of diabetic foot ulcers. To gain further insight into the mechanical etiology of diabetic foot ulcers, examination of the pressure gradient angle (PGA has been recently proposed. The PGA quantifies directional variation or orientation of the pressure gradient during walking, and provides a measure of whether pressure gradient patterns are concentrated or dispersed along the plantar surface. We hypothesized that diabetics at risk of foot ulceration would have smaller PGA in key plantar regions, suggesting less movement of the pressure gradient over time. A total of 27 participants were studied, including 19 diabetics with peripheral neuropathy and 8 non-diabetic control subjects. A foot pressure measurement system was used to measure plantar pressures during walking. PPP, PPG and PGA were calculated for four foot regions - 1st toe (T1, 1st metatarsal head (M1, 2nd metatarsal head (M2, and heel (HL. Consistent with prior studies, PPP and PPG were significantly larger in the diabetic group compared to non-diabetic controls in the T1 and M1 regions, but not M2 or HL. For example, PPP was 165% (P=0.02 and PPG was 214% (P<0.001 larger in T1. PGA was found to be significantly smaller in the diabetic group in T1 (46%, P=0.04, suggesting a more concentrated pressure gradient pattern under the toe. The proposed PGA may improve our understanding of the role of pressure gradient on the risk of diabetic foot ulcers.

  10. EFFECT OF IMPAIREMENT-BASED KALTENBORN TECHNIQUE FOR PLANTAR FASCIITIS: A RANDOMIZED CONTROL TRIAL

    Directory of Open Access Journals (Sweden)

    Anand B Heggannavar

    2015-08-01

    Full Text Available Relevance: Plantar fasciitis, the most common cause of heel pain, is due to repetitive strain injury to the medial arch and the heel, causing functional disabilities. Any biomechanical alteration in the lower extremity has its effect on plantar fascia. Kaltenborn mobilization techniques have been proved effective in improving the range of motion of the affected joints. There is a need to evaluate these techniques in plantar fasciitis by treating whole lower extremity. Participants: 20 subjects with the mean age (23.80±2.71 with primary heel pain are recruited in the study. Method: Subjects of randomized controlled trial were randomly allocated into two groups, Group A (n=10 received therapeutic ultrasound, stretching’s and exercises and Group B ( n=10 received therapeutic ultra sound, Kaltenborn mobilizations to the affected joints of lower extremity, stretching and exercises. The outcome measures are visual analogue scale ( VAS , foot function index ( FFI and range of motion measured by Goniometer assessed on day 1 pre-treatment and day 12 post treatment. Analysis: It was done using Mann Whitney U test and Wilcoxon matched pairs test using SPSS software. Results: The intra-group mean differences in pre and post values for group-A are 1.80±2.39, 2.50±2.64, 3.40±1.84, and 19.75±8.16 for ankle dorsiflexion, plantarflexion, VAS and FFI respectively, and in group-B are 1.00±2.11, 10.50±8.32, 4.70±0.67and 28.07±8.26 for ankle dorsiflexion, plantarflexion, VAS and FFI respectively. The intra-group comparison had shown statistical significance with p<0.05 and whereas in between comparison group-B had shown better improvement than group-A. Conclusion: Kaltenborn mobilizations along with therapeutic ultrasound, stretches and exercises have shown better improvement compared to the control group.

  11. Medial and Lateral Plantar Nerve Entrapment

    Science.gov (United States)

    ... Foot Problems Overview of Foot Problems Achilles Tendon Bursitis Achilles Tendon Enthesopathy Bunion Corns and Calluses Damage ... the Foot Freiberg Disease Hammer Toe Inferior Calcaneal Bursitis Medial and Lateral Plantar Nerve Entrapment Metatarsal Joint ...

  12. Foot Plantar Pressure Measurement System: A Review

    Directory of Open Access Journals (Sweden)

    Yufridin Wahab

    2012-07-01

    Full Text Available Foot plantar pressure is the pressure field that acts between the foot and the support surface during everyday locomotor activities. Information derived from such pressure measures is important in gait and posture research for diagnosing lower limb problems, footwear design, sport biomechanics, injury prevention and other applications. This paper reviews foot plantar sensors characteristics as reported in the literature in addition to foot plantar pressure measurement systems applied to a variety of research problems. Strengths and limitations of current systems are discussed and a wireless foot plantar pressure system is proposed suitable for measuring high pressure distributions under the foot with high accuracy and reliability. The novel system is based on highly linear pressure sensors with no hysteresis.

  13. Objective evaluation of plantar hyperhidrosis after sympathectomy

    Directory of Open Access Journals (Sweden)

    Nelson Wolosker

    2013-01-01

    Full Text Available OBJECTIVE: The aim of the present study was to prospectively, randomly, blindly, and objectively investigate how surgery affects plantar sudoresis in patients with palmar and plantar hyperhidrosis over a one-year period using a sudorometer (VapoMeter. METHODS: From February 2007 to May 2009, 40 consecutive patients with combined palmar hyperhidrosis and plantar hyperhidrosis underwent video-assisted thoracic sympathectomy at the T3 or T4 ganglion level (15 women and 25 men, with a mean age of 25 years. RESULTS: Immediately after the operation and during the one-year follow-up, all of the patients were free from palmar hyperhidrosis episodes. Compensatory hyperhidrosis of varying degrees was observed in 35 (87.5% patients after one year. Only two (2.5% patients suffered from severe compensatory hyperhidrosis. There was a large initial improvement in plantar hyperhidrosis in 46.25% of the cases, followed by a progressive regression of that improvement, such that only 30% continued to show this improvement after one year. The proportion of patients whose condition worsened increased progressively (from 21.25% to 47.50%, and the proportion of stable patients decreased (32.5% to 22.50%. This was not related to resection level; however, a lower intensity of plantar hyperhidrosis prior to sympathectomy correlated with worse evolution. CONCLUSION: Patients with palmar hyperhidrosis and plantar hyperhidrosis who underwent video-assisted thoracic sympathectomy to treat their palmar hyperhidrosis exhibited good initial improvement in plantar hyperhidrosis, which then decreased to lesser degrees of improvement over a one-year period following the surgery. For this reason, video-assisted thoracic sympathectomy should not be performed when only plantar hyperhidrosis is present.

  14. Plantar ROI Characterization during the Stance Phase of Gait Based on a Low-cost Pressure Acquisition Platform

    Institute of Scientific and Technical Information of China (English)

    Zhanyong Mei; Guoru Zhao; Qingsong Zhu; Lei Wang

    2012-01-01

    Plantar Region of Interest (ROI) detection is important for the early diagnosis and treatment of morphologic defects of the foot and foot bionic research.Conventional methods have employed complex procedures and expensive instruments which prohibit their widespread use in healthcare.In this paper an automatic plantar ROIs detection method using a customized low-cost pressure acquisition device is proposed.Plantar pressure data and 3D motion capture data were collected from 28subjects (14 healthy subjects and 14 subjects with hallux valgus).The maximal inter-frame difference during the stance phase was calculated.Consequently,the ROIs were defined by the first-order difference in combination with prior anatomic knowledge.The anatomic locations were determined by the maximal inter-frame difference and second maximal inter-frame difference,which nearly coincided.Our system can achieve average recognition accuracies of 92.90%,89.30%,89.30%,92.90%,92.90%,and 89.30% for plantar ROIs hallux and metatarsi Ⅰ-Ⅴ,respectively,as compared with the annotations using the 3Dmotion capture system.The maximal difference of metatarsus heads Ⅱ-Ⅴ,and the impulse of the medial and lateral heel features made a significant contribution to the classification of hallux valgus and healthy subjects with ≥ 80% sensitivity and specificity.Furthermore,the plantar pressure acquisition system is portable and convenient to use,thus can be used in home- or community-based healthcare applications.

  15. Plantar flexor stretch reflex responses to whole body loading/unloading during human walking

    DEFF Research Database (Denmark)

    Grey, Michael James; van Doornik, Johannes; Sinkjær, Thomas

    2002-01-01

    was to investigate the contribution of load receptor feedback to the compensatory stretch reflex response. We examined the contribution of load receptor feedback to the magnitude of the short and medium latency components of the ankle plantar flexor stretch reflex responses following an unexpected dorsiflexion...... perturbation during human walking. Three body load conditions were investigated: normal body load, a 30% increase in body load, and a 30% decrease in body load. Healthy subjects walked on a treadmill at approximately 3.6 km/h with the left ankle attached to a portable stretching device. Dorsiflexion...... perturbations (8 degrees; 350-425 degrees/s) were generated during the late stance phase of gate (approximately 400 ms following heel contact). Electromyographic activity was recorded from the soleus, tibialis anterior, medial gastrocnemius, rectus femoris, and biceps femoris muscles using bipolar surface...

  16. Análise do arco longitudinal medial em adolescentes usuárias de calçados de salto alto Analysis of the medial longitudinal arch in adolescents users of high heeled shoes

    Directory of Open Access Journals (Sweden)

    Sílvia Maria Amado João

    2012-03-01

    Full Text Available O objetivo do estudo foi analisar a influência do calçado de salto alto no arco longitudinal medial (ALM do pé de adolescentes. Fizeram parte do estudo 82 adolescentes entre 13 e 20 anos, sendo 54 não usuárias (grupo controle - GC e 28 usuárias (grupo experimental - GE de calçado de salto alto. Foram obtidas as impressões plantares de ambos os pés para análise do ALM, antes e depois do uso de um calçado de salto alto padronizado por um período de 30 minutos. As impressões plantares foram avaliadas pelo índice de Chippaux-Smirak (ICS e pelo arco de Cavanagh & Rodgers (ICR. O teste de Shapiro-Wilks foi utilizado para a verificação da normalidade dos dados. Variáveis paramétricas pareadas foram tratadas com o Teste t de Student pareado e as não-paramétricas com o teste de Wilcoxon. As comparações não-pareadas foram realizadas com o teste t de Student para as variáveis paramétricas e o de Mann-Withney para as não-paramétricas, com nível de significância de 0,05. Houve diferença no ALM entre os lados direito e esquerdo apenas no GC antes do uso do calçado. Na comparação entre antes e depois do uso do sapato, notou-se diferença apenas no pé esquerdo do GC pelo ICS. Já entre GC e GE, não houve diferença. Apesar dos resultados não evidenciarem alterações no ALM, deve-se lembrar que esta é uma medida estática, sendo necessários estudos do componente dinâmico e do uso do calçado de salto crônico para correlacionar com os achados deste trabalho.The aim of this study was to analyze the influence of high heeled shoes in foot´s medial longitudinal arch in adolescents. Eighty two female adolescents between 13 and 20 years old participated, being 54 non-users of high heleed shoes (control group - GC and 28 usuaries (experimental group - GE. The footprints of both feet were collected to analyse the medial longitudinal arch (ALM, before and after 30 minutes using a shoe with heel high given by the examiner, an then

  17. Influence of Inflammatory Polyarthritis on Quantitative Heel Ultrasound Measurements

    Directory of Open Access Journals (Sweden)

    Pye Stephen R

    2012-07-01

    Full Text Available Abstract Background There are few data concerning the impact of inflammatory polyarthritis (IP on quantitative heel ultrasound (QUS measurements. The aims of this analysis were i to determine the influence of IP on QUS measurements at the heel and, ii among those with IP to determine the influence of disease related factors on these measurements. Methods Men and women aged 16 years and over with recent onset IP were recruited to the Norfolk Arthritis Register (NOAR. Individuals with an onset of joint symptoms between 1989 and 1999 were included in this analysis. At the baseline visit subjects underwent a standardised interview and clinical examination with blood taken for rheumatoid factor. A population-based prospective study of chronic disease (EPIC-Norfolk independently recruited men and women aged 40 to 79 years from the same geographic area between 1993 and 1997. At a follow up assessment between 1998 and 2000 subjects in EPIC-Norfolk were invited to have quantitative ultrasound measurements of the heel (CUBA-Clinical performed. We compared speed of sound (SOS and broadband ultrasound attenuation (BUA, in those subjects recruited to NOAR who had ultrasound measurements performed (as part of EPIC-Norfolk subsequent to the onset of joint symptoms with a group of age and sex matched non-IP controls who had participated in EPIC-Norfolk. Fixed effect linear regression was used to explore the influence of IP on the heel ultrasound parameters (SOS and BUA so the association could be quantified as the mean difference in BUA and SOS between cases and controls. In those with IP, linear regression was used to examine the association between these parameters and disease related factors. Results 139 men and women with IP and 278 controls (mean age 63.2 years were studied. Among those with IP, mean BUA was 76.3 dB/MHz and SOS 1621.8 m/s. SOS was lower among those with IP than the controls (difference = −10.0; 95% confidence interval (CI

  18. Observations of the origin and insertion of the plantar aponeurosis based on anatomic and sonographic analysis%跖腱膜起点的解剖及超声影像学研究

    Institute of Scientific and Technical Information of China (English)

    程迅生; 章仁品; 罗福成; 张勇

    2009-01-01

    Objective To identify the exact origin and insertion of plantar aponeurosis and the anatomic relationship of calcaneal spur to plantar aponeurosis. Methods Fourteen specimen of feet were dissected and radiographed. Three fetus feet were observed histologically. Sonographic evaluation was carried out on 20 normal adults and 52 patients with plantar fasciitis. Results (1) Anatomic observation found that plantar aponeurosis was located under the medial process of caleaneus but not attached to it, and proximally attached to the plantar aspect of calcaneal tuborosity. The insertion (origin) of plantar aponeurosis was not a point but a face. Posteriorly the plantar aponeurosis and fascia of Archlles heel were fused or transmigrated together,entirely covered and attached very coherently to the plantar and posterior aspect of calcaneal tuborosity. (2) Histological observation of heel of fetuses found plantar aponeurosis and fascia of Arehlles heel were eosinophil band-like structure. Both continued at the plantar and posterior aspect of calcaneus and attached closely to bone at this area. There were no significant demarcation between them. (3) Sonographic evaluation:normal plantar aponeurosis showed a thin band-like echo, its orgin attached to entire plantar aspect of calcaneal tuberosity and continued with fascia coming posteriorly from Archlles heel. No distinct boundary existed between these two fascias. When plantar fasciitis occurred, the orgin of plantar aponeurosis thickened significantly,this phenomenon could be detected in wholly plantar aspect of calcaneal tuberrosity. The heel spur didn't located within plantar aponeurosis. Conclusions Plantar aponeurosis orginates from entire plantar aspect of cancaneal tuberosity. Heel spur oeeures in the orgin of the intrinsic musculature, such as flexor digitorum brevis,and doesn't locate within plantar aponeurosis.%目的 研究跖腱膜起点的确切部位及其与跟骨骨刺的关系.方法 对14只足标

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

    Directory of Open Access Journals (Sweden)

    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.

  20. The reliability of plantar pressure assessment during barefoot level walking in children aged 7-11 years

    Directory of Open Access Journals (Sweden)

    Cousins Stephen D

    2012-03-01

    Full Text Available Abstract Background Plantar pressure assessment can provide information pertaining to the dynamic loading of the foot, as well as information specific to each region in contact with the ground. There have been few studies which have considered the reliability of plantar pressure data and therefore the purpose of this study was to investigate the reliability of assessing plantar pressure variables in a group of typically developing children, during barefoot level walking. Methods Forty-five participants, aged 7 to 11 years, were recruited from local primary and secondary schools in East London. Data from three walking trials were collected at both an initial and re-test session, taken one week apart, to determine both the within- and between-session reliability of selected plantar pressure variables. The variables of peak pressure, peak force, pressure-time and force-time integrals were extracted for analysis in the following seven regions of the foot; lateral heel, medial heel, midfoot, 1st metatarsophalangeal joint, 2nd-5th metatarsophalangeal joint, hallux and the lesser toes. Reliability of the data were explored using Intra Class Correlation Coefficients (ICC 3,1 and 3,2 and variability with Coefficients of Variation (CoV's. Results The measurements demonstrated moderate to good levels of within-session reliability across all segments of the foot (0.69-0.93, except the lesser toes, which demonstrated poor reliability (0.17-0.50. CoV's across the three repeated trials ranged from 10.12-19.84% for each of the measured variables across all regions of the foot, except the lesser toes which demonstrated the greatest variability within trials (27.15-56.08%. The between-session results demonstrated good levels of reliability across all foot segments (0.79-0.99 except the lesser toes; with moderate levels of reliability reported at this region of the foot (0.58-0.68. The CoV's between-sessions demonstrated that the midfoot (16.41-36.23% and lesser

  1. Classification and mass production technique for three-quarter shoe insoles using non-weight-bearing plantar shapes.

    Science.gov (United States)

    Sun, Shuh-Ping; Chou, Yi-Jiun; Sue, Chun-Chia

    2009-07-01

    We have developed a technique for the mass production and classification of three-quarter shoe insoles via a 3D anthropometric measurement of full-size non-weight-bearing plantar shapes. The plantar shapes of fifty 40-60-year-old adults from Taiwan were categorized and, in conjunction with commercially available flat or leisure shoe models, three-quarter shoe-insole models were generated using a CAD system. Applying a rapid prototype system, these models were then used to provide the parameters for manufacturing the shoe insoles. The insoles developed in this study have been classified into S, M and L types that offer user-friendly options for foot-care providers. We concluded that these insoles can mate tightly with the foot arch and disperse the pressure in the heel and forefoot over the foot arch. Thus, practically, the pressure difference over the plantar region can be minimised, and the user can experience comfort when wearing flat or leisure shoes.

  2. Plantar Pressure Changes and Correlating Risk Factors in Chinese Patients with Type 2 Diabetes: Preliminary 2-year Results of a Prospective Study

    Institute of Scientific and Technical Information of China (English)

    Xuan Qiu; De-Hu Tian; Chang-Ling Han; Wei Chen; Zhan-Jian Wang; Zhen-Yun Mu; Kuan-Zhi Liu

    2015-01-01

    Background: Plantar pressure serves as a key factor for predicting ulceration in the feet of diabetes patients.We designed this study to analyze plantar pressure changes and correlating risk factors in Chinese patients with type 2 diabetes.Methods: We recruited 65 patients with type 2 diabetes.They were invited to participate in the second wave 2 years later.The patients completed identical examinations at the baseline point and 2 years later.We obtained maximum force, maximum pressure, impulse, pressure-time integral, and loading rate values from 10 foot regions.We collected data on six history-based variables, six anthropometric variables, and four metabolic variables of the patients.Results: Over the course of the study, significant plantar pressure increases in some forefoot portions were identified (P < 0.05), especially in the second to forth metatarsal heads.Decreases in heel impulse and pressure-time integral levels were also found (P < 0.05).Plantar pressure parameters increased with body mass index (BMI) levels.Hemoglobin A1 c (HbA1 c) changes were positively correlated with maximum force (β =0.364, P =0.001) and maximum pressure (β =0.366, P =0.002) changes in the first metatarsal head.Cholesterol changes were positively correlated with impulse changes in the lateral portion of the heel (β =0.179, P =0.072) and pressure-time integral changes in the second metatarsal head (β =0.236, P =0.020).Ankle-brachial index (ABI) changes were positively correlated with maximum force changes in the first metatarsal head (β =0.137, P =0.048).Neuropathy symptom score (NSS) and common peroneal nerve sensory nerve conduction velocity (SCV) changes were positively correlated with some plantar pressure changes.In addition, plantar pressure changes had a correlation with the appearance of infections, blisters (β =0.244, P =0.014), and calluses over the course of the study.Conclusions: We should pay attention to the BMI, HbA1c, cholesterol, ABI, SCV, and NSS

  3. Recovery of plutonium from electrorefining anode heels at Savannah River

    International Nuclear Information System (INIS)

    In a joint effort, the Savannah River Laboratory (SRL), Savannah River Plant (SRP), and the Rocky Flats Plant (RFP) have developed two processes to recover plutonium from electrorefining anode heel residues. Aqueous dissolution of anode heel metal was demonstrated at SRL on a laboratory scale and on a larger pilot scale using either sulfamic acid or nitric acid-hydrazine-fluoride solutions. This direct anode heel metal dissolution requires the use of a geometrically favorable dissolver. The second process developed involves first diluting the plutonium in the anode heel residues by alloying with aluminum. The alloyed anode heel plutonium can then be dissolved using a nitric acid-fluoride-mercury(II) solution in large non-geometrically favorable equipment where nuclear safety is ensured by concentration control

  4. ULTRASONOGRAPHY, AN EFFECTIVE TOOL IN DIAGNOSING PLANTAR FASCIITIS: A SYSTEMATIC REVIEW OF DIAGNOSTIC TRIALS

    Science.gov (United States)

    Wyland, Matthew; Applequist, Lee; Bolowsky, Erin; Klingensmith, Heather; Virag, Isaac

    2016-01-01

    Background Plantar fasciitis (PF) is the most common cause of heel pain that affects 10% of the general population, whether living an athletic or sedentary lifestyle. The most frequent mechanism of injury is an inflammatory response that is caused by repetitive micro trauma. Many techniques are available to diagnose PF, including the use of ultrasonography (US). Purpose The purpose of this study is to systematically review and appraise previously published articles published between the years 2000 and 2015 that evaluated the effectiveness of using US in the process of diagnosing PF, as compared to alternative diagnostic methods. Methods A total of eight databases were searched to systematically review scholarly (peer reviewed) diagnostic and intervention articles pertaining to the ability of US to diagnose PF. Results Using specific key words the preliminary search yielded 264 articles, 10 of which were deemed relevant for inclusion in the study. Two raters independently scored each article using the 15 point modified QUADAS scale. Discussion Six studies compared the diagnostic efficacy of US to another diagnostic technique to diagnose PF, and four studies focused on comparing baseline assessment of plantar fascia before subsequent intervention. The most notable US outcomes measured were plantar fascia thickness, enthesopathy, and hypoechogenicity. Conclusion US was found to be accurate and reliable compared to alternative reference standards like MRI in the diagnosis of PF. The general advantages of US (e.g. cost efficient, ease of administration, non-invasive, limited contraindications) make it a superior diagnostic modality in the diagnosis of PF. US should be considered in rehabilitation clinics to effectively diagnose PF and to accurately monitor improvement in the disease process following rehabilitation interventions. Level of Evidence 1A PMID:27757279

  5. Could Insoles Offload Pressure? An Evaluation of the Effects of Arch-supported Functional Insoles on Plantar Pressure Distribution during Race Walking.

    Science.gov (United States)

    Song, Qipeng; Xu, Kaisheng; Yu, Bing; Zhang, Cui; Sun, Wei; Mao, Dewei

    2015-01-01

    This study investigated the effectiveness of functional insoles on plantar pressure distribution during race walking so as to reduce the high plantar pressure and force on race walkers, who tend to suffer from overuse injury. A total of 20 male race walkers aged 21.19 ± 3.66 years and with a mean height of 178.85 ± 14.07 cm were recruited as participants. Each participant completed a race walking with functional or normal insoles. Plantar pressure insoles were used to collect vertical plantar pressure data. A two-way analysis of variance with a mixed design was used to determine the difference between the two conditions. Results showed that the use of functional insoles reduces the peak pressure and the impulse in the metatarsophalangeal joints and heels and thus suggest that functional insoles reduce the overuse injury risks of these parts. The first ground reaction force peak also decreased. This result suggested that functional insoles reduce the risks of foot and leg injuries.

  6. Quantitative Ultrasound Measurements at the Heel

    DEFF Research Database (Denmark)

    Daugschies, M.; Brixen, K.; Hermann, P.;

    2015-01-01

    Calcaneal quantitative ultrasound can be used to predict osteoporotic fracture risk, but its ability to monitor therapy is unclear possibly because of its limited precision. We developed a quantitative ultrasound device (foot ultrasound scanner) that measures the speed of sound at the heel...... with the aim of minimizing common error sources like the position and penetration angle of the ultrasound beam, as well as the soft tissue temperature. To achieve these objectives, we used a receiver array, mechanics to adjust the beam direction and a foot temperature sensor. In a group of 60 volunteers, short......-term precision was evaluated for the foot ultrasound scanner and a commercial device (Achilles Insight, GE Medical, Fairfield, CT, USA). In a subgroup of 20 subjects, mid-term precision (1-mo follow-up) was obtained. Compared with measurement of the speed of sound with the Achilles Insight, measurement...

  7. Sectioning the plantar fascia. Effect on first metatarsophalangeal joint motion.

    Science.gov (United States)

    Harton, Francois M; Weiskopf, Steven A; Goecker, Robert M

    2002-01-01

    A study on the effect of sectioning the plantar fascia on the range of motion at the first metatarsophalangeal joint is presented. Dorsiflexion and plantarflexion range-of-motion data from 18 patients who had no first metatarsophalangeal joint pathology and had undergone an in-step plantar fasciotomy for recalcitrant plantar fasciitis were analyzed. The average increase in dorsiflexion of the first metatarsophalangeal joint after plantar fascia release was 9.8 degrees, which represented a statistically significant increase using a paired t-test. Thus release of the plantar fascia can be considered a potential adjunct to hallux limitus surgery. PMID:12438498

  8. Heel pad avulsion injury: an approach with hyperbaric oxygen therapy

    Directory of Open Access Journals (Sweden)

    Pradeoth Korambayil Mukundan

    2015-04-01

    Full Text Available Aim: Crush injuries of the foot are often associated with partial or complete degloving of the heel pad. The purpose of this study is to present an algorithm for the management of various types of heel pad avulsion injuries, including hyperbaric oxygen (HBO therapy in the treatment regimen. Methods: We present a prospective study of 27 patients with various types of heel pad avulsion managed in our institution from December 2012 to June 2013. Heel pad avulsion injuries were classified according to the angiosomal pattern. Partial or complete avulsions were classified and treated accordingly. HBO therapy was administered postoperatively. The postoperative period, hospital course, and follow-up were documented in patients with heel pad avulsion injuries. Results: Of 27 patients, 20 cases presented with partial avulsion and 7 cases were complete avulsion. Of 20 cases of partial avulsion, one of the flaps was anchored with K-wire. Nineteen cases of partial heel pad avulsion were managed by suturing. Eight patients out of 20 required skin grafting as a secondary procedure at a later date. Out of 7 cases of complete avulsion, one was managed by full-thickness skin grafting, one case by reverse sural artery flap coverage, and four cases were managed by free tissue transfer. No flap revisions were required, and no complications were experienced for the transferred flaps. Conclusion: HBO therapy may be a useful adjunct in the treatment of heel pad avulsion injuries.

  9. The effects of orthotic intervention on multisegment foot kinematics and plantar fascia strain in recreational runners.

    Science.gov (United States)

    Sinclair, Jonathan; Isherwood, Josh; Taylor, Paul J

    2015-02-01

    Chronic injuries are a common complaint in recreational runners. Foot orthoses have been shown to be effective for the treatment of running injuries but their mechanical effects are still not well understood. This study aims to examine the influence of orthotic intervention on multisegment foot kinematics and plantar fascia strain during running. Fifteen male participants ran at 4.0 m · s(-1) with and without orthotics. Multisegment foot kinematics and plantar fascia strain were obtained during the stance phase and contrasted using paired t tests. Relative coronal plane range of motion of the midfoot relative to the rearfoot was significantly reduced with orthotics (1.0°) compared to without (2.2°). Similarly, relative transverse plane range of motion was significantly lower with orthotics (1.1°) compared to without (1.8°). Plantar fascia strain did not differ significantly between orthotic (7.1) and nonorthotic (7.1) conditions. This study shows that although orthotics did not serve to reduce plantar fascia strain, they are able to mediate reductions in coronal and transverse plane rotations of the midfoot.

  10. Plantar pressure distribution in older people with osteoarthritis of the first metatarsophalangeal joint (hallux limitus/rigidus).

    Science.gov (United States)

    Zammit, Gerard V; Menz, Hylton B; Munteanu, Shannon E; Landorf, Karl B

    2008-12-01

    The purpose of this study was to evaluate differences in dynamic plantar pressure distribution between older people with and without radiographically confirmed osteoarthritis (OA) of the first metatarsophalangeal joint (first MPJ) of the foot. Dynamic plantar pressure recordings using the TekScan MatScan system were obtained during barefoot level walking in 40 older participants; 20 with radiographically confirmed OA of the first MPJ displaying less than 55 degrees of passive dorsiflexion, and 20 with no evidence of OA in the first MPJ displaying greater than 55 degrees of passive dorsiflexion. Group comparisons between the variables maximum force and peak pressure were made for seven different regions underneath the right foot (heel, midfoot, first MPJ, second MPJ, third to fifth MPJs, hallux, and lesser toes). Compared to the control group, participants with OA of the first MPJ exhibited 34% greater maximum force (7.9 +/- 2.5 vs. 5.9 +/- 1.7 kg, p = 0.005) and 23% higher peak pressure (1.6 +/- 0.3 vs. 1.3 +/- 0.3 kg/cm(2), p = 0.001) under the hallux. Similar results were also found under the lesser toes with 43% greater maximum force (5.0 +/- 1.9 vs. 3.5 +/- 1.4 kg; p = 0.006) and 29% higher peak pressure (0.9 +/- 0.2 vs. 0.7 +/- 0.2 kg/cm(2), p = 0.018). No significant differences were found to exist between groups for any other plantar region. These findings indicate that OA of the first MPJ is associated with significant changes in load-bearing function of the foot, which may contribute to the development of secondary pathological changes associated with the condition, such as plantar callus formation and hyperextension of the hallux interphalangeal joint. PMID:18634037

  11. Plantar fascia coronal length: a new parameter for plantar fascia assessment.

    Science.gov (United States)

    Sari, Ahmet Sinan; Demircay, Emre; Cakmak, Gokhan; Sahin, M Sukru; Tuncay, I Cengiz; Altun, Suleyman

    2015-01-01

    The effects of gender and various anthropometric variables were previously reported as significant predictors of plantar fascia thickness. Although a strong correlation between either the body weight or body mass index (BMI) and plantar fascia thickness were not demonstrated, a moderate relation was stated. We retrospectively investigated the role of gender, height, weight, and body mass index on plantar fascia thickness at the calcaneal origin (PFCO) and 1 cm distal from the calcaneal origin (PF1cm) and the coronal length of the plantar fascia at the calcaneal origin (CLPF) in healthy subjects. The PFCO, PF1cm, and CLPF were retrospectively measured from magnetic resonance images of 100 healthy subjects. The gender, height, weight, and body mass index of the participants were also noted. Gender was a predictive factor for the length of the CLPF. The subjects with a BMI >25 kg/m(2) had a significantly greater PFCO, PF1cm, and CLPF. Height was mildly and BMI and weight were moderately related to the PFCO. However the CLPF showed a better correlation with height, BMI, and weight than that of plantar fascia thickness. CLPF better reflected the role of weight, BMI, and height than its thickness. It is a new parameter that could be valuable in the evaluation of plantar fascia disorders.

  12. Diagnostic accuracy of heel pad palpation - A phantom study

    DEFF Research Database (Denmark)

    Torp-Pedersen, Søren; Matteoli, Sara; Wilhjelm, Jens E.;

    2008-01-01

    Falanga torture involves repetitive blunt trauma to the soles of the feet and typically leaves few detectable changes. Reduced elasticity in the heel pads has been reported as characteristic sequelae and palpatory testing of heel pad elasticity is therefore part of medicolegal assessment of alleged...... torture victims. The goal was to test the accuracy of two experienced investigators in determining whether a heel pad model was soft, medium or hard. The skin-to-bone distance in the models varied within the human range....

  13. Heeling Moment Acting on a River Cruiser in Manoeuvring Motion

    Directory of Open Access Journals (Sweden)

    Tabaczek Tomasz

    2016-01-01

    Full Text Available By using fully theoretical method the heeling moment due to centrifugal forces has been determined for a small river cruiser in turning manoeuvre. The authors applied CFD software for determination of hull hydrodynamic forces, and open water characteristics of ducted propeller for estimation of thrust of rudder-propellers. Numerical integration of equations of 3DOF motion was used for prediction of ship trajectory and time histories of velocities, forces and heeling moment.

  14. Research on Normal Human Plantar Pressure Test

    Directory of Open Access Journals (Sweden)

    Liu Xi Yang

    2016-01-01

    Full Text Available FSR400 pressure sensor, nRF905 wireless transceiver and MSP40 SCM are used to design the insole pressure collection system, LabVIEW is used to make HMI of data acquisition, collecting a certain amount of normal human foot pressure data, statistical analysis of pressure distribution relations about five stages of swing phase during walking, using the grid closeness degree to identify plantar pressure distribution pattern recognition, and the algorithm simulation, experimental results demonstrated this method feasible.

  15. The effect of the gastrocnemius on the plantar fascia.

    Science.gov (United States)

    Pascual Huerta, Javier

    2014-12-01

    Although anatomic and functional relationship has been established between the gastrocnemius muscle, via the Achilles tendon, and the plantar fascia, the exact role of gastrocnemius tightness in foot and plantar fascia problems is not completely understood. This article summarizes past and current literature linking these 2 structures and gives a mechanical explanation based on functional models of the relationship between gastrocnemius tightness and plantar fascia. The effect of gastrocnemius tightness on the sagittal behavior of the foot is also discussed.

  16. In-shoe plantar tri-axial stress profiles during maximum-effort cutting maneuvers.

    Science.gov (United States)

    Cong, Yan; Lam, Wing Kai; Cheung, Jason Tak-Man; Zhang, Ming

    2014-12-18

    Soft tissue injuries, such as anterior cruciate ligament rupture, ankle sprain and foot skin problems, frequently occur during cutting maneuvers. These injuries are often regarded as associated with abnormal joint torque and interfacial friction caused by excessive external and in-shoe shear forces. This study simultaneously investigated the dynamic in-shoe localized plantar pressure and shear stress during lateral shuffling and 45° sidestep cutting maneuvers. Tri-axial force transducers were affixed at the first and second metatarsal heads, lateral forefoot, and heel regions in the midsole of a basketball shoe. Seventeen basketball players executed both cutting maneuvers with maximum efforts. Lateral shuffling cutting had a larger mediolateral braking force than 45° sidestep cutting. This large braking force was concentrated at the first metatarsal head, as indicated by its maximum medial shear stress (312.2 ± 157.0 kPa). During propulsion phase, peak shear stress occurred at the second metatarsal head (271.3 ± 124.3 kPa). Compared with lateral shuffling cutting, 45° sidestep cutting produced larger peak propulsion shear stress (463.0 ± 272.6 kPa) but smaller peak braking shear stress (184.8 ± 181.7 kPa), of which both were found at the first metatarsal head. During both cutting maneuvers, maximum medial and posterior shear stress occurred at the first metatarsal head, whereas maximum pressure occurred at the second metatarsal head. The first and second metatarsal heads sustained relatively high pressure and shear stress and were expected to be susceptible to plantar tissue discomfort or injury. Due to different stress distribution, distinct pressure and shear cushioning mechanisms in basketball footwear might be considered over different foot regions. PMID:25468303

  17. Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot

    Energy Technology Data Exchange (ETDEWEB)

    Chundru, Usha [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Liebeskind, Amy; Beltran, Javier [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Seidelmann, Frank; Franklin, Peter [Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Fogel, Joshua [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Brooklyn College, Department of Economics, Brooklyn, NY (United States)

    2008-06-15

    To determine the association of atrophy of the abductor digiti minimi muscle (ADMA), an MRI manifestation of chronic compression of the inferior calcaneal nerve suggesting the clinical diagnosis of Baxter's neuropathy, with MRI markers of potential etiologies, including calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and posterior tibial tendon dysfunction (PTTD). Prevalence of calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and PTTD was assessed retrospectively on 100 MRI studies with ADMA and 100 MRI studies without ADMA. Patients ranged in age from 10-92 years. Pearson chi-square analyses and Fisher's exact test were used to compare prevalence of the above findings in patients with and without ADMA. Logistic regression was used to determine which variables were significantly associated with ADMA. Among patients with ADMA, there was significantly greater age (57.2 years vs 40.8 years, p < 0.001), presence of Achilles tendinosis (22.0% vs 3.0%, P<0.001), calcaneal edema (15.0% vs 3.0%, P = 0.005), calcaneal spur (48.0% vs 7.0%, P < 0.001), plantar fasciitis (52.5% vs 11.0%, P<0.001), and PTTD (32.0% vs 11.0%, P<0.001). After multivariate logistic regression analysis, only age [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03, 1.09], calcaneal spur (OR 3.60, 95% CI 1.28, 10.17), and plantar fasciitis (OR 3.35, 95% CI 1.31, 8.56) remained significant. Advancing age, calcaneal spur, and plantar fasciitis are significantly associated with ADMA. Their high odds ratios support the notion of a possible etiologic role for calcaneal spur and plantar fasciitis in the progression to Baxter's neuropathy. (orig.)

  18. 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.

  19. [Research on Adaptive Balance Reaction for Gait Slippery Instability Events on Level Walk Based on Plantar Pressure and Gait Parameter Analysis].

    Science.gov (United States)

    Li, Yang; Zhang, Junxia; Si, Ying

    2015-12-01

    Nowadays, for gait instability phenomenon, many researches have been carried out at home and abroad. However, the relationship between plantar pressure and gait parameters in the process of balance adjustment is still unclear. This study describes the human body adaptive balance reaction during slip events on slippery level walk by plantar pressure and gait analysis. Ten healthy male subjects walked on a level path wearing shoes with two contrastive contaminants (dry, oil). The study collected and analyzed the change rule of spatiotemporal parameters, plantar pressure parameters, vertical ground reaction force (VGRF), etc. The results showed that the human body adaptive balance reaction during slip events on slippery level walk mainly included lighter touch at the heel strikes, tighter grip at the toe offs, a lower velocity, a shorter stride length and longer support time. These changes are used to maintain or recover body balance. These results would be able to explore new ideas and provide reference value for slip injury prevention, walking rehabilitation training design, research and development of walking assistive equipments, etc. PMID:27079090

  20. Cryotherapy usage to treat plantar warts

    International Nuclear Information System (INIS)

    Treating dermatosis with liquid nitrogen as cryogen (substance generating cold) allows cellular destruction in more than 5 mm depth, making it indispensable to use it treating cutaneous cancers; besides that, it is cheap, easy to conserve and manage, and it is not considered flammable or toxic. Its applying retains the growth factor inside the injury, the collagen is not damaged as it is in burning by hot, there is not almost injury contraction, the perineurium is not altered, and when the tissue necrosis takes place, it retains tissue necrosis factor, helping to increase the necrosis of tissues. Taking into account the high incidence of dermatosis that can be treated with cryogen, in our consultation; we decided to generalize this treatment at the Provincial Interior Ministry Clinic. Plantar warts represent a big percent, limiting our patients in developing their working activities. This cutaneous viral disease is favored by the patients' systemic immunodepressions, hyperhidrosis and podalic disturbances. We selected the patients assisting to our extern al consultation with plantar wart clinical diagnosis in the period from September 2006 to September 2007. They signed an act of informed consent where the possible side effects are explained. Liquid nitrogen was applied with cotton applicators once a week after mechanical reduction. We made a clinical evolving evaluation fortnightly during the treatment, according to the elements and clinical characteristics referred by the patient, and proved by the physical examination carried out by the main investigator, because of the likelihood of short and long time side effects. This investigation demonstrated that cryotherapy is efficacious in treating plantar warts, since all the patients were healed in a short time period, most of them without side effects

  1. Dynamic Patterns of Forces and Loading Rate in Runners with Unilateral Plantar Fasciitis: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Ana Paula Ribeiro

    Full Text Available The etiology of plantar fasciitis (PF has been related to several risk factors, but the magnitude of the plantar load is the most commonly described factor. Although PF is the third most-common injury in runners, only two studies have investigated this factor in runners, and their results are still inconclusive regarding the injury stage.Analyze and compare the plantar loads and vertical loading rate during running of runners in the acute stage of PF to those in the chronic stage of the injury in relation to healthy runners.Forty-five runners with unilateral PF (30 acute and 15 chronic and 30 healthy control runners were evaluated while running at 12 km/h for 40 meters wearing standardized running shoes and Pedar-X insoles. The contact area and time, maximum force, and force-time integral over the rearfoot, midfoot, and forefoot were recorded and the loading rate (20-80% of the first vertical peak was calculated. Groups were compared by ANOVAs (p<0.05.Maximum force and force-time integral over the rearfoot and the loading rate was higher in runners with PF (acute and chronic compared with controls (p<0.01. Runners with PF in the acute stage showed lower loading rate and maximum force over the rearfoot compared to runners in the chronic stage (p<0.01.Runners with PF showed different dynamic patterns of plantar loads during running over the rearfoot area depending on the injury stage (acute or chronic. In the acute stage of PF, runners presented lower loading rate and forces over the rearfoot, possibly due to dynamic mechanisms related to pain protection of the calcaneal area.

  2. Internal strain estimation for quantification of human heel pad elastic modulus: A phantom study

    DEFF Research Database (Denmark)

    Holst, Karen; Liebgott, Hervé; Wilhjelm, Jens E.;

    2013-01-01

    Shock absorption is the most important function of the human heel pad. However, changes in heel pad elasticity, as seen in e.g. long-distance runners, diabetes patients, and victims of Falanga torture are affecting this function, often in a painful manner. Assessment of heel pad elasticity...... is usually based on one or a few strain measurements obtained by an external load-deformation system. The aim of this study was to develop a technique for quantitative measurements of heel pad elastic modulus based on several internal strain measures from within the heel pad by use of ultrasound images. Nine...... heel phantoms were manufactured featuring a combination of three heel pad stiffnesses and three heel pad thicknesses to model the normal human variation. Each phantom was tested in an indentation system comprising a 7MHz linear array ultrasound transducer, working as the indentor, and a connected load...

  3. Plantar pressure cartography reconstruction from 3 sensors.

    Science.gov (United States)

    Abou Ghaida, Hussein; Mottet, Serge; Goujon, Jean-Marc

    2014-01-01

    Foot problem diagnosis is often made by using pressure mapping systems, unfortunately located and used in the laboratories. In the context of e-health and telemedicine for home monitoring of patients having foot problems, our focus is to present an acceptable system for daily use. We developed an ambulatory instrumented insole using 3 pressures sensors to visualize plantar pressure cartographies. We show that a standard insole with fixed sensor position could be used for different foot sizes. The results show an average error measured at each pixel of 0.01 daN, with a standard deviation of 0.005 daN.

  4. Ultrasound-assisted endoscopic partial plantar fascia release.

    Science.gov (United States)

    Ohuchi, Hiroshi; Ichikawa, Ken; Shinga, Kotaro; Hattori, Soichi; Yamada, Shin; Takahashi, Kazuhisa

    2013-01-01

    Various surgical treatment procedures for plantar fasciitis, such as open surgery, percutaneous release, and endoscopic surgery, exist. Skin trouble, nerve disturbance, infection, and persistent pain associated with prolonged recovery time are complications of open surgery. Endoscopic partial plantar fascia release offers the surgeon clear visualization of the anatomy at the surgical site. However, the primary medial portal and portal tract used for this technique have been shown to be in close proximity to the posterior tibial nerves and their branches, and there is always the risk of nerve damage by introducing the endoscope deep to the plantar fascia. By performing endoscopic partial plantar fascia release under ultrasound assistance, we could dynamically visualize the direction of the endoscope and instrument introduction, thus preventing nerve damage from inadvertent insertion deep to the fascia. Full-thickness release of the plantar fascia at the ideal position could also be confirmed under ultrasound imaging. We discuss the technique for this new procedure. PMID:24265989

  5. 基于LABVIEW系统对鞋底压力的研究%The Pressure and Comfort of the High- heeled Shoes Based on LABVIEW System

    Institute of Scientific and Technical Information of China (English)

    唐方; 张海泉; 魏取福; 肖居霞

    2011-01-01

    With the use of LABVIEW Virtual Instrument (VI) , the plantar pressure caused by high-heeled shoes (with heel of 5 cm to 9 cm) is collected and stored. By analyzing these data, we get a clearer recognition of the relations between the shoe soles and the plantar pressure, which will provide the customers and the enterprises with more rational and scientific principles. According to these principles, not only the requirements of the artistry of shoes can be satisfied, but also the shoes can be more comfortable. Thus we can unit the beauty and comfort of shoes.%以LABVIEW虚拟测试仪器为手段,对高跟鞋不同的跟高(5~9 cm)所产生的足底特征部位的压力值进行测试、采集、存储.通过对数据的分析,得到对鞋底对足底压力影响的清晰认识,为人们选购高跟鞋提供理性的科学依据,并为高跟鞋生产企业在做鞋设计时,提供确凿的参考依据,让其明确在满足美观性的同时,如何设计鞋底更有利于足底压力的舒适性,以达到美观性和舒适性的统一.

  6. Temperature as a predictive tool for plantar triaxial loading.

    Science.gov (United States)

    Yavuz, Metin; Brem, Ryan W; Davis, Brian L; Patel, Jalpa; Osbourne, Abe; Matassini, Megan R; Wood, David A; Nwokolo, Irene O

    2014-11-28

    Diabetic foot ulcers are caused by moderate repetitive plantar stresses in the presence of peripheral neuropathy. In severe cases, the development of these foot ulcers can lead to lower extremity amputations. Plantar pressure measurements have been considered a capable predictor of ulceration sites in the past, but some investigations have pointed out inconsistencies when solely relying on this method. The other component of ground reaction forces/stresses, shear, has been understudied due to a lack of adequate equipment. Recent articles reported the potential clinical significance of shear in diabetic ulcer etiology. With the lack of adequate tools, plantar temperature has been used as an alternative method for determining plantar triaxial loading and/or shear. However, this method has not been previously validated. The purpose of this study was to analyze the potential association between exercise-induced plantar temperature increase and plantar stresses. Thirteen healthy individuals walked on a treadmill for 10 minutes at 3.2km/h. Pre and post-exercise temperature profiles were obtained with a thermal camera. Plantar triaxial stresses were quantified with a custom-built stress plate. A statistically significant correlation was observed between peak shear stress (PSS) and temperature increase (r=0.78), but not between peak resultant stress (PRS) and temperature increase (r=0.46). Plantar temperature increase could predict the location of PSS and PRS in 23% and 39% of the subjects, respectively. Only a moderate linear relationship was established between triaxial plantar stresses and walking-induced temperature increase. Future research will investigate the value of nonlinear models in predicting plantar loading through foot temperature. PMID:25446272

  7. Unilobed Rotational Flap for Plantar Hallux Interphalangeal Joint Ulceration Complicated by Osteomyelitis.

    Science.gov (United States)

    Boffeli, Troy J; Hyllengren, Shelby B

    2015-01-01

    Diabetes-related neuropathic ulcers located at the plantar aspect of the hallux interphalangeal joint are often chronic or recurrent and frequently become complicated by osteomyelitis. Once infected, treatment will typically involve hallux amputation. Although intended as a definitive procedure, amputation of the first toe is not desirable from a cosmetic or functional standpoint and often leads to transfer ulcers at adjacent locations of the foot. Reconstructive wound surgery, combined with limited bone resection, is possible if the infection is caught early before the local tissue and bone have become necrotic. In addition to neuropathy, biomechanical issues, including ankle equinus, hallux limitus, hallux extensus, and hallux valgus, predispose patients with diabetes mellitus to developing plantar hallux ulcers. We commonly employ a proximal based unilobed plantar rotational flap combined with hallux interphalangeal joint arthroplasty as an alternative to hallux amputation. We present a typical case with long-term follow-up to highlight our flap protocol, including patient selection criteria, flap design, surgical technique, bone resection and biopsy pearls, staging timeline, and a typical postoperative course. Periodic follow-up during the next 72 months for unrelated conditions allowed long-term monitoring with no recurrence of osteomyelitis or subsequent amputation. The foot remained ulcer free 6 years later. The benefits of this surgical approach include complete excision of the ulcer, adequate exposure for bone resection, early bone biopsy before the spread of infection or necrosis of local tissue, flap coverage with viable soft tissue, and partial offloading of mechanical pressure at the plantar interphalangeal joint.

  8. Unilobed Rotational Flap for Plantar Hallux Interphalangeal Joint Ulceration Complicated by Osteomyelitis.

    Science.gov (United States)

    Boffeli, Troy J; Hyllengren, Shelby B

    2015-01-01

    Diabetes-related neuropathic ulcers located at the plantar aspect of the hallux interphalangeal joint are often chronic or recurrent and frequently become complicated by osteomyelitis. Once infected, treatment will typically involve hallux amputation. Although intended as a definitive procedure, amputation of the first toe is not desirable from a cosmetic or functional standpoint and often leads to transfer ulcers at adjacent locations of the foot. Reconstructive wound surgery, combined with limited bone resection, is possible if the infection is caught early before the local tissue and bone have become necrotic. In addition to neuropathy, biomechanical issues, including ankle equinus, hallux limitus, hallux extensus, and hallux valgus, predispose patients with diabetes mellitus to developing plantar hallux ulcers. We commonly employ a proximal based unilobed plantar rotational flap combined with hallux interphalangeal joint arthroplasty as an alternative to hallux amputation. We present a typical case with long-term follow-up to highlight our flap protocol, including patient selection criteria, flap design, surgical technique, bone resection and biopsy pearls, staging timeline, and a typical postoperative course. Periodic follow-up during the next 72 months for unrelated conditions allowed long-term monitoring with no recurrence of osteomyelitis or subsequent amputation. The foot remained ulcer free 6 years later. The benefits of this surgical approach include complete excision of the ulcer, adequate exposure for bone resection, early bone biopsy before the spread of infection or necrosis of local tissue, flap coverage with viable soft tissue, and partial offloading of mechanical pressure at the plantar interphalangeal joint. PMID:25681281

  9. Medial calcaneal nerve and neurogenic painful heel syndrome: anatomic basis%跟内侧神经与神经源性跟痛症关系的解剖学基础

    Institute of Scientific and Technical Information of China (English)

    冯成安; 孙俊; 刘宗良; 范炜; 张东葵; 叶频

    2012-01-01

    Objective To investigate the relationship between the medial calcaneal nerve (MCN) and neurogenic painful heel syndrome (NPHS), and provide anatomical evidence for study, diagnosis and therapy. Methods 32 formalin-fixed adult lower limb specimens were used in the study. MCN was dissected for demonstrating the origin, course, branches and the distribution. Results 41.42% of MCN originated from the trunk of tibial nerve, however, 28.57% originated from the bifurcation site of tibial nerve, 18.57% from the medial plantar nerve, and 11.42% from the lateral plantar nerve. The distance from the origin of MCN to the middle point between the lowest margin of the medial malleolus and the medial process of calcaneal tuberosity was about (30.22± 15.34)mm. MCN distributed to medial heel, the skin of footplate, and soft tissue of heel, after passing through flexor retinaculum. Conclusions MCN maybe compressed in the ankle canal, or the calcaneal tunnel, or at the site of passing from the flexor retinaculum, which are probably related to the occurrence of the plantar fasciitis and heel pain.%目的 探讨跟内侧神经的局部解剖特点及其与神经源性跟痛症的关系,为临床诊断治疗提供解剖学依据.方法 32侧防腐成人尸体下肢标本,解剖观察跟内侧神经的起源、分支、走行和分布特点.结果 跟内侧神经41.42%起源于胫神经,28.57%起源于胫神经分叉处,18.57%起源于足底内侧神经,11.42%起源于足底外侧神经.起点距O点(内踝尖最下缘与跟骨结节内侧突连线中点)(30.22±15.34)mm.跟内侧神经穿出屈肌支持带后分布于足跟内侧及跟底的皮肤和跟垫组织.结论 跟内侧神经在踝管内,浅出屈肌支持带处及跟管内可能被卡压;神经卡压或病变可能与足底腱膜炎发生及疼痛有关.

  10. Treatment of Painful Heels with Acupuncture in 32 Cases

    Institute of Scientific and Technical Information of China (English)

    YE Ming-zhu; CHEN Han-ping

    2003-01-01

    Points Fengfu(GV 16), Fengchi(GB 20) and Anmian were selected as main acupoints to treat painful heels and the total effective rate of 96.9% was got. The technique of lifting needle was the key to the therapy.

  11. Physiological Achilles' heels of Enteropathogenic bacteria in livestock

    NARCIS (Netherlands)

    Becker, P.M.

    2005-01-01

    An elaborate feeding regimen of animals, which takes advantage of the Achilles' heels of enteropathogenic bacteria, can possibly enable prophylaxis in the intestinal tract, attenuate actual disease symptoms, accelerate recovery from a bacterial gastroenteritis or ensure food safety. There is a wide

  12. Mechanical behaviour of the heel pad: experimental and numerical approach

    DEFF Research Database (Denmark)

    Matteoli, Sara; Fontanella, C. G.; Virga, A.;

    compared with those obtained from finite element analysis performed on numerical 3D subject-specific heel pad model built on the basis of MRI. The calcaneal fat pad tissue was described with a visco-hyperelastic model, while a fiber-reinforced hyperelastic model was formulated for the skin. The reliability...

  13. Aspects of treatment for posterior heel pain in young athletes

    Directory of Open Access Journals (Sweden)

    Thomas Elengard

    2010-12-01

    Full Text Available Thomas Elengard1, Jón Karlsson1, Karin Grävare Silbernagel21Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden; 2Department of Mechanical Engineering, University of Delaware, Newark, Delaware, USAAbstract: Posterior heel pain occurs in young athletes involved in running and jumping. Due to the pain, the child often limits his/her physical activity level, with a possible negative effect on health and well-being. Although numerous research studies have examined the cause and treatment of heel and Achilles tendon pain in adults, there are no randomized clinical trials on treatment in children and adolescents. Therefore, there is limited evidence for how to treat young athletes with this type of complaint. The purpose of this review was to analyze critically and summarize the literature in regards to the cause and treatment of posterior heel pain in young athletes. The various diagnoses and clinical presentations relating to posterior heel and Achilles tendon pain are discussed. The theory and mechanism behind various recommended treatment strategies are also reviewed in the context of use in the young athlete. In summary, it is important to perform a thorough evaluation of each young athlete with heel pain to determine the appropriate diagnosis and to treat the deficits found and allow for a gradual progression to training. However, the recommendations at this time are based on clinical experience and a few retrospective studies, so further well designed prospective studies with validated outcome measures are urgently needed for the young athlete.Keywords: Sever's disease, apophysitis, tendinitis, tendinopathy, child, adolescent

  14. Use of platelet rich plasma to treat plantar fasciitis: design of a multi centre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Peerbooms Joost C

    2010-04-01

    Full Text Available Abstract Background If conservative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporarily pain reduction, but no healing. Blood platelets initiate the natural healing rate. GPS® gives an eightfold concentrate platelets of patients own blood. Injection of these platelets in the attachment of the fascia to the os calcis might induce a healing rate. Methods and design A randomized controlled multi centre trial will be performed. The study population consists of 120 patients of 18 years and older. Patients with chronic plantar fasciitis will be allocated randomly to have a steroid injection or an autologous platelet concentrate injections. Data will be collected before the procedure, 4,8,12,26 weeks and 1 year after the procedure. The main outcome measures of this study are pain and function measured with questionnaires. Conclusion Recent literature show positive effects for the treatment of tendinosis with autologous platelet injections. The forthcoming trial will compare treatment for chronic plantar fasciitis with a steroid injection versus an autologous platelet injection. Our results will be published as soon as they become available. Trial Registration Trial registration number: http://www.clinicaltrials.gov NCT00758641.

  15. EFFECTS OF COMBINED FOOT/ANKLE ELECTROMYOSTIMULATION AND RESISTANCE TRAINING ON THE IN-SHOE PLANTAR PRESSURE PATTERNS DURING SPRINT IN YOUNG ATHLETES

    Directory of Open Access Journals (Sweden)

    François Fourchet

    2011-06-01

    Full Text Available Several studies have already reported that specific foot/ankle muscle reinforcement strategies induced strength and joint position sense performance enhancement. Nevertheless the effects of such protocols on sprint performance and plantar loading distribution have not been addressed yet. The objective of the study is to investigate the influence of a 5-wk foot/ankle strength training program on plantar loading characteristics during sprinting in adolescent males. Sixteen adolescent male athletes of a national training academy were randomly assigned to either a combined foot/ankle electromyostimulation and resistance training (FAST or a control (C group. FAST consisted of foot medial arch and extrinsic ankle muscles reinforcement exercises, whereas C maintained their usual training routine. Before and after training, in-shoe loading patterns were measured during 30-m running sprints using pressure sensitive insoles (right foot and divided into nine regions for analysis. Although sprint times remained unchanged in both groups from pre- to post- training (3.90 ± 0.32 vs. 3.98 ± 0.46 s in FAST and 3.83 ± 0.42 vs. 3.81 ± 0.44 s in C, changes in force and pressure appeared from heel to forefoot between FAST and C. In FAST, mean pressure and force increased in the lateral heel area from pre- to post- training (67.1 ± 44.1 vs. 82.9 ± 28.6 kPa [p = 0.06]; 25.5 ± 17.8 vs. 34.1 ± 14.3 N [p = 0.05] and did not change in the medial forefoot (151.0 ± 23.2 vs. 146.1 ± 30.0 kPa; 142.1 ± 29.4 vs. 136.0 ± 33.8; NS. Mean area increased in FAST under the lateral heel from pre- to post- (4.5 ± 1.3 vs. 5.7 ± 1.6 cm2 [p < 0.05] and remained unchanged in C (5.5 ± 2.8 vs. 5.0 ± 3.0 cm2. FAST program induced significant promising lateral and unwanted posterior transfer of the plantar loads without affecting significantly sprinting performance

  16. On the comparison between MRI and US imaging for human heel pad thickness measurements

    DEFF Research Database (Denmark)

    Matteoli, Sara; Corbin, Nadège Corbin; Wilhjelm, Jens E.;

    2011-01-01

    The human heel pad thickness, defined as the shortest distance between the calcaneus and heel skin, is one of the intrinsic factor which must be taken into account when investigating the biomechanics of the heel pad. US and MRI are the preferable imaging modalities used to measure the heel pad...... thickness as they are both ionizing-free radiations. The aim of this paper is to measure the bone to skin distance of nine heel pad phantoms from MRI and US images, and to compare the results with a true value (TV) in order to find the errors. Paired sample t-test was used to compare the measurements......1530 (P-value=0.402). Results confirm the necessity to investigate on the real speed of sound for the heel pad tissues, in order to have realistic measurements when dealing with human heel pads. __________________________________________________________________________________________________________...

  17. Exostectomy for chronic midfoot plantar ulcer in Charcot deformity

    DEFF Research Database (Denmark)

    Laurinaviciene, R.; Kirketerp-Moeller, K.; Holstein, Per Evald

    2008-01-01

    Charcot midfoot ulcers are rare and very difficult to heal, with surgery being an option. This retrospective study assessed healing rates, complications, and the incidence of re-ulceration and other foot ulcer problems following exostectomies Udgivelsesdato: 2008/2...

  18. Foot Modeling and Smart Plantar Pressure Reconstruction from Three Sensors

    Science.gov (United States)

    Ghaida, Hussein Abou; Mottet, Serge; Goujon, Jean-Marc

    2014-01-01

    In order to monitor pressure under feet, this study presents a biomechanical model of the human foot. The main elements of the foot that induce the plantar pressure distribution are described. Then the link between the forces applied at the ankle and the distribution of the plantar pressure is established. Assumptions are made by defining the concepts of a 3D internal foot shape, which can be extracted from the plantar pressure measurements, and a uniform elastic medium, which describes the soft tissues behaviour. In a second part, we show that just 3 discrete pressure sensors per foot are enough to generate real time plantar pressure cartographies in the standing position or during walking. Finally, the generated cartographies are compared with pressure cartographies issued from the F-SCAN system. The results show 0.01 daN (2% of full scale) average error, in the standing position. PMID:25400713

  19. Ultrasound-Assisted Endoscopic Partial Plantar Fascia Release

    OpenAIRE

    Ohuchi, Hiroshi; Ichikawa, Ken; Shinga, Kotaro; Hattori, Soichi; Shin YAMADA; Takahashi, Kazuhisa

    2013-01-01

    Various surgical treatment procedures for plantar fasciitis, such as open surgery, percutaneous release, and endoscopic surgery, exist. Skin trouble, nerve disturbance, infection, and persistent pain associated with prolonged recovery time are complications of open surgery. Endoscopic partial plantar fascia release offers the surgeon clear visualization of the anatomy at the surgical site. However, the primary medial portal and portal tract used for this technique have been shown to be in clo...

  20. Heel and toe driving on fuel cell vehicle

    Science.gov (United States)

    Choi, Tayoung; Chen, Dongmei

    2012-12-11

    A system and method for providing nearly instantaneous power in a fuel cell vehicle. The method includes monitoring the brake pedal angle and the accelerator pedal angle of the vehicle, and if the vehicle driver is pressing both the brake pedal and the accelerator pedal at the same time and the vehicle is in a drive gear, activating a heel and toe mode. When the heel and toe mode is activated, the speed of a cathode compressor is increased to a predetermined speed set-point, which is higher than the normal compressor speed for the pedal position. Thus, when the vehicle brake is removed, the compressor speed is high enough to provide enough air to the cathode, so that the stack can generate nearly immediate power.

  1. Pedal arteries of monkeys, with special reference to the plantar metatarsal arteries.

    Directory of Open Access Journals (Sweden)

    Hinenoya,Hitoshi

    1987-12-01

    Full Text Available In the Japanese, Formosan and crab-eating monkeys, the dorsal metatarsal arteries and their lateral distal perforating branches were well developed and supplied, directly or via the catella plantaris distalis, the plantar digital arteries. In the black ape, the plantar digital arteries arose from the medial plantar artery. The plantar metatarsal arteries of these monkeys, including the black ape, arose from the catella plantaris proximalis or deep plantar arch and were classified into the superficial plantar metatarsal (sM, superficial plantar intermetatarsal (sI, deep plantar metatarsal (dM and deep plantar intermetatarsal (dI arteries in relation to the interosseous muscles and metatarsal bones. This classification largely coincides with that of the human hand and foot (Murakami, 1969, 1971 and the monkey hand (Nakai et al., 1987.

  2. Can foot anthropometric measurements predict dynamic plantar surface contact area?

    Directory of Open Access Journals (Sweden)

    Collins Natalie

    2009-10-01

    Full Text Available Abstract Background Previous studies have suggested that increased plantar surface area, associated with pes planus, is a risk factor for the development of lower extremity overuse injuries. The intent of this study was to determine if a single or combination of foot anthropometric measures could be used to predict plantar surface area. Methods Six foot measurements were collected on 155 subjects (97 females, 58 males, mean age 24.5 ± 3.5 years. The measurements as well as one ratio were entered into a stepwise regression analysis to determine the optimal set of measurements associated with total plantar contact area either including or excluding the toe region. The predicted values were used to calculate plantar surface area and were compared to the actual values obtained dynamically using a pressure sensor platform. Results A three variable model was found to describe the relationship between the foot measures/ratio and total plantar contact area (R2 = 0.77, p R2 = 0.76, p Conclusion The results of this study indicate that the clinician can use a combination of simple, reliable, and time efficient foot anthropometric measurements to explain over 75% of the plantar surface contact area, either including or excluding the toe region.

  3. The effects of the application of low-dye taping on paretic side plantar pressure among patients with plantar fasciitis.

    Science.gov (United States)

    Park, Chan; Lee, Sangyong; Kim, Shingyun; Hwangbo, Gak

    2015-11-01

    [Purpose] This study aimed to examine the effects of low-dye taping on paretic side plantar pressure in patients with plantar fasciitis. [Subjects] The 30 patients in this study were randomly allocated to a low-dye taping group (n = 15) or a conservative treatment group (n =15). [Methods] Both groups received treatment thrice a week for six weeks. BioRescue was used to measure the weight distribution of the patients' paretic side. [Results] Within-group comparison showed that the posterior weight distribution significantly increased among patients in both groups. However, comparison between the two groups showed that the low-dye taping group's posterior weight distribution was significantly higher than that of the conservative treatment group. [Conclusion] These findings show that the application of low-dye taping is an effective intervention for paretic-side plantar pressure among patients with plantar fasciitis. PMID:26696737

  4. Aneurisma verdadeiro de artéria plantar medial: relato de caso True aneurysm of medial plantar artery: case report

    Directory of Open Access Journals (Sweden)

    Flavio Renato de Almeida Senefonte

    2011-09-01

    Full Text Available Os aneurismas periféricos merecem atenção pela sua baixa frequência e associação com outros aneurismas arteriais, principalmente o de aorta abdominal. O aneurisma de artéria plantar verdadeiro é ainda mais raro. A escassa literatura disponível concentra-se nos casos de pseudoaneurisma pós-traumático dessa artéria. Relata-se o caso de uma paciente do sexo feminino, 85 anos, com queixa de dor no pé direito ao deambular durante um ano, acompanhada de nódulo pulsátil em região plantar, próximo da base do primeiro pododáctilo. Não havia história prévia de trauma ou cirurgia na região plantar acometida. Realizou-se ecografia vascular e angiorressonância, que diagnosticaram aneurisma de artéria plantar. A paciente foi então submetida à aneurismectomia com ligadura das artérias nutricionais, apresentando boa evolução pós- operatória.Peripheral aneurysms deserve attention because of their low frequency and potential association with other aneurysms, especially of the abdominal aorta. The true aneurysm of the plantar artery is even less frequent. The literature available is scarce and focuses on cases of post-traumatic arterial pseudoaneurysms. In this paper, we report the case of an 85-year-old female patient with a one-year history of pain on the right foot when walking associated with a pulsatile tumor in the plantar region at the base of the big toe. The patient had no history of trauma or foot surgery. Vascular ultrasonography and MR angiography showed a plantar artery aneurysm. Aneurysmectomy with ligation of the medial plantar artery was performed. The patient had a good postoperative course.

  5. Effect of viscoelastic properties of plantar soft tissues on plantar pressures at the first metatarsal head in diabetics with peripheral neuropathy

    International Nuclear Information System (INIS)

    Diabetic foot ulcers are one of the most serious complications associated with diabetes mellitus. Current research studies have demonstrated that biomechanical alterations of the diabetic foot contribute to the development of foot ulcers. However, the changes of soft tissue biomechanical properties associated with diabetes and its influences on the development of diabetic foot ulcers have not been investigated. The purpose of this study was to investigate the effect of diabetes on the biomechanical properties of plantar soft tissues and the relationship between biomechanical properties and plantar pressure distributions. We used the ultrasound indentation tests to measure force-deformation relationships of plantar soft tissues and calculate the effective Young's modulus and quasi-linear viscoelastic parameters to quantify biomechanical properties of plantar soft tissues. We also measured plantar pressures to calculate peak plantar pressure and plantar pressure gradient. Our results showed that diabetics had a significantly greater effective Young's modulus and initial modulus of quasi-linear viscoelasticity compared to non-diabetics. The plantar pressure gradient and biomechanical properties were significantly correlated. Our findings indicate that diabetes is linked to an increase in viscoelasticity of plantar soft tissues that may contribute to a higher peak plantar pressure and plantar pressure gradient in the diabetic foot. (paper)

  6. Plantar fibromatosis and Dupuytren’s contracture in an adolescent

    Directory of Open Access Journals (Sweden)

    Nikolić Jelena

    2011-01-01

    Full Text Available Background. Fibromatosis represents a wide group of benign, locally proliferative disorders of fibroblasts. Dupuytren` s disease is a benign proliferative disease of palmar aponeurosis which usually affects adults between 40 and 60 years of age. Ledderhose`s disease or plantar fibromatosis is plantar equivalent of Dupuyten`s disease most often affecting middle- aged and older men, usually bilateral, represented with painless nodule in the medial division of plantar fascia. Case report. We presented a 19-year old adolescent that turned to a plastic surgeon complaining to his small finger contracture. He noticed palmar thickening with nodule over the metacarpophalangeal joint of small finger of his right hand when he was 16 years old. A year later a finger started to band. During physical checkup we noticed plantar nodule that also had his father and grandmother. Magnetic resonance and tumor biopsy confirmed a suspicion on plantar fibromatosis - Ledderhose`s disease. Clinical exam of the hand clearly led to a conclusion that the patient had Dupuytren`s contracture with pretendinous cord over the small finger flexor tendons and lack of extension of proximal interphalangeal (PIP joint. On the extensor side of the PIP joints there were Garrod`s nodes. The patient refused surgical treatment of plantar tumor, but agreed to surgical correction of finger contracture. Conclusion. Despite the fact that Dupuytren`s disease and plantar fibromatosis are diseases of adults, the possibility of conjoint appearance of these forms of fibromatosis in adolescent period of life should be kept in mind especially in patients with strong genetic predisposition.

  7. Acral-lentiginous naevus of plantar skin.

    Science.gov (United States)

    Clemente, C; Zurrida, S; Bartoli, C; Bono, A; Collini, P; Rilke, F

    1995-12-01

    In a consecutive series of 165 plantar naevi, a group of 36 benign naevi with sufficiently distinctive histopathological features to justify their classification as a special entity, here designated acral-lentiginous naevus, was identified. The main morphological features distinguishing the acral-lentiginous naevi from other acral non-lentiginous naevi are: elongation of rete ridges, continuous proliferation of melanocytes at the dermo-epidermal junction, presence of single scattered melanocytes, or less commonly small clusters, within the upper epidermis, poor or absent lateral circumscription, melanocytes with abundant pale cytoplasm and round to oval, sometimes hyperchromatic, nuclei and prominent nucleoli present at the dermo-epidermal junction. Some histological features of acral-lentiginous naevi are similar to those of dysplastic naevi: however, anastomosing rete ridges, cytological atypia and well-formed lamellar fibroplasia are absent. The histopathological criteria to distinguish these naevi from melanoma are: the lack of pagetoid lateral spread, the absence of mitotic activity in the deep dermal component and the evidence of dermal naevocytic differentiation. The identification of this benign acral naevus, that we have identified as the benign counterpart of acral lentiginous melanoma, is important in order to avoid misdiagnoses and consequent under- or over-treatment of doubtful pigmented lesions of acral skin.

  8. Retrospective study on radiotherapy efficacy in case of painful heel spur

    International Nuclear Information System (INIS)

    Objective: The effect of radiotherapy in context of a plantar fasciitis in order to reduce pain was evaluated in this retrospective study. Patients and methods: The data of 188 patients who suffered of heel spur pain and who were irradiated in the period from 1994 to 2009 were evaluated in this study. All of them had at least one follow up examination after radiatiotherapy. The mean age amounted to 57 years. 76.5% of the patients were female. All patients described a local pain which was the basis for the indication. 74.4 % of the patients described pain especially under stress. The duration of anamnesis was averaged as follows: 15 % of the patients had pain for some weeks to 3 months, 43 % for 4 to 6 months, 28% even for 7 to 12 months. The period of medical history was longer than 12 months for 12 % of the patients in this study. 122 of 188 patients received orthopedic arch support (shoe inlays) as first therapy method. Most of the patients were irradiated using regular lateral opposing fields with photons of the energy 4 MV and 6 MV of a linear accelerator, applying a total dose of 6Gy in 6 fractions to 1,0Gy twice weekly. Only one patient was irradiated using a Co60 machine. The acquisition of data regarding the effect was performed on the last day of the radiotherapy and in 3 to 6 monthly follow ups. Additionally the doctors who attended the patients beyond the radiotherapy received a special questionnaire about the pain reduction, so that the follow up data could be completed. Results: On the last day of radiotherapy 120/188 patients (63,8%)reported an improvement of pain reduction, 7/188 patients (3,7%) absence of pain. For 52/188 patients (27.6 %) pain remained constant. At the second follow up examination after in the median 100 days the effect of radiotherapy of 165 patients could be evaluated, 43/165 patients (26 %) were pain free, 79/165 patients (47,8 %) reported an obvious pain reduction, and for 33/165 patients there was no pain improvement. At the

  9. Heel raises versus prefabricated orthoses in the treatment of posterior heel pain associated with calcaneal apophysitis (Sever's Disease: a randomised control trial

    Directory of Open Access Journals (Sweden)

    Williams Cylie M

    2010-03-01

    Full Text Available Abstract Background Posterior Heel pain can present in children of 8 to 14 years, associated with or clinically diagnosed as Sever's disease, or calcaneal apophysitis. Presently, there are no comparative randomised studies evaluating treatment options for posterior heel pain in children with the clinical diagnosis of calcaneal apophysitis or Sever's disease. This study seeks to compare the clinical efficacy of some currently employed treatment options for the relief of disability and pain associated with posterior heel pain in children. Method Design: Factorial 2 × 2 randomised controlled trial with monthly follow-up for 3 months. Participants: Children with clinically diagnosed posterior heel pain possibly associated with calcaneal apophysitis/Sever's disease (n = 124. Interventions: Treatment factor 1 will be two types of shoe orthoses: a heel raise or prefabricated orthoses. Both of these interventions are widely available, mutually exclusive treatment approaches that are relatively low in cost. Treatment factor 2 will be a footwear prescription/replacement intervention involving a shoe with a firm heel counter, dual density EVA midsole and rear foot control. The alternate condition in this factor is no footwear prescription/replacement, with the participant wearing their current footwear. Outcomes: Oxford Foot and Ankle Questionnaire and the Faces pain scale. Discussion This will be a randomised trial to compare the efficacy of various treatment options for posterior heel pain in children that may be associated with calcaneal apophysitis also known as Sever's disease. Trial Registration Trial Number: ACTRN12609000696291 Ethics Approval Southern Health: HREC Ref: 09271B

  10. Temporal redistribution of plantar pressure points in diabetic and control subjects: A time-series analysis of neuro-capillary chaos

    Directory of Open Access Journals (Sweden)

    Devesh V Oberoi

    2010-02-01

    Full Text Available BackgroundIn diabetic individuals (DI, neuropathy hinders theredistribution of plantar pressure points thus leading tosusceptible areas where there is constant capillaryblanching which may develop into trophic ulcers. Theredistribution of pressure points may precede evidenceof clinical neuropathy. In this study we comparetemporal redistribution of plantar pressure points (areasof capillary blanching between normal subjects taken ascontrols and DI with no clinical signs of neuropathy.MethodFour adults (45±4.55 years diagnosed to have Type-2Diabetes, without signs of clinical neuropathy andage -matched controls (43±3.74 years were studied.The subjects were asked to stand on a glass slab and a10 minute video recording of 10 selected plantarpressure points was made. Changes in the distance ofthese points with reference to a defined point onMayer’s line were measured at every 10 seconds.Standard deviation of difference of redistributedconsecutive pressure point (SDPP in cms., andfractal dimension (FD was used to compare the twogroups.ResultsCombined mean SDPP (DI =0.013 ± 0.008 cms,controls= 0.196±0.233 cms, P <0.001 and FD (DI=1.000 ± 0.000, controls= 1.010±0.017, P <0.001 ofdiabetic patients were significantly lower thancontrols. Pressure point at base of the 4th toe andthe lower limit of blanching to the left Mayers line atthe heel did not differ significantly between DI andcontrols.ConclusionThere is impaired redistribution of plantar pressurepoints in individuals with diabetes without signs ofclinical neuropathy. This can be attributed to loss ofchaos generating mechanisms in DI. Redistributionof pressure points may be essential in theprevention of trophic ulcers in susceptibleindividuals.

  11. Quantitative scintigraphy in diagnosis and management of plantar fasciitis (Calcaneal periostitis): concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Sewell, J.R.; Black, C.M.; Chapman, A.H.; Statham, J.; Hughes, G.R.V.; Lavender, J.P.

    1980-07-01

    We have found that Tc-99m methylene diphosphonate imaging of the heel is of diagnostic value in the painful heel syndrome, permitting positive identification of the site of inflammation in cases where radiography is unhelpful. With this technique, tracer uptake in the heel is susceptible to quantification, allowing a serial and objective assessment of response to therapy.

  12. Plantar Fat Grafting and Tendon Balancing for the Diabetic Foot Ulcer in Remission.

    Science.gov (United States)

    Luu, Cynthia A; Larson, Ethan; Rankin, Timothy M; Pappalardo, Jennifer L; Slepian, Marvin J; Armstrong, David G

    2016-07-01

    We report on the use of free fat grafting as a means of redistributing normal and shear stress after healing of plantar diabetic foot wounds. Although fat augmentation (lipofilling) has been described previously as an approach to supplement defects and prevent atrophy, including use as an adjunct to wound healing and to mitigate pain in the foot, we are unaware of any reports in the medical literature that have described its use in the high-risk diabetic foot in remission. An active 37-year-old man with type 2 diabetes and neuropathy presented with gangrene of his fifth ray, which was amputated. He subsequently developed a chronic styloid process ulceration that progressed despite treatment. We performed a tibialis anterior tendon transfer and total contact casting. He went on to heal but with residual fat pad atrophy and recalcitrant preulcerative lesions. We then used autologous fat grafting for the plantar atrophy. The patient was able to successfully transition to normal shoe gear after 4 weeks with successful engraftment without complication or recurrence of the wound at 6 weeks. This therapy may provide a promising adjunct to increase ulcer-free days to the patient in diabetic foot remission. PMID:27536489

  13. Plantar Fat Grafting and Tendon Balancing for the Diabetic Foot Ulcer in Remission

    Science.gov (United States)

    Luu, Cynthia A.; Larson, Ethan; Rankin, Timothy M.; Pappalardo, Jennifer L.; Slepian, Marvin J.

    2016-01-01

    Summary: We report on the use of free fat grafting as a means of redistributing normal and shear stress after healing of plantar diabetic foot wounds. Although fat augmentation (lipofilling) has been described previously as an approach to supplement defects and prevent atrophy, including use as an adjunct to wound healing and to mitigate pain in the foot, we are unaware of any reports in the medical literature that have described its use in the high-risk diabetic foot in remission. An active 37-year-old man with type 2 diabetes and neuropathy presented with gangrene of his fifth ray, which was amputated. He subsequently developed a chronic styloid process ulceration that progressed despite treatment. We performed a tibialis anterior tendon transfer and total contact casting. He went on to heal but with residual fat pad atrophy and recalcitrant preulcerative lesions. We then used autologous fat grafting for the plantar atrophy. The patient was able to successfully transition to normal shoe gear after 4 weeks with successful engraftment without complication or recurrence of the wound at 6 weeks. This therapy may provide a promising adjunct to increase ulcer-free days to the patient in diabetic foot remission. PMID:27536489

  14. A Case of Recalcitrant Plantar Warts Associated with Statin Use

    Directory of Open Access Journals (Sweden)

    Aaron G. Wernham

    2015-01-01

    Full Text Available Background. Plantar warts are a common presenting skin complaint caused by the human papillomavirus. 1st line therapies include cryotherapy and topical salicylic acid. Where there is resistance to these treatments, consideration is made for 2nd line therapies, including intralesional bleomycin, imiquimod, 5-fluorouracil, and photodynamic therapy. We present a case of bilateral persistent plantar warts, resistant to treatment with repeated cryotherapy and topical salicylic acid over a 6-year period. Following a patient initiated decision to discontinue their statin medication, we observed rapid clearance of plantar warts without change to standard therapy or their environment. This case correlates with emerging literature demonstrating a link between statin medication and proliferation of HPV through increased levels of FOXP3+ regulatory T cells.

  15. Finite element analysis of heel pad with insoles.

    Science.gov (United States)

    Luo, Gangming; Houston, Vern L; Garbarini, Mary Anne; Beattie, Aaron C; Thongpop, Chaiya

    2011-05-17

    To design optimal insoles for reduction of pedal tissue trauma, experimental measurements and computational analyses were performed. To characterize the mechanical properties of the tissues, indentation tests were performed. Pedal tissue geometry and morphology were obtained from magnetic resonance scan of the subject's foot. Axisymmetrical finite element models of the heel of the foot were created with 1/4 of body weight load applied. The stress, strain and strain energy density (SED) fields produced in the pedal tissues were computed. The effects of various insole designs and materials on the resulting stress, strain, and SED in the soft pedal tissues were analyzed. The results showed: (a) Flat insoles made of soft material provide some reductions in the maximum stress, strain and SED produced in the pedal tissues. These maximum values were computed near the calcaneus. (b) Flat insoles, with conical/cylindrical reliefs, provided more reductions in these maximum values than without reliefs. (c) Custom insoles, contoured to match the pedal geometry provide most reductions in the maximum stress, strain and SED. Also note, the maximum stress, strain and SED computed near the calcaneus were found to be about 10 times the corresponding peak values computed on the skin surface. Based on the FEA analysis, it can be concluded that changing insole design and using different material can significantly redistribute the stress/strain inside the heel pad as well as on the skin surface.

  16. Heel spur radiotherapy and radiation carcinogenesis risk estimation

    International Nuclear Information System (INIS)

    Radiotherapy is a nonsurgical alternative therapy of painful heel spur patients. Nonetheless, cancer induction is the most important somatic effect of ionizing radiation. This study was designed to evaluate the carcinogenesis risk factor in benign painful heel spur patients treated by radiotherapy. Between 1974 and 1999, a total of 20 patients received mean 8.16 Gy total irradiation dose in two fractions. Thermoluminescent dosimeters (TLD100) were placed on multiple phantom sites in vivo within the irradiated volume to verify irradiation accuracy and carcinogenesis risk factor calculation. The 20 still-alive patients, who had a minimum 5-year and maximum 29-year follow-up (mean 11.9 years), have been evaluated by carcinogenic radiation risk factor on the basis of tissue weighting factors as defined by the International Commission on Radiological Protection Publication 60. Reasonable pain relief has been obtained in all 20 patients. The calculated mean carcinogenesis risk factor is 1.3% for radiation portals in the whole group, and no secondary cancer has been clinically observed. Radiotherapy is an effective treatment modality for relieving pain in calcaneal spur patients. The estimated secondary cancer risk factor for irradiation of this benign lesion is not as high as was feared. (author)

  17. Heel Removal Analysis for Mixing Pumps of Tank 8

    International Nuclear Information System (INIS)

    Computational fluid dynamics methods were used to recommend a slurry pump operational strategy for sludge heel removal in Tank 8. Flow patterns calculated by the model were used to evaluate the performance of various combinations of operating pumps and their orientation. The models focused on removal of the sludge heel located at the east side of Tank 8 using the four existing slurry pumps. The models and calculations were based on prototypic tank geometry and expected normal operating conditions as defined by Waste Removal Closure (WRC) Engineering. The calculated results demonstrated that for pump speeds higher than 1800 rpm and at a 130 inch liquid level, a recommended orientation of the slurry pumps could be provided, based on a minimum sludge suspension velocity of 2.27 ft per sec. Further results showed that the time to reach a steady-state flow pattern was affected by both the tank level and the pump speed. Sensitivity studies showed that for a given pump speed, a higher tank level and a lower pump nozzle elevation would result in better performance in suspending and removing the sludge. The results also showed that the presence of flow obstructions were advantageous for certain pump orientations

  18. Walking on high heels changes muscle activity and the dynamics of human walking significantly

    DEFF Research Database (Denmark)

    Simonsen, Erik Bruun; Svendsen, Morten B; Nørreslet, Andreas;

    2012-01-01

    phase was doubled when walking on high heels. The knee joint angle showed that high-heeled walking caused the subjects to flex the knee joint significantly more in the first half of the stance phase. In the frontal plane a significant increase was observed in the knee joint abductor moment and the hip...

  19. Walking on high heels changes muscle activity and the dynamics of human walking significantly

    DEFF Research Database (Denmark)

    Simonsen, Erik B; Svendsen, Morten Bo Søndergaard; Nørreslet, Andreas;

    2012-01-01

    digital video cameras operating at 50 frames/second. Both barefooted walking and walking on high-heeled shoes (heel height: 9 cm) were recorded. Net joint moments were calculated by 3D inverse dynamics. EMG was recorded from eight leg muscles. The knee extensor moment peak in the first half of the stance...

  20. Hyperkeratosis of the heels: treatment with salicylic acid in a novel delivery system.

    Science.gov (United States)

    Bikowski, Joseph

    2004-01-01

    A 43-year-old woman presented with dryness and scaling of the lateral and posterior aspects of both heels, which was diagnosed as hyperkeratotic xerosis (Figure 1). Pertinent medical history included dry skin with winter exacerbation and painful hyperkeratosis of the heels present for many years. The patient applied a topical multivesicular cream formulation of 6% salicylic add (Salex, Healthpoint Ltd., Fort Worth, TX) to one foot b.i.d. The physician was blinded as to which foot was treated. After 2 weeks of treatment, it was apparent that the patient was applying the cream to the right foot, as evidenced by reduced dryness, scaling, and hyperkeratosis (Figure2). The patient continued treatment of the same foot for an additional 2 weeks, revealing a dramatic improvement of the right heel,which appeared smooth and soft and devoid of pain. No irritation was associated with treatment; the patient commented that this was the best her heel had been "in years." Subsequently, the patient treated both heels with salicylic acid 60%, multivesicular cream. A second patient, a 25-year-old woman, was treated for ichthyosis vulgaris and hyperkeratosis of both heels. She presented w ith multiple painful fissures and hyperkeratosis of the posterior heels bilaterally (Figure 3). After I week of topical treatment with salicylic add 6%, multivesicular cream applied b.i.d. to the left heel only, there was rapid resolution of both hyperkeratosis and pain (Figure 4).

  1. Effects of foot posture and heel padding devices on soft tissue deformations under the heel in supine position in males: MRI studies

    Directory of Open Access Journals (Sweden)

    Shay Tenenbaum, MD

    2013-11-01

    Full Text Available Heel ulcers (HUs are the second most common pressure ulcers (PUs. Despite the significant morbidity and economic cost associated with HUs, there remains a lack of understanding of the basic pathophysiology of PUs because of limited basic research. There are only sparse data regarding the efficacy of prevention aids such as heel padding devices, and these data are based mainly on epidemiological research rather than biomechanical models and deformation measurements. This study was designed to explore the effects of foot posture and support stiffness properties on soft tissue deformations using magnetic resonance imaging (MRI. Subjects were scanned with and without weight bearing, in neutral external rotation position and in 90 degrees to supporting surface and with different heel padding devices. Tissue strains were calculated for skin, subcutaneous tissue, and effective (total soft tissue. We found skin strains with the foot in external rotation to be significantly greater than when the foot was upright. Heel padding devices have a statistically significant effect on reducing the extent of deformations in both skin and subcutaneous tissues. Furthermore, the design features of heel padding devices have substantial influence on tissue deformations. This study demonstrates how MRI provides convenient, accurate, and quantitative comparison of biomechanical performances of heel padding devices.

  2. Relationship between elevated plantar pressure of toes and forefoot and gait features in diabetic patients.

    Science.gov (United States)

    Amemiya, Ayumi; Noguchi, Hiroshi; Oe, Makoto; Takehara, Kimie; Yamada, Amika; Ohashi, Yumiko; Ueki, Kohjiro; Kadowaki, Takashi; Mori, Taketoshi; Sanada, Hiromi

    2013-01-01

    This cross-sectional observational study is to reveal what kind of gait feature is relevant to elevated segment and its plantar pressure for prevention of diabetic foot ulcers. In 57 diabetic patients, the relationship between elevated plantar pressure and gait features was analyzed. To conduct this investigation, a simultaneous measurement system of plantar pressure and gait features was constructed. Plantar pressure distribution was measured by F-scan with customized footwear, and gait features were mainly measured using wireless motion sensors attached to the sacrum and feet. Several gait features of small rolling during the mid-stance phase were relevant to the elevated plantar pressure.

  3. The influence of heel height on utilized coefficient of friction during walking.

    Science.gov (United States)

    Blanchette, Mark G; Brault, John R; Powers, Christopher M

    2011-05-01

    Wearing high heel shoes has been associated with an increased potential for slips and falls. The association between wearing high heels and the increased potential for slipping suggests that the friction demand while wearing high heels may be greater when compared to wearing low heel shoes. The purpose of this study was to determine if heel height affects utilized friction (uCOF) during walking. A secondary purpose of this study was to compare kinematics at the ankle, knee, and hip that may explain uCOF differences among shoes with varied heel heights. Fifteen healthy women (mean age 24.5±2.5yrs) participated. Subjects walked at self-selected velocity under 3 different shoe conditions that varied in heel height (low: 1.27cm, medium: 6.35cm, and high: 9.53cm). Ground reaction forces (GRFs) were recorded using a force platform (1560Hz). Kinematic data were obtained using an 8 camera motion analysis system (120Hz). Utilized friction was calculated as the ratio of resultant shear force to vertical force. One-way repeated measures ANOVAs were performed to test for differences in peak uCOF, GRFs at peak uCOF and lower extremity joint angles at peak uCOF. On average, peak uCOF was found to increase with heel height. The increased uCOF observed in high heel shoes was related to an increase in the resultant shear force and decrease in the vertical force. Our results signify the need for proper public education and increased footwear industry awareness of how high heel shoes affect slip risk. PMID:21536444

  4. Investigations on the visco-elastic behaviour of a human healthy heel pad: in vivo compression tests and numerical analysis

    DEFF Research Database (Denmark)

    Matteoli, Sara; Fontanella, Chiara G.; Carniel, Emanuele L.;

    2013-01-01

    The aim of this study was to investigate the viscoelastic behaviour of the human heel pad by comparing the stress–relaxation curves obtained from a compression device used on an in vivo heel pad with those obtained from a threedimensional computer-based subject-specific heel pad model subjected...

  5. Innovations in plantar pressure and foot temperature measurements in diabetes.

    Science.gov (United States)

    Bus, S A

    2016-01-01

    Plantar pressure and temperature measurements in the diabetic foot primarily contribute to identifying abnormal values that increase risk for foot ulceration, and they are becoming increasingly more integrated in clinical practice and daily life of the patient. While plantar pressure measurements have long been present, only recently evidence shows their importance in ulcer prevention, as a data-driven approach to therapeutic footwear provision. The long-term monitoring of plantar pressures with the option to provide feedback, when alarming pressure levels occur, is a promising development in this area, although more technical and clinical validation is required. Shear is considered important in ulcer aetiology but is technically difficult to measure. Innovative research is underway to assess if foot temperature can act as a useful surrogate for shear. Because the skin heats up before it breaks down, frequent monitoring of foot temperature can identify these warning signals. This approach has shown to be effective in preventing foot ulcers. Innovation in diagnostic methods for foot temperature monitoring and evidence on cost effectiveness will likely facilitate implementation. Finally, monitoring of adherence to offloading treatment using temperature-based sensors has proven to be a feasible and relevant method with a wide range of possible research and patient care applications. These innovations in plantar pressure and temperature measurements illustrate an important transfer in diabetic foot care from subjective to objective evaluation of the high-risk patient. They demonstrate clinical value and a large potential in helping to reduce the patient and economic burden of diabetic foot disease.

  6. The plantar reflex : a historical, clinical and electromyographic study

    NARCIS (Netherlands)

    J. van Gijn (Jan)

    1977-01-01

    textabstractThe plantar reflex is one of the most important physical signs in medicine. Few patients undergoing a full medical examination can avoid having their soles stroked, because an upgoing great toe is regarded as a reliable sign of dysfunction of corticospinal nerve fibres. So far, there is

  7. Running shoes for relief of plantar pressure in diabetic patients.

    Science.gov (United States)

    Kästenbauer, T; Sokol, G; Auinger, M; Irsigler, K

    1998-06-01

    There is a causal relationship between diabetic foot ulceration, elevated plantar pressure, and severe sensory neuropathy. Cushioned footwear intended to relieve plantar pressure is well established for prevention and healing of plantar ulcers. The aim of the present study was to investigate whether pressure relief by means of a running shoe with optimized forefoot pressure damping is comparable to that of a custom-made soft insole placed into an in-depth shoe. The in-shoe pressures were compared to an in-depth shoe with the original cork insole and with a leather-soled Oxford shoe. The maximum reduction of plantar pressure in the running shoe was 47% under the 2nd and 3rd metatarsal heads, 29% at the first metatarsal head, and 32% at the great toe in comparison to the Oxford shoe. This was surpassed only by the custom-made insole, which reduced pressures at the metatarsal heads by 50%. The specially designed running shoe yielded the same pressure relief at the central metatarsal heads as the custom-made insole. Such shoes are likely to be very useful in preventing diabetic foot ulceration in high-risk patients as a comparatively affordable and immediately available device. PMID:9632129

  8. Distribution and correlates of plantar hyperkeratotic lesions in older people

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2009-03-01

    Full Text Available Abstract Background Plantar hyperkeratotic lesions are common in older people and are associated with pain, mobility impairment and functional limitations. However, little has been documented in relation to the frequency or distribution of these lesions. The aim of this study was to document the occurrence of plantar hyperkeratotic lesions and the patterns in which they occur in a random sample of older people. Methods A medical history questionnaire was administered to a random sample of 301 people living independently in the community (117 men, 184 women aged between 70 and 95 years (mean 77.2, SD 4.9, who also underwent a clinical assessment of foot problems, including the documentation of plantar lesion locations, toe deformities and the presence and severity of hallux valgus. Results Of the 301 participants, 180 (60% had at least one plantar hyperkeratotic lesion. Those with plantar lesions were more likely to be female (χ2 = 18.75, p 2 = 6.15, p vs 36.3 ± 8.4°; t = 2.68, df = 286, p vs 4.8 ± 1.3 hours, t = -2.46, df = 299, p = 0.01. No associations were found between the presence of plantar lesions and body mass index, obesity, foot posture, dominant foot or forefoot pain. A total of 53 different lesions patterns were observed, with the most common lesion pattern being "roll-off" hyperkeratosis on the medial aspect of the 1st metatarsophalangeal joint (MPJ, accounting for 12% of all lesion patterns. "Roll-off" lesions under the 1st MPJ and interphalangeal joint were significantly associated with moderate to severe hallux valgus (p p Conclusion Plantar hyperkeratotic lesions affect 60% of older people and are associated with female gender, hallux valgus, toe deformity, increased ankle flexibility and time spent on feet, but are not associated with obesity, limb dominance, forefoot pain or foot posture. Although there are a wide range of lesion distribution patterns, most can be classified into medial, central or lateral groups. Further

  9. Radiation levels on empty cylinders containing heel material

    Energy Technology Data Exchange (ETDEWEB)

    Shockley, C.W. [Martin Marietta Energy Systems, Inc., Paducah, KY (United States)

    1991-12-31

    Empty UF{sub 6} cylinders containing heel material were found to emit radiation levels in excess of 200 mr/hr, the maximum amount stated in ORO-651. The radiation levels were as high as 335 mr/hr for thick wall (48X and 48Y) cylinders and 1050 mr/hr for thin wall (48G and 48H) cylinders. The high readings were found only on the bottom of the cylinders. These radiation levels exceeded the maximum levels established in DOT 49 CFR, Part 173.441 for shipment of cylinders. Holding periods of four weeks for thick-wall cylinders and ten weeks for thin-wall cylinders were established to allow the radiation levels to decay prior to shipment.

  10. Trypanosome resistance to human innate immunity: targeting Achilles' heel.

    Science.gov (United States)

    Stephens, Natalie A; Kieft, Rudo; Macleod, Annette; Hajduk, Stephen L

    2012-12-01

    Trypanosome lytic factors (TLFs) are powerful, naturally occurring toxins in humans that provide sterile protection against infection by several African trypanosomes. These trypanocidal complexes predominantly enter the parasite by binding to the trypanosome haptoglobin/hemoglobin receptor (HpHbR), trafficking to the lysosome, causing membrane damage and, ultimately, cell lysis. Despite TLF-mediated immunity, the parasites that cause human African Trypanosomiasis (HAT), Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense, have developed independent mechanisms of resistance to TLF killing. In this review we describe the parasite defenses that allow trypanosome infections of humans and discuss how targeting these apparent strengths of the parasite may reveal their Achilles' heel, leading to new approaches in the treatment of HAT. PMID:23059119

  11. Trypanosome resistance to human innate immunity: targeting Achilles’ heel

    Science.gov (United States)

    Stephens, Natalie A.; Kieft, Rudo; MacLeod, Annette; Hajduk, Stephen L.

    2015-01-01

    Trypanosome lytic factors (TLFs) are powerful, naturally-occurring toxins in humans that provide sterile protection against infection by several African trypanosomes. These trypanocidal complexes predominantly enter the parasite by binding to the trypanosome haptoglobin/hemoglobin receptor (HpHbR), trafficking to the lysosome, causing membrane damage and ultimately, cell lysis. Despite TLF-mediated immunity, the parasites that cause human African Trypanosomiasis (HAT), Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense, have developed independent mechanisms of resistance to TLF killing. Here we describe the parasite defenses that allow trypanosome infections of humans and discuss how targeting these apparent strengths of the parasite may reveal their Achilles’ heel, leading to new approaches in the treatment of HAT. PMID:23059119

  12. Heel Ultrasound Scan in Detecting Osteoporosis in Low Trauma Fracture Patients.

    Science.gov (United States)

    Hashmi, Faiz R; Elfandi, Khaled O

    2016-06-27

    Osteoporosis is the most common metabolic disease with significant impact on the morbidity and mortality of affected patients. Osteoporosis has a significant impact on the economy worldwide. The aim of this study was to find out whether heel ultrasound is as good as central bone densitometry scanning in diagnosing osteoporosis in patients who are at high risk of osteoporosis. This was a prospective study of patients comparing heel ultrasound to central bone densitometry scanning (dual X-ray absorptiometry, DEXA) in patients. The recruited patients attended for a DEXA scan of the left hip and lumbar spine. All subjects had an ultrasound of the left heel using the quantitative heel ultrasound machine. The results of DEXA scan were blinded from the results of ultrasound and vice versa. There were 59 patients who took part in the study, 12 men and 47 women. The mean age was 66 years (SD 11.9) and mean weight was 62.5 kg (SD 10.7). The sensitivity and specificity of the ultrasound heel test to predict osteoporosis were 53% (95%CI: 29-77) and 86% (95%CI: 75-96) respectively. Specificity for predicting bone mineral density (BMD)-defined osteoporosis was high (86%), but sensitivity was low (53%). A heel ultrasound result in the osteoporotic range was highly predictive of BMD-defined osteoporosis. A positive ultrasound heel test in high risk patients is more useful in ruling in osteoporosis than a negative test to rule out osteoporosis. PMID:27433300

  13. Heel ultrasound scan in detecting osteoporosis in low trauma fracture patients

    Directory of Open Access Journals (Sweden)

    Faiz R. Hashmi

    2016-06-01

    Full Text Available Osteoporosis is the most common metabolic disease with significant impact on the morbidity and mortality of affected patients. Osteoporosis has a significant impact on the economy worldwide. The aim of this study was to find out whether heel ultrasound is as good as central bone densitometry scanning in diagnosing osteoporosis in patients who are at high risk of osteoporosis. This was a prospective study of patients comparing heel ultrasound to central bone densitometry scanning (dual X-ray absorptiometry, DEXA in patients. The recruited patients attended for a DEXA scan of the left hip and lumbar spine. All subjects had an ultrasound of the left heel using the quantitative heel ultrasound machine. The results of DEXA scan were blinded from the results of ultrasound and vice versa. There were 59 patients who took part in the study, 12 men and 47 women. The mean age was 66 years (SD 11.9 and mean weight was 62.5 kg (SD 10.7. The sensitivity and specificity of the ultrasound heel test to predict osteoporosis were 53% (95%CI: 29-77 and 86% (95%CI: 75- 96 respectively. Specificity for predicting bone mineral density (BMD-defined osteoporosis was high (86%, but sensitivity was low (53%. A heel ultrasound result in the osteoporotic range was highly predictive of BMD-defined osteoporosis. A positive ultrasound heel test in high risk patients is more useful in ruling in osteoporosis than a negative test to rule out osteoporosis.

  14. Targeting late SV40 factor: Is the achilles heel of hepatocarcinogenesis revealed?

    Institute of Scientific and Technical Information of China (English)

    Amir Shlomal

    2012-01-01

    Hepatocellular carcinoma (HCC) is a dreadful cancer and a major cause of death among patients with chronic liver disease and cirrhosis.The apparent alterations in a diversity of intracellular pathways found in HCC has set the rational for developing moleculardirected drugs that simultaneously inhibit multiple pathways,such as the multi-kinase inhibitor Sorafenib.However,recently this concept has been challenged by showing that HCC is heavily dependent on a single oncogene designated late SV-40 factor (LSF),a transcription factor that is over-expressed in liver cancer cells and that its expression is strongly correlated with tumor grade and aggressiveness.Furthermore,using an intensive screening for drugs that inhibit LSF activity,Grant eta/have found a molecule designated factor quinolinone inhibitor 1 that can specifically block the ability of LSF to bind its target promoters,resulting in a massive death of HCC cells both in vitro and in vivo.The innovative findings of HCC representing "oncogene addiction" to LSF and the ability of a single molecule to block the activity of this oncogene resulting in tumor abolishment are encouraging and provide us with the hope that the "Achilles heel" of HCC has been found.

  15. Modelling and measurement of a wireless foot plantar pressure

    Directory of Open Access Journals (Sweden)

    Khwaja Ramizuddin

    2013-07-01

    Full Text Available Foot plantar pressure is the pressure fields that act between the foot skin and its supporting surface that humans experience during daily activities. Information derived from such pressure is important for diagnosing lower limb problems, footwear design, sport biomechanics performance and injury prevention. This paper presents the design and implementation of a wireless data acquisition (DAQ for foot plantar pressure sensors. The system is intended for an in-shoe wireless pressure measurement system. The objective of this DAQ is to be a system which can be integrated into a shoe with the ability of wireless transmission to an external on body receiver. Such device provides low power consumption, convenient and comfortable testing system simulating a range of normal daily life activities.

  16. Presence of growth factors in palmar and plantar fibromatoses.

    Science.gov (United States)

    Zamora, R L; Heights, R; Kraemer, B A; Erlich, H P; Groner, J P

    1994-05-01

    Palmar and plantar fibromatoses are disease processes in which the presence of certain growth factors has not been defined. Monoclonal antibodies against transforming growth factor-beta, epidermal growth factor, procollagen type 1, fibronectin, phosphotyrosine residues, and CD41 platelet antigen were used in standard immunoperoxidase staining to study 36 nodules and 24 cords obtained from patients with fibromatoses. The specimens were studied via light microscopy, and staining intensity was quantitated using a computer-enhanced video system. Transforming growth factor-beta staining paralleled procollagen I, fibronectin, and phosphotyrosine staining within the nodule (early stages) but not the cord (late stages) tissue. These factors showed significant increased staining in the early stage of fibromatosis when compared to the late stage. This study is a preliminary demonstration of the presence of transforming growth factor-beta in palmar and plantar fibromatoses.

  17. Minimally invasive surgery for diabetic plantar foot ulcerations

    Directory of Open Access Journals (Sweden)

    Caio Nery

    2011-11-01

    Full Text Available Complications of diabetes mellitus constitute the most common indications for hospitalization and non-traumatic amputations in the USA. The most important risk factors for the development of diabetic foot ulcerations include the presence of peripheral neuropathy, vasculopathy, limited joint mobility, and pre-existing foot deformities. In our study, 500 diabetic patients treated for plantar forefoot ulcerations were enrolled in a prospective study from 2000 to 2008 at the Federal University of São Paulo, Brazil. Fifty-two patients in the study met the criteria and underwent surgical treatment consisting of percutaneous Achilles tendon lengthening to treat plantar forefoot ulcerations. The postoperative follow-up demonstrated prevention of recurrent foot ulcerations in 92% of these diabetic patients that maintained an improved foot function. In conclusion, our study supports that identification and treatment of ankle equinus in the diabetic population may potentially lead to decreased patient morbidity, including reduced risk for both reulceration, and potential lower extremity amputation.

  18. Analysis of Factors Affecting Stress Solution at Concrete Gravity Dam Heel

    Science.gov (United States)

    Hung, Vu Hoang; Quoc Cong, Trinh; Tongchun, Li

    2010-05-01

    Along with Vietnam's development, various hydraulic constructions including concrete gravity dams have been being built. In some of these dams, the fractures occurred at the heel of the dams are even in small and media dams. There are various reasons cause the factures at dam heel but the main reason is the stress states at dam heel are not determined correctly while designing dam. In this paper, several factors affecting stress solution at concrete gravity dam heel such as element mesh size, crack joints of upstream foundation, execution process are investigated by using finite element model of Banve concrete gravity dam. This work is very significant when the more high concrete gravity dams will be constructed in Vietnam year after year.

  19. Sludge Heel Removal Analysis for Slurry Pumps of Tank 11

    International Nuclear Information System (INIS)

    Computational fluid dynamics methods were used to develop and recommend a slurry pump operational strategy for sludge heel removal in Tank 11. Flow patterns calculated by the model were used to evaluate the performance of various combinations of operating pumps and their orientation. The models focused on removal of the sludge heel located at the edge of Tank 11 using the four existing slurry pumps. The models and calculations were based on prototypic tank geometry and expected normal operating conditions as defined by Tank Closure Project (TCP) Engineering. Computational fluid dynamics models of Tank 11 with different operating conditions were developed using the FLUENT(tm) code. The modeling results were used to assess the efficiency of sludge suspension and removal operations in the 75-ft tank. The models employed a three-dimensional approach, a two-equation turbulence model, and an approximate representation of flow obstructions. The calculated local velocity was used as a measure of sludge removal and mixing capability. For the simulations, a series of the modeling calculations was performed with indexed pump orientations until an efficient flow pattern near the potential location of the sludge mound was established for sludge removal. The calculated results demonstrated that the existing slurry pumps running at 1600 rpm could remove the sludge mound from the tank with a 103 in. liquid level, based on a minimum sludge suspension velocity of 2.27 ft/sec. In this case, the only exception is the region within about 2 ft. from the tank wall. Further results showed that the capabilities of sludge removal were affected by the indexed pump orientation, the number of operating pumps, and the pump speed. A recommended operational strategy for an efficient flow pattern was developed to remove the sludge mound assuming that local fluid velocity can be used as a measure of sludge suspension and removal. Sensitivity results showed that for a given pump speed, a higher tank

  20. Resistance exercise prevents plantar flexor deconditioning during bed rest

    Science.gov (United States)

    Bamman, M. M.; Hunter, G. R.; Stevens, B. R.; Guilliams, M. E.; Greenisen, M. C.

    1997-01-01

    Because resistance exercise (REX) and unloading induce opposing neuromuscular adaptations, we tested the efficacy of REX against the effects of 14 d of bed rest unloading (BRU) on the plantar flexor muscle group. Sixteen men were randomly assigned to no exercise (NOE, N = 8) or REX (N = 8). REX performed 5 sets x 6-10 repetitions to failure of constant resistance concentric/eccentric plantar flexion every other day during BRU. One-repetition maximum (1RM) strength was tested on the training device. The angle-specific torque-velocity relationship across 5 velocities (0, 0.52, 1.05, 1.75, and 2.97 rad.s-1) and the full range-of-motion power-velocity relationship were assessed on a dynamometer. Torque-position analyses identified strength changes at shortened, neutral, and stretched muscle lengths. Concentric and eccentric contractile work were measured across ten repetitions at 1.05 rad.s-1. Maximal neural activation was measured by surface electromyography (EMG). 1RM decreased 9% in NOE and improved 11% in REX (P muscle lengths (P < 0.05) in NOE while REX maintained or improved strength at all joint positions. Concentric (15%) and eccentric (11%) contractile work fell in NOE (P < 0.05) but not in REX. Maximal plantar flexor EMG did not change in either group. In summary, constant resistance concentric/eccentric REX completely prevented plantar flexor performance deconditioning induced by BRU. The reported benefits of REX should prove useful in prescribing exercise for astronauts in microgravity and for patients susceptible to functional decline during bed- or chair-bound hospital stays.

  1. The Three Dimensional Conformal Radiotherapy for Hyperkeratotic Plantar Mycosis Fungoides

    OpenAIRE

    Lee, Sun Young; Kwon, Hyoung Cheol; Cho, Yong-Sun; Nam, Kyung-Hwa; Ihm, Chull-Wan; Kim, Jung Soo

    2011-01-01

    The localized early-stage of Mycosis fungoides (MF) (stage IA-IIA) is usually treated with topical agents, such as nitrogen mustard, steroids, and phototherapy (UVB/PUVA) as first line therapy; response to these initial treatments is usually good. However, hyperkeratotic plantar lesions are clinically rare and have decreased responsiveness to topical agents. For such cases, physicians may consider local radiotherapy. Here, a case of an 18-year-old Korean woman who was treated with three-dimen...

  2. Extracorporeal shock wave therapy of gastroc-soleus trigger points in patients with plantar fasciitis: A randomized, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Alireza Moghtaderi

    2014-01-01

    Conclusion: The combination of ESWT for both plantar fasciitis and gastroc-soleus trigger points in treating patients with plantar fasciitis is more effective than utilizing it solely for plantar fasciitis.

  3. Plantar calcaneal spurs in older people: longitudinal traction or vertical compression?

    OpenAIRE

    Landorf Karl B; Zammit Gerard V; Menz Hylton B; Munteanu Shannon E

    2008-01-01

    Abstract Background Plantar calcaneal spurs are common, however their pathophysiology is poorly understood. This study aimed to evaluate the prevalence and correlates of plantar calcaneal spurs in a large sample of older people. Methods Weightbearing lateral foot radiographs of 216 people (140 women and 76 men) aged 62 to 94 years (mean age 75.9, SD 6.6) were examined for plantar calcaneal and Achilles tendon spurs. Associations between the presence of spurs and sex, body mass index, radiogra...

  4. Plantar pitted keratolysis: a study from non-risk groups

    Directory of Open Access Journals (Sweden)

    Asli Feride Kaptanoglu

    2012-02-01

    Full Text Available Pitted keratolysis is an acquired, superficial bacterial infection of the skin which is characterized by typical malodor and pits in the hyperkeratotic areas of the soles. It is more common in barefooted people in tropical areas, or those who have to wear occlusive shoes, such as soldiers, sailors and athletes. In this study, we evaluated 41 patients who had been diagnosed with plantar pitted keratolysis. The patients were of high socioeconomic status, were office-workers, and most had a university degree. Malodor and plantar hyperhydrosis were the most frequently reported symptoms. The weight-bearing metatarsal parts of the feet were those most affected. Almost half the women in the study gave a history of regular pedicure and foot care in a spa salon. Mean treatment duration was 19 days. All patients were informed about the etiology of the disease, predisposing factors and preventive methods. Recurrences were observed in only 17% of patients during the one year follow-up period. This study emphasizes that even malodorous feet among non-risk city dwellers may be a sign of plantar pitted keratolysis. A study of the real incidence of the disease in a large population-based series is needed.

  5. Thinking while walking: Experienced high-heel walkers flexibly adjust their gait

    Directory of Open Access Journals (Sweden)

    Sabine eSchaefer

    2013-06-01

    Full Text Available Theories of motor skill acquisition postulate that attentional demands of motor execution decrease with practice. Hence, motor experts should experience less attentional resource conflict when performing a motor task in their domain of expertise concurrently with a demanding cognitive task. We assessed cognitive and motor performance in high-heel experts and novices who were performing a working memory task while walking in gym shoes or high heels on a treadmill. Surprisingly, neither group showed lower working memory performance when walking than when sitting, irrespective of shoe type. However, high-heel experts adapted walking regularity more flexibly to shoe type and cognitive load than novices, by reducing the variability of time spent in the single-support phase of the gait cycle in high heels when cognitively challenged. We conclude that high-heel expertise is associated with more flexible adjustments of movement patterns. Future research should investigate whether a more demanding walking task (e.g., wearing high heels on uneven surfaces and during gait perturbations results in expertise-related differences in the simultaneous execution of a cognitive task.

  6. The Human Papillomavirus and Its Role in Plantar Warts: A Comprehensive Review of Diagnosis and Management.

    Science.gov (United States)

    Vlahovic, Tracey C; Khan, M Tariq

    2016-07-01

    Viral warts or verruca pedis (plantar warts) are common skin conditions seen in both children and adults. Human papilloma virus (HPV), a DNA virus, is responsible for plantar verrucae. It needs an epidermal abrasion and a transiently impaired immune system to inoculate a keratinocyte. These entities are a therapeutic conundrum for many practitioners. This article discusses HPV infiltration and its subtypes involved in plantar warts; the evaluation of patients with plantar warts; and subsequent treatment options, such as laser, Candida albicans immunotherapy, topical therapy such as phytotherapy, and surgical excision. PMID:27215155

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

    Directory of Open Access Journals (Sweden)

    Ulla Hellstrand Tang

    2015-06-01

    Full Text Available 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 high plantar pressure. Patients and methods: Patients diagnosed with type 1 (n=27 or type 2 (n=47 diabetes (mean age 60.0±15.0 years were included in this cross-sectional study. Assessments included the registration of foot deformities; test of gross function at the hip, knee, and ankle joints; a stratification of the risk of developing foot ulcers according to the Swedish National Diabetes Register; a walking test; and self-reported questionnaires including the SF-36 health survey. In-shoe PP was measured in seven regions of interests on the sole of the foot using F-Scan®. An exploratory analysis of the association of risk factors with PP was performed. Results: Neuropathy was present in 28 (38%, and 39 (53% had callosities in the heel region. Low forefoot arch was present in 57 (77%. Gait-related parameters, such as the ability to walk on the forefoot or heel, were normal in all patients. Eighty percent had normal function at the hip and ankle joints. Gait velocity was 1.2±0.2 m/s. All patients were stratified to risk group 3. Hallux valgus and hallux rigidus were associated with an increase in the PP in the medial forefoot. A higher body mass index (BMI was found to increase the PP at metatarsal heads 4 and 5. Pes planus was associated with a decrease in PP at metatarsal head 1. Neuropathy did not have a high association with PP. Conclusions: This study identified several potential risk factors for the onset of diabetic foot ulcers (DFU. Hallux valgus

  8. Simpactectomia lombar retroperitoneoscópica para tratamento da hiper-hidrose plantar Retroperitoneoscopic lumbar sympathectomy for the treatment of plantar hyperidrosis

    Directory of Open Access Journals (Sweden)

    Marcelo de Paula Loureiro

    2007-08-01

    Full Text Available OBJETIVO: Observar o seguimento de até quatro anos de mulheres submetidas à simpatectomia lombar por retroperitonioscopia, procurando identificar seus efeitos colaterais, bem como sua efetividade no controle da hiper-hidrose plantar. MÉTODOS: Entre junho/2002 e julho2006, operamos 44 pacientes com hiperidrose plantar. Todas apresentavam hiper-hidrose plantar persistente pós simpatectomia torácica com exceção de uma única paciente com diagnóstico de hiperidrose plantar primária. RESULTADOS: O seguimento médio de 22,3 meses, mostra grande satisfação referida pela maioria das pacientes e piora do suor compensatório em 37% delas. Não houve relato de alteração sexual nesta casuística. CONCLUSÃO: A simpatectomia lombar por retroperitonioscopia é uma técnica segura, eficaz e associada a e aceitáveis efeitos colaterais, quando empregada no tratamento da hiperidrose plantar em mulheres jovens.BACKGROUND: Describe a 4-years follow-up of females submitted to lumbar sympathectomy for hiperhidrosis. METHODS: From June 2002 to July 2006, we have operated 44 patients with plantar hyperidrosis. Only one of them had primary plantar hyperidrosis. The others had persistent plantar hyperidrosis after thoracic sympathectomy. RESULTS: We show our results with a median follow up of 22.3 months. Most patients were very satisfied and only 37% had worsened their compensatory sweat. CONCLUSION: Laparoscopic lumbar sympathectomy is a safe and effective technique which is associated with few and acceptable collateral effects, when it is indicated in the treatment of plantar hyperhidrosis in young women.

  9. Heel effect adaptive flat field correction of digital x-ray detectors

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Yongjian [X-ray Products, Varian Medical Systems Inc., Liverpool, New York 13088 (United States); Wang, Jue [Department of Mathematics, Union College, Schenectady, New York 12308 (United States)

    2013-08-15

    Purpose: Anode heel effect renders large-scale background nonuniformities in digital radiographs. Conventional offset/gain calibration is performed at mono source-to-image distance (SID), and disregards the SID-dependent characteristic of heel effect. It results in a residual nonuniform background in the corrected radiographs when the SID settings for calibration and correction differ. In this work, the authors develop a robust and efficient computational method for digital x-ray detector gain correction adapted to SID-variant heel effect, without resorting to physical filters, phantoms, complicated heel effect models, or multiple-SID calibration and interpolation.Methods: The authors present the Duo-SID projection correction method. In our approach, conventional offset/gain calibrations are performed only twice, at the minimum and maximum SIDs of the system in typical clinical use. A fast iterative separation algorithm is devised to extract the detector gain and basis heel patterns from the min/max SID calibrations. The resultant detector gain is independent of SID, while the basis heel patterns are parameterized by the min- and max-SID. The heel pattern at any SID is obtained from the min-SID basis heel pattern via projection imaging principles. The system gain desired at a specific acquisition SID is then constructed using the projected heel pattern and detector gain map.Results: The method was evaluated for flat field and anatomical phantom image corrections. It demonstrated promising improvements over interpolation and conventional gain calibration/correction methods, lowering their correction errors by approximately 70% and 80%, respectively. The separation algorithm was able to extract the detector gain and heel patterns with less than 2% error, and the Duo-SID corrected images showed perceptually appealing uniform background across the detector.Conclusions: The Duo-SID correction method has substantially improved on conventional offset/gain corrections for

  10. Chronic arsenicism: criminal poisoning or drug-intoxication? Report of two cases.

    Science.gov (United States)

    Sass, U; Grosshans, E; Simonart, J M

    1993-01-01

    We report two cases with chronic arsenicism. The first one is a young 37-year-old woman who presents leucomelanoderma, plantar keratoderma, polyneuropathy of the legs and transversal striae of the nails. After investigations, criminal intoxication with arsenic caused by her own sister was discovered. The second case is a 42-year-old man who had developed plantar keratoderma, arsenical keratoses and two squamous cell epitheliomas 10 years after a 2-year treatment with Fowler's solution for androgenetic alopecia.

  11. Use of primary corticosteroid injection in the management of plantar fasciopathy: is it time to challenge existing practice?

    Science.gov (United States)

    Kirkland, Paul; Beeson, Paul

    2013-01-01

    Plantar fasciopathy (PF) is characterized by degeneration of the fascia at the calcaneal enthesis. It is a common cause of foot pain, accounting for 90% of clinical presentations of heel pathology. In 2009-2010, 9.3 million working days were lost in England due to musculoskeletal disorders, with 2.4 million of those attributable to lower-limb disorders, averaging 16.3 lost working days per case. Numerous studies have attempted to establish the short- and long-term clinical efficacy of corticosteroid injections in the management of PF. Earlier studies have not informed clinical practice. As the research base has developed, evidence has emerged supporting clinical efficacy. With diverse opinions surrounding the etiology and efficacy debate, there does not seem to be a consensus of opinion on a common treatment pathway. For example, in England, the National Institute for Clinical Health and Excellence does not publish strategic guidance for clinical practice. Herein, we review and evaluate core literature that examines the clinical efficacy of corticosteroid injection as a treatment for PF. Outcome measures were wide ranging but largely yielded results supportive of the short- and long-term benefits of this modality. The analysis also looked to establish, where possible, "proof of concept." This article provides evidence supporting the clinical efficacy of corticosteroid injections, in particular those guided by imaging technology. The evidence challenges existing orthodoxy, which marginalizes this treatment as a secondary option. This challenge is supported by recently revised guidelines published by the American College of Foot and Ankle Surgeons advocating corticosteroid injection as a primary treatment option.

  12. Effect of gender, age and anthropometric variables on plantar fascia thickness at different locations in asymptomatic subjects

    OpenAIRE

    Pascual Huerta, Javier; Alarcón García, Juan María

    2007-01-01

    The study was aimed to investigate plantar fascia thickness at different locations in healthy asymptomatic subjects and its relationship to the following variables: weight, height, sex and age. The study evaluates 96 feet of healthy asymptomatic volunteers. The plantar fascia thickness was measured at four different locations: 1 cm proximal to the insertion of the plantar fascia, at the insertion of the plantar fascia on the calcaneus and separate out 1 cm + 2 cm distal to the insertion. A 10...

  13. Plantar flexor neuromuscular adjustments following match-play football in hot and cool conditions

    DEFF Research Database (Denmark)

    Girard, O; Nybo, Lars; Mohr, Magni;

    2015-01-01

    We assessed neuromuscular fatigue and recovery of the plantar flexors after playing football with or without severe heat stress. Neuromuscular characteristics of the plantar flexors were assessed in 17 male players at baseline and ∼30 min, 24, and 48 h after two 90-min football matches in tempera...

  14. Effect of plantar cutaneous inputs on center of pressure during quiet stance in older adults

    Directory of Open Access Journals (Sweden)

    Yun Wang

    2016-06-01

    Conclusion: The findings indicate that mechanical facilitation of sensation on the plantar soles enhanced postural stability in older adults. The results show that plantar cutaneous inputs provide information that leads to reduced postural sway in healthy older adults. This could have implications in clinical and rehabilitative areas.

  15. The influence of valgus heel position on foot loading in a child's gait

    Directory of Open Access Journals (Sweden)

    Eliška Martinásková

    2012-12-01

    Full Text Available BACKGROUND: Flat foot is a typical clinical sign in childhood, expressed as valgus positioning of the heel during vertical foot loading. This may lead to medial deviation of the foot axis and cause overloading of some foot areas. OBJECTIVE: To determine the influence of valgus position of the heel (both bilateral and unilateral on foot loading during gait. METHODS: An experimental group consisting of children with bilateral heel valgus deformity (16 children, age 5.3 ± 1.3 years and children with unilateral heel valgus deformity (14 children, age 5.6 ± 1.6 years. The control group comprised of 14 children (age 4.5 ± 1.2 years. For measuring foot loading during gait, the Footscan (RSScan International, Olen, Belgium pressure plate was used. Each subject went through 8 trials of gait measurement. From each trial, 8 foot areas were evaluated. Data processing with mean values for each subject was performed by non-parametric tests (Mann-Whitney and Wilcoxon tests, Spearman correlation in the STATISTICA programme (StatSoft, Inc., Tulsa, USA. RESULTS: Pressure peak and pressure impulse in the first metatarsal was greater for the bilateral valgus group (p CONCLUSION: The results show that valgus positioning of the heel influences foot loading in children during gait. The findings of this study suggest the necessity of a complex solution to the problem of preventing further progression of pathological changes.

  16. The Effects of Various Running Inclines on Three-Segment Foot Mechanics and Plantar Fascia Strain

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2014-12-01

    Full Text Available Purpose. There has yet to be a combined analysis of three-dimensional multi-segment foot kinematics and plantar fascia strain in running gait at various degrees of inclination. The aim of the current study was therefore to investigate the above during treadmill running at different inclines (0°, 5°, 10° and 15°. Methods. Twelve male participants ran at 4.0 m · s-1 in the four different inclinations. Three-dimensional kinematics of the foot segments and plantar fascia strain were quantified for each incline and contrasted using one-way repeated measures ANOVA. Results and conclusions. The results showed that plantar fascia strain increased significantly as a function of running incline. Given the projected association between plantar fascia strain and the aetiology of injury, inclined running may be associated with a greater incidence of injury to the plantar fascia.

  17. How Plantar Exteroceptive Efficiency Modulates Postural and Oculomotor Control: Inter-Individual Variability.

    Science.gov (United States)

    Foisy, Arnaud; Kapoula, Zoï

    2016-01-01

    In a previous experiment, we showed that among young and healthy subjects, thin plantar inserts improve postural control and modify vergence amplitudes. In this experiment, however, significant inter-individual variability was observed. We hypothesize that its origin could be attributed to a different reliance upon feet cutaneous afferents. In order to test this hypothesis, we re-analyzed the data relative to 31 young (age 25.7 ± 3.8) and healthy subjects who participated in the first experiment after having classified them into two groups depending on their Plantar Quotient (PQ = Surface area of CoPfoam/Surface area of CoPfirm ground × 100). Foam decreases the information arising from the feet, normally resulting in a PQ > 100. Hence, the PQ provides information on the weight of plantar cutaneous afferents used in postural control. Twelve people were Plantar-Independent Subjects, as indicated by a PQ like the Normal Plantar Quotient Subjects: they were almost insensitive to the plantar stimulations in terms of postural control and totally insensitive in terms of oculomotor control. We conclude that the inter-individual variability observed in our first experiment is explained by the subjects' degree of plantar reliance. We propose that plantar independence is a dysfunctional situation revealing inefficiency in plantar cutaneous afferents. The latter could be due to a latent somatosensory dysfunction generating a noise which prevents the CNS from correctly processing and using feet somatosensory afferents both for balance and vergence control: Plantar Irritating Stimulus. Considering the non-noxious nature and prevalence of this phenomenon, these results can be of great interest to researchers and clinicians who attempt to trigger postural or oculomotor responses through mechanical stimulation of the foot sole. PMID:27242490

  18. How plantar exteroceptive efficiency modulates postural and oculomotor control: inter-individual variability

    Directory of Open Access Journals (Sweden)

    Arnaud eFoisy

    2016-05-01

    Full Text Available In a previous experiment, we showed that among young and healthy subjects, thin plantar inserts improve postural control and modify vergence amplitudes. In this experiment, however, significant inter-individual variability was observed. We hypothesize that its origin could be attributed to a different reliance upon feet cutaneous afferents. In order to test this hypothesis, we re-analyzed the data relative to 31 young (age 25,7±3,8 and healthy subjects who participated in the first experiment after having classified them into two groups depending on their Plantar Quotient (PQ = Surface area of CoP foam / Surface area of CoP firm ground x100. Foam decreases the information arising from the feet, normally resulting in a PQ>100. Hence, the PQ provides information on the weight of plantar cutaneous afferents used in postural control. Twelve people were Plantar-Independent Subjects, as indicated by a PQ<100. These individuals did not behave like the Normal Plantar Quotient Subjects: they were almost insensitive to the plantar stimulations in terms of postural control and totally insensitive in terms of oculomotor control. We conclude that the inter-individual variability observed in our first experiment is explained by the subjects’ degree of plantar reliance. We propose that plantar independence is a dysfunctional situation revealing an inefficiency in plantar cutaneous afferents. The latter could be due to a latent somatosensory dysfunction generating a noise which prevents the CNS from correctly processing and using feet somatosensory afferents both for balance and vergence control: Plantar Irritating Stimulus. Considering the non-noxious nature and prevalence of this phenomenon, these results can be of great interest to researchers and clinicians who attempt to trigger postural or oculomotor responses through mechanical stimulation of the foot sole.

  19. The plantar fasciotomy: MR imaging findings in asymptomatic volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Yu, J.S.; Ashman, C. [Ohio State Univ. Medical Center, Department of Radiology, Columbus, OH (United States); Smith, G.; Kaeding, C. [Ohio State Univ. Medical Center, Department of Surgery, Columbus, OH (United States)

    1999-08-01

    Objective. To determine the postoperative appearance of the plantar fascia on MR imaging after a fasciotomy has been performed, and to compare the postsurgical appearance of the fascia after an open and endoscopic procedure.< rate at head-abs-p1.lf>Design and patients. Fifteen asymptomatic volunteers (12 women, 3 men; age range 22-49 years, mean age 33 years) with prior fasciotomies for treatment of longstanding plantar fasciitis were studied. Fourteen volunteers had a unilateral release and one volunteer had bilateral releases, allowing for assessment of 16 ankles. Eight fasciotomies were performed through an open incision and eight were performed endoscopically. The average time between surgery and imaging was 24 months (range 11-46 months). The site of surgery was established from the operative reports. Proton density (PD)-weighted and T2-weighted images in three orthogonal planes were obtained on a 1.5-T magnet. In eight studies, T1-weighted sagittal and STIR sagittal images were included. The fascia in each ankle was assessed for morphology and signal intensity. Perifascial soft tissues and bone marrow were assessed for edema. Preoperative MR studies were available in five volunteers.< rate at head-abs-p1.lf>Results. There was no apparent difference in the postoperative appearance of the ankle after an open or endoscopic procedure except for scar formation in the subcutaneous fat which was common after an open procedure (P<0.05). Three ankles had a gap in the fascia (one open, two endoscopic). The plantar fascia measured a mean of 7.0 mm (range 5-10 mm) at the fasciotomy, and 8.3 mm (range 6-12 mm) at the enthesis. At the fasciotomy, 11 of 13 ankles had an indistinct deep contour and 9 of 13 had an indistinct superficial contour. At the enthesis, 13 of 16 ankles had an indistinct deep contour and 6 of 16 had an indistinct superficial contour. Compared with preoperative MR studies there was an average reduction in the fascial thickness at the enthesis of 14

  20. How to Select the Right Athletic Shoes

    Science.gov (United States)

    ... metatarsal area). This will help reduce heel pain (plantar fasciitis and pump bumps) as well as burning and ... effective way to alleviate pain beneath the heel (plantar fasciitis). Made of plastic or rubber, the heel cup ...

  1. 高能量损伤致足跟软组织缺损的修复%Repair of high energy injury-induced soft tissue wound of the heel

    Institute of Scientific and Technical Information of China (English)

    蓝旭; 厉孟; 葛宝丰; 高杰; 李志琳

    2015-01-01

    Objective To investigate the methods and effects of different flaps for repair of high energy injury-induced soft tissue wound of the heel.Methods From January 2002 to June 2012,the patients including 12 males and 9 females aged 18-57 years (mean,32 years) underwent heel soft tissue defect reconstruction.Causes of injury were traffic injury in 11 case and mechanical injury in 10 cases.Dimension of soft tissue defect ranged from 5 cm × 3 cm to 8 cm × 6 cm.Soft-tissue defect was repaired with sural neurovascular flaps at the posterolateral heel in 9 cases (Group A),with posterior tibial artery flaps at the posterolateral heel in 5 cases (Group B),and with medial plantar flaps at the loading area of heel in 7 cases (Group C).Sensory recovery and two point discrimination motion of the ankle joint were observed and compared among groups 12 month after operation.Heel pain was observed during weight bearing and joint activity was evaluated using the visual analogue scale (VAS).Results All the flaps survived,except for one with epidermal necrosis over the distal part,which healed after partial changing medication.Duration of follow-up was 12-24 months.There were no differences in the appearance,texture and contour between the flaps and recipient sites.Flaps showed no ulcer in the weight-bearing area and recovered their protective sense.Patients could walk normally after surgery.At postoperative 1 year,sensory recovery rate of the flaps in Groups A,B and C was 0,20% and 100% respectively (P <0.01).Appearance of the heel in all groups recovered to almost normal.Cases that could start nil weight-bearing exercise without pain accounted for 8 (89%) in Group A,4 (80%) in Group B,and 6 (86%) in Group C (P > 0.05).While heel pain existed in weight-bearing exercise.Difference in VAS was significant among the three groups (P < 0.05),but ankle range of motion was not (P >0.05).Conclusion Medial plantar flaps are suitable for tissue defect of 5-8 cm in length but

  2. Correlation between plantar pressure and walking ability in hemiplegic stroke survivors%脑卒中患者足底压力与步行能力的相关性分析

    Institute of Scientific and Technical Information of China (English)

    岳童; 倪朝民; 刘孟; 陈进; 杨洁; 尹傲冉; 王丽

    2015-01-01

    目的 探讨脑卒中后偏瘫患者的足底压力与步行能力(步速)之间的关系.方法 选取脑卒中偏瘫患者30例作为偏瘫组,与其相匹配的健康中老年人30例作为对照组,均采用步态与平衡功能评估系统进行步态检测和分析,获取步速、首次触地期和蹬离期的足底压力峰值、单支撑相压力中心位移(DCOP),并计算上述各项参数的不对称性,用两独立样本t检验分析比较2组各参数的差异,用Pearson相关性分析法分析步速与足底压力峰值及DCOP之间的相关程度.结果 ①偏瘫组患者的步速明显慢于对照组[(0.32±0.26)m/s vs (0.82 ±0.35)m/s,P<0.05];②与对照组相比,偏瘫组双下肢首次触地期的足底压力峰值[患侧(2.26±0.89) kg/cm2,健侧(3.02±0.27) kg/cm2]及患侧下肢蹬离期的足底压力峰值(3.67±1.52) kg/cm2]均明显下降,单支撑相矢状面的DCOP[患侧(3.24 ±3.65) cm,健侧(4.18 ±4.12) cm]亦减小,组间差异均有统计学意义(P<0.05);③偏瘫组足蹬离期、首次触地期的足底压力峰值和矢状面DCOP(DCOPx)的不对称性均较对照组增大(P<0.05),而冠状面DCOP(DCOPy)的不对称性与对照组比较,差异无统计学意义(P>0.05);④应用Pearson相关分析显示,偏瘫患者的步速与双侧下肢的首次触地期、蹬离期的压力峰值及DCOP均呈正相关(r=0.666 ~0.950,P<0.01).结论 脑卒中偏瘫患者双侧足底压力峰值较健康人均有所下降,步行中的重心转移能力下降,且与步行能力(步速)之间有一定的相关性.%Objective To explore the correlation between plantar pressure and walking function in hemiplegic stroke patients.Methods Thirty hemiplegic patients with stroke (a hemiplegic group) and thirty age-matched healthy persons (a control group) were recruited.Gait and balance function training and assessment system (model:AL-600) were used to quantify the walking velocity,peak plantar pressure at heel-strike and push-off periods

  3. The Artificial Gravity Bed Rest Pilot Project: Effects on Knee Extensor and Plantar Flexor Muscle Groups

    Science.gov (United States)

    Caiozzo, V. J.; Haddad, F.; Lee, S.; Baker, M.; Baldwin, K. M.

    2007-01-01

    The goal of this project was to examine the effects of artificial gravity (2.5 g) on skeletal muscle strength and key anabolic/catabolic markers known to regulate muscle mass. Two groups of subjects were selected for study: 1) a 21 day-bed rest (BR) control (C) group (N=7); and 2) an AG group (N=8), which was exposed to 21 days of bed-rest plus daily 1 hr exposures to AG (2.5 g). This particular experiment was part of an integrated AG Pilot Project sponsored by NASA/Johnson Space Center. The in vivo torque-velocity relationships of the knee extensors and plantar flexors of the ankle were determined pre and post treatment. Also, pre- and post treatment biopsy samples were obtained from both the vastus lateralis and soleus muscles and were used, in part, for a series of analyses on gene expression (mRNA abundance) of key factors implicated in the anabolic versus catabolic state of the muscle. Post/Pre toque-velocity determinations revealed greater decrements in knee extensor performance in the C versus AG group (P less than 0.04). The plantar flexor muscle group of the AG subjects actually demonstrated a net gain in torque-velocity relationship; whereas, in the C group the overall post/pre responses declined (AG vs C; P less than 0.001). Measurements of muscle fiber cross-sectional area (for both muscles) demonstrated a loss of approx. 20% in the C group while no losses were evident in the AG group. RT-PCR analyses of muscle biopsy specimens demonstrated that markers of growth and cytoskeletal integrity (IGF-1, IGF-1 BP4, mechano growth factor, total RNA, and pro-collagen 3a) were higher in the AG group, whereas catabolic markers (myostatin and atrogen) were elevated in the C group. Importantly, these patterns were seen in both muscles. Based on these observations we conclude that paradigms of AG have the potential to maintain the functional, biochemical, and structural homeostasis of skeletal muscle in the face of chronic unloading states. These findings also

  4. Heel blood sampling in European neonatal intensive care units: compliance with pain management guidelines

    DEFF Research Database (Denmark)

    Losacco, Valentina; Cuttini, Marina; Greisen, Gorm;

    2011-01-01

    Objective To describe the use of heel blood sampling and non-pharmacological analgesia in a large representative sample of neonatal intensive care units (NICUs) in eight European countries, and compare their self-reported practices with evidence-based recommendations. Methods Information on use...... with published guidelines is needed for clinical and ethical reasons....

  5. Tank Farm WM-182 and WM-183 Heel Slurry Samples PSD Results

    Energy Technology Data Exchange (ETDEWEB)

    Batcheller, T.A.; Huestis, G.M.

    2000-08-31

    Particle size distribution (PSD) analysis of INTEC Tank Farm WM-182 and WM-183 heel slurry samples were performed using a modified Horiba LA-300 PSD analyzer at the RAL facility. There were two types of testing performed: typical PSD analysis, and setting rate testing. Although the heel slurry samples were obtained from two separate vessels, the particle size distribution results were quite similar. The slurry solids were from approximately a minimum particle size of 0.5 mm to a maximum of 230 mm with about 90% of the material between 2-to-133 mm, and the cumulative 50% value at approximately 20 mm. This testing also revealed that high frequency sonication with an ultrasonic element may break-up larger particles in the WM-182 and WM-183 tank from heel slurries. This finding represents useful information regarding ultimate tank heel waste processing. Settling rate testing results were also fairly consistent with material from both vessels in that it appears that most of the mass of solids settle to an agglomerated, yet easily redispersed layer at the bottom. A dispersed and suspended material remained in the ''clear'' layer above the settled layer after about one-half an hour of settling time. This material had a statistical mode of approximately 5 mm and a maximum particle size of 30 mm.

  6. Tank Farm WM-182 and WM 183 Heel Slurry Samples PSD Results

    Energy Technology Data Exchange (ETDEWEB)

    Batcheller, Thomas Aquinas

    2000-09-01

    Particle size distribution (PSD) analysis of INTEC Tank Farm WM-182 and WM-183 heel slurry samples were performed using a modified Horiba LA-300 PSD analyzer at the RAL facility. There were two types of testing performed: typical PSD analysis, and setting rate testing. Although the heel slurry samples were obtained from two separate vessels, the particle size distribution results were quite similar. The slurry solids were from approximately a minimum particle size of 0.5 mm to a maximum of 230 mm-with about 90% of the material between 2-to-133 mm, and the cumulative 50% value at approximately 20 mm. This testing also revealed that high frequency sonication with an ultrasonic element may break-up larger particles in the WM-182 and WM-183 tank from heel slurries. This finding represents useful information regarding ultimate tank heel waste processing. Settling rate testing results were also fairly consistent with material from both vessels in that it appears that most of the mass of solids settle to an agglomerated, yet easily redispersed layer at the bottom. A dispersed and suspended material remained in the "clear" layer above the settled layer after about one-half an hour of settling time. This material had a statistical mode of approximately 5 mm and a maximum particle size of 30 mm.

  7. Lower limb mechanics during moderate high-heel jogging and running in different experienced wearers.

    Science.gov (United States)

    Fu, Fengqin; Zhang, Yan; Shu, Yang; Ruan, Guoqing; Sun, Jianjun; Baker, Julien; Gu, Yaodong

    2016-08-01

    The aim of this study is to investigate the differences in lower limb kinematics and kinetics between experienced (EW) and inexperienced (IEW) moderate high-heel wearers during jogging and running. Eleven experienced female wearers of moderate high-heel shoes and eleven matched controls participated in jogging and running tests. A Vicon motion analysis system was used to capture kinematic data and a Kistler force platform was used to collect ground reaction force (GRF). There were no significant differences in jogging and running speed respectively. Compared with IEW, EW adopted larger stride length (SL) with lower stride frequency (SF) at each corresponding speed. During running, EW enlarged SL significantly while IEW increased both SL and SF significantly. Kinematic data showed that IEW had generally larger joint range of motion (ROM) and peak angles during stance phase. Speed effect was not obvious within IEW. EW exhibited a significantly increased maximal vertical GRF (Fz2) and vertical average loading rate (VALR) during running, which was potentially caused by overlong stride. These suggest that both EW and IEW are at high risk of joint injuries when running on moderate high heels. For wearers who have to do some running on moderate high heels, it is crucial to control joint stability and balance SL and SF consciously. PMID:27101561

  8. EXCISION OF RETROCALCANEAL SPUR BY A LATERAL APPROA CH FOR RELIEF OF HEEL PAIN

    Directory of Open Access Journals (Sweden)

    Nandivada

    2013-04-01

    Full Text Available ABSTRACT : retrocalcaneal pain could be due to various reason s depending on the structure involved in the region. Bursal irritation is a comm on finding which is well relieved by non surgical modality of treatment rest, ice therapy, a nd other modalities of physiotherapy. CONTEXT (background: Podiatric or foot problems are increasing in our lif estyles due to various reasons . HEEL PAIN DUE TO RETROCALCANEAL S PUR IS AN IMPORTANT CAUSE AMONGST THE MANY CAUSES OF HEEL PAIN Retrocalcaneal bursitis is a common presentation which is easily identifiable and treated . The retr ocalcaneal spur or bony osteophyte poses a potential problem to the tendon of tendo achillis and results in its repeated irritation causing tendinitis and future weakening .Hence this study o f 5 cases showed that the excision of the retrocalcaneum provided greater relief and i feel t he lateral approach to the calcaneal spur area more comfortable . AIM: Aim of this case study is to inform the orthopaedic fraternity and the post graduate students about the pain relief obtained by excision of the retrocalcaneal spur by a lateral approach to the ankle postero lateral to the t endo achillis . MATERIAL AND METHODS : Between 2011 and 2013 an analysis of the retrocalca neal spur patients and their resistant heel pain cases were given a detailed x ray examination a nd were found to have an impinging retrocalcaneal spur and the method of treatment used was a lateral approach to the heel and excision of the posterior retrocalcaneal spur under d irect vision

  9. Implementation guide for Hanford Tanks Initiative C-106 heel retrieval contract management HNF-2511

    Energy Technology Data Exchange (ETDEWEB)

    McDaniel, L.B.

    1998-04-17

    This report is an Implementation Guide for Hanford Tanks Initiative C-106 heel retrieval contract management HNF-2511 to provide a set of uniform instructions for managing the two contractors selected. The primary objective is to produce the necessary deliverables and services for the HTI project within schedule and budget.

  10. Accelerations due to impact at heel strike using below-knee prosthesis

    NARCIS (Netherlands)

    Jaarsveld, van H.W.L.; Grootenboer, H.J.; Vries, de J.

    1990-01-01

    The acceleration in the sagittal plane of the prosthetic tube at heel strike in normal walking was measured in five healthy amputees with their definitive below-knee prosthesis, every subject using six different prosthetic feet, wearing sport shoes as well as leather shoes. The experiments were carr

  11. Effect of functional insoles to plantar pressure distribution of race walkers%足弓支撑功能鞋垫对竞走运动员足底压力分布的影响

    Institute of Scientific and Technical Information of China (English)

    王康康; 王一乐; 郭翔; 宋祺鹏; 张翠

    2015-01-01

    This study investigates the effectiveness of functional insoles on plantar pressure distribution during race walking so as to reduce the high plantar pressure and force on race walkers,who tend to suffer from overuse injury.A total of 20 male race walkers aged 21 .1 9 ± 2.66 years and with a mean height of 1 78.85 ±1 4.07 cm were recruited as subjects.Each participant completed a race walk with and without functional insoles.Plantar pressure insoles were used to collect plantar pressure data.A two-way analysis of variance with a mixed design was used to determine the difference between the two conditions.Results show that the use of functional insoles reduced the peak pressure and the impulse in the metatarsal heads and heels and thus suggest that functional insoles have reduced the overuse injury risks of these parts. The first ground reaction force peak also decreased.This result suggests that functional insoles have reduced the risks of foot and leg injuries.%通过分析竞走运动中运动员的足底压力特征,研究足底功能鞋垫对减小足底压力和降低竞走运动员过度使用性损伤的效果。研究对象:20名男性竞走运动员;年龄20.19±2.66岁;身高178.85±14.07厘米。每名受试者分别穿功能鞋垫和不穿功能鞋垫来完成测试。使用足底压力鞋垫来收集足底压力的数据。使用双因素方差分析(Two way ANOVA)来确定两个条件之间的差异。结果显示足底功能鞋垫能够减小跖骨头和足跟的压强峰值和冲量,表明功能鞋垫能够降低这些部位过度使用性损伤的风险。穿功能鞋垫时地面反作用力第一峰值下降,表明足底功能鞋垫能够降低足部和腿过度使用性损伤的风险。

  12. Dynamics Research on Plantar Pressures While Running on the Brae During Judokas' Training%柔道运动员体能训练中斜坡跑的足底动力学研究

    Institute of Scientific and Technical Information of China (English)

    徐志明; 张嫄

    2012-01-01

    采用德国NovelPedar-X足底压力测试系统,对柔道运动员裸足和穿跑鞋两种情况在不同角度的坡面上足底压力及其分布特征,进行实时在体测量和统计分析。结果显示:1)在裸足情况下,大拇趾区、外侧跖骨区和外侧足弓区在坡度为8^。和16^。时,与O^。相比均没有显著性差异,24^。时差异显著;其他脚趾区仅在坡度为8^。时没有显著差异,16。和240时均差异显著;足跟区在各个坡度上均有显著差异,而其余足底各区在各个坡度上均没有显著性差异。2)大拇趾区各坡度和外侧足弓区24^。坡度上跑鞋的降压功效均不显著。结论:防止人体足底局部过载的安伞坡度为80~160.跪麟具有一定的分解转移足底局部高压的功效.%We researched on plantar biomechanic influences between different brea grades to provide scientific basis for judo coaches to choose the right brea. We measured the plantar pressures and recorded the statistics distributing by Novel Pedar-X system,in conditions of different brea grades between bared and shoed. It showed that compared to 0^.,the differences of GT,LM and LA (8^.,16^.) area appeared unsignificant,LA (24^.) area appeared significant.The OT area all appeared unsignificant,except OT (8^.). Heel area appeared significant,the opposite of the other areas.The pressure prevent efficacy of GT and LA (24^.) seemed be of no significant effect. These plantar dynamics findings suggested that the safe brae grade was 8^.-16^.. Shoes can reduce plantar pressures to a certain extent. Therefore,the coaches may heighten the brea (〈24^.) based on the safe brae grade.

  13. Comprehensive treatment of complicated plantar ulcers in leprosy

    Institute of Scientific and Technical Information of China (English)

    YAN Liangbin 严良斌; ZHANG Guocheng 张国成; ZHENG Zhiju 郑志菊; LI Wenzhong 李文忠; ZHENG Tisheng 郑逖生; Jean M. Watson; Angelika Piefer

    2003-01-01

    Objective To investigate feasible treatment methods for plantar ulcers in leprosy patients according to the agreement between the Ministry of Health (MOH) of China and the Leprosy Mission International (LMI).Methods A total of 2599 complicated foot ulcers in 1804 leprosy cases underwent surgic treatment. Plastic fixation and supports were used, dressings were changed regularly, and protective footwear and modified insoles were provided.Results Of the 2599 foot ulcers 1446 (55.64%) healed. The cure rate of the patients treated in leprosy hospitals was 71.31%, with 219 (15.15%) recurrences of foot ulcers. The recurrence rate of those who lived at home was 18.35%.Conclusions Comprehensive treatment of foot ulcers has a high cure rate and a low recurrence rate. Reduction of workload, avoidance of long distance walking, intensification of education on foot self-care and provision of financial support are the main measures for preventing a recurrence of foot ulcers.

  14. Evaluation and selection of materials for plantar orthoses

    OpenAIRE

    Oliveira, André Pereira

    2013-01-01

    Dissertação de mestrado integrado em Engenharia de Materiais A Diabetes Mellitus (DM) é uma patologia do foro metabólico causada pelo défice ou resistência á insulina. Os portadores desta doença podem desenvolver várias complicações neuropáticas, contudo, o pé diabético tem maior destaque pejorativo por sujeitar o paciente à amputação dos membros inferiores. A prevenção deste problema pode ser realizada pela utilização de ortóteses plantares que se ajustem à anatomia do pé, ten...

  15. Microsurgical Reconstruction of Plantar Ulcers of the Insensate Foot.

    Science.gov (United States)

    Kadam, Dinesh

    2016-06-01

    Background Plantar, neuropathic, or trophic ulcers are often found in patients with decreased sensation in the foot. These ulcers can be complicated by infection, deformity, and increased patient morbidity. Excision results in wider defects and local tissues are often insufficient for reconstruction Methods Total 26 free flaps were used in 25 patients to reconstruct plantar ulcers between years 2007 and 2013. The etiology included diabetic neuropathy (n = 13), leprosy (n = 3), spinal/peripheral nerve injury (n = 7), spina bifida (n = 1), and peripheral neuropathy (n = 1). The duration of the ulcer ranged from 1 to 18 years. Fifteen patients had associated systemic comorbidities and six had previous attempts. Free flaps used in reconstruction were the anterolateral thigh flap (n = 18), radial artery forearm flap (n = 4), and the gracilis muscle flap (n = 4). Recipient vessels were the posterior tibial artery (end to side) in 19 and the dorsalis pedis artery in 7. Results The average age at presentation was 44.6 years with mean duration of ulcer of 5.8 years predominantly located over weight-bearing areas. Mean size of ulcer was 59.45 cm(2) and mean follow-up period was 48 months. All flaps survived except a partial loss. Average time to resume ambulation was 6 weeks. Three patients had recurrence with mean follow-up of 48 months. Secondary flap reduction and bony resection was done in four. Conclusion Microvascular reconstruction of the sole has advantages of vascularity, adequate tissue, and leaving rest of the foot undisturbed for offloading. Three significant local conditions influencing selection and transfer of the flap include (1) distally located forefoot ulcers, (2) extensive subcutaneous fibrosis secondary to frequent inflammation, and (3) Charcot arthropathy. In our series, the anterolateral thigh flap is our first choice for reconstruction of these defects.

  16. Dissolution of Plutonium Scrub Alloy and Anode Heel Materials in H-Canyon

    International Nuclear Information System (INIS)

    H-Canyon has a ''gap'' in dissolver operations during the last three months of FY03. One group of material to be processed during the gap is pre-existing scrub alloy material. There are 14 cans of material containing approximately 3.8 kilograms of plutonium. Of the 14 cans, it was anticipated that four cans contain salts, two cans contain anode heel materials, and eight cans contain scrub alloy buttons. H-Canyon desires to process the materials using a flowsheet similar to the SS and C (sand, slag and crucible) dissolution flowsheet used in F-Canyon. The materials will be loaded into carbon steel cans and then placed into aluminum metal charging bundles. Samples were sent to Savannah River Technology Center (SRTC) for characterization and flowsheet testing -- four MSE salts, two anode heels, and seven scrub alloy buttons. SRTC dissolved and characterized each of the samples. Two of them, originally thought to be MSE salts, were found to be graphite mold materials and were unsuitable for processing in H-Canyon. Characterization studies confirmed that the identification of the remaining items as MSE salts, scrub alloy buttons, and anode heel materials was correct. The MSE salts and anode heels solids are comprised primarily of plutonium, potassium, sodium and chloride. Both the MSE salts and anode heels left behind small amounts of residual solids. The scrub alloy buttons are comprised primarily of plutonium and aluminum. The solids dissolve readily with light, effervescent gas generation at the material surface and only trace amounts of NOx generation. Of the seven button samples, four dissolved completely. Two button samples contained small amounts of tantalum that did not dissolve. The last of the seven scrub alloy samples left a trace amount of residual plutonium solids. It is anticipated that the presence of undissolved fissile material is a function of where the sample was located relative to the button surface

  17. Three-dimensional evaluation of heel raise test in pediatric planovalgus feet and normal feet.

    Science.gov (United States)

    Krautwurst, Britta K; Wolf, Sebastian I; Dreher, Thomas

    2016-07-01

    Planovalgus foot is a common pediatric deformity which may be associated with pain. To evaluate flexibility of the foot, the heel raise test is used. During this test the arch and hindfoot are assessed. Several studies have described planovalgus foot based on 3D gait and standing analysis. However, no studies have evaluated foot flexibility during heel raise using an objective 3D analysis. Therefore, the purpose of this study is to evaluate the flexibility of planovalgus feet during the heel raise test using an objective 3D assessment and to determine whether any hypotheses can be generated about potential differences between painful and painless flexible planovalgus feet and reference feet. Here, 3D foot analysis was conducted in 33 children (7 reference feet, 16 painless, and 10 painful flexible planovalgus feet) during the heel raise test. To identify the characteristics of planovalgus foot, the concept of 3D projection angles was used as introduced in the Heidelberg Foot Measurement Method (HFMM), with a modified marker set. All feet showed dynamic movements of the medial arch and hindfoot from valgus to varus position during heel raise. Reference feet had the smallest range of motion, perhaps due to joint stability and absence of foot deformity. Painful and painless flexible planovalgus feet demonstrated similar movements. No significant differences were found between the painful and painless groups. However, the kinematics of the pain group seemed to differ more from those of the reference group than did kinematics of the painless group. This assessment is a new, practical, and objective method to measure the flexibility of small children's feet. PMID:27262407

  18. Effect of medial arch-heel support in inserts on reducing ankle eversion: a biomechanics study

    Directory of Open Access Journals (Sweden)

    Yung Patrick SH

    2008-02-01

    Full Text Available Abstract Background Excessive pronation (or eversion at ankle joint in heel-toe running correlated with lower extremity overuse injuries. Orthotics and inserts are often prescribed to limit the pronation range to tackle the problem. Previous studies revealed that the effect is product-specific. This study investigated the effect of medial arch-heel support in inserts on reducing ankle eversion in standing, walking and running. Methods Thirteen pronators and 13 normal subjects participated in standing, walking and running trials in each of the following conditions: (1 barefoot, and shod condition with insert with (2 no, (3 low, (4 medium, and (5 high medial arch-heel support. Motions were captured and processed by an eight-camera motion capture system. Maximum ankle eversion was calculated by incorporating the raw coordinates of 15 anatomical positions to a self-compiled Matlab program with kinematics equations. Analysis of variance with repeated measures with post-hoc Tukey pairwise comparisons was performed on the data among the five walking conditions and the five running conditions separately. Results Results showed that the inserts with medial arch-heel support were effective in dynamics trials but not static trials. In walking, they successfully reduced the maximum eversion by 2.1 degrees in normal subjects and by 2.5–3.0 degrees in pronators. In running, the insert with low medial arch support significantly reduced maximum eversion angle by 3.6 and 3.1 degrees in normal subjects and pronators respectively. Conclusion Medial arch-heel support in inserts is effective in reducing ankle eversion in walking and running, but not in standing. In walking, there is a trend to bring the over-pronated feet of the pronators back to the normal eversion range. In running, it shows an effect to restore normal eversion range in 84% of the pronators.

  19. Effect of shoe heel height on vastus medialis and vastus lateralis electromyographic activity during sit to stand

    Directory of Open Access Journals (Sweden)

    Hodgson David

    2008-01-01

    Full Text Available Abstract Background It has been proposed that high-heeled shoes may contribute to the development and progression of knee pain. However, surprisingly little research has been carried out on how shoe heel height affects muscle activity around the knee joint. The purpose of this study was to investigate the effect of differing heel height on the electromyographic (EMG activity in vastus medialis (VM and vastus lateralis (VL during a sit to stand activity. This was an exploratory study to inform future research. Methods A repeated measures design was used. Twenty five healthy females carried out a standardised sit to stand activity under 4 conditions; barefoot, and with heel wedges of 1, 3, and 5 cm in height. EMG activity was recorded from VM and VL during the activity. Data were analysed using 1 × 4 repeated measures ANOVA. Results Average rectified EMG activity differed with heel height in both VM (F2.2, 51.7 = 5.24, p 3, 72 = 5.32, p 3, 72 = 0.61, p = 0.609. Conclusion We found that as heel height increased, there was an increase in EMG activity in both VM and VL, but no change in the relative EMG intensity of VM and VL as measured by the VM: VL ratio. This showed that no VM: VL imbalance was elicited. This study provides information that will inform future research on how heel height affects muscle activity around the knee joint.

  20. The Role of Arch Compression and Metatarsophalangeal Joint Dynamics in Modulating Plantar Fascia Strain in Running

    OpenAIRE

    McDonald, Kirsty A.; Sarah M. Stearne; Alderson, Jacqueline A.; North, Ian; Pires, Neville J.; Rubenson, Jonas

    2016-01-01

    Elastic energy returned from passive-elastic structures of the lower limb is fundamental in lowering the mechanical demand on muscles during running. The purpose of this study was to investigate the two length-modulating mechanisms of the plantar fascia, namely medial longitudinal arch compression and metatarsophalangeal joint (MPJ) excursion, and to determine how these mechanisms modulate strain, and thus elastic energy storage/return of the plantar fascia during running. Eighteen runners (9...

  1. Surface effects on in-shoe plantar pressure and tibial impact during running

    OpenAIRE

    Weijie Fu; Ying Fang; David Ming Shuo Liu; Lin Wang; Sicong Ren; Yu Liu

    2015-01-01

    Purpose: This study aims to explore the effects of running on different surfaces on the characteristics of in-shoe plantar pressure and tibial acceleration. Methods: Thirteen male recreational runners were required to run at 12 km/h velocity on concrete, synthetic track, natural grass, a normal treadmill, and a treadmill equipped with an ethylene vinyl acetate (EVA) cushioning underlay (treadmill_EVA), respectively. An in-shoe plantar pressure system and an accelerometer attached to the ti...

  2. How Plantar Exteroceptive Efficiency Modulates Postural and Oculomotor Control: Inter-Individual Variability.

    Science.gov (United States)

    Foisy, Arnaud; Kapoula, Zoï

    2016-01-01

    In a previous experiment, we showed that among young and healthy subjects, thin plantar inserts improve postural control and modify vergence amplitudes. In this experiment, however, significant inter-individual variability was observed. We hypothesize that its origin could be attributed to a different reliance upon feet cutaneous afferents. In order to test this hypothesis, we re-analyzed the data relative to 31 young (age 25.7 ± 3.8) and healthy subjects who participated in the first experiment after having classified them into two groups depending on their Plantar Quotient (PQ = Surface area of CoPfoam/Surface area of CoPfirm ground × 100). Foam decreases the information arising from the feet, normally resulting in a PQ > 100. Hence, the PQ provides information on the weight of plantar cutaneous afferents used in postural control. Twelve people were Plantar-Independent Subjects, as indicated by a PQ postural control and totally insensitive in terms of oculomotor control. We conclude that the inter-individual variability observed in our first experiment is explained by the subjects' degree of plantar reliance. We propose that plantar independence is a dysfunctional situation revealing inefficiency in plantar cutaneous afferents. The latter could be due to a latent somatosensory dysfunction generating a noise which prevents the CNS from correctly processing and using feet somatosensory afferents both for balance and vergence control: Plantar Irritating Stimulus. Considering the non-noxious nature and prevalence of this phenomenon, these results can be of great interest to researchers and clinicians who attempt to trigger postural or oculomotor responses through mechanical stimulation of the foot sole.

  3. Effects of 12-wk eccentric calf muscle training on muscle-tendon glucose uptake and SEMG in patients with chronic Achilles tendon pain

    DEFF Research Database (Denmark)

    Masood, Tahir; Kalliokoski, Kari; Magnusson, S Peter;

    2014-01-01

    and Achilles tendon GU. A longitudinal study design with control (n = 10) and patient (n = 10) groups was used. Surface electromyography (SEMG) from four ankle plantar flexors and GU from the same muscles and the Achilles tendon were measured during submaximal intermittent isometric plantar flexion task......High-load eccentric exercises have been a key component in the conservative management of chronic Achilles tendinopathy. This study investigated the effects of a 12-wk progressive, home-based eccentric rehabilitation program on ankle plantar flexors' glucose uptake (GU) and myoelectric activity...

  4. 学龄前肥胖儿童足底压力分布特征研究%Study on Plantar Pressure Characteristics of Obese Preschool Children

    Institute of Scientific and Technical Information of China (English)

    陈谦; 杨红春; 周建伟

    2013-01-01

    Objective:The present study was to explore the adverse effect of obesity on plantar morphology in 4-6 years old preschool children by analyzing the characteristics of plantar pressure distribution between obese and normal children, and to make some intervene suggestions. Methods: According to the obesity-related definitions by WHO, 47 obese children from 4 district kindergartens in Zhejiang Province were chose to be studied as obese preschool subject. Meanwhile, 47 ordinary children were chose as normal subject corresponding to the gender and age. The research instruments were Inbody J20 (Korea) and Rscan (Belgium). The differences of contact time(CT), contact area(CA), peak pressure(PP) between these two groups were investigated to explore the impact of obesity on plantar pressure. Results: The contact time of obese children during walking was longer than that of normal group. The contact area and peak pressure of heel and metatarsal of the obesities were higher that those of the normal. Especially the difference of CT and PP in the arch region between these two groups was more remarkable. Conclusions: The obese children performing the body buffering and the taking off were not as good as the normal children. And they displayed poor stability. The characteristics of plantar pressure in obese children were closer to those of flatfoot gait and should be paid more attentions.%目的:分析了学龄前肥胖与正常儿童(4~6岁)自然行走时足底压力的分布特征,旨在探讨肥胖对儿童足部形态的不利影响,进而提出干预措施.方法:采用韩国Inbody J20和比利时Rsscan足底压力板测试系统对浙江省4所不同地市幼儿园的691名4~6岁学龄前儿童进行测量.根据WHO的相关定义,筛选出47人为肥胖儿童组,按性别和年龄配对随机抽取体重正常儿童47人为正常组,分别研究在接触时间、接触面积、压力峰值等指标方面的差异,来探索肥胖对足底压力的影响.结果:肥胖

  5. 基于F-Scan三维动态足底压力分析系统的动静态足底压力分析%Static and dynamic plantar pressure analysis by F-Scan three-dimensional dynamic plantar pressure analysis system

    Institute of Scientific and Technical Information of China (English)

    樊霄燕; 周军杰; 曹成福; 陈贤奇

    2011-01-01

    lateral heel (P < 0.01). For the outs preferred right foot, the mean peak force value of greattoe. The first and second metatarsafc. The inner and outer heel regiors of the right footwas larger than that of the left foot (P<0.05). While the mean pe* value of the frith metatarsal. Two foot arch regions of the left footwas larger than that of the right foot (P< 0.05). During waking, the load centers in the whole foot contact phase and the outside-grcundphasewttethefiEt and second metataisafc. The inner and outer heel regions. The modmum load park of foot were the first and second mttetarsak. The inner and outer httl regions. Tht distribution regularity of left foot was similar to that of the right foot and there was no difference between genders. In conclusion, there k a consistency in the attribution regularities of tht lift and rightfoot static and dynamic plantar pressure analysis in the healthy adolescent soccer players.

  6. Plantar Pressures During Long Distance Running: An Investigation of 10 Marathon Runners

    Directory of Open Access Journals (Sweden)

    Erik Hohmann, Peter Reaburn, Kevin Tetsworth, Andreas Imhoff

    2016-06-01

    Full Text Available The objective of this study was to record plantar pressures using an in-shoe measuring system before, during, and after a marathon run in ten experienced long-distance runners with a mean age of 37.7 ± 11.5 years. Peak and mean plantar pressures were recorded before, after, and every three km during a marathon race. There were no significant changes over time in peak and mean plantar pressures for either the dominant or non-dominant foot. There were significant between foot peak and mean plantar pressure differences for the total foot (p = 0.0001, forefoot (p = 0.0001, midfoot (p = 0.02 resp. p = 0.006, hindfoot (p = 0.0001, first ray (p = 0.01 resp. p = 0.0001 and MTP (p = 0.05 resp. p = 0.0001. Long-distance runners do not demonstrate significant changes in mean or peak plantar foot pressures over the distance of a marathon race. However, athletes consistently favoured their dominant extremity, applying significantly higher plantar pressures through their dominant foot over the entire marathon distance.

  7. Plantar Pressures During Long Distance Running: An Investigation of 10 Marathon Runners

    Science.gov (United States)

    Hohmann, Erik; Reaburn, Peter; Tetsworth, Kevin; Imhoff, Andreas

    2016-01-01

    The objective of this study was to record plantar pressures using an in-shoe measuring system before, during, and after a marathon run in ten experienced long-distance runners with a mean age of 37.7 ± 11.5 years. Peak and mean plantar pressures were recorded before, after, and every three km during a marathon race. There were no significant changes over time in peak and mean plantar pressures for either the dominant or non-dominant foot. There were significant between foot peak and mean plantar pressure differences for the total foot (p = 0.0001), forefoot (p = 0.0001), midfoot (p = 0.02 resp. p = 0.006), hindfoot (p = 0.0001), first ray (p = 0.01 resp. p = 0.0001) and MTP (p = 0.05 resp. p = 0.0001). Long-distance runners do not demonstrate significant changes in mean or peak plantar foot pressures over the distance of a marathon race. However, athletes consistently favoured their dominant extremity, applying significantly higher plantar pressures through their dominant foot over the entire marathon distance. Key points Fatigue does not increase foot pressures Every runner has a dominant foot where pressures are higher and that he/she favours Foot pressures do not increase over the distance of a marathon run PMID:27274662

  8. Estudo retrospectivo do tratamento cirúrgico do neuroma de morton por via plantar Retrospective study of surgery treatment im monrton's neuroma by plantar approach

    OpenAIRE

    Gustavo Gennari Barbosa; Gustavo Maluf Tiradentes; Helencar Ignácio; Guaracy de Carvalho Filho; Alceu Gomes Chueire

    2005-01-01

    Com o propósito de avaliar a eficácia da técnica cirúrgica - neurectomia por via plantar -, em portadores de neuroma de Morton, 19 pacientes foram submetidos a esse tratamento. Portanto, foram 19 neuromas, sendo 84,3% do sexo feminino, 15,7% do sexo masculino; 31,5% no segundo espaço intermetatarsal, 68,5% no terceiro; 47,3% no lado direito e 52,7% no esquerdo. A cirurgia foi realizada por via plantar em todos os casos, com tempo médio de acompanhamento de 9 meses, e o resultado foi considera...

  9. Mathematical model establishment of irregular plantar surface of ostrich didactyl foot%鸵鸟足底非规则曲面形貌数学模型构建

    Institute of Scientific and Technical Information of China (English)

    张锐; 杨明明; 潘润铎; 刘海宝; 曾桂银; 李建桥

    2015-01-01

    walking or running in the desert, the third toe supports the heavy weight and provides locomotor propulsion, while the fourth toe maintains balance as an outrigger. Therefore, the mathematical model of the third toe plantar surface of ostrich foot was studied. The ostrich foot of an adult male ostrich was gained from Changchun Lushengyuan mountain villa, Jilin Province, P.R. China. The geometric point clouds of the ostrich foot were obtained by using a 3D hand-held non-contact laser scanner. And then, the point cloud data were imported into Geomagic Studio software to analyze and reconstruct. Using the cutting function of the software, the reconstructed model of the third toe plantar surface of ostrich foot was divided into three typical characteristic areas, including the forefoot gradual surface, the middle groove and the heel spherical cap. In order to reduce the amount of calculation of the fitting curved surfaces, the digitized shape editor module of CATIA was utilized to filter the dense point clouds and retain the characteristic points. The retained characteristic points could reflect the third toe plantar surface morphology of ostrich foot through adopting the reasonable filtering way. The 3D characteristic point data of the three typical characteristic areas were then exported. The forefoot gradual surface and the middle groove were fitted by using the surface fitting module of MATLAB software. The equations of the curved surfaces and the solution fitted parameters were achieved. Because the heel spherical cap looked like a part of an ellipsoid from appearance, an ellipsoid model was used to fit the heel spherical cap by using the nonlinear regression module of SAS software. The fitted solution parameters of three curved surfaces were satisfactory, R2 is the parameter for measuring the mathematical model conformed to original model or not. The fitting results would be more accurate if R2 is more close to 1. According to the fitting results R2 of three curved

  10. Distribuição da força plantar e oscilação do centro de pressão em relação ao peso e posicionamento do material escolar Plantar force distribution and pressure center oscillation in relation to the weight and positioning of school supplies and books in student's backpack

    Directory of Open Access Journals (Sweden)

    S Rodrigues

    2008-02-01

    Full Text Available OBJETIVO: Investigou-se a influência da carga e posicionamento do material escolar sobre a distribuição da força plantar (DFP e trajetória do centro de pressão (COP em estudantes. MÉTODOS: Participaram 30 voluntários (10,7 ± 1,35 anos, ambos os gêneros, sem alteração postural. Dados baropodométricos foram coletados em sistema de baropodometria computadorizada (Matscan Research, Teckscanâ, 5.72: sem carga (controle; com carga (mochila de 5, 10 e 15% da massa corporal, posicionada nas regiões anterior e posterior do tronco, ombro direito e esquerdo. RESULTADOS: Sem carga, a DFP foi maior no calcâneo esquerdo comparado ao direito (pOBJECTIVE: The influence of the weight and positioning of school supplies and books in backpacks, on plantar force distribution (PFD and pressure center location, was investigated among students. METHODS: Thirty volunteers of both genders participated in the study. Their mean age was 10.76 (± 1.35 years and none of them had postural abnormalities. Baropodometric data were collected using a computerized baropodometric system (Matscan Research, Tekscanâ, 5.72: without load (control and with loads of 5, 10 and 15% of body weight in a backpack, positioned on the back, on the chest and on the right and left shoulders. RESULTS: The PFD without load was greater on the left heel than on the right heel (p< 0.05. With a load of 10% on the left shoulder, the PFD was greater on the right and smaller on the left foot, in comparison with the control (p< 0.05. With a load of 5% on the back, the PFD was smaller on the right midfoot (RMF and left forefoot (lff; with 10%, it was smaller on the RMF and left midfoot (LMF and greater on the right toes (RT; with 15%, it was smaller on the RMF and greater on the RT (p< 0.05. The plantar force was greater on the RT with loads of 10% and 15% than it was with loads of 5% (p< 0.05. With loads of 15% on the back and on the chest, the pressure center displacement was greater than

  11. EFFECT OF SECOND TOE-TO-HAND TRANSFER ON THE PLANTAR PRESSURE DISTRIBUTION OF THE DONOR FOOT

    OpenAIRE

    Li, Bing; Chen, Da-Wei; Yang, Yun-feng; Yu, Guang-rong

    2016-01-01

    ABSTRACT Objective: To investigate the effect of second toe-to-hand transfer on the plantar pressure distribution of the donor foot. Methods: Twelve normal fresh-frozen cadaveric foot specimens were subjected to an axial load of 600 N. An F-Scan plantar pressure analysis system was used to measure the forefoot plantar pressure. The testing was performed under the conditions of intact second toe, second toe removal with the second metatarsal head reserved, and second toe removal in combination...

  12. Accelerations due to impact at heel strike using below-knee prosthesis.

    Science.gov (United States)

    Van Jaarsveld, H W; Grootenboer, H J; De Vries, J

    1990-08-01

    The acceleration in the sagittal plane of the prosthetic tube at heel strike in normal walking was measured in five healthy amputees with their definitive below-knee prosthesis, every subject using six different prosthetic feet, wearing sport shoes as well as leather shoes. The experiments were carried out in the rehabilitation centre "Het Roessingh", Enschede, The Netherlands. Maximum accelerations were extracted from the acceleration-time-signal. Mean acceleration maxima of all subjects were calculated for each foot-shoe combination to eliminate the individual influence of the subjects. In the axial direction the maximal accelerations demonstrate a clear difference among the prosthetic feet and the shoes, while in dorsoventral (tangential) direction the inter-individual variation in the acceleration extremes dominates the difference between the types of footwear. In comparison with non-amputees the magnitude of the maximal axial acceleration at heel strike does not differ significantly. PMID:2235301

  13. 冲击波对足底筋膜炎疼痛及功能的即时疗效分析及筋膜形态学与疼痛的网络相关性研究%Study on Instant Efficacy of Pain and Function in Plantar Fasciitis Treated with Shock Wave and Correlation in Fascia Morphology and Pain Network

    Institute of Scientific and Technical Information of China (English)

    李建新; 方建辉; 邓建林; 张志杰

    2014-01-01

    Objective:To analyze the instant efficacy of pain and function in plantar fasciitis treated with extracorporeal shock wave, and to explore the correlation in fascia morphology and pain network. Methods:20 cases of patients with chronic plantar fasciitis were all treated with shock wave, before and after treatment the degree of pain was respectively evaluated with Visual Analogue Scale (VAS), distance of single leg jumping was test-ed, and plantar fascia thickness was measured with musculoskeletal ultrasound, to analyze the correlation between plantar fascia thickness and degree of pain. Results:After treatment shock wave VAS score and single leg jumping distance were both significantly better than those before treatment (P<0.05);the plantar fascia thickness had positive correlation with VAS score, which meant the thicker the plantar fascia, the more serious the pain. Con-clusion:Instant efficacy of shock wave in chronic plantar fasciitis is remarkable, and plantar fascia thickness has certain correlation with pain.%目的:分析体外冲击波治疗对足底筋膜炎疼痛及功能的即时疗效,并探讨筋膜形态学与疼痛的相关性。方法:20例慢性足底筋膜炎患者均采用冲击波治疗,分别于治疗前后采用视觉模拟评分法(Visual Analogue Scale,VAS)对患者的疼痛程度进行评价,测试单腿跳跃距离,并应用肌骨超声测量足底筋膜厚度,分析足底筋膜厚度与疼痛程度的相关性。结果:经冲击波治疗后,患者的VAS评分及单腿跳跃距离均较治疗前显著改善(P<0.05);足底筋膜厚度与VAS评分呈正相关,即足底筋膜越厚,疼痛越严重。结论:冲击波治疗慢性足底筋膜炎即时疗效显著,且足底筋膜厚度与疼痛有一定相关性。

  14. The Role of Arch Compression and Metatarsophalangeal Joint Dynamics in Modulating Plantar Fascia Strain in Running.

    Directory of Open Access Journals (Sweden)

    Kirsty A McDonald

    Full Text Available Elastic energy returned from passive-elastic structures of the lower limb is fundamental in lowering the mechanical demand on muscles during running. The purpose of this study was to investigate the two length-modulating mechanisms of the plantar fascia, namely medial longitudinal arch compression and metatarsophalangeal joint (MPJ excursion, and to determine how these mechanisms modulate strain, and thus elastic energy storage/return of the plantar fascia during running. Eighteen runners (9 forefoot and 9 rearfoot strike performed three treadmill running trials; unrestricted shod, shod with restricted arch compression (via an orthotic-style insert, and barefoot. Three-dimensional motion capture and ground reaction force data were used to calculate lower limb kinematics and kinetics including MPJ angles, moments, powers and work. Estimates of plantar fascia strain due to arch compression and MPJ excursion were derived using a geometric model of the arch and a subject-specific musculoskeletal model of the plantar fascia, respectively. The plantar fascia exhibited a typical elastic stretch-shortening cycle with the majority of strain generated via arch compression. This strategy was similar in fore- and rear-foot strike runners. Restricting arch compression, and hence the elastic-spring function of the arch, was not compensated for by an increase in MPJ-derived strain. In the second half of stance the plantar fascia was found to transfer energy between the MPJ (energy absorption and the arch (energy production during recoil. This previously unreported energy transfer mechanism reduces the strain required by the plantar fascia in generating useful positive mechanical work at the arch during running.

  15. The Role of Arch Compression and Metatarsophalangeal Joint Dynamics in Modulating Plantar Fascia Strain in Running.

    Science.gov (United States)

    McDonald, Kirsty A; Stearne, Sarah M; Alderson, Jacqueline A; North, Ian; Pires, Neville J; Rubenson, Jonas

    2016-01-01

    Elastic energy returned from passive-elastic structures of the lower limb is fundamental in lowering the mechanical demand on muscles during running. The purpose of this study was to investigate the two length-modulating mechanisms of the plantar fascia, namely medial longitudinal arch compression and metatarsophalangeal joint (MPJ) excursion, and to determine how these mechanisms modulate strain, and thus elastic energy storage/return of the plantar fascia during running. Eighteen runners (9 forefoot and 9 rearfoot strike) performed three treadmill running trials; unrestricted shod, shod with restricted arch compression (via an orthotic-style insert), and barefoot. Three-dimensional motion capture and ground reaction force data were used to calculate lower limb kinematics and kinetics including MPJ angles, moments, powers and work. Estimates of plantar fascia strain due to arch compression and MPJ excursion were derived using a geometric model of the arch and a subject-specific musculoskeletal model of the plantar fascia, respectively. The plantar fascia exhibited a typical elastic stretch-shortening cycle with the majority of strain generated via arch compression. This strategy was similar in fore- and rear-foot strike runners. Restricting arch compression, and hence the elastic-spring function of the arch, was not compensated for by an increase in MPJ-derived strain. In the second half of stance the plantar fascia was found to transfer energy between the MPJ (energy absorption) and the arch (energy production during recoil). This previously unreported energy transfer mechanism reduces the strain required by the plantar fascia in generating useful positive mechanical work at the arch during running.

  16. Radiation therapy for painful heel spurs. Results of a prospective randomized study

    Energy Technology Data Exchange (ETDEWEB)

    Heyd, R.; Tselis, N.; Roeddiger, S.J.; Zamboglou, N. [Dept. of Radiotherapy, Klinikum Offenbach (Germany); Ackermann, H. [Dept. of Biomathematics, Univ. Hospital, J.W. Goethe Univ. Frankfurt/Main (Germany)

    2007-01-15

    Purpose: to evaluate the efficacy of two different dose-fractionation schedules for radiation therapy (RT) in patients with painful heel spurs. Patients and methods: 130 patients were randomized into two groups: the low-dose (LD) group (n = 65 heels) received a total dose of 3.0 Gy given in two weekly fractions of 0.5 Gy; in the high-dose (HD) group (n = 65 heels), two weekly fractions of 1.0 Gy were applied over 3 weeks (total dose 6.0 Gy). In 24 sites of the HD group and 17 sites of the LD group, a second RT course was given. The results were assessed using a five-level function score which was documented before RT, at the end of each RT course, and at 6 weeks and 6 months thereafter. Results: at 6-month follow-up, RT led to a highly significant reduction of symptoms in both groups. In the HD group, 31 sites were classified as excellent (score: 90-100), 13 as good (score: 70-85), twelve as moderate (score: 45-65), and nine as poor (score: 0-40). In the LD group, 35 sites were classified as excellent, eight as good, ten as moderate, and twelve as poor. The comparison of the difference of the sum score and the single criteria before RT and at 6 months after RT using the Wilcoxon-Mann-Whitney U-test revealed no statistically significant difference of response to RT between both groups. Conclusion: RT is an effective treatment option for the management of inflammatory heel spurs. The dose for an RT course should not exceed 3.0 Gy. (orig.)

  17. Radiation therapy for painful heel spurs. Results of a prospective randomized study

    International Nuclear Information System (INIS)

    Purpose: to evaluate the efficacy of two different dose-fractionation schedules for radiation therapy (RT) in patients with painful heel spurs. Patients and methods: 130 patients were randomized into two groups: the low-dose (LD) group (n = 65 heels) received a total dose of 3.0 Gy given in two weekly fractions of 0.5 Gy; in the high-dose (HD) group (n = 65 heels), two weekly fractions of 1.0 Gy were applied over 3 weeks (total dose 6.0 Gy). In 24 sites of the HD group and 17 sites of the LD group, a second RT course was given. The results were assessed using a five-level function score which was documented before RT, at the end of each RT course, and at 6 weeks and 6 months thereafter. Results: at 6-month follow-up, RT led to a highly significant reduction of symptoms in both groups. In the HD group, 31 sites were classified as excellent (score: 90-100), 13 as good (score: 70-85), twelve as moderate (score: 45-65), and nine as poor (score: 0-40). In the LD group, 35 sites were classified as excellent, eight as good, ten as moderate, and twelve as poor. The comparison of the difference of the sum score and the single criteria before RT and at 6 months after RT using the Wilcoxon-Mann-Whitney U-test revealed no statistically significant difference of response to RT between both groups. Conclusion: RT is an effective treatment option for the management of inflammatory heel spurs. The dose for an RT course should not exceed 3.0 Gy. (orig.)

  18. The effect of melody on the physiological responses of heel sticks pain in neonates

    OpenAIRE

    Marofi, Maryam; Nikobakht, Farzaneh; Badiee, Zohreh; Golchin, Mehri

    2015-01-01

    Background: During health care in the neonatal intensive care unit (NICU), infants undergo extremely painful procedures, which may cause problems, if not controlled, such as changes in the pattern of respiratory rate, heart rate, and blood oxygen saturation. The present study aimed to find the effect of melody on the physiological responses of neonates’ heel stick pain. Materials and Methods: This quasi-experimental study was conducted in Alzahra Hospital (Isfahan, Iran) for 5 months. Fifty i...

  19. An investigation into plantar pressure measurement protocols for footwear research.

    Science.gov (United States)

    Melvin, J M A; Preece, S; Nester, C J; Howard, D

    2014-09-01

    Many researchers investigate how footwear design affects plantar pressure (PP) and ask participants to walk in unfamiliar footwear as part of their studies. However, there are no clear guidelines for the required period of time or number of steps a healthy participant requires to acclimatise to unfamiliar footwear. Nor are there clear guidelines for how many steps should be collected to produce data that is representative of gait in each particular shoe being tested. There were therefore two aims to this study: (1) to investigate the number of steps required to produce an average step that is representative of normal gait; (2) to investigate the number of steps required for a participant to acclimatise to a range of footwear types. PP data were collected in 20 healthy participants whilst they walked for 400 m in a range of footwear. The results showed that the number of steps required for both acclimatisation and to ensure data quality are dependent on shoe type and the foot region being investigated. It is recommended that 30 steps from one foot are collected during data collection and an acclimatisation period of at least 166 steps is given for each shoe condition. The former recommendation is not met by most studies in the literature.

  20. Anatomic Reconstruction Technique for a Plantar Calcaneonavicular (Spring) Ligament Tear.

    Science.gov (United States)

    Palmanovich, Ezequiel; Shabat, Shay; Brin, Yaron S; Feldman, Viktor; Kish, Benny; Nyska, Meir

    2015-01-01

    Acquired flatfoot deformity in adults is usually due to partial or complete tearing of the posterior tibial tendon, with secondary failure of other structures such as the plantar calcaneonavicular (spring) ligament (SL), which maintain the medial longitudinal arch. In flexible cases, the tibialis posterior can be replaced with the flexor digitorum longus. It is common practice to suture the SL directly in the case of a tear; however, if the tear is complete, suturing directly to the ligament alone will not be possible. Reconstruction of the ligament is needed; however, no validated methods are available to reconstruct this ligament. The operative technique of SL reconstruction described in this report as a part of acquired flatfoot deformity reconstruction consists of augmenting remnants of the spring from the navicularis to the sustentaculum tali and suspending it to the medial malleolus using 2-mm-wide, long-chain polyethylene suture tape. This technique results in the firm anatomic reconstruction of the SL, in addition to "classic" medial arch reconstruction. We recommend SL reconstruction for medial arch reconstruction when the SL is torn. PMID:26253476

  1. Design and Reliability of a Novel Heel Rise Test Measuring Device for Plantarflexion Endurance

    Directory of Open Access Journals (Sweden)

    Amy D. Sman

    2014-01-01

    Full Text Available Background. Plantarflexion results from the combined action of the soleus and gastrocnemius muscles in the calf. The heel rise test is commonly used to test calf muscle endurance, function, and performance by a wide variety of professionals; however, no uniform description of the test is available. This paper aims to document the construction and reliability of a novel heel rise test device and measurement protocol that is suitable for the needs of most individuals. Methods. This device was constructed from compact and lightweight materials and is fully adjustable, enabling the testing of a wide variety of individuals. It is easy to assemble and disassemble, ensuring that it is portable for use in different settings. Findings. We tested reliability on 40 participants, finding excellent interrater reliability (ICC2,1 0.97, 95% CI: 0.94 to 0.98. Limits of agreement were less than two repetitions in 90% of cases and the Bland-Altman plot showed no bias. Interpretation. We have designed a novel, standardized, simple, and reliable device and measurement protocol for the heel rise test which can be used by researchers and clinicians in a variety of settings.

  2. Influence of shoes and heel strike on the loading of the hip joint.

    Science.gov (United States)

    Bergmann, G; Kniggendorf, H; Graichen, F; Rohlmann, A

    1995-07-01

    The forces and moments acting at the hip joint influence the long-term stability of the fixation of endoprostheses and the course of coxarthrosis. These loads may depend on the kind of footwear and the walking or running style. These factors were investigated in a patient with instrumented hip implants. He wore different sports shoes, normal leather shoes, hiking boots and clogs and walked barefoot with soft, normal and hard heel strikes. The loads were lowest while walking and jogging without shoes. All shoes increased the joint force and the bending moment at the implant slightly but the torsional moment rose by up to 50%. No relation was found between the different type of shoes and the load increase, only shoes with very hard soles were clearly disadvantageous. Soft heels, soles or insoles did not offer advantages. Gait stability seems to play the most important role in increasing the joint loading and should be the criterion for the choice of footwear. Smooth gait patterns with soft heel strikes are the only means to reduce joint loading during slow jogging. PMID:7657680

  3. Dynamic material characterization of the human heel pad based on in vivo experimental tests and numerical analysis.

    Science.gov (United States)

    Kardeh, M; Vogl, T J; Huebner, F; Nelson, K; Stief, F; Silber, G

    2016-09-01

    A numerical-experimental, proof-of-concept approach is described to characterize the mechanical material behavior of the human heel pad under impact conditions similar to a heel strike while running. A 3D finite-element model of the right foot of a healthy female subject was generated using magnetic resonance imaging. Based on quasi-static experimental testing of the subject's heel pad, force-displacement data was obtained. Using this experimental data as well as a numerical optimization algorithm, an inverse finite-element analysis and the 3D model, heel pad hyperelastic (long-term) material parameters were determined. Applying the same methodology, based on the dynamic experimental data from the impact test and obtained long-term parameters, linear viscoelastic parameters were established with a Prony series. Model validation was performed employing quasi-static and dynamic force-displacement data. Coefficients of determination when comparing model to experimental data during quasi-static and dynamic (initial velocity: 1480mm/s) procedure were R(2) = 0.999 and R(2) = 0.990, respectively. Knowledge of these heel pad material parameters enables realistic numerical analysis to evaluate internal stress and strain in the heel pad during different quasi-static or dynamic load conditions.

  4. Experience with extracorporeal shock wave therapy (ESWT) in the United States

    Science.gov (United States)

    Furia, John P.

    2005-04-01

    The purpose of this presentation is to summarize the literature and to report on single treatment, high-energy ESWT for the treatment of chronic plantar fasciitis and lateral epicondylitis. Fifty-three patients (60 heels) were treated with 3800 shock waves. Sixteen patients (19 heels) were active, 21 (22 heels), were moderately active, and 16 (19 heels) were sedentary. Twelve weeks post treatment, mean visual analog scores (VAS) for the entire group improved from 9.2 to 2.4 (pplantar fasciitis and lateral epicondylitis.

  5. 汗渍性跖部红斑疼痛症16例临床分析%Clinical analysis of 16 cases of sweat-soaking painful plantar erythema

    Institute of Scientific and Technical Information of China (English)

    范晴

    2012-01-01

    Objective To study the clinical features and relevant risk factors with sweat-soaking painful plantar erythema. Methods The clinical data on 16 patients were retrospectively collected and analyzed. Results Soldiers and children were common and the male incidence than women. The disease occured in the late autumn and early winter. The lesions showed edematous and tender erythema in plantar toe, heel, arch and toe web and the lesions in the evolution of a certain regularity. Conclusion This disease was associated with foot sweating and personal hygiene, climatic factors, mechanical stimuli.%目的 探讨和分析汗渍性跖部红斑疼痛症临床特征和发病的相关因素.方法 对16例汗渍性跖部红斑疼痛症患者的临床资料进行回顾性分析.结果 部队战士和儿童好发汗渍性跖部红斑疼痛症,男性发病率高于女性,好发于秋末冬初.临床表现为足跖、趾腹、足弓和足跟部位的水肿性疼痛性红斑,皮损演变具有一定的规律性.结论 本病与足部多汗和个人卫生、气候因素、机械性刺激等有关.

  6. Effects of mat characteristics on plantar pressure patterns and perceived mat properties during landing in gymnastics.

    Science.gov (United States)

    Pérez-Soriano, Pedro; Llana-Belloch, Salvador; Morey-Klapsing, Gaspar; Perez-Turpin, Jose Antonio; Cortell-Tormo, Juan Manuel; van den Tillaar, Roland

    2010-11-01

    Shock absorption and stability during landings is provided by both, gymnast ability and mat properties. The aims of this study were to determine the influence of different mat constructions on their energy absorption and stability capabilities, and to analyse how these properties affect gymnast's plantar pressures as well as subjective mat perception during landing. Six mats were tested using a standard mechanical drop test. In addition, plantar pressures and subjective perception during landing were obtained from 15 expert gymnasts. The different mats influenced plantar pressures and gymnasts' subjective perception during landing of gymnasts. Significant correlations between plantar pressures at the medial metatarsal and lateral metatarsal zones of the gymnasts' feet with the different shock absorption characteristics of the mats were found. However, subjective perception tests were not able to discriminate mat functionality between the six mats as no significant correlations between the mechanical mat properties with the subjective perception of these properties were found. This study demonstrated that plantar pressures are a useful tool for discriminating different landing mats. Using similar approaches, ideally including kinematics as well, could help us in our understanding about the influences of different mats upon gymnast-mat interaction. PMID:21309299

  7. EFFECTIVENESS OF DIADYNAMIC CURRENT AND MENS IN HEEL PAIN: A RANDOMIZED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    Anand B. Heggannavar

    2015-04-01

    Full Text Available Relevance: Heel pain is one of the most common conditions leading to functional disabilities seen worldwide. There are different methods to manage heel pain, conservatively, and/or surgically. Physiotherapy treatment, as a part of conservative management, involves reduction of pain and improvement of functional ability by various approaches like exercise therapy, electrotherapy and manual therapy techniques. Various studies have shown that Diadynamic current and MENS along with conventional treatments give significant beneficial effects in pain reliving. Hence the present study was undertaken to compare and see the effect of Diadynamic current and MENS in heel pain. Participants: 30 subjects (mean age 25.73 ± 6.56 diagnosed with heel pain were recruited from Out-Patient Department of Physiotherapy of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi. Method: Subjects were randomly allocated into 2 groups namely Group A (n=15 who received Diadynamic current along with conventional treatment as Therapeutic ultrasound and strengthening and stretching exercises and Group B (n=15 who received MENS with conventional treatment same as in group A for 7 days. The outcome measures were Visual Analog Scale (VAS for pain, Pain disability index (PDI and foot disability index (FDI for functional disability. Analysis: Within group and between group analyses after intervention was done to assess changes using paired t-test and unpaired t - test. Result: Mean difference of VAS scores for Group A was 6.9 ± 1.48 and for Group B was 4.3 ± 2.43. Mean difference of PDI scores for Group A was 274 ± 117 and for Group B was 171 ± 99.Mean difference of FDI scores for Group A was 0.36 ± 0.24 and for Group B was 0.15 ± 0.15. Intra group comparison was statistically significant with p= <0.001 for both the groups in terms of VAS, PDI and FDI respectively. Inter group comparison was statistically significant with p= 0.005, 0.031, 0.007 for VAS, PDI

  8. Effects of plantar-flexor muscle fatigue on the magnitude and regularity of center-of-pressure fluctuations

    NARCIS (Netherlands)

    Roerdink, M.; Hlavackova, P.; Vuillerme, N.

    2011-01-01

    Control of bipedal posture is highly automatized but requires attentional investment, the amount of which varies between participants and with postural constraints, such as plantar-flexor muscle fatigue. Elevated attentional demands for standing with fatigued plantar flexors have been demonstrated u

  9. HPV type in plantar warts influences natural course and treatment response: Secondary analysis of a randomised controlled trial

    NARCIS (Netherlands)

    Bruggink, S.C.; Gussekloo, J.; Koning, M.N. de; Feltkamp, M.C.; Bavinck, J.N.; Quint, W.G.V.; Assendelft, W.J.J.; Eekhof, J.A.H.

    2013-01-01

    BACKGROUND: Cryotherapy is effective for common warts, but for plantar warts available treatments often fail. OBJECTIVES: Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-

  10. Predictive MRI correlates of lesser metatarsophalangeal joint plantar plate tear

    Energy Technology Data Exchange (ETDEWEB)

    Umans, Rachel L. [Cornell University Medical College, New York, NY (United States); Umans, Benjamin D. [Harvard University, Cambridge, MA (United States); Umans, Hilary [Albert Einstein College of Medicine, Bronx, NY (United States); Lenox Hill Radiology and Imaging Associates, New York, NY (United States); Elsinger, Elisabeth [Albert Einstein College of Medicine, Bronx, NY (United States); Montefiore Medical Center, Bronx, NY (United States)

    2016-07-15

    To identify correlated signs on non-enhanced MRI that might improve diagnostic detection of plantar plate (PP) tear. We performed an IRB-approved, HIPAA-compliant retrospective analysis of 100 non-contrast MRI (50 PP tear, 50 controls). All were anonymized, randomized, and reviewed; 20 were duplicated to assess consistency. One musculoskeletal radiologist evaluated qualitative variables. A trained non-physician performed measurements. Consistency and concordance were assessed. Pearson's Chi-square test was used to test the correlation between qualitative findings and PP tear status. Correlation between measurements and PP status was assessed using t tests and Wilcoxon's rank-sum test (p values < 0.05 considered significant). Classification and regression trees were utilized to identify attributes that, taken together, would consistently distinguish PP tear from controls. Quantitative measurements were highly reproducible (concordance 0.88-0.99). Elevated 2nd MT protrusion, lesser MT supination and rotational divergence of >45 between the 1st-2nd MT axis correlated with PP tear. Pericapsular soft tissue thickening correlated most strongly with PP tear, correctly classifying 95 % of cases and controls. Excluding pericapsular soft tissue thickening, sequential assessment of 2nd toe enthesitis, 2nd flexor tendon subluxation, and splaying of the second and third toes accurately classified PP status in 92 %. Pericapsular soft tissue thickening most strongly correlated with PP tear. For cases in which it might be difficult to distinguish pericapsular fibrosis from neuroma, sequential assessment of 2nd toe enthesitis, flexor tendon subluxation and splaying of the 2nd and 3rd toe is most helpful for optimizing accurate diagnosis of PP tear. (orig.)

  11. Methods for Heel Retrieval for Tanks C-101, C-102, and C-111 at the Hanford Site - 13064

    International Nuclear Information System (INIS)

    The purpose of this paper is to evaluate the prospects of using bulk waste characteristics to determine the most appropriate heel retrieval technology. If the properties of hard to remove heels can be determined before bulk retrieval, then a heel retrieval technology can be selected before bulk retrieval is complete. This would save substantially on sampling costs and would allow the deployment of the heel retrieval technology immediately after bulk retrieval. The latter would also accelerate the heel removal schedule. A number of C-farm retrievals have been fully or partially completed at the time of this writing. Thus, there is already substantial information on the success of different technologies and the composition of the heels. There is also substantial information on the waste types in each tank based on historical records. Therefore, this study will correlate the performance of technologies used so far and compare them to the known waste types in the tanks. This will be used to estimate the performance of future C Farm heel retrievals. An initial decision tree is developed and employed on tanks C-101, C-102, and C 111. An assumption of this study is that no additional characterization information would be available, before or after retrieval. Note that collecting additional information would substantially increase the probability of success. Deploying some in-situ testing technologies, such as a water lance or an in-situ Raman probe, might substantially increase the probability of successfully selecting the process conditions without having to take samples from the tanks for laboratory analysis. (authors)

  12. Methods for heel retrieval for tanks C-101, C-102, and C-111 at the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Sams, Terry L. [Washington River Protection Solutions, LLC, Richland, WA (United States); Kirch, N. W. [Washington River Protection Solutions, LLC, Richland, WA (United States); Reynolds, Jacob G. [Washington River Protection Solutions, LLC, Richland, WA (United States)

    2013-01-11

    The purpose of this paper is to evaluate the prospects of using bulk waste characteristics to determine the most appropriate heel retrieval technology. If the properties of hard to remove heels can be determined before bulk retrieval, then a heel retrieval technology can be selected before bulk retrieval is complete. This would save substantially on sampling costs and would allow the deployment of the heel retrieval technology immediately after bulk retrieval. The latter would also accelerate the heel removal schedule. A number of C-farm retrievals have been fully or partially completed at the time of this writing. Thus, there is already substantial information on the success of different technologies and the composition of the heels. There is also substantial information on the waste types in each tank based on historical records. Therefore, this study will correlate the performance of technologies used so far and compare them to the known waste types in the tanks. This will be used to estimate the performance of future C Farm heel retrievals. An initial decision tree is developed and employed on tanks C-101, C-102, and C 111. An assumption of this study is that no additional characterization information would be available, before or after retrieval. Note that collecting additional information would substantially increase the probability of success. Deploying some in-situ testing technologies, such as a water lance or an in-situ Raman probe, might substantially increase the probability of successfully selecting the process conditions without having to take samples from the tanks for laboratory analysis.

  13. 儿童足跟部严重损伤的骨及软组织修复%Repair of soft tissue and bone in children with badly damaged heel

    Institute of Scientific and Technical Information of China (English)

    胡长青; 王顺义; 马战备; 张志桐; 李辉; 史占雷; 孙建涛; 马伟松; 于涛

    2013-01-01

    目的 探讨儿童足跟部严重损伤的骨及软组织修复方法.方法 对9例(11侧患肢)儿童新鲜的足跟部严重损伤患儿急诊实施跟骨皮质包埋跟腱法修复跟骨及跟腱,腓动脉穿支蒂皮瓣逆行转移修复软组织缺损,伴有足底皮肤缺损的患儿同时行腓肠外侧皮神经移位后用于感觉恢复,术后随访1年.结果 临床9例(11侧患肢)手术均顺利完成,所有跟骨及跟腱均愈合良好,皮瓣均成活,随访1年,皮瓣血运良好,质地柔软.踝关节屈伸平均达48°,接近健侧.修复足底的皮瓣共4例,感觉恢复达S3+,两点分辨率为7~10 mm.结论 儿童足跟部严重损伤采用跟骨皮质包埋跟腱法修复跟骨及跟腱,腓动脉穿支蒂皮瓣逆行转移修复软组织缺损,其手术方式安全、可靠,腓肠外侧皮神经用于修复足底感觉时效果良好.%Objective To discuss a new surgical procedure for repairing of soft tissue and bone defect in badly damaged heels of children.Methods Nine cases (11 limbs) of badly damaged heels were performed as emergency operations.The Achilles's tendon was embedded in the cortical bone of calcaneus and the pedicled flap with perforating branch of the peroneal artery was used for repairing the soft tissue defect of the heel.Lateral sural nerve was transferred for the recovery of the thenar sensation.All cases were followed up for one year.Results All operations were performed with no complications.Calcaneus and Achilles's tendon had reunited well.At 12 months postoperatively,the flap had good blood supply and soft texture.Ankle function was similar to the normal side,with an average arc of motion of 48°.The sensitivity of the flaps with nerve transferring (4 cases of plantar defect) reaches S3+,2-PD was 7 mm to 10 mm.Conclusions The technique of Achilles's tendon embedded in cortical bone of calcaneus,with calf flap is safe,and reliable for repairing badly damaged heels in children.

  14. 麦粒灸配合针刺治疗跖筋膜炎疗效观察%Therapeutic Observation of Grain-sized Moxibustion plus Acupuncture for Plantar Fasciitis

    Institute of Scientific and Technical Information of China (English)

    蔡玉梅; 郑继范; 黄文燕

    2015-01-01

    目的:观察麦粒灸配合针刺治疗跖筋膜炎的临床疗效。方法将40例跖筋膜炎患者随机分为治疗组和对照组,每组20例。治疗组采用麦粒灸配合针刺治疗,对照组采用常规针刺治疗。观察两组治疗前后晨起足跟痛的VAS评分,比较两组临床疗效。结果两组治疗后VAS评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后VAS评分与对照组比较,差异具有统计学意义(P<0.05)。治疗组痊愈率和总有效率分别为45.0%和95.0%,对照组分别为10.0%和90.0%,两组痊愈率比较,差异具有统计学意义(P<0.01)。结论麦粒灸配合针刺是一种治疗跖筋膜炎的有效方法。%Objective To observe the clinical efficacy of grain-sized moxibustion plus acupuncture in treating plantar fasciitis. Method Forty patients with plantar fasciitis were randomized into a treatment group and a control group, 20 in each group. The treatment group was intervened by grain-sized moxibustion plus acupuncture, while the control group was by ordinary acupuncture. Visual Analogue Scale (VAS) was used to observe the morning heel pain degree before and after the treatment, and the clinical efficacies were compared.Result The VAS scores were significantly changed after treatment in the two groups (P<0.05). After treatment, VAS score in the treatment group was significantly different from that in the control group (P<0.05). The recovery rate and total effective rate were respectively 45.0% and 95.0% in the treatment group, versus 10.0% and 90.0% in the control group, and there was a significant difference in comparing the recovery rates (P<0.01).Conclusion Grain-sized moxibustion plus acupuncture is an effective method in treating plantar fasciitis.

  15. Estudo retrospectivo do tratamento cirúrgico do neuroma de morton por via plantar Retrospective study of surgery treatment im monrton's neuroma by plantar approach

    Directory of Open Access Journals (Sweden)

    Gustavo Gennari Barbosa

    2005-01-01

    Full Text Available Com o propósito de avaliar a eficácia da técnica cirúrgica - neurectomia por via plantar -, em portadores de neuroma de Morton, 19 pacientes foram submetidos a esse tratamento. Portanto, foram 19 neuromas, sendo 84,3% do sexo feminino, 15,7% do sexo masculino; 31,5% no segundo espaço intermetatarsal, 68,5% no terceiro; 47,3% no lado direito e 52,7% no esquerdo. A cirurgia foi realizada por via plantar em todos os casos, com tempo médio de acompanhamento de 9 meses, e o resultado foi considerado satisfatório em 89,5% dos pacientes. O tempo de retorno às atividades foi de 6 semanas em 84,2%. Dois pacientes se apresentaram insatisfeitos, ambos devido à dor residual abaixo da cicatriz. Os autores concluem que, a neurectomia por via plantar foi satisfatória, pois há uma melhor exposição do neuroma, boa cicatrização, retorno rápido às atividades e melhora da dor.With an eye to evaluate the surgical technic efficiency - neurectomy by plantar approach -, 19 patients with Morton's neuroma were submitted to this treatment. Therefore, were 19 neuroma patients including 84,3% female, 15,7% male; 31,5% in second intermetatarsal space, 68,5% in third; 47,3% on right side and 52,7% on left side. The surgery was made by plantar approach in every cases, with middle time of attendance around 9 months, and the result was considered satisfactory on 89,5% of patients. The time of return to activities was 6 weeks on 84,2%. Two patients were considered unsatisfied, both because of remain pain under the scar. The authors conclude that, a neurectomy by plantar approach is satisfactory, because there is a better exposition of neuroma, good healing, fast return to activities and improve of pain.

  16. Retrospective study on radiotherapy efficacy in case of painful heel spur; Retrospektive Studie ueber die Wirksamkeit der Strahlentherapie beim schmerzhaftem Fersensporn

    Energy Technology Data Exchange (ETDEWEB)

    Klossok-Niethammer, Ruth Giuliana

    2011-07-01

    Objective: The effect of radiotherapy in context of a plantar fasciitis in order to reduce pain was evaluated in this retrospective study. Patients and methods: The data of 188 patients who suffered of heel spur pain and who were irradiated in the period from 1994 to 2009 were evaluated in this study. All of them had at least one follow up examination after radiatiotherapy. The mean age amounted to 57 years. 76.5% of the patients were female. All patients described a local pain which was the basis for the indication. 74.4 % of the patients described pain especially under stress. The duration of anamnesis was averaged as follows: 15 % of the patients had pain for some weeks to 3 months, 43 % for 4 to 6 months, 28% even for 7 to 12 months. The period of medical history was longer than 12 months for 12 % of the patients in this study. 122 of 188 patients received orthopedic arch support (shoe inlays) as first therapy method. Most of the patients were irradiated using regular lateral opposing fields with photons of the energy 4 MV and 6 MV of a linear accelerator, applying a total dose of 6Gy in 6 fractions to 1,0Gy twice weekly. Only one patient was irradiated using a Co{sup 60} machine. The acquisition of data regarding the effect was performed on the last day of the radiotherapy and in 3 to 6 monthly follow ups. Additionally the doctors who attended the patients beyond the radiotherapy received a special questionnaire about the pain reduction, so that the follow up data could be completed. Results: On the last day of radiotherapy 120/188 patients (63,8%)reported an improvement of pain reduction, 7/188 patients (3,7%) absence of pain. For 52/188 patients (27.6 %) pain remained constant. At the second follow up examination after in the median 100 days the effect of radiotherapy of 165 patients could be evaluated, 43/165 patients (26 %) were pain free, 79/165 patients (47,8 %) reported an obvious pain reduction, and for 33/165 patients there was no pain improvement. At

  17. Plantar Pressure, Comfort and Rearfoot Motion during Running: Comparison between Laced Running Shoes and Elastic-covered Running Shoes%有鞋带跑鞋和松紧鞋舌跑鞋跑步主观舒适度、足底压力和后足运动参数比较

    Institute of Scientific and Technical Information of China (English)

    洪友廉; 王琳; 周继和; 李静先

    2011-01-01

    Objective The purpose of this study was to examine whether there were differences in the perceived comfort, plantar pressure, and rearfoot motion between laced running shoes and elastic-covered running shoes. Methods Fifteen male amateur runners participated in the study. The perceived comfort, plantar loading, and rearfoot motion control (inversion and eversion of the heel to the shank) of each type of shoes during running were recorded. Results When the laced running shoes and elasticcovered running shoes were compared, the elastic-covered running shoes showed lower perceived comfort rating in terms of shoe length, width, heel cup fitting, and forefoot cushioning. The elasticcovered running shoes also recorded higher peak plantar pressure in the lateral side of the forefoot,as well as larger maximum rearfoot pronation. Conclusions Overall, shoelaces can help runners obtain better foot-shoe fit. Moreover, shoelaces may help prevent injury in running by better controlling the aforementioned factors.%目的:比较穿着鞋带跑鞋和采用松紧鞋舌跑鞋在主观舒适度、足底压力分布和后足运动参数方面的区别.方法:15名有经验的跑步者自愿参与本研究.采用一份可靠的问卷进行主观舒适度调查;采用Novel pedar足底压力测试系统记录受试者穿着两种跑鞋跑步时的足底压力分布;采用二维高速摄像系统和Ariel动作解析系统记录、分析受试者穿着两种跑鞋跑步时后足的运动图像及足跟相对小腿的内、外翻参数.结果:与穿着有鞋带跑鞋比较,受试者在穿着松紧鞋舌跑鞋跑步时的主观舒适度较差,第4和第5跖趾关节分区足底压强明显增加,后足外翻角度较大.结论:松紧鞋舌式设计并不适用于跑鞋.有鞋带跑鞋合脚性更好,可以帮助跑步者固定鞋内的脚.

  18. The Effects of Various Running Inclines on Three-Segment Foot Mechanics and Plantar Fascia Strain

    OpenAIRE

    Sinclair Jonathan; Atkins Stephen; Vincent Hayley

    2014-01-01

    Purpose. There has yet to be a combined analysis of three-dimensional multi-segment foot kinematics and plantar fascia strain in running gait at various degrees of inclination. The aim of the current study was therefore to investigate the above during treadmill running at different inclines (0°, 5°, 10° and 15°). Methods. Twelve male participants ran at 4.0 m · s-1 in the four different inclinations. Three-dimensional kinematics of the foot segments and plantar fascia strain were quantified f...

  19. Misdiagnosis of plexiform neurofibroma of the medial plantar nerve: case report.

    Science.gov (United States)

    D'Orazi, Valerio; Venditto, Teresa; Panunzi, Andrea; Anichini, Silvia; Manzini, Gabriele; Tallarico, Arturo; Bernetti, Andrea; Paoloni, Marco

    2014-09-01

    Plexiform neurofibromas are benign tumors of the peripheral nerve. Diagnosis may be challenging, if they present mimicking other peripheral nerve pathologies. We report the case of a patient who had severe foot pain, which progressively hampered her walking ability, erroneously attributed to recurrent Morton's neuroma. Diagnosis of plexiform neurofibroma of her right medial plantar nerve was made 15 years after the appearance of symptoms. Pain and function recovered after radical neurotomy of the medial plantar nerve. A correct diagnosis is an essential starting point in the treatment of neurofibromas and a misdiagnosis may lead to an inappropriate treatment. PMID:25024003

  20. Hip and fragility fracture prediction by 4-item clinical risk score and mobile heel BMD: a women cohort study

    Directory of Open Access Journals (Sweden)

    Thulesius Hans

    2010-03-01

    Full Text Available Abstract Background One in four Swedish women suffers a hip fracture yielding high morbidity and mortality. We wanted to revalidate a 4-item clinical risk score and evaluate a portable heel bone mineral density (BMD technique regarding hip and fragility fracture risk among elderly women. Methods In a population-based prospective cohort study we used clinical risk factors from a baseline questionnaire and heel BMD to predict a two-year hip and fragility fracture outcome for women, in a fracture preventive program. Calcaneal heel BMD was measured by portable dual X-ray laser absorptiometry (DXL and compared to hip BMD, measured with stationary dual X-ray absorptiometry (DXA technique. Results Seven women suffered hip fracture and 14 women fragility fracture/s (at hip, radius, humerus and pelvis among 285 women; 60% having heel BMD ≤ -2.5 SD. The 4-item FRAMO (Fracture and Mortality Index combined the clinical risk factors age ≥80 years, weight Conclusions In a follow-up study we identified high risk groups for hip and fragility fracture with our plain 4-item risk model. Increased fracture risk was also related to decreasing heel BMD in calcaneal bone, measured with a mobile DXL technique. A combination of high FRAMO Index, prior fragility fracture, and very low BMD restricted the high risk group to 11%, among whom most hip fractures occurred (71%. These practical screening methods could eventually reduce hip fracture incidence by concentrating preventive resources to high fracture risk women.

  1. SLUDGE HEEL REMOVAL BY ALUMINUM DISSOLUTION AT SAVANNAH RIVER SITE 12390

    Energy Technology Data Exchange (ETDEWEB)

    Keefer, M.

    2012-01-12

    High Level Waste (HLW) at the Savannah River Site (SRS) is currently stored in aging underground storage tanks. This waste is a complex mixture of insoluble solids, referred to as sludge, and soluble salts. Continued long-term storage of these radioactive wastes poses an environmental risk. Operations are underway to remove and disposition the waste, clean the tanks and fill with grout for permanent closure. Heel removal is the intermediate phase of the waste retrieval and tank cleaning process at SRS, which is intended to reduce the volume of waste prior to treatment with oxalic acid. The goal of heel removal is to reduce the residual amount of radioactive sludge wastes to less than 37,900 liters (10,000 gallons) of wet solids. Reducing the quantity of residual waste solids in the tank prior to acid cleaning reduces the amount of acid required and reduces the amount of excess acid that could impact ongoing waste management processes. Mechanical heel removal campaigns in Tank 12 have relied solely on the use of mixing pumps that have not been effective at reducing the volume of remaining solids. The remaining waste in Tank 12 is known to have a high aluminum concentration. Aluminum dissolution by caustic leaching was identified as a treatment step to reduce the volume of remaining solids and prepare the tank for acid cleaning. Dissolution was performed in Tank 12 over a two month period in July and August, 2011. Sample results indicated that 16,440 kg of aluminum oxide (boehmite) had been dissolved representing 60% of the starting inventory. The evolution resulted in reducing the sludge solids volume by 22,300 liters (5900 gallons), preparing the tank for chemical cleaning with oxalic acid.

  2. Results of Characterization and Retrieval Testing on Tank 241-C-109 Heel Solids

    Energy Technology Data Exchange (ETDEWEB)

    Callaway, William S.

    2013-09-26

    Eight samples of heel solids from tank 241-C-109 were delivered to the 222-S Laboratory for characterization and dissolution testing. After being drained thoroughly, one-half to two-thirds of the solids were off-white to tan solids that, visually, were fairly evenly graded in size from coarse silt (30-60 μm) to medium pebbles (8-16 mm). The remaining solids were mostly strongly cemented aggregates ranging from coarse pebbles (16-32 mm) to fine cobbles (6-15 cm) in size. Solid phase characterization and chemical analysis indicated that the air-dry heel solids contained ≈58 wt% gibbsite [Al(OH){sub 3}] and ≈37 wt% natrophosphate [Na{sub 7}F(PO{sub 4}){sub 2}·19H{sub 2}O]. The strongly cemented aggregates were mostly fine-grained gibbsite cemented with additional gibbsite. Dissolution testing was performed on two test samples. One set of tests was performed on large pieces of aggregate solids removed from the heel solids samples. The other set of dissolution tests was performed on a composite sample prepared from well-drained, air-dry heel solids that were crushed to pass a 1/4-in. sieve. The bulk density of the composite sample was 2.04 g/mL. The dissolution tests included water dissolution followed by caustic dissolution testing. In each step of the three-step water dissolution tests, a volume of water approximately equal to 3 times the initial volume of the test solids was added. In each step, the test samples were gently but thoroughly mixed for approximately 2 days at an average ambient temperature of 25 °C. The caustic dissolution tests began with the addition of sufficient 49.6 wt% NaOH to the water dissolution residues to provide ≈3.1 moles of OH for each mole of Al estimated to have been present in the starting composite sample and ≈2.6 moles of OH for each mole of Al potentially present in the starting aggregate sample. Metathesis of gibbsite to sodium aluminate was then allowed to proceed over 10 days of gentle mixing of the

  3. Calcaneal osteosarcoma: a rare cause of heel pain in the paediatric population.

    Science.gov (United States)

    Taslakian, Bedros; Issa, Ghada; Saab, Raya; Jabbour, Mark N; Khoury, Nabil J

    2013-02-04

    Osteosarcoma is the most common primary non-haemopoietic malignant bone tumour in children and adolescents. However, it rarely occurs in the calcaneus with only a few case reports in the literature. We report a case of a 14-year-old boy with calcaneal osteosarcoma, who presented with heel pain followed by swelling. The pain was initially thought to be related to a benign process and treated with analgesics, delaying the diagnosis. We discuss the clinical presentation, the differential diagnosis, multi-imaging and pathological findings of a calcaneal osteosarcoma, its clinical outcome and the importance of early diagnosis to improve outcome.

  4. Results of Characterization and Retrieval Testing on Tank 241-C-110 Heel Solids

    Energy Technology Data Exchange (ETDEWEB)

    Callaway, William S.

    2013-09-30

    Nine samples of heel solids from tank 241-C-110 were delivered to the 222-S Laboratory for characterization and dissolution testing. After being drained thoroughly, the sample solids were primarily white to light-brown with minor dark-colored inclusions. The maximum dimension of the majority of the solids was <2 mm; however, numerous pieces of aggregate, microcrystalline, and crystalline solids with maximum dimensions ranging from 5-70 mm were observed. In general, the larger pieces of aggregate solids were strongly cemented. Natrophosphate [Na{sub 7}F(PO{sub 4}){sub 2}°19H{sub 2}O] was the dominant solid phase identified in the heel solids. Results of chemical analyses suggested that 85-87 wt% of the heel solids were the fluoridephosphate double salt. The average bulk density measured for the heel solids was 1.689 g/mL; the reference density of natrophosphate is 1.71 g/mL. Dissolution tests on composite samples indicate that 94 to 97 wt% of the tank 241-C-110 heel solids can be retrieved by dissolution in water. Dissolution and recovery of the soluble components in 1 kg (0.59 L) of the heel solids required the addition of ≈9.5 kg (9.5 L) of water at 15 °C and ≈4.4 kg (4.45 L) of water at 45 °C. Calculations performed using the Environmental Simulation Program indicate that dissolution of the ≈0.86 kg of natrophosphate in each kilogram of the tank 241-C-110 heel solids would require ≈9.45 kg of water at 15 °C and ≈4.25 kg of water at 45 °C. The slightly larger quantities of water determined to be required to retrieve the soluble components in 1 kg of the heel solids are consistent with that required for the dissolution of solids composed mainly of natrophosphate with a major portion of the balance consisting of highly soluble sodium salts. At least 98% of the structural water, soluble phosphate, sodium, fluoride, nitrate, carbonate, nitrite, sulfate, oxalate, and chloride in the test composites was dissolved and recovered in the

  5. Study on plantar pressure in patients with lumbar disc herniation%腰椎间盘突出症患者的足底压力分布研究

    Institute of Scientific and Technical Information of China (English)

    曹娟娟; 夏清; 曹晓光

    2015-01-01

    Objective:To investigate the gait features of patients with lumbar disc herniation suffering from the low back pain radiating into the unilateral lower limb during normal walking .Methods :The study was carried out among 32 patients with lumbar disc herniation suffering from the low back pain radiating into the unilateral lower limb as the observation group ,and 31 healthy adults as the control group .Footscan plantar system was used in the gait phase ,the contacting time of every plantar region and max force analysis between the two groups .Result:(1) There was no significant difference in the gait phase between the left and right lower limbs of the healthy adults .In the forefoot contact phase and foot flat phase ,the figures of patients on the affected sides were obviously lower , while obviously higher than those in the forefoot push off phase on the healthy sides and control group (P<0 .05) , and no significant difference was found between the healthy sides in the observation group and control group in the gait phase .(2) Except for the region of M4 ,there was no significant difference in the contacting time of every plan‐tar region between the left and right lower limbs of control group .Except for the region of M5 ,the contacting time of every plantar region on the affected sides of observation group was shorter than that on the healthy sides (P<0 .05) .Except for the region of M 3 ,the contacting time of every plantar region on the affected sides was shorter than in control group (P<0 .05) .No significant difference was found between the healthy sides in observation group and control group ;(3) Except for the region of M1 ,there was no significant difference in the max force between the left and right lower limbs of control group .In the regions such as M4 ,M5 ,and heel lateral ,the max force on the affected sides of observation group was lower than that on the healthy sides (P<0 .05) ,and that on the affected sides in M2 ,M4 ,M5 ,heel lateral ,heel

  6. Stresses in the plantar region for long- and short-range throws in women basketball players.

    Science.gov (United States)

    Pau, Massimiliano; Ciuti, Carla

    2013-01-01

    This study aimed to assess plantar pressure pattern modifications caused by short- and long-distance shots in women basketball players. To this end, 24 experienced national- and regional-level basketball players performed 3 trials of 4 technical gestures (free throw, jump stop shot, three-point shot and lay-up) barefoot on a pressure platform placed in fixed positions on the court. Raw data were processed to calculate location and magnitude of pressure peaks in three sub-regions (forefoot, midfoot and rearfoot), and the increase ratio was calculated relative to plantar pressure measured during a static bipedal and unipedal upright stance. The results showed significant increases (p<0.001) in plantar pressure peaks in forefoot (but not midfoot and rearfoot) for all the gestures that involved the use of both legs. Particularly large increases were detected for the three-point shot. All three sub-regions underwent significant changes of the pressure peak in the case of lay-up (forefoot and rearfoot: p<0.001, midfoot: p=0.002). The high levels of contact stress detected for routinely performed technical gestures suggest that a detailed knowledge of changes in the physiological patterns of plantar stresses that take place during play is crucial in reducing the risk of foot injuries and establishing proper training and rehabilitation protocols. PMID:24050476

  7. In-Shoe Plantar Pressures and Ground Reaction Forces during Overweight Adults' Overground Walking

    Science.gov (United States)

    de Castro, Marcelo P.; Abreu, Sofia C.; Sousa, Helena; Machado, Leandro; Santos, Rubim; Vilas-Boas, João Paulo

    2014-01-01

    Purpose: Because walking is highly recommended for prevention and treatment of obesity and some of its biomechanical aspects are not clearly understood for overweight people, we compared the absolute and normalized ground reaction forces (GRF), plantar pressures, and temporal parameters of normal-weight and overweight participants during…

  8. Effects of imagery motor training on torque production of ankle plantar flexor muscles

    NARCIS (Netherlands)

    Zijdewind, Inge; Toering, ST; Bessem, B; van der Laan, O; Diercks, RL

    2003-01-01

    The aim of this study was to investigate in control subjects the effect of imagery training on the torque of plantar-flexor muscles of the ankle. Twenty-nine subjects were allocated to one of three groups that performed either imagery training, low-intensity strength training, or no training (only m

  9. Effect of pinpoint plantar long-wavelength infrared light irradiation on subcutaneous temperature and stress markers

    OpenAIRE

    Ryotokuji, Kenji; Ishimaru, Keisou; Kihara, Kazuhiko; Namiki, Yoshihisa; Hozumi, Nobumichi

    2013-01-01

    Background and aims: The current investigation was aimed at the development of a novel non-invasive treatment system, “pinpoint plantar long-wavelength infrared light irradiation (PP-LILI)”, which may be able to relieve mental stress and reduce stress-related hormones.

  10. Palmar-plantar erythrodysesthesia secondary to docetaxel chemotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Al-Niaimi Amjad

    2011-02-01

    Full Text Available Abstract Introduction Docetaxel is a chemotherapeutic agent used alone or in combination for the management of many neoplastic conditions. Numerous side effects are well described as a consequence. Palmar-plantar erythrodysesthesia, although a relatively common side effect of some types of chemotherapy, occurs infrequently with docetaxel and is often attributed to other drug agents. Case Presentation We report the case of a 66-year-old Caucasian woman who received adjuvant docetaxel monotherapy for invasive breast cancer. She developed palmar-plantar erythrodysesthesia following her first cycle of treatment, which necessitated a change in management. Conclusion Palmar-plantar erythrodysesthesia is a relatively common side effect of cytotoxic chemotherapy, particularly with drugs such as 5-fluorouracil, capecitabine and liposomal doxorubicin. Docetaxel is commonly used both alone and in combination with a number of these agents for the management of various malignant conditions. We would like to highlight the occurrence of palmar-plantar erythrodysesthesia as a result of docetaxel monotherapy so that it can be considered as a potential cause in patients receiving combination treatment with chemotherapeutic agents better known to cause this toxicity.

  11. Rearfoot alignment and medial longitudinal arch configurations of runners with symptoms and histories of plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Ana Paula Ribeiro

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate and compare rearfoot alignment and medial longitudinal arch index during static postures in runners, with and without symptoms and histories of plantar fasciitis (PF. INTRODUCTION: PF is the third most common injury in runners but, so far, its etiology remains unclear. In the literature, rearfoot misalignment and conformations of the longitudinal plantar arch have been described as risk factors for the development of PF. However, in most of the investigated literature, the results are still controversial, mainly regarding athletic individuals and the effects of pain associated with these injuries. METHODS: Forty-five runners with plantar fasciitis (30 symptomatic and 15 with previous histories of injuries and 60 controls were evaluated. Pain was assessed by a visual analogue scale. The assessment of rearfoot alignment and the calculations of the arch index were performed by digital photographic images. RESULTS: There were observed similarities between the three groups regarding the misalignments of the rearfoot valgus. The medial longitudinal arches were more elevated in the group with symptoms and histories of PF, compared to the control runners. CONCLUSIONS: Runners with symptoms or histories of PF did not differ in rearfoot valgus misalignments, but showed increases in the longitudinal plantar arch during bipedal static stance, regardless of the presence of pain symptoms.

  12. Ankle Bracing, Plantar-Flexion Angle, and Ankle Muscle Latencies During Inversion Stress in Healthy Participants

    OpenAIRE

    Kernozek, Thomas; Durall, Christopher J; Friske, Allison; Mussallem, Matthew

    2008-01-01

    Context: Ankle braces may enhance ankle joint proprioception, which in turn may affect reflexive ankle muscle activity during a perturbation. Despite the common occurrence of plantar-flexion inversion ankle injuries, authors of previous studies of ankle muscle latencies have focused on inversion stresses only.

  13. Plantar pressures in diabetic patients with foot ulcers which have remained healed

    NARCIS (Netherlands)

    T.M. Owings; J. Apelqvist; A. Stenstrom; M. Becker; S.A. Bus; A. Kalpen; J.S. Ulbrecht; P.R. Cavanagh

    2009-01-01

    Aims The recurrence of foot ulcers is a significant problem in people with diabetic neuropathy. The purpose of this study was to measure in-shoe plantar pressures and other characteristics in a group of neuropathic patients with diabetes who had prior foot ulcers which had remained healed. Methods T

  14. Plantar pressure with and without custom insoles in patients with common foot complaints.

    NARCIS (Netherlands)

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

    2011-01-01

    BACKGROUND: Although many patients with foot complaints receive customized insoles, the choice for an insole design can vary largely among foot experts. To investigate the variety of insole designs used in daily practice, the insole design and its effect on plantar pressure distribution were investi

  15. Plantar Pressure and Foot Temperature Responses to Acute Barefoot and Shod Running

    Directory of Open Access Journals (Sweden)

    Priego Quesada Jose Ignacio

    2015-09-01

    Full Text Available Purpose. Increased contact pressure and skin friction may lead to higher skin temperature. Here, we hypothesized a relationship between plantar pressure and foot temperature. To elicit different conditions of stress to the foot, participants performed running trials of barefoot and shod running. Methods. Eighteen male recreational runners ran shod and barefoot at a self-selected speed for 15 min over different days. Before and immediately after running, plantar pressure during standing (via a pressure mapping system and skin temperature (using thermography were recorded. Results. No significant changes were found in plantar pressure after barefoot or shod conditions (p > 0.9. Shod running elicited higher temperatures in the forefoot (by 0.5-2.2°C or 0.1-1.2% compared with the whole foot, p -0.5, p > 0.05. Conclusions. The increase in temperature after the shod condition was most likely the result of footwear insulation. However, variation of the temperature in the rearfoot was higher after barefoot running, possible due to a higher contact load. Changes in temperature could not predict changes in plantar pressure and vice-versa.

  16. Surface effects on in-shoe plantar pressure and tibial impact during running

    Directory of Open Access Journals (Sweden)

    Weijie Fu

    2015-12-01

    Conclusion: There may not be an inevitable relationship between the surface and the lower-limb impact in runners. It is, however, still noteworthy that the effects of different treadmill surfaces should be considered in the interpretation of plantar pressure performance and translation of such results to overground running.

  17. Tendons in the plantar aspect of the foot: MR imaging and anatomic correlation in cadavers

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Rodrigo [University of California San Diego, Radiology, San Diego, CA (United States); Fleury Medical Center, Radiology, Sao Paulo, SP (Brazil); Aguiar, Rodrigo; Trudell, Debra; Resnick, Donald [University of California San Diego, Radiology, San Diego, CA (United States)

    2007-02-15

    The purpose of this anatomic imaging study was to illustrate the normal complex anatomy of tendons of the plantar aspect of the ankle and foot using magnetic resonance (MR) imaging with anatomic correlation in cadavers. Seven fresh cadaveric feet (obtained and used according to institutional guidelines, with informed consent from relatives of the deceased) were studied with intermediate-weighted fast-spin-echo MR imaging. For anatomic analysis, cadaveric specimens were sectioned in 3-mm-thick slices in the coronal and axial planes that approximated the sections acquired at MR imaging. The entire courses of the tendons into the plantar aspect of the foot were analyzed. The tibialis posterior tendon has a complex distal insertion. The insertions in the navicular, second, and third cuneiforms bones were identify in all cases using axial and coronal planes. A tendinous connection between the flexor hallucis longus and the flexor digitorum longus tendons was identified in five of our specimens (71%). The coronal plane provided the best evaluation. The peroneus longus tendon changes its direction at three points then obliquely crosses the sole and inserts in the base of the first metatarsal bone and the plantar aspect of the first cuneiform. MR imaging provides detailed information about the anatomy of tendons in the plantar aspect of the ankle and foot. It allows analysis of their insertions and the intertendinous connection between the flexor hallucis longus and the flexor digitorum longus tendons. (orig.)

  18. Reliability of in-Shoe Plantar Pressure Measurements in Rheumatoid Arthritis Patients

    Science.gov (United States)

    Vidmar, Gaj; Novak, Primoz

    2009-01-01

    Plantar pressures measurement is a frequently used method in rehabilitation and related research. Metric characteristics of the F-Scan system have been assessed from different standpoints and in different patients, but not its reliability in rheumatoid arthritis patients. Therefore, our objective was to assess reliability of the F-Scan plantar…

  19. Plantar pressure relief in the diabetic foot using forefoot offloading shoes

    NARCIS (Netherlands)

    S.A. Bus; R.W.M. van Deursen; R.V. Kanade; M. Wissink; E.A. Manning; J.G. van Baal; K.G. Harding

    2009-01-01

    Purpose: Forefoot offloading shoes (FOS) are commonly used in clinical practice for treatment of plantar forefoot ulcers in the diabetic foot. The aim of this study was to assess the offloading efficacy of four different FOS models in comparison with a cast shoe and control shoe. Methods: In-shoe pl

  20. Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers

    Directory of Open Access Journals (Sweden)

    Tatiana Almeida Bacarin

    2009-02-01

    Full Text Available OBJECTIVE: To investigate and compare the influence of a previous history of foot ulcers on plantar pressure variables during gait of patients with diabetic neuropathy. INTRODUCTION: Foot ulcers may be an indicator of worsening diabetic neuropathy. However, the behavior of plantar pressure patterns over time and during the progression of neuropathy, especially in patients who have a clinical history of foot ulcers, is still unclear. METHODS: Subjects were divided into the following groups: control group, 20 subjects; diabetic neuropathy patients without foot ulcers, 17 subjects; and diabetic neuropathy patients with at least one healed foot ulcer within the last year, 10 subjects. Plantar pressure distribution was recorded during barefoot gait using the Pedar-X system. RESULTS: Neuropathic subjects from both the diabetic neuropathy and DNU groups showed higher plantar pressure than control subjects. At midfoot, the peak pressure was significantly different among all groups: control group (139.4±76.4 kPa, diabetic neuropathy (205.3±118.6 kPa and DNU (290.7±151.5 kPa (p=0.008. The pressure-time integral was significantly higher in the ulcerated neuropathic groups at midfoot (CG: 37.3±11.4 kPa.s; DN: 43.3±9.1 kPa.s; DNU: 68.7±36.5 kPa.s; p=0.002 and rearfoot (CG: 83.3±21.2 kPa.s; DN: 94.9±29.4 kPa.s; DNU: 102.5±37.9 kPa.s; p=0.048. CONCLUSION: A history of foot ulcers in the clinical history of diabetic neuropathy subjects influenced plantar pressure distribution, resulting in an increased load under the midfoot and rearfoot and an increase in the variability of plantar pressure during barefoot gait. The progression of diabetic neuropathy was not found to influence plantar pressure distribution.

  1. Dynamic Patterns of Forces and Loading Rate in Runners with Unilateral Plantar Fasciitis: A Cross-Sectional Study

    OpenAIRE

    Ana Paula Ribeiro; Silvia Maria Amado João; Roberto Casanova Dinato; Vitor Daniel Tessutti; Isabel de Camargo Neves Sacco

    2015-01-01

    Aim/Hypothesis The etiology of plantar fasciitis (PF) has been related to several risk factors, but the magnitude of the plantar load is the most commonly described factor. Although PF is the third most-common injury in runners, only two studies have investigated this factor in runners, and their results are still inconclusive regarding the injury stage. Objective Analyze and compare the plantar loads and vertical loading rate during running of runners in the acute stage of PF to those in the...

  2. Chronic arsenic poisoning.

    Science.gov (United States)

    Hall, Alan H

    2002-03-10

    Symptomatic arsenic poisoning is not often seen in occupational exposure settings. Attempted homicide and deliberate long-term poisoning have resulted in chronic toxicity. Skin pigmentation changes, palmar and plantar hyperkeratoses, gastrointestinal symptoms, anemia, and liver disease are common. Noncirrhotic portal hypertension with bleeding esophageal varices, splenomegaly, and hypersplenism may occur. A metallic taste, gastrointestinal disturbances, and Mee's lines may be seen. Bone marrow depression is common. 'Blackfoot disease' has been associated with arsenic-contaminated drinking water in Taiwan; Raynaud's phenomenon and acrocyanosis also may occur. Large numbers of persons in areas of India, Pakistan, and several other countries have been chronically poisoned from naturally occurring arsenic in ground water. Toxic delirium and encephalopathy can be present. CCA-treated wood (chromated copper arsenate) is not a health risk unless burned in fireplaces or woodstoves. Peripheral neuropathy may also occur. Workplace exposure or chronic ingestion of arsenic-contaminated water or arsenical medications is associated with development of skin, lung, and other cancers. Treatment may incklude the use of chelating agents such as dimercaprol (BAL), dimercaptosuccinic acid (DMSA), and dimercaptopanesulfonic acid (DMPS).

  3. Glossary of Foot and Ankle Terms

    Science.gov (United States)

    ... a number of problems. The most common is plantar fasciitis . Other pain-causing conditions include Achilles tendinitis , stress ... Heel spur - Heel spurs are commonly associated with plantar fasciitis . On X-rays, they appear as a spur ...

  4. Results of Characterization and Retrieval Testing on Tank 241-C-109 Heel Solids

    Energy Technology Data Exchange (ETDEWEB)

    Callaway, William S.

    2013-09-26

    Eight samples of heel solids from tank 241-C-109 were delivered to the 222-S Laboratory for characterization and dissolution testing. After being drained thoroughly, one-half to two-thirds of the solids were off-white to tan solids that, visually, were fairly evenly graded in size from coarse silt (30-60 μm) to medium pebbles (8-16 mm). The remaining solids were mostly strongly cemented aggregates ranging from coarse pebbles (16-32 mm) to fine cobbles (6-15 cm) in size. Solid phase characterization and chemical analysis indicated that the air-dry heel solids contained ≈58 wt% gibbsite [Al(OH){sub 3}] and ≈37 wt% natrophosphate [Na{sub 7}F(PO{sub 4}){sub 2}·19H{sub 2}O]. The strongly cemented aggregates were mostly fine-grained gibbsite cemented with additional gibbsite. Dissolution testing was performed on two test samples. One set of tests was performed on large pieces of aggregate solids removed from the heel solids samples. The other set of dissolution tests was performed on a composite sample prepared from well-drained, air-dry heel solids that were crushed to pass a 1/4-in. sieve. The bulk density of the composite sample was 2.04 g/mL. The dissolution tests included water dissolution followed by caustic dissolution testing. In each step of the three-step water dissolution tests, a volume of water approximately equal to 3 times the initial volume of the test solids was added. In each step, the test samples were gently but thoroughly mixed for approximately 2 days at an average ambient temperature of 25 °C. The caustic dissolution tests began with the addition of sufficient 49.6 wt% NaOH to the water dissolution residues to provide ≈3.1 moles of OH for each mole of Al estimated to have been present in the starting composite sample and ≈2.6 moles of OH for each mole of Al potentially present in the starting aggregate sample. Metathesis of gibbsite to sodium aluminate was then allowed to proceed over 10 days of gentle mixing of the

  5. Kangaroo mother care diminishes pain from heel lance in very preterm neonates: A crossover trial

    Directory of Open Access Journals (Sweden)

    McNaughton Kathryn

    2008-04-01

    Full Text Available Abstract Background Skin-to-skin contact, or kangaroo mother care (KMC has been shown to be efficacious in diminishing pain response to heel lance in full term and moderately preterm neonates. The purpose of this study was to determine if KMC would also be efficacious in very preterm neonates. Methods Preterm neonates (n = 61 between 28 0/7 and 31 6/7 weeks gestational age in three Level III NICU's in Canada comprised the sample. A single-blind randomized crossover design was employed. In the experimental condition, the infant was held in KMC for 15 minutes prior to and throughout heel lance procedure. In the control condition, the infant was in prone position swaddled in a blanket in the incubator. The primary outcome was the Premature Infant Pain Profile (PIPP, which is comprised of three facial actions, maximum heart rate, minimum oxygen saturation levels from baseline in 30-second blocks from heel lance. The secondary outcome was time to recover, defined as heart rate return to baseline. Continuous video, heart rate and oxygen saturation monitoring were recorded with event markers during the procedure and were subsequently analyzed. Repeated measures analysis-of-variance was employed to generate results. Results PIPP scores at 90 seconds post lance were significantly lower in the KMC condition (8.871 (95%CI 7.852–9.889 versus 10.677 (95%CI 9.563–11.792 p CI 103–142 versus 193 seconds (95%CI 158–227. Facial actions were highly significantly lower across all points in time reaching a two-fold difference by 120 seconds post-lance and heart rate was significantly lower across the first 90 seconds in the KMC condition. Conclusion Very preterm neonates appear to have endogenous mechanisms elicited through skin-to-skin maternal contact that decrease pain response, but not as powerfully as in older preterm neonates. The shorter recovery time in KMC is clinically important in helping maintain homeostasis. Trial Registration (Current

  6. [Incurable keratitis and chronic palmoplantar hyperkeratosis with hypertyrosinemia. Cure using a tyrosine-restricted diet. Type II tyrosinemia].

    Science.gov (United States)

    Hervé, F; Moreno, J L; Ogier, H; Saudubray, J M; De Prost, Y; Duffier, J L; Charpentier, C; Lemonnier, F; Frézal, J

    1986-01-01

    One should henceforth systematically search for hypertyrosinemia which, too often, goes unrecognized for years, in patients presenting chronic keratitis associated with palmar and plantar hyperkeratosis. As a matter of fact, this highly crippling disease may be cured with an appropriate diet and the diagnosis, once suspected, is easily confirmed by simple investigations.

  7. Plantar calcaneal enthesophytes: new observations regarding sites of origin based on radiographic, MR imaging, anatomic, and paleopathologic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, M.R.; Chung, C.B.; Mendes, L.; Mohana-Borges, A.; Trudell, D.; Resnick, D. [Department of Radiology, Musculoskeletal Section, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161 (United States)

    2003-01-01

    To determine the relationship between sites of calcaneal plantar enthesophytes and surrounding fascial and soft tissue structures using routine radiography, MR imaging, and data derived from cadaveric and paleopathologic specimens.Design and patients. Two observers analyzed the MR imaging studies of 40 ankles in 38 patients (35 males, 3 females; mean age 48.3 years) with plantar calcaneal enthesophytes that were selected from all the ankle MR examinations performed during the past year. Data derived from these MR examinations were the following: the size of the enthesophyte; its location in relation to the plantar fascia (PF) and flexor muscles; and the thickness and signal of the PF. The corresponding radiographs of the ankles were evaluated at a different time by the same observers for the presence or absence of plantar enthesophytes and, when present, their measurements. A third observer reviewed all the discordant observations of MR imaging and radiographic examinations. Two observers analyzed 22 calcaneal specimens with plantar enthesophytes at an anthropology museum to determine the orientation of each plantar enthesophyte. MR imaging of a cadaveric foot with a plantar enthesophyte with subsequent sagittal sectioning was performed to provide further anatomic understanding.Results. With regard to MR imaging, the mean size of the plantar enthesophytes was 4.41 mm (SD 2.4). Twenty (50%) enthesophytes were located above the PF, 16 (40%) between the fascia and abductor digiti minimi, flexor digitorum brevis and abductor hallucis muscles, and only one (3%) was located within the PF. In three (8%) cases the location was not determined. The size of enthesophytes seen with MR imaging and radiographs was highly correlated (P<0.01). The interobserver agreement for all measurements was good (Pearson >0.8, kappa >0.9). Eleven of the 22 bone specimens had plantar enthesophytes oriented in the direction of the abductor digiti minimi and 11 oriented in the direction of the

  8. Testing the proficiency to distinguish locations with elevated plantar pressure within and between professional groups of foot therapists

    Directory of Open Access Journals (Sweden)

    Schaper Nicolaas C

    2006-12-01

    Full Text Available Abstract Background Identification of locations with elevated plantar pressures is important in daily foot care for patients with rheumatoid arthritis, metatarsalgia and diabetes. The purpose of the present study was to evaluate the proficiency of podiatrists, pedorthists and orthotists, to distinguish locations with elevated plantar pressure in patients with metatarsalgia. Methods Ten podiatrists, ten pedorthists and ten orthotists working in The Netherlands were asked to identify locations with excessively high plantar pressure in three patients with forefoot complaints. Therapists were instructed to examine the patients according to the methods used in their everyday clinical practice. Regions could be marked through hatching an illustration of a plantar aspect. A pressure sensitive platform was used to quantify the dynamic bare foot plantar pressures and was considered as 'Gold Standard' (GS. A pressure higher than 700 kPa was used as cut-off criterion for categorizing peak pressure into elevated or non-elevated pressure. This was done for both patient's feet and six separate forefoot regions: big toe and metatarsal one to five. Data were analysed by a mixed-model ANOVA and Generalizability Theory. Results The proportions elevated/non-elevated pressure regions, based on clinical ratings of the therapists, show important discrepancies with the criterion values obtained through quantitative plantar pressure measurement. In general, plantar pressures in the big toe region were underrated and those in the metatarsal regions were overrated. The estimated method agreement on clinical judgement of plantar pressures with the GS was below an acceptable level: i.e. all intraclass correlation coefficient's equal or smaller than .60. The inter-observer agreement for each discipline demonstrated worrisome results: all below .18. The estimated mutual agreements showed that there was virtually no mutual agreement between the professional groups studied

  9. Effects of low-dye taping on plantar pressure pre and post exercise: an exploratory study.

    LENUS (Irish Health Repository)

    Nolan, Damien

    2009-01-01

    BACKGROUND: Low-Dye taping is used for excessive pronation at the subtalar joint of the foot. Previous research has focused on the tape\\'s immediate effect on plantar pressure. Its effectiveness following exercise has not been investigated. Peak plantar pressure distribution provides an indirect representation of subtalar joint kinematics. The objectives of the study were 1) To determine the effects of Low-Dye taping on peak plantar pressure immediately post-application. 2) To determine whether any initial effects are maintained following exercise. METHODS: 12 asymptomatic subjects participated; each being screened for excessive pronation (navicular drop > 10 mm). Plantar pressure data was recorded, using the F-scan, at four intervals during the testing session: un-taped, baseline-taped, post-exercise session 1, and post-exercise session 2. Each exercise session consisted of a 10-minute walk at a normal pace. The foot was divided into 6 regions during data analysis. Repeated-measures analysis of variance (ANOVA) was used to assess regional pressure variations across the four testing conditions. RESULTS: Reduced lateral forefoot peak plantar pressure was the only significant difference immediately post tape application (p = 0.039). This effect was lost after 10 minutes of exercise (p = 0.036). Each exercise session resulted in significantly higher medial forefoot peak pressure compared to un-taped; (p = 0.015) and (p = 0.014) respectively, and baseline-taped; (p = 0.036) and (p = 0.015) respectively. Medial and lateral rearfoot values had also increased after the second session (p = 0.004), following their non-significant reduction at baseline-taped. A trend towards a medial-to-lateral shift in pressure present in the midfoot immediately following tape application was still present after 20 minutes of exercise. CONCLUSION: Low-Dye tape\\'s initial effect of reduced lateral forefoot peak plantar pressure was lost after a 10-minute walk. However, the tape continued

  10. Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis

    OpenAIRE

    Bus, Sicco A.; Haspels, Rob; Busch-Westbroek, Tessa E.

    2011-01-01

    OBJECTIVE Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to evaluate and optimize the pressure-reducing effects of diabetic therapeutic footwear. RESEARCH DESIGN AND METHODS Dynamic in-shoe plantar pressure distribution was measured in 23 neuropathic...

  11. Láser infrarrojo frente a acupuntura en el tratamiento del espolón calcáneo Infrared laser vs. acupuncture in the treatment of heel spurs

    Directory of Open Access Journals (Sweden)

    A. Orellana Molina

    2010-03-01

    se curó al 61,5% de los pacientes. En acupuntura el comienzo de la mejoría se produjo a partir de la cuarta sesión, y se curó a un 42,3%. En el grupo de laserterapia, se demuestra la efectividad de este método, debido a que la desviación promedio de laserterapia (0,683 se aparta menos de la media que la desviación promedio de acupuntura (0,882. Recomendamos el uso de láser de baja potencia, como tratamiento de primera línea para el manejo de condiciones álgicas e inflamatorias asociadas al espolón calcáneo.Introduction: Physical Medicine and Rehabilitation and Traditional and Natural Medicine are medical specialties that develop measures for the promotion of health, prevention, diagnosis and treatment, using physiotherapy and natural agents, along with acupuncture and therapeutic laser. The heel spur is an osteophyte that grows in the front part of the plantar tuberosity of the heel bone secondary to inflammatory processes of a degenerative cause or of immune origin associated with the spondyloarthropathies. It is mainly diagnosed by clinical examination, x-ray studies and ultrasound. The most important symptom is the pain and the treatment is almost always conservative, although other therapeutic agents can be employed. Objective: We studied the analgesic effect obtained by the application of an infrared laser radiation in patient suffering from heel spur. Methods: The investigation consisted of a comparative, descriptive, and prospective study. Of a total of 62 patients who attended the Department of Traditional and Natural Medicine of the November 30th University Polyclinic, in the period of January 2005 to January 2008, 52 patients were formed into 2 groups of 26. One group had lasertherapy and the other acupuncture treatment. Patients of both sexes and of any race were included, and ages ranged from 20 to 80 years. We excluded pregnant women and patients with cancer. The pain intensity was measured in all of them using the visual analog scale (VAS

  12. Preventing healthcare-associated transmission of the Middle East Respiratory Syndrome (MERS): Our Achilles heel.

    Science.gov (United States)

    Balkhy, Hanan H; Perl, Trish M; Arabi, Yaseen M

    2016-01-01

    Middle East Respiratory Syndrome (MERS) coronavirus is the most recent among the Coronaviridae family to jump species and infect humans. Major healthcare associated MERS outbreaks have occurred in the Middle East and Korea that affected both patients and healthcare workers. These outbreaks were characterized by intra and inter-hospital spread and were exacerbated specifically by overcrowding, delayed diagnosis and appropriate use of personal protective equipment. Recent experience with this virus emphasizes the importance of compliance with infection control practices and with other interventions addressing patient triage, placement and flow within and between healthcare facilities. Our Achilles heel remains compliance with the best infection prevention practices and their harmonization with patient flow. Both infection prevention compliance and maintenance of patient flow are critical in preventing healthcare-associated transmission of many of these emerging infectious diseases, including MERS. PMID:27158023

  13. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

  14. THE EFFECT OF LANDING SURFACE ON THE PLANTAR KINETICS OF CHINESE PARATROOPERS USING HALF-SQUAT LANDING

    Directory of Open Access Journals (Sweden)

    Yi Li

    2013-09-01

    Full Text Available The objective of the study was to determine the effect of landing surface on plantar kinetics during a half-squat landing. Twenty male elite paratroopers with formal parachute landing training and over 2 years of parachute jumping experience were recruited. The subjects wore parachuting boots in which pressure sensing insoles were placed. Each subject was instructed to jump off a platform with a height of 60 cm, and land on either a hard or soft surface in a half-squat posture. Outcome measures were maximal plantar pressure, time to maximal plantar pressure (T-MPP, and pressure-time integral (PTI upon landing on 10 plantar regions. Compared to a soft surface, hard surface produced higher maximal plantar pressure in the 1st to 4th metatarsal and mid-foot regions, but lower maximal plantar pressure in the 5th metatarsal region. Shorter T- MPP was found during hard surface landing in the 1st and 2nd metatarsal and medial rear foot. Landing on a hard surface landing resulted in a lower PTI than a soft surface in the 1stphalangeal region. For Chinese paratroopers, specific foot prosthesis should be designed to protect the1st to 4thmetatarsal region for hard surface landing, and the 1stphalangeal and 5thmetatarsal region for soft surface landing

  15. Effects of knee joint angle on the fascicle behavior of the gastrocnemius muscle during eccentric plantar flexions.

    Science.gov (United States)

    Wakahara, Taku; Kanehisa, Hiroaki; Kawakami, Yasuo; Fukunaga, Tetsuo

    2009-10-01

    The present study aimed to clarify the effects of knee joint angle on the behavior of the medial gastrocnemius muscle (MG) fascicles during eccentric plantar flexions. Eight male subjects performed maximal eccentric plantar flexions at two knee positions [fully extended (K0) and 90 degrees flexed (K90)]. The eccentric actions were preceded by static plantar flexion at a 30 degrees plantar flexed position and then the ankle joint was forcibly dorsiflexed to 15 degrees of dorsiflexion with an isokinetic dynamometer at 30 degrees /s and 150 degrees /s. Tendon force was calculated by dividing the plantar flexion torque by the estimated moment arm of the Achilles tendon. The MG fascicle length was determined with ultrasonography. The tendon forces during eccentric plantar flexions were influenced by the knee joint angle, but not by the angular velocity. The MG fascicle lengths were elongated as the ankle was dorsiflexed in K0, but in K90 they were almost constant despite the identical range of ankle joint motion. These results suggested that MG fascicle behavior during eccentric actions was markedly affected by the knee joint angle. The difference in the fascicle behavior between K0 and K90 could be attributed to the non-linear force-length relations and/or to the slackness of tendinous tissues.

  16. [Vascularization of the lateral heel in relation to extensive skin incisions in osteosynthesis of calcaneal fractures].

    Science.gov (United States)

    Rak, V; Matonoha, P; Otáhal, M; Masek, M M

    2007-09-01

    The aim of the study was to document soft tissue vascularization of the lateral heel on cadavers and, therefore, to indirectly demonstrate the importance to perform perfectly precise incisions, in order to prevent ischemic complications. Sections of 8 human lower limb cadavers were performed in cooperation with the Anatomical Institute of the MU Medical Faculty in Brno, according to current common standards for anatomical preparations. In successive steps, cutaneous and subcutanous covers of the lateral ankle, malleolar and heel regions were preparated. Final branches of the individual arteries were followed and the authors aimed to demonstrate their vascular arcade consisting of anastomosis of the lateral calcaneal artery--LCA (a branch of a. peronea)--which is a clinical term for rami calcaneares laterales, ventrolateral tarsal arteries--LTA (a branch of a. dorsalis pedis) and lateral malleolar artery branching off medially--LMA (a branch of a. tibialis ant.). The course of the arteries and their location is related to a reference point--a lateral tip of the lateral ankle. The investigators found out that all three arteries, as well as the arterial arch, had standard courses. The course of the arch defines the outline of the lateral extensive incision during osteosynthesis in calcaneal fractures, which lies fairly close to the lateral outline of this vascular arcade. Incorrect performance of the incision results, invitably, in serious ischemic complications. Open reduction and internal fixation of intraarticular calcaneal fractures has become a standard surgical method. Correct indication, good timing and saving open reduction, internal fixation using arthroscopy and early mobilization are the prerequisites to prevent further postoperative complications and to achieve complete healing of the fracture. Considering the demandingness of these fractures treatment and their rare incidence, their management should be centred in specialized traumatological clinics. PMID

  17. In vivo and in vitro testing of shoe heel insert properties; a comparative study

    International Nuclear Information System (INIS)

    Shoe heel inserts (SHI) are a common method of conservative treatment for various painful disorders like degenerative joint diseases (010) and overuse injuries. They are also used to enhance exercise performance in athletes. There is little in the literature to guide orthopaedic practitioners in relation to optimum material for these SHI. The current study examines properties of three different kinds of off-the-shelf SHI in terms of their performance, endurance and cost. The material properties of inserts were tested on a universal material testing machine (UTM) before and after mechanical degradation (MO) that was performed by a purpose built repetitive loading machine (RLM) under compression and shearing forces. The results of material. tests were augmented through subject tests by a pressure sensitive insole system, Pedar. The data provided evidence that MO, simulating a normal walking distance of 100 to 130 Km, deteriorated the performance of all inserts tested in the current study. There were significant changes in the stiffness and elastic hysteresis of inserts and they were less efficient in cushioning heel areas. The SHI were responsible for putting more pressure under the lateral metatarsal heads. The SHI may be effective in symptomatic relief of painful 010 and overuse injuries but should be used cautiously in diabetic patients. Acknowledgements: The authors would like to acknowledge Mr. Ian Christie and Mr. Sadlq Nasir for their assistance. The study was funded by Institute of Motion Analysis and Research. The authors have no financial or personal relationships with the companies whose products were evaluated in this work. (author)

  18. ROLE OF LOW DYE TAPING FOR SHORT TERM TREATMENT OF PLANTAR FASCIITIS

    Directory of Open Access Journals (Sweden)

    Rajni

    2016-02-01

    Full Text Available BACKGROUND Plantar fasciitis is a common cause of foot discomfort. Different treatment modalities exist for its treatment. Low dye taping is often used in conjunction with other treatment options. AIMS AND OBJECTIVES Purpose of the study was to evaluate therapeutic effect of low dye taping in plantar fasciitis. MATERIALS AND METHODS In this prospective study, 56 patients were included. Low dye taping applied for one week. First step pain (Measured on VAS scale and Foot Health Status Questionnaire domain of foot pain, foot function and general foot health were used to evaluate the patient prior to taping and after one week of low dye taping. RESULT Patient treated with low dye taping reported significant improvement in first step pain and Foot Health Questionnaires Score after one week of treatment. Five patients experienced an adverse event. CONCLUSION Low dye taping is effective in short term basis.

  19. Increased calf and plantar muscle fibrotic contents in obese subjects may cause ankle instability.

    Science.gov (United States)

    Zhu, Junwei; Zhang, Lei; Chen, Yong; Zhao, Jianning

    2016-08-01

    Obesity is strongly associated with musculoskeletal disorders of the lower limb, including ankle instability and resulting gait problems. In the present study, we aimed to examine, using paired comparisons of subjects, whether moderate duration of obesity in patients with mild to moderate elevations of body mass index (BMI), changes the fibrous contents of muscles that support the ankle mortices, namely calf and plantar muscles. We attempted to examine these parameters because this shall provide direct evidence of whether obesity directly impacts myoarchitecture and support of the adjoining joints. MRI image segmentation and pixel correlations by grey level co-occurrence matrix (GLCM) and entropy were used to analyse the changes. The differences in the means between groups (both GLCM and entropy) were significant from control lean populations (Pcalf and the plantar muscles. Reduction in weight should thus be a first-line approach in preventing these changes that may significantly affect quality of life due to gait disturbances. PMID:27380952

  20. 三种皮瓣修复足跟部恶性黑色素瘤术后缺损的疗效比较%COMPARISON STUDY ON DIFFERENT FLAPS IN REPAIRING DEFECT CAUSED BY RESECTION OF CUTANEOUS MALIGNANT MELANOMA IN THE HEEL REGION

    Institute of Scientific and Technical Information of China (English)

    姚伟涛; 蔡启卿; 王家强; 高嵩涛; 王鑫

    2011-01-01

    by resection of cutaneous malignant melanoma (CMM) in the heel region. Methods The clinical data were retrospectively analysed from 24 patients with defect who had CMM in the heel region and were treated by radical excision and flap repairing between March 2007 and March 2010. Defects were repaired with the reverse sural neurocutaneous flaps of 8 cm × 7 cm-14 cm × 12 cm at size in 12 patients (group A), with the medial plantar flaps of 6 cm × 5 cm-8 cm x 7 cm at size in 7 patients (group B), and with the retrograde posterior tibial vascular flaps of 9 cm x 7 cm-15 cm × 13 cm at size in 5 patients (group C). There was no significant difference in gender, age, duration of illness, clinical stage, and size of CMM among 3 groups (P > 0.05). The donor site was sutured directly or by free skin graft. Results No significant difference was found in the operation time and the intraoperative blood loss among 3 groups (P > 0.05). All skin flaps or grafts survived and wounds healed by first intention. The patients were followed up 1-3 years. The flaps had normal texture and color with no ulcer in 3 groups. At 1 year after operation, the sensory recovery rates of the flaps were 0,100%, and 20% in groups A, B, and C, respectively, showing significant difference among 3 groups (P=0.001). The patients had normal appearance of heel and pain-free walking [10 (83%) in group A, 6 (86%) in group B, and 4 (80%) in group C] of heel region, showing no significant difference among 3 groups (X =40.000, P=0.135). Heel pain existed in weight-bearing walking of 3 groups, and there were significant differences in visule analogue scale (VAS) score (P 0.05). Except 1 patiant of relapse in group A at 1 month after operation, no relapse was observed in the other patients during follow-up. Conclusion The medial plantar flap, the retrograde posterior tibial vascular flap, and the reverse sural neurocutaneous flap can achieve the good clinical effectiveness in treating heel defect caused by the

  1. Plantar Pressure Distribution During Robotic-Assisted Gait in Post-stroke Hemiplegic Patients

    OpenAIRE

    Yang, Jin Kyu; Ahn, Na El; Kim, Dae Hyun; Kim, Deog Young

    2014-01-01

    Objective To assess the plantar pressure distribution during the robotic-assisted walking, guided through normal symmetrical hip and knee physiological kinematic trajectories, with unassisted walking in post-stroke hemiplegic patients. Methods Fifteen hemiplegic stroke patients, who were able to walk a minimum of ten meters independently but with asymmetric gait patterns, were enrolled in this study. All the patients performed both the robotic-assisted walking (Lokomat) and the unassisted wal...

  2. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training

    OpenAIRE

    BEHRENS, Martin; Weippert, Matthias; Wassermann, Franziska; Bader, Rainer; Bruhn, Sven; Mau-Moeller, Anett

    2015-01-01

    Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals ...

  3. EFFECT OF MANUAL THERAPY VERSUS CONVENTIONAL THERAPY IN PATIENTS WITH PLANTAR FASCIITIS – A COMPARATIVE STUDY

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    Shashwat Prakash

    2014-02-01

    Full Text Available Objective: To compare the effectiveness of manual therapy with conventional therapy on pain and disability in patients with plantar fasciitis. Background: There is limited evidence available which support that manual therapy can be used as an intervention in the management of plantar fasciitis. Study Design: experimental study and different subject design Methods: Patients diagnosed with plantar fasciitis underwent a standard evaluation and completed a self-report questionnaire including the Foot Function Index (FFI, and the Numeric Pain Rating Scale (NPRS. 30 patients were randomly divided in two groups, to be treated with either Conventional therapy or Manual therapy approach. Outcomes of treatment were captured on the 1st day and 21st day of the treatment session. Results: The data was analysed using unpaired‘t’ tests. NPRS was mean 6.53 versus 6.80 for pre-treatment in group A and group B respectively; t28=0.50, p=0.62 and mean 2.27 versus 1.00 for post-treatment in group A and group B respectively; t28=2.62, p=0.01 FFI was mean 41.01 versus 42.67 for pre-treatment in group A and group B respectively; t28=0.77, p=0.49 and mean 6.20 versus 4.16 for post-treatment in group A and group B respectively; t28=2.68, p=0.01 Conclusion: The results of this study provide evidence that manual therapy is a superior approach in improving pain and disability in individuals with plantar fasciitis and can be incorporated in the regular treatment regime of the same.

  4. Characteristics of Plantar Loads in Maximum Forward Lunge Tasks in Badminton.

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    Xiaoyue Hu

    Full Text Available Badminton players often perform powerful and long-distance lunges during such competitive matches. The objective of this study is to compare the plantar loads of three one-step maximum forward lunges in badminton.Fifteen right-handed male badminton players participated in the study. Each participant performed five successful maximum lunges at three directions. For each direction, the participant wore three different shoe brands. Plantar loading, including peak pressure, maximum force, and contact area, was measured by using an insole pressure measurement system. Two-way ANOVA with repeated measures was employed to determine the effects of the different lunge directions and different shoes, as well as the interaction of these two variables, on the measurements.The maximum force (MF on the lateral midfoot was lower when performing left-forward lunges than when performing front-forward lunges (p = 0.006, 95% CI = -2.88 to -0.04%BW. The MF and peak pressures (PP on the great toe region were lower for the front-forward lunge than for the right-forward lunge (MF, p = 0.047, 95% CI = -3.62 to -0.02%BW; PP, p = 0.048, 95% CI = -37.63 to -0.16 KPa and left-forward lunge (MF, p = 0.015, 95% CI = -4.39 to -0.38%BW; PP, p = 0.008, 95% CI = -47.76 to -5.91 KPa.These findings indicate that compared with the front-forward lunge, left and right maximum forward lunges induce greater plantar loads on the great toe region of the dominant leg of badminton players. The differences in the plantar loads of the different lunge directions may be potential risks for injuries to the lower extremities of badminton players.

  5. Plantar pressure measurements and running-related injury: A systematic review of methods and possible associations.

    Science.gov (United States)

    Mann, Robert; Malisoux, Laurent; Urhausen, Axel; Meijer, Kenneth; Theisen, Daniel

    2016-06-01

    Pressure-sensitive measuring devices have been identified as appropriate tools for measuring an array of parameters during running. It is unclear which biomechanical characteristics relate to running-related injury (RRI) and which data-processing techniques are most promising to detect this relationship. This systematic review aims to identify pertinent methodologies and characteristics measured using plantar pressure devices, and to summarise their associations with RRI. PubMed, Embase, CINAHL, ScienceDirect and Scopus were searched up until March 2015. Retrospective and prospective, biomechanical studies on running using any kind of pressure-sensitive device with RRI as an outcome were included. All studies involving regular or recreational runners were considered. The study quality was assessed and the measured parameters were summarised. One low quality, two moderate quality and five high quality studies were included. Five different subdivisions of plantar area were identified, as well as five instants and four phases of measurement during foot-ground contact. Overall many parameters were collated and subdivided as plantar pressure and force, plantar pressure and force location, contact area, timing and stride parameters. Differences between the injured and control group were found for mediolateral and anteroposterior displacement of force, contact area, velocity of force displacement, relative force-time integral, mediolateral force ratio, time to peak force and inter-stride correlative patterns. However, no consistent results were found between studies and no biomechanical risk patterns were apparent. Additionally, conflicting findings were reported for peak force in three studies. Based on these observations, we provide suggestions for improved methodology measurement of pertinent parameters for future studies. PMID:27264395

  6. Do spike insoles enhance postural stability and plantar-surface cutaneous sensitivity in the elderly?

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    Palluel, Estelle; Nougier, Vincent; Olivier, Isabelle

    2008-03-01

    Balance problems are often related to a loss of plantar-sensitivity in elderly people. The purpose of this study was to explore the contribution of plantar cutaneous inputs induced by a spike support surface to the control of stance. Nineteen elderly (mean age 69.0 years, range 62-80) and 19 young adults (mean age 25.9 years, range 21-32) were instructed to stand (standing session) or to walk (walking session) for 5 min with sandals equipped with spike insoles (spike condition). Both sessions also involved a no spike condition in which participants stood or walked for 5 min without these insoles (no spike condition). In all conditions, postural responses were assessed during unperturbed stance and were performed (1) immediately after putting the spike or the no spike insoles, and (2) 5 min after standing or walking with them. Sway parameters, such as centre of foot pressure mean location, surface area, mean speed, root mean square and median frequency on the antero-posterior and medio-lateral axes, were calculated. As postural performances are often related to plantar-surface sensitivity, cutaneous sensitivity threshold was also evaluated with Semmes-Weinstein monofilaments. Although no immediate effect of the spike insoles was found, results indicated that standing or walking for 5 min with sandals equipped with spike insoles led to a significant improvement of quiet standing in the elderly. Balance improvement was also observed in young adults. The results provided evidence that wearing sandals with spike insoles can contribute, at least temporarily, to the improvement of unperturbed stance in elderly people with relatively intact plantar cutaneous sensation. Further research is needed to assess the effects of longer and discontinuous stimulations with spike insoles on postural control.

  7. Randomized trial - oxybutynin for treatment of persistent plantar hyperhidrosis in women after sympathectomy

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    Altair da Silva Costa Jr

    2014-02-01

    Full Text Available OBJECTIVE: Hyperhidrosis is a common disease, and thoracoscopic sympathectomy improves its symptoms in up to 95% of cases. Unfortunately, after surgery, plantar hyperhidrosis may remain in 50% of patients, and compensatory sweating may be observed in 70%. This clinical scenario remains a challenge. Our objective was to evaluate the effectiveness of oxybutynin in the treatment of persistent plantar hyperhidrosis and compensatory sweating and its effects on quality of life in women after thoracoscopic sympathectomy. METHOD: We conducted a prospective, randomized study to compare the effects of oxybutynin at 10 mg daily and placebo in women with persistent plantar hyperhidrosis. The assessment was performed using a quality-of-life questionnaire for hyperhidrosis and sweating measurement with a device for quantifying transepidermal water loss. Clinicaltrials.gov: NCT01328015. RESULTS: Sixteen patients were included in each group (placebo and oxybutynin. There were no significant differences between the groups prior to treatment. After oxybutynin treatment, there was a decrease in symptoms and clinical improvement based on the quality-of-life questionnaire (before treatment, 40.4 vs. after treatment, 17.5; p = 0.001. The placebo group showed modest improvement (p = 0.09. The outcomes of the transepidermal water loss measurements in the placebo group showed no differences (p = 0.95, whereas the oxybutynin group revealed a significant decrease (p = 0.001. The most common side effect was dry mouth (100% in the oxybutynin group vs. 43.8% in the placebo group; p = 0.001. CONCLUSION: Oxybutynin was effective in the treatment of persistent plantar hyperhidrosis, resulting in a better quality of life in women who had undergone thoracoscopic sympathectomy.

  8. Controlling Posture and Vergence Eye Movements in Quiet Stance: Effects of Thin Plantar Inserts.

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    A Foisy

    Full Text Available The purpose of this study was to assess properties of vergence and saccade eye movements as well as posture in quiet stance, and the effects of thin plantar inserts upon postural and oculomotor control. The performances of 36 young healthy subjects were recorded by a force platform and an eye tracker in three testing conditions: without plantar stimulation, with a 3 millimetre-thick plantar insert, either a Medial or a Lateral Arch Support (MAS/LAS. The results showed a decrease of the Surface and Variance of Speed and a more posterior position of the CoP with either stimulation compared with the control condition. The fractal analysis showed a decrease with MAS. Wavelet analysis in the time-frequency domain revealed an increase in the Cancelling Time of the low frequency band with MAS. These results suggest a better stability for a lower energy cost. Concerning eye movements, the inserts influenced only vergence (not saccades: MAS caused an increase of the phasic amplitude of divergence, and conversely a decrease of the tonic amplitude. In contrast, LAS caused an increase of the tonic amplitude of convergence. Thus, MAS renders divergence less visually driven, while LAS renders convergence more visually driven. We conclude that the CNS uses the podal signal for both postural and vergence control via specific mechanisms. Plantar inserts have an influence upon posture and vergence movements in a different way according to the part of the foot sole being stimulated. These results can be useful to clinicians interested in foot or eye.

  9. High probability of healing without amputation of plantar forefoot ulcers in patients with diabetes.

    Science.gov (United States)

    Örneholm, Hedvig; Apelqvist, Jan; Larsson, Jan; Eneroth, Magnus

    2015-01-01

    Diabetic foot ulcer is an important entity which in many cases is the first serious complication in diabetes. Although a plantar forefoot location is common, there are few studies on larger cohorts and in such studies there is often a combination of various types of ulcer and ulcer locations. The purpose of this study is to discern the outcome of plantar forefoot ulcers and their specific characteristics in a large cohort. All patients (n = 770), presenting with a plantar forefoot ulcer at a multidisciplinary diabetes foot clinic from January 1, 1983 to December 31, 2012 were considered for the study. Seven hundred one patients (median age 67 [22-95]) fulfilled the inclusion criteria and were followed according to a preset protocol until final outcome (healing or death). Severe peripheral vascular disease was present in 26% of the patients and 14% had evidence of deep infection upon arrival at the foot clinic. Fifty-five percent (385/701) of the patients healed without foot surgery, 25% (173/701) healed after major debridement, 9% (60/701) healed after minor or major amputation and 12% (83/701) died unhealed. Median healing time was 17 weeks. An ulcer classified as Wagner grade 1 or 2 at inclusion and independent living were factors associated with a higher healing rate. Seventy-nine percent of 701 patients with diabetes and a plantar forefoot ulcer treated at a multidisciplinary diabetes foot clinic healed without amputation. For one third some form of foot surgery was needed to achieve healing.

  10. A distribuição da força plantar está associada aos diferentes tipos de pés? Is the distribution of plantar forces associated with different types of feet?

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    Liliana Aparecida P. Azevedo

    2009-09-01

    Full Text Available OBJETIVO: Quantificar as forças e mensurar o arco longitudinal medial em pés de escolares. MÉTODOS: Estudo transversal envolvendo escolares da primeira série do ensino fundamental de uma escola pública de Guaratinguetá (SP. Para identificar a distribuição das pressões plantares, foram utilizadas duas plataformas de força e a impressão plantar em papel para mensurar o arco longitudinal medial. Compararam-se as forças plantares da porção medial e lateral e as forças plantares da região anterior e posterior dos pés. Os pés, depois de classificados, foram comparados quanto às médias das forças plantares de cada sensor. A aquisição da atividade baropodométrica foi coletada três vezes seguidas para cada sensor e realizada na posição ortostática. Os valores médios foram comparados através dos testes t de Student e ANOVA. RESULTADOS: Participaram do estudo 57 escolares com idade média de 7,5 anos sem qualquer queixa ou indício de doença ortopédica e/ou neurológica. As forças plantares foram significativamente maiores da região medial do pé esquerdo (p=0,003 e em ambos os retropés (pOBJECTIVE: To quantify the distribution of plantar forces and to measure the foot arch of school children. METHODS: This cross-sectional study enrolled school children of the first year from a public elementary school of Guaratinguetá, SP, Brazil. In order to identify the distribution of plantar forces, two platforms of force were used and foot printing in paper was obtained to measure the foot medial arch. The plantar force was compared in medial and lateral sites and in anterior and posterior sites of the feet. The feet were compared regarding the average plantar forces in each sensor. The baropodometric acquisition was performed three times for each sensor in orthostatic position. The average values were compared by Student's t and ANOVA tests. RESULTS: 57 students with mean age of 7.5 years old were enrolled. None of them had any

  11. Effectiveness of adjustable dorsiflexion night splint in combination with accommodative foot orthosis on plantar fasciitis

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    Winson C. C. Lee, PhD

    2013-01-01

    Full Text Available Foot orthoses and night splints have been used separately to treat patients with plantar fasciitis, but were not always successful. Combined use of both orthoses might give better outcomes. This study evaluated the effectiveness of a soft and self-adjustable dorsiflexion night splint in combination with an accommodative foot orthosis for patients with plantar fasciitis. Twenty-eight patients were assigned to group A (foot orthosis only and group B (combination of foot orthosis and dorsiflexion night splints. A Foot Function Index (FFI questionnaire was used to evaluate the pain and functions of feet just before, 2 weeks after, and 8 weeks after the treatments. Results showed that subjects in group B had significantly reduced pain scores at week 2 (p < 0.001 and week 8 (p < 0.001. In group A, no statistical differences were noted in the pain (p = 0.15, disability (p = 0.56, activity limitation (p = 0.75, and total FFI (p = 0.35 scores for the three time periods. The application of foot orthoses with adjustable dorsiflexion night splints was found to be more effective than the application of foot orthoses alone in relieving foot pain in patients with plantar fasciitis.

  12. Sonoelastography of Plantar Fascia: Reproducibility and Pattern Description in Healthy Subjects and Symptomatic Subjects.

    Science.gov (United States)

    Ríos-Díaz, José; Martínez-Payá, Jacinto J; del Baño-Aledo, María Elena; de Groot-Ferrando, Ana; Botía-Castillo, Paloma; Fernández-Rodríguez, David

    2015-10-01

    The purpose of the work reported here was to describe the sonoelastographic appearance of the plantar fascia of healthy volunteers and patients with fasciitis. Twenty-three healthy subjects and 21 patients with plantar fasciitis were examined using B-mode and real-time sonoelastography (RTSR) scanning. B-Mode examination included fascia thickness and echotexture. Echogenicity and echovariation of the color histogram were analyzed. Fasciae were classified into type 1, blue (more elastic); type 2, blue/green (intermediate); or type 3, green (less elastic). RTSE revealed 72.7% of fasciae as type 2, with no significant association with fasciitis (χ(2) = 3.6, df = 2, p = 0.17). Quantitative analysis of the color histogram revealed a significantly greater intensity of green (mean = 77.8, 95% confidence interval [CI] = 71.9-83.6) and blue (mean = 74.2, 95% CI = 69.7-78.8) in healthy subjects. Echovariation of the color red was 33.4% higher in the fasciitis group than in the healthy group (95% CI = 16.7-50.1). Sonoelastography with quantitative analysis of echovariation can be a useful tool for evaluation of plantar fascia pathology. PMID:26164287

  13. Plantar measurements to determine success of surgical correction of Stage IIb adult acquired flatfoot deformity.

    Science.gov (United States)

    Matheis, Erika A; Spratley, E Meade; Hayes, Curtis W; Adelaar, Robert S; Wayne, Jennifer S

    2014-01-01

    Adult acquired flatfoot deformity is a degenerative disease causing medial arch dysfunction. Surgical correction has typically involved tendon reconstruction with calcaneal osteotomy; however, the postoperative changes have not been fully characterized. The present study assessed the success of surgical correction of Stage IIb adult acquired flatfoot deformity through changes in plantar pressures and patient-generated outcome scores. With Institutional Review Board approval, 6 participants were evaluated before and after surgery using pedobarography, the Foot and Ankle Outcome Score, and the Medical Outcomes Study 36-item short-form questionnaire. The plantar pressures were recorded using a TekScan HRMat(®) during walking and in a 1- and 2-foot stance. The resulting contour maps were segmented into 9 regions, with the peak pressure, normalized force, and arch index calculated. Surgical effects were analyzed using paired t tests. Postoperatively, the Foot and Ankle Outcome Score and Medical Outcomes Study 36-item short-form questionnaire scores increased significantly from 180 ± 78 to 360 ± 136 (p flatfoot deformity can be accurately assessed using patient-reported outcome measures and plantar pressures.

  14. Plantar forefoot pressures in psoriatic arthritis-related dactylitis: an exploratory study.

    Science.gov (United States)

    Wilkins, Richard A; Siddle, Heidi J; Redmond, Anthony C; Helliwell, Philip S

    2016-09-01

    Dactylitis is a common feature of psoriatic arthritis (PsA); local physical trauma has been identified as a possible contributing factor. The aim of this study was to explore differences in forefoot plantar pressures in patients with PsA with and without dactylitis and compare to healthy controls. Thirty-six participants were recruited into three groups: group A PsA plus a history of dactylitis; group B PsA, no dactylitis; group C control participants. Forefoot plantar pressures were measured barefoot and in-shoe at the left second and fourth toes and corresponding metatarsophalangeal joints. Temporal and spatial parameters were measured and data from the foot impact scale for rheumatoid arthritis (FIS-RA), EQ5D and health assessment questionnaire (HAQ) were collected. Pressure time integral peak plantar pressure, and contact time barefoot and in-shoe were not significantly different between groups. Temporal and spatial parameters reported no significant differences between groups. ANOVA analysis and subsequent post hoc testing using Games-Howell test yielded significance in FIS-RA scores between both PsA groups versus controls, A p ≤ 0.0001 and PsA group B p history of dactylitis does not appear to worsen patient reported outcomes. PMID:27225246

  15. Bacteriological study of aerobic isolates from plantar ulcers of paucibacillary leprosy patients

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    Majumdar Monalisa

    2010-01-01

    Full Text Available Background: Plantar ulcers commonly occur in leprosy patients, which usually recur and cause morbidity in such cases. Aims: The aim of the study is to find out the bacteriological profile of these ulcers and to find out the antibiotic susceptibility of the isolates so that appropriate drugs may be chosen for treatment and for prevention of recurrence. Materials and Methods: Fifty-six samples from recurrent plantar ulcers of paucibacillary leprosy patients (attending the outpatient department of Calcutta School of Tropical Medicine were studied for the purpose. Proper sample collection, gram staining, inoculation on culture media, and final identification by biochemical methods were undertaken. Antibiotic susceptibility testing was done for appropriate choice of drugs. Results: Mixed growth of bacteria was seen in 20 (36% cases while single organism was isolated from the rest. Staphylococcus aureus is the predominant single isolate followed by E. coil, Proteus sp. and Pseudomonas sp. Chloramphenicol and gentamycin are the two drugs that have shown efficacy to the extent of 75 to 100% and 25 to 100% respectively in vitro studies. Conclusion: Bacteriological study of plantar ulcers of leprosy patients has revealed Staphylococcus aureus as the main pathogen. Treatment with chloramphenicol and gentamycin holds good prospect as per our study.

  16. Sonoelastography of Plantar Fascia: Reproducibility and Pattern Description in Healthy Subjects and Symptomatic Subjects.

    Science.gov (United States)

    Ríos-Díaz, José; Martínez-Payá, Jacinto J; del Baño-Aledo, María Elena; de Groot-Ferrando, Ana; Botía-Castillo, Paloma; Fernández-Rodríguez, David

    2015-10-01

    The purpose of the work reported here was to describe the sonoelastographic appearance of the plantar fascia of healthy volunteers and patients with fasciitis. Twenty-three healthy subjects and 21 patients with plantar fasciitis were examined using B-mode and real-time sonoelastography (RTSR) scanning. B-Mode examination included fascia thickness and echotexture. Echogenicity and echovariation of the color histogram were analyzed. Fasciae were classified into type 1, blue (more elastic); type 2, blue/green (intermediate); or type 3, green (less elastic). RTSE revealed 72.7% of fasciae as type 2, with no significant association with fasciitis (χ(2) = 3.6, df = 2, p = 0.17). Quantitative analysis of the color histogram revealed a significantly greater intensity of green (mean = 77.8, 95% confidence interval [CI] = 71.9-83.6) and blue (mean = 74.2, 95% CI = 69.7-78.8) in healthy subjects. Echovariation of the color red was 33.4% higher in the fasciitis group than in the healthy group (95% CI = 16.7-50.1). Sonoelastography with quantitative analysis of echovariation can be a useful tool for evaluation of plantar fascia pathology.

  17. Effects of Wearing Different Personal Equipment on Force Distribution at the Plantar Surface of the Foot

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    Christoph Schulze

    2013-01-01

    Full Text Available Background. The wearing of personal equipment can cause specific changes in muscle activity and posture. In the present study, we investigated the influence of differences in equipment related weight loading and load distribution on plantar pressure. In addition, we studied functional effects of wearing different equipment with a particular focus on relevant changes in foot shape. Methods. Static and dynamic pedobarography were performed on 31 male soldiers carrying increasing weights consisting of different items of equipment. Results. The pressure acting on the plantar surface of the foot increased with higher loading, both under static and dynamic conditions (p < 0.05. We observed an increase in the contact area (p < 0.05 and an influence of load distribution through different ways to carry the rifle. Conclusions. The wearing of heavier weights leads to an increase in plantar pressure and contact area. This may be caused by flattening of the transverse and longitudinal arches. The effects are more evident in subjects with flat feet deformities which seem to flatten at an earlier load condition with a greater amount compared to subjects with normal arches. Improving load distribution should be a main goal in the development of military equipment in order to prevent injuries or functional disorders of the lower extremity.

  18. One-year treatment follow-up of plantar fasciitis: radial shockwaves vs. conventional physiotherapy

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    Marcus Vinicius Grecco

    2013-01-01

    Full Text Available OBJECTIVE: To compare radial shockwave treatment with conventional physiotherapy for plantar fasciitis after 12 months of follow-up. METHOD: This was a randomized, prospective, comparative clinical study. Forty patients with a diagnosis of plantar fasciitis were divided randomly into two treatment groups: group 1, with 20 patients who underwent ten physiotherapy sessions comprising ultrasound, kinesiotherapy and guidance for home-based stretching; and group 2, with 20 patients who underwent three applications of radial shockwaves, once a week, and guidance for home-based stretching. All patients were assessed regarding pain and functional abilities before treatment, immediately after and 12 months after treatment. The mean age was 49.6 ±11.8 years (range: 25-68 years, 85% were female, 88% were overweight, 63% were affected bilaterally, and 83% used analgesics regularly. RESULTS: At the 12-month follow-up, both treatments were effective for improving pain and functional ability among the patients with plantar fasciitis. The improvement with shockwaves was faster. CONCLUSION: Shockwave treatment was not more effective than conventional physiotherapy treatment 12 months after the end of the treatment.

  19. Comparison of radial shockwaves and conventional physiotherapy for treating plantar fasciitis

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    Júlia Maria D'Andréa Greve

    2009-02-01

    Full Text Available OBJECTIVE: To compare radial shockwave treatment and conventional physiotherapy for plantar fasciitis. MATERIALS AND METHODS: Thirty-two patients with plantar fasciitis were included in this study. They were randomly divided into two groups. Group 1 was composed of 16 patients who underwent 10 physiotherapy sessions each, consisting of ultrasound, kinesiotherapy and instruction for stretching exercises at home. Group 2 was composed of 16 patients who underwent three applications of radial shockwaves (once a week and received instruction for stretching exercises at home. Pain and ability to function were evaluated before treatment, immediately afterwards, and three months later. The mean age of the patients was 47.3 ± 10.3 years (range 25-68; 81% were female, 87% were overweight, 56% had bilateral impairment, and 75% used analgesics regularly. RESULTS: Both treatments were effective for pain reduction and for improving the functional abilities of patients with plantar fasciitis. The effect of the shockwaves was apparent sooner than physiotherapy after the onset of treatment. CONCLUSION: Shockwave treatment was no more effective than conventional physiotherapy treatment when evaluated three months after the end of treatment.

  20. Can ultrasound of plantar plate have normal appearance with a positive drawer test?

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    Fernandes, Eloy de Avila [Affiliated Professor, Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo (Brazil); Mann, Tania Szejnfeld [Medical Assistant of Medicine and Surgery of the Foot and Ankle Group, Department of Orthopedics and Traumatology, EPM-Unifesp, São Paulo (Brazil); Puchnick, Andrea, E-mail: andrea.ddi@epm.br [Professor and Coordinator of Educational and Research Support, Department of Diagnostic Imaging, EPM-Unifesp, São Paulo (Brazil); Tertulino, Franklin de Freitas [Postgraduate Physician, Department of Diagnostic Imaging, EPM-Unifesp, São Paulo (Brazil); Cannato, Camila Testoni [Resident Physician, Department of Surgery, EPM-Unifesp, São Paulo (Brazil); Nery, Caio [Associate Professor, Department of Orthopedics and Traumatology, EPM-Unifesp, São Paulo (Brazil); Fernandes, Artur da Rocha Corrêa [Associate Professor, Department of Diagnostic Imaging, EPM-Unifesp, São Paulo (Brazil)

    2015-03-15

    Highlights: •We evaluate the accuracy of ultrasound to identify and measure the plantar plate. •We correlate ultrasound findings with those of physical examination and MRI. •Ultrasound and MRI measures of plantar plate were positively correlated. •Ultrasound is efficient in identifying and measuring plantar plate. •Ultrasound may complement physical examination. •Young asymptomatic subjects can present a grade I positive drawer test. -- Abstract: Objectives: The aims of this study were (1) to evaluate the reliability of ultrasound (US) examination in the identification and measurement of the metatarsophalangeal plantar plate (MTP-PP) in asymptomatic subjects and (2) to establish the correlation of US findings with those of physical examination and magnetic resonance imaging (MRI), once it is an important tool in the evaluation of the instability syndrome of the second and third rays. Materials and Methods: US examinations of the second and third MTP-PPs were performed in eight asymptomatic volunteers, totaling 32 MTP joints, by three examiners with different levels of experience in musculoskeletal US. Plantar plate dimensions, integrity and echogenicity, the presence of ruptures, and confidence level in terms of structure identification were determined using conventional US. Vascular flow was assessed using power Doppler. US data were correlated with data from physical examination and MRI. Results: MTP-PPs were ultrasonographically identified in 100% of cases, always showing homogeneous hyperechoic features and no detectable vascular flow on power Doppler, with 100% certainty in identification for all examiners. There was excellent US inter-observer agreement for longitudinal measures of second and third toe MTP-PPs and for transverse measures of the second toe MTP-PP. The MTP drawer test was positive for grade 1 MTP instability in 34.4% of joints with normal US results. Transverse MTP-PP measures were significantly higher in individuals with positive

  1. Biomechanical analysis of the support in race walking. Relationship between footprint, subtalar joint angles, and plantar pressures Análisis biomecánico del apoyo plantar en la marcha atlética. Relación entre la huella plantar, ángulos de la articulación subastragalina y presiones plantares

    Directory of Open Access Journals (Sweden)

    M. Meana

    2010-09-01

    Full Text Available

    The aims were to describe the behavior of the subtalar joint and foot in the race walk, and seek for correlations between them and the footprint. 12 race walkers participated in the study. The arch index was calculated on their footprints. Plantar pressures were measured and 3D photogrammetry used on a single support while they race walked at their own competitive speed. Maximum pressures were calculated in each region of the foot and also the maximum and minimum values of the three angles that describe the subtalar joint. The maximum pronation was higher than that described in the walking gait and similar to that of the running gait (-13.6 ± 3.90. In the beginning of the support the subtalar joint was between the walking and the running gaits. This suggests that the cushioning mechanism of this joint is adjusted according to the type of locomotion. The region of the foot that registered higher pressures was the external rearfoot (21.02 kPa/kg followed by the internal forefoot (13.12 kPa/kg, showing a different behaviour to that of the running gait, in which both present similar maximum pressures. The subjects with lower arches tended to support with the internal face of the foot (r=-0.713 and with the leg inclined medially (r=0.874. Likewise, the racewalkers with higher arches registered higher pressures in the external part of the rearfoot, whereas the lowest ones did it in the internal part of the midfoot.
    Key Words: Biomechanics, race walk, footprint, subtalar joint, plantar pressure.

    Los objetivos fueron describir el comportamiento de la articulación subastragalina y el pie en la marcha atlética y buscar correlaciones entre estos y la huella plantar. Participaron 12 marchadores. Se calculó el índice del arco sobre sus huellas plantares. Se registraron presiones plantares y se aplicó fotogrametría 3D durante un apoyo

  2. REMOVING SLUDGE HEELS FROM SAVANNAH RIVER SITE WASTE TANKS BY OXALIC ACID DISSOLUTION

    Energy Technology Data Exchange (ETDEWEB)

    Poirier, M; David Herman, D; Fernando Fondeur, F; John Pareizs, J; Michael Hay, M; Bruce Wiersma, B; Kim Crapse, K; Thomas Peters, T; Samuel Fink, S; Donald Thaxton, D

    2009-03-01

    The Savannah River Site (SRS) will remove sludge as part of waste tank closure operations. Typically the bulk sludge is removed by mixing it with supernate to produce a slurry, and transporting the slurry to a downstream tank for processing. Experience shows that a residual heel may remain in the tank that cannot be removed by this conventional technique. In the past, SRS used oxalic acid solutions to disperse or dissolve the sludge heel to complete the waste removal. To better understand the actual conditions of oxalic acid cleaning of waste from carbon steel tanks, the authors developed and conducted an experimental program to determine its effectiveness in dissolving sludge, the hydrogen generation rate, the generation rate of other gases, the carbon steel corrosion rate, the impact of mixing on chemical cleaning, the impact of temperature, and the types of precipitates formed during the neutralization process. The test samples included actual SRS sludge and simulated SRS sludge. The authors performed the simulated waste tests at 25, 50, and 75 C by adding 8 wt % oxalic acid to the sludge over seven days. They conducted the actual waste tests at 50 and 75 C by adding 8 wt % oxalic acid to the sludge as a single batch. Following the testing, SRS conducted chemical cleaning with oxalic acid in two waste tanks. In Tank 5F, the oxalic acid (8 wt %) addition occurred over seven days, followed by inhibited water to ensure the tank contained enough liquid to operate the mixer pumps. The tank temperature during oxalic acid addition and dissolution was approximately 45 C. The authors analyzed samples from the chemical cleaning process and compared it with test data. The conclusions from the work are: (1) Oxalic acid addition proved effective in dissolving sludge heels in the simulant demonstration, the actual waste demonstration, and in SRS Tank 5F. (2) The oxalic acid dissolved {approx} 100% of the uranium, {approx} 100% of the iron, and {approx} 40% of the manganese

  3. Chronic Diarrhea

    Science.gov (United States)

    ... infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  4. Analysis of clinical curative effect of minimal invasion surgery for heel pain elderly patients with calcaneal tubercle osteophyte%微创治疗老年跟骨结节骨赘型跟痛症临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    孙建民; 孙良智; 苏保辉; 李忠; 徐晓梅; 刘美秀

    2012-01-01

    [Objective] To discuss the clinical curative effect of minimal invasion surgery for heel pain in elderly patients (age ≥60 years) with calcaneal tubercle osteophyte. [Methods] From July 2000 to July 2010, the surgical methods and clinical curative effect were analyzed in 159 cases ( 173 feet) of heel pain with calcaneal lubercle osteophyle. According to the Maryland scoring system, all the cases were < 50 scores before surgery. Minimally invasive removal of osteophytes, the release of plantar fascia insertion and bursa surgery were operated in 57 feet (minimal invasion group) , while other 47 feet received open surgery ( open group) . [ Results] A total of 93 cases (104 feet) obtained a mean of 19 months follow up. In minimal invasion group, the pain was completely relieved without walking effect in 55 feet. Other 2 feet also improved pain relief significantly, but the pain was residual after severe activity, which can be relieved by rest. In open group, the pain was completely relieved without walking effect in 45 feet. One foot improved pain relief significantly, but the pain was residual after severe activity, which can be relieved by rest. One foot suffered from scarring pain for six months, which disappeared after the softening of the scar. [Conclusion] For the heel pain with calcaneal tubercle osteophyte, it can obtain good clinical curative effect by releasing the plantar fascia insertion and removing the osteophytes and bursa both in minimal invasion surgery and open surgery. Compared with the open surgery, the minimal invasion surgery can be acceptable easily for ihe less invasion and faster recovery.%[目的]探讨老年(年龄≥60岁)跟骨结节骨赘型跟痛症微创治疗的临床疗效.[方法]对2000年7月~2010年7月本院治疗的159例(173足)跟骨结节骨赘型跟痛症老年患者的手术方式及疗效进行分析.根据Maryland 评分患者均<50分,其中82足(微创组)患者接受了微创骨赘切除、跖腱膜止

  5. Mixing of process heels, process solutions, and recycle streams: Results of the small-scale radioactive tests

    International Nuclear Information System (INIS)

    Various recycle streams will be combined with the low-activity waste (LAW) or the high-level waste (HLW) feed solutions during the processing of the Hanford tank wastes by BNFL, Inc. In addition, the LAW and HLW feed solutions will also be mixed with heels present in the processing equipment. This report describes the results of a test conducted by Battelle to assess the effects of mixing specific process streams. Observations were made regarding adverse reactions (mainly precipitation) and effects on the Tc oxidation state (as indicated by Kd measurements with SuperLigregsign 639). The work was conducted according to test plan BNFL-TP-29953-023, Rev. 0, Small Scale Mixing of Process Heels, Solutions, and Recycle Streams. The test went according to plan, with only minor deviations from the test plan. The deviations from the test plan are discussed in the experimental section

  6. The oscillatory behavior of the CoM facilitates mechanical energy balance between push-off and heel strike.

    Science.gov (United States)

    Kim, Seyoung; Park, Sukyung

    2012-01-10

    Humans use equal push-off and heel strike work during the double support phase to minimize the mechanical work done on the center of mass (CoM) during the gait. Recently, a step-to-step transition was reported to occur over a period of time greater than that of the double support phase, which brings into question whether the energetic optimality is sensitive to the definition of the step-to-step transition. To answer this question, the ground reaction forces (GRFs) of seven normal human subjects walking at four different speeds (1.1-2.4 m/s) were measured, and the push-off and heel strike work for three differently defined step-to-step transitions were computed based on the force, work, and velocity. To examine the optimality of the work and the impulse data, a hybrid theoretical-empirical analysis is presented using a dynamic walking model that allows finite time for step-to-step transitions and incorporates the effects of gravity within this period. The changes in the work and impulse were examined parametrically across a range of speeds. The results showed that the push-off work on the CoM was well balanced by the heel strike work for all three definitions of the step-to-step transition. The impulse data were well matched by the optimal impulse predictions (R(2)>0.7) that minimized the mechanical work done on the CoM during the gait. The results suggest that the balance of push-off and heel strike energy is a consistent property arising from the overall gait dynamics, which implies an inherited oscillatory behavior of the CoM, possibly by spring-like leg mechanics. PMID:22035641

  7. A Vibrotactile and Plantar Force Measurement-Based Biofeedback System: Paving the Way towards Wearable Balance-Improving Devices

    Directory of Open Access Journals (Sweden)

    Christina Zong-Hao Ma

    2015-12-01

    Full Text Available Although biofeedback systems have been used to improve balance with success, they were confined to hospital training applications. Little attempt has been made to investigate the use of in-shoe plantar force measurement and wireless technology to turn hospital training biofeedback systems into wearable devices. This research developed a wearable biofeedback system which detects body sway by analyzing the plantar force and provides users with the corresponding haptic cues. The effects of this system were evaluated in thirty young and elderly subjects with simulated reduced foot sensation. Subjects performed a Romberg test under three conditions: (1 no socks, system turned-off; (2 wearing five layers of socks, system turned-off; (3 wearing five layers of socks, and system turned-on. Degree of body sway was investigated by computing the center of pressure (COP movement measured by a floor-mounted force platform. Plantar tactile sensation was evaluated using a monofilament test. Wearing multiple socks significantly decreased the plantar tactile sensory input (p < 0.05, and increased the COP parameters (p < 0.017, indicating increased postural sway. After turning on the biofeedback system, the COP parameters decreased significantly (p < 0.017. The positive results of this study should inspire future development of wearable plantar force-based biofeedback systems for improving balance in people with sensory deficits.

  8. A Vibrotactile and Plantar Force Measurement-Based Biofeedback System: Paving the Way towards Wearable Balance-Improving Devices.

    Science.gov (United States)

    Ma, Christina Zong-Hao; Wan, Anson Hong-Ping; Wong, Duo Wai-Chi; Zheng, Yong-Ping; Lee, Winson Chiu-Chun

    2015-12-15

    Although biofeedback systems have been used to improve balance with success, they were confined to hospital training applications. Little attempt has been made to investigate the use of in-shoe plantar force measurement and wireless technology to turn hospital training biofeedback systems into wearable devices. This research developed a wearable biofeedback system which detects body sway by analyzing the plantar force and provides users with the corresponding haptic cues. The effects of this system were evaluated in thirty young and elderly subjects with simulated reduced foot sensation. Subjects performed a Romberg test under three conditions: (1) no socks, system turned-off; (2) wearing five layers of socks, system turned-off; (3) wearing five layers of socks, and system turned-on. Degree of body sway was investigated by computing the center of pressure (COP) movement measured by a floor-mounted force platform. Plantar tactile sensation was evaluated using a monofilament test. Wearing multiple socks significantly decreased the plantar tactile sensory input (p < 0.05), and increased the COP parameters (p < 0.017), indicating increased postural sway. After turning on the biofeedback system, the COP parameters decreased significantly (p < 0.017). The positive results of this study should inspire future development of wearable plantar force-based biofeedback systems for improving balance in people with sensory deficits.

  9. A Holter-type, microprocessor-based, rehabilitation instrument for acquisition and storage of plantar pressure data.

    Science.gov (United States)

    Abu-Faraj, Z O; Harris, G F; Abler, J H; Wertsch, J J

    1997-04-01

    A Holter-type, microprocessor-based, portable, in-shoe, plantar pressure data acquisition system has been developed. The system allows continuous recording of pressure data between the sole of the foot and the shoe during the performance of daily living activities. Fourteen conductive polymer sensors acquire the plantar pressure history, which is then stored in the system memory. Pressures are sampled at a rate of 40 Hz from each of the 14 sensors for up to 8 hrs. The extended recording and processing capacity of the system developed in this study allows quantitative analysis of cumulative plantar pressure and temporal gait data necessary for characterization of event-related alterations in plantar pressures. The alterations that could be examined with the system include rehabilitative, therapeutic, surgical, and nonsurgical treatment. The system is fully portable and does not disrupt the natural gait pattern of the subject during ambulation. Peak plantar pressures, pressure-time integrals, and contact durations are determined for each of the insole sensors.

  10. Relation of Reproductive Factors and Heel Quantitative Ultrasound Parameters in Normal Women of Tehran

    Directory of Open Access Journals (Sweden)

    B Larijani

    2004-11-01

    Full Text Available Quantitative Ultrasound (QUS is a noninvasive, inexpensive and portable method for bone densitometry. It may measure some other parameters in addition to BMD, like elasticity and micro architecture. This study designed to determine the relation between reproductive factors and calcaneus QUS parameters in normal women of Tehran. BMD of heel in 151 normal women, 20-72Y/O (participator of Iranian Multi center Osteoporosis Study was assessed using Achilles+ (GE, Lunar Corporation, USA. After assessment of normal values, Stiffness Index percentiles acquired. With consideration of correlation between variables, multiple regression analysis was used. Mean±SD values of Speed of Sound (SOS, Broad Band Ultrasound Attenuation (BUA and Stiffness Index (SI, was 36/751527/25, 121/4215/1, 94/4617/92, respectively. Parameters decreased with age (P<0/01. Years of menopause significantly related with QUS parameters and age of menopause significant related with SOS and SI. Results show effectiveness of some reproductive factors on QUS parameters.

  11. Unsupervised segmentation of heel-strike IMU data using rapid cluster estimation of wavelet features.

    Science.gov (United States)

    Yuwono, Mitchell; Su, Steven W; Moulton, Bruce D; Nguyen, Hung T

    2013-01-01

    When undertaking gait-analysis, one of the most important factors to consider is heel-strike (HS). Signals from a waist worn Inertial Measurement Unit (IMU) provides sufficient accelerometric and gyroscopic information for estimating gait parameter and identifying HS events. In this paper we propose a novel adaptive, unsupervised, and parameter-free identification method for detection of HS events during gait episodes. Our proposed method allows the device to learn and adapt to the profile of the user without the need of supervision. The algorithm is completely parameter-free and requires no prior fine tuning. Autocorrelation features (ACF) of both antero-posterior acceleration (aAP) and medio-lateral acceleration (aML) are used to determine cadence episodes. The Discrete Wavelet Transform (DWT) features of signal peaks during cadence are extracted and clustered using Swarm Rapid Centroid Estimation (Swarm RCE). Left HS (LHS), Right HS (RHS), and movement artifacts are clustered based on intra-cluster correlation. Initial pilot testing of the system on 8 subjects show promising results up to 84.3%±9.2% and 86.7%±6.9% average accuracy with 86.8%±9.2% and 88.9%±7.1% average precision for the segmentation of LHS and RHS respectively. PMID:24109847

  12. Dendritic cells as Achilles' heel and Trojan horse during varicella zoster virus infection

    Directory of Open Access Journals (Sweden)

    Günther eSchönrich

    2015-05-01

    Full Text Available Varicella zoster virus (VZV, a human alphaherpesvirus, causes varicella and subsequently estab-lishes latency within sensory nerve ganglia. Later in life VZV can reactivate to cause herpes zoster. A reduced frequency of VZV-specific T cells is strongly associated with herpes zoster illustrating that these immune cells are central to control latency. Dendritic cells (DCs are required for the generation of VZV-specific T cells. However, DCs can also be infected in vitro and in vivo allowing VZV to evade the antiviral immune response. Thus, DCs represent the immune systems’ Achilles heel. Uniquely among the human herpesviruses, VZV infects both DCs and T cells, and exploits both as Trojan horses. During primary infection VZV-infected DCs traffic to the draining lymph nodes and tonsils, where the virus is transferred to T cells. VZV-infected T cells subsequently spread infection throughout the body to give the typical varicella skin rash. The delicate interplay between VZV and DCs and its consequences for viral immune evasion and viral dissemination will be discussed in this article.

  13. [Bleeding, the Achilles' heel in patients treated with anticoagulants. Approach in patients with atrial fibrillation].

    Science.gov (United States)

    Morais, João

    2012-04-01

    Bleeding is always the Achilles' heel of all antithrombotic therapy, being unthinkable to use this type of therapy ignoring the complications that it may arise. The bleeding risk raises very particular problems, namely how to predict it and how to manage it. The withdrawal of antithrombotic drugs and transfusion are two important practical problems, involving clinical decisions that are generally very difficult. The new oral anticoagulants pose new problems. If on the one hand its bleeding risk appears to be less, specially in what concerns intracranial bleeding and potentially life-threatening bleeding, on the other hand the lack of an antidote or the lack of a quick and effective laboratory test to evaluate its efficacy, are arguments used by the critics. The risk of bleeding is conditioned by several factors, among them old age. The elderly patient is, by definition, the patient that can bleed more but also the one that, due to its ischemic risk, can reap more benefit. In this paper some of the tools used to predict the risk of bleeding and its clinical impact are also presented.

  14. EM-21 ALTERNATIVE ENHANCED CHEMICAL CLEANING PROGRAM FOR SLUDGE HEEL REMOVAL

    Energy Technology Data Exchange (ETDEWEB)

    Hay, M; King, W; Martino, C

    2009-12-18

    Preliminary studies in the EM-21 Alternative Chemical Cleaning Program have focused on understanding the dissolution of Hematite (a primary sludge heel phase) in oxalic acid, with a focus on minimizing oxalic acid usage. Literature reviews, thermodynamic modeling, and experimental results have all confirmed that pH control, preferably using a supplemental proton source, is critical to oxalate minimization. With pH control, iron concentrations as high as 0.103 M have been obtained in 0.11 M oxalic acid. This is consistent with the formation of a 1:1 (iron:oxalate) complex. The solubility of Hematite in oxalic acid has been confirmed to increase by a factor of 3 when the final solution pH decreases from 5 to below 1. This is consistent with literature predictions of a shift in speciation from a 1:3 to 1:1 as the pH is lowered. Above a solution pH of 6, little Hematite dissolves. These results emphasize the importance of pH control in optimizing Hematite dissolution in oxalic acid.

  15. Use of an orthotic device in the treatment of posterior heel pain.

    Science.gov (United States)

    Wooten, B; Uhl, T L; Chandler, J

    1990-01-01

    Research Funded by the Lexington Clinic Foundation for Research and Education. Posterior heel pain (PHP) presents a difficult clinical challenge. The causes of PHP include Haglund syndrome (pump bump deformity), Achilles tendinitis, and Sever's disease (retrocalcaneal bursitis, traction apophysitis). The purposes of this study were to 1) describe a new orthotic device used in the treatment of PHP and 2) evaluate the effectiveness of this device. The orthotic device consisted of a neoprene sleeve holding 1/4 inch PPT foam rubber horseshoe (Sports Supports, Inc., Dallas, TX). The horseshoe was placed directly over the injury to protect and relieve pressure or was inverted and used as a counterforce brace to reduce the tensile stress to the Achilles tendon. Eight patients (6 children, 2 adults) were evaluated at the time of application and after 1 month of use. Three criteria were considered: 1) subjective pain scale, 2) active goniometric measurements, and 3) toe raise test. The statistical analysis indicated a significant improvement in pain during activity from initial to follow-up and in pain after activity from initial to follow-up. All patients demonstrated improved strength and flexibility. It was concluded that this device may be an effective adjunct to the treatment of PHP. J Orthop Sports Phys Ther 1990;11(9):410-413. PMID:18787273

  16. Dendritic cells as Achilles' heel and Trojan horse during varicella zoster virus infection.

    Science.gov (United States)

    Schönrich, Günther; Raftery, Martin J

    2015-01-01

    Varicella zoster virus (VZV), a human alphaherpesvirus, causes varicella and subsequently establishes latency within sensory nerve ganglia. Later in life VZV can reactivate to cause herpes zoster. A reduced frequency of VZV-specific T cells is strongly associated with herpes zoster illustrating that these immune cells are central to control latency. Dendritic cells (DCs) are required for the generation of VZV-specific T cells. However, DCs can also be infected in vitro and in vivo allowing VZV to evade the antiviral immune response. Thus, DCs represent the immune systems' Achilles heel. Uniquely among the human herpesviruses, VZV infects both DCs and T cells, and exploits both as Trojan horses. During primary infection VZV-infected DCs traffic to the draining lymph nodes and tonsils, where the virus is transferred to T cells. VZV-infected T cells subsequently spread infection throughout the body to give the typical varicella skin rash. The delicate interplay between VZV and DCs and its consequences for viral immune evasion and viral dissemination will be discussed in this article. PMID:26005438

  17. Reconstruction of Heel With Propeller Flap in Postfasciotomy and Popliteal Artery Revascularization State.

    Science.gov (United States)

    Kang, Jin Seok; Choi, Hwan Jun; Tak, Min Sung

    2016-06-01

    Free flaps are still the gold standard for large defects of the lower limb, but propeller perforator flaps have become a simpler and faster alternative to free flaps because of some advantages such as reliable vascular pedicle, wide mobilization and rotation, great freedom in design, low donor site morbidity, and easy harvest with no requirement for anastomosis. But when the vessels show insufficient findings in preoperative evaluation using a Doppler probe or the vessel is injured, the surgeon should avoid performing free flap surgery to prevent flap failure and should select a propeller perforator flap as an alternative method on the condition that more than one perforator is intact. In this study, we report reconstruction of soft tissue defects of the heel with a pedicled propeller flap in postfasciotomy and popliteal artery revascularization state by making an incision on the central portion above the Achilles tendon, which can be covered by the posterior tibial artery perforator or the peroneal artery perforator based flaps. In conclusion, we showed that although the popliteal artery was injured, the soft tissue defect can be reconstructed using a perforator propeller flap if intact distal flow in the anastomosis site was confirmed. PMID:25673623

  18. Monochloroacetic acid application is an effective alternative to cryotherapy for common and plantar warts in primary care: a randomized controlled trial

    NARCIS (Netherlands)

    Bruggink, S.C.; Gussekloo, J.; Egberts, P.F.; Bavinck, J.N.; Waal, M.W. de; Assendelft, W.J.J.; Eekhof, J.A.

    2015-01-01

    Cryotherapy and salicylic acid (SA) often fail as treatments for skin warts. We examined the effectiveness of monochloroacetic acid (MCA) for patients with common or plantar warts. Consecutive patients aged 4 years and older with one or more newly diagnosed common or plantar warts were recruited in

  19. Styrketräning av tårnas flexormuskulatur vid plantar fasciit : Tre Single-Case studier

    OpenAIRE

    Ullberg, Oskar

    2016-01-01

    Bakgrund: Hälsmärta drabbar en av 10 individer någon gång i livet, i cirka 80 procent av fallen är orsaken plantar fasciit. Läkningstiden för plantar fasciit kan bli mycket lång, i vissa fall upp till två år. Följsamhet till träningsprogram är av stor betydelse för utfallet vid fysioterapeutiska behandling. Syfte: Att undersöka hur styrketräning av tårnas flexormuskulatur, med fokus på excentrisk belastning, påverkar tilltro till aktivitetsnivå (rask promenad) och symtom vid plantar fasciit. ...

  20. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training.

    Science.gov (United States)

    Behrens, Martin; Weippert, Matthias; Wassermann, Franziska; Bader, Rainer; Bruhn, Sven; Mau-Moeller, Anett

    2015-01-01

    Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after 8 weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms) and iMVC of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave), peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that cycling endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue resistance. PMID:26029114

  1. Local plantar pressure relief in therapeutic footwear: design guidelines from finite element models.

    Science.gov (United States)

    Erdemir, Ahmet; Saucerman, Jeffrey J; Lemmon, David; Loppnow, Bryan; Turso, Brie; Ulbrecht, Jan S; Cavanagh, Peter Re

    2005-09-01

    A major goal of therapeutic footwear in patients with pain or those at risk for skin injury is to relieve focal loading under prominent metatarsal heads. One frequent approach is to place plugs of compliant material into the midsole of the shoe. This study investigated 36 plug designs, a combination of three materials, six geometries, and two placements using a two-dimensional (2D) finite element model. Realistic loading conditions were obtained from plantar pressures (PP) recorded during walking in five subjects who wore control midsoles manufactured using Microcell Puff. Measured peak pressures underneath the second metatarsal head were similar to the results of the control model. PP obtained from simulations with the plugs built into a firm midsole were compared to the simulation results of the control midsole. Large plugs (e.g. 40 mm width), made out of Microcell Puff Lite or Plastazote Medium, placed at peak pressure sites, resulted in highest reductions in peak pressures (18-28%). Smaller plugs benefited from tapering when placed at high pressure areas. Case studies were completed on a healthy male subject and a diabetic female patient to address the efficacy of a plug design favored by our simulations (pressure based placement, 40 x 20 mm, Plastazote Medium). Successful reductions of second metatarsal head pressures were observed with a mediolateral load redistribution that was not represented by our model. 2D computer simulations allowed systematic investigation of plug properties without the need for high volume experimentation on human subjects and established basic guidelines for plug selection. In particular, plugs that are placed based on plantar pressure measurements were proven to be more effective when compared to those positioned according to the projection of the bony landmark on the foot-shoe plantar contact area. PMID:16023466

  2. Plantar pressure analysis of accommodative insole in older people with metatarsalgia.

    Science.gov (United States)

    Chang, Bao-Chi; Liu, Ding-Hao; Chang, Jeffrey Liao; Lee, Si-Huei; Wang, Jia-Yi

    2014-01-01

    Foot pain frequently reduces physical activity and increases the risk of falls in older people. In current orthotic management of forefoot pain, metatarsal padding is the main strategy to reduce metatarsal pressure. However, pressure reductions are usually diverse and limited. The multi-step accommodative insole is fabricated by sequential foam padding on Plastazote under dynamic accommodation in daily walking. The aims of this study were to investigate the effectiveness and mechanisms of accommodative insole on plantar pressure redistribution in older people with metatarsalgia. The study was conducted on 21 old outpatients with moderate to severe metatarsalgia, using the ethylene vinyl acetate control, 9-mm flat Plastazote, and accommodative insoles with and without metatarsal and arch support. Outcome measures included pressure-related variables measured by a Pedar-X system, and pain scores assessed with a 0-10 Visual Analog Scale. The accommodative insole significantly decreased peak pressure under the metatarsal heads by 47.2% (p<0.001) and the pain scores from 8.2 to 1.1 (p<0.001). Plantar pressure analyses indicated that the effects of dynamic metatarsal contouring and cushioning on reducing peak pressure were greater than those of metatarsal padding. The temporo-spatial relationships between the toe and metatarsal head can assist in explaining an elevated metatarsal pressure and higher risk of falls in older people with toe deformities. The multi-step insole is simple in orthotic fabrication and ensures an even distribution of plantar pressure loading in walking. It can effectively relieve metatarsalgia and help to preserve regular walking activity for older people with metatarsalgia. PMID:24119776

  3. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training

    Directory of Open Access Journals (Sweden)

    Martin eBehrens

    2015-05-01

    Full Text Available Previously published studies on the effect of short-term endurance training on the neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after eight weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms and isometric maximum voluntary contraction of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave, peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that the endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue

  4. The Effect of Different Foot Orthosis Inverted Angles on Plantar Pressure in Children with Flexible Flatfeet.

    Directory of Open Access Journals (Sweden)

    Soo-Kyung Bok

    Full Text Available Although orthotic modification using the inverted technique is available for the treatment of flatfoot, empirical evidence for the biomechanical effects of inverted-angle foot orthoses (FOs is lacking. The aim of this study was to evaluate the effects of different FO inversion angles on plantar pressure during gait in children with flatfoot. Twenty-one children with flexible flatfeet (mean age 9.9 years were enrolled in this study. The plantar pressures were measured for the rearfoot; medial and lateral midfoot; and medial, central, and lateral forefoot as participants walked on a treadmill while wearing shoes only and shoes with the following 3 orthotic conditions: (i orthosis with no inverted angle, (ii orthosis with a 15° inverted angle, and (iii orthosis with a 30° inverted angle. A one-way repeated measures analysis of variance (ANOVA with the Bonferroni-adjusted post-hoc test was used to compare the mean values of each orthotic condition. Compared with the shoe only condition, the peak pressure decreased significantly under the medial forefoot and rearfoot with all FOs (p <0.05. However, no significant differences in the peak pressure under the medial forefoot and rearfoot were observed between the FOs. The peak pressure under the medial midfoot increased significantly with all FOs, and a maximal increase in the peak pressure was obtained with a 30° inverted angle orthosis. Furthermore, the contact area under the medial midfoot and rearfoot increased significantly with all FOs, compared with the shoe only condition (p <0.05. Again, no significant differences were observed between the FOs. For plantar pressure redistribution, a FO with a low inverted angle could be effective, accommodative, and convenient for children with flatfoot.

  5. The effect of knee joint angle on plantar flexor power in young and old men.

    Science.gov (United States)

    Dalton, Brian H; Allen, Matti D; Power, Geoffrey A; Vandervoort, Anthony A; Rice, Charles L

    2014-04-01

    Human adult aging is associated with a loss of strength, contractile velocity and hence, power. The principal plantar flexors, consisting of the bi-articular gastrocnemeii and the mono-articular soleus, appear to be affected differently by the aging process. However, the age-related effect of knee joint angle on the torque-angular velocity relationship and power production of this functionally important muscle group is unknown. The purpose was to determine whether flexing the knee, thereby reducing the gastrocnemius contribution to plantar flexion, would exacerbate the age-related decrements in plantar flexion power, or shift the torque-angular velocity relationship differently in older compared with young men. Neuromuscular properties were recorded from 10 young (~25 y) and 10 old (~78 y) men with the knee extended (170°) and flexed (90°), in a randomized order. Participants performed maximal voluntary isometric contractions (MVCs), followed by maximal velocity-dependent shortening contractions at pre-set loads, ranging from 15 to 75% MVC. The young men were ~20-25% stronger, ~12% faster and ~30% more powerful than the old for both knee angles (Ptorque was ~17% greater in the extended than flexed knee position, with no differences in voluntary activation (>95%). The young men produced 7-12% faster angular velocities in the extended knee position for loads ≤30% MVC, but no differences at higher loads; whereas there were no detectable differences in angular velocity between knee positions in the old across all relative loads. For both knee angles, young men produced peak power at 43.3±9.0% MVC, whereas the old men produced peak power at 54.8±7.9% MVC. These data indicate that the young, who have faster contracting muscles compared with the old, can rely more on velocity than torque for generating maximal power.

  6. Influencia do indice de massa corporal no equilibrio e na configuracao plantar em obesos adultos

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    Liu Chiao Yi

    2014-01-01

    Full Text Available INTRODUÇÃO: A obesidade é uma doença crônica degenerativa multifatorial que pode levar a alterações do sistema musculoesquelético, como mudança do centro de gravidade e sobrecarga mecânica sobre os membros inferiores. OBJETIVOS: Correlacionar o índice de massa corporal (IMC com o equilíbrio corporal e verificar associação entre o IMC e a configuração plantar. MÉTODOS: Foram avaliados 30 obesos, de ambos os gêneros, com IMC maior ou igual a 30 Kg/m². Inicialmente, os voluntários foram submetidos às avaliações de medidas antropométricas a fim de calcular o valor do IMC. Em seguida, foram submetidos ao teste de equilíbrio corporal estático Balance Error Scoring System (BESS e a plantigrafia para a identificação da impressão plantar. Por meio do método de Viladot, os voluntários foram classificados em grupos: pé plano (GPP, pé cavo (GPC e pé neutro (GPN. A correlação entre as variáveis IMC e BESS foi calculada por meio do coeficiente de correlação linear de Pearson e associação entre o IMC e a configuração plantar foi realizada por meio da análise de variância (Anova. Para todas as análises, nível de significância considerado foi p < 0,05. RESULTADOS: Os valores da correlação entre o IMC e o BESS foram r = - 0,1 e p = 0,59. Os valores da associação do IMC entre GPN - GPP; GPN - GPC; GPP - GPC foram respectivamente: p = 0,76; p = 0,001; p = 0,07. CONCLUSÃO: O índice de massa corporal de adultos obesos não influencia o equilíbrio corporal, porém influencia na configuração plantar.

  7. Influence of the surface area approximation on plantar arch index calculus

    Science.gov (United States)

    Toth-Taşcǎu, Mirela; Stoia, Dan Ioan; Vigaru, Cosmina; Pasca, Oana

    2012-09-01

    The general purpose of this study was to establish some correction coefficients used in plantar index calculus. In order to compute the correction coefficients, the total area of scanned footprints was estimated using two methods. The footprints were acquired on white plan paper by means of graphite powder, and scanned at five different resolutions. One of the methods of area computing refers to counting squares of an applied grid on the image, while the other method uses a computer software to determine footprint limits and area.

  8. Influence of pressure-relief insoles developed for loaded gait (backpackers and obese people) on plantar pressure distribution and ground reaction forces.

    Science.gov (United States)

    Peduzzi de Castro, Marcelo; Abreu, Sofia; Pinto, Viviana; Santos, Rubim; Machado, Leandro; Vaz, Mario; Vilas-Boas, João Paulo

    2014-07-01

    The aims of this study were to test the effects of two pressure relief insoles developed for backpackers and obese people on the ground reaction forces (GRF) and plantar pressure peaks during gait; and to compare the GRF and plantar pressures among normal-weight, backpackers, and obese participants. Based on GRF, plantar pressures, and finite element analysis two insoles were manufactured: flat cork-based insole with (i) corkgel in the rearfoot and forefoot (SLS1) and with (ii) poron foam in the great toe and lateral forefoot (SLS2). Gait data were recorded from 21 normal-weight/backpackers and 10 obese participants. The SLS1 did not influence the GRF, but it relieved the pressure peaks for both backpackers and obese participants. In SLS2 the load acceptance GRF peak was lower; however, it did not reduce the plantar pressure peaks. The GRF and plantar pressure gait pattern were different among the normal-weight, backpackers and obese participants.

  9. Larger plantar flexion torque variability implies less stable balance in the young: an association affected by knee position.

    Science.gov (United States)

    Mello, Emanuele Moraes; Magalhães, Fernando Henrique; Kohn, André Fabio

    2013-12-01

    The present study examined the association between plantar flexion torque variability during isolated isometric contractions and during quiet bipedal standing. For plantar flexion torque measurements in quiet stance (QS), subjects stood still over a force plate. The mean plantar flexion torque level exerted by each subject in QS (divided by 2 to give the torque due to a single leg) served as the target torque level for right leg force-matching tasks in extended knee (KE) and flexed knee (KF) conditions. Muscle activation levels (EMG amplitudes) of the triceps surae and mean, standard deviation and coefficient of variation of plantar flexion torque were computed from signals acquired during periods with and without visual feedback. No significant correlations were found between EMG amplitudes and torque variability, regardless of the condition and muscle being analyzed. A significant correlation was found between torque variability in QS and KE, whereas no significant correlation was found between torque variability in QS and KF, regardless of vision availability. Therefore, torque variability measured in a controlled extended knee plantar flexion contraction is a predictor of torque variability in the anterior-posterior direction when the subjects are in quiet standing. In other words, larger plantar flexion torque variability in KE (but not in KF) implies less stable balance. The mechanisms underlying the findings above are probably associated with the similar proprioceptive feedback from the triceps surae in QS and KE and poorer proprioceptive feedback from the triceps surae in KF due to the slackening of the gastrocnemii. An additional putative mechanism includes the different torque contributions of each component of the triceps surae in the two knee angles. From a clinical and research standpoint, it would be advantageous to be able to estimate changes in balance ability by means of simple measurements of torque variability in a force matching task.

  10. Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic hemiplegic children with cerebral palsy

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria; Andersen, Jacob Buus; Sinkjær, Thomas;

    2014-01-01

    It is commonly assumed that exaggerated stretch reflex activity and the resulting increased muscle tone in ankle plantar flexors contribute to reduced ankle joint movement during gait in children with cerebral palsy (CP). We investigated the contribution of sensory feedback mechanisms to ankle...... in a similar proportion in both groups. Shortening of the plantar flexors in swing caused a larger drop in Soleus EMG in control children than in children with CP. The lack of age related decline in stretch reflexes in the stance phase and the inability to suppress the reflex in the swing phase is likely...

  11. Appearance of the Spontaneous Secretion of the Palmar and Plantar Sweat Glands in Rats during Postnatal Period

    OpenAIRE

    Matsumoto, Itsuro; Abe, Kiichiro

    1981-01-01

    Functional development of the palmar and plantar sweat glands in rats during postnatal period was evaluated by examining the appearance of spontaneous secretion of these sweat glands. After non-secretory period, spontaneous secretion of the palmar sweat glands began to occur between 10 and 17 days and that of the plantar sweat glands between 16 and 21 days after birth. In each individual rat, the palmar sweat glands began to secrete spontaneously 5 ± 1.5 days (mean ± SEM) earlier than did the...

  12. Alinhamento frontal estático do joelho e cargas plantares durante a marcha de adultos jovens assintomáticos Static frontal knee alignment and plantar loads during gait in healthy young adults

    Directory of Open Access Journals (Sweden)

    Isabel C.N. Sacco

    2009-03-01

    Full Text Available Na prática fisioterapêutica, pressupõe-se que alterações posturais do membro inferior influenciem a biomecânica e função dos demais complexos durante o movimento. No entanto, a literatura sobre a relação entre desalinhamentos estáticos do joelho e possíveis alterações dinâmicas ainda é escassa e inconclusiva. Assim, buscou-se avaliar o efeito do alinhamento frontal estático do joelho sobre a distribuição da pressão plantar durante a marcha. Foram avaliados inicialmente 44 adultos jovens assintomáticos. Por fotogrametria digital, mediu-se o ângulo frontal do joelho, classificado como normal (170° a 175°, valgo 175°. Dado o baixo número de valgos, foram analisados dois grupos: de joelhos normais (n=18 e de joelhos varos (n=23. A distribuição da pressão plantar foi avaliada durante a marcha em cinco áreas. Os grupos mostraram-se estatistica-mente semelhantes em todas as variáveis cinéticas avaliadas em todas as áreas plantares. Joelhos normais apresentaram significativa correlação com o tempo de contato no antepé lateral e médio-pé; e os varos, correlação com a área e tempo de contato em duas e três áreas plantares, e com a pressão integral no antepé lateral. Os resultados mostraram que o desalinhamento frontal de 3° do joelho, embora com moderada correlação, não influencia a distribuição de cargas na superfície plantar durante a marcha. Sugere-se pois que a avaliação clínica não se limite à avaliação articular estática do joelho, mas inclua atividades dinâmicas.In physical therapy practice, it is assumed that lower-limb posture changes may influence other complexes' biomechanics or function during movement. However, literature on the relationship between static knee alignment and possible dynamic changes is still scarce and inconclusive. This study assessed the effect of static frontal knee alignment on plantar pressure distribution during gait. At first 44 young asymptomatic adults were

  13. Botulinum toxin treatment for lower limb extensor spasticity in chronic hemiparetic patients.

    OpenAIRE

    Hesse, S; Lücke, D; Malezic, M; Bertelt, C; Friedrich, H. (Hergen); Gregoric, M; Mauritz, K H

    1994-01-01

    Twelve chronic hemiparetic outpatients with pronounced lower limb extensor spasticity were injected with 400 units of botulinum toxin A, EMG guided into the soleus, tibialis posterior, and both heads of the gastrocnemius muscles. Botulinum toxin A caused a definite reduction of plantar flexor spasticity, in 10 patients two weeks after the injection, as assessed by the Ashworth scale. Four of the patients were able to achieve active dorsiflexion of their affected ankle. Gait analysis including...

  14. OPTIMAL POSITION OF THE HEEL FOLLOWING RECONSTRUCTION OF THE STAGE II ADULT ACQUIRED FLATFOOT DEFORMITY

    Science.gov (United States)

    Conti, Matthew S.; Ellis, Scott J.; Chan, Jeremy Y.; Do, Huong T.; Deland, Jonathan T.

    2016-01-01

    Background While previous work has demonstrated a linear relationship between the amount of medializing calcaneal osteotomy (MCO) and the change in radiographic hindfoot alignment following reconstruction, an ideal postoperative hindfoot alignment has yet to be reported. The aim of this study was to identify an optimal postoperative hindfoot alignment by correlating radiographic alignment with patient outcomes. Methods Fifty-five feet in 55 patients underwent flatfoot reconstruction for stage II AAFD by two fellowship-trained foot and ankle orthopedic surgeons. Hindfoot alignment was determined as previously described by Saltzman and El-Khoury. Changes in pre- and postoperative scores in each FAOS subscale were calculated for patients in postoperative hindfoot valgus (≥0 mm valgus, n=18), mild varus (>0 to 5 mm varus, n=17), and moderate varus (>5 mm varus, n=20). Analysis of variance and post-hoc Tukey’s tests were used to compare the change in FAOS scores between these three groups. Results At 22 months or more postoperatively, patients corrected to mild hindfoot varus showed a significantly greater improvement in the FAOS pain subscale compared to patients in valgus (p=0.04) and symptoms subscale compared to patients in moderate varus (p=0.03). Although mild hindfoot varus did not differ significantly from moderate varus or valgus in the other subscales, mild hindfoot varus did not perform worse than these alignments in any FAOS subscale. No statistically significant correlations between intraoperative MCO slide distances and FAOS subscales were found. Conclusions Our study indicates that correction of hindfoot alignment to between 0 and 5 mm of varus on the hindfoot alignment view (clinically a straight heel) following stage II flatfoot reconstruction was associated with the greatest improvement in clinical outcomes following hindfoot reconstruction in stage II AAFD. PMID:25948692

  15. An Ethylene-Protected Achilles’ Heel of Etiolated Seedlings for Arthropod Deterrence

    Science.gov (United States)

    Boex-Fontvieille, Edouard; Rustgi, Sachin; von Wettstein, Diter; Pollmann, Stephan; Reinbothe, Steffen; Reinbothe, Christiane

    2016-01-01

    A small family of Kunitz protease inhibitors exists in Arabidopsis thaliana, a member of which (encoded by At1g72290) accomplishes highly specific roles during plant development. Arabidopsis Kunitz-protease inhibitor 1 (Kunitz-PI;1), as we dubbed this protein here, is operative as cysteine PI. Activity measurements revealed that despite the presence of the conserved Kunitz-motif the bacterially expressed Kunitz-PI;1 was unable to inhibit serine proteases such as trypsin and chymotrypsin, but very efficiently inhibited the cysteine protease RESPONSIVE TO DESICCATION 21. Western blotting and cytolocalization studies using mono-specific antibodies recalled Kunitz-PI;1 protein expression in flowers, young siliques and etiolated seedlings. In dark-grown seedlings, maximum Kunitz-PI;1 promoter activity was detected in the apical hook region and apical parts of the hypocotyls. Immunolocalization confirmed Kunitz-PI;1 expression in these organs and tissues. No transmitting tract (NTT) and HECATE 1 (HEC1), two transcription factors previously implicated in the formation of the female reproductive tract in flowers of Arabidopsis, were identified to regulate Kunitz-PI;1 expression in the dark and during greening, with NTT acting negatively and HEC1 acting positively. Laboratory feeding experiments with isopod crustaceans such as Porcellio scaber (woodlouse) and Armadillidium vulgare (pillbug) pinpointed the apical hook as ethylene-protected Achilles’ heel of etiolated seedlings. Because exogenous application of the ethylene precursor 1-aminocyclopropane-1-carboxylic acid (ACC) and mechanical stress (wounding) strongly up-regulated HEC1-dependent Kunitz-PI;1 gene expression, our results identify a new circuit controlling herbivore deterrence of etiolated plants in which Kunitz-PI;1 is involved. PMID:27625656

  16. 小趾展肌神经与神经源性跟痛症关系的解剖学基础%Anatomic relationship of abductor digiti miniini nerve and neuragenic painful heel syndrome

    Institute of Scientific and Technical Information of China (English)

    冯成安; 孙俊; 刘宗良; 范炜; 张东葵; 陆地

    2012-01-01

    目的 探讨小趾展肌神经的局部解剖特点及其与神经源性跟痛症的关系,为临床诊断治疗提供解剖学依据.方法 32侧防腐成人尸体下肢标本,解剖观察小趾展肌神经的起源、分支、走行和分布特点.结果 小趾展肌神经81.25%起源于足底外侧神经,起点59.38%位于后上象限;起点与参考线的垂直深度,左侧( 10.81±0.96)mm,右侧(10.24±1.10)mm;小趾展肌神经发出1~3支骨膜支到达跟骨结节内侧突的骨膜;小趾展肌神经与跟骨结节内侧突该的水平距离左侧(19.95±1.82)mm,右侧(20.89±2.48)mm.结论 小趾展肌神经行经(足母)展肌和足底方肌内侧头之间,跟骨结节内侧突前可能被卡压,卡压或病变(特别是骨膜支)可能与足底腱膜炎发生有关;跟骨骨刺不一定会造成神经源性跟痛症.%Objective To investigate anatomic relationship between abductor digiti minimi nerve (ADMN) and neurogenic painful heel syndrome (NPHS) for clinical diagnosis and therapy. Methods 32 fixed adult lower limb specimens were used in the study. The ADMN was dissected for observing it's origin, course, branches and distribution. Results For cases of 81.25%, ADMN originated from the lateral plantar nerve, which consisted of 19 trunks (59.38%) located in the postcrosuperior quadrant. The vertical depth of the origin site to the reference line was (10.81±0.96)mm and (10.24±1.10) mm at left and right sides respectively. ADMN firstly issued 1-3 periosteum branches, which arrived the periosteum of medial process of calcaneal tuberosity. The horizontal distances from the site of medial process of calcaneal tuberosity to the left or right tuberosities were (19.95*1.82) mm and (20.89 ±2.48)mm, seperately. Conclusions ADMN is probably stamped when it goes through the abductor hallucis, the medial head of quadratus plantae and the medial process of calcaneal tuberosity. The stamp or lesion of ADMN (especially periosteum branch) is probably

  17. The Effect of Different Foot Orthosis Inverted Angles on Plantar Pressure in Children with Flexible Flatfeet

    Science.gov (United States)

    Lee, Hyunkeun; Ahn, Soyoung; Song, Youngshin; Park, Insik

    2016-01-01

    Although orthotic modification using the inverted technique is available for the treatment of flatfoot, empirical evidence for the biomechanical effects of inverted-angle foot orthoses (FOs) is lacking. The aim of this study was to evaluate the effects of different FO inversion angles on plantar pressure during gait in children with flatfoot. Twenty-one children with flexible flatfeet (mean age 9.9 years) were enrolled in this study. The plantar pressures were measured for the rearfoot; medial and lateral midfoot; and medial, central, and lateral forefoot as participants walked on a treadmill while wearing shoes only and shoes with the following 3 orthotic conditions: (i) orthosis with no inverted angle, (ii) orthosis with a 15° inverted angle, and (iii) orthosis with a 30° inverted angle. A one-way repeated measures analysis of variance (ANOVA) with the Bonferroni-adjusted post-hoc test was used to compare the mean values of each orthotic condition. Compared with the shoe only condition, the peak pressure decreased significantly under the medial forefoot and rearfoot with all FOs (p flatfoot. PMID:27458719

  18. Effects of surface characteristics on the plantar shape of feet and subjects' perceived sensations.

    Science.gov (United States)

    Witana, Channa P; Goonetilleke, Ravindra S; Xiong, Shuping; Au, Emily Y L

    2009-03-01

    Orthotics and other types of shoe inserts are primarily designed to reduce injury and improve comfort. The interaction between the plantar surface of the foot and the load-bearing surface contributes to foot and surface deformations and hence to perceived comfort, discomfort or pain. The plantar shapes of 16 participants' feet were captured when standing on three support surfaces that had different cushioning properties in the mid-foot region. Foot shape deformations were quantified using 3D laser scans. A questionnaire was used to evaluate the participant's perceptions of perceived shape and perceived feeling. The results showed that the structure in the mid-foot could change shape, independent of the rear-foot and forefoot regions. Participants were capable of identifying the shape changes with distinct preferences towards certain shapes. The cushioning properties of the mid-foot materials also have a direct influence on perceived feelings. This research has strong implications for the design and material selection of orthotics, insoles and footwear.

  19. Effectiveness of moulded insoles in reducing plantar pressure in diabetic patients.

    Science.gov (United States)

    Zequera, M; Stephan, S; Paul, J

    2007-01-01

    For an effective prevention of foot sole ulcers in diabetic patients, the Bioengineering and Signal processing group of the Electronics Department of the Pontificia Universidad Javeriana developed a novel method for the computer assisted design and production of therapeutic insoles, integrating several technologies, such as: CAD/CAM registration of pressure on the foot sole, Podoscopy, and an expert system based on knowledge. The afore mentioned method allows topographical modeling of the insoles starting by the digitization in 3D of a cast of the foot sole surface of the patient and its computer assisted design taking into account the recommendations of the knowledge based system. The aim of this study was to evaluate the effect on plantar pressure distribution of different insoles prescribed and manufactured with various techniques on a random group of patients with diabetes mellitus in the early stages of the disease. Four different types of insoles were manufactured by methods available in the market and by the computer model system proposed on a previous research, which was used in order to design and manufacture one of the insoles evaluated. The differences between the four types of insoles were established by comparing their effectiveness in plantar pressure reduction.

  20. Reliability of Various Measurement Stations for Determining Plantar Fascia Thickness and Echogenicity.

    Science.gov (United States)

    Bisi-Balogun, Adebisi; Cassel, Michael; Mayer, Frank

    2016-04-13

    This study aimed to determine the relative and absolute reliability of ultrasound (US) measurements of the thickness and echogenicity of the plantar fascia (PF) at different measurement stations along its length using a standardized protocol. Twelve healthy subjects (24 feet) were enrolled. The PF was imaged in the longitudinal plane. Subjects were assessed twice to evaluate the intra-rater reliability. A quantitative evaluation of the thickness and echogenicity of the plantar fascia was performed using Image J, a digital image analysis and viewer software. A sonography evaluation of the thickness and echogenicity of the PF showed a high relative reliability with an Intra class correlation coefficient of ≥0.88 at all measurement stations. However, the measurement stations for both the PF thickness and echogenicity which showed the highest intraclass correlation coefficient (ICCs) did not have the highest absolute reliability. Compared to other measurement stations, measuring the PF thickness at 3 cm distal and the echogenicity at a region of interest 1 cm to 2 cm distal from its insertion at the medial calcaneal tubercle showed the highest absolute reliability with the least systematic bias and random error. Also, the reliability was higher using a mean of three measurements compared to one measurement. To reduce discrepancies in the interpretation of the thickness and echogenicity measurements of the PF, the absolute reliability of the different measurement stations should be considered in clinical practice and research rather than the relative reliability with the ICC.

  1. ACUTE EFFECTS OF TWO MASSAGE TECHNIQUES ON ANKLE JOINT FLEXIBILITY AND POWER OF THE PLANTAR FLEXORS

    Directory of Open Access Journals (Sweden)

    Grant J.B. McKechnie

    2007-12-01

    Full Text Available The purpose of this study was to determine if three minutes of petrissage and tapotement forms of massage would influence plantar flexors' flexibility, and muscle power. Nineteen participants were randomly subjected to three conditions (control and two massages before performing two power tests. Prior to the intervention, subjects completed ankle joint flexibility assessments. The conditions were; (1 control, where subjects lay prone and had a therapist's hands resting, (2 vigorous petrissage, and (3 tapotement applied at a rate of 4Hz; all on the triceps surae. Following completion of the intervention, subjects immediately completed a post- ankle joint flexibility test, followed by a drop-jump and concentric calf raise. The power measures were; concentric peak force, rate of force development, and drop-jump height / contact time. The data showed a significant increase (p < 0.05 in ankle joint angle on the right leg and a corresponding tendency on the left. No significant change was seen with the power measures. Results suggest that massage can increase plantar flexors' flexibility without a change in power and thus may be an alternative to static stretching during an athletic warm-up

  2. The effect of three different toe props on plantar pressure and patient comfort

    Directory of Open Access Journals (Sweden)

    Johnson Sarah

    2012-08-01

    Full Text Available Abstract Background Arthritic toe pathologies frequently lead to the development of painful apical pressure skin lesions that can compromise gait and affect quality of life. Historically conservative treatments involve the use of a toe prop with the intended aim of reducing plantar pressure from the apex of the digit. However, the effect of toe prop treatment on plantar digital pressure has not been investigated. Method Twenty two subjects were recruited with lesser digital deformities and associated apical skin lesions. Individual pressure sensors were placed on the apices of the lesser toes and pressure was recorded under three toe prop conditions (leather, gel and silicone mould. A modified comfort index was utilised to assess the comfort of each condition. Results Significant difference (p nd toe when using the gel (p p nd toe when using gel (p p  Conclusion As compared to the leather and silicone mould toe props, gel toe props were found to be the most effective for reducing peak pressure and pressure time integral on the apex of the second digit in patients with claw or hammer toe deformity.

  3. Is Lumbo-Sacral Angle Related to Plantar Loading Patterns in Patients with Ankylosing Spondylitis?

    Directory of Open Access Journals (Sweden)

    Elif Aydın

    2016-08-01

    Full Text Available Objective: Loss of lumbar lordosis is a clinical feature of ankylosing spondylitis (AS. Pedobarographic analysis assesses the interaction between the foot and the supporting surface. Postural abnormalities can reflect as pressure distribution deviations on pedobarography. The objective of the present study was to assess whether loss of lumbar lordosis detected with lumbo-sacral angle measurement is related to postural control assessed by plantar loading distribution in patients with AS. Materials and Methods: Thirty-two patients (two female, 30 male, mean age: 43.06±7.8 years with the diagnosis of AS, who already had a lateral lumbo-sacral X-ray performed within the past one year, were included in the study. Static and dynamic pedobarographic analyses of the patients were performed. The radiographic measurement of lumbo-sacral angle was done from lateral lumbo-sacral X-rays of the patients. Results: The static pedobarographic measurement revealed that lumbo-sacral angle was significantly correlated with forefoot plantar pressure (p=0.042; r=0.361. In the dynamic assessment, the maximum pressures were lower under the first metatarsal area in patients with lower lumbo-sacral angle (p=0.352; r=0.048. Conclusion: These findings suggest that foot joints may contribute to the compensation mechanism against the postural changes in patients with AS, statically and dynamically.

  4. The efficacy of a removable vacuum-cushioned cast replacement system in reducing plantar forefoot pressures in diabetic patients

    NARCIS (Netherlands)

    S.A. Bus; R. Waaijman; M. Arts; H. Manning

    2009-01-01

    Background: The purpose of this study was to determine the plantar forefoot offloading efficacy of a new prefabricated vacuum-cushioned cast replacement system designed for foot ulcer treatment in neuropathic diabetic patients. Methods: Fifteen diabetic subjects with peripheral neuropathy underwent

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Comparative Clustering of Plantar Pressure Distributions in Diabetics with Polyneuropathy May Be Applied to Reveal Inappropriate Biomechanical Stress

    Science.gov (United States)

    Niemann, Uli; Spiliopoulou, Myra; Szczepanski, Thorsten; Samland, Fred; Grützner, Jens; Senk, Dominik; Ming, Antao; Kellersmann, Juliane; Malanowski, Jan; Klose, Silke; Mertens, Peter R.

    2016-01-01

    In diabetic patients, excessive peak plantar pressure has been identified as major risk factor for ulceration. Analyzing plantar pressure distributions potentially improves the identification of patients with a high risk for foot ulceration development. The goal of this study was to classify regional plantar pressure distributions. By means of a sensor-equipped insole, pressure recordings of healthy controls (n = 18) and diabetics with severe polyneuropathy (n = 25) were captured across eight foot regions. The study involved a controlled experimental protocol with multiple sessions, where a session contained several cycles of pressure exposure. Clustering was used to identify subgroups of study participants that are characterized by similar pressure distributions. For both analyzed groups, the number of clusters to best describe the pressure profiles was four. When both groups were combined, analysis again led to four distinct clusters. While three clusters did not separate between healthy and diabetic volunteers the fourth cluster was only represented by diabetics. Here the pressure distribution pattern is characterized by a focal point of pressure application on the forefoot and low pressure on the lateral region. Our data suggest that pressure clustering is a feasible means to identify inappropriate biomechanical plantar stress. PMID:27529421

  7. Effects of the application of Low-Dye taping on the pain and stability of patients with plantar fasciitis.

    Science.gov (United States)

    Park, Chan; Lee, Sangyong; Lim, Dong-Young; Yi, Char-Woo; Kim, Jang Hwan; Jeon, Chunbae

    2015-08-01

    [Purpose] This study examined how the application of Low-Dye (LD) taping affected the pain and stability of patients with plantar fasciitis. [Subjects] The subjects were 30 patients with plantar fasciitis who were divided into two groups: a Low-Dye taping group (LTG, n=15) and a conservative treatment group (CTG, n=15). [Methods] The treatments were performed three times a week for six weeks in both groups. A visual analog scale (VAS) was used to evaluate the pain and stability of patients with plantar fasciitis, and the transfer area of the center of gravity (TAOCOG) was measured to evaluate stability using a BioRescue device. [Results] In the within-group comparison of the VAS, the LTG and CTG values significantly decreased. In the post-test between-group comparison, the VAS pain decreased more significantly in LTG than in CTG. In the within-group comparison of the TAOCOG, the LTG value significantly increased. In the post-test between-group comparison, the TAOCOG value increased more significantly than in LTG than in CTG. [Conclusion] Utilizing Low-Dye taping for patients with plantar fasciitis appears to be an effective intervention method for reducing pain and enhancing stability. PMID:26355306

  8. Evaluation and optimization of therapeutic footwear for neuropathic diabetic foot patients using in-shoe plantar pressure analysis

    NARCIS (Netherlands)

    S.A. Bus; R. Haspels; T.E. Busch-Westbroek

    2011-01-01

    Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to eva

  9. Tendon elastic strain energy in the human ankle plantar-flexors and its role with increased running speed.

    Science.gov (United States)

    Lai, Adrian; Schache, Anthony G; Lin, Yi-Chung; Pandy, Marcus G

    2014-09-01

    The human ankle plantar-flexors, the soleus and gastrocnemius, utilize tendon elastic strain energy to reduce muscle fiber work and optimize contractile conditions during running. However, studies to date have considered only slow to moderate running speeds up to 5 m s(-1). Little is known about how the human ankle plantar-flexors utilize tendon elastic strain energy as running speed is advanced towards maximum sprinting. We used data obtained from gait experiments in conjunction with musculoskeletal modeling and optimization techniques to calculate muscle-tendon unit (MTU) work, tendon elastic strain energy and muscle fiber work for the ankle plantar-flexors as participants ran at five discrete steady-state speeds ranging from jogging (~2 m s(-1)) to sprinting (≥8 m s(-1)). As running speed progressed from jogging to sprinting, the contribution of tendon elastic strain energy to the positive work generated by the MTU increased from 53% to 74% for the soleus and from 62% to 75% for the gastrocnemius. This increase was facilitated by greater muscle activation and the relatively isometric behavior of the soleus and gastrocnemius muscle fibers. Both of these characteristics enhanced tendon stretch and recoil, which contributed to the bulk of the change in MTU length. Our results suggest that as steady-state running speed is advanced towards maximum sprinting, the human ankle plantar-flexors continue to prioritize the storage and recovery of tendon elastic strain energy over muscle fiber work.

  10. Differences in plantar loading between training shoes and racing flats at a self-selected running speed

    NARCIS (Netherlands)

    J.I. Wiegerinck; J. Boyd; J.C. Yoder; A.N. Abbey; J.A. Nunley; R.M. Queen

    2009-01-01

    The purpose of this study was to examine the difference in plantar loading between two different running shoe types. We hypothesized that a higher maximum force, peak pressure, and contact area would exist beneath the entire foot while running in a racing flat when compared to a training shoe. 37 at

  11. Three Case Reports of Successful Vibration Therapy of the Plantar Fascia for Spasticity Due to Cerebral Palsy-Like Syndrome, Fetal-Type Minamata Disease.

    Science.gov (United States)

    Usuki, Fusako; Tohyama, Satsuki

    2016-04-01

    Fetal-type Minamata disease is caused by the exposure to high concentrations of methylmercury in the fetal period and shows cerebral palsy-like clinical features. Relief of spasticity is a major task of rehabilitation to improve their activities of daily living. Here we report the effect of long-term vibration therapy on bilateral lower-limb spasticity in 3 patients with fetal-type Minamata disease. We used a simple, inexpensive, and noninvasive approach with hand-held vibration massagers, which were applied to the plantar fascia at 90 Hz for 15 minutes. The effect was observed soon after the first treatment and resulted in better performance of the repetitive facilitation. Vibration therapy for 1 year improved Modified Ashworth Scale for the ankle flexors in 2 cases. The labored gait improved and gait speed increased in another case. Continued vibration therapy for another 1 year further improved Modified Ashworth Scale score and range of motion of ankle dorsiflexion in 1 case. This case showed the decreased amplitude of soleus H-reflex after the 15-minute vibration therapy, suggesting that α-motor neuron excitability was suppressed. Vibration therapy using a hand-held vibration massager may offer safe and effective treatment for lower-limb spasticity in patients with chronic neurological disorders.

  12. Screening with ultrasound of the heel may contribute to the prevention in osteoporosis

    Institute of Scientific and Technical Information of China (English)

    Sun Ai-Jun; Megumu Kasai; Jack Wang; John C T; Richard N P

    2005-01-01

    Objective: To calibrate a Quantitative Ultrasonography (QUS) system against densitometry by defining the sensitivity and specificity of the method, and to propose a series of QUS interpretation thresholds to classify the individual risk with regards to the risk of developing osteoporosis in later life. Methods: Subjects were recruited in New York City over a 1-year period. Women with amenorrhea for at least 12 months were defined as postmenopausal, and all other women as premenopausal. Bone mineral density (BMD) was measured with a dual energy X-ray absorptiometer (DXA) and QUS performed with the calcaneus of broadband ultrasound attenuation (BUA) and speed of sound (SOS) using the Lunar Achilles system. Statistical analysis was performed using SPSS software Version 10.0. Results: Two hundred twenty-eight premenopausal and menopausal women were recruited. Most of the participants were Hispanic, Caucasian and African-American in this study. All the subjects had DXA and QUS examined and T-score was got from both. The statistical results showed that the T-score of QUS has a significant relationship with that of DXA(spine: r=0.557, P<0.0001;femur: r=0.611,P<0.0001). Both QUS and DXA T-score has a significant and negative relationship with age (QUS: r=-0.241, P<0.0001; Spine: r=-0.277, P<0.0001; femur: -0.296, P<0.0001). When T-score of heel ultrasound -1.5 was set as the interpretation threshold, the osteoporosis patients with T-score of DXA-femur scan (100%) and DXA-spine (77.10%) less than -2.5 were detected. As well, the specificities of T-score -1.5 of QUS for DXA-femur and DXA-spine were 67.5% and 72.8%, respectively. In addition, if we set -1.0 of T-score of QUS as the cutoff, 74.80% and 79.60% of the osteopenia based on DXA of spine and femur were identified. The specificities were 59.4% and 57.7%. Conclusions: QUS of the calcaneus may be an effective method for providing risk stratification for osteoporosis, and for the closely associated future risk

  13. Solid Phase Characterization Of Heel Samples From Tank 241-C-110

    International Nuclear Information System (INIS)

    During sluicing operations of tank 241-C-110, a significant amount of solids were unable to be retrieved. These solids (often referred to as the tank 'heel') were sampled in 2010 and chemically and mineralogically analyzed in the 222-S Laboratory. Additionally, dissolution tests were performed to identify the amount of undissolvable material after using multiple water contacts. This report covers the solid phase characterization of six samples from these tests using scanning electron microscopy, polarized light microscopy, and X-ray diffraction. The chemical analyses, particle size distribution analysis, and dissolution test results are reported separately. Two of the samples were from composites created from as-received material - Composite A and Composite B. The main phase in these samples was sodium-fluoride-phosphate hydrate (natrophosphate) - in the X-ray diffraction spectra, this phase was the only phase identifiable. Polarized light microscopy showed the presence of minor amounts of gibbsite and other phases. These phases were identified by scanning electron microscopy - energy dispersive X-ray spectroscopy as sodium aluminosilicates, sodium diuranate, and sodium strontium phosphate hydrate (nastrophite) crystals. The natrophosphate crystals in the scanning electron microscopy analysis showed a variety of erosive and dissolution features from perfectly shaped octahedral to well-rounded appearance. Two samples were from water-washed Composites A and B, with no change in mineralogy compared to the as-received samples. This is not surprising, since the water wash had only a short period of water contact with the material as opposed to the water dissolution tests. The last two samples were residual solids from the water dissolution tests. These tests included multiple additions of water at 15 C and 45 C. The samples were sieved to separate a coarser fraction of > 710 μm and a finer fraction of < 710 μm. These two fractions were analyzed separately. The coarser

  14. SOLID PHASE CHARACTERIZATION OF HEEL SAMPLES FROM TANK 241-C-110

    Energy Technology Data Exchange (ETDEWEB)

    PAGE JS; COOKE GA; PESTOVICH JA; HUBER HJ

    2011-12-01

    During sluicing operations of tank 241-C-110, a significant amount of solids were unable to be retrieved. These solids (often referred to as the tank 'heel') were sampled in 2010 and chemically and mineralogically analyzed in the 222-S Laboratory. Additionally, dissolution tests were performed to identify the amount of undissolvable material after using multiple water contacts. This report covers the solid phase characterization of six samples from these tests using scanning electron microscopy, polarized light microscopy, and X-ray diffraction. The chemical analyses, particle size distribution analysis, and dissolution test results are reported separately. Two of the samples were from composites created from as-received material - Composite A and Composite B. The main phase in these samples was sodium-fluoride-phosphate hydrate (natrophosphate) - in the X-ray diffraction spectra, this phase was the only phase identifiable. Polarized light microscopy showed the presence of minor amounts of gibbsite and other phases. These phases were identified by scanning electron microscopy - energy dispersive X-ray spectroscopy as sodium aluminosilicates, sodium diuranate, and sodium strontium phosphate hydrate (nastrophite) crystals. The natrophosphate crystals in the scanning electron microscopy analysis showed a variety of erosive and dissolution features from perfectly shaped octahedral to well-rounded appearance. Two samples were from water-washed Composites A and B, with no change in mineralogy compared to the as-received samples. This is not surprising, since the water wash had only a short period of water contact with the material as opposed to the water dissolution tests. The last two samples were residual solids from the water dissolution tests. These tests included multiple additions of water at 15 C and 45 C. The samples were sieved to separate a coarser fraction of > 710 {mu}m and a finer fraction of < 710 {mu}m. These two fractions were analyzed

  15. Retrograde transdorsal-to-plantar or transplantar-to-dorsal intraluminal re-entry treatment following unsuccessful subintimal angioplasty for below-the-ankle arterial occlusion

    International Nuclear Information System (INIS)

    Objective: To assess the technical feasibility and efficacy of transdorsal-to-plantar (TDP) or transplantar-to-dorsal (TPD) intraluminal re-entry procedure following unsuccessful subintimal angioplasty for the treatment of arterial occlusion below the ankle. Methods: TDP or TPD retrograde intraluminal re-entry angioplasty was carried out in 8 diseased limbs of 8 diabetic patients (5 males and 3 females, aged 62∼81 years with a mean age of 75±8 years), who were accompanied with chronic below-the-ankle arterial occlusive disease, after the standard transtibial subintimal angioplasty had failed. Both before and after the procedure the clinical symptoms, dorsal or plantar arterial pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the degree of pain relief, the healing of the wound, the salvage of the diseased limb and the restenosis occurrence of the target vessels were evaluated. Results: Of the total 8 patients, TDP or TPD retrograde intraluminal re-entry angioplasty was successfully performed in 5(62.5%). After the treatment the foot pain was markedly relieved, the median pulse volume scores and ankle-brachial indexes were increased from 0.60±0.55 and 0.32±0.20 before the procedure to 2.40±0.55 and 0.75±0.12 after the procedure, respectively (P<0.01 for both). At the end of the follow-up lasting for twelve months, the visual analogue scale was apparently improved, the scores decreased from preoperative 7.40±1.14 to 2.20±1.48 (P=0.002). Of two cases with intractable skin ulcer, the skin lesion was completely healed in one and was significantly decreased in size in another. No amputation surgery was needed in all successfully treated patients. Magnetic resonance angiography revealed that one target vessel developed re-stenosis. Conclusion: TDP and TDP retrograde intraluminal re-entry techniques are clinically feasible and effective for the

  16. Intermediate-term results of partial plantar fascia release with microtenotomy using bipolar radiofrequency microtenotomy.

    Science.gov (United States)

    Lucas, Douglas E; Ekroth, Scott R; Hyer, Christopher F

    2015-01-01

    Plantar fasciitis is a common condition, with most patients treated successfully with nonoperative management. Recalcitrant disease has been managed with surgical procedures that vary in design and associated morbidity. The present study sought to determine the intermediate-term results of percutaneous bipolar radiofrequency microtenotomy in recalcitrant plantar fasciitis. The patient medical records were reviewed, and data were gathered for all the patients who met the inclusion criteria. The foot function index and visual analog scale (VAS) pain scale questionnaires were mailed to the 111 patients. Of the 111 patients, 61 (55.0%) returned their questionnaires and were ultimately included in the present analysis. Of the 61 patients, 44 (72.1%) were female and 17 were (27.9%) male, with an average reported follow-up of 33.3 ± 8.6 (range 16.1 to 46.6) months. The median postoperative VAS score was 0.0 (range 0.0 to 10.0), and the median foot function index score was 3.1 (range 0.0 to 97.1). The patients were subdivided into success and failure groups according to their satisfaction. Of the 61 patients, 51 (83.6%) were satisfied and would recommend the procedure to a friend. The median VAS score in the success group was 0.0 (range 0.0 to 5.0), and the median VAS score in the failure group was 6.0 (range 0.0 to 10.0), a significant difference (p < .001). A significant difference was also seen in the foot function index score between the success (median 2.4, range 0.0 to 25.7) and failure (median 37.4, range 0.0 to 97.1) groups (p < .001). Bipolar radiofrequency microtenotomy appears to be a safe procedure that can provide outcomes equivalent to those with open surgery, with less morbidity, for recalcitrant plantar fasciitis. PMID:25617155

  17. Plantar pressure and joint motion after the Youngswick procedure for hallux limitus.

    Science.gov (United States)

    Bryant, Alan R; Tinley, Paul; Cole, Joan H

    2004-01-01

    The effects of the Youngswick osteotomy on plantar peak pressure distribution in the forefoot are presented for 17 patients (23 feet) with mild-to-moderate hallux limitus deformity and 23 control subjects (23 feet). During 2 years of follow-up, the operation produced a significant increase in the range of dorsiflexion of the first metatarsophalangeal joint in these patients, reaching near-normal values. Preoperative and postoperative measurements, using a pressure-distribution measurement system, show that peak pressure beneath the hallux and the first metatarsal head remained unchanged. However, peak pressure was significantly increased beneath the second metatarsal head and decreased beneath the fifth metatarsal head. These findings suggest that the foot functioned in a less inverted manner postoperatively. Compared with normal feet, hallux limitus feet demonstrated significantly higher peak pressure beneath the fourth metatarsal head preoperatively and postoperatively. PMID:14729987

  18. Range of motion, neuromechanical and architectural daptations to plantar flexor stretch training in humans

    DEFF Research Database (Denmark)

    Blazevich, Anthony John; Cannavan, Dale; Waugh, Charlie M;

    2014-01-01

    The neuromuscular adaptations in response to muscle stretch training have not been clearly described. In the present study, changes in muscle (at fascicular and whole muscle levels) and tendon mechanics, muscle activity and spinal motoneuron excitability were examined during standardized plantar...... elongation or tendon stiffness following training. A lack of change in MVC moment and RFD at any joint angle was taken to indicate a lack of change in series compliance of the muscle-tendon unit. Thus, increases in end ROM were underpinned by increases in maximum tolerable passive joint moment ('stretch...... flexor stretches after 3 wk of twice-daily stretch training (4×30-s). No changes were observed in a non-exercising control group (N=9), however stretch training elicited a 19.9% increase in dorsiflexion range of motion (ROM) and 28% increase in passive joint moment at end ROM (N=12). Only a trend toward...

  19. An update on the evaluation and management of plantar puncture wounds and Pseudomonas osteomyelitis.

    Science.gov (United States)

    Inaba, A S; Zukin, D D; Perro, M

    1992-02-01

    The management of children who present to the ED with plantar puncture wounds is dependent upon the nature of the injury, the examination of the puncture site, and the potential risk of a retained foreign body. Not all patients will require wound enlargement and a search for a retained foreign body. Close follow-up of all children who are being treated as outpatients is of vital importance in detecting an early development of an infectious complication. Pseudomonas osteomyelitis should be suspected in all patients who present with foot pain, swelling, and a decreased ability to bear weight after sustaining a nail puncture through a sneaker. The current consensus favors open surgical débridement followed by a course of intravenous antibiotics. The exact duration of the postoperative antibiotic course is still being debated. PMID:1603689

  20. Controlling posture using a plantar pressure-based, tongue-placed tactile biofeedback system

    CERN Document Server

    Vuillerme, Nicolas; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    The present paper introduces an original biofeedback system for improving human balance control, whose underlying principle consists in providing additional sensory information related to foot sole pressure distribution to the user through a tongue-placed tactile output device. To assess the effect of this biofeedback system on postural control during quiet standing, ten young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Results showed reduced CoP displacements in the Biofeedback relative to the No-biofeedback condition. The present findings evidenced the ability of the central nervous system to efficiently integrate an artificial plantar-based, tongue-placed tactile biofeedback for controlling control posture during quiet standing.

  1. The effects of passive stretching plus vibration on strength and activation of the plantar flexors.

    Science.gov (United States)

    Miller, Jonathan D; Herda, Trent J; Trevino, Michael A; Mosier, Eric M

    2016-09-01

    This study examined the effects of passive stretching only (PS+CON) and passive stretching with the addition of continuous vibration (VIB) during post-passive stretching tests (PS+VIB) on peak torque (PT), percent voluntary inactivation (%VI), single stimulus twitch torque (TTSINGLE), and doublet stimuli twitch torque (TTDOUBLET) of the plantar flexors at a short (20° plantar flexion (PF)) and long muscle length (15° dorsiflexion (DF)). Fourteen healthy men (age = 22 ± 3 years) performed isometric maximal voluntary contractions at PF and DF, and passive range of motion (PROM) assessments before and after 8 × 30-s passive stretches without (PS+CON) or with VIB (PS+VIB) administered continuously throughout post-passive stretching tests. The passive properties of the muscle tendon unit were assessed pre- and post-passive stretching via PROM, passive torque (PASSTQ), and musculotendinous stiffness (MTS) measurements. PT, TTSINGLE, and TTDOUBLET decreased, whereas, %VI increased following passive stretching at PF and DF (P stretching during both trials (P stretching-induced force/torque deficit and increases in %VI were evident following passive stretching at short and long muscle lengths. Although not statistically significant, effect size calculations suggested large and moderate differences in the absolute changes in PT (Cohen's d = 1.14) and %VI (Cohen's d = 0.54) from pre- to post-passive stretching between treatments, with PS+VIB having greater decreases of PT and higher %VI than PS+CON. The decrement in PT following passive stretching may be primarily neural in origin. PMID:27512816

  2. Ambulatory assessment of 3D ground reaction force using plantar pressure distribution.

    Science.gov (United States)

    Rouhani, H; Favre, J; Crevoisier, X; Aminian, K

    2010-07-01

    This study aimed to use the plantar pressure insole for estimating the three-dimensional ground reaction force (GRF) as well as the frictional torque (T(F)) during walking. Eleven subjects, six healthy and five patients with ankle disease participated in the study while wearing pressure insoles during several walking trials on a force-plate. The plantar pressure distribution was analyzed and 10 principal components of 24 regional pressure values with the stance time percentage (STP) were considered for GRF and T(F) estimation. Both linear and non-linear approximators were used for estimating the GRF and T(F) based on two learning strategies using intra-subject and inter-subjects data. The RMS error and the correlation coefficient between the approximators and the actual patterns obtained from force-plate were calculated. Our results showed better performance for non-linear approximation especially when the STP was considered as input. The least errors were observed for vertical force (4%) and anterior-posterior force (7.3%), while the medial-lateral force (11.3%) and frictional torque (14.7%) had higher errors. The result obtained for the patients showed higher error; nevertheless, when the data of the same patient were used for learning, the results were improved and in general slight differences with healthy subjects were observed. In conclusion, this study showed that ambulatory pressure insole with data normalization, an optimal choice of inputs and a well-trained nonlinear mapping function can estimate efficiently the three-dimensional ground reaction force and frictional torque in consecutive gait cycle without requiring a force-plate.

  3. Unilateral Plantar Flexors Static-Stretching Effects on Ipsilateral and Contralateral Jump Measures

    Directory of Open Access Journals (Sweden)

    Josinaldo Jarbas da Silva, David George Behm, Willy Andrade Gomes, Fernando Henrique Domingues de Oliveira Silva, Enrico Gori Soares, Érica Paes Serpa, Guanis de Barros Vilela Junior, Charles Ricardo Lopes, Paulo Henrique Marchetti

    2015-06-01

    Full Text Available The aim of this study was to evaluate the acute effects of unilateral ankle plantar flexors static-stretching (SS on the passive range of movement (ROM of the stretched limb, surface electromyography (sEMG and single-leg bounce drop jump (SBDJ performance measures of the ipsilateral stretched and contralateral non-stretched lower limbs. Seventeen young men (24 ± 5 years performed SBDJ before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch unilateral ankle plantar flexor SS (6 sets of 45s/15s, 70-90% point of discomfort. SBDJ performance measures included jump height, impulse, time to reach peak force, contact time as well as the sEMG integral (IEMG and pre-activation (IEMGpre-activation of the gastrocnemius lateralis. Ankle dorsiflexion passive ROM increased in the stretched limb after the SS (pre-test: 21 ± 4° and post-test: 26.5 ± 5°, p < 0.001. Post-stretching decreases were observed with peak force (p = 0.029, IEMG (P<0.001, and IEMGpre-activation (p = 0.015 in the stretched limb; as well as impulse (p = 0.03, and jump height (p = 0.032 in the non-stretched limb. In conclusion, SS effectively increased passive ankle ROM of the stretched limb, and transiently (less than 10 minutes decreased muscle peak force and pre-activation. The decrease of jump height and impulse for the non-stretched limb suggests a SS-induced central nervous system inhibitory effect.

  4. Chronic recurrent multifocal osteomyelitis: how to suggest this diagnosis?

    International Nuclear Information System (INIS)

    Chronic recurrent multifocal osteomyelitis is a rare disorder that affects children and teenagers. Clinically, it is characterized by insidious onset of local swelling and pain in several metaphyses. A symmetric, recurrent and multifocal pattern is usual. Spinal involvement is possible. Inconstant association with a cutaneous affection (palmo-plantar pustulosis, acne fulminans, psoriasis), or less frequently with an inflammatory chronic gut disorder is described. Pathogenesis usually recognized is an enthesopathy. Enthesitis may progress to the osseous part of the enthese and produce an aseptic chronic osteomyelitis. Biopsy specimen with culture is certainly necessary to rule out bacterial osteomyelitis and bone tumor. It is particularly true when the bone lesion is isolated. Disease course is benign and self-limited. The clinical course is characterized by recurrences and remissions occurring for 6 to 10 years. Treatment based on non steroid anti-inflammatory drugs is usually effective. (authors)

  5. Magnetic resonance imaging of lesions to the superficial plantar aponevrosis; Imagerie par resonance magnetique des lesions de l`aponevrose plantaire superficielle

    Energy Technology Data Exchange (ETDEWEB)

    Helie, O.; Dubayle, P.; Boyer, B.; Pharaboz, C. [Hopital des Armees Begin, 94 - Saint-Mande (France)

    1995-01-01

    MRI is an efficient imaging modality to establish the diagnosis of plantar fascia tear and planta fasciitis. MRI allows to differentiate recent rupture from scar and fasciitis. (authors). 13 refs., 6 figs.

  6. Topical pyruvic acid (70% versus topical salicylic acid (16.7% compound in treatment of plantar warts: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Zabihollah Shahmoradi

    2015-01-01

    Conclusion: Topical pyruvic acid and compound salicylic acid had the same efficacy and complications in treating plantar warts. Decision for choosing the treatment can be made based on the costs and individual factors as well as patients preferences.

  7. 竞走运动的足底压力及身体姿态特征分析%Characteristics of plantar pressure and body postures during race walking

    Institute of Scientific and Technical Information of China (English)

    宋祺鹏; 毛德伟; 张翠

    2011-01-01

    竞走作为一项流行运动与人类其他行走方式有着根本的区别。本研究的目的是描述竞走过程中的动力学和运动学指标与正常走各指标的差异,探讨受限于竞走规则的动作是否会造成对竞走运动员的潜在伤害。研究选取14名优秀竞走运动员作为测试对象,使用Rs-SCaB测力板和3台SONY摄像机采集竞走和正常走的动力学和运动学指标,采用配对T检验的统计学方法来比较两种行走方式的指标差异。在竞走中,足跟外侧(H1)和足跟内侧(Hm)压力峰值、地面反作用力第一、第二压力峰值和谷值大小、压力中心曲线在前后方向和左右方向的位移等指标都显著大于正常走。支撑腿着地时伸直的膝关节引起了足跟外侧(H1)和足跟内侧(Hm)压强峰值的增大;竞走中较大的水平速度、较大的水平冲力和较快的踝关节背伸速度分别造成了地面反作用力第一、第二峰值和谷值的增大;更多的大脚趾肌肉用力和较大的髋关节内收动作造成了竞走时足底压力中心曲线在前后方向和内外方向的位移增大。竞走时较大的足跟部位压力峰值和较大的踝关节外翻角度以及大脚趾肌群的过度利用可能是由竞走规则导致的潜在伤病因素。%Race walking is a popular sports event with an unusual form of human gait. The purpose of this study is to describe the plantar pressure distribution characteristics during race walking and identify whether the race walking rules can cause potential injury risks. Fourteen elite race walkers participated in this study. Rs -scan plantar pressure plate and three digitalcameras were used to collect data during race walking and normal walking. Independent t - tests were used to detect differences between two groups. The results showed that during race walking, the peak pressure of lateral heel (HI) and medial heel (Hm) subareas, the first, second peak

  8. 石家庄市部分青年男性"外八字"步态足底压力特征分析%Plantar pressure characteristics in some young males with toe-out foot from Shijiazhuang city

    Institute of Scientific and Technical Information of China (English)

    魏孟田; 赵建波; 李立

    2011-01-01

    背景:外八字的脚外翻破坏了膝关节正常力的分布,使关节一侧所受的生物应力增大,对侧相对减少.目的:更进一步认识"外八字"步态行走过程中足底压力的特征.方法:运用比利时Footscan足底压力分布测试系统对石家庄市部分20~25岁的青年男性进行足底压力测试,通过分析筛选出双足步态均正常的青年男性39人为正常步态组,筛选出双足步态均为外八字的青年男性39人为异常步态组分别进行分析.结果与结论:异常步态组青年左足足底第3跖骨峰力值明显高于正常步态组(P < 0.01),第5跖骨、足弓两区域骨峰力值明显低于正常步态组(P < 0.05).正常步态组青年左、右足足底第1跖骨、第5跖骨两区域冲量差异有显著性意义(P < 0.05).异常步态组青年左、右足足底第2,4跖骨冲量差异有显著性意义(P < 0.01,P < 0.05).异常步态组与正常步态组青年左足足底第3跖骨区域差异有显著性意义(P < 0.05),足跟内侧、足跟外侧两区域冲量差异有非常显著性意义(P < 0.01);右足足底足跟内侧区域冲量比较差异有非常显著性意义(P < 0.01).提示"外八字"行走会导致蹬伸时的推进力不是斜向向前,行走方向上的蹬地力较小;行走过程中足受力顺序不是沿足纵弓的方向,而是有一定的夹角,因此足弓不能起到减震的作用,冲量的增大也就增加损伤的概率.所以"外八字"步态者应当注意足底压力和作用时间的关系,增加足与地面的接触时间,从而减小冲击力值,避免运动损伤.%BACKGROUND: Toe-out feet destroys the distribution of normal power in knee joint, then increases the biological stress on one side and reduces on the other.OBJECTIVE: To further understand the characteristics of plantar pressu re in toe-out foot.METHODS: Footscan plantar pressure test system (Belgium) was used to detect pole pressure of young males aged 20-25 years, selected from Shijiazhuang

  9. Unique Hippocampal Changes and Allodynia in a Model of Chronic Stress

    OpenAIRE

    Kim, Seong-Ho; Moon, Il Soo; Park, In-Sick

    2013-01-01

    Sustained stress can have numerous pathologic effects. There have been several animal models for chronic stress. We tried to identify the changes of pain threshold and hippocampus in a model of chronic stress. Male Sprague-Dawley rats were kept in a cage filled with 23℃ water to a height of 2.2 cm for 7 days. Nociceptive thresholds, expressed in grams, were measured with a Dynamic Plantar Aesthesiometer. Golgi staining was used to identify hippocampal changes. To demonstrate how long allodyni...

  10. Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: a meta-analysis of observational studies.

    Directory of Open Access Journals (Sweden)

    Malindu Eranga Fernando

    Full Text Available AIMS: Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. METHODS: Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP and pressure time integral (PTI were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310. RESULTS: Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290-0.811, p<0.001; and 0.762, 95% CI 0.303-1.221, p = 0.001, respectively. Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181- 0.753, p = 0.001. Statistical heterogeneity between studies was moderate. CONCLUSIONS: Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic

  11. Telangiectasia hemorrágica hereditária: ácido tranexâmico no tratamento de úlcera plantar Hereditary hemorrhagic telangiectasia: tranexamic acid for plantar ulcer

    OpenAIRE

    Gabriella Corrêa de Albuquerque; Célia Regina S. Corrêa de Carvalho; Cristiane R. de Oliveira; Dayse Pereira Terra; Sérgio Soares Quinete

    2005-01-01

    Relato de um caso de úlcera plantar por fístula arteriovenosa em paciente portador de telangiectasia hemorrágica hereditária ou doença de Rendu-Osler-Weber tratado com ácido tranexâmico. Este fármaco é utilizado para tratamento de epistaxe, referindo-se o principal achado deste artigo ao uso eficaz desse medicamento na terapia de úlceras plantares hemorrágicas. São descritos os aspectos fisiopatológicos e clínicos da doença e as propriedades antifibrinolíticas do ácido tranexâmico. Este foi b...

  12. Effectiveness of a heel cup with an arch support insole on the standing balance of the elderly

    Directory of Open Access Journals (Sweden)

    Chen TH

    2014-02-01

    Full Text Available Tzu-Hsuan Chen,1,* Li-Wei Chou,2,3,* Mei-Wun Tsai,4 Ming-Jor Lo,5 Mu-Jung Kao4,5 1Department of Rehabilitation, Mackay Memorial Hospital, Hsinchu, Taiwan; 2Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 3School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 4Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan; 5Department of Rehabilitation, Yangming Branch, Taipei City Hospital, Taipei, Taiwan *These authors contributed equally to this paper Background: The use of insoles may enhance postural stability and prevent falls. The aim of this study was to design a new insole and to explore the effectiveness of the insole on the standing balance of the healthy elderly. Methods: The study was conducted at a community hospital. Patients older than 65 years at an outpatient clinic without abnormal gait patterns, lower limb deformities, or foot pain were enrolled. The participants were assigned to good- and poor-stability groups on the basis of the stability index (SI, using the Biodex® Balance System. A heel cup with an arch support insole was provided. Participants wore the insole for 8 weeks for a minimum of 4 hours/day. A static balance test for SI was performed at the initial meeting and 8 weeks after the assigned insoles were worn for each participant. Results: Five participants (10.0% of 50 total did not finish the study. There were 25 patients in the good-stability group and 20 in the poor-stability group. The SI, before and after intervention, was significantly different for all 45 participants (3.244±0.688 versus 3.064±0.671; P<0.001. The differences in SI before and after the intervention both in the good-stability group (2.764±0.546 versus 2.592±0.538 and the poor-stability group (3.845±0.188 versus 3.655±0.128 were statistically significant (P<0.001. No statistically significant

  13. Telangiectasia hemorrágica hereditária: ácido tranexâmico no tratamento de úlcera plantar Hereditary hemorrhagic telangiectasia: tranexamic acid for plantar ulcer

    Directory of Open Access Journals (Sweden)

    Gabriella Corrêa de Albuquerque

    2005-12-01

    Full Text Available Relato de um caso de úlcera plantar por fístula arteriovenosa em paciente portador de telangiectasia hemorrágica hereditária ou doença de Rendu-Osler-Weber tratado com ácido tranexâmico. Este fármaco é utilizado para tratamento de epistaxe, referindo-se o principal achado deste artigo ao uso eficaz desse medicamento na terapia de úlceras plantares hemorrágicas. São descritos os aspectos fisiopatológicos e clínicos da doença e as propriedades antifibrinolíticas do ácido tranexâmico. Este foi bem tolerado e apresentou evidências de eficácia na utilização para controle do sangramento e cicatrização da úlcera.Case report of one patient with Hereditary Hemorrhagic Telangiectasia, also known as Rendu-Osler-Weber syndrome, treated with Tranexamic Acid for arteriovenous plantar ulcer. This drug has proved effective in controlling epistaxis, but the main point of this report is to expose the success use of this medication in the therapy of skin bleeding ulcer. The pathophysiologic and clinical features of the disease are reviewed and also the pharmacological aspects of the antifibrinolytic drugs. This drug was well tolerated by the patient and show evidence of good activity in the bleeding and healed the ulcer.

  14. A pedestrian dead-reckoning system that considers the heel-strike and toe-off phases when using a foot-mounted IMU

    Science.gov (United States)

    Ju, Hojin; Lee, Min Su; Park, So Young; Song, Jin Woo; Park, Chan Gook

    2016-01-01

    In this paper, we propose an advanced pedestrian dead-reckoning (PDR) algorithm that considers the heel-strike and toe-off phases. Generally, PDR systems that use a foot-mounted inertial measurement unit are based on an inertial navigation system with an extended Kalman filter (EKF). To reduce the influence of the bias and white noises in the gyroscope and accelerometer signals, a zero-velocity update is often adopted at the stance phase. However, transient and large acceleration, which cannot be measured by the accelerometer used in pedestrian navigation, occur momentarily in the heel-strike phase. The velocity information from integration of the acceleration is not reliable because the acceleration is not measured in the heel-strike phase. Therefore, the designed EKF does not correctly reflect the actual environment, because conventional algorithms do not take the non-measurable acceleration into consideration. In order to reflect the actual environment, we propose a PDR system that considers the non-measurable acceleration from the heel-strike impact. To improve the PDR system’s performance, the proposed algorithm uses a new velocity measurement obtained using the constraint between the surface and the foot during the toe-off phase. The experimental results show improved filter performance after comparison of the proposed algorithm and a conventional algorithm.

  15. A Novel and Alternative Treatment Method for Diabetic Heel Ulceration Exposing the Calcaneus Which Is Not Suitable for Flap Surgery: Vacuum Assisted Sandwich Dermal Matrix

    Directory of Open Access Journals (Sweden)

    Ugur A. Bingol

    2015-01-01

    Full Text Available Background. Currently, free flaps and pedicled flaps are the first treatment choices for large heel ulcer reconstruction. However, flap reconstruction of heel ulcerations cannot be performed in all diabetics especially with concurrent severe peripheral vascular disease because of higher flap failure rate. In recent years, the use of acellular dermal matrix (ADM has emerged as an alternative treatment option for extremity ulcers. Methods. We present 13 diabetic patients with a large heel ulceration exposing the calcaneus, who were not eligible for flap surgery due to the presence of only one patent artery of trifurcation. These cases were treated with the vacuum assisted sandwich dermal matrix (VASDEM method. Results. None of the patients required amputation. Skin grafting was successful in ten patients. Although partial losses were observed in three patients, they were healed spontaneously without surgical interventions. During the follow-up period none of the patients developed ulceration on the treatment area. All patients maintained their preoperative ambulatory ability. Conclusion. VASDEM is a novel method offering opportunity for treatment before proceeding to amputation in diabetic heel ulceration exposing the calcaneus which is not suitable for flap surgery. It also has the potential to close wounds of all sizes independent of the vessel status and wound size in selected diabetic patients.

  16. A pedestrian dead-reckoning system that considers the heel-strike and toe-off phases when using a foot-mounted IMU

    International Nuclear Information System (INIS)

    In this paper, we propose an advanced pedestrian dead-reckoning (PDR) algorithm that considers the heel-strike and toe-off phases. Generally, PDR systems that use a foot-mounted inertial measurement unit are based on an inertial navigation system with an extended Kalman filter (EKF). To reduce the influence of the bias and white noises in the gyroscope and accelerometer signals, a zero-velocity update is often adopted at the stance phase. However, transient and large acceleration, which cannot be measured by the accelerometer used in pedestrian navigation, occur momentarily in the heel-strike phase. The velocity information from integration of the acceleration is not reliable because the acceleration is not measured in the heel-strike phase. Therefore, the designed EKF does not correctly reflect the actual environment, because conventional algorithms do not take the non-measurable acceleration into consideration. In order to reflect the actual environment, we propose a PDR system that considers the non-measurable acceleration from the heel-strike impact. To improve the PDR system’s performance, the proposed algorithm uses a new velocity measurement obtained using the constraint between the surface and the foot during the toe-off phase. The experimental results show improved filter performance after comparison of the proposed algorithm and a conventional algorithm. (paper)

  17. Kinaesthetic ipsilateral and crossed extensor plantar response: A new way to elicit upgoing toe sign (Babinski response?

    Directory of Open Access Journals (Sweden)

    Abraham Kuruvilla

    2011-01-01

    Full Text Available We describe a phenomenon of "kinaesthetic extensor plantar response" in advanced pyramidal dysfunction, an interesting observation noted in a patient with dorsal myelopathy. A 44-year-old woman presented with one-year history of gradually progressive weakness and stiffness of both lower limbs along with urge incontinence of urine. Examination showed spontaneous elicitation of extensor plantar response while assessing the tone by rolling method as well as on noxious stimulation of the thigh. Magnetic resonance imaging (MRI of the dorsal spine and digital subtraction angiography showed the presence of spinal dural arteriovenous fistula causing myelopathy. This case exemplifies the fact that in advanced pyramidal dysfunction, not only the receptive field of Babinski reflex may extend to the leg or thigh, but may also integrate with other modalities of stimulation, such as the rolling movement. The possible underlying pathophysiology of such a phenomenon is discussed.

  18. How a plantar pressure-based, tongue-placed tactile biofeedback modifies postural control mechanisms during quiet standing

    CERN Document Server

    Vuillerme, Nicolas; Chenu, Olivier; Boisgontier, Matthieu; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    The purpose of the present study was to determine the effects of a plantar pressure-based, tongue-placed tactile biofeedback on postural control mechanisms during quiet standing. To this aim, sixteen young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements, recorded using a force platform, were used to compute the horizontal displacements of the vertical projection the centre of gravity (CoGh) and those of the difference between the CoP and the vertical projection of the CoG (CoP-CoGv). Altogether, the present findings suggest that the main way the plantar pressure-based, tongue-placed tactile biofeedback improves postural control during quiet standing is via both a reduction of the correction thresholds and an increased efficiency of the corrective mechanism involving the CoGh displacements.

  19. Adherence to Wearing Prescription Custom-Made Footwear in Patients With Diabetes at High Risk for Plantar Foot Ulceration

    OpenAIRE

    Waaijman, Roelof; Keukenkamp, Renske; Haart, Mirjam de; Polomski, Wojtek P.; Nollet, Frans; Bus, Sicco A.

    2013-01-01

    OBJECTIVE Prescription custom-made footwear can only be effective in preventing diabetic foot ulcers if worn by the patient. Particularly, the high prevalence of recurrent foot ulcers focuses the attention on adherence, for which objective data are nonexisting. We objectively assessed adherence in patients with high risk of ulcer recurrence and evaluated what determines adherence. RESEARCH DESIGN AND METHODS In 107 patients with diabetes, neuropathy, a recently healed plantar foot ulcer, and ...

  20. EVALUATION OF THE EFFICACY OF A COMBINATION –MEASLES, MUMPS AND RUBELLA VACCINE IN THE TREATMENT OF PLANTAR WARTS

    Directory of Open Access Journals (Sweden)

    Nagat Sobhy Mohamad

    2013-10-01

    Full Text Available Introduction: The treatment of patients with plantar warts continues to be a frustrating matter for both primary care physicians and dermatologists. There are new trends towards the use of immunotherapy in treatment of warts, as the immune system seems to play an important role in the control of warts infection. Aim: Assessing the efficacy of intralesional injection of MMR vaccine (measles, mumps, rubella in the treatment of plantar warts. Patients: One hundred patients complaining of plantar warts were included in this study. Methods: The patients were divided into two groups: Group 1: This group included 50 patients subjected to intralesional injection of measles, mumps, rubella vaccine (MMR. Group 2: This group included 50 patients as a control group and subjected to intralesional injection of 0.3 ml saline. Only single wart was injected. Injections were done at 3-weeks interval until complete clearance or for a maximum of 3 treatments. Follow up of patients was done every month for six months for clinical assessment of results and to show any recurrence. Results: Regarding the response of the target wart, MMR- treated group showed significantly higher rate of complete clearance compared with the control group (82% versus 0% respectively. The rate of partial response was 6% versus 30%, and the rate of no response was 12% versus 70%, respectively. Regarding the response of untreated distant warts, MMR-treated group showed 86.9% complete and 13.1% partial clearance of the warts whereas the control group showed 100% no response. This strongly indicates the development of a widespread HPV-targeted immunity as a response of antigen injection and represents a major advantage of the intra lesional immunotherapy. Conclusions: We found that treatment of plantar warts by MMR vaccine is effective, with good cure rates and excellent safety profile..

  1. Why person affected by leprosy did not look after their plantar ulcer? Experience from Pakokku zone, Myanmar.

    Science.gov (United States)

    Win, Le Le; Shwe, San; Maw, Win; Ishida, Yutaka; Myint, Kyaw; Mar, Kyi Kyi; Min, Thandar; Oo, Phyo Min; Khine, Aye Win

    2010-09-01

    A cross-sectional study was carried out to identify methods of caring plantar ulcers in leprosy patients and the underlying causes of poor plantar ulcer care during January and February 2008. This was conducted in Pakokku zone as it was one of the "9 selected townships of the Disabilities survey, i.e., Basic Health Staff project 2003/4", which was funded by Japan International Cooperation Agency. After getting consent, all available leprosy cases, i.e., 101 cases with foot disability grade 2 were interviewed with the pre-tested questionnaire. Among 101 cases, 13 cases who took care of their ulcer poorly and 20 who did none of the recommended measures were recruited for in-depth interview (IDI). The subjects were largely old people, males and people with no marriage partner. The majority had earned money by doing sedentary job. Prolongation of ulcers was observed in 78 cases. Most had been suffering from ulcers for years. When asking face-to-face interview, all the recommended care measures were not reported. Among these recommended measures, a large number of respondents reported about soaking measure. However, these reported measures were contradicted to the preventive methods which they disclosed in IDI. Plantar ulcer care seemed to be an individualised practice. The individual ways of performing were related to their view of ulcer, the environment, and occupation, and custom, communication with family and health staff. The findings identified the actual practice of plantar ulcer care in study areas. It is suggested that the current performance of planar ulcer care is inadequate and more attention should be given to achieve the target set by the programme as a recommendation. PMID:20857653

  2. Contributions of knee swing initiation and ankle plantar flexion to the walking mechanics of amputees using a powered prosthesis.

    Science.gov (United States)

    Ingraham, Kimberly A; Fey, Nicholas P; Simon, Ann M; Hargrove, Levi J

    2014-01-01

    Recently developed powered prostheses are capable of producing near-physiological joint torque at the knee and/or ankle joints. Based on previous studies of biological joint impedance and the mechanics of able-bodied gait, an impedance-based controller has been developed for a powered knee and ankle prosthesis that integrates knee swing initiation and powered plantar flexion in late stance with increasing ankle stiffness throughout stance. In this study, five prosthesis configuration conditions were tested to investigate the individual contributions of each sub-strategy to the overall walking mechanics of four unilateral transfemoral amputees as they completed a clinical 10-m walk test using a powered knee and ankle prosthesis. The baseline condition featured constant ankle stiffness and no swing initiation or powered plantar flexion. The four remaining conditions featured knee swing initiation alone (SI) or in combination with powered plantar flexion (SI+PF), increasing ankle stiffness (SI+IK), or both (SI+PF+IK). Self-selected walking speed did not significantly change between conditions, although subjects tended to walk the slowest in the baseline condition compared to conditions with swing initiation. The addition of powered plantar flexion resulted in significantly higher ankle power generation in late stance irrespective of ankle stiffness. The inclusion of swing initiation resulted in a significantly more flexed knee at toe off and a significantly higher average extensor knee torque following toe off. Identifying individual contributions of intrinsic control strategies to prosthesis biomechanics could help inform the refinement of impedance-based prosthesis controllers and simplify future designs of prostheses and lower-limb assistive devices alike.

  3. Effect of plantar subcutaneous administration of bergamot essential oil and linalool on formalin-induced nociceptive behavior in mice.

    Science.gov (United States)

    Katsuyama, Soh; Otowa, Akira; Kamio, Satomi; Sato, Kazuma; Yagi, Tomomi; Kishikawa, Yukinaga; Komatsu, Takaaki; Bagetta, Giacinto; Sakurada, Tsukasa; Nakamura, Hitoshi

    2015-01-01

    This study investigated the effect of bergamot essential oil (BEO) or linalool, a major volatile component of BEO, on the nociceptive response to formalin. Plantar subcutaneous injection of BEO or linalool into the ipsilateral hindpaw reduced both the first and late phases of the formalin-induced licking and biting responses in mice. Plantar subcutaneous injection of BEO or linalool into the contralateral hindpaw did not yield an antinociceptive effect, suggesting that the antinociceptive effect of BEO or linalool in the formalin test occurred peripherally. Intraperitoneal and plantar subcutaneous injection pretreatment with naloxone hydrochloride, an opioid receptor antagonist, significantly attenuated both BEO- and linalool-induced antinociception. Pretreatment with naloxone methiodide, a peripherally acting opioid receptor antagonists, also significantly antagonized the antinociceptive effects of BEO and linalool. Our results provide evidence for the involvement of peripheral opioids in antinociception induced by BEO and linalool. These results suggest that activation of peripheral opioid receptors may play an important role in reducing formalin-induced nociception.

  4. A lumped-parameter model to investigate the effect of plantar pressure on arterial blood flow in a diabetic foot.

    Science.gov (United States)

    Hahn, C; Mahajan, A; Chu, T; Schoen, M

    2007-08-01

    This paper presents a lumped-parameter model for the big-toe region that investigates the effect of plantar pressure on the diameter of the blood vessels, specifically the arteries, in the presence of arterial and/or tissue changes. The model developed in this paper uses a multi-domain energy system approach to develop the lumped-parameter differential equations. Blood flow is modelled as fluidic flow through compliant pipes that have inertia, stiffness, and damping. The tissue material is treated as a soft compliant material that transmits the external force to the blood vessels. Conclusions have been drawn to show the effect of plantar pressure, tissue damage, and their combination on the diameter of the blood vessels. The principles used here can be used to model the entire foot and the model used to investigate the effect of plantar pressure, tissue damage, and arterial changes on different parts of the foot. The work presented here may also have applications in other vascular diseases. PMID:17937206

  5. Greater Reduction of Balance as a Result of Increased Plantar Fascia Elasticity at Ovulation during the Menstrual Cycle.

    Science.gov (United States)

    Petrofsky, Jerrold; Lee, Haneul

    2015-01-01

    One of the sexual hormones, estrogen, increases elasticity of human connective tissue such as the anterior cruciate ligament during the menstrual cycle in women. In the present investigation, the plantar fascia was investigated to see if there is a difference in elasticity with the menstrual cycle. Fifteen young healthy females in the age range of 18-35 years old with a regular menstrual cycle were tested twice throughout one full menstrual cycle; once during the early follicular phases and once at ovulation. Foot length, while standing on both feet and one foot were used to assess plantar fascia elasticity, ultrasound measured plantar fascia thickness while lying and standing, and posture sway and tremor using a balance platform during 8 different balance tests were assessed to see the impact of elasticity changes. Foot length increased significantly at ovulation compared to menstruation when standing on two feet (p = 0.03) and standing on one foot (p fascia in thinning per kilogram weight applied to the foot at ovulation compared to menstruation (p = 0.014). Associated with this increase in elasticity at ovulation, there was a reduction in balance in the most difficult balance tasks and an increase in tremor during ovulation (p fascia elasticity change during the menstrual cycle might have effects on posture sway and tremor, which could have a potential risk of falling. Therefore, healthy professionals working with young female adults should recognize these physiological effects.

  6. School-based screening of plantar pressures during level walking with a backpack among overweight and obese schoolchildren.

    Science.gov (United States)

    Pau, Massimiliano; Leban, Bruno; Corona, Federica; Gioi, Sara; Nussbaum, Maury A

    2016-05-01

    Among children, postural modifications due to backpack carriage have direct consequences on how forces are exchanged between body and ground and thus on plantar pressure distribution. However, it is unknown whether such alterations are influenced by the foot structure and functionality typical of obesity. In this study, we tested 65 overweight/obese primary schoolchildren using a pressure platform while walking with and without the backpack. Contact areas, arch index, peak and mean plantar pressures in the forefoot, midfoot and rearfoot were compared with those from an additional 65 age- and gender-matched group of normal-weight children. Backpack carriage modified pressure distribution similarly in both groups, with the exception of mean midfoot pressure, which increased significantly among normal-weight children but not in the overweight/obese group. Notably, the pressure values associated with mass excess and backpack carriage still raise some concerns regarding potential long-term adverse consequences on foot structure and functionality of overweight/obese children. Practitioner summary: Backpack carriage by overweight/obese schoolchildren altered plantar pressures similar to what was observed in their normal-weight peers. Yet, high pressures were found among the overweight/obese children. This raises concerns regarding potential long-term adverse consequences on foot structure and functionality, and supports establishing more specific limits for the carried load. PMID:26226045

  7. Low-pressure, single-point grout injection for tank heel sludge mixing and in-situ immobilization

    International Nuclear Information System (INIS)

    This report describes tests conducted in an approximately 9-ft diameter test tank situated outside the 336 building in Hanford's 300 area. The tests were performed to measure the ability of jets of grout slurry to mobilize and mix simulated tank sludge. The technique is intended for in situ immobilization of tank waste heels. The current approach uses a single, rotated, larger-diameter nozzle driven at lower pressure. Due to the larger diameter, the potential for plugging is reduced and the effective radius around an injection point over which the jet is effective in mobilizing sludge from the tank bottom can be made larger. A total of three grout injection tests were conducted in a 9-ft diameter tank. In each case, a 2-in. layer of kaolin clay paste was placed on a dry tank floor to simulate a sludge heel. The clay was covered with 4 inches of water. The grout slurry, consisting of Portland cement, class F fly ash, and eater, was prepared and delivered by an offsite vendor. In the third test, the sludge in half of the tank was replaced by a layer of 20x50 mesh zeolite, and bentonite clay was added to the grout formulation. After injection, the grout was allowed to set and then the entire grout monolith was manually broken up and excavated using a jack hammer. Intact pieces of clay were visually apparent due to a sharp color contrast between the grout and clay. Remaining clay deposits were collected and weighed and suspended clay pieces within the monolith were photographed. The mobilization performance of the grout jets exceeded expectations

  8. Evaluation of potential variables contributing to the development and duration of plantar lesions in a population of aquarium-maintained African penguins (Spheniscus demersus).

    Science.gov (United States)

    Erlacher-Reid, Claire; Dunn, J Lawrence; Camp, Tracy; Macha, Laurie; Mazzaro, Lisa; Tuttle, Allison D

    2012-01-01

    Bumblefoot (pododermatitis), often described as the most significant environmental disease of captive penguins, is commonly due to excessive pressure or trauma on the plantar surface of the avian foot, resulting in inflammation or necrosis and causing severe swelling, abrasions, or cracks in the skin. Although not formally evaluated in penguins, contributing factors for bumblefoot are thought to be similar to those initiating the condition in raptors and poultry. These factors include substrate, body weight, and lack of exercise. The primary purpose of this retrospective study was to evaluate variables potentially contributing to the development and duration of plantar lesions in aquarium-maintained African penguins (Spheniscus demersus), including sex, weight, age, season, exhibit activity, and territory substrate. Results indicate that males develop significantly more plantar lesions than females. Penguins weighing between 3.51 and 4.0 kg develop plantar lesions significantly more often than penguins weighing between 2.5 and 3.5 kg, and because male African penguins ordinarily weigh significantly more than females, weight is likely a contributing factor in the development of lesions in males compared with females. Significantly more plantar lesions were observed in penguins standing for greater than 50% of their time on exhibit than swimming. Penguins occupying smooth concrete territories developed more plantar lesions compared with penguins occupying grate territories. Recommendations for minimizing bumblefoot in African penguins include training penguins for monthly foot examinations for early detection of plantar lesions predisposing for the disease, encouraging swimming activity, and replacing smooth surfaces on exhibit with surfaces providing variable degrees of pressure and texture on the feet.

  9. Correlation between maximum in-shoe plantar pressures and clubhead speed in amateur golfers.

    Science.gov (United States)

    Pataky, Todd Colin

    2015-01-01

    Disagreements exist in the literature regarding the manner in which weight should be dynamically shared during the golf swing, both within-feet and between the back- and target-foot, to generate maximal clubhead speed. The purpose of this study was to determine whether preferential foot-loading locations underlie weight sharing by examining the correlation between clubhead speed and maximum plantar pressure (PP) distributions. Thirty-two amateur golfers with handicap indexes ranging from 2.7 to 25 performed 10 driver swings on artificial turf following a warm-up. PP distributions were recorded at 100 Hz, and clubhead speed was recorded using a ball-tracking Doppler radar system. Maximum PPs were extracted from a 2-s window approximately centred on ball contact and were regressed against clubhead speed. Significance was assessed over the entire foot surface using statistical parametric mapping (SPM), a spatially continuous technique. SPM revealed, at relatively high anatomical resolution, significant positive correlations between clubhead speed and PPs in the lateral target-foot (P < 0.05). This suggests that not only weight transfer but also weight-transfer location may be an important determinant of clubhead speed in amateur golfers. PMID:25010946

  10. Palmar-plantar hyperhidrosis occurring in a kindred with nail-patella syndrome.

    Science.gov (United States)

    Pechman, K J; Bergfeld, W F

    1980-12-01

    Nail-patella syndrome (NPS) is an autosomal dominant genetic defect, which may be associated with, or closely linked to, the locus controlling palmar and plantar hyperhidrosis (HH). A clinical review of a family with NPS involving six generations was performed. Data were accumulated by personal examination and analysis of medical and family records for the trials characterizing NPS as well as the coincidence of HH. A family pedigree of each entity was constructed and the pedigree for HH was compared to the NPS pedigree. Thirty-three of sixty-eight members of the extended family were affected with NPS and nine members had HH. The NPS pedigree supported the previously known autosomal dominant mode of inheritance. The incidence of HH indicated a direct inheritance and occurred only in members affected with NPS. The pedigree provides evidence for concluding that HH occurred as a spontaneous mutation transmitted as an autosomal dominant trait closely linked to NPS or that HH represents a previous unrecognized associated disorder. PMID:7204680

  11. Hybrid diffuse optical techniques for continuous hemodynamic measurement in gastrocnemius during plantar flexion exercise

    Science.gov (United States)

    Henry, Brad; Zhao, Mingjun; Shang, Yu; Uhl, Timothy; Thomas, D. Travis; Xenos, Eleftherios S.; Saha, Sibu P.; Yu, Guoqiang

    2015-12-01

    Occlusion calibrations and gating techniques have been recently applied by our laboratory for continuous and absolute diffuse optical measurements of forearm muscle hemodynamics during handgrip exercises. The translation of these techniques from the forearm to the lower limb is the goal of this study as various diseases preferentially affect muscles in the lower extremity. This study adapted a hybrid near-infrared spectroscopy and diffuse correlation spectroscopy system with a gating algorithm to continuously quantify hemodynamic responses of medial gastrocnemius during plantar flexion exercises in 10 healthy subjects. The outcomes from optical measurement include oxy-, deoxy-, and total hemoglobin concentrations, blood oxygen saturation, and relative changes in blood flow (rBF) and oxygen consumption rate (rV˙O2). We calibrated rBF and rV˙O2 profiles with absolute baseline values of BF and V˙O2 obtained by venous and arterial occlusions, respectively. Results from this investigation were comparable to values from similar studies. Additionally, significant correlation was observed between resting local muscle BF measured by the optical technique and whole limb BF measured concurrently by a strain gauge venous plethysmography. The extensive hemodynamic and metabolic profiles during exercise will allow for future comparison studies to investigate the diagnostic value of hybrid technologies in muscles affected by disease.

  12. Quantitative Estimation of Temperature Variations in Plantar Angiosomes: A Study Case for Diabetic Foot

    Directory of Open Access Journals (Sweden)

    H. Peregrina-Barreto

    2014-01-01

    Full Text Available Thermography is a useful tool since it provides information that may help in the diagnostic of several diseases in a noninvasive and fast way. Particularly, thermography has been applied in the study of the diabetic foot. However, most of these studies report only qualitative information making it difficult to measure significant parameters such as temperature variations. These variations are important in the analysis of the diabetic foot since they could bring knowledge, for instance, regarding ulceration risks. The early detection of ulceration risks is considered an important research topic in the medicine field, as its objective is to avoid major complications that might lead to a limb amputation. The absence of symptoms in the early phase of the ulceration is conceived as the main disadvantage to provide an opportune diagnostic in subjects with neuropathy. Since the relation between temperature and ulceration risks is well established in the literature, a methodology that obtains quantitative temperature differences in the plantar area of the diabetic foot to detect ulceration risks is proposed in this work. Such methodology is based on the angiosome concept and image processing.

  13. International scientific consensus on medical plantar pressure measurement devices: technical requirements and performance

    Directory of Open Access Journals (Sweden)

    Claudia Giacomozzi

    2012-01-01

    Full Text Available BACKGROUND: Since 2006, the Italian National Institute of Health (ISS has been conducting independent scientific activities to standardize the technical assessment of plantar pressure measurement devices (PMDs. MATERIAL AND METHODS: On the basis of the ISS results, in 2010 the Pedobarographic Group of the International Foot and Ankle Biomechanics community (i-FAB-PG promoted a consensus activity about the main technical requirements for the appropriate use of PMDs. The activity relied on a moodlebased on-line forum, documents exchange, discussions, reviews, meetings and a final survey. RESULTS: The participation of clinical and technical researchers, users, and manufacturers, contributed to the delivery of the hereby reported recommendations which specifically regard Medical PMDs in the form of platforms. CONCLUSIONS: The i-FAB-PG community reached overall agreement on the recommendations, with a few minor objections which are reported and commented in the document. RELEVANCE: The present document, the highest result achievable within a small scientific community, will hopefully represent the starting point of the wider process of establishing official international guidelines or standards, within scientific communities and standardization organizations.

  14. Accuracy of Plantar Electrodes Compared with Hand and Foot Electrodes in Fat-free-mass Measurement

    Directory of Open Access Journals (Sweden)

    Michel Y. Jaffrin

    2014-01-01

    Full Text Available This paper investigates the measurement of fat-free mass (FFM by bioimpedance using foot-to-foot impedancemeters (FFI with plantar electrodes measuring the foot-to-foot resistance R34 and hand-to-foot medical impedancemeters. FFM measurements were compared with corresponding data using Dual X-ray absorptiometry (DXA. Equations giving FFM were established using linear multiple regression on DXA data in a first group of 170 subjects. For validation, these equations were used on a second group of 86 subjects, and FFM were compared with DXA data; no significant difference was observed. The same protocol was repeated, but using electrodes on the right hand and foot in standing position to measure the hand to-foot resistance R13. Mean differences with DXA were higher for R13 than for R34. Effect of electrode size and feet position on resistance was also investigated. R34 decreased when electrode area increased or if feet were moved forward. It decreased if feet were moved backward. A proper configuration of contact electrodes can improve measurement accuracy and reproducibility of FFI.

  15. [Preliminary report on a method for establishing the relation between the surface of a plantar load and the total projective surface of the foot: index of plantar load (IPL)].

    Science.gov (United States)

    Della Capanna, G P

    1983-07-30

    The creation of a Plantar Load Index (PLI) is proposed, with a view to studying the plantar surface of the foot from a morphofunctional standpoint. This Index would provide information on the centesimal relationship between the surface load values and the total projective values of the foot, expressed in cm2. The measurements in question are homogeneous in nature and may, therefore, be easily related to one another. To obtain these values, the two surfaces are visualized, photographed together in a single photogram and analyzed by means of the computerized visual system (Zeiss Videoplan). Visualization is obtained by means of a thermochromatic variation plate which is placed on the stand of a reflexion podoscope and which is sensitive to the heat of the plantar skin and the suitably emitted infra-red rays. The heat of the skin in contact with the plate shows the load surface. The intra-red rays suitably emitted from above onto the plate and onto the back of the foot produce the general chromatic variation of the plate, also showing the perimetrical outline of the foot. The picture to be photographed will, then, be as follows: a continuous black edge formed from the outside by the colouring of the plate produced by the infra-red rays (the perimeter of the foot); more black, extending inwards, in varying degrees, when the skin is not touching the plate (the archer and furrows in the skin); coloured areas inside of the perimeter, showing the load surface.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6626330

  16. Tratamento do neuroma de Morton via plantar: avaliação retrospectiva dos resultados cirúrgicos Norton's neuroma treatment through plantar port: retrospective assessment of surgical outcomes

    Directory of Open Access Journals (Sweden)

    Caio Augusto de Souza Nery

    2007-01-01

    Full Text Available Com a finalidade de avaliar a eficácia da técnica cirúrgica, envolvendo a neurectomia por via plantar, transversa, fora da zona de carga, em portadores de neuroma de Morton, 217 pacientes foram submetidos a este tratamento.Um total de 264 pés foram observados, sendo 32,2% no pé direito, 46,1% no pé esquerdo e 21,7% bilateralmente.Quanto ao sexo, foram observadas ocorrências de 86,6% no sexo feminino e 13,4% masculino.Quanto a localização, 83,5% (220 neuromas estavam presentes no terceiro espaço interdigital, 7,5% no segundo espaço, com presença de bilateralidade em 47 pacientes.O tempo médio de acompanhamento foi de 7,5 anos, variando de 4 a 216 meses, com resultado satisfatório e regulares em 95,8% dos pacientes no total, com apenas 11 pacientes (4,2% insatisfeitos com o tratamento de forma global.Os autores concluem, por tanto, que a neurectomia por via plantar transversa é uma opção satisfatória, com boa visibilização anatômica do neuroma, evoluindo com boa cicatrização, retorno precoce às atividades e satisfação do paciente com o resultado alcançado.With the objective of assessing the effectiveness of the surgical technique involving neurectomy through plantar, cross-sectional port out of the load zone in individuals with Morton’s neuroma, 217 patients were submitted to this treatment. A total of 264 feet were observed, being 32.2% right feet, 46.1% left feet, and 21.7% bilaterally. Regarding gender, 86.6% of the occurrences were seen in women, and 13.4% in men. Regarding the site, 83.5% (220 neuromas were present at the third interdigital space, 7.5% at the second space, and 47 patients presented it bilaterally. The average follow-up time was 7.5 years, ranging from 4 to 216 months, with satisfactory and fair outcomes in 95.8% of all patients, with only 11 patients (4.2% not satisfied with the overall treatment. The authors conclude, therefore, that neurectomy through cross-sectional plantar port is a

  17. Effects of plasma magnesium and prolactin on quantitative ultrasound measurements of heel bone among schizophrenic patients

    Directory of Open Access Journals (Sweden)

    Renn Jenn-Huei

    2010-02-01

    Full Text Available Abstract Background Osteoporosis is a bone disease that can reduce both bone mass and bone strength. It can cause serious fractures of bones, along with causing significant and even devastating physical, psychological and financial consequences for patients and their family members. Many reports have revealed that the prevalence of decreased bone density is higher in schizophrenic patients than in the non-psychological diseased population. The previous report of our group revealed that chronic schizophrenia patients have poorer BUA levels since they were young as compared to the general community population. Hyperprolactinemia and antipsychotics are reported to be among the risk factors for osteoporosis in chronic schizophrenic patients. Methods 93 schizophrenic patients with severely poor adjusted BUA values and 93 age and gender matched patients with normal adjusted BUA values from a previous survey study were selected. Data were collected via questionnaires and via reviews of antipsychotic medications. Blood samples were drawn, and serum levels of prolactin, estradiol, testosterone, magnesium, calcium, phosphate, osteocalcin, Cross-linked N-teleopeptide of type I collagen (NTX, thyroid hormone and parathyroid hormone were checked. The association between BUA levels and serum levels of the above items, along with the type of received antipsychotic medication, was evaluated. Results There was no significant association found between reduced BUA levels and serum prolactin, calcium, phosphate, osteocalcin, NTX, thyroid stimulating hormone and parathyroid hormone levels. There was also no association between BUA levels and types of currently received antipsychotics. There was no association between BUA levels and menstruation condition in female patients. Hypermagnesemia had a borderline association with classical and combined (classical and atypical antipsychotic medications in male patients. Nevertheless, hypermagnesemia is a significant

  18. 基于ANSYS有限元的混凝土重力坝坝踵正应力分析%ANSYS finite element analysis on normal stress of heel of concrete gravity dam heel

    Institute of Scientific and Technical Information of China (English)

    李芬花; 崔学坤; 邢健

    2009-01-01

    采用ANSYS结构分析软件,对桌混凝土重力坝进行有限元应力分析,对比二维与三维模型,针对完建工况、运行工况中是否设置防渗帷幕及排水孔,研究了上游边坡坡率对坝踵正应力的影响,由此得出一些有价值的结论,供设计单位参考.%The finite element stress analysis is made on a concrete gravity dam with the structure analysis software based on ANSYS ; in which the effect of the ratio of the upstream slope on the normal stress of the dam heel is studied for both the completed condition and operation condition of the dam with or without arrangement of anti-seepage curtain and drainage system, and then some valuable conclusions are obtained; which can be provided as the references for the designer concerned.

  19. Simplified versus geometrically accurate models of forefoot anatomy to predict plantar pressures: A finite element study.

    Science.gov (United States)

    Telfer, Scott; Erdemir, Ahmet; Woodburn, James; Cavanagh, Peter R

    2016-01-25

    Integration of patient-specific biomechanical measurements into the design of therapeutic footwear has been shown to improve clinical outcomes in patients with diabetic foot disease. The addition of numerical simulations intended to optimise intervention design may help to build on these advances, however at present the time and labour required to generate and run personalised models of foot anatomy restrict their routine clinical utility. In this study we developed second-generation personalised simple finite element (FE) models of the forefoot with varying geometric fidelities. Plantar pressure predictions from barefoot, shod, and shod with insole simulations using simplified models were compared to those obtained from CT-based FE models incorporating more detailed representations of bone and tissue geometry. A simplified model including representations of metatarsals based on simple geometric shapes, embedded within a contoured soft tissue block with outer geometry acquired from a 3D surface scan was found to provide pressure predictions closest to the more complex model, with mean differences of 13.3kPa (SD 13.4), 12.52kPa (SD 11.9) and 9.6kPa (SD 9.3) for barefoot, shod, and insole conditions respectively. The simplified model design could be produced in 3h in the case of the more detailed model, and solved on average 24% faster. FE models of the forefoot based on simplified geometric representations of the metatarsal bones and soft tissue surface geometry from 3D surface scans may potentially provide a simulation approach with improved clinical utility, however further validity testing around a range of therapeutic footwear types is required.

  20. MRI of lesser metatarsophalangeal joint plantar plate tears and associated adjacent interspace lesions

    Energy Technology Data Exchange (ETDEWEB)

    Umans, Hilary [Albert Einstein College of Medicine and Lenox Hill Radiology Imaging and Associates, Bronx, NY (United States); Srinivasan, Ramya; Elsinger, Elisabeth [Albert Einstein College of Medicine, Bronx, NY (United States); Wilde, Gregory E. [Lenox Hill Radiology Imaging and Associates, Bronx, NY (United States)

    2014-10-15

    To identify the variety of second and third intermetatarsal space (IS) lesions that may coexist with and without adjacent metatarsophalangeal joint (MTP) plantar plate (PP) tears. One hundred forefoot MRIs in 96 patients with metatarsalgia obtained between 30 September 2011 and 21 July 2012 using 1.5- or 3-T MRI were retrospectively reviewed in consensus by two MSK radiologists and one podiatrist (DPM). MRI was evaluated for second and third MTP PP tear and the presence/nature of second and third IS lesions. Second and third IS neuromas were measured in transverse (trans) dimension. A total of 40 PP tears were identified: 36 at the second and 4 at the third MTP. Second MTP PP tear was identified in 33 % of females and 40.5 % of males. In the 63 female feet there were 21 second MTP PP tears, all of which also had second IS lesions: pericapsular fibrosis (16), bursitis (4), and ganglion (1). In the 37 male feet there were 15 second MTP PP tears, 14 of which had second IS lesions: pericapsular fibrosis (8), bursitis (5), and ganglion (1). There was no definite second IS neuroma adjacent to any second MTP PP tear. In females without PP tear, there were 24 second (3 mm trans average) and 43 third IS neuromas (4.1 mm trans average). In males without PP tear, there were 9 second (3.4 mm trans average) and 16 third IS neuromas (4.1 mm trans average). MTP PP tears occurred in 40 % of our cases, 90 % of which occurred at the second MTP. Almost all coexisted with non-neuromatous second IS lesions. (orig.)

  1. Treatment of Palmar Plantar Erythrodysesthesia (PPE) with Topical Sildenafil: A Pilot Study

    Science.gov (United States)

    Meadows, Kellen L.; Rushing, Christel; Honeycutt, Wanda; Latta, Kenneth; Howard, Leigh; Arrowood, Christy A.; Niedzwiecki, Donna; Hurwitz, Herbert I.

    2016-01-01

    Purpose Palmar-plantar erythrodysethesia (PPE) is a common chemotherapy and anti-VEGF multi-kinase inhibitor class-related toxicity that often results in debilitating skin changes and often limits the use of active anti-cancer regimens. Mechanistic and anecdotal clinical evidence suggested that topical application of sildenafil cream may help reduce the severity of PPE. Therefore, we conducted a randomized, double-blind, placebo-controlled pilot study to evaluate the feasibility, safety and efficacy of topical sildenafil cream for the treatment of PPE. Methods Eligible subjects were required to have grade 1–3 PPE associated with either capecitabine or sunitinib. Subjects were randomized to receive 1% topical sildenafil cream to the left extremities or right extremities and placebo cream on the opposite extremity. 0.5 mL of cream was applied to each affected hand/foot two times per day. The primary endpoint was improvement in PPE grading at any point on study. Clinical assessments were evaluated by NCI-CTC 4.0 grading and patient self-reported pain. Results Ten subjects were enrolled; 9 were evaluable for safety and efficacy. Five of nine subjects reported some improvement in foot pain and 3 of 8 subjects for hand pain improvement. One of these subjects noted specific improvement in tactile function. No treatment-related toxicities were observed. Conclusions In this limited, single center study, topical cream containing 1% sildenafil is feasible to administer, is well-tolerated, and may mitigate PPE-related symptoms due to anti-cancer therapeutic agents. Further validation is necessary. PMID:25341548

  2. Tradeoffs between impact loading rate, vertical impulse and effective mass for walkers and heel strike runners wearing footwear of varying stiffness.

    Science.gov (United States)

    Addison, Brian J; Lieberman, Daniel E

    2015-05-01

    Humans experience repetitive impact forces beneath the heel during walking and heel strike running that cause impact peaks characterized by high rates and magnitudes of loading. Impact peaks are caused by the exchange of momentum between the ground and a portion of the body that comes to a full stop (the effective mass) during the period of the impact peak. A number of factors can influence this exchange of momentum, including footwear stiffness. This study presents and tests an impulse-momentum model of impact mechanics which predicts that effective mass and vertical impulse is greater in walkers and heel strike runners wearing less stiff footwear. The model also predicts a tradeoff between impact loading rate and effective mass, and between impact loading rate and vertical impulse among individuals wearing footwear of varying stiffness. We tested this model using 19 human subjects walking and running in minimal footwear and in two experimental footpads. Subjects walked and ran on an instrumented treadmill and 3D kinematic data were collected. As predicted, both vertical impulse (walking: F(2,54)=52.0, p=2.6E-13; running: F(2,54)=25.2, p=1.8E-8) and effective mass (walking: F(2,54)=12.1, p=4.6E-5; running: F(2,54)=15.5, p=4.7E-6) increase in less stiff footwear. In addition, there is a significant inverse relationship between impact loading rate and vertical impulse (walking: r=-0.88, ploading rate and effective mass (walking: r=-0.88, p<0.0001; running: r=-0.82, p<0.0001). The tradeoff relationships documented here raise questions about how and in what ways the stiffness of footwear heels influence injury risk during human walking and running. PMID:25814181

  3. Heel-strike in walking: assessment of potential sources of intra- and inter-subject variability in the activation patterns of muscles stabilizing the knee joint.

    Science.gov (United States)

    Huber, Cora; Federolf, Peter; Nüesch, Corina; Cattin, Philippe C; Friederich, Niklaus F; Tscharner, Vinzenz von

    2013-04-26

    The electromyographic (EMG) signal is known to show large intra-subject and inter-subject variability. Adaptation to, and preparation for, the heel-strike event have been hypothesized to be major sources of EMG variability in walking. The aim of this study was to assess these hypotheses using a principal component analysis (PCA). Two waveform shapes with distinct characteristic features were proposed based on conceptual considerations of how the neuro-muscular system might prepare for, or adapt to, the heel-strike event. PCA waveforms obtained from knee muscle EMG signals were then compared with the predicted characteristic features of the two proposed waveforms. Surface EMG signals were recorded for ten healthy adult female subjects during level walking at a self-selected speed, for the following muscles; rectus femoris, vastus medialis, vastus lateralis, semitendinosus, and biceps femoris. For a period of 200 ms before and after heel-strike, EMG power was extracted using a wavelet transformation (19-395 Hz). The resultant EMG waveforms (18 per subject) were submitted to intra-subject and inter-subject PCA. In all analyzed muscles, the shapes of the first and second principal component (PC-) vectors agreed well with the predicted waveforms. These two PC-vectors accounted for 50-60% of the overall variability, in both inter-subject and intra-subject analyses. It was also found that the shape of the first PC-vector was consistent between subjects, while higher-order PC-vectors differed between subjects. These results support the hypothesis that adaptation to, and preparation for, a variable heel-strike event are both major sources of EMG variability in walking.

  4. Comparison of the analgesic effect of ultrasound and low-level laser therapy in patients suffering from plantar fasciitis (calcar calcanei)

    Science.gov (United States)

    Navratil, Leos; Skopek, Jiri; Hronkova, Hana; Kymplova, Jaroslava; Knizek, Jiri

    2001-10-01

    To compare the effectiveness of the two therapeutic approaches, ultrasound and low level laser (LLLT) used in 181 patients suffering from calcar calcanei-plantar fasciitis. The effectiveness of the treatment was determined according to the evaluation of the patient using certain criteria described in the table. The complete disappearance of pain was seen in 50% of 60 patients treated with US and partial improvement in 16.6% and 69 patients were treated with LLLT from which 67% described complete pain relief, and 20% partial improvement. The results show that the LLLT is a good therapeutic approach in the treatment of pain in patients suffering from calcar calcanei-plantar fasciitis. The treatment with laser was significantly more successful then the ultrasound therapy, which is currently the most common therapy used for plantar fasciitis.

  5. Estudo da impressão plantar obtida durante o teste de Jack em crianças Footprint study in children during the Jack test

    Directory of Open Access Journals (Sweden)

    José Antonio Pinto

    2011-01-01

    Full Text Available OBJETIVO: Avaliar as impressões plantares durante o teste de Jack em crianças quantificando e observando os resultados numa faixa etária crítica para a formação do arco plantar. MÉTODO: Avaliamos 60 crianças brancas (120 pés sendo 35 meninos e 25 meninas com idades entre 2 e 5 anos, sem queixas ortopédicas. Simulamos o teste de Jack com uma órtese em cunha de 45º apoiada sob o hálux. Obtivemos impressões em apoio monopodálico bilateralmente utilizando um pedígrafo. O exame dividiu-se em duas etapas: com e sem o uso da órtese. A metodologia de Valenti e Volpon foi utilizada para mensurar as impressões plantares e os dados obtidos foram analisados estatisticamente. RESULTADOS: Os valores dos índices de Valenti e Volpon diminuiram quando a órtese foi utilizada. A diferença entre os índices com ou sem órtese diminuiu gradualmente com a progressão etária. CONCLUSÕES: É possível quantificar o teste de Jack pelwas impressões plantares pelo método de Valenti e Volpon. A variação do seu formato apresentou tendência a ser menor a partir dos 4 anos. O teste de Jack perdeu gradativamente a capacidade de modificar a impressão plantar com a idade, diminuindo sua acuidade como parâmetro de bom prognóstico na formação do arco longitudinal medial. Nível de Evidência: Nível IV, estudo descritivo observacional.OBJECTIVE: To assess the plantar impressions obtained in children during the Jack test, with the aim of quantifying and analyzing their variability in the critical period for plantar foot arch formation. METHOD: A hundred and twenty feet from 60 healthy White children, recruited in an outpatient pediatric clinic, were examined. Our sample included 35 boys and 25 girls, ranging from 2 to 5 years. The Jack test was simulated using a 45o wedge-shaped orthosis applied to the hallux. Bilateral plantar impressions were acquired in the alternate single-foot standing position using a pedigraph. Two plantar impressions were

  6. Effects of Hardness of Custom Insoles on Plantar Pressure%定制鞋垫硬度对足底压力的影响

    Institute of Scientific and Technical Information of China (English)

    李鑫; 徐波; 喻伟才; 沈妮

    2013-01-01

    为了改善脚底的压力舒适性,设置不同的定制鞋垫硬度梯度,并通过动态足部压力测试以及VAS主观舒适性评价,分析了鞋垫硬度变化对足部压力舒适度的影响.结果表明,主观舒适度大体随着定制鞋垫硬度的增加而降低,且与峰值压强显著相关.%Insoles in different hardness were made to try to improve the plantar pressure comfort. By means of dynamic plantar pressure measurements and Visual Analogue Scale(VAS), the effects of hardness of custom insoles on plantar pressure were assessed. It can be concluded that, subject comfort reduced with advancing hardness and correlated significantly with peak pressure.

  7. Plantar pressure relief under the metatarsal heads: therapeutic insole design using three-dimensional finite element model of the foot.

    Science.gov (United States)

    Chen, Wen-Ming; Lee, Sung-Jae; Lee, Peter Vee Sin

    2015-02-26

    Therapeutic footwear with specially-made insoles is often used in people with diabetes and rheumatoid arthritis to relieve ulcer risks and pain due to high pressures from areas beneath bony prominences of the foot, in particular to the metatarsal heads (MTHs). In a three-dimensional finite element study of the foot and footwear with sensitivity analysis, effects of geometrical variations of a therapeutic insole, in terms of insole thicknesses and metatarsal pad (MP) placements, on local peak plantar pressure under MTHs and stress/strain states within various forefoot tissues, were determined. A validated musculoskeletal finite element model of the human foot was employed. Analyses were performed in a simulated muscle-demanding instant in gait. For many design combinations, increasing insole thicknesses consistently reduce peak pressures and internal tissue strain under MTHs, but the effects reach a plateau when insole becomes very thick (e.g., a value of 12.7mm or greater). Altering MP placements, however, showed a proximally- and a distally-placed MP could result in reverse effects on MTH pressure-relief. The unsuccessful outcome due to a distally-placed MP may attribute to the way it interacts with plantar tissue (e.g., plantar fascia) adjacent to the MTH. A uniform pattern of tissue compression under metatarsal shaft is necessary for a most favorable pressure-relief under MTHs. The designated functions of an insole design can best be achieved when the insole is very thick, and when the MP can achieve a uniform tissue compression pattern adjacent to the MTH.

  8. Local analgesic effect of tramadol is mediated by opioid receptors in late postoperative pain after plantar incision in rats

    Science.gov (United States)

    de Oliveira Junior, José Oswaldo; de Freitas, Milena Fernandes; Bullara de Andrade, Carolina; Chacur, Marucia; Ashmawi, Hazem Adel

    2016-01-01

    Tramadol is a drug used to treat moderate to severe pain. It is known to present a peripheral effect, but the local mechanisms underlying its actions remain unclear. The role of peripheral opioid receptors in postoperative pain is not well understood. In the present study, we examined the peripheral opioid receptors to determine the local effect of tramadol in a plantar incision pain model. Rats were subjected to plantar incision and divided into four groups on postoperative day (POD) 1: SF_SF, 0.9% NaCl injected into the right hindpaw; SF_TraI, 0.9% NaCl and tramadol injected into the right hindpaw; SF_TraC, 0.9% NaCl and tramadol injected into the contralateral hindpaw; and Nal_Tra, naloxone and tramadol injected into the ipsilateral hindpaw. To determine the animals’ nociceptive threshold, mechanical hyperalgesia was measured before incision, on POD1 before treatment and at 15, 30, 45, and 60 minutes after the incision. The same procedure was repeated on the POD2. The expression levels of μ-opioid receptor (MOR) and δ-opioid receptor (DOR) were obtained through immunoblotting assays in the lumbar dorsal root ganglia (L3–L6) in naïve rats and 1, 2, 3, and 7 days after the incision. Our results showed that the plantar incision was able to cause an increase in mechanical hyperalgesia and that tramadol reversed this hyperalgesia on POD1 and POD2. Tramadol injections in the contralateral paw did not affect the animals’ nociceptive threshold. Naloxone was able to antagonize the tramadol effect partially on POD1 and completely on POD2. The DOR expression increased on POD2, POD3, and POD7, whereas the MOR expression did not change. Together, our results show that tramadol promoted a local analgesic effect in the postoperative pain model that was antagonized by naloxone in POD2, alongside the increase of DOR expression. PMID:27799813

  9. The effect of low-dye taping on rearfoot motion and plantar pressure during the stance phase of gait

    Directory of Open Access Journals (Sweden)

    Kennedy Norelee

    2008-08-01

    Full Text Available Abstract Background Low-dye (LD taping is commonly used to reduce rearfoot pronation. No studies have previously investigated the effectiveness of LD taping using both plantar pressure distribution (F-Scan and 3-D (CODA analysis of rearfoot motion. Methods 20 healthy subjects with a navicular drop test exceeding 10 mm participated in the study. T tests were used to determine whether significant (p Results LD taping resulted in statistically significant increases in peak plantar pressure in the lateral midfoot (p = 0.000, along with significant decreases in pressure in the medial forefoot (p = 0.014, and the medial (p = 0.000 and lateral hindfoot (p = 0.007. No significant changes occurred in the medial midfoot (p = 0.794 or lateral forefoot (p = 0.654. When assessed using motion analysis, taping resulted in a statistically significant decrease in rearfoot pronation (p = 0.006, supination (p = 0.025 and total rearfoot range of motion (p = 0.000. The mean rearfoot position during stance was not significantly different however (p = 0.188. Conclusion LD taping is associated with alterations in peak plantar pressure in the midfoot and forefoot that indicate reduced pronation with LD taping. However, LD taping appears to reduce both pronation and supination in the rearfoot, rather than simply reducing pronation, when assessed using 3D motion analysis. Therefore, it would appear that LD taping does indeed reduce pronation, by restricting rearfoot motion in general, rather than pronation specifically. The degree of change observed with LD taping was however very small, and further research is needed to clarify the clinical significance of these initial findings.

  10. The effect of medial arch support over the plantar pressure and triceps surae muscle strength after prolonged standing

    Directory of Open Access Journals (Sweden)

    Hindun Saadah

    2015-11-01

    Full Text Available Background: The activity with prolonged standing position is one of the causes of abnormalities in the lower leg and foot. The aim of this study is to discover the effect of medial arch support over the distribution of plantar pressure when standing and walking.Methods: This was an experimental study with pre- and post-design the strength of triceps surae muscle after prolonged standing, was also evaluated in an experimental study with pre- and post-design. Variables of plantar pressure measurement are the contact area and pressure peak were measured by using the Mat-scan tool. The measurement of the triceps surae muscle strength was done with a hand-held dynamometer, before and after using the medial arch support. Measurement was performed before and after working with prolonged standing position which took place about seven hours using the medial arch support inserted in the shoes. Data was analyzed using paired T-test.Results: There was a significant difference of peak pressure between standing (p = 0.041 and walking (p = 0.001. Whereas the contact area showed a significant decrease in the width of the contact area when standing (104.12 ± 12.42 vs 99.08 ± 10.21 p = 0.023. Whereas, the triceps surae muscle strength pre- and post-standing prolonged did not indicate a significant difference.Conclusion: There was decrease in peak pressure when standing and walking and decrease in contact area when standing on plantar after used of the medial arch support after prolonged standing.

  11. Prospective Randomized Comparison of the Effectiveness of Radiation Therapy and Local Steroid Injection for the Treatment of Plantar Fasciitis

    Energy Technology Data Exchange (ETDEWEB)

    Canyilmaz, Emine, E-mail: dremocan@ktu.edu.tr [Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon (Turkey); Canyilmaz, Fatih [Department of Orthopaedics and Traumatology, Yavuz Selim Bone Disease and Rehabilitation Hospital, Trabzon (Turkey); Aynaci, Ozlem; Colak, Fatma; Serdar, Lasif [Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon (Turkey); Uslu, Gonca Hanedan [Department of Radiation Oncology, Kanuni Research and Education Hospital, Trabzon (Turkey); Aynaci, Osman [Department of Orthopaedics and Traumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon (Turkey); Yoney, Adnan [Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon (Turkey)

    2015-07-01

    Purpose: The purpose of this study was to conduct a randomized trial of radiation therapy for plantar fasciitis and to compare radiation therapy with local steroid injections. Methods and Materials: Between March 2013 and April 2014, 128 patients with plantar fasciitis were randomized to receive radiation therapy (total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy three times a week) or local corticosteroid injections a 1 ml injection of 40 mg methylprednisolone and 0.5 ml 1% lidocaine under the guidance of palpation. The results were measured using a visual analog scale, a modified von Pannewitz scale, and a 5-level function score. The fundamental phase of the study was 3 months, with a follow-up period of up to 6 months. Results: The median follow-up period for all patients was 12.5 months (range, 6.5-18.6 months). For the radiation therapy patients, the median follow-up period was 13 months (range, 6.5-18.5 months), whereas in the palpation-guided (PG) steroid injection arm, it was 12.1 months (range, 6.5-18.6 months). After 3 months, results in the radiation therapy arm were significantly superior to those in the PG steroid injection arm (visual analog scale, P<.001; modified von Pannewitz scale, P<.001; 5-level function score, P<.001). Requirements for a second treatment did not significantly differ between the 2 groups, but the time interval for the second treatment was significantly shorter in the PG steroid injection group (P=.045). Conclusion: This study confirms the superior analgesic effect of radiation therapy compared to mean PG steroid injection on plantar fasciitis for at least 6 months after treatment.

  12. Application of Plantar Pressure Analysis in Rehabilitation Evaluation of Cerebral Palsy Children with Talipes Valgus%足底压力测量技术在足外翻脑性瘫痪患儿康复疗效评定中的应用

    Institute of Scientific and Technical Information of China (English)

    叶玲; 吴建贤

    2012-01-01

    recorded at the initial stage. After 6 months rehabilitation treatment, the experiment would repeat the test on the same indicators. Comprehensive evaluation of efficacy of rehabilitation treatment will be generated by the statistical analysis that was carried out between the stage before and after treatment. Results There was correlation between therapeutic outcome and change of lateral forefoot pressure and lateral midfoot with application of plantar pressure analysis(Pa <0.05) ,and the correlation also could be found between medial forefoot pressure, medial midfoot pressure, heel pressure and the therapeutic outcome (Pa<0.05). There was correlation between foot flat phase,push off phase and the therapeutic outcome( Pa <0.01). There was a significant correlation between therapeutic outcome and rehabilitation in cerebral palsy children with talipes valgus while using GMFCS classification (Pa<0.01 ). Conclusions Comprehensive rehabilitation treatment is effective for treating cerebral palsy children with talipes valgus. Application of plantar pressure analysis can offer an effective and objective method for rehabilitation evaluation for those patients.

  13. Marine Automatic Anti-Heeling System of Pump-Control Type%泵控式船舶横倾平衡自动控制系统

    Institute of Scientific and Technical Information of China (English)

    许安静

    2011-01-01

    During loading and unloading operations on ships,transverse inclination may occur due to improper lading.Anti-heeling system is used to detect ship heeling angles and adjust the water volume in balance water tanks to create counter moment for correcting ship inclination.An anti-heeling control system and its technical scheme are introduced.Practical operation in the ship family of "1 300 passengers/1 800 lanes meter RO-PAX" proves,that the logical control sequence design is rational;pump valve interlock control is effective and the system can provide a safeguard for marine transport business.%船舶在港口装卸作业时,若配载不当会产生倾斜。横倾平衡控制系统通过检测横倾角度、进行平衡水舱的水量调载,产生复原力矩纠正船舶倾斜。介绍了横倾平衡的控制系统及技术解决方案。通过该控制系统在1 300客位/1 800 m车道客滚船等的实际应用,证明其逻辑控制时序设计合理、泵阀连锁控制有效,为船舶的安全运营提供了保障。

  14. Modified Xiaoyaosan Decoction on Treatment of Heel Pain%逍遥散加味治疗足跟痛临床观察

    Institute of Scientific and Technical Information of China (English)

    李吉武; 王评

    2011-01-01

    Objective: To study the efficacy of modified Xiaoyaosan decoction on the treatment of Heel Pain. Methods: 48 patients with outpatient, syndrome differentiation of heel pain with modified Xiaoyaosan decoction, 1 week for a course of treatment. Results: In 48 patients who accomplished the valuation, 13 cases were cured, 24 cases were significant progress, 8 cases were better, and 3 were of no effect. The total effective rate was 93.8%. Conclusion: Modified Xiaoyaosan has significantly clinical effect on the treatment of heel pain syndrome after 3 months .The effect of significantly, safe and reliable.%目的:探讨逍遥散加味治疗足跟痛的临床疗效.方法:选取48例门诊患者以逍遥散加味为主方辨证施治,7天为1疗程.结果:临床治愈13例,显效24例,有效8例,无效3例,总有效率为93.8%.结论:3个月后观察逍遥散加味治疗足跟痛临床疗效显著,安全可靠.

  15. 后现代主义语境下异形鞋跟的艺术性%The Artistry of Heteromorphous Shoe Heel in Postmodernism

    Institute of Scientific and Technical Information of China (English)

    刘芸; 姚云鹤

    2012-01-01

    后现代主义是当代社会人文和哲学的一个重大主题,因其丰富的多样性而很难有一个确切的定义.后现代主义语境下的设计独具特色,具体到鞋类设计的异形鞋跟设计,艺术性更是光彩夺目.通过异形鞋跟与典型艺术风格的分析,结合后现代主义下相关的设计和人文特色,重点讨论了异形鞋跟设计的艺术性,主要包括设计美学和人文艺术两方面.%Postmodernism is a major theme of the humanism and philosophy in modern society. Being rich and various, it is very difficult to have a precise definition. The design of heteromorphous shoe heel under postmodern is distinctive, and its artistry is dazzling. Through the analysis of the typical style of heteromophous shoe heel, as well as associated design and humanities characteristic, this essay mainly focus on the artistry of heteromorphous shoe heel, which includes design aesthetics and humanity art.

  16. Effect of continuing or stopping smoking during pregnancy on infant birth weight, crown-heel length, head circumference, ponderal index, and brain:body weight ratio.

    Science.gov (United States)

    Lindley, A A; Becker, S; Gray, R H; Herman, A A

    2000-08-01

    The objective of this study was to determine whether stopping smoking between the first prenatal care visit and the 32nd week of pregnancy affects the smoking-associated changes in five infant anthropometric indices. The study population consisted of 15,185 births in the Swedish Medical Birth Register from 1991 and 1992. The associations between birth weight, crown-heel length, head circumference, ponderal index, brain:body weight ratio, maternal smoking status at the first prenatal care visit and at 32 weeks' gestation, and other maternal and infant characteristics were assessed using multivariate linear regression. The infants of 946 women who stopped smoking before week 32 of pregnancy were statistically indistinguishable from the 9,802 infants of nondaily smokers in terms of birth weight, head circumference, and brain:body weight ratio, but they retained a significant deficit in crown-heel length of 0.23 cm (standard error, 0.08) and a significant elevation in ponderal index of 0.027 (standard error, 0.009). In this study, stopping smoking between the first prenatal care visit and week 32 of pregnancy prevented smoking-associated deficits in infant birth weight, head circumference, and brain:body weight ratio, but did not completely prevent deficits in crown-heel length in comparison with nonsmokers' infants of the same age, and did not prevent elevation of ponderal index in comparison with nonsmokers' infants of the same weight and age. PMID:10933268

  17. Nervus cutaneus femoris posterior pedicle flap for repairing large soft tissue defects at the heel or inferior segment of the shank

    Institute of Scientific and Technical Information of China (English)

    WANG Rui-ying; HU Jun-zu; XIN Lin-wei; TANG Ji-cun; GAO Yan

    2009-01-01

    Objective: To investigate the clinical effect of the nervus cutaneus femoris posterior pedicle flap on repairing large soft tissue defects at the heel or inferior segment of the shank.Methods: Totally 14 cases were followed up for 8-22 months (mean 15.5 months) to observe the clinical effects of nervus cutaneus femoris posterior pedicle flap on repairing large soft tissue defects of the heel or inferior segment of the shank. Among them, there were 3 patients afflicted with infection and cutaneous defects in the middle and inferior segment of the shank after internal fixation of open fracture, 4 patients with soft tissue defects of the ankle and uncovered tendo calcaneus, and 7 patients with soft tissue defects of the heel and exposed calcaneus.Results: The flaps survived well in 13 cases and partial necrosis occurred in 1 case that was thereafter cured with changing dressing. Various extents of pain and stiffness of the knee joints were present in all cases and disappeared through 1-8 weeks' (mean 3.2 weeks) functional exercises. The last follow-up showed that all the flaps kept good texture and satisfactory appearance.Conclusions: The nervus cutaneus femoris posterior pedicle flap, having the advantages of simple surgical procedures, anastomosing the nerves and restoring the sensation of recipient site, can be used for recovering large soft tissue defects of the shank and ankle.

  18. Modelación de órtesis personalizadas para alivio de presiones plantares en pie diabético

    OpenAIRE

    Rodriguez Montaño, Óscar Libardo

    2015-01-01

    Las órtesis de pie para alivio de presión plantar son dispositivos que han sido ampliamente usados para aliviar el dolor en los pies y evitar la aparición de lesiones por altas presiones, factor que está relacionado con los procesos de ulceración especialmente en pacientes con pie diabético consecuencia de la diabetes mellitus. La fabricación de estos dispositivos está sufriendo grandes cambios en los últimos años gracias a la introducción de nuevas tecnologías como el diseño a...

  19. Extracorporeal shock wave therapy in patients with plantar fasciitis. A randomized, placebo-controlled trial with ultrasonographic and subjective outcome assessments

    Directory of Open Access Journals (Sweden)

    Babak Vahdatpour

    2012-01-01

    Full Text Available Background and Aim: Results of previous studies have been conflicting on the efficacy of extracorporeal shock wave therapy (ESWT in the treatment of plantar fasciitis. We evaluated the effects of ESWT on plantar fasciitis in terms of ultrasonographic and subjective evaluations. Materials and Methods: In this randomized placebo-controlled trial, patients with plantar fasciitis were assigned to receive ESWT (4000 shock waves/session of 0.2 mJ/mm 2 in 3 sessions at weekly intervals or sham therapy (n = 20 in each group. Outcomes were documented by the ultrasonographic appearance of the aponeurosis and by patients′ pain scores, performed at baseline and 12 weeks after completion of the therapy. Results : The two groups were similar in baseline characteristics. Over the study period, plantar fascia thickness significantly reduced in the ESWT group (4.1 ± 1.3 to 3.6 ± 1.2 mm, P < 0.001, but slightly increased in the sham group (4.1 ± 0.8 to 4.5 ± 0.9 mm, P = 0.03. Both groups showed significant pain improvement over the course of the study (P < 0.001, though pain scores were significantly more reduced in the ESWT than the sham group (-4.2 ± 2.9 vs. -2.7 ± 1.8, P = 0.049. Conclusions: Extracorporeal shock wave therapy contributes to healing and pain reduction in plantar fasciitis and ultrasound imaging is able to depict the morphologic changes related to plantar fasciitis as a result of this therapy.

  20. A novel approach to mapping load transfer from the plantar surface of the foot to the walls of the total contact cast: a proof of concept study

    Directory of Open Access Journals (Sweden)

    Begg Lindy

    2012-12-01

    Full Text Available Abstract Background Total contact casting is regarded as the gold standard treatment for plantar foot ulcers. Load transfer from the plantar surface of the foot to the walls of the total contact cast has previously been assessed indirectly. The aim of this proof of concept study was to determine the feasibility of a new method to directly measure the load between the cast wall and the lower leg interface using capacitance sensors. Methods Plantar load was measured with pedar® sensor insoles and cast wall load with pliance® sensor strips as participants (n=2 walked along a 9 m walkway at 0.4±0.04 m/sec. The relative force (% on the cast wall was calculated by dividing the mean cast wall force (N per step by the mean plantar force (N per step in the shoe-cast condition. Results The combined average measured load per step upon the walls of the TCC equated to 23-34% of the average plantar load on the opposite foot. The highest areas of load on the lower leg were located at the posterior margin of the lateral malleolus and at the anterior ankle/extensor retinaculum. Conclusions These direct measurements of cast wall load are similar to previous indirect assessment of load transfer (30-36% to the cast walls. This new methodology may provide a more comprehensive understanding of the mechanism of load transfer from the plantar surface of the foot to the cast walls of the total contact cast.