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Sample records for dynamic foot function

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

    Science.gov (United States)

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

    2017-01-01

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

  2. Association between hip abductor function, rear-foot dynamic alignment, and dynamic knee valgus during single-leg squats and drop landings

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    Yoshinori Kagaya

    2015-06-01

    Conclusion: Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.

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

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

    2014-01-01

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

  4. The Predictive Value of the Foot Posture Index on Dynamic Function

    DEFF Research Database (Denmark)

    Mølgaard, Carsten Møller; Olesen Gammelgaard, Christian; Nielsen, R. G.

    2008-01-01

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...... dynamic measures are not feasible. Redmond et. al. found the model able to predict 41% of the variation in the complex rotation of the ankle joint, representing inversion/eversion, during midstance of walking. To our knowledge no studies have been published on the relationship between FPI and the movement...

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

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    Mickle, Karen J; Steele, Julie R

    2015-10-01

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

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

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

    2017-01-01

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

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

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

    2014-01-01

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

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

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

    2018-01-01

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

  9. A study of dynamic foot pressure measurement in diabetic patients

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    Milka D Madhale

    2017-01-01

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

  10. Generation of subject-specific, dynamic, multisegment ankle and foot models to improve orthotic design: a feasibility study

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    Oosterwaal Michiel

    2011-11-01

    Full Text Available Abstract Background Currently, custom foot and ankle orthosis prescription and design tend to be based on traditional techniques, which can result in devices which vary greatly between clinicians and repeat prescription. The use of computational models of the foot may give further insight in the biomechanical effects of these devices and allow a more standardised approach to be taken to their design, however due to the complexity of the foot the models must be highly detailed and dynamic. Methods/Design Functional and anatomical datasets will be collected in a multicentre study from 10 healthy participants and 15 patients requiring orthotic devices. The patient group will include individuals with metarsalgia, flexible flat foot and drop foot. Each participant will undergo a clinical foot function assessment, 3D surface scans of the foot under different loading conditions, and detailed gait analysis including kinematic, kinetic, muscle activity and plantar pressure measurements in both barefoot and shod conditions. Following this each participant will undergo computed tomography (CT imaging of their foot and ankle under a range of loads and positions while plantar pressures are recorded. A further subgroup of participants will undergo magnetic resonance imaging (MRI of the foot and ankle. Imaging data will be segmented to derive the geometry of the bones and the orientation of the joint axes. Insertion points of muscles and ligaments will be determined from the MRI and CT-scans and soft tissue material properties computed from the loaded CT data in combination with the plantar pressure measurements. Gait analysis data will be used to drive the models and in combination with the 3D surface scans for scaling purposes. Predicted plantar pressures and muscle activation patterns predicted from the models will be compared to determine the validity of the models. Discussion This protocol will lead to the generation of unique datasets which will be used

  11. Comparison of dynamic balance ability in healthy university students according to foot shape.

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    Hyong, In Hyouk; Kang, Jong Ho

    2016-01-01

    [Purpose] This study aimed to compare dynamic balance ability according to foot shape, defined as normal, pronated, or supinated on the basis of the height of the medial arch. [Subjects] In this study, 14 subjects for the pronated foot group, 14 for the supinated foot group, and 14 for the normal foot group were selected from among 162 healthy university students by using the navicular drop test proposed by Brody. To measure dynamic balance ability, a star excursion balance test (SEBT) was conducted for each group, in which a cross-shaped line and lines at 45° in eight directions were drawn on the floor. In this study, only three directions were used, namely anterior, posterolateral, and posteromedial. The mean of the SEBT was calculated by measuring three times for each group, and the values were standardized using the following equation: measured value/leg length × 100. [Results] No significant differences in dynamic balance ability were found between the normal, pronated, and supinated foot groups. [Conclusion] No significant differences in dynamic balance ability according to the foot shape were found among the healthy university students with normal, pronated, and supinated feet.

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

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

    2017-05-11

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

  13. Ambulatory assessment of ankle and foot dynamics

    NARCIS (Netherlands)

    Schepers, H. Martin; Koopman, Hubertus F.J.M.; Veltink, Petrus H.

    Ground reaction force (GRF) measurement is important in the analysis of human body movements. The main drawback of the existing measurement systems is the restriction to a laboratory environment. This paper proposes an ambulatory system for assessing the dynamics of ankle and foot, which integrates

  14. The Predictive Value of the Foot Posture Index on Dynamic Function

    DEFF Research Database (Denmark)

    Mølgaard, Carsten Møller; Olesen Gammelgaard, Christian; Nielsen, R. G.

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...

  15. The predictive value of the foot posture index on dynamic function

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Gottschalk; Rathleff, Michael Skovdal; Kersting, U G

    2008-01-01

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when d...

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

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

    2013-03-01

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

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

    Science.gov (United States)

    2013-01-01

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

  18. The role of foot morphology on foot function in diabetic subjects with or without neuropathy.

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    Guiotto, Annamaria; Sawacha, Zimi; Guarneri, Gabriella; Cristoferi, Giuseppe; Avogaro, Angelo; Cobelli, Claudio

    2013-04-01

    The aim of this study was to investigate the role of foot morphology, related with respect to diabetes and peripheral neuropathy in altering foot kinematics and plantar pressure during gait. Healthy and diabetic subjects with or without neuropathy with different foot types were analyzed. Three dimensional multisegment foot kinematics and plantar pressures were assessed on 120 feet: 40 feet (24 cavus, 20 with valgus heel and 11 with hallux valgus) in the control group, 80 feet in the diabetic (25 cavus 13 with valgus heel and 13 with hallux valgus) and the neuropathic groups (28 cavus, 24 with valgus heel and 18 with hallux valgus). Subjects were classified according to their foot morphology allowing further comparisons among the subgroups with the same foot morphology. When comparing neuropathic subjects with cavus foot, valgus heel with controls with the same foot morphology, important differences were noticed: increased dorsiflexion and peak plantar pressure on the forefoot (Pfoot morphology in altering both kinematics and plantar pressure in diabetic subjects, diabetes appeared to further contribute in altering foot biomechanics. Surprisingly, all the diabetic subjects with normal foot arch or with valgus hallux were no more likely to display significant differences in biomechanics parameters than controls. This data could be considered a valuable support for future research on diabetic foot function, and in planning preventive interventions. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Imaging of vascular dynamics within the foot using dynamic diffuse optical tomography to diagnose peripheral arterial disease

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    Khalil, M. A.; Kim, H. K.; Hoi, J. W.; Kim, I.; Dayal, R.; Shrikande, G.; Hielscher, A. H.

    2013-03-01

    Peripheral Arterial Disease (PAD) is the narrowing of the functional area of the artery generally due to atherosclerosis. It affects between 8-12 million people in the United States and if untreated this can lead to ulceration, gangrene and ultimately amputation. The current diagnostic method for PAD is the ankle-brachial index (ABI). The ABI is a ratio of the patient's systolic blood pressure in the foot to that of the brachial artery in the arm, a ratio below 0.9 is indicative of affected vasculature. However, this method is ineffective in patients with calcified arteries (diabetic and end-stage renal failure patients), which falsely elevates the ABI recording resulting in a false negative reading. In this paper we present our results in a pilot study to deduce optical tomography's ability to detect poor blood perfusion in the foot. We performed an IRB approved 30 patient study, where we imaged the feet of the enrolled patients during a five stage dynamic imaging sequence. The patients were split up into three groups: 10 healthy subjects, 10 PAD patients and 10 PAD patients with diabetes and they were imaged while applying a pressure cuff to their thigh. Differences in the magnitude of blood pooling in the foot and rate at which the blood pools in the foot are all indicative of arterial disease.

  20. Lessons from dynamic cadaver and invasive bone pin studies: do we know how the foot really moves during gait?

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    Nester Christopher J

    2009-05-01

    Full Text Available Abstract Background This paper provides a summary of a Keynote lecture delivered at the 2009 Australasian Podiatry Conference. The aim of the paper is to review recent research that has adopted dynamic cadaver and invasive kinematics research approaches to better understand foot and ankle kinematics during gait. It is not intended to systematically cover all literature related to foot and ankle kinematics (such as research using surface mounted markers. Since the paper is based on a keynote presentation its focuses on the authors own experiences and work in the main, drawing on the work of others where appropriate Methods Two approaches to the problem of accessing and measuring the kinematics of individual anatomical structures in the foot have been taken, (i static and dynamic cadaver models, and (ii invasive in-vivo research. Cadaver models offer the advantage that there is complete access to all the tissues of the foot, but the cadaver must be manipulated and loaded in a manner which replicates how the foot would have performed when in-vivo. The key value of invasive in-vivo foot kinematics research is the validity of the description of foot kinematics, but the key difficulty is how generalisable this data is to the wider population. Results Through these techniques a great deal has been learnt. We better understand the valuable contribution mid and forefoot joints make to foot biomechanics, and how the ankle and subtalar joints can have almost comparable roles. Variation between people in foot kinematics is high and normal. This includes variation in how specific joints move and how combinations of joints move. The foot continues to demonstrate its flexibility in enabling us to get from A to B via a large number of different kinematic solutions. Conclusion Rather than continue to apply a poorly founded model of foot type whose basis is to make all feet meet criteria for the mechanical 'ideal' or 'normal' foot, we should embrace variation

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

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

    2017-11-03

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

  2. The immediate effects of foot orthoses on functional performance in individuals with patellofemoral pain syndrome.

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    Barton, C J; Menz, H B; Crossley, K M

    2011-03-01

    Patellofemoral pain syndrome (PFPS) often results in reduced functional performance. There is growing evidence for the use of foot orthoses to treat this multifactorial condition. In this study, the immediate effects of foot orthoses on functional performance and the association of foot posture and footwear with improvements in function were evaluated. Fifty-two individuals with PFPS (18-35 years) were prescribed prefabricated foot orthoses (Vasyli Pro; Vasyli International, Labrador, Australia). Functional outcome measures evaluated included the change in (1) pain and (2) ease of a single-leg squat on a five-point Likert scale, and change in the number of (3) pain-free step downs and (4) single-leg rises from sitting. The association of foot posture using the Foot Posture Index, navicular drop and calcaneal angle relative to subtalar joint neutral; and the footwear motion control properties scale score with improved function were evaluated using Spearman's ρ statistics. Prefabricated foot orthoses produced significant improvements (psquat and improvements in the number of pain-free single-leg rises from sitting when wearing foot orthoses. In addition, a more pronated foot type was also found to be associated with improved ease of completing a single-leg squat when wearing foot orthoses. Prefabricated foot orthoses provide immediate improvements in functional performance, and these improvements are associated with a more pronated foot type and poorer footwear motion control properties.

  3. Foot length is a functional parameter for assessment of height.

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    Krishan, Kewal; Kanchan, Tanuj

    2013-03-01

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

  4. French validation of the Foot Function Index (FFI).

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    Pourtier-Piotte, C; Pereira, B; Soubrier, M; Thomas, E; Gerbaud, L; Coudeyre, E

    2015-10-01

    French validation of the Foot Function Index (FFI), self-questionnaire designed to evaluate rheumatoid foot according to 3 domains: pain, disability and activity restriction. The first step consisted of translation/back translation and cultural adaptation according to the validated methodology. The second stage was a prospective validation on 53 patients with rheumatoid arthritis who filled out the FFI. The following data were collected: pain (Visual Analog Scale), disability (Health Assessment Questionnaire) and activity restrictions (McMaster Toronto Arthritis questionnaire). A test/retest procedure was performed 15 days later. The statistical analyses focused on acceptability, internal consistency (Cronbach's alpha and Principal Component Analysis), test-retest reproducibility (concordance coefficients), external validity (correlation coefficients) and responsiveness to change. The FFI-F is a culturally acceptable version for French patients with rheumatoid arthritis. The Cronbach's alpha ranged from 0.85 to 0.97. Reproducibility was correct (correlation coefficients>0.56). External validity and responsiveness to change were good. The use of a rigorous methodology allowed the validation of the FFI in the French language (FFI-F). This tool can be used in routine practice and clinical research for evaluating the rheumatoid foot. The FFI-F could be used in other pathologies with foot-related functional impairments. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  5. Sweat function in the diabetic foot

    Directory of Open Access Journals (Sweden)

    Markendeya Nirmala

    2004-01-01

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

  6. An Evaluation of Surgical Functional Reconstruction of the Foot Using Kinetic and Kinematic Systems: A Case Report.

    Science.gov (United States)

    Jordán-Palomar, Elena Irene; Javierre, Etelvina; Rey-Vasalo, José; Alfaro-Santafé, Víctor; Gómez-Benito, María José

    Most pedobarographic studies of microsurgical foot reconstruction have been retrospective. In the present study, we report the results from a prospective pedobarographic study of a patient after microsurgical reconstruction of her foot with a latissimus dorsi flap and a cutaneous paddle, with a 42-month follow-up period. We describe the foot reconstruction plan and the pedobarographic measurements and analyzed its functional outcome. The goal of the present study was to demonstrate that pedobarography could have a role in the treatment of foot reconstruction from a quantitative perspective. The pedobarographic measurements were recorded after the initial coverage surgery and 2 subsequent foot remodeling procedures. A total of 4 pedobarographic measurements and 2 gait analyses were recorded and compared for both the noninvolved foot and the injured foot. Furthermore, the progress of the reconstructed foot was critically evaluated using this method. Both static and dynamic patterns were compared at subsequent follow-up visits after the foot reconstruction. The values and progression of the foot shape, peak foot pressure (kPa), average foot pressure (kPa), total contact surface (cm 2 ), loading time (%), and step time (ms) were recorded. Initially, the pressure distribution of the reconstructed foot showed higher peak values at nonanatomic locations, revealing a greater ulceration risk. Over time, we found an improvement in the shape and values of these factors in the involved foot. To homogenize the pressure distribution and correct the imbalance between the 2 feet, patient-specific insoles were designed and fabricated. In our patient, pedobarography provided an objective, repeatable, and recordable method for the evaluation of the reconstructed foot. Pedobarography can therefore provide valuable insights into the prevention of pressure ulcers and optimization of rehabilitation. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc

  7. Clinical outcomes and static and dynamic assessment of foot posture after lateral column lengthening procedure.

    Science.gov (United States)

    Barske, Heather; Chimenti, Ruth; Tome, Josh; Martin, Elizabeth; Flemister, Adolph S; Houck, Jeff

    2013-05-01

    Lateral column lengthening (LCL) has been shown to radiographically restore the medial longitudinal arch. However, the impact of LCL on foot function during gait has not been reported using validated clinical outcomes and gait analysis. Thirteen patients with a stage II flatfoot who had undergone unilateral LCL surgery and 13 matched control subjects completed self-reported pain and functional scales as well as a clinical examination. A custom force transducer was used to establish the maximum passive range of motion of first metatarsal dorsiflexion at 40 N of force. Foot kinematic data were collected during gait using 3-dimensional motion analysis techniques. Radiographic correction of the flatfoot was achieved in all cases. Despite this, most patients continued to report pain and dysfunction postoperatively. Participants post LCL demonstrated similar passive and active movement of the medial column when we compared the operated and the nonoperated sides. However, participants post LCL demonstrated significantly greater first metatarsal passive range of motion and first metatarsal dorsiflexion during gait than did controls (P stage II adult-acquired flatfoot deformity experience mixed outcomes and similar foot kinematics as the uninvolved limb despite radiographic correction of deformity. These patients maintain a low arch posture similar to their uninvolved limb. The consequence is that first metatarsal movement operates at the end range of dorsiflexion and patients do not obtain full hindfoot inversion at push-off. Longitudinal data are necessary to make a more valid comparison of the effects of surgical correction measured using radiographs and dynamic foot posture during gait. Level III, comparative series.

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

    Science.gov (United States)

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

    2016-01-01

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

  9. Protocol for evaluating the effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: a randomized controlled trial.

    Science.gov (United States)

    Matias, Alessandra B; Taddei, Ulisses T; Duarte, Marcos; Sacco, Isabel C N

    2016-04-14

    Overall performance, particularly in a very popular sports activity such as running, is typically influenced by the status of the musculoskeletal system and the level of training and conditioning of the biological structures. Any change in the musculoskeletal system's biomechanics, especially in the feet and ankles, will strongly influence the biomechanics of runners, possibly predisposing them to injuries. A thorough understanding of the effects of a therapeutic approach focused on feet biomechanics, on strength and functionality of lower limb muscles will contribute to the adoption of more effective therapeutic and preventive strategies for runners. A randomized, prospective controlled and parallel trial with blind assessment is designed to study the effects of a "ground-up" therapeutic approach focused on the foot-ankle complex as it relates to the incidence of running-related injuries in the lower limbs. One hundred and eleven (111) healthy long-distance runners will be randomly assigned to either a control (CG) or intervention (IG) group. IG runners will participate in a therapeutic exercise protocol for the foot-ankle for 8 weeks, with 1 directly supervised session and 3 remotely supervised sessions per week. After the 8-week period, IG runners will keep exercising for the remaining 10 months of the study, supervised only by web-enabled software three times a week. At baseline, 2 months, 4 months and 12 months, all runners will be assessed for running-related injuries (primary outcome), time for the occurrence of the first injury, foot health and functionality, muscle trophism, intrinsic foot muscle strength, dynamic foot arch strain and lower-limb biomechanics during walking and running (secondary outcomes). This is the first randomized clinical trial protocol to assess the effect of an exercise protocol that was designed specifically for the foot-and-ankle complex on running-related injuries to the lower limbs of long-distance runners. We intend to show

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

    Science.gov (United States)

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

    2017-12-01

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

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

    Science.gov (United States)

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

    2018-05-06

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

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

    Science.gov (United States)

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

    2017-04-01

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

  13. Cross-cultural adaptation and validation of the Foot Function Index to Spanish.

    Science.gov (United States)

    Paez-Moguer, Joaquin; Budiman-Mak, Elly; Cuesta-Vargas, Antonio I

    2014-03-01

    The purpose of this study was to adapt and validate the Foot Function Index to the Spanish (FFI-Sp) following the guidelines of the American Academy of Orthopaedic Surgeons. A cross-sectional study 80 participants with some foot pathology. A statistical analysis was made, including a correlation study with other questionnaires (the Foot Health Status Questionnaire, EuroQol 5-D, Visual Analogue Pain Scale, and the Short Form SF-12 Health Survey). Data analysis included reliability, construct and criterion-related validity and factor analyses. The principal components analysis with varimax rotation produced 3 principal factors that explained 80% of the variance. The confirmatory factor analysis showed an acceptable fit with a comparative fit index of 0.78. The FFI-Sp demonstrated excellent internal consistency on the three subscales: pain 0.95; disability 0.96; and activity limitation 0.69, the subscale that scored lowest. The correlation between the FFI-Sp and the other questionnaires was high to moderate. The Spanish version of the Foot Function Index (FFI-Sp) is a tool that is a valid and reliable tool with a very good internal consistency for use in the assessment of pain, disability and limitation of the function of the foot, for use both in clinic and research. Copyright © 2013 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  14. Are foot posture and functional health different in children with growing pains?

    Science.gov (United States)

    Evans, Angela Margaret; Scutter, Sheila Doreen

    2007-12-01

    The aim of the present paper was to investigate and compare findings of foot posture and functional health between groups of children aged 4-6 years with and without leg pain (described as "growing pains"). The null hypothesis: that there is no difference in measures of either foot posture or functional health between groups of children with and without leg pain. A stratified random sample of children was obtained. The children were identified with and without leg pain using a validated questionnaire for parents. The examiner was blind to the children's pain status. The schools and child care centers were from each geographical quadrant of metropolitan Adelaide and a northern rural region of South Australia. One hundred and eighty children (94 boys, 86 girls) entered and completed the study. Children whose parents returned a completed questionnaire and consent form were entered into the study. All participants were assessed by the one examiner. The foot posture measures used were those found to be most reliable in previous studies and for which the intra-rater reliability of the examiner was ascertained. Initial analysis of foot posture measures between the leg pain and no leg pains groups indicated a statistically significant result for the measure of navicular height, but only on the left side (P = 0.033). Logistic regression modeling showed that navicular height (left foot only) was positively yet weakly related to growing pains (odds ratio, 1.072; 95% confidence interval: 0.991-1.160) and the effect was not significant (P = 0.08). Measures of functional health returned many statistically significant yet weakly correlated relationships. The null hypothesis of the present study was supported in terms of clinical significance. While the foot posture measure of navicular height on the left foot was statistically significant it was not predictive for growing pains nor clinically significant as a measure between groups. The present study does not support the

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

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    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.

  16. Dynamic 3D shape of the plantar surface of the foot using coded structured light: a technical report.

    Science.gov (United States)

    Thabet, Ali K; Trucco, Emanuele; Salvi, Joaquim; Wang, Weijie; Abboud, Rami J

    2014-01-23

    The foot provides a crucial contribution to the balance and stability of the musculoskeletal system, and accurate foot measurements are important in applications such as designing custom insoles/footwear. With better understanding of the dynamic behavior of the foot, dynamic foot reconstruction techniques are surfacing as useful ways to properly measure the shape of the foot. This paper presents a novel design and implementation of a structured-light prototype system providing dense three dimensional (3D) measurements of the foot in motion. The input to the system is a video sequence of a foot during a single step; the output is a 3D reconstruction of the plantar surface of the foot for each frame of the input. Engineering and clinical tests were carried out to test the accuracy and repeatability of the system. Accuracy experiments involved imaging a planar surface from different orientations and elevations and measuring the fitting errors of the data to a plane. Repeatability experiments were done using reconstructions from 27 different subjects, where for each one both right and left feet were reconstructed in static and dynamic conditions over two different days. The static accuracy of the system was found to be 0.3 mm with planar test objects. In tests with real feet, the system proved repeatable, with reconstruction differences between trials one week apart averaging 2.4 mm (static case) and 2.8 mm (dynamic case). The results obtained in the experiments show positive accuracy and repeatability results when compared to current literature. The design also shows to be superior to the systems available in the literature in several factors. Further studies need to be done to quantify the reliability of the system in clinical environments.

  17. Dynamic 3D shape of the plantar surface of the foot using coded structured light: a technical report

    KAUST Repository

    Thabet, Ali Kassem

    2014-01-23

    Background The foot provides a crucial contribution to the balance and stability of the musculoskeletal system, and accurate foot measurements are important in applications such as designing custom insoles/footwear. With better understanding of the dynamic behavior of the foot, dynamic foot reconstruction techniques are surfacing as useful ways to properly measure the shape of the foot. This paper presents a novel design and implementation of a structured-light prototype system providing dense three dimensional (3D) measurements of the foot in motion. The input to the system is a video sequence of a foot during a single step; the output is a 3D reconstruction of the plantar surface of the foot for each frame of the input. Methods Engineering and clinical tests were carried out to test the accuracy and repeatability of the system. Accuracy experiments involved imaging a planar surface from different orientations and elevations and measuring the fitting errors of the data to a plane. Repeatability experiments were done using reconstructions from 27 different subjects, where for each one both right and left feet were reconstructed in static and dynamic conditions over two different days. Results The static accuracy of the system was found to be 0.3 mm with planar test objects. In tests with real feet, the system proved repeatable, with reconstruction differences between trials one week apart averaging 2.4 mm (static case) and 2.8 mm (dynamic case). Conclusion The results obtained in the experiments show positive accuracy and repeatability results when compared to current literature. The design also shows to be superior to the systems available in the literature in several factors. Further studies need to be done to quantify the reliability of the system in clinical environments.

  18. Foot morphometric phenomena.

    Science.gov (United States)

    Agić, Ante

    2007-06-01

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

  19. Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background Foot musculoskeletal deficits are seldom addressed by preventive medicine despite their high prevalence in patients with diabetic polyneuropathy. AIM: To investigate the effects of strengthening, stretching, and functional training on foot rollover process during gait. Methods A two-arm parallel-group randomized controlled trial with a blinded assessor was designed. Fifty-five patients diagnosed with diabetic polyneuropathy, 45 to 65 years-old were recruited. Exercises for foot-ankle and gait training were administered twice a week, for 12 weeks, to 26 patients assigned to the intervention group, while 29 patients assigned to control group received recommended standard medical care: pharmacological treatment for diabetes and foot care instructions. Both groups were assessed after 12 weeks, and the intervention group at follow-up (24 weeks). Primary outcomes involved foot rollover changes during gait, including peak pressure (PP). Secondary outcomes involved time-to-peak pressure (TPP) and pressure–time integral (PTI) in six foot-areas, mean center of pressure (COP) velocity, ankle kinematics and kinetics in the sagittal plane, intrinsic and extrinsic muscle function, and functional tests of foot and ankle. Results Even though the intervention group primary outcome (PP) showed a not statistically significant change under the six foot areas, intention-to-treat comparisons yielded softening of heel strike (delayed heel TPP, p=.03), better eccentric control of forefoot contact (decrease in ankle extensor moment, pforefoot contact with respect to medial forefoot (TPP anticipation, p<.01), and increased participation of hallux (increased PP and PTI, p=.03) and toes (increase in PTI, medium effect size). A slower COP mean velocity (p=.05), and an increase in overall foot and ankle function (p<.05) were also observed. In most cases, the values returned to baseline after the follow-up (p<.05). Conclusions Intervention discreetly changed foot rollover towards a

  20. Evaluation of the Pain and Foot Functions in Women with Hallux valgus deformities

    Directory of Open Access Journals (Sweden)

    Burcu Talu

    2016-06-01

    Full Text Available Objectives: The aim of this study was to investigate whether deformity affects pain and associated functional status in women with hallux valgus (HV. Methods: The study included 27 women (mean age: 40.5±10.3 years diagnosed with HV and with a deformity level of two or more as determined using the Manchester scale. Demographic data of the participants were recorded. In addi­tion, Visual Analog Scale (VAS was used to determine the intensity of pain during walking. To determine the function affected by pain and deformity, Foot Function Index (FFI, and the American Orthopaedic Foot and Ankle Society MTP-IP (AOFAS MTP-IP Scale along with AOFAS Midfoot (MF Scale were used. Results: Based on the study results, we determined a statistically significant relationship between foot function and pain among our patients (p<0.05. These significant relationships were observed between the pain and total scores of the Foot Function Index (p<0.05, the pain parameter of AOFAS MTP-IP and the pain and total scores of AOFAS midfoot-pain scale (p<0.05. Conclusion: It was concluded that when assessing and planning treatment for hallux valgus, all health profession­als dealing with foot health, pathologies, deformities and treatment should consider the patient as a whole, bearing in mind that pathologies can affect not only the perceived symptoms of individuals, but also their normal functions through various physical and social limitations. J Clin Exp Invest 2016; 7 (2: 144-149

  1. The prevention of diabetic foot ulceration: how biomechanical research informs clinical practice

    Directory of Open Access Journals (Sweden)

    Frank E. DiLiberto

    Full Text Available ABSTRACT Background Implementation of interprofessional clinical guidelines for the prevention of neuropathic diabetic foot ulceration has demonstrated positive effects regarding ulceration and amputation rates. Current foot care recommendations are primarily based on research regarding the prevention of ulcer recurrence and focused on reducing the magnitude of plantar stress (pressure overload. Yet, foot ulceration remains to be a prevalent and debilitating consequence of Diabetes Mellitus. There is limited evidence targeting the prevention of first-time ulceration, and there is a need to consider additional factors of plantar stress to supplement current guidelines. Objectives The first purpose of this article is to discuss the biomechanical theory underpinning diabetic foot ulcerations and illustrate how plantar tissue underloading may precede overloading and breakdown. The second purpose of this commentary is to discuss how advances in biomechanical foot modeling can inform clinical practice in the prevention of first-time ulceration. Discussion Research demonstrates that progressive weight-bearing activity programs to address the frequency of plantar stress and avoid underloading do not increase ulceration risk. Multi-segment foot modeling studies indicate that dynamic foot function of the midfoot and forefoot is compromised in people with diabetes. Emerging research demonstrates that implementation of foot-specific exercises may positively influence dynamic foot function and improve plantar stress in people with diabetes. Conclusion Continued work is needed to determine how to best design and integrate activity recommendations and foot-specific exercise programs into the current interprofessional paradigm for the prevention of first-time ulceration in people with Diabetes Mellitus.

  2. Cross-cultural adaptation and validation of the Foot Function Index for use in German-speaking patients with foot complaints.

    Science.gov (United States)

    Naal, Florian D; Impellizzeri, Franco M; Huber, Martin; Rippstein, Pascal F

    2008-12-01

    The purpose of this study was to cross-culturally adapt the Foot Function Index (FFI) for use in German-speaking patients with foot complaints. The FFI was adapted for the German language according to the recommended forward/backward translation protocol. The following metric properties were assessed in 53 consecutive patients (mean age, 57.2 years; 39 women) undergoing foot surgery at our department: feasibility, reliability (intraclass correlation coefficient ICC), internal consistency (Cronbach's alpha, CA), and construct validity (correlation with the Short Form (SF-36), a VAS assessing pain, a VAS assessing function, and the University of California at Los Angeles (UCLA) activity scale. The German FFI (FFI-D) comprised 18 items separated into a pain and a disability subscale. Completion of the FFI-D was feasible. The reliability and the internal consistency were both excellent with an ICC of 0.98 and a CA of 0.97 for the total score. We found moderate to high correlations between the FFI-D and the physical related SF-36 domains (r = -0.43 to -0.80), the VAS pain (r = 0.81), the VAS function (r = 0.77), and the UCLA (r = -0.52). Correlation coefficients between the FFI-D and the mental health related SF-36 domains were significantly lower (r = -0.08 to -0.32; p validity. The German version of the FFI is a reliable and valid questionnaire for the self-assessment of pain and disability in German-speaking patients with foot complaints.

  3. Assessment of a virtual functional prototyping process for the rapid manufacture of passive-dynamic ankle-foot orthoses.

    Science.gov (United States)

    Schrank, Elisa S; Hitch, Lester; Wallace, Kevin; Moore, Richard; Stanhope, Steven J

    2013-10-01

    Passive-dynamic ankle-foot orthosis (PD-AFO) bending stiffness is a key functional characteristic for achieving enhanced gait function. However, current orthosis customization methods inhibit objective premanufacture tuning of the PD-AFO bending stiffness, making optimization of orthosis function challenging. We have developed a novel virtual functional prototyping (VFP) process, which harnesses the strengths of computer aided design (CAD) model parameterization and finite element analysis, to quantitatively tune and predict the functional characteristics of a PD-AFO, which is rapidly manufactured via fused deposition modeling (FDM). The purpose of this study was to assess the VFP process for PD-AFO bending stiffness. A PD-AFO CAD model was customized for a healthy subject and tuned to four bending stiffness values via VFP. Two sets of each tuned model were fabricated via FDM using medical-grade polycarbonate (PC-ISO). Dimensional accuracy of the fabricated orthoses was excellent (average 0.51 ± 0.39 mm). Manufacturing precision ranged from 0.0 to 0.74 Nm/deg (average 0.30 ± 0.36 Nm/deg). Bending stiffness prediction accuracy was within 1 Nm/deg using the manufacturer provided PC-ISO elastic modulus (average 0.48 ± 0.35 Nm/deg). Using an experimentally derived PC-ISO elastic modulus improved the optimized bending stiffness prediction accuracy (average 0.29 ± 0.57 Nm/deg). Robustness of the derived modulus was tested by carrying out the VFP process for a disparate subject, tuning the PD-AFO model to five bending stiffness values. For this disparate subject, bending stiffness prediction accuracy was strong (average 0.20 ± 0.14 Nm/deg). Overall, the VFP process had excellent dimensional accuracy, good manufacturing precision, and strong prediction accuracy with the derived modulus. Implementing VFP as part of our PD-AFO customization and manufacturing framework, which also includes fit customization, provides a novel and powerful method to

  4. Effects of Rigid and Soft Foot Orthoses on Dynamic Balance in Females With Flatfoot

    Directory of Open Access Journals (Sweden)

    Hassan Saeedi

    2007-08-01

    Full Text Available Background:Various types of foot orthoses are prescribed for people with flatfoot.It has been reported that orthoses not only improve the biomechanics of the lower limb, but also have good effects on some balance parameters in these subjects.It is hypothesized that the latter effect is dependent on the rigidity of the orthoses. The aim of this study was to evaluate and compare the effects of rigid and soft foot orthoses on dynamic balance in females with flatfoot. The Biodex Balance System was used in a clinical trial study. Methods: 20 healthy students with bilateral flatfoot were randomly assigned to two equal groups. Each participant was tested on two days with 2-week interval. On each day, dynamic stability test was performed while standing in single-leg stance on an unstable platform of the balance system in 3 conditions (barefoot, with shoe, shoe with orthosis. SPSS11.5 was used for statistical analysis. Results: A significant group-by-day-by-condition interaction was found. Both groups on day 2 testing had a decreased overall stability index while wearing orthoses. Overall stability index was significantly lower on day 2 testing. Conclusion: Foot orthoses, depending on the amount of rigidity, were associated with some improvements in dynamic balance in subjects with flatfoot.

  5. The Effect of Rope Jumping Exercise on Postural Control, Static and Dynamic Balance in Male Students with Cavus Foot

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    Mahdi Ghaderiyan

    2016-06-01

    Full Text Available Background and Objectives: Plantar foot is a very active part in leap activities, such as rope jumping and with its small surface playes an important role in balance control. In this research, the effect of 12 week rope jumping exercise was investigated on postural control and static and dynamic balance in 10-13 years old male students with cavus foot. Methods: This quasi-experimental study was done on 450 male students aged 13-10 years in Jarghouyeh sofla. After the initial evaluation by pedescope (qualitative and then measurement by a foot scanner (quantitative and Staheli index, 30 students were selected as samples and were divided into two groups (experimental and control, each 15 cases. To measure the postural control, a foot scanner device was used and changes in plantar center of pressure was recorded for 20 seconds. Static balance was evaluated with stork test and dynamic balance by Y balance test. The subjects of the experimental group participated in a rope jumping training protocol three 45-minute sessions per week for 12 weeks. In this period of time, the subjects of the control group did not participate in any regular physical activity program in this time. Data were analyzed using dependent and independent t-tests. The significance level was considered p<0/05. Results: A 12-week rope jumping exercise improved postural control and static and dynamic balance in patients with cavus foot, which this change was significant (p<0.001. Conclusion: According to the results of this study, rope jumping can be a useful exercise to improve static and dynamic balance and postural control in individuals with cavus foot.

  6. Dynamically adjustable foot-ground contact model to estimate ground reaction force during walking and running.

    Science.gov (United States)

    Jung, Yihwan; Jung, Moonki; Ryu, Jiseon; Yoon, Sukhoon; Park, Sang-Kyoon; Koo, Seungbum

    2016-03-01

    Human dynamic models have been used to estimate joint kinetics during various activities. Kinetics estimation is in demand in sports and clinical applications where data on external forces, such as the ground reaction force (GRF), are not available. The purpose of this study was to estimate the GRF during gait by utilizing distance- and velocity-dependent force models between the foot and ground in an inverse-dynamics-based optimization. Ten males were tested as they walked at four different speeds on a force plate-embedded treadmill system. The full-GRF model whose foot-ground reaction elements were dynamically adjusted according to vertical displacement and anterior-posterior speed between the foot and ground was implemented in a full-body skeletal model. The model estimated the vertical and shear forces of the GRF from body kinematics. The shear-GRF model with dynamically adjustable shear reaction elements according to the input vertical force was also implemented in the foot of a full-body skeletal model. Shear forces of the GRF were estimated from body kinematics, vertical GRF, and center of pressure. The estimated full GRF had the lowest root mean square (RMS) errors at the slow walking speed (1.0m/s) with 4.2, 1.3, and 5.7% BW for anterior-posterior, medial-lateral, and vertical forces, respectively. The estimated shear forces were not significantly different between the full-GRF and shear-GRF models, but the RMS errors of the estimated knee joint kinetics were significantly lower for the shear-GRF model. Providing COP and vertical GRF with sensors, such as an insole-type pressure mat, can help estimate shear forces of the GRF and increase accuracy for estimation of joint kinetics. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Congenital and acquired foot disorders and their roentgenographic examination

    International Nuclear Information System (INIS)

    Weber, M.

    1986-01-01

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

  8. The Multi-Functional Foot in Athletic Movement: Extraordinary Feats by Our Extraordinary Feet

    Directory of Open Access Journals (Sweden)

    Wilson Jennifer

    2016-03-01

    Full Text Available The unique architecture of the foot system provides a sensitive, multi-tensional method of communicating with the surrounding environment. Within the premise of the paper, we discuss three themes: complexity, degeneracy and bio-tensegrity. Complex structures within the foot allow the human movement system to negotiate strategies for dynamic movement during athletic endeavours. We discuss such complex structures with particular attention to properties of a bio-tensegrity system. Degeneracy within the foot structure offers a distinctive solution to the problems posed by differing terrains and uneven surfaces allowing lower extremity structures to overcome perturbation as and when it occurs. This extraordinary structure offers a significant contribution to bipedalism through presenting a robust base of support and as such, should be given more consideration when designing athletic development programmes.

  9. Foot pain and functional limitation in healthy adults with hallux valgus: a cross-sectional study

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    Nix Sheree E

    2012-10-01

    Full Text Available Abstract Background Hallux valgus (HV is a very common deformity of the first metatarsophalangeal joint that often requires surgical correction. However, the association between structural HV deformity and related foot pain and disability is unclear. Furthermore, no previous studies have investigated concerns about appearance and difficulty with footwear in a population with HV not seeking surgical correction. The aim of this cross-sectional study was to investigate foot pain, functional limitation, concern about appearance and difficulty with footwear in otherwise healthy adults with HV compared to controls. Methods Thirty volunteers with HV (radiographic HV angle >15 degrees and 30 matched controls were recruited for this study (50 women, 10 men; mean age 44.4 years, range 20 to 76 years. Differences between groups were examined for self-reported foot pain and disability, satisfaction with appearance, footwear difficulty, and pressure-pain threshold at the first metatarsophalangeal joint. Functional measures included balance tests, walking performance, and hallux muscle strength (abduction and plantarflexion. Mean differences (MD and 95% confidence intervals (CI were calculated. Results All self-report measures showed that HV was associated with higher levels of foot pain and disability and significant concerns about appearance and footwear (p Conclusions These findings show that HV negatively impacts on self-reported foot pain and function, and concerns about foot appearance and footwear in otherwise healthy adults. There was also evidence of impaired hallux muscle strength and increased postural sway in HV subjects compared to controls, although general physical functioning and participation in physical activity were not adversely affected.

  10. Analysis of Foot Slippage Effects on an Actuated Spring-Mass Model of Dynamic Legged Locomotion

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    Yizhar Or

    2016-04-01

    Full Text Available The classical model of spring-loaded inverted pendulum (SLIP and its extensions have been widely accepted as a simple description of dynamic legged locomotion at various scales in humans, legged robots and animals. Similar to the majority of models in the literature, the SLIP model assumes ideal sticking contact of the foot. However, there are practical scenarios of low ground friction that causes foot slippage, which can have a significant influence on dynamic behaviour. In this work, an extension of the SLIP model with two masses and torque actuation is considered, which accounts for possible slippage under Coulomb's friction law. The hybrid dynamics of this model is formulated and numerical simulations under representative parameter values reveal several types of stable periodic solutions with stick-slip transitions. Remarkably, it is found that slippage due to low friction can sometimes increase average speed and improve energetic efficiency by significantly reducing the mechanical cost of transport.

  11. Fragility of foot process morphology in kidney podocytes arises from chaotic spatial propagation of cytoskeletal instability.

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    Cibele V Falkenberg

    2017-03-01

    Full Text Available Kidney podocytes' function depends on fingerlike projections (foot processes that interdigitate with those from neighboring cells to form the glomerular filtration barrier. The integrity of the barrier depends on spatial control of dynamics of actin cytoskeleton in the foot processes. We determined how imbalances in regulation of actin cytoskeletal dynamics could result in pathological morphology. We obtained 3-D electron microscopy images of podocytes and used quantitative features to build dynamical models to investigate how regulation of actin dynamics within foot processes controls local morphology. We find that imbalances in regulation of actin bundling lead to chaotic spatial patterns that could impair the foot process morphology. Simulation results are consistent with experimental observations for cytoskeletal reconfiguration through dysregulated RhoA or Rac1, and they predict compensatory mechanisms for biochemical stability. We conclude that podocyte morphology, optimized for filtration, is intrinsically fragile, whereby local transient biochemical imbalances may lead to permanent morphological changes associated with pathophysiology.

  12. Using the Oxford Foot Model to determine the association between objective measures of foot function and results of the AOFAS Ankle-Hindfoot Scale and the Foot Function Index: a prospective gait analysis study in Germany.

    Science.gov (United States)

    Kostuj, Tanja; Stief, Felix; Hartmann, Kirsten Anna; Schaper, Katharina; Arabmotlagh, Mohammad; Baums, Mike H; Meurer, Andrea; Krummenauer, Frank; Lieske, Sebastian

    2018-04-05

    After cross-cultural adaption for the German translation of the Ankle-Hindfoot Scale of the American Orthopaedic Foot and Ankle Society (AOFAS-AHS) and agreement analysis with the Foot Function Index (FFI-D), the following gait analysis study using the Oxford Foot Model (OFM) was carried out to show which of the two scores better correlates with objective gait dysfunction. Results of the AOFAS-AHS and FFI-D, as well as data from three-dimensional gait analysis were collected from 20 patients with mild to severe ankle and hindfoot pathologies.Kinematic and kinetic gait data were correlated with the results of the total AOFAS scale and FFI-D as well as the results of those items representing hindfoot function in the AOFAS-AHS assessment. With respect to the foot disorders in our patients (osteoarthritis and prearthritic conditions), we correlated the total range of motion (ROM) in the ankle and subtalar joints as identified by the OFM with values identified during clinical examination 'translated' into score values. Furthermore, reduced walking speed, reduced step length and reduced maximum ankle power generation during push-off were taken into account and correlated to gait abnormalities described in the scores. An analysis of correlations with CIs between the FFI-D and the AOFAS-AHS items and the gait parameters was performed by means of the Jonckheere-Terpstra test; furthermore, exploratory factor analysis was applied to identify common information structures and thereby redundancy in the FFI-D and the AOFAS-AHS items. Objective findings for hindfoot disorders, namely a reduced ROM, in the ankle and subtalar joints, respectively, as well as reduced ankle power generation during push-off, showed a better correlation with the AOFAS-AHS total score-as well as AOFAS-AHS items representing ROM in the ankle, subtalar joints and gait function-compared with the FFI-D score.Factor analysis, however, could not identify FFI-D items consistently related to these three

  13. Validation of a Russian-language version of the Foot Functional Index (FFI questionnaire

    Directory of Open Access Journals (Sweden)

    E. V. Orlova

    2016-01-01

    Full Text Available The Foot Functional Index (FFI questionnaire most completely reflects the functional status of patients with joint diseases of the feet.Objective: to study the psychometric properties of a Russian-language version of the FFI questionnaire.Patients and methods. The reliability, sensitivity, and validity of the Russian-language version of the FFI questionnaire were assessed in 55 patients with rheumatoid arthritis (RA. The investigators checked the reliability by assessing the internal consistency (calculating Cronbach's alpha and reproducibility by a test-retest analysis. The criterion validity was evaluated by correlation analysis using HAQ, RAPID3, and pain visual analogue scale (VAS scores. The sensitivity of FFI was studied by comparing its dynamics with RAPID3 changes during treatment.Results. Evaluating the internal consistency yielded a high Cronbach's alpha (0.78. The test-retest analysis demonstrated a significant correlation (0.83 between the results of primary and secondary testing. Assessing the criterion validity showed a high or near-high relationship to the scores of RAPID3 (0.78, HAQ (0.69, and pain VAS (0.76. The group of patients who were observed to have a decrease in disease activity according to RAPID3 from a high (16.2±4.1 to moderate (10.5±5.2 degree displayed a more marked reduction in FFI (ΔFFI = 20.5±2.3 than the group that did not exhibit significant changes in disease activity (ΔFFI = 6.9±3.4.Conclusion. FFI is a reliable, valid, and sensitive tool to evaluate the functional status of patients with foot diseases in RA.

  14. Criterion-related validity of the foot health status questionnaire regarding strength and plantar pressure measurements in elderly people.

    Science.gov (United States)

    Cuesta-Vargas, Antonio I; Galan-Mercant, Alejandro; Martín-Borras, Maria Carmen; González-Sánchez, Manuel

    2012-12-01

    Criterion-related validity of a self-administered questionnaire listed as gold standard requires objective testing. The aim of this study was to analyze the Foot Health Status Questionnaire (FHSQ) using functional variable measures (dynamic plantar pressure and foot strength). A total of 22 elderly healthy participants (13 women and 9 men) were screened by interview and physical examination for foot or gait abnormalities. Foot strength, footprint pressure, and foot health status were measured. All the items of the FHSQ show significant correlation with functional variables, but general foot health shows the highest correlation with the 4 physical variables related to plantar pressure (R2 = 0.741), followed by foot pain (R2 = 0.652). A set of different, directly measured physical variables related to foot strength and plantar pressure significantly correlate with the FHSQ dimensions. Cross-sectional trial.

  15. Foot anthropometry and morphology phenomena.

    Science.gov (United States)

    Agić, Ante; Nikolić, Vasilije; Mijović, Budimir

    2006-12-01

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

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

    Science.gov (United States)

    Irez, Gonul Babayigit

    2014-01-01

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

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

    Science.gov (United States)

    Tang, Ulla Hellstrand; Zügner, Roland; Lisovskaja, Vera; Karlsson, Jon; Hagberg, Kerstin; Tranberg, Roy

    2015-01-01

    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 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. 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. This study identified several potential risk factors for the onset of diabetic foot ulcers (DFU). Hallux valgus and hallux rigidus appeared to increase the PP under the medial

  18. 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

  19. Clinical and functional correlates of foot pain in diabetic patients.

    NARCIS (Netherlands)

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

    1998-01-01

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

  20. Clinical assessment of dynamic coefficient of friction effects in shoe-sole trituration of patients with drop foot.

    Science.gov (United States)

    Nima, Jamshidi; Firooz, Salami

    2012-06-01

    The aim of this study was examining the effect of human factors such as plantar friction, contact period time, and impulse on shoe-sole trituration of drop foot patients. Twenty-five patients with drop foot and twenty normal subjects were recruited in the study. The force plate and its related software's recorded human factor (coefficient of friction, ground reaction force, time of stance phase) as time dependent parameters. Dynamic coefficient of friction patterns were categorized based on their magnitude versus time when the longitudinal axis of the sole was plotted as the Y-axis and the transverse axis of the sole as X-axis during stance phase. The result of this research indicated that the average coefficient of friction among drop foot patients is 77.53 % (p value <0.05) lower than the normal subjects. Also the time of stance phase among drop foot patients is 7.56 % (p value <0.05) greater than normal subjects. There is no difference in the peaks, of vertical ground reaction force between normal and control group. The findings of this research revealed that the time of stance phase has a key role in shoe-sole trituration of patients with drop foot.

  1. Characterizing multisegment foot kinematics during gait in diabetic foot patients

    Directory of Open Access Journals (Sweden)

    Denti Paolo

    2009-10-01

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

  2. Effects of ankle foot orthoses on body functions and activities in people with floppy paretic ankle muscles : a systematic review

    NARCIS (Netherlands)

    Wilk, van der Dymphy; Dijkstra, Pieter Ubele; Postema, Klaas; Verkerke, Gijsbertus Jacob; Hijmans, Juha Markus

    2015-01-01

    Background: People with floppy ankle muscles paresis use ankle foot orthoses to improve their walking ability. Ankle foot orthoses also limit ankle range of motion thereby introducing additional problems. Insight in effects of ankle foot orthoses on body functions and activities in people with

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  4. Flat feet, happy feet? Comparison of the dynamic plantar pressure distribution and static medial foot geometry between Malawian and Dutch adults.

    Directory of Open Access Journals (Sweden)

    Niki M Stolwijk

    Full Text Available In contrast to western countries, foot complaints are rare in Africa. This is remarkable, as many African adults walk many hours each day, often barefoot or with worn-out shoes. The reason why Africans can withstand such loading without developing foot complaints might be related to the way the foot is loaded. Therefore, static foot geometry and dynamic plantar pressure distribution of 77 adults from Malawi were compared to 77 adults from the Netherlands. None of the subjects had a history of foot complaints. The plantar pressure pattern as well as the Arch Index (AI and the trajectory of the center of pressure during the stance phase were calculated and compared between both groups. Standardized pictures were taken from the feet to assess the height of the Medial Longitudinal Arch (MLA. We found that Malawian adults: (1 loaded the midfoot for a longer and the forefoot for a shorter period during roll off, (2 had significantly lower plantar pressures under the heel and a part of the forefoot, and (3 had a larger AI and a lower MLA compared to the Dutch. These findings demonstrate that differences in static foot geometry, foot loading, and roll off technique exist between the two groups. The advantage of the foot loading pattern as shown by the Malawian group is that the plantar pressure is distributed more equally over the foot. This might prevent foot complaints.

  5. Nineteen-Foot Diameter Explosively Driven Blast Simulator; TOPICAL

    International Nuclear Information System (INIS)

    VIGIL, MANUEL G.

    2001-01-01

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

  6. Influence of non-preferred foot technical training in reducing lower limbs functional asymmetry among young football players.

    Science.gov (United States)

    Guilherme, José; Garganta, Júlio; Graça, Amândio; Seabra, André

    2015-01-01

    The functional asymmetry of the lower limbs has been regarded as a relevant factor of the performance of football players. We purposed to ascertain whether a specific technical training programme for the non-preferred foot has implications in the increasing utilisation rate of the respective member during the game. Young football players (n = 71) were randomly divided into experimental group (N = 35; 14.37 ± 1.94 years) and control group (N = 36; 14.50 ± 1.81 years). The study was developed into three stages: first, assessment of the index utilisation of both limbs during the game; second, application of a technical training programme that includes the drilling of specific motor skills exclusively directed to the non-preferred foot; and third, assessment of the new rate of both limbs' utilisation after the predefined six months. The main findings were: (1) the use of the non-preferred foot increased significantly with the technical training programme in the experimental group and remained constant in the control group; (2) the use of the preferred foot decreased significantly in the experimental group and remained similar in control group. We concluded that a systematic and specific technical training for the non-preferred foot increases its use and reduces functional asymmetry in game situation, consequently improving the player's performance.

  7. Effects of wearing different personal equipment on force distribution at the plantar surface of the foot.

    Science.gov (United States)

    Schulze, Christoph; Lindner, Tobias; Woitge, Sandra; Finze, Susanne; Mittelmeier, Wolfram; Bader, Rainer

    2013-01-01

    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. Static and dynamic pedobarography were performed on 31 male soldiers carrying increasing weights consisting of different items of equipment. The pressure acting on the plantar surface of the foot increased with higher loading, both under static and dynamic conditions (p 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.

  8. A review of the biomechanics of the diabetic foot

    NARCIS (Netherlands)

    van Schie, C. H. M.

    2005-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  10. Feasibility of using Lokomat combined with functional electrical stimulation for the rehabilitation of foot drop

    Directory of Open Access Journals (Sweden)

    Christian B. Laursen

    2016-08-01

    Full Text Available This study investigated the clinical feasibility of combining the electromechanical gait trainer Lokomat with functional electrical therapy (LokoFET, stimulating the common peroneal nerve during the swing phase of the gait cycle to correct foot drop as an integrated part of gait therapy. Five patients with different acquired brain injuries trained with LokoFET 2-3 times a week for 3-4 weeks. Pre- and post-intervention evaluations were performed to quantify neurophysiological changes related to the patients’ foot drop impairment during the swing phase of the gait cycle. A semi-structured interview was used to investigate the therapists’ acceptance of LokoFET in clinical practice. The patients showed a significant increase in the level of activation of the tibialis anterior muscle and the maximal dorsiflexion during the swing phase, when comparing the pre- and post-intervention evaluations. This showed an improvement of function related to the foot drop impairment. The interview revealed that the therapists perceived the combined system as a useful tool in the rehabilitation of gait. However, lack of muscle selectivity relating to the FES element of LokoFET was assessed to be critical for acceptance in clinical practice.

  11. Feasibility of Using Lokomat Combined with Functional Electrical Stimulation for the Rehabilitation of Foot Drop.

    Science.gov (United States)

    Laursen, Christian B; Nielsen, Jørgen F; Andersen, Ole K; Spaich, Erika G

    2016-06-13

    This study investigated the clinical feasibility of combining the electromechanical gait trainer Lokomat with functional electrical therapy (LokoFET), stimulating the common peroneal nerve during the swing phase of the gait cycle to correct foot drop as an integrated part of gait therapy. Five patients with different acquired brain injuries trained with LokoFET 2-3 times a week for 3-4 weeks. Pre- and post-intervention evaluations were performed to quantify neurophysiological changes related to the patients' foot drop impairment during the swing phase of the gait cycle. A semi-structured interview was used to investigate the therapists' acceptance of LokoFET in clinical practice. The patients showed a significant increase in the level of activation of the tibialis anterior muscle and the maximal dorsiflexion during the swing phase, when comparing the pre- and post-intervention evaluations. This showed an improvement of function related to the foot drop impairment. The interview revealed that the therapists perceived the combined system as a useful tool in the rehabilitation of gait. However, lack of muscle selectivity relating to the FES element of LokoFET was assessed to be critical for acceptance in clinical practice.

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

    Science.gov (United States)

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

    2012-11-01

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

  13. Static, dynamic balance and functional performance in subjects with and without plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Geiseane Aguiar Gonçalves

    Full Text Available Abstract Introduction: Plantar fasciitis (PF is characterized by non-inflammatory degeneration and pain under the heel, and is one of the most common foot complaints. The compensations and adjustments made to decrease the discomfort caused by the disease are clinical findings and can be a factor that contributes to impaired balance and decreased functional performance. Objective: To compare functional performance as well as static and dynamic balance among subjects with and without PF. Methods: The sample consisted of 124 subjects of both sexes aged 20-60 years. Participants were divided into two groups: a bilateral PF group (PFG; n = 62 and a control group (CG, n = 62. The following outcomes were analyzed: static and dynamic balance (using functional tests and functional performance (using a questionnaire. We used Student’s t test for independent samples to compare variables between the groups. The alpha error was set at 0.05. Results: Subjects with PF showed greater impairment in their overall dynamic balance performance (p < 0.001 than the control group, except for left posteromedial movement (p = 0.19. The CG showed showed better functional performance (p < 0.001 than the PF group. There was no difference between groups for the variable static balance on stable (p = 0.160 and unstable surfaces (p = 0.085. Conclusion: Subjects with PF displayed smaller reach distances in the overall Star Excursion Balance Test (SEBT, demonstrating a deficit in dynamic balance and functional performance when compared with healthy subjects.

  14. Validation of a Russian-language version of the Foot Functional Index (FFI) questionnaire

    OpenAIRE

    E. V. Orlova; A. V. Surnov; D. E. Karateev; V. N. Amirdzhanova

    2016-01-01

    The Foot Functional Index (FFI) questionnaire most completely reflects the functional status of patients with joint diseases of the feet.Objective: to study the psychometric properties of a Russian-language version of the FFI questionnaire.Patients and methods. The reliability, sensitivity, and validity of the Russian-language version of the FFI questionnaire were assessed in 55 patients with rheumatoid arthritis (RA). The investigators checked the reliability by assessing the internal consis...

  15. Optical measurements of microvascular circulatory function in the foot for detection of peripheral neuropathy

    Science.gov (United States)

    Zamora, G.; Chekh, V.; Burge, M.; Barriga, E. S.; Luan, S.; Heintz, P.; Edwards, A.; McGrew, E.; Soliz, P.

    2012-03-01

    The purpose of this research is to quantify functional signals in the microvascular circulation of the plantar. Our device is based on thermal and spectral technologies that can be easily adopted in clinical and tele-screening settings. Eightytwo thousand amputations are performed annually on diabetics in the US. The cost of foot disorder diagnosis and management are estimated at $10.9 billion dollars annually. Our experiments on normal controls and diabetics assess the temperature recovery time characteristics due to cold provocation to the bottom of the foot (plantar). A difference in the nature of the recovery time between normal controls and diabetics was observed.

  16. Functional electrical stimulation and ankle foot orthoses provide equivalent therapeutic effects on foot drop: A meta-analysis providing direction for future research

    Directory of Open Access Journals (Sweden)

    Sarah Prenton

    2017-10-01

    Full Text Available Objective: To compare the randomized controlled trial evidence for therapeutic effects on walking of functional electrical stimulation and ankle foot orthoses for foot drop caused by central nervous system conditions. Data sources: MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination, Scopus and clinicaltrials.gov. Study selection: One reviewer screened titles/abstracts. Two independent reviewers then screened the full articles. Data extraction: One reviewer extracted data, another screened for accuracy. Risk of bias was assessed by 2 independent reviewers using the Cochrane Risk of Bias Tool. Data synthesis: Eight papers were eligible; 7 involving participants with stroke and 1 involving participants with cerebral palsy. Two papes reporting different measures from the same trial were grouped, resulting in 7 synthesized randomized controlled trials (n= 464. Meta-analysis of walking speed at final assessment (p = 0.46, for stroke participants (p = 0.54 and after 4–6 weeks’ use (p = 0.49 showed equal improvement for both devices. Conclusion: Functional electrical stimulation and ankle foot orthoses have an equally positive therapeutic effect on walking speed in non-progressive central nervous system diagnoses. The current randomized controlled trial evidence base does not show whether this improvement translates into the user’s own environment or reveal the mechanisms that achieve that change. Future studies should focus on measuring activity, muscle activity and gait kinematics. They should also report specific device details, capture sustained therapeutic effects and involve a variety of central nervous system diagnoses.

  17. A generic analytical foot rollover model for predicting translational ankle kinematics in gait simulation studies.

    Science.gov (United States)

    Ren, Lei; Howard, David; Ren, Luquan; Nester, Chris; Tian, Limei

    2010-01-19

    The objective of this paper is to develop an analytical framework to representing the ankle-foot kinematics by modelling the foot as a rollover rocker, which cannot only be used as a generic tool for general gait simulation but also allows for case-specific modelling if required. Previously, the rollover models used in gait simulation have often been based on specific functions that have usually been of a simple form. In contrast, the analytical model described here is in a general form that the effective foot rollover shape can be represented by any polar function rho=rho(phi). Furthermore, a normalized generic foot rollover model has been established based on a normative foot rollover shape dataset of 12 normal healthy subjects. To evaluate model accuracy, the predicted ankle motions and the centre of pressure (CoP) were compared with measurement data for both subject-specific and general cases. The results demonstrated that the ankle joint motions in both vertical and horizontal directions (relative RMSE approximately 10%) and CoP (relative RMSE approximately 15% for most of the subjects) are accurately predicted over most of the stance phase (from 10% to 90% of stance). However, we found that the foot cannot be very accurately represented by a rollover model just after heel strike (HS) and just before toe off (TO), probably due to shear deformation of foot plantar tissues (ankle motion can occur without any foot rotation). The proposed foot rollover model can be used in both inverse and forward dynamics gait simulation studies and may also find applications in rehabilitation engineering. Copyright 2009 Elsevier Ltd. All rights reserved.

  18. Nonlinear dynamics of skin blood flow response to mechanical and thermal stresses in the plantar foot of diabetics with peripheral neuropathy.

    Science.gov (United States)

    Liao, Fuyuan; Jan, Yih-Kuen

    2017-01-01

    Diabetic foot ulcers (DFU) are a major complication in diabetics. Impaired microvascular reactivity is a major contributor to the development of DFU and has been traditionally quantified by time-domain or frequency-domain measures of skin blood flow (SBF). These measures, however, are unable to characterize the changes of nonlinear dynamics of SBF associated with diabetes and peripheral neuropathy. The objective of this study was to investigate altered nonlinear dynamics of skin blood flow in the plantar foot of diabetics with peripheral neuropathy. 18 type 2 diabetics with peripheral neuropathy and 8 healthy controls were recruited. SBF at the first metatarsal head in response to a loading pressure of 300 mmHg and a local heating was measured using laser Doppler flowmetry. A sample entropy approach was used to quantify the degree of regularity of SBF. Our results showed that the regularity degree of SBF in the diabetic foot underwent only small changes during post-occlusive reactive hyperemia and thermally induced biphasic response compared to non-diabetics. SBF of the diabetic foot has higher degree of irregularity during reactive hyperemia because of attenuated myogenic activity, and demonstrated higher regularity during the biphasic response largely due to significantly enhanced cardiac activities. This study suggests that the regularity degree of SBF at the first metatarsal head could be used to assess impaired microvascular reactivity and thus may be used to assess the risk for DFU in diabetics with peripheralneuropathy.

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

    Science.gov (United States)

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

    2016-11-11

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

  20. Modelling foot height and foot shape-related dimensions.

    Science.gov (United States)

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

    2008-08-01

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

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

    Science.gov (United States)

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

    2018-04-01

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

  2. The influence of the program of prophylaxis of flat foot on the biomechanics characteristics of foot of children of pre-school age

    Directory of Open Access Journals (Sweden)

    Bychuk I.O.

    2011-02-01

    Full Text Available In the article is defined linear and angular biomechanics descriptions of children's foot of senior preschool age. It is analysed the dynamics and increase of the explored indexes during realization of the program of prophylaxis of flat foot in the teaching process. In experiment took part teachers and instructors of physical culture; control and experimental group consist of 20 children at the age of 5-6 years old. Efficiency of the offered program of prophylaxis of flat foot is proved.

  3. Structural and functional biological materials: Abalone nacre, sharp materials, and abalone foot adhesion

    Science.gov (United States)

    Lin, Albert Yu-Min

    A three-part study of lessons from nature is presented through the examination of various biological materials, with an emphasis on materials from the mollusk Haliotis rufescens, commonly referred to as the red abalone. The three categories presented are: structural hierarchy, self-assembly, and functionality. Ocean mollusk shells are composed of aragonite/calcite crystals interleaved with layers of a visco-elastic protein, having dense, tailored structures with excellent mechanical properties. The complex nano-laminate structure of this bio-composite material is characterized and related to its mechanical properties. Three levels of structural hierarchy are identified: macroscale mesolayers separating larger regions of tiled aragonite, microscale organization of 0.5 mum by 10 mum aragonite bricks; nanoscale mineral bridges passing through 30 nm layers of organic matrix separating individual aragonite tiles. Composition and growth mechanisms of this nanostructure were observed through close examination of laboratory-grown samples using scanning electron microscopy (SEM), Raman spectroscopy, and transmission electron microscopy (TEM). Glass slides and nacre pucks were implanted onto the growth surface of living abalone and removed periodically to observe trends in nacre deposition. Various deproteinization and demineralization experiments are used to explore the inorganic and organic components of the nacre's structure. The organic component of the shell is characterized by atomic force microscopy (AFM). The functionality of various biological materials is described and investigated. Two specific types of functionality are characterized, the ability of some materials to cut and puncture through sharp designs, and the ability for some materials to be used as attachment devices. Aspects of cutting materials employed by a broad range of animals were characterized and compared. In respect to the attachment mechanisms the foot of the abalone and the tree frog were

  4. Functional result of the surgical treatment of the fractures opened up in the severely traumatised hind foot

    International Nuclear Information System (INIS)

    Ramos Tovar, William Domingo; Arroyo Sanchez, Carlos Augusto

    2006-01-01

    Present study plans to carry out an evaluation of the functional result of the surgical treatment of the open fractures of the severely traumatised hind foot, in the Hospital Militar Central during 1998 to 2002 for the above-mentioned we plane a descriptive retrospective study type: series of cases. We also think about specific objectives in relation to demographic aspects, aspects of the treatment and of the complications that are presented in these patients. For the functional evaluation we used the AOFAS (American Orthopaedic Foot and Ankle Society Scale) scale for the hind foot. 60 patients were included. 95% was men. The age average was of 26 years. The mechanism in 51% of the cases was trauma due to high-speed firearm (rifle), 27% trauma for mine, 12% fall of height, 7% has an accident of traffic, and 3% of firearm of low speed (gun). The presentation frequency according to the classification of Gustilo was type ll 12%, type lllA 63% and type IIIB 25%. In all the cases the initial care was begin with surgical debridement and take of cultures and I. V. antibiotics. The interval of time between the lesion and the definitive surgery was of 6 months (1 month to 24 months). The initial handling was orthopedic in 23 cases, open reduction and internal fixation in 16 cases, external fixation in 19 cases, and external fixation plus internal fixation in 2 cases. Additional surgeries were required in 48 cases, 8 of these were tibiotalar arthrodesis, 26 subtalar arthrodesis, 5 tibiocalcaneal arthrodesis, 5 panarthrodesis, 4 arthrodesis of the mid foot. The final average score according to the AOFAS scale for the hind foot was 81 points

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

    Science.gov (United States)

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

    2012-01-01

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

  6. Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl [AMC, Dept of Radiology (Netherlands); Koelemay, Mark J. W., E-mail: m.j.koelemaij@amc.uva.nl [AMC, Dept of Vascular Surgery (Netherlands); Marquering, Henk A., E-mail: h.a.marquering@amc.uva.nl; Bavel, Ed T. van, E-mail: e.vanbavel@amc.uva.n [AMC, Dept of Biomedical Engineering and Physics (Netherlands)

    2016-02-15

    PurposeTo report on the first clinical experience with perfusion angiography (PA) of the foot in patients with chronic critical limb ischemia.Materials and MethodsPA is a post-processing software algorithm and no extra digital subtraction angiography (DSA) has to be performed for this analysis. The data used to test the feasibility of PA were obtained from a consecutive group of 89 patients with CLI who were treated with standard below the knee angioplasty and 12 separate patients who were not suitable for endovascular revascularization.ResultsMotion artifacts in the dataset of the DSA made post-procedural analysis impossible in 10 % intervention. In the majority of patients (59/68) PA showed an increase in volume flow in the foot after successful angioplasty of the crural vessels. However, in 9/68 patients no increase was seen after successful angioplasty. With the use of a local administered competitive α-adrenergic receptor antagonist, it is also possible to test and quantify the capillary resistance index which is a parameter for the remaining functionality of the microcirculation in CLI patients.ConclusionPA might be used as a new endpoint for lower limb revascularization and can also be used to test the functionality the microcirculation to identify sub-types of patients with CLI. Clinical evaluation and standardization of PA is mandatory before introduction in daily practice.

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

    Science.gov (United States)

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

    1998-09-01

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

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

    OpenAIRE

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

    2015-01-01

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

  9. Reliability and Correlation of Static and Dynamic Foot Arch Measurement in a Healthy Pediatric Population.

    Science.gov (United States)

    Scholz, Timo; Zech, Astrid; Wegscheider, Karl; Lezius, Susanne; Braumann, Klaus-Michael; Sehner, Susanne; Hollander, Karsten

    2017-09-01

    Measurement of the medial longitudinal foot arch in children is a controversial topic, as there are many different methods without a definite standard procedure. The purpose of this study was to 1) investigate intraday and interrater reliability regarding dynamic arch index and static arch height, 2) explore the correlation between both arch indices, and 3) examine the variation of the medial longitudinal arch at two different times of the day. Eighty-six children (mean ± SD age, 8.9 ± 1.9 years) participated in the study. Dynamic footprint data were captured with a pedobarographic platform. For static arch measurements, a specially constructed caliper was used to assess heel-to-toe length and dorsum height. A mixed model was established to determine reliability and variation. Reliability was found to be excellent for the static arch height index in sitting (intraday, 0.90; interrater, 0.80) and standing positions (0.88 and 0.85) and for the dynamic arch index (both 1.00). There was poor correlation between static and dynamic assessment of the medial longitudinal arch (standing dynamic arch index, r = -0.138; sitting dynamic arch index, r = -0.070). Static measurements were found to be significantly influenced by the time of day (P body mass index (P mind. For clinical purposes, static and dynamic arch data should be interpreted separately.

  10. Research Paper: Effect of Custom-Molded Insole With New Technique on Pain and Function in Females With Flexible Flat Foot: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Fateme Bahramian

    2017-02-01

    Conclusion According to our findings, there was a significant difference in pain and function in patients with a flat foot through medial heel skive technique. Therefore, it seems that the insoles can be an effective prescription for subjects with a flat foot.

  11. Dynamic renal and static bone imaging after a single foot injection of Tc-99m methylene diphosphonate

    International Nuclear Information System (INIS)

    Siddiqui, A.R.; Cohen, M.; Moran, D.P.

    1982-01-01

    Much better information regarding the renal anatomy and physiology can be obtained by imaging the kidneys immediately after the injection of Tc-99m MDP, rather than on the bone scan a few hours later. Evaluation of inferior vena cava is possible if the radiotracer is injected in the foot and dynamic images of the abdomen are obtained. It is possible to differentiate renal from extra-renal masses during bone scanning without any additional radiation to the patient

  12. Finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis.

    Science.gov (United States)

    Tanigawa, Makoto; Stein, Jason; Park, John; Kosa, Peter; Cortese, Irene; Bielekova, Bibiana

    2017-01-01

    While magnetic resonance imaging contrast-enhancing lesions represent an excellent screening tool for disease-modifying treatments in relapsing-remitting multiple sclerosis (RRMS), this biomarker is insensitive for testing therapies against compartmentalized inflammation in progressive multiple sclerosis (MS). Therefore, alternative sensitive outcomes are needed. Using machine learning, clinician-acquired disability scales can be combined with timed measures of neurological functions such as walking speed (e.g. 25-foot walk; 25FW) or fine finger movements (e.g. 9-hole peg test; 9HPT) into sensitive composite clinical scales, such as the recently developed combinatorial, weight-adjusted disability scale (CombiWISE). Ideally, these complementary simplified measurements of certain neurological functions could be performed regularly at patients' homes using smartphones. We asked whether tests amenable to adaptation to smartphone technology, such as finger and foot tapping have comparable sensitivity and specificity to current non-clinician-acquired disability measures. We observed that finger and foot tapping can differentiate RRMS and progressive MS in a cross-sectional study and can also measure yearly and two-year disease progression in the latter, with better power (based on z-scores) in comparison to currently utilized 9HPT and 25FW. Replacing the 9HPT and 25FW with simplified tests broadly adaptable to smartphone technology may enhance the power of composite scales for progressive MS.

  13. Foot Placement Indicator for Balance of Planar Bipeds with Point Feet

    Directory of Open Access Journals (Sweden)

    Pieter van Zutven

    2013-05-01

    Full Text Available Abstract If humanoid robots are to be used in society, they should be able to maintain their balance. Knowing where to step is crucially important. In this paper we contribute an algorithm that can compute the foot step location such that bipedal balance is maintained for planar bipeds with point feet and an arbitrary number of non-massless links on a horizontal and flat ground. The algorithm is called the foot placement indicator (FPI and it extends the foot placement estimator (FPE. The FPE uses an inverted pendulum model to capture the dynamics of a humanoid robot, whereas the FPI deals with multi-body models with distributed masses. This paper analyses equilibrium sets and the stability of planar bipeds with point feet. The algorithm uses conservation of energy throughout the step, taking into account the instantaneous impact dynamics at foot strike. A simulation case study on a five-link planar biped shows the effectiveness of the FPI.

  14. Relationship between static foot posture and foot mobility

    Directory of Open Access Journals (Sweden)

    McPoil Thomas G

    2011-01-01

    Full Text Available Abstract Background It is not uncommon for a person's foot posture and/or mobility to be assessed during a clinical examination. The exact relationship, however, between static posture and mobility is not known. Objective The purpose of this study was to determine the degree of association between static foot posture and mobility. Method The static foot posture and foot mobility of 203 healthy individuals was assessed and then analyzed to determine if low arched or "pronated" feet are more mobile than high arched or "supinated" feet. Results The study demonstrated that those individuals with a lower standing dorsal arch height and/or a wider standing midfoot width had greater mobility in their foot. In addition, those individuals with higher Foot Posture Index (FPI values demonstrated greater mobility and those with lower FPI values demonstrated less mobility. Finally, the amount of foot mobility that an individual has can be predicted reasonably well using either a 3 or 4 variable linear regression model. Conclusions Because of the relationship between static foot posture and mobility, it is recommended that both be assessed as part of a comprehensive evaluation of a individual with foot problems.

  15. Study on dynamic buckling behavior of a cylindrical liquid storage tanks under seismic excitation. 1st report, effects of liquid pressure on elephant foot bulge

    International Nuclear Information System (INIS)

    Ito, Tomohiro; Morita, Hideyuki; Sugiyama, Akihisa; Kawamoto, Yoji; Sirai, Eiji; Ogo, Hideyasu

    2004-01-01

    When a thin walled cylindrical liquid storage tank is exposed to a very large seismic base excitation, buckling phenomena may be caused such as bending buckling where diamond buckling pattern or elephant foot bulge pattern will be found at the bottom portion, and shear buckling at the middle portion of the tank. In this study, dynamic buckling tests were performed using scale models of thin cylindrical liquid storage tanks for the nuclear power plants. The input seismic acceleration was increased until the elephant foot bulge occurred and the vibrational behavior before and after buckling was investigated. And the effects of static and dynamic liquid pressure on the bending buckling patterns and the buckling critical force was investigated by fundamental tests using small tank models. (author)

  16. Gender-related Changes in Dorsal Hand and Foot Vein Function Following 60 Days of Head Down Bed Rest

    Science.gov (United States)

    Westby, Christian M.; Phillips, Tiffany; Stenger, Michael B.; Platts, Steven H.

    2009-01-01

    It is well known that female astronauts are more likely to experience post-flight orthostatic hypotension and presyncope compared to male astronauts. It has been suggested that the disproportionally higher incidence of presyncope (83% of female vs. 20% male crewmembers) may be due to sex-related differences in vascular function between the upper and lower limbs. However, much of this evidence is specific to changes in resistance vessels. Given that more than 70% of the circulating blood volume resides in compliance vessels, it is conceivable that even small changes in venous function may contribute to post-flight orthostatic hypotension. In spite of this, little is currently known regarding the influence of microgravity exposure on venous function between males and females. PURPOSE: To determine the influence of 60 days of HDBR on dorsal foot and hand vein function between healthy males (M) and females (F). METHODS: Using 2-D ultrasound, dorsal hand and foot vein diameter responses to intravenous infusions phenylephrine (PE), acetylcholine (ACh), and nitroglycerine (NTG) were determined in 26 adults; 10 females (age:37 +/- 2 yr ) and 16 males (age:34 +/- 2 yr ). Changes in venous function were calculated as the difference between diameter at baseline and following each venoactive drug. Differences in venous function between limb and sexes across HDBR were determined using mixed-effects linear regression. RESULTS: In response to 60 days of HDBR, the change in venousconstrictor response to PE in the dorsal hand veins was not significantly different between M and F. Interestingly, the change in constrictor response in the dorsal foot veins (compared to pre HDBR) was approximately 30% greater in the F, whereas the constrictor response was approximately 45% less in the M (p=0.026). HDBR had no influence on the change in dilator response to ACh, or NTG between M and F and between vascular beds. CONCLUSION: These results demonstrate that 60 days of HDBR contributes to sex

  17. Adaptation and Validation of the Foot Function Index-Revised Short Form into Polish

    OpenAIRE

    Rutkowski, Radosław; Gałczyńska-Rusin, Małgorzata; Gizińska, Małgorzata; Straburzyński-Lupa, Marcin; Zdanowska, Agata; Romanowski, Mateusz Wojciech; Romanowski, Wojciech; Budiman-Mak, Elly; Straburzyńska-Lupa, Anna

    2017-01-01

    Purpose The aim of the present study was to adapt the Foot Function Index-Revised Short Form (FFI-RS) questionnaire into Polish and verify its reliability and validity in a group of patients with rheumatoid arthritis (RA). Methods The study included 211 patients suffering from RA. The FFI-RS questionnaire underwent standard linguistic adaptation and its psychometric parameters were investigated. The enrolled participants had been recruited for seven months as a convenient sample from the rheu...

  18. Evaluation of the validity of the Foot Function Index in measuring outcomes in patients with foot and ankle disorders.

    Science.gov (United States)

    SooHoo, Nelson F; Samimi, David B; Vyas, Raj M; Botzler, Tin

    2006-01-01

    There is uncertainty regarding which outcomes tools should be used to report the results of treatment for patients with foot and ankle disorders. This study evaluates the validity of the Foot Function Index (FFI) by examining its level of correlation to the Medical Outcomes Study Short Form-36 (SF-36). The SF-36 is an extensively validated outcomes tool that has been used as a benchmark in examining the validity of several orthopaedic outcomes tools. Seventy-three patients were recruited at a tertiary referral foot and ankle practice. Patients completed packets which included informed consent forms, the FFI, and the SF-36 questionnaires. The questionnaires were scored and Pearson correlation coefficients were determined between the three domains of the FFI and the eight SF-36 sub-scales, as well as the two SF-36 summary scales. Sixty-nine patients completed an adequate number of items to be included in the study. The mean age of the patient sample was 46 (range 16 to 82) years and 44 were women (64%). Twenty-one patients (30%) had conditions affecting the forefoot, while 48 patients (70%) had conditions affecting the ankle or hindfoot. All three FFI domains had moderate to high levels of correlation to many of the SF-36 scales. The Disability domain of the FFI had the most consistent level of correlation to the SF-36 with Pearson coefficients in the range of -0.23 to -0.69. The Activity Limitation (r=-0.28 to -0.64) and Pain domains (r=-0.10 to -0.61) also demonstrated moderate levels of correlation to several of the SF-36 scales. The consistently moderate to high levels of correlation of the FFI to the SF-36 seen in this study support the FFI as a valid measure of health status. This suggests that the FFI is a reasonable method to monitor patient outcomes. Future studies should focus on determining if the FFI improves responsiveness to clinical change when used in combination with generic instruments like the SF-36.

  19. The Effect of Rocker Bar Ankle Foot Orthosis on Functional Mobility in Post-Stroke Hemiplegic Patients

    Directory of Open Access Journals (Sweden)

    Farzad Farmani

    2015-09-01

    Full Text Available Objectives: Ankle Foot Orthoses (AFOs are widely utilized to improve walking ability in hemiplegic patients. The present study aimed to evaluate the effect of Rocker bar Ankle Foot Orthosis (RAFO on functional mobility in post-stroke hemiplegic patients. Methods: Fifteen hemiplegic patients (men and women who were at least 6-months post-stroke and able to walk without assistive device for at least 10 meters voluntarily participated in this study. The patients were examined with and without RAFO. Their functional mobility was evaluated through 10-meter walk test and Timed Up and Go (TUG test. Also, paired t-test was used to analyze obtained data. Results: When patients used RAFO, their gait speed significantly increased (P<0.05. Also, the time of performing TUG test experienced a significant decrease using RAFO compared with utilizing shoe only (P<0.05. Discussion: RAFO led to a significant improvement in functional mobility in hemiplegic patient’s secondary to stroke. It seems that, it has been due to the positive effect of rocker modification on improving push off and transferring weight during stance phase of gait.

  20. Assessing economic consequences of foot disorders in dairy cattle using a dynamic stochastic simulation model

    NARCIS (Netherlands)

    Bruijnis, M.R.N.; Hogeveen, H.; Stassen, E.N.

    2010-01-01

    Foot disorders are an important health problem in dairy cattle, in terms of economics and animal welfare. The incidence, severity, and duration of foot disorders account for their importance. Prevalence of both subclinical and clinical foot disorders is high. More insight into the economic

  1. Evaluation of foot static disturbances in patients with rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Anna Kuryliszyn-Moskal

    2017-04-01

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

  2. Effect of ski mountaineering track on foot sole loading pattern.

    Science.gov (United States)

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

    2014-09-01

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

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

    African Journals Online (AJOL)

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

  4. Landing Control of Foot with Springs for Walking Robots on Rough Terrain

    Directory of Open Access Journals (Sweden)

    Moyuru Yamada

    2009-09-01

    Full Text Available Landing control is one of the important issues for biped walking robot, because robots are expected to walk on not only known flat surfaces but also unknown and uneven terrain for working at various fields. This paper presents a new controller design for a robotic foot to land on unknown terrain. The robotic foot considered in this study equips springs to reduce the impact force at the foot landing. There are two objectives in the landing control; achieving the desired ground reaction force and positioning the foot on unknown terrain. To achieve these two objectives simultaneously by adjusting the foot position, we propose a PI force controller with a desired foot position, which guarantees the robust stability of control system with respect to terrain variance, and exact positioning of the foot to unknown terrain. Simulation results using the Open Dynamics Engine demonstrate the effectiveness of the proposed controller.

  5. Foot Conditions among Homeless Persons: A Systematic Review

    Science.gov (United States)

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

    2016-01-01

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

  6. Foot Conditions among Homeless Persons: A Systematic Review.

    Science.gov (United States)

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

    2016-01-01

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

  7. Nonplantigrade Foot Posture: A Constraint on Dinosaur Body Size

    OpenAIRE

    Kubo, Tai; Kubo, Mugino O.

    2016-01-01

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

  8. PROMIS Pain Interference and Physical Function Scores Correlate With the Foot and Ankle Ability Measure (FAAM) in Patients With Hallux Valgus.

    Science.gov (United States)

    Nixon, Devon C; McCormick, Jeremy J; Johnson, Jeffrey E; Klein, Sandra E

    2017-11-01

    Traditional patient-reported outcome instruments like the Foot and Ankle Ability Measure (FAAM) quantify patient disability but often are limited by responder burden and incomplete questionnaires. The Patient-Reported Outcome Measurement Information System (PROMIS) overcomes such obstacles through computer-adaptive technology and can capture outcome data from various domains including physical and psychosocial function. Prior work has compared the FAAM with PROMIS physical function; however, there is little evidence comparing the association between foot and ankle-specific tools like the FAAM with more general outcomes measures of PROMIS pain interference and depression in foot and ankle conditions. (1) We asked whether there was a relationship between FAAM Activities of Daily Living (ADL) scores with PROMIS physical function, pain interference, and depression in patients with hallux valgus. (2) Additionally, we asked if we could identify specific factors that are associated with variance in FAAM and PROMIS physical function scores in patients with hallux valgus. Eighty-five new patients with either a primary or secondary diagnosis of hallux valgus based on clinic billing codes from July 2015 to February 2016 were retrospectively identified. Patients completed FAAM ADL paper-based surveys and electronic PROMIS questionnaires for physical function, pain interference, and depression from new patient visits at a single time. Spearman rho correlations were performed between FAAM ADL and PROMIS scores. Analyses then were used to identify differences in FAAM ADL and PROMIS physical function measures based on demographic variables. Stepwise linear regressions then determined which demographic and/or outcome variable(s) accounted for the variance in FAAM ADL and PROMIS physical function scores. FAAM scores correlated strongly with PROMIS physical function (r = 0.70, p hallux valgus. PROMIS tools allow for more-efficient data collection across multiple domains and, moving

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

    Science.gov (United States)

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

    2015-01-01

    Bed rest has been widely used as a simulation of weightlessness in studying the effects of microgravity exposure on human physiology and cognition. Changes in muscle function and functional mobility have been reported to be associated with bed rest. Understanding the effect of bed rest on neural control of movement would provide helpful information for spaceflight. In the current study, we evaluated how the brain activation for foot movement changed as a function of bed rest. Eighteen healthy men (aged 25 to 39 years) participated in this HDBR study. They remained continuously in the 6deg head-down tilt position for 70 days. Functional MRI was acquired during 1-Hz right foot tapping, and repeated at 7 time points: 12 days pre-, 8 days pre-, 7 days in-, 50 days in-, 70 days in-, 8 days post-, and 12 days post- HDBR. In all 7 sessions, we observed increased activation in the left motor cortex, right cerebellum and right occipital cortex during foot movement blocks compared to rest. Compared to the pre-HDBR baseline (1st and 2nd sessions), foot movement-induced activation in the left hippocampus increased during HDBR. This increase emerged in the 4th session, enlarged in the 5th session, and remained significant in the 6th and 7th sessions. Furthermore, increased activation relative to the baseline in left precuneus was observed in the 5th, 6th and 7th sessions. In addition, in comparison with baseline, increased activation in the left cerebellum was found in the 4th and 5th sessions, whereas increased activation in the right cerebellum was observed in the 4th, 6th and 7th sessions. No brain region exhibited decreased activation during bed rest compared to baseline. The increase of foot movement related brain activation during HDBR suggests that in a long-term head-down position, more neural control is needed to accomplish foot movements. This change required a couple of weeks to develop in HDBR (between 3rd and 4th sessions), and did not return to baseline even 12

  10. Does obesity influence foot structure and plantar pressure patterns in prepubescent children?

    Science.gov (United States)

    Dowling, A M; Steele, J R; Baur, L A

    2001-06-01

    This study examined the effects of obesity on plantar pressure distributions in prepubescent children. Field-based, experimental data on BMI (body mass index), foot structure and plantar pressures were collected for 13 consenting obese children and 13 non-obese controls. Thirteen obese (age 8.1+/-1.2 y; BMI 25.5+/-2.9 kg/m(2)) and 13 non-obese (age 8.4+/-0.9 y; BMI 16.9+/-1.2 kg/m(2)) prepubescent children, matched to the obese children for gender, age and height. Height and weight were measured to calculate BMI. Static weight-bearing footprints for the right and left foot of each subject were recorded using a pedograph to calculate the footprint angle and the Chippaux-Smirak index as representative measures of the surface area of the foot in contact with the ground. Right and left foot plantar pressures were then obtained using a mini-emed(R) pressure platform to calculate the force and pressure experienced under each child's foot during static and dynamic loaded and unloaded conditions. Obese subjects displayed significantly lower footprint angle (t=4.107; P=plantar pressures between the two subject groups. That is, although rearfoot dynamic forces generated by the obese subjects were significantly higher than those generated by the non-obese subjects, these forces were experienced over significantly higher mean peak areas of contact with the mini-emed(R) system. Therefore, rearfoot pressures experienced by the two subject groups did not differ. However, the mean peak dynamic forefoot pressures generated by the obese subjects (39.3+/-15.7 N.cm(-2); q=3.969) were significantly higher than those generated by the non-obese subjects (32.3+/-9.2 N.cm(-2)). It is postulated that foot discomfort-associated structural changes and increased forefoot plantar pressures in the obese foot may hinder obese children from participating in physical activity and therefore warrants immediate further investigation.

  11. Foot Health

    Science.gov (United States)

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

  12. Epidemiology and outcome in patients of diabetic foot

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  13. Translation and validation of the Danish Foot Function Index (FFI-DK).

    Science.gov (United States)

    Jorgensen, J E; Andreasen, J; Rathleff, M S

    2015-08-01

    The objective of this study was to translate the Foot Function Index (FFI) for use in Danish-speaking patients with foot complaints. The FFI consists of 23 items scored on a numeric rating scale from 0 to 10. The 23 items are grouped into three subscales: pain (nine items), activity limitation (five items), and disability (nine items). The Danish FFI was developed according to the recommended forward/backward translation protocol. The data analysis included reliability [intraclass correlation coefficient (ICC) 2.1] and internal consistency (Cronbach's alpha). Excellent internal consistency was shown for the three subscales: pain (0.99), disability (0.98), and activity limitation (0.98), as for the total score (0.97). The test-retest reliability was excellent: pain subscale: ICC 0.98 [95% confidence interval (CI): 0.97-0.99]; activity limitation subscale: ICC: 0.95 (95% CI: 0.91-0.98); disability subscale: ICC 0.97 (95% CI: 0.95-0.98); total score: ICC: 0.95 (95% CI: 0.91 to 0.98). The mean difference between test and retest was below 1 point and P > 0.08. Bland-Altman plots showed no significant or clinically relevant differences from test to retest in any of the subscales or in the total score. The Danish version of the FFI was found to be valid and reliable and therefore acceptable for use in the Danish population. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Painful Lytic Lesions of the Foot : A Case Report

    Directory of Open Access Journals (Sweden)

    R Vaishya

    2015-03-01

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

  15. Role of dynamic MRI in the follow-up of acute Charcot foot in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    Zampa, Virna; Bargellini, Irene; Turini, Francesca; Ortori, Simona; Bartolozzi, Carlo; Rizzo, Loredana; Piaggesi, Alberto

    2011-01-01

    To evaluate the usefulness of magnetic resonance imaging (MRI) in assessing the level of activity of acute Charcot foot, monitoring treatment response and predicting healing time. Forty diabetic patients with acute Charcot foot were prospectively enrolled. Patients underwent limb immobilization and were followed every 3 months by clinical examination (skin temperature and circumferences) and MRI. MR protocol included T1-weighted and fast spin echo inversion recovery (FSE-IR) sequences, and a dynamic study (fast spoiled gradient echo), after gadolinium administration (0.1 ml/kg). The contrast medium uptake rate at D-MRI and the signal intensity (SI) ratio on the FSE-IR sequence were measured. At baseline, mean contrast medium uptake rate was 136±49.7% and the mean SI ratio was 5±3. A high intra- and inter-observer agreement was found for the contrast medium uptake rate, whereas a low agreement was observed for the SI ratio. At 3 months' follow-up, reduction of the contrast medium uptake rate was observed in all patients with improved clinical findings (n = 34), whereas the SI ratio was reduced in 15/34 (44.1%) patients. Mean healing time was significantly related to the baseline contrast medium uptake rate (P=0.005); it was 5.3 ± 2.7 months in patients with contrast medium uptake rate ≤100%, compared with 9.1 ± 2.5 months in the remaining patients (P=0.0003). Contrast medium uptake rate obtained at D-MRI represents a reproducible parameter that is reliable for predicting and monitoring treatment outcome in acute Charcot foot. (orig.)

  16. Role of dynamic MRI in the follow-up of acute Charcot foot in patients with diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Zampa, Virna; Bargellini, Irene; Turini, Francesca; Ortori, Simona; Bartolozzi, Carlo [University of Pisa, Department of Diagnostic and Interventional Radiology, Pisa (Italy); Rizzo, Loredana; Piaggesi, Alberto [University of Pisa, Department of Endocrinology and Metabolism, Diabetic Foot Section, Pisa (Italy)

    2011-08-15

    To evaluate the usefulness of magnetic resonance imaging (MRI) in assessing the level of activity of acute Charcot foot, monitoring treatment response and predicting healing time. Forty diabetic patients with acute Charcot foot were prospectively enrolled. Patients underwent limb immobilization and were followed every 3 months by clinical examination (skin temperature and circumferences) and MRI. MR protocol included T1-weighted and fast spin echo inversion recovery (FSE-IR) sequences, and a dynamic study (fast spoiled gradient echo), after gadolinium administration (0.1 ml/kg). The contrast medium uptake rate at D-MRI and the signal intensity (SI) ratio on the FSE-IR sequence were measured. At baseline, mean contrast medium uptake rate was 136{+-}49.7% and the mean SI ratio was 5{+-}3. A high intra- and inter-observer agreement was found for the contrast medium uptake rate, whereas a low agreement was observed for the SI ratio. At 3 months' follow-up, reduction of the contrast medium uptake rate was observed in all patients with improved clinical findings (n = 34), whereas the SI ratio was reduced in 15/34 (44.1%) patients. Mean healing time was significantly related to the baseline contrast medium uptake rate (P=0.005); it was 5.3 {+-} 2.7 months in patients with contrast medium uptake rate {<=}100%, compared with 9.1 {+-} 2.5 months in the remaining patients (P=0.0003). Contrast medium uptake rate obtained at D-MRI represents a reproducible parameter that is reliable for predicting and monitoring treatment outcome in acute Charcot foot. (orig.)

  17. Investigating the effect of external trauma through a dynamic system modeling approach for clustering causality in diabetic foot ulcer development.

    Science.gov (United States)

    Salimi, Parisa; Hamedi, Mohsen; Jamshidi, Nima; Vismeh, Milad

    2017-04-01

    Diabetes and its associated complications are realized as one of the most challenging medical conditions threatening more than 29 million people only in the USA. The forecasts suggest a suffering of more than half a billion worldwide by 2030. Amid all diabetic complications, diabetic foot ulcer (DFU) has attracted much scientific investigations to lead to a better management of this disease. In this paper, a system thinking methodology is adopted to investigate the dynamic nature of the ulceration. The causal loop diagram as a tool is utilized to illustrate the well-researched relations and interrelations between causes of the DFU. The result of clustering causality evaluation suggests a vicious loop that relates external trauma to callus. Consequently a hypothesis is presented which localizes development of foot ulceration considering distribution of normal and shear stress. It specifies that normal and tangential forces, as the main representatives of external trauma, play the most important role in foot ulceration. The evaluation of this hypothesis suggests the significance of the information related to both normal and shear stress for managing DFU. The results also discusses how these two react on different locations on foot such as metatarsal head, heel and hallux. The findings of this study can facilitate tackling the complexity of DFU problem and looking for constructive mitigation measures. Moreover they lead to developing a more promising methodology for managing DFU including better prognosis, designing prosthesis and insoles for DFU and patient caring recommendations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. A musculoskeletal foot model for clinical gait analysis.

    Science.gov (United States)

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

    2010-06-18

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

  19. Clinical workflow for personalized foot pressure ulcer prevention.

    Science.gov (United States)

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

    2016-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2011-09-01

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

  1. Anaplerosis in Complex Treatment of Patients with Diabetic Foot Syndrome

    Directory of Open Access Journals (Sweden)

    B.G. Bezrodny

    2015-05-01

    Full Text Available The article describes the improvement of anaplerosis in patients with diabetic foot syndrome using skin flaps on vascular pedicle of the perforating vessels. The study involved patients with type 2 diabetes mellitus complicated with diabetic foot syndrome of neuroischemic form and chronic wounds of the lower extremities that do not heal for more than 21 days from the date of occurrence. The wounds were cleaned with ultrasonic cavitation. There was applied bandage with sorption antibacterial remedy base on nanodispersed silicon dioxide. There was applied a drainage vacuum bandage on a wound on the third day (VAC therapy. The flap is forming fitting to the size and configuration of a wound on a foot. Fourteen patients (93 % in the basic group were found to have survived flaps. Long-term follow up in 6 months demonstrated full maintenance of supporting function and good survived skin graft, absence of foot ulcers. In a control group 7 patients had recurrent foot ulcer. Improved techniques of autodermoplasty in patients with diabetic foot syndrome include glycemia control, preparation of a wound using vacuum apparatus bandage. Usage of split-skin graft combined with vacuum apparatus bandage allows close acute and chronic wounds effectively, maintain supporting function of an extremity, decrease in-hospital staying, and improve quality of patient’s life. Adequate foot wound closure prevents high-level amputation of low extremities in diabetic patients.

  2. Effect of dynamic temperature stimulus to plantar surface of the foot in the standing position

    Directory of Open Access Journals (Sweden)

    Ryo Watanabe

    2016-11-01

    Full Text Available We have previously found that a vertical force or tactile sensation occurs when the temperature of a participant's skin changes rapidly. In this illusion, upward motion, pressure or force sensation is elicited when stimulus temperature rises rapidly, whereas in the opposite case, downward motion or pulling sensation is elicited. In this paper, we applied this phenomenon to the sole (plantar surface of the foot to present the sensation of ground slope. To investigate this, we conducted an experiment that measured the correlation between stimulation temperature and front-back direction position of the center of gravity (COG. Participants stood on a thermal stimulator on Nintendo Wii Balance Board (WBB and they remained standing during 30 s dynamic temperature stimulus. In result of analysis, it was suggested that dynamic thermal change in sole might influence standing position and the effect pattern was anomalous in case of the participants who reported a swaying sensation without a haptic sensation. This behavior might be applied to the diagnosis of the presence of thermoesthesia of the patients who might have disease with absence of thermoesthesia.

  3. Effects of Wearing Different Personal Equipment on Force Distribution at the Plantar Surface of the Foot

    Directory of Open Access Journals (Sweden)

    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.

  4. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function

    Directory of Open Access Journals (Sweden)

    Gabriel Peixoto Leão Almeida

    2016-04-01

    Full Text Available OBJECTIVE: To investigate the relationship between the q-angle and anterior knee pain severity, functional capacity, dynamic knee valgus and hip abductor torque in women with patellofemoral pain syndrome (PFPS. METHODS: This study included 22 women with PFPS. The q-angle was assessed using goniometry: the participants were positioned in dorsal decubitus with the knee and hip extended, and the hip and foot in neutral rotation. Anterior knee pain severity was assessed using a visual analog scale, and functional capacity was assessed using the anterior knee pain scale. Dynamic valgus was evaluated using the frontal plane projection angle (FPPA of the knee, which was recorded using a digital camera during step down, and hip abductor peak torque was recorded using a handheld dynamometer. RESULTS: The q-angle did not present any significant correlation with severity of knee pain (r = -0.29; p = 0.19, functional capacity (r = -0.08; p = 0.72, FPPA (r = -0.28; p = 0.19 or isometric peak torque of the abductor muscles (r = -0.21; p = 0.35. CONCLUSION: The q-angle did not present any relationship with pain intensity, functional capacity, FPPA, or hip abductor peak torque in the patients with PFPS.

  5. Efficient foot motor control by Neymar’s brain

    Directory of Open Access Journals (Sweden)

    Eiichi eNaito

    2014-08-01

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

  6. The role of functional foot orthoses on calcaneal and tibial kinematics : a clinical perspective using 3-dimensional motion analysis

    OpenAIRE

    Kelly, Joseph J

    2010-01-01

    peer-reviewed In-shoe orthoses are used in the treatment and prevention of lower limb injuries in particular patellofemoral pain associated with subtalar joint pronation. The aim of this thesis was to investigate the precise effects of in-shoe orthotic on the Calcaneus and Tibia. Two-dimension frontal plane kinematics may be used in the clinical setting to determine static and dynamic kinematics of the lower limb and foot. The findings of this thesis highlight several limitations of the...

  7. Assessing the welfare impact of foot disorders in dairy cattle by a modeling approach

    NARCIS (Netherlands)

    Bruijnis, M.R.N.; Beerda, B.; Hogeveen, H.; Stassen, E.N.

    2012-01-01

    Foot disorders are the main cause of dairy cow lameness and are considered to have a major impact on the welfare of dairy cattle. This study adopts a modeling approach, using a dynamic stochastic model, to provide more insight into the welfare impact of different types of foot disorders, both

  8. Finite element modeling of a 3D coupled foot-boot model.

    Science.gov (United States)

    Qiu, Tian-Xia; Teo, Ee-Chon; Yan, Ya-Bo; Lei, Wei

    2011-12-01

    Increasingly, musculoskeletal models of the human body are used as powerful tools to study biological structures. The lower limb, and in particular the foot, is of interest because it is the primary physical interaction between the body and the environment during locomotion. The goal of this paper is to adopt the finite element (FE) modeling and analysis approaches to create a state-of-the-art 3D coupled foot-boot model for future studies on biomechanical investigation of stress injury mechanism, foot wear design and parachute landing fall simulation. In the modeling process, the foot-ankle model with lower leg was developed based on Computed Tomography (CT) images using ScanIP, Surfacer and ANSYS. Then, the boot was represented by assembling the FE models of upper, insole, midsole and outsole built based on the FE model of the foot-ankle, and finally the coupled foot-boot model was generated by putting together the models of the lower limb and boot. In this study, the FE model of foot and ankle was validated during balance standing. There was a good agreement in the overall patterns of predicted and measured plantar pressure distribution published in literature. The coupled foot-boot model will be fully validated in the subsequent works under both static and dynamic loading conditions for further studies on injuries investigation in military and sports, foot wear design and characteristics of parachute landing impact in military. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  9. Analysis of risk factors for neuropathic foot ulceration in diabetes mellitus.

    Science.gov (United States)

    Bennett, P J; Stocks, A E; Whittam, D J

    1996-03-01

    Diabetes mellitus affects about one in 25 Australians. Neuropathic foot ulceration is a frequent complication in persons with diabetes. This study evaluates the importance of different risk factors for the development of this condition. The role of nonenzymatic glycosylation and pressure beneath the sole of the foot in the pathogenesis of neuropathic foot ulcers was investigated. Twenty-seven subjects with diabetes with a recent history of neuropathic foot ulceration were matched by age and sex with a group of 50 control subjects without neuropathy or history of foot ulceration. The degree of nonenzymatic glycosylation was assessed by analyzing the average level of glycosylated hemoglobin in the 3 years prior to the development of the foot ulcer and a goniometer assessment of peripheral joint (hand and ankle) flexibility. Dynamic pressure of the plantar aspect of the foot was recorded using a Musgrave Footprint System pedobarograph during a normal gait cycle. There was no significant difference in age, sex, body mass index, and duration or type of diabetes between the ulcer and control groups. The pressure of the plantar aspect of the foot was significantly elevated (p < 0.01). Ankle joint flexibility was reduced (p < 0.01) in cases with neuropathic foot ulceration compared with the control group. There was a trend toward elevation of glycosylated hemoglobin (HbA1c fraction) or HbA1c in the ulcer group (p = 0.06). The results suggested that nonenzymatic glycosylation occurs at a more significant level in patients with diabetes with a history of neuropathic foot ulceration.

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

    Science.gov (United States)

    Zissimopoulos, Angelika; Fatone, Stefania; Gard, Steven

    2015-10-01

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

  11. [Asymmetries in dynamic plantar pressure distribution measurement in able-bodied gait: application to the study of the gait asymmetries in children with hemiplegic cerebral palsy].

    Science.gov (United States)

    Femery, V; Moretto, P; Renaut, H; Lensel, G; Thevenon, A

    2002-03-01

    The aim of this study was to analyse, firstly, the plantar pressure distribution in healthy subjects in order to validate or invalidate the previous studies results on the asymmetrical profile of the stance phase. The studies of asymmetries was based on the identification of a propulsive foot and a loading foot from a concept introduced by Viel. Secondly, the approach was applied to the study of gait asymmetries in two children with hemiplegic cerebral plasy. Thirty healthy control subjects and two hemiplegic children (H1 and H2) performed a walking test at self selected speed. The recordings of dynamic parameters were realized thanks to an in-shoe plantar pressure analysis system (Parotec, by Paromed Medizintechnik, GMBH, Germany). The pressure peaks were determined from the recording of pressures under eight footprint locations. A program calculated the sum of forces under the heel and determined the loading foot. By defect, the second foot is the propulsive foot. The asymmetrical profile of the human normal stance phase was validated. Under the heel, the pressure peaks lower by 28 % were noticed beneath the loading foot compared to the propulsive foot. Inversely, under the metatarsal heads and the hallux, the pressure peaks were greater by 32 % beneath the propulsive foot. For the two hemiplegic children, the plantar pressure profile equally highlighted significant differences between the unaffected and affected feet. The pressure peaks under the affected heel were respectively lower by 21 % and 97 % for H1 and H2. The loading function was found and associated to the affected limb. The propulsive function was not systematically found under the unaffected foot. The analysis of plantar pressure measurements during able-bodied gait showed differences between the two lower limbs. These dynamic asymmetries are the results of a natural functional organization of the supports differentiating a loading foot and a propulsive foot and corroborating the concept proposed by

  12. [Effect of self-foot reflexology massage on depression, stress responses and immune functions of middle aged women].

    Science.gov (United States)

    Lee, Yun-Mi

    2006-02-01

    This study was aimed to identify the effects of a self-foot reflexology massage on depression, stress responses and functions of the immune system of middle-aged women. This study was a one group pretest-posttest experimental design and the data was collected from August 1st, 2004 to May 31st, 2005. The subjects consisted of 46 middle-aged women (40 - 64 years) who were recruited from the Community Health Center in Busan city. Subjects were not treated for 4 weeks, subsequently they were trained in self foot reflexology massage for 2 weeks, and then they did their own daily for 6 weeks (2 days at the research center, 5 days at home). The outcome variables were measured 4 times, at baseline, pre training, after training, and after the intervention. The collected data was analyzed using repeated measure ANOVA by the SPSS/WIN program. There was a statistically significant difference in depression, perceived stress, systolic blood pressure, natural-killer cells and Ig G. However, there was not a statistically significant difference in diastolic blood pressure, pulse or serum cortisol. These results suggest that a self-foot reflexology massage could be utilized as an effective nursing intervention to reduce depression and stress responses, and to strengthen immune systems in middle-aged women.

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

    Science.gov (United States)

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

    2018-03-01

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

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

    Science.gov (United States)

    Xu, Miaomiao; Wang, Lin

    2017-08-01

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

  15. Comparison platelet indices in diabetic patients with and without diabetic foot ulcer

    Science.gov (United States)

    Mardia, A. I.; Gatot, D.; Lindarto, D.

    2018-03-01

    Diabetes Mellitus is a group of metabolic disease which incidence increases every year. Some diabetic patients have diabetic foot ulcer as acomplication. The occurrence of ulcers in diabetic patients can be caused by the presence of thrombosis due to increased platelet function. Therefore, a cross-sectional study on 40 diabetic patients was performed at RSUP Adam Malik Medan to see whether there were differences in platelet indices between diabetic patients with and without diabetic foot ulcers. Platelets indices were examined and looked for differences in diabetic patients with and without diabetic foot ulcers. Data were analyzed using Chi-Square and Mann-Whitney U test with 95% CI. P-valuediabetic patients with diabetic foot ulcers indicating more reactive and aggregatable platelet function.

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

    Science.gov (United States)

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

    2018-02-28

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

  17. Analysis of the epidemiological dynamics during the 1982-1983 epidemic of foot-and-mouth disease in Denmark based on molecular high-resolution strain identification

    DEFF Research Database (Denmark)

    Christensen, Laurids Siig; Normann, Preben; Thykier-Nielsen, Søren

    2005-01-01

    An epidemic of foot-and-mouth disease (FMD) causing a total of 23 cases in 1982-1983, primarily on the island of Funen, Denmark, was subjected to molecular epidemiological investigations. In an attempt to exploit the quasi-species nature of foot-and-mouth disease virus strains for molecular high......-resolution strain identification in order to analyse the dynamics of this epidemic, full-length VP1 coding regions were sequenced for 17 isolates collected at different farms during the epidemic. The sequence information together with epidemiological information gathered during the epidemic suggests......, and the prerequisite of co- or superinfection of animals with variant strains in turn implies that they have a common source or epidemiologically related sources originating from an area with endemic FMD....

  18. Development and validation of a questionnaire to assess disabling foot pain.

    Science.gov (United States)

    Garrow, A P; Papageorgiou, A C; Silman, A J; Thomas, E; Jayson, M I; Macfarlane, G J

    2000-03-01

    This study outlines the design and validation of a new self-administered instrument for assessing foot pain and disability. The 19-item questionnaire was tested on 45 rheumatology patients, 33 patients who had attended their general practitioner with a foot-related problem and 1000 responders to a population survey of foot disorders. Levels of reported disability were found to be greatest for rheumatology patients and least for community subjects. In addition, the instrument was able to detect differences in disability levels reported by community subjects who did and did not consult with a health care professional and those who did and did not have a history of past and current foot pain. A good level of agreement was found when items on the questionnaire were compared with similar items on the ambulation sub-scale of the Functional Limitation Profile questionnaire. A Cronbach's alpha value of 0.99 and item-total correlation values between 0.25 and 0.62 confirmed the internal consistency of the instrument. Finally the results of a principal components analysis identified three constructs that reflected disabilities that are associated with foot pain: functional limitation, pain intensity and personal appearance. The design of the foot disability questionnaire makes it a suitable instrument for assessing the impact of painful foot conditions in both community and clinical populations.

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

    Science.gov (United States)

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

    1998-10-01

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

  20. Functional asynchronous networks: Factorization of dynamics and function

    Directory of Open Access Journals (Sweden)

    Bick Christian

    2016-01-01

    Full Text Available In this note we describe the theory of functional asynchronous networks and one of the main results, the Modularization of Dynamics Theorem, which for a large class of functional asynchronous networks gives a factorization of dynamics in terms of constituent subnetworks. For these networks we can give a complete description of the network function in terms of the function of the events comprising the network and thereby answer a question originally raised by Alon in the context of biological networks.

  1. Anthropometric measurements of foot length and shape in children 2 to 7 years of age

    OpenAIRE

    Vrdoljak, Ozren; Kujundžić Tiljak, Mirjana; Čimić, Mislav

    2017-01-01

    Background and purpose: A child’s foot changes shape and proportions during growth so that it adapts to function. The purpose of this article is to determine foot length in children aged 2-7 years as a fundamental unit for measuring the growth of the foot, with which it will be able to compare other anthropometric measures of the foot. Determination of the shape of the foot and interpretation of the growth curve of the foot in length are important for standardization of the foot.Materials and...

  2. A multi-segment foot model based on anatomically registered technical coordinate systems: method repeatability in pediatric feet.

    Science.gov (United States)

    Saraswat, Prabhav; MacWilliams, Bruce A; Davis, Roy B

    2012-04-01

    Several multi-segment foot models to measure the motion of intrinsic joints of the foot have been reported. Use of these models in clinical decision making is limited due to lack of rigorous validation including inter-clinician, and inter-lab variability measures. A model with thoroughly quantified variability may significantly improve the confidence in the results of such foot models. This study proposes a new clinical foot model with the underlying strategy of using separate anatomic and technical marker configurations and coordinate systems. Anatomical landmark and coordinate system identification is determined during a static subject calibration. Technical markers are located at optimal sites for dynamic motion tracking. The model is comprised of the tibia and three foot segments (hindfoot, forefoot and hallux) and inter-segmental joint angles are computed in three planes. Data collection was carried out on pediatric subjects at two sites (Site 1: n=10 subjects by two clinicians and Site 2: five subjects by one clinician). A plaster mold method was used to quantify static intra-clinician and inter-clinician marker placement variability by allowing direct comparisons of marker data between sessions for each subject. Intra-clinician and inter-clinician joint angle variability were less than 4°. For dynamic walking kinematics, intra-clinician, inter-clinician and inter-laboratory variability were less than 6° for the ankle and forefoot, but slightly higher for the hallux. Inter-trial variability accounted for 2-4° of the total dynamic variability. Results indicate the proposed foot model reduces the effects of marker placement variability on computed foot kinematics during walking compared to similar measures in previous models. Copyright © 2011 Elsevier B.V. All rights reserved.

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

    NARCIS (Netherlands)

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

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

  4. Estimation of Foot Plantar Center of Pressure Trajectories with Low-Cost Instrumented Insoles Using an Individual-Specific Nonlinear Model

    Directory of Open Access Journals (Sweden)

    Xinyao Hu

    2018-02-01

    Full Text Available Postural control is a complex skill based on the interaction of dynamic sensorimotor processes, and can be challenging for people with deficits in sensory functions. The foot plantar center of pressure (COP has often been used for quantitative assessment of postural control. Previously, the foot plantar COP was mainly measured by force plates or complicated and expensive insole-based measurement systems. Although some low-cost instrumented insoles have been developed, their ability to accurately estimate the foot plantar COP trajectory was not robust. In this study, a novel individual-specific nonlinear model was proposed to estimate the foot plantar COP trajectories with an instrumented insole based on low-cost force sensitive resistors (FSRs. The model coefficients were determined by a least square error approximation algorithm. Model validation was carried out by comparing the estimated COP data with the reference data in a variety of postural control assessment tasks. We also compared our data with the COP trajectories estimated by the previously well accepted weighted mean approach. Comparing with the reference measurements, the average root mean square errors of the COP trajectories of both feet were 2.23 mm (±0.64 (left foot and 2.72 mm (±0.83 (right foot along the medial–lateral direction, and 9.17 mm (±1.98 (left foot and 11.19 mm (±2.98 (right foot along the anterior–posterior direction. The results are superior to those reported in previous relevant studies, and demonstrate that our proposed approach can be used for accurate foot plantar COP trajectory estimation. This study could provide an inexpensive solution to fall risk assessment in home settings or community healthcare center for the elderly. It has the potential to help prevent future falls in the elderly.

  5. Estimation of Foot Plantar Center of Pressure Trajectories with Low-Cost Instrumented Insoles Using an Individual-Specific Nonlinear Model.

    Science.gov (United States)

    Hu, Xinyao; Zhao, Jun; Peng, Dongsheng; Sun, Zhenglong; Qu, Xingda

    2018-02-01

    Postural control is a complex skill based on the interaction of dynamic sensorimotor processes, and can be challenging for people with deficits in sensory functions. The foot plantar center of pressure (COP) has often been used for quantitative assessment of postural control. Previously, the foot plantar COP was mainly measured by force plates or complicated and expensive insole-based measurement systems. Although some low-cost instrumented insoles have been developed, their ability to accurately estimate the foot plantar COP trajectory was not robust. In this study, a novel individual-specific nonlinear model was proposed to estimate the foot plantar COP trajectories with an instrumented insole based on low-cost force sensitive resistors (FSRs). The model coefficients were determined by a least square error approximation algorithm. Model validation was carried out by comparing the estimated COP data with the reference data in a variety of postural control assessment tasks. We also compared our data with the COP trajectories estimated by the previously well accepted weighted mean approach. Comparing with the reference measurements, the average root mean square errors of the COP trajectories of both feet were 2.23 mm (±0.64) (left foot) and 2.72 mm (±0.83) (right foot) along the medial-lateral direction, and 9.17 mm (±1.98) (left foot) and 11.19 mm (±2.98) (right foot) along the anterior-posterior direction. The results are superior to those reported in previous relevant studies, and demonstrate that our proposed approach can be used for accurate foot plantar COP trajectory estimation. This study could provide an inexpensive solution to fall risk assessment in home settings or community healthcare center for the elderly. It has the potential to help prevent future falls in the elderly.

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

    Science.gov (United States)

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

    2010-03-01

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

  7. Hallux valgus and plantar pressure loading: the Framingham foot study

    Science.gov (United States)

    2013-01-01

    Background Hallux valgus (HV), a common structural foot deformity, can cause foot pain and lead to limited mobility. The purpose of this study was to evaluate differences in plantar pressure and force during gait by HV status in a large population-based cohort of men and women. Methods A trained examiner performed a validated physical examination on participants’ feet and recorded the presence of hallux valgus and other specific foot disorders. Each foot was classified into one of four mutually exclusive groups based on the foot examination. Foot groups were: (i) HV only, (ii) HV and at least one additional foot disorder (FD), (iii) no HV but at least one other FD, and (iv) neither HV nor FD (referent). Biomechanical data for both feet were collected using Tekscan Matscan. Foot posture during quiet standing, using modified arch index (MAI), and foot function during gait, using center of pressure excursion index (CPEI), were calculated per foot. Further, walking scans were masked into eight sub-regions using Novel Automask, and peak pressure and maximum force exerted in each region were calculated. Results There were 3205 participants, contributing 6393 feet with complete foot exam data and valid biomechanical measurements. Participants with HV had lower hallucal loading and higher forces at lesser toes as well as higher MAI and lower CPEI values compared to the referent. Participants with HV and other FDs were also noted to have aberrant rearfoot forces and pressures. Conclusions These results suggest that HV alters foot loading patterns and pressure profiles. Future work should investigate how these changes affect the risk of other foot and lower extremity ailments. PMID:24138804

  8. Unilateral Cleft Hand with Cleft Foot

    Science.gov (United States)

    Baba, Asif Nazir; Bhat, Yasmeen J.; Ahmed, Sheikh Mushtaq; Nazir, Abid

    2009-01-01

    Congenital anomalies of the hand form an important class of congenital malformations. They have a huge functional importance because of the part played by the hand in the daily activities of a person. The deformities also have significant cosmetic significance and may also be associated with other anomalies. Amongst the congenital anomalies, central deficiency or cleft hand is relatively rare. The association of cleft foot with cleft hand is an even more rare occurance. We present a case report of a 6 year old child, born of a non-consanginous marriage, having congenital central deficiency of ipsilateral hand and foot. PMID:21475543

  9. Dynamic soil-structure interaction of monopod and polypod foundations

    DEFF Research Database (Denmark)

    Andersen, Lars Vabbersgaard

    2016-01-01

    within the time domain, frequency-independent lumped-parameter models are developed. The paper proposes a decision criterion for determination of which components must be included within a lumped-parameter model in order to account for the structure–soil–structure interaction in an adequate and efficient......The paper concerns the importance of through–soil coupling for structures having foundations with more footings. First, a model for dynamic analysis of polypod footings is established in the frequency domain, employing Green’s function for wave propagation in a layered half-space. To allow analysis...

  10. Contemporary Evaluation and Management of the Diabetic Foot

    Science.gov (United States)

    Sumpio, Bauer E.

    2012-01-01

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

  11. Dynamics and computation in functional shifts

    Science.gov (United States)

    Namikawa, Jun; Hashimoto, Takashi

    2004-07-01

    We introduce a new type of shift dynamics as an extended model of symbolic dynamics, and investigate the characteristics of shift spaces from the viewpoints of both dynamics and computation. This shift dynamics is called a functional shift, which is defined by a set of bi-infinite sequences of some functions on a set of symbols. To analyse the complexity of functional shifts, we measure them in terms of topological entropy, and locate their languages in the Chomsky hierarchy. Through this study, we argue that considering functional shifts from the viewpoints of both dynamics and computation gives us opposite results about the complexity of systems. We also describe a new class of shift spaces whose languages are not recursively enumerable.

  12. Validity and Reliability of Visual Analog Scale Foot and Ankle: The Turkish Version.

    Science.gov (United States)

    Gur, Gozde; Turgut, Elif; Dilek, Burcu; Baltaci, Gul; Bek, Nilgun; Yakut, Yavuz

    The present study tested the reliability and validity of the Turkish version of the visual analog scale foot and ankle (VAS-FA) among healthy subjects and patients with foot problems. A total of 128 participants, 65 healthy subjects and 63 patients with foot problems, were evaluated. The VAS-FA was translated into Turkish and administered to the 128 subjects on 2 separate occasions with a 5-day interval. The test-retest reliability and internal consistency were assessed with the intraclass correlation coefficient and Cronbach's α. The validity was assessed using the correlations with Turkish versions of the Foot Function Index, the Foot and Ankle Outcome Score, and the Short-Form 36-item Health Survey. A statistically significant difference was found between the healthy group and the patient group in the overall score and subscale scores of the VAS-FA (p Foot Function Index, Foot and Ankle Outcome Score, and Short-Form 36-item Health Survey scores in the healthy and patient groups both. The Turkish version of the VAS-FA is sensitive enough to distinguish foot and ankle-specific pathologic conditions from asymptomatic conditions. The Turkish version of the VAS-FA is a reliable and valid method and can be used for foot-related problems. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

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

    OpenAIRE

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

    2012-01-01

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

  14. Results of flutter test OS6 obtained using the 0.14-scale wing/elevon model (54-0) in the NASA LaRC 16-foot transonic dynamics wind tunnel

    Science.gov (United States)

    Berthold, C. L.

    1977-01-01

    A 0.14-scale dynamically scaled model of the space shuttle orbiter wing was tested in the Langley Research Center 16-Foot Transonic Dynamics Wind Tunnel to determine flutter, buffet, and elevon buzz boundaries. Mach numbers between 0.3 and 1.1 were investigated. Rockwell shuttle model 54-0 was utilized for this investigation. A description of the test procedure, hardware, and results of this test is presented.

  15. A clinically applicable six-segmented foot model.

    Science.gov (United States)

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

    2012-04-01

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

  16. A superellipsoid-plane model for simulating foot-ground contact during human gait.

    Science.gov (United States)

    Lopes, D S; Neptune, R R; Ambrósio, J A; Silva, M T

    2016-01-01

    Musculoskeletal models and forward dynamics simulations of human movement often include foot-ground interactions, with the foot-ground contact forces often determined using a constitutive model that depends on material properties and contact kinematics. When using soft constraints to model the foot-ground interactions, the kinematics of the minimum distance between the foot and planar ground needs to be computed. Due to their geometric simplicity, a considerable number of studies have used point-plane elements to represent these interacting bodies, but few studies have provided comparisons between point contact elements and other geometrically based analytical solutions. The objective of this work was to develop a more general-purpose superellipsoid-plane contact model that can be used to determine the three-dimensional foot-ground contact forces. As an example application, the model was used in a forward dynamics simulation of human walking. Simulation results and execution times were compared with a point-like viscoelastic contact model. Both models produced realistic ground reaction forces and kinematics with similar computational efficiency. However, solving the equations of motion with the surface contact model was found to be more efficient (~18% faster), and on average numerically ~37% less stiff. The superellipsoid-plane elements are also more versatile than point-like elements in that they allow for volumetric contact during three-dimensional motions (e.g. rotating, rolling, and sliding). In addition, the superellipsoid-plane element is geometrically accurate and easily integrated within multibody simulation code. These advantages make the use of superellipsoid-plane contact models in musculoskeletal simulations an appealing alternative to point-like elements.

  17. Dynamical zeta functions and dynamical determinants for hyperbolic maps a functional approach

    CERN Document Server

    Baladi, Viviane

    2018-01-01

    The spectra of transfer operators associated to dynamical systems, when acting on suitable Banach spaces, contain key information about the ergodic properties of the systems. Focusing on expanding and hyperbolic maps, this book gives a self-contained account on the relation between zeroes of dynamical determinants, poles of dynamical zeta functions, and the discrete spectra of the transfer operators. In the hyperbolic case, the first key step consists in constructing a suitable Banach space of anisotropic distributions. The first part of the book is devoted to the easier case of expanding endomorphisms, showing how the (isotropic) function spaces relevant there can be studied via Paley–Littlewood decompositions, and allowing easier access to the construction of the anisotropic spaces which is performed in the second part. This is the first book describing the use of anisotropic spaces in dynamics. Aimed at researchers and graduate students, it presents results and techniques developed since the beginning of...

  18. A cross-sectional observational study comparing foot and ankle characteristics in people with stroke and healthy controls.

    Science.gov (United States)

    Kunkel, Dorit; Potter, Julia; Mamode, Louis

    2017-06-01

    The purpose of this study was to explore and compare foot and ankle characteristics in people with stroke and healthy controls; and between stroke fallers and non-fallers. Participants were recruited from community groups and completed standardized tests assessing sensation, foot posture, foot function, ankle dorsiflexion and first metatarsal phalangeal joint range of motion (1st MPJ ROM), hallux valgus presence and severity. Twenty-three stroke participants (mean age 75.09 ± 7.57 years; 12 fallers) and 16 controls (mean age 73.44 ± 8.35 years) took part. Within the stroke group, reduced 1st MPJ sensation (p = 0.016) and 1st MPJ ROM (p = 0.025) were observed in the affected foot in comparison to the non-affected foot; no other differences were apparent. Pooled data (for both feet) was used to explore between stroke/control (n = 78 feet) and stroke faller/non-faller (n = 46 feet) group differences. In comparison to the control group, stroke participants exhibited reduced sensation of the 1st MPJ (p = 0.020), higher Foot Posture Index scores (indicating greater foot pronation, p = 0.008) and reduced foot function (p = 0.003). Stroke fallers exhibited significantly greater foot pronation in comparison to non-fallers (p = 0.027). Results indicated differences in foot and ankle characteristics post stroke in comparison to healthy controls. These changes may negatively impact functional ability and the ability to preserve balance. Further research is warranted to explore the influence of foot problems on balance ability and falls in people with stroke. Implications for Rehabilitation Foot problems are common post stroke. As foot problems have been linked to increased fall risk among the general population we recommend that it would be beneficial to include foot and ankle assessments or a referral to a podiatrist for people with stroke who report foot problems. Further research is needed to explore if we can improve functional

  19. Charcot Foot

    Science.gov (United States)

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

  20. Foot Disability in Patients with Ankylosing Spondylitis: A Clinical and Ultrasonographic Assessment

    Directory of Open Access Journals (Sweden)

    Erkan Mesci

    2016-04-01

    Full Text Available Aim: The objective of this study was to perform a clinical and ultrasonographic assessment of foot disability and related factors among patients with ankylosing spondylitis. Material and Method: The study enrolled 40 patients diagnosed with ankylosing spondylitis (AS according to the modified New York criteria and 30 matched healthy controls. In addition to the assessments for Disease activity (BASDAI and functional status (BASFI, foot functioning was evaluated using the Foot Function Index (FFI and quality of life using the Ankylosing Spondylitis Quality of Life (ASQoL questionnaire. Thickness of plantar fascia (PF and Achilles tendon (AT, changes in echogenicity and presence of bone erosions, entesophytes and bursitis were examined using ultrasound. Results: The mean age of patients was 39.9 ± 10.4 years and median disease duration was 48 (1-288 months. Sixteen patients (40% had foot pain. Thirteen patients (32.5% had clinical evidence for enthesitis. Thirty patients (75% showed at least one pathological finding at ultrasonographic examination. Mean FFI score was higher in the AS group versus control group (p

  1. Nonadiabatic dynamics with intersystem crossings: A time-dependent density functional theory implementation

    Energy Technology Data Exchange (ETDEWEB)

    Franco de Carvalho, F. [Centre Européen de Calcul Atomique et Moléculaire, Ecole Polytechnique Fédérale de Lausanne, Lausanne (Switzerland); Tavernelli, I. [IBM Research GmbH, Zurich Research Laboratory, 8803 Ruschlikon (Switzerland)

    2015-12-14

    In this work, we derive a method to perform trajectory-based nonadiabatic dynamics that is able to describe both nonadiabatic transitions and intersystem crossing events (transitions between states of different spin-multiplicity) at the same level of theory, namely, time-dependent density functional theory (TDDFT). To this end, we combined our previously developed TDDFT-based trajectory surface hopping scheme with an accurate and efficient algorithm for the calculation of the spin-orbit coupling (SOC) matrix elements. More specifically, we designed two algorithms for the calculation of intersystem crossing transitions, one based on an extended Tully’s surface hopping scheme including SOC and the second based on a Landau-Zener approximation applied to the spin sector of the electronic Hilbert space. This development allows for the design of an efficient on-the-fly nonadiabatic approach that can handle, on an equal footing, nonadiabatic and intersystem crossing transitions. The method is applied to the study of the photophysics of sulfur dioxide (SO{sub 2}) in gas and liquid phases.

  2. Gigantism of the foot: our experience in seven cases.

    Science.gov (United States)

    Turra, S; Santini, S; Cagnoni, G; Jacopetti, T

    1998-01-01

    We report our experience in seven patients with congenital gigantism of the foot with the following diagnoses: neurofibromatosis (two), fibrolipomatosis (two), Proteus syndrome (two), and idiopathic localized gigantism (one). Our purpose is to introduce a new classification of foot gigantism, based on the concept of "neuroinduction." In our experience, intraoperative examination and subsequent histologic examination show consistently pathologic findings in the plantar nerve and its terminal branches in the foot affected by gigantism. Limited surgical treatment was used in five patients. To prevent forefoot enlargement and recurrence of deformity, we suggest complete ray resection. We evaluated our results using radiographs, functional status, and cosmetic considerations.

  3. Movement coordination patterns between the foot joints during walking

    Directory of Open Access Journals (Sweden)

    John B. Arnold

    2017-10-01

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

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

    OpenAIRE

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

    2010-01-01

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

  5. Normal foot and ankle

    International Nuclear Information System (INIS)

    Weissman, S.D.

    1989-01-01

    The foot may be thought of as a bag of bones tied tightly together and functioning as a unit. The bones re expected to maintain their alignment without causing symptomatology to the patient. The author discusses a normal radiograph. The bones must have normal shape and normal alignment. The density of the soft tissues should be normal and there should be no fractures, tumors, or foreign bodies

  6. Foot Morphological Difference between Habitually Shod and Unshod Runners.

    Directory of Open Access Journals (Sweden)

    Yang Shu

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

  7. Foot placement modulation diminishes for perturbations near foot contact

    NARCIS (Netherlands)

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

    2018-01-01

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

  8. Recovery of dynamic balance after general anesthesia with sevoflurane in short-duration oral surgery.

    Science.gov (United States)

    Fujisawa, Toshiaki; Miyamoto, Eriko; Takuma, Shigeru; Shibuya, Makiko; Kurozumi, Akihiro; Kimura, Yukifumi; Kamekura, Nobuhito; Fukushima, Kazuaki

    2009-01-01

    Recovery of dynamic balance, involving adjustment of the center of gravity, is essential for safe discharge on foot after ambulatory anesthesia. The purpose of this study was to assess the recovery of dynamic balance after general anesthesia with sevoflurane, using two computerized dynamic posturographies. Nine hospitalized patients undergoing oral surgery of less than 2 h duration under general anesthesia (air-oxygensevoflurane) were studied. A dynamic balance test, assessing the ability of postural control against unpredictable perturbation stimuli (Stability System; Biodex Medical), a walking analysis test using sheets with foot pressure sensors (Walk Way-MG1000; Anima), and two simple psychomotor function tests were performed before anesthesia (baseline), and 150 and 210 min after the emergence from anesthesia. Only the double-stance phase in the walking analysis test showed a significant difference between baseline and results at 150 min. None of the other variables showed any differences among results at baseline and at 150 and 210 min. The recovery times for dynamic balance and psychomotor function seem to be within 150 min after emergence from general anesthesia with sevoflurane in patients undergoing oral surgery of less than 2-h duration.

  9. Interpreting outcome following foot surgery in people with rheumatoid arthritis.

    Science.gov (United States)

    Backhouse, Michael R; Vinall-Collier, Karen A; Redmond, Anthony C; Helliwell, Philip S; Keenan, Anne-Maree

    2016-01-01

    Foot surgery is common in RA but the current lack of understanding of how patients interpret outcomes inhibits evaluation of procedures in clinical and research settings. This study aimed to explore which factors are important to people with RA when they evaluate the outcome of foot and ankle surgery. Semi structured interviews with 11 RA participants who had mixed experiences of foot surgery were conducted and analysed using thematic analysis. Responses showed that while participants interpreted surgical outcome in respect to a multitude of factors, five major themes emerged: functional ability, participation, appearance of feet and footwear, surgeons' opinion, and pain. Participants interpreted levels of physical function in light of other aspects of their disease, reflecting on relative change from their preoperative state more than absolute levels of ability. Appearance was important to almost all participants: physical appearance, foot shape, and footwear were closely interlinked, yet participants saw these as distinct concepts and frequently entered into a defensive repertoire, feeling the need to justify that their perception of outcome was not about cosmesis. Surgeons' post-operative evaluation of the procedure was highly influential and made a lasting impression, irrespective of how the outcome compared to the participants' initial goals. Whilst pain was important to almost all participants, it had the greatest impact upon them when it interfered with their ability to undertake valued activities. People with RA interpret the outcome of foot surgery using multiple interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than anticipated. These factors can help clinicians in discussing surgical options in patients.

  10. Nociception at the diabetic foot, an uncharted territory

    Science.gov (United States)

    Chantelau, Ernst A

    2015-01-01

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

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

    African Journals Online (AJOL)

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

  12. Three dimensional design, simulation and optimization of a novel, universal diabetic foot offloading orthosis

    Science.gov (United States)

    Sukumar, Chand; Ramachandran, K. I.

    2016-09-01

    Leg amputation is a major consequence of aggregated foot ulceration in diabetic patients. A common sense based treatment approach for diabetic foot ulceration is foot offloading where the patient is required to wear a foot offloading orthosis during the entire treatment course. Removable walker is an excellent foot offloading modality compared to the golden standard solution - total contact cast and felt padding. Commercially available foot offloaders are generally customized with huge cost and less patient compliance. This work suggests an optimized 3D model of a new type light weight removable foot offloading orthosis for diabetic patients. The device has simple adjustable features which make this suitable for wide range of patients with weight of 35 to 74 kg and height of 137 to 180 cm. Foot plate of this orthosis is unisexual, with a size adjustability of (US size) 6 to 10. Materials like Aluminum alloy 6061-T6, Acrylonitrile Butadiene Styrene (ABS) and Polyurethane acted as the key player in reducing weight of the device to 0.804 kg. Static analysis of this device indicated that maximum stress developed in this device under a load of 1000 N is only 37.8 MPa, with a small deflection of 0.150 cm and factor of safety of 3.28, keeping the safety limits, whereas dynamic analysis results assures the load bearing capacity of this device. Thus, the proposed device can be safely used as an orthosis for offloading diabetic ulcerated foot.

  13. Correlation between static radiographic measurements and intersegmental angular measurements during gait using a multisegment foot model.

    Science.gov (United States)

    Lee, Dong Yeon; Seo, Sang Gyo; Kim, Eo Jin; Kim, Sung Ju; Lee, Kyoung Min; Farber, Daniel C; Chung, Chin Youb; Choi, In Ho

    2015-01-01

    Radiographic examination is a widely used evaluation method in the orthopedic clinic. However, conventional radiography alone does not reflect the dynamic changes between foot and ankle segments during gait. Multiple 3-dimensional multisegment foot models (3D MFMs) have been introduced to evaluate intersegmental motion of the foot. In this study, we evaluated the correlation between static radiographic indices and intersegmental foot motion indices. One hundred twenty-five females were tested. Static radiographs of full-leg and anteroposterior (AP) and lateral foot views were performed. For hindfoot evaluation, we measured the AP tibiotalar angle (TiTA), talar tilt (TT), calcaneal pitch, lateral tibiocalcaneal angle, and lateral talcocalcaneal angle. For the midfoot segment, naviculocuboid overlap and talonavicular coverage angle were calculated. AP and lateral talo-first metatarsal angles and metatarsal stacking angle (MSA) were measured to assess the forefoot. Hallux valgus angle (HVA) and hallux interphalangeal angle were measured. In gait analysis by 3D MFM, intersegmental angle (ISA) measurements of each segment (hallux, forefoot, hindfoot, arch) were recorded. ISAs at midstance phase were most highly correlated with radiography. Significant correlations were observed between ISA measurements using MFM and static radiographic measurements in the same segment. In the hindfoot, coronal plane ISA was correlated with AP TiTA (P foot motion indices at midstance phase during gait measured by 3D MFM gait analysis were correlated with the conventional radiographic indices. The observed correlation between MFM measurements at midstance phase during gait and static radiographic measurements supports the fundamental basis for the use of MFM in analysis of dynamic motion of foot segment during gait. © The Author(s) 2014.

  14. [Which foot deformities should be radiologist be familiar with?

    Science.gov (United States)

    von Stillfried, E

    2018-05-01

    Most deformities of the foot are visible at birth and can be diagnosed without imaging. They can be divided into congenital flexible, congenital structural and acquired foot deformities. The most common congenital flexible foot deformity in children is the metatarsus adductus, which usually requires no long-term therapy. Regarding congenital structural deformities, such as the clubfoot and talus verticalis, plaster therapy should be started during the first week of life, so that by the end of the first year of life and the beginning of the verticalization, a pain-free resilient foot with normal function is present. Imaging is usually only necessary if a relapse arises. Coalitio of the tarsal bones is often visible only in the course of growth through the development of a rigid flatfoot and always requires imaging to confirm the diagnosis. This article is intended to give the radiologist an overview of the most important deformities and to inform about their course and therapy.

  15. Mortality associated with acute Charcot foot and neuropathic foot ulceration

    NARCIS (Netherlands)

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

    2010-01-01

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

  16. Identification of Foot Pathologies Based on Plantar Pressure Asymmetry

    Directory of Open Access Journals (Sweden)

    Linah Wafai

    2015-08-01

    Full Text Available Foot pathologies can negatively influence foot function, consequently impairing gait during daily activity, and severely impacting an individual’s quality of life. These pathologies are often painful and correspond with high or abnormal plantar pressure, which can result in asymmetry in the pressure distribution between the two feet. There is currently no general consensus on the presence of asymmetry in able-bodied gait, and plantar pressure analysis during gait is in dire need of a standardized method to quantify asymmetry. This paper investigates the use of plantar pressure asymmetry for pathological gait diagnosis. The results of this study involving plantar pressure analysis in fifty one participants (31 healthy and 20 with foot pathologies support the presence of plantar pressure asymmetry in normal gait. A higher level of asymmetry was detected at the majority of the regions in the feet of the pathological population, including statistically significant differences in the plantar pressure asymmetry in two regions of the foot, metatarsophalangeal joint 3 (MPJ3 and the lateral heel. Quantification of plantar pressure asymmetry may prove to be useful for the identification and diagnosis of various foot pathologies.

  17. Biomechanically acquired foot types

    International Nuclear Information System (INIS)

    Weissman, S.D.

    1989-01-01

    Over the years, orthopedics of the foot has gone through many stages and phases, each of which has spawned a whole vocabulary of its own. According the author, today we are in the biomechanical age, which represents a step forward in understanding the mechanisms governing the functions of the lower extremity. A great deal of scientific research on the various foot types and pathological entities is now being performed. This paper discusses how, from a radiographic point of view, a knowledge of certain angular relationships must be achieved before one can perform a biomechanical evaluation. In order to validate the gross clinical findings, following an examination of a patient, a biomechanical evaluation can be performed on the radiographs taken. It must be remembered, however, that x-rays are never the sole means of making a diagnosis. They are just one of many findings that must be put together to arrive at a pertinent clinical assessment or diagnosis

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

    Science.gov (United States)

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

    2018-03-01

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

  19. LOCAL ENTROPY FUNCTION OF DYNAMICAL SYSTEM

    Directory of Open Access Journals (Sweden)

    İsmail TOK

    2013-05-01

    Full Text Available In this work, we first,define the entropy function of the topological dynamical system and investigate basic properties of this function without going into details. Let (X,A,T be a probability measure space and consider P = { pl5p2,...,pn} a finite measurable partition of all sub-sets of topological dynamical system (X,T.Then,the quantity H (P = ^ zpt is called the i=1 entropy function of finite measurable partition P.Where f-1 log t if 0 0.If diam(P < s,then the quantity L^ (T = h^ (T - h^ (T,P is called a local entropy function of topological dynamical system (X,T . In conclusion, Let (X,T and (Y,S be two topological dynamical system. If TxS is a transformation defined on the product space (XxY,TxS with (TxS(x , y = (Tx,Sy for all (x,y X x Y.Then L ^^ (TxS = L^d(T + L (S .and, we prove some fundamental properties of this function.

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

    Science.gov (United States)

    Saghazadeh, Mahshid; Kitano, Naruki; Okura, Tomohiro

    2015-01-01

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

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

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

    2018-04-29

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

  3. Results of flutter test OS7 obtained using the 0.14-scale space shuttle orbiter fin/rudder model number 55-0 in the NASA LaRC 16-foot transonic dynamics wind tunnel

    Science.gov (United States)

    Berthold, C. L.

    1977-01-01

    A 0.14-scale dynamically scaled model of the space shuttle orbiter vertical tail was tested in a 16-foot transonic dynamic wind tunnel to determine flutter, buffet, and rudder buzz boundaries. Mach numbers between .5 and 1.11 were investigated. Rockwell shuttle model 55-0 was used for this investigation. A description of the test procedure, hardware, and results of this test is presented.

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

    DEFF Research Database (Denmark)

    Brushøj, C; Larsen, Klaus; Nielsen, MB

    2007-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  7. Determining the protective function of sports footwear.

    Science.gov (United States)

    Lake, M J

    2000-10-01

    To reduce the risk of injury associated with foot-ground interaction during sporting activities, there is a need for adequate assessment of the protective function of sports footwear. The present objectives are to review the typical biomechanical approaches used to identify protection offered by sports footwear during dynamic activities and to outline some of the recent methodological approaches aimed at improving this characterization. Attention is focused on biomechanical techniques that have been shown to best differentiate safety features of footwear. It was determined that subject tests would be used in combination with standard mechanical techniques to evaluate footwear protection. Impact attenuation characteristics of footwear during sporting activities were most distinguished by analysis of tibial shock signals in the frequency and joint time-frequency domains. It has been argued that lateral stability and traction properties of footwear are better assessed using game-like manoeuvres of subjects on the actual sporting surface. Furthermore, the ability of such tests to discriminate between shoes has been improved through methods aimed at reducing or accounting for variability in individual execution of dynamic manoeuvres. Advances in tools allowing measurement of dynamic foot function inside the shoe also aid our assessment of shoe protective performance. In combination, these newer approaches should provide more information for the design of safer sports footwear.

  8. Exercise therapy and custom-made insoles are effective in patients with excessive pronation and chronic foot pain

    DEFF Research Database (Denmark)

    Andreasen, Jane; Mølgaard, Carsten; Christensen, Marianne

    2013-01-01

    Background: Excessive foot pronation is a causal mechanisms described in relation to injuries of the lower extremities. Evidence to support an effective treatment is insufficient. Objective: To investigate the effect of exercise and custom-made insoles to patients with excessive pronation...... and posted. Pain was measured during walking, resting and running. Static and dynamic foot postures were measured as calcaneal angle, navicular drift, drop and height. Results: The average duration of foot pain was 7.3 years. There was a significant pain reduction during walking within all groups at 4 and 12...

  9. Quantification of Foot-and-mouth Disease Virus Transmission Rates Using Published Data

    NARCIS (Netherlands)

    Goris, N.E.; Eble, P.L.; Jong, de M.C.M.; Clercq, K.

    2009-01-01

    Foot-and-mouth disease is an extremely infectious and devastating disease affecting all species of cloven-hoofed animals. To understand the epidemiology of the causative virus and predict viral transmission dynamics, quantified transmission parameters are essential to decision makers and modellers

  10. Structural predictions for Correlated Electron Materials Using the Functional Dynamical Mean Field Theory Approach

    Science.gov (United States)

    Haule, Kristjan

    2018-04-01

    The Dynamical Mean Field Theory (DMFT) in combination with the band structure methods has been able to address reach physics of correlated materials, such as the fluctuating local moments, spin and orbital fluctuations, atomic multiplet physics and band formation on equal footing. Recently it is getting increasingly recognized that more predictive ab-initio theory of correlated systems needs to also address the feedback effect of the correlated electronic structure on the ionic positions, as the metal-insulator transition is almost always accompanied with considerable structural distortions. We will review recently developed extension of merger between the Density Functional Theory (DFT) and DMFT method, dubbed DFT+ embedded DMFT (DFT+eDMFT), whichsuccessfully addresses this challenge. It is based on the stationary Luttinger-Ward functional to minimize the numerical error, it subtracts the exact double-counting of DFT and DMFT, and implements self-consistent forces on all atoms in the unit cell. In a few examples, we will also show how the method elucidated the important feedback effect of correlations on crystal structure in rare earth nickelates to explain the mechanism of the metal-insulator transition. The method showed that such feedback effect is also essential to understand the dynamic stability of the high-temperature body-centered cubic phase of elemental iron, and in particular it predicted strong enhancement of the electron-phonon coupling over DFT values in FeSe, which was very recently verified by pioneering time-domain experiment.

  11. [Real-time Gait Training System with Embedded Functional Electrical Stimulation].

    Science.gov (United States)

    Gu, Linyan; Ruan, Zhaomin; Jia, Guifeng; Xla, Jing; Qiu, Lijian; Wu, Changwang; Jin, Xiaoqing; Ning, Gangmin

    2015-07-01

    To solve the problem that mostly gait analysis is independent from the treatment, this work proposes a system that integrates the functions of gait training and assessment for foot drop treatment. The system uses a set of sensors to collect gait parameters and designes multi-mode functional electrical stimulators as actuator. Body area network technology is introduced to coordinate the data communication and execution of the sensors and stimulators, synchronize the gait analysis and foot drop treatment. Bluetooth 4.0 is applied to low the power consumption of the system. The system realizes the synchronization of treatment and gait analysis. It is able to acquire and analyze the dynamic parameters of ankle, knee and hip in real-time, and treat patients by guiding functional electrical stimulation delivery to the specific body locations of patients.

  12. Is there any relationship between orthotic usage and functional activities in children with neuromuscular disorders?

    Science.gov (United States)

    Alemdaroğlu, İpek; Gür, Gozde; Bek, Nilgün; Yilmaz, Öznur T; Yakut, Yavuz; Uygur, Fatma; Karaduman, Ayşe

    2014-02-01

    Contractures of Achilles tendons and gastrocnemius muscle deteriorate the performance in daily living activities of patients with neuromuscular diseases. Ankle-foot orthoses help to prevent the progression of deformities and to obtain optimal position of the joints to support standing and walking. To investigate the relationship between orthotic usage and functional activities in pediatric patients with different neuromuscular diseases. Retrospective study. A total of 127 subjects' physical assessment forms were analyzed. Functional level, type of orthoses, falling frequencies, ankle joint range of motion, and timed performance tests were examined in two consecutive dates with an interval of 3 months. A total of 91 patients were using orthoses while 36 patients were not within assessment dates. A total of 64 of 91 (70.3%) patients were diagnosed with Duchenne muscular dystrophy. A total of 81 (89.0%) subjects were using plastic ankle-foot orthoses for positioning at nights and 10 (11%) were using different types of the orthoses (knee-ankle-foot orthoses, dynamic ankle-foot orthoses, and so on) for gait in the study group. Night ankle-foot orthoses were not found to be effective directly on functional performance in children with neuromuscular diseases, although they protect ankle from contractures and may help to correct gait and balance. This retrospective study shows that the positive effects of using an ankle-foot orthosis at night are not reflected in the functional performance of children with neuromuscular diseases. This may be due to the progressive deteriorating nature of the disease.

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

    Directory of Open Access Journals (Sweden)

    Jarvis Hannah L

    2012-06-01

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

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

    OpenAIRE

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

    2012-01-01

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

  15. Nonlinear MHD Waves in a Prominence Foot

    Science.gov (United States)

    Ofman, L.; Knizhnik, K.; Kucera, T.; Schmieder, B.

    2015-11-01

    We study nonlinear waves in a prominence foot using a 2.5D MHD model motivated by recent high-resolution observations with Hinode/Solar Optical Telescope in Ca ii emission of a prominence on 2012 October 10 showing highly dynamic small-scale motions in the prominence material. Observations of Hα intensities and of Doppler shifts show similar propagating fluctuations. However, the optically thick nature of the emission lines inhibits a unique quantitative interpretation in terms of density. Nevertheless, we find evidence of nonlinear wave activity in the prominence foot by examining the relative magnitude of the fluctuation intensity (δI/I ˜ δn/n). The waves are evident as significant density fluctuations that vary with height and apparently travel upward from the chromosphere into the prominence material with quasi-periodic fluctuations with a typical period in the range of 5-11 minutes and wavelengths <2000 km. Recent Doppler shift observations show the transverse displacement of the propagating waves. The magnetic field was measured with the THEMIS instrument and was found to be 5-14 G. For the typical prominence density the corresponding fast magnetosonic speed is ˜20 km s-1, in qualitative agreement with the propagation speed of the detected waves. The 2.5D MHD numerical model is constrained with the typical parameters of the prominence waves seen in observations. Our numerical results reproduce the nonlinear fast magnetosonic waves and provide strong support for the presence of these waves in the prominence foot. We also explore gravitational MHD oscillations of the heavy prominence foot material supported by dipped magnetic field structure.

  16. NONLINEAR MHD WAVES IN A PROMINENCE FOOT

    Energy Technology Data Exchange (ETDEWEB)

    Ofman, L. [Catholic University of America, Washington, DC 20064 (United States); Knizhnik, K.; Kucera, T. [NASA Goddard Space Flight Center, Code 671, Greenbelt, MD 20771 (United States); Schmieder, B. [LESIA, Observatoire de Paris, PSL Research University, CNRS, Sorbonne Universités, UPMC Univ. Paris 06, Univ. Paris-Diderot, Sorbonne Paris Cit, 5 place Jules Janssen, F-92195 Meudon (France)

    2015-11-10

    We study nonlinear waves in a prominence foot using a 2.5D MHD model motivated by recent high-resolution observations with Hinode/Solar Optical Telescope in Ca ii emission of a prominence on 2012 October 10 showing highly dynamic small-scale motions in the prominence material. Observations of Hα intensities and of Doppler shifts show similar propagating fluctuations. However, the optically thick nature of the emission lines inhibits a unique quantitative interpretation in terms of density. Nevertheless, we find evidence of nonlinear wave activity in the prominence foot by examining the relative magnitude of the fluctuation intensity (δI/I ∼ δn/n). The waves are evident as significant density fluctuations that vary with height and apparently travel upward from the chromosphere into the prominence material with quasi-periodic fluctuations with a typical period in the range of 5–11 minutes and wavelengths <2000 km. Recent Doppler shift observations show the transverse displacement of the propagating waves. The magnetic field was measured with the THEMIS instrument and was found to be 5–14 G. For the typical prominence density the corresponding fast magnetosonic speed is ∼20 km s{sup −1}, in qualitative agreement with the propagation speed of the detected waves. The 2.5D MHD numerical model is constrained with the typical parameters of the prominence waves seen in observations. Our numerical results reproduce the nonlinear fast magnetosonic waves and provide strong support for the presence of these waves in the prominence foot. We also explore gravitational MHD oscillations of the heavy prominence foot material supported by dipped magnetic field structure.

  17. Foot-and-mouth disease virus serotype SAT1 in cattle, Nigeria.

    Science.gov (United States)

    Ehizibolo, D O; Haegeman, A; De Vleeschauwer, A R; Umoh, J U; Kazeem, H M; Okolocha, E C; Van Borm, S; De Clercq, K

    2017-06-01

    The knowledge of foot-and-mouth disease virus (FMDV) dynamics and epidemiology in Nigeria and the West Africa subregion is important to support local and regional control plans and international risk assessment. Foot-and-mouth disease virus serotype South African territories (SAT)1 was isolated, identified and characterized from an FMD outbreak in cattle in Nigeria in 2015, 35 years after the last report of FMDV SAT1 in West Africa. The VP1 coding sequence of the Nigerian 2015 SAT1 isolates diverges from reported SAT1 topotypes resulting in a separate topotype. The reporting of a novel FMDV SAT1 strain in the virus pool 5 (West and Central Africa) highlights the dynamic and complex nature of FMDV in this region of Africa. Sustained surveillance is needed to understand the origin, the extent and distribution of this novel SAT1 topotype in the region as well as to detect and monitor the occurrence of (re-)emerging FMDV strains. © 2017 Blackwell Verlag GmbH.

  18. SPECT/CT in imaging foot and ankle pathology-the demise of other coregistration techniques.

    Science.gov (United States)

    Mohan, Hosahalli K; Gnanasegaran, Gopinath; Vijayanathan, Sanjay; Fogelman, Ignac

    2010-01-01

    Disorders of the ankle and foot are common and given the complex anatomy and function of the foot, they present a significant clinical challenge. Imaging plays a crucial role in the management of these patients, with multiple imaging options available to the clinician. The American College of radiology has set the appropriateness criteria for the use of the available investigating modalities in the management of foot and ankle pathologies. These are broadly classified into anatomical and functional imaging modalities. Recently, single-photon emission computed tomography and/or computed tomography scanners, which can elegantly combine functional and anatomical images have been introduced, promising an exciting and important development. This review describes our clinical experience with single-photon emission computed tomography and/or computed tomography and discusses potential applications of these techniques.

  19. Functional System Dynamics

    NARCIS (Netherlands)

    Ligterink, N.E.

    2007-01-01

    Functional system dynamics is the analysis, modelling, and simulation of continuous systems usually described by partial differential equations. From the infinite degrees of freedom of such systems only a finite number of relevant variables have to be chosen for a practical model description. The

  20. Assessment of the influence of jogging on the shape of female foot arches.

    Science.gov (United States)

    Maslon, Agata; Golec, Joanna; Szczygiel, Elzbieta; Czechowska, Dorota; Golec, Boguslaw

    2017-12-23

    Both walking and its faster, running, consist of cyclical subsequent phases of swing and support; however, they differ in their time proportions as well as magnitude of acting forces. There is a lack of studies concerning the long-term consequences of repeated jogging cycles on the function of feet and, above all, on their permanent impact on the shape of foot arches. The objective of this study was to answer the question whether regular jogging changes the shape of the transverse and medial longitudinal arches of the feet. The research material consisted of 96 women with an average age of 26.57, and included 50 actively jogging women, and 46 of non-joggers. The study was performed with the use of EMED-SF force platform. The plantar surface of the foot was divided into 10 regions according to Cavanagh, for which peak pressure and contact time were established. Two indicators were defined: metatarsal bone pressure distribution pattern acc. to Kantali, and longitudinal arch index acc. to Cavanagh. The data obtained revealed more frequent occurrence of the greatest pressure under the centrally located metatarsal heads (lack of functional foot transverse arch) among the female joggers, compared with the non-joggers. Moreover, the findings indicate the higher frequency of medial longitudinal foot arch flattening among female runners, with a great deal of consistency between both feet, whereas results for the control group show asymmetrical medial arch shapes with right foot propensity to normal arch shape and left foot tendency for excessive arch. The observed differences in feet arch shapes between female joggers and non-joggers indicate the influence of jogging on feet functional adaptations.

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

    Science.gov (United States)

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

    2011-03-18

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Priorities in offloading the diabetic foot

    NARCIS (Netherlands)

    Bus, Sicco A.

    2012-01-01

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

  5. Effectiveness of Foot Orthoses Versus Rocker-Sole Footwear for First Metatarsophalangeal Joint Osteoarthritis: Randomized Trial.

    Science.gov (United States)

    Menz, Hylton B; Auhl, Maria; Tan, Jade M; Levinger, Pazit; Roddy, Edward; Munteanu, Shannon E

    2016-05-01

    To compare the effectiveness of prefabricated foot orthoses to rocker-sole footwear in reducing foot pain in people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). Participants (n = 102) with first MTP joint OA were randomly allocated to receive individualized, prefabricated foot orthoses or rocker-sole footwear. The primary outcome measure was the pain subscale on the Foot Health Status Questionnaire (FHSQ) at 12 weeks. Secondary outcome measures included the function, footwear, and general foot health subscales of the FHSQ; the Foot Function Index; severity of pain and stiffness at the first MTP joint; perception of global improvement; general health status; use of rescue medication and co-interventions to relieve pain; physical activity; and the frequency of self-reported adverse events. The FHSQ pain subscale scores improved in both groups, but no statistically significant difference between the groups was observed (adjusted mean difference 2.05 points, 95% confidence interval [95% CI] -3.61, 7.71; P = 0.477). However, the footwear group exhibited lower adherence (mean ± SD total hours worn 287 ± 193 versus 448 ± 234; P footwear are similarly effective at reducing foot pain in people with first MTP joint OA. However, prefabricated foot orthoses may be the intervention of choice due to greater adherence and fewer associated adverse events. © 2016 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.

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

    OpenAIRE

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

    2016-01-01

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

  7. Management of lawn mower injuries to the foot and ankle.

    Science.gov (United States)

    Corcoran, J; Zamboni, W A; Zook, E G

    1993-09-01

    Seventy consecutive patients treated for lawn mower injuries to the foot and ankle were reviewed to determine optimal treatment, functional results, and complications. Injuries were classified into 1 or more functional-anatomical zones (I, digits; II, dorsum; III, plantar nonweight-bearing surface; IV, heel; and V, ankle) for a total of 96 injuries. Thirty-one patients were available for follow-up. Mean age was 36.7 years and 84% were males. Most injuries (67%) involved patients > 16 years old using a push mower; however, 18% involved children Lawn mower injuries to the foot and ankle can be closed primarily after adequate irrigation and debridement without compromise of infection rate or function. Antibiotic prophylaxis is recommended. One-sixth of these injuries involve children < 5 years of age and can be prevented.

  8. Foot and Ankle Kinematics During Descent From Varying Step Heights.

    Science.gov (United States)

    Gerstle, Emily E; O'Connor, Kristian; Keenan, Kevin G; Cobb, Stephen C

    2017-12-01

    In the general population, one-third of incidences during step negotiation occur during the transition to level walking. Furthermore, falls during curb negotiation are a common cause of injury in older adults. Distal foot kinematics may be an important factor in determining injury risk associated with transition step negotiation. The purpose of this study was to identify foot and ankle kinematics of uninjured individuals during descent from varying step heights. A 7-segment foot model was used to quantify kinematics as participants walked on a level walkway, stepped down a single step (heights: 5 cm, 15 cm, 25 cm), and continued walking. As step height increased, landing strategy transitioned from the rearfoot to the forefoot, and the rearfoot, lateral and medial midfoot, and medial forefoot became more plantar flexed. During weight acceptance, sagittal plane range of motion of the rearfoot, lateral midfoot, and medial and lateral forefoot increased as step height increased. The changes in landing strategy and distal foot function suggest a less stable ankle position at initial contact and increased demand on the distal foot at initial contact and through the weight acceptance phase of transition step negotiation as step height increases.

  9. Dynamic radial distribution function from inelastic neutron scattering

    International Nuclear Information System (INIS)

    McQueeney, R.J.

    1998-01-01

    A real-space, local dynamic structure function g(r,ω) is defined from the dynamic structure function S(Q,ω), which can be measured using inelastic neutron scattering. At any particular frequency ω, S(Q,ω) contains Q-dependent intensity oscillations which reflect the spatial distribution and relative displacement directions for the atoms vibrating at that frequency. Information about local and dynamic atomic correlations is obtained from the Fourier transform of these oscillations g(r,ω) at the particular frequency. g(r,ω) can be formulated such that the elastic and frequency-summed limits correspond to the average and instantaneous radial distribution function, respectively, and is thus called the dynamic radial distribution function. As an example, the dynamic radial distribution function is calculated for fcc nickel in a model which considers only the harmonic atomic displacements due to phonons. The results of these calculations demonstrate that the magnitude of the atomic correlations can be quantified and g(r,ω) is a well-defined correlation function. This leads to a simple prescription for investigating local lattice dynamics. copyright 1998 The American Physical Society

  10. Development of an Active Ankle Foot Orthosis to Prevent Foot Drop and Toe Drag in Hemiplegic Patients: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Jungyoon Kim

    2011-01-01

    Full Text Available We developed an active ankle-foot orthosis (AAFO that controls dorsiflexion/plantarflexion of the ankle joint to prevent foot drop and toe drag during hemiplegic walking. To prevent foot slap after initial contact, the ankle joint must remain active to minimize forefoot collision against the ground. During late stance, the ankle joint must also remain active to provide toe clearance and to aid with push-off. We implemented a series elastic actuator in our AAFO to induce ankle dorsiflexion/plantarflexion. The activator was controlled by signals from force sensing register (FSR sensors that detected gait events. Three dimensional gait analyses were performed for three hemiplegic patients under three different gait conditions: gait without AFO (NAFO, gait with a conventional hinged AFO that did not control the ankle joint (HAFO, and gait with the newly-developed AFO (AAFO. Our results demonstrate that our newly-developed AAFO not only prevents foot drop by inducing plantarflexion during loading response, but also prevents toe drag by facilitating plantarflexion during pre-swing and dorsiflexion during swing phase, leading to improvement in most temporal-spatial parameters. However, only three hemiplegic patients were included in this gait analysis. Studies including more subjects will be required to evaluate the functionality of our newly developed AAFO.

  11. Education for diabetic foot

    Directory of Open Access Journals (Sweden)

    Fabio Batista

    2009-03-01

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

  12. Foot Health Facts for Athletes

    Science.gov (United States)

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

  13. Sesamoid Injuries in the Foot

    Science.gov (United States)

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

  14. Combined diabetic foot infections treatment, complicated by foot phlegmon

    Directory of Open Access Journals (Sweden)

    Yavruyan O.A.

    2017-01-01

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

  15. Acceptability and Potential Effectiveness of a Foot Drop Stimulator in Children and Adolescents with Cerebral Palsy

    Science.gov (United States)

    Prosser, Laura A.; Curatalo, Lindsey A.; Alter, Katharine E.; Damiano, Diane L.

    2012-01-01

    Aim: Ankle-foot orthoses are the standard of care for foot drop in cerebral palsy (CP), but may overly constrain ankle movement and limit function in those with mild CP. Functional electrical stimulation (FES) may be a less restrictive and more effective alternative, but has rarely been used in CP. The primary objective of this study was to…

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

    Science.gov (United States)

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

    2017-12-01

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

  17. Foot bones from Omo: implications for hominid evolution.

    Science.gov (United States)

    Gebo, Daniel L; Schwartz, Gary T

    2006-04-01

    We reanalyze a hominid talus and calcaneus from Omo dating to 2.2 mya and 2.36 mya, respectively. Although both specimens occur at different localities and times, both tarsals articulate well together, suggesting a single taxon on the basis of size and function. We attribute these foot bones to early Homo on the basis of their morphology. The more modern-like tarsal morphology of these Omo foot bones makes them very similar to a talus from Koobi Fora (KNM-ER 813), a specimen attributed to Homo rudolfensis or Homo erectus. Although the Omo tarsals are a million years younger than the oldest known foot bones from Hadar, both localities demonstrate anatomical differences representing two distinct morphological patterns. Although all known hominid tarsals demonstrate clear bipedal features, the tarsal features noted below suggest that biomechanical changes did occur over time, and that certain features are associated with different hominid lineages (especially the robust australopithecines). Copyright 2006 Wiley-Liss, Inc.

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

    Directory of Open Access Journals (Sweden)

    Yifang Fan

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

  19. Mechatronics Approach for a Controlled Actuation of the Presser Foot Mechanism on an Industrial Sewing Machine

    Directory of Open Access Journals (Sweden)

    L. F. Silva

    2000-01-01

    Full Text Available This paper describes the study of the research program being carried out on the feeding system of an industrial overlock sewing machine. The results obtained from the presser foot bar displacement and compression force, together with the graphic kinematic analysis, which includes the velocity and acceleration taken from the displacement-time curves of the presser bar, led to further understanding of the feeding system dynamics. This study is providing the basis for the development of a redesigned and optimized fabric feeding system. The new actuation system, based on a proportional force solenoid integrated in the presser foot bar, will be also discussed as an important contribution to achieving a desired dynamic behaviour at high sewing speeds.

  20. Impact of foot progression angle on the distribution of plantar pressure in normal children.

    Science.gov (United States)

    Lai, Yu-Cheng; Lin, Huey-Shyan; Pan, Hui-Fen; Chang, Wei-Ning; Hsu, Chien-Jen; Renn, Jenn-Huei

    2014-02-01

    Plantar pressure distribution during walking is affected by several gait factors, most especially the foot progression angle which has been studied in children with neuromuscular diseases. However, this relationship in normal children has only been reported in limited studies. The purpose of this study is to clarify the correlation between foot progression angle and plantar pressure distribution in normal children, as well as the impacts of age and sex on this correlation. This study retrospectively reviewed dynamic pedobarographic data that were included in the gait laboratory database of our institution. In total, 77 normally developed children aged 5-16 years who were treated between 2004 and 2009 were included. Each child's footprint was divided into 5 segments: lateral forefoot, medial forefoot, lateral midfoot, medial midfoot, and heel. The percentages of impulse exerted at the medial foot, forefoot, midfoot, and heel were calculated. The average foot progression angle was 5.03° toe-out. Most of the total impulse was exerted on the forefoot (52.0%). Toe-out gait was positively correlated with high medial (r = 0.274; P plantar pressure as part of the treatment of various foot pathologies. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Lawn mower injuries of the pediatric foot and ankle: observations on prevention and management.

    Science.gov (United States)

    Vosburgh, C L; Gruel, C R; Herndon, W A; Sullivan, J A

    1995-01-01

    We reviewed 32 children with lower extremity injuries caused by power lawn mowers. Functional outcome of 21 patients was evaluated. Anatomical injury patterns provide some guidelines in management and prediction of functional outcome. Consistently, the most severe injuries result from ride-on mowers and wounds to the posterior/plantar foot and ankle. Our experience with pediatric foot and ankle lawn mower injuries permits recommendations for maximum functional outcome with minimal intervention. Public awareness and mower safety devices may be required to decrease the rate of accidents in the future.

  3. Validation of a short questionnaire to measure symptoms and functional limitations associated with hand-foot syndrome and mucositis in patients with metastatic renal cell carcinoma.

    Science.gov (United States)

    Lai, Jin-Shei; Beaumont, Jennifer L; Diaz, Jose; Khan, Sadya; Cella, David

    2016-01-15

    Hand-foot syndrome and mucositis/stomatitis are frequent adverse events (AEs) of treatment with tyrosine kinase inhibitors in cancer therapy. Quality-of-life instruments that measure the functional consequences of these AEs are needed to assess the impact of therapeutic interventions and to guide patient care. The Hand-Foot and Mucositis Symptom and Impact Questionnaire (HAMSIQ [formerly the Supplementary Quality of Life Questionnaire]) was used in the COMPARZ trial (Pazopanib vs Sunitinib in the Treatment of Locally Advanced and/or Metastatic Renal Cell Carcinoma [national clinical trial no. NCT00720941]) and the PISCES study (Patient Preference Study of Pazopanib vs Sunitinib in Advanced or Metastatic Kidney Cancer [clinicaltrials.gov NCT01064310]) to assess mouth/throat and hand/foot soreness symptoms and subsequent limitations in patients receiving pazopanib or sunitinib for metastatic renal cell carcinoma. The objective of the current analysis was to validate the HAMSIQ using data from the PISCES study. The HAMSIQ was administered in the PISCES study at baseline and every 2 weeks over two 10-week periods to patients who were receiving pazopanib or sunitinib. Data from the first 10-week period were used to assess the feasibility, validity, and responsiveness of the HAMSIQ. In total, ≥85% of 169 patients completed the HAMSIQ (excluding the item concerning days off work). Correlations among items within the same limitation subscale generally were high (Cronbach α ≥ .80). HAMSIQ limitation scores differentiated patients according to their baseline performance status and severity of soreness. Small-to-moderate correlations were observed for the symptoms/limitation scores and for changes from baseline scores between the HAMSIQ and the Functional Assessment of Chronic Illness Therapy fatigue survey. The HAMSIQ demonstrated responsiveness to changes in clinical status and the development of hand-foot syndrome AEs over time. The HAMSIQ is a feasible, valid

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

    Science.gov (United States)

    Amin, Noha; Doupis, John

    2016-01-01

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

  5. Impedance of Surface Footings on Layered Ground

    DEFF Research Database (Denmark)

    Andersen, Lars; Clausen, Johan

    2008-01-01

    is discussed. Based on the Green's function for a stratified half-space, the impedance of a surface footing with arbitrary shape is computed. A wind turbine foundation is analysed in the frequency range 0-3 Hz. Analyses show that soil stratification may lead to significant changes in the impedance related...

  6. Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: a meta-analysis of observational studies.

    Science.gov (United States)

    Fernando, Malindu Eranga; Crowther, Robert George; Pappas, Elise; Lazzarini, Peter Anthony; Cunningham, Margaret; Sangla, Kunwarjit Singh; Buttner, Petra; Golledge, Jonathan

    2014-01-01

    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. 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). 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, pdiabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings.

  7. Nonplantigrade Foot Posture: A Constraint on Dinosaur Body Size.

    Directory of Open Access Journals (Sweden)

    Tai Kubo

    Full Text Available Dinosaurs had functionally digitigrade or sub-unguligrade foot postures. With their immediate ancestors, dinosaurs were the only terrestrial nonplantigrades during the Mesozoic. Extant terrestrial mammals have different optimal body sizes according to their foot posture (plantigrade, digitigrade, and unguligrade, yet the relationship of nonplantigrade foot posture with dinosaur body size has never been investigated, even though the body size of dinosaurs has been studied intensively. According to a large dataset presented in this study, the body sizes of all nonplantigrades (including nonvolant dinosaurs, nonvolant terrestrial birds, extant mammals, and extinct Nearctic mammals are above 500 g, except for macroscelid mammals (i.e., elephant shrew, a few alvarezsauroid dinosaurs, and nondinosaur ornithodirans (i.e., the immediate ancestors of dinosaurs. When nonplantigrade tetrapods evolved from plantigrade ancestors, lineages with nonplantigrade foot posture exhibited a steady increase in body size following Cope's rule. In contrast, contemporaneous plantigrade lineages exhibited no trend in body size evolution and were largely constrained to small body sizes. This evolutionary pattern of body size specific to foot posture occurred repeatedly during both the Mesozoic and the Cenozoic eras. Although disturbed by the end-Cretaceous extinction, species of mid to large body size have predominantly been nonplantigrade animals from the Jurassic until the present; conversely, species with small body size have been exclusively composed of plantigrades in the nonvolant terrestrial tetrapod fauna.

  8. Nonplantigrade Foot Posture: A Constraint on Dinosaur Body Size.

    Science.gov (United States)

    Kubo, Tai; Kubo, Mugino O

    2016-01-01

    Dinosaurs had functionally digitigrade or sub-unguligrade foot postures. With their immediate ancestors, dinosaurs were the only terrestrial nonplantigrades during the Mesozoic. Extant terrestrial mammals have different optimal body sizes according to their foot posture (plantigrade, digitigrade, and unguligrade), yet the relationship of nonplantigrade foot posture with dinosaur body size has never been investigated, even though the body size of dinosaurs has been studied intensively. According to a large dataset presented in this study, the body sizes of all nonplantigrades (including nonvolant dinosaurs, nonvolant terrestrial birds, extant mammals, and extinct Nearctic mammals) are above 500 g, except for macroscelid mammals (i.e., elephant shrew), a few alvarezsauroid dinosaurs, and nondinosaur ornithodirans (i.e., the immediate ancestors of dinosaurs). When nonplantigrade tetrapods evolved from plantigrade ancestors, lineages with nonplantigrade foot posture exhibited a steady increase in body size following Cope's rule. In contrast, contemporaneous plantigrade lineages exhibited no trend in body size evolution and were largely constrained to small body sizes. This evolutionary pattern of body size specific to foot posture occurred repeatedly during both the Mesozoic and the Cenozoic eras. Although disturbed by the end-Cretaceous extinction, species of mid to large body size have predominantly been nonplantigrade animals from the Jurassic until the present; conversely, species with small body size have been exclusively composed of plantigrades in the nonvolant terrestrial tetrapod fauna.

  9. Flat Feet, Happy Feet? Comparison of the Dynamic Plantar Pressure Distribution and Static Medial Foot Geometry between Malawian and Dutch Adults

    NARCIS (Netherlands)

    Stolwijk, N.M.; Duysens, J.E.J.; Louwerens, J.W.; Ven, Y.H. van de; Keijsers, N.L.

    2013-01-01

    In contrast to western countries, foot complaints are rare in Africa. This is remarkable, as many African adults walk many hours each day, often barefoot or with worn-out shoes. The reason why Africans can withstand such loading without developing foot complaints might be related to the way the foot

  10. The effect of ankle foot orthosis stiffness on the energy cost of walking: a simulation study.

    Science.gov (United States)

    Bregman, D J J; van der Krogt, M M; de Groot, V; Harlaar, J; Wisse, M; Collins, S H

    2011-11-01

    In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot Orthoses are frequently prescribed. However, it is unknown what Ankle Foot Orthoses stiffness should be used to obtain the most efficient gait. The aim of this simulation study was to gain insights into the effect of variation in Ankle Foot Orthosis stiffness on the amount of energy stored in the Ankle Foot Orthosis and the energy cost of walking. We developed a two-dimensional forward-dynamic walking model with a passive spring at the ankle representing the Ankle Foot Orthosis and two constant torques at the hip for propulsion. We varied Ankle Foot Orthosis stiffness while keeping speed and step length constant. We found an optimal stiffness, at which the energy delivered at the hip joint was minimal. Energy cost decreased with increasing energy storage in the ankle foot orthosis, but the most efficient gait did not occur with maximal energy storage. With maximum storage, push-off occurred too late to reduce the impact of the contralateral leg with the floor. Maximum return prior to foot strike was also suboptimal, as push-off occurred too early and its effects were subsequently counteracted by gravity. The optimal Ankle Foot Orthosis stiffness resulted in significant push-off timed just prior to foot strike and led to greater ankle plantar-flexion velocity just before contralateral foot strike. Our results suggest that patient energy cost might be reduced by the proper choice of Ankle Foot Orthosis stiffness. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. 24 CFR 3285.312 - Footings.

    Science.gov (United States)

    2010-04-01

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

  12. Stresses in a simplified two dimensional model of a normal foot : a preliminary analysis

    NARCIS (Netherlands)

    Patil, K.M.; Braak, L.H.; Huson, A.

    1993-01-01

    The loss of motor functions of the foot muscles in leprosy or diabetes changes the pattern of internal stresses in the foot skeleton. This may provoke local foci of relatively high stresses. In those cases where osteoporosis and cystic degeneration has weakened the mechanical strength of the bones,

  13. Foot muscles strengthener

    Directory of Open Access Journals (Sweden)

    Boris T. Glavač

    2012-04-01

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

  14. Clinical applications of dynamic functional musculoskeletal ultrasound

    Directory of Open Access Journals (Sweden)

    Petscavage-Thomas J

    2014-02-01

    Full Text Available Jonelle Petscavage-Thomas Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, USA Abstract: There is an increasing trend in medicine to utilize ultrasound for diagnosis of musculoskeletal pathology. Although magnetic resonance imaging provides excellent spatial resolution of musculoskeletal structures in multiple imaging planes and is generally the cross-sectional modality of choice, it does not provide dynamic functional assessment of muscles, tendons, and ligaments. Dynamic maneuvers with ultrasound provide functional data and have been shown to be accurate for diagnosis. Ultrasound is also less expensive, portable, and more readily available. This article will review the common snapping, impingement, and friction syndromes imaged with dynamic ultrasound. It will also discuss future areas of research, including musculoskeletal sonoelastography. Keywords: snapping, dynamic, ultrasound, functional, musculoskeletal

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

    Directory of Open Access Journals (Sweden)

    David Rodríguez-Sanz

    2018-03-01

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

  16. Physical activity and exercise on diabetic foot related outcomes: A systematic review.

    Science.gov (United States)

    Matos, Monica; Mendes, Romeu; Silva, André B; Sousa, Nelson

    2018-05-01

    Diabetic foot is one of the most common complications of diabetes. It has the potential risk of pathologic consequences including infection, ulceration and amputation, but a growing body of evidence suggests that physical activity and exercise may improve diabetic foot outcomes. To analyze de effects of exercise and physical activity interventions on diabetic foot outcomes. A comprehensive and systematic search was conducted according to PRISMA recommendations. Only controlled clinical trials with patients with diabetes were included. Six studies, involving 418 patients with diabetes, were included. Two studies used only aerobic exercise; two studies combined aerobic, resistance and balance exercise; and two studies combined aerobic and balance exercise by Thai Chin Chuan methods. Physical activity and exercise significantly improved nerve velocity conduction, peripheral sensory function and foot peak pressure distribution. Moreover, the ulcers incidence rate per year was lower in the intervention groups, compared with the controls [0.02 vs. 0.12]. This review suggests evidence that physical activity and exercise is an effective non-pharmacological intervention to improve diabetic foot related outcomes. Combined multi-disciplinary treatments are more effective in the prevention of foot complications in patients with diabetes. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Characterisation of foot-and-mouth disease virus strains circulating in Turkey during 1996-2004

    DEFF Research Database (Denmark)

    Parlak, Ü.; Özyörük, F.; Knowles, N.J.

    2007-01-01

    Two genotypes of foot-and-mouth disease virus serotype A were identified as the cause of disease outbreaks in Turkey during 1996-2004, while serotype O strains, identified during the same period, seem to represent an evolutionary continuum, and Asia1 strains were only rarely identified. The data...... genotypes. It is suggested that further studies to reveal the nature of the difference in epidemiological dynamics of type A and type O strains might lead to an understanding of the measures required to control foot-and-mouth disease in islands of persistent circulation....

  18. The Effect of a Microprocessor Prosthetic Foot on Function and Quality of Life in Transtibial Amputees Who Are Limited Community Ambulators

    Science.gov (United States)

    2017-09-01

    motion and active power , will translate into improved functional performance, ambulatory safety (risk of falls) and quality of life in trans-tibial...clinical trial designed to determine if a microprocessor controlled prosthetic foot (MPF), with greater range of motion and active power , will...contact over a 6 month period of time and receive physical therapy training to minimize deviations resulting from habit or lack of training, education

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

    Science.gov (United States)

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

    2014-02-01

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

  20. Foot Complications in a Representative Australian Inpatient Population

    Directory of Open Access Journals (Sweden)

    Peter A. Lazzarini

    2017-01-01

    Full Text Available We investigated the prevalence and factors independently associated with foot complications in a representative inpatient population (adults admitted for any reason with and without diabetes. We analysed data from the Foot disease in inpatients study, a sample of 733 representative inpatients. Previous amputation, previous foot ulceration, peripheral arterial disease (PAD, peripheral neuropathy (PN, and foot deformity were the foot complications assessed. Sociodemographic, medical, and foot treatment history were collected. Overall, 46.0% had a foot complication with 23.9% having multiple; those with diabetes had higher prevalence of foot complications than those without diabetes (p<0.01. Previous amputation (4.1% was independently associated with previous foot ulceration, foot deformity, cerebrovascular accident, and past surgeon treatment (p<0.01. Previous foot ulceration (9.8% was associated with PN, PAD, past podiatry, and past nurse treatment (p<0.02. PAD (21.0% was associated with older age, males, indigenous people, cancer, PN, and past surgeon treatment (p<0.02. PN (22.0% was associated with older age, diabetes, mobility impairment, and PAD (p<0.05. Foot deformity (22.4% was associated with older age, mobility impairment, past podiatry treatment, and PN (p<0.01. Nearly half of all inpatients had a foot complication. Those with foot complications were older, male, indigenous, had diabetes, cerebrovascular accident, mobility impairment, and other foot complications or past foot treatment.

  1. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

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

  2. Habitual Physical Activity, Peripheral Neuropathy, Foot Deformities ...

    African Journals Online (AJOL)

    Results: Habitual physical activity index (3.2 ± 0.83) was highest in work-related activities; 69 (26.1 %) patients presented with peripheral neuropathy and 52 (19. 7%) had the lowest limb function. Pes planus was the most prevalent foot deformity (20.1%). Significant differences existed in physical activity indices across ...

  3. Impedance of Surface Footings on Layered Ground

    DEFF Research Database (Denmark)

    Andersen, Lars; Clausen, Johan Christian

    2005-01-01

    is discussed. Based on the Green's function for a stratified half-space, the impedance of a surface footing with arbitrary shape is computed. A wind turbine foundation is analysed in the frequency range 0 to 3 Hz. Analyses show that soil stratification may lead to a significant changes in the impedance related...

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

    Science.gov (United States)

    Giacomozzi, Claudia; Leardini, Alberto; Caravaggi, Paolo

    2014-08-22

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

  5. Sex-related differences in foot shape.

    Science.gov (United States)

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

    2008-11-01

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

  6. Does footprint depth correlate with foot motion and pressure?

    OpenAIRE

    Bates, K. T.; Savage, R.; Pataky, T. C.; Morse, S. A.; Webster, E.; Falkingham, P. L.; Ren, L.; Qian, Z.; Collins, D.; Bennett, M. R.; McClymont, J.; Crompton, R. H.

    2013-01-01

    Footprints are the most direct source of evidence about locomotor biomechanics in extinct vertebrates. One of the principal suppositions underpinning biomechanical inferences is that footprint geometry correlates with dynamic foot pressure, which, in turn, is linked with overall limb motion of the trackmaker. In this study, we perform the first quantitative test of this long-standing assumption, using topological statistical analysis of plantar pressures and experimental and computer-simulate...

  7. Reliability and validity of the Dutch version of the foot and ankle outcome score (FAOS)

    NARCIS (Netherlands)

    van den Akker-Scheek, Inge; Seldentuis, Arnoud; Reininga, Inge H. F.; Stevens, Martin

    2013-01-01

    Background: The Foot and Ankle Outcome Score (FAOS) is a patient-reported questionnaire measuring symptoms and functional limitations of the foot and ankle. Aim is to translate and culturally adapt the Dutch version of the FAOS and to investigate internal consistency, validity, repeatability and

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  9. User manual for NASA Lewis 10 by 10 foot supersonic wind tunnel. Revised

    Science.gov (United States)

    Soeder, Ronald H.

    1995-01-01

    This manual describes the 10- by 10-Foot Supersonic Wind Tunnel at the NASA Lewis Research Center and provides information for users who wish to conduct experiments in this facility. Tunnel performance operating envelopes of altitude, dynamic pressure, Reynolds number, total pressure, and total temperature as a function of test section Mach number are presented. Operating envelopes are shown for both the aerodynamic (closed) cycle and the propulsion (open) cycle. The tunnel test section Mach number range is 2.0 to 3.5. General support systems, such as air systems, hydraulic system, hydrogen system, fuel system, and Schlieren system, are described. Instrumentation and data processing and acquisition systems are also described. Pretest meeting formats and schedules are outlined. Tunnel user responsibility and personnel safety are also discussed.

  10. Functional System Dynamics

    OpenAIRE

    Ligterink, N.E.

    2007-01-01

    Functional system dynamics is the analysis, modelling, and simulation of continuous systems usually described by partial differential equations. From the infinite degrees of freedom of such systems only a finite number of relevant variables have to be chosen for a practical model description. The proper input and output of the system are an important part of the relevant variables.

  11. Imaging of Charcot foot

    International Nuclear Information System (INIS)

    Erlemann, Rainer; Schmitz, Annette

    2014-01-01

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

  12. Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery

    Directory of Open Access Journals (Sweden)

    Lu Bai

    2015-01-01

    Full Text Available Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Patients received oral vitamin B 12 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory function in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months

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

    Science.gov (United States)

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

    2015-01-01

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

  14. Functional integral approach to classical statistical dynamics

    International Nuclear Information System (INIS)

    Jensen, R.V.

    1980-04-01

    A functional integral method is developed for the statistical solution of nonlinear stochastic differential equations which arise in classical dynamics. The functional integral approach provides a very natural and elegant derivation of the statistical dynamical equations that have been derived using the operator formalism of Martin, Siggia, and Rose

  15. ECONOMICAL DESIGN OF CIRCULAR FOOTINGS ADJACENT TO SLOPES ON SANDY SOILS

    Directory of Open Access Journals (Sweden)

    Adnan Jayed Zedan

    2013-05-01

    Full Text Available The analysis presented here introduces three optimization techniques namely, Hooke and Jeeves, Fletcher-Reeves and Davidon-Fletcher-Powell as applied to design of the circular footing adjacent to slopes. A computer program was developed to solve this design problem using the conventional structural design approach   in conjunction with these methods, A simple study was performed to detect the sensitivity of the objective function to its design variables. A further parametric study was performed regarding the geometric configurations of the footing and loading conditions in order to provide the geotechnical engineer with some useful design curves. Hooke and Jeeves method has been proved to be very instructive in exposing the effect of the other methods.It has been proved that the minimum cost of the circular footing increases with the increase of the load whereas it decreases as the angle of internal friction increases and the Dcl/B ratio (column diameter/diameter of footing.

  16. Diabetic Foot - Multiple Languages

    Science.gov (United States)

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

  17. Adaptation and Validation of the Foot Function Index-Revised Short Form into Polish

    Directory of Open Access Journals (Sweden)

    Radosław Rutkowski

    2017-01-01

    Full Text Available Purpose. The aim of the present study was to adapt the Foot Function Index-Revised Short Form (FFI-RS questionnaire into Polish and verify its reliability and validity in a group of patients with rheumatoid arthritis (RA. Methods. The study included 211 patients suffering from RA. The FFI-RS questionnaire underwent standard linguistic adaptation and its psychometric parameters were investigated. The enrolled participants had been recruited for seven months as a convenient sample from the rheumatological hospital in Śrem (Poland. They represented different sociodemographic characteristics and were characterized as rural and city environments residents. Results. The mean age of the patients was 58.9±10.2 years. The majority of patients (85% were female. The average final FFI-RS score was 62.9±15.3. The internal consistency was achieved at a high level of 0.95 in Cronbach’s alpha test, with an interclass correlation coefficient ranging between 0.78 and 0.84. A strong correlation was observed between the FFI-RS and Health Assessment Questionnaire-Disability Index (HAQ-DI questionnaires. Conclusion. The Polish version of FFI-RS-PL indicator is an important tool for evaluating the functional condition of patients’ feet and can be applied in the diagnosis and treatment of Polish-speaking patients suffering from RA.

  18. Adaptation and Validation of the Foot Function Index-Revised Short Form into Polish.

    Science.gov (United States)

    Rutkowski, Radosław; Gałczyńska-Rusin, Małgorzata; Gizińska, Małgorzata; Straburzyński-Lupa, Marcin; Zdanowska, Agata; Romanowski, Mateusz Wojciech; Romanowski, Wojciech; Budiman-Mak, Elly; Straburzyńska-Lupa, Anna

    2017-01-01

    The aim of the present study was to adapt the Foot Function Index-Revised Short Form (FFI-RS) questionnaire into Polish and verify its reliability and validity in a group of patients with rheumatoid arthritis (RA). The study included 211 patients suffering from RA. The FFI-RS questionnaire underwent standard linguistic adaptation and its psychometric parameters were investigated. The enrolled participants had been recruited for seven months as a convenient sample from the rheumatological hospital in Śrem (Poland). They represented different sociodemographic characteristics and were characterized as rural and city environments residents. The mean age of the patients was 58.9 ± 10.2 years. The majority of patients (85%) were female. The average final FFI-RS score was 62.9 ± 15.3. The internal consistency was achieved at a high level of 0.95 in Cronbach's alpha test, with an interclass correlation coefficient ranging between 0.78 and 0.84. A strong correlation was observed between the FFI-RS and Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaires. The Polish version of FFI-RS-PL indicator is an important tool for evaluating the functional condition of patients' feet and can be applied in the diagnosis and treatment of Polish-speaking patients suffering from RA.

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

    Science.gov (United States)

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

    2016-09-01

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

  20. Foot segmental motion and coupling in stage II and III tibialis posterior tendon dysfunction.

    Science.gov (United States)

    Van de Velde, Maarten; Matricali, Giovanni Arnoldo; Wuite, Sander; Roels, Charlotte; Staes, Filip; Deschamps, Kevin

    2017-06-01

    Classification systems developed in the field of posterior tibialis tendon dysfunction omit to include dynamic measurements. Since this may negatively affect the selection of the most appropriate treatment modality, studies on foot kinematics are highly recommended. Previous research characterised the foot kinematics in patients with posterior tibialis tendon dysfunction. However, none of the studies analysed foot segmental motion synchrony during stance phase, nor compared the kinematic behaviour of the foot in presence of different posterior tibialis tendon dysfunction stages. Therefore, we aimed at comparing foot segmental motion and coupling in patients with posterior tibialis tendon dysfunction grade 2 and 3 to those of asymptomatic subjects. Foot segmental motion of 11 patients suffering from posterior tibialis tendon dysfunction stage 2, 4 patients with posterior tibialis tendon dysfunction stage 3 and 15 asymptomatic subjects was objectively quantified with the Rizzoli foot model using an instrumented walkway and a 3D passive motion capture system. Dependent variables were the range of motion occurring at the different inter-segment angles during subphases of stance and swing phase as well as the cross-correlation coefficient between a number of segments. Significant differences in range of motion were predominantly found during the forefoot push off phase and swing phase. In general, both patient cohorts demonstrated a reduced range of motion compared to the control group. This hypomobility occurred predominantly in the rearfoot and midfoot (pfoot which should be considered in the decision making process since it may help explaining the success and failure of certain conservative and surgical interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

  2. [Dutch-language patient-reported outcome measures for foot and ankle injuries; a systematic review].

    Science.gov (United States)

    Weel, Hanneke; Zwiers, Ruben; Sierevelt, Inger N; Haverkamp, Daniel; van Dijk, C Niek; Kerkhoffs, Gino M M J

    2015-01-01

    To investigate which valid and reliable patient-reported outcome measures (PROMs) are available for foot and ankle disorders in the Dutch population, and which of these is the most suitable for uniform use. Systematic review. PubMed, Embase and Google Scholar were systematically searched for relevant articles; subsequently two researchers screened first the title and the abstract, and then the full article within a selection of these articles. Studies that described a validation process for foot- and ankle-PROMs in a Dutch population were included. Data on measurement characteristics and translation procedure were extracted, and methodological quality of the studies was assessed using the COSMIN checklist. ('COSMIN' stands for 'Consensus-based standards for the selection of health status measurement instruments'.) Two general foot- and ankle-PROMs in the Dutch language were validated: the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measurement (FAAM); two foot-PROMs: the Manchester Foot Pain and Disability Index (MFPDI) and the 5-point Foot Function Index (FFI-5pt) were also validated. There were also two disorder-specific PROMs available in Dutch: the Victorian Institute of Sports Assessment-Achilles (VISA-A) for Achilles tendinopathies and the Foot Impact Scale for Rheumatoid Arthritis (FIS-RA) for rheumatoid arthritis patients. The FAOS and the FFI-5pt showed the strongest evidence for having good measurement characteristics. Currently, we regard the FAOS as the most appropriate foot- and ankle-PROM for general foot and ankle problems. Further studies of higher methodological quality are, however, required to draw firmer conclusions.

  3. Macrodystrophia lipomatosa: a reconstructive approach to gigantism of the foot.

    Science.gov (United States)

    Watt, Andrew J; Chung, Kevin C

    2004-01-01

    Localized gigantism poses a challenging surgical dilemma, and it may be treated with amputation. This case report documents the application of a reconstructive approach to a severe case of pedal macrodystrophia lipomatosa in a 1-year-old girl. A series of 3 surgeries were designed to reduce the length, width, height, and overall bulk of the congenitally enlarged foot. The 3 procedures debulked the foot for normal ambulation and same-size shoe wear for both feet. The resulting functional and aesthetic improvements achieved through reconstructive treatment provided a desirable alternative to amputation.

  4. A multi-segment foot model based on anatomically registered technical coordinate systems: method repeatability and sensitivity in pediatric planovalgus feet.

    Science.gov (United States)

    Saraswat, Prabhav; MacWilliams, Bruce A; Davis, Roy B; D'Astous, Jacques L

    2013-01-01

    Several multisegment foot models have been proposed and some have been used to study foot pathologies. These models have been tested and validated on typically developed populations; however application of such models to feet with significant deformities presents an additional set of challenges. For the first time, in this study, a multisegment foot model is tested for repeatability in a population of children with symptomatic abnormal feet. The results from this population are compared to the same metrics collected from an age matched (8-14 years) typically developing population. The modified Shriners Hospitals for Children, Greenville (mSHCG) foot model was applied to ten typically developing children and eleven children with planovalgus feet by two clinicians. Five subjects in each group were retested by both clinicians after 4-6 weeks. Both intra-clinician and inter-clinician repeatability were evaluated using static and dynamic measures. A plaster mold method was used to quantify variability arising from marker placement error. Dynamic variability was measured by examining trial differences from the same subjects when multiple clinicians carried out the data collection multiple times. For hindfoot and forefoot angles, static and dynamic variability in both groups was found to be less than 4° and 6° respectively. The mSHCG model strategy of minimal reliance on anatomical markers for dynamic measures and inherent flexibility enabled by separate anatomical and technical coordinate systems resulted in a model equally repeatable in typically developing and planovalgus populations. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Treatment of congenital club foot with Ponseti method

    Directory of Open Access Journals (Sweden)

    Agrawal R

    2005-01-01

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

  6. Fractal diffusion coefficient from dynamical zeta functions

    Energy Technology Data Exchange (ETDEWEB)

    Cristadoro, Giampaolo [Max Planck Institute for the Physics of Complex Systems, Noethnitzer Str. 38, D 01187 Dresden (Germany)

    2006-03-10

    Dynamical zeta functions provide a powerful method to analyse low-dimensional dynamical systems when the underlying symbolic dynamics is under control. On the other hand, even simple one-dimensional maps can show an intricate structure of the grammar rules that may lead to a non-smooth dependence of global observables on parameters changes. A paradigmatic example is the fractal diffusion coefficient arising in a simple piecewise linear one-dimensional map of the real line. Using the Baladi-Ruelle generalization of the Milnor-Thurnston kneading determinant, we provide the exact dynamical zeta function for such a map and compute the diffusion coefficient from its smallest zero. (letter to the editor)

  7. Fractal diffusion coefficient from dynamical zeta functions

    International Nuclear Information System (INIS)

    Cristadoro, Giampaolo

    2006-01-01

    Dynamical zeta functions provide a powerful method to analyse low-dimensional dynamical systems when the underlying symbolic dynamics is under control. On the other hand, even simple one-dimensional maps can show an intricate structure of the grammar rules that may lead to a non-smooth dependence of global observables on parameters changes. A paradigmatic example is the fractal diffusion coefficient arising in a simple piecewise linear one-dimensional map of the real line. Using the Baladi-Ruelle generalization of the Milnor-Thurnston kneading determinant, we provide the exact dynamical zeta function for such a map and compute the diffusion coefficient from its smallest zero. (letter to the editor)

  8. Spatial model of the gecko foot hair: functional significance of highly specialized non-uniform geometry.

    Science.gov (United States)

    Filippov, Alexander E; Gorb, Stanislav N

    2015-02-06

    One of the important problems appearing in experimental realizations of artificial adhesives inspired by gecko foot hair is so-called clusterization. If an artificially produced structure is flexible enough to allow efficient contact with natural rough surfaces, after a few attachment-detachment cycles, the fibres of the structure tend to adhere one to another and form clusters. Normally, such clusters are much larger than original fibres and, because they are less flexible, form much worse adhesive contacts especially with the rough surfaces. Main problem here is that the forces responsible for the clusterization are the same intermolecular forces which attract fibres to fractal surface of the substrate. However, arrays of real gecko setae are much less susceptible to this problem. One of the possible reasons for this is that ends of the seta have more sophisticated non-uniformly distributed three-dimensional structure than that of existing artificial systems. In this paper, we simulated three-dimensional spatial geometry of non-uniformly distributed branches of nanofibres of the setal tip numerically, studied its attachment-detachment dynamics and discussed its advantages versus uniformly distributed geometry.

  9. A cumulant functional for static and dynamic correlation

    International Nuclear Information System (INIS)

    Hollett, Joshua W.; Hosseini, Hessam; Menzies, Cameron

    2016-01-01

    A functional for the cumulant energy is introduced. The functional is composed of a pair-correction and static and dynamic correlation energy components. The pair-correction and static correlation energies are functionals of the natural orbitals and the occupancy transferred between near-degenerate orbital pairs, rather than the orbital occupancies themselves. The dynamic correlation energy is a functional of the statically correlated on-top two-electron density. The on-top density functional used in this study is the well-known Colle-Salvetti functional. Using the cc-pVTZ basis set, the functional effectively models the bond dissociation of H 2 , LiH, and N 2 with equilibrium bond lengths and dissociation energies comparable to those provided by multireference second-order perturbation theory. The performance of the cumulant functional is less impressive for HF and F 2 , mainly due to an underestimation of the dynamic correlation energy by the Colle-Salvetti functional.

  10. The dynamic adjoint as a Green’s function

    International Nuclear Information System (INIS)

    Pázsit, I.; Dykin, V.

    2015-01-01

    Highlight: • The relationship between the direct Green’s function and the dynamic adjoint function is discussed in two-group theory. • It is shown that the elements of the direct Greens’ function matrix are identical to those of the transpose of the adjoint Green’s function matrix, with an interchange of arguments. • It is also remarked how the dynamic adjoint function of van Dam can be given in terms of the direct Green’s function matrix. - Abstract: The concept of the dynamic adjoint was introduced by Hugo van Dam for calculating the in-core neutron noise in boiling water reactors in the mid-70’s. This successful approach found numerous applications for calculating the neutron noise in both PWRs and BWRs since then. Although the advantages and disadvantages of using the direct (forward) or the adjoint (backward) approach for the calculation of the neutron noise were analysed in a number of publications, the direct relationship between the forward Green’s function and the dynamic adjoint has not been discussed. On the other hand, in particle transport theory the relationship between the direct and adjoint Green’s function has been discussed in detail, in which Mike Williams has had many seminal contributions. In this note we analyse the relationship between the direct Green’s function and the dynamic adjoint in the spirit of Mike’s work in neutron transport and radiation damage theory. The paper is closed with some personal remarks and reminiscences.

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    Science.gov (United States)

    Forsythe, Rachael O; Hinchliffe, Robert J

    2016-01-01

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

  13. The diabetic foot

    OpenAIRE

    Nabuurs-Franssen, M.H.

    2005-01-01

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

  14. Foot-and-mouth disease

    DEFF Research Database (Denmark)

    Belsham, Graham; Charleston, Bryan; Jackson, Terry

    2009-01-01

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

  15. 49 CFR 214.115 - Foot protection.

    Science.gov (United States)

    2010-10-01

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

  16. Robust transient dynamics and brain functions

    Directory of Open Access Journals (Sweden)

    Mikhail I Rabinovich

    2011-06-01

    Full Text Available In the last few decades several concepts of Dynamical Systems Theory (DST have guided psychologists, cognitive scientists, and neuroscientists to rethink about sensory motor behavior and embodied cognition. A critical step in the progress of DST application to the brain (supported by modern methods of brain imaging and multi-electrode recording techniques has been the transfer of its initial success in motor behavior to mental function, i.e., perception, emotion, and cognition. Open questions from research in genetics, ecology, brain sciences, etc. have changed DST itself and lead to the discovery of a new dynamical phenomenon, i.e., reproducible and robust transients that are at the same time sensitive to informational signals. The goal of this review is to describe a new mathematical framework -heteroclinic sequential dynamics- to understand self-organized activity in the brain that can explain certain aspects of robust itinerant behavior. Specifically, we discuss a hierarchy of coarse-grain models of mental dynamics in the form of kinetic equations of modes. These modes compete for resources at three levels: (i within the same modality, (ii among different modalities from the same family (like perception, and (iii among modalities from different families (like emotion and cognition. The analysis of the conditions for robustness, i.e., the structural stability of transient (sequential dynamics, give us the possibility to explain phenomena like the finite capacity of our sequential working memory -a vital cognitive function-, and to find specific dynamical signatures -different kinds of instabilities- of several brain functions and mental diseases.

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

    Science.gov (United States)

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

    2014-01-01

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

  18. 脑性瘫痪患儿踝足矫形器配戴前后对运动功能的量化评价%Quantitative assessment of motor function on children with cerebral palsy before and after wearing ankle foot orthopedic instruments

    Institute of Scientific and Technical Information of China (English)

    李润洁

    2002-01-01

    Objective To assess motor function quantitatively on children with cerebral palsy before and after wearing ankle foot orthopedic instruments.Method Ankle foot orthopedic instruments were made by Dalian Prosthesis Factory.Children' motor function was assessed with self made quantitative assessment scale according to the forth,fifth function area of motor assessment scale of children with cerebral palsy after one week of wearing orthopedic instruments. Result In all 23 patients, orthopedic instruments proved effective in controlling leg muscular tension,correcting equines,genu recurvatum,talips valgus and talipes varus,keeping erect posture and modifying gait.Motor function assessed show significant difference before and one week after wearing orthopedic instruments (P< 0.001).Conclusion Ankle foot orthopedic instruments play a positive role in improving motor function of lower extremity in cerebral palsy patients.

  19. [Study of the foot ground pressure pattern in children (author's transl)].

    Science.gov (United States)

    Huguenin, P; Themar-Noel, C; Bensahel, H

    1981-01-01

    The use of a new apparatus has enabled the authors to study the distribution to the ground of the plantar pressures by the way of ciphering each support area. This procedure is valuable and very precise as 500 pressure pick-up are used which give reliable, numerous and regularly distributed informations. The normal footprint has first been evaluated. Then, a comparison was possible with pathologic foot, so it was possible to estimate the result of a functional or surgical treatment on the morphology of the foot.

  20. Adaptive control of dynamic balance in human gait on a split-belt treadmill.

    Science.gov (United States)

    Buurke, Tom J W; Lamoth, Claudine J C; Vervoort, Danique; van der Woude, Lucas H V; den Otter, Rob

    2018-05-17

    Human bipedal gait is inherently unstable and staying upright requires adaptive control of dynamic balance. Little is known about adaptive control of dynamic balance in reaction to long-term, continuous perturbations. We examined how dynamic balance control adapts to a continuous perturbation in gait, by letting people walk faster with one leg than the other on a treadmill with two belts (i.e. split-belt walking). In addition, we assessed whether changes in mediolateral dynamic balance control coincide with changes in energy use during split-belt adaptation. In nine minutes of split-belt gait, mediolateral margins of stability and mediolateral foot roll-off changed during adaptation to the imposed gait asymmetry, especially on the fast side, and returned to baseline during washout. Interestingly, no changes in mediolateral foot placement (i.e. step width) were found during split-belt adaptation. Furthermore, the initial margin of stability and subsequent mediolateral foot roll-off were strongly coupled to maintain mediolateral dynamic balance throughout the gait cycle. Consistent with previous results net metabolic power was reduced during split-belt adaptation, but changes in mediolateral dynamic balance control were not correlated with the reduction of net metabolic power during split-belt adaptation. Overall, this study has shown that a complementary mechanism of relative foot positioning and mediolateral foot roll-off adapts to continuously imposed gait asymmetry to maintain dynamic balance in human bipedal gait. © 2018. Published by The Company of Biologists Ltd.

  1. 3D finite element model of the diabetic neuropathic foot: a gait analysis driven approach.

    Science.gov (United States)

    Guiotto, Annamaria; Sawacha, Zimi; Guarneri, Gabriella; Avogaro, Angelo; Cobelli, Claudio

    2014-09-22

    Diabetic foot is an invalidating complication of diabetes that can lead to foot ulcers. Three-dimensional (3D) finite element analysis (FEA) allows characterizing the loads developed in the different anatomical structures of the foot in dynamic conditions. The aim of this study was to develop a subject specific 3D foot FE model (FEM) of a diabetic neuropathic (DNS) and a healthy (HS) subject, whose subject specificity can be found in term of foot geometry and boundary conditions. Kinematics, kinetics and plantar pressure (PP) data were extracted from the gait analysis trials of the two subjects with this purpose. The FEM were developed segmenting bones, cartilage and skin from MRI and drawing a horizontal plate as ground support. Materials properties were adopted from previous literature. FE simulations were run with the kinematics and kinetics data of four different phases of the stance phase of gait (heel strike, loading response, midstance and push off). FEMs were then driven by group gait data of 10 neuropathic and 10 healthy subjects. Model validation focused on agreement between FEM-simulated and experimental PP. The peak values and the total distribution of the pressures were compared for this purpose. Results showed that the models were less robust when driven from group data and underestimated the PP in each foot subarea. In particular in the case of the neuropathic subject's model the mean errors between experimental and simulated data were around the 20% of the peak values. This knowledge is crucial in understanding the aetiology of diabetic foot. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Transcriptome analysis of tube foot and large scale marker discovery in sea cucumber, Apostichopus japonicus.

    Science.gov (United States)

    Zhou, Xiaoxu; Wang, Hongdi; Cui, Jun; Qiu, Xuemei; Chang, Yaqing; Wang, Xiuli

    2016-12-01

    Tube foot as one of the ambulacral appendages types in Aspidochirote holothurioids, is known for their functions in locomotion, feeding, chemoreception, light sensitivity and respiration. In this study, we explored the characteristic of transcriptome in the tube foot of sea cucumber (Apostichopus japonicus). Our results showed that among 390 unigenes which specifically expressed in the tube foot, 190 of them were annotated. Based on the assembly transcriptome, we found 219,860 SNPs from 34,749 unigenes, 97,683, 53,624, 27,767 and 40,786 were located in CDSs, 5'-UTRs, 3'-UTRs and non-CDS separately. Furthermore, 12,114 SSRs were detected from 7394 unigenes. Target genes of four specifically expressed miRNAs (miR-29a, miR-29b, miR-278-3p and miR-2005) in tube foot were also predicted based on the transcriptome, which contain immune-related factors (MBL, VLRA, AjC3, MyD88, CFB), skin pigmentation (MITF), candidate regeneration factor (TRP) and holothurians autolysis-related factor (CL). These results develop a relatively large number of molecular markers and transcriptome resources, and will provide a foundation for further analyses on the function and molecular mechanisms underlying A. japonicas tube foot. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Mobility and Balance and Their Correlation with Physiological Factors in Elderly with Different Foot Postures

    Directory of Open Access Journals (Sweden)

    Aisyah Mohd Said

    2015-01-01

    Full Text Available This study determines (1 the correlation between mobility and balance performances with physiological factors and (2 the relationship between foot postures with anthropometric characteristics and lower limb characteristics among elderly with neutral, pronated, and supinated foot. A cross-sectional observational study was conducted in community-dwelling elderly (age: 69.86 ± 5.62 years. Participants were grouped into neutral (n=16, pronated (n=14, and supinated (n=14 foot based on the foot posture index classification. Anthropometric data (height, weight, and BMI, lower limb strength (5-STS and endurance (30 s chair rise test, mobility (TUG, and balance (FSST were determined. Data were analyzed using Spearman’s correlation coefficient. Body weight was negatively and moderately correlated (rs=-0.552, P<0.05 with mobility in supinated foot; moderate-to-high positive linear rank correlation was found between lower limb strength and mobility (rs=0.551 to 0.804, P<0.05 for pronated and neutral foot. Lower limb endurance was negatively and linearly correlated with mobility in pronated (rs=-0.699 and neutral (rs=-0.573 foot. No correlation was observed in balance performance with physiological factors in any of the foot postures. We can conclude that muscle function may be the most important feature to make movement possible in older persons regardless of the type of foot postures.

  4. Mechanical energy profiles of the combined ankle-foot system in normal gait: insights for prosthetic designs.

    Science.gov (United States)

    Takahashi, Kota Z; Stanhope, Steven J

    2013-09-01

    Over the last half-century, the field of prosthetic engineering has continuously evolved with much attention being dedicated to restoring the mechanical energy properties of ankle joint musculatures during gait. However, the contributions of 'distal foot structures' (e.g., foot muscles, plantar soft tissue) have been overlooked. Therefore, the purpose of this study was to quantify the total mechanical energy profiles (e.g., power, work, and work-ratio) of the natural ankle-foot system (NAFS) by combining the contributions of the ankle joint and all distal foot structures during stance in level-ground steady state walking across various speeds (0.4, 0.6, 0.8 and 1.0 statures/s). The results from eleven healthy subjects walking barefoot indicated ankle joint and distal foot structures generally performed opposing roles: the ankle joint performed net positive work that systematically increased its energy generation with faster walking speeds, while the distal foot performed net negative work that systematically increased its energy absorption with faster walking speeds. Accounting for these simultaneous effects, the combined ankle-foot system exhibited increased work-ratios with faster walking. Most notably, the work-ratio was not significantly greater than 1.0 during the normal walking speed of 0.8 statures/s. Therefore, a prosthetic design that strategically exploits passive-dynamic properties (e.g., elastic energy storage and return) has the potential to replicate the mechanical energy profiles of the NAFS during level-ground steady-state walking. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Integrated pressure-force-kinematics measuring system for the characterisation of plantar foot loading during locomotion.

    Science.gov (United States)

    Giacomozzi, C; Macellari, V; Leardini, A; Benedetti, M G

    2000-03-01

    Plantar pressure, ground reaction force and body-segment kinematics measurements are largely used in gait analysis to characterise normal and abnormal function of the human foot. The combination of all these data together provides a more exhaustive, detailed and accurate view of foot loading during activities than traditional measurement systems alone do. A prototype system is presented that integrates a pressure platform, a force platform and a 3D anatomical tracking system to acquire combined information about foot function and loading. A stereophotogrammetric system and an anatomically based protocol for foot segment kinematics is included in a previously devised piezo-dynamometric system that combines pressure and force measurements. Experimental validation tests are carried out to check for both spatial and time synchronisation. Misalignment of the three systems is found to be within 6.0, 5.0 and 1.5 mm for the stereophotogrammetric system, force platform and pressure platform, respectively. The combination of position and pressure data allows for a more accurate selection of plantar foot subareas on the footprint. Measurements are also taken on five healthy volunteers during level walking to verify the feasibility of the overall experimental protocol. Four main subareas are defined and identified, and the relevant vertical and shear force data are computed. The integrated system is effective when there is a need for loading measurements in specific plantar foot subareas. This is attractive both in clinical assessment and in biomechanics research.

  6. Foot preferences during resting in wildfowl and waders.

    Science.gov (United States)

    Randler, Christoph

    2007-03-01

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

  7. Non-linear finite element model to assess the effect of tendon forces on the foot-ankle complex.

    Science.gov (United States)

    Morales-Orcajo, Enrique; Souza, Thales R; Bayod, Javier; Barbosa de Las Casas, Estevam

    2017-11-01

    A three-dimensional foot finite element model with actual geometry and non-linear behavior of tendons is presented. The model is intended for analysis of the lower limb tendon forces effect in the inner foot structure. The geometry of the model was obtained from computational tomographies and magnetic resonance images. Tendon tissue was characterized with the first order Ogden material model based on experimental data from human foot tendons. Kinetic data was employed to set the load conditions. After model validation, a force sensitivity study of the five major foot extrinsic tendons was conducted to evaluate the function of each tendon. A synergic work of the inversion-eversion tendons was predicted. Pulling from a peroneus or tibialis tendon stressed the antagonist tendons while reducing the stress in the agonist. Similar paired action was predicted for the Achilles tendon with the tibialis anterior. This behavior explains the complex control motion performed by the foot. Furthermore, the stress state at the plantar fascia, the talocrural joint cartilage, the plantar soft tissue and the tendons were estimated in the early and late midstance phase of walking. These estimations will help in the understanding of the functional role of the extrinsic muscle-tendon-units in foot pronation-supination. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  8. A protocol for a randomised controlled trial of prefabricated versus customised foot orthoses for people with rheumatoid arthritis: the FOCOS RA trial [Foot Orthoses - Customised v Off-the-Shelf in Rheumatoid Arthritis].

    Science.gov (United States)

    Gallagher, Kellie S; Godwin, Jon; Hendry, Gordon J; Steultjens, Martijn; Woodburn, Jim

    2018-01-01

    Foot pain is common in rheumatoid arthritis and appears to persist despite modern day medical management. Several clinical practice guidelines currently recommend the use of foot orthoses for the treatment of foot pain in people with rheumatoid arthritis. However, an evidence gap currently exists concerning the comparative clinical- and cost-effectiveness of prefabricated and customised foot orthoses in people with early rheumatoid arthritis. Early intervention with orthotics may offer the best opportunity for positive therapeutic outcomes. The primary aim of this study is to evaluate the comparative clinical- and cost-effectiveness of prefabricated versus customised orthoses for reducing foot pain over 12 months. This is a multi-centre two-arm parallel randomised controlled trial comparing prefabricated versus customised orthoses in participants with early rheumatoid arthritis (rheumatoid arthritis, global functional status via the Stanford Health Assessment Questionnaire, foot disease activity via the Rheumatoid Arthritis Foot Disease Activity Index, and health-related quality of life at baseline, 6 and 12 months. Process outcomes will include recruitment/retention rates, data completion rates, intervention adherence rates, and participant intervention and trial participation satisfaction. Cost-utility and cost-effectiveness analyses will be undertaken. Outcome measures collected at baseline, 6 and 12 months will be used to evaluate the comparative clinical- and cost- effectiveness of customised versus prefabricated orthoses for this treatment of early rheumatoid arthritis foot conditions. This trial will help to guide orthotic prescription recommendations for the management of foot pain for people with early rheumatoid arthritis in future. ISRCTN13654421. Registered 09 February 2016.

  9. Dynamical Functional Theory for Compressed Sensing

    DEFF Research Database (Denmark)

    Cakmak, Burak; Opper, Manfred; Winther, Ole

    2017-01-01

    the Thouless-Anderson-Palmer (TAP) equations corresponding to the ensemble. Using a dynamical functional approach we are able to derive an effective stochastic process for the marginal statistics of a single component of the dynamics. This allows us to design memory terms in the algorithm in such a way...

  10. The detailed measurement of foot clearance by young adults during stair descent.

    Science.gov (United States)

    Telonio, A; Blanchet, S; Maganaris, C N; Baltzopoulos, V; McFadyen, B J

    2013-04-26

    Foot clearance is an important variable for understanding safe stair negotiation, but few studies have provided detailed measures of it. This paper presents a new method to calculate minimal shoe clearance during stair descent and compares it to previous literature. Seventeen healthy young subjects descended a five step staircase with step treads of 300 mm and step heights of 188 mm. Kinematic data were collected with an Optotrak system (model 3020) and three non-colinear infrared markers on the feet. Ninety points were digitized on the foot sole prior to data collection using a 6 marker probe and related to the triad of markers on the foot. The foot sole was reconstructed using the Matlab (version 7.0) "meshgrid" function and minimal distance to each step edge was calculated for the heel, toe and foot sole. Results showed significant differences in minimum clearance between sole, heel and toe, with the shoe sole being the closest and the toe the furthest. While the hind foot sole was closest for 69% of the time, the actual minimum clearance point on the sole did vary across subjects and staircase steps. This new method, and the findings on healthy young subjects, can be applied to future studies of other populations and staircase dimensions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Power functional theory for the dynamic test particle limit

    International Nuclear Information System (INIS)

    Brader, Joseph M; Schmidt, Matthias

    2015-01-01

    For classical Brownian systems both in and out of equilibrium we extend the power functional formalism of Schmidt and Brader (2013 J. Chem. Phys. 138 214101) to mixtures of different types of particles. We apply the framework to develop an exact dynamical test particle theory for the self and distinct parts of the van Hove function, which characterize tagged and collective particle motion. The memory functions that induce non-Markovian dynamics are related to functional derivatives of the excess (over ideal) free power dissipation functional. The method offers an alternative to the recently found nonequilibrium Ornstein–Zernike relation for dynamic pair correlation functions. (paper)

  12. Central polydactyly of the foot: surgical management with plantar and dorsal advancement flaps.

    Science.gov (United States)

    Osborn, Emily J; Davids, Jon R; Leffler, Lauren C; Gibson, Thomas W; Pugh, Linda I

    2014-01-01

    Central polydactyly is the least common form of foot polydactyly, and the intercalary location of the duplicated ray makes the surgical exposure, excision, and closure more complex. For these reasons there is little consensus concerning the optimal technique for surgical management. A retrospective case series of 22 patients with 27 feet with central polydactyly, treated surgically by the dorsal and plantar advancement flap technique, was performed. Change in width of the forefoot was measured from radiographs by the metatarsal gap ratio. Functional outcomes were assessed by the Foot and Ankle Ability Measure. Signficant narrowing of the forefoot, as measured radiographically by the metatarsal gap ratio, was achieved after surgery (Psports, and overall function categories. The few reports of less than normal foot function were related to shoe wear issues and incisional scarring that was painful or cosmetically unappealing. The radiographic and functional outcomes after surgical management of central polydactyly with the dorsal and plantar advancement flap technique are excellent. The technique successfully narrows the forefoot on radiographs, and this narrowing is maintained with growth over time. However, families should be advised that persistent perceived widening of the forefoot relative to normal is common, despite successful radiographic narrowing after surgery. IV.

  13. Introduction of hind foot coronal alignment view

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  14. A cross-sectional observational study comparing foot and ankle characteristics in people with stroke and healthy controls

    OpenAIRE

    Kunkel, Dorit; Potter, Julia; Mamode, Louis

    2016-01-01

    Purpose: The purpose of this study was to explore and compare foot and ankle characteristics in people with stroke and healthy controls; and between stroke fallers and non-fallers.Methods: Participants were recruited from community groups and completed standardized tests assessing sensation, foot posture, foot function, ankle dorsiflexion and first metatarsal phalangeal joint range of motion (1st MPJ ROM), hallux valgus presence and severity.Results: Twenty-three stroke participants (mean age...

  15. [Minor foot amputations in diabetic foot syndrome].

    Science.gov (United States)

    Biehl, C; Eckhard, M; Szalay, G; Heiss, C

    2016-10-01

    The treatment strategy for diabetic foot syndrome must take into account protective sensibility of the foot, open wounds, infection status, and the rules of septic bone surgery. Interventions are classified as elective, prophylactic, curative, or emergency. Amputations in the forefoot and midfoot region are performed as ray amputations (including metatarsal), which can often be carried out as "inner" amputations. Gentle tissue treatment mandatory because of greater risk of revision with re-amputation compared to classical amputation. Good demarcation of infection, acute osteomyelitis, osteolytic lesions, neurotropic ulcer, arterial and venous blood flow to the other toes, gangrene of other toes with metatarsal affection. Arterial occlusive disease, infection of neighboring areas, avoidable amputations, poorly healing ulcers on the lower leg. Primary dorsal approach; minimal incisional distance (5 cm) to minimize skin necrosis risk. Atraumatic preparation, minimize hemostasis to not compromise the borderline perfusion situation. In amputations, plantar skin preparation and longer seams placed as dorsal as possible, either disarticulated and maintain cartilage, or round the cortical metatarsal bone after resection. Diabetes control. Braun splint, mobilization in a shoe with forefoot decompression and hindfoot support, physiotherapy. Antibiotics based on resistance testing. If no complications, dressing change on postoperative day 1. Optimal wound drainage by lowering foot several times a day; drainage removal after 12-24 h. Insoles and footwear optimization. Amputations require continued attention and if necessary treatment to avoid sequelae. Insufficient treatment associated with recurrent ulceration and altered anatomy.

  16. Effect of a steam foot spa on geriatric inpatients with cognitive impairment: a pilot study

    Science.gov (United States)

    Koike, Yoshihisa; Kondo, Hideki; Kondo, Satoshi; Takagi, Masayuki; Kano, Yoshio

    2013-01-01

    Purpose To investigate whether a steam foot spa improves cognitive impairment in geriatric inpatients. Methods Geriatric inpatients with cognitive impairment were given a steam foot spa treatment at 42°C for 20 minutes for 2 weeks (5 days/week). Physiological indicators such as blood pressure, percutaneous oxygen saturation, pulse, tympanic temperature, and sleep time and efficiency were assessed. Cognitive function and behavioral and psychological symptoms of dementia were assessed using the Mini-Mental State Examination, Dementia Mood Assessment Scale, and Dementia Behavior Disturbance scale. Results Significant decreases in systolic (P steam foot spas. A significant improvement was seen in the Mini-Mental State Examination score (P steam foot baths. In this study, a control group was not used. Raters and enforcers were not blinded. Conclusion The results of this pilot study suggest that steam foot spas mitigate cognitive impairment in geriatric inpatients. PMID:23717038

  17. Dynamic response function and large-amplitude dissipative collective motion

    International Nuclear Information System (INIS)

    Wu Xizhen; Zhuo Yizhong; Li Zhuxia; Sakata, Fumihiko.

    1993-05-01

    Aiming at exploring microscopic dynamics responsible for the dissipative large-amplitude collective motion, the dynamic response and correlation functions are introduced within the general theory of nuclear coupled-master equations. The theory is based on the microscopic theory of nuclear collective dynamics which has been developed within the time-dependent Hartree-Fock (TDHF) theory for disclosing complex structure of the TDHF-manifold. A systematic numerical method for calculating the dynamic response and correlation functions is proposed. By performing numerical calculation for a simple model Hamiltonian, it is pointed out that the dynamic response function gives an important information in understanding the large-amplitude dissipative collective motion which is described by an ensemble of trajectories within the TDHF-manifold. (author)

  18. The foot and ankle

    International Nuclear Information System (INIS)

    Berquist, T.H.

    1985-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chin Robin

    2009-06-01

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

  20. [Digital gigantism of the foot: a clinical study of 12 cases].

    Science.gov (United States)

    Wang, Hai-hua; Tian, Guang-lei; Zhu, Yin; Zhang, You-le; Zhao, Jun-hui; Tian, Wen

    2008-03-15

    To summarize the clinical characteristic and outcome of digital gigantism of the foot. Retrospectively analyze the clinical documents of cases of digital gigantism of the foot. Twelve 12 cases with 13 feet in this study included 8 male and 4 female with an average 4.6-years-old. All the deformities were found at birth. Multiple toes involved were more than single toe, and tibial toe involved more than fibular. Forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all cases in the operation which infiltrated interossei and articular capsules. The appearance of the nerves and its branches in the foot were normal and fat infiltrating was not discovered. The operation types included debulking, epiphyseal arrest, amputation, nerve stripping and anastomosis. Seven cases were followed up with mean periods 25.6 months. Functional evaluation according to a criterion formulated by author revealed a result of 2 excellent, 2 good and 3 fair. Digital gigantism of the foot is an uncommon congenital deformity of the foot characterized by overgrowth of both the soft-tissue and the osseous elements of the enlarged toe and forefoot. Surgical treatment is the unique method, and the goal is to reduce the size of the foot to allow fitting regular shoes and walking readily. There are several types of operations which to be chosen. The indication, the timing of operative intervention and the selection of operation type should be paid more attention.

  1. Dynamics of solar magnetic fields. VI. Force-free magnetic fields and motions of magnetic foot-points

    International Nuclear Information System (INIS)

    Low, B.C.; Nakagawa, Y.

    1975-01-01

    A mathematical model is developed to consider the evolution of force-free magnetic fields in relation to the displacements of their foot-points. For a magnetic field depending on only two Cartesian coordinates and time, the problem reduces to solving a nonlinear elliptic partial differential equation. As illustration of the physical process, two specific examples of evolving force-free magnetic fields are examined in detail, one evolving with rising and the other with descending field lines. It is shown that these two contrasting behaviors of the field lines correspond to sheared motions of their foot-points of quite different characters. The physical implications of these two examples of evolving force-free magnetic fields are discussed. (auth)

  2. Putting the “dynamic” back into dynamic functional connectivity

    Directory of Open Access Journals (Sweden)

    Stewart Heitmann

    2018-06-01

    Full Text Available The study of fluctuations in time-resolved functional connectivity is a topic of substantial current interest. As the term “dynamic functional connectivity” implies, such fluctuations are believed to arise from dynamics in the neuronal systems generating these signals. While considerable activity currently attends to methodological and statistical issues regarding dynamic functional connectivity, less attention has been paid toward its candidate causes. Here, we review candidate scenarios for dynamic (functional connectivity that arise in dynamical systems with two or more subsystems; generalized synchronization, itinerancy (a form of metastability, and multistability. Each of these scenarios arises under different configurations of local dynamics and intersystem coupling: We show how they generate time series data with nonlinear and/or nonstationary multivariate statistics. The key issue is that time series generated by coupled nonlinear systems contain a richer temporal structure than matched multivariate (linear stochastic processes. In turn, this temporal structure yields many of the phenomena proposed as important to large-scale communication and computation in the brain, such as phase-amplitude coupling, complexity, and flexibility. The code for simulating these dynamics is available in a freeware software platform, the Brain Dynamics Toolbox. The study of network fluctuations in time-resolved functional connectivity is a topic of substantial current interest. However, the topic remains hotly disputed, with both positive and negative reports. A number of fundamental issues remain disputed, including statistical benchmarks and putative causes of nonstationarities. Dynamic models of large-scale brain activity can play a key role in this field by proposing the types of instabilities and dynamics that may be present. The purpose of the present paper is to employ simple dynamic models to illustrate the basic processes (“primitives” that

  3. Avoiding foot complications in diabetes

    African Journals Online (AJOL)

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

  4. Foot, leg, and ankle swelling

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Swerissen Hal

    2009-02-01

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

  6. Foot ulcer risk and location in relation to prospective clinical assessment of foot shape and mobility among persons with diabetes.

    Science.gov (United States)

    Cowley, Matthew S; Boyko, Edward J; Shofer, Jane B; Ahroni, Jessie H; Ledoux, William R

    2008-11-01

    We assessed baseline clinical foot shape for 2939 feet of diabetic subjects who were monitored prospectively for foot ulceration. Assessments included hammer/claw toes, hallux valgus, hallux limitus, prominent metatarsal heads, bony prominences, Charcot deformity, plantar callus, foot type, muscle atrophy, ankle and hallux mobility, and neuropathy. Risk factors were linked to ulcer occurrence and location via a Cox proportional hazards model. Hammer/claw toes (hazard ratio [HR] (95% confidence interval [CI])=1.43 (1.06, 1.94) p=0.02), marked hammer/claw toes (HR=1.77 (1.18, 2.66) p=0.006), bony prominences (HR=1.38 (1.02, 1.88), p=0.04), and foot type (Charcot or drop foot vs. neutrally aligned) (HR=2.34 (1.33, 4.10), p=0.003) were significant risk factors for ulceration adjusting for age, body mass index, insulin medication, ulcer history and amputation history. With adjustment for neuropathy only hammer/claw toes (HR=1.40 (1.03, 1.90), p=0.03) and foot type (HR=1.76 (1.04, 3.04), p=0.05) were significantly related to ulceration. However, there was no relationship between ulcer location and foot deformity. Certain foot deformities were predictive of ulceration, although there was no relationship between clinical foot deformity and ulcer location.

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

    Directory of Open Access Journals (Sweden)

    Hendry Gordon J

    2009-06-01

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

  8. Capacidade funcional dos pacientes com diabetes mellitus e pé ulcerado Capacidad funcional de pacientes con diabetes mellitus y pié ulcerado Functional capability of patients with diabetes with foot ulceration

    Directory of Open Access Journals (Sweden)

    Geraldo Magela Salomé

    2009-01-01

    Full Text Available OBJETIVO: Avaliar a capacidade funcional de pessoas com diabetes mellitus e pé ulcerado. MÉTODOS: Estudo analítico, transversal e comparativo, realizado em hospital público do município de São Paulo, sendo os dados coletados no período de 2 de junho a 30 julho de 2008. Foram selecionados para compor o Grupo de Estudo, 20 pacientes com diabetes mellitus e pé ulcerado; para o Grupo Controle 20 pessoas com diagnóstico médico de diabetes mellitus, sem úlcera no pé. O instrumento utilizado foi Health Assessment Questionnaire-20. RESULTADOS: O grupo estudo diferiu do grupo controle, quanto ao escores HAQ-20, bem como em relação aos componentes 1,2,3,5,6,7 e 8. Também apresentaram diferença estatística significante (POBJETIVO: Evaluar la capacidad funcional de personas con diabetes mellitus y pié ulcerado. MÉTODOS: Se trata de un estudio analítico, transversal y comparativo, realizado en un hospital público del municipio de Sao Paulo, cuyos datos fueron recolectados en el período del 2 de junio al 30 julio del 2008. Fueron seleccionados para componer el Grupo de Estudio, 20 pacientes con diabetes mellitus y pié ulcerado; para el Grupo Control 20 personas con diagnóstico médico de diabetes mellitus, sin úlcera en el pié. El instrumento utilizado fue el Health Assessment Questionnaire-20. RESULTADOS: El grupo de estudio difirió del grupo control, en cuanto a los escores HAQ-20, así como en relación a los componentes 1,2,3,5,6,7 y 8. También presentaron diferencia estadísticamente significativa (POBJECTIVE: To evaluate and compare the functional capability of patients with diabetes with foot ulceration and patients with diabetes without foot ulceration. METHODS: A cross sectional descriptive comparative study was conducted in a public hospital in the district of São Paulo. The sample consisted of 20 patients with foot ulceration and 20 patients without foot ulceration. Data were collected from June 2 to July 30, 2008. The

  9. Pathophysiology diabetic foot ulcer

    Science.gov (United States)

    Syafril, S.

    2018-03-01

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

  10. Reliability of ultrasound for measurement of selected foot structures.

    Science.gov (United States)

    Crofts, G; Angin, S; Mickle, K J; Hill, S; Nester, C J

    2014-01-01

    Understanding the relationship between the lower leg muscles, foot structures and function is essential to explain how disease or injury may relate to changes in foot function and clinical pathology. The aim of this study was to investigate the inter-operator reliability of an ultrasound protocol to quantify features of: rear, mid and forefoot sections of the plantar fascia (PF); flexor hallucis brevis (FHB); flexor digitorum brevis (FDB); abductor hallucis (AbH); flexor digitorum longus (FDL); flexor hallucis longus (FHL); tibialis anterior (TA); and peroneus longus and brevis (PER). A sample of 6 females and 4 males (mean age 29.1 ± 7.2 years, mean BMI 25.5 ± 4.8) was recruited from a university student and staff population. Scans were obtained using a portable Venue 40 musculoskeletal ultrasound system (GE Healthcare UK) with a 5-13 MHz wideband linear array probe with a 12.7 mm × 47.1mm footprint by two operators in the same scanning session. Intraclass Correlation Coefficients (ICC) values for muscle thickness (ICC range 0.90-0.97), plantar fascia thickness (ICC range 0.94-0.98) and cross sectional muscle measurements (ICC range 0.91-0.98) revealed excellent inter-operator reliability. The limits of agreement, relative to structure size, ranged from 9.0% to 17.5% for muscle thickness, 11.0-18.0% for plantar fascia, and 11.0-26.0% for cross sectional area measurements. The ultrasound protocol implemented in this work has been shown to be reliable. It therefore offers the opportunity to quantify the structures concerned and better understand their contributions to foot function. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2013-10-01

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

  12. Ankle foot orthosis-footwear combination tuning: an investigation into common clinical practice in the United Kingdom.

    Science.gov (United States)

    Eddison, Nicola; Chockalingam, Nachiappan; Osborne, Stephen

    2015-04-01

    Ankle foot orthoses are used to treat a wide variety of gait pathologies. Ankle foot orthosis-footwear combination tuning should be routine clinical practice when prescribing an ankle foot orthosis. Current research suggests that failure to tune ankle foot orthosis-footwear combinations can lead to immediate detrimental effect on function, and in the longer term, it may actually contribute to deterioration. The purpose of this preliminary study was to identify the current level of knowledge clinicians have in the United Kingdom regarding ankle foot orthosis-footwear combination tuning and to investigate common clinical practice regarding ankle foot orthosis-footwear combination tuning among UK orthotists. Cross-sectional survey. A prospective study employing a multi-item questionnaire was sent out to registered orthotists and uploaded on to the official website of British Association of Prosthetists and Orthotists to be accessed by their members. A total of 41 completed questionnaires were received. The results demonstrate that only 50% of participants use ankle foot orthosis-footwear combination tuning as standard clinical practice. The most prevalent factors preventing participants from carrying out ankle foot orthosis-footwear combination tuning are a lack of access to three-dimensional gait analysis equipment (37%) and a lack of time available in their clinics (27%). Although, ankle foot orthosis-footwear combination tuning has been identified as an essential aspect of the prescription of ankle foot orthoses, the results of this study show a lack of understanding of the key principles behind ankle foot orthosis-footwear combination tuning. © The International Society for Prosthetics and Orthotics 2014.

  13. Diabetic foot ulcers. Pathophysiology, assessment, and therapy.

    OpenAIRE

    Bowering, C. K.

    2001-01-01

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

  14. Taiwanese adult foot shape classification using 3D scanning data.

    Science.gov (United States)

    Lee, Yu-Chi; Wang, Mao-Jiun

    2015-01-01

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

  15. The effect of moderate running on foot posture index and plantar pressure distribution in male recreational runners.

    Science.gov (United States)

    Escamilla-Martínez, Elena; Martínez-Nova, Alfonso; Gómez-Martín, Beatriz; Sánchez-Rodríguez, Raquel; Fernández-Seguín, Lourdes María

    2013-01-01

    Fatigue due to running has been shown to contribute to changes in plantar pressure distribution. However, little is known about changes in foot posture after running. We sought to compare the foot posture index before and after moderate exercise and to relate any changes to plantar pressure patterns. A baropodometric evaluation was made, using the FootScan platform (RSscan International, Olen, Belgium), of 30 men who were regular runners and their foot posture was examined using the Foot Posture Index before and after a 60-min continuous run at a moderate pace (3.3 m/sec). Foot posture showed a tendency toward pronation after the 60-min run, gaining 2 points in the foot posture index. The total support and medial heel contact areas increased, as did pressures under the second metatarsal head and medial heel. Continuous running at a moderate speed (3.3 m/sec) induced changes in heel strike related to enhanced pronation posture, indicative of greater stress on that zone after physical activity. This observation may help us understand the functioning of the foot, prevent injuries, and design effective plantar orthoses in sport.

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

    Science.gov (United States)

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

    2017-08-01

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

  17. Ambulatory Function and Perception of Confidence in Persons with Stroke with a Custom-Made Hinged versus a Standard Ankle Foot Orthosis

    Directory of Open Access Journals (Sweden)

    Angélique Slijper

    2012-01-01

    Full Text Available Objective. The aim was to compare walking with an individually designed dynamic hinged ankle foot orthosis (DAFO and a standard carbon composite ankle foot orthosis (C-AFO. Methods. Twelve participants, mean age 56 years (range 26–72, with hemiparesis due to stroke were included in the study. During the six-minute walk test (6MW, walking velocity, the Physiological Cost Index (PCI, and the degree of experienced exertion were measured with a DAFO and C-AFO, respectively, followed by a Stairs Test velocity and perceived confidence was rated. Results. The mean differences in favor for the DAFO were in 6MW 24.3 m (95% confidence interval [CI] 4.90, 43.76, PCI −0.09 beats/m (95% CI −0.27, 0.95, velocity 0.04 m/s (95% CI −0.01, 0.097, and in the Stairs Test −11.8 s (95% CI −19.05, −4.48. All participants except one perceived the degree of experienced exertion lower and felt more confident when walking with the DAFO. Conclusions. Wearing a DAFO resulted in longer walking distance and faster stair climbing compared to walking with a C-AFO. Eleven of twelve participants felt more confident with the DAFO, which may be more important than speed and distance and the most important reason for prescribing an AFO.

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

    Science.gov (United States)

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

    2016-04-19

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

  19. Features force between the foot and performance of special-based tests young basketball players

    Directory of Open Access Journals (Sweden)

    S.V. Stroganov

    2013-12-01

    Full Text Available Purpose . A quantitative analysis of biomechanical force interactions between the foot and the support when the athletes special tests. Material and methods . In the experiment involved 30 young athletes aged 7-8 years who are at the stage of initial training. Subjects performed four tests: jump up from their seats repulsion two feet, jump up and down with one foot repulsion run, stop step, jump stop. Results . As a result of studies to obtain quantitative values of reference indices interactions as the maximum reaction force impulse force, force gradient, the reference duration, and other interactions. Revealed that when jumping forward and upward to run and jump and step stops the horizontal component of force production is from 38 to 73 % of the resulting value. Conclusions . Significant power load on the musculoskeletal system and in particular the foot of young basketball players can lead to abnormalities in the foot. In connection with what the training process should include funds for the correction and prevention of foot function.

  20. Vertical Profunda Artery Perforator Flap for Plantar Foot Wound Closure: A New Application.

    Science.gov (United States)

    Alfonso, Allyson R; Mayo, James L; Sharma, Vishal K; Allen, Robert J; Chiu, Ernest S

    2018-02-01

    Plantar foot reconstruction requires special consideration of both form and function. There are several fasciocutaneous flap options, each with indications and reservations. This case presents a new application of the vertical profunda artery perforator flap for definitive closure of a neuropathic foot ulcer in a young woman with spina bifida. The postoperative course was uneventful, and the flap survived completely. The surgical and donor sites were without wound recurrence at 5-month follow-up. Understanding the variability of foot flap options is important because of unique cases such as the one presented where the wound was caused by specific and less commonly observed foot anatomy. The specific choice to use the vertical profunda artery perforator flap for this patient and her neuropathic wound type was made based on its excellent flexibility, durability, and donor site appeal. The vertical profunda artery perforator flap has adequate surface area and bulk and a favorable pedicle length and caliber, can be thinned, and leaves a donor scar in a less conspicuous area than other popular free flaps for lower-extremity reconstruction. For these reasons, it should be considered a first-line therapy for free flap coverage of selected foot wounds.

  1. [Foot reflexology massage: a clinical study].

    Science.gov (United States)

    Kesselring, A

    1999-02-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

  3. Foot loading with an ankle-foot orthosis: the accuracy of an integrated physical strain trainer.

    Science.gov (United States)

    Pauser, Johannes; Jendrissek, Andreas; Brem, Matthias; Gelse, Kolja; Swoboda, Bernd; Carl, Hans-Dieter

    2012-07-01

    To investigate the value of a built-in physical strain trainer for the monitoring of partial weight bearing with an ankle-foot orthosis. 12 healthy volunteers were asked to perform three trials. Plantar peak pressure values from normal gait (trial one) were defined as 100% (baseline). The following trials were performed with the Vacoped® dynamic vacuum ankle orthosis worn in a neutral position with full weight bearing (trial two) and a restriction to 10% body weight (BW) (trial three), as monitored with an integrated physical strain trainer. Peak plantar pressure values were obtained using the pedar® X system. Peak pressure values were statistically significantly reduced wearing the Vacoped® shoe with full weight bearing for the hindfoot to 68% of the baseline (normal gait) and for the midfoot and forefoot to 83% and 60%, respectively. Limited weight bearing with 10% BW as controlled by physical strain trainer further reduced plantar peak pressure values for the hindfoot to 19%, for the midfoot to 43% of the baseline and the forefoot to 22% of the baseline. The Vacoped® vacuum ankle orthosis significantly reduces plantar peak pressure. The integrated physical strain trainer seems unsuitable to monitor a limitation to 10% BW adequately for the total foot. The concept of controlling partial weight bearing with the hindfoot-addressing device within the orthosis seems debatable but may be useful when the hindfoot in particular must be off-loaded.

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

    Science.gov (United States)

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

    2010-01-01

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

  5. A local dynamic correlation function from inelastic neutron scattering

    International Nuclear Information System (INIS)

    McQueeney, R.J.

    1997-01-01

    Information about local and dynamic atomic correlations can be obtained from inelastic neutron scattering measurements by Fourier transform of the Q-dependent intensity oscillations at a particular frequency. A local dynamic structure function, S(r,ω), is defined from the dynamic scattering function, S(Q,ω), such that the elastic and frequency-integrated limits correspond to the average and instantaneous pair-distribution functions, respectively. As an example, S(r,ω) is calculated for polycrystalline aluminum in a model where atomic motions are entirely due to harmonic phonons

  6. Narrative review: Diabetic foot and infrared thermography

    Science.gov (United States)

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

    2016-09-01

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

  7. Predicting individual brain maturity using dynamic functional connectivity

    Directory of Open Access Journals (Sweden)

    Jian eQin

    2015-07-01

    Full Text Available Neuroimaging-based functional connectivity (FC analyses have revealed significant developmental trends in specific intrinsic connectivity networks linked to cognitive and behavioral maturation. However, knowledge of how brain functional maturation is associated with FC dynamics at rest is limited. Here, we examined age-related differences in the temporal variability of FC dynamics with data publicly released by the Nathan Kline Institute (NKI (n=183, ages 7-30 and showed that dynamic inter-region interactions can be used to accurately predict individual brain maturity across development. Furthermore, we identified a significant age-dependent trend underlying dynamic inter-network FC, including increasing variability of the connections between the visual network, default mode network (DMN and cerebellum as well as within the cerebellum and DMN and decreasing variability within the cerebellum and between the cerebellum and DMN as well as the cingulo-opercular network. Overall, the results suggested significant developmental changes in dynamic inter-network interaction, which may shed new light on the functional organization of typical developmental brains.

  8. [Relationships between foot problems, fall experience and fear of falling among Japanese community-dwelling elderly].

    Science.gov (United States)

    Harada, Kazuhiro; Oka, Koichiro; Shibata, Ai; Kaburagi, Hironobu; Nakamura, Yoshio

    2010-08-01

    Although a foot care program for long-term care prevention has been launched in Japan, few studies have examined its effectiveness. The purpose of the present investigation was to examine the association of foot problems with fall experience and fear of falling among Japanese community-dwelling elderly people. The participants were 10,581 community-dwelling elderly people (75.2 +/- 5.6 years) and the study design was cross-sectional using a questionnaire. Self-reported tinea pedis, skin problems (inflammation, swelling, or discoloration), nail problems (thickening or deformities), impairment (in function or blood flow), regular foot care, and wearing of appropriate shoes were selected as parameters of foot problems and their care. Logistic regression analysis was conducted to examine whether these were related to fall experience (in the past 1 year) and fear of falling adjusted for age, the Tokyo Metropolitan institute of gerontology index of competence, medical conditions, and lower limb functions. Forty-six percents of males and 39.0% of females reported at least one foot problem. After adjusting for covariates, tinea pedis (male: adjusted odds ratio = 1.37[95% confidence interval= 1.15-1.63], female: 1.29[1.08-1.53]), skin problems (male: 1.66[1.32-2.101, female: 1.37[1.13-1.66]), nail problems (male: 1.72[1.45-2.051, female: 1.48[1.26-1.74]), and functional impairment (male: 2.42[1.91-3.05], female: 1.66[1.36-2.04]) were significantly associated with fall experience. Also, each problem was negatively associated with fear of falling (tinea pedis[male: 1.37 [1.15-1.62], female: 1.25[1.07-1.47

  9. Foot burns: epidemiology and management.

    Science.gov (United States)

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

    2007-12-01

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

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

    LENUS (Irish Health Repository)

    Hurley, L

    2013-09-25

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

  11. Real-time feedback of dynamic foot pressure index for gait training of toe-walking children with spastic diplegia.

    Science.gov (United States)

    Pu, Fang; Ren, Weiyan; Fan, Xiaoya; Chen, Wei; Li, Shuyu; Li, Deyu; Wang, Yu; Fan, Yubo

    2017-09-01

    The aim of this study was to determine whether and how real-time feedback of dynamic foot pressure index (DFPI) could be used to correct toe-walking gait in spastic diplegic children with dynamic equinus. Thirteen spastic diplegic children with dynamic equinus were asked to wear a monitoring device to record their ambulation during daily gait, conventional training gait, and feedback training gait. Parameters based on their DFPI and stride duration were compared among the three test conditions. The results with feedback training were significantly better for all DFPI parameters in comparison to patients' daily gait and showed significant improvements in DFPI for toe-walking gait and percentage of normal gait in comparison to conventional training methods. Moreover, stride duration under two training gaits was longer than patient's daily gait, but there was no significant difference between the two training gaits. Although the stride duration for the two training gaits was similar, gait training with real-time feedback of DFPI did produce noticeably superior results by increasing heel-loading impulse of toe-walking gait and percentage of normal gait in comparison to convention training methods. However, its effectiveness was still impacted by the motion limitations of diplegic children. Implications for Rehabilitation The DFPI-based gait training feedback system introduced in this study was shown to be more effective at toe-walking gait rehabilitation training over conventional training methods. The feedback system accomplished superior improvement in correcting toe-walking gait, but its effectiveness in an increasing heel-loading impulse in normal gait was still limited by the motion limitations of diplegic children. Stride duration of normal gait and toe-walking gait was similar under conventional and feedback gait training.

  12. Analysis of NASA Common Research Model Dynamic Data

    Science.gov (United States)

    Balakrishna, S.; Acheson, Michael J.

    2011-01-01

    Recent NASA Common Research Model (CRM) tests at the Langley National Transonic Facility (NTF) and Ames 11-foot Transonic Wind Tunnel (11-foot TWT) have generated an experimental database for CFD code validation. The database consists of force and moment, surface pressures and wideband wing-root dynamic strain/wing Kulite data from continuous sweep pitch polars. The dynamic data sets, acquired at 12,800 Hz sampling rate, are analyzed in this study to evaluate CRM wing buffet onset and potential CRM wing flow separation.

  13. Network structure shapes spontaneous functional connectivity dynamics.

    Science.gov (United States)

    Shen, Kelly; Hutchison, R Matthew; Bezgin, Gleb; Everling, Stefan; McIntosh, Anthony R

    2015-04-08

    The structural organization of the brain constrains the range of interactions between different regions and shapes ongoing information processing. Therefore, it is expected that large-scale dynamic functional connectivity (FC) patterns, a surrogate measure of coordination between brain regions, will be closely tied to the fiber pathways that form the underlying structural network. Here, we empirically examined the influence of network structure on FC dynamics by comparing resting-state FC (rsFC) obtained using BOLD-fMRI in macaques (Macaca fascicularis) to structural connectivity derived from macaque axonal tract tracing studies. Consistent with predictions from simulation studies, the correspondence between rsFC and structural connectivity increased as the sample duration increased. Regions with reciprocal structural connections showed the most stable rsFC across time. The data suggest that the transient nature of FC is in part dependent on direct underlying structural connections, but also that dynamic coordination can occur via polysynaptic pathways. Temporal stability was found to be dependent on structural topology, with functional connections within the rich-club core exhibiting the greatest stability over time. We discuss these findings in light of highly variable functional hubs. The results further elucidate how large-scale dynamic functional coordination exists within a fixed structural architecture. Copyright © 2015 the authors 0270-6474/15/355579-10$15.00/0.

  14. Foot positioning instruction, initial vertical load position and lifting technique: effects on low back loading

    NARCIS (Netherlands)

    Kingma, I.; Bosch, T.; Bruins, L.; van Dieen, J.H.

    2004-01-01

    This study investigated the effects of initial load height and foot placement instruction in four lifting techniques: free, stoop (bending the back), squat (bending the knees) and a modified squat technique (bending the knees and rotating them outward). A 2D dynamic linked segment model was combined

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

    Directory of Open Access Journals (Sweden)

    Borthwick Alan M

    2008-07-01

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

  16. Dynamical density functional theory for dense atomic liquids

    International Nuclear Information System (INIS)

    Archer, A J

    2006-01-01

    Starting from Newton's equations of motion, we derive a dynamical density functional theory (DDFT) applicable to atomic liquids. The theory has the feature that it requires as input the Helmholtz free energy functional from equilibrium density functional theory. This means that, given a reliable equilibrium free energy functional, the correct equilibrium fluid density profile is guaranteed. We show that when the isothermal compressibility is small, the DDFT generates the correct value for the speed of sound in a dense liquid. We also interpret the theory as a dynamical equation for a coarse grained fluid density and show that the theory can be used (making further approximations) to derive the standard mode coupling theory that is used to describe the glass transition. The present theory should provide a useful starting point for describing the dynamics of inhomogeneous atomic fluids

  17. Foot and ankle problems in Thai monks.

    Science.gov (United States)

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

    2015-01-01

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

  18. Foot and ankle problems in Muay Thai kickboxers.

    Science.gov (United States)

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

    2015-01-01

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

  19. [Effects of foot reflexology on essential hypertension patients].

    Science.gov (United States)

    Park, Hyoung-Sook; Cho, Gyoo-Yeong

    2004-08-01

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

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

    NARCIS (Netherlands)

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

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

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

    Science.gov (United States)

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

    2015-04-01

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

  2. Analysis of Uncertainty in Dynamic Processes Development of Banks Functioning

    Directory of Open Access Journals (Sweden)

    Aleksei V. Korovyakovskii

    2013-01-01

    Full Text Available The paper offers the approach to measure of uncertainty estimation in dynamic processes of banks functioning, using statistic data of different banking operations indicators. To calculate measure of uncertainty in dynamic processes of banks functioning the phase images of relevant sets of statistic data are considered. Besides, it is shown that the form of phase image of the studied sets of statistic data can act as a basis of measure of uncertainty estimation in dynamic processes of banks functioning. The set of analytical characteristics are offered to formalize the form of phase image definition of the studied sets of statistic data. It is shown that the offered analytical characteristics consider inequality of changes in values of the studied sets of statistic data, which is one of the ways of uncertainty display in dynamic processes development. The invariant estimates of measure of uncertainty in dynamic processes of banks functioning, considering significant changes in absolute values of the same indicators for different banks were obtained. The examples of calculation of measure of uncertainty in dynamic processes of concrete banks functioning were cited.

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

    Science.gov (United States)

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

    2014-03-01

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

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

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    parvane bazipoor

    2017-03-01

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

  5. Hand, Foot, and Mouth Disease

    Centers for Disease Control (CDC) Podcasts

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

  6. What is the diabetic foot?

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2010-02-01

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

  8. Coupling functions: Universal insights into dynamical interaction mechanisms

    Science.gov (United States)

    Stankovski, Tomislav; Pereira, Tiago; McClintock, Peter V. E.; Stefanovska, Aneta

    2017-10-01

    The dynamical systems found in nature are rarely isolated. Instead they interact and influence each other. The coupling functions that connect them contain detailed information about the functional mechanisms underlying the interactions and prescribe the physical rule specifying how an interaction occurs. A coherent and comprehensive review is presented encompassing the rapid progress made recently in the analysis, understanding, and applications of coupling functions. The basic concepts and characteristics of coupling functions are presented through demonstrative examples of different domains, revealing the mechanisms and emphasizing their multivariate nature. The theory of coupling functions is discussed through gradually increasing complexity from strong and weak interactions to globally coupled systems and networks. A variety of methods that have been developed for the detection and reconstruction of coupling functions from measured data is described. These methods are based on different statistical techniques for dynamical inference. Stemming from physics, such methods are being applied in diverse areas of science and technology, including chemistry, biology, physiology, neuroscience, social sciences, mechanics, and secure communications. This breadth of application illustrates the universality of coupling functions for studying the interaction mechanisms of coupled dynamical systems.

  9. Diabetic Foot Complications Despite Successful Pancreas Transplantation.

    Science.gov (United States)

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

    2017-06-01

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

  10. Bearing capacity of Skirt circular footing on sand

    Directory of Open Access Journals (Sweden)

    Amr Z. EL Wakil

    2013-09-01

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

  11. Principles of management of vascular problems in the diabetic foot

    African Journals Online (AJOL)

    atherosclerosis is the most important principle in the management ... Lynne Tudhope is President of the Diabetic Foot Working Group of South Africa and ... functional and physiological status belies ... contrast volume is always of paramount .... the adequacy of blood circulation to ... population costs the health care system of.

  12. Two-Segment Foot Model for the Biomechanical Analysis of Squat.

    Science.gov (United States)

    Panero, E; Gastaldi, L; Rapp, W

    2017-01-01

    Squat exercise is acquiring interest in many fields, due to its benefits in improving health and its biomechanical similarities to a wide range of sport motions and the recruitment of many body segments in a single maneuver. Several researches had examined considerable biomechanical aspects of lower limbs during squat, but not without limitations. The main goal of this study focuses on the analysis of the foot contribution during a partial body weight squat, using a two-segment foot model that considers separately the forefoot and the hindfoot. The forefoot and hindfoot are articulated by the midtarsal joint. Five subjects performed a series of three trials, and results were averaged. Joint kinematics and dynamics were obtained using motion capture system, two force plates closed together, and inverse dynamics techniques. The midtarsal joint reached a dorsiflexion peak of 4°. Different strategies between subjects revealed 4° supination and 2.5° pronation of the forefoot. Vertical GRF showed 20% of body weight concentrated on the forefoot and 30% on the hindfoot. The percentages varied during motion, with a peak of 40% on the hindfoot and correspondently 10% on the forefoot, while the traditional model depicted the unique constant 50% value. Ankle peak of plantarflexion moment, power absorption, and power generation was consistent with values estimated by the one-segment model, without statistical significance.

  13. Two-Segment Foot Model for the Biomechanical Analysis of Squat

    Directory of Open Access Journals (Sweden)

    E. Panero

    2017-01-01

    Full Text Available Squat exercise is acquiring interest in many fields, due to its benefits in improving health and its biomechanical similarities to a wide range of sport motions and the recruitment of many body segments in a single maneuver. Several researches had examined considerable biomechanical aspects of lower limbs during squat, but not without limitations. The main goal of this study focuses on the analysis of the foot contribution during a partial body weight squat, using a two-segment foot model that considers separately the forefoot and the hindfoot. The forefoot and hindfoot are articulated by the midtarsal joint. Five subjects performed a series of three trials, and results were averaged. Joint kinematics and dynamics were obtained using motion capture system, two force plates closed together, and inverse dynamics techniques. The midtarsal joint reached a dorsiflexion peak of 4°. Different strategies between subjects revealed 4° supination and 2.5° pronation of the forefoot. Vertical GRF showed 20% of body weight concentrated on the forefoot and 30% on the hindfoot. The percentages varied during motion, with a peak of 40% on the hindfoot and correspondently 10% on the forefoot, while the traditional model depicted the unique constant 50% value. Ankle peak of plantarflexion moment, power absorption, and power generation was consistent with values estimated by the one-segment model, without statistical significance.

  14. Research Paper: Evaluation of the Effects of Two Types of Foot Rockers on the Temporal-Spatial Gait Parameters in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Zeinab Rezaeian

    2016-07-01

    Conclusion The results of this study showed that the force-time integral of vertical component of the ground reaction force increased significantly in subjects with diabetes, which is the main cause of foot ulcers. Although, heel and toe rockers did not influence the force applied to the foot or the force-time integral, it is recommended to use rocker shoes with wide base of support to increase the dynamic stability while decreasing the foot pressure. The main limitation is that the immediate effect of use of rocker was studies in this study . It is recommended to check the effect of rockers interventions after a certain period of their use.

  15. Foot shape and its effect on functioning in Royal Australian Air Force recruits. Part 2: Pilot, randomized, controlled trial of orthotics in recruits with flat feet.

    Science.gov (United States)

    Esterman, Adrian; Pilotto, Louis

    2005-07-01

    As part of a larger study of the effect of foot shape on functioning, 47 Royal Australian Air Force recruits with flexible flat feet who were embarking on a 10-week basic training course took part in a randomized controlled trial of orthotic therapy. In particular, recruits were assigned at random to an untreated group or a group that received Australian Orthotics Laboratory, three-quarter-length, flexible, shoe inserts. The groups were assessed at baseline and week 8. Outcome measures included pain, injury, foot health, and quality of life. The untreated group (n = 22) had a greater proportion of heavier recruits than did the treated group (n = 25). There were no significant differences in outcome measures at baseline. Only one-half of the group assigned to orthotic therapy wore the orthotics most or all of the time. At the end of the trial, although the results were not statistically significant, those who were provided with orthotics and wore them had the least lower limb pain and the best general foot health and quality of life. Notably, none of the recruits who wore their orthotics most or all of the time sustained a training injury.

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

    Science.gov (United States)

    Nolan, Karen J; Yarossi, Mathew

    2011-03-01

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

  17. Quality of Life Impact Related to Foot Health in a Sample of Older People with Hallux Valgus

    Science.gov (United States)

    López, Daniel López; Callejo González, Lucía; Iglesias, Marta Elena Losa; Canosa, Jesús Luis Saleta; Sanz, David Rodríguez; Lobo, Cesar Calvo; de Bengoa Vallejo, Ricardo Becerro

    2016-01-01

    Hallux Valgus (HV) is a highly prevalent forefoot deformity in older people associated with progressive subluxation and osteoarthritis of the first metatarsophalangeal (MTP) joint and it is believed to be associated with varying degrees of HV effect on the quality of life related to foot health. The aim of this study is to compare the impact of varying degrees of HV on foot health in a sample of older people. The sample consisted of 115 participants, mean age 76.7 ± 9.1, who attended an outpatient center where self-report data were recorded. The degree of HV deformity was determined in both feet using the Manchester Scale (MS) from stage 1 (mild) to 4 (very severe). Scores obtained on the Foot Health Status Questionnaire (FHSQ) were compared. This has 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The stage 4 of HV shown lower scores for the footwear domain (11.23 ± 15.6); general foot health (27.62 ± 19.1); foot pain (44.65 ± 24.5); foot function (53.04 ± 27.2); vigour (42.19 ± 16.8); social capacity (44.46 ± 28.1); and general health (41.15 ± 25.5) compared with stage 1 of HV (Phallux valgus deformity which appears to be associated with the presence of greater degree of HV, regardless of gender. PMID:26816663

  18. Holographic interferometry for early diagnosisof children flat foot

    Directory of Open Access Journals (Sweden)

    Oleg Petrovich Bolshakov

    2015-03-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  20. An information theory framework for dynamic functional domain connectivity.

    Science.gov (United States)

    Vergara, Victor M; Miller, Robyn; Calhoun, Vince

    2017-06-01

    Dynamic functional network connectivity (dFNC) analyzes time evolution of coherent activity in the brain. In this technique dynamic changes are considered for the whole brain. This paper proposes an information theory framework to measure information flowing among subsets of functional networks call functional domains. Our method aims at estimating bits of information contained and shared among domains. The succession of dynamic functional states is estimated at the domain level. Information quantity is based on the probabilities of observing each dynamic state. Mutual information measurement is then obtained from probabilities across domains. Thus, we named this value the cross domain mutual information (CDMI). Strong CDMIs were observed in relation to the subcortical domain. Domains related to sensorial input, motor control and cerebellum form another CDMI cluster. Information flow among other domains was seldom found. Other methods of dynamic connectivity focus on whole brain dFNC matrices. In the current framework, information theory is applied to states estimated from pairs of multi-network functional domains. In this context, we apply information theory to measure information flow across functional domains. Identified CDMI clusters point to known information pathways in the basal ganglia and also among areas of sensorial input, patterns found in static functional connectivity. In contrast, CDMI across brain areas of higher level cognitive processing follow a different pattern that indicates scarce information sharing. These findings show that employing information theory to formally measured information flow through brain domains reveals additional features of functional connectivity. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    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 diabetic foot patients wearing fully customized footwear. Regions of interest (with peak pressure >200 kPa) were selected and targeted for pressure optimization by modifying the shoe or insole. After each of a maximum of three rounds of modifications, the effect on in-shoe plantar pressure was measured. Successful optimization was achieved with a peak pressure reduction of >25% (criterion A) or below an absolute level of 200 kPa (criterion B). RESULTS In 35 defined regions, mean peak pressure was significantly reduced from 303 (SD 77) to 208 (46) kPa after an average 1.6 rounds of footwear modifications (P diabetic foot. This result provides an objective approach to instantly improve footwear quality, which should reduce the risk for pressure-related plantar foot ulcers. PMID:21610125

  2. CLINICOMICROBIOLOGICAL STUDY OF DIABETIC FOOT ULCERS

    Directory of Open Access Journals (Sweden)

    Nirmal Kumar Palaniappan

    2017-11-01

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

  3. Increased plantar foot pressure in persons affected by leprosy

    NARCIS (Netherlands)

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

    2012-01-01

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

  4. Effects of spinal cord injury-induced changes in muscle activation on foot drag in a computational rat ankle model.

    Science.gov (United States)

    Hillen, Brian K; Jindrich, Devin L; Abbas, James J; Yamaguchi, Gary T; Jung, Ranu

    2015-04-01

    Spinal cord injury (SCI) can lead to changes in muscle activation patterns and atrophy of affected muscles. Moderate levels of SCI are typically associated with foot drag during the swing phase of locomotion. Foot drag is often used to assess locomotor recovery, but the causes remain unclear. We hypothesized that foot drag results from inappropriate muscle coordination preventing flexion at the stance-to-swing transition. To test this hypothesis and to assess the relative contributions of neural and muscular changes on foot drag, we developed a two-dimensional, one degree of freedom ankle musculoskeletal model with gastrocnemius and tibialis anterior muscles. Anatomical data collected from sham-injured and incomplete SCI (iSCI) female Long-Evans rats as well as physiological data from the literature were used to implement an open-loop muscle dynamics model. Muscle insertion point motion was calculated with imposed ankle trajectories from kinematic analysis of treadmill walking in sham-injured and iSCI animals. Relative gastrocnemius deactivation and tibialis anterior activation onset times were varied within physiologically relevant ranges based on simplified locomotor electromyogram profiles. No-atrophy and moderate muscle atrophy as well as normal and injured muscle activation profiles were also simulated. Positive moments coinciding with the transition from stance to swing phase were defined as foot swing and negative moments as foot drag. Whereas decreases in activation delay caused by delayed gastrocnemius deactivation promote foot drag, all other changes associated with iSCI facilitate foot swing. Our results suggest that even small changes in the ability to precisely deactivate the gastrocnemius could result in foot drag after iSCI. Copyright © 2015 the American Physiological Society.

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

    Directory of Open Access Journals (Sweden)

    Christopher R. Carcia

    2006-12-01

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

  6. Maintenance of longitudinal foot arch after different mid/hind-foot arthrodesis procedures in a cadaveric model.

    Science.gov (United States)

    Chen, Yanxi; Zhang, Kun; Qiang, Minfei; Hao, Yini

    2014-02-01

    Currently, the optimal treatment of flatfoot remains inconclusive. Our objectives were to understand the effect of different arthrodeses on maintenance of foot arch and provide experimental basis for rational selection in treatment of flatfoot. Sixteen fresh-frozen cadaver feet amputated above the ankle along with a section of leg were studied from ten males and six females. We used standard clinical techniques and hardware for making the arthrodeses. Plantar pressure in the medial and lateral longitudinal arch distribution was measured with a plantar pressure mapping system under different loading conditions. Values of plantar pressure reaction, mean and maximum dynamic peak pressure between all group pairs were statistically significant (Pfoot, compared with 1080 N after subtalar arthrodesis, 1200 N after talonavicular arthrodesis, 1080 N after calcaneocuboid arthrodesis, 1320 N after double arthrodesis, and 1560 N after triple arthrodesis. The plantar pressure reaction appeared at the load of 360 N in the lateral arch of the unoperated foot, compared with 600 N after subtalar arthrodesis, 600 N after talonavicular arthrodesis, 840 N after calcaneocuboid arthrodesis, 960 N after double arthrodesis, and 1440 N after triple arthrodesis. The triple arthrodesis provided the highest support to both arches; the double arthrodesis appeared to be similar to talonavicular arthrodesis in supporting the medial arch and similar to calcaneocuboid arthrodesis in supporting the lateral arch; subtalar arthrodesis was less effective in supporting both arches. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Management of sports injuries of the foot and ankle: An update.

    Science.gov (United States)

    Hong, C C; Pearce, C J; Ballal, M S; Calder, J D F

    2016-10-01

    Injuries to the foot in athletes are often subtle and can lead to a substantial loss of function if not diagnosed and treated appropriately. For these injuries in general, even after a diagnosis is made, treatment options are controversial and become even more so in high level athletes where limiting the time away from training and competition is a significant consideration. In this review, we cover some of the common and important sporting injuries affecting the foot including updates on their management and outcomes. Cite this article: Bone Joint J 2016;98-B:1299-1311. ©2016 The British Editorial Society of Bone & Joint Surgery.

  8. Find an Orthopaedic Foot and Ankle MD/DO

    Science.gov (United States)

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

  9. Effect of forward/backward standing posture on foot shape

    NARCIS (Netherlands)

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

    2000-01-01

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

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

    Science.gov (United States)

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

    2010-10-01

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

  11. Clinical management of acute diabetic Charcot foot in Denmark

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  12. Isolation of a substance activating foot formation in hydra

    DEFF Research Database (Denmark)

    Grimmelikhuijzen, C J; Schaller, H C

    1977-01-01

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

  13. Optimal Cost-Analysis and Design of Circular Footings

    Directory of Open Access Journals (Sweden)

    Prabir K. Basudhar

    2012-10-01

    Full Text Available The study pertains to the optimal cost-analysis and design of a circular footing subjected to generalized loadings using sequential unconstrained minimization technique (SUMT in conjunction with Powell’s conjugate direction method for multidimensional search and quadratic interpolation method for one dimensional minimization. The cost of the footing is minimized satisfying all the structural and geotechnical engineering design considerations. As extended penalty function method has been used to convert the constrained problem into an unconstrained one, the developed technique is capable of handling both feasible and infeasible initial design vector. The net saving in cost starting from the best possible manual design ranges from 10 to 20 %. For all practical purposes, the optimum cost is independent of the initial design point. It was observed that for better convergence, the transition parameter  should be chosen at least 100 times the initial penalty parameter kr .

  14. Management of diabetic foot infections

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  15. Cosmetic Foot Surgery: Fashion's Pandora's Box

    Science.gov (United States)

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

  16. Growth factors for treating diabetic foot ulcers

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  17. Reconstruction of bilateral tibial aplasia and split hand-foot syndrome in a father and daughter.

    Science.gov (United States)

    Al Kaissi, Ali; Ganger, Rudolf; Klaushofer, Klaus; Grill, Franz

    2014-01-01

    Tibial aplasia is of heterogeneous aetiology, the majority of reports are sporadic. We describe the reconstruction procedures in two subjects - a daughter and father manifested autosomal dominant (AD) inheritance of the bilateral tibial aplasia and split hand-foot syndrome. Reconstruction of these patients required multiple surgical procedures and orthoprosthesis was mandatory. The main goal of treatment was to achieve walking. Stabilization of the ankle joint by fibular-talar-chondrodesis on both sides, followed by bilateral Brown-procedure at the knee joint level has been applied accordingly. The outcome was with improved function of the deformed limbs and walking was achieved with simultaneous designation of orthotic fitting. This is the first study encompassing the diagnosis and management of a father and daughter with bilateral tibial aplasia associated with variable split hand/foot deformity without foot ablation. Our patients showed the typical AD pattern of inheritance of split-hand/foot and tibial aplasia.

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

    Science.gov (United States)

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

    2012-07-01

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

  19. Targeted quantification of functional enzyme dynamics in environmental samples for microbially mediated biogeochemical processes: Targeted quantification of functional enzyme dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Li, Minjing [School of Environmental Studies, China University of Geosciences, Wuhan 430074 People' s Republic of China; Gao, Yuqian [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Qian, Wei-Jun [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Shi, Liang [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Liu, Yuanyuan [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Nelson, William C. [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Nicora, Carrie D. [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Resch, Charles T. [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Thompson, Christopher [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Yan, Sen [School of Environmental Studies, China University of Geosciences, Wuhan 430074 People' s Republic of China; Fredrickson, James K. [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Zachara, John M. [Pacific Northwest National Laboratory, Richland, WA 99354 USA; Liu, Chongxuan [Pacific Northwest National Laboratory, Richland, WA 99354 USA; School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055 People' s Republic of China

    2017-07-13

    Microbially mediated biogeochemical processes are catalyzed by enzymes that control the transformation of carbon, nitrogen, and other elements in environment. The dynamic linkage between enzymes and biogeochemical species transformation has, however, rarely been investigated because of the lack of analytical approaches to efficiently and reliably quantify enzymes and their dynamics in soils and sediments. Herein, we developed a signature peptide-based technique for sensitively quantifying dissimilatory and assimilatory enzymes using nitrate-reducing enzymes in a hyporheic zone sediment as an example. Moreover, the measured changes in enzyme concentration were found to correlate with the nitrate reduction rate in a way different from that inferred from biogeochemical models based on biomass or functional genes as surrogates for functional enzymes. This phenomenon has important implications for understanding and modeling the dynamics of microbial community functions and biogeochemical processes in environments. Our results also demonstrate the importance of enzyme quantification for the identification and interrogation of those biogeochemical processes with low metabolite concentrations as a result of faster enzyme-catalyzed consumption of metabolites than their production. The dynamic enzyme behaviors provide a basis for the development of enzyme-based models to describe the relationship between the microbial community and biogeochemical processes.

  20. Standardizing foot-type classification using arch index values.

    Science.gov (United States)

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

    2012-01-01

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

  1. Standardizing Foot-Type Classification Using Arch Index Values

    Science.gov (United States)

    Weil, Rich; de Boer, Emily

    2012-01-01

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

  2. Athlete's Foot: Clinical Update.

    Science.gov (United States)

    Ramsey, M L

    1989-10-01

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

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

    Science.gov (United States)

    Graham, Andrea S; Williams, Anita E

    2016-03-01

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

  4. Infrared thermal imaging for automated detection of diabetic foot complications.

    Science.gov (United States)

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

    2013-09-01

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

  5. Podiatric care for diabetic patients with foot problems: an observational study.

    NARCIS (Netherlands)

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

    1999-01-01

    The aims of this study were to describe podiatric care for diabetic patients with foot problems and to explore the changes in knowledge, self-care behaviour and physical functioning after podiatric care. the treatment characteristics of 26 diabetic patients referred to podiatry were assessed. Prior

  6. Impact of plantar fasciitis on the quality of life of male and female patients according to the Foot Health Status Questionnaire

    Directory of Open Access Journals (Sweden)

    Palomo-López P

    2018-04-01

    Full Text Available Patricia Palomo-López,1 Ricardo Becerro-de-Bengoa-Vallejo,2 Marta Elena Losa-Iglesias,3 David Rodríguez-Sanz,4 César Calvo-Lobo,5 Daniel López-López6 1Department of Nursing, University Center of Plasencia, Universidad de Extremadura, Spain; 2School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Spain; 3Faculty of Health Sciences, Universidad Rey Juan Carlos, Spain; 4Physiotherapy Department, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid, Spain; 5Nursing and Physical Therapy Department, Faculty of Health Sciences, University of León, Ponferrada, León, Spain; 6Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain Background and purpose: Plantar fasciitis (PF is a foot disorder in adults secondary to an inflammatory response caused by repetitive micro-trauma. We evaluated and compared the impact on quality of life (QoL related to foot health and general health between males and females with PF. Methods: In this cross-sectional descriptive study, patients with PF were recruited from a podiatry clinic. Physical examination, sociodemographic data, and the self-reported Foot Health Status Questionnaire (FHSQ were recorded. The FHSQ has three sections and provides two composite scores from 0 to 100. Higher scores (close to 100 reflect better QoL related to foot health and health in general; lower scores (close to 0 denote a worse QoL related to these health items. Results: One hundred patients (49 males [42.38 ± 14.065 years old] and 51 females [43.90 ± 14.305 years old] were recruited. Section one of the FHSQ evaluates four foot domains, and significant differences (P<0.05 were shown for foot pain and footwear, with males having higher scores than females, but not for foot function and general foot health (P>0.05. Section two assesses four domains of general wellbeing, and significant

  7. Variable Lysozyme Transport Dynamics on Oxidatively Functionalized Polystyrene Films.

    Science.gov (United States)

    Moringo, Nicholas A; Shen, Hao; Tauzin, Lawrence J; Wang, Wenxiao; Bishop, Logan D C; Landes, Christy F

    2017-10-17

    Tuning protein adsorption dynamics at polymeric interfaces is of great interest to many biomedical and material applications. Functionalization of polymer surfaces is a common method to introduce application-specific surface chemistries to a polymer interface. In this work, single-molecule fluorescence microscopy is utilized to determine the adsorption dynamics of lysozyme, a well-studied antibacterial protein, at the interface of polystyrene oxidized via UV exposure and oxygen plasma and functionalized by ligand grafting to produce varying degrees of surface hydrophilicity, surface roughness, and induced oxygen content. Single-molecule tracking indicates lysozyme loading capacities, and surface mobility at the polymer interface is hindered as a result of all functionalization techniques. Adsorption dynamics of lysozyme depend on the extent and the specificity of the oxygen functionalities introduced to the polystyrene surface. Hindered adsorption and mobility are dominated by hydrophobic effects attributed to water hydration layer formation at the functionalized polystyrene surfaces.

  8. Foot Problems

    Science.gov (United States)

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

  9. Role of procalcitonin in infected diabetic foot ulcer.

    Science.gov (United States)

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

    2017-06-01

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

  10. Foot-strike pattern and performance in a marathon.

    Science.gov (United States)

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

    2013-05-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

  12. A preliminary case study of the effect of shoe-wearing on the biomechanics of a horse’s foot

    Directory of Open Access Journals (Sweden)

    Olga Panagiotopoulou

    2016-07-01

    Full Text Available Horse racing is a multi-billion-dollar industry that has raised welfare concerns due to injured and euthanized animals. Whilst the cause of musculoskeletal injuries that lead to horse morbidity and mortality is multifactorial, pre-existing pathologies, increased speeds and substrate of the racecourse are likely contributors to foot disease. Horse hooves have the ability to naturally deform during locomotion and dissipate locomotor stresses, yet farriery approaches are utilised to increase performance and protect hooves from wear. Previous studies have assessed the effect of different shoe designs on locomotor performance; however, no biomechanical study has hitherto measured the effect of horseshoes on the stresses of the foot skeleton in vivo. This preliminary study introduces a novel methodology combining three-dimensional data from biplanar radiography with inverse dynamics methods and finite element analysis (FEA to evaluate the effect of a stainless steel shoe on the function of a Thoroughbred horse’s forefoot during walking. Our preliminary results suggest that the stainless steel shoe shifts craniocaudal, mediolateral and vertical GRFs at mid-stance. We document a similar pattern of flexion-extension in the PIP (pastern and DIP (coffin joints between the unshod and shod conditions, with slight variation in rotation angles throughout the stance phase. For both conditions, the PIP and DIP joints begin in a flexed posture and extend over the entire stance phase. At mid-stance, small differences in joint angle are observed in the PIP joint, with the shod condition being more extended than the unshod horse, whereas the DIP joint is extended more in the unshod than the shod condition. We also document that the DIP joint extends more than the PIP after mid-stance and until the end of the stance in both conditions. Our FEA analysis, conducted solely on the bones, shows increased von Mises and Maximum principal stresses on the forefoot phalanges

  13. CONSIDERATIONS REGARDING THE DESIGN OF FOOTWEAR WHICH ASSURES THE HEALTH OF THE FOOT

    Directory of Open Access Journals (Sweden)

    MĂRCUŞ Liviu

    2016-05-01

    Full Text Available The high demands for cheap footwear can only be satisfied by mass fabrication. Costumed footwear would represent a regress, despite the advantages that it brings. This paper regards mainly the demands that mass footwear requires, in order to maintain the health of the foot. The desire to maintain the foot shape and functionality requires certain last forms and fabrication algorithms. We analyze certain aspects referring to: the correct design of the inner sole, insuring the flexibility of the lower part of the footwear by choosing the right type of materials and confection systems, choosing the right height of the heel, setting the adequate shape by increasing the number of different shoe sizes. In order to give a loose space to the adults’ toes, where they are not pressed, but have a complete range of motion, the orthopedists and the last specialists have set several requirements for building the contour of the inner sole. The technique of building a bond between the footwear forepart and the inferior ensemble is dependent to the purpose and partially to the fashion demands of the shoe. The sole shape is influenced by the buyers, as seen by the development of the ex-flex footwear. There must be noted that in this case, the work of the model designer coincides with the exigencies of the specialist in footwear health. With the help of certain functional considerations and of several mechanical calculations, it can be proven that a heel with a height of 3 cm does not necessarily have a negative impact on the foot health. This is why even the orthopedics consider this limit as acceptable. Higher heels must be avoided if we want to maintain a normal function and development of the foot.

  14. Dynamical Functional Theory for Compressed Sensing

    DEFF Research Database (Denmark)

    Cakmak, Burak; Opper, Manfred; Winther, Ole

    2017-01-01

    the Thouless Anderson-Palmer (TAP) equations corresponding to the ensemble. Using a dynamical functional approach we are able to derive an effective stochastic process for the marginal statistics of a single component of the dynamics. This allows us to design memory terms in the algorithm in such a way...... that the resulting fields become Gaussian random variables allowing for an explicit analysis. The asymptotic statistics of these fields are consistent with the replica ansatz of the compressed sensing problem....

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

    Science.gov (United States)

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

    2011-02-01

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

  16. Changes in Foot Shape after Long-Distance Running

    OpenAIRE

    Fukano, Mako; Iso, Shigeo

    2015-01-01

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

  17. Extracting neuronal functional network dynamics via adaptive Granger causality analysis.

    Science.gov (United States)

    Sheikhattar, Alireza; Miran, Sina; Liu, Ji; Fritz, Jonathan B; Shamma, Shihab A; Kanold, Patrick O; Babadi, Behtash

    2018-04-24

    Quantifying the functional relations between the nodes in a network based on local observations is a key challenge in studying complex systems. Most existing time series analysis techniques for this purpose provide static estimates of the network properties, pertain to stationary Gaussian data, or do not take into account the ubiquitous sparsity in the underlying functional networks. When applied to spike recordings from neuronal ensembles undergoing rapid task-dependent dynamics, they thus hinder a precise statistical characterization of the dynamic neuronal functional networks underlying adaptive behavior. We develop a dynamic estimation and inference paradigm for extracting functional neuronal network dynamics in the sense of Granger, by integrating techniques from adaptive filtering, compressed sensing, point process theory, and high-dimensional statistics. We demonstrate the utility of our proposed paradigm through theoretical analysis, algorithm development, and application to synthetic and real data. Application of our techniques to two-photon Ca 2+ imaging experiments from the mouse auditory cortex reveals unique features of the functional neuronal network structures underlying spontaneous activity at unprecedented spatiotemporal resolution. Our analysis of simultaneous recordings from the ferret auditory and prefrontal cortical areas suggests evidence for the role of rapid top-down and bottom-up functional dynamics across these areas involved in robust attentive behavior.

  18. Efficacy of foot orthoses for the treatment of plantar heel pain

    DEFF Research Database (Denmark)

    Rasenberg, Nadine; Riel, Henrik; Rathleff, Michael S

    2018-01-01

    BACKGROUND: Plantar heel pain (PHP) is common. Foot orthoses are often applied as treatment for PHP, even though there is little evidence to support this. OBJECTIVE: To investigate the effects of different orthoses on pain, function and self-reported recovery in patients with PHP and compare them...

  19. Genetics of club foot in Maori and Pacific people

    Science.gov (United States)

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

    2000-01-01

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


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

  20. Mycetoma foot

    Directory of Open Access Journals (Sweden)

    Somnath Gooptu

    2013-01-01

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

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

    OpenAIRE

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

    2008-01-01

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

  2. Thyrotoxicosis Presenting as Unilateral Drop Foot.

    Science.gov (United States)

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

    2017-01-01

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

  3. Inverse Dynamics Model for the Ankle Joint with Applications in Tibia Malleolus Fracture

    Science.gov (United States)

    Budescu, E.; Merticaru, E.; Chirazi, M.

    The paper presents a biomechanical model of the ankle joint, in order to determine the force and the torque of reaction into the articulation, through inverse dynamic analysis, in various stages of the gait. Thus, knowing the acceleration of the foot and the reaction force between foot and ground during the gait, determined by experimental measurement, there was calculated, for five different positions of the foot, the joint reaction forces, on the basis of dynamic balance equations. The values numerically determined were compared with the admissible forces appearing in the technical systems of osteosynthesis of tibia malleolus fracture, in order to emphasize the motion restrictions during bone healing.

  4. Treatment options for diabetic foot osteomyelitis.

    Science.gov (United States)

    Senneville, Eric; Robineau, Olivier

    2017-06-01

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

  5. Reconstruction of bilateral tibial aplasia and split hand-foot syndrome in a father and daughter

    Directory of Open Access Journals (Sweden)

    Ali Al Kaissi

    2014-01-01

    Full Text Available Background: Tibial aplasia is of heterogeneous aetiology, the majority of reports are sporadic. We describe the reconstruction procedures in two subjects - a daughter and father manifested autosomal dominant (AD inheritance of the bilateral tibial aplasia and split hand-foot syndrome. Materials and Methods: Reconstruction of these patients required multiple surgical procedures and orthoprosthesis was mandatory. The main goal of treatment was to achieve walking. Stabilization of the ankle joint by fibular-talar-chondrodesis on both sides, followed by bilateral Brown-procedure at the knee joint level has been applied accordingly. Results: The outcome was with improved function of the deformed limbs and walking was achieved with simultaneous designation of orthotic fitting. Conclusion: This is the first study encompassing the diagnosis and management of a father and daughter with bilateral tibial aplasia associated with variable split hand/foot deformity without foot ablation. Our patients showed the typical AD pattern of inheritance of split-hand/foot and tibial aplasia.

  6. Dynamic equations for gauge-invariant wave functions

    International Nuclear Information System (INIS)

    Kapshaj, V.N.; Skachkov, N.B.; Solovtsov, I.L.

    1984-01-01

    The Bethe-Salpeter and quasipotential dynamic equations for wave functions of relative quark motion, have been derived. Wave functions are determined by the gauge invariant method. The V.A. Fock gauge condition is used in the construction. Despite the transl tional noninvariance of the gauge condition the standard separation of variables has been obtained and wave function doesn't contain gauge exponents

  7. Peripheral arterial disease and revascularization of the diabetic foot.

    Science.gov (United States)

    Forsythe, R O; Brownrigg, J; Hinchliffe, R J

    2015-05-01

    Diabetes is a complex disease with many serious potential sequelae, including large vessel arterial disease and microvascular dysfunction. Peripheral arterial disease is a common large vessel complication of diabetes, implicated in the development of tissue loss in up to half of patients with diabetic foot ulceration. In addition to peripheral arterial disease, functional changes in the microcirculation also contribute to the development of a diabetic foot ulcer, along with other factors such as infection, oedema and abnormal biomechanical loading. Peripheral arterial disease typically affects the distal vessels, resulting in multi-level occlusions and diffuse disease, which often necessitates challenging distal revascularisation surgery or angioplasty in order to improve blood flow. However, technically successful revascularisation does not always result in wound healing. The confounding effects of microvascular dysfunction must be recognised--treatment of a patient with a diabetic foot ulcer and peripheral arterial disease should address this complex interplay of pathophysiological changes. In the case of non-revascularisable peripheral arterial disease or poor response to conventional treatment, alternative approaches such as cell-based treatment, hyperbaric oxygen therapy and the use of vasodilators may appear attractive, however more robust evidence is required to justify these novel approaches. © 2014 John Wiley & Sons Ltd.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  9. Fleet of Foot: Adolescent Foot and Ankle Mobility

    Science.gov (United States)

    Legacy, Kelly Bromley

    2018-01-01

    In today's world of advanced technologies, accessible transportation, and fingertip talking, adolescents are spending too many hours each day sedentary. The purpose of this article is to underscore the importance of foot and ankle mobility in an adolescent population that spends very little time on their feet. Physical educators and athletic…

  10. Psychometric properties of the foot and ankle outcome score in a community-based study of adults with and without osteoarthritis

    DEFF Research Database (Denmark)

    Golightly, Yvonne M; Devellis, Robert F; Nelson, Amanda E

    2014-01-01

    Objective. Foot and ankle problems are common in adults, and large observational studies are needed to advance our understanding of the etiology and impact of these conditions. Valid and reliable measures of foot and ankle symptoms and physical function are necessary for this research. This study...

  11. Structure and Dynamics of Hydroxyl-Functionalized Protic Ammonium Carboxylate Ionic Liquids.

    Science.gov (United States)

    Thummuru, Dhileep Nagi Reddy; Mallik, Bhabani S

    2017-10-26

    We performed classical molecular dynamics simulations to investigate the structure and dynamics of protic ionic liquids, 2-hydroxy ethylammonium acetate, ethylammonium hydroxyacetate, and 2-hydroxyethylammonium hydroxyacetate at ambient conditions. Structural properties such as density, radial distribution functions, spatial distribution functions, and structure factors have been calculated. Dynamic properties such as mean square displacements, as well as residence and hydrogen bond dynamics have also been calculated. Hydrogen bond lifetimes and residence times change with the addition of hydroxyl groups. We observe that when a hydroxyl group is present on the cation, dynamics become very slow and it forms a strong hydrogen bond with carboxylate oxygen atoms of the anion. The hydroxyl functionalized ILs show more dynamic diversity than structurally similar ILs.

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

    Science.gov (United States)

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

    2010-08-01

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

  13. Preventing Diabetic Foot Complications : Strategic Recommendations

    African Journals Online (AJOL)

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

  14. Membrane topology and cellular dynamics of foot-and-mouth disease virus 3A protein.

    Directory of Open Access Journals (Sweden)

    Mónica González-Magaldi

    Full Text Available Foot-and-mouth disease virus non-structural protein 3A plays important roles in virus replication, virulence and host-range; nevertheless little is known on the interactions that this protein can establish with different cell components. In this work, we have performed in vivo dynamic studies from cells transiently expressing the green fluorescent protein (GFP fused to the complete 3A (GFP3A and versions including different 3A mutations. The results revealed the presence of a mobile fraction of GFP3A, which was found increased in most of the mutants analyzed, and the location of 3A in a continuous compartment in the cytoplasm. A dual behavior was also observed for GFP3A upon cell fractionation, being the protein equally recovered from the cytosolic and membrane fractions, a ratio that was also observed when the insoluble fraction was further fractioned, even in the presence of detergent. Similar results were observed in the fractionation of GFP3ABBB, a 3A protein precursor required for initiating RNA replication. A nonintegral membrane protein topology of FMDV 3A was supported by the lack of glycosylation of versions of 3A in which each of the protein termini was fused to a glycosylation acceptor tag, as well as by their accessibility to degradation by proteases. According to this model 3A would interact with membranes through its central hydrophobic region exposing its N- and C- termini to the cytosol, where interactions between viral and cellular proteins required for virus replication are expected to occur.

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

    Science.gov (United States)

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

    2017-02-24

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

  16. Foot pain

    Science.gov (United States)

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

  17. Evaluation of Bearing Capacity of Strip Footing Using Random Layers Concept

    Directory of Open Access Journals (Sweden)

    Kawa Marek

    2015-09-01

    Full Text Available The paper deals with evaluation of bearing capacity of strip foundation on random purely cohesive soil. The approach proposed combines random field theory in the form of random layers with classical limit analysis and Monte Carlo simulation. For given realization of random the bearing capacity of strip footing is evaluated by employing the kinematic approach of yield design theory. The results in the form of histograms for both bearing capacity of footing as well as optimal depth of failure mechanism are obtained for different thickness of random layers. For zero and infinite thickness of random layer the values of depth of failure mechanism as well as bearing capacity assessment are derived in a closed form. Finally based on a sequence of Monte Carlo simulations the bearing capacity of strip footing corresponding to a certain probability of failure is estimated. While the mean value of the foundation bearing capacity increases with the thickness of the random layers, the ultimate load corresponding to a certain probability of failure appears to be a decreasing function of random layers thickness.

  18. A survey of foot problems in juvenile idiopathic arthritis.

    Science.gov (United States)

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

    2008-12-01

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

  19. Dynamic Stiffness Transfer Function of an Electromechanical Actuator Using System Identification

    Science.gov (United States)

    Kim, Sang Hwa; Tahk, Min-Jea

    2018-04-01

    In the aeroelastic analysis of flight vehicles with electromechanical actuators (EMAs), an accurate prediction of flutter requires dynamic stiffness characteristics of the EMA. The dynamic stiffness transfer function of the EMA with brushless direct current (BLDC) motor can be obtained by conducting complicated mathematical calculations of control algorithms and mechanical/electrical nonlinearities using linearization techniques. Thus, system identification approaches using experimental data, as an alternative, have considerable advantages. However, the test setup for system identification is expensive and complex, and experimental procedures for data collection are time-consuming tasks. To obtain the dynamic stiffness transfer function, this paper proposes a linear system identification method that uses information obtained from a reliable dynamic stiffness model with a control algorithm and nonlinearities. The results of this study show that the system identification procedure is compact, and the transfer function is able to describe the dynamic stiffness characteristics of the EMA. In addition, to verify the validity of the system identification method, the simulation results of the dynamic stiffness transfer function and the dynamic stiffness model were compared with the experimental data for various external loads.

  20. Black-footed ferrets and Siberian polecats as ecological surrogates and ecological equivalents

    Science.gov (United States)

    Biggins, D.E.; Hanebury, L.R.; Miller, B.J.; Powell, R.A.

    2011-01-01

    Ecologically equivalent species serve similar functions in different communities, and an ecological surrogate species can be used as a substitute for an equivalent species in a community. Siberian polecats (Mustela eversmanii) and black-footed ferrets (M. nigripes) have long been considered ecological equivalents. Polecats also have been used as investigational surrogates for black-footed ferrets, yet the similarities and differences between the 2 species are poorly understood. We contrasted activity patterns of radiotagged polecats and ferrets released onto ferret habitat. Ferrets tended to be nocturnal and most active after midnight. Polecats were not highly selective for any period of the day or night. Ferrets and polecats moved most during brightly moonlit nights. The diel activity pattern of ferrets was consistent with avoidance of coyotes (Canis latrans) and diurnal birds of prey. Similarly, polecat activity was consistent with avoidance of red foxes (Vulpes vulpes) in their natural range. Intraguild predation (including interference competition) is inferred as a selective force influencing behaviors of these mustelines. Examination of our data suggests that black-footed ferrets and Siberian polecats might be ecological equivalents but are not perfect surrogates. Nonetheless, polecats as surrogates for black-footed ferrets have provided critical insight needed, especially related to predation, to improve the success of ferret reintroductions. ?? 2011 American Society of Mammalogists.

  1. Shp2 Associates with and Enhances Nephrin Tyrosine Phosphorylation and Is Necessary for Foot Process Spreading in Mouse Models of Podocyte Injury

    Science.gov (United States)

    Verma, Rakesh; Venkatareddy, Madhusudan; Kalinowski, Anne; Patel, Sanjeevkumar R.; Salant, David J.

    2015-01-01

    In most forms of glomerular diseases, loss of size selectivity by the kidney filtration barrier is associated with changes in the morphology of podocytes. The kidney filtration barrier is comprised of the endothelial lining, the glomerular basement membrane, and the podocyte intercellular junction, or slit diaphragm. The cell adhesion proteins nephrin and neph1 localize to the slit diaphragm and transduce signals in a Src family kinase Fyn-mediated tyrosine phosphorylation-dependent manner. Studies in cell culture suggest nephrin phosphorylation-dependent signaling events are primarily involved in regulation of actin dynamics and lamellipodium formation. Nephrin phosphorylation is a proximal event that occurs both during development and following podocyte injury. We hypothesized that abrogation of nephrin phosphorylation following injury would prevent nephrin-dependent actin remodeling and foot process morphological changes. Utilizing a biased screening approach, we found nonreceptor Src homology 2 (sh2) domain-containing phosphatase Shp2 to be associated with phosphorylated nephrin. We observed an increase in nephrin tyrosine phosphorylation in the presence of Shp2 in cell culture studies. In the human glomerulopathies minimal-change nephrosis and membranous nephropathy, there is an increase in Shp2 phosphorylation, a marker of increased Shp2 activity. Mouse podocytes lacking Shp2 do not develop foot process spreading when subjected to podocyte injury in vivo using protamine sulfate or nephrotoxic serum (NTS). In the NTS model, we observed a lack of foot process spreading in mouse podocytes with Shp2 deleted and smaller amounts of proteinuria. Taken together, these results suggest that Shp2-dependent signaling events are necessary for changes in foot process structure and function following injury. PMID:26644409

  2. Foot shape in arboreal birds: two morphological patterns for the same pincer-like tool.

    Science.gov (United States)

    Abourachid, Anick; Fabre, Anne-Claire; Cornette, Raphaël; Höfling, Elizabeth

    2017-07-01

    The feet are the only contact between the body and the substrate in limbed animals and as such they provide a crucial interface between the animal and its environment. This is especially true for bipedal and arboreal species living in a complex three-dimensional environment that likely induces strong selection on foot morphology. In birds, foot morphology is highly variable, with different orientations of the toes, making it a good model for the study of the role of functional, developmental, and phylogenetic constraints in the evolution of phenotypic diversity. Our data on the proportions of the phalanges analyzed in a phylogenetic context show that two different morphological patterns exist that depend mainly on habitat and toe orientation. In the anisodactyl foot, the hallux is the only backward-oriented toe and is enlarged in climbing species and reduced in terrestrial ones. Moreover, a proximo-distal gradient in phalanx size is observed depending on the degree of terrestriality. In the two other cases (heterodactyl and zygodactyl) that have two toes that point backward, the hallux is rather small in contrast to the other backward-pointing toe, which is enlarged. The first pattern is convergent and common among tetrapods and follows rules of skeletal development. The second pattern is unique for the clade and under muscle-morphogenetic control. In all cases, the functional result is the same tool, a pincer-like foot. © 2017 Anatomical Society.

  3. Iambic Feet in Paumari and the Theory of Foot Structure

    Directory of Open Access Journals (Sweden)

    Daniel L. Everett

    2003-01-01

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

  4. The prevalence of diabetic foot disease in the Waikato region.

    Science.gov (United States)

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

    2017-07-01

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

  5. Dynamics of inequalities in geometric function theory

    Directory of Open Access Journals (Sweden)

    Reich Simeon

    2001-01-01

    Full Text Available A domain in the complex plane which is star-like with respect to a boundary point can be approximated by domains which are star-like with respect to interior points. This approximation process can be viewed dynamically as an evolution of the null points of the underlying holomorphic functions from the interior of the open unit disk towards a boundary point. We trace these dynamics analytically in terms of the Alexander–Nevanlinna and Robertson inequalities by using the framework of complex dynamical systems and hyperbolic monotonicity.

  6. Hand, Foot, and Mouth Disease

    Centers for Disease Control (CDC) Podcasts

    2013-08-08

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

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

    Science.gov (United States)

    Eraydin, Şahizer; Avşar, Gülçin

    2017-12-19

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

  8. Effect of a steam foot spa on geriatric inpatients with cognitive impairment: a pilot study

    Directory of Open Access Journals (Sweden)

    Koike Y

    2013-05-01

    Full Text Available Yoshihisa Koike,1 Hideki Kondo,2 Satoshi Kondo,1 Masayuki Takagi,1 Yoshio Kano31Department of Occupational Therapy, Prefectural University of Hiroshima, Mihara, Japan; 2Yoshiigawa Hospital, Okayama, Japan; 3Department of Occupational Therapy, Kibi International University, Takahashi, JapanPurpose: To investigate whether a steam foot spa improves cognitive impairment in geriatric inpatients.Methods: Geriatric inpatients with cognitive impairment were given a steam foot spa treatment at 42°C for 20 minutes for 2 weeks (5 days/week. Physiological indicators such as blood pressure, percutaneous oxygen saturation, pulse, tympanic temperature, and sleep time and efficiency were assessed. Cognitive function and behavioral and psychological symptoms of dementia were assessed using the Mini-Mental State Examination, Dementia Mood Assessment Scale, and Dementia Behavior Disturbance scale.Results: Significant decreases in systolic (P < 0.01 and diastolic blood pressure (P < 0.05 along with a significant increase in tympanic temperature (P < 0.01 were observed after the steam foot spas. A significant improvement was seen in the Mini-Mental State Examination score (P < 0.01 and the overall dementia severity items in Dementia Mood Assessment Scale (P < 0.05.Limitations: Japanese people are very fond of foot baths. However, it is difficult to understand why inpatients cannot receive steam foot baths. In this study, a control group was not used. Raters and enforcers were not blinded.Conclusion: The results of this pilot study suggest that steam foot spas mitigate cognitive impairment in geriatric inpatients.Keywords: steam foot spa, geriatric inpatients, cognitive impairment, tympanic temperature

  9. Diabetes: foot ulcers and amputations.

    Science.gov (United States)

    Hunt, Dereck L

    2011-08-26

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

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

    Science.gov (United States)

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

    2016-03-01

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

  11. Functional outcomes of transmetatarsal amputation in the diabetic foot: timing of revascularization, wound healing and ambulatory status.

    Science.gov (United States)

    Mandolfino, T; Canciglia, A; Salibra, M; Ricciardello, D; Cuticone, G

    2016-12-01

    Transmetatarsal amputation (TMA) is an effective surgical approach to treat forefoot infection and gangrene in diabetic patients. However, a high rate of complications and failure to heal require reamputation in a large number of cases. We analysed the outcomes of TMA to define the role of revascularization, wound healing and ambulatory status. From January 2008 to January 2013, 218 diabetic patients with foot infection and gangrene, submitted to TMA associated to revascularization were followed until healing, amputation or death. Revascularization was done in 202 (92 %) cases. In 16 (7 %) no revascularization was required. The TMA was closed in 135 (62 %) and left open in 83 (38 %) cases. The reamputation rate was 34 % and major amputation 12.6 % at 1-year follow-up. Patient following ranged 2-30 months with a mean of 15 months. The functional outcomes, living at home and ambulation outdoors, were 60 and 36 % at hospital discharge after TMA, 81 and 77 % at 1-year follow-up. TMA associated to revascularization can provide an effective limb salvage and functional results in diabetic patients with forefoot tissue loss and infection.

  12. Functional dynamics of cell surface membrane proteins.

    Science.gov (United States)

    Nishida, Noritaka; Osawa, Masanori; Takeuchi, Koh; Imai, Shunsuke; Stampoulis, Pavlos; Kofuku, Yutaka; Ueda, Takumi; Shimada, Ichio

    2014-04-01

    Cell surface receptors are integral membrane proteins that receive external stimuli, and transmit signals across plasma membranes. In the conventional view of receptor activation, ligand binding to the extracellular side of the receptor induces conformational changes, which convert the structure of the receptor into an active conformation. However, recent NMR studies of cell surface membrane proteins have revealed that their structures are more dynamic than previously envisioned, and they fluctuate between multiple conformations in an equilibrium on various timescales. In addition, NMR analyses, along with biochemical and cell biological experiments indicated that such dynamical properties are critical for the proper functions of the receptors. In this review, we will describe several NMR studies that revealed direct linkage between the structural dynamics and the functions of the cell surface membrane proteins, such as G-protein coupled receptors (GPCRs), ion channels, membrane transporters, and cell adhesion molecules. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    African Journals Online (AJOL)

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

  14. CT guided diagnostic foot injections

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  15. Dynamic Functional Connectivity States Between the Dorsal and Ventral Sensorimotor Networks Revealed by Dynamic Conditional Correlation Analysis of Resting-State Functional Magnetic Resonance Imaging.

    Science.gov (United States)

    Syed, Maleeha F; Lindquist, Martin A; Pillai, Jay J; Agarwal, Shruti; Gujar, Sachin K; Choe, Ann S; Caffo, Brian; Sair, Haris I

    2017-12-01

    Functional connectivity in resting-state functional magnetic resonance imaging (rs-fMRI) has received substantial attention since the initial findings of Biswal et al. Traditional network correlation metrics assume that the functional connectivity in the brain remains stationary over time. However, recent studies have shown that robust temporal fluctuations of functional connectivity among as well as within functional networks exist, challenging this assumption. In this study, these dynamic correlation differences were investigated between the dorsal and ventral sensorimotor networks by applying the dynamic conditional correlation model to rs-fMRI data of 20 healthy subjects. k-Means clustering was used to determine an optimal number of discrete connectivity states (k = 10) of the sensorimotor system across all subjects. Our analysis confirms the existence of differences in dynamic correlation between the dorsal and ventral networks, with highest connectivity found within the ventral motor network.

  16. Crossing the entropy barrier of dynamical zeta functions

    International Nuclear Information System (INIS)

    Aurich, R.; Bolte, J.; Matthies, C.; Sieber, M.; Steiner, F.

    1992-01-01

    Dynamical zeta functions are an important tool to quantize chaotic dynamical systems. The basic quantization rules require the computation of the zeta functions on the real energy axis, where the Euler product representations running over the classical periodic orbits usually do not converge due to the existence of the so-called entropy barrier determined by the topological entropy of the classical system. We shown that the convergence properties of the dynamical zeta functions rewritten as Dirichlet series are governed not only by the well-known topological and metric entropy, but depend crucially on subtle statistical properties of the Maslow indices and of the multiplicities of the periodic orbits that are measured by a new parameter for which we introduce the notion of a third entropy. If and only if the third entropy is nonvanishing, one can cross the entropy barrier; if it exceeds a certain value, one can even compute the zeta function in the physical region by means of a convergent Dirichlet series. A simple statistical model is presented which allows to compute the third entropy. Four examples of chaotic systems are studied in detail to test the model numerically. (orig.)

  17. Crossing the entropy barrier of dynamical zeta functions

    Energy Technology Data Exchange (ETDEWEB)

    Aurich, R.; Bolte, J.; Matthies, C.; Sieber, M.; Steiner, F. (Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik)

    1992-01-01

    Dynamical zeta functions are an important tool to quantize chaotic dynamical systems. The basic quantization rules require the computation of the zeta functions on the real energy axis, where the Euler product representations running over the classical periodic orbits usually do not converge due to the existence of the so-called entropy barrier determined by the topological entropy of the classical system. We shown that the convergence properties of the dynamical zeta functions rewritten as Dirichlet series are governed not only by the well-known topological and metric entropy, but depend crucially on subtle statistical properties of the Maslow indices and of the multiplicities of the periodic orbits that are measured by a new parameter for which we introduce the notion of a third entropy. If and only if the third entropy is nonvanishing, one can cross the entropy barrier; if it exceeds a certain value, one can even compute the zeta function in the physical region by means of a convergent Dirichlet series. A simple statistical model is presented which allows to compute the third entropy. Four examples of chaotic systems are studied in detail to test the model numerically. (orig.).

  18. Function of dynamic models in systems biology: linking structure to behaviour.

    Science.gov (United States)

    Knüpfer, Christian; Beckstein, Clemens

    2013-10-08

    Dynamic models in Systems Biology are used in computational simulation experiments for addressing biological questions. The complexity of the modelled biological systems and the growing number and size of the models calls for computer support for modelling and simulation in Systems Biology. This computer support has to be based on formal representations of relevant knowledge fragments. In this paper we describe different functional aspects of dynamic models. This description is conceptually embedded in our "meaning facets" framework which systematises the interpretation of dynamic models in structural, functional and behavioural facets. Here we focus on how function links the structure and the behaviour of a model. Models play a specific role (teleological function) in the scientific process of finding explanations for dynamic phenomena. In order to fulfil this role a model has to be used in simulation experiments (pragmatical function). A simulation experiment always refers to a specific situation and a state of the model and the modelled system (conditional function). We claim that the function of dynamic models refers to both the simulation experiment executed by software (intrinsic function) and the biological experiment which produces the phenomena under investigation (extrinsic function). We use the presented conceptual framework for the function of dynamic models to review formal accounts for functional aspects of models in Systems Biology, such as checklists, ontologies, and formal languages. Furthermore, we identify missing formal accounts for some of the functional aspects. In order to fill one of these gaps we propose an ontology for the teleological function of models. We have thoroughly analysed the role and use of models in Systems Biology. The resulting conceptual framework for the function of models is an important first step towards a comprehensive formal representation of the functional knowledge involved in the modelling and simulation process

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  20. Bearing Capacity of Strip Footings near Slopes Using Lower Bound Limit Analysis

    Directory of Open Access Journals (Sweden)

    Javad Mofidi rouchi

    2014-06-01

    Full Text Available Stability of foundations near slopes is one of the important and complicated problems in geotechnical engineering, which has been investigated by various methods such as limit equilibrium, limit analysis, slip-line, finite element and discrete element. The complexity of this problem is resulted from the combination of two probable failures: foundation failure and overall slope failure. The current paper describes a lower bound solution for estimation of bearing capacity of strip footings near slopes. The solution is based on the finite element formulation and linear programming technique, which lead to a collapse load throughout a statically admissible stress field. Three-nodded triangular stress elements are used for meshing the domain of the problem, and stress discontinuities occur at common edges of adjacent elements. The Mohr-Coulomb yield function and an associated flow rule are adopted for the soil behavior. In this paper, the average limit pressure of strip footings, which are adjacent to slopes, is considered as a function of dimensionless parameters affecting the stability of the footing-on-slope system. These parameters, particularly the friction angle of the soil, are investigated separately and relevant charts are presented consequently. The results are compared to some other solutions that are available in the literature in order to verify the suitability of the methodology used in this research.

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

    LENUS (Irish Health Repository)

    Groarke, P J

    2014-04-27

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

  2. Care of Patients with Diabetic Foot Disease in Oman

    Science.gov (United States)

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

    2016-01-01

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

  3. Comparing of Normal Stress Distribution in Static and Dynamic Soil-Structure Interaction Analyses

    International Nuclear Information System (INIS)

    Kholdebarin, Alireza; Massumi, Ali; Davoodi, Mohammad; Tabatabaiefar, Hamid Reza

    2008-01-01

    It is important to consider the vertical component of earthquake loading and inertia force in soil-structure interaction analyses. In most circumstances, design engineers are primarily concerned about the analysis of behavior of foundations subjected to earthquake-induced forces transmitted from the bedrock. In this research, a single rigid foundation with designated geometrical parameters located on sandy-clay soil has been modeled in FLAC software with Finite Different Method and subjected to three different vertical components of earthquake records. In these cases, it is important to evaluate effect of footing on underlying soil and to consider normal stress in soil with and without footing. The distribution of normal stress under the footing in static and dynamic states has been studied and compared. This Comparison indicated that, increasing in normal stress under the footing caused by vertical component of ground excitations, has decreased dynamic vertical settlement in comparison with static state

  4. Metallic Foreign Body in the Foot

    Directory of Open Access Journals (Sweden)

    Firat Ozan

    2016-04-01

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

  5. Ultrasound Findings of the Painful Ankle and Foot

    Directory of Open Access Journals (Sweden)

    Suheil Artul

    2014-01-01

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

  6. Semigroups of transcendental entire functions and their dynamics

    Indian Academy of Sciences (India)

    DINESH KUMAR

    Abstract. We investigate the dynamics of semigroups of transcendental entire func- tions using Fatou–Julia theory. Several results of the dynamics associated with iteration of a transcendental entire function have been extended to transcendental semigroups. We provide some condition for connectivity of the Julia set of the ...

  7. 29 CFR 1918.104 - Foot protection.

    Science.gov (United States)

    2010-07-01

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

  8. Factors associated with combined hand and foot eczema

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  9. Foot posture in basketball players with history of the shin splint

    Directory of Open Access Journals (Sweden)

    Saeed Forghany

    2013-07-01

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

  10. Rotational foot placement specifies the lever arm of the ground reaction force during the push-off phase of walking initiation.

    Science.gov (United States)

    Erdemir, Ahmet; Piazza, Stephen J

    2002-06-01

    The lever arm of the ground reaction force (GRF) about the talocrural joint axis is a functionally important indicator of the nature of foot loading. Walking initiation experiments (ten subjects; age, 23-29 years) were completed to demonstrate that rotational foot placement is a possible strategy to specify the lever arm. Externally-rotated foot placement resulted in larger lever arms during push-off. A computer simulation of push-off revealed that a decreased lever arm reduces the plantarflexion moment necessary to maintain a constant forward velocity, while increasing the required plantarflexion velocity. Shortening of the foot thus diminishes the muscular force demand but also requires high muscle fiber shortening velocities that may limit the force generating capacity of plantar flexors. Decreased plantar flexion moment and slow walking previously noted in partial-foot amputees may result from shortened lever arms in this manner.

  11. The Efficacy of Jing Wan Hong Ointment for Nerve Injury Diabetic Foot Ulcer and Its Mechanisms

    Directory of Open Access Journals (Sweden)

    Shumei Jin

    2014-01-01

    Full Text Available Jing Wan Hong ointment contains 30 kinds of Chinese herbs, with functions of activating blood circulation to disperse blood stasis, clearing heat, eliminating dampness, and reducing swelling by detoxification. Therefore, Jing Wan Hong ointment may facilitate the healing of ulcers. The aim of this study was to evaluate the efficacy and mechanisms of Jing Wan Hong ointment for healing diabetic foot ulceration in Wistar rats induced by streptozotocin and sciatic nerve damage. The results showed that Jing Wan Hong ointment had a marked effect on foot ulcers in diabetic rats induced by initial nerve injury. These effects were manifested by reducing the foot ulcer size and Wagner grade after seven days of treatment. The diabetic rats with foot ulcers were almost healed after 21 days of treatment. Moreover, the mechanisms of this effect seem to be dependent on increased expression of PDGF mRNA, but there was no influence on the expression of TGF-β, VEGF, and FLT-1 mRNA.

  12. Hallux valgus and hallux rigidus: a comparison of impact on health-related quality of life in patients presenting to foot surgeons in Australia

    Science.gov (United States)

    Gilheany, Mark F; Landorf, Karl B; Robinson, Priscilla

    2008-01-01

    Background Hallux valgus and hallux rigidus are common foot conditions that lead to a deterioration in health status. Patients with significant pain or deformity from these conditions frequently resort to surgery. In this project, the foot health status of patients with hallux valgus and hallux rigidus presenting to foot surgeons in Australia was compared. Methods Foot health status was measured in 120 participants using the Foot Health Status Questionnaire (FHSQ), a validated 0 – 100 point health status instrument. All participants had presented for surgical advice regarding hallux valgus/rigidus. The mean age of participants was 48.0 years (SD ± 14.3, range 19 – 79). Results In the sample, 68% of participants were diagnosed with hallux valgus and 32% with hallux rigidus. Participants with hallux rigidus had greater levels of pain and functional limitation compared with hallux valgus. The mean difference for pain was 13.8 points (95% CI 4.6 to 22.9) and the mean difference for function was 15.0 points (95% CI 5.3 to 24.7). Both conditions result in similarly negative levels of impact on shoe fit and overall foot health. Conclusion This study found measurable differences in foot health status between hallux valgus and hallux rigidus in participants presenting for surgical consultation. While both appear to have a negative impact on health status, hallux rigidus has a more significant impact. PMID:19077213

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

    Science.gov (United States)

    Randler, Christoph; Braun, Michael; Lintker, Stephanie

    2011-03-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  15. Full-Span Tiltrotor Aeroacoustic Model (TRAM) Overview and 40- by 80-Foot Wind Tunnel Test. [conducted in the 40- by 80-Foot Wind Tunnel at Ames Research Center

    Science.gov (United States)

    McCluer, Megan S.; Johnson, Jeffrey L.; Rutkowski, Michael (Technical Monitor)

    2001-01-01

    Most helicopter data trends cannot be extrapolated to tiltrotors because blade geometry and aerodynamic behavior, as well as rotor and fuselage interactions, are significantly different for tiltrotors. A tiltrotor model has been developed to investigate the aeromechanics of tiltrotors, to develop a comprehensive database for validating tiltrotor analyses, and to provide a research platform for supporting future tiltrotor designs. The Full-Span Tiltrotor Aeroacoustic Model (FS TRAM) is a dual-rotor, powered aircraft model with extensive instrumentation for measurement of structural and aerodynamic loads. This paper will present the Full-Span TRAM test capabilities and the first set of data obtained during a 40- by 80-Foot Wind Tunnel test conducted in late 2000 at NASA Ames Research Center. The Full-Span TRAM is a quarter-scale representation of the V-22 Osprey aircraft, and a heavily instrumented NASA and U.S. Army wind tunnel test stand. Rotor structural loads are monitored and recorded for safety-of-flight and for information on blade loads and dynamics. Left and right rotor balance and fuselage balance loads are monitored for safety-of-flight and for measurement of vehicle and rotor aerodynamic performance. Static pressure taps on the left wing are used to determine rotor/wing interactional effects and rotor blade dynamic pressures measure blade airloads. All of these measurement capabilities make the FS TRAM test stand a unique and valuable asset for validation of computational codes and to aid in future tiltrotor designs. The Full-Span TRAM was tested in the NASA Ames Research Center 40- by 80-Foot Wind Tunnel from October through December 2000. Rotor and vehicle performance measurements were acquired in addition to wing pressures, rotor acoustics, and Laser Light Sheet (LLS) flow visualization data. Hover, forward flight, and airframe (rotors off) aerodynamic runs were performed. Helicopter-mode data were acquired during angle of attack and thrust sweeps for

  16. Motion of the foot and ankle during the stance phase in rats

    NARCIS (Netherlands)

    Varejao, ASP; Cabrita, AM; Meek, MF; Bulas-Cruz, J; Gabriel, RC; Filipe, VM; Melo-Pinto, P; Winter, DA

    2002-01-01

    Computerized analysis of rat gait is becoming an invaluable technique used by some peripheral nerve investigators for the evaluation of function. In this article we describe the use of a biomechanical model of the foot and ankle that allows a quantitative assessment and description of the ankle

  17. Novel Thermal Analysis Model of the Foot-Shoe Sole Interface during Gait Motion

    Directory of Open Access Journals (Sweden)

    Yasuhiro Shimazaki

    2018-02-01

    Full Text Available Excessive heat at the foot-shoe sole interface negatively affects a human’s thermal comfort. An understanding of the thermal behavior at this interface is important for alleviating this discomfort. During gait motion, a human’s body weight cyclically compresses a shoe sole (commonly constructed of viscoelastic materials, generating heat during loading. To evaluate the thermal effects of this internal heat generation on foot comfort, we developed and empirically validated a thermal analysis model during gait motion. A simple, one-dimensional prediction model for heat conduction with heat generation during compressive loading was used. Heat generation was estimated as a function of the shoe sole’s material properties (e.g., elastic modulus and various gait parameters. When compared with experimental results, the proposed model proved effective in predicting thermal behavior at the foot-shoe sole interface under various conditions and shows potential for improving a human’s thermal comfort during gait motion through informed footwear design.

  18. Etiology, pathophysiology and classifications of the diabetic Charcot foot

    Science.gov (United States)

    Papanas, Nikolaos; Maltezos, Efstratios

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    Sibbald, R. Gary; Martin, Carlos

    2015-01-01

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

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

    Science.gov (United States)

    Ozen, Mustafa; Sayman, Onur; Havitcioglu, Hasan

    2013-01-01

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

  2. Effectiveness of off-the-shelf, extra-depth footwear in reducing foot pain in older people: a randomized controlled trial.

    Science.gov (United States)

    Menz, Hylton B; Auhl, Maria; Ristevski, Sonja; Frescos, Nicoletta; Munteanu, Shannon E

    2015-04-01

    Foot pain is highly prevalent in older people and in many cases is associated with inappropriate footwear. This study evaluated the effectiveness of off-the-shelf, extra-depth footwear in reducing foot pain. Community-dwelling older people with disabling foot pain (72 men and 48 women aged 65 to 96 years; mean age 82 [SD 8]) were randomly allocated to an intervention group (n = 59) or control group (n = 61). The intervention group was provided with off-the-shelf, extra-depth footwear. Participants in the control group received their footwear at the completion of the study. Both groups continued to receive usual podiatry care for the study period. The primary outcome measure was the Foot Health Status Questionnaire (FHSQ), measured at baseline and 16 weeks. There was a significant improvement in the FHSQ pain domain (ANCOVA-adjusted mean difference 11.5 points, 95% confidence interval 4.2 to 18.8, p = .002) and FHSQ function domain (10.0 points, 0.9 to 19.1, p = .032) in the intervention group compared to the control group. The intervention group also developed fewer keratotic lesions (mean difference -1.4, -2.5 to -0.2, p = .021), were less likely to report the use of co-interventions (relative risk [RR] 0.74, 0.56 to 0.98, p = .026) and were more likely to report that their foot pain had moderately or markedly improved during the study (RR = 7.93, 2.51 to 25.00, p footwear significantly reduces foot pain, improves foot function and is associated with the development of fewer keratotic lesions in older people. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Neuropathic diabetic foot ulcers – evidence-to-practice

    Directory of Open Access Journals (Sweden)

    Ndip A

    2012-02-01

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

  4. Foot ulcers in the diabetic patient, prevention and treatment

    Science.gov (United States)

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

    2007-01-01

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

  5. Influence of the program of prophylaxis of violations of vaults of foot on physical preparedness of children of midchildhood

    Directory of Open Access Journals (Sweden)

    Valkevich A.V.

    2012-06-01

    Full Text Available Purpose of work - to probe influence of the program of prophylaxis of violations of vaults of foot on physical preparedness of children of midchildhood. 40 children which studied in a tourist class took part in experiment. All of children on the state a health were attributed to the basic group. In the process of testing determined the indexes of speed (run 30 meters, flexibility (forerake from position «sitting», adroitness (shuttle run 4x9 meters, speed-power qualities (broad jump from a place, force (undercutting on a low cross-beam and endurance (run, meters. The substantive provisions of the program of prophylaxis of violations of vaults of foot are reflected for children. Certain and analysed dynamics of indexes of physical preparedness of schoolboys on completion of the program of prophylaxis of violations of vaults of foot in educational process.

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

    Science.gov (United States)

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

    2016-05-01

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    African Journals Online (AJOL)

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

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

    OpenAIRE

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

    1998-01-01

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

  10. Radionuclide renal dynamic and function study

    International Nuclear Information System (INIS)

    Guan Liang

    1991-01-01

    The radionuclide dynamic and function study, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were reported in 14 cases of renal and ureteral calculi patients before and after extracorporeal shock wave lithotripsy (ESWL). In 12 cases with normal renal blood flow, within 3 months after ESWL, the GFR of shock and non-shock side decreased with different extent, while the individual ERPF had little change. In 5 cases followed up 1 year after ESWL, the individual GFR and ERPF were normal. In 2 cases of severe renal function insufficiency, there was no improvement in renal function in shock side, after 5 months and 1 year, the renal function was still at low level. Thereby it is considered that ESWL is not suitable for the renal calculi patients with severe renal function insufficiency

  11. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Foot Care in the Management of Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Brosseau, Lucie; Toupin-April, Karine; Wells, George; Smith, Christine A; Pugh, Arlanna G; Stinson, Jennifer N; Duffy, Ciarán M; Gifford, Wendy; Moher, David; Sherrington, Catherine; Cavallo, Sabrina; De Angelis, Gino; Loew, Laurianne; Rahman, Prinon; Marcotte, Rachel; Taki, Jade; Bisaillon, Jacinthe; King, Judy; Coda, Andrea; Hendry, Gordon J; Gauvreau, Julie; Hayles, Martin; Hayles, Kay; Feldman, Brian; Kenny, Glen P; Li, Jing Xian; Briggs, Andrew M; Martini, Rose; Feldman, Debbie Ehrmann; Maltais, Désirée B; Tupper, Susan; Bigford, Sarah; Bisch, Marg

    2016-07-01

    To create evidence-based guidelines evaluating foot care interventions for the management of juvenile idiopathic arthritis (JIA). An electronic literature search of the following databases from database inception to May 2015 was conducted: MEDLINE (Ovid), EMBASE (Ovid), Cochrane CENTRAL, and clinicaltrials.gov. The Ottawa Panel selection criteria targeted studies that assessed foot care or foot orthotic interventions for the management of JIA in those aged 0 to ≤18 years. The Physiotherapy Evidence Database scale was used to evaluate study quality, of which only high-quality studies were included (score, ≥5). A total of 362 records were screened, resulting in 3 full-text articles and 1 additional citation containing supplementary information included for the analysis. Two reviewers independently extracted study data (intervention, comparator, outcome, time period, study design) from the included studies by using standardized data extraction forms. Directed by Cochrane Collaboration methodology, the statistical analysis produced figures and graphs representing the strength of intervention outcomes and their corresponding grades (A, B, C+, C, C-, D+, D, D-). Clinical significance was achieved when an improvement of ≥30% between the intervention and control groups was present, whereas P>.05 indicated statistical significance. An expert panel Delphi consensus (≥80%) was required for the endorsement of recommendations. All included studies were of high quality and analyzed the effects of multidisciplinary foot care, customized foot orthotics, and shoe inserts for the management of JIA. Custom-made foot orthotics and prefabricated shoe inserts displayed the greatest improvement in pain intensity, activity limitation, foot pain, and disability reduction (grades A, C+). The use of customized foot orthotics and prefabricated shoe inserts seems to be a good choice for managing foot pain and function in JIA. Copyright © 2016 American Congress of Rehabilitation

  12. Diagnostic value of newborn foot length to predict gestational age

    Directory of Open Access Journals (Sweden)

    Mutia Farah Fawziah

    2017-08-01

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

  13. Congenital hypertrophy of multiple intrinsic muscles of the foot.

    Science.gov (United States)

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

    2014-12-01

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

  14. Are we telling the diabetic patients adequately about foot care

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ali Rahmani

    2016-12-01

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

  16. Chemical purification of Gunungpati elephant foot yam flour to improve physical and chemical quality on processed food

    Science.gov (United States)

    Paramita, Octavianti; Wahyuningsih, Ansori, Muhammad

    2017-03-01

    This study was aimed at improving the physicochemical quality of elephant foot yam flour in Gunungpati, Semarang by chemical purification. The utilization of elephant foot yam flour in several processed food was also discussed in this study. The flour purification discussed in this study was expected to become a reference for the manufacturers of elephant foot yam flour and its processed food in Gunungpati. This study modified the elephant foot yam flour using pre - gelatinization method. The physical and chemical quality of each elephant foot yam flour purification sample were assessed using proximate analysis. The likability test was conducted for its processed food. 20 grams of elephant foot yam flour was put into a beaker glass, then 60 ml of water was added. The suspension was then heated at a temperature of 60 ° C and 70 ° C while stirred until it was homogeneous and thickened for 10, 30 and 60 minutes. The flour which had been heated was then cooled at room temperature for 1 hour and then at a temperature of 0 ° C until it was frozen. Furthermore, flour was dried in an oven at a temperature of 60 ° C for 9 hours. The dried flour was sifted with a 80 mesh sieve. Chemical test was conducted after elephant foot yam was pre-gelatinized to determine changes in the quality flour: test levels of protein, fat, crude fiber content, moisture content, ash content and starch content. In addition, color tests and granular test on elephant foot yam flour were also conducted. The pre-gelatinization as chemical treatment on elephant foot yam flour in this study was able to change the functional properties of elephant foot yam flour towards a better processing characterized by a brighter color (L = 70, a = 6 and b = 12), the hydrolysis of polysaccharides flour into shorter chain (flour content decreased to 44%), the expansion of granules in elephant foot yam resulting in a process - ready flour, and better monolayer water content of 9%. The content of protein and fiber

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

    Science.gov (United States)

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

    2018-03-01

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

  18. Foot orgasm syndrome: a case report in a woman.

    Science.gov (United States)

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

    2013-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Maizatul Nadwa Mohd Razi

    2017-08-01

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

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

    Science.gov (United States)

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

    2009-08-01

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

  1. Dynamic Analysis of Money Demand Function: Case of Turkey*

    OpenAIRE

    doğru, bülent

    2013-01-01

    In this paper, the dynamic determinants of money demand function and the long-run and short-run relationships between money demand, income and nominal interest rates are examined in Turkey for the time period 1980-2012. In particular we estimate a dynamic specification of a log money demand function based on Keynesian liquidity preference theory to ascertain the relevant elasticity of money demand. The empirical results of the study show that in Turkey inflation, exchange rate and money deman...

  2. A New Mobile Application for Standardizing Diabetic Foot Images.

    Science.gov (United States)

    Yap, Moi Hoon; Chatwin, Katie E; Ng, Choon-Ching; Abbott, Caroline A; Bowling, Frank L; Rajbhandari, Satyan; Boulton, Andrew J M; Reeves, Neil D

    2018-01-01

    We describe the development of a new mobile app called "FootSnap," to standardize photographs of diabetic feet and test its reliability on different occasions and between different operators. FootSnap was developed by a multidisciplinary team for use with the iPad. The plantar surface of 30 diabetic feet and 30 nondiabetic control feet were imaged using FootSnap on two separate occasions by two different operators. Reproducibility of foot images was determined using the Jaccard similarity index (JSI). High intra- and interoperator reliability was demonstrated with JSI values of 0.89-0.91 for diabetic feet and 0.93-0.94 for control feet. Similarly high reliability between groups indicates FootSnap is appropriate for longitudinal follow-ups in diabetic feet, with potential for monitoring pathology.

  3. Does footprint depth correlate with foot motion and pressure?

    Science.gov (United States)

    Bates, K T; Savage, R; Pataky, T C; Morse, S A; Webster, E; Falkingham, P L; Ren, L; Qian, Z; Collins, D; Bennett, M R; McClymont, J; Crompton, R H

    2013-06-06

    Footprints are the most direct source of evidence about locomotor biomechanics in extinct vertebrates. One of the principal suppositions underpinning biomechanical inferences is that footprint geometry correlates with dynamic foot pressure, which, in turn, is linked with overall limb motion of the trackmaker. In this study, we perform the first quantitative test of this long-standing assumption, using topological statistical analysis of plantar pressures and experimental and computer-simulated footprints. In computer-simulated footprints, the relative distribution of depth differed from the distribution of both peak and pressure impulse in all simulations. Analysis of footprint samples with common loading inputs and similar depths reveals that only shallow footprints lack significant topological differences between depth and pressure distributions. Topological comparison of plantar pressures and experimental beach footprints demonstrates that geometry is highly dependent on overall print depth; deeper footprints are characterized by greater relative forefoot, and particularly toe, depth than shallow footprints. The highlighted difference between 'shallow' and 'deep' footprints clearly emphasizes the need to understand variation in foot mechanics across different degrees of substrate compliance. Overall, our results indicate that extreme caution is required when applying the 'depth equals pressure' paradigm to hominin footprints, and by extension, those of other extant and extinct tetrapods.

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

    Science.gov (United States)

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

    2013-11-01

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

  5. Hallux valgus and hallux rigidus: a comparison of impact on health-related quality of life in patients presenting to foot surgeons in Australia

    Directory of Open Access Journals (Sweden)

    Landorf Karl B

    2008-12-01

    Full Text Available Abstract Background Hallux valgus and hallux rigidus are common foot conditions that lead to a deterioration in health status. Patients with significant pain or deformity from these conditions frequently resort to surgery. In this project, the foot health status of patients with hallux valgus and hallux rigidus presenting to foot surgeons in Australia was compared. Methods Foot health status was measured in 120 participants using the Foot Health Status Questionnaire (FHSQ, a validated 0 – 100 point health status instrument. All participants had presented for surgical advice regarding hallux valgus/rigidus. The mean age of participants was 48.0 years (SD ± 14.3, range 19 – 79. Results In the sample, 68% of participants were diagnosed with hallux valgus and 32% with hallux rigidus. Participants with hallux rigidus had greater levels of pain and functional limitation compared with hallux valgus. The mean difference for pain was 13.8 points (95% CI 4.6 to 22.9 and the mean difference for function was 15.0 points (95% CI 5.3 to 24.7. Both conditions result in similarly negative levels of impact on shoe fit and overall foot health. Conclusion This study found measurable differences in foot health status between hallux valgus and hallux rigidus in participants presenting for surgical consultation. While both appear to have a negative impact on health status, hallux rigidus has a more significant impact.

  6. Ascending infection of foot tendons in diabetic patients.

    Science.gov (United States)

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

    2013-12-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  9. Surgical management of diabetic foot and role of UT (University of Texas) classification

    International Nuclear Information System (INIS)

    Mishwani, A.H.; Kiyani, K.A.

    2011-01-01

    To evaluate the role of University of Texas Classification in the management of Diabetic foot. Design: Descriptive study Place and Duration of Study: Surgical unit II Combined Military Hospital Rawalpindi (2003 to 2008) and Department of Surgery Combined Military Hospital Peshawar (July 2008 to Jan 2010). Patients and Method: A total of 300 patients who reported to Surgical Department with a foot ulcer or infection and diagnosed to have Diabetes Mellitus were studied. Patients of both gender and age >12 years were included. Patients of end stage renal disease, compromised immunity or on steroid therapy were excluded. Detailed history and clinical examination were recorded. Routine investigations including complete blood examination, urine routine examination, renal function tests, x-ray foot, chest x-ray, ECG and pus for culture and sensitivity were recorded. Lesions were classified according to University of Texas classification and treated accordingly. Results: Majority of the patients were of 50 to 70 years age group. Male to female ratio was 4:1. Big toe was the commonest site followed by fore foot and heel. Patients were classified according to UT classification. Patients were managed with antibiotics, dressings, incision and drainage, debridement, vacuum assisted closure (VAC) with or without skin grafting and amputations of different types. Staphylococcus aureus was the commonest isolate. Conclusion: Our study has shown that UT classification is an effective system of assessing the severity of Diabetic foot at the time of presentation and planning its management. Amputation rates, time of healing and morbidity increases with increasing stage and grade. (author)

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

    Science.gov (United States)

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

    2016-04-01

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

  11. Angiography in the region of the foot

    Energy Technology Data Exchange (ETDEWEB)

    Zeitler, E.

    1984-06-01

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

  12. Angiography in the region of the foot

    International Nuclear Information System (INIS)

    Zeitler, E.

    1984-01-01

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

  13. Does the thickening of Achilles tendon and plantar fascia contribute to the alteration of diabetic foot loading?

    Science.gov (United States)

    Giacomozzi, C; D'Ambrogi, E; Uccioli, L; Macellari, V

    2005-06-01

    The diabetic foot often undergoes abnormal plantar pressures, changing in walking strategy, ulcerative processes. The present study focuses on the effects that diabetes-induced alterations of Achilles tendon, plantar fascia and first metatarso-phalangeal joint-both anatomical and functional-may have on foot loading. Sixty-one diabetic patients, with or without neuropathy, and 21 healthy volunteers were recruited. Thickness of Achilles tendon and plantar fascia was measured by ultrasound. Flexion-extension of the first metatarso-phalangeal joint was measured passively. Main biomechanic parameters of foot-floor interaction during gait were acquired and related to the above measurements. Plantar fascia and Achilles tendon were significantly (Pplantar fascia, respectively, and 4.0 mm (0.5), 4.6 mm (1.0) and 4.9 mm (1.7) for Achilles tendon, respectively. Flexion-extension of the first metatarso-phalangeal joint was significantly (Pplantar fascia and Achilles tendon in diabetics, more evident in the presence of neuropathy, concurs to develop a rigid foot, which poorly absorbs shock during landing (performs the physiological impact force absorption during landing). More generally, an overall alteration of the foot-ankle complex motion likely occurs throughout the whole gait cycle, which partly explains the abnormal loading under the forefoot.

  14. Ultrastructure and Glycoconjugate Pattern of the Foot Epithelium of the Abalone Haliotis tuberculata (Linnaeus, 1758 (Gastropoda, Haliotidae

    Directory of Open Access Journals (Sweden)

    I. Bravo Portela

    2012-01-01

    Full Text Available The foot epithelium of the gastropod Haliotis tuberculata is studied by light and electron microscopy in order to contribute to the understanding of the anatomy and functional morphology of the mollusks integument. Study of the external surface by scanning electron microscopy reveals that the side foot epithelium is characterized by a microvillus border with a very scant presence of small ciliary tufts, but the sole foot epithelium bears a dense field of long cilia. Ultrastructural examination by transmission electron microscopy of the side epithelial cells shows deeply pigmented cells with high electron-dense granular content which are not observed in the epithelial sole cells. Along the pedal epithelium, seven types of secretory cells are present; furthermore, two types of subepithelial glands are located just in the sole foot. The presence and composition of glycoconjugates in the secretory cells and subepithelial glands are analyzed by conventional and lectin histochemistry. Subepithelial glands contain mainly N-glycoproteins rich in fucose and mannose whereas secretory cells present mostly acidic sulphated glycoconjugates such as glycosaminoglycans and mucins, which are rich in galactose, N-acetyl-galactosamine, and N-acetyl-glucosamine. No sialic acid is present in the foot epithelium.

  15. Imaging diagnostics of the foot; Bildgebende Diagnostik des Fusses

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-01

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

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

    Science.gov (United States)

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

    2009-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Ismail, Hossam El-din Ali

    2017-01-01

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

  18. Benign and malignant tumors of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

  19. Cumulant approach to dynamical correlation functions at finite temperatures

    International Nuclear Information System (INIS)

    Tran Minhtien.

    1993-11-01

    A new theoretical approach, based on the introduction of cumulants, to calculate thermodynamic averages and dynamical correlation functions at finite temperatures is developed. The method is formulated in Liouville instead of Hilbert space and can be applied to operators which do not require to satisfy fermion or boson commutation relations. The application of the partitioning and projection methods for the dynamical correlation functions is discussed. The present method can be applied to weakly as well as to strongly correlated systems. (author). 9 refs

  20. Social Dynamics Management and Functional Behavioral Assessment

    Science.gov (United States)

    Lee, David L.

    2018-01-01

    Managing social dynamics is a critical aspect of creating a positive learning environment in classrooms. In this paper three key interrelated ideas, reinforcement, function, and motivating operations, are discussed with relation to managing social behavior.