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Sample records for plantar pressure-based tongue-placed

  1. How a plantar pressure-based, tongue-placed tactile biofeedback modifies postural control mechanisms during quiet standing

    CERN Document Server

    Vuillerme, Nicolas; Chenu, Olivier; Boisgontier, Matthieu; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    The purpose of the present study was to determine the effects of a plantar pressure-based, tongue-placed tactile biofeedback on postural control mechanisms during quiet standing. To this aim, sixteen young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements, recorded using a force platform, were used to compute the horizontal displacements of the vertical projection the centre of gravity (CoGh) and those of the difference between the CoP and the vertical projection of the CoG (CoP-CoGv). Altogether, the present findings suggest that the main way the plantar pressure-based, tongue-placed tactile biofeedback improves postural control during quiet standing is via both a reduction of the correction thresholds and an increased efficiency of the corrective mechanism involving the CoGh displacements.

  2. Controlling posture using a plantar pressure-based, tongue-placed tactile biofeedback system

    CERN Document Server

    Vuillerme, Nicolas; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    The present paper introduces an original biofeedback system for improving human balance control, whose underlying principle consists in providing additional sensory information related to foot sole pressure distribution to the user through a tongue-placed tactile output device. To assess the effect of this biofeedback system on postural control during quiet standing, ten young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Results showed reduced CoP displacements in the Biofeedback relative to the No-biofeedback condition. The present findings evidenced the ability of the central nervous system to efficiently integrate an artificial plantar-based, tongue-placed tactile biofeedback for controlling control posture during quiet standing.

  3. How a plantar pressure-based, tongue-placed tactile biofeedback modifies postural control mechanisms during quiet standing.

    Science.gov (United States)

    Vuillerme, Nicolas; Pinsault, Nicolas; Chenu, Olivier; Boisgontier, Matthieu; Demongeot, Jacques; Payan, Yohan

    2007-08-01

    The purpose of the present study was to determine the effects of a plantar pressure-based, tongue-placed tactile biofeedback on postural control mechanisms during quiet standing. To this aim, 16 young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements, recorded using a force platform, were used to compute the horizontal displacements of the vertical projection of the centre of gravity (CoG( v )) and those of the difference between the CoP and the vertical projection of the CoG (CoP-CoG( v )). Analysis of the CoP-CoG( v ) displacements showed larger root mean square (RMS) and mean power frequencies (MPF) in the Biofeedback than in the No-biofeedback condition. Stabilogram-diffusion analysis further showed a concomitant increased spatial and reduced temporal transition point co-ordinates at which the corrective processes were initiated and an increased persistent behaviour of the CoP-CoG( v ) displacements over the short-term region. Analysis of the CoG( v ) displacements showed decreased RMS and increased MPF in the Biofeedback relative to the No-biofeedback condition. Stabilogram-diffusion analysis further indicated that these effects mainly stem from reduced spatio-temporal transition point co-ordinates at which the corrective process involving CoG( v ) displacements is initiated and an increased anti-persistent behaviour of the CoG( v ) displacements over the long-term region. Altogether, the present findings suggest that the main way the plantar pressure-based, tongue-placed tactile biofeedback improves postural control during quiet standing is via both a reduction of the correction thresholds and an increased efficiency of the corrective mechanism involving the CoG( v ) displacements.

  4. A Plantar-pressure Based Tongue-placed Tactile Biofeedback System for Balance Improvement

    CERN Document Server

    Vuillerme, Nicolas; Pinsault, Nicolas; Fleury, Anthony; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    Maintaining an upright stance represents a complex task, which is achieved by integrating sensory information from the visual, vestibular and somatosensory systems. When one of these sensory inputs becomes unavailable and/or inaccurate and/or unreliable, postural control generally is degraded. One way to solve this problem is to supplement and/or substitute limited/altered/missing sensory information by providing additional sensory information to the central nervous system via an alternative sensory modality. Along these lines, we developed an original biofeedback system [1] whose underlying principle consists in supplying the user with supplementary sensory information related to foot sole pressure distribution through a tongue-placed output device (Tongue Display Unit, "TDU" [2]). The purpose of the present experiment was to assess its effectiveness in improving balance in young healthy adults.

  5. Inter-individual variability in sensory weighting of a plantar pressure-based, tongue-placed tactile biofeedback for controlling posture

    CERN Document Server

    Vuillerme, Nicolas; Boisgontier, Matthieu; Chenu, Olivier; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    The purpose of the present experiment was to investigate whether the sensory weighting of a plantar pressure-based, tongue-placed tactile biofeedback for controlling posture could be subject to inter-individual variability. To achieve this goal, 60 young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Overall, results showed reduced CoP displacements in the Biofeedback relative to the No-biofeedback condition, evidencing the ability of the central nervous system to efficiently integrate an artificial plantar-based, tongue-placed tactile biofeedback for controlling posture during quiet standing. Results further showed a significant positive correlation between the CoP displacements measured in the No-biofeedback condition and the decrease in the CoP displacements induced by the use of the biofeedback. In other words, the degree of postural stab...

  6. Prevention of recurrent foot ulcers with plantar pressure-based in-shoe orthoses: the CareFUL prevention multicenter randomized controlled trial.

    Science.gov (United States)

    Ulbrecht, Jan S; Hurley, Timothy; Mauger, David T; Cavanagh, Peter R

    2014-07-01

    To assess the efficacy of in-shoe orthoses that were designed based on shape and barefoot plantar pressure in reducing the incidence of submetatarsal head plantar ulcers in people with diabetes, peripheral neuropathy, and a history of similar prior ulceration. Single-blinded multicenter randomized controlled trial with subjects randomized to wear shape- and pressure-based orthoses (experimental, n = 66) or standard-of-care A5513 orthoses (control, n = 64). Patients were followed for 15 months, until a study end point (forefoot plantar ulcer or nonulcerative plantar forefoot lesion) or to study termination. Proportional hazards regression was used for analysis. There was a trend in the composite primary end point (both ulcers and nonulcerative lesions) across the full follow-up period (P = 0.13) in favor of the experimental orthoses. This trend was due to a marked difference in ulcer occurrence (P = 0.007) but no difference in the rate of nonulcerative lesions (P = 0.76). At 180 days, the ulcer prevention effect of the experimental orthoses was already significant (P = 0.003) when compared with control, and the benefit of the experimental orthoses with respect to the composite end point was also significant (P = 0.042). The hazard ratio was 3.4 (95% CI 1.3-8.7) for the occurrence of a submetatarsal head plantar ulcer in the control compared with experimental arm over the duration of the study. We conclude that shape- and barefoot plantar pressure-based orthoses were more effective in reducing submetatarsal head plantar ulcer recurrence than current standard-of-care orthoses, but they did not significantly reduce nonulcerative lesions. © 2014 by the American Diabetes Association.

  7. Optimizing the use of an artificial tongue-placed tactile biofeedback for improving ankle joint position sense in humans.

    Science.gov (United States)

    Vuillerme, N; Chenu, O; Fleury, A; Demongeot, J; Payan, Y

    2006-01-01

    The performance of an artificial tongue-placed tactile biofeedback device for improving ankle joint position sense was assessed in 12 young healthy adults using an active matching task. The underlying principle of this system consisted of supplying individuals with supplementary information about the position of the matching ankle relative to the reference ankle position through a tongue-placed tactile output device generating electrotactile stimulation on a 36- point (6 x 6) matrix held against the surface of the tongue dorsum. Precisely, (1) no electrodes were activated when both ankles were in a similar angular position within predetermined "angular dead zone" (ADZ); (2) 12 electrodes (2 x 6) of the anterior and posterior zones of the matrix were activated (corresponding to the stimulation of the front and rear portion of the tongue) when the matching ankle was in too plantar and dorsiflexed position relative to the reference ankle, respectively. The effects of two ADZ values of 0.5 degrees and 1.5 degrees were evaluated. Results showed (1) more accurate and more consistent matching performances with than without biofeedback and (2) more accurate and more consistent ankle joint matching performances when using the biofeedback device with the smaller ADZ value. These findings suggest that (1) electrotactile stimulation of the tongue can be used to improve ankle joint proprioception and (2) this improvement can be increased through an appropriate specification of the ADZ parameter provided by the biofeedback system. Further investigations are needed to strengthen the potential clinical value of this device.

  8. Artificial Tongue-Placed Tactile Biofeedback for perceptual supplementation: application to human disability and biomedical engineering

    CERN Document Server

    Vuillerme, Nicolas; Moreau-Gaudry, Alexandre; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    The present paper aims at introducing the innovative technologies, based on the concept of "sensory substitution" or "perceptual supplementation", we are developing in the fields of human disability and biomedical engineering. Precisely, our goal is to design, develop and validate practical assistive biomedical and/technical devices and/or rehabilitating procedures for persons with disabilities, using artificial tongue-placed tactile biofeedback systems. Proposed applications are dealing with: (1) pressure sores prevention in case of spinal cord injuries (persons with paraplegia, or tetraplegia); (2) ankle proprioceptive acuity improvement for driving assistance in older and/or disabled adults; and (3) balance control improvement to prevent fall in older and/or disabled adults. This paper presents results of three feasibility studies performed on young healthy adults.

  9. Improving human ankle joint position sense using an artificial tongue-placed tactile biofeedback

    CERN Document Server

    Vuillerme, N; Demongeot, J; Payan, Y; Vuillerme, Nicolas; Chenu, Olivier; Demongeot, Jacques; Payan, Yohan

    2006-01-01

    Proprioception is comprised of sensory input from several sources including muscle spindles, joint capsule, ligaments and skin. The purpose of the present experiment was to investigate whether the central nervous system was able to integrate an artificial biofeedback delivered through electrotactile stimulation of the tongue to improve proprioceptive acuity at the ankle joint. To address this objective, nine young healthy adults were asked to perform an active ankle-matching task with and without biofeedback. The underlying principle of the biofeedback consisted of supplying subjects with supplementary information about the position of their matching ankle position relative to their reference ankle position through a tongue-placed tactile output device (Tongue Display Unit). Measures of the overall accuracy and the variability of the positioning were determined using the absolute error and the variable error, respectively. Results showed more accurate and more consistent matching performances with than withou...

  10. Plantar Fasciitis

    Science.gov (United States)

    ... Causes3. Diagnosis4. Treatment5. Questions OverviewWhat is the plantar fascia?The plantar fascia is a band of tissue, much like a ... form the ball of your foot. The plantar fascia works like a rubber band between the heel ...

  11. Plantar fibromatosis.

    Science.gov (United States)

    Zgonis, Thomas; Jolly, Gary Peter; Polyzois, Vasilios; Kanuck, David M; Stamatis, Emmanouil D

    2005-01-01

    Plantar fibromatosis is defined as a benign fibrous disorder involving the plantar aponeurosis. Although its incidence is well described on the hands, it is less commonly seen on the feet, and its etiology is unknown. A differential diagnosis for the heel pain along the medial arch could be a benign thickening of the plantar fascia associated with plantar fibromatosis. Its high recurrence after surgical excision and problematic scarring and wound presents a significant challenge to the reconstructive foot and ankle surgeon. This article reviews the history, clinical presentation, pathologic findings, and surgical approaches to the treatment of plantar fibromatosis.

  12. Optimizing the Use of an Artificial Tongue-Placed Tactile Biofeedback for Improving Ankle Joint Position Sense in Humans

    CERN Document Server

    Vuillerme, N; Fleury, A; Demongeot, J; Payan, Y; Vuillerme, Nicolas; Chenu, Olivier; Fleury, Anthony; Demongeot, Jacques; Payan, Yohan

    2006-01-01

    The performance of an artificial tongue-placed tactile biofeedback device for improving ankle joint position sense was assessed in 12 young healthy adults using an active matching task. The underlying principle of this system consists of supplying individuals with supplementary information about the position of the matching ankle relative to the reference ankle position through a tongue-placed tactile output device generating electrotactile stimulation on a 36-point (6 X 6) matrix held against the surface of the tongue dorsum. Precisely, (1) no electrodes were activated when both ankles were in a similar angular position within a predetermined "angular dead zone" (ADZ); (2) 12 electrodes (2 X 6) of the anterior and posterior zones of the matrix were activated (corresponding to the stimulation of the front and rear portion of the tongue) when the matching ankle was in a too plantarflexed and dorsiflexed position relative to the reference ankle, respectively. Two ADZ values of 0.5° and 1.5° were...

  13. Tongue-placed tactile biofeedback suppresses the deleterious effects of muscle fatigue on joint position sense at the ankle

    CERN Document Server

    Vuillerme, Nicolas; Chenu, Olivier; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    Whereas the acuity of the position sense at the ankle can be disturbed by muscle fatigue, it recently also has been shown to be improved, under normal ankle neuromuscular state, through the use of an artificial tongue-placed tactile biofeedback. The underlying principle of this biofeedback consisted of supplying individuals with supplementary information about the position of their matching ankle position relative to their reference ankle position through electrotactile stimulation of the tongue. Within this context, the purpose of the present experiment was to investigate whether this biofeedback could mitigate the deleterious effect of muscle fatigue on joint position sense at the ankle. To address this objective, sixteen young healthy university students were asked to perform an active ankle-matching task in two conditions of No-fatigue and Fatigue of the ankle muscles and two conditions of No-biofeedback and Biofeedback. Measures of the overall accuracy and the variability of the positioning were determin...

  14. Plantar Fibroma

    Science.gov (United States)

    ... it can also arise when walking or standing barefoot. Diagnosis To diagnose a plantar fibroma, the foot ... Where do you hurt? Interactive Foot Diagram Going Barefoot? Beware! Tips for a safer barefoot summer. Millions ...

  15. Plantar Warts

    Science.gov (United States)

    ... Consequently, you may contract the virus by walking barefoot around swimming pools or locker rooms. If the ... have had plantar warts before People who walk barefoot where exposure to a wart-causing virus is ...

  16. Plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Tahririan

    2012-01-01

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

  17. Fascitis plantar

    OpenAIRE

    López Pérez, Diego

    2014-01-01

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

  18. Pressure sensor-based tongue-placed electrotactile biofeedback for balance improvement - Biomedical application to prevent pressure sores formation and falls

    CERN Document Server

    Vuillerme, Nicolas; Pinsault, Nicolas; Moreau-Gaudry, Alexandre; Fleury, Anthony; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    We introduce the innovative technologies, based on the concept of "sensory substitution", we are developing in the fields of biomedical engineering and human disability. Precisely, our goal is to design, develop and validate practical assistive biomedical and/or technical devices and/or rehabilitating procedures for persons with disabilities, using artificial tongue-placed tactile biofeedback systems. Proposed applications are dealing with: (1) pressure sores prevention in case of spinal cord injuries (persons with paraplegia, or tetraplegia); and (2) balance control improvement to prevent fall in older and/or disabled adults. This paper describes the architecture and the functioning principle of these biofeedback systems and presents preliminary results of two feasibility studies performed on young healthy adults.

  19. Plantar fascia (image)

    Science.gov (United States)

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

  20. Plantar Vein Thrombosis: An Unusual Cause of Plantar Pain

    OpenAIRE

    Vansevenant, Milan; Vanhoenacker, Filip M.

    2015-01-01

    We present a case of an 80-year-old man with progressive pain for 5 days at the medial and plantar aspect of the left heel. Wearing shoes aggravated the pain. Ultrasound and magnetic resonance imaging (MRI) revealed thrombosis of the medial plantar veins. Plantar vein thrombosis is a rare condition. The clinical symptoms are non-specific and can be confused with plantar fasciitis. It has been associated with hypercoagulable conditions, foot trauma and recent surgery. The imaging modality of c...

  1. [Plantar fibromatosis (Ledderhose's disease)].

    Science.gov (United States)

    Koudela, K; Koudela, K; Kunešová, M; Koudelová, J

    2010-08-01

    The authors describe the concomitant presence of plantar fibromatosis and Dupuytren's disease in a 33-year-old man. A lesion located under the sesamoid bones of the first metatarsophalangeal joint on the right showed an aggressive tendency (rapid growth, pain, impossibility to put weight on the medial side of the foot). Another lesion located proximal to the first one was smaller and painless. Neither plain radiography nor computed tomography showed any structural changes of the skeleton. Contrast-enhancement on magnetic resonance imaging revealed two lesions on the sole of the foot. Since a concurrence of plantar fibromatosis and malignant tumour could not be ruled out, an excision of both lesions and the adjacent plantar aponeurosis was made for biopsy examination. The operative procedure was carried out from two incisions.The intra-operative findings included proliferative growth and bleeding in the lesion located under the first metatarsophalangeal joint, and delimited growth without noticeable bleeding in the other lesion. Based on histological examination, the diagnosis of plantar fibromatosis was made for both lesions.The differential diagnosis and therapy of plantar fibromatosis is discussed.

  2. Rupture of the plantar fascia.

    Science.gov (United States)

    Pai, V S

    1996-01-01

    Rupture of the plantar fascia in athletes engaged in sports that require running and jumping has been reported. However, spontaneous degenerative rupture of the plantar fascia is not well documented in the literature. This paper reports a patient with degenerative rupture of the plantar fascia.

  3. Talalgia: plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Ricardo Cardenuto Ferreira

    2014-06-01

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

  4. MRI of plantar fasciitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-12-01

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

  5. Treatment of Chronic Plantar Fasciitis With Percutaneous Latticed Plantar Fasciotomy.

    Science.gov (United States)

    Yanbin, Xu; Haikun, Chu; Xiaofeng, Ji; Wanshan, Yang; Shuangping, Liu

    2015-01-01

    Plantar fasciitis, the most common cause of pain in the inferior heel, accounts for 11% to 15% of all foot symptoms requiring professional care among adults. The present study reports the results of a minimally invasive surgical treatment of chronic plantar fasciitis. All patients with plantar fasciitis who had undergone percutaneous latticed plantar fasciotomy at 3 clinical sites from March 2008 to March 2009 were included in the present study. The follow-up evaluations for this treatment were conducted using the Mayo clinical scoring system. We investigated 17 patients with recalcitrant chronic plantar fasciitis who had undergone this treatment within a follow-up period of ≥13 months. All procedures were performed in the clinic with the patient under local anesthesia. No wound infections or blood vessel or nerve damage occurred. At a mean follow-up period of 16.0 ± 2.29 (range 13 to 21) months, significant improvement was seen in the preoperative mean Mayo score (from 12.06 ± 2.54 to 89.76 ± 4.28, p plantar fasciitis with percutaneous latticed plantar fasciotomy could be a promising treatment option for patients with recalcitrant chronic plantar fasciitis.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-03-15

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

  7. Variant position of the medial plantar nerve

    OpenAIRE

    Astik RB; Dave UH; Gajendra KS

    2011-01-01

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

  8. Acute Medial Plantar Fascia Tear.

    Science.gov (United States)

    Pascoe, Stephanie C; Mazzola, Timothy J

    2016-06-01

    A 32-year-old man who participated in competitive soccer came to physical therapy via direct access for a chief complaint of plantar foot pain. The clinical examination findings and mechanism of injury raised a concern for a plantar fascia tear, so the patient was referred to the physician and magnetic resonance imaging was obtained. The magnetic resonance image confirmed a high-grade, partial-thickness, proximal plantar fascia tear with localized edema at the location of the medial band. J Orthop Sports Phys Ther 2016;46(6):495. doi:10.2519/jospt.2016.0409.

  9. Plantar fibromatosis. Ultrasound assessment; La fibromatosi plantare: risultati ecografici

    Energy Technology Data Exchange (ETDEWEB)

    Solivetti, F.R.; Luzi, F.; Bucher, S.; Thorel, M.F.; Muscardin, L. [Rome Ospedale Santa Maria e San Gallicano, Rome (Italy)

    1999-05-01

    In 1998-99, six patients with plantar fibromatosis were submitted to US (ultrasound) with plantar fibromatosis were submitted to US with 13 MHz linear array and 20 MHz mechanical annular array probes. All patients were examined in prone recumbency with the probe positioned on the sole of the foot. Only some of them were subsequently submitted to surgery. Plantar fibromatosis exhibited an almost pathognomonic pattern and US proved to be a quick, noninvasive and cost-effective technique to confirm clinical diagnosis. The nodule is typically single and iso echoic, with maximum diameter of about 1 cm, inhomogeneous internal structure and few thin hyperechoic septa. The nodular fibrous proliferation adheres with the major axis along the plantar fascia; it exhibits clear-cut margins and US beam transmission is good. No calcifications or fluid collections are seen within the nodule. Color and power Doppler show no flow inside. It is demonstrated that US is an adequate tool for the study of plantar fibromatosis. [Italian] Negli anni 1998-99 sono stati osservati ben sei casi di fibromatosi plantare, solo in parte trattati chirurgicamente. Tutti sono stati studiati con ecografia, con apparecchiatura in tempo reale e sonde lineari da 13 MHz e anulari da 20 MHz. Si puo' descrivere un quadro tipico della malattia diagnosticabile con l'ecografia, specie in associazione con sintomi clinici caratteristici.

  10. PLANTAR FİBROMATOZİS

    OpenAIRE

    Eryılmaz, Tolga

    2010-01-01

    Plantar fibromatozis veya Ledderhose hastalığı, plantar aponevrozun nedeni bilinmeyen, nadir, hiperproliferatif, benign lezyonudur. Mikroskobik olarak Dupuytren hastalığıyla benzerliği nedeniyle plantar fasyanın Dupuytren hastalığı da denilmektedir. Plantar fasyanın özellikle medial parçasını etkileyen bir veya daha fazla sert nodül oluşumu görülür. Çoğunlukla ortopedi bölümü tarafından takip edildiğinden plastik cerrahların nadir olarak karşılaştığı bir hastalıktır. Bu çalışmada, 2008–2009 y...

  11. Reliability of plantar pressure platforms.

    Science.gov (United States)

    Hafer, Jocelyn F; Lenhoff, Mark W; Song, Jinsup; Jordan, Joanne M; Hannan, Marian T; Hillstrom, Howard J

    2013-07-01

    Plantar pressure measurement is common practice in many research and clinical protocols. While the accuracy of some plantar pressure measuring devices and methods for ensuring consistency in data collection on plantar pressure measuring devices have been reported, the reliability of different devices when testing the same individuals is not known. This study calculated intra-mat, intra-manufacturer, and inter-manufacturer reliability of plantar pressure parameters as well as the number of plantar pressure trials needed to reach a stable estimate of the mean for an individual. Twenty-two healthy adults completed ten walking trials across each of two Novel emed-x(®) and two Tekscan MatScan(®) plantar pressure measuring devices in a single visit. Intraclass correlation (ICC) was used to describe the agreement between values measured by different devices. All intra-platform reliability correlations were greater than 0.70. All inter-emed-x(®) reliability correlations were greater than 0.70. Inter-MatScan(®) reliability correlations were greater than 0.70 in 31 and 52 of 56 parameters when looking at a 10-trial average and a 5-trial average, respectively. Inter-manufacturer reliability including all four devices was greater than 0.70 for 52 and 56 of 56 parameters when looking at a 10-trial average and a 5-trial average, respectively. All parameters reached a value within 90% of an unbiased estimate of the mean within five trials. Overall, reliability results are encouraging for investigators and clinicians who may have plantar pressure data sets that include data collected on different devices.

  12. Sonographic evaluation of plantar fasciitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-03-01

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

  13. Topical cidofovir for plantar warts.

    Science.gov (United States)

    Padilla España, Laura; Del Boz, Javier; Fernández Morano, Teresa; Arenas Villafranca, Javier; de Troya Martín, Magdalena

    2014-01-01

    Plantar warts are a common reason for dermatological consultations and their treatment can occasionally be a challenge. Plantar warts are benign lesions produced by the human papillomavirus (HPV) that often fail to respond to habitual treatment. Cidofovir is a potent antiviral drug that acts competitively, inhibiting viral DNA polymerase. Our aim was to assess the efficacy and safety of cidofovir cream for the treatment of viral plantar warts. We undertook a retrospective observational study of patients with plantar warts who received treatment with topical cidofovir between July 2008 and July 2011 at the Dermatology Service of the Hospital Costa del Sol, Marbella, Spain. Data about the rate of treatment response, the adverse effects, and recurrences, as well as the characteristics of the patient cohort, were recorded. We identified 35 patients who had received some previous treatment. The usual concentration was 3% (in 33 of 35 cases), applied twice a day (in 31 of 35 cases). A greater or lesser response was noted in 28 cases. There were two recurrences. Topical cidofovir seems to be a useful alternative for the therapeutic management of recalcitrant plantar common warts that fail to respond to usual treatment.

  14. Variant position of the medial plantar nerve

    Directory of Open Access Journals (Sweden)

    Astik RB

    2011-01-01

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

  15. Plantar fibromatosis--topical review.

    Science.gov (United States)

    Veith, Nils T; Tschernig, Thomas; Histing, Tina; Madry, Henning

    2013-12-01

    Morbus Ledderhose is a rare hyperproliferative disease of the plantar fascia, leading to the formation of nodules. Its origin is unknown. No causal therapy is available, and treatment remains symptomatic. Various therapeutic strategies to alleviate symptoms are available and are adapted to the severity of the disease. In early stages, conservative therapy including nonpharmacological, physical, and pharmacological treatments is applied. If the disease progresses, irradiation of the plantar surface, injections of steroids, shock wave therapy, and partial or complete fasciectomy as an ultimate therapy may be indicated. Novel experimental treatment options including application of fibrinolytic agents are currently being tested, but no controlled, randomized long-term studies are available. This review aims to provide a systematic overview of current established procedures and outlines novel experimental strategies for the treatment of morbus Ledderhose, including future avenues to treat this rare disease.

  16. Comparison between different plantar arch

    OpenAIRE

    2009-01-01

    The longitudinal plantar arch (LPA) perform biomechanics functions in the foot. The aim of this study was to compare the relationship between different index to measure the LPA of the foot. The arc index, Staheli index, Viladot classification and Feiss line were compared. In the transversal study, the experimental samples were soccer players females with age between 13 to 19 years. The measure were performed by plantigraphy, with out Feiss line. Although non significant the higher agreement w...

  17. Spontaneous rupture of the plantar fascia.

    Science.gov (United States)

    Ahstrom, J P

    1988-01-01

    In this study, rupture of the plantar fascia was seen in five feet, of which four had had plantar fasciitis. At the time of the injury, which is an acceleration type of motion, there is severe pain in the heel followed by the development of ecchymosis in the sole and toward the heel of the foot. With conservative symptomatic care, the acute symptoms as well as the plantar fasciitis symptoms subside, generally allowing full activity in 3 to 4 weeks.

  18. Plantar fascia softening in plantar fasciitis with normal B-mode sonography.

    Science.gov (United States)

    Wu, Chueh-Hung; Chen, Wen-Shiang; Wang, Tyng-Guey

    2015-11-01

    To investigate plantar fascia elasticity in patients with typical clinical manifestations of plantar fasciitis but normal plantar fascia morphology on B-mode sonography. Twenty patients with plantar fasciitis (10 unilateral and 10 bilateral) and 30 healthy volunteers, all with normal plantar fascia morphology on B-mode sonography, were included in the study. Plantar fascia elasticity was evaluated by sonoelastographic examination. All sonoelastograms were quantitatively analyzed, and less red pixel intensity was representative of softer tissue. Pixel intensity was compared among unilateral plantar fasciitis patients, bilateral plantar fasciitis patients, and healthy volunteers by one-way ANOVA. A post hoc Scheffé's test was used to identify where the differences occurred. Compared to healthy participants (red pixel intensity: 146.9 ± 9.1), there was significantly less red pixel intensity in the asymptomatic sides of unilateral plantar fasciitis (140.4 ± 7.3, p = 0.01), symptomatic sides of unilateral plantar fasciitis (127.1 ± 7.4, p fascia thickness or green or blue pixel intensity among these groups. Sonoelastography revealed that the plantar fascia is softer in patients with typical clinical manifestations of plantar fasciitis, even if they exhibit no abnormalities on B-mode sonography.

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

    Science.gov (United States)

    Jeswani, T; Morlese, J; McNally, E G

    2009-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-09-15

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

  1. Association of Achilles tendinopathy and plantar spurs.

    Science.gov (United States)

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

    2014-10-01

    Plantar spurs and Achilles tendinopathy are common causes of heel pain. In the authors' practice, it was anecdotally noted that patients with Achilles tendinopathy often presented with plantar spurs. Nonetheless, there is a shortage of studies investigating whether Achilles tendinopathy and plantar spurs exist concomitantly. A better understanding of the association between the 2 pathologies might help physicians recognize and treat both conditions, educate patients about Achilles tendinopathy and plantar spurs, and ultimately investigate possible underlying causes of both pathologies that could be addressed together. The authors examined the prevalence of plantar spurs in patients diagnosed with Achilles tendinopathy as well as demographic differences within the unilateral and bilateral Achilles tendinopathy populations. A total of 785 patient records were retrospectively reviewed. Mean patient age was 56.2±15.5 years (46.9% men and 53.1% women). Seventy-two (9.2%) patients were affected bilaterally by Achilles tendinopathy. Lateral radiographs were reviewed by an orthopedic surgeon to identify the presence of plantar spurs. A total of 329 (41.9%) patients with Achilles tendinopathy were found to have a concomitant plantar spur. Patients with unilateral Achilles tendinopathy and a plantar spur were more likely to be women (58.7% vs 49.8%, P=.020) and older (62.7 vs 51.7 years, Ptendinopathy group, there were 46 (63.9%) patients with at least one foot presenting with a plantar spur. The study's findings suggest a significant association between Achilles tendinopathy and plantar spurs. Older women with Achilles tendinopathy are at greater risk of being affected by plantar spurs. Copyright 2014, SLACK Incorporated.

  2. Post-traumatic unilateral plantar hyperhidrosis.

    Science.gov (United States)

    Eren, Y; Yavasoglu, N G; Comoglu, S S

    2016-02-01

    Localized unilateral hyperhidrosis is rare and poorly understood, sometimes stemming from trauma. Feet, quite vulnerable to trauma are affected by disease-mediated plantar hyperhidrosis, usually bilaterally. This report describes partial hyperhidrosis developing post-traumatically on the left plantar region of a 52-year-old male.

  3. Plantar fascia rupture associated with corticosteroid injection.

    Science.gov (United States)

    Sellman, J R

    1994-07-01

    A series of 37 patients, all with a presumptive diagnosis of plantar fascia rupture, is presented. All had had prior heel pain diagnosed as plantar fasciitis, and all had been treated with corticosteroid injection into the calcaneal origin of the fascia. One third described a sudden tearing episode in the heel, while the rest had a gradual change in symptoms. Most of the patients had relief of the original heel pain, which had been replaced by a variety of new foot problems, including dorsal and lateral midfoot pain, swelling, foot weakness, metatarsal pain, and metatarsal fracture. In all 37 patients, there was a palpable diminution in the tension of the plantar fascia on the involved side, and footprints often showed a flattening of the involved arch. Magnetic resonance imaging done on one patient showed attenuation of the plantar fascia. From these observations and data, the author concluded that plantar fascia rupture had occurred. Treatment following rupture included supportive shoes, orthoses, and time. The majority had resolution of their new symptoms, but this often took 6 to 12 months to occur. In the remainder, there were persisting symptoms. Corticosteroid injections, although helpful in the treatment of plantar fasciitis, appear to predispose to plantar fascia rupture.

  4. Recurrence of plantar fibromatosis after plantar fasciectomy: single-center long-term results.

    Science.gov (United States)

    van der Veer, Willem M; Hamburg, Stijn M; de Gast, Arthur; Niessen, Frank B

    2008-08-01

    Plantar fibromatosis is a rare, hyperproliferative, benign lesion of the plantar aponeurosis with an unknown cause. Surgical treatment is associated with a high recurrence rate and risk of complications. The goal of this study was to determine the recurrence rate of plantar fibromatosis after plantar fasciectomy at the authors' institute during the past three decades and the factors associated with an increased risk for recurrence. The study group contained 27 patients with plantar fibromatosis, who underwent 40 operations on 33 feet, including 13 right (39 percent) and 20 left (61 percent) feet. The overall recurrence rate was 60 percent. Treating a primary lesion with total plantar fasciectomy was associated with the lowest (25 percent) and local resection of the lesion was associated with the highest recurrence rate (100 percent). There seemed to be a relation between the existence of multiple nodules in one foot and a higher recurrence rate. The recurrence of a primary lesion treated with fasciectomy combined with postoperative radiotherapy seemed to be lower in comparison with the recurrence rate after surgery only. Surgical treatment of plantar fibromatosis is associated with a high recurrence rate and indicated only when the lesions are highly symptomatic and conservative measures fail. Total plantar fasciectomy is the most successful treatment in this study, particularly for primary lesions. The role of postoperative radiotherapy should be evaluated further. A prospective multicenter study comparing different surgical procedures will be needed to determine the type of operation that most effectively eliminates plantar fibromatosis.

  5. Foot Plantar Pressure Measurement System: A Review

    Directory of Open Access Journals (Sweden)

    Yufridin Wahab

    2012-07-01

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

  6. Magnetic resonance imaging of plantar aponeurosis lesions

    Energy Technology Data Exchange (ETDEWEB)

    Roger, B. and others

    1987-12-01

    Exploration of sporting injuries to plantar aponeurosis (PA) has up to now been based mainly on clinical examination, from which the diagnosis was established. Imaging technics such as standard radiography and ultrasound scanning have limitations allowing diagnosis to be made usually only by elimination, the lesion being very rarely visualized directly. Ten patients with hyperalgic lesion of plantar arch and functional impotence were explored by MR imaging, and in all cases this examination provided superior data confirmed at operation. The examination is painless and little invasive and can be carried out during the acute phase. The plantar aponeurosis is visualized directly between the muscle mass of the plantar arch and the fatty cushion. All three spatial planes can be investigated, most interesting data being obtained from the sagittal (in the PA axis) and frontal (comparative) planes.

  7. Medial and Lateral Plantar Nerve Entrapment

    Science.gov (United States)

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

  8. Vendaje Funcional para la Fascitis Plantar

    OpenAIRE

    Julián Rochina, Iván

    2012-01-01

    El profesor Vicente Tormo aplica un vendaje funcional que aproxima a su centro geométrico las estructuras que configuran la planta del pie, con el objetivo de mantener relajada la fascia plantar durante la bipedestación.

  9. Vendaje Funcional para la Fascitis Plantar

    OpenAIRE

    Julián Rochina, Iván

    2012-01-01

    El profesor Vicente Tormo aplica un vendaje funcional que aproxima a su centro geométrico las estructuras que configuran la planta del pie, con el objetivo de mantener relajada la fascia plantar durante la bipedestación.

  10. Objective evaluation of plantar hyperhidrosis after sympathectomy

    Directory of Open Access Journals (Sweden)

    Nelson Wolosker

    2013-01-01

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

  11. Objective evaluation of plantar hyperhidrosis after sympathectomy

    Science.gov (United States)

    Wolosker, Nelson; Ishy, Augusto; Yazbek, Guilherme; de Campos, José Ribas Milanez; Kauffman, Paulo; Puech-Leão, Pedro; Jatene, Fábio Biscegli

    2013-01-01

    OBJECTIVE: The aim of the present study was to prospectively, randomly, blindly, and objectively investigate how surgery affects plantar sudoresis in patients with palmar and plantar hyperhidrosis over a one-year period using a sudorometer (VapoMeter). METHODS: From February 2007 to May 2009, 40 consecutive patients with combined palmar hyperhidrosis and plantar hyperhidrosis underwent video-assisted thoracic sympathectomy at the T3 or T4 ganglion level (15 women and 25 men, with a mean age of 25 years). RESULTS: Immediately after the operation and during the one-year follow-up, all of the patients were free from palmar hyperhidrosis episodes. Compensatory hyperhidrosis of varying degrees was observed in 35 (87.5%) patients after one year. Only two (2.5%) patients suffered from severe compensatory hyperhidrosis. There was a large initial improvement in plantar hyperhidrosis in 46.25% of the cases, followed by a progressive regression of that improvement, such that only 30% continued to show this improvement after one year. The proportion of patients whose condition worsened increased progressively (from 21.25% to 47.50%), and the proportion of stable patients decreased (32.5% to 22.50%). This was not related to resection level; however, a lower intensity of plantar hyperhidrosis prior to sympathectomy correlated with worse evolution. CONCLUSION: Patients with palmar hyperhidrosis and plantar hyperhidrosis who underwent video-assisted thoracic sympathectomy to treat their palmar hyperhidrosis exhibited good initial improvement in plantar hyperhidrosis, which then decreased to lesser degrees of improvement over a one-year period following the surgery. For this reason, video-assisted thoracic sympathectomy should not be performed when only plantar hyperhidrosis is present. PMID:23644849

  12. Surgery for Patients With Recalcitrant Plantar Fasciitis

    OpenAIRE

    Wheeler, Patrick; Boyd, Kevin; Shipton, Mary

    2014-01-01

    Background: Plantar fasciitis is a common cause of foot pain, and although many episodes are self-limiting with short duration, 10% leave chronic symptoms. Recalcitrant cases can be managed surgically, with studies demonstrating good results in the short term but uncertainties over longer term outcomes. Purpose: To assess the outcome following surgical intervention for patients with plantar fasciitis. Study Design: Case series; Level of evidence, 4. Methods: Seventy-nine patients were identif...

  13. Human papillomaviruses genotyping in plantar warts.

    Science.gov (United States)

    de Planell-Mas, Elena; Martínez-Garriga, Blanca; Zalacain, Antonio Jesús; Vinuesa, Teresa; Viñas, Miguel

    2017-05-01

    Plantar warts are caused by human papillomaviruses (HPVs) and have been associated with several HPV genotypes. However, there are few studies focused exclusively on plantar warts. In this work, we aim to identify the HPV genotypes of plantar warts and explore their relation to demographic and clinical characteristics of patients. A total of 72 patients diagnosed with plantar warts were recruited at the Laser unit at Podiatric Hospital, University of Barcelona, Spain. Inner hyperkeratosis laminar sections of warts were collected and DNA of samples were extracted. Amplification of a conserved region of the HPV L1 gene was performed with the SK-Polymerase chain reaction method. DNA amplicons were sequenced and HPV types identified. The most prevalent genotypes detected among the 105 analyzed plantar warts were HPV-57 (37.1%), HPV-27 (23.8%), HPV-1a (20.9%), HPV-2 (15.2%), and HPV-65 (2.8%). The majority of patients (78%) presented one single plantar wart, whereas multiple warts were detected in 22.2% of patients. One patient with multiple warts presented HPV types from two different genera, suggesting the spread of warts by self-inoculation as well as by de novo infection. No significant differences between the number of warts in toes, midfoot and heel were found. The most prevalent HPV types detected in all areas belonged to the alpha genus. This work provides new insight on plantar warts and their associated HPV genotypes, and evidences the usefulness and reliability of both the sample collection procedure and the PCR method used for HPV detection and typing. J. Med. Virol. 89:902-907, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Clinical Characteristics of the Causes of Plantar Heel Pain

    OpenAIRE

    Yi, Tae Im; Lee, Ga Eun; Seo, In Seok; Huh, Won Seok; Yoon, Tae Hee; Kim, Bo Ra

    2011-01-01

    Objective The objectives of this study were to investigate the causes of plantar heel pain and find differences in the clinical features of plantar fasciitis (PF) and fat pad atrophy (FPA), which are common causes of plantar heel pain, for use in differential diagnosis. Method This retrospective study analyzed the medical records of 250 patients with plantar heel pain at the Foot Clinic of Rehabilitation Medicine at Bundang Jesaeng General Hospital from January to September, 2008. Results The...

  15. Plantar fibromatosis: an immunohistochemical and ultrastructural study.

    Science.gov (United States)

    de Palma, L; Santucci, A; Gigante, A; Di Giulio, A; Carloni, S

    1999-04-01

    The analogies between plantar fibromatosis and Dupuytren's disease (palmar fibromatosis) are well known. The latter is clinically more frequent and has been the object of extensive immunohistochemical and ultrastructural studies, with a view to investigating its pathogenesis. By contrast, such data on plantar fibromatosis are quite scarce. A histochemical, immunohistochemical, and ultrastructural study was performed on nodule tissue from six patients who were subjected to total fasciectomy for plantar fibromatosis. The study of myofibroblasts revealed features suggestive of their fibroblastic origin and evidenced a cytoskeleton and an extracellular filamentous system that could enable myofibroblasts to generate and exert the intracellular forces that contribute to the contraction of the aponeurosis. These aspects are similar to those observed in Dupuytren's disease and seem to lend support to the theory that the two diseases are expressions of the same disorder.

  16. [Plantar fibromatosis: therapy by total plantarfasciectomy].

    Science.gov (United States)

    Beckmann, J; Kalteis, T; Baer, W; Grifka, J; Lerch, K

    2004-01-01

    Morbus Ledderhose is a rare fibromatous disease of the plantar fascia. Clinical features include palpable solitary or multiple nodules and cords, mainly affecting the medial part of the plantar fascia. When clinical symptoms occur, conservative options include stretching, orthotics, nonsteroidal antirheumatic drugs, local cortisone-injections and physiotherapy. Operative treatment is indicated in case of persistent pain or if conservative measures fail. The standard procedure includes a partial fasciectomy of the plantar aponeurosis. There is a high recurrence rate with an increased risk of complications and more aggressive ingrowth into anatomical structures after partial resection. Therefore we recommend a complete fasciectomy not only in recurrent disease, but also as the primary procedure of choice.

  17. Plantar fasciitis: diagnosis and therapeutic considerations.

    Science.gov (United States)

    Roxas, Mario

    2005-06-01

    Plantar fasciitis is the most common cause of inferior heel pain. The pain and discomfort associated with this condition can have a dramatic impact on physical mobility. The etiology of this condition is not clearly understood and is probably multi-factorial in nature. Weight gain, occupation-related activity, anatomical variations, poor biomechanics, overexertion, and inadequate footwear are contributing factors. Although plantar fasciitis is generally regarded as a self-limited condition, it can take months to years to resolve, presenting a challenge for clinicians. Many treatment options are available that demonstrate variable levels of efficacy. Conservative therapies include rest and avoidance of potentially aggravating activities, stretching and strengthening exercises, orthotics, arch supports, and night splinting. Other considerations include use of anti-inflammatory agents, ultrasonic shockwave therapy, and, in the most extreme cases, surgery. This article reviews plantar fasciitis, presents the most effective treatment options currently available, and proposes nutritional considerations that may be beneficial in the management of this condition.

  18. Plantar fascia rupture: diagnosis and treatment.

    Science.gov (United States)

    Rolf, C; Guntner, P; Ericsäter, J; Turan, I

    1997-01-01

    Two patients with spontaneous medial plantar fascia rupture due to a definite injury with no prior symptoms, were referred to our institution. Clinically, there was a tender lump in the sole, and magnetic resonance imaging confirmed the diagnosis. Nonoperative treatment was sufficient in curing the acute total rupture. Endoscopic release was used on the partially ruptured plantar fascia, but it is probably more optimal in the acute phase. The literature provides no comparative data on operative or nonoperative treatment efficacy for this rare condition.

  19. Rupture of the plantar fascia in athletes.

    Science.gov (United States)

    Leach, R; Jones, R; Silva, T

    1978-06-01

    Symptoms resembling those of plantar fasciitis were seen in six athletes who were thought to have a partial rupture of the plantar fascia. Treatment, which included the use of crutches, anti-inflammatory agents, strapping of the arch, and ice packs, was successful in all but one patient who had a painful mass in the area of the previous rupture. After surgical excision of the painful mass and release of the fascia, he recovered. Five of the six athletes had been previously treated with repeated local injections of steroid.

  20. Plantar fasciitis: a degenerative process (fasciosis) without inflammation.

    Science.gov (United States)

    Lemont, Harvey; Ammirati, Krista M; Usen, Nsima

    2003-01-01

    The authors review histologic findings from 50 cases of heel spur surgery for chronic plantar fasciitis. Findings include myxoid degeneration with fragmentation and degeneration of the plantar fascia and bone marrow vascular ectasia. Histologic findings are presented to support the thesis that "plantar fasciitis" is a degenerative fasciosis without inflammation, not a fasciitis. These findings suggest that treatment regimens such as serial corticosteroid injections into the plantar fascia should be reevaluated in the absence of inflammation and in light of their potential to induce plantar fascial rupture.

  1. Biomechanical consequences of adding plantar fascia release to metatarsal osteotomies: Changes in forefoot plantar pressures.

    Science.gov (United States)

    Aydogan, Umur; Roush, Evan P; Moore, Blake E; Andrews, Seth H; Lewis, Gregory S

    2017-04-01

    Destruction of the normal metatarsal arch by a long metatarsal is often a cause for metatarsalgia. When surgery is warranted, distal oblique, or proximal dorsiflexion osteotomies of the long metatarsal bones are commonly used. The plantar fascia has anatomical connection to all metatarsal heads. There is controversial scientific evidence on the effect of plantar fascia release on forefoot biomechanics. In this cadaveric biomechanical study, we hypothesized that plantar fascia release would augment the plantar metatarsal pressure decreasing effects of two common second metatarsal osteotomy techniques. Six matched pairs of foot and ankle specimens were mounted on a pressure mat loading platform. Two randomly assigned surgery groups, which had received either distal oblique, or proximal dorsiflexion osteotomy of the second metatarsal, were evaluated before and after plantar fasciectomy. Specimens were loaded up to a ground reaction force of 400 N at varying Achilles tendon forces. Average pressures, peak pressures, and contact areas were analyzed. Supporting our hypothesis, average pressures under the second metatarsal during 600 N Achilles load were decreased by plantar fascia release following proximal osteotomy (p fascia release following modified distal osteotomy, under multiple Achilles loading conditions (p < 0.05). Plantar fasciotomy should not be added to distal metatarsal osteotomy in the treatment of metatarsalgia. If proximal dorsiflexion osteotomy would be preferred, plantar fasciotomy should be approached cautiously not to disturb the forefoot biomechanics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:800-804, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  2. Risk factors affecting chronic rupture of the plantar fascia.

    Science.gov (United States)

    Lee, Ho Seong; Choi, Young Rak; Kim, Sang Woo; Lee, Jin Yong; Seo, Jeong Ho; Jeong, Jae Jung

    2014-03-01

    Prior to 1994, plantar fascia ruptures were considered as an acute injury that occurred primarily in athletes. However, plantar fascia ruptures have recently been reported in the setting of preexisting plantar fasciitis. We analyzed risk factors causing plantar fascia rupture in the presence of preexisting plantar fasciitis. We retrospectively reviewed 286 patients with plantar fasciitis who were referred from private clinics between March 2004 and February 2008. Patients were divided into those with or without a plantar fascia rupture. There were 35 patients in the rupture group and 251 in the nonrupture group. The clinical characteristics and risk factors for plantar fascia rupture were compared between the 2 groups. We compared age, gender, the affected site, visual analog scale pain score, previous treatment regimen, body mass index, degree of ankle dorsiflexion, the use of steroid injections, the extent of activity, calcaneal pitch angle, the presence of a calcaneal spur, and heel alignment between the 2 groups. Of the assessed risk factors, only steroid injection was associated with the occurrence of a plantar fascia rupture. Among the 35 patients with a rupture, 33 had received steroid injections. The odds ratio of steroid injection was 33. Steroid injections for plantar fasciitis should be cautiously administered because of the higher risk for plantar fascia rupture. Level III, retrospective comparative study.

  3. Incidence of plantar fascia ruptures following corticosteroid injection.

    Science.gov (United States)

    Kim, Chul; Cashdollar, Michael R; Mendicino, Robert W; Catanzariti, Alan R; Fuge, LaDonna

    2010-12-01

    Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection. A retrospective chart review of 120 patients who received corticosteroid injection for plantar fasciitis was performed at the authors' institution to determine the incidence of plantar fascia rupture. The plantar fascia rupture was diagnosed clinically and confirmed with magnetic resonance imaging. Various factors were analyzed, including the number of injections, interval between injections, body mass index (BMI), and activity level. Four patients (2.4%) consequently experienced plantar fascia rupture following an average of 2.67 injections. The average BMI of these patients was 38.6 kg/m². The authors conclude that corticosteroid injection therapy appears to be a safe and effective form of nonoperative treatment with minimal complications and a relatively low incident of plantar fascia rupture.

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

    Science.gov (United States)

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

    2015-01-01

    The effects of gender and various anthropometric variables were previously reported as significant predictors of plantar fascia thickness. Although a strong correlation between either the body weight or body mass index (BMI) and plantar fascia thickness were not demonstrated, a moderate relation was stated. We retrospectively investigated the role of gender, height, weight, and body mass index on plantar fascia thickness at the calcaneal origin (PFCO) and 1 cm distal from the calcaneal origin (PF1cm) and the coronal length of the plantar fascia at the calcaneal origin (CLPF) in healthy subjects. The PFCO, PF1cm, and CLPF were retrospectively measured from magnetic resonance images of 100 healthy subjects. The gender, height, weight, and body mass index of the participants were also noted. Gender was a predictive factor for the length of the CLPF. The subjects with a BMI >25 kg/m(2) had a significantly greater PFCO, PF1cm, and CLPF. Height was mildly and BMI and weight were moderately related to the PFCO. However the CLPF showed a better correlation with height, BMI, and weight than that of plantar fascia thickness. CLPF better reflected the role of weight, BMI, and height than its thickness. It is a new parameter that could be valuable in the evaluation of plantar fascia disorders. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Plantar fasciitis: current diagnostic modalities and treatments.

    Science.gov (United States)

    Healey, Kevin; Chen, Katherine

    2010-07-01

    Plantar fasciitis is a common cause of heel pain. The diagnosis is made clinically and validated with different diagnostic modalities ranging from ultrasound to magnetic resonance imaging. Treatments vary from stretching exercises to different surgical options. No single treatment is guaranteed to alleviate the heel pain.

  6. Mechanical Information of Plantar Fascia during Normal Gait

    Science.gov (United States)

    Gu, Yaodong; Li, Zhiyong

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

  7. Management of plantar fasciitis in the outpatient setting.

    Science.gov (United States)

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

    2016-04-01

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

  8. Current therapeutic approaches for plantar fasciitis

    OpenAIRE

    Martinelli N; Bonifacini C; Romeo G

    2014-01-01

    Nicolò Martinelli, Carlo Bonifacini, Giovanni RomeoDepartment of Ankle and Foot Surgery, IRCCS Galeazzi Orthopaedic Institute, Milan, ItalyAbstract: Almost 1 million Americans are affected by plantar fasciitis (PF), which is the commonest cause of chronic heel pain. This condition is often managed conservatively, and many rehabilitation protocols, some with the aid of orthoses, have been adopted, with good-to-excellent clinical results. Although most cases of chronic PF can be succ...

  9. Research on Normal Human Plantar Pressure Test

    Directory of Open Access Journals (Sweden)

    Liu Xi Yang

    2016-01-01

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

  10. Management of plantar fasciitis in the outpatient setting

    OpenAIRE

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

    2016-01-01

    Plantar fasciitis is a very common cause of inferior heel pain that can be triggered and aggravated by prolonged standing, walking, running and obesity, among other factors. Treatments are largely noninvasive and efficacious. Supportive treatments, including the plantar fascia-specific stretch, calf stretching, appropriate orthotics and night dorsiflexion splinting, can alleviate plantar fascia pain. While local injections of corticosteroids can help with pain relief, the effects are short-li...

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

    Directory of Open Access Journals (Sweden)

    Devrim Özer

    2015-12-01

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

  12. Plantar pressure changes after long-distance walking.

    NARCIS (Netherlands)

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

    2010-01-01

    PURPOSE: The popularity of long-distance walking (LDW) has increased in the last decades. However, the effects of LDW on plantar pressure distribution and foot complaints, in particular, after several days of walking, have not been studied. METHODS: We obtained the plantar pressure data of 62

  13. Reactive eccrine syringofibroadenomatosis presenting as bilateral plantar hyperkeratosis

    Directory of Open Access Journals (Sweden)

    Nidhi Singh

    2015-01-01

    Full Text Available Eccrine syringofibroadenoma (ESFA is a rare cutaneous tumor with eccrine differentiation with varied clinical manifestations. We report a case of reactive eccrine syringofibroadenomatosis associated with chronic bilateral plantar ulcers in a patient with diabetes mellitus presenting as plantar hyperkeratosis and verrucous growth at margins.

  14. Estudio del proceso evolutivo de la huella plantar

    OpenAIRE

    Oller Asensio, Antonio

    1995-01-01

    1. Cronología del proceso evolutivo del estudio de la huella plantar. 2. Descripción y análisis de las biometrías del pie realizadas con los diferentes sistemas de obtención de la 1a huella plantar.

  15. Current therapeutic approaches for plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Martinelli N

    2014-03-01

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

  16. Iontophoresis for palmar and plantar hyperhidrosis.

    Science.gov (United States)

    Pariser, David M; Ballard, Angela

    2014-10-01

    Iontophoresis is a safe, efficacious, and cost-effective primary treatment of palmar and plantar hyperhidrosis. Decades of clinical experience and research show significant reduction in palmoplantar excessive sweating with minimal side effects. To get the best results from iontophoresis, health care professionals need to provide education on the mechanism of action and benefits, evidence of its use, and creation of a future patient-specific plan of care for continued treatments at home or in the physician's office. Iontophoresis may be combined with other hyperhidrosis treatments, such as topical antiperspirants and botulinum toxin injections.

  17. Baja autoestima situacional. Psoriasis palmo-plantar

    OpenAIRE

    Romero García, Rafael

    2015-01-01

    Cartel presentado en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de Madrid Introducción: Paciente de 62 años de edad que acude al servicio de dermatología en agosto de 2015 con Psoriasis Hiperqueratosica palmo plantar. Durante toda la vida se ha dedicado a pintar durante 8 horas diarias. Posee pequeñas fisuras molestas que le afectan psicológicamente y le impiden realizar las actividades de la vida diaria. L...

  18. Material properties of the plantar aponeurosis.

    Science.gov (United States)

    Kitaoka, H B; Luo, Z P; Growney, E S; Berglund, L J; An, K N

    1994-10-01

    Material properties of the plantar aponeurosis were determined by a two-dimensional video tracking method to simultaneously measure the aponeurosis deformation. Failure loads averaged 1189 +/- 244 N and were higher in men. Average stiffness of the intact fascia was 203.7 +/- 50.5 N/mm at a loading rate of 11.12 N/sec and it did not vary significantly for the loading rates of 11.12 to 1112 N/sec. The high tensile loads required for failure were consistent with clinical and biomechanical studies and indicated the importance of the aponeurosis in foot function and arch stability.

  19. Plantar pressure cartography reconstruction from 3 sensors.

    Science.gov (United States)

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

    2014-01-01

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

  20. Plantar enthesopathy: thickening of the enthesis is correlated with energy dissipation of the plantar fat pad during walking.

    Science.gov (United States)

    Wearing, Scott C; Smeathers, James E; Urry, Stephen R; Sullivan, Patrick M; Yates, Bede; Dubois, Philip

    2010-12-01

    The enthesis of the plantar fascia is thought to play an important role in stress dissipation. However, the potential link between entheseal thickening characteristic of enthesopathy and the stress-dissipating properties of the intervening plantar fat pad have not been investigated. This study was conducted to identify whether plantar fat pad mechanics explain variance in the thickness of the fascial enthesis in individuals with and without plantar enthesopathy. Case-control study; Level of evidence, 3. The study population consisted of 9 patients with unilateral plantar enthesopathy and 9 asymptomatic, individually matched controls. The thickness of the enthesis of the symptomatic, asymptomatic, and a matched control limb was acquired using high-resolution ultrasound. The compressive strain of the plantar fat pad during walking was estimated from dynamic lateral radiographs acquired with a multifunction fluoroscopy unit. Peak compressive stress was simultaneously acquired via a pressure platform. Principal viscoelastic parameters were estimated from subsequent stress-strain curves. The symptomatic fascial enthesis (6.7 ± 2.0 mm) was significantly thicker than the asymptomatic enthesis (4.2 ± 0.4 mm), which in turn was thicker than the enthesis (3.3 ± 0.4 mm) of control limbs (P stress, peak strain, or secant modulus of the plantar fat pad between limbs. However, the energy dissipated by the fat pad during loading and unloading was significantly lower in the symptomatic limb (0.55 ± 0.17) when compared with asymptomatic (0.69 ± 0.13) and control (0.70 ± 0.09) limbs (P correlated with the energy dissipation ratio of the plantar fat pad (r = .72, P < .05), but only in the symptomatic limb. The energy-dissipating properties of the plantar fat pad are associated with the sonograpic appearance of the enthesis in symptomatic limbs, providing a previously unidentified link between the mechanical behavior of the plantar fat pad and enthesopathy.

  1. Ultrasound evaluation of a spontaneous plantar fascia rupture.

    Science.gov (United States)

    Louwers, Michael J; Sabb, Brian; Pangilinan, Percival H

    2010-11-01

    Plantar fascia rupture is an occasional complication in patients with chronic plantar fasciitis or in patients with plantar fasciitis treated with steroid injection. Very few cases of spontaneous plantar fascia rupture have been reported in the literature (Herrick and Herrick, Am J Sports Med 1983;11:95; Lun et al, Clin J Sports Med 1999;9:48-9; Rolf et al, J Foot Ankle Surg 1997;36:112-4; Saxena and Fullem, Am J Sports Med 2004;32:662-5). Spontaneous medial plantar fascia rupture in a 37-yr-old man with no preceding symptoms or steroid injections was confirmed with diagnostic ultrasound, which revealed severe fasciitis at the calcaneal insertion with partial tearing. After conservative treatment, the patient returned to full activities. We discuss the anatomy, risk factors, examination findings, and treatment for this condition, as well as the unique benefits that ultrasound offers over magnetic resonance imaging. It is important to consider plantar fascia rupture in patients with hindfoot pain and medioplantar ecchymosis, particularly if an injury occurred during acceleration maneuvers. Ultrasound in these cases can be used to diagnose a plantar fascia tear quickly, accurately, and cost-effectively.

  2. Subcalcaneal bursitis with plantar fasciitis treated by arthroscopy.

    Science.gov (United States)

    Yamakado, Kotaro

    2013-05-01

    We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent to the calcaneal tubercle on T2-weighted sagittal and coronal images and thickening of the plantar fascia on T2-weighted sagittal images. A diagnosis of a recalcitrant subcalcaneal bursitis with plantar fasciitis was made, and surgery was performed. The arthroscope was placed between the calcaneus and the plantar fascia. With the surgeon viewing from the lateral portal and working from the medial portal, the dorsal surface of the degenerative plantar fascia was debrided and the medial half of the plantar fascia was released, followed by debridement of the subcalcaneal bursal cavity through the incised plantar fascia. Full weight bearing and gait were allowed immediately after the operation. At the latest follow-up, the patient had achieved complete resolution of heel pain without a recurrence of the mass, confirmed by magnetic resonance imaging.

  3. [Plantar fibromatosis and Dupuytren's contracture in an adolescent].

    Science.gov (United States)

    Nikolić, Jelena; Janjić, Zlata; Momcilović, Dragan; Ninković, Srdjan; Harhai, Vladimir

    2011-10-01

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

  4. 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.

  5. Classification of Calcaneal Spurs and Their Relationship With Plantar Fasciitis.

    Science.gov (United States)

    Zhou, Binghua; Zhou, You; Tao, Xu; Yuan, Chengsong; Tang, Kanglai

    2015-01-01

    Calcaneal spurs, as a cause of plantar fasciitis, are currently debatable. A prospective study was performed to classify calcaneal spurs according to the findings from an investigation of the relationship between calcaneal spurs and plantar fasciitis. Thirty patients with calcaneal spurs and plantar heel pain underwent calcaneal spur removal and endoscopic plantar fasciotomy. The relationship between the classification of calcaneal spurs and plantar fasciitis was evaluated by endoscopic findings, clinical symptoms, radiographic images, and biopsy findings. The visual analog scale for pain and the American Orthopedic Foot and Ankle Society ankle-hindfoot scores for functional evaluation were used preoperatively and postoperatively, respectively. The mean follow-up period was 24 months. Two separate types of calcaneal spurs were recognized. Type A calcaneal spurs were located superior to the plantar fascia insertion, and type B calcaneal spurs were located within the plantar fascia. Magnetic resonance imaging results showed a more severe plantar fasciitis grade in type B calcaneal spurs preoperatively. Histologic examination showed that the numbers of granulocytes per image in type B spurs were significantly increased compared with those in type A spurs. Statistically significant improvements were found in the mean visual analog scale and American Orthopedic Foot and Ankle Society scores and magnetic resonance imaging results in both groups. The amount of change in the visual analog scale score and American Orthopedic Foot and Ankle Society score, the number of granulocytes per image, and calcaneal spur length showed a high association with the classification of the calcaneal spurs. Calcaneal spurs were completely removed and did not recur in any of the patients on radiographic assessment during the follow-up period. Calcaneal spurs can be classified into 2 distinct types that are indicative of the severity of plantar fasciitis.

  6. A COMPARITIVE STUDY ON EFFECTIVENESS OF TAPING WITH IONTOPHORESIS AND TAPING ALONE IN CHRONIC PLANTAR FASCITIS

    OpenAIRE

    Biju Chetri, U.T. Ifthikar Ali, Madhusmita Koch, Abhijit Dutta

    2016-01-01

    Background: Plantar fasciitis is a painful condition caused by microtrauma to plantar fascia due to overuse. It is a most common cause of heel pain in runners. Various studies proved taping and Iontophoresis as effective in the treating plantar fasciitis. But there are no studies comparing the combined effect of iontophoresis with taping and taping alone in the treatment of plantar fasciitis. Methods: 50 patients suffering from plantar fasciitis who met the inclusion criteria were selected...

  7. Sistema Aquíleo Calcáneo Plantar

    OpenAIRE

    Leal Serra, V.

    2010-01-01

    El Sistema Aquíleo Calcáneo Plantar fue descrito por los Profesores Arandes y Viladot el año 1953 demostrando cómo el Tríceps sural que termina en el tendón de Aquiles, se refleja en la tuberosidad del calcáneo, continuando con la aponeurosis plantar y la musculatura corta plantar, hasta llegar a insertarse en los dedos del pie. Esto representó, desde el punto de vista biomecánico, un gran avance para la comprensión de la marcha, la carrera y el salto en el homo erectus. The Achillean-calc...

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

    Science.gov (United States)

    Pascual Huerta, Javier

    2014-12-01

    Although anatomic and functional relationship has been established between the gastrocnemius muscle, via the Achilles tendon, and the plantar fascia, the exact role of gastrocnemius tightness in foot and plantar fascia problems is not completely understood. This article summarizes past and current literature linking these 2 structures and gives a mechanical explanation based on functional models of the relationship between gastrocnemius tightness and plantar fascia. The effect of gastrocnemius tightness on the sagittal behavior of the foot is also discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Spatial resolution in plantar pressure measurement revisited.

    Science.gov (United States)

    Pataky, Todd C

    2012-08-09

    Plantar pressures are typically measured using sensors of finite area, so the accuracy with which one can measure true maximum pressure is dependent on sensor size. Measurement accuracy has been modeled previously for one patient's metatarsals (Lord, 1997), but has not been modeled either for general subjects or for other parts of the foot. The purposes of this study were (i) to determine whether Lord's (1997) model is also valid for heel and hallux pressures, and (ii) to examine how sensor size relates to measurement accuracy in the context of four factors common to many measurement settings: pressure pulse size, foot positioning, pressure change quantification, and gross pressure redistribution. Lord's (1997) model was first generalized and was then validated using 10 healthy walking subjects, with relatively low RMSE values on the order of 20 kPa. Next, postural data were used to show that gross pressure redistributions can be accurately quantified (ppressure measurement tasks.

  10. Percutaneous surgery for plantar fasciitis due to a calcaneal spur

    National Research Council Canada - National Science Library

    Apóstol-González, Saúl; Herrera, Jesús

    2009-01-01

    .... This is an observational, descriptive, clinical series analyzing the outcomes of 10 patients with a diagnosis of talalgia due to plantar fasciitis with a calcaneal spur treated with percutaneous foot surgery...

  11. [Magnetic resonance imaging in lesions of the plantar aponeurosis].

    Science.gov (United States)

    Roger, B; Christel, P; Poux, D; Saillant, G; Cabanis, E A

    1987-12-01

    Exploration of sporting injures to plantar aponeurosis (PA) has up to now been based mainly on clinical examination, from which the diagnosis was established. Imaging technics such as standard radiography and ultrasound scanning have limitations allowing diagnosis to be made usually only by elimination, the lesion being very rarely visualized directly. Ten patients with hyperalgic lesion of plantar arch and functional impotence were explored by MR imaging, and in all cases this examination provided superior data confirmed at operation. The examination is painless and little invasive and can be carried out during the acute phase. The plantar aponeurosis is visualized directly between the muscle mass of the plantar arch and the fatty cushion. All three spatial planes can be investigated, most interesting data being obtained from the sagittal (in the PA axis) and frontal (comparative) planes.

  12. Plantar fasciitis: evidence-based review of diagnosis and therapy.

    Science.gov (United States)

    Cole, Charles; Seto, Craig; Gazewood, John

    2005-12-01

    Plantar fasciitis causes heel pain in active as well as sedentary adults of all ages. The condition is more likely to occur in persons who are obese or in those who are on their feet most of the day. A diagnosis of plantar fasciitis is based on the patient's history and physical findings. The accuracy of radiologic studies in diagnosing plantar heel pain is unknown. Most interventions used to manage plantar fasciitis have not been studied adequately; however, shoe inserts, stretching exercises, steroid injection, and custom-made night splints may be beneficial. Extracorporeal shock wave therapy may effectively treat runners with chronic heel pain but is ineffective in other patients. Limited evidence suggests that casting or surgery may be beneficial when conservative measures fail.

  13. Plantar fascitis: evidence-based review of treatment

    National Research Council Canada - National Science Library

    Lafuente Guijosa, Ana; O'mullony Muñoz, Isabel; de La Fuente, Maruxa Escribá; Cura-Ituarte, Paula

    2007-01-01

    .... After an updated review of the treatment of plantar fascitis, we have found several therapy options to treat this problem, but their efficacy is variable, and none show strong evidence of benefit...

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

    Science.gov (United States)

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

    2014-01-01

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

  15. Plantar Fascia Rupture in a Professional Soccer Player

    OpenAIRE

    Suzue, Naoto; Iwame, Toshiyuki; Kato, Kenji; Takao, Shoichiro; Tateishi, Tomohiko; Takeda, Yoshitsugu; Hamada, Daisuke; Goto, Tomohiro; Takata, Yoichiro; Matsuura, Tetsuya; Sairyo, Koichi

    2014-01-01

    We report the case of a 29-year-old male professional soccer player who presented with symptoms of plantar fasciitis. His symptoms occurred with no remarkable triggers and gradually worsened despite conservative treatments including taping, use of insoles, and physical therapy. Local corticosteroid injection was given twice as a further intervention, but his plantar fascia partially ruptured 49 days after the second injection. He was treated conservatively with platelet-rich plasma, and magne...

  16. Heel lipoma mimicking plantar fasciitis in a ballroom dancer.

    Science.gov (United States)

    Taweel, Nicholas R; Raikin, Steven M

    2015-01-01

    The present case illustrates a lipoma as an unusual cause of heel pain. A 64-year-old female ballroom dancer presented with 8 months of pain that was unresponsive to previous treatment of plantar fasciitis. Magnetic resonance imaging revealed a heel lipoma. Her pain was fully resolved after surgical excision. Soft tissue tumors should be included in the differential diagnosis of heel pain, especially when symptoms and treatment response do not follow the typical course of plantar fasciitis.

  17. Ultrasound-Assisted Endoscopic Partial Plantar Fascia Release

    OpenAIRE

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

    2013-01-01

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

  18. Identification of Foot Pathologies Based on Plantar Pressure Asymmetry

    OpenAIRE

    Linah Wafai; Aladin Zayegh; John Woulfe; Syed Mahfuzul Aziz; Rezaul Begg

    2015-01-01

    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 standar...

  19. Discrete sensors distribution for accurate plantar pressure analyses.

    Science.gov (United States)

    Claverie, Laetitia; Ille, Anne; Moretto, Pierre

    2016-12-01

    The aim of this study was to determine the distribution of discrete sensors under the footprint for accurate plantar pressure analyses. For this purpose, two different sensor layouts have been tested and compared, to determine which was the most accurate to monitor plantar pressure with wireless devices in research and/or clinical practice. Ten healthy volunteers participated in the study (age range: 23-58 years). The barycenter of pressures (BoP) determined from the plantar pressure system (W-inshoe®) was compared to the center of pressures (CoP) determined from a force platform (AMTI) in the medial-lateral (ML) and anterior-posterior (AP) directions. Then, the vertical ground reaction force (vGRF) obtained from both W-inshoe® and force platform was compared for both layouts for each subject. The BoP and vGRF determined from the plantar pressure system data showed good correlation (SCC) with those determined from the force platform data, notably for the second sensor organization (ML SCC= 0.95; AP SCC=0.99; vGRF SCC=0.91). The study demonstrates that an adjusted placement of removable sensors is key to accurate plantar pressure analyses. These results are promising for a plantar pressure recording outside clinical or laboratory settings, for long time monitoring, real time feedback or for whatever activity requiring a low-cost system. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  20. 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.

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

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    Hinenoya,Hitoshi

    1987-12-01

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

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

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    Flavio Renato de Almeida Senefonte

    2011-09-01

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

  3. Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain.

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    Lui, Tun Hing

    2016-06-01

    Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal anti-inflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conservative treatment failed. Endoscopic release of the nerve through the dorsal and plantar portals, as well as endoscopic plantar aponeurosis release, is a feasible approach.

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

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    Nikolić Jelena

    2011-01-01

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

  5. Acral-lentiginous naevus of plantar skin.

    Science.gov (United States)

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

    1995-12-01

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

  6. Plantar focal idiopathic hyperhidrosis and botulinum toxin: a pilot study.

    Science.gov (United States)

    Campanati, Anna; Bernardini, Maria Luisa; Gesuita, Rosaria; Offidani, Annamaria

    2007-01-01

    Botulinum toxin is a safe and effective treatment for idiopatic focal axillary and palmar hyperhidrosis, but very few data are reported in the literature on its effect on plantar idiopatic hyperhidrosis. The current study was undertaken to investigate the impact of BTX-A administration on sweat production and quality of life in patients suffering from plantar hyperhidrosis. Ten patients with idiopathic, recalcitrant plantar hyperhidrosis were included in a pilot study and underwent intradermal injections with 100 MU of BTX-A in the plantar skin, bilaterally. All the patients were followed for 16 weeks after treatment with objective (Minor's test) and subjective (DLQI test) evaluation. Patients experienced an improvement of symptoms with a significant decrease of Minor's test and DLQI levels for 12 weeks. No significant side effects occurred in any treated patient. BTX-A seems to be a promising treatment for plantar hyperhidrosis. However, clinical trials on larger patient series are needed in order to evaluate its safety and effectiveness for this application.

  7. Differences in calcium accumulation between human plantar and palmar aponeuroses.

    Science.gov (United States)

    Azuma, Cho; Tohno, Yoshiyuki; Morimoto, Mamoru; Tohno, Setsuko; Minami, Takeshi; Takano, Yasuo; Utsumi, Masako; Moriwake, Yumi; Nishiwaki, Fumio; Yamada, Masa-oki

    2002-01-01

    To elucidate the characteristics of calcium accumulation of human plantar and palmar aponeuroses, the authors determined the calcium content of human plantar and palmar aponeuroses by atomic absorption flame emission spectrophotometry. The subjects consisted of 9 men and 14 women, ranging in age from 61 to 93 yr. In the plantar aponeurosis, the calcium content was significantly higher in the anterior and posterior parts than in the middle part. It is known that pressure distribution under the sole of a foot is higher in the anterior and posterior parts than in the middle part. The present study suggests that the accumulation of calcium in the plantar aponeurosis is related with the pressure distribution under the sole of a foot. The calcium content increased progressively with aging in the anterior part of the plantar aponeurosis, but not in the middle and posterior parts. Regarding the palmar aponeurosis, the calcium content was significantly higher in the anterior and posterior parts in comparison with the middle part. It was found that the calcium content increased progressively with aging in the posterior part of the palmar aponeurosis, whereas it did not increase significantly with aging in the anterior and middle parts. Regarding the relationship between the calcium content of the aponeuroses and the bone mineral density, a significant correlation was found between the calcium content in the anterior part of the palmar aponeurosis and the bone mineral density of the scaphoid bone.

  8. A review of plantar heel pain of neural origin: differential diagnosis and management.

    Science.gov (United States)

    Alshami, Ali M; Souvlis, Tina; Coppieters, Michel W

    2008-05-01

    Plantar heel pain is a symptom commonly encountered by clinicians. Several conditions such as plantar fasciitis, calcaneal fracture, rupture of the plantar fascia and atrophy of the heel fat pad may lead to plantar heel pain. Injury to the tibial nerve and its branches in the tarsal tunnel and in the foot is also a common cause. Entrapment of these nerves may play a role in both the early phases of plantar heel pain and recalcitrant cases. Although the contribution of nerve entrapment to plantar heel pain has been well documented in the literature, its pathophysiology, diagnosis and management are still controversial. Therefore, the purpose of this article was to critically review the available literature on plantar heel pain of neural origin. Possible sites of nerve entrapment, effectiveness of diagnostic clinical tests and electrodiagnostic tests, differential diagnoses for plantar heel pain, and conservative and surgical treatment will be discussed.

  9. Methods of Sports Genetics: toe and plantar dermatoglyphic analysis (information 3

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    Serhiyenko L.P.

    2010-03-01

    Full Text Available The article summarized the data and dermatoglyphic analysis of human toe and plantar prints. It is defined that toe and plantar triradii, papillary ridge patterns, the main plantar lines, the types of dermatoglyphic patterns can be the objects of the dermatoglyphic analysis. The recommendations to use the technology of dermatoglyphic analysis of human toe and plantar prints in sport genetics are given.

  10. Role of the plantar fascia in digital stabilization. A case report.

    Science.gov (United States)

    Pontious, J; Flanigan, K P; Hillstrom, H J

    1996-01-01

    The plantar aponeurosis is a ligamentous structure that extends from the calcaneus to the proximal phalanges. Under tension, it functions to support the longitudinal arch, supinate the rearfoot, and stabilize the digits against the ground. The anatomy and biomechanics of the plantar fascia and plantar aponeurosis, particularly their role in digital stabilization, are reviewed. A case is presented showing a patient who developed hammer toes as a postoperative complication after having a portion of the plantar aponeurosis removed.

  11. High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis (Ledderhose’s disease)

    OpenAIRE

    Knobloch, Karsten; Peter M Vogt

    2012-01-01

    Background Plantar fibromatosis is a benign disease creating nodules on the medial plantar side of affected patients. While surgical removal is regarded as the therapeutic mainstay, recurrence rates and impairment of daily activities remains substantial. High-energy focussed extracorporeal shockwave therapy has been suggested to be potentially effective in plantar fibromatosis in terms of pain reduction. Hypothesis High-energy focussed extracorporeal shockwave therapy reduces pain in plantar ...

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

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    Malkoc Melih

    2015-03-01

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

  13. Endoscopic Plantar Fasciotomy Improves Early Postoperative Results: A Retrospective Comparison of Outcomes After Endoscopic Versus Open Plantar Fasciotomy.

    Science.gov (United States)

    Chou, Andrew Chia Chen; Ng, Sean Yung Chuan; Koo, Kevin Oon Thien

    2016-01-01

    Plantar fasciotomy is offered to patients with recalcitrant plantar fasciitis. Few studies have characterized the functional outcomes over time for the endoscopic approach compared with the open approach. We hypothesized that patients undergoing endoscopic surgery will have better postoperative functional outcomes early in the postoperative period but equivalent long-term outcomes compared with patients undergoing open surgery. We analyzed the prospectively collected data of all patients undergoing plantar fasciotomy at our institution from December 2007 to August 2014. A total of 42 feet of 38 patients were included in the analysis. The clinical data were collected preoperatively and at 3 and 6 months and 1 year. The functional outcomes analyzed included the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale, the Medical Outcomes Study, Short-Form, 36-item Health Survey, and patient satisfaction and expectations. Patients undergoing endoscopic surgery had significantly greater American Orthopaedic Foot and Ankle Society Ankle-Hindfoot and SF-36 Health Survey scores and lower pain scores at the 3-month period. They were also significantly more likely to be satisfied with and have had their expectations met by surgery. Compared with the open approach, the patients who had undergone endoscopic plantar fasciotomy experienced significantly greater improvements in the subjective and objective functional outcomes, with less pain and greater satisfaction, and had had their expectations met earlier in the recovery period, with equivalent long-term outcomes, compared with the patients who had undergone open plantar fasciotomy.

  14. Distally Based Abductor Hallucis Adipomuscular Flap for Forefoot Plantar Reconstruction.

    Science.gov (United States)

    Lee, Sanglim; Kim, Min Bom; Lee, Young Ho; Baek, Jeong Kook; Baek, Goo Hyun

    2015-09-01

    Soft tissue and bone defects of the lower leg, ankle, and heel region often require coverage by local or distant flaps. The authors successfully used the distally based adipomuscular abductor hallucis flap for the treatment of 7 patients with soft tissue defect on the plantar forefoot after diabetic ulcer (n = 2), excision of melanoma at the medial forefoot (n = 3), and posttraumatic defects of the plantar forefoot (n = 2). The size of the defects ranged from 6 to 36 cm. All defects were covered successfully without major complications. The distally based adipomuscular flap from the abductor hallucis muscle provides a reliable coverage for small and moderate defects of the plantar and medial forefoot. This flap is often preferable to the use of free flaps because the surgery is rapidly performed and does not require microsurgical expertise.

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

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    Aaron G. Wernham

    2015-01-01

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

  16. A COMPARITIVE STUDY ON EFFECTIVENESS OF TAPING WITH IONTOPHORESIS AND TAPING ALONE IN CHRONIC PLANTAR FASCITIS

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    Biju Chetri

    2016-04-01

    Full Text Available Background: Plantar fasciitis is a painful condition caused by microtrauma to plantar fascia due to overuse. It is a most common cause of heel pain in runners. Various studies proved taping and Iontophoresis as effective in the treating plantar fasciitis. But there are no studies comparing the combined effect of iontophoresis with taping and taping alone in the treatment of plantar fasciitis. Methods: 50 patients suffering from plantar fasciitis who met the inclusion criteria were selected. The subjects were randomly divided into two groups i.e. Group A and Group B. Group A received taping, iontophoresis with plantar fascia stretching. Group B received taping and plantar fascia stretching. A total of 6 treatment sessions were given on alternate days over a period of two weeks for both the groups. Results: VAS and FFI scores across baseline and post intervention showed a significant improvement statistically in their mean scores between Groups A and B (P<0.05. Between group comparison of VAS and FFI scores, it showed that subject treated with Iontophoresis in combination with taping and plantar fascia stretch (Group A had significant improvement in VAS and functional ability when compared to subjects treated with taping and plantar fascia stretching alone (Group B. Conclusion: Iontophoresis along with Taping and plantar fascia stretching gave an additional benefit when compared with Taping and plantar fascia stretching alone in reducing pain and improving function in plantar fasciitis.

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

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

    2005-06-01

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

  18. Complications of plantar fascia rupture associated with corticosteroid injection.

    Science.gov (United States)

    Acevedo, J I; Beskin, J L

    1998-02-01

    From 1992 to 1995, 765 patients with a clinical diagnosis of plantar fasciitis were evaluated by one of the authors. Fifty-one patients were diagnosed with plantar fascia rupture, and 44 of these ruptures were associated with corticosteroid injection. The authors injected 122 of the 765 patients, resulting in 12 of the 44 plantar fascia ruptures. Subjective and objective evaluations were conducted through chart and radiographic review. Thirty-nine of these patients were evaluated at an average 27-month follow-up. Thirty patients (68%) reported a sudden onset of tearing at the heel, and 14 (32%) had a gradual onset of symptoms. In most cases the original heel pain was relieved by rupture. However, these patients subsequently developed new problems including longitudinal arch strain, lateral and dorsal midfoot strain, lateral plantar nerve dysfunction, stress fracture, hammertoe deformity, swelling, and/or antalgia. All patients exhibited diminished tension of the plantar fascia upon examination by the stretch test. Comparison of calcaneal pitch angles in the affected and uninvolved foot showed a statistically significant difference of 3.7 degrees (P = 0.0001). Treatment included NSAIDs, rest or cross-training, stretching, orthotics, and boot-brace immobilization. At an average 27-month follow-up, 50% had good/excellent scores and 50% had fair/poor scores. Recovery time was varied. Ten feet were asymptomatic by 6 months post rupture, four feet by 12 months post rupture, and 26 feet remained symptomatic 1 year post rupture. Our findings demonstrate that plantar fascia rupture after corticosteroid injection may result in long-term sequelae that are difficult to resolve.

  19. Abnormal attachments between a plantar aponeurosis and calcaneus

    Science.gov (United States)

    KALNIEV, MANOL ANASTASOV; KRASTEV, DIMO; KRASTEV, NIKOLAY; VIDINOV, KALIN; VELTCHEV, LUDMIL; MILEVA, MILKA

    2013-01-01

    Background and aims The plantar aponeurosis or fascia is a thick fascial seal located on the lower surface of the sole. It consists of three parts central, lateral, and medial. The central portion is the thickest. It is narrow behind and wider in front. The central portion has two strong vertical intermuscular septa which are directed upward into the foot. The lateral and medial portions are thinner. The medial portion is thinnest. The lateral portion is thin in front and thick behind. The main function of the plantar fascia is to support the longitudinal arch of the foot. In May 2013 during a routine dissection in the section hall of the Department of Anatomy and Histology in Medical University – Sofia, Bulgaria we came across a very interesting variation of the plantar aponeurosis. Materials and methods For the present morphological study tissues from a human corpse material were used. This unusual anatomical variation was photographed using a Nikon Coolpix 995 camera with a 3.34 Megapixels. Results We found some fibrous strands which started from the proximal portion of the plantar aponeurosis on the left foot. The fibrous strands resembled the tentacles of an octopus and started from the proximal portion of the aponeurosis. Two of fibrous strands were directed laterally to adipose tissue and one was directed medially and backward. The first lateral fibrous strand was divided into several fascicles. We found very few data in literature about the varieties of the plantar fascia. Conclusion It is very important to consider the occurrence of above mentioned variations in the plantar aponeurosis when surgical procedures are performed on the sole. PMID:26527947

  20. Management of Plantar Hyperhidrosis with Endoscopic Lumbar Sympathectomy.

    Science.gov (United States)

    Rieger, Roman

    2016-11-01

    Primary plantar hyperhidrosis is defined as excessive secretion of the sweat glands of the feet and may lead to significant limitations in private and professional lifestyle and reduction of health-related quality of life. Conservative therapy measures usually fail to provide sufficient relieve of symptoms and do not allow long-lasting elimination of hyperhidrosis. Endoscopic lumbar sympathectomy appears to be a safe and effective procedure for eliminating excessive sweating of the feet and improves quality of life of patients with severe plantar hyperhidrosis.

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

    Science.gov (United States)

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

    2013-01-01

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

  2. Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

    OpenAIRE

    Lui, Tun Hing

    2016-01-01

    Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal anti-inflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conse...

  3. Plantar Pressure Variation during Jogging with Different Heel Height

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    Y. D. Gu

    2013-01-01

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

  4. Early experience with endoscopic lumbar sympathectomy for plantar hyperhidrosis.

    Science.gov (United States)

    Singh, Sanjay; Kaur, Simranjit; Wilson, Paul

    2016-05-01

    We describe our endoscopic lumbar sympathectomy technique and our early experience using it to treat plantar hyperhidrosis. We reviewed 20 lumbar sympathectomies performed in our vascular unit for plantar hyperhidrosis in 10 patients from 2011 and 2014. Demographics and outcomes were analyzed and a review of the literature conducted. All procedures were carried out endoscopically with no intraoperative or postoperative morbidity. Plantar anhidrosis was achieved in all the patients, although two patients (20%) suffered a relapse. Unwanted side-effects occurred in the form of compensatory sweating in three patients (30%) and post-sympathectomy neuralgia in two patients (20%). None of the patients experienced sexual dysfunction. Management of plantar hyperhidrosis may be based upon a therapeutic ladder starting with conservative measures and working up to surgery depending on the severity of the disease. Minimally invasive (endoscopic) sympathectomy for the thoracic chain is well established, but minimally invasive sympathectomy for the lumbar chain is a relatively new technique. Endoscopic lumbar sympathectomy provides an effective, minimally invasive method of surgical management, but long-term data are lacking. © 2016 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

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

    Science.gov (United States)

    Bus, S A

    2016-01-01

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

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

    NARCIS (Netherlands)

    J. van Gijn (Jan)

    1977-01-01

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

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

    Science.gov (United States)

    Tanner, Suzanne M.; Harvey, Jack S.

    1988-01-01

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

  8. Calculation of plantar pressure time integral, an alternative approach.

    Science.gov (United States)

    Melai, Tom; IJzerman, T Herman; Schaper, Nicolaas C; de Lange, Ton L H; Willems, Paul J B; Meijer, Kenneth; Lieverse, Aloysius G; Savelberg, Hans H C M

    2011-07-01

    In plantar pressure measurement, both peak pressure and pressure time integral are used as variables to assess plantar loading. However, pressure time integral shows a high concordance with peak pressure. Many researchers and clinicians use Novel software (Novel GmbH Inc., Munich, Germany) that calculates this variable as the summation of the products of peak pressure and duration per time sample, which is not a genuine integral of pressure over time. Therefore, an alternative calculation method was introduced. The aim of this study was to explore the relevance of this alternative method, in different populations. Plantar pressure variables were measured in 76 people with diabetic polyneuropathy, 33 diabetic controls without polyneuropathy and 19 healthy subjects. Peak pressure and pressure time integral were obtained using Novel software. The quotient of the genuine force time integral over contact area was obtained as the alternative pressure time integral calculation. This new alternative method correlated less with peak pressure than the pressure time integral as calculated by Novel. The two methods differed significantly and these differences varied between the foot sole areas and between groups. The largest differences were found under the metatarsal heads in the group with diabetic polyneuropathy. From a theoretical perspective, the alternative approach provides a more valid calculation of the pressure time integral. In addition, this study showed that the alternative calculation is of added value, along peak pressure calculation, to interpret adapted plantar pressures patterns in particular in patients at risk for foot ulceration. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Sonographic evaluation of the plantar fascia in asymptomatic subjects.

    Science.gov (United States)

    Gadalla, N; Kichouh, M; Boulet, C; Machiels, F; De Mey, J; De Maeseneer, M

    2014-01-01

    To evaluate the appearance of the plantar fascia in asymptomatic subjects. Thirty-one asymptomatic subjects were examined by 2 musculoskeletal radiologists. The plantar fascia was evaluated for thickness, echogenicity, vascularity on power Doppler, rupture, fluid adjacent to the fascia, andcalcifications. The study included 14 men and 17 women (age, 17-79 years; mean, 45 years). The mean thickness of the plantar fascia in men was 3.7 mm (range 2.5-7 mm), and in women 3.5 mm (range, 1.7-5.1 mm). The thickness was greater than 4 mm in 4 men (bilateral in 2). The mean thickness of fascias thicker than 4 mm in men was 5.4 mm (range, 4.3-7 mm). The thickness was greater than 4 mm in 5 women ( bilateral in 4). The mean thickness of fascias thicker than 4 mm in women was 4.7 mm (range, 4.2-5.1 mm). There was no statistically significant difference between men and women and between both heels. Hypoechogenicity was observed in 3 men (bilateral in 2), and in 5 women (bilateral in 6). Hypervascularity, rupture, fluid adjacent to the fascia, and calcifications were not observed. A thickness greater than 4 mm and hypoechogenicity, are common in the plantar fascia of asymptomatic subjects. Findings that were not seen in asymptomatic subjects include a thickness greater than 7 mm, hypervascularity on power Doppler, rupture, fluid adjacent to the fascia, and calcifications.

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

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2009-03-01

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

  11. Plantar pressure distribution in patients with ankylosing spondylitis.

    Science.gov (United States)

    Aydin, Elif; Turan, Yasemin; Tastaban, Engin; Kurt Omurlu, Imran; Sendur, Omer Faruk

    2015-03-01

    Ankylosing spondylitis is one of the most common inflammatory rheumatic diseases and is associated with alterations in posture. The aim of this study was to investigate the pedobarographic changes among ankylosing spondylitis patients, in an attempt to understand whether the alterations in the posture affect the plantar pressure distribution. The study population consisted of 38 patients with ankylosing spondylitis and 33 healthy volunteers. The static and dynamic pedobarographic measurements were performed to determine the plantar pressure distribution. Moreover, the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life Questionnaire and Bath Ankylosing Spondylitis Metrology Index were used to assess the clinical state of the patients. The static pedobarographic measurements did not reveal any intergroup difference. There were differences between the groups in the results of dynamic peak pressure measurements under the metatarsal areas and under the midfoot region. The percentage of the midfoot in the dynamic plantar contact area was higher in ankylosing spondylitis patients in comparison to the controls. No clinically significant correlation was found between the clinical scores and static pedobarographic measurements. The plantar pressures under the metatarsal heads, medial and lateral heel regions declined with increasing disease activity according to the Bath Ankylosing Spondylitis Disease Activity Index scores. The lower peak pressures on the forefoot and rearfoot, were associated with the higher Bath Ankylosing Spondylitis Metrology Index scores of the patients. The alterations in the posture may have effects on the plantar pressures in patients with ankylosing spondylitis, especially during dynamic activities. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-08-01

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

  13. A PRESSURE-BASED ALGORITHM FOR CAVITATING FLOW COMPUTATIONS

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ling-xin; ZHAO Wei-guo; SHAO Xue-ming

    2011-01-01

    A pressure-based algorithm for the prediction of cavitating flows is presented. The algorithm employs a set of equations including the Navier-Stokes equations and a cavitation model explaining the phase change between liquid and vapor. A pressure-based method is used to construct the algorithm and the coupling between pressure and velocity is considered. The pressure correction equation is derived from a new continuity equation which employs a source term related to phase change rate instead of the material derivative of density Dp/Dt.Thispressure-based algorithm allows for the computation of steady or unsteady,2-Dor 3-D cavitating flows. Two 2-D cases, flows around a flat-nose cylinder and around a NACA0015 hydrofoil, are simulated respectively, and the periodic cavitation behaviors associated with the re-entrant jets are captured. This algorithm shows good capability of computating time-dependent cavitating flows.

  14. Minimally invasive surgery for diabetic plantar foot ulcerations

    Directory of Open Access Journals (Sweden)

    Caio Nery

    2011-11-01

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

  15. [Anatomical quantification of the tibial part of the plantar aponeurosis].

    Science.gov (United States)

    Hiramoto, Y

    1983-03-01

    The metrical analysis of the anatomical characteristics is important because of its objectiveness. As it is concerned with the organs belonging to the locomotor system, the metrical method of the bones has already been systematized by Martin (1928), whereas the same kind of method for use on other organs remains undeveloped. The author aims to establish the metrical method of the plantar aponeurosis. The method for measuring the tibial part of the aponeurosis developed in this paper is sufficiently applicable for obtaining its principal anatomical characteristics. The results show that the tibial portion of the plantar aponeurosis becomes statistically significantly wider and thinner in its anterior part, and that the thickness of the tibial portion of the aponeurosis in the anterior part is larger on the right side than on the left side.

  16. Continuous phenobarbital treatment leads to recurrent plantar fibromatosis.

    Science.gov (United States)

    Strzelczyk, Adam; Vogt, Heinrich; Hamer, Hajo M; Krämer, Günter

    2008-11-01

    Despite contrary recommendations by expert opinion and international guidelines phenobarbital remains the most widely prescribed anticonvulsant worldwide. Although associated connective tissue disorders were described in a timely way after its introduction, the association between plantar fibromatosis--also called Ledderhose syndrome--and phenobarbital seems not to be well known in general. Our case series uniquely demonstrates that continuous phenobarbital treatment leads to recurrent plantar fibromatosis and may result in long-term disability and numerous unnecessary operations. In general, the association between connective tissue disorders and phenobarbital most prominently appears in adult patients of northern European descent. However, our case series and data from the literature suggest that patient groups less susceptible to connective tissue disorders may as well develop Ledderhose syndrome or other associated syndromes as Dupuytren's contractures, frozen shoulder, Peyronie's disease or complex regional pain syndrome in the course of phenobarbital treatment.

  17. Plantar fascia rupture in a professional soccer player.

    Science.gov (United States)

    Suzue, Naoto; Iwame, Toshiyuki; Kato, Kenji; Takao, Shoichiro; Tateishi, Tomohiko; Takeda, Yoshitsugu; Hamada, Daisuke; Goto, Tomohiro; Takata, Yoichiro; Matsuura, Tetsuya; Sairyo, Koichi

    2014-01-01

    We report the case of a 29-year-old male professional soccer player who presented with symptoms of plantar fasciitis. His symptoms occurred with no remarkable triggers and gradually worsened despite conservative treatments including taping, use of insoles, and physical therapy. Local corticosteroid injection was given twice as a further intervention, but his plantar fascia partially ruptured 49 days after the second injection. He was treated conservatively with platelet-rich plasma, and magnetic resonance imaging showed regenerative change of the ruptured fascia. Five months after the rupture, he returned to his original level of training. If professional athletes find it difficult to refrain from athletic activity, as in the present case, the risk of rupture due to corticosteroid injection should not be overlooked.

  18. Palmar-Plantar Erythrodysesthesia Associated with Chemotherapy and Its Treatment

    Directory of Open Access Journals (Sweden)

    Katherina Podlekareva Farr

    2011-04-01

    Full Text Available Palmar-plantar erythrodysesthesia (PPE, also called hand-foot syndrome, is a relatively common dermatologic toxic reaction associated with cytotoxic chemotherapy that can limit the use of such drugs. Definitive prevention and treatment strategies for PPE have not yet been established. We present a patient with recurrent ovarian cancer developing severe hand-foot syndrome after treatment with pegylated liposomal doxorubicin. A review of the relevant literature concerning pathophysiology, preventive measures and management of PPE is given. Electronic search was conducted using the Medline database for English-language records. The search terms used were ‘palmar-plantar erythrodysesthesia’, ‘hand-foot syndrome’, ‘pegylated liposomal doxorubicin’ and ‘acral erythema’.

  19. Extracorporeal shockwave therapy for chronic proximal plantar fasciitis.

    Science.gov (United States)

    Strash, Walter W; Perez, Richard R

    2002-10-01

    Although much enthusiasm surrounds applying extracorporeal shock wave therapy for various musculoskeletal conditions, its effects are not well understood and warrant continued study. Certain body tissues or organs may be damaged either acutely or chronically by ESWT; however, it is unequivocal that lung tissue may be damaged. It is theorized that neovascularization is responsible for improvement in symptoms of plantar fasciitis. Neovascularization is the direct effect of macrophage stimulation through cytokines. ESWT has effects at the cellular level--does it interfere with metabolic activity or enhance it? The noninvasive nature and minimal complications of appropriately applied ESWT are its primary advantages. Symptoms may continue to improve for three weeks to six months after treatment; the effects of shock wave therapy seem to be time dependent. ESWT is an effective form of treatment for proximal insertional plantar fasciitis after exhaustive, conservative forms of treatment have failed.

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

    Directory of Open Access Journals (Sweden)

    A S Nair

    2016-01-01

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

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

    Science.gov (United States)

    Yu, J S

    2000-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-09-01

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

  3. Applicability of contrast-enhanced ultrasound in the diagnosis of plantar fasciitis

    DEFF Research Database (Denmark)

    Broholm, Rikke; Pingel, Jessica; Simonsen, Lene

    2017-01-01

    Contrast-enhanced ultrasound (CEUS) is used to visualize the microvascularisation in various tissues. The purpose of this study was to investigate whether CEUS could be used to visualize the microvascular volume (MV) in the plantar fascia, and to compare the method to clinical symptoms and B......-mode ultrasound (US) in patients with plantar fasciitis (PF). 20 patients with unilateral PF were included and were divided by US in insertional thickening (10), midsubstance thickening (5) and no US changes (5). The MV was measured simultaneously in both heels. Four areas in the plantar fascia and plantar fat...... pad were measured independently by two observers. Inter- and intra-observer correlation analyses were performed. The asymptomatic heels showed a constantly low MV, and for the whole group of patients a significantly higher MV was found in the symptomatic plantar fascia and plantar fat pad. Inter...

  4. [The cutaneous extensor plantar reflex (Babinski, 1896/1898)].

    Science.gov (United States)

    Oliveira-Souza, R; de Figueiredo, W M

    1995-06-01

    The extensor plantar reflex was described by Babinski in 1896. Given the obvious relevance of the sign for internal medicine as well as the paucity of translations of the original sources into Portuguese, we thought it timely to recall the ingenious arguments Babinski used to demonstrate his views on the "toe phenomenon", as he would call it. A careful analysis of Babinski's writings suggests, further, that he was driven by keen intuition as well as by medico-legal interests.

  5. Shock wave therapy for chronic proximal plantar fasciitis.

    Science.gov (United States)

    Ogden, J A; Alvarez, R; Levitt, R; Cross, G L; Marlow, M

    2001-06-01

    Three hundred two patients with chronic heel pain caused by proximal plantar fasciitis were enrolled in a study to assess the treatment effects consequent to administration of electrohydraulicall-generated extracorporeal shock waves. Symptoms had been present from 6 months to 18 years. Each treated patient satisfied numerous inclusion and exclusion criteria before he or she was accepted into this study, which was approved by the Food and Drug Administration as a randomized, double-blind evaluation of the efficacy of shock wave therapy for this disorder. Overall, at the predetermined evaluation period 3 months after one treatment, 56% more of the treated patients had a successful result by all four of the evaluation criteria when compared with the patients treated with a placebo. This difference was significant and corroborated the fact that this difference in the results was specifically attributable to the shock wave treatment, rather than any natural improvement caused by the natural history of the condition. The current study showed that the directed application of electrohydraulic-generated shock waves to the insertion of the plantar fascia onto the calcaneus is a safe and effective nonsurgical method for treating chronic, recalcitrant heel pain syndrome that has been present for at least 6 months and has been refractory to other commonly used nonoperative therapies. This technology, when delivered using the OssaTron (High Medical Technology, Kreuz-lingen, Switzerland), has been approved by the Food and Drug Administration specifically for the treatment of chronic proximal plantar fasciitis. The results suggest that this therapeutic modality should be considered before any surgical options, and even may be preferable to cortisone injection, which has a recognized risk of rupture of the plantar fascia and recurrence of symptoms.

  6. [Surgical treatment of rupture of the plantar fascia].

    Science.gov (United States)

    Christel, P; Rigal, S; Poux, D; Roger, B; Witvoët, J

    1993-01-01

    Among the various lesions of the hindfoot in athletes, plantar fascia ruptures are not well documented and their surgical treatment is not often reported in the literature. The purpose of the current work was to more precisely define therapeutic indications and to evaluate the results of the surgical treatment based on the excision-release of the plantar fascia. Between 1986 and 1991, 19 patients (5 females, 14 males, average age 32 years) were operated on by one surgeon. All patients were either recreational or competitive athletes. The plantar fascia rupture occurred 18 times during sports activity. Surgical treatment was indicated when pain persisted despite a well conducted conservative treatment. In 17 cases, MRI allowed to plan the operative strategy by showing the fascia lesion. The patients were operated after an average of 8 months following the initial injury (6-16 months). One patient was lost for follow-up, 2 had a follow-up below 6 months, thus 16 patients were available for analysis. The clinical outcome was evaluated through persistence of pain, return to sports, and functional activity. With a 16-month average follow-up (6-51 months) it was observed that pain constantly disappeared and that 11 patients over 16 returned to the same level of sports activity after 6 months with a time-stable result. After failure of a well conducted conservative treatment, surgical treatment of plantar fascia rupture must be proposed. Surgical technique is based not only on fascia release but also on the excision of the pathological scar tissue in order to avoid the restoration of the continuity of the fascia with the calcaneus.

  7. Subcalcaneal Bursitis With Plantar Fasciitis Treated by Arthroscopy

    OpenAIRE

    Yamakado, Kotaro

    2013-01-01

    We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent ...

  8. Resistance exercise prevents plantar flexor deconditioning during bed rest

    Science.gov (United States)

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

    1997-01-01

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

  9. Proteus syndrome: MRI characteristics of plantar cerebriform hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Vanhoenacker, F.M.; Beuckeleer, L.H. de; Schepper, A.M. de [Dept. of Radiology, University Hospital Antwerp, Edegem (Belgium); Deprettere, A. [Dept. of Pediatrics, University Hospital Antwerp, Edegem (Belgium); Moor, A. de [Dept. of Dermatology, Univ. Hospital Antwerp, Edegem (Belgium)

    2000-02-01

    Proteus syndrome is a rare congenital hamartomatous syndrome with a variety of abnormalities. It shares many features with other congenital hamartomatous disorders, but cerebriform hyperplasia of the soles and the palms is known as a quite distinctive characteristic in the dermatologic literature. The purpose of this case report is to demonstrate the MRI features of plantar cerebriform hyperplasia in a 9-year-old boy with known Proteus syndrome. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Asli Feride Kaptanoglu

    2012-02-01

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

  11. Changes in foot plantar pressure in pregnant women.

    Science.gov (United States)

    Elsayed, Enas; Devreux, Isabelle; Embaby, Heba; Alsayed, Amani; Alshehri, Maram

    2017-01-01

    During pregnancy, the body undergoes many hormonal and anatomical changes causing several medical problems as the musculoskeletal system problems. To investigate the plantar pressure distribution during pregnancy. Twenty two pregnant and non-pregnant females were selected from the King Abdulaziz University in Jeddah. All females were evaluated by inspection regarding their deformities of the spine, pelvis, lower extremities and feet. Pain was assessed by the Visual Analog Scale (VAS), and the weight and height were recorded using a calibrated weighing scale. Finally, the plantar pressure distribution was examined by a Global Postural Analysis device (GPA). The results revealed significant asymmetry of weight bearing in the study group (pregnant) compared to the control group (non-pregnant) (p 0.05). Moreover, there was a significant direct relationship between the month of pregnancy and increased weight bearing on the 5th metatarsal in the study group (p= 0.04). There is an effect of pregnancy on plantar pressure distribution as well as weight symmetry which should be considered when designing an antenatal program.

  12. Plantar pressures in children with and without sever's disease.

    Science.gov (United States)

    Becerro de Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; Rodríguez Sanz, David; Prados Frutos, Juan Carlos; Salvadores Fuentes, Paloma; Chicharro, José López

    2011-01-01

    a case-control study was conducted to compare static plantar pressures and distribution of body weight across the two lower limbs, as well as the prevalence of gastrocnemius soleus equinus, in children with and without calcaneal apophysitis (Sever's disease). the participants were 54 boys enrolled in a soccer academy, of which eight were lost to follow-up. Twenty-two boys with unilateral Sever's disease comprised the Sever's disease group and 24 healthy boys constituted a control group. Plantar pressure data were collected using pedobarography, and gastrocnemius soleus equinus was assessed. peak pressure and percentage of body weight supported were significantly higher in the symptomatic feet of the Sever's disease group than in the asymptomatic feet of the Sever's disease group and the control group. Every child in the Sever's disease group had bilateral gastrocnemius equinus, while nearly all children in the control group had no equinus. high plantar foot pressures are associated with Sever's disease, although it is unclear whether they are a predisposing factor or a result of the condition. Gastrocnemius equinus may be a predisposing factor for Sever's disease. Further research is needed to identify other factors involved in the disease and to better understand the factors that contribute to abnormal distribution of body weight in the lower limbs.

  13. OA03.12. Herbal socks an effective medication against plantar hyperkeratosis

    OpenAIRE

    Geethadevi, C; Rajendran, R.; Radhai, R; ,

    2013-01-01

    Purpose: Plantar hyperkeratosis commonly called cracked heel is a common condition among adults. Causes for plantar hyperkeratosis are many and include genetic defects reflected in skin structure, allergic dermatoses, and paraneoplastic syndromes seen with particular forms of internal malignancy. Treatment for this condition could be possibly done using traditional herbs. The current study throws light on the cure of plantar hyperkeratosis using socks worn daily. Method: Solanum xanthocarpum ...

  14. Fibromatosis of the Plantar Fascia: Diagnosis and Indications For Surgical Treatment

    OpenAIRE

    Dürr, Hans R.; Krödel, Andreas; Trouillier, Hans; Lienemann, Andreas; Refior, Hans J.

    1999-01-01

    Plantar fibromatosis is a rare, benign lesion involving the plantar aponeurosis. Eleven patients (13 feet) underwent 24 operations, including local excision, wide excision, or complete plantar fasciectomy. Clinical results were evaluated retrospectively. There were no differences among the subgroups in postoperative complications. Two primary fasciectomies did not recur. Three of six revised fasciectomies, seven of nine wide excisions, and six of seven local excisions recurred. Our results in...

  15. Proportional EMG control of ankle plantar flexion in a powered transtibial prosthesis.

    OpenAIRE

    Wang, Jing; Kannape, Oliver; Herr, Hugh M.

    2013-01-01

    The human calf muscle generates 80% of the mechanical work to walk throughout stance-phase, powered plantar flexion. Powered plantar flexion is not only important for walking energetics, but also to minimize the impact on the leading leg at heel-strike. For unilateral transtibial amputees, it has recently been shown that knee load on the leading, intact limb decreases as powered plantar flexion in the trailing prosthetic ankle increases. Not surprisingly, excessive loads on the leading, intac...

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

    Directory of Open Access Journals (Sweden)

    Alireza Moghtaderi

    2014-01-01

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

  17. Fibromatosis of the plantar fascia: diagnosis and indications for surgical treatment.

    Science.gov (United States)

    Dürr, H R; Krödel, A; Trouillier, H; Lienemann, A; Refior, H J

    1999-01-01

    Plantar fibromatosis is a rare, benign lesion involving the plantar aponeurosis. Eleven patients (13 feet) underwent 24 operations, including local excision, wide excision, or complete plantar fasciectomy. Clinical results were evaluated retrospectively. There were no differences among the subgroups in postoperative complications. Two primary fasciectomies did not recur. Three of six revised fasciectomies, seven of nine wide excisions, and six of seven local excisions recurred. Our results indicate that recurrence of plantar fibromatosis after surgical resection can be reduced by aggressive initial surgical resection.

  18. [The use of magnetic resonance imaging in the diagnosis of plantar fibromatosis: a case report].

    Science.gov (United States)

    Halefoğlu, Ahmet Mesrur

    2005-01-01

    Plantar fibromatosis is a benign but infiltrative neoplasm, presenting as a slow-growing nodular thickening most often within the central band of the plantar aponeurosis. In this case report, we presented a 43-year-old male patient who had a tender nodule in the sole of the right foot for two years. On magnetic resonance images, the location and signal intensity characteristics of the lesion were suggestive of plantar fibromatosis, which was histologically confirmed following an incisional biopsy. Magnetic resonance imaging is a noninvasive method for confirmation of the clinical diagnosis of plantar fibromatosis and also has an important role in planning surgical treatment by delineating the extent of the lesion.

  19. Biomechanical consequences of plantar fascial release or rupture during gait. Part II: alterations in forefoot loading.

    Science.gov (United States)

    Sharkey, N A; Donahue, S W; Ferris, L

    1999-02-01

    With a model using feet from cadavers, we tested the hypothesis that plantar fascial release or rupture alters the loading environment of the forefoot during the latter half of the stance phase of gait. The model simulated the position and loading environment of the foot at two instants: early in terminal stance immediately after heel-off and late in terminal stance just preceding contralateral heel strike. Eight feet were loaded at both positions by simulated plantar flexor contraction, and the distribution of plantar pressure was measured before and after progressive release of the plantar fascia. Strain in the diaphysis of the second metatarsal was also measured, from which the bending moments and axial force imposed on the metatarsal were calculated. Cutting the medial half of the central plantar fascial band significantly increased peak pressure under the metatarsal heads but had little effect on pressures in other regions of the forefoot or on second metatarsal strain and loading. Dividing the entire central band or completely releasing the plantar fascia from the calcaneus had a much greater effect and caused significant shifts in plantar pressure and force from the toes to beneath the metatarsal heads. These shifts were accompanied by significantly increased strain and bending in the second metatarsal. Complete fasciotomy increased the magnitude of strain in the dorsal aspect of the second metatarsal by more than 80%, suggesting that plantar fascial release or rupture accelerates the accumulation of fatigue damage in these bones. Altered forefoot loading may be a potential complication of plantar fasciotomy.

  20. Simultaneous Knee Extensor Muscle Action Induces an Increase in Voluntary Force Generation of Plantar Flexor Muscles.

    Science.gov (United States)

    Suzuki, Takahito; Shioda, Kohei; Kinugasa, Ryuta; Fukashiro, Senshi

    2017-02-01

    Suzuki, T, Shioda, K, Kinugasa, R, and Fukashiro, S. Simultaneous knee extensor muscle action induces an increase in voluntary force generation of plantar flexor muscles. J Strength Cond Res 31(2): 365-371, 2017-Maximum activation of the plantar flexor muscles is required for various sporting activities that involve simultaneous plantar flexion and knee extension. During a multi-joint movement, activation of the plantar flexor muscles is affected by the activity of the knee extensor muscles. We hypothesized that coactivation of the plantar flexor muscles and knee extensor muscles would result in a higher plantar flexion torque. To test this hypothesis, 8 male volunteers performed maximum voluntary isometric action of the plantar flexor muscles with and without isometric action of the knee extensor muscles. Surface electromyographic data were collected from 8 muscles of the right lower limb. Voluntary activation of the triceps surae muscles, evaluated using the interpolated twitch technique, significantly increased by 6.4 percentage points with intentional knee extensor action (p = 0.0491). This finding is in line with a significant increase in the average rectified value of the electromyographic activity of the vastus lateralis, fibularis longus, and soleus muscles (p = 0.013, 0.010, and 0.045, respectively). The resultant plantar flexion torque also significantly increased by 11.5% of the predetermined maximum (p = 0.031). These results suggest that higher plantar flexor activation coupled with knee extensor activation facilitates force generation during a multi-joint task.

  1. Aplicacion de la termografia en el diagnostico y valoracion de la pododermatitis plantar en rapaces

    National Research Council Canada - National Science Library

    Melero Asensio, M; Lopez Marquez, I; Sanchez-Vizcaino Rodriguez, J.M

    2010-01-01

    .... Los resultados obtenidos muestran que la termografia permite detectar la pododermatitis plantar antes de la aparicion de lesiones, por la mayor diferencia entre las temperaturas maxima y minima...

  2. Applicability of contrast-enhanced ultrasound in the diagnosis of plantar fasciitis.

    Science.gov (United States)

    Broholm, Rikke; Pingel, Jessica; Simonsen, Lene; Bülow, Jens; Johannsen, Finn

    2017-02-27

    Contrast-enhanced ultrasound (CEUS) is used to visualize the microvascularisation in various tissues. The purpose of this study was to investigate whether CEUS could be used to visualize the microvascular volume (MV) in the plantar fascia, and to compare the method to clinical symptoms and B-mode ultrasound (US) in patients with plantar fasciitis (PF). 20 patients with unilateral PF were included and were divided by US in insertional thickening (10), midsubstance thickening (5) and no US changes (5). The MV was measured simultaneously in both heels. Four areas in the plantar fascia and plantar fat pad were measured independently by two observers. Inter- and intra-observer correlation analyses were performed. The asymptomatic heels showed a constantly low MV, and for the whole group of patients a significantly higher MV was found in the symptomatic plantar fascia and plantar fat pad. Inter-observer correlation as well as intra-observer agreement was excellent. The MV in the plantar fascia and plantar fat pad can be measured reliably using CEUS, suggesting that it is a reproducible method to examine patients with plantar fasciitis. This article is protected by copyright. All rights reserved.

  3. Sonographically guided deep plantar fascia injections: where does the injectate go?

    Science.gov (United States)

    Maida, Eugene; Presley, James C; Murthy, Naveen; Pawlina, Wojciech; Smith, Jay

    2013-08-01

    To determine the distribution of sonographically guided deep plantar fascia injections in an unembalmed cadaveric model. A single experienced operator completed 10 sonographically guided deep plantar fascia injections in 10 unembalmed cadaveric specimens (5 right and 5 left) obtained from 6 donors (2 male and 4 female) aged 49 to 95 years (mean, 77.5 years) with a mean body mass index of 23.2 kg/m(2) (range, 18.4-26.3 kg/m(2)). A 12-3-MHz linear array transducer was used to direct a 22-gauge, 38-mm stainless steel needle deep to the plantar fascia at the anterior aspect of the calcaneus using an in-plane, medial-to-lateral approach. In each case, 1.5 mL of 50% diluted colored latex was injected deep to the plantar fascia. After a minimum of 72 hours, study coinvestigators dissected each specimen to assess injectate placement. All 10 injections accurately placed latex adjacent to the deep side of the plantar fascia at the anterior calcaneus. However, the flexor digitorum brevis (FDB) origin from the plantar fascia variably limited direct latex contact with the plantar fascia, and small amounts of latex interdigitated with the FDB origin in 90% (9 of 10). In all 10 specimens, latex also covered the traversing first branch of the lateral plantar nerve (FBLPN, ie, Baxter nerve) between the FDB and quadratus plantae muscles. No latex was found in the plantar fat pad or plantar fascia in any specimen. Sonographically guided deep plantar fascia injections reliably deliver latex deep to the plantar fascia while avoiding intrafascial injection. However, the extent of direct plantar fascia contact is variable due to the intervening FDB. On the contrary, the traversing FBLPN is reliably covered by the injection. Deep plantar fascia injections may have a role in the management of refractory plantar fasciitis, particularly following failed superficial perifascial or intrafascial injections, in cases of preferential deep plantar fascia involvement, or when entrapment

  4. A review of 105 consecutive uniport endoscopic plantar fascial release procedures for the treatment of chronic plantar fasciitis.

    Science.gov (United States)

    Morton, Troy N; Zimmerman, Jeffrey P; Lee, Michael; Schaber, John D

    2013-01-01

    Plantar fasciitis is a common cause of heel pain in the U.S. Army soldier, resulting in a significant loss of man hours. Given the heavy operations tempo of the U.S. military, successful treatment options need to be considered and used as quickly as possible. Plantar fasciitis can be successfully treated in up to 90% of patients using conservative measures. Operative intervention might need to be considered for those in whom conservative measures have failed. The present report is a review of 105 consecutive uniport endoscopic plantar fascial release procedures performed by the principal investigator during a 9-year period. The following data were collected and analyzed: gender, age, weight, height, body mass index, medical treatment facility, procedure laterality, preoperative pain levels, postoperative pain levels at 3 months, first ambulatory day in the controlled ankle motion boot, return to activity as tolerated, and complications. Three major points were of interest: evidence of improvement in chronic plantar fasciitis when treated with uniport endoscopic procedures; the patient attributes associated with self-reported pain levels 90 days postoperatively; and the patient attributes associated with the average time until patients were able to return to activities as tolerated in a controlled ankle motion boot. It was noted that 44.5% of those with a body mass index of 29.80 kg/m(2) or greater reported a postoperative pain level of 0; and 96.3% of those with a body mass index of 25.53 kg/m(2) or less reported postoperative pain levels of 0. The analyzed data were used to characterize the clinical outcomes of the procedure, identify changes in outcome with surgeon experience, and identify whether certain patient subgroups have better outcomes, allowing surgeons to identify which patient might be the best candidates for an endoscopic release procedure.

  5. Cooperative Opportunistic Pressure Based Routing for Underwater Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Nadeem Javaid

    2017-03-01

    Full Text Available In this paper, three opportunistic pressure based routing techniques for underwater wireless sensor networks (UWSNs are proposed. The first one is the cooperative opportunistic pressure based routing protocol (Co-Hydrocast, second technique is the improved Hydrocast (improved-Hydrocast, and third one is the cooperative improved Hydrocast (Co-improved Hydrocast. In order to minimize lengthy routing paths between the source and the destination and to avoid void holes at the sparse networks, sensor nodes are deployed at different strategic locations. The deployment of sensor nodes at strategic locations assure the maximum monitoring of the network field. To conserve the energy consumption and minimize the number of hops, greedy algorithm is used to transmit data packets from the source to the destination. Moreover, the opportunistic routing is also exploited to avoid void regions by making backward transmissions to find reliable path towards the destination in the network. The relay cooperation mechanism is used for reliable data packet delivery, when signal to noise ratio (SNR of the received signal is not within the predefined threshold then the maximal ratio combining (MRC is used as a diversity technique to improve the SNR of the received signals at the destination. Extensive simulations validate that our schemes perform better in terms of packet delivery ratio and energy consumption than the existing technique; Hydrocast.

  6. Cooperative Opportunistic Pressure Based Routing for Underwater Wireless Sensor Networks.

    Science.gov (United States)

    Javaid, Nadeem; Muhammad; Sher, Arshad; Abdul, Wadood; Niaz, Iftikhar Azim; Almogren, Ahmad; Alamri, Atif

    2017-03-19

    In this paper, three opportunistic pressure based routing techniques for underwater wireless sensor networks (UWSNs) are proposed. The first one is the cooperative opportunistic pressure based routing protocol (Co-Hydrocast), second technique is the improved Hydrocast (improved-Hydrocast), and third one is the cooperative improved Hydrocast (Co-improved Hydrocast). In order to minimize lengthy routing paths between the source and the destination and to avoid void holes at the sparse networks, sensor nodes are deployed at different strategic locations. The deployment of sensor nodes at strategic locations assure the maximum monitoring of the network field. To conserve the energy consumption and minimize the number of hops, greedy algorithm is used to transmit data packets from the source to the destination. Moreover, the opportunistic routing is also exploited to avoid void regions by making backward transmissions to find reliable path towards the destination in the network. The relay cooperation mechanism is used for reliable data packet delivery, when signal to noise ratio (SNR) of the received signal is not within the predefined threshold then the maximal ratio combining (MRC) is used as a diversity technique to improve the SNR of the received signals at the destination. Extensive simulations validate that our schemes perform better in terms of packet delivery ratio and energy consumption than the existing technique; Hydrocast.

  7. Calcaneal attachment of the plantar fascia: MR findings in asymptomatic volunteers.

    Science.gov (United States)

    Ehrmann, Christine; Maier, Matthias; Mengiardi, Bernard; Pfirrmann, Christian W A; Sutter, Reto

    2014-09-01

    To determine the spectrum of magnetic resonance (MR) imaging findings at the calcaneal attachment of the plantar fascia in asymptomatic volunteers. The study was approved by the institutional review board, and informed consent was obtained from all subjects. MR imaging was performed in 77 asymptomatic volunteers (mean age, 48.0 years; age range, 23-83 years) with use of a 1.5-T system. There were 40 women (mean age, 49.0 years; age range, 24-83 years) and 37 men (mean age, 48.0 years; age range, 23-83 years). Signal intensity characteristics and thickness of the medial, central, and lateral fascicles of the plantar fascia were assessed independently by two radiologists. The presence of soft-tissue edema, bone marrow edema, and bone spur formation at the attachment of the plantar fascia was noted. Datasets were analyzed with inferential statistic procedures. The mean thickness of the plantar fascia was 0.6 mm (medial fascicle), 4.0 mm (central fascicle), and 2.3 mm (lateral fascicle). Increased signal intensity in the plantar fascia was seen with the T1-weighted sequence in 16 of the 77 volunteers (21%), the T2-weighted sequence in six (7.8%), and the short inversion time inversion-recovery sequence in six (7.8%). Soft-tissue edema was seen deep to the plantar fascia in five of the 77 volunteers (6.5%) and superficial to the plantar fascia in 16 (21%). A calcaneal spur was detected in 15 of the 77 volunteers (19%). Calcaneal bone marrow edema was present in four volunteers (5.2%). T1-weighted signal intensity changes in the plantar fascia, soft-tissue edema superficial to the plantar fascia, and calcaneal spurs are common findings in asymptomatic volunteers and should be used with caution in the diagnosis of plantar fasciitis. Increased signal intensity within the plantar fascia with fluid-sensitive sequences is uncommon in asymptomatic volunteers.

  8. Plantar pressure distribution in elderly subjec Ts after proprioceptive exercises

    Directory of Open Access Journals (Sweden)

    Fábio Marcon Alfieri

    2008-04-01

    Full Text Available Changes related to aging limit cutaneous plantar perception, interfering in postural control. The aim of this study was to verify the effects of a regular program of proprioceptive intervention on plantar pressure distribution in older adults. Plantar pressure distribution was evaluated in 29 volunteers (63.06 ±2.84 years standing on both feet with eyes open (EO and eyes closed (EC. After baropodometric evaluation, the subjects attended 3 weekly proprioceptive intervention sessions of 1 hour’s duration for 3 months. Results: Prior to the intervention, participants exhibited mean EO values of 0.29 ±0.044 Kg/cm² for the right foot and 0.31 ±0.04 Kg/cm² for the left foot (p=0.0078 and post-intervention these were 0.28±0.04 Kg/cm² and 0.30±0.04 Kg/cm², respectively. Pre-intervention EC values were 0.30 ±0.044 Kg/cm² for the right and 0.31 ±0.05 Kg/cm² for the left foot and post-intervention these figures were 0.28 ±0.04 Kg/cm² and 0.29 ±0.049 Kg/cm², respectively. The results of MANOVA indicated significant differences in contact pressure between pre-intervention and post-intervention measurements. Conclusions: The intervention used here reduced the participants’ plantar pressure, but was unable to improve the distribution of plantar pressure between the right and left feet. Resumo Alterações decorrentes do envelhecimento limitam a percepção cutâneo-plantar, interferindo no controle postural. O objetivo deste trabalho foi de verificar os efeitos de um programa regular de intervenção proprioceptiva sobre a distribuição da pressão plantar em idosos. Avaliou-se a distribuição da pressão plantar em 29 indivíduos (63,06 ±2,84 anos em apoio bipodal com olhos abertos (BA e fechados (BF. Após avaliação baropodométrica, iniciou-se intervenção proprioceptiva (3 sessões semanais de 1 hora durante 3 meses. No apoio BA, os indivíduos apresentaram valor médio de 0,29±0,044 Kg/cm² no pé direito e de 0,31± 0,04 Kg

  9. 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,

  10. Impact of Diabetes and Peripheral Arterial Occlusive Disease on the Functional Microcirculation at the Plantar Foot

    Directory of Open Access Journals (Sweden)

    Mohammad Kabbani, MD

    2013-10-01

    Conclusions: Functional microcirculation at the plantar foot differs between healthy subjects and patients suffering from diabetes or PAOD of the same age. Patients with either diabetes or PAOD demonstrate deteriorated cutaneous oxygen saturation with equivalent blood perfusion at the plantar foot. More clinical studies have to be conducted to evaluate therapeutical methods that might ameliorate cutaneous oxygen saturation within diabetic foot disease and PAOD.

  11. Plantar pressures and relative lesser metatarsal lengths in older people with and without forefoot pain.

    Science.gov (United States)

    Menz, Hylton B; Fotoohabadi, Mohammad R; Munteanu, Shannon E; Zammit, Gerard V; Gilheany, Mark F

    2013-03-01

    Forefoot pain is a common problem in older people. We determined whether plantar pressures during gait and the relative lengths of the lesser metatarsals differ between older people with and without plantar forefoot pain. Dynamic plantar pressure assessment during walking was undertaken using the Tekscan MatScan® system in 118 community-dwelling older people (44 males and 74 females), mean age 74 (standard deviation=5.9) years, 43 (36%) of whom reported current or previous plantar forefoot pain. The relative lengths of metatarsals 1-5 were determined from weightbearing X-rays. Participants with current or previous plantar forefoot pain exhibited significantly (p=0.032) greater peak plantar pressure under metatarsal heads 3-5 (1.93 ± 0.41 kg/cm(2) vs. 1.74 ± 0.48 kg/cm(2) ). However, no differences were found in relative metatarsal lengths between the groups. These findings indicate that older people with forefoot pain generate higher peak plantar pressures under the lateral metatarsal heads when walking, but do not exhibit relatively longer lesser metatarsals. Other factors may be responsible for the observed pressure increase, such as reduced range of motion of the metatarsophalangeal joints and increased stiffness of plantar soft tissues. Copyright © 2012 Orthopaedic Research Society.

  12. Differences in foot sensitivity and plantar pressure between young adults and elderly

    NARCIS (Netherlands)

    Machado, A.S.; Bombach, G.D.; Duysens, J.; Carpes, F.P.

    2016-01-01

    OBJECTIVE: The understanding of foot sensitivity and plantar pressure contributes to the design of insoles, shoes, as well as to guide therapeutic interventions. Here we investigate differences in plantar pressure and foot sensitivity between young adults and community-dwelling elderly. METHODS:

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

    Directory of Open Access Journals (Sweden)

    Yun Wang

    2016-06-01

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

  14. The effect of heel elevation on strain within the plantar aponeurosis: in vitro study.

    Science.gov (United States)

    Kogler, G F; Veer, F B; Verhulst, S J; Solomonidis, S E; Paul, J P

    2001-05-01

    Mild, temporary reduction of symptoms from plantar fasciitis have been reported with the use of high heeled shoes (i.e. cowboy boots, ladies pumps). However, little is known on how heel elevation may contribute to a decrease in the pain and inflammation. The aim of this study was to quantify strain in the plantar aponeurosis in cadaveric feet with the use of various heel elevation configurations. An in vitro method that simulated "static" stance was used to determine the loading characteristics of the plantar aponeurosis (n = 12). Heel elevation was evaluated with blocks placed beneath the heel and with a contoured platform that simulated the arch profile of a shoe at three different heel heights (2.0, 4.0, 6.0 cm) with a level plane serving as the control. Strain in the plantar aponeurosis decreased with elevations of the heel that simulated the arch profile of a shoe at load levels (337, 450 N) (P plantar aponeurosis (P plantar aponeurosis may be dependent on individual variation and foot structure differences. Therefore, clinicians should be cautious in recommending heel elevation as a treatment for plantar fasciitis since some subjects may not achieve the desired decrease in plantar aponeurosis strain.

  15. Metatarsophalangeal joint stability: A systematic review on the plantar plate of the lesser toes

    NARCIS (Netherlands)

    Maas, N.M.G. (Nico M.G.); M. van der Grinten (Margot); W.M. Bramer (Wichor); G.J. Kleinrensink (Gert Jan)

    2016-01-01

    textabstractBackground: Instability of the metatarsophalangeal (MTP) joints of the lesser toes (digiti 2-5) is increasingly being treated by repair of the plantar plate (PP). This systematic review examines the anatomy of the plantar plate of the lesser toes, and the relation between the integrity

  16. Metatarsophalangeal joint stability: A systematic review on the plantar plate of the lesser toes

    NARCIS (Netherlands)

    Maas, N.M.G. (Nico M.G.); M. van der Grinten (Margot); W.M. Bramer (Wichor); G.J. Kleinrensink (Gert Jan)

    2016-01-01

    textabstractBackground: Instability of the metatarsophalangeal (MTP) joints of the lesser toes (digiti 2-5) is increasingly being treated by repair of the plantar plate (PP). This systematic review examines the anatomy of the plantar plate of the lesser toes, and the relation between the integrity o

  17. Metatarsophalangeal joint stability: A systematic review on the plantar plate of the lesser toes

    NARCIS (Netherlands)

    Maas, N.M.G. (Nico M.G.); M. van der Grinten (Margot); W.M. Bramer (Wichor); G.J. Kleinrensink (Gert Jan)

    2016-01-01

    textabstractBackground: Instability of the metatarsophalangeal (MTP) joints of the lesser toes (digiti 2-5) is increasingly being treated by repair of the plantar plate (PP). This systematic review examines the anatomy of the plantar plate of the lesser toes, and the relation between the integrity o

  18. Imaging of Lesser Metatarsophalangeal Joint Plantar Plate Degeneration, Tear, and Repair.

    Science.gov (United States)

    Linklater, James M; Bird, Stephen J

    2016-04-01

    Plantar plate degeneration and tear is a common cause of forefoot pain, typically involving the second metatarsophalangeal joint at the proximal phalangeal insertion laterally, frequently confused with the second web space Morton neuroma. The condition has received increased attention with the development of surgical techniques that can result in successful repair of the plantar plate and substantial improvement in patient symptoms. High-resolution MRI or ultrasound can confirm a diagnosis of plantar plate degeneration and tear and exclude other pathologies, particularly Morton neuroma. The normal plantar plate is a mildly hyperechoic structure on ultrasound and is hypointense on all conventional MR sequences. Plantar plate degeneration manifests on ultrasound as hypoechoic echotextural change and on MRI as mild signal hyperintensity on short TE sequences, becoming less conspicuous on long TE sequences. Adjacent entheseal bony irregularity is commonly present. Plantar plate tears on ultrasound may be seen as an anechoic cleft defect or area of heterogeneous echotexture, sometimes more conspicuous with dorsiflexion stress. Plantar plate tears demonstrate greater signal hyperintensity on proton-density sequences, becoming more conspicuous on fat-suppressed proton density and T2-weighted sequences. Edema and fibrotic change in the pericapsular fat plane is commonly seen in the setting of an adjacent plantar plate tear and should not be misinterpreted as reflecting a Morton neuroma.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  20. Abnormal attachments between a plantar aponeurosis and calcaneus

    OpenAIRE

    KALNIEV, MANOL ANASTASOV; Krastev,Dimo; KRASTEV, NIKOLAY; VIDINOV, KALIN; VELTCHEV, LUDMIL; Mileva, Milka

    2013-01-01

    Background and aims The plantar aponeurosis or fascia is a thick fascial seal located on the lower surface of the sole. It consists of three parts central, lateral, and medial. The central portion is the thickest. It is narrow behind and wider in front. The central portion has two strong vertical intermuscular septa which are directed upward into the foot. The lateral and medial portions are thinner. The medial portion is thinnest. The lateral portion is thin in front and thick behind. The ma...

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

    Science.gov (United States)

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

    2013-12-01

    Plantar fascia and distal Achilles injuries are common in elite athletes. Acute athletic injuries of the plantar fascia include acute plantar fasciopathy and partial or complete tears. Underlying most acute injuries is a background of underlying chronic plantar fasciopathy. Injuries may affect the central or less commonly lateral portions of the fascia and acute tears are generally proximal. Athletic Achilles injuries may occur at the mid tendon or the distal insertion, and there may be an underlying chronic tendinopathy. Acute or chronic paratendinopathy may occur as a separate entity or combined with Achilles injury. In this article, the spectrum of athletic injuries of the plantar fascia and Achilles is described, illustrated by imaging findings from the London 2012 Olympic games.

  2. Reconstruction of lateral forefoot using reversed medial plantar flap with free anterolateral thigh flap.

    Science.gov (United States)

    Fujioka, Masaki; Hayashida, Kenji; Senju, Chikako

    2014-01-01

    Skin defects of the heel have frequently been reconstructed using the medial plantar flap; however, forefoot coverage has remained a challenge, because the alternatives for flap coverage have been very limited. We describe a case of malignant melanoma on the lateral forefoot that was radically removed and reconstructed successfully with a distally based medial plantar flap, together with a free anterolateral thigh flap. The advantages of this flap include that it does not reduce the vascular supply to the foot owing to reconstruction of the medial plantar vascular systems, reduces the risk of flap congestion, minimizes donor site morbidity, and enables the transport of structurally similar tissues to the plantar forefoot. We believe this technique is a reasonable reconstructive option for large lateral plantar forefoot defects.

  3. The deep band of the plantar aponeurosis of the human foot.

    Science.gov (United States)

    Cralley, J C; Schuberth, J M; Fitch, K L

    1982-01-01

    The deep band of the plantar aponeurosis is a variable structure formed by fibers from both the medial and lateral portions of the plantar aponeurosis. This band courses directly to the plantar ligament of the fourth metatarsophalangeal joint. Proximally it is superficial. Distally it passes deep to the tendons of the flexor digitorum longus to attach at the metatarsophalangeal joint. The second plantar and third and fourth dorsal interosseous muscles as well as the transverse head of adductor hallucis have attachments to the deep aponeurotic band. This band becomes taut when the proximal phalanx of the fourth toe is extended. No recent references to this structure could be found. The function of the deep band of the plantar aponeurosis is unknown, although the anatomical arrangement may make it important in stabilizing the fourth ray of the foot during locomotion.

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

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2014-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Arnaud eFoisy

    2016-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-10-15

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

  7. Intraosseous lipoma of the calcaneus mimicking plantar fascitis.

    Science.gov (United States)

    Karthik, K; Aarthi, S

    2011-06-01

    Benign lytic lesions of the calcaneus are rare and are usually asymptomatic. We report this case of a 55-year-old man with bilateral non-traumatic plantar heel pain, which was treated conservatively as plantar fasciitis. At three months follow-up, the patient had complete relief of symptoms in the left heel with partial relief of symptoms on the right side. However under the insistence of the patient an X-ray was taken, which revealed an expansile lytic lesion of the right calcaneus and a normal left heel. CT-scan revealed an expansile lytic lesion on the right calcaneus and an early lytic lesion in the left calcaneus. Following surgical intervention, the diagnosis was confirmed as intra-osseous lipoma and the patient was completely symptom free at two-year follow-up. Patients presenting with non-traumatic heel pain should be explained about the possible causes of heel pain, and should be offered X-ray at the first visit. In patients with X-ray showing unilateral lipoma of the calcaneus, CT scan should be offered to rule out involvement of the opposite side.

  8. Effect of the silicone heel pad on plantar fasciitis.

    Science.gov (United States)

    Niazi, Noman Shakeel; Khan Niazi, Suhail Niaz; Khan Niazi, Khalid Niazi; Iqbal, Madiha

    2015-11-01

    To evaluate the effect of silicone heel pad in the management of pain in plantar fasciitis patients. The descriptive case series study was conducted at Hope Rehabilitation Centre, Lahore, from March 1 to September 30, 2013, and comprised patients aged > 18 years with symptomatic plantar fasciitis who were treated with silicone heel pad. All patients were assessed at one month and six months for pain relief measured on % Maximum Total Pain Relief and Pain Intensity Difference percentage scales. Data was analysed using SPSS 20. Out of 100 patients, 37(37%) were male and 63(63%) were female. The mean age of the patients was 44.25±12.75 years. Five (5%) patients were lost to follow-up during the study, while 7(7%) patients changed their initial treatment because they did not experience relief. Silicone heel pad reported a better outcome measure associated with the patient\\'s heel pain as 74(84.09%) patients resolved their condition or reached a tolerance level and showed preferable reduction in heel pain .There were statistically significant difference between pain relieved and treatment duration (p=0.039). Conservative intervention with silicone heel pad showed relief from heel pain and it allowed the patient to manage the condition more effectively with no complications but for shortterm. It was less effective in the long term.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-08-01

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

  10. High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis (Ledderhose's disease).

    Science.gov (United States)

    Knobloch, Karsten; Vogt, Peter M

    2012-10-02

    Plantar fibromatosis is a benign disease creating nodules on the medial plantar side of affected patients. While surgical removal is regarded as the therapeutic mainstay, recurrence rates and impairment of daily activities remains substantial. High-energy focussed extracorporeal shockwave therapy has been suggested to be potentially effective in plantar fibromatosis in terms of pain reduction. High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis. A total number of six patients (5 males, 58±4 years) were included with plantar fibromatosis (Ledderhose's disease) associated with pain. Three patients were operated on previously, one had concomitant Dupuytren's contracture. High-energy focussed ESWT was applied using a Storz Duolith SD1 (2000 impulses, 3 Hz, 1.24 mJ/mm²) in two sessions with 7 days between. Pain was 6±2 at baseline, 2±1 after 14 days and 1±1 after 3 months. Softening of the nodules was noted by all patients. No adverse effects were noted. High-energy focussed extracorporeal shockwave energy reduces pain in painful plantar fibromatosis (Morbus Ledderhose). Further large-scale prospective trials are warranted to elucidate the value of high-energy focussed extracorporeal shockwave therapy (ESWT) in plantar fibromatosis in terms of recurrence and efficacy.

  11. High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis (Ledderhose’s disease)

    Science.gov (United States)

    2012-01-01

    Background Plantar fibromatosis is a benign disease creating nodules on the medial plantar side of affected patients. While surgical removal is regarded as the therapeutic mainstay, recurrence rates and impairment of daily activities remains substantial. High-energy focussed extracorporeal shockwave therapy has been suggested to be potentially effective in plantar fibromatosis in terms of pain reduction. Hypothesis High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis. Findings A total number of six patients (5 males, 58±4 years) were included with plantar fibromatosis (Ledderhose’s disease) associated with pain. Three patients were operated on previously, one had concomitant Dupuytren’s contracture. High-energy focussed ESWT was applied using a Storz Duolith SD1 (2000 impulses, 3 Hz, 1.24 mJ/mm2) in two sessions with 7 days between. Pain was 6±2 at baseline, 2±1 after 14 days and 1±1 after 3 months. Softening of the nodules was noted by all patients. No adverse effects were noted. Conclusions High-energy focussed extracorporeal shockwave energy reduces pain in painful plantar fibromatosis (Morbus Ledderhose). Further large-scale prospective trials are warranted to elucidate the value of high-energy focussed extracorporeal shockwave therapy (ESWT) in plantar fibromatosis in terms of recurrence and efficacy. PMID:23031080

  12. Strength training for plantar fasciitis and the intrinsic foot musculature: A systematic review.

    Science.gov (United States)

    Huffer, Dean; Hing, Wayne; Newton, Richard; Clair, Mike

    2017-03-01

    The aim was to critically evaluate the literature investigating strength training interventions in the treatment of plantar fasciitis and improving intrinsic foot musculature strength. A search of PubMed, CINHAL, Web of Science, SPORTSDiscus, EBSCO Academic Search Complete and PEDRO using the search terms plantar fasciitis, strength, strengthening, resistance training, intrinsic flexor foot, resistance training. Seven articles met the eligibility criteria. Methodological quality was assessed using the modified Downs and Black checklist. All articles showed moderate to high quality, however external validity was low. A comparison of the interventions highlights significant differences in strength training approaches to treating plantar fasciitis and improving intrinsic strength. It was not possible to identify the extent to which strengthening interventions for intrinsic musculature may benefit symptomatic or at risk populations to plantar fasciitis. There is limited external validity that foot exercises, toe flexion against resistance and minimalist running shoes may contribute to improved intrinsic foot musculature function. Despite no plantar fascia thickness changes being observed through high-load plantar fascia resistance training there are indications that it may aid in a reduction of pain and improvements in function. Further research should use standardised outcome measures to assess intrinsic foot musculature strength and plantar fasciitis symptoms.

  13. Plantar fascia evaluation with a dedicated magnetic resonance scanner in weight-bearing position: our experience in patients with plantar fasciitis and in healthy volunteers.

    Science.gov (United States)

    Sutera, R; Iovane, A; Sorrentino, F; Candela, F; Mularo, V; La Tona, G; Midiri, M

    2010-03-01

    This study assessed the usefulness of upright weight-bearing examination of the ankle/hind foot performed with a dedicated magnetic resonance (MR) imaging scanner in the evaluation of the plantar fascia in healthy volunteers and in patients with clinical evidence of plantar fasciitis. Between January and March 2009, 20 patients with clinical evidence of plantar fasciitis (group A) and a similar number of healthy volunteers (group B) underwent MR imaging of the ankle/hind foot in the upright weight-bearing and conventional supine position. A 0.25-Tesla MR scanner (G-Scan, Esaote SpA, Genoa, Italy) was used with a dedicated receiving coil for the ankle/hind foot. Three radiologists, blinded to patients' history and clinical findings, assessed in consensus morphological and dimensional changes and signal intensity alterations on images acquired in both positions, in different sequences and in different planes. In group A, MR imaging confirmed the diagnosis in 15/20 cases; in 4/15 cases, a partial tear of the plantar fascia was identified in the upright weight-bearing position alone. In the remaining 5/20 cases in group A and in all cases in group B, the plantar fascia showed no abnormal signal intensity. Because of the increased stretching of the plantar fascia, in all cases in group A and B, thickness in the proximal third was significantly reduced (pbearing compared with the supine position. Imaging the ankle/hind foot in the upright weight-bearing position with a dedicated MR scanner and a dedicated coil might enable the identification of partial tears of the plantar fascia, which could be overlooked in the supine position.

  14. Comparison of Plantar Pressure Distribution between Different Speed and Incline During Treadmill Jogging.

    Science.gov (United States)

    Ho, I-Ju; Hou, Yi-You; Yang, Chich-Haung; Wu, Wen-Lan; Chen, Sheng-Kai; Guo, Lan-Yuen

    2010-01-01

    The aim of this study was to examine the effect of changes in speed and incline slope on plantar pressure distribution of the foot during treadmill jogging. Plantar pressure parameters were measured with the Pedar-X system in twenty healthy girls (mean age of 20.7 years, mean height of 1.60m, and a mean weight of 53.35kg). Because variations in walking speed or slope can significantly change the magnitude of plantar pressure, comparisons of plantar pressure distribution between the two independent protocols during treadmill jogging were considered in this study. First, the subjects ran at the same speed of 2 m·s(-1) with different incline slopes of 0%, 5%, 10%, and 15%. Second, they ran on the same slope of 0% with different speeds of 1.5 m·s(-1), 2.0 m·s(-1), and 2.5 m·s(-1). The peak pressure of the eight plantar surface areas, apart from the medial forefoot and the hallux, significantly increased (p jogging were associated with changes in plantar pressures. By systematic investigation of foot kinematics and plantar pressure during jogging with varying incline slope and speed, the results of this study provided further insight into foot biomechanics during jogging. Key pointsThe study aimed to compare the plantar pressure distribution of the foot between different incline and speed during treadmill jogging by using plantar insole measurement system.With the increase of speed, apart from the hallux and medical forefoot, the peak pressure of all regions was raised significantly.As the slope increased, there was reduced peak pressure of the heel, medial forefoot, and hallux and toes.

  15. Ostectomy and Medial Plantar Artery Flap Reconstruction for Charcot Foot Ulceration Involving the Midfoot.

    Science.gov (United States)

    Sato, Tomoya; Ichioka, Shigeru

    2016-01-01

    Charcot foot is a serious complication of diabetes, characterized by deformity and overlying ulceration. The condition most commonly affects the midfoot. However, little information is available on the use of a medial plantar artery flap to treat diabetic midfoot ulceration. The purpose of the present study was to evaluate the versatility of ostectomy and medial plantar flap reconstruction for midfoot plantar ulceration associated with rocker-bottom deformity secondary to Charcot foot. Four patients underwent ostectomy and medial plantar flap reconstruction. Before flap reconstruction, the devitalized soft tissues and bone were radically resected. After the infection had been controlled, the ulcerated portion was minimally excised, and the bony prominence underlying the ulcer was removed. A medial plantar artery flap was applied to the ulcer. The donor site was covered with a split-thickness skin graft or artificial dermis. In all patients, the ulcers healed and independent ambulation was achieved. However, 1 patient experienced ulcer recurrence, and subsequent infection necessitated a major amputation. Limb salvage is challenging in the setting of deformity and intractable plantar ulceration. The advantages of medial plantar artery flap reconstruction are that tissues with a rich blood supply are used to cover the exposed bone, and the flap can withstand the pressure and shear stress of the patient's body weight. However, a dominant artery in the foot is sacrificed. Therefore, the patency of the dorsalis pedis artery must be confirmed in every patient. The results of the present study have demonstrated that a medial plantar artery can be an effective alternative for diabetic patients with a plantar ulcer secondary to Charcot foot.

  16. Finite element analysis of plantar fascia during walking: a quasi-static simulation.

    Science.gov (United States)

    Chen, Yen-Nien; Chang, Chih-Wei; Li, Chun-Ting; Chang, Chih-Han; Lin, Cheng-Feng

    2015-01-01

    The plantar fascia is a primary arch supporting structure of the foot and is often stressed with high tension during ambulation. When the loading on the plantar fascia exceeds its capacity, the inflammatory reaction known as plantar fasciitis may occur. Mechanical overload has been identified as the primary causative factor of plantar fasciitis. However, a knowledge gap exists between how the internal mechanical responses of the plantar fascia react to simple daily activities. Therefore, this study investigated the biomechanical responses of the plantar fascia during loaded stance phase by use of the finite element (FE) modeling. A 3-dimensional (3-D) FE foot model comprising bones, cartilage, ligaments, and a complex-shaped plantar fascia was constructed. During the stance phase, the kinematics of the foot movement was reproduced and Achilles tendon force was applied to the insertion site on the calcaneus. All the calculations were made on a single healthy subject. The results indicated that the plantar fascia underwent peak tension at preswing (83.3% of the stance phase) at approximately 493 N (0.7 body weight). Stress concentrated near the medial calcaneal tubercle. The peak von Mises stress of the fascia increased 2.3 times between the midstance and preswing. The fascia tension increased 66% because of the windlass mechanism. Because of the membrane element used in the ligament tissue, this FE model was able to simulate the mechanical structure of the foot. After prescribing kinematics of the distal tibia, the proposed model indicated the internal fascia was stressed in response to the loaded stance phase. Based on the findings of this study, adjustment of gait pattern to reduce heel rise and Achilles tendon force may lower the fascia loading and may further reduce pain in patients with plantar fasciitis. © The Author(s) 2014.

  17. LOCAL CORTICOSTEROID VS. AUTOLOGOUS BLOOD FOR PLANTAR FASCIITIS

    Directory of Open Access Journals (Sweden)

    Syam Sunder B

    2017-01-01

    Full Text Available BACKGROUND Plantar fasciitis is the most common cause of heel pain for which professional care is sought. Initially thought of as an inflammatory process, plantar fasciitis is a disorder of degenerative changes in the fascia and maybe more accurately termed plantar fasciosis. Traditional therapeutic efforts have been directed at decreasing the presumed inflammation. These treatments include icing, Nonsteroidal Anti-inflammatory Drugs (NSAIDs, rest and activity modification, corticosteroids, botulinum toxin type A, splinting, shoe modifications and orthosis. Other treatment techniques have been directed at resolving the degeneration caused by the disease process. In general, these techniques are designed to create an acute inflammatory reaction with the goal of restarting the healing process. These techniques include autologous blood injection, Platelet-Rich Plasma (PRP injection, nitroglycerin patches, Extracorporeal Shock Wave Therapy (ESWT and surgical procedures. Recently, research has focused on regenerative therapies with high expectations of success. The use of autologous growth factors is thought to heal through collagen regeneration and the stimulation of a well-ordered angiogenesis. These growth factors are administered in the form of autologous whole blood or Platelet-Rich Plasma (PRP. Platelets can be isolated using simple cell-separating systems. The degranulation of the alpha granules in the platelets releases many different growth factors that play a role in tissue regeneration processes. Platelet-derived growth factor, transforming growth factor-P, vascular-derived endothelial growth factor, epithelial growth factor, hepatocyte growth factor and insulin-like growth factor are examples of such growth factors. Injections with autologous growth factors are becoming common in clinical practice. The present study was an attempt to compare the efficacy of autologous blood injection in plantar fasciitis by comparing it with the local

  18. Differential impact of visual feedback on plantar- and dorsi-flexion maximal torque output.

    Science.gov (United States)

    Toumi, Anis; Jakobi, Jennifer M; Simoneau-Buessinger, Emilie

    2016-05-01

    The effect of visual feedback on enhancing isometric maximal voluntary contractions (MVC) was evaluated. Twelve adults performed plantar-flexion and dorsi-flexion MVCs in 3 conditions (no visual feedback, visual feedback, and visual feedback with target). There was no significant effect of visual conditions on dorsi-flexion MVC but there was an effect on plantar-flexion. Irrespective of whether a target was evident, visual feedback increased plantar-flexion MVC by ∼15%. This study highlights the importance of optimal feedback to enhance MVC.

  19. Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae): a randomised controlled trial.

    Science.gov (United States)

    Cockayne, Sarah; Hewitt, Catherine; Hicks, Kate; Jayakody, Shalmini; Kang'ombe, Arthur Ricky; Stamuli, Eugena; Turner, Gwen; Thomas, Kim; Curran, Mike; Denby, Gary; Hashmi, Farina; McIntosh, Caroline; McLarnon, Nichola; Torgerson, David; Watt, Ian

    2011-06-07

    To compare the clinical effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts. A multicentre, open, two arm randomised controlled trial. University podiatry school clinics, NHS podiatry clinics, and primary care in England, Scotland, and Ireland. 240 patients aged 12 years and over, with a plantar wart that in the opinion of the healthcare professional was suitable for treatment with both cryotherapy and salicylic acid. Cryotherapy with liquid nitrogen delivered by a healthcare professional, up to four treatments two to three weeks apart. Patient self treatment with 50% salicylic acid (Verrugon) daily up to a maximum of eight weeks. Complete clearance of all plantar warts at 12 weeks. Secondary outcomes were (a) complete clearance of all plantar warts at 12 weeks controlling for age, whether the wart had been treated previously, and type of wart, (b) patient self reported clearance of plantar warts at six months, (c) time to clearance of plantar wart, (d) number of plantar warts at 12 weeks, and (e) patient satisfaction with the treatment. There was no evidence of a difference between the salicylic acid and cryotherapy groups in the proportions of participants with complete clearance of all plantar warts at 12 weeks (17/119 (14%) v 15/110 (14%), difference 0.65% (95% CI -8.33 to 9.63), P=0.89). The results did not change when the analysis was repeated but with adjustment for age, whether the wart had been treated previously, and type of plantar wart or for patients' preferences at baseline. There was no evidence of a difference between the salicylic acid and cryotherapy groups in self reported clearance of plantar warts at six months (29/95 (31%) v 33/98 (34%), difference -3.15% (-16.31 to 10.02), P=0.64) or in time to clearance (hazard ratio 0.80 (95% CI 0.51 to 1.25), P=0.33). There was also no evidence of a difference in the number of plantar warts at 12 weeks (incident rate ratio 1.08 (0.81 to 1.43), P=0.62). Salicylic acid and

  20. Comprehensive treatment of complicated plantar ulcers in leprosy

    Institute of Scientific and Technical Information of China (English)

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

    2003-01-01

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

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

    Science.gov (United States)

    Kadam, Dinesh

    2016-06-01

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

  2. Glabrous skin reconstruction of palmar/plantar defects: a case for the ...

    African Journals Online (AJOL)

    DR LEGBO

    Methods: A prospective descriptive study of consecutive patients with benign soft tissue palmar/plantar defects ... a long-standing and useful concept for plastic surgeons. One arena in .... The latter resulted mainly from burns and road traffic ...

  3. Atypical presentation of plantar fasciitis secondary to soft-tissue mass infiltration.

    Science.gov (United States)

    Ng, A; Beegle, T; Rockett, A K

    2001-02-01

    This article describes a patient with plantar fascial pain who presented to the office of one of the authors. Physical examination and the patient's description of the history of symptoms revealed classic signs and symptoms of plantar fasciitis. The patient was treated with numerous conservative modalities, including ultrasound, nonsteroidal anti-inflammatory medications, trigger-point injections, over-the-counter orthoses, and stretching exercises. When the pain was not relieved by these conservative measures, magnetic resonance imaging of the area was performed. Visualization of the insertional area of the plantar fascia revealed a mass inferior to, as well as infiltrated into, the plantar fascia. Surgical excision of the lesion resulted in complete elimination of the patient's pain.

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

    Institute of Scientific and Technical Information of China (English)

    刘占奇

    2010-01-01

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

  5. Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy

    Directory of Open Access Journals (Sweden)

    Willems Paul JB

    2009-02-01

    Full Text Available Abstract Background Patients with diabetic polyneuropathy (DPN are often confronted with ulceration of foot soles. Increased plantar pressure under the forefoot has been identified as a major risk factor for ulceration. This study sets out to test the hypothesis that changes in gait characteristics induced by DPN related muscle weakness are the origin of the elevated plantar pressures. Methods Three groups of subjects participated: people diagnosed with diabetes without polyneuropathy (DC, people diagnosed with diabetic polyneuropathy (DPN and healthy, age-matched controls (HC. In all subjects isometric strength of plantar and dorsal flexors was assessed. Moreover, joint moments at ankle, knee and hip joints were determined while walking barefoot at a velocity of 1.4 m/s. Simultaneously plantar pressure patterns were measured. Results Compared to HC-subjects, DPN-participants walked with a significantly increased internal plantar flexor moment at the first half of the stance phase. Also in DPN-subjects the maximal braking and propelling force applied to the floor was decreased. Moreover, in DPN-subjects the ratio of forefoot-to-rear foot plantar pressures was increased. Body-mass normalized strength of dorsal flexors showed a trend to be reduced in people with diabetes, both DC and DPN, compared to HC-subjects. Plantar flexors tended to be less weak in DC compared to HC and in DPN relative to DC. Conclusion The results of this study suggest that adverse plantar pressure patterns are associated with redistribution of joint moments, and a consequent reduced capacity to control forward velocity at heel strike.

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

    Directory of Open Access Journals (Sweden)

    Uden H

    2011-05-01

    Full Text Available Hayley Uden1, Eva Boesch1, Saravana Kumar1,21Division of Health Sciences, 2International Centre for Allied Health Evidence, University of South Australia, North Terrace, Adelaide, South Australia, AustraliaBackground: Plantar fasciitis is a common condition routinely managed by podiatrists in the community and is widely treated conservatively. Two commonly used treatments for plantar fasciitis are customized functional foot orthoses and corticosteroid injections. While common to clinical practice, the evidence base underpinning these treatment strategies is unknown. Therefore, the aim of this systematic review was to assess the effectiveness and safety of customized functional foot orthoses and corticosteroid injections in the treatment of plantar fasciitis.Methods: A systematic literature search was conducted. Experimental studies, in English, from 1998 to 2010 were accepted for inclusion in this review. The PEDro quality assessment tool and the National Health and Medical Research Council's hierarchy of evidence were used to assess the quality of the included studies.Results: Six randomized controlled trials which met the selection criteria were included in this review. Four reported on customized functional foot orthoses and 2 on corticosteroid injections. Current best available evidence highlights that both customized functional foot orthoses and corticosteroid injections can lead to a decrease in pain associated with plantar fasciitis. Additionally, customized functional foot orthoses may also provide an additional benefit in terms of increased functional ability in patients with plantar fasciitis. Corticosteroid injections may have side effects, especially pain (from the injection.Conclusion: Both customized functional foot orthoses and corticosteroid injections can lead to reduction in pain associated with plantar fasciitis. While customized functional foot orthoses may increase the functional outcomes in patients with plantar fasciitis

  7. Posttraumatic pseudoaneurysm of medial plantar artery in a child: treatment with percutaneous thrombin injection

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    Fabrício Neto Ladeira

    2014-03-01

    Full Text Available Pseudoaneurysms of the medial plantar artery are rare. The authors describe a case of a pseudoaneurysm of the medial plantar artery of a child who had suffered a penetrating laceration injury. Diagnosis can be confirmed using Doppler ultrasound and magnetic resonance angiography. As an alternative to the conventional surgery technique, percutaneous Doppler ultrasound-guided thrombin injection is a safe and effective treatment.

  8. Association of Abnormal Metatarsal Parabola With Second Metatarsophalangeal Joint Plantar Plate Pathology.

    Science.gov (United States)

    Fleischer, Adam E; Klein, Erin E; Ahmad, Maheen; Shah, Shivang; Catena, Fernanda; Weil, Lowell Scott; Weil, Lowell

    2017-03-01

    Plantar plate pathology is common, yet it is unclear whether, and to what extent, the length of the second metatarsal contributes to this problem. We conducted a retrospective case-control (1:2) study to examine radiographic risk factors for plantar plate tears. One hundred patients (age 55.7 ± 12.3 years) with plantar plate injuries and 200 healthy controls (age 56.3 ± 11.3 years) were included. Cases were defined as patients with nonacute, isolated, plantar plate pathology of the second metatarsophalangeal joint confirmed by intraoperative inspection at a single foot and ankle specialty practice from June 1, 2007, to January 31, 2014. Patients presenting for pain outside of the forefoot served as the control group. Controls were matched on age (±2 years), gender, and year of presentation. Weight-bearing foot x-rays were assessed for several predetermined angular relationships by a single rater. Conditional logistic regression was used to identify risk factors for plantar plate injury. A long second metatarsal, defined as a metatarsal protrusion index less than -4 mm, was the only significant risk factor for plantar plate pathology in both the univariate and multivariable analyses (multivariate odds ratio 2.5 [95% confidence interval 1.8 to 3.3], P = .002). We found that a long second metatarsal was a risk factor for developing second metatarsophalangeal joint plantar plate tears. This knowledge may aid foot and ankle surgeons when contemplating the need for second metatarsal shortening osteotomies (eg, Weil osteotomy) during plantar plate surgery and when deciding on the amount of shortening for second metatarsal osteotomies. Level III, retrospective comparative study.

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

    Science.gov (United States)

    Foisy, Arnaud; Kapoula, Zoï

    2016-01-01

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

  10. Constitutive Modeling of Time-Dependent Response of Human Plantar Aponeurosis

    OpenAIRE

    Pavan, P. G.; Pachera, P.; Stecco, C.; Natali, A. N.

    2014-01-01

    The attention is focused on the viscoelastic behavior of human plantar aponeurosis tissue. At this purpose, stress relaxation tests were developed on samples taken from the plantar aponeurosis of frozen adult donors with age ranging from 67 to 78 years, imposing three levels of strain in the physiological range (4%, 6%, and 8%) and observing stress decay for 240 s. A viscohyperelastic fiber-reinforced constitutive model with transverse isotropy was assumed to describe the time-dependent behav...

  11. Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy

    OpenAIRE

    Willems Paul JB; Schaper Nicolaas C; Savelberg Hans HCM; de Lange Ton LH; Meijer Kenneth

    2009-01-01

    Abstract Background Patients with diabetic polyneuropathy (DPN) are often confronted with ulceration of foot soles. Increased plantar pressure under the forefoot has been identified as a major risk factor for ulceration. This study sets out to test the hypothesis that changes in gait characteristics induced by DPN related muscle weakness are the origin of the elevated plantar pressures. Methods Three groups of subjects participated: people diagnosed with diabetes without polyneuropathy (DC), ...

  12. The effects of extracorporeal shock wave therapy on stroke patients with plantar fasciitis.

    Science.gov (United States)

    Kim, Tae Gon; Bae, Sea Hyun; Kim, Gye Yeop; Kim, Kyung Yoon

    2015-02-01

    [Purpose] The purpose of this research was to analyze the efficacy of extracorporeal shock wave therapy for the treatment of stroke patients with plantar fasciitis. [Subjects and Methods] This study included 10 stroke patients diagnosed with plantar fasciitis who were administered 3 sessions of extracorporeal shock wave therapy per week. After the last session, they performed stretching exercises for their Achilles tendon and plantar fascia for 30 min/day, 5 times a week for 6 months. The following parameters were measured and compared prior to therapy, 6 weeks after therapy, and 6 months after therapy: thickness of the plantar fascia, using an ultrasonic imaging system; degree of spasticity, using a muscle tension measuring instrument; degree of pain, using the visual analogue scale; and gait ability, using the Functional Gait Assessment. [Results] Decreased plantar fascia thickness, spasticity, and pain and increased gait ability were noted after therapy. These changes were significantly greater at 6 months after therapy than at 6 weeks after therapy. [Conclusion] These results indicated that extracorporeal shock wave therapy reduced tension in the plantar fascia, relieving pain and improving gait ability in stroke patients.

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

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    Erik Hohmann, Peter Reaburn, Kevin Tetsworth, Andreas Imhoff

    2016-06-01

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

  14. Functional characteristics of the foot and plantar aponeurosis under tibiotalar loading.

    Science.gov (United States)

    Sarrafian, S K

    1987-08-01

    Structurally the foot is equivalent to a twisted plate. The hindpart is located in the sagittal plane and the forepart in the transverse plane. The transition induced by the twist creates the transverse and the longitudinal arches. Under vertical loading of the foot plate by the tibiotalar column, compressive forces are created on the dorsum and tensile forces on the plantar aspect of the foot plate. The plantar aponeurosis acting as a tie-rod when under tension relieves the tensile forces from the plantar aspect of the foot plate. The increased tension in the plantar aponeurosis in the weightbearing position of the foot occurs with anterior flexion of the leg or with hyperextension of the toes. In the plantigrade position when vertical loading and external rotation are simultaneously applied by the tibiotalar column on the foot, the hindfoot and the midfoot are supinated, and the forefoot is pronated. The medial longitudinal arch is higher, the foot is shorter, and the plantar aponeurosis is relaxed. The foot is then more flexible. With vertical loading and simultaneous internal rotation, the hindfoot and the midfoot are pronated, and the forefoot is supinated. The medial longitudinal arch is lower, the foot is longer, and the plantar aponeurosis is tense. The foot is then more rigid and a better lever arm. Demonstrations are presented both in living and in anatomic dissections.

  15. Variability and repeatability analysis of plantar pressure during gait in older people.

    Science.gov (United States)

    Franco, Pedro S; Silva, Caio Borella P da; Rocha, Emmanuel S da; Carpes, Felipe P

    2015-01-01

    Repeatability and variability of the plantar pressure during walking are important components in the clinical assessment of the elderly. However, there is a lack of information on the uniformity of plantar pressure patterns in the elderly. To analyze the repeatability and variability in plantar pressure considering mean, peak and asymmetries during aged gait. Plantar pressure was monitored in four different days for ten elderly subjects (5 female), with mean±standard-deviation age of 73±6 years, walking barefoot at preferred speed. Data were compared between steps for each day and between different days. Mean and peak plantar pressure values were similar between the different days of evaluation. Asymmetry indexes were similar between the different days evaluated. Plantar pressure presented a consistent pattern in the elderly. However, the asymmetry indexes observed suggest that the elderly are exposed to repetitive asymmetric loading during locomotion. Such result requires further investigation, especially concerning the role of these asymmetries for development of articular injuries. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  16. Integrated kinematics-kinetics-plantar pressure data analysis: a useful tool for characterizing diabetic foot biomechanics.

    Science.gov (United States)

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

    2012-05-01

    The fundamental cause of lower-extremity complications in diabetes is chronic hyperglycemia leading to diabetic foot ulcer pathology. While the relationship between abnormal plantar pressure distribution and plantar ulcers has been widely investigated, little is known about the role of shear stress. Moreover, the mutual relationship among plantar pressure, shear stress, and abnormal kinematics in the etiology of diabetic foot has not been established. This lack of knowledge is determined by the lack of commercially available instruments which allow such a complex analysis. This study aims to develop a method for the simultaneous assessment of kinematics, kinetics, and plantar pressure on foot subareas of diabetic subjects by means of combining three commercial systems. Data were collected during gait on 24 patients (12 controls and 12 diabetic neuropathics) with a motion capture system synchronized with two force plates and two baropodometric systems. A four segment three-dimensional foot kinematics model was adopted for the subsegment angles estimation together with a three segment model for the plantar sub-area definition during gait. The neuropathic group exhibited significantly excessive plantar pressure, ground reaction forces on each direction, and a reduced loading surface on the midfoot subsegment (pfoot ulcerations, and help planning prevention programs.

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

    Science.gov (United States)

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

    2016-01-01

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

  18. [The design of plantar pressure distribution monitoring system and preliminary clinical application].

    Science.gov (United States)

    Zhu, Xianfeng; Zhao, Zilei; Xu, Donghao; Xu, Dongming

    2014-04-01

    Plantar pressure distribution can reflect the force of several key points on foot while standing and walking. A comprehensive understanding of the plantar pressure distribution makes great sense in the following aspects: the understanding of the normal foot biomechanics and function, clinical diagnosis, measurement of disease extent, postoperative efficacy evaluation, and rehabilitation research. A simple plantar pressure measurement device was designed in this study. This paper uses FlexiForce flexible sensor to pickup plantar pressure signal and USB A/D board to do data acquisition. The data are transferred into a laptop and processed by a VB-based software which can display, remember and replay the data. We chose patients with hallux valgus and normal people to measure the pressure distribution and make contrast analysis of plantar pressure with this device. It can be concluded that people with hallux valgus have higher pressure on the second metatarsophalangeal joint and the distribution move outward. The plantar pressure of patients postoperative could be greatly improved compared to the preoperative. The function of this device has been confirmed.

  19. Evaluation of plantar flexion contracture contribution during the gait of children with Duchenne muscular dystrophy.

    Science.gov (United States)

    Gaudreault, Nathaly; Gravel, Denis; Nadeau, Sylvie

    2009-06-01

    Because of extensor weakness, children with Duchenne muscular dystrophy (DMD) maintain internal flexion moments at the joints of the lower extremities when they walk. We believe that at the ankle, the plantar flexion moments caused by contractures may contribute significantly to the production of the net ankle flexion moment during the gait in these children. The goal of the present study is to quantify ankle plantar flexion passive moments that may be associated with the presence of flexion contractures and to estimate their contribution to the net moment during the gait of children with DMD. Kinematic and kinetic parameters were collected during gait of eleven subjects with DMD. Ankle plantar flexion passive moments were also measured experimentally during the same session. Fourteen control children participated in the study in order to have normal reference values. The presence of ankle plantar flexion contractures in children with DMD was reflected by a rigidity coefficient obtained at a common moment of -7 Nm that was higher for these children (0.75 Nm/degrees vs. 0.48 Nm/degrees; p<0.05). The relative passive moment contribution to the net plantar flexion moments was higher for the children with DMD at the end of the lengthening phase of the plantar flexors (25% vs. 18%; p<0.05). We believe that the passive moments can compensate for the presence of progressive muscle weakness in the children with DMD and help these children with gait.

  20. How effective is acupuncture for reducing pain due to plantar fasciitis?

    Science.gov (United States)

    Thiagarajah, Anandan Gerard

    2017-01-01

    INTRODUCTION Plantar fasciitis is a commonly seen outpatient condition that has numerous treatment modalities of varying degrees of efficacy. This systematic review aimed to determine the effectiveness of acupuncture in reducing pain caused by plantar fasciitis. METHODS Online literature searches were performed on the PubMed and Cochrane Library databases for studies on the use of acupuncture for pain caused by plantar fasciitis. Studies designed as randomised controlled trials and that compared acupuncture with standard treatments or had real versus sham acupuncture arms were selected. The Delphi list was used to assess the methodological quality of the studies retrieved. RESULTS Three studies that compared acupuncture with standard treatment and one study on real versus sham acupuncture were found. These showed that acupuncture significantly reduced pain levels in patients with plantar fasciitis, as measured on the visual analogue scale and the Plantar Fasciitis Pain/Disability Scale. These benefits were noted between four and eight weeks of treatment, with no further significant reduction in pain beyond this duration. Side effects were found to be minimal. CONCLUSION Although acupuncture may reduce plantar fasciitis pain in the short term, there is insufficient evidence for a definitive conclusion regarding its effectiveness in the longer term. Further research is required to strengthen the acceptance of acupuncture among healthcare providers. PMID:27526703

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

    OpenAIRE

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

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kirsty A McDonald

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

  3. Plantar pressure changes in normal and pathological foot during bipedal standing

    Directory of Open Access Journals (Sweden)

    Rai D

    2006-01-01

    Full Text Available Background : Plantar pressure measurement during bipedal standing provides an important information of loading of human body on foot under various postural activities. Therefore, the objective of the present work was to monitor the plantar pressure during bipedal standing in normal and pathological conditions. Use of orthotics in attenuating the peak pressure to distribute it uniformly on plantar surface of the foot was also examined. Methods: The pedobarographs of 66 subjects were recorded using computer assisted indigenously developed optical pedobarograph. The pedobarographs were evaluated using Asha 3-D software developed during present study. Standard size universal orthotics (FootmaxxTM, Canada was used to determine the effect in attenuating the peak pressure. Results: Results showed distribution of plantar pressure in the right and left foot of normal subject under the various regions was not equal. It was observed that among the normal subjects 17% experienced equal pressure on the both feet, 7% showed greater pressure on left foot and 76% found higher load on the right foot. Similarly the pathological subjects were analyzed and noticed the changes in the pedobarographs depending upon the type and location of pathology. It was found that orthotics improved the plantar pressure and distributed it uniformly to make the person standing comfortably. Conclusion: Plantar pressure measurement techniques are useful in the analysis and understanding of the biomechanics of human foot. It was found that orthotics attenuated the peak pressure and distributed it uniformly on the plantar area of the foot. The data seem to be useful in understanding the biomechanics of bipedal standing.

  4. COMPARISON OF PLANTAR PRESSURE DISTRIBUTION BETWEEN DIFFERENT SPEED AND INCLINE DURING TREADMILL JOGGING

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    I-Ju Ho

    2010-03-01

    Full Text Available The aim of this study was to examine the effect of changes in speed and incline slope on plantar pressure distribution of the foot during treadmill jogging. Plantar pressure parameters were measured with the Pedar-X system in twenty healthy girls (mean age of 20.7 years, mean height of 1.60m, and a mean weight of 53.35kg. Because variations in walking speed or slope can significantly change the magnitude of plantar pressure, comparisons of plantar pressure distribution between the two independent protocols during treadmill jogging were considered in this study. First, the subjects ran at the same speed of 2 m·s-1 with different incline slopes of 0%, 5%, 10%, and 15%. Second, they ran on the same slope of 0% with different speeds of 1.5 m·s-1, 2.0 m·s-1, and 2.5 m·s-1. The peak pressure of the eight plantar surface areas, apart from the medial forefoot and the hallux, significantly increased (p < 0.05 with an increase of 33% of peak pressure from 1.5 m·s-1 to 2.5 m·s-1 (speed at heel region. In contrast, the peak pressures at the heel, medial fore-foot, toe and hallux decreased significantly (p < 0. 05 with increasing incline slope. At the heel, peak pressure reduced by 27% from 0% to 15% incline, however, pressure at the lateral midfoot region increased as following. Different speeds and incline slopes during jogging were associated with changes in plantar pressures. By systematic investigation of foot kinematics and plantar pressure during jogging with varying incline slope and speed, the results of this study provided further insight into foot biomechanics during jogging

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

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    Landorf Karl B

    2008-08-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  7. [Plantar pressure measurement in children and youths during sports activities].

    Science.gov (United States)

    Lampe, R; Mitternacht, J; Gerdesmeyer, L; Gradinger, R

    2005-01-01

    The aim of this study was to consider whether changes occur in the foot area while under repeated physical stress and if they are age related. In addition it interests what consequences this might have in regard to proper shoe wear. The subjects for this study consisted of 15 children and youths aged between 4 and 16 years. The plantar pressure distribution and vertical ground reaction forces were measured before and after physical exercise. The subjects first ran a given distance wearing sport shoes, had a rest and then ran the same distance barefoot. The results showed marked age related differences after exercise. The pressure values were increased in all of the youths in the middle foot region. In comparison young children always exhibited an unbound gait pattern without any dynamic foot roll during heel strike or toe-off. The forefoot had ground contact from the beginning of the stance phase. To compensate for the lack of dynamic foot roll it is recommended that children wear a shoe with a soft sole and with sufficient space for toe movement. The sports shoe for youths should grip the heel and support the longitudinal arch to prevent an incorrect weight distribution.

  8. History of the extensor plantar response: Babinski and Chaddock signs.

    Science.gov (United States)

    Goetz, Christopher G

    2002-12-01

    The testing of reflexes involving the lower extremities is a pivotal part of the modern neurological examination. The normal response to noxious stimulation of the foot is plantar flexion of the toes, causing them to curl downward toward the undersurface of the foot. In 1896, Joseph Babinski described an extensor toe response that he claimed was a consistent finding among patients with pyramidal tract lesions of the cortex, subcortex, brain stem, or spinal cord. He considered it a distinct sign of organic disease and found it to be absent in cases of hysterical weakness. Charles Gilbert Chaddock admired the work of Babinski and described a modification of the Babinski technique, demonstrating that stimulation of the lateral surface of the foot could induce the same type of toe extension in patients with pyramidal tract lesions. The two reflexes are complementary, and each can occur without the other, although both are usually present in cases of pyramidal tract impairment. Although these two reflexes are the most commonly described pathological reflexes indicative of pyramidal tract disruption, the names of other celebrated neurologists are also linked to the study of extensor toe signs, each having identified a variant of the Babinski sign.

  9. [Tumoral proliferations in chronic plantar ulcers: how to treat?].

    Science.gov (United States)

    Grauwin, M Y; Mane, I; Cartel, J L

    1996-01-01

    Between 1983 and 1994, 66 Senegalese leprosy patients were seen for cauliflower growths developed in chronic plantar ulcer (CPU), (2 patients had each 2 tumors). 68 biopsies for pathological examination were taken: the diagnosis of squamous cell carcinoma was effectively made in 39 cases (38 patients) and that of pseudo-epitheliomatous hyperplasia in the remaining 29 cases (28 patients). The mean annual frequency of cauliflower growths was 0.45 per 100 CPU. Among these tumors, the percentage of carcinoma was 57%. Of the 38 patients with a carcinoma, 5 refused amputation and all of them died. The 33 others were amputated and of these 8 died as a direct result of their carcinoma (24%). In the case of the 28 patients with hyperplasia, amputation was carried out on 18 patients and local excision on 10. In the months following the operation 8 recurrences were observed in 10 of the patients on whom excision had been carried out. These recurrences were treated by amputation. This gives a total of 93% of amputations in the cases of hyperplasia. These facts lead as to conclude that at least in countries where pathological examination is not available below knee amputation is the most reasonable action to take in the proliferative tumors developed on a CPU.

  10. [Characterization of chronic plantar ulcers in former leprosy patients].

    Science.gov (United States)

    Grauwin, M Y; Gentile, B; Chevallard, A; Cartel, J L

    1994-01-01

    Between 1988 and 1992, 21 biopsies for pathological examination were taken from 20 Senegalese leprosy patients suffering from chronic plantar ulcers (CPU) suspected of malignant transformation. The diagnosis of squamous cell carcinoma was effectively made in 13 cases and that of pseudoepitheliomatous hyperplasia in the remaining 8 cases. The mean period of time between the onset of CPU and that of malignant transformation was 10 years (range: 1 to 15 years); the mean annual frequency of the malignant transformation was 2 per 1,000 CPU. In countries where pathological examination is not available, below knee amputation could be considered whenever main clinical signs of malignant transformation are present. In countries where pathological examination is available, the therapeutic decision may differ according to the diagnosis: below knee amputation supplemented with block dissection of inguinal lymph nodes whenever possible in cases of carcinoma; below knee amputation depending on the function status of the foot and on the volume of tumor in case of pseudo-epitheliomatous hyperplasia.

  11. Operative outcome of partial plantar fasciectomy and neurolysis to the nerve of the abductor digiti minimi muscle for recalcitrant plantar fasciitis.

    Science.gov (United States)

    Conflitti, Joseph M; Tarquinio, Thom A

    2004-07-01

    A retrospective review was conducted of 23 patients (26 feet) to assess operative outcome of partial plantar fasciectomy and neurolysis to the nerve of the abductor digiti minimi muscle for recalcitrant plantar fasciitis. Nonsurgical treatment was implemented in all patients with no relief of symptoms (average 20.8 months) prior to surgery. Using a visual analog pain scale (0-10), the average preoperative pain was 9.2 (range, 8-10). Prior to surgery, 65.2% of patients had severe limitations of activity, and 34.8% of patients had moderate limitations of activity. An average 25.3-month follow-up (range, 8-51) was performed by telephone interview. Average postoperative pain decreased to 1.7 using the same visual analog scale. Thirteen patients (57%) had no functional limitations postoperatively and nine patients (39%) had minimal functional limitations postoperatively. One patient (4%) had moderate functional limitations postoperatively. Twenty patients (87%) were completely satisfied with the surgery, two patients (9%) were satisfied with reservations, and one patient (4%) was unsatisfied with the surgery. The average period before return to work or daily activities was 1.5 months. Two patients had minor complications of partial wound dehiscence that healed uneventfully and mild dorsal midfoot pain which required temporary use of a boot walker. While the majority of patients with plantar fasciitis can be managed with nonoperative treatment, those patients with recalcitrant plantar fasciitis can be effectively treated with partial plantar fasciectomy and neurolysis to the nerve of the abductor digiti minimi muscle.

  12. Deformation and stress distribution of the human foot after plantar ligaments release: a cadaveric study and finite element analysis.

    Science.gov (United States)

    Liang, Jun; Yang, Yunfeng; Yu, Guangrong; Niu, Wenxin; Wang, Yubin

    2011-03-01

    The majority of foot deformities are related to arch collapse or instability, especially the longitudinal arch. Although the relationship between the plantar fascia and arch height has been previously investigated, the stress distribution remains unclear. The aim of this study was to explore the role of the plantar ligaments in foot arch biomechanics. We constructed a geometrical detailed three-dimensional (3-D) finite element (FE) model of the human foot and ankle from computer tomography images. The model comprised the majority of joints in the foot as well as bone segments, major ligaments, and plantar soft tissue. Release of the plantar fascia and other ligaments was simulated to evaluate the corresponding biomechanical effects on load distribution of the bony and ligamentous structures. These intrinsic ligaments of the foot arch were sectioned to simulate different pathologic situations of injury to the plantar ligaments, and to explore bone segment displacement and stress distribution. The validity of the 3-D FE model was verified by comparing results with experimentally measured data via the displacement and von Mise stress of each bone segment. Plantar fascia release decreased arch height, but did not cause total collapse of the foot arch. The longitudinal foot arch was lost when all the four major plantar ligaments were sectioned simultaneously. Plantar fascia release was compromised by increased strain applied to the plantar ligaments and intensified stress in the midfoot and metatarsal bones. Load redistribution among the centralized metatarsal bones and focal stress relief at the calcaneal insertion were predicted. The 3-D FE model indicated that plantar fascia release may provide relief of focal stress and associated heel pain. However, these operative procedures may pose a risk to arch stability and clinically may produce dorsolateral midfoot pain. The initial strategy for treating plantar fasciitis should be non-operative.

  13. Biomechanics of longitudinal arch support mechanisms in foot orthoses and their effect on plantar aponeurosis strain.

    Science.gov (United States)

    Kogler, G F; Solomonidis, S E; Paul, J P

    1996-07-01

    OBJECTIVE: The purpose of this investigation was to quantify the longitudinal arch support properties of several types of foot orthosis. DESIGN: An in vitro method that simulated 'static stance' was used to determine arch support capabilities, with plantar aponeurosis strain implemented as the performance measure. BACKGROUND: A longitudinal arch support mechanism of an orthosis resists depression of the foot's arches by transferring a portion of the load to the medial structures of the foot. Since the plantar aponeurosis is in tension when the foot is loaded, a quantifiable decrease in strain should occur with an adequate orthotic arch control mechanism. METHODS: A differential variable reluctance transducer was surgically implanted in the plantar aponeurosis of cadaveric donor limb feet (n = 7). Each specimen was mounted in an electromechanical test machine which applied a load of up to 900 N axially to the tibia. The test schedule was divided into seven test conditions: specimen barefoot; specimen with shoe and specimen with shoe and five different orthoses. RESULTS: The University of California Biomechanics Laboratory Shoe Insert and two other foot orthoses significantly decreased the strain in the plantar aponeurosis compared to the barefoot control and were considered effective arch supports (P plantar aponeurosis strain. Significant variations of time required to achieve the specified load levels were recorded among the test conditions, indicating the relative cushioning properties of the shoe/orthosis systems. CONCLUSIONS: The patterns of plantar aponeurosis strain observed in cadaveric tests suggest that certain types of orthoses are more effective than others in the support of the foot's longitudinal arches. It is suggested that to support the longitudinal arches of the foot effectively the medial surface contours of the orthosis must stabilize the apical bony structure of the foot's arch. RELEVANCE: Reducing tension in the plantar aponeurosis is an

  14. Effects of botulinum toxin-a therapy for palmar hyperhidrosis in plantar sweat production.

    Science.gov (United States)

    Gregoriou, Stamatis; Rigopoulos, Dimitris; Makris, Michael; Liakou, Anastasia; Agiosofitou, Efi; Stefanaki, Christina; Kontochristopoulos, George

    2010-04-01

    Patients with focal hyperhidrosis in multiple areas often report improvement of plantar hyperhidrosis after botulinum toxin A (BTX-A) therapy for palmar hyperhidrosis. To assess sweat production from the soles in patients receiving BTX-A treatment for their palmar hyperhidrosis. Thirty-six patients with both palmar and plantar hyperhidrosis received 100 U of BTX-A per palm. Sweat production of palms and soles was assessed using a starch iodine test and gravimetry at baseline and 1, 3, and 8 months after treatment. Patients were subjectively assessed using a percentile scale. All patients had significant improvement in their palmar hyperhidrosis that lasted for 6.2 +/- 1.8 months. Gravimetry revealed marginal improvement of plantar hyperhidrosis in 12 patients (from 39.7 +/- 21.3 to 31.5 +/- 18.0 mg/min; p=.01) and statistically significant worsening in 24 patients (from 71.6 +/- 70.60 to 109.94 +/- 82.93 mg/min, pBTX-A increased plantar sweating in many patients affected by both palmar and plantar hyperhidrosis in the population under study. Regardless, patients reported satisfaction with the results and were willing to repeat treatment.

  15. Influence of shoe midsole hardness on plantar pressure distribution in four basketball-related movements.

    Science.gov (United States)

    Lam, Wing-Kai; Ng, Wei Xuan; Kong, Pui Wah

    2017-01-01

    This study examined how shoe midsole hardness influenced plantar pressure in basketball-related movements. Twenty male university basketball players wore customized shoes with hard and soft midsoles (60 and 50 Shore C) to perform four movements: running, maximal forward sprinting, maximal 45° cutting and lay-up. Plantar loading was recorded using an in-shoe pressure measuring system, with peak pressure (PP) and pressure time integral (PTI) extracted from 10 plantar regions. Compared with hard shoes, subjects exhibited lower PP in one or more plantar regions when wearing the soft shoes across all tested movements (Ps < 0.05). Lower PTI was also observed in the hallux for 45° cutting, and the toes and forefoot regions during the first step of lay-up in the soft shoe condition (Ps < 0.05). In conclusion, using a softer midsole in the forefoot region may be a plausible remedy to reduce the high plantar loading experienced by basketball players.

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

    Science.gov (United States)

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

    2010-11-01

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

  17. Achilles tendon and plantar fascia in recently diagnosed type II diabetes: role of body mass index.

    Science.gov (United States)

    Abate, Michele; Schiavone, Cosima; Di Carlo, Luigi; Salini, Vincenzo

    2012-07-01

    Previous research has shown that plantar fascia and Achilles tendon thickness is increased in diabetes. The aims of present study were to assess whether tendon changes can occur in the early stages of the disease and to evaluate the extent of the influence of body mass index (BMI). The study population included 51 recent-onset type II diabetic subjects, who were free from diabetic complications, divided according to BMI into three groups (normal weight, overweight, and obese). Eighteen non-diabetic, normal-weight subjects served as controls. Plantar fascia and Achilles tendon thickness was measured by means of sonography. The groups were well balanced for age and sex. In all the diabetic subjects, plantar fascia and Achilles tendon thickness was increased compared to the controls (p fascia thickness and BMI values (r = 0.749, p fascia and Achilles tendon thickness is increased in the early stages of type II diabetes and that BMI is related more to plantar fascia than Achilles tendon thickness. Further longitudinal studies are needed to evaluate whether these early changes can overload the metatarsal heads and increase the stress transmitted to plantar soft tissues, thus representing an additional risk factor for foot ulcer development.

  18. Imbalanced Gait Characteristics Based on Plantar Pressure Assessment in Patients with Hemiplegia

    Directory of Open Access Journals (Sweden)

    Suwaporn SANGHAN

    2014-10-01

    Full Text Available This study aimed to assess the plantar pressure and the gait characteristics in patients with hemiplegia compared with normal subjects. Plantar pressure was measured and evaluated by the Pedar-x system®. Twenty healthy Thai volunteers and 10 Thai patients with hemiplegia were recruited for this study. Patients with hemiplegia had significant differences in gait pattern and plantar pressure distribution compared with normal subjects. The percentages of the plantar pressure difference were 5 ± 3 and 30 ± 12 % in the normal group and the hemiplegic group, respectively. The time interval during single limb support on the affected side was 11 % shorter than the unaffected side while there was no difference of the time interval during single limb support in normal subjects. The pattern and area under the curve of normalized force-time relationship in patients with hemiplegia were particularly distinguishable from normal subjects. The progression lines of both feet were asymmetric in patients with hemiplegia but they were particularly symmetric in normal subjects. The gait characteristics derived from plantar pressure in patients with hemiplegia are apparently imbalanced and clearly different from that in normal subjects in both qualitative and quantitative aspects.

  19. Plantar pressure asymmetry and risk of stress injuries in the foot of young soccer players.

    Science.gov (United States)

    Azevedo, Renato R; da Rocha, Emmanuel S; Franco, Pedro S; Carpes, Felipe P

    2017-03-01

    Asymmetries in the magnitude of plantar pressure are considered a risk factor for stress fracture of the fifth metatarsal in soccer athletes. To investigate the presence of plantar pressure asymmetries among young soccer athletes. Observational. Laboratory. Thirty young adolescents divided into a soccer player group (n = 15) or a matched control group (n = 15). Mean plantar pressure was determined for seven different regions of the foot. Data were compared between the preferred and non-preferred foot, and between the groups, during barefoot standing on a pressure mat system. Higher pressure was found in the hallux, 5th metatarsal and medial rearfoot of the non-preferred foot in the young soccer players. These asymmetries were not observed in the control group. Magnitudes of plantar pressure did not differ between the groups. Young soccer players present asymmetries in plantar pressure in the hallux, 5th metatarsal and medial rearfoot, with higher pressure observed in the non-preferred foot. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Proportional EMG control of ankle plantar flexion in a powered transtibial prosthesis.

    Science.gov (United States)

    Wang, Jing; Kannape, Oliver A; Herr, Hugh M

    2013-06-01

    The human calf muscle generates 80% of the mechanical work to walk throughout stance-phase, powered plantar flexion. Powered plantar flexion is not only important for walking energetics, but also to minimize the impact on the leading leg at heel-strike. For unilateral transtibial amputees, it has recently been shown that knee load on the leading, intact limb decreases as powered plantar flexion in the trailing prosthetic ankle increases. Not surprisingly, excessive loads on the leading, intact knee are believed to be causative of knee osteoarthritis, a leading secondary impairment in lower-extremity amputees. In this study, we hypothesize that a transtibial amputee can learn how to control a powered ankle-foot prosthesis using a volitional electromyographic (EMG) control to directly modulate ankle powered plantar flexion. We here present preliminary data, and find that an amputee participant is able to modulate toe-off angle, net ankle work and peak power across a broad range of walking speeds by volitionally modulating calf EMG activity. The modulation of these key gait parameters is shown to be comparable to the dynamical response of the same powered prosthesis controlled intrinsically (No EMG), suggesting that transtibial amputees can achieve an adequate level of powered plantar flexion controllability using direct volitional EMG control.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  2. A dorsal night splint with continuous extension of the big toe for treatment of plantar heel pain

    DEFF Research Database (Denmark)

    Mehlhorn, Alexander; Hirschmüller, Anja; Südkamp, Norbert P.

    2014-01-01

    Plantar heel pain may be attributed to a painful overloading of the plantar aponeurosis at its insertion of processus calcanei. Conservative treatment is the "golden standard". If it fails, partial fasciotomie is indicated but carries risks and complications. In the present work the use of a dors...

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  4. Children with ADHD Show No Deficits in Plantar Foot Sensitivity and Static Balance Compared to Healthy Controls

    Science.gov (United States)

    Schlee, Gunther; Neubert, Tom; Worenz, Andreas; Milani, Thomas L.

    2012-01-01

    The goal of this study was to investigate plantar foot sensitivity and balance control of ADHD (n = 21) impaired children compared to age-matched healthy controls (n = 25). Thresholds were measured at 200 Hz at three anatomical locations of the plantar foot area of both feet (hallux, first metatarsal head (METI) and heel). Body balance was…

  5. Investigation of the acute plantar fasciitis with contrast-enhanced ultrasound and shear wave elastography - first results.

    Science.gov (United States)

    Putz, Franz Josef; Hautmann, Matthias G; Banas, Miriam; Jung, Ernst Michael

    2017-09-04

    The plantar fasciitis is a common disease with a high prevalence in public and a frequent cause of heel pain. In our pilot study, we wanted to characterise the feasibility of shear-wave elastography and contrast-enhanced ultrasound (CEUS) in the assessment of the plantar fasciitis. 23 cases of painful heels were examined by B-Mode ultrasound, Power Doppler (PD), shear wave elastography and contrast-enhanced ultrasound before anti-inflammatory radiation. Time-intensity-curves were analysed by the integrated software. The results for area-under-the-curve (AUC), peak, time-to-peak (TTP) and mean-transit-time (MTT) were compared between the plantar fascia and the surrounding tissue. All cases showed thickening of the plantar fascia, in most cases with interstitial oedema (87.0%). Shear wave elastography showed inhomogeneous stiffness of the plantar fascia. 83.3% of cases showed a visible hyperperfusion in CEUS at the proximal plantar fascia in comparison to the surrounding tissue. This hyperperfusion could also be found in 75.0% of cases with no signs of vascularisation in PD. AUC (p = 0.0005) and peak (p = 0.037) were significantely higher in the plantar fascia than in the surrounding tissue. CEUS and shear wave elastography are new diagnostic tools in the assessment of plantar fasciitis and can provide quantitative parameters for monitoring therapy.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-07-15

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

  7. Constitutive modeling of time-dependent response of human plantar aponeurosis.

    Science.gov (United States)

    Pavan, P G; Pachera, P; Stecco, C; Natali, A N

    2014-01-01

    The attention is focused on the viscoelastic behavior of human plantar aponeurosis tissue. At this purpose, stress relaxation tests were developed on samples taken from the plantar aponeurosis of frozen adult donors with age ranging from 67 to 78 years, imposing three levels of strain in the physiological range (4%, 6%, and 8%) and observing stress decay for 240 s. A viscohyperelastic fiber-reinforced constitutive model with transverse isotropy was assumed to describe the time-dependent behavior of the aponeurotic tissue. This model is consistent with the structural conformation of the tissue where collagen fibers are mainly aligned with the proximal-distal direction. Constitutive model fitting to experimental data was made by implementing a stochastic-deterministic procedure. The stress relaxation was found close to 40%, independently of the level of strain applied. The agreement between experimental data and numerical results confirms the suitability of the constitutive model to describe the viscoelastic behaviour of the plantar aponeurosis.

  8. Shock waves do more than just crush stones: extracorporeal shock wave therapy in plantar fasciitis.

    Science.gov (United States)

    Rajkumar, P; Schmitgen, G F

    2002-12-01

    Heel pain is a common orthopaedic problem, The cause of this clinical entity remains an enigma. The overall prognosis is good, however, and the symptoms generally settle well with time. There appears to be little evidence of the effectiveness of local steroid injections and dorsiflexion night splints. Extracorporeal shock wave therapy (ECSW) has been used in orthopaedics since the 1980s. With this, a new tool has become available for the treatment of plantar fasciitis, achillis tendinitis, shoulder pain and tendinosis of the elbow. In our pilot study we found good results with the use of ECSW therapy in resistant plantar fasciitis. Additional controlled studies are required to define the precise role of this new modality in the treatment of chronic plantar fasciitis.

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

    Directory of Open Access Journals (Sweden)

    Gustavo Gennari Barbosa

    2005-01-01

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

  10. Influence of dental occlusion on postural control and plantar pressure distribution.

    Science.gov (United States)

    Scharnweber, Benjamin; Adjami, Frederic; Schuster, Gabriele; Kopp, Stefan; Natrup, Jörg; Erbe, Christina; Ohlendorf, Daniela

    2016-10-20

    The number of studies investigating correlations between the temporomandibular system and body posture, postural control or plantar pressure distribution is continuously increasing. If a connection can be found, it is often of minor influence or for only a single parameter. However, small subject groups are critical. This study was conducted to define correlations between dental parameters, postural control and plantar pressure distribution in healthy males. In this study, 87 male subjects with an average age of 25.23 ± 3.5 years (ranging from 18 to 35 years) were examined. Dental casts of the subjects were analyzed. Postural control and plantar pressure distribution were recorded by a force platform. Possible orthodontic and orthopedic factors of influence were determined by either an anamnesis or a questionnaire. All tests performed were randomized and repeated three times each for intercuspal position (ICP) and blocked occlusion (BO). For a statistical analysis of the results, non-parametric tests (Wilcoxon-Matched-Pairs-Test, Kruskall-Wallis-Test) were used. A revision of the results via Bonferroni-Holm correction was considered. ICP increases body sway in the frontal (p ≤ 0.01) and sagittal planes (p ≤ 0.03) compared to BO, whereas all other 29 correlations were independent of the occlusion position. For both of the ICP or BO cases, Angle-class, midline-displacement, crossbite, or orthodontic therapy were found to have no influence on postural control or plantar pressure distribution (p > 0.05). However, the contact time of the left foot decreased (p ≤ 0.001) while detecting the plantar pressure distribution in each position. Persistent dental parameters have no effect on postural sway. In addition, postural control and plantar pressure distribution have been found to be independent postural criteria.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  12. [Mobile phone platform for wireless monitoring of human dynamic plantar pressure].

    Science.gov (United States)

    Wang, Hao; Han, Meng; Liu, Jing

    2010-11-01

    This paper constructed a plantar pressure sensing system based on Bluetooth communication of mobile phone with embedded Windows Mobile system. With the MCU (Microprocessor Control Unit) and Bluetooth module, the pressure sensor and the data acquisition circuit was designed and integrated, with software developed under Visual Studio 2008 environment. The real-time monitoring of human dynamic plantar pressure signal, and transferring, displaying and storing the recorded data on a mobile phone were achieved. This method offers an important measure to acquire human gait information via a pervasive and low cost way.

  13. Tratamiento podológico de la fascitis plantar en el deportista

    OpenAIRE

    Prats Climent, Baldiri; Vázquez Amela, F. Xavier (Francesc Xavier)

    1994-01-01

    Podemos definir la fascitis plantar como la inflamación del origen de la fascia plantar a nivel de la tuberosidad interna del calcáneo. La molestia principal que presenta es el dolor y la hipersensibilidad debajo de la porción anterior del talón, que frecuentemente se irradia a la planta del pie. Aparece frecuentemente en deportistas, principalmente aquellos que presentan marcha con pronación acentuada. Puede acompañarse con la presencia de un espolón de calcáneo que en ningún caso es la caus...

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

    Science.gov (United States)

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

    2014-09-01

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

  15. Influencia de la gestación en la huella plantar

    OpenAIRE

    Alcahuz Griñán, Maria Montserrat

    2016-01-01

    Introducción. El objetivo de este estudio fue analizar la evolución de las presiones plantares, las huellas plantares así como la posición del pie durante el embarazo y tras el parto. Material y métodos. Veintitrés embarazadas fueron analizadas con el sistema Biofoot ® de plantillas instrumentadas. El sistema emplea unas plantillas con 64 sensores piezoeléctricos. Se midieron las presiones del antepié, mediopié, interno, externo y talón. Las variables de estudio de presurometría fuero...

  16. Detection of normal plantar fascia thickness in adults via the ultrasonographic method.

    Science.gov (United States)

    Abul, Kadir; Ozer, Devrim; Sakizlioglu, Secil Sezgin; Buyuk, Abdul Fettah; Kaygusuz, Mehmet Akif

    2015-01-01

    Heel pain is a prevalent concern in orthopedic clinics, and there are numerous pathologic abnormalities that can cause heel pain. Plantar fasciitis is the most common cause of heel pain, and the plantar fascia thickens in this process. It has been found that thickening to greater than 4 mm in ultrasonographic measurements can be accepted as meaningful in diagnoses. Herein, we aimed to measure normal plantar fascia thickness in adults using ultrasonography. We used ultrasonography to measure the plantar fascia thickness of 156 healthy adults in both feet between April 1, 2011, and June 30, 2011. These adults had no previous heel pain. The 156 participants comprised 88 women (56.4%) and 68 men (43.6%) (mean age, 37.9 years; range, 18-65 years). The weight, height, and body mass index of the participants were recorded, and statistical analyses were conducted. The mean ± SD (range) plantar fascia thickness measurements for subgroups of the sample were as follows: 3.284 ± 0.56 mm (2.4-5.1 mm) for male right feet, 3.3 ± 0.55 mm (2.5-5.0 mm) for male left feet, 2.842 ± 0.42 mm (1.8-4.1 mm) for female right feet, and 2.8 ± 0.44 mm (1.8-4.3 mm) for female left feet. The overall mean ± SD (range) thickness for the right foot was 3.035 ± 0.53 mm (1.8-5.1 mm) and for the left foot was 3.053 ± 0.54 mm (1.8-5.0 mm). There was a statistically significant and positive correlation between plantar fascia thickness and participant age, weight, height, and body mass index. The plantar fascia thickness of adults without heel pain was measured to be less than 4 mm in most participants (~92%). There was no statistically significant difference between the thickness of the right and left foot plantar fascia.

  17. Tratamiento de necrosis plantar postsepsis neumocóccica con terapia V.A.C.® Treatment of post-pneumococcal plantar necrosis with VAC® therapy

    Directory of Open Access Journals (Sweden)

    E. Guisantes

    2011-12-01

    Full Text Available La terapia VAC® es un dispositivo que favorece la curación de las heridas mediante un sistema cerrado que aplica presión negativa sobre el lecho. Este tratamiento favorece la cicatrización porque reduce el edema y el líquido intersticial, mejora la microcirculación, disminuye el riesgo de infección y favorece la granulación del tejido. Presentamos un caso clínico de un varón de 31 años con un defecto amplio plantar tras necrosis distal por sepsis neumocóccica. Tras 20 días de terapia VAC® la granulación fue adecuada y permitió la cobertura del defecto con un injerto de piel. La terapia VAC® es una opción útil para la reconstrucción de defectos plantares amplios de forma sencilla.VAC® Therapy is a device that lets promote wound healing through a closed system that applies negative pressure on the wound bed. This treatment promotes healing by reducing edema and interstitial fluid, improving microcirculation, reducing the risk of infection and promoting tissue granulation. We report the case of a 31 year old man with a large plantar defect due to distal necrosis after pneumococcal sepsis. After 20 days of VAC® therapy, the granulation was adequate and allowed the coverage of the defect with a skin graft. VAC® therapy is a useful and simple option for reconstruction of broad plantar defects.

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

    Directory of Open Access Journals (Sweden)

    Ana P. Ribeiro

    2016-02-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-01

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

  1. Enhanced physiological tremor deteriorates plantar flexor torque steadiness after bed rest

    NARCIS (Netherlands)

    Mulder, E.R.; Horstman, A.M.; Gerrits, K.; Massa, M.; Kleine, B.U.; Haan, A. de; Belavy, D.L.; Felsenberg, D.; Zwarts, M.J.; Stegeman, D.F.

    2011-01-01

    This study evaluated the effectiveness of resistance training to preserve submaximal plantar flexor (PF) torque steadiness following 60 days of bed rest (BR). Twenty-two healthy male subjects underwent either BR only (CTR, n=8), or BR plus resistance training (RT, n=14). The magnitude of torque fluc

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  3. Plantar pressure analysis after percutaneous repair of displaced intra-articular calcaneal fractures

    NARCIS (Netherlands)

    T. Schepers (Tim); A. van der Stoep (Arjan); H. van der Avert (Hans); E.M.M. van Lieshout (Esther); P. Patka (Peter)

    2008-01-01

    textabstractBackground: Clinical results for the treatment of displaced intra-articular calcaneal fractures are mainly expressed using disease-specific outcome scores, physical examination and radiographs. We hypothesized that plantar pressure and foot position analysis is a valuable tool in

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

    Directory of Open Access Journals (Sweden)

    Zonghuan Li

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

  5. Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers

    Directory of Open Access Journals (Sweden)

    Yong Jin Cho

    2013-05-01

    Full Text Available BackgroundThe reconstruction of volar surface defects is difficult because of the special histologic nature of the tissue involved. The plantar surface is the most homologous in shape and function and could be considered the most ideal of reconstructive options in select cases of volar surface defects. In this paper, we evaluate a single institutional case series of volar tissue defects managed with second toe plantar free flaps.MethodsA single-institution retrospective review was performed on 12 cases of reconstruction using a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years with a male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 cases followed by amputations (3 cases and a single case of burn injury. Half of the indications (6 cases were for soft-tissue defects with the other half for scar contracture.ResultsAll of the flaps survived through the follow-up period. Sensory recovery was related to the time interval between injury and reconstruction-with delayed operations portending worse outcomes. There were no postoperative complications in this series.ConclusionsFlexion contracture is the key functional deficit of volar tissue defects. The second toe plantar free flap is the singular flap whose histology most closely matches those of the original volar tissue. In our experience, this flap is the superior reconstructive option within the specific indications dictated by the defect size and location.

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

    Science.gov (United States)

    Vidmar, Gaj; Novak, Primoz

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2003-01-01

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

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

    Science.gov (United States)

    Vidmar, Gaj; Novak, Primoz

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  10. Wound coverage of plantar metatarsal ulcers in leprosy using a toe web flap

    Directory of Open Access Journals (Sweden)

    Joshua J

    2005-01-01

    Full Text Available Plantar metatarsal ulcers and sinuses are frequently seen problems in anaesthetic feet in leprosy. They may occur singly or as multiple sinuses. Many flaps have been described in the management of small defects of the forefoot. During the course of four years, from March 2000 to February 2004, a total of 708 plantar metatarsal ulcers in anaesthetic feet due to leprosy were seen. 280 surgeries were performed on 257 cases. Most of these were debridement and or excision of the metatarsophalangeal joints through a dorsal incision. Thirteen cases were dealt with by a toe web flap, using the plantar metatarsal artery as the source of supply to the flap. Nine were to cover defects under the 1st metatarsophalangeal joint. Three were to cover defects under the second and third metatarsophalangeal joints and one involved coverage of a defect under the 5th metatarsophalangeal joint. In all cases except the last, the big toe contributed the flap. In the last case the fourth toe was the donor. In all cases the flaps survived and did well. The secondary defects were covered with split thickness skin graft. Wound dehiscence was seen in one case and recurrence of a sinus, was seen in one case. Hyperkeratosis of the secondary defect was seen in three cases. Follow up ranged from 3 years to six months. We found this flap to be durable and safe with little chance of recurrence when used to cover plantar metatarsal ulcers.

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

    Directory of Open Access Journals (Sweden)

    Priego Quesada Jose Ignacio

    2015-09-01

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

  12. A composite medial plantar flap for the repair of an achilles' tendon defect: a case report.

    Science.gov (United States)

    Dumont, C E; Kessler, J

    2001-12-01

    The surgical management of infected necrosis of the Achilles' tendon and overlying skin is very demanding, and reconstruction with vascularized tendon and skin flaps is considered the benchmark procedure. The authors report a 65-year-old man who sustained a chronic wound after operative repair of a chronic rupture of the Achilles' tendon. A pedicled medial plantar flap including the surrounding vascularized plantar aponeurosis was elevated. The plantar aponeurosis was split and used to bridge the 4-cm-long tendon defect. The flap donor site was covered with a thin skin graft. The flap survived completely without recurrence of the infection. At the 7-month follow-up, the reconstructed Achilles' tendon showed a good functional result and a normal range of dorsi- and plantar flexion of the foot. This technique is of great interest in comparison with free flaps because it does not require vascular anastomosis in a septic environment or a secondary debulking operation, yet it still provides both vascularized tendon and skin graft.

  13. The use of dry needling and myofascial meridians in a case of plantar fasciitis.

    Science.gov (United States)

    Akhbari, Behnam; Salavati, Mahyar; Ezzati, Kamran; Mohammadi Rad, Shahrzad

    2014-03-01

    The purpose of this case report is to describe the use of dry needling based on myofascial meridians for management of plantar fasciitis. A 53-year-old man presented with bilateral chronic foot pain for more than 2 years. After 2 months of conventional treatment (ultrasound, plantar fascia and Achilles tendon stretching, and intrinsic foot strengthening), symptoms eventually improved; however, symptoms returned after prolonged standing or walking. Almost all previous treatment methods were localized in the site of pain that targeted only the plantar fascia. Initial examination of this individual revealed that multiple tender points were found along the insertion of Achilles tendon, medial gastrocnemius, biceps femoris, semimembranosus, and ischial tuberosity. Dry needling of the trigger points was applied. After 4 treatments over 2 weeks, the patient felt a 60% to 70% reduction in pain. His pressure pain threshold was increased, and pain was alleviated. The patient returned to full daily activities. The rapid relief of this patient's pain after 2 weeks of dry needling to additional locations along the superficial back line suggests that a more global view on management was beneficial to this patient. Dry needling based on myofascial meridians improved the symptoms for a patient with recurrent plantar fasciitis.

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

    Science.gov (United States)

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

    1979-05-01

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

  15. Effects of shoe sole hardness on plantar pressure and comfort in older people with forefoot pain.

    Science.gov (United States)

    Lane, Tamara J; Landorf, Karl B; Bonanno, Daniel R; Raspovic, Anita; Menz, Hylton B

    2014-01-01

    Plantar forefoot pain is common in older people and is related to increased peak pressures under the foot during gait. Variations in the hardness of the shoe sole may therefore influence both the magnitude of loading under the foot and the perceived comfort of the shoe in this population. The aim of this investigation was to determine the effect of varying shoe sole hardness on plantar pressures and comfort in older people with forefoot pain. In-shoe plantar pressures under the forefoot, midfoot and rearfoot were recorded from 35 older people (mean age 73.2, SD 4.5 years) with current or previous forefoot pain using the pedar-X(®) system. Participants walked at their normal comfortable speed along an 8m walkway in shoes with three different levels of sole hardness: soft (Shore A25), medium (Shore A40) and hard (Shore A58). Shoe comfort was measured on a 100mm visual analogue scale. There were statistically significant differences in peak pressure of between 5% and 23% across the forefoot, midfoot and rearfoot (phard-soled shoe registered the highest peak pressures and the soft-soled shoe the lowest peak pressures. However, no differences in comfort scores across the three shoe conditions were observed. These findings demonstrate that as shoe sole hardness increases, plantar pressure increases, however this does not appear to have a significant effect on shoe comfort.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-02-15

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

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

    Science.gov (United States)

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

    2014-01-01

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

  18. The configuration of plantar pressure sensing cells for wearable measurement of COP coordinates.

    Science.gov (United States)

    Wang, Dian; Cai, Ping; Mao, Zhiyong

    2016-10-26

    Wearable measurement of center of pressure (COP) coordinates is the key of obtaining the measurement of natural gait. Plantar pressure insole is the right sensing unit for plantar pressure monitoring for long-term outdoor measurements and the control of walking assisting exoskeleton robot. It's necessary to study the configuration of pressure sensing cells. This study explored the sensing cell configuration for the plantar pressure insole. The data of plantar pressure of walking is collected for layout variants. The RMSE of COP coordinates estimations are used as the evaluation criteria. The RMSE of COP coordinates decreases from 8.00 to 3.20 mm as the amount of pressure sensing cells increases from 2 to 7. The size of pressure sensing cells contribute to reduce the RMSE of COP coordinates and 7 pressure sensing cells, with the size of 2.0-2.5 cm have the satisfying performance. Adding pressure sensing cell in the heel and hallux area increase the accuracy of estimating COP coordinates. Comparison results indicate that the configuration of 7 pressure sensing cells has a satisfying measurement performance.

  19. Range of motion, neuromechanical and architectural daptations to plantar flexor stretch training in humans

    DEFF Research Database (Denmark)

    Blazevich, Anthony John; Cannavan, Dale; Waugh, Charlie M

    2014-01-01

    The neuromuscular adaptations in response to muscle stretch training have not been clearly described. In the present study, changes in muscle (at fascicular and whole muscle levels) and tendon mechanics, muscle activity and spinal motoneuron excitability were examined during standardized plantar ...... tolerance') and both muscle and fascicle elongation rather than changes in volitional muscle activation or motoneuron pool excitability....

  20. A quantitative index for classification of plantar thermal changes in the diabetic foot

    Science.gov (United States)

    Hernandez-Contreras, D.; Peregrina-Barreto, H.; Rangel-Magdaleno, J.; Gonzalez-Bernal, J. A.; Altamirano-Robles, L.

    2017-03-01

    One of the main complications caused by diabetes mellitus is the development of diabetic foot, which in turn, can lead to ulcerations. Because ulceration risks are linked to an increase in plantar temperatures, recent approaches analyze thermal changes. These approaches try to identify spatial patterns of temperature that could be characteristic of a diabetic group. However, this is a difficult task since thermal patterns have wide variations resulting on complex classification. Moreover, the measurement of contralateral plantar temperatures is important to determine whether there is an abnormal difference but, this only provides information when thermal changes are asymmetric and in absence of ulceration or amputation. Therefore, in this work is proposed a quantitative index for measuring the thermal change in the plantar region of participants diagnosed diabetes mellitus regards to a reliable reference (control) or regards to the contralateral foot (as usual). Also, a classification of the thermal changes based on a quantitative index is proposed. Such classification demonstrate the wide diversity of spatial distributions in the diabetic foot but also demonstrate that it is possible to identify common characteristics. An automatic process, based on the analysis of plantar angiosomes and image processing, is presented to quantify these thermal changes and to provide valuable information to the medical expert.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  3. Sonographic measurements of the achilles tendon, plantar fascia, and heel fat pad are reliable

    DEFF Research Database (Denmark)

    Johannsen, Finn E; Jensen, Signe; Stallknecht, Sandra E

    2016-01-01

    PURPOSE: To determine intra- and interobserver reliability and precision of sonographic (US) scanning in measuring thickness of the Achilles tendon, plantar fascia, and heel fat pad in patients with heel pain. METHODS: Seventeen consecutive patients referred with heel pain were included. Two...

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

    Science.gov (United States)

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

    2015-02-01

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

  5. Mouse Plantar Flexor Muscle Size and Strength After Inactivity and Training

    Science.gov (United States)

    2010-07-01

    droperidol (16.7 mg z kg 2 1 ), and diazepam (5 mg z kg 2 1 ), and the skin over the dorsal cervical region was shaved and aseptically prepared. The...the eccentric contractions, the foot was pas- sively moved from the neutral position (i.e., 90° between the plantar surface and the tibial bone long

  6. Plantar Pressure Distribution among Older Persons with Different Types of Foot and Its Correlation with Functional Reach Distance

    Directory of Open Access Journals (Sweden)

    Aisyah Mohd Said

    2016-01-01

    Full Text Available Background. Changes in biomechanical structures of human foot are common in the older person, which may lead to alteration of foot type and plantar pressure distribution. We aimed to examine how foot type affects the plantar pressure distribution and to determine the relationship between plantar pressure distribution and functional reach distance in older persons. Methods. Fifty community-dwelling older persons (age: 69.98±5.84 were categorized into three groups based on the Foot Posture Index. The plantar pressure (max⁡P and contact area were analyzed using Footscan® RSScan platform. The Kruskal-Wallis test was used to compare the plantar pressure between foot types and Spearman’s correlation coefficient was used to correlate plantar pressure with the functional reach distance. Results. There were significant differences of max⁡P in the forefoot area across all foot types. The post hoc analysis found significantly lower max⁡P in the pronated foot compared to the supinated foot. A high linear rank correlation was found between functional reach distance and max⁡P of the rearfoot region of the supinated foot. Conclusions. These findings suggested that types of the foot affect the plantar maximal pressure in older persons with functional reach distance showing some associations.

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

    Science.gov (United States)

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

    2008-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Tatiana Almeida Bacarin

    2009-02-01

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

  9. Plantar pressures are elevated in people with longstanding diabetes-related foot ulcers during follow-up

    Science.gov (United States)

    Fernando, Malindu E.; Crowther, Robert G.; Lazzarini, Peter A.; Yogakanthi, Saiumaeswar; Sangla, Kunwarjit S.; Buttner, Petra; Jones, Rhondda; Golledge, Jonathan

    2017-01-01

    Objective High plantar pressures are implicated in the development of diabetes-related foot ulcers. Whether plantar pressures remain high in patients with chronic diabetes-related foot ulcers over time is uncertain. The primary aim of this study was to compare plantar pressures at baseline and three and six months later in participants with chronic diabetes-related foot ulcers (cases) to participants without foot ulcers (controls). Methods Standardised protocols were used to measure mean peak plantar pressure and pressure-time integral at 10 plantar foot sites (the hallux, toes, metatarsals 1 to 5, mid-foot, medial heel and lateral heel) during barefoot walking. Measurements were performed at three study visits: baseline, three and six months. Linear mixed effects random-intercept models were utilised to assess whether plantar pressures differed between cases and controls after adjusting for age, sex, body mass index, neuropathy status and follow-up time. Standardised mean differences (Cohen’s d) were used to measure effect size. Results Twenty-one cases and 69 controls started the study and 16 cases and 63 controls completed the study. Cases had a higher mean peak plantar pressure at several foot sites including the toes (p = 0.005, Cohen’s d = 0.36) and mid-foot (p = 0.01, d = 0.36) and a higher pressure-time integral at the hallux (ppressure-time integral at multiple plantar sites over time was detected in all participants (ppressures assessed during gait are higher in diabetes patients with chronic foot ulcers than controls at several plantar sites throughout prolonged follow-up. Long term offloading is needed in diabetes patients with diabetes-related foot ulcers to facilitate ulcer healing. PMID:28859075

  10. Metatarsal pain and plantar hyperkeratosis in the forefeet of female professional flamenco dancers.

    Science.gov (United States)

    Castillo-López, José M; Vargas-Macías, Alfonso; Domínguez-Maldonado, Gabriel; Lafuente-Sotillos, Guillermo; Ramos-Ortega, Javier; Palomo-Toucedo, Inmaculada C; Reina-Bueno, María; Munuera-Martínez, Pedro V

    2014-12-01

    The objectives of this study were to determine the frequency of metatarsal pain and of hyperkeratosis on the plantar forefoot in female professional flamenco dancers, and to determine whether there is a relationship between the two disorders. Forty-four female professional flamenco dancers, with a minimum activity of 25 hrs/wk, participated in this cross-sectional study. The presence or absence of metatarsal pain while dancing was recorded, and plantar pressures were measured on a pressure platform, both barefoot and shod with the usual dance shoe. The heel height of the dance shoe was also measured. Of the dancers, 80.7% experienced metatarsal pain while dancing, and 84.1% presented with plantar hyperkeratosis. Plantar hyperkeratosis coincided with the presence of metatarsal pain in 67.04% of the feet studied. The maximum load point in the feet when the dancers were barefoot was located 59.5% in the rearfoot and 40.5% in the forefoot; when dancers wore their specific flamenco dancing shoes, it was located 52.4% in the rearfoot and 47.6% in the forefoot. Metatarsal pain and plantar hyperkeratosis in the forefoot are common foot disorders in female flamenco dancing. The incidence of the maximum load point being located in the forefoot, and the difference between the results of the tests while shod or barefoot, are both too low to support the idea that the raised heels of flamenco shoes are a major contributing factor for these injuries. Therefore, these disorders may be caused by chronic repetitive trauma suffered during the practice of footwork dancing.

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

    Directory of Open Access Journals (Sweden)

    Parish Ben

    2011-06-01

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

  12. Effectiveness of trigger point dry needling for plantar heel pain: a randomized controlled trial.

    Science.gov (United States)

    Cotchett, Matthew P; Munteanu, Shannon E; Landorf, Karl B

    2014-08-01

    Plantar heel pain can be managed with dry needling of myofascial trigger points; however, there is only poor-quality evidence supporting its use. The purpose of this study was to evaluate the effectiveness of dry needling for plantar heel pain. The study was a parallel-group, participant-blinded, randomized controlled trial. The study was conducted in a university health sciences clinic. Study participants were 84 patients with plantar heel pain of at least 1 month's duration. Participants were randomly assigned to receive real or sham trigger point dry needling. The intervention consisted of 1 treatment per week for 6 weeks. Participants were followed for 12 weeks. Primary outcome measures included first-step pain, as measured with a visual analog scale (VAS), and foot pain, as measured with the pain subscale of the Foot Health Status Questionnaire (FHSQ). The primary end point for predicting the effectiveness of dry needling for plantar heel pain was 6 weeks. At the primary end point, significant effects favored real dry needling over sham dry needling for pain (adjusted mean difference: VAS first-step pain=-14.4 mm, 95% confidence interval [95% CI]=-23.5 to -5.2; FHSQ foot pain=10.0 points, 95% CI=1.0 to 19.1), although the between-group difference was lower than the minimal important difference. The number needed to treat at 6 weeks was 4 (95% CI=2 to 12). The frequency of minor transitory adverse events was significantly greater in the real dry needling group (70 real dry needling appointments [32%] compared with only 1 sham dry needling appointment [Dry needling provided statistically significant reductions in plantar heel pain, but the magnitude of this effect should be considered against the frequency of minor transitory adverse events. © 2014 American Physical Therapy Association.

  13. Moberg Osteotomy Shifts Contact Pressure Plantarly in the First Metatarsophalangeal Joint in a Biomechanical Model.

    Science.gov (United States)

    Kim, Paul Hyon-Uk; Chen, Xiang; Hillstrom, Howard; Ellis, Scott J; Baxter, Josh R; Deland, Jonathan T

    2016-01-01

    A proximal phalangeal dorsiflexion osteotomy (Moberg osteotomy) is commonly used to treat hallux rigidus, but the mechanical explanation for its effectiveness is unclear. The purpose of our study was to test the effect of a Moberg osteotomy on first metatarsophalangeal joint contact mechanics. Ten cadaveric first ray specimens were dissected, with the medial band of the plantar aponeurosis preserved at its origin, and placed in a custom testing apparatus. Forefoot loads during mid-stance with the first metatarsal positioned at 10 degrees were simulated using a custom-made loading jig while contact mechanics were acquired with a thin pressure-sensitive sensor. A Moberg osteotomy was performed starting 9 mm distal to the proximal phalanx with excision of a 3-mm wedge of bone and fixated with a 2-mm Kirschner wire. The effect of the Moberg osteotomy was tested by reapplying the forefoot loads and acquiring the joint pressures. The center of pressure, peak pressure, and contact area were calculated. Paired t tests were performed to determine if the Moberg osteotomy affected joint contact mechanics. The Moberg osteotomy shifted the center of contact pressure on the proximal phalanx surface more plantarly (P osteotomy did not affect the peak pressure (P = .62) or the joint contact area (P = .96). There were no differences in peak pressure or first MTPJ contact area, but a plantar shift in the center of pressure occurred after the Moberg osteotomy. The plantar cartilage, which is often spared from arthritic changes, may be preferentially loaded and the potential edge loading following cheilectomy may be avoided with the Moberg osteotomy secondary to the plantar shift of center of pressure. © The Author(s) 2015.

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

    Science.gov (United States)

    2011-01-01

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

  15. EFFECTIVENESS OF INSTUMENTAL ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUE WITH STATIC STRETCHING IN SUBJECTS WITH PLANTAR FASCIITIS

    Directory of Open Access Journals (Sweden)

    Vinod Babu. K

    2014-08-01

    Full Text Available Background: Instrumental assisted soft tissue mobilization and static stretching found to be effective in plantar fasciitis, however the combined effectiveness of these techniques were unknown. The purpose of this study is to find the effect of Instrumental assisted soft tissue mobilization technique for plantar fascia combined with static stretching of triceps surae for subjects with chronic stage of Plantar Fasciitis on pain intensity, ankle dorsiflexion range of motion and functional disability. Methods: An experimental study design, selected subjects with chronic Plantar Fasciitis randomized subjects into each Study and Control group. Total of 40 subject’s data who completed study, 20 in each group, was used for analysis. Control group received conventional exercise while Study group received conventional exercises with Instrumental assisted soft tissue mobilization combined with static stretching of triceps surae muscle. Outcome measurements such as Intensity of pain using Numerical Pain Rating Scale-101 (NPRS-101, function disability using Foot Function Index Pain Subscale (FFI and ankle dorsiflexion active range of motion using Goniometer was measured before and after 2 weeks of intervention. Results: There is statistically significant improvement in means of NRS-101, ankle dorsiflexion active range of motion and Foot Function Index Pain Subscale after intervention in both groups. When the post-intervention means were compared between Study and Control group after 2 weeks of treatment there is statistically significant difference in means between the groups whereas study group showed greater percentage of improvement than control group. Conclusion: It is concluded that Instrumental assisted soft tissue mobilization technique combined with static stretching of triceps surae muscle is significantly effective than conventional exercises on reducing pain, improving ankle dorsiflexion range of motion and functional disability for subjects

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

    Science.gov (United States)

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

    2016-01-01

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

  17. 足底主要韧带损伤对足底压力分布的影响%Effect of injury to plantar ligaments on plantar pressure distribution

    Institute of Scientific and Technical Information of China (English)

    杨云峰; 俞光荣; 周家钤; 陈雁西; 袁锋; 贾永伟; 牛文鑫; 丁祖泉

    2009-01-01

    目的 分析足底主要韧带损伤后足底压力及接触面积的变化情况. 方法 7例正常成人新鲜尸体足标本,解剖显露并依次切断足底跖筋膜,弹簧韧带、跖长韧带、跖短韧带,模拟足底主要韧带损伤.经电子万能试验机逐级加载至700 N,利用F-scan足底压力测鼍系统,测量足底韧带损伤前后足底压力峰值及接触面积的变化情况,对结果进行统计分析. 结果 标本后足部位一直为压力峰值区,当足弓内在维持结构损伤后,前足压力增加,峰值压力位于第3跖骨头下;而足底接触总面积无明显改变. 结论 足底韧带损伤后,足底压力分布将发生改变,足外侧的应力集中,可能是出现临床症状的一个重要原因.%Objective To explore the changes in plantar pressure distribution and contact area after injury to the plantar ligaments in a normal adult cadaveric model. Methods Seven fresh adult cadaverie feet were used in the test. F-scan insoles were put under the plantar aspect of the feet when the specimens were loaded to 700 N vertieally. The plantar pressure data in the specimens were collected and stored before and after the plantar fascia, spring ligament, short plantar ligament and long plantar ligament were sectioned. Results were statistically analyzed. Results The peak pressure was always observed at the hindfoot area in all conditions. The peak plantar pressure on the forefoot was observed at the third metatarsal area and in-creased when the plantar ligaments were sectioned, while the total contact area of the foot was constant in both intact and pathological situations. Conclusion After the plantar ligaments are injured, the plantar pressure of the foot changes significantly and the pressure concentration occurs at the lateral foot, which may lead to clinical symptoms.

  18. The influence of gait cadence on the ground reaction forces and plantar pressures during load carriage of young adults.

    Science.gov (United States)

    Castro, Marcelo P; Figueiredo, Maria Cristina; Abreu, Sofia; Sousa, Helena; Machado, Leandro; Santos, Rubim; Vilas-Boas, João Paulo

    2015-07-01

    Biomechanical gait parameters--ground reaction forces (GRFs) and plantar pressures--during load carriage of young adults were compared at a low gait cadence and a high gait cadence. Differences between load carriage and normal walking during both gait cadences were also assessed. A force plate and an in-shoe plantar pressure system were used to assess 60 adults while they were walking either normally (unloaded condition) or wearing a backpack (loaded condition) at low (70 steps per minute) and high gait cadences (120 steps per minute). GRF and plantar pressure peaks were scaled to body weight (or body weight plus backpack weight). With medium to high effect sizes we found greater anterior-posterior and vertical GRFs and greater plantar pressure peaks in the rearfoot, forefoot and hallux when the participants walked carrying a backpack at high gait cadences compared to walking at low gait cadences. Differences between loaded and unloaded conditions in both gait cadences were also observed.

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

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    Nolan Damien

    2009-04-01

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

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

    LENUS (Irish Health Repository)

    Nolan, Damien

    2009-01-01

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

  1. Indication, surgical technique and results of endoscopic fascial release in plantar fasciitis (E FRPF).

    Science.gov (United States)

    Jerosch, Jörg; Schunck, Jochem; Liebsch, Dietrich; Filler, Tim

    2004-09-01

    The purpose of the present study is to present the surgical technique for, and review our indications and results after, endoscopic fascial release in patients with plantar fasciitis. In five thiel-embalmed human specimens, a biportal technique for endoscopic release of the plantar fascia was established. The aim was here to evaluate the relation between the plantar fascia and the heel spur and to perform a release that would not exceed 50-70% of the diameter of the calcaneoplantar fascia. The endoscopic technique was performed within the last 5 years in ten male and seven female patients. All patients with the clinical entity of plantar fasciitis underwent conservative treatment for at least 6 months. The average age at surgery was 35 years (24-56 years). In the first five patients, surgery was performed under c-arm control. In all patients the operation could be finished endoscopically. The endoscopic portals healed without complications. The time for surgery during the learning curve ranged between 21 and 74 min (average 41 min) and was still longer compared to the open technique. The clinical follow-up ranged between 4 and 48 months (average 18.5 months). Out of 17 patients, 13 improved clinically, and they would choose the treatment option again. In the Ogilvie-Harris score, seven patients showed good and six excellent results. In two patients, the initial results were not satisfactory, because of a bony stress reaction of the calcaneus. This complication was treated by 6 weeks of partial weight bearing, without any further problems. Two other patients developed secondary pain in the lateral column. In spite of the minimal invasive approach it seems to be important to be careful in increasing the weight bearing in early rehabilitation. The technique of the endoscopic plantar fascia release (E FRPF) can be performed in a standardised and reproducible procedure. The follow-up examination showed good midterm results, but a loss of stability of the plantar arch

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

    Directory of Open Access Journals (Sweden)

    Schaper Nicolaas C

    2006-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-01-01

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

  4. Surgical Treatment of a Case of Ledderhose’s Disease: A Safe Plantar Approach to Subtotal Fasciectomy

    OpenAIRE

    Souza, Bruno Gonçalves Schröder e; Gilberto Zaquine de Souza Júnior; Raíssa Mansilla Cabrera Rodrigues; Diogo Stelito Rezende Dias; Valdeci Manoel de Oliveira

    2015-01-01

    Plantar fibromatosis, Ledderhose's disease, or Morbus Ledderhose is an uncommon benign nodular hyperplasia of the plantar aponeurosis. The aim of this paper was to report the case of a 47-year-old male patient who had concomitant Dupuytren's disease and failed all conservative measures. He was treated surgically with prompt and complete relief of symptoms postoperatively, and he has had no recurrence at the 2-year follow-up. In this richly documented case, we discuss details of the surgical t...

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

    Science.gov (United States)

    Bruggink, Sjoerd C; Gussekloo, Jacobijn; de Koning, Maurits N C; Feltkamp, Mariet C W; Bavinck, Jan Nico Bouwes; Quint, Wim G V; Assendelft, Willem J J; Eekhof, Just A H

    2013-07-01

    Cryotherapy is effective for common warts, but for plantar warts available treatments often fail. Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-associated HPV type. Consecutive patients with new common or plantar warts were recruited in 30 Dutch family practices. Patients (n=250) were randomly allocated to liquid-nitrogen cryotherapy, 40% salicylic acid self-application, or wait-and-see policy. Before treatment, swabs were taken from all separate warts and analysed by a broad spectrum HPV genotyping assay. At 13 weeks, cure rates with 95% confidence intervals of common and plantar warts on intention to treat basis were compared between treatment arms for the different wart-associated HPV types. In total, 7% of swabs tested negative for HPV DNA and 16% contained multiple types, leaving 278 of 371 common swabs (75%) and 299 of 373 plantar swabs (80%) with a single type for analysis. After wait-and-see policy, cure rates were 2/70 (3%, 95% confidence interval 1-10) for HPV 2/27/57-associated common warts, 4/58 (7%, 3-16) for HPV 2/27/57-associated plantar warts, and 21/36 (58%, 42-73) for HPV 1-associated plantar warts. After cryotherapy, cure rates were 30/44 (68%, 53-80), 6/56 (11%, 5-21), and 15/23 (65%, 45-81); after salicylic acid 16/87 (18%, 12-28), 15/60 (25%, 16-37), and 24/26 (92%, 76-98), respectively. HPV type influenced the natural course and response to treatment for plantar warts. HPV testing potentially optimises wart treatment in primary care. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. A Vibrotactile and Plantar Force Measurement-Based Biofeedback System: Paving the Way towards Wearable Balance-Improving Devices

    OpenAIRE

    Christina Zong-Hao Ma; Anson Hong-Ping Wan; Duo Wai-Chi Wong; Yong-Ping Zheng; Winson Chiu-Chun Lee

    2015-01-01

    Although biofeedback systems have been used to improve balance with success, they were confined to hospital training applications. Little attempt has been made to investigate the use of in-shoe plantar force measurement and wireless technology to turn hospital training biofeedback systems into wearable devices. This research developed a wearable biofeedback system which detects body sway by analyzing the plantar force and provides users with the corresponding haptic cues. The effects of this ...

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2009-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Yi Li

    2013-09-01

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

  10. Dynamic plantar pressure distribution, strength capacity and postural control after Lisfranc fracture-dislocation

    DEFF Research Database (Denmark)

    Mehlhorn, Alexander T; Walther, Markus; Yilmaz, Tayfun

    2017-01-01

    of life. 17 consecutive patients suffering from a Lisfranc fracture dislocation were registered, underwent open reduction and internal fixation and were followed-up for 50.5±25.7months (Mean±SDM). Biomechanical analysis of muscle strength capacities, postural control and plantar pressure distribution...... correlated well with clinical outcome. Altered postural control was evident by a significant reduction in unilateral stance time, from which we calculated a strong correlation between stance time and the isokinetic strength measurement. Plantar pressure measurements revealed a significant reduction in peak...... pressure under the midfoot and of Force-Time Integral beneath the second metatarsal. Sufficient rehabilitation is crucial to the clinical outcome following anatomical open reduction of Lisfranc fracture-dislocation. The present study supports a rehabilitation approach focussing on restoring proprioception...

  11. Surgical Treatment of a Case of Ledderhose's Disease: A Safe Plantar Approach to Subtotal Fasciectomy.

    Science.gov (United States)

    Souza, Bruno Gonçalves Schröder E; de Souza Júnior, Gilberto Zaquine; Rodrigues, Raíssa Mansilla Cabrera; Dias, Diogo Stelito Rezende; de Oliveira, Valdeci Manoel

    2015-01-01

    Plantar fibromatosis, Ledderhose's disease, or Morbus Ledderhose is an uncommon benign nodular hyperplasia of the plantar aponeurosis. The aim of this paper was to report the case of a 47-year-old male patient who had concomitant Dupuytren's disease and failed all conservative measures. He was treated surgically with prompt and complete relief of symptoms postoperatively, and he has had no recurrence at the 2-year follow-up. In this richly documented case, we discuss details of the surgical technique and anatomy, which was important for a successful outcome and preventing complications. The technique for subtotal fasciectomy is reviewed and the relevance of the adequate choice of skin incision to prevent painful scarring, skin necrosis, and difficulties with shoe wearing is highlighted.

  12. Activation of brain areas following ankle dorsiflexion versus plantar flexion Functional magnetic resonance imaging verification

    Institute of Scientific and Technical Information of China (English)

    Tianyu Jiang; Weiping Wu; Xinglin Wang; Changshui Weng; Qiuhua Wang; Yanmei Guo

    2012-01-01

    Changes in activated areas of the brain during ankle active dorsiflexion and ankle active plantar flexion were observed in six healthy subjects using functional magnetic resonance imaging.Excited areas of ankle active dorsiflexion involved the bilateral primary motor area and the primary somatosensory area, as well as the bilateral supplementary sensory area, the primary visual area, the right second visual area, and the vermis of cerebellum.Excited areas of ankle active plantar flexion included the ipsilateral supplementary motor area, the limbic system, and the contralateral corpus striatum.Fine movements of the cerebral cortex control the function of the ankle dorsiflexion to a larger extent than ankle plate flexion, and the function of ankle plate flexion is more controlled by the subcortical area.

  13. ¿Dónde estamos en la patología de la fascitis plantar?

    OpenAIRE

    Keenan, Anne Marie

    2014-01-01

    La fascitis plantar es uno de los problemas musculoesqueléticos más frecuentes en las extremidades inferiores. Es una de las pocas áreas de la práctica podológica donde hay un conjunto de pruebas que evalúan el tratamiento y el diagnóstico. Esta presentación le permitirá navegar a través de la investigación para explorar los problemas actuales en el diagnóstico de fascitis plantar, incluyendo la presentación clínica y diagnóstico diferencial. Universidad de Málaga. Campus de Excelencia Int...

  14. ANÁLISIS BIOMECÁNICO DEL APOYO PLANTAR EN LA MARCHA ATLÉTICA. RELACIÓN ENTRE LA HUELLA PLANTAR, ÁNGULOS DE LA ARTICULACIÓN SUBASTRAGALINA Y PRESIONES PLANTARES

    Directory of Open Access Journals (Sweden)

    J.L.L. Elvira

    2010-09-01

    Full Text Available

     

    RESUMEN

    Los objetivos fueron describir el comportamiento de la articulación subastragalina y el pie en la marcha atlética y buscar correlaciones entre estos y la huella plantar. Participaron 12 marchadores. Se calculó el índice del arco sobre sus huellas plantares. Se registraron presiones plantares y se aplicó fotogrametría 3D durante un apoyo mientras marchaban a velocidad individual de competición. Se calcularon las presiones máximas en cada región del pie y los valores máximos y mínimos de los tres ángulos que describen la articulación subastragalina. La máxima pronación ha mostrado ser mayor que la descrita en la marcha común y similar a la de la carrera (-13.6±3.90. Al inicio del apoyo, la articulación subastragalina se encuentra entre la marcha y la carrera, sugiriendo un ajuste en su mecanismo amortiguador según el tipo de locomoción. La zona que registra mayores presiones es el retropié externo (21.02 kPa/kg yseguida lu ego del antepié interno (13.12 kPa/kg, a diferencia de la carrera, que presenta presiones máximas similares. Los sujetos con pies más planos tienden a apoyar con la cara interna del pie (r=-0.713 y con la pierna inclinada medialmente (r=0.874. Asimismo, los marchadores con pies más cavos registran mayores presiones en la parte externa del retropié y, mientras que los más planos lo hacen en la parte interna del mediopié.
    Palabras Clave: Biomecánica, marcha atlética, huella plantar, articulación subastragalina, presiones plantares.

     

    ABSTRACT

    The aims were to describe the behavior of the subtalar joint and foot in the race walk, and seek for correlations between them and the

  15. Lower activity levels are related to higher plantar pressures in overweight children.

    Science.gov (United States)

    Riddiford-Harland, Diane L; Steele, Julie R; Cliff, Dylan P; Okely, Anthony D; Morgan, Philip J; Jones, Rachel A; Baur, Louise A

    2015-02-01

    This study aimed to establish whether the peak plantar pressures generated by overweight and obese school-age children during walking were associated with their objectively measured physical activity. Physical activity levels of a subset of 73 overweight/obese children from a randomized controlled trial (mean ± SD: age, 8.3 ± 1.1 yr; 47 girls; body mass index z-score, 2.7 ± 0.7) were objectively measured using accelerometers. Plantar pressure distributions were also quantified as the participants walked over a pressure platform. Pearson product moment correlation coefficients were calculated to determine the strength of the relations between the peak plantar pressures generated during walking and the physical activity levels for overweight/obese children. Peak pressures generated beneath the forefoot during walking were inversely correlated with time spent in different intensity levels of physical activity. Moderate-intensity (r = -0.321, P = 0.007), vigorous-intensity (r = -0.326, P = 0.006), and moderate- to vigorous-intensity (r = -0.342, P = 0.004) physical activity were significantly correlated with middle forefoot pressure and with lateral forefoot pressure (r = -0.248, P = 0.040; r = -0.264, P = 0.028; r = -0.267, P = 0.027, respectively). Lateral midfoot (r = -0.244, P = 0.044) and second toe (r = 0.227, P = 0.021) pressure were also significantly correlated with vigorous-intensity activity. Those children who generated higher pressures beneath their forefoot and midfoot during walking had lower levels of physical activity. Further research is required to determine the long-term effects of excessive body mass on participation in physical activity and whether the walking plantar pressure patterns associated with reduced physical activity are related to foot pain or discomfort.

  16. Arteriographic pattern of plantar ulcers in lepromatous leprosy--study of 20 cases.

    Science.gov (United States)

    Debi, B P; Mohanty, H C; Tripathy, N; Tompe, D B; Sarangi, B K

    1980-07-01

    Sixty arteriograms were done in twenty cases of lepromatous leprosy with thirty five plantar ulcers of six months to two years duration. Tortuosity, narrowing and obliteration of vascular lumen was mostly observed. Obliteration of vascular lumen was seen in twenty five percent of cases. Arteriographic findings were directly proportional with age of patient and duration of ulcer. Hyperemia and neovascularisation were seen in active and infected ulcers. Advanced vascular changes were associated with osteolytic changes of the bone along with neurological deficit.

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

    Science.gov (United States)

    Boffeli, Troy J; Hyllengren, Shelby B

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chi-Wen Lung

    2016-07-01

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

  19. Randomized trial - oxybutynin for treatment of persistent plantar hyperhidrosis in women after sympathectomy

    Directory of Open Access Journals (Sweden)

    Altair da Silva Costa Jr

    2014-02-01

    Full Text Available OBJECTIVE: Hyperhidrosis is a common disease, and thoracoscopic sympathectomy improves its symptoms in up to 95% of cases. Unfortunately, after surgery, plantar hyperhidrosis may remain in 50% of patients, and compensatory sweating may be observed in 70%. This clinical scenario remains a challenge. Our objective was to evaluate the effectiveness of oxybutynin in the treatment of persistent plantar hyperhidrosis and compensatory sweating and its effects on quality of life in women after thoracoscopic sympathectomy. METHOD: We conducted a prospective, randomized study to compare the effects of oxybutynin at 10 mg daily and placebo in women with persistent plantar hyperhidrosis. The assessment was performed using a quality-of-life questionnaire for hyperhidrosis and sweating measurement with a device for quantifying transepidermal water loss. Clinicaltrials.gov: NCT01328015. RESULTS: Sixteen patients were included in each group (placebo and oxybutynin. There were no significant differences between the groups prior to treatment. After oxybutynin treatment, there was a decrease in symptoms and clinical improvement based on the quality-of-life questionnaire (before treatment, 40.4 vs. after treatment, 17.5; p = 0.001. The placebo group showed modest improvement (p = 0.09. The outcomes of the transepidermal water loss measurements in the placebo group showed no differences (p = 0.95, whereas the oxybutynin group revealed a significant decrease (p = 0.001. The most common side effect was dry mouth (100% in the oxybutynin group vs. 43.8% in the placebo group; p = 0.001. CONCLUSION: Oxybutynin was effective in the treatment of persistent plantar hyperhidrosis, resulting in a better quality of life in women who had undergone thoracoscopic sympathectomy.

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

    Science.gov (United States)

    Bus, Sicco A; van Deursen, Robert W M; Kanade, Rajani V; Wissink, Marieke; Manning, Erik A; van Baal, Jeff G; Harding, Keith G

    2009-06-01

    Forefoot offloading shoes (FOS) are commonly used in clinical practice for treatment of plantar forefoot ulcers in the diabetic foot. The aim of this study was to assess the offloading efficacy of four different FOS models in comparison with a cast shoe and control shoe. In-shoe plantar pressures were measured during walking in each of the six footwear conditions in 24 neuropathic diabetic patients at high risk for plantar foot ulceration. For each of six foot regions, peak pressure, pressure-time integral, and force-time integral were calculated. Load transfer diagrams were developed to assess the footwear mechanisms of action. Perceived walking comfort was measured using a visual analogue scale (VAS). All comparisons between conditions were tested at Pheads and hallux regions were significantly reduced (by 38-58%) in all FOS models when compared with the control shoe. The FOS also relieved metatarsal head peak pressure to a significantly larger extent than the cast shoe (approximately 20%). The load transfer diagrams showed a major transfer of approximately 40% of forefoot load to the midfoot explaining the offloading efficacy of the FOS. Perceived walking comfort was significantly lower in the FOS (VAS score 2.7-5.9) when compared with the control shoe (VAS 8.2) and cast shoe (VAS 6.8). The data showed that all FOS models were effective in their primary goal, relieving forefoot pressure in at-risk neuropathic diabetic patients. Therefore, these shoes may be effective in offloading and healing plantar forefoot ulcers, although the low comfort scores should be considered as this may potentially affect adherence to treatment.

  1. Randomized trial - oxybutynin for treatment of persistent plantar hyperhidrosis in women after sympathectomy

    Science.gov (United States)

    da Silva Costa, Altair; Leão, Luiz Eduardo Villaça; Succi, José Ernesto; Perfeito, Joao Aléssio Juliano; Filho, Adauto Castelo; Rymkiewicz, Erika; Filho, Marco Aurelio Marchetti

    2014-01-01

    OBJECTIVE: Hyperhidrosis is a common disease, and thoracoscopic sympathectomy improves its symptoms in up to 95% of cases. Unfortunately, after surgery, plantar hyperhidrosis may remain in 50% of patients, and compensatory sweating may be observed in 70%. This clinical scenario remains a challenge. Our objective was to evaluate the effectiveness of oxybutynin in the treatment of persistent plantar hyperhidrosis and compensatory sweating and its effects on quality of life in women after thoracoscopic sympathectomy. METHOD: We conducted a prospective, randomized study to compare the effects of oxybutynin at 10 mg daily and placebo in women with persistent plantar hyperhidrosis. The assessment was performed using a quality-of-life questionnaire for hyperhidrosis and sweating measurement with a device for quantifying transepidermal water loss. Clinicaltrials.gov: NCT01328015. RESULTS: Sixteen patients were included in each group (placebo and oxybutynin). There were no significant differences between the groups prior to treatment. After oxybutynin treatment, there was a decrease in symptoms and clinical improvement based on the quality-of-life questionnaire (before treatment, 40.4 vs. after treatment, 17.5; p = 0.001). The placebo group showed modest improvement (p = 0.09). The outcomes of the transepidermal water loss measurements in the placebo group showed no differences (p = 0.95), whereas the oxybutynin group revealed a significant decrease (p = 0.001). The most common side effect was dry mouth (100% in the oxybutynin group vs. 43.8% in the placebo group; p = 0.001). CONCLUSION: Oxybutynin was effective in the treatment of persistent plantar hyperhidrosis, resulting in a better quality of life in women who had undergone thoracoscopic sympathectomy. PMID:24519200

  2. Quantifying Dynamic Changes in Plantar Pressure Gradient in Diabetics with Peripheral Neuropathy

    Science.gov (United States)

    Lung, Chi-Wen; Hsiao-Wecksler, Elizabeth T.; Burns, Stephanie; Lin, Fang; Jan, Yih-Kuen

    2016-01-01

    Diabetic foot ulcers remain one of the most serious complications of diabetes. Peak plantar pressure (PPP) and peak pressure gradient (PPG) during walking have been shown to be associated with the development of diabetic foot ulcers. To gain further insight into the mechanical etiology of diabetic foot ulcers, examination of the pressure gradient angle (PGA) has been recently proposed. The PGA quantifies directional variation or orientation of the pressure gradient during walking and provides a measure of whether pressure gradient patterns are concentrated or dispersed along the plantar surface. We hypothesized that diabetics at risk of foot ulceration would have smaller PGA in key plantar regions, suggesting less movement of the pressure gradient over time. A total of 27 participants were studied, including 19 diabetics with peripheral neuropathy and 8 non-diabetic control subjects. A foot pressure measurement system was used to measure plantar pressures during walking. PPP, PPG, and PGA were calculated for four foot regions – first toe (T1), first metatarsal head (M1), second metatarsal head (M2), and heel (HL). Consistent with prior studies, PPP and PPG were significantly larger in the diabetic group compared with non-diabetic controls in the T1 and M1 regions, but not M2 or HL. For example, PPP was 165% (P = 0.02) and PPG was 214% (P < 0.001) larger in T1. PGA was found to be significantly smaller in the diabetic group in T1 (46%, P = 0.04), suggesting a more concentrated pressure gradient pattern under the toe. The proposed PGA may improve our understanding of the role of pressure gradient on the risk of diabetic foot ulcers. PMID:27486576

  3. Controlling Posture and Vergence Eye Movements in Quiet Stance: Effects of Thin Plantar Inserts.

    Directory of Open Access Journals (Sweden)

    A Foisy

    Full Text Available The purpose of this study was to assess properties of vergence and saccade eye movements as well as posture in quiet stance, and the effects of thin plantar inserts upon postural and oculomotor control. The performances of 36 young healthy subjects were recorded by a force platform and an eye tracker in three testing conditions: without plantar stimulation, with a 3 millimetre-thick plantar insert, either a Medial or a Lateral Arch Support (MAS/LAS. The results showed a decrease of the Surface and Variance of Speed and a more posterior position of the CoP with either stimulation compared with the control condition. The fractal analysis showed a decrease with MAS. Wavelet analysis in the time-frequency domain revealed an increase in the Cancelling Time of the low frequency band with MAS. These results suggest a better stability for a lower energy cost. Concerning eye movements, the inserts influenced only vergence (not saccades: MAS caused an increase of the phasic amplitude of divergence, and conversely a decrease of the tonic amplitude. In contrast, LAS caused an increase of the tonic amplitude of convergence. Thus, MAS renders divergence less visually driven, while LAS renders convergence more visually driven. We conclude that the CNS uses the podal signal for both postural and vergence control via specific mechanisms. Plantar inserts have an influence upon posture and vergence movements in a different way according to the part of the foot sole being stimulated. These results can be useful to clinicians interested in foot or eye.

  4. High probability of healing without amputation of plantar forefoot ulcers in patients with diabetes.

    Science.gov (United States)

    Örneholm, Hedvig; Apelqvist, Jan; Larsson, Jan; Eneroth, Magnus

    2015-01-01

    Diabetic foot ulcer is an important entity which in many cases is the first serious complication in diabetes. Although a plantar forefoot location is common, there are few studies on larger cohorts and in such studies there is often a combination of various types of ulcer and ulcer locations. The purpose of this study is to discern the outcome of plantar forefoot ulcers and their specific characteristics in a large cohort. All patients (n = 770), presenting with a plantar forefoot ulcer at a multidisciplinary diabetes foot clinic from January 1, 1983 to December 31, 2012 were considered for the study. Seven hundred one patients (median age 67 [22-95]) fulfilled the inclusion criteria and were followed according to a preset protocol until final outcome (healing or death). Severe peripheral vascular disease was present in 26% of the patients and 14% had evidence of deep infection upon arrival at the foot clinic. Fifty-five percent (385/701) of the patients healed without foot surgery, 25% (173/701) healed after major debridement, 9% (60/701) healed after minor or major amputation and 12% (83/701) died unhealed. Median healing time was 17 weeks. An ulcer classified as Wagner grade 1 or 2 at inclusion and independent living were factors associated with a higher healing rate. Seventy-nine percent of 701 patients with diabetes and a plantar forefoot ulcer treated at a multidisciplinary diabetes foot clinic healed without amputation. For one third some form of foot surgery was needed to achieve healing.

  5. Rat sciatic nerve crush injury and recovery tracked by plantar test and immunohistochemistry analysis.

    Science.gov (United States)

    Pavić, Roman; Pavić, Michele L; Tvrdeić, Ante; Tot, Ozana K; Heffer, Marija

    2011-01-01

    An experimental crush injury to the sciatic nerve, with a crush force of 49.2 N (pressure p=1.98x10(8) Pa), was inflicted in 30 male rats (Wistar). A control group (sham), with the same number of rats, was also operated upon exactly as the experimental group but without the crush injury. We tested the sensory and motor recovery of the sciatic nerve with Hargreaves method, using an apparatus from Ugo Basile, Italy. Testing was continued for both legs of each rat, injured and uninjured, starting preoperatively (0 day), and then 1, 7, 14, 21, and 28 days postoperatively. The same experiment was run simultaneously with the sham group. The Plantar test showed recovery of the sensory and motor function of the sciatic nerve, though not complete recovery, by 28 days. An immunohistochemical experiment was run in parallel with the plantar test on L3-L6 segments of the spinal cord from where the sciatic nerve extends. We used antibodies for Myelin-associated glycoprotein (MAG), and gangliosides GD1a and GT1b on the aforesaid part of the spinal cord. The immunohistochemical methods showed changes in sensory and motor axons in the spinal cord segment L3-L6 which suggest correspondence with the results of the Plantar test, in terms of recovery of the sensory and motor function after injury of the sciatic nerve. The immunohistochemical results also show ipsilateral and contralateral changes following injury. Results of the plantar test are suggestive that the rat shows compensation for an injury in its contralateral leg.

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

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

    2000-10-01

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

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

    Science.gov (United States)

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

    2000-01-01

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

  8. [Realization of a compact mobile phone based wireless plantar pressure monitoring system and application].

    Science.gov (United States)

    Liu, Lin; Liu, Jing

    2012-05-01

    An improved compact mobile phone based wireless plantar pressure monitoring system and software are proposed based on former progress, which can collect pressure data by sensors and circuit board, transmit data through Bluetooth wirelessly, and display and calculate the data on the mobile terminal. Conceptual experiments carried out demonstrate the feasibility and accuracy of the new system The system is expected to be widely used in the future owing to its portability, ease of use, and cost-effectiveness

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

    OpenAIRE

    Ang, Teck Wee Andrew

    2015-01-01

    Plantar fasciitis is a common cause of heel pain in adults. Although it is usually a self-limiting condition, the pain may become prolonged and severe enough to cause significant distress and disruption to the patient’s daily activities and work. PubMed and Cochrane Central Register of Controlled Trials databases were searched for randomised controlled trials (RCTs) and a total of ten RCTs were selected for evaluation. These RCTs involved the use of either palpation- or ultrasonography-guided...

  10. Mini-Invasive floating metatarsal osteotomy for resistant or recurrent neuropathic plantar metatarsal head ulcers.

    Science.gov (United States)

    Tamir, Eran; Finestone, Aharon S; Avisar, Erez; Agar, Gabriel

    2016-07-11

    Patients with peripheral neuropathy and pressure under a relatively plantar deviated metatarsal head frequently develop plantar foot ulcers. When conservative management with orthotics and shoes does not cure the ulcer, surgical metatarsal osteotomy may be indicated to relieve the pressure and enable the ulcer to heal. The purpose of this study is to evaluate the use of a mini-invasive floating metatarsal osteotomy in treating recalcitrant ulcers or recurrent ulcers plantar to the metatarsal heads in patients with diabetes mellitus (DM) related neuropathy. Computerized medical files of patients with diabetic neuropathy treated with an osteotomy during 2013 and 2014 were retrospectively reviewed. There were 20 osteotomies performed on 17 patients (mean age 58 years). The patients had a diagnosis of DM for a mean of 17 years. All ulcers were University of Texas grade 1A; mean ulcer age was 19 months. After 17/20 operations, the ulcer completely resolved after 6 weeks and did not recur after a mean follow-up of 11.5 months. One patient developed an early post-operative infection with osteomyelitis at the osteotomy site (proximal shaft of the fifth metatarsal) that needed debridement and IV antibiotics. In the other 19 cases, the surgical wound healed within 1 week. Asymptomatic radiological non-union developed in six cases (30 %). Mini-invasive floating metatarsal osteotomy can cure resistant and recurrent University of Texas grade 1A ulcerations plantar to the metatarsal heads in neuropathic patients.

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

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    Shashwat Prakash

    2014-02-01

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

  12. Influence of sex on performance fatigability of the plantar flexors following repeated maximal dynamic shortening contractions.

    Science.gov (United States)

    Lanning, Amelia C; Power, Geoffrey A; Christie, Anita D; Dalton, Brian H

    2017-10-01

    The purpose was to determine sex differences in fatigability during maximal, unconstrained velocity, shortening plantar flexions. The role of time-dependent measures (i.e., rate of torque development, rate of velocity development, and rate of neuromuscular activation) in such sex-related differences was also examined. By task termination, females exhibited smaller reductions in power and similar changes in rate of neuromuscular activation than males, indicating females were less fatigable than males.

  13. Do spike insoles enhance postural stability and plantar-surface cutaneous sensitivity in the elderly?

    Science.gov (United States)

    Palluel, Estelle; Nougier, Vincent; Olivier, Isabelle

    2008-03-01

    Balance problems are often related to a loss of plantar-sensitivity in elderly people. The purpose of this study was to explore the contribution of plantar cutaneous inputs induced by a spike support surface to the control of stance. Nineteen elderly (mean age 69.0 years, range 62-80) and 19 young adults (mean age 25.9 years, range 21-32) were instructed to stand (standing session) or to walk (walking session) for 5 min with sandals equipped with spike insoles (spike condition). Both sessions also involved a no spike condition in which participants stood or walked for 5 min without these insoles (no spike condition). In all conditions, postural responses were assessed during unperturbed stance and were performed (1) immediately after putting the spike or the no spike insoles, and (2) 5 min after standing or walking with them. Sway parameters, such as centre of foot pressure mean location, surface area, mean speed, root mean square and median frequency on the antero-posterior and medio-lateral axes, were calculated. As postural performances are often related to plantar-surface sensitivity, cutaneous sensitivity threshold was also evaluated with Semmes-Weinstein monofilaments. Although no immediate effect of the spike insoles was found, results indicated that standing or walking for 5 min with sandals equipped with spike insoles led to a significant improvement of quiet standing in the elderly. Balance improvement was also observed in young adults. The results provided evidence that wearing sandals with spike insoles can contribute, at least temporarily, to the improvement of unperturbed stance in elderly people with relatively intact plantar cutaneous sensation. Further research is needed to assess the effects of longer and discontinuous stimulations with spike insoles on postural control.

  14. Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking.

    Science.gov (United States)

    Actis, Ricardo L; Ventura, Liliana B; Lott, Donovan J; Smith, Kirk E; Commean, Paul K; Hastings, Mary K; Mueller, Michael J

    2008-04-01

    There is evidence that appropriate footwear is an important factor in the prevention of foot pain in otherwise healthy people or foot ulcers in people with diabetes and peripheral neuropathy. A standard care for reducing forefoot plantar pressure is the utilization of orthotic devices such as total contact inserts (TCI) with therapeutic footwear. Most neuropathic ulcers occur under the metatarsal heads, and foot deformity combined with high localized plantar pressure, appear to be the most significant factors contributing to these ulcers. In this study, patient-specific finite element models of the second ray of the foot were developed to study the influence of TCI design on peak plantar pressure (PPP) under the metatarsal heads. A typical full contact insert was modified based on the results of finite element analyses, by inserting 4 mm diameter cylindrical plugs of softer material in the regions of high pressure. Validation of the numerical model was addressed by comparing the numerical results obtained by the finite element method with measured pressure distribution in the region of the metatarsal heads for a shoe and TCI condition. Two subjects, one with a history of forefoot pain and one with diabetes and peripheral neuropathy, were tested in the laboratory while wearing therapeutic shoes and customized inserts. The study showed that customized inserts with softer plugs distributed throughout the regions of high plantar pressure reduced the PPP over that of the TCI alone. This supports the outcome as predicted by the numerical model, without causing edge effects as reported by other investigators using different plug designs, and provides a greater degree of flexibility for customizing orthotic devices than current practice allows.

  15. The short-term effects of plantar vibration on balance disorder after stroke

    OpenAIRE

    Soofia Naghdi; Maede Khalifeloo; Noureddin Nakhostin Ansari; Mohammad Akbari; Shohreh Jalaie; Davood Jannat

    2013-01-01

    Background: Balance disorders are common in patients following stroke. There are a number of physiotherapy modalities to treat balance impairments, one of which is vibration. The effects of vibration on balance disorders after stroke have not been investigated. This case report demonstrates the short-term effects of plantar vibration on the balance impairment of a patient with stroke. Case presentation: A 72-years-old man with right hemiplegia resulted from stroke was admitted for vibration t...

  16. Plantar pressure of clipless and toe-clipped pedals in cyclists - A pilot study.

    Science.gov (United States)

    Davis, Andrea; Pemberton, Troy; Ghosh, Subhajit; Maffulli, Nicola; Padhiar, Nat

    2011-01-01

    To determine the effect of clipless and toe-clipped pedals on plantar foot pressure while cycling. Seven bikers and 11 healthy volunteers were tested on a Giant ATX Team mountain bike, Tekscan Clinical 5.24 F-scan® system with an inner sole pressure sensor, a Tacx Cycle force One Turbo Trainer and a Cateye Mity 8 computerized speedometer were used. The subjects wore Shimano M037 shoes and used a standard clipless and toe-clipped pedal. The seat height was set at 100% of subject's trochanteric height. Plantar pressures were recorded over 12 consecutive crank cycles at a constant speed for each of the power outputs. The videos were analysed to record the pressure exerted at 12 positions on the foot for each variable. Whether there is any dominance of any of the metatarsals, and any difference in plantar pressures between clipped and clipless pedal. There was a significant difference in the pressure at many positions of the foot, but the sites were different for each individual. General regression analysis indicated that pedal type had a statistically significant effect on plantar pressure at the sites of 1(st) metatarsal (p=0.042), 3(rd) metatarsal (p<0.001), 5(th) metatarsal (<0.001), 2(nd) (p=0.018) and 5(th) toe (p<0.001), lateral midfoot (p<0.001) and central heel (p<0.001) areas. Clipless pedals produce higher pressures which are more spread across the foot than toe-clipped pedals. This may have implications for their use in the prevention and/or management of overuse injuries in the knee and foot.

  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. A distribuição da força plantar está associada aos diferentes tipos de pés? Is the distribution of plantar forces associated with different types of feet?

    Directory of Open Access Journals (Sweden)

    Liliana Aparecida P. Azevedo

    2009-09-01

    Full Text Available OBJETIVO: Quantificar as forças e mensurar o arco longitudinal medial em pés de escolares. MÉTODOS: Estudo transversal envolvendo escolares da primeira série do ensino fundamental de uma escola pública de Guaratinguetá (SP. Para identificar a distribuição das pressões plantares, foram utilizadas duas plataformas de força e a impressão plantar em papel para mensurar o arco longitudinal medial. Compararam-se as forças plantares da porção medial e lateral e as forças plantares da região anterior e posterior dos pés. Os pés, depois de classificados, foram comparados quanto às médias das forças plantares de cada sensor. A aquisição da atividade baropodométrica foi coletada três vezes seguidas para cada sensor e realizada na posição ortostática. Os valores médios foram comparados através dos testes t de Student e ANOVA. RESULTADOS: Participaram do estudo 57 escolares com idade média de 7,5 anos sem qualquer queixa ou indício de doença ortopédica e/ou neurológica. As forças plantares foram significativamente maiores da região medial do pé esquerdo (p=0,003 e em ambos os retropés (pOBJECTIVE: To quantify the distribution of plantar forces and to measure the foot arch of school children. METHODS: This cross-sectional study enrolled school children of the first year from a public elementary school of Guaratinguetá, SP, Brazil. In order to identify the distribution of plantar forces, two platforms of force were used and foot printing in paper was obtained to measure the foot medial arch. The plantar force was compared in medial and lateral sites and in anterior and posterior sites of the feet. The feet were compared regarding the average plantar forces in each sensor. The baropodometric acquisition was performed three times for each sensor in orthostatic position. The average values were compared by Student's t and ANOVA tests. RESULTS: 57 students with mean age of 7.5 years old were enrolled. None of them had any

  19. Comparison of plantar pressure distribution in subjects with normal and flat feet during gait

    Directory of Open Access Journals (Sweden)

    Aluisio Otavio Vargas Avila

    2010-06-01

    Full Text Available The aim of this study was to determine the possible relationship between loss of thenormal medial longitudinal arch measured by the height of the navicular bone in a static situationand variables related to plantar pressure distribution measured in a dynamic situation. Elevenmen (21 ± 3 years, 74 ± 10 kg and 175 ± 4 cm participated in the study. The Novel Emed-ATSystem was used for the acquisition of plantar pressure distribution data (peak pressure, meanpressure, contact area, and relative load at a sampling rate of 50 Hz. The navicular drop testproposed by Brody (1982 was used to assess the height of the navicular bone for classificationof the subjects. The results were compared by the Mann-Whitney U test, with the level of significanceset at p ≤ 0.05. Differences were observed between the two groups in the mid-foot regionfor all variables studied, with the observation of higher mean values in subjects with flat feet.There were also significant differences in contact area, relative load, peak pressure, and meanpressure between groups. The present study demonstrates the importance of paying attentionto subjects with flat feet because changes in plantar pressure distribution are associated withdiscomfort and injuries.

  20. Reliability of Baropodometry on the Evaluation of Plantar Load Distribution: A Transversal Study

    Directory of Open Access Journals (Sweden)

    Daniel Baumfeld

    2017-01-01

    Full Text Available Introduction. Baropodometry is used to measure the load distribution on feet during rest and walking. The aim of this study was to evaluate changes in plantar foot pressures distribution due to period of working and due to stretching exercises of the posterior muscular chain. Methods. In this transversal study, all participants were submitted to baropodometric evaluation at two different times: before and after the working period and before and after stretching the muscles of the posterior chain. Results. We analyzed a total of 54 feet of 27 participants. After the working period, there was an average increase in the forefoot pressure of 0.16 Kgf/cm2 and an average decrease in the hindfoot pressure of 0.17 Kgf/cm2. After stretching the posterior muscular chain, the average increase in the forefoot pressure was 0.56 Kgf/cm2 and the hindfoot average pressure decrease was 0.56 Kgf/cm2. These changes were not statistically significant. Discussion. It was reported that the strength of the Achilles tendon generates greater forefoot load transferred from the hindfoot. In our study, no significant variation in the distribution of plantar pressure was observed. It can be inferred that baropodometry was a reliable instrument to determine the plantar pressure, regardless of the tension of the posterior chain muscles.

  1. Comparison of plantar pressures and contact area between normal and cavus foot.

    Science.gov (United States)

    Fernández-Seguín, Lourdes M; Diaz Mancha, Juan Antonio; Sánchez Rodríguez, Raquel; Escamilla Martínez, Elena; Gómez Martín, Beatriz; Ramos Ortega, Javier

    2014-02-01

    In pes cavus, the medial longitudinal arch elevation reduces the contact surface area and consequently increases the corresponding plantar pressure measurements. This poor distribution of loads may produce associated pathology and pain in this or other areas of the body. Normal reference values need to be established in order to determine which patterns are prone to pathology. To compare the plantar pressures and weight-bearing surface in a population with pes cavus to a population with neutral feet. The sample comprised 68 adults, 34 with pes cavus and 34 with neutral feet. The Footscan USB Gait Clinical System(®) was used as a platform to measure the total contact area and plantar pressure under the forefoot, midfoot, hindfoot, each metatarsal head, and the overall metatarsal area. A statistical analysis of the data was performed using Student's t-test for independent samples. The pes cavus subjects showed a significant reduction in their weight-bearing area [neutral feet: 165.04 ( ± 20.68) cm(2); pes cavus: 118.26 ( ± 30.31) cm(2); p pressures under all zones of the forefoot except the fifth metatarsal [metatarsal pressure: in neutral feet 503,797 ( ± 9.32) kPa; in pes cavus 656.12 ( ± 22.39) kPa; p relative distribution of this load is similar in both groups. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Effectiveness of local tenoxicam versus corticosteroid injection for plantar fasciitis treatment.

    Science.gov (United States)

    Guner, Savas; Onder, Haci; Guner, Sukriye Ilkay; Ceylan, Mehmet Fethi; Gökalp, Mehmet Ata; Keskin, Siddik

    2013-10-01

    Plantar fasciitis is one of the most common causes of foot pain in adults. In this prospective study, the outcomes of local tenoxicam injection and corticosteroid therapy for the treatment of plantar fasciitis were compared. Patients were randomly assigned to either the tenoxicam or corticosteroid group. The tenoxicam group (n=31) was treated using a local injection of 1 mL of tenoxicam (20 mg/2 mL) and 1 mL of 2% lidocaine, whereas the steroid group (n=30) was treated with a local 1-mL injection containing 40 mg of methylprednisolone acetate and 1 mL of 2% lidocaine. Clinical evaluations, which were performed before the injection and 6 and 12 months after the injection, consisted of patient-assessed pain using a visual analog scale. In addition, patient satisfaction was measured using the Roles and Maudsley score. Comparison of pre- and posttreatment visual analog scale scores demonstrated a statistically significant difference in both groups (P.05). The tenoxicam injection was not significantly more effective than the corticosteroid injection. However, both methods were effective and successful in treating patients with plantar fasciitis. Tenoxicam therapy appears to provide pain relief, but its effectiveness in the long term should be explored in additional studies.

  3. In-shoe plantar pressure measurement and analysis system based on fabric pressure sensing array.

    Science.gov (United States)

    Shu, Lin; Hua, Tao; Wang, Yangyong; Qiao Li, Qiao; Feng, David Dagan; Tao, Xiaoming

    2010-05-01

    Spatial and temporal plantar pressure distributions are important and useful measures in footwear evaluation, athletic training, clinical gait analysis, and pathology foot diagnosis. However, present plantar pressure measurement and analysis systems are more or less uncomfortable to wear and expensive. This paper presents an in-shoe plantar pressure measurement and analysis system based on a textile fabric sensor array, which is soft, light, and has a high-pressure sensitivity and a long service life. The sensors are connected with a soft polymeric board through conductive yarns and integrated into an insole. A stable data acquisition system interfaces with the insole, wirelessly transmits the acquired data to remote receiver through Bluetooth path. Three configuration modes are incorporated to gain connection with desktop, laptop, or smart phone, which can be configured to comfortably work in research laboratories, clinics, sport ground, and other outdoor environments. A real-time display and analysis software is presented to calculate parameters such as mean pressure, peak pressure, center of pressure (COP), and shift speed of COP. Experimental results show that this system has stable performance in both static and dynamic measurements.

  4. Constitutive Modeling of Time-Dependent Response of Human Plantar Aponeurosis

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    P. G. Pavan

    2014-01-01

    Full Text Available The attention is focused on the viscoelastic behavior of human plantar aponeurosis tissue. At this purpose, stress relaxation tests were developed on samples taken from the plantar aponeurosis of frozen adult donors with age ranging from 67 to 78 years, imposing three levels of strain in the physiological range (4%, 6%, and 8% and observing stress decay for 240 s. A viscohyperelastic fiber-reinforced constitutive model with transverse isotropy was assumed to describe the time-dependent behavior of the aponeurotic tissue. This model is consistent with the structural conformation of the tissue where collagen fibers are mainly aligned with the proximal-distal direction. Constitutive model fitting to experimental data was made by implementing a stochastic-deterministic procedure. The stress relaxation was found close to 40%, independently of the level of strain applied. The agreement between experimental data and numerical results confirms the suitability of the constitutive model to describe the viscoelastic behaviour of the plantar aponeurosis.

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

    Science.gov (United States)

    Ang, Teck Wee Andrew

    2015-08-01

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

  6. [Application of cantharidin, podophyllotoxin, and salicylic acid in recalcitrant plantar warts. A preliminary study].

    Science.gov (United States)

    López-López, Daniel; Agrasar-Cruz, Carlos; Bautista-Casasnovas, Adolfo; Álvarez-Castro, Carlos Javier

    2015-01-01

    Plantar warts often are refractory to any treatment and can last for decades in adults. Recalcitrant warts are defined as those that have persisted for more than two years, or after at least two treatment modalities. A total of 15 consecutive patients with recalcitrant plantar warts were included in this preliminary study. The treatment consisted of applying one to two sessions that comprised compounding 1% cantharidin, 5% of podophyllotoxin, and 30% salicylic acid (CPS), with an interval between applications of four weeks. With treatment and subsequent follow-up for six months, there was complete eradication of lesions in 15 patients, eight (53.3%) required a single application of the solution, and seven (46.7%) two applications, with no side effects. Patient satisfaction related to treatment was measured by a visual analog scale (VAS) of 10 cm in length, with an average score 9.73 ± 0.46, and all said they would proceed with the treatment again if necessary. Topical treatment by compounding is safe, effective, and a promising therapeutic modality when applied in recalcitrant plantar warts.

  7. Amniotic Tissues for the Treatment of Chronic Plantar Fasciosis and Achilles Tendinosis

    Directory of Open Access Journals (Sweden)

    Bruce Werber

    2015-01-01

    Full Text Available Introduction. Allogeneic amniotic tissue and fluid may be used to treat chronic plantar fasciosis and Achilles tendinosis. This innovative approach involves delivering a unique allograft of live human cells in a nonimmunogenic structural tissue matrix to treat chronic tendon injury. These tissues convey very positive regenerative attributes; procurement is performed with maternal consent during elective caesarian birth. Materials and Methods. In the present investigation all patients were unresponsive to multiple standard therapies for a minimum of 6 months and were treated with one implantation of PalinGen SportFLOW around the plantar fascia and/or around the Achilles paratenon. The patients were given a standard protocol for postimplant active rehabilitation. Results. The analogue pretreatment pain score (VAS of 8. By the fourth week after treatment, all patients had significantly reduced self-reported pain. Twelve weeks following the procedure the average pain level had reduced to only 2. No adverse reactions were reported in any of the patients. Conclusion. All patients in this study experienced heel or Achilles pain, unresponsive to standard therapy protocols. After treatment all patients noted significant pain reduction, indicating that granulized amniotic membrane and amniotic fluid can be successfully used to treat both chronic plantar fasciosis and Achilles tendinosis.

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

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    Nikos Malliaropoulos

    2016-01-01

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

  9. The effects of dynamic stretching on plantar flexor muscle-tendon tissue properties.

    Science.gov (United States)

    Samukawa, Mina; Hattori, Masaki; Sugama, Naoko; Takeda, Naoki

    2011-12-01

    Dynamic stretching is commonly used in warm-up routines for athletic activities. Even though several positive effects of dynamic stretching on athletic performance have been reported, the effects on the muscle-tendon unit (MTU) itself are still unclear. The objective of this study is to determine the effects of dynamic stretching on the ankle plantar flexor muscle-tendon properties by use of ultrasonography. Twenty healthy male subjects participated in the present study. The subjects were asked to engage in dynamic stretching of plantar flexors for 30 s and to repeat for 5 sets. Ankle dorsiflexion ROM was measured before and after the dynamic stretching. Changes in the displacement of the myotendinous junction (MTJ), pennation angle, and fascicle length were also determined by using ultrasonography. Ankle dorsiflexion ROM increased significantly after the dynamic stretching (p MTJ was observed until the second stretching set (p MTJ was found, indicating some change in the tendon tissues. Therefore, dynamic stretching of the plantar flexors was considered an effective means of lengthening the tendon tissues. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Preventing heel pressure ulcers and plantar flexion contractures in high-risk sedated patients.

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    Meyers, Tina R

    2010-01-01

    An intervention using heel pressure ulcer and plantar flexion contracture prevention protocols for high-risk patients was established to promote earlier recognition of heel skin issues and provide effective prevention of both conditions. Fifty-three patients who were sedated, managed in an intensive care unit for 5 days or more, and had a Braden Scale score of 16 or less were treated with heel protector devices that maintained the foot in a neutral position and floated the heel off the bed. On admission to the intensive care unit, heel skin assessment and the Braden Scale were administered to all patients. Initial ankle range of motion was measured with a goniometer on admission and before the application of the heel protector. Goniometric measurements were documented every other day. Heel assessments and the Braden Scale for Predicting Pressure Sore Prevention and Ramsay Sedation Scale scores were recorded in every shift and recorded as part of the study every other day. Measurements continued until the patient was transferred, the heel protector boot was discontinued by the physician, or the patient's Braden Scale score rose above 16. Application of the heel protectors led to a 50% reduction in prevalence of abnormal heel position. No patients developed plantar flexion contractures or new heel ulcers. Patients with normal heels had significantly higher Braden Scale scores compared to those with abnormal heels (P 5 .0136). Despite their high risk, no patients using the heel protector device developed a heel pressure ulcer or plantar flexion contracture.

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

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    Christoph Schulze

    2013-01-01

    Full Text Available Background. The wearing of personal equipment can cause specific changes in muscle activity and posture. In the present study, we investigated the influence of differences in equipment related weight loading and load distribution on plantar pressure. In addition, we studied functional effects of wearing different equipment with a particular focus on relevant changes in foot shape. Methods. Static and dynamic pedobarography were performed on 31 male soldiers carrying increasing weights consisting of different items of equipment. Results. The pressure acting on the plantar surface of the foot increased with higher loading, both under static and dynamic conditions (p < 0.05. We observed an increase in the contact area (p < 0.05 and an influence of load distribution through different ways to carry the rifle. Conclusions. The wearing of heavier weights leads to an increase in plantar pressure and contact area. This may be caused by flattening of the transverse and longitudinal arches. The effects are more evident in subjects with flat feet deformities which seem to flatten at an earlier load condition with a greater amount compared to subjects with normal arches. Improving load distribution should be a main goal in the development of military equipment in order to prevent injuries or functional disorders of the lower extremity.

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

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    Bowker Peter

    2011-02-01

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

  13. Sonoelastography of Plantar Fascia: Reproducibility and Pattern Description in Healthy Subjects and Symptomatic Subjects.

    Science.gov (United States)

    Ríos-Díaz, José; Martínez-Payá, Jacinto J; del Baño-Aledo, María Elena; de Groot-Ferrando, Ana; Botía-Castillo, Paloma; Fernández-Rodríguez, David

    2015-10-01

    The purpose of the work reported here was to describe the sonoelastographic appearance of the plantar fascia of healthy volunteers and patients with fasciitis. Twenty-three healthy subjects and 21 patients with plantar fasciitis were examined using B-mode and real-time sonoelastography (RTSR) scanning. B-Mode examination included fascia thickness and echotexture. Echogenicity and echovariation of the color histogram were analyzed. Fasciae were classified into type 1, blue (more elastic); type 2, blue/green (intermediate); or type 3, green (less elastic). RTSE revealed 72.7% of fasciae as type 2, with no significant association with fasciitis (χ(2) = 3.6, df = 2, p = 0.17). Quantitative analysis of the color histogram revealed a significantly greater intensity of green (mean = 77.8, 95% confidence interval [CI] = 71.9-83.6) and blue (mean = 74.2, 95% CI = 69.7-78.8) in healthy subjects. Echovariation of the color red was 33.4% higher in the fasciitis group than in the healthy group (95% CI = 16.7-50.1). Sonoelastography with quantitative analysis of echovariation can be a useful tool for evaluation of plantar fascia pathology. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  14. The effect of landing surface on the plantar kinetics of chinese paratroopers using half-squat landing.

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    Li, Yi; Wu, Ji; Zheng, Chao; Huang, Rong Rong; Na, Yuhong; Yang, Fan; Wang, Zengshun; Wu, Di

    2013-01-01

    The objective of the study was to determine the effect of landing surface on plantar kinetics during a half-squat landing. Twenty male elite paratroopers with formal parachute landing training and over 2 years of parachute jumping experience were recruited. The subjects wore parachuting boots in which pressure sensing insoles were placed. Each subject was instructed to jump off a platform with a height of 60 cm, and land on either a hard or soft surface in a half-squat posture. Outcome measures were maximal plantar pressure, time to maximal plantar pressure (T-MPP), and pressure-time integral (PTI) upon landing on 10 plantar regions. Compared to a soft surface, hard surface produced higher maximal plantar pressure in the 1(st) to 4(th) metatarsal and mid-foot regions, but lower maximal plantar pressure in the 5(th) metatarsal region. Shorter T- MPP was found during hard surface landing in the 1(st) and 2(nd) metatarsal and medial rear foot. Landing on a hard surface landing resulted in a lower PTI than a soft surface in the 1(st)phalangeal region. For Chinese paratroopers, specific foot prosthesis should be designed to protect the1(st) to 4(th)metatarsal region for hard surface landing, and the 1(st)phalangeal and 5(th)metatarsal region for soft surface landing. Key PointsUnderstanding plantar kinetics during the half-squat landing used by Chinese paratroopers can assist in the design of protective footwear.Compared to landing on a soft surface, a hard surface produced higher maximal plantar pressure in the 1(st) to 4(th) metatarsal and mid-foot regions, but lower maximal plantar pressure in the 5(th) metatarsal region.A shorter time to maximal plantar pressure was found during a hard surface landing in the 1(st) and 2(nd) metatarsals and medial rear foot.Landing on a hard surface resulted in a lower pressure-time integral than landing on a soft surface in the 1(st) phalangeal region.For Chinese paratroopers, specific foot prosthesis should be designed to protect

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

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    Landorf Karl B

    2011-01-01

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

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

    Science.gov (United States)

    2011-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

  18. Can ultrasound of plantar plate have normal appearance with a positive drawer test?

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Eloy de Avila [Affiliated Professor, Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo (Brazil); Mann, Tania Szejnfeld [Medical Assistant of Medicine and Surgery of the Foot and Ankle Group, Department of Orthopedics and Traumatology, EPM-Unifesp, São Paulo (Brazil); Puchnick, Andrea, E-mail: andrea.ddi@epm.br [Professor and Coordinator of Educational and Research Support, Department of Diagnostic Imaging, EPM-Unifesp, São Paulo (Brazil); Tertulino, Franklin de Freitas [Postgraduate Physician, Department of Diagnostic Imaging, EPM-Unifesp, São Paulo (Brazil); Cannato, Camila Testoni [Resident Physician, Department of Surgery, EPM-Unifesp, São Paulo (Brazil); Nery, Caio [Associate Professor, Department of Orthopedics and Traumatology, EPM-Unifesp, São Paulo (Brazil); Fernandes, Artur da Rocha Corrêa [Associate Professor, Department of Diagnostic Imaging, EPM-Unifesp, São Paulo (Brazil)

    2015-03-15

    Highlights: •We evaluate the accuracy of ultrasound to identify and measure the plantar plate. •We correlate ultrasound findings with those of physical examination and MRI. •Ultrasound and MRI measures of plantar plate were positively correlated. •Ultrasound is efficient in identifying and measuring plantar plate. •Ultrasound may complement physical examination. •Young asymptomatic subjects can present a grade I positive drawer test. -- Abstract: Objectives: The aims of this study were (1) to evaluate the reliability of ultrasound (US) examination in the identification and measurement of the metatarsophalangeal plantar plate (MTP-PP) in asymptomatic subjects and (2) to establish the correlation of US findings with those of physical examination and magnetic resonance imaging (MRI), once it is an important tool in the evaluation of the instability syndrome of the second and third rays. Materials and Methods: US examinations of the second and third MTP-PPs were performed in eight asymptomatic volunteers, totaling 32 MTP joints, by three examiners with different levels of experience in musculoskeletal US. Plantar plate dimensions, integrity and echogenicity, the presence of ruptures, and confidence level in terms of structure identification were determined using conventional US. Vascular flow was assessed using power Doppler. US data were correlated with data from physical examination and MRI. Results: MTP-PPs were ultrasonographically identified in 100% of cases, always showing homogeneous hyperechoic features and no detectable vascular flow on power Doppler, with 100% certainty in identification for all examiners. There was excellent US inter-observer agreement for longitudinal measures of second and third toe MTP-PPs and for transverse measures of the second toe MTP-PP. The MTP drawer test was positive for grade 1 MTP instability in 34.4% of joints with normal US results. Transverse MTP-PP measures were significantly higher in individuals with positive

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

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    Ruth Barn

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

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

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    Gilheany Mark F

    2010-07-01

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

  1. A Vibrotactile and Plantar Force Measurement-Based Biofeedback System: Paving the Way towards Wearable Balance-Improving Devices.

    Science.gov (United States)

    Ma, Christina Zong-Hao; Wan, Anson Hong-Ping; Wong, Duo Wai-Chi; Zheng, Yong-Ping; Lee, Winson Chiu-Chun

    2015-12-15

    Although biofeedback systems have been used to improve balance with success, they were confined to hospital training applications. Little attempt has been made to investigate the use of in-shoe plantar force measurement and wireless technology to turn hospital training biofeedback systems into wearable devices. This research developed a wearable biofeedback system which detects body sway by analyzing the plantar force and provides users with the corresponding haptic cues. The effects of this system were evaluated in thirty young and elderly subjects with simulated reduced foot sensation. Subjects performed a Romberg test under three conditions: (1) no socks, system turned-off; (2) wearing five layers of socks, system turned-off; (3) wearing five layers of socks, and system turned-on. Degree of body sway was investigated by computing the center of pressure (COP) movement measured by a floor-mounted force platform. Plantar tactile sensation was evaluated using a monofilament test. Wearing multiple socks significantly decreased the plantar tactile sensory input (p wearable plantar force-based biofeedback systems for improving balance in people with sensory deficits.

  2. A Vibrotactile and Plantar Force Measurement-Based Biofeedback System: Paving the Way towards Wearable Balance-Improving Devices

    Directory of Open Access Journals (Sweden)

    Christina Zong-Hao Ma

    2015-12-01

    Full Text Available Although biofeedback systems have been used to improve balance with success, they were confined to hospital training applications. Little attempt has been made to investigate the use of in-shoe plantar force measurement and wireless technology to turn hospital training biofeedback systems into wearable devices. This research developed a wearable biofeedback system which detects body sway by analyzing the plantar force and provides users with the corresponding haptic cues. The effects of this system were evaluated in thirty young and elderly subjects with simulated reduced foot sensation. Subjects performed a Romberg test under three conditions: (1 no socks, system turned-off; (2 wearing five layers of socks, system turned-off; (3 wearing five layers of socks, and system turned-on. Degree of body sway was investigated by computing the center of pressure (COP movement measured by a floor-mounted force platform. Plantar tactile sensation was evaluated using a monofilament test. Wearing multiple socks significantly decreased the plantar tactile sensory input (p < 0.05, and increased the COP parameters (p < 0.017, indicating increased postural sway. After turning on the biofeedback system, the COP parameters decreased significantly (p < 0.017. The positive results of this study should inspire future development of wearable plantar force-based biofeedback systems for improving balance in people with sensory deficits.

  3. Cantharidin-podophylotoxin-salicylic acid versus cryotherapy in the treatment of plantar warts: a randomized prospective study.

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    Kaçar, N; Taşlı, L; Korkmaz, S; Ergin, S; Erdoğan, B Ş

    2012-07-01

    Plantar warts are refractory to any form of treatment. High cure rates have been reported with a topical proprietary formulation consisting of 1% cantharidin, 5% podophyllotoxin and 30% salicylic acid (CPS). However, no data exists comparing the efficacy of this formulation with another treatment. Cryotherapy is a method that is also widely used in the treatment of plantar warts. Likewise, there is no evidence that it is more effective than any topical treatment. We aim to compare the efficacy of topical CPS and cryotherapy in the treatment of plantar warts. Patients with plantar warts were consecutively treated with either cryotherapy or topical CPS. Both treatments were performed every 2 weeks for up to five sessions. In patients without complete clearance, the therapy was switched to the other treatment option. Twenty-six patients with a total of 134 warts were included. Fourteen patients were completely cleared of their warts with topical CPS, whereas only in five of 12 patients (41.7%) warts were completely cleared with cryotherapy (P=0.001). In seven patients without complete clearance, the therapy was switched to CPS. Four of these patients missed the follow-up. While the two of the remaining three patients were cleared of their warts, one patient's warts still failed to clear. Topical CPS is more effective than cryotherapy in the treatment of plantar warts. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

  4. A Holter-type, microprocessor-based, rehabilitation instrument for acquisition and storage of plantar pressure data.

    Science.gov (United States)

    Abu-Faraj, Z O; Harris, G F; Abler, J H; Wertsch, J J

    1997-04-01

    A Holter-type, microprocessor-based, portable, in-shoe, plantar pressure data acquisition system has been developed. The system allows continuous recording of pressure data between the sole of the foot and the shoe during the performance of daily living activities. Fourteen conductive polymer sensors acquire the plantar pressure history, which is then stored in the system memory. Pressures are sampled at a rate of 40 Hz from each of the 14 sensors for up to 8 hrs. The extended recording and processing capacity of the system developed in this study allows quantitative analysis of cumulative plantar pressure and temporal gait data necessary for characterization of event-related alterations in plantar pressures. The alterations that could be examined with the system include rehabilitative, therapeutic, surgical, and nonsurgical treatment. The system is fully portable and does not disrupt the natural gait pattern of the subject during ambulation. Peak plantar pressures, pressure-time integrals, and contact durations are determined for each of the insole sensors.

  5. Topical adapalene in the treatment of plantar warts; Randomized comparative open trial in comparison with cryo-therapy

    Directory of Open Access Journals (Sweden)

    Ramji Gupta

    2015-01-01

    Full Text Available Background: Various therapeutic modalities, which are available for treating plantar wart, have not been successful every time. Aims: To evaluate topical adapalene under occlusion in the treatment of plantar warts and compare it with cryo-therapy. Materials and Methods: 50 patients with 424 plantar warts were included in this single center, two arm, prospective, randomized, control, open study. Patients were allocated randomly into two groups consisting of 25 patients each. Group A patients having 299 plantar warts were treated using adapalene gel 0.1% under occlusion while Group B patients having 125 warts were treated using cryo-therapy. All the patients were evaluated weekly till the clearance of all the warts and the results compared. Result: All the warts of 25 patients of Group A that were treated using adapalene gel 0.1% cleared in 36.71 ± 19.24 (55.95-17.47 days except those in one patient. In Group B, warts in all except one treated by cryo-therapy cleared in 52.17 ± 30.06 (82.23-22.11 days. There were no side effects like scar formation, irritation, erythema, or infections with adapalene group while in the cryo group scar was seen in 2 patients, pain in 24, erythema in 10, and infection in 3 patients. Conclusion: Adapalene gel 0.1% under occlusion is an effective, safe and easy to use treatment for plantar warts and may help clear lesions faster than cryo-therapy.

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

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    Renata Graciele Zanon

    2006-01-01

    Full Text Available Neste trabalho avaliou-se a eficácia do ultra-som contínuo e alta intensidade como tratamento na fasciíte plantar. Foram avaliadas 22 pessoas, com dor a mais de seis meses, através de questionário funcional e escala visual para a dor no primeiro apoio matinal. Vinte e sete pés foram distribuídos nos grupos: grupo 1 (alongamento + ultra-som desligado e grupo 2 (alongamento + ultra-som 2 w/cm². Após 15 sessões de tratamento, foi realizada análise dos valores absolutos e das porcentagens de melhora das variáveis coletadas. Houve melhora funcional para os dois grupos, sem diferença entre eles. A análise dos valores absolutos de intensidade de dor (primeira, oitava e última sessão mostrou semelhança entre os grupos. A porcentagem de melhora nas 15 sessões não apresentou diferença entre os grupos. Esta porcentagem também foi calculada para dois períodos (antes e após a oitava sessão. Notou-se que a porcentagem de melhora das 15 sessões do grupo2 (46,5% foi inferior à porcentagem das oito primeiras sessões do grupo1 (54,6%. Portanto, o ultra-som contínuo com alta intensidade não acrescentou ganhos em relação à função e à dor; além disso, apenas a realização de alongamentos específicos foi eficaz para a redução de mais de 50% da dor na fasciíte plantar crônica.In this study, the efficiency of continuous high-power ultrasound was assessed for plantar fasciitis treatment. Twenty two individuals were assessed, reporting pain lasting more than six months, through a functional questionnaire and visual scale for pain at the first morning load. Twenty seven feet were distributed into two groups: group 1 (stretching + ultrasound turned off and group 2 (stretching + 2 w/cm² ultrasound. After 15 treatment sessions, an analysis of the absolute values and improvement percentages for collected variables was performed. A functional improvement was seen for both groups, with no difference between them. The analysis of the

  7. Monochloroacetic acid application is an effective alternative to cryotherapy for common and plantar warts in primary care: a randomized controlled trial

    NARCIS (Netherlands)

    Bruggink, S.C.; Gussekloo, J.; Egberts, P.F.; Bavinck, J.N.; Waal, M.W. de; Assendelft, W.J.J.; Eekhof, J.A.

    2015-01-01

    Cryotherapy and salicylic acid (SA) often fail as treatments for skin warts. We examined the effectiveness of monochloroacetic acid (MCA) for patients with common or plantar warts. Consecutive patients aged 4 years and older with one or more newly diagnosed common or plantar warts were recruited in

  8. Monochloroacetic acid application is an effective alternative to cryotherapy for common and plantar warts in primary care: a randomized controlled trial

    NARCIS (Netherlands)

    Bruggink, S.C.; Gussekloo, J.; Egberts, P.F.; Bavinck, J.N.; Waal, M.W. de; Assendelft, W.J.J.; Eekhof, J.A.

    2015-01-01

    Cryotherapy and salicylic acid (SA) often fail as treatments for skin warts. We examined the effectiveness of monochloroacetic acid (MCA) for patients with common or plantar warts. Consecutive patients aged 4 years and older with one or more newly diagnosed common or plantar warts were recruited in

  9. La efectividad de los materiales de amortiguación usados en las ortesis plantares para el tratamiento de las sobrecargas metatarsales

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    G. Dominguez

    2016-12-01

    Conclusiones: El uso de almohadillas con materiales tradicionalmente usados seleccionados en este estudio tiene un ligero efecto negativo en la presión máxima plantar en la cabezas metatarsales y la presión máxima plantar en la zona de antepié durante la fase propulsiva.

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

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    Shi Ping Zhang

    2011-01-01

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

  11. Plantar thermography is useful in the early diagnosis of diabetic neuropathy

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    Luciane Fachin Balbinot

    2012-12-01

    Full Text Available OBJECTIVES: This study evaluated plantar thermography sensitivity and specificity in diagnosing diabetic polyneuropathy using cardiac tests (heart rate variability as a reference standard because autonomic small fibers are affected first by this disease. METHODS: Seventy-nine individuals between the ages of 19 and 79 years old (28 males were evaluated and divided into three groups: control (n = 37, pre-diabetics (n = 13 and type 2 diabetics (n = 29. The plantar images were recorded at baseline and then minutes after a provocative maneuver (Cold Stress Test using an infrared camera that is appropriate for clinical use. Two thermographic variables were studied: the thermal recovery index and the interdigital anisothermal technique. Heart rate variability was measured in a seven-test battery that included three spectral indexes (in the frequency domain and four Ewing tests (the Valsalva maneuver, the orthostatic test, a deep breathing test, and the orthostatic hypotension test. Other classically recommended tests were applied, including electromyography (EMG, Michigan inventory, and a clinical interview that included a neurological physical examination. RESULTS: Among the diabetic patients, the interdigital anisothermal technique alone performed better than the thermal recovery index alone, with a better sensitivity (81.3% and specificity (46.2%. For the pre-diabetic patients, the three tests performed equally well. None of the control subjects displayed abnormal interdigital anisothermal readouts or thermal recovery indices, which precluded the sensitivity estimation in this sample of subjects. However, the specificity (70.6% was higher in this group. CONCLUSION: In this study, plantar thermography, which predominately considers the small and autonomic fibers that are commonly associated with a sub-clinical condition, proved useful in diagnosing diabetic neuropathy early. The interdigital anisothermal test, when used alone, performed best.

  12. Plantar thermography is useful in the early diagnosis of diabetic neuropathy

    Science.gov (United States)

    Balbinot, Luciane Fachin; Canani, Luis Henrique; Robinson, Caroline Cabral; Achaval, Matilde; Zaro, Milton Antônio

    2012-01-01

    OBJECTIVES: This study evaluated plantar thermography sensitivity and specificity in diagnosing diabetic polyneuropathy using cardiac tests (heart rate variability) as a reference standard because autonomic small fibers are affected first by this disease. METHODS: Seventy-nine individuals between the ages of 19 and 79 years old (28 males) were evaluated and divided into three groups: control (n = 37), pre-diabetics (n = 13) and type 2 diabetics (n = 29). The plantar images were recorded at baseline and then minutes after a provocative maneuver (Cold Stress Test) using an infrared camera that is appropriate for clinical use. Two thermographic variables were studied: the thermal recovery index and the interdigital anisothermal technique. Heart rate variability was measured in a seven-test battery that included three spectral indexes (in the frequency domain) and four Ewing tests (the Valsalva maneuver, the orthostatic test, a deep breathing test, and the orthostatic hypotension test). Other classically recommended tests were applied, including electromyography (EMG), Michigan inventory, and a clinical interview that included a neurological physical examination. RESULTS: Among the diabetic patients, the interdigital anisothermal technique alone performed better than the thermal recovery index alone, with a better sensitivity (81.3%) and specificity (46.2%). For the pre-diabetic patients, the three tests performed equally well. None of the control subjects displayed abnormal interdigital anisothermal readouts or thermal recovery indices, which precluded the sensitivity estimation in this sample of subjects. However, the specificity (70.6%) was higher in this group. CONCLUSION: In this study, plantar thermography, which predominately considers the small and autonomic fibers that are commonly associated with a sub-clinical condition, proved useful in diagnosing diabetic neuropathy early. The interdigital anisothermal test, when used alone, performed best

  13. Dynamics of longitudinal arch support in relation to walking speed: contribution of the plantar aponeurosis.

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    Caravaggi, Paolo; Pataky, Todd; Günther, Michael; Savage, Russell; Crompton, Robin

    2010-09-01

    The plantar aponeurosis (PA), in spanning the whole length of the plantar aspect of the foot, is clearly identified as one of the key structures that is likely to affect compliance and stability of the longitudinal arch. A recent study performed in our laboratory showed that tension/elongation in the PA can be predicted from the kinematics of the segments to which the PA is attached. In the present investigation, stereophotogrammetry and inverse kinematics were employed to shed light on the mechanics of the longitudinal arch and its main passive stabilizer, the PA, in relation to walking speed. When compared with a neutral unloaded position, the medial longitudinal arch underwent greater collapse during the weight-acceptance phase of stance at higher walking speed (0.1 degrees +/-1.9 degrees in slow walking; 0.9 degrees +/-2.6 degrees in fast walking; P = 0.0368). During late stance the arch was higher (3.4 degrees +/-3.1 degrees in slow walking; 2.8 degrees +/-2.7 degrees in fast walking; P = 0.0227) and the metatarsophalangeal joints more dorsiflexed (e.g. at the first metatarsophalangeal joint, 52 degrees +/-5 degrees in slow walking; 64 degrees +/-4 degrees in fast walking; P walking. Early-stance tension in the PA increased with speed, whereas maximum tension during late stance did not seem to be significantly affected by walking speed. Although, on the one hand, these results give evidence for the existence of a pre-heel-strike, speed-dependent, arch-stiffening mechanism, on the other hand they suggest that augmentation of arch height in late stance is enhanced by higher forces exerted by the intrinsic muscles on the plantar aspect of the foot when walking at faster speeds.

  14. The Effect of Different Foot Orthosis Inverted Angles on Plantar Pressure in Children with Flexible Flatfeet.

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    Soo-Kyung Bok

    Full Text Available Although orthotic modification using the inverted technique is available for the treatment of flatfoot, empirical evidence for the biomechanical effects of inverted-angle foot orthoses (FOs is lacking. The aim of this study was to evaluate the effects of different FO inversion angles on plantar pressure during gait in children with flatfoot. Twenty-one children with flexible flatfeet (mean age 9.9 years were enrolled in this study. The plantar pressures were measured for the rearfoot; medial and lateral midfoot; and medial, central, and lateral forefoot as participants walked on a treadmill while wearing shoes only and shoes with the following 3 orthotic conditions: (i orthosis with no inverted angle, (ii orthosis with a 15° inverted angle, and (iii orthosis with a 30° inverted angle. A one-way repeated measures analysis of variance (ANOVA with the Bonferroni-adjusted post-hoc test was used to compare the mean values of each orthotic condition. Compared with the shoe only condition, the peak pressure decreased significantly under the medial forefoot and rearfoot with all FOs (p <0.05. However, no significant differences in the peak pressure under the medial forefoot and rearfoot were observed between the FOs. The peak pressure under the medial midfoot increased significantly with all FOs, and a maximal increase in the peak pressure was obtained with a 30° inverted angle orthosis. Furthermore, the contact area under the medial midfoot and rearfoot increased significantly with all FOs, compared with the shoe only condition (p <0.05. Again, no significant differences were observed between the FOs. For plantar pressure redistribution, a FO with a low inverted angle could be effective, accommodative, and convenient for children with flatfoot.

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

    Science.gov (United States)

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

    2015-01-01

    Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after 8 weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms) and iMVC of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave), peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that cycling endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue resistance.

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

    Directory of Open Access Journals (Sweden)

    Martin eBehrens

    2015-05-01

    Full Text Available Previously published studies on the effect of short-term endurance training on the neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after eight weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms and isometric maximum voluntary contraction of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave, peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that the endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue

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

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    Bonanno Daniel R

    2012-08-01

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

  18. Plantar aponeurosis and internal architecture of the ball of the foot.

    Science.gov (United States)

    Bojsen-Moller, F; Flagstad, K E

    1976-07-01

    On the basis of its internal structure, the ball of the foot can be divided into three transverse areas, each with a different mechanical function: (1) an area proximal to the heads of the metatarsals in which the retinacula cutis are developed into a series of transverse bands, and in which the deep fibres of the plantar aponeurosis form ten sagittal septa connected to the deep transverse metatarsal ligament and through this the proximal phalanges of the toes, (2) an area below the heads of the metatarsals in which vertical fibres from the joint capsules and the sides of the fibrous flexor sheaths form a cushion below each metatarsal head, and in which fat bodies cover the digital nerves and vessels in their passage between the cushions, and (3) a distal area which comprises the interdigital web. The superficial fibres of the plantar aponeurosis are inserted into the skin of this distal area, and deep to them the plantar interdigital ligament forms a series of transverse lamellae connected to the proximal phalanges by a mooring ligament which arches from one fibrous flexor sheath to the next. When the metatarsophalangeal joints are extended, the fibres of the three areas are tensed and the skin is anchored firmly to the skeleton. The direction of the fibres in the distal and proximal area promotes the transfer of forces exerted on the skin during push-off and braking respectively, while the intermediate area is adapted to bear the weight of the body. A concentration of Pacinian corpuscles is found along the digital nerves in the weight-bearing area below the transverse metatarsal ligament. The nerves for the second, and especially for the third, interstice are close to or in contact with the sharp proximal edges of the sagittal septa.

  19. Intermediate-term results of partial plantar fascia release with microtenotomy using bipolar radiofrequency microtenotomy.

    Science.gov (United States)

    Lucas, Douglas E; Ekroth, Scott R; Hyer, Christopher F

    2015-01-01

    Plantar fasciitis is a common condition, with most patients treated successfully with nonoperative management. Recalcitrant disease has been managed with surgical procedures that vary in design and associated morbidity. The present study sought to determine the intermediate-term results of percutaneous bipolar radiofrequency microtenotomy in recalcitrant plantar fasciitis. The patient medical records were reviewed, and data were gathered for all the patients who met the inclusion criteria. The foot function index and visual analog scale (VAS) pain scale questionnaires were mailed to the 111 patients. Of the 111 patients, 61 (55.0%) returned their questionnaires and were ultimately included in the present analysis. Of the 61 patients, 44 (72.1%) were female and 17 were (27.9%) male, with an average reported follow-up of 33.3 ± 8.6 (range 16.1 to 46.6) months. The median postoperative VAS score was 0.0 (range 0.0 to 10.0), and the median foot function index score was 3.1 (range 0.0 to 97.1). The patients were subdivided into success and failure groups according to their satisfaction. Of the 61 patients, 51 (83.6%) were satisfied and would recommend the procedure to a friend. The median VAS score in the success group was 0.0 (range 0.0 to 5.0), and the median VAS score in the failure group was 6.0 (range 0.0 to 10.0), a significant difference (p surgery, with less morbidity, for recalcitrant plantar fasciitis.

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Effectiveness of myofascial release in the management of plantar heel pain: a randomized controlled trial.

    Science.gov (United States)

    Ajimsha, M S; Binsu, D; Chithra, S

    2014-06-01

    Previous studies have reported that stretching of the calf musculature and the plantar fascia are effective management strategies for plantar heel pain (PHP). However, it is unclear whether myofascial release (MFR) can improve the outcomes in this population. To investigate whether myofascial release (MFR) reduces the pain and functional disability associated with plantar heel pain (PHP) in comparison with a control group receiving sham ultrasound therapy (SUST). Randomized, controlled, double blinded trial. Nonprofit research foundation clinic in India. Sixty-six patients, 17 men and 49 women with a clinical diagnosis of PHP were randomly assigned into MFR or a control group and given 12 sessions of treatment per client over 4 weeks. The Foot Function Index (FFI) scale was used to assess pain severity and functional disability. The primary outcome measure was the difference in FFI scale scores between week 1 (pretest score), week 4 (posttest score), and follow-up at week 12 after randomization. Additionally, pressure pain thresholds (PPT) were assessed over the affected gastrocnemii and soleus muscles, and over the calcaneus, by an assessor blinded to the treatment allocation. The simple main effects analysis showed that the MFR group performed better than the control group in weeks 4 and 12 (Ppain and functional disability in week 4 compared with that in week 1, which persisted as 60.6% in the follow-up at week 12 in the MFR group compared to the baseline. The mixed ANOVA also revealed significant group-by-time interactions for changes in PPT over the gastrocnemii and soleus muscles, and the calcaneus (Peffective than a control intervention for PHP. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Plantar measurements to determine success of surgical correction of Stage IIb adult acquired flatfoot deformity.

    Science.gov (United States)

    Matheis, Erika A; Spratley, E Meade; Hayes, Curtis W; Adelaar, Robert S; Wayne, Jennifer S

    2014-01-01

    Adult acquired flatfoot deformity is a degenerative disease causing medial arch dysfunction. Surgical correction has typically involved tendon reconstruction with calcaneal osteotomy; however, the postoperative changes have not been fully characterized. The present study assessed the success of surgical correction of Stage IIb adult acquired flatfoot deformity through changes in plantar pressures and patient-generated outcome scores. With Institutional Review Board approval, 6 participants were evaluated before and after surgery using pedobarography, the Foot and Ankle Outcome Score, and the Medical Outcomes Study 36-item short-form questionnaire. The plantar pressures were recorded using a TekScan HRMat(®) during walking and in a 1- and 2-foot stance. The resulting contour maps were segmented into 9 regions, with the peak pressure, normalized force, and arch index calculated. Surgical effects were analyzed using paired t tests. Postoperatively, the Foot and Ankle Outcome Score and Medical Outcomes Study 36-item short-form questionnaire scores increased significantly from 180 ± 78 to 360 ± 136 (p < .03) and 47 ± 18 to 71 ± 19 (p = .06), respectively. During the 2-foot stance, the normalized force had increased significantly in the lateral midfoot (p < .03), although no significant differences were found in peak pressures. No significant differences were observed in the 1-foot stance. During walking, the normalized force increased significantly in the lateral mid- and forefoot (p < .05). The peak pressure increased significantly in the lateral forefoot (p < .01). The arch index values demonstrated no significant changes. The increased questionnaire scores indicated that surgical correction improved the self-perceived health of the participants. Lateral shifts in the peak pressure and normalized force suggest that forefoot and midfoot loading is altered postoperatively, consistent with the goal of offloading the dysfunctional arch. Thus, the present study has

  3. The effect of knee joint angle on plantar flexor power in young and old men.

    Science.gov (United States)

    Dalton, Brian H; Allen, Matti D; Power, Geoffrey A; Vandervoort, Anthony A; Rice, Charles L

    2014-04-01

    Human adult aging is associated with a loss of strength, contractile velocity and hence, power. The principal plantar flexors, consisting of the bi-articular gastrocnemeii and the mono-articular soleus, appear to be affected differently by the aging process. However, the age-related effect of knee joint angle on the torque-angular velocity relationship and power production of this functionally important muscle group is unknown. The purpose was to determine whether flexing the knee, thereby reducing the gastrocnemius contribution to plantar flexion, would exacerbate the age-related decrements in plantar flexion power, or shift the torque-angular velocity relationship differently in older compared with young men. Neuromuscular properties were recorded from 10 young (~25 y) and 10 old (~78 y) men with the knee extended (170°) and flexed (90°), in a randomized order. Participants performed maximal voluntary isometric contractions (MVCs), followed by maximal velocity-dependent shortening contractions at pre-set loads, ranging from 15 to 75% MVC. The young men were ~20-25% stronger, ~12% faster and ~30% more powerful than the old for both knee angles (Ptorque was ~17% greater in the extended than flexed knee position, with no differences in voluntary activation (>95%). The young men produced 7-12% faster angular velocities in the extended knee position for loads ≤30% MVC, but no differences at higher loads; whereas there were no detectable differences in angular velocity between knee positions in the old across all relative loads. For both knee angles, young men produced peak power at 43.3±9.0% MVC, whereas the old men produced peak power at 54.8±7.9% MVC. These data indicate that the young, who have faster contracting muscles compared with the old, can rely more on velocity than torque for generating maximal power.

  4. Biomechanical analysis of suture locations of the distal plantar fascia in partial foot.

    Science.gov (United States)

    Guo, Jun-Chao; Wang, Li-Zhen; Mo, Zhong-Jun; Chen, Wei; Fan, Yu-Bo

    2015-12-01

    The aim of this study was to evaluate the rationality of the suture locations of distal plantar fascia (DPF) after foot amputation to avoid the risk factors of re-amputation or plantar fasciitis. The tensile strain of plantar fascia (PF) in the different regions was measured by uni-axial tensile experiment. A three-dimensional (3D) finite element model was also developed to simulate tensile behaviour of PF in weight bearing conditions. The model includes 12 bones, ligaments, PF, cartilage and soft tissues. Four suture location models for the DPF were considered: the fourth and fifth DPF were sutured on the third metatarsal, the cuboid, and both the third metatarsal and the cuboid, and one un-sutured model. The peak tensile strain of the first, second and third PF was 0.134, 0.128 and 0.138 based on the mechanical test, respectively. The fourth and fifth DPF sutured at the cuboid and the third metatarsal could offer more favourable outcomes. The peak strain of 4.859 × 10(-2), 2.347 × 10(-2) and 1.364 × 10(-2) in the first, second and third PF showed the least outcomes in stance phase. Also, peak strain and stress of the residual PF reduced to 4.859 × 10(-2) and 1.834 MPa, respectively. The stress region was redistributed on the mid-shaft of the first and third PF and the peak stress of medial cuneiform bone evidently decreased. The fourth and fifth DPF suture at the third metatarsal and cuboid was appropriate for the partial foot. The findings are expected to suggest optimal surgical plan of the DPF suture and guide further therapeutic planning of partial foot patients.

  5. [Nature and sensitivity of bacteria superinfecting plantar ulcers caused by leprosy at the Marchoux Institute, Bamako, Mali].

    Science.gov (United States)

    Tiendrebeogo, A; Coulibaly, I; Sarr, A M; Sow, S O

    1999-01-01

    To determine potential usefulness of antimicrobial agents and to guide their prescription in the treatment of leprosy plantar ulcers, we conducted an in vitro study about germs' nature and sensitivity to antibiotics. We took samples of plantar ulcers secretion from 107 patients at Marchoux Institute. 92.5% of those ulcers were infected. These samples revealed 145 strains of micro-organisms among those, Staphylococcus aureus (70 strains) and genus Pseudomonas (41 strains) were the most frequent. These bacteria were resistant to several antibiotics currently used at Marchoux Institute (tetracycline, penicillin, cotrimoxazol and erythromicin). Antibiotics, efficient at 80% on tested strains, were expensive for patients. They cannot be recommended for the treatment of local infections. These results outline that the main treatment in plantar ulcers is based upon antiseptic solutions and keeping feet at rest. Antibiotherapy in case of extension of local infection would be based on the results of a previous study of sensitivity.

  6. Plantar fasciitis and fascial rupture: MR imaging findings in 26 patients supplemented with anatomic data in cadavers.

    Science.gov (United States)

    Theodorou, D J; Theodorou, S J; Kakitsubata, Y; Lektrakul, N; Gold, G E; Roger, B; Resnick, D

    2000-10-01

    Understanding of the normal anatomy of the plantar aponeurosis (PA) and familiarity with pathologic conditions are required for an accurate evaluation of the patient with subcalcaneal heel pain. In this study, we evaluated the diagnostic capabilities of magnetic resonance (MR) imaging in the assessment of the PA with close anatomic correlation. Herein, we describe the MR imaging features of plantar fasciitis and fascial rupture in 26 patients. High-spatial-resolution MR imaging was performed in four cadaveric feet, and a prescribed imaging plane was used for depiction of the peroneal component of the PA. MR imaging delineated the anatomy of the PA and perifascial soft tissues. The peroneal component was best visualized in prescribed sagittal oblique images. Perifascial edema was the most common finding of plantar fasciitis, and it was remarkable in those cases with acute fascial rupture. MR imaging reliably delineated the anatomy of the PA and may allow precise localization and definition of the extent of involvement in disease processes.

  7. Image intensifier-guided injection of corticosteroid and local anesthetic agent for the treatment of recalcitrant plantar fasciitis.

    Science.gov (United States)

    Atkins, Kate L; Chin, Kuen Foo; Noorani, Ali M; Nairn, David S

    2010-08-01

    Plantar fasciitis is the most common cause of plantar heel pain. The condition is potentially self-limiting and can respond to conservative treatment, but patients may opt for surgery if the treatments fail. Surgical intervention is associated with potential complications. This study set out to explore the efficacy of the specific nonsurgical intervention offered to treatment-resistant cases in a local clinical setting. The technique involves image intensifier-guided injection of corticosteroid and local anesthetic agents under general anesthesia. Nineteen patients with recalcitrant plantar fasciitis of over 12 months' duration received injections. A simple follow-up questionnaire was given to patients after the procedure that focused on their subjective opinion of any change in their pain. They were also asked if the injection had solved their problems with heel pain. The improvements that the patients reported were found to be statistically significant (P = .012).

  8. A novel technique towards deployment of hydrostatic pressure based level sensor in nuclear fuel reprocessing facility.

    Science.gov (United States)

    Praveen, K; Rajiniganth, M P; Arun, A D; Sahoo, P; Murty, S A V Satya

    2016-02-01

    A novel approach towards deployment of a hydrostatic pressure based level monitoring device is presented for continuous monitoring of liquid level in a reservoir with high resolution and precision. Some of the major drawbacks such as spurious information of measured level due to change in ambient temperature, requirement of high resolution pressure sensor, and bubbling effect by passing air or any gaseous fluid into the liquid are overcome by using such a newly designed hydrostatic pressure based level monitoring device. The technique involves precise measurement of hydrostatic pressure exerted by the process liquid using a high sensitive pulsating-type differential pressure sensor (capacitive type differential pressure sensor using a specially designed oil manometer) and correlating it to the liquid level. In order to avoid strong influence of temperature on liquid level, a temperature compensation methodology is derived and used in the system. A wireless data acquisition feature has also been provided in the level monitoring device in order to work in a remote area such as a radioactive environment. At the outset, a prototype level measurement system for a 1 m tank is constructed and its test performance has been well studied. The precision, accuracy, resolution, uncertainty, sensitivity, and response time of the prototype level measurement system are found to be less than 1.1 mm in the entire range, 1%, 3 mm, <1%, 10 Hz/mm, and ∼4 s, respectively.

  9. Anatomy and biomechanical properties of the plantar aponeurosis: a cadaveric study.

    Directory of Open Access Journals (Sweden)

    Da-wei Chen

    Full Text Available OBJECTIVES: To explore the anatomy of the plantar aponeurosis (PA and its biomechanical effects on the first metatarsophalangeal (MTP joint and foot arch. METHODS: Anatomic parameters (length, width and thickness of each central PA bundle and the main body of the central part were measured in 8 cadaveric specimens. The ratios of the length and width of each bundle to the length and width of the central part were used to describe these bundles. Six cadaveric specimens were used to measure the range of motion of the first MTP joint before and after releasing the first bundle of the PA. Another 6 specimens were used to evaluate simulated static weight-bearing. Changes in foot arch height and plantar pressure were measured before and after dividing the first bundle. RESULTS: The average width and thickness of the origin of the central part at the calcaneal tubercle were 15.45 mm and 2.79 mm respectively. The ratio of the length of each bundle to the length of the central part was (from medial to lateral 0.29, 0.30, 0.28, 0.25, and 0.27, respectively. Similarly, the ratio of the widths was 0.26, 0.25, 0.23, 0.19 and 0.17. The thickness of each bundle at the bifurcation of the PA into bundles was (from medial to lateral 1.26 mm, 1.04 mm, 0.91 mm, 0.84 mm and 0.72 mm. The average dorsiflexion of the first MTP joint increased 10.16° after the first bundle was divided. Marked acute changes in the foot arch height and the plantar pressure were not observed after division. CONCLUSIONS: The first PA bundle was not the longest, widest, or the thickest bundle. Releasing the first bundle increased the range of motion of the first MTP joint, but did not acutely change foot arch height or plantar pressure during static load testing.

  10. Age-related decreases in motor unit discharge rate and force control during isometric plantar flexion

    DEFF Research Database (Denmark)

    Kallio, J; Søgaard, Karen; Avela, J

    2012-01-01

    Aging is related to multiple changes in muscle physiology and function. Previous findings concerning the effects of aging on motor unit discharge rate (DR) and fluctuations in DR and force are somewhat contradictory. Eight YOUNG and nine OLD physically active males performed isometric ramp (RECR......) and isotonic (ISO) plantar flexions at 10 and 20% of surface EMG at MVC. Motor unit (MU) action potentials were recorded with intramuscular fine-wire electrodes and decomposed with custom build software "Daisy". DR was lower in OLD in RECR-10% (17.9%, p...

  11. Treatment of Athlete's Plantar Warts Using a Botanical Blend: A Case Report.

    Science.gov (United States)

    Nelson, Erik O; Kozin, Adam F; Ruiz, Guillermo; Lasku, Arben; Langland, Jeffrey O

    2017-05-01

    Context • Viral plantar warts, or verruca plantaris, are a benign epithelial tumor caused by various strains of the human papilloma virus (HPV). Current treatments have had mixed degrees of success, are moderately invasive, and are often incompatible with participation in sports. Objective • The study intended to examine the benefits of treating plantar warts with a topical, botanical blend that has had clinical success treating herpes simplex virus cold sores. Methods • A synergistic botanical blend was applied topically. Setting • The case report was completed at the Southwest College of Naturopathic Medicine (Tempe, Arizona, USA). Participant • The participant was a 24-y-old male soccer player, 177.8 cm tall, and weighing 69 kg with previously diagnosed, viral mosaic warts. Intervention • The patient used a pumice stone during bathing for the first week to remove dead tissue and ensure sufficient contact and entry of the botanical gel into infected tissue. After drying the area, the patient applied the botanical gel blend 1 to 2 times daily postshower, spreading it evenly across the surface of the entire lesion. The patient discontinued the exfoliation technique after the first week. Results • Within the first week of treatment, the patient noted changes to the infected area of the hallux epidermal tissue. The combination of exfoliation and application of the gel caused marked, visible differences in presentation by the fifth day of treatment. At 1-mo postintervention, or day 90, the epidermal tissue was asymptomatic and devoid of petechiae, malformations, or visible infection. Conclusions • The results of the current case study directly contrast with the drawbacks of commonly accepted, first-line interventions in the treatment of viral plantar warts and, in many respects, demonstrate better efficacy and fewer side effects than the standard of care. The positive results also highlight the necessity for additional study in the fields of sports

  12. Influencia do indice de massa corporal no equilibrio e na configuracao plantar em obesos adultos

    Directory of Open Access Journals (Sweden)

    Liu Chiao Yi

    2014-01-01

    Full Text Available INTRODUÇÃO: A obesidade é uma doença crônica degenerativa multifatorial que pode levar a alterações do sistema musculoesquelético, como mudança do centro de gravidade e sobrecarga mecânica sobre os membros inferiores. OBJETIVOS: Correlacionar o índice de massa corporal (IMC com o equilíbrio corporal e verificar associação entre o IMC e a configuração plantar. MÉTODOS: Foram avaliados 30 obesos, de ambos os gêneros, com IMC maior ou igual a 30 Kg/m². Inicialmente, os voluntários foram submetidos às avaliações de medidas antropométricas a fim de calcular o valor do IMC. Em seguida, foram submetidos ao teste de equilíbrio corporal estático Balance Error Scoring System (BESS e a plantigrafia para a identificação da impressão plantar. Por meio do método de Viladot, os voluntários foram classificados em grupos: pé plano (GPP, pé cavo (GPC e pé neutro (GPN. A correlação entre as variáveis IMC e BESS foi calculada por meio do coeficiente de correlação linear de Pearson e associação entre o IMC e a configuração plantar foi realizada por meio da análise de variância (Anova. Para todas as análises, nível de significância considerado foi p < 0,05. RESULTADOS: Os valores da correlação entre o IMC e o BESS foram r = - 0,1 e p = 0,59. Os valores da associação do IMC entre GPN - GPP; GPN - GPC; GPP - GPC foram respectivamente: p = 0,76; p = 0,001; p = 0,07. CONCLUSÃO: O índice de massa corporal de adultos obesos não influencia o equilíbrio corporal, porém influencia na configuração plantar.

  13. Protocolo kinésico preventivo de la fascitis plantar en corredores

    OpenAIRE

    Pujals Robert, Feliciana

    2013-01-01

    El propósito de este trabajo fue determinar cuáles son los factores que inciden en la fascitis plantar en los grupos de corredores de la ciudad de Mar del Plata. Material Y Métodos: Se realizo un estudio descriptivo, No experimental, Observacional y transversal. Los datos de este trabajo se extrajeron de dos muestras en paralelo. Por un lado se realizo un muestreo aleatorio simple, sobre un total de 101 corredores de ambos sexos de entre 18 y 60 años de edad que realiz...

  14. Influence of pressure-relief insoles developed for loaded gait (backpackers and obese people) on plantar pressure distribution and ground reaction forces.

    Science.gov (United States)

    Peduzzi de Castro, Marcelo; Abreu, Sofia; Pinto, Viviana; Santos, Rubim; Machado, Leandro; Vaz, Mario; Vilas-Boas, João Paulo

    2014-07-01

    The aims of this study were to test the effects of two pressure relief insoles developed for backpackers and obese people on the ground reaction forces (GRF) and plantar pressure peaks during gait; and to compare the GRF and plantar pressures among normal-weight, backpackers, and obese participants. Based on GRF, plantar pressures, and finite element analysis two insoles were manufactured: flat cork-based insole with (i) corkgel in the rearfoot and forefoot (SLS1) and with (ii) poron foam in the great toe and lateral forefoot (SLS2). Gait data were recorded from 21 normal-weight/backpackers and 10 obese participants. The SLS1 did not influence the GRF, but it relieved the pressure peaks for both backpackers and obese participants. In SLS2 the load acceptance GRF peak was lower; however, it did not reduce the plantar pressure peaks. The GRF and plantar pressure gait pattern were different among the normal-weight, backpackers and obese participants.

  15. Comparison of Plantar Pressure Distribution in Dominant & Non-dominant leg of female Kata and Kumite National Team

    Directory of Open Access Journals (Sweden)

    Elnaz Dizaji

    2016-09-01

    Full Text Available Objective: The aim of this study was to compare the plantar pressure distribution of dominant and non-dominant legs of females who were participated in the kata and kumite national team. Methods: Twelve kumite and 8 kata female athletes of the Karate national team participated in this study. Plantar pressure was measured using emed platform during barefoot walking. After dividing the foot into 10 masks, peak pressure, pressure-time integral, maximum force and force-time integral were calculated. Wilcoxon and U-Mann-Witney tests were used to analyze parameters at a significance level of p ≤ 0.05. Results: In comparison of kata and kumite teams it was found that, kata plantar pressure parameters in Metatarsal-2 (p=0.05 and Metatarsals-3, 4, 5 (p=0.04 were significantly less than those in kumite. Also, in comparison of dominant and non-dominant leg, plantar pressure parameters of dominant leg were less in Metatarsal-2 (p=0.04 and more in Bigtoe (p=0.04 and Toes-3, 4, 5 (p=0.03 than those in the non-dominant leg. Conclusion: Results may be indicative different of natures of the two athletic fields in that Kumite has a higher impact on plantar pressure due to higher mechanical loads. Furthermore, the unequal use of the legs may affect plantar pressure because of leg dominance. Thus, further and more comprehensive studies are necessary to prevent exercise-induced adaptations in professional levels and their treatments.

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

    Directory of Open Access Journals (Sweden)

    Sara Jones

    2010-11-01

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

  17. Larger plantar flexion torque variability implies less stable balance in the young: an association affected by knee position.

    Science.gov (United States)

    Mello, Emanuele Moraes; Magalhães, Fernando Henrique; Kohn, André Fabio

    2013-12-01

    The present study examined the association between plantar flexion torque variability during isolated isometric contractions and during quiet bipedal standing. For plantar flexion torque measurements in quiet stance (QS), subjects stood still over a force plate. The mean plantar flexion torque level exerted by each subject in QS (divided by 2 to give the torque due to a single leg) served as the target torque level for right leg force-matching tasks in extended knee (KE) and flexed knee (KF) conditions. Muscle activation levels (EMG amplitudes) of the triceps surae and mean, standard deviation and coefficient of variation of plantar flexion torque were computed from signals acquired during periods with and without visual feedback. No significant correlations were found between EMG amplitudes and torque variability, regardless of the condition and muscle being analyzed. A significant correlation was found between torque variability in QS and KE, whereas no significant correlation was found between torque variability in QS and KF, regardless of vision availability. Therefore, torque variability measured in a controlled extended knee plantar flexion contraction is a predictor of torque variability in the anterior-posterior direction when the subjects are in quiet standing. In other words, larger plantar flexion torque variability in KE (but not in KF) implies less stable balance. The mechanisms underlying the findings above are probably associated with the similar proprioceptive feedback from the triceps surae in QS and KE and poorer proprioceptive feedback from the triceps surae in KF due to the slackening of the gastrocnemii. An additional putative mechanism includes the different torque contributions of each component of the triceps surae in the two knee angles. From a clinical and research standpoint, it would be advantageous to be able to estimate changes in balance ability by means of simple measurements of torque variability in a force matching task.

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

    Directory of Open Access Journals (Sweden)

    Roberto Androson

    2013-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Cotchett Matthew P

    2010-09-01

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

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

    Science.gov (United States)

    Cotchett, Matthew P; Landorf, Karl B; Munteanu, Shannon E

    2010-09-01

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

  1. Successful treatment of plantar warts with very diluted bleomycin using a translesional multipuncture technique: pilot prospective study.

    Science.gov (United States)

    Alghamdi, Khalid M; Khurram, Huma

    2012-01-01

    Plantar warts are common and often painful. Treatment of plantar warts is difficult and requires multiple treatments. Several clinical trials have proven the efficacy of bleomycin, but relatively high concentrations have been required and considerable side effects have been experienced. To evaluate the efficacy and safety of low-concentration (0.1 U/mL) bleomycin using a translesional injection technique for the treatment of plantar warts. The study included 23 patients with single or multiple plantar warts. Very low-concentration bleomycin was injected into a single wart or the largest plantar wart in the case of multiple lesions. Injections were performed at 4-week intervals until resolution of the warts or development of side effects. The translesional multipuncture technique was used. Thirteen patients were male (56.5%), and the mean age was 27.7 years. The results revealed complete clearance of warts in 17 of 23 (74%) patients, partial response in 1 (4.3%) patient, and no response in 3 (13%) patients. Recurrence was observed in 2 patients at 3 months of follow-up. Among those two, one patient showed complete clearance after the second injection at 6 months of follow-up. All patients were followed for 6 months after the initial treatment. No significant long-term adverse effects were noted. Only three patients (13%) had localized moderate pain for 2 to 3 days after the injection. Translesional injection by very low-concentration (0.1 U/mL) bleomycin appears to be a simple, effective, and safe treatment modality for plantar warts.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-06-15

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

  3. Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic hemiplegic children with cerebral palsy

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria; Andersen, Jacob Buus; Sinkjær, Thomas;

    2014-01-01

    It is commonly assumed that exaggerated stretch reflex activity and the resulting increased muscle tone in ankle plantar flexors contribute to reduced ankle joint movement during gait in children with cerebral palsy (CP). We investigated the contribution of sensory feedback mechanisms to ankle...... in a similar proportion in both groups. Shortening of the plantar flexors in swing caused a larger drop in Soleus EMG in control children than in children with CP. The lack of age related decline in stretch reflexes in the stance phase and the inability to suppress the reflex in the swing phase is likely...

  4. Verrugas plantares recalcitrantes: estudio de la respuesta al tratamiento con cantaridina-podofilotoxina-ácido salicílico

    OpenAIRE

    2016-01-01

    [Resumen] Objetivo: Determinar si la aplicación de la cantaridina-podofilotoxinaácido salicílico es un tratamiento eficaz y seguro para el tratamiento de las verrugas plantares recalcitrantes. Material y Métodos: Un total de 75 pacientes de edad media 21 .35 años que presentaban verrugas plantares recalcitrantes participaron en el estudio. El tratamiento consistió en aplicar 1 o 2 sesiones de la formulación magistral compuesta por 1 % cantaridina, 5% podofilotoxina, y ...

  5. Influencia de la práctica deportiva sobre la huella plantar en atletas españoles

    OpenAIRE

    Martínez-Amat, A.; F. Hita-Contreras; Ruiz-Ariza, A.; Muñoz-Jiménez, M.; Cruz-Díaz, D.; Martínez-López, E.J.

    2016-01-01

    El objetivo de este estudio fue conocer la asociación entre el entrenamiento de atletas con las características de cada pie. Se midieron y compararon las huellas plantares de tres grupos de deportistas (28 velocistas, 29 fondistas, 47 nadadores) y de 67 sujetos no entrenados (GC). Para la captura de parámetros plantares se empleó una plataforma de escaneado podálico Podoscanalycer®. El índice podálico, metatarsal, medio podálico, y calcáneo fue inferior en GC respecto a corr...

  6. Alinhamento frontal estático do joelho e cargas plantares durante a marcha de adultos jovens assintomáticos Static frontal knee alignment and plantar loads during gait in healthy young adults

    Directory of Open Access Journals (Sweden)

    Isabel C.N. Sacco

    2009-03-01

    Full Text Available Na prática fisioterapêutica, pressupõe-se que alterações posturais do membro inferior influenciem a biomecânica e função dos demais complexos durante o movimento. No entanto, a literatura sobre a relação entre desalinhamentos estáticos do joelho e possíveis alterações dinâmicas ainda é escassa e inconclusiva. Assim, buscou-se avaliar o efeito do alinhamento frontal estático do joelho sobre a distribuição da pressão plantar durante a marcha. Foram avaliados inicialmente 44 adultos jovens assintomáticos. Por fotogrametria digital, mediu-se o ângulo frontal do joelho, classificado como normal (170° a 175°, valgo 175°. Dado o baixo número de valgos, foram analisados dois grupos: de joelhos normais (n=18 e de joelhos varos (n=23. A distribuição da pressão plantar foi avaliada durante a marcha em cinco áreas. Os grupos mostraram-se estatistica-mente semelhantes em todas as variáveis cinéticas avaliadas em todas as áreas plantares. Joelhos normais apresentaram significativa correlação com o tempo de contato no antepé lateral e médio-pé; e os varos, correlação com a área e tempo de contato em duas e três áreas plantares, e com a pressão integral no antepé lateral. Os resultados mostraram que o desalinhamento frontal de 3° do joelho, embora com moderada correlação, não influencia a distribuição de cargas na superfície plantar durante a marcha. Sugere-se pois que a avaliação clínica não se limite à avaliação articular estática do joelho, mas inclua atividades dinâmicas.In physical therapy practice, it is assumed that lower-limb posture changes may influence other complexes' biomechanics or function during movement. However, literature on the relationship between static knee alignment and possible dynamic changes is still scarce and inconclusive. This study assessed the effect of static frontal knee alignment on plantar pressure distribution during gait. At first 44 young asymptomatic adults were

  7. The short-term effects of plantar vibration on balance disorder after stroke

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    Soofia Naghdi

    2013-05-01

    Full Text Available Background: Balance disorders are common in patients following stroke. There are a number of physiotherapy modalities to treat balance impairments, one of which is vibration. The effects of vibration on balance disorders after stroke have not been investigated. This case report demonstrates the short-term effects of plantar vibration on the balance impairment of a patient with stroke. Case presentation: A 72-years-old man with right hemiplegia resulted from stroke was admitted for vibration therapy after not responding to standard rehabilitation interventions. He complained of balance problems despite walking independently. Main studied outcomes were timed up and go test and posturography. Foot sensation, ankle plantar flexor spasticity, and the passive range of ankle dorsiflexion were assessed, as well. Vibration with a frequency of 100 Hz was introduced to the sole of the affected foot for 5 minutes. After intervention, all tests were improved compared to the baselines. Conclusion: This case showed that the vibration was effective for improving balance disorder after stroke.

  8. Is Lumbo-Sacral Angle Related to Plantar Loading Patterns in Patients with Ankylosing Spondylitis?

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    Elif Aydın

    2016-08-01

    Full Text Available Objective: Loss of lumbar lordosis is a clinical feature of ankylosing spondylitis (AS. Pedobarographic analysis assesses the interaction between the foot and the supporting surface. Postural abnormalities can reflect as pressure distribution deviations on pedobarography. The objective of the present study was to assess whether loss of lumbar lordosis detected with lumbo-sacral angle measurement is related to postural control assessed by plantar loading distribution in patients with AS. Materials and Methods: Thirty-two patients (two female, 30 male, mean age: 43.06±7.8 years with the diagnosis of AS, who already had a lateral lumbo-sacral X-ray performed within the past one year, were included in the study. Static and dynamic pedobarographic analyses of the patients were performed. The radiographic measurement of lumbo-sacral angle was done from lateral lumbo-sacral X-rays of the patients. Results: The static pedobarographic measurement revealed that lumbo-sacral angle was significantly correlated with forefoot plantar pressure (p=0.042; r=0.361. In the dynamic assessment, the maximum pressures were lower under the first metatarsal area in patients with lower lumbo-sacral angle (p=0.352; r=0.048. Conclusion: These findings suggest that foot joints may contribute to the compensation mechanism against the postural changes in patients with AS, statically and dynamically.

  9. The Effect of Different Foot Orthosis Inverted Angles on Plantar Pressure in Children with Flexible Flatfeet

    Science.gov (United States)

    Lee, Hyunkeun; Ahn, Soyoung; Song, Youngshin; Park, Insik

    2016-01-01

    Although orthotic modification using the inverted technique is available for the treatment of flatfoot, empirical evidence for the biomechanical effects of inverted-angle foot orthoses (FOs) is lacking. The aim of this study was to evaluate the effects of different FO inversion angles on plantar pressure during gait in children with flatfoot. Twenty-one children with flexible flatfeet (mean age 9.9 years) were enrolled in this study. The plantar pressures were measured for the rearfoot; medial and lateral midfoot; and medial, central, and lateral forefoot as participants walked on a treadmill while wearing shoes only and shoes with the following 3 orthotic conditions: (i) orthosis with no inverted angle, (ii) orthosis with a 15° inverted angle, and (iii) orthosis with a 30° inverted angle. A one-way repeated measures analysis of variance (ANOVA) with the Bonferroni-adjusted post-hoc test was used to compare the mean values of each orthotic condition. Compared with the shoe only condition, the peak pressure decreased significantly under the medial forefoot and rearfoot with all FOs (p flatfoot. PMID:27458719

  10. Oscillation of plantar pressure center in athletes and non-athletes with and without ankle sprains

    Directory of Open Access Journals (Sweden)

    André Kenzo Saito

    2016-08-01

    Full Text Available ABSTRACT OBJECTIVE: To assess whether there is any difference in the oscillation of the plantar pressure center in single-leg stance between athletes and non-athletes with and without ankle sprains. METHODS: 54 volunteers performed four static assessments and one dynamic assessment while standing on one foot on a baropodometer, barefoot, for 10 s in each test. The variables of area (cm2, distance (cm, anteroposterior oscillation (cm, mediolateral oscillation (cm and mean velocity (cm/s were analyzed. The items "other symptoms" and "sports and recreation" of the subjective Foot and Ankle Outcome Score (FAOS questionnaire were applied. For the statistical analysis, repeated-measurement ANOVA (ANOVA-MR, multivariate ANOVA (MANOVA, Tukey's post hoc test and partial eta squared were used. RESULTS: ANOVA-MR revealed differences regarding distance, with major effects for eyes (p 0.05; and "sport and recreation", p > 0.05. CONCLUSION: Athletes present higher mean velocity of oscillation of plantar pressure center and generally do not have differences in oscillation amplitude in the sagittal and coronal planes, in comparison with non-athletes.

  11. Effectiveness and safety profile of 40% trichloroacetic acid and cryotherapy for plantar warts.

    Science.gov (United States)

    Cengiz, Fatma Pelin; Emiroglu, Nazan; Su, Ozlem; Onsun, Nahide

    2016-09-01

    Plantar warts are one of the most common infectious skin disease caused by the human papillomavirus. In this study, cryotherapy with liquid nitrogen delivered by the physician, up to four treatments 2 weeks apart. Forty percent trichloroacetic acid (TCA) was applied to warts weekly up to four treatments. At the end of 4 weeks, the clinical improvement of the TCA group (n = 30) was six patients (20%) with no change, one patient (3.3%) with a mild response, 13 patients (43.3%) with a moderate response and 10 patients (33.3%) with a good response. In the cryotherapy group, clinical responses were 12 patients (40%) with no change, four patients (13.3%) with a mild response, 12 patients (40%) with a moderate response and two patients (6.7%) with a good response. There was a statistically significant difference in improvement between the two treatment groups (P = 0.027). According to our results, TCA 40% is more effective for clearance of plantar warts with significantly improved long-term safety profile.

  12. EMG activities and plantar pressures during ski jumping take-off on three different sized hills.

    Science.gov (United States)

    Virmavirta, M; Perttunen, J; Komi, P V

    2001-04-01

    Different profiles of ski jumping hills have been assumed to make the initiation of take-off difficult especially when moving from one hill to another. Neuromuscular adaptation of ski jumpers to the different jumping hills was examined by measuring muscle activation and plantar pressure of the primary take-off muscles on three different sized hills. Two young ski jumpers volunteered as subjects and they performed several trials from each hill (K-35 m, K-65 m and K-90 m) with the same electromyographic (EMG) electrode and insole pressure transducer set-up. The results showed that the differences in plantar pressure and EMGs between the jumping hills were smaller than expected for both jumpers. The small changes in EMG amplitudes between the hills support the assumption that the take-off was performed with the same intensity on different jumping hills and the timing of the gluteus EMG demonstrates well the similarity of the muscle activation on different hills. On the basis of the results obtained it seems that ski jumping training on small hills does not disturb the movement patterns for bigger hills and can also be helpful for special take-off training with low speed.

  13. Transtibial amputation with plantar flap for congenital deficiency of the tibia.

    Science.gov (United States)

    Fujii, Hiroshi; Doi, Kazuteru; Baliarsing, Amresh S

    2002-10-01

    Disarticulation of the knee has been the preferred treatment for the severe type (Type Ia and Type Ib classification of Jones et al) of congenital deficiency of the tibia because of marked flexion contracture of the knee and loss of quadriceps function. In such cases, the disarticulated stump is often small and poorly covered by soft tissues because of dysplastic femoral condyles and calf muscles. Therefore, stump complications after disarticulation may prevent early aggressive walking exercises and delay independent ambulation. To overcome this problem, a greater weightbearing surface was created by a transtibial amputation with a short stump of the fibula using the flexed knee. By this method, the distal femoral condyle and the anterior surface of the fibula were used for weightbearing. In addition, coverage of the new weightbearing area by a neurovascular pedicled sensate plantar flap provided a more tolerable weightbearing site. The purpose of the current study was to report a 5-year-old boy with bilateral congenital total deficiency of both tibias, who was treated using this technique. The patient was ambulating independently 15 weeks after surgery. A transtibial amputation with a plantar flap is an alternative procedure to knee disarticulation for the severe type of congenital deficiency of the tibia.

  14. Effects of the lapidus arthrodesis and chevron bunionectomy on plantar forefoot pressures.

    Science.gov (United States)

    King, Christy M; Hamilton, Graham A; Ford, Lawrence A

    2014-01-01

    Hallux valgus with or without first ray insufficiency has been strongly implicated as a contributing factor in lesser metatarsal overload. The principle goals of a bunionectomy are to relieve the pain, correct the deformity, and restore first metatarsophalangeal joint congruity. Until now, little evidence has been available to assess the effects of bunionectomy procedures on forefoot pressure. The primary aim of the present prospective study was to evaluate the preoperative and postoperative plantar pressures after 2 specific bunionectomies: the chevron bunionectomy and Lapidus arthrodesis. A total of 68 subjects, 34 in each group, were included for radiographic and pedographic evaluation. Both procedures demonstrated radiographic improvements in the mean intermetatarsal and hallux abductus angles. The mean hallux plantar pressure decreased significantly in both procedure groups (p forefoot pressure (p = .01). Furthermore, the pressure under the second metatarsal as a percentage of the total forefoot pressure decreased significantly (p = .01). This study suggests that the Lapidus arthrodesis and chevron bunionectomy both provide correction for hallux valgus deformity, but when comparing forefoot load sharing pressures, the Lapidus arthrodesis appeared to have greater influence on the load sharing distribution of forefoot pressure than did the bunionectomy employing the chevron osteotomy.

  15. Case report 423: Clear-cell sarcoma plantar aspect of right foot

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    Sartoris, D.J.; Resnick, D.; Haghighi, P.

    1987-06-01

    The case is presented of a 65-year-old woman who developed a painful swelling of the plantar aspect of the right foot over a 3-year period. Conventional roentgenograms of the foot showed a large, soft tissue mass on the plantar aspect, with some suggestion of erosion of the adjacent metatarsals. CT studies, however, failed to confirm the presence of any bony abnormalities. At the time of the initial presentation, a biopsy was performed and approximately 3 months later the patient was treated definitely with wide excision of the mass. Histological sections showed the presence of a clear-cell sarcoma - an uncommon lesion mainly confined to the lower extremities and originating either in tendons or aponeurosis. The differential diagnosis, radiologically and clinically was described, and similarly, the differential diagnosis pathologically was also considered. The clinical, pathological and radiological aspects of clear-cell sarcoma of tendon sheath or aponeurosis were discussed in depth and the treatment and prognosis were considered. The authors stress that the importance of the case from a diagnostic imaging perspective lies in the successful use of CT in defining such a soft tissue neoplasm. The ability of CT to determine the extent of involvement of soft tissue and bone by such a lesion is important. Cross-sectional techniques, including magnetic resonance as well as CT, must be the procedure of choice in the definitive diagnosis and treatment of such lesions.

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

    Science.gov (United States)

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

    2016-08-01

    Obesity is strongly associated with musculoskeletal disorders of the lower limb, including ankle instability and resulting gait problems. In the present study, we aimed to examine, using paired comparisons of subjects, whether moderate duration of obesity in patients with mild to moderate elevations of body mass index (BMI), changes the fibrous contents of muscles that support the ankle mortices, namely calf and plantar muscles. We attempted to examine these parameters because this shall provide direct evidence of whether obesity directly impacts myoarchitecture and support of the adjoining joints. MRI image segmentation and pixel correlations by grey level co-occurrence matrix (GLCM) and entropy were used to analyse the changes. The differences in the means between groups (both GLCM and entropy) were significant from control lean populations (P<0.0001, ANOVA) for the parameters examined for both the calf and the plantar muscles. Reduction in weight should thus be a first-line approach in preventing these changes that may significantly affect quality of life due to gait disturbances.

  17. Status of oxidative stress on lesional skin surface of plantar warts.

    Science.gov (United States)

    Arican, O; Ozturk, P; Kurutas, E B; Unsal, V

    2013-03-01

    Warts are abnormal skin growths caused by human papilloma virus (HPV) infections within the skin of the patients. Sometimes the disease is difficult to treatment, and also, the relationship between HPV and some forms of skin cancers is important. The cutaneous oxidative stress status of warts is absent in the literature. To evaluate the role of oxidative stress in affected skin areas in a group of patients with plantar warts. Thirty-six consecutive patients with a diagnosis of plantar warts were enrolled. The samples were obtained by scraping the skin surface. Superoxide dismutase (SOD) and catalase (CAT) activities and malondialdehyde (MDA) levels were measured spectrophotometrically at samples. The SOD activity was significantly lower, and the MDA level was significantly higher on the lesional area than on the non-lesional area (P warts may play a role in pathogenesis of the disease. The addition of topical drugs with antioxidative effects may be valuable in the treatment of warts. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  18. Human ankle plantar flexor muscle–tendon mechanics and energetics during maximum acceleration sprinting

    Science.gov (United States)

    Schache, Anthony G.; Brown, Nicholas A. T.; Pandy, Marcus G.

    2016-01-01

    Tendon elastic strain energy is the dominant contributor to muscle–tendon work during steady-state running. Does this behaviour also occur for sprint accelerations? We used experimental data and computational modelling to quantify muscle fascicle work and tendon elastic strain energy for the human ankle plantar flexors (specifically soleus and medial gastrocnemius) for multiple foot contacts of a maximal sprint as well as for running at a steady-state speed. Positive work done by the soleus and medial gastrocnemius muscle fascicles decreased incrementally throughout the maximal sprint and both muscles performed more work for the first foot contact of the maximal sprint (FC1) compared with steady-state running at 5 m s−1 (SS5). However, the differences in tendon strain energy for both muscles were negligible throughout the maximal sprint and when comparing FC1 to SS5. Consequently, the contribution of muscle fascicle work to stored tendon elastic strain energy was greater for FC1 compared with subsequent foot contacts of the maximal sprint and compared with SS5. We conclude that tendon elastic strain energy in the ankle plantar flexors is just as vital at the start of a maximal sprint as it is at the end, and as it is for running at a constant speed. PMID:27581481

  19. Reliability of Various Measurement Stations for Determining Plantar Fascia Thickness and Echogenicity.

    Science.gov (United States)

    Bisi-Balogun, Adebisi; Cassel, Michael; Mayer, Frank

    2016-04-13

    This study aimed to determine the relative and absolute reliability of ultrasound (US) measurements of the thickness and echogenicity of the plantar fascia (PF) at different measurement stations along its length using a standardized protocol. Twelve healthy subjects (24 feet) were enrolled. The PF was imaged in the longitudinal plane. Subjects were assessed twice to evaluate the intra-rater reliability. A quantitative evaluation of the thickness and echogenicity of the plantar fascia was performed using Image J, a digital image analysis and viewer software. A sonography evaluation of the thickness and echogenicity of the PF showed a high relative reliability with an Intra class correlation coefficient of ≥0.88 at all measurement stations. However, the measurement stations for both the PF thickness and echogenicity which showed the highest intraclass correlation coefficient (ICCs) did not have the highest absolute reliability. Compared to other measurement stations, measuring the PF thickness at 3 cm distal and the echogenicity at a region of interest 1 cm to 2 cm distal from its insertion at the medial calcaneal tubercle showed the highest absolute reliability with the least systematic bias and random error. Also, the reliability was higher using a mean of three measurements compared to one measurement. To reduce discrepancies in the interpretation of the thickness and echogenicity measurements of the PF, the absolute reliability of the different measurement stations should be considered in clinical practice and research rather than the relative reliability with the ICC.

  20. Influence of backpack load and gait speed on plantar forces during walking.

    Science.gov (United States)

    Watanabe, Kazuhiko; Wang, Yun

    2013-01-01

    The purpose of this study is to examine the differences in plantar force associated with changes in backpack load and gait speed during walking. The F-scan tethered system was used to collect plantar pressure data. Subjects were asked to walk on a treadmill with varied levels of backpack load (0%, 10%, 20%, and 30% of body mass) and gait speed (4, 5, and 6 km/h). We found that an increase in gait speed and backpack load lead to increase in the magnitude of the first vertical ground reaction force (vGRF) peak. Greater magnitudes of the second vGRF peak were only associated with an increase when gait speeds were 4 km/h and 5 km/h. There was no speed-related change in the magnitudes of the second vGRF peak at the speed of 6 km/h. The results of this study may be important for the purpose of constituting a load-bearing walking program for protecting against osteoporosis.

  1. The effect of three different toe props on plantar pressure and patient comfort

    Directory of Open Access Journals (Sweden)

    Johnson Sarah

    2012-08-01

    Full Text Available Abstract Background Arthritic toe pathologies frequently lead to the development of painful apical pressure skin lesions that can compromise gait and affect quality of life. Historically conservative treatments involve the use of a toe prop with the intended aim of reducing plantar pressure from the apex of the digit. However, the effect of toe prop treatment on plantar digital pressure has not been investigated. Method Twenty two subjects were recruited with lesser digital deformities and associated apical skin lesions. Individual pressure sensors were placed on the apices of the lesser toes and pressure was recorded under three toe prop conditions (leather, gel and silicone mould. A modified comfort index was utilised to assess the comfort of each condition. Results Significant difference (p nd toe when using the gel (p p nd toe when using gel (p p  Conclusion As compared to the leather and silicone mould toe props, gel toe props were found to be the most effective for reducing peak pressure and pressure time integral on the apex of the second digit in patients with claw or hammer toe deformity.

  2. Effects of surface characteristics on the plantar shape of feet and subjects' perceived sensations.

    Science.gov (United States)

    Witana, Channa P; Goonetilleke, Ravindra S; Xiong, Shuping; Au, Emily Y L

    2009-03-01

    Orthotics and other types of shoe inserts are primarily designed to reduce injury and improve comfort. The interaction between the plantar surface of the foot and the load-bearing surface contributes to foot and surface deformations and hence to perceived comfort, discomfort or pain. The plantar shapes of 16 participants' feet were captured when standing on three support surfaces that had different cushioning properties in the mid-foot region. Foot shape deformations were quantified using 3D laser scans. A questionnaire was used to evaluate the participant's perceptions of perceived shape and perceived feeling. The results showed that the structure in the mid-foot could change shape, independent of the rear-foot and forefoot regions. Participants were capable of identifying the shape changes with distinct preferences towards certain shapes. The cushioning properties of the mid-foot materials also have a direct influence on perceived feelings. This research has strong implications for the design and material selection of orthotics, insoles and footwear.

  3. Effectiveness of moulded insoles in reducing plantar pressure in diabetic patients.

    Science.gov (United States)

    Zequera, M; Stephan, S; Paul, J

    2007-01-01

    For an effective prevention of foot sole ulcers in diabetic patients, the Bioengineering and Signal processing group of the Electronics Department of the Pontificia Universidad Javeriana developed a novel method for the computer assisted design and production of therapeutic insoles, integrating several technologies, such as: CAD/CAM registration of pressure on the foot sole, Podoscopy, and an expert system based on knowledge. The afore mentioned method allows topographical modeling of the insoles starting by the digitization in 3D of a cast of the foot sole surface of the patient and its computer assisted design taking into account the recommendations of the knowledge based system. The aim of this study was to evaluate the effect on plantar pressure distribution of different insoles prescribed and manufactured with various techniques on a random group of patients with diabetes mellitus in the early stages of the disease. Four different types of insoles were manufactured by methods available in the market and by the computer model system proposed on a previous research, which was used in order to design and manufacture one of the insoles evaluated. The differences between the four types of insoles were established by comparing their effectiveness in plantar pressure reduction.

  4. ACUTE EFFECTS OF TWO MASSAGE TECHNIQUES ON ANKLE JOINT FLEXIBILITY AND POWER OF THE PLANTAR FLEXORS

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    Grant J.B. McKechnie

    2007-12-01

    Full Text Available The purpose of this study was to determine if three minutes of petrissage and tapotement forms of massage would influence plantar flexors' flexibility, and muscle power. Nineteen participants were randomly subjected to three conditions (control and two massages before performing two power tests. Prior to the intervention, subjects completed ankle joint flexibility assessments. The conditions were; (1 control, where subjects lay prone and had a therapist's hands resting, (2 vigorous petrissage, and (3 tapotement applied at a rate of 4Hz; all on the triceps surae. Following completion of the intervention, subjects immediately completed a post- ankle joint flexibility test, followed by a drop-jump and concentric calf raise. The power measures were; concentric peak force, rate of force development, and drop-jump height / contact time. The data showed a significant increase (p < 0.05 in ankle joint angle on the right leg and a corresponding tendency on the left. No significant change was seen with the power measures. Results suggest that massage can increase plantar flexors' flexibility without a change in power and thus may be an alternative to static stretching during an athletic warm-up

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Different surgical treatment of post-burn trophic ulcers of the plantar surface in foot burns.

    Science.gov (United States)

    Shakirov, Babur M

    2011-12-01

    Burns of the plantar surface of the foot with the subsequent formation of scar is often complicated by unhealing trophic ulcers. Trophic ulcers increase due to constant local irritation, reaching various depth and area, penetrating to the bone and the tendons and covering the area of several centimetres in diameter up to the whole heel area. A total of 21 patients (12 men and nine women) have been under our observation at Samarkand Inter-Regional Burn Center, Uzbekistan, for prolonged trophic ulcers of soft tissues of the plantar surface of the foot. Ulcers sizes were from 1.0-2.5 to 3-5 cm in diameter. All patients had undergone earlier unsuccessful operation (3-5 times). The method of closure should be chosen according to both severity and localisation of the injury, using local uninjured tissues and soft scars to make bilobed skin-flap plasty, one-lobed skin-flat flap, tube graft and other shaped flaps and free grafts placed on the area of the excised scars. In 18 observations, a good result was achieved and no complications were noted. The grafts were viable, sensibility was preserved and no marginal necrosis was noticed. Patients can take up their work by 1.5-2.0 months after surgery. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  7. Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers

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    Yong Jin Cho

    2013-05-01

    Full Text Available Background  The reconstruction of volar surface defects is difficult because of the specialhistologic nature ofthe tissue involved. The plantarsurface isthe most homologousin shapeand function and could be considered the mostideal ofreconstructive optionsin select casesof volar surface defects. In this paper, we evaluate a single institutional case series of volartissue defectsmanagedwith second toe plantarfree flaps.Methods  Asingle-institution retrospective reviewwas performed on 12 cases ofreconstructionusing a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years witha male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 casesfollowed by amputations (3 cases and a single case of burn injury. Half of the indications (6caseswere forsoft-tissue defectswith the other halfforscar contracture.Results  All ofthe flapssurvived through the follow-up period. Sensory recoverywasrelatedto the time interval between injury and reconstruction−with delayed operations portendingworse outcomes. Therewere no postoperative complicationsin thisseries.Conclusions  Flexion contracture is the key functional deficit of volar tissue defects. Thesecond toe plantar free flap is the singular flap whose histology most closely matches thoseof the original volar tissue. In our experience, this flap is the superior reconstructive optionwithin the specific indications dictated by the defectsize and location.

  8. Ultrasound evaluation of intrinsic plantar muscles and fascia in hallux valgus

    Science.gov (United States)

    Lobo, César Calvo; Marín, Alejandro Garrido; Sanz, David Rodríguez; López, Daniel López; López, Patricia Palomo; Morales, Carlos Romero; Corbalán, Irene Sanz

    2016-01-01

    Abstract A cross-sectional area (CSA) and thickness reduction of the abductor hallucis (AbH) is shown in subjects with hallux valgus (HV). To date, other soft-tissue structures have not been researched in relation with HV. The aim of this study was to compare the CSA and thickness of the intrinsic plantar muscles and fascia (PF) between feet with and without HV. Therefore, a cross-sectional and case-control study was performed using B-mode with an iU22 Philips ultrasound system and a 5 to 17-MHz transducer. The CSA and thickness were measured for the AbH, flexor digitorum brevis (FDB) and flexor hallucis brevis (FHB), and also the thickness for the anterior, middle, and posterior PF portions. A convenience sample of 40 feet, 20 with HV and 20 without HV, was recruited from a clinical and research center. A multivariate regression analysis using linear regression was performed to evaluate the ultrasound imaging measurements (α = 0.05). Consequently, statistically significant differences were observed between the groups (P fascia thickness increase in favor of the HV group. On the contrary, the FDB thickness and CSA did not show statistically significant differences (P ≥ 0.05). In conclusion, the CSA and thickness of the AbH and FHB intrinsic plantar muscles are reduced, whereas the thickness of the anterior, middle, and posterior PF portions are increased, in subjects with HV compared with those without HV. PMID:27828846

  9. Evaluation and optimization of therapeutic footwear for neuropathic diabetic foot patients using in-shoe plantar pressure analysis

    NARCIS (Netherlands)

    S.A. Bus; R. Haspels; T.E. Busch-Westbroek

    2011-01-01

    Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to eva

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

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    Clara Sanz Morère

    2016-01-01

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

  11. Effect of arch type and Body Mass Index on plantar pressure distribution during stance phase of gait.

    Science.gov (United States)

    O'Brien, Davida Louise; Tyndyk, Magdalena

    2014-01-01

    Several factors have been associated with the presence of abnormally high plantar foot pressure including: (i) increased body weight, (ii) foot structure and (iii) walking strategy. It is predicted that the biomechanics of the foot is influenced by the structure of the foot, primarily the Medial Longitudinal Arch. The objective of this study was to examine if Body Mass Index and the foot arch have a direct effect on dynamic peak plantar pressure for healthy subjects. Following a clinical lower limb examination, the Tekscan HR mat was utilised for this study, plantar pressure was profiled at specific events during stance phase of gait including heel strike, midstance and toe off. Results indicated to the preferable normal arch as this produced a low plantar pressure distribution in all cases. The 2nd and 3rd metatarsal head region recorded the highest pressure for all arch types during dynamic analysis. The lowest pressure for the normal and overweight BMI was at toe-off. While the obese BMI group showed highest pressure during toe-off. The obese BMI flat arch subcategory indicated to functional ambulation differences. Future work involves comparing this healthy database to a demographically matched diabetic group.

  12. The efficacy of a removable vacuum-cushioned cast replacement system in reducing plantar forefoot pressures in diabetic patients

    NARCIS (Netherlands)

    S.A. Bus; R. Waaijman; M. Arts; H. Manning

    2009-01-01

    Background: The purpose of this study was to determine the plantar forefoot offloading efficacy of a new prefabricated vacuum-cushioned cast replacement system designed for foot ulcer treatment in neuropathic diabetic patients. Methods: Fifteen diabetic subjects with peripheral neuropathy underwent

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

    Directory of Open Access Journals (Sweden)

    Rogéria Nobre Rodrigues

    2015-12-01

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

  14. Differences in plantar loading between training shoes and racing flats at a self-selected running speed

    NARCIS (Netherlands)

    J.I. Wiegerinck; J. Boyd; J.C. Yoder; A.N. Abbey; J.A. Nunley; R.M. Queen

    2009-01-01

    The purpose of this study was to examine the difference in plantar loading between two different running shoe types. We hypothesized that a higher maximum force, peak pressure, and contact area would exist beneath the entire foot while running in a racing flat when compared to a training shoe. 37 at

  15. Comparison of elasticity of human tendon and aponeurosis in knee extensors and ankle plantar flexors in vivo.

    Science.gov (United States)

    Kubo, Keitaro; Kanehisa, Hiroaki; Fukunaga, Tetsuo

    2005-05-01

    The purposes of this study were to compare the elasticity of tendon and aponeurosis in human knee extensors and ankle plantar flexors in vivo and to examine whether the maximal strain of tendon was correlated to that of aponeurosis. The elongation of tendon and aponeurosis during isometric knee extension (n = 23) and ankle plantar flexion (n = 22), respectively, were determined using a real-time ultrasonic apparatus, while the participants performed ramp isometric contractions up to voluntary maximum. To calculate the strain values from the measured elongation, we measured the respective length of tendon and aponeurosis. For the knee extensors, the maximal strain of aponeurosis (12.1 +/- 2.8 %) was significantly greater than that of the patella tendon (8.3 +/- 2.4 %), p aponeurosis in ankle plantar flexors (2.7 +/- 1.4 %), p plantar flexors there was no significant correlation between maximal strain of tendon and aponeurosis. These results would be important for understanding the different roles of tendon and aponeurosis during human movements and for more accurate muscle modeling.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Association of limited joint mobility and increased plantar hardness in diabetic foot ulceration in north Asian Indian: a preliminary study.

    Science.gov (United States)

    Periyasamy, R; Anand, Sneh; Ammini, A C

    2012-04-01

    The aim of this article is to investigate the association of limited joint mobility and foot sole hardness in north Asian Indian type 2 diabetic patients. Limited joint mobility and hardness of the foot sole were measured for 39 subjects attending the AIIMS Endocrinology & Metabolism Clinic. The total subject divided into three groups: 13 control subjects (nondiabetic), 13 diabetic patients without neuropathy and 13 diabetic neuropathy patients. Neuropathy status was assessed using 10 gm Semen's Weinstein monofilament. Joint mobility parameters, such as ankle dorsiflexion/plantar flexion and metatarsophalangeal-1 dorsiflexion/plantar flexion, are measured using a goniometer. Foot sole hardness was measured using a durometer or shore meter. We found that diabetic patients with a neuropathic foot had significantly reduced joint mobility and increased foot sole hardness, placing them at risk for subsequent ulceration. Metatarsophalangeal-1 dorsiflexion/plantar flexion of both feet of diabetic patients had significant correlation (at p hardness in both feet of diabetic neuropathy subjects. Also linear regression analysis showed that duration of diabetes was significantly associated with the joint mobility parameters. In this study we conclude that joint mobility had reduced further if neuropathy and increased foot sole hardness coexisted owing to high plantar pressures. Hence, both limited joint mobility and increased foot sole hardness appears to be important determinants of foot sole ulceration in diabetic neuropathic subject.

  19. Association between rapid force production by the plantar flexors and balance performance in elderly men and women.

    Science.gov (United States)

    Ema, Ryoichi; Saito, Megumi; Ohki, Shunsuke; Takayama, Hirokazu; Yamada, Yosuke; Akagi, Ryota

    2016-12-01

    Plantar flexion strength and balance ability are considered to be crucial for avoiding falls. However, no clear relationship has been established between these two factors in elderly population. This study aimed to examine the association between plantar flexion strength and balance performance in elderly men and women. Forty-three men and 35 women aged over 65 years performed isometric plantar flexion as fast and hard as possible. From the time-torque curve, the rate of torque development in time intervals of 30, 50, 100, 150, and 200 ms from the onset of contraction was determined and normalized to peak torque. In addition, the center of pressure displacement during single-leg standing was calculated and normalized to height. When the data were collapsed over sexes, the normalized rate of torque development was negatively correlated with the normalized center of pressure displacement, except for the time interval of 200 ms. By sex, regardless of the time interval, there was a negative correlation between the normalized rate of torque development and the normalized center of pressure displacement in the elderly men but not in the elderly women. No correlation was seen between the peak torque and normalized center of pressure displacement in either pooled or separated data. The findings suggest that the capability of rapid force production rather than maximal force production of the plantar flexion is important for balance ability in elderly men, but this capability may not be relevant in elderly women.

  20. Tendon elastic strain energy in the human ankle plantar-flexors and its role with increased running speed.

    Science.gov (United States)

    Lai, Adrian; Schache, Anthony G; Lin, Yi-Chung; Pandy, Marcus G

    2014-09-01

    The human ankle plantar-flexors, the soleus and gastrocnemius, utilize tendon elastic strain energy to reduce muscle fiber work and optimize contractile conditions during running. However, studies to date have considered only slow to moderate running speeds up to 5 m s(-1). Little is known about how the human ankle plantar-flexors utilize tendon elastic strain energy as running speed is advanced towards maximum sprinting. We used data obtained from gait experiments in conjunction with musculoskeletal modeling and optimization techniques to calculate muscle-tendon unit (MTU) work, tendon elastic strain energy and muscle fiber work for the ankle plantar-flexors as participants ran at five discrete steady-state speeds ranging from jogging (~2 m s(-1)) to sprinting (≥8 m s(-1)). As running speed progressed from jogging to sprinting, the contribution of tendon elastic strain energy to the positive work generated by the MTU increased from 53% to 74% for the soleus and from 62% to 75% for the gastrocnemius. This increase was facilitated by greater muscle activation and the relatively isometric behavior of the soleus and gastrocnemius muscle fibers. Both of these characteristics enhanced tendon stretch and recoil, which contributed to the bulk of the change in MTU length. Our results suggest that as steady-state running speed is advanced towards maximum sprinting, the human ankle plantar-flexors continue to prioritize the storage and recovery of tendon elastic strain energy over muscle fiber work.

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

    Directory of Open Access Journals (Sweden)

    Babak Vahdatpour

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Zhanyong Mei; Guoru Zhao; Qingsong Zhu; Lei Wang

    2012-01-01

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

  3. Free Medial Plantar Flap Connection with a Posterior Tibial Artery Flap in Reconstruction of Fore–Mid Foot Skin Defect

    Science.gov (United States)

    Wu, Hao; Sheng, Jia-Gen

    2016-01-01

    Background: Although there are many surgical treatments for covering the skin defect of the fore–mid foot, how to reconstruct the weight-bearing region remains a challenge. The weight-bearing region of the sole needs to withstand the pressure and shearing stresses of walking, so the plantar skin is anatomically different from other skins in the areas of texture, thickness, subcutaneous tissue, etc. Medial plantar flaps that are harvested from the instep region are regarded as the first choice for weight-bearing region reconstruction because of their excellent functional and aesthetic long-term result. However, when facing an extensive skin defect on a weight-bearing area such as a fore–mid foot avulsion, the application of this flap is limited because if we put the flap in a weight-bearing area of the forefoot, the set of vessels will be exposed to outside. Methods: We suggest 2 connected free flaps (posterior tibial artery flap and medial plantar flap) pedicled with 1 set of vessels. The medial plantar flap was used to cover the skin defect of the weight-bearing area in the forefoot. The dorsal skin defect of the injured foot was covered with a posterior tibial artery flap and supplied the medial plantar flap with the posterior tibial vessel. The midfoot skin defect was repaired by a full-skin grafting. Results: Long-term follow-up results showed that the shape and function of the injured limbs recovered almost entirely. Conclusion: This method of connected flaps is suitable for repairing large skin defects of the fore–mid foot. PMID:27975013

  4. Plantar fasciitis

    Science.gov (United States)

    ... suddenly Have a tight Achilles tendon (the tendon connecting the calf muscles to the heel) Wear shoes ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

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

    Directory of Open Access Journals (Sweden)

    Anand B Heggannavar

    2015-08-01

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

  6. Plantar flexor muscle weakness and fatigue in spastic cerebral palsy patients.

    Science.gov (United States)

    Neyroud, Daria; Armand, Stéphane; De Coulon, Geraldo; Sarah R Dias Da Silva; Maffiuletti, Nicola A; Kayser, Bengt; Place, Nicolas

    2017-02-01

    Patients with cerebral palsy develop an important muscle weakness which might affect the aetiology and extent of exercise-induced neuromuscular fatigue. This study evaluated the aetiology and extent of plantar flexor neuromuscular fatigue in patients with cerebral palsy. Ten patients with cerebral palsy and 10 age- and sex-matched healthy individuals (∼20 years old, 6 females) performed four 30-s maximal isometric plantar flexions interspaced by a resting period of 2-3s to elicit a resting twitch. Maximal voluntary contraction force, voluntary activation level and peak twitch were quantified before and immediately after the fatiguing task. Before fatigue, patients with cerebral palsy were weaker than healthy individuals (341±134N vs. 858±151N, pcerebral palsy following the fatiguing task (-10±23%, p>0.05), whereas it decreased by 30±12% (pcerebral palsy were weaker than their healthy peers but showed greater fatigue resistance. Cerebral palsy is a widely defined pathology that is known to result in muscle weakness. The extent and origin of muscle weakness were the topic of several previous investigations; however some discrepant results were reported in the literature regarding how it might affect the development of exercise-induced neuromuscular fatigue. Importantly, most of the studies interested in the assessment of fatigue in patients with cerebral palsy did so with general questionnaires and reported increased levels of fatigue. Yet, exercise-induced neuromuscular fatigue was quantified in just a few studies and it was found that young patients with cerebral palsy might be more fatigue resistant that their peers. Thus, it appears that (i) conflicting results exist regarding objectively-evaluated fatigue in patients with cerebral palsy and (ii) the mechanisms underlying this muscle fatigue - in comparison to those of healthy peers - remain poorly understood. The present study adds important knowledge to the field as it shows that when young adults with

  7. Synergistic co-activation increases the extent of mechanical interaction between rat ankle plantar-flexors

    Directory of Open Access Journals (Sweden)

    Chris Tijs

    2016-09-01

    Full Text Available Force transmission between rat ankle plantar-flexors has been found for physiological muscle lengths and relative positions, but only with all muscles maximally activated. The aims of this study were to assess intermuscular mechanical interactions between ankle plantar-flexors during (i fully passive conditions, (ii excitation of soleus (SO, (iii excitation of lateral gastrocnemius (LG, and (iv during co-activation of SO and LG (SO&LG. We assessed effects of proximal lengthening of LG and plantaris (PL muscles (i.e. simulating knee extension on forces exerted at the distal SO tendon (FSO and on the force difference between the proximal and distal LG+PL tendons (ΔFLG+PL of the rat. LG+PL lengthening increased FSO to a larger extent (p=0.017 during LG excitation (0.0026 N/mm than during fully passive conditions (0.0009 N/mm. Changes in FSO in response to LG+PL lengthening were lower (p=0.002 during SO only excitation (0.0056 N/mm than during SO&LG excitation (0.0101 N/mm. LG+PL lengthening changed ∆FLG+PL to a larger extent (p=0.007 during SO excitation (0.0211 N/mm than during fully passive conditions (0.0157 N/mm. In contrast, changes in ∆FLG+PL in response to LG+PL lengthening during LG excitation (0.0331 N/mm were similar (p=0.161 to that during SO&LG excitation (0.0370 N/mm. In all conditions, changes of FSO were lower than those of ∆FLG+PL. This indicates that muscle forces were transmitted not only between LG+PL and SO, but also between LG+PL and other surrounding structures. In addition, epimuscular myofascial force transmission between rat ankle plantar-flexors was enhanced by muscle activation. However, the magnitude of this interaction was limited.

  8. An intensive self care training programme reduces admissions for the treatment of plantar ulcers.

    Science.gov (United States)

    Cross, H; Newcombe, L

    2001-09-01

    This paper describes, in detail, an intensive 14 day Self Care Training Programme that is conducted at Lalgadh Leprosy Services Centre in Nepal. An evaluation of the programme was undertaken in which hospital admission for infected plantar ulceration was the outcome measure. It was found that those who had undertaken the programme were less likely to have been admitted for hospital treatment in a 3-month follow-up period (chi 2 = 5.1, P = 0.02). An odds ratio of 1:1.8 (95% CI = 0.15-0.01) was also calculated. This paper presents an overview of the issues related to impairment, a description of the Self Care Training Programme, an analysis of the evaluation results and a discussion of the findings.

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

    DEFF Research Database (Denmark)

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

    2002-01-01

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

  10. O reflexo cutâneo-plantar em extensão (Babinski, 1896/1898

    Directory of Open Access Journals (Sweden)

    R. Oliveira-souza

    1995-06-01

    Full Text Available A dois anos do centenário da identificação do reflexo cutâneo-plantar em extensão como sinal de afecção do sistema nervoso central, pareceu-nos oportuno traduzir passagens relevantes de Babinski sobre o fenômeno que descreveu. Há indícios de que um dos motosmais influentes na criação do espírito de época que facilitou a valorização clínica do "fenômeno dos artelhos", deveu-se à exigência pragmática de se distinguir paralisias "histéricas" de "orgânicas" para aplicação médico-legal imediata.

  11. [Variation of the fibular part of the plantar aponeurosis among present-day Japanese].

    Science.gov (United States)

    Hiramoto, Y

    1983-03-01

    The plantar aponeurosis consists of the tibial and fibular parts. It is already known that the form of the fibular part markedly varies according to individuals. However, there have been few anatomical observations on this variation and none have statistically analysed it. This paper is concerned with the variation of the fibular part of the aponeurosis. Observations were carried out by dissecting thirty-nine present-day Japanese cadavers. The variations observed were classified into four types according to the Loth's method. It was clarified by means of the Chi-square test that the percentage of the medial fibre bundle is significantly higher in present-day Japanese than in Europeans, that is up to 20.5%. It was also found that the top portion of the medial fibre bundle, if it exists, is the origin of a part of the transverse head of the adductor pollicis muscle and the flexor digiti minimi brevis muscle in some cases.

  12. Plantar fibromatosis may adopt the brain gyriform pattern of a low-grade fibromyxoid sarcoma.

    Science.gov (United States)

    Touraine, Sébastien; Bousson, Valérie; Kaci, Rachid; Parlier-Cuau, Caroline; Haddad, Samuel; Laouisset, Liess; Petrover, David; Laredo, Jean-Denis

    2013-01-01

    We report the case of a 42-year-old man with histologically proven plantar fibromatosis (Ledderhose disease) demonstrating an uncommon brain gyriform pattern at MRI, so far exclusively described in the low-grade fibromyxoid sarcoma (LGFMS). An acoustic posterior enhancement at ultrasound, a high intensity on T2w and post-contrast T1wMR images were unusual and related to a high tumor cellularity at histology with no myxoid tissue. The juxtaposition of areas of high and low cellularity (with more fibrous material) in a multilobulated mass built a brain gyriform pattern at MR, similar to what was so far described exclusively in LGFMS. This case demonstrates that the brain gyriform pattern may also be observed in other soft tissue fibrous tumors with no myxoid material but with high cellularity areas alternating with fibrous zones of low cellularity. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. An update on the evaluation and management of plantar puncture wounds and Pseudomonas osteomyelitis.

    Science.gov (United States)

    Inaba, A S; Zukin, D D; Perro, M

    1992-02-01

    The management of children who present to the ED with plantar puncture wounds is dependent upon the nature of the injury, the examination of the puncture site, and the potential risk of a retained foreign body. Not all patients will require wound enlargement and a search for a retained foreign body. Close follow-up of all children who are being treated as outpatients is of vital importance in detecting an early development of an infectious complication. Pseudomonas osteomyelitis should be suspected in all patients who present with foot pain, swelling, and a decreased ability to bear weight after sustaining a nail puncture through a sneaker. The current consensus favors open surgical débridement followed by a course of intravenous antibiotics. The exact duration of the postoperative antibiotic course is still being debated.

  14. Sensory denervation of the plantar lumbrical muscle spindles in pyridoxine neuropathy.

    Science.gov (United States)

    Krinke, G; Heid, J; Bittiger, H; Hess, R

    1978-09-15

    Male albino rats treated with excessive amounts of pyridoxine developed an impairment of neuromuscular function. The equatorial region of the plantar lumbrical intrafusal muscle fibres was studied in the electron microscope and the calibre of the nerve fibres was determined in semi-thin sections of the posterior tibial nerves. Degeneration of the primary sensory endings coincided with the onset of ataxia, and in more advanced stages of the neuropathy as well as after a 2-month treatment-free period the equatorial region was denervated. There was a corresponding decrease in the number of large nerve fibres. It is considered essential that primary sensory endings of lumbrical muscle spindles should be included in studies of distally accentuated sensory neuropathies.

  15. Effect of overground vs treadmill running on plantar pressure: influence of fatigue.

    Science.gov (United States)

    García-Pérez, José A; Pérez-Soriano, Pedro; Llana, Salvador; Martínez-Nova, Alfonso; Sánchez-Zuriaga, Daniel

    2013-09-01

    The differences produced when running on a treadmill vs overground may call into question the use and validity of the treadmill as a piece of equipment commonly used in research, training, and rehabilitation. The aim of the present study was to analyze under pre/post fatigue conditions the effect of treadmill vs overground on plantar pressures. Twenty-seven recreational runners (17 men and 10 women) ran on a treadmill and overground at two speeds: S1=3.33 m/s and S2=4.00 m/s, before and after a fatigue protocol consisting of a 30-min run at 85% of their individual maximal aerobic speed (MAS). Contact time (CT in seconds), peak pressure (PP in kPa), and relative load (RL in %) were analyzed under nine foot zones of the left foot using an in-shoe plantar pressure device. A two-way repeated measures ANOVA showed that running on a treadmill increases CT (7.70% S1 and 9.91% S2), modifies the pressure distribution and reduces PP (25.98% S1 and 31.76% S2), especially under the heel, medial metatarsals, and hallux, compared to running overground. Moreover, on both surfaces, fatigue (S2) led to a reduced stride frequency (2.78%) and reduced PP on the lateral heel and hallux (15.96% and 16.35%, respectively), and (S1) increased relative load on the medial arch (9.53%). There was no significant interaction between the two factors analyzed (surface and fatigue). Therefore, the aforementioned surface effect, which occurs independently of the fatigue state, should be taken into account when interpreting the results of studies that use the treadmill in their experimental protocols, and when prescribing physical exercise on a treadmill.

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

    Science.gov (United States)

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

    2014-12-18

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-04-15

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

  18. The effects of passive stretching plus vibration on strength and activation of the plantar flexors.

    Science.gov (United States)

    Miller, Jonathan D; Herda, Trent J; Trevino, Michael A; Mosier, Eric M

    2016-09-01

    This study examined the effects of passive stretching only (PS+CON) and passive stretching with the addition of continuous vibration (VIB) during post-passive stretching tests (PS+VIB) on peak torque (PT), percent voluntary inactivation (%VI), single stimulus twitch torque (TTSINGLE), and doublet stimuli twitch torque (TTDOUBLET) of the plantar flexors at a short (20° plantar flexion (PF)) and long muscle length (15° dorsiflexion (DF)). Fourteen healthy men (age = 22 ± 3 years) performed isometric maximal voluntary contractions at PF and DF, and passive range of motion (PROM) assessments before and after 8 × 30-s passive stretches without (PS+CON) or with VIB (PS+VIB) administered continuously throughout post-passive stretching tests. The passive properties of the muscle tendon unit were assessed pre- and post-passive stretching via PROM, passive torque (PASSTQ), and musculotendinous stiffness (MTS) measurements. PT, TTSINGLE, and TTDOUBLET decreased, whereas, %VI increased following passive stretching at PF and DF (P stretching during both trials (P stretching-induced force/torque deficit and increases in %VI were evident following passive stretching at short and long muscle lengths. Although not statistically significant, effect size calculations suggested large and moderate differences in the absolute changes in PT (Cohen's d = 1.14) and %VI (Cohen's d = 0.54) from pre- to post-passive stretching between treatments, with PS+VIB having greater decreases of PT and higher %VI than PS+CON. The decrement in PT following passive stretching may be primarily neural in origin.

  19. Unilateral Plantar Flexors Static-Stretching Effects on Ipsilateral and Contralateral Jump Measures

    Directory of Open Access Journals (Sweden)

    Josinaldo Jarbas da Silva, David George Behm, Willy Andrade Gomes, Fernando Henrique Domingues de Oliveira Silva, Enrico Gori Soares, Érica Paes Serpa, Guanis de Barros Vilela Junior, Charles Ricardo Lopes, Paulo Henrique Marchetti

    2015-06-01

    Full Text Available The aim of this study was to evaluate the acute effects of unilateral ankle plantar flexors static-stretching (SS on the passive range of movement (ROM of the stretched limb, surface electromyography (sEMG and single-leg bounce drop jump (SBDJ performance measures of the ipsilateral stretched and contralateral non-stretched lower limbs. Seventeen young men (24 ± 5 years performed SBDJ before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch unilateral ankle plantar flexor SS (6 sets of 45s/15s, 70-90% point of discomfort. SBDJ performance measures included jump height, impulse, time to reach peak force, contact time as well as the sEMG integral (IEMG and pre-activation (IEMGpre-activation of the gastrocnemius lateralis. Ankle dorsiflexion passive ROM increased in the stretched limb after the SS (pre-test: 21 ± 4° and post-test: 26.5 ± 5°, p < 0.001. Post-stretching decreases were observed with peak force (p = 0.029, IEMG (P<0.001, and IEMGpre-activation (p = 0.015 in the stretched limb; as well as impulse (p = 0.03, and jump height (p = 0.032 in the non-stretched limb. In conclusion, SS effectively increased passive ankle ROM of the stretched limb, and transiently (less than 10 minutes decreased muscle peak force and pre-activation. The decrease of jump height and impulse for the non-stretched limb suggests a SS-induced central nervous system inhibitory effect.

  20. Ambulatory assessment of 3D ground reaction force using plantar pressure distribution.

    Science.gov (United States)

    Rouhani, H; Favre, J; Crevoisier, X; Aminian, K

    2010-07-01

    This study aimed to use the plantar pressure insole for estimating the three-dimensional ground reaction force (GRF) as well as the frictional torque (T(F)) during walking. Eleven subjects, six healthy and five patients with ankle disease participated in the study while wearing pressure insoles during several walking trials on a force-plate. The plantar pressure distribution was analyzed and 10 principal components of 24 regional pressure values with the stance time percentage (STP) were considered for GRF and T(F) estimation. Both linear and non-linear approximators were used for estimating the GRF and T(F) based on two learning strategies using intra-subject and inter-subjects data. The RMS error and the correlation coefficient between the approximators and the actual patterns obtained from force-plate were calculated. Our results showed better performance for non-linear approximation especially when the STP was considered as input. The least errors were observed for vertical force (4%) and anterior-posterior force (7.3%), while the medial-lateral force (11.3%) and frictional torque (14.7%) had higher errors. The result obtained for the patients showed higher error; nevertheless, when the data of the same patient were used for learning, the results were improved and in general slight differences with healthy subjects were observed. In conclusion, this study showed that ambulatory pressure insole with data normalization, an optimal choice of inputs and a well-trained nonlinear mapping function can estimate efficiently the three-dimensional ground reaction force and frictional torque in consecutive gait cycle without requiring a force-plate.

  1. Towards a standard for the dynamic measurement of pressure based on laser absorption spectroscopy

    Science.gov (United States)

    Douglass, K. O.; Olson, D. A.

    2016-06-01

    We describe an approach for creating a standard for the dynamic measurement of pressure based on the measurement of fundamental quantum properties of molecular systems. From the linewidth and intensities of ro-vibrational transitions we plan on making an accurate determination of pressure and temperature. The goal is to achieve an absolute uncertainty for time-varying pressure of 5% with a measurement rate of 100 kHz, which will in the future serve as a method for the traceable calibration of pressure sensors used in transient processes. To illustrate this concept we have used wavelength modulation spectroscopy (WMS), due to inherent advantages over direct absorption spectroscopy, to perform rapid measurements of carbon dioxide in order to determine the pressure. The system records the full lineshape profile of a single ro-vibrational transition of CO2 at a repetition rate of 4 kHz and with a systematic measurement uncertainty of 12% for the linewidth measurement. A series of pressures were measured at a rate of 400 Hz (10 averages) and from these measurements the linewidth was determined with a relative uncertainty of about 0.5% on average. The pressures measured using WMS have an average difference of 0.6% from the absolute pressure measured with a capacitance diaphragm sensor.

  2. [Arterial pressure-based cardiac output monitoring: 1. FloTrac sensor and SVV].

    Science.gov (United States)

    Seo, Katsuhiro

    2009-07-01

    FloTrac is a recently introduced semi-invasive arterial pressure-based cardiac output (APCO) monitoring device. The accuracy of a new device is usually evaluated by Bland-Altman method, which shows graphically the mean value of differences between a new method and the reference method (bias), standard deviation of the differences (precision) and limits of agreement or 2 standard deviations. Critchley et al calculated the percentage errors which are two standard deviations divided by mean cardiac output, and proposed that percentage error should be less than 30% as a reliable new method. Cardiac output was measured by FloTrac (APCO) and pulmonary arterial catheter-based thermodilution method (ICO) during off-pump coronary artery bypass and resection of pheochromocytoma, procedures associated with hemodynamically unstable conditions. As algorithm is renewed in a new version of the device, the accuracy of the device is improved; bias, precision and limits of agreement decreased; correlation coefficient increased, and percentage error was assessed to be around 30%. On the other hand, there was a tendency for increased negative bias as cardiac output increased, implying APCO tends to underestimate ICO in high CO ranges. APCO is less invasive and could rapidly respond to fast changes of hemodynamic state. FloTrac is expected to become a reliable cardiac output monitoring device even under hemodynamically unstable conditions. Further improvement of the algorithm is anticipated.

  3. Towards a standard for the dynamic measurement of pressure based on laser absorption spectroscopy.

    Science.gov (United States)

    Douglass, K O; Olson, D A

    2016-06-01

    We describe an approach for creating a standard for the dynamic measurement of pressure based on the measurement of fundamental quantum properties of molecular systems. From the linewidth and intensities of ro-vibrational transitions we plan on making an accurate determination of pressure and temperature. The goal is to achieve an absolute uncertainty for time-varying pressure of 5 % with a measurement rate of 100 kHz, which will in the future serve as a method for the traceable calibration of pressure sensors used in transient processes. To illustrate this concept we have used wavelength modulation spectroscopy (WMS), due to inherent advantages over direct absorption spectroscopy, to perform rapid measurements of carbon dioxide in order to determine the pressure. The system records the full lineshape profile of a single ro-vibrational transition of CO2 at a repetition rate of 4 kHz and with a systematic measurement uncertainty of 12 % for the linewidth measurement. A series of pressures were measured at a rate of 400 Hz (10 averages) and from these measurements the linewidth was determined with a relative uncertainty of about 0.5 % on average. The pressures measured using WMS have an average difference of 0.6 % from the absolute pressure measured with a capacitance diaphragm sensor.

  4. Significance of Plantar Pressure Balance and Gait Stability in Early Prevention and Cure of Diabetic Foot%平衡足底压力及稳定步态在早期糖尿病足防治中的意义

    Institute of Scientific and Technical Information of China (English)

    胡伊玢; 孟晓静

    2013-01-01

    patients ( Wanger classification = 0 ) were divided randomly into groups therapy and control, 21 in each. Belgian - footscan(R) plantar pressure gait detection system was used to monitor dynamical plantar pressure and static impulse in 2 groups, and then made personalized programs to balance plantar pressure based on the monitoring data in therapy group. Control group received conventional treatment without personalized programs. Two groups were followed up for 1 year, to observe the plantar pressure, gait stability curve, incidence of foot ulcers, impulse before and after treatment. Results No significant difference in plantar pressure between 2 groups before treatment ( P > 0. 05 ). After 1 year of treatment, the pretreatment pressures of the 3rd, 4th, 5th metatarsal base of control group were higher than those in control group before treatment and those in therapy group after treatment, the differences were significant ( P 0. 05 ). After treatment, the gait balance curve fluctuated remarkably and gravity pressure distribution curve was a little short of smoothness ( namely gait stability was not good ) in control group, while in therapy group no obvious fluctuation was noted, the plantar pressure distribution was balanced. The incidences of foot ulcers were 42. 9% ( 9/21 ) in control group, 14. 3% ( 3/ 21 ) in therapy group, the difference was significant ( P 65% [ 42. 9% ( 9/21 ) vs. 14. 3% ( 3/21 ) ] between control group and therapy group ( P > 0. 05 ). Conclusion Plantar pressure change is one of the important causes of diabetic foot ulcers. Early detection and evaluation of plantar pressure of diabetic patients is very important, and positive and effective measures to balance plantar pressure can reduce incidence of foot ulcers, to decrease amputation rate from source to guarantee the quality of life of diabetes patients.

  5. Magnetic resonance imaging of lesions to the superficial plantar aponevrosis; Imagerie par resonance magnetique des lesions de l`aponevrose plantaire superficielle

    Energy Technology Data Exchange (ETDEWEB)

    Helie, O.; Dubayle, P.; Boyer, B.; Pharaboz, C. [Hopital des Armees Begin, 94 - Saint-Mande (France)

    1995-01-01

    MRI is an efficient imaging modality to establish the diagnosis of plantar fascia tear and planta fasciitis. MRI allows to differentiate recent rupture from scar and fasciitis. (authors). 13 refs., 6 figs.

  6. Topical pyruvic acid (70% versus topical salicylic acid (16.7% compound in treatment of plantar warts: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Zabihollah Shahmoradi

    2015-01-01

    Conclusion: Topical pyruvic acid and compound salicylic acid had the same efficacy and complications in treating plantar warts. Decision for choosing the treatment can be made based on the costs and individual factors as well as patients preferences.

  7. [Anesthesia management of geriatric patients with arterial pressure-based cardiac output monitoring FloTrac sensor for emergency surgery].

    Science.gov (United States)

    Yamamoto, Shunsuke; Goto, Koji; Yasuda, Norihisa; Kusaka, Junya; Hidaka, Seigo; Miyakawa, Hiroshi; Noguchi, Takayuki

    2009-06-01

    In cases of emergency surgery for geriatric patients, immediate anesthesia induction and careful intraoperative management is necessary without sufficient preoperative information. We report anesthesia management of a 96-year and a 90-year old patients with FloTrac sensor which is an arterial pressure-based cardiac output monitoring device and is able to manage critical patients effectively and safely during anesthesia.

  8. Stenosing Tenosynovitis of the Flexor Hallucis Longus Tendon Associated with the Plantar Capsular Accessory Ossicle at the Interphalangeal Joint of the Great Toe

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    Song Ho Chang

    2017-01-01

    Full Text Available This report presents a case of stenosing tenosynovitis of the flexor hallucis longus tendon associated with the plantar capsular accessory ossicle at the interphalangeal joint of the great toe, which was confirmed by intraoperative observation and was successfully treated with surgical resection of the ossicle. As the plantar capsular accessory ossicle was not visible radiographically due to the lack of ossification, ultrasonography was helpful for diagnosing this disorder.

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

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    Malindu Eranga Fernando

    Full Text Available AIMS: Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. METHODS: Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP and pressure time integral (PTI were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310. RESULTS: Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290-0.811, p<0.001; and 0.762, 95% CI 0.303-1.221, p = 0.001, respectively. Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181- 0.753, p = 0.001. Statistical heterogeneity between studies was moderate. CONCLUSIONS: Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic

  10. Stenosing Tenosynovitis of the Flexor Hallucis Longus Tendon Associated with the Plantar Capsular Accessory Ossicle at the Interphalangeal Joint of the Great Toe

    Science.gov (United States)

    Chang, Song Ho; Naito, Masashi

    2017-01-01

    This report presents a case of stenosing tenosynovitis of the flexor hallucis longus tendon associated with the plantar capsular accessory ossicle at the interphalangeal joint of the great toe, which was confirmed by intraoperative observation and was successfully treated with surgical resection of the ossicle. As the plantar capsular accessory ossicle was not visible radiographically due to the lack of ossification, ultrasonography was helpful for diagnosing this disorder. PMID:28255483

  11. Treatment Outcomes of Corticosteroid Injection and Extracorporeal Shock Wave Therapy as Two Primary Therapeutic Methods for Acute Plantar Fasciitis: A Prospective Randomized Clinical Trial.

    Science.gov (United States)

    Mardani-Kivi, Mohsen; Karimi Mobarakeh, Mahmoud; Hassanzadeh, Zabihallah; Mirbolook, Ahmadreza; Asadi, Kamran; Ettehad, Hossein; Hashemi-Motlagh, Keyvan; Saheb-Ekhtiari, Khashayar; Fallah-Alipour, Keyvan

    2015-01-01

    The outcome of corticosteroid injection (CSI) and extracorporeal shock wave therapy (ESWT) as primary treatment of acute plantar fasciitis has been debated. The purpose of the present study was to evaluate and compare the therapeutic effects of CSI and ESWT in patients with acute ( .05). Both ESWT and CSI can be used as the primary and/or initial treatment option for treating patients with acute plantar fasciitis; however, the CSI technique had better therapeutic outcomes.

  12. Avaliação funcional do equilíbrio e da sensibilidade cutânea plantar de idosos moradores na comunidade Balance and plantar cutaneous sensitivity functional assessment in community-dwelling elderly

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    Onivaldo Bretan

    2010-04-01

    Full Text Available Desequilíbrio é um dos muitos fatores de risco que aumenta a susceptibilidade de um idoso a quedas. O equilíbrio pode ser avaliado mediante testes posturais e de sensibilidade plantar. OBJETIVO: Avaliar a ocorrência de desequilíbrio e perda de sensibilidade cutânea plantar em idosos da comunidade e verificar a existência de associação entre ambas as alterações. CASUÍSTICA E MÉTODOS: Estudo transversal descritivo envolvendo 45 idosos submetidos à escala de equilíbrio de Berg (EEB e ao teste de sensibilidade plantar com monofilamento de nylon. Foram utilizados os testes qui-quadrado e exato de Fisher e elaboradas curvas ROC para estudo da sensibilidade e especificidade da EEB. RESULTADOS: Idosos com alteração do equilíbrio e da sensibilidade cutânea foram em número de 2 e 4, respectivamente. Houve associação significativa entre queixa de desequilíbrio e perda da sensibilidade (p = 0,047 e ocorreu concordância razoável (Kappa: 0,6457 entre a EEB e o teste da sensibilidade. Verificou-se também associação significativa entre 6 dos 14 tarefas da EEB e o teste sensorial. CONCLUSÃO: Idosos vivendo com independência na comunidade, em sua maioria, apresentam equilíbrio e sensibilidade cutânea plantar normais. Quando alteradas estas funções mostram-se associadas de forma que, se os testes forem realizados conjuntamente, a precisão da avaliação do equilíbrio idoso aumenta.Impaired balance is one of several factors that increase an elderly's susceptibility to falls. Balance assessment can be performed using postural tests and plantar cutaneous sensitivity tests. AIM: To assess balance disorders and loss of plantar cutaneous sensitivity in the elderly and look for association between these alterations. MATERIALS AND METHODS: A descriptive cross-sectional study involving 45 elderly submitted to the Berg Balance Scale (BBS and the plantar sensitivity test with nylon monofilament. We used chi-square and Fisher's exact tests

  13. Validation of a continuous, arterial pressure-based cardiac output measurement: a multicenter, prospective clinical trial.

    Science.gov (United States)

    McGee, William T; Horswell, Jeffrey L; Calderon, Joachim; Janvier, Gerard; Van Severen, Tom; Van den Berghe, Greet; Kozikowski, Lori

    2007-01-01

    The present study compared measurements of cardiac output by an arterial pressure-based cardiac output (APCO) analysis method with measurement by intermittent thermodilution cardiac output (ICO) via pulmonary artery catheter in a clinical setting. The multicenter, prospective clinical investigation enrolled patients with a clinical indication for cardiac output monitoring requiring pulmonary artery and radial artery catheters at two hospitals in the United States, one hospital in France, and one hospital in Belgium. In 84 patients (69 surgical patients), the cardiac output was measured by analysis of the arterial pulse using APCO and was measured via pulmonary artery catheter by ICO; to establish a reference comparison, the cardiac output was measured by continuous cardiac output (CCO). Data were collected continuously by the APCO and CCO technologies, and at least every 4 hours by ICO. No clinical interventions were made as part of the study. For APCO compared with ICO, the bias was 0.20 l/min, the precision was +/- 1.28 l/min, and the limits of agreement were -2.36 l/m to 2.75 l/m. For CCO compared with ICO, the bias was 0.66 l/min, the precision was +/- 1.05 l/min, and the limits of agreement were -1.43 l/m to 2.76 l/m. The ability of APCO and CCO to assess changes in cardiac output was compared with that of ICO. In 96% of comparisons, APCO tracked the change in cardiac output in the same direction as ICO. The magnitude of change was comparable 59% of the time. For CCO, 95% of comparisons were in the same direction, with 58% of those changes being of similar magnitude. In critically ill patients in the intensive care unit, continuous measurement of cardiac output using either APCO or CCO is comparable with ICO. Further study in more homogeneous populations may refine specific situations where APCO reliability is strongest.

  14. EFFECT OF KINESIO TAPING IN ADJUNCT TO CONVENTIONAL THERAPY IN REDUCING PAIN AND IMPROVING FUNCTIONAL ABILITY IN INDIVIDUALS WITH PLANTAR FASCIITIS A RANDOMIZED CONTROLLED TRIAL

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    S.Tulasi Ratna

    2015-08-01

    Full Text Available Background: Plantar fasciitis is one of the most common musculoskeletal disorders of foot. The pain and discomfort associated with this condition has a dramatic impact on physical mobility and function. Treatment of this condition is usually conservative; however, review of literature revealed no clinical studies demonstrating the efficacy of any targeted treatment for this condition. Methods: This was a prospective study which included 60 subjects with plantar fasciitis, who were randomly divided into two groups. Subjects in group I received ultrasound and exercise therapy while subjects in group II received kinesio tape in addition to ultrasound and exercise therapy. Patients were evaluated at the beginning of the study and at the end of three weeks using VAS (visual analogue scale for pain intensity, PFPS (plantar fasciitis pain / disability scale for functional ability and ultra sonography for any change in the caliber of plantar fascia. Results: A statistically significant difference in improvement was noted within the groups and between the groups in terms of visual analogue scale and plantar fasciitis pain /disability scale score (p0.05. Conclusion: Kinesio taping can be used as an adjunct to conventional therapy in clinical application for greater improvement in pain levels and functional ability in patients with plantar fasciitis.

  15. Use of high-resolution ultrasound to measure changes in plantar fascia thickness resulting from tissue creep in runners and walkers.

    Science.gov (United States)

    Welk, Aaron B; Haun, Daniel W; Clark, Thomas B; Kettner, Norman W

    2015-01-01

    This study sought to use high-resolution ultrasound to measure changes in plantar fascia thickness as a result of tissue creep generated by walking and running. Independent samples of participants were obtained. Thirty-six walkers and 25 runners walked on a treadmill for 10 minutes or ran for 30 minutes, respectively. Standardized measures of the thickness of the plantar fascia were obtained in both groups using high-resolution ultrasound. The mean thickness of the plantar fascia was measured immediately before and after participation. The mean plantar fascia thickness was decreased by 0.06 ± 0.33 mm SD after running and 0.03 ± 0.22 mm SD after walking. The difference between groups was not significant. Although the parameters of this study did not produce significant changes in the plantar fascia thickness, a slightly higher change in the mean thickness of the plantar fascia in the running group deserves further investigation. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  16. Self-induced plantar-flexion objectively reduces wave amplitude of detrusor overactivity and subjectively improve urinary urgency: a pilot study.

    Science.gov (United States)

    Stav, Kobi; Leibovici, Dan; Yoram, Siegel I; Ronny, Ohlgisser; Zisman, Amnon

    2014-11-01

    To estimate the effect of plantar-flexion on the wave amplitude of involuntary detrusor contraction and the severity of urinary urgency during filling cystometry in patients with detrusor overactivity (DO). Twenty-two consecutive patients with DO were enrolled. During urodynamics, the mean peak detrusor pressures of each contraction were documented and compared. At the beginning of the 2nd or 3rd wave, patients were asked to perform continuous plantar-flexion by pushing their tiptoes against the floor. Following each wave, patients were asked to grade the severity of the urgency by a visual analogue scale (VAS). The mean peak detrusor pressure without plantar-flexion was 58 cmH2 O (95% CI: 46.3-69.7) compared to 31 cmH2 O (95% CI: 23.1-38.9) with plantar-flexion (P < 0.001). All patients reported a reduced degree of urgency during plantar-flexion reflected in a significant reduction in mean VAS score from 9.3 (95% CI: 9-9.5) to 4.7 (95% CI: 3.9-5.4; P < 0.0001). Self-performed plantar-flexion maneuver might reduce the severity of urinary urgency and the magnitude of overactive detrusor contractions, which may have a role in the conservative therapy of detrusor overactivity. © 2013 Wiley Periodicals, Inc.

  17. Telangiectasia hemorrágica hereditária: ácido tranexâmico no tratamento de úlcera plantar Hereditary hemorrhagic telangiectasia: tranexamic acid for plantar ulcer

    Directory of Open Access Journals (Sweden)

    Gabriella Corrêa de Albuquerque

    2005-12-01

    Full Text Available Relato de um caso de úlcera plantar por fístula arteriovenosa em paciente portador de telangiectasia hemorrágica hereditária ou doença de Rendu-Osler-Weber tratado com ácido tranexâmico. Este fármaco é utilizado para tratamento de epistaxe, referindo-se o principal achado deste artigo ao uso eficaz desse medicamento na terapia de úlceras plantares hemorrágicas. São descritos os aspectos fisiopatológicos e clínicos da doença e as propriedades antifibrinolíticas do ácido tranexâmico. Este foi bem tolerado e apresentou evidências de eficácia na utilização para controle do sangramento e cicatrização da úlcera.Case report of one patient with Hereditary Hemorrhagic Telangiectasia, also known as Rendu-Osler-Weber syndrome, treated with Tranexamic Acid for arteriovenous plantar ulcer. This drug has proved effective in controlling epistaxis, but the main point of this report is to expose the success use of this medication in the therapy of skin bleeding ulcer. The pathophysiologic and clinical features of the disease are reviewed and also the pharmacological aspects of the antifibrinolytic drugs. This drug was well tolerated by the patient and show evidence of good activity in the bleeding and healed the ulcer.

  18. Kinaesthetic ipsilateral and crossed extensor plantar response: A new way to elicit upgoing toe sign (Babinski response?

    Directory of Open Access Journals (Sweden)

    Abraham Kuruvilla

    2011-01-01

    Full Text Available We describe a phenomenon of "kinaesthetic extensor plantar response" in advanced pyramidal dysfunction, an interesting observation noted in a patient with dorsal myelopathy. A 44-year-old woman presented with one-year history of gradually progressive weakness and stiffness of both lower limbs along with urge incontinence of urine. Examination showed spontaneous elicitation of extensor plantar response while assessing the tone by rolling method as well as on noxious stimulation of the thigh. Magnetic resonance imaging (MRI of the dorsal spine and digital subtraction angiography showed the presence of spinal dural arteriovenous fistula causing myelopathy. This case exemplifies the fact that in advanced pyramidal dysfunction, not only the receptive field of Babinski reflex may extend to the leg or thigh, but may also integrate with other modalities of stimulation, such as the rolling movement. The possible underlying pathophysiology of such a phenomenon is discussed.

  19. Kinaesthetic ipsilateral and crossed extensor plantar response: A new way to elicit upgoing toe sign (Babinski response)?

    Science.gov (United States)

    Kuruvilla, Abraham; Wattamwar, Pandurang R

    2011-07-01

    We describe a phenomenon of "kinaesthetic extensor plantar response" in advanced pyramidal dysfunction, an interesting observation noted in a patient with dorsal myelopathy. A 44-year-old woman presented with one-year history of gradually progressive weakness and stiffness of both lower limbs along with urge incontinence of urine. Examination showed spontaneous elicitation of extensor plantar response while assessing the tone by rolling method as well as on noxious stimulation of the thigh. Magnetic resonance imaging (MRI) of the dorsal spine and digital subtraction angiography showed the presence of spinal dural arteriovenous fistula causing myelopathy. This case exemplifies the fact that in advanced pyramidal dysfunction, not only the receptive field of Babinski reflex may extend to the leg or thigh, but may also integrate with other modalities of stimulation, such as the rolling movement. The possible underlying pathophysiology of such a phenomenon is discussed.

  20. Surgical Treatment of a Case of Ledderhose’s Disease: A Safe Plantar Approach to Subtotal Fasciectomy

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    Bruno Gonçalves Schröder e Souza

    2015-01-01

    Full Text Available Plantar fibromatosis, Ledderhose’s disease, or Morbus Ledderhose is an uncommon benign nodular hyperplasia of the plantar aponeurosis. The aim of this paper was to report the case of a 47-year-old male patient who had concomitant Dupuytren’s disease and failed all conservative measures. He was treated surgically with prompt and complete relief of symptoms postoperatively, and he has had no recurrence at the 2-year follow-up. In this richly documented case, we discuss details of the surgical technique and anatomy, which was important for a successful outcome and preventing complications. The technique for subtotal fasciectomy is reviewed and the relevance of the adequate choice of skin incision to prevent painful scarring, skin necrosis, and difficulties with shoe wearing is highlighted.

  1. [Analgesic effect of low energy extracorporeal shock waves in tendinosis calcarea, epicondylitis humeri radialis and plantar fasciitis].

    Science.gov (United States)

    Maier, M; Dürr, H R; Köhler, S; Staupendahl, D; Pfahler, M; Refior, H J; Meier, M

    2000-01-01

    Is there a pain reduction at the application site after extracorporeal shockwave application for tendinitis calcarea, epicondylitis radialis and plantar fasziitis? In a prospective study 85 patients were observed. Shockwave application was performed three or five times using low energies (0.09-0.18 ml/mm2). Before and after shockwave application pain was evaluated using SF-36 score and Visual Analog Scale (VAS). After 5 months for all three indications a significant improvement of the pain situation could be reached. Patients with plantar fasziitis demonstrated the highest decrease of pain, followed by tendinosis calcarea and epicondylitis radialis. The number of applications had no influence to the clinical result of the ESWT. In the present study the analgetic effect of ESWT after repeated low-energy application was described for the standard indications.

  2. Contributions of knee swing initiation and ankle plantar flexion to the walking mechanics of amputees using a powered prosthesis.

    Science.gov (United States)

    Ingraham, Kimberly A; Fey, Nicholas P; Simon, Ann M; Hargrove, Levi J

    2014-01-01

    Recently developed powered prostheses are capable of producing near-physiological joint torque at the knee and/or ankle joints. Based on previous studies of biological joint impedance and the mechanics of able-bodied gait, an impedance-based controller has been developed for a powered knee and ankle prosthesis that integrates knee swing initiation and powered plantar flexion in late stance with increasing ankle stiffness throughout stance. In this study, five prosthesis configuration conditions were tested to investigate the individual contributions of each sub-strategy to the overall walking mechanics of four unilateral transfemoral amputees as they completed a clinical 10-m walk test using a powered knee and ankle prosthesis. The baseline condition featured constant ankle stiffness and no swing initiation or powered plantar flexion. The four remaining conditions featured knee swing initiation alone (SI) or in combination with powered plantar flexion (SI+PF), increasing ankle stiffness (SI+IK), or both (SI+PF+IK). Self-selected walking speed did not significantly change between conditions, although subjects tended to walk the slowest in the baseline condition compared to conditions with swing initiation. The addition of powered plantar flexion resulted in significantly higher ankle power generation in late stance irrespective of ankle stiffness. The inclusion of swing initiation resulted in a significantly more flexed knee at toe off and a significantly higher average extensor knee torque following toe off. Identifying individual contributions of intrinsic control strategies to prosthesis biomechanics could help inform the refinement of impedance-based prosthesis controllers and simplify future designs of prostheses and lower-limb assistive devices alike.

  3. Effect of Transcutaneous Electrical Nerve Stimulation on Plantar Flexor Muscle Spasticity and Walking Speed in Stroke Patients.

    Science.gov (United States)

    Laddha, Darshan; Ganesh, G Shankar; Pattnaik, Monalisa; Mohanty, Patitapaban; Mishra, Chittaranjan

    2016-12-01

    Spasticity is a major disabling symptom in patients post stroke. Although studies have demonstrated that transcutaneous electrical nerve stimulation (TENS) can reduce spasticity, the duration of single session TENS is a subject of debate. The purpose of this study was to determine the sustainability of the effects of TENS applied over common peroneal nerve in the reduction of ankle plantar-flexor spasticity and improving gait speed in patients post stroke. Thirty patients (11 women and 19 men) (mean age of 46.46 years) were randomly assigned to group 1 (task oriented exercises), group 2 (TENS for 30 min and task oriented exercises) and group 3 (TENS for 60 min and task oriented exercises) for a period of five sessions per week for 6 weeks. All patients were assessed for ankle plantar-flexor spasticity, passive ankle dorsi-flexion range of motion, clonus and timed up and go test at the time of recruitment to study, at 3 and 6 weeks of therapeutic intervention. The overall results of the study suggest that there was a decrease in ankle plantar flexor spasticity, ankle clonus and timed up and go score in all the groups. A greater reduction of spasticity was seen in TENS groups (groups 2 and 3) when compared to control. No significant improvement was found in timed up and go test (TUG) scores between groups. Both 30 min and 60 min of application of TENS are effective in reducing spasticity of ankle plantar flexors, improving walking ability and increase the effectiveness of task related training. Based on the effect size, we would recommend a longer duration application for the reduction of spasticity. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  4. Why person affected by leprosy did not look after their plantar ulcer? Experience from Pakokku zone, Myanmar.

    Science.gov (United States)

    Win, Le Le; Shwe, San; Maw, Win; Ishida, Yutaka; Myint, Kyaw; Mar, Kyi Kyi; Min, Thandar; Oo, Phyo Min; Khine, Aye Win

    2010-09-01

    A cross-sectional study was carried out to identify methods of caring plantar ulcers in leprosy patients and the underlying causes of poor plantar ulcer care during January and February 2008. This was conducted in Pakokku zone as it was one of the "9 selected townships of the Disabilities survey, i.e., Basic Health Staff project 2003/4", which was funded by Japan International Cooperation Agency. After getting consent, all available leprosy cases, i.e., 101 cases with foot disability grade 2 were interviewed with the pre-tested questionnaire. Among 101 cases, 13 cases who took care of their ulcer poorly and 20 who did none of the recommended measures were recruited for in-depth interview (IDI). The subjects were largely old people, males and people with no marriage partner. The majority had earned money by doing sedentary job. Prolongation of ulcers was observed in 78 cases. Most had been suffering from ulcers for years. When asking face-to-face interview, all the recommended care measures were not reported. Among these recommended measures, a large number of respondents reported about soaking measure. However, these reported measures were contradicted to the preventive methods which they disclosed in IDI. Plantar ulcer care seemed to be an individualised practice. The individual ways of performing were related to their view of ulcer, the environment, and occupation, and custom, communication with family and health staff. The findings identified the actual practice of plantar ulcer care in study areas. It is suggested that the current performance of planar ulcer care is inadequate and more attention should be given to achieve the target set by the programme as a recommendation.

  5. Preserving plantar flexion strength after surgical treatment for contracture of the triceps surae: a computer simulation study.

    Science.gov (United States)

    Delp, S L; Statler, K; Carroll, N C

    1995-01-01

    Contractures of the triceps surae commonly are treated by surgical lengthening of the gastrocnemius aponeurosis or the Achilles tendon. Although these procedures generally relieve contractures, patients sometimes are left with dramatically decreased plantar flexion strength (i.e., decreased capacity to generate plantar flexion moment). The purpose of this study was to examine the trade-off between restoring range of motion and maintaining plantar flexion strength after surgical treatment for contracture of the triceps surae. A computer model representing the normal moment-generating characteristics of the triceps surae was altered to represent two conditions: isolated contracture of the gastrocnemius and contracture of both the gastrocnemius and the soleus. The effects of lengthening the gastrocnemius aponeurosis and the Achilles tendon were simulated for each condition. The simulations showed that nearly normal moment-generating characteristics could be restored when isolated gastrocnemius contracture was treated with lengthening of the gastrocnemius aponeurosis. However, when isolated gastrocnemius contracture was treated with lengthening of the Achilles tendon, the moment-generating capacity of the plantar flexors decreased greatly. This suggests that lengthening of the Achilles tendon should be avoided in persons with isolated gastrocnemius contracture. Our simulations also suggest that neither lengthening of the gastrocnemius aponeurosis nor lengthening of the Achilles tendon by itself is an effective treatment for combined contracture of the gastrocnemius and soleus. Lengthening the gastrocnemius aponeurosis did not decrease the excessive passive moment developed by the contracted soleus. Lengthening the Achilles tendon restored the normal passive range of motion but substantially decreased the active force-generating capacity of the muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Pulsed dye laser versus Nd:YAG laser in the treatment of plantar warts: a comparative study.

    Science.gov (United States)

    El-Mohamady, Abd El-Shakor; Mearag, Ibrahim; El-Khalawany, Mohamed; Elshahed, Ahmed; Shokeir, Hisham; Mahmoud, Anas

    2014-05-01

    Plantar warts are common viral infection that are usually challenging in treatment. Conventional treatment methods are usually invasive, have low efficacy, and need long recovery periods. In this study, we compared pulsed dye laser (PDL) and neodymium yttrium aluminum garnet (Nd:YAG) lasers in the treatment of recalcitrant plantar warts. The study included 46 patients with multiple plantar warts. In each patient, lesions were divided into two groups: one treated with Nd:YAG (spot size, 7 mm; energy, 100 J/cm(2); and pulse duration, 20 ms) and the other with PDL (spot size, 7 mm; energy, 8 J/cm(2); and pulse duration, 0.5 ms). Laser sessions were applied every 2 weeks with maximum of six sessions. The study included 63% males and 37% females with a mean age of 29.6 ± 7.34 years. The cure rate was 73.9% with PDL with no significant difference (p = 0.87) from Nd:YAG (78.3%). The number of sessions required was more in PDL (mean, 5.05 ± 0.2) compared with Nd:YAG (mean, 4.65 ± 0.5) but without significant difference. Complications were significantly higher with Nd:YAG (43.5%) compared with PDL (8.7%). Hematoma was the most common complication recorded by Nd:YAG (28.3 %), and it was significantly higher (p = 0.002) than PDL (2.2%). Relapse was recorded in 8.7% with Nd:YAG compared with 13% in PDL with no significant difference (p = 0.74). Our results suggested that PDL and Nd:YAG lasers are effective in the treatment of resistant plantar warts. PDL is safer and less painful but needs more sessions, while Nd:YAG is more painful and shows more complications.

  7. Gait cycle and plantar pressure distribution in children with cerebral palsy: clinically useful outcome measures for a management and rehabilitation.

    Science.gov (United States)

    Nsenga Leunkeu, Angeline; Lelard, Thierry; Shephard, Roy J; Doutrellot, Pierre-Louis; Ahmaidi, Said

    2014-01-01

    Information on altered foot pressures during ambulation would clarify how far limb deformities modify walking patterns in cerebral palsy (CP), and whether such data can inform prognosis and guide rehabilitation. To compare patterns of plantar pressures during walking between children with CP and their able-bodied (AB) peers. Twenty-five children/adolescents (10 with hemiplegia, 5 with diplegia, and 10 AB, respective ages 13.0 ± 1.9, 13.0 ± 0.6 and 14.0 ± 0.7 years) walked a 12 m line at a self-selected speed. Spatio-temporal parameters and peak in-shoe plantar pressures were recorded for both feet, using the Parotec analysis system. Walking speeds (m·-1) differed significantly between groups (0.65 ± 0.13, hemiplegia, 0.93 ± 0.22 diplegia and 1.26 ± 0.05 AB), with shorter stride lengths in CP. Contact time, double support time and step duration were also shorter in hemiplegia. Plantar pressures differed substantially and consistently between AB and CP, with increased medial heel pressures in hemiplegia, and reduced hallux and lateral heel pressures but increased lateral, medial mid-foot and first metatarsal pressures in diplegia. Substantial alterations in spatio-temporal parameters (greater in hemiplegia than in diplegia) and plantar pressure distribution reflect attempts to compensate for poor stability of posture in CP. Further study of these adaptive changes holds clinical promise in providing data relevant to the design of orthotics, determinations of prognosis and the planning of neurorehabilitation.

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

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    Ana Paula Ribeiro

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

  9. The relationship between trans-femoral prosthesis alignment and the center trajectory of plantar pressure in the frontal plane

    OpenAIRE

    Nomura, Tomohiro; Watanabe, Kota; Nosaka, Toshiya; Matsubara, Hiroyuki; Akiyama, Masaharu; Inui, Kimiharu

    2016-01-01

    [Purpose] It is difficult to identify by visual observation whether alignment abnormalities in trans-femoral prostheses in the frontal plane are attributable to the adduction angle or the abnormal alignment of the positions of the medial and lateral sides of the socket in relation to the foot. Therefore, we focused on the trajectory of the center of plantar pressure during walking, and we proposed a method for differentiating these two alignment abnormalities. [Subjects and Methods] We recrui...

  10. Plantar fascia anatomy and its relationship with Achilles tendon and paratenon.

    Science.gov (United States)

    Stecco, Carla; Corradin, Marco; Macchi, Veronica; Morra, Aldo; Porzionato, Andrea; Biz, Carlo; De Caro, Raffaele

    2013-12-01

    Although the plantar fascia (PF) has been studied quite well from a biomechanical viewpoint, its microscopic properties have been overlooked: nothing is known about its content of elastic fibers, the features of the extracellular matrix or the extent of innervation. From a functional and clinical standpoint, the PF is often correlated with the triceps surae muscle, but the anatomical grounds for this link are not clear. The aim of this work was to focus on the PF macroscopic and microscopic properties and study how Achilles tendon diseases might affect it. Twelve feet from unembalmed human cadavers were dissected to isolate the PF. Specimens from each PF were tested with various histological and immunohistochemical stains. In a second stage, 52 magnetic resonance images (MRI) obtained from patients complaining of aspecific ankle or foot pain were analyzed, dividing the cases into two groups based on the presence or absence of signs of degeneration and/or inflammation of the Achilles tendon. The thickness of PF and paratenon was assessed in the two groups and statistical analyses were conducted. The PF is a tissue firmly joined to plantar muscles and skin. Analyzing its possible connections to the sural structures showed that this fascia is more closely connected to the paratenon of Achilles tendon than to the Achilles tendon, through the periosteum of the heel. The PF extended medially and laterally, continuing into the deep fasciae enveloping the abductor hallucis and abductor digiti minimi muscles, respectively. The PF was rich in hyaluronan, probably produced by fibroblastic-like cells described as 'fasciacytes'. Nerve endings and Pacini and Ruffini corpuscles were present, particularly in the medial and lateral portions, and on the surface of the muscles, suggesting a role for the PF in the proprioception of foot. In the radiological study, 27 of the 52 MRI showed signs of Achilles tendon inflammation and/or degeneration, and the PF was 3.43 ± 0.48 mm thick

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

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    Rajan

    2014-04-01

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

  12. Biomechanical consequences of plantar fascial release or rupture during gait: part I--disruptions in longitudinal arch conformation.

    Science.gov (United States)

    Sharkey, N A; Ferris, L; Donahue, S W

    1998-12-01

    To examine whether conformational changes induced by plantar fascial division may progress during gait, we loaded the feet of seven cadavers using an apparatus that simulates the actions of the extrinsic plantarflexors. We measured the effects of plantar fasciotomy at two instants in the terminal-stance phase of gait. Radiographic measurements of height of the arch, base length of the arch, and talo first-metatarsal angle were used to assess contributions to arch support made by the plantar fascia, tibialis posterior, peroneus longus and brevis, and digital flexor muscles. Complete fasciotomy caused significant collapse of the arch in the sagittal plane. Early in terminal stance, at the instant after heel-off, mean height of the arch decreased from 47 to 45 mm. Late in terminal stance, at the instant preceding contralateral heel strike, mean height of the arch decreased from 46 to 43. Effects of division of the central band, though significant, were mild. Medial base length of the arch increased from 163 to 167 mm in the absence of tibialis posterior contraction at late terminal stance. Arch-supporting abilities of the other extrinsic muscles were insignificant.

  13. Muscle oxygenation of superficial and deep regions in knee extensor and plantar flexor muscles during repeated isometric contractions.

    Science.gov (United States)

    Kubo, K

    2015-04-01

    The purpose of this study was to investigate changes in muscle oxygenation of knee extensor and plantar flexor muscles during repeated muscle contractions under the same condition. In addition, we compared changes in muscle oxygenation between superficial and deep regions of both muscles. Eleven healthy males participated in this study. During repeated knee extensions and plantar flexions (50 repetitions at 50% of the isometric maximum voluntary contraction for 3 s with 3 s relaxations), blood volume and oxygen saturation (StO₂) of the vastus lateralis and medial gastrocnemius muscles (superficial and deep region of each muscle) were measured using near infrared spectroscopy. The decrement of StO₂at the end of exercises was greater in plantar flexor muscle than in knee extensor muscle (Pmuscles, the decrement of StO₂at the end of exercises was greater in the deep region than in the superficial one (both Pmuscle and deep regions of each muscle were higher than that of knee extensor muscle and superficial regions of each muscle.

  14. The Analysis of Plantar Pressure Data Based on Multimodel Method in Patients with Anterior Cruciate Ligament Deficiency during Walking

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    Xiaoli Li

    2016-01-01

    Full Text Available The movement information of the human body can be recorded in the plantar pressure data, and the analysis of plantar pressure data can be used to judge whether the human body motion function is normal or not. A two-meter footscan® system was used to collect the plantar pressure data, and the kinetic and dynamic gait characteristics were extracted. According to the different description of gait characteristics, a set of models was established according to various people to present the movement of lower limbs. By the introduction of algorithm in machine learning, the FCM clustering algorithm is used to cluster the sample set and create a set of models, and then the SVM algorithm was used to identify the new samples, so as to complete the normal and abnormal motion function identification. The multimodel presented in this paper was carried out into the analysis of the anterior cruciate ligament deficiency. This method demonstrated being effective and can provide auxiliary analysis for clinical diagnosis.

  15. Effect of plantar subcutaneous administration of bergamot essential oil and linalool on formalin-induced nociceptive behavior in mice.

    Science.gov (United States)

    Katsuyama, Soh; Otowa, Akira; Kamio, Satomi; Sato, Kazuma; Yagi, Tomomi; Kishikawa, Yukinaga; Komatsu, Takaaki; Bagetta, Giacinto; Sakurada, Tsukasa; Nakamura, Hitoshi

    2015-01-01

    This study investigated the effect of bergamot essential oil (BEO) or linalool, a major volatile component of BEO, on the nociceptive response to formalin. Plantar subcutaneous injection of BEO or linalool into the ipsilateral hindpaw reduced both the first and late phases of the formalin-induced licking and biting responses in mice. Plantar subcutaneous injection of BEO or linalool into the contralateral hindpaw did not yield an antinociceptive effect, suggesting that the antinociceptive effect of BEO or linalool in the formalin test occurred peripherally. Intraperitoneal and plantar subcutaneous injection pretreatment with naloxone hydrochloride, an opioid receptor antagonist, significantly attenuated both BEO- and linalool-induced antinociception. Pretreatment with naloxone methiodide, a peripherally acting opioid receptor antagonists, also significantly antagonized the antinociceptive effects of BEO and linalool. Our results provide evidence for the involvement of peripheral opioids in antinociception induced by BEO and linalool. These results suggest that activation of peripheral opioid receptors may play an important role in reducing formalin-induced nociception.

  16. The effect of backpack load on muscle activities of the trunk and lower extremities and plantar foot pressure in flatfoot.

    Science.gov (United States)

    Son, Hohee

    2013-11-01

    [Purpose] The purpose of this study was to investigate the changes in muscle activation of the trunk and lower extremities and plantar foot pressure due to backpack loads of 0, 10, 15, and 20% of body weight during level walking in individuals with flatfoot. [Methods] Fourteen young flatfoot subjects and 12 normal foot subjects participated in this study. In each session, the subjects were assigned to carry a backpack load, and there were four level walking modes: (1) unloaded walking (0%), (2) 10% body weight (BW) load, (3) 15% BW load, and (4) 20% BW load. Trunk and lower extremity muscle activities were recorded by surface EMG, and contact area and plantar foot pressure were determined using a RS scan system. [Results] The erector spinae, vastus medialis, tibialis anterior and gastrocnemius muscle activities, but not the rectus femoris and rectus abdominis muscle activities of flatfoot subjects significantly and progressively increased as load increased in flatfoot subjects. Contact area and pressure of the lateral and medial heel zones were significantly increased too. [Conclusion] Based on this data, the weight of a backpack could influence muscle activation and plantar foot pressure in flatfoot.

  17. School-based screening of plantar pressures during level walking with a backpack among overweight and obese schoolchildren.

    Science.gov (United States)

    Pau, Massimiliano; Leban, Bruno; Corona, Federica; Gioi, Sara; Nussbaum, Maury A

    2016-05-01

    Among children, postural modifications due to backpack carriage have direct consequences on how forces are exchanged between body and ground and thus on plantar pressure distribution. However, it is unknown whether such alterations are influenced by the foot structure and functionality typical of obesity. In this study, we tested 65 overweight/obese primary schoolchildren using a pressure platform while walking with and without the backpack. Contact areas, arch index, peak and mean plantar pressures in the forefoot, midfoot and rearfoot were compared with those from an additional 65 age- and gender-matched group of normal-weight children. Backpack carriage modified pressure distribution similarly in both groups, with the exception of mean midfoot pressure, which increased significantly among normal-weight children but not in the overweight/obese group. Notably, the pressure values associated with mass excess and backpack carriage still raise some concerns regarding potential long-term adverse consequences on foot structure and functionality of overweight/obese children. Practitioner summary: Backpack carriage by overweight/obese schoolchildren altered plantar pressures similar to what was observed in their normal-weight peers. Yet, high pressures were found among the overweight/obese children. This raises concerns regarding potential long-term adverse consequences on foot structure and functionality, and supports establishing more specific limits for the carried load.

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

    Science.gov (United States)

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

    2009-07-01

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

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

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    Peerbooms Joost C

    2010-04-01

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

  20. Greater Reduction of Balance as a Result of Increased Plantar Fascia Elasticity at Ovulation during the Menstrual Cycle.

    Science.gov (United States)

    Petrofsky, Jerrold; Lee, Haneul

    2015-11-01

    One of the sexual hormones, estrogen, increases elasticity of human connective tissue such as the anterior cruciate ligament during the menstrual cycle in women. In the present investigation, the plantar fascia was investigated to see if there is a difference in elasticity with the menstrual cycle. Fifteen young healthy females in the age range of 18-35 years old with a regular menstrual cycle were tested twice throughout one full menstrual cycle; once during the early follicular phases and once at ovulation. Foot length, while standing on both feet and one foot were used to assess plantar fascia elasticity, ultrasound measured plantar fascia thickness while lying and standing, and posture sway and tremor using a balance platform during 8 different balance tests were assessed to see the impact of elasticity changes. Foot length increased significantly at ovulation compared to menstruation when standing on two feet (p = 0.03) and standing on one foot (p fascia in thinning per kilogram weight applied to the foot at ovulation compared to menstruation (p = 0.014). Associated with this increase in elasticity at ovulation, there was a reduction in balance in the most difficult balance tasks and an increase in tremor during ovulation (p fascia elasticity change during the menstrual cycle might have effects on posture sway and tremor, which could have a potential risk of falling. Therefore, healthy professionals working with young female adults should recognize these physiological effects.