The Effects of Foot Intrinsic Muscle and Tibialis Posterior Strengthening Exercise on Plantar Pressure and Dynamic Balance in Adults Flexible Pes Planus

2016 ◽  
Vol 23 (4) ◽  
pp. 27-37 ◽  
Author(s):  
Da-bee Lee ◽  
◽  
Jong-duk Choi
Author(s):  
Koen Andre Horstink ◽  
Lucas Henricus Vincentius van der Woude ◽  
Juha Markus Hijmans

AbstractPatients with diabetic peripheral neuropathy (DPN) usually have reduced somatosensory information and altered perception in feet and ankles. Somatosensory information acts as feedback for movement control and loss of somatosensation leads to altered plantar pressure patterns during gait and stance. Offloading devices are used to reduce peak plantar pressure and prevent diabetic foot ulcers. However, offloading devices can unfortunately have negative effects on static and dynamic balance. It is important to investigate these unwanted effects, since patient with DPN already are at high risk of falling and offloading devices could potentially increase this risk. The aim of this systematic review is to investigate the effects of plantar offloading devices used for ulcer prevention on their role in static and dynamic balance control in patients with DPN. PubMed and Embase were systematically searched using relevant search terms. After title selection, abstract selection, and full-text selection only five articles could be included for further analysis. Two articles included static balance measurements, two articles included dynamic balance measurements, and one article included both. Results suggested that static balance control is reduced when rocker bottom shoes and different insole configurations are used, however, toe-only rockers showed less evidence for reduced static balance control. There was no evidence for reduced dynamic balance control in combination with offloading devices. However, these results should be interpreted with care, since the number of studies was very small and the quality of the studies was moderate. Future research should evaluate balance in combination with different offloading devices, so that clinicians subscribing them are more aware of their potential unwanted consequences.


2018 ◽  
Vol 40 (3) ◽  
pp. 352-355 ◽  
Author(s):  
Eric Swanton ◽  
Lauren Fisher ◽  
Andrew Fisher ◽  
Andrew Molloy ◽  
Lyndon Mason

Background: Weight-bearing radiographic analysis of pes planus deformities show, with varying degree of severity, a break in the Meary line. The break in the Meary line occurs not only at the talonavicular joint but also distal to the spring ligament and reported tibialis posterior insertion. Our aim in this study was to investigate the distal plantar ligaments of the medial longitudinal arch, to try to identify other areas where deformity correction could be affected. Methods: We examined 11 cadaveric lower limbs that had been preserved for dissection in a solution of formaldehyde. The lower limbs were carefully dissected to identify the plantar aspect of the medial longitudinal arch. Results: In all specimens, the tibialis posterior tendon inserted into the plantar medial aspect of the navicular with separate slips to the intermediate and lateral cuneiform. The navicular cuneiform ligament extended from the navicular to medial cuneiform. This structure was statically inserted between the navicular and medial cuneiform, which would allow the pull of the tibialis posterior to act on the navicular and medial cuneiform in tandem. The average width of the naviculocuneiform ligament was 15.2 mm (range 12.4-18.0) compared to 9.5 mm (range 7.6-11.4) for the tibialis posterior tendon. Conclusion: The tibialis posterior tendon inserted into the navicular and continued onto the medial cuneiform to provide a static restraint between 2 bony insertions, thus supporting the distal aspect of the medial longitudinal arch. Clinical Relevance: We are confident that it is a structure of importance in maintaining the distal aspect of the medial longitudinal arch and may therefore have significant clinical and surgical implications when treating the pes planus deformity.


The Foot ◽  
2018 ◽  
Vol 34 ◽  
pp. 83-89 ◽  
Author(s):  
Mira Pecheva ◽  
Adam Devany ◽  
Basil Nourallah ◽  
Steven Cutts ◽  
Chandra Pasapula

2021 ◽  
Vol 15 (10) ◽  
pp. 3429-3431
Author(s):  
Shenbaga Subramanian Sundaram ◽  
Makesh Babu Subramanian ◽  
Riziq Allah Mustafa Gaowgeh ◽  
Mikhled Falah Maayah ◽  
Ziyad Neamatallah ◽  
...  

Background: Knee osteoarthritis is characterised clinically by usage-related pain and/or functional limitation. OA that is associated with physical dysfunction and decline in health-related quality of life caused the main disability worldwide and is expected to increase due to aging and obesity rates and further load on the population and health system. The strengthening exercises that normally used is knee flexion and extensions, isometric quadriceps exercise, isometric hamstring exercise, and sit to stand to improve the balance. Objectives: is to find out the impact of Strengthening exercise on Balance in patients with knee Osteoarthritis Study Design: Quasi experimental study Methods: Fifty-six (n=56) of knee OA patients were involved in this study by judgemental sampling design. Researcher will first demonstrate and explain the Y-balance tools testing procedure based on Plisky and colleagues study. Participants are given to practice six trials before the formal testing, stated that SEBT have a significant learning effect and found that the reaching distances reached the longest distance after six trials and then will be constant. Results: Independent t-test shows significant difference in only anterior direction. In the experimental group the mean value is 69.83 with a SD of 11.62 while in the control group the mean value is 63.51 with a SD of 11.36; p-value of .045 and t-value of 2.056. In postero-lateral directions result shows there is no significant difference, experimental group the mean value is 91.10 with a SD of 9.74 while in control group mean value is 90.88 with SD value of 12.68; p-value of .947 and t-value of .067. Result of postero-medial shows no significant difference too, in experimental group the mean value of 95.16 with SD of 10.92 while in control group the mean value is 93.40 with SD of 8.20; p=value of .501 and t-value of .678. Conclusion: This study has proven strengthening exercise using YBT improved only anterior direction of YBT but no significant difference in postero-lateral and postero-medial direction. Key Words: Knee Osteoarthritis, Strengthening exercise, Dynamic Balance, Star excursion test


Sensors ◽  
2018 ◽  
Vol 18 (12) ◽  
pp. 4193 ◽  
Author(s):  
Cunguang Lou ◽  
Chenyao Pang ◽  
Congrui Jing ◽  
Shuo Wang ◽  
Xufeng He ◽  
...  

The center of plantar pressure (COP) reflects the dynamic balance of subjects to a certain extent. In this study, wearable pressure insoles are designed, body pose measure is detected by the Kinect sensor, and a balance evaluation system is formulated. With the designed games for the interactive actions, the Kinect sensor reads the skeletal poses to judge whether the desired action is performed, and the pressure insoles simultaneously collect the plantar pressure data. The COP displacement and its speed are calculated to determine the body sway and the ability of balance control. Significant differences in the dispersion of the COP distribution of the 12 subjects have been obtained, indicating different balancing abilities of the examined subjects. A novel assessment process is also proposed in the paper, in which a correlation analysis is made between the de facto sit-to-stand (STS) test and the proposed method; the Pearson and Spearman correlations are also conducted, which reveal a significant positive correlation. Finally, four undergraduate volunteers with a right leg sports injury participate in the experiments. The experimental results show that the normal side and abnormal side have significantly different characters, suggesting that our method is effective and robust for balance measurements.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
MohammadBagher Shamsi ◽  
Maryam Mirzaei ◽  
Soodeh Shahsavari ◽  
Ameneh Safari ◽  
Morteza Saeb

Abstract Background Hamstring shortening may have negative impacts on function and biomechanics of knee and hip joints and lumbo-pelvic rhythm. Many interventions are believed to correct hamstring to its normal length. There are several reports of impairment in postural control of patients with low back pain. The purpose of this study was to compare the effect of stretching exercise and strengthening exercise in lengthened position of the hamstring muscle on improving the dynamic balance of the person in patients with chronic low back pain with short hamstring muscles. Methods Forty-five patients with hamstring shortening who referred to physiotherapy clinic of Kermanshah university of Medical Sciences, Kermanshah, Iran were randomly allocated to the three groups; static stretching (n = 15), strengthening exercise in lengthened hamstring position (n = 15) and control (n = 15). All groups received conventional physiotherapy for low back pain and the two intervention groups received stretching exercise and strengthening exercise in lengthened position programs as well. All groups performed three treatment sessions for a week, a total of 12 sessions. For balance assessment, Y-Balance test was performed for each participant in three reach directions. To determine the important and significant variables, all variables entered a model (Generalized Estimation Equations method). Results The results indicate that based on GEE model, by controlling other variables, participants of static stretching exercise showed more improvement in balance than control group (β = 9.58, p-value = 0.014). Also, balance status showed significant improvement in the end of study compared to baseline of the study (β = 7.71, P-value< 0.001). In addition, the balance in three reach directions improved significantly and the greatest balance improvement was in the anterior reach direction (β ranged over = 6.16 to 11.59) and the height of patients affected their balance (β = 0.28, P-value = 0.034). Conclusions Group (type of intervention), phase of intervention, reach direction of test (anterior, posteromedial and posterolateral) and height of participants were associated with balance performance. Static stretching exercise was more effective than muscle strengthening exercise in lengthened position for improving dynamic balance in low back pain patients with hamstring tightness. Trial registration Iranian Registry of Clinical Trials (IRCT201507258035n2). Registered 16th September 2015.


2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Paulina E. Wowiling ◽  
Lidwina S. Sengkey ◽  
Julius H. Lolombulan

Abstract: This study aimed to analyze whether core-strengthening exercise could correct trunk stability and increase balance in post stroke patients. This was an experimental study with a pretest – posttest group design. Subjects were trained to perform the core strengthening exercise for 12 sessions. The trunk stability was evaluated with trunk impairment scale (TIS) and the balance was evaluated with Berg balance scale (BBS) and timed up and go test (TUG). Data were analyzed with the paired T-test and the Wilcoxon test. The results showed that there were 23 subjects that met the inclusion criteria. Of the 23 subjects, only 19 subjects completed the 12 sessions of exercise. The statistical analysis showed that there were significant increases of TIS (P <0.0001), BBS (P <0.0001), and TUG (P <0.0001) after the whole exercise. Conclusion: Core-strengthening exercise improved trunk stability as wel as static and dynamic balance in post stroke patients.Keywords: core-strengthening exercise, trunk stability, static and dynamic balanceAbstrak: Penelitian ini bertujuan untuk menganalisis sejauh mana latihan core-strengthening memperbaiki stabilitas trunkus dan meningkatkan keseimbangan pada pasien pascastroke. Jenis penelitian ini ialah eksperimental dengan pretest–posttest group design. Subjek penelitian ialah 23 pasien pasca stroke yang memenuhi kriteria inklusi. Perlakuan yang diberikan ialah latihan core-strengthening sebanyak12 sesi. Penilaian stabilitas trunkus menggunakan trunk impairment scale (TIS) sedangkan keseimbangan diukur dengan Berg balance scale (BBS) dan timed up and go test (TUG). Data dianalisis menggunakan uji T berpasangan dan uji Wilcoxon. Hasil penelitian memperlihatkan dari 23 subjek penelitian hanya 19 yang menyelesaian 12 sesi latihan, Analisis statistik menunjukkan bahwa setelah dilakukan latihan penguatan trunkus sebanyak 12 sesi didapatkan peningkatan bermakna dari TIS (P <0,0001), BBS (P <0,0001), dan TUG (P <0,0001). Simpulan: Latihan core-strengthening dapat memperbaiki stabilitas trunkus serta keseimbangan statik dan dinamik pada pasien pasca stroke.Kata kunci: Latihan core-strengthening, stabilitas trunkus, keseimbangan statik dan dinamik


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