scholarly journals FOOT ALIGNMENT IN SYMPTOMATIC NATIONAL FOOTBALL LEAGUE (NFL) ATHLETES: A WEIGHTBEARING CT ANALYSIS

2021 ◽  
Vol 29 (3) ◽  
pp. 118-123
Author(s):  
ALESSIO BERNASCONI ◽  
CESAR DE CESAR NETTO ◽  
LAUREN ROBERTS ◽  
FRANÇOIS LINTZ ◽  
ALEXANDRE LEME GODOY-SANTOS ◽  
...  
Keyword(s):  
National Football League ◽  
Normal Population ◽  
Control Group ◽  
Medial Longitudinal Arch ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Hindfoot Alignment ◽  
Longitudinal Arch ◽  
Medial Cuneiform ◽  
Foot Alignment

ABSTRACT Objective: Our aim was to describe the foot alignment in National Football League (NFL) players with different symptomatic foot and ankle pathologies using weightbearing cone-beam computed tomography (WBCBCT), comparing them to normally aligned feet as control group. Methods: 41 feet (36 active NFL players) were assessed using WBCBCT and compared to 20 normally aligned controls from a normal population. Measurements included: Foot and Ankle Offset (FAO); Calcaneal Offset (CO); Hindfoot Alignment Angle (HAA); angle between inferior and superior facets of the talus (Inftal-Suptal); angle between inferior facet of the talus and the horizontal/floor (Inftal-Hor); Forefoot Arch Angle (FAA); navicular- and medial cuneiform-to-floor distance. Results: NFL athletes showed a neutrally aligned hindfoot when compared to controls (FAO: 1% vs 0.5%; CO: 2.3 mm vs 0.8 mm; HAA: 2.9° vs 0.8° in two groups, with all p > 0.05) and a normal morphology of the subtalar joint (no difference in Inftal-Suptal and Inftal-Hor angles). Conversely, in athletes we found a decreased medial longitudinal arch (FAA: 15° vs 18.3°, p = 0.03) with smaller navicular (38.2 mm vs 42.2 mm, p = 0.03) and medial cuneiform (27 mm vs 31.3 mm, p = 0.01) mean distances to the floor when compared to controls. Conclusion: In our series, NFL players presented a lower medial longitudinal arch than controls but a neutrally aligned hindfoot. WBCBCT may help shed light on anatomical risk factors for injuries in professional players. Level of Evidence III, Retrospective comparative study.

scholarly journals Foot Alignment Profile in Injured Professional Basketball and Football Athletes

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0020
Author(s):  
Cesar de Cesar Netto ◽  
Alessio Bernasconi ◽  
Lauren Roberts ◽  
Francois Lintz ◽  
Martinus Richter ◽  
...  
Keyword(s):  
Elite Athletes ◽  
American Football ◽  
Foot And Ankle ◽  
Hindfoot Alignment ◽  
P Values ◽  
Professional Basketball ◽  
Horizontal Angle ◽  
Longitudinal Arch ◽  
Alignment Angle ◽  
Foot Alignment

Category: Sports Introduction/Purpose: Adequate evaluation of foot and ankle problems in elite athletes is paramount for planning the correct treatment, predicting clinical prognosis and supporting decision making. A complete physical examination that includes the assessment of foot alignment during weightbearing is mandatory. The three-dimensional evaluation provided by weightbearing CT imaging (WBCT) represent an important diagnostic tool for foot and ankle surgeons when dealing with these extremely physically active patients. The purpose of this study was to assess different WBCT measurements of hindfoot and forefoot alignment in injured high-level football and basketball players. We hypothesized that specific patterns of hindfoot alignment and height of the longitudinal arch of the foot could be identified. Methods: In this single center retrospective comparative study, 80 professional male athletes - 47 basketball and 33 American football players from College, NBA and NFL leagues - that underwent WBCT as part of the clinical investigation for different injuries of the foot and ankle were included in the study. WBCTs images were evaluated by a blinded board-certified foot and ankle orthopedic surgeon. Multiple measurements used for assessment of hindfoot valgus and longitudinal arch height were assessed and included: foot and ankle offset (%), calcaneal offset (mm), hindfoot alignment angle (°), navicular-floor distance (mm), medial cuneiform-floor distance (mm), forefoot arch angle (°), inferior talar-superior talar angle (°), and subtalar horizontal angle (°). An unpaired Student’s t test was performed to evaluate any differences in the measurements when comparing professional basketball and football patients. P-values less than 0.05 were considered significant. Results: A summary of demographic characteristics and each measurement’s distributions and standard deviations, as well as p-values for the analysis between groups, is given in table 1. No significant differences were found between basketball and American football elite athletes when comparing the mean values of measurements evaluated (mean differences): foot and ankle offset (0.26%), calcaneal offset (0.58 mm), hindfoot alignment angle (0.73°), navicular-floor (0.35 mm) and medical cuneiform-floor distances (0.38 mm), forefoot arch angle (0.74°), inferior talar–superior talar angle (0.83°) and subtalar horizontal angle (0.1°). Conclusion: Although we did not find significant differences in foot alignment when comparing basketball and American football professional athletes, the results of our study highlight some of the important foot alignment parameters and establish distributions in an extreme but important population. Further studies correlating foot alignment with the incidence of some of the most common pathologies diagnosed in elite athletes, such as the ones reported in our study, can help in the understanding and prevention of those injuries.

scholarly journals Foot Alignment in Symptomatic National Basketball Association Players Using Weightbearing Cone Beam Computed Tomography

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711982608 ◽  
Author(s):  
Cesar de Cesar Netto ◽  
Alessio Bernasconi ◽  
Lauren Roberts ◽  
Pedro Augusto Pontin ◽  
Francois Lintz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
National Basketball Association ◽  
Ankle Injuries ◽  
Cone Beam ◽  
Foot And Ankle ◽  
Hindfoot Alignment ◽  
Medial Cuneiform ◽  
The Mean ◽  
Foot Alignment

Background: Weightbearing cone beam computed tomography (WB CBCT) allows detailed 3-dimensional imaging of the foot and ankle in a weightbearing state and provides improved accuracy and reliability of foot alignment measures, especially when compared with conventional radiographic views. Purpose: To describe the foot alignment in National Basketball Association (NBA) players with different symptomatic foot and ankle injuries using WB CBCT and to determine if any predominant morphotype would be identified. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 45 active NBA players (mean age, 24.4 years [range, 20-34 years]; N = 54 feet [29 right, 25 left]) were assessed using WB CBCT. Measurements included the following: (1) foot and ankle offset (FAO), (2) calcaneal offset (CO), (3) hindfoot alignment angle (HAA), (4) angle between the inferior and superior facets of the talus (Inftal-Suptal), (5) angle between the inferior facet of the talus and the horizontal floor line (Inftal-Hor), (6) forefoot arch angle (FAA), (7) navicular-to-floor distance, and (8) medial cuneiform–to-floor distance. Measurements were then compared with values available in the literature for a “normal” foot morphotype. Results: Among the 54 feet, the mean FAO was 0.48% (95% CI, –0.25% to 1.21%), the mean CO was 1.18 mm (95% CI, –0.50 to 2.87 mm), and the mean HAA was 1.42° (95% CI, –0.80° to 3.65°). The mean Inftal-Suptal angle was 5.31° (95% CI, 3.50°-7.12°), while the mean Inftal-Hor angle was 4.04° (95% CI, 2.56°-5.51°). The mean FAA was 15.84° (95% CI, 14.73°-16.92°), the mean navicular-to-floor distance was 38.30 mm (95% CI, 36.19-40.42 mm), and the mean medial cuneiform–to-floor distance was 26.79 mm (95% CI, 25.30-28.28 mm). None of these values were found to be significantly different when comparing forwards, guards, and centers. Conclusion: NBA players presenting with symptomatic foot and ankle injuries had a fairly “normal” foot morphology, with a tendency toward a varus hindfoot and a high-arched morphotype. No significant differences were found between players based on their position on the court. WB CBCT may help to shed light on anatomic risk factors for common injuries in professional players and may aid in the planning of specific prevention programs.

scholarly journals Early Outcomes of Pes Planus Reconstruction Using Either Hamstring Allograft or Synthetic Ligament

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0021
Author(s):  
Gavin Heyes ◽  
Amir Vosoughi ◽  
Lyndon W Mason ◽  
Andrew P. Molloy
Keyword(s):  
Ligament Reconstruction ◽  
T Test ◽  
Medial Gastrocnemius ◽  
Medial Longitudinal Arch ◽  
Pes Planus ◽  
Hindfoot Alignment ◽  
Longitudinal Arch ◽  
Medial Cuneiform ◽  
Functional Scores ◽  
Synthetic Ligament

Category: Hindfoot, Midfoot/Forefoot Introduction/Purpose: Maintenance of the medial longitudinal arch is crucial to efficient kinematics in gait. It is supported by as complex interplay of osseous structures, ligaments, extrinsic tendons and plantar fascia. Two ligaments critical to stabilising the medial longitudinal arch are the Spring (Calcaneofibular) and Naviculocuneiform ligaments. The Spring Ligament serves as a sling within the “Acetabulum Pedis” to orientate the Talus relative to the Calcaneus and Navicular. The Naviculocuneiform ligament is an important plantar tension band and a separate entity to the Posterior Tibial Tendon (PTT) insertion. Attenuation of these ligaments leads to Pes Planus deformity and subsequent defunctioning of the PTT. This study evaluates the functional and radiological outcomes of Spring and Naviculocuneiform ligament reconstruction using Hamstring (Semitendinosis) Allograft and Synthetic ligament (Internal BraceTM, Arthrex). Methods: 33 consecutive Pes Planus reconstructions were performed between 11/11/2013 and 06/03/2018. All patients were followed up prospectively with serial radiographs and functional scores including; MOXFQ, EQF5D and VAS. Minimum follow up was six months. At the midpoint during the study there was transition to using Synthetic Ligament instead of allograft. This was due to availability and ease of use. Surgical technique for both reconstructions included a proximal medial gastrocnemius recession and medialising calcaneal osteotomy. For allograft reconstructions, a pre-tensioned Semitendinosis allograft was fixed proximally to Talar neck using a tenodesis screw and passed plantar to PTT and through a bone tunnel in the medial cuneiform. Synthetic ligaments were inserted from the Sustentaculum Tali to the medial cuneiform in a hammock fashion. In both reconstructions tendinopathic PTTs were excised and a Flexor Digitorum Longus transfer used. Results: There were 17 synthetic ligament reconstructions (6 male, 11 female) and 16 allograft reconstructions (6 male, 10 female). Groups were matched pre-operatively for age, functional scores and radiological markers (T test P values >0.05). At six months significantly better improvements were observed in the synthetic ligament group compared to allograft group with regards to VAS, MOXFQ pain score, Meary’s line, 1st metatarsal Talus angle, Talonavicular uncoverage angle and Hindfoot alignment (T test P < 0.05). Statistical significance was maintained at 12 months with the synthetic ligament providing a significantly better reduction of Meary’s line 1st Metatarsal Talar angle, Talonavicular uncoverage and hindfoot alignment. 2 patients were revised to double fusions in the allograft group and 1 patient revised in the synthetic ligament group. Conclusion: Statistically significant improved functional scores and radiological appearance can be found up to 1 year following Synthetic ligament reconstruction of the Spring and Naviculocuneiform ligaments when compared to Hamstring allograft.

scholarly journals 3D Biometrics for Hindfoot Alignment Using Weightbearing CT

2017 ◽  
Vol 38 (6) ◽  
pp. 684-689 ◽  
Author(s):  
François Lintz ◽  
Matthew Welck ◽  
Alessio Bernasconi ◽  
James Thornton ◽  
Nicholas P. Cullen ◽  
...  
Keyword(s):  
Normal Population ◽  
Interobserver Reliability ◽  
Mean Value ◽  
Data Sets ◽  
Anatomical Landmarks ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Hindfoot Alignment ◽  
Significant Difference ◽  
The Mean

Background: Hindfoot alignment on 2D radiographs can present anatomical and operator-related bias. In this study, software designed for weightbearing computed tomography (WBCT) was used to calculate a new 3D biometric tool: the Foot and Ankle Offset (FAO). We described the distribution of FAO in a series of data sets from clinically normal, varus, and valgus cases, hypothesizing that FAO values would be significantly different in the 3 groups. Methods: In this retrospective cohort study, 135 data sets (57 normal, 38 varus, 40 valgus) from WBCT (PedCAT; CurveBeam LLC, Warrington, PA) were obtained from a specialized foot and ankle unit. 3D coordinates of specific anatomical landmarks (weightbearing points of the calcaneus, of the first and fifth metatarsal heads and the highest and centermost point on the talar dome) were collected. These data were processed with the TALAS system (CurveBeam), which resulted in an FAO value for each case. Intraobserver and interobserver reliability were also assessed. Results: In normal cases, the mean value for FAO was 2.3% ± 2.9%, whereas in varus and valgus cases, the mean was −11.6% ± 6.9% and 11.4% ± 5.7%, respectively, with a statistically significant difference among groups ( P < .001). The distribution of the normal population was Gaussian. The inter- and intraobserver reliability were 0.99 +/- 0.00 and 0.97 +/-0.02 Conclusions: This pilot study suggests that the FAO is an efficient tool for measuring hindfoot alignment using WBCT. Previously published research in this field has looked at WBCT by adapting 2D biometrics. The present study introduces the concept of 3D biometrics and describes an efficient, semiautomatic tool for measuring hindfoot alignment. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Prevalence of isolated gastrocnemius tightness in patients with foot and ankle pathology – a population based study

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0033
Author(s):  
Karan Malhotra ◽  
Oliver Chan ◽  
Nicholas Cullen ◽  
Matthew Welck ◽  
Andrew Goldberg ◽  
...  
Keyword(s):  
Normal Population ◽  
Population Based ◽  
Activity Level ◽  
Control Group ◽  
Power Calculation ◽  
Foot And Ankle ◽  
Population Based Study ◽  
The Difference ◽  
A Prospective Study ◽  
Gastrocnemius Tightness

Category: Other Introduction/Purpose: Gastrocnemius tightness (GT) is thought to predispose patients to multiple musculoskeletal pathologies including back pain, plantar fasciitis, and metatarsalgia. It is thought to be especially prevalent in patients with foot and ankle pathology (FAP) and consequently there is an emerging trend to perform lengthening / release procedures in this patient group. However, it is not clear what proportion of the normal population has GT and how this differs in patients with FAP. We set out to investigate what the incidence and degree of GT in the foot and ankle population is compared to the normal population. Methods: This was a prospective study comparing GT in a cohort of patients with FAP with GT in controls matched for age, gender, and ethnicity. The control group consisted of healthy adult volunteers and the FAP group consisted of patients presenting to our Foot & Ankle unit. Patients with previous surgery, tendoachilles tightness, or ankle arthritis were excluded. GT was measured using a digital inclinometer and the lunge test. It was calculated as the difference between maximal ankle dorsiflexion with the knee extended and with the knee flexed. Data on the control group was collected first and a power calculation suggested a FAP cohort size of 91 feet was required to detect a 2° difference in GT (a= 0.05, ß = 0.05, Ratio 3:1). Results: After case-matching 97 FAP cases were paired with 291 controls for analysis. Mean GT was 8.0° ±5.7° (range: 0-21°) in FAP patients versus 6.0° ±3.5° (range: 0-16°) in controls (p<0.001). Regression analysis demonstrated demographics including BMI and activity level were not significant determinants of GT in the FAP group (r=0.141, p=0.599). Subgroup analysis of the FAP group revealed a mean GT of 10.3° ±6.0° in patients with forefoot pathology (FoP) versus 6.9° ±5.3° in the other FAP patients (NFoP) (p=0.008). When comparing the NFoP group to the controls, there was no difference in GT (p=0.188). In total 21 FAP patients (21.6%) and 12 FoP patients (37.5%) had GT greater than 2 standard deviations of the control group (Figure 1). Conclusion: This population based study demonstrates increased GT in the FAP population versus the normal population; however, in patients without forefoot pathology, this difference may not be clinically relevant. Over a third of patients with forefoot pathology have GT which is greater than the normal population range. We conclude that not all patients with foot and ankle pathology have inherently increased GT, compared with the normal population, but it is reasonably common in patients with forefoot pathology. Further work is required to define what degree of GT may be considered significant, to determine which patients will benefit from surgical treatment.

scholarly journals Plantar flexion, dorsiflexion, range of movement and hindfoot deviation are important determinants of foot function in children

2019 ◽  
Vol 13 (5) ◽  
pp. 486-499
Author(s):  
C. Alves ◽  
M. Lysenko ◽  
G. A. Tomlinson ◽  
J. Donovan ◽  
U. G. Narayanan ◽  
...  
Keyword(s):  
Plantar Flexion ◽  
Control Group ◽  
Foot Deformities ◽  
Physical Domain ◽  
Range Of Movement ◽  
Level Of Evidence ◽  
Hindfoot Alignment ◽  
Level Ii ◽  
Children And Parents ◽  
Foot Function

Purpose Paediatric foot surgery is often performed to restore anatomical shape or range of movement (ROM). The purpose of this study was to determine how foot morphology and ROM are associated with foot function in children aged five to 16 years of age. Methods Participants included 89 patients with foot disorders and 58 healthy controls. In addition to measuring children’s foot alignment and ankle ROM, children and parents completed the Oxford Ankle and Foot Questionnaire (OxAFQ). Results Mean age was 10.3 years for patients and 10.6 years for controls; 53 of 89 patients had clubfoot. All foot measurements and scores on the OxAFQ significantly differed (p < 0.001) between patients and controls. Patients and their parents significantly differed on the physical (p = 0.03) and emotional (p = 0.02) domains of the OxAFQ, with parents’ ratings being lower than their children. Moderate correlations (r = 0.54 to 0.059; p < 0.001) were found between physical domain (reported by parents on the OxAFQ) and dorsiflexion-knee flexed, and foot- arc-of-movement. Moderate correlations were found between physical domain (reported by children on OxAFQ) and foot-arc-of-movement (r = 0.56; p < 0.001). Patients in the surgical group showed moderate correlations (r = 0.57;, p < 0.001) between physical domain (reported by children on OxAFQ) and plantar flexion, and foot arc-of-movement. The control group and the patients in non-surgical subgroup showed no significant correlations. Conclusion Plantar flexion, arc of ankle ROM and hindfoot alignment impact foot function in children with foot deformities. Parents report significantly lower scores on the OxAFQ when judging foot functioning. Level of evidence Level II. Prognostic Studies

Hard, soft and off-the-shelf foot orthoses and their effect on the angle of the medial longitudinal arch: A biplane fluoroscopy study

2019 ◽  
Vol 43 (3) ◽  
pp. 331-338 ◽  
Author(s):  
Megan Balsdon ◽  
Colin Dombroski ◽  
Kristen Bushey ◽  
Thomas R Jenkyn
Keyword(s):  
Study Design ◽  
Foot Orthoses ◽  
Medial Longitudinal Arch ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Longitudinal Arch ◽  
Significant Difference ◽  
Skeletal Kinematics ◽  
Dynamic Gait ◽  
Foot Orthosis

Background: Foot orthoses have proven to be effective for conservative management of various pathologies. Pathologies of the lower limb can be caused by abnormal biomechanics such as irregular foot structure and alignment, leading to inadequate support. Objectives: To compare biomechanical effects of different foot orthoses on the medial longitudinal arch during dynamic gait using skeletal kinematics. Study design: This study follows a prospective, cross-sectional study design. Methods: The medial longitudinal arch angle was measured for 12 participants among three groups: pes planus, pes cavus and normal arch. Five conditions were compared: three orthotic devices (hard custom foot orthosis, soft custom foot orthosis and off-the-shelf Barefoot Science©), barefoot and shod. An innovative method, markerless fluoroscopic radiostereometric analysis, was used to measure the medial longitudinal arch angle. Results: Mean medial longitudinal arch angles for both custom foot orthosis conditions were significantly different from the barefoot and shod conditions ( p < 0.05). There was no significant difference between the off-the-shelf device and the barefoot or shod conditions ( p > 0.05). In addition, the differences between hard and soft custom foot orthoses were not statistically significant. All foot types showed a medial longitudinal arch angle decrease with both the hard and soft custom foot orthoses. Conclusion: These results suggest that custom foot orthoses can reduce motion of the medial longitudinal arch for a range of foot types during dynamic gait. Level of evidence: Therapeutic study, Level 2. Clinical relevance Custom foot orthoses support and alter the position of the foot during weightbearing. The goal is to eliminate compensation of the foot for a structural deformity or malalignment and redistribute abnormal plantar pressures. By optimizing the position of the foot, the medial longitudinal arch (MLA) will also change and quantifying this change is of interest to clinicians.

An Anatomic Study of the Naviculocuneiform Ligament and Its Possible Role Maintaining the Medial Longitudinal Arch

2018 ◽  
Vol 40 (3) ◽  
pp. 352-355 ◽  
Author(s):  
Eric Swanton ◽  
Lauren Fisher ◽  
Andrew Fisher ◽  
Andrew Molloy ◽  
Lyndon Mason
Keyword(s):  
Weight Bearing ◽  
Lower Limbs ◽  
Tibialis Posterior ◽  
Medial Longitudinal Arch ◽  
Pes Planus ◽  
Average Width ◽  
Tibialis Posterior Tendon ◽  
Longitudinal Arch ◽  
Medial Cuneiform ◽  
Distal Aspect

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.

scholarly journals Acute Response of Toe-Spread-Out Exercise on Medial Longitudinal Arch Height and Balance

2021 ◽  
Vol 23 (1) ◽  
pp. 27-33
Author(s):  
Jinseon Kim ◽  
Jusung Lee ◽  
Daeyoung Kim ◽  
Boymirzozoda Islomjon ◽  
Bobokyaw ◽  
...  
Keyword(s):  
Exercise Group ◽  
Control Group ◽  
Medial Longitudinal Arch ◽  
Arch Height ◽  
Balance Test ◽  
Young Males ◽  
Total Distance ◽  
Acute Response ◽  
Longitudinal Arch ◽  
Males And Females

OBJECTIVES This study was to determine the acute response of the toe-spread-out exercise(TSE) on the medial longitudinal arch height(MLAH) and the static and dynamic balance.METHODS Twenty-four healthy young males and females were randomly assigned to the exercise group(n=12) or to the control group(n=12). The exercise group performed 40 repetitions of TSE while the control group had a rest on the chair. Before and after the exercise or rest, MLAH was measured while standing. One-leg standing test was conducted on the force plate with eyes closed and open. The total distance of the center of pressure (COP) was calculated to assess the static balance. Y-balance test was performed; and the anterior, and medial/lateral posterior reach distances were measured to assess the dynamic balance.RESULTS There was an interaction between group and time for the MLAH (p<.001), and the MLAH in the exercise group increased after the exercise (2.03±1.01 mm; t=-6.930, p<.001). There was an interaction between group and time for the anterior reach distance during the Y-balance test (p=.023), and the distance in the exercise group showed a strong tendency to increase after the exercise (t=-2.104, p=.059). No interaction was found for the total distance of the COP.CONCLUSIONS The 40 repetitions of TSE increased MLAH and showed a positive effect on dynamic balance in healthy young males and females. These results suggest that TSE can be useful as a new exercise method to improve the foot arch structure and function. Further research with the longer duration of TSE training for various populations is warranted.

scholarly journals Hindfoot alignment using weight-bearing computed tomography

2020 ◽  
Vol 14 (3) ◽  
pp. 239-242
Author(s):  
Eduardo Pires ◽  
Carlos Lôbo ◽  
Cesar De Cesar Netto ◽  
Alexandre Godoy-Santos
Keyword(s):  
Computed Tomography ◽  
Weight Bearing ◽  
Treatment Decision ◽  
Metatarsal Head ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Hindfoot Alignment ◽  
Treatment Decision Making ◽  
First Metatarsal ◽  
Block Test

Measurement of hindfoot malalignment and flexibility is essential for treatment decision-making in cavovarus foot deformity. Weight-bearing computed tomography (WBCT) shows greater diagnostic accuracy and allows the study of osteoarticular alignment in the physiological upright position. The most commonly used method for measurements on WBCT scans is the foot and ankle offset (FAO), which is based on the structural tripod of the foot: the calcaneus and the first and fifth metatarsal heads. During the Coleman block test, the first metatarsal head is not resting on the ground and, therefore, does not represent the physiological support of the tripod. We describe a new measurement, the forefoot/hindfoot offset (FHO), for assessing hindfoot alignment on WBCT scans. Level of Evidence V; Diagnostic Studies; Expert Opinion.

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