scholarly journals The clinical assessment of the normal and abnormal foot during locomotion

1979 ◽  
Vol 3 (2) ◽  
pp. 103-110 ◽  
Author(s):  
M. T. Manley ◽  
E. Solomon
Keyword(s):  
Clinical Assessment ◽  
Quantitative Measurement ◽  
Weight Bearing ◽  
Corrective Surgery ◽  
Plantar Surface ◽  
Abnormal Gait ◽  
Subjective Judgement ◽  
Quantitative Visualization ◽  
The Many ◽  
Dynamic Loading Conditions

The clinical assessment of the weight-bearing foot during locomotion is normally based on subjective judgement rather than on quantitative measurement. Although anatomical abnormalities are often apparent at examination, the accurate assessment of an abnormality of function is more difficult to assess particularly if the abnormality is only apparent under dynamic loading conditions. The many drawbacks in previous methods proposed for the clinical assessment of gait have led to the development of a novel system which allows an immediate quantitative visualization of the magnitude and point of application of the forces applied to the plantar surface of the foot during locomotion. This paper describes the technique and presents visual data on normal locomotion, on abnormal locomotion and the changes induced into a patient's abnormal gait by corrective surgery.

Evidence-based Assessment

2010 ◽  
pp. 76-98
Author(s):  
John Hunsley ◽  
Eric J. Mash
Keyword(s):  
Decision Making ◽  
Clinical Assessment ◽  
Assessment Process ◽  
Evidence Based ◽  
The Past ◽  
Specific Assessment ◽  
The Many ◽  
Selection Of ◽  
Made In

Evidence-based assessment relies on research and theory to inform the selection of constructs to be assessed for a specific assessment purpose, the methods and measures to be used in the assessment, and the manner in which the assessment process unfolds. An evidence-based approach to clinical assessment necessitates the recognition that, even when evidence-based instruments are used, the assessment process is a decision-making task in which hypotheses must be iteratively formulated and tested. In this chapter, we review (a) the progress that has been made in developing an evidence-based approach to clinical assessment in the past decade and (b) the many challenges that lie ahead if clinical assessment is to be truly evidence-based.

Department of Clarification

1986 ◽  
Vol 7 (10) ◽  
pp. 318-318
Keyword(s):  
Weight Bearing ◽  
Rapid Diagnosis ◽  
Bearing Surface ◽  
Simple Manner ◽  
Plantar Surface ◽  
Separate Category

Dr Allen L. Hoekman of Harrison, SD, has written as follows: I would appreciate clarification on an inconsistency I've noticed in William Weston's article, "Dermatoses of the Foot" (PIR 1985;7:45). On page 45 and in Table 2, it says that scabies does not involve the plantar surface of the foot. On page 49, it says that scabies can involve the plantar surface (weight-bearing surface). Please clarify. William L. Weston has replied: I agree with Dr Hoekman that it is confusing in the article as to whether or not the weight-bearing surface of the foot is involved in scabies. Clearly, involvement of the weight-bearing surface of the foot in scabies may occur, although the lesions occur predominantly over the dorsum of the foot and extend onto the ankle. For the purposes of making the algorithm in the article work in a simple manner, scabies was placed in this category to help with rapid diagnosis. However, it is clear that scabies can involve the weight-bearing surface of the foot; involvement of this area does not exclude the diagnosis. The algorithm would have perhaps been better if I had included a separate category for involvement of both the sole and the dorsum of the foot, but I believed this would have made the algorithm too complex.

836 Custom Fabricated Open Anterior Ankle Foot Orthosis to Promote Early Mobility with Lower Extremity Grafts

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S256-S257
Author(s):  
Lisa LePage
Keyword(s):  
Lower Extremity ◽  
Direct Contact ◽  
Weight Bearing ◽  
Heel Strike ◽  
Early Mobility ◽  
Foot Placement ◽  
Ankle Foot Orthosis ◽  
Plantar Surface ◽  
Distal Aspect ◽  
Foot Orthosis

Abstract Introduction Distal lower extremity STSG’s present a challenge with the balance of early mobility and immobilization of the ankle. Traditional commercially available ambulation boots or pre-fabricated orthotics may impose circumferential compression endangering graft integrity. Custom fabricated posterior AFO’s comprised of thermoplastic, scotch cast or fiberglass materials are not recommended for weight-bearing of the lower extremity during mobility/ambulation. What may also hinder promotion of early mobility is having a multitude of injuries or advanced age with decreased ability to adhere to a LE NWB status. An anterior approach to immobilization of the ankle was thought of to free the plantar surface of the foot for weight-bearing. The open concept of the orthosis itself minimizes direct contact with the involved LE graft. This promotes graft integrity during mobility with ankle immobilization. Methods Materials: Thermoplastic material, scissors, strapping, dense adhesive foam, adhesive Velcro and a heat gun. Fabrication: Measure the point of distance between where the desired proximal end of the orthosis would be to the patient’s metatarsal heads on the dorsal aspect of the foot; double it to calculate the amount of material needed. The width of the material should be approx. 3 to 4 inches. Warm material and tri-fold it together reducing width to approx. 1 ½ to 2 inches to increase stability. Shape the folded material into a continuous oval and place on the patient’s distal LE. As the material cools, shape the oval away from the medial/ lateral aspects of the distal LE restricting the points of contact to the anterior most proximal and distal aspect of the desired splint parameters. Remove once cooled and add dense adhesive foam to the 2 points of contact that will rest against the patient. This will allow for a slight area of “give” against the patient during weight-bearing of the LE/foot. Velcro and straps are added to the proximal/distal ends of the oval; heating the adhesive side will imbed the Velcro allowing increased durability with repeated donning/doffing. Results The open construction of this orthosis allows different degrees of weight-bearing eliminating contact with the distal LE STSG. The forefoot and heel are available to weight bear safely within the confines of the open anterior ankle foot orthosis. Conclusions Patients have been trialed with/without an AD with success in the achievement of ankle immobilization with mobility. Weight-bearing instructions that accompany this splint wear is foot placement rather than a normal heel strike cadence to avoid undue pressure at the proximal aspect of the splint on the lower extremity. Applicability of Research to Practice This splint has been successfully utilized for immobilization without compromise to STSG integrity due to the anterior open support it offers the ankle. Perhaps this concept could be applied to other joints to avoid direct contact of the splint with STSG during the initial stages of healing.

scholarly journals Ultrasound Therapy in the Treatment of Plantar Wart: A Case Study

2021 ◽  
Vol SP (1) ◽  
Author(s):  
Poonam Dhankher ◽  
Sakshi ◽  
Dimple Choudhry
Keyword(s):  
Case Report ◽  
Weight Bearing ◽  
Previous History ◽  
Skin Condition ◽  
Papilloma Virus ◽  
Plantar Wart ◽  
Plantar Surface ◽  
History Of ◽  
Plantar Warts

Verucae or plantar warts is a painful skin condition that demonstrates a high resistance to various treatments. They can be caused by trauma or human papilloma virus. The infection is mostly caused by a breach in the skin. The virus is usually contacted by walking barefoot in community swimming pool areas. The condition is common in sports persons. Our research focused on warts that occur on plantar surface of foot also known as plantar warts. They result in pain with pressure on weight bearing surfaces so walking is difficult and painful. Risk factors include using community showers barefoot, previous history of warts and decreased immune function. Case Report: We present a case report of a female aged 24 years who was clinically diagnosed with plantar wart. She developed recurrent plantar warts. For a year she was treated with pairing and punch excision with no success. Then ultrasound program was initiated with dosage of 0.6 watt /cm2 and increased up to 1 watt/cm2 for 15 min given at 1-week interval for 15 weeks. At the end of 15th week, the plantar wart had completely disappeared.

Cutaneous microvascular flow in the foot during simulated variable gravities

1996 ◽  
Vol 271 (4) ◽  
pp. R961-R966
Author(s):  
D. S. Chang ◽  
G. A. Breit ◽  
J. R. Styf ◽  
A. R. Hargens
Keyword(s):  
Blood Flow ◽  
Human Subjects ◽  
Weight Bearing ◽  
Blood Perfusion ◽  
Whole Body ◽  
External Compression ◽  
Doppler Flowmetry ◽  
Gravitational Fields ◽  
Plantar Surface ◽  
Opening Load

Our objective was to understand how weight bearing with varying gravitational fields affects blood perfusion in the sole of the foot. Human subjects underwent whole body tilting at four angles: upright [1 gravitational vector from head to foot (Gz)], 22 degrees (0.38 Gz), 10 degrees (0.17 Gz), and supine (0 Gz), simulating the gravitational fields of Earth, Mars, Moon, and microgravity, respectively. Cutaneous capillary blood flow was monitored on the plantar surface of the heel by laser Doppler flowmetry while weight-bearing load was measured. At each tilt angle, subjects increased weight bearing on one foot in graded load increments of 1 kg beginning with zero. The weight bearing at which null flow first occurred was determined as the closing load. Subsequently, the weight bearing was reduced in reverse steps until blood flow returned (opening load). Mean closing loads for simulated Earth gravity, Mars gravity, Moon gravity, and microgravity were 9.1, 4.6, 4.4, and 3.6 kg, respectively. Mean opening loads were 7.9, 4.1, 3.5, and 3.1 kg, respectively. Mean arterial pressures in the foot (MAP(foot)) calculated for each simulated gravitational field were 192, 127, 106, and 87 mmHg, respectively. Closing load and opening load were significantly correlated with MAP(foot) (r =0.70, 0.72, respectively) and were significantly different (P < 0.001) from each other. The data suggest that decreased local arterial pressure in the foot lowers tolerance to external compression. Consequently, the human foot sole may be more prone to cutaneous ischemia during load bearing in microgravity than on Earth.

scholarly journals The Many Faces of Communication Quality

2006 ◽  
Vol 1 (1) ◽  
Author(s):  
Peter Kastberg
Keyword(s):  
Quantitative Measurement ◽  
Communication Quality ◽  
Instructional Text ◽  
Sales Presentation ◽  
Words And Images ◽  
The Many ◽  
Image Ratio

When it comes to quantity, you can easily measure and quantify, the length of an instructional text, the number of words and images used in an ad, or the duration of a sales presentation etc.There is nothing, however, in such a purely quantitative measurement that will tell you whether or not the text, the ad and the talk were “good”. A “good” instructional text is not necessarily a short one, the text to image ratio of an ad says nothing about how effective the ad may be, and a compressed talk will often leave the inquisitive listener unsatisfied.

Contact Pressure of Quadrupedal Animals

2003 ◽  
Author(s):  
Dan B. Marghitu ◽  
Steven F. Swaim ◽  
Paul F. Rumph ◽  
Dorian Cojocaru ◽  
Robert L. Gillette ◽  
...  
Keyword(s):  
Stance Phase ◽  
Detrimental Effect ◽  
Weight Bearing ◽  
Central Area ◽  
Wound Site ◽  
Plantar Surface ◽  
Hind Limbs ◽  
Working Dogs ◽  
Tissue Stresses ◽  
Insight Into

In this study we determine the pressure on the central area of each of the weight bearing pads of the paws of dogs at the walk. Pressure signal data from stance phase during walking were analyzed. Within paws, there were significant pressure differences among pads on both fore and hind limbs. The coefficient of restitution, the embedding dimension, and the Lyapunov exponents were calculated. The ability to measure and analyze pressure on individual paw pads provides insight into soft tissue stresses on the palmar/plantar surface of the paw. Pressure at a wound site on the pads has a detrimental effect on wound healing and a better understanding these stresses will be of benefit when suturing and bandaging pad wounds. Such information is especially important in athletic and working dogs, e.g. search and rescue dogs.

scholarly journals The Ankle-Joint Complex: A Kinesiologic Approach to Lateral Ankle Sprains

2019 ◽  
Vol 54 (6) ◽  
pp. 589-602 ◽  
Author(s):  
Jennifer M. Medina McKeon ◽  
Matthew C. Hoch
Keyword(s):  
Daily Living ◽  
Ankle Instability ◽  
Clinical Care ◽  
Weight Bearing ◽  
Ankle Sprains ◽  
Anatomical Structures ◽  
Lateral Ankle ◽  
Force Transfer ◽  
Ankle Complex ◽  
The Many

Copious research exists regarding ankle instability, yet lateral ankle sprains (LASs) persist in being among the most common recurrent musculoskeletal injuries. Key anatomical structures of the ankle include a triform articulating structure that includes the inferior tibiofibular, talocrural, and subtalar joints. Functionally, force absorption and propulsion through the ankle complex are necessary for any task that occurs in weight bearing. For optimal ankle performance and avoidance of injury, an intricate balance between stability and mobility is necessary to ensure that appropriate force transfer occurs during sports and activities of daily living. Consideration for the many structures that may be directly or indirectly involved in LASs will likely translate into advancements in clinical care. In this clinical review, we present the structure, function, and relevant pathologic states of the ankle complex to stimulate a better understanding of the prevention, evaluation, and treatment of LASs.

Integrating the Hemodynamic Profile with Clinical Assessment

1993 ◽  
Vol 4 (1) ◽  
pp. 161-179 ◽  
Author(s):  
Nancie Urban
Keyword(s):  
Cardiac Output ◽  
Critical Care ◽  
Critically Ill ◽  
Clinical Assessment ◽  
Critical Care Units ◽  
Hemodynamic Compromise ◽  
Valuable Adjunct ◽  
Hemodynamic Profile ◽  
The Many ◽  
To Receive

Hemodynamic profiling has become common practice in critical care units. While the ability to monitor, measure, and calculate the many parameters related to cardiac output is a valuable adjunct in the care of the critically ill, it cannot be used as a substitute for sound clinical assessment. The ability to integrate the hemodynamic profile with clinical assessment is necessary if patients arc to receive comprehensive critical care. In addition, assessment frameworks such as Forrester’s subsets of hemodynamic compromise provide clinically useful guidance in the diagnosis and treatment of a variety of clinical challenges

scholarly journals Medial Plantar Flap for Reconstruction of Heel Defect

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Benny Raymond ◽  
Gentur Sudjatmiko
Keyword(s):  
Weight Bearing ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Full Thickness ◽  
Plantar Surface ◽  
Defect Reconstruction ◽  
Secondary Defect ◽  
Foot Function

Heel is subjected to exceed weight bearing and shearing forces. Full-thickness defects to the plantar surface of the foot present a challenge. Variety of procedures have been described for resurfacing this site, but not all achieve normal foot function. Reporting two cases, defects of the plantar surface of the heel resurfaced with medial plantar flap, an island fasciocutaneus flap and innervated, thus provide a good replacement.One patient show good result within 4 weeks, with minimal raw surface on secondary defect. While other patient didn’t show up after 2 weeks. Medial plantar flap was successfully used for heel defect reconstruction. Donor site morbidity was minimal, and patient could walk post-operatively without special devices for the heel.

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