scholarly journals Effect of Foot Orthoses in Children With Symptomatic Flexible Flatfoot Based on Ultrasonography of the Ankle Invertor and Evertor Muscles

2021 ◽  
Vol 45 (6) ◽  
pp. 459-470
Author(s):  
Dong Joon Cho ◽  
So Young Ahn ◽  
Soo-Kyung Bok
Keyword(s):  
Tibialis Anterior ◽  
Tibialis Posterior ◽  
Disability Score ◽  
Cross Sectional ◽  
Peroneus Longus ◽  
Radiographic Measurements ◽  
Total Pain ◽  
Flexible Flatfoot ◽  
Foot Function ◽  
Foot Orthosis

Objective To examine the changes in the cross-sectional area (CSA) ratio of the ankle invertors and evertors following rigid foot orthosis (RFO) application in children with symptomatic flexible flatfoot and to determine the correlation between the degree of change in CSA ratio and pain-severity after RFO application.Methods We included 24 children with symptomatic flexible flatfoot without comorbidities and measured the CSAs of tibialis anterior (TA), tibialis posterior (TP), and peroneus longus (PL) using ultrasonography, resting calcaneal stance position (RCSP) angle, calcaneal pitch (CP), Meary’s angle, talonavicular coverage angle, and talocalcaneal angle using radiography, and foot function index (FFI) at baseline and 12 months after RFO application. We analyzed 48 data by measuring both feet of 24 children. The CSA ratios, the ratio of CSA of each muscle to the sum of CSA of TA, TP, and PL, were also compared. Correlations between the degree of change in FFI, each muscle’s CSA ratio, RCSP angle, and radiographic measurements were investigated.Results Following RFO application, significant increase in the PL ratio and CP and significant decrease in the RCSP angle, FFI total, pain, and disability scores were observed. The degree of change in the total score, pain, and disability score of FFI were significantly correlated with the degree of change in the PL ratio and RCSP angle.Conclusion RFOs applied to children with symptomatic flexible flatfoot might reduce the compensatory activities of the ankle invertors, thereby increasing the PL ratio, and pain decreases as the PL ratio increases.

The Effects of Talus Control Foot Orthoses in Children with Flexible Flatfoot

2017 ◽  
Vol 107 (1) ◽  
pp. 46-53 ◽  
Author(s):  
So Young Ahn ◽  
Soo Kyung Bok ◽  
Bong Ok Kim ◽  
In Sik Park
Keyword(s):  
Therapeutic Effect ◽  
Foot Orthoses ◽  
Talonavicular Joint ◽  
Radiographic Measurements ◽  
Flexible Flatfoot ◽  
Foot Orthosis

Background: A talus control foot orthosis (TCFO) combines an inverted rigid foot orthosis (RFO) with a broad upright portion that rises well above the navicular to cover and protect the talonavicular joint. We sought to identify the therapeutic effect of TCFOs in children with flexible flatfoot. Methods: Flexible flatfoot was diagnosed in 40 children when either of the feet had greater than 4° valgus of resting calcaneal stance position (RCSP) angle and one of the radiographic indicators was greater than 30° in anteroposterior talocalcaneal angles, 45° in lateral talocalcaneal angles, and 4° in lateral talometatarsal angles and less than 10° of calcaneal pitch in barefoot radiographs. Of 40 children with flexible flatfoot, 20 were fitted with a pair of RFOs and 20 with TCFOs, randomly. Follow-up clinical and radiographic measurements were completed 12 months later. Results: All of the radiographic indicators changed toward the corrective direction in both groups. There were significant improvements in calcaneal pitch and RCSP in both groups (P < .05). In the TCFO group, the anteroposterior talocalcaneal angle and the RCSP showed statistically significant improvement compared with the RFO group. Conclusions: In this study, the TCFO was more effective than the RFO at treating children with flexible flatfoot.

Investigation of Muscle Imbalance in the Leg in Symptomatic Forefoot Pes Cavus: A Multidisciplinary Study

Foot & Ankle ◽  
1992 ◽  
Vol 13 (9) ◽  
pp. 489-501 ◽  
Author(s):  
Martin C. Tynan ◽  
Leslie Klenerman ◽  
T.R. Helliwell ◽  
R.H.T. Edwards ◽  
Michael Hayward
Keyword(s):  
Tibialis Anterior ◽  
Cross Sectional ◽  
Pes Cavus ◽  
Anterior Compartment ◽  
Peroneus Longus ◽  
Charcot Marie Tooth Disease ◽  
Multidisciplinary Study ◽  
Relative Expansion ◽  
Normal Controls ◽  
Tooth Disease

The cross-sectional areas of the peroneal and anterior muscle compartments at the same level in the upper leg were measured using magnetic resonance imaging in 41 cases of forefoot pes cavus. The pes cavus group included idiopathic cases and pes cavus associated with Charcot-Marie-Tooth disease, Friedreich's ataxia, cerebral palsy, status postpoliomyelitis, nerve trauma, and spinal cord tethering. Thirty-nine of these cases were symptomatic. The results were compared with studies of 11 normal controls. It was found that in the majority of cases of forefoot cavus, the peroneal compartment was enlarged relative to the anterior compartment when compared with the normal controls. Biopsies of the tibialis anterior and peroneus longus muscles in 18 patients with forefoot pes cavus showed that any relative expansion of the peroneus longus was not due to pseudohypertrophy. Overaction of the peroneus longus in comparison to its antagonist the tibialis anterior is proposed as an important factor in the pathogenesis of the majority of symptomatic cases of forefoot pes cavus.

scholarly journals Leg muscle cross-sectional area measured by ultrasound is highly correlated with MRI

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Joshua K. Sponbeck ◽  
Clint R. Frandsen ◽  
Sarah T. Ridge ◽  
Derek A. Swanson ◽  
Dallin C. Swanson ◽  
...  
Keyword(s):  
Tibialis Anterior ◽  
Tibialis Anterior Muscle ◽  
Cross Sectional Area ◽  
Tibialis Posterior ◽  
Sectional Area ◽  
Cross Sectional ◽  
Leg Muscles ◽  
Detectable Difference ◽  
Minimum Detectable Difference ◽  
Leg Muscle

Abstract Background The leg muscles are important for balance, posture, and movement during static and dynamic activity. Obtaining cross-sectional area measurements (CSA) of the leg muscles helps researchers understand the health and force production capability of individual leg muscles. Therefore, having an easy to use and readily available method to assess leg muscle CSA is needed. Thus, the purpose of this study was to compare the magnitude, repeatability, and validity of CSA measurements of select leg muscles from ultrasound (US) and the current gold standard, magnetic resonance imaging (MRI). Methods 20 healthy volunteers participated in this study. Each participant was imaged via US and MRI. The muscles of interest obtained on each participant consisted of the tibialis anterior at both 30 and 50% of the shank length, tibialis posterior at both 30 and 50% of the shank length, the flexor digitorum longus, the fibularis (peroneus) longus, and the fibularis (peroneus) brevis. Results Strong Pearson correlations were seen for all of the muscles when comparing US to MRI with a range from .7840 to .9676. For all measurements, standard error of the measurement ranged from .003 to 0.260 cm2. Minimum detectable difference for muscle measurements ranged from .008 cm2 for MRI fibularis longus and fibularis brevis to .693 cm2 for MRI of tibialis anterior at 30%. US minimum detectable difference ranged from .125 cm2 for the tibialis posterior muscle at 30% to .449 cm2 for the tibialis anterior muscle at 50%. Conclusions Based on these results ultrasound is a valid method to obtain CSA of muscles of the leg when compared with MRI.

scholarly journals Physical Activity and Diet Quality Modify the Association between Comorbidity and Disability among Stroke Patients

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1641
Author(s):  
Lien T. K. Nguyen ◽  
Binh N. Do ◽  
Dinh N. Vu ◽  
Khue M. Pham ◽  
Manh-Tan Vu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diet Quality ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
World Health ◽  
Short Version ◽  
Linear Regression Models ◽  
Stroke Patients ◽  
Disability Score ◽  
Cross Sectional

Background: Comorbidity is common and causes poor stroke outcomes. We aimed to examine the modifying impacts of physical activity (PA) and diet quality on the association between comorbidity and disability in stroke patients. Methods: A cross-sectional study was conducted on 951 stable stroke patients in Vietnam from December 2019 to December 2020. The survey questionnaires were administered to assess patients’ characteristics, clinical parameters (e.g., Charlson Comorbidity Index items), health-related behaviors (e.g., PA using the International Physical Activity Questionnaire- short version), health literacy, diet quality (using the Dietary Approaches to Stop Hypertension Quality (DASH-Q) questionnaire), and disability (using the World Health Organization Disability Assessment Schedule II (WHODAS II)). Linear regression models were used to analyze the associations and interactions. Results: The proportion of comorbidity was 49.9% (475/951). The scores of DASH-Q and WHODAS II were 29.2 ± 11.8, 32.3 ± 13.5, respectively. Patients with comorbidity had a higher score of disability (regression coefficient, B, 8.24; 95% confidence interval, 95%CI, 6.66, 9.83; p < 0.001) as compared with those without comorbidity. Patients with comorbidity and higher tertiles of PA (B, −4.65 to −5.48; p < 0.05), and a higher DASH-Q score (B, −0.32; p < 0.001) had a lower disability score, as compared with those without comorbidity and the lowest tertile of PA, and the lowest score of DASH-Q, respectively. Conclusions: Physical activity and diet quality significantly modified the negative impact of comorbidity on disability in stroke patients. Strategic approaches are required to promote physical activity and healthy diet which further improve stroke rehabilitation outcomes.

Thigh and Leg Muscle MRI Findings in GNE Myopathy

2021 ◽  
pp. 1-8
Author(s):  
Farzad Fatehi ◽  
Soroor Advani ◽  
Ali Asghar Okhovat ◽  
Bentolhoda Ziaadini ◽  
Hosein Shamshiri ◽  
...  
Keyword(s):  
Tibialis Anterior ◽  
Vastus Lateralis ◽  
Fatty Infiltration ◽  
Muscular Dystrophies ◽  
Tibialis Posterior ◽  
Muscle Mri ◽  
Muscle Involvement ◽  
Fat Infiltration ◽  
Gne Myopathy ◽  
Adductor Magnus

Background: Muscle MRI protocols have been developed to assess muscle involvement in a wide variety of muscular dystrophies. Different muscular dystrophies can involve muscle groups in characteristic patterns. These patterns can be identified in muscle MRI in the form of fatty infiltration. Objective: This study was conducted to add the existing knowledge of muscle MRI in GNE myopathy and evaluate the correlation of muscular involvement with different gene mutations. Methods: The MRI scans of the 18 GNE patients were analyzed retrospectively. Cluster analysis was done for grouping the muscles and patients. Results: The four muscles with the highest fat infiltration were adductor magnus, tibialis anterior, semitendinosus, and semimembranosus. Furthermore, three clusters of muscle involvement were found, including cluster 1, typical muscle involvement indicating muscles with the highest infiltration: extensor digitorum longus, gracilis, biceps femoris, soleus, gastrocnemius medial, adductor longus, tibialis anterior, adductor magnus, semimembranosus, semitendinosus; cluster 2, less typical muscle involvement indicating muscles with intermediate fat infiltration, peroneus longus, gastrocnemius lateral, and minimal fat infiltration in most of the patients, i.e., tibialis posterior; and cluster 3, atypical muscle involvement with low-fat infiltration: rectus femoris, sartorius, vastus intermedius, vastus medialis, and vastus lateralis. Conclusions: This study found three clusters of muscle involvement and three groups of patients among GNE patients. Hamstring muscles and the anterior compartment of the lower leg were the muscles with the highest fat infiltration. Moreover, a weak genotype-muscle MRI association was found in which tibialis posterior was more involved in patients with the most frequent mutation, i.e., C.2228T >  C (p.M743T) mutation; however, this finding may be related to longer disease duration.

Clinicoradiographic Assessment of Flexible Flatfoot in Children

2010 ◽  
Vol 100 (6) ◽  
pp. 463-471 ◽  
Author(s):  
Maria Grazia Benedetti ◽  
Lisa Berti ◽  
Sofia Straudi ◽  
Francesco Ceccarelli ◽  
Sandro Giannini
Keyword(s):  
Daily Living ◽  
Functional Limitation ◽  
Standing Position ◽  
Valgus Deformity ◽  
Lateral View ◽  
Heel Pain ◽  
Clinical Parameters ◽  
Radiographic Assessment ◽  
Radiographic Measurements ◽  
Flexible Flatfoot

Background: Radiographic assessment is still used to evaluate flexible flatfoot in children. Methods: To find a set of radiologic parameters for assessing this disease, we studied 53 children aged 10 to 14 years. The degree of plantar collapse was measured by Viladot’s classification (grades 0–4). The degree of valgus deformity measured in the heel in a standing position, the presence of painful points, and functional limitation during daily-living activities were also reported. The children underwent standard radiography of the foot under load. On the dorsoplantar view, the talocalcaneal, hallux metatarsophalangeal, and first intermetatarsal angles were measured. On the lateral view, the talocalcaneal, Costa Bertani, talometatarsal, talonavicular, and tibiotalar angles were measured. The radiographic measurements were compared with the data reported in the literature and were correlated with the clinical parameters studied (degree of flatfoot, valgus deviation of the heel, pain, and functional limitation). Results: The radiographic measures that resulted increased with respect to the reference values reported in the literature for the Costa Bertani (93.1% of feet), talometatarsal (93.5%), talonavicular (89.1%), and tibiotalar (69.7%) angles, all in the lateral view. Of the angles assessed in the dorsoplantar view, the hallux metatarsophalangeal (11.1%) and first intermetatarsal (24.2%) angles were increased. The degree of flatfoot was correlated with the Costa Bertani angle (P &lt; .0005). In the group with pain, the lateral talocalcaneal (P = .016) and first intermetatarsal (P = .02) angles were increased compared within the group without pain. Conclusions: Despite technical limitations, we still consider standard radiography of the foot, combined with clinical examination, to be a valid tool for assessing flexible flatfoot in children, especially when surgical treatment is expected and when a basic measure of the structural setup of the foot is necessary. (J Am Podiatr Med Assoc 100(6): 463–471, 2010)

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