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Background: To better understand the preventive or therapeutic clinical interventions that may be supported by the association between rheumatoid arthritis (RA) and postural deformities including hallux valgus, flat foot, and scoliosis, this study was conducted using Mendelian randomization (MR) analysis. It aimed to investigate whether RA is causally associated with postural deformities in European populations. Methods: Summary-level data on RA and postural deformities were obtained from the IEU OpenGWAS project and Finngen database, respectively. LDSC regression analysis was conducted to assess the genetic correlation between these diseases. The inverse variance weighting (IVW) method was employed as the primary approach for two-sample MR analyses to evaluate causality. Supplementary methods included MR-Egger, maximum likelihood, weighted median, and cML-MA. To test for potential horizontal pleiotropy, we performed the MR-Egger intercept test, cML-MA, and secondary analyses after excluding confounders. Additionally, mediation analyses were conducted using two-step MR. Results: The IVW method revealed RA to be causally associated with hallux valgus (OR 1.132, 95% CI 1.087-1.178, P < 0.001) and flat foot (OR 1.197, 95% CI 1.110-1.291, P < 0.001). Among postural deformities, hallux valgus was causally associated with flat foot (OR 1.823, 95% CI 1.569-2.119, P < 0.001) and scoliosis (OR 1.150, 95% CI 1.027-1.287, P < 0.05). No significant horizontal pleiotropy was detected. Moreover, mediation analyses indicated that hallux valgus mediates the effect of RA on flat foot (mediation effect 0.024, 95% CI 0.005-0.044, P < 0.05), with a mediation proportion of 41.31%. Conclusion: These findings indicate a potential causal association between genetically predicted RA and both hallux valgus and flat foot. Furthermore, hallux valgus serves as a mediator in the pathway from RA to flat foot. This underscores the importance of early screening and preventive treatment of foot deformities in RA patients. Further research is necessary to determine the applicability of these findings in non-European populations. [ABSTRACT FROM AUTHOR]

Background: Pes planus, commonly known as flat foot is a deformity of the foot, characterized by loss of the medial longitudinal arch of the foot. There are several diagnostic methods available, such -as radiographs and digital footprint scanning techniques, that involve the usage of ink, dyes, and expensive instrumentation which may be harmful and not readily available at all time. The arch height may prove to be a user-friendly, portable, and affordable means of grading the foot. However, no tools were found during the search for review of literature. Hence, a need for a tool to measure the arch height and further give standard range of the arch height for flat feet and non-flat feet was identified. Objective: To design a tool and further provide values to differentiate flatfoot and non-flatfoot using arch height as a measurement tool. Relevance: The instrument was designed to quantify arch height and values to differentiate flatfoot and non-flatfoot are provided by comparison with Chippaux Smirak Index (CSI). Method: The study evaluated the medial longitudinal arches of 30 individuals (60 feet) using static footprints and arch height measurement with tool. The footprints were classified into flatfoot and non-flatfoot using CSI. Data was subjected to appropriate statistical analysis. Results: The range of medial longitudinal arch height between 15-21 mm in sitting position and 13-19 mm in standing position identified with non-flat foot, while the range of medial longitudinal arch height between 10-14 mm in sitting position and 8-12 mm in standing position identified with flat foot when compared with CSI. These findings suggest that the tool can be used effectively to measure the medial longitudinal arch height and differentiate between individuals with flat foot and non-flat foot. Conclusion: The study concludes that the tool is effective in measuring the medial longitudinal arch height and can be used to differentiate between individuals with flat foot and non-flat foot. Designers of the tool would like to name the tool as ArchCheck Tool. [ABSTRACT FROM AUTHOR]

Individuals with pronated feet often experience altered foot biomechanics, leading to increased risk of lower limb injuries. Step width modification has been proposed as a potential intervention to improve foot alignment during gait. Does modifying step width influence rearfoot eversion and medial longitudinal arch angle (MLAA) in individuals with pronated feet during walking and running? Twenty individuals with pronated feet underwent analysis during walking and running on treadmill, maintaining increased or decreased step width using real-time visual feedback. Three-dimensional motion analysis measured rearfoot eversion and MLAA during the stance phase of gait. Wide step width significantly reduced peak rearfoot eversion during waking (mean difference — with normal step width — (MD) = 3.6°, p < 0.001) and running (MD = 4.4°, p < 0.001), time to peak rearfoot eversion during walking (MD = 16.6 p < 0.001) and running (MD = 13.8°, p = 0.014), rearfoot eversion at touch down (TD) during walking (MD = 1.3°, p = 0.004), rearfoot eversion excursion during running (MD = 4.3°, p < 0.001), and peak MLAA during walking (MD = 2.9°, p = 0.006) and MLAA excursion during running (MD = 4.8°, p = 0.004). By contrast, during running, narrow condition significantly increased peak rearfoot eversion (MD = 3.4°, p < 0.001). During walking, time to peak rearfoot eversion (MD = 16.1, p < 0.001), rearfoot eversion at TD (MD = 1.4°, p = 0.008), rearfoot eversion excursion (MD = 5.9°, p < 0.001), and peak MLAA (MD = 3.4°, p < 0.001) were significantly increased. This study highlights the potential of step width modification as a simple yet effective intervention to improve foot biomechanics in pronated feet individuals during walking and running. Further research could lead to the development of personalized strategies for pronated feet individuals. • Wide step width reduces peak rearfoot eversion in pronated feet. • Narrow step width increases rearfoot eversion during running. • Step width modification improves foot biomechanics in pronated individuals. [ABSTRACT FROM AUTHOR]

Objective: To study the prevalence of femoral anteversion and tibial torsion in flat-foot individuals. Methods: This project was done among individuals having flat feet. All the genders were included in the study. Flat-foot individuals of the age group 20-30 years were included. Flat-foot individuals with any other orthopaedic problems were excluded from the study. After obtaining ethical permission, the consent form was filled out by all the subjects. A structured assessment was used for assessing the individuals having flat feet, after which segregation was done in that group and the individuals having tibial torsion were included and then the femoral anteversion was checked among the group. Results: Among 80 subjects, the finding of this study revealed that there is a prevalence of femoral anteversion along with tibial torsion in flat-foot individuals. The group analysis demonstrated statistically significant impairments in all the outcome measures. After obtaining permission from the ethical committee, the subjects fulfilling inclusion criteria were explained about the study and a structural assessment was conducted, revealing a significant correlation among the Feiss line test, femoral anteversion test and tibial torsion test. Conclusion: Flat-foot individuals have femoral anteversion among various individuals. The prevalence of flat-foot individuals having femoral anteversion along with tibial torsion is predominantly higher among the group. [ABSTRACT FROM AUTHOR]

This case report presents a novel cause of rigid flatfoot caused by the entrapment of the Flexor Hallucis Longus (FHL) tendon within the subtalar joint. A 19-year-old male with chronic right ankle and foot pain diagnosed with rigid flatfoot deformity. MRI identified the FHL tendon entrapped within the subtalar joint, a condition to our knowledge never previously reported. This report highlights the importance of thorough clinical evaluation and advanced imaging techniques in diagnosing rare causes of rigid flatfoot and suggests that surgical options may still be valid for such rare presentations.

Introduction: A flat foot is an arch deformity, and being overweight is one of the risk factors. It can cause problems such as fatigue, pain in the ankle and back, foot pain (especially during long walks or sports), and disturbances in balance and walking patterns. This study aimed to examine the relationship between flat feet (measured using Clarke's angle) and overweight students at the Faculty of Medicine, Universitas Airlangga. Methods: This study used an observational analytic design with a cross-sectional method, gathering primary data directly from the research sample. The data were analyzed using the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26. Results: Of the 56 samples meeting inclusion criteria, most cases of flat foot occurred in males. A total of 36 research subjects were overweight or obese, evenly split between females and males. Among the 112 samples, 19 had flat feet, and 93 did not. Chi-square test analysis indicated a highly significant p-value (0.001, p < 0.05), suggesting a significant relationship between flat feet and overweight. Conclusion: There was a significant relationship between flat feet (measured using Clarke's angle) and overweight. The majority of subjects in this study were overweight based on body mass index (BMI), and most had a non-flat foot arch type. All cases of flat foot were found in subjects with overweight BMI.

Background: This study evaluates the potential of ChatGPT and Google Bard as educational tools for patients in orthopedics, focusing on sports medicine and pediatric orthopedics. The aim is to compare the quality of responses provided by these natural language processing (NLP) models, addressing concerns about the potential dissemination of incorrect medical information. Methods: Ten ACL- and flat foot-related questions from a Google search were presented to ChatGPT-3.5 and Google Bard. Expert orthopedic surgeons rated the responses using the Global Quality Score (GQS). The study minimized bias by clearing chat history before each question, maintaining respondent anonymity and employing statistical analysis to compare response quality. Results: ChatGPT-3.5 and Google Bard yielded good-quality responses, with average scores of 4.1 ± 0.7 and 4 ± 0.78, respectively, for sports medicine. For pediatric orthopedics, Google Bard scored 3.5 ± 1, while the average score for responses generated by ChatGPT was 3.8 ± 0.83. In both cases, no statistically significant difference was found between the platforms (p = 0.6787, p = 0.3092). Despite ChatGPT's responses being considered more readable, both platforms showed promise for AI-driven patient education, with no reported misinformation. Conclusions: ChatGPT and Google Bard demonstrate significant potential as supplementary patient education resources in orthopedics. However, improvements are needed for increased reliability. The study underscores the evolving role of AI in orthopedics and calls for continued research to ensure a conscientious integration of AI in healthcare education. [ABSTRACT FROM AUTHOR]

Objective：To explore the characteristics of arch function in patients with flexible flat foot by comparing the differences of static and dynamic arch function between normal and flexible flat foot patients, provide theoretical reference for the functional distinction of different types of foot arch. Method：Thirty adult male subjects were recruited. Normal and flat feet were distinguished by foot printing method, and flexible flat feet were screened by heel raising test and passive toe raising test. Sixteen normal feet and fourteen patients with flexible flat feet were screened. Static arch stiffness was calculated by the difference of arch height between natural standing and sitting at different loading positions, and the relative arch height at the beginning of the middle support period, change value of relative arch height, change rate of relative arch height and proportion of middle foot impulse during walking were evaluated by 3D motion capture and plantar pressure. The correlation between static arch stiffness and dynamic arch function was analyzed by partial correlation(controlling step speed). Result：The static arch stiffness of flexible flat feet was lower than that of normal feet (P<0.05). The results of dynamic arch function test showed that the relative height and change rate of arch height in the middle of walking support decreased gradually in both normal and flexible flat feet, the change value and change rate of arch height in flexible flat feet at the beginning of the middle of walking support period were lower than those in normal feet (P<0.05). The proportion of impulse of flexible flat feet in walking support was higher than that of normal feet (P<0.05). Partial correlation analysis showed that the relative height, relative height change value and relative height change rate at the beginning of middle support were positively correlated with static arch stiffness (r=0.580—0.679, P<0.05), the proportion of middle foot impulse was negatively correlated with static arch stiffness(r=﹣0.478, P<0.05). Conclusion：During walking, the arch of the foot continued to decline in the middle of support, and the rate of decline gradually decreased. The adaptability of static and dynamic arches to loading in patients with flexible flat feet was lower than that of normal feet. It is the key of ankle rehabilitation to improve the weight bearing adaptability of arch in patients with flexible flat foot. Arch stiffness is correlated with dynamic arch function, which is an important reference value for the functional division of different types of foot arch. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze patient-reported outcomes following this procedure as well as any demographics that may confer prognostic capability. A retrospective analysis was conducted of patients who underwent Triple Arthrodesis at our facility from 2014-2021. Patients were selected if they underwent an isolated triple arthrodesis. All cases included either a gastrocnemius recession versus a percutaneous tendo-achilles lengthening depending on the patient's Silverskiold examination. The electronic medical record was utilized to collect basic patient demographics, previous foot and ankle surgeries, hardware failures, additional procedures, and surgical complications. To evaluate outcomes, we compared patient reported outcomes measurement information system (PROMIS) survey scores with the general population and preoperative versus postoperative visual analog scale (VAS) scores. Foot function index (FFI) scores and scores were utilized as a validation tool for our results. A total of 132 patients met the criteria for our study with a total of 50 participants completing the PROMIS and FFI surveys. The average time point at which the outcomes were collected was 5.50 y postoperatively, ranging from 1.65 to 7.57 y. The average PROMIS physical function was 38.35, pain interference was 61.52, and depression was 49.82 for this population. The mean FFI scores were 58.56 for pain, 60.07 for disability, and 48.07 for activity limitation. There was a significant decrease in preoperative and postoperative VAS scores from 5.4 to 2.55 (p <.001). Three patients experienced wound complications related to decreased sensation. Our results indicated that only PROMIS depression scores were within one standard deviation of the population mean following a triple arthrodesis procedure. PROMIS physical function and pain interference were both outside of one standard deviation for the population. [ABSTRACT FROM AUTHOR]

Background and Aims A flat foot is associated with complications, such as pain, fatigue, and balance decline. The present study investigated the effect of 8 weeks of foot reflexology massage on balance, foot arch, and pain in girls aged 14 to 18 years with flat feet. Methods In this quasi-experimental research, 30 girls with flat feet (mean age: 15.1±1.1 years, mean height: 156.1±2.2, and mean weight: 47.3±2.2 kg) voluntarily and conveniently were selected and randomly divided into two equal experimental and control groups. The massage program consisted of eight weeks (three sessions per week) of foot reflexology massage on the entire sole of both feet, in which two to three relaxation techniques were used in each session, according to the subject's condition, for six minutes. Twenty-four hours before and 24 hours after the end of the massage therapy protocol, foot arch, dynamic balance, static balance, and pain intensity were assessed using the index of navicular drop test, star excursion balance test, balance error scoring system, and visual analog scale, respectively. Data analysis was done with an analysis of covariance at a significance level of 0.05. Results The results showed that reflexology massage significantly affects static balance (P=0.0001) and pain intensity (P=0.0001) of young girls with flat feet. However, no significant effect was observed on the arch of the foot (P=0.38) and the dynamic balance (P=0.36). Conclusion Reflexology massage improves the proprioceptive information of the skin. Accordingly, it has improved static balance and reduced the pain intensity of girls with flat feet. [ABSTRACT FROM AUTHOR]

Purpose: Foot pressure measurement devices are used widely in clinical settings for plantar pressure assessments. Despite the availability of various devices, studies evaluating the inter-device reliability are limited. This study compared plantar pressure measurements obtained from HR Mat (Tekscan Inc.) and EMED-n50 (Novel GmbH). Materials and Methods: The study involved 38 healthy male volunteers. The participants were categorized into two groups based on the Meary's angle in standing foot lateral radiographs: those with normal feet (angles ranging from -4° to 4°) and those with mild flatfeet (angles from -8° to -15°). The static and dynamic plantar pressures of the participants were measured using HR Mat and EMED-n50. The reliability of the contact area and mean force was assessed using the interclass correlation coefficient (ICC). Furthermore, the differences in measurements between the two devices were examined, considering the presence of mild flatfoot. Results: The ICC values for the contact area and mean force ranged from 0.703 to 0.947, indicating good-to-excellent reliability across all areas. EMED-n50 tended to record higher contact areas than HR Mat. The mean force was significantly higher in the forefoot region when measured with EMED-n50, whereas, in the hindfoot region, this difference was observed only during static measurements with HR Mat. Participants with mild flatfeet exhibited significantly higher contact areas in the midfoot region for both devices, with no consistent differences in the other parameters. Conclusion: The contact area and mean force measurements of the HR Mat and EMED-n50 showed high reliability. On the other hand, EMED-n50 tended to record higher contact areas than HR Mat. In cases of mild flatfoot, an increase in contact area within the midfoot region was observed, but no consistent impact on the differences between the two devices was evident. [ABSTRACT FROM AUTHOR]

The objective of this study was to establish the accuracy of the resting calcaneal stance position (RCSP) for the assessment of flat foot (FF) in children, aligned to the validity of the foot posture index (FPI). The RCSP cut-off point was explored, in context of both FF prevalence and the relationship between FF and body weight. A total of 205 healthy children, aged 5 to 10 years, participated in a cross-sectional study. Correlation was performed between RCSP and FPI. ROC curve technique was calculated to assess differentiation between groups. A score equal to or greater than 7 on the FPI was used as the 'gold standard' for analysis. The correlation between FPI and RCSP was significant (r = 0.63; p < 0.01). The discrimination score on the ROC curve (6 points/degrees) shows that the model can be used to identify FF through RCSP, with a sensitivity of 67% and specificity of 85% returned. Conclusion: The results of this study indicate the role of RCSP for simple, accessible and quick screening of paediatric FF. This is especially pertinent for non-podiatric healthcare professional without specialised paediatric foot knowledge. What is Known: • Most children develop a normal arch quickly, and flat feet usually resolve on their own between 2 and 6 years of age. • The measurement used to diagnose flat foot in children must be accurate, consistent, and valid to characterize the standard foot position. The Resting Calcaneal Stance Position (RCSP) is another widely used measure to evaluate the position of the flat foot in children. What is New: • The RCSP cut-off point 6 shows a sensitivity of 67% and a specificity of 85% thanks to the FPI as the Gold standard. • The RCSP is useful for health professionals who are not specialised in pediatric foot health. The RCSP is useful to detect flat foot in children. [ABSTRACT FROM AUTHOR]

The aim was to find if foot orthotics alone can improve flat feet in children and analyze how the addition of Zukunft-Huber manual therapy and corrective bandaging changes the outcome. Forty-nine children aged 5 to 10 with asymptomatic flexible flat feet were divided into 2 groups. The first was treated with foot orthoses alone, in the second wearing foot orthoses was supplemented with Zukunft-Huber manual therapy and corrective bandaging. Pedobarography during gait was performed before the therapy and after a year. In the first group decrease in arch index, width, force, and area of midfoot, increase in force MH2 and area hindfoot was found, in the second decrease in arch index, width, force, and area of midfoot, increase in force under metatarsal head second, third, fourth, and fifth, area metatarsal head fourth and area hindfoot. Both methods showed positive changes, but foot orthoses with additional intervention were more effective. [ABSTRACT FROM AUTHOR]

Background and aim: The foot is crucial for maintaining balance and bearing weight, as it is the lowest part of the movement chain of the lower limb. Pes planus is a common condition where the height of the medial longitudinal arch of the foot decreases or disappears. In this study, we aim to determine the effect of kinesio tape and dynamic tape on the balance and ankle dorsiflexion range of motion (DFROM) of men suffering from pes planus following fatigue. Methods: In this cross-sectional study, 35 men aged between 18 and 35 with pes planus participated, meeting the inclusion and exclusion criteria. The study evaluated dynamic balance and ankle DFROM on three separate days under each of the three conditions: control (without tape), kinesio-tape, and dynamic tape before and after fatigue. The modified low-dye method was used for taping. The data was analyzed using a repeated measure analysis of variance test, with a significance level of P<0.05 . Results: No significant differences were found in ankle DFROM before and after fatigue (P<0.05). Additionally, DB results were not significant differences before fatigue (P<0.05). However, after fatigue, a significant difference was found between the dynamic tape and other conditions in all three directions: anterior, posteromedial, and posterolateral (P<0.05). Conclusion: According to the results obtained, DT is recommended to improve DB in men with pes planus after fatigue. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of the study was to identify the variables of the internal compensatory mechanisms that differentiate the body build and posture of people with Down syndrome (DS) from the intellectual disability (ID) population. It was assumed that gaining knowledge in the abovementioned aspect will allow for a better understanding of the limitation of the kinesthetic abilities of people with ID and DS and simultaneously enable to optimize the process of planning and interventions to improve physical activity in this population with the adequate use of theirs strengths in the biomechanical and morphofunctional systems. Methods The methodology of this systematic review was developed according to the PRISMA guidelines. A search of PubMed, EBSCO, Scopus databases was conducted to identify all studies on DS/ID and the body build and posture from 2003 to 2023. Results 395 articles were assessed to determine eligibility, while 22 studies met the inclusion criteria and were subjected to detailed analysis and assessment of their methodological quality. The differentiation of the body build and posture in DS population can be induced by both internal and external compensatory mechanisms. It is difficult to confirm the direct effect of the intrinsic variables that impact the body build and posture in the ID population, excluding people with DS. Conclusions Compared to other ID, the intrinsic differences in the body build and posture in DS individuals were induced by gender, age, and level of ID. The tendency for diversity between DS and other ID populations in body build and posture may be determined by the presence of the third copy of chromosome 21 in DS group. Internal compensatory processes may be induced mainly by abnormalities in the structure of the cervical vertebrae and feet. IQ should not be used as the only variable that identifies the population of people with ID.

Abstract Background Flat foot, also known as pes planus, is a common condition among primary school children and is a leading cause of all clinical visits related to foot problems worldwide. It can cause skeletal problems and joint misalignment. This study aimed to assess the magnitude of flat foot and its associated factors among public primary school children. Methods An institutional-based cross-sectional study was conducted on 1072 school children aged 11 to 18 years. A structured questionnaire was used for data collection and the footprints were used to calculate the plantar arch index. Data were entered into Epi data version 4.6, and analyzed by STATA version 15. Bivariable and multivariable binary logistic regressions were conducted. Adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs) were calculated. Statistical significance was declared at a P-value

Background: The aim of the study was to identify the variables of the internal compensatory mechanisms that differentiate the body build and posture of people with Down syndrome (DS) from the intellectual disability (ID) population. It was assumed that gaining knowledge in the abovementioned aspect will allow for a better understanding of the limitation of the kinesthetic abilities of people with ID and DS and simultaneously enable to optimize the process of planning and interventions to improve physical activity in this population with the adequate use of theirs strengths in the biomechanical and morphofunctional systems. Methods: The methodology of this systematic review was developed according to the PRISMA guidelines. A search of PubMed, EBSCO, Scopus databases was conducted to identify all studies on DS/ID and the body build and posture from 2003 to 2023. Results: 395 articles were assessed to determine eligibility, while 22 studies met the inclusion criteria and were subjected to detailed analysis and assessment of their methodological quality. The differentiation of the body build and posture in DS population can be induced by both internal and external compensatory mechanisms. It is difficult to confirm the direct effect of the intrinsic variables that impact the body build and posture in the ID population, excluding people with DS. Conclusions: Compared to other ID, the intrinsic differences in the body build and posture in DS individuals were induced by gender, age, and level of ID. The tendency for diversity between DS and other ID populations in body build and posture may be determined by the presence of the third copy of chromosome 21 in DS group. Internal compensatory processes may be induced mainly by abnormalities in the structure of the cervical vertebrae and feet. IQ should not be used as the only variable that identifies the population of people with ID. [ABSTRACT FROM AUTHOR]

Background: Flat foot is a condition in which the Medial longitudinal arch (MLA) has a more flattened curve when foot makes full contact with the ground. In medical terms, flat foot is associated with the pronated foot. For people ages 20 to 60, flat foot prevalence is 13.6%. People who have weak posterior tibial tendons are more likely to have flat feet and Flat foot is one of the contributing factors to development of anterior knee pain. Purpose: To compare the effectiveness of Tibialis posterior strengthening exercise and Quadriceps strengthening exercise among people with anterior knee pain. Materials and Method: The experimental study included 170 volunteers, both male and female, aged 20-60 years, who were drawn from Martin Physiotherapy Clinic by convenience sample method. informed consent was obtained before beginning the study. The participants were divided into two groups, the Tibialis posterior (n=85) group received Tibialis posterior strengthening exercise, whereas the Quadriceps (n=85) group received Quadriceps strengthening exercise. The intervention was administered five times over the course of six weeks. Study Period: March 2023 to July 2023. Results: The collected data was statistically analysed using paired and unpaired t-test, showed significant improvement in Tibialis posterior group than quadriceps group with p<0.0001. Conclusion: The study concludes that Tibialis posterior strengthening was more effective in reducing pain and improving functional status among peoples with anterior knee pain. [ABSTRACT FROM AUTHOR]

Introduction: Competitive swimming is one of the most popular Olympic sports. Although studies indicate that explored flat feet improved running performance, research on foot types and their impact on swimming is scarce and unexplored. This study investigates the difference between flutter kicking speed among competitive swimmers with flat and standard feet. Materials and Methods: A total of 78 competitive swimmers in the age range of 13 to 19 years were recruited from Pusat Akuatik Darul Ehsan swimming training using a purposive sampling method and a cross-sectional study design. Based on their navicular drop test scores, the participants were categorized as flat-footed (group A) and normal-footed (group B). An independent t-test was applied to compare the kicking speeds between flat-footed and normalfooted swimmers. The swimmers in group A and group B were instructed to perform a standard 50-m kicking front crawl performance with the upper limb placed over the sliding board individually in a swimming pool, and their reaching time was recorded using a stopwatch. Results: The results indicated flat-foot swimmers' front crawl kicking performance was faster than normal-foot swimmers' (P=0.03) with a medium effect size (d=0.50). Conclusion: This study concludes that flat-footed competitive swimmers have an advantage in reaching 50 m in less time than normal-footed swimmers. Conclusion: This study concludes that flat-footed competitive swimmers have an advantage in reaching 50 m in less time than normal-footed swimmers. [ABSTRACT FROM AUTHOR]

Background: Flat foot, also known as pes planus, is a common condition among primary school children and is a leading cause of all clinical visits related to foot problems worldwide. It can cause skeletal problems and joint misalignment. This study aimed to assess the magnitude of flat foot and its associated factors among public primary school children. Methods: An institutional-based cross-sectional study was conducted on 1072 school children aged 11 to 18 years. A structured questionnaire was used for data collection and the footprints were used to calculate the plantar arch index. Data were entered into Epi data version 4.6, and analyzed by STATA version 15. Bivariable and multivariable binary logistic regressions were conducted. Adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs) were calculated. Statistical significance was declared at a P-value < 0.05. Result: Out of 1022 participants, 105(10.27%) 95%CI: 8.5–12) had a flat foot. Being male (AOR = 2; 95%CI:1.22-3.30), living in highland altitude (AOR = 8.83; 95% CI: 4.64-16.79), living in midland altitude (AOR = 3.32;95% CI:1.75-6.29), living in an urban area (AOR = 2.42;95% CI:1.15-5.09), insufficient physical activity (AOR = 8.78;95% CI: 4.42-12.3), wearing closed-toe shoes (AOR = 2.33;95%CI:1.27-4.28), obesity (AOR = 6.30;95% CI:3.31-11.9), and foot pain (AOR = 3.52;95%CI:2.08-6.27) had a higher likelihood of flat foot as compared to their counterparts. Conclusion: One in every ten children had a flat foot. Altitude, residence, sex, physical activity, foot pain, body mass index, and type of footwear were found to be factors statistically associated with flat foot. Integrated interventions for children to have sufficient physical activity, wearing sandals, maintaining a healthy body mass index, and flatfoot screening and monitoring are recommended. [ABSTRACT FROM AUTHOR]

This study aims to analyse the relationship between body mass index and foot length in Chinese adolescents and to provide theoretical guidance for preventing a flat foot in Chinese adolescents. This study recruited 1477 students aged 14–23 years. The participants' height, weight, and body mass index were measured, as well as baseline data, including age, gender and foot length. Differences in foot length (bilateral) and flat foot distribution were statistically significant except for the normal foot and high arch foot distribution based on different body mass index groups. Linear correlation analysis demonstrated that body height, weight and body mass index were positively correlated with bilateral foot length regardless of gender. Body mass index acted as a risk factor for flat foot (bilateral) through disordered multi-classification logistic regression analysis. Body mass index was positively correlated with left and right foot length regardless of gender and acted as a risk factor for a flat foot in Chinese adolescents. Practitioner summary: Significant differences exist in the anthropometric data of various races and ethnic groups. The study was investigated in the form of a cross-sectional study. BMI was positively correlated with bilateral foot length and acted as a risk factor for a flat foot in Chinese adolescents. [ABSTRACT FROM AUTHOR]

Background: This study evaluates the potential of ChatGPT and Google Bard as educational tools for patients in orthopedics, focusing on sports medicine and pediatric orthopedics. The aim is to compare the quality of responses provided by these natural language processing (NLP) models, addressing concerns about the potential dissemination of incorrect medical information. Methods: Ten ACL- and flat foot-related questions from a Google search were presented to ChatGPT-3.5 and Google Bard. Expert orthopedic surgeons rated the responses using the Global Quality Score (GQS). The study minimized bias by clearing chat history before each question, maintaining respondent anonymity and employing statistical analysis to compare response quality. Results: ChatGPT-3.5 and Google Bard yielded good-quality responses, with average scores of 4.1 ± 0.7 and 4 ± 0.78, respectively, for sports medicine. For pediatric orthopedics, Google Bard scored 3.5 ± 1, while the average score for responses generated by ChatGPT was 3.8 ± 0.83. In both cases, no statistically significant difference was found between the platforms (p = 0.6787, p = 0.3092). Despite ChatGPT’s responses being considered more readable, both platforms showed promise for AI-driven patient education, with no reported misinformation. Conclusions: ChatGPT and Google Bard demonstrate significant potential as supplementary patient education resources in orthopedics. However, improvements are needed for increased reliability. The study underscores the evolving role of AI in orthopedics and calls for continued research to ensure a conscientious integration of AI in healthcare education.

The prevalence of individuals with flat feet and high arches is very high (between 15% to 37%), which can often lead to other orthopedic complications. Three-dimensional-printed insoles are being studied and validated for their effects in correcting these highly prevalent foot disorders. Highly customizable parameters while printing the insole allows for precise correction of foot biomechanics. In this study, 200 patients suffering from various foot-related problems and joint pain were given 3d-printed insoles (designed using plantar pressure systems and clinical practitioner’s assessment) to use in their footwear. Tested activities included standing, walking, running, sports, and gym workout. Customization of insoles included custom density, heel cup, heel rise, medial arch height, and lateral wedge. Based on the patient history, additional podiatry elements were provided for patients with diabetes. Each insole was designed as per the insole profile of the shoe with a comfortable fit. These insoles were found to be effective in alleviating pain for more than 90% of the patients and provided a longer life cycle with effective orthotic correction (for >16 months of daily use). This paper presents the post-use effects (6–18 months) of custom 3D-printed insoles.

Purpose: The purpose of this study was to compare the incidence of revision in those with pes planovalgus deformity to those without using a large national database. Given the reciprocal changes in lower extremity alignment associated with planovalgus foot deformity, it has been suggested that patients with this deformity has worse outcomes following total knee arthroplasty (TKA). Methods: A retrospective cohort analysis of patients undergoing elective TKA was conducted using the PearlDiver database. Patients were stratified into three cohorts: those without pes planovalgus, patients with ipsilateral or bilateral pes planovalgus relative to the TKA, and patients with contralateral pes planovalgus. Patients with prior foot reconstructive surgery were excluded. The cohorts were each matched to those without pes planovalgus. Bivariate analysis was performed comparing 90-day medical complications and 2- and 4-year revisions following TKA. An adjusted number needed to be exposed for one additional person to be harmed (NNEH) was calculated using the adjusted odds ratio (OR) and unexposed event rate. Results: Following matched analysis, those with contralateral pes planovalgus had similar odds (OR 3.41; 95% CI 0.93–12.54; p = n.s.) for aseptic revision within 2 years but significantly higher odds (OR 3.35; 95% CI 1.08–10.41; p = 0.03) within 4 years when compared to those without a pes planovalgus deformity. Within 4 years, there was no significant difference in the incidence of aseptic revision (p = n.s.) in patients with ipsilateral/bilateral pes planovalgus. No patients in any cohort underwent septic revision within 4 years of TKA. Conclusion: This study found that patients with contralateral pes planovalgus deformity had higher odds of aseptic revision within 4 years following primary TKA in a national database, suggesting that the change in gait kinematics associated with this deformity could possibly be associated with increased revision rates. Level of evidence: Level III. [ABSTRACT FROM AUTHOR]

BACKGROUND: Scarf osteotomy is an effective procedure for correcting the valgus of the flat foot, which is a three-dimensional orthopedic procedure. Whether the angle of the osteotomy will affect the orthopedic strength needs to be studied. OBJECTIVE: To simulate Scarf osteotomy at different angles in 3-matic software, and to analyze the effect of Scarf osteotomy angle on flat foot orthopedics. METHODS: Three-dimensional models of the flat foot on weight-bearing state were imported into 3-matic software to obtain the sketches of the frontal lateral and coronal rear foot. The relevant indexes of flat feet were measured as the flat feet indexes before operation. In the same model, the traditional Evans combined with medial displacement calcaneal osteotomy, as well as different angles of Scarf osteotomy, such as 45°, 60°, 75°, 90°, 105°, 120° were performed. After the osteotomy was completed, the flat foot-related indicators were measured again, and compared with those before the operation. RESULTS AND CONCLUSION: Simple bone surgery had little effect on the talus pitch angle and the talo-first metatarsal angle on lateral side. Evans operation had greater correction of fore foot abduction, while Scarf osteotomy had no significant effect on it. For the effect on the hind foot valgus, Scarf osteotomy showed greater effects than the traditional Evans combined with medial displacement calcaneal osteotomy. The contact area of the osteotomy was larger than that of the traditional one, and decreased gradually with the increase of the angle of Scarf osteotomy. In addition, this study found that perpendicular to the lateral wall of the opposite bone after osteotomy, along the perpendicular to the lateral wall of the external bone can play a part in the role of deepening the arch. [ABSTRACT FROM AUTHOR]

Flat foot is a postural deformity in which the plantar part of the foot is either completely or partially contacted with the ground. In recent clinical practices, X-ray radiographs have been introduced to detect flat feet because they are more affordable to many clinics than using specialized devices. This research aims to develop an automated model that detects flat foot cases and their severity levels from lateral foot X-ray images by measuring three different foot angles: the Arch Angle, Meary's Angle, and the Calcaneal Inclination Angle. Since these angles are formed by connecting a set of points on the image, Template Matching is used to allocate a set of potential points for each angle, and then a classifier is used to select the points with the highest predicted likelihood to be the correct point. Inspired by literature, this research constructed and compared two models: a Convolutional Neural Network-based model and a Random Forest-based model. These models were trained on 8000 images and tested on 240 unseen cases. As a result, the highest overall accuracy rate was 93.13% achieved by the Random Forest model, with mean values for all foot types (normal foot, mild flat foot, and moderate flat foot) being: 93.38 precision, 92.56 recall, 96.46 specificity, 95.42 accuracy, and 92.90 F-Score. The main conclusions that were deduced from this research are: (1) Using transfer learning (VGG-16) as a feature-extractor-only, in addition to image augmentation, has greatly increased the overall accuracy rate. (2) Relying on three different foot angles shows more accurate estimations than measuring a single foot angle. [ABSTRACT FROM AUTHOR]

Background and Aims Karate is one of the most popular martial arts worldwide, and flat foot deformity is one of the most common disorders in people participating in this sport. This disorder can negatively affect the static and dynamic balance in individuals. Therefore, this study aimed to investigate the effect of corrective exercises on foot posture and balance in female karate athletes with flat foot.Methods This research was a quasi-experimental study performed in two phases: pre-test and post-test. Forty female karatekas with flexible flat foot postures entered the study as subjects. They were randomly divided into exercise group (Mean±SD age: Mean±SD 20.00±1.81 y, Mean±SD height: 161.4±6.49 cm, and Mean±SD weight: 55.27±6.56 kg) and control (Mean±SD age: 21.02±2.19 y, Mean±SD height cm: 160.4±4.23, and Mean±SD weight: 55.75±3.90 kg). As one of the inclusion criteria, a navicular drop test was performed for all subjects to assess the condition of the foot posture. Also, the balance error scoring system and Y balance tests were used for all subjects to check the static and dynamic balance. Then, the exercise group performed 6 weeks of corrective exercises, but the control group did not perform any specific exercises during this period. After 6 weeks, the tests were repeated. Statistical analysis was performed in SPSS software version 26. A covariance analysis test was used to evaluate the between-group differences, and paired sample t test was used to evaluate the within-group changes.Results This study’s findings showed that the corrective exercise group in thepost-test had a better performance than the pre-test in the navicular drop test, in all three directions of the Y balance test, and in the balance error scoring system (P=0.0001). But in the control group, no significant difference was observed between the two stages of the test (P>0.05). It was also observed in the comparison between groups that in thepost-test in the variables of the navicular drop test and also in all three directions of the Y balance test and the test of the scoring system, the balance error scoring system of the experimental group achieved better results than the control group (P>0.05). Conclusion This study showed that 6 weeks of corrective exercises has significantly improved foot posture and static and dynamic balance in karate women with flexible flat feet. According to the results obtained in this study, it seems that comprehensive corrective exercises can be used in this group to improve balance and posture.

Introduction: Competitive swimming is one of the most popular Olympic sports. Although studies indicate that explored flat feet improved running performance, research on foot types and their impact on swimming is scarce and unexplored. This study investigates the difference between flutter kicking speed among competitive swimmers with flat and standard feet. Materials and Methods: A total of 78 competitive swimmers in the age range of 13 to 19 years were recruited from Pusat Akuatik Darul Ehsan swimming training using a purposive sampling method and a cross-sectional study design. Based on their navicular drop test scores, the participants were categorized as flat-footed (group A) and normal-footed (group B). An independent t-test was applied to compare the kicking speeds between flat-footed and normal-footed swimmers. The swimmers in group A and group B were instructed to perform a standard 50-m kicking front crawl performance with the upper limb placed over the sliding board individually in a swimming pool, and their reaching time was recorded using a stopwatch. Results: The results indicated flat-foot swimmers’ front crawl kicking performance was faster than normal-foot swimmers’ (P=0.03) with a medium effect size (d=0.50). Conclusion: This study concludes that flat-footed competitive swimmers have an advantage in reaching 50 m in less time than normal-footed swimmers.

A cross-sectional analytical study was conducted on 165 healthy young adults. Individuals with pes rectus and pes planus to correlate the medial longitudinal arch height with postural stability, sensory integration and balance and fall risks. Persons with pes cavus, congenital foot anomalies other than pes planus, leg length discrepancies, recent history of trauma, lower limb amputations, history of serious foot injury, ligamentous laxity, or an active inflammatory disorder were excluded. Outcome measurements included normalised truncated navicular height (NTNH), Chippaux Smirak index (CSI), single leg athletic stability (ASLS) index, fall risk (FR) index, postural stability (PS), clinical test of sensory integration of balance (CTSIB), and balance error scoring system (BESS). Spearman correlation and Mann Whitney U test were used for data analysis. ---Continue

Background: The role of the plantar venous pump (PVP) on venous return is evident but the effects of the foot morphology have never been characterized properly. Method: 52 healthy volunteers—26 with normal plantar arch (control) and 26 with dysmorphic plantar arch (in two subgroups: 13 flat feet, 13 hollow feet)—were included. Using Doppler ultrasound, we measured the diameter and the peak systolic velocity in the large veins of the lower limb after PVP stimulation by manual compression and bodyweight transfer. Result: The mean peak systolic velocity of the studied veins varied from 12.2 cm/s to 41.7 cm/s in the control group and from 10.9 cm/s to 39.1 cm/s in the dysmorphic plantar group. The foot arch morphology did not affect significantly the venous blood flows, except in the great saphenous vein during manual compression. Conclusion: The plantar morphology did not induce a significant increase of venous blood velocity resulting from PVP stimulation. [ABSTRACT FROM AUTHOR]

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Flatfoot is a condition in which part or all of the soles of the feet do not form an arch (longitudinal arch) as normal so that the soles of the feet appear flat and touch the ground. This condition makes the function of the soles of the feet as shock absorbers and as a support for body weight during activities, cannot work properly. This greatly affects the development of body components, including flexibility and balance. Flexibility and balance are needed when a person is active, especially at the age of 2-6 years which is a golden age in determining future growth and development. Pathology in the form of weak extrinsic muscles of the foot which makes the midtarsal joint unstable so that the foot looks pronated, besides that there is tension in the ligaments in the foot. Measurements of the wet footprint test, Clarke's angle, Knee to Wall Test, and stork stand test. Strengthening ball roll exercises increased extrinsic muscle strength, and the application of rolling the ball can relax muscles that are experiencing tension. [ABSTRACT FROM AUTHOR]

The prevalence of individuals with flat feet and high arches is very high (between 15% to 37%), which can often lead to other orthopedic complications. Three-dimensional-printed insoles are being studied and validated for their effects in correcting these highly prevalent foot disorders. Highly customizable parameters while printing the insole allows for precise correction of foot biomechanics. In this study, 200 patients suffering from various foot-related problems and joint pain were given 3d-printed insoles (designed using plantar pressure systems and clinical practitioner's assessment) to use in their footwear. Tested activities included standing, walking, running, sports, and gym workout. Customization of insoles included custom density, heel cup, heel rise, medial arch height, and lateral wedge. Based on the patient history, additional podiatry elements were provided for patients with diabetes. Each insole was designed as per the insole profile of the shoe with a comfortable fit. These insoles were found to be effective in alleviating pain for more than 90% of the patients and provided a longer life cycle with effective orthotic correction (for >16 months of daily use). This paper presents the post-use effects (6–18 months) of custom 3D-printed insoles. [ABSTRACT FROM AUTHOR]

Study aim: A flexible flat foot (FFF), one of the most common postural deformities among children, should not be perceived as an isolated problem of static alignment of foot and ankle, but as a part of dynamic biomechanical chain of a lower extremity, pelvis, and lower back. The aim of the study was to compare the impact of two methods, used for treating FFF, on the gait pattern in children after 12 months treatment.

Abstract Background A flat foot is a common cause of chronic sports injuries and therefore many opportunities for arch support interventions exist. However, young athletes change their foot morphology due to developmental influences even without intervention. Therefore, developmental influences need to be considered when examining the effects of arch support, but there have not been sufficient longitudinal studies to date. This study aimed to determine the effect of the arch support intervention by performing a 9-weeks arch support intervention on the foot morphology and cross-sectional area of the foot muscles in flat-footed young athletes. Thirty-one elementary school boys (Age 11.4 ± 0.5 years, Height 145.2 ± 7.4 cm, Weight 38.8 ± 8.3 kg, BMI 18.2 ± 2.2 kg/m2) with a decreased medial longitudinal arch in the foot posture index were selected as participants from a local soccer club and randomly divided into two groups. Methods In one group, in the intervention period, an existing arch supporter was used to provide arch support, while in the other group, no special intervention was provided in the observation period. To account for developmental effects, the intervention study was conducted as an 18-weeks crossover study in which the intervention and observational phases were switched at 9 weeks after the intervention. Foot morphology was assessed using a three-dimensional foot measuring machine, and the cross-sectional area (CSA) of the internal and external muscles of the foot was assessed using an ultrasound imaging device. We examined the effect of the intervention by comparing the amount of change in the measurement results between the intervention and observation periods using corresponding t-tests and Wilcoxon signed-rank sum test, analysis of covariance methods. Results After adapting the exclusion criteria, 14 patients (28 feet) were included in the final analysis. The CSA of the abductor hallucis muscle (ABH) increased 9.7% during the intervention period and 3.0% during the observation period (p = 0.01). The CSA of the flexor digitorum longus muscle (FDL) increased 7.7% during the intervention period and 4.2% during the observation period (p = 0.02). Conclusion A 9-weeks arch supporter intervention may promote the development of the ABH and FDL CSA in young flat-footed soccer players.

Background: determining the appropriate rehabilitation protocol is essential to influence the correction of flat feet, e.g., by activating the intrinsic muscles of the foot. Therefore, this study aimed to determine the impact of the exercises activating the intrinsic foot muscles for postural control in children with flat feet, with normal and excessive body weight. Methods: Fifty-four children aged 7 to 12 were enrolled in the research. Forty-five children were qualified for the final evaluation. Each child in the experimental group was demonstrated an appropriate technique for performing a short foot exercise without compensation by extrinsic muscle. The participants then performed a supervised short foot training session once a week and on other days of the week under the supervision of caregivers for 6 weeks. Flat feet were scored on the foot posture index scale. A postural test was evaluated with a Biodex balance system SD. Statistical significance in the foot posture index scale and postural test were evaluated using an analysis of variance (ANOVA) with Tukey's post-hoc test. Results: according to the six indices of the foot posture index scale, five indicators showed statistically significant improvement after rehabilitation. At the 8–12 platform mobility level, it was revealed that the excessive body weight group had significant improvements in the overall stability index and medio-lateral stability index, with eyes closed. Conclusion: our results indicate that a 6-week rehabilitation program based on the activation of the intrinsic muscles of the foot resulted in an improvement in the foot position. This, in turn, affected balance control, especially in children with excess body weight in conditions of closed eyes. [ABSTRACT FROM AUTHOR]

Introduction: Lower Extremity Alignment (LEA) is a main influencing cause in the active motion of the human body. Changes in the lower limb kinetic chain can be pushed by Body Mass Index (BMI). The gait may be impacted, which may result in more energy usage. However, little is known about how BMI and other static alignment parameters such as Quadriceps (Q)- angle, tibial torsion and plantar arch index are related. Aim: To determine the correlation between BMI and lower extremity kinetic chain variables such as pronated feet, femoral anteversion, Q-angle, tibial torsion, plantar arch index, angle of toe and pelvic inclination. Materials and Methods: The present cross-sectional study was conducted in the Department of Physiotherapy, Santosh Hospital Ghaziabad, Uttar Pradesh, India, from January 2021 to December 2021. A total of 160 participants age ranged between 18 years and 30 years with a BMI between 25 kg/m2 and 29 kg/m2 were included in the study. The following parameters were measured: pronated foot, angle of toe, plantar arch index, pelvic inclination, femoral anteversion, Q-angle and tibial torsion. Correlation between BMI with the seven static alignment parameters mentioned above was statistically analysed by using Pearson's correlation coefficient and Spearman's correlation test. Results: The mean age of the subjects was 23.82±2.021 years and mean BMI of the participants was 26.37±1.501 kg/m2. There was significant correlation between BMI and pronated foot of both sides (r-value=0.256, 0.199, p-value=0.001, 0.012), BMI and plantar arch index of both sides (r-value=0.198, 0.161, p-value=0.013, 0.043). However, no significant correlation was found between BMI and Q-angle (r-value=0.137,0.144, p-value=0.087, 0.72), BMI and tibial torsion (r-value=0.024, 0.066, p-value=0.766, 0.413), BMI and anteversion (r-value=0.111, 0.134, p-value=0.164, 0.92), BMI and angle of toe (r-value=0.127, 0.139, p-value=0.111, 0.081) and, BMI and pelvic inclination (r-value=0.012, 0.013, p-value=0.885, 0.870). Conclusion: BMI was positively correlated with the pronated feet and plantar arch index, and this relationship was statistically significant. However, no statistically significant relationship between BMI and pelvic tilt, femoral anteversion, Q-angle, tibial torsion and angle of toe. [ABSTRACT FROM AUTHOR]

Morton's neuroma (MN) is a compressive neuropathy of the common digital plantar nerve causing forefoot pain. Foot posture and altered plantar pressure distribution have been identified as predispoing factors, however no studies have compared individuls with different foot postures with MN. Thus, we aimed to compare the effect of MN on spatiotemporal gait parameters and foot-pressure distribution in individuals with pes planus and pes cavus. Thirty-eight patients with unilateral MN were evaluated between June and August 2021. Nineteen patients with bilateral pes planus and 19 age and gender-matched patients with pes cavus who had no prior surgery were recruited. A Zebris FDM–THM–S treadmill system (Zebris Medical GmbH, Germany) was used to evaluate step length, stride length, step width, step time, stride time, cadence, velocity, foot-pressure distribution, force and whole stance phase, loading response, mid stance, pre-swing and swing phase percentages. There were no significant differences between the groups in spatiotemporal gait parameters (p > 0.05). Patients with pes planus displayed the following results for step length (49.36 ± 8.38), step width (9.05 ± 2.12), stance phase percentage (65.92 ± 2.11), swing phase percentage (34.08 ± 2.12), gait speed (2.96 ± 0.55), and cadence (100.57 ± 8.84). In contrast, patients with pes cavus displayed the following results for step length (49.06 ± 8.37), step width (8.10 ± 2.46), stance phase percentage (64.96 ± 1.61), swing phase percentage (34.79 ± 1.60), gait speed (2.95 ± 0.65), and cadence (99.73 ± 13.81). Foot-pressure distribution values showed no differences were detected in force, forefoot, and rearfoot pressure distribution, except for midfoot force (p

Purpose: Karate is one of the most popular martial arts around the world, and flatfoot deformity is one of the most common disorders in people participating in this sport. This disorder can negatively affect the function and joint position sense (JPS). This study aimed to investigate the effect of 6 weeks of comprehensive corrective exercise training on the function of the lower limb and JPS in female karatekas with flatfoot. Methods: In this field trial study, 40 female karatekas with flexible flatfoot postures were recruited and randomly divided into two groups of exercise and control. The Staheli index test was performed for all subjects to assess the condition of the foot posture, as one of the inclusion criteria also, single leg 6-m timed hop test, single leg triple hop for distance test, and ankle joint JPS were used to evaluate the function of the lower limb. Then, the exercise group performed 6 weeks of corrective exercises, but the control group did not perform any specific exercises during this period. After 6 weeks, the tests were repeated. A covariance analysis test was used to evaluate the between-groups differences, and paired sample t-test was used to evaluate the within-group changes. Results: Corrective exercise group in the post-test had a better performance than the pre-test in the Staheli index test, JPS, the single leg 6-m timed hop test, and single leg triple hop for distance test (P=0.0001). However, in the control group, no significant difference was observed between the two stages of the test (P>0.05). Also, by comparing groups in the post-test via the Staheli index test, JPS, single leg 6-m timed hop test, and single leg triple hop for distance test. It was found that the experimental group achieved better results than the control group (P>0.05). Conclusion: Six weeks of comprehensive corrective training has significantly improved foot posture, JPS, and function of the lower limb in female karatekas with flatfoot. Thus, comprehensive corrective exercises can be used in this group to improve foot posture, JPS, and function of the lower limb.

Introduction: Lower Extremity Alignment (LEA) is a main influencing cause in the active motion of the human body. Changes in the lower limb kinetic chain can be pushed by Body Mass Index (BMI). The gait may be impacted, which may result in more energy usage. However, little is known about how BMI and other static alignment parameters such as Quadriceps (Q)-angle, tibial torsion and plantar arch index are related. Aim: To determine the correlation between BMI and lower extremity kinetic chain variables such as pronated feet, femoral anteversion, Q-angle, tibial torsion, plantar arch index, angle of toe and pelvic inclination. Materials and Methods: The present cross-sectional study was conducted in the Department of Physiotherapy, Santosh Hospital Ghaziabad, Uttar Pradesh, India, from January 2021 to December 2021. A total of 160 participants age ranged between 18 years and 30 years with a BMI between 25 kg/m2 and 29 kg/m2 were included in the study. The following parameters were measured: pronated foot, angle of toe, plantar arch index, pelvic inclination, femoral anteversion, Q-angle and tibial torsion. Correlation between BMI with the seven static alignment parameters mentioned above was statistically analysed by using Pearson’s correlation coefficient and Spearman’s correlation test. Results: The mean age of the subjects was 23.82±2.021 years and mean BMI of the participants was 26.37±1.501 kg/m2. There was significant correlation between BMI and pronated foot of both sides (r-value=0.256, 0.199, p-value=0.001, 0.012), BMI and plantar arch index of both sides (r-value=0.198, 0.161, p-value=0.013, 0.043). However, no significant correlation was found between BMI and Q-angle (r-value=0.137,0.144, p-value=0.087, 0.72), BMI and tibial torsion (r-value=0.024, 0.066, p-value=0.766, 0.413), BMI and anteversion (r-value=0.111, 0.134, p-value=0.164, 0.92), BMI and angle of toe (r-value=0.127, 0.139, p-value=0.111, 0.081) and, BMI and pelvic inclination (r-value=0.012, 0.013, p-value=0.885, 0.870). Conclusion: BMI was positively correlated with the pronated feet and plantar arch index, and this relationship was statistically significant. However, no statistically significant relationship between BMI and pelvic tilt, femoral anteversion, Q-angle, tibial torsion and angle of toe.

OBJECTIVE: To perform a Meta-analysis to comprehensively and quantitatively evaluate the effects of short foot training on foot and ankle function in patients with flat feet, and to provide a theoretical basis for more effective training in patients with flat feet. METHODS: Chinese and foreign literature databases such as Web of Science, The Cochrane Library, PubMed, Embase, CNKI database, VIP database, and China Biomedical Literature Database were searched. The search time was from database inception to January 31, 2022. Chinese database search terms and search formula: (flatfoot OR valgus foot OR stiff foot) AND (short foot training OR physical therapy). English database search terms and search formula: (flatfoot OR talipes valgus OR talipes calcaneovalgus) AND (short foot exercises OR physical therapy OR neurophysiotherapy). The Cochrane risk of bias assessment tool was selected to evaluate the quality of the included literature, and all included articles were analyzed for outcome indicators (navicular drop and foot posture index) using Revman 5.4 and Stata 12.0 software. RESULTS: A total of 12 papers with 443 subjects were included. Five were moderate risk of bias and seven were low risk of bias literature. Short-foot training could reduce navicular drop [standardized mean difference (SMD)=-0.59, P < 0.05). Subject age (regression coefficient: -1.563 9, P=0.004), body mass index (regression coefficient: -1.563 9, P=0.023) and intervention duration (regression coefficient: -1.445 6, P=0.042) influenced the overall effect of the included literature. Short foot training showed insignificant effects on foot posture index (SMD=-0.26, P > 0.05). CONCLUSION: Short-foot training can effectively reduce navicular drop in patients with flat foot but has no clear effects on foot posture index. Age, body mass index, and intervention time are the factors that influence the effectiveness of short-foot training interventions and are the factors that need to be considered when conducting relevant studies and organizing rehabilitation training for patients with flat feet. Short-foot training is recommended as a training tool for patients with flat feet. [ABSTRACT FROM AUTHOR]

BACKGROUND: The arch of the foot plays a supporting and cushioning role in people’s daily physical activities. The abnormal arch of the foot can cause movement disorders and lower limb pain. It is the premise of making the corresponding prevention and nursing corrective measures to accurately identify the pathological foot type. OBJECTIVE: The accuracy of foot recognition can be improved effectively by extracting common features of quadrupedal foot and designing foot interruption feature combined with gradient boosted decision tree classifier. METHODS: Totally 1 710 plantar pressure images of 45 people were collected, including high-arch, flat and normal foot. Arch index, footprint index, arch width, and ratio index of plantar pressure images were extracted respectively. At the same time, the foot interruption feature was designed, and the gradient boosted decision tree algorithm was used to recognize different foot types of plantar pressure images.RESULTS AND CONCLUSION: On the constructed data set of 1 710 plantar pressure images of 45 people, the average recognition accuracy of the proposed algorithm reached 96.43%, which was higher than the current commonly used methods based on arch index, footprint index, arch width, and ratio index. [ABSTRACT FROM AUTHOR]

Open techniques for foot surgery are well established. Minimally invasive surgery (MIS) offers the potential of less morbidity, scarring and quicker recovery. Small incisions reduce surgical trauma, improving recovery and decreasing rehabilitation times. Evaluation of the literature enables us to assess the benefits of MIS over existing open techniques to support its widespread adoption. Our aim was to assess levels of evidence for the use of MIS surgery in various aspects of foot and ankle surgery. In the field of hallux valgus correction, randomized control trials, or prospective cohort studies have provided level 1 evidence for the use of MIS techniques. Other aspects of foot and ankle surgery are mainly dominated by technical descriptions or case series. MIS techniques have the opportunity to provide satisfactory outcomes in many fields, with many domains reporting promising results. However, more studies are required to provide good level 1/2 evidence for comparative analysis to equivalent open techniques and establish their true benefit. More trials, longer follow-up and larger patient series may provide more meaningful data to justify MIS's use. Comparative analysis of MIS's true benefit compared to open surgery in areas of foot and ankle surgery outside hallux valgus has yet to be established with higher levels of evidence lacking. [ABSTRACT FROM AUTHOR]

Aim: The current study aimed to compare the arch angles of the foot, Achilles tendinopathy, subcutaneous fat tissue thickness of the heel, and epin calcanei (EC) in patients with osteochondral lesion of the talus (OLT). Materials and Methods: The magnetic resonance images (MRI) of the ankle performed by the radiology clinic between March 2020 and October 2021 were examined. Based on the MRI findings, the patients diagnosed with OLT were included in the study group (n = 55) and those not diagnosed with OLT formed the control group (n = 118). All the patients included in the study were investigated for their demographic characteristics and presence of EC. Weight-bearing lateral X-ray images were used to measure the lateral talusfirst metatarsal angle (Meary's angle), lateral talocalcaneal angle (LTCA), and calcaneal inclination angle (also known as the calcaneal pitch). Results: The study and control groups had no significant difference in terms of gender distribution (P = 0.575). The patients in the study group had a significantly higher mean age than the control group (P < 0.001). Evaluation of the arch angles of the foot showed the patients with OLT to have higher LTCA and calcaneal pitch angles and greater subcutaneous fat thicknesses (p < 0.001, p < 0.001, and p = 0.004, respectively). In addition, the study group showed higher rates of patients with EC and Achilles tendinopathy (p = 0.076 and p = 0.019, respectively). According to the binary logistic regression analysis model, each unit of increase in the patients' age increases the presence of osteochondritis dissecans (OCD) of the talus by 1.063 times (95% confidence interval (CI): 1.012-1.116; P = 0.015). Each unit of increase in LTCA increases the presence of OCD of the talus by 1.360 times (95% CI: 1.219-1.516; P < 0.001). Conclusion: Our study demonstrated that sex had no effect on OLT incidence, whereas changes in the LTCA and pitch angles elevated the risk of OLT. Furthermore, increased age was found to be associated with a higher risk of OLT formation. We also showed that Achilles tendinopathy and EC were significantly higher in patients with OLT. A considerable number of future studies are needed to establish whether this significant relationship is causal. [ABSTRACT FROM AUTHOR]

Introduction: Flat foot and postural control problems is one of the most common physical and motor disorders among students. The aim of this study was to comparison of the effects of comprehensive corrective thera band and water resistance training protocols on the correction of flexible flat foot and postural control in boy students with overweight. Material and Methods: In this quasi-experimental study, which was performed as a pre-test, post-test with a control group, a total of 60 overweight students with flexible flat foot were selected purposefully and divided into three equal groups (Thera band exercise, water resistance training and control) randomly. The experimental groups performed correction exercises for 8 weeks, 3 sessions with 45 minutes per week. Variables were measured at the baseline and after 8 weeks of correction program. Data were analyzed using analysis of covariance by SPSS 24 software at the significance level of p≤0.05. Results: The results showed that the two protocols; theraband exercise, and water resistance training had a significant effect on the improvement of flexible flat feet in overweight male students with coefficients of 0.23, and 0.15, respectively (p ≥0.05). Furthermore, the significant effect was confirmed of these two correction protocols on the improvement of postural control with coefficients of 0.21, and 0.35 respectively (p≥ 0.05). Conclusions: These findings indicate that the two correction exercises of this study have a significant effect on the improvement of flexible flat feet and postural control. Therefore, it is recommended trainers of corrective movements, rehabilitation centers and corrective movements use these training methods. [ABSTRACT FROM AUTHOR]

• We have evaluated the the characteristics in foot morphology in the adult population with and without bilateral flatfoot deformity. • Bilateral flatfoot adults showed changes in the surface areas in both foot. • Adults with bilateral flatfoot recorded higher levels in static plantar pressures. Adult pes planus is a highly prevalent condition characterized by the gradual or sudden appearance of fallen arches in adulthood, which is a recognized cause of difficulty with balance and stability, discomfort, pain, swelling, tired and achy feet and impairment. Accordingly, the main purpose of this analytical, case-control study was to evaluate the characteristics in foot morphology related to static plantar pressure distribution in adults with and without a bilateral condition. Sixty-eight subjects were recruited by a laboratory in this analytical case-control study, involving thirty-four adults with a bilateral condition and thirty-four healthy controls. Static plantar pressure was measured in all participants using a specific portable pressure platform with multiple resistive sensors which was placed on the floor. Static plantar pressure distribution in the cases group showed significant increases in the right and left surface areas, in the right heel surface area and also in the left foot mean peak pressure (p < 0.001), as well as in the left heel surface area (p = 0.003). Adults with bilateral flatfoot showed changes in the surface areas in both feet and recorded higher levels in static plantar pressures with respect to the control group, a feature which can be associated with this common bilateral condition. [ABSTRACT FROM AUTHOR]

Flat foot is a postural deformity in which the plantar part of the foot is either completely or partially contacted with the ground. In recent clinical practices, X-ray radiographs have been introduced to detect flat feet because they are more affordable to many clinics than using specialized devices. This research aims to develop an automated model that detects flat foot cases and their severity levels from lateral foot X-ray images by measuring three different foot angles: the Arch Angle, Meary’s Angle, and the Calcaneal Inclination Angle. Since these angles are formed by connecting a set of points on the image, Template Matching is used to allocate a set of potential points for each angle, and then a classifier is used to select the points with the highest predicted likelihood to be the correct point. Inspired by literature, this research constructed and compared two models: a Convolutional Neural Network-based model and a Random Forest-based model. These models were trained on 8000 images and tested on 240 unseen cases. As a result, the highest overall accuracy rate was 93.13% achieved by the Random Forest model, with mean values for all foot types (normal foot, mild flat foot, and moderate flat foot) being: 93.38 precision, 92.56 recall, 96.46 specificity, 95.42 accuracy, and 92.90 F-Score. The main conclusions that were deduced from this research are: (1) Using transfer learning (VGG-16) as a feature-extractor-only, in addition to image augmentation, has greatly increased the overall accuracy rate. (2) Relying on three different foot angles shows more accurate estimations than measuring a single foot angle.