ORCID Profile
0000-0002-5527-1161
Current Organisations
University of Barcelona
,
La Trobe University
,
Bond University
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Publisher: Wiley
Date: 02-07-2020
DOI: 10.1111/JPC.14558
Abstract: Footprints have long been used as proxy measures of foot morphology, yet there is little consensus regarding footprints versus measures of foot posture, which address foot anatomy directly. Foot posture in children can be a confusing clinical presentation, with previous studies both supporting and refuting the relationship between childhood obesity and flat feet. The aim of this study was to determine the relationship between footprints and foot posture in children. A total of 316 school children (153 boys, 163 girls) from Spain, aged 6-9 years, were assessed for both footprint (Clarke's angle (CA)), by Tecniwork Pedrograph Plate, and foot posture (foot posture index (FPI)) measures, with participants barefoot, in a relaxed standing position, on a 50-cm elevated platform. A negative correlation was found between FPI and footprints (CA) (rho = -0.505 left, P < 0.001) and by gender (rho = -0.457 for the left foot in girls, P < 0.001 rho = -0.548 for the left foot in boys, P < 0.001). The children with pes cavus according to the CA (73.3%) had normal feet according to FPI, and the children with severe pes planus according to the CA (78.98%) had pronated feet according to the FPI. A χ An inverse relationship between CA and FPI was identified, that is, the greater the FPI, the smaller the CA, but not all pronated foot are planus feet and not all cavus feet are supinated feet. Footprints may overestimate and misguide paediatric foot posture concerns.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.GAITPOST.2019.01.023
Abstract: Heel lifts, placed inside footwear are recommended for the management of numerous musculoskeletal conditions. Despite the potential therapeutic benefit of heel lifts, the mechanism(s) by which they exert their effects is unclear. The aim of this systematic review was to synthesise reported findings and summarise the effects of heel lifts on lower limb biomechanics and muscle function. Do heel lifts affect lower limb biomechanics and muscle function during walking and running? Electronic databases (MEDLINE, EMBASE, CINAHL, SPORTDiscus, AMED) were searched from inception to April 2018. Studies were included if they (i) included participants without a limb length discrepancy or neurological condition, (ii) evaluated the effect of bilateral heel lifts that were removable (attached to the participants' foot (barefoot) or inserted inside footwear) or an existing feature of a shoe, and (iii) assessed lower limb biomechanics or muscle function during walking or running in asymptomatic or symptomatic participants. A total of 23 studies (377 participants) were included. Study quality, assessed using a Modified Quality Index, ranged from 5 to 13 out of 15. A large number of biomechanical parameters were assessed, but few effects were statistically significant. The differences that were significant and had a large effect size are described below. In asymptomatic participants, heel lifts of 10 mm decreased duration of swing phase (standardised mean difference [SMD] = -1.3) and heel lifts of at least 5 cm decreased velocity (SMD = -0.93) during walking. In asymptomatic participants, heel lifts of 15 mm decreased maximum ankle dorsiflexion angle (SMD = -1.5) and heel lifts of 12 and 18 mm decreased gastrocnemius muscle tendon unit length (SMD = -0.96) during running. In participants with restricted ankle joint dorsiflexion, heel lifts of 6 and 9 mm increased medial gastrocnemius electromyography litude (SMD between 0.68 and 0.98) during walking. In participants with haemophilia, heel lifts of 9 mm increased ankle joint maximum range of motion (SMD = 1.6) during walking. Heel lifts affect specific lower limb biomechanical and muscle function parameters during walking and running. The clinical relevance and potential therapeutic benefits of these effects needs further investigation.
Publisher: Wiley
Date: 31-10-2007
Publisher: Springer Science and Business Media LLC
Date: 09-11-2016
Publisher: American Podiatric Medical Association
Date: 03-2009
DOI: 10.7547/0980179
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2012
Publisher: Springer Science and Business Media LLC
Date: 21-03-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2013
Publisher: Springer Science and Business Media LLC
Date: 09-12-2022
DOI: 10.1186/S13047-022-00591-Y
Abstract: This commentary outlines practical ways of positively incorporating green podiatry, foot health, physical activity benefits, and relevance to climate change into the clinical setting as Conference of Parties (COP27) approaches. Recent reports from the Intergovernmental Panel on Climate Change, the World Economic Forum, and undergraduate curricula concerns, are presented. Climate change is irrefutable, and as health professionals, podiatrists can discuss the benefits and principles of green podiatry with patients of all ages in their clinics, appreciating that people are increasingly worried about the climate crisis. Feet as fundamental for independent, healthy, and carbon–neutral active transport, needs to become a key message. The three pillars for green podiatry are exercise, evidence, and the everyday changes that all podiatrists can make. Likewise, podiatrists can encourage their patients, and in doing so, join with community leadership, alongside other allied health and medical peers. Podiatrists have a shared responsibility to work and live as ‘green’ as possible, and to share this message with patients. Reducing waste, physically and in the form of unnecessary treatment, and supporting a review of supply chains, are important aspects of reducing health care emissions. Promoting feet as carbon–neutral transport, and physical activity as evidence based and health enhancing, are a sound contribution to twenty-first century public health. Podiatry has a great opportunity for positive legacy.
Publisher: Research Square Platform LLC
Date: 26-04-2023
DOI: 10.21203/RS.3.RS-2838521/V1
Abstract: Objective To develop a new diagnostic tool for joint hypermobility of the paediatric foot and ankle, based on a dichotomous scoring system, the validated Lower Limb Assessment Score (LLAS). With separation of the foot and ankle items, we obtained a new diagnostic tool for joint hypermobility of the foot and ankle, specifically, based on a dichotomous scoring system. Methods A total of 205 children between 5 and 10 years of age participated in the present cross-sectional study. The new tool Foot and Ankle Flexibility Index (FAFI) was the choice of the last 7 items of LLAS, which are specific to assess the foot and ankle. The internal consistency was measured with Cronbach’s test. Kappa statistics with 95% CI were calculated to verify the level of inter-rater and intra-rater agreement for the FAFI test. Results Cronbach's alpha returned 0.82. The correlations between items returned a mean of 0.59 (range: 0.43–0.74). The discrimination score on the ROC curve (4 points) showed that the model can be used to identify children with joint hypermobility of the foot and ankle. Conclusions This study identified high reliability between evaluators, and high sensitivity and specificity, for a new reliable and valid tool for the diagnosis of foot and ankle joint hypermobility.
Publisher: MDPI AG
Date: 23-01-2021
Abstract: Introduction: Drop-out before treatment completion is a vexing problem for all clubfoot clinics. We and others have previously identified better engagement with parents as a crucial method of ameliorating incomplete clubfoot treatment, which increases deformity relapse. Materials and methods: The novel use of community facilitators enabled an audit of over 300 families who had dropped-out from a child’s clubfoot treatment. A questionnaire standardized the parent interviews. Parents were encouraged to present for clinical review of their child’s clubfeet. Results: When treatment was discontinued for six months, 309 families were audited. A social profile of families was developed, showing that most lived in tin houses with one working family member, indicating low affluence. Family issues, brace difficulty, travel distances, and insufficient understanding of ongoing bracing and follow-up were the main reasons for discontinuing treatment. Overt deformity relapse was found in 9% of children, while half of the children recommenced brace use after review. Conclusions: Identifying families at risk of dropping out from clubfoot care enables support to be instigated. Our findings encourage clinicians to empathize with parents of children with clubfoot deformity. The parent load indicator, in parallel with the initial clubfoot severity assessment, may help clinicians to better appreciate the demand that treatment will place on parents, the associated risk of drop-out, and the opportunity to enlist support.
Publisher: Springer Science and Business Media LLC
Date: 12-02-2015
Publisher: Springer Science and Business Media LLC
Date: 22-04-2011
Publisher: Springer International Publishing
Date: 2016
Publisher: Informa UK Limited
Date: 13-06-2018
DOI: 10.1080/10538712.2018.1477221
Abstract: Growing evidence shows that non-offending mothers experience significant loss and trauma following their child reporting experiencing sexual abuse. Maternal support offered to sexually abused children following disclosure can be a crucial factor in children's recovery. Although mothers are often seen as playing a central role in facilitating the recovery of their sexually abused child, there has been little focus on their own needs and profiles. This present study aimed to increase our understanding of the ersity of profiles of non-offending mothers of sexually abused children by exploring the differences in psychosocial traits of non-offending mothers (N = 68 age range 28-67 years) reporting higher and lower resilience. The mediating role of these psychosocial factors on the relationship between resilience and psychological distress will also be explored. Results found that non-offending mothers in the higher resilience group reported higher levels of positive reappraisal, self-compassion, social support, and significantly lower levels of psychological distress compared to non-offending mothers in the lower resilience group. Additionally, multiple mediation analysis indicated positive reappraisal, self-compassion, and social support to be significant mediators of the relationship between resilience and psychological distress. Increased levels of self-compassion and social support were found to be predictive of lowered psychological distress, while increased positive reappraisal predicted increased psychological distress. The findings of the present study provide support for the targeting of the psychosocial factors such as self-compassion, social support, and positive reappraisal in interventions for non-offending mothers in an effort to promote resilience.
Publisher: Informa UK Limited
Date: 22-09-2016
Publisher: Springer Science and Business Media LLC
Date: 09-11-2017
Publisher: American Podiatric Medical Association
Date: 2004
Abstract: The Foot Posture Index is a new multidimensional and multiplanar tool aimed at quantifying the degree of pronation to supination of the foot, comprising eight criteria that sum to produce a final “score” of foot posture. In an initial study involving 31 subjects, angulations measured from dorsoplantar and lateral radiographs were compared with the corresponding Foot Posture Index criteria using Spearman’s rho and the generalized linear model of analysis of variance. Eleven of the participants from Study 1 completed a second study in which wedges were used to alter foot position to determine whether changes to foot position were sensitively reflected in Foot Posture Index criterion scores and associated radiographic images. Study 1 demonstrated a significant correlation for only one criterion (talar head palpation), while Study 2 demonstrated intrasubject sensitivity to overall changes from supinated to pronated and supinated to resting positions but insensitivity to changes from resting to pronated positions. The results suggest that although the Foot Posture Index could be a useful tool to broadly classify foot postures, it is not sensitive to all small movements when assessed by this method. (J Am Podiatr Med Assoc 94(1): 31-38, 2004)
Publisher: John Wiley & Sons, Ltd
Date: 24-01-2007
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 04-2004
DOI: 10.2519/JOSPT.2004.34.4.201
Abstract: A preintervention and postintervention, repeated-measures experimental design. To investigate the immediate effect of low-Dye taping on peak and mean plantar pressures during gait in subjects with navicular drop exceeding 10 mm. Low-Dye taping is commonly used to support the longitudinal and transverse arches of the foot in an attempt to reduce the effects of symptoms associated with excessive pronation. Plantar pressure measurement has been used as an indirect indicator of pronation during gait. METHOD AND MEASURES: The right foot of 60 subjects was tested using the Emed-AT system to obtain plantar pressure values. Subjects performed 6 barefoot walks over the Emed pressure platform while taped and a further 6 walks while untaped. Plantar pressures were recorded. Each footprint obtained was ided into 10 sections or 'masks.' Average peak and mean plantar pressure values (N/cm2) were calculated for both taped and untaped walks for each mask. Paired t tests demonstrated significant changes in peak plantar pressure in 8 of the 10 areas of the foot and significant changes in mean plantar pressure in 9 of the 10 areas of the foot. Low-Dye taping significantly decreased pressure under the heel and the medial and middle forefoot, while increasing pressure under the lateral midfoot and under the toes. A significant decrease in mean plantar pressure was observed under the lateral forefoot, while no significant difference was demonstrated in peak plantar pressure under this area. The area under the medial midfoot demonstrated no significant change in either peak or mean pressure. Low-Dye taping significantly altered peak and mean plantar pressure values in subjects with navicular drop exceeding 10 mm. In particular, peak and mean plantar pressure increased under the lateral midfoot and under the toes, and decreased under the heel and forefoot, suggesting that a decrease in the amount of pronation occurred.
Publisher: Springer Science and Business Media LLC
Date: 09-01-2012
Publisher: Elsevier BV
Date: 08-2004
Publisher: Springer Science and Business Media LLC
Date: 29-11-2021
DOI: 10.1186/S13047-021-00497-1
Abstract: The eyes of the world will be on COP26 as it meets in Glasgow in November, 2021. Our planet is displaying weather extremes due to climate change which cannot be ignored, and which are deleterious for people’s health. Ironically, healthcare contributes to climate change, contributing approximately 5% of carbon emissions globally. Climate change due to global warming is ‘ the biggest global health threat of the 21st century’ . The Australian Podiatry Association conference held a sustainability panel, hearing perspectives of industry and science, medicine and sport, fashion, and retail. Content unified a broad planet and human health message, which is highly relevant for podiatrists. Key themes included waste as a resource, exercise as evidence-based intervention, responsibility and circular economy recycling principles for end-of-life product (footwear) purchases, and wider ethical considerations of footwear and clothing. The Anthropocene origin of climate change requires humanity to collaborate and to live more sustainably. Innovation is essential for better energy modes, cleaner air, human health and earth care. Green Podiatry joins the concerted activity of medical and health groups within Australia. The UK’s NHS is an exemplar in this area, having already reduced healthcare emissions by 35%, and aiming for net zero by 2045, and perhaps sooner. People are increasingly concerned about climate change, and COP26 is an important and imminent meeting for human and planet health. This commentary on Green Podiatry directs us all to lighten our carbon footprint. A final, and forthcoming commentary will outline practical ways of positively incorporating climate change communication into the clinical setting.
Publisher: Springer Science and Business Media LLC
Date: 28-07-2008
Publisher: American Podiatric Medical Association
Date: 09-2006
DOI: 10.7547/0960418
Abstract: Measurement of ankle dorsiflexion is a routine part of the podiatric examination of children, yet the reliability of this measure is largely unknown in healthy in iduals. This study assessed the intrarater and interrater reliability of the first and second resistance levels of sagittal ankle range of motion in 4- to 6-year-old children. The results show that measures of ankle dorsiflexion in children are highly variable among examiners, and, in general, gastrocnemius range of motion is more reliable than soleal range of motion. (J Am Podiatr Med Assoc 96(5): 418–422, 2006)
Publisher: Springer Science and Business Media LLC
Date: 28-06-2018
Publisher: SAGE Publications
Date: 12-2010
DOI: 10.1007/S11832-010-0290-6
Abstract: To evaluate the short-term results of the non-surgical Ponseti method training programs run in Ho Chinh Minh City, Vietnam. A questionnaire was developed and distributed to the 57 trainees who had completed one of the 3-day training courses. Of the 57 questionnaires distributed, 36 (63%) were completed and returned for evaluation. Most responders were continuing to use the Ponseti method for management of clubfoot. On average, each trainee had treated 16 babies with clubfoot, most of whom were less than 12 months of age, within 2 years of the initial training course and were achieving good clinical correction. The major problems identified were the inability to perform an Achilles tenotomy, lack of availability of the foot abduction splint, and parent compliance. The course materials were being used for reference and for dissemination of the Ponseti method to other clinical peers. Evaluation of the Ponseti method training program for management of clubfoot in Vietnam revealed continued use of the technique at 12–24 months post-training. A longer term and more objective assessment of the babies/children treated and of the associated gait function and foot comfort would be beneficial.
Publisher: Elsevier BV
Date: 03-2004
Publisher: Springer Science and Business Media LLC
Date: 03-2000
Publisher: Springer Science and Business Media LLC
Date: 27-08-2015
Publisher: Elsevier BV
Date: 06-2003
Publisher: Springer Science and Business Media LLC
Date: 18-07-2018
Publisher: Springer Science and Business Media LLC
Date: 24-07-2012
Publisher: Springer Science and Business Media LLC
Date: 27-04-2016
Publisher: Springer Science and Business Media LLC
Date: 19-08-2009
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2014
Publisher: Wiley
Date: 11-2017
DOI: 10.1111/JPC.13761
Publisher: Springer Science and Business Media LLC
Date: 15-06-2021
DOI: 10.1186/S13047-021-00483-7
Abstract: Healthcare aims to promote good health and yet demonstrably contributes to climate change, which is purported to be ‘ the biggest global health threat of the 21st century’ . This is happening now, with healthcare as an industry representing 4.4% of global carbon dioxide emissions. Climate change promotes health deficits from many angles however, primarily it is the use of fossil fuels which increases atmospheric carbon dioxide (also nitrous oxide, and methane). These greenhouse gases prevent the earth from cooling, resulting in the higher temperatures and rising sea levels, which then cause ‘wild weather’ patterns, including floods, storms, and droughts. Particular vulnerability is afforded to those already health compromised (older people, pregnant women, children, wider health co-morbidities) as well as populations closer to equatorial zones, which encompasses many low-and-middle-income-countries. The paradox here, is that poorer nations by spending less on healthcare, have lower carbon emissions from health-related activity, and yet will suffer most from global warming effects, with scant resources to off-set the increasing health care needs. Global recognition has forged the Paris agreement, the United Nations sustainable developments goals, and the World Health Organisation climate change action plan. It is agreed that most healthcare impact comes from consumption of energy and resources, and the production of greenhouse gases into the environment. Many professional associations of medicine and allied health professionals are advocating for their members to lead on environmental sustainability the Australian Podiatry Association is incorporating climate change into its strategic direction. Podiatrists, as allied health professionals, have wide community engagement, and hence, can model positive environmental practices, which may be effective in changing wider community behaviours, as occurred last century when doctors stopped smoking. As foot health consumers, our patients are increasingly likely to expect more sustainable practices and products, including ‘green footwear’ options. Green Podiatry, as a part of sustainable healthcare, directs us to be responsible energy and product consumers, and reduce our workplace emissions.
Publisher: Wiley
Date: 24-03-2016
DOI: 10.1002/ACR.22719
Abstract: To determine, first, if fat mass index (FMI) or fat-free mass index (FFMI) and serum adipokines tumor necrosis factor (TNF) and interleukin-6 (IL-6) are associated with prevalent (stage 2) foot pain, and, second, if they are predictive of future (stage 3) foot pain. A subset of participants ages ≥50 years (n = 1,462) from the North West Adelaide Health Study were used for this study. Participants from this community cohort were asked in stage 2 (2004-2006) and stage 3 (2008-2010) if they had foot pain, aching, or stiffness. In stage 2, serum adipokines and anthropometry were measured, while body composition was analyzed with dual x-ray absorptiometry. These variables, along with comorbidities and social history, were used in logistic regression analyses to determine if FMI, FFMI, and serum adipokines were associated with foot pain. Prevalent foot pain was present in 20.2% of participants, and future foot pain in 36.4%. Following multivariate modeling, the odds of having pain at stage 2 increased by 8% for each FMI unit (odds ratio [OR] 1.08, 95% confidence interval [95% CI] 1.04-1.12), while the odds of having pain at stage 3 increased by 6% for each FMI unit at stage 2 (OR 1.06, 95% CI 1.02-1.11). TNF level, IL-6 level, and FFMI were not associated with pain. Increased FMI, but not body mass index, FFMI, or TNF or IL-6 level, was associated with both prevalent and future foot pain. These results suggest that body fat may be more important than body weight with respect to foot pain. The role played by other adipokines requires further investigation.
Publisher: Elsevier BV
Date: 09-2006
Publisher: BMJ
Date: 04-2019
DOI: 10.1136/BMJOPEN-2018-023341
Abstract: The foot posture index (FPI) is an observational tool designed to measure the position of the foot. The objective of this study was to establish international reference data for foot posture across childhood, and influence of body mass index (BMI) on paediatric foot posture. Cross-sectional study. The dataset comprised 3217 healthy children, aged from 3 to 15 years. Contributing data were acquired from Spain, UK and Australia. Foot posture was described by means and z-score of the FPI and the height and weight of each subject was measured and the BMI was calculated. The foot posture of 3217 children were reviewed. A pronated (FPI ≥+6) foot posture was found in 960 (29.8%) children, a normal (FPI 0 to +6) foot posture in 1776 (55.2%) and a highly pronated (FPI +10) foot posture was found in 127 children (3.9%) (range −4 to +12 FPI). Less than 11% were found to have a supinated foot type (n=354). Approximately 20% of children were overweight/obese, but correlation between BMI and FPI was weak and inverse (r=−0.066, p .01), refuting the relationship between increased body mass and flatfeet. This study confirms that the ‘flat’ or pronated foot is the common foot posture of childhood, with FPI score of +4 (3) the average finding. Trend indicated a less flatfoot with age, although non-linear. A wide normal range of foot posture across childhood is confirmed.
Publisher: Informa UK Limited
Date: 22-11-2019
DOI: 10.1080/09638288.2019.1692380
Abstract: To determine the feasibility of conducting a definitive randomised trial to evaluate the efficacy of custom-fitted footwear for increasing physical activity in children and adolescents with Down syndrome. Assessor-blinded, parallel-group randomised pilot study. Thirty-three children and adolescents with Down syndrome were randomly allocated to a custom-fitted footwear group (Clarks Three participants were recruited per month. The use of co-interventions was common with six control group participants purchasing new footwear during the study. Mean adherence was 35 h/week in the custom-fitted footwear group, and there were few minor adverse events. There were trends for differences in physical activity favouring the custom-fitted footwear, but no trends for differences in disability associated with foot and ankle problems or gait parameters. The fit of the custom-fitted footwear was no better than participants' regular footwear. A definitive randomised trial is feasible. However, recruitment, use of co-interventions and footwear fit need further consideration.Implications for rehabilitationConducting a definitive randomised trial to determine the efficacy of custom-fitted footwear in increasing physical activity in children and adolescents with Down syndrome is feasible.Custom-fitted footwear may improve physical activity in children and adolescents with Down syndrome.Commercially available footwear may not be suitable for children and adolescents with Down syndrome due to their unique foot shape.
Publisher: Wiley
Date: 26-01-2022
Publisher: Springer Science and Business Media LLC
Date: 06-05-2014
Publisher: Springer Science and Business Media LLC
Date: 24-05-2018
DOI: 10.1007/S00296-018-4056-7
Abstract: Paediatric leg pains, long described as 'growing pains', frequently present to clinicians, are prevalent in early childhood, disrupt sleep, and distress affected children and parents. There are many cited associations, but no defined leg pain sub-types, nor revealed predictive factors. We explored the implicated factors (viz. foot arches, foot strength, joint mobility, vitamin D, iron) in children with leg pain versus a control group. Leg pain sub-groups-growing pains (GP), restless legs (RLS), both (mixed)-are defined for the first time. A case controlled study design, in a primary care setting, Mumbai, India. A total of 77 children with leg pains (n = 64) and controls (n = 13), aged 3-12 years, identified by paediatricians, completed data collection. Blood assays for iron and vitamin D, pain, Beighton score, foot arch, foot strength and anthropometrical data were collected. All outcome measures were validated, with standardised protocols. Leg pain (all groups) was predicted by increased joint mobility and increased ankle dorsiflexion strength (β = 0.56, P < 0.05). GP sub-group was predicted by increased ankle dorsiflexion strength (β = - 0.06, P < 0.05). Mixed (GP/RLS) and RLS sub-groups were predicted by increased ankle dorsiflexion strength (β = 0.66, P < 0.05) and pain questionnaire (β = 0.11, P < 0.05). Hypovitaminosis D was detected in 87% of the s le, and anaemia in 13%. Increased strength of ankle dorsiflexors and joint flexibility were each found predictive for leg pain. Increased body weight, waist girth, and BMI were all associated with leg pain.
Publisher: American Podiatric Medical Association
Date: 07-2001
DOI: 10.7547/87507315-91-7-356
Abstract: Podiatric physicians encounter many conditions, especially in sports medicine, that involve pain in the vicinity of the rearfoot or lower leg. These conditions are often associated with ankle equinus and may affect either child or adult sports participants. A review of the literature and clinical experience identify posterior night stretch splinting as an effective adjunct in the treatment of persistent symptomatic plantar fasciitis, negating the need for corticosteroid injections, further protracted pain, or surgery. This article reviews clinical cases in which night stretch splinting was used for a variety of diagnoses. Further research is needed into its efficacy for conditions other than plantar fasciitis. (J Am Podiatr Med Assoc 91(7): 356-360, 2001)
Publisher: American Podiatric Medical Association
Date: 03-2003
DOI: 10.7547/87507315-93-2-111
Abstract: Many young children present to the podiatric physician with the complaint of aching legs. Many of these children are clinically assessed as having a pronated foot posture. This foot posture is thought to be deleterious and is often treated with in-shoe devices such as triplane wedges or orthoses. Intervention aiming to reduce the amount of foot pronation in both stance and gait has been reported by parents and children to reduce, and in many cases eliminate, the episodes of aching legs. To test this theory and establish a degree of causality, a single-case experimental design was used in conjunction with age-appropriate pain scores for the children and independent parental ratings. Single-case experimental design is a useful research tool for the clinical practice setting that can identify cause-effect relationships and obviates large s le sizes. Eight complete single-case experimental designs were performed in the clinical setting. The in-shoe intervention proved efficacious for children with a pronated foot posture and aching legs. These findings may provide the impetus for a more rigorous examination of the possible relationship between pronation and “growing pains.” (J Am Podiatr Med Assoc 93(2): 111-117, 2003)
Publisher: American Podiatric Medical Association
Date: 05-2009
DOI: 10.7547/0980268
Publisher: American Podiatric Medical Association
Date: 09-2008
DOI: 10.7547/0980386
Abstract: Background: This article addresses the treatment of pediatric flatfoot with foot orthoses and explores the existing knowledge from an evidence-based perspective. Methods: Studies investigating the use of foot orthoses for pediatric flatfoot were reviewed and ranked on the evidence hierarchy model according to research designs. Clinical guidelines and efficacy rating methods were also reviewed. Results: Three randomized controlled trials exist, and a systematic review and possible meta-analysis of these studies is in progress. The results of these studies, although not definitive for the use of orthoses for pediatric flatfoot, provide useful direction. Clinical guidelines for the management of flatfoot are a useful supplement for clinical decision making and have been enhanced. Conclusion: This article presents a pragmatic and evidence-based clinical care pathway for clinicians to use for pediatric flatfoot. It uses a simple “traffic light” framework to identify three subtypes of pediatric flatfoot. The clinician is advised to 1) treat symptomatic pediatric flatfoot, 2) monitor (or with discretion simply treat) asymptomatic nondevelopmental pediatric flatfoot, and 3) identify and advise asymptomatic developmental pediatric flatfoot. (Children with juvenile arthritis should receive customized foot orthoses.) This approach will dispel much of the contention surrounding the use of foot orthoses in children. (J Am Podiatr Med Assoc 98(5): 386–393, 2008)
Publisher: American Podiatric Medical Association
Date: 05-2003
DOI: 10.7547/87507315-93-3-203
Abstract: Repeatable measures are essential for clinicians and researchers alike. Both need baseline measures that are reliable, as intervention effects cannot be accurately identified without consistent measures. The intrarater and interrater reliability of the new Foot Posture Index and current podiatric measures of foot position were assessed using a same-subject, repeated-measures study design across three age groups. The Foot Posture Index total score showed moderate reliability overall, demonstrating better reliability than most other current measures, although navicular height (normalized for foot length) was the single most reliable measure in adults. None of the tested measures exhibited adequate reliability in young children, and, with less-than-desirable reliability being demonstrated, most measures need to be interpreted accordingly when repeated measures are involved. (J Am Podiatr Med Assoc 93(3): 203-213, 2003)
Publisher: MDPI AG
Date: 14-06-2022
Abstract: The methodological heterogeneity in paediatric foot studies does not entail a stable foundation on which to focus the diagnosis and treatment of the various childhood foot problems. For this reason, the use of highly reliable tests is essential to find relationships and to establish a basis to guide the following studies. The main objective proposed in this cross-sectional observational study protocol is to examine the relationship between hypermobility (Lower Limb Assessment Score and Beighton score) and ankle muscle strength in different types of feet. The second objective is to describe the relationship between physical activity tests in children, and to compare with foot type and ankle muscle strength. The Strengthening Reporting of Observational Studies in Epidemiology (STROBE) criteria will be followed. The hypermobility, posture, strength and physical condition tests will be analyzed through three stations, each one directed by a single specialist in paediatric podiatry. The study has been approved by the Ethics Committee of the Universidad Católica San Antonio de Murcia CE112104. The results will be disseminated regardless of the magnitude or direction of effect. Intra-examiner and inter-examiner reliability will be analyzed.
Publisher: MDPI AG
Date: 20-09-2023
Publisher: American Podiatric Medical Association
Date: 07-2009
DOI: 10.7547/0980306
Abstract: Background: The Feet for Walking clubfoot project from Australia formally introduced the Ponseti technique in Vietnam in 2004 and is based at the Da Nang Orthopedic and Rehabilitation Centre in central Vietnam. Methods: We provide an initial overview of the management of infant clubfoot deformity using the nonsurgical Ponseti method. Results: Early indicators of the outcome of implementing this clubfoot project are largely positive but also require ongoing review. Further analyses of the use of the Ponseti method (or obstacles preventing the same) following training of personnel is underway. Conclusions: Recent research has improved and refined the technique that must now be both appreciated and incorporated by clinicians. This technique is used across the world in both developed and developing countries and is universally regarded as the best management method for clubfoot deformities. (J Am Podiatr Med Assoc 99(4): 306–316, 2009)
Publisher: Springer Science and Business Media LLC
Date: 21-08-2019
DOI: 10.1038/S41598-019-48675-3
Abstract: The purpose of this study was to analyze spatiotemporal parameters of gait in children using varyingly loaded Backpacks(BP). This cross-sectional study examined 231 schoolchildren (118 boys, 113 girls) aged six to 12 years, carrying a traditional BP to manipulate loading (Crossing Backpack Children Arpenaz 7 Litres, Junior Red Quechua). Load was added to the BPs in increments of 5%, 10%, 15% and 20% of the child’s body weight. Spatio-temporal parameters were measured with the OptoGait system. Significant differences were observed in single support (p 0.001), and double support (p 0.001). No statistically significant differences were observed in step length (p = 0.959) between the five loading conditions. Similarly, no statistically significant differences were found in the contact phase (p = 0.208), although significant changes were seen between baseline, 15% of body weight (p 0.005), and 20% of body weight (p 0.005). The effect sizes from the ANOVA in the single support was low (0.015), and double support was moderate (0.02). Increased weight in BPs reduced both children’s balance and single support, increased double support, but did not change step length. The children increase double support with heavier loads to help their balance. The spatio-temporal changes were most evident with BP loads between 15–20% of body weight. Affective responses, including the perception of heaviness or difficulty in carrying the schoolbags need to be included in further and prospective investigations.
Publisher: PAGEPress Publications
Date: 25-05-2023
DOI: 10.4081/GH.2023.1174
Abstract: Clubfoot is a congenital anomaly affecting 1/1,000 live births. Ponseti casting is an effective and affordable treatment. About 75% of affected children have access to Ponseti treatment in Bangladesh, but 20% are at risk of drop-out. We aimed to identify the areas in Bangladesh where patients are at high or low risk for drop-out. This study used a cross-sectional design based on publicly available data. The nationwide clubfoot program: ‘Walk for Life’ identified five risk factors for drop-out from the Ponseti treatment, specific to the Bangladeshi setting: household poverty, household size, population working in agriculture, educational attainment and travel time to the clinic. We explored the spatial distribution and clustering of these five risk factors. The spatial distribution of children years with clubfoot and the population density differ widely across the different sub-districts of Bangladesh. Analysis of risk factor distribution and cluster analysis showed areas at high risk for dropout in the Northeast and the Southwest, with poverty, educational attainment and working in agriculture as the most prevalent driving risk factor. Across the entire country, twenty-one multivariate high-risk clusters were identified. As the risk factors for drop-out from clubfoot care are not equally distributed across Bangladesh, there is a need in regional prioritization and ersification of treatment and enrolment policies. Local stakeholders and policy makers can identify high-risk areas and allocate resources effectively.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.GAITPOST.2018.03.032
Abstract: The paediatric flatfoot is a common presentation but it is unclear whether the condition will resolve on its own as the child gets older or whether treatment is required. Therefore, the study objective was to evaluate paediatric foot posture, and anthropometry, in children at two time points, three years apart. A s le of 1032 healthy children (505 boys, 527 girls aged 5-11 years) was recruited for foot posture index (FPI) and anthropometry assessment (weight, height and body mass index, BMI). Assessment was repeated when the children were aged 8 years to 14 years. Paired t-tests, Anova, frequency tables and a multiple regressions were conducted. Initially, approximately 70% had a neutral FPI range, 20% pronated, 3% highly pronated, and 4% supinated. Initial mean FPI was 3.6 ± 2.8, being higher in boys 3.7 ± 2.8 than in girls 3.4 ± 2.7 (p = 0.034). All FPI categories changed over time, with supinated and neutral FPI increased by 19.5% and 4.7% respectively. In contrast, pronated and highly pronated FPI reduced by 10.6% and 55.6% respectively. Regression showed only 1% FPI change was explained by increased height. FPI scores were significantly reduced after three years (3.57 to 3.33 p < 0.001). Children's foot posture shifts toward neutral as age increases. There is minimal relationship with weight, height or BMI. Appreciation of developing foot posture could reduce over diagnosis and unnecessary treatment of paediatric flatfeet.
Publisher: SAGE Publications
Date: 07-2003
Abstract: Exploring the structures of the pediatric foot may guide both clinicians and researchers toward better examination techniques. The navicular is the last foot bone to complete ossification and a crucial component of the medial column of the foot. This study explores the developing morphology of the navicular in a s le of four-year-old children using nonionizing sonographic imaging. Correlation was found between the length of the foot and the length of the navicular, with inverse correlation between navicular length and the depth of the navicular from the skin surface. There is preliminary suggestion of a critical foot length at which navicular palpation (and hence associated clinical measures) becomes more accurate. It appears that young children's feet require a different examination approach from more skeletally mature foot structures.
Publisher: Springer Science and Business Media LLC
Date: 17-05-2017
DOI: 10.1007/S00296-017-3743-0
Abstract: Body composition and poor mental health are risk factors for developing foot pain, but the role of different fat deposits and psychological features related to chronic pain are not well understood. The aim of this study was to investigate the association between body composition, psychological health and foot pain. Eighty-eight women participated in this study: 44 with chronic, disabling foot pain (mean age 55.3 SD 7.0 years, BMI 29.5 SD 6.7 kg/m
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.SOARD.2018.06.015
Abstract: Foot pain is a common manifestation of obesity. To determine if bariatric surgery is associated with a reduction in foot pain and if body mass index (BMI) or body composition predict a change in foot pain. University hospital. Participants with foot pain awaiting bariatric surgery were recruited for this prospective study. Multivariable linear regression was used to determine predictors of change in foot pain between baseline and 6-month follow-up using body composition (fat mass index and fat-free mass index) or BMI, adjusting for, depression, age, sex, and group (surgery versus control). Forty-five participants (38 female), mean ± standard deviation age of 45.7 ± 9.4 years, were recruited for this study. Twenty-nine participants mean ± standard deviation BMI of 44.8 ± 7.0 kg underwent bariatric surgery, while 16 participants mean ± standard deviation BMI of 47.9 ± 5.2 kg were on the waiting list (control). One participant was lost to follow-up. The treatment group lost a mean of 24.3 kg (95% confidence interval [CI] 21.1-27.5), while the control group gained 1.2 kg (95% CI -2.5 to 4.9), respectively. In multivariable analysis, bariatric surgery was significantly associated with reduced foot pain at 6-month follow-up -32.6 points (95% CI -43.8 to -21.4, P < .001), while fat mass index was significantly associated with increased pain at follow-up 1.5 points (95% CI .2 to 2.8, P = .027), after controlling for fat-free mass index, age, sex, and depression. Bariatric surgery was significantly associated with reduced foot pain. Higher baseline fat mass index, but not fat-free mass index or BMI, was predictive of increased foot pain at follow-up. Foot pain may be mediated by metabolic, rather than mechanical, factors in bariatric surgery candidates.
Publisher: BMJ
Date: 28-09-2020
DOI: 10.1136/BJSPORTS-2019-101776
Abstract: To compare the efficacy of in-shoe heel lifts to calf muscle eccentric exercise in reducing pain and improving function in mid-portion Achilles tendinopathy. This was a parallel-group randomised superiority trial at a single centre (La Trobe University Health Sciences Clinic, Discipline of Podiatry, Melbourne, Victoria, Australia). One hundred participants (52 women and 48 men, mean age 45.9, SD 9.4 years) with clinically diagnosed and ultrasonographically confirmed mid-portion Achilles tendinopathy were randomly allocated to either a (1) heel lifts (n=50) or (2) eccentric exercise (n=50) group. The primary outcome measure was the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire at 12 weeks. Differences between groups were analysed using intention to treat with analysis of covariance. There was 80% follow-up of participants (n=40 per group) at 12 weeks. The mean VISA-A score improved by 26.0 points (95% CI 19.6 to 32.4) in the heel lifts group and by 17.4 points (95% CI 9.5 to 25.3) in the eccentric exercise group. On average, there was a between-group difference in favour of the heel lifts for the VISA-A (adjusted mean difference 9.6, 95% CI 1.8 to 17.4, p=0.016), which approximated, but did not meet our predetermined minimum important difference of 10 points. In adults with mid-portion Achilles tendinopathy, heel lifts were more effective than calf muscle eccentric exercise in reducing pain and improving function at 12 weeks. However, there is uncertainty in the estimate of effect for this outcome and patients may not experience a clinically worthwhile difference between interventions. ACTRN12617001225303.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Angela Evans.