scholarly journals Heel Height as an Etiology of Hallux Abductus Valgus Development: An electromagnetic Static and Dynamic First Metatarsophalangeal Joint Study

Sensors ◽  
2019 ◽  
Vol 19 (6) ◽  
pp. 1328
Author(s):  
Rubén Sánchez-Gómez ◽  
Ricardo Becerro de Bengoa-Vallejo ◽  
Marta Elena Losa-Iglesias ◽  
César Calvo-Lobo ◽  
Carlos Romero-Morales ◽  
...  
Keyword(s):  
Dynamic Condition ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
First Metatarsophalangeal Joint ◽  
Dynamic Conditions ◽  
Intrinsic Factors ◽  
Heel Height ◽  
Static Conditions

Background: Hallux abductus valgus (HAV) is a forefoot condition produced by extrinsic and intrinsic factors. Shoes with a high heel height and a typical narrow tip toe box can induce deviations in both the proximal phalanx of the hallux (PPH) and the first metatarsal (IMTT) bones. Nevertheless, the isolated role of heel height remains unclear in the development of HAV pathology. Objectives: The goal was to determine if the heel height increase of shoes without a narrow box toe could augment the PPH and IMTT deviation in frontal, sagittal, and transverse planes toward the first metatarsophalangeal joint (MPJ) and the first metatarsocuneiform joint (MCJ), respectively, during static and dynamic conditions in relation to precursor movements of HAV. Methods: Women with an average age of 25.10 ± 4.67 years were recruited in this cross-sectional study to assess the three planes of motion of PPH and IMTT while wearing high heels with heights at 3, 6, 9 cm and unshod conditions via sandals. The measurements used an electromagnetic goniometer device with sensors placed on medial aspects of the PPH and IMTT bones under static and dynamic conditions. Results: Wearing shoes with a 6 cm heel in dynamic condition may increase the PPH valgus and abduction deviation from 3.15 ± 0.10° to 3.46 ± 0.05° (p < 0.05) and from 1.35 ± 0.28° to 1.69 ± 0.30° (p < 0.001), respectively. In addition, a PPH abduction increase from 1.01 ± 0.36° to 1.31 ± 0.46° (p < 0.05) after wearing shoes with a 6 cm heel height was observed under static conditions. Conclusions: Wearing shoes with a heel height of 6 cm without a narrow box toe interference may produce PPH abduction and valgus deviations related to HAV formation.

scholarly journals Prevalence of and risk factors for hallux rigidus: a cross-sectional study in Japan

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yoshiyuki Senga ◽  
Akinobu Nishimura ◽  
Naoya Ito ◽  
Yukie Kitaura ◽  
Akihiro Sudo
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Metatarsophalangeal Joint ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Hallux Rigidus ◽  
Trend Test ◽  
Cross Sectional ◽  
First Metatarsophalangeal Joint ◽  
Independent Risk Factors

Abstract Background Hallux rigidus (HR) is a common osteoarthritis of the first metatarsophalangeal joint. However, the epidemiology and risk factors of this pathology have yet to be clarified. Methods We have been conducting cohort studies among individuals over 50 years old every 2 years since 1997. This study analyzed data from the 7th to 10th checkups in 2009, 2011, 2013, and 2015. We investigated the prevalence of HR and its risk factors in a total of 604 individuals (mean age, 67.1 ± 6.4 years; 208 men, 396 women). Radiographic HR was defined as Hattrup and Johnson classification grade 1 or higher. Knee osteoarthritis (KOA) was scored according to the Kellgren-Lawrence grading system. Radiographic KOA was defined as grade 2 or higher. Cases with a hallux valgus (HV) angle of 20° or higher were defined as showing HV. Statistical analyses were performed using the Kruskal-Wallis test, Fisher’s exact test, logistic regression modeling, and the Cochran-Armitage trend test. All p-values presented are two-sided and values of p < .05 were considered statistically significant. Results The prevalence of HR was 26.7% (161/604). Rates of grade 0, 1, 2, and 3 HR according to the Hattrup and Johnson classification were 73.3% (443/604), 16.4% (99/604), 8.0% (48/604), and 2.3% (14/604), respectively. Overall ratio of symptomatic HR was 8.1%. Univariate analysis revealed KOA, gout attack (GA), and HV as significantly associated with HR. The same factors were confirmed as independent risk factors for HR in multivariate analysis. All parameters were significantly associated with HR. Odds ratios of KOA, HV, and GA for HR were 1.73, 3.98, and 3.86, respectively. The presence or absence of KOA was significantly associated with severity of HR. Conclusions This study revealed that the prevalence of HR in the elderly (≥50 years) was 26.7%. KOA, HV, and GA were independent risk factors for HR. KOA was associated with severity of HR.

scholarly journals Assessment of the Foot’s Longitudinal Arch by Different Indicators and Their Correlation with the Foot Loading Paradigm in School-Aged Children: A Cross Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5196
Author(s):  
Beata Szczepanowska-Wołowiec ◽  
Paulina Sztandera ◽  
Ireneusz Kotela ◽  
Marek Zak
Keyword(s):  
Morphological Structure ◽  
Cross Sectional Study ◽  
Strongly Correlated ◽  
Cross Sectional ◽  
School Aged Children ◽  
Longitudinal Arch ◽  
Flat Feet ◽  
Foot Loading ◽  
Static Conditions ◽  
Increased Pressure

Background: There are numerous studies assessing the morphological structure of the foot, but there is a notable scarcity of those focused on juxtaposing various longitudinal arch indices with foot loading paradigm. The present study aimed to determine the overall reliability, diagnostic accuracy of respective variables, and their correlation with the foot loading paradigm. Methods: The study group consisted of 336 children, aged 10–15 years (girls 49.1% and boys 50.9%). The morphological structure of the plantar part of the foot in static conditions was assessed with the aid of a 2D podoscan. Individual foot loading paradigm in static conditions was assessed making use of the FreeMed platform. Results: Staheli (SI), Chippaux–Smirak (CSI), and Sztriter–Godunow (KY) indices were strongly correlated with each other (ρ > 0.84, p < 0.001). Own research corroborated an increased pressure of hollow feet, as assessed by the SI, CSI, and KY indices, on the forefoot and the hindfoot, foot zones B, E, F; these correlations being statistically significant. The results yielded by the present study also indicate an increased pressure on the metatarsal, and foot zones C, D of the flat feet. Conclusions: Flatfootedness is not believed to be a common deformity among children and adolescents. The SI, CSI, and KY indices were found to be strongly correlated, as well as proved reliable in assessing the foot’s longitudinal arch.

scholarly journals Metatarsophalangeal Hyperextension Movement Pattern Related to Diabetic Forefoot Deformity

2016 ◽  
Vol 96 (8) ◽  
pp. 1143-1151 ◽  
Author(s):  
Victor A. Cheuy ◽  
Mary K. Hastings ◽  
Michael J. Mueller
Keyword(s):  
Diabetic Neuropathy ◽  
Plantar Flexion ◽  
Metatarsophalangeal Joint ◽  
Movement Pattern ◽  
Cross Sectional Study ◽  
Ankle Dorsiflexion ◽  
Cross Sectional ◽  
3 Dimensional ◽  
Foot Motion ◽  
Standing Up

Abstract Background Metatarsophalangeal joint (MTPJ) hyperextension deformity is common in people with diabetic neuropathy and a known risk factor for ulceration and amputation. An MTPJ hyperextension movement pattern may contribute to the development of this acquired deformity. Objective The purpose of this study was to determine, in people with diabetes mellitus and peripheral neuropathy (DM+PN), the ankle and MTPJ ranges of motion that characterize an MTPJ hyperextension movement pattern and its relationship to MTPJ deformity severity. It was hypothesized that severity of MTPJ deformity would be related to limitations in maximum ankle dorsiflexion and increased MTPJ extension during active ankle dorsiflexion movement tasks. Design A cross-sectional study design was used that included 34 people with DM+PN (mean age=59 years, SD=9). Methods Computed tomography and 3-dimensional motion capture analysis were used to measure resting MTPJ angle and intersegmental foot motion during the tasks of ankle dorsiflexion and plantar flexion with the knee extended and flexed to 90 degrees, walking, and sit-to/from-stand. Results The MTPJ extension movement pattern during all tasks was directly correlated with severity of MTPJ deformity: maximum ankle dorsiflexion with knee extended (r=.35; 95% confidence interval [CI]=.02, .62), with knee flexed (r=.35; 95% CI=0.01, 0.61), during the swing phase of gait (r=.47; 95% CI=0.16, 0.70), during standing up (r=.48; 95% CI=0.17, 0.71), and during sitting down (r=.38; 95% CI=0.05, 0.64). All correlations were statistically significant. Limitations This study was cross-sectional, and causal relationships cannot be made. Conclusions A hyperextension MTPJ movement pattern associated with limited ankle dorsiflexion has been characterized in people with diabetic neuropathy. Increased MTPJ extension during movement and functional tasks was correlated with severity of resting MTPJ alignment. Repetition of this movement pattern could be an important factor in the etiology of MTPJ deformity and future risk of ulceration.

scholarly journals Metatarsophalangeal joint pain in psoriatic arthritis: a cross-sectional study

Rheumatology ◽  
2013 ◽  
Vol 53 (4) ◽  
pp. 737-740 ◽  
Author(s):  
D. E. Turner ◽  
E. Hyslop ◽  
R. Barn ◽  
I. B. McInnes ◽  
M. P. M. Steultjens ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Joint Pain ◽  
Metatarsophalangeal Joint ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Traumatic Hallux Varus Treated by Minimally Invasive Extensor Hallucis Brevis Tenodesis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
C. N. Cheung ◽  
T. H. Lui
Keyword(s):  
Minimally Invasive ◽  
Avulsion Fracture ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Lateral Side ◽  
Lateral Instability ◽  
First Metatarsophalangeal Joint ◽  
Hallux Varus ◽  
Adductor Hallucis

A case of traumatic hallux varus due to avulsion fracture of the lateral side of the base of proximal phalanx was reported. The lateral instability of the first metatarsophalangeal joint was believed to be due to the disruption of adductor hallucis function. It was successfully managed by minimally invasive extensor hallucis brevis tenodesis.

The Effects of Cheilectomy on Dorsiflexion of the First Metatarsophalangeal Joint

1997 ◽  
Vol 18 (12) ◽  
pp. 803-808 ◽  
Author(s):  
William A. Heller ◽  
Michael E. Brage
Keyword(s):  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Hallux Rigidus ◽  
Surface Velocity ◽  
First Metatarsophalangeal Joint ◽  
Motion Patterns ◽  
Custom Made ◽  
Fresh Frozen ◽  
End Stage

Our purpose in this study was to determine the effects of cheilectomy on the mechanics of dorsiflexion of the first metatarsophalangeal (MTP) joint. Ten fresh-frozen cadaver feet were utilized, of which two demonstrated radiographic evidence of hallux rigidus. Each specimen was rigidly mounted on a custom-made slide tray that was articulated with a hinge mechanism designed to dorsiflex the first MTP joint. Range-of-motion measurements were made on the first MTP joint. Cheilectomy of 30% of the metatarsal head diameter was performed. Lateral radiographs with the beam centered on the MTP joint were taken with the joint at neutral, 20°, 40°, and at the limits of dorsiflexion. This process was repeated after a 50% cheilectomy was performed. The radiographs were examined for changes in joint congruence and in patterns of surface motion as the hallux moved from neutral to full dorsiflexion. Instant centers of rotation were determined by a method first described by Rouleaux. We constructed surface velocity vectors to describe patterns of motion of the first MTP joint. The mean dorsiflexion of the first MTP joint was 67.9° and increased to 78.3° after 30% cheilectomy. The increase in dorsiflexion was significantly greater in the two specimens with hallux rigidus (33%) than in the other specimens (12.1%). After both levels of cheilectomy, the proximal phalanx demonstrated pivoting at the resection site on the metatarsal head. This pivoting resulted in abnormal motion patterns across the MTP joint. Normal sliding motion predominated in early dorsiflexion, with compression peaking at the end stage of dorsiflexion, producing jamming of the articular surfaces. Cheilectomy significantly increased dorsiflexion of the MTP joint, but resulted in abnormal motion patterns. The increase in dorsiflexion resulted from pivoting of the proximal phalanx on the metatarsal head, resulting in anomalous velocity vectors and compression across the MTP joint.

scholarly journals Adherence to Home-based Neuro-rehabilitation Exercise program in Stroke survivors

2021 ◽  
Vol 20 (1) ◽  
pp. 145-153
Author(s):  
Priyanka Babbar ◽  
K Vijaya Kumar ◽  
PT Abraham Joshua ◽  
M Chakrapani ◽  
ZK Misri
Keyword(s):  
Stroke Rehabilitation ◽  
Medical Science ◽  
Exercise Program ◽  
Cross Sectional Study ◽  
Home Exercise ◽  
Post Discharge ◽  
Cross Sectional ◽  
Intrinsic Factors ◽  
Home Based ◽  
First Onset

Background:Post discharge, Home-based exercise program (HEP), prescribed by physiotherapistis an integral part, to plan effective stroke rehabilitation, with the intended goal of maintainingfunctional motor performance and enhancing functional progress.Earlier studies have shown thatmany factors attribute to adherence and barriers for structured group based exercise program. Objective: This study was designed to identify the factors in stroke subjects, which mayinfluence the adherence and barriers to individually tailored HEP post-discharge, in strokesubjects. Method: An analytical cross-sectional study, with non-random sampling, consistingof first onset stroke subjects who had received acute stroke rehabilitation from tertiary carehospitals. Post-discharge, seventy-four participants were followed up and their responses relatedto adherence and barriers to the prescribed HEP by administering a self-reported adherence to home exercise questionnaire. Results: 63.5% were adherent and 36.5% were non-adherent toHEP, among 74 subjects. The adherent group had performed exercises for at least 5-6 times in aweek, for 31-45 minutes each day. Intrinsic factors related to self-efficacy and perceived level ofanticipated recovery had found an association with adherent and non-adherent groups.The mostcommon barriers for adherence to HEP were fear of fall or injury and fatigue for both adherent and non-adherent subjects. Conclusion: This present study helped to put an insight, onto sociodemographicand intrinsic factors, with the level of adherence and to identify the barriers foradherence to individually tailored HEP. Bangladesh Journal of Medical Science Vol.20(1) 2021 p.145-153

scholarly journals Lifetime occupation is not associated with radiographic osteoarthritis of the first metatarsophalangeal joint in a cohort study of UK women

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
L. Cherry ◽  
L. Gates ◽  
N. K. Arden ◽  
C. J. Bowen
Keyword(s):  
Interactive Effect ◽  
Metatarsophalangeal Joint ◽  
Later Life ◽  
Population Based ◽  
Positive Trend ◽  
International Consensus ◽  
Cross Sectional ◽  
First Metatarsophalangeal Joint ◽  
High Heel ◽  
Radiographic Osteoarthritis

Abstract Objective The study aim was to determine whether lifetime occupation was associated with the presence of radiographic osteoarthritis (ROA) of the first metatarsophalangeal joint (MTPJ) in women. Method Data were collected from the prospective, population-based Chingford 1000 Women study. This cohort of women, aged 45–64 years at inception, was established in 1989 from a single general practice in Chingford, UK. Data has subsequently been collected repeatedly. Data from baseline, year six and year ten was used for the purposes of this cross-sectional study. The primary outcome was the presence of dorsal view ROA of the first MTPJ. The main exposure was lifetime occupation, categorised according to levels of occupation previously defined via international consensus: 1. Sedentary, 2. Light, 3. Light manual, 4. Heavy manual. Logistic regression analyses were conducted to quantify the relationship between lifetime occupation type and the presence of ROA of the first MTPJ, adjusting for age, body mass index and lifetime high-heeled footwear use as potential interactive variables for each decade. Results Data for 209 women were included within this study. The mean (SD) age was 57 (±5.2) years. Predominant lifetime occupation was reported as sedentary by 51.7%, as light by 0%, as light manual by 33.5% and as heavy manual by 14.8% of participants. There were no statistical associations between lifetime occupation type and the presence of ROA of the first MTPJ in either the unadjusted (OR = 0.99, CI = 0.78–1.26,P = 0.96) partially adjusted (for age and BMI; OR = 1.00, CI = 0.78–1.29, P = 0.99) or fully adjusted models (for age, BMI and lifetime high heel footwear use for each decade of working life (OR = 1.02, CI = 0.79–1.31, P = 0.91); high-heel footwear use up to 20s (OR = 0.83, CI = 0.71–1.31, P = 0.83); high-heel footwear use in 20–30s (OR = 1.00, CI = 0.75–1.3, P = 0.98); high-heel footwear use in 30–40s (OR = 1.00, CI = 0.70–1.42, P = 0.99); high-heel footwear use in 40–50s (OR = 0.90, CI = 0.58–1.40, P = 0.65); high-heel footwear use in 50s (OR = 0.63,CI = 0.36–1.09, P = 0.10). Conclusions The findings suggest that lifetime occupation is not associated with the presence of ROA of the fist metatarsophalangeal joint. There does not appear to be any interactive effect between lifetime occupation, lifetime high-heel footwear use, age or BMI and ROA of the first MTPJ. In later life a positive trend towards increased ROA in those who reported lifetime high-heel footwear use was noted and this may be worthy of further research.

scholarly journals Does Function Determine the Structure? Changes in Flexor Hallucis Longus Muscle and the Associated Performance Related to Dance Modality: A Cross-Sectional Study

Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 186
Author(s):  
Blanca De-la-Cruz-Torres ◽  
Irene Barrera-García-Martín ◽  
Mónica De la Cueva-Reguera ◽  
María Bravo-Aguilar ◽  
María Blanco-Morales ◽  
...  
Keyword(s):  
Metatarsophalangeal Joint ◽  
Cross Sectional Area ◽  
Flexor Hallucis Longus ◽  
Full Time ◽  
Sectional Area ◽  
Range Of Movement ◽  
Cross Sectional ◽  
First Metatarsophalangeal Joint ◽  
Counter Movement Jump ◽  
Longus Muscle

Background and Objectives: Flexor hallucis longus pathology is one of the most common conditions of the ankle and foot in dancers, due to the high demand of dance movements performed in an extreme plantar flexion and dorsiflexion range of motion. The objectives of this study were to determine the bilateral differences between the thickness and cross-sectional area of the flexor hallucis longus muscle in dancers, to establish possible differences between dance modalities, and to analyze whether there is a correlation between ultrasonographic parameters or performance variables and the dance modality. Material and Methods: A sample of 50 (29 classical and 21 contemporary) full-time pre-professional female dancers were included in the study. The thickness and cross-sectional area of the flexor hallucis longus muscle were evaluated for both limbs using ultrasound imaging. The range of movement of the first metatarsophalangeal joint was measured using functional extension with maximal ankle plantarflexion, balance was measured in a unilateral stance with the heel raised, endurance was evaluated through a modified heel rise fatigue test, and a counter movement jump to assess the vertical jump performance was measured bilaterally. Results: There were no significant differences recorded between the dominant and non-dominant limbs for each variable, within both groups. Contemporary dancers showed a greater thickness and cross-sectional area of the flexor hallucis longus muscle than classical dancers. However, classical dancers showed an increase of balance, endurance, range of movement of the first metatarsophalangeal joint, and counter movement jump with respect to contemporary dancers. Conclusion: Bilateral symmetry was identified in all variables for both groups. The size and performance of the flexor hallucis longus muscle may be influenced by the specific nature of dance modality.

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