Effect of 4 Weeks of Foot Orthosis Intervention on Ambulatory Capacities and Posture in Normal-Weight and Obese Patients

2020 ◽  
Vol 110 (1) ◽  
Author(s):  
Patricia Griffon ◽  
Bruno Vie ◽  
Jean Paul Weber ◽  
Yves Jammes
Keyword(s):  
Postural Sway ◽  
Center Of Pressure ◽  
Effective Means ◽  
Normal Weight ◽  
Foot Orthoses ◽  
Obese Patients ◽  
Healthy Individuals ◽  
Foot Arch ◽  
Foot Orthosis ◽  
Study Inclusion

Background: Several works have shown the benefits of foot orthosis intervention on postural stability in healthy individuals and patients with foot malalignment. However, the effects of foot orthoses on the daily ambulatory activities explored by the Six-Minute Walk Test (6MWT) were never examined. We hypothesized that foot orthoses could increase the gait distance and attenuate the post-6MWT posture alterations already reported in healthy individuals. Methods: In ten normal-weight (NW) and ten obese patients with foot malalignment and/or abnormal foot arch, we examined the benefits of 4 weeks of custom-molded orthosis intervention (D30) on 6MWT gait distance, fatigue sensation scores, ankle plantarflexion force, and post-6MWT sway of the center of pressure (COP) measured by a pedobarographic platform. Data were compared with those measured in two control-matched groups of ten NW and ten obese individuals, explored at study inclusion and at D30. Results: At study inclusion, the post-6MWT changes in COP surface and the medial and lateral COP deviations were significantly higher in obese participants who needed to wear the foot orthoses compared with obese control subjects. The foot orthosis intervention significantly improved the ambulatory performances of NW and obese individuals during the 6MWT, attenuated the bodily fatigue sensation after the 6MWT, and reduced the post-6MWT COP deviations, with the benefits of insoles being significantly accentuated in obese participants. Conclusions: Four weeks of foot orthosis intervention significantly increases gait distance and is an effective means to reduce postural sway after walking.

The influence of foot orthoses on foot mobility magnitude and arch height index in adults with flexible flat feet

2014 ◽  
Vol 39 (3) ◽  
pp. 190-196 ◽  
Author(s):  
Roghaye Sheykhi-Dolagh ◽  
Hassan Saeedi ◽  
Behshid Farahmand ◽  
Mojtaba Kamyab ◽  
Mohammad Kamali ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Foot Orthoses ◽  
Arch Height ◽  
Flat Foot ◽  
Dynamic Mobility ◽  
Flat Feet ◽  
Quasi Experimental ◽  
Foot Arch ◽  
Foot Mobility ◽  
Foot Orthosis

Background:Flexible flat foot is described as a reduction in the height of the medial longitudinal arch and may occur from abnormal foot pronation. A foot orthosis is thought to modify and control excessive pronation and improve arch height.Objective:To compare the immediate effect of three types of orthoses on foot mobility and the arch height index in subjects with flexible flat feet.Study design:A quasi-experimental study.Method:The dorsal arch height, midfoot width, foot mobility and arch height index were assessed in 20 participants with flexible flat feet (mean age = 23.2 ± 3 years) for three different foot orthosis conditions: soft, semi-rigid and rigid University of California Biomechanics Laboratory (UCBL).Results:Maximum midfoot width at 90% with arch mobility in the coronal plane was shown in the semi-rigid orthosis condition. The semi-rigid orthosis resulted in the highest mean foot mobility in 90% of weight bearing, and the rigid orthosis (UCBL) had the lowest mean foot mobility. The soft orthosis resulted in foot mobility between that of the rigid and the semi-rigid orthosis. UCBL orthosis showed the highest arch height index, and the semi-rigid orthosis showed the lowest mean arch height index.Conclusion:Due to its rigid structure and long medial–lateral walls, the UCBL orthosis appears to limit foot mobility. Therefore, it is necessary to make an orthosis that facilitates foot mobility in the normal range of the foot arch. Future studies should address the dynamic mobility of the foot with using various types of foot orthoses.Clinical relevanceAlthough there are many studies focussed on flat foot and the use of foot orthoses, the mechanism of action is still unclear. This study explored foot mobility and the influence of foot orthoses and showed that a more rigid foot orthosis should be selected based on foot mobility.

The effect of custom carbon ankle-foot orthosis alignment on roll-over shape and center of pressure velocity

2020 ◽  
pp. 030936462097140
Author(s):  
Elizabeth Russell Esposito ◽  
Mitchell D Ruble ◽  
Andrea J Ikeda ◽  
Jason M Wilken
Keyword(s):  
Lower Limb ◽  
Sagittal Plane ◽  
Center Of Pressure ◽  
Heel Strike ◽  
Control Group ◽  
Foot Orthoses ◽  
Ankle Foot Orthosis ◽  
Ankle Foot Orthoses ◽  
Foot Orthosis ◽  
Center Of Pressure Velocity

Background: Maintaining an optimal rolling of the foot over the ground is thought to increase the stability and efficiency of pathologic gait. Ankle-foot orthoses are often prescribed to improve gait mechanics in individuals with lower extremity injuries; however, their design may compromise how the foot rolls over the ground. Objectives: The aim of this study was to investigate the effects of the sagittal plane ankle-foot orthosis alignment on roll-over shape and center of pressure velocity in individuals with lower limb reconstructions. Study design: Randomized cross-over study with a control group comparison. Methods: In total, 12 individuals with lower limb reconstruction who used a custom carbon ankle-foot orthosis and 12 uninjured controls underwent gait analysis. Ankle-foot orthosis users were tested in their clinically-provided ankle-foot orthosis alignment, with an alignment that was 3° more plantarflexed, and with an alignment that was 3° more dorsiflexed. Components of roll-over shape and center of pressure velocity were calculated from heel strike on the ankle-foot orthosis limb to contralateral heel strike. Results: Roll-over shape radius was not affected by 3° changes to alignment and was not significantly different from controls. Aligning the ankle-foot orthosis in more dorsiflexion than clinically provided resulted in a smaller peak center of pressure velocity that occurred later in stance. Conclusion: Individuals using custom carbon ankle-foot orthoses can accommodate 3° alterations in the dorsiflexion or plantarflexion alignment.

scholarly journals Determination of TLQP-21 Neuropeptide Plasma Level in Morbid Obese

2021 ◽  
Author(s):  
Gülşah Koç ◽  
Ahu Soyocak ◽  
Burak Kankaya ◽  
Halil Alis
Keyword(s):  
Plasma Levels ◽  
Elisa Test ◽  
Normal Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Healthy Individuals ◽  
Significant Difference ◽  
Morbid Obese ◽  
Treatment Of Obesity

INTRODUCTION: In this study, it was aimed to measure TLQP-21 neuropeptide plasma levels, which is thought to be effective in preventing or treating obesity in morbidly obese and normal weight healthy individuals, and to make a comparison between both groups. METHODS: Fifty-one morbidly obese patients with a body mass index (BMI) of 40 kg/m2 and above and 22 healthy individuals of normal weight with a BMI between 18.5-24.9 kg/m2 without any metabolic disease were included in the study. Enzyme- linked immunosorbent analysis (ELISA) test was performed on plasma samples taken from all individuals participating in the study. All data were evaluated statistically. RESULTS: Although it was observed that TLQP-21 peptide values in morbidly obese individuals increased compared to healthy individuals with normal weight, this increase was not statistically significant (p>0.05) (p=0.718). The amount of TLQP-21 peptide was also evaluated according to gender distributions in the whole study group, but any statistically significant difference was not determined. DISCUSSION AND CONCLUSION: Our study showed that there is no difference in plasma levels of TLQP-21 neuropeptide, which is thought to play a key role in the treatment of obesity, in mordidly obese and healthy individuals.

Effect of cast and noncast foot orthoses on plantar pressure and force during normal gait

2000 ◽  
Vol 90 (9) ◽  
pp. 441-449 ◽  
Author(s):  
A Redmond ◽  
PS Lumb ◽  
K Landorf
Keyword(s):  
Contact Area ◽  
Plantar Pressure ◽  
Foot Orthoses ◽  
Pressure Measurements ◽  
Healthy Individuals ◽  
Normal Gait ◽  
Foot Function ◽  
Foot Orthosis

A variety of plantar pressure and force measures were explored in 22 healthy individuals with excessive pronation. The measures were obtained while the subjects wore a thin-soled athletic shoe alone, a modified Root foot orthosis made from a neutral cast, and a flat noncast insole with a 6 degrees varus rearfoot post. The data obtained from subjects wearing the noncast insole differed only minimally from those obtained while they were wearing the shoe only. In contrast, the modified Root orthosis had a profound effect on foot function. Heel forces and pressures were reduced, and the rearfoot contact area was increased. Measures of force in the midfoot demonstrated substantial increases in load in this region, but the increase in area associated with the contoured device resulted in no increase in midfoot pressure measurements. Forefoot pressures were reduced both medially and laterally with the cast device in place.

Comparing the immediate effects of UCBL and modified foot orthoses on postural sway in people with flexible flatfoot

2014 ◽  
Vol 40 (1) ◽  
pp. 117-122 ◽  
Author(s):  
Somaieh Payehdar ◽  
Hassan Saeedi ◽  
Amir Ahmadi ◽  
Mohammad Kamali ◽  
Maryam Mohammadi ◽  
...  
Keyword(s):  
Postural Sway ◽  
Material Selection ◽  
Stability Index ◽  
Foot Orthoses ◽  
Flexible Flatfoot ◽  
Overall Stability ◽  
Quasi Experimental ◽  
Foot Orthosis ◽  
Biodex Stability System ◽  
Anterior Posterior

Background: Different types of foot orthoses have been prescribed for patients with flatfoot. Results of several studies have shown that orthoses were able to change balance parameters in people with flatfoot. However, the possible effect of orthosis flexibility on balance has not yet been investigated. Objectives: The aim of the current study was to investigate the immediate effect of a rigid University of California Berkeley Laboratory (UCBL) foot orthosis, a modified foot orthosis, and a normal shoe on the postural sway of people with flexible flatfoot. Study design: Quasi-experimental. Methods: In all, 20 young adults with flatfoot (aged 23.5 ± 2.8 years) were invited to participate in this study. The Biodex Stability System was employed to perform standing balance tests under three testing conditions, namely, shoe only, UCBL, and modified foot orthosis. Total, medial–lateral, and anterior–posterior sway were evaluated for each condition. Results: The results of this study revealed no statistical difference in the medial–lateral and anterior–posterior stability indices between foot orthoses and shoed conditions. The overall stability index with the UCBL foot orthosis, however, was significantly lower than that with the modified foot orthosis. Conclusion: The UCBL foot orthosis was able to decrease total sway and improve balance in people with flexible flatfoot. Clinical relevance Results of previous studies have indicated that foot orthoses were able to affect the balance of people with flatfeet. However, the possible effects of flexible orthoses on balance have not been examined. The results of this study may provide new insight into material selection for those people with balance disorders.

Clinical Features and Hepatic Molecular Characteristics in NAFLD and NASH Patients Compared to Normal Weight Healthy Individuals

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 260-LB
Author(s):  
MALTE P. SUPPLI ◽  
KRISTOFFER RIGBOLT ◽  
SANNE VEIDAL ◽  
SARA HEEBØLL ◽  
MIA DEMANT ◽  
...  
Keyword(s):  
Clinical Features ◽  
Normal Weight ◽  
Molecular Characteristics ◽  
Healthy Individuals

scholarly journals Higher body mass index is associated with larger postoperative improvement in patient-reported outcomes following total knee arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
K Giesinger ◽  
JM Giesinger ◽  
DF Hamilton ◽  
J Rechsteiner ◽  
A Ladurner
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Pain Relief ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Normal Weight ◽  
World Health ◽  
Obese Patients ◽  
Total Knee ◽  
The Impact

Abstract Background Total knee arthroplasty is known to successfully alleviate pain and improve function in endstage knee osteoarthritis. However, there is some controversy with regard to the influence of obesity on clinical benefits after TKA. The aim of this study was to investigate the impact of body mass index (BMI) on improvement in pain, function and general health status following total knee arthroplasty (TKA). Methods A single-centre retrospective analysis of primary TKAs performed between 2006 and 2016 was performed. Data were collected preoperatively and 12-month postoperatively using WOMAC score and EQ-5D. Longitudinal score change was compared across the BMI categories identified by the World Health Organization. Results Data from 1565 patients [mean age 69.1, 62.2% women] were accessed. Weight distribution was: 21.2% BMI < 25.0 kg/m2, 36.9% BMI 25.0–29.9 kg/m2, 27.0% BMI 30.0–34.9 kg/m2, 10.2% BMI 35.0–39.9 kg/m2, and 4.6% BMI ≥ 40.0 kg/m2. All outcome measures improved between preoperative and 12-month follow-up (p < 0.001). In pairwise comparisons against normal weight patients, patients with class I-II obesity showed larger improvement on the WOMAC function and total score. For WOMAC pain improvements were larger for all three obesity classes. Conclusions Post-operative improvement in joint-specific outcomes was larger in obese patients compared to normal weight patients. These findings suggest that obese patients may have the greatest benefits from TKA with regard to function and pain relief one year post-op. Well balanced treatment decisions should fully account for both: Higher benefits in terms of pain relief and function as well as increased potential risks and complications. Trial registration This trial has been registered with the ethics committee of Eastern Switzerland (EKOS; Project-ID: EKOS 2020–00,879)

scholarly journals mRNA-Based Vaccines

Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 390
Author(s):  
Frank Kowalzik ◽  
Daniel Schreiner ◽  
Christian Jensen ◽  
Daniel Teschner ◽  
Stephan Gehring ◽  
...  
Keyword(s):  
Large Scale ◽  
New Technologies ◽  
Vaccine Development ◽  
Effective Means ◽  
Cost Effective ◽  
Clinical Applications ◽  
Cell Mediated Immunity ◽  
Healthy Individuals ◽  
Emerging Pathogens ◽  
Cell Genome

Increases in the world’s population and population density promote the spread of emerging pathogens. Vaccines are the most cost-effective means of preventing this spread. Traditional methods used to identify and produce new vaccines are not adequate, in most instances, to ensure global protection. New technologies are urgently needed to expedite large scale vaccine development. mRNA-based vaccines promise to meet this need. mRNA-based vaccines exhibit a number of potential advantages relative to conventional vaccines, namely they (1) involve neither infectious elements nor a risk of stable integration into the host cell genome; (2) generate humoral and cell-mediated immunity; (3) are well-tolerated by healthy individuals; and (4) are less expensive and produced more rapidly by processes that are readily standardized and scaled-up, improving responsiveness to large emerging outbreaks. Multiple mRNA vaccine platforms have demonstrated efficacy in preventing infectious diseases and treating several types of cancers in humans as well as animal models. This review describes the factors that contribute to maximizing the production of effective mRNA vaccine transcripts and delivery systems, and the clinical applications are discussed in detail.

scholarly journals The Influence of Obesity on Treatment and Outcome of Severely Burned Patients

2019 ◽  
Vol 40 (6) ◽  
pp. 996-1008 ◽  
Author(s):  
Christian Tapking ◽  
Khosrow S Houschyar ◽  
Victoria G Rontoyanni ◽  
Gabriel Hundeshagen ◽  
Karl-Friedrich Kowalewski ◽  
...  
Keyword(s):  
Fluid Resuscitation ◽  
Chronic Conditions ◽  
Perioperative Management ◽  
Normal Weight ◽  
Burn Patients ◽  
Obese Patients ◽  
Nonalcoholic Fatty Liver ◽  
Wound Coverage ◽  
Severe Burns ◽  
Early Wound

Abstract Obesity and the related medical, social, and economic impacts are relevant multifactorial and chronic conditions that also have a meaningful impact on outcomes following a severe injury, including burns. In addition to burn-specific difficulties, such as adequate hypermetabolic response, fluid resuscitation, and early wound coverage, obese patients also present with common comorbidities, such as arterial hypertension, diabetes mellitus, or nonalcoholic fatty liver disease. In addition, the pathophysiologic response to severe burns can be enhanced. Besides the increased morbidity and mortality compared to burn patients with normal weight, obese patients present a challenge in fluid resuscitation, perioperative management, and difficulties in wound healing. The present work is an in-depth review of the current understanding of the influence of obesity on the management and outcome of severe burns.

scholarly journals POS0358 EVALUATION OF THE EFFECT OF mTOR EXPRESSION ON THE CLINICAL MANIFESTATIONS OF KNEE OSTEOARTHRITIS IN OBESE AND NORMAL WEIGHT PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 409.2-409
Author(s):  
E. Strebkova ◽  
E. Tchetina ◽  
L. Alekseeva
Keyword(s):  
Body Weight ◽  
Knee Pain ◽  
Mammalian Target Of Rapamycin ◽  
Clinical Manifestations ◽  
Normal Weight ◽  
Womac Pain ◽  
Obese Patients ◽  
Normal Body ◽  
Knee Oa ◽  
Normal Body Weight

Background:Currently, a large number of molecular biological and genetic markers are known to be involved in the development of osteoarthritis (OA). The mammalian target of rapamycin (mTOR) signaling pathway is responsible for chondrocyte proliferation, cartilage matrix production, and cell growth. OA is characterized by increased mTOR synthesis, which is accompanied by an increase in proliferative activity and destruction of chondrocytes. Obesity is an important factor in the progression of knee OA. The study of mTOR expression in patients with OA and obesity is an urgent task in the development of personalized OA therapy.Objectives:To determine the expression of mTOR in patients with knee OA in combination with obesity and normal body weight. To evaluate the effect of mTOR on the clinical manifestations of OA in patients with different body mass index (BMI).Methods:The study included 73 female patients aged 45-65 y.o. with Kellgren-Lawrence stage II-III knee OA. The patients were divided into 2 groups: group 1 (n=50) with obesity (BMI > 30 kg / cm2) and group 2 (n=23) with normal or increased body weight (BMI < 30 kg/cm2). The average age of patients with obesity is 56.5 ± 5.87 years, without obesity - 58.7 ± 5.43 years. Clinical manifestations were evaluated by a WOMAС. RNA was isolated from the patients ‘ blood samples, which was used to determine the expression of mTOR.Results:Patients with knee OA with and without obesity did not differ in age. OA develops at an earlier age in obese patients, than in non-obese patients (p < 0.001). Patients from 1 group had a high BMI > 30 kg/m2 at the onset of OA. Obese patients had more severe knee OA is significantly more often detected: Kellgren-Lawrence stage III was determined in 10% of obese patients and in 4.35% - without obesity (p < 0.001). Significantly higher values of the WOMAC index pain, stiffness, joint functional failure, and total WOMAC were observed in obese patients (p = 0.006, p = 0.039, p = 0.037, and p = 0.014, respectively). Obese patients had higher VAS pain scores (p < 0.05) compared to patients with a lower BMI. Obese patients had a higher mTOR expression (p < 0.05) of 8.02±8.62, compared to non-obese patients. High mTOR expression was associated with VAS knee pain (r=0.78; p < 0.05) and WOMAC pain (r=0.89; p<0.05) in obese patients (Table 1).Table 1.Correlation of m-TORParametersmTOR (1 group, n=50)mTOR (2 group, n=23)Body weightр > 0,05р > 0,05Pain (VAS)r=0,78; р<0,05p = 0,07; r = 0,45Pain (WOMAC)r=0,89; р<0,05р > 0,05Total WOMACр > 0,05р > 0,05Conclusion:Our study showed that patients with obesity and knee OA have higher rates of mTOR expression, compared to patients with normal body weight. High mTOR expression correlates with the severity of knee pain in obese patients. Thus, the evaluation of mTOR expression in obese patients and knee OA plays an important role in predicting the severity of clinical manifestations of OA, and may influence the choice of personalized therapy tactics for such patients.Disclosure of Interests:None declared

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