FOOT PRESSURE MEASURMENT AND MAPPING, IN A CASE SERIES ASSESSMENT FOR DIAGNOSING AND TREATING ORTHOPAEDIC FOOT ABNORMALITIES.

Introduction: The study that measures the existing elds of pressure between a surface that is used to support, and foot surface that is plantar, is called Pedobarography. It has important applications in the analysis of Gait and other Foot Health problems. The requirement of foot pressure measurement sensors, are that they must have mobility with limited cabling. Materials And Methods: This was a prospective study done as an outpatient procedure at Chettinad Hospital and Research Institute, Kelambakkam, Chengalpattu district of Tamil Nadu, from January 2019 to December 2019, for foot related ailments of outpatients presenting in the Department of Orthopaedics. The foot mapping was done by standard static mapping and gait analytical mapping systems. The ndings were recorded and analyzed by a computer and the patients were prescribed custom made foot-wear. Results: 945 cases were included in the study of which 575 patients had foot related orthopaedic pain pathology in the age group of 28 to 57years. Only for the 170 patients in the plantar fasciitis group was Hydrocortisone Injection administered. Remaining foot pathologies were treated with wax bath and ultrasound therapy. For the neurological foot pain segment comprising of 114 patients, neurologist consultation was sought, of which 36 cases turned out to be, due to lumbar canal stenosis and were surgically intervened upon. Of the 208 patients with Achilles tendonitis, 165 patients resolved with a heel and sole raise, with physiotherapy and the remaining 43 patient required spur and bursal surgical exploration and excision. Conclusion: Plantar foot pressure mapping, should be an integral part of the list of investigations, while trying to diagnose and treat the problems related to foot abnormalities and pathologies.

A Radiographic Study of Biomechanical Relationship between the Achilles Tendon and Plantar Fascia

Background. Previously, scholars have concluded that the Achilles tendon and the plantar fascia were closely biomechanically related, although there is little clinical evidence of the relationship between the two. To investigate the biomechanical relationship between the Achilles tendon and the plantar fascia, the author used standing lateral ankle radiographs of patients with insertional Achilles tendonitis to determine the biomechanical relationship between the Achilles tendon and plantar fascia. Methods. The author collected standing lateral ankle radiographs from patients with insertional Achilles tendonitis who accepted surgical treatment in the author’s hospital from March 2009 to July 2018. According to whether there were bone spurs on the posterior side of the calcaneus, patients were divided into group A (spur present on the posterior side) and group B (spur not present on the posterior side). The positive rates of spurs on the plantar side of the calcaneus were determined in group A and group B. The chi-square test was used to compare the measurement results between the two groups. Results. In group A, 13 heels were positive for calcaneal bone spurs, and the positive rate was 65.0%. In group B, 3 heels were positive for plantar calcaneal spurs, and the positive rate was 12%. Among all 16 patients with positive plantar calcaneal spurs, 13 had posterior calcaneal spurs (accounting for 81.3%), and 3 had negative results, accounting for 18.7%. There was a significant difference between the results in groups A and B (P<0.05). Conclusion. There is a relationship between posterior calcaneal spurs and plantar calcaneal spurs in patients with insertional Achilles tendonitis, which can be inferred as resulting from the increasing tension in the biomechanically complex relationship between the Achilles tendon and the plantar fascia.

FORTALECIMENTO MUSCULAR EXCÊNTRICO NO TRATAMENTO DA TENDINOPATIA DE AQUILES: UMA REVISÃO SISTEMÁTICA

INTRODUÇÃO: A Fisioterapia, no manejo da tendinopatia de Aquiles, utiliza-se de recursos físicos moduladores da inflamação e analgésicos. Como parte do tratamento fisioterapêutico a literatura tem sugerido o exercício de fortalecimento excêntrico com eficaz na resolução de tendinopatias. OBJETIVO: O presente estudo teve como objetivo a busca de evidências científicas sobre o uso do exercício de fortalecimento excêntrico no manejo da Tendinopatia de Aquiles. MÉTODOS: Para a composição da revisão foi realizada busca por estudos nas base de dados virtuais Pubmed e PEDro. Os descritores utilizados foram as seguintes: Eccentric, tendinopathy, Achilles Tendonitis. Para compor o estudo os artigos deveriam obedecer os seguintes critérios de elegibilidade: artigos publicados na língua inglesa, intervalo de publicação entre 2013 a 2017, ensaios clínicos randomizados, com pontuação superior a 6 na escala de qualidade PEDro. RESULTADOS: Foram localizados um total de 87 artigos, dos quais apenas 21 referiam-se a temática em questão. Dos 21 artigos 14 foram excluídos pelos seguintes motivos: 3 por consistirem em relatos de caso, 1 classificado como revisão de literatura, 1 caracterizava-se como comentário clinico, 1 envolvia um estudo com modelo animal, 1 era um projeto de pesquisa, 5 não classificavam-se com ensaios clínicos randomizados, 1 obteve nota inferior a 6 na escala de qualidade PEDro e 1 deles proporcionava descrição incompleta dos resultados. CONCLUSÃO: O fortalecimento muscular excêntrico caracteriza-se como uma modelo terapêutico de escolha para o manejo da tendinopatia de aquiles, a combinação com outras modalidades potencializa seus efeitos fisiológicos.