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Longitudinal arch angle with the foot in subtalar neutral position. The foot was in its subtalar neutral position and the landmarks (1-3) were used to measure LAA. 1 head of first metatarsal bone; 2 navicular tuberosity; and 3 centre of the medial malleolus. A line was drawn from landmark 1 to 2 and from landmark 2 to 3. The superior angle between line 1 to 2 and line 2 to 3 was measured in degrees. With the foot in a weightbearing position, the measurements were repeated and the navicular tuberosity was marked again.
Source publication
The risk of developing injuries during standing work may vary between persons with different foot types. High arched and low arched feet, as well as rigid and flexible feet, are considered to have different injury profiles, while those with normal arches may sustain fewer injuries. However, the cut-off values for maximum values (subtalar position d...
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Citations
... The truncated FL (TFL) was measured as the distance between the most rear load support portion from the calcaneus to the first metatarsal head [10]. Medial longitudinal arch height (MLAH) was measured as the perpendicular distance from navicular tuberosity to the TFL [11]. The longitudinal arch angle (LAA) was calculated by drawing a line from the center of the medial malleoli to the navicular tuberosity, and another line was drawn from the navicular tuberosity to the head of the first metatarsal. ...
... The obtuse angle between these lines was measured as LAA [5]. The arch height index was measured as the height of the dorsum of the foot at 50% of the FL divided by the TFL [11]. The Feiss line was measured as a line that was drawn from the center of the medial malleoli to the head of the first metatarsal [11]. ...
... The arch height index was measured as the height of the dorsum of the foot at 50% of the FL divided by the TFL [11]. The Feiss line was measured as a line that was drawn from the center of the medial malleoli to the head of the first metatarsal [11]. ...
Introduction
Muscles, ligaments, tendons, bones, and cartilage undergo age-related changes, affecting the foot-ankle joint complex biomechanics in both genders. While international studies have extensively researched these dynamics, Indian studies are limited. Our study aims to fill this gap by analyzing the anthropometric and biomechanical function of the foot-ankle joint complex in normal individuals and those with painful pathologies at All India Institute of Medical Sciences (AIIMS) Rajkot’s OPD.
Methods
In a two-year case-control study of the cross-sectional type conducted at AIIMS Rajkot’s OPD, 158 patients with similar pain intensity on the Numeric Pain Rating Scale were examined. Anthropometric and biomechanical measurements were taken for both affected and non-affected foot and ankle joints. Cases comprised patients with foot and ankle joint pain, while controls were selected based on predefined criteria and were without such pain. Ethical approval was acquired from the Institutional Ethical Committee of AIIMS Rajkot.
Results
The sprain of the ankle joint and foot was the most common musculoskeletal pathology (65 out of 158 cases, i.e., 41.13%) affecting the ankle joint-foot complex. Patients involved in occupations requiring higher physical inactivity suffer more commonly from ankle joint-foot pathologies. The mean difference in the range of motion, i.e., dorsiflexion, plantar flexion, inversion, and eversion, between affected and non-affected feet was found to be lower in the patients who belonged to occupations involving low physical activity compared to those patients having occupations with high physical activity.
Conclusion
Reduced physical activity increases the stiffness and reduces the flexibility of the tendons, muscles, and ligaments of any joint (the ankle joint-foot complex in this study) and is associated with a higher incidence of musculoskeletal pathologies.
... After reviewing the recent literature, we found a few pieces of research about the foot that employ biomedical measurements. Previous studies have usually focused on the shape and characteristics of the foot [28][29][30][31]. The study [21] designed a method for 3D morphological measurements of the normal calcaneus based on CT image processing techniques. ...
It is important to present the biometric data of anatomical structures. This study formed 3D models of the metatarsal bones of the feet of young women by image processing techniques to examine biometric measurements and determine morphology on these 3D models. This study aimed to investigate the bone lengths in the feet metatarsal bones of women in Turkey. A total of ten young female subjects were included as the test group to measure their foot metatarsal bone lengths by means of CT scans, and 20 feet (left/right) were examined. The parameters that were used for the analyses were detector collimation of 64x0.5 mm, section thickness of 0.5 mm, current of 100 mA, tube voltage of 120 kVp, and pixel spacing of 512x512 pixels with a monochrome resolution providing 16-bit grey levels. CT images were processed, and a 3D metatarsal reconstruction was obtained. Then, biometric measurements were calculated on this 3D model. For the volunteers' right/left foot metatarsal bone lengths, statistically significant differences were calculated using a one-sample t-test. For the female metatarsal bones of the left and right feet, statistically significant differences in length were calculated on 3D models. The mean results of the metatarsal length measurements were MT1: 59.52±1.42 mm, MT2: 70.45±1.82 mm, MT3: 66.25±1.82 mm, MT4: 65.12±1.81 mm and MT5: 63.63±1.81 mm. The level of statistical significance was accepted as p
... The participants had no foot deformities or diseases, and no foot pain or neurological disorders. Pes planus was defined as ≥10 mm in the NDT, 17,18 the MLA angle of >131 degrees, 19 and the body mass index (BMI) <30. 18 The dominant foot, as determined by kicking a ball, was recorded in all participants. ...
... When the patient stood, if the tubercle of the navicularwas under the line, this was accepted as indicating pes planus. If the tubercle of navicular fell to the upper 1/3 of the distance between the line and the floor, this was interpreted as a first-degree pes planus; if it fell to the middle 2/3 of this distance, this was interpreted as a second-degree pes planus; if it completely touched the floor, this was interpreted as a third-degree pes planus (19). ...
Introduction: The objective was to compare the rate and localization of trigger points and muscle strength in patients with and without pes planus. Methods: A total of 88 female patients were divided into two groups according to the presence (with the mean age of 32.50 ± 7.95) (n=52) or absence of pes planus (with the mean age of 33.5 ± 7.80) (n=36). Muscle strength was evaluated with handgrip-strength, leg-back strength. The presence of trigger points (present/absent), the pain region of trigger points (masseter muscle, cervical/thoracic/lumber regions, upper/lower extremity) and the Visual Analog-Scale for pain severity were detected. Results: The rate of trigger points was significantly higher in the pes planus group in all regions: in the masseter muscle (p=0.042), upper extremities (p=0.006), cervicotorasic region (p=0.020), lumbar region (p=0.014), and lower extremities (p=0.020). 98.1% of the patients with pes planus were found to have at least one trigger point. The pain severity of trigger points was significantly higher in pes planus group (p=0.037). However muscle strength were found to be significantly similar between the groups. Conclusion: A significant relationship was found between pes planus and the rate of having trigger points not only in lower extremities and lumbar region, but also in masseter, upper extremities and the servicotorasic region in females. However, any relationship were not found between pes planus and muscle strength.
... 11 To measure the medial longitudinal arch angle, the evaluator placed the center of the goniometer in the tuberosity of the navicular, with its ends facing the center of the medial malleolus and the head of the first metatarsus. 12 For the navicular height, he measured the distance (in centimeters) between the ground and the tuberosity of the navicular. 12 All measurements were made in both feet of each participant by same evaluator. ...
... 12 For the navicular height, he measured the distance (in centimeters) between the ground and the tuberosity of the navicular. 12 All measurements were made in both feet of each participant by same evaluator. ...
... Typical values for navicular height were between 3.6 and 5.5 cm and 130 and 152 degrees for medial longitudinal arch angle in a study in Denmark. 12 Our participants had values within these ranges both before and after exercising and electric stimulation, indicating that, if any, the effects of the intervention were not evidenced by anatomical changes. Short-foot exercises can reactivate muscular components of the core system that may be inactive, allowing these muscles to contribute to the absorption and propulsion during activities involving the foot, 6 such as walking and standing. ...
Objective
The extrinsic muscles, such as the posterior tibialis and long flexor of the hallux and the intrinsic of the foot, are part of the active subsystem of the central system of the foot and play an essential role in the control of the medial longitudinal arch resulting from difficulty in contracting the muscle, neuromuscular electrostimulation (NMES) becomes a resource combined with strengthening and recommended for rehabilitation. T this work aims to evaluate the effectiveness of NMES associated with exercise in deforming the medial longitudinal arch.
Methods
This is a randomized blind clinical trial. 60 asymptomatic participants were divided into three groups: NMES, exercise and control. The NMES and exercise group performed seven exercises for the intrinsic and extrinsic muscles twice a week for 6 weeks, and the NMES group used an NMES associated with five exercises. Navicular height and medial longitudinal arch angle were taken before and after the intervention period.
Results
No statistically significant differences existed between groups for navicular height and medial longitudinal arch angle.
Conclusion
NMES associated with exercise does not change the characteristics of the medial longitudinal arch in association with asymptomatic. Level of Evidence I; Randomized clinical trial.
Electrical stimulation therapy; Foot; Foot deformities; Talipes Valgus; Talipes Cavus
... The structure and movements of the arches of the feet are crucial to a person's health and optimal body function. This area of the foot is particularly important for foot function, as the MLA is the foot's primary shock absorbing structure (Nilsson et al., 2012). Deformities that result specifically from MLA, such as pes cavus and pes planus, affect the function of lower extremity muscles and joints (Torun and Çay, 2018). ...
The human foot is a complex anatomical and
biomechanical structure that is of interest to various
experts (Wozniacka et al., 2013; Gwani et al., 2017).
Leonardo da Vinci, a Renaissance genius, architect
and painter, described it as a very cleverly constructed
machine and a true work of art. The foot, which is the
distal part of the lower extremity, consists of 26 bones
and more than 30 joints. Foot structure has a complex
structure formed by the ideal harmony of bones, muscles
and joints from an anatomical point of view. It is a
complex structure that carries the body weight during
standing and distributes the weight on the floor, pushes
the body forward during movement, and acts as a lever during walking and running, with the complex interaction
between the anatomical structures it contains. Therefore,
the shape and condition of the foot, all the features of the
bones, muscles and ligaments involved in its structure are
arranged to fulfill these tasks (Zeybek, 2011; Wozniacka
et al., 2013).
The foot is the limb that provides mobility and ground
contact for humans (Ekici, 2022). The shape and condition
of the foot bones are adjusted to the task of carrying the
body weight. Increasing the number of bones distally
widens the support surface (Zeybek, 2011; Wozniacka et
al., 2013). The foot performs its functions ideally, thanks
to the arch structure of many bones connected by joints.
The foot bones are connected by muscles and ligaments
to form the arches. The foot bones functionally form
three arch structures. The task of these arcs is to provide
elasticity and compliance with the surface (Yücel et al,
2017). These are medial longitudinal arch (MLA), lateral
longitudinal arch (LLA) and transverse arch (TA). These
arches are protected by the shape of the bones, strong
ligaments and muscle tone, allowing the foot to perform
its functions properly. The deterioration of the structures
that protect the arches of the foot or their inability to
perform them completely disrupts this dynamic structure
of the foot and causes deformities to occur by losing the
functionality of the foot (Zeybek, 2011; Gwani et al.,
2017; Ekici, 2022).
... If the tubercle of the navicular is reduced by 1/3 of the distance between the Feiss line and the ground, the pes planus is categorized as 1st degree, if it has decreased by 2/3 of it, it is classified as 2nd degree, and if it completely touches the ground, it is categorized as 3rd degree. If the tubercle of the navicular is above the Feiss line, it is defined as pes cavus [27][28][29][30]. The pes planus degrees of the athletes participating in the study were evaluated separately as right and left. ...
The foot absorbs shocks with its arches, muscles, ligaments and joints, and bodyweight transmission and it pushes the body forward during all movement patterns. Pes planus is more important in sports activities that include balance and sports performance, such as walking, running, jumping, or transferring weight to a single lower limb. This study, conducted with this information in mind, aims to examine the effects of pes planus deformity on balance and vertical jump performance. Fifty athletes were included in the study. The presence of pes planus was evaluated according to the Feiss line. Balance measurements were performed with a Balance System SD Biodex. Vertical jump performance was recorded using an Omegawave jumping mat. The relationship between the pes planus grades of the participants and their balance and jump performances was analyzed using the Spearman correlation method. Vertical jump and Limit of stability (LOS) was significantly correlated with pes planus.
... Foot Arch Measurement using the Longitudinal Arch Angle (LAA) Method. McPoil and Cornwall (2005); Nilsson et al. (2012). The participant stands up with the test foot limb weigh on step and looks straight forward. ...
... respectively. This was an increase to almost within maximal normal values, which were in the range of 131-152° (Nilsson et al., 2012), but still not in the normal range maybe from short time. ...
This study examines the effects that functional intrinsic foot muscle exercises for six weeks can have on the hard and elastic surfaces of the arch of the foot in persons with low-arched feet. The 33 participants were all student volunteers aged between 18 and 23 years old. The arch of the foot was measured with the longitudinal arch angle and the functional foot stability was measured using the Balance Error Scoring System. The participants were divided into three groups of 11: control group, exercise on hard surfaces group and exercise on elastic surfaces group. The results showed significant differences (p<0.05) in the arch of both feet between the control and the exercise groups. However, there was no significant difference (p>0.05) in the arch of both feet between the exercise groups. The stability of both feet was not significantly different (p>0.05) between any groups.
... For recording, navicular height and rearfoot angle, a rigid tape and a goniometer were used respectively. The testing measurement used for both screening measurements was standardized (21) (22) as provided in the literature. Participants exhibiting bilateral at or normal feet were recruited for this study. ...
Purpose: The aim of this study is to determine differences in plantar pressure distribution and centre of pressure (COP) characteristics in normal and at feet individuals. Methods: Forty individuals (20 normal and 20 at feet) were included in this study for pressure analysis using OHM 3000 (Mumbai, India) pressure system. Dynamic pressure parameters were recorded for four regions- toes, forefoot, midfoot, and hindfoot while walking. Dynamic parameters included maximum pressure, arch index, centre of pressure excursion index, and pressure time integral (PTI). The COP excursion for both the groups were macroscopically evaluated. The independent t-test was used for determining the pressure difference between both the groups. Results:The at feet group reported maximum pressure on the midfoot region relative to the normal foot group. The PTI was recorded higher over the midfoot and the toe region in the at feet group than those of the normal foot group. The COP excursion in dynamic state was observed to be traversing straight from the heel to the hallux in at feet group in contrary to the normal foot group which demonstrated a medial shift at the forefoot region. Conclusion: The study reports that the individuals with at feet exert increased plantar pressure on the midfoot region compared to that of the normal foot individuals. The COP excursion in at feet individuals during walking is straight compared to that in the normal foot individuals, which we believe is due to reduced medial longitudinal arch and hyper pronation at the foot.
... This happens when the arch of the foot is flattened when weight is applied to it. Both aspects open a discussion about the behavior of the subtalar angle which determines subtalar flexibility in functional activities [1]. ...
Flat foot is a common pediatric foot deformity which involves subtalar flexibility; it can affect the plantar arch. This study analyzes the evolution of two parameters, i.e., plantar index arch and subtalar flexibility, before and after physiotherapy and orthoses interventions, and examines the correlation between these two parameters.
Methods:
The study included 30 participants (17 boys, 12 girls, average age 9.37 ± 1.42 years) with bilateral flat foot. We made two groups, each with 15 subjects. Assessments of the subtalar flexibility and plantar arch index used RSScan the platform, and were undertaken at two time points. Therapeutic interventions: Group 1-short foot exercises (SFE); Group 2-SFE and insoles. Statistical analyses included Student's t-test, Cohen's D coefficient, Pearson and Sperman correlation.
Results:
Group 1-subtalar flexibility decreased for the left and right feet by 28.6% and 15.9% respectively, indicating good evolution for the left foot. For both feet, a decrease of the plantar index arch was observed. Group 2-subtalar flexibility decreased for the right and left feet by 43.4% and 37.7% respectively, indicating a good evolution for the right foot. For both feet, a decrease of plantar index arch was observed. Between groups, subtalar flexibility evolved well for Group 2; this was attributed to mixt intervention, physical therapy and orthosis. For plantar arch index, differences were not significant between the two groups. We observed an inverse correlation between subtalar flexibility and plantar arch index.
Conclusions:
Improvement of plantar index arch in static and dynamic situations creates the premise of a good therapeutic intervention and increases foot balance and postural control. The parameter which showed the most beneficial influence was the evolution is subtalar flexibility.
