Effectiveness of the foot orthotics as treatment in femoropatellar syndrome: systematic review

[Resumen] Objetivo: El objetivo principal de este trabajo es analizar la evidencia científica en relación a la efectividad de los soportes plantares para tratar el dolor femoropatelar. Material y métodos: Se realizó una búsqueda bibliográfica en cuatro bases de datos (Pubmed, Cochrane, Science Direct y Dialnet). Los términos empleados en la búsqueda fueron: patelofemoral pain syndrome, treatment, orthoses y orthotics. Se tuvieron en cuenta los artículos de los últimos 15 años que hablaran de soportes plantares a medida y prefabricados, que no combinaran las plantillas con otra terapia y que no fueran revisiones sistemáticas. Resultados: Se revisó un total de 10 artículos al completo. Tanto las ortesis a medida como las prefabricadas obtuvieron buenos resultados, aunque a largo plazo fueron mejores las plantillas a medida. Conclusión: Los soportes plantares son una buena alternativa al tratamiento del síndrome de dolor patelofemoral.[Abstract] Objective: patellofemoral pain syndrome is one of the main causes of pathology in the knee and consists of a pain in the anterior area of the knee due to stress conditions in the patellofemoral Joint. Its causes are not entirely clear, so there is no concrete treatment to solve it. The main objective of this work is to analyse the scientific evidence in relation to the effectiveness of plantar supports to treat the patellofemoral pain. Methods: A bibliographic search was carried out in four databases (Pubmed, Cochrane, Science Direct and Dialnet). The terms used in the search were: patellofemoral pain syndrome, treatment, orthoses and orthotics. The articles of the last 15 years that spoke of custom and prefabricated plantar supports, that did not combine the templates with other therapy and that were not systematic reviews, were taken into account. Results: A total of 10 articles were reviewed. Both the customized and prefabricated orthoses obtained good results, although in the long term the customized templates were better. Conclusion: The plantar supports are a good alternative to the treatment of patellofemoral pain syndrome

Foot Anatomical Structural Variations Increase the Risk of Falls in Older Adults

Falls are common among older adults. The purpose of this study was to demonstrate the relationship between foot anatomical structural variations and balance in older adults and quantify foot posture and stabilometry as predictors of fall risk. This case-control study of older adults classified cases or controls according to falls in the last five years. All subjects were healthy women and men > 65 years old (n = 164), who were divided into two groups: 83 individuals who had suffered from a fall in the previous five years (case group) and 81 individuals who had not suffered from a fall (control group). Hallux abductus valgus (HAV) and tailor’s bunion are stability-determining factors. Women have a higher probability of falling. HAV (p = 0.042) and tailor’s bunion (p = 0.069) also increased the fall probability. Morphological foot variations (HAV and tailor’s bunion) linked to gender and age increase fall risk among older adults. In women fallers with HAV, there was a higher possibility of falling (63.9%). According to age, in older adults with HAV, the percentage of falls is high (62%). Fallers with tailor’s bunion (60.7%) are more numerous than fallers without this pathology. Older adults with HAV and tailor´s bunion had twice the probability of suffering a fall than older people without foot anatomical structural. Foot morphology is decisive in falling risk

Baropodometric association of the first metatarsal bone in medial tibial stress syndrome

[Resumen] Objetivos: El síndrome de estrés tibial medial (SETM) es una lesión de sobreuso por estrés mecánico, que se localiza por lo general en el borde postero-medial de la tibia. El objetivo de este estudio es cuantificar la diferencia baropodométrica existente en la primera cabeza metatarsal entre dos grupos. Métodos: Se analizaron las huellas de 30 participantes, de los cuales 15 padecían SETM y 15 controles. Se trata de un estudio observacional en el que se obtuvieron las huellas baropodométricas de los participantes, caminando sobre una plataforma de presiones. Se cuantificó la presión plantar media y la integral presión/tiempo que estaba recibiendo cada paciente en la primera cabeza metatarsal. Realizamos la prueba t-student para muestras independientes con el objetivo de definir las diferencias. Resultados: Los resultados de la variable presión plantar media muestran diferencias estadísticamente significativas entre los 2 grupos (p=0,001 para pie izquierdo y p=0,001 para pie derecho). Por el contrario no se observaron diferencias estadísticamente significativas para la variable integral presión/tiempo en ambos grupos (p=0,327 para pie izquierdo y p=0,300 para pie derecho). Conclusiones: Según nuestro estudio, los resultados obtenidos concluyen que el SETM se ocasiona con mayor frecuencia en personas con una disminución significativa de la presión plantar en la cabeza del primer metatarsiano medida en plataforma baropodométrica. Consideramos que son necesarios más estudios que evidencien esta relación biomecánica mediante plantillas instrument[Abstract] Objectives: Medial tibial stress syndrome (MTSS) is a mechanical stress overuse lesion, which is usually located at the post-medial border of the tibia. This study aims to quantify the baropodometric difference in the first metatarsal head between two groups. Methods: For the study 30 patient footprints were analyzed. Among them, half were affected by MTSS and the other half were controls. The baropodometric footprint samples were obtained by walking barefooted over a platform. While the patients were walking the average plantar pressure and the integral ratio pressure/time was quantified. The T-student test was performed in independent samples in order to define the differences. Results: The average plantar pressure results show statistically significant differences amongst the 2 groups (p=0.001 for the left foot and p=0.001 for the right foot). On the other hand, there were not any significant differences for the integral pressure/time variable in both groups (p=0.327 for the left foot and p=0.300 for the right foot). Conclusion: By having done this study, we can affirm that the MTSS is more frequent in persons with a significant plantar pressure decrease in the first metatarsal head measured in the baropodometric platform. We consider the need for further studies that prove this biomechanical connection through instrumented insoles

Eficacia del tratamiento ortopodológico en la apofisitis calcánea en niños con normo y sobrepeso

Tesis inédita presentada en la Universidad Europea de Madrid. Facultad de Salud y Ciencias Biomédicas. Programa de Doctorado en Podología AvanzadaEstudio experimental longitudinal prospectivo en el que se incluyen sujetos con una edad comprendida entre 9 y 12 años diagnosticados de apofisitis del calcáneo. Mediante el índice de masa corporal se clasifica a los niños en normopeso o sobrepeso y de forma aleatoria reciben tratamiento mediante plantillas a medida o taloneras estándar. Se incluyen en el estudio 180 pacientes, 45 asignados a cada uno de los cuatro grupos. Al inicio del estudio el 51,7% de los pacientes tiene dolor en reposo, el 97,8% tiene dolor al correr y el 100% tiene dolor al saltar. Considerando todas las variables de eficacia, la mejora en media es un 51,5% superior a favor de las plantillas a medida respecto a las taloneras. El dolor disminuye un 19,2% (DE=22,2) en los pacientes tratados con taloneras frente al 88,4% (DE=18,5) en los tratados con plantillas (p<0,001). La influencia del IMC del paciente en la efectividad del tratamiento es mínima, solo influye cuando evaluamos el dolor en reposo. A nivel multivariante, menor edad, mayor intensidad en el deporte y menor nivel de Lunge test, aumentan la eficacia del tratamiento. [Resumen Teseo]UE

Effectiveness of Custom-Made Foot Orthoses vs. Heel-Lifts in Children with Calcaneal Apophysitis (Sever’s Disease): A CONSORT-Compliant Randomized Trial

The aim of the present research was to determine the effectiveness of relieving calcaneal apophysitis pain using “off-the-shelf” heel-lifts and custom-made orthotics. Two intervention modalities were evaluated and compared in a 12-week follow-up trial. Inclusion criteria included 9- to 12-year-old children diagnosed with calcaneal apophysitis. Children were randomly stratified into treatment A (custom-made polypropylene foot orthoses) and treatment B (“off-the-shelf” heel-lifts) groups. Treatment effectiveness was measured by algometry and the visual analogical scale (VAS). A total of 208 patients were included. The treatment A group showed an increase in threshold algometry of 53.4% (95% CI 47.1% to 59.7%) and a decrease in VAS of −68.6% (95% CI −74.5% to −62.7%) compared with the treatment B group (p &lt; 0.001). Calcaneal apophysitis pain perception was improved in both groups, but children who used custom-made foot orthoses showed a greater improvement

Relationship of Lunge and Jack test in calcaneal apophysitis (sever´s disease) in young soccer players

La talalgia de Sever o apofisitis calcánea ocurre generalmente antes o durante el pico de crecimiento acelerado en niños y niñas. En ocasiones se presenta al practicar un nuevo deporte que implique desplazamientos y saltos como el fútbol. Fue descrita por el Doctor J. W. Sever, a causa de la detección de un dolor con sensibilidad localizada en la cara posterior del hueso calcáneo en jóvenes. El objetivo de este estudio es relacionar la incidencia de la talalgia de Sever con la restricción en los valores del Lunge test y con la incapacidad para activar el mecanismo de Windlass medido a través del test de Jack. Se realizaron los dos test a una muestra de 60 futbolistas jóvenes divididos en dos grupos (Sever = 30 jóvenes, de 10,84±0,79 años y 16,87±0,85 de IMC; No Sever = 30 jóvenes, de 10,87±0,80 y 17,58±1,41 de IMC). Los resultados muestran un test de Jack del pie derecho positivo en el 26,7% de los niños con Sever frente al 10,0% de los niños sin Sever (p=0,181). Mientras que, para el pie izquierdo, el 33,3% de los niños con Sever tiene el test de Jack positivo frente al 13,3% de los niños sin Sever (p=0,125). Por otro lado, el Lunge test para el pie derecho muestra una diferencia significativa.Sever´s Disease or calcaneal apophysitis occur before or during the early growth in children. Experienced after a new practice of psychical activity that involve running or jumping as soccer. It was described by Dr. J. W. Sever, due to detection of pain with localized sensitivity in the posterior area of the calcaneus bone in young people. The aim of the study is relate the Sever´s Disease incidence and restricted values of Lunge test. In the same way, the inability to activate the windlass mechanism measured through the Jack test related with Sever´s Disease incidence. We performed both test to 60 young soccer players divided in two groups (Sever = 30 young players, 10,84±0,79 years old and 16,87±0,85 IMC values; No Sever = 30 young players, 10,87±0,80 years old and y 17,58±1,41 IMC values). The results shows that a 26,7% of Sever´s Disease patient had a positive Jack test in right foot versus 10,0% of non Sever´s Disease patient (p=0,181). While for left foot, a 33,3% of Sever´s Disease patient had a positive Jack test versus 13,3% of non Sever´s Disease patient (p=0,125). On the other hand, Lunge test for right foot show a significant difference (p<0,01).Sin financiaciónNo data JCR 2017No data SJR 2017No data IDR 2017UE

Foot Anatomical Structural Variations Increase the Risk of Falls in Older Adults

Falls are common among older adults. The purpose of this study was to demonstrate the relationship between foot anatomical structural variations and balance in older adults and quantify foot posture and stabilometry as predictors of fall risk. This case-control study of older adults classified cases or controls according to falls in the last five years. All subjects were healthy women and men &gt; 65 years old (n = 164), who were divided into two groups: 83 individuals who had suffered from a fall in the previous five years (case group) and 81 individuals who had not suffered from a fall (control group). Hallux abductus valgus (HAV) and tailor&rsquo;s bunion are stability-determining factors. Women have a higher probability of falling. HAV (p = 0.042) and tailor&rsquo;s bunion (p = 0.069) also increased the fall probability. Morphological foot variations (HAV and tailor&rsquo;s bunion) linked to gender and age increase fall risk among older adults. In women fallers with HAV, there was a higher possibility of falling (63.9%). According to age, in older adults with HAV, the percentage of falls is high (62%). Fallers with tailor&rsquo;s bunion (60.7%) are more numerous than fallers without this pathology. Older adults with HAV and tailor&acute;s bunion had twice the probability of suffering a fall than older people without foot anatomical structural. Foot morphology is decisive in falling risk