The effect of unsupportive and supportive footwear on children’s multi-segment foot dynamics during gait

Footwear is necessary for children’s foot comfort and protection. Despite the popularity of flip-flop (thongs) footwear among children, strong clinical opinion endures of the potential deleterious effect this footwear may have on developing feet. On the contrary, thongs may be beneficial for children’s developing feet due to the footwear’s flexible and unrestrictive nature, as children who mature within habitually barefoot communities are observed to develop stronger and healthier feet. This thesis considers the developing nature of human ambulation and the physiological basis for children’s foot maturation. It then explores the effect of thong footwear on childrens barefoot dynamics with comparisons to traditionally advocated supportive footwear. Foot compensations were observed when thongs were worn while walking and to a lesser extent while jogging. Greater ankle dorsiflexion and reduced hallux dorsiflexion suggests a mechanism to retain the thong. Greater midfoot plantarflexion indicates a gripping action to sustain the thong. Barefoot motions were unaffected by thongs during the sidestep. The midfoot splinting effect of supportive shoes was reinforced while walking, jogging and sidestepping. Thongs had a minimal effect on barefoot dynamics, while supportive shoes limited midfoot power generation with a corresponding increase in ankle power generation. Overall findings suggest that foot motion when wearing thongs may be more replicable of barefoot motion than originally believed. In terms of foot arch development, thongs may be more beneficial than supportive shoes, due to the minimal alterations to barefoot motions when they are worn. The reported midfoot plantarflexion required to grip the thong may be beneficial to children’s foot arch strengthening and overall foot development. While supportive shoes have the necessary protective features, they have been shown to inhibit midfoot and hallux motions with a compensatory increase in ankle motions

1000 Norms Project: Protocol of a cross-sectional study cataloging human variation

Background Clinical decision-making regarding diagnosis and management largely depends on comparison with healthy or ‘normal’ values. Physiotherapists and researchers therefore need access to robust patient-centred outcome measures and appropriate reference values. However there is a lack of high-quality reference data for many clinical measures. The aim of the 1000 Norms Project is to generate a freely accessible database of musculoskeletal and neurological reference values representative of the healthy population across the lifespan. Methods/design In 2012 the 1000 Norms Project Consortium defined the concept of ‘normal’, established a sampling strategy and selected measures based on clinical significance, psychometric properties and the need for reference data. Musculoskeletal and neurological items tapping the constructs of dexterity, balance, ambulation, joint range of motion, strength and power, endurance and motor planning will be collected in this cross-sectional study. Standardised questionnaires will evaluate quality of life, physical activity, and musculoskeletal health. Saliva DNA will be analysed for the ACTN3 genotype (‘gene for speed’). A volunteer cohort of 1000 participants aged 3 to 100 years will be recruited according to a set of self-reported health criteria. Descriptive statistics will be generated, creating tables of mean values and standard deviations stratified for age and gender. Quantile regression equations will be used to generate age charts and age-specific centile values. Discussion This project will be a powerful resource to assist physiotherapists and clinicians across all areas of healthcare to diagnose pathology, track disease progression and evaluate treatment response. This reference dataset will also contribute to the development of robust patient-centred clinical trial outcome measures

EFFECT OF THONG STYLE FLIP-FLOPS AND SUPPORTIVE SHOES ON CHILDRENS BAREFOOT SIDESTEP KINEMATICS

Thongs and supportive have been shown to alter children’s barefoot motion. However, the effect of thongs on other types of activities such as sidestepping are unknown. The purpose of this study was to evaluate the effect thong style flip-flops and supportive have on childrens knee and foot motion during a jogging sidestep task when compared to barefoot. Eleven healthy children with no foot deformity (aged 8 to 13 years) were recruited. Motion and force capture was used to record knee and multisegment foot motion. Motion adaptations while thongs were worn were restricted to the hallux and while supportive were worn, occurred with knee, midfoot and hallux motion. All footwear conditions increased ankle inversion magnitude. Thongs had less effect on children’s barefoot sidestep motion than supportive shoes

Effect of thong style flip-flops on children’s midfoot motion during gait

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Effect of thong style flip-flops on children’s barefoot walking and jogging kinematics

BACKGROUND: Thong style flip-flops are a popular form of footwear for children. Health professionals relate the wearing of thongs to foot pathology and deformity despite the lack of quantitative evidence to support or refute the benefits or disadvantages of children wearing thongs. The purpose of this study was to compare the effect of thong footwear on children’s barefoot three dimensional foot kinematics during walking and jogging. METHODS: Thirteen healthy children (age 10.3 ± 1.6 SD years) were recruited from the metropolitan area of Sydney Australia following a national press release. Kinematic data were recorded at 200 Hz using a 14 camera motion analysis system (Cortex, Motion Analysis Corporation, Santa Rosa, USA) and simultaneous ground reaction force were measured using a force platform (Model 9281B, Kistler, Winterthur, Switzerland). A three-segment foot model was used to describe three dimensional ankle, midfoot and one dimensional hallux kinematics during the stance sub-phases of contact, midstance and propulsion. RESULTS: Thongs resulted in increased ankle dorsiflexion during contact (by 10.9°, p; = 0.005 walk and by 8.1°, p; = 0.005 jog); increased midfoot plantarflexion during midstance (by 5.0°, p; = 0.037 jog) and propulsion (by 6.7°, p; = 0.044 walk and by 5.4°, p;= 0.020 jog); increased midfoot inversion during contact (by 3.8°, p;= 0.042 jog) and reduced hallux dorsiflexion during walking 10% prior to heel strike (by 6.5°, p; = 0.005) at heel strike (by 4.9°, p; = 0.031) and 10% post toe-off (by 10.7°, p; = 0.001). CONCLUSIONS: Ankle dorsiflexion during the contact phase of walking and jogging, combined with reduced hallux dorsiflexion during walking, suggests a mechanism to retain the thong during weight acceptance. Greater midfoot plantarflexion throughout midstance while walking and throughout midstance and propulsion while jogging may indicate a gripping action to sustain the thong during stance. While these compensations exist, the overall findings suggest that foot motion whilst wearing thongs may be more replicable of barefoot motion than originally thought

Effect of thong style flip-flops on children’s barefoot walking and jogging kinematics

BACKGROUND: Thong style flip-flops are a popular form of footwear for children. Health professionals relate the wearing of thongs to foot pathology and deformity despite the lack of quantitative evidence to support or refute the benefits or disadvantages of children wearing thongs. The purpose of this study was to compare the effect of thong footwear on children’s barefoot three dimensional foot kinematics during walking and jogging. METHODS: Thirteen healthy children (age 10.3 ± 1.6 SD years) were recruited from the metropolitan area of Sydney Australia following a national press release. Kinematic data were recorded at 200 Hz using a 14 camera motion analysis system (Cortex, Motion Analysis Corporation, Santa Rosa, USA) and simultaneous ground reaction force were measured using a force platform (Model 9281B, Kistler, Winterthur, Switzerland). A three-segment foot model was used to describe three dimensional ankle, midfoot and one dimensional hallux kinematics during the stance sub-phases of contact, midstance and propulsion. RESULTS: Thongs resulted in increased ankle dorsiflexion during contact (by 10.9°, p; = 0.005 walk and by 8.1°, p; = 0.005 jog); increased midfoot plantarflexion during midstance (by 5.0°, p; = 0.037 jog) and propulsion (by 6.7°, p; = 0.044 walk and by 5.4°, p;= 0.020 jog); increased midfoot inversion during contact (by 3.8°, p;= 0.042 jog) and reduced hallux dorsiflexion during walking 10% prior to heel strike (by 6.5°, p; = 0.005) at heel strike (by 4.9°, p; = 0.031) and 10% post toe-off (by 10.7°, p; = 0.001). CONCLUSIONS: Ankle dorsiflexion during the contact phase of walking and jogging, combined with reduced hallux dorsiflexion during walking, suggests a mechanism to retain the thong during weight acceptance. Greater midfoot plantarflexion throughout midstance while walking and throughout midstance and propulsion while jogging may indicate a gripping action to sustain the thong during stance. While these compensations exist, the overall findings suggest that foot motion whilst wearing thongs may be more replicable of barefoot motion than originally thought

Extract, Transform, Load Framework for the Conversion of Health Databases to OMOP

ABSTRACTObjectiveDevelop an extract, transform, load (ETL) framework for the conversion of health databases to the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) that supports transparency of the mapping process, readability, refactoring, and maintainability.Materials and MethodsWe propose an ETL framework that is metadata-driven and generic across source datasets. The ETL framework reads mapping logic for OMOP tables from YAML files, which organize SQL snippets in key-value pairs that define the extract and transform logic to populate OMOP columns.ResultsWe developed a data manipulation language (DML) for writing the mapping logic from health datasets to OMOP, which defines mapping operations on a column-by-column basis. A core ETL pipeline converts the DML in YAML files and generates an ETL script. We provide access to our ETL framework via a web application, allowing users to upload and edit YAML files and obtain an ETL SQL script that can be used in development environments.DiscussionThe structure of the DML and the mapping operations defined in column-by-column operations maximizes readability, refactoring, and maintainability, while minimizing technical debt, and standardizes the writing of ETL operations for mapping to OMOP. Our web application allows institutions and teams to reuse the ETL pipeline by writing their own rules using our DML.ConclusionThe research community needs tools that reduce the cost and time effort needed to map datasets to OMOP. These tools must support transparency of the mapping process for mapping efforts to be reused by different institutions.</jats:sec

Extract, transform, load framework for the conversion of health databases to OMOP

Common data models standardize the structures and semantics of health datasets, enabling reproducibility and large-scale studies that leverage the data from multiple locations and settings. The Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) is one of the leading common data models. While there is a strong incentive to convert datasets to OMOP, the conversion is time and resource-intensive, leaving the research community in need of tools for mapping data to OMOP. We propose an extract, transform, load (ETL) framework that is metadata-driven and generic across source datasets. The ETL framework uses a new data manipulation language (DML) that organizes SQL snippets in YAML. Our framework includes a compiler that converts YAML files with mapping logic into an ETL script. Access to the ETL framework is available via a web application, allowing users to upload and edit YAML files via web editor and obtain an ETL SQL script for use in development environments. The structure of the DML maximizes readability, refactoring, and maintainability, while minimizing technical debt and standardizing the writing of ETL operations for mapping to OMOP. Our framework also supports transparency of the mapping process and reuse by different institutions.</jats:p