Vascular Alteration with Postural Change as Observed Using the Anterior Tibial Artery: A Pilot Study

Plantar fasciopathy and plantar fasciosis are common lower extremity conditions. Vascular health is an important aspect of plantar fascia health. Footwear choices are thought to influence lower extremity vascular flow, but how the anterior tibial artery is affected by purely postural changes over time is unknown. PURPOSE: To observe the anterior tibial artery vascular alterations over a ten-minute period after transitioning from a sitting to a standing position while barefoot. METHODS: Nine participants (age= 23.8yrs ±2.5, height= 176.0cm ±8.0, weight= 69.8kg ±10.2) were recruited from Brigham Young University for a single 30-minute visit. The participants had no previous lower extremity injuries within 6 months. The individual’s dominant foot arch height index was recorded, and the participant had a 3-lead ECG placed on their trunk. A Logic Fortis machine with an L8-18i probe was used to capture pulse wave (PW) images of the anterior tibial artery of the dominant foot. The participant sat barefoot on an elevated platform for five minutes and baseline PW was recorded. The participant then stood on the platform for 11 total minutes. PW images were captured once at the end of every minute for the first five minutes and a final PW measurement was captured after ten minutes of standing. A paired t-test was used to compare standing time points to baseline (α=0.05). RESULTS: After standing, time-averaged mean velocity (TAMean) significantly dropped through minutes one (pCONCLUSION: Blood flow through the anterior tibial artery is significantly altered with postural changes likely through cardiovascular responses. Vascular recovery is observed after three minutes while the average increase in vascular response occurs around ten minutes

Individuals Wearing Cleats Transitioning from Sitting to Standing Demonstrate a Significant Decrease in Blood Flow to the Foot

Plantar fasciopathy is a common foot condition with 10% prevalence in the general population. Plantar fasciosis (a type of fasciopathy) is considered a degenerative condition associated with cell death due to a lack of blood flow. Narrow, tight footwear, such as cleats, have been implicated as a potential contributing factors for the development of plantar fasciopathy and their direct influence on blood flow to the foot is currently unknown. PURPOSE: To investigate blood flow change in the anterior and posterior tibial arteries between sitting and standing in a cleated foot. METHODS: Eight individuals participated in this pilot study (weight=70.5 kg±12.9, height=1.8m±0.17). The participant put cleats on both feet, with a perceived tightness of 5/10 or greater on a VAS scale. Blood flow volume measurements of the anterior and posterior tibial arteries were taken simultaneously using pulse wave ultrasound, while the participant sat on a platform. These measurements were then repeated in the standing position on the same platform. Blood flow was measured in the dominate shod foot. A paired t-test was used to compare sitting to standing conditions within participants. RESULTS: In the anterior tibial artery, average volume flow changed from 6.25 ml/min (sitting) to 2.6 ml/min (standing), a 58% drop in blood flow (p=0.09). In the posterior tibial artery, volume flow decreased from an average of 11.25 ml/min to 3.95 ml/min, a decrease of 65% (p\u3c0.05). Total reduced blood flow between the two arteries decreased from 8.75 ml/min to 3.28 ml/min, a 63% drop (p\u3c0.05). CONCLUSION: There appears to be an important alteration of blood flow to the foot in individuals wearing cleats as they transition from a sitting to standing position. If this decrease in blood flow were to persist while wearing cleats, it may help explain the development of plantar fasciopathy observed in individuals wearing narrow, tight footwear