Foot Pain and Morphofunctional Foot Disorders in Patients with Rheumatoid Arthritis: A Multicenter Cross-Sectional Study

[Abstract] Foot problems are highly prevalent in people with rheumatoid arthritis. This study aims to explore the foot morphology, pain and function in rheumatoid arthritis patients and the relation with the time of disease debut. A cross-sectional study was designed. Footprint, the Foot Posture Index, the hallux valgus prevalence, foot pain and function in 66 rheumatoid arthritis patients and the association with time since diagnosis, were recorded. The Foot Function Index, the Manchester Foot Pain and Disability Index, the Visual Analogic Scale, and the Manchester Scale for hallux valgus were administered and analyzed in two groups, with less and more than 10 years of diagnosis of the disease. A high prevalence of pronated (right 36.8% and left 38.6%) and highly pronated (right 15.8% and left 15.8%) feet was observed, as well as an elevated percentage of low arched footprints (right 68.4 and left 66.7%) and hallux valgus (right 59.6% and left 54.4%). Hallux valgus prevalence, toe deformities and Foot Function Index (Functional limitation) factors were significantly associated with the time since RA diagnosed adjusted for the other factors. The adjusted odds ratio of Hallux valgus prevalence was 4.9 (1.2–19.7). In addition, the foot function was diminished, and foot pain was present in most participants. In conclusion, rheumatoid arthritis patients’ feet showed altered morphology and function, and with longer rheumatoid arthritis history, metatarsophalangical stability and foot function, but not pain and global foot posture, were likely to deteriorat

Pilot Study: Effect of Morton’s Extension on the Subtalar Joint Forces in Subjects with Excessive Foot Pronation

This study focuses on the assessment of the mechanical effect produced by Morton’s extension as an orthopedic intervention in patients with bilateral foot pronation posture, through a variation in hindfoot and forefoot prone-supinator forces during the stance phase of gait. A quasi-experimental and transversal research was designed comparing three conditions: barefoot (A); wearing footwear with a 3 mm EVA flat insole (B); and wearing a 3 mm EVA flat insole with a 3 mm thick Morton’s extension (C), with respect to the force or time relational to the maximum time of supination or pronation of the subtalar joint (STJ) using a Bertec force plate. Morton’s extension did not show significant differences in the moment during the gait phase in which the maximum pronation force of the STJ is produced, nor in the magnitude of the force, although it decreased. The maximum force of supination increased significantly and was advanced in time. The use of Morton’s extension seems to decrease the maximum force of pronation and increase supination of the subtalar joint. As such, it could be used to improve the biomechanical effects of foot orthoses to control excessive pronation

The Short-Term Effect of Dynamic Tape versus the Low-Dye Taping Technique in Plantar Fasciitis: A Randomized Clinical Trial

Background: Plantar fasciitis is a painful disorder that affects the plantar fascia of the foot, with a multifactorial aetiology. Dorsal flexion deficiency in the ankle is a risk factor for it. The provisional use of taping is described as part of conservative treatment. Dynamic Tape® is a type of tape that, adhered to muscles, allows for potential elastic energy to accumulate and dissipate later, optimizing its function. Therefore, it can offer immediate benefits while the patient awaits definitive treatment depending on the cause. Objective: To verify the effectiveness of Dynamic Tape® and the low-dye taping technique on pain intensity, ankle range of motion, and foot posture index. Method: A randomised, double-blind clinical trial was conducted. A total of 57 subjects from the Clinical Podiatry Area of the University of Seville (Spain), clinically diagnosed with plantar fasciitis, were randomized into two groups. For one week, in the gastrocnemius–Achilles–plantar system, one group was treated with Dynamic Tape® and another group with low-dye taping. Pain, degrees of movement of dorsal flexion, and the foot posture index were measured in both groups before the intervention and one week after the intervention. A repeated-measures analysis of variance (ANOVA) was used to explore the differences between groups. Results: Significant differences in the decrease in pain intensity using Dynamic Tape® were found when comparing the treatments (p = 0.015) and the foot posture index was more normal in low-dye taping (p < 0.001). In both cases, the treatment showed similar behaviour with respect to the dorsal flexion ankle movement. Conclusion: The effectiveness of Dynamic Tape®, compared to that of the low-dye taping, has a major benefit with regard to pain intensity from fasciitis, although it does not produce changes in the ankle range of motion and foot posture index. Consequently, Dynamic Tape® can be considered a taping technique with beneficial effects on pain intensity in the provisional approach to plantar fasciitis

Assessment of Selected Spatio-Temporal Gait Parameters on Subjects with Pronated Foot Posture on the Basis of Measurements Using OptoGait. A Case-Control Study

Walking is part of daily life and in asymptomatic subjects it is relatively easy. The physi ology of walking is complex and when this complex control system fails, the risk of falls increases. As a result, gait disorders have a major impact on the older adult population and have increased in frequency as a result of population aging. Therefore, the OptoGait sensor is intended to identify gait imbalances in pronating feet to try to prevent falling and injury by compensating for it with treatments that normalize such alteration. This study is intended to assess whether spatiotemporal alterations occur in the gait cycle in a young pronating population (cases) compared to a control group (non-pronating patients) analyzed with OptoGait. Method: a total of n = 142 participants consisting of n = 70 cases (pronators) and n = 72 healthy controls were studied by means of a 30 s treadmill program with a system of 96 OptoGait LED sensors. Results: Significant differences were found between the two groups and both feet in stride length and stride time, gait cycle duration and gait cadence (in all cases p < 0.05). Conclusions: pronating foot posture alters normal gait patterns measured by OptoGait; this finding presents imbalance in gait as an underlying factor. Prevention of this alteration could be considered in relation to its relationship to the risk of falling in future investigations.Ye

El Hallux Abductus Valgus en la bailaora de flamenco.

The hallux abductus valgus (HAV), commonly known as bunion, is defined as first toe lateral curvature and its rotation in valgus. Its origin can be derived from multiple factors, such as the existence of pathomechanics etiology: subastragalina joint hiperpronation, excessive length of first metatarsal and/or first toe, or peroneus longus muscle failure. Statiscally, it affects more to females than males, and as regards flamenco dance there are two factors which are closely related to such high levels of deformity: high-heeled shoes and narrow toe cap use, and some sports gesture methodsEl Hallux Abductus Valgus (HAV), comúnmente llamado juanete, se define como la desviación lateral del primer dedo del pie y su rotación en valgo. Su origen es multifactorial, existiendo etiología patomecánica de base: hiperpronación subastragalina, excesiva longitud del primer metatarsiano y/o del primer dedo, o la insuficiencia del músculo peroneo largo. Estadísticamente, afecta más al sexo femenino que al masculino, y, en relación al baile flamenco, hay dos factores que se han asociado con una alta incidencia: uso del calzado de tacón y puntera estrecha, y ciertas modalidades del gesto deportivo. Mediante estudio observacional transversal realizado en diferentes academias de flamenco de Andalucía, Área Clínica de Podología de la Universidad de Sevilla y centros privados de Investigación y Podología, sobre 32 bailaoras de flamenco, se determina que existe una muy alta prevalencia de hallux abductus valgus en la bailaora profesional de flamenco

Análisis podológico del zapateado flamenco

Desde el punto de vista artístico, el zapateado conforma la seña de identidad del baile flamenco, es el principal elemento de creación musical, percutiva en esencia, y su intensidad, velocidad en la ejecución y simetría son principios fundamentales para un profesional. Desde una visión podológica, es literalmente un gesto lesivo. El zapateado es sinónimo de impacto, impactos de repetición, y de inestabilidad asociada. Se relaciona con patologías y deformidades dígitometatarsales, como el Hallus Abductus Valgus o el Juanete de Sastre, con lesiones de partes blandas y problemas articulares a distancia, en rodilla, cadera y columna fundamentalmente. En el presente artículo de revisión, se analiza el zapateado flamenco desde el punto de vista podológico, biomecánico en su ejecución, y en relación a las lesiones de miembro inferior asociadas al mismo

Effectiveness of custom-made foot orthoses in patients with systemic lupus erythaematosus: protocol for a randomised controlled trial

Introduction Systemic lupus erythaematosus (SLE) is a chronic autoimmune disease of heterogeneous involvement. The disease may affect feet with a high prevalence of symptoms such as, for example, pain, forefoot and rearfoot deformities, and biomechanics dysfunctions. Custom-made foot orthoses (CMFO) have been previously reported to be effective in patients with other rheumatic diseases. However, as far as the authors know, there exist no studies about their effectiveness in SLE. This study aims at determining the effect of CMFO versus placebo flat cushioning insoles on pain, foot functionality, fatigue and quality of life in patients with SLE.Methods and analysis A randomised controlled trial would compare the effects of (1) CMFO and group B, which received a placebo, flat cushioning insoles, for 3 months. The main outcome measures are foot pain, foot functionality and foot-related disability. The secondary outcome measures are fatigue and quality of life.Ethics and dissemination The study has been approved by the Portal de Ética de la Investigación Biomédica de Andalucía ethical committee 1494-N-19. The results will be disseminated regardless of the magnitude or direction of effect.Trial registartion number Clinicaltrials.gov identifier NCT04098055