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Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study.

Ribeiro AP, Sacco IC, Dinato RC, João SM - Braz J Phys Ther (2016)

Bottom Line: The rearfoot valgus alignment predicted the maximum force over the rearfoot in both PF groups: acute (R²=0.18) and chronic (R²=0.45).The rearfoot valgus alignment also predicted higher loading rates in the PF groups: acute (R²=0.19) and chronic (R²=0.40).However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

ABSTRACT

Background: The risk factors for the development of plantar fasciitis (PF) have been associated with the medial longitudinal arch (MLA), rearfoot alignment and calcaneal overload. However, the relationships between the biomechanical variables have yet to be determined.

Objective: The goal of this study was to investigate the relationships between the MLA, rearfoot alignment, and dynamic plantar loads in runners with unilateral PF in acute and chronic phases.

Method: Cross-sectional study which thirty-five runners with unilateral PF were evaluated: 20 in the acute phase (with pain) and 15 with previous chronic PF (without pain). The MLA index and rearfoot alignment were calculated using digital images. The contact area, maximum force, peak pressure, and force-time integral over three plantar areas were acquired with Pedar X insoles while running at 12 km/h, and the loading rates were calculated from the vertical forces.

Results: The multiple regression analyses indicated that both the force-time integral (R²=0.15 for acute phase PF; R²=0.17 for chronic PF) and maximum force (R²=0.35 for chronic PF) over the forefoot were predicted by an elevated MLA index. The rearfoot valgus alignment predicted the maximum force over the rearfoot in both PF groups: acute (R²=0.18) and chronic (R²=0.45). The rearfoot valgus alignment also predicted higher loading rates in the PF groups: acute (R²=0.19) and chronic (R²=0.40).

Conclusion: The MLA index and the rearfoot alignment were good predictors of plantar loads over the forefoot and rearfoot areas in runners with PF. However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot.

No MeSH data available.


Related in: MedlinePlus

- Position of individual and digital camera to capture digital imageof rearfoot angle and measurement of the frontal alignment of therearfoot in AutoCAD software.
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f01: - Position of individual and digital camera to capture digital imageof rearfoot angle and measurement of the frontal alignment of therearfoot in AutoCAD software.

Mentions: To evaluate the alignment of the rearfoot in the posterior view of the frontalplane, the runners stood over a 45 cm platform, keeping their feet 7.5 cm apart.With a dermatographic pen and 9 mm white markers, the following anatomical pointswere identified on the inferoposterior regions of both legs: 1) the posteriorcalcaneal tuberosity; 2) the second point above the center of the calcaneus; and3) the lower third of the leg13,34,35 (Figure1). The center of each marker in the medial-lateral axis was obtainedwith a digital caliper that was used to measure the distances between the twosymmetrically opposing sides with a ruler13. The images were then obtained with a digital camera positionedanterior and perpendicular to the subjects at a distance of 90 cm and at a heightof 45 cm. The images obtained (with a minimum size of 768 pixels) were analyzed ona 96-ppi screen, due the good inter-examiner reliability for the photogrammetricmeasurements of the rearfoot static angles35 (Figure 1).


Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study.

Ribeiro AP, Sacco IC, Dinato RC, João SM - Braz J Phys Ther (2016)

- Position of individual and digital camera to capture digital imageof rearfoot angle and measurement of the frontal alignment of therearfoot in AutoCAD software.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835169&req=5

f01: - Position of individual and digital camera to capture digital imageof rearfoot angle and measurement of the frontal alignment of therearfoot in AutoCAD software.
Mentions: To evaluate the alignment of the rearfoot in the posterior view of the frontalplane, the runners stood over a 45 cm platform, keeping their feet 7.5 cm apart.With a dermatographic pen and 9 mm white markers, the following anatomical pointswere identified on the inferoposterior regions of both legs: 1) the posteriorcalcaneal tuberosity; 2) the second point above the center of the calcaneus; and3) the lower third of the leg13,34,35 (Figure1). The center of each marker in the medial-lateral axis was obtainedwith a digital caliper that was used to measure the distances between the twosymmetrically opposing sides with a ruler13. The images were then obtained with a digital camera positionedanterior and perpendicular to the subjects at a distance of 90 cm and at a heightof 45 cm. The images obtained (with a minimum size of 768 pixels) were analyzed ona 96-ppi screen, due the good inter-examiner reliability for the photogrammetricmeasurements of the rearfoot static angles35 (Figure 1).

Bottom Line: The rearfoot valgus alignment predicted the maximum force over the rearfoot in both PF groups: acute (R²=0.18) and chronic (R²=0.45).The rearfoot valgus alignment also predicted higher loading rates in the PF groups: acute (R²=0.19) and chronic (R²=0.40).However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

ABSTRACT

Background: The risk factors for the development of plantar fasciitis (PF) have been associated with the medial longitudinal arch (MLA), rearfoot alignment and calcaneal overload. However, the relationships between the biomechanical variables have yet to be determined.

Objective: The goal of this study was to investigate the relationships between the MLA, rearfoot alignment, and dynamic plantar loads in runners with unilateral PF in acute and chronic phases.

Method: Cross-sectional study which thirty-five runners with unilateral PF were evaluated: 20 in the acute phase (with pain) and 15 with previous chronic PF (without pain). The MLA index and rearfoot alignment were calculated using digital images. The contact area, maximum force, peak pressure, and force-time integral over three plantar areas were acquired with Pedar X insoles while running at 12 km/h, and the loading rates were calculated from the vertical forces.

Results: The multiple regression analyses indicated that both the force-time integral (R²=0.15 for acute phase PF; R²=0.17 for chronic PF) and maximum force (R²=0.35 for chronic PF) over the forefoot were predicted by an elevated MLA index. The rearfoot valgus alignment predicted the maximum force over the rearfoot in both PF groups: acute (R²=0.18) and chronic (R²=0.45). The rearfoot valgus alignment also predicted higher loading rates in the PF groups: acute (R²=0.19) and chronic (R²=0.40).

Conclusion: The MLA index and the rearfoot alignment were good predictors of plantar loads over the forefoot and rearfoot areas in runners with PF. However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot.

No MeSH data available.


Related in: MedlinePlus