"Antero-medial load shift" in unilateral plantar heel pain - A cross-sectional exploratory study.

BACKGROUND AND PURPOSE: Plantar foot pressure provides an insightful data in the ankle and foot complex which may aid in the detection of underlying pathology. Since individuals with unilateral plantar heel pain (PHP) tend to develop compensatory loading strategies, this study aimed to observe the foot loading pattern compared to the asymptomatic side and its relationship with the morphological variations in individuals with unilateral PHP. METHODS: It was a prospective cross-sectional study done on 17 participants with unilateral PHP. The calcaneal inclination and calcaneal first metatarsal angles were measured using lateral weight-bearing radiographs for both symptomatic and asymptomatic feet. Static and dynamic plantar foot pressures for both sides were obtained using a "Portable baropodometry platform 0, 5 m Entry Level footscan®. RESULTS: On the symptomatic side, the pressure in the lateral heel was reduced by 65% in static and 67% in dynamic measurements, while in the medial heel, it was reduced by 16 % in static and 47 % in dynamic measurements compared to that of the asymptomatic side. There was a transfer of pressure from the hind foot to the forefoot by 44 % in static and 46 % in dynamic measurements resulting in anterior load shift. It was also observed that the prevalence of PHP was higher in the normal arched foot (59%). CONCLUSION: Based on the observations, compared to the asymptomatic side, patients with unilateral plantar heel pain exhibited an anteromedial load shift (AMLS) in their plantar pressures. PHP was reported higher in the foot with normal morphology. LEVEL OF EVIDENCE: Level 4.

Additive effect of "Brahma Mudra" on pain, proprioception and functional abilities in non-specific mechanical neck pain.

OBJECTIVE: Being the second highest musculoskeletal problem irrespective of age, gender and occupation, the etiology of neck pain is predominantly mechanical in nature. This can lead to dysfunction with time and recurrence. Altered joint position sense (JPS) from soft tissues can alter the cervical biomechanics by compromising the cephalo spatial orientation, which depends on the visual, vestibular and proprioceptive cues. This study was done to observe the additive effect of "Brahma mudra" (BM) a yogic tool on non-specific mechanical neck pain and its clinical implication on pain, proprioception and functional abilities. METHODS: It was a quasi-experimental pre -post study design involving 30 individuals from a software firm between the age group of 18-45 years. The conventional treatment group received standard physiotherapy regime and in the BM group BM was incorporated in addition to standard physiotherapy regime. Independent sample student t-test/Mann Whitney test were used to compare continuous variables between two groups. Paired sample test/Wilcoxon signed rank test were used for within groups. RESULTS: There was a significant reduction in pain, improved functional abilities and proprioception in BM group when compared to conventional treatment group with 0.01 level of statistical significance. CONCLUSION: It may be concluded that practice of BM had an added effect to conventional standard physiotherapy regime in reduction of pain, improvement of proprioception and functional abilities among individuals with chronic non-specific mechanical neck pain.