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1.
J Orthop Traumatol ; 24(1): 4, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36680654

RESUMO

BACKGROUND: Displaced intra-articular calcaneal fractures are challenging injuries, and there is debate regarding the best method of treatment. PATIENTS AND METHODS: Between January 2018 and January 2021, a prospective study was conducted on 46 patients with 56 displaced intraarticular calcaneal fractures that were treated with minimally invasive fixation using Kirschner wires (KWs) through the sinus tarsi approach. RESULTS: The mean follow-up period was 22.36 months. The American Orthopaedic Foot and Ankle Society (AOFAS) score was adopted as a method of clinical evaluation; the mean AOFAS score was 78.4. All cases showed radiographic evidence of adequate healing, with no collapse till the final follow-up. Complications included persistent pain, subtalar arthritis, deep infection and superficial pin site infection. CONCLUSION: The use of the sinus tarsi approach and percutaneous KWs represents a minimally invasive approach which expands the indications of surgery for displaced intra-articular calcaneal fractures with fewer treatment-related complications. Level of evidence (4) case series. Trial registration This study has been approved by the ethical research committee of the Faculty of Medicine, Tanta University, under the code: 35901/10/22.


Assuntos
Traumatismos do Tornozelo , Calcâneo , Fraturas Ósseas , Fraturas Intra-Articulares , Traumatismos do Joelho , Humanos , Calcanhar , Fios Ortopédicos , Estudos Prospectivos , Calcâneo/cirurgia , Calcâneo/lesões , Fixação Interna de Fraturas/métodos , Resultado do Tratamento , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos , Fraturas Intra-Articulares/diagnóstico por imagem , Fraturas Intra-Articulares/cirurgia , Estudos Retrospectivos
2.
Cell Metab ; 35(1): 1-2, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36599296

RESUMO

Resistance to ferroptosis, a form of programmed cell death, is associated with the development of some refractory cancers. In this issue, Yang et al. systematically illustrate the ferroptosis heterogeneity in triple-negative breast cancers (TNBCs) and reveal an innovative immunotherapy combination strategy for the luminal androgen receptor (LAR) subtype of TNBC.


Assuntos
Ferroptose , Neoplasias de Mama Triplo Negativas , Humanos , Imunoterapia , Neoplasias de Mama Triplo Negativas/metabolismo , Calcanhar
3.
Med Sci Monit ; 29: e938485, 2023 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-36632023

RESUMO

BACKGROUND Plantar pressure analysis is widely used in the study of knee osteoarthritis (KOA). The present study aimed to investigate the static and dynamic plantar pressure distribution in patients with different stages of unilateral KOA using the Footscan® platform system. MATERIAL AND METHODS We recruited 94 patients aged 61.75±7.23 years old with different stages of unilateral KOA for static and dynamic analysis using the Footscan® platform system. The static pressure (%) of the left, right, anterior, posterior, and the pelvic rotation (°) was assessed. The peak pressure (PP, kPa) was investigated in 10 areas of the foot: medial heel (MH), lateral heel (LH), midfoot (MF), first to fifth metatarsals (M1-M5), hallux (T1), and toes 2-5 (T2-5). The correlation between KOA stages and plantar pressure distributions was investigated. RESULTS The results revealed that static pressure on the unaffected side and pelvic rotation were positively correlated with KOA stages. In addition, there was a positive correlation between KOA stages and PP of M5, MF, and LH zones on the affected side and PP of M2, M3, and M4 zones on the unaffected side, and a negative correlation between KOA stages and PP of T1 and T2-5 zones on the affected side. CONCLUSIONS With the progression of KOA, static plantar pressure tends to distributed on the unaffected side, and the dynamic plantar pressure tends to be distributed laterally on both feet. The plantar pressure distributions in unilateral KOA patients are abnormal and are closely related to the severity of KOA.


Assuntos
Osteoartrite do Joelho , Humanos , Pessoa de Meia-Idade , Idoso , Marcha , Pressão , , Calcanhar
4.
Prosthet Orthot Int ; 46(6): 569-575, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36515902

RESUMO

BACKGROUND: Postoperative protocols after surgical treatment of calcaneal fracture have not been standardized to date. There are only a few reports on the efficacy of heel-unloading orthoses (HUOs; Mars shoe, Graffin orthosis), and thier efficacy is uncertain. OBJECTIVES: The purpose of this study was to compare postoperative radiologic and clinical outcomes in patients with calcaneal fractures who used Graffin orthosis. STUDY DESIGN: Multicenter retrospective study. METHODS: We finally extracted 182 patients from a database of the Trauma Research Group of Nagoya and divided them into two groups: group C (underwent casting or splinting only) and group O (Graffin orthosis was used). A propensity score algorithm was used to match group C to group O in a 1:1 ratio. We evaluated American Orthopaedic Foot and Ankle Society (AOFAS) score at three and six months after surgery and at final follow-up. Differences in reduction of the Böhler angle between the two groups were evaluated radiographically. All data were analyzed with a t-test or Fisher's exact test. P < .05 was considered statistically significant. RESULTS: The AOFAS score 3 months after surgery in group O was significantly higher than that in group C (69.57 vs. 77.22; P = .004). However, there were no statistically significant differences between group C vs. group O in AOFAS scores at 6 months after surgery and at final follow-up (81.92 vs. 85.67 and 89.18 vs. 88.13; P = .087 and 0.597, respectively). There was no significant statistical difference in the reduction of the Böhler angle (5.07 vs. 5.89; P = .529). CONCLUSIONS: At 3 months postoperatively, the orthosis group showed predominantly better functional results. We believe that heel-unloading orthoses are useful for patients who require an early return to work and to daily life.


Assuntos
Traumatismos do Tornozelo , Calcâneo , Fraturas Ósseas , Traumatismos do Joelho , Humanos , Calcâneo/cirurgia , Calcâneo/lesões , Estudos Retrospectivos , Calcanhar , Fixação Interna de Fraturas/métodos , Resultado do Tratamento , Fraturas Ósseas/cirurgia , Aparelhos Ortopédicos
5.
Zhongguo Gu Shang ; 35(12): 1166-9, 2022 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-36572433

RESUMO

Flatfoot could be divided into flexible flatfoot and rigid flatfoot. Flatfoot with symptoms is called symptomatic flatfoot, surgical treatment is required if conservative treatment is not effective. Subtalar arthroereisis is a minimally invasive procedure which has been used for many years with good results in flexible flatfoot, however, still has many controversial points. Controversial points focus on indications and contraindications, optimal age, subtalar arthroereisis alone or not, efficacy and safety of absorbable material implants, and implant removal. The paper reviewed and summarized the use and controversies of subtalar arthroereisis in symptomatic flatfoot as follows:the best indication for subtalar arthroereisis was pediatric flexible flatfoot syndrome and aged from 10 to 12 years old was optimal age for treatment;tarsal coalitions with flatfoot and adult flatfoot were relative indications. Stiff flatfoot, joint laxity, and subtalar arthritis were contraindications;obesity and neurogenic flexible flatfoot were relative contraindications. The correction ability of subtalar arthroereisis alone was limited, and it's combined with other procedures depending on patient's situation. The safety and efficacy of absorbable material implants had been reported. Routine removal of the implant was not necessary, the main reason of which was tarsal sinus pain.


Assuntos
Pé Chato , Procedimentos Ortopédicos , Articulação Talocalcânea , Adulto , Humanos , Criança , Pé Chato/cirurgia , Procedimentos Ortopédicos/métodos , Implantes Absorvíveis , Articulação Talocalcânea/cirurgia , Calcanhar/cirurgia , Dor/cirurgia
6.
J Trop Pediatr ; 69(1)2022 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-36525534

RESUMO

AIMS: The study aimed to determine the effect of using a crochet octopus to reduce acute pain and maintain optimal physiological measurements that develops during procedural pain in neonates. MATERIALS AND METHODS: This was a parallel design randomized controlled study. During the procedure of heel lance, experimental groups were delivered a crochet octopus 10 min before the process and let them touch the octopus during and for up to 10 min after the procedure. Control group experienced the process without any intervention. SpO2, duration of crying of neonates and pain they experienced were evaluated. RESULTS: The study was completed with 100 (50 for the experimental group and 50 for the control group) term neonates. SpO2 of neonates, touching the crochet octopus during and after in second minute of the process was found higher and also the duration of crying was shorter during whole the process, and the pain they experienced due to the process was lower than the control group. CONCLUSIONS: Crochet octopus affected physiological measurements of the neonates positively and reduced the procedural pain as well.


Assuntos
Octopodiformes , Dor Processual , Recém-Nascido , Animais , Humanos , Punções , Dor/etiologia , Dor/prevenção & controle , Calcanhar
7.
Artigo em Inglês | MEDLINE | ID: mdl-36360967

RESUMO

There is no standard clinically adaptable criterion for assessing plantar sensation for pre- and post-intervention comparisons. Studies using Semmes-Weinstein monofilaments (SWMs) to investigate intervention effects on plantar sensation vary in procedure and do not consider measurement errors. This study aimed to develop a simple criterion using SWMs to assess plantar sensation, determine the measurement error range, and identify areas of low error. Six examiners assessed 87 healthy young adults in Experiment 1, while two examiners assessed 10 participants in Experiment 2. Filaments were graded from 1 to 20 based on increasing diameter. The smallest grade that could be perceived for three sequential stimuli was used as the criterion (smallest perceivable grade, SPG). The SPG was significantly smaller at the hallux and larger at the heel than at other sites. There were no significant differences between the SPG of the repeated tests performed by the same versus different examiners. The interquartile range of the differences was <±3 at all sites. Thus, our criteria were reliable in evaluating the effects of plantar sensation interventions, especially at the heel and the middle of the metatarsal heads and could contribute to the development of more effective treatments for plantar sensations.


Assuntos
Calcanhar , Sensação , Adulto Jovem , Humanos , Reprodutibilidade dos Testes
8.
BMJ Open ; 12(11): e062523, 2022 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-36343988

RESUMO

INTRODUCTION: Persistent heel pain is a prevalent complaint affecting up to 10% of the population. Insoles adapted in flip-flop sandals are an alternative treatment for pain and function of individuals with persistent heel pain, showing improvement within 12 weeks of treatment. Most studies considered foot posture and biomechanics to prescribe insoles for persistent heel pain, but few verified the effects of a 12-week treatment on pain catastrophising. This study will investigate the effects of insoles adapted in flip-flop sandals on pain intensity, function, functional walking capacity and pain catastrophising of individuals with persistent heel pain. METHODS AND ANALYSIS: This is a protocol for a sham-controlled randomised trial. Eighty individuals with persistent heel pain will be assessed and randomised into two intervention groups: insoles adapted in flip-flop sandals and flip-flop sandals with sham (ie, flat) insoles. Assessments will be conducted at baseline (T0), after 6 weeks (T6), 12 weeks postintervention (T12) and after a 4-week follow-up (T16). The primary outcome will be the pain intensity, and secondary outcomes will be foot function, functional walking capacity and pain catastrophising. Analysis of variance with mixed design (if normal distribution) or Friedman's test (if not normal distribution) will verify intergroup and intragroup differences. Bonferroni post hoc tests will be performed in case of significant group or time interaction. Intent-to-treat analysis will be used, and a significance level of 5% and 95% CIs will be considered. ETHICS AND DISSEMINATION: This study was approved by the research ethics committee of the Federal University of Rio Grande do Norte (registry no. 4,018,821). Results will be disseminated to individuals, submitted to a peer-reviewed journal and disclosed in scientific meetings. TRIAL REGISTRATION NUMBER: NCT04784598.


Assuntos
Doenças do Pé , Calcanhar , Humanos , Sapatos , , Dor , Doenças do Pé/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Sensors (Basel) ; 22(19)2022 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-36236656

RESUMO

Gait assessment is an important tool for determining whether a person has a gait disorder. Existing gait analysis studies have a high error rate due to the heel-contact-event-based technique. Our goals were to overcome the shortcomings of existing gait analysis techniques and to develop more objective indices for assessing gait disorders. This paper proposes a method for assessing gait disorders via the observation of changes in the center of pressure (COP) in the medial-lateral direction, i.e., COPx, during the gait cycle. The data for the COPx were used to design a gait cycle estimation method applicable to patients with gait disorders. A polar gaitogram was drawn using the gait cycle and COPx data. The difference between the areas inside the two closed curves in the polar gaitogram, area ratio index (ARI), and the slope of the tangential line common to the two closed curves were proposed as gait analysis indices. An experimental study was conducted to verify that these two indices can be used to differentiate between stroke patients and healthy adults. The findings indicated the potential of using the proposed polar gaitogram and indices to develop and apply wearable devices to assess gait disorders.


Assuntos
Análise da Marcha , Dispositivos Eletrônicos Vestíveis , Adulto , Fenômenos Biomecânicos , Marcha , Calcanhar , Humanos , Caminhada
10.
Medicine (Baltimore) ; 101(38): e30672, 2022 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-36197155

RESUMO

BACKGROUND: Functional ankle instability (FAI) is defined as the subjective sensation of instability or "giving way" after an ankle sprain and occurs in approximately 40% of patients with lateral ankle instability. As an ankle joint rehabilitation intervention, heel raising exercises, toe jumping exercises, ankle joint proprioceptive exercises, as well as orthosis and taping are commonly applied to prevent the recurrence of an ankle joint injury. So this study was evaluated effect of quarter heel raising exercise (QHR) on balance and peroneus longus muscle strength in FAI subjects. METHODS: Among 26 FAI subjects, 13 with FAI were assigned to the QHR group, and 13 with FAI were assigned to the control group which was no intervention. All of 30 subjects were evaluated Teskscan included static balance ability, Y balance test included dynamic balance ability with three directions which is anterior, posterolateral, posteromedial direction. Commander muscle testing included eversion/inversion strength ratio at pre- and post-intervention. RESULTS: There was a significant interaction between group and time in static, dynamic balance, and strength. In QHR group, there was simple effect on static, dynamic balance, and strength. But control group showed no simple effect on static, dynamic balance, and strength. In the pre- and post-intervention differences between the groups. There was a significant difference in pre-intervention condition between the groups, but no significant difference between the groups in post-intervention in all conditions. CONCLUSIONS: QHR exercise is useful for improving the balance ability and muscle strength of the peroneus longus muscle in FAI subjects.


Assuntos
Traumatismos do Tornozelo , Instabilidade Articular , Tornozelo , Articulação do Tornozelo , Calcanhar , Humanos , Equilíbrio Postural/fisiologia
11.
Medicine (Baltimore) ; 101(38): e30613, 2022 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-36197189

RESUMO

To study the changes of plantar fascia in patients with knee osteoarthritis. Collect knee arthritis surgery patients and according to the length of the course is divided into long-course and short-course group, collection of healthy volunteers as control group at the same time, basic information such as age, height, weight, and body mass index (BMI) were recorded; the application of Philips and Siemens ultrasonic diagnostic instrument, a foot plantar fascia in patients with knee osteoarthritis in ultrasonic scanning, measuring the thickness of the heel of plantar fascia, observe its sonographic manifestation; age, BMI, and plantar fascia thickness were compared between groups. The plantar fascia thickness of the normal control group was 0.30 ±â€…0.06 cm on the left side and 0.30 ±â€…0.05 cm on the right side. The plantar fascia thickness of the long-course group was 0.44 ±â€…0.10 cm on the left side and 0.42 ±â€…0.10 cm on the right side. The plantar fascia thickness of the group with short course of disease was 0.37 ±â€…0.06 cm on the left side and 0.34 ±â€…0.7 cm on the right side. Multivariable analysis of variance was used to compare the thickness of plantar fascia in the long-course group, the short-course group, and the control group, P < .05; there were statistical differences among the 3 groups. Multivariate analysis of variance was used to compare the general data of the long-course group, the short-course group, and the control group. Age: the long-course group was compared with the short-course group and the control group, P < .05; short-course group compared with control group, P > .05. BMI: compared with long-course group and short-course group, P < .05; long course of disease group compared with short course of disease group, P > .05. BMI was statistically different between the case group and the control group. Plantar fascia was thickened in patients with knee osteoarthritis, and the thickening of plantar fascia was related to BMI. The thickening of plantar fascia was uneven, and the degree of thickening was related to the course of disease. At the same time, the sonogram of plantar fascia was less echogenic than that of normal controls.


Assuntos
Fasciíte Plantar , Osteoartrite do Joelho , Fáscia/diagnóstico por imagem , Pé/diagnóstico por imagem , Calcanhar/diagnóstico por imagem , Humanos , Osteoartrite do Joelho/diagnóstico por imagem , Ultrassom , Ultrassonografia
12.
Med Eng Phys ; 108: 103888, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36195361

RESUMO

Pressure ulcers are a severe disease affecting patients that are bedridden or in a wheelchair bound for long periods of time. These wounds can develop in the deep layers of the skin of specific parts of the body, mostly on heels or sacrum, making them hard to detect in their early stages. Strain levels have been identified as a direct danger indicator for triggering pressure ulcers. Prevention could be possible with the implementation of subject-specific Finite Element (FE) models. However, generation and validation of such FE models is a complex task, and the current implemented techniques offer only a partial solution of the entire problem considering only external displacements and pressures, or cadaveric samples. In this paper, we propose an in vivo solution based on the 3D non-rigid registration between two Magnetic Resonance (MR) images, one in an unloaded configuration and the other deformed by means of a plate or an indenter. From the results of the image registration, the displacement field and subsequent strain maps for the soft tissues were computed. An extensive study, considering different cases (on heel pad and sacrum regions) was performed to evaluate the reproducibility and accuracy of the results obtained with this methodology. The implemented technique can give insight for several applications. It adds a useful tool for better understanding the propagation of deformations in the heel soft tissues that could generate pressure ulcers. This methodology can be used to obtain data on the material properties of the soft tissues to define constitutive laws for FE simulations and finally it offers a promising technique for validating FE models.


Assuntos
Lesão por Pressão , Análise de Elementos Finitos , Calcanhar , Humanos , Espectroscopia de Ressonância Magnética , Pressão , Lesão por Pressão/diagnóstico por imagem , Lesão por Pressão/prevenção & controle , Reprodutibilidade dos Testes
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 1797-1800, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36085778

RESUMO

Forefoot pain, hallux valgus, shoe sore, flat foot, and calluses are among the common foot problems encountered by high heel wearers. This study aimed to investigate the external forces associated with shoe sore and callus while wearing formal heel shoes. The external force on the 1st, 2nd, and 5th metatarsal heads and heel center was measured using the ShokacChip. Women were asked to wear pumps with four heel heights (10, 30, 55, and 80 mm) and walk 15 m twice. Thirty-five women were included. The data of two participants were excluded due to sensor fault. With higher heels, normal stress (pressure) was significantly stronger on the inside of the forefoot and significantly weaker on the outside. Shear stress did not always increase or decrease proportionally with respect to heel height. SPR-i of the forefoot associated with callus formation was minimal in the 30-mm heel. Clinical Relevance- This study aims to provide a guide for shoe selection in order to avoid foot troubles in women.


Assuntos
, Calcanhar , Estatura , Feminino , Humanos , Extremidade Inferior , Dor , Caminhada
14.
Front Endocrinol (Lausanne) ; 13: 894383, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36060939

RESUMO

Objective: This study was aimed to compare the material properties of heel pad between diabetes patients and healthy adults, and investigate the impact of compressive loading history and length of diabetes course on the material properties of heel pad. Methods: The dual fluoroscopic imaging system (DFIS) and dynamic foot-ground contact pressure-test plate were used for measuring the material properties, including primary thickness, peak strain, peak stress, stiffness, viscous modulus and energy dissipation ratio (EDR), both at time zero and following continuous loading. Material properties between healthy adults and DM patients were compared both at time zero and following continuous weight bearing. After then, comparison between time-zero material properties and properties following continuous loading was performed to identify the loading history-dependent biomechanical behaviour of heel pad. Subgroup-based sensitivity analysis was then conducted to investigate the diabetes course (<10 years vs. ≥10 years) on the material properties of heel pad. Results: Ten type II DM subjects (20 legs), aged from 59 to 73 (average: 67.8 ± 4.9), and 10 age-matched healthy adults (20 legs), aged from 59 to 72 (average: 64.4 ± 3.4), were enrolled. Diabetes history was demonstrated to be associated with significantly lower primary thickness (t=3.18, p=0.003**), higher peak strain (t=2.41, p=0.021*), lower stiffness (w=283, p=0.024*) and lower viscous modulus (w=331, p<0.001***) at time zero, and significantly lower primary thickness (t=3.30, p=0.002**), higher peak strain (w=120, p=0.031*) and lower viscous modulus (t=3.42, p=0.002**) following continuous loading. The continuous loading was found to be associated with significantly lower primary thickness (paired-w=204, p<0.001***) and viscous modulus (paired-t=5.45, p<0.001***) in healthy adults, and significantly lower primary thickness (paired-w=206, p<0.001***) and viscous modulus (paired-t=7.47, p<0.001***) in diabetes group. No any significant difference was found when conducting the subgroup analysis based on length of diabetes course (<10 years vs. ≥10 years), but the regression analysis showed that the length of diabetes history was positively associated with the peak strain, at time zero (r=0.506, p<0.050) and following continuous loading (r=0.584, p<0.010). Conclusions: Diabetes patients were found to be associated with decreased primary thickness and viscous modulus, and increased peak strain, which may contribute to the vulnerability of heel pad to injury and ulceration. Pre-compression history-dependent behaviour is observable in soft tissue of heel pad, with lowered primary thickness and viscous modulus.


Assuntos
Diabetes Mellitus Tipo 2 , Calcanhar , Adulto , Fenômenos Biomecânicos , Marcha , Humanos , Suporte de Carga
15.
Microsurgery ; 42(8): 800-809, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36134728

RESUMO

BACKGROUND: The superficial circumflex iliac artery perforator flap's overall success in the reconstruction of the lower limb has been acceptable, but the sole of the foot remains more challenging. The purpose of this article is to report our experience employing the SCIP flap and evaluate its durability in reconstructing different units of the foot's sole, heel, middle, and forefoot. PATIENTS AND METHODS: This retrospective study reviewed 18 patients with sole defect reconstructed with free SCIP flap from 2017 to 2019. 18 free SCIP flaps were harvested depending on the superficial branch of SCIA (n = 16) or deep branch (n = 2). All flaps were thin and elevated above the scrapa's fascia. The heel (n = 10), middle foot sole (n = 5), forefoot sole (n = 2), and combined heel and midfoot in one patient were among the defect locations. Sole defects were caused by trauma in 10 patients (55.5%), while the rest of the causes were melanoma (three patients, 16.7%), diabetic ulcer (three patients, 16.7%), and unstable scar (one patient), and calcaneal osteomyelitis (one patient). The defect size ranged from 24 to 230 cm2 . RESULTS: The flap dimensions ranged from 6 × 4 to 18 × 11 cm. Mean follow-up observations were 42.5 months. 72.2% of our patients developed protective sensation between 12-18 months. No ulcerations were observed, and all of the patients had successful functional recoveries with satisfying cosmetic outcomes. CONCLUSION: The SCIP flap can be an optimal durable skin flap for weight-bearing sole reconstruction. SCIP flap has the advantage of being thin minimizing the problem of shearing, the need for secondary procedures, and the faster recovery of protective sensation that could prevent ulceration.


Assuntos
Retalho Perfurante , Humanos , Retalho Perfurante/irrigação sanguínea , Artéria Ilíaca/cirurgia , Estudos Retrospectivos , Calcanhar/cirurgia
16.
Hum Mov Sci ; 85: 102998, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36108484

RESUMO

Necessary for effective ambulation, head stability affords optimal conditions for the perception of visual information during dynamic tasks. This maintenance of head-in-space equilibrium is achieved, in part, by the attenuation of the high frequency impact shock resulting from ground contact. While a great deal of experimentation has been done on the matter during steady state locomotion, little is known about how locomotor asymmetry might affect head stability or dynamic visual acuity. In this study, fifteen participants walked on a split-belt treadmill while verbally reporting the orientation of a randomized Landolt-C optotype that was projected at heel strike. Participants were exposed to baseline, adaptation, and washout conditions, as characterized by belt speed ratios of 1:1, 1:3, and 1:1, respectively. Step length asymmetry, shock attenuation, high and low frequency head signal power, and dynamic visual acuity were averaged across the first and last fifty strides of each condition. Across the first fifty strides, step length asymmetry was significantly greater during adaptation than during baseline (p < 0.001; d = 2.442), and shock attenuation was significantly lower during adaptation than during baseline (p = 0.041; d = -0.679). High frequency head signal power was significantly greater during adaptation than during baseline (p < 0.001; d = -1.227), indicating a reduction in head stability. While dynamic visual acuity was not significantly lower during adaptation than during baseline (p = 0.052), a moderate effect size suggests a decrease in the measure between the two conditions (d = 0.653). Across the last fifty strides, many of the decrements observed between the baseline and adaptation conditions were greatly reduced. The results of this study indicate that the locomotor asymmetry imposed by the split-belt treadmill during early adaptation might lead to moderate decrements in shock attenuation, head stability, and dynamic visual acuity. Moreover, the relative reduction in magnitude of these decrements across the last fifty strides underscores the adaptive nature of the locomotor and visuomotor systems.


Assuntos
Teste de Esforço , Caminhada , Adaptação Fisiológica , Marcha , Calcanhar , Humanos , Locomoção
17.
J Am Podiatr Med Assoc ; 112(2)2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-36115030

RESUMO

Plantar vein thrombosis (PVT) is an atypical cause of plantar heel pain and is seldom reported in the literature. We present a unique, rare case report of a patient exhibiting plantar heel and medial arch pain caused by thrombosis in the plantar medial branch of the posterior tibial vein. The diagnosis was made by means of magnetic resonance imaging, showing lobulated hypointensity in the medial plantar vein, consistent with a PVT. In this article, we provide an overview of the clinical signs of PVT, which is most commonly plantar heel pain. Furthermore, we discuss ultrasound and magnetic resonance imaging as diagnostic modalities, and conservative treatment options, including anti-inflammatory medications, anticoagulation therapy, and compression therapy. As with other types of venous thromboembolism, this condition must also be diagnosed without delay to avoid potential complications.


Assuntos
Doenças do Pé , Trombose Venosa , Anticoagulantes/uso terapêutico , Pé/irrigação sanguínea , Pé/diagnóstico por imagem , Doenças do Pé/diagnóstico , Calcanhar , Humanos , Dor/etiologia , Trombose Venosa/diagnóstico , Trombose Venosa/diagnóstico por imagem
18.
Sci Rep ; 12(1): 15652, 2022 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-36123358

RESUMO

This study aimed to compare health-related quality of life (HRQoL) in people with and without plantar heel pain (PHP). This was a cross-sectional observational study that compared 50 adult participants with PHP to 25 participants without PHP who were matched for age, sex and body mass index (BMI). HRQoL measures included a generic measure, the Short Form 36 version 2 (SF-36v2), and foot-specific measures, including 100 mm visual analogue scales (VASs) for pain, the Foot Health Status Questionnaire (FHSQ), and the Foot Function Index-Revised (FFI-R). Comparisons in HRQoL between the two groups were conducted using linear regression, with additional adjustment for the comorbidity, osteoarthritis, which was found to be substantially different between the two groups. For generic HRQoL, participants with PHP scored worse in the SF-36v2 physical component summary score (p < 0.001, large effect size), but there was no difference in the mental component summary score (p = 0.690, very small effect size). Specifically, physical function (p < 0.001, very large effect size), role physical (p < 0.001, large effect size) and bodily pain (p < 0.001, large effect size) in the physical component section were worse in those with PHP. For foot-specific HRQoL, participants with PHP also scored worse in the VASs, the FHSQ and the FFI-R (p ≤ 0.005, huge effect sizes for all domains, except FHSQ footwear, which was large effect size, and FFR-R stiffness, activity limitation, and social issues, which were very large effect sizes). After accounting for age, sex, BMI and osteoarthritis, adults with PHP have poorer generic and foot-specific HRQoL.


Assuntos
Doenças do Pé , Calcanhar , Qualidade de Vida , Adulto , Estudos Transversais , Humanos , Osteoartrite/complicações , Dor
19.
Artigo em Inglês | MEDLINE | ID: mdl-36074346

RESUMO

Primary cutaneous cribriform carcinoma (PCCC) is an extremely rare carcinoma of the sweat glands. In this case report, we present a 41-year-old man with PCCC in the heel. The patient had heel pain for 10 months, and his complaints had increased in the past 2 months. Physical examination revealed a firm nonmobile mass at his heel. The PCCC in the heel was excised by wide resection after biopsy, and the defect that occurred after resection was reconstructed with a vascularized free anterolateral thigh flap. There were no complications during or after the surgery. No recurrence or metastasis was encountered during 48 months of follow-up. The patient continues his daily life activities without any problems or pain. In the heel, PCCC can be effectively treated by extensive resection and reconstruction of the defect with a skin graft/vascularized flap. Cribriform carcinomas of visceral organs and primary cutaneous adenoid cystic carcinoma should be included in the differential diagnosis, which should be made carefully, histopathologically, and immunohistochemically.


Assuntos
Adenocarcinoma , Carcinoma Adenoide Cístico , Retalhos de Tecido Biológico , Adulto , Carcinoma Adenoide Cístico/cirurgia , Retalhos de Tecido Biológico/patologia , Calcanhar/patologia , Calcanhar/cirurgia , Humanos , Masculino , Dor , Coxa da Perna/patologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-36074737

RESUMO

BACKGROUND: There is a paucity of literature regarding rock climbing footwear. Rock climbers anecdotally voice numerous complaints regarding their current footwear. In an effort to improve existing rock-climbing footwear, implementation of a survey tool assessing the attitudes and practices of rock climbers was undertaken. METHODS: A Web-based survey was developed to assess the demographics, attitudes, and practices of individuals active in rock climbing, with a focus on footwear. RESULTS: Forty-five of the 417 respondents were male and 55% were female. The average years climbing was 7, with a majority of respondents in the 18- to 34-year-old category. The majority climbed 5 to 10 hours/week. Eighty percent identified as intermediate or advanced climbers. Climbing shoes were an average of 0.83 size smaller than the climber's street shoes. The more elite the climber, the greater the mismatch. Overall satisfaction with current rock-climbing shoes was 88%; however, as the age of climber and number of years of participation increased, the level of satisfaction decreased. The most frequently reported problems with shoes included inconsistent sizing between brands and poor heel fit. The most commonly reported locations of pain were the toes and heel. CONCLUSIONS: The authors concluded the following: 1) a surprisingly high satisfaction with current rock-climbing shoes was reported; 2) the difference in size between climbing shoes and street shoes was less than expected; 3) more shoe fitting problems were experienced by those with the most experience in climbing and those who spend the most time climbing; 4) the most common locations for experiencing pain were the toes and the posterior heel or Achilles tendon; 5) higher than expected satisfaction levels with climbing shoes contrasted with the very high number of specific complaints and recommendations for improvement; and 6) because of the increasing popularity of rock climbing, foot care providers should learn about the various types of climbing and the shoe gear needs that result therefrom.


Assuntos
Calcanhar , Sapatos , Adolescente , Adulto , Atitude , Feminino , Humanos , Masculino , Dor , Inquéritos e Questionários , Adulto Jovem
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