BACKGROUND There are numerous static measures of foot posture but there is no published score of dynamic foot motion. Three-dimensional gait analysis can include a multi-segment foot model like the Oxford Foot Model (OFM) to comprehensively quantify foot kinematic deviations across the gait cycle but it lacks an overall score, like the Gait Profile score (GPS), used to summarize the quality of lower extremity motion. RESEARCH QUESTION This paper introduces the Foot Profile Score (FPS), a single number, analogous to the GPS but based on kinematic data of the OFM. The aim of this study is to validate the FPS by studying its properties and design, and analyse it against a clinical assessment of foot deformity. METHODS Concurrent validity was established for the FPS analysing the relationship with Clinical Foot Deformity Score (CFDS) in 60 subjects with a condition affecting the lower limbs globally Content validity was established for the six Foot Variable Scores (FVS) that make up the FPS using a multiple regression of the CFDS on the 6 FVS in the 60 subjects. Predictive validity was established analysing the relationship of the FPS and GPS comparing 60 global involvement subjects with 60 subjects with isolated foot deformity. RESULTS Pearson correlation between the FPS and CFDS was significant at 0.62 (p<0.001). Each element of FVS contributes positively to predicting the CFDS with R2 = 0.456 (p<0.001). FPS contributed independently to the prediction of CFDS (t=3.9, p<0.001). The correlation between the GPS and FPS in the global involvement group was significant at r = 0.64 (p<0.001), while there was no correlation found with r = 0.08 (p=0.54) in the foot deformity group. SIGNIFICANCE The FPS is the first validated score of dynamic foot motion.
Aims To assess if older symptomatic children with club foot deformity differ in perceived disability and foot function during gait, depending on initial treatment with Ponseti or surgery, compared to a control group. Second aim was to investigate correlations between foot function during gait and perceived disability in this population. Methods In all, 73 children with idiopathic club foot were included: 31 children treated with the Ponseti method (mean age 8.3 years; 24 male; 20 bilaterally affected, 13 left and 18 right sides analyzed), and 42 treated with primary surgical correction (mean age 11.6 years; 28 male; 23 bilaterally affected, 18 left and 24 right sides analyzed). Foot function data was collected during walking gait and included Oxford Foot Model kinematics (Foot Profile Score and the range of movement and average position of each part of the foot) and plantar pressure (peak pressure in five areas of the foot). Oxford Ankle Foot Questionnaire, Disease Specific Index for club foot, Paediatric Quality of Life Inventory 4.0 were also collected. The gait data were compared between the two club foot groups and compared to control data. The gait data were also correlated with the data extracted from the questionnaires. Results Our findings suggest that symptomatic children with club foot deformity present with similar degrees of gait deviations and perceived disability regardless of whether they had previously been treated with the Ponseti Method or surgery. The presence of sagittal and coronal plane hindfoot deformity and coronal plane forefoot deformity were associated with higher levels of perceived disability, regardless of their initial treatment. Conclusion This is the first paper to compare outcomes between Ponseti and surgery in a symptomatic older club foot population seeking further treatment. It is also the first paper to correlate foot function during gait and perceived disability to establish a link between deformity and subjective outcomes Cite this article: Bone Joint Open 2020;1-7:384–391.
The results suggest that the ADS is a potentially useful method of transport by people with amputations or a wide spectrum of unilateral lower limb disabilities in developed and developing countries.
In three-dimensional gait analysis, anatomical axes are defined by and therefore sensitive to marker placement. Previous analysis of the Oxford Foot Model (OFM) has suggested that the axes of the hindfoot are most sensitive to marker placement on the posterior aspect of the heel. Since other multi-segment foot models also use a similar marker, it is important to find methods to place this as accurately as possible. The aim of this pilot study was to test two different 'jigs' (anatomical alignment devices) against eyeball marker placement to improve reliability of heel marker placement and calculation of hindfoot angles using the OFM. Methods: Two jigs were designed using three-dimensional printing: a ratio caliper and heel mould. OFM kinematics were collected for ten healthy adults; intra-tester and inter-tester repeatability of hindfoot marker placement were assessed using both an experienced and inexperienced gait analyst for 5 clinically relevant variables. Results: For 3 out of 5 variables the intra-tester and inter-tester variability was below 2 degrees for all methods of marker placement. The ratio caliper had the lowest intra-tester variability for the experienced gait analyst in all 5 variables and for the inexperienced gait analyst in 4 out of 5 variables. However for inter-tester variability, the ratio caliper was only lower than the eyeball method in 2 out of the 5 variables. The mould produced the worst results for 3 of the 5 variables, and was particularly prone to variability when assessing average hindfoot rotation, making it the least reliable method overall. Conclusions: The use of the ratio caliper may improve intra-tester variability, but does not seem superior to the eyeball method of marker placement for inter-tester variability. The use of a heel mould is discouraged.
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