No abstract

Background: The aim of this study was to determine the level of agreement between common clinical foot classification measures. Methods: Static foot assessment was undertaken using the Foot Posture Index (FPI-6), rearfoot angle (RFA), medial longitudinal arch angle (MLAA) and navicular drop (ND) in 30 participants (29 ± 6 years, 1.72 ± 0.08 m, 75 ± 18 kg). The right foot was measured on two occasions by one rater within the same test environment. Agreement between the test sessions was initially determined for each measure using the Weighted Kappa. Agreement between the measures was determined using Fleiss Kappa. Results: Foot classification across the two test occasions was almost perfect for MLAA (Kw = .92) and FPI-6 (Kw = .92), moderate for RFA (Kw = .60) and fair for ND (Kw = .40) for comparison within the measures. Overall agreement between the measures for foot classification was moderate (Kf = .58). Conclusion:The findings reported in this study highlight discrepancies between the chosen foot classification measures. The FPI-6 was a reliable multi-planar measure whereas navicular drop emerged as an unreliable measure with only fair agreement across test sessions. The use of this measure for foot assessment is discouraged. The lack of strong consensus between measures for foot classification underpins the need for a consensus on appropriate clinical measures of foot structure.

The purpose of this study was to monitor neuromuscular changes in quadriceps femoris muscle at 1 and 3 months after anterior cruciate ligament reconstruction (ACLR). Changes in isometric muscle strength (MVC), voluntary activation and surface electromyogram (EMG) parameters were examined in relation to knee stability, pain and swelling in 31 patients (25 M, 6 F) mean (SD) 30(8) years. Physically inactive (RC) and sports participants (SC) acted as controls. Median frequency (Hz) and amplitude (mV) of rectus femoris using Fast Fourier Transform (FFT) 2(11) was calculated during 5-s isometric contractions at 100, 75, 50 and 25% of MVC. One month after surgery, a significant correlation (P < 0.01) was found between activation (%) and MVC of injured knee extensors. By 3 months, most patients were pain free and had achieved full activation but still had muscle weakness. At 1 and 3 months post-surgery and for all levels of MVC contraction, the median frequencies of the injured limbs were significantly lower (P < 0.05) compared to the SC group as were those of the RC group. There was a significant lowering of the median frequencies of the uninjured limbs compared to the SC group at 75 and 100% of MVC. The EMG amplitude of the uninjured and injured limbs mirrored those of the SC and RC groups, respectively. These results support the view that muscle activation patterns were altered following ACL injury and surgical repair and may contribute to subsequent changes in muscle fibre properties during detraining and subsequent retraining.

Lower limb somatosensory impairments are present in the majority of chronic stroke survivors and differ widely across modalities. Deficits of foot and ankle proprioception are most strongly associated with, but not predictive, of reported falls. The relative contribution of lower limb somatosensory impairments to mobility in chronic stroke survivors appears limited. Further investigation, particularly with regard to community mobility and falls, is warranted. Implications for Rehabilitation Somatosensory impairments in the lower limb were present in approximately half of this cohort of chronic stroke survivors. Tactile discrimination is commonly impaired; clinicians should include an assessment of discriminative ability. Deficits of foot and ankle proprioception are most strongly associated with reported falls. Understanding post-stroke lower limb somatosensory impairments may help inform therapeutic strategies that aim to maximise long-term participation, minimise disability, and reduce falls.

This community-based exercise programme was feasible and delivered positive improvements in physical function for participants. Further issues raised for investigation include the individual response to training and the benefits of extended training.